Search results for: maternity care model

Authors: Sangbok Lee

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There has been much effort on process improvement for outpatient clinics to provide quality and acute care to patients. One of the efforts is no-show analysis or prediction. This work analyzes patient no-shows along with patient health conditions. The health conditions refer to clinical symptoms that each patient has, out of the followings; hyperlipidemia, diabetes, metastatic solid tumor, dementia, chronic obstructive pulmonary disease, hypertension, coronary artery disease, myocardial infraction, congestive heart failure, atrial fibrillation, stroke, drug dependence abuse, schizophrenia, major depression, and pain. A dataset from a regional hospital is used to find the relationship between the number of the symptoms and no-show probabilities. Additional analysis reveals how each symptom or combination of symptoms affects no-shows. In the above analyses, cross-classification of patients by age and gender is carried out. The findings from the analysis will be used to take extra care to patients with particular health conditions. They will be forced to visit clinics by being informed about their health conditions and possible consequences more clearly. Moreover, this work will be used in the preparation of making institutional guidelines for patient reminder systems.

Keywords: healthcare system, no show analysis, process improvment, statistical data analysis

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Authors: Hamad M. Alhajeri

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Swirling chamber is a promising cooling method for heavily thermally loaded parts like turbine blades due to the additional circumferential velocity and therefore improved turbulent mixing of the fluid. This paper investigates numerically the effect of turbulence model on the heat convection of the swirling chamber. Grid independence analysis is conducted to obtain the proper grid dimension. The work validated with experimental data available in the literature. Flow analysis using improved delayed detached eddy simulation turbulence model and Reynolds averaged Navier-Stokes k-ɛ turbulence model is carried. The flow characteristic near the exit is reformed when improved delayed detached eddy simulation model used.

Keywords: gas turbine, Nusselt number, flow characteristics, heat transfer

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Authors: Raphael Naryongo, Philip Ngare, Anthony Waititu

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This paper deals with numerical simulation of Wishart processes for a single asset risky pricing model whose volatility is described by Wishart affine diffusion processes. The multi-factor specification of volatility will make the model more flexible enough to fit the stock market data for short or long maturities for better returns. The Wishart process is a stochastic process which is a positive semi-definite matrix-valued generalization of the square root process. The aim of the study is to model the log asset stock returns under the double Wishart stochastic volatility model. The solution of the log-asset return dynamics for Bi-Wishart processes will be obtained through Euler-Maruyama discretization schemes. The numerical results on the asset returns are compared to the existing models returns such as Heston stochastic volatility model and double Heston stochastic volatility model

Keywords: euler schemes, log-asset return, infinitesimal generator, wishart diffusion affine processes

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Authors: H. Z. Ulukan, E. Demircioğlu, M. Erol Genevois

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The scope of this paper and the aim of proposed model were to apply monetary Input –Output (I-O) analysis to point out the importance of reusing know-how and other requirements in order to reduce the production costs in a manufacturing process for a laptop computer. I-O approach using the monetary input-output model is employed to demonstrate the impacts of different factors in a manufacturing process. A sensitivity analysis showing the correlation between these different factors is also presented. It is expected that the recommended model would have an advantageous effect in the cost minimization process.

Keywords: input-output analysis, monetary input-output model, manufacturing process, laptop computer

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Authors: Irtaza M. Syed, Kaamran Raahemifar

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In this paper, we present a comparative assessment of Space Vector Pulse Width Modulation (SVPWM) and Model Predictive Control (MPC) for two-level three phase (2L-3P) Voltage Source Inverter (VSI). VSI with associated system is subjected to both control techniques and the results are compared. Matlab/Simulink was used to model, simulate and validate the control schemes. Findings of this study show that MPC is superior to SVPWM in terms of total harmonic distortion (THD) and implementation.

Keywords: voltage source inverter, space vector pulse width modulation, model predictive control, comparison

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Authors: Salman Mohamadi, Seyed Mohammad Ali Tayaranian Hosseini, Hamidreza Amindavar

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In this paper, we provide a procedure to analyze and model EEG (electroencephalogram) signal as a time series using ARIMA-GARCH to predict an epileptic attack. The heteroskedasticity of EEG signal is examined through the ARCH or GARCH, (Autore- gressive conditional heteroskedasticity, Generalized autoregressive conditional heteroskedasticity) test. The best ARIMA-GARCH model in AIC sense is utilized to measure the volatility of the EEG from epileptic canine subjects, to forecast the future values of EEG. ARIMA-only model can perform prediction, but the ARCH or GARCH model acting on the residuals of ARIMA attains a con- siderable improved forecast horizon. First, we estimate the best ARIMA model, then different orders of ARCH and GARCH modelings are surveyed to determine the best heteroskedastic model of the residuals of the mentioned ARIMA. Using the simulated conditional variance of selected ARCH or GARCH model, we suggest the procedure to predict the oncoming seizures. The results indicate that GARCH modeling determines the dynamic changes of variance well before the onset of seizure. It can be inferred that the prediction capability comes from the ability of the combined ARIMA-GARCH modeling to cover the heteroskedastic nature of EEG signal changes.

