896 resultados para Continuous quality improvement


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With increasing recognition of the roles RNA molecules and RNA/protein complexes play in an unexpected variety of biological processes, understanding of RNA structure-function relationships is of high current importance. To make clean biological interpretations from three-dimensional structures, it is imperative to have high-quality, accurate RNA crystal structures available, and the community has thoroughly embraced that goal. However, due to the many degrees of freedom inherent in RNA structure (especially for the backbone), it is a significant challenge to succeed in building accurate experimental models for RNA structures. This chapter describes the tools and techniques our research group and our collaborators have developed over the years to help RNA structural biologists both evaluate and achieve better accuracy. Expert analysis of large, high-resolution, quality-conscious RNA datasets provides the fundamental information that enables automated methods for robust and efficient error diagnosis in validating RNA structures at all resolutions. The even more crucial goal of correcting the diagnosed outliers has steadily developed toward highly effective, computationally based techniques. Automation enables solving complex issues in large RNA structures, but cannot circumvent the need for thoughtful examination of local details, and so we also provide some guidance for interpreting and acting on the results of current structure validation for RNA.

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High pollution levels have been often observed in urban street canyons due to the increased traffic emissions and reduced natural ventilation. Microscale dispersion models with different levels of complexity may be used to assess urban air qualityand support decision-making for pollution control strategies and traffic planning. Mathematical models calculate pollutant concentrations by solving either analytically a simplified set of parametric equations or numerically a set of differential equations that describe in detail wind flow and pollutant dispersion. Street canyon models, which might also include simplified photochemistry and particle deposition–resuspension algorithms, are often nested within larger-scale urban dispersion codes. Reduced-scale physical models in wind tunnels may also be used for investigating atmospheric processes within urban canyons and validating mathematical models. A range of monitoring techniques is used to measure pollutant concentrations in urban streets. Point measurement methods (continuous monitoring, passive and active pre-concentration sampling, grab sampling) are available for gaseous pollutants. A number of sampling techniques (mainlybased on filtration and impaction) can be used to obtain mass concentration, size distribution and chemical composition of particles. A combination of different sampling/monitoring techniques is often adopted in experimental studies. Relativelysimple mathematical models have usually been used in association with field measurements to obtain and interpret time series of pollutant concentrations at a limited number of receptor locations in street canyons. On the other hand, advanced numerical codes have often been applied in combination with wind tunnel and/or field data to simulate small-scale dispersion within the urban canopy.

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This paper concerns the development and validation (using an oil/water system) of a finite volume computer model of the continuous casting process for steel flat products. The emphasis is on hydrodynamic aspects and in particular the dynamic behaviour of the metal/slag interface. Instability and wave action encourage the entrainment of inclusions into the melt affecting product quality. To track the interface between oil and water a new implicit algorithm was developed, called the Counter Diffusion Method. To prevent excessive damping, a time-filtered version of the k-e model, was found necessary, with appropriate density stratification terms representing interface turbulence damping.

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The Continuous Plankton Recorder (CPR) survey was conceived from the outset as a programme of applied research designed to assist the fishing industry. Its survival and continuing vigour after 70 years is a testament to its utility, which has been achieved in spite of great changes in our understanding of the marine environment and in our concerns over how to manage it. The CPR has been superseded in several respects by other technologies, such as acoustics and remote sensing, but it continues to provide unrivalled seasonal and geographic information about a wide range of zooplankton and phytoplankton taxa. The value of this coverage increases with time and provides the basis for placing recent observations into the context of long-term, large-scale variability and thus suggesting what the causes are likely to be. Information from the CPR is used extensively in judging environmental impacts and producing quality status reports (QSR); it has shown the distributions of fish stocks, which had not previously been exploited; it has pointed to the extent of ungrazed phytoplankton production in the North Atlantic, which was a vital element in establishing the importance of carbon sequestration by phytoplankton. The CPR continues to be the principal source of large-scale, long-term information about the plankton ecosystem of the North Atlantic. It has recently provided extensive information about the biodiversity of the plankton and about the distribution of introduced species. It serves as a valuable example for the design of future monitoring of the marine environment and it has been essential to the design and implementation of most North Atlantic plankton research.

