995 resultados para Hospital architecture
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For a decade, embedded driving assistance systems were mainly dedicated to the management of short time events (lane departure, collision avoidance, collision mitigation). Recently a great number of projects have been focused on cooperative embedded devices in order to extend environment perception. Handling an extended perception range is important in order to provide enough information for both path planning and co-pilot algorithms which need to anticipate events. To carry out such applications, simulation has been widely used. Simulation is efficient to estimate the benefits of Cooperative Systems (CS) based on Inter-Vehicular Communications (IVC). This paper presents a new and modular architecture built with the SiVIC simulator and the RTMaps™ multi-sensors prototyping platform. A set of improvements, implemented in SiVIC, are introduced in order to take into account IVC modelling and vehicles’ control. These 2 aspects have been tuned with on-road measurements to improve the realism of the scenarios. The results obtained from a freeway emergency braking scenario are discussed.
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This study aimed to examine the use of hospital emergency departments and to investigate the level of satisfaction with the emergency department service among patients from a non-English-speaking background compared to those of patients from an English-speaking background in Queensland. The findings of this study might inform health professionals and policy planners to develop educational interventions and policies to ensure equitable use of emergency services among the populations.
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This report describes the evaluation of the Refugee Antenatal Clinic (Mater Mothers' Hospital, Brisbane) which was established in November 2008
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There are limited studies that describe patient meal preferences in hospital; however this data is critical to develop menus that address satisfaction and nutrition whilst balancing resources. This quality study aimed to determine preferences for meals and snacks to inform a comprehensive menu revision in a large (929 bed) tertiary public hospital. The method was based on Vivanti et al. (2008) with data collected by two final year dietetic students. The first survey comprised 72 questions, achieved a response rate of 68% (n = 192), with the second more focused at 47 questions achieving a higher response rate of 93% (n = 212). Findings showed over half the patients reporting poor or less than normal appetite, 20% describing taste issues, over a third with a LOS >7 days, a third with a MST _ 2 and less than half eating only from the general menu. Soup then toast was most frequently reported as eaten at home when unwell, and whilst most reported not missing any foods when in hospital (25%), steak was most commonly missed. Hot breakfasts were desired by the majority (63%), with over half preferring toast (even if cold). In relation to snacks, nearly half (48%) wanted something more substantial than tea/coffee/biscuits, with sandwiches (54%) and soup (33%) being suggested. Sandwiches at the evening meal were not popular (6%). Difficulties with using cutlery and meal size selection were identified as issues. Findings from this study had high utility and supported a collaborative and evidenced based approach to a successful major menu change for the hospital.
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Information on foods patients like and dislike is the essential basis for planning menus which are acceptable to patients and promote adequate consumption. The aim of this study was to obtain quantitative data on the food preferences of inpatients at a large metropolitan public hospital for use in menu planning. Methodology was based on a study by Williams et al (1988), and included additional questions about appetite and taste changes. The survey used a 9 point hedonic scale to rate foods listed in random order and was modified to incorporate more contemporary foods than those used in the originalWilliams study. Surveys were conducted by final year University of Queensland dietetics students on Food Service Practicum at the Royal Brisbane and Women’s Hospital (929 beds) in 2012. The first survey (220 questions, n = 157) had a response rate of 61%. The second included more sandwich fillings and salads (231 questions, n = 219, response rate 67%). Total number surveyed was 376. Results showed the most preferred foods were roast potato, grilled steak, ice cream, fresh strawberries, roast lamb, roast beef, grapes and banana. The least preferred foods were grapefruit, soybeans, lentils, sardines, prune juice and grapefruit juice. Patients who reported taste changes (10%) had similar food preferences to those who didn’t report taste changes. Patients who reported poor/very poor appetite (10%) generally scored foods lower than those who reported OK (22%), good/very good appetite (65%). The results of this study informed planning for a new patient menu at the RBWH in December 2012.
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Enterprise architectures are exposed to fast emerging business and information technology capabilities. A prominent example is the paradigm of service-orientation, which leads to its own architectural requirements and impacts the design and ongoing evolution of Enterprise Architectures. This thesis develops the first theoretical model describing enterprise architecture evolution and outcomes in light of a changing IT landscape such as service-oriented architectures. The developed theoretical model explains enterprise architecture evolution, its main stages and related capabilities. This model can be used to derive theoretical, sound guidelines to manage enterprise architectures in a changing environment.
