Health system context and implementation of evidence-based practices-development and validation of the Context Assessment for Community Health (COACH) tool for low- and middle-income settings

Background: The gap between what is known and what is practiced results in health service users not benefitting from advances in healthcare, and in unnecessary costs. A supportive context is considered a key element for successful implementation of evidence-based practices (EBP). There were no tools available for the systematic mapping of aspects of organizational context influencing the implementation of EBPs in low- and middle-income countries (LMICs). Thus, this project aimed to develop and psychometrically validate a tool for this purpose. Methods: The development of the Context Assessment for Community Health (COACH) tool was premised on the context dimension in the Promoting Action on Research Implementation in Health Services framework, and is a derivative product of the Alberta Context Tool. Its development was undertaken in Bangladesh, Vietnam, Uganda, South Africa and Nicaragua in six phases: (1) defining dimensions and draft tool development, (2) content validity amongst in-country expert panels, (3) content validity amongst international experts, (4) response process validity, (5) translation and (6) evaluation of psychometric properties amongst 690 health workers in the five countries. Results: The tool was validated for use amongst physicians, nurse/midwives and community health workers. The six phases of development resulted in a good fit between the theoretical dimensions of the COACH tool and its psychometric properties. The tool has 49 items measuring eight aspects of context: Resources, Community engagement, Commitment to work, Informal payment, Leadership, Work culture, Monitoring services for action and Sources of knowledge. Conclusions: Aspects of organizational context that were identified as influencing the implementation of EBPs in high-income settings were also found to be relevant in LMICs. However, there were additional aspects of context of relevance in LMICs specifically Resources, Community engagement, Commitment to work and Informal payment. Use of the COACH tool will allow for systematic description of the local healthcare context prior implementing healthcare interventions to allow for tailoring implementation strategies or as part of the evaluation of implementing healthcare interventions and thus allow for deeper insights into the process of implementing EBPs in LMICs.

On Real-Time Monitoring And Control For Efficient Management Of Drinking Water Networks: Barcelona Case Study

Drinking water utilities in urban areas are focused on finding smart solutions facing new challenges in their real-time operation because of limited water resources, intensive energy requirements, a growing population, a costly and ageing infrastructure, increasingly stringent regulations, and increased attention towards the environmental impact of water use. Such challenges force water managers to monitor and control not only water supply and distribution, but also consumer demand. This paper presents and discusses novel methodologies and procedures towards an integrated water resource management system based on advanced ICT technologies of automation and telecommunications for largely improving the efficiency of drinking water networks (DWN) in terms of water use, energy consumption, water loss minimization, and water quality guarantees. In particular, the paper addresses the first results of the European project EFFINET (FP7-ICT2011-8-318556) devoted to the monitoring and control of the DWN in Barcelona (Spain). Results are split in two levels according to different management objectives: (i) the monitoring level is concerned with all the aspects involved in the observation of the current state of a system and the detection/diagnosis of abnormal situations. It is achieved through sensors and communications technology, together with mathematical models; (ii) the control level is concerned with computing the best suitable and admissible control strategies for network actuators as to optimize a given set of operational goals related to the performance of the overall system. This level covers the network control (optimal management of water and energy) and the demand management (smart metering, efficient supply). The consideration of the Barcelona DWN as the case study will allow to prove the general applicability of the proposed integrated ICT solutions and their effectiveness in the management of DWN, with considerable savings of electricity costs and reduced water loss while ensuring the high European standards of water quality to citizens.

