956 resultados para Order of the Hospital


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This article examines hospital provision in Ireland during the early twentieth century. It examines attempts by the newly independent Irish Free State to reform and de-stigmatise medical relief in former workhouse infirmaries. Such reforms were designed to move away from nineteenth century welfare regimes which were underpinned by principles of deterrence. The reform initiated in independent Ireland - the first attempted break-up of the New Poor Law in Great Britain or Ireland - was partly successful. Many of the newly named County and District Hospitals provided solely for medical cases and managed to dissociate such health care provision from the relief of poverty. However, some hospitals continued to act as multifunctional institutions and provided for various categories including the sick, the aged and infirm, 'unmarried mothers' and 'harmless lunatics'. Such institutions often remained associated with the relief of poverty. This article also examines patient fee-payment and outlines how fresh terms of entitlement and means-testing were established. Such developments were even more pronounced in voluntary hospitals where the majority of patients made a financial contribution to their treatment. The article argues that the ability to pay at times determined the type of provision, either voluntary or rate-aided, available to the sick. However, it concludes that the clinical condition of patients often determined whether they entered a more prestigious voluntary hospital or the former workhouse. Although this article concentrates on two Irish case studies, County Kerry and Cork City; it is conceptualised within wider developments with particular reference to the British context.

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In this paper we investigate the first order characteristics of the radio channel between a moving vehicle and a stationary person positioned by the side of a road at 5.8 GHz. The experiments considered a transmitter positioned at different locations on both the body and receivers positioned on the vehicle. The transmitter was alternated between positions on the central chest region, back and the wrist (facing the roadside) of the body, with the receivers placed on the outside roof, the outside rear window and the inside dashboard of the vehicle. The Rice fading model was applied to the measurement data to assess its suitability for characterizing this emerging type of wireless channel. The Ricean K factors calculated from the data suggest that a significant dominant component existed in the majority of the channels considered in this study.

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To investigate the performance of ambisonics systems reproduced over headphones, a pairwise comparison test was carried out. Binaurally reproduced sound scenes for 2D ambisonic orders 1 to 4 decoded on 2M + 2 virtual loudspeakers using two decoder options, basic and mixed basic and maxrE were used. Similarity ratings are obtained from pairwise comparisons between all of the combinations of systemsa and a binaural reference.

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Reduced Order Models (ROMs) have proven to be a valid and efficient approach to model the thermal behaviour of building zones. The main issues associated with the use of zonal/lumped models are how to (1) divide the domain (lumps) and (2) evaluate the pa- rameters which characterise the lump-to-lump exchange of energy and momentum. The object of this research is to develop a methodology for the generation of ROMs from CFD models. The lumps of the ROM and their average property values are automatically ex- tracted from the CFD models through user defined constraints. This methodology has been applied to validated CFD models of a zone of the Environmental Research Insti- tute (ERI) Building in University College Cork (UCC). The ROM predicts temperature distribution in the domain with an average error lower than 2%. It is computationally efficient with an execution time of 3.45 seconds. Future steps in this research will be the development of the procedure to automatically extract the parameters which define lump-to-lump energy and momentum exchange. At the moment these parameters are evaluated through the minimisation of a cost function. The ROMs will also be utilised to predict the transient thermal behaviour of the building zone.

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Medicines reconciliation is a way to identify and act on discrepancies in patients’ medical histories and it is found to play a key role in patient safety. This review focuses on discrepancies and medical errors that occurred at point of discharge from hospital. Studies were identified through the following electronic databases: PubMed, Sciences Direct, EMBASE, Google Scholar, Cochrane Reviews and CINAHL. Each of the six databases was screened from inception to end of January 2014. To determine eligibility of the studies; the title, abstract and full manuscript were screened to find 15 articles that meet the inclusion criteria. The median number of discrepancies across the articles was found to be 60%. In average patient had between 1.2–5.3 discrepancies when leaving the hospital. More studies also found a relation between the numbers of drugs a patient was on and the number of discrepancies. The variation in the number of discrepancies found in the 15 studies could be due to the fact that some studies excluded patient taking more than 5 drugs at admission. Medication reconciliation would be a way to avoid the high number of discrepancies that was found in this literature review and thereby increase patient safety.

