314 resultados para Healthcare architecture
Resumo:
The Regional Cultural Centre in Letterkenny is a new 2000sqm arts center containing theatre, galleries, workshops and ancillary offices. The site is set back from the street, on high ground with good views. The form and envelope of the building was derived from geometrically connecting the site with the town’s two other main public buildings, the Cathedral (1901) and new Civic Offices (2002, also designed by MacGabhann Architects). This geometrical connection or vectors informed the geometry and shape of the building. This urban matrix of geometrically connecting three corner stones of society, namely the ecclesiastical headquarters, the administrative head quarters and the art centre helps to improve the town planning and urban design of the disparate and chaotic development that Letterkenny has become.
The large cantilever, which houses a 300sqm gallery, is aligned towards the Civic Offices, marks the entrance, and signifies a change of direction of the pedestrian route past the building, like a modern day obelisk.
The circulation routes and stairs internally provide views towards the civic offices and cathedral, thus reinforcing the connection between the three buildings and helps visitors make some sense of Letterkenny as an urban center. The main stairs and vertical circulation are contained behind the large glazed foyer, which is framed to be viewed externally like a proscenium stage, with visitors to the building passively acting their routes through the building.
Resumo:
OBJECTIVES. Adherence to hand hygiene among healthcare workers (HCWs) is widely believed to be a key factor in reducing the spread of healthcare-associated infection. The objective of this study was to evaluate the impact of a multifaceted intervention to increase rates of adherence to hand hygiene among HCWs and to assess the effect on the incidence of hospital-acquired methicillin-resistant Staphylococcus aureus (MRSA) colonization. DESIGN. Cluster-randomized controlled trial. SETTING. Thirty hospital units in 3 tertiary care hospitals in Hamilton, Ontario, Canada. INTERVENTION. After a 3-month baseline period of data collection, 15 units were randomly assigned to the intervention arm (with performance feedback, small-group teaching seminars, and posters) and 15 units to usual practice. Hand hygiene was observed during randomly selected 15-minute periods on each unit, and the incidence of MRSA colonization was measured using weekly surveillance specimens from June 2007 through May 2008. RESULTS. We found that 3,812 (48.2%) of 7,901 opportunities for hand hygiene in the intervention group resulted in adherence, compared with 3,205 (42.6%) of 7,526 opportunities in the control group (P <.001; independent t test). There was no reduction in the incidence of hospital-acquired MRSA colonization in the intervention group. CONCLUSION. Among HCWs in Ontario tertiary care hospitals, the rate of adherence to hand hygiene had a statistically significant increase of 6% with a multifaceted intervention, but the incidence of MRSA colonization was not reduced.
Resumo:
Aims: The objective of the present study was to study the relationship between hospital antibiotic use, community antibiotic use and the incidence of extended-spectrum beta-lactamase (ESBL)-producing bacteria in hospitals, while assessing the impact of a fluoroquinolone restriction policy on ESBL-producing bacteria incidence rates. METHODS: The study was retrospective and ecological in design. A multivariate autoregressive integrated moving average (ARIMA) model was built to relate antibiotic use to ESB-producing bacteria incidence rates and resistance patterns over a 5 year period (January 2005-December 2009). Results: Analysis showed that the hospital incidence of ESBLs had a positive relationship with the use of fluoroquinolones in the hospital (coefficient = 0.174, P= 0.02), amoxicillin-clavulanic acid in the community (coefficient = 1.03, P= 0.03) and mean co-morbidity scores for hospitalized patients (coefficient = 2.15, P= 0.03) with various time lags. The fluoroquinolone restriction policy was implemented successfully with the mean use of fluoroquinolones (mainly ciprofloxacin) being reduced from 133 to 17 defined daily doses (DDDs)/1000 bed days (P <0.001) and from 0.65 to 0.54 DDDs/1000 inhabitants/day (P= 0.0007), in both the hospital and its surrounding community, respectively. This was associated with an improved ciprofloxacin susceptibility in both settings [ciprofloxacin susceptibility being improved from 16% to 28% in the community (P <0.001)] and with a statistically significant reduction in ESBL-producing bacteria incidence rates. Discussion: This study supports the value of restricting the use of certain antimicrobial classes to control ESBL, and demonstrates the feasibility of reversing resistance patterns post successful antibiotic restriction. The study also highlights the potential value of the time-series analysis in designing efficient antibiotic stewardship. © 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.
