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Journal of Healthcare Engineering 2016A maintenance program generated through the consideration of characteristics and failures of medical equipment is an important component of technology management....
Two Different Maintenance Strategies in the Hospital Environment: Preventive Maintenance for Older Technology Devices and Predictive Maintenance for Newer High-Tech Devices.
A maintenance program generated through the consideration of characteristics and failures of medical equipment is an important component of technology management. However, older technology devices and newer high-tech devices cannot be efficiently managed using the same strategies because of their different characteristics. This study aimed to generate a maintenance program comprising two different strategies to increase the efficiency of device management: preventive maintenance for older technology devices and predictive maintenance for newer high-tech devices. For preventive maintenance development, 589 older technology devices were subjected to performance verification and safety testing (PVST). For predictive maintenance development, the manufacturers' recommendations were used for 134 high-tech devices. These strategies were evaluated in terms of device reliability. This study recommends the use of two different maintenance strategies for old and new devices at hospitals in developing countries. Thus, older technology devices that applied only corrective maintenance will be included in maintenance like high-tech devices.
Topics: Equipment Safety; Equipment and Supplies; Equipment and Supplies, Hospital; Hospitals; Maintenance; Maintenance and Engineering, Hospital; Reproducibility of Results; Technology; United States
PubMed: 27195666
DOI: 10.1155/2016/7267983 -
Clinical Therapeutics Jul 2018Maintenance therapy after autologous stem cell transplantation (ASCT) improves clinical outcomes in multiple myeloma (MM), but the effect of continued treatment with... (Observational Study)
Observational Study
Treatment Outcomes and Health Care Resource Utilization in Patients With Newly Diagnosed Multiple Myeloma Receiving Lenalidomide-only Maintenance, Any Maintenance, or No Maintenance: Results from the Connect MM Registry.
PURPOSE
Maintenance therapy after autologous stem cell transplantation (ASCT) improves clinical outcomes in multiple myeloma (MM), but the effect of continued treatment with lenalidomide-only maintenance, or any maintenance, on health care resource utilization (HCRU) is largely unknown.
METHODS
Here we present an analysis of HCRU and clinical outcomes in a cohort of patients from the Connect MM registry, the largest, ongoing, observational, prospective US registry of patients with symptomatic newly diagnosed MM. In this study, patients with newly diagnosed MM who completed induction and single ASCT without subsequent consolidation received lenalidomide-only maintenance (n = 180), any maintenance (n = 256), or no maintenance (n = 165). HCRU (hospitalization, surgery/procedures, and concurrent medications [growth factors, bisphosphonates, or neuropathic pain medication]) was assessed starting from 100 days post-ASCT for up to 2 years.
FINDINGS
Although the rates of hospitalization per 100 person-years were similar across groups at the end of years 1 and 2, the median duration of hospitalization was numerically longer with no maintenance. The rates of use of growth factors, bisphosphonates, and neuropathic pain medication were generally similar in all 3 groups. The receipt of any maintenance was associated with significantly reduced use of neuropathic pain medications during year 1. Of note, lenalidomide-only maintenance was associated with significantly longer progression-free survival (54.5 vs 30.4 months; hazard ratio [HR] = 0.58; 95% CI, 0.43-0.79; P = 0.0005) and overall survival (OS) (median OS not reached in either group; HR = 0.45; 95% CI, 0.28-0.73; P = 0.001) compared with no maintenance. Likewise, the group treated with any maintenance had significantly longer median progression-free survival (44.7 vs 30.4 months; HR = 0.62; 95% CI, 0.47-0.82; P = 0.0008) and OS (median OS not reached in either group; HR = 0.50; 95% CI, 0.33-0.76; P = 0.001) than did the group that did not receive maintenance.
IMPLICATIONS
These findings suggest that in this largely community-based study population, post-ASCT maintenance therapy, including lenalidomide-only maintenance, improves clinical outcomes without negatively affecting HCRU. ClinicalTrials.gov identifier: NCT01081028.
