Asleep or not asleep? Evaluation of the Quality of Patients’ Sleep in Critical Care Nursing

Sleep is important for the recovery of a critically ill patient, as lack of sleep is known to influence negatively a person’s cardiovascular system, mood, orientation, and metabolic and immune function and thus, it may prolong patients’ intensive care unit (ICU) and hospital stay. Intubated and mechanically ventilated patients suffer from fragmented and light sleep. However, it is not known well how non-intubated patients sleep. The evaluation of the patients’ sleep may be compromised by their fatigue and still position with no indication if they are asleep or not. The purpose of this study was to evaluate ICU patients’ sleep evaluation methods, the quality of non-intubated patients’ sleep, and the sleep evaluations performed by ICU nurses. The aims were to develop recommendations of patients’ sleep evaluation for ICU nurses and to provide a description of the quality of non-intubated patients’ sleep. The literature review of ICU patients’ sleep evaluation methods was extended to the end of 2014. The evaluation of the quality of patients’ sleep was conducted with four data: A) the nurses’ narrative documentations of the quality of patients’ sleep (n=114), B) the nurses’ sleep evaluations (n=21) with a structured observation instrument C) the patients’ self-evaluations (n=114) with the Richards-Campbell Sleep Questionnaire, and D) polysomnographic evaluations of the quality of patients’ sleep (n=21). The correspondence of data A with data C (collected 4–8/2011), and data B with data D (collected 5–8/2009) were analysed. Content analysis was used for the nurses’ documentations and statistical analyses for all the other data. The quality of non-intubated patients’ sleep varied between individuals. In many patients, sleep was light, awakenings were frequent, and the amount of sleep was insufficient as compared to sleep in healthy people. However, some patients were able to sleep well. The patients evaluated the quality of their sleep on average neither high nor low. Sleep depth was evaluated to be the worst and the speed of falling asleep the best aspect of sleep, on a scale 0 (poor sleep) to 100 (good sleep). Nursing care was mostly performed while the patients were awake, and thus the disturbing effect was low. The instruments available for nurses to evaluate the quality of patients’ sleep were limited and measured mainly the quantity of sleep. Nurses’ structured observatory evaluations of the quality of patients’ sleep were correct for approximately two thirds of the cases, and only regarding total sleep time. Nurses’ narrative documentations of the patients’ sleep corresponded with patients’ self-evaluations in just over half of the cases. However, nurses documented several dimensions of sleep that are not included in the present sleep evaluation instruments. They could be classified according to the components of the nursing process: needs assessment, sleep assessment, intervention, and effect of intervention. Valid, more comprehensive sleep evaluation methods for nurses are needed to evaluate, document, improve and study patients’ quality of sleep.

Physiological quality of wheat seeds submitted to saline stress

The objective of this experiment was to determine the influence of different salt levels (zero, 15, 30, 45 and 60mM NaCl) on seed physiological quality of two wheat cultivars (BRS 177 and BRS 179). SUMMARIZE METHODOLOGY. The results allow the following conclusions: the physiological quality (germination and vigor) of wheat seeds, cultivars BRS 179 and BRS 177, decrease with the increase of the salinity. The wheat seeds cv. BRS 179 performs better than BRS 177, mainly in higher salt concentrations (³ 45mM of NaCl). The electric conductivity of wheat seeds increases in function of the increment of the saline concentrations.

Incidence of green soybean seeds as a function of environmental stresses during seed maturation

Hot and dry weather conditions during soybean [Glycine max (L.) Merrill] seed maturation can cause forced maturation of the seed, resulting in the production of high levels of green seed, which may be detrimental to seed germination. These stressful conditions were imposed on soybean plants during seed maturation to investigate the production of green seeds and seed quality. Plants of the CD 206 cultivar were grown in a greenhouse until the R5.5 growing stage and then transferred to phytotrons at R6 and R7.2 for stress induction. Plants were subjected to two temperature regimes, high (28ºC to 36ºC) and normal (19ºC to 26ºC), and four soil water availability conditions, control (adequate water supply), 30% gravimetric moisture (GM), 20% GM and no water supply. Seed were harvested at R9. Green seed percentages and 100-seed weights from the lower, middle and upper thirds of each plant were determined. Seed quality was assessed by germination, tetrazolium (viability and vigor) and electrical conductivity tests. Occurrence of green seed varied from 9% to 86%, depending on the severity of the stresses imposed. High temperature, coupled with no water supply at R6, resulted in a pronounced occurrence of green seeds. There was no difference in the percentage of green seeds among the plant segments. Seed quality was negatively affected by the incidence of green seeds. A procedure for screening soybean genotypes in a phytotron for their tolerance and/or susceptibility to the production of green seeds was developed.

