614 resultados para state care
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Three different methods of inclusion of current measurements by phasor measurement units (PMUs) in a power sysetm state estimator is investigated. A comprehensive formulation of the hybrid state estimator incorporating conventional, as well as PMU measurements, is presented for each of the three methods. The behaviour of the elements because of the current measurements in the measurement Jacobian matrix is examined for any possible ill-conditioning of the state estimator gain matrix. The performance of the state estimators are compared in terms of the convergence properties and the varian in the estimated states. The IEEE 14-bus and IEEE 300-bus systems are used as test beds for the study.
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Background This economic evaluation reports the results of a detailed study of the cost of major trauma treated at Princess Alexandra Hospital (PAH), Australia. Methods A bottom-up approach was used to collect and aggregate the direct and indirect costs generated by a sample of 30 inpatients treated for major trauma at PAH in 2004. Major trauma was defined as an admission for Multiple Significant Trauma with an Injury Severity Score >15. Direct and indirect costs were amalgamated from three sources, (1) PAH inpatient costs, (2) Medicare Australia, and (3) a survey instrument. Inpatient costs included the initial episode of inpatient care including clinical and outpatient services and any subsequent representations for ongoing-related medical treatment. Medicare Australia provided an itemized list of pharmaceutical and ambulatory goods and services. The survey instrument collected out-of-pocket expenses and opportunity cost of employment forgone. Inpatient data obtained from a publically funded trauma registry were used to control for any potential bias in our sample. Costs are reported in Australian dollars for 2004 and 2008. Results The average direct and indirect costs of major trauma incurred up to 1-year postdischarge were estimated to be A$78,577 and A$24,273, respectively. The aggregate costs, for the State of Queensland, were estimated to range from A$86.1 million to $106.4 million in 2004 and from A$135 million to A$166.4 million in 2008. Conclusion These results demonstrate that (1) the costs of major trauma are significantly higher than previously reported estimates and (2) the cost of readmissions increased inpatient costs by 38.1%.
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Introduction: Emergency prehospital medical care providers are frontline health workers during emergencies. However, little is known about their attitudes, perceptions, and likely behaviors during emergency conditions. Understanding these attitudes and behaviors is crucial to mitigating the psychological and operational effects of biohazard events such as pandemic influenza, and will support the business continuity of essential prehospital services. ----- ----- Problem: This study was designed to investigate the association between knowledge and attitudes regarding avian influenza on likely behavioral responses of Australian emergency prehospital medical care providers in pandemic conditions. ----- ----- Methods: Using a reply-paid postal questionnaire, the knowledge and attitudes of a national, stratified, random sample of the Australian emergency prehospital medical care workforce in relation to pandemic influenza were investigated. In addition to knowledge and attitudes, there were five measures of anticipated behavior during pandemic conditions: (1) preparedness to wear personal protective equipment (PPE); (2) preparedness to change role; (3) willingness to work; and likely refusal to work with colleagues who were exposed to (4) known and (5) suspected influenza. Multiple logistic regression models were constructed to determine the independent predictors of each of the anticipated behaviors, while controlling for other relevant variables. ----- ----- Results: Almost half (43%) of the 725 emergency prehospital medical care personnel who responded to the survey indicated that they would be unwilling to work during pandemic conditions; one-quarter indicated that they would not be prepared to work in PPE; and one-third would refuse to work with a colleague exposed to a known case of pandemic human influenza. Willingness to work during a pandemic (OR = 1.41; 95% CI = 1.0–1.9), and willingness to change roles (OR = 1.44; 95% CI = 1.04–2.0) significantly increased with adequate knowledge about infectious agents generally. Generally, refusal to work with exposed (OR = 0.48; 95% CI = 0.3–0.7) or potentially exposed (OR = 0.43; 95% CI = 0.3–0.6) colleagues significantly decreased with adequate knowledge about infectious agents. Confidence in the employer’s capacity to respond appropriately to a pandemic significantly increased employee willingness to work (OR = 2.83; 95% CI = 1.9–4.1); willingness to change roles during a pandemic (OR = 1.52; 95% CI = 1.1–2.1); preparedness to wear PPE (OR = 1.68; 95% CI = 1.1–2.5); and significantly decreased the likelihood of refusing to work with colleagues exposed to (suspected) influenza (OR = 0.59; 95% CI = 0.4–0.9). ----- ----- Conclusions:These findings indicate that education and training alone will not adequately prepare the emergency prehospital medical workforce for a pandemic. It is crucial to address the concerns of ambulance personnel and the perceived concerns of their relationship with partners in order to maintain an effective prehospital emergency medical care service during pandemic conditions.