Topics: Adult; Aged; Disease Progression; Female; Health Resources; Hematopoietic Stem Cell Transplantation; Humans; Immunologic Factors; Lenalidomide; Male; Middle Aged; Multiple Myeloma; Registries; Transplantation, Autologous; Treatment Outcome; Young Adult
PubMed: 30007443
DOI: 10.1016/j.clinthera.2018.05.017 -
Journal of the American Society of... Apr 2019
Topics: Death, Sudden, Cardiac; Electrocardiography; Humans; Maintenance; Renal Dialysis; Safety; Selective Serotonin Reuptake Inhibitors
PubMed: 30885936
DOI: 10.1681/ASN.2019020185 -
Journal of Bacteriology Feb 2020Replicative DNA helicases are essential cellular enzymes that unwind duplex DNA in front of the replication fork during chromosomal DNA replication. Replicative... (Review)
Review
Replicative DNA helicases are essential cellular enzymes that unwind duplex DNA in front of the replication fork during chromosomal DNA replication. Replicative helicases were discovered, beginning in the 1970s, in bacteria, bacteriophages, viruses, and eukarya, and, in the mid-1990s, in archaea. This year marks the 20th anniversary of the first report on the archaeal replicative helicase, the minichromosome maintenance (MCM) protein. This minireview summarizes 2 decades of work on the archaeal MCM.
Topics: Archaea; Archaeal Proteins; Bacteria; DNA Replication; DNA, Archaeal; Eukaryota; History, 20th Century; History, 21st Century; Minichromosome Maintenance Proteins; Protein Domains; Research; Structure-Activity Relationship
PubMed: 31907204
DOI: 10.1128/JB.00729-19 -
Optimizing preventive maintenance policy: A data-driven application for a light rail braking system.Proceedings of the Institution of... Oct 2017This article presents a case study determining the optimal preventive maintenance policy for a light rail rolling stock system in terms of reliability, availability, and...
This article presents a case study determining the optimal preventive maintenance policy for a light rail rolling stock system in terms of reliability, availability, and maintenance costs. The maintenance policy defines one of the three predefined preventive maintenance actions at fixed time-based intervals for each of the subsystems of the braking system. Based on work, maintenance, and failure data, we model the reliability degradation of the system and its subsystems under the current maintenance policy by a Weibull distribution. We then analytically determine the relation between reliability, availability, and maintenance costs. We validate the model against recorded reliability and availability and get further insights by a dedicated sensitivity analysis. The model is then used in a sequential optimization framework determining preventive maintenance intervals to improve on the key performance indicators. We show the potential of data-driven modelling to determine optimal maintenance policy: same system availability and reliability can be achieved with 30% maintenance cost reduction, by prolonging the intervals and re-grouping maintenance actions.
PubMed: 29278245
DOI: 10.1177/1748006X17712662 -
Chiropractic & Manual Therapies 2019Maintenance Care is a traditional chiropractic approach, whereby patients continue treatment after optimum benefit is reached. A review conducted in 1996 concluded that...
BACKGROUND
Maintenance Care is a traditional chiropractic approach, whereby patients continue treatment after optimum benefit is reached. A review conducted in 1996 concluded that evidence behind this therapeutic strategy was lacking, and a second review from 2008 reached the same conclusion. Since then, a systematic research program in the Nordic countries was undertaken to uncover the definition, indications, prevalence of use and beliefs regarding Maintenance Care to make it possible to investigate its clinical usefulness and cost-effectiveness. As a result, an evidence-based clinical study could be performed. It was therefore timely to review the evidence.
METHOD
Using the search terms "chiropractic OR manual therapy" AND "Maintenance Care OR prevention", PubMed and Web of Science were searched, and the titles and abstracts reviewed for eligibility, starting from 2007. In addition, a search for "The Nordic Maintenance Care Program" was conducted. Because of the diversity of topics and study designs, a systematic review with narrative reporting was undertaken.
RESULTS
Fourteen original research articles were included in the review. Maintenance Care was defined as a secondary/tertiary preventive approach, recommended to patients with previous pain episodes, who respond well to chiropractic care. Maintenance Care is applied to approximately 30% of Scandinavian chiropractic patients. Both chiropractors and patients believe in the efficacy of Maintenance Care. Four studies investigating the effect of chiropractic Maintenance Care were identified, with disparate results on pain and disability of neck and back pain. However, only one of these studies utilized all the existing evidence when selecting study subjects and found that Maintenance Care patients experienced fewer days with low back pain compared to patients invited to contact their chiropractor 'when needed'. No studies were found on the cost-effectiveness of Maintenance Care.
