The impact of leprosy on health-related quality of life

INTRODUCTION: Leprosy is a potentially disabling infectious disease that evolves into emotional issues due to the prejudice that persists about the illness. The endemic has declined substantially with multidrug therapy (MDT) in the 80's; however, new demands associated with the reduction of stigma and the improvement of the affected people's quality of life have emerged. In Brazil, leprosy is still a public health problem. Piauí is the second state in the Northeast in prevalence and detection, and Teresina is a hyperendemic city. This study aimed to analyze the health-related quality of life (HRQoL) of people in treatment for leprosy in Teresina/PI. METHODS: An observational study was conducted using the SF-36 (a specific questionnaire for assessing quality of life), which sought the determinants of poor quality of life among people with leprosy, outlining the sociodemographic, clinical, and epidemiological characteristics of the 107 patients interviewed. RESULTS: The correlations between the variables showed five determinants of HRQoL: late diagnosis, multibacillary forms, reactions, disability diagnosis grade II, and prejudice. The profile of the participants showed that leprosy still affects the lower social classes in historically endemic areas, causing high percentages of secondary injuries that compromise the work capacity and quality of life of the affected people, perpetuating the stigma associated with the disease. CONCLUSIONS: The study reinforces the need to implement more effective strategies of disease control, due to the development of severe and disabling forms of leprosy is directly related to poor HRQoL in the same cured patient.

Implementation of WHO Quality Rights assessment in Kabul Mental Health Hospital

RESUMO: Objetivo Avaliar a qualidade dos serviços de saúde mental e a situação dos direitos humanos no Hospital de Saúde Mental de Kabul (KMHH) e fornecer recomendações para o desenvolvimento de um plano de melhoria, actualização e revisão da Política, Estratégia e Plano Nacionais de Saúde Mental,. Métodos A avaliação foi realizada em Janeiro de 2015 no KMHH e na Burn Ward do Hospital Terciário de Isteqlal por uma equipa multidisciplinar usando Qualidade Direitos Tool Kit da OMS. Antes da avaliação, o protocolo foi aprovado pelo Institutional Review Board e obtido o consentimento informado de cada entrevistado. Realizaram-se entrevistas com 16 utentes do serviço, 17 funcionários do hospital e 7 familiares, além da revisão de documentos e da observação das unidades de internamento do KMHH e das interações interpessoais entre funcionários do hospital e utentes do serviço. A comissão de avaliação reviu também a documentação e observou a Unidade de Queimados do Hospital Terciário de Isteqlal, a fim de avaliar e comparar a paridade entre as duas instalações. Após a avaliação, todos os membros da comissão se reuniram e puseram em conjunto todas as conclusões num relatório final. Resultados Encontrámos algumas lacunas graves no nível de prestação de serviços e no respeito pelos direitos humanos dos utentes dos serviços e dos seus familiares. Uma série de políticas, diretrizes e procedimentos relacionados com os direitos humanos dos pacientes estavam ausentes. O ambiente terapêutico e o padrão de vida eram inadequados, existia má qualidade do atendimento e dos serviços prestados, os utilizadores enfrentavam violações do direito ao exercício da capacidade legal e da liberdade pessoal, eram quimica e fisicamente (uso de correntes) contidos e expostos a abusos verbais, físicos e emocionais, e havia grande ênfase no tratamento institucional. Todos estes aspectos foram considerados como extensa violação dos direitos humanos dos utentes de serviço do KMHH. Conclusão Os serviços disponíveis para utentes dos serviços de saúde mental apresentam alguns problemas devido à desconfiança e falta de consciencialização sobre os direitos das pessoas com doença mental e precisam ser alterados de forma positiva. A Lei de Saúde Mental existente difere muito das recomendações da Convenção sobre os Direitos das Pessoas com Incapacidades (CRPD) e requer revisão e adaptação de acordo com esta Convenção. -------------------------------- ABSTRACT: Objective To assess the quality of mental health services and human rights condition in the Kabul Mental Health Hospital (KMHH) and provide recommendations for development of an improvement plan and to update and revise the National Mental Health Policy, Strategy and Plan. Methods The assessment was conducted in January 2015 in the KMHH and the Burn Ward of Isteqlal Tertiary Hospital by a multidisciplinary team using WHO Quality Rights Tool Kit. Before the assessment, Institutional Review Board approval and informed consent from each interviewee were obtained. Interviews were conducted with 16 service users, 17 hospital staffs and 7 family members in addition to documents review and observation of inpatient units of KMHH plus interpersonal interactions between hospital staff and service users. The assessment committee reviewed the documentation and observed the Burn Ward of Isteqlal Tertiary hospital in order to measure and compare parity between the two facilities. After the assessment, all committee members gathered and synchronized all findings into a final report. Results There were some serious gaps on service provision level and respecting human rights of service users and their family members. A series of policies, guidelines and procedures related to patients’ human rights were absent. Inadequate treatment environment and standard of living, poor quality of care and services, violations of the right to exercise legal capacity and personal liberty, being chemically and physically (e.g. chain) restrained, being exposed to verbal, physical and emotional abuse, and emphasis on institutional treatment were all extensive human rights violation that service users were experiencing in KMHH. Conclusion The available services for mental health service users are questionable due to mistrust and lack of awareness about rights of people with disabilities and need to be positively changed. Existing Mental Health Act has a large number of disparities with the CRPD and requires revision and adaptation in accordance to CRPD.