Model to Build a Service Quality Centric Customer Reference Portfolio in a Software as a Service Company

The goal of the master’s thesis was to develop a model to build a service quality centric customer reference portfolio for a software as a service company. The case company is Meltwater Finland Oy that leverages customer references externally but there is no systematic model to produce good quality customer references that are in line with the company strategy. The project was carried out as a case study, where the primary source of information were seventeen internal interviews with the employees of the case company. The theory part focuses on customer references as assets and service quality in software as a service industry. In the empirical part the research problem is solved. As a result of the case study, the model to build a service quality centric customer reference portfolio was created and further research areas were suggested.

I Believe in me, not OCB: Evaluation of Group Function-Based CBT as a Treatment for Obsessive Compulsive Behaviour in Four Children with HFA

Researchers have conceptualized repetitive behaviours in individuals with Autism Spectrum Disorder (ASD) on a continuum oflower-Ievel, motoric, repetitive behaviours and higher-order, repetitive behaviours that include symptoms ofOCD (Hollander, Wang, Braun, & Marsh, 2009). Although obsessional, ritualistic, and stereotyped behaviours are a core feature of ASD, individuals with ASD frequently experience obsessions and compulsions that meet DSM-IV-TR (American Psychiatric Association, 2000) criteria for Obsessive-Compulsive Disorder (OCD). Given the acknowledged difficulty in differentiating between OCD and Autism-related obsessive-compulsive phenomena, the present study uses the term Obsessive Compulsive Behaviour (OCB) to represent both phenomena. This study used a multiple baseline design across behaviours and ABC designs (Cooper, Heron, & Heward, 2007) to investigate if a 9-week Group Function-Based Cognitive Behavioural Therapy (CBT) decreased OCB in four children (ages 7 - 11 years) with High Functioning Autism (HFA). Key treatment components included traditional CBT components (awareness training, cognitive-behavioural skills training, exposure and response prevention) as well as function-based assessment and intervention. Time series data indicated significant decreases in OCBs. Standardized assessments showed decreases in symptom severity, and increases in quality of life for the participants and their families. Issues regarding symptom presentation, assessment, and treatment of a dually diagnosed child are discussed.

Conceptions of Quality and Approaches to Quality Assurance in Ontario’s Universities

Many international, political, and economic influences led to increased demands for development of new quality assurance systems for universities. Like many policies and processes that aim to assure quality, Ontario’s Quality Assurance Framework (QAF) did not define quality. This study sought to explore conceptions of quality and approaches to quality assurance used within Ontario’s universities. A document analysis of the QAF’s rationale and structure suggested that quality was conceived primarily as fitness for purpose, while suggested indicators represented an exceptional conception of quality. Ontario universities perpetuated such confusion by adopting the framework without customizing it to their institutional conceptions of quality. Drawing upon phenomenographic traditions, a qualitative investigation was conducted to better understand various conceptions of quality held by university administrators and to appreciate ways in which they implemented the QAF. Three main approaches to quality assurance were identified: (a) Defending Quality, characterized by conceptions of quality as exceptional, which focuses on administrative accountability and uses a hands-off strategy to defend traditional notions of quality inputs and resources; (b) Demonstrating Quality, characterized by conceptions of quality as fitness for purpose and value for money, which focuses on accountability to students and uses centralized engaged strategies to demonstrate how programs meet current priorities and intended outcomes; and (c) Enhancing Quality, characterized by conceptions of quality as transformation, which focuses on reflection and learning experience and uses engaged strategies to find new ways of improving learning and teaching. The development of a campus culture that values the institution’s function in student learning and quality teaching would benefit from Enhancing Quality approaches to quality assurance. This would require holistic consideration of the beliefs held by members of the institution, a clear articulation of the institution’s conceptions of quality, and a critical analysis of how these conceptions align with institutional practices and policies.

