Maternal health care professionals perspective on the provision and use of antenatal and delivery care : a qualitative descriptive study in rural Vietnam

Background. High quality maternal health care is an important tool to reduce maternal and neonatal mortality. Services offered should be evidence based and adapted to the local setting. This qualitative descriptive study explored the perspectives and experiences of midwives, assistant physicians and medical doctors on the content and quality of maternal health care in rural Vietnam. Method. The study was performed in a rural district in northern Vietnam. Four focus group discussions with health care professionals at primary health care level were conducted. The data was analysed using qualitative manifest and latent content analysis. Result. Two main themes emerged: "Contextual conditions for maternal health care" and "Balancing between possibilities and constraints". Contextual conditions influenced both pregnant women's use of maternal health care and health care professionals' performance. The study participants stated that women's uses of maternal health care were influenced by economical constraints and cultural norms that impeded their autonomy in relation to childbearing. Structural constraints within the health care system included inadequate financing of the primary health care, resulting in lack of human resources, professional re-training and adequate equipment. Conclusion. Contextual conditions strongly influenced the performance and interaction between pregnant women and health care professionals within antenatal care and delivery care in a rural district of Vietnam. Although Vietnam is performing comparatively well in terms of low maternal and child mortality figures, this study revealed midwives' and other health care professionals' perceived difficulties in their daily work. It seemed maternal health care was under-resourced in terms of staff, equipment and continuing education activities. The cultural setting in Vietnam constituting a strong patriarchal society and prevailing Confucian norms limits women's autonomy and reduce their possibility to make independent decisions about their own reproductive health. This issue should be further addressed by policy-makers. Strategies to reduce inequities in maternal health care for pregnant women are needed. The quality of client-provider interaction and management of pregnancy may be strengthened by education, human resources, re-training and provision of essential equipment.

Design and application of experimental methods for steel sheet shearing

Shearing is the process where sheet metal is mechanically cut between two tools. Various shearing technologies are commonly used in the sheet metal industry, for example, in cut to length lines, slitting lines, end cropping etc. Shearing has speed and cost advantages over competing cutting methods like laser and plasma cutting, but involves large forces on the equipment and large strains in the sheet material. The constant development of sheet metals toward higher strength and formability leads to increased forces on the shearing equipment and tools. Shearing of new sheet materials imply new suitable shearing parameters. Investigations of the shearing parameters through live tests in the production are expensive and separate experiments are time consuming and requires specialized equipment. Studies involving a large number of parameters and coupled effects are therefore preferably performed by finite element based simulations. Accurate experimental data is still a prerequisite to validate such simulations. There is, however, a shortage of accurate experimental data to validate such simulations. In industrial shearing processes, measured forces are always larger than the actual forces acting on the sheet, due to friction losses. Shearing also generates a force that attempts to separate the two tools with changed shearing conditions through increased clearance between the tools as result. Tool clearance is also the most common shearing parameter to adjust, depending on material grade and sheet thickness, to moderate the required force and to control the final sheared edge geometry. In this work, an experimental procedure that provides a stable tool clearance together with accurate measurements of tool forces and tool displacements, was designed, built and evaluated. Important shearing parameters and demands on the experimental set-up were identified in a sensitivity analysis performed with finite element simulations under the assumption of plane strain. With respect to large tool clearance stability and accurate force measurements, a symmetric experiment with two simultaneous shears and internal balancing of forces attempting to separate the tools was constructed. Steel sheets of different strength levels were sheared using the above mentioned experimental set-up, with various tool clearances, sheet clamping and rake angles. Results showed that tool penetration before fracture decreased with increased material strength. When one side of the sheet was left unclamped and free to move, the required shearing force decreased but instead the force attempting to separate the two tools increased. Further, the maximum shearing force decreased and the rollover increased with increased tool clearance. Digital image correlation was applied to measure strains on the sheet surface. The obtained strain fields, together with a material model, were used to compute the stress state in the sheet. A comparison, up to crack initiation, of these experimental results with corresponding results from finite element simulations in three dimensions and at a plane strain approximation showed that effective strains on the surface are representative also for the bulk material. A simple model was successfully applied to calculate the tool forces in shearing with angled tools from forces measured with parallel tools. These results suggest that, with respect to tool forces, a plane strain approximation is valid also at angled tools, at least for small rake angles. In general terms, this study provide a stable symmetric experimental set-up with internal balancing of lateral forces, for accurate measurements of tool forces, tool displacements, and sheet deformations, to study the effects of important shearing parameters. The results give further insight to the strain and stress conditions at crack initiation during shearing, and can also be used to validate models of the shearing process.

