The antimicrobial efficacy of copper alloy furnishing in the clinical environment:a crossover study

Objective. To determine whether copper incorporated into hospital ward furnishings and equipment can reduce their surface microbial load. Design. A crossover study. Setting. Acute care medical ward with 19 beds at a large university hospital. Methods. Fourteen types of frequent-touch items made of copper alloy were installed in various locations on an acute care medical ward. These included door handles and push plates, toilet seats and flush handles, grab rails, light switches and pull cord toggles, sockets, overbed tables, dressing trolleys, commodes, taps, and sink fittings. Their surfaces and those of equivalent standard items on the same ward were sampled once weekly for 24 weeks. The copper and standard items were switched over after 12 weeks of sampling to reduce bias in usage patterns. The total aerobic microbial counts and the presence of indicator microorganisms were determined. Results. Eight of the 14 copper item types had microbial counts on their surfaces that were significantly lower than counts on standard materials. The other 6 copper item types had reduced microbial numbers on their surfaces, compared with microbial counts on standard items, but the reduction did not reach statistical significance. Indicator microorganisms were recovered from both types of surfaces; however, significantly fewer copper surfaces were contaminated with vancomycin-resistant enterococci, methicillin-susceptible Staphylococcus aureus, and coliforms, compared with standard surfaces. Conclusions. Copper alloys (greater than or equal to 58% copper), when incorporated into various hospital furnishings and fittings, reduce the surface microorganisms. The use of copper in combination with optimal infection-prevention strategies may therefore further reduce the risk that patients will acquire infection in healthcare environments.

An objective approach to measuring video playback quality in lossy networks using TCP

In this work, we investigate a new objective measurement for assessing the video playback quality for services delivered in networks that use TCP as a transport layer protocol. We define the new metric as pause intensity to characterize the quality of playback in terms of its continuity since, in the case of TCP, data packets are protected from losses but not from delays. Using packet traces generated from real TCP connections in a lossy environment, we are able to simulate the playback of a video and monitor buffer behaviors in order to calculate pause intensity values. We also run subjective tests to verify the effectiveness of the metric introduced and show that the results of pause intensity and the subjective scores made over the same real video clips are closely correlated.

Az elektronikus kereskedelem alkalmazása a hazai vállalatok körében - a piacorientáció és a marketingkörnyezet szerepe (E-commerce practises of the Hungarian companies – Role of market orientation and marketing environment)

A szerzők tanulmányának célja, hogy bemutassa, milyen célokra alkalmazzák az internetet a hazai vállalatok, milyen várakozásaik vannak az e-kereskedelem versenyben betöltött szerepével kapcsolatban, és hogyan észlelik annak előnyeit. Vizsgálják azt is, hogy az elmúlt öt évben milyen változások tapasztalhatók a vállalatok gyakorlatában e téren. Elemzik továbbá, hogy a piacorientáció és a vállalat külső marketingkörnyezete hogyan befolyásolja az e-kereskedelem megítélését és alkalmazását. Elemzésük a "Versenyben a világgal" kutatási program 2009-ben készült felmérésének eredményeire támaszkodik, amelyben 300 vállalat szakembereit kérdezték meg. Kutatásukban megerősítést nyert, hogy Magyarországon az elektronikus kereskedelem jelentősége nő. A vállalatoknak kedvezőek az elektronikus kereskedelem jövőjével kapcsolatos várakozásaik, és úgy vélik, hogy ez versenyelőny forrása lehet. A vállalat piacorientációja erőteljesen befolyásolja azt, hogy egy vállalat milyen mértékben alkalmazza az internetet, és hogyan viszonyul az elektronikus kereskedelemhez / === / The objective of the authors’ research is to show how internet is used among Hungarian companies, to analyse their expectations with regard of the role e-commerce plays in competition, and the benefits resulting from e-commerce. They also focus on the changes that have taken place the past five years in the practice of Hungarian companies. The authors investigate how market orientation and the external marketing environment of firms influence evaluations of e-commerce and its implementation. Their analysis is based on the results of the research program „Competing with the world” , which includes the answers of 300 companies. Their research results confirm that the importance of e-commerce is growing in Hungary and overall Hungarian firms have positive expectations with regard of the future of e-commerce and consider it a source of competitive advantage. Market orientation of the firm strongly influences the extent of internet applications and attitudes toward ecommerce.

