Journal articles: 'Intermittent service'

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Owen, Cathy, Christopher Tennant, Deslee Jessie, Michael Jones, and Valerie Rutherford. "A Model for Clinical and Educational Psychiatric Service Delivery in Remote Communities." Australian & New Zealand Journal of Psychiatry 33, no. 3 (June 1999): 372–78. http://dx.doi.org/10.1046/j.1440-1614.1999.00578.x.

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Objective: A model of intermittent psychiatric service provision to rural and remote New South Wales communities by metropolitan psychiatrists and mental health professionals has been evaluated. The services provided included peer support to lone mental health and generic health workers, direct psychiatric care to clients in their own environment and skills development education sessions to general health staff and other professionals affiliated with health care (e.g. police and ambulance officers). Method: There were 10 visits of teams made up of a psychiatrist and another mental health professional to six rural and remote locations. Outcomes of the services delivered were examined including clinical services and teaching skills training sessions. Indirect outcome measures included changes to Pharmaceutical Benefits Scheme prescription patterns in areas serviced and data regarding transfer of clients for psychiatric care in regional centres. Difficulties in evaluation are discussed. Results: The feasibility of intermittent service provision was demonstrated. Education packages were well received and a positive change in workers' attitudes toward mental health practice was found. Conclusion: Intermittent psychiatric services in remote settings add value to health care delivery particularly when dovetailed with skills-based education sessions.

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Mokssit, Assia, Bernard de Gouvello, Aurélie Chazerain, François Figuères, and Bruno Tassin. "Building a Methodology for Assessing Service Quality under Intermittent Domestic Water Supply." Water 10, no. 9 (August 30, 2018): 1164. http://dx.doi.org/10.3390/w10091164.

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This document proposes a methodology for assessing the quality of water distribution service in the context of intermittent supply, based on a comparison of joint results from literature reviews and feedback from drinking water operators who had managed these networks, with standards for defining the quality of drinking water service. The paper begins by reviewing and proposing an analysis of the definition and characterization of intermittent water supply (IWS), highlighting some important findings. The diversity of approaches used to address the issue and the difficulty of defining a precise and detailed history of water supply in the affected systems broadens the spectrum of intermittency characterization and the problems it raises. The underlined results are then used to structure an evaluation framework for the water service and to develop improvement paths defined in the intermittent networks. The resulting framework highlights the means available to water stakeholders to assess their operational and management performance in achieving the improvement objectives defined by the environmental and socio-economic contexts in which the network operates. Practical examples of intermittent system management are collected from water system operators and presented for illustration purposes (Jeddah, Algiers, Port-au-Prince, Amman, Cartagena, Barranquilla, Mexico, Cancun, Saltillo, Mumbai, Delhi, Coimbatore …).

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Berry, Randall, Michael Honig, Thành Nguyen, Vijay Subramanian, and Rakesh Vohra. "The Value of Sharing Intermittent Spectrum." Management Science 66, no. 11 (November 2020): 5242–64. http://dx.doi.org/10.1287/mnsc.2019.3437.

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We examine a model of Cournot competition with congestion motivated by recent policy to allow commercial sharing of wireless spectrum that is assigned to other users such as government agencies. A key feature of such spectrum is that it is intermittently available because of the incumbent user’s activity. In our model, wireless service providers (SPs) compete for a common pool of customers using their own proprietary (exclusively licensed) bands of spectrum along with access to an additional intermittent band. When the intermittent band is unavailable, any traffic carried on that band must be shifted to the proprietary bands. Customers are sensitive to both the price they pay and the average congestion they experience across the bands of spectrum from which they receive service. We compare two different access policies for this intermittent band: one in which it is open to all SPs and one in which it is licensed to a single SP. We also allow the band to be divided into multiple subbands where each subband is either open or licensed. We characterize trade-offs between social welfare and consumer welfare that depend on the choice of different access policies and assignments of subbands to SPs. These can involve subtle issues related to the ability of a larger SP to make more efficient use of intermittent spectrum and the increase in competition by assigning more spectrum to smaller SPs. This paper was accepted by David Simchi-Levi, operations management.

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Taylor, Monica, Naomi Kikkawa, Elisabeth Hoehn, Helen Haydon, Maike Neuhaus, Anthony C. Smith, and Liam J. Caffery. "The importance of external clinical facilitation for a perinatal and infant telemental health service." Journal of Telemedicine and Telecare 25, no. 9 (October 2019): 566–71. http://dx.doi.org/10.1177/1357633x19870916.

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Introduction Clinical facilitation is an established strategy for introducing innovation into clinical practice. The Queensland Centre for Perinatal and Infant Mental Health has used clinical facilitation to establish a telehealth service to support perinatal and infant mental health in regional, rural and remote areas of the Australian state of Queensland. The aim of this study is to explore the role of clinical facilitation in implementing and sustaining the telehealth service. Methods Semi-structured interviews were conducted with 14 remote-site users of the telehealth service. Interviews were analysed using thematic analysis. Results Two dominant themes emerged: unmet need and service visibility. The study confirms the usefulness of telehealth as a way to address unmet need for specialist mental health services in regional, rural and remote areas. The study also provides evidence that a telehealth service with intermittent demand requires a consistent clinical facilitator, to keep the service visible to remote-site clinicians and maintain awareness of the service as a referral option. Conclusion Previous research has identified the importance of clinical facilitation in initial service implementation. This study demonstrates the necessity of clinical facilitation for ongoing service provision. Facilitation is likely to be more important where the telehealth service responds to intermittent or infrequent clinical need, compared with high-volume services where clinics are conducted routinely.

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Rojas, Fernando, Peter Wanke, Giuliani Coluccio, Juan Vega-Vargas, and Gonzalo F. Huerta-Canepa. "Managing slow-moving item: a zero-inflated truncated normal approach for modeling demand." PeerJ Computer Science 6 (September 14, 2020): e298. http://dx.doi.org/10.7717/peerj-cs.298.

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This paper proposes a slow-moving management method for a system using of intermittent demand per unit time and lead time demand of items in service enterprise inventory models. Our method uses zero-inflated truncated normal statistical distribution, which makes it possible to model intermittent demand per unit time using mixed statistical distribution. We conducted numerical experiments based on an algorithm used to forecast intermittent demand over fixed lead time to show that our proposed distributions improved the performance of the continuous review inventory model with shortages. We evaluated multi-criteria elements (total cost, fill-rate, shortage of quantity per cycle, and the adequacy of the statistical distribution of the lead time demand) for decision analysis using the Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS). We confirmed that our method improved the performance of the inventory model in comparison to other commonly used approaches such as simple exponential smoothing and Croston’s method. We found an interesting association between the intermittency of demand per unit of time, the square root of this same parameter and reorder point decisions, that could be explained using classical multiple linear regression model. We confirmed that the parameter of variability of the zero-inflated truncated normal statistical distribution used to model intermittent demand was positively related to the decision of reorder points. Our study examined a decision analysis using illustrative example. Our suggested approach is original, valuable, and, in the case of slow-moving item management for service companies, allows for the verification of decision-making using multiple criteria.

