Space charge and dielectric response measurements to assess insulation aging of low-voltage cables used in nuclear power plants

The current design life of nuclear power plant (NPP) could potentially be extended to 80 years. During this extended plant life, all safety and operationally relevant Instrumentation & Control (I&C) systems are required to meet their designed performance requirements to ensure safe and reliable operation of the NPP, both during normal operation and subsequent to design base events. This in turn requires an adequate and documented qualification and aging management program. It is known that electrical insulation of I&C cables used in safety related circuits can degrade during their life, due to the aging effect of environmental stresses, such as temperature, radiation, vibration, etc., particularly if located in the containment area of the NPP. Thus several condition monitoring techniques are required to assess the state of the insulation. Such techniques can be used to establish a residual lifetime, based on the relationship between condition indicators and ageing stresses, hence, to support a preventive and effective maintenance program. The object of this thesis is to investigate potential electrical aging indicators (diagnostic markers) testing various I&C cable insulations subjected to an accelerated multi-stress (thermal and radiation) aging.

Estimating the Value of Source Verification in Iowa Feeder Cattle Markets

Source verification and pooling of feeder cattle into larger lots resulted in higher selling prices compared to more typical sales at a southern Iowa auction market. After higher prices due to larger lot sizes were accounted for, cattle that received a specified management program and were source verified as to origin received additional price premiums. The data do not distinguish between the value of the specific management program and the value of the source verification process. However, cow–calf producers participating in the program took home more money.

Estimating the Value of Source Verification in Iowa Feeder Cattle Markets

Source verification and pooling of feeder cattle into larger lots resulted in higher selling prices compared with more typical sales at a southern Iowa auction market. After accounting for higher prices due to larger lot sizes, cattle that received a specified management program and were source verified as to origin received additional price premiums. The data do not distinguish between the value of the specific management program and the value of the source verification process. However, cow-calf producers participating in the program took home more money.

Possible Demographic Consequences of Intraspecific Shelter Competition Among American Lobsters

Pioneering work by J. Stan Cobb described how habitat architecture and body size scaling affect shelter-related behavior of American lobsters. Subsequent research suggested that shelter availability and competition could set local carrying capacity and demographics for this species. To determine how shelter spacing affects population density, the intensity of intraspecific competition and the distribution of body size for this species, I deployed sets of 10 identically sized artificial shelters spaced at distances of 2.5, 0.5, 1.0, 1.5 and 2.0 meters on otherwise featureless substrate at 10 m depth in mid-coast Maine, U.S.A. Five sets had two parallel strings of five opposing shelters and an additional linear string set 2 to apart without opposing shelters was the most widely separated treatment. Shelters spaced I m apart and closer had higher lobster population densities, more intraspecific competition and higher proportions of empty shelters. Surprisingly, lobsters there were also significantly smaller, declining from 62.7 mm to 50.9 on the carapace (CL) for 2 to linear to 0.25 m spaced shelters, respectively. Nearly all 932 lobsters measured in this study were juvenile (< 90 mm CL) and preharvestable (< 83 mm CL) sized, so mate selection and fishing effects were unlikely. At the scale of the experiment, larger lobsters leave or avoid areas of high lobster population density and intense competition for areas of low population density and relaxed competition (called "demographic diffusion"). Scuba surveys in coastal zones found lobster population densities scale with shelter densities and were highest in boulder habitat where, like the experiment, more than half the shelters were vacant. Fisheries independent scuba and trawl surveys in Maine's shallow coastal zone repeatedly recorded declines of preharvestable, lobsters larger than 60 turn CL in size and increases of those sizes offshore and in deep water. It is possible that this demographic diffusion is driven by behaviors associated with intraspecific shelter competition.

Seasonal Distributions of Satellite-Measured Phytoplankton Pigment Concentration Along the Chilean Coast

Five years (1979-1983) of Coastal Zone Color Scanner satellite ocean color data are used to examine seasonal patterns of phytoplankton pigment concentration along the Chilean coast from 20 degrees S to 45 degrees S. Four kilometer resolution, 2-4 day composites document the presence of filaments of elevated pigment concentration extending offshore throughout the study area, with maximum offshore extension at higher latitudes. In three years, 1979, 1981, and 1983, sufficient data exist in monthly composites to allow recreation of portions of the seasonal cycle. Data in 1979 are the most complete. Near-shore concentrations and cross-shelf extension of pigment concentrations in 1979 are maximum in austral winter throughout the study area and minimum in summer. Available data from 1981 and 1983 are consistent with this temporal pattern but with concentrations approximately double those of 1979. Seasonal, spatial patterns within 10 km of shore and 50 km offshore indicate a latitudinal discontinuity both in absolute concentration and in the magnitude of the seasonal cycle at approximately 33 degrees S in both 1979 and in the climatological time series. The discontinuity is strongest ill fall-winter and weakest in summer. South of this latitude, concentrations are relatively high (2-3 mg m(-3) in 1979), a strong seasonal cycle is present, and patterns 50 km offshore are correlated with those within 10 km of shore. North of 33 degrees S, concentrations are < 1.5 mg m(-3) (in 1979), and the seasonal cycle within 10 km of shore is present but much weaker and less obviously correlated with that 50 km offshore. The seasonal cycle of pigment concentrations is 180 degrees out of phase with monthly averaged upwelling favorable winds. Noncoincident Pathfinder sea surface temperature data show that over most latitudes, coastal low surface temperatures lag wind forcing by 1-2 months, but these too are out of phase with the pigment seasonal cycle. These data point to control of pigment patterns along the Chilean coast by the interaction of upwelling with circulation patterns unconnected to local wind forcing.

