Application of a New Resource-Constrained Triage Method to Military-Age Victims

DTIC Science & Technology

2009-12-01

evidence based, does not consider resources, and has been shown to be scientifically and opera- tionally flawed.’ General P . K. Carlton, former USAF Surgeon...metric that can be used to predict sur- vival probability) P ^ (t) = the survival probability of victims with original SCORE s treated in time period t. n...function coefficients were derived on the design set, and validated on the test set. The logistic function has the form: P ^ - 1/(1 + e"), where P ^ is

Integration of real-time mapping technology in disaster relief distribution.

DOT National Transportation Integrated Search

2013-02-01

Vehicle routing for disaster relief distribution involves many challenges that distinguish this problem from those in commercial settings, given the time sensitive and resource constrained nature of relief activities. While operations research approa...

Outcomes of antiretroviral therapy in a northern Indian urban clinic

PubMed Central

Dhooria, Sahajal; Prasad, KT; George, Ninoo; Ranjan, Sanjay; Gupta, Deepak; Sreenivas, Vishnubhatla; Kadhiravan, Tamilarasu; Miglani, Sunita; Sinha, Sanjeev; Wig, Naveet; Biswas, Ashutosh; Vajpayee, Madhu

2010-01-01

Abstract Problem Antiretroviral therapy (ART) programmes have been successful in several countries. However, whether they would succeed as part of a national programme in a resource-constrained setting such as India is not clear. The outcomes and specific problems encountered in such a setting have not been adequately studied. Approach We assessed the efficacy and functioning of India’s national ART programme in a tertiary care centre in northern India. All ART-naive patients started on ART between May 2005 and October 2006 were included in the study and were followed until 31 April 2008. Periodic clinical and laboratory evaluations were carried out in accordance with national guidelines. Changes in CD4+ lymphocyte count, body weight and body mass index were assessed at follow-up, and the operational problems analysed. Local setting The setting was a tertiary care centre in northern India with a mixed population of patients, mostly of low socioeconomic status. The centre is reasonably well resourced but faces constraints in health-care delivery, such as lack of adequate human resources and a high patient load. Relevant changes The response to ART in the cohort studied was comparable to that reported from other countries. However, the programme had a high attrition rate, possibly due to patient-related factors and operational constraints. Lessons learnt A high rate of attrition can affect the overall efficacy and functioning of an ART programme. Addressing the issues causing attrition might improve patient outcomes in India and in other resource-constrained countries. PMID:20428391

Stochastic Averaging for Constrained Optimization With Application to Online Resource Allocation

NASA Astrophysics Data System (ADS)

Chen, Tianyi; Mokhtari, Aryan; Wang, Xin; Ribeiro, Alejandro; Giannakis, Georgios B.

2017-06-01

Existing approaches to resource allocation for nowadays stochastic networks are challenged to meet fast convergence and tolerable delay requirements. The present paper leverages online learning advances to facilitate stochastic resource allocation tasks. By recognizing the central role of Lagrange multipliers, the underlying constrained optimization problem is formulated as a machine learning task involving both training and operational modes, with the goal of learning the sought multipliers in a fast and efficient manner. To this end, an order-optimal offline learning approach is developed first for batch training, and it is then generalized to the online setting with a procedure termed learn-and-adapt. The novel resource allocation protocol permeates benefits of stochastic approximation and statistical learning to obtain low-complexity online updates with learning errors close to the statistical accuracy limits, while still preserving adaptation performance, which in the stochastic network optimization context guarantees queue stability. Analysis and simulated tests demonstrate that the proposed data-driven approach improves the delay and convergence performance of existing resource allocation schemes.

Scheduling Operational Operational-Level Courses of Action

DTIC Science & Technology

2003-10-01

Process modelling and analysis – process synchronisation techniques Information and knowledge management – Collaborative planning systems – Workflow...logistics – Some tasks may consume resources The military user may wish to impose synchronisation constraints among tasks A military end state can be...effects, – constrained with resource and synchronisation considerations, and – lead to the achievement of conditions set in the end state. The COA is

Implementing interprofessional education and practice: Lessons from a resource-constrained university.

PubMed

Frantz, J M; Rhoda, A J

2017-03-01

Interprofessional education is seen as a vehicle to facilitate collaborative practice and, therefore, address the complex health needs of populations. A number of concerns have, however, been raised with the implementation of interprofessional education. The three core concerns raised in the literature and addressed in the article include the lack of an explicit framework, challenges operationalising interprofessional education and practice, and the lack of critical mass in terms of human resources to drive activities related to interprofessional education and practice. This article aims to present lessons learnt when attempting to overcome the main challenges and implementing interprofessional education activities in a resource-constrained higher education setting in South Africa. Boyer's model of scholarship, which incorporates research, teaching integration, and application, was used to address the challenge of a lack of a framework in which to conceptualise the activities of interprofressional education. In addition, a scaffolding approach to teaching activities within a curriculum was used to operationalise interprofessional education and practice. Faculty development initiatives were additionally used to develop a critical mass that focused on driving interprofessional education. Lessons learnt highlighted that if a conceptual model is agreed upon by all, it allows for a more focused approach, and both human and financial resources may be channelled towards a common goal which may assist resource-constrained institutions in successfully implementing interprofessional activities.

Critical determinants of the epilepsy treatment gap: a cross-national analysis in resource-limited settings

PubMed Central

Meyer, Ana-Claire L.; Dua, Tarun; Boscardin, John; Escarce, José J.; Saxena, Shekhar; Birbeck, Gretchen L.

2013-01-01

Purpose Epilepsy is one of the most common serious neurological disorders worldwide. Our objective was to determine which economic, healthcare, neurology and epilepsy specific resources were associated with untreated epilepsy in resource-constrained settings. Methods A systematic review of the literature identified community-based studies in resource-constrained settings that calculated the epilepsy treatment gap, the proportion with untreated epilepsy, from prevalent active epilepsy cases. Economic, healthcare, neurology and epilepsy specific resources were taken from existing datasets. Poisson regression models with jackknifed standard errors were used to create bivariate and multivariate models comparing the association between treatment status and economic and health resource indicators. Relative risks were reported. Key Findings Forty-seven studies of 8285 individuals from 24 countries met inclusion criteria. Bivariate analysis demonstrated that individuals residing in rural locations had significantly higher risks of untreated epilepsy [Relative Risk(RR)=1.63; 95% confidence interval(CI):1.26,2.11]. Significantly lower risks of untreated epilepsy were observed for higher physician density [RR=0.65, 95% CI:0.55,0.78], presence of a lay [RR=0.74, 95%CI:0.60,0.91] or professional association for epilepsy [RR=0.73, 95%CI:0.59,0.91], or post-graduate neurology training program [RR=0.67, 95%CI:0.55, 0.82]. In multivariate models, higher physician density maintained significant effects [RR=0.67; 95%CI:0.52,0.88]. Significance Even among resource-limited regions, people with epilepsy in countries with fewer economic, healthcare, neurology and epilepsy specific resources are more likely to have untreated epilepsy. Community-based epilepsy care programs have improved access to treatment but in order to decrease the epilepsy treatment gap, poverty and inequalities of healthcare, neurological and epilepsy resources must be dealt with at the local, national, and global levels. PMID:23106784

Outcomes of antiretroviral therapy in a northern Indian urban clinic.

PubMed

Sharma, Surendra K; Dhooria, Sahajal; Prasad, K T; George, Ninoo; Ranjan, Sanjay; Gupta, Deepak; Sreenivas, Vishnubhatla; Kadhiravan, Tamilarasu; Miglani, Sunita; Sinha, Sanjeev; Wig, Naveet; Biswas, Ashutosh; Vajpayee, Madhu

2010-03-01

Antiretroviral therapy (ART) programmes have been successful in several countries. However, whether they would succeed as part of a national programme in a resource-constrained setting such as India is not clear. The outcomes and specific problems encountered in such a setting have not been adequately studied. We assessed the efficacy and functioning of India's national ART programme in a tertiary care centre in northern India. All ART-naive patients started on ART between May 2005 and October 2006 were included in the study and were followed until 31 April 2008. Periodic clinical and laboratory evaluations were carried out in accordance with national guidelines. Changes in CD4+ lymphocyte count, body weight and body mass index were assessed at follow-up, and the operational problems analysed. The setting was a tertiary care centre in northern India with a mixed population of patients, mostly of low socioeconomic status. The centre is reasonably well resourced but faces constraints in health-care delivery, such as lack of adequate human resources and a high patient load. The response to ART in the cohort studied was comparable to that reported from other countries. However, the programme had a high attrition rate, possibly due to patient-related factors and operational constraints. A high rate of attrition can affect the overall efficacy and functioning of an ART programme. Addressing the issues causing attrition might improve patient outcomes in India and in other resource-constrained countries.

Establishing and Delivering Quality Radiation Therapy in Resource-Constrained Settings: The Story of Botswana.

PubMed

Efstathiou, Jason A; Heunis, Magda; Karumekayi, Talkmore; Makufa, Remigio; Bvochora-Nsingo, Memory; Gierga, David P; Suneja, Gita; Grover, Surbhi; Kasese, Joseph; Mmalane, Mompati; Moffat, Howard; von Paleske, Alexander; Makhema, Joseph; Dryden-Peterson, Scott

2016-01-01

There is a global cancer crisis, and it is disproportionately affecting resource-constrained settings, especially in low- and middle-income countries (LMICs). Radiotherapy is a critical and cost-effective component of a comprehensive cancer control plan that offers the potential for cure, control, and palliation of disease in greater than 50% of patients with cancer. Globally, LMICs do not have adequate access to quality radiation therapy and this gap is particularly pronounced in sub-Saharan Africa. Although there are numerous challenges in implementing a radiation therapy program in a low-resource setting, providing more equitable global access to radiotherapy is a responsibility and investment worth prioritizing. We outline a systems approach and a series of key questions to direct strategy toward establishing quality radiation services in LMICs, and highlight the story of private-public investment in Botswana from the late 1990s to the present. After assessing the need and defining the value of radiation, we explore core investments required, barriers that need to be overcome, and assets that can be leveraged to establish a radiation program. Considerations addressed include infrastructure; machine choice; quality assurance and patient safety; acquisition, development, and retention of human capital; governmental engagement; public-private partnerships; international collaborations; and the need to critically evaluate the program to foster further growth and sustainability. © 2015 by American Society of Clinical Oncology.

Regionalization as an approach to regulatory systems strengthening: a case study in CARICOM member states.

PubMed

Preston, Charles; Chahal, Harinder S; Porrás, Analia; Cargill, Lucette; Hinds, Maryam; Olowokure, Babatunde; Cummings, Rudolph; Hospedales, James

2016-05-01

Improving basic capacities for regulation of medicines and health technologies through regulatory systems strengthening is particularly challenging in resource-constrained settings. "Regionalization"-an approach in which countries with common histories, cultural values, languages, and economic conditions work together to establish more efficient systems-may be one answer. This report describes the Caribbean Regulatory System (CRS), a regionalization initiative being implemented in the mostly small countries of the Caribbean Community and Common Market (CARICOM). This initiative is an innovative effort to strengthen regulatory systems in the Caribbean, where capacity is limited compared to other subregions of the Americas. The initiative's concept and design includes a number of features and steps intended to enhance sustainability in resource-constrained contexts. The latter include 1) leveraging existing platforms for centralized cooperation, governance, and infrastructure; 2) strengthening regulatory capacities with the largest potential public health impact; 3) incorporating policies that promote reliance on reference authorities; 4) changing the system to encourage industry to market their products in CARICOM (e.g., using a centralized portal of entry to reduce regulatory burdens); and 5) building human resource capacity. If implemented properly, the CRS will be self-sustaining through user fees. The experience and lessons learned thus far in implementing this initiative, described in this report, can serve as a case study for the development of similar regulatory strengthening initiatives in resource-constrained environments.

Study participants incentives, compensation and reimbursement in resource-constrained settings.

PubMed

Mduluza, Takafira; Midzi, Nicholas; Duruza, Donold; Ndebele, Paul

2013-01-01

Controversies still exists within the research fraternity on the form and level of incentives, compensation and reimbursement to study participants in resource-constrained settings. While most research activities contribute significantly to advancement of mankind, little has been considered in rewarding directly the research participants from resource-constrained areas. A study was conducted in Zimbabwe to investigate views and expectations of various stakeholders on study participation incentives, compensation and reimbursement issues. Data was collected using various methods including a survey of about 1,008 parents/guardians of school children participating in various immunological cohort studies and parasitology surveys. Community advisory boards (CABs) at 9 of the sites were also consulted. Further, information was gathered during discussions held at a basic research ethics training workshop. The workshop had 45 participants that including 40 seasoned Zimbabwean researchers and 5 international research collaborators. About 90% (907) of the study participants and guardians expected compensation of reasonable value, in view of the researchers' value and comparison to other sites regardless of economic status of the community. During discussion with researchers at a basic ethics training workshop, about 80% (32) believed that decisions on level of compensation should be determined by the local research ethics committees. While, the few international research collaborators were of the opinion that compensation should be in accordance with local guidelines, and incentives should be in line with funding. Both the CAB members and study participants expressed that there should be a clear distinction between study incentive and compensation accorded to individual and community expectations on benefits from studies. However, CABs expressed that their suggestions on incentives and compensation are often moderated by the regulatory authorities who cite fear of unknown concerns. Overall, both personal and community benefits need to be considered collectively in future studies to be conducted in resource-constrained communities. There is projected fear that recruitment in future may be a challenge, now that almost every community, has somehow been reached and participated in some form of studies. A major concern on reimbursement, compensation or incentives should be internationally pegged regardless of different economic status of the individuals or communities where the study is to be conducted.

An Ecological Perspective on U.S. Latinos' Health Communication Behaviors, Access, and Outcomes

ERIC Educational Resources Information Center

Katz, Vikki S.; Ang, Alfonso; Suro, Roberto

2012-01-01

U.S. Latinos experience constrained access to formal health care resources, contributing to higher incidence of preventable diseases and chronic health conditions than the general population. The authors explore whether a rich set of informal health communication connections--to friends, family, radio, television, Internet, newspapers, magazines,…

Interconnection-wide hour-ahead scheduling in the presence of intermittent renewables and demand response: A surplus maximizing approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Behboodi, Sahand; Chassin, David P.; Djilali, Ned

This study describes a new approach for solving the multi-area electricity resource allocation problem when considering both intermittent renewables and demand response. The method determines the hourly inter-area export/import set that maximizes the interconnection (global) surplus satisfying transmission, generation and load constraints. The optimal inter-area transfer set effectively makes the electricity price uniform over the interconnection apart from constrained areas, which overall increases the consumer surplus more than it decreases the producer surplus. The method is computationally efficient and suitable for use in simulations that depend on optimal scheduling models. The method is demonstrated on a system that represents Northmore » America Western Interconnection for the planning year of 2024. Simulation results indicate that effective use of interties reduces the system operation cost substantially. Excluding demand response, both the unconstrained and the constrained scheduling solutions decrease the global production cost (and equivalently increase the global economic surplus) by 12.30B and 10.67B per year, respectively, when compared to the standalone case in which each control area relies only on its local supply resources. This cost saving is equal to 25% and 22% of the annual production cost. Including 5% demand response, the constrained solution decreases the annual production cost by 10.70B, while increases the annual surplus by 9.32B in comparison to the standalone case.« less

Interconnection-wide hour-ahead scheduling in the presence of intermittent renewables and demand response: A surplus maximizing approach

DOE PAGES

Behboodi, Sahand; Chassin, David P.; Djilali, Ned; ...

2016-12-23

This study describes a new approach for solving the multi-area electricity resource allocation problem when considering both intermittent renewables and demand response. The method determines the hourly inter-area export/import set that maximizes the interconnection (global) surplus satisfying transmission, generation and load constraints. The optimal inter-area transfer set effectively makes the electricity price uniform over the interconnection apart from constrained areas, which overall increases the consumer surplus more than it decreases the producer surplus. The method is computationally efficient and suitable for use in simulations that depend on optimal scheduling models. The method is demonstrated on a system that represents Northmore » America Western Interconnection for the planning year of 2024. Simulation results indicate that effective use of interties reduces the system operation cost substantially. Excluding demand response, both the unconstrained and the constrained scheduling solutions decrease the global production cost (and equivalently increase the global economic surplus) by 12.30B and 10.67B per year, respectively, when compared to the standalone case in which each control area relies only on its local supply resources. This cost saving is equal to 25% and 22% of the annual production cost. Including 5% demand response, the constrained solution decreases the annual production cost by 10.70B, while increases the annual surplus by 9.32B in comparison to the standalone case.« less

"Talkin' about a revolution": How electronic health records can facilitate the scale-up of HIV care and treatment and catalyze primary care in resource-constrained settings.

PubMed

Braitstein, Paula; Einterz, Robert M; Sidle, John E; Kimaiyo, Sylvester; Tierney, William

2009-11-01

Health care for patients with HIV infection in developing countries has increased substantially in response to major international funding. Scaling up treatment programs requires timely data on the type, quantity, and quality of care being provided. Increasingly, such programs are turning to electronic health records (EHRs) to provide these data. We describe how a medical school in the United States and another in Kenya collaborated to develop and implement an EHR in a large HIV/AIDS care program in western Kenya. These data were used to manage patients, providers, and the program itself as it grew to encompass 18 sites serving more than 90,000 patients. Lessons learned have been applicable beyond HIV/AIDS to include primary care, chronic disease management, and community-based health screening and disease prevention programs. EHRs will be key to providing the highest possible quality of care for the funds developing countries can commit to health care. Public, private, and academic partnerships can facilitate the development and implementation of EHRs in resource-constrained settings.

Integrated Medical Model (IMM) Optimization Version 4.0 Functional Improvements

NASA Technical Reports Server (NTRS)

Arellano, John; Young, M.; Boley, L.; Garcia, Y.; Saile, L.; Walton, M.; Kerstman, E.; Reyes, D.; Goodenow, D. A.; Myers, J. G.

2016-01-01

The IMMs ability to assess mission outcome risk levels relative to available resources provides a unique capability to provide guidance on optimal operational medical kit and vehicle resources. Post-processing optimization allows IMM to optimize essential resources to improve a specific model outcome such as maximization of the Crew Health Index (CHI), or minimization of the probability of evacuation (EVAC) or the loss of crew life (LOCL). Mass and or volume constrain the optimized resource set. The IMMs probabilistic simulation uses input data on one hundred medical conditions to simulate medical events that may occur in spaceflight, the resources required to treat those events, and the resulting impact to the mission based on specific crew and mission characteristics. Because IMM version 4.0 provides for partial treatment for medical events, IMM Optimization 4.0 scores resources at the individual resource unit increment level as opposed to the full condition-specific treatment set level, as done in version 3.0. This allows the inclusion of as many resources as possible in the event that an entire set of resources called out for treatment cannot satisfy the constraints. IMM Optimization version 4.0 adds capabilities that increase efficiency by creating multiple resource sets based on differing constraints and priorities, CHI, EVAC, or LOCL. It also provides sets of resources that improve mission-related IMM v4.0 outputs with improved performance compared to the prior optimization. The new optimization represents much improved fidelity that will improve the utility of the IMM 4.0 for decision support.

Experimental platform utilising melting curve technology for detection of mutations in Mycobacterium tuberculosis isolates.

PubMed

Broda, Agnieszka; Nikolayevskyy, Vlad; Casali, Nicki; Khan, Huma; Bowker, Richard; Blackwell, Gemma; Patel, Bhakti; Hume, James; Hussain, Waqar; Drobniewski, Francis

2018-04-20

Tuberculosis (TB) remains one of the most deadly infections with approximately a quarter of cases not being identified and/or treated mainly due to a lack of resources. Rapid detection of TB or drug-resistant TB enables timely adequate treatment and is a cornerstone of effective TB management. We evaluated the analytical performance of a single-tube assay for multidrug-resistant TB (MDR-TB) on an experimental platform utilising RT-PCR and melting curve analysis that could potentially be operated as a point-of-care (PoC) test in resource-constrained settings with a high burden of TB. Firstly, we developed and evaluated the prototype MDR-TB assay using specimens extracted from well-characterised TB isolates with a variety of distinct rifampicin and isoniazid resistance conferring mutations and nontuberculous Mycobacteria (NTM) strains. Secondly, we validated the experimental platform using 98 clinical sputum samples from pulmonary TB patients collected in high MDR-TB settings. The sensitivity of the platform for TB detection in clinical specimens was 75% for smear-negative and 92.6% for smear-positive sputum samples. The sensitivity of detection for rifampicin and isoniazid resistance was 88.9 and 96.0% and specificity was 87.5 and 100%, respectively. Observed limitations in sensitivity and specificity could be resolved by adjusting the sample preparation methodology and melting curve recognition algorithm. Overall technology could be considered a promising PoC methodology especially in resource-constrained settings based on its combined accuracy, convenience, simplicity, speed, and cost characteristics.

Resource-constrained scheduling with hard due windows and rejection penalties

NASA Astrophysics Data System (ADS)

Garcia, Christopher

2016-09-01

This work studies a scheduling problem where each job must be either accepted and scheduled to complete within its specified due window, or rejected altogether. Each job has a certain processing time and contributes a certain profit if accepted or penalty cost if rejected. There is a set of renewable resources, and no resource limit can be exceeded at any time. Each job requires a certain amount of each resource when processed, and the objective is to maximize total profit. A mixed-integer programming formulation and three approximation algorithms are presented: a priority rule heuristic, an algorithm based on the metaheuristic for randomized priority search and an evolutionary algorithm. Computational experiments comparing these four solution methods were performed on a set of generated benchmark problems covering a wide range of problem characteristics. The evolutionary algorithm outperformed the other methods in most cases, often significantly, and never significantly underperformed any method.

Management of multiple myeloma in resource-constrained settings.

PubMed

Kumar, Lalit; Kumar Sahoo, Ranjit

2016-12-01

The prognosis of patients with multiple myeloma (MM) has improved significantly in the past two decades. This is attributed to use of novel agents for induction, high-dose chemotherapy and autologous stem cell transplantation (ASCT), maintenance therapy, and improved supportive care. Currently, evidence-based management guidelines/recommendations developed by International societies/groups are being followed partially in low-resource settings. Lack of quality diagnostics (eg, cytogenetics/fluorescence in situ hybridization (FISH), serum free light chains), novel therapeutics, and trained manpower, and limited financial resources are key challanges. An optimal utilization of available resources with continued educational activities of treating physicians focused on improving knowledge in the management of such patients may be a way forward to improve the outcome of myeloma patients in these countries. Our current approach to the management of this disease is presented here through a discussion of clinical vignettes. Copyright © 2016 Elsevier Inc. All rights reserved.

Implementation of HIV Palliative Care: Interprofessional Education to Improve Patient Outcomes in Resource-Constrained Settings, 2004-2012.

PubMed

Alexander, Carla S; Pappas, Gregory; Amoroso, Anthony; Lee, Mei Ching; Brown-Henley, Yvonne; Memiah, Peter; O'Neill, Joseph F; Dix, Olivia; Redfield, Robert R

2015-09-01

Palliative care (PC), introduced early in the management of chronic illness, improves patient outcomes. Early integration of a palliative approach for persons with HIV has been documented to be effective in identifying and managing patient-level concerns over the past decade in African settings. The experience of implementing PC in multiple African and other resource-constrained settings (RCSs) emphasizes the need for essential palliative competencies that can be integrated with chronic disease management for patients and their families facing life-limiting illness. This article is an historical description of how basic palliative competencies were observed to be acceptable for health workers providing outpatient HIV care and treatment during eight years of U.S. implementation of "care and support," a term coined to represent PC for persons living with HIV in RCS. The need for team building and interprofessional education is highlighted. The model is currently being tested in one U.S. city and may represent a mechanism for expanding the palliative approach into management of chronic disease. Such competencies may play a role in the development of the patient-centered medical home, a critical component of U.S. health care reform. Copyright © 2015 American Academy of Hospice and Palliative Medicine. All rights reserved.

Management of cryotherapy-ineligible women in a “screen-and-treat” cervical cancer prevention program targeting HIV-infected women in Zambia: Lessons from the field

PubMed Central

Pfaendler, Krista S.; Mwanahamuntu, Mulindi H.; Sahasrabuddhe, Vikrant V.; Mudenda, Victor; Stringer, Jeffrey S.A.; Parham, Groesbeck P.

2009-01-01

Objective We demonstrate the feasibility of implementing a referral and management system for cryotherapy-ineligible women in a “screen-and-treat” cervical cancer prevention program targeting HIV-infected women in Zambia. Methods We established criteria for patient referral, developed a training program for loop electrosurgical excision procedure (LEEP) providers, and adapted LEEP to a resource-constrained setting. Results We successfully trained 15 nurses to perform visual inspection with acetic acid (VIA) followed by immediate cryotherapy. Women with positive tests but ineligible for cryotherapy were referred for further evaluation. We trained four Zambian physicians to evaluate referrals, perform punch biopsy, LEEP, and manage intra-operative and post-operative complications. From January 2006 through October 2007, a total of 8823 women (41.5% HIV seropositive) were evaluated by nurses in outlying prevention clinics; of these, 1477 (16.7%) were referred for physician evaluation based on established criteria. Of the 875 (59.2% of 1147 referred) that presented for evaluation, 748 (8.4% of total screened) underwent histologic evaluation in the form of punch biopsy or LEEP. Complications associated with LEEP included anesthesia reaction (n=2) which spontaneously resolved, intra-operative (n=12) and post-operative (n=2) bleeding managed by local measures, and post-operative infection (n=12) managed with antibiotics. Conclusion With adaptations for a resource-constrained environment, we have demonstrated that performing LEEP is feasible and safe, with low rates of complications that can be managed locally. It is important to establish referral and management systems using LEEP-based excisional evaluation for women with cryotherapy-ineligible lesions in VIA-based “screen-and-treat” protocols nested within HIV-care programs in resource-constrained settings. PMID:18556050

Management of cryotherapy-ineligible women in a "screen-and-treat" cervical cancer prevention program targeting HIV-infected women in Zambia: lessons from the field.

PubMed

Pfaendler, Krista S; Mwanahamuntu, Mulindi H; Sahasrabuddhe, Vikrant V; Mudenda, Victor; Stringer, Jeffrey S A; Parham, Groesbeck P

2008-09-01

We demonstrate the feasibility of implementing a referral and management system for cryotherapy-ineligible women in a "screen-and-treat" cervical cancer prevention program targeting HIV-infected women in Zambia. We established criteria for patient referral, developed a training program for loop electrosurgical excision procedure (LEEP) providers, and adapted LEEP to a resource-constrained setting. We successfully trained 15 nurses to perform visual inspection with acetic acid (VIA) followed by immediate cryotherapy. Women with positive tests but ineligible for cryotherapy were referred for further evaluation. We trained four Zambian physicians to evaluate referrals, perform punch biopsy, LEEP, and manage intra-operative and post-operative complications. From January 2006 through October 2007, a total of 8823 women (41.5% HIV seropositive) were evaluated by nurses in outlying prevention clinics; of these, 1477 (16.7%) were referred for physician evaluation based on established criteria. Of the 875 (59.2% of 1147 referred) that presented for evaluation, 748 (8.4% of total screened) underwent histologic evaluation in the form of punch biopsy or LEEP. Complications associated with LEEP included anesthesia reaction (n=2) which spontaneously resolved, intra-operative (n=12) and post-operative (n=2) bleeding managed by local measures, and post-operative infection (n=12) managed with antibiotics. With adaptations for a resource-constrained environment, we have demonstrated that performing LEEP is feasible and safe, with low rates of complications that can be managed locally. It is important to establish referral and management systems using LEEP-based excisional evaluation for women with cryotherapy-ineligible lesions in VIA-based "screen-and-treat" protocols nested within HIV-care programs in resource-constrained settings.

Challenges and impact of conducting vaccine trials in Asia and Africa

PubMed Central

Kochhar, Sonali

2013-01-01

Immunization is one of the most beneficial and cost-effective disease prevention measures. There are global efforts to develop new vaccines for disease control. The vaccine clinical trials must be conducted in the countries where they will be used. This has led to vaccine trials being conducted across Asia and Africa where there is a high burden of infectious diseases. The setup and successful conduct of International standard GCP vaccine trials across trial centers located in resource constrained settings are challenging. The challenges, ethical considerations and impact of the implementation of clinical trials in low-resource settings are highlighted here to help vaccine development programs successfully conduct such trials. PMID:23321645

Emotion based attentional priority for storage in visual short-term memory.

PubMed

Simione, Luca; Calabrese, Lucia; Marucci, Francesco S; Belardinelli, Marta Olivetti; Raffone, Antonino; Maratos, Frances A

2014-01-01

A plethora of research demonstrates that the processing of emotional faces is prioritised over non-emotive stimuli when cognitive resources are limited (this is known as 'emotional superiority'). However, there is debate as to whether competition for processing resources results in emotional superiority per se, or more specifically, threat superiority. Therefore, to investigate prioritisation of emotional stimuli for storage in visual short-term memory (VSTM), we devised an original VSTM report procedure using schematic (angry, happy, neutral) faces in which processing competition was manipulated. In Experiment 1, display exposure time was manipulated to create competition between stimuli. Participants (n = 20) had to recall a probed stimulus from a set size of four under high (150 ms array exposure duration) and low (400 ms array exposure duration) perceptual processing competition. For the high competition condition (i.e. 150 ms exposure), results revealed an emotional superiority effect per se. In Experiment 2 (n = 20), we increased competition by manipulating set size (three versus five stimuli), whilst maintaining a constrained array exposure duration of 150 ms. Here, for the five-stimulus set size (i.e. maximal competition) only threat superiority emerged. These findings demonstrate attentional prioritisation for storage in VSTM for emotional faces. We argue that task demands modulated the availability of processing resources and consequently the relative magnitude of the emotional/threat superiority effect, with only threatening stimuli prioritised for storage in VSTM under more demanding processing conditions. Our results are discussed in light of models and theories of visual selection, and not only combine the two strands of research (i.e. visual selection and emotion), but highlight a critical factor in the processing of emotional stimuli is availability of processing resources, which is further constrained by task demands.

Teaching for Better Learning: A Blended Learning Pilot Project with First-Year Geography Undergraduates

ERIC Educational Resources Information Center

Moore, Niamh; Gilmartin, Mary

2010-01-01

Internationally, recognition is growing that the transition between post-primary and higher education is raising a number of challenges for both students and educators. Simultaneously with growing class sizes, resources have become more constrained and there is a new set of expectations from the "net generation" (Mohanna, 2007, p. 211…

Dimensions of Open Research: Critical Reflections on Openness in the ROER4D Project

ERIC Educational Resources Information Center

King, Thomas; Hodgkinson-Williams, Cheryl; Willmers, Michelle; Walji, Sukaina

2016-01-01

Open Research has the potential to advance the scientific process by improving the transparency, rigour, scope and reach of research, but choosing to experiment with Open Research carries with it a set of ideological, legal, technical and operational considerations. Researchers, especially those in resource-constrained situations, may not be aware…

Cardiovascular disease prevention in low resource settings: lessons from the Heartfile experience in Pakistan.

PubMed

Nishtar, Sania

2003-01-01

This paper outlines activities of the Heartfile Program in Pakistan (http://heartfile.org). The program focuses on cardiovascular disease prevention and health promotion, and includes several initiatives that encompass building policy, reorienting health services, and developing community interventions that utilize the print and electronic media and outreach at the grass-root level to incorporate social marketing approaches. Initiated by the nonprofit private sector, the program now links with major public sector primary healthcare programs, and is currently spearheading formulation of the National Action Plan on Noncommunicable Disease Prevention and Control in Pakistan. In addition, the program is being refined, validated, and packaged as a replicable model for other developing countries and in low resource settings, utilizing appropriate principles of franchising with inbuilt components sensitive to cultural and social adaptations. A review of the planning process, implementation strategy, and fund-raising experience is presented. Strategies unique to low resource settings, such as the development of cost- and time-efficient strategic alliances and partnerships, have also been highlighted. In addition, specific caveats are identified as being helpful to private sector development of chronic disease prevention programs in resource-constrained settings, and a road map to a sustainable public-private sector partnership is provided.

Pediatric surgical capacity building - a pathway to improving access to pediatric surgical care in Haiti.

PubMed

Kaseje, Neema; Jenny, Hillary; Jeudy, Andre Patrick; MacLee, Jean Louis; Meara, John G; Ford, Henri R

2018-02-01

Lack of human resources is a major barrier to accessing pediatric surgical care globally. Our aim was to establish a model for pediatric surgical training of general surgery residents in a resource constrained region. A pediatric surgical program with a pediatric surgical rotation for general surgery residents in a tertiary hospital in Haiti in 2015 was established. We conducted twice daily patient rounds, ran an outpatient clinic, and provided emergent and elective pediatric surgical care, with tasks progressively given to residents until they could run clinic and perform the most common elective and emergent procedures. We conducted baseline and post-intervention knowledge exams and dedicated 1 day a week to teaching and research activities. We measured the following outcomes: number of residents that completed the rotation, mean pre and post intervention test scores, patient volume in clinic and operating room, postoperative outcomes, resident ability to perform most common elective and emergent procedures, and resident participation in research. Nine out of 9 residents completed the rotation; 987 patients were seen in outpatient clinic, and 564 procedures were performed in children <15years old. There was a 50% increase in volume of pediatric cases and a 100% increase in procedures performed in children <4years old. Postoperative outcomes were: 0% mortality for elective cases and 18% mortality for emergent cases, 3% complication rate for elective cases and 6% complication rate for emergent cases. Outcomes did not change with increased responsibility given to residents. All senior residents (n=4) could perform the most common elective and emergent procedures without changes in mortality and complication rates. Increases in mean pre and post intervention test scores were 12% (PGY1), 24% (PGY2), and 10% (PGY3). 75% of senior residents participated in research activities as first or second authors. Establishing a program in pediatric surgery with capacity building of general surgery residents for pediatric surgical care provision is feasible in a resource constrained setting without negative effects on patient outcomes. This model can be applied in other resource constrained settings to increase human resources for global pediatric surgical care provision. III. Copyright © 2017 Elsevier Inc. All rights reserved.

Study abroad programs: Using alumni and graduate students as affiliate faculty.

PubMed

Palmer, Sheri; Wing, Debra; Miles, Leslie; Heaston, Sondra; de la Cruz, Karen

2013-01-01

To expand student appreciation of global health and diversity, many schools of nursing offer study abroad programs. However, this type of labor-intensive program can be difficult in light of faculty shortages and constrained resources. The authors discuss how these issues were addressed using alumni and graduate students as affiliate teachers in 3 clinical study abroad settings.

Superdense teleportation using hyperentangled photons

PubMed Central

Graham, Trent M.; Bernstein, Herbert J.; Wei, Tzu-Chieh; Junge, Marius; Kwiat, Paul G

2015-01-01

Transmitting quantum information between two remote parties is a requirement for many quantum applications; however, direct transmission of states is often impossible because of noise and loss in the communication channel. Entanglement-enhanced state communication can be used to avoid this issue, but current techniques require extensive experimental resources to transmit large quantum states deterministically. To reduce these resource requirements, we use photon pairs hyperentangled in polarization and orbital angular momentum to implement superdense teleportation, which can communicate a specific class of single-photon ququarts. We achieve an average fidelity of 87.0(1)%, almost twice the classical limit of 44% with reduced experimental resources than traditional techniques. We conclude by discussing the information content of this constrained set of states and demonstrate that this set has an exponentially larger state space volume than the lower-dimensional general states with the same number of state parameters. PMID:26018201

An Optimization Model for Scheduling Problems with Two-Dimensional Spatial Resource Constraint

NASA Technical Reports Server (NTRS)

Garcia, Christopher; Rabadi, Ghaith

2010-01-01

Traditional scheduling problems involve determining temporal assignments for a set of jobs in order to optimize some objective. Some scheduling problems also require the use of limited resources, which adds another dimension of complexity. In this paper we introduce a spatial resource-constrained scheduling problem that can arise in assembly, warehousing, cross-docking, inventory management, and other areas of logistics and supply chain management. This scheduling problem involves a twodimensional rectangular area as a limited resource. Each job, in addition to having temporal requirements, has a width and a height and utilizes a certain amount of space inside the area. We propose an optimization model for scheduling the jobs while respecting all temporal and spatial constraints.

Automated chest-radiography as a triage for Xpert testing in resource-constrained settings: a prospective study of diagnostic accuracy and costs

NASA Astrophysics Data System (ADS)

Philipsen, R. H. H. M.; Sánchez, C. I.; Maduskar, P.; Melendez, J.; Peters-Bax, L.; Peter, J. G.; Dawson, R.; Theron, G.; Dheda, K.; van Ginneken, B.

2015-07-01

Molecular tests hold great potential for tuberculosis (TB) diagnosis, but are costly, time consuming, and HIV-infected patients are often sputum scarce. Therefore, alternative approaches are needed. We evaluated automated digital chest radiography (ACR) as a rapid and cheap pre-screen test prior to Xpert MTB/RIF (Xpert). 388 suspected TB subjects underwent chest radiography, Xpert and sputum culture testing. Radiographs were analysed by computer software (CAD4TB) and specialist readers, and abnormality scores were allocated. A triage algorithm was simulated in which subjects with a score above a threshold underwent Xpert. We computed sensitivity, specificity, cost per screened subject (CSS), cost per notified TB case (CNTBC) and throughput for different diagnostic thresholds. 18.3% of subjects had culture positive TB. For Xpert alone, sensitivity was 78.9%, specificity 98.1%, CSS $13.09 and CNTBC $90.70. In a pre-screening setting where 40% of subjects would undergo Xpert, CSS decreased to $6.72 and CNTBC to $54.34, with eight TB cases missed and throughput increased from 45 to 113 patients/day. Specialists, on average, read 57% of radiographs as abnormal, reducing CSS ($8.95) and CNTBC ($64.84). ACR pre-screening could substantially reduce costs, and increase daily throughput with few TB cases missed. These data inform public health policy in resource-constrained settings.

Design and implementation of a patient navigation system in rural Nepal: Improving patient experience in resource-constrained settings.

PubMed

Raut, Anant; Thapa, Poshan; Citrin, David; Schwarz, Ryan; Gauchan, Bikash; Bista, Deepak; Tamrakar, Bibhu; Halliday, Scott; Maru, Duncan; Schwarz, Dan

2015-12-01

Patient navigation programs have shown to be effective across multiple settings in guiding patients through the care delivery process. Limited experience and literature exist, however, for such programs in rural and resource-constrained environments. Patients living in such settings frequently have low health literacy and substantially lower social status than their providers. They typically have limited experiences interfacing with formalized healthcare systems, and, when they do, their experience can be unpleasant and confusing. At a district hospital in rural far-western Nepal, we designed and implemented a patient navigation system that aimed to improve patients' subjective care experience. First, we hired and trained a team of patient navigators who we recruited from the local area. Their responsibility is exclusively to demonstrate compassion and to guide patients through their care process. Second, we designed visual cues throughout our hospital complex to assist in navigating patients through the buildings. Third, we incorporated the patient navigators within the management and communications systems of the hospital care team, and established standard operating procedures. We describe here our experiences and challenges in designing and implementing a patient navigator program. Such patient-centered systems may be relevant at other facilities in Nepal and globally where patient health literacy is low, patients come from backgrounds of substantial marginalization and disempowerment, and patient experience with healthcare facilities is limited. Copyright © 2015 Elsevier Inc. All rights reserved.

Understanding the facilitators and barriers of antiretroviral adherence in Peru: A qualitative study

PubMed Central

2010-01-01

Background Antiretroviral scale-up is increasing in resource-constrained settings. To date, few studies have explored the barriers and facilitators of adherence to ART in these settings. Facilitators and barriers of antiretroviral adherence in Peru are not completely understood. Methods At two clinics that serve a large number of HIV-positive individuals in Lima, Peru, 31 in-depth interviews were carried out in 2006 with adult HIV-positive individuals receiving ART. Purposive sampling was used to recruit the participants. Interviews were transcribed and coded using two Spanish-speaking researchers and a content analysis approach to identify themes in the data. Results Among the participants, 28/31 (90%) were male, 25/31 (81%) were self-identified as mestizo, and 19/31 (61%) had an education above high school. The most frequently discussed barriers to adherence included side effects, simply forgetting, inconvenience, dietary requirements, being away from home, and fear of disclosure/stigma. The most frequently discussed facilitators to adherence included having a fixed routine, understanding the need for compliance, seeing positive results, treatment knowledge, and faith in treatment. Conclusions Overall, these findings were similar to the facilitators and challenges experienced by individuals on ART in other resource constrained settings. Further treatment support tools and networks should be developed to decrease the challenges of ART adherence for HIV-positive individuals in Lima, Peru. PMID:20070889

Resource Management in Constrained Dynamic Situations

NASA Astrophysics Data System (ADS)

Seok, Jinwoo

Resource management is considered in this dissertation for systems with limited resources, possibly combined with other system constraints, in unpredictably dynamic environments. Resources may represent fuel, power, capabilities, energy, and so on. Resource management is important for many practical systems; usually, resources are limited, and their use must be optimized. Furthermore, systems are often constrained, and constraints must be satisfied for safe operation. Simplistic resource management can result in poor use of resources and failure of the system. Furthermore, many real-world situations involve dynamic environments. Many traditional problems are formulated based on the assumptions of given probabilities or perfect knowledge of future events. However, in many cases, the future is completely unknown, and information on or probabilities about future events are not available. In other words, we operate in unpredictably dynamic situations. Thus, a method is needed to handle dynamic situations without knowledge of the future, but few formal methods have been developed to address them. Thus, the goal is to design resource management methods for constrained systems, with limited resources, in unpredictably dynamic environments. To this end, resource management is organized hierarchically into two levels: 1) planning, and 2) control. In the planning level, the set of tasks to be performed is scheduled based on limited resources to maximize resource usage in unpredictably dynamic environments. In the control level, the system controller is designed to follow the schedule by considering all the system constraints for safe and efficient operation. Consequently, this dissertation is mainly divided into two parts: 1) planning level design, based on finite state machines, and 2) control level methods, based on model predictive control. We define a recomposable restricted finite state machine to handle limited resource situations and unpredictably dynamic environments for the planning level. To obtain a policy, dynamic programing is applied, and to obtain a solution, limited breadth-first search is applied to the recomposable restricted finite state machine. A multi-function phased array radar resource management problem and an unmanned aerial vehicle patrolling problem are treated using recomposable restricted finite state machines. Then, we use model predictive control for the control level, because it allows constraint handling and setpoint tracking for the schedule. An aircraft power system management problem is treated that aims to develop an integrated control system for an aircraft gas turbine engine and electrical power system using rate-based model predictive control. Our results indicate that at the planning level, limited breadth-first search for recomposable restricted finite state machines generates good scheduling solutions in limited resource situations and unpredictably dynamic environments. The importance of cooperation in the planning level is also verified. At the control level, a rate-based model predictive controller allows good schedule tracking and safe operations. The importance of considering the system constraints and interactions between the subsystems is indicated. For the best resource management in constrained dynamic situations, the planning level and the control level need to be considered together.

Global Health Initiatives of the International Oncology Community.

PubMed

Al-Sukhun, Sana; de Lima Lopes, Gilberto; Gospodarowicz, Mary; Ginsburg, Ophira; Yu, Peter Paul

2017-01-01

Cancer has become one of the leading causes of morbidity and mortality in low- and middle-income countries (LMICs), where 60% of the world's total new cases are diagnosed. The challenge for effective control of cancer is multifaceted. It mandates integration of effective cancer prevention, encouraging early detection, and utilization of resource-adapted therapeutic and supportive interventions. In the resource-constrained setting, it becomes challenging to deliver each service optimally, and efficient allocation of resources is the best way to improve the outcome. This concept was translated into action through development of resource-stratified guidelines, pioneered by the Breast Health Global Initiative (BHGI), and later adopted by most oncology societies in an attempt to help physicians deliver the best possible care in a limited-resource setting. Improving outcome entails collaboration between key stakeholders, including the pharmaceutical industry, local and national health authorities, the World Health Organization (WHO), and other nonprofit, patient-oriented organizations. Therefore, we started to observe global health initiatives-led by ASCO, the Union for International Cancer Control (UICC), and the WHO-to address these challenges at the international level. This article discusses some of these initiatives.

Implementing antiretroviral therapy programs in resource-constrained settings: lessons from Monze, Zambia.

PubMed

Adedimeji, Adebola; Malokota, Oliver; Manafa, Ogenna

2011-05-01

We describe the impact of an antiretroviral therapy program on human resource utilization and service delivery in a rural hospital in Monze, Zambia, using qualitative data. We assess project impact on staff capacity utilization, service delivery, and community perception of care. Increased workload resulted in fatigue, low staff morale, and exacerbated critical manpower shortages, but also an increase in users of antiretroviral therapy, improvement in hospital infrastructure and funding, and an overall community satisfaction with service delivery. Integrating HAART programs within existing hospital units and services may be a good alternative to increase overall efficiency.

Frugal innovation in medicine for low resource settings.

PubMed

Tran, Viet-Thi; Ravaud, Philippe

2016-07-07

Whilst it is clear that technology is crucial to advance healthcare: innovation in medicine is not just about high-tech tools, new procedures or genome discoveries. In constrained environments, healthcare providers often create unexpected solutions to provide adequate healthcare to patients. These inexpensive but effective frugal innovations may be imperfect, but they have the power to ensure that health is within reach of everyone. Frugal innovations are not limited to low-resource settings: ingenuous ideas can be adapted to offer simpler and disruptive alternatives to usual care all around the world, representing the concept of "reverse innovation". In this article, we discuss the different types of frugal innovations, illustrated with examples from the literature, and argue for the need to give voice to this neglected type of innovation in medicine.

Use of programme budgeting and marginal analysis to set priorities for local NHS dental services: learning from the north east of England.

PubMed

Holmes, R D; Steele, J G; Exley, C; Vernazza, C R; Donaldson, C

2018-05-03

Priority setting is necessary where competing demands exceed the finite resources available. The aim of the study was to develop and test a prioritization framework based upon programme budgeting and marginal analysis (PBMA) as a tool to assist National Health Service (NHS) commissioners in their management of resources for local NHS dental services. Twenty-seven stakeholders (5 dentists, 8 commissioners and 14 patients) participated in a case-study based in a former NHS commissioning organization in the north of England. Stakeholders modified local decision-making criteria and applied them to a number of different scenarios. The majority of financial resources for NHS dental services in the commissioning organization studied were allocated to primary care dental practitioners' contracts in perpetuity, potentially constraining commissioners' abilities to shift resources. Compiling the programme budget was successful, but organizational flux and difficulties engaging local NHS commissioners significantly impacted upon the marginal analysis phase. NHS dental practitioners' contracts resemble budget-silos which do not facilitate local resource reallocation. 'Context-specific' factors significantly challenged the successful implementation and impact of PBMA. A local PBMA champion embedded within commissioning organizations should be considered. Participants found visual depiction of the cost-value ratio helpful during their initial priority setting deliberations.

Diabetes and Hypertension among Patients Receiving Antiretroviral Treatment Since 1998 in Senegal: Prevalence and Associated Factors

PubMed Central

Diouf, Assane; Cournil, Amandine; Ba-Fall, Khadidiatou; Ngom-Guèye, Ndèye Fatou; Eymard-Duvernay, Sabrina; Ndiaye, Ibrahima; Batista, Gilbert; Guèye, Papa Mandoumbé; Bâ, Pape Samba; Taverne, Bernard; Delaporte, Eric; Sow, Papa Salif

2012-01-01

Cardiovascular risk factors in people on antiretroviral treatment (ART) are poorly documented in resource-constrained settings. A cross-sectional study was conducted in 2009 to assess prevalence of diabetes and hypertension in a sample of 242 HIV-infected patients who had initiated ART between 1998 and 2002 in Dakar, Senegal (ANRS 1215 observational cohort). World Health Organization (WHO) criteria were applied to diagnose diabetes and hypertension. Multiple logistic regressions were used to identify factors associated with diabetes and hypertension. Patients had a median age of 46 years and had received ART for a median duration of about 9 years. 14.5% had diabetes and 28.1% had hypertension. Long duration of ART (≥119 months), older age, higher body mass index (BMI), and higher levels of total cholesterol were associated with higher risks of diabetes. Older age, higher BMI at ART initiation, and higher levels of triglycerides were associated with higher risk of hypertension. This study shows that diabetes and hypertension were frequent in these Senegalese HIV patients on ART. It confirms the association between duration of ART and diabetes and highlights the need to implement programs for prevention of cardiovascular risk factors in HIV patients from resource-constrained settings. PMID:24052880

Secure Service Proxy: A CoAP(s) Intermediary for a Securer and Smarter Web of Things

PubMed Central

Van den Abeele, Floris; Moerman, Ingrid; Demeester, Piet

2017-01-01

As the IoT continues to grow over the coming years, resource-constrained devices and networks will see an increase in traffic as everything is connected in an open Web of Things. The performance- and function-enhancing features are difficult to provide in resource-constrained environments, but will gain importance if the WoT is to be scaled up successfully. For example, scalable open standards-based authentication and authorization will be important to manage access to the limited resources of constrained devices and networks. Additionally, features such as caching and virtualization may help further reduce the load on these constrained systems. This work presents the Secure Service Proxy (SSP): a constrained-network edge proxy with the goal of improving the performance and functionality of constrained RESTful environments. Our evaluations show that the proposed design reaches its goal by reducing the load on constrained devices while implementing a wide range of features as different adapters. Specifically, the results show that the SSP leads to significant savings in processing, network traffic, network delay and packet loss rates for constrained devices. As a result, the SSP helps to guarantee the proper operation of constrained networks as these networks form an ever-expanding Web of Things. PMID:28696393

Secure Service Proxy: A CoAP(s) Intermediary for a Securer and Smarter Web of Things.

PubMed

Van den Abeele, Floris; Moerman, Ingrid; Demeester, Piet; Hoebeke, Jeroen

2017-07-11

As the IoT continues to grow over the coming years, resource-constrained devices and networks will see an increase in traffic as everything is connected in an open Web of Things. The performance- and function-enhancing features are difficult to provide in resource-constrained environments, but will gain importance if the WoT is to be scaled up successfully. For example, scalable open standards-based authentication and authorization will be important to manage access to the limited resources of constrained devices and networks. Additionally, features such as caching and virtualization may help further reduce the load on these constrained systems. This work presents the Secure Service Proxy (SSP): a constrained-network edge proxy with the goal of improving the performance and functionality of constrained RESTful environments. Our evaluations show that the proposed design reaches its goal by reducing the load on constrained devices while implementing a wide range of features as different adapters. Specifically, the results show that the SSP leads to significant savings in processing, network traffic, network delay and packet loss rates for constrained devices. As a result, the SSP helps to guarantee the proper operation of constrained networks as these networks form an ever-expanding Web of Things.

Exploring constrained quantum control landscapes

NASA Astrophysics Data System (ADS)

Moore, Katharine W.; Rabitz, Herschel

2012-10-01

The broad success of optimally controlling quantum systems with external fields has been attributed to the favorable topology of the underlying control landscape, where the landscape is the physical observable as a function of the controls. The control landscape can be shown to contain no suboptimal trapping extrema upon satisfaction of reasonable physical assumptions, but this topological analysis does not hold when significant constraints are placed on the control resources. This work employs simulations to explore the topology and features of the control landscape for pure-state population transfer with a constrained class of control fields. The fields are parameterized in terms of a set of uniformly spaced spectral frequencies, with the associated phases acting as the controls. This restricted family of fields provides a simple illustration for assessing the impact of constraints upon seeking optimal control. Optimization results reveal that the minimum number of phase controls necessary to assure a high yield in the target state has a special dependence on the number of accessible energy levels in the quantum system, revealed from an analysis of the first- and second-order variation of the yield with respect to the controls. When an insufficient number of controls and/or a weak control fluence are employed, trapping extrema and saddle points are observed on the landscape. When the control resources are sufficiently flexible, solutions producing the globally maximal yield are found to form connected "level sets" of continuously variable control fields that preserve the yield. These optimal yield level sets are found to shrink to isolated points on the top of the landscape as the control field fluence is decreased, and further reduction of the fluence turns these points into suboptimal trapping extrema on the landscape. Although constrained control fields can come in many forms beyond the cases explored here, the behavior found in this paper is illustrative of the impacts that constraints can introduce.

Injury surveillance in low-resource settings using Geospatial and Social Web technologies

PubMed Central

2010-01-01

Background Extensive public health gains have benefited high-income countries in recent decades, however, citizens of low and middle-income countries (LMIC) have largely not enjoyed the same advancements. This is in part due to the fact that public health data - the foundation for public health advances - are rarely collected in many LMIC. Injury data are particularly scarce in many low-resource settings, despite the huge associated burden of morbidity and mortality. Advances in freely-accessible and easy-to-use information and communication (ICT) technology may provide the impetus for increased public health data collection in settings with limited financial and personnel resources. Methods and Results A pilot study was conducted at a hospital in Cape Town, South Africa to assess the utility and feasibility of using free (non-licensed), and easy-to-use Social Web and GeoWeb tools for injury surveillance in low-resource settings. Data entry, geocoding, data exploration, and data visualization were successfully conducted using these technologies, including Google Spreadsheet, Mapalist, BatchGeocode, and Google Earth. Conclusion This study examined the potential for Social Web and GeoWeb technologies to contribute to public health data collection and analysis in low-resource settings through an injury surveillance pilot study conducted in Cape Town, South Africa. The success of this study illustrates the great potential for these technologies to be leveraged for public health surveillance in resource-constrained environments, given their ease-of-use and low-cost, and the sharing and collaboration capabilities they afford. The possibilities and potential limitations of these technologies are discussed in relation to the study, and to the field of public health in general. PMID:20497570

Constrained binary classification using ensemble learning: an application to cost-efficient targeted PrEP strategies.

PubMed

Zheng, Wenjing; Balzer, Laura; van der Laan, Mark; Petersen, Maya

2018-01-30

Binary classification problems are ubiquitous in health and social sciences. In many cases, one wishes to balance two competing optimality considerations for a binary classifier. For instance, in resource-limited settings, an human immunodeficiency virus prevention program based on offering pre-exposure prophylaxis (PrEP) to select high-risk individuals must balance the sensitivity of the binary classifier in detecting future seroconverters (and hence offering them PrEP regimens) with the total number of PrEP regimens that is financially and logistically feasible for the program. In this article, we consider a general class of constrained binary classification problems wherein the objective function and the constraint are both monotonic with respect to a threshold. These include the minimization of the rate of positive predictions subject to a minimum sensitivity, the maximization of sensitivity subject to a maximum rate of positive predictions, and the Neyman-Pearson paradigm, which minimizes the type II error subject to an upper bound on the type I error. We propose an ensemble approach to these binary classification problems based on the Super Learner methodology. This approach linearly combines a user-supplied library of scoring algorithms, with combination weights and a discriminating threshold chosen to minimize the constrained optimality criterion. We then illustrate the application of the proposed classifier to develop an individualized PrEP targeting strategy in a resource-limited setting, with the goal of minimizing the number of PrEP offerings while achieving a minimum required sensitivity. This proof of concept data analysis uses baseline data from the ongoing Sustainable East Africa Research in Community Health study. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

The Role of the Global SOF Network in a Resource Constrained Environment

DTIC Science & Technology

2013-11-01

backed by actions. Step Two: Matching Skill Sets with Individuals: Who Needs to Know What? This step sounds simple enough in theory . You need to...Training Finally, step five is the recognition that, like physical training and condition- ing, cognitive skills need to be continuously refreshed. These...and maintaining the data needed , and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other

Rural-Nonrural Disparities in Postsecondary Educational Attainment Revisited

PubMed Central

Byun, Soo-yong; Meece, Judith L.; Irvin, Matthew J.

2013-01-01

Using data from the National Educational Longitudinal Study, this study revisited rural-nonrural disparities in educational attainment by considering a comprehensive set of factors that constrain and support youth's college enrollment and degree completion. Results showed that rural students were more advantaged in community social resources compared to nonrural students, and these resources were associated with a significant increase in the likelihood of bachelor's degree attainment. Yet results confirmed that rural students lagged behind nonrural students in attaining a bachelor's degree largely due to their lower socioeconomic background. The findings present a more comprehensive picture of the complexity of geographic residence in shaping college enrollment and degree attainment. PMID:24285873

A chance-constrained programming model to allocate wildfire initial attack resources for a fire season

Treesearch

Yu Wei; Michael Bevers; Erin Belval; Benjamin Bird

2015-01-01

This research developed a chance-constrained two-stage stochastic programming model to support wildfire initial attack resource acquisition and location on a planning unit for a fire season. Fire growth constraints account for the interaction between fire perimeter growth and construction to prevent overestimation of resource requirements. We used this model to examine...

Online Planning Algorithm

NASA Technical Reports Server (NTRS)

Rabideau, Gregg R.; Chien, Steve A.

2010-01-01

AVA v2 software selects goals for execution from a set of goals that oversubscribe shared resources. The term goal refers to a science or engineering request to execute a possibly complex command sequence, such as image targets or ground-station downlinks. Developed as an extension to the Virtual Machine Language (VML) execution system, the software enables onboard and remote goal triggering through the use of an embedded, dynamic goal set that can oversubscribe resources. From the set of conflicting goals, a subset must be chosen that maximizes a given quality metric, which in this case is strict priority selection. A goal can never be pre-empted by a lower priority goal, and high-level goals can be added, removed, or updated at any time, and the "best" goals will be selected for execution. The software addresses the issue of re-planning that must be performed in a short time frame by the embedded system where computational resources are constrained. In particular, the algorithm addresses problems with well-defined goal requests without temporal flexibility that oversubscribes available resources. By using a fast, incremental algorithm, goal selection can be postponed in a "just-in-time" fashion allowing requests to be changed or added at the last minute. Thereby enabling shorter response times and greater autonomy for the system under control.

Building sustainable organizational capacity to deliver HIV programs in resource-constrained settings: stakeholder perspectives.

PubMed

Sharma, Anjali; Chiliade, Philippe; Michael Reyes, E; Thomas, Kate K; Collens, Stephen R; Rafael Morales, José

2013-12-13

In 2008, the US government mandated that HIV/AIDS care and treatment programs funded by the US President's Emergency Plan for AIDS Relief (PEPFAR) should shift from US-based international partners (IPs) to registered locally owned organizations (local partners, or LPs). The US Health Resources and Services Administration (HRSA) developed the Clinical Assessment for Systems Strengthening (ClASS) framework for technical assistance in resource-constrained settings. The ClASS framework involves all stakeholders in the identification of LPs' strengths and needs for technical assistance. This article examines the role of ClASS in building capacity of LPs that can endure and adapt to changing financial and policy environments. All stakeholders (n=68) in Kenya, Zambia, and Nigeria who had participated in the ClASS from LPs and IPs, the US Centers for Disease Control and Prevention (CDC), and, in Nigeria, HIV/AIDS treatment facilities (TFs) were interviewed individually or in groups (n=42) using an open-ended interview guide. Thematic analysis revealed stakeholder perspectives on ClASS-initiated changes and their sustainability. Local organizations were motivated to make changes in internal operations with the ClASS approach, PEPFAR's competitive funding climate, organizational goals, and desired patient health outcomes. Local organizations drew on internal resources and, if needed, technical assistance from IPs. Reportedly, ClASS-initiated changes and remedial action plans made LPs more competitive for PEPFAR funding. LPs also attributed their successful funding applications to their preexisting systems and reputation. Bureaucracy, complex and competing tasks, and staff attrition impeded progress toward the desired changes. Although CDC continues to provide technical assistance through IPs, declining PEPFAR funds threaten the consolidation of gains, smooth program transition, and continuity of treatment services. The well-timed adaptation and implementation of ClASS successfully engaged stakeholders who committed their own resources toward strengthening organizational capacity. The sustainability of built capacity depends on continued investment in leadership, staff retention, and quality improvement.

Building sustainable organizational capacity to deliver HIV programs in resource-constrained settings: stakeholder perspectives

PubMed Central

Sharma, Anjali; Chiliade, Philippe; Reyes, E. Michael; Thomas, Kate K.; Collens, Stephen R.; Morales, José Rafael

2013-01-01

Background In 2008, the US government mandated that HIV/AIDS care and treatment programs funded by the US President's Emergency Plan for AIDS Relief (PEPFAR) should shift from US-based international partners (IPs) to registered locally owned organizations (local partners, or LPs). The US Health Resources and Services Administration (HRSA) developed the Clinical Assessment for Systems Strengthening (ClASS) framework for technical assistance in resource-constrained settings. The ClASS framework involves all stakeholders in the identification of LPs’ strengths and needs for technical assistance. Objective This article examines the role of ClASS in building capacity of LPs that can endure and adapt to changing financial and policy environments. Design All stakeholders (n=68) in Kenya, Zambia, and Nigeria who had participated in the ClASS from LPs and IPs, the US Centers for Disease Control and Prevention (CDC), and, in Nigeria, HIV/AIDS treatment facilities (TFs) were interviewed individually or in groups (n=42) using an open-ended interview guide. Thematic analysis revealed stakeholder perspectives on ClASS-initiated changes and their sustainability. Results Local organizations were motivated to make changes in internal operations with the ClASS approach, PEPFAR's competitive funding climate, organizational goals, and desired patient health outcomes. Local organizations drew on internal resources and, if needed, technical assistance from IPs. Reportedly, ClASS-initiated changes and remedial action plans made LPs more competitive for PEPFAR funding. LPs also attributed their successful funding applications to their preexisting systems and reputation. Bureaucracy, complex and competing tasks, and staff attrition impeded progress toward the desired changes. Although CDC continues to provide technical assistance through IPs, declining PEPFAR funds threaten the consolidation of gains, smooth program transition, and continuity of treatment services. Conclusions The well-timed adaptation and implementation of ClASS successfully engaged stakeholders who committed their own resources toward strengthening organizational capacity. The sustainability of built capacity depends on continued investment in leadership, staff retention, and quality improvement. PMID:24331715

The US Food and Drug Administration's tentative approval process and the global fight against HIV.

PubMed

Chahal, Harinder Singh; Murray, Jeffrey S; Shimer, Martin; Capella, Peter; Presto, Ryan; Valdez, Mary Lou; Lurie, Peter G

2017-12-01

In 2004, the US government began to utilize the Food and Drug Administration's (USFDA) tentative approval process (tFDA) as a basis to determine which HIV drugs are appropriate to be purchased and used in resource-constrained settings. This process permits products that are not approved for marketing in the US, including medicines with active patents or marketing restrictions in the US, to be purchased and distributed in resource-constrained settings. Although the tFDA was originally intended to support the United States' President's Emergency Plan for AIDS Relief (PEPFAR), the USFDA list has become a cornerstone of international HIV programmes that support procurement of ARVs, such as the World Health Organization and the Global Fund to Fight AIDS, Tuberculosis, and Malaria. Our objective in this article is to help the global HIV policy makers and implementers of HIV programmes better understand the benefits and limitations of the tFDA by providing an in-depth review of the relevant legal and regulatory processes. USFDA's dedicated tFDA process for ARVs used by the PEPFAR programme has a wide impact globally; however, the implementation and the regulatory processes governing the programme have not been thoroughly described in the medical literature. This paper seeks to help stakeholders better understand the legal and regulatory aspects associated with review of ARVs under the tFDA by describing the following: (1) the tFDA and its importance to global ARV procurement; (2) the regulatory pathways for applications under tFDA for the PEPFAR programme, including modifications to applications, review timelines and costs; (3) the role of US patents, US marketing exclusivity rights, and the Medicines Patents Pool in tFDA; and (4) an overview of how applications for PEPFAR programme are processed through the USFDA. We also provide a case study of a new ARV, tenofovir alafenamide fumarate (TAF), not yet reviewed by USFDA for PEPFAR use. In this paper, we describe the importance and implementation of USFDA's tentative approval process to review ARVs for resource-constrained settings. We also highlight the impact of patents and exclusivities on review of HIV drugs under tFDA and illustrate the concepts using a new HIV drug as an example. © 2017 The Authors. Journal of the International AIDS Society published by John Wiley & sons Ltd on behalf of the International AIDS Society.

Effect of resource constraints on intersimilar coupled networks.

PubMed

Shai, S; Dobson, S

2012-12-01

Most real-world networks do not live in isolation but are often coupled together within a larger system. Recent studies have shown that intersimilarity between coupled networks increases the connectivity of the overall system. However, unlike connected nodes in a single network, coupled nodes often share resources, like time, energy, and memory, which can impede flow processes through contention when intersimilarly coupled. We study a model of a constrained susceptible-infected-recovered (SIR) process on a system consisting of two random networks sharing the same set of nodes, where nodes are limited to interact with (and therefore infect) a maximum number of neighbors at each epidemic time step. We obtain that, in agreement with previous studies, when no limit exists (regular SIR model), positively correlated (intersimilar) coupling results in a lower epidemic threshold than negatively correlated (interdissimilar) coupling. However, in the case of the constrained SIR model, the obtained epidemic threshold is lower with negatively correlated coupling. The latter finding differentiates our work from previous studies and provides another step towards revealing the qualitative differences between single and coupled networks.

Effect of resource constraints on intersimilar coupled networks

NASA Astrophysics Data System (ADS)

Shai, S.; Dobson, S.

2012-12-01

Most real-world networks do not live in isolation but are often coupled together within a larger system. Recent studies have shown that intersimilarity between coupled networks increases the connectivity of the overall system. However, unlike connected nodes in a single network, coupled nodes often share resources, like time, energy, and memory, which can impede flow processes through contention when intersimilarly coupled. We study a model of a constrained susceptible-infected-recovered (SIR) process on a system consisting of two random networks sharing the same set of nodes, where nodes are limited to interact with (and therefore infect) a maximum number of neighbors at each epidemic time step. We obtain that, in agreement with previous studies, when no limit exists (regular SIR model), positively correlated (intersimilar) coupling results in a lower epidemic threshold than negatively correlated (interdissimilar) coupling. However, in the case of the constrained SIR model, the obtained epidemic threshold is lower with negatively correlated coupling. The latter finding differentiates our work from previous studies and provides another step towards revealing the qualitative differences between single and coupled networks.

Mobile technology in clinical teaching.

PubMed

Mackay, B J; Anderson, J; Harding, T

2017-01-01

Technology is having a profound effect on education in the 21st century and nurse educators are being challenged to integrate technological innovation to assist students in their learning. This paper reports a study on the introduction of smart mobile technology to support student learning in the clinical environment. In a climate of collaborative inquiry, clinical lecturers and two researchers from the same department carried out a project in three phases: formation, implementation and analysis. Following the formation phase, six clinical lecturers adopted iPads to support their clinical teaching (implementation phase). At this time they also kept reflective journals. In the analysis phase a thematic analysis of the data from the journals and from a focus group found both enabling and constraining factors influenced the use of iPads by clinical lecturers. The themes categorised as enablers were: resources and technology; and, management and technology support. Those identified as barriers or constraining factors were: clinical staff engagement; and lecturer experience with technology. Student engagement and learning, and connectivity were both enabling and constraining factors. This paper concludes that the use of a mobile device such as an iPad can enhance teaching in clinical settings but that in order for such devices to be successfully integrated into clinical teaching consideration needs to be given to professional development needs, adequate resourcing and technology support. Copyright © 2016 Elsevier Ltd. All rights reserved.

'Constrained collaboration': Patient empowerment discourse as resource for countervailing power.

PubMed

Vinson, Alexandra H

2016-11-01

Countervailing powers constrain the authority and autonomy of the medical profession. One countervailing power is patient consumerism, a movement with roots in health social movements. Patient empowerment discourses that emerge from health social movements suggest that active patienthood is a normative good, and that patients should inform themselves, claim their expertise, and participate in their care. Yet, little is known about how patient empowerment is understood by physicians. Drawing on ethnographic fieldwork in an American medical school, this article examines how physicians teach medical students to carry out patient encounters while adhering to American cultural expectations of a collaborative physician-patient relationship. Overt medical paternalism is characterised by professors as 'here's the orders' paternalism, and shown to be counterproductive to 'closing the deal' - achieving patient agreement to a course of treatment. To explain how physicians accomplish their therapeutic goals without violating cultural mandates of patient empowerment I develop the concept of 'constrained collaboration'. This analysis of constrained collaboration contrasts with structural-level narratives of diminishing professional authority and contributes to a theory of the micro-level reproduction of medical authority as a set of interactional practices. © 2016 Foundation for the Sociology of Health & Illness.

Barriers and facilitators to Electronic Medical Record (EMR) use in an urban slum.

PubMed

Jawhari, Badeia; Keenan, Louanne; Zakus, David; Ludwick, Dave; Isaac, Abraam; Saleh, Abdullah; Hayward, Robert

2016-10-01

Rapid urbanization has led to the growth of urban slums and increased healthcare burdens for vulnerable populations. Electronic Medical Records (EMRs) have the potential to improve continuity of care for slum residents, but their implementation is complicated by technical and non-technical limitations. This study sought practical insights about facilitators and barriers to EMR implementation in urban slum environments. Descriptive qualitative method was used to explore staff perceptions about a recent open-source EMR deployment in two primary care clinics in Kibera, Nairobi. Participants were interviewed using open-ended, semi-structured questions. Content analysis was used when exploring transcribed data. Three major themes - systems, software, and social considerations - emerged from content analysis, with sustainability concerns prevailing. Although participants reported many systems (e.g., power, network, Internet, hardware, interoperability) and software (e.g., data integrity, confidentiality, function) challenges, social factors (e.g., identity management, training, use incentives) appeared the most important impediments to sustainability. These findings are consistent with what others have reported, especially the importance of practical barriers to EMR deployments in resource-constrained settings. Other findings contribute unique insights about social determinants of EMR impact in slum settings, including the challenge of multiple-identity management and development of meaningful incentives to staff compliance. This study exposes front-line experiences with opportunities and shortcomings of EMR implementations in urban slum primary care clinics. Although the promise is great, there are a number of unique system, software and social challenges that EMR advocates should address before expecting sustainable EMR use in resource-constrained settings. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Are endemics functionally distinct? Leaf traits of native and exotic woody species in a New Zealand forest.