Health care utilization behavior of elders in a multicultural urban environment

The objective of this research is to determine the influences of social, environmental, behavioral, and economic forces on the health care service utilization of four racial/ethnic groups of non-institutionalized elders in a multicultural urban environment. To address these issues this dissertation examines three intertwined themes of culture, aging, and health, using a sample of elders residing in Miami-Dade County, FL in four racial/ethnic groups: white non-Hispanic; black non-Hispanic English speakers; Cuban; and non-Cuban Hispanic. ^ The research questions were analyzed using both quantitative and qualitative data. Data for the quantitative component uses telephone survey data from the Dade County Needs Assessment. The purpose of this component is to develop a more comprehensive model of elder health care utilization behavior. The qualitative component uses data from focus groups from Dade County Needs Assessment, archival data and a literature review of previous ethnographic research. The purpose of this component is to gain a better understanding of the social construction of the terms “age”' and “aging,” as well as to place issues of health and health care in the lives of elders. ^ The findings raised several important issues. First, just because people share a common chronological age does not mean that they are the same in every other respect. Examining elders as a homogeneous group of users of formal health care services in a community is simplistic. Placing “aging” and “health” in a cultural context is important. My findings confirm that the meaning of “aging” and “old” are socially constructed. Further, the term “aging” is NOT synonymous with ill health or frailty. This was a consistent finding in both the quantitative and qualitative results. ^ While all aging individuals share a mutual orientation toward aging (i.e., biological process), they do not age the same way (i.e., social construction of “aging”). Thus, policymakers and others serving the elder population must be aware of the particular cultural context, as well as the previous life experiences of the individuals that they serve. This analysis documents the importance of culture and geographic community in understanding health care service utilization of elders. ^

The order selection and lot sizing problem in the make-to-order environment

This research is motivated by the need for considering lot sizing while accepting customer orders in a make-to-order (MTO) environment, in which each customer order must be delivered by its due date. Job shop is the typical operation model used in an MTO operation, where the production planner must make three concurrent decisions; they are order selection, lot size, and job schedule. These decisions are usually treated separately in the literature and are mostly led to heuristic solutions. The first phase of the study is focused on a formal definition of the problem. Mathematical programming techniques are applied to modeling this problem in terms of its objective, decision variables, and constraints. A commercial solver, CPLEX is applied to solve the resulting mixed-integer linear programming model with small instances to validate the mathematical formulation. The computational result shows it is not practical for solving problems of industrial size, using a commercial solver. The second phase of this study is focused on development of an effective solution approach to this problem of large scale. The proposed solution approach is an iterative process involving three sequential decision steps of order selection, lot sizing, and lot scheduling. A range of simple sequencing rules are identified for each of the three subproblems. Using computer simulation as the tool, an experiment is designed to evaluate their performance against a set of system parameters. For order selection, the proposed weighted most profit rule performs the best. The shifting bottleneck and the earliest operation finish time both are the best scheduling rules. For lot sizing, the proposed minimum cost increase heuristic, based on the Dixon-Silver method performs the best, when the demand-to-capacity ratio at the bottleneck machine is high. The proposed minimum cost heuristic, based on the Wagner-Whitin algorithm is the best lot-sizing heuristic for shops of a low demand-to-capacity ratio. The proposed heuristic is applied to an industrial case to further evaluate its performance. The result shows it can improve an average of total profit by 16.62%. This research contributes to the production planning research community with a complete mathematical definition of the problem and an effective solution approach to solving the problem of industry scale.

The Food Service Industry Environment: Market Volatility Analysis

In their dialogue entitled - The Food Service Industry Environment: Market Volatility Analysis - by Alex F. De Noble, Assistant Professor of Management, San Diego State University and Michael D. Olsen, Associate Professor and Director, Division of Hotel, Restaurant & Institutional Management at Virginia Polytechnic Institute and State University, De Noble and Olson preface the discussion by saying: “Hospitality executives, as a whole, do not believe they exist in a volatile environment and spend little time or effort in assessing how current and future activity in the environment will affect their success or failure. The authors highlight potential differences that may exist between executives' perceptions and objective indicators of environmental volatility within the hospitality industry and suggest that executives change these perceptions by incorporating the assumption of a much more dynamic environment into their future strategic planning efforts. Objective, empirical evidence of the dynamic nature of the hospitality environment is presented and compared to several studies pertaining to environmental perceptions of the industry.” That weighty thesis statement presumes that hospitality executives/managers do not fully comprehend the environment in which they operate. The authors provide a contrast, which conventional wisdom would seem to support and satisfy. “Broadly speaking, the operating environment of an organization is represented by its task domain,” say the authors. “This task domain consists of such elements as a firm's customers, suppliers, competitors, and regulatory groups.” These are dynamic actors and the underpinnings of change, say the authors by way of citation. “The most difficult aspect for management in this regard tends to be the development of a proper definition of the environment of their particular firm. Being able to precisely define who the customers, competitors, suppliers, and regulatory groups are within the environment of the firm is no easy task, yet is imperative if proper planning is to occur,” De Noble and Olson further contribute to support their thesis statement. The article is bloated, and that’s not necessarily a bad thing, with tables both survey and empirically driven, to illustrate market volatility. One such table is the Bates and Eldredge outline; Table-6 in the article. “This comprehensive outline…should prove to be useful to most executives in expanding their perception of the environment of their firm,” say De Noble and Olson. “It is, however, only a suggested outline,” they advise. “…risk should be incorporated into every investment decision, especially in a volatile environment,” say the authors. De Noble and Olson close with an intriguing formula to gauge volatility in an environment.

