276 resultados para PROTOCOL FOR SURGERY


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Online scheduling in the Operating Theatre Department is a dynamic process that deals with both elective and emergency patients. Each business day begins with an elective schedule determined in advance based on a mastery surgery schedule. Throughout the course of the day however, disruptions to this baseline schedule occur due to variations in treatment time, emergency arrivals, equipment failure and resource unavailability. An innovative robust reactive surgery assignment model is developed for the operating theatre department. Following the completion of each surgery, the schedule is re-solved taking into account any disruptions in order to minimise cancellations of pre-planned patients and maximise throughput of emergency cases. The single theatre case is solved and future work on the computationally more complex multiple theatre case under resource constraints is discussed.

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Background: An estimated 285 million people worldwide have diabetes and its prevalence is predicted to increase to 439 million by 2030. For the year 2010, it is estimated that 3.96 million excess deaths in the age group 20-79 years are attributable to diabetes around the world. Self-management is recognised as an integral part of diabetes care. This paper describes the protocol of a randomised controlled trial of an automated interactive telephone system aiming to improve the uptake and maintenance of essential diabetes self-management behaviours. ---------- Methods/Design: A total of 340 individuals with type 2 diabetes will be randomised, either to the routine care arm, or to the intervention arm in which participants receive the Telephone-Linked Care (TLC) Diabetes program in addition to their routine care. The intervention requires the participants to telephone the TLC Diabetes phone system weekly for 6 months. They receive the study handbook and a glucose meter linked to a data uploading device. The TLC system consists of a computer with software designed to provide monitoring, tailored feedback and education on key aspects of diabetes self-management, based on answers voiced or entered during the current or previous conversations. Data collection is conducted at baseline (Time 1), 6-month follow-up (Time 2), and 12-month follow-up (Time 3). The primary outcomes are glycaemic control (HbA1c) and quality of life (Short Form-36 Health Survey version 2). Secondary outcomes include anthropometric measures, blood pressure, blood lipid profile, psychosocial measures as well as measures of diet, physical activity, blood glucose monitoring, foot care and medication taking. Information on utilisation of healthcare services including hospital admissions, medication use and costs is collected. An economic evaluation is also planned.---------- Discussion: Outcomes will provide evidence concerning the efficacy of a telephone-linked care intervention for self-management of diabetes. Furthermore, the study will provide insight into the potential for more widespread uptake of automated telehealth interventions, globally.

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We consider the problem of object tracking in a wireless multimedia sensor network (we mainly focus on the camera component in this work). The vast majority of current object tracking techniques, either centralised or distributed, assume unlimited energy, meaning these techniques don't translate well when applied within the constraints of low-power distributed systems. In this paper we develop and analyse a highly-scalable, distributed strategy to object tracking in wireless camera networks with limited resources. In the proposed system, cameras transmit descriptions of objects to a subset of neighbours, determined using a predictive forwarding strategy. The received descriptions are then matched at the next camera on the objects path using a probability maximisation process with locally generated descriptions. We show, via simulation, that our predictive forwarding and probabilistic matching strategy can significantly reduce the number of object-misses, ID-switches and ID-losses; it can also reduce the number of required transmissions over a simple broadcast scenario by up to 67%. We show that our system performs well under realistic assumptions about matching objects appearance using colour.

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Scoliosis is a spinal deformity that requires surgical correction in progressive cases. In order to optimize surgical outcomes, patient-specific finite element models are being developed by our group. In this paper, a single rod anterior correction procedure is simulated for a group of six scoliosis patients. For each patient, personalised model geometry was derived from low-dose CT scans, and clinically measured intra-operative corrective forces were applied. However, tissue material properties were not patient-specific, being derived from existing literature. Clinically, the patient group had a mean initial Cobb angle of 47.3 degrees, which was corrected to 17.5 degrees after surgery. The mean simulated post-operative Cobb angle for the group was 18.1 degrees. Although this represents good agreement between clinical and simulated corrections, the discrepancy between clinical and simulated Cobb angle for individual patients varied between -10.3 and +8.6 degrees, with only three of the six patients matching the clinical result to within accepted Cobb measurement error of +-5 degrees. The results of this study suggest that spinal tissue material properties play an important role in governing the correction obtained during surgery, and that patient-specific modelling approaches must address the question of how to prescribe patient-specific soft tissue properties for spine surgery simulation.