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Mazzo, Alessandra, Valtuir D. Souza-Junior, Beatriz M. Jorge, Aline Nassif, Cintia F. B. Biaziolo, Marcelo F. Cassini, Raquel C. R. Santos, and Isabel Amélia Costa Mendes. "Intermittent urethral catheterization—descriptive study at a Brazilian service." Applied Nursing Research 27, no. 3 (August 2014): 170–74. http://dx.doi.org/10.1016/j.apnr.2013.12.002.

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BELMAN, A. BARRY. "Ureteropelvic Junction Obstruction as a Cause for Intermittent Abdominal Pain in Children." Pediatrics 88, no. 5 (November 1, 1991): 1066–69. http://dx.doi.org/10.1542/peds.88.5.1066.

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Two or three times each year children are seen by the Urology Service at Children's Hospital, Washington, DC, who have a history of intermittent, severe midabdominal pain associated with vomiting due to intermittent ureteropelvic junction obstruction. These symptoms may have been on-going for years. The following case history serves as a typical example. CASE REPORT A 6-years-old boy was referred to the Urology Service from the Gastrointestinal Service where he had been sent by his primary physician. He had a 1-year history of episodic abdominal pain occurring one to two times per month initially, but becoming more frequent during the past few months.

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Chen, Liang Kuang, and Mao Yuan Hsiao. "Control of Service Robot by Integration of Multiple Intermittent Sensors." Advanced Materials Research 939 (May 2014): 609–14. http://dx.doi.org/10.4028/www.scientific.net/amr.939.609.

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In this paper, we design a service robot which not only can plan road to a destination by itself, but also can take an elevator to every floor. For planning road, in order to solve the Hagisonic Stargazer Robot localization system problem which in large environment will need to set a lot of landmark and this way will increase the lead time and memory capacity. So we use the concept of road nodes to combine with Stargazer landmark and Dijkstra’s algorithm. Robot can localize by itself and can plan the shortest road to a destination. In dead region of Stargazer, we integrate with a laser range finder and e-compass to assist robot in navigation, and use the laser range finder simultaneously to avoid front obstacle. For taking elevator, we design a wireless control of independent mechanism. Robot can use Xbee transmit command to control servo motor to push elevator button and use RFID to determine whether the arrival task Floor. Last, we use Borland C++ Builder to design a Human–Computer interaction. People can operate monitor to choice receiver, and we add the functions of remote call and setting code which can increase the practicability of this service robots.

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Small, Tara, and Zygmunt J. Haas. "Quality of Service and Capacity in Constrained Intermittent-Connectivity Networks." IEEE Transactions on Mobile Computing 6, no. 7 (July 2007): 803–14. http://dx.doi.org/10.1109/tmc.2007.1033.

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Pastor, A. V., O. Tzoraki, D. Bruno, T. Kaletová, C. Mendoza-Lera, A. Alamanos, M. Brummer, et al. "Rethinking ecosystem service indicators for their application to intermittent rivers." Ecological Indicators 137 (April 2022): 108693. http://dx.doi.org/10.1016/j.ecolind.2022.108693.

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Asiaban, Siavash, Nezmin Kayedpour, Arash E. Samani, Dimitar Bozalakov, Jeroen D. M. De Kooning, Guillaume Crevecoeur, and Lieven Vandevelde. "Wind and Solar Intermittency and the Associated Integration Challenges: A Comprehensive Review Including the Status in the Belgian Power System." Energies 14, no. 9 (May 4, 2021): 2630. http://dx.doi.org/10.3390/en14092630.

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Renewable Energy Sources (RES) have drawn significant attention in the past years to make the transition towards low carbon emissions. On the one hand, the intermittent nature of RES, resulting in variable power generation, hinders their high-level penetration in the power system. On the other hand, RES can aid not only to supply much more eco-friendly energy but also it allows the power system to enhance its stability by ancillary service provision. This article reviews the challenges related to the most intermittent RES utilised in Belgium, that is, wind energy and solar energy. Additionally, wind speed and solar irradiance variations, which are the cause of wind and solar intermittency, are studied. Then, recent techniques to forecast their changes, and approaches to accommodate or mitigate their impacts on the power system, are discussed. Finally, the latest statistics and future situation of RES in the Belgian power system are evaluated.

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Govender, P. "An ethical dilemma: A case of student training, intermittent service and impact on service delivery." African Journal of Health Professions Education 7, no. 1 (January 26, 2016): 8. http://dx.doi.org/10.7196/ajhpe.405.

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Willemain, Thomas R., Charles N. Smart, and Henry F. Schwarz. "A new approach to forecasting intermittent demand for service parts inventories." International Journal of Forecasting 20, no. 3 (July 2004): 375–87. http://dx.doi.org/10.1016/s0169-2070(03)00013-x.

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Xiao, Jixue, Li Ran, and Phil Taylor. "Dynamic rating of a service power cable subject to intermittent loading." Journal of Renewable and Sustainable Energy 8, no. 4 (July 2016): 045902. http://dx.doi.org/10.1063/1.4955083.

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Yi, Zhuo, Xuehui Du, Ying Liao, and Lifeng Cao. "A quality-of-service-aware dynamic evolution model for space–ground integrated network." International Journal of Distributed Sensor Networks 13, no. 8 (August 2017): 155014771772864. http://dx.doi.org/10.1177/1550147717728649.

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Space–ground integrated network, a strategic, driving, and irreplaceable infrastructure, guarantees the development of economic and national security. However, its natures of limited resources, frequent handovers, and intermittently connected links significantly reduce the quality of service. To address this issue, a quality-of-service-aware dynamic evolution model is proposed based on complex network theory. On one hand, a quality-of-service-aware strategy is adopted in the model. During evolution phases of growth and handovers, links are established or deleted according to the quality-of-service-aware preferential attachment following the rule of better quality of service getting richer and worse quality of service getting poor or to die. On the other hand, dynamic handover of nodes and intermittent connection of links are taken into account and introduced into the model. Meanwhile, node heterogeneity is analyzed and heterogeneous nodes are endowed with discriminate interactions. Theoretical analysis and simulations are utilized to explore the degree distribution and its characteristics. Results reveal that this model is a scale-free model with drift power-law distribution, fat-tail and small-world effect, and drift character of degree distribution results from dynamic handover. Furthermore, this model exerts well fault tolerance and attack resistance compared to signal-strength-based strategy. In addition, node heterogeneity and quality-of-service-aware strategy improve the attack resistance and overall quality of service of space–ground integrated network.

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Nyahora, Passwell Pepukai, Mukand Singh Babel, David Ferras, and Andres Emen. "Multi-objective optimization for improving equity and reliability in intermittent water supply systems." Water Supply 20, no. 5 (April 17, 2020): 1592–603. http://dx.doi.org/10.2166/ws.2020.066.

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Abstract Intermittent water systems suffer from several drawbacks such as unfair distribution among users, low reliability and poor water quality. Given limited water and financial resources, making decisions for improving intermittent water supply (IWS) becomes a complex process. The paths to continuous supply are a priori undefined, however, the provision of efficient service is crucial. In the scientific literature, limited research addresses how to improve intermittent systems, to enhance the current service while transitioning to continuous supply. A multi-objective optimization (MOO) tool using a genetic algorithm has been developed to assist in investment decision-making. This approach uses multiple cost-effective intervention options to maximize equity and reliability while minimizing cost implications in an IWS system. The costs in such interventions include expenditure on pipe replacement, booster pump and elevated tank installation. The approach was first tested on a benchmark Hanoi synthetic network, and then applied to the water distribution network of Milagro (Ecuador). The developed tool reveals the extent to which equity and reliability can be driving objectives, and how they can be factored into decision-making. The application of the MOO tool in intermittent systems in order to improve existing distribution networks with strategic infrastructure addition can provide greater equity and reliability.