Keywords: epileptic seizure prediction , ARIMA, ARCH and GARCH modeling, heteroskedasticity, EEG

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Authors: V. Moser-Siegmeth, M. C. Gambal, M. Jelovcak, B. Prytek, I. Swietalsky, D. Würzl, C. Fida, V. Mühlegger

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Adaptability is the capacity to adjust without great difficulty to changing circumstances. Within our project, we aimed to detect whether older people living within a long-term care hospital lose the ability to adapt. Theoretical concepts are contradictory in their statements. There is also lack of evidence in the literature how the adaptability of older people changes over the time. Following research questions were generated: Are older residents of a long-term care facility able to adapt to changes within their daily routine? How long does it take for older people to adapt? The study was designed as a convergent parallel mixed method intervention study, carried out within a four-month period and took place within seven wards of a long-term care hospital. As a planned intervention, a change of meal-times was established. The inhabitants were surveyed with qualitative interviews and quantitative questionnaires and diaries before, during and after the intervention. In addition, a survey of the nursing staff was carried out in order to detect changes of the people they care for and how long it took them to adapt. Quantitative data was analysed with SPSS, qualitative data with a summarizing content analysis. The average age of the involved residents was 82 years, the average length of stay 45 months. The adaptation to new situations does not cause problems for older residents. 47% of the residents state that their everyday life has not changed by changing the meal times. 24% indicate ‘neither nor’ and only 18% respond that their daily life has changed considerably due to the changeover. The diaries of the residents, which were conducted over the entire period of investigation showed no changes with regard to increased or reduced activity. With regard to sleep quality, assessed with the Pittsburgh sleep quality index, there is little change in sleep behaviour compared to the two survey periods (pre-phase to follow-up phase) in the cross-table. The subjective sleep quality of the residents is not affected. The nursing staff points out that, with good information in advance, changes are not a problem. The ability to adapt to changes does not deteriorate with age or by moving into a long-term care facility. It only takes a few days to get used to new situations. This can be confirmed by the nursing staff. Although there are different determinants like the health status that might make an adjustment to new situations more difficult. In connection with the limitations, the small sample size of the quantitative data collection must be emphasized. Furthermore, the extent to which the quantitative and qualitative sample represents the total population, since only residents without cognitive impairments of selected units participated. The majority of the residents has cognitive impairments. It is important to discuss whether and how well the diary method is suitable for older people to examine their daily structure.

Keywords: adaptability, intervention study, mixed methods, nursing home residents

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Authors: Jun Tian, Yu Yang, Liping Zhang, Qianhua Kan

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Experimental results show that SA 508-3 steel exhibits temperature dependent cyclic softening characteristic and obvious ratcheting behaviors, and dynamic strain age was observed at temperature range of 200 ºC to 350 ºC. Based on these observations, a temperature dependent cyclic plastic constitutive model was proposed by introducing the nonlinear cyclic softening and kinematic hardening rules, and the dynamic strain age was also considered into the constitutive model. Comparisons between experiments and simulations were carried out to validate the proposed model at elevated temperature.

Keywords: constitutive model, elevated temperature, ratcheting, SA 508-3

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Authors: Masica Jordan Alston, Angela N. Bullock, Angela S. Henderson, Stephanie Strianse, Sade Dunn, Joseph Hackett, Alaysia Black Hackett, Marcus Mason

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The Energy Model of Cumulative Grief was created in 2018. The Energy Model of Cumulative Grief utilizes historic models of grief stage theories. The innovative model is additionally unique due to its focus on cultural responsiveness. The Energy Model of Cumulative Grief helps to train practitioners who work with clients dealing with grief and loss. This paper assists in introducing the world to this innovative model and exploring how this model positively impacted a convenience sample of 140 practitioners and individuals experiencing grief and loss. Respondents participated in Webinars provided by the National Grief and Loss Center of America (NGLCA). Participants in this cross-sectional research design study completed one of three Grief and Loss Surveys created by the Grief and Loss Centers of America. Data analysis for this study was conducted via SPSS and Survey Hero to examine survey results for respondents. Results indicate that the Energy Model of Cumulative Grief was an effective resource for participants in addressing grief and loss. The majority of participants found the Webinars to be helpful and a conduit to providing them with higher levels of hope. The findings suggest that using The Energy Model of Cumulative Grief is effective in providing culturally responsive grief and loss resources to practitioners and clients. There are far reaching implications with the use of technology to provide hope to those suffering from grief and loss worldwide through The Energy Model of Cumulative Grief.

