Using Needs Assessment to Understand Continuing Disability in Patients with Enduring Mental Illness. Implications for Considerations of Service Development

Particular strengths of the MRC Needs for Care Assessment Schedule have been used to investigate the treatment status of patients with persistent psychiatric disability in ways that other needs assessment tools are unable to. One hundred and seventy-nine such patients from three settings; a private sector psychiatric hospital, two public sector day hospitals situated in the same town, and a high security hospital, were found to have a high level of need. Although there were differences between settings, overall these needs were well met in all three. The high level of persistent disability found amongst these patients could not be attributed to failure on the part of those treating them to use the best available methods, or to failures to comply or engage with treatment on the patient's part. In some two thirds of instances persistent disability was best explained by the fact that even the most suitable available treatments have to be considered only partially effective.

IQuOD 4th workshop in Tokyo: Copernicus Marine in situ TAC, a service for operational oceanography

Copernicus is a European system for monitoring the Earth. COPERNICUS-CMEMS products and services are meant to serve all marine applications: Marine resources, Maritime safety, Coastal and Marine Environment, Seasonal Forecast & Climate. The service is ambitious as the ocean is complex and many processes are involved, from physical oceanography, biology, geology, ocean-atmosphere fluxes, solar radiations, moon induced tides, anthropic activity. A multi-platform approach is essential, taking into account sea-level stations, coastal buoys, HF radars, river flows, drifting buoys, sea-mammal or fishes fitted with sensors, vessels, gliders, floats.

Challenges and Opportunities in Transforming Laser System Industry to Deliver Integrated Product and Service Offers

Part 4: Transition Towards Product-Service Systems

Agreement of Mixed Venous Carbon Dioxide Tension (PvCO2) and Transcutaneous Carbon Dioxide (PtCO2) Measurements in Ventilated Infants

Background: Noninvasive transcutaneous carbon dioxide monitoring has been shown to be accurate in infants and children, limited data are available to show the usefulness and limitations of partial transcutaneous carbon dioxide tension (PtCO2) value. Objectives: The current study prospectively determines the effectiveness and accuracy of PtCO2 measurements in newborns. Materials and Methods: Venous blood gas sampling and monitoring of the PtCO2 level (TCM TOSCA, Radiometer) were done simultaneously. All measurements are performed on mechanically ventilated infants. Partial venous carbon dioxide tension (PvCO2) values divided into three groups according to hypocapnia (Group 1: < 4.68 kPa), normocapnia (Group 2: 4.68–7.33 kPa), hypercapnia (Group 3: > 7.33 kPa) and then PvCO2 and PtCO2 data within each group were compared separately. Results: A total of 168 measurements of each PvCO2 and PtCO2 data were compared in three separated groups simultaneously (13 in Group 1, 118 in Group 2, and 37 in Group 3). A bias of more than ± 0.7 kPa was considered unacceptable. PtCO2 was related to PvCO2 with acceptable results between the two measurements in hypocapnia (mean difference 0.20 ± 0.19 kPa) and normocapnia (0.002 ± 0.30 kPa) groups. On the other hand in hypercapnia group PtCO2 values were statistically significant (P < 0.001) and lower than PvCO2 data (mean difference 0.81 ± 1.19 kPa) Conclusions: PtCO2 measurements have generally good agreement with PvCO2 in hypocapnic and normocapnic intubated infants but there are some limitations especially with high level of CO2 tension. Monitoring of PtCO2 is generally a useful non-invasive indicator of PvCO2 in hypocapnic and normocapnic infants.