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Puleo, Valeria, Chiara Maria Fontanazza, Vincenza Notaro, Mauro De Marchis, Gabriele Freni, and Goffredo La Loggia. "Pumps as turbines (PATs) in water distribution networks affected by intermittent service." Journal of Hydroinformatics 16, no. 2 (May 3, 2013): 259–71. http://dx.doi.org/10.2166/hydro.2013.200.

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A hydraulic model was developed in order to evaluate the potential energy recovery from the use of centrifugal pumps as turbines (PATs) in a water distribution network characterized by the presence of private tanks. The model integrates the Global Gradient Algorithm (GGA), with a pressure-driven model that permits a more realistic representation of the influence on the network behaviour of the private tanks filling and emptying. The model was applied to a real case study: a District Metered Area in Palermo (Italy). Three different scenarios were analysed and compared with a baseline scenario (Scenario 0 – no PAT installed) to identify the system configuration with added PATs that permits the maximal energy recovery without penalizing the hydraulic network performance. In scenarios involving PAT on service connections, the specification of PAT operational parameters was also evaluated by means of Monte Carlo Analysis. The centralized solution with a PAT installed downstream of the inlet node of the analysed district, combined with local PATs on the larger service connections, proves to be the most energy-efficient scenario.

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Logan, Karen, and Chris Shaw. "Intermittent self-catheterization service provision: perspectives of people with spinal cord injury." International Journal of Urological Nursing 5, no. 2 (June 13, 2011): 73–82. http://dx.doi.org/10.1111/j.1749-771x.2011.01120.x.

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Lu, Juan, and Yan Lu. "Dimensions and influencing factors of customer loyalty in the intermittent service industry." Frontiers of Business Research in China 3, no. 1 (January 21, 2009): 63–78. http://dx.doi.org/10.1007/s11782-009-0004-4.

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Köstepen Özbek, Kübra Göksu, Seda Özcan, and Fatmanur Avar Çalışkan. "Customer complaints encountered in the online food retail during the COVID-19 intermittent curfew period." Turkish Journal of Marketing 6, no. 3 (December 24, 2021): 223–38. http://dx.doi.org/10.30685/tujom.v6i3.129.

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Almost everything has changed fundamentally with the coronavirus (COVID-19) epidemic. The pandemic has adversely affected the retail industry and the global economy. After detecting COVID-19, customers’ shopping preferences have moved to popular platforms like online shopping websites. Meanwhile, due to inadequate distribution structures and decentralized supply chain networks of businesses, customers have experienced many failures in service encounters. This study employed a document review method to analyse customer complaints covering common logistic service failures in the food sector during the three months (March, April and May 2020) intermittent curfew period. In addition, using content analysis, “şikayetvar.com” complaints were classified according to the service quality gap model. Since disruptions in the food industry are critical with their stimulating effects on supply chains, this industry has been analysed in detail. In terms of practical contribution, the study introduces an insight to enhance the customer service capabilities of private shopping sites. Furthermore, the theoretical background of the study reveals the service quality dimensions prioritized by customers in the pandemic environment and their critical role in service quality gaps.

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Bearne, Lindsay, Melissa Galea Holmes, Julie Bieles, Saskia Eddy, Graham Fisher, Bijan Modarai, Sanjay Patel, et al. "Motivating Structured walking Activity in people with Intermittent Claudication (MOSAIC): protocol for a randomised controlled trial of a physiotherapist-led, behavioural change intervention versus usual care in adults with intermittent claudication." BMJ Open 9, no. 8 (August 2019): e030002. http://dx.doi.org/10.1136/bmjopen-2019-030002.

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IntroductionWalking exercise is a recommended but underused treatment for intermittent claudication caused by peripheral arterial disease (PAD). Addressing the factors that influence walking exercise may increase patient uptake of and adherence to recommended walking. The primary aim of this randomised controlled trial (RCT) is to evaluate the efficacy of a physiotherapist-led behavioural change intervention on walking ability in adults with intermittent claudication (MOtivating Structured walking Activity in people with Intermittent Claudication (MOSAIC)) in comparison with usual care.Methods and analysisThe MOSAIC trial is a two-arm, parallel-group, single-blind RCT. 192 adults will be recruited from six National Health Service Hospital Trusts. Inclusion criteria are: aged ≥50 years, PAD (Ankle Brachial Pressure Index ≤0.90, radiographic evidence or clinician report) and intermittent claudication (San Diego Claudication Questionnaire), being able and willing to participate and provide informed consent. The primary outcome is walking ability (6 min walking distance) at 3 months. Outcomes will be obtained at baseline, 3 and 6 months by an assessor blind to group allocation. Participants will be individually randomised (n=96/group, stratified by centre) to receive either MOSAIC or usual care by an independent randomisation service. Estimates of treatment effects will use an intention-to-treat framework implemented using multiple regression adjusted for baseline values and centre.Ethics and disseminationThis trial has full ethical approval (London—Bloomsbury Research Ethics Committee (17/LO/0568)). It will be disseminated via patient forums, peer-reviewed publications and conference presentations.Trial registration numberISRCTN14501418

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Beer, Dominic, Susan Cope, Janet Smith, and Roger Smith. "The crisis team as part of comprehensive local services." Psychiatric Bulletin 19, no. 10 (October 1995): 616–19. http://dx.doi.org/10.1192/pb.19.10.616.

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An attempt to categorise the nature of the work done by an inner city crisis intervention service (CIS) which is part of a comprehensive community mental health service is described. The work of the CIS as it relates to models of crisis intervention recognised in the literature is outlined. The role of this CIS in providing additional intermittent support to individuals receiving long-term community care is commended.

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Matthews, Susan, Martin Fox, Sarah Coy, Jane Whittaker, Gail Brough, Mohammad Yasin, and Susan Whittle. "Saving more lives and limbs: applying a cardiac rehabilitation model of structured exercise to symptomatic peripheral arterial disease." British Journal of Cardiac Nursing 16, no. 4 (April 2, 2021): 1–8. http://dx.doi.org/10.12968/bjca.2020.0086.

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Background/Aims Peripheral arterial disease is common among those aged 60 years or above and can cause debilitating intermittent claudication. This impacts quality of life and is a marker for increased morbidity and mortality, mainly from cardiovascular disease. Access to recommended exercise programmes for people with symptomatic peripheral arterial disease is poor in most areas of the UK. This study aimed to evaluate the benefits of expanding an established cardiac rehabilitation service to accommodate supervised exercise for people with peripheral arterial disease Methods The study evaluated 11 participants peripheral arterial disease and intermittent claudication who were referred by the Manchester leg circulation service. Participants underwent the programme involving eight weekly 1.5 hour sessions of supervised exercise and cardiovascular education with support, reassurance and motivation. The participants' blood pressure, walking impairment, quality of life, anxiety and depression were monitored and reviewed. Results Overall, the participants' walking distance, intermittent claudication, quality of life and blood pressure had improved. The participants' overall satisfaction with the programme was excellent. The programme also demonstrated clinical and cost-effectiveness. Conclusions A structured, supervised exercise programme can have considerable benefits for people with peripheral arterial disease, improving their symptoms and quality of life. It may also help to reduce the morbidity and mortality risks associated with inactivity in this patient group.