Keywords: grief, loss, grief energy, grieving brain

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Authors: Shayem Saleh ALresheedi, Lu Song Feng, Abdulaziz Abdulwahab M. Fatani

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Cloud computing is an emerging concept in the technological sphere. Its development enables many applications to avail information online and on demand. It is becoming an essential element for businesses due to its ability to diminish the costs of IT infrastructure and is being adopted in Saudi Arabia. However, there exist many factors that affect its adoption. Several researchers in the field have ignored the study of the TAM model for identifying the relevant factors and their impact for adopting of cloud computing. This study focuses on evaluating the acceptability of cloud computing and analyzing its impacting factors using Technology Acceptance Model (TAM) of technology adoption in Saudi Arabia. It suggests a model to examine the influential factors of the TAM model along with external factors of technical support in adapting the cloud computing. The proposed model has been tested through the use of multiple hypotheses based on calculation tools and collected data from customers through questionnaires. The findings of the study prove that the TAM model along with external factors can be applied in measuring the expected adoption of cloud computing. The study presents an investigation of influential factors and further recommendation in adopting cloud computing in Saudi Arabia.

Keywords: cloud computing, acceptability, adoption, determinants

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Authors: Jui Chen Wu, Ming Yi Hsu

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Background and Purpose: Shift work of nursing staff is inevitable in hospital to provide continuing medical care. However, shift work is considered as a health hazard that may cause physical and psychological problems. Serious workplace fatigue of nursing shift work might impact on family, social and work life, moreover, causes serious reduction of quality of medical care, or even malpractice. This study aims to explore relationships among nursing staff’s shift, workplace fatigue and quality of working life. Method: Structured questionnaires were used in this study to explore relationships among shift work, workplace fatigue and quality of working life in nursing staffs. We recruited 590 nursing staffs in different Community Teaching hospitals in Taiwan. Data analysed by descriptive statistics, single sample t-test, single factor analysis, Pearson correlation coefficient and hierarchical regression, etc. Results: The overall workplace fatigue score is 50.59 points. In further analysis, the score of personal burnout, work-related burnout, over-commitment and client-related burnout are 57.86, 53.83, 45.95 and 44.71. The basic attributes of nursing staff are significantly different from those of workplace fatigue with different ages, licenses, sleeping quality, self-conscious health status, number of care patients of chronic diseases and number of care people in the obstetric ward. The shift variables revealed no significant influence on workplace fatigue during the hierarchical regression analysis. About the analysis on nursing staff’s basic attributes and shift on the quality of working life, descriptive results show that the overall quality of working life of nursing staff is 3.23 points. Comparing the average score of the six aspects, the ranked average score are 3.47 (SD= .43) in interrelationship, 3.40 (SD= .46) in self-actualisation, 3.30 (SD= .40) in self-efficacy, 3.15 (SD= .38) in vocational concept, 3.07 (SD= .37) in work aspects, and 3.02 (SD= .56) in organization aspects. The basic attributes of nursing staff are significantly different from quality of working life in different marriage situations, education level, years of nursing work, occupation area, sleep quality, self-conscious health status and number of care in medical ward. There are significant differences between shift mode and shift rate with the quality of working life. The results of the hierarchical regression analysis reveal that one of the shifts variables 'shift mode' which does affect staff’s quality of working life. The workplace fatigue is negatively correlated with the quality of working life, and the over-commitment in the workplace fatigue is positively related to the vocational concept of the quality of working life. According to the regression analysis of nursing staff’s basic attributes, shift mode, workplace fatigue and quality of working life related shift, the results show that the workplace fatigue has a significant impact on nursing staff’s quality of working life. Conclusion: According to our study, shift work is correlated with workplace fatigue in nursing staffs. This results work as important reference for human resources management in hospitals to establishing a more positive and healthy work arrangement policy.

Keywords: nursing staff, shift, workplace fatigue, quality of working life

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Authors: Royia Soliman, Salma ElAnsary, Akram Amin Abdellatif, Florian Holzapfel

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Model-Based Safety Analysis (MBSA) is an approach in which the system and safety engineers share a common system model created using a model-based development process. The model can also be extended by the failure modes of the system components. There are two famous approaches for the addition of fault behaviors to system models. The first one is to enclose the failure into the system design directly. The second approach is to develop a fault model separately from the system model, thus combining both independent models for safety analysis. This paper introduces a hybrid approach of MBSA. The approach tries to use informal abstracted models to investigate failure behaviors. The approach will combine various concepts such as directed graph traversal, event lists and Constraint Satisfaction Problems (CSP). The approach is implemented using an Object Oriented programming language. The components are abstracted to its failure logic and relationships of connected components. The implemented approach is tested on various flight control systems, including electrical and multi-domain examples. The various tests are analyzed, and a comparison to different approaches is represented.