Analysis of english teachers' perceptions related to strategies studied in a in-service course in Cuenca

El presente estudio describe las percepciones de los profesores fiscales de inglés en relación a las estrategias aprendidas durante una capacitación realizada en el año 2012 por un grupo de investigadores de la Facultad de Filosofía de la Universidad de Cuenca. En el año 2014, este grupo de investigadores inició un proyecto para analizar el impacto de dicha capacitación. Este es el marco contextual en el cual se desarrolla el análisis de la percepción docente. La propuesta está basada en el método exploratorio. El instrumento de investigación fue la entrevista personal a diez profesores que participaron de la capacitación en el año 2012. Los resultados fueron analizados con la ayuda del Software Atlas ti. Se identificaron catorce códigos diferentes que fueron agrupados en cuatro grupos de familias: estrategias comunicativas, aprendizaje significativo, percepciones de las necesidades e inconsistencias. Todas estas familias de códigos convergieron alrededor del Aprendizaje Basado en Tareas (ABT), el cual permitía generar un outcome, cuyo significado específico es la generación de un producto a partir del uso del idioma inglés por parte de los estudiantes. Un hallazgo importante fue que casi todos los profesores recordaron varias estrategias aprendidas en la capacitación, mismas que sumaron un total de nueve, además la mitad de docentes estaba usando el outcome en sus clases, ello da cuenta de la percepción positiva que tienen los docentes sobre el curso, a pesar de haber transcurrido dos años de su clausura.

Morbidity and temporary cycles for the outpatient service at Universidad Estatal a Distancia in Costa Rica

No data has apparently been published on morbidity and outpatient service of faculty and staff of a distance university.  This report presents such data from the Universidad Estatal a Distancia (Costa Rican State University for Distance Education). The participants in this study were the employees who were outpatients between January 15, 2004 and December 15, 2006.  Instead of using a sample, the entire population was studied with a total of 1,526 medical records. Procedure: During the first stage all of the medical records were read and the morbidity data was tabulated.  Subsequently, this information was statistically analyzed using Statgraphics Centurion XV. The main findings were that 50% of the patients used the outpatient service only once during the study period and that most of them were between 20 and 50 years of age.  The days with the most consultations were Mondays, Tuesdays, and Wednesdays.  The number of consultations was relatively stable throughout the year, with a slight increase in June. The three main causes for visiting the service were: upper respiratory tract diseases, muscular-skeletal disorders, and irritated digestive system problems. Main conclusions: Most of the consultations were from the departments with the more faculty and staff members; however, some departments had extremely high or low consultation rates per capita, maybe due to factors such as pathologies that require periodic control, geographical proximity, and psycho-social issues of patients who create a vicious circle due to the somatization of such problems.  The hypothesis that this population’s morbidity rate would differ from the national average because of its high educational level was rejected.  Nevertheless, the hypothesis that there are weekly and yearly cycles was maintained.

Are adolescents/young people and their families getting the best service when being cared for by young adolescent student nurses?

The purpose of this presentation is to highlight issues that exist for student nurses who embark on a career in children's nursing at a very young age and subsequently find themselves in a situation where they are expected to deliver high quality care to young people and their families. An introductory sentence indicating the purpose of the presentation: Currently in the UK under the Making a Différence Curriculum (DOH 1999) students can enrol on a single registration programme for Children's Nursing as young as 17.5 years. Children are admitted to hospital onto the children's wards between the ages of 0-16 years (occasionally older). Using Viner's (2003) définition of adolescence as being that period between the ages of ten and twenty-five years when biopsychosocial maturation leads to functional independence in adult iife demonstrates the possibility that both the patients and the nursing students could be undergoing very similar transitional experiences. Historically, in the 1940-50's children were admitted to childrens wards between the ages of 2-12 years. Nurse education at that time tended to be undertaken for first or second level registration in the first instance, followed by post-registration training for specialist areas. Subsequently, the phenomenon of adolescent paediatric nursing students being required to care for adolescents and their families on the children's wards did not exist some 60 years ago. A brief description of the highiights of the présentation: This présentation will focus on adolescent transitions with particular reference to issues that could arise when young students are required to care for young people and their families, particularly when there is a diagnosis of self harm or substance abuse. A summary of findings and/or other relevant information: Preliminary findings have indicated that very young student nurses find caring for adolescents to be particularly challenging. Health issues pertinent to young people appear to présent particular challenges for the students which raises questions in respect of the quality of care that the young people and their families may receive. A conclusion and implications: The following need to be further explored: i) Support within the clinical areas and adequate de-briefing strategies, ii) The efficacy of single registration to children's nursing, iii) Young people and their family's perception of the quality of care they receive from very young students.