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Introduction Older people recovering from cardiac events requiring an acute hospital admission may experience a decline in physical function limiting their ability to return home to their previous accommodation. Subacute inpatient rehabilitation therapies have potential to assist recovery of physical functioning. However, it is unknown whether age influences the length of stay or physical functioning at discharge from subacute inpatient rehabilitation for this population. Objectives This study examined the outcomes of a cohort of older patients recovering from a cardiac event requiring hospitalisation to investigate the association between age and physical function at discharge, as well as age and length of rehabilitation stay. Methods Participants included 145 consecutive inpatient admissions to a subacute geriatric assessment and rehabilitation unit with a cardiac condition as their primary reason for hospital admission. Participants were required to complete a multi-disciplinary physical functioning assessment within 72 hours of admission to the unit, and again within 72 hours prior to discharge from the unit. The primary outcome measure was the Functional Independence Measure motor score. Demographic and clinical information, including length of stay and discharge destination, were also recorded. Results A total n=126 (87%) participants, with a mean (standard deviation) age of 79 (10) years, had both assessments completed and were included in analyses. Participants who had passed away (n=4, 3%), or did not have both assessments completed per protocol were excluded from analyses. Discharge destinations included home (n=101, 80%), residential aged care (n=17, 13%) and another hospital (n=8, 6%). The (median, interquartile range) Functional Independence Measure motor score was higher at discharge (79, 71 to 84) than admission (61, 48 to 71); z=7.75 p<0.001. Age was not associated with Functional Independence Measure motor score at discharge (t= -0.18, p=0.86), or length of stay in the rehabilitation unit (t= -0.52, 0.60). Conclusion Any perception that age may be associated with longer lengths of stay and reduced physical function outcomes among patients with cardiac conditions admitted for subacute inpatient rehabilitation for older adults is not supported data from this investigation. Older age should not be considered a disincentive when considering the suitability of patients with cardiac diagnoses for this type of inpatient rehabilitation or their potential physical functioning outcome.
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Plasmonic gold nano-assemblies that self-assemble with the aid of linking molecules or polymers have the potential to yield controlled hierarchies of morphologies and consequently result in materials with tailored optical (e.g. localized surface plasmon resonances (LSPR)) and spectroscopic properties (e.g. surface enhanced Raman scattering (SERS)). Molecular linkers that are structurally well-defined are promising for forming hybrid nano-assemblies which are stable in aqueous solution and are increasingly finding application in nanomedicine. Despite much ongoing research in this field, the precise role of molecular linkers in governing the morphology and properties of the hybrid nano-assemblies remains unclear. Previously we have demonstrated that branched linkers, such as hyperbranched polymers, with specific anchoring end groups can be successfully employed to form assemblies of gold NPs demonstrating near-infrared SPRs and intense SERS scattering. We herein introduce a tailored polymer as a versatile molecular linker, capable of manipulating nano-assembly morphologies and hot-spot density. In addition, this report explores the role of the polymeric linker architecture, specifically the degree of branching of the tailored polymer in determining the formation, morphology and properties of the hybrid nano-assemblies. The degree of branching of the linker polymer, in addition to the concentration and number of anchoring groups, is observed to strongly influence the self-assembly process. The assembly morphology shifts primarily from 1D-like chains to 2D plates and finally to 3D-like globular structures, with increase in degree of branching. Insights have been gained into how the morphology influences the SERS performance of these nano-assemblies with respect to hot-spot density. These findings supplement the understanding of the morphology determining nano-assembly formation and pave the way for the possible application of these nano-assemblies as SERS bio-sensors for medical diagnostics.
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This article describes the first steps toward comprehensive characterization of molecular transport within scaffolds for tissue engineering. The scaffolds were fabricated using a novel melt electrospinning technique capable of constructing 3D lattices of layered polymer fibers with well - defined internal microarchitectures. The general morphology and structure order was then determined using T 2 - weighted magnetic resonance imaging and X - ray microcomputed tomography. Diffusion tensor microimaging was used to measure the time - dependent diffusivity and diffusion anisotropy within the scaffolds. The measured diffusion tensors were anisotropic and consistent with the cross - hatched geometry of the scaffolds: diffusion was least restricted in the direction perpendicular to the fiber layers. The results demonstrate that the cross - hatched scaffold structure preferentially promotes molecular transport vertically through the layers ( z - axis), with more restricted diffusion in the directions of the fiber layers ( x – y plane). Diffusivity in the x – y plane was observed to be invariant to the fiber thickness. The characteristic pore size of the fiber scaffolds can be probed by sampling the diffusion tensor at multiple diffusion times. Prospective application of diffusion tensor imaging for the real - time monitoring of tissue maturation and nutrient transport pathways within tissue engineering scaffolds is discussed.