The FCLT with Dependent Errors: an Helicopter Tour of the Quality of the Approximation

This note investigates the adequacy of the finite-sample approximation provided by the Functional Central Limit Theorem (FCLT) when the errors are allowed to be dependent. We compare the distribution of the scaled partial sums of some data with the distribution of the Wiener process to which it converges. Our setup is purposely very simple in that it considers data generated from an ARMA(1,1) process. Yet, this is sufficient to bring out interesting conclusions about the particular elements which cause the approximations to be inadequate in even quite large sample sizes.

Dietary patterns associated with diet quality among First Nations women living on reserves in British Columbia

Les Indigènes canadiens vivent une rapide transition nutritionnelle marquée par une consommation accrue des produits commercialisés au dépit des aliments traditionnels. Ce mémoire cherche à identifier les patrons alimentaires associés à une meilleure alimentation des femmes autochtones vivant dans les réserves en Colombie Britannique. L’échantillon (n=493) a été sélectionné de l’étude ‘First Nations Food, Nutrition, and Environment Study’. L’étude a utilisé des rappels alimentaires de 24 heures. Pour identifier les patrons alimentaires, un indice de qualité alimentaire (QA) basé sur 10 éléments nutritionnels (fibre alimentaire, gras totaux/saturés, folate, magnésium, calcium, fer, vitamines A, C, D) a permis de classifier les sujets en trois groupes (tertiles). Ces groupes ont été comparés sur leur consommation de 25 groupes alimentaires (GAs) en employant des tests statistiques non-paramétriques (Kruskal-Wallis et ANCOVA). Une analyse discriminante (AD) a confirmé les GAs associés à la QA. La QA des sujets était globalement faible car aucun rappel n’a rencontré les consommations recommandées pour tous les 10 éléments nutritionnels. L'AD a confirmé que les GAs associés de façon significative à la QA étaient ‘légumes et produits végétaux’, ‘fruits’, ‘aliments traditionnels’, ‘produits laitiers faibles en gras’, ‘soupes et bouillons’, et ‘autres viandes commercialisées’ (coefficients standardisés= 0,324; 0,295; 0,292; 0,282; 0,157; -0.189 respectivement). Le pourcentage de classifications correctes était 83.8%. Nos résultats appuient la promotion des choix alimentaires recommandés par le « Guide Alimentaire Canadien- Premières Nations, Inuits, et Métis ». Une consommation accrue de légumes, fruits, produits laitiers faibles en gras, et aliments traditionnels caractérise les meilleurs patrons alimentaires.

Routage adaptatif et stabilité dans les réseaux maillés sans fil

Grâce à leur flexibilité et à leur facilité d’installation, les réseaux maillés sans fil (WMNs) permettent un déploiement d’une infrastructure à faible coût. Ces réseaux étendent la couverture des réseaux filaires permettant, ainsi, une connexion n’importe quand et n’importe où. Toutefois, leur performance est dégradée par les interférences et la congestion. Ces derniers causent des pertes de paquets et une augmentation du délai de transmission d’une façon drastique. Dans cette thèse, nous nous intéressons au routage adaptatif et à la stabilité dans ce type de réseaux. Dans une première partie de la thèse, nous nous intéressons à la conception d’une métrique de routage et à la sélection des passerelles permettant d’améliorer la performance des WMNs. Dans ce contexte nous proposons un protocole de routage à la source basé sur une nouvelle métrique. Cette métrique permet non seulement de capturer certaines caractéristiques des liens tels que les interférences inter-flux et intra-flux, le taux de perte des paquets mais également la surcharge des passerelles. Les résultats numériques montrent que la performance de cette métrique est meilleure que celle des solutions proposées dans la littérature. Dans une deuxième partie de la thèse, nous nous intéressons à certaines zones critiques dans les WMNs. Ces zones se trouvent autour des passerelles qui connaissent une concentration plus élevé du trafic ; elles risquent de provoquer des interférences et des congestions. À cet égard, nous proposons un protocole de routage proactif et adaptatif basé sur l’apprentissage par renforcement et qui pénalise les liens de mauvaise qualité lorsqu’on s’approche des passerelles. Un chemin dont la qualité des liens autour d’une passerelle est meilleure sera plus favorisé que les autres chemins de moindre qualité. Nous utilisons l’algorithme de Q-learning pour mettre à jour dynamiquement les coûts des chemins, sélectionner les prochains nœuds pour faire suivre les paquets vers les passerelles choisies et explorer d’autres nœuds voisins. Les résultats numériques montrent que notre protocole distribué, présente de meilleurs résultats comparativement aux protocoles présentés dans la littérature. Dans une troisième partie de cette thèse, nous nous intéressons aux problèmes d’instabilité des réseaux maillés sans fil. En effet, l’instabilité se produit à cause des changements fréquents des routes qui sont causés par les variations instantanées des qualités des liens dues à la présence des interférences et de la congestion. Ainsi, après une analyse de l’instabilité, nous proposons d’utiliser le nombre de variations des chemins dans une table de routage comme indicateur de perturbation des réseaux et nous utilisons la fonction d’entropie, connue dans les mesures de l’incertitude et du désordre des systèmes, pour sélectionner les routes stables. Les résultats numériques montrent de meilleures performances de notre protocole en comparaison avec d’autres protocoles dans la littérature en termes de débit, délai, taux de perte des paquets et l’indice de Gini.

