Developing an intervention to equip nurses for acute life threatening events (ALTEs) in hospital:a phenomenological approach to healthcare research

Objectives: To understand staff's experiences of acute life threatening events (ALTEs) in a pediatric hospital setting. These data will inform an intervention to equip nurses with clinical and emotional skills for dealing with ALTEs. Method: A mixed design was used in the broader research program; this paper focuses on phenomenon-focused interviews analyzed using interpretative phenomenological analysis (IPA). Results: Emerging themes included staff's relationships with patients and the impact of personhood on their ability to perform competently in an emergency. More experienced nurses described "automatic" competence generated through increased exposure to ALTEs and were able to recognize "fumbling and shaking" as a normal stress response. Designating a role was significant to staff experience of effectiveness. Key to nurses' learning experience was reflection and identifying experiences as "teachable moments." Findings were considered alongside existing theories of self-efficacy, reflective thought, and advocacy inquiry to create an experiential learning intervention involving a series of clinical and role-related scenarios. Conclusion: The phenomenological work facilitated an in-depth reading of experience. It accentuated the importance of exposure to ALTEs giving nurses experiential knowledge to prepare them for the impact of these events. Challenges included bracketing the personhood of child patients, shifting focus to clinical tasks during the pressured demands of managing an ALTE, normalizing the physiological stress response, and the need for a forum and structure for reflection and learning. An intervention will be designed to provide experiential learning and encourage nurses to realize and benefit from their embodied knowledge.

Analysis and improvement of performance in LCL filter-based PWM rectifier/inverter application using hybrid damping approach

A hybrid passive-active damping solution with improved system stability margin and enhanced dynamic performance is proposed for high power grid interactive converters. In grid connected active rectifier/inverter application, line side LCL filter improves the high frequency attenuation and makes the converter compatible with the stringent grid power quality regulations. Passive damping though offers a simple and reliable solution but it reduces overall converter efficiency. Active damping solutions do not increase the system losses but can guarantee the stable operation up to a certain speed of dynamic response which is limited by the maximum bandwidth of the current controller. This paper examines this limit and introduces a concept of hybrid passive-active damping solution with improved stability margin and high dynamic performance for line side LCL filter based active rectifier/inverter applications. A detailed design, analysis of the hybrid approach and trade-off between system losses and dynamic performance in grid connected applications are reported. Simulation and experimental results from a 10 kVA prototype demonstrate the effectiveness of the proposed solution. An analytical study on system stability and dynamic response with the variations of various controller and passive filter parameters is presented.

Linked knowledge sources for topic classification of microposts:a semantic graph-based approach

Short text messages a.k.a Microposts (e.g. Tweets) have proven to be an effective channel for revealing information about trends and events, ranging from those related to Disaster (e.g. hurricane Sandy) to those related to Violence (e.g. Egyptian revolution). Being informed about such events as they occur could be extremely important to authorities and emergency professionals by allowing such parties to immediately respond. In this work we study the problem of topic classification (TC) of Microposts, which aims to automatically classify short messages based on the subject(s) discussed in them. The accurate TC of Microposts however is a challenging task since the limited number of tokens in a post often implies a lack of sufficient contextual information. In order to provide contextual information to Microposts, we present and evaluate several graph structures surrounding concepts present in linked knowledge sources (KSs). Traditional TC techniques enrich the content of Microposts with features extracted only from the Microposts content. In contrast our approach relies on the generation of different weighted semantic meta-graphs extracted from linked KSs. We introduce a new semantic graph, called category meta-graph. This novel meta-graph provides a more fine grained categorisation of concepts providing a set of novel semantic features. Our findings show that such category meta-graph features effectively improve the performance of a topic classifier of Microposts. Furthermore our goal is also to understand which semantic feature contributes to the performance of a topic classifier. For this reason we propose an approach for automatic estimation of accuracy loss of a topic classifier on new, unseen Microposts. We introduce and evaluate novel topic similarity measures, which capture the similarity between the KS documents and Microposts at a conceptual level, considering the enriched representation of these documents. Extensive evaluation in the context of Emergency Response (ER) and Violence Detection (VD) revealed that our approach outperforms previous approaches using single KS without linked data and Twitter data only up to 31.4% in terms of F1 measure. Our main findings indicate that the new category graph contains useful information for TC and achieves comparable results to previously used semantic graphs. Furthermore our results also indicate that the accuracy of a topic classifier can be accurately predicted using the enhanced text representation, outperforming previous approaches considering content-based similarity measures. © 2014 Elsevier B.V. All rights reserved.

