Predictors of psychiatric hospitalization during 6 months of maintenance treatment with olanzapine long-acting injection: post hoc analysis of a randomized, double-blind study.

BACKGROUND: Hospitalization is a costly and distressing event associated with relapse during schizophrenia treatment. No information is available on the predictors of psychiatric hospitalization during maintenance treatment with olanzapine long-acting injection (olanzapine-LAI) or how the risk of hospitalization differs between olanzapine-LAI and oral olanzapine. This study aimed to identify the predictors of psychiatric hospitalization during maintenance treatment with olanzapine-LAI and assessed four parameters: hospitalization prevalence, incidence rate, duration, and the time to first hospitalization. Olanzapine-LAI was also compared with a sub-therapeutic dose of olanzapine-LAI and with oral olanzapine. METHODS: This was a post hoc exploratory analysis of data from a randomized, double-blind study comparing the safety and efficacy of olanzapine-LAI (pooled active depot groups: 405 mg/4 weeks, 300 mg/2 weeks, and 150 mg/2 weeks) with oral olanzapine and sub-therapeutic olanzapine-LAI (45 mg/4 weeks) during 6 months' maintenance treatment of clinically stable schizophrenia outpatients (n=1064). The four psychiatric hospitalization parameters were analyzed for each treatment group. Within the olanzapine-LAI group, patients with and without hospitalization were compared on baseline characteristics. Logistic regression and Cox's proportional hazards models were used to identify the best predictors of hospitalization. Comparisons between the treatment groups employed descriptive statistics, the Kaplan-Meier estimator and Cox's proportional hazards models. RESULTS: Psychiatric hospitalization was best predicted by suicide threats in the 12 months before baseline and by prior hospitalization. Compared with sub-therapeutic olanzapine-LAI, olanzapine-LAI was associated with a significantly lower hospitalization rate (5.2% versus 11.1%, p < 0.01), a lower mean number of hospitalizations (0.1 versus 0.2, p = 0.01), a shorter mean duration of hospitalization (1.5 days versus 2.9 days, p < 0.01), and a similar median time to first hospitalization (35 versus 60 days, p = 0.48). Olanzapine-LAI did not differ significantly from oral olanzapine on the studied hospitalization parameters. CONCLUSIONS: In clinically stable schizophrenia outpatients receiving olanzapine-LAI maintenance treatment, psychiatric hospitalization was best predicted by a history of suicide threats and prior psychiatric hospitalization. Olanzapine-LAI was associated with a significantly lower incidence of psychiatric hospitalization and shorter duration of hospitalization compared with sub-therapeutic olanzapine-LAI. Olanzapine-LAI did not differ significantly from oral olanzapine on hospitalization parameters.

Change of Electricity Distribution Industry: Drivers and Opening Business Opportunities

As a result of the recent regulatory amendments and other development trends in the electricity distribution business, the sector is currently witnessing radical restructuring that will eventually impact the business logics of the sector. This report represents upcoming changes in the electricity distribution industry and concentrates on the factors that are expected to be the most fundamental ones. Electricity network companies nowadays struggle with legislative and regulatory requirements that focus on both the operational efficiency and the reliability of electricity distribution networks. The forces that have an impact on the distribution network companies can be put into three main categories that define the transformation at a general level. Those are: (1) a requirement for a more functional marketplace for energy, (2) environmental aspects (combating climate change etc.), and (3) a strongly emphasized requirement for the security of energy supply. The first point arises from the legislators’ attempt to increase competition in electricity retail markets, the second one concerns both environmental protection and human safety issues, and the third one indicates societies’ reduced willingness to accept interruptions in electricity supply. In the future, regulation of electricity distribution business may lower the threshold for building more weather-resistant networks, which in turn means increased underground cabling. This development pattern is reinforced by tightening safety and environmental regulations that ultimately make the overhead lines expensive to build and maintain. The changes will require new approaches particularly in network planning, construction, and maintenance. The concept for planning, constructing, and maintaining cable networks is necessary because the interdependencies between network operations are strong, in other words, the nature of the operation requires a linkage to other operations.