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Bell, Elizabeth D., Donald H. Penning, Edward F. Cousineau, William D. White, Andrew J. Hartle, William C. Gilbert, and David A. Lubarsky. "How Much Labor Is in a Labor Epidural?" Anesthesiology 92, no. 3 (March 1, 2000): 851–58. http://dx.doi.org/10.1097/00000542-200003000-00029.

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Background Some anesthesiologists avoid provision of obstetric analgesia services (OAS) because of low reimbursement rates for the work involved. This study defines the manpower costs of operating an OAS in a tertiary referral center and examines reimbursement for this cost. Methods The time spent providing OAS in a total of 55 parturients was studied prospectively using a modification of classic time and motion studies. Results Mean duration of OAS in our population was 412 +/- 313 min. Mean bedside anesthesia staff time was 90 +/- 40 min, and mean number of visits to each patient's bedside was 6.3 +/- 2.0 visits. Assuming staffing on demand for service (intermittent staffing), a minimum of 2.5 full-time equivalent (FTE) attending anesthesiologists was required to meet demand. With intermittent staffing, labor cost was $325 per patient. Actual practice at Duke University Medical Center is around-the-clock (dedicated) staffing, which requires 4.4 FTEs at a cost of $728 per patient. Neither average indemnity reimbursement ($299) nor Medicaid reimbursement ($204) covered the cost per OAS patient. Breaking even is possible under indemnity reimbursement because operating room reimbursement subsidizes OAS costs. Breaking even cannot occur with Medicaid reimbursement under any circumstances. Conclusions Obstetric analgesia services requires a minimum of 2.5 FTE attending anesthesiologists at Duke University Medical Center. With the current payer mix, positive-margin operating room activities associated with the obstetric service are not sufficient to compensate for the losses incurred by an OAS. Around-the-clock dedicated obstetric staffing (4.4 FTEs) cannot operate profitably under any reasonable circumstances at our institution.

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Aristanto, Eko, Indri Damayanti, Sunarjo Sunarjo, and Zaenal Aripin. "Assistance in integrity zone development for strengthening the public services quality at Sabo Technical Center." Abdimas: Jurnal Pengabdian Masyarakat Universitas Merdeka Malang 7, no. 2 (May 19, 2022): 217–29. http://dx.doi.org/10.26905/abdimas.v7i2.7615.

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The development of the integrity zone (ZI) is an effort to maintain integrity as a state civil apparatus in carrying out public services for the community. This activity aims to assist and facilitate performance assessors of the integrity zone (ZI) implementation at the Sabo Technical Center. The implementation of the activity uses two methods, online by using Zoom Meetings and in-person meetings with tutors, technical assistance, and evaluation desks. Carried out effectively for six intermittent working days in September 2021, this activity is located at the Sabo Technical Center, Yogyakarta. The results of the initial evaluation of the implementation of the development of the integrity zone (ZI) on the leveraging component of strengthening public services, for each aspect that becomes the assessment indicator, includes the service standard rate of 85.33; service culture excellence rate of 88.26 and; service satisfaction assessment rate of 91.67. The impact of the implementation of this activity includes increasing implementation team understanding of various regulations that become the harborage of the development of the integrity zone (ZI); governance improvisation of integrity zone (ZI) development documents; improvise infrastructure facilities in public service rooms by meeting the minimum standards set; and presentation improvements on the website owned by the Sabo Technical Center.

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Wilton, P., J. Mitchell, P. Doyle, H. Dell, and K. Goon. "Provision of intermittent renal replacement service outside an ICU is safe and effective." Critical Care 12, Suppl 2 (2008): P474. http://dx.doi.org/10.1186/cc6695.

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BUSHORE, MARTHA. "Monitoring Patients in Pediatric Intensive Care." Pediatrics 77, no. 5 (May 1, 1986): 778–79. http://dx.doi.org/10.1542/peds.77.5.778.

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Physicians are responsible for cost containment. Use of more expensive hospital services for which less expensive hospital or outpatient services can be substituted without significant threat to outcome of clinical care will no longer be tolerated. Every service traditionally provided to inpatients will be scrutinized for possible delivery in a less expensive manner. The sophistication of these services has progressed dramatically in recent years. It was progressive to allow children with chronic pulmonary disease to access self-administered β-adrenergic inhalation treatments at home; it is progressive to allow parents to care for respirator-dependent infants and children at home. It was progressive to sustain life by providing inpatient intravenous hyperalimentation; it is progressive to sustain life by providing intermittent home hyperalimentation.

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Erickson, John J., Yamileth C. Quintero, and Kara L. Nelson. "Characterizing Supply Variability and Operational Challenges in an Intermittent Water Distribution Network." Water 12, no. 8 (July 29, 2020): 2143. http://dx.doi.org/10.3390/w12082143.

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Intermittent piped water supply is common in low- and middle-income countries and is inconvenient for users, particularly when supply schedules are unreliable. In this study, supply schedules and operational challenges were characterized in intermittent areas of the Arraiján, Panama distribution network based on one year of pressure and flow monitoring in four study zones, analysis of three years of pipe break data, and observations of system operation. Service quality was found to vary among users and supply schedules were often irregular and unpredictable. Direct causes of unanticipated supply outages included pump failures, chronic pipe breaks in specific parts of the system, transmission main breaks, irregular valve operations, and treatment plant outages. The extent and duration of these outages were often increased by high rates of water loss, insufficient storage capacity, and difficulty detecting and resolving infrastructure failures. Factors associated with intermittent supply, such as intermittent pumping, appeared to be associated with a higher frequency of pipe breaks. However, the analysis did not indicate a strong general correlation between intermittent supply and pipe breaks. Pressure and flow monitoring in intermittent supply areas, similar to that undertaken in this study, could be a valuable tool to improve regular operations as well as longer-term planning and prioritization of system improvements. Water loss reduction and adequate distribution storage capacity could also mitigate the effects of operational failures. Investments in monitoring and data analysis have the potential to improve the reliability of intermittent supply in cases where continuous supply is not immediately feasible.

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Jiang, Aiping, Junjun Gao, Qiuguo Chi, and Sixian Zheng. "The Effects of the Correlation of Electric Materials on Forecasting and Stock Control." European Scientific Journal, ESJ 12, no. 22 (August 30, 2016): 107. http://dx.doi.org/10.19044/esj.2016.v12n22p107.

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Forecasting and stock control play an important role in the electric companies because outstanding forecasting and stock control increase service level obviously and decrease stock cost effectively. However, the majority of the electric materials are intermittent demand, resulting in poor forecasting and stock control performance. Therefore, exploring the reasons that affect forecasting performance and stock control is necessary. This paper explores the effects of the correlation of intermittent electric materials on forecasting and stock control. First, we divide the correlation into three categories: autocorrelation in demand sizes, autocorrelation in intervals and cross-correlation between demand size and interval. Forecasting by SBA approach and using periodic dynamic inventory strategy (T, S) to control stock, exploring the effects of these three correlations on forecast accuracy, stock cost and service level. The data shows that correlations of electric materials affect their forecasting and stock control, which will help company find more accurate forecast approach and lower the cost of stock in the future.