PubMed

Heberling, J Mason; Mason, Norman W H

2018-01-01

Recent studies have concluded that native and invasive species share a common set of trait relationships. However, native species in isolated regions might be functionally constrained by their unique evolutionary histories such that they follow different carbon capture strategies than introduced species. We compared leaf traits relating to resource investment, carbon return, and resource-use efficiency in 16 native (endemic) and three non-native (invasive) species in a temperate forest in Canterbury, South Island, New Zealand. Trait differences were more closely associated with leaf habit than nativity. Deciduous species (including invaders) exhibited greater maximum photosynthetic rates at similar resource costs, which resulted in greater nitrogen- and energy-use efficiencies than evergreen natives. Leaf area was the only trait that differed significantly by nativity (over two-fold larger in invaders). Invaders and deciduous natives both occupied the 'fast return' end of the leaf economics spectrum in contrast to the native evergreens which had comparatively slow return on investment. Dominant woody invaders in this forest are physiologically distinct from many New Zealand endemic species, which are overwhelmingly evergreen. It remains unclear whether these trait differences translate to an ecological divergence in plant strategy, but these results suggest that ecophysiological tradeoffs are likely constrained by biogeography.

Resource-aware taxon selection for maximizing phylogenetic diversity.

PubMed

Pardi, Fabio; Goldman, Nick

2007-06-01

Phylogenetic diversity (PD) is a useful metric for selecting taxa in a range of biological applications, for example, bioconservation and genomics, where the selection is usually constrained by the limited availability of resources. We formalize taxon selection as a conceptually simple optimization problem, aiming to maximize PD subject to resource constraints. This allows us to take into account the different amounts of resources required by the different taxa. Although this is a computationally difficult problem, we present a dynamic programming algorithm that solves it in pseudo-polynomial time. Our algorithm can also solve many instances of the Noah's Ark Problem, a more realistic formulation of taxon selection for biodiversity conservation that allows for taxon-specific extinction risks. These instances extend the set of problems for which solutions are available beyond previously known greedy-tractable cases. Finally, we discuss the relevance of our results to real-life scenarios.

Context- and Template-Based Compression for Efficient Management of Data Models in Resource-Constrained Systems.

PubMed

Macho, Jorge Berzosa; Montón, Luis Gardeazabal; Rodriguez, Roberto Cortiñas

2017-08-01

The Cyber Physical Systems (CPS) paradigm is based on the deployment of interconnected heterogeneous devices and systems, so interoperability is at the heart of any CPS architecture design. In this sense, the adoption of standard and generic data formats for data representation and communication, e.g., XML or JSON, effectively addresses the interoperability problem among heterogeneous systems. Nevertheless, the verbosity of those standard data formats usually demands system resources that might suppose an overload for the resource-constrained devices that are typically deployed in CPS. In this work we present Context- and Template-based Compression (CTC), a data compression approach targeted to resource-constrained devices, which allows reducing the resources needed to transmit, store and process data models. Additionally, we provide a benchmark evaluation and comparison with current implementations of the Efficient XML Interchange (EXI) processor, which is promoted by the World Wide Web Consortium (W3C), and it is the most prominent XML compression mechanism nowadays. Interestingly, the results from the evaluation show that CTC outperforms EXI implementations in terms of memory usage and speed, keeping similar compression rates. As a conclusion, CTC is shown to be a good candidate for managing standard data model representation formats in CPS composed of resource-constrained devices.

Context- and Template-Based Compression for Efficient Management of Data Models in Resource-Constrained Systems

PubMed Central

Montón, Luis Gardeazabal

2017-01-01

The Cyber Physical Systems (CPS) paradigm is based on the deployment of interconnected heterogeneous devices and systems, so interoperability is at the heart of any CPS architecture design. In this sense, the adoption of standard and generic data formats for data representation and communication, e.g., XML or JSON, effectively addresses the interoperability problem among heterogeneous systems. Nevertheless, the verbosity of those standard data formats usually demands system resources that might suppose an overload for the resource-constrained devices that are typically deployed in CPS. In this work we present Context- and Template-based Compression (CTC), a data compression approach targeted to resource-constrained devices, which allows reducing the resources needed to transmit, store and process data models. Additionally, we provide a benchmark evaluation and comparison with current implementations of the Efficient XML Interchange (EXI) processor, which is promoted by the World Wide Web Consortium (W3C), and it is the most prominent XML compression mechanism nowadays. Interestingly, the results from the evaluation show that CTC outperforms EXI implementations in terms of memory usage and speed, keeping similar compression rates. As a conclusion, CTC is shown to be a good candidate for managing standard data model representation formats in CPS composed of resource-constrained devices. PMID:28763013

Exponential Arithmetic Based Self-Healing Group Key Distribution Scheme with Backward Secrecy under the Resource-Constrained Wireless Networks

PubMed Central

Guo, Hua; Zheng, Yandong; Zhang, Xiyong; Li, Zhoujun

2016-01-01

In resource-constrained wireless networks, resources such as storage space and communication bandwidth are limited. To guarantee secure communication in resource-constrained wireless networks, group keys should be distributed to users. The self-healing group key distribution (SGKD) scheme is a promising cryptographic tool, which can be used to distribute and update the group key for the secure group communication over unreliable wireless networks. Among all known SGKD schemes, exponential arithmetic based SGKD (E-SGKD) schemes reduce the storage overhead to constant, thus is suitable for the the resource-constrained wireless networks. In this paper, we provide a new mechanism to achieve E-SGKD schemes with backward secrecy. We first propose a basic E-SGKD scheme based on a known polynomial-based SGKD, where it has optimal storage overhead while having no backward secrecy. To obtain the backward secrecy and reduce the communication overhead, we introduce a novel approach for message broadcasting and self-healing. Compared with other E-SGKD schemes, our new E-SGKD scheme has the optimal storage overhead, high communication efficiency and satisfactory security. The simulation results in Zigbee-based networks show that the proposed scheme is suitable for the resource-restrained wireless networks. Finally, we show the application of our proposed scheme. PMID:27136550

Using a geographic information system to enhance patient access to point-of-care diagnostics in a limited-resource setting.

PubMed

Ferguson, William J; Kemp, Karen; Kost, Gerald

2016-03-01

Rapid and accurate diagnosis drives evidence-based care in health. Point-of-care testing (POCT) aids diagnosis by bringing advanced technologies closer to patients. Health small-world networks are constrained by natural connectivity in the interactions between geography of resources and social forces. Using a geographic information system (GIS) we can understand how populations utilize their health networks, visualize their inefficiencies, and compare alternatives. This project focuses on cardiac care resource in rural Isaan, Thailand. A health care access analysis was created using ArcGIS Network Analyst 10.1 from data representing aggregated population, roads, health resource facilities, and diagnostic technologies. The analysis quantified cardiac health care access and identified ways to improve it using both widespread and resource-limited strategies. Results indicated that having diagnostic technologies closer to populations streamlines critical care paths. GIS allowed us to compare the effectiveness of the implementation strategies and put into perspective the benefits of adopting rapid POCT within health networks. Geospatial analyses derive high impact by improving alternative diagnostic placement strategies in limited-resource settings and by revealing deficiencies in health care access pathways. Additionally, the GIS provides a platform for comparing relative costs, assessing benefits, and improving outcomes. This approach can be implemented effectively by health ministries seeking to enhance cardiac care despite limited resources.

Prioritizing CD4 Count Monitoring in Response to ART in Resource-Constrained Settings: A Retrospective Application of Prediction-Based Classification

PubMed Central

Liu, Yan; Li, Xiaohong; Johnson, Margaret; Smith, Collette; Kamarulzaman, Adeeba bte; Montaner, Julio; Mounzer, Karam; Saag, Michael; Cahn, Pedro; Cesar, Carina; Krolewiecki, Alejandro; Sanne, Ian; Montaner, Luis J.

2012-01-01

Background Global programs of anti-HIV treatment depend on sustained laboratory capacity to assess treatment initiation thresholds and treatment response over time. Currently, there is no valid alternative to CD4 count testing for monitoring immunologic responses to treatment, but laboratory cost and capacity limit access to CD4 testing in resource-constrained settings. Thus, methods to prioritize patients for CD4 count testing could improve treatment monitoring by optimizing resource allocation. Methods and Findings Using a prospective cohort of HIV-infected patients (n = 1,956) monitored upon antiretroviral therapy initiation in seven clinical sites with distinct geographical and socio-economic settings, we retrospectively apply a novel prediction-based classification (PBC) modeling method. The model uses repeatedly measured biomarkers (white blood cell count and lymphocyte percent) to predict CD4+ T cell outcome through first-stage modeling and subsequent classification based on clinically relevant thresholds (CD4+ T cell count of 200 or 350 cells/µl). The algorithm correctly classified 90% (cross-validation estimate = 91.5%, standard deviation [SD] = 4.5%) of CD4 count measurements <200 cells/µl in the first year of follow-up; if laboratory testing is applied only to patients predicted to be below the 200-cells/µl threshold, we estimate a potential savings of 54.3% (SD = 4.2%) in CD4 testing capacity. A capacity savings of 34% (SD = 3.9%) is predicted using a CD4 threshold of 350 cells/µl. Similar results were obtained over the 3 y of follow-up available (n = 619). Limitations include a need for future economic healthcare outcome analysis, a need for assessment of extensibility beyond the 3-y observation time, and the need to assign a false positive threshold. Conclusions Our results support the use of PBC modeling as a triage point at the laboratory, lessening the need for laboratory-based CD4+ T cell count testing; implementation of this tool could help optimize the use of laboratory resources, directing CD4 testing towards higher-risk patients. However, further prospective studies and economic analyses are needed to demonstrate that the PBC model can be effectively applied in clinical settings. Please see later in the article for the Editors' Summary PMID:22529752

Symbol-string sensitivity and children's reading.

PubMed

Pammer, Kristen; Lavis, Ruth; Hansen, Peter; Cornelissen, Piers L

2004-06-01

In this study of primary school children, a novel 'symbol-string' task is used to assess sensitivity to the position of briefly presented non-alphabetic but letter-like symbols. The results demonstrate that sensitivity in the symbol-string task explains a unique proportion of the variability in children's contextual reading accuracy. Moreover, developmental dyslexic readers show reduced sensitivity in this task, compared to chronological age controls. The results suggest that limitations set by visuo-spatial processes and/or attentional iconic memory resources may constrain children's reading accuracy.

Support for Resource Constrained Microcontroller Programming by a Broad Developer Community

ERIC Educational Resources Information Center

Amar, Amichi

2010-01-01

Resource constrained microcontrollers with as little as several hundred bytes of RAM and a few dozen megahertz of processing power are the most prevalent computing devices on earth. Microcontrollers and the many application components that interface to them, such as sensors, actuators, transceivers and displays are now cheap and readily available.…

Common mental disorders among women, social circumstances and toddler growth in rural Vietnam: a population-based prospective study.

PubMed

Fisher, J; Tran, T; Nguyen, T T; Nguyen, H; Tran, T D

2015-11-01

Common mental disorders (CMD) and adverse social circumstances are widespread among mothers of infants and toddlers in resource-constrained settings. These can undermine early childhood development through compromised caregiving and insufficient access to essential resources. The aim was to examine the effect of maternal CMD and social adversity in the post-partum year on toddler's length-for-age index in a rural low-income setting. A population-based prospective cohort study of women in Ha Nam province, Vietnam who completed baseline assessments in either late pregnancy or 4-6 weeks post partum and were followed up, with their toddlers, 15 months later. CMD were assessed at both points by psychiatrist-administered Structured Clinical Interviews for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Diagnoses. Anthropometric indices were calculated from toddler's age, sex, weight and length using World Health Organization Child Growth Standards. Social adversities were assessed by study-specific questions and locally validated psychometric instruments. The hypothesized model of factors governing toddler's length-for-age Z score (LAZ) was tested using path analysis. In total, 211/234 (90.1%) mother-toddler pairs provided complete data. Baseline prevalence of CMD among women was 33.6% and follow-up was 18.5%. The mean LAZ among toddlers was -1.03 and stunting prevalence (LAZ < -2) was 15.6%. Maternal CMD at baseline were indirectly related to toddler LAZ via maternal CMD at follow-up (regression coefficient = -0.05, 95% CI -0.11 to -0.01). Maternal CMD at follow-up was associated significantly with toddler LAZ (regression coefficient = -0.15, 95% CI -0.28 to -0.05). Poorer quality of marital relationship, mothers' experiences of childhood abuse and <30 days dedicated post-partum care were associated indirectly with lower toddler LAZ via maternal CMD. Maternal post-natal CMD are associated with child growth measured by LAZ in this resource-constrained setting. Social adversities affect child growth indirectly through increasing the risk of maternal CMD. Interventions to reduce stunting in low-income settings may need to address maternal CMD and social adversities in order to improve impact. © 2015 John Wiley & Sons Ltd.

Integration of E-education and Knowledge Management

NASA Astrophysics Data System (ADS)

Wan, Liyong; Zhao, Chengling; Guo, Wei

With the realization that knowledge is a core resource, organizations are now attempting to manage knowledge in a more systematic and more effective way. However, managing knowledge is not always an easy task. In particular contexts, such as online e-education, knowledge is distributed across both time and space and may be constrained by social, cultural and language differences. This paper demonstrated the common characters of knowledge management and e-education, and proposed the current potential problems in e-education. The authors tried to develop a set of guidelines to help overcome problems using tools and techniques from KM, they proposed three strategies: corporate explicit knowledge and tacit knowledge; use the theory of KM to guide e-education resource management; use the theory of KM to guide e-education resource management. These strategies will help us to develop a better e-education framework.

A strategy to implement and support pre-hospital emergency medical systems in developing, resource-constrained areas of South Africa.

PubMed

Sun, Jared H; Shing, Rachel; Twomey, Michele; Wallis, Lee A

2014-01-01

Resource-constrained countries are in extreme need of pre-hospital emergency care systems. However, current popular strategies to provide pre-hospital emergency care are inappropriate for and beyond the means of a resource-constrained country, and so new ones are needed-ones that can both function in an under-developed area's particular context and be done with the area's limited resources. In this study, we used a two-location pilot and consensus approach to develop a strategy to implement and support pre-hospital emergency care in one such developing, resource-constrained area: the Western Cape province of South Africa. Local community members are trained to be emergency first aid responders who can provide immediate, on-scene care until a Transporter can take the patient to the hospital. Management of the system is done through local Community Based Organizations, which can adapt the model to their communities as needed to ensure local appropriateness and feasibility. Within a community, the system is implemented in a graduated manner based on available resources, and is designed to not rely on the whole system being implemented first to provide partial function. The University of Cape Town's Division of Emergency Medicine and the Western Cape's provincial METRO EMS intend to follow this model, along with sharing it with other South African provinces. Copyright © 2012 Elsevier Ltd. All rights reserved.

Butterfly Encryption Scheme for Resource-Constrained Wireless Networks †

PubMed Central

Sampangi, Raghav V.; Sampalli, Srinivas

2015-01-01

Resource-constrained wireless networks are emerging networks such as Radio Frequency Identification (RFID) and Wireless Body Area Networks (WBAN) that might have restrictions on the available resources and the computations that can be performed. These emerging technologies are increasing in popularity, particularly in defence, anti-counterfeiting, logistics and medical applications, and in consumer applications with growing popularity of the Internet of Things. With communication over wireless channels, it is essential to focus attention on securing data. In this paper, we present an encryption scheme called Butterfly encryption scheme. We first discuss a seed update mechanism for pseudorandom number generators (PRNG), and employ this technique to generate keys and authentication parameters for resource-constrained wireless networks. Our scheme is lightweight, as in it requires less resource when implemented and offers high security through increased unpredictability, owing to continuously changing parameters. Our work focuses on accomplishing high security through simplicity and reuse. We evaluate our encryption scheme using simulation, key similarity assessment, key sequence randomness assessment, protocol analysis and security analysis. PMID:26389899

Butterfly Encryption Scheme for Resource-Constrained Wireless Networks.

PubMed

Sampangi, Raghav V; Sampalli, Srinivas

2015-09-15

Resource-constrained wireless networks are emerging networks such as Radio Frequency Identification (RFID) and Wireless Body Area Networks (WBAN) that might have restrictions on the available resources and the computations that can be performed. These emerging technologies are increasing in popularity, particularly in defence, anti-counterfeiting, logistics and medical applications, and in consumer applications with growing popularity of the Internet of Things. With communication over wireless channels, it is essential to focus attention on securing data. In this paper, we present an encryption scheme called Butterfly encryption scheme. We first discuss a seed update mechanism for pseudorandom number generators (PRNG), and employ this technique to generate keys and authentication parameters for resource-constrained wireless networks. Our scheme is lightweight, as in it requires less resource when implemented and offers high security through increased unpredictability, owing to continuously changing parameters. Our work focuses on accomplishing high security through simplicity and reuse. We evaluate our encryption scheme using simulation, key similarity assessment, key sequence randomness assessment, protocol analysis and security analysis.

LiteNet: Lightweight Neural Network for Detecting Arrhythmias at Resource-Constrained Mobile Devices.

PubMed

He, Ziyang; Zhang, Xiaoqing; Cao, Yangjie; Liu, Zhi; Zhang, Bo; Wang, Xiaoyan

2018-04-17

By running applications and services closer to the user, edge processing provides many advantages, such as short response time and reduced network traffic. Deep-learning based algorithms provide significantly better performances than traditional algorithms in many fields but demand more resources, such as higher computational power and more memory. Hence, designing deep learning algorithms that are more suitable for resource-constrained mobile devices is vital. In this paper, we build a lightweight neural network, termed LiteNet which uses a deep learning algorithm design to diagnose arrhythmias, as an example to show how we design deep learning schemes for resource-constrained mobile devices. Compare to other deep learning models with an equivalent accuracy, LiteNet has several advantages. It requires less memory, incurs lower computational cost, and is more feasible for deployment on resource-constrained mobile devices. It can be trained faster than other neural network algorithms and requires less communication across different processing units during distributed training. It uses filters of heterogeneous size in a convolutional layer, which contributes to the generation of various feature maps. The algorithm was tested using the MIT-BIH electrocardiogram (ECG) arrhythmia database; the results showed that LiteNet outperforms comparable schemes in diagnosing arrhythmias, and in its feasibility for use at the mobile devices.

LiteNet: Lightweight Neural Network for Detecting Arrhythmias at Resource-Constrained Mobile Devices

PubMed Central

Zhang, Xiaoqing; Cao, Yangjie; Liu, Zhi; Zhang, Bo; Wang, Xiaoyan

2018-01-01

By running applications and services closer to the user, edge processing provides many advantages, such as short response time and reduced network traffic. Deep-learning based algorithms provide significantly better performances than traditional algorithms in many fields but demand more resources, such as higher computational power and more memory. Hence, designing deep learning algorithms that are more suitable for resource-constrained mobile devices is vital. In this paper, we build a lightweight neural network, termed LiteNet which uses a deep learning algorithm design to diagnose arrhythmias, as an example to show how we design deep learning schemes for resource-constrained mobile devices. Compare to other deep learning models with an equivalent accuracy, LiteNet has several advantages. It requires less memory, incurs lower computational cost, and is more feasible for deployment on resource-constrained mobile devices. It can be trained faster than other neural network algorithms and requires less communication across different processing units during distributed training. It uses filters of heterogeneous size in a convolutional layer, which contributes to the generation of various feature maps. The algorithm was tested using the MIT-BIH electrocardiogram (ECG) arrhythmia database; the results showed that LiteNet outperforms comparable schemes in diagnosing arrhythmias, and in its feasibility for use at the mobile devices. PMID:29673171

Multiobjective genetic algorithm conjunctive use optimization for production, cost, and energy with dynamic return flow

NASA Astrophysics Data System (ADS)

Peralta, Richard C.; Forghani, Ali; Fayad, Hala

2014-04-01

Many real water resources optimization problems involve conflicting objectives for which the main goal is to find a set of optimal solutions on, or near to the Pareto front. E-constraint and weighting multiobjective optimization techniques have shortcomings, especially as the number of objectives increases. Multiobjective Genetic Algorithms (MGA) have been previously proposed to overcome these difficulties. Here, an MGA derives a set of optimal solutions for multiobjective multiuser conjunctive use of reservoir, stream, and (un)confined groundwater resources. The proposed methodology is applied to a hydraulically and economically nonlinear system in which all significant flows, including stream-aquifer-reservoir-diversion-return flow interactions, are simulated and optimized simultaneously for multiple periods. Neural networks represent constrained state variables. The addressed objectives that can be optimized simultaneously in the coupled simulation-optimization model are: (1) maximizing water provided from sources, (2) maximizing hydropower production, and (3) minimizing operation costs of transporting water from sources to destinations. Results show the efficiency of multiobjective genetic algorithms for generating Pareto optimal sets for complex nonlinear multiobjective optimization problems.

Tackling the climate targets set by the Paris Agreement (COP 21): Green leadership empowers public hospitals to overcome obstacles and challenges in a resource-constrained environment.

PubMed

Weimann, E; Patel, B

2016-12-21

The healthcare sector itself contributes to climate change, the creation of hazardous waste, use of toxic metals such as mercury, and water and air pollution. To mitigate the effect of healthcare provision on the deteriorating environment and avoid creating further challenges for already burdened health systems, Global Green Hospitals was formed as a global network. Groote Schuur Hospital (GSH), as the leading academic hospital in Africa, joined the network in 2014. Since then, several projects have been initiated to reduce the amount of general waste, energy consumption and food waste, and create an environmentally friendlier and more sustainable hospital in a resource-constrained public healthcare setting. We outline the various efforts made to reduce the carbon footprint of GSH and reduce waste and hazardous substances such as mercury and polystyrene, and elaborate how obstacles and resistance to change were overcome. The hospital was able to halve the amount of coal and water used, increase recycling by 50% over 6 months, replace polystyrene cups and packaging with Forest Stewardship Council recyclable paper-based products, reduce the effect of food wastage by making use of local farmers, and implement measures to reduce the amount of expired pharmaceutical drugs. To improve commitment from all involved roleplayers, political leadership, supportive government policies and financial funding is mandatory, or public hospitals will be unable to tackle the exponentially increasing costs related to climate change and its effects on healthcare.

Establishing a regulatory value chain model: An innovative approach to strengthening medicines regulatory systems in resource-constrained settings.

PubMed

Chahal, Harinder Singh; Kashfipour, Farrah; Susko, Matt; Feachem, Neelam Sekhri; Boyle, Colin

2016-05-01

Medicines Regulatory Authorities (MRAs) are an essential part of national health systems and are charged with protecting and promoting public health through regulation of medicines. However, MRAs in resource-constrained settings often struggle to provide effective oversight of market entry and use of health commodities. This paper proposes a regulatory value chain model (RVCM) that policymakers and regulators can use as a conceptual framework to guide investments aimed at strengthening regulatory systems. The RVCM incorporates nine core functions of MRAs into five modules: (i) clear guidelines and requirements; (ii) control of clinical trials; (iii) market authorization of medical products; (iv) pre-market quality control; and (v) post-market activities. Application of the RVCM allows national stakeholders to identify and prioritize investments according to where they can add the most value to the regulatory process. Depending on the economy, capacity, and needs of a country, some functions can be elevated to a regional or supranational level, while others can be maintained at the national level. In contrast to a "one size fits all" approach to regulation in which each country manages the full regulatory process at the national level, the RVCM encourages leveraging the expertise and capabilities of other MRAs where shared processes strengthen regulation. This value chain approach provides a framework for policymakers to maximize investment impact while striving to reach the goal of safe, affordable, and rapidly accessible medicines for all.

Correlates of birth asphyxia using two Apgar score classification methods.

PubMed

Olusanya, Bolajoko O; Solanke, Olumuyiwa A

2010-01-01

Birth asphyxia is commonly indexed by low five-minute Apgar scores especially in resource-constrained settings but the impact of different classification thresholds on the associated risk factors has not been reported. To determine the potential impact of two classification methods of five-minute Apgar score as predictor for birth asphyxia. A cross-sectional study of preterm and term survivors in Lagos, Nigeria in which antepartum and intrapartum factors associated with "very low" (0-3) or "intermediate" (4-6) five-minute Apgar scores were compared with correlates of low five-minute Apgar scores (0-6) based on multinomial and binary logistic regression analyses. Of the 4281 mother-infant pairs enrolled, 3377 (78.9%) were full-term and 904 (21.1%) preterm. Apgar scores were very low in 99 (2.3%) and intermediate in 1115 (26.0%). Antenatal care, premature rupture of membranes (PROM), hypertensive disorders and mode of delivery were associated with very low and intermediate Apgar scores in all infants. Additionally, parity, antepartum haemorrhage and prolonged/obstructed labour (PROL) were predictive in term infants compared with maternal occupation and intrauterine growth restriction (IUGR) in preterm infants. Conversely, PROM in term infants and maternal occupation in preterm infants were not significantly associated with the composite low Apgar scores (0-6) while IUGR was associated with term infants. Predictors of birth asphyxia in preterm and term infants are likely to be affected by the Apgar score classification method adopted and the clinical implications for optimal resuscitation practices merit attention in resource-constrained settings.

The power of data mining in diagnosis of childhood pneumonia.

PubMed

Naydenova, Elina; Tsanas, Athanasios; Howie, Stephen; Casals-Pascual, Climent; De Vos, Maarten

2016-07-01

Childhood pneumonia is the leading cause of death of children under the age of 5 years globally. Diagnostic information on the presence of infection, severity and aetiology (bacterial versus viral) is crucial for appropriate treatment. However, the derivation of such information requires advanced equipment (such as X-rays) and clinical expertise to correctly assess observational clinical signs (such as chest indrawing); both of these are often unavailable in resource-constrained settings. In this study, these challenges were addressed through the development of a suite of data mining tools, facilitating automated diagnosis through quantifiable features. Findings were validated on a large dataset comprising 780 children diagnosed with pneumonia and 801 age-matched healthy controls. Pneumonia was identified via four quantifiable vital signs (98.2% sensitivity and 97.6% specificity). Moreover, it was shown that severity can be determined through a combination of three vital signs and two lung sounds (72.4% sensitivity and 82.2% specificity); addition of a conventional biomarker (C-reactive protein) further improved severity predictions (89.1% sensitivity and 81.3% specificity). Finally, we demonstrated that aetiology can be determined using three vital signs and a newly proposed biomarker (lipocalin-2) (81.8% sensitivity and 90.6% specificity). These results suggest that a suite of carefully designed machine learning tools can be used to support multi-faceted diagnosis of childhood pneumonia in resource-constrained settings, compensating for the shortage of expensive equipment and highly trained clinicians. © 2016 The Authors.

Improving the Performance of Highly Constrained Water Resource Systems using Multiobjective Evolutionary Algorithms and RiverWare

NASA Astrophysics Data System (ADS)

Smith, R.; Kasprzyk, J. R.; Zagona, E. A.

2015-12-01

Instead of building new infrastructure to increase their supply reliability, water resource managers are often tasked with better management of current systems. The managers often have existing simulation models that aid their planning, and lack methods for efficiently generating and evaluating planning alternatives. This presentation discusses how multiobjective evolutionary algorithm (MOEA) decision support can be used with the sophisticated water infrastructure model, RiverWare, in highly constrained water planning environments. We first discuss a study that performed a many-objective tradeoff analysis of water supply in the Tarrant Regional Water District (TRWD) in Texas. RiverWare is combined with the Borg MOEA to solve a seven objective problem that includes systemwide performance objectives and individual reservoir storage reliability. Decisions within the formulation balance supply in multiple reservoirs and control pumping between the eastern and western parts of the system. The RiverWare simulation model is forced by two stochastic hydrology scenarios to inform how management changes in wet versus dry conditions. The second part of the presentation suggests how a broader set of RiverWare-MOEA studies can inform tradeoffs in other systems, especially in political situations where multiple actors are in conflict over finite water resources. By incorporating quantitative representations of diverse parties' objectives during the search for solutions, MOEAs may provide support for negotiations and lead to more widely beneficial water management outcomes.

Improving Service Management in the Internet of Things

PubMed Central

Sammarco, Chiara; Iera, Antonio

2012-01-01

In the Internet of Things (IoT) research arena, many efforts are devoted to adapt the existing IP standards to emerging IoT nodes. This is the direction followed by three Internet Engineering Task Force (IETF) Working Groups, which paved the way for research on IP-based constrained networks. Through a simplification of the whole TCP/IP stack, resource constrained nodes become direct interlocutors of application level entities in every point of the network. In this paper we analyze some side effects of this solution, when in the presence of large amounts of data to transmit. In particular, we conduct a performance analysis of the Constrained Application Protocol (CoAP), a widely accepted web transfer protocol for the Internet of Things, and propose a service management enhancement that improves the exploitation of the network and node resources. This is specifically thought for constrained nodes in the abovementioned conditions and proves to be able to significantly improve the node energetic performance when in the presence of large resource representations (hence, large data transmissions).

Assessing the Readiness of Nursing Sectors in Low- and Middle-Income Countries to Adopt Holistic Practice: Rwanda as Exemplar.

PubMed

Rosa, William

Over the past several years, holistic nursing education has become more readily available to nurses working in high-income nations, and holistic practice has become better defined and promoted through countless organizational and governmental initiatives. However, global nursing community members, particularly those serving in low- and middle-income countries (LMICs) within resource-constrained health care systems, may not find holistic nursing easily accessible or applicable to practice. The purpose of this article is to assess the readiness of nursing sectors within these resource-constrained settings to access, understand, and apply holistic nursing principles and practices within the context of cultural norms, diverse definitions of the nursing role, and the current status of health care in these countries. The history, current status, and projected national goals of professional nursing in Rwanda is used as an exemplar to forward the discussion regarding the readiness of nurses to adopt holistic education into practice in LMICs. A background of holistic nursing practice in the United States is provided to illustrate the multifaceted aspects of support necessary in order that such a specialty continues to evolve and thrive within health care arenas and the communities it cares for.

A greedy algorithm for species selection in dimension reduction of combustion chemistry

NASA Astrophysics Data System (ADS)

Hiremath, Varun; Ren, Zhuyin; Pope, Stephen B.

2010-09-01

Computational calculations of combustion problems involving large numbers of species and reactions with a detailed description of the chemistry can be very expensive. Numerous dimension reduction techniques have been developed in the past to reduce the computational cost. In this paper, we consider the rate controlled constrained-equilibrium (RCCE) dimension reduction method, in which a set of constrained species is specified. For a given number of constrained species, the 'optimal' set of constrained species is that which minimizes the dimension reduction error. The direct determination of the optimal set is computationally infeasible, and instead we present a greedy algorithm which aims at determining a 'good' set of constrained species; that is, one leading to near-minimal dimension reduction error. The partially-stirred reactor (PaSR) involving methane premixed combustion with chemistry described by the GRI-Mech 1.2 mechanism containing 31 species is used to test the algorithm. Results on dimension reduction errors for different sets of constrained species are presented to assess the effectiveness of the greedy algorithm. It is shown that the first four constrained species selected using the proposed greedy algorithm produce lower dimension reduction error than constraints on the major species: CH4, O2, CO2 and H2O. It is also shown that the first ten constrained species selected using the proposed greedy algorithm produce a non-increasing dimension reduction error with every additional constrained species; and produce the lowest dimension reduction error in many cases tested over a wide range of equivalence ratios, pressures and initial temperatures.

Giant fibrosarcoma prostuberans of abodominal wall: management problems in resources-constrained country.

PubMed

Chukwuanukwu, T O G; Anyanwu, S N C

2009-09-01

Abdominal wall sarcomas represent less than 1% of adult malignancies. Dermatofibrosarcoma protuberans can grow to very large sizes and the recommended resection 2-3 cm from the macroscopic tumour margin can produce very large full thickness defects of the abdominal wall. Reconstruction of such defects can be quite challenging in resource constrained areas where patients present late with giant lesions. To highlight the presentation and management challenges faced by the surgical oncologist and reconstructive surgeon in a resource constrained country when faced with giant Dermatofibrosarcoma protuberans of the abdominal wall. Prospective study of patients with abdominal wall soft tissue sarcoma presenting to the authors. Cases of giant dermatofibrosarcoma protuberns who underwent surgery were analysed. Seven cases managed over an eight year period (January 2000 to December 2007). Age ranged from 27-70 yrs with slight female preponderance 1.5:1 F:M. Three presented with recurrent fungating masses. Only one could be reconstructed with prolene mesh. One recurrence was noted during the period under study. Poverty, ignorance and lack of necessary working tools are major challenges faced by the surgical oncologist and reconstructive surgeon in resource constrained areas and pose a major obstacle to the control of cancer in these areas.

Bridging the gap between evidence-based innovation and national health-sector reform in Ghana.

PubMed

Awoonor-Williams, John Koku; Feinglass, Ellie S; Tobey, Rachel; Vaughan-Smith, Maya N; Nyonator, Frank K; Jones, Tanya C

2004-09-01

Although experimental trials often identify optimal strategies for improving community health, transferring operational innovation from well-funded research programs to resource-constrained settings often languishes. Because research initiatives are based in institutions equipped with unique resources and staff capabilities, results are often dismissed by decisionmakers as irrelevant to large-scale operations and national health policy. This article describes an initiative undertaken in Nkwanta District, Ghana, focusing on this problem. The Nkwanta District initiative is a critical link between the experimental study conducted in Navrongo, Ghana, and a national effort to scale up the innovations developed in that study. A 2002 Nkwanta district-level survey provides the basis for assessing the likelihood that the Navrongo model is replicable elsewhere in Ghana. The effect of community-based health planning and services exposure on family planning and safe-motherhood indicators supports the hypothesis that Navrongo effects are transferable to impoverished rural settings elsewhere, confirming the need for strategies to bridge the gap between Navrongo evidence-based innovation and national health-sector reform.

Masivukeni: Development of a Multimedia Based Antiretroviral Therapy Adherence Intervention for Counselors and Patients in South Africa

PubMed Central

Remien, Robert H; Mellins, Claude A.; Robbins, Reuben N.; Kelsey, Ryan; Rowe, Jessica; Warne, Patricia; Chowdhury, Jenifar; Lalkhen, Nuruneesa; Hoppe, Lara; Abrams, Elaine J.; El-Bassel, Nabila; Witte, Susan; Stein, Dan J.

2013-01-01

Effective medical treatment for HIV/AIDS requires patients’ optimal adherence to antiretroviral therapy (ART). In resource-constrained settings, lack of adequate standardized counseling for patients on ART remains a significant barrier to adherence. Masivukeni (“Lets Wake Up” in Xhosa) is an innovative multimedia-based intervention designed to help people living with HIV in resource-limited settings achieve and maintain high levels of ART adherence. Adapted from a couples-based intervention tested in the United States (US), Masivukeni was developed through community-based participatory research with US and South African partners and informed by Ewart’s Social Action Theory. Innovative computer-based multimedia strategies were used to translate a labor- and training-intensive intervention into one that could be readily and widely used by lay counselors with relatively little training with low-literacy patients. In this paper, we describe the foundations of this new intervention, the process of its development, and the evidence of its high acceptability and feasibility. PMID:23468079

Measuring Health-Related Quality of Life of HIV-Positive Adolescents in Resource-Constrained Settings

PubMed Central

Masquillier, Caroline; Wouters, Edwin; Loos, Jasna; Nöstlinger, Christiana

2012-01-01

Background and Objectives Access to antiretroviral treatment among adolescents living with HIV (ALH) is increasing. Health-related quality of life (HRQOL) is relevant for monitoring the impact of the disease on both well-being and treatment outcomes. However, adequate screening tools to assess HRQOL in low-resource settings are scarce. This study aims to fill this research gap, by 1) assessing the psychometric properties and reliability of an Eastern African English version of a European HRQOL scale for adolescents (KIDSCREEN) and 2) determining which version of the KIDSCREEN (52-, 27- and 10-item version) is most suitable for low-resource settings. Methods The KIDSCREEN was translated into Eastern African English, Luganda (Uganda) and Dholuo (Kenya) according to standard procedures. The reconciled version was administered in 2011 to ALH aged 13–17 in Kenya (n = 283) and Uganda (n = 299). All three KIDSCREEN versions were fitted to the data with confirmatory factor analysis (CFA). After comparison, the most suitable version was adapted based on the CFA outcomes utilizing the results of previous formative research. In order to develop a general HRQOL factor, a second-order measurement model was fitted to the data. Results The CFA results showed that without adjustments, the KIDSCREEN cannot be used for measuring the HRQOL of HIV-positive adolescents. After comparison, the most suitable version for low-resource settings - the 27-item version - was adapted further. The introduction of a negative wording factor was required for the Dholuo model. The Dholuo (CFI: 0.93; RMSEA: 0.039) and the Luganda model (CFI: 0.90; RMSEA: 0.052) showed a good fit. All cronbach’s alphas of the factors were 0.70 or above. The alpha value of the Dholuo and Lugandan HRQOL second-order factor was respectively 0.84 and 0.87. Conclusions The study showed that the adapted KIDSCREEN-27 is an adequate tool for measuring HRQOL in low-resource settings with high HIV prevalence. PMID:22815776

Prevalence of gestational diabetes mellitus based on various screening strategies in western Kenya: a prospective comparison of point of care diagnostic methods.

PubMed

Pastakia, Sonak D; Njuguna, Benson; Onyango, Beryl Ajwang'; Washington, Sierra; Christoffersen-Deb, Astrid; Kosgei, Wycliffe K; Saravanan, Ponnusamy

2017-07-14

Early diagnosis of gestational diabetes mellitus (GDM) is crucial to prevent short term delivery risks and long term effects such as cardiovascular and metabolic diseases in the mother and infant. Diagnosing GDM in Sub-Saharan Africa (SSA) however, remains sub-optimal due to associated logistical and cost barriers for resource-constrained populations. A cost-effective strategy to screen for GDM in such settings are therefore urgently required. We conducted this study to determine the prevalence of gestational diabetes mellitus (GDM) and assess utility of various GDM point of care (POC) screening strategies in a resource-constrained setting. Eligible women aged ≥18 years, and between 24 and 32 weeks of a singleton pregnancy, prospectively underwent testing over two days. On day 1, a POC 1-h 50 g glucose challenge test (GCT) and a POC glycated hemoglobin (HbA1c) was assessed. On day 2, fasting blood glucose, 1-h and 2-h 75 g oral glucose tolerance test (OGTT) were determined using both venous and POC tests, along with a venous HbA1c. The International Association of Diabetes in Pregnancy Study Group (IADPSG) criteria was used to diagnose GDM. GDM prevalence was reported with 95% confidence interval (CI). Specificity, sensitivity, positive predictive value, and negative predictive value of the various POC testing strategies were determined using IADPSG testing as the standard reference. Six hundred-sixteen eligible women completed testing procedures. GDM was diagnosed in 18 women, a prevalence of 2.9% (95% CI, 1.57% - 4.23%). Compared to IADPSG testing, POC IADPSG had a sensitivity and specificity of 55.6% and 90.6% respectively while that of POC 1-h 50 g GCT (using a diagnostic cut-off of ≥7.2 mmol/L [129.6 mg/dL]) was 55.6% and 63.9%. All other POC tests assessed showed poor sensitivity. POC screening strategies though feasible, showed poor sensitivity for GDM detection in our resource-constrained population of low GDM prevalence. Studies to identify sensitive and specific POC GDM screening strategies using adverse pregnancy outcomes as end points are required. Clinical trials.gov : NCT02978807 , Registered 29 November 2016.

Explanation of random experiment sheduling and its application to space station analysis

NASA Technical Reports Server (NTRS)

Moore, J. E.

1970-01-01

The capability of the McDonnell-Douglas Phase B space station concept to complete the Blue Book Experiment program is analyzed and the Random experiment program with Resource Impact (REPRI) which was used to generate the data is described. The results indicate that station manpower and electrical power are the two resources which will constrain the amount of the Blue Book program that the station can complete. The station experiment program and its resource requirements are sensitive to levels of manpower and electrical power 13.5 men and 11 kilowatts. Continuous artificial gravity experiments have much less impact on the experiment program than experiments using separate artificial gravity periods. Station storage volume presently allocated for the FPE's and their supplies (1600 cu ft) is more than adequate. The REPRI program uses the Monte Carlo technique to generate a set of feasible experiment schedules for a space station. The schedules are statistically analyzed to determine the impact of the station experiment program resource requirements on the station concept. Also, the sensitivity of the station concept to one or more resources is assessed.

Design and optimization of organic rankine cycle for low temperature geothermal power plant

NASA Astrophysics Data System (ADS)

Barse, Kirtipal A.

Rising oil prices and environmental concerns have increased attention to renewable energy. Geothermal energy is a very attractive source of renewable energy. Although low temperature resources (90°C to 150°C) are the most common and most abundant source of geothermal energy, they were not considered economical and technologically feasible for commercial power generation. Organic Rankine Cycle (ORC) technology makes it feasible to use low temperature resources to generate power by using low boiling temperature organic liquids. The first hypothesis for this research is that using ORC is technologically and economically feasible to generate electricity from low temperature geothermal resources. The second hypothesis for this research is redesigning the ORC system for the given resource condition will improve efficiency along with improving economics. ORC model was developed using process simulator and validated with the data obtained from Chena Hot Springs, Alaska. A correlation was observed between the critical temperature of the working fluid and the efficiency for the cycle. Exergy analysis of the cycle revealed that the highest exergy destruction occurs in evaporator followed by condenser, turbine and working fluid pump for the base case scenarios. Performance of ORC was studied using twelve working fluids in base, Internal Heat Exchanger and turbine bleeding constrained and non-constrained configurations. R601a, R245ca, R600 showed highest first and second law efficiency in the non-constrained IHX configuration. The highest net power was observed for R245ca, R601a and R601 working fluids in the non-constrained base configuration. Combined heat exchanger area and size parameter of the turbine showed an increasing trend as the critical temperature of the working fluid decreased. The lowest levelized cost of electricity was observed for R245ca followed by R601a, R236ea in non-constrained base configuration. The next best candidates in terms of LCOE were R601a, R245ca and R600 in non-constrained IHX configuration. LCOE is dependent on net power and higher net power favors to lower the cost of electricity. Overall R245ca, R601, R601a, R600 and R236ea show better performance among the fluids studied. Non constrained configurations display better performance compared to the constrained configurations. Base non-constrained offered the highest net power and lowest LCOE.

Characteristics and critical success factors for implementing problem-based learning in a human resource-constrained country.

PubMed

Giva, Karen R N; Duma, Sinegugu E

2015-08-31

Problem-based learning (PBL) was introduced in Malawi in 2002 in order to improve the nursing education system and respond to the acute nursing human resources shortage. However, its implementation has been very slow throughout the country. The objectives of the study were to explore and describe the goals that were identified by the college to facilitate the implementation of PBL, the resources of the organisation that facilitated the implementation of PBL, the factors related to sources of students that facilitated the implementation of PBL, and the influence of the external system of the organisation on facilitating the implementation of PBL, and to identify critical success factors that could guide the implementation of PBL in nursing education in Malawi. This is an ethnographic, exploratory and descriptive qualitative case study. Purposive sampling was employed to select the nursing college, participants and documents for review.Three data collection methods, including semi-structured interviews, participant observation and document reviews, were used to collect data. The four steps of thematic analysis were used to analyse data from all three sources. Four themes and related subthemes emerged from the triangulated data sources. The first three themes and their subthemes are related to the characteristics related to successful implementation of PBL in a human resource-constrained nursing college, whilst the last theme is related to critical success factors that contribute to successful implementation of PBL in a human resource-constrained country like Malawi. This article shows that implementation of PBL is possible in a human resource-constrained country if there is political commitment and support.

Influence of transportation cost on long-term retention in clinic for HIV patients in rural Haiti.

PubMed

Sowah, Leonard A; Turenne, Franck V; Buchwald, Ulrike K; Delva, Guesly; Mesidor, Romaine N; Dessaigne, Camille G; Previl, Harold; Patel, Devang; Edozien, Anthony; Redfield, Robert R; Amoroso, Anthony

2014-12-01

With improved access to antiretroviral therapy in resource-constrained settings, long-term retention in HIV clinics has become an important means of reducing costs and improving outcomes. Published data on retention in HIV clinics beyond 24 months are, however, limited. In our clinic in rural Haiti, we hypothesized that individuals residing in locations with higher transportation costs to clinic would have poorer retention than those who had lower costs. We used a retrospective cohort design to evaluate potential predictors of HIV clinic retention. Patient information was abstracted from the electronic medical records. Cox proportional hazards regression was used to identify independent predictors of 4-year clinic retention. There were 410 patients in our cohort, 266 (64.9%) females and 144 (35.1%) males. Forty-five (11%) patients lived in locations with transportation costs >$2. Males were 1.5 times more likely to live in municipalities with transportation costs to clinic of >$2. Multivariate analysis suggested that age <30 years, male gender, and transportation cost were independent predictors of loss to follow-up (LTFU): risk ratio of 2.98, 95% confidence interval (CI): 1.73 to 4.96, P < 0.001; 1.71, CI: 1.08 to 2.70, P = 0.02; and 1.91, CI: 1.08 to 3.36, P = 0.02, respectively. Patients with transportation costs greater than $2 were 1.9 times more likely to be lost to care compared with those who paid less for transportation. HIV treatment programs in resource-constrained settings may need to pay closer attention to issues related to transportation cost to improve patient retention.

A cluster randomized trial of routine HIV-1 viral load monitoring in Zambia: study design, implementation, and baseline cohort characteristics.

PubMed

Koethe, John R; Westfall, Andrew O; Luhanga, Dora K; Clark, Gina M; Goldman, Jason D; Mulenga, Priscilla L; Cantrell, Ronald A; Chi, Benjamin H; Zulu, Isaac; Saag, Michael S; Stringer, Jeffrey S A

2010-03-12

The benefit of routine HIV-1 viral load (VL) monitoring of patients on antiretroviral therapy (ART) in resource-constrained settings is uncertain because of the high costs associated with the test and the limited treatment options. We designed a cluster randomized controlled trial to compare the use of routine VL testing at ART-initiation and at 3, 6, 12, and 18 months, versus our local standard of care (which uses immunological and clinical criteria to diagnose treatment failure, with discretionary VL testing when the two do not agree). Dedicated study personnel were integrated into public-sector ART clinics. We collected participant information in a dedicated research database. Twelve ART clinics in Lusaka, Zambia constituted the units of randomization. Study clinics were stratified into pairs according to matching criteria (historical mortality rate, size, and duration of operation) to limit the effect of clustering, and independently randomized to the intervention and control arms. The study was powered to detect a 36% reduction in mortality at 18 months. From December 2006 to May 2008, we completed enrollment of 1973 participants. Measured baseline characteristics did not differ significantly between the study arms. Enrollment was staggered by clinic pair and truncated at two matched sites. A large clinical trial of routing VL monitoring was successfully implemented in a dynamic and rapidly growing national ART program. Close collaboration with local health authorities and adequate reserve staff were critical to success. Randomized controlled trials such as this will likely prove valuable in determining long-term outcomes in resource-constrained settings. Clinicaltrials.gov NCT00929604.

Determinants of Antibiotic Consumption - Development of a Model using Partial Least Squares Regression based on Data from India.

PubMed

Tamhankar, Ashok J; Karnik, Shreyasee S; Stålsby Lundborg, Cecilia

2018-04-23

Antibiotic resistance, a consequence of antibiotic use, is a threat to health, with severe consequences for resource constrained settings. If determinants for human antibiotic use in India, a lower middle income country, with one of the highest antibiotic consumption in the world could be understood, interventions could be developed, having implications for similar settings. Year wise data for India, for potential determinants and antibiotic consumption, was sourced from publicly available databases for the years 2000-2010. Data was analyzed using Partial Least Squares regression and correlation between determinants and antibiotic consumption was evaluated, formulating 'Predictors' and 'Prediction models'. The 'prediction model' with the statistically most significant predictors (root mean square errors of prediction for train set-377.0 and test set-297.0) formulated from a combination of Health infrastructure + Surface transport infrastructure (HISTI), predicted antibiotic consumption within 95% confidence interval and estimated an antibiotic consumption of 11.6 standard units/person (14.37 billion standard units totally; standard units = number of doses sold in the country; a dose being a pill, capsule, or ampoule) for India for 2014. The HISTI model may become useful in predicting antibiotic consumption for countries/regions having circumstances and data similar to India, but without resources to measure actual data of antibiotic consumption.

Improved Methods for Fire Risk Assessment in Low-Income and Informal Settlements.

PubMed

Twigg, John; Christie, Nicola; Haworth, James; Osuteye, Emmanuel; Skarlatidou, Artemis

2017-02-01

Fires cause over 300,000 deaths annually worldwide and leave millions more with permanent injuries: some 95% of these deaths are in low- and middle-income countries. Burn injury risk is strongly associated with low-income and informal (or slum) settlements, which are growing rapidly in an urbanising world. Fire policy and mitigation strategies in poorer countries are constrained by inadequate data on incidence, impacts, and causes, which is mainly due to a lack of capacity and resources for data collection, analysis, and modelling. As a first step towards overcoming such challenges, this project reviewed the literature on the subject to assess the potential of a range of methods and tools for identifying, assessing, and addressing fire risk in low-income and informal settlements; the process was supported by an expert workshop at University College London in May 2016. We suggest that community-based risk and vulnerability assessment methods, which are widely used in disaster risk reduction, could be adapted to urban fire risk assessment, and could be enhanced by advances in crowdsourcing and citizen science for geospatial data creation and collection. To assist urban planners, emergency managers, and community organisations who are working in resource-constrained settings to identify and assess relevant fire risk factors, we also suggest an improved analytical framework based on the Haddon Matrix.

Engagement in the HIV Care Continuum among Key Populations in Tijuana, Mexico.

PubMed

Smith, Laramie R; Patterson, Thomas L; Magis-Rodriguez, Carlos; Ojeda, Victoria D; Burgos, Jose Luis; Rojas, Sarah A; Zúñiga, María Luisa; Strathdee, Steffanie A

2016-05-01

In Tijuana, Mexico, HIV is concentrated in sub-epidemics of key populations: persons who inject drugs (PWID), sex workers (SW), and men who have sex with men (MSM). To date, data on engagement in the HIV care continuum among these key populations, particularly in resource-constrained settings, are sparse. We pooled available epidemiological data from six studies (N = 3368) to examine HIV testing and treatment uptake in these key populations; finding an overall HIV prevalence of 5.7 %. Of the 191 identified HIV-positive persons, only 11.5 % knew their HIV-positive status and 3.7 % were on ART. Observed differences between these HIV-positive key populations suggest PWID (vs. non-PWID) were least likely to have previously tested or initiate HIV care. MSM (vs. non-MSM) were more likely to have previously tested but not more likely to know their HIV-positive status. Of persons aware of their HIV-positive status, SW (vs. non-SW) were more likely to initiate HIV care. Findings suggest engagement of key populations in HIV treatment is far below estimates observed for similarly resource-constrained generalized epidemics in sub-Saharan Africa. These data provide one of the first empirical-snapshots highlighting the extent of HIV treatment disparities in key populations.

Ethics and Rationing Access to Dialysis in Resource-Limited Settings: The Consequences of Refusing a Renal Transplant in the South African State Sector.

PubMed

Etheredge, Harriet; Paget, Graham

2015-12-01

Resource constraints in developing countries compel policy makers to ration the provision of healthcare services. This article examines one such set of Guidelines: A patient dialysing in the state sector in South Africa may not refuse renal transplantation when a kidney becomes available. Refusal of transplantation can lead to exclusion from the state-funded dialysis programme. This Guideline is legally acceptable as related to Constitutional stipulations which allow for rationing healthcare resources in South Africa. Evaluating the ethical merit of the Guideline, and exploring the ethical dilemma it poses, proves a more complex task. We examine the actions of healthcare professionals as constrained by the Guideline. From a best interests framework, we argue that in these circumstances directing patient decision making (pressurising a patient to undergo renal transplantation) is not necessarily unethical or unacceptably paternalistic. We then scrutinise the guideline itself through several different ethical 'lenses'. Here, we argue that bioethics does not provide a definitive answer as to the moral merit of rationing dialysis under these circumstances, however it can be considered just in this context. We conclude by examining a potential pitfall of the Guideline: Unwilling transplant recipients may not comply with immunosuppressive medication, which raises questions for policies based on resource management and rationing. © 2014 John Wiley & Sons Ltd.

Distributional impacts of water markets on small farmers: Is there a safety net?

NASA Astrophysics Data System (ADS)

Hadjigeorgalis, Ereney

2008-10-01

The United Nations 2006 human development report states that water markets have not been shown to protect the interests of the poor, while other research has found that water markets have benefited smaller, resource-constrained farmers. This article provides insight into this international development debate by analyzing the impact of water markets on small farmers in the Limarí River Basin of Chile. The analysis is based on data collected from an extensive in-person survey of 316 farmers in the basin. Results show that water markets in the basin have been successful in moving water and water rights from low- to high-valued uses and that resource-constrained farmers use temporary water sales as a safety net. The long-term beneficial effects of water market trades for the most resource-constrained farmers, however, remain unclear. These results are relevant to both Chile and a host of developing countries where agriculture is a predominant activity and water resources are scarce. They are also applicable to the western United States, where water market trades often originate in the agricultural sector.

Resource Constrained Planning of Multiple Projects with Separable Activities

NASA Astrophysics Data System (ADS)

Fujii, Susumu; Morita, Hiroshi; Kanawa, Takuya

In this study we consider a resource constrained planning problem of multiple projects with separable activities. This problem provides a plan to process the activities considering a resource availability with time window. We propose a solution algorithm based on the branch and bound method to obtain the optimal solution minimizing the completion time of all projects. We develop three methods for improvement of computational efficiency, that is, to obtain initial solution with minimum slack time rule, to estimate lower bound considering both time and resource constraints and to introduce an equivalence relation for bounding operation. The effectiveness of the proposed methods is demonstrated by numerical examples. Especially as the number of planning projects increases, the average computational time and the number of searched nodes are reduced.

C-reactive protein point-of-care testing and antibiotic prescribing for acute respiratory tract infections in rural primary health centres of North Ethiopia: a cross-sectional study.

PubMed

Yebyo, Henock; Medhanyie, Araya Abrha; Spigt, Mark; Hopstaken, Rogier

2016-01-14

Unjustified antibiotic prescribing for acute upper respiratory infections (URTIs) is probably more common in poor-resource settings where physicians are scarce. Introducing C-reactive protein (CRP) point-of-care testing in such settings could reduce the misuse of antibiotics, which could avert antibiotic resistance. However, information useful for the applicability of CRP test in resource-limited settings is lacking. This study aimed to elicit the frequency of antibiotic prescribing and distribution of CRP levels in remote, rural settings in Ethiopia. We included 414 patients with acute URTIs from four health centres. Health professionals recorded the clinical features of the patients, but the laboratory professionals measured the CRP levels of all patients at the point of care. The most prominent respiratory causes for consultation were acute URTIs combined (44.4%), and lower respiratory tract infections-pneumonia (29.71%) and acute bronchitis (25.84%). The CRP distribution was <20 mg/l, 20-99 mg/l and 100 mg/l or more in 66.6%, 27.9% and 5.5% of the patients, respectively. The CRP levels were significantly different among these clinical diagnoses (X(2)=114.3, P<0.001, d.f.=4). A wide range of antibiotics was administered for 87.8% of the patients, regardless of the diagnostic or prognostic nature of their diseases. Antibiotic prescribing for acute URTIs in the rural areas of Ethiopia is unduly high, with high proportions of mild, self-limiting illness, mostly URTIs. Implementation of CRP point-of-care testing in such resource-constrained settings, with low- or middle-grade healthcare professionals, could help reconcile the inappropriate use of antibiotics by withholding from patients who do not benefit from antibiotic treatment.

C-reactive protein point-of-care testing and antibiotic prescribing for acute respiratory tract infections in rural primary health centres of North Ethiopia: a cross-sectional study

PubMed Central

Yebyo, Henock; Medhanyie, Araya Abrha; Spigt, Mark; Hopstaken, Rogier

2016-01-01

Unjustified antibiotic prescribing for acute upper respiratory infections (URTIs) is probably more common in poor-resource settings where physicians are scarce. Introducing C-reactive protein (CRP) point-of-care testing in such settings could reduce the misuse of antibiotics, which could avert antibiotic resistance. However, information useful for the applicability of CRP test in resource-limited settings is lacking. This study aimed to elicit the frequency of antibiotic prescribing and distribution of CRP levels in remote, rural settings in Ethiopia. We included 414 patients with acute URTIs from four health centres. Health professionals recorded the clinical features of the patients, but the laboratory professionals measured the CRP levels of all patients at the point of care. The most prominent respiratory causes for consultation were acute URTIs combined (44.4%), and lower respiratory tract infections—pneumonia (29.71%) and acute bronchitis (25.84%). The CRP distribution was <20 mg/l, 20–99 mg/l and 100 mg/l or more in 66.6%, 27.9% and 5.5% of the patients, respectively. The CRP levels were significantly different among these clinical diagnoses (X2=114.3, P<0.001, d.f.=4). A wide range of antibiotics was administered for 87.8% of the patients, regardless of the diagnostic or prognostic nature of their diseases. Antibiotic prescribing for acute URTIs in the rural areas of Ethiopia is unduly high, with high proportions of mild, self-limiting illness, mostly URTIs. Implementation of CRP point-of-care testing in such resource-constrained settings, with low- or middle-grade healthcare professionals, could help reconcile the inappropriate use of antibiotics by withholding from patients who do not benefit from antibiotic treatment. PMID:26769226

Use of capillary blood glucose for screening for gestational diabetes mellitus in resource-constrained settings.

PubMed

Bhavadharini, Balaji; Mahalakshmi, Manni Mohanraj; Maheswari, Kumar; Kalaiyarasi, Gunasekaran; Anjana, Ranjit Mohan; Deepa, Mohan; Ranjani, Harish; Priya, Miranda; Uma, Ram; Usha, Sriram; Pastakia, Sonak D; Malanda, Belma; Belton, Anne; Unnikrishnan, Ranjit; Kayal, Arivudainambi; Mohan, Viswanathan

2016-02-01

The aim of the study was to evaluate usefulness of capillary blood glucose (CBG) for diagnosis of gestational diabetes mellitus (GDM) in resource-constrained settings where venous plasma glucose (VPG) estimations may be impossible. Consecutive pregnant women (n = 1031) attending antenatal clinics in southern India underwent 75-g oral glucose tolerance test (OGTT). Fasting, 1- and 2-h VPG (AU2700 Beckman, Fullerton, CA) and CBG (One Touch Ultra-II, LifeScan) were simultaneously measured. Sensitivity and specificity were estimated for different CBG cut points using the International Association of Diabetes in Pregnancy Study Groups (IADPSG) criteria for the diagnosis of GDM as gold standard. Bland-Altman plots were drawn to look at the agreement between CBG and VPG. Correlation and regression equation analysis were also derived for CBG values. Pearson's correlation between VPG and CBG for fasting was r = 0.433 [intraclass correlation coefficient (ICC) = 0.596, p < 0.001], for 1H, it was r = 0.653 (ICC = 0.776, p < 0.001), and for 2H, r = 0.784 (ICC = 0.834, p < 0.001). Comparing a single CBG 2-h cut point of 140 mg/dl (7.8 mmol/l) with the IADPSG criteria, the sensitivity and specificity were 62.3 and 80.7 %, respectively. If CBG cut points of 120 mg/dl (6.6 mmol/l) or 110 mg/dl (6.1 mmol/l) were used, the sensitivity improves to 78.3 and 92.5 %, respectively. In settings where VPG estimations are not possible, CBG can be used as an initial screening test for GDM, using lower 2H CBG cut points to maximize the sensitivity. Those who screen positive can be referred to higher centers for definitive testing, using VPG.

Saturating effects of species diversity on life-history evolution in bacteria.

PubMed

Fiegna, Francesca; Scheuerl, Thomas; Moreno-Letelier, Alejandra; Bell, Thomas; Barraclough, Timothy G

2015-09-22

Species interactions can play a major role in shaping evolution in new environments. In theory, species interactions can either stimulate evolution by promoting coevolution or inhibit evolution by constraining ecological opportunity. The relative strength of these effects should vary as species richness increases, and yet there has been little evidence for evolution of component species in communities. We evolved bacterial microcosms containing between 1 and 12 species in three different environments. Growth rates and yields of isolates that evolved in communities were lower than those that evolved in monocultures, consistent with recent theory that competition constrains species to specialize on narrower sets of resources. This effect saturated or reversed at higher levels of richness, consistent with theory that directional effects of species interactions should weaken in more diverse communities. Species varied considerably, however, in their responses to both environment and richness levels. Mechanistic models and experiments are now needed to understand and predict joint evolutionary dynamics of species in diverse communities. © 2015 The Authors.

Chance-Constrained System of Systems Based Operation of Power Systems

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kargarian, Amin; Fu, Yong; Wu, Hongyu

In this paper, a chance-constrained system of systems (SoS) based decision-making approach is presented for stochastic scheduling of power systems encompassing active distribution grids. Based on the concept of SoS, the independent system operator (ISO) and distribution companies (DISCOs) are modeled as self-governing systems. These systems collaborate with each other to run the entire power system in a secure and economic manner. Each self-governing system accounts for its local reserve requirements and line flow constraints with respect to the uncertainties of load and renewable energy resources. A set of chance constraints are formulated to model the interactions between the ISOmore » and DISCOs. The proposed model is solved by using analytical target cascading (ATC) method, a distributed optimization algorithm in which only a limited amount of information is exchanged between collaborative ISO and DISCOs. In this paper, a 6-bus and a modified IEEE 118-bus power systems are studied to show the effectiveness of the proposed algorithm.« less

Beyond the biomedical: community resources for mental health care in rural Ethiopia.

PubMed

Selamu, Medhin; Asher, Laura; Hanlon, Charlotte; Medhin, Girmay; Hailemariam, Maji; Patel, Vikram; Thornicroft, Graham; Fekadu, Abebaw

2015-01-01

The focus of discussion in addressing the treatment gap is often on biomedical services. However, community resources can benefit health service scale-up in resource-constrained settings. These assets can be captured systematically through resource mapping, a method used in social action research. Resource mapping can be informative in developing complex mental health interventions, particularly in settings with limited formal mental health resources. We employed resource mapping within the Programme for Improving Mental Health Care (PRIME), to systematically gather information on community assets that can support integration of mental healthcare into primary care in rural Ethiopia. A semi-structured instrument was administered to key informants. Community resources were identified for all 58 sub-districts of the study district. The potential utility of these resources for the provision of mental healthcare in the district was considered. The district is rich in community resources: There are over 150 traditional healers, 164 churches and mosques, and 401 religious groups. There were on average 5 eddir groups (traditional funeral associations) per sub-district. Social associations and 51 micro-finance institutions were also identified. On average, two traditional bars were found in each sub-district. The eight health centres and 58 satellite clinics staffed by Health Extension Workers (HEWs) represented all the biomedical health services in the district. In addition the Health Development Army (HDA) are community volunteers who support health promotion and prevention activities. The plan for mental healthcare integration in this district was informed by the resource mapping. Community and religious leaders, HEWs, and HDA may have roles in awareness-raising, detection and referral of people with mental illness, improving access to medical care, supporting treatment adherence, and protecting human rights. The diversity of community structures will be used to support rehabilitation and social reintegration. Alcohol use was identified as a target disorder for community-level intervention.

Beyond the Biomedical: Community Resources for Mental Health Care in Rural Ethiopia

PubMed Central

Selamu, Medhin; Asher, Laura; Hanlon, Charlotte; Medhin, Girmay; Hailemariam, Maji; Patel, Vikram; Thornicroft, Graham; Fekadu, Abebaw

2015-01-01

Background The focus of discussion in addressing the treatment gap is often on biomedical services. However, community resources can benefit health service scale-up in resource-constrained settings. These assets can be captured systematically through resource mapping, a method used in social action research. Resource mapping can be informative in developing complex mental health interventions, particularly in settings with limited formal mental health resources. Method We employed resource mapping within the Programme for Improving Mental Health Care (PRIME), to systematically gather information on community assets that can support integration of mental healthcare into primary care in rural Ethiopia. A semi-structured instrument was administered to key informants. Community resources were identified for all 58 sub-districts of the study district. The potential utility of these resources for the provision of mental healthcare in the district was considered. Results The district is rich in community resources: There are over 150 traditional healers, 164 churches and mosques, and 401 religious groups. There were on average 5 eddir groups (traditional funeral associations) per sub-district. Social associations and 51 micro-finance institutions were also identified. On average, two traditional bars were found in each sub-district. The eight health centres and 58 satellite clinics staffed by Health Extension Workers (HEWs) represented all the biomedical health services in the district. In addition the Health Development Army (HDA) are community volunteers who support health promotion and prevention activities. Discussion The plan for mental healthcare integration in this district was informed by the resource mapping. Community and religious leaders, HEWs, and HDA may have roles in awareness-raising, detection and referral of people with mental illness, improving access to medical care, supporting treatment adherence, and protecting human rights. The diversity of community structures will be used to support rehabilitation and social reintegration. Alcohol use was identified as a target disorder for community-level intervention. PMID:25962075

Optimising molecular diagnostic capacity for effective control of tuberculosis in high-burden settings.

PubMed

Sabiiti, W; Mtafya, B; Kuchaka, D; Azam, K; Viegas, S; Mdolo, A; Farmer, E C W; Khonga, M; Evangelopoulos, D; Honeyborne, I; Rachow, A; Heinrich, N; Ntinginya, N E; Bhatt, N; Davies, G R; Jani, I V; McHugh, T D; Kibiki, G; Hoelscher, M; Gillespie, S H

2016-08-01

The World Health Organization's 2035 vision is to reduce tuberculosis (TB) associated mortality by 95%. While low-burden, well-equipped industrialised economies can expect to see this goal achieved, it is challenging in the low- and middle-income countries that bear the highest burden of TB. Inadequate diagnosis leads to inappropriate treatment and poor clinical outcomes. The roll-out of the Xpert(®) MTB/RIF assay has demonstrated that molecular diagnostics can produce rapid diagnosis and treatment initiation. Strong molecular services are still limited to regional or national centres. The delay in implementation is due partly to resources, and partly to the suggestion that such techniques are too challenging for widespread implementation. We have successfully implemented a molecular tool for rapid monitoring of patient treatment response to anti-tuberculosis treatment in three high TB burden countries in Africa. We discuss here the challenges facing TB diagnosis and treatment monitoring, and draw from our experience in establishing molecular treatment monitoring platforms to provide practical insights into successful optimisation of molecular diagnostic capacity in resource-constrained, high TB burden settings. We recommend a holistic health system-wide approach for molecular diagnostic capacity development, addressing human resource training, institutional capacity development, streamlined procurement systems, and engagement with the public, policy makers and implementers of TB control programmes.

Fishing for leadership: The role diversification plays in facilitating change agents.

PubMed

Stoll, Joshua S

2017-09-01

Leadership is often viewed as being critical to successful natural resource management. This research focuses on a set of leaders identified through a social network analysis of fishers in a rural coastal region. Leaders' connections to different fisheries are evaluated, and these actors are found to be significantly more diversified than other fishers in the area. Drawing on theory related to institutional entrepreneurship and a series of in-depth interviews with these actors, this paper puts forward several hypotheses to explain how diverse social-ecological connections facilitate leadership. Three mechanisms are identified. Being diversified facilitates: (1) production of alternative visions; (2) framing of tractable strategies to sustain local marine resource; and (3) participation in the management process. While more research is needed to understand the relationship between diversification and leadership, these exploratory results suggest that leadership is, in part, a manifestation of ecological circumstance, supporting recent assertions that scholarship on leadership in natural resource management settings could benefit from being more attentive to the processes that shape leadership rather than fixating on individuals and their personal attributes. Given that fisheries policies increasingly constrain diversification, policymakers and managers should consider how specialization of fishers might change the form and function of leaders in the future. Copyright © 2017 Elsevier Ltd. All rights reserved.

A bispecific antibody based assay shows potential for detecting tuberculosis in resource constrained laboratory settings.

PubMed

Sarkar, Susmita; Tang, Xinli L; Das, Dipankar; Spencer, John S; Lowary, Todd L; Suresh, Mavanur R

2012-01-01

The re-emergence of tuberculosis (TB) as a global public health threat highlights the necessity of rapid, simple and inexpensive point-of-care detection of the disease. Early diagnosis of TB is vital not only for preventing the spread of the disease but also for timely initiation of treatment. The later in turn will reduce the possible emergence of multi-drug resistant strains of Mycobacterium tuberculosis. Lipoarabinomannan (LAM) is an important non-protein antigen of the bacterial cell wall, which is found to be present in different body fluids of infected patients including blood, urine and sputum. We have developed a bispecific monoclonal antibody with predetermined specificities towards the LAM antigen and a reporter molecule horseradish peroxidase (HRPO). The developed antibody was subsequently used to design a simple low cost immunoswab based assay to detect LAM antigen. The limit of detection for spiked synthetic LAM was found to be 5.0 ng/ml (bovine urine), 0.5 ng/ml (rabbit serum) and 0.005 ng/ml (saline) and that for bacterial LAM from M. tuberculosis H37Rv was found to be 0.5 ng/ml (rabbit serum). The assay was evaluated with 21 stored clinical serum samples (14 were positive and 7 were negative in terms of anti-LAM titer). In addition, all 14 positive samples were culture positive. The assay showed 100% specificity and 64% sensitivity (95% confidence interval). In addition to good specificity, the end point could be read visually within two hours of sample collection. The reported assay might be used as a rapid tool for detecting TB in resource constrained laboratory settings.