Efficient installed base information management and utilization in global after sales service business

This Master´s thesis explores how the a global industrial corporation’s after sales service department should arrange its installed base management practices in order to maintain and utilize the installed base information effectively. Case company has product-related records, such as product’s lifecycle information, service history information and information about product’s performance. Information is collected and organized often case by case, therefore the systematic and effective use of installed base information is difficult also the overview of installed base is missing. The goal of the thesis study was to find out how the case company can improve the installed base maintenance and management practices and improve the installed base information availability and reliability. Installed base information management practices were first examined through the literature. The empirical research was conducted by the interviews and questionnaire survey, targeted to the case company’s service department. The research purpose was to find out the challenges related to case company´s service department’s information management practices. The study also identified the installed base information needs and improvement potential in the availability of information. Based on the empirical research findings, recommendations for improve installed base management practices and information availability were created. Grounding of the recommendations, the case company is suggested the following proposals for action: Service report development, improving the change management process, ensuring the quality of the product documentation in early stages of product life cycle and decision to improve installed base management practices.

Establishment of a health and safety management system according to the OHSAS 18001 standard

The thesis develops guidelines for the implementation of the health and safety management system according to the OHSAS 18001 standard, as well as the feasible threat analysis, project proposal schedule, future system quality improvements and organizational change evaluation. The theoretical part clarifies determination of occupational health and safety, its management system, the OHSAS 18001 standard and integrated management system compounded of triple ISO 14001, ISO 9001 and OHSAS 18001 standards. The literature includes such important aspects as human factor, organizational policies, possible benefits, threats, organizational safety culture, Deming’s quality improvement cycle, system implementation, maintenance and cost matters. The empirical part demonstrates real-life situation by using Andritz Pulp & Paper Oy as a case study. Prior the thesis proposal, Andritz Group is analysed including separate business areas, acquisition and integration strategies, current status of the health and safety management and parallel experiences of the largest business area Andritz Hydro. The proposal is aimed at improving the current health and safety system for the permanent and sub-contracted employees at Andritz Pulp & Paper both in Finland and in various projects globally.

Paperitehtaan arkittamon kokonaistehokkuuden nostaminen kunnossapitoa kehittämällä

Tämän diplomityön tavoitteena oli tutkia, miten UPM:n Kymin tehtaan A4- arkittamon kunnossapitotoimintaa pystyttäisiin kehittämään niin, että tuotantolaitoksen kokonaistehokkuutta saataisiin kasvatettua. Työssä on pohdittu keinoja nykyisen, pääasiallisesti korjaavan kunnossapitotoiminnan muuttamiseksi suunnitelmalliseksi eri teorialähtökohtien pohjalta. Keskeinen teoria, johon työn tulokset pohjautuvat, on kokonaisvaltainen tuottava kunnossapito (TPM). Kirjallisuuslähteisiin tukeutuvaa tutkimusta täydensivät useat haastattelut, A4-valmistajille suunnattu laitteiden kuntokartoituskysely ja tuotannon- ja toiminnanohjausjärjestelmistä kerätty mittausaineisto. Työn merkittävimmät tulokset osoittavat, että A4-arkittamon kunnossapitotoimintaa tulisi suunnata nykyistä enemmän käyttökunnossapitolähtöiseksi. Käyttökunnossapito perustuu tuotannon operaattoreiden osallistumiseen kunnossapitotoimiin varsinaisen kunnossapitohenkilöstön ohella. Tuotantooperaattoreilla on työnsä vuoksi parhaat mahdollisuudet käyttämiensä laitteiden kunnonvalvontaan ja näin ollen mahdollisten vikaantumisten ennakointiin jo varhaisessa vaiheessa. Ennakoimalla pystyttäisiin parantamaan kunnossapidon suunnitelmallisuutta, minkä ansiosta laitteiden käytettävyys ja sitä kautta tuotantolaitoksen kokonaistehokkuus olisivat nykyistä korkeampia.