Cultural perceptions of space and place in the South Florida *environment

Public opinion polls in the United States reveal that a great majority of Americans are aware and show concern about ecological issues and the need to preserve natural areas. In South Florida, natural resources have been subjected to enormous strain as the pressure to accommodate a growing population has led to rapid development. Suburbs have been built on areas that were once natural wetlands and farmlands, and the impact today shows a landscape where natural places have all but disappeared. This dissertation examines the intersection between the perceptions that individuals living in the South Florida region have with respect to the natural environment and local ecological problems with where their relationship to nature takes place. ^ The research is based upon both quantitative and qualitative data. The principal methodology used in this research is the ethnographic method, which employed the data gathering techniques of in-depth interviewing and participant observation. The objective of the qualitative portion of the study was to determine how people perceive and relate to their immediate environment. The quantitative portion of the study employed telephone survey data from the FIU/Florida Poll 2000. Data collected through this survey provided the basis to statistically test responses to the research questions. ^ The findings show that people in South Florida have a general idea of the relationship between the human population and the environment but very little knowledge of how they individually affect each other. The experience of private places and public spaces in everyday life permits people to compartmentalize cultural values and understandings of the natural world in separate cognitive schemas. The appreciation of the natural world has almost no connection to their personal sense of obligation to preserve the environment. That obligation is only felt in their home space even though the South Florida environment overall struggles desperately with water shortages, land encroachment, and a rapidly expanding human population whose activities continuously aggravate an already delicate natural balance. ^

New trends in health architecture for children and the effects of the built environment on young patients

The objective of this thesis was to investigate the effects of the built environment on the outcome of young patients. This investigation included recent innovations in children's hospitals that integrated both medical and architectural case studies as part of their design issues. In addition, the intervention responded to man-made conditions and natural elements of the site. The thesis project, a Children's Rehabilitation Hospital, is located at 1500 N.W. River Drive in Miami, Florida. The thesis intervention emerged from a site analysis that focused on the shifting of the urban grid, the variation in scale of the immediate context and the visual-physical connection to the river's edge. Furthermore, it addressed the issues of overnight accommodation for patient's families, as well as sound control through the use of specific materials in space enclosures and open courtyards. The key to the success of this intervention lies in the special attention given to the integration between nature and the built environment. Issues such as the incorporation of nature within a building through the use of vistas and the exploitation of natural light through windows and skylights, were pivotal in the creation of a pleasant environment for visitors, employees and young patients.

Building connections: political participation, social capital and the built environment in St. John's, Newfoundland

How does where we live affect how we live? Do characteristics of the built environment affect the civic and social lives of the people living there? This study examines these questions at the neighbourhood scale in the Canadian city of St. John's, Newfoundland. To do so, it combines data from a survey measuring respondents' social capital (defined as a combination of social participation, social trust, and civic participation) and a "built environment audit" that records the built characteristics of each respondent's neighbourhood. The study finds a significant, positive relationship between the walkability of a neighbourhood and the social capital of the people living there. This relationship is driven primarily by the effect of the built environment on voluntary participation and relationships with neighbours. The study also tests several methods of measuring walkability, and finds that an objective measure based on street geometry is the best predictor of social capital.