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Purpose – The purpose of this paper is to focus on the growing interest of the role of business in society, commonly referred to as CSR. Historically CSR can be traced back to the 1950s, although in very recent times there has been a virtual explosion of interest in its use and applicability in organisations. However, there are many unresolved issues, most notably in terms of how CSR should or can be implemented and embedded in an organisation. This paper therefore seeks to explore the relationship and potential synergies between quality management and CSR. Design/methodology/approach – The qualitative exploratory study in this paper represents the first stage of an ongoing research programme, and is based on an in-depth analysis of quality award submission documentation from six case organisations that have recently been recognised as winners in relation to their quest for business improvement. Findings – The paper finds that substantial evidence from each of the case organisations demonstrates the breadth and depth of activities in which they are engaging under the broad headings of workplace, environment, social impact, and economic impact. However, whilst there is no doubting the sincerity of the actions, the approaches and activities, a strategic focus on CSR is still very much in its infancy. Research limitations/implications – In this paper there is a paucity of empirical research examining how existing management tools, techniques and methodologies can be used to further the CSR debate. This paper represents an important first step in redressing this imbalance. Practical implications – The paper suggests that the quality management and business excellence frameworks can offer a strong foundation from which to develop CSR strategies, behaviours and activities in an organisation. Originality/value – This paper represents an important first step in understanding how and where CSR “fits” into an organisation and potentially how existing quality methodologies, tools and frameworks can be used to aid the implementation of CSR.

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In this paper we analyze the partial grades – of continuous assessment activities including the final exam – and the final grades – computed as a weighted average of partial grades – for nine subjects taught in the third year of Business Administration Degree. On one hand, results show that there is a significant positive correlation between the grades of continuous assessment activities (excluded the final exam) and final exam in seven subjects. On the other hand, overall we find that students’ grades in continuous assessment activities (excluded the final exam) help in the improvement of their final grades (i.e., students’ final grades exceed the grades that they would obtain by only taking into account their final exam grades). The results are consistent when the analysis is carried out over each subject area as well as over the grades of the students who registered for the nine subjects.

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Este artículo resulta de investigaciones en torno al “enverdecimiento” de las ciudades y las oportunidades de la agricultura urbana para la alimentación de una población en constante aumento que no trabaja la tierra. También es fruto de actividades de mejora de ambientes urbanos realizadas con la Escuela de Ingenieros Agrónomos de la Universidad Politécnica de Madrid. A través de casos de agricultura urbana, entendiendo por ella el conjunto de prácticas para la producción de alimentos y plantas ornamentales dentro de las ciudades y en sus entornos, se analizan alternativas para la recuperación de espacios construidos e incremento de la calidad de vida de la población. Todo ello se traduce, además, en creación de riqueza y mejora del paisaje urbano, siempre desde criterios de sostenibilidad que favorecen el desarrollo local desde la Cumbre de la Tierra de Río de 1992 y la Conferencia sobre Desarrollo Sostenible Río+20 de 2013.

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Patients with bronchiectasis often have impaired quality of life (QoL), which deteriorates with exacerbations. The aim of this study was to investigate changes in QoL and how these were influenced by changes in airway physiology and inflammation in patients with bronchiectasis before and after resolution of an exacerbation. Sputum induction and a QoL questionnaire were undertaken on the first day, day 14, and 4 weeks after completion of intravenous antibiotics (day 42). Eighteen patients (12 female) were recruited, median (IQ range) age of 54 (47–60) years. There was a trend towards an improvement in lung function from visit 1 to visit 2, but this was not statistically significant. C-reactive protein (CRP) [mean (SEM)] reduced between visit 1 and visit 2 [55.4 (21.5) vs 9.4 (3.1) mg/L, P = 0.03] but did not increase significantly on visit 3 [44.4 (32.9) mg/L, P = 0.27]. The median (interquartile range) sputum cell count (×106 cells/g of sputum) decreased from visit 1 to visit 2 [21.6 (11.8–37.6)–13.3 (6.7–22.9) × 106 cells/g, respectively, P = 0.008] and increased from visit 2 to visit 3 [26.3 (14.1–33.6) × 106 cells/g, P = 0.03]. All soluble markers of inflammation significantly reduced from visit 1 to visit 2 but increased on visit 3 with the exception of TNF-a. Regarding QoL, three of the four domains (dyspnoea, emotional, mastery) significantly improved from visit 1 to visit 2 but did not change between visit 2 and visit 3. The improvements in QoL scores could not be explained by the improvements in lung function or inflammatory markers.