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Proposed transmission smart grids will use a digital platform for the automation of substations operating at voltage levels of 110 kV and above. The IEC 61850 series of standards, released in parts over the last ten years, provide a specification for substation communications networks and systems. These standards, along with IEEE Std 1588-2008 Precision Time Protocol version 2 (PTPv2) for precision timing, are recommended by the both IEC Smart Grid Strategy Group and the NIST Framework and Roadmap for Smart Grid Interoperability Standards for substation automation. IEC 61850-8-1 and IEC 61850-9-2 provide an inter-operable solution to support multi-vendor digital process bus solutions, allowing for the removal of potentially lethal voltages and damaging currents from substation control rooms, a reduction in the amount of cabling required in substations, and facilitates the adoption of non-conventional instrument transformers (NCITs). IEC 61850, PTPv2 and Ethernet are three complementary protocol families that together define the future of sampled value digital process connections for smart substation automation. This paper describes a specific test and evaluation system that uses real time simulation, protection relays, PTPv2 time clocks and artificial network impairment that is being used to investigate technical impediments to the adoption of SV process bus systems by transmission utilities. Knowing the limits of a digital process bus, especially when sampled values and NCITs are included, will enable utilities to make informed decisions regarding the adoption of this technology.

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The Myer Centre Youth Protocol outlines agreed guidelines and a grievance procedure in respect of young people's use of The Myer Centre, a shopping centre in central Brisbane. The Protocol was the first of its type in Australia and is a collaboration between the Brisbane City Council, the Myer Centre Management, and the Youth Affairs Network of Queensland. The development of the protocol was undertaken by Phil Crane and Greg Marston of Queensland University of Technology (QUT).

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This report summarises the research undertaken that informed the Protocol, the process of development, and the first eighteen months of implementation. Particular chapters examine shopping centre use by young poeple, understanding conflict and opposition in the Centre, the Protocol development process, and the monitoring and review of the Protocol.

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Analyzing security protocols is an ongoing research in the last years. Different types of tools are developed to make the analysis process more precise, fast and easy. These tools consider security protocols as black boxes that can not easily be composed. It is difficult or impossible to do a low-level analysis or combine different tools with each other using these tools. This research uses Coloured Petri Nets (CPN) to analyze OSAP trusted computing protocol. The OSAP protocol is modeled in different levels and it is analyzed using state space method. The produced model can be combined with other trusted computing protocols in future works.

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Background: People with cardiac disease and type 2 diabetes have higher hospital readmission rates (22%)compared to those without diabetes (6%). Self-management is an effective approach to achieve better health outcomes; however there is a lack of specifically designed programs for patients with these dual conditions. This project aims to extend the development and pilot test of a Cardiac-Diabetes Self-Management Program incorporating user-friendly technologies and the preparation of lay personnel to provide follow-up support. Methods/Design: A randomised controlled trial will be used to explore the feasibility and acceptability of the Cardiac-Diabetes Self-Management Program incorporating DVD case studies and trained peers to provide follow-up support by telephone and text-messaging. A total of 30 cardiac patients with type 2 diabetes will be randomised, either to the usual care group, or to the intervention group. Participants in the intervention group will received the Cardiac-Diabetes Self-Management Program in addition to their usual care. The intervention consists of three faceto- face sessions as well as telephone and text-messaging follow up. The face-to-face sessions will be provided by a trained Research Nurse, commencing in the Coronary Care Unit, and continuing after discharge by trained peers. Peers will follow up patients for up to one month after discharge using text messages and telephone support. Data collection will be conducted at baseline (Time 1) and at one month (Time 2). The primary outcomes include self-efficacy, self-care behaviour and knowledge, measured by well established reliable tools. Discussion: This paper presents the study protocol of a randomised controlled trial to pilot evaluates a Cardiac- Diabetes Self-Management program, and the feasibility of incorporating peers in the follow-ups. Results of this study will provide directions for using such mode in delivering a self-management program for patients with both cardiac condition and diabetes. Furthermore, it will provide valuable information of refinement of the intervention program.