Keywords: flight control systems, model based safety analysis, safety assessment analysis, system modelling

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Authors: Arnab Roy, P. S. Anil Kumar

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We discuss angle dependent changes to the Barkhausen noise signatures of thin epitaxial Fe films upon altering the angle of the applied field. We observe a sub-critical to critical phase transition in the hysteresis loop of the sample upon increasing the out-of-plane component of the applied field. The observations are discussed in the light of simulations of a 2D Gaussian Random Field Ising Model with references to a reducible form of the Random Anisotropy Ising Model.

Keywords: Barkhausen noise, Planar Hall effect, Random Field Ising Model, Random Anisotropy Ising Model

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Authors: Deyu Zhou, Xiao Xue, Lizhen Cui

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With the increasing collaboration among various services and the growing complexity of user demands, there are more and more factors affecting the stable development of the cloud manufacturing service economic system (CMSE). This poses new challenges to the evolution analysis of the CMSE. Many researchers have modeled and analyzed the evolution process of CMSE from the perspectives of individual learning and internal factors influencing the system, but without considering other important characteristics of the system's individuals (such as heterogeneity, bounded rationality, etc.) and the impact of external environmental factors. Therefore, this paper proposes an integrated artificial social model for the cloud manufacturing service economic system, which considers both the characteristics of the system's individuals and the internal and external influencing factors of the system. The model consists of three parts: the Agent model, environment model, and rules model (Agent-Environment-Rules, AER): (1) the Agent model considers important features of the individuals, such as heterogeneity and bounded rationality, based on the adaptive behavior mechanisms of perception, action, and decision-making; (2) the environment model describes the activity space of the individuals (real or virtual environment); (3) the rules model, as the driving force of system evolution, describes the mechanism of the entire system's operation and evolution. Finally, this paper verifies the effectiveness of the AER model through computational and experimental results.

Keywords: cloud manufacturing service economic system (CMSE), AER model, artificial social modeling, integrated framework, computing experiment, agent-based modeling, social networks

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Authors: Joshna Rani S., Ahmadi Banu

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Artificial Intelligence (AI) has a significant task to carry out in the medical care contributions of things to come. As AI, it is the essential capacity behind the advancement of accuracy medication, generally consented to be a painfully required development in care. Albeit early endeavors at giving analysis and treatment proposals have demonstrated testing, we anticipate that AI will at last dominate that area too. Given the quick propels in AI for imaging examination, it appears to be likely that most radiology, what's more, pathology pictures will be inspected eventually by a machine. Discourse and text acknowledgment are now utilized for assignments like patient correspondence and catch of clinical notes, and their utilization will increment. The best test to AI in these medical services areas isn't regardless of whether the innovations will be sufficiently skilled to be valuable, but instead guaranteeing their appropriation in day by day clinical practice. For far reaching selection to happen, AI frameworks should be affirmed by controllers, coordinated with EHR frameworks, normalized to an adequate degree that comparative items work likewise, instructed to clinicians, paid for by open or private payer associations, and refreshed over the long haul in the field. These difficulties will, at last, be survived, yet they will take any longer to do as such than it will take for the actual innovations to develop. Therefore, we hope to see restricted utilization of AI in clinical practice inside 5 years and more broad use inside 10 years. It likewise appears to be progressively evident that AI frameworks won't supplant human clinicians for a huge scope, yet rather will increase their endeavors to really focus on patients. Over the long haul, human clinicians may advance toward errands and work plans that draw on remarkably human abilities like sympathy, influence, and higher perspective mix. Maybe the lone medical services suppliers who will chance their professions over the long run might be the individuals who will not work close by AI

Keywords: artificial intellogence, health care, breast cancer, AI applications

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Authors: Michael Airton

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This case study examines the development of a new service delivery model for prisons that focuses on using NGO’s to provide more effective case management and post release support functions. The model includes the co-design of the service delivery model and innovative commercial agreements that encourage embedded service providers within the prison and continuity of services post release with outcomes based payment mechanisms. The collaboration of prison staff, probation and parole officers and NGO’s is critical to the success of the model and its ability to deliver value and positive outcomes in relation to desistance from offending.

Keywords: collaborative service delivery, desistance, non-government organisations, post release support services

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Authors: Garreth Kestell, Lukah Dykes, Danielle Zerk, Kyla Trewartha, Rhianon Marshall, Elena Rudnik