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Introduction: Little is known about the risk perceptions and attitudes of healthcare personnel, especially of emergency prehospital medical care personnel, regarding the possibility of an outbreak or epidemic event. Problem: This study was designed to investigate pre-event knowledge and attitudes of a national sample of the emergency prehospital medical care providers in relation to a potential human influenza pandemic, and to determine predictors of these attitudes. Methods: Surveys were distributed to a random, cross-sectional sample of 20% of the Australian emergency prehospital medical care workforce (n = 2,929), stratified by the nine services operating in Australia, as well as by gender and location. The surveys included: (1) demographic information; (2) knowledge of influenza; and (3) attitudes and perceptions related to working during influenza pandemic conditions. Multiple logistic regression models were constructed to identify predictors of pandemic-related risk perceptions. Results: Among the 725 Australian emergency prehospital medical care personnel who responded, 89% were very anxious about working during pandemic conditions, and 85% perceived a high personal risk associated with working in such conditions. In general, respondents demonstrated poor knowledge in relation to avian influenza, influenza generally, and infection transmission methods. Less than 5% of respondents perceived that they had adequate education/training about avian influenza. Logistic regression analyses indicate that, in managing the attitudes and risk perceptions of emergency prehospital medical care staff, particular attention should be directed toward the paid, male workforce (as opposed to volunteers), and on personnel whose relationship partners do not work in the health industry. Conclusions: These results highlight the potentially crucial role of education and training in pandemic preparedness. Organizations that provide emergency prehospital medical care must address this apparent lack of knowledge regarding infection transmission, and procedures for protection and decontamination. Careful management of the perceptions of emergency prehospital medical care personnel during a pandemic is likely to be critical in achieving an effective response to a widespread outbreak of infectious disease.
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Workplace wellness initiatives are currently unreflective of the multidimensional and holistic nature of the wellness construct. There exists an opportunity for promoters of health to move toward models of workplace wellness promotion that more fully appreciate the interconnected nature of health dimensions and promote them even-handedly. The Blue Care Staff Wellness Program framework was developed in response to a recognised need for consistent and wellness-focused constructs for workplace wellness promotion and dissemination. The framework promotes and supports the individual and organisational wellness of the Blue Care employee population by providing a comprehensive and sustainable employee wellness program. This has been achieved by the adoption of consistent wellness principles to guide the framework conception and theory based development. The use of the framework in a pilot program will provide insight into the frameworks effectiveness in promoting a comprehensive workplace wellness program, and go further to establish the relationship between wellness and productivity in the workplace.
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There has been increasing international efforts to ensure that health care policies are evidence based. One area where there is a lack of ‘effectiveness’ evidence is in the use of end-of-life care pathways (EOLCP) (1). Despite the lack of evidence supporting the efficacy of the EOCLP, their use has been endorsed in the recent national palliative care strategy document in the UK (2). In addition, a publication endorsed by the Australian Government (titled: Supporting Australians to live well at the End of Life- National Palliative Care Strategy 2010) (3), recommended a national roll out of EOLCP across all sectors (primary, acute and aged care) in Australia. According to this document, it is a measure of “appropriateness” and “effectiveness” for promoting quality end-of-life care.
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This is the opening article of a two-part exchange between Jean-Paul Gagnon and Michael Gardiner on the nation-state.
