The use of cusum analysis in the early detection and management of hospital bed occupancy crises

Objective: To assess the value of cusum analysis in hospital bed management. Design: Comparative analysis of medical patient flows, bed occupancy, and emergency department admission rates and access block over 2 years. Setting: Internal Medicine Services and Emergency Department in a teaching hospital. Interventions: Improvements in bed use and changes in the level of available beds. Main outcome measures: Average length of stay; percentage occupancy of available beds; number of patients waiting more than 8 hours for admission (access block); number of medical patients occupying beds in non-medical wards; and number of elective surgical admissions. Results: Cusum analysis provided a simple means of revealing important trends in patient flows that were not obvious in conventional time-series data. This prompted improvements in bed use that resulted in a decrease of 9500 occupied bed-days over a year. Unfortunately and unexpectedly, after some initial improvement, the levels of access block, medical ward congestion and elective surgical admissions all then deteriorated significantly. This was probably caused by excessive bed closures in response to the initial improvement in bed use. Conclusion: Cusum analysis is a useful technique for the early detection of significant changes in patient flows and bed use, and in determining the appropriate number of beds required for a given rate of patient flow.

Bed shear stress measurements in dam break and swash flows

A novel shear plate was used to make direct bed shear stress measurements in laboratory dam break and swash flows on smooth, fixed, impermeable beds. The pressure gradient due to the slope of the fluid free-surface across the plate was measured using pressure transducers. Surface elevation was measured at five locations using acoustic displacement sensors. Flow velocity was measured using an Acoustic-Doppler Velocimeter and calculated using the ANUGA inundation model. The measured bed shear stress at the dam break fluid tip for an initially dry, horizontal bed was close to twice that estimated using steady flow theory. The temporal variation of swash bed shear stress showed a large peak in landward directed stress at the uprush tip, followed by a rapid decay throughout the uprush flow interior. The peak seaward directed stress during the backwash phase was less than half that measured in the uprush. Close to the still water line, in the region of bore collapse and at the time of initial uprush, favourable pressure gradients were measured. In the lower swash region predominately weak adverse pressure gradients were measured.

Standing wave bed forms at Plage de la Grande Roche, le Verdelet, Pléneuf-Val-André, Cote d’Armor (France)

Coastal Photograph by Hubert Chanson This photograph of standing wave bed forms was taken at very low tide. The tidal range was 10 m. The bed forms were located on the island of Le Verdelet, in a channel between Le Grande Jaune and Le Verdelet. It is likely that these standing wave bed forms were formed during transcritical shallow water flows at the end of ebb tide. The author’s watch is in the foreground for scale. (Coastal Photograph by Hubert Chanson, Division of Civil Engineering, the University of Queensland, Brisbane, Queensland 4072, Australia.)

Enzyme deactivation in fixed bed reactors with michaelis-menten kinetics

Rate expression for enzyme poisoning which are consistent with a Michaelis-Menten main reaction are used to analyze the performance of a fixed bed reactor containing immobilized enzyme. When enzyme deactivation results from the irreversible bonding of a product molecule to an existing substrate-enzyme complex, it is shown that minimum enzyme activity can occur in the interior of the bed, well away from the ends. This suggests that bed sectioning techniques may enable direct evaluation of fundamental poisoning mechanisms.

Fixed bed reactors with catalyst poisoning - first order kinetics.

The long performance of an isothermal fixed bed reactor undergoing catalyst poisoning is theoretically analyzed using the dispersion model. First order reaction with dth order deactivation is assumed and the model equations are solved by matched asymptotic expansions for large Peclet number. Simple closed-form solutions, uniformly valid in time, are obtained.