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Hospital disaster resilience can be defined as “the ability of hospitals to resist, absorb, and respond to the shock of disasters while maintaining and surging essential health services, and then to recover to its original state or adapt to a new one.” This article aims to provide a framework which can be used to comprehensively measure hospital disaster resilience. An evaluation framework for assessing hospital resilience was initially proposed through a systematic literature review and Modified-Delphi consultation. Eight key domains were identified: hospital safety, command, communication and cooperation system, disaster plan, resource stockpile, staff capability, disaster training and drills, emergency services and surge capability, and recovery and adaptation. The data for this study were collected from 41 tertiary hospitals in Shandong Province in China, using a specially designed questionnaire. Factor analysis was conducted to determine the underpinning structure of the framework. It identified a four-factor structure of hospital resilience, namely, emergency medical response capability (F1), disaster management mechanisms (F2), hospital infrastructural safety (F3), and disaster resources (F4). These factors displayed good internal consistency. The overall level of hospital disaster resilience (F) was calculated using the scoring model: F = 0.615F1 + 0.202F2 + 0.103F3 + 0.080F4. This validated framework provides a new way to operationalise the concept of hospital resilience, and it is also a foundation for the further development of the measurement instrument in future studies.
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This research aimed to develop a framework for performance evaluation of public hospitals in Vietnam that is culturally, socially, and politically appropriate. The research included both qualitative and quantitative methods and identified and validated novel instruments to measure patient satisfaction and job satisfaction of hospital staff and to determine a set of hospital indicators that reflect the quality of hospital performance. New models for understanding the determinants of patient and staff satisfaction were developed along with a new performance indicator framework for hospital performance. These instruments will now be applied to the evaluation of hospital services in Khanh Hoa Province, permitting longer term evaluation of their effectiveness in changing system wide performance and satisfaction.
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Globalization, financial deregulation, economic turmoil, and technology breakthroughs are profoundly exposing organizations to business networks. Engaging these networks requires explicit planning from the strategic level down to the operational level of an organization, which significantly affects organizational artefacts such as business services, processes, and resources. Although enterprise architecture (EA) aligns business and IT aspects of organizational systems, previous applications of EA have not comprehensively addressed a methodological framework for planning. In the context of business networks, this study seeks to explore the application of EA for business network planning where it builds upon relevant and well-established prescriptive and descriptive aspects of EA. Prescriptive aspects include integrated models of services, business processes, and resources among other organizational artefacts, at both business and IT levels. Descriptive aspects include ontological classifications of business functionality, which allow EA models to be aligned semantically to organizational artefacts and, ultimately higher-level business strategy. A prominent approach for capturing descriptive aspects of EA is business capability modelling. In order to explore and develop the illustrative extensions of EA through capability modelling, a list of requirements (capability dimensions) for business network planning will be identified and validated through a revelatory case study encompassing different business network manifestations, or situations. These include virtual organization, liquid workforce, business network orchestration, and headquarters-subsidiary. The use of artefacts, conventionally, modelled through EA will be considered in these network situations. Two general considerations for EA extensions are explored for the identified requirements at the level of the network: extension of artefacts through the network and alignment of network level artefacts with individual organization artefacts. The list of requirements provides the basis for a constructivist extension of EA in the following ways. Firstly, for descriptive aspects, it offers constructivist insights to guide extensions for particular EA techniques and concepts. Secondly, for prescriptive aspects it defines a set of capability dimensions, which improve the analysis and assessment of organization capabilities for business network situations.
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Objective: To examine the effects of personal and community characteristics, specifically race and rurality, on lengths of state psychiatric hospital and community stays using maximum likelihood survival analysis with a special emphasis on change over a ten year period of time. Data Sources: We used the administrative data of the Virginia Department of Mental Health, Mental Retardation, and Substance Abuse Services (DMHMRSAS) from 1982-1991 and the Area Resources File (ARF). Given these two sources, we constructed a history file for each individual who entered the state psychiatric system over the ten year period. Histories included demographic, treatment, and community characteristics. Study Design: We used a longitudinal, population-based design with maximum likelihood estimation of survival models. We presented a random effects model with unobserved heterogeneity that was independent of observed covariates. The key dependent variables were lengths of inpatient stay and subsequent length of community stay. Explanatory variables measured personal, diagnostic, and community characteristics, as well as controls for calendar time. Data Collection: This study used secondary, administrative, and health planning data. Principal Findings: African-American clients leave the community more quickly than whites. After controlling for other characteristics, however, race does not affect hospital length of stay. Rurality does not affect length of community stays once other personal and community characteristics are controlled for. However, people from rural areas have longer hospital stays even after controlling for personal and community characteristics. The effects of time are significantly smaller than expected. Diagnostic composition effects and a decrease in the rate of first inpatient admissions explain part of this reduced impact of time. We also find strong evidence for the existence of unobserved heterogeneity in both types of stays and adjust for this in our final models. Conclusions: Our results show that information on client characteristics available from inpatient stay records is useful in predicting not only the length of inpatient stay but also the length of the subsequent community stay. This information can be used to target increased discharge planning for those at risk of more rapid readmission to inpatient care. Correlation across observed and unobserved factors affecting length of stay has significant effects on the measurement of relationships between individual factors and lengths of stay. Thus, it is important to control for both observed and unobserved factors in estimation.