Border intervention by Promotores for type 2 diabetes

Purpose of the study. This study had two components. The first component of the study was the development and implementation of an infrastructure that integrated Promotores who teach diabetes self-management into a community clinic. The second component was a six-month randomized clinical trial (RCT) designed to test the effectiveness of the Promotores in changing knowledge, beliefs, and HbA1c levels among Mexican American patients with type 2 diabetes. ^ Methods. Starfield's adaptation of the Donbedian structure, process, and outcome methodology was used to develop a clinic infrastructure that allowed the integration of Promotores as diabetes educators. The RCT of the culturally sensitive Promotores-led 10-week diabetes self-management program compared the outcomes of 63 patients in the intervention group with 68 patients in a wait-list, usual care control group. Participants were Mexican Americans, at least 18 years of age, with type 2 diabetes, who were patients at a Federally Qualified Health Center on the Texas-Mexico border. At baseline, three months, and six months, data were collected using the Diabetes Knowledge Questionnaire (DKQ, the Health Beliefs Questionnaire (HBQ, and HbA1c levels were drawn by the clinic laboratory. A mixed model methodology was used to analyze the data. ^ Results. The infrastructure to support a Promotores-led diabetes self-management course designed in concert with administration, the physicians, and the CDE, resulted in (1) employment of Promotores to teach diabetes self-management courses; (2) integration of provider and nurse oversight of course design and implementation; (3) management of Promotora training, and the development of teaching competencies and skills; (4) coordination of care through communication and documentation policies and procedures; (5) utilization of quality control mechanisms to maintain patient safety; and (6) promotion of a culturally competent approach to the educational process. The RCT resulted in a significant improvement in the intervention group's DKQ scores over time (F [1, 129] = 4.77, p = 0.0308), and in treatment by time (F [2, 168] = 5.85, p = 0.0035). Neither the HBQ scores nor the HbA1c changed over time. However, the baseline HbA1c was 7.49, almost at the therapeutic level. The DKQ, HBQ, and HbA1c results were significantly affected by age; the DKQ and HbA1c by years with diabetes. ^ Conclusions. The clinic model provides a systematic approach to safely address the educational needs of large numbers of patients with type 2 diabetes who live in communities that suffer from a lack of health care professionals. The Promotores-led diabetes self-management course improved the knowledge of patients with diabetes and may be a culturally sensitive strategy for meeting patient educational needs. The low baseline HbA1c levels in this border community suggested that patients in this Federally Qualified Health Center on the Texas-Mexico border were experiencing good medical management of their diabetes. ^

The role of workplace absence as an organizational mechanism in predicting employee alcohol and drug disorders