An Objective Framework to Test the Quality of Candidate Indicators of Good Environmental Status

Large efforts are on-going within the EU to prepare the Marine Strategy Framework Directive’s (MSFD) assessment of the environmental status of the European seas. This assessment will only be as good as the indicators chosen to monitor the eleven descriptors of good environmental status (GEnS). An objective and transparent framework to determine whether chosen indicators actually support the aims of this policy is, however, not yet in place. Such frameworks are needed to ensure that the limited resources available to this assessment optimize the likelihood of achieving GEnS within collaborating states. Here, we developed a hypothesis-based protocol to evaluate whether candidate indicators meet quality criteria explicit to the MSFD, which the assessment community aspires to. Eight quality criteria are distilled from existing initiatives, and a testing and scoring protocol for each of them is presented. We exemplify its application in three worked examples, covering indicators for three GEnS descriptors (1, 5 and 6), various habitat components (seaweeds, seagrasses, benthic macrofauna and plankton), and assessment regions (Danish, Lithuanian and UK waters). We argue that this framework provides a necessary, transparent and standardized structure to support the comparison of candidate indicators, and the decision-making process leading to indicator selection. Its application could help identify potential limitations in currently available candidate metrics and, in such cases, help focus the development of more adequate indicators. Use of such standardized approaches will facilitate the sharing of knowledge gained across the MSFD parties despite context-specificity across assessment regions, and support the evidence-based management of European seas.

An Objective Framework to Test the Quality of Candidate Indicators of Good Environmental Status

Large efforts are on-going within the EU to prepare the Marine Strategy Framework Directive’s (MSFD) assessment of the environmental status of the European seas. This assessment will only be as good as the indicators chosen to monitor the eleven descriptors of good environmental status (GEnS). An objective and transparent framework to determine whether chosen indicators actually support the aims of this policy is, however, not yet in place. Such frameworks are needed to ensure that the limited resources available to this assessment optimize the likelihood of achieving GEnS within collaborating states. Here, we developed a hypothesis-based protocol to evaluate whether candidate indicators meet quality criteria explicit to the MSFD, which the assessment community aspires to. Eight quality criteria are distilled from existing initiatives, and a testing and scoring protocol for each of them is presented. We exemplify its application in three worked examples, covering indicators for three GEnS descriptors (1, 5 and 6), various habitat components (seaweeds, seagrasses, benthic macrofauna and plankton), and assessment regions (Danish, Lithuanian and UK waters). We argue that this framework provides a necessary, transparent and standardized structure to support the comparison of candidate indicators, and the decision-making process leading to indicator selection. Its application could help identify potential limitations in currently available candidate metrics and, in such cases, help focus the development of more adequate indicators. Use of such standardized approaches will facilitate the sharing of knowledge gained across the MSFD parties despite context-specificity across assessment regions, and support the evidence-based management of European seas.

The physical classroom environment : roles, conceptions, and preferences

The problem addressed in this thesis is that a considerable proportion of students around the world attend school in inadequate facilities, which is detrimental for the students’ learning outcome. The overall objective in this thesis is to develop a methodology, with a novel approach to involve teachers, to generate a valuable basis for decisions regarding design and improvement of physical school environment, based on the expressed needs for a specific school, municipality, or district as well as evidence from existing research. Three studies have been conducted to fulfil the objective: (1) a systematic literature review and development of a theoretical model for analysing the role of the physical environment in schools; (2) semi structured interviews with teachers to get their conceptions of the physical school environment; (3) a stated preference study with experimental design as an online survey. Wordings from the transcripts from the interview study were used when designing the survey form. The aim of the stated preference study was to examine the usability of the method when applied in this new context of physical school environment. The result is the methodology with a mixed method chain where the first step involves a broad investigation of the specific circumstances and conceptions for the specific school, municipality, or district. The second step is to use the developed theoretical model and results from the literature study to analyse the results from the first step and transform them in to a format that fits the design of a stated preference study. The final step is a refined version of the procedure of the performed stated preference study.

Objective Methods for Characterizing Physical Exposures which may contribute to Work-related Musculoskeletal Disorders in Agricultural Workers

Thesis (Ph.D.)--University of Washington, 2016-08

On precise three-dimensional environment modeling via UAV-based photogrammetric systems

