Midwifery-led antenatal care models: mapping a systematic review to an evidence-based quality framework to identify key components and characteristics of care

Background: Implementing effective antenatal care models is a key global policy goal. However, the mechanisms of action of these multi-faceted models that would allow widespread implementation are seldom examined and poorly understood. In existing care model analyses there is little distinction between what is done, how it is done, and who does it. A new evidence-informed quality maternal and newborn care (QMNC) framework identifies key characteristics of quality care. This offers the opportunity to identify systematically the characteristics of care delivery that may be generalizable across contexts, thereby enhancing implementation. Our objective was to map the characteristics of antenatal care models tested in Randomised Controlled Trials (RCTs) to a new evidence-based framework for quality maternal and newborn care; thus facilitating the identification of characteristics of effective care.

Methods: A systematic review of RCTs of midwifery-led antenatal care models. Mapping and evaluation of these models’ characteristics to the QMNC framework using data extraction and scoring forms derived from the five framework components. Paired team members independently extracted data and conducted quality assessment using the QMNC framework and standard RCT criteria.

Results: From 13,050 citations initially retrieved we identified 17 RCTs of midwifery-led antenatal care models from Australia (7), the UK (4), China (2), and Sweden, Ireland, Mexico and Canada (1 each). QMNC framework scores ranged from 9 to 25 (possible range 0–32), with most models reporting fewer than half the characteristics associated with quality maternity care. Description of care model characteristics was lacking in many studies, but was better reported for the intervention arms. Organisation of care was the best-described component. Underlying values and philosophy of care were poorly reported.

Conclusions: The QMNC framework facilitates assessment of the characteristics of antenatal care models. It is vital to understand all the characteristics of multi-faceted interventions such as care models; not only what is done but why it is done, by whom, and how this differed from the standard care package. By applying the QMNC framework we have established a foundation for future reports of intervention studies so that the characteristics of individual models can be evaluated, and the impact of any differences appraised.

Coupling short-term (B2G model) and long-term (g-function) models for ground source heat exchanger simulation in TRNSYS. Application in a real installation

Ground-source heat pump (GSHP) systems represent one of the most promising techniques for heating and cooling in buildings. These systems use the ground as a heat source/sink, allowing a better efficiency thanks to the low variations of the ground temperature along the seasons. The ground-source heat exchanger (GSHE) then becomes a key component for optimizing the overall performance of the system. Moreover, the short-term response related to the dynamic behaviour of the GSHE is a crucial aspect, especially from a regulation criteria perspective in on/off controlled GSHP systems. In this context, a novel numerical GSHE model has been developed at the Instituto de Ingeniería Energética, Universitat Politècnica de València. Based on the decoupling of the short-term and the long-term response of the GSHE, the novel model allows the use of faster and more precise models on both sides. In particular, the short-term model considered is the B2G model, developed and validated in previous research works conducted at the Instituto de Ingeniería Energética. For the long-term, the g-function model was selected, since it is a previously validated and widely used model, and presents some interesting features that are useful for its combination with the B2G model. The aim of the present paper is to describe the procedure of combining these two models in order to obtain a unique complete GSHE model for both short- and long-term simulation. The resulting model is then validated against experimental data from a real GSHP installation.

A Generalized Fuzzy Linguistic Model for Predicting Component Concentrations in an Optical Gas Sensing System

Motivated by environmental protection concerns, monitoring the flue gas of thermal power plant is now often mandatory due to the need to ensure that emission levels stay within safe limits. Optical based gas sensing systems are increasingly employed for this purpose, with regression techniques used to relate gas optical absorption spectra to the concentrations of specific gas components of interest (NOx, SO2 etc.). Accurately predicting gas concentrations from absorption spectra remains a challenging problem due to the presence of nonlinearities in the relationships and the high-dimensional and correlated nature of the spectral data. This article proposes a generalized fuzzy linguistic model (GFLM) to address this challenge. The GFLM is made up of a series of “If-Then” fuzzy rules. The absorption spectra are input variables in the rule antecedent. The rule consequent is a general nonlinear polynomial function of the absorption spectra. Model parameters are estimated using least squares and gradient descent optimization algorithms. The performance of GFLM is compared with other traditional prediction models, such as partial least squares, support vector machines, multilayer perceptron neural networks and radial basis function networks, for two real flue gas spectral datasets: one from a coal-fired power plant and one from a gas-fired power plant. The experimental results show that the generalized fuzzy linguistic model has good predictive ability, and is competitive with alternative approaches, while having the added advantage of providing an interpretable model.

A generalized fuzzy linguistic model for predicting component concentrations in an optical gas sensing system

Motivated by environmental protection concerns, monitoring the flue gas of thermal power plant is now often mandatory due to the need to ensure that emission levels stay within safe limits. Optical based gas sensing systems are increasingly employed for this purpose, with regression techniques used to relate gas optical absorption spectra to the concentrations of specific gas components of interest (NO_x, SO₂ etc.). Accurately predicting gas concentrations from absorption spectra remains a challenging problem due to the presence of nonlinearities in the relationships and the high-dimensional and correlated nature of the spectral data. This article proposes a generalized fuzzy linguistic model (GFLM) to address this challenge. The GFLM is made up of a series of “If-Then” fuzzy rules. The absorption spectra are input variables in the rule antecedent. The rule consequent is a general nonlinear polynomial function of the absorption spectra. Model parameters are estimated using least squares and gradient descent optimization algorithms. The performance of GFLM is compared with other traditional prediction models, such as partial least squares, support vector machines, multilayer perceptron neural networks and radial basis function networks, for two real flue gas spectral datasets: one from a coal-fired power plant and one from a gas-fired power plant. The experimental results show that the generalized fuzzy linguistic model has good predictive ability, and is competitive with alternative approaches, while having the added advantage of providing an interpretable model.