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Adolescent mental health is an international priority and the impact of innovative service models must be evaluated. Secondary school-based mental health services (SBMHS) involving private general practitioners and psychologists are a model of care being trialed in South Australia. Measures of depression, anxiety, and stress are routinely collected throughout psychotherapy sessions. This research set out to quantify the impact of psychotherapy for rural adolescents in a school setting and explore the importance of session frequency. Methods: Demographics, session date and DASS21 scores from students (n=65) seen in 2016 by three psychologists working at the SBMHS were recorded. Students were aged 13-18 years (M=15.43, SD= 1.24), mostly female (F=51, M=14), attended between 1 and 23 sessions with a median of 6 sessions (MAD 5.93) in one-year. The treating psychologist collected self-administered DASS21 scores. A mixed model analysis was used with age, sex, treating psychologist, months from first session, and session number as fixed effects, with response variables of DASS depression, anxiety, and stress scores. Results: 71.5% were classified as having extreme or severe anxiety and half had extreme or severe depression and/or stress scores. On average males had a greater increase in DASS scores over time but males attending more sessions benefited most from therapy. Discussion: Psychologists are treating rural adolescents in schools for severe anxiety, depression, and stress. This pilot study indicates that a predictive model combining demographics, session frequency, and DASS scores may help identify who is most likely to benefit from individual psychotherapy. Variations in DAS scores of individuals over time indicate the need for the collection of information such as living situation and exposure to alcohol. A larger sample size and additional data are currently being collected to allow for a more robust analysis.

Keywords: adolescent health, psychotherapy, school based mental health services, DAS21

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Authors: Kamel Abdelaziz Mohamed

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Intoduction:Inadequate knowledge about obstetric admission and infrequent dealing with the obstetric patients in ICU results in high mortality and morbidity. Aim of the work:To evaluate the indications, course, severity of illness, and outcome of obstetric patients admitted to the intensive care unit (ICU). Patients and Methods: We collected baseline data and acute physiology and chronic health evaluation II (APACHE II) scores. ICU mortality was the primary outcome. Results: Seventy obstetric patients were admitted to the ICU over 3 years, 36 of these patients (51.4 %) were admitted during the antepartum period. The primary obstetric indication for ICU admission was pregnancy-induced hypertension (22 patients, 31.4%), followed by sepsis (8 patients, 11.4%) as the leading non-obstetric admission. The mean APACHE II score was 19.6. The predicted mortality rate based on the APACHE II score was 22%, however, only 4 maternal deaths (5.7%) were among the obstetric patients admitted to the ICU. Conclusion: Evaluation of obstetric patients by (APACHE II) scores showed higher predicted mortality rate, however the overall mortality was lower. Regular follow up, together with early detection of complications and prompt ICU admission necessitating proper management by specialized team can improve mortality.

Keywords: obstetric, complication, postpartum, sepsis

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Authors: Jason Ceavers, Travis Thompson, Juan Torres, Ramanakumar Anam, Alan Wong, Andrei Carvalho, Shane Quo, Shawn Alonso, Moises Cintron, Ricardo C. Carrero, German Lopez, Vamsi Garimella, German Giese

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Introduction: Advance directives (AD) are essential for patients to communicate their wishes when they are not able to. Ideally, these discussions should not occur for the first time when a patient is hospitalized with an acute life-threatening illness. There is a large number of patients who do not have clearly documented ADs, resulting in the misutilization of resources and additional patient harm. This is a nationwide issue, and the Joint Commission has it as one of its national quality metrics. Presented here is a proposed protocol to increase the number of documented AD discussions in a community-based, internal medicine residency primary care clinic in South Florida. Methods: The SMART Aim for this quality improvement project is to increase documentation of AD discussions in the outpatient setting by 25% within three months in medicare patients. A survey was sent to stakeholders (clinic attendings, residents, medical assistants, front desk staff, and clinic managers), asking them for three factors they believed contributed most to the low documentation rate of AD discussions. The two most important factors were time constraints and systems issues (such as lack of a standard method to document ADs and ADs not being uploaded to the chart) which were brought up by 25% and 21.2% of the 32 survey responders, respectively. Pre-intervention data from clinic patients in 2020-2021 revealed 17.05% of patients had clear, actionable ADs documented. To address these issues, an AD pocket card was created to give to patients. One side of the card has a brief explanation of what ADs are. The other side has a column of interventions (cardiopulmonary resuscitation, mechanical ventilation, dialysis, tracheostomy, feeding tube) with boxes patients check off if they want the intervention done, do not want the intervention, do not want to discuss the topic, or need more information. These cards are to be filled out and scanned into their electronic chart to be reviewed by the resident before their appointment. The interventions that patients want more information on will be discussed by the provider. If any changes are made, the card will be re-scanned into their chart. After three months, we will chart review the patients seen in the clinic to determine how many medicare patients have a pocket card uploaded and how many have advance directives discussions documented in a progress note or annual wellness note. If there is not enough time for an AD discussion, a follow-up appointment can be scheduled for that discussion. Discussion: ADs are a crucial part of patient care, and failure to understand a patient’s wishes leads to improper utilization of resources, avoidable litigation, and patient harm. Time constraints and systems issues were identified as two major factors contributing to the lack of advance directive discussion in our community-based resident primary care clinic. Our project aims at increasing the documentation rate for ADs through a simple pocket card intervention. These are self-explanatory, easy to read and allow the patients to clearly express what interventions they desire or what they want to discuss further with their physician.

