Influence of prolonged hospitalization on overall bed occupancy: a five-year single-centre study

Background: Effective bed use is crucial to an efficient NHS. Current targets suggest a decrease in mean occupancy as the most appropriate method of improving overall efficiency. The elderly and those suffering from complex medical problems are thought to account for a high proportion of overall bed occupancy.

Aim: To assess the effect of prolonged hospital stay (>100 days) on overall bed occupancy in a modern teaching hospital.

Design: Retrospective analysis.

Methods: Analysis of all admission episodes (n = 117 178) over a five-year period in a large teaching hospital in a single UK region, serving a population of approximately 200 000. A logistic regression multi-factorial model was used to assess the effect of demographic and diagnostic variables on duration of stay.

Results: A prolonged stay (>100 days) was seen in 648 admission episodes (0.6%). These accounted for 11% of the overall bed occupancy over the 5-year period. Excluding all prolonged admission episodes from our analysis made no difference to the overall median length of stay.

Discussion: Prolonged hospitalizations have a significant impact on bed occupancy. Targeting these very long (>100 days) hospital stays may better improve overall efficiency, compared to targeting mean or median length of stay.

A wavelet-based damage detection algorithm based on bridge acceleration response to a vehicle

Previous research based on theoretical simulations has shown the potential of the wavelet transform to detect damage in a beam by analysing the time-deflection response due to a constant moving load. However, its application to identify damage from the response of a bridge to a vehicle raises a number of questions. Firstly, it may be difficult to record the difference in the deflection signal between a healthy and a slightly damaged structure to the required level of accuracy and high scanning frequencies in the field. Secondly, the bridge is going to have a road profile and it will be loaded by a sprung vehicle and time-varying forces rather than a constant load. Therefore, an algorithm based on a plot of wavelet coefficients versus time to detect damage (a singularity in the plot) appears to be very sensitive to noise. This paper addresses these questions by: (a) using the acceleration signal, instead of the deflection signal, (b) employing a vehicle-bridge finite element interaction model, and (c) developing a novel wavelet-based approach using wavelet energy content at each bridge section which proves to be more sensitive to damage than a wavelet coefficient line plot at a given scale as employed by others.

Identification of damping in a bridge using a moving instrumented vehicle

In recent years, there has been a significant increase in the number of bridges which are being instrumented and monitored on an ongoing basis. This is in part due to the introduction of bridge management systems designed to provide a high level of protection to the public and early warning if the bridge becomes unsafe. This paper investigates a novel alternative; a low-cost method consisting of the use of a vehicle fitted with accelerometers on its axles to monitor the dynamic behaviour of bridges. A simplified half-car vehicle-bridge interaction model is used in theoretical simulations to test the effectiveness of the approach in identifying the damping ratio of the bridge. The method is tested for a range of bridge spans and vehicle velocities using theoretical simulations and the influences of road roughness, initial vibratory condition of the vehicle, signal noise, modelling errors and frequency matching on the accuracy of the results are investigated.

Dynamic Axle Force and Road Profile Identification Using a Moving Vehicle

In the interaction between vehicles, pavements and bridges, it is essential to aim towards a reduction of vehicle axle forces to promote longer pavement life spans and to prevent bridges loads becoming too high. Moreover, as the road surface roughness affects the vehicle dynamic forces, an efficient monitoring of pavement condition is also necessary to achieve this aim. This paper uses a novel algorithm to identify the dynamic interaction forces and pavement roughness from vehicle accelerations in both theoretical simulations and a laboratory experiment; moving force identification theory is applied to a vehicle model for this purpose. Theoretical simulations are employed to evaluate the ability of the algorithm to predict forces over a range of bridge spans and to evaluate the influence of road roughness level on the accuracy of the results. Finally, in addressing the challenge for the real-world problem, the effects of vehicle configuration and speed on the predicted road roughness are also investigated in a laboratory experiment.

Vehicle-barrier tracking of a scaled crash test for roadside barrier design

In this paper the tracking system used to perform a scaled vehicle-barrier crash test is reported. The scaled crash test was performed as part of a wider project aimed at designing a new safety barrier making use of natural building materials. The scaled crash test was designed and performed as a proof of concept of the new mass-based safety barriers and the study was composed of two parts: the scaling technique and of a series of performed scaled crash tests. The scaling method was used for 1) setting the scaled test impact velocity so that energy dissipation and momentum transferring, from the car to the barrier, can be reproduced and 2) predicting the acceleration, velocity and displacement values occurring in the full-scale impact from the results obtained in a scaled test. To achieve this goal the vehicle and barrier displacements were to be recorded together with the vehicle accelerations and angular velocities. These quantities were measured during the tests using acceleration sensors and a tracking system. The tracking system was composed of a high speed camera and a set of targets to measure the vehicle linear and angular velocities. A code was developed to extract the target velocities from the videos and the velocities obtained were then compared with those obtained integrating the accelerations provided by the sensors to check the reliability of the method.