Dam safety guide

A new Dam Safety Act (494/2009) came into force on 1st October 2009 and a Government Decree on Dam Safety (319/2010) on 5th May 2010. This Dam Safety Guide replaces the Dam Safety Code of Practice (Publication of the Ministry of Agriculture and Forestry 7/1997), removed from circulation on 1st October 2009. The Dam Safety Guide is not binding on the dam owner; the purpose is to complement and elucidate the relevant law and and decree through examples and descriptions. The Guide takes up questions concerning dam design, for instance hydrological dimensioning and technical safety requirements, dam construction and use, the dam break hazard analysis and the dam owner’s emergency action plan, maintenance, use, monitoring as well as the annual and periodic inspections. Dams are classified according to the hazard they pose into class 1, 2 or 3 dams. The classification is not needed, if, according to the dam safety authority, the dam poses no danger. The owner of a classified dam must prepare a monitoring programme, to be approved by decision of the dam safety authority. To establish the hazard caused by a dam, the owner of a class 1 dam must prepare an analysis of the dam hazard to humans and property as well as to the environment. The dam safety authority may also require a dam break hazard analysis for a dam other than class 1 dam if deemed necessary for classification. The owner of a class 1 dam must prepare a plan of measures in case of emergency or operational failure. The plan shall present the dam owner’s state of preparedness to act on their own initiative in the situations described above. In each case, the rescue authorities make a separate assessment for the need to prepare a plan as set out in the Rescue Act. The dam owner must provide the information specified in the Dam Safety Decree to be entered into the dam safety information system. The dam safety authority and the owner of the dam must keep up-to-date printouts in their own dam safety files from the information system for each dam as well as other important documents connected with dam safety to ensure that these are readily available in case of disturbance.

Capecitabine maintenance therapy in patients with recurrent or metastatic breast cancer

Our objective was to investigate the efficacy and safety of capecitabine maintenance therapy (CMT) after capecitabine-based combination chemotherapy in patients with metastatic breast cancer. The clinical data of 139 metastatic breast cancer patients treated from March 2008 to May 2012 with capecitabine-based combination chemotherapy were retrospectively analyzed. When initial disease control was achieved by the combination chemotherapy, we used CMT for 50 patients, while 37 patients were treated with a different (non-CMT) maintenance therapy. We compared time to progression (TTP), objective response rate, disease control rate, clinical benefit rate, and safety of the two groups, and a sub-group analysis was performed according to pathological characteristics. Sixty-four percent of the patients received a median of six cycles of a docetaxel+capecitabine combination chemotherapy regimen (range 1-45); the median TTP (MTTP) for the complete treatment was 9.43 months (95%CI=8.38-10.48 months) for the CMT group and 4.5 months (95%CI=4.22-4.78 months; P=0.004) for the non-CMT group. The MTTPs for the maintenance therapies administered after the initial capecitabine combined chemotherapy were 4.11 months (95%CI=3.34-4.87 months) for the CMT group and 2.0 months (95%CI=1.63-2.38 months) for the non-CMT group. Gastrointestinal side effects, decreased white blood cells and palmar-plantar erythrodysesthesia were the main adverse reactions experienced with the combination chemotherapies, CMT and non-CMT treatments. No significant differences in the incidence of adverse reactions were detected in the CMT and non-CMT patients. After initial disease control was achieved with the capecitabine-based combination chemotherapy, CMT can significantly prolong TTP rates with a favorable safety profile.

Statistical Inference for Some Measures of System Availability

Department of Statistics, Cochin University of Science and Technology

Effect of management strategies on the performance of ruminant livestock production systems and the safety of plant and animal products in the city of Sikasso, Mali