The overlapping of legal concepts:a legal realist approach to the classification of private law

The thesis presented an overlapping analysis of private law institutions, in response to the arguments that law must be separated into discrete categories. The basis of this overlapping approach was the realist perspective, which emphasises the role of facts and outcomes as the starting point for legal analysis as opposed to legal principle or doctrine.

Towards asphalt mixture morphology evaluation with the virtual specimen approach

The morphology of asphalt mixture can be defined as a set of parameters describing the geometrical characteristics of its constituent materials, their relative proportions as well as spatial arrangement in the mixture. The present study is carried out to investigate the effect of the morphology on its meso- and macro-mechanical response. An analysis approach is used for the meso-structural characterisation based on the X-ray computed tomography (CT) data. Image processing techniques are used to systematically vary the internal structure to obtain different morphology structures. A morphology framework is used to characterise the average mastic coating thickness around the main load carrying structure in the structures. The uniaxial tension simulation shows that the mixtures with the lowest coating thickness exhibit better inter-particle interaction with more continuous load distribution chains between adjacent aggregate particles, less stress concentrations and less strain localisation in the mastic phase.

Retinal arteriolar diameter response to flicker light provocation - A useful marker for risk stratification in cardiovascular disease?

Purpose: To to evaluate the benefit of bilinear and linear fitting to characterize the retinal vessel dilation to flicker light stimulation for the purpose of risk stratification in cardiovascular disease. Methods: Forty-five patients (15 with coronary artery disease (CAD), 15 with Diabetes Mellitus (DM) and 15 with CAD and DM) all underwent contact tonometry, digital blood pressure measurement, fundus photography, retinal vessel oximetry, static retinal vessel analysis and continous retinal diameter assessment using the retinal vessel analyser (and flicker light provocation). In addition we measured blood glucose (HbA1c) and keratinin levels in DM patients. Results: With increased severity of cardiovascular disease a more linear reaction profile of retinal arteriolar diameter to flicker light provocation can be observed. Conclusion: Absolute values of vessel dilation provide only limited information on the state of retinal arteriolar dilatory response to flicker light. The approach of bilinear fitting takes into account the immediate response to flicker light provocation as well as the maintained dilatory capacity during prolonged stimulation. Individuals with cardiovascular disease however show a largely linear reaction profile indicating an impairment of the initial rapid dilatory response as usually observed in healty individuals

Cutting the Gordian knot [?]:a response to Lukka and Vinnari (2014)

Purpose – The purpose of this paper is to constructively discuss the meaning and nature of (theoretical) contribution in accounting research, as represented by Lukka and Vinnari (2014) (hereafter referred to as LV). The authors aim is to further encourage debate on what constitutes management accounting theory (or theories) and how to modestly clarify contributions to the extant literature. Design/methodology/approach – The approach the authors take can be seen as (a)n interdisciplinary literature sourced analysis and critique of the movement’s positioning and trajectory” (Parker and Guthrie, 2014, p. 1218). The paper also draws upon and synthesizes the present authors and other’s contributions to accounting research using actor network theory. Findings – While a distinction between domain and methods theories … may appear analytically viable, it may be virtually impossible to separate them in practice. In line with Armstrong (2008), the authors cast a measure of doubt on the quest to significantly extend theoretical contributions from accounting research. Research limitations/implications – Rather than making (apparently) grandiose claims about (theoretical) contributions from individual studies, the authors suggest making more modest claims from the research. The authors try to provide a more appropriate and realistic approach to the appreciation of research contributions. Originality/value – The authors contribute to the debate on how theoretical contributions can be made in the accounting literature by constructively debating some views that have recently been outlined by LV. The aim is to provide some perspective on the usefulness of the criteria suggested by these authors. The authors also suggest and highlight (alternative) ways in which contributions might be discerned and clarified.

