Reducing the time before consulting with symptoms of lung cancer:a randomised controlled trial in primary care

Background: Most individuals with lung cancer have symptoms for several months before presenting to their GP. Earlier consulting may improve survival. Aim: To evaluate whether a theory-based primary care intervention increased timely consulting of individuals with symptoms of lung cancer. Design and setting: Open randomised controlled trial comparing intervention with usual care in two general practices in north-east Scotland. Method: Smokers and ex-smokers aged ≥55 years were randomised to receive a behavioural intervention or usual care. The intervention comprised a single nurse consultation at participants' general practice and a self-help manual. The main outcomes were consultations within target times for individuals with new chest symptoms (≤3 days haemoptysis, ≤3 weeks other symptoms) in the year after the intervention commenced, and intentions about consulting with chest symptoms at 1 and 6 months. Results: Two hundred and twelve participants were randomised and 206 completed the trial. The consultation rate for new chest symptoms in the intervention group was 1.19 (95% confidence interval [CI] = 0.92 to 1.53; P = 0.18) times higher than in the usual-care group and the proportion of consultations within the target time was 1.11 (95% CI = 0.41 to 3.03; P = 0.83) times higher. One month after the intervention commenced, the intervention group reported intending to consult with chest symptoms 31 days (95% CI = 7 to 54; P = 0.012) earlier than the usual care group, and at 6 months this was 25 days (95% CI = 1.5 to 48; P = 0.037) earlier. Conclusion: Behavioural intervention in primary care shortened the time individuals at high risk of lung disease intended to take before consulting with new chest symptoms (the secondary outcome of the study), but increases in consultation rates and the proportions of consultations within target times were not statistically significant. © British Journal of General Practice.

Managing risk in a large rural electrification programme in India

Rural electrification projects and programmes in many countries have suffered from design, planning, implementation and operational flaws as a result of ineffective project planning and lack of systematic project risk analysis. This paper presents a hierarchical risk-management framework for effectively managing large-scale development projects. The proposed framework first identifies, with the involvement of stakeholders, the risk factors for a rural electrification programme at three different levels (national, state and site). Subsequently it develops a qualitative risk prioritising scheme through probability and severity mapping and provides mitigating measures for most vulnerable risks. The study concludes that the hierarchical risk-management approach provides an effective framework for managing large-scale rural electrification programmes. © IAIA 2007.

Decision support system for risk management:a case study

This study demonstrates a quantitative approach to construction risk management through analytic hierarchy process and decision tree analysis. All the risk factors are identified, their effects are quantified by determining probability and severity, and various alternative responses are generated with cost implication for mitigating the quantified risks. The expected monetary values are then derived for each alternative in a decision tree framework and subsequent probability analysis aids the decision process in managing risks. The entire methodology is explained through a case application of a cross-country petroleum pipeline project in India and its effectiveness in project management is demonstrated.

A study of liquid-liquid extraction in a sieve plate column

The literature relating to sieve plate liquid extraction columns and relevant hydrodynamic phenomena have been surveyed. Mass transfer characteristics during drop formation, rise and coalescence, and related models were also reviewed. Important design parameters i.e. flooding, dispersed phase hold-up, drop size distribution, mean drop size, coalescence/flocculation zone height beneath a plate and jetting phenomena were investigated under non-mass transfer and mass transfer conditions in a 0.45m diameter, 2.3m high sieve plate column. This column had provision for four different plate designs, and variable plate spacing and downcomer heights, and the system used was Clairsol `350' (dispersed) - acetone - deionised water (continuous) with either direction of mass transfer. Drop size distributions were best described by the functions proposed by Gal-or, and then Mugele-Evans. Using data from this study and the literature, correlations were developed for dispersed phase hold-up, mean drop size in the preferred jetting regime and in the non-jetting regime, and coalescence zone height. A method to calculate the theoretical overall mass transfer coefficient allowing for the range of drop sizes encountered in the column gave the best fit to experimental data. This applied the drop size distribution diagram to estimate the volume percentage of stagnant, circulating and oscillating drops in the drop population. The overall coefficient Kcal was then calculated as the fractional sum of the predicted individual single drop coefficients and their proportion in the drop population. In a comparison between the experimental and calculated overall mass transfer coefficients for cases in which all the drops were in the oscillating regime (i.e. 6.35mm hole size plate), and for transfer from the dispersed(d) to continuous(c) phase, the film coefficient kd predicted from the Rose-Kintner correlation together with kc from that of Garner-Tayeban gave the best representation. Droplets from the 3.175mm hole size plate, were of a size to be mainly circulating and oscillating; a combination of kd from the Kronig-Brink (circulating) and Rose-Kintner (oscillating) correlations with the respective kc gave the best agreement. The optimum operating conditions for the SPC were identified and a procedure proposed for design from basic single drop data.

Call admission control algorithms in OFDM-based wireless multiservice networks

Orthogonal frequency division multiplexing (OFDM) is becoming a fundamental technology in future generation wireless communications. Call admission control is an effective mechanism to guarantee resilient, efficient, and quality-of-service (QoS) services in wireless mobile networks. In this paper, we present several call admission control algorithms for OFDM-based wireless multiservice networks. Call connection requests are differentiated into narrow-band calls and wide-band calls. For either class of calls, the traffic process is characterized as batch arrival since each call may request multiple subcarriers to satisfy its QoS requirement. The batch size is a random variable following a probability mass function (PMF) with realistically maximum value. In addition, the service times for wide-band and narrow-band calls are different. Following this, we perform a tele-traffic queueing analysis for OFDM-based wireless multiservice networks. The formulae for the significant performance metrics call blocking probability and bandwidth utilization are developed. Numerical investigations are presented to demonstrate the interaction between key parameters and performance metrics. The performance tradeoff among different call admission control algorithms is discussed. Moreover, the analytical model has been validated by simulation. The methodology as well as the result provides an efficient tool for planning next-generation OFDM-based broadband wireless access systems.

A dynamic bandwidth reservation scheme for hybrid IEEE 802.16 wireless networks

A dynamic bandwidth reservation (DBR) scheme for hybrid IEEE 802.16 wireless networks is investigated, in which 802.16 networks serve as the backhaul for client networks, such as WiFi hotspots and cellular networks. The DBR scheme implemented in the subscription stations (SSs) (co-locating with access pointers) consists of two components: connection admission controller (CAC), and bandwidth controller (BC). The CAC processes the received connection set-up requests from the client networks connected to the SSs. The BC manages the request and release of bandwidth from the base station (BS). It dynamically changes the reserved bandwidth between a small number of values. Hysteresis is incorporated in bandwidth release to reduce bandwidth request signalling load and connection blocking probability. An analytical model is proposed to evaluate the performances of reserved bandwidth, connection blocking probability and signalling load. The impacts of hysteresis mechanism and probability of reservation request blocking are taken into account. Simulation verifies the analytical model. ©2008 IEEE.