Service quality and reliability assessment of mobile communication infrastructure

The service quality of any sector has two major aspects namely technical and functional. Technical quality can be attained by maintaining technical specification as decided by the organization. Functional quality refers to the manner which service is delivered to customer which can be assessed by the customer feed backs. A field survey was conducted based on the management tool SERVQUAL, by designing 28 constructs under 7 dimensions of service quality. Stratified sampling techniques were used to get 336 valid responses and the gap scores of expectations and perceptions are analyzed using statistical techniques to identify the weakest dimension. To assess the technical aspects of availability six months live outage data of base transceiver were collected. The statistical and exploratory techniques were used to model the network performance. The failure patterns have been modeled in competing risk models and probability distribution of service outage and restorations were parameterized. Since the availability of network is a function of the reliability and maintainability of the network elements, any service provider who wishes to keep up their service level agreements on availability should be aware of the variability of these elements and its effects on interactions. The availability variations were studied by designing a discrete time event simulation model with probabilistic input parameters. The probabilistic distribution parameters arrived from live data analysis was used to design experiments to define the availability domain of the network under consideration. The availability domain can be used as a reference for planning and implementing maintenance activities. A new metric is proposed which incorporates a consistency index along with key service parameters that can be used to compare the performance of different service providers. The developed tool can be used for reliability analysis of mobile communication systems and assumes greater significance in the wake of mobile portability facility. It is also possible to have a relative measure of the effectiveness of different service providers.

“Effect of spice oleoresins in microbial decontamination and their potential application in quality stabilization of Tuna (Euthynnus affinis) during storage”

Unprocessed seafood harbor high number of bacteria, hence are more prone to spoilage. In this circumstance, the use of spice in fish for reduction of microorganism can play an important role in seafood processing. Many essential oils from herbs and spices are used widely in the food, health and personal care industries and are classified as GRAS (Generally regarded as safe) substances or are permitted food additives. A large number of these compounds have been the subject of extensive toxicological scrutiny. However, their principal function is to impart desirable flavours and aromas and not necessarily to act as antimicrobial agents. Given the high flavour and aroma impact to plant essential oils, the future for using these compound as food preservatives lies in the careful selection and evaluation of their efficacy at low concentrations but in combination with other chemical preservatives or preservation processes. For this reason they are worth of study alone or in combination with processing methods in order to establish if they could extend the shelf-life of foods. In this study, the effect of the spices, clove, turmeric, cardamom, oregano, rosemary and garlic in controlling the spoilage and pathogenic bacteria is investigated. Their effect on biogenic amine formation in tuna especially, histamine, as a result of bacterial control is also studied in detail. The contribution of spice oleoresin in the sensory and textural parameters is investigated using textural profile analysis and sensory panel. Finally, the potential of spices in quality stabilization and in increasing the shelf–life of tuna during frozen storage is analysed