Background. EAP programs for airline pilots in companies with a well developed recovery management program are known to reduce pilot absenteeism following treatment. Given the costs and safety consequences to society, it is important to identify pilots who may be experiencing an AOD disorder to get them into treatment. ^ Hypotheses. This study investigated the predictive power of workplace absenteeism in identifying alcohol or drug disorders (AOD). The first hypothesis was that higher absenteeism in a 12-month period is associated with higher risk that an employee is experiencing AOD. The second hypothesis was that AOD treatment would reduce subsequent absence rates and the costs of replacing pilots on missed flights. ^ Methods. A case control design using eight years (time period) of monthly archival absence data (53,000 pay records) was conducted with a sample of (N = 76) employees having an AOD diagnosis (cases) matched 1:4 with (N = 304) non-diagnosed employees (controls) of the same profession and company (male commercial airline pilots). Cases and controls were matched on the variables age, rank and date of hire. Absence rate was defined as sick time hours used over the sum of the minimum guarantee pay hours annualized using the months the pilot worked for the year. Conditional logistic regression was used to determine if absence predicts employees experiencing an AOD disorder, starting 3 years prior to the cases receiving the AOD diagnosis. A repeated measures ANOVA, t tests and rate ratios (with 95% confidence intervals) were conducted to determine differences between cases and controls in absence usage for 3 years pre and 5 years post treatment. Mean replacement costs were calculated for sick leave usage 3 years pre and 5 years post treatment to estimate the cost of sick leave from the perspective of the company. ^ Results. Sick leave, as measured by absence rate, predicted the risk of being diagnosed with an AOD disorder (OR 1.10, 95% CI = 1.06, 1.15) during the 12 months prior to receiving the diagnosis. Mean absence rates for diagnosed employees increased over the three years before treatment, particularly in the year before treatment, whereas the controls’ did not (three years, x = 6.80 vs. 5.52; two years, x = 7.81 vs. 6.30, and one year, x = 11.00cases vs. 5.51controls. In the first year post treatment compared to the year prior to treatment, rate ratios indicated a significant (60%) post treatment reduction in absence rates (OR = 0.40, CI = 0.28, 0.57). Absence rates for cases remained lower than controls for the first three years after completion of treatment. Upon discharge from the FAA and company’s three year AOD monitoring program, case’s absence rates increased slightly during the fourth year (controls, x = 0.09, SD = 0.14, cases, x = 0.12, SD = 0.21). However, the following year, their mean absence rates were again below those of the controls (controls, x = 0.08, SD = 0.12, cases, x¯ = 0.06, SD = 0.07). Significant reductions in costs associated with replacing pilots calling in sick, were found to be 60% less, between the year of diagnosis for the cases and the first year after returning to work. A reduction in replacement costs continued over the next two years for the treated employees. ^ Conclusions. This research demonstrates the potential for workplace absences as an active organizational surveillance mechanism to assist managers and supervisors in identifying employees who may be experiencing or at risk of experiencing an alcohol/drug disorder. Currently, many workplaces use only performance problems and ignore the employee’s absence record. A referral to an EAP or alcohol/drug evaluation based on the employee’s absence/sick leave record as incorporated into company policy can provide another useful indicator that may also carry less stigma, thus reducing barriers to seeking help. This research also confirms two conclusions heretofore based only on cross-sectional studies: (1) higher absence rates are associated with employees experiencing an AOD disorder; (2) treatment is associated with lower costs for replacing absent pilots. Due to the uniqueness of the employee population studied (commercial airline pilots) and the organizational documentation of absence, the generalizability of this study to other professions and occupations should be considered limited. ^ Transition to Practice. The odds ratios for the relationship between absence rates and an AOD diagnosis are precise; the OR for year of diagnosis indicates the likelihood of being diagnosed increases 10% for every hour change in sick leave taken. In practice, however, a pilot uses approximately 20 hours of sick leave for one trip, because the replacement will have to be paid the guaranteed minimum of 20 hour. Thus, the rate based on hourly changes is precise but not practical. ^ To provide the organization with practical recommendations the yearly mean absence rates were used. A pilot flies on average, 90 hours a month, 1080 annually. Cases used almost twice the mean rate of sick time the year prior to diagnosis (T-1) compared to controls (cases, x = .11, controls, x = .06). Cases are expected to use on average 119 hours annually (total annual hours*mean annual absence rate), while controls will use 60 hours. The cases’ 60 hours could translate to 3 trips of 20 hours each. Management could use a standard of 80 hours or more of sick time claimed in a year as the threshold for unacceptable absence, a 25% increase over the controls (a cost to the company of approximately of $4000). At the 80-hour mark, the Chief Pilot would be able to call the pilot in for a routine check as to the nature of the pilot’s excessive absence. This management action would be based on a company standard, rather than a behavioral or performance issue. Using absence data in this fashion would make it an active surveillance mechanism. ^

Pediatric obesity: Managed care collaborating with providers to improve diagnosis and treatment

Child overweight and obesity reaches across ethnic, cultural, socioeconomic and regional barriers. It must be assessed, diagnosed and treated to help families make sustainable behavior changes. Treatment recommendations have been made to address pediatric overweight and obesity. They include screening for risk factors, monitoring BMI trends and educating patients and families to make small sustainable changes. Health insurance companies can play a meaningful role in supporting and facilitating provider education and behavior change to diagnose, treat and prevent pediatric overweight and obesity.^ The aims of this thesis were: (1) Describe a disease management program that uses evidence-based practices to create provider behavior change related to pediatric obesity screening, diagnosis and treatment. (2) Identify ways to improve the implementation of the program based on the perceptions of participating clinicians.^ A literature review was completed to evaluate current recommendations for screening and treating pediatric obesity using the Ovid data base. The evidenced-based recommendations were compared against the practices of the Healthy Lifestyles Program (HeLP). The literature confirmed that HeLP is following evidence-based recommendations for assessment, diagnosis and treatment of pediatric obesity.^ A Children’s Mercy Family Health Partners focus group was convened to create a provider survey. The goals of the survey were to assess providers’ perception of the Healthy Lifestyles Program (HeLP). The survey was sent out through email using Survey Monkey. All survey responses were anonymous. The survey was sent to a total of 80 providers who had completed HeLP. Twenty-five percent responded. The survey results were evaluated to make recommendations for HeLP.^ Results of the survey included motivating factors for participation in HeLP. Concern about the increasing prevalence of pediatric obesity was a frequent motivator for participation. Provider barriers to obesity diagnosis were evaluated. Lack of time during clinic visits a frequent barrier to obesity diagnosis. ^ In conclusion several recommendations for the HeLP were made based on survey results. It is recommended that the program evaluate methods and tools for facilitating effective weight management follow up visits. Promotional materials should highlight the increasing prevalence of pediatric obesity when advertising HeLP. These recommendations will be used to refine the current Healthy Lifestyles Program.^