Child-care attendance and common morbidity: evidence of association in the literature and questions of design

Papers on child-care attendance as a risk factor for acute respiratory infections and diarrhea were reviewed. There was great variety among the studies with regard to the design, definition of exposure and definition of outcomes. All the traditional epidemiological study designs have been used. The studies varied in terms of how child-care attendance in general was defined, and for different settings. These definitions differed especially in relation to the minimum time of attendance required. The outcomes were also defined and measured in several different ways. The analyses performed were not always appropriate, leading to sets of results of uneven quality, and composed of different measures of association relating different exposures and outcomes, that made summarizing difficult. Despite that, the results reported were remarkably consistent. Only two of the papers reviewed failed to show some association between child-care attendance and increased acute respiratory infections, or diarrhea. On the other hand, the magnitude of the associations reported varied widely, especially for lower respiratory infections. Taken together, the studies so far published provide evidence that children attending child-care centers, especially those under three years of age, are at a higher risk of upper respiratory infections, lower respiratory infections, and diarrhea. The studies were not consistent, however, in relation to attendance at child-care homes. Children in such settings were sometimes similar to those in child-care centers, sometimes similar to those cared for at home, and sometimes presented an intermediate risk.

A Method for Assessing the Sustainability of Design in Developing World Projects

Projects for the developing world usually find themselves at the bottom of an engineer’s priority list. There is often very little engineering effort placed on creating new products for the poorest people in the world. This trend is beginning to change now as people begin to recognize the potential for these projects. Engineers are beginning to try and solve some of the direst issues in the developing world and many are having positive impacts. However, the conditions needed to support these projects can only be maintained in the short term. There is now a need for greater sustainability. Sustainability has a wide variety of definitions in both business and engineering. These concepts are analyzed and synthesized to develop a broad meaning of sustainability in the developing world. This primarily stems from the “triple bottom line” concept of economic, social, and environmental sustainability. Using this model and several international standards, this thesis develops a metric for guiding and evaluating the sustainability of engineering projects. The metric contains qualitative questions that investigate the sustainability of a project. It is used to assess several existing projects in order to determine flaws. Specifically, three projects seeking to deliver eyeglasses are analyzed for weaknesses to help define a new design approach for achieving better results. Using the metric as a guiding tool, teams designed two pieces of optometry equipment: one to cut lenses for eyeglasses and the other to diagnose refractive error, or prescription. These designs are created and prototyped in the developed and developing worlds in order to determine general feasibility. Although there is a recognized need for eventual design iterations, the whole project is evaluated using the developed metric and compared to the existing projects. Overall, the success demonstrates the improvements made to the long-term sustainability of the project resulting from the use of the sustainability metric.

Impact of definitions of loss to follow-up (LTFU) in antiretroviral therapy program evaluation: variation in the definition can have an appreciable impact on estimated proportions of LTFU

OBJECTIVE To examine the impact of different definitions of loss to follow-up (LTFU) on estimates of program outcomes in cohort studies of patients on antiretroviral therapy (ART). STUDY DESIGN AND SETTING We examined the impact of different definitions of LTFU using data from the International Epidemiological Databases to Evaluate AIDS-Southern Africa. The reference approach, Definition A, was compared with five alternative scenarios that differed in eligibility for analysis and the date assigned to the LTFU outcome. Kaplan-Meier estimates of LTFU were calculated up to 2 years after starting ART. RESULTS Estimated cumulative LTFU were 14% and 22% at 12 and 24 months, respectively, using the reference approach. Differences in the proportion LTFU were reported in the alternative scenarios with 12-month estimates of LTFU varying by up to 39% compared with Definition A. Differences were largest when the date assigned to the LTFU outcome was 6 months after the date of last contact and when the site-specific definition of LTFU was used. CONCLUSION Variation in the definitions of LTFU within cohort analyses can have an appreciable impact on estimated proportions of LTFU over 2 years of follow-up. Use of a standardized definition of LTFU is needed to accurately measure program effectiveness and comparability between programs.

Evaluating historic graffiti based on cultural significance and definitions of art.

Many examples of historic graffiti have been shown to be worthy of attention and conservation. The examples discussed in this article have been selected for their previous academic study, enabling rational assessment. This work does not suggest that only those examples of historic graffiti that have been subject to academic investigation can be evaluated and classified. This article, the result of a collaboration between two individuals with complementary interests in building conservation and contextual studies in art and design, brings together formal techniques used in the assessment of cultural significance in traditional architectural conservation and established theories in the evaluation of art. It is the purpose of this work to help those who are attempting to evaluate the merit of graffiti to do so. The current Scottish system that assesses cultural significance may be incomplete in its evaluation of graffiti. This necessitates a supplementary investigation of the artistic characteristics and merit of graffiti. Almost all graffiti could be said to be 'art', using established definitions, but not 'good' art. This evaluation may only be undertaken by experts, as with other aspects of identification of cultural significance within the built environment.