Evaluation of water retention capacity and flood control function of the forest catchment

This research quantitatively evaluates the water retention capacity and flood control function of the forest catchments by using hydrological data of the large flood events which happened after the serious droughts. The objective sites are the Oodo Dam and the Sameura Dam catchments in Japan. The kinematic wave model, which considers saturated and unsaturated sub-surface soil zones, is used for the rainfall-runoff analysis. The result shows that possible storage volume of the Oodo Dam catchment is 162.26 MCM in 2005, while that of Samerua is 102.83 MCM in 2005 and 102.64 MCM in 2007. Flood control function of the Oodo Dam catchment is 173 mm in water depth in 2005, while the Sameura Dam catchment 114 mm in 2005 and 126 mm in 2007. This indicates that the Oodo Dam catchment has more than twice as big water capacity as its capacity (78.4 mm), while the Sameura Dam catchment has about one-fifth of the its storage capacity (693 mm).

Transport magnetischer Partikel durch maßgeschneiderte magnetische Feldlandschaften zur Anwendung in mikrofluidischen Mischprozessen

Die Miniaturisierung von konventioneller Labor- und Analysetechnik nimmt eine zentrale Rolle im Bereich der allgemeinen Lebenswissenschaften und medizinischen Diagnostik ein. Neuartige und preiswerte Technologieplattformen wie Lab-on-a-Chip (LOC) oder Mikrototalanalysesysteme (µTAS) versprechen insbesondere im Bereich der Individualmedizin einen hohen gesellschaftlichen Nutzen zur frühzeitigen und nichtinvasiven Diagnose krankheitsspezifischer Indikatoren. Durch den patientennahen Einsatz preiswerter und verlässlicher Mikrochips auf Basis hoher Qualitätsstandards entfallen kostspielige und zeitintensive Zentrallaboranalysen, was gleichzeitig Chancen für den globalen Einsatz - speziell in Schwellen- und Entwicklungsländern - bietet. Die technischen Herausforderungen bei der Realisierung moderner LOC-Systeme sind in der kontrollierten und verlässlichen Handhabung kleinster Flüssigkeitsmengen sowie deren diagnostischem Nachweis begründet. In diesem Kontext wird der erfolgreichen Integration eines fernsteuerbaren Transports von biokompatiblen, magnetischen Mikro- und Nanopartikeln eine Schlüsselrolle zugesprochen. Die Ursache hierfür liegt in der vielfältigen Einsetzbarkeit, die durch die einzigartigen Materialeigenschaften begründet sind. Diese reichen von der beschleunigten, aktiven Durchmischung mikrofluidischer Substanzvolumina über die Steigerung der molekularen Interaktionsrate in Biosensoren bis hin zur Isolation und Aufreinigung von krankheitsspezifischen Indikatoren. In der Literatur beschriebene Ansätze basieren auf der dynamischen Transformation eines makroskopischen, zeitabhängigen externen Magnetfelds in eine mikroskopisch veränderliche potentielle Energielandschaft oberhalb magnetisch strukturierter Substrate, woraus eine gerichtete und fernsteuerbare Partikelbewegung resultiert. Zentrale Kriterien, wie die theoretische Modellierung und experimentelle Charakterisierung der magnetischen Feldlandschaft in räumlicher Nähe zur Oberfläche der strukturierten Substrate sowie die theoretische Beschreibung der Durchmischungseffekte, wurden jedoch bislang nicht näher beleuchtet, obwohl diese essentiell für ein detailliertes Verständnis der zu Grunde liegenden Mechanismen und folglich für einen Markteintritt zukünftiger Geräte sind. Im Rahmen der vorgestellten Arbeit wurde daher ein neuartiger Ansatz zur erfolgreichen Integration eines Konzepts zum fernsteuerbaren Transport magnetischer Partikel zur Anwendung in modernen LOC-Systemen unter Verwendung von magnetisch strukturierten Exchange-Bias (EB) Dünnschichtsystemen verfolgt. Die Ergebnisse zeigen, dass sich das Verfahren der ionenbe-schussinduzierten magnetischen Strukturierung (IBMP) von EB-Systemen zur Herstellung von maßgeschneiderten magnetischen Feldlandschaften (MFL) oberhalb der Substratoberfläche, deren Stärke und räumlicher Verlauf auf Nano- und Mikrometerlängenskalen gezielt über die Veränderung der Materialparameter des EB-Systems via IBMP eingestellt werden kann, eignet. Im Zuge dessen wurden erstmals moderne, experimentelle Verfahrenstechniken (Raster-Hall-Sonden-Mikroskopie und rastermagnetoresistive Mikroskopie) in Kombination mit einem eigens entwickelten theoretischen Modell eingesetzt, um eine Abbildung der MFL in unterschiedlichen Abstandsbereichen zur Substratoberfläche zu realisieren. Basierend auf der quantitativen Kenntnis der MFL wurde ein neuartiges Konzept zum fernsteuerbaren Transport magnetischer Partikel entwickelt, bei dem Partikelgeschwindigkeiten im Bereich von 100 µm/s unter Verwendung von externen Magnetfeldstärken im Bereich weniger Millitesla erzielt werden können, ohne den magnetischen Zustand des Substrats zu modifizieren. Wie aus den Untersuchungen hervorgeht, können zudem die Stärke des externen Magnetfelds, die Stärke und der Gradient der MFL, das magnetfeldinduzierte magnetische Moment der Partikel sowie die Größe und der künstlich veränderliche Abstand der Partikel zur Substratoberfläche als zentrale Einflussgrößen zur quantitativen Modifikation der Partikelgeschwindigkeit genutzt werden. Abschließend wurde erfolgreich ein numerisches Simulationsmodell entwickelt, das die quantitative Studie der aktiven Durchmischung auf Basis des vorgestellten Partikeltransportkonzepts von theoretischer Seite ermöglicht, um so gezielt die geometrischen Gegebenheiten der mikrofluidischen Kanalstrukturen auf einem LOC-System für spezifische Anwendungen anzupassen.