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This protocol represents an attempt to assist in the instruction of teamwork assessment for first-year students across QUT. We anticipate that teaching staff will view this protocol as a generic resource in teamwork instruction, processes and evaluation. Teamwork has been acknowledged as a problematic practice at QUT while existing predominantly in importance amongst graduate capabilities for all students at this institution. This protocol is not an extensive document on the complexities and dynamics of teamwork processes, but instead presents itself as a set of best practice guidelines and recommendations to assist in team design, development, management, support and assessment. It is recommended that this protocol be progressively implemented across QUT, not only to attain teamwork teaching consistency, but to address and deal with the misconceptions and conflict around the importance of the teamwork experience. The authors acknowledge the extensive input and contributions from a Teamwork Steering Committee selected from academic staff and administrative members across the institution. As well, we welcome feedback and suggestions to both fine tune and make inclusive those strategies that staff believe add to optimal teamwork outcomes.

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Choi et al. recently proposed an efficient RFID authentication protocol for a ubiquitous computing environment, OHLCAP(One-Way Hash based Low-Cost Authentication Protocol). However, this paper reveals that the protocol has several security weaknesses : 1) traceability based on the leakage of counter information, 2) vulnerability to an impersonation attack by maliciously updating a random number, and 3) traceability based on a physically-attacked tag. Finally, a security enhanced group-based authentication protocol is presented.

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Introduction. Surgical treatment of scoliosis is assessed in the spine clinic by the surgeon making numerous measurements on X-Rays as well as the rib hump. But it is important to understand which of these measures correlate with self-reported improvements in patients’ quality of life following surgery. The objective of this study was to examine the relationship between patient satisfaction after thoracoscopic (keyhole) anterior scoliosis surgery and standard deformity correction measures using the Scoliosis Research Society (SRS) adolescent questionnaire. Methods. A series of 100 consecutive adolescent idiopathic scoliosis patients received a single anterior rod via a keyhole approach at the Mater Children’s Hospital, Brisbane. Patients completed SRS outcomes questionnaires before surgery and again at 24 months after surgery. Multiple regression and t-tests were used to investigate the relationship between SRS scores and deformity correction achieved after surgery. Results. There were 94 females and 6 males with a mean age of 16.1 years. The mean Cobb angle improved from 52º pre-operatively to 21º for the instrumented levels post-operatively (59% correction) and the mean rib hump improved from 16º to 8º (51% correction). The mean total SRS score for the cohort was 99.4/120 which indicated a high level of satisfaction with the results of their scoliosis surgery. None of the deformity related parameters in the multiple regressions were significant. However, the twenty patients with the smallest Cobb angles after surgery reported significantly higher SRS scores than the twenty patients with the largest Cobb angles after surgery, but there was no difference on the basis of rib hump correction. Discussion. Patients undergoing thoracoscopic (keyhole) anterior scoliosis correction report good SRS scores which are comparable to those in previous studies. We suggest that the absence of any statistically significant difference in SRS scores between patients with and without rod or screw complications is because these complications are not associated with any clinically significant loss of correction in our patient group. The Cobb angle after surgery was the only significant predictor of patient satisfaction when comparing subgroups of patients with the largest and smallest Cobb angles after surgery.

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In this paper we consider the case of large cooperative communication systems where terminals use the protocol known as slotted amplify-and-forward protocol to aid the source in its transmission. Using the perturbation expansion methods of resolvents and large deviation techniques we obtain an expression for the Stieltjes transform of the asymptotic eigenvalue distribution of a sample covariance random matrix of the type HH† where H is the channel matrix of the transmission model for the transmission protocol we consider. We prove that the resulting expression is similar to the Stieltjes transform in its quadratic equation form for the Marcenko-Pastur distribution.