Lean Six-Sigma in Aviation Safety: An implementation guide for measuring aviation system’s safety performance

The paper introduces a conceptual framework that could improve the safety performance measurement process and ultimately the aviation system safety performance. The framework provides an implementation guide on how organisations could design and develop a proactive, measurement tool for assessing and measuring the Acceptable Level of Safety Performance (ALoSP) at sigma (σ) level, a statistical measurement unit. In fact, the methodology adapts and combines quality management tools, a leading indicators programme and Lean-Six Sigma methodology to formally measure and continuously improve a stable and in-control safety management process by reducing safety defects and variability from core organisational processes and objectives. The implementation guide was empirically tested and validated with data collected and analysed within a period of nine months by the safety department of a complex aviation organisation operating a large transport aircraft fleet

Family support and cardiac rehabilitation: A comparative study of the experiences of South Asian and White-European patients and their carer's living in the United Kingdom

Background: Effective lifestyle modification facilitated by cardiac rehabilitation is known to reduce the occurrence of adverse coronary events and mortality. South Asians have poorer outcomes after a myocardial infarction than the general UK population, but little is known about their experiences of family support, cardiac rehabilitation and lifestyle change. Aims: To explore the nature of family support available to a sample of South Asian and White-European cardiac patients and to highlight similarities and differences between these groups with regard to cardiac rehabilitation and lifestyle modification. Methods: Using a qualitative approach, semi-structured interviews (in 1 of 6 languages) were conducted by researchers with; 45 South Asian patients and 37 carers and 20 White-European patients and 17 carers. Interviews were conducted in a home setting, up to eighteen months after discharge from hospital following myocardial infarction, coronary artery bypass surgery or unstable angina. Results: The main themes that emerged related to the provision of advice and information, family support and burden, dietary change and exercise regimes. Conclusions: Several cultural and ethnic differences were identified between patients and their families alongside similarities, irrespective of ethnicity. These may represent generic characteristics of recovery after a cardiac event. Health professionals should develop a cultural repertoire to engage with diversity and difference. Not every difficulty a person encounters as they try to access appropriate service delivery can be attributed to ethnic background. By improving services generally, support for South Asian populations can be improved. The challenge is to know when ethnicity makes a difference and mediates a person's relationship with service support and when it does not. (C) 2007 European Society of Cardiology. Published by Elsevier B.V. All rights reserved

Respiration as a percentage of daily photosynthesis in whole plants is homeostatic at moderate, but not high, growth temperatures

• Here, we investigated the impact of temperature on the carbon economy of two Plantago species from contrasting habitats. • The lowland Plantago major and the alpine Plantago euryphylla were grown hydroponically at three constant temperatures: 13, 2

Experimental investigation of the vorticity amplification on a swept wing with a blunt leading edge

A high level of turbulence is generated in the region upstream of the leading edge of a wing. The phenomenon has been investigated on two-dimensional wings and the existence of coherent structures at the stagnation point has been observed. The present paper deals with the flow upstream of the leading edge of a swept wing. A swept wing with a blunt leading edge has been used as a model in order to have a relatively thick boundary layer on the attachment line. The experiment has been carried out in a low turbulence wind tunnel and the freestream turbulence has been changed through a metallic string positioned ahead of the model. Two different configurations for the same string have been studied and compared to the clean case

Patient-reported outcomes following flexible sigmoidoscopy screening for colorectal cancer in a demonstration screening programme in the UK

