Shared-decision making in designing new healthcare environments : ready to take off for improved quality

Background Successful implementation of new methods and models of healthcare to achieve better patient outcomes and safe, person-centered care is dependent on the physical environment of the healthcare architecture in which the healthcare is provided. Thus, decisions concerning healthcare architecture are critical because it affects people and work processes for many years and requires a long-term financial commitment from society. In this paper, we describe and suggest several strategies (critical factors) to promote shared-decision making when planning and designing new healthcare environments. Discussion This paper discusses challenges and hindrances observed in the literature and from the authors extensive experiences in the field of planning and designing healthcare environments. An overview is presented of the challenges and new approaches for a process that involves the mutual exchange of knowledge among various stakeholders. Additionally, design approaches that balance the influence of specific and local requirements with general knowledge and evidence that should be encouraged are discussed. Summary We suggest a shared-decision making and collaborative planning and design process between representatives from healthcare, construction sector and architecture based on evidence and end-users’ perspectives. If carefully and systematically applied, this approach will support and develop a framework for creating high quality healthcare environments.

Optimization of cable cycles : a trade-off between reliability and cost

This paper elaborates the routing of cable cycle through available routes in a building in order to link a set of devices, in a most reasonable way. Despite of the similarities to other NP-hard routing problems, the only goal is not only to minimize the cost (length of the cycle) but also to increase the reliability of the path (in case of a cable cut) which is assessed by a risk factor. Since there is often a trade-off between the risk and length factors, a criterion for ranking candidates and deciding the most reasonable solution is defined. A set of techniques is proposed to perform an efficient and exact search among candidates. A novel graph is introduced to reduce the search-space, and navigate the search toward feasible and desirable solutions. Moreover, admissible heuristic length estimation helps to early detection of partial cycles which lead to unreasonable solutions. The results show that the method provides solutions which are both technically and financially reasonable. Furthermore, it is proved that the proposed techniques are very efficient in reducing the computational time of the search to a reasonable amount.

Train Dispatching: Heuristic Optimization

Train dispatchers faces lots of challenges due to conflicts which causes delays of trains as a result of solving possible dispatching problems the network faces. The major challenge is for the train dispatchers to make the right decision and have reliable, cost effective and much more faster approaches needed to solve dispatching problems. This thesis work provides detail information on the implementation of different heuristic algorithms for train dispatchers in solving train dispatching problems. The library data files used are in xml file format and deals with both single and double tracks between main stations. The main objective of this work is to build different heuristic algorithms to solve unexpected delays faced by train dispatchers and to help in making right decisions on steps to take to have reliable and cost effective solution to the problems. These heuristics algorithms proposed were able to help dispatchers in making right decisions when solving train dispatching problems.

Electricity Supply Solutions for an Educational Center in Tanzania

The aim of this study was to investigate electricity supply solutions for an educationalcenter that is being built in Chonyonyo Tanzania. Off-grid power generation solutions andfurther optimization possibilities were studied for the case.The study was done for Engineers Without Borders in Sweden. Who are working withMavuno Project on the educational center. The school is set to start operating in year 2015with 40 girl students in the beginning. The educational center will help to improve genderequality by offering high quality education in a safe environment for girls in rural area.It is important for the system to be economically and environmentally sustainable. Thearea has great potential for photovoltaic power generation. Thus PV was considered as theprimary power generation and a diesel generator as a reliable backup. The system sizeoptimization was done with HOMER. For the simulations HOMER required componentdata, weather data and load data. Common components were chose with standardproperties, the loads were based on load estimations from year 2011 and the weather datawas acquired from NASA database. The system size optimization result for this base casewas a system with 26 kW PW; 5.5 kW diesel generator, 15 kW converter and 112 T-105batteries. The initial cost of the system was 55 875 €, the total net present cost 92 121 €and the levelized cost of electricity 0.264 €/kWh.In addition three optimization possibilities were studied. First it was studied how thesystem should be designed and how it would affect the system size to have night loads(security lights) use DC and could the system then be extended in blocks. As a result it wasfound out that the system size could be decreased as the inverter losses would be avoided.Also the system extension in blocks was found to be possible. The second study was aboutinverter stacking where multiple inverters can work as one unit. This type of connectionallows only the required number of inverters to run while shutting down the excess ones.This would allow the converter-unit to run with higher efficiency and lower powerconsumption could be achieved. In future with higher loads the system could be easilyextendable by connecting more inverters either in parallel or series depending on what isneeded. Multiple inverters would also offer higher reliability than using one centralizedinverter. The third study examined how the choice of location for a centralized powergeneration affects the cable sizing for the system. As a result it was found that centralizedpower generation should be located close to high loads in order to avoid long runs of thickcables. Future loads should also be considered when choosing the location. For theeducational center the potential locations for centralized power generation were found outto be close to the school buildings and close to the dormitories.

Techno-economic Appraisal of Concentrating Solar Power Systems (CSP)

The diffusion of Concentrating Solar Power Systems (CSP) systems is currently taking place at a much slower pace than photovoltaic (PV) power systems. This is mainly because of the higher present cost of the solar thermal power plants, but also for the time that is needed in order to build them. Though economic attractiveness of different Concentrating technologies varies, still PV power dominates the market. The price of CSP is expected to drop significantly in the near future and wide spread installation of them will follow. The main aim of this project is the creation of different relevant case studies on solar thermal power generation and a comparison betwwen them. The purpose of this detailed comparison is the techno-economic appraisal of a number of CSP systems and the understanding of their behaviour under various boundary conditions. The CSP technologies which will be examined are the Parabolic Trough, the Molten Salt Power Tower, the Linear Fresnel Mirrors and the Dish Stirling. These systems will be appropriatly sized and simulated. All of the simulations aim in the optimization of the particular system. This includes two main issues. The first is the achievement of the lowest possible levelized cost of electricity and the second is the maximization of the annual energy output (kWh). The project also aims in the specification of these factors which affect more the results and more specifically, in what they contribute to the cost reduction or the power generation. Also, photovoltaic systems will be simulated under same boundary conditions to facolitate a comparison between the PV and the CSP systems. Last but not leats, there will be a determination of the system which performs better in each case study.