IQRray, a new method for Affymetrix microarray quality control, and the homologous organ conservation score, a new benchmark method for quality control metrics.

MOTIVATION: Microarray results accumulated in public repositories are widely reused in meta-analytical studies and secondary databases. The quality of the data obtained with this technology varies from experiment to experiment, and an efficient method for quality assessment is necessary to ensure their reliability. RESULTS: The lack of a good benchmark has hampered evaluation of existing methods for quality control. In this study, we propose a new independent quality metric that is based on evolutionary conservation of expression profiles. We show, using 11 large organ-specific datasets, that IQRray, a new quality metrics developed by us, exhibits the highest correlation with this reference metric, among 14 metrics tested. IQRray outperforms other methods in identification of poor quality arrays in datasets composed of arrays from many independent experiments. In contrast, the performance of methods designed for detecting outliers in a single experiment like Normalized Unscaled Standard Error and Relative Log Expression was low because of the inability of these methods to detect datasets containing only low-quality arrays and because the scores cannot be directly compared between experiments. AVAILABILITY AND IMPLEMENTATION: The R implementation of IQRray is available at: ftp://lausanne.isb-sib.ch/pub/databases/Bgee/general/IQRray.R. CONTACT: Marta.Rosikiewicz@unil.ch SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

Personality, psychosocial and health-related predictors of quality of life in old age.

OBJECTIVES: Beyond its well-documented association with depressive symptoms across the lifespan, at an individual level, quality of life may be determined by multiple factors: psychosocial characteristics, current physical health and long-term personality traits. METHOD: Quality of life was assessed in two distinct community-based age groups (89 young adults aged 36.2 ± 6.3 and 92 older adults aged 70.4 ± 5.5 years), each group equally including adults with and without acute depressive symptoms. Regression models were applied to explore the association between quality of life assessed with the World Health Organization Quality of Life - Bref (WHOQOL-Bref) and depression severity, education, social support, physical illness, as well as personality dimensions as defined by the Five-Factor Model. RESULTS: In young age, higher quality of life was uniquely associated with lower severity of depressive symptoms. In contrast, in old age, higher quality of life was related to both lower levels of depressive mood and of physical illness. In this age group, a positive association was also found between quality of life and higher levels of Openness to experience and Agreeableness personality dimensions. CONCLUSION: Our data indicated that, in contrast to young cohorts, where acute depression is the main determinant of poor quality of life, physical illness and personality dimensions represent additional independent predictors of this variable in old age. This observation points to the need for concomitant consideration of physical and psychological determinants of quality of life in old age.

