1000 resultados para Approche design
Resumo:
State Highway Departments and local street and road agencies are currently faced with aging highway systems and a need to extend the life of some of the pavements. The agency engineer should have the opportunity to explore the use of multiple surface types in the selection of a preferred rehabilitation strategy. This study was designed to look at the portland cement concrete overlay alternative and especially the design of overlays for existing composite (portland cement and asphaltic cement concrete) pavements. Existing design procedures for portland cement concrete overlays deal primarily with an existing asphaltic concrete pavement with an underlying granular base or stabilized base. This study reviewed those design methods and moved to the development of a design for overlays of composite pavements. It deals directly with existing portland cement concrete pavements that have been overlaid with successive asphaltic concrete overlays and are in need of another overlay due to poor performance of the existing surface. The results of this study provide the engineer with a way to use existing deflection technology coupled with materials testing and a combination of existing overlay design methods to determine the design thickness of the portland cement concrete overlay. The design methodology provides guidance for the engineer, from the evaluation of the existing pavement condition through the construction of the overlay. It also provides a structural analysis of various joint and widening patterns on the performance of such designs. This work provides the engineer with a portland cement concrete overlay solution to composite pavements or conventional asphaltic concrete pavements that are in need of surface rehabilitation.
Resumo:
An easy-living home requires a full-sized bathroom on the main level. Family members will appreciate the extra space and guests of all ages and abilities will feel more welcome. At a minimum, you’ll need a five foot circle of open floor space for maneuvering a wheelchair between bathroom fixtures. A small powder room won’t work for guests who use walkers or wheelchairs. A shower stall—with no curb to step over—is more convenient than a tub for most guests. Make sure the doorway opening for the bathroom is at least 32 inches wide (preferably 36 inches). Universal design features, such as these, make homes better for everyone.
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If they don’t carry the item, ask them to order it for you. Look at discount stores, such as Target, Wal-Mart, K-Mart, or Menard’s (they are more likely to carry items with universal design features). Look at the “Gadgets and Gizmos” section of the Iowa State University Extension Web site on “Universal Design & Home Accessibility.”
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Contexte : La prise en charge de l'artériopathie périphérique et de l'ischémie critique a fortement évolué depuis plusieurs années en faveur des traitements endovasculaires. En effet, la revascularisation chirurgicale a prouvé son efficacité à moyen et long terme mais reste invasif avec un temps de séjour hospitalier prolongé. Plusieurs études ont démontré l'intérêt de la prise en charge endovasculaire afin de réduire la morbidité et diminuer la durée de séjour. Néanmoins, elle n'offre pas des taux de succès à moyen et long terme équivalent à la chirurgie. Une approche hybride chirurgicale et endovasculaire cherchant à utiliser les avantages des 2 techniques pourrait permettre d'obtenir des taux de succès élevé avec un taux de complication plus faible. Objectifs : Nos objectifs sont d'analyser rétrospectivement la population de patients ayant bénéficié d'une approche hybride pour la revascularisation des membres inférieurs pour une claudication intermittente ou une ischémie critique. Le taux de mortalité à 30 jours ainsi que les complications locales et systémiques seront relevés. Les taux de perméabilité à 12 mois seront également analysés. Finalement, le taux de sauvetage de membre ainsi que le pourcentage de déambulation seront reportés. Méthodes : La cohorte de patients ayant bénéficié d'une approche hybride dans le service de chirurgie thoracique et vasculaire du CHUV de janvier 2008 à janvier 2011 seront systématiquement inclus dans l'analyse. L'ensemble des données démographiques et angiologiques seront reportés dans un cahier d'observation. De plus, tous les événements liés à des complications locales ou systémiques seront également analysés. Les décès seront reportés. Un appel téléphonique au patient et à son médecin traitant permettra de connaître l'état de santé actuel du patient ainsi que sa capacité à la marche. Une analyse statistique comportant une courbe de survivre selon Kaplan Meier permettra d'analyser le taux de perméabilité ainsi que la survie à moyen terme. Résultats escomptés : Les résultats devraient nous démontrés un taux de perméabilité supérieur ou équivalent à la prise en charge séparée chirurgicale ou endovasculaire. De plus les complications locales devraient être inférieures au taux obtenus dans la prise en charge chirurgicale. Le taux de sauvetage de membre et de déambulation pourrait être identique à la prise en charge chirurgicale. Plus value escomptés : L'approche hybride pour la revascularisation des membres inférieurs reste peu décrite dans la littérature. Cette étude permettra de décrire de manière globale une grande cohorte de patients homogène ayant bénéficié de cette approche dans un seul centre. Elle démontrera aussi l'éventuel intérêt de ce type de prise en charge pour les patients souffrant d'une artériopathie périphérique multiétagée.