Newly Automated System For Integrated Assessment Of The Conditions Of Underwater Gas Pipelines

An underwater gas pipeline is the portion of the pipeline that crosses a river beneath its bottom. Underwater gas pipelines are subject to increasing dangers as time goes by. An accident at an underwater gas pipeline can lead to technological and environmental disaster on the scale of an entire region. Therefore, timely troubleshooting of all underwater gas pipelines in order to prevent any potential accidents will remain a pressing task for the industry. The most important aspect of resolving this challenge is the quality of the automated system in question. Now the industry doesn't have any automated system that fully meets the needs of the experts working in the field maintaining underwater gas pipelines. Principle Aim of this Research: This work aims to develop a new system of automated monitoring which would simplify the process of evaluating the technical condition and decision making on planning and preventive maintenance and repair work on the underwater gas pipeline. Objectives: Creation a shared model for a new, automated system via IDEF3; Development of a new database system which would store all information about underwater gas pipelines; Development a new application that works with database servers, and provides an explanation of the results obtained from the server; Calculation of the values MTBF for specified pipelines based on quantitative data obtained from tests of this system. Conclusion: The new, automated system PodvodGazExpert has been developed for timely and qualitative determination of the physical conditions of underwater gas pipeline; The basis of the mathematical analysis of this new, automated system uses principal component analysis method; The process of determining the physical condition of an underwater gas pipeline with this new, automated system increases the MTBF by a factor of 8.18 above the existing system used today in the industry.

The Brazilian financial system and the green economy : alignment with sustainable development

Three studies were prepared and are presented in this document. The first, The Brazilian Financial Sector Institutional Context in the Transition to Sustainable Development looks at the legislation, regulation, and public policies aimed at socio-environmental themes related to the financial sector. The second study, Current Financing for the Green Economy in Brazil, provides an initial estimate of the financial assets already allocated to the green economy, as well as a methodological proposal for the survey and monitoring of the respective flow of assets. The third and final study looks at two important segments of the Brazilian economy and their process of transition to a greener economy: renewable energy and agriculture.

Low cost non-intrusive home energy monitoring

This thesis presents a low cost non-intrusive home energy monitor built on top of Non-Intrusive Load Monitoring (NILM) concepts and techniques. NILM solutions are already considered low cost alternatives to the big majority of existing commercial energy monitors but the goal here is to make its cost even lower by using a mini netbook as a whole in one solution. The mini netbook is installed in the homes main circuit breaker and computes power consumption by reading current and voltage from the built-in sound card. At the same time, feedback to the users is provided using the 11’’ LCD screen as well as other built-in I/O modules. Our meter is also capable of detecting changes in power and tries to find out which appliance lead to that change and it is being used as part of an eco-feedback platform that was build to study the long terms of energy eco-feedback in individuals. In this thesis the steps that were taken to come up with such a system are presented, from the basics of AC power measurements to the implementation of an event detector and classifier that was used to disaggregate the power load. In the last chapter results from some validation tests that have been performed are presented in order to validate the experiment. It is believed that such a system will not only be important as an energy monitor, but also as an open system than can be easily changed to accommodate and test new or existing nonintrusive load monitoring techniques.

Stochastic simulation of time-series models combined with geostatistics to predict water-table scenarios in a Guarani Aquifer System outcrop area, Brazil

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

MICROBIOLOGICAL CONTAMINATION of A HEMODIALYSIS CENTER WATER DISTRIBUTION SYSTEM

The microbiological monitoring of the water used for hemodialysis is extremely important, especially because of the debilitated immune system of patients suffering from chronic renal insufficiency. To investigate the occurrence and species diversity of bacteria in waters, water samples were collected monthly from a hemodialysis center in upstate São Paulo and tap water samples at the terminal sites of the distribution system was sampled repeatedly (22 times) at each of five points in the distribution system; a further 36 samples were taken from cannulae in 19 hemodialysis machines that were ready for the next patient, four samples from the reuse system and 13 from the water storage system. To identify bacteria, samples were filtered through 0.22 mu m-pore membranes; for mycobacteria, 0.45 mu m pores were used. Conventional microbiological and molecular methods were used in the analysis. Bacteria were isolated from the distribution system (128 isolates), kidney machine water (43) and reuse system (3). Among these isolates, 32 were Gram-positive rods, 120 Gram-negative rods, 20 Gram-positive cocci and 11 mycobacteria. We propose the continual monitoring of the water supplies in hemodialysis centers and the adoption of effective prophylactic measures that minimize the exposure of these immunodeficient patients to contaminated sources of water.