Nutritional supplementation: the additional costs of managing children infected with HIV in resource-constrained settings.

PubMed

Cobb, G; Bland, R M

2013-01-01

To explore the financial implications of applying the WHO guidelines for the nutritional management of HIV-infected children in a rural South African HIV programme. WHO guidelines describe Nutritional Care Plans (NCPs) for three categories of HIV-infected children: NCP-A: growing adequately; NCP-B: weight-for-age z-score (WAZ) ≤-2 but no evidence of severe acute malnutrition (SAM), confirmed weight loss/growth curve flattening, or condition with increased nutritional needs (e.g. tuberculosis); NCP-C: SAM. In resource-constrained settings, children requiring NCP-B or NCP-C usually need supplementation to achieve the additional energy recommendation. We estimated the proportion of children initiating antiretroviral treatment (ART) in the Hlabisa HIV Programme who would have been eligible for supplementation in 2010. The cost of supplying 26-weeks supplementation as a proportion of the cost of supplying ART to the same group was calculated. A total of 251 children aged 6 months to 14 years initiated ART. Eighty-eight required 6-month NCP-B, including 41 with a WAZ ≤-2 (no evidence of SAM) and 47 with a WAZ >-2 with co-existent morbidities including tuberculosis. Additionally, 25 children had SAM and required 10-weeks NCP-C followed by 16-weeks NCP-B. Thus, 113 of 251 (45%) children were eligible for nutritional supplementation at an estimated overall cost of $11 136, using 2010 exchange rates. These costs are an estimated additional 11.6% to that of supplying 26-week ART to the 251 children initiated. It is essential to address nutritional needs of HIV-infected children to optimise their health outcomes. Nutritional supplementation should be integral to, and budgeted for, in HIV programmes. © 2012 Blackwell Publishing Ltd.

An interval chance-constrained fuzzy modeling approach for supporting land-use planning and eco-environment planning at a watershed level.

PubMed

Ou, Guoliang; Tan, Shukui; Zhou, Min; Lu, Shasha; Tao, Yinghui; Zhang, Zuo; Zhang, Lu; Yan, Danping; Guan, Xingliang; Wu, Gang

2017-12-15

An interval chance-constrained fuzzy land-use allocation (ICCF-LUA) model is proposed in this study to support solving land resource management problem associated with various environmental and ecological constraints at a watershed level. The ICCF-LUA model is based on the ICCF (interval chance-constrained fuzzy) model which is coupled with interval mathematical model, chance-constrained programming model and fuzzy linear programming model and can be used to deal with uncertainties expressed as intervals, probabilities and fuzzy sets. Therefore, the ICCF-LUA model can reflect the tradeoff between decision makers and land stakeholders, the tradeoff between the economical benefits and eco-environmental demands. The ICCF-LUA model has been applied to the land-use allocation of Wujiang watershed, Guizhou Province, China. The results indicate that under highly land suitable conditions, optimized area of cultivated land, forest land, grass land, construction land, water land, unused land and landfill in Wujiang watershed will be [5015, 5648] hm 2 , [7841, 7965] hm 2 , [1980, 2056] hm 2 , [914, 1423] hm 2 , [70, 90] hm 2 , [50, 70] hm 2 and [3.2, 4.3] hm 2 , the corresponding system economic benefit will be between 6831 and 7219 billion yuan. Consequently, the ICCF-LUA model can effectively support optimized land-use allocation problem in various complicated conditions which include uncertainties, risks, economic objective and eco-environmental constraints. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Tractable Cognition Thesis

ERIC Educational Resources Information Center

van Rooij, Iris

2008-01-01

The recognition that human minds/brains are finite systems with limited resources for computation has led some researchers to advance the "Tractable Cognition thesis": Human cognitive capacities are constrained by computational tractability. This thesis, if true, serves cognitive psychology by constraining the space of computational-level theories…

Introducing New Priority Setting and Resource Allocation Processes in a Canadian Healthcare Organization: A Case Study Analysis Informed by Multiple Streams Theory.

PubMed

Smith, Neale; Mitton, Craig; Dowling, Laura; Hiltz, Mary-Ann; Campbell, Matthew; Gujar, Shashi Ashok

2015-09-24

In this article, we analyze one case instance of how proposals for change to the priority setting and resource allocation (PSRA) processes at a Canadian healthcare institution reached the decision agenda of the organization's senior leadership. We adopt key concepts from an established policy studies framework - Kingdon's multiple streams theory - to inform our analysis. Twenty-six individual interviews were conducted at the IWK Health Centre in Halifax, NS, Canada. Participants were asked to reflect upon the reasons leading up to the implementation of a formal priority setting process - Program Budgeting and Marginal Analysis (PBMA) - in the 2012/2013 fiscal year. Responses were analyzed qualitatively using Kingdon's model as a template. The introduction of PBMA can be understood as the opening of a policy window. A problem stream - defined as lack of broad engagement and information sharing across service lines in past practice - converged with a known policy solution, PBMA, which addressed the identified problems and was perceived as easy to use and with an evidence-base from past applications across Canada and elsewhere. Conditions in the political realm allowed for this intervention to proceed, but also constrained its potential outcomes. Understanding in a theoretically-informed way how change occurs in healthcare management practices can provide useful lessons to researchers and decision-makers whose aim is to help health systems achieve the most effective use of available financial resources. © 2016 by Kerman University of Medical Sciences.

Configuration of the thermal landscape determines thermoregulatory performance of ectotherms

PubMed Central

Sears, Michael W.; Angilletta, Michael J.; Schuler, Matthew S.; Borchert, Jason; Dilliplane, Katherine F.; Stegman, Monica; Rusch, Travis W.; Mitchell, William A.

2016-01-01

Although most organisms thermoregulate behaviorally, biologists still cannot easily predict whether mobile animals will thermoregulate in natural environments. Current models fail because they ignore how the spatial distribution of thermal resources constrains thermoregulatory performance over space and time. To overcome this limitation, we modeled the spatially explicit movements of animals constrained by access to thermal resources. Our models predict that ectotherms thermoregulate more accurately when thermal resources are dispersed throughout space than when these resources are clumped. This prediction was supported by thermoregulatory behaviors of lizards in outdoor arenas with known distributions of environmental temperatures. Further, simulations showed how the spatial structure of the landscape qualitatively affects responses of animals to climate. Biologists will need spatially explicit models to predict impacts of climate change on local scales. PMID:27601639

Ethical Challenges in the Provision of Dialysis in Resource-Constrained Environments.

PubMed

Luyckx, Valerie A; Miljeteig, Ingrid; Ejigu, Addisu M; Moosa, M Rafique

2017-05-01

The number of patients requiring dialysis by 2030 is projected to double worldwide, with the largest increase expected in low- and middle-income countries (LMICs). Dialysis is seldom considered a high priority by health care funders, consequently, few LMICs develop policies regarding dialysis allocation. Dialysis facilities may exist, but access remains highly inequitable in LMICs. High out-of-pocket payments make dialysis unsustainable and plunge many families into poverty. Patients, families, and clinicians suffer significant emotional and moral distress from daily life-and-death decisions imposed by dialysis. The health system's obligation to provide financial risk protection is an important component of global and national strategies to achieve universal health coverage. An ethical imperative therefore exists to develop transparent dialysis priority-setting guidelines to facilitate public understanding and acceptance of the realistic limits within the health system, and facilitate fair allocation of scarce resources. In this article, we present ethical challenges faced by patients, families, clinicians, and policy makers where dialysis is not universally accessible and discuss the potential ethical consequences of various dialysis allocation strategies. Finally, we suggest an ethical framework for use in policy development for priority setting of dialysis care. The accountability for reasonableness framework is proposed as a procedurally fair decision-making, priority-setting process. Copyright © 2017 Elsevier Inc. All rights reserved.

Neonatal resuscitation in low-resource settings: What, who, and how to overcome challenges to scale up?

PubMed Central

Wall, Stephen N.; Lee, Anne CC; Niermeyer, Susan; English, Mike; Keenan, William J.; Carlo, Wally; Bhutta, Zulfiqar A.; Bang, Abhay; Narayanan, Indira; Ariawan, Iwan; Lawn, Joy E.

2009-01-01

Background Each year approximately 10 million babies do not breathe immediately at birth, of which about 6 million require basic neonatal resuscitation. The major burden is in low-income settings, where health system capacity to provide neonatal resuscitation is inadequate. Objective To systematically review the evidence for neonatal resuscitation content, training and competency, equipment and supplies, cost, and key program considerations, specifically for resource-constrained settings. Results Evidence from several observational studies shows that facility-based basic neonatal resuscitation may avert 30% of intrapartum-related neonatal deaths. Very few babies require advanced resuscitation (endotracheal intubation and drugs) and these newborns may not survive without ongoing ventilation; hence, advanced neonatal resuscitation is not a priority in settings without neonatal intensive care. Of the 60 million nonfacility births, most do not have access to resuscitation. Several trials have shown that a range of community health workers can perform neonatal resuscitation with an estimated effect of a 20% reduction in intrapartum-related neonatal deaths, based on expert opinion. Case studies illustrate key considerations for scale up. Conclusion Basic resuscitation would substantially reduce intrapartum-related neonatal deaths. Where births occur in facilities, it is a priority to ensure that all birth attendants are competent in resuscitation. Strategies to address the gap for home births are urgently required. More data are required to determine the impact of neonatal resuscitation, particularly on long-term outcomes in low-income settings. PMID:19815203

Implementing Mobile Phone Solutions for Health in Resource Constrained Areas: Understanding the Opportunities and Challenges

NASA Astrophysics Data System (ADS)

Manda, Tiwonge Davis; Herstad, Jo

This paper presents results from a study on mobile phone use to connect two rural hospitals in Malawi with community health workers (CHWs), the hospitals work with. Mobile phone use at the hospitals has helped reduce the need for face-to-face communication to permit patient information exchange, meetings and appointments scheduling, as well as work coordination. On the other hand mobile phone use has proved paradoxical as it has introduced users to challenges, like recharging of phone batteries, they did not anticipate. The paper highlights use context-centric and solution based opportunities and challenges associated with mobile phone use in rural settings.

Families Matter! Presexual Risk Prevention Intervention

PubMed Central

Lasswell, Sarah M.; Riley, Drewallyn B.; Poulsen, Melissa N.

2013-01-01

Parent-based HIV prevention programming may play an important role in reaching youths early to help establish lifelong patterns of safe and healthy sexual behaviors. Families Matter! is a 5-session, evidence-based behavioral intervention designed for primary caregivers of children aged 9 to 12 years to promote positive parenting and effective parent–child communication about sexuality and sexual risk reduction. The program’s 5-step capacity-building model was implemented with local government, community, and faith-based partners in 8 sub-Saharan African countries with good intervention fidelity and high levels of participant retention. Families Matter! may be useful in other resource-constrained settings. PMID:24028229

Improved Methods for Fire Risk Assessment in Low-Income and Informal Settlements

PubMed Central

Twigg, John; Christie, Nicola; Haworth, James; Osuteye, Emmanuel; Skarlatidou, Artemis

2017-01-01

Fires cause over 300,000 deaths annually worldwide and leave millions more with permanent injuries: some 95% of these deaths are in low- and middle-income countries. Burn injury risk is strongly associated with low-income and informal (or slum) settlements, which are growing rapidly in an urbanising world. Fire policy and mitigation strategies in poorer countries are constrained by inadequate data on incidence, impacts, and causes, which is mainly due to a lack of capacity and resources for data collection, analysis, and modelling. As a first step towards overcoming such challenges, this project reviewed the literature on the subject to assess the potential of a range of methods and tools for identifying, assessing, and addressing fire risk in low-income and informal settlements; the process was supported by an expert workshop at University College London in May 2016. We suggest that community-based risk and vulnerability assessment methods, which are widely used in disaster risk reduction, could be adapted to urban fire risk assessment, and could be enhanced by advances in crowdsourcing and citizen science for geospatial data creation and collection. To assist urban planners, emergency managers, and community organisations who are working in resource-constrained settings to identify and assess relevant fire risk factors, we also suggest an improved analytical framework based on the Haddon Matrix. PMID:28157149

High Sensitivity and Specificity of Clinical Microscopy in Rural Health Facilities in Western Kenya Under an External Quality Assurance Program

PubMed Central

Wafula, Rebeccah; Sang, Edna; Cheruiyot, Olympia; Aboto, Angeline; Menya, Diana; O'Meara, Wendy Prudhomme

2014-01-01

Microscopic diagnosis of malaria is a well-established and inexpensive technique that has the potential to provide accurate diagnosis of malaria infection. However, it requires both training and experience. Although it is considered the gold standard in research settings, the sensitivity and specificity of routine microscopy for clinical care in the primary care setting has been reported to be unacceptably low. We established a monthly external quality assurance program to monitor the performance of clinical microscopy in 17 rural health centers in western Kenya. The average sensitivity over the 12-month period was 96% and the average specificity was 88%. We identified specific contextual factors that contributed to inadequate performance. Maintaining high-quality malaria diagnosis in high-volume, resource-constrained health facilities is possible. PMID:24935953

Solution techniques for transient stability-constrained optimal power flow – Part II

DOE PAGES

Geng, Guangchao; Abhyankar, Shrirang; Wang, Xiaoyu; ...

2017-06-28

Transient stability-constrained optimal power flow is an important emerging problem with power systems pushed to the limits for economic benefits, dense and larger interconnected systems, and reduced inertia due to expected proliferation of renewable energy resources. In this study, two more approaches: single machine equivalent and computational intelligence are presented. Also discussed are various application areas, and future directions in this research area. In conclusion, a comprehensive resource for the available literature, publicly available test systems, and relevant numerical libraries is also provided.

Solution techniques for transient stability-constrained optimal power flow – Part II

DOE Office of Scientific and Technical Information (OSTI.GOV)

Geng, Guangchao; Abhyankar, Shrirang; Wang, Xiaoyu

Transient stability-constrained optimal power flow is an important emerging problem with power systems pushed to the limits for economic benefits, dense and larger interconnected systems, and reduced inertia due to expected proliferation of renewable energy resources. In this study, two more approaches: single machine equivalent and computational intelligence are presented. Also discussed are various application areas, and future directions in this research area. In conclusion, a comprehensive resource for the available literature, publicly available test systems, and relevant numerical libraries is also provided.

Portfolio theory and the alternative decision rule of cost-effectiveness analysis: theoretical and practical considerations.

PubMed

Sendi, Pedram; Al, Maiwenn J; Gafni, Amiram; Birch, Stephen

2004-05-01

Bridges and Terris (Soc. Sci. Med. (2004)) critique our paper on the alternative decision rule of economic evaluation in the presence of uncertainty and constrained resources within the context of a portfolio of health care programs (Sendi et al. Soc. Sci. Med. 57 (2003) 2207). They argue that by not adopting a formal portfolio theory approach we overlook the optimal solution. We show that these arguments stem from a fundamental misunderstanding of the alternative decision rule of economic evaluation. In particular, the portfolio theory approach advocated by Bridges and Terris is based on the same theoretical assumptions that the alternative decision rule set out to relax. Moreover, Bridges and Terris acknowledge that the proposed portfolio theory approach may not identify the optimal solution to resource allocation problems. Hence, it provides neither theoretical nor practical improvements to the proposed alternative decision rule.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dufour, F., E-mail: dufour@math.u-bordeaux1.fr; Prieto-Rumeau, T., E-mail: tprieto@ccia.uned.es

We consider a discrete-time constrained discounted Markov decision process (MDP) with Borel state and action spaces, compact action sets, and lower semi-continuous cost functions. We introduce a set of hypotheses related to a positive weight function which allow us to consider cost functions that might not be bounded below by a constant, and which imply the solvability of the linear programming formulation of the constrained MDP. In particular, we establish the existence of a constrained optimal stationary policy. Our results are illustrated with an application to a fishery management problem.

A Global Health Diagnostic for Personalized Medicine in Resource-Constrained World Settings: A Simple PCR-RFLP Method for Genotyping CYP2B6 g.15582C>T and Science and Policy Relevance for Optimal Use of Antiretroviral Drug Efavirenz

PubMed Central

Evans, Jonathan; Swart, Marelize; Soko, Nyarai; Wonkam, Ambroise; Huzair, Farah

2015-01-01

Abstract The use of pharmacogenomics (PGx) knowledge in treatment of individual patients is becoming a common phenomenon in the developed world. However, poorly resourced countries have thus far been constrained for three main reasons. First, the cost of whole genome sequencing is still considerably high in comparison to other (non-genomics) diagnostics in the developing world where both science and social dynamics create a dynamic and fragile healthcare ecosystem. Second, studies correlating genomic differences with drug pharmacokinetics and pharmacodynamics have not been consistent, and more importantly, often not indexed to impact on societal end-points, beyond clinical practice. Third, ethics regulatory frames over PGx testing require improvements based on nested accountability systems and in ways that address the user community needs. Thus, CYP2B6 is a crucial enzyme in the metabolism of antiretroviral drugs, efavirenz and nevirapine. More than 40 genetic variants have been reported, but only a few contribute to differences in plasma EFV and NVP concentrations. The most widely reported CYP2B6 variants affecting plasma drug levels include c.516G>T, c.983T>C, and to a lesser extent, g.15582C>T, which should be considered in future PGx tests. While the first two variants are easily characterized, the g.15582C>T detection has been performed primarily by sequencing, which is costly, labor intensive, and requires access to barely available expertise in the developing world. We report here on a simple, practical PCR-RFLP method with vast potentials for use in resource-constrained world regions to detect the g.15582C>T variation among South African and Cameroonian persons. The effects of CYP2B6 g.15582C>T on plasma EFV concentration were further evaluated among HIV/AIDS patients. We report no differences in the frequency of the g.15582T variant between the South African (0.08) and Cameroonian (0.06) groups, which are significantly lower than reported in Asians (0.39) and Caucasians (0.31). The g.15582C/T and T/T genotypes were associated with significantly reduced EFV levels (p=0.006). This article additionally presents the policy relevance of the PGX global health diagnostics and therefore, collectively makes an original interdisciplinary contribution to the field of integrative biology and personalized medicine in developing world. Such studies are, in fact, broadly important because resource-constrained regions exist not only in developing world but also in major geographical parts of the G20 nations and the developed countries. PMID:26415139

Constrained creation of poetic forms during theme-driven exploration of a domain defined by an N-gram model

NASA Astrophysics Data System (ADS)

Gervás, Pablo

2016-04-01

Most poetry-generation systems apply opportunistic approaches where algorithmic procedures are applied to explore the conceptual space defined by a given knowledge resource in search of solutions that might be aesthetically valuable. Aesthetical value is assumed to arise from compliance to a given poetic form - such as rhyme or metrical regularity - or from evidence of semantic relations between the words in the resulting poems that can be interpreted as rhetorical tropes - such as similes, analogies, or metaphors. This approach tends to fix a priori the aesthetic parameters of the results, and imposes no constraints on the message to be conveyed. The present paper describes an attempt to initiate a shift in this balance, introducing means for constraining the output to certain topics and allowing a looser mechanism for constraining form. This goal arose as a result of the need to produce poems for a themed collection commissioned to be included in a book. The solution adopted explores an approach to creativity where the goals are not solely aesthetic and where the results may be surprising in their poetic form. An existing computer poet, originally developed to produce poems in a given form but with no specific constraints on their content, is put to the task of producing a set of poems with explicit restrictions on content, and allowing for an exploration of poetic form. Alternative generation methods are devised to overcome the difficulties, and the various insights arising from these new methods and the impact they have on the set of resulting poems are discussed in terms of their potential contribution to better poetry-generation systems.

Effective Teaching of Economics: A Constrained Optimization Problem?

ERIC Educational Resources Information Center

Hultberg, Patrik T.; Calonge, David Santandreu

2017-01-01

One of the fundamental tenets of economics is that decisions are often the result of optimization problems subject to resource constraints. Consumers optimize utility, subject to constraints imposed by prices and income. As economics faculty, instructors attempt to maximize student learning while being constrained by their own and students'…

A Near-Optimal Distributed QoS Constrained Routing Algorithm for Multichannel Wireless Sensor Networks

PubMed Central

Lin, Frank Yeong-Sung; Hsiao, Chiu-Han; Yen, Hong-Hsu; Hsieh, Yu-Jen

2013-01-01

One of the important applications in Wireless Sensor Networks (WSNs) is video surveillance that includes the tasks of video data processing and transmission. Processing and transmission of image and video data in WSNs has attracted a lot of attention in recent years. This is known as Wireless Visual Sensor Networks (WVSNs). WVSNs are distributed intelligent systems for collecting image or video data with unique performance, complexity, and quality of service challenges. WVSNs consist of a large number of battery-powered and resource constrained camera nodes. End-to-end delay is a very important Quality of Service (QoS) metric for video surveillance application in WVSNs. How to meet the stringent delay QoS in resource constrained WVSNs is a challenging issue that requires novel distributed and collaborative routing strategies. This paper proposes a Near-Optimal Distributed QoS Constrained (NODQC) routing algorithm to achieve an end-to-end route with lower delay and higher throughput. A Lagrangian Relaxation (LR)-based routing metric that considers the “system perspective” and “user perspective” is proposed to determine the near-optimal routing paths that satisfy end-to-end delay constraints with high system throughput. The empirical results show that the NODQC routing algorithm outperforms others in terms of higher system throughput with lower average end-to-end delay and delay jitter. In this paper, for the first time, the algorithm shows how to meet the delay QoS and at the same time how to achieve higher system throughput in stringently resource constrained WVSNs.

Breaking down the barriers of using strong authentication and encryption in resource constrained embedded systems

NASA Astrophysics Data System (ADS)

Knobler, Ron; Scheffel, Peter; Jackson, Scott; Gaj, Kris; Kaps, Jens Peter

2013-05-01

Various embedded systems, such as unattended ground sensors (UGS), are deployed in dangerous areas, where they are subject to compromise. Since numerous systems contain a network of devices that communicate with each other (often times with commercial off the shelf [COTS] radios), an adversary is able to intercept messages between system devices, which jeopardizes sensitive information transmitted by the system (e.g. location of system devices). Secret key algorithms such as AES are a very common means to encrypt all system messages to a sufficient security level, for which lightweight implementations exist for even very resource constrained devices. However, all system devices must use the appropriate key to encrypt and decrypt messages from each other. While traditional public key algorithms (PKAs), such as RSA and Elliptic Curve Cryptography (ECC), provide a sufficiently secure means to provide authentication and a means to exchange keys, these traditional PKAs are not suitable for very resource constrained embedded systems or systems which contain low reliability communication links (e.g. mesh networks), especially as the size of the network increases. Therefore, most UGS and other embedded systems resort to pre-placed keys (PPKs) or other naïve schemes which greatly reduce the security and effectiveness of the overall cryptographic approach. McQ has teamed with the Cryptographic Engineering Research Group (CERG) at George Mason University (GMU) to develop an approach using revolutionary cryptographic techniques that provides both authentication and encryption, but on resource constrained embedded devices, without the burden of large amounts of key distribution or storage.

Resource and activity substitutes for recreational salmon fishing in New Zealand

Treesearch

Bo Shelby

1985-01-01

Substitutes become an issue when people are constrained from participating in desired activities. This study investigates and compares activity and resource substitutes for recreational salmon fishing in New Zealand. Results suggest that resource substitution and inventories need more attention, user perceptions of substitutes are important, substitutes can be...

Landscape Simplification Constrains Adult Size in a Native Ground-Nesting Bee

PubMed Central

Renauld, Miles; Hutchinson, Alena; Loeb, Gregory; Poveda, Katja; Connelly, Heather

2016-01-01

Bees provide critical pollination services to 87% of angiosperm plants; however, the reliability of these services may become threatened as bee populations decline. Agricultural intensification, resulting in the simplification of environments at the landscape scale, greatly changes the quality and quantity of resources available for female bees to provision their offspring. These changes may alter or constrain the tradeoffs in maternal investment allocation between offspring size, number and sex required to maximize fitness. Here we investigate the relationship between landscape scale agricultural intensification and the size and number of individuals within a wild ground nesting bee species, Andrena nasonii. We show that agricultural intensification at the landscape scale was associated with a reduction in the average size of field collected A. nasonii adults in highly agricultural landscapes but not with the number of individuals collected. Small females carried significantly smaller (40%) pollen loads than large females, which is likely to have consequences for subsequent offspring production and fitness. Thus, landscape simplification is likely to constrain allocation of resources to offspring through a reduction in the overall quantity, quality and distribution of resources. PMID:26943127

Landscape Simplification Constrains Adult Size in a Native Ground-Nesting Bee.

PubMed

Renauld, Miles; Hutchinson, Alena; Loeb, Gregory; Poveda, Katja; Connelly, Heather

2016-01-01

Bees provide critical pollination services to 87% of angiosperm plants; however, the reliability of these services may become threatened as bee populations decline. Agricultural intensification, resulting in the simplification of environments at the landscape scale, greatly changes the quality and quantity of resources available for female bees to provision their offspring. These changes may alter or constrain the tradeoffs in maternal investment allocation between offspring size, number and sex required to maximize fitness. Here we investigate the relationship between landscape scale agricultural intensification and the size and number of individuals within a wild ground nesting bee species, Andrena nasonii. We show that agricultural intensification at the landscape scale was associated with a reduction in the average size of field collected A. nasonii adults in highly agricultural landscapes but not with the number of individuals collected. Small females carried significantly smaller (40%) pollen loads than large females, which is likely to have consequences for subsequent offspring production and fitness. Thus, landscape simplification is likely to constrain allocation of resources to offspring through a reduction in the overall quantity, quality and distribution of resources.

Vaccination program in a resource-limited setting: A case study in the Philippines.

PubMed

Chootipongchaivat, Sarocha; Chantarastapornchit, Varit; Kulpeng, Wantanee; Ceria, Joyce Anne; Tolentino, Niña Isabelle; Teerawattananon, Yot

2016-09-14

Implementing national-level vaccination programs involves long-term investment, which can be a significant financial burden, particularly in resource-limited settings. Although many studies have assessed the economic impacts of providing vaccinations, evidence on the positive and negative implications of human resources for health (HRH) is still lacking. Therefore, this study aims to estimate the HRH impact of introducing pneumococcal conjugate vaccine (PCV) using a model-based economic evaluation. This study adapted a Markov model from a prior study that was conducted in the Philippines for assessing the cost-effectiveness of 10-valent and 13-valent PCV compared to no vaccination. The Markov model was used for estimating the number of cases of pneumococcal-related diseases, categorized by policy options. HRH-related parameters were obtained from document reviews and interviews using the quantity, task, and productivity model (QTP model). The number of full-time equivalent (FTE) of general practitioners, nurses, and midwives increases significantly if the universal vaccine coverage policy is implemented. A universal coverage of PCV13 - which is considered to be the best value for money compared to other vaccination strategies - requires an additional 380 FTEs for general practitioners, 602 FTEs for nurses, and 205 FTEs for midwives; it can reduce the number of FTEs for medical social workers, paediatricians, infectious disease specialists, neurologists, anaesthesiologists, radiologists, ultrasonologists, medical technologists, radiologic technologists, and pharmacists by 7, 17.9, 9.7, 0.4, 0.1, 0.7, 0.1, 12.3, 2, and 9.7, respectively, when compared to the no vaccination policy. This is the first attempt to estimate the impact of HRH alongside a model-based economic evaluation study, which can be eventually applied to other vaccine studies, especially those which inform resource allocation in developing settings where not only financial resources but also HRH are constrained. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

An Authentication and Key Management Mechanism for Resource Constrained Devices in IEEE 802.11-based IoT Access Networks.

PubMed

Kim, Ki-Wook; Han, Youn-Hee; Min, Sung-Gi

2017-09-21

Many Internet of Things (IoT) services utilize an IoT access network to connect small devices with remote servers. They can share an access network with standard communication technology, such as IEEE 802.11ah. However, an authentication and key management (AKM) mechanism for resource constrained IoT devices using IEEE 802.11ah has not been proposed as yet. We therefore propose a new AKM mechanism for an IoT access network, which is based on IEEE 802.11 key management with the IEEE 802.1X authentication mechanism. The proposed AKM mechanism does not require any pre-configured security information between the access network domain and the IoT service domain. It considers the resource constraints of IoT devices, allowing IoT devices to delegate the burden of AKM processes to a powerful agent. The agent has sufficient power to support various authentication methods for the access point, and it performs cryptographic functions for the IoT devices. Performance analysis shows that the proposed mechanism greatly reduces computation costs, network costs, and memory usage of the resource-constrained IoT device as compared to the existing IEEE 802.11 Key Management with the IEEE 802.1X authentication mechanism.

An Authentication and Key Management Mechanism for Resource Constrained Devices in IEEE 802.11-based IoT Access Networks

PubMed Central

Han, Youn-Hee; Min, Sung-Gi

2017-01-01

Many Internet of Things (IoT) services utilize an IoT access network to connect small devices with remote servers. They can share an access network with standard communication technology, such as IEEE 802.11ah. However, an authentication and key management (AKM) mechanism for resource constrained IoT devices using IEEE 802.11ah has not been proposed as yet. We therefore propose a new AKM mechanism for an IoT access network, which is based on IEEE 802.11 key management with the IEEE 802.1X authentication mechanism. The proposed AKM mechanism does not require any pre-configured security information between the access network domain and the IoT service domain. It considers the resource constraints of IoT devices, allowing IoT devices to delegate the burden of AKM processes to a powerful agent. The agent has sufficient power to support various authentication methods for the access point, and it performs cryptographic functions for the IoT devices. Performance analysis shows that the proposed mechanism greatly reduces computation costs, network costs, and memory usage of the resource-constrained IoT device as compared to the existing IEEE 802.11 Key Management with the IEEE 802.1X authentication mechanism. PMID:28934152

Access and management of HIV-related diseases in resource-constrained settings: a workshop report.

PubMed

Dimba, Eao; Yengopal, V; Joshua, E; Thavarajah, R; Balasundaram, S

2016-04-01

With advancement of medical interventions, the lifespan of people living with HIV has increased globally. However, low- and middle-income countries (LMICs) which bear the greatest burden of the HIV pandemic face a constant challenge in addressing the treatment needs of immune-suppressed patients. An analysis of the current management protocols and access to medication in resource-poor settings was conducted at this workshop, with emphasis on the situation in resource-poor settings. The participants developed a consensus document based on the need to respond to the constantly changing HIV pandemic. Provision of oral health care must be guided by interconnecting principles based on population based strategies that address upstream determinants of health. Basic oral health coverage in developing countries can only be realized with a strong foundation at the primary health level. Early diagnosis of HIV-related comorbidities including the adverse effects of ARVs is essential for the improvement of treatment outcomes. Standardization of oral health care delivery mechanisms will facilitate evaluation at national and regional levels. Oral health care workers have a moral obligation to participate in sustained campaigns to reduce the social stigma associated with HIV/AIDS in their work places at every stage of the referral chain. Future research also needs to realign itself towards prevention using the common risk factor approach, which has a broader impact on non-communicable diseases, which are increasingly affecting patients with HIV/AIDS as their life expectancies increase. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Introducing New Priority Setting and Resource Allocation Processes in a Canadian Healthcare Organization: A Case Study Analysis Informed by Multiple Streams Theory

PubMed Central

Smith, Neale; Mitton, Craig; Dowling, Laura; Hiltz, Mary-Ann; Campbell, Matthew; Gujar, Shashi Ashok

2016-01-01

Background: In this article, we analyze one case instance of how proposals for change to the priority setting and resource allocation (PSRA) processes at a Canadian healthcare institution reached the decision agenda of the organization’s senior leadership. We adopt key concepts from an established policy studies framework – Kingdon’s multiple streams theory – to inform our analysis. Methods: Twenty-six individual interviews were conducted at the IWK Health Centre in Halifax, NS, Canada. Participants were asked to reflect upon the reasons leading up to the implementation of a formal priority setting process – Program Budgeting and Marginal Analysis (PBMA) – in the 2012/2013 fiscal year. Responses were analyzed qualitatively using Kingdon’s model as a template. Results: The introduction of PBMA can be understood as the opening of a policy window. A problem stream – defined as lack of broad engagement and information sharing across service lines in past practice – converged with a known policy solution, PBMA, which addressed the identified problems and was perceived as easy to use and with an evidence-base from past applications across Canada and elsewhere. Conditions in the political realm allowed for this intervention to proceed, but also constrained its potential outcomes. Conclusion: Understanding in a theoretically-informed way how change occurs in healthcare management practices can provide useful lessons to researchers and decision-makers whose aim is to help health systems achieve the most effective use of available financial resources PMID:26673646

Modeling the Land Use/Cover Change in an Arid Region Oasis City Constrained by Water Resource and Environmental Policy Change using Cellular Automata Model

NASA Astrophysics Data System (ADS)

Hu, X.; Li, X.; Lu, L.

2017-12-01

Land use/cover change (LUCC) is an important subject in the research of global environmental change and sustainable development, while spatial simulation on land use/cover change is one of the key content of LUCC and is also difficult due to the complexity of the system. The cellular automata (CA) model had an irreplaceable role in simulating of land use/cover change process due to the powerful spatial computing power. However, the majority of current CA land use/cover models were binary-state model that could not provide more general information about the overall spatial pattern of land use/cover change. Here, a multi-state logistic-regression-based Markov cellular automata (MLRMCA) model and a multi-state artificial-neural-network-based Markov cellular automata (MANNMCA) model were developed and were used to simulate complex land use/cover evolutionary process in an arid region oasis city constrained by water resource and environmental policy change, the Zhangye city during the period of 1990-2010. The results indicated that the MANNMCA model was superior to MLRMCA model in simulated accuracy. These indicated that by combining the artificial neural network with CA could more effectively capture the complex relationships between the land use/cover change and a set of spatial variables. Although the MLRMCA model were also some advantages, the MANNMCA model was more appropriate for simulating complex land use/cover dynamics. The two proposed models were effective and reliable, and could reflect the spatial evolution of regional land use/cover changes. These have also potential implications for the impact assessment of water resources, ecological restoration, and the sustainable urban development in arid areas.

Working Memory in Children: A Time-Constrained Functioning Similar to Adults

ERIC Educational Resources Information Center

Portrat, Sophie; Camos, Valerie; Barrouillet, Pierre

2009-01-01

Within the time-based resource-sharing (TBRS) model, we tested a new conception of the relationships between processing and storage in which the core mechanisms of working memory (WM) are time constrained. However, our previous studies were restricted to adults. The current study aimed at demonstrating that these mechanisms are present and…

Use of evidence-based assessments for childhood anxiety disorders within a regional medical system.

PubMed

Sattler, Adam F; Ale, Chelsea M; Nguyen, Kristin; Gregg, Melissa S; Geske, Jennifer R; Whiteside, Stephen P H

2016-11-01

Anxiety disorders represent a common and serious threat to mental health in children and adolescents. To effectively treat anxiety in children, clinicians must conduct accurate assessment of patients' symptoms. However, despite the importance of assessment in the treatment of childhood anxiety disorders, the literature lacks a thorough analysis of the practices used by clinicians' when evaluating such disorders in community settings. Thus, the current study examines the quality of assessment for childhood anxiety disorders in a large regional health system. The results suggest that clinicians often provide non-specific diagnoses, infrequently document symptoms according to diagnostic criteria, and rarely administer rating scales and structured diagnostic interviews. Relatedly, diagnostic agreement across practice settings was low. Finally, the quality of assessment differed according to the setting in which the assessment was conducted and the complexity of the patient's symptomatology. These results highlight the need to develop and disseminate clinically feasible evidence-based assessment practices that can be implemented within resource-constrained service settings. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Clinical Pharmacy Consultations Provided by American and Kenyan Pharmacy Students During an Acute Care Advanced Pharmacy Practice Experience

PubMed Central

Pastakia, Sonak D.; Manji, Imran; Kamau, Evelyn; Schellhase, Ellen M.

2011-01-01

Objective To compare the clinical consultations provided by American and Kenyan pharmacy students in an acute care setting in a developing country. Methods The documented pharmacy consultation recommendations made by American and Kenyan pharmacy students during patient care rounds on an advanced pharmacy practice experience at a referral hospital in Kenya were reviewed and classified according to type of intervention and therapeutic area. Results The Kenyan students documented more interventions than American students (16.7 vs. 12.0 interventions/day) and provided significantly more consultations regarding human immunodeficiency virus (HIV) and antibiotics. The top area of consultations provided by American students was cardiovascular diseases. Conclusions American and Kenyan pharmacy students successfully providing clinical pharmacy consultations in a resource-constrained, acute-care practice setting suggests an important role for pharmacy students in the reconciliation of prescriber orders with medication administration records and in providing drug information. PMID:21655396

High sensitivity and specificity of clinical microscopy in rural health facilities in western Kenya under an external quality assurance program.

PubMed

Wafula, Rebeccah; Sang, Edna; Cheruiyot, Olympia; Aboto, Angeline; Menya, Diana; O'Meara, Wendy Prudhomme

2014-09-01

Microscopic diagnosis of malaria is a well-established and inexpensive technique that has the potential to provide accurate diagnosis of malaria infection. However, it requires both training and experience. Although it is considered the gold standard in research settings, the sensitivity and specificity of routine microscopy for clinical care in the primary care setting has been reported to be unacceptably low. We established a monthly external quality assurance program to monitor the performance of clinical microscopy in 17 rural health centers in western Kenya. The average sensitivity over the 12-month period was 96% and the average specificity was 88%. We identified specific contextual factors that contributed to inadequate performance. Maintaining high-quality malaria diagnosis in high-volume, resource-constrained health facilities is possible. © The American Society of Tropical Medicine and Hygiene.

Cosmic shear as a probe of galaxy formation physics

DOE PAGES

Foreman, Simon; Becker, Matthew R.; Wechsler, Risa H.

2016-09-01

Here, we evaluate the potential for current and future cosmic shear measurements from large galaxy surveys to constrain the impact of baryonic physics on the matter power spectrum. We do so using a model-independent parametrization that describes deviations of the matter power spectrum from the dark-matter-only case as a set of principal components that are localized in wavenumber and redshift. We perform forecasts for a variety of current and future data sets, and find that at least ~90 per cent of the constraining power of these data sets is contained in no more than nine principal components. The constraining powermore » of different surveys can be quantified using a figure of merit defined relative to currently available surveys. With this metric, we find that the final Dark Energy Survey data set (DES Y5) and the Hyper Suprime-Cam Survey will be roughly an order of magnitude more powerful than existing data in constraining baryonic effects. Upcoming Stage IV surveys (Large Synoptic Survey Telescope, Euclid, and Wide Field Infrared Survey Telescope) will improve upon this by a further factor of a few. We show that this conclusion is robust to marginalization over several key systematics. The ultimate power of cosmic shear to constrain galaxy formation is dependent on understanding systematics in the shear measurements at small (sub-arcminute) scales. Lastly, if these systematics can be sufficiently controlled, cosmic shear measurements from DES Y5 and other future surveys have the potential to provide a very clean probe of galaxy formation and to strongly constrain a wide range of predictions from modern hydrodynamical simulations.« less

Human Resource Development Issues in the Implementation of the Western China Development Strategy

ERIC Educational Resources Information Center

Xiao, Mingzheng

2007-01-01

This paper systematically illustrates the value and role of human resource development in the implementation of the Western China development strategy. It analyzes in details some current human resource issues constraining the implementation of the Western China development strategy and those on the sustainable development process of economic…

Communities and School Ratings: Examining Geography of Opportunity in an Urban School District Located in a Resource-Rich City

ERIC Educational Resources Information Center

Green, Terrance L.; Sánchez, Joanna; Germain, Emily

2017-01-01

Research on geography of opportunity documents how residential patterns influence students' access to equitable educational opportunities and resources. This scholarship often highlights how geography reinforces educational inequity in urban school districts located in resource-constrained cities. Yet, less research has explored how the geography…

Successes and Lessons Learned From Implementing Community Health Worker Programs in Community-Based and Clinical Settings: Insights From the Gulf Coast.

PubMed

Sherman, Mya; Covert, Hannah; Fox, Laila; Lichtveld, Maureen

Community health workers (CHWs) are an increasingly viable component of the American health system. While organizations may be interested in incorporating CHWs into the health care workforce, there are challenges to doing so. This study characterizes the successes and lessons learned from implementing new CHW programs in clinical and community-based settings in 4 US Gulf states. Semistructured interviews were conducted with CHWs and their supervisors. Interviews were conducted with participants in 16 community-based organizations and federally qualified health centers located in coastal counties and parishes of Louisiana, Florida, Alabama, and Mississippi. Study participants consisted of 22 CHWs and 17 CHW supervisors. Although most challenges and strategies were reported by participants working in both clinical and community-based settings, some were workplace-specific. Participants from predominantly clinical settings described the importance of strengthening organizational cohesion and coordination, whereas participants from community-based participants discussed the need for specialized training for CHWs. In both work environments, participants indicated that CHW functioning was constrained by limited organizational resources, difficulty accessing the client population, and limited knowledge regarding the CHW's scope of practice. Strategies to improve CHW functioning in both settings included investing in local partnerships, streamlining resources, prioritizing strong communication and outreach, and establishing explicit operating procedures. The majority of participants noted that challenges lessened over time. Evaluating successes and lessons learned in CHW work is critical to maximize CHWs' abilities to address clients' health needs and promote health in underserved communities. This study provides important insights into how to successfully integrate CHWs into the public health workforce.

A systems approach to implementation of eLearning in medical education: five MEPI schools' journeys.

PubMed

Vovides, Yianna; Chale, Selamawit Bedada; Gadhula, Rumbidzayi; Kebaetse, Masego B; Nigussie, Netsanet Animut; Suleman, Fatima; Tibyampansha, Dativa; Ibrahim, Glory Ramadhan; Ntabaye, Moshi; Frehywot, Seble; Nkomazana, Oathokwa

2014-08-01

How should eLearning be implemented in resource-constrained settings? The introduction of eLearning at four African medical schools and one school of pharmacy, all part of the Medical Education Partnership Initiative (MEPI) eLearning Technical Working Group, highlighted the need for five factors essential for successful and sustainable implementation: institutional support; faculty engagement; student engagement; technical expertise; and infrastructure and support systems. All five MEPI schools reported strengthening technical expertise, infrastructure, and support systems; four schools indicated that they were also successful in developing student engagement; and three reported making good progress in building institutional support. Faculty engagement was the one core component that all five schools needed to enhance.

The metabolic score: A decision making tool in diabetes care.

PubMed

Kalra, Sanjay; Gupta, Yashdeep

2015-11-01

The heterogeneity of diabetes mellitus, and the various metabolic abnormalities associated with it, are well known. Current management guidelines used to help choose glucose-lowering drugs in diabetes mellitus describe various drug classes in detail, but do not take the overall metabolic profile into consideration. To help physicians choose appropriate oral therapy, we propose a discrete metabolic score, based upon the presence and absence of metabolic comorbidities included in the definition of metabolic syndrome. This communication describes how to choose an appropriate oral antidiabetic drug using such a score. The metabolic score based decision making aid should be able to prove its utility in all health care settings, especially resource constrained societies.

A systematic approach for introducing innovative product design in courses with engineering and nonengineering students.

PubMed

Patterson, P E

2007-01-01

In our new global economy, biomedical product development teams need to be even more innovative in an environment constrained by fewer resources with less time from concept to market. Teams are often comprised of individuals spread around the world. To simulate this setting, we revised an existing course to incorporate teams of on-campus and distance students, with each team including both engineers and other specialties. Through interactive lectures and projects, we presented a systematic approach to innovation that should be useful to engineers and non-engineers alike. Students found the course challenging and exciting, displaying an improved ability to work in distributed teams and in developing innovative design solutions.

Multiplatform Mission Planning and Operations Simulation Environment for Adaptive Remote Sensors

NASA Astrophysics Data System (ADS)

Smith, G.; Ball, C.; O'Brien, A.; Johnson, J. T.

2017-12-01

We report on the design and development of mission simulator libraries to support the emerging field of adaptive remote sensors. We will outline the current state of the art in adaptive sensing, provide analysis of how the current approach to performing observing system simulation experiments (OSSEs) must be changed to enable adaptive sensors for remote sensing, and present an architecture to enable their inclusion in future OSSEs.The growing potential of sensors capable of real-time adaptation of their operational parameters calls for a new class of mission planning and simulation tools. Existing simulation tools used in OSSEs assume a fixed set of sensor parameters in terms of observation geometry, frequencies used, resolution, or observation time, which allows simplifications to be made in the simulation and allows sensor observation errors to be characterized a priori. Adaptive sensors may vary these parameters depending on the details of the scene observed, so that sensor performance is not simple to model without conducting OSSE simulations that include sensor adaptation in response to varying observational environment. Adaptive sensors are of significance to resource-constrained, small satellite platforms because they enable the management of power and data volumes while providing methods for multiple sensors to collaborate.The new class of OSSEs required to utilize adaptive sensors located on multiple platforms must answer the question: If the physical act of sensing has a cost, how does the system determine if the science value of a measurement is worth the cost and how should that cost be shared among the collaborating sensors?Here we propose to answer this question using an architecture structured around three modules: ADAPT, MANAGE and COLLABORATE. The ADAPT module is a set of routines to facilitate modeling of adaptive sensors, the MANAGE module will implement a set of routines to facilitate simulations of sensor resource management when power and data volume are constrained, and the COLLABORATE module will support simulations of coordination among multiple platforms with adaptive sensors. When used together these modules will for a simulation OSSEs that can enable both the design of adaptive algorithms to support remote sensing and the prediction of the sensor performance.

Measuring Constraint-Set Utility for Partitional Clustering Algorithms

NASA Technical Reports Server (NTRS)

Davidson, Ian; Wagstaff, Kiri L.; Basu, Sugato

2006-01-01

Clustering with constraints is an active area of machine learning and data mining research. Previous empirical work has convincingly shown that adding constraints to clustering improves the performance of a variety of algorithms. However, in most of these experiments, results are averaged over different randomly chosen constraint sets from a given set of labels, thereby masking interesting properties of individual sets. We demonstrate that constraint sets vary significantly in how useful they are for constrained clustering; some constraint sets can actually decrease algorithm performance. We create two quantitative measures, informativeness and coherence, that can be used to identify useful constraint sets. We show that these measures can also help explain differences in performance for four particular constrained clustering algorithms.

Ensembl comparative genomics resources.

PubMed

Herrero, Javier; Muffato, Matthieu; Beal, Kathryn; Fitzgerald, Stephen; Gordon, Leo; Pignatelli, Miguel; Vilella, Albert J; Searle, Stephen M J; Amode, Ridwan; Brent, Simon; Spooner, William; Kulesha, Eugene; Yates, Andrew; Flicek, Paul

2016-01-01

Evolution provides the unifying framework with which to understand biology. The coherent investigation of genic and genomic data often requires comparative genomics analyses based on whole-genome alignments, sets of homologous genes and other relevant datasets in order to evaluate and answer evolutionary-related questions. However, the complexity and computational requirements of producing such data are substantial: this has led to only a small number of reference resources that are used for most comparative analyses. The Ensembl comparative genomics resources are one such reference set that facilitates comprehensive and reproducible analysis of chordate genome data. Ensembl computes pairwise and multiple whole-genome alignments from which large-scale synteny, per-base conservation scores and constrained elements are obtained. Gene alignments are used to define Ensembl Protein Families, GeneTrees and homologies for both protein-coding and non-coding RNA genes. These resources are updated frequently and have a consistent informatics infrastructure and data presentation across all supported species. Specialized web-based visualizations are also available including synteny displays, collapsible gene tree plots, a gene family locator and different alignment views. The Ensembl comparative genomics infrastructure is extensively reused for the analysis of non-vertebrate species by other projects including Ensembl Genomes and Gramene and much of the information here is relevant to these projects. The consistency of the annotation across species and the focus on vertebrates makes Ensembl an ideal system to perform and support vertebrate comparative genomic analyses. We use robust software and pipelines to produce reference comparative data and make it freely available. Database URL: http://www.ensembl.org. © The Author(s) 2016. Published by Oxford University Press.

The benefits of international rotations to resource-limited settings for U.S. surgery residents.

PubMed

Henry, Jaymie A; Groen, Reinou S; Price, Raymond R; Nwomeh, Benedict C; Kingham, T Peter; Hardy, Mark A; Kushner, Adam L

2013-04-01

U.S. surgery residents increasingly are interested in international experiences. Recently, the Residency Review Committee approved international surgery rotations for credit toward graduation. Despite this growing interest, few U.S. surgery residency programs offer formal international rotations. We aimed to present the benefits of international surgery rotations and how these rotations contribute to the attainment of the 6 Accreditation Council for Graduate Medical Education (ACGME) competencies. An e-mail-based survey was sent in November 2011 to the 188 members of Surgeons OverSeas, a group of surgeons, residents, fellows, and medical students with experience working in resource-limited settings. They were asked to list 5 benefits of international rotations for surgery residents. The frequency of benefits was qualitatively grouped into 4 major categories: educational, personal, benefits to the foreign institution/Global Surgery, and benefits to the home institution. The themes were correlated with the 6 ACGME competencies. The 58 respondents (31% response rate) provided a total of 295 responses. Fifty themes were identified. Top benefits included learning to optimally function with limited resources, exposure to a wide variety of operative pathology, exposure to a foreign culture, and forming relationships with local counterparts. All ACGME competencies were covered by the themes. International surgery rotations to locations in which resources are constrained, operative diseases vary, and patient diversity abound provide unique opportunities for surgery residents to attain the 6 ACGME competencies. General surgery residency programs should be encouraged to establish formal international rotations as part of surgery training to promote resident education and assist with necessary oversight. Copyright © 2013 Mosby, Inc. All rights reserved.

Ensembl comparative genomics resources

PubMed Central

Muffato, Matthieu; Beal, Kathryn; Fitzgerald, Stephen; Gordon, Leo; Pignatelli, Miguel; Vilella, Albert J.; Searle, Stephen M. J.; Amode, Ridwan; Brent, Simon; Spooner, William; Kulesha, Eugene; Yates, Andrew; Flicek, Paul

2016-01-01

Evolution provides the unifying framework with which to understand biology. The coherent investigation of genic and genomic data often requires comparative genomics analyses based on whole-genome alignments, sets of homologous genes and other relevant datasets in order to evaluate and answer evolutionary-related questions. However, the complexity and computational requirements of producing such data are substantial: this has led to only a small number of reference resources that are used for most comparative analyses. The Ensembl comparative genomics resources are one such reference set that facilitates comprehensive and reproducible analysis of chordate genome data. Ensembl computes pairwise and multiple whole-genome alignments from which large-scale synteny, per-base conservation scores and constrained elements are obtained. Gene alignments are used to define Ensembl Protein Families, GeneTrees and homologies for both protein-coding and non-coding RNA genes. These resources are updated frequently and have a consistent informatics infrastructure and data presentation across all supported species. Specialized web-based visualizations are also available including synteny displays, collapsible gene tree plots, a gene family locator and different alignment views. The Ensembl comparative genomics infrastructure is extensively reused for the analysis of non-vertebrate species by other projects including Ensembl Genomes and Gramene and much of the information here is relevant to these projects. The consistency of the annotation across species and the focus on vertebrates makes Ensembl an ideal system to perform and support vertebrate comparative genomic analyses. We use robust software and pipelines to produce reference comparative data and make it freely available. Database URL: http://www.ensembl.org. PMID:26896847

Development and Validation of a Simple Risk Score for Undiagnosed Type 2 Diabetes in a Resource-Constrained Setting

PubMed Central

Gilman, Robert H.; Sanchez-Abanto, Jose R.; Study Group, CRONICAS Cohort

2016-01-01

Objective. To develop and validate a risk score for detecting cases of undiagnosed diabetes in a resource-constrained country. Methods. Two population-based studies in Peruvian population aged ≥35 years were used in the analysis: the ENINBSC survey (n = 2,472) and the CRONICAS Cohort Study (n = 2,945). Fasting plasma glucose ≥7.0 mmol/L was used to diagnose diabetes in both studies. Coefficients for risk score were derived from the ENINBSC data and then the performance was validated using both baseline and follow-up data of the CRONICAS Cohort Study. Results. The prevalence of undiagnosed diabetes was 2.0% in the ENINBSC survey and 2.9% in the CRONICAS Cohort Study. Predictors of undiagnosed diabetes were age, diabetes in first-degree relatives, and waist circumference. Score values ranged from 0 to 4, with an optimal cutoff ≥2 and had a moderate performance when applied in the CRONICAS baseline data (AUC = 0.68; 95% CI: 0.62–0.73; sensitivity 70%; specificity 59%). When predicting incident cases, the AUC was 0.66 (95% CI: 0.61–0.71), with a sensitivity of 69% and specificity of 59%. Conclusions. A simple nonblood based risk score based on age, diabetes in first-degree relatives, and waist circumference can be used as a simple screening tool for undiagnosed and incident cases of diabetes in Peru. PMID:27689096

Normal Modes of a Lagrangian System Constrained in a Potential Well.

DTIC Science & Technology

1983-12-01

A’ -137 948 NORMAL MODES OF A LFHbRANGIAN SYSTEM CONSTRAINED INvi P0TENTIAL WELL(U WISCONSNN UNIV-MADISON MATHEMATICS RESEARCH CENTER V EN DEC F1...Carolina 27709 DT FLE OP Y UNIVERSITY OF WISCONSIN-MADISON MATHEMATICS RESEARCH CENTER NORMAL MODES OF A LAGRANGIAN SYSTEM CONSTRAINED IN A POTENTIAL WELL...respect to the norm lYE [f i + 2 yi )dtl/ 0 Since H I(S’ 1 n’) C CO(S, fle ), then the set A 1 0 is an open set in H1 (lf’) The periodic solution of

Public Input on Stream Monitoring in the Willamette Valley, Oregon

EPA Science Inventory

The goal of environmental monitoring is to track resource condition, and thereby support environmental knowledge and management. Judgments are inevitable during monitoring design regarding what resource features will be assessed. Constraining what to measure given a complex envir...

Public input on stream monitoring in the Willamette Valley, Oregon - ACES

EPA Science Inventory

The goal of environmental monitoring is to track resource condition, and thereby support environmental knowledge and management. Judgments are inevitable during monitoring design regarding what resource features will be assessed. Constraining what to measure given a complex envir...

What Do They Want to Know? Public Input on Stream Monitoring

EPA Science Inventory

The goal of environmental monitoring is to track resource condition, and thereby support environmental knowledge and management. Judgments are inevitable during monitoring design regarding what resource features will be assessed. Constraining what to measure in a complex environm...

Constraining the dark energy equation of state using Bayes theorem and the Kullback-Leibler divergence

NASA Astrophysics Data System (ADS)

Hee, S.; Vázquez, J. A.; Handley, W. J.; Hobson, M. P.; Lasenby, A. N.

2017-04-01

Data-driven model-independent reconstructions of the dark energy equation of state w(z) are presented using Planck 2015 era cosmic microwave background, baryonic acoustic oscillations (BAO), Type Ia supernova (SNIa) and Lyman α (Lyα) data. These reconstructions identify the w(z) behaviour supported by the data and show a bifurcation of the equation of state posterior in the range 1.5 < z < 3. Although the concordance Λ cold dark matter (ΛCDM) model is consistent with the data at all redshifts in one of the bifurcated spaces, in the other, a supernegative equation of state (also known as 'phantom dark energy') is identified within the 1.5σ confidence intervals of the posterior distribution. To identify the power of different data sets in constraining the dark energy equation of state, we use a novel formulation of the Kullback-Leibler divergence. This formalism quantifies the information the data add when moving from priors to posteriors for each possible data set combination. The SNIa and BAO data sets are shown to provide much more constraining power in comparison to the Lyα data sets. Further, SNIa and BAO constrain most strongly around redshift range 0.1-0.5, whilst the Lyα data constrain weakly over a broader range. We do not attribute the supernegative favouring to any particular data set, and note that the ΛCDM model was favoured at more than 2 log-units in Bayes factors over all the models tested despite the weakly preferred w(z) structure in the data.

An Efficient Approach to Improve the Usability of e-Learning Resources: The Role of Heuristic Evaluation

ERIC Educational Resources Information Center

Davids, Mogamat Razeen; Chikte, Usuf M. E.; Halperin, Mitchell L.

2013-01-01

Optimizing the usability of e-learning materials is necessary to maximize their potential educational impact, but this is often neglected when time and other resources are limited, leading to the release of materials that cannot deliver the desired learning outcomes. As clinician-teachers in a resource-constrained environment, we investigated…

A Two-stage Approach for Water Demand Prediction under Constrained total water use and Water Environmental Capacity

NASA Astrophysics Data System (ADS)

He, Y.; Xiaohong, C.; Lin, K.; Wang, Z.

2016-12-01

Water demand (WD) is the basis for water allocation (WA) because it can fully reflect the pressure on water resources from population and socioeconomic development. To deal with the great uncertainties and the absence of consideration of water environmental capacity (WEC) in traditional water demand prediction methods, e.g. Statistical models, System Dynamics and quota method, this study develops a two-stage approach to predict WD under constrained total water use from the perspective of ecological restraint. Regional total water demand (RTWD) is constrained by WEC, available water resources amount and total water use quota. Based on RTWD, WD is allocated in two stages according to the game theory, including predicting sub regional total water demand (SRWD) by calculating the sub region weights based on the selected indicators of socioeconomic development and predicting industrial water demand (IWD) according to the game theory. Taking the Dongjiang river basin, South China as an example of WD prediction, according to its constrained total water use quota and WEC, RTWD in 2020 is 9.83 billion m3, and IWD for agriculture, industry, service, ecology (off-stream), and domesticity are 2.32 billion m3, 3.79 billion m3, 0.75 billion m3 , 0.18 billion m3and 1.79 billion m3 respectively. The results from this study provide useful insights for effective water allocation under climate change and the strict policy of water resources management.

Identity formation and motivation of new faculty developers: A replication study in a resource constrained university.

PubMed

O'Sullivan, Patricia S; Mkony, Charles; Beard, Jessica; Irby, David M

2016-09-01

Previous studies on the identity development and motivation of faculty developers have occurred with seasoned developers in a research-rich environment. We sought to determine if the findings of those studies could be replicated with novice faculty developers in a resource-constrained environment. We interviewed 15 novice faculty developers from Muhimbili University of Health and Allied Sciences (MUHAS) who, at the time, had led faculty development activities for no more than two years. We conducted a qualitative analysis sensitized by the previous findings. Results were very similar to the previous work. The developers described compartmentalized, hierarchical, and merged identities. The impact was on their teaching as well as on others at MUHAS and on the institution itself. The motivations related to mastery, purpose, duty, satisfaction, and relatedness. This replication led us to conclude that identity development as a faculty developer occurs even in novice developers who do faculty development as only part of their work and despite constrained resources and a different culture. These developers find the work richly rewarding and their motivations benefit the institution. This body of research highlights how faculty development provides benefits to the institution as well as engaging career opportunities.

MIROS: A Hybrid Real-Time Energy-Efficient Operating System for the Resource-Constrained Wireless Sensor Nodes

PubMed Central

Liu, Xing; Hou, Kun Mean; de Vaulx, Christophe; Shi, Hongling; Gholami, Khalid El

2014-01-01

Operating system (OS) technology is significant for the proliferation of the wireless sensor network (WSN). With an outstanding OS; the constrained WSN resources (processor; memory and energy) can be utilized efficiently. Moreover; the user application development can be served soundly. In this article; a new hybrid; real-time; memory-efficient; energy-efficient; user-friendly and fault-tolerant WSN OS MIROS is designed and implemented. MIROS implements the hybrid scheduler and the dynamic memory allocator. Real-time scheduling can thus be achieved with low memory consumption. In addition; it implements a mid-layer software EMIDE (Efficient Mid-layer Software for User-Friendly Application Development Environment) to decouple the WSN application from the low-level system. The application programming process can consequently be simplified and the application reprogramming performance improved. Moreover; it combines both the software and the multi-core hardware techniques to conserve the energy resources; improve the node reliability; as well as achieve a new debugging method. To evaluate the performance of MIROS; it is compared with the other WSN OSes (TinyOS; Contiki; SOS; openWSN and mantisOS) from different OS concerns. The final evaluation results prove that MIROS is suitable to be used even on the tight resource-constrained WSN nodes. It can support the real-time WSN applications. Furthermore; it is energy efficient; user friendly and fault tolerant. PMID:25248069

'One health' and development priorities in resource-constrained countries: policy lessons from avian and pandemic influenza preparedness in Zambia.

PubMed

Mwacalimba, Kennedy Kapala; Green, Judith

2015-03-01

'One World, One Health' has become a key rallying theme for the integration of public health and animal health priorities, particularly in the governance of pandemic-scale zoonotic infectious disease threats. However, the policy challenges of integrating public health and animal health priorities in the context of trade and development issues remain relatively unexamined, and few studies to date have explored the implications of global disease governance for resource-constrained countries outside the main centres of zoonotic outbreaks. This article draws on a policy study of national level avian and pandemic influenza preparedness between 2005 and 2009 across the sectors of trade, health and agriculture in Zambia. We highlight the challenges of integrating disease control interventions amidst trade and developmental realities in resource-poor environments. One Health prioritizes disease risk mitigation, sidelining those trade and development narratives which speak to broader public health concerns. We show how locally important trade and development imperatives were marginalized in Zambia, limiting the effectiveness of pandemic preparedness. Our findings are likely to be generalizable to other resource-constrained countries, and suggest that effective disease governance requires alignment with trade and development sectors, as well as integration of veterinary and public health sectors. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2014; all rights reserved.

MIROS: a hybrid real-time energy-efficient operating system for the resource-constrained wireless sensor nodes.

PubMed

Liu, Xing; Hou, Kun Mean; de Vaulx, Christophe; Shi, Hongling; El Gholami, Khalid

2014-09-22

Operating system (OS) technology is significant for the proliferation of the wireless sensor network (WSN). With an outstanding OS; the constrained WSN resources (processor; memory and energy) can be utilized efficiently. Moreover; the user application development can be served soundly. In this article; a new hybrid; real-time; memory-efficient; energy-efficient; user-friendly and fault-tolerant WSN OS MIROS is designed and implemented. MIROS implements the hybrid scheduler and the dynamic memory allocator. Real-time scheduling can thus be achieved with low memory consumption. In addition; it implements a mid-layer software EMIDE (Efficient Mid-layer Software for User-Friendly Application Development Environment) to decouple the WSN application from the low-level system. The application programming process can consequently be simplified and the application reprogramming performance improved. Moreover; it combines both the software and the multi-core hardware techniques to conserve the energy resources; improve the node reliability; as well as achieve a new debugging method. To evaluate the performance of MIROS; it is compared with the other WSN OSes (TinyOS; Contiki; SOS; openWSN and mantisOS) from different OS concerns. The final evaluation results prove that MIROS is suitable to be used even on the tight resource-constrained WSN nodes. It can support the real-time WSN applications. Furthermore; it is energy efficient; user friendly and fault tolerant.

Low-Cost Virtual Laboratory Workbench for Electronic Engineering

ERIC Educational Resources Information Center

Achumba, Ifeyinwa E.; Azzi, Djamel; Stocker, James

2010-01-01

The laboratory component of undergraduate engineering education poses challenges in resource constrained engineering faculties. The cost, time, space and physical presence requirements of the traditional (real) laboratory approach are the contributory factors. These resource constraints may mitigate the acquisition of meaningful laboratory…

A Comparison of Four Item-Selection Methods for Severely Constrained CATs

ERIC Educational Resources Information Center

He, Wei; Diao, Qi; Hauser, Carl

2014-01-01

This study compared four item-selection procedures developed for use with severely constrained computerized adaptive tests (CATs). Severely constrained CATs refer to those adaptive tests that seek to meet a complex set of constraints that are often not conclusive to each other (i.e., an item may contribute to the satisfaction of several…

Promoting community participation in priority setting in district health systems: experiences from Mbarali district, Tanzania

PubMed Central

Kamuzora, Peter; Maluka, Stephen; Ndawi, Benedict; Byskov, Jens; Hurtig, Anna-Karin

2013-01-01

Background Community participation in priority setting in health systems has gained importance all over the world, particularly in resource-poor settings where governments have often failed to provide adequate public-sector services for their citizens. Incorporation of public views into priority setting is perceived as a means to restore trust, improve accountability, and secure cost-effective priorities within healthcare. However, few studies have reported empirical experiences of involving communities in priority setting in developing countries. The aim of this article is to provide the experience of implementing community participation and the challenges of promoting it in the context of resource-poor settings, weak organizations, and fragile democratic institutions. Design Key informant interviews were conducted with the Council Health Management Team (CHMT), community representatives, namely women, youth, elderly, disabled, and people living with HIV/AIDS, and other stakeholders who participated in the preparation of the district annual budget and health plans. Additionally, minutes from the Action Research Team and planning and priority-setting meeting reports were analyzed. Results A number of benefits were reported: better identification of community needs and priorities, increased knowledge of the community representatives about priority setting, increased transparency and accountability, promoted trust among health systems and communities, and perceived improved quality and accessibility of health services. However, lack of funds to support the work of the selected community representatives, limited time for deliberations, short notice for the meetings, and lack of feedback on the approved priorities constrained the performance of the community representatives. Furthermore, the findings show the importance of external facilitation and support in enabling health professionals and community representatives to arrive at effective working arrangement. Conclusion Community participation in priority setting in developing countries, characterized by weak democratic institutions and low public awareness, requires effective mobilization of both communities and health systems. In addition, this study confirms that community participation is an important element in strengthening health systems. PMID:24280341

Strengthening fairness, transparency and accountability in health care priority setting at district level in Tanzania

PubMed Central

Maluka, Stephen Oswald

2011-01-01

Health care systems are faced with the challenge of resource scarcity and have insufficient resources to respond to all health problems and target groups simultaneously. Hence, priority setting is an inevitable aspect of every health system. However, priority setting is complex and difficult because the process is frequently influenced by political, institutional and managerial factors that are not considered by conventional priority-setting tools. In a five-year EU-supported project, which started in 2006, ways of strengthening fairness and accountability in priority setting in district health management were studied. This review is based on a PhD thesis that aimed to analyse health care organisation and management systems, and explore the potential and challenges of implementing Accountability for Reasonableness (A4R) approach to priority setting in Tanzania. A qualitative case study in Mbarali district formed the basis of exploring the sociopolitical and institutional contexts within which health care decision making takes place. The study also explores how the A4R intervention was shaped, enabled and constrained by the contexts. Key informant interviews were conducted. Relevant documents were also gathered and group priority-setting processes in the district were observed. The study revealed that, despite the obvious national rhetoric on decentralisation, actual practice in the district involved little community participation. The assumption that devolution to local government promotes transparency, accountability and community participation, is far from reality. The study also found that while the A4R approach was perceived to be helpful in strengthening transparency, accountability and stakeholder engagement, integrating the innovation into the district health system was challenging. This study underscores the idea that greater involvement and accountability among local actors may increase the legitimacy and fairness of priority-setting decisions. A broader and more detailed analysis of health system elements, and socio-cultural context is imperative in fostering sustainability. Additionally, the study stresses the need to deal with power asymmetries among various actors in priority-setting contexts. PMID:22072991

The ‘empty choice’: A sociological examination of choosing medical research participation in resource-limited Sub-Saharan Africa

PubMed Central

Kingori, Patricia

2015-01-01

This article explores the views of frontline research staff in different Sub-Saharan African contexts on the notion of choice in biomedical research. It argues that the current emphasis on individual choice, in the conduct of biomedical research, ignores significant structural and contextual factors in resource-limited settings. These factors severely constrain individual options and often make biomedical research enrolment the most amenable route to healthcare for the world’s poorest. From the position of frontline research staff, local contextual factors and structural issues narrowly frame the parameters within which many prospective participants are asked to choose, to such an extent that individuals are effectively presented with an ‘empty choice’. The article draws on ethnographic and interview data and insights gained through graphic elucidation techniques. It demonstrates that for frontline research staff, macro-level structural factors and their bearing on everyday realities shape what choice in biomedical research participation means in practice. PMID:27182072

Clinicopathological correlates in HIV seropositive tuberculosis cases presenting with jaundice after initiating antiretroviral therapy with a structured review of the literature.

PubMed

Barr, David A; Ramdial, Pravistadevi K

2012-10-14

The development of jaundice after initiation of HAART in HIV-TB co-infected patients is a challenging presentation in resource constrained settings, and is often attributed to drug induced liver injury (DILI).Some investigators have described hepatic tuberculosis Immune Reconstitution Inflammatory Syndrome (TB-IRIS) as a cause of liver disease in patients initiating HAART, which could also cause jaundice. We report the clinical and histopathological features of five HIV-TB co-infected patients presenting with a syndrome of jaundice, tender hepatomegaly, bile canalicular enzyme rise and return of constitutional symptoms within 8 weeks of initiation of highly active antiretroviral therapy (HAART) for advanced HIV infection at a rural clinic in KwaZulu Natal, South Africa.All five patients had been diagnosed with tuberculosis infection prior to HAART initiation and were on antituberculous medication at time of developing jaundice. There was evidence of multiple aetiologies of liver injury in all patients. However, based on clinical course and pathological findings, predominant hepatic injury was thought to be drug induced in one case and hepatic tuberculosis associated immune reconstitution inflammatory syndrome (TB-IRIS) in the other four.In these later 4 patients, liver biopsy findings included necrotising and non-necrotising granulomatous inflammation in the lobules and portal tracts. The granulomas demonstrated - in addition to epithelioid histiocytes and Langhans giant cells - neutrophils, plasma cells and large numbers of lymphocytes, which are not features of a conventional untreated tuberculous response. In this high TB prevalent, low resource setting, TB-IRIS may be an important cause of jaundice post-HAART initiation. Clinicopathological correlation is essential for optimal diagnosis. Further multi-organ based histopathological studies in the context of immune reconstitution would be useful to clinicians in low resource settings dealing with this challenging presentation.

