222 research outputs found
Evaluation program for secondary spacecraft cells. acceptance test of sonotone corpora- tion 5.0 ampere-hour nickel cadmium cells
Evaluation program for secondary spacecraft cells - acceptance testing of 5.0 ampere-hour nickel-cadmium cell
Screening and treatment for latent tuberculosis infection among asylum seekers entering Switzerland.
AIM OF THE STUDY: To evaluate the compliance of doctors and patients with the current recommendations for screening and preventive treatment of immigrants with a positive tuberculin skin test (TST) suggestive of latent tuberculosis infection (LTBI).
METHODS: Retrospective cohort study of all asylum seekers entering Switzerland between 1 January 1993 and 31 December 1993 and assigned to the cantons of Aargau, Fribourg, Geneva, NeuchĂątel, Valais and Vaud, who underwent a TST at the border. The medical documents of all individuals with a TST size suggestive of LTBI (> or = 10 mm in children <15 years, > or = 18 mm in young adults aged 15-25 years) were reviewed for final diagnosis, therapeutic decision, compliance with treatment if prescribed, and notification for tuberculosis within the next 3 years.
RESULTS: Among 2515 asylum seekers, 172 had a positive TST suggestive of LTBI. The documents of 93 persons were available. The final diagnosis was LTBI in 71 cases, possible tuberculosis in 10 cases, an effect of BCG immunisation in 10 cases, and other diagnoses in 2 cases. Among 82 individuals with normal chest X-ray or no radiological examination, only 37 (46%) received a preventive treatment and one a full course of antituberculosis drugs. Among 11 persons with an abnormal chest X-ray, 2 received a full course of antituberculosis drugs, 7 a preventive therapy and 2 had no treatment prescribed. Among the 44 subjects in whom a preventive treatment was prescribed, 30 adhered to the treatment regimen. One case (without prescribed treatment) was notified for tuberculosis two years after entry.
CONCLUSIONS: Compliance of doctors and patients with current recommendations for examination and treatment of immigrants with a TST suggestive of LTBI is unsatisfactory. New guidelines are needed to provide a clearer definition of the indications and explain the benefits of treating LTBI
Road user related risks and measures â evidence based decision support for road safety policy
The EU-funded SafetyCube project aims at facilitating decision making in road safety by providing systematically analysed and assessed scientific evidence on risk factors and countermeasures. While this is done for the areas infrastructure, vehicle and road users, this paper focus solely on the latter. The project outcomes are available online and are targeted at actual decision makers as well as researchers. Various stakeholders were consulted to identify hot topics and the needs of practitioners. The accessible database currently contains about 450 individual study outcomes and synopses with condensed information for 49 road risks (e.g. speeding, drink-driving, fatigue) and measures (fitness to drive, education, enforcement, campaigns, etc.) associated with all kinds of road users (vehicle drivers, cyclists, pedestrians, elderly, young, commercial drivers). In a further step, cost-benefit will be assessed on the basis of the effectiveness of countermeasures. While vehicle and infrastructure related risks and measures are well suited for effect quantification, this is a challenging endeavour for road users for many reasons
The application of systems approach for road safety policy making, Deliverable 8.1 of the H2020 project SafetyCube
The present Deliverable (D8.1) describes the co-ordination of the analysis of risks and measures using a systems framework within the SafetyCube project. It outlines the results of Task 8.1 of Work Package (WP) 8 of SafetyCube. This has involved (i) defining the systems approach to be used within SafetyCube, (ii) developing a taxonomy of risks and measures, (iii) identifying a common set of accident scenarios and (iv) initiating work on the Decision Support System (DSS) development. WP8 of the SafetyCube project has a number of specific aims, including developing the European DSS for supporting evidence-based policy making. It also aims to co-ordinate analysis undertaken in other WPs ensuring integrated research outputs, compilation of the project outputs into a suitable form to be incorporated within the DSS and the European Road Safety Observatory, and finally to develop tools to enable the continued support of evidence based road safety policies beyond SafetyCube.
Evidence-based policy making enables policy makers to make justified decisions in the complex reality of road safety interventions. It refers to the use of objective, scientifically-based evidence in all stages of the policy making process. Two important pillars for evidence-based road safety policy making are road safety data and statistics and scientific knowledge (Wegman et al, 2015). This type of policy making can be beneficial (e.g. helps to identify road safety problems and select most appropriate interventions) but also has itâs challenges (e.g. a lot of information at varying levels of detail is required to inform decisions). The DSS that is being developed within SafetyCube aims to support decision makers as well as other stakeholders in their evidence-based policy making.
In addition to evidence-based policy making, SafetyCube and in particular the DSS is grounded in the systems approach. The systems approach aims to steer away from the more traditionally âhuman errorâ blame focussed approach to road safety, and instead takes into account all âcomponentsâ in a system (i.e. road users, vehicles, roads) which contribute to a risk of an accident occurring. In SafetyCube, the systems approach is being integrated in the DSS in two main ways. First, the risk factors which relate to the road user, the road or the vehicle will be linked to measures in any or all of these areas if appropriate. Second, to clarify the added value of complementary measures rather than measures in isolation, where appropriate, a description of a measure will pay special attention to and link to supporting measures.
