515 resultados para end-state comfort


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Purpose Endotracheal suctioning causes significant lung derecruitment. Closed suction (CS) minimizes lung volume loss during suction, and therefore, volumes are presumed to recover more quickly postsuctioning. Conflicting evidence exists regarding this. We examined the effects of open suction (OS) and CS on lung volume loss during suctioning, and recovery of end-expiratory lung volume (EELV) up to 30 minutes postsuction. Material and Methods Randomized crossover study examining 20 patients postcardiac surgery. CS and OS were performed in random order, 30 minutes apart. Lung impedance was measured during suction, and end-expiratory lung impedance was measured at baseline and postsuctioning using electrical impedance tomography. Oximetry, partial pressure of oxygen in the alveoli/fraction of inspired oxygen ratio and compliance were collected. Results Reductions in lung impedance during suctioning were less for CS than for OS (mean difference, − 905 impedance units; 95% confidence interval [CI], − 1234 to –587; P < .001). However, at all points postsuctioning, EELV recovered more slowly after CS than after OS. There were no statistically significant differences in the other respiratory parameters. Conclusions Closed suctioning minimized lung volume loss during suctioning but, counterintuitively, resulted in slower recovery of EELV postsuction compared with OS. Therefore, the use of CS cannot be assumed to be protective of lung volumes postsuctioning. Consideration should be given to restoring EELV after either suction method via a recruitment maneuver.

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This paper discusses the situation of welfare claimants, often constructed as faulty citizens and flawed welfare subjects. Many are on the receiving end of complex, multi-layered forms of surveillance aimed at securing socially responsible and compliant behaviours. In Australia, as in other Western countries, neoliberal economic regimes with their harsh and often repressive treatment of welfare recipients operate in tandem with a burgeoning and costly arsenal of CCTV and other surveillance and governance assemblages. The Australian Government’s Centrelink BasicsCard is but one example of welfare surveillance, whereby a percentage of a welfare claimant’s allowances must be spent on ‘approved’ items. The BasicsCard which has perhaps slipped under the radar of public discussion and is expanding nationally, raises significant questions about whether it is possible to encourage people to take responsibility for themselves if they no longer have real control over the most important aspects of their lives. Resistance and critical feedback, particularly from Indigenous people, points to a loss of dignity around the imposition of income management, operational complexity and denial of individual agency in using the BasicsCard, alongside the contradiction of apparently becoming ‘self-reliant’ through being income managed by the welfare state. This paper highlights the lack of solid evidence for the implementation/imposition of the BasicsCard and points to the importance of developing critically based research to inform the enactment of evidence based policy, also acting as a touchstone for governmental accountability. In highlighting issues around the BasicsCard this paper makes a contribution to the largely under discussed area of income management and the growth of welfare surveillance in Australia.

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By any measure, 2011 was a year marked by disasters. In Australia, it began with major flooding which saw vast portions of the state of Queensland, including Brisbane and surrounding areas, under water. A significant earthquake caused massive destruction and serious loss of life in Christchurch, New Zealand. And a 9.0 quake off the Sendai coast caused an unprecedented tsunami in Japan and led to the Fukushima meltdown. All this before the end of March; later months would see a range of human-made crises from the Arab Spring to the London riots.

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Background: End-of-life care is a significant component of work in intensive care. Limited research has been undertaken on the provision of end-of-life care by nurses in the intensive care setting. The purpose of this study was to explore the end-of-life care beliefs and practices of intensive care nurses. Methods: A descriptive exploratory qualitative research approach was used to invite a convenience sample of five intensive care nurses from one hospital to participate in a semi-structured interview. Interview transcripts were analysed using an inductive coding approach. Findings: Three major categories emerged from analysis of the interviews: beliefs about end-of-life care, end-of-life care in the intensive care context and facilitating end-of-life care. The first two categories incorporated factors contributing to the end-of-life care experiences and practices of intensive care nurses. The third category captured the nurses’ end-of-life care practices. Conclusions: Despite the uncertainty and ambiguity surrounding end-of-life care in this practice context, the intensive care setting presents unique opportunities for nurses to facilitate positive end-of-life experiences and nurses valued their participation in the provision of end-of-life care. Care of the family was at the core of nurses’ end-of-life care work and nurses play a pivotal role in supporting the patient and their family to have positive and meaningful experiences at the end-of-life.Variation in personal beliefs and organisational support may influence nurses’ experiences and the care provided to patients and their families. Strategies to promote an organisational culture supportive of quality end-of-life care practices, and to mentor and support nurses in the provision of this care are needed.