Building competencies for nurse administrators in the Republic of Georgia.

PubMed

Nishiyama, M; Wold, J L; Partskhladze, N

2008-06-01

To assess the level of competency among nurse administrators in the Republic of Georgia (Georgia) and to recommend interventions to implement effective nursing management practices in a resource constrained setting. The collapse of the Soviet Union in 1991 resulted in deterioration of the healthcare system in Georgia. Even though the 1995 healthcare reformers recognized that baccalaureate educated nurses were essential resources for quality health care, limited resources delayed further steps. Hence, Georgia has struggled to raise nursing education levels and to establish nursing as a professional occupation. Using an exploratory descriptive research technique, surveys of nurse managers were conducted in 2004 and in 2005. This study assessed the level of practice among Georgian nurse administrators compared with the international competencies of the International Council of Nurses. There were no organized procedures to evaluate competencies of nurses on a regular basis. While minimal clinical nursing practice guidelines exist, nurse managers did not fully utilize them for either mentoring the staff nurses or assuring an adequate quality of nursing care. Many nurse managers viewed financial constraints as an obstacle to delivering better nursing care. Recommendations include: (1) establishing effective protocols to evaluate the competencies of nurses, (2) mandating the use of existing nursing guidelines, (3) establishing effective resource inventory systems, and (4) mandating safety education and ensuring a safe work environment.

Economic incentives to capture ecosystem services through increased temporal intensification of crop production

USDA-ARS?s Scientific Manuscript database

Land resources are becoming progressively more constrained with increasing demands for food, feed, fiber, and now fuel production. Developing strategies to intensify crop production without increasing the negative impacts on water, soil, and air resources are critical. Much of the best agricultural ...

Treatment outcomes after implementation of an adapted WHO protocol for severe sepsis and septic shock in Haiti.

PubMed

Papali, Alfred; Eoin West, T; Verceles, Avelino C; Augustin, Marc E; Nathalie Colas, L; Jean-Francois, Carl H; Patel, Devang M; Todd, Nevins W; McCurdy, Michael T

2017-10-01

The World Health Organization (WHO) has developed a simplified algorithm specific to resource-limited settings for the treatment of severe sepsis emphasizing early fluids and antibiotics. However, this protocol's clinical effectiveness is unknown. We describe patient outcomes before and after implementation of an adapted WHO severe sepsis protocol at a community hospital in Haiti. Using a before-and-after study design, we retrospectively enrolled 99 adult Emergency Department patients with severe sepsis from January through March 2012. After protocol implementation in January 2014, we compared outcomes to 67 patients with severe sepsis retrospectively enrolled from February to April 2014. We defined sepsis according to the WHO's Integrated Management of Adult Illness guidelines and severe sepsis as sepsis plus organ dysfunction. After protocol implementation, quantity of fluid administered increased and the physician's differential diagnoses more often included sepsis. Patients were more likely to have follow-up vital signs taken sooner, a radiograph performed, and a lactic acid tested. There were no improvements in mortality, time to fluids or antimicrobials. Use of a simplified sepsis protocol based primarily on physiologic parameters allows for substantial improvements in process measures in the care of severely septic patients in a resource-constrained setting. Copyright © 2017 Elsevier Inc. All rights reserved.

Provider-initiated HIV testing and counselling for TB patients and suspects in Nairobi, Kenya.

PubMed

Odhiambo, J; Kizito, W; Njoroge, A; Wambua, N; Nganga, L; Mburu, M; Mansoer, J; Marum, L; Phillips, E; Chakaya, J; De Cock, K M

2008-03-01

Integrated tuberculosis (TB) and human immunodeficiency virus (HIV) services in a resource-constrained setting. Pilot provider-initiated HIV testing and counselling (PITC) for TB patients and suspects. Through partnerships, resources were mobilised to establish and support services. After community sensitisation and staff training, PITC was introduced to TB patients and then to TB suspects from December 2003 to December 2005. Of 5457 TB suspects who received PITC, 89% underwent HIV testing. Although not statistically significant, TB suspects with TB disease had an HIV prevalence of 61% compared to 63% for those without. Of the 614 suspects who declined HIV testing, 402 (65%) had TB disease. Of 2283 patients referred for cotrimoxazole prophylaxis, 1951 (86%) were enrolled, and of 1727 patients assessed for antiretroviral treatment (ART), 1618 (94%) were eligible and 1441 (83%) started treatment. PITC represents a paradigm shift and is feasible and acceptable to TB patients and TB suspects. Clear directives are nevertheless required to change practice. When offered to TB suspects, PITC identifies large numbers of persons requiring HIV care. Community sensitisation, staff training, multitasking and access to HIV care contributed to a high acceptance of HIV testing. Kenya is using this experience to inform national response and advocate wide PITC implementation in settings faced with the TB-HIV epidemic.

Forecast of Future Aviation Fuels. Part 1: Scenarios

NASA Technical Reports Server (NTRS)

English, J. M.; Liu, C. Y.; Smith, J. L.; Yin, A. K. K.; Pan, G. A.; Ayati, M. B.; Gyamfi, M.; Arabzadah, M. R.

1978-01-01

A preliminary set of scenarios is described for depicting the air transport industry as it grows and changes, up to the year 2025. This provides the background for predicting the needs for future aviation fuels to meet the requirements of the industry as new basic sources, such as oil shale and coal, which are utilized to supplement petroleum. Five scenarios are written to encompass a range of futures from a serious resource-constrained economy to a continuous and optimistic economic growth. A unique feature is the choice of one immediate range scenario which is based on a serious interruption of economic growth occasioned by an energy shortfall. This is presumed to occur due to lags in starting a synfuels program.

Solving LP Relaxations of Large-Scale Precedence Constrained Problems

NASA Astrophysics Data System (ADS)

Bienstock, Daniel; Zuckerberg, Mark

We describe new algorithms for solving linear programming relaxations of very large precedence constrained production scheduling problems. We present theory that motivates a new set of algorithmic ideas that can be employed on a wide range of problems; on data sets arising in the mining industry our algorithms prove effective on problems with many millions of variables and constraints, obtaining provably optimal solutions in a few minutes of computation.

Constraining soil C cycling with strategic, adaptive action for data and model reporting

NASA Astrophysics Data System (ADS)

Harden, J. W.; Swanston, C.; Hugelius, G.

2015-12-01

Regional to global carbon assessments include a variety of models, data sets, and conceptual structures. This includes strategies for representing the role and capacity of soils to sequester, release, and store carbon. Traditionally, many soil carbon data sets emerged from agricultural missions focused on mapping and classifying soils to enhance and protect production of food and fiber. More recently, soil carbon assessments have allowed for more strategic measurement to address the functional and spatially explicit role that soils play in land-atmosphere carbon exchange. While soil data sets are increasingly inter-comparable and increasingly sampled to accommodate global assessments, soils remain poorly constrained or understood with regard to their role in spatio-temporal variations in carbon exchange. A more deliberate approach to rapid improvement in our understanding involves a community-based activity than embraces both a nimble data repository and a dynamic structure for prioritization. Data input and output can be transparent and retrievable as data-derived products, while also being subjected to rigorous queries for merging and harmonization into a searchable, comprehensive, transparent database. Meanwhile, adaptive action groups can prioritize data and modeling needs that emerge through workshops, meta-data analyses or model testing. Our continual renewal of priorities should address soil processes, mechanisms, and feedbacks that significantly influence global C budgets and/or significantly impact the needs and services of regional soil resources that are impacted by C management. In order to refine the International Soil Carbon Network, we welcome suggestions for such groups to be led on topics such as but not limited to manipulation experiments, extreme climate events, post-disaster C management, past climate-soil interactions, or water-soil-carbon linkages. We also welcome ideas for a business model that can foster and promote idea and data sharing.

Evaluation of Effectiveness and Cost‐Effectiveness of a Clinical Decision Support System in Managing Hypertension in Resource Constrained Primary Health Care Settings: Results From a Cluster Randomized Trial

PubMed Central

Anchala, Raghupathy; Kaptoge, Stephen; Pant, Hira; Di Angelantonio, Emanuele; Franco, Oscar H.; Prabhakaran, D.

2015-01-01

Background Randomized control trials from the developed world report that clinical decision support systems (DSS) could provide an effective means to improve the management of hypertension (HTN). However, evidence from developing countries in this regard is rather limited, and there is a need to assess the impact of a clinical DSS on managing HTN in primary health care center (PHC) settings. Methods and Results We performed a cluster randomized trial to test the effectiveness and cost‐effectiveness of a clinical DSS among Indian adult hypertensive patients (between 35 and 64 years of age), wherein 16 PHC clusters from a district of Telangana state, India, were randomized to receive either a DSS or a chart‐based support (CBS) system. Each intervention arm had 8 PHC clusters, with a mean of 102 hypertensive patients per cluster (n=845 in DSS and 783 in CBS groups). Mean change in systolic blood pressure (SBP) from baseline to 12 months was the primary endpoint. The mean difference in SBP change from baseline between the DSS and CBS at the 12th month of follow‐up, adjusted for age, sex, height, waist, body mass index, alcohol consumption, vegetable intake, pickle intake, and baseline differences in blood pressure, was −6.59 mm Hg (95% confidence interval: −12.18 to −1.42; P=0.021). The cost‐effective ratio for CBS and DSS groups was $96.01 and $36.57 per mm of SBP reduction, respectively. Conclusion Clinical DSS are effective and cost‐effective in the management of HTN in resource‐constrained PHC settings. Clinical Trial Registration URL: http://www.ctri.nic.in. Unique identifier: CTRI/2012/03/002476. PMID:25559011

Biomass Allocation of Stoloniferous and Rhizomatous Plant in Response to Resource Availability: A Phylogenetic Meta-Analysis

PubMed Central

Xie, Xiu-Fang; Hu, Yu-Kun; Pan, Xu; Liu, Feng-Hong; Song, Yao-Bin; Dong, Ming

2016-01-01

Resource allocation to different functions is central in life-history theory. Plasticity of functional traits allows clonal plants to regulate their resource allocation to meet changing environments. In this study, biomass allocation traits of clonal plants were categorized into absolute biomass for vegetative growth vs. for reproduction, and their relative ratios based on a data set including 115 species and derived from 139 published literatures. We examined general pattern of biomass allocation of clonal plants in response to availabilities of resource (e.g., light, nutrients, and water) using phylogenetic meta-analysis. We also tested whether the pattern differed among clonal organ types (stolon vs. rhizome). Overall, we found that stoloniferous plants were more sensitive to light intensity than rhizomatous plants, preferentially allocating biomass to vegetative growth, aboveground part and clonal reproduction under shaded conditions. Under nutrient- and water-poor condition, rhizomatous plants were constrained more by ontogeny than by resource availability, preferentially allocating biomass to belowground part. Biomass allocation between belowground and aboveground part of clonal plants generally supported the optimal allocation theory. No general pattern of trade-off was found between growth and reproduction, and neither between sexual and clonal reproduction. Using phylogenetic meta-analysis can avoid possible confounding effects of phylogeny on the results. Our results shown the optimal allocation theory explained a general trend, which the clonal plants are able to plastically regulate their biomass allocation, to cope with changing resource availability, at least in stoloniferous and rhizomatous plants. PMID:27200071

Multiple R&D projects scheduling optimization with improved particle swarm algorithm.

PubMed

Liu, Mengqi; Shan, Miyuan; Wu, Juan

2014-01-01

For most enterprises, in order to win the initiative in the fierce competition of market, a key step is to improve their R&D ability to meet the various demands of customers more timely and less costly. This paper discusses the features of multiple R&D environments in large make-to-order enterprises under constrained human resource and budget, and puts forward a multi-project scheduling model during a certain period. Furthermore, we make some improvements to existed particle swarm algorithm and apply the one developed here to the resource-constrained multi-project scheduling model for a simulation experiment. Simultaneously, the feasibility of model and the validity of algorithm are proved in the experiment.

A Multiuser Manufacturing Resource Service Composition Method Based on the Bees Algorithm

PubMed Central

Xie, Yongquan; Zhou, Zude; Pham, Duc Truong; Xu, Wenjun; Ji, Chunqian

2015-01-01

In order to realize an optimal resource service allocation in current open and service-oriented manufacturing model, multiuser resource service composition (RSC) is modeled as a combinational and constrained multiobjective problem. The model takes into account both subjective and objective quality of service (QoS) properties as representatives to evaluate a solution. The QoS properties aggregation and evaluation techniques are based on existing researches. The basic Bees Algorithm is tailored for finding a near optimal solution to the model, since the basic version is only proposed to find a desired solution in continuous domain and thus not suitable for solving the problem modeled in our study. Particular rules are designed for handling the constraints and finding Pareto optimality. In addition, the established model introduces a trusted service set to each user so that the algorithm could start by searching in the neighbor of more reliable service chains (known as seeds) than those randomly generated. The advantages of these techniques are validated by experiments in terms of success rate, searching speed, ability of avoiding ingenuity, and so forth. The results demonstrate the effectiveness of the proposed method in handling multiuser RSC problems. PMID:26339232

Dynamic Resource Management for Parallel Tasks in an Oversubscribed Energy-Constrained Heterogeneous Environment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Imam, Neena; Koenig, Gregory A; Machovec, Dylan

2016-01-01

Abstract: The worth of completing parallel tasks is modeled using utility functions, which monotonically-decrease with time and represent the importance and urgency of a task. These functions define the utility earned by a task at the time of its completion. The performance of such a system is measured as the total utility earned by all completed tasks over some interval of time (e.g., 24 hours). To maximize system performance when scheduling dynamically arriving parallel tasks onto a high performance computing (HPC) system that is oversubscribed and energy-constrained, we have designed, analyzed, and compared different heuristic techniques. Four utility-aware heuristics (i.e.,more » Max Utility, Max Utility-per-Time, Max Utility-per-Resource, and Max Utility-per-Energy), three FCFS-based heuristics (Conservative Backfilling, EASY Backfilling, and FCFS with Multiple Queues), and a Random heuristic were examined in this study. A technique that is often used with the FCFS-based heuristics is the concept of a permanent reservation. We compare the performance of permanent reservations with temporary place-holders to demonstrate the advantages that place-holders can provide. We also present a novel energy filtering technique that constrains the maximum energy-per-resource used by each task. We conducted a simulation study to evaluate the performance of these heuristics and techniques in an energy-constrained oversubscribed HPC environment. With place-holders, energy filtering, and dropping tasks with low potential utility, our utility-aware heuristics are able to significantly outperform the existing FCFS-based techniques.« less

Reflecting the real value of health care resources in modelling and cost-effectiveness studies-The example of viral load informed differentiated care.

PubMed

Revill, Paul; Walker, Simon; Cambiano, Valentina; Phillips, Andrew; Sculpher, Mark J

2018-01-01

The WHO HIV Treatment Guidelines suggest routine viral-load monitoring can be used to differentiate antiretroviral therapy (ART) delivery and reduce the frequency of clinic visits for patients stable on ART. This recommendation was informed by economic analysis that showed the approach is very likely to be cost-effective, even in the most resource constrained of settings. The health benefits were shown to be modest but the costs of introducing and scaling up viral load monitoring can be offset by anticipated reductions in the costs of clinic visits, due to these being less frequent for many patients. The cost-effectiveness of introducing viral-load informed differentiated care depends upon whether cost reductions are possible if the number of clinic visits is reduced and/or how freed clinic capacity is used for alternative priorities. Where freed resources, either physical or financial, generate large health gains (e.g. if committed to patients failing ART or to other high value health care interventions), the benefits of differentiated care are expected to be high; if however these freed physical resources are already under-utilized or financial resources are used less efficiently and would not be put to as beneficial an alternative use, the policy may not be cost-effective. The implication is that the use of conventional unit costs to value resources may not well reflect the latter's value in contributing to health improvement. Analyses intended to inform resource allocated decisions in a number of settings may therefore have to be interpreted with due consideration to local context. In this paper we present methods of how economic analyses can reflect the real value of health care resources rather than simply applying their unit costs. The analyses informing the WHO Guidelines are re-estimated by implementing scenarios using this framework, informing how differentiated care can be prioritized to generate greatest gains in population health. The findings have important implications for how economic analyses should be undertaken and reported in HIV and other disease areas. Results provide guidance on conditions under which viral load informed differentiated care will more likely prove to be cost effective when implemented.

Research in surgery and anesthesia: challenges for post-graduate trainees in Uganda.

PubMed

Elobu, Alex E; Kintu, Andrew; Galukande, Moses; Kaggwa, Sam; Mijjumbi, Cephas; Tindimwebwa, Joseph; Roche, Anthony; Dubowitz, Gerald; Ozgediz, Doruk; Lipnick, Michael

2015-01-01

Research is critical to the training and practice of surgery and anesthesia in all settings, regardless of available resources. Unfortunately, the output of surgical and perioperative research from Africa is low. Makerere University College of Health Sciences' (MakCHS) surgical and anesthesia trainees are required to conduct research, though few publish findings or go on to pursue careers that incorporate research. We believe that early career experiences with research may greatly influence physicians' future conduct and utilization of research. We therefore sought to analyze trainee experiences and perceptions of research to identify interventions that could increase production of high-quality, locally led, surgical disease research in our resource-constrained setting. Following ethical approval, a descriptive, cross-sectional survey was conducted among anesthesia and surgery trainees using a pretested, self-administered questionnaire. Data were tabulated and frequency tables generated. Of the 43 eligible trainees, 33 (77%) responded. Ninety-four percent identify research as important to career development, and 85% intend to publish their dissertations. The research dissertation is considered a financial burden by 64%. Also, 49% reported that their departments place low value on their research, and few of the findings are utilized. Trainees report that lack of protected research time, difficulty in finding research topics, and inadequate mentorship are the main challenges to conducting research projects. Our anesthesia and surgery trainees spend considerable resources on research endeavors. Most have significant interest in incorporating research into their careers, and most intend to publish their work in peer-reviewed journals. Here we identify several challenges facing trainees including research project development, financing and mentorship. We hope to use these results to improve support in these areas for our trainees and those in other resource-limited areas.

East Meet West? U.S. and China: Strategies for Global Leadership

DTIC Science & Technology

2013-03-01

construct to serve as a broader framework for this research project to describe instruments of national power in a constantly changing, resource...construct to serve as a broader framework for this research project to describe instruments of national power in a constantly changing, resource...for this research project to describe instruments of national power in a constantly changing, resource-constrained, geopolitical environment. This

On the Allocation of Resources for Secondary Schools

ERIC Educational Resources Information Center

Haelermans, Carla; De Witte, Kristof; Blank, Jos L. T.

2012-01-01

This paper studies the optimal allocation of resources--in terms of school management, teachers, supporting employees and materials--in secondary schools. We use a flexible budget constrained output distance function model to estimate both technical and allocative efficiency scores for 448 Dutch secondary schools between 2002 and 2007. The results…

Assessment of the Effectiveness of an Online Learning System in Improving Student Test Performance

ERIC Educational Resources Information Center

Buttner, E. Holly; Black, Aprille Noe

2014-01-01

Colleges and universities, particularly public institutions, are facing higher enrollments and declining resources from state and federal governments. In this resource-constrained environment, faculty are seeking more efficient and effective teaching strategies to improve student learning and test performance. The authors assessed an online…

Academic Entrepreneurship and Traditional Academic Duties: Synergy or Rivalry?

ERIC Educational Resources Information Center

De Silva, Muthu

2016-01-01

This study investigates the influence of academic entrepreneurship on traditional academic duties carried out in a resource-constrained environment, particularly focusing on whether there is synergy or rivalry between these two activities. Using qualitative evidence, we discover that there are funding, resource, knowledge and skill and networking…

Constraining the noncommutative spectral action via astrophysical observations.

PubMed

Nelson, William; Ochoa, Joseph; Sakellariadou, Mairi

2010-09-03

The noncommutative spectral action extends our familiar notion of commutative spaces, using the data encoded in a spectral triple on an almost commutative space. Varying a rather simple action, one can derive all of the standard model of particle physics in this setting, in addition to a modified version of Einstein-Hilbert gravity. In this Letter we use observations of pulsar timings, assuming that no deviation from general relativity has been observed, to constrain the gravitational sector of this theory. While the bounds on the coupling constants remain rather weak, they are comparable to existing bounds on deviations from general relativity in other settings and are likely to be further constrained by future observations.

An Optimization Framework for Dynamic, Distributed Real-Time Systems

NASA Technical Reports Server (NTRS)

Eckert, Klaus; Juedes, David; Welch, Lonnie; Chelberg, David; Bruggerman, Carl; Drews, Frank; Fleeman, David; Parrott, David; Pfarr, Barbara

2003-01-01

Abstract. This paper presents a model that is useful for developing resource allocation algorithms for distributed real-time systems .that operate in dynamic environments. Interesting aspects of the model include dynamic environments, utility and service levels, which provide a means for graceful degradation in resource-constrained situations and support optimization of the allocation of resources. The paper also provides an allocation algorithm that illustrates how to use the model for producing feasible, optimal resource allocations.

Evaluation of an Android-based mHealth system for population surveillance in developing countries

PubMed Central

Mbugua, Samuel; Amadi, David; Chepnǵeno, Viola; Saleem, Jason J; Anokwa, Yaw; Hartung, Carl; Borriello, Gaetano; Mamlin, Burke W; Ndege, Samson K; Were, Martin C

2012-01-01

Objective In parts of the developing world traditionally modeled healthcare systems do not adequately meet the needs of the populace. This can be due to imbalances in both supply and demand—there may be a lack of sufficient healthcare and the population most at need may be unable or unwilling to take advantage of it. Home-based care has emerged as a possible mechanism to bring healthcare to the populace in a cost-effective, useful manner. This study describes the development, implementation, and evaluation of a mobile device-based system to support such services. Materials and Methods Mobile phones were utilized and a structured survey was implemented to be administered by community health workers using Open Data Kit. This system was used to support screening efforts for a population of two million persons in western Kenya. Results Users of the system felt it was easy to use and facilitated their work. The system was also more cost effective than pen and paper alternatives. Discussion This implementation is one of the largest applications of a system utilizing handheld devices for performing clinical care during home visits in a resource-constrained environment. Because the data were immediately available electronically, initial reports could be performed and important trends in data could thus be detected. This allowed adjustments to the programme to be made sooner than might have otherwise been possible. Conclusion A viable, cost-effective solution at scale has been developed and implemented for collecting electronic data during household visits in a resource-constrained setting. PMID:22366295

Investigating motivating factors for sound hospital waste management.

PubMed

Ali, Mustafa; Wang, Wenping; Chaudhry, Nawaz

2016-08-01

Sustainable management of hospital waste requires an active involvement of all key players. This study aims to test the hypothesis that three motivating factors, namely, Reputation, Liability, and Expense, influence hospital waste management. The survey for this study was conducted in two phases, with the pilot study used for exploratory factor analysis and the subsequent main survey used for cross-validation using confirmatory factor analysis. The hypotheses were validated through one-sample t tests. Correlations were established between the three motivating factors and organizational characteristics of hospital type, location, category, and size. The hypotheses were validated, and it was found that the factors of Liability and Expense varied considerably with respect to location and size of a hospital. The factor of Reputation, however, did not exhibit significant variation. In conclusion, concerns about the reputation of a facility and an apprehension of liability act as incentives for sound hospital waste management, whereas concerns about financial costs and perceived overburden on staff act as disincentives. This paper identifies the non economic motivating factors that can be used to encourage behavioral changes regarding waste management at hospitals in resource constrained environments. This study discovered that organizational characteristics such as hospital size and location cause the responses to vary among the subjects. Hence a policy maker must take into account the institutional setting before introducing a change geared towards better waste management outcomes across hospitals. This study covers a topic that has hitherto been neglected in resource constrained countries. Thus it can be used as one of the first steps to highlight and tackle the issue.

A Unified Approach to Dynamic Matching and Barter Exchange

DTIC Science & Technology

2016-09-01

my quest to become a doctor (but not that kind of doctor) iv Abstract The exchange of indivisible goods without money addresses a variety of con...strained economic settings where a medium of exchange—such as money —is con- sidered inappropriate. Participants are either matched directly with another...goods without money addresses a variety of constrained economic settings where a medium of exchange—such as money —is considered repugnant [181] or other

Laboratory diagnostics in dog-mediated rabies: an overview of performance and a proposed strategy for various settings.

PubMed

Duong, Veasna; Tarantola, Arnaud; Ong, Sivuth; Mey, Channa; Choeung, Rithy; Ly, Sowath; Bourhy, Hervé; Dussart, Philippe; Buchy, Philippe

2016-05-01

The diagnosis of dog-mediated rabies in humans and animals has greatly benefited from technical advances in the laboratory setting. Approaches to diagnosis now include the detection of rabies virus (RABV), RABV RNA, or RABV antigens. These assays are important tools in the current efforts aimed at the global elimination of dog-mediated rabies. The assays available for use in laboratories are reviewed herein, as well as their strengths and weaknesses, which vary with the types of sample analyzed. Depending on the setting, however, the public health objectives and use of RABV diagnosis in the field will also vary. In non-endemic settings, the detection of all introduced or emergent animal or human cases justifies exhaustive testing. In dog RABV-endemic settings, such as rural areas of developing countries where most cases occur, the availability of or access to testing may be severely constrained. Thus, these issues are also discussed along with a proposed strategy to prioritize testing while access to rabies testing in the resource-poor, highly endemic setting is improved. As the epidemiological situation of rabies in a country evolves, the strategy should shift from that of an endemic setting to one more suitable for a decreased rabies incidence following the implementation of efficient control measures and when nearing the target of dog-mediated rabies elimination. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

The Use of Ebola Convalescent Plasma to Treat Ebola Virus Disease in Resource-Constrained Settings: A Perspective From the Field

PubMed Central

van Griensven, Johan; De Weiggheleire, Anja; Delamou, Alexandre; Smith, Peter G.; Edwards, Tansy; Vandekerckhove, Philippe; Bah, Elhadj Ibrahima; Colebunders, Robert; Herve, Isola; Lazaygues, Catherine; Haba, Nyankoye; Lynen, Lutgarde

2016-01-01

The clinical evaluation of convalescent plasma (CP) for the treatment of Ebola virus disease (EVD) in the current outbreak, predominantly affecting Guinea, Sierra Leone, and Liberia, was prioritized by the World Health Organization in September 2014. In each of these countries, nonrandomized comparative clinical trials were initiated. The Ebola-Tx trial in Conakry, Guinea, enrolled 102 patients by 7 July 2015; no severe adverse reactions were noted. The Ebola-CP trial in Sierra Leone and the EVD001 trial in Liberia have included few patients. Although no efficacy data are available yet, current field experience supports the safety, acceptability, and feasibility of CP as EVD treatment. Longer-term follow-up as well as data from nontrial settings and evidence on the scalability of the intervention are required. CP sourced from within the outbreak is the most readily available source of anti-EVD antibodies. Until the advent of effective antivirals or monoclonal antibodies, CP merits further evaluation. PMID:26261205

Integrating cervical cancer prevention initiatives with HIV care in resource-constrained settings: A formative study in Durban, South Africa

PubMed Central

Ports, Katie A.; Haffejee, Firoza; Mosavel, Maghboeba; Rameshbabu, Anjali

2015-01-01

Cervical cancer screening rates remain suboptimal among women in South Africa (SA), where cervical cancer prevalence is high. The rollout of HIV-related services across SA may provide a means to deliver cervical cancer screening to populations with limited access to healthcare systems. In this mixed methods study, psychosocial factors influencing cervical cancer prevention and perceptions of the provision of Pap smears in HIV care settings were examined. Structured interviews were conducted with women (n=67) from a municipal housing estate in Durban, SA. Key informants (n=12) also participated in semi-structured interviews. Findings revealed that participants had low cervical cancer knowledge, but desired more information. Relevant themes included the normalization of HIV and beliefs that cervical cancer might be worse than HIV. A comprehensive community clinic was desired by most, even if HIV-positive patients were treated there. This study provides important insight into integrating cervical cancer screening with HIV clinics, which may increase cancer screening among South African women. PMID:25654190

Developing a national health research system: participatory approaches to legislative, institutional and networking dimensions in Zambia.

PubMed

Chanda-Kapata, Pascalina; Campbell, Sandy; Zarowsky, Christina

2012-06-06

For many sub-Saharan African countries, a National Health Research System (NHRS) exists more in theory than in reality, with the health system itself receiving the majority of investments. However, this lack of attention to NHRS development can, in fact, frustrate health systems in achieving their desired goals. In this case study, we discuss the ongoing development of Zambia's NHRS. We reflect on our experience in the ongoing consultative development of Zambia's NHRS and offer this reflection and process documentation to those engaged in similar initiatives in other settings. We argue that three streams of concurrent activity are critical in developing an NHRS in a resource-constrained setting: developing a legislative framework to determine and define the system's boundaries and the roles all actors will play within it; creating or strengthening an institution capable of providing coordination, management and guidance to the system; and focusing on networking among institutions and individuals to harmonize, unify and strengthen the overall capacities of the research community.

Integrating Undergraduate Patient Partners into Diabetes self-management education: Evaluating a free clinic pilot program for the Underserved.

PubMed

Lee, Tiffany C; Frangos, Stephanie N; Torres, Marcella; Winckler, Britanny; Ji, Sung G; Dow, Emily

2016-01-01

Diabetes self-management education (DSME) improves glycemic control and health outcomes in patients with diabetes. A process evaluation of a two-year pilot intervention examined the feasibility and acceptability of undergraduate volunteers as Patient Partners to foster DSME participation among the underserved.Design setting, and participants. In the setting of a student-run free clinic, 22 patients enrolled in DSME were paired with 16 undergraduate volunteers. During the DSME courses, Patient Partners assisted patients during classes, called patients weekly, and accompanied patients to clinic appointments.Key process evaluation results. Average attendance at DSME classes was 79.4% and 94.7% for patients and Patient Partners, respectively. Sixty-three percent of phone calls were successful and Patient Partners attended 50% of appointments with their patients. Focus groups demonstrated resounding acceptability of the Patient Partner role. Volunteer undergraduate Patient Partners are a beneficial adjunct to DSME delivery in the resource-constrained environment of a student-run free clinic.

Health sector governance: should we be investing more?

PubMed Central

Fryatt, Robert; Bennett, Sara; Soucat, Agnes

2017-01-01

Governance is central to improving health sector performance and achieving Universal Health Coverage (UHC). However, the growing body of research on governance and health has not yet led to a global consensus on the need for more investment in governance interventions to improve health. This paper aims to summarise the latest evidence on the influence of governance on health, examines how we can assess governance interventions and considers what might constitute good investments in health sector governance in resource constrained settings. The paper concludes that agendas for improving governance need to be realistic and build on promising in-country innovation and the growing evidence base of what works in different settings. For UHC to be achieved, governance will require new partnerships and opportunities for dialogue, between state and non-state actors. Countries will require stronger platforms for effective intersectoral actions and more capacity for applied policy research and evaluation. Improved governance will also come from collective action across countries in research, norms and standards, and communicable disease control. PMID:29225938

Health sector governance: should we be investing more?

PubMed

Fryatt, Robert; Bennett, Sara; Soucat, Agnes

2017-01-01

Governance is central to improving health sector performance and achieving Universal Health Coverage (UHC). However, the growing body of research on governance and health has not yet led to a global consensus on the need for more investment in governance interventions to improve health. This paper aims to summarise the latest evidence on the influence of governance on health, examines how we can assess governance interventions and considers what might constitute good investments in health sector governance in resource constrained settings. The paper concludes that agendas for improving governance need to be realistic and build on promising in-country innovation and the growing evidence base of what works in different settings. For UHC to be achieved, governance will require new partnerships and opportunities for dialogue, between state and non-state actors. Countries will require stronger platforms for effective intersectoral actions and more capacity for applied policy research and evaluation. Improved governance will also come from collective action across countries in research, norms and standards, and communicable disease control.

Constrained target controllability of complex networks

NASA Astrophysics Data System (ADS)

Guo, Wei-Feng; Zhang, Shao-Wu; Wei, Ze-Gang; Zeng, Tao; Liu, Fei; Zhang, Jingsong; Wu, Fang-Xiang; Chen, Luonan

2017-06-01

It is of great theoretical interest and practical significance to study how to control a system by applying perturbations to only a few driver nodes. Recently, a hot topic of modern network researches is how to determine driver nodes that allow the control of an entire network. However, in practice, to control a complex network, especially a biological network, one may know not only the set of nodes which need to be controlled (i.e. target nodes), but also the set of nodes to which only control signals can be applied (i.e. constrained control nodes). Compared to the general concept of controllability, we introduce the concept of constrained target controllability (CTC) of complex networks, which concerns the ability to drive any state of target nodes to their desirable state by applying control signals to the driver nodes from the set of constrained control nodes. To efficiently investigate the CTC of complex networks, we further design a novel graph-theoretic algorithm called CTCA to estimate the ability of a given network to control targets by choosing driver nodes from the set of constrained control nodes. We extensively evaluate the CTC of numerous real complex networks. The results indicate that biological networks with a higher average degree are easier to control than biological networks with a lower average degree, while electronic networks with a lower average degree are easier to control than web networks with a higher average degree. We also show that our CTCA can more efficiently produce driver nodes for target-controlling the networks than existing state-of-the-art methods. Moreover, we use our CTCA to analyze two expert-curated bio-molecular networks and compare to other state-of-the-art methods. The results illustrate that our CTCA can efficiently identify proven drug targets and new potentials, according to the constrained controllability of those biological networks.

Constrained minimization of smooth functions using a genetic algorithm

NASA Technical Reports Server (NTRS)

Moerder, Daniel D.; Pamadi, Bandu N.

1994-01-01

The use of genetic algorithms for minimization of differentiable functions that are subject to differentiable constraints is considered. A technique is demonstrated for converting the solution of the necessary conditions for a constrained minimum into an unconstrained function minimization. This technique is extended as a global constrained optimization algorithm. The theory is applied to calculating minimum-fuel ascent control settings for an energy state model of an aerospace plane.

Dark clouds in co-creation, and their silver linings practical challenges we faced in a participatory project in a resource-constrained community in India, and how we overcame (some of) them.

PubMed

Sushama, Preeti; Ghergu, Cristian; Meershoek, Agnes; de Witte, Luc P; van Schayck, Onno C P; Krumeich, Anja

2018-01-01

While any type of field-based research is challenging, building action-oriented, participatory research in resource-constrained settings can be even more so. In this article, we aim to examine and provide insights into some of the practical challenges that were faced during the course of a participatory project based in two non-notified slums in Bangalore, India, aiming to build solutions to indoor air pollution from cooking on traditional cook stoves. The article draws upon experiences of the authors as field researchers engaged in a community-based project that adopted an exploratory, iterative design to its planning and implementation, which involved community visits, semi-structured interviews, prioritization workshops, community forums, photo voice activities, chulha-building sessions and cooking trials. The main obstacles to field work were linked to fostering open, continued dialogue with the community, aimed at bridging the gap between the 'scientific' and the 'local' worlds. Language and cultural barriers led to a reliance on interpreters, which affected both the quality of the interaction as well as the relationship between the researchers and the community that was built out of that interaction. The transience in housing and location of members of the community also led to difficulties in following up on incomplete information. Furthermore, facilitating meaningful participation from the people within the context of restricted resources, differing priorities, and socio-cultural diversity was particularly challenging. These were further compounded by the constraints of time and finances brought on by the embeddedness of the project within institutional frameworks and conventional research requirements of a fixed, pre-planned and externally determined focus, timeline, activities and benchmarks for the project. This article calls for revisiting of scientific conventions and funding prerequisites, in order to create spaces that support flexible, emergent and adaptive field-based research projects which can respond effectively to the needs and priorities of the community.

Remote gaming on resource-constrained devices

NASA Astrophysics Data System (ADS)

Reza, Waazim; Kalva, Hari; Kaufman, Richard

2010-08-01

Games have become important applications on mobile devices. A mobile gaming approach known as remote gaming is being developed to support games on low cost mobile devices. In the remote gaming approach, the responsibility of rendering a game and advancing the game play is put on remote servers instead of the resource constrained mobile devices. The games rendered on the servers are encoded as video and streamed to mobile devices. Mobile devices gather user input and stream the commands back to the servers to advance game play. With this solution, mobile devices with video playback and network connectivity can become game consoles. In this paper we present the design and development of such a system and evaluate the performance and design considerations to maximize the end user gaming experience.

Knowledge-based design of generate-and-patch problem solvers that solve global resource assignment problems

NASA Technical Reports Server (NTRS)

Voigt, Kerstin

1992-01-01

We present MENDER, a knowledge based system that implements software design techniques that are specialized to automatically compile generate-and-patch problem solvers that satisfy global resource assignments problems. We provide empirical evidence of the superior performance of generate-and-patch over generate-and-test: even with constrained generation, for a global constraint in the domain of '2D-floorplanning'. For a second constraint in '2D-floorplanning' we show that even when it is possible to incorporate the constraint into a constrained generator, a generate-and-patch problem solver may satisfy the constraint more rapidly. We also briefly summarize how an extended version of our system applies to a constraint in the domain of 'multiprocessor scheduling'.

MOOCs Feasibility Study: Demand among Teachers in Rural Ghana

ERIC Educational Resources Information Center

Johnston, Jamie

2016-01-01

Massive Open Online Courses (MOOCs) are a relatively new, low-cost resource that hold potential for improving learning in developing nations where resources are constrained and teacher expertise can be limited. However, little information currently exists about the effectiveness of leveraging MOOCs as a vehicle for teacher training. The aim of…

A chance constraint estimation approach to optimizing resource management under uncertainty

Treesearch

Michael Bevers

2007-01-01

Chance-constrained optimization is an important method for managing risk arising from random variations in natural resource systems, but the probabilistic formulations often pose mathematical programming problems that cannot be solved with exact methods. A heuristic estimation method for these problems is presented that combines a formulation for order statistic...

A Novel Optimal Joint Resource Allocation Method in Cooperative Multicarrier Networks: Theory and Practice

PubMed Central

Gao, Yuan; Zhou, Weigui; Ao, Hong; Chu, Jian; Zhou, Quan; Zhou, Bo; Wang, Kang; Li, Yi; Xue, Peng

2016-01-01

With the increasing demands for better transmission speed and robust quality of service (QoS), the capacity constrained backhaul gradually becomes a bottleneck in cooperative wireless networks, e.g., in the Internet of Things (IoT) scenario in joint processing mode of LTE-Advanced Pro. This paper focuses on resource allocation within capacity constrained backhaul in uplink cooperative wireless networks, where two base stations (BSs) equipped with single antennae serve multiple single-antennae users via multi-carrier transmission mode. In this work, we propose a novel cooperative transmission scheme based on compress-and-forward with user pairing to solve the joint mixed integer programming problem. To maximize the system capacity under the limited backhaul, we formulate the joint optimization problem of user sorting, subcarrier mapping and backhaul resource sharing among different pairs (subcarriers for users). A novel robust and efficient centralized algorithm based on alternating optimization strategy and perfect mapping is proposed. Simulations show that our novel method can improve the system capacity significantly under the constraint of the backhaul resource compared with the blind alternatives. PMID:27077865

"Whatever I have, I have made by coming into this profession": the intersection of resources, agency, and achievements in pathways to sex work in Kolkata, India.

PubMed

Swendeman, Dallas; Fehrenbacher, Anne E; Ali, Samira; George, Sheba; Mindry, Deborah; Collins, Mallory; Ghose, Toorjo; Dey, Bharati

2015-05-01

This article investigated the complex interplay of choice, socioeconomic structural factors, and empowerment influencing engagement in sex work. The analysis was focused on pathways into and reasons for staying in sex work from in-depth qualitative interviews with participants (n = 37) recruited from the Durbar community-led structural intervention in Kolkata, India. Kabeer's theory of empowerment focused on resources, agency, and achievements was utilized to interpret the results. Results identified that contexts of disempowerment constraining resources and agency set the stage for initiating sex work, typically due to familial poverty, loss of a father or husband as a breadwinner, and lack of economic opportunities for women in India. Labor force participation in informal sectors was common, specifically in domestic, construction, and manufacturing work, but was typically insufficient to provide for families and also often contingent on sexual favors. The availability of an urban market for sex work served as a catalyst or resource, in conjunction with Durbar's programmatic resources, for women to find and exercise agency and achieve financial and personal autonomy not possible in other work or as dependents on male partners. Resources lost in becoming a sex worker due to stigma, discrimination, and rejection by family and communities were compensated for by achievements in gaining financial and social resources, personal autonomy and independence, and the ability to support children and extended family. Durbar's programs and activities (e.g., savings and lending cooperative, community mobilization, advocacy) function as empowering resources that are tightly linked to sex workers' agency, achievements, and sex work pathways.

“Whatever I have, I have made by coming into this profession”: The intersection of resources, agency, and achievements in pathways to sex work in Kolkata, India

PubMed Central

Swendeman, Dallas; Fehrenbacher, Anne E.; Ali, Samira; George, Sheba; Mindry, Deborah; Collins, Mallory; Ghose, Toorjo; Dey, Bharati

2015-01-01

This paper investigates the complex interplay of choice, socio-economic structural factors, and empowerment influencing engagement in sex work. The analysis is focused on pathways into and reasons for staying in sex work from in-depth qualitative interviews with participants (n=37) recruited from the Durbar community-led structural intervention in Kolkata, India. Kabeer’s theory of empowerment focused on resources, agency, and achievements is utilized to interpret the results. Results identify that contexts of disempowerment constraining resources and agency set the stage for initiating sex work, typically due to familial poverty, loss of a father or husband as a breadwinner, and lack of economic opportunities for women in India. Labor force participation in informal sectors was common, specifically in domestic, construction, and manufacturing work, but was typically insufficient to provide for families and also often contingent on sexual favors. The availability of an urban market for sex work served as a catalyst or resource, in conjunction with Durbar’s programmatic resources, for women to find and exercise agency and achieve financial and personal autonomy not possible in other work or as dependents on male partners. Resources lost in becoming a sex worker due to stigma, discrimination, and rejection by family and communities were compensated for by achievements in gaining financial and social resources, personal autonomy and independence, and the ability to support children and extended family. Durbar’s programs and activities (e.g., savings and lending cooperative, community mobilization, advocacy) function as empowering resources that are tightly linked to sex workers’ agency, achievements, and sex work pathways. PMID:25583373

Constrained Multiobjective Biogeography Optimization Algorithm

PubMed Central

Mo, Hongwei; Xu, Zhidan; Xu, Lifang; Wu, Zhou; Ma, Haiping

2014-01-01

Multiobjective optimization involves minimizing or maximizing multiple objective functions subject to a set of constraints. In this study, a novel constrained multiobjective biogeography optimization algorithm (CMBOA) is proposed. It is the first biogeography optimization algorithm for constrained multiobjective optimization. In CMBOA, a disturbance migration operator is designed to generate diverse feasible individuals in order to promote the diversity of individuals on Pareto front. Infeasible individuals nearby feasible region are evolved to feasibility by recombining with their nearest nondominated feasible individuals. The convergence of CMBOA is proved by using probability theory. The performance of CMBOA is evaluated on a set of 6 benchmark problems and experimental results show that the CMBOA performs better than or similar to the classical NSGA-II and IS-MOEA. PMID:25006591

Regularizing Unpredictable Variation: Evidence from a Natural Language Setting

ERIC Educational Resources Information Center

Hendricks, Alison Eisel; Miller, Karen; Jackson, Carrie N.

2018-01-01

While previous sociolinguistic research has demonstrated that children faithfully acquire probabilistic input constrained by sociolinguistic and linguistic factors (e.g., gender and socioeconomic status), research suggests children regularize inconsistent input-probabilistic input that is not sociolinguistically constrained (e.g., Hudson Kam &…

Cluster randomised controlled trial of a peer-led lifestyle intervention program: study protocol for the Kerala diabetes prevention program.

PubMed

Sathish, Thirunavukkarasu; Williams, Emily D; Pasricha, Naanki; Absetz, Pilvikki; Lorgelly, Paula; Wolfe, Rory; Mathews, Elezebeth; Aziz, Zahra; Thankappan, Kavumpurathu Raman; Zimmet, Paul; Fisher, Edwin; Tapp, Robyn; Hollingsworth, Bruce; Mahal, Ajay; Shaw, Jonathan; Jolley, Damien; Daivadanam, Meena; Oldenburg, Brian

2013-11-04

India currently has more than 60 million people with Type 2 Diabetes Mellitus (T2DM) and this is predicted to increase by nearly two-thirds by 2030. While management of those with T2DM is important, preventing or delaying the onset of the disease, especially in those individuals at 'high risk' of developing T2DM, is urgently needed, particularly in resource-constrained settings. This paper describes the protocol for a cluster randomised controlled trial of a peer-led lifestyle intervention program to prevent diabetes in Kerala, India. A total of 60 polling booths are randomised to the intervention arm or control arm in rural Kerala, India. Data collection is conducted in two steps. Step 1 (Home screening): Participants aged 30-60 years are administered a screening questionnaire. Those having no history of T2DM and other chronic illnesses with an Indian Diabetes Risk Score value of ≥60 are invited to attend a mobile clinic (Step 2). At the mobile clinic, participants complete questionnaires, undergo physical measurements, and provide blood samples for biochemical analysis. Participants identified with T2DM at Step 2 are excluded from further study participation. Participants in the control arm are provided with a health education booklet containing information on symptoms, complications, and risk factors of T2DM with the recommended levels for primary prevention. Participants in the intervention arm receive: (1) eleven peer-led small group sessions to motivate, guide and support in planning, initiation and maintenance of lifestyle changes; (2) two diabetes prevention education sessions led by experts to raise awareness on T2DM risk factors, prevention and management; (3) a participant handbook containing information primarily on peer support and its role in assisting with lifestyle modification; (4) a participant workbook to guide self-monitoring of lifestyle behaviours, goal setting and goal review; (5) the health education booklet that is given to the control arm. Follow-up assessments are conducted at 12 and 24 months. The primary outcome is incidence of T2DM. Secondary outcomes include behavioural, psychosocial, clinical, and biochemical measures. An economic evaluation is planned. Results from this trial will contribute to improved policy and practice regarding lifestyle intervention programs to prevent diabetes in India and other resource-constrained settings. Australia and New Zealand Clinical Trials Registry: ACTRN12611000262909.

The impact of hospital-based and community based models of cerebral palsy rehabilitation: a quasi-experimental study.

PubMed

Dambi, Jermaine M; Jelsma, Jennifer

2014-12-05

Cerebral palsy requires appropriate on-going rehabilitation intervention which should effectively meet the needs of both children and parents/care-givers. The provision of effective support is a challenge, particularly in resource constrained settings. A quasi-experimental pragmatic research design was used to compare the impact of two models of rehabilitation service delivery currently offered in Harare, Zimbabwe, an outreach-based programme and the other institution-based. Questionnaires were distributed to 46 caregivers of children with cerebral palsy at baseline and after three months. Twenty children received rehabilitation services in a community setting and 26 received services as outpatients at a central hospital. The Gross Motor Function Measurement was used to assess functional change. The burden of care was measured using the Caregiver Strain Index, satisfaction with physiotherapy was assessed using the modified Medrisk satisfaction with physiotherapy services questionnaire and compliance was measured as the proportion met of the scheduled appointments. Children receiving outreach-based treatment were significantly older than children in the institution-based group. Regression analysis revealed that, once age and level of severity were controlled for, children in the outreach-based treatment group improved their motor function 6% more than children receiving institution-based services. There were no differences detected between the groups with regard to caregiver well-being and 51% of the caregivers reported signs consistent with clinical distress/depression. Most caregivers (83%) expressed that they were overwhelmed by the caregiving role and this increased with the chronicity of care. The financial burden of caregiver was predictive of caregiver strain. Caregivers in the outreach-based group reported greater satisfaction with services and were more compliant (p < .001) as compared to recipients of institution-based services. Long term caregiving leads to strain in caregivers and there is a need to design interventions to alleviate the burden. The study was a pragmatic, quasi-experimental study thus causality cannot be inferred. However findings from this study suggest that the provision of care within a community setting as part of a well-structured outreach programme may be preferable method of service delivery within a resource-constrained context. It was associated with a greater improvement in functioning, greater satisfaction with services and better compliance.

Resource constrained flux balance analysis predicts selective pressure on the global structure of metabolic networks.

PubMed

Abedpour, Nima; Kollmann, Markus

2015-11-23

A universal feature of metabolic networks is their hourglass or bow-tie structure on cellular level. This architecture reflects the conversion of multiple input nutrients into multiple biomass components via a small set of precursor metabolites. However, it is yet unclear to what extent this structural feature is the result of natural selection. We extend flux balance analysis to account for limited cellular resources. Using this model, optimal structure of metabolic networks can be calculated for different environmental conditions. We observe a significant structural reshaping of metabolic networks for a toy-network and E. coli core metabolism if we increase the share of invested resources for switching between different nutrient conditions. Here, hub nodes emerge and the optimal network structure becomes bow-tie-like as a consequence of limited cellular resource constraint. We confirm this theoretical finding by comparing the reconstructed metabolic networks of bacterial species with respect to their lifestyle. We show that bow-tie structure can give a system-level fitness advantage to organisms that live in highly competitive and fluctuating environments. Here, limitation of cellular resources can lead to an efficiency-flexibility tradeoff where it pays off for the organism to shorten catabolic pathways if they are frequently activated and deactivated. As a consequence, generalists that shuttle between diverse environmental conditions should have a more predominant bow-tie structure than specialists that visit just a few isomorphic habitats during their life cycle.

Energy-constrained two-way assisted private and quantum capacities of quantum channels

NASA Astrophysics Data System (ADS)

Davis, Noah; Shirokov, Maksim E.; Wilde, Mark M.

2018-06-01

With the rapid growth of quantum technologies, knowing the fundamental characteristics of quantum systems and protocols is essential for their effective implementation. A particular communication setting that has received increased focus is related to quantum key distribution and distributed quantum computation. In this setting, a quantum channel connects a sender to a receiver, and their goal is to distill either a secret key or entanglement, along with the help of arbitrary local operations and classical communication (LOCC). In this work, we establish a general theory of energy-constrained, LOCC-assisted private and quantum capacities of quantum channels, which are the maximum rates at which an LOCC-assisted quantum channel can reliably establish a secret key or entanglement, respectively, subject to an energy constraint on the channel input states. We prove that the energy-constrained squashed entanglement of a channel is an upper bound on these capacities. We also explicitly prove that a thermal state maximizes a relaxation of the squashed entanglement of all phase-insensitive, single-mode input bosonic Gaussian channels, generalizing results from prior work. After doing so, we prove that a variation of the method introduced by Goodenough et al. [New J. Phys. 18, 063005 (2016), 10.1088/1367-2630/18/6/063005] leads to improved upper bounds on the energy-constrained secret-key-agreement capacity of a bosonic thermal channel. We then consider a multipartite setting and prove that two known multipartite generalizations of the squashed entanglement are in fact equal. We finally show that the energy-constrained, multipartite squashed entanglement plays a role in bounding the energy-constrained LOCC-assisted private and quantum capacity regions of quantum broadcast channels.

Scaling-up strategic purchasing: analysis of health system governance imperatives for strategic purchasing in a free maternal and child healthcare programme in Enugu State, Nigeria.

PubMed

Ogbuabor, Daniel Chukwuemeka; Onwujekwe, Obinna Emmanuel

2018-04-05

Significant knowledge gaps exist in the functioning of institutional designs and organisational practices in purchasing within free healthcare schemes in low resource countries. The study provides evidence of the governance requirements to scale up strategic purchasing in free healthcare policies in Nigeria and other low-resource settings facing similar approaches. The study was conducted at the Ministry of Health and in two health districts in Enugu State, Nigeria, using a qualitative case study design. Semi-structured interviews were conducted with 44 key health system actors (16 policymakers, 16 providers and 12 health facility committee leaders) purposively selected from the Ministry of Health and the two health districts. Data collection and analysis were guided by Siddiqi and colleagues' health system governance framework. Data were analysed using a framework approach. The key findings show that supportive governance practices in purchasing included systems to verify questionable provider claims, pay providers directly for services, compel providers to procure drugs centrally and track transfer of funds to providers. However, strategic vision was undermined by institutional conflicts, absence of purchaser-provider split and lack of selective contracting of providers. Benefit design was not based on stakeholder involvement. Rule of law was limited by delays in provider payment. Benefits and obligations to users were not transparent. The criteria and procedure for resource allocation were unclear. Some target beneficiaries seemed excluded from the scheme. Effectiveness and efficiency was constrained by poor adherence to purchasing rules. Accountability of purchasers and providers to users was weak. Intelligence and information is constrained by paper-based system. Rationing of free services by providers and users' non-adherence to primary gate-keeping role hindered ethics. Weak governance of purchasing function limits potential of FMCHP to contribute towards universal health coverage. Appropriate governance model for strengthening strategic purchasing in the FMCHP and possibly free healthcare interventions in other low-resource countries must pay attention to the creation of an autonomous purchasing agency, clear framework for selective contracting, stakeholder involvement, transparent benefit design, need-based resource allocation, efficient provider payment methods, stronger roles for citizens, enforcement of gatekeeping rules and use of data for decision-making.

Pain Management for Persons Living With HIV Disease: Experience With Interprofessional Education in Nigeria.

PubMed

Alexander, Carla S; Pappas, Gregory; Henley, Yvonne; Kangalawe, Angela Kaiza; Oyebola, Folaju Olusegun; Obiefune, Michael; Nwene, Ejike; Stanis-Ezeobi, Winifred; Enejoh, Victor; Nwizu, Chidi; Nwandu, Anthea Nwandu; Memiah, Peter; Etienne-Mesubi, Martine; Oni, Babatunji; Amoroso, Anthony; Redfield, Robert R

2015-08-01

Pain management (PM) has not been routinely incorporated into HIV/AIDS care and treatment in resource-constrained settings. We describe training for multidisciplinary teams tasked with integrating care management into HIV clinics to address pain for persons living with HIV in Nigeria. Education on PM was provided to mixed-disciplinary teams including didactic and iterative sessions following home and hospital visits. Participants identified challenges and performed group problem solving. HIV trainers identified barriers to introducing PM reflecting views of the patient, providers, culture, and the health environment. Implementation strategies included (1) building upon existing relationships; (2) preliminary advocacy; (3) attention to staff needs; and (4) structured data review. Implementing PM in Nigerian HIV clinics requires recognition of cultural beliefs. © The Author(s) 2014.

Homelessness and drug misuse in developing countries: A mathematical approach

NASA Astrophysics Data System (ADS)

Bhunu, C. P.

2014-06-01

Homelessness and drug-misuse are known to exist like siamese twins. We present a model to capture the dynamics in the growth in the number of homeless (street kids and street adults) and drug misusers. The reproduction numbers of the model are determined and analyzed. Results from this study suggests that adult peer pressure plays a more significant role in the growth of drug-misuse and the number of street kids. This result suggests that in resource constrained settings intervention strategies should be tailor made to target adults whose behaviour influence others to misuse drugs and abuse children. Furthermore, numerical simulations show that homelessness and drug-misuse positively enhances, the growth of each other. Thus, to effectively control these two social problems require strategies targeting both of them.

Empirical lessons regarding contraception in a protracted refugee setting: A descriptive study from Maela camp on the Thai-Myanmar border 1996 – 2015

PubMed Central

Parker, Amber L.; Lee, Tracey; Min, Aung Myat; Ontuwong, Pranee; Oo Tan, Saw; Sirinonthachai, Supachai; McGready, Rose

2017-01-01

Conflict settings and refugee camps can be chaotic places, with large and rapid population movements, exacerbated public health problems, and ad hoc health services. Reproductive health care that includes family planning is of heightened importance in such settings, however, funding and resources tend to be constrained and geared towards acute health services such as trauma management and infectious disease containment. Here we report on the complexities and challenges of providing family planning in a post-emergency refugee setting, using the example of the largest refugee camp on the Thai-Myanmar border, in existence now for over 30 years. Data from 2009 demonstrates an upward trend in uptake of all contraceptives, especially long acting reversible contraception (LARC) and permanent methods (e.g. sterilization) over time. Increased uptake occurred during periods of time when there were boosts in funding or when barriers to access were alleviated. For example a surgeon fluent in local languages is correlated with increased uptake of tubal ligation in females. These data indicate that funding directed toward contraceptives in this refugee setting led to increases in contraceptives use. However, contraceptive uptake estimates depend on the baseline population which is difficult to measure in this setting. As far as we are aware, this is the longest reported review of family planning services for a refugee camp setting to date. The lessons learned from this setting may be valuable given the current global refugee crisis. PMID:28231251

Improved One-Way Hash Chain and Revocation Polynomial-Based Self-Healing Group Key Distribution Schemes in Resource-Constrained Wireless Networks

PubMed Central

Chen, Huifang; Xie, Lei

2014-01-01

Self-healing group key distribution (SGKD) aims to deal with the key distribution problem over an unreliable wireless network. In this paper, we investigate the SGKD issue in resource-constrained wireless networks. We propose two improved SGKD schemes using the one-way hash chain (OHC) and the revocation polynomial (RP), the OHC&RP-SGKD schemes. In the proposed OHC&RP-SGKD schemes, by introducing the unique session identifier and binding the joining time with the capability of recovering previous session keys, the problem of the collusion attack between revoked users and new joined users in existing hash chain-based SGKD schemes is resolved. Moreover, novel methods for utilizing the one-way hash chain and constructing the personal secret, the revocation polynomial and the key updating broadcast packet are presented. Hence, the proposed OHC&RP-SGKD schemes eliminate the limitation of the maximum allowed number of revoked users on the maximum allowed number of sessions, increase the maximum allowed number of revoked/colluding users, and reduce the redundancy in the key updating broadcast packet. Performance analysis and simulation results show that the proposed OHC&RP-SGKD schemes are practical for resource-constrained wireless networks in bad environments, where a strong collusion attack resistance is required and many users could be revoked. PMID:25529204

Social Class, Solipsism, and Contextualism: How the Rich Are Different from the Poor

ERIC Educational Resources Information Center

Kraus, Michael W.; Piff, Paul K.; Mendoza-Denton, Rodolfo; Rheinschmidt, Michelle L.; Keltner, Dacher

2012-01-01

Social class is shaped by an individual's material resources as well as perceptions of rank vis-a-vis others in society, and in this article, we examine how class influences behavior. Diminished resources and lower rank create contexts that constrain social outcomes for lower-class individuals and enhance contextualist tendencies--that is, a focus…

Developing Inventory and Monitoring Programs Based on Multiple Objectives

Treesearch

Daniel L. Schmoldt; David L. Peterson; David G. Silsbee

1995-01-01

Resource inventory and monitoring (I&M) programs in national parks combine multiple objectives in order to create a plan of action over a finite time horizon. Because all program activities are constrained by time and money, it is critical to plan I&M activities that make the best use of available agency resources. However, multiple objectives complicate a...

Constrained Optimization Problems in Cost and Managerial Accounting--Spreadsheet Tools

ERIC Educational Resources Information Center

Amlie, Thomas T.

2009-01-01

A common problem addressed in Managerial and Cost Accounting classes is that of selecting an optimal production mix given scarce resources. That is, if a firm produces a number of different products, and is faced with scarce resources (e.g., limitations on labor, materials, or machine time), what combination of products yields the greatest profit…

The Supernovae Analysis Application (SNAP)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bayless, Amanda J.; Fryer, Christopher Lee; Wollaeger, Ryan Thomas

The SuperNovae Analysis aPplication (SNAP) is a new tool for the analysis of SN observations and validation of SN models. SNAP consists of a publicly available relational database with observational light curve, theoretical light curve, and correlation table sets with statistical comparison software, and a web interface available to the community. The theoretical models are intended to span a gridded range of parameter space. The goal is to have users upload new SN models or new SN observations and run the comparison software to determine correlations via the website. There are problems looming on the horizon that SNAP is beginningmore » to solve. For example, large surveys will discover thousands of SNe annually. Frequently, the parameter space of a new SN event is unbounded. SNAP will be a resource to constrain parameters and determine if an event needs follow-up without spending resources to create new light curve models from scratch. Second, there is no rapidly available, systematic way to determine degeneracies between parameters, or even what physics is needed to model a realistic SN. The correlations made within the SNAP system are beginning to solve these problems.« less

The Supernovae Analysis Application (SNAP)

DOE PAGES

Bayless, Amanda J.; Fryer, Christopher Lee; Wollaeger, Ryan Thomas; ...

2017-09-06

The SuperNovae Analysis aPplication (SNAP) is a new tool for the analysis of SN observations and validation of SN models. SNAP consists of a publicly available relational database with observational light curve, theoretical light curve, and correlation table sets with statistical comparison software, and a web interface available to the community. The theoretical models are intended to span a gridded range of parameter space. The goal is to have users upload new SN models or new SN observations and run the comparison software to determine correlations via the website. There are problems looming on the horizon that SNAP is beginningmore » to solve. For example, large surveys will discover thousands of SNe annually. Frequently, the parameter space of a new SN event is unbounded. SNAP will be a resource to constrain parameters and determine if an event needs follow-up without spending resources to create new light curve models from scratch. Second, there is no rapidly available, systematic way to determine degeneracies between parameters, or even what physics is needed to model a realistic SN. The correlations made within the SNAP system are beginning to solve these problems.« less

The Supernovae Analysis Application (SNAP)

NASA Astrophysics Data System (ADS)

Bayless, Amanda J.; Fryer, Chris L.; Wollaeger, Ryan; Wiggins, Brandon; Even, Wesley; de la Rosa, Janie; Roming, Peter W. A.; Frey, Lucy; Young, Patrick A.; Thorpe, Rob; Powell, Luke; Landers, Rachel; Persson, Heather D.; Hay, Rebecca

2017-09-01

The SuperNovae Analysis aPplication (SNAP) is a new tool for the analysis of SN observations and validation of SN models. SNAP consists of a publicly available relational database with observational light curve, theoretical light curve, and correlation table sets with statistical comparison software, and a web interface available to the community. The theoretical models are intended to span a gridded range of parameter space. The goal is to have users upload new SN models or new SN observations and run the comparison software to determine correlations via the website. There are problems looming on the horizon that SNAP is beginning to solve. For example, large surveys will discover thousands of SNe annually. Frequently, the parameter space of a new SN event is unbounded. SNAP will be a resource to constrain parameters and determine if an event needs follow-up without spending resources to create new light curve models from scratch. Second, there is no rapidly available, systematic way to determine degeneracies between parameters, or even what physics is needed to model a realistic SN. The correlations made within the SNAP system are beginning to solve these problems.

Cross-cultural differences in preference for recovery of mobility among spinal cord injury rehabilitation professionals.

PubMed

Ditunno, P L; Patrick, M; Stineman, M; Morganti, B; Townson, A F; Ditunno, J F

2006-09-01

Direct observation of a constrained consensus-building process in three culturally independent five-person panels of rehabilitation professionals from the US, Italy and Canada. To illustrate cultural differences in belief among rehabilitation professionals about the relative importance of alternative functional goals during spinal cord injury (SCI) rehabilitation. Spinal Cord Injury Units in Philadelphia-USA, Rome-Italy and Vancouver-Canada. Each of the three panels came to independent consensus about recovery priorities in SCI utilizing the features resource trade-off game. The procedure involves trading imagined levels of independence (resources) across different functional items (features) assuming different stages of recovery. Sphincter management was of primary importance to all three groups. The Italian and Canadian rehabilitation professionals, however, showed preference for walking over wheelchair mobility at lower stages of assumed recovery, whereas the US professionals set wheelchair independence at a higher priority than walking. These preliminary results suggest cross-cultural recovery priority differences among SCI rehabilitation professionals. These dissimilarities in preference may reflect disparities in values, cultural expectations and health care policies.

A generalized network flow model for the multi-mode resource-constrained project scheduling problem with discounted cash flows

NASA Astrophysics Data System (ADS)

Chen, Miawjane; Yan, Shangyao; Wang, Sin-Siang; Liu, Chiu-Lan

2015-02-01

An effective project schedule is essential for enterprises to increase their efficiency of project execution, to maximize profit, and to minimize wastage of resources. Heuristic algorithms have been developed to efficiently solve the complicated multi-mode resource-constrained project scheduling problem with discounted cash flows (MRCPSPDCF) that characterize real problems. However, the solutions obtained in past studies have been approximate and are difficult to evaluate in terms of optimality. In this study, a generalized network flow model, embedded in a time-precedence network, is proposed to formulate the MRCPSPDCF with the payment at activity completion times. Mathematically, the model is formulated as an integer network flow problem with side constraints, which can be efficiently solved for optimality, using existing mathematical programming software. To evaluate the model performance, numerical tests are performed. The test results indicate that the model could be a useful planning tool for project scheduling in the real world.

Intelligent Sampling of Hazardous Particle Populations in Resource-Constrained Environments

NASA Astrophysics Data System (ADS)

McCollough, J. P.; Quinn, J. M.; Starks, M. J.; Johnston, W. R.

2017-10-01

Sampling of anomaly-causing space environment drivers is necessary for both real-time operations and satellite design efforts, and optimizing measurement sampling helps minimize resource demands. Relating these measurements to spacecraft anomalies requires the ability to resolve spatial and temporal variability in the energetic charged particle hazard of interest. Here we describe a method for sampling particle fluxes informed by magnetospheric phenomenology so that, along a given trajectory, the variations from both temporal dynamics and spatial structure are adequately captured while minimizing oversampling. We describe the coordinates, sampling method, and specific regions and parameters employed. We compare resulting sampling cadences with data from spacecraft spanning the regions of interest during a geomagnetically active period, showing that the algorithm retains the gross features necessary to characterize environmental impacts on space systems in diverse orbital regimes while greatly reducing the amount of sampling required. This enables sufficient environmental specification within a resource-constrained context, such as limited telemetry bandwidth, processing requirements, and timeliness.

Joint Resource Optimization for Cognitive Sensor Networks with SWIPT-Enabled Relay.

PubMed

Lu, Weidang; Lin, Yuanrong; Peng, Hong; Nan, Tian; Liu, Xin

2017-09-13

Energy-constrained wireless networks, such as wireless sensor networks (WSNs), are usually powered by fixed energy supplies (e.g., batteries), which limits the operation time of networks. Simultaneous wireless information and power transfer (SWIPT) is a promising technique to prolong the lifetime of energy-constrained wireless networks. This paper investigates the performance of an underlay cognitive sensor network (CSN) with SWIPT-enabled relay node. In the CSN, the amplify-and-forward (AF) relay sensor node harvests energy from the ambient radio-frequency (RF) signals using power splitting-based relaying (PSR) protocol. Then, it helps forward the signal of source sensor node (SSN) to the destination sensor node (DSN) by using the harvested energy. We study the joint resource optimization including the transmit power and power splitting ratio to maximize CSN's achievable rate with the constraint that the interference caused by the CSN to the primary users (PUs) is within the permissible threshold. Simulation results show that the performance of our proposed joint resource optimization can be significantly improved.

Improved triage and emergency care for children reduces inpatient mortality in a resource-constrained setting.

PubMed Central

Molyneux, Elizabeth; Ahmad, Shafique; Robertson, Ann

2006-01-01

PROBLEM: Early assessment, prioritization for treatment and management of sick children attending a health service are critical to achieving good outcomes. Many hospitals in developing countries see large numbers of patients and have few staff, so patients often have to wait before being assessed and treated. APPROACH: We present the example of a busy Under-Fives Clinic that provided outpatient services, immunizations and treatment for medical emergencies. The clinic was providing an inadequate service resulting in some inappropriate admissions and a high case-fatality rate. We assessed the deficiencies and sought resources to improve services. LOCAL SETTING: A busy paediatric outpatient clinic in a public tertiary care hospital in Blantyre, Malawi. RELEVANT CHANGES: The main changes we made were to train staff in emergency care and triage, improve patient flow through the department and to develop close cooperation between inpatient and outpatient services. Training coincided with a restructuring of the physical layout of the department. The changes were put in place when the department reopened in January 2001. LESSONS LEARNED: Improvements in the process and delivery of care and the ability to prioritize clinical management are essential to good practice. Making the changes described above has streamlined the delivery of care and led to a reduction in inpatient mortality from 10-18% before the changes were made (before 2001) to 6-8% after. PMID:16628305

Probabilistic Reasoning for Plan Robustness

NASA Technical Reports Server (NTRS)

Schaffer, Steve R.; Clement, Bradley J.; Chien, Steve A.

2005-01-01

A planning system must reason about the uncertainty of continuous variables in order to accurately project the possible system state over time. A method is devised for directly reasoning about the uncertainty in continuous activity duration and resource usage for planning problems. By representing random variables as parametric distributions, computing projected system state can be simplified in some cases. Common approximation and novel methods are compared for over-constrained and lightly constrained domains. The system compares a few common approximation methods for an iterative repair planner. Results show improvements in robustness over the conventional non-probabilistic representation by reducing the number of constraint violations witnessed by execution. The improvement is more significant for larger problems and problems with higher resource subscription levels but diminishes as the system is allowed to accept higher risk levels.

An English language interface for constrained domains

NASA Technical Reports Server (NTRS)

Page, Brenda J.

1989-01-01

The Multi-Satellite Operations Control Center (MSOCC) Jargon Interpreter (MJI) demonstrates an English language interface for a constrained domain. A constrained domain is defined as one with a small and well delineated set of actions and objects. The set of actions chosen for the MJI is from the domain of MSOCC Applications Executive (MAE) Systems Test and Operations Language (STOL) directives and contains directives for signing a cathode ray tube (CRT) on or off, calling up or clearing a display page, starting or stopping a procedure, and controlling history recording. The set of objects chosen consists of CRTs, display pages, STOL procedures, and history files. Translation from English sentences to STOL directives is done in two phases. In the first phase, an augmented transition net (ATN) parser and dictionary are used for determining grammatically correct parsings of input sentences. In the second phase, grammatically typed sentences are submitted to a forward-chaining rule-based system for interpretation and translation into equivalent MAE STOL directives. Tests of the MJI show that it is able to translate individual clearly stated sentences into the subset of directives selected for the prototype. This approach to an English language interface may be used for similarly constrained situations by modifying the MJI's dictionary and rules to reflect the change of domain.