The SafetyCube DSS is underpinned by four taxonomies; Road User Behaviour (WP4), Infrastructure (WP5), Vehicles (WP6) and Post Impact Care (WP7). The taxonomy is a main structural part of the DSS system, it can be used as a search option in the DSS, it creates a uniform structure over all work packages and it can be used as a basis for linking risk factors with their corresponding measures. The structure consists of three levels, which are topic, subtopic and specific topic. Thirteen main topics were identified for Road User Behaviour (WP4), 10 main topics for Infrastructure (WP5) and six main topics for Vehicle (WP6). Four topics (based on the DaCoTA webtext on Post Impact Care, 2012), were included in WP7 (Post Impact Care). As expected, there was found to be some overlap between risk factors in one taxonomy and risk factors in another (e.g. is poor vehicle maintenance a Vehicle or Road User-related risk factor?), and some overlaps where a topic could be a risk factor or a countermeasure. Discussions between WPs ensured decisions could be made about how to overcome these ambiguities.
Accident scenarios are used within SafetyCube. These are considered to be a classification system for crashes whereby crash types may be grouped according to similar characteristics under a particular scenario heading, creating specific clusters. In total, nine high level accident scenarios will form an entry point to the DSS. Each high level has multiple sub-levels which provide more detailed information about the conflict situation (before the crash). A total of 63 sub-level scenarios are considered. The task of linking risks and measures is currently underway within the SafetyCube project. The accident scenarios will provide a useful and systematic way by which to link risks and measures. They will be used, in order to generate a meaningful set of links, between risks related to specific situations, and measures to address them. The primary objective of the DSS is to provide the European and Global road safety community a user friendly, web-based, interactive Decision Support Tool which will enable policy-makers and stakeholders to select and implement the most appropriate strategies, measures and cost-effective approaches to reduce casualties and crash severity for all road users. It consists of information such as risk factors, road safety measures, cost-benefit, casualty reduction effectiveness estimates.
In order to develop the DSS, a review of current existing Decision Support Systems was carried out to provide a first insight into such tools (e.g. Crash Modification Factors Clearinghouse, PRACT Repository, Road Safety Engineering Kit, iRAP). No European DSS were found in the search and of the DSS reviewed, the majority focussed on infrastructure and no risk factors were included. The SafetyCube DSS addresses these gaps. To understand user needs better, three stakeholders workshops were carried out, which allowed participants to comment on the proposed DSS and suggest âhot topicsâ (i.e. important risk factors) to address in SafetyCube, and the findings of these workshops found that the DSS should be suitable for use by a wide range of users, should be impartial, include robust data and access to all studies used and generated results. A comprehensive common SafetyCube methodology was designed, which included: a complete taxonomy of human behaviour, infrastructure and vehicle; a detailed and recorded literature review and the development of a template for coding research studies and existing results to be stored in a database linked to the DSS.
The DSS is being created on the basis of a number of design principles (e.g. modern web-based tool, ergonomic interface, simple, easily updatedâŠ). As well as a consistent layout the content itself is also of high importance (e.g. quantitative results over qualitative, methodologically sound, clarity). The DSS itself consists of the backend (relational database), the front end (website) and the way they integrate (queries). The heart of the DSS consists of the searchable/dynamic and static aspects, which consists of five entry points and three levels. The design principles of the DSS ensure a smooth integration of the Work Packages in two ways, firstly that the SafetyCube common methodology is applied and secondly that the fully linked search allows the end user to better perceive the interactions between various components in road safety.
There are five entry points into DSS: âtext searchâ, ârisk factorsâ, âroad safety measuresâ, âroad user groupsâ and âaccident scenariosâ. Once a search has been undertaken using one of these five entry points, a results page is shown to the user, which consists of a table listing the available synopses1 (overview of the topic created by synthesising findings from the coding of existing studies), meta-analysis and other studies in the database. From this, the user can then also access the individual study pages for each study listed in the results. Finally, a Tools page allows the user to access other SafetyCube tools (e.g. cost-benefit calculator, methodology information, glossary).
1 More details about the synopses can be found in the Milestone M3.1 (Martensen 2016).
So far, more than 500 studies have been analysed in the area of road risks with more than 3,500 risk estimates, summarised in more than 60 synopses (including approximately 10 meta-analyses), and the related measures analyses are in progress. This wealth of information will all be incorporated into the DSS and become its core outputs. The overall design of the DSS is finalised and is currently available, with the next stage being the DSS development, including all risk factors and measures. The DSS Pilot Operation will occur later in the project, followed by the final opening of the DSS, with continual updates from the end of the project onwards. The SafetyCube DSS is intended to have a life well beyond the end of the SafetyCube research project
Economic evaluation of road user related measures. Deliverable 4.3 of the H2020 project SafetyCube
Safety CaUsation, Benefits and Efficiency (SafetyCube) is a European Commission supported
Horizon 2020 project with the objective of developing an innovative road safety Decision Support
System (DSS). The DSS will enable policy-makers and stakeholders to select and implement the
most appropriate strategies, measures, and cost-effective approaches to reduce casualties of all
road user types and all severities.