The kinetics of NO and N2O reduction over coal chars in fluidised-bed combustion

This paper presents a comprehensive and critical review of the mechanisms and kinetics of NO and N2O reduction reaction with coal chars under fluidised-bed combustion conditions (FBC). The heterogeneous reactions of NO and N2O with char/carbon surface have been well recognised as the most important processes in reducing both NOx and N2O in situ FBC. Compared to NO-carbon reactions in FBC, the reactions of N2O with chars have been relatively less understood and studied. Beginning with the overall reaction schemes for both NO and N2O reduction, the paper extensively discusses the reaction mechanisms including the effects of active surface sites. Generally, NO- and N2O-carbon reactions follow a series of step reactions. However, questions remain concerning the role of adsorbed phases of NO and N2O, and the behaviour of different surface sites. Important kinetics factors such as the rate expressions, kinetics parameters as well as the effects of surface area and pore structure are discussed in detail. The main factors influencing the reduction of NO and N2O in FBC conditions are the chemical and physical properties of chars, and the operating parameters of FBC such as temperature, presence of CO, O-2 and pressure. It is shown that under similar conditions, N2O is more readily reduced on the char surface than NO. Temperature was found to be a very important parameter in both NO and N2O reduction. It is generally agreed that both NO- and N2O-carbon reactions follow first-order reaction kinetics with respect to the NO and N2O concentrations. The kinetic parameters for NO and N2O reduction largely depend on the pore structure of chars. The correlation between the char surface area and the reactivities of NO/N2O-char reactions is considered to be of great importance to the determination of the reaction kinetics. The rate of NO reduction by chars is strongly enhanced by the presence of CO and O-2, but these species may not have significant effects on the rate of N2O reduction. However, the presence of these gases in FBC presents difficulties in the study of kinetics since CO cannot be easily eliminated from the carbon surface. In N2O reduction reactions, ash in chars is found to have significant catalytic effects, which must be accounted for in the kinetic models and data evaluation. (C) 1997 Elsevier Science Ltd.

A comparative study of the fluidized-bed coating of cylindrical metal surfaces with various thermoplastic polymer powders

This paper reports the results of an experimental investigation into the fluidized-bed coating of cylindrical metal specimens using two types of thermoplastic powders, Rilsan(R) PA11, a nylon-11 powder produced by Elf Atochem, France and Cotene(TM) 4612, a linear low density polyethylene powder produced by J.R Courtenay (New Zealand). The effects of dipping time, preheat temperature and particle size distribution on coating thickness and surface finish were investigated. Consistent trends in coating thickness growth with dipping time were obtained for both nylon-11 and polyethylene powders with increases in coating thickness with preheat temperature. For the same preheat temperature, the lower melting point of polyethylene results in thicker coatings compared to those of nylon-11. There is a negligible change in the coating thickness for sieved powders compared to that for unsieved powders. A pre-heat temperatures of between 240 degrees C and 300 degrees C is necessary to achieve an acceptable surface finish with both nylon-11 and polyethylene powders. To minimize errors in achieving the desired coating thickness, dipping times shorter than 2 s are not recommended. The use of graphs of coating thickness versus dipping time in combination with the coating surface roughness plots presented in this paper enable the optimal choice of pre-heat temperature and dipping time to achieve acceptable surface finish. (C) 1999 Elsevier Science S.A. All rights reserved.

Physical properties and fluidization behaviour of fresh green bean particulates during fluidized bed drying

Changes in the physical properties (such as particle density, bulk density of the bed, shrinkage and bed porosity) of fresh green bean particulates were investigated during drying. Three length:diameter ratios (1:1, 2:1 and 3:1) were considered, using drying conditions of 50 +/- 2 degrees C and 13 +/- 2% relative humidity in a heat pump dehumidifier system. The fluidization behaviour was also evaluated at 10 levels of moisture content. The fluidization experiments demonstrated that the minimum fluidization velocity decreases as the drying proceeds due to the reduced moisture content and changes in the physical properties of the bean particulates. Empirical relationships of the following nature were developed for the change in shrinkage [VR = 1 - Be-kMR], particle density [rho(p) = A + BMR + C (exp)(-D MR)], bulk density [rho(b) = a(1) + b(1)MR + c(1)MR(2)] and bed porosity [epsilon = a(2) + b(2)MR + c(2)MR(2)] with the moisture content during fluidized bed drying.

