Maintaining quality of life in patients with chronic obstructive pulmonary disease (COPD) by extending the maintenance phase of community-based pulmonary rehabilitation: protocol for a randomised controlled trial (ComEx3 Study)

IntroductionPulmonary rehabilitation is a core component of the treatment of people with chronic obstructive pulmonary disease (COPD); however, the benefits gained diminish in the ensuing months. The optimal strategy for maintaining the benefits is unclear with weekly supervised maintenance exercise programmes proposed as one strategy. However, the long-term future of maintenance programs is dependent on quality evidence.Methods and analysisThe ComEx3 randomised controlled trial will investigate the efficacy of extending a weekly supervised maintenance programme for an additional 6 months following an initial 10-week maintenance programme (intervention) by comparing with a control group who receive the same 10-week maintenance programme followed by 6 months of usual care. 120 participants with COPD will be recruited. Primary objective is to determine health-related quality of life over 12 months. Secondary objectives are to determine functional exercise capacity trajectory and to perform an economic evaluation of the intervention to the health system. Outcomes will be analysed for superiority according to intention-to-treat and per-protocol approaches.Ethics and disseminationApproval has been received from the relevant ethics committees. Findings will be disseminated in peer-reviewed journals and conferences, targeting those involved in managing people with COPD as well as those who develop policies and guidelines.Clinical trial registrationANZCTR 12618000933257

South African emergency energy plans may disappoint

Significance Eskom's new CEO, Andre de Ruyter, recently warned that ‘load shedding’ (power outages) will continue in the medium term as the utility embarks on an accelerated maintenance programme to put the grid on a more stable basis. In turn, Ramaphosa and energy minister Gwede Mantashe have promised various measures to supplement energy production, notably allowing municipalities to procure electricity from 'independent power producers' (IPPs) and easing conditions for companies to generate their own electricity. Impacts An Eskom voluntary retrenchment package will partly buoy investor confidence about the potential for wider reforms. Eskom’s new spokesperson, a respected financial journalist, could help improve the utility’s poor public image. The coal lobby and related ANC-aligned figures will pose a formidable hurdle for the successful implementation of Pretoria's energy plan.

RFID TAGS USED IN PREVENTIVE MAINTENANCE PROGRAMME FOR MOTORS AND GENERATORS

In modern plant operations, a well-planned preventive maintenance programme is vital to reliable and long-life operation of motors and generators. Many companies lack such a programme due to the high cost and intricacy associated with employing major sensing techniques for monitoring live equipment status. This paper presents the findings of a pilot project that was to design a low cost Radio Frequency Identification (RFID) based system paired with the Internet of Things (IoT) communications to create a preventive maintenance programme that could provide real-time updates for installed motors and generators at a particular site. The basic system would incorporate ultra-high frequency RFID sensor tags for monitoring vibration and temperature, fixed RFID readers with antennas, and a based unit (built around a personal computer) with access to the internet. This is an on-line RFID-based monitoring system. The RFID tags would allow the connection of the physical assets to the digital world having a direct effect to a company’s business drivers such as cost savings, greater operational efficiency, and increased productivity. Installing the basic system on a trial basis is recommended. It is anticipated that, the RFID based system could provide a long-term solution to the current problems of complex and expensive data collection

Performance evaluation of continuous miner based underground mine operation system: An OEE based approach

CM is a globally renowned machine, designed to work as a mass production technology for underground coal. Different major coal producers across the globe are using this technology for decades to produce underground coal efficiently. India is also one of the major players globally in the arena of coal production and adopted this cutting edge technology since last decade by implementing at. few of the selective underground coal mining projects. Performance of CM technology is influenced by the geo-mining condition, fleets of other ancillary units and reliability of subsystems while implementation of this system depends largely on the extent of reserve. These aspects generate a scope of large scale research and development in this field. Overall Equipment Effectiveness (OEE) is the parameter to benchmark the equipment performance globally. OEE is the product of equipment availability, performance and product quality. This mining machine based paper focuses on the Overall Equipment Effectiveness (OEE) of the complete CM based operation to identify the vulnerable systems, which helps to design proper preventive maintenance programme. The CM based system is divided into few subsystems, such as; electrical, cutter, gathering arrangement, traction, hydraulic, chassis, feeder breaker, shuttle car, CM conveyor and out-bye conveyor. The downtime data used for this analysis is collected from an underground coal mine situated in the central part of India, belongs to one leading coal producing company of the country. From analysis it was found that, electrical systems and conveyors are among most vulnerable systems and deserves more care during maintenance. On the basis of these results recommendations are made to redesign the Preventive Maintenance Programme, in order to avoid the lower availability as well as lower OEE.

Healthy Weight for Life programme: Evaluating the practice and effectiveness of a weight loss maintenance programme in the private health insurance setting

Background: Australian private health insurers are increasingly involved in the delivery of chronic disease management programmes to their members, recognising the importance of decreasing and managing lifestyle risk factors and the impact such factors have on health service utilisation. One such secondary prevention programme is the Healthy Weight for Life programme, an intensive weight loss and lifestyle modification programme that has been designed for overweight and obese private health insurance members in Australia. Together with the insurer, the Healthy Weight for Life service provider developed and implemented a long-term maintenance programme that supports participants who complete the Healthy Weight for Life programme to maintain the weight loss they achieved during the programme. Various studies have shown that evidence-based weight management programmes can be effective; however, the results may vary in different contexts. Objective: This article presents the evaluation rationale and framework designed to assess the process and impact of the long-term maintenance programme on weight loss maintenance, other health-related benefits and participants’ experience with the programme. Methods: The evaluation will comprise a number of inter-related sub-studies balancing evaluation of programme effectiveness and implementation. The maintenance programme presented a unique opportunity for researchers to partner with private health insurance and a service provider to assess a real-world programme in the under-researched area of weight loss maintenance in this setting and emphasises the importance of evaluating such programmes given the potential the private health insurance context has in the future delivery of health care.