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Childhood obesity and physical inactivity are increasing dramatically worldwide. Children of low socioeconomic status and/or children of migrant background are especially at risk. In general, the overall effectiveness of school-based programs on health-related outcomes has been disappointing. A special gap exists for younger children and in high risk groups. This paper describes the rationale, design, curriculum, and evaluation of a multicenter preschool randomized intervention study conducted in areas with a high migrant population in two out of 26 Swiss cantons. Twenty preschool classes in the German (canton St. Gallen) and another 20 in the French (canton Vaud) part of Switzerland were separately selected and randomized to an intervention and a control arm by the use of opaque envelopes. The multidisciplinary lifestyle intervention aimed to increase physical activity and sleep duration, to reinforce healthy nutrition and eating behaviour, and to reduce media use. According to the ecological model, it included children, their parents and the teachers. The regular teachers performed the majority of the intervention and were supported by a local health promoter. The intervention included physical activity lessons, adaptation of the built infrastructure; promotion of regional extracurricular physical activity; playful lessons about nutrition, media use and sleep, funny homework cards and information materials for teachers and parents. It lasted one school year. Baseline and post-intervention evaluations were performed in both arms. Primary outcome measures included BMI and aerobic fitness (20 m shuttle run test). Secondary outcomes included total (skinfolds, bioelectrical impedance) and central (waist circumference) body fat, motor abilities (obstacle course, static and dynamic balance), physical activity and sleep duration (accelerometry and questionnaires), nutritional behaviour and food intake, media use, quality of life and signs of hyperactivity (questionnaires), attention and spatial working memory ability (two validated tests). Researchers were blinded to group allocation. The purpose of this paper is to outline the design of a school-based multicenter cluster randomized, controlled trial aiming to reduce body mass index and to increase aerobic fitness in preschool children in culturally different parts of Switzerland with a high migrant population. Trial Registration: (clinicaltrials.gov) NCT00674544.
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According to the 1972 Clean Water Act, the Environmental Protection Agency (EPA) established a set of regulations for the National Pollutant Discharge Elimination System (NPDES). The purpose of these regulations is to reduce pollution of the nation’s waterways. In addition to other pollutants, the NPDES regulates stormwater discharges associated with industrial activities, municipal storm sewer systems, and construction sites. Phase II of the NPDES stormwater regulations, which went into effect in Iowa in 2003, applies to construction activities that disturb more than one acre of ground. The regulations also require certain communities with Municipal Separate Storm Sewer Systems (MS4) to perform education, inspection, and regulation activities to reduce stormwater pollution within their communities. Iowa does not currently have a resource to provide guidance on the stormwater regulations to contractors, designers, engineers, and municipal staff. The Statewide Urban Design and Specifications (SUDAS) manuals are widely accepted as the statewide standard for public improvements. The SUDAS Design manual currently contains a brief chapter (Chapter 7) on erosion and sediment control; however, it is outdated, and Phase II of the NPDES stormwater regulations is not discussed. In response to the need for guidance, this chapter was completely rewritten. It now escribes the need for erosion and sediment control and explains the NPDES stormwater regulations. It provides information for the development and completion of Stormwater Pollution Prevention Plans (SWPPPs) that comply with the stormwater regulations, as well as the proper design and implementation of 28 different erosion and sediment control practices. In addition to the design chapter, this project also updated a section in the SUDAS Specifications manual (Section 9040), which describes the proper materials and methods of construction for the erosion and sediment control practices.
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In this paper, we examine the design of permit trading programs when the objective is to minimize the cost of achieving an ex ante pollution target, that is, one that is defined in expectation rather than an ex post deterministic value. We consider two potential sources of uncertainty, the presence of either of which can make our model appropriate: incomplete information on abatement costs and uncertain delivery coefficients. In such a setting, we find three distinct features that depart from the well-established results on permit trading: (1) the regulator’s information on firms’ abatement costs can matter; (2) the optimal permit cap is not necessarily equal to the ex ante pollution target; and (3) the optimal trading ratio is not necessarily equal to the delivery coefficient even when it is known with certainty. Intuitively, since the regulator is only required to meet a pollution target on average, she can set the trading ratio and total permit cap such that there will be more pollution when abatement costs are high and less pollution when abatement costs are low. Information on firms’ abatement costs is important in order for the regulator to induce the optimal alignment between pollution level and abatement costs.