Is a 4-bit synaptic weight resolution enough? - constraints on enabling spike-timing dependent plasticity in neuromorphic hardware.

PubMed

Pfeil, Thomas; Potjans, Tobias C; Schrader, Sven; Potjans, Wiebke; Schemmel, Johannes; Diesmann, Markus; Meier, Karlheinz

2012-01-01

Large-scale neuromorphic hardware systems typically bear the trade-off between detail level and required chip resources. Especially when implementing spike-timing dependent plasticity, reduction in resources leads to limitations as compared to floating point precision. By design, a natural modification that saves resources would be reducing synaptic weight resolution. In this study, we give an estimate for the impact of synaptic weight discretization on different levels, ranging from random walks of individual weights to computer simulations of spiking neural networks. The FACETS wafer-scale hardware system offers a 4-bit resolution of synaptic weights, which is shown to be sufficient within the scope of our network benchmark. Our findings indicate that increasing the resolution may not even be useful in light of further restrictions of customized mixed-signal synapses. In addition, variations due to production imperfections are investigated and shown to be uncritical in the context of the presented study. Our results represent a general framework for setting up and configuring hardware-constrained synapses. We suggest how weight discretization could be considered for other backends dedicated to large-scale simulations. Thus, our proposition of a good hardware verification practice may rise synergy effects between hardware developers and neuroscientists.

Is a 4-Bit Synaptic Weight Resolution Enough? – Constraints on Enabling Spike-Timing Dependent Plasticity in Neuromorphic Hardware

PubMed Central

Pfeil, Thomas; Potjans, Tobias C.; Schrader, Sven; Potjans, Wiebke; Schemmel, Johannes; Diesmann, Markus; Meier, Karlheinz

2012-01-01

Large-scale neuromorphic hardware systems typically bear the trade-off between detail level and required chip resources. Especially when implementing spike-timing dependent plasticity, reduction in resources leads to limitations as compared to floating point precision. By design, a natural modification that saves resources would be reducing synaptic weight resolution. In this study, we give an estimate for the impact of synaptic weight discretization on different levels, ranging from random walks of individual weights to computer simulations of spiking neural networks. The FACETS wafer-scale hardware system offers a 4-bit resolution of synaptic weights, which is shown to be sufficient within the scope of our network benchmark. Our findings indicate that increasing the resolution may not even be useful in light of further restrictions of customized mixed-signal synapses. In addition, variations due to production imperfections are investigated and shown to be uncritical in the context of the presented study. Our results represent a general framework for setting up and configuring hardware-constrained synapses. We suggest how weight discretization could be considered for other backends dedicated to large-scale simulations. Thus, our proposition of a good hardware verification practice may rise synergy effects between hardware developers and neuroscientists. PMID:22822388

Implementation of health information technology to maximize efficiency of resource utilization in a geographically dispersed prenatal care delivery system.

PubMed

Cochran, Marlo Baker; Snyder, Russell R; Thomas, Elizabeth; Freeman, Daniel H; Hankins, Gary D V

2012-04-01

This study investigated the utilization of health information technology (HIT) to enhance resource utilization in a geographically dispersed tertiary care system with extensive outpatient and delivery services. It was initiated as a result of a systems change implemented after Hurricane Ike devastated southeast Texas. A retrospective database and electronic medical record review was performed, which included data collection from all patients evaluated 18 months prior (epoch I) and 18 months following (epoch II) the landfall of Hurricane Ike. The months immediately following the storm were omitted from the analysis, allowing time to establish a new baseline. We analyzed a total of 21,201 patients evaluated in triage at the University of Texas Medical Branch. Epoch I consisted of 11,280 patients and epoch II consisted of 9922 patients. Using HIT, we were able to decrease the number of visits to triage while simultaneously managing more complex patients in the outpatient setting with no clinically significant change in maternal or fetal outcome. This study developed an innovated model of care using constrained resources while providing quality and safety to our patients without additional cost to the health care delivery system. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Orchestrating care: nursing practice with hospitalised older adults.

PubMed

Dahlke, Sherry Ann; Phinney, Alison; Hall, Wendy Ann; Rodney, Patricia; Baumbusch, Jennifer

2015-12-01

The increased incidence of health challenges with aging means that nurses are increasingly caring for older adults, often in hospital settings. Research about the complexity of nursing practice with this population remains limited. To seek an explanation of nursing practice with hospitalised older adults. Design. A grounded theory study guided by symbolic interactionism was used to explore nursing practice with hospitalised older adults from a nursing perspective. Glaserian grounded theory methods were used to develop a mid-range theory after analysis of 375 hours of participant observation, 35 interviews with 24 participants and review of selected documents. The theory of orchestrating care was developed to explain how nurses are continuously trying to manage their work environments by understanding the status of the patients, their unit, mobilising the assistance of others and stretching available resources to resolve their problem of providing their older patients with what they perceived as 'good care' while sustaining themselves as 'good' nurses. They described their practice environments as hard and under-resourced. Orchestrating care is comprised of two subprocesses: building synergy and minimising strain. These two processes both facilitated and constrained each other and nurses' abilities to orchestrate care. Although system issues presented serious constraints to nursing practice, the ways in which nurses were making meaning of their work environment both aided them in managing their challenges and constrained their agency. Nurses need to be encouraged to share their important perspective about older adult care. Administrators have a role to play in giving nurses voice in workplace committees and in forums. Further research is needed to better understand how multidisciplinary teams influence care of hospitalized older adults. © 2014 John Wiley & Sons Ltd.

Prevalence and predictors of squamous intraepithelial lesions of the cervix in HIV-infected women in Lusaka, Zambia

PubMed Central

Parham, Groesbeck P.; Sahasrabuddhe, Vikrant V.; Mwanahamuntu, Mulindi H.; Shepherd, Bryan E.; Hicks, Michael L.; Stringer, Elizabeth M.; Vermund, Sten H.

2009-01-01

Objectives HIV-infected women living in resource-constrained nations like Zambia are now accessing antiretroviral therapy and thus may live long enough for HPV-induced cervical cancer to manifest and progress. We evaluated the prevalence and predictors of cervical squamous intraepithelial lesions (SIL) among HIV-infected women in Zambia. Methods We screened 150 consecutive, non-pregnant HIV-infected women accessing HIV/AIDS care services in Lusaka, Zambia. We collected cervical specimens for cytological analysis by liquid-based monolayer cytology (ThinPrep Pap Test®) and HPV typing using the Roche Linear Array® PCR assay. Results The median age of study participants was 36 years (range 23-49 years) and their median CD4+ count was 165/μL (range 7-942). The prevalence of SIL on cytology was 76% (114/150), of which 23.3% (35/150) women had low-grade SIL, 32.6% (49/150) had high-grade SIL, and 20% (30/150) had lesions suspicious for squamous cell carcinoma (SCC). High-risk HPV types were present in 85.3% (128/150) women. On univariate analyses, age of the participant, CD4+ cell count, and presence of any high-risk HPV type were significantly associated with the presence of severely abnormal cytological lesions (i.e., high-grade SIL and lesions suspicious for SCC). Multivariable logistic regression modeling suggested the presence of any high-risk HPV type as an independent predictor of severely abnormal cytology (adjusted OR: 12.4, 95% CI 2.62-58.1, p=0.02). Conclusions The high prevalence of abnormal squamous cytology in our study is one of the highest reported in any population worldwide. Screening of HIV-infected women in resource-constrained settings like Zambia should be implemented to prevent development of HPV-induced SCC. PMID:16875716

Life after pelvic organ prolapse surgery: a qualitative study in Amhara region, Ethiopia.

PubMed

Gjerde, Janne L; Rortveit, Guri; Adefris, Mulat; Belayneh, Tadesse; Blystad, Astrid

2018-05-29

Women living in resource constrained settings often have limited knowledge of and access to surgical treatment for pelvic organ prolapse. Additionally, little is known about experiences during recovery periods or about the reintegration process for women who do gain access to medical services, including surgery. This study aimed to explore women's experiences related to recovery and reintegration after free surgical treatment for pelvic organ prolapse in a resource-constrained setting. The study had a qualitative design and used in-depth interviews in the data collection with a purposive sample of 25 participants, including 12 women with pelvic organ prolapse. Recruitment took place at the University of Gondar Hospital, Ethiopia, where women with pelvic organ prolapse had been admitted for free surgical treatment. In-depth interviews were carried out with women at the hospital prior to surgery and in their homes 5-9 months following surgery. Interviews were also conducted with health-care providers (8), representatives from relevant organizations (3), and health authorities (2). The fieldwork was carried out in close collaboration with a local female interpreter. The majority of the women experienced a transformation after prolapse surgery. They went from a life dominated by fear of disclosure, discrimination, and divorce due to what was perceived as a shameful and strongly prohibitive condition both physically and socially, to a life of gradually regained physical health and reintegration into a social life. The strong mobilization of family-networks for most of the women facilitated work-related help and social support during the immediate post-surgery period as well as on a long-term basis. The women with less extensive social networks expressed greater challenges, and some struggled to meet their basic needs. All the women openly disclosed their health condition after surgery, and several actively engaged in creating awareness about the condition. Free surgical treatment substantially improved the health and social life for most of the study participants. The impact of the surgery extended to the communities in which the women lived through increased openness and awareness and thus had the potential to ensure increased disclosure among other women who suffer from this treatable condition.

The Single-Visit Approach as a Cervical Cancer Prevention Strategy Among Women With HIV in Ethiopia: Successes and Lessons Learned.

PubMed

Shiferaw, Netsanet; Salvador-Davila, Graciela; Kassahun, Konjit; Brooks, Mohamad I; Weldegebreal, Teklu; Tilahun, Yewondwossen; Zerihun, Habtamu; Nigatu, Tariku; Lulu, Kidest; Ahmed, Ismael; Blumenthal, Paul D; Asnake, Mengistu

2016-03-01

Cervical cancer is the second most common form of cancer for women in Ethiopia. Using a single-visit approach to prevent cervical cancer, the Addis Tesfa (New Hope) project in Ethiopia tested women with HIV through visual inspection of the cervix with acetic acid wash (VIA) and, if tests results were positive, offered immediate cryotherapy of the precancerous lesion or referral for loop electrosurgical excision procedure (LEEP). The objective of this article is to review screening and treatment outcomes over nearly 4 years of project implementation and to identify lessons learned to improve cervical cancer prevention programs in Ethiopia and other resource-constrained settings. We analyzed aggregate client data from August 2010 to March 2014 to obtain the number of women with HIV who were counseled, screened, and treated, as well as the number of annual follow-up visits made, from the 14 tertiary- and secondary-level health facilities implementing the single-visit approach. A health facility assessment (HFA) was also implemented from August to December 2013 to examine the effects of the single-visit approach on client flow, staff workload, and facility infrastructure 3 years after initiating the approach. Almost all (99%) of the 16,632 women with HIV counseled about the single-visit approach were screened with VIA during the study period; 1,656 (10%) of them tested VIA positive (VIA+) for precancerous lesions. Among those who tested VIA+ and were thus eligible for cryotherapy, 1,481 (97%) received cryotherapy treatment, but only 80 (63%) women eligible for LEEP actually received the treatment. The HFA results showed frequent staff turnover, some shortage of essential supplies, and rooms that were judged by providers to be too small for delivery of cervical cancer prevention services. The high proportions of VIA screening and cryotherapy treatment in the Addis Tesfa project suggest high acceptance of such services by women with HIV and feasibility of implementation in secondary- and tertiary-level health facilities. However, success of cervical cancer prevention programming must address wider health system challenges to ensure sustainability and appropriate scale-up to the general population of Ethiopia and other resource-constrained settings. © Shiferaw et al.

Accuracy of Mobile Phone and Handheld Light Microscopy for the Diagnosis of Schistosomiasis and Intestinal Protozoa Infections in Côte d'Ivoire.

PubMed

Coulibaly, Jean T; Ouattara, Mamadou; D'Ambrosio, Michael V; Fletcher, Daniel A; Keiser, Jennifer; Utzinger, Jürg; N'Goran, Eliézer K; Andrews, Jason R; Bogoch, Isaac I

2016-06-01

Handheld light microscopy using compact optics and mobile phones may improve the quality of health care in resource-constrained settings by enabling access to prompt and accurate diagnosis. Laboratory technicians were trained to operate two handheld diagnostic devices (Newton Nm1 microscope and a clip-on version of the mobile phone-based CellScope). The accuracy of these devices was compared to conventional light microscopy for the diagnosis of Schistosoma haematobium, S. mansoni, and intestinal protozoa infection in a community-based survey in rural Côte d'Ivoire. One slide of 10 ml filtered urine and a single Kato-Katz thick smear from 226 individuals were subjected to the Newton Nm1 microscope and CellScope for detection of Schistosoma eggs and compared to conventional microscopy. Additionally, 121 sodium acetate-acetic acid-formalin (SAF)-fixed stool samples were examined by the Newton Nm1 microscope and compared to conventional microscopy for the diagnosis of intestinal protozoa. The prevalence of S. haematobium, S. mansoni, Giardia intestinalis, and Entamoeba histolytica/E. dispar, as determined by conventional microscopy, was 39.8%, 5.3%, 20.7%, and 4.9%, respectively. The Newton Nm1 microscope had diagnostic sensitivities for S. mansoni and S. haematobium infection of 91.7% (95% confidence interval (CI) 59.8-99.6%) and 81.1% (95% CI 71.2-88.3%), respectively, and specificities of 99.5% (95% CI 97.0-100%) and 97.1% (95% CI 92.2-99.1%), respectively. The CellScope demonstrated sensitivities for S. mansoni and S. haematobium of 50.0% (95% CI 25.4-74.6%) and 35.6% (95% CI 25.9-46.4%), respectively, and specificities of 99.5% (95% CI 97.0-100%) and 100% (95% CI 86.7-100%), respectively. For G. intestinalis and E. histolytica/E. dispar, the Newton Nm1 microscope had sensitivity of 84.0% (95% CI 63.1-94.7%) and 83.3% (95% CI 36.5-99.1%), respectively, and 100% specificity. Handheld diagnostic devices can be employed in community-based surveys in resource-constrained settings after minimal training of laboratory technicians to diagnose intestinal parasites.

Phonological mismatch makes aided speech recognition in noise cognitively taxing.

PubMed

Rudner, Mary; Foo, Catharina; Rönnberg, Jerker; Lunner, Thomas

2007-12-01

The working memory framework for Ease of Language Understanding predicts that speech processing becomes more effortful, thus requiring more explicit cognitive resources, when there is mismatch between speech input and phonological representations in long-term memory. To test this prediction, we changed the compression release settings in the hearing instruments of experienced users and allowed them to train for 9 weeks with the new settings. After training, aided speech recognition in noise was tested with both the trained settings and orthogonal settings. We postulated that training would lead to acclimatization to the trained setting, which in turn would involve establishment of new phonological representations in long-term memory. Further, we postulated that after training, testing with orthogonal settings would give rise to phonological mismatch, associated with more explicit cognitive processing. Thirty-two participants (mean=70.3 years, SD=7.7) with bilateral sensorineural hearing loss (pure-tone average=46.0 dB HL, SD=6.5), bilaterally fitted for more than 1 year with digital, two-channel, nonlinear signal processing hearing instruments and chosen from the patient population at the Linköping University Hospital were randomly assigned to 9 weeks training with new, fast (40 ms) or slow (640 ms), compression release settings in both channels. Aided speech recognition in noise performance was tested according to a design with three within-group factors: test occasion (T1, T2), test setting (fast, slow), and type of noise (unmodulated, modulated) and one between-group factor: experience setting (fast, slow) for two types of speech materials-the highly constrained Hagerman sentences and the less-predictable Hearing in Noise Test (HINT). Complex cognitive capacity was measured using the reading span and letter monitoring tests. PREDICTION: We predicted that speech recognition in noise at T2 with mismatched experience and test settings would be associated with more explicit cognitive processing and thus stronger correlations with complex cognitive measures, as well as poorer performance if complex cognitive capacity was exceeded. Under mismatch conditions, stronger correlations were found between performance on speech recognition with the Hagerman sentences and reading span, along with poorer speech recognition for participants with low reading span scores. No consistent mismatch effect was found with HINT. The mismatch prediction generated by the working memory framework for Ease of Language Understanding is supported for speech recognition in noise with the highly constrained Hagerman sentences but not the less-predictable HINT.

Constrained variational calculus for higher order classical field theories

NASA Astrophysics Data System (ADS)

Campos, Cédric M.; de León, Manuel; Martín de Diego, David

2010-11-01

We develop an intrinsic geometrical setting for higher order constrained field theories. As a main tool we use an appropriate generalization of the classical Skinner-Rusk formalism. Some examples of applications are studied, in particular to the geometrical description of optimal control theory for partial differential equations.

Constrained Subjective Assessment of Student Learning

ERIC Educational Resources Information Center

Saliu, Sokol

2005-01-01

Student learning is a complex incremental cognitive process; assessment needs to parallel this, reporting the results in similar terms. Application of fuzzy sets and logic to the criterion-referenced assessment of student learning is considered here. The constrained qualitative assessment (CQA) system was designed, and then applied in assessing a…

Variable-Metric Algorithm For Constrained Optimization

NASA Technical Reports Server (NTRS)

Frick, James D.

1989-01-01

Variable Metric Algorithm for Constrained Optimization (VMACO) is nonlinear computer program developed to calculate least value of function of n variables subject to general constraints, both equality and inequality. First set of constraints equality and remaining constraints inequalities. Program utilizes iterative method in seeking optimal solution. Written in ANSI Standard FORTRAN 77.

Advanced timeline systems

NASA Technical Reports Server (NTRS)

Bulfin, R. L.; Perdue, C. A.

1994-01-01

The Mission Planning Division of the Mission Operations Laboratory at NASA's Marshall Space Flight Center is responsible for scheduling experiment activities for space missions controlled at MSFC. In order to draw statistically relevant conclusions, all experiments must be scheduled at least once and may have repeated performances during the mission. An experiment consists of a series of steps which, when performed, provide results pertinent to the experiment's functional objective. Since these experiments require a set of resources such as crew and power, the task of creating a timeline of experiment activities for the mission is one of resource constrained scheduling. For each experiment, a computer model with detailed information of the steps involved in running the experiment, including crew requirements, processing times, and resource requirements is created. These models are then loaded into the Experiment Scheduling Program (ESP) which attempts to create a schedule which satisfies all resource constraints. ESP uses a depth-first search technique to place each experiment into a time interval, and a scoring function to evaluate the schedule. The mission planners generate several schedules and choose one with a high value of the scoring function to send through the approval process. The process of approving a mission timeline can take several months. Each timeline must meet the requirements of the scientists, the crew, and various engineering departments as well as enforce all resource restrictions. No single objective is considered in creating a timeline. The experiment scheduling problem is: given a set of experiments, place each experiment along the mission timeline so that all resource requirements and temporal constraints are met and the timeline is acceptable to all who must approve it. Much work has been done on multicriteria decision making (MCDM). When there are two criteria, schedules which perform well with respect to one criterion will often perform poorly with respect to the other. One schedule dominates another if it performs strictly better on one criterion, and no worse on the other. Clearly, dominated schedules are undesireable. A nondominated schedule can be generated by some sort of optimization problem. Generally there are two approaches: the first is a hierarchical approach while the second requires optimizing a weighting or scoring function.

Robot-Beacon Distributed Range-Only SLAM for Resource-Constrained Operation

PubMed Central

Torres-González, Arturo; Martínez-de Dios, Jose Ramiro; Ollero, Anibal

2017-01-01

This work deals with robot-sensor network cooperation where sensor nodes (beacons) are used as landmarks for Range-Only (RO) Simultaneous Localization and Mapping (SLAM). Most existing RO-SLAM techniques consider beacons as passive devices disregarding the sensing, computational and communication capabilities with which they are actually endowed. SLAM is a resource-demanding task. Besides the technological constraints of the robot and beacons, many applications impose further resource consumption limitations. This paper presents a scalable distributed RO-SLAM scheme for resource-constrained operation. It is capable of exploiting robot-beacon cooperation in order to improve SLAM accuracy while meeting a given resource consumption bound expressed as the maximum number of measurements that are integrated in SLAM per iteration. The proposed scheme combines a Sparse Extended Information Filter (SEIF) SLAM method, in which each beacon gathers and integrates robot-beacon and inter-beacon measurements, and a distributed information-driven measurement allocation tool that dynamically selects the measurements that are integrated in SLAM, balancing uncertainty improvement and resource consumption. The scheme adopts a robot-beacon distributed approach in which each beacon participates in the selection, gathering and integration in SLAM of robot-beacon and inter-beacon measurements, resulting in significant estimation accuracies, resource-consumption efficiency and scalability. It has been integrated in an octorotor Unmanned Aerial System (UAS) and evaluated in 3D SLAM outdoor experiments. The experimental results obtained show its performance and robustness and evidence its advantages over existing methods. PMID:28425946

Robot-Beacon Distributed Range-Only SLAM for Resource-Constrained Operation.

PubMed

Torres-González, Arturo; Martínez-de Dios, Jose Ramiro; Ollero, Anibal

2017-04-20

This work deals with robot-sensor network cooperation where sensor nodes (beacons) are used as landmarks for Range-Only (RO) Simultaneous Localization and Mapping (SLAM). Most existing RO-SLAM techniques consider beacons as passive devices disregarding the sensing, computational and communication capabilities with which they are actually endowed. SLAM is a resource-demanding task. Besides the technological constraints of the robot and beacons, many applications impose further resource consumption limitations. This paper presents a scalable distributed RO-SLAM scheme for resource-constrained operation. It is capable of exploiting robot-beacon cooperation in order to improve SLAM accuracy while meeting a given resource consumption bound expressed as the maximum number of measurements that are integrated in SLAM per iteration. The proposed scheme combines a Sparse Extended Information Filter (SEIF) SLAM method, in which each beacon gathers and integrates robot-beacon and inter-beacon measurements, and a distributed information-driven measurement allocation tool that dynamically selects the measurements that are integrated in SLAM, balancing uncertainty improvement and resource consumption. The scheme adopts a robot-beacon distributed approach in which each beacon participates in the selection, gathering and integration in SLAM of robot-beacon and inter-beacon measurements, resulting in significant estimation accuracies, resource-consumption efficiency and scalability. It has been integrated in an octorotor Unmanned Aerial System (UAS) and evaluated in 3D SLAM outdoor experiments. The experimental results obtained show its performance and robustness and evidence its advantages over existing methods.

Risk-based analysis and decision making in multi-disciplinary environments

NASA Technical Reports Server (NTRS)

Feather, Martin S.; Cornford, Steven L.; Moran, Kelly

2003-01-01

A risk-based decision-making process conceived of and developed at JPL and NASA, has been used to help plan and guide novel technology applications for use on spacecraft. These applications exemplify key challenges inherent in multi-disciplinary design of novel technologies deployed in mission-critical settings. 1) Cross-disciplinary concerns are numerous (e.g., spacecraft involve navigation, propulsion, telecommunications). These concems are cross-coupled and interact in multiple ways (e.g., electromagnetic interference, heat transfer). 2) Time and budget pressures constrain development, operational resources constrain the resulting system (e.g., mass, volume, power). 3) Spacecraft are critical systems that must operate correctly the first time in only partially understood environments, with no chance for repair. 4) Past experience provides only a partial guide: New mission concepts are enhanced and enabled by new technologies, for which past experience is lacking. The decision-making process rests on quantitative assessments of the relationships between three classes of information - objectives (the things the system is to accomplish and constraints on its operation and development), risks (whose occurrence detracts from objectives), and mitigations (options for reducing the likelihood and or severity of risks). The process successfully guides experts to pool their knowledge, using custom-built software to support information gathering and decision-making.

Competitive learning with pairwise constraints.

PubMed

Covões, Thiago F; Hruschka, Eduardo R; Ghosh, Joydeep

2013-01-01

Constrained clustering has been an active research topic since the last decade. Most studies focus on batch-mode algorithms. This brief introduces two algorithms for on-line constrained learning, named on-line linear constrained vector quantization error (O-LCVQE) and constrained rival penalized competitive learning (C-RPCL). The former is a variant of the LCVQE algorithm for on-line settings, whereas the latter is an adaptation of the (on-line) RPCL algorithm to deal with constrained clustering. The accuracy results--in terms of the normalized mutual information (NMI)--from experiments with nine datasets show that the partitions induced by O-LCVQE are competitive with those found by the (batch-mode) LCVQE. Compared with this formidable baseline algorithm, it is surprising that C-RPCL can provide better partitions (in terms of the NMI) for most of the datasets. Also, experiments on a large dataset show that on-line algorithms for constrained clustering can significantly reduce the computational time.

Clinicopathological correlates in HIV seropositive tuberculosis cases presenting with jaundice after initiating antiretroviral therapy with a structured review of the literature

PubMed Central

2012-01-01

Background The development of jaundice after initiation of HAART in HIV-TB co-infected patients is a challenging presentation in resource constrained settings, and is often attributed to drug induced liver injury (DILI).Some investigators have described hepatic tuberculosis Immune Reconstitution Inflammatory Syndrome (TB-IRIS) as a cause of liver disease in patients initiating HAART, which could also cause jaundice. Case presentations We report the clinical and histopathological features of five HIV-TB co-infected patients presenting with a syndrome of jaundice, tender hepatomegaly, bile canalicular enzyme rise and return of constitutional symptoms within 8 weeks of initiation of highly active antiretroviral therapy (HAART) for advanced HIV infection at a rural clinic in KwaZulu Natal, South Africa. All five patients had been diagnosed with tuberculosis infection prior to HAART initiation and were on antituberculous medication at time of developing jaundice. There was evidence of multiple aetiologies of liver injury in all patients. However, based on clinical course and pathological findings, predominant hepatic injury was thought to be drug induced in one case and hepatic tuberculosis associated immune reconstitution inflammatory syndrome (TB-IRIS) in the other four. In these later 4 patients, liver biopsy findings included necrotising and non-necrotising granulomatous inflammation in the lobules and portal tracts. The granulomas demonstrated – in addition to epithelioid histiocytes and Langhans giant cells – neutrophils, plasma cells and large numbers of lymphocytes, which are not features of a conventional untreated tuberculous response. Conclusion In this high TB prevalent, low resource setting, TB-IRIS may be an important cause of jaundice post-HAART initiation. Clinicopathological correlation is essential for optimal diagnosis. Further multi-organ based histopathological studies in the context of immune reconstitution would be useful to clinicians in low resource settings dealing with this challenging presentation. PMID:23061403

Effectiveness of the WHO SCC on improving adherence to essential practices during childbirth, in resource constrained settings.

PubMed

Kumar, Somesh; Yadav, Vikas; Balasubramaniam, Sudharsanam; Jain, Yashpal; Joshi, Chandra Shekhar; Saran, Kailash; Sood, Bulbul

2016-11-08

India accounts for 27 % of world's neonatal deaths. Although more Indian women deliver in facilities currently than a decade ago, early neonatal mortality has not declined, likely because of insufficient quality of care. The WHO Safe Childbirth Checklist (SCC) was developed to support health workers to perform essential practices known to reduce preventable maternal and new-born deaths around the time of childbirth. Despite promising early research many outstanding questions remain about effectiveness of the SCC in low-resource settings. In collaboration with the Ministry of Health SCC was modified for Indian context and introduced in 101 intervention facilities in Rajasthan, India and 99 facilities served as comparison to study if it reduces mortality. This Quasi experimental Observational intervention-comparison was embedded in this larger program to test whether a program for introduction of SCC with simple implementation package was associated with increased adherence to 28 evidence-based practices. This study was conducted in 8 intervention and 8 comparison sites. Program interventions to promote appropriate use of the SCC included orienting providers to the checklist, modest modifications of the SCC to promote provider uptake and accountability, ensuring availability of essential supplies, and providing supportive supervision for helping providers in using the SCC. The SCC was used by providers in 86 % of 240 deliveries observed in the eight intervention facilities. Providers in the intervention group significantly adhered to practices included in the SCC than providers in the comparison group controlling for baseline scores and confounders. Women delivering in the intervention facilities received on an average 11.5 more of the 28 practices included compared with women in the comparison facilities. For selected practices provider performance in the intervention group increased as much as 93 % than comparison sites. Use of the SCC and provider performance of best practices increased in intervention facilities reflecting improvement in quality of facility childbirth care for women and new-born in low resource settings.

Development of a technical assistance framework for building organizational capacity of health programs in resource-limited settings.

PubMed

Reyes, E Michael; Sharma, Anjali; Thomas, Kate K; Kuehn, Chuck; Morales, José Rafael

2014-09-17

Little information exists on the technical assistance needs of local indigenous organizations charged with managing HIV care and treatment programs funded by the US President's Emergency Plan for AIDS Relief (PEPFAR). This paper describes the methods used to adapt the Primary Care Assessment Tool (PCAT) framework, which has successfully strengthened HIV primary care services in the US, into one that could strengthen the capacity of local partners to deliver priority health programs in resource-constrained settings by identifying their specific technical assistance needs. Qualitative methods and inductive reasoning approaches were used to conceptualize and adapt the new Clinical Assessment for Systems Strengthening (ClASS) framework. Stakeholder interviews, comparisons of existing assessment tools, and a pilot test helped determine the overall ClASS framework for use in low-resource settings. The framework was further refined one year post-ClASS implementation. Stakeholder interviews, assessment of existing tools, a pilot process and the one-year post- implementation assessment informed the adaptation of the ClASS framework for assessing and strengthening technical and managerial capacities of health programs at three levels: international partner, local indigenous partner, and local partner treatment facility. The PCAT focus on organizational strengths and systems strengthening was retained and implemented in the ClASS framework and approach. A modular format was chosen to allow the use of administrative, fiscal and clinical modules in any combination and to insert new modules as needed by programs. The pilot led to refined pre-visit planning, informed review team composition, increased visit duration, and restructured modules. A web-based toolkit was developed to capture three years of experiential learning; this kit can also be used for independent implementation of the ClASS framework. A systematic adaptation process has produced a qualitative framework that can inform implementation strategies in support of country led HIV care and treatment programs. The framework, as a well-received iterative process focused on technical assistance, may have broader utility in other global programs.

Healthcare Associated Infections in a Resource Limited Setting

PubMed Central

Doradla, Saikumar; Belgode, Harish Narasimha; Kumar, Harichandra; Swaminathan, Rathinam Palamalai

2017-01-01

Introduction Health Care associated Infections (HAI) are the most common complications affecting the hospitalized patients. HAI are more common in developing and under developed countries. However, there are no systematic surveillance programs in these countries. Aim To find out the burden, predisposing factors and multidrug resistant organisms causing HAI in a resource limited setting. Materials and Methods This prospective observational study was done at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER). Patients aged 13 years or more with stay of more than 48 hours in a 16 bedded Medical Intensive Care Unit (MICU) between November 2011 and April 2013 were included in the study. Patients were prospectively followed up till discharge or death for the development of HAI. Device associated HAI like Ventilator Associated Pneumonia (VAP), Catheter Related-Blood Stream Infection (CR-BSI) and Catheter Associated-Urinary Tract Infections (CA-UTI) were studied. Standard laboratory methods were used for identification of microorganisms causing HAI and to test their antibiotic sensitivity. Results A total of 346 patients were included in the study with median age of 38 years. Common indications for admission to Medical Intensive Care Unit (MICU) were poisoning (31.5%); neurological illness (23.4%) like Guillian-Barre syndrome, tetanus, meningitis, encephalitis; respiratory illness (14.5%) like pneumonia, acute respiratory distress syndrome and tropical infections (7.2%) like malaria, scrub typhus, leptospirosis. Fifty percent (174/346) patients developed one or more HAI with VAP being the most common. The rates of HAI per 1000 device days for VAP, CR-BSI, CA-UTI were 72.56, 3.98 and 12.4, respectively. Acinetobacter baumannii was the most common organism associated with HAI. Multidrug resistance was seen in 74% of the isolates. Conclusion The burden of HAI, especially with MDR organisms, in resource constrained setting like ours is alarming. There is urgent need for infection control and monitoring system to reduce HAI. PMID:28273989

Healthcare Associated Infections in a Resource Limited Setting.

PubMed

Bammigatti, Chanaveerappa; Doradla, Saikumar; Belgode, Harish Narasimha; Kumar, Harichandra; Swaminathan, Rathinam Palamalai

2017-01-01

Health Care associated Infections (HAI) are the most common complications affecting the hospitalized patients. HAI are more common in developing and under developed countries. However, there are no systematic surveillance programs in these countries. To find out the burden, predisposing factors and multidrug resistant organisms causing HAI in a resource limited setting. This prospective observational study was done at Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER). Patients aged 13 years or more with stay of more than 48 hours in a 16 bedded Medical Intensive Care Unit (MICU) between November 2011 and April 2013 were included in the study. Patients were prospectively followed up till discharge or death for the development of HAI. Device associated HAI like Ventilator Associated Pneumonia (VAP), Catheter Related-Blood Stream Infection (CR-BSI) and Catheter Associated-Urinary Tract Infections (CA-UTI) were studied. Standard laboratory methods were used for identification of microorganisms causing HAI and to test their antibiotic sensitivity. A total of 346 patients were included in the study with median age of 38 years. Common indications for admission to Medical Intensive Care Unit (MICU) were poisoning (31.5%); neurological illness (23.4%) like Guillian-Barre syndrome, tetanus, meningitis, encephalitis; respiratory illness (14.5%) like pneumonia, acute respiratory distress syndrome and tropical infections (7.2%) like malaria, scrub typhus, leptospirosis. Fifty percent (174/346) patients developed one or more HAI with VAP being the most common. The rates of HAI per 1000 device days for VAP, CR-BSI, CA-UTI were 72.56, 3.98 and 12.4, respectively. Acinetobacter baumannii was the most common organism associated with HAI. Multidrug resistance was seen in 74% of the isolates. The burden of HAI, especially with MDR organisms, in resource constrained setting like ours is alarming. There is urgent need for infection control and monitoring system to reduce HAI.

Higher Educational Cost-Sharing, Dual-Track Tuition Fees, and Higher Educational Access: The East African Experience

ERIC Educational Resources Information Center

Marcucci, Pamela; Johnstone, D. Bruce; Ngolovoi, Mary

2008-01-01

Three universal demands characterize higher education globally: the demand for higher quality, for increased access, and for greater equity. In East Africa, where resources are highly constrained, no nation has been able to meet these demands on the basis of public expenditures alone. Instead countries have had to increase resources from nonpublic…

Dynamic Generation of Reduced Ontologies to Support Resource Constraints of Mobile Devices

ERIC Educational Resources Information Center

Schrimpsher, Dan

2011-01-01

As Web Services and the Semantic Web become more important, enabling technologies such as web service ontologies will grow larger. At the same time, use of mobile devices to access web services has doubled in the last year. The ability of these resource constrained devices to download and reason across these ontologies to support service discovery…

Flexible Job-Shop Scheduling with Dual-Resource Constraints to Minimize Tardiness Using Genetic Algorithm

NASA Astrophysics Data System (ADS)

Paksi, A. B. N.; Ma'ruf, A.

2016-02-01

In general, both machines and human resources are needed for processing a job on production floor. However, most classical scheduling problems have ignored the possible constraint caused by availability of workers and have considered only machines as a limited resource. In addition, along with production technology development, routing flexibility appears as a consequence of high product variety and medium demand for each product. Routing flexibility is caused by capability of machines that offers more than one machining process. This paper presents a method to address scheduling problem constrained by both machines and workers, considering routing flexibility. Scheduling in a Dual-Resource Constrained shop is categorized as NP-hard problem that needs long computational time. Meta-heuristic approach, based on Genetic Algorithm, is used due to its practical implementation in industry. Developed Genetic Algorithm uses indirect chromosome representative and procedure to transform chromosome into Gantt chart. Genetic operators, namely selection, elitism, crossover, and mutation are developed to search the best fitness value until steady state condition is achieved. A case study in a manufacturing SME is used to minimize tardiness as objective function. The algorithm has shown 25.6% reduction of tardiness, equal to 43.5 hours.

Reflecting the real value of health care resources in modelling and cost-effectiveness studies—The example of viral load informed differentiated care

PubMed Central

Walker, Simon; Cambiano, Valentina; Phillips, Andrew; Sculpher, Mark J.

2018-01-01

Background The WHO HIV Treatment Guidelines suggest routine viral-load monitoring can be used to differentiate antiretroviral therapy (ART) delivery and reduce the frequency of clinic visits for patients stable on ART. This recommendation was informed by economic analysis that showed the approach is very likely to be cost-effective, even in the most resource constrained of settings. The health benefits were shown to be modest but the costs of introducing and scaling up viral load monitoring can be offset by anticipated reductions in the costs of clinic visits, due to these being less frequent for many patients. Key issues for economic evaluation The cost-effectiveness of introducing viral-load informed differentiated care depends upon whether cost reductions are possible if the number of clinic visits is reduced and/or how freed clinic capacity is used for alternative priorities. Where freed resources, either physical or financial, generate large health gains (e.g. if committed to patients failing ART or to other high value health care interventions), the benefits of differentiated care are expected to be high; if however these freed physical resources are already under-utilized or financial resources are used less efficiently and would not be put to as beneficial an alternative use, the policy may not be cost-effective. The implication is that the use of conventional unit costs to value resources may not well reflect the latter’s value in contributing to health improvement. Analyses intended to inform resource allocated decisions in a number of settings may therefore have to be interpreted with due consideration to local context. In this paper we present methods of how economic analyses can reflect the real value of health care resources rather than simply applying their unit costs. The analyses informing the WHO Guidelines are re-estimated by implementing scenarios using this framework, informing how differentiated care can be prioritized to generate greatest gains in population health. Implications The findings have important implications for how economic analyses should be undertaken and reported in HIV and other disease areas. Results provide guidance on conditions under which viral load informed differentiated care will more likely prove to be cost effective when implemented. PMID:29293611

Compromise Approach-Based Genetic Algorithm for Constrained Multiobjective Portfolio Selection Model

NASA Astrophysics Data System (ADS)

Li, Jun

In this paper, fuzzy set theory is incorporated into a multiobjective portfolio selection model for investors’ taking into three criteria: return, risk and liquidity. The cardinality constraint, the buy-in threshold constraint and the round-lots constraints are considered in the proposed model. To overcome the difficulty of evaluation a large set of efficient solutions and selection of the best one on non-dominated surface, a compromise approach-based genetic algorithm is presented to obtain a compromised solution for the proposed constrained multiobjective portfolio selection model.

Explicit reference governor for linear systems

NASA Astrophysics Data System (ADS)

Garone, Emanuele; Nicotra, Marco; Ntogramatzidis, Lorenzo

2018-06-01

The explicit reference governor is a constrained control scheme that was originally introduced for generic nonlinear systems. This paper presents two explicit reference governor strategies that are specifically tailored for the constrained control of linear time-invariant systems subject to linear constraints. Both strategies are based on the idea of maintaining the system states within an invariant set which is entirely contained in the constraints. This invariant set can be constructed by exploiting either the Lyapunov inequality or modal decomposition. To improve the performance, we show that the two strategies can be combined by choosing at each time instant the least restrictive set. Numerical simulations illustrate that the proposed scheme achieves performances that are comparable to optimisation-based reference governors.

Approximate error conjugation gradient minimization methods

DOEpatents

Kallman, Jeffrey S

2013-05-21

In one embodiment, a method includes selecting a subset of rays from a set of all rays to use in an error calculation for a constrained conjugate gradient minimization problem, calculating an approximate error using the subset of rays, and calculating a minimum in a conjugate gradient direction based on the approximate error. In another embodiment, a system includes a processor for executing logic, logic for selecting a subset of rays from a set of all rays to use in an error calculation for a constrained conjugate gradient minimization problem, logic for calculating an approximate error using the subset of rays, and logic for calculating a minimum in a conjugate gradient direction based on the approximate error. In other embodiments, computer program products, methods, and systems are described capable of using approximate error in constrained conjugate gradient minimization problems.

Identification of different geologic units using fuzzy constrained resistivity tomography

NASA Astrophysics Data System (ADS)

Singh, Anand; Sharma, S. P.

2018-01-01

Different geophysical inversion strategies are utilized as a component of an interpretation process that tries to separate geologic units based on the resistivity distribution. In the present study, we present the results of separating different geologic units using fuzzy constrained resistivity tomography. This was accomplished using fuzzy c means, a clustering procedure to improve the 2D resistivity image and geologic separation within the iterative minimization through inversion. First, we developed a Matlab-based inversion technique to obtain a reliable resistivity image using different geophysical data sets (electrical resistivity and electromagnetic data). Following this, the recovered resistivity model was converted into a fuzzy constrained resistivity model by assigning the highest probability value of each model cell to the cluster utilizing fuzzy c means clustering procedure during the iterative process. The efficacy of the algorithm is demonstrated using three synthetic plane wave electromagnetic data sets and one electrical resistivity field dataset. The presented approach shows improvement on the conventional inversion approach to differentiate between different geologic units if the correct number of geologic units will be identified. Further, fuzzy constrained resistivity tomography was performed to examine the augmentation of uranium mineralization in the Beldih open cast mine as a case study. We also compared geologic units identified by fuzzy constrained resistivity tomography with geologic units interpreted from the borehole information.

Improving Service Delivery in a County Health Department WIC Clinic: An Application of Statistical Process Control Techniques

PubMed Central

Boe, Debra Thingstad; Parsons, Helen

2009-01-01

Local public health agencies are challenged to continually improve service delivery, yet they frequently operate with constrained resources. Quality improvement methods and techniques such as statistical process control are commonly used in other industries, and they have recently been proposed as a means of improving service delivery and performance in public health settings. We analyzed a quality improvement project undertaken at a local Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinic to reduce waiting times and improve client satisfaction with a walk-in nutrition education service. We used statistical process control techniques to evaluate initial process performance, implement an intervention, and assess process improvements. We found that implementation of these techniques significantly reduced waiting time and improved clients' satisfaction with the WIC service. PMID:19608964

GTAG: architecture and design of miniature transmitter with position logging for radio telemetry

NASA Astrophysics Data System (ADS)

Řeřucha, Šimon; Bartonička, Tomáš; Jedlička, Petr

2011-10-01

The radio telemetry is a well-known technique used within zoological research to exploit the behaviour of animal species. A usage of GPS for a frequent and precise position recording gives interesting possibility for a further enhancement of this method. We present our proposal of an architecture and design concepts of telemetry transmitter with GPS module, called GTAG, that is suited for study of the Egyptian fruit bat (Rousettus aegyptiacus). The model group we study set particular constrains, especially the weight limit (9 g) and prevention of any power resources recharging technique. We discuss the aspect of physical realization and the energyconsumption issues. We have developed a reference implementation that has been already deployed during telemetry sessions and we evaluate the experience and compare the estimated performance of our device to a real data.

Order-Constrained Solutions in K-Means Clustering: Even Better than Being Globally Optimal

ERIC Educational Resources Information Center

Steinley, Douglas; Hubert, Lawrence

2008-01-01

This paper proposes an order-constrained K-means cluster analysis strategy, and implements that strategy through an auxiliary quadratic assignment optimization heuristic that identifies an initial object order. A subsequent dynamic programming recursion is applied to optimally subdivide the object set subject to the order constraint. We show that…

A Hybrid Scheme for Fine-Grained Search and Access Authorization in Fog Computing Environment

PubMed Central

Xiao, Min; Zhou, Jing; Liu, Xuejiao; Jiang, Mingda

2017-01-01

In the fog computing environment, the encrypted sensitive data may be transferred to multiple fog nodes on the edge of a network for low latency; thus, fog nodes need to implement a search over encrypted data as a cloud server. Since the fog nodes tend to provide service for IoT applications often running on resource-constrained end devices, it is necessary to design lightweight solutions. At present, there is little research on this issue. In this paper, we propose a fine-grained owner-forced data search and access authorization scheme spanning user-fog-cloud for resource constrained end users. Compared to existing schemes only supporting either index encryption with search ability or data encryption with fine-grained access control ability, the proposed hybrid scheme supports both abilities simultaneously, and index ciphertext and data ciphertext are constructed based on a single ciphertext-policy attribute based encryption (CP-ABE) primitive and share the same key pair, thus the data access efficiency is significantly improved and the cost of key management is greatly reduced. Moreover, in the proposed scheme, the resource constrained end devices are allowed to rapidly assemble ciphertexts online and securely outsource most of decryption task to fog nodes, and mediated encryption mechanism is also adopted to achieve instantaneous user revocation instead of re-encrypting ciphertexts with many copies in many fog nodes. The security and the performance analysis show that our scheme is suitable for a fog computing environment. PMID:28629131

A Hybrid Scheme for Fine-Grained Search and Access Authorization in Fog Computing Environment.

PubMed

Xiao, Min; Zhou, Jing; Liu, Xuejiao; Jiang, Mingda

2017-06-17

In the fog computing environment, the encrypted sensitive data may be transferred to multiple fog nodes on the edge of a network for low latency; thus, fog nodes need to implement a search over encrypted data as a cloud server. Since the fog nodes tend to provide service for IoT applications often running on resource-constrained end devices, it is necessary to design lightweight solutions. At present, there is little research on this issue. In this paper, we propose a fine-grained owner-forced data search and access authorization scheme spanning user-fog-cloud for resource constrained end users. Compared to existing schemes only supporting either index encryption with search ability or data encryption with fine-grained access control ability, the proposed hybrid scheme supports both abilities simultaneously, and index ciphertext and data ciphertext are constructed based on a single ciphertext-policy attribute based encryption (CP-ABE) primitive and share the same key pair, thus the data access efficiency is significantly improved and the cost of key management is greatly reduced. Moreover, in the proposed scheme, the resource constrained end devices are allowed to rapidly assemble ciphertexts online and securely outsource most of decryption task to fog nodes, and mediated encryption mechanism is also adopted to achieve instantaneous user revocation instead of re-encrypting ciphertexts with many copies in many fog nodes. The security and the performance analysis show that our scheme is suitable for a fog computing environment.

Improving financial access to health care in the Kisantu district in the Democratic Republic of Congo: acting upon complexity.

PubMed

Stasse, Stéphanie; Vita, Dany; Kimfuta, Jacques; da Silveira, Valèria Campos; Bossyns, Paul; Criel, Bart

2015-01-01

Comzmercialization of health care has contributed to widen inequities between the rich and the poor, especially in settings with suboptimal regulatory frameworks of the health sector. Poorly regulated fee-for-service payment systems generate inequity and initiate a vicious circle in which access to quality health care gradually deteriorates. Although the abolition of user fees is high on the international health policy agenda, the sudden removal of user fees may have disrupting effects on the health system and may not be affordable or sustainable in resource-constrained countries, such as the Democratic Republic of Congo. Between 2008 and 2011, the Belgian development aid agency (BTC) launched a set of reforms in the Kisantu district, in the province of Bas Congo, through an action-research process deemed appropriate for the implementation of change within open complex systems such as the Kisantu local health system. Moreover, the entire process contributed to strengthen the stewardship capacity of the Kisantu district management team. The reforms mainly comprised the rationalization of resources and the regulation of health services financing. Flat fees per episode of disease were introduced as an alternative to fee-for-service payments by patients. A financial subsidy from BTC allowed to reduce the height of the flat fees. The provision of the subsidy was made conditional upon a range of measures to rationalize the use of resources. The results in terms of enhancing people access to quality health care were immediate and substantial. The Kisantu experience demonstrates that a systems approach is essential in addressing complex problems. It provides useful lessons for other districts in the country.

An empirical comparison of Markov cohort modeling and discrete event simulation in a capacity-constrained health care setting.

PubMed

Standfield, L B; Comans, T A; Scuffham, P A

2017-01-01

To empirically compare Markov cohort modeling (MM) and discrete event simulation (DES) with and without dynamic queuing (DQ) for cost-effectiveness (CE) analysis of a novel method of health services delivery where capacity constraints predominate. A common data-set comparing usual orthopedic care (UC) to an orthopedic physiotherapy screening clinic and multidisciplinary treatment service (OPSC) was used to develop a MM and a DES without (DES-no-DQ) and with DQ (DES-DQ). Model results were then compared in detail. The MM predicted an incremental CE ratio (ICER) of $495 per additional quality-adjusted life-year (QALY) for OPSC over UC. The DES-no-DQ showed OPSC dominating UC; the DES-DQ generated an ICER of $2342 per QALY. The MM and DES-no-DQ ICER estimates differed due to the MM having implicit delays built into its structure as a result of having fixed cycle lengths, which are not a feature of DES. The non-DQ models assume that queues are at a steady state. Conversely, queues in the DES-DQ develop flexibly with supply and demand for resources, in this case, leading to different estimates of resource use and CE. The choice of MM or DES (with or without DQ) would not alter the reimbursement of OPSC as it was highly cost-effective compared to UC in all analyses. However, the modeling method may influence decisions where ICERs are closer to the CE acceptability threshold, or where capacity constraints and DQ are important features of the system. In these cases, DES-DQ would be the preferred modeling technique to avoid incorrect resource allocation decisions.

Improving financial access to health care in the Kisantu district in the Democratic Republic of Congo: acting upon complexity

PubMed Central

Stasse, Stéphanie; Vita, Dany; Kimfuta, Jacques; da Silveira, Valèria Campos; Bossyns, Paul; Criel, Bart

2015-01-01

Background Comzmercialization of health care has contributed to widen inequities between the rich and the poor, especially in settings with suboptimal regulatory frameworks of the health sector. Poorly regulated fee-for-service payment systems generate inequity and initiate a vicious circle in which access to quality health care gradually deteriorates. Although the abolition of user fees is high on the international health policy agenda, the sudden removal of user fees may have disrupting effects on the health system and may not be affordable or sustainable in resource-constrained countries, such as the Democratic Republic of Congo. Methods and Results Between 2008 and 2011, the Belgian development aid agency (BTC) launched a set of reforms in the Kisantu district, in the province of Bas Congo, through an action-research process deemed appropriate for the implementation of change within open complex systems such as the Kisantu local health system. Moreover, the entire process contributed to strengthen the stewardship capacity of the Kisantu district management team. The reforms mainly comprised the rationalization of resources and the regulation of health services financing. Flat fees per episode of disease were introduced as an alternative to fee-for-service payments by patients. A financial subsidy from BTC allowed to reduce the height of the flat fees. The provision of the subsidy was made conditional upon a range of measures to rationalize the use of resources. Conclusions The results in terms of enhancing people access to quality health care were immediate and substantial. The Kisantu experience demonstrates that a systems approach is essential in addressing complex problems. It provides useful lessons for other districts in the country. PMID:25563450

Figure of merit and different combinations of observational data sets

NASA Astrophysics Data System (ADS)

Su, Qiping; Tuo, Zhong-Liang; Cai, Rong-Gen

2011-11-01

To constrain cosmological parameters, one often makes a joint analysis with different combinations of observational data sets. In this paper we take the figure of merit (FoM) for Dark Energy Task Force fiducial model (Chevallier-Polarski-Linder model) to estimate goodness of different combinations of data sets, which include 11 widely used observational data sets (type Ia supernovae, observational hubble parameter, baryon acoustic oscillation, cosmic microwave background, x-ray cluster baryon mass fraction, and gamma-ray bursts). We analyze different combinations and make a comparison for two types of combinations based on two types of basic combinations, which are often adopted in the literature. We find two sets of combinations, which have a strong ability to constrain the dark energy parameters: one has the largest FoM, and the other contains less observational data with a relatively large FoM and a simple fitting procedure.

Portable Microfluidic Integrated Plasmonic Platform for Pathogen Detection

PubMed Central

Tokel, Onur; Yildiz, Umit Hakan; Inci, Fatih; Durmus, Naside Gozde; Ekiz, Okan Oner; Turker, Burak; Cetin, Can; Rao, Shruthi; Sridhar, Kaushik; Natarajan, Nalini; Shafiee, Hadi; Dana, Aykutlu; Demirci, Utkan

2015-01-01

Timely detection of infectious agents is critical in early diagnosis and treatment of infectious diseases. Conventional pathogen detection methods, such as enzyme linked immunosorbent assay (ELISA), culturing or polymerase chain reaction (PCR) require long assay times, and complex and expensive instruments, which are not adaptable to point-of-care (POC) needs at resource-constrained as well as primary care settings. Therefore, there is an unmet need to develop simple, rapid, and accurate methods for detection of pathogens at the POC. Here, we present a portable, multiplex, inexpensive microfluidic-integrated surface plasmon resonance (SPR) platform that detects and quantifies bacteria, i.e., Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) rapidly. The platform presented reliable capture and detection of E. coli at concentrations ranging from ~105 to 3.2 × 107 CFUs/mL in phosphate buffered saline (PBS) and peritoneal dialysis (PD) fluid. The multiplexing and specificity capability of the platform was also tested with S. aureus samples. The presented platform technology could potentially be applicable to capture and detect other pathogens at the POC and primary care settings. PMID:25801042

Charting a course to competency: an approach to mapping public health core competencies to existing trainings.

PubMed

Neiworth, Latrissa L; Allan, Susan; D'Ambrosio, Luann; Coplen-Abrahamson, Marlene

2014-03-01

Consistent with other professional fields, the goals of public health training have moved from a focus on knowledge transfer to the development of skills or competencies. At least six national competency sets have been developed in the past decade pertaining to public health professionals. State and local public health agencies are increasingly using competency sets as frameworks for staff development and assessment. Mapping competencies to training has potential for enhancing the value of public health training during resource-constrained times by directly linking training content to the desired skills. For existing public health trainings, the challenge is how to identify competencies addressed in those courses in a manner that is not burdensome and that produces valid results. This article describes a process for mapping competencies to the learning objectives, assignments, and assessments of existing trainings. The process presented could be used by any training center or organization that seeks to connect public health workforce competencies to previously developed instruction. Public health practice can be strengthened more effectively if trainings can be selected for the desired practice skills or competencies.

The quality of hospital-based antenatal care in Istanbul.

PubMed

Turan, Janet Molzan; Bulut, Ayşpen; Nalbant, Hacer; Ortayli, Nuriye; Akalin, A Arzu Koloğlu

2006-03-01

The aim of this study was to gather comprehensive data from three hospitals in Istanbul, Turkey, in order to gain in-depth understanding of the quality of antenatal care in this setting. The Bruce-Jain framework for quality of care was adapted for use in evaluating antenatal care. Methods included examination of hospital records, in-depth interviews, exit questionnaires, and structured observations. The study revealed deficiencies in the quality of antenatal care being delivered at the study hospitals in all six elements of the quality-of-care framework. The technical content of visits varied greatly among the hospitals, and an overuse of technology was accompanied by neglect of some essential components of antenatal care. Although at the private hospital some problems with the technical content of care were identified, client satisfaction was higher there, where the care included good interpersonal relations, information provision, and continuity. Providers at all three hospitals felt constrained by heavy patient loads and a lack of resources. Multifaceted approaches are needed to improve the quality of antenatal care in this setting.

Decentralisation and health services delivery in Tanzania: Analysis of decision space in planning, allocation, and use of financial resources.

PubMed

Kigume, Ramadhani; Maluka, Stephen; Kamuzora, Peter

2018-04-01

While decentralisation of health systems has been on the policy agenda in low-income and middle-income countries since the 1970s, many studies have focused on understanding who has more decision-making powers but less attention is paid to understand what those powers encompass. Using the decision space approach, this study aimed to understand the amount of decision-making space transferred from the central government to institutions at the periphery in the decentralised health system in Tanzania. The findings of this study indicated that the decentralisation process in Tanzania has provided authorities with a range of decision-making space. In the areas of priority setting and planning, district health authorities had moderate decision space. However, in the financial resource allocation and expenditure of funds from the central government, the districts had narrow decision-making space. The districts, nevertheless, had wider decision-making space in mobilising and using locally generated financial resources. However, the ability of the districts to allocate and use locally generated resources was constrained by bureaucratic procedures of the central government. The study concludes that decentralisation by devolution which is being promoted in the policy documents in Tanzania is yet to be realised at the district and local levels. The study recommends that the central government should provide more space to the decentralised district health systems to incorporate locally defined priorities in the district health plans. Copyright © 2018 John Wiley & Sons, Ltd.

The added value of remote sensing products in constraining hydrological models

NASA Astrophysics Data System (ADS)

Nijzink, Remko C.; Almeida, Susana; Pechlivanidis, Ilias; Capell, René; Gustafsson, David; Arheimer, Berit; Freer, Jim; Han, Dawei; Wagener, Thorsten; Sleziak, Patrik; Parajka, Juraj; Savenije, Hubert; Hrachowitz, Markus

2017-04-01

The calibration of a hydrological model still depends on the availability of streamflow data, even though more additional sources of information (i.e. remote sensed data products) have become more widely available. In this research, the model parameters of four different conceptual hydrological models (HYPE, HYMOD, TUW, FLEX) were constrained with remotely sensed products. The models were applied over 27 catchments across Europe to cover a wide range of climates, vegetation and landscapes. The fluxes and states of the models were correlated with the relevant products (e.g. MOD10A snow with modelled snow states), after which new a-posteriori parameter distributions were determined based on a weighting procedure using conditional probabilities. Briefly, each parameter was weighted with the coefficient of determination of the relevant regression between modelled states/fluxes and products. In this way, final feasible parameter sets were derived without the use of discharge time series. Initial results show that improvements in model performance, with regard to streamflow simulations, are obtained when the models are constrained with a set of remotely sensed products simultaneously. In addition, we present a more extensive analysis to assess a model's ability to reproduce a set of hydrological signatures, such as rising limb density or peak distribution. Eventually, this research will enhance our understanding and recommendations in the use of remotely sensed products for constraining conceptual hydrological modelling and improving predictive capability, especially for data sparse regions.

Selection and Storage of Perceptual Groups Is Constrained by a Discrete Resource in Working Memory

ERIC Educational Resources Information Center

Anderson, David E.; Vogel, Edward K.; Awh, Edward

2013-01-01

Perceptual grouping can lead observers to perceive a multielement scene as a smaller number of hierarchical units. Past work has shown that grouping enables more elements to be stored in visual working memory (WM). Although this may appear to contradict so-called discrete resource models that argue for fixed item limits in WM storage, it is also…

Improving Surgical Safety and Nontechnical Skills in Variable-Resource Contexts: A Novel Educational Curriculum.

PubMed

Lin, Yihan; Scott, John W; Yi, Sojung; Taylor, Kathryn K; Ntakiyiruta, Georges; Ntirenganya, Faustin; Banguti, Paulin; Yule, Steven; Riviello, Robert

2017-10-23

A substantial proportion of adverse intraoperative events are attributed to failures in nontechnical skills. To strengthen these skills and improve surgical safety, the Non-Technical Skills for Surgeons (NOTSS) taxonomy was developed as a common framework. The NOTSS taxonomy was adapted for low- and middle-income countries, where variable resources pose a significant challenge to safe surgery. The NOTSS for variable-resource contexts (VRC) curriculum was developed and implemented in Rwanda, with the aim of enhancing knowledge and attitudes about nontechnical skills and promoting surgical safety. The NOTSS-VRC curriculum was developed through a rigorous process of integrating contextually appropriate values. It was implemented as a 1-day training course for surgical and anesthesia postgraduate trainees. The curriculum comprises lectures, videos, and group discussions. A pretraining and posttraining questionnaire was administered to compare knowledge and attitudes regarding nontechnical skills, and their potential to improve surgical safety. The setting of this study was in the tertiary teaching hospital of Kigali, Rwanda. Participants were residents of the University of Kigali. A total of 55 residents participated from general surgery (31.4%), obstetrics (25.5%), anesthesia (17.6%), and other surgical specialties (25.5%). In a paired analysis, understanding of NOTSS improved significantly (55.6% precourse, 80.9% postcourse, p<0.01). All residents reported that the course would improve their ability to provide safer patient care, and 97.4% believed developing nontechnical skills would improve patient outcomes. Nontechnical skills must be highlighted in surgical training in low- and middle-income countries. The NOTSS-VRC curriculum can be implemented without additional technology or significant financial cost. Its deliberate design for resource-constrained settings allows it to be used both as an educational course and a quality improvement strategy. Our research demonstrates it is feasible to improve knowledge and attitudes about NOTSS through a 1-day course, and represents a novel approach to improving global surgical safety. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Asset management as a strategic decision-making tool in DelDOT.

DOT National Transportation Integrated Search

2008-10-01

Asset management has been receiving greater attention at both the state and national : levels. Escalating demands by the public for increased accountability, aging : infrastructure, increasingly constrained resources, new funding challenges, and incr...

Quantifying Elements of a Lunar Economy Based on Resource Needs

NASA Astrophysics Data System (ADS)

Greenblatt, J. B.

2017-10-01

We model a simplified lunar economy from human life support, Earth materials consumption, and energy and propulsion requirement estimates, constrained by lunar elemental abundances; estimate likely imports/exports and "gross interplanetary product."

Modifications to ART service delivery models by health facilities in Uganda in promotion of intervention sustainability: a mixed methods study.

PubMed

Zakumumpa, Henry; Bennett, Sara; Ssengooba, Freddie

2017-04-04

In November 2015, WHO released new treatment guidelines recommending that all diagnosed as HIV positive be enrolled on antiretroviral therapy (ART). Sustaining and expanding ART scale-up programs in resource-limited settings will require adaptations and modifications to traditional ART delivery models to meet the rapid increase in demand. We identify modifications to ART service delivery models by health facilities in Uganda to sustain ART interventions over a 10-year period (2004-2014). A mixed methods approach involving two study phases was adopted. In the first phase, a survey of a nationally representative sample of health facilities (n = 195) in Uganda which were accredited to provide ART between 2004 and 2009 was conducted. The second phase involved semi-structured interviews (n = 18) with ART clinic managers of 6 of the 195 health facilities purposively selected from the first study phase. We adopted a thematic framework consisting of four categories of modifications (format, setting, personnel, and population). The majority of health facilities 185 (95%) reported making modifications to ART interventions between 2004 and 2014. Of the 195 health facilities, 157 (81%) rated the modifications made to ART as "major." Modifications to ART were reported under all the four themes. The quantitative and qualitative findings are integrated and presented under four themes. Format: Reducing the frequency of clinic appointments and pharmacy-only refill programs was identified as important strategies for decongesting ART clinics. Home-based care programs were introduced to reduce provider ART delivery costs. Personnel: Task shifting to non-physician cadre was reported in 181 (93%) of the health facilities. Visits to the ART clinic were rationalized in favor of the sub-population deemed to have more clinical need. Two health facilities focused on patients living nearer the health facilities to align with targets set by external donors. Over the study period, health facilities made several modifications ART interventions to improve fit with their resource-constrained settings thereby promoting long-term sustainability. Further research evaluating the effect of these modifications on patient outcomes and ART delivery costs is recommended. Our findings have implications for the sustainability of ART scale-up programs in Uganda and other resource-limited settings.

Strategic plan, 1991: A strategy for leadership in space through excellence in space science and applications

NASA Technical Reports Server (NTRS)

1991-01-01

In 1988, the Office of Space Science and Applications (OSSA) developed and published a Strategic Plan for the United States' space science and applications program during the next 5 to 10 years. The Plan presented the proposed OSSA program for the next fiscal year and defined a flexible process that provides the basis for near-term decisions on the allocation of resources and the planning of future efforts. Based on the strategies that have been developed by the advisory committees both of the National Academy of Sciences and of NASA, the Plan balances major, moderate, and small mission initiatives, the utilization of Space Station Freedom, and the requirements for a vital research base. The Plan can be adjusted to accommodate varying budget levels, both those levels that provide opportunities for an expanded science and applications program, and those that constrain growth. SSA's strategic planning is constructed around five actions: establish a set of programmatic themes; establish a set of decision rules; establish a set of priorities for missions and programs within each theme; demonstrate that the strategy can yield a viable program; and check the strategy for consistency with resource constraints. The outcome of this process is a clear, coherent strategy that meets both NASA's and OSSA's goals, that assures realism in long-range planning and advanced technology development, and that provides sufficient resiliency to respond and adapt to both known and unexpected internal and external realities. The OSSA Strategic Plan is revised annually to reflect the approval of new programs, improved understanding of requirements and issues, and any major changes in the circumstances, both within NASA and external to NASA, in which OSSA initiatives are considered.

Using 10Be erosion rates and fluvial channel morphology to constrain fault throw rates in the southwestern Sacramento River Valley, California, USA

NASA Astrophysics Data System (ADS)

Cyr, A. J.

2013-12-01

The Sacramento - San Joaquin River Delta, California, USA, is a critical region for California water resources, agriculture, and threatened or endangered species. This landscape is affected by an extensive set of levees that enclose artificial islands created for agricultural use. In addition to their importance for sustaining agriculture, this levee system also supports extensive transport and power transmission infrastructure and urban/suburban development. These levees are susceptible to damage from even moderate ground shaking by either a large earthquake on one of the high-activity faults in the nearby San Francisco Bay region, or even a moderate earthquake on one of the low-activity faults in the Delta region itself. However, despite this danger the earthquake hazards in this region are poorly constrained due to our lack of understanding of faults in and near the Delta region. As part of an effort to better constrain the seismic hazard associated with known, but poorly constrained, faults in the region, a geomorphic analysis of the Dunnigan Hills, northwest of Woodland, CA, is being combined with cosmogenic 10Be catchment-averaged erosion rates. The Dunnigan Hills are a low-relief (maximum elevation 87 m) landscape generated by fault-bend folding above the west-vergent Sweitzer reverse fault that soles into a blind east-vergent reverse fault. These faults have been imaged by seismic reflection data, and local microseismicity indicates that this system is actively propagating to the east. However, the throw rates on the faults in this system remain unconstrained, despite the potential for significant shaking such as that experienced in the nearby April, 1892 earthquake sequence between Winters and Vacaville, Ca, ~25 km to the south, which has been estimated at magnitude 6.0 or greater. Geomorphic and cosmogenic 10Be analyses from 12 catchments draining the eastern flank of the Dunnigan Hills will be used to infer vertical rock uplift rates to better constrain activity on the west-vergent Sweitzer fault and the east-vergent blind reverse fault. All of the sampled catchments are underlain exclusively by Tehama Sandstone. Moreover, there are no mapped surface traces of faults in the sampled catchments. This minimizes the possibility of changes in lithogic resistance to impact the erosion rates and channel analyses. These analyses, combined with fault geometries derived from published seismic reflection data and structural cross sections, allows us to constrain the throw rates on these faults and thus better evaluate the associated seismic hazard.

Open burn wound dressing: a practical option in resource constrained settings

PubMed Central

Olawoye, O.A.; Osinupebi, O.O.; Ayoade, B.A.

2013-01-01

Summary Various types of wound care products abound for the treatment of burn injuries. Most of these products are rather expensive and beyond the means of many patients in poorer countries. This poses a challenge to burn care workers in these environments and calls for the adoption of practical solutions with the use of less expensive and readily available alternatives. The aim of this study is to review the outcome of our burn patients managed with topical silver sulphadiazine dressing in terms of time to wound healing and length of hospital stay. Consecutive burn patients admitted over a four year period were included in the study. The patients were resuscitated along standard protocols and their wounds were dressed daily with dermazin. The demographic and clinical characteristics of the patients were retrieved and analyzed using the SPSS version 16. The primary outcome measure for the study was the time to complete re-epithelialization of the wounds and discharge of the patients. 144 patients with a M: F ratio of 2.3: 1 were managed during the period. The age range was 4 months to 81.9 years with a median age of 26 years. The TBSA range was 1 to 99% with a median of 28.5%. The mean duration from time of injury to wound healing was 21.5 days with a median of 17 days. Open burn wound dressing with silver sulphadiazine offers a satisfactory outcome and should be considered for burn dressing in low resource settings. PMID:24563642

Cluster randomised controlled trial of a peer-led lifestyle intervention program: study protocol for the Kerala diabetes prevention program

PubMed Central

2013-01-01

Background India currently has more than 60 million people with Type 2 Diabetes Mellitus (T2DM) and this is predicted to increase by nearly two-thirds by 2030. While management of those with T2DM is important, preventing or delaying the onset of the disease, especially in those individuals at ‘high risk’ of developing T2DM, is urgently needed, particularly in resource-constrained settings. This paper describes the protocol for a cluster randomised controlled trial of a peer-led lifestyle intervention program to prevent diabetes in Kerala, India. Methods/design A total of 60 polling booths are randomised to the intervention arm or control arm in rural Kerala, India. Data collection is conducted in two steps. Step 1 (Home screening): Participants aged 30–60 years are administered a screening questionnaire. Those having no history of T2DM and other chronic illnesses with an Indian Diabetes Risk Score value of ≥60 are invited to attend a mobile clinic (Step 2). At the mobile clinic, participants complete questionnaires, undergo physical measurements, and provide blood samples for biochemical analysis. Participants identified with T2DM at Step 2 are excluded from further study participation. Participants in the control arm are provided with a health education booklet containing information on symptoms, complications, and risk factors of T2DM with the recommended levels for primary prevention. Participants in the intervention arm receive: (1) eleven peer-led small group sessions to motivate, guide and support in planning, initiation and maintenance of lifestyle changes; (2) two diabetes prevention education sessions led by experts to raise awareness on T2DM risk factors, prevention and management; (3) a participant handbook containing information primarily on peer support and its role in assisting with lifestyle modification; (4) a participant workbook to guide self-monitoring of lifestyle behaviours, goal setting and goal review; (5) the health education booklet that is given to the control arm. Follow-up assessments are conducted at 12 and 24 months. The primary outcome is incidence of T2DM. Secondary outcomes include behavioural, psychosocial, clinical, and biochemical measures. An economic evaluation is planned. Discussion Results from this trial will contribute to improved policy and practice regarding lifestyle intervention programs to prevent diabetes in India and other resource-constrained settings. Trial registration Australia and New Zealand Clinical Trials Registry: ACTRN12611000262909. PMID:24180316

Dark clouds in co-creation, and their silver linings practical challenges we faced in a participatory project in a resource-constrained community in India, and how we overcame (some of) them

PubMed Central

Sushama, Preeti; Ghergu, Cristian; Meershoek, Agnes; de Witte, Luc P.; van Schayck, Onno C. P.; Krumeich, Anja

2018-01-01

ABSTRACT Background: While any type of field-based research is challenging, building action-oriented, participatory research in resource-constrained settings can be even more so. Objective: In this article, we aim to examine and provide insights into some of the practical challenges that were faced during the course of a participatory project based in two non-notified slums in Bangalore, India, aiming to build solutions to indoor air pollution from cooking on traditional cook stoves. Methods: The article draws upon experiences of the authors as field researchers engaged in a community-based project that adopted an exploratory, iterative design to its planning and implementation, which involved community visits, semi-structured interviews, prioritization workshops, community forums, photo voice activities, chulha-building sessions and cooking trials. Results: The main obstacles to field work were linked to fostering open, continued dialogue with the community, aimed at bridging the gap between the ‘scientific’ and the ‘local’ worlds. Language and cultural barriers led to a reliance on interpreters, which affected both the quality of the interaction as well as the relationship between the researchers and the community that was built out of that interaction. The transience in housing and location of members of the community also led to difficulties in following up on incomplete information. Furthermore, facilitating meaningful participation from the people within the context of restricted resources, differing priorities, and socio-cultural diversity was particularly challenging. These were further compounded by the constraints of time and finances brought on by the embeddedness of the project within institutional frameworks and conventional research requirements of a fixed, pre-planned and externally determined focus, timeline, activities and benchmarks for the project. Conclusions: This article calls for revisiting of scientific conventions and funding prerequisites, in order to create spaces that support flexible, emergent and adaptive field-based research projects which can respond effectively to the needs and priorities of the community. PMID:29353542

Optimization-based channel constrained data aggregation routing algorithms in multi-radio wireless sensor networks.