CONCLUSION
Knowledge of chiropractic Maintenance Care has advanced. There is reasonable consensus among chiropractors on what Maintenance Care is, how it should be used, and its indications. Presently, Maintenance Care can be considered an evidence-based method to perform secondary or tertiary prevention in patients with previous episodes of low back pain, who report a good outcome from the initial treatments. However, these results should not be interpreted as an indication for Maintenance Care on all patients, who receive chiropractic treatment.
Topics: Back Pain; Chiropractic; Female; Humans; Male; Neck Pain; Randomized Controlled Trials as Topic; Time Factors
PubMed: 31832142
DOI: 10.1186/s12998-019-0283-6 -
Public Health Reports (Washington, D.C.... 1996CHLORINATED DIOXINS and related compounds are extremely potent toxic substances, producing effects in humans and animals at extremely low doses. Because these compounds... (Review)
Review
CHLORINATED DIOXINS and related compounds are extremely potent toxic substances, producing effects in humans and animals at extremely low doses. Because these compounds are persistent in the environment and accumulate in the food chain, they are now distributed globally, and every member of the human population is exposed to them, primarily through the food supply and mothers' milk. An emerging body of information suggests that dioxin contamination has reached a level that may pose a large-scale, long-term public health risk. Of particular concern are dioxin's effects on reproduction, development, immune system function, and carcinogenesis. Medical waste incineration is a major source of dioxins. Polyvinyl chloride (PVC) plastic, as the dominant source of organically bound chlorine in the medical waste stream, is the primary cause of "iatrogenic" dioxin produced by the incineration of medical wastes. Health professionals have a responsibility to work to reduce dioxin exposure from medical sources. Health care institutions should implement policies to reduce the use of PVC plastics, thus achieving major reductions in medically related dioxin formation.
Topics: Bioethics; Dioxins; Environmental Pollution; Global Health; Humans; Incineration; Maintenance and Engineering, Hospital; Medical Waste Disposal; Polyvinyl Chloride; United States; United States Environmental Protection Agency
PubMed: 8711095
DOI: No ID Found -
Chinese Journal of Cancer Research =... Dec 2011Nowadays, advanced non-small cell lung cancer (NSCLC) is still an incurable disease. However, recent researches on maintenance therapy have led to considerable progress....
Nowadays, advanced non-small cell lung cancer (NSCLC) is still an incurable disease. However, recent researches on maintenance therapy have led to considerable progress. Recently, pemetrexed and erlotinib have been approved for maintenance chemotherapy by both the U.S. Food and Drug Administration and European Medicines Agency. However, there are not adequate data to support the maintenance therapy as the standard treatment for advanced NSCLC and there has been no conclusive predictor of who will get benefit from maintenance chemotherapy and what type of maintenance, continuation or switch, is preferred. This article reviews the main studies on maintenance therapy of advanced NSCLC and discusses the results available to date.
PubMed: 23359213
DOI: 10.1007/s11670-011-0254-5 -
Circulation Journal : Official Journal... Jun 2016
Topics: Heart Failure; Humans; Sleep Initiation and Maintenance Disorders
PubMed: 27264415
DOI: 10.1253/circj.CJ-16-0501 -
Health Psychology Review Jun 2017Behaviour change interventions can be effective in helping people to lose weight, but weight is often regained. Effective interventions are required to prevent this. We... (Review)
Review
Behaviour change interventions can be effective in helping people to lose weight, but weight is often regained. Effective interventions are required to prevent this. We conducted a systematic review and synthesis of qualitative research on people's experiences of weight loss maintenance. We searched bibliographic databases for qualitative studies about the experience of currently or previously overweight adults trying to maintain weight loss. We thematically synthesised study findings to develop a model of weight loss maintenance. Twenty six studies from five countries with 710 participants were included. The model developed through our synthesis proposes that making the behaviour changes required for weight loss maintenance generates psychological 'tension' due to the need to override existing habits, and incompatibility of the new behaviours with the fulfilment of psychological needs. Successful maintenance involves management or resolution of this tension. Management of tension can be achieved through self-regulation, renewing of motivation and managing external influences, although this can require constant effort. Resolution may be achieved through changing habits, finding non-obesogenic methods for addressing needs, and potentially through change in self-concept. Implications for the development of weight loss maintenance interventions are explored.
Topics: Habits; Humans; Models, Psychological; Motivation; Overweight; Qualitative Research; Self-Control; Weight Loss
PubMed: 28281891
DOI: 10.1080/17437199.2017.1299583