The regional population growth in West Africa, and especially its urban centers, will bring about new and critical challenges for urban development policy, especially in terms of ensuring food security and providing employment for the growing population. (Peri-) urban livestock and vegetable production systems, which can contribute significantly to these endeavours, are limited by various constraints, amongst them limited access to expensive production factors and their (in)efficient use. To achieve sustainable production systems with low consumer health risks, that can meet the urban increased demand, this doctoral thesis determined nutrient use efficiencies in representative (peri-) urban livestock production systems in three West African cities, and investigated potential health risks for consumers ensuing from there. The field study, which was conducted during July 2007 to December 2009, undertook a comparative analysis of (peri-) urban livestock production strategies across 210 livestock keeping households (HH) in the three West African cities of Kano/Nigeria (84 HH), Bobo Dioulasso/Burkina Faso (63 HH) and Sikasso/Mali (63 HH). These livestock enterprises were belonging to the following three farm types: commercial gardening plus field crops and livestock (cGCL; 88 HH), commercial livestock plus subsistence field cropping (cLsC; 109 HH) and commercial gardening plus semi-commercial livestock (cGscL; 13 HH) which had been classified in a preceding study; they represented the diversity of (peri-) urban livestock production systems in West Africa. In the study on the efficiency of ruminant livestock production, lactating cowsand sheep herd units were differentiated based on whether feed supplements were offered to the animals at the homestead (Go: grazing only; Gsf: mainly grazing plus some supplement feeding). Inflows and outflows of nutrients were quantified in these herds during 18 months, and the effects of seasonal variations in nutrient availability on animals’ productivity and reproductive performance was determined in Sikasso. To assess the safety of animal products and vegetables, contamination sources of irrigated lettuce and milk with microbiological contaminants, and of tomato and cabbage with pesticide residues in (peri-) urban agriculture systems of Bobo Dioulasso and Sikasso were characterized at three occasions in 2009. Samples of irrigation water, organic fertilizer and ix lettuce were collected in 6 gardens, and samples of cabbage and tomato in 12 gardens; raw and curdled milk were sampled in 6 dairy herds. Information on health risks for consumers of such foodstuffs was obtained from 11 health centers in Sikasso. In (peri-) urban livestock production systems, sheep and goats dominated (P<0.001) in Kano compared to Bobo Dioulasso and Sikasso, while cattle and poultry were more frequent (P<0.001) in Bobo Dioulasso and Sikasso than in Kano. Across cities, ruminant feeding relied on grazing and homestead supplementation with fresh grasses, crop residues, cereal brans and cotton seed cake; cereal grains and brans were the major ingredients of poultry feeds. There was little association of gardens and livestock; likewise field cropping and livestock were rarely integrated. No relation existed between the education of the HH head and the adoption of improved management practices (P>0.05), but the proportion of HH heads with a long-term experience in (peri-) urban agriculture was higher in Kano and in Bobo Dioulasso than in Sikasso (P<0.001). Cattle and sheep fetched highest market prices in Kano; unit prices for goats and chicken were highest in Sikasso. Animal inflow, outflow and dairy herd growth rates were significantly higher (P<0.05) in the Gsf than in the Go cattle herds. Maize bran and cottonseed expeller were the main feeds offered to Gsf cows as dry-season supplement, while Gsf sheep received maize bran, fresh grasses and cowpea pods. The short periodic transhumance of Go dairy cows help them maintaining their live weight, whereas Gsf cows lost weight during the dry season despite supplement feeding at a rate of 1506 g dry matter per cow and day, resulting in low productivity and reproductive performance. The daily live weight gains of calves and lambs, respectively, were low and not significantly different between the Go and the Gsf system. However, the average live weight gains of lambs were significantly higher in the dry season (P<0.05) than in the rainy season because of the high pressure of gastrointestinal parasites and of Trypanosoma sp. In consequence, 47% of the sheep leaving the Go and Gsf herds died due to diseases during the study period. Thermo-tolerant coliforms and Escherichia coli contamination levels of irrigation water significantly exceeded WHO recommendations for the unrestricted irrigation of vegetables consumed raw. Microbial contamination levels of lettuce at the farm gate and the market place in Bobo Dioulasso and at the farm gate in Sikasso were higher than at the market place in Sikasso (P<0.05). Pesticide residues were detected in only one cabbage and one tomato sample and were below the maximum residue limit for consumption. Counts of thermo-tolerant coliforms and Escherichia coli were higher in curdled than in raw milk (P<0.05). From 2006 to x 2009, cases of diarrhea/vomiting and typhoid fever had increased by 11% and 48%, respectively, in Sikasso. For ensuring economically successful and ecologically viable (peri-) urban livestock husbandry and food safety of (peri-) urban foodstuffs of animal and plant origin, the dissemination and adoption of improved feeding practices, livestock healthcare and dung management are key. In addition, measures fostering the safety of animal products and vegetables including the appropriate use of wastewater in (peri-) urban agriculture, restriction to approve vegetable pesticides and the respect of their latency periods, and passing and enforcement of safety laws is required. Finally, the incorporation of environmentally sound (peri-) urban agriculture in urban planning by policy makers, public and private extension agencies and the urban farmers themselves is of utmost importance. To enable an efficient (peri-) urban livestock production in the future, research should concentrate on cost-effective feeding systems that allow meeting the animals’ requirement for production and reproduction. Thereby focus should be laid on the use of crop-residues and leguminous forages. The improvement of the milk production potential through crossbreeding of local cattle breeds with exotic breeds known for their high milk yield might be an accompanying option, but it needs careful supervision to prevent the loss of the local trypanotolerant purebreds.