A dual catalyst bed system for the elimination of hydrogen from CO2 feed gas in urea synthesis

A dual catalyst bed system (Au/Fe2O3 + Pt-Pd/Al2O3) for eliminating hydrogen from the CO2 feed gas in urea synthesis is found to be far superior to commercially available and patented catalysts in catalytic activity. At relatively low temperatures, hydrogen is eliminated and coexistent CO is also oxidized completely to useful CO2. This can avoid effectively the accidental explosion of hydrogen-oxygen-ammonia mixed gases, thus ensuring the safety of urea synthesis.

Modeling of heat transfer in fluidized-bed coating of cylinders

A numerical model of heat transfer in fluidized-bed coating of solid cylinders is presented. By defining suitable dimensionless parameters, the governing equations and its associated initial and boundary conditions are discretized using the method of orthogonal collocation and the resulting ordinary differential equations simultaneously solved for the dimensionless coating thickness and wall temperatures. Parametric Studies showed that the dimensionless coating thickness and wall temperature depend on the relative heat capacities of the polymer powder and object, the latent heat of fusion and the size of the cylinder. Model predictions for the coating thickness and wall temperature compare reasonably well with numerical predictions and experimental coating data in the literature and with our own coating experiments using copper cylinders immersed in nylon-11 and polyethylene powders. (C) 2001 Elsevier Science Ltd. All rights reserved.

Surface diffusion of hydrocarbons in activated carbon: Comparison between constant molar flow, differential permeation and differential adsorption bed methods

This paper presents the comparison of surface diffusivities of hydrocarbons in activated carbon. The surface diffusivities are obtained from the analysis of kinetic data collected using three different kinetics methods- the constant molar flow, the differential adsorption bed and the differential permeation methods. In general the values of surface diffusivity obtained by these methods agree with each other, and it is found that the surface diffusivity increases very fast with loading. Such a fast increase can not be accounted for by a thermodynamic Darken factor, and the surface heterogeneity only partially accounts for the fast rise of surface diffusivity versus loading. Surface diffusivities of methane, ethane, propane, n-butane, n-hexane, benzene and ethanol on activated carbon are reported in this paper.

The effect of latent heat of fusion on heat transfer in fluidized-bed coating of thin plates

This paper presents a numerical study of fluidized-bed coating on thin plates using an orthogonal collocation technique. Inclusion of the latent heat of fusion term in the boundary conditions of the mathematical model accounts for the fact that some polymer powders used in coating may be partially crystalline. Predictions of coating thickness on flat plates were made with actual polymers used in fluidized-bed coating. Reasonably good agreement between numerical predictions of the coating thickness and experimental coating data of Richart was obtained for steel panels preheated to 316 degreesC. A good agreement was also obtained between numerical predictions and our coating thickness data for nylon-11 and polyethylene powders. Predicted coating thickness for polyethylene powder on flat plates were obtained with values of heat transfer coefficient closer to those obtained from our experiments. (C) 2002 Elsevier Science B.V. All rights reserved.

The Limits of Rational Choice: New Institutionalism in the Test Bed of Central Banking Politics in Australia

This paper tests the explanatory capacities of different versions of new institutionalism by examining the Australian case of a general transition in central banking practice and monetary politics: namely, the increased emphasis on low inflation and central bank independence. Standard versions of rational choice institutionalism largely dominate the literature on the politics of central banking, but this approach (here termed RC1) fails to account for Australian empirics. RC1 has a tendency to establish actor preferences exogenously to the analysis; actors' motives are also assumed a priori; actor's preferences are depicted in relatively static, ahistorical terms. And there is the tendency, even a methodological requirement, to assume relatively simple motives and preference sets among actors, in part because of the game theoretic nature of RC1 reasoning. It is possible to build a more accurate rational choice model by re-specifying and essentially updating the context, incentives and choice sets that have driven rational choice in this case. Enter RC2. However, this move subtly introduces methodological shifts and new theoretical challenges. By contrast, historical institutionalism uses an inductive methodology. Compared with deduction, it is arguably better able to deal with complexity and nuance. It also utilises a dynamic, historical approach, and specifies (dynamically) endogenous preference formation by interpretive actors. Historical institutionalism is also able to more easily incorporate a wider set of key explanatory variables and incorporate wider social aggregates. Hence, it is argued that historical institutionalism is the preferred explanatory theory and methodology in this case.