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Ding, Ling, Ning Zhang, and Zhen Dong Qian. "Analysis of Managed Bus Lane Strategies Based on Microcosmic Traffic Simulation." Advanced Materials Research 1079-1080 (December 2014): 440–47. http://dx.doi.org/10.4028/www.scientific.net/amr.1079-1080.440.

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In order todetermine the optimum Managed Bus Lane (MBL) strategies under different traffic conditions, it is essential tocompare the before-after traffic performanceswhen a MBL strategyis produced. Microscopictraffic simulation is often used to evaluate the effects of operation strategies on traffic performances. In addition to the commonly used bus lane strategies, the dedicated bus lane (DBL),intermittent bus lane (IBL) strategies were also studied byVISSIM in this study. Delay and time occupancy wereadopted as evaluation indexes in the evaluation. The analysis results showed that traffic condition has a great influence on the traffic performances for different managed bus lane strategies.Specifically, volumeplays a higher influence on the bus lane performance as compared tobus ratio. It is also shown that the DBL has the advantage of free buses from traffic interference but has the disadvantage of disrupting traffic. IBL strategies also can improve bus service and maintaingood car service. In addition, it is found that when both volume and bus ratio arelow, there is no need to implementany bus lane strategy;if the bus ratio is at a medium level, intermittent bus lanes-near intersection(IBL-NI) strategy is preferred; when the volume is high, intermittent bus lane-basic road segment(IBL-BRS) performsbetter. The results indicate that different MBL strategies should be consideredbased ontraffic conditions.This studycan provide some valuable information for traffic managers to address traffic congestion fromaperspective of transit priority.

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Zhao, Donghao, Yu Lu, Xiaoguang Liu, Wenxin Qiao, Zhiwei Li, and Yicen Liu. "Design of emergency UAV network identity authentication protocol based on Beidou." MATEC Web of Conferences 336 (2021): 04004. http://dx.doi.org/10.1051/matecconf/202133604004.

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In view of the bad environment and intermittent communication of UAV network, based on the short message communication function of Beidou satellite navigation system, which can provide all-weather and no blind area communication service, a UAV network identity authentication protocol under emergency state when conventional means cannot communicate is designed.

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Crocker, Candice, Michael Teehan, Zenovia Ursuliak, Jason Morrison, Nancy Robertson, Maria Alexiadis, and Philip Tibbo. "S238. PATIENT ENGAGEMENT TO EARLY INTERVENTION IN PSYCHOSIS SERVICES: RETROSPECTIVE ANALYSIS OF ENGAGEMENT PATTERNS." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S129—S130. http://dx.doi.org/10.1093/schbul/sbaa031.304.

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Abstract Background Within outpatient mental health services there exists an important awareness of the difficulties in engaging and maintaining contact with patients, as well as the understanding of the negative effects of disengagement, including worse patient outcomes and increased healthcare burden. Despite the importance of engagement on service delivery and recovery outcomes, few studies have examined rates and predictors of engagement in the early phase psychosis population. Although better than community care, it has been reported that an average of 30% of patients disengage from specialized early intervention services for psychosis (EIS). We examined rates of disengagement to a 5 year EIS for psychosis, including potential individual risk factors for disengagement at entry to service. Methods This cross-sectional cohort study examined engagement to services to a single EIS site from November 2006 to November 2016. Disengagement was determined retrospectively on review of medical records, defined as not attending to clinic services despite repeated attempts by clinicians/clinic for a three month time frame. Gender, age at clinic entry, ethnicity, Positive and Negative Syndrome Scale (PANSS), Drug Attitude Inventory (DAI-30), General Assessment of Function (GAF), Social and Occupational Functioning Assessment Scale (SOFAS), WHO-ASSIST version 3.0, and the Psychological General Well Being (PGWB)scale at entry to service were examined between groups. . Descriptive statistical and survival analyses for time to disengagement were conducted on the patient data set. Results 331 patient records were complete (with above scales) from entry to service to discharge or loss to follow-up. Patients were found to fall into 3 categories with regard to patterns of engagement. The first category we named “engagers” as they remained committed to their care throughout the program and comprised 50% of the sample. The second group were labeled the disengagers (20% of the group) and these were individuals who disengaged at some point in the program and did not return, in contrast to “intermittent engagers“ who comprised 30% of the sample. Intermittent engagers were patients who at some point during their care would meet criteria for disengagement but would re-engage later (still within the 5 years from entry to EIS) and complete the program. Absolute disengagement by the disengager group was predominantly prior to 12 months of treatment (78% of the group) with a survival analysis showing a median time to absolute disengagement of 8 months. The 3 groups though defined based on their engagement status, did not significantly differ in age, gender and ethnicity. Additionally, the clinician reported scores GAF and SOFAS did not differ between the groups. Patterns of substance use differed between the groups. There was a trend toward higher tobacco use in the two groups showing disengagement. Cannabis use did not differ significantly between groups but the pattern of use was highest in the disengagers followed by the engagers and then intermittent engagers. Alcohol use was significantly different between the groups with 81% of the disengagers having problem levels of alcohol use (WHO ASSIST v. 3.0 score above 4), however, there was no correlation between alcohol score and time to disengagement. Discussion Our retrospective study found a surprisingly large portion of the patient population will wax and wane in their commitment to health services but ultimately maintain attendance to complete the program, suggesting that patients should not be discharged early from EIS for psychosis. Substance use patterns and functional measures may identify patients who are at risk of early disengagement from EIS.

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Al Ammari, Nazzirah, Harsali Lampus, and Andreas Kurniawan. "Intussusception: Diagnosis and Management According to the Competence of Primary Service Doctors." e-CliniC 10, no. 1 (March 31, 2022): 145. http://dx.doi.org/10.35790/ecl.v10i1.37464.

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Abstract: Intussusception is defined as the invagination of a bowel segment into another. Intussusception can occur at any age but it is most common in children aged three months to two years. In children, the cause of intussusception is idio-pathic and is assumed to be associated with uncoordinated intestinal peristalsis or lymphoid hyperplasia, which may be due to gastrointestinal infection. Clinical findings include intermittent abdominal pain, vomiting, and red currant jelly stools. The diagnosis of intussusception is confirmed by using contrast enema, ultrasound, and CT-Scan. Improving condition must be done before performing a surgery. In conclusion, intussusception has a good prognosis with early diagnosis and treat-ment. Surgery is an option if the intussusception is followed with complication or if the enema reduction fails.Keywords: intussusception; invaginationAbstract: Intussusception is defined as the invagination of a bowel segment into another. Intussusception can occur at any age but it is most common in children aged three months to two years. In children, the cause of intussusception is idiopathic and is assumed to be associated with uncoordinated intestinal peristalsis or lymphoid hyperplasia, which may be due to gastrointestinal infection. Clinical findings include intermittent abdominal pain, vomiting, and red currant jelly stools. The diagnosis of intussusception is confirmed by using contrast enema, ultrasound, and CT-Scan. Improving condition must be done before performing a surgery. In conclusion, intussusception has a good prognosis with early diagnosis and treatment. Surgery is an option if the intussusception is followed with complication or if the enema reduction fails.Keywords: intussusception; invagination

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Cloutier, Denise S., Margaret J. Penning, Kim Nuernberger, Deanne Taylor, and Stuart MacDonald. "Long-Term Care Service Trajectories and Their Predictors for Persons Living With Dementia: Results From a Canadian Study." Journal of Aging and Health 31, no. 1 (August 17, 2017): 139–64. http://dx.doi.org/10.1177/0898264317725618.