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Significant proteinuria is not an unfinding in children. Its causes are variable. When detected by dipstick examination of urine, the proteinuria must be assessed quantitatively by measuring the urinary protein/creatinine ratio in a spot sample. Orthostatic proteinuria is the most common cause of intermittent proteinuria. Persistent glomerular or tubular proteinuria are the consequences of various glomerulopathies or tubulopathies, the prognosis of which is variable. Whether glomerular or tubular, persistent proteinuria must be fully investigated, including by renal biopsy.
Resumo:
1) Etat des connaissances : Actuellement, les indications à la transplantation pulmonaire sont bien décrites et validées. Par contre, lors d'une retransplantation, les résultats restent encore discutés : la retransplantation pulmonaire reste la seule option thérapeutique dans certains cas de rejet du greffon, de syndrome de bronchiolite oblitérante avancée et aussi lors de graves affections respiratoires, principalement de sténose cicatricielle. Malgré cela, son utilité a été mise en doute en raison de la pénurie de donneurs d'organes et des rapports indiquant des résultats insatisfaisants. 2) But de l'étude : Ce travail est une étude d'évaluation méthodologique dans lequel on utilisera un questionnaire DELPHI auprès de 10 soignants engagés dans le programme Vaud-Genève de transplantation pulmonaire afin de déterminer les critères de sélection qui mèneraient à la pratique d'une retransplantation. 3) Objectifs : Ce projet a pour but d'élaborer un consensus local sur les critères et les contre-indications à une retransplantation pulmonaire, dans le cadre du programme Vaud-Genève et du système d'allocation d'organes en vigueur en Suisse. D'où la question : ''Quelles sont les indications potentielles à une retransplantation pulmonaire ?'' 4) Justification : Dans une situation de pénurie explicite de ressources (manque de donneurs), l'utilisation des greffons doit être basée à la fois sur des critères d'équité et d'efficacité médicale. En l'absence de données claires dans la littérature sur les indications à la retransplantation pulmonaire, la recherche d'une attitude pragmatique au sein du programme local est justifiée. 5) Méthode : Cette étude monocentrique multisite est une étude clinique ouverte où les personnes interrogées restent en insu: un questionnaire DELPHI sera envoyé à 10 soignants spécialisés dans le domaine de la transplantation pulmonaire issus du programme Vaud-Genève. La méthode Delphi a pour but de mettre en évidence des convergences d'opinions afin de trouver des consensus grâce à l'interrogation de différents experts par le biais de questionnaires successifs. L'objectif des études Delphi est d'apporter l'éclairage des experts sur des zones d'incertitude en vue d'une aide à la décision. 6) Sélection des sujets : Les ''sujets'' éligibles sont un groupe de 10 experts anonymes spécialisés dans le domaine de la retransplantation pulmonaire du canton de Vaud et de Genève. 6.1 Critères d'inclusion : Personnel médical et paramédical directement impliqué dans le cadre du programme de transplantation Vaud-Genève. 6.2 Critère d'exclusion : Toute personne qui est elle-même directement impliquée dans l'analyse de l'étude. 7) Déroulement de l'étude et investigations prévues: L'étude aura lieu au CHUV et au HUG pour une durée de 2 ans. Les investigations seront effectuées par le biais de questionnaires envoyés par courrier électronique et seront analysées au CHUV.
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Optimum experimental designs depend on the design criterion, the model andthe design region. The talk will consider the design of experiments for regressionmodels in which there is a single response with the explanatory variables lying ina simplex. One example is experiments on various compositions of glass such asthose considered by Martin, Bursnall, and Stillman (2001).Because of the highly symmetric nature of the simplex, the class of models thatare of interest, typically Scheff´e polynomials (Scheff´e 1958) are rather differentfrom those of standard regression analysis. The optimum designs are also ratherdifferent, inheriting a high degree of symmetry from the models.In the talk I will hope to discuss a variety of modes for such experiments. ThenI will discuss constrained mixture experiments, when not all the simplex is availablefor experimentation. Other important aspects include mixture experimentswith extra non-mixture factors and the blocking of mixture experiments.Much of the material is in Chapter 16 of Atkinson, Donev, and Tobias (2007).If time and my research allows, I would hope to finish with a few comments ondesign when the responses, rather than the explanatory variables, lie in a simplex.ReferencesAtkinson, A. C., A. N. Donev, and R. D. Tobias (2007). Optimum ExperimentalDesigns, with SAS. Oxford: Oxford University Press.Martin, R. J., M. C. Bursnall, and E. C. Stillman (2001). Further results onoptimal and efficient designs for constrained mixture experiments. In A. C.Atkinson, B. Bogacka, and A. Zhigljavsky (Eds.), Optimal Design 2000,pp. 225–239. Dordrecht: Kluwer.Scheff´e, H. (1958). Experiments with mixtures. Journal of the Royal StatisticalSociety, Ser. B 20, 344–360.1