Quality Standards for the Delivery of Specialist Stop Smoking Services in Northern Ireland September 2011

Cigarette smoking is the major cause of preventable ill health in Northern Ireland. It accounts for 2400 premature deaths every year. Fifty percent or one in every two smokers will die prematurely due to their addiction; many will suffer chronic ill health and poor quality of life before their death (DHSSPS, 2007; ASH, 2008). Approximately 340,000 people smoke in Northern Ireland or 24% of the population over 16yrs. The Public Health Agency (PHA) commissions specialist stop smoking services across Northern Ireland. It has enabled the establishment of specialist stop smoking services in a range of settings including GP practices, pharmacies, hospitals and community settings. Tobacco control activities are overseen locally by the PHA's Tobacco Control Groups. The multi-agency groups oversee and advise on tobacco control initiatives.All stop smoking services are required to comply with the requirements of 18 standards. This report highlights the standards.

Generation of cardiomyocytes from new human embrionic stem cell lines derived from poor-quanlity blastocysts

Human embryonic stem (hES) cells represent a potential source for cell replacement therapy of many degenerative diseases. Most frequently, hES cell lines are derived from surplus embryos from assisted reproduction cycles, independent of their quality or morphology. Here, we show that hES cell lines can be obtained from poor-quality blastocysts with the same efficiency as that obtained from good- or intermediate-quality blastocysts. Furthermore, we show that the self-renewal, pluripotency, and differentiation ability of hES cell lines derived from either source are comparable. Finally, we present a simple and reproducible embryoid body-based protocol for the differentiation of hES cells into functional cardiomyocytes. The five new hES cell lines derived here should widen the spectrum of available resources for investigating the biology of hES cells and advancing toward efficient strategies of regenerative medicine.

Kulutusosapalvelun hinnoittelumallin kehittäminen

Tämä diplomityö käsittelee paperikoneiden kulutusosapalvelua tarjoavan yrityksen hinnoittelumallin kehittämistä haastavassa toimintaympäristössä, jossa kilpailu on kiristynyt ja asiakkaat ovat muuttuneet entistä hintatietoisemmiksi. Työn tavoitteena on kehittää kulutusosapalvelulle hinnoittelumalli ja pohtia ¤/tuotettu paperitonni (¤/tonni)-hinnoittelun soveltuvuutta paperikoneiden kulutusosapalvelua toimittaville yrityksille. ¤/tonni-hinnoittelussalähtökohta on asiakkaalle tuotettu hyöty; kuinka paljon paperia kulutusosilla pystytään tuottamaan. ¤/tonni-hinnoittelua tarkastellaan tarkemmin esimerkkiasiakkaiden avulla, joiden tehtailla toimintatavat kulutusosapalveluun liittyen vaihtelevat. Tavoitteena on selvittää kulutusosapalvelun ¤/tonni-kustannukset eri toimintatavoissa kulutusosapalveluita tarjoavan yrityksen sekä asiakkaan näkökulmasta. Työssä selvitetään kuinka eri toimintatapojen ja asiakkaiden kannattavuus vaihtelee kulutusosapalveluita tarjoavan yrityksen kannalta, jamikä toimintamalli on edullisin asiakkaan kannalta. Kehitettävän hinnoittelumallin avulla analysoidaan, kuinka paljon hyötyä kulutusosapalveluita tarjoava yritys tarjoaa asiakkailleen palveluillaan. Kulutusosapalvelu jaetaan kolmeen selvitettävään kustannuskomponenttiin; kulutusosa-, logistiikka- ja laadun puutekustannuksiin. Työn teoreettinen osa koostuu kirjallisuustutkimuksesta liittyen hinnoitteluun, hinnoittelumalleihin ja hinnoittelusopimuksiin. Työnempiirinen osa perustuu haastatteluihin ja sisäisten tietojärjestelmien tietoihin. Kirjallisuustutkimuksen, haastattelujen ja kohdeyrityksen sisäisen materiaalin avulla mallinnetaan loogismatemaattisesti taulukkolaskentasovellus, ¤/tonni-hinnoittelumalli. Työn keskeiset tulokset liittyvät siihen, mitä asioita tulee huomioida ¤/tonni-hinnoittelusopimusta asiakkaan kanssa tehtäessä, miten ¤/tonni-kustannukset vaihtelevat eri toimintavoissa ja kuinka hinnoittelumallin kehittämistä kannattaa edelleen jatkaa.