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Objective: We used latent transition analysis to explore common long-term care (LTC) service trajectories and their predictors for older adults with dementia. Method: Using linked administrative data collected over a 4-year interval (2008-2011), the study sample included 3,541 older persons with dementia who were clients of publicly funded LTC in British Columbia, Canada. Results: Our results revealed relatively equal reliance on home care (HC) and facility-based residential care (RC) as starting points. HC service users were further differentiated into “intermittent HC” and “continuous HC” groups. Mortality was highest for the RC group. Age, changes in cognitive performance, and activities of daily living were important predictors of transitions into HC or RC. Discussion: Reliance on HC and RC by persons with dementia raises critical questions about ensuring that an adequate range of services is available in local communities to support aging in place and to ensure appropriate timing for entry into institutions.

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Erskine, Samuel Kofi, and Khaled M. Elleithy. "Secure Intelligent Vehicular Network Using Fog Computing." Electronics 8, no. 4 (April 24, 2019): 455. http://dx.doi.org/10.3390/electronics8040455.

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VANET (vehicular ad hoc network) has a main objective to improve driver safety and traffic efficiency. The intermittent exchange of real-time safety message delivery in VANET has become an urgent concern due to DoS (denial of service) and smart and normal intrusions (SNI) attacks. The intermittent communication of VANET generates huge amount of data which requires typical storage and intelligence infrastructure. Fog computing (FC) plays an important role in storage, computation, and communication needs. In this research, fog computing (FC) integrates with hybrid optimization algorithms (OAs) including the Cuckoo search algorithm (CSA), firefly algorithm (FA), firefly neural network, and the key distribution establishment (KDE) for authenticating both the network level and the node level against all attacks for trustworthiness in VANET. The proposed scheme is termed “Secure Intelligent Vehicular Network using fog computing” (SIVNFC). A feedforward back propagation neural network (FFBP-NN), also termed the firefly neural, is used as a classifier to distinguish between the attacking vehicles and genuine vehicles. The SIVNFC scheme is compared with the Cuckoo, the FA, and the firefly neural network to evaluate the quality of services (QoS) parameters such as jitter and throughput.

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Asogwa, Brendan E., Cyprian I. Ugwu, and Ferdinand C. Ugwuanyi. "Evaluation of electronic service infrastructures and quality of e-services in Nigerian academic libraries." Electronic Library 33, no. 6 (November 2, 2015): 1133–49. http://dx.doi.org/10.1108/el-04-2014-0071.

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Purpose – The purpose of this paper is to evaluate the quality of online services in academic libraries in Nigeria. It seeks to assess the functionality of electronic infrastructures, to expose areas where the service needs of users are not adequately provided and to recommend solutions. Design/methodology/approach – The sample population was 210 staff and students who used electronic resources in Nigerian university libraries during the 2012-2013 academic session. A questionnaire was the main instrument for data collection. Modified WebQual four performance indicators were designed and used to measure: library equipment, library website, online public access catalogue (OPAC) and e-user education in the university libraries. The five-point service performance scale that ranged from very poor performance to excellent was used in measuring the views of the respondents. Findings – None of the indicators was rated excellent; six were rated good; nine were average; two and five indicators scored poor and very poor, respectively. Poor funding, intermittent power supply and weak telecommunication infrastructures were among the major impediments to online services in Nigerian universities. Through adequate funding and prudent management of library funds, online services in Nigerian university libraries could meet global standards. Practical implications – Results from this paper could guide library management on several concrete remedial actions to sustain e-service performance that could meet the missions and visions of contemporary academic libraries. Originality/value – This paper was the first to apply WebQual model in the evaluation of electronic performance quality of academic libraries in Nigeria.

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Nyende-Byakika, Stephen, Julius M. Ndambuki, and Gaddi Ngirane-Katashaya. "Modelling of pressurised water supply networks that may exhibit transient low pressure – open channel flow conditions." Water Practice and Technology 8, no. 3-4 (September 1, 2013): 503–14. http://dx.doi.org/10.2166/wpt.2013.054.

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On account of an ever increasing scarcity of potable water, ineffective water distribution networks (WDNs) and growing demand, several water distribution systems exhibit intermittent flow behaviour, either inevitably or under the deliberate action of operators, when they are expanded beyond their design capacities. This tendency is generally undesirable due to the fact that it leads to reduced service levels and consumer dissatisfaction. Moreover, due to inadequate system pressures and insufficient flows, the analysis of intermittent flow behaviour requires unconventional approaches, ultimately complicating network management. In this paper, a description is given, of tools that were developed to aid the analysis of WDNs during situations of low or non-existent pressures. Testing of the tools revealed that they could represent network behaviour fairly accurately.

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De Marchis, M., C. M. Fontanazza, G. Freni, G. La Loggia, E. Napoli, and V. Notaro. "Analysis of the impact of intermittent distribution by modelling the network-filling process." Journal of Hydroinformatics 13, no. 3 (December 22, 2010): 358–73. http://dx.doi.org/10.2166/hydro.2010.026.

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In many countries, users acquire private tanks to reduce their vulnerability to water scarcity. In such conditions, water managers often apply intermittent distribution in order to reduce the water volumes supplied to the users. This practice modifies the hydraulic behaviour of the network and determines competition among users that need to collect enough water resource for their uses. Intermittent distribution is thus responsible for the inequality that can occur among users: those located in advantaged positions of the network are able to obtain water resources soon after the service period begins, while others have to wait much longer, after the network is full. This paper analyses the inequalities that take part when intermittent distribution is applied in water scarcity scenarios. Considering the complexity of the process, the analysis was performed by means of an unsteady numerical model. The model was applied to a real case study which provided interesting insights into the network filling process, helping to highlight the advantaged and disadvantaged areas of the network in different water scarcity scenarios.

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Cabin, William. "“Less is Better” Philosophy Decreases Home Health Aide Utilization to Increase Reimbursement in Medicare Home Health." Home Health Care Management & Practice 32, no. 2 (December 1, 2019): 105–9. http://dx.doi.org/10.1177/1084822319890104.

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There has been a 75% decline in home health aide visits between 2000 and 2016, the only Medicare home health nonskilled service. A literature review indicates no studies addressing reasons for the decrease. This study summarizes interviews of nine executives from three for-profit chain-owned Medicare-certified home health agencies. Results indicate agreement on three themes: Medicare home health uses a medical model, focusing on intermittent skilled care; the Medicare home health prospective payment system exacerbated the focus on skilled care by rewarding higher reimbursement for skilled care–based episodes; and a “less is better” synergy has evolved regarding utilization of home health aide services and reimbursement. Policymakers are urged to use the forthcoming Medicare home health Patient-Driven Groupings Model Reform and recent Medicare Advantage changes covering nonmedical services to encourage greater utilization of home health aides and other nonmedical services addressing patient and caregiver social needs affecting care.