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Sound tagging has been studied for years. Among all sound types, music, speech, and environmental sound are three hottest research areas. This survey aims to provide an overview about the state-of-the-art development in these areas.We discuss about the meaning of tagging in different sound areas at the beginning of the journey. Some examples of sound tagging applications are introduced in order to illustrate the significance of this research. Typical tagging techniques include manual, automatic, and semi-automatic approaches.After reviewing work in music, speech and environmental sound tagging, we compare them and state the research progress to date. Research gaps are identified for each research area and the common features and discriminations between three areas are discovered as well. Published datasets, tools used by researchers, and evaluation measures frequently applied in the analysis are listed. In the end, we summarise the worldwide distribution of countries dedicated to sound tagging research for years.

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The internet has become important in political communication in Australia. Using Habermas' ideal types, it is argued that political blogs can be viewed as public spheres that might provide scope for the expansion of deliberative democratic discussion. This hypothesis is explored through analysis of the group political blog Pineapple Party Time. It is evident that the bloggers and those who commented on their posts were highly knowledgeable about and interested in politics. Form an examination of these posts and the comments on them, Pineapple Party Time did act as a public sphere to some degree, and did provide for the deliberative discussion essential for a democracy, but it was largely restricted to Crikey readers. For a deliberative public sphere and democratic discussion to function to any extent, the public sphere must be open to all citizens, who need to have the access and knowledge to engage in deliberative discussion.

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The ability to accurately predict the remaining useful life of machine components is critical for machine continuous operation, and can also improve productivity and enhance system safety. In condition-based maintenance (CBM), maintenance is performed based on information collected through condition monitoring and an assessment of the machine health. Effective diagnostics and prognostics are important aspects of CBM for maintenance engineers to schedule a repair and to acquire replacement components before the components actually fail. All machine components are subjected to degradation processes in real environments and they have certain failure characteristics which can be related to the operating conditions. This paper describes a technique for accurate assessment of the remnant life of machines based on health state probability estimation and involving historical knowledge embedded in the closed loop diagnostics and prognostics systems. The technique uses a Support Vector Machine (SVM) classifier as a tool for estimating health state probability of machine degradation, which can affect the accuracy of prediction. To validate the feasibility of the proposed model, real life historical data from bearings of High Pressure Liquefied Natural Gas (HP-LNG) pumps were analysed and used to obtain the optimal prediction of remaining useful life. The results obtained were very encouraging and showed that the proposed prognostic system based on health state probability estimation has the potential to be used as an estimation tool for remnant life prediction in industrial machinery.

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Despite increasingly stringent energy performance regulations for new homes, southeast Queensland has a high and growing penetration of, and reliance on, air conditioners to provide thermal comfort to housing inhabitants. This reliance impacts on electricity infrastructure investment which is the key driving force behind rising electricity prices. This paper reports initial findings of a research project that seeks to better understand three key issues: (i) how families manage their thermal comfort in summer and how well their homes limit overheating; (ii) the extent to which the homes have been constructed according to the building approval documentation; and (iii) the impact that these issues have on urban design, especially in relation to electricity infrastructure in urban developments.

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This chapter is a tutorial that teaches you how to design extended finite state machine (EFSM) test models for a system that you want to test. EFSM models are more powerful and expressive than simple finite state machine (FSM) models, and are one of the most commonly used styles of models for model-based testing, especially for embedded systems. There are many languages and notations in use for writing EFSM models, but in this tutorial we write our EFSM models in the familiar Java programming language. To generate tests from these EFSM models we use ModelJUnit, which is an open-source tool that supports several stochastic test generation algorithms, and we also show how to write your own model-based testing tool. We show how EFSM models can be used for unit testing and system testing of embedded systems, and for offline testing as well as online testing.

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The resection of DNA double-strand breaks (DSBs) to generate ssDNA tails is a pivotal event in the cellular response to these breaks. In the two-step model of resection, primarily elucidated in yeast, initial resection by Mre11-CtIP is followed by extensive resection by two distinct pathways involving Exo1 or BLM/WRN-Dna2. However, resection pathways and their exact contributions in humans in vivo are not as clearly worked out as in yeast. Here, we examined the contribution of Exo1 to DNA end resection in humans in vivo in response to ionizing radiation (IR) and its relationship with other resection pathways (Mre11-CtIP or BLM/WRN). We find that Exo1 plays a predominant role in resection in human cells along with an alternate pathway dependent on WRN. While Mre11 and CtIP stimulate resection in human cells, they are not absolutely required for this process and Exo1 can function in resection even in the absence of Mre11-CtIP. Interestingly, the recruitment of Exo1 to DNA breaks appears to be inhibited by the NHEJ protein Ku80, and the higher level of resection that occurs upon siRNA-mediated depletion of Ku80 is dependent on Exo1. In addition, Exo1 may be regulated by 53BP1 and Brca1, and the restoration of resection in BRCA1-deficient cells upon depletion of 53BP1 is dependent on Exo1. Finally, we find that Exo1-mediated resection facilitates a transition from ATM- to ATR-mediated cell cycle checkpoint signaling. Our results identify Exo1 as a key mediator of DNA end resection and DSB repair and damage signaling decisions in human cells.