Reliability-based evaluation of design code provisions for circular concrete-filled steel columns

This paper presents an investigation of design code provisions for steel-concrete composite columns. The study covers the national building codes of United States, Canada and Brazil, and the transnational EUROCODE. The study is based on experimental results of 93 axially loaded concrete-filled tubular steel columns. This includes 36 unpublished, full scale experimental results by the authors and 57 results from the literature. The error of resistance models is determined by comparing experimental results for ultimate loads with code-predicted column resistances. Regression analysis is used to describe the variation of model error with column slenderness and to describe model uncertainty. The paper shows that Canadian and European codes are able to predict mean column resistance, since resistance models of these codes present detailed formulations for concrete confinement by a steel tube. ANSI/AISC and Brazilian codes have limited allowance for concrete confinement, and become very conservative for short columns. Reliability analysis is used to evaluate the safety level of code provisions. Reliability analysis includes model error and other random problem parameters like steel and concrete strengths, and dead and live loads. Design code provisions are evaluated in terms of sufficient and uniform reliability criteria. Results show that the four design codes studied provide uniform reliability, with the Canadian code being best in achieving this goal. This is a result of a well balanced code, both in terms of load combinations and resistance model. The European code is less successful in providing uniform reliability, a consequence of the partial factors used in load combinations. The paper also shows that reliability indexes of columns designed according to European code can be as low as 2.2, which is quite below target reliability levels of EUROCODE. (C) 2009 Elsevier Ltd. All rights reserved.

Design, Science and Conceptual Analysis

Philosophers expend considerable effort on the analysis of concepts, but the value of such work is not widely appreciated. This paper principally analyses some arguments, beliefs, and presuppositions about the nature of design and the relations between design and science common in the literature to illustrate this point, and to contribute to the foundations of design theory.

A Comparison of the Consensus and Clinical Definitions of Pancreatitis With a Proposal to Redefine Post-Endoscopic Retrograde Cholangiopancreatography Pancreatitis

Objectives: We evaluated the correlation between the consensus and clinical definitions of pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP), with the objective of updating and revising the definition of post-ERCP pancreatitis (PEP). Methods: Three hundred patients were subjected to serial serum amylase & lipase levels testing and abdominal computed tomography scan for abdominal pain after ERCP. Main outcome measures included the correlation between consensus and clinical definitions. Results: Using consensus criteria, 25 patients had acute pancreatitis (11 of mild and 14 of moderate severity). Forty-three patients had acute pancreatitis using the clinical definitions (18 of mild and 25 of moderate severity). At 4 hours, serum hyperamylasemia of under 1.5-fold and at 12 hours a serum hyperamylasemia of under 2-fold had a negative predictive value of 0.94 for development of PEP. Serum hyperamylasemia following ERCP had a poor positive predictive value for PEP. Conclusions: Clinical and consensus definitions are poorly correlated; use of the latter leads to significant underrecognition of PEP. The adoption of clinical definition results in uniformity of diagnosis of pancreatitis for clinical care and research. Serum amylase levels at 4 and 12 hours after ERCP have a high negative predictive value for PEP.

A qualitative assessment of modularity in CaesarJ components based on implementations of design patterns

Tese de Mestrado em Engenharia Informática

Impact of design options in zero energy building conception: the case of large buildings in Portugal

The new recast of Directive 2010/31/EU in order to implement the new concept NZEB in new buildings, is to be fully respected by all Member States, and is revealed as important measure to promote the reduction of energy consumption of buildings and encouraging the use of renewable energy. In this study, it was tested the applicability of the nearly zero energy building concept to a big size office building and its impact after a 50-years life cycle span.

The evolution of design with concerns on sustainability

This paper aims to analyse the birth and evolution of design with concerns over sustainability, in the context of social and civilizational changes experienced since the industrial revolution, with particular focus since the post-war period and in the context of sustainable development. It will examine several factors that influenced this design approach and that drove its evolution through different stages of maturity and complexity. It will analyse the various forms of design with environmental concerns, as well as the inclusion of other criteria in the context of sustainability, namely social ones. The aim is to settle knowledge that can allow us to draw some lessons to meet the challenges we face today.

The mixed impact of design thinking on business collaborations

The present work project investigates the implications of design thinking on an interbusiness collaborative project, unveiling both the benefits and fragilities that derive from the use of such methodology within the mentioned context. The study is organized in two parts. The first one starts with a literature review on the two relevant frames of reference – design thinking and business collaboration. It proceeds to the creation of a conceptual framework to assess the potential value of the design-based approach. The second part focuses on the practical application of to the newly developed instrument to the inTRAIN project – R&D for railway interiors.