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Zhao, Yanqi, Tongtong Zhang, Li Sun, Xiaowei Zhao, Lige Tong, Li Wang, Jianning Ding, and Yulong Ding. "Energy storage for black start services: A review." International Journal of Minerals, Metallurgy and Materials 29, no. 4 (April 2022): 691–704. http://dx.doi.org/10.1007/s12613-022-2445-0.

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AbstractWith the increasing deployment of renewable energy-based power generation plants, the power system is becoming increasingly vulnerable due to the intermittent nature of renewable energy, and a blackout can be the worst scenario. The current auxiliary generators must be upgraded to energy sources with substantially high power and storage capacity, a short response time, good profitability, and minimal environmental concern. Difficulties in the power restoration of renewable energy generators should also be addressed. The different energy storage methods can store and release electrical/thermal/mechanical energy and provide flexibility and stability to the power system. Herein, a review of the use of energy storage methods for black start services is provided, for which little has been discussed in the literature. First, the challenges that impede a stable, environmentally friendly, and cost-effective energy storage-based black start are identified. The energy storage-based black start service may lack supply resilience. Second, the typical energy storage-based black start service, including explanations on its steps and configurations, is introduced. Black start services with different energy storage technologies, including electrochemical, thermal, and electromechanical resources, are compared. Results suggest that hybridization of energy storage technologies should be developed, which mitigates the disadvantages of individual energy storage methods, considering the deployment of energy storage-based black start services.

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Pickard, Luke, Alison Rodriguez, and Kiara Lewis. "Person-centred phenomenology: service user experiences of exercise." Mental Health and Social Inclusion 21, no. 2 (April 10, 2017): 119–26. http://dx.doi.org/10.1108/mhsi-01-2017-0001.

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Purpose The purpose of this paper is to explore the lived experience of sport and exercise amongst a group of mental health service users. Participants were recruited from a north of England NHS mental health trust that was piloting a sport and exercise intervention for adults with mental health needs. Design/methodology/approach In depth semi-structured interviews were conducted with five mental health service users. The chosen phenomenological methodology was collaborative and interpretive. Findings Two essential themes were highlighted: “Intermittent health breaking through heavy clouds of illness” and “The cycle of recovery”. In addition, this person-centred research identified a number of intervention benefits beyond those relating to the impact of physical activity on mental health and wellbeing. The main findings are expressed using visual imagery which participants found expressed their perceptions and experiences better than written prose. This includes the way day-to-day illness impacts on the journey of health for people with mental health problems. Research limitations/implications The intervention looked to help the transition between leaving mental health services and developing a regular routine to promote recovery. The study illuminates the voices of service users and identifies that sport and exercise for mental health service users can be beneficial for recovery and feelings of belonging which can strengthen perceptions of the self. Originality/value Few studies have approached this methodological approach. This study demonstrates the value of phenomenological research with a collaborative, person-centred or indeed an involved patient focus. This collaborative approach enabled a shared understanding of the phenomena.

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Mohapatra, Snigdha Sarita, Wenyan Wu, Manoj Kumar Tiwari, and Meenakshi Arora. "An IUWM incorporated model to improve water supply reliability in intermittent and no service areas." Resources, Conservation and Recycling 181 (June 2022): 106248. http://dx.doi.org/10.1016/j.resconrec.2022.106248.

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Miletić, Marija, Hrvoje Pandžić, and Dechang Yang. "Operating and Investment Models for Energy Storage Systems." Energies 13, no. 18 (September 4, 2020): 4600. http://dx.doi.org/10.3390/en13184600.

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In the context of climate changes and the rapid growth of energy consumption, intermittent renewable energy sources (RES) are being predominantly installed in power systems. It has been largely elucidated that challenges that RES present to the system can be mitigated with energy storage systems (ESS). However, besides providing flexibility to intermittent RES, ESS have other sources of revenue, such as price arbitrage in the markets, balancing services, and reducing the cost of electricity procurement to end consumers. In order to operate the ESS in the most profitable way, it is often necessary to make optimal siting and sizing decisions, and to determine optimal ways for the ESS to participate in a variety of energy and ancillary service markets. As a result, many publications on ESS models with various goals and operating environments are available. This paper aims at presenting the results of these papers in a structured way. A standard ESS model is first outlined, and that is followed by a literature review on operational and investment ESS models at the transmission and distribution levels. Both the price taking and price making models are elaborated on and presented in detail. Based on the examined body of work, the paper is concluded with recommendations for future research paths in the analysis of ESS.

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Sánchez, David H., Jesús R. Sánchez-Navarro, Carmen J. Navarro-Gómez, and Marusia Renteria. "Practical pressure management for a gradual transition from intermittent to continuous water supply." Water Practice and Technology 17, no. 3 (February 11, 2022): 699–707. http://dx.doi.org/10.2166/wpt.2022.015.

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Abstract Cities in developing countries that do not consider water resources as the basis for sustainable growth usually accept intermittent water supply (IWS) as the alternative to satisfy the demand of the population. Networks designed as constant water supply (CWS) operated as IWS hinder a safe and reliable water supply; thus, feasible alternatives to return the operation to CWS are required. This paper presents a methodology based flow/pressure control to accomplish an efficient transformation from an IWS sector to a CWS in the City of Chihuahua, Mexico. The management of pressure at sector entrance and critical supply points leads to successful improvement of service, ensuring water availability with adequate pressure at the peak of demand, as well as reducing the supply of water volume by 58% compared to the sector operated in IWS. The methodology allowed the improvement of decision-making and operating policy for the water operating agency (WOA), fixing service deficiency, avoiding the loss of water volumes, and maintaining competent management control. Nonetheless, resistance to the transition of using automation and setting the volume/pressure consumption based on reliable data persists. The change process will be successful to the extent that the WOA efficiently channels the participation of the personnel.

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Raza, Ahmed, and Vladimir Ulansky. "Through-Life Maintenance Cost of Digital Avionics." Applied Sciences 11, no. 2 (January 13, 2021): 715. http://dx.doi.org/10.3390/app11020715.

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Modern avionics can account for around 30% of the total cost of the aircraft. Therefore, it is essential to reduce the operational cost of avionics during a lifetime. This article addresses the critical scientific problem of creating the appropriate maintenance models for digital avionics systems that significantly increase their operational effectiveness. In this research, we propose the lifecycle cost equations to select the best option for the maintenance of digital avionics. The proposed cost equations consider permanent failures, intermittent faults, and false-positives occurred during the flight. The lifecycle cost equations are determined for the warranty and the post-warranty interval of aircraft operation. We model several maintenance options for each period of service. The cost equations consider the characteristics of the permanent failures and intermittent faults, conditional probabilities of in-flight false-positive and true-positive as well as the cost of different maintenance operations, duration of the flight, and some other parameters. We have demonstrated that a three-level post-warranty maintenance variant with a detector of intermittent faults is the best because it minimizes the total expected maintenance cost several folds compared to other maintenance options.