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Research Paper examining the introduction of VEA’s on the industrial and political framework of Queensland
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The new configuration proposed in this paper for Marx Generator (MG) aims to generate high voltage for pulsed power applications through reduced number of semiconductor components with a more efficient load supplying process. The main idea is to charge two groups of capacitors in parallel through an inductor and take advantage of resonant phenomenon in charging each capacitor up to a double input voltage level. In each resonant half a cycle, one of those capacitor groups are charged, and eventually the charged capacitors will be connected in series and the summation of the capacitor voltages can be appeared at the output of the topology. This topology can be considered as a modified Marx generator which works based on the resonant concept. Simulated models of this converter have been investigated in Matlab/SIMULINK platform and a prototype set up has been implemented in laboratory. The acquired results of either fully satisfy the anticipations in proper operation of the converter.
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The new configuration proposed in this paper for Marx Generator (MG.) aims to generate high voltage for pulsed power applications through reduced number of semiconductor components with a more efficient load supplying process. The main idea is to charge two groups of capacitors in parallel through an inductor and take the advantage of resonant phenomenon in charging each capacitor up to a double input voltage level. In each resonant half a cycle, one of those capacitor groups are charged, and eventually the charged capacitors will be connected in series and the summation of the capacitor voltages can be appeared at the output of the topology. This topology can be considered as a modified Marx generator which works based on the resonant concept. Simulated models of this converter have been investigated in Matlab/SIMULINK platform and the acquired results fully satisfy the anticipations in proper operation of the converter.
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Australia is currently witnessing considerable change in conceptualisation of the role of child care. This is a response to the strong evidence from developmental science that demonstrates the lifelong impact of early experiences. The recent commitment made by the Council of Australian Governments (COAG) (Communiqué, December 2009a) to improved qualifications and quality of those working in child care is a manifestation of this shift and highlights the importance of the childcare workforce. This study focused on the considerations of a third year cohort of B.Ed (EC) pre-service teachers (n = 55), about entering the childcare workforce. It examines their willingness to work in child care and identifies barriers and incentives for so doing. Our results indicate that, although attitudes to maternal work and child care were largely positive, few would prefer to work in child care under the current conditions. Key barriers were the pay and work conditions, particularly as they compare to other forms of potential employment. Incentives were the opportunity for leadership, creativity and a commitment to advocate for the rights of children. Those more willing to consider work in child care were distinguished from those less willing by altruism—foregoing personal gain to advocate for improved quality as a child’s right.
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Estimating and predicting degradation processes of engineering assets is crucial for reducing the cost and insuring the productivity of enterprises. Assisted by modern condition monitoring (CM) technologies, most asset degradation processes can be revealed by various degradation indicators extracted from CM data. Maintenance strategies developed using these degradation indicators (i.e. condition-based maintenance) are more cost-effective, because unnecessary maintenance activities are avoided when an asset is still in a decent health state. A practical difficulty in condition-based maintenance (CBM) is that degradation indicators extracted from CM data can only partially reveal asset health states in most situations. Underestimating this uncertainty in relationships between degradation indicators and health states can cause excessive false alarms or failures without pre-alarms. The state space model provides an efficient approach to describe a degradation process using these indicators that can only partially reveal health states. However, existing state space models that describe asset degradation processes largely depend on assumptions such as, discrete time, discrete state, linearity, and Gaussianity. The discrete time assumption requires that failures and inspections only happen at fixed intervals. The discrete state assumption entails discretising continuous degradation indicators, which requires expert knowledge and often introduces additional errors. The linear and Gaussian assumptions are not consistent with nonlinear and irreversible degradation processes in most engineering assets. This research proposes a Gamma-based state space model that does not have discrete time, discrete state, linear and Gaussian assumptions to model partially observable degradation processes. Monte Carlo-based algorithms are developed to estimate model parameters and asset remaining useful lives. In addition, this research also develops a continuous state partially observable semi-Markov decision process (POSMDP) to model a degradation process that follows the Gamma-based state space model and is under various maintenance strategies. Optimal maintenance strategies are obtained by solving the POSMDP. Simulation studies through the MATLAB are performed; case studies using the data from an accelerated life test of a gearbox and a liquefied natural gas industry are also conducted. The results show that the proposed Monte Carlo-based EM algorithm can estimate model parameters accurately. The results also show that the proposed Gamma-based state space model have better fitness result than linear and Gaussian state space models when used to process monotonically increasing degradation data in the accelerated life test of a gear box. Furthermore, both simulation studies and case studies show that the prediction algorithm based on the Gamma-based state space model can identify the mean value and confidence interval of asset remaining useful lives accurately. In addition, the simulation study shows that the proposed maintenance strategy optimisation method based on the POSMDP is more flexible than that assumes a predetermined strategy structure and uses the renewal theory. Moreover, the simulation study also shows that the proposed maintenance optimisation method can obtain more cost-effective strategies than a recently published maintenance strategy optimisation method by optimising the next maintenance activity and the waiting time till the next maintenance activity simultaneously.
