Clinical governance : the next hype?

Clinical governance is to be the main vehicle for continuously improving the quality of patient care and developing the capacity to maintain high standards. The World Health Organisation has divided the approach into four principle aspects: professional performance; resource use; risk management; patient involvement. In this article the author seeks to explain the terms and their contribution to the whole scenario of Clinical governance. An overview of the local scene in the light of these concepts is also discussed.peer-reviewe

Antimicrobial Resistance in Neisseria gonorrhoeae: Proceedings of the STAR Sexually Transmitted Infection-Clinical Trial Group Programmatic Meeting.

The goal of the Sexually Transmitted Infection Clinical Trial Group's Antimicrobial Resistance (AMR) in Neisseria gonorrhoeae (NG) meeting was to assemble experts from academia, government, nonprofit and industry to discuss the current state of research, gaps and challenges in research and technology and priorities and new directions to address the continued emergence of multidrug-resistant NG infections. Topics discussed at the meeting, which will be the focus of this article, include AMR NG global surveillance initiatives, the use of whole genome sequencing and bioinformatics to understand mutations associated with AMR, mechanisms of AMR, and novel antibiotics, vaccines and other methods to treat AMR NG. Key points highlighted during the meeting include: (i) US and International surveillance programs to understand AMR in NG; (ii) the US National Strategy for combating antimicrobial-resistant bacteria; (iii) surveillance needs, challenges, and novel technologies; (iv) plasmid-mediated and chromosomally mediated mechanisms of AMR in NG; (v) novel therapeutic (eg, sialic acid analogs, factor H [FH]/Fc fusion molecule, monoclonal antibodies, topoisomerase inhibitors, fluoroketolides, LpxC inhibitors) and preventative (eg, peptide mimic) strategies to combat infection. The way forward will require renewed political will, new funding initiatives, and collaborations across academic and commercial research and public health programs

Human Factors Considerations in System Design

Human factors considerations in systems design was examined. Human factors in automated command and control, in the efficiency of the human computer interface and system effectiveness are outlined. The following topics are discussed: human factors aspects of control room design; design of interactive systems; human computer dialogue, interaction tasks and techniques; guidelines on ergonomic aspects of control rooms and highly automated environments; system engineering for control by humans; conceptual models of information processing; information display and interaction in real time environments

Analysis of Disengagements in Semi-Autonomous Vehicles: Drivers’ Takeover Performance and Operational Implications

This report analyzes the reactions of human drivers placed in simulated Autonomous Technology disengagement scenarios. The study was executed in a human-in-the-loop setting, within a high-fidelity integrated car simulator capable of handling both manual and autonomous driving. A population of 40 individuals was tested, with metrics for control takeover quantification given by: i) response times (considering inputs of steering, throttle, and braking); ii) vehicle drift from the lane centerline after takeover as well as overall (integral) drift over an S-turn curve compared to a baseline obtained in manual driving; and iii) accuracy metrics to quantify human factors associated with the simulation experiment. Independent variables considered for the study were the age of the driver, the speed at the time of disengagement, and the time at which the disengagement occurred (i.e., how long automation was engaged for). The study shows that changes in the vehicle speed significantly affect all the variables investigated, pointing to the importance of setting up thresholds for maximum operational speed of vehicles driven in autonomous mode when the human driver serves as back-up. The results shows that the establishment of an operational threshold could reduce the maximum drift and lead to better control during takeover, perhaps warranting a lower speed limit than conventional vehicles. With regards to the age variable, neither the response times analysis nor the drift analysis provide support for any claim to limit the age of drivers of semi-autonomous vehicles

Causal Relations of Factors Representing the Elderly Independence in Doing Activities of Daily Livings Using S3C-Latent Algorithm

The growth of the elderly population in Indonesia from year to year has always increased, followed by the problem of decreasing physical strength and psychological health of the elderly. These problems can affect the increase in dependence and decrease the independence of the elderly in ADL. In previous studies, various factors affect independence in ADLs such as cognitive, psychological, economic, nutrition, and health. However, In general, these studies only focus on predictive analysis or correlation of variables, and no research has attempted to identify the casual relationship of the elderly independence factors. Therefore, this study aimed to determine the mechanism of the causal relationship of the factors that influence the independence of the elderly in ADLs using a casual method called the Stable Specification Search for Cross-Sectional Data With Latent Variables (S3C-Latent). In this research we found strong causal and associative relationships between factors.The causal relationship of elderly independence in ADLs was influenced by cognitive, psychological, nutritional and health factors and gender with α values respectively (0.61; 0.61;1.00, 0.65;0.70). Cognitive factors associated with psychological, economic, nutrition, and health with a value of α (0.77; 1.00; 1.00; 0.64). Furthermore, psychological factors associated with economy, nutrition, and health with a value of α (0.77; 0.95; 0.63). Bisides, economic factors are associated with nutrition and health with α values of ( 0.86; 0.75) and nutrition with health with α values of 0.64. The last association was found between nutritional factors and gender with a value of α 0.76. This research is expected to increase the independence of the elderly in carrying out daily activities

Simulation Study of Ammonia Synthesis Loop Reactor-Separator System

The Ammonia recovery is not extremely efficient so the recycled gas typically contains 4.0% mol fraction of Ammonia (Appl.M,2003). Some specific energy is consumed just to recycle small amount of Ammonia back to the Reactor. Thus, the objectives of the project is to simulate and study the Ammonia synthesis loop using iCON® Process Simulation software as well as to investigate the best operating conditions of Ammonia Reactor-Separator System in order to minimize the fraction of unrecovered Ammonia in the recycled gas. The scope of this work focuses on the synthesis and development of the flowsheet for the Ammonia synthesis loop process in PETRONAS‟s iCON® Process Simulation software. The simulated Ammonia synthesis is achieved in Ammonia Reactor at temperature of 250 oC and pressure of 135 atm with 25% reaction conversion. From the simulation, about 6.5% mol fraction of Ammonia is predicted in the recycled gas. The effects of inlet temperature and pressure of Ammonia Reactor-Separator towards the amount of unrecovered Ammonia in the recycled gas were studied. Based on the result, minimum fraction of unrecovered Ammonia in the recycled gas favored at low temperature and high pressure at the inlet stream of Ammonia Separator. The best operating conditions for the inlet stream of Ammonia Separator is deduced at -5.0 oC and 140 kg.f/cm2 respectively. Meanwhile changing the inlet temperature and pressure of Ammonia Reactor does not give significant changes on the fraction of unrecovered Ammonia in the recycled gas. Comparisons of the simulation result are also made with the real plant data from literature