The Performance and Service Life Prediction of High Performance Concrete in Sulfate and Acidic Environments

Concrete substructures are often subjected to environmental deterioration, such as sulfate and acid attack, which leads to severe damage and causes structure degradation or even failure. In order to improve the durability of concrete, the High Performance Concrete (HPC) has become widely used by partially replacing cement with pozzolanic materials. However, HPC degradation mechanisms in sulfate and acidic environments are not completely understood. It is therefore important to evaluate the performance of the HPC in such conditions and predict concrete service life by establishing degradation models. This study began with a review of available environmental data in the State of Florida. A total of seven bridges have been inspected. Concrete cores were taken from these bridge piles and were subjected for microstructural analysis using Scanning Electron Microscope (SEM). Ettringite is found to be the products of sulfate attack in sulfate and acidic condition. In order to quantitatively analyze concrete deterioration level, an image processing program is designed using Matlab to obtain quantitative data. Crack percentage (Acrack/Asurface) is used to evaluate concrete deterioration. Thereafter, correlation analysis was performed to find the correlation between five related variables and concrete deterioration. Environmental sulfate concentration and bridge age were found to be positively correlated, while environmental pH level was found to be negatively correlated. Besides environmental conditions, concrete property factor was also included in the equation. It was derived from laboratory testing data. Experimental tests were carried out implementing accelerated expansion test under controlled environment. Specimens of eight different mix designs were prepared. The effect of pozzolanic replacement rate was taken into consideration in the empirical equation. And the empirical equation was validated with existing bridges. Results show that the proposed equations compared well with field test results with a maximum deviation of ± 20%. Two examples showing how to use the proposed equations are provided to guide the practical implementation. In conclusion, the proposed approach of relating microcracks to deterioration is a better method than existing diffusion and sorption models since sulfate attack cause cracking in concrete. Imaging technique provided in this study can also be used to quantitatively analyze concrete samples.

Health Status, Living Arrangements, and Service Use at 100: Findings From the Oporto Centenarian Study

This paper describes the sociodemographic characteristics, health status, and service use of centenarians living in the community and centenarians residing in an elder care facility/nursing home and examines their main differences. Participants were 140 centenarians from the population-based Oporto Centenarian Study (Mage = 101.2; SD = 1.6). Main findings revealed that the majority of the centenarians lived at home with their family members (57.9%). Increased health care needs, living alone, and family caregiving constraints were the most common reasons for entering a nursing home. Community-dwelling centenarians were cared for mostly by their children and were less dependent and in better cognitive health than those who resided in a nursing home. Differences were found in the pattern of health service use according to the centenarians' residence, ability to pay medical expenses, and dependency level. Findings highlight the need for an accurate assessment of caregiving support systems, particularly family intergenerational duties, and of the factors constraining the access and use of health and social services. Policy makers may be guided by the insights gained from this research and work toward improvement of support options and removal of barriers to service access.

A next application prediction service using the BaranC framework

Predicting user behaviour enables user assistant services provide personalized services to the users. This requires a comprehensive user model that can be created by monitoring user interactions and activities. BaranC is a framework that performs user interface (UI) monitoring (and collects all associated context data), builds a user model, and supports services that make use of the user model. A prediction service, Next-App, is built to demonstrate the use of the framework and to evaluate the usefulness of such a prediction service. Next-App analyses a user's data, learns patterns, makes a model for a user, and finally predicts, based on the user model and current context, what application(s) the user is likely to want to use. The prediction is pro-active and dynamic, reflecting the current context, and is also dynamic in that it responds to changes in the user model, as might occur over time as a user's habits change. Initial evaluation of Next-App indicates a high-level of satisfaction with the service.