Keywords: advance directives, community-based, pocket card, primary care clinic

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Authors: Aline Giardin, Ana Fontoura, Thomas Anderson

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Transsexuality is a condition that requires the work of professionals from various fields for diagnosis and treatment. The correct diagnosis is very important because the surgery is irreversible. Diagnostic elements are essentially clinical and an observation period of two years prior to surgery is recommended. In this review article, we discuss the importance of psychiatric nursing for the care of transgender patients, as well as their mental health. Transsexuality is a phenomenon that contrasts our common understandings of sexuality, but it is not a sexual issue. Also called gender dysphoria is a mismatch between the anatomical sex of an individual and their gender identity. In relation to mental health, among transsexuals, we find variations ranging from psychoses to total normality. As the etiology is still controversial, there is no biological marker and only the clinical criteria can be used. Portaria nº 2803, of November 19, 2013, Brazil, regulates the surgical reassignment of sex by the SUS and the nurse started to work also in operational groups (transsexuals who wish to perform surgery and other procedures of reassignment of sex). Health and education, establishes links and guides the care that female and male transsexual patients will have to have before and after surgery. It is also important to say that the work of health education is not only concerned with aspects related to the sexual reassignment surgery, but also with the mental health of its patients and with the family. One of the main complaints of patients is the impression that professionals seem to find them strange and feel extremely uncomfortable when they talk about their desire to undergo sex-change surgery: Investigate the role of nursing in the process of change sexual. Our methodology was a review of articles produced between 1994 and 2015. It was concluded that nursing should specialize for this new demand, which is growing more and more in our health services. We believe that nursing is specializing to enter this context and the expectations are good for the professionals and for the reception of the transsexual patient.

Keywords: transex, nursing, importance, patient

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Authors: Nicolò Vaiana, Giorgio Serino

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The nonlinear time history analysis of seismically base-isolated structures can require a significant computational effort when the behavior of each seismic isolator is predicted by adopting the widely used differential equation Bouc-Wen model. In this paper, a nonlinear exponential model, able to simulate the response of seismic isolation bearings within a relatively large displacements range, is described and adopted in order to reduce the numerical computations and speed up the nonlinear dynamic analysis. Compared to the Bouc-Wen model, the proposed one does not require the numerical solution of a nonlinear differential equation for each time step of the analysis. The seismic response of a 3d base-isolated structure with a lead rubber bearing system subjected to harmonic earthquake excitation is simulated by modeling each isolator using the proposed analytical model. The comparison of the numerical results and computational time with those obtained by modeling the lead rubber bearings using the Bouc-Wen model demonstrates the good accuracy of the proposed model and its capability to reduce significantly the computational effort of the analysis.

Keywords: base isolation, computational efficiency, nonlinear exponential model, nonlinear time history analysis

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Authors: Juan Manuel Uriarte Lopez, Hector Raul Guemez Gaxiola, Javier Alonso Romo Rubio, Juan Manuel Romo Valdez

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The objective of this investigation was to determine the influence of the use of recycled vegetable oil from restaurants in the productive performance of sows in lactation. Twenty-four hybrids lactating sows (Landrace x Yorkshire) were divided into three treatments with eight sows per treatment. On day 107 of gestation, the sows were moved to the mesh floor maternity cages in an environment regulated by the environment regulated (2.4 × 0.6 m) contained an area (2.4 × 0.5 m) for newborn pigs on each side, all diets were provided as a dry powder, and the sows received free access to water throughout the experimental period. After farrowing, the sows were fasted for 12 hours, the daily feed ration gradually increased, and the sows had ad libitum access to feed on the fourth day. The diets used were corn-soybean meal-based, containing 0 (CONT), recycled vegetable oil 1.0 % (RVOL), or recycled vegetable oil 1.5 % (RVOH) for 30 days. The diets contained similar calculated levels of crude protein and metabolizable energy and contained vitamins and minerals that exceeded National Research Council (1998) recommendations; sows were fed three times daily. On day 30, piglets were weaned, and performances of lactating sows and nursery piglets were recorded. Results indicated that average daily feed intake (5.58, 5.55, and 5.49 kg for CONT, RVOL, and RVO, respectively) of sows were not affected (P > 0.05) by different dietary. There was no difference in the average body weight of piglets on the day of birth, with 1.33, 1.36, and 1.35 kg, respectively (P > 0.05). There was no difference in average body weight of piglets on day 30, with 6.91, 6.75, and 7.05 kg, respectively 0.05) between treatments numbers of weaned piglets per sow (9.95, 9.80, and 9.80) were not affected by treatments (P > 0.05).In conclusion, the substitution of virgin vegetable oil for recycled vegetable oil in the diet does not affect the productive performance of lactating sows.

