Thinking outside of the [cold] box: implementing a human-centered design approach to understand barriers and craft solutions to cold chain equipment maintenance in Niger.

Background: Vaccines require cold chain equipment (CCE) to ensure quality and potency, yet the risk of CCE failing is well-documented, often due to lack of equipment maintenance. While general barriers to a reliable CCE maintenance system are known, little has been done to understand the barriers from the cold chain technician's perspective. This human-centered design (HCD) study in Niger sought to better understand the gap in the current maintenance approaches from the technicians' perspectives and to collaboratively identify forward-thinking solutions.

Mammography film processor replenishment rate: bromide level monitoring.

The effects of the mammography film processing replenishment rate on contrast and speed are studied sensitometrically. Two experiments studied decreasing replenishment rates in the Kodak RP developer and quantified changes in the developer by measuring bromide ion concentrations. First, values of NaBr concentration from 1.

Physics and chemistry of film and processing.

An image containing the equivalent of almost 1 billion digital bits of diagnostic information can be recorded and displayed on a single sheet of film with use of a high-resolution screen-film radiographic system. The information storage capacity, versatility, and very low cost of screen-film radiographic systems are impressive. However, the inherent coupling of the recording and display functions does not allow optimization of these two functions independently, and this limitation has important implications for optimizing the radiographic image.

Optimum processing of mammographic film.

Underprocessing of mammographic film can result in reduced contrast and visibility of breast structures and an unnecessary increase in radiation dose to the patient. Underprocessing can be caused by physical factors (low developer temperature, inadequate development time, insufficient developer agitation) or chemical factors (developer not optimized for film type; overdiluted, underreplenished, contaminated, or frequently changed developer). Conventional quality control programs are designed to produce consistent processing but do not address the issue of optimum processing.

Late effects of poliomyelitis.

Muscular atrophy and decreased functional abilities are recognized as late complications of poliomyelitis. This study sought to more clearly define late-onset, postpolio muscular weakness--age of onset, symptoms, and severity--and to determine whether people might benefit from environmental modification, respiratory aids, and orthoses. A total of 183 postpolio patients were examined by a physician and completed a questionnaire on their ambulatory status and related musculoskeletal and respiratory symptoms.