New insights into boar sperm function and survival from integrated field and laboratory studies

En aquesta tesi s'han dut a terme dos tipus d'estudis diferents. L'objectiu del primer era la preservació del semen de porcí a 15ºC i el del segon eren els co-cultius homòlegs de cèl·lules epitelials de l'oviducte i espermatozoides de porcí. Pel que fa al primer estudi, s'ha observat que l'addició de la prostaglandina F2α i àcid hialurònic a les dosis seminals no malmena la qualitat espermàtica i que la tolerància dels espermatozoides als canvis d'osmolalitat del medi es pot correlacionar proves de fertilitat i prolificitat.. Respecte el segon, s'ha determinat que les cèl·lules oviductals afecten els paràmetres espermàtics i que la presència d'espermatozoides sobreexpressa els gens que codifiquen per les proteïnes de xoc tèrmic. Així, se suggereix que aquestes proteïnes tenen algun paper en els processos reproductius que tenen lloc a l'oviducte, malgrat que s'hagi observat, mitjançant la tècnica de la interferència de l'RNA, que la HSP90AA1 no està implicada en el perllongament de la viabilitat espermàtica.

Prediction leaching of potassium using the convective-dispersive and the convective log-normal transfer function models

There is increasing concern about soil enrichment with K+ and subsequent potential losses following long-term application of poor quality water to agricultural land. Different models are increasingly being used for predicting or analyzing water flow and chemical transport in soils and groundwater. The convective-dispersive equation (CDE) and the convective log-normal transfer function (CLT) models were fitted to the potassium (K+) leaching data. The CDE and CLT models produced equivalent goodness of fit. Simulated breakthrough curves for a range of CaCl2 concentration based on parameters of 15 mmol l(-1) CaCl2 were characterised by an early peak position associated with higher K+ concentration as the CaCl2 concentration used in leaching experiments decreased. In another method, the parameters estimated from 15 mmol l(-1) CaCl2 solution were used for all other CaCl2 concentrations, and the best value of retardation factor (R) was optimised for each data set. A better prediction was found. With decreasing CaCl2 concentration the value of R is required to be more than that measured (except for 10 mmol l(-1) CaCl2), if the estimated parameters of 15 mmol l(-1) CaCl2 are used. The two models suffer from the fact that they need to be calibrated against a data set, and some of their parameters are not measurable and cannot be determined independently.