<p>OBJECTIVES: Flexible sigmoidoscopy (FS) screening for colorectal cancer will be introduced into the National Cancer Screening Programmes in England in 2013. Patient-reported outcome measures (PROMs) from trial participants indicate high acceptability and no adverse physical or psychological consequences, but this may not generalize to routine screening in the community. This study examined PROMs in a community-based FS screening programme.</p> <p>METHODS: Eligible adults aged 58-59 (n = 2016) registered at 34 London general practices were mailed a National Health Service-endorsed invitation to attend FS screening. Pain and side-effects were assessed in a 'morning-after' questionnaire, and satisfaction was assessed in a three-month follow-up questionnaire. Anxiety, self-rated health and colorectal symptoms were assessed at prescreening and follow-up.</p> <p>RESULTS: In total, 1020 people attended screening and were included in the current analyses, of whom 913 (90%) returned the morning-after questionnaire, and 674 (66%) the follow-up questionnaire. The prescreening questionnaire had been completed by 751 (74%) of those who attended. The majority (87%) of respondents reported no pain or mild pain, and the most frequent side-effect (wind) was only experienced more than mildly by 16%. Satisfaction was extremely high, with 98% glad they had the test; 97% would encourage a friend to have it. From prescreening to follow-up there were no changes in anxiety or self-rated health, and the number of colorectal symptoms declined. Satisfaction and changes in wellbeing were not moderated by gender, deprivation, ethnicity or screening outcome.</p> <p>CONCLUSIONS: PROMs indicate high acceptability of FS screening in 58-59 year olds, with no adverse effects on colorectal symptoms, health status or psychological wellbeing.</p&gt

On higher congruences between cusp forms and Eisenstein series

In this paper we present several finite families of congruences between cusp forms and Eisenstein series of higher weights at powers of prime ideals. We formulate a conjecture which describes properties of the prime ideals and their relation to the weights. We check the validity of the conjecture on several numerical examples.Comment: 20 page

Effect of once-only flexible sigmoidoscopy screening on the outcomes of subsequent faecal occult blood test screening

Objectives: To investigate the outcomes of biennial guaiac faecal occult blood test (gFOBT) screening after once-only flexible sigmoidoscopy (FS) screening. Methods: Between 1994 and 1999, as part of the UK FS Screening Trial (UKFSST), adults aged 55-64 years were randomly allocated to an intervention group (offered FS screening) or a control group (not contacted). From 2006, a subset of UKFSST participants (20,895/44,041 intervention group; 41,497/87,149 control group) were invited to biennial gFOBT screening by the English Bowel Cancer Screening Programme. We analysed gFOBT uptake, test positivity, yield of colorectal cancer (CRC), and positive predictive value (PPV) for CRC, advanced adenomas (AA), and advanced colorectal neoplasia (ACN: AA/CRC). Results: Uptake of gFOBT at first invite was 1.9% lower (65.7% vs. 67.6%, p<0.01) among intervention versus control group participants; positivity was 0.4% lower (2.0% vs. 2.4%, p<0.01); and CRC yield was 0.08% lower (0.19% vs. 0.27%, p=0.14). PPVs were also lower in the intervention versus control group at 10.3% vs. 12.3% (p=0.44) for CRC, 22.7% vs. 31.4% (p<0.01) for AA, and 33.0% vs. 43.7% (p<0.01) for ACN. Among those who refused FS (n=5,532), gFOBT uptake at first invite was 47.7%, CRC yield was 0.25%, and PPV for ACN was 46.2%; among FS attenders (n=15,363), uptake was 72.2%, CRC yield was 0.18%, and PPV for ACN was 27.9%. Conclusions: Uptake, positivity and PPV of gFOBT screening were reduced following prior offer of FS screening. However, a quarter of FS screened participants receiving a diagnostic examination after positive gFOBT were diagnosed with ACN

Perceived family functioning and friendship quality: cross-sectional associations with physical activity and sedentary behaviours.

This study examined the association of adolescent-reported family functioning and friendship quality with objectively-measured moderate to vigorous physical activity (MVPA), sedentary time, and self-reported sedentary behaviours.The work of Andrew J Atkin, Kirsten Corder, and Esther M F van Sluijs was supported, wholly or in part, by the Centre for Diet and Activity Research (CEDAR), a UKCRC Public Health Research Centre of Excellence (RES-590-28-0002). Funding from the British Heart Foundation, Department of Health, Economic and Social Research Council, Medical Research Council, and the Wellcome Trust, under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The work of Esther M F van Sluijs, Kirsten Corder, Ulf Ekelund and Soren Brage was supported by the Medical Research Council (MC_UU_12015/7, MC_UU_12015/3). The ROOTS data collection was supported by a programme grant to Ian Goodyer (074296/Z/04/Z) from the Wellcome Trust and by the Medical Research Council Epidemiology Unit and Medical Research Council Human Nutrition Research.This is the final version of the article. It first appeared at http://www.ijbnpa.org/content/12/1/2