Keywords: lactating, sow, vegetable, oil

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Authors: Kyngäs Helvi, Patala-Pudas, Kaakinen Pirjo

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It has been reported that COPD -patients may experience much emotional distress, which can compromise positive health outcomes. The aim of this study was to explore disease-related uncertainty as reported by Chronic Obstructive Pulmonary Disease (COPD) patients. Uncertainty was defined as a lack of confidence; negative feelings; a sense of confidence; and awareness of the sources of uncertainty. Research design was a non-experimental cross-sectional survey. The data (n=141) was collected by validated questionnaire during COPD -patients’ visits or admissions to a tertiary hospital. The response rate was 62%. The data was analyzed by statistical methods. Around 70% of the participants were male with COPD diagnosed many years ago. Fifty-four percent were under 65 years and used an electronic respiratory aid apparatus (52%) (oxygen concentrator, ventilator or electronic inhalation device). Forty-one percent of the participants smoked. Disease-related uncertainty was widely reported. Seventy-three percent of the participants had uncertainty about their knowledge of the disease, the pulmonary medication and nutrition. One-quarter (25%) did not feel sure about managing COPD exacerbation. About forty percent (43%) reported that they did not have a written exacerbation decision aid indicating how to act in relation to COPD symptoms. Over half of the respondents were uncertain about self-management behavior related to health habits such as exercise and nutrition. Over a third of the participants (37%) felt uncertain about self-management skills related to giving up smoking. Support from the care providers was correlated significantly with the patients’ sense of confidence. COPD -patients who felt no confidence stated that they received significantly less support in care. Disease-related uncertainty should be considered more closely and broadly in the patient care context, and those strategies within patient education that enhance adherence should be strengthened and incorporated into standard practice.

Keywords: adherence, COPD, disease-management, uncertainty

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Authors: Jing Zhang, Jie Chen

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In this paper, we deal with the optimal I/O point location in an automated parking system. In this system, the S/R machine (storage and retrieve machine) travels independently in vertical and horizontal directions. Based on the characteristics of the parking system and the basic principle of AS/RS system (Automated Storage and Retrieval System), we obtain the continuous model in units of time. For the single command cycle using the randomized storage policy, we calculate the probability density function for the system travel time and thus we develop the travel time model. And we confirm that the travel time model shows a good performance by comparing with discrete case. Finally in this part, we establish the optimal model by minimizing the expected travel time model and it is shown that the optimal location of the I/O point is located at the middle of the left-hand above corner.

Keywords: parking system, optimal location, response time, S/R machine

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Authors: J. P. Panda, K. Sasmal, H. V. Warrior

Abstract:

Eddy viscosity models in turbulence modeling can be mainly classified as linear and nonlinear models. Linear formulations are simple and require less computational resources but have the disadvantage that they cannot predict actual flow pattern in complex geophysical flows where streamline curvature and swirling motion are predominant. A constitutive equation of Reynolds stress anisotropy is adopted for the formulation of eddy viscosity including all the possible higher order terms quadratic in the mean velocity gradients, and a simplified model is developed for actual oceanic flows where only the vertical velocity gradients are important. The new model is incorporated into the one dimensional General Ocean Turbulence Model (GOTM). Two realistic oceanic test cases (OWS Papa and FLEX' 76) have been investigated. The new model predictions match well with the observational data and are better in comparison to the predictions of the two equation k-epsilon model. The proposed model can be easily incorporated in the three dimensional Princeton Ocean Model (POM) to simulate a wide range of oceanic processes. Practically, this model can be implemented in the coastal regions where trasverse shear induces higher vorticity, and for prediction of flow in estuaries and lakes, where depth is comparatively less. The model predictions of marine turbulence and other related data (e.g. Sea surface temperature, Surface heat flux and vertical temperature profile) can be utilized in short term ocean and climate forecasting and warning systems.

Keywords: Eddy viscosity, turbulence modeling, GOTM, CFD

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Authors: Hassen Mohammed, Michelle Clarke, Helen Marshall

Abstract:

Maternal immunization is an effective strategy to protect pregnant women and their offspring from vaccine-preventable diseases. Despite the recommendation of maternal influenza and more recently pertussis immunization in Australia, uptake of these vaccines has been suboptimal. Monitoring the impact of the current funded vaccine programs for pregnant women is limited. The study aimed to assess the impact of the funded program and determine factors associated with vaccine uptake in pregnant women. This observational prospective study was undertaken between November 2014 and July 2016 at the Women’s and Children’s Hospital in South Australia (WCH). Demographic details and vaccination history from South Australian pregnant women who attended the WCH were reviewed. A standardized self-reported survey was conducted in antenatal care with a follow up telephone interview at 8-10 weeks post-delivery. A midwife delivered immunization program for pregnant women in antenatal clinic commenced in April 2015. Of the 180 pregnant women who completed the survey questionnaire, 75.5% and 80.5 % received maternal influenza and pertussis vaccines respectively. First-time mothers had twice the odds of having received influenza vaccine during pregnancy than multiparous women (OR 2.4; CI 1.14 - 4.94; p= 0.021). The proportion of women who received pertussis vaccine during pregnancy, following the introduction of the midwife delivered pertussis vaccination program (140/155, 90.3%) was significantly higher compared with women who received maternal pertussis vaccination prior to the introduction of the program (5/22, 23.7%, p < 0.001). The odds of women receiving maternal pertussis vaccine following the implementation of the midwife delivered program were 31 times higher than women who delivered babies prior to the program (OR 31.7, CI 10.24- 98.27; p < 0.001). High uptake of influenza and pertussis vaccines during pregnancy can be attained with health care provider recommendation and inclusion of maternal immunization as part of standard antenatal care.