Resumo:
Aims: The present study examined the differences between physicians working in public and private health care in strenuous working environments (presence of occupational hazards, physical violence, and presenteeism) and health behaviours (alcohol consumption, body mass index, and physical activity). In addition, we examined whether gender or age moderated these potential differences. Methods: Cross-sectional survey data were compiled on 1422 female and 948 male randomly selected physicians aged 25-65 years from The Finnish Health Care Professionals Study. Logistic regression and linear regression analyses were used with adjustment for gender, age, specialisation status, working time, managerial position, and on-call duty. Results: Occupational hazards, physical violence, and presenteeism were more commonly reported by physicians working in the public sector than by their counterparts in the private sector. Among physicians aged 50 years or younger, those who worked in the public sector consumed more alcohol than those who worked in the private sector, whereas in those aged 50 or more the reverse was true. In addition, working in the private sector was most strongly associated with lower levels of physical violence in those who were older than 50 years, and with lower levels of presenteeism among those aged 40-50 years. Conclusions: The present study found evidence for the public sector being a more strenuous work environment for physicians than the private sector. Our results suggest that public healthcare organisations should pay more attention to the working conditions of their employees.
Resumo:
A novel high performance bit parallel architecture to perform square root and division is proposed. Relevant VLSI design issues have been addressed. By employing redundant arithmetic and a semisystolic schedule, the throughput has been made independent of the size of the array.
Resumo:
In this paper, a novel configurable content addressable memory (CCAM) cell is proposed, to increase the flexibility of embedded CAMs for SoC employment. It can be easily configured as a Binary CAM (BiCAM) or Ternary CAM (TCAM) without significant penalty of power consumption or searching speed. A 64x128 CCAM array has been built and verified through simulation. ©2007 IEEE.
Resumo:
A high-performance VLSI architecture to perform combined multiply-accumulate, divide, and square root operations is proposed. The circuit is highly regular, requires only minimal control, and can be reconfigured for every cycle. The execution time for each operation is the same. The combination of redundancy and pipelining results in a throughput independent of the wordsize of the array. With current CMOS technology, throughput rates in excess of 80 million operations per second are achievable.
Resumo:
The application of fine grain pipelining techniques in the design of high performance Wave Digital Filters (WDFs) is described. It is shown that significant increases in the sampling rate of bit parallel circuits can be achieved using most significant bit (msb) first arithmetic. A novel VLSI architecture for implementing two-port adaptor circuits is described which embodies these ideas. The circuit in question is highly regular, uses msb first arithmetic and is implemented using simple carry-save adders. © 1992 Kluwer Academic Publishers.
Resumo:
A novel bit-level systolic array architecture for implementing bit-parallel IIR filter sections is presented. The authors have shown previously how the fundamental obstacle of pipeline latency in recursive structures can be overcome by the use of redundant arithmetic in combination with bit-level feedback. These ideas are extended by optimizing the degree of redundancy used in different parts of the circuit and combining redundant circuit techniques with those of conventional arithmetic. The resultant architecture offers significant improvements in hardware complexity and throughput rate.
Resumo:
A bit-level systolic array system for performing a binary tree Vector Quantization codebook search is described. This consists of a linear chain of regular VLSI building blocks and exhibits data rates suitable for a wide range of real-time applications. A technique is described which reduces the computation required at each node in the binary tree to that of a single inner product operation. This method applies to all the common distortion measures (including the Euclidean distance, the Weighted Euclidean distance and the Itakura-Saito distortion measure) and significantly reduces the hardware required to implement the tree search system. © 1990 Kluwer Academic Publishers.