Lifecycle Value Framework for Tactical Aircraft Product Development

Due to a dramatic reduction in defense procurement, the benchmark for developing new defense systems today is performance at an affordable cost. In an attempt to encircle a more holistic perspective of value, lifecycle value has evolved as a concept within the Lean Aerospace Initiative, LAI. The implication of this is development of products incorporating lifecycle and long-term focus instead of a shortsighted cost cutting focus. The interest to reduce total cost of ownership while still improving performance, availability, and sustainability, other dimensions taken into account within the lifecycle value approach, falls well within this context. Several factors prevent enterprises from having a holistic perspective during product development. Some important aspects are increased complexity of the products and significant technological uncertainty. The combination of complexity in system design and the limits of individual human comprehension typically prevent a best value solution to be envisioned. The purpose of this research was to examine relative contributions in product development and determine factors that significantly promote abilities to consider and achieve lifecycle value. This paper contributes a maturity matrix based on important practices and lessons learned through extensive interview based case studies of three tactical aircraft programs, including experiences from more than 100 interviews.

Availability analysis of GMPLS connections based on physical network topology

This paper presents a study of connection availability in GMPLS over optical transport networks (OTN) taking into account different network topologies. Two basic path protection schemes are considered and compared with the no protection case. The selected topologies are heterogeneous in geographic coverage, network diameter, link lengths, and average node degree. Connection availability is also computed considering the reliability data of physical components and a well-known network availability model. Results show several correspondences between suitable path protection algorithms and several network topology characteristics

Probabilistic models to assist maintenance of multiple instruments

The paper discusses maintenance challenges of organisations with a huge number of devices and proposes the use of probabilistic models to assist monitoring and maintenance planning. The proposal assumes connectivity of instruments to report relevant features for monitoring. Also, the existence of enough historical registers with diagnosed breakdowns is required to make probabilistic models reliable and useful for predictive maintenance strategies based on them. Regular Markov models based on estimated failure and repair rates are proposed to calculate the availability of the instruments and Dynamic Bayesian Networks are proposed to model cause-effect relationships to trigger predictive maintenance services based on the influence between observed features and previously documented diagnostics

HSE - Microbiological Safety Cabinet Training Video

This training video is intended to familiarise researchers and technicians, working with potentially airborne pathogens, on the correct and safe use of Microbiological Safety Cabinets. The video also provides instruction on cleaning, disinfection and fumigation regimes; maintenance and testing regimes; and commissioning and decommissioning requirements of such Local Exhaust Ventilation (LEV) systems. It is in Windows Media Video format which will require a free media player such as Windows Media Player or VLC Media Player (http://www.videolan.org/vlc/) to watch.

Evaluación del nivel de seguridad ocupacional en laboratorios universitarios de ingeniería en Bogotá