Keywords: influenza, maternal immunization, pertussis, provider recommendation

Procedia PDF Downloads 261

Authors: Jina Hong, Seongeun Ryu, Sungeun You

Abstract:

Suicide rate among homeless people are much higher than one in the general population. The purpose of this study was to examine the mediating effect of PTSD and aggression in the relationship between childhood physical abuse and suicidal behavior among homeless people. One hundred one homeless were recruited from street and shelters in Korea. Face-to-face interviews were conducted by master’s level graduate students or facility employees of shelters. All participants completed the Suicidal Behaviors Questionnaire-Revised (SBQ-R), Life History of Aggression Questionnaire (LHAQ), Primary Care PTSD (PC-PTSD), and Traumatic Life Events Questionnaire (TLEQ). The average age of homeless people participated in the study was 55.2 years (SD = 10.7) with the age range of 30 to 87. Results indicated that PTSD symptoms and aggression fully mediated the relationship between childhood physical abuse and suicidal behavior among the homeless. These findings suggest the need for trauma-informed care for the homeless, and warrant the need for psychological services for PTSD and aggression in order to reduce suicide risk among homeless people.

Keywords: aggression, homeless, PTSD, suicidal behavior

Procedia PDF Downloads 372

Authors: Alpana Goel, Kawalpreet Kalra

Abstract:

The study of level structures of deformed nuclei is the most complex topic in nuclear physics. For the description of level structure, a simple model is good enough to bring out the basic features which may then be further refined. The low lying level structures of these nuclei can, therefore, be understood in terms of Two Quasiparticle plus axially symmetric Rotor Model (TQPRM). The formulation of TQPRM for deformed nuclei has been presented. The analysis of available experimental data on two quasiparticle rotational bands of deformed nuclei present unusual features like signature dependence, odd-even staggering, signature inversion and signature reversal in two quasiparticle rotational bands of deformed nuclei. These signature effects are well discussed within the framework of TQPRM. The model is well efficient in reproducing the large odd-even staggering and anomalous features observed in even-even and odd-odd deformed nuclei. The effect of particle-particle and the Coriolis coupling is well established from the model. Detailed description of the model with implications to deformed nuclei is presented in the paper.

Keywords: deformed nuclei, signature effects, signature inversion, signature reversal

Procedia PDF Downloads 153

Authors: M. Guemmadi, A. Ouibrahim

Abstract:

This numerical investigation aims to evaluate how a viscoelastic lubricant described by a generalized Maxwell model, affects the pressure distribution, the load capacity and thermal effect in a journal bearing lubrication. We use for the purpose the CFD package software completed by adapted user define functions (UDFs) to solve the coupled equations of momentum, of energy and of the viscoelastic model (generalized Maxwell model). Two parameters, viscosity and relaxation time are involved to show how viscoelasticity substantially affect the pressure distribution, the load capacity and the thermal transfer by comparison to Newtonian lubricant. These results were also compared with the available published results.

Keywords: journal bearing, lubrication, Maxwell model, viscoelastic fluids, computational modelling, load capacity

Procedia PDF Downloads 532

Authors: Gondu Vykunta Rao, Madhuri Bayya, Aruna Bharathi M., Paramesw Chidamparam, B. Murali

Abstract:

The increase in software content in today’s electric vehicles is increasing attention to having vast, unique topographies from low emission to high efficiency, whereas the chemical batteries have huge short comes, such as limited cycle life, power density, and cost. As for understanding and visualization, the companies are turning toward the virtual vehicle to test their design in software which is known as a simulation in the loop (SIL). In this project, in addition to the electric vehicle (EV) technology, we are adding a dynamo with the vehicle for regenerative braking. Traditionally the principle of dynamos is used in lighting the purpose of the bicycle. Here by using the same mechanism, we are running the vehicle as well as charging the vehicle from system-level simulation to the model in the loop and then to the Hardware in Loop (HIL) by using model-based development.

Keywords: electric vehicle, simulation in the loop (SIL), model in loop (MIL), hardware in loop (HIL), dynamos, model-based development (MBD), permanent magnet synchronous motor (PMSM), current control (CC), field-oriented control (FOC), regenerative braking

Procedia PDF Downloads 100