A self-learning teaching-learning based optimization for dynamic economic/environmental dispatch considering multiple plug-in electric vehicle loads

Economic and environmental load dispatch aims to determine the amount of electricity generated from power plants to meet load demand while minimizing fossil fuel costs and air pollution emissions subject to operational and licensing requirements. These two scheduling problems are commonly formulated with non-smooth cost functions respectively considering various effects and constraints, such as the valve point effect, power balance and ramp rate limits. The expected increase in plug-in electric vehicles is likely to see a significant impact on the power system due to high charging power consumption and significant uncertainty in charging times. In this paper, multiple electric vehicle charging profiles are comparatively integrated into a 24-hour load demand in an economic and environment dispatch model. Self-learning teaching-learning based optimization (TLBO) is employed to solve the non-convex non-linear dispatch problems. Numerical results on well-known benchmark functions, as well as test systems with different scales of generation units show the significance of the new scheduling method.

Risks of high-powered motorcycles among younger adults

OBJECTIVES:
We assessed whether policies designed to safeguard young motorcyclists would be effective given shifts in ownership toward high-powered motorcycles.
METHODS:
We investigated population-wide motor vehicle driver and motorcyclist casualties (excluding passengers) recorded in Britain between 2002 and 2009. To adjust for exposure and measure individual risk, we used the estimated number of trips of motorcyclists and drivers, which had been collected as part of a national travel survey.
RESULTS:
Motorcyclists were 76 times more likely to be killed than were drivers for every trip. Older motorcyclist age-strongly linked to experience, skill set, and riding behavior-did not abate the risks of high-powered motorcycles. Older motorcyclists made more trips on high-powered motorcycles.
CONCLUSIONS:
Tighter engine size restrictions would help reduce the use of high-powered motorcycles. Policymakers should introduce health warnings on the risks of high-powered motorcycles and the benefits of safety equipment.

Monitoring Bridge Dynamic Behaviour using an Instrumented Two Axle Vehicle

Highway structures such as bridges are subject to continuous degradation primarily due to ageing, loading and environmental factors. A rational transport policy must monitor and provide adequate maintenance to this infrastructure to guarantee the required levels of transport service and safety. Increasingly in recent years, bridges are being instrumented and monitored on an ongoing basis due to the implementation of Bridge Management Systems. This is very effective and provides a high level of protection to the public and early warning if the bridge becomes unsafe. However, the process can be expensive and time consuming, requiring the installation of sensors and data acquisition electronics on the bridge. This paper investigates the use of an instrumented 2-axle vehicle fitted with accelerometers to monitor the dynamic behaviour of a bridge network in a simple and cost-effective manner. A simplified half car-beam interaction model is used to simulate the passage of a vehicle over a bridge. This investigation involves the frequency domain analysis of the axle accelerations as the vehicle crosses the bridge. The spectrum of the acceleration record contains noise, vehicle, bridge and road frequency components. Therefore, the bridge dynamic behaviour is monitored in simulations for both smooth and rough road surfaces. The vehicle mass and axle spacing are varied in simulations along with bridge structural damping in order to analyse the sensitivity of the vehicle accelerations to a change in bridge properties. These vehicle accelerations can be obtained for different periods of time and serve as a useful tool to monitor the variation of bridge frequency and damping with time.

Extracting statistically dominant modes of a steel truss bridge from vehicle-induced vibrations

This study is intended to investigate the validity of the stability diagram (SD) aided multivariate autoregressive (MAR) analysis for identifying modal parameters of a real truss bridge. The MAR models are adopted to fit the time series of the dynamic accelerations recorded from a number of observation points on the bridge; then the modal parameters are extracted from the MAR model coefficient matrix. The SD is adopted to determine statistically dominant modes. In plotting the SD, a number of stability criteria are further adopted for filtering out those modes with unstable modal parameters. By the present method, the first five modal frequencies and mode shapes are identified with very high precision, while the damping ratios are identified with high precision for the 1st mode but with poorer precision for higher modes. Moreover, the ability of the SD in selecting structural modes without getting involved in any model-order optimization problem is highlighted through a comparison study.

A field experiment on a steel Gerber-truss bridge for damage detection utilizing vehicle-induced vibrations

A field experiment was conducted on a real continuous steel Gerber-truss bridge with artificial damage applied. This article summarizes the results of the experiment for bridge damage detection utilizing traffic-induced vibrations. It investigates the sensitivities of a number of quantities to bridge damage including the identified modal parameters and their statistical patterns, Nair’s damage indicator and its statistical pattern and different sets of measurement points. The modal parameters are identified by autoregressive time-series models. The decision on bridge health condition is made and the sensitivity of variables is evaluated with the aid of the Mahalanobis–Taguchi system, a multivariate pattern recognition tool. Several observations are made as follows. For the modal parameters, although bridge damage detection can be achieved by performing Mahalanobis–Taguchi system on certain modal parameters of certain sets of measurement points, difficulties were faced in subjective selection of meaningful bridge modes and low sensitivity of the statistical pattern of the modal parameters to damage. For Nair’s damage indicator, bridge damage detection could be achieved by performing Mahalanobis–Taguchi system on Nair’s damage indicators of most sets of measurement points. As a damage indicator, Nair’s damage indicator was superior to the modal parameters. Three main advantages were observed: it does not require any subjective decision in calculating Nair’s damage indicator, thus potential human errors can be prevented and an automatic detection task can be achieved; its statistical pattern has high sensitivity to damage and, finally, it is flexible regarding the choice of sets of measurement points.