13 resultados para corrective orthodontics.

em University of Queensland eSpace - Australia


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For leased equipment, the lessor carries out the maintenance of the equipment. Usually, the contract of lease specifies the penalty for equipment failures and for repairs not being carried out within specified time limits. This implies that optimal preventive maintenance policies must take these penalty costs into account and properly traded against the cost of preventive maintenance actions. The costs associated with failures are high as unplanned corrective maintenance actions are costly and the resulting penalties due to lease contract terms being violated. The paper develops a model to determine the optimal parameters of a preventive maintenance policy that takes into account all these costs to minimize the total expected cost to the lessor for new item lease. The parameters of the policy are (i) the number of preventive maintenance actions to be carried out over the lease period, (ii) the time instants for such actions, and (iii) the level of action. (c) 2005 Elsevier B.V. All rights reserved.

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Community awareness of the sustainable use of land, water and vegetation resources is increasing. The sustainable use of these resources is pivotal to sustainable farming systems. However, techniques for monitoring the sustainable management of these resources are poorly understood and untested. We propose a framework to benchmark and monitor resources in the grains industry. Eight steps are listed below to achieve these objectives: (i) define industry issues; (ii) identify the issues through growers, stakeholder and community consultation; (iii) identify indicators (measurable attributes, properties or characteristics) of sustainability through consultation with growers, stakeholders, experts and community members, relating to: crop productivity; resource maintenance/enhancement; biodiversity; economic viability; community viability; and institutional structure; (iv) develop and use selection criteria to select indicators that consider: responsiveness to change; ease of capture; community acceptance and involvement; interpretation; measurement error; stability, frequency and cost of measurement; spatial scale issues; and mapping capability in space and through time. The appropriateness of indicators can be evaluated using a decision making system such as a multiobjective decision support system (MO-DSS, a method to assist in decision making from multiple and conflicting objectives); (v) involve stakeholders and the community in the definition of goals and setting benchmarking and monitoring targets for sustainable farming; (vi) take preventive and corrective/remedial action; (vii) evaluate effectiveness of actions taken; and (viii) revise indicators as part of a continual improvement principle designed to achieve best management practice for sustainable farming systems. The major recommendations are to: (i) implement the framework for resources (land, water and vegetation, economic, community and institution) benchmarking and monitoring, and integrate this process with current activities so that awareness, implementation and evolution of sustainable resource management practices become normal practice in the grains industry; (ii) empower the grains industry to take the lead by using relevant sustainability indicators to benchmark and monitor resources; (iii) adopt a collaborative approach by involving various industry, community, catchment management and government agency groups to minimise implementation time. Monitoring programs such as Waterwatch, Soilcheck, Grasscheck and Topcrop should be utilised; (iv) encourage the adoption of a decision making system by growers and industry representatives as a participatory decision and evaluation process. Widespread use of sustainability indicators would assist in validating and refining these indicators and evaluating sustainable farming systems. The indicators could also assist in evaluating best management practices for the grains industry.

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This paper surveys current work on the design of alarms for anesthesia environments and notes some of the problems arising from the need to interpret alarms in context. Anesthetists' responses to audible alarms in the operating room were observed across four types of surgical procedure (laparoscopic, arthroscopic, cardiac, and intracranial) and across three phases of a procedure (induction, maintenance, and emergence). Alarms were classified as (a) requiring a corrective response, (b) being the intended result of a decision, (c) being ignored as a nuisance alarm, or (d) functioning as a reminder. Results revealed strong effects of the type of procedure and phase of procedure on the number and rate of audible alarms. Some alarms were relatively confined to specific phases; others were seen across phases, and responses differed according to phase. These results were interpreted in light of their significance for the development of effective alarm systems. Actual or potential applications of this research include the design of alarm systems that are more informative and more sensitive to operative context than are current systems.