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We no longer have the luxury of time as the effects of climate change are being felt, according to the latest Intergovernmental Panel on Climate Change report, on every continent and in every ocean. More than 50% of the population of the United States and 85% of Australians live in coastal regions. The number of people living in the world’s coastal regions is expected to increase along with the need to improve capacity to mitigate hazards , and manage the multiple risks that have been identified by the scientific community. Under the auspices of the Association of Collegiate Schools of Architecture (ACSA) design academics and practitioners from the Americas, Asia, and Australia met in Fort Lauderdale, Florida for the fourth Subtropical Cities international conference to share outcomes of research and new pedagogies to address the critical transformation of the physical environments and infrastructures of the world’s vulnerable coastal communities. The theme of Subtropical Cities, adopted by the ACSA for its Fall 2014 Conference, is not confined entirely to a latitudinal or climatic frame of reference. The paper and project presentations addressed a range of theoretical, practice-led, and education-oriented research topics in architecture and urban design related to the subtropics, with emphasis on urban and coastal regions. More than half the papers originate from universities and practices in coastal regions. Threads emerged from a tapestry of localized investigations to reveal a more global understanding about possible futures we are designing for current and future generations. The one hundred-plus conference delegates and presenters represented 33 universities and institutions from across the United States, Mexico, Canada, Australia, the Middle East, Peru and China. Case studies from India, Morocco, Tahiti, Indonesia, Jordan, and Cambodia were also presented, expanding the global knowledge base. Co-authored submissions presented new directions for architecture and design, with a resounding theme of collaboration across diverse disciplines. The ability to deal with abstraction and complexity, and the capacity to develop synthesis and frameworks for defining problem boundaries can be considered key attributes of architectural thinking. Such a unique set of abilities can forge collaboration with different professional disciplines to achieve extraordinary outcomes. As the broad range of papers presented at this conference suggest, existing architectural and urban typologies and practices are increasingly considered part of the cause and not the solution to adapting to climate change and sea level rise. Design responses and the actions needed to generate new and unfamiliar forms of urbanism and infrastructure for defense, adaptation, and retreat in subtropical urban regions are being actively explored in academic design studios and research projects around the world. Many presentations propose provocative and experimental strategies as global climate moves beyond our “comfort zone”. The ideas presented at the Subtropical Cities conference are timely as options for low-energy passive climatic design are becoming increasingly limited in the context of changing climate. At the same time, ways of reducing or obsoleting energy intensive mechanical systems in densely populated urban centres present additional challenges for designers and communities as a whole. The conference was marked by a common theme of trans-disciplinary research, where design integration with emerging technologies resonate with a reaffirmation of the centrality of design thinking, expanding the scope of the traditional architecture studio pedagogy to integrate knowledge from other disciplines and the participation of diverse communities.
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Design Science is the process of solving ‘wicked problems’ through designing, developing, instantiating, and evaluating novel solutions (Hevner, March, Park and Ram, 2004). Wicked problems are described as agent finitude in combination with problem complexity and normative constraint (Farrell and Hooker, 2013). In Information Systems Design Science, determining that problems are ‘wicked’ differentiates Design Science research from Solutions Engineering (Winter, 2008) and is a necessary part of proving the relevance to Information Systems Design Science research (Hevner, 2007; Iivari, 2007). Problem complexity is characterised as many problem components with nested, dependent and co-dependent relationships interacting through multiple feedback and feed-forward loops. Farrell and Hooker (2013) specifically state for wicked problems “it will often be impossible to disentangle the consequences of specific actions from those of other co-occurring interactions”. This paper discusses the application of an Enterprise Information Architecture modelling technique to disentangle the wicked problem complexity for one case. It proposes that such a modelling technique can be applied to other wicked problems and can lay the foundations for proving relevancy to DSR, provide solution pathways for artefact development, and aid to substantiate those elements required to produce Design Theory.