Modelling and simulations of ductile iron solidification-induced variations in mechanical behaviour on component and microstructural level

The mechanical behaviour and performance of a ductile iron component is highly dependent on the local variations in solidification conditions during the casting process. Here we show a framework which combine a previously developed closed chain of simulations for cast components with a micro-scale Finite Element Method (FEM) simulation of the behaviour and performance of the microstructure. A casting process simulation, including modelling of solidification and mechanical material characterization, provides the basis for a macro-scale FEM analysis of the component. A critical region is identified to which the micro-scale FEM simulation of a representative microstructure, generated using X-ray tomography, is applied. The mechanical behaviour of the different microstructural phases are determined using a surrogate model based optimisation routine and experimental data. It is discussed that the approach enables a link between solidification- and microstructure-models and simulations of as well component as microstructural behaviour, and can contribute with new understanding regarding the behaviour and performance of different microstructural phases and morphologies in industrial ductile iron components in service.

Communication across cultures? An intercultural approach to customer service in the hotel industry: a study with globally branded hotels in the United Kingdom

In a professional and business-social context such as that of global hotel brands in the United Kingdom, intercultural communication, contacts and relationships are found at the heart of daily operations and of customer service. A large part of the clientele base of hotels in the United Kingdom is formed by individuals who belong to different cultural groups that travel in the country either for leisure or business. At the same time, the global workforce which is recruited in the hotel industry in the United Kingdom is a reality here to stay. Global travelling and labor work mobility are phenomena which have been generated by changes which occur on a socio-economic, cultural and political level due to the phenomenon of globalization. The hotel industry is therefore well acquainted with the essence of different cultures either to be accommodated within hotel premises, as in the case of external customers, or of diversity management where different cultures are recruited in the hotel industry, as in the case of internal customers. This thesis derives from research conducted on eight different global hotel brands in the United Kingdom in particular, with reference to three, four and five star categories. The research aimed to answer the question of how hotels are organized in order to address issues of intercultural communication during customer service and if intercultural barriers arise during the intercultural interaction of hotel staff and global customers. So as to understand how global hotel brands operate the research carried out focused in three main areas relating to each hotel: organizational culture, customer service–customer care and intercultural issues. The study utilized qualitative interviews with hotel management staff and non-management staff from different cultural backgrounds, public space observations between customers and staff during check-in and checkout in the reception area and during dining at the café-bar and restaurant. Thematic analysis was also applied to the official web page of each hotel and to job advertisements to enhance the findings from the interviews and the observations. For the process of analysis of the data interpretive (hermeneutic) phenomenology of Martin Heidegger has been applied. Generally, it was found that hotel staff quite often feel perplexed by how to deal with and how to overcome, for instance, language barriers and religious issues and how to interpret non verbal behaviors or matters on food culture relating to the intercultural aspect of customer service. In addition, it was interesting to find that attention to excellent customer service on the part of hotel staff is a top organizational value and customer care is a priority. Despite that, the participating hotel brands appear to have not yet, realized how intercultural barriers can affect the daily operation of the hotel, the job performance and the psychology of hotel staff. Employees indicated that they were keen to receive diversity training, provided by their organizations, so as to learn about different cultural needs and expand their intercultural skills. The notion of diversity training in global hotel brands is based on the sense that one of the multiple aims of diversity management as a practice and policy in the workplace of hotels is the better understanding of intercultural differences. Therefore global hotel brands can consider diversity training as a practice which will benefit their hotel staff and clientele base at the same time. This can have a distinctive organizational advantage for organizational affairs in the hotel industry, with potential to influence the effectiveness and performance of hotels.