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Objective: To assess the diagnostic error rate among echocardiograms undertaken by individuals other than paediatric cardiologists in our referral area. Methodology: External group: The charts and echocardiographic results of all patients who had undergone outside echocardiograms between January 1996 and December 1999 were reviewed (110). Age at echocardiography, diagnostic complexity, presence of any diagnostic errors and the severity of any diagnostic errors were identified. Internal group: To assess our own error rate, the initial echocardiographic diagnoses of 100 patients undergoing cardiac catheterisation or corrective surgery were compared with the post-catheterisation or postoperative diagnoses. Age and diagnostic complexity were also assessed in the control group. Results: Diagnostic errors occurred in 47/110 patients (44%) of the externally studied group (of which 24% were either major or life threatening) as opposed to 3/100 of the internally studied group, despite the internally studied group being of increased diagnostic complexity. Errors were more common and of increased severity in infants less than 1 month of age but extended throughout all age groups. Major and life threatening errors increased with increasing diagnostic complexity. In the externally studied group, 8/47 errors were patients inappropriately designated as normal. Four of these patients required cardiac surgery or interventional cardiac catheterisation. Conclusions: This study suggests an unacceptably high error rate in paediatric echocardiographic diagnoses by non-paediatric cardiologists throughout all age groups. Such errors are more likely in younger infants and with increasing diagnostic complexity.

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When products are sold under warranty, the manufacturer incurs additional costs for warranty servicing. Preventive maintenance actions can be used to reduce this cost and these are worthwhile only if the extra cost incurred is less than the reduction achieved. In this paper we propose a new preventive maintenance policy where the parameters are selected optimally to minimize the total warranty servicing cost.

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In this paper we use sensor-annotated abstraction hierarchies (Reising & Sanderson, 1996, 2002a,b) to show that unless appropriately instrumented, configural displays designed according to the principles of ecological interface design (EID) might be vulnerable to misinterpretation when sensors become unreliable or are unavailable. Building on foundations established in Reising and Sanderson (2002a) we use a pasteurization process control example to show how sensor-annotated AHs help the analyst determine the impact of different instrumentation engineering policies on a configural display that is part of an ecological interface. Our analyses suggest that configural displays showing higher-order properties of a system are especially vulnerable under some conservative instrumentation configurations. However, sensor-annotated AHs can be used to indicate where corrective instrumentation might be placed. We argue that if EID is to be effectively employed in the design of displays for complex systems, then the information needs of the human operator need to be considered while instrumentation requirements are being formulated. Rasmussen's abstraction hierarchy-and particularly its extension to the analysis of information captured by sensors and derived from sensors-may therefore be a useful adjunct to up-stream instrumentation design. (C) 2002 Elsevier Science Ltd. All rights reserved.

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Objective : To report the history of the Royal Alexandra Hospital for Children (RAHC) Papua New Guinea (PNG) cardiac surgical programme and describe the selection, preoperative clinical features and postoperative outcome of children with congenital heart disease managed by the programme. Methods : Details for each of the PNG cardiac patients admitted to RAHC following selection by visiting cardiologists between 1978 and 1994 were entered into a database, and analysed and interpreted. Results : A congenital heart defect was confirmed in 165 of the 170 children selected. The male to female ratio was 1:1 and the mean age on admission to RAHC was 5.5 years. Almost all of the children for whom data were available (98%) had a weight for age and 41% had a height for age less than the 3rd centile. One-sixth had delayed milestones. A large number were tachypnoeic, in heart failure, or had pulmonary hypertension on admission. Ventricular septal defect and tetralogy of Fallot were the commonest defects, and lesions such as aortic stenosis, coarctation of the aorta and transposition of the great arteries were absent or rare. Thirty-one (19%) of the children selected initially did not receive surgery because of pulmonary hypertension, or because the lesions did not fall within the programme guidelines for operation. One hundred and twenty-nine children had corrective and four had palliative procedures. Half of the operated children had postoperative complications. Eight children died, all following open-heart procedures, giving a case fatality rate of 6%. Preoperative tachypnoea, hepatomegaly, cardiac failure and pulmonary hypertension were strongly associated with poor outcome. Conclusions : The programme was an arduous exercise for all organizations concerned, but achieved comparatively good short-term outcomes. The experience gained should assist in planning for similar programmes.