Antecedentes: Los laboratorios estudiantiles ofrecen riesgos para los estudiantes, la normatividad específica vigente no es de carácter obligatorio y en Bogotá aproximadamente hay 387 laboratorios. Objetivo: Evaluar el nivel de seguridad referente a salud, higiene y seguridad industrial en las prácticas que se desarrollan en los laboratorios de pregrado de Ingeniería en universidades de Bogotá. Métodos: Estudio descriptivo con un muestreo estratificado por conglomerado en ocho (8) universidades de la ciudad de Bogotá, con una confiabilidad del 95% y una precisión absoluta del 6% para una proporción máxima esperada; para evaluar los laboratorios se utilizó el Cuestionario de seguridad para laboratorios de secundaria (NTP 921) del Instituto Nacional de Seguridad e Higiene del Trabajo de España Resultados: Se evaluaron 166 laboratorios de 8 universidades de Bogotá, 65 de los laboratorios evaluados presentaron un riesgo bajo de los aspectos evaluados. Los aspectos con un porcentaje mayor o igual al 80% de cumplimiento de condiciones fueron aspectos generales del laboratorio, trabajo de los alumnos, manipulación de material, manipulación del producto, protección contra Incendios, eliminación de residuos, seguridad eléctrica y formación. Los ítems con un porcentaje menor del 60% de cumplimiento son los siguientes: sistemas de alarma contra incendios o emergencias; mantenimiento preventivo de la red eléctrica del laboratorio, capacitaciones anuales sobre seguridad en los laboratorios. aspectos generales del laboratorio, trabajo de los alumnos, manipulación de material, manipulación del producto, protección contra Incendios, eliminación de residuos, seguridad eléctrica y formación. Se realizó una prueba de asociación entre el tipo de laboratorio y cada ítem de las condiciones de seguridad del laboratorio. Los laboratorios que cumplen con un mayor número de condiciones de seguridad fueron los laboratorios químicos, el aspecto que obtuvo un porcentaje bajo de cumplimiento fue protección personal (40%); los aspectos que se cumplieron son aspectos generales del laboratorio, trabajo de los alumnos, manipulación de material, manipulación del producto, protección contra Incendios, eliminación de residuos, seguridad eléctrica y formación.

Determinación del perfil de exposición potencial a contaminantes químicos mediante el uso de metodologías de evaluación simplificada en trabajadores de autopartes en el barrio La Paz, Bogotá 2015

Las actividades de mantenimiento automotriz en el sector de autopartes conlleva el uso de agentes químicos bajo diversas circunstancias de exposición, tanto en las condiciones de manipulación de productos químicos como a las características propias de cada actividad de mantenimiento asociado a las tareas específicas del trabajo. Tradicionalmente la evaluación de contaminantes químicos desde la visión de la Higiene Ocupacional incluye la evaluación cuantitativa de la exposición mediante técnicas instrumentales concretas y estandarizadas, determinando el nivel de concentración en aire a la cual un trabajador se ve expuesto y que, en comparación con valores límites permisibles (VLPs), inducen el establecimiento de medidas de control y vigilancia, según el nivel de riesgo caracterizado. Sin embargo es evidente la limitación de la implementación de esta sistemática en particular en micros y pequeñas empresas que carecen de los recursos suficientes para abordar la problemática de forma objetiva. En este contexto diversas metodologías de evaluación cualitativa o subjetiva se han desarrollado por distintas organizaciones en el mundo con el fin de disminuir la brecha entre el establecimiento de medidas de control y la valoración del riesgo, ofreciendo alternativas confiables para la toma de decisiones preventivas sin la necesidad de acudir a mediciones cuantitativas. Mediante la presente investigación se pretende validar la efectividad en el uso de una herramienta de evaluación simplificada del riesgo químico propuesta por el INRS (Institut National de Recherche et de Sécurité Francés) mediante la determinación del perfil de exposición potencial a contaminantes químicos de la población laboral de 36 almacenes de autopartes ubicados en el barrio la Paz de la ciudad de Bogotá, Colombia, divididos según énfasis de actividades en Partes Externas, Partes Eléctricas e Inyección, Partes Mecánicas, Partes Múltiples, a través de un estudio de corte transversal. El estudio permitió Jerarquizar el riesgo potencial, valorar el riesgo vía inhalatoria y dérmica para finalmente construir el perfil de exposición potencial a contaminantes químicos de trabajadores. La información de las variables de análisis fue consolidada en una herramienta informática diseñada para tal fin, la cual facilito la administración de los datos y su respectivo análisis. Con base en los hallazgos fue posible establecer los productos químicos que de acuerdo a las condiciones de trabajo y circunstancias de exposición sugieren medidas específicas para la disminución del riesgo potencial de acuerdo a la calificación global de los agentes, permitiendo deducir la viabilidad de la aplicación de herramientas de valoración cualitativa para la evaluación del riesgo químico como estrategia de prevención primaria.