Computational study of the step size parameter of the subgradient optimization method

The subgradient optimization method is a simple and flexible linear programming iterative algorithm. It is much simpler than Newton's method and can be applied to a wider variety of problems. It also converges when the objective function is non-differentiable. Since an efficient algorithm will not only produce a good solution but also take less computing time, we always prefer a simpler algorithm with high quality. In this study a series of step size parameters in the subgradient equation is studied. The performance is compared for a general piecewise function and a specific p-median problem. We examine how the quality of solution changes by setting five forms of step size parameter.

Modeling and forecasting long-term natural gas (NG) consumption in Iran, using particle swarm optimization (PSO)

The gradual changes in the world development have brought energy issues back into high profile. An ongoing challenge for countries around the world is to balance the development gains against its effects on the environment. The energy management is the key factor of any sustainable development program. All the aspects of development in agriculture, power generation, social welfare and industry in Iran are crucially related to the energy and its revenue. Forecasting end-use natural gas consumption is an important Factor for efficient system operation and a basis for planning decisions. In this thesis, particle swarm optimization (PSO) used to forecast long run natural gas consumption in Iran. Gas consumption data in Iran for the previous 34 years is used to predict the consumption for the coming years. Four linear and nonlinear models proposed and six factors such as Gross Domestic Product (GDP), Population, National Income (NI), Temperature, Consumer Price Index (CPI) and yearly Natural Gas (NG) demand investigated.

The importance of body-mass exponent optimization for evaluation of performance capability in cross-country skiing

Introduction Performance in cross-country skiing is influenced by the skier’s ability to continuously produce propelling forces and force magnitude in relation to the net external forces. A surrogate indicator of the “power supply” in cross-country skiing would be a physiological variable that reflects an important performance-related capability, whereas the body mass itself is an indicator of the “power demand” experienced by the skier. To adequately evaluate an elite skier’s performance capability, it is essential to establish the optimal ratio between the physiological variable and body mass. The overall aim of this doctoral thesis was to investigate the importance of body-mass exponent optimization for the evaluation of performance capability in cross-country skiing. Methods In total, 83 elite cross-country skiers (56 men and 27 women) volunteered to participate in the four studies. The physiological variables of maximal oxygen uptake (V̇O2max) and oxygen uptake corresponding to a blood-lactate concentration of 4 mmol∙l-1 (V̇O2obla) were determined while treadmill roller skiing using the diagonal-stride technique; mean oxygen uptake (V̇O2dp) and upper-body power output (Ẇ) were determined during double-poling tests using a ski-ergometer. Competitive performance data for elite male skiers were collected from two 15-km classical-technique skiing competitions and a 1.25-km sprint prologue; additionally, a 2-km double-poling roller-skiing time trial using the double-poling technique was used as an indicator of upper-body performance capability among elite male and female junior skiers. Power-function modelling was used to explain the race and time-trial speeds based on the physiological variables and body mass. Results The optimal V̇O2max-to-mass ratios to explain 15-km race speed were V̇O2max divided by body mass raised to the 0.48 and 0.53 power, and these models explained 68% and 69% of the variance in mean skiing speed, respectively; moreover, the 95% confidence intervals (CI) for the body-mass exponents did not include either 0 or 1. For the modelling of race speed in the sprint prologue, body mass failed to contribute to the models based on V̇O2max, V̇O2obla, and V̇O2dp. The upper-body power output-to-body mass ratio that optimally explained time-trial speed was Ẇ ∙ m-0.57 and the model explained 63% of the variance in speed. Conclusions The results in this thesis suggest that V̇O2max divided by the square root of body mass should be used as an indicator of performance in 15-km classical-technique races among elite male skiers rather than the absolute or simple ratio-standard scaled expression. To optimally explain an elite male skier’s performance capability in sprint prologues, power-function models based on oxygen-uptake variables expressed absolutely are recommended. Moreover, to evaluate elite junior skiers’ performance capabilities in 2-km double-poling roller-skiing time trials, it is recommended that Ẇ divided by the square root of body mass should be used rather than absolute or simple ratio-standard scaled expression of power output.

Koffeinets ergogena effekter på power i överkropp

Koffein har sedan 1962 fram och tillbaka varit dopingklassat men är sedan 2004 ett tillåtet ergogent preparat inom idrotten. Flera studier har visat positiva resultat i uthållighetsidrotter och på maximal styrkeförmåga. Syftet med denna studie var att se om koffein har någon ergogen effekt på power i överkroppsmuskulaturen. I denna studie användes en dubbel-blindad, randomiserad cross-over design. En slumpmässig indelning inför det första testtillfället avgjorde ifall deltagarna började studien med koffein- eller placebosupplementering och bytte sedan supplementering inför testtillfälle två. Som supplementeringsmetod användes koffein i tuggummiform på grund av att det ger ett snabbare upptag. Power mättes genom testet sittande stöt med en kula på 5 kg. Resultatet visar på en mycket svag (ES=0,13) positiv förbättring av stötlängderna mellan interventionerna. En av anledningarna till det triviala resultatet tros kunna bero på att det urval som användes ej bestod av en homogengrupp vad gäller träningsbakgrund och prestationsnivå. På grund av detta är det svårt att dra några slutsatser om koffeinet har eller inte har några ergogena effekter på power i överkroppen.