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Capacity probability models of generating units are commonly used in many power system reliability studies, at hierarchical level one (HLI). Analytical modelling of a generating system with many units or generating units with many derated states in a system, can result in an extensive number of states in the capacity model. Limitations on available memory and computational time of present computer facilities can pose difficulties for assessment of such systems in many studies. A cluster procedure using the nearest centroid sorting method was used for IEEE-RTS load model. The application proved to be very effective in producing a highly similar model with substantially fewer states. This paper presents an extended application of the clustering method to include capacity probability representation. A series of sensitivity studies are illustrated using IEEE-RTS generating system and load models. The loss of load and energy expectations (LOLE, LOEE), are used as indicators to evaluate the application

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Raman spectroscopy, X-ray diffraction (XRD), and scanning electron microscopy (SEM) have been used to compare samples of YBa2Cu3O7 (YBCO) synthesised by the solid-state method and a novel co-precipitation technique. XRD results indicate that YBCO prepared by these two methods are phase pure, however the Raman and SEM results show marked differences between these samples.

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Well-designed initialisation and keystream generation processes for stream ciphers should ensure that each key-IV pair generates a distinct keystream. In this paper, we analyse some ciphers where this does not happen due to state convergence occurring either during initialisation, keystream generation or both. We show how state convergence occurs in each case and identify two mechanisms which can cause state convergence.

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The Internet is one of the most significant information and communication technologies to emerge during the end of the last century. It created new and effective means by which individuals and groups communicate. These advances led to marked institutional changes most notably in the realm of commercial exchange: it did not only provide the high-speed communication infrastructure to business enterprises; it also opened them to the global consumer base where they could market their products and services. Commercial interests gradually dominated Internet technology over the past several years and have been a factor in the increase of its user population and enhancement of infrastructure. Such commercial interests fitted comfortably within the structures of the Philippine government. As revealed in the study, state policies and programs make use of Internet technology as an enabler of commercial institutional reforms using traditional economic measures. Yet, despite efforts to maximize the Internet as an enabler for market-driven economic growth, the accrued benefits are yet to come about; it is largely present only in major urban areas and accessible to a small number of social groups. The failure of the Internet’s developmental capability can be traced back to the government’s wholesale adoption of commercial-centered discourse. The Internet’s developmental gains (i.e. instrumental, communicative and emancipatory) and features, which were always there since its inception, have been visibly left out in favor of its commercial value. By employing synchronic and diachronic analysis, it can be shown that the Internet can be a vital technology in promoting genuine social development in the Philippines. In general, the object is to realize a social environment of towards a more inclusive and participatory application of Internet technology, equally aware of the caveats or risks the technology may pose. It is argued further that there is a need for continued social scientific research regarding the social as and developmental implications of Internet technology at local level structures, such social sectors, specific communities and organizations. On the meta-level, such approach employed in this research can be a modest attempt in increasing the calculus of hope especially among the marginalized Filipino sectors, with the use of information and communications technologies. This emerging field of study—tentatively called Progressive Informatics—must emanate from the more enlightened social sectors, namely: the non-government, academic and locally-based organizations.

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In recent years, some models have been proposed for the fault section estimation and state identification of unobserved protective relays (FSE-SIUPR) under the condition of incomplete state information of protective relays. In these models, the temporal alarm information from a faulted power system is not well explored although it is very helpful in compensating the incomplete state information of protective relays, quickly achieving definite fault diagnosis results and evaluating the operating status of protective relays and circuit breakers in complicated fault scenarios. In order to solve this problem, an integrated optimization mathematical model for the FSE-SIUPR, which takes full advantage of the temporal characteristics of alarm messages, is developed in the framework of the well-established temporal constraint network. With this model, the fault evolution procedure can be explained and some states of unobserved protective relays identified. The model is then solved by means of the Tabu search (TS) and finally verified by test results of fault scenarios in a practical power system.