An Intelligent System for Petroleum Well Drilling Cutting Analysis

Cutting analysis is a important and crucial task task to detect and prevent problems during the petroleum well drilling process. Several studies have been developed for drilling inspection, but none of them takes care about analysing the generated cutting at the vibrating shale shakers. Here we proposed a system to analyse the cutting's concentration at the vibrating shale shakers, which can indicate problems during the petroleum well drilling process, such that the collapse of the well borehole walls. Cutting's images are acquired and sent to the data analysis module, which has as the main goal to extract features and to classify frames according to one of three previously classes of cutting's volume. A collection of supervised classifiers were applied in order to allow comparisons about their accuracy and efficiency. We used the Optimum-Path Forest (OPF), Artificial Neural Network using Multi layer Perceptrons (ANN-MLP), Support Vector Machines (SVM) and a Bayesian Classifier (BC) for this task. The first one outperformed all the remaining classifiers. Recall that we are also the first to introduce the OPF classifier in this field of knowledge. Very good results show the robustness of the proposed system, which can be also integrated with other commonly system (Mud-Logging) in order to improve the last one's efficiency.

In-process grinding monitoring by acoustic emission

This work aims to investigate the efficiency of digital signal processing tools of acoustic emission signals in order to detect thermal damages in grinding process. To accomplish such a goal, an experimental work was carried out for 15 runs in a surface grinding machine operating with an aluminum oxide grinding wheel and ABNT 1045. The acoustic emission signals were acquired from a fixed sensor placed on the workpiece holder. A high sampling rate data acquisition system at 2.5 MHz was used to collect the raw acoustic emission instead of root mean square value usually employed. Many statistics have shown effective to detect burn, such as the root mean square (RMS), correlation of the AE, constant false alarm (CFAR), ratio of power (ROP) and mean-value deviance (MVD). However, the CFAR, ROP, Kurtosis and correlation of the AE have been presented more sensitive than the RMS.

Influence of Excitation Signal on Impedance-based Structural Health Monitoring

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Automatic dimming multi-lamp fluorescent management system with active input power factor corrector stage

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Non-destructive evaluation tool for monitoring and detection of structural damage by using neural network.

This work studies the capability of generalization of Neural Network using vibration based measurement data aiming at operating condition and health monitoring of mechanical systems. The procedure uses the backpropagation algorithm to classify the input patters of a system with different stiffness ratios. It has been investigated a large set of input data, containing various stiffness ratios as well as a reduced set containing only the extreme ones in order to study generalizing capability of the network. This allows to definition of Neural Networks capable to use a reduced set of data during the training phase. Once it is successfully trained, it could identify intermediate failure condition. Several conditions and intensities of damages have been studied by using numerical data. The Neural Network demonstrated a good capacity of generalization for all case. Finally, the proposal was tested with experimental data.

Structural Health Monitoring in Smart Structures Through Time Series Analysis

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Microbiological Evaluation of Chicken Carcasses in an Immersion Chilling System with Water Renewal at 8 and 16 Hours

Since 2004, Brazil has been the leading exporter of chicken. Because of the importance of this sector in the Brazilian economy, food safety must be ensured by control and monitoring of the production stages susceptible to contamination, such as the chilling process. The goal of this study was to evaluate changes in microbial levels on chicken carcasses and in chilling water after immersion in a chilling system for 8 and 16 h during commercial processing. An objective of the study was to encourage discussion regarding the Brazilian Ministry of Agriculture Livestock and Food Supply regulation that requires chicken processors to completely empty, clean, and disinfect each tank of the chilling system after every 8-h shift. Before and after immersion carcasses were collected and analyzed for mesophilic bacteria, Enterobacteriaceae, conforms, and Escherichia coli. Samples of water from the chilling system were also analyzed for residual free chlorine. The results do not support required emptying of the chiller tank after 8 h; these tanks could be emptied after 16 h. The results for all carcasses tested at the 8- and 16-h time points indicated no significant differences in the microbiological indicators evaluated. These data provide both technical and scientific support for discussing changes in federal law regarding the management of immersion chilling water systems used as part of the poultry processing line.

Allium cepa test in environmental monitoring: A review on its application

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)