Power Management Controls

In an office building in the US the office equipment uses about 7% of the total electricity use. Eventhough this is a low number, there is still a reason to save more energy, especially since one third of theenergy savings are lost when power management is not enabled.The core in the project ”Power Management Controls” is to develop a voluntary standard, The UserInterface Standard, that manufacturers of office equipment can use as a reference when they developnew equipment and design new interfaces. The interface is an important part of the use of powermanagement and doing this should increase the use of power management and save more energy. Theinterfaces are ofter hidden or inconsistent and confusing, which makes it harder for the user tounderstand power management. A more consistent interface makes it easier for the user to understandthe meaning of an interface and power management itselfThe standard consists of six different parts, which describe what can be done to achieve a consistentinterface. The standard also describes the part of the project called Dynamic Behavior. This part isconcentrating on the interfaces and the behavior of the device over time, which is important for the userto understand.The purpose of this degree project is to study and participate in the project ”Power ManagementControls”, and to understand what is being done to save more energy.

MACHINE VISION FOR AUTOMATICVISUAL INSPECTION OF WOODENRAILWAY SLEEPERS USING UNSUPERVISED NEURAL NETWORKS

The motivation for this thesis work is the need for improving reliability of equipment and quality of service to railway passengers as well as a requirement for cost-effective and efficient condition maintenance management for rail transportation. This thesis work develops a fusion of various machine vision analysis methods to achieve high performance in automation of wooden rail track inspection.The condition monitoring in rail transport is done manually by a human operator where people rely on inference systems and assumptions to develop conclusions. The use of conditional monitoring allows maintenance to be scheduled, or other actions to be taken to avoid the consequences of failure, before the failure occurs. Manual or automated condition monitoring of materials in fields of public transportation like railway, aerial navigation, traffic safety, etc, where safety is of prior importance needs non-destructive testing (NDT).In general, wooden railway sleeper inspection is done manually by a human operator, by moving along the rail sleeper and gathering information by visual and sound analysis for examining the presence of cracks. Human inspectors working on lines visually inspect wooden rails to judge the quality of rail sleeper. In this project work the machine vision system is developed based on the manual visual analysis system, which uses digital cameras and image processing software to perform similar manual inspections. As the manual inspection requires much effort and is expected to be error prone sometimes and also appears difficult to discriminate even for a human operator by the frequent changes in inspected material. The machine vision system developed classifies the condition of material by examining individual pixels of images, processing them and attempting to develop conclusions with the assistance of knowledge bases and features.A pattern recognition approach is developed based on the methodological knowledge from manual procedure. The pattern recognition approach for this thesis work was developed and achieved by a non destructive testing method to identify the flaws in manually done condition monitoring of sleepers.In this method, a test vehicle is designed to capture sleeper images similar to visual inspection by human operator and the raw data for pattern recognition approach is provided from the captured images of the wooden sleepers. The data from the NDT method were further processed and appropriate features were extracted.The collection of data by the NDT method is to achieve high accuracy in reliable classification results. A key idea is to use the non supervised classifier based on the features extracted from the method to discriminate the condition of wooden sleepers in to either good or bad. Self organising map is used as classifier for the wooden sleeper classification.In order to achieve greater integration, the data collected by the machine vision system was made to interface with one another by a strategy called fusion. Data fusion was looked in at two different levels namely sensor-level fusion, feature- level fusion. As the goal was to reduce the accuracy of the human error on the rail sleeper classification as good or bad the results obtained by the feature-level fusion compared to that of the results of actual classification were satisfactory.

Accelerated aging of thick glass second surface silvered reflectors under sandstorm conditions