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This paper details the development of, and perceived role and effectiveness of an innovative intervention designed to ultimately improve the safety of a group of community care (CC) nurses while driving. Recruiting participants from an Australian CC nursing car fleet, qualitative responses from a series of open-ended questions were obtained from drivers (n = 36), supervisors (n = 22), and managers (n = 6). The findings supported the effectiveness of the intervention in reducing self-reported speeding and promoting greater insight into one’s behaviour on the road. This research has important practical implications in that it highlights the value of developing an intervention based on a sound theoretical framework and which is aligned with the needs and beliefs of personnel within a particular organisation.
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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’s safety. In condition-based maintenance (CBM), maintenance is performed based on information collected through condition monitoring and 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. Although a variety of prognostic methodologies have been reported recently, their application in industry is still relatively new and mostly focused on the prediction of specific component degradations. Furthermore, they required significant and sufficient number of fault indicators to accurately prognose the component faults. Hence, sufficient usage of health indicators in prognostics for the effective interpretation of machine degradation process is still required. Major challenges for accurate longterm prediction of remaining useful life (RUL) still remain to be addressed. Therefore, continuous development and improvement of a machine health management system and accurate long-term prediction of machine remnant life is required in real industry application. This thesis presents an integrated diagnostics and prognostics framework based on health state probability estimation for accurate and long-term prediction of machine remnant life. In the proposed model, prior empirical (historical) knowledge is embedded in the integrated diagnostics and prognostics system for classification of impending faults in machine system and accurate probability estimation of discrete degradation stages (health states). The methodology assumes that machine degradation consists of a series of degraded states (health states) which effectively represent the dynamic and stochastic process of machine failure. The estimation of discrete health state probability for the prediction of machine remnant life is performed using the ability of classification algorithms. To employ the appropriate classifier for health state probability estimation in the proposed model, comparative intelligent diagnostic tests were conducted using five different classifiers applied to the progressive fault data of three different faults in a high pressure liquefied natural gas (HP-LNG) pump. As a result of this comparison study, SVMs were employed in heath state probability estimation for the prediction of machine failure in this research. The proposed prognostic methodology has been successfully tested and validated using a number of case studies from simulation tests to real industry applications. The results from two actual failure case studies using simulations and experiments indicate that accurate estimation of health states is achievable and the proposed method provides accurate long-term prediction of machine remnant life. In addition, the results of experimental tests show that the proposed model has the capability of providing early warning of abnormal machine operating conditions by identifying the transitional states of machine fault conditions. Finally, the proposed prognostic model is validated through two industrial case studies. The optimal number of health states which can minimise the model training error without significant decrease of prediction accuracy was also examined through several health states of bearing failure. The results were very encouraging and show that the proposed prognostic model based on health state probability estimation has the potential to be used as a generic and scalable asset health estimation tool in industrial machinery.