PubMed

Yen, Hong-Hsu

2009-01-01

In wireless sensor networks, data aggregation routing could reduce the number of data transmissions so as to achieve energy efficient transmission. However, data aggregation introduces data retransmission that is caused by co-channel interference from neighboring sensor nodes. This kind of co-channel interference could result in extra energy consumption and significant latency from retransmission. This will jeopardize the benefits of data aggregation. One possible solution to circumvent data retransmission caused by co-channel interference is to assign different channels to every sensor node that is within each other's interference range on the data aggregation tree. By associating each radio with a different channel, a sensor node could receive data from all the children nodes on the data aggregation tree simultaneously. This could reduce the latency from the data source nodes back to the sink so as to meet the user's delay QoS. Since the number of radios on each sensor node and the number of non-overlapping channels are all limited resources in wireless sensor networks, a challenging question here is to minimize the total transmission cost under limited number of non-overlapping channels in multi-radio wireless sensor networks. This channel constrained data aggregation routing problem in multi-radio wireless sensor networks is an NP-hard problem. I first model this problem as a mixed integer and linear programming problem where the objective is to minimize the total transmission subject to the data aggregation routing, channel and radio resources constraints. The solution approach is based on the Lagrangean relaxation technique to relax some constraints into the objective function and then to derive a set of independent subproblems. By optimally solving these subproblems, it can not only calculate the lower bound of the original primal problem but also provide useful information to get the primal feasible solutions. By incorporating these Lagrangean multipliers as the link arc weight, the optimization-based heuristics are proposed to get energy-efficient data aggregation tree with better resource (channel and radio) utilization. From the computational experiments, the proposed optimization-based approach is superior to existing heuristics under all tested cases.

Management of late-preterm and term infants with hyperbilirubinaemia in resource-constrained settings.

PubMed

Olusanya, Bolajoko O; Ogunlesi, Tinuade A; Kumar, Praveen; Boo, Nem-Yun; Iskander, Iman F; de Almeida, Maria Fernanda B; Vaucher, Yvonne E; Slusher, Tina M

2015-04-12

Hyperbilirubinaemia is a ubiquitous transitional morbidity in the vast majority of newborns and a leading cause of hospitalisation in the first week of life worldwide. While timely and effective phototherapy and exchange transfusion are well proven treatments for severe neonatal hyperbilirubinaemia, inappropriate or ineffective treatment of hyperbilirubinaemia, at secondary and tertiary hospitals, still prevails in many poorly-resourced countries accounting for a disproportionately high burden of bilirubin-induced mortality and long-term morbidity. As part of the efforts to curtail the widely reported risks of frequent but avoidable bilirubin-induced neurologic dysfunction (acute bilirubin encephalopathy (ABE) and kernicterus) in low and middle-income countries (LMICs) with significant resource constraints, this article presents a practical framework for the management of late-preterm and term infants (≥ 35 weeks of gestation) with clinically significant hyperbilirubinaemia in these countries particularly where local practice guidelines are lacking. Standard and validated protocols were followed in adapting available evidence-based national guidelines on the management of hyperbilirubinaemia through a collaboration among clinicians and experts on newborn jaundice from different world regions. Tasks and resources required for the comprehensive management of infants with or at risk of severe hyperbilirubinaemia at all levels of healthcare delivery are proposed, covering primary prevention, early detection, diagnosis, monitoring, treatment, and follow-up. Additionally, actionable treatment or referral levels for phototherapy and exchange transfusion are proposed within the context of several confounding factors such as widespread exclusive breastfeeding, infections, blood group incompatibilities and G6PD deficiency, which place infants at high risk of severe hyperbilirubinaemia and bilirubin-induced neurologic dysfunction in LMICs, as well as the limited facilities for clinical investigations and inconsistent functionality of available phototherapy devices. The need to adjust these levels as appropriate depending on the available facilities in each clinical setting and the risk profile of the infant is emphasised with a view to avoiding over-treatment or under-treatment. These recommendations should serve as a valuable reference material for health workers, guide the development of contextually-relevant national guidelines in each LMIC, as well as facilitate effective advocacy and mobilisation of requisite resources for the optimal care of infants with hyperbilirubinaemia at all levels.

Light-weight cyptography for resource constrained environments

NASA Astrophysics Data System (ADS)

Baier, Patrick; Szu, Harold

2006-04-01

We give a survey of "light-weight" encryption algorithms designed to maximise security within tight resource constraints (limited memory, power consumption, processor speed, chip area, etc.) The target applications of such algorithms are RFIDs, smart cards, mobile phones, etc., which may store, process and transmit sensitive data, but at the same time do not always support conventional strong algorithms. A survey of existing algorithms is given and new proposal is introduced.

Securing resource constraints embedded devices using elliptic curve cryptography

NASA Astrophysics Data System (ADS)

Tam, Tony; Alfasi, Mohamed; Mozumdar, Mohammad

2014-06-01

The use of smart embedded device has been growing rapidly in recent time because of miniaturization of sensors and platforms. Securing data from these embedded devices is now become one of the core challenges both in industry and research community. Being embedded, these devices have tight constraints on resources such as power, computation, memory, etc. Hence it is very difficult to implement traditional Public Key Cryptography (PKC) into these resource constrained embedded devices. Moreover, most of the public key security protocols requires both public and private key to be generated together. In contrast with this, Identity Based Encryption (IBE), a public key cryptography protocol, allows a public key to be generated from an arbitrary string and the corresponding private key to be generated later on demand. While IBE has been actively studied and widely applied in cryptography research, conventional IBE primitives are also computationally demanding and cannot be efficiently implemented on embedded system. Simplified version of the identity based encryption has proven its competence in being robust and also satisfies tight budget of the embedded platform. In this paper, we describe the choice of several parameters for implementing lightweight IBE in resource constrained embedded sensor nodes. Our implementation of IBE is built using elliptic curve cryptography (ECC).

Resource Effective Strategies to Prevent and Treat Cardiovascular Disease

PubMed Central

Schwalm, Jon-David; McKee, Martin; Huffman, Mark D.; Yusuf, Salim

2016-01-01

Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality. PMID:26903017

On the nullspace of TLS multi-station adjustment

NASA Astrophysics Data System (ADS)

Sterle, Oskar; Kogoj, Dušan; Stopar, Bojan; Kregar, Klemen

2018-07-01

In the article we present an analytic aspect of TLS multi-station least-squares adjustment with the main focus on the datum problem. The datum problem is, compared to previously published researches, theoretically analyzed and solved, where the solution is based on nullspace derivation of the mathematical model. The importance of datum problem solution is seen in a complete description of TLS multi-station adjustment solutions from a set of all minimally constrained least-squares solutions. On a basis of known nullspace, estimable parameters are described and the geometric interpretation of all minimally constrained least squares solutions is presented. At the end a simulated example is used to analyze the results of TLS multi-station minimally constrained and inner constrained least-squares adjustment solutions.

The Development of Lyophilized Loop-mediated Isothermal Amplification Reagents for the Detection of Coxiella burnetii.

PubMed

Chen, Hua-Wei; Ching, Wei-Mei

2016-04-18

Coxiella burnetii, the agent causing Q fever, is an obligate intracellular bacterium. PCR based diagnostic assays have been developed for detecting C. burnetii DNA in cell cultures and clinical samples. PCR requires specialized equipment and extensive end user training, and therefore, it is not suitable for routine work especially in a resource-constrained area. We have developed a loop-mediated isothermal amplification (LAMP) assay to detect the presence of C. burnetii in patient samples. This method is performed at a single temperature around 60 °C in a water bath or heating block. The sensitivity of this LAMP assay is very similar to PCR with a detection limit of about 25 copies per reaction. This report describes the preparation of the reaction using lyophilized reagents and visualization of results using hydroxynaphthol blue (HNB) or a UV lamp with fluorescent intercalating dye in the reaction. The LAMP reagents were lyophilized and stored at room temperature (RT) for one month without loss of detection sensitivity. This LAMP assay is particularly robust because the reaction mixture preparation does not involve complex steps. This method is ideal for use in resource-limited settings where Q fever is endemic.

Animal movement constraints improve resource selection inference in the presence of telemetry error

USGS Publications Warehouse

Brost, Brian M.; Hooten, Mevin B.; Hanks, Ephraim M.; Small, Robert J.

2016-01-01

Multiple factors complicate the analysis of animal telemetry location data. Recent advancements address issues such as temporal autocorrelation and telemetry measurement error, but additional challenges remain. Difficulties introduced by complicated error structures or barriers to animal movement can weaken inference. We propose an approach for obtaining resource selection inference from animal location data that accounts for complicated error structures, movement constraints, and temporally autocorrelated observations. We specify a model for telemetry data observed with error conditional on unobserved true locations that reflects prior knowledge about constraints in the animal movement process. The observed telemetry data are modeled using a flexible distribution that accommodates extreme errors and complicated error structures. Although constraints to movement are often viewed as a nuisance, we use constraints to simultaneously estimate and account for telemetry error. We apply the model to simulated data, showing that it outperforms common ad hoc approaches used when confronted with measurement error and movement constraints. We then apply our framework to an Argos satellite telemetry data set on harbor seals (Phoca vitulina) in the Gulf of Alaska, a species that is constrained to move within the marine environment and adjacent coastlines.

Remote sensing of plant functional types.

PubMed

Ustin, Susan L; Gamon, John A

2010-06-01

Conceptually, plant functional types represent a classification scheme between species and broad vegetation types. Historically, these were based on physiological, structural and/or phenological properties, whereas recently, they have reflected plant responses to resources or environmental conditions. Often, an underlying assumption, based on an economic analogy, is that the functional role of vegetation can be identified by linked sets of morphological and physiological traits constrained by resources, based on the hypothesis of functional convergence. Using these concepts, ecologists have defined a variety of functional traits that are often context dependent, and the diversity of proposed traits demonstrates the lack of agreement on universal categories. Historically, remotely sensed data have been interpreted in ways that parallel these observations, often focused on the categorization of vegetation into discrete types, often dependent on the sampling scale. At the same time, current thinking in both ecology and remote sensing has moved towards viewing vegetation as a continuum rather than as discrete classes. The capabilities of new remote sensing instruments have led us to propose a new concept of optically distinguishable functional types ('optical types') as a unique way to address the scale dependence of this problem. This would ensure more direct relationships between ecological information and remote sensing observations.

Improving clinical handover in a paediatric ward: implications for nursing management.

PubMed

Mannix, Trudi; Parry, Yvonne; Roderick, Allison

2017-04-01

To describe how nursing staff in a paediatric ward improved the conduct of clinical handover, using a practise development approach. ISBAR (Identify, Situation, Background, Assessment and Recommendation) is a mnemonic tool to aid the safe transfer of patient information in clinical handover. The nurses identified the need to improve the use of ISBAR, and other issues related to handover that could compromise patient safety and constrain family-centred care. Sixty-one percent of nurses on the ward contributed to issue identification and the design of the educational material, including a set of written and video resources and incorporating the role of a handover coach. Staff performance was evaluated before and after access to the resources using self-administered Likert scales, observation and a focus group. After the intervention, there was a stronger relationship between the participants' understanding of ISBAR and their application of it in handover. Further, there were statistically significant increases in improved handover practises, including family inclusion and safety checks. A practise development approach is useful in the provision of education to guide clinical performance in patient handover. Nurse managers can use this approach to empower their staff to make positive changes to practise. © 2017 John Wiley & Sons Ltd.

Do efforts to standardize, assess and improve the quality of health service provision to adolescents by government-run health services in low and middle income countries, lead to improvements in service-quality and service-utilization by adolescents?

PubMed

Chandra-Mouli, Venkatraman; Chatterjee, Subidita; Bose, Krishna

2016-02-06

Researchers and implementers working in adolescent health, and adolescents themselves question whether government-run health services in conservative and resource-constrained settings can be made adolescent friendly. This paper aims to find out what selected low and middle income country (LMIC) governments have set out to do to improve the quality of health service provision to adolescents; whether their efforts led to measurable improvements in quality and to increased health service-utilization by adolescents. We gathered normative guidance and reports from eight LMICs in Asia, Africa, Central and Eastern Europe and the Western Pacific. We analysed national quality standards for adolescent friendly health services, findings from the assessments of the quality of health service provision, and findings on the utilization of health services. Governments of LMICs have set out to improve the accessibility, acceptability, equity, appropriateness and effectiveness of health service provision to adolescents by defining standards and actions to achieve them. Their actions have led to measurable improvements in quality and to increases in health service utilisation by adolescents. With support, government-run health facilities in LMICs can improve the quality of health services and their utilization by adolescents.

Population dynamics in an intermittent refuge

NASA Astrophysics Data System (ADS)

Colombo, E. H.; Anteneodo, C.

2016-10-01

Population dynamics is constrained by the environment, which needs to obey certain conditions to support population growth. We consider a standard model for the evolution of a single species population density, which includes reproduction, competition for resources, and spatial spreading, while subject to an external harmful effect. The habitat is spatially heterogeneous, there existing a refuge where the population can be protected. Temporal variability is introduced by the intermittent character of the refuge. This scenario can apply to a wide range of situations, from a laboratory setting where bacteria can be protected by a blinking mask from ultraviolet radiation, to large-scale ecosystems, like a marine reserve where there can be seasonal fishing prohibitions. Using analytical and numerical tools, we investigate the asymptotic behavior of the total population as a function of the size and characteristic time scales of the refuge. We obtain expressions for the minimal size required for population survival, in the slow and fast time scale limits.

Long-term albendazole effectiveness for hepatic cystic echinococcosis.

PubMed

Salinas, Jorge Luis; Vildozola Gonzales, Herman; Astuvilca, Juan; Arce-Villavicencio, Yanet; Carbajal-Gonzalez, Danny; Talledo, Lety; Willig, James H

2011-12-01

Little is known about the long-term effectiveness of albendazole in the medical therapy of non-complicated hepatic cystic echinococcosis (HCE) in resource-constrained settings. We performed a retrospective review of patients starting albendazole for HCE in Lima, Peru from January 1997 to December 2007. Patients successfully recontacted underwent chart abstraction and clinical and ultrasonographic reevaluation. Descriptive statistics were used to delineate patient characteristics and treatment effectiveness at the conclusion of albendazole and after reevaluation. Patients (N = 27) were primarily female, mean age was 51. Initial treatment success at albendazole conclusion was 26% (N = 7) per patient and 37.5% (N = 24) per cyst. After 3.8 ± 2.5 years, albendazole success was 34% (N = 9) per patient and 40% (N = 24) per cyst. We found a gap in the effectiveness of albendazole HCE therapy compared with the efficacy reported in clinical trials. This underscores the need for further investigation into alternate therapeutic strategies for this neglected disease.

Improved Geothermometry Through Multivariate Reaction-path Modeling and Evaluation of Geomicrobiological Influences on Geochemical Temperature Indicators: Final Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mattson, Earl; Smith, Robert; Fujita, Yoshiko

2015-03-01

The project was aimed at demonstrating that the geothermometric predictions can be improved through the application of multi-element reaction path modeling that accounts for lithologic and tectonic settings, while also accounting for biological influences on geochemical temperature indicators. The limited utilization of chemical signatures by individual traditional geothermometer in the development of reservoir temperature estimates may have been constraining their reliability for evaluation of potential geothermal resources. This project, however, was intended to build a geothermometry tool which can integrate multi-component reaction path modeling with process-optimization capability that can be applied to dilute, low-temperature water samples to consistently predict reservoirmore » temperature within ±30 °C. The project was also intended to evaluate the extent to which microbiological processes can modulate the geochemical signals in some thermal waters and influence the geothermometric predictions.« less

Flipped Class - Making that One Hour Effective in a Resource Constrained Setting.

PubMed

Zafar, Afsheen

2016-09-01

Flipped-class teaching has a great potential to replace traditional lectures in medical education. This study was designed to explore attitude of undergraduate medical students from Pakistan towards flipped-class. Five flipped classes were conducted in third year MBBS by a single teacher for a class of 100 students. Quantitative data was collected through a survey questionnaire to assess students' response to the new method. Afocused group discussion was then conducted with students who disliked the method and preferred traditional lectures. Asequential mixed methods approach was used for analysis. Seventy-one students participated in the survey, 84.5% students liked this method of teaching. Students identified fruitful interaction, better retention, better conceptualisation, prior knowledge, active learning, individual student attention, and application of knowledge as strengths of the class. Noise, limited time, lack of self-confidence, and presence of uninterested students were identified as problems for engaging in the class.

Integration of multi-omics data of a genome-reduced bacterium: Prevalence of post-transcriptional regulation and its correlation with protein abundances

PubMed Central

Chen, Wei-Hua; van Noort, Vera; Lluch-Senar, Maria; Hennrich, Marco L.; H. Wodke, Judith A.; Yus, Eva; Alibés, Andreu; Roma, Guglielmo; Mende, Daniel R.; Pesavento, Christina; Typas, Athanasios; Gavin, Anne-Claude; Serrano, Luis; Bork, Peer

2016-01-01

We developed a comprehensive resource for the genome-reduced bacterium Mycoplasma pneumoniae comprising 1748 consistently generated ‘-omics’ data sets, and used it to quantify the power of antisense non-coding RNAs (ncRNAs), lysine acetylation, and protein phosphorylation in predicting protein abundance (11%, 24% and 8%, respectively). These factors taken together are four times more predictive of the proteome abundance than of mRNA abundance. In bacteria, post-translational modifications (PTMs) and ncRNA transcription were both found to increase with decreasing genomic GC-content and genome size. Thus, the evolutionary forces constraining genome size and GC-content modify the relative contributions of the different regulatory layers to proteome homeostasis, and impact more genomic and genetic features than previously appreciated. Indeed, these scaling principles will enable us to develop more informed approaches when engineering minimal synthetic genomes. PMID:26773059

A general optimality criteria algorithm for a class of engineering optimization problems

NASA Astrophysics Data System (ADS)

Belegundu, Ashok D.

2015-05-01

An optimality criteria (OC)-based algorithm for optimization of a general class of nonlinear programming (NLP) problems is presented. The algorithm is only applicable to problems where the objective and constraint functions satisfy certain monotonicity properties. For multiply constrained problems which satisfy these assumptions, the algorithm is attractive compared with existing NLP methods as well as prevalent OC methods, as the latter involve computationally expensive active set and step-size control strategies. The fixed point algorithm presented here is applicable not only to structural optimization problems but also to certain problems as occur in resource allocation and inventory models. Convergence aspects are discussed. The fixed point update or resizing formula is given physical significance, which brings out a strength and trim feature. The number of function evaluations remains independent of the number of variables, allowing the efficient solution of problems with large number of variables.

Faces of integration.

PubMed

Williams, Paul; Sullivan, Helen

2009-12-22

Two central themes permeate this paper-the interplay between structure and agency in integration processes and the extent to which this is mediated through sensemaking by individual actors. The empirical base for the paper is provided by case study research from Wales which draws on examples of different types of integration in health and social care. The individual case studies highlight different interpretations of integration set against a background of the resources involved, processes employed and outcomes achieved. A wide ranging discussion exposes the complex interplay and dynamics between structural factors and the manner in which they enable or constrain integration, and individual actors realising their potential agency through leadership, professionalism and boundary spanning to influence outcomes. The importance of structure and agency complementing each other to determine effective integration is emphasised, together with the scope that is available for interpretation and meaning by individual actors within the contested discourse of integration.

Faces of integration

PubMed Central

Williams, Paul; Sullivan, Helen

2009-01-01

Theme Two central themes permeate this paper—the interplay between structure and agency in integration processes and the extent to which this is mediated through sensemaking by individual actors. Case study The empirical base for the paper is provided by case study research from Wales which draws on examples of different types of integration in health and social care. The individual case studies highlight different interpretations of integration set against a background of the resources involved, processes employed and outcomes achieved. Discussion A wide ranging discussion exposes the complex interplay and dynamics between structural factors and the manner in which they enable or constrain integration, and individual actors realising their potential agency through leadership, professionalism and boundary spanning to influence outcomes. The importance of structure and agency complementing each other to determine effective integration is emphasised, together with the scope that is available for interpretation and meaning by individual actors within the contested discourse of integration. PMID:20087420

Mapping the function of neuronal ion channels in model and experiment

PubMed Central

Podlaski, William F; Seeholzer, Alexander; Groschner, Lukas N; Miesenböck, Gero; Ranjan, Rajnish; Vogels, Tim P

2017-01-01

Ion channel models are the building blocks of computational neuron models. Their biological fidelity is therefore crucial for the interpretation of simulations. However, the number of published models, and the lack of standardization, make the comparison of ion channel models with one another and with experimental data difficult. Here, we present a framework for the automated large-scale classification of ion channel models. Using annotated metadata and responses to a set of voltage-clamp protocols, we assigned 2378 models of voltage- and calcium-gated ion channels coded in NEURON to 211 clusters. The IonChannelGenealogy (ICGenealogy) web interface provides an interactive resource for the categorization of new and existing models and experimental recordings. It enables quantitative comparisons of simulated and/or measured ion channel kinetics, and facilitates field-wide standardization of experimentally-constrained modeling. DOI: http://dx.doi.org/10.7554/eLife.22152.001 PMID:28267430

Employing Simulation to Evaluate Designs: The APEX Approach

NASA Technical Reports Server (NTRS)

Freed, Michael A.; Shafto, Michael G.; Remington, Roger W.; Null, Cynthia H. (Technical Monitor)

1998-01-01

The key innovations of APEX are its integrated approaches to task analysis, procedure definition, and intelligent, resource-constrained multi-tasking. This paper presents a step-by-step description of how APEX is used, from scenario development through trace analysis.

SU-E-T-551: Monitor Unit Optimization in Stereotactic Body Radiation Therapy for Stage I Lung Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huang, B-T; Lu, J-Y

2015-06-15

Purpose: The study aims to reduce the monitor units (MUs) in the stereotactic body radiation therapy (SBRT) treatment for lung cancer by adjusting the optimizing parameters. Methods: Fourteen patients suffered from stage I Non-Small Cell Lung Cancer (NSCLC) were enrolled. Three groups of parameters were adjusted to investigate their effects on MU numbers and organs at risk (OARs) sparing: (1) the upper objective of planning target volume (UOPTV); (2) strength setting in the MU constraining objective; (3) max MU setting in the MU constraining objective. Results: We found that the parameters in the optimizer influenced the MU numbers in amore » priority, strength and max MU dependent manner. MU numbers showed a decreasing trend with the UOPTV increasing. MU numbers with low, medium and high priority for the UOPTV were 428±54, 312±48 and 258±31 MU/Gy, respectively. High priority for UOPTV also spared the heart, cord and lung while maintaining comparable PTV coverage than the low and medium priority group. It was observed that MU numbers tended to decrease with the strength increasing and max MU setting decreasing. With maximum strength, the MU numbers reached its minimum while maintaining comparable or improved dose to the normal tissues. It was also found that the MU numbers continued to decline at 85% and 75% max MU setting but no longer to decrease at 50% and 25%. Combined with high priority for UOPTV and MU constraining objectives, the MU numbers can be decreased as low as 223±26 MU/Gy. Conclusion:: The priority of UOPTV, MU constraining objective in the optimizer impact on the MU numbers in SBRT treatment for lung cancer. Giving high priority to the UOPTV, setting the strength to maximum value and the max MU to 50% in the MU objective achieves the lowest MU numbers while maintaining comparable or improved OAR sparing.« less

A generalized fuzzy credibility-constrained linear fractional programming approach for optimal irrigation water allocation under uncertainty

NASA Astrophysics Data System (ADS)

Zhang, Chenglong; Guo, Ping

2017-10-01

The vague and fuzzy parametric information is a challenging issue in irrigation water management problems. In response to this problem, a generalized fuzzy credibility-constrained linear fractional programming (GFCCFP) model is developed for optimal irrigation water allocation under uncertainty. The model can be derived from integrating generalized fuzzy credibility-constrained programming (GFCCP) into a linear fractional programming (LFP) optimization framework. Therefore, it can solve ratio optimization problems associated with fuzzy parameters, and examine the variation of results under different credibility levels and weight coefficients of possibility and necessary. It has advantages in: (1) balancing the economic and resources objectives directly; (2) analyzing system efficiency; (3) generating more flexible decision solutions by giving different credibility levels and weight coefficients of possibility and (4) supporting in-depth analysis of the interrelationships among system efficiency, credibility level and weight coefficient. The model is applied to a case study of irrigation water allocation in the middle reaches of Heihe River Basin, northwest China. Therefore, optimal irrigation water allocation solutions from the GFCCFP model can be obtained. Moreover, factorial analysis on the two parameters (i.e. λ and γ) indicates that the weight coefficient is a main factor compared with credibility level for system efficiency. These results can be effective for support reasonable irrigation water resources management and agricultural production.

Evolutionary optimization methods for accelerator design

NASA Astrophysics Data System (ADS)

Poklonskiy, Alexey A.

Many problems from the fields of accelerator physics and beam theory can be formulated as optimization problems and, as such, solved using optimization methods. Despite growing efficiency of the optimization methods, the adoption of modern optimization techniques in these fields is rather limited. Evolutionary Algorithms (EAs) form a relatively new and actively developed optimization methods family. They possess many attractive features such as: ease of the implementation, modest requirements on the objective function, a good tolerance to noise, robustness, and the ability to perform a global search efficiently. In this work we study the application of EAs to problems from accelerator physics and beam theory. We review the most commonly used methods of unconstrained optimization and describe the GATool, evolutionary algorithm and the software package, used in this work, in detail. Then we use a set of test problems to assess its performance in terms of computational resources, quality of the obtained result, and the tradeoff between them. We justify the choice of GATool as a heuristic method to generate cutoff values for the COSY-GO rigorous global optimization package for the COSY Infinity scientific computing package. We design the model of their mutual interaction and demonstrate that the quality of the result obtained by GATool increases as the information about the search domain is refined, which supports the usefulness of this model. We Giscuss GATool's performance on the problems suffering from static and dynamic noise and study useful strategies of GATool parameter tuning for these and other difficult problems. We review the challenges of constrained optimization with EAs and methods commonly used to overcome them. We describe REPA, a new constrained optimization method based on repairing, in exquisite detail, including the properties of its two repairing techniques: REFIND and REPROPT. We assess REPROPT's performance on the standard constrained optimization test problems for EA with a variety of different configurations and suggest optimal default parameter values based on the results. Then we study the performance of the REPA method on the same set of test problems and compare the obtained results with those of several commonly used constrained optimization methods with EA. Based on the obtained results, particularly on the outstanding performance of REPA on test problem that presents significant difficulty for other reviewed EAs, we conclude that the proposed method is useful and competitive. We discuss REPA parameter tuning for difficult problems and critically review some of the problems from the de-facto standard test problem set for the constrained optimization with EA. In order to demonstrate the practical usefulness of the developed method, we study several problems of accelerator design and demonstrate how they can be solved with EAs. These problems include a simple accelerator design problem (design a quadrupole triplet to be stigmatically imaging, find all possible solutions), a complex real-life accelerator design problem (an optimization of the front end section for the future neutrino factory), and a problem of the normal form defect function optimization which is used to rigorously estimate the stability of the beam dynamics in circular accelerators. The positive results we obtained suggest that the application of EAs to problems from accelerator theory can be very beneficial and has large potential. The developed optimization scenarios and tools can be used to approach similar problems.

Reference View Selection in DIBR-Based Multiview Coding.

PubMed

Maugey, Thomas; Petrazzuoli, Giovanni; Frossard, Pascal; Cagnazzo, Marco; Pesquet-Popescu, Beatrice

2016-04-01

Augmented reality, interactive navigation in 3D scenes, multiview video, and other emerging multimedia applications require large sets of images, hence larger data volumes and increased resources compared with traditional video services. The significant increase in the number of images in multiview systems leads to new challenging problems in data representation and data transmission to provide high quality of experience on resource-constrained environments. In order to reduce the size of the data, different multiview video compression strategies have been proposed recently. Most of them use the concept of reference or key views that are used to estimate other images when there is high correlation in the data set. In such coding schemes, the two following questions become fundamental: 1) how many reference views have to be chosen for keeping a good reconstruction quality under coding cost constraints? And 2) where to place these key views in the multiview data set? As these questions are largely overlooked in the literature, we study the reference view selection problem and propose an algorithm for the optimal selection of reference views in multiview coding systems. Based on a novel metric that measures the similarity between the views, we formulate an optimization problem for the positioning of the reference views, such that both the distortion of the view reconstruction and the coding rate cost are minimized. We solve this new problem with a shortest path algorithm that determines both the optimal number of reference views and their positions in the image set. We experimentally validate our solution in a practical multiview distributed coding system and in the standardized 3D-HEVC multiview coding scheme. We show that considering the 3D scene geometry in the reference view, positioning problem brings significant rate-distortion improvements and outperforms the traditional coding strategy that simply selects key frames based on the distance between cameras.

Capturing the Range of Learning: Implications for Disaster Health in a Resource Constrained Future

DTIC Science & Technology

2012-12-01

article suggests the value of Coombs and Ahmed’s three interrelated “modes of education” (formal, nonformal, and informal) in considering disaster health...learning by health professionals, amidst an environment of resource constraint, is challenging. This article suggests the value of Coombs and...TABLES Table 1. Coombs and Ahmed’s three interelated "modes of education" (formal, nonformal, and informal)a,b with disaster health examples

Adaptive Fuzzy Output Constrained Control Design for Multi-Input Multioutput Stochastic Nonstrict-Feedback Nonlinear Systems.

PubMed

Li, Yongming; Tong, Shaocheng

2017-12-01

In this paper, an adaptive fuzzy output constrained control design approach is addressed for multi-input multioutput uncertain stochastic nonlinear systems in nonstrict-feedback form. The nonlinear systems addressed in this paper possess unstructured uncertainties, unknown gain functions and unknown stochastic disturbances. Fuzzy logic systems are utilized to tackle the problem of unknown nonlinear uncertainties. The barrier Lyapunov function technique is employed to solve the output constrained problem. In the framework of backstepping design, an adaptive fuzzy control design scheme is constructed. All the signals in the closed-loop system are proved to be bounded in probability and the system outputs are constrained in a given compact set. Finally, the applicability of the proposed controller is well carried out by a simulation example.

Climate-wise choices in a world of oil abundance

NASA Astrophysics Data System (ADS)

Brandt, Adam R.; Masnadi, Mohammad S.; Englander, Jacob G.; Koomey, Jonathan; Gordon, Deborah

2018-04-01

Constrained oil supply has given way to abundance at a time when strong action on climate change is wavering. Recent innovation has pushed US oil production to all-time heights and driven oil prices lower. At the same time, attention to climate policy is wavering due to geopolitical upheaval. Nevertheless, climate-wise choices in the oil sector remain a priority, given oil’s large role in modern economies. Here we use a set of open-source models along with a detailed dataset comprising 75 global crude oils (~25% of global production) to estimate the effects of carbon intensity and oil demand on decadal scale oil-sector emissions. We find that oil resources are abundant relative to all projections of 21st century demand, due to large light-tight oil (LTO) and heavy oil/bitumen (HOB) resources. We then investigate the ‘barrel forward’ emissions from producing, refining, and consuming all products from a barrel of crude. These oil resources have diverse life-cycle-greenhouse gas (LC-GHG) emissions impacts, and median per-barrel emissions for unconventional resources vary significantly. Median HOB life cycle emissions are 1.5 times those of median LTO emissions, exceeding them by 200 kgCO2eq./bbl. We show that reducing oil LC-GHGs is a mitigation opportunity worth 10–50 gigatonnes CO2 eq. cumulatively by 2050. We discuss means to reduce oil sector LC-GHGs. Results point to the need for policymakers to address both oil supply and oil demand when considering options to reduce LC-GHGs.

An efficient approach to improve the usability of e-learning resources: the role of heuristic evaluation.

PubMed

Davids, Mogamat Razeen; Chikte, Usuf M E; Halperin, Mitchell L

2013-09-01

Optimizing the usability of e-learning materials is necessary to maximize their potential educational impact, but this is often neglected when time and other resources are limited, leading to the release of materials that cannot deliver the desired learning outcomes. As clinician-teachers in a resource-constrained environment, we investigated whether heuristic evaluation of our multimedia e-learning resource by a panel of experts would be an effective and efficient alternative to testing with end users. We engaged six inspectors, whose expertise included usability, e-learning, instructional design, medical informatics, and the content area of nephrology. They applied a set of commonly used heuristics to identify usability problems, assigning severity scores to each problem. The identification of serious problems was compared with problems previously found by user testing. The panel completed their evaluations within 1 wk and identified a total of 22 distinct usability problems, 11 of which were considered serious. The problems violated the heuristics of visibility of system status, user control and freedom, match with the real world, intuitive visual layout, consistency and conformity to standards, aesthetic and minimalist design, error prevention and tolerance, and help and documentation. Compared with user testing, heuristic evaluation found most, but not all, of the serious problems. Combining heuristic evaluation and user testing, with each involving a small number of participants, may be an effective and efficient way of improving the usability of e-learning materials. Heuristic evaluation should ideally be used first to identify the most obvious problems and, once these are fixed, should be followed by testing with typical end users.

On the optimal identification of tag sets in time-constrained RFID configurations.

PubMed

Vales-Alonso, Javier; Bueno-Delgado, María Victoria; Egea-López, Esteban; Alcaraz, Juan José; Pérez-Mañogil, Juan Manuel

2011-01-01

In Radio Frequency Identification facilities the identification delay of a set of tags is mainly caused by the random access nature of the reading protocol, yielding a random identification time of the set of tags. In this paper, the cumulative distribution function of the identification time is evaluated using a discrete time Markov chain for single-set time-constrained passive RFID systems, namely those ones where a single group of tags is assumed to be in the reading area and only for a bounded time (sojourn time) before leaving. In these scenarios some tags in a set may leave the reader coverage area unidentified. The probability of this event is obtained from the cumulative distribution function of the identification time as a function of the sojourn time. This result provides a suitable criterion to minimize the probability of losing tags. Besides, an identification strategy based on splitting the set of tags in smaller subsets is also considered. Results demonstrate that there are optimal splitting configurations that reduce the overall identification time while keeping the same probability of losing tags.

Developments in Stochastic Fuel Efficient Cruise Control and Constrained Control with Applications to Aircraft

NASA Astrophysics Data System (ADS)

McDonough, Kevin K.

The dissertation presents contributions to fuel-efficient control of vehicle speed and constrained control with applications to aircraft. In the first part of this dissertation a stochastic approach to fuel-efficient vehicle speed control is developed. This approach encompasses stochastic modeling of road grade and traffic speed, modeling of fuel consumption through the use of a neural network, and the application of stochastic dynamic programming to generate vehicle speed control policies that are optimized for the trade-off between fuel consumption and travel time. The fuel economy improvements with the proposed policies are quantified through simulations and vehicle experiments. It is shown that the policies lead to the emergence of time-varying vehicle speed patterns that are referred to as time-varying cruise. Through simulations and experiments it is confirmed that these time-varying vehicle speed profiles are more fuel-efficient than driving at a comparable constant speed. Motivated by these results, a simpler implementation strategy that is more appealing for practical implementation is also developed. This strategy relies on a finite state machine and state transition threshold optimization, and its benefits are quantified through model-based simulations and vehicle experiments. Several additional contributions are made to approaches for stochastic modeling of road grade and vehicle speed that include the use of Kullback-Liebler divergence and divergence rate and a stochastic jump-like model for the behavior of the road grade. In the second part of the dissertation, contributions to constrained control with applications to aircraft are described. Recoverable sets and integral safe sets of initial states of constrained closed-loop systems are introduced first and computational procedures of such sets based on linear discrete-time models are given. The use of linear discrete-time models is emphasized as they lead to fast computational procedures. Examples of these sets for aircraft longitudinal and lateral aircraft dynamics are reported, and it is shown that these sets can be larger in size compared to the more commonly used safe sets. An approach to constrained maneuver planning based on chaining recoverable sets or integral safe sets is described and illustrated with a simulation example. To facilitate the application of this maneuver planning approach in aircraft loss of control (LOC) situations when the model is only identified at the current trim condition but when these sets need to be predicted at other flight conditions, the dependence trends of the safe and recoverable sets on aircraft flight conditions are characterized. The scaling procedure to estimate subsets of safe and recoverable sets at one trim condition based on their knowledge at another trim condition is defined. Finally, two control schemes that exploit integral safe sets are proposed. The first scheme, referred to as the controller state governor (CSG), resets the controller state (typically an integrator) to enforce the constraints and enlarge the set of plant states that can be recovered without constraint violation. The second scheme, referred to as the controller state and reference governor (CSRG), combines the controller state governor with the reference governor control architecture and provides the capability of simultaneously modifying the reference command and the controller state to enforce the constraints. Theoretical results that characterize the response properties of both schemes are presented. Examples are reported that illustrate the operation of these schemes on aircraft flight dynamics models and gas turbine engine dynamic models.

Accuracy of Mobile Phone and Handheld Light Microscopy for the Diagnosis of Schistosomiasis and Intestinal Protozoa Infections in Côte d’Ivoire

PubMed Central

Coulibaly, Jean T.; Ouattara, Mamadou; D’Ambrosio, Michael V.; Fletcher, Daniel A.; Keiser, Jennifer; Utzinger, Jürg; N’Goran, Eliézer K.

2016-01-01

Background Handheld light microscopy using compact optics and mobile phones may improve the quality of health care in resource-constrained settings by enabling access to prompt and accurate diagnosis. Methodology Laboratory technicians were trained to operate two handheld diagnostic devices (Newton Nm1 microscope and a clip-on version of the mobile phone-based CellScope). The accuracy of these devices was compared to conventional light microscopy for the diagnosis of Schistosoma haematobium, S. mansoni, and intestinal protozoa infection in a community-based survey in rural Côte d’Ivoire. One slide of 10 ml filtered urine and a single Kato-Katz thick smear from 226 individuals were subjected to the Newton Nm1 microscope and CellScope for detection of Schistosoma eggs and compared to conventional microscopy. Additionally, 121 sodium acetate-acetic acid-formalin (SAF)-fixed stool samples were examined by the Newton Nm1 microscope and compared to conventional microscopy for the diagnosis of intestinal protozoa. Principal Findings The prevalence of S. haematobium, S. mansoni, Giardia intestinalis, and Entamoeba histolytica/E. dispar, as determined by conventional microscopy, was 39.8%, 5.3%, 20.7%, and 4.9%, respectively. The Newton Nm1 microscope had diagnostic sensitivities for S. mansoni and S. haematobium infection of 91.7% (95% confidence interval (CI) 59.8–99.6%) and 81.1% (95% CI 71.2–88.3%), respectively, and specificities of 99.5% (95% CI 97.0–100%) and 97.1% (95% CI 92.2–99.1%), respectively. The CellScope demonstrated sensitivities for S. mansoni and S. haematobium of 50.0% (95% CI 25.4–74.6%) and 35.6% (95% CI 25.9–46.4%), respectively, and specificities of 99.5% (95% CI 97.0–100%) and 100% (95% CI 86.7–100%), respectively. For G. intestinalis and E. histolytica/E. dispar, the Newton Nm1 microscope had sensitivity of 84.0% (95% CI 63.1–94.7%) and 83.3% (95% CI 36.5–99.1%), respectively, and 100% specificity. Conclusions/Significance Handheld diagnostic devices can be employed in community-based surveys in resource-constrained settings after minimal training of laboratory technicians to diagnose intestinal parasites. PMID:27348755

Use of an electronic Partograph: feasibility and acceptability study in Zanzibar, Tanzania.

PubMed

Litwin, Lindsay Elizabeth; Maly, Christina; Khamis, Asma Ramadan; Hiner, Cyndi; Zoungrana, Jérémie; Mohamed, Khadija; Drake, Mary; Machaku, Michael; Njozi, Mustafa; Muhsin, Salhiya Ali; Kulindwa, Yusuph K; Gomez, Patricia P

2018-05-09

The ePartogram is a tablet-based application developed to improve care for women in labor by addressing documented challenges in partograph use. The application is designed to provide real-time decision support, improve data entry, and increase access to information for appropriate labor management. This study's primary objective was to evaluate the feasibility and acceptability of ePartogram use in resource-constrained clinical settings. The ePartogram was introduced at three facilities in Zanzibar, Tanzania. Following 3 days of training, skilled birth attendants (SBAs) were observed for 2 weeks using the ePartogram to monitor laboring women. During each observed shift, data collectors used a structured observation form to document SBA comfort, confidence, and ability to use the ePartogram. Results were analyzed by shift. Short interviews, conducted with SBAs (n = 82) after each of their first five ePartogram-monitored labors, detected differences over time. After the observation period, in-depth interviews were conducted (n = 15). A thematic analysis of interview transcripts was completed. Observations of 23 SBAs using the ePartogram to monitor 103 women over 84 shifts showed that the majority of SBAs (87-91%) completed each of four fundamental ePartogram tasks-registering a client, entering first and subsequent measurements, and navigating between screens-with ease or increasing ease on their first shift; this increased to 100% by the fifth shift. Nearly all SBAs (93%) demonstrated confidence and all SBAs demonstrated comfort in using the ePartogram by the fifth shift. SBAs expressed positive impressions of the ePartogram and found it efficient and easy to use, beginning with first client use. SBAs noted the helpfulness of auditory reminders (indicating that measurements were due) and visual alerts (signaling abnormal measurements). SBAs expressed confidence in their ability to interpret and act on these reminders and alerts. It is feasible and acceptable for SBAs to use the ePartogram to support labor management and care. With structured training and support during initial use, SBAs quickly became competent and confident in ePartogram use. Qualitative findings revealed that SBAs felt the ePartogram improved timeliness of care and supported decision-making. These findings point to the ePartogram's potential to improve quality of care in resource-constrained labor and delivery settings.

The Single-Visit Approach as a Cervical Cancer Prevention Strategy Among Women With HIV in Ethiopia: Successes and Lessons Learned

PubMed Central

Shiferaw, Netsanet; Salvador-Davila, Graciela; Kassahun, Konjit; Brooks, Mohamad I; Weldegebreal, Teklu; Tilahun, Yewondwossen; Zerihun, Habtamu; Nigatu, Tariku; Lulu, Kidest; Ahmed, Ismael; Blumenthal, Paul D; Asnake, Mengistu

2016-01-01

ABSTRACT Introduction: Cervical cancer is the second most common form of cancer for women in Ethiopia. Using a single-visit approach to prevent cervical cancer, the Addis Tesfa (New Hope) project in Ethiopia tested women with HIV through visual inspection of the cervix with acetic acid wash (VIA) and, if tests results were positive, offered immediate cryotherapy of the precancerous lesion or referral for loop electrosurgical excision procedure (LEEP). The objective of this article is to review screening and treatment outcomes over nearly 4 years of project implementation and to identify lessons learned to improve cervical cancer prevention programs in Ethiopia and other resource-constrained settings. Methods: We analyzed aggregate client data from August 2010 to March 2014 to obtain the number of women with HIV who were counseled, screened, and treated, as well as the number of annual follow-up visits made, from the 14 tertiary- and secondary-level health facilities implementing the single-visit approach. A health facility assessment (HFA) was also implemented from August to December 2013 to examine the effects of the single-visit approach on client flow, staff workload, and facility infrastructure 3 years after initiating the approach. Results: Almost all (99%) of the 16,632 women with HIV counseled about the single-visit approach were screened with VIA during the study period; 1,656 (10%) of them tested VIA positive (VIA+) for precancerous lesions. Among those who tested VIA+ and were thus eligible for cryotherapy, 1,481 (97%) received cryotherapy treatment, but only 80 (63%) women eligible for LEEP actually received the treatment. The HFA results showed frequent staff turnover, some shortage of essential supplies, and rooms that were judged by providers to be too small for delivery of cervical cancer prevention services. Conclusion: The high proportions of VIA screening and cryotherapy treatment in the Addis Tesfa project suggest high acceptance of such services by women with HIV and feasibility of implementation in secondary- and tertiary-level health facilities. However, success of cervical cancer prevention programming must address wider health system challenges to ensure sustainability and appropriate scale-up to the general population of Ethiopia and other resource-constrained settings. PMID:27016546

Multiobjective Resource-Constrained Project Scheduling with a Time-Varying Number of Tasks

PubMed Central

Abello, Manuel Blanco

2014-01-01

In resource-constrained project scheduling (RCPS) problems, ongoing tasks are restricted to utilizing a fixed number of resources. This paper investigates a dynamic version of the RCPS problem where the number of tasks varies in time. Our previous work investigated a technique called mapping of task IDs for centroid-based approach with random immigrants (McBAR) that was used to solve the dynamic problem. However, the solution-searching ability of McBAR was investigated over only a few instances of the dynamic problem. As a consequence, only a small number of characteristics of McBAR, under the dynamics of the RCPS problem, were found. Further, only a few techniques were compared to McBAR with respect to its solution-searching ability for solving the dynamic problem. In this paper, (a) the significance of the subalgorithms of McBAR is investigated by comparing McBAR to several other techniques; and (b) the scope of investigation in the previous work is extended. In particular, McBAR is compared to a technique called, Estimation Distribution Algorithm (EDA). As with McBAR, EDA is applied to solve the dynamic problem, an application that is unique in the literature. PMID:24883398

Far-from-equilibrium bidirectional transport system with constrained entrances competing for pool of limited resources

NASA Astrophysics Data System (ADS)

Verma, Atul Kumar; Sharma, Natasha; Gupta, Arvind Kumar

2018-02-01

Motivated by the wide occurrence of limited resources in many real-life systems, we investigate two-lane totally asymmetric simple exclusion process with constrained entrances under finite supply of particles. We analyze the system within the framework of mean-field theory and examine various complex phenomena, including phase separation, phase transition, and symmetry breaking. Based on the theoretical analysis, we analytically derive the phase boundaries for various symmetric as well as asymmetric phases. It has been observed that the symmetry-breaking phenomenon initiates even for very small number of particles in the system. The phases with broken symmetry originates as shock-low density phase under limited resources, which is in contrast to the scenario with infinite number of particles. As expected, the symmetry breaking continues to persist even for higher values of system particles. Seven stationary phases are observed, with three of them exhibiting symmetry-breaking phenomena. The critical values of a total number of system particles, beyond which various symmetrical and asymmetrical phases appear and disappear are identified. Theoretical outcomes are supported by extensive Monte Carlo simulations. Finally, the size-scaling effect and symmetry-breaking phenomenon on the simulation results have also been examined based on particle density histograms.

Reanalysis of Water, Land Use, and Production Data for Assessing China's Agricultural Resources

NASA Astrophysics Data System (ADS)

Smith, T.; Pan, J.; McLaughlin, D.

2016-12-01

Quantitative data about water availability, crop evapotranspiration (ET), agricultural land use, and production are needed at high temporal and spatial resolutions to develop sustainable water and agricultural plan and policies. However, large-scale high-resolution measured data can be susceptible to errors, physically inconsistent, or incomplete. Reanalysis provides a way to develop improved physically consistent estimates of both measured and hidden variables. The reanalysis approach described here uses a least-squares technique constrained by water balances and crop water requirements to assimilate many possibly redundant data sources to yield estimates of water, land use, and food production variables that are physically consistent while minimizing differences from measured data. As an example, this methodology is applied in China, where food demand is expected to increase but land and water resources could constrain further increases in food production. Hydrologic fluxes, crop ET, agricultural land use, yields, and food production are characterized at 0.5o by 0.5o resolution for a nominal year around the year 2000 for 22 different crop groups. The reanalysis approach provides useful information for resource management and policy, both in China and around the world.

Constraining the Mechanism of D" Anisotropy: Diversity of Observation Types Required

NASA Astrophysics Data System (ADS)

Creasy, N.; Pisconti, A.; Long, M. D.; Thomas, C.

2017-12-01

A variety of different mechanisms have been proposed as explanations for seismic anisotropy at the base of the mantle, including crystallographic preferred orientation of various minerals (bridgmanite, post-perovskite, and ferropericlase) and shape preferred orientation of elastically distinct materials such as partial melt. Investigations of the mechanism for D" anisotropy are usually ambiguous, as seismic observations rarely (if ever) uniquely constrain a mechanism. Observations of shear wave splitting and polarities of SdS and PdP reflections off the D" discontinuity are among our best tools for probing D" anisotropy; however, typical data sets cannot constrain a unique scenario suggested by the mineral physics literature. In this work, we determine what types of body wave observations are required to uniquely constrain a mechanism for D" anisotropy. We test multiple possible models based on both single-crystal and poly-phase elastic tensors provided by mineral physics studies. We predict shear wave splitting parameters for SKS, SKKS, and ScS phases and reflection polarities off the D" interface for a range of possible propagation directions. We run a series of tests that create synthetic data sets by random selection over multiple iterations, controlling the total number of measurements, the azimuthal distribution, and the type of phases. We treat each randomly drawn synthetic dataset with the same methodology as in Ford et al. (2015) to determine the possible mechanism(s), carrying out a grid search over all possible elastic tensors and orientations to determine which are consistent with the synthetic data. We find is it difficult to uniquely constrain the starting model with a realistic number of seismic anisotropy measurements with only one measurement technique or phase type. However, having a mix of SKS, SKKS, and ScS measurements, or a mix of shear wave splitting and reflection polarity measurements, dramatically increases the probability of uniquely constraining the starting model. We also explore what types of datasets are needed to uniquely constrain the orientation(s) of anisotropic symmetry if the mechanism is assumed.

A fuzzy chance-constrained programming model with type 1 and type 2 fuzzy sets for solid waste management under uncertainty

NASA Astrophysics Data System (ADS)

Ma, Xiaolin; Ma, Chi; Wan, Zhifang; Wang, Kewei

2017-06-01

Effective management of municipal solid waste (MSW) is critical for urban planning and development. This study aims to develop an integrated type 1 and type 2 fuzzy sets chance-constrained programming (ITFCCP) model for tackling regional MSW management problem under a fuzzy environment, where waste generation amounts are supposed to be type 2 fuzzy variables and treated capacities of facilities are assumed to be type 1 fuzzy variables. The evaluation and expression of uncertainty overcome the drawbacks in describing fuzzy possibility distributions as oversimplified forms. The fuzzy constraints are converted to their crisp equivalents through chance-constrained programming under the same or different confidence levels. Regional waste management of the City of Dalian, China, was used as a case study for demonstration. The solutions under various confidence levels reflect the trade-off between system economy and reliability. It is concluded that the ITFCCP model is capable of helping decision makers to generate reasonable waste-allocation alternatives under uncertainties.

The New World of Materials

ERIC Educational Resources Information Center

Abelson, Philip H.; Hammond, Allen L.

1976-01-01

Economic growth will be constrained by supplies of energy and raw materials. Natural resource ownership is shifting toward nationalization rather than foreign ownership. Energy prices and environmental awareness are forcing reevaluation of extracting and processing techniques. These developments will affect the industrial and social character of…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Geng, Guangchao; Abhyankar, Shrirang; Wang, Xiaoyu

Transient stability-constrained optimal power flow is an important emerging problem with power systems pushed to the limits for economic benefits, dense and larger interconnected systems, and reduced inertia due to expected proliferation of renewable energy resources. In this study, two more approaches: single machine equivalent and computational intelligence are presented. Also discussed are various application areas, and future directions in this research area. In conclusion, a comprehensive resource for the available literature, publicly available test systems, and relevant numerical libraries is also provided.

Designing programs to improve diets for maternal and child health: estimating costs and potential dietary impacts of nutrition-sensitive programs in Ethiopia, Nigeria, and India.

PubMed

Masters, William A; Rosettie, Katherine L; Kranz, Sarah; Danaei, Goodarz; Webb, Patrick; Mozaffarian, Dariush

2018-05-01

Improving maternal and child nutrition in resource-poor settings requires effective use of limited resources, but priority-setting is constrained by limited information about program costs and impacts, especially for interventions designed to improve diet quality. This study utilized a mixed methods approach to identify, describe and estimate the potential costs and impacts on child dietary intake of 12 nutrition-sensitive programs in Ethiopia, Nigeria and India. These potential interventions included conditional livestock and cash transfers, media and education, complementary food processing and sales, household production and food pricing programs. Components and costs of each program were identified through a novel participatory process of expert regional consultation followed by validation and calibration from literature searches and comparison with actual budgets. Impacts on child diets were determined by estimating of the magnitude of economic mechanisms for dietary change, comprehensive reviews of evaluations and effectiveness for similar programs, and demographic data on each country. Across the 12 programs, total cost per child reached (net present value, purchasing power parity adjusted) ranged very widely: from 0.58 to 2650 USD/year among five programs in Ethiopia; 2.62 to 1919 USD/year among four programs in Nigeria; and 27 to 586 USD/year among three programs in India. When impacts were assessed, the largest dietary improvements were for iron and zinc intakes from a complementary food production program in Ethiopia (increases of 17.7 mg iron/child/day and 7.4 mg zinc/child/day), vitamin A intake from a household animal and horticulture production program in Nigeria (335 RAE/child/day), and animal protein intake from a complementary food processing program in Nigeria (20.0 g/child/day). These results add substantial value to the limited literature on the costs and dietary impacts of nutrition-sensitive interventions targeting children in resource-limited settings, informing policy discussions and serving as critical inputs to future cost-effectiveness analyses focusing on disease outcomes.

Designing programs to improve diets for maternal and child health: estimating costs and potential dietary impacts of nutrition-sensitive programs in Ethiopia, Nigeria, and India

PubMed Central

Rosettie, Katherine L; Kranz, Sarah; Danaei, Goodarz; Webb, Patrick; Mozaffarian, Dariush; Bhattacharjee, Lalita; Chandrasekhar, S; Christensen, Cheryl; Desai, Sonalde; Kazi-Hutchins, Nabeeha; Levin, Carol; Paarlberg, Robert; Vosti, Steven; Adekugbe, Olayinka; Atomsa, Gudina Egata; Badham, Jane; Baye, Kaleab; Beyero, Mesfin; Covic, Namukolo; Dalton, Babukiika; Dufour, Charlotte; Fracassi, Patrizia; Getahun, Zewditu; Haidar, Jemal; Hailu, Tesfaye; Kebede, Aweke; Kinabo, Joyce; Kussaga, Jamal Bakari; Mavrotas, George; Mwanja, Wilson Waiswa; Oguntona, Babatunde; Oladipo, Abiodun; Oniang’o, Ruth; Sibanda, Simbarashe; Sodjinou, Roger; Tom, Carol; Wamani, Henry; Wendelin, Akwilina; Adhikari, Ramesh Kant; Amatya, Archana; Bhattarai, Manav; Brahmbhatt, Viral; Chandyo, Ram Krishna; Gulati, Seema; Kapil, Umesh; Mehta, Ranju; Mohan, Sailesh; Prabhakaran, D; Prakash, V; Puri, Seema; Roy, S K; Sharma, Rekha; Shivakoti, Sabnam; Thorne-Lyman, Andrew; Rana, Pooja Pandey; Trilok-Kumar, Geeta

2018-01-01

Abstract Improving maternal and child nutrition in resource-poor settings requires effective use of limited resources, but priority-setting is constrained by limited information about program costs and impacts, especially for interventions designed to improve diet quality. This study utilized a mixed methods approach to identify, describe and estimate the potential costs and impacts on child dietary intake of 12 nutrition-sensitive programs in Ethiopia, Nigeria and India. These potential interventions included conditional livestock and cash transfers, media and education, complementary food processing and sales, household production and food pricing programs. Components and costs of each program were identified through a novel participatory process of expert regional consultation followed by validation and calibration from literature searches and comparison with actual budgets. Impacts on child diets were determined by estimating of the magnitude of economic mechanisms for dietary change, comprehensive reviews of evaluations and effectiveness for similar programs, and demographic data on each country. Across the 12 programs, total cost per child reached (net present value, purchasing power parity adjusted) ranged very widely: from 0.58 to 2650 USD/year among five programs in Ethiopia; 2.62 to 1919 USD/year among four programs in Nigeria; and 27 to 586 USD/year among three programs in India. When impacts were assessed, the largest dietary improvements were for iron and zinc intakes from a complementary food production program in Ethiopia (increases of 17.7 mg iron/child/day and 7.4 mg zinc/child/day), vitamin A intake from a household animal and horticulture production program in Nigeria (335 RAE/child/day), and animal protein intake from a complementary food processing program in Nigeria (20.0 g/child/day). These results add substantial value to the limited literature on the costs and dietary impacts of nutrition-sensitive interventions targeting children in resource-limited settings, informing policy discussions and serving as critical inputs to future cost-effectiveness analyses focusing on disease outcomes. PMID:29522103

Constraining a Possible Variation of G with Type Ia Supernovae

NASA Astrophysics Data System (ADS)

Mould, Jeremy; Uddin, Syed A.

2014-03-01

Astrophysical cosmology constrains the variation of Newton's Constant in a manner complementary to laboratory experiments, such as the celebrated lunar laser ranging campaign. Supernova cosmology is an example of the former and has attained campaign status, following planning by a Dark Energy Task Force in 2005. In this paper, we employ the full SNIa data set to the end of 2013 to set a limit on G variation. In our approach, we adopt the standard candle delineation of the redshift distance relation. We set an upper limit on its rate of change |dot{G}/G| of 0.1 parts per billion per year over 9 Gyrs. By contrast, lunar laser ranging tests variation of G over the last few decades. Conversely, one may adopt the laboratory result as a prior and constrain the effect of variable G in dark energy equation of state experiments to δw < 0.02. We also examine the parameterisation G 1 + z. Its short expansion age conflicts with the measured values of the expansion rate and the density in a flat Universe. In conclusion, supernova cosmology complements other experiments in limiting G variation. An important caveat is that it rests on the assumption that the same mass of 56Ni is burned to create the standard candle regardless of redshift. These two quantities, f and G, where f is the Chandrasekhar mass fraction burned, are degenerate. Constraining f variation alone requires more understanding of the SNIa mechanism.

More for less: best patient outcomes in a time of financial restraint.

PubMed

Merry, Alan F; Hamblin, Richard

2012-12-01

In many countries, expenditure on health care has increased dramatically over recent years. There have been parallel improvements in many indicators of population health, but too many patients continue to be harmed by health care or receive care that is supply-sensitive, ineffective, or poorly aligned with their needs and values. In addition to human costs, this translates into substantial waste of resource. The world has recently faced economic challenges unseen since the great depression of the 1930s. The financial situation of a country can, like a business, be expressed in three sets of accounts: statements of financial position, financial performance, and cash flow. A key test of solvency is the ability to pay debts as they become due (whether from current account or further borrowing). In general, this is a function of public debt, which for many countries has become very high. However, private debt and net financial position are also relevant to a country's financial prospects. Ultimately, borrowing is not sustainable indefinitely and given limited prospects for growth in income in the coming years, most countries will likely need to reduce or at least constrain expenditure on health care. This implies obtaining better value from the resources that are available, and we suggest that the key to this lies in improving the quality of care and, in particular, reducing variation in health care. In the United States, new legislation promoting accountable care organizations may help to do this. Cardiac surgery can be particularly effective in extending patients' lives and in improving the quality of their lives. Our ability to continue to provide cardiac surgery in the face of constrained economic times will depend on engaging more actively in ensuring that what we do is the right thing: that our operations are effective and that they truly meet the needs and values of our patients. It will also depend on doing these operations right the first time.

Estimating Poromechanical and Hydraulic Properties of Fractured Media Aquifers Using a Model of the Aquifer at Ploemeur France: Broad Applications and Future Uses

NASA Astrophysics Data System (ADS)

Wilson, M. W.; Burbey, T. J.

2017-12-01

Aquifers in fractured crystalline bedrock are located over half of the earth's surface and are vital civil and economic resources particularly in places where ample, safe surface water is not available. With fractured media aquifers providing large percentages of water for municipal, industrial, and agricultural use in many regions of the world. Distinguishing sustainable quantities of extraction is of paramount importance to the continuing viability of these important resources and the communities they serve. The fractured and faulted crystalline-rock aquifer system supporting the community of Ploemeur France has been providing one million cubic meters of water annually, resulting in a modest long-term drawdown of about 15m. To understand the sources and mechanisms of recharge that support this aquifer system, a three-dimensional ABAQUS model was developed using known geologic, water-level and geodetic (tiltmeters and GPS) data to simulate the natural aquifer system that is dominated by a permeable sub-vertical fault and an intersecting semi-horizontal contact zone. The model is used to constrain the poromechanical properties of the fault and contact zones relative to the host crystalline rocks and overlying saprolite by taking advantage of the tilt and seasonal GPS responses caused by municipal pumping along with water-level data for the area. A chief goal in this modeling effort is to assess the sources of recharge to this aquifer system that is atypically productive for a crystalline-rock setting. Preliminary results suggest that the source of water supplying this community is a combination of rapid localized recharge through the saprolite and fault zone and recharge along the contact zone, both from the north (older water) and where it is exposed to the south (younger water). The modeling effort also shows the importance of combining GPS and surface tiltmeter data with water-level measurements for constraining the properties of this complex aquifer system and providing a realistic framework of the recharge and flow characteristics.

More for Less: Best Patient Outcomes in a Time of Financial Restraint

PubMed Central

Merry, Alan F.; Hamblin, Richard

2012-01-01

Abstract: In many countries, expenditure on health care has increased dramatically over recent years. There have been parallel improvements in many indicators of population health, but too many patients continue to be harmed by health care or receive care that is supply-sensitive, ineffective, or poorly aligned with their needs and values. In addition to human costs, this translates into substantial waste of resource. The world has recently faced economic challenges unseen since the great depression of the 1930s. The financial situation of a country can, like a business, be expressed in three sets of accounts: statements of financial position, financial performance, and cash flow. A key test of solvency is the ability to pay debts as they become due (whether from current account or further borrowing). In general, this is a function of public debt, which for many countries has become very high. However, private debt and net financial position are also relevant to a country’s financial prospects. Ultimately, borrowing is not sustainable indefinitely and given limited prospects for growth in income in the coming years, most countries will likely need to reduce or at least constrain expenditure on health care. This implies obtaining better value from the resources that are available, and we suggest that the key to this lies in improving the quality of care and, in particular, reducing variation in health care. In the United States, new legislation promoting accountable care organizations may help to do this. Cardiac surgery can be particularly effective in extending patients’ lives and in improving the quality of their lives. Our ability to continue to provide cardiac surgery in the face of constrained economic times will depend on engaging more actively in ensuring that what we do is the right thing: that our operations are effective and that they truly meet the needs and values of our patients. It will also depend on doing these operations right the first time. PMID:23441557

Tuber size variation and organ preformation constrain growth responses of a spring geophyte.

PubMed

Werger, Marinus J A; Huber, Heidrun

2006-03-01

Functional responses to environmental variation do not only depend on the genetic potential of a species to express different trait values, but can also be limited by characteristics, such as the timing of organ (pre-) formation, aboveground longevity or the presence of a storage organ. In this experiment we tested to what degree variation in tuber size and organ preformation constrain the responsiveness to environmental quality and whether responsiveness is modified by the availability of stored resources by exposing the spring geophyte Bunium bulbocastanum to different light and nutrient regimes. Growth and biomass partitioning were affected by initial tuber size and resource availability. On average, tuber weight amounted to 60%, but never less than 30% of the total plant biomass. Initial tuber size, considered an estimate of the total carbon pool available at the onset of treatments, affected plant growth and reproduction throughout the experiment but had little effect on the responsiveness of plants to the treatments. The responsiveness was partly constrained by organ preformation: in the second year variation of leaf number was considerably larger than in the first year of the treatments. The results indicate that a spring geophyte with organ preformation has only limited possibilities to respond to short-term fluctuations of the environment, as all leaves and the inflorescence are preformed in the previous growing season and resources stored in tubers are predominantly used for survival during dormancy and are not invested into plastic adjustments to environmental quality. Such spring geophytes have only limited possibilities to buffer environmental variation. This explains their restriction to habitats characterized by predictable changes of the environmental conditions.

The impact of a supportive supervision intervention on health workers in Niassa, Mozambique: a cluster-controlled trial.

PubMed

Madede, Tavares; Sidat, Mohsin; McAuliffe, Eilish; Patricio, Sergio Rogues; Uduma, Ogenna; Galligan, Marie; Bradley, Susan; Cambe, Isabel

2017-09-02

Regular supportive supervision is critical to retaining and motivating staff in resource-constrained settings. Previous studies have shown the particular contribution that supportive supervision can make to improving job satisfaction amongst over-stretched health workers in such settings. The Support, Train and Empower Managers (STEM) study designed and implemented a supportive supervision intervention and measured its' impact on health workers using a controlled trial design with a three-arm pre- and post-study in Niassa Province in Mozambique. Post-intervention interviews with a small sample of health workers were also conducted. The quantitative measurements of job satisfaction, emotional exhaustion and work engagement showed no statistically significant differences between end-line and baseline. The qualitative data collected from health workers post the intervention showed many positive impacts on health workers not captured by this quantitative survey. Health workers perceived an improvement in their performance and attributed this to the supportive supervision they had received from their supervisors following the intervention. Reports of increased motivation were also common. An unexpected, yet important consequence of the intervention, which participants directly attributed to the supervision intervention, was the increase in participation and voice amongst health workers in intervention facilities.

The Differential Effects of Reward on Space- and Object-Based Attentional Allocation

PubMed Central

Shomstein, Sarah

2013-01-01

Estimating reward contingencies and allocating attentional resources to a subset of relevant information are the most important contributors to increasing adaptability of an organism. Although recent evidence suggests that reward- and attention-based guidance recruits overlapping cortical regions and has similar effects on sensory responses, the exact nature of the relationship between the two remains elusive. Here, using event-related fMRI on human participants, we contrasted the effects of reward on space- and object-based selection in the same experimental setting. Reward was either distributed randomly or biased a particular object. Behavioral and neuroimaging results show that space- and object-based attention is influenced by reward differentially. Space-based attentional allocation is mandatory, integrating reward information over time, whereas object-based attentional allocation is a default setting that is completely replaced by the reward signal. Nonadditivity of the effects of reward and object-based attention was observed consistently at multiple levels of analysis in early visual areas as well as in control regions. These results provide strong evidence that space- and object-based allocation are two independent attentional mechanisms, and suggest that reward serves to constrain attentional selection. PMID:23804086

Structural barriers to ART adherence in Southern Africa: challenges and potential ways forward

PubMed Central

KAGEE, A.; REMIEN, R.H.; BERKMAN, A.; HOFFMAN, S.; CAMPOS, L.; SWARTZ, L.

2010-01-01

Structural barriers to antiretroviral treatment (ART) adherence are economic, institutional, political and cultural factors, that collectively influence the extent to which persons living with HIV follow their medication regimens. We identify three sets of structural barriers to ART adherence that are salient in Southern Africa: poverty-related, institutional, and political and cultural. Examples of poverty-related barriers are competing demands in the context of resource-constrained settings, the lack of transport infrastructure, food insecurity, the role of disability grants and poor social support. Examples of institutional factors are logistical barriers, overburdened health care facilities, limited access to mental health services and difficulties in ensuring adequate counseling. Examples of political and cultural barriers are controversies in the provision of treatment for AIDS, migration, traditional beliefs about HIV and AIDS, poor health literacy and gender inequalities. In forging a way forward, we identify ways in which individuals, communities and health care systems may overcome some of these structural barriers. Finally, we make recommendations for further research on structural barriers to ART adherence. In all likelihood, enhancing adherence to ART requires the efforts of a variety of disciplines, including public health, psychology, anthropology, sociology and medicine. PMID:20509066

Groundwater availability as constrained by hydrogeology and environmental flows

USGS Publications Warehouse

Watson, Katelyn A.; Mayer, Alex S.; Reeves, Howard W.