Warranty Practices and Costs in the Industry of Welding Machines Manufacturing

The objective of the master’s thesis is to define the warranty practices and costs in the welding machines manufacturing company and do a proposal for a warranty policy based on the practices and costs. The study include a disquisition of the warranty practices in the subsidiaries and distributor sales. The disquisition of the warranty practices introduces the information relates to warranty period, warranty costs, including repair, spare part and other costs, the practices with the replaced parts, the utilization rate of the eWarranty system and information relates to special arrangements in the warranties. The warranty costs are defined besides the group level also separately per regions and product families. From some product families the disquisition is done per products. In this study is also done a proposal for a warranty policy for the company. The proposal speaks out the length of warranty period, the compensation of the warranty costs, the practices with replaced parts and usage of eWarranty system.

Supply chain costs of a small board lot: sheet cutting and logistics

Succeeding in small board lot (0-20 tons) deliveries, is not always prosperous and failures as well as extra costs compared to standard costs arise. Failure deliveries from converting plants to customer locations tie a lot of unwanted and unexpected costs. Extra costs are handled as quality costs and more precise, internal failure costs. These costs revolve from unsuccessful truck payloads, redundant warehousing or unfavorable routing as examples. Quality costs are becoming more and more important factor in company’s financial decision making. Actual, realized truck payload correlates with the extra costs occurring, so filling the truck payload all get-out well is a key to lower the extra costs. Case company in this study is Corporation A, business segment Boards. Boards have outsourced half of their converting in order to gain better customer service via flexibility, lead time reductions and logistics efficiency improvements. Examination period of the study is first two quarters of year 2008 and deliveries examined are from converters to the customer locations. In Corporation A’s case, the total loss in failure deliveries is hundreds of thousands of Euros during the examination period. So, the logistics goal of getting the right product to the right place and right time for the least cost, does not completely realize.

Climate driven changes in temperature, pH and food quality : effects on copepod reproduction