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Bougnères, Pierre. "Efficacy of intermittent therapy in growth hormone-deficient children." European Journal of Endocrinology 130, no. 5 (May 1994): 459–62. http://dx.doi.org/10.1530/eje.0.1300459.

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Bougnères P. Efficacy of intermittent therapy in growth hormone-deficient children. Eur J Endocrinol 1994;130:459–62. ISSN 0804–4643 Eighty-six growth hormone-deficient children treated with extractive growth hormone were transferred to recombinant growth hormone (rGH): 57 children were transferred directly to rGH, but 29 experienced a 9.7 ± 1-month pause in growth hormone administration. The retrospective analysis of growth from 1 year before to 1 year after initiation of rGH showed that the interruption of growth hormone administration did not modify the final height gain. During the 2 years, children with continuous therapy gained 12.2 ± 0.5 cm with a cumulative growth hormone dose of 43 ± 3 U/kg, while those who paused gained 12.1 ±0.3 cm with a cumulative growth hormone dose of only 24 ± 2 U/kg (p < 0.0005). As expected, during the year preceding the onset of rGH, the children who paused gained less height than those treated continuously, but grew more rapidly during the first year of rGH administration. This was due to an important re-acceleration of growth rate at re-initiation of therapy after the pause. Our observation suggests that regimens of discontinuous rGH administration could be as efficient as continuous treatment. If confirmed in prospective randomized trials, this could have important consequences for improving the clinical efficiency of a given dose of rGH, as well as for the patient's comfort, secondary effects and cost of therapy. Pierre Bougnères, Service d'Endocrinologie Pédiatrique, Hôpital Saint Vincent de Paul, 82 avenue DenfertRochereau, 75014 Paris, France

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Fusar-Poli, P., M. Byrne, S. Badger, L. R. Valmaggia, and P. K. McGuire. "Outreach and support in South London (OASIS), 2001–2011: Ten years of early diagnosis and treatment for young individuals at high clinical risk for psychosis." European Psychiatry 28, no. 5 (June 2013): 315–26. http://dx.doi.org/10.1016/j.eurpsy.2012.08.002.

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AbstractIntroduction:Prevention of psychosis has become a major objective of modern clinical psychiatry. An increasing number of new services have been established in Europe and in the world. The OASIS team has become an established model where clinical practice and research are fully integrated in the field of preventative interventions in psychosis.Method:Comprehensive analysis of different clinical and service measures describing the 2001–2011 implementation of the OASIS team.Results:Over the last decade, the OASIS team has received a total of 1102 referrals, mostly young males from ethnic minorities. After the assessment, 35% were diagnosed with an At Risk Mental State (ARMS) while 32% were already psychotic. Within the ARMS, 70% met the inclusion criteria for the attenuated psychotic symptoms subgroup, 1% met the inclusion criteria for the genetic deterioration syndrome, 9% met inclusion criteria for a brief and self-limited intermittent psychotic episode and the others met inclusion criteria for more than one subgroup. Most of them had at least one comorbid diagnosis, mainly relating to anxiety and depressive domains. The majority of the OASIS clients received cognitive behavioural therapy alone or in combination with antidepressants/antipsychotics. Over the 2-year follow-up time, 44 subjects (15.2%) developed a frank psychotic episode.Conclusions:The OASIS service represents one of the largest and most established prodromal services in the world. The burden of research evidence and the translational impact produced on the clinical practice support the OASIS as a model for the development of similar services.

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Gidikova, Pavlina, Gospodinka Prakova, Petar Ruev, and Gergana Sandeva. "Hearing impairment among workers occupationally exposed to excessive levels of noise." Open Medicine 2, no. 3 (September 1, 2007): 313–18. http://dx.doi.org/10.2478/s11536-007-0034-2.

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AbstractPure tone audiometry screening and ear examinations were conducted among 138 males working as machine and equipment operators occupationally exposed to intermittent noise of 85 to 105 dBA. Hearing loss up to 30 dB (preserved socially adequate hearing) was found in 25 workers. The hearing impairment was confirmed by distortion products of otoacoustic emissions measurements. A sharp increase in the frequency of cases can be found among the workers with service length over 10 years. While the frequency of the cases among workers with service length below 10 years is 5.45%, it is 26.5% among the subjects with service length over 10 years, with a gradual increase as a result of the increase in exposure duration. A positive correlation (p < 0.05) was found between the frequency of hearing impairment among the workers and the years of exposure to excessive noise levels. Some measures for preventing occupational noise-induced hearing loss were suggested.

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Li, Shiqi, and Tianyang Ma. "Dynamic performance fluctuation of solid-lubricated rotating mechanism for intermittent operation caused by launch vibration load." Proceedings of the Institution of Mechanical Engineers, Part J: Journal of Engineering Tribology 232, no. 4 (July 3, 2017): 401–14. http://dx.doi.org/10.1177/1350650117716371.

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Space mechanism is the key to success of long-term space missions. The service life of solid-lubricated space mechanisms is affected by various mechanical loads before in-orbit operation, among which the load caused by the launch vibration is the most severe one. Dynamic performance is an indication of the operating state of solid-lubricated mechanisms. The fluctuation of dynamic performances caused by the load of launch vibration is an unanswered but important question. In this paper, the fluctuation of dynamic performances of solid-lubricated rotating mechanisms for intermittent operation was studied by means of experiments and theoretical analyses. One group of rotating mechanisms for intermittent operation with solid-lubricated ball bearings were subjected to sine sweep tests and random vibration tests, followed by continuous operation test. The dynamic performance of mechanisms was obtained throughout all tests. The other group of mechanisms were studied with continuous operation test only for comparing the effects of vibration on the dynamic performance of mechanisms. At the same time, the sample moments of the dynamic performance of mechanisms were calculated and analyzed. The contact stress in the vibration tests was calculated by the Hertz theory. The fluctuation of the dynamic performances of solid-lubricated rotating mechanisms for intermittent operation caused by the load of launch vibration was then concluded with further discussion.

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Mohammadi, Ali, Mohammadreza Jalili-Ghazizadeh, Iman Moslehi, and Ehsan Yousefi-Khoshqalb. "Survival analysis of water distribution network under intermittent water supply conditions." Water Supply 20, no. 8 (September 21, 2020): 3531–41. http://dx.doi.org/10.2166/ws.2020.228.

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Abstract Intermittent water supply (IWS) is established temporarily or continuously in many water distribution networks (WDNs) worldwide due to prolonged drought, low rainfall periods, water scarcity and high level of leakage. IWS causes several adverse consequences on the network operation, resulting in ineffective supply and demand management. This paper presents a survival analysis of the network elements, including water mains, service connections, and valves using the Kaplan-Meier approach to determine the survival probability and the probability of failure rates of events of interest. The objective is to explore the changes in failure rates of network elements after implementing an IWS scheme. The non-parametric survival method is applied to the large zone (Zone-5) of the WDN in Tehran (Iran) based on the frequency of failures before, during, and after the implementation of an IWS regime. The results show that the probability of failure rates significantly increase after implementing the IWS scheme, and can remain for several years after, even when the network returns to continuous water supply (CWS). The results of this study can assist utility managers to understand the detrimental effects of IWS systems on increasing failure rates.

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Journal articles on the topic 'Intermittent service'

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