2014-01-01

Groundwater pumping from aquifers in hydraulic connection with nearby streams has the potential to cause adverse impacts by decreasing flows to levels below those necessary to maintain aquatic ecosystems. The recent passage of the Great Lakes-St. Lawrence River Basin Water Resources Compact has brought attention to this issue in the Great Lakes region. In particular, the legislation requires the Great Lakes states to enact measures for limiting water withdrawals that can cause adverse ecosystem impacts. This study explores how both hydrogeologic and environmental flow limitations may constrain groundwater availability in the Great Lakes Basin. A methodology for calculating maximum allowable pumping rates is presented. Groundwater availability across the basin may be constrained by a combination of hydrogeologic yield and environmental flow limitations varying over both local and regional scales. The results are sensitive to factors such as pumping time, regional and local hydrogeology, streambed conductance, and streamflow depletion limits. Understanding how these restrictions constrain groundwater usage and which hydrogeologic characteristics and spatial variables have the most influence on potential streamflow depletions has important water resources policy and management implications.

McMAC: Towards a MAC Protocol with Multi-Constrained QoS Provisioning for Diverse Traffic in Wireless Body Area Networks

PubMed Central

Monowar, Muhammad Mostafa; Hassan, Mohammad Mehedi; Bajaber, Fuad; Al-Hussein, Musaed; Alamri, Atif

2012-01-01

The emergence of heterogeneous applications with diverse requirements for resource-constrained Wireless Body Area Networks (WBANs) poses significant challenges for provisioning Quality of Service (QoS) with multi-constraints (delay and reliability) while preserving energy efficiency. To address such challenges, this paper proposes McMAC, a MAC protocol with multi-constrained QoS provisioning for diverse traffic classes in WBANs. McMAC classifies traffic based on their multi-constrained QoS demands and introduces a novel superframe structure based on the “transmit-whenever-appropriate” principle, which allows diverse periods for diverse traffic classes according to their respective QoS requirements. Furthermore, a novel emergency packet handling mechanism is proposed to ensure packet delivery with the least possible delay and the highest reliability. McMAC is also modeled analytically, and extensive simulations were performed to evaluate its performance. The results reveal that McMAC achieves the desired delay and reliability guarantee according to the requirements of a particular traffic class while achieving energy efficiency. PMID:23202224

Manual cleaning of hospital mattresses: an observational study comparing high- and low-resource settings.

PubMed

Hopman, J; Hakizimana, B; Meintjes, W A J; Nillessen, M; de Both, E; Voss, A; Mehtar, S

2016-01-01

Hospital-associated infections (HAIs) are more frequently encountered in low- than in high-resource settings. There is a need to identify and implement feasible and sustainable approaches to strengthen HAI prevention in low-resource settings. To evaluate the biological contamination of routinely cleaned mattresses in both high- and low-resource settings. In this two-stage observational study, routine manual bed cleaning was evaluated at two university hospitals using adenosine triphosphate (ATP). Standardized training of cleaning personnel was achieved in both high- and low-resource settings. Qualitative analysis of the cleaning process was performed to identify predictors of cleaning outcome in low-resource settings. Mattresses in low-resource settings were highly contaminated prior to cleaning. Cleaning significantly reduced biological contamination of mattresses in low-resource settings (P < 0.0001). After training, the contamination observed after cleaning in both the high- and low-resource settings seemed comparable. Cleaning with appropriate type of cleaning materials reduced the contamination of mattresses adequately. Predictors for mattresses that remained contaminated in a low-resource setting included: type of product used, type of ward, training, and the level of contamination prior to cleaning. In low-resource settings mattresses were highly contaminated as noted by ATP levels. Routine manual cleaning by trained staff can be as effective in a low-resource setting as in a high-resource setting. We recommend a multi-modal cleaning strategy that consists of training of domestic services staff, availability of adequate time to clean beds between patients, and application of the correct type of cleaning products. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

On the formation of granulites

USGS Publications Warehouse

Bohlen, S.R.

1991-01-01

The tectonic settings for the formation and evolution of regional granulite terranes and the lowermost continental crust can be deduced from pressure-temperature-time (P-T-time) paths and constrained by petrological and geophysical considerations. P-T conditions deduced for regional granulites require transient, average geothermal gradients of greater than 35??C km-1, implying minimum heat flow in excess of 100 mW m-2. Such high heat flow is probably caused by magmatic heating. Tectonic settings wherein such conditions are found include convergent plate margins, continental rifts, hot spots and at the margins of large, deep-seated batholiths. Cooling paths can be constrained by solid-solid and devolatilization equilibria and geophysical modelling. -from Author

Acquired and Participatory Competencies in Health Professions Education: Definition and Assessment in Global Health.

PubMed

Eichbaum, Quentin

2017-04-01

Many health professions education programs in high-income countries (HICs) have adopted a competency-based approach to learning. Although global health programs have followed this trend, defining and assessing competencies has proven problematic, particularly in resource-constrained settings of low- and middle-income countries (LMICs) where HIC students and trainees perform elective work. In part, this is due to programs failing to take sufficient account of local learning, cultural, and health contexts.A major divide between HIC and LMIC settings is that the learning contexts of HICs are predominantly individualist, whereas those of LMICs are generally collectivist. Individualist cultures view learning as something that the individual acquires independent of context and can possess; collectivist cultures view learning as arising dynamically from specific contexts through group participation.To bridge the individualist-collectivist learning divide, the author proposes that competencies be classified as either acquired or participatory. Acquired competencies can be transferred across contexts and assessed using traditional psychometric approaches; participatory competencies are linked to contexts and require alternative assessment approaches. The author proposes assessing participatory competencies through the approach of self-directed assessment seeking, which includes multiple members of the health care team as assessors.The proposed classification of competencies as acquired or participatory may apply across health professions. The author suggests advancing participatory competencies through mental models of sharing. In global health education, the author recommends developing three new competency domains rooted in participatory learning, collectivism, and sharing: resourceful learning; transprofessionalism and transformative learning; and social justice and health equity.

Using the WHO Surgical Safety Checklist to Direct Perioperative Quality Improvement at a Surgical Hospital in Cambodia: The Importance of Objective Confirmation of Process Completion.

PubMed

Garland, Naomi Y; Kheng, Sokhavatey; De Leon, Michael; Eap, Hourt; Forrester, Jared A; Hay, Janice; Oum, Palritha; Sam Ath, Socheat; Stock, Simon; Yem, Samprathna; Lucas, Gerlinda; Weiser, Thomas G

2017-12-01

The WHO surgical safety checklist (SSC) is known to prevent postoperative complications; however, strategies for effective implementation are unclear. In addition to cultural and organizational barriers faced by high-income countries, resource-constrained settings face scarcity of durable and consumable goods. We used the SSC to better understand barriers to improvement at a trauma hospital in Battambang, Cambodia. We introduced the SSC and trained data collectors to observe surgical staff performing the checklist. Members of the research team observed cases and data collection. After 3 months, we modified the data collection tool to focus on infection prevention and elicit more accurate responses. Over 16 months we recorded data on 695 operations (304 cases using the first tool and 391 cases with the modified tool). The first tool identified five items as being in high compliance, which were then excluded from further assessment. Two items-instrument sterility confirmation and sponge counting-were identified as being misinterpreted by the data collectors' tool. These items were reworded to capture objective assessment of task completion. Confirmation of instrument sterility was initially never performed but rectified to >95% compliance; sponge counting and prophylactic antibiotic administration were consistently underperformed. Staff complied with communication elements of the SSC and quickly adopted process improvements. The wording of our data collection tool affected interpretation of compliance with standards. Material resources are not the primary barrier to checklist implementation in this setting, and future work should focus on clarification of protocols and objective confirmation of tasks.

Implementation Research to Inform the Use of Xpert MTB/RIF in Primary Health Care Facilities in High TB and HIV Settings in Resource Constrained Settings.

PubMed

Muyoyeta, Monde; Moyo, Maureen; Kasese, Nkatya; Ndhlovu, Mapopa; Milimo, Deborah; Mwanza, Winfridah; Kapata, Nathan; Schaap, Albertus; Godfrey Faussett, Peter; Ayles, Helen

2015-01-01

The current cost of Xpert MTB RIF (Xpert) consumables is such that algorithms are needed to select which patients to prioritise for testing with Xpert. To evaluate two algorithms for prioritisation of Xpert in primary health care settings in a high TB and HIV burden setting. Consecutive, presumptive TB patients with a cough of any duration were offered either Xpert or Fluorescence microscopy (FM) test depending on their CXR score or HIV status. In one facility, sputa from patients with an abnormal CXR were tested with Xpert and those with a normal CXR were tested with FM ("CXR algorithm"). CXR was scored automatically using a Computer Aided Diagnosis (CAD) program. In the other facility, patients who were HIV positive were tested using Xpert and those who were HIV negative were tested with FM ("HIV algorithm"). Of 9482 individuals pre-screened with CXR, Xpert detected TB in 2090/6568 (31.8%) with an abnormal CXR, and FM was AFB positive in 8/2455 (0.3%) with a normal CXR. Of 4444 pre-screened with HIV, Xpert detected TB in 508/2265 (22.4%) HIV positive and FM was AFB positive in 212/1920 (11.0%) in HIV negative individuals. The notification rate of new bacteriologically confirmed TB increased; from 366 to 620/ 100,000/yr and from 145 to 261/100,000/yr at the CXR and HIV algorithm sites respectively. The median time to starting TB treatment at the CXR site compared to the HIV algorithm site was; 1(IQR 1-3 days) and 3 (2-5 days) (p<0.0001) respectively. Use of Xpert in a resource-limited setting at primary care level in conjunction with pre-screening tests reduced the number of Xpert tests performed. The routine use of Xpert resulted in additional cases of confirmed TB patients starting treatment. However, there was no increase in absolute numbers of patients starting TB treatment. Same day diagnosis and treatment commencement was achieved for both bacteriologically confirmed and empirically diagnosed patients where Xpert was used in conjunction with CXR.

Implementation Research to Inform the Use of Xpert MTB/RIF in Primary Health Care Facilities in High TB and HIV Settings in Resource Constrained Settings

PubMed Central

Muyoyeta, Monde; Moyo, Maureen; Kasese, Nkatya; Ndhlovu, Mapopa; Milimo, Deborah; Mwanza, Winfridah; Kapata, Nathan; Schaap, Albertus; Godfrey Faussett, Peter; Ayles, Helen

2015-01-01

Background The current cost of Xpert MTB RIF (Xpert) consumables is such that algorithms are needed to select which patients to prioritise for testing with Xpert. Objective To evaluate two algorithms for prioritisation of Xpert in primary health care settings in a high TB and HIV burden setting. Method Consecutive, presumptive TB patients with a cough of any duration were offered either Xpert or Fluorescence microscopy (FM) test depending on their CXR score or HIV status. In one facility, sputa from patients with an abnormal CXR were tested with Xpert and those with a normal CXR were tested with FM (“CXR algorithm”). CXR was scored automatically using a Computer Aided Diagnosis (CAD) program. In the other facility, patients who were HIV positive were tested using Xpert and those who were HIV negative were tested with FM (“HIV algorithm”). Results Of 9482 individuals pre-screened with CXR, Xpert detected TB in 2090/6568 (31.8%) with an abnormal CXR, and FM was AFB positive in 8/2455 (0.3%) with a normal CXR. Of 4444 pre-screened with HIV, Xpert detected TB in 508/2265 (22.4%) HIV positive and FM was AFB positive in 212/1920 (11.0%) in HIV negative individuals. The notification rate of new bacteriologically confirmed TB increased; from 366 to 620/ 100,000/yr and from 145 to 261/100,000/yr at the CXR and HIV algorithm sites respectively. The median time to starting TB treatment at the CXR site compared to the HIV algorithm site was; 1(IQR 1-3 days) and 3 (2-5 days) (p<0.0001) respectively. Conclusion Use of Xpert in a resource-limited setting at primary care level in conjunction with pre-screening tests reduced the number of Xpert tests performed. The routine use of Xpert resulted in additional cases of confirmed TB patients starting treatment. However, there was no increase in absolute numbers of patients starting TB treatment. Same day diagnosis and treatment commencement was achieved for both bacteriologically confirmed and empirically diagnosed patients where Xpert was used in conjunction with CXR. PMID:26030301

Computer-aided resource planning and scheduling for radiological services

NASA Astrophysics Data System (ADS)

Garcia, Hong-Mei C.; Yun, David Y.; Ge, Yiqun; Khan, Javed I.

1996-05-01

There exists tremendous opportunity in hospital-wide resource optimization based on system integration. This paper defines the resource planning and scheduling requirements integral to PACS, RIS and HIS integration. An multi-site case study is conducted to define the requirements. A well-tested planning and scheduling methodology, called Constrained Resource Planning model, has been applied to the chosen problem of radiological service optimization. This investigation focuses on resource optimization issues for minimizing the turnaround time to increase clinical efficiency and customer satisfaction, particularly in cases where the scheduling of multiple exams are required for a patient. How best to combine the information system efficiency and human intelligence in improving radiological services is described. Finally, an architecture for interfacing a computer-aided resource planning and scheduling tool with the existing PACS, HIS and RIS implementation is presented.

Multiple-Vehicle Resource-Constrained Navigation in the Deep Ocean

DTIC Science & Technology

2011-09-01

Kalman filtering is often used in practice with intermit - tent observations, which uses the simple intuitive result that the optimal method for...trajectory? This level is concerned with fast vehicle dynamics, which are highly dependent on the particular vehicle design and hydrodynamics. Some

Resource-Constrained Project Scheduling Under Uncertainty: Models, Algorithms and Applications

DTIC Science & Technology

2014-11-10

Make-to-Order (MTO) Production Planning using Bayesian Updating, International Journal of Production Economics (04 2014) Norman Keith Womer, Haitao...2013) Made-to-Order Production Scheduling using Bayesian Updating, Working Paper, under second-round review in International Journal of Production Economics . VI

Globalisation, Consumption and the Learning Business.

ERIC Educational Resources Information Center

Field, John

1995-01-01

Distance open learning represents both an outcome of and a primary factor in globalization. Despite investment in infrastructure, software, and human resources, demand for distance open learning in the European market remains constrained. The European Union's policies conceptualize a "European economic space" that ignores the real…

Utilizing Partnerships to Maximize Resources in College Counseling Services

ERIC Educational Resources Information Center

Stewart, Allison; Moffat, Meridith; Travers, Heather; Cummins, Douglas

2015-01-01

Research indicates an increasing number of college students are experiencing severe psychological problems that are impacting their academic performance. However, many colleges and universities operate with constrained budgets that limit their ability to provide adequate counseling services for their student population. Moreover, accessing…

Education Reform in China: Toward Classroom Communities

ERIC Educational Resources Information Center

Tan, Charlene; Hairon, Salleh

2016-01-01

Focusing on China's current education reform, this article critically discusses how contextual factors, specifically sociocultural factors and resources, assist and constrain Chinese educators in their attempt to develop dynamic and inviting classroom communities. Three main findings are highlighted in this article, the first being that the…

Trade-Offs Between Plant Growth and Defense Against Insect Herbivory: An Emerging Mechanistic Synthesis.

PubMed

Züst, Tobias; Agrawal, Anurag A

2017-04-28

Costs of defense are central to our understanding of interactions between organisms and their environment, and defensive phenotypes of plants have long been considered to be constrained by trade-offs that reflect the allocation of limiting resources. Recent advances in uncovering signal transduction networks have revealed that defense trade-offs are often the result of regulatory "decisions" by the plant, enabling it to fine-tune its phenotype in response to diverse environmental challenges. We place these results in the context of classic studies in ecology and evolutionary biology, and propose a unifying framework for growth-defense trade-offs as a means to study the plant's allocation of limiting resources. Pervasive physiological costs constrain the upper limit to growth and defense traits, but the diversity of selective pressures on plants often favors negative correlations at intermediate trait levels. Despite the ubiquity of underlying costs of defense, the current challenge is using physiological and molecular approaches to predict the conditions where they manifest as detectable trade-offs.

Multimode resource-constrained multiple project scheduling problem under fuzzy random environment and its application to a large scale hydropower construction project.

PubMed

Xu, Jiuping; Feng, Cuiying

2014-01-01

This paper presents an extension of the multimode resource-constrained project scheduling problem for a large scale construction project where multiple parallel projects and a fuzzy random environment are considered. By taking into account the most typical goals in project management, a cost/weighted makespan/quality trade-off optimization model is constructed. To deal with the uncertainties, a hybrid crisp approach is used to transform the fuzzy random parameters into fuzzy variables that are subsequently defuzzified using an expected value operator with an optimistic-pessimistic index. Then a combinatorial-priority-based hybrid particle swarm optimization algorithm is developed to solve the proposed model, where the combinatorial particle swarm optimization and priority-based particle swarm optimization are designed to assign modes to activities and to schedule activities, respectively. Finally, the results and analysis of a practical example at a large scale hydropower construction project are presented to demonstrate the practicality and efficiency of the proposed model and optimization method.

Post-approval monitoring and oversight of U.S.-initiated human subjects research in resource-constrained countries.

PubMed

Brown, Brandon; Kinsler, Janni; Folayan, Morenike O; Allen, Karen; Cáceres, Carlos F

2014-06-01

The history of human subjects research and controversial procedures in relation to it has helped form the field of bioethics. Ethically questionable elements may be identified during research design, research implementation, management at the study site, or actions by a study's investigator or other staff. Post-approval monitoring (PAM) may prevent violations from occurring or enable their identification at an early stage. In U.S.-initiated human subjects research taking place in resource-constrained countries with limited development of research regulatory structures, arranging a site visit from a U.S. research ethics committee (REC) becomes difficult, thus creating a potential barrier to regulatory oversight by the parent REC. However, this barrier may be overcome through the use of digital technologies, since much of the world has at least remote access to the Internet. Empirical research is needed to pilot test the use of these technologies for research oversight to ensure the protection of human subjects taking part in research worldwide.

Application of service oriented architecture for sensors and actuators in district heating substations.

PubMed

Gustafsson, Jonas; Kyusakov, Rumen; Mäkitaavola, Henrik; Delsing, Jerker

2014-08-21

Hardwired sensor installations using proprietary protocols found in today's district heating substations limit the potential usability of the sensors in and around the substations. If sensor resources can be shared and re-used in a variety of applications, the cost of sensors and installation can be reduced, and their functionality and operability can be increased. In this paper, we present a new concept of district heating substation control and monitoring, where a service oriented architecture (SOA) is deployed in a wireless sensor network (WSN), which is integrated with the substation. IP-networking is exclusively used from sensor to server; hence, no middleware is needed for Internet integration. Further, by enabling thousands of sensors with SOA capabilities, a System of Systems approach can be applied. The results of this paper show that it is possible to utilize SOA solutions with heavily resource-constrained embedded devices in contexts where the real-time constrains are limited, such as in a district heating substation.

Application of Service Oriented Architecture for Sensors and Actuators in District Heating Substations

PubMed Central

Gustafsson, Jonas; Kyusakov, Rumen; Mäkitaavola, Henrik; Delsing, Jerker

2014-01-01

Hardwired sensor installations using proprietary protocols found in today's district heating substations limit the potential usability of the sensors in and around the substations. If sensor resources can be shared and re-used in a variety of applications, the cost of sensors and installation can be reduced, and their functionality and operability can be increased. In this paper, we present a new concept of district heating substation control and monitoring, where a service oriented architecture (SOA) is deployed in a wireless sensor network (WSN), which is integrated with the substation. IP-networking is exclusively used from sensor to server; hence, no middleware is needed for Internet integration. Further, by enabling thousands of sensors with SOA capabilities, a System of Systems approach can be applied. The results of this paper show that it is possible to utilize SOA solutions with heavily resource-constrained embedded devices in contexts where the real-time constrains are limited, such as in a district heating substation. PMID:25196165

Hydrothermal Alteration of Open Fractures in Prospective Geothermal Drill Cores, Akutan Island, Alaska

NASA Astrophysics Data System (ADS)

Kent, T.

2011-12-01

The goal of this study is to constrain the most recent thermal alteration of two drill cores (HSB2/HSB4) from the Island of Akutan in the Aleutian Islands of Alaska. These cores are characterized by identifying mineralogy using x-ray diffraction spectra, energy dispersive spectroscopy with a scanning electron microscope and optical mineralogy. This is then compared with the coincident thermal data gathered on site in order to help constrain the most recent thermal activity of this dynamic resource. Using multiple temperature diagnostic minerals and their paragenesis, a relative thermal history is produced of expansive propylitic alteration. When combined with the wireline temperature gradients of the cores a model of downward migration emerges. Shallow occurrences of high temperature minerals that lie above the boiling point to depth curve indicate higher hydrostatic pressures in the past which can be attributed to a combination of glacial effects, including a significant amount of glacial erosion that is recognized due to a lack of significant clay cap to the geothermal resource.

Multimode Resource-Constrained Multiple Project Scheduling Problem under Fuzzy Random Environment and Its Application to a Large Scale Hydropower Construction Project

PubMed Central

Xu, Jiuping

2014-01-01

This paper presents an extension of the multimode resource-constrained project scheduling problem for a large scale construction project where multiple parallel projects and a fuzzy random environment are considered. By taking into account the most typical goals in project management, a cost/weighted makespan/quality trade-off optimization model is constructed. To deal with the uncertainties, a hybrid crisp approach is used to transform the fuzzy random parameters into fuzzy variables that are subsequently defuzzified using an expected value operator with an optimistic-pessimistic index. Then a combinatorial-priority-based hybrid particle swarm optimization algorithm is developed to solve the proposed model, where the combinatorial particle swarm optimization and priority-based particle swarm optimization are designed to assign modes to activities and to schedule activities, respectively. Finally, the results and analysis of a practical example at a large scale hydropower construction project are presented to demonstrate the practicality and efficiency of the proposed model and optimization method. PMID:24550708

Constraint-Based Local Search for Constrained Optimum Paths Problems

NASA Astrophysics Data System (ADS)

Pham, Quang Dung; Deville, Yves; van Hentenryck, Pascal

Constrained Optimum Path (COP) problems arise in many real-life applications and are ubiquitous in communication networks. They have been traditionally approached by dedicated algorithms, which are often hard to extend with side constraints and to apply widely. This paper proposes a constraint-based local search (CBLS) framework for COP applications, bringing the compositionality, reuse, and extensibility at the core of CBLS and CP systems. The modeling contribution is the ability to express compositional models for various COP applications at a high level of abstraction, while cleanly separating the model and the search procedure. The main technical contribution is a connected neighborhood based on rooted spanning trees to find high-quality solutions to COP problems. The framework, implemented in COMET, is applied to Resource Constrained Shortest Path (RCSP) problems (with and without side constraints) and to the edge-disjoint paths problem (EDP). Computational results show the potential significance of the approach.

Constrained Low-Interference Relay Node Deployment for Underwater Acoustic Wireless Sensor Networks

NASA Astrophysics Data System (ADS)

Li, Deying; Li, Zheng; Ma, Wenkai; Chen, Wenping

An Underwater Acoustic Wireless Sensor Network (UA-WSN) consists of many resource-constrained Underwater Sensor Nodes (USNs), which are deployed to perform collaborative monitoring tasks over a given region. One way to preserve network connectivity while guaranteing other network QoS is to deploy some Relay Nodes (RNs) in the networks, in which RNs' function is more powerful than USNs and their cost is more expensive. This paper addresses Constrained Low-interference Relay Node Deployment (C-LRND) problem for 3-D UA-WSNs in which the RNs are placed at a subset of candidate locations to ensure connectivity between the USNs, under both the number of RNs deployed and the value of total incremental interference constraints. We first prove that it is NP-hard, then present a general approximation algorithm framework and get two polynomial time O(1)-approximation algorithms.

Controlled, Constrained, or Flexible? How Self-Management Goals Are Shaped By Patient-Provider Interactions.

PubMed

Franklin, Marika; Lewis, Sophie; Willis, Karen; Rogers, Anne; Venville, Annie; Smith, Lorraine

2018-06-01

A person-centered approach to goal-setting, involving collaboration between patients and health professionals, is advocated in policy to support self-management. However, this is difficult to achieve in practice, reducing the potential effectiveness of self-management support. Drawing on observations of consultations between patients and health professionals, we examined how goal-setting is shaped in patient-provider interactions. Analysis revealed three distinct interactional styles. In controlled interactions, health professionals determine patients' goals based on biomedical reference points and present these goals as something patients should do. In constrained interactions, patients are invited to present goals, yet health professionals' language and questions orientate goals toward biomedical issues. In flexible interactions, patients and professionals both contribute to goal-setting, as health professionals use less directive language, create openings, and allow patients to decide on their goals. Findings suggest that interactional style of health professionals could be the focus of interventions when aiming to increase the effectiveness of goal-setting.

Intervention complexity--a conceptual framework to inform priority-setting in health.

PubMed Central

Gericke, Christian A.; Kurowski, Christoph; Ranson, M. Kent; Mills, Anne

2005-01-01

Health interventions vary substantially in the degree of effort required to implement them. To some extent this is apparent in their financial cost, but the nature and availability of non-financial resources is often of similar importance. In particular, human resource requirements are frequently a major constraint. We propose a conceptual framework for the analysis of interventions according to their degree of technical complexity; this complements the notion of institutional capacity in considering the feasibility of implementing an intervention. Interventions are categorized into four dimensions: characteristics of the basic intervention; characteristics of delivery; requirements on government capacity; and usage characteristics. The analysis of intervention complexity should lead to a better understanding of supply- and demand-side constraints to scaling up, indicate priorities for further research and development, and can point to potential areas for improvement of specific aspects of each intervention to close the gap between the complexity of an intervention and the capacity to implement it. The framework is illustrated using the examples of scaling up condom social marketing programmes, and the DOTS strategy for tuberculosis control in highly resource-constrained countries. The framework could be used as a tool for policy-makers, planners and programme managers when considering the expansion of existing projects or the introduction of new interventions. Intervention complexity thus complements the considerations of burden of disease, cost-effectiveness, affordability and political feasibility in health policy decision-making. Reducing the technical complexity of interventions will be crucial to meeting the health-related Millennium Development Goals. PMID:15868020

Intervention complexity--a conceptual framework to inform priority-setting in health.

PubMed

Gericke, Christian A; Kurowski, Christoph; Ranson, M Kent; Mills, Anne

2005-04-01

Health interventions vary substantially in the degree of effort required to implement them. To some extent this is apparent in their financial cost, but the nature and availability of non-financial resources is often of similar importance. In particular, human resource requirements are frequently a major constraint. We propose a conceptual framework for the analysis of interventions according to their degree of technical complexity; this complements the notion of institutional capacity in considering the feasibility of implementing an intervention. Interventions are categorized into four dimensions: characteristics of the basic intervention; characteristics of delivery; requirements on government capacity; and usage characteristics. The analysis of intervention complexity should lead to a better understanding of supply- and demand-side constraints to scaling up, indicate priorities for further research and development, and can point to potential areas for improvement of specific aspects of each intervention to close the gap between the complexity of an intervention and the capacity to implement it. The framework is illustrated using the examples of scaling up condom social marketing programmes, and the DOTS strategy for tuberculosis control in highly resource-constrained countries. The framework could be used as a tool for policy-makers, planners and programme managers when considering the expansion of existing projects or the introduction of new interventions. Intervention complexity thus complements the considerations of burden of disease, cost-effectiveness, affordability and political feasibility in health policy decision-making. Reducing the technical complexity of interventions will be crucial to meeting the health-related Millennium Development Goals.

Killing the cMSSM softly

DOE PAGES

Bechtle, Philip; Camargo-Molina, José Eliel; Desch, Klaus; ...

2016-02-24

We investigate the constrained Minimal Supersymmetric Standard Model (cMSSM) in the light of constraining experimental and observational data from precision measurements, astrophysics, direct supersymmetry searches at the LHC and measurements of the properties of the Higgs boson, by means of a global fit using the program Fittino. As in previous studies, we find rather poor agreement of the best fit point with the global data. We also investigate the stability of the electro-weak vacuum in the preferred region of parameter space around the best fit point.We find that the vacuum is metastable, with a lifetime significantly longer than the agemore » of the Universe. For the first time in a global fit of supersymmetry, we employ a consistent methodology to evaluate the goodness-of-fit of the cMSSM in a frequentist approach by deriving p values from large sets of toy experiments. We analyse analytically and quantitatively the impact of the choice of the observable set on the p value, and in particular its dilution when confronting the model with a large number of barely constraining measurements. Lastly, for the preferred sets of observables, we obtain p values for the cMSSM below 10 %, i.e. we exclude the cMSSM as a model at the 90 % confidence level.« less

Reducing usage of the computational resources by event driven approach to model predictive control

NASA Astrophysics Data System (ADS)

Misik, Stefan; Bradac, Zdenek; Cela, Arben

2017-08-01

This paper deals with a real-time and optimal control of dynamic systems while also considers the constraints which these systems might be subject to. Main objective of this work is to propose a simple modification of the existing Model Predictive Control approach to better suit needs of computational resource-constrained real-time systems. An example using model of a mechanical system is presented and the performance of the proposed method is evaluated in a simulated environment.

Planning applications in image analysis

NASA Technical Reports Server (NTRS)

Boddy, Mark; White, Jim; Goldman, Robert; Short, Nick, Jr.

1994-01-01

We describe two interim results from an ongoing effort to automate the acquisition, analysis, archiving, and distribution of satellite earth science data. Both results are applications of Artificial Intelligence planning research to the automatic generation of processing steps for image analysis tasks. First, we have constructed a linear conditional planner (CPed), used to generate conditional processing plans. Second, we have extended an existing hierarchical planning system to make use of durations, resources, and deadlines, thus supporting the automatic generation of processing steps in time and resource-constrained environments.

Carrier Enabled Power Projection: Delivering for Britain or Papering over the Cracks? Exerting Influence in an Age of Austerity

DTIC Science & Technology

2015-04-13

direction for apportionment of resources to deliver this national capability. The last time the UK introduced new aircraft carriers was at the height of...carefully in all but the most existential threats to a nation . Mahan believed that the blockade was the Navy’s greatest tactic in winning great wars. He...carriers at the heart of a comprehensive air, sea, and land capability to meet the national aims. But, in a severely resource constrained

Population-level resource selection by sympatric brown and American black bears in Alaska

USGS Publications Warehouse

Belant, Jerrold L.; Griffith, Brad; Zhang, Yingte; Follmann, Erich H.; Adams, Layne G.

2010-01-01

Distribution theory predicts that for two species living in sympatry, the subordinate species would be constrained from using the most suitable resources (e.g., habitat), resulting in its use of less suitable habitat and spatial segregation between species. We used negative binomial generalized linear mixed models with fixed effects to estimate seasonal population-level resource selection at two spatial resolutions for female brown bears (Ursus arctos) and female American black bears (U. americanus) in southcentral Alaska during May–September 2000. Black bears selected areas occupied by brown bears during spring which may be related to spatially restricted (i.e., restricted to low elevations) but dispersed or patchy availability of food. In contrast, black bears avoided areas occupied by brown bears during summer. Brown bears selected areas near salmon streams during summer, presumably to access spawning salmon. Use of areas with high berry production by black bears during summer appeared in response to avoidance of areas containing brown bears. Berries likely provided black bears a less nutritious, but adequate food source. We suggest that during summer, black bears were displaced by brown bears, which supports distribution theory in that black bears appeared to be partially constrained from areas containing salmon, resulting in their use of areas containing less nutritious forage. Spatial segregation of brown and American black bears apparently occurs when high-quality resources are spatially restricted and alternate resources are available to the subordinate species. This and previous work suggest that individual interactions between species can result in seasonal population-level responses.

Essential Medications for Patients With Suspected or Confirmed Ebola Virus Disease in Resource-Limited Environments.

PubMed

Pierce, William F; Ready, Selena D; Chapman, John Tyson; Kulick, Corrinne; Shields, Anastasia; Wang, Jialynn; Andrews, Kimberly; Childs, Richard W; Bell, Carlos; Kosyak, Alexandr; Pham, Jade

2017-09-01

In 2014, the U.S. Public Health Service (USPHS) Commissioned Corps deployed to Monrovia, Liberia, to operate a 25-bed Ebola treatment unit (ETU) constructed by the U.S. Military. The ETU was named the Monrovia Medical Unit (MMU) and was constructed from an U.S. Air Force Expeditionary Medical Support (EMEDS) unit with modifications on the basis of consultation from Médecins Sans Frontières, the World Health Organization, and expert panels from the U.S. Department of Defense and Department of Health and Human Services. From November 12, 2014, to April 30, 2015, 42 patients (18 confirmed Ebola virus disease [EVD] and 24 suspected EVD) from nine countries were treated by USPHS providers at the MMU. The medications used in the MMU were primarily procured from the EMEDS 25-bed pharmacy cache. However, specific formulary additions were made for treatment of EVD. Using the MMU pharmacy dispensing data, we compared and contrasted the medications used in the MMU with recommendations in published EVD treatment guidelines for austere settings. After comparing and contrasting the MMU pharmacy dispensing data with publications with EVD medication recommendations applicable to resource-limited settings, 101 medications were included in the USPHS Essential Medications for the Management of EVD List (EML) for an austere, isolated clinical environment. Because Ebola outbreaks often occur in remote areas, proactive planning, improved preparedness, and optimal patient care for EVD are needed, especially in the context of austere environments with a scarcity of resources. We developed the EML to assist in the planning for future Ebola outbreaks in a remote clinical environment and to provide a list of medications that have been used in an ETU. The EML is a comprehensive medication list that builds on the existing publications with EVD treatment recommendations applicable to supply-constrained clinical environments. As well, it is a resource for the provision of medications when evaluating donations, procurement, and may help inform estimates for product inventory requirements for an ETU. We hope the EML will improve readiness and enhance the capabilities of local and regional international responders. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Priorities for Antiretroviral Therapy Research in Sub-Saharan Africa: A 2002 Consensus Conference in Zambia

PubMed Central

Zulu, Isaac; Schuman, Paula; Musonda, Rosemary; Chomba, Elwyn; Mwinga, Kasonde; Sinkala, Moses; Chisembele, Maureen; Mwaba, Peter; Kasonde, Dorothy; Vermund, Sten H.

2009-01-01

Background A consensus conference was held to discuss priorities for antiretroviral therapy (ART) research in Zambia, one of the world’s most heavily HIV-afflicted nations. Zambia, like other resource-limited settings, has increasing access to highly active antiretroviral therapy (HAART) because of declining drug costs, use of government-purchased generic medications, and increased global donations. For sustained delivery of care with HAART in a resource-constrained medical and public health context, operational research is required and clinical trials are desirable. The priority areas for research are most relevant today given the increasing availability of HAART. Methods A conference was held in Lusaka, Zambia, in January 2002 to discuss priority areas for ART research in Zambia, with participants drawn from a broad cross section of Zambian society. State-of-the-art reviews and 6 intensive small group discussions helped to formulate a suggested research agenda. Results Conference participants believed that the most urgent research priorities were to assess how therapeutic resources could be applied for the greatest overall benefit and to minimize the impact of nonadherence and viral resistance. Identified research priorities were as follows: To determine when to initiate HAART in relation to CD4+ cell count To assess whether HIV/AIDS can be managed well without the use of costly frequent viral load measurements and CD4+ cell count monitoring To assess whether HIV/AIDS can be managed in the same fashion in patients coinfected with opportunistic infections such as tuberculosis and HIV-related chronic diarrhea, taking into consideration complications that may occur in tuberculosis such as immune reconstitution syndrome and medication malabsorption in the presence of diarrhea To carefully assess and characterize toxicities, adverse effects, and viral resistance patterns in Zambia, including studies of mothers exposed to prepartum single-dose nevirapine To conduct operational research to assess clinical and field-based strategies to maximize adherence for better outcomes of ART in Zambia To assess ART approaches most valuable for pediatric and adolescent patients in Zambia Conference participants recommended that HIV-related clinical care and research be integrated within home-based care services and operated within the existing health delivery structures to ensure sustainability, reduce costs, and strengthen the structures. Conclusion Our consensus was that antiretroviral clinical trials and operational research are essential for Zambia to address the new challenges arising from increasing ART availability. There is global consensus that antiretroviral clinical trials in resource-constrained countries are possible, and the capacity for such trials should be developed further in Africa. PMID:15213567

Characterizing breast conditions at an open-access breast clinic in South Africa: a model that is more than cancer care for a resource-limited setting.

PubMed

Rayne, Sarah; Lince-Deroche, Naomi; Hendrickson, Cheryl; Shearer, Kate; Moyo, Faith; Michelow, Pam; Rubin, Grace; Benn, Carol; Firnhaber, Cynthia

2017-01-21

While most breast-related research focuses on cancer, presentation of symptomatic persons in non-screened environments requires understanding the spectrum of breast diseases so as to plan services in resource-constrained settings. This study presents the variety of breast disease managed at a government, open-access breast clinic in South Africa. We performed a retrospective file review using a systematic random sample of patients 18 years and above presenting for breast care over a 14-month period. We collected demographics, clinical characteristics, management and final diagnoses from the first visit and twelve subsequent months. The final sample contained 365 individuals (97 · 5% women). Most were black, unmarried and South African citizens with a median age of 43 years (IQR 31-55) . Of those reporting their status (24 · 1%) 38 · 6% were HIV-positive. A mass (57 · 0%) and/or pain (28 · 5%) were the most common symptoms. Imaging and breast biopsies were required in 78 and 25% of individuals, respectively. Nearly half of biopsies identified breast cancer (44 · 1% of women ≤40 and 57 · 3% for women >40). Benign conditions (47 · 7%) and no abnormality (18 · 2%) were common final classifications among women. There was no difference between the final classifications of patients who self-referred versus those who were formally referred from another health care provider. Nearly half of the participants (46 · 6%) travelled 20 km or more to attend the clinic. Benign breast conditions far outweighed cancer diagnoses. As breast cancer awareness increases in resource-limited countries, facilities offering breast care require administrative and clinical preparation to manage a range of non-cancer related conditions.

Influence of sub-specialty surgical care on outcomes for pediatric emergency general surgery patients in a low-middle income country.

PubMed

Shah, Adil A; Shakoor, Amarah; Zogg, Cheryl K; Oyetunji, Tolulope; Ashfaq, Awais; Garvey, Erin M; Latif, Asad; Riviello, Robert; Qureshi, Faisal G; Mateen, Arif; Haider, Adil H; Zafar, Hasnain

2016-05-01

Whether adult general surgeons should handle pediatric emergencies is controversial. In many resource-limited settings, pediatric surgeons are not available. The study examined differences in surgical outcomes among children/adolescents managed by pediatric and adult general surgery teams for emergency general surgical (EGS) conditions at a university-hospital in South Asia. Pediatric patients (<18y) admitted with an EGS diagnosis (March 2009-April 2014) were included. Patients were dichotomized by adult vs. pediatric surgical management team. Outcome measures included: length of stay (LOS), mortality, and occurrence of ≥1 complication(s). Descriptive statistics and multivariable regression analyses with propensity scores to account for potential confounding were used to compare outcomes between the two groups. Quasi-experimental counterfactual models further examined hypothetical outcomes, assuming that all patients had been treated by pediatric surgeons. A total of 2323 patients were included. Average age was 7.1y (±5.5 SD); most patients were male (77.7%). 1958 (84.3%) were managed by pediatric surgery. The overall probability of developing a complication was 1.8%; 0.9% died (all adult general surgery). Patients managed by adult general surgery had higher risk-adjusted odds of developing complications (OR [95%CI]: 5.42 [2.10-14.00]) and longer average LOS (7.98 vs. 5.61 days, p < 0.01). 39.8% fewer complications and an 8.2% decrease in LOS would have been expected if all patients had been managed by pediatric surgery. Pediatric patients had better post-operative outcomes under pediatric surgical supervision, suggesting that, where possible in resource-constrained settings, resources should be allocated to promote development and staffing of pediatric surgical specialties parallel to adult general surgical teams. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Primary care challenges of an obscure case of "Alice in Wonderland" syndrome in a patient with severe malaria in a resource-constrained setting: a case report.

PubMed

Kadia, Benjamin Momo; Ekabe, Cyril Jabea; Agborndip, Ettamba

2017-12-22

"Alice in Wonderland" syndrome (AIWS) is a rare neurological abnormality characterized by distortions of visual perceptions, body schema and experience of time. AIWS has been reported in patients with various infections such as infectious mononucleosis, H1N1 influenza, Cytomegalovirus encephalitis, and typhoid encephalopathy. However, AIWS occurring in a patient with severe malaria is less familiar and could pose serious primary care challenges in a low-income context. A 9-year-old male of black African ethnicity was brought by his parents to our primary care hospital because for 2 days he had been experiencing intermittent sudden perceptions of his parents' heads and objects around him either "shrinking" or "expanding". The visual perceptions were usually brief and resolved spontaneously. One week prior to the onset of the visual problem, he had developed an intermittent high grade fever that was associated with other severe constitutional symptoms. Based on the historical and clinical data that were acquired, severe malaria was suspected and this was confirmed by hyperparasitaemia on blood film analysis. The patient was treated with quinine for 10 days. Apart from a single episode of generalized tonic-clonic seizures that was observed on the first day of treatment, the overall clinical progress was good. The visual illusions completely resolved and no further abnormalities were recorded during 3 months of follow-up. Symptoms of AIWS usually resolve spontaneously or after treatment of an underlying cause. In our case, the successful treatment of severe malaria coincided with a complete regression of AIWS whose aetiology was poorly-elucidated given the resource constraints. In any case, the good outcome of our patient aligns with previous reports on acute AIWS that highlight a limited need for excessive investigation and treatment modalities which are, in passing, predominantly unaffordable in resource-limited primary care settings.

Transforming Atmospheric and Remotely-Sensed Information to Hydrologic Predictability in South Asia

NASA Astrophysics Data System (ADS)

Hopson, T. M.; Riddle, E. E.; Broman, D.; Brakenridge, G. R.; Birkett, C. M.; Kettner, A.; Sampson, K. M.; Boehnert, J.; Priya, S.; Collins, D. C.; Rostkier-Edelstein, D.; Young, W.; Singh, D.; Islam, A. S.

2017-12-01

South Asia is a flashpoint for natural disasters with profound societal impacts for the region and globally. Although close to 40% of the world's population depends on the Greater Himalaya's great rivers, $20 Billion of GDP is affected by river floods each year. The frequent occurrence of floods, combined with large and rapidly growing populations with high levels of poverty, make South Asia highly susceptible to humanitarian disasters. The challenges of mitigating such devastating disasters are exacerbated by the limited availability of real-time rain and stream gauge measuring stations and transboundary data sharing, and by constrained institutional commitments to overcome these challenges. To overcome such limitations, India and the World Bank have committed resources to the National Hydrology Project III, with the development objective to improve the extent, quality, and accessibility of water resources information and to strengthen the capacity of targeted water resources management institutions in India. The availability and application of remote sensing products and weather forecasts from ensemble prediction systems (EPS) have transformed river forecasting capability over the last decade, and is of interest to India. In this talk, we review the potential predictability of river flow contributed by some of the freely-available remotely-sensed and weather forecasting products within the framework of the physics of water migration through a watershed. Our specific geographical context is the Ganges, Brahmaputra, and Meghna river basin and a newly-available set of stream gauge measurements located over the region. We focus on satellite rainfall estimation, river height and width estimation, and EPS weather forecasts. For the later, we utilize the THORPEX-TIGGE dataset of global forecasts, and discuss how atmospheric predictability, as measured by an EPS, is transformed into hydrometeorological predictability. We provide an overview of the strengths and weaknesses of each of these data sets to the river flow prediction problem, generalizing their utility across spatial- and temporal-scales, and highlight the benefits of joint utilization and multi-modeling to minimize uncertainty and enhance operational robustness.

Infinite horizon problems on stratifiable state-constraints sets

NASA Astrophysics Data System (ADS)

Hermosilla, C.; Zidani, H.

2015-02-01

This paper deals with a state-constrained control problem. It is well known that, unless some compatibility condition between constraints and dynamics holds, the Value Function has not enough regularity, or can fail to be the unique constrained viscosity solution of a Hamilton-Jacobi-Bellman (HJB) equation. Here, we consider the case of a set of constraints having a stratified structure. Under this circumstance, the interior of this set may be empty or disconnected, and the admissible trajectories may have the only option to stay on the boundary without possible approximation in the interior of the constraints. In such situations, the classical pointing qualification hypothesis is not relevant. The discontinuous Value Function is then characterized by means of a system of HJB equations on each stratum that composes the state-constraints. This result is obtained under a local controllability assumption which is required only on the strata where some chattering phenomena could occur.

Professional Development for Aspiring CIOs

ERIC Educational Resources Information Center

Hogue, William F.; Dodd, David W.

2006-01-01

Leading a campus through rapid IT change is a challenge, particularly from the perspectives of planning and leadership. At the same time, many observers would concede that today's highly competitive, resource-constrained, global environment offers the greatest opportunities for fundamental change in higher education since the emergence of Clark…

"Sustaining the Shrinking City: Concepts, Dynamics and Management" (A special issue of Sustainability) (ISSN 2071-1050).

EPA Science Inventory

Sustainability can be broadly defined as the resilient outcome of the interaction among social equity, economic stability, and environmental quality factors. For example, the utilization of natural resource capitals are constrained by economic forces, and further modulated by soc...

International HRD Perspectives.

ERIC Educational Resources Information Center

1999

The first of the four papers in this symposium, "Towards a Meaningful HRD [Human Resource Development] Function in the Post-Command Economies of Central and Eastern Europe" (Devi Jankowicz), examines the existing knowledge-base among managers who are to be trained as HRD practitioners and suggests that efforts may be constrained by…

Rural Women and Their Work: Dependence and Alternatives for Change.

ERIC Educational Resources Information Center

Ahmad, Zubeida

1984-01-01

Rural women engage in a wide range of income-generating activities, but their participation in the labor market is constrained by lack of access to land and other resources, lack of control over labor and income, and lack of physical and occupational mobility. (SK)

Complete to Compete: Common College Completion Metrics

ERIC Educational Resources Information Center

Reyna, Ryan

2010-01-01

Governors face unprecedented demands across state government to deliver vital services in an environment of constrained resources. Higher education is no exception. States must increase the number of high-quality college graduates within available funding to meet workforce needs and compete globally. To meet this goal, policymakers--including…

Fault Imaging with High-Resolution Seismic Reflection for Earthquake Hazard and Geothermal Resource Assessment in Reno, Nevada

DOE Office of Scientific and Technical Information (OSTI.GOV)

Frary, Roxanna

2012-05-05

The Truckee Meadows basin is situated adjacent to the Sierra Nevada microplate, on the western boundary of the Walker Lane. Being in the transition zone between a range-front normal fault on the west and northwest-striking right-lateral strike slip faults to the east, there is no absence of faulting in this basin. The Reno- Sparks metropolitan area is located in this basin, and with a signi cant population living here, it is important to know where these faults are. High-resolution seismic reflection surveys are used for the imaging of these faults along the Truckee River, across which only one fault wasmore » previously mapped, and in southern Reno near and along Manzanita Lane, where a swarm of short faults has been mapped. The reflection profiles constrain the geometries of these faults, and suggest additional faults not seen before. Used in conjunction with depth to bedrock calculations and gravity measurements, the seismic reflection surveys provide de nitive locations of faults, as well as their orientations. O sets on these faults indicate how active they are, and this in turn has implications for seismic hazard in the area. In addition to seismic hazard, the faults imaged here tell us something about the conduits for geothermal fluid resources in Reno.« less

Optimizing lay counsellor services for chronic care in South Africa: a qualitative systematic review.

PubMed

Petersen, Inge; Fairall, Lara; Egbe, Catherine O; Bhana, Arvin

2014-05-01

To conduct a qualitative systematic review on the use of lay counsellors in South Africa to provide lessons on optimizing their use for psychological and behavioural change counselling for chronic long-term care in scare-resource contexts. A qualitative systematic review of the literature on lay counsellor services in South Africa. Twenty-nine studies met the inclusion criteria. Five randomized control trials and two cohort studies reported that lay counsellors can provide behaviour change counselling with good outcomes. One multi-centre cohort study provided promising evidence of improved anti-retroviral treatment adherence and one non-randomized controlled study provided promising results for counselling for depression. Six studies found low fidelity of lay counsellor-delivered interventions in routine care. Reasons for low fidelity include poor role definition, inconsistent remuneration, lack of standardized training, and poor supervision and logistical support. Within resource-constrained settings, adjunct behaviour change and psychological services provided by lay counsellors can be harnessed to promote chronic care at primary health care level. Optimizing lay counsellor services requires interventions at an organizational level that provide a clear role definition and scope of practice; in-service training and formal supervision; and sensitization of health managers to the importance and logistical requirements of counselling. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Synthetic hardware performance analysis in virtualized cloud environment for healthcare organization.

PubMed

Tan, Chee-Heng; Teh, Ying-Wah

2013-08-01

The main obstacles in mass adoption of cloud computing for database operations in healthcare organization are the data security and privacy issues. In this paper, it is shown that IT services particularly in hardware performance evaluation in virtual machine can be accomplished effectively without IT personnel gaining access to actual data for diagnostic and remediation purposes. The proposed mechanisms utilized the hypothetical data from TPC-H benchmark, to achieve 2 objectives. First, the underlying hardware performance and consistency is monitored via a control system, which is constructed using TPC-H queries. Second, the mechanism to construct stress-testing scenario is envisaged in the host, using a single or combination of TPC-H queries, so that the resource threshold point can be verified, if the virtual machine is still capable of serving critical transactions at this constraining juncture. This threshold point uses server run queue size as input parameter, and it serves 2 purposes: It provides the boundary threshold to the control system, so that periodic learning of the synthetic data sets for performance evaluation does not reach the host's constraint level. Secondly, when the host undergoes hardware change, stress-testing scenarios are simulated in the host by loading up to this resource threshold level, for subsequent response time verification from real and critical transactions.

Modelling socio-environmental sensitivities: how public responses to low carbon energy technologies could shape the UK energy system.

PubMed

Moran Jay, Brighid; Howard, David; Hughes, Nick; Whitaker, Jeanette; Anandarajah, Gabrial

2014-01-01

Low carbon energy technologies are not deployed in a social vacuum; there are a variety of complex ways in which people understand and engage with these technologies and the changing energy system overall. However, the role of the public's socio-environmental sensitivities to low carbon energy technologies and their responses to energy deployments does not receive much serious attention in planning decarbonisation pathways to 2050. Resistance to certain resources and technologies based on particular socio-environmental sensitivities would alter the portfolio of options available which could shape how the energy system achieves decarbonisation (the decarbonisation pathway) as well as affecting the cost and achievability of decarbonisation. Thus, this paper presents a series of three modelled scenarios which illustrate the way that a variety of socio-environmental sensitivities could impact the development of the energy system and the decarbonisation pathway. The scenarios represent risk aversion (DREAD) which avoids deployment of potentially unsafe large-scale technology, local protectionism (NIMBY) that constrains systems to their existing spatial footprint, and environmental awareness (ECO) where protection of natural resources is paramount. Very different solutions for all three sets of constraints are identified; some seem slightly implausible (DREAD) and all show increased cost (especially in ECO).

Mental health service utilization in sub-Saharan Africa: is public mental health literacy the problem? Setting the perspectives right.

PubMed

Atilola, Olayinka

2016-06-01

The severely constrained resources for mental health service in less-developed regions like sub-Saharan Africa underscore the need for good public mental health literacy as a potential additional mental health resource. Several studies examining the level of public knowledge about the nature and dynamics of mental illness in sub-Saharan Africa in the last decade had concluded that such knowledge was poor and had called for further public enlightenment. What was thought to be mental health 'ignorance' has also been blamed for poor mainstream service utilization. These views however assume that non-alignment of the views of community dwellers in sub-Saharan Africa with the biomedical understanding of mental illness connotes 'ignorance', and that correcting such 'ignorance' will translate to improvements in service utilization. Within the framework of contemporary thinking in mental health literacy, this paper argues that such assumptions are not culturally nuanced and may have overrated the usefulness of de-contextualized public engagement in enhancing mental health service utilization in the region. The paper concludes with a discourse on how to contextualize public mental health enlightenment in the region and the wider policy initiatives that can improve mental health service utilization. © The Author(s) 2015.

Modelling Socio-Environmental Sensitivities: How Public Responses to Low Carbon Energy Technologies Could Shape the UK Energy System

PubMed Central

Moran Jay, Brighid

2014-01-01

Low carbon energy technologies are not deployed in a social vacuum; there are a variety of complex ways in which people understand and engage with these technologies and the changing energy system overall. However, the role of the public's socio-environmental sensitivities to low carbon energy technologies and their responses to energy deployments does not receive much serious attention in planning decarbonisation pathways to 2050. Resistance to certain resources and technologies based on particular socio-environmental sensitivities would alter the portfolio of options available which could shape how the energy system achieves decarbonisation (the decarbonisation pathway) as well as affecting the cost and achievability of decarbonisation. Thus, this paper presents a series of three modelled scenarios which illustrate the way that a variety of socio-environmental sensitivities could impact the development of the energy system and the decarbonisation pathway. The scenarios represent risk aversion (DREAD) which avoids deployment of potentially unsafe large-scale technology, local protectionism (NIMBY) that constrains systems to their existing spatial footprint, and environmental awareness (ECO) where protection of natural resources is paramount. Very different solutions for all three sets of constraints are identified; some seem slightly implausible (DREAD) and all show increased cost (especially in ECO). PMID:24587735

Improved triage and emergency care for children reduces inpatient mortality in a resource-constrained setting.

PubMed

Molyneux, Elizabeth; Ahmad, Shafique; Robertson, Ann

2006-04-01

Early assessment, prioritization for treatment and management of sick children attending a health service are critical to achieving good outcomes. Many hospitals in developing countries see large numbers of patients and have few staff, so patients often have to wait before being assessed and treated. We present the example of a busy Under-Fives Clinic that provided outpatient services, immunizations and treatment for medical emergencies. The clinic was providing an inadequate service resulting in some inappropriate admissions and a high case-fatality rate. We assessed the deficiencies and sought resources to improve services. A busy paediatric outpatient clinic in a public tertiary care hospital in Blantyre, Malawi. The main changes we made were to train staff in emergency care and triage, improve patient flow through the department and to develop close cooperation between inpatient and outpatient services. Training coincided with a restructuring of the physical layout of the department. The changes were put in place when the department reopened in January 2001. Improvements in the process and delivery of care and the ability to prioritize clinical management are essential to good practice. Making the changes described above has streamlined the delivery of care and led to a reduction in inpatient mortality from 10-18% before the changes were made (before 2001) to 6-8% after.

American Association of Diabetes Educators

MedlinePlus

... Blood Glucose Monitoring Resources Medication Taking Resources Insulin Infusion Set Resources Diabetes and CVD Resources AADE in ... Blood Glucose Monitoring Resources Medication Taking Resources Insulin Infusion Set Resources Diabetes and CVD Resources AADE in ...

An openstack-based flexible video transcoding framework in live

NASA Astrophysics Data System (ADS)

Shi, Qisen; Song, Jianxin

2017-08-01

With the rapid development of mobile live business, transcoding HD video is often a challenge for mobile devices due to their limited processing capability and bandwidth-constrained network connection. For live service providers, it's wasteful for resources to delay lots of transcoding server because some of them are free to work sometimes. To deal with this issue, this paper proposed an Openstack-based flexible transcoding framework to achieve real-time video adaption for mobile device and make computing resources used efficiently. To this end, we introduced a special method of video stream splitting and VMs resource scheduling based on access pressure prediction,which is forecasted by an AR model.

Constraining new physics models with isotope shift spectroscopy

NASA Astrophysics Data System (ADS)

Frugiuele, Claudia; Fuchs, Elina; Perez, Gilad; Schlaffer, Matthias

2017-07-01

Isotope shifts of transition frequencies in atoms constrain generic long- and intermediate-range interactions. We focus on new physics scenarios that can be most strongly constrained by King linearity violation such as models with B -L vector bosons, the Higgs portal, and chameleon models. With the anticipated precision, King linearity violation has the potential to set the strongest laboratory bounds on these models in some regions of parameter space. Furthermore, we show that this method can probe the couplings relevant for the protophobic interpretation of the recently reported Be anomaly. We extend the formalism to include an arbitrary number of transitions and isotope pairs and fit the new physics coupling to the currently available isotope shift measurements.

Using Airborne High Spectral Resolution Lidar Data to Evaluate Combined Active Plus Passive Retrievals of Aerosol Extinction Profiles

NASA Technical Reports Server (NTRS)

Burton, S. P.; Ferrare, R. A.; Kittaka, C.; Hostetler, C. A.; Hair, J. W.; Obland, M. D.; Rogers, R. R.; Cook, A. L.; Haper, D. B.

2008-01-01

Aerosol extinction profiles are derived from backscatter data by constraining the retrieval with column aerosol optical thickness (AOT), for example from coincident MODIS observations and without reliance on a priori assumptions about aerosol type or optical properties. The backscatter data were acquired with the NASA Langley High Spectral Resolution Lidar (HSRL). The HSRL also simultaneously measures extinction independently, thereby providing an ideal data set for evaluating the constrained retrieval of extinction from backscatter. We will show constrained extinction retrievals using various sources of column AOT, and examine comparisons with the HSRL extinction measurements and with a similar retrieval using data from the CALIOP lidar on the CALIPSO satellite.

Forward Modeling of Atmospheric Carbon Dioxide in GEOS-5: Uncertainties Related to Surface Fluxes and Sub-Grid Transport

NASA Technical Reports Server (NTRS)

Pawson, Steven; Ott, Lesley E.; Zhu, Zhengxin; Bowman, Kevin; Brix, Holger; Collatz, G. James; Dutkiewicz, Stephanie; Fisher, Joshua B.; Gregg, Watson W.; Hill, Chris;

Efficient Transition State Optimization of Periodic Structures through Automated Relaxed Potential Energy Surface Scans.

PubMed

Plessow, Philipp N

2018-02-13

This work explores how constrained linear combinations of bond lengths can be used to optimize transition states in periodic structures. Scanning of constrained coordinates is a standard approach for molecular codes with localized basis functions, where a full set of internal coordinates is used for optimization. Common plane wave-codes for periodic boundary conditions almost exlusively rely on Cartesian coordinates. An implementation of constrained linear combinations of bond lengths with Cartesian coordinates is described. Along with an optimization of the value of the constrained coordinate toward the transition states, this allows transition optimization within a single calculation. The approach is suitable for transition states that can be well described in terms of broken and formed bonds. In particular, the implementation is shown to be effective and efficient in the optimization of transition states in zeolite-catalyzed reactions, which have high relevance in industrial processes.

Adaptive Fuzzy Output-Constrained Fault-Tolerant Control of Nonlinear Stochastic Large-Scale Systems With Actuator Faults.

PubMed

Li, Yongming; Ma, Zhiyao; Tong, Shaocheng

2017-09-01

The problem of adaptive fuzzy output-constrained tracking fault-tolerant control (FTC) is investigated for the large-scale stochastic nonlinear systems of pure-feedback form. The nonlinear systems considered in this paper possess the unstructured uncertainties, unknown interconnected terms and unknown nonaffine nonlinear faults. The fuzzy logic systems are employed to identify the unknown lumped nonlinear functions so that the problems of structured uncertainties can be solved. An adaptive fuzzy state observer is designed to solve the nonmeasurable state problem. By combining the barrier Lyapunov function theory, adaptive decentralized and stochastic control principles, a novel fuzzy adaptive output-constrained FTC approach is constructed. All the signals in the closed-loop system are proved to be bounded in probability and the system outputs are constrained in a given compact set. Finally, the applicability of the proposed controller is well carried out by a simulation example.

Fast alternating projection methods for constrained tomographic reconstruction

PubMed Central

Liu, Li; Han, Yongxin

2017-01-01

The alternating projection algorithms are easy to implement and effective for large-scale complex optimization problems, such as constrained reconstruction of X-ray computed tomography (CT). A typical method is to use projection onto convex sets (POCS) for data fidelity, nonnegative constraints combined with total variation (TV) minimization (so called TV-POCS) for sparse-view CT reconstruction. However, this type of method relies on empirically selected parameters for satisfactory reconstruction and is generally slow and lack of convergence analysis. In this work, we use a convex feasibility set approach to address the problems associated with TV-POCS and propose a framework using full sequential alternating projections or POCS (FS-POCS) to find the solution in the intersection of convex constraints of bounded TV function, bounded data fidelity error and non-negativity. The rationale behind FS-POCS is that the mathematically optimal solution of the constrained objective function may not be the physically optimal solution. The breakdown of constrained reconstruction into an intersection of several feasible sets can lead to faster convergence and better quantification of reconstruction parameters in a physical meaningful way than that in an empirical way of trial-and-error. In addition, for large-scale optimization problems, first order methods are usually used. Not only is the condition for convergence of gradient-based methods derived, but also a primal-dual hybrid gradient (PDHG) method is used for fast convergence of bounded TV. The newly proposed FS-POCS is evaluated and compared with TV-POCS and another convex feasibility projection method (CPTV) using both digital phantom and pseudo-real CT data to show its superior performance on reconstruction speed, image quality and quantification. PMID:28253298

Optimizing Hydropower Day-Ahead Scheduling for the Oroville-Thermalito Project

NASA Astrophysics Data System (ADS)

Veselka, T. D.; Mahalik, M.

2012-12-01

Under an award from the U.S. Department of Energy, Office of Energy Efficiency and Renewable Energy, Water Power Program, a team of national laboratories is developing and demonstrating a suite of advanced, integrated analytical tools to assist managers and planners increase hydropower resources while enhancing the environment. As part of the project, Argonne National Laboratory is developing the Conventional Hydropower Energy and Environmental Systems (CHEERS) model to optimize day-ahead scheduling and real-time operations. We will present the application of CHEERS to the Oroville-Thermalito Project located in Northern California. CHEERS will aid California Department of Water Resources (CDWR) schedulers in making decisions about unit commitments and turbine-level operating points using a system-wide approach to increase hydropower efficiency and the value of power generation and ancillary services. The model determines schedules and operations that are constrained by physical limitations, characteristics of plant components, operational preferences, reliability, and environmental considerations. The optimization considers forebay and afterbay implications, interactions between cascaded power plants, turbine efficiency curves and rough zones, and operator preferences. CHEERS simultaneously considers over time the interactions among all CDWR power and water resources, hydropower economics, reservoir storage limitations, and a set of complex environmental constraints for the Thermalito Afterbay and Feather River habitats. Power marketers, day-ahead schedulers, and plant operators provide system configuration and detailed operational data, along with feedback on model design and performance. CHEERS is integrated with CDWR data systems to obtain historic and initial conditions of the system as the basis from which future operations are then optimized. Model results suggest alternative operational regimes that improve the value of CDWR resources to the grid while enhancing the environment and complying with water delivery obligations for non-power uses.

Visual data mining for quantized spatial data

NASA Technical Reports Server (NTRS)

Braverman, Amy; Kahn, Brian

2004-01-01

In previous papers we've shown how a well known data compression algorithm called Entropy-constrained Vector Quantization ( can be modified to reduce the size and complexity of very large, satellite data sets. In this paper, we descuss how to visualize and understand the content of such reduced data sets.

Communicative Competence in American Trial Courtrooms.

ERIC Educational Resources Information Center

Johnson, Bruce C.

Gumperz and Hymes have stated the theoretical goal of one type of sociolinguistic investigation as the characterization of communicative competence, "what a speaker needs to know to communicate effectively in culturally significant settings." This knowledge is seen as describable by a set of rules constraining verbal behavior in reference to…

Periodic Forced Response of Structures Having Three-Dimensional Frictional Constraints

NASA Astrophysics Data System (ADS)

CHEN, J. J.; YANG, B. D.; MENQ, C. H.

2000-01-01

Many mechanical systems have moving components that are mutually constrained through frictional contacts. When subjected to cyclic excitations, a contact interface may undergo constant changes among sticks, slips and separations, which leads to very complex contact kinematics. In this paper, a 3-D friction contact model is employed to predict the periodic forced response of structures having 3-D frictional constraints. Analytical criteria based on this friction contact model are used to determine the transitions among sticks, slips and separations of the friction contact, and subsequently the constrained force which consists of the induced stick-slip friction force on the contact plane and the contact normal load. The resulting constrained force is often a periodic function and can be considered as a feedback force that influences the response of the constrained structures. By using the Multi-Harmonic Balance Method along with Fast Fourier Transform, the constrained force can be integrated with the receptance of the structures so as to calculate the forced response of the constrained structures. It results in a set of non-linear algebraic equations that can be solved iteratively to yield the relative motion as well as the constrained force at the friction contact. This method is used to predict the periodic response of a frictionally constrained 3-d.o.f. oscillator. The predicted results are compared with those of the direct time integration method so as to validate the proposed method. In addition, the effect of super-harmonic components on the resonant response and jump phenomenon is examined.

Using integrated noble gas and hydrocarbon geochemistry to constrain the source of hydrocarbon gases in shallow aquifers in the northern Appalachian Basin

EPA Pesticide Factsheets

Rising demands for domestic energy sources, mandates for cleaner burning fuels for electricity generation, and the approach of peak global hydrocarbon production are driving the transformation from coal to natural gas from unconventional energy resources.

A Promising Approach to Addressing America's Biggest Challenges. Needle-Moving Community Collaboratives

ERIC Educational Resources Information Center

Jolin, Michele; Schmitz, Paul; Seldon, Willa

2012-01-01

Communities face powerful challenges--a high-school dropout epidemic, youth unemployment, teen pregnancy--that require powerful solutions. In a climate of increasingly constrained resources, those solutions must help communities to achieve more with less. A new kind of community collaborative--an approach that aspires to significant,…

Extending the Aircraft Availability Model to a Constrained Depot Environment Using Activity-Based Costing and the Theory of Constraints

DTIC Science & Technology

2004-06-01

Overselling Activity-Based Concepts,” Management Accounting , September 1992:26-35. Kaplan, Robert S . and Robin Cooper. Cost & Effect. Using... Accounting .............................................14 Increasing Need for Cost Information...15 Implications for Costs Accounting Systems ....................................................17 Section 2 – Costs and Resources

Augmented Reflective Learning and Knowledge Retention Perceived among Students in Classrooms Involving Virtual Laboratories

ERIC Educational Resources Information Center

Achuthan, Krishnashree; Francis, Saneesh P.; Diwakar, Shyam

2017-01-01

Learning theories converge on the principles of reflective learning processes and perceive them as fundamental to effective learning. Traditional laboratory education in science and engineering often happens in highly resource-constrained environments that compromise some of the learning objectives. This paper focuses on characterizing three…

Evaluation of satellite-based, modeled-derived daily solar radiation data for the continental U.S.

USDA-ARS?s Scientific Manuscript database

Many applications of simulation models and related decision support tools for agriculture and natural resource management require daily meteorological data as inputs. Availability and quality of such data, however, often constrain research and decision support activities that require use of these to...

Teaching IP Networking Fundamentals in Resource Constrained Educational Environments

ERIC Educational Resources Information Center

Armitage, Grenville; Harrop, Warren

2005-01-01

Many educational institutions suffer from a lack of funding to keep telecommunications laboratory classes up to date and flexible. This paper describes our Remote Unix Lab Environment (RULE), a solution for exposing students to the latest Internet based telecommunications software tools in a Unix like environment. RULE leverages existing PC…

Implementing a Help Desk at a Small Liberal Arts College.

ERIC Educational Resources Information Center

Actis, Bev

1993-01-01

Planning for a computer use "help desk" at Kenyon College (Ohio) was constrained by very limited resources. However, careful and thorough planning resulted in a low-budget, homegrown, but highly effective facility. Staffing, training, staff communication, and marketing the service were essential elements in its success. (MSE)

Where to Start when Previous Facilities Data are Questionable

ERIC Educational Resources Information Center

Watt, Catherine E.; Higerd, Thomas B.; Valcik, Nicolas A.

2007-01-01

Academic leaders and governing boards are increasingly aware of the importance and difficulty in managing physical plants as finite resources. In addition, the finances needed to renovate or build facilities have become severely constrained. The National Science Foundation (2000), in its survey of research facilities, suggests that research space…

Achieving an Effective National Security Posture in an Age of Austerity

DTIC Science & Technology

2014-05-14

then the packages move through 300 miles of conveyor sorting- belts  Wal-Mart and Dell distinguish themselves based on their “sense and respond...Require “cost” as a design /military “requirement” (because cost, in a resource-constrained environment, is numbers; and, per Lanchester, numbers are

Bringing the Budget Back into Academic Work Allocation Models: A Management Perspective

ERIC Educational Resources Information Center

Robertson, Michael; Germov, John

2015-01-01

Issues surrounding increasingly constrained resources and reducing levels of sector-based funding require consideration of a different Academic Work Allocation Model (AWAM) approach. Evidence from the literature indicates that an effective work allocation model is founded on the principles of equity and transparency in the distribution and…

Prediction of cheatgrass field germination potential using wet thermal accumulation

Treesearch

Bruce A. Roundy; Stuart P. Hardegree; Jeane C. Chambers; Alison Whittaker

2007-01-01

Invasion and dominance of weedy species is facilitated or constrained by environmental and ecological factors that affect resource availability during critical life stages. We compared the relative effects of season, annual weather, site, and disturbance on potential cheatgrass (Bromus tectorum L.) germination in big sagebrush (Artemisia...

Expanding Expectations for Narrative Styles in the Context of Dementia

ERIC Educational Resources Information Center

Guendouzi, Jackie; Davis, Boyd H.; Maclagan, Margaret

2015-01-01

This article uses discourse analyses to examine the narrative styles produced by 2 women with a diagnosis of dementia. Because of constrained cognitive resources, people with dementia (PWD) often use alternative strategies to weave their stories into conversations. People with dementia have difficulty in initiating and maintaining a canonical…

Conservation priorities for tree crop wild relatives in the United States

USDA-ARS?s Scientific Manuscript database

Our native crop wild relatives have proved useful as genetic resources in breeding more productive, nutritious, and resilient crops. Their utilization is expected only to increase with better information on the species and improving breeding tools, but may well be constrained by their limited repres...