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Background: When cure is impossible, cancer treatment should focus on both length and quality of life. Maximisation of time without toxic effects could be one effective strategy to achieve both of these goals. The COIN trial assessed preplanned treatment holidays in advanced colorectal cancer to achieve this aim. Methods: COIN was a randomised controlled trial in patients with previously untreated advanced colorectal cancer. Patients received either continuous oxaliplatin and fluoropyrimidine combination (arm A), continuous chemotherapy plus cetuximab (arm B), or intermittent (arm C) chemotherapy. In arms A and B, treatment continued until development of progressive disease, cumulative toxic effects, or the patient chose to stop. In arm C, patients who had not progressed at their 12-week scan started a chemotherapy-free interval until evidence of disease progression, when the same treatment was restarted. Randomisation was done centrally (via telephone) by the MRC Clinical Trials Unit using minimisation. Treatment allocation was not masked. The comparison of arms A and B is described in a companion paper. Here, we compare arms A and C, with the primary objective of establishing whether overall survival on intermittent therapy was non-inferior to that on continuous therapy, with a predefined non-inferiority boundary of 1·162. Intention-to-treat (ITT) and per-protocol analyses were done. This trial is registered, ISRCTN27286448. Findings: 1630 patients were randomly assigned to treatment groups (815 to continuous and 815 to intermittent therapy). Median survival in the ITT population (n=815 in both groups) was 15·8 months (IQR 9·4—26·1) in arm A and 14·4 months (8·0—24·7) in arm C (hazard ratio [HR] 1·084, 80% CI 1·008—1·165). In the per-protocol population (arm A, n=467; arm C, n=511), median survival was 19·6 months (13·0—28·1) in arm A and 18·0 months (12·1—29·3) in arm C (HR 1·087, 0·986—1·198). The upper limits of CIs for HRs in both analyses were greater than the predefined non-inferiority boundary. Preplanned subgroup analyses in the per-protocol population showed that a raised baseline platelet count, defined as 400 000 per µL or higher (271 [28%] of 978 patients), was associated with poor survival with intermittent chemotherapy: the HR for comparison of arm C and arm A in patients with a normal platelet count was 0·96 (95% CI 0·80—1·15, p=0·66), versus 1·54 (1·17—2·03, p=0·0018) in patients with a raised platelet count (p=0·0027 for interaction). In the per-protocol population, more patients on continuous than on intermittent treatment had grade 3 or worse haematological toxic effects (72 [15%] vs 60 [12%]), whereas nausea and vomiting were more common on intermittent treatment (11 [2%] vs 43 [8%]). Grade 3 or worse peripheral neuropathy (126 [27%] vs 25 [5%]) and hand—foot syndrome (21 [4%] vs 15 [3%]) were more frequent on continuous than on intermittent treatment. Interpretation: Although this trial did not show non-inferiority of intermittent compared with continuous chemotherapy for advanced colorectal cancer in terms of overall survival, chemotherapy-free intervals remain a treatment option for some patients with advanced colorectal cancer, offering reduced time on chemotherapy, reduced cumulative toxic effects, and improved quality of life. Subgroup analyses suggest that patients with normal baseline platelet counts could gain the benefits of intermittent chemotherapy without detriment in survival, whereas those with raised baseline platelet counts have impaired survival and quality of life with intermittent chemotherapy and should not receive a treatment break.