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This paper presents the measurement, frequency-response modeling and identification, and the corresponding impulse time response of the human respiratory impedance and admittance. The investigated adult patient groups were healthy, diagnosed with chronic obstructive pulmonary disease and kyphoscoliosis, respectively. The investigated children patient groups were healthy, diagnosed with asthma and cystic fibrosis, respectively. Fractional order (FO) models are identified on the measured impedance to quantify the respiratory mechanical properties. Two methods are presented for obtaining and simulating the time-domain impulse response from FO models of the respiratory admittance: (i) the classical pole-zero interpolation proposed by Oustaloup in the early 90s, and (ii) the inverse discrete Fourier Transform (DFT). The results of the identified FO models for the respiratory admittance are presented by means of their average values for each group of patients. Consequently, the impulse time response calculated from the frequency response of the averaged FO models is given by means of the two methods mentioned above. Our results indicate that both methods provide similar impulse response data. However, we suggest that the inverse DFT is a more suitable alternative to the high order transfer functions obtained using the classical Oustaloup filter. Additionally, a power law model is fitted on the impulse response data, emphasizing the intrinsic fractal dynamics of the respiratory system.

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The self similar branching arrangement of the airways makes the respiratory system an ideal candidate for the application of fractional calculus theory. The fractal geometry is typically characterized by a recurrent structure. This study investigates the identification of a model for the respiratory tree by means of its electrical equivalent based on intrinsic morphology. Measurements were obtained from seven volunteers, in terms of their respiratory impedance by means of its complex representation for frequencies below 5 Hz. A parametric modeling is then applied to the complex valued data points. Since at low-frequency range the inertance is negligible, each airway branch is modeled by using gamma cell resistance and capacitance, the latter having a fractional-order constant phase element (CPE), which is identified from measurements. In addition, the complex impedance is also approximated by means of a model consisting of a lumped series resistance and a lumped fractional-order capacitance. The results reveal that both models characterize the data well, whereas the averaged CPE values are supraunitary and subunitary for the ladder network and the lumped model, respectively.

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Bipedal gaits have been classified on the basis of the group symmetry of the minimal network of identical differential equations (alias cells) required to model them. Primary bipedal gaits (e.g., walk, run) are characterized by dihedral symmetry, whereas secondary bipedal gaits (e.g., gallop-walk, gallop- run) are characterized by a lower, cyclic symmetry. This fact has been used in tests of human odometry (e.g., Turvey et al. in P Roy Soc Lond B Biol 276:4309–4314, 2009, J Exp Psychol Hum Percept Perform 38:1014–1025, 2012). Results suggest that when distance is measured and reported by gaits from the same symmetry class, primary and secondary gaits are comparable. Switching symmetry classes at report compresses (primary to secondary) or inflates (secondary to primary) measured distance, with the compression and inflation equal in magnitude. The present research (a) extends these findings from overground locomotion to treadmill locomotion and (b) assesses a dynamics of sequentially coupled measure and report phases, with relative velocity as an order parameter, or equilibrium state, and difference in symmetry class as an imperfection parameter, or detuning, of those dynamics. The results suggest that the symmetries and dynamics of distance measurement by the human odometer are the same whether the odometer is in motion relative to a stationary ground or stationary relative to a moving ground.

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Children were afforded the opportunity to control the order of repetitions for three novel spatiotemporal sequences. The following was predicted: a) children and adults in the self-regulated (SELF) groups would produce faster movement (MT) and reaction times (R T) and greater recall success (RS) during retention compared to the age-matched yoked (YOKE) groups; b) children would choose to switch sequences less often than adults; c) adults would produce faster MT and RT and greater RS than the children during acquisition and retention, independent of experimental group. During acquisition, no effects were seen for RS, however for MT and RT there was a main effect for age as well as block. During retention a main effect for practice condition was seen for RS and failed to reach statistical significance for MT and RT, thus partially supporting our first and second hypotheses. The third hypothesis was not supported.