Putting time into proof outlines

NASA Technical Reports Server (NTRS)

Schneider, Fred B.; Bloom, Bard; Marzullo, Keith

1991-01-01

A logic for reasoning about timing of concurrent programs is presented. The logic is based on proof outlines and can handle maximal parallelism as well as resource-constrained execution environments. The correctness proof for a mutual exclusion protocol that uses execution timings in a subtle way illustrates the logic in action.

Impacts of invading alien plant species on water flows at stand and catchment scales.

PubMed

Le Maitre, D C; Gush, M B; Dzikiti, S

2015-05-01

There have been many studies of the diverse impacts of invasions by alien plants but few have assessed impacts on water resources. We reviewed the information on the impacts of invasions on surface runoff and groundwater resources at stand to catchment scales and covering a full annual cycle. Most of the research is South African so the emphasis is on South Africa's major invaders with data from commercial forest plantations where relevant. Catchment studies worldwide have shown that changes in vegetation structure and the physiology of the dominant plant species result in changes in surface runoff and groundwater discharge, whether they involve native or alien plant species. Where there is little change in vegetation structure [e.g. leaf area (index), height, rooting depth and seasonality] the effects of invasions generally are small or undetectable. In South Africa, the most important woody invaders typically are taller and deeper rooted than the native species. The impacts of changes in evaporation (and thus runoff) in dryland settings are constrained by water availability to the plants and, thus, by rainfall. Where the dryland invaders are evergreen and the native vegetation (grass) is seasonal, the increases can reach 300-400 mm/year. Where the native vegetation is evergreen (shrublands) the increases are ∼200-300 mm/year. Where water availability is greater (riparian settings or shallow water tables), invading tree water-use can reach 1.5-2.0 times that of the same species in a dryland setting. So, riparian invasions have a much greater impact per unit area invaded than dryland invasions. The available data are scattered and incomplete, and there are many gaps and issues that must be addressed before a thorough understanding of the impacts at the site scale can be gained and used in extrapolating to watershed scales, and in converting changes in flows to water supply system yields. Published by Oxford University Press on behalf of the Annals of Botany Company.

Impacts of invading alien plant species on water flows at stand and catchment scales

PubMed Central

Le Maitre, D. C.; Gush, M. B.; Dzikiti, S.

2015-01-01

There have been many studies of the diverse impacts of invasions by alien plants but few have assessed impacts on water resources. We reviewed the information on the impacts of invasions on surface runoff and groundwater resources at stand to catchment scales and covering a full annual cycle. Most of the research is South African so the emphasis is on South Africa's major invaders with data from commercial forest plantations where relevant. Catchment studies worldwide have shown that changes in vegetation structure and the physiology of the dominant plant species result in changes in surface runoff and groundwater discharge, whether they involve native or alien plant species. Where there is little change in vegetation structure [e.g. leaf area (index), height, rooting depth and seasonality] the effects of invasions generally are small or undetectable. In South Africa, the most important woody invaders typically are taller and deeper rooted than the native species. The impacts of changes in evaporation (and thus runoff) in dryland settings are constrained by water availability to the plants and, thus, by rainfall. Where the dryland invaders are evergreen and the native vegetation (grass) is seasonal, the increases can reach 300–400 mm/year. Where the native vegetation is evergreen (shrublands) the increases are ∼200–300 mm/year. Where water availability is greater (riparian settings or shallow water tables), invading tree water-use can reach 1.5–2.0 times that of the same species in a dryland setting. So, riparian invasions have a much greater impact per unit area invaded than dryland invasions. The available data are scattered and incomplete, and there are many gaps and issues that must be addressed before a thorough understanding of the impacts at the site scale can be gained and used in extrapolating to watershed scales, and in converting changes in flows to water supply system yields. PMID:25935861

Using High Resolution Simulations with WRF/SSiB Regional Climate Model Constrained by In Situ Observations to Assess the Impacts of Dust in Snow in the Upper Colorado River Basin

NASA Astrophysics Data System (ADS)

Oaida, C. M.; Skiles, M.; Painter, T. H.; Xue, Y.

2015-12-01

The mountain snowpack is an essential resource for both the environment as well as society. Observational and energy balance modeling work have shown that dust on snow (DOS) in western U.S. (WUS) is a major contributor to snow processes, including snowmelt timing and runoff amount in regions like the Upper Colorado River Basin (UCRB). In order to accurately estimate the impact of DOS to the hydrologic cycle and water resources, now and under a changing climate, we need to be able to (1) adequately simulate the snowpack (accumulation), and (2) realistically represent DOS processes in models. Energy balance models do not capture the impact on a broader local or regional scale, nor the land-atmosphere feedbacks, while GCM studies cannot resolve orographic-related precipitation processes, and therefore snowpack accumulation, owing to coarse spatial resolution and smoother terrain. All this implies the impacts of dust on snow on the mountain snowpack and other hydrologic processes are likely not well captured in current modeling studies. Recent increase in computing power allows for RCMs to be used at higher spatial resolutions, while recent in situ observations of dust in snow properties can help constrain modeling simulations. Therefore, in the work presented here, we take advantage of these latest resources to address the some of the challenges outlined above. We employ the newly enhanced WRF/SSiB regional climate model at 4 km horizontal resolution. This scale has been shown by others to be adequate in capturing orographic processes over WUS. We also constrain the magnitude of dust deposition provided by a global chemistry and transport model, with in situ measurements taken at sites in the UCRB. Furthermore, we adjust the dust absorptive properties based on observed values at these sites, as opposed to generic global ones. This study aims to improve simulation of the impact of dust in snow on the hydrologic cycle and related water resources.

An Elective Pharmaceutical Care Course to Prepare Students for an Advanced Pharmacy Practice Experience in Kenya

PubMed Central

Miller, Monica L.; Ogallo, William; Pastakia, Sonak D.

2013-01-01

Objective. To develop a prerequisite elective course to prepare students for an advanced pharmacy practice experience (APPE) in Kenya. Design. The course addressed Kenyan culture, travel preparation, patient care, and disease-state management. Instructional formats used were small-group discussions and lectures, including some Web-based presentations by Kenyan pharmacists on disease states commonly treated in Kenya. Cultural activities include instruction in conversational and medical Kiswahili and reading of a novel related to global health programs. Assessment. Student performance was assessed using written care plans, quizzes, reflection papers, a formulary management exercise, and pre- and post-course assessments. Student feedback on course evaluations indicated that the course was well received and students felt prepared for the APPE. Conclusion. This course offered a unique opportunity for students to learn about pharmacy practice in global health and to apply previously acquired skills in a resource-constrained international setting. It prepares students to actively participate in clinical care activities during an international APPE. PMID:23610478

Macro- and microlevel processes affect food choice and nutritional status in the republic of the marshall islands.

PubMed

Gittelsohn, Joel; Haberle, Heather; Vastine, Amy E; Dyckman, William; Palafox, Neal A

2003-01-01

Despite its relative isolation from the world stage and lack of resources, the Marshall Islands serve as an example of the interaction between global political power, macroeconomic forces and local cultural factors. At the national level, patterns of food importation and government programs encourage the consumption of high fat foods. These factors have fostered dependency on Western foods and a loss of traditional food practices. Beliefs come into play as microlevel factors that influence food choice and aspects of lifestyle. Nearly three quarters of women are overweight or obese in this setting. Obesity in women is associated with greater age, higher education and more imported food consumption. Over a third of children ages 1-5 y are stunted, with stunting associated with worse economic status, less active feeding, increased consumption of imported foods and urban residence. What can be done at the microlevel is constrained by macrolevel factors of disempowerment. In this way, issues of power and belief are played out in the bodies of individuals.

Propeller Flap for Complex Distal Leg Reconstruction: A Versatile Alternative when Reverse Sural Artery Flap is Not Feasible.

PubMed

Ademola, Samuel A; Michael, Afieharo I; Oladeji, Femi J; Mbaya, Kefas M; Oyewole, O

2015-01-01

Reverse sural artery fasciocutaneous flap has become a workhorse for the reconstruction of distal leg soft tissue defects. When its use is not feasible, perforator-based propeller flap offers a better, easier, faster, and cheaper alternative to free flap. We present our experience with two men both aged 34 years who sustained Gustilo 3B injuries from gunshot. The donor area for reversed sural artery flap was involved in the injuries. They had early debridement, external fixation, and wound coverage with perforator-based propeller flaps. The donor sites were covered with skin graft. All flaps survived. There were minor wound edge ulcers due to the pressure of positioning that did not affect flap survival and the ulcers healed with conservative management. Perforator-based propeller flap is a versatile armamentarium for reconstruction of soft tissue defects of the distal leg in resource-constrained settings, especially when the donor area for a reverse flow sural flap artery is involved in the injury.

The role of domain-general cognitive control in language comprehension

PubMed Central

Fedorenko, Evelina

2014-01-01

What role does domain-general cognitive control play in understanding linguistic input? Although much evidence has suggested that domain-general cognitive control and working memory resources are sometimes recruited during language comprehension, many aspects of this relationship remain elusive. For example, how frequently do cognitive control mechanisms get engaged when we understand language? And is this engagement necessary for successful comprehension? I here (a) review recent brain imaging evidence for the neural separability of the brain regions that support high-level linguistic processing vs. those that support domain-general cognitive control abilities; (b) define the space of possibilities for the relationship between these sets of brain regions; and (c) review the available evidence that constrains these possibilities to some extent. I argue that we should stop asking whether domain-general cognitive control mechanisms play a role in language comprehension, and instead focus on characterizing the division of labor between the cognitive control brain regions and the more functionally specialized language regions. PMID:24803909

Monoclonal gammopathy with double M-bands: An atypical presentation on serum protein electrophoresis simulating biclonal gammopathy.

PubMed

Bora, Kaustubh; Das, Umesh; Barman, Bhupen; Ruram, Alice Abraham

2017-01-01

Monoclonal gammopathies, such as multiple myeloma, typically exhibit high levels of a monoclonal immunoglobulin (M-protein), produced by a clone of abnormally proliferating B-lymphocytes and/or plasma cells. The M-protein can be evaluated by serum protein electrophoresis (SPEP), which yields a single discrete band (M-band), usually in the γ-globulin region. Rarely, two M-bands appear simultaneously at different positions during SPEP - a condition known as biclonal gammopathy, which is a result of clonal expansion of two different neoplastic cell lines. Here, we describe an atypical case of IgA-λ multiple myeloma, where double M-bands (one in β- and the other in γ-globulin region) were found during SPEP simulating biclonal gammopathy, although it was monoclonal in nature. This peculiar presentation of double M-bands in monoclonal gammopathy was attributed to polymeric forms of IgA by systematic workup. Further, we discuss how true and apparent biclonality can be distinguished by inexpensive analytical techniques in resource-constrained settings.

Using mobile phones as acoustic sensors for high-throughput mosquito surveillance

PubMed Central

Mukundarajan, Haripriya; Hol, Felix Jan Hein; Castillo, Erica Araceli; Newby, Cooper

2017-01-01

The direct monitoring of mosquito populations in field settings is a crucial input for shaping appropriate and timely control measures for mosquito-borne diseases. Here, we demonstrate that commercially available mobile phones are a powerful tool for acoustically mapping mosquito species distributions worldwide. We show that even low-cost mobile phones with very basic functionality are capable of sensitively acquiring acoustic data on species-specific mosquito wingbeat sounds, while simultaneously recording the time and location of the human-mosquito encounter. We survey a wide range of medically important mosquito species, to quantitatively demonstrate how acoustic recordings supported by spatio-temporal metadata enable rapid, non-invasive species identification. As proof-of-concept, we carry out field demonstrations where minimally-trained users map local mosquitoes using their personal phones. Thus, we establish a new paradigm for mosquito surveillance that takes advantage of the existing global mobile network infrastructure, to enable continuous and large-scale data acquisition in resource-constrained areas. PMID:29087296

Early phase clinical trials with human immunodeficiency virus-1 and malaria vectored vaccines in The Gambia: frontline challenges in study design and implementation.

PubMed

Afolabi, Muhammed O; Adetifa, Jane U; Imoukhuede, Egeruan B; Viebig, Nicola K; Kampmann, Beate; Bojang, Kalifa

2014-05-01

Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) and malaria are among the most important infectious diseases in developing countries. Existing control strategies are unlikely to curtail these diseases in the absence of efficacious vaccines. Testing of HIV and malaria vaccines candidates start with early phase trials that are increasingly being conducted in developing countries where the burden of the diseases is high. Unique challenges, which affect planning and implementation of vaccine trials according to internationally accepted standards have thus been identified. In this review, we highlight specific challenges encountered during two early phase trials of novel HIV-1 and malaria vectored vaccine candidates conducted in The Gambia and how some of these issues were pragmatically addressed. We hope our experience will be useful for key study personnel involved in day-to-day running of similar clinical trials. It may also guide future design and implementation of vaccine trials in resource-constrained settings.

Long-Term Albendazole Effectiveness for Hepatic Cystic Echinococcosis

PubMed Central

Salinas, Jorge Luis; Gonzales, Herman Vildozola; Astuvilca, Juan; Arce-Villavicencio, Yanet; Carbajal-Gonzalez, Danny; Talledo, Lety; Willig, James H.

2011-01-01

Little is known about the long-term effectiveness of albendazole in the medical therapy of non-complicated hepatic cystic echinococcosis (HCE) in resource-constrained settings. We performed a retrospective review of patients starting albendazole for HCE in Lima, Peru from January 1997 to December 2007. Patients successfully recontacted underwent chart abstraction and clinical and ultrasonographic reevaluation. Descriptive statistics were used to delineate patient characteristics and treatment effectiveness at the conclusion of albendazole and after reevaluation. Patients (N = 27) were primarily female, mean age was 51. Initial treatment success at albendazole conclusion was 26% (N = 7) per patient and 37.5% (N = 24) per cyst. After 3.8 ± 2.5 years, albendazole success was 34% (N = 9) per patient and 40% (N = 24) per cyst. We found a gap in the effectiveness of albendazole HCE therapy compared with the efficacy reported in clinical trials. This underscores the need for further investigation into alternate therapeutic strategies for this neglected disease. PMID:22144447

Using mobile phones as acoustic sensors for high-throughput mosquito surveillance.

PubMed

Mukundarajan, Haripriya; Hol, Felix Jan Hein; Castillo, Erica Araceli; Newby, Cooper; Prakash, Manu

2017-10-31

The direct monitoring of mosquito populations in field settings is a crucial input for shaping appropriate and timely control measures for mosquito-borne diseases. Here, we demonstrate that commercially available mobile phones are a powerful tool for acoustically mapping mosquito species distributions worldwide. We show that even low-cost mobile phones with very basic functionality are capable of sensitively acquiring acoustic data on species-specific mosquito wingbeat sounds, while simultaneously recording the time and location of the human-mosquito encounter. We survey a wide range of medically important mosquito species, to quantitatively demonstrate how acoustic recordings supported by spatio-temporal metadata enable rapid, non-invasive species identification. As proof-of-concept, we carry out field demonstrations where minimally-trained users map local mosquitoes using their personal phones. Thus, we establish a new paradigm for mosquito surveillance that takes advantage of the existing global mobile network infrastructure, to enable continuous and large-scale data acquisition in resource-constrained areas.

Ethical considerations for vaccination programmes in acute humanitarian emergencies

PubMed Central

Hardie, Kate; Selgelid, Michael J; Waldman, Ronald J; Strebel, Peter; Rees, Helen; Durrheim, David N

2013-01-01

Abstract Humanitarian emergencies result in a breakdown of critical health-care services and often make vulnerable communities dependent on external agencies for care. In resource-constrained settings, this may occur against a backdrop of extreme poverty, malnutrition, insecurity, low literacy and poor infrastructure. Under these circumstances, providing food, water and shelter and limiting communicable disease outbreaks become primary concerns. Where effective and safe vaccines are available to mitigate the risk of disease outbreaks, their potential deployment is a key consideration in meeting emergency health needs. Ethical considerations are crucial when deciding on vaccine deployment. Allocation of vaccines in short supply, target groups, delivery strategies, surveillance and research during acute humanitarian emergencies all involve ethical considerations that often arise from the tension between individual and common good. The authors lay out the ethical issues that policy-makers need to bear in mind when considering the deployment of mass vaccination during humanitarian emergencies, including beneficence (duty of care and the rule of rescue), non-maleficence, autonomy and consent, and distributive and procedural justice. PMID:23599553

Intraclass reliability for assessing how well Taiwan constrained hospital-provided medical services using statistical process control chart techniques

PubMed Central

2012-01-01

Background Few studies discuss the indicators used to assess the effect on cost containment in healthcare across hospitals in a single-payer national healthcare system with constrained medical resources. We present the intraclass correlation coefficient (ICC) to assess how well Taiwan constrained hospital-provided medical services in such a system. Methods A custom Excel-VBA routine to record the distances of standard deviations (SDs) from the central line (the mean over the previous 12 months) of a control chart was used to construct and scale annual medical expenditures sequentially from 2000 to 2009 for 421 hospitals in Taiwan to generate the ICC. The ICC was then used to evaluate Taiwan’s year-based convergent power to remain unchanged in hospital-provided constrained medical services. A bubble chart of SDs for a specific month was generated to present the effects of using control charts in a national healthcare system. Results ICCs were generated for Taiwan’s year-based convergent power to constrain its medical services from 2000 to 2009. All hospital groups showed a gradually well-controlled supply of services that decreased from 0.772 to 0.415. The bubble chart identified outlier hospitals that required investigation of possible excessive reimbursements in a specific time period. Conclusion We recommend using the ICC to annually assess a nation’s year-based convergent power to constrain medical services across hospitals. Using sequential control charts to regularly monitor hospital reimbursements is required to achieve financial control in a single-payer nationwide healthcare system. PMID:22587736

Intraclass reliability for assessing how well Taiwan constrained hospital-provided medical services using statistical process control chart techniques.

PubMed

Chien, Tsair-Wei; Chou, Ming-Ting; Wang, Wen-Chung; Tsai, Li-Shu; Lin, Weir-Sen

2012-05-15

Few studies discuss the indicators used to assess the effect on cost containment in healthcare across hospitals in a single-payer national healthcare system with constrained medical resources. We present the intraclass correlation coefficient (ICC) to assess how well Taiwan constrained hospital-provided medical services in such a system. A custom Excel-VBA routine to record the distances of standard deviations (SDs) from the central line (the mean over the previous 12 months) of a control chart was used to construct and scale annual medical expenditures sequentially from 2000 to 2009 for 421 hospitals in Taiwan to generate the ICC. The ICC was then used to evaluate Taiwan's year-based convergent power to remain unchanged in hospital-provided constrained medical services. A bubble chart of SDs for a specific month was generated to present the effects of using control charts in a national healthcare system. ICCs were generated for Taiwan's year-based convergent power to constrain its medical services from 2000 to 2009. All hospital groups showed a gradually well-controlled supply of services that decreased from 0.772 to 0.415. The bubble chart identified outlier hospitals that required investigation of possible excessive reimbursements in a specific time period. We recommend using the ICC to annually assess a nation's year-based convergent power to constrain medical services across hospitals. Using sequential control charts to regularly monitor hospital reimbursements is required to achieve financial control in a single-payer nationwide healthcare system.

Automated Probabilistic Reconstruction of White-Matter Pathways in Health and Disease Using an Atlas of the Underlying Anatomy

PubMed Central

Yendiki, Anastasia; Panneck, Patricia; Srinivasan, Priti; Stevens, Allison; Zöllei, Lilla; Augustinack, Jean; Wang, Ruopeng; Salat, David; Ehrlich, Stefan; Behrens, Tim; Jbabdi, Saad; Gollub, Randy; Fischl, Bruce

2011-01-01

We have developed a method for automated probabilistic reconstruction of a set of major white-matter pathways from diffusion-weighted MR images. Our method is called TRACULA (TRActs Constrained by UnderLying Anatomy) and utilizes prior information on the anatomy of the pathways from a set of training subjects. By incorporating this prior knowledge in the reconstruction procedure, our method obviates the need for manual interaction with the tract solutions at a later stage and thus facilitates the application of tractography to large studies. In this paper we illustrate the application of the method on data from a schizophrenia study and investigate whether the inclusion of both patients and healthy subjects in the training set affects our ability to reconstruct the pathways reliably. We show that, since our method does not constrain the exact spatial location or shape of the pathways but only their trajectory relative to the surrounding anatomical structures, a set a of healthy training subjects can be used to reconstruct the pathways accurately in patients as well as in controls. PMID:22016733

Dynamic Extension of a Virtualized Cluster by using Cloud Resources

NASA Astrophysics Data System (ADS)

Oberst, Oliver; Hauth, Thomas; Kernert, David; Riedel, Stephan; Quast, Günter

2012-12-01

The specific requirements concerning the software environment within the HEP community constrain the choice of resource providers for the outsourcing of computing infrastructure. The use of virtualization in HPC clusters and in the context of cloud resources is therefore a subject of recent developments in scientific computing. The dynamic virtualization of worker nodes in common batch systems provided by ViBatch serves each user with a dynamically virtualized subset of worker nodes on a local cluster. Now it can be transparently extended by the use of common open source cloud interfaces like OpenNebula or Eucalyptus, launching a subset of the virtual worker nodes within the cloud. This paper demonstrates how a dynamically virtualized computing cluster is combined with cloud resources by attaching remotely started virtual worker nodes to the local batch system.

Development of a Dynamic Model to Evaluate the Effect of Natural Resource Policies on Recovery Following Nuclear Attack. Volume 1. Description and Simulations

DTIC Science & Technology

1981-09-01

and constrain the output of major energy- consuming sectors. Government stockpiles are most effectively used in a " pump -priming" role. They have to...11 - stockpile for " pump priming" are fuels and basic metals such as iron, steel, copper, and aluminum. The esoteric metals are of secondary...are released, the more impact they have in aiding recovery. Particularly if resource imports are interrupted, post-attack " pump priming" is the best

Phytozome Comparative Plant Genomics Portal

DOE Office of Scientific and Technical Information (OSTI.GOV)

Goodstein, David; Batra, Sajeev; Carlson, Joseph

2014-09-09

The Dept. of Energy Joint Genome Institute is a genomics user facility supporting DOE mission science in the areas of Bioenergy, Carbon Cycling, and Biogeochemistry. The Plant Program at the JGI applies genomic, analytical, computational and informatics platforms and methods to: 1. Understand and accelerate the improvement (domestication) of bioenergy crops 2. Characterize and moderate plant response to climate change 3. Use comparative genomics to identify constrained elements and infer gene function 4. Build high quality genomic resource platforms of JGI Plant Flagship genomes for functional and experimental work 5. Expand functional genomic resources for Plant Flagship genomes

Biomedical databases: protecting privacy and promoting research.

PubMed

Wylie, Jean E; Mineau, Geraldine P

2003-03-01

When combined with medical information, large electronic databases of information that identify individuals provide superlative resources for genetic, epidemiology and other biomedical research. Such research resources increasingly need to balance the protection of privacy and confidentiality with the promotion of research. Models that do not allow the use of such individual-identifying information constrain research; models that involve commercial interests raise concerns about what type of access is acceptable. Researchers, individuals representing the public interest and those developing regulatory guidelines must be involved in an ongoing dialogue to identify practical models.

Constrained model predictive control, state estimation and coordination

NASA Astrophysics Data System (ADS)

Yan, Jun

In this dissertation, we study the interaction between the control performance and the quality of the state estimation in a constrained Model Predictive Control (MPC) framework for systems with stochastic disturbances. This consists of three parts: (i) the development of a constrained MPC formulation that adapts to the quality of the state estimation via constraints; (ii) the application of such a control law in a multi-vehicle formation coordinated control problem in which each vehicle operates subject to a no-collision constraint posed by others' imperfect prediction computed from finite bit-rate, communicated data; (iii) the design of the predictors and the communication resource assignment problem that satisfy the performance requirement from Part (ii). Model Predictive Control (MPC) is of interest because it is one of the few control design methods which preserves standard design variables and yet handles constraints. MPC is normally posed as a full-state feedback control and is implemented in a certainty-equivalence fashion with best estimates of the states being used in place of the exact state. However, if the state constraints were handled in the same certainty-equivalence fashion, the resulting control law could drive the real state to violate the constraints frequently. Part (i) focuses on exploring the inclusion of state estimates into the constraints. It does this by applying constrained MPC to a system with stochastic disturbances. The stochastic nature of the problem requires re-posing the constraints in a probabilistic form. In Part (ii), we consider applying constrained MPC as a local control law in a coordinated control problem of a group of distributed autonomous systems. Interactions between the systems are captured via constraints. First, we inspect the application of constrained MPC to a completely deterministic case. Formation stability theorems are derived for the subsystems and conditions on the local constraint set are derived in order to guarantee local stability or convergence to a target state. If these conditions are met for all subsystems, then this stability is inherited by the overall system. For the case when each subsystem suffers from disturbances in the dynamics, own self-measurement noises, and quantization errors on neighbors' information due to the finite-bit-rate channels, the constrained MPC strategy developed in Part (i) is appropriate to apply. In Part (iii), we discuss the local predictor design and bandwidth assignment problem in a coordinated vehicle formation context. The MPC controller used in Part (ii) relates the formation control performance and the information quality in the way that large standoff implies conservative performance. We first develop an LMI (Linear Matrix Inequality) formulation for cross-estimator design in a simple two-vehicle scenario with non-standard information: one vehicle does not have access to the other's exact control value applied at each sampling time, but to its known, pre-computed, coupling linear feedback control law. Then a similar LMI problem is formulated for the bandwidth assignment problem that minimizes the total number of bits by adjusting the prediction gain matrices and the number of bits assigned to each variable. (Abstract shortened by UMI.)

Role of vault cytology in follow-up of hysterectomized women: results and inferences from a low resource setting.

PubMed

Gupta, Sanjay; Sodhani, Pushpa; Singh, Veena; Sehgal, Ashok

2013-09-01

The study was undertaken to assess the utility of cervico-vaginal/vault cytology in the follow-up of women treated for cervical cancer and benign gynecological conditions. Records of 3,523 cervico-vaginal smears from 2,658 women who underwent hysterectomy and/or radiotherapy or chemotherapy, over a 10-year period were retrieved. Data was collected on type of treatment received, indication for hysterectomy, age of patient, presenting symptoms, stage of tumor, interval since treatment, cytology and biopsy results. The results of cytology versus other parameters were analyzed separately for women treated for cervical cancer and those hysterectomized for benign indications. Malignant cells were detected in 141/1949 (7.2%) follow-up smears from treated cervical cancer cases (140 recurrences and 1 VAIN). Around 92% of recurrences of cervical cancer were detected with in 2 years of follow-up and 75% of these women were symptomatic. Cytology first alerted the clinicians to a recurrence in a quarter of cases. On the other hand, VAIN was detected in 5/1079 (0.46%) vault smears from 997 women hysterectomized for benign gynecologic disease. All these women were asymptomatic and majority (80%) were detected in follow-up smears performed between 3 and 10 years. Vault cytology is an accurate tool to detect local recurrences/VAIN in women treated for cervical cancer or benign gynecological conditions. It may even first alert the clinicians to a possibility of recurrence. However, due to extremely low prevalence of VAIN/vaginal cancer, it seems unwarranted in women hysterectomized for benign indications, especially in resource constrained settings. Copyright © 2012 Wiley Periodicals, Inc., a Wiley company.

ISS-An Electronic Syndromic Surveillance System for Infectious Disease in Rural China

PubMed Central

Yan, Weirong; Palm, Lars; Lu, Xin; Nie, Shaofa; Xu, Biao; Zhao, Qi; Tao, Tao; Cheng, Liwei; Tan, Li; Dong, Hengjin; Diwan, Vinod K.

2013-01-01

Background syndromic surveillance system has great advantages in promoting the early detection of epidemics and reducing the necessities of disease confirmation, and it is especially effective for surveillance in resource poor settings. However, most current syndromic surveillance systems are established in developed countries, and there are very few reports on the development of an electronic syndromic surveillance system in resource-constrained settings. Objective this study describes the design and pilot implementation of an electronic surveillance system (ISS) for the early detection of infectious disease epidemics in rural China, complementing the conventional case report surveillance system. Methods ISS was developed based on an existing platform ‘Crisis Information Sharing Platform’ (CRISP), combining with modern communication and GIS technology. ISS has four interconnected functions: 1) work group and communication group; 2) data source and collection; 3) data visualization; and 4) outbreak detection and alerting. Results As of Jan. 31st 2012, ISS has been installed and pilot tested for six months in four counties in rural China. 95 health facilities, 14 pharmacies and 24 primary schools participated in the pilot study, entering respectively 74256, 79701, and 2330 daily records into the central database. More than 90% of surveillance units at the study sites are able to send daily information into the system. In the paper, we also presented the pilot data from health facilities in the two counties, which showed the ISS system had the potential to identify the change of disease patterns at the community level. Conclusions The ISS platform may facilitate the early detection of infectious disease epidemic as it provides near real-time syndromic data collection, interactive visualization, and automated aberration detection. However, several constraints and challenges were encountered during the pilot implementation of ISS in rural China. PMID:23626853

ISS--an electronic syndromic surveillance system for infectious disease in rural China.

PubMed

Yan, Weirong; Palm, Lars; Lu, Xin; Nie, Shaofa; Xu, Biao; Zhao, Qi; Tao, Tao; Cheng, Liwei; Tan, Li; Dong, Hengjin; Diwan, Vinod K

2013-01-01

Syndromic surveillance system has great advantages in promoting the early detection of epidemics and reducing the necessities of disease confirmation, and it is especially effective for surveillance in resource poor settings. However, most current syndromic surveillance systems are established in developed countries, and there are very few reports on the development of an electronic syndromic surveillance system in resource-constrained settings. This study describes the design and pilot implementation of an electronic surveillance system (ISS) for the early detection of infectious disease epidemics in rural China, complementing the conventional case report surveillance system. ISS was developed based on an existing platform 'Crisis Information Sharing Platform' (CRISP), combining with modern communication and GIS technology. ISS has four interconnected functions: 1) work group and communication group; 2) data source and collection; 3) data visualization; and 4) outbreak detection and alerting. As of Jan. 31(st) 2012, ISS has been installed and pilot tested for six months in four counties in rural China. 95 health facilities, 14 pharmacies and 24 primary schools participated in the pilot study, entering respectively 74,256, 79,701, and 2330 daily records into the central database. More than 90% of surveillance units at the study sites are able to send daily information into the system. In the paper, we also presented the pilot data from health facilities in the two counties, which showed the ISS system had the potential to identify the change of disease patterns at the community level. The ISS platform may facilitate the early detection of infectious disease epidemic as it provides near real-time syndromic data collection, interactive visualization, and automated aberration detection. However, several constraints and challenges were encountered during the pilot implementation of ISS in rural China.

Improved detection of Burkholderia pseudomallei from non-blood clinical specimens using enrichment culture and PCR: narrowing diagnostic gap in resource-constrained settings.

PubMed

Tellapragada, Chaitanya; Shaw, Tushar; D'Souza, Annet; Eshwara, Vandana Kalwaje; Mukhopadhyay, Chiranjay

2017-07-01

To evaluate the diagnostic utility of enrichment culture and PCR for improved case detection rates of non-bacteraemic form of melioidosis in limited resource settings. Clinical specimens (n = 525) obtained from patients presenting at a tertiary care hospital of South India with clinical symptoms suggestive of community-acquired pneumonia, lower respiratory tract infections, superficial or internal abscesses, chronic skin ulcers and bone or joint infections were tested for the presence of Burkholderia pseudomallei using conventional culture (CC), enrichment culture (EC) and PCR. Sensitivity, specificity, positive and negative predictive values of CC and PCR were initially deduced using EC as the gold standard method. Further, diagnostic accuracies of all the three methods were analysed using Bayesian latent class modelling (BLCM). Detection rates of B. pseudomallei using CC, EC and PCR were 3.8%, 5.3% and 6%, respectively. Diagnostic sensitivities and specificities of CC and PCR were 71.4, 98.4% and 100 and 99.4%, respectively in comparison with EC as the gold standard test. With Bayesian latent class modelling, EC and PCR demonstrated sensitivities of 98.7 and 99.3%, respectively, while CC showed a sensitivity of 70.3% for detection of B. pseudomallei. An increase of 1.6% (95% CI: 1.08-4.32%) in the case detection rate of melioidosis was observed in the study population when EC and/or PCR were used in adjunct to the conventional culture technique. Our study findings underscore the diagnostic superiority of enrichment culture and/or PCR over conventional microbiological culture for improved case detection of melioidosis from non-blood clinical specimens. © 2017 John Wiley & Sons Ltd.

Rapid detection of Mycobacterium tuberculosis by recombinase polymerase amplification.

PubMed

Boyle, David S; McNerney, Ruth; Teng Low, Hwee; Leader, Brandon Troy; Pérez-Osorio, Ailyn C; Meyer, Jessica C; O'Sullivan, Denise M; Brooks, David G; Piepenburg, Olaf; Forrest, Matthew S

2014-01-01

Improved access to effective tests for diagnosing tuberculosis (TB) has been designated a public health priority by the World Health Organisation. In high burden TB countries nucleic acid based TB tests have been restricted to centralised laboratories and specialised research settings. Requirements such as a constant electrical supply, air conditioning and skilled, computer literate operators prevent implementation of such tests in many settings. Isothermal DNA amplification technologies permit the use of simpler, less energy intensive detection platforms more suited to low resource settings that allow the accurate diagnosis of a disease within a short timeframe. Recombinase Polymerase Amplification (RPA) is a rapid, low temperature isothermal DNA amplification reaction. We report here RPA-based detection of Mycobacterium tuberculosis complex (MTC) DNA in <20 minutes at 39 °C. Assays for two MTC specific targets were investigated, IS6110 and IS1081. When testing purified MTC genomic DNA, limits of detection of 6.25 fg (IS6110) and 20 fg (IS1081)were consistently achieved. When testing a convenience sample of pulmonary specimens from suspected TB patients, RPA demonstrated superior accuracy to indirect fluorescence microscopy. Compared to culture, sensitivities for the IS1081 RPA and microscopy were 91.4% (95%CI: 85, 97.9) and 86.1% (95%CI: 78.1, 94.1) respectively (n = 71). Specificities were 100% and 88.6% (95% CI: 80.8, 96.1) respectively. For the IS6110 RPA and microscopy sensitivities of 87.5% (95%CI: 81.7, 93.2) and 70.8% (95%CI: 62.9, 78.7) were obtained (n = 90). Specificities were 95.4 (95% CI: 92.3,98.1) and 88% (95% CI: 83.6, 92.4) respectively. The superior specificity of RPA for detecting tuberculosis was due to the reduced ability of fluorescence microscopy to distinguish Mtb complex from other acid fast bacteria. The rapid nature of the RPA assay and its low energy requirement compared to other amplification technologies suggest RPA-based TB assays could be of use for integration into a point-of-care test for use in resource constrained settings.

Application of sepsis definitions to pediatric patients admitted with suspected infections in Uganda

PubMed Central

Wiens, Matthew O.; Larson, Charles P.; Kumbakumba, Elias; Kissoon, Niranjan; Ansermino, J. Mark; Singer, Joel; Wong, Hubert; Ndamira, Andrew; Kabakyenga, Jerome; Moschovis, Peter; Kiwanuka, Julius

2017-01-01

Objectives Acute infectious diseases are the most common cause of under-5 mortality. However, the hospital burden of non-neonatal pediatric sepsis has not previously been described in the resource poor setting. The objective of this study was to determine the prevalence of sepsis among children 6 months to 5 years of age admitted with proven or suspected infection and to evaluate the presence of sepsis as a predictive tool for mortality during admission. Design In this Prospective cohort study we used the pediatric International Consensus Conference definition of sepsis to determine the prevalence of sepsis among children admitted to the pediatric ward with a proven or suspected infection. The diagnosis of sepsis, as well as each individual component of the sepsis definition, were evaluated for capturing in-hospital mortality. Setting The pediatric ward of two hospitals in Mbarara, Uganda Patients Admitted children between 6 months and 5 years with a confirmed or suspected infection. Interventions None Measurements and Main Results One thousand three hundred and seven (1307) subjects with a confirmed or suspected infection were enrolled and 65 children died (5.0%) during their admission. One thousand one hundred and twenty-one (85.9%) met the systemic inflammatory response syndrome criteria, and therefore were defined as having sepsis. The sepsis criteria captured 61 deaths, demonstrating a sensitivity and specificity of 95% (95% CI 90% – 100%) and 15% (95% CI 13% – 17%), respectively. The most discriminatory individual component of the SIRS criteria was the leukocyte count which alone had a sensitivity of 72% and a specificity of 56% for the identification of mortality in hospital. Conclusions This study is among the first to quantify the burden of non-neonatal pediatric sepsis in children with suspected infection, using the international consensus sepsis definition, in a typical resource constrained setting in Africa. This definition was found to be highly sensitive in identifying those who died, but had very low specificity as most children who were admitted with infections had sepsis. The SIRS-based sepsis definition offers little value in identification of children at high risk of in-hospital mortality in this setting. PMID:27043996

Methodology for assessment of undiscovered oil and gas resources for the 2008 Circum-Arctic Resource Appraisal

USGS Publications Warehouse

Charpentier, Ronald R.; Moore, Thomas E.; Gautier, D.L.

2017-11-15

The methodological procedures used in the geologic assessments of the 2008 Circum-Arctic Resource Appraisal (CARA) were based largely on the methodology developed for the 2000 U.S. Geological Survey World Petroleum Assessment. The main variables were probability distributions for numbers and sizes of undiscovered accumulations with an associated risk of occurrence. The CARA methodology expanded on the previous methodology in providing additional tools and procedures more applicable to the many Arctic basins that have little or no exploration history. Most importantly, geologic analogs from a database constructed for this study were used in many of the assessments to constrain numbers and sizes of undiscovered oil and gas accumulations.

QoS-Oriented High Dynamic Resource Allocation in Vehicular Communication Networks

PubMed Central

2014-01-01

Vehicular ad hoc networks (VANETs) are emerging as new research area and attracting an increasing attention from both industry and research communities. In this context, a dynamic resource allocation policy that maximizes the use of available resources and meets the quality of service (QoS) requirement of constraining applications is proposed. It is a combination of a fair packet scheduling policy and a new adaptive QoS oriented call admission control (CAC) scheme based on the vehicle density variation. This scheme decides whether the connection request is to be admitted into the system, while providing fair access and guaranteeing the desired throughput. The proposed algorithm showed good performance in testing in real world environment. PMID:24616639

Plant characteristics and growth parameters of vegetable pigeon pea cultivars

USDA-ARS?s Scientific Manuscript database

Pigeon pea is an important crop in dry land and semi-arid regions and is a supplementary source of dietary protein for the resource-constrained farmers. The aim of this research was to evaluate growth parameters of twelve vegetable pigeon pea genotypes at two locations in Eastern Kenya. The number o...

Prevalence and multidrug resistance of Escherichia coli from community acquired infections in Lagos, Nigeria

USDA-ARS?s Scientific Manuscript database

Escherichia coli is one of the most frequent causes of bacterial infections among humans. The emergence of multi-drug resistance (MDR; resistance to >2 more antimicrobials) in E. coli is of great concern due to the complications encountered in its treatment in a resource constrained economy. In th...

Remembering to Laugh and Explore: Improvisational Activities for Literacy Teaching in Urban Classrooms

ERIC Educational Resources Information Center

Smith, Katy; McKnight, Katherine S.

2009-01-01

In an effort to push back against contextual factors that have constrained arts instruction and integration while recognizing that schools have limited resources, The Second City Training Center in Chicago has developed several educational programs that bring the art of improvisation to teachers and students. This article specifically focuses on…

The Salience of Alcohol-Related Issues across the Adult Lifespan

ERIC Educational Resources Information Center

Pettigrew, Simone; Pescud, Melanie

2016-01-01

Objective: The growing costs to the community of excessive alcohol consumption have resulted in pressure for governments and non-governmental organisations (NGOs) to develop strategies to address this problem, but they do so in a highly constrained resource environment. To provide evidence of health education approaches that may be effective…

Silviculture for restoration of degraded temperate and boreal forests

Treesearch

John A. Stanturf; Palle Madsen; Emile S. Gardiner

2004-01-01

Throughout the temperate and boreal zones, human intervention has influenced landscapes and forests for millennia. The degree of human disturbance has only been constrained by the technology and resources available to different cultures and by time since initial habitation. Humans have influenced forests by regulating populations of browsers, clearing for agriculture,...

Marking and Moderation in the UK: False Assumptions and Wasted Resources

ERIC Educational Resources Information Center

Bloxham, Sue

2009-01-01

This article challenges a number of assumptions underlying marking of student work in British universities. It argues that, in developing rigorous moderation procedures, we have created a huge burden for markers which adds little to accuracy and reliability but creates additional work for staff, constrains assessment choices and slows down…

Considering a Cost Analysis Project? A Planned Approach

ERIC Educational Resources Information Center

Parish, Mina; Teetor, Travis

2006-01-01

As resources become more constrained in the library community, many organizations are finding that they need to have a better understanding of their costs. To this end, this article will present one approach to conducting a cost analysis (including questions to ask yourself, project team makeup, organizational support, and data organization). We…

Faculty Agency: Departmental Contexts That Matter in Faculty Careers

ERIC Educational Resources Information Center

Campbell, Corbin M.; O'Meara, KerryAnn

2014-01-01

In a modern context of constrained resources and high demands, faculty exert agency to strategically navigate their careers (Baez 2000a; Neumann et al. 2006). Guided by the O'Meara et al. (2011) framework on agency in faculty professional lives, this study used Structural Equation Modeling to investigate which departmental factors…

"On Course" for Supporting Expanded Participation and Improving Scientific Reasoning in Undergraduate Thesis Writing

ERIC Educational Resources Information Center

Dowd, Jason E.; Roy, Christopher P.; Thompson, Robert J., Jr.; Reynolds, Julie A.

2015-01-01

The Department of Chemistry at Duke University has endeavored to expand participation in undergraduate honors thesis research while maintaining the quality of the learning experience. Accomplishing this goal has been constrained by limited departmental resources (including faculty time) and increased diversity in students' preparation to engage in…

Awaking the Public Sector with Strategic Corporate Philanthropy: Revitalizing the Public Servant's Organizational Knowledge, Innovative Capability, and Commitment

ERIC Educational Resources Information Center

Jackson, Janese Marie

2011-01-01

Given the perils of today's dynamic and resource-constrained environment, intellectual capital has become a source of competitive advantage for public sector organizations. Composed of three elements--organizational knowledge, innovative capability, and organizational commitment--intellectual capital is an asset that cannot simply be bought or…

Intellectual Transformation and Budgetary Savings through Academic Reorganization

ERIC Educational Resources Information Center

Capaldi, Elizabeth D.

2009-01-01

When times are good, there is little urgency to evaluate fundamental assumptions, as investments can be made in new projects and structures while the old continue. Constrained resources do not allow this luxury. The current economic crisis and associated budget woes in universities requires individuals to be open to more radical and rapid change…

Challenges and Opportunities for Teacher Professional Development in Interactive Use of Technology in African Schools

ERIC Educational Resources Information Center

Hennessy, Sara; Haßler, Bjoern; Hofmann, Riikka

2015-01-01

This article examines the supporting and constraining factors influencing professional learning about interactive teaching and mobile digital technology use in low-resourced basic schools in sub-Saharan Africa. It draws on a case study of iterative development and refinement of a school-based, peer-facilitated professional learning programme…

A Resource-Constrained Approach to Implementing Analytics in an Institution of Higher Education: An Experience Report

ERIC Educational Resources Information Center

Buerck, John P.; Mudigonda, Srikanth P.

2014-01-01

Academic analytics and learning analytics have been increasingly adopted by academic institutions of higher learning for improving student performance and retention. While several studies have reported the implementation details and the successes of specific analytics initiatives, relatively fewer studies exist in literature that describe the…

Mental Capacity and Working Memory in Chemistry: Algorithmic "versus" Open-Ended Problem Solving

ERIC Educational Resources Information Center

St Clair-Thompson, Helen; Overton, Tina; Bugler, Myfanwy

2012-01-01

Previous research has revealed that problem solving and attainment in chemistry are constrained by mental capacity and working memory. However, the terms mental capacity and working memory come from different theories of cognitive resources, and are assessed using different tasks. The current study examined the relationships between mental…

From 35,000 FT: Getting Air Force Squadron Commanders to Altitude Amid a Resource Constrained Environment

DTIC Science & Technology

Force Inspection System, the Inspector General Complaints Resolution Program, and the Total Force Climate Survey, this paper sought to understand what...by means of the Air Force Inspection System. This research determined that the data collected by the Inspector General and the Total Force Climate

Speed Kills, Speed Thrills: Constraining and Enabling Accelerations in Academic Work-Life

ERIC Educational Resources Information Center

Vostal, Filip

2015-01-01

Intensification, speed of change and faster pace of life have recently emerged as significant issues in studies analysing the current academic climate. This article takes up the "social acceleration thesis" as a conceptual resource for capturing the relationship between the individual experience of time and the changing structure and…

A malicious pattern detection engine for embedded security systems in the Internet of Things.

PubMed

Oh, Doohwan; Kim, Deokho; Ro, Won Woo

2014-12-16

With the emergence of the Internet of Things (IoT), a large number of physical objects in daily life have been aggressively connected to the Internet. As the number of objects connected to networks increases, the security systems face a critical challenge due to the global connectivity and accessibility of the IoT. However, it is difficult to adapt traditional security systems to the objects in the IoT, because of their limited computing power and memory size. In light of this, we present a lightweight security system that uses a novel malicious pattern-matching engine. We limit the memory usage of the proposed system in order to make it work on resource-constrained devices. To mitigate performance degradation due to limitations of computation power and memory, we propose two novel techniques, auxiliary shifting and early decision. Through both techniques, we can efficiently reduce the number of matching operations on resource-constrained systems. Experiments and performance analyses show that our proposed system achieves a maximum speedup of 2.14 with an IoT object and provides scalable performance for a large number of patterns.

Efficient Hardware Implementation of the Lightweight Block Encryption Algorithm LEA

PubMed Central

Lee, Donggeon; Kim, Dong-Chan; Kwon, Daesung; Kim, Howon

2014-01-01

Recently, due to the advent of resource-constrained trends, such as smartphones and smart devices, the computing environment is changing. Because our daily life is deeply intertwined with ubiquitous networks, the importance of security is growing. A lightweight encryption algorithm is essential for secure communication between these kinds of resource-constrained devices, and many researchers have been investigating this field. Recently, a lightweight block cipher called LEA was proposed. LEA was originally targeted for efficient implementation on microprocessors, as it is fast when implemented in software and furthermore, it has a small memory footprint. To reflect on recent technology, all required calculations utilize 32-bit wide operations. In addition, the algorithm is comprised of not complex S-Box-like structures but simple Addition, Rotation, and XOR operations. To the best of our knowledge, this paper is the first report on a comprehensive hardware implementation of LEA. We present various hardware structures and their implementation results according to key sizes. Even though LEA was originally targeted at software efficiency, it also shows high efficiency when implemented as hardware. PMID:24406859

An Energy Efficient Mutual Authentication and Key Agreement Scheme Preserving Anonymity for Wireless Sensor Networks.

PubMed

Lu, Yanrong; Li, Lixiang; Peng, Haipeng; Yang, Yixian

2016-06-08

WSNs (Wireless sensor networks) are nowadays viewed as a vital portion of the IoTs (Internet of Things). Security is a significant issue in WSNs, especially in resource-constrained environments. AKA (Authentication and key agreement) enhances the security of WSNs against adversaries attempting to get sensitive sensor data. Various AKA schemes have been developed for verifying the legitimate users of a WSN. Firstly, we scrutinize Amin-Biswas's currently scheme and demonstrate the major security loopholes in their works. Next, we propose a lightweight AKA scheme, using symmetric key cryptography based on smart card, which is resilient against all well known security attacks. Furthermore, we prove the scheme accomplishes mutual handshake and session key agreement property securely between the participates involved under BAN (Burrows, Abadi and Needham) logic. Moreover, formal security analysis and simulations are also conducted using AVISPA(Automated Validation of Internet Security Protocols and Applications) to show that our scheme is secure against active and passive attacks. Additionally, performance analysis shows that our proposed scheme is secure and efficient to apply for resource-constrained WSNs.

An Energy Efficient Mutual Authentication and Key Agreement Scheme Preserving Anonymity for Wireless Sensor Networks

PubMed Central

Lu, Yanrong; Li, Lixiang; Peng, Haipeng; Yang, Yixian

2016-01-01

WSNs (Wireless sensor networks) are nowadays viewed as a vital portion of the IoTs (Internet of Things). Security is a significant issue in WSNs, especially in resource-constrained environments. AKA (Authentication and key agreement) enhances the security of WSNs against adversaries attempting to get sensitive sensor data. Various AKA schemes have been developed for verifying the legitimate users of a WSN. Firstly, we scrutinize Amin-Biswas’s currently scheme and demonstrate the major security loopholes in their works. Next, we propose a lightweight AKA scheme, using symmetric key cryptography based on smart card, which is resilient against all well known security attacks. Furthermore, we prove the scheme accomplishes mutual handshake and session key agreement property securely between the participates involved under BAN (Burrows, Abadi and Needham) logic. Moreover, formal security analysis and simulations are also conducted using AVISPA(Automated Validation of Internet Security Protocols and Applications) to show that our scheme is secure against active and passive attacks. Additionally, performance analysis shows that our proposed scheme is secure and efficient to apply for resource-constrained WSNs. PMID:27338382

SUMO: operation and maintenance management web tool for astronomical observatories

NASA Astrophysics Data System (ADS)

Mujica-Alvarez, Emma; Pérez-Calpena, Ana; García-Vargas, María. Luisa

2014-08-01

SUMO is an Operation and Maintenance Management web tool, which allows managing the operation and maintenance activities and resources required for the exploitation of a complex facility. SUMO main capabilities are: information repository, assets and stock control, tasks scheduler, executed tasks archive, configuration and anomalies control and notification and users management. The information needed to operate and maintain the system must be initially stored at the tool database. SUMO shall automatically schedule the periodical tasks and facilitates the searching and programming of the non-periodical tasks. Tasks planning can be visualized in different formats and dynamically edited to be adjusted to the available resources, anomalies, dates and other constrains that can arise during daily operation. SUMO shall provide warnings to the users notifying potential conflicts related to the required personal availability or the spare stock for the scheduled tasks. To conclude, SUMO has been designed as a tool to help during the operation management of a scientific facility, and in particular an astronomical observatory. This is done by controlling all operating parameters: personal, assets, spare and supply stocks, tasks and time constrains.

Dual baseline search for muon antineutrino disappearance at 0.1 eV²

DOE PAGES

Cheng, G.; Huelsnitz, W.; Aguilar-Arevalo, A. A.; ...

2012-09-25

The MiniBooNE and SciBooNE collaborations report the results of a joint search for short baseline disappearance of ν¯ μ at Fermilab’s Booster Neutrino Beamline. The MiniBooNE Cherenkov detector and the SciBooNE tracking detector observe antineutrinos from the same beam, therefore the combined analysis of their data sets serves to partially constrain some of the flux and cross section uncertainties. Uncertainties in the ν μ background were constrained by neutrino flux and cross section measurements performed in both detectors. A likelihood ratio method was used to set a 90% confidence level upper limit on ν¯ μ disappearance that dramatically improves uponmore » prior limits in the Δm²=0.1–100 eV² region.« less

Prediction-Correction Algorithms for Time-Varying Constrained Optimization

DOE PAGES

Simonetto, Andrea; Dall'Anese, Emiliano

2017-07-26

This article develops online algorithms to track solutions of time-varying constrained optimization problems. Particularly, resembling workhorse Kalman filtering-based approaches for dynamical systems, the proposed methods involve prediction-correction steps to provably track the trajectory of the optimal solutions of time-varying convex problems. The merits of existing prediction-correction methods have been shown for unconstrained problems and for setups where computing the inverse of the Hessian of the cost function is computationally affordable. This paper addresses the limitations of existing methods by tackling constrained problems and by designing first-order prediction steps that rely on the Hessian of the cost function (and do notmore » require the computation of its inverse). In addition, the proposed methods are shown to improve the convergence speed of existing prediction-correction methods when applied to unconstrained problems. Numerical simulations corroborate the analytical results and showcase performance and benefits of the proposed algorithms. A realistic application of the proposed method to real-time control of energy resources is presented.« less

Sustaining Lesson Study: Resources and Factors that Support and Constrain Mathematics Teachers' Ability to Continue After the Grant Ends

NASA Astrophysics Data System (ADS)

Druken, Bridget Kinsella

Lesson study, a teacher-led vehicle for inquiring into teacher practice through creating, enacting, and reflecting on collaboratively designed research lessons, has been shown to improve mathematics teacher practice in the United States, such as improving knowledge about mathematics, changing teacher practice, and developing communities of teachers. Though it has been described as a sustainable form of professional development, little research exists on what might support teachers in continuing to engage in lesson study after a grant ends. This qualitative and multi-case study investigates the sustainability of lesson study as mathematics teachers engage in a district scale-up lesson study professional experience after participating in a three-year California Mathematics Science Partnership (CaMSP) grant to improve algebraic instruction. To do so, I first provide a description of material (e.g. curricular materials and time), human (attending district trainings and interacting with mathematics coaches), and social (qualities like trust, shared values, common goals, and expectations developed through relationships with others) resources present in the context of two school districts as reported by participants. I then describe practices of lesson study reported to have continued. I also report on teachers' conceptions of what it means to engage in lesson study. I conclude by describing how these results suggest factors that supported and constrained teachers' in continuing lesson study. To accomplish this work, I used qualitative methods of grounded theory informed by a modified sustainability framework on interview, survey, and case study data about teachers, principals, and Teachers on Special Assignment (TOSAs). Four cases were selected to show the varying levels of lesson study practices that continued past the conclusion of the grant. Analyses reveal varying levels of integration, linkage, and synergy among both formally and informally arranged groups of teachers. High levels of integration and linkage among groups of teachers supported them in sustaining lesson study practices. Groups of teachers with low levels of integration but with linked individuals sustained some level of practices, whereas teachers with low levels of integration and linkage constrained them in continuing lesson study at their site. Additionally, teachers' visions of lesson study and its uses shaped the types of activities teachers engaged, with well-developed conceptions of lesson study supporting and limited visions constraining the ability to attract or align resources to continue lesson study practices. Principals' support, teacher autonomy, and cultures of collaboration or isolation were also factors that either supported or constrained teachers' ability to continue lesson study. These analyses provide practical implications on how to support mathematics teachers in continuing lesson study, and theoretical contributions on developing the construct of sustainability within mathematics education research.

How can mathematical models advance tuberculosis control in high HIV prevalence settings?

PubMed

Houben, R M G J; Dowdy, D W; Vassall, A; Cohen, T; Nicol, M P; Granich, R M; Shea, J E; Eckhoff, P; Dye, C; Kimerling, M E; White, R G

2014-05-01

Existing approaches to tuberculosis (TB) control have been no more than partially successful in areas with high human immunodeficiency virus (HIV) prevalence. In the context of increasingly constrained resources, mathematical modelling can augment understanding and support policy for implementing those strategies that are most likely to bring public health and economic benefits. In this paper, we present an overview of past and recent contributions of TB modelling in this key area, and suggest a way forward through a modelling research agenda that supports a more effective response to the TB-HIV epidemic, based on expert discussions at a meeting convened by the TB Modelling and Analysis Consortium. The research agenda identified high-priority areas for future modelling efforts, including 1) the difficult diagnosis and high mortality of TB-HIV; 2) the high risk of disease progression; 3) TB health systems in high HIV prevalence settings; 4) uncertainty in the natural progression of TB-HIV; and 5) combined interventions for TB-HIV. Efficient and rapid progress towards completion of this modelling agenda will require co-ordination between the modelling community and key stakeholders, including advocates, health policy makers, donors and national or regional finance officials. A continuing dialogue will ensure that new results are effectively communicated and new policy-relevant questions are addressed swiftly.

Modeling using discrete event simulation: a report of the ISPOR-SMDM Modeling Good Research Practices Task Force--4.

PubMed

Karnon, Jonathan; Stahl, James; Brennan, Alan; Caro, J Jaime; Mar, Javier; Möller, Jörgen

2012-01-01

Discrete event simulation (DES) is a form of computer-based modeling that provides an intuitive and flexible approach to representing complex systems. It has been used in a wide range of health care applications. Most early applications involved analyses of systems with constrained resources, where the general aim was to improve the organization of delivered services. More recently, DES has increasingly been applied to evaluate specific technologies in the context of health technology assessment. The aim of this article was to provide consensus-based guidelines on the application of DES in a health care setting, covering the range of issues to which DES can be applied. The article works through the different stages of the modeling process: structural development, parameter estimation, model implementation, model analysis, and representation and reporting. For each stage, a brief description is provided, followed by consideration of issues that are of particular relevance to the application of DES in a health care setting. Each section contains a number of best practice recommendations that were iterated among the authors, as well as among the wider modeling task force. Copyright © 2012 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Buddhism, science, and market: The globalisation of Tibetan medicine.

PubMed

Janes, Craig R

2002-01-01

In this paper I discuss the processes by which Tibetan medicine has become globalised, and the ways in which these have come to determine, constrain, and, ultimately, transform local practices of healing in both Tibet and the West. I examine the degree to which globalisation, in particular international market capitalism, operating in this case through the Chinese state, structures the content of primary medical resources, confers legitimacy to certain technologies, and sets the ground rules by which the healers in charge of deploying such technologies are set into conversation with one another. I also argue that the cultural dimensions of globalisation enter the local context through the multiple-stranded flows of people, images, and ideas, and contribute to redefinitions of identity, suffering, and body praxis among patients/consumers in diverse local contexts. I proceed within two registers of analysis. In the first, I analyse these movements in the context of Tibetan medicine as it has been transformed, practised, and used, in the Tibet Autonomous Region of China. In the second, the analytic lens shifts to a focus on Tibetan medicine as a 'global' alternative medicine in North America and Europe. The focus throughout is on the global-local dialectic: how Tibetan medicine is both produced as global commodity and consumed as 'local' tradition.

A new resource for developing and strengthening large-scale community health worker programs.

PubMed

Perry, Henry; Crigler, Lauren; Lewin, Simon; Glenton, Claire; LeBan, Karen; Hodgins, Steve

2017-01-12

Large-scale community health worker programs are now growing in importance around the world in response to the resurgence of interest and growing evidence of the importance of community-based primary health care for improving the health of populations in resource-constrained, high-mortality settings. These programs, because of their scale and operational challenges, merit special consideration by the global health community, national policy-makers, and program implementers. A new online resource is now available to assist in that effort: Developing and Strengthening Community Health Worker Programs at Scale: A Reference Guide and Case Studies for Program Managers and Policymakers ( http://www.mchip.net/CHWReferenceGuide ). This CHW Reference Guide is the product of 27 different collaborators who, collectively, have a formidable breadth and depth of experience and knowledge about CHW programming around the world. It provides a thoughtful discussion about the many operational issues that large-scale CHW programs need to address as they undergo the process of development, expansion or strengthening. Detailed case studies of 12 national CHW programs are included in the Appendix-the most current and complete cases studies as a group that are currently available. Future articles in this journal will highlight many of the themes in the CHW Reference Guide and provide an update of recent advances and experiences. These articles will serve, we hope, to (1) increase awareness about the CHW Reference Guide and its usefulness and (2) connect a broader audience to the critical importance of strengthening large-scale CHW programs for the health benefits that they can bring to underserved populations around the world.

Measurements of Sexuality-Based Stigma among Gay, Bisexual, and Other Men Who Have Sex with Men (GBMSM) in Resource-Poor Settings: A Review.

PubMed

Freeland, Ryan; Rogers, Erin; van Rooyen, Heidi; Darbes, Lynae; Saylor, Kate; Stephenson, Rob

2018-05-01

Gay, bisexual, and other men who have sex with men (GBMSM) in resource-poor settings are disproportionately affected by the HIV/AIDS epidemic. GBMSM living in these settings may face unique barriers to HIV prevention, including legal barriers and increased sexuality-based stigma. It is therefore imperative to tailor HIV prevention and care resources to recognize the lived realities of GBMSM in these settings. Central to this is the accurate measurement of sexuality-based stigma. However, there is wide inconsistency in how sexuality-based stigma is measured among GBMSM in resource-poor settings. This paper reviews recent studies of sexuality-based stigma among GBMSM in resource-poor settings, finding great variability in measurements. The results of the review call for greater attention to the development of contextually and culturally specific measures of sexuality-based stigma for GBMSM living in resource-poor settings.

Modeling and query the uncertainty of network constrained moving objects based on RFID data

NASA Astrophysics Data System (ADS)

Han, Liang; Xie, Kunqing; Ma, Xiujun; Song, Guojie

2007-06-01

The management of network constrained moving objects is more and more practical, especially in intelligent transportation system. In the past, the location information of moving objects on network is collected by GPS, which cost high and has the problem of frequent update and privacy. The RFID (Radio Frequency IDentification) devices are used more and more widely to collect the location information. They are cheaper and have less update. And they interfere in the privacy less. They detect the id of the object and the time when moving object passed by the node of the network. They don't detect the objects' exact movement in side the edge, which lead to a problem of uncertainty. How to modeling and query the uncertainty of the network constrained moving objects based on RFID data becomes a research issue. In this paper, a model is proposed to describe the uncertainty of network constrained moving objects. A two level index is presented to provide efficient access to the network and the data of movement. The processing of imprecise time-slice query and spatio-temporal range query are studied in this paper. The processing includes four steps: spatial filter, spatial refinement, temporal filter and probability calculation. Finally, some experiments are done based on the simulated data. In the experiments the performance of the index is studied. The precision and recall of the result set are defined. And how the query arguments affect the precision and recall of the result set is also discussed.

A two-stage rule-constrained seedless region growing approach for mandibular body segmentation in MRI.

PubMed

Ji, Dong Xu; Foong, Kelvin Weng Chiong; Ong, Sim Heng

2013-09-01

Extraction of the mandible from 3D volumetric images is frequently required for surgical planning and evaluation. Image segmentation from MRI is more complex than CT due to lower bony signal-to-noise. An automated method to extract the human mandible body shape from magnetic resonance (MR) images of the head was developed and tested. Anonymous MR images data sets of the head from 12 subjects were subjected to a two-stage rule-constrained region growing approach to derive the shape of the body of the human mandible. An initial thresholding technique was applied followed by a 3D seedless region growing algorithm to detect a large portion of the trabecular bone (TB) regions of the mandible. This stage is followed with a rule-constrained 2D segmentation of each MR axial slice to merge the remaining portions of the TB regions with lower intensity levels. The two-stage approach was replicated to detect the cortical bone (CB) regions of the mandibular body. The TB and CB regions detected from the preceding steps were merged and subjected to a series of morphological processes for completion of the mandibular body region definition. Comparisons of the accuracy of segmentation between the two-stage approach, conventional region growing method, 3D level set method, and manual segmentation were made with Jaccard index, Dice index, and mean surface distance (MSD). The mean accuracy of the proposed method is [Formula: see text] for Jaccard index, [Formula: see text] for Dice index, and [Formula: see text] mm for MSD. The mean accuracy of CRG is [Formula: see text] for Jaccard index, [Formula: see text] for Dice index, and [Formula: see text] mm for MSD. The mean accuracy of the 3D level set method is [Formula: see text] for Jaccard index, [Formula: see text] for Dice index, and [Formula: see text] mm for MSD. The proposed method shows improvement in accuracy over CRG and 3D level set. Accurate segmentation of the body of the human mandible from MR images is achieved with the proposed two-stage rule-constrained seedless region growing approach. The accuracy achieved with the two-stage approach is higher than CRG and 3D level set.

Cardiac rehabilitation delivery model for low-resource settings

PubMed Central

Grace, Sherry L; Turk-Adawi, Karam I; Contractor, Aashish; Atrey, Alison; Campbell, Norm; Derman, Wayne; Melo Ghisi, Gabriela L; Oldridge, Neil; Sarkar, Bidyut K; Yeo, Tee Joo; Lopez-Jimenez, Francisco; Mendis, Shanthi; Oh, Paul; Hu, Dayi; Sarrafzadegan, Nizal

2016-01-01

Objective Cardiovascular disease is a global epidemic, which is largely preventable. Cardiac rehabilitation (CR) is demonstrated to be cost-effective and efficacious in high-income countries. CR could represent an important approach to mitigate the epidemic of cardiovascular disease in lower-resource settings. The purpose of this consensus statement was to review low-cost approaches to delivering the core components of CR, to propose a testable model of CR which could feasibly be delivered in middle-income countries. Methods A literature review regarding delivery of each core CR component, namely: (1) lifestyle risk factor management (ie, physical activity, diet, tobacco and mental health), (2) medical risk factor management (eg, lipid control, blood pressure control), (3) education for self-management and (4) return to work, in low-resource settings was undertaken. Recommendations were developed based on identified articles, using a modified GRADE approach where evidence in a low-resource setting was available, or consensus where evidence was not. Results Available data on cost of CR delivery in low-resource settings suggests it is not feasible to deliver CR in low-resource settings as is delivered in high-resource ones. Strategies which can be implemented to deliver all of the core CR components in low-resource settings were summarised in practice recommendations, and approaches to patient assessment proffered. It is suggested that CR be adapted by delivery by non-physician healthcare workers, in non-clinical settings. Conclusions Advocacy to achieve political commitment for broad delivery of adapted CR services in low-resource settings is needed. PMID:27181874

Macroscopically constrained Wang-Landau method for systems with multiple order parameters and its application to drawing complex phase diagrams

NASA Astrophysics Data System (ADS)

Chan, C. H.; Brown, G.; Rikvold, P. A.

2017-05-01

A generalized approach to Wang-Landau simulations, macroscopically constrained Wang-Landau, is proposed to simulate the density of states of a system with multiple macroscopic order parameters. The method breaks a multidimensional random-walk process in phase space into many separate, one-dimensional random-walk processes in well-defined subspaces. Each of these random walks is constrained to a different set of values of the macroscopic order parameters. When the multivariable density of states is obtained for one set of values of fieldlike model parameters, the density of states for any other values of these parameters can be obtained by a simple transformation of the total system energy. All thermodynamic quantities of the system can then be rapidly calculated at any point in the phase diagram. We demonstrate how to use the multivariable density of states to draw the phase diagram, as well as order-parameter probability distributions at specific phase points, for a model spin-crossover material: an antiferromagnetic Ising model with ferromagnetic long-range interactions. The fieldlike parameters in this model are an effective magnetic field and the strength of the long-range interaction.

Localizing tuberculosis in chest radiographs with deep learning

NASA Astrophysics Data System (ADS)

Xue, Zhiyun; Jaeger, Stefan; Antani, Sameer; Long, L. Rodney; Karargyris, Alexandros; Siegelman, Jenifer; Folio, Les R.; Thoma, George R.

2018-03-01

Chest radiography (CXR) has been used as an effective tool for screening tuberculosis (TB). Because of the lack of radiological expertise in resource-constrained regions, automatic analysis of CXR is appealing as a "first reader". In addition to screening the CXR for disease, it is critical to highlight locations of the disease in abnormal CXRs. In this paper, we focus on the task of locating TB in CXRs which is more challenging due to the intrinsic difficulty of locating the abnormality. The method is based on applying a convolutional neural network (CNN) to classify the superpixels generated from the lung area. Specifically, it consists of four major components: lung ROI extraction, superpixel segmentation, multi-scale patch generation/labeling, and patch classification. The TB regions are located by identifying those superpixels whose corresponding patches are classified as abnormal by the CNN. The method is tested on a publicly available TB CXR dataset which contains 336 TB images showing various manifestations of TB. The TB regions in the images were marked by radiologists. To evaluate the method, the images are split into training, validation, and test sets with all the manifestations being represented in each set. The performance is evaluated at both the patch level and image level. The classification accuracy on the patch test set is 72.8% and the average Dice index for the test images is 0.67. The factors that may contribute to misclassification are discussed and directions for future work are addressed.

A Multi-Band Uncertainty Set Based Robust SCUC With Spatial and Temporal Budget Constraints

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dai, Chenxi; Wu, Lei; Wu, Hongyu

2016-11-01

The dramatic increase of renewable energy resources in recent years, together with the long-existing load forecast errors and increasingly involved price sensitive demands, has introduced significant uncertainties into power systems operation. In order to guarantee the operational security of power systems with such uncertainties, robust optimization has been extensively studied in security-constrained unit commitment (SCUC) problems, for immunizing the system against worst uncertainty realizations. However, traditional robust SCUC models with single-band uncertainty sets may yield over-conservative solutions in most cases. This paper proposes a multi-band robust model to accurately formulate various uncertainties with higher resolution. By properly tuning band intervalsmore » and weight coefficients of individual bands, the proposed multi-band robust model can rigorously and realistically reflect spatial/temporal relationships and asymmetric characteristics of various uncertainties, and in turn could effectively leverage the tradeoff between robustness and economics of robust SCUC solutions. The proposed multi-band robust SCUC model is solved by Benders decomposition (BD) and outer approximation (OA), while taking the advantage of integral property of the proposed multi-band uncertainty set. In addition, several accelerating techniques are developed for enhancing the computational performance and the convergence speed. Numerical studies on a 6-bus system and the modified IEEE 118-bus system verify the effectiveness of the proposed robust SCUC approach for enhancing uncertainty modeling capabilities and mitigating conservativeness of the robust SCUC solution.« less