This document is the third deliverable (4.3) of work package 4, which is dedicated to the economic
evaluation - mainly by means of a cost-benefit analysis - of road user related safety measures [...continues]
SafetyCube: Building a decision support system on risks and measures
The EU research project SafetyCube (Safety CaUsation, Benefits and Efficiency) is developing an innovative road safety Decision Support System (DSS) collecting the available evidence on a broad range of road risks and possible countermeasures. The structure underlying the DSS consists of (1) a taxonomy identifying risk factors and measures and linking them to each other, (2) a repository of studies, and (3) synopses summarizing the effects estimated in the literature for each risk factor and measure, and (4) an economic efficiency evaluation (E3-calculator). The DSS is implemented in a modern web-based tool with a highly ergonomic interface, allowing users to get a quick overview or go deeper into the results of single studies according to their own needs
αv integrins: key regulators of tissue fibrosis
Chronic tissue injury with fibrosis results in the disruption of tissue architecture, organ dysfunction and eventual organ failure. Therefore, the development of effective anti-fibrotic therapies is urgently required. During fibrogenesis, complex interplay occurs between cellular and extracellular matrix components of the wound healing response. Integrins, a family of transmembrane cell adhesion molecules, play a key role in mediating intercellular and cell-matrix interactions. Thus, integrins provide a major node of communication between the extracellular matrix, inflammatory cells, fibroblasts and parenchymal cells and, as such, are intimately involved in the initiation, maintenance and resolution of tissue fibrosis. Modulation of members of the αv integrin family has exhibited profound effects on fibrosis in multiple organs and disease states. In this review, we discuss the current knowledge of the mechanisms of αv-integrin-mediated regulation of fibrogenesis and show that the therapeutic targeting of specific αv integrins represents a promising avenue to treat patients with a broad range of fibrotic diseases
Tuberculosis screening and follow-up of asylum seekers in Norway: a cohort study
<p>Abstract</p> <p>Background</p> <p>About 80% of new tuberculosis cases in Norway occur among immigrants from high incidence countries. On arrival to the country all asylum seekers are screened with Mantoux test and chest x-ray aimed to identify cases of active tuberculosis and, in the case of latent tuberculosis, to offer follow-up or prophylactic treatment.</p> <p>We assessed a national programme for screening, treatment and follow-up of tuberculosis infection and disease in a cohort of asylum seekers.</p> <p>Methods</p> <p>Asylum seekers â„ 18 years who arrived at the National Reception Centre from January 2005 to June 2006, were included as the total cohort. Those with a Mantoux test â„ 6 mm or positive x-ray findings were included in a study group for follow-up.</p> <p>Data were collected from public health authorities in the municipality to where the asylum seekers had moved, and from hospital based internists in case they had been referred to specialist care.</p> <p>Individual subjects included in the study group were matched with the Norwegian National Tuberculosis Register which receive reports of everybody diagnosed with active tuberculosis, or who had started treatment for latent tuberculosis.</p> <p>Results</p> <p>The total cohort included 4643 adult asylum seekers and 97.5% had a valid Mantoux test. At least one inclusion criterion was fulfilled by 2237 persons. By end 2007 municipal public health authorities had assessed 758 (34%) of them. Altogether 328 persons had been seen by an internist. Of 314 individuals with positive x-rays, 194 (62%) had seen an internist, while 86 of 568 with Mantoux â„ 15, but negative x-rays (16%) were also seen by an internist. By December 31<sup>st </sup>2006, 23 patients were diagnosed with tuberculosis (prevalence 1028/100 000) and another 11 were treated for latent infection.</p> <p>Conclusion</p> <p>The coverage of screening was satisfactory, but fewer subjects than could have been expected from the national guidelines were followed up in the community and referred to an internist. To improve follow-up of screening results, a simplification of organisation and guidelines, introduction of quality assurance systems, and better coordination between authorities and between different levels of health care are all required.</p
The European road safety decision support system on risks and measures
The European Road Safety Decision Support System (roadsafety-dss.eu) is an innovative system providing the available evidence on a broad range of road risks and possible countermeasures. This paper describes the scientific basis of the DSS. The structure underlying the DSS consists of (1) a taxonomy identifying risk factors and measures and linking them to each other, (2) a repository of studies, and (3) synopses summarizing the effects estimated in the literature for each risk factor and measure, and (4) an economic efficiency evaluation instrument (E3-calculator). The DSS is implemented in a modern web-based tool with a highly ergonomic interface, allowing users to get a quick overview or go deeper into the results of single studies according to their own needs
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