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In this paper, we investigate the remanufacturing problem of pricing single-class used products (cores) in the face of random price-dependent returns and random demand. Specifically, we propose a dynamic pricing policy for the cores and then model the problem as a continuous-time Markov decision process. Our models are designed to address three objectives: finite horizon total cost minimization, infinite horizon discounted cost, and average cost minimization. Besides proving optimal policy uniqueness and establishing monotonicity results for the infinite horizon problem, we also characterize the structures of the optimal policies, which can greatly simplify the computational procedure. Finally, we use computational examples to assess the impacts of specific parameters on optimal price and reveal the benefits of a dynamic pricing policy. © 2013 Elsevier B.V. All rights reserved.

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Herein batch and continuous mesophilic anaerobic digestion of grass silage liquor was studied. The continuous process was carried out in Armfield digesters with an OLR ranging from 0.851 to 1.77 kg COD m-3 day-1. The effect of recirculation of effluent from the digester was investigated using different OLRs of grass silage liquor feed. These results showed that as the OLR increased, the methane yield decreased for the reactor with no recycle and increased for the reactor with recycle. However, the COD removal for both digesters was nearly the same at the same OLR. Overall these studies show that grass silage liquor can produce a high quality methane steam between 70% and 80% and achieve methane yields of 0.385 m3 kg-1 COD.

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Laser plasma interferograms are currently analyzed by extraction of the phase-shift map with fast Fourier transform (FFT) techniques [Appl. Opt. 18, 3101 (1985)]. This methodology works well when interferograms are only marginally affected by noise and reduction of fringe visibility, but it can fail to produce accurate phase-shift maps when low-quality images are dealt with. We present a novel procedure for a phase-shift map computation that makes extensive use of the ridge extraction in the continuous wavelet transform (CWT) framework. The CWT tool is flexible because of the wide adaptability of the analyzing basis, and it can be accurate because of the intrinsic noise reduction in the ridge extraction. A comparative analysis of the accuracy performances of them new tool and the FFT-based one shows that the CWT-based tool produces phase maps considerably less noisy and that it can better resolve local inhomogeneties. (C) 2001 Optical Society of America.

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Aim. To report a study measuring the quality of life and side effects in men receiving radiotherapy and hormone ablation for prostate cancer up to 1year after treatment. Background. Prostate cancer incidence is increasing with the result that more men are living longer with the disease and the side effects of treatment. It is important to know the effects this has on their quality of life. Design. Survey. Method. Between September 2006-September 2007, all men who were about to undergo radical conformal radiotherapy ± neo-adjuvant androgen deprivation for localized prostate cancer were invited to participate in the study; 149 men were recruited. They completed the European Organization on Research and Treatment of Cancer quality of life questionnaire C-30 and Prostate Cancer module PR25 at four time-points. Results. At 4-6weeks after radiotherapy, participants experienced the biggest relative decline in global quality of life, social, physical, and role functioning and an increase in treatment side effects. At 6months postradiotherapy the majority of men experienced an improvement in their side effects. However, a minority of men were experiencing severe side effects of radiotherapy at 1year post-treatment. Single men and men who had a low quality of life prior to radiotherapy, reported a lower quality of life at 1year after treatment in comparison to married men. Conclusion. Men with prostate cancer suffer limitations due to the symptoms they experience and disruption to their quality of life. It is essential that nurses develop and deliver follow-up care which is flexible and appropriate to the individual needs of these men. © 2012 Blackwell Publishing Ltd.

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Improvement in the quality of end-of-life (EOL) care is a priority health care issue since serious deficiencies in quality of care have been reported across care settings. Increasing pressure is now focused on Canadian health care organizations to be accountable for the quality of palliative and EOL care delivered. Numerous domains of quality EOL care upon which to create accountability frameworks are now published, with some derived from the patient/family perspective. There is a need to reach common ground on the domains of quality EOL care valued by patients and families in order to develop consistent performance measures and set priorities for health care improvement. This paper describes a meta-synthesis study to develop a common conceptual framework of quality EOL care integrating attributes of quality valued by patients and their families. © 2005 Centre for Bioethics, IRCM.