Abstract : Images acquired from unmanned aerial vehicles (UAVs) can provide data with unprecedented spatial and temporal resolution for three-dimensional (3D) modeling. Solutions developed for this purpose are mainly operating based on photogrammetry concepts, namely UAV-Photogrammetry Systems (UAV-PS). Such systems are used in applications where both geospatial and visual information of the environment is required. These applications include, but are not limited to, natural resource management such as precision agriculture, military and police-related services such as traffic-law enforcement, precision engineering such as infrastructure inspection, and health services such as epidemic emergency management. UAV-photogrammetry systems can be differentiated based on their spatial characteristics in terms of accuracy and resolution. That is some applications, such as precision engineering, require high-resolution and high-accuracy information of the environment (e.g. 3D modeling with less than one centimeter accuracy and resolution). In other applications, lower levels of accuracy might be sufficient, (e.g. wildlife management needing few decimeters of resolution). However, even in those applications, the specific characteristics of UAV-PSs should be well considered in the steps of both system development and application in order to yield satisfying results. In this regard, this thesis presents a comprehensive review of the applications of unmanned aerial imagery, where the objective was to determine the challenges that remote-sensing applications of UAV systems currently face. This review also allowed recognizing the specific characteristics and requirements of UAV-PSs, which are mostly ignored or not thoroughly assessed in recent studies. Accordingly, the focus of the first part of this thesis is on exploring the methodological and experimental aspects of implementing a UAV-PS. The developed system was extensively evaluated for precise modeling of an open-pit gravel mine and performing volumetric-change measurements. This application was selected for two main reasons. Firstly, this case study provided a challenging environment for 3D modeling, in terms of scale changes, terrain relief variations as well as structure and texture diversities. Secondly, open-pit-mine monitoring demands high levels of accuracy, which justifies our efforts to improve the developed UAV-PS to its maximum capacities. The hardware of the system consisted of an electric-powered helicopter, a high-resolution digital camera, and an inertial navigation system. The software of the system included the in-house programs specifically designed for camera calibration, platform calibration, system integration, onboard data acquisition, flight planning and ground control point (GCP) detection. The detailed features of the system are discussed in the thesis, and solutions are proposed in order to enhance the system and its photogrammetric outputs. The accuracy of the results was evaluated under various mapping conditions, including direct georeferencing and indirect georeferencing with different numbers, distributions and types of ground control points. Additionally, the effects of imaging configuration and network stability on modeling accuracy were assessed. The second part of this thesis concentrates on improving the techniques of sparse and dense reconstruction. The proposed solutions are alternatives to traditional aerial photogrammetry techniques, properly adapted to specific characteristics of unmanned, low-altitude imagery. Firstly, a method was developed for robust sparse matching and epipolar-geometry estimation. The main achievement of this method was its capacity to handle a very high percentage of outliers (errors among corresponding points) with remarkable computational efficiency (compared to the state-of-the-art techniques). Secondly, a block bundle adjustment (BBA) strategy was proposed based on the integration of intrinsic camera calibration parameters as pseudo-observations to Gauss-Helmert model. The principal advantage of this strategy was controlling the adverse effect of unstable imaging networks and noisy image observations on the accuracy of self-calibration. The sparse implementation of this strategy was also performed, which allowed its application to data sets containing a lot of tie points. Finally, the concepts of intrinsic curves were revisited for dense stereo matching. The proposed technique could achieve a high level of accuracy and efficiency by searching only through a small fraction of the whole disparity search space as well as internally handling occlusions and matching ambiguities. These photogrammetric solutions were extensively tested using synthetic data, close-range images and the images acquired from the gravel-pit mine. Achieving absolute 3D mapping accuracy of 11±7 mm illustrated the success of this system for high-precision modeling of the environment.

Learning environment, preparedness and satisfaction in osteopathy in Europe: The PreSS study

Objective: 1) to assess the preparedness to practice and satisfaction in learning environment amongst new graduates from European osteopathic institutions; 2) to compare the results of preparedness to practice and satisfaction in learning environment between and within countries where osteopathy is regulated and where regulation is still to be achieved; 3) to identify possible correlations between learning environment and preparedness to practice. Method: Osteopathic education providers of full-time education located in Europe were enrolled, and their final year students were contacted to complete a survey. Measures used were: Dundee Ready Educational Environment Measure (DREEM), the Association of American Medical Colleges (AAMC) and a demographic questionnaire. Scores were compared across institutions using one-way ANOVA and generalised linear model. Results: Nine European osteopathic education institutions participated in the study (4 located in Italy, 2 in the UK, 1 in France, 1 in Belgium and 1 in the Netherlands) and 243 (77%) of their final-year students completed the survey. The DREEM total score mean was 121.4 (SEM: 1.66) whilst the AAMC was 17.58 (SEM:0.35). A generalised linear model found a significant association between not-regulated countries and total score as well as subscales DREEM scores (p<0.001). Learning environment and preparedness to practice were significantly positively correlated (r=0.76; p<0.01). Discussion: A perceived higher level of preparedness and satisfaction was found amongst students from osteopathic institutions located in countries without regulation compared to those located in countries where osteopathy is regulated; however, all institutions obtained a 'more positive than negative' result. Moreover, in general, cohorts with fewer than 20 students scored significantly higher compared to larger student cohorts. Finally, an overall positive correlation between students' preparedness and satisfaction were found across all institutions recruited.