Asfixia perinatal y proteína S100B

La asfixia perinatal es la principal causa de muerte en la primera semana de vida la nivel mundial, los niños que sufren esta complicación y sobreviven pueden presentar trastornos neurológicos de diferente nivel de compromiso que inciden en su desarrollo personal y social. Las cifras de muerte por este problema de salud han disminuido de manera importante, sin embargo en el reporte de la Organización Mundial de Salud (OPS) del 2010, la asfixia perinatal es causa del 29% de muertes infantiles en los países de América Latina y el Caribe 2. Es necesario conocer además la extensión del daño neurológico que sufren estos niños, con este fin se desarrolló un estudio piloto en el Hospital Universitario Mayor Mederi de Bogotá, en el cual se determinó la concentración de un marcador metabólico de daño cerebral, la proteína S100B en suero de 60 recién nacidos sanos, con el objetivo de analizar la asociación del mismo con el peso al nacer, la edad gestacional y el diagnóstico. Los resultados no mostraron diferencias significativas entre este marcador y las variables analizadas que puede asociarse al pequeño número de pacientes, sin embargo han sentado las bases para el desarrollo de un estudio que incluya varios hospitales de Bogotá y sobre todo la determinación del mismo en recién nacidos con diagnóstico de hipoxia en el período perinatal, lo cual aportará información del grado de la alteración que puedan tener a nivel cerebral y contribuya al mejor manejo evolutivo con la aplicación de medidas de intervención en estadios tempranos de la vida.

Predicamento de seguridad yemení

Con el inicio del periodo Post-Guerra Fría el Sistema Internacional comienza a experimentar un incremento en el fortalecimiento de su componente social; la Sociedad de Estados alcanza un mayor nivel de homogenización, el estado, unidad predominante de esta, comienzan atravesar una serie de transformaciones que obedecerán a una serie de cambios y continuidades respecto al periodo anterior. Desde la perspectiva del Realismo Subalterno de las Relaciones Internacionales se destacan el proceso de construcción de estado e inserción al sistema como las variables que determinan el sentimiento de inseguridad experimentado por las elites estatales del Tercer Mundo; procesos que en el contexto de un nuevo y turbulento periodo en el sistema, tomara algunas características particulares que darán un sentido especifico al sentimiento de inseguridad y las acciones a través de las cuales las elites buscan disminuirlo. La dimensión externa del sentimiento de inseguridad, el nuevo papel que toma la resistencia popular como factor determinante del sentimiento de inseguridad y de la cooperación, así como del conflicto, entre los miembros de la Sociedad Internacional, la inserción como promotor de estrategias de construcción de Estado, son alguno de los temas puntuales, que desde la perspectiva subalterna, parecen salir a flote tras el análisis del sistema en lo que se ha considerado como el periodo Post-Guerra Fría. En este sentido Yemen, se muestra como un caso adecuado no solo para poner a prueba las postulados de la teoría subalterna, veinte años después de su obra más prominente (The third world security Predicament), escrita por M. Ayoob, sino como un caso pertinente que permite acercarse más a la comprensión del papel del Tercer Mundo al interior de la Sociedad Internacional de Estados.

Interoperability Challenges in Internet of Things Systems: a Service-Oriented Computing Approach

Internet of Things systems are pervasive systems evolved from cyber-physical to large-scale systems. Due to the number of technologies involved, software development involves several integration challenges. Among them, the ones preventing proper integration are those related to the system heterogeneity, and thus addressing interoperability issues. From a software engineering perspective, developers mostly experience the lack of interoperability in the two phases of software development: programming and deployment. On the one hand, modern software tends to be distributed in several components, each adopting its most-appropriate technology stack, pushing programmers to code in a protocol- and data-agnostic way. On the other hand, each software component should run in the most appropriate execution environment and, as a result, system architects strive to automate the deployment in distributed infrastructures. This dissertation aims to improve the development process by introducing proper tools to handle certain aspects of the system heterogeneity. Our effort focuses on three of these aspects and, for each one of those, we propose a tool addressing the underlying challenge. The first tool aims to handle heterogeneity at the transport and application protocol level, the second to manage different data formats, while the third to obtain optimal deployment. To realize the tools, we adopted a linguistic approach, i.e.\ we provided specific linguistic abstractions that help developers to increase the expressive power of the programming language they use, writing better solutions in more straightforward ways. To validate the approach, we implemented use cases to show that the tools can be used in practice and that they help to achieve the expected level of interoperability. In conclusion, to move a step towards the realization of an integrated Internet of Things ecosystem, we target programmers and architects and propose them to use the presented tools to ease the software development process.