Increased emissions of greenhouse gases into the atmosphere are causing an anthropogenic climate change. The resulting global warming challenges the ability of organisms to adapt to the new temperature conditions. However, warming is not the only major threat. In marine environments, dissolution of carbon dioxide from the atmosphere causes a decrease in surface water pH, the so called ocean acidification. The temperature and acidification effects can interact, and create even larger problems for the marine flora and fauna than either of the effects would cause alone. I have used Baltic calanoid copepods (crustacean zooplankton) as my research object and studied their growth and stress responses using climate predictions projected for the next century. I have studied both direct temperature and pH effects on copepods, and indirect effects via their food: the changing phytoplankton spring bloom composition and toxic cyanobacterium. The main aims of my thesis were: 1) to find out how warming and acidification combined with a toxic cyanobacterium affect copepod reproductive success (egg production, egg viability, egg hatching success, offspring development) and oxidative balance (antioxidant capacity, oxidative damage), and 2) to reveal the possible food quality effects of spring phytoplankton bloom composition dominated by diatoms or dinoflagellates on reproducing copepods (egg production, egg hatching, RNA:DNA ratio). The two copepod genera used, Acartia sp. and Eurytemora affinis are the dominating mesozooplankton taxa (0.2 – 2 mm) in my study area the Gulf of Finland. The 20°C temperature seems to be within the tolerance limits of Acartia spp., because copepods can adapt to the temperature phenotypically by adjusting their body size. Copepods are also able to tolerate a pH decrease of 0.4 from present values, but the combination of warm water and decreased pH causes problems for them. In my studies, the copepod oxidative balance was negatively influenced by the interaction of these two environmental factors, and egg and nauplii production were lower at 20°C and lower pH, than at 20°C and ambient pH. However, presence of toxic cyanobacterium Nodularia spumigena improved the copepod oxidative balance and helped to resist the environmental stress, in question. In addition, adaptive maternal effects seem to be an important adaptation mechanism in a changing environment, but it depends on the condition of the female copepod and her diet how much she can invest in her offspring. I did not find systematic food quality difference between diatoms and dinoflagellates. There are both good and bad diatom and dinoflagellate species. Instead, the dominating species in the phytoplankton bloom composition has a central role in determining the food quality, although copepods aim at obtaining as a balanced diet as possible by foraging on several species. If the dominating species is of poor quality it can cause stress when ingested, or lead to non-optimal foraging if rejected. My thesis demonstrates that climate change induced water temperature and pH changes can cause problems to Baltic Sea copepod communities. However, their resilience depends substantially on their diet, and therefore the response of phytoplankton to the environmental changes. As copepods are an important link in pelagic food webs, their future success can have far reaching consequences, for example on fish stocks.

A quality and cost approach for welding process selection

The aim of this work was to propose, apply and evaluate a methodical approach to select welding processes in a productive environment based on market requirements of Quality and Costs. A case study was used. The welds were carried out in laboratory, simulating the joint conditions of a manufacturer and using several welding processes: SMAW, GTAW, pulsed GTAW, GMAW with CO2 and Ar based shielding gases and pulsed GMAW. For Quality analysis geometrical aspects of the beads were considered and for Cost analysis, welding parameters and consumable prices. Quantitative indices were proposed and evaluated. After that, evaluation of both Quality and Costs was done, showing to be possible to select the most suitable welding process to a specific application, taking into account the market conditions of a company.

CTQ process flow development and the impact for cost of quality

Tämä työ tehtiin Kone Industrial Oy:lle Major Projects yksikköön, laatuosastolle. Kone Major Projects yksikkö keskittyy erikoisiin ja suuriin hissi- ja liukuporras projekteihin. Työn tavoitteena oli luoda harmonisoitu prosessi hissikomponenttien laaduntarkkailua varten sekä tarkastella ja vertailla kustannussäästöjä, jota tällä uudella prosessilla voidaan saavuttaa. Tavoitteena oli saavuttaa 80-prosentin kustannussäästöt laatukustannuksissa uuden laatuprosessin avulla. Työn taustana ja tutkimusongelmana ovat lisääntyneet erikoisprojektit ja niiden myötä lisääntynyt laaduntarkkailun tarve. Ongelmana laaduntarkkailussa voitiin pitää harmonisoidun ja selkeän prosessin puuttumista C-prosessikomponenttien valmistuksessa. Lisäksi kehitysprosessin aikana luotiin vanhojen työkalujen pohjalta keskeinen laaduntarkkailutyökalu, CTQ-työkalu. Työssä käsitellään ensin Konetta yhtiönä ja selvitetään Koneen keskeisimmät prosessit työn taustaksi. Teoria osuudessa käsitellään prosessin kehitykseen liittyviä teorioita sekä yleisiä laatukäsitteitä ja esitetään teorioita laadun asemasta nykypäivänä. Lopuksi käsitellään COQ eli laatukustannusten teoriaa ja esitellään teoria PAF-analyysille, jota käytetään työssä laatukustannusten vertailuun case esimerkin avulla. Työssä kuvataan CTQ prosessin luominen alusta loppuun ja case esimerkin avulla testataan uutta CTQ prosessia pilottihankkeessa. Tässä case esimerkissä projektin bracket eli johdekiinnitysklipsi tuotetaan uuden laatuprosessin avulla sekä tehdään kustannusvertailu saman projektin toisen bracketin kanssa, joka on tuotettu ennen uuden laatuprosessin implementoimista. Työn lopputuloksena CTQ prosessi saatiin luotua ja sitä pystyttiin testaamaan käytännössä case esimerkin avulla. Tulosten perusteella voidaan sanoa, että CTQ prosessin käyttö vähentää laatukustannuksia huomattavasti ja helpottaa laadunhallintaa C-prosessikomponenttien tuotannossa.