Concentrated solar power systems are expected to be sited in desert locations where the direct normal irradiation is above 1800 kWh/m2.year. These systems include large solar collector assemblies, which account for a significant share of the investment cost. Solarreflectors are the main components of these solar collector assemblies and dust/sand storms may affect their reflectance properties, either by soiling or by surface abrasion. While soiling can be reverted by cleaning, surface abrasion is a non reversible degradation.The aim of this project was to study the accelerated aging of second surface silvered thickglass solar reflectors under simulated sandstorm conditions and develop a multi-parametric model which relates the specular reflectance loss to dust/sand storm parameters: wind velocity, dust concentration and time of exposure. This project focused on the degradation caused by surface abrasion.Sandstorm conditions were simulated in a prototype environmental test chamber. Material samples (6cm x 6cm) were exposed to Arizona coarse test dust. The dust stream impactedthese material samples at a perpendicular angle. Both wind velocity and dust concentrationwere maintained at a stable level for each accelerated aging test. The total exposure time in the test chamber was limited to 1 hour. Each accelerated aging test was interrupted every 4 minutes to measure the specular reflectance of the material sample after cleaning.The accelerated aging test campaign had to be aborted prematurely due to a contamination of the dust concentration sensor. A robust multi-parametric degradation model could thus not be derived. The experimental data showed that the specular reflectance loss decreasedeither linearly or exponentially with exposure time, so that a degradation rate could be defined as a single modeling parameter. A correlation should be derived to relate this degradation rate to control parameters such as wind velocity and dust/sand concentration.The sandstorm chamber design would have to be updated before performing further accelerated aging test campaigns. The design upgrade should improve both the reliability of the test equipment and the repeatability of accelerated aging tests. An outdoor exposure test campaign should be launched in deserts to learn more about the intensity, frequencyand duration of dust/sand storms. This campaign would also serve to correlate the results of outdoor exposure tests with accelerated exposure tests in order to develop a robust service lifetime prediction model for different types of solar reflector materials.

Implementation of Video Monitoring In Aluminium Industry

The aim was to evaluate results and experiences from development of new technology, a training program and implementation of strategies for the use of a video exposure monitoring method, PIMEX. Starting point of this study is an increased incidence of asthma among workers in the aluminium industry. Exposure peaks of fumes are supposed to play an important role. PIMEX makes it possible to link used work practice, use of control technology, and so forth to peaks. Nine companies participated in the project, which was divided into three parts, development of PIMEX technology, production of training material, and training in use of equipment and related strategies. The use of the video exposure monitoring method PIMEX offers prerequisites supporting workers participation in safety activities. The experiences from the project reveal the importance of good timing of primary training, technology development, technical support, and follow up training. In spite of a delay of delivery of the new technology, representatives from the participating companies declared that the experiences showed that PIMEX gave an important contribution for effective control of hazards in the companies. Eight out of nine smelters used the PIMEX method as a part of a strategy for control of workers exposure to fumes in potrooms. Possibilities to conduct effective control measures were identified. This article describes experiences from implementation of a, for this branch, new method supporting workers participation for workplace improvements.

Palliativ omvårdnad i hemmet - de anhörigas upplevelse av delaktighet : En litteraturstudie

Bakgrund: Tack vare en mer avancerad hemsjukvård har den palliativa vården utvecklats, vilket gör det möjligt för fler människor att dö i det egna hemmet. Palliativ vård handlar inte endast om patienten, utan involverar även de anhöriga. Det övergripande målet för palliativ vård är att patienten och den anhörige upplever god livskvalitet till livets slut. De anhörigas närvaro är betydelsefull, inte endast för patienten utan även för vårdarna. De anhöriga befinner sig i en mycket påfrestande situation och det är viktigt att vårdare har kunskap om vad de anhöriga upplever och hur man kan stötta de anhöriga i deras situation. Syfte: Att belysa anhörigas upplevelser av delaktighet i samband med palliativ omvårdnad i hemmet. Metod: En litteraturstudie baserad på 11 vetenskapliga artiklar av kvalitativ ansats. Resultat: 2 kategorier framkom ur studien. Delaktighet ger anhöriga upplevelsen av att få vardagen att fungera och Anhörigas delaktighet bidrar till personcentrerad vård. Det blev en drastisk förändring i livet för de anhöriga. Det var inte bara hemmet som förändras i och med all teknisk utrustning och hjälpmedel som patienten behövde. De anhörigas livsförändringar gjorde att det sociala livet fick lida. Tankar kring existentiella frågor dök upp när man levde så nära inpå döden och det var viktigt för de anhöriga att vårdarna kunde se och lyssna även på deras behov. En god kommunikation var viktigt för att de anhöriga skulle våga prata om sina egna behov, tankar och åsikter. Slutsats: Det viktigaste för de anhöriga var att kommunikationen, stödet och informationen fungerade mellan alla parter. Fungerade dessa delar så byggdes en god relation mellan parterna och man fick en god tillit till vården. Samarbetet blev bättre och de anhöriga kände sig som en i teamet.