959 resultados para years of life lost


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In smaller countries where the key players in construction IT development tend to know each other personally and where public R&D funding is concentrated to a few channels, IT roadmaps and strategies would seem to have a better chance of influencing development than in the bigger industrial countries. In this paper Finland and the RATAS-project is presented as a historical case illustrating such impact. RATAS was initiated as a construction IT roadmap project in 1985, involving many of the key organisations and companies active in construction sector development. Several of the individuals who took an active part in the project have played an important role in later developments both in Finland and on the international scene. The central result of RATAS was the identification of what is nowadays called Building Information Modelling (BIM) technology as the central issue in getting IT into efficient use in the construction sector. BIM, which earlier was referred to as building product modelling, has been a key ingredient in many roadmaps since and the subject of international standardisation efforts such as STEP and IAI/IFCs. The RATAS project can in hindsight be seen as a forerunner with an impact which also transcended national borders.

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Health-related quality of life (HRQoL) measurement has become an important outcome in treatment trials and in health policy decisions. HRQoL can be measured by using generic or disease-specific tools. Generic instruments can be used for comparing health status among patients in different health states and conditions but they do not focus specifically on the issues relevant in a particular disease. Disease-specific tools may be more responsive to changes within a specific condition. In earlier studies, impairment of HRQoL has been evident in patients with inflammatory bowel disease (IBD), especially when the disease is active. Data about the impact of comorbidity or demographic characteristics of the patients on HRQoL are partly controversial. This study, which comprised 2913 adult IBD patients, examined HRQoL using the disease-specific IBDQ and the general 15D instruments. The 15D scores of IBD patients were compared with scores of a gender and age matched general population sample. Frequency of IBD symptoms and arrangement of therapy were studied and compared with those of IBD patients in an earlier European study. Furthermore, data of other chronic diseases of the patients were obtained from the Social Insurance Institution s reimbursement register and comorbidity of IBD patients was compared with that of age and gender matched controls. --- Of the respondents, 37% reported that they suffered from disturbing IBD symptoms weekly. In 17% of the patients, the symptoms greatly affected the ability to enjoy leisure activities, and 14% stated that these symptoms greatly affected their capacity to work. Despite that, the great majority (93%) of patients expressed satisfaction with their current treatment, which exceeded the rate observed in the other European patients. The mean IBDQ score was 163, as the possible range is 32-224, and disease activity was strongly correlated with HRQoL. Older age, comorbid diseases, and female gender were also related to impairment of HRQoL. Lower HRQoL scores were seen also in newly-diagnosed patients and in those with a history of surgery, especially after stoma or ileal pouch-anal anastomosis (IPAA) operation. The range of 15D scores was 0.30-1.00, with mean of 0.87. As with the IBDQ, disease activity, older age and history of surgery were correlated with the score. Both the newly-diagnosed patients and patients with a long-lasting disease had lower scores than average even after adjusting for age. The 15D scores of IBD patients were significantly lower than those of the control group. A strong correlation was seen between the 15D and the IBDQ scores. Comorbidity with other chronic diseases was observed in 29% of IBD patients. Connective tissue diseases, chronic obstructive pulmonary diseases, pernicious anaemia, and coronary heart disease (CHD) were significantly increased in patients with IBD. Especially female IBD patients appeared to be at increased risk for CHD, and patients who reported weekly IBD symptoms had a higher risk for having other chronic diseases in addition to IBD. Comorbidity impaired HRQoL, as measured with both generic and disease-specific tools. In conclusion, HRQoL is impaired in IBD patients. An understanding of predictors of HRQoL will help to recognise patients who will need special support.

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Click chemistry has played a significant role as a rapid and versatile strategy for conjugating two molecular fragments under very mild reaction conditions. Introduction of ferrocene-derived triazole systems using click chemistry has attracted enormous interest in various fields due to its potential applications in electrochemical techniques for detection and sensing. The present discussion focuses on the synthesis of ferrocene-triazole and the importance of using a CuAAC reaction for such conjugation. Applications of ferrocene-based click reactions in conjugate chemistry, asymmetric catalysis, medicinal chemistry, host-guest interactions, and materials chemistry have been highlighted.

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Epoxy resin bonded mica splitting is the insulation of choice for machine stators. However, this system is seen to be relatively weak under time varying mechanical stress, in particular the vibration causing delamination of mica and deboning of mica from the resin matrix. The situation is accentuated under the combined action of electrical, thermal and mechanical stress. Physical and probabilistic models for failure of such systems have been proposed by one of the authors of this paper earlier. This paper presents a pragmatic accelerated failure data acquisition and analytical paradigm under multi factor coupled stress, Electrical, Thermal. The parameters of the phenomenological model so developed are estimated based on sound statistical treatment of failure data.