Warranty Prediction Using Weibull Simulation

The main objective of this master’s thesis is to examine if Weibull analysis is suitable method for warranty forecasting in the Case Company. The Case Company has used Reliasoft’s Weibull++ software, which is basing on the Weibull method, but the Company has noticed that the analysis has not given right results. This study was conducted making Weibull simulations in different profit centers of the Case Company and then comparing actual cost and forecasted cost. Simula-tions were made using different time frames and two methods for determining future deliveries. The first sub objective is to examine, which parameters of simulations will give the best result to each profit center. The second sub objective of this study is to create a simple control model for following forecasted costs and actual realized costs. The third sub objective is to document all Qlikview-parameters of profit centers. This study is a constructive research, and solutions for company’s problems are figured out in this master’s thesis. In the theory parts were introduced quality issues, for example; what is quality, quality costing and cost of poor quality. Quality is one of the major aspects in the Case Company, so understand-ing the link between quality and warranty forecasting is important. Warranty management was also introduced and other different tools for warranty forecasting. The Weibull method and its mathematical properties and reliability engineering were introduced. The main results of this master’s thesis are that the Weibull analysis forecasted too high costs, when calculating provision. Although, some forecasted values of profit centers were lower than actual values, the method works better for planning purposes. One of the reasons is that quality improving or alternatively quality decreasing is not showing in the results of the analysis in the short run. The other reason for too high values is that the products of the Case Company are com-plex and analyses were made in the profit center-level. The Weibull method was developed for standard products, but products of the Case Company consists of many complex components. According to the theory, this method was developed for homogeneous-data. So the most im-portant notification is that the analysis should be made in the product level, not the profit center level, when the data is more homogeneous.

Enhancing change detection in low-quality surveillance footage using markov random fields

Urban surveillance footage can be of poor quality, partly due to the low quality of the camera and partly due to harsh lighting and heavily reflective scenes. For some computer surveillance tasks very simple change detection is adequate, but sometimes a more detailed change detection mask is desirable, eg, for accurately tracking identity when faced with multiple interacting individuals and in pose-based behaviour recognition. We present a novel technique for enhancing a low-quality change detection into a better segmentation using an image combing estimator in an MRF based model.

Are differences in life history parameters of the pine beauty moth Panolis flammea modified by host plant quality or gender?

Pine beauty moth (Panolis flammea D&S, Lepidoptera: Noctuidae) were reared individually from egg hatch to pupation on one of three host plants, Pinus sylvestris (native host plant), Pinus contorta (Central Interior seed origin - good quality introduced host) and P. contorta (Alaskan seed origin - poor quality introduced host). After emerging from the pupae the adult moths were confined to a Skeena River seed origin of P. contorta. Female pupal weight and adult life span were significantly higher on P. sylvestris than on the two lodgepole pine seed origins. Development time was, however, not significantly different between treatments, but larval mean relative growth rate was found to be negatively correlated with birth weight and positively correlated with pupal weight. The time to emerge from the pupa was also not significantly different between treatments. However, there were marked differences between the genders. Male moths lost a significantly greater proportion of their weight over the pupal stage but lived significantly longer as adults than the females. Female moths emerged from the pupal stage significantly sooner than male moths. There was no apparent advantage of lai-ge birth size when looked at in terms of subsequent performance. These results are discussed in light of current life history theory.