Consumer response to gift promotions

Purpose: The objective of this paper is to better understand the factors that influence consumers' responses toward gift promotions. Specifically, the aim is to analyse four variables: the nature of the promoted product, the fit between the product and the gift, the type of brand used in the promotion and the deal-proneness. Design/methodology/approach: In an experimental context, 247 subjects were randomly assigned to a 2 (product type: utilitarian vs hedonic)×2 (gift type: utilitarian vs hedonic)×2 (brand type: high equity vs medium equity) between-subjects factorial design. Findings: Results indicate that the nature of the promoted product does not influence consumer response. Overall evaluation of gift promotions is more favourable when simultaneously the brand promoted has high equity and the fit between the promoted product and the gift is high. Offering a gift that fits with the product and using high equity brands is a wise strategy to positively influence purchase intentions. Findings also show that deal proneness has a positive impact on purchase intentions. Research limitations/implications: A limited set of product categories, gifts and brands were used. Future research should also examine other variables and use a representative sample. Practical implications: Findings provide useful guidelines for the design of gift promotions. Originality/value: Most previous research has focused on monetary promotions with little about non-monetary promotions. This paper addresses this gap by analysing consumers' responses to gift promotions incorporating key determinants in the analysis. © Emerald Group Publishing Limited.

Understanding and improving the manufacturing and changeover process in Saudi Arabian business - a multiple case study approach

The importance of the changeover process in the manufacturing industry is becoming widely recognised. Changeover is a complete process of changing between the manufacture of one product to manufacture of an alternative product until specified production and quality rates are reached. The initiatives to improve changeover exist in industry, as better changeover process typically contribute to improved quality performance. A high-quality and reliable changeover process can be achieved through implementation of continuous or radical improvements. This research examines the changeover process of Saudi Arabian manufacturing firms because Saudi Arabia’s government is focused on the expansion of GDP and increasing the number of export manufacturing firms. Furthermore, it is encouraging foreign manufacturing firms to invest within Saudi Arabia. These initiatives, therefore, require that Saudi manufacturing businesses develop the changeover practice in order to compete in the market and achieve the government’s objectives. Therefore, the aim of this research is to discover the current status of changeover process implementation in Saudi Arabian manufacturing businesses. To achieve this aim, the main objective of this research is to develop a conceptual model to understand and examine the effectiveness of the changeover process within Saudi Arabian manufacturing firms, facilitating identification of those activities that affect the reliability and high-quality of the process. In order to provide a comprehensive understanding of this area, this research first explores the concept of quality management and its relationship to firm performance and the performance of manufacturing changeover. An extensive body of literature was reviewed on the subject of lean manufacturing and changeover practice. A research conceptual model was identified based on this review, and focus was on providing high-quality and reliable manufacturing changeover processes during set-up in a dynamic environment. Exploratory research was conducted in sample Saudi manufacturing firms to understand the features of the changeover process within the manufacturing sector, and as a basis for modifying the proposed conceptual model. Qualitative research was employed in the study with semi-structured interviews, direct observations and documentation in order to understand the real situation such as actual daily practice and current status of changeover process in the field. The research instrument, the Changeover Effectiveness Assessment Tool (CEAT) was developed to evaluate changeover practices. A pilot study was conducted by examining the CEAT, proposed for the main research. Consequently, the conceptual model was modified and CEAT was improved in response to the pilot study findings. Case studies have been conducted within eight Saudi manufacturing businesses. These case studies assessed the implementation of manufacturing changeover practice in the lighting and medical products sectors. These two sectors were selected based on their operation strategy which was batch production as well as the fact that they fulfilled the research sampling strategy. The outcomes of the research improved the conceptual model, ultimately to facilitate the firms’ adoption and rapid implementation of a high-quality and reliability changeover during the set-up process. The main finding of this research is that Quality’s factors were considering the lowest levels comparing to the other factors which are People, Process and Infrastructure. This research contributes to enable Saudi businesses to implement the changeover process by adopting the conceptual model. In addition, the guidelines for facilitating implementation were provided in this thesis. Therefore, this research provides insight to enable the Saudi manufacturing industry to be more responsive to rapidly changing customer demands.