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The Channel Islands—sometimes called the Galapagos of North America—are known for their great beauty, rich biodiversity, cultural heritage, and recreational opportunities. In 1980, in recognition of the islands’ importance, the United States Congress established a national park encompassing 5 of California’s Channel Islands (Santa Barbara, Anacapa, Santa Cruz, Santa Rosa, and San Miguel Islands) and waters within 1 nautical mile of the islands. In the same year, Congress declared a national marine sanctuary around each of these islands, including waters up to 6 nautical miles offshore. Approximately 60,000 people visit the Channel Islands each year for aquatic recreation such as fishing, sailing, kayaking, wildlife watching, surfing, and diving. Another 30,000 people visit the islands for hiking, camping, and sightseeing. Dozens of commercial fishing boats based in Santa Barbara, Ventura, Oxnard, and other ports go to the Channel Islands to catch squid, spiny lobster, sea urchin, rockfish, crab, sheephead, flatfish, and sea cucumber, among other species. In the past few decades, advances in fishing technology and the rising number of fishermen, in conjunction with changing ocean conditions and diseases, have contributed to declines in some marine fishes and invertebrates at the Channel Islands. In 1998, citizens from Santa Barbara and Ventura proposed establishment of no-take marine reserves at the Channel Islands, beginning a 4-year process of public meetings, discussions, and scientific analyses. In 2003, the California Fish and Game Commission designated a network of marine protected areas (MPAs) in state waters around the northern Channel Islands. In 2006 and 2007, the National Oceanic and Atmospheric Administration (NOAA) extended the MPAs into the national marine sanctuary’s deeper, federal waters. To determine if the MPAs are protecting marine species and habitats, scientists are monitoring ecological changes. They are studying changes in habitats; abundance and size of species of interest; the ocean food web and ecosystem; and movement of fish and invertebrates from MPAs to surrounding waters. Additionally, scientists are monitoring human activities such as commercial and recreational fisheries, and compliance with MPA regulations. This booklet describes some results from the first 5 years of monitoring the Channel Islands MPAs. Although 5 years is not long enough to determine if the MPAs will accomplish all of their goals, this booklet offers a glimpse of the changes that are beginning to take place and illustrates the types of information that will eventually be used to assess the MPAs’ effectiveness. (PDF contains 24 pages.)

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Executive Summary: Circulation and Exchange of Florida Bay and South Florida Coastal Waters The coastal ecosystem of South Florida is comprised of distinct marine environments. Circulation of surface waters and exchange processes, which respond to both local and regional forcings, interconnect different coastal environments. In addition, re-circulating current systems within the South Florida coastal ecosystem such as the Tortugas Gyre contribute to retention of locally spawned larvae. Variability in salinity, chlorophyll, and light transmittance occurs on a wide range of temporal and spatial scales, in response to both natural forcing, such as seasonal precipitation and evaporation and interannual “El Niño” climate signals, and anthropogenic forcing, such as water management practices in south Florida. The full time series of surface property maps are posted at www.aoml.noaa.gov/sfp. Regional surface circulation patterns, shown by satellite-tracked surface drifters, respond to large-scale forcing such as wind variability and sea level slopes. Recent patterns include slow flow from near the mouth of the Shark River to the Lower Keys, rapid flow from the Tortugas to the shelf of the Carolinas, and flow from the Tortugas around the Tortugas Gyre and out of the Florida Straits. The Southwest Florida Shelf and the Atlantic side of the Florida Keys coastal zone are directly connected by passages between the islands of the Middle and Lower Keys. Movement of water between these regions depends on a combination of local wind-forced currents and gravitydriven transports through the passages, produced by cross-Key sea level differences on time scales of several days to weeks, which arise because of differences in physical characteristics (shape, orientation, and depth) of the shelf on either side of the Keys. A southeastward mean flow transports water from western Florida Bay, which undergoes large variations in water quality, to the reef tract. Adequate sampling of oceanographic events requires both the capability of near real-time recognition of these events, and the flexibility to rapidly stage targeted field sampling. Capacity to respond to events is increasing, as demonstrated by investigations of the 2002 “blackwater” event and a 2003 entrainment of Mississippi River water to the Tortugas. (PDF contains 364 pages.)