The provision of patient personal hygiene in the intensive care unit : a descriptive exploratory study of bed-bathing practice

Background/objectives The provision of the patient bed-bath is a fundamental nursing care activity yet few quantitative data and no qualitative data are available on registered nurses’ (RNs) clinical practice in this domain in the intensive care unit (ICU). The aim of this study was to describe ICU RNs current practice with respect to the timing, frequency and duration of the patient bed-bath and the cleansing and emollient agents used. Methods The study utilised a two-phase sequential explanatory mixed method design. Phase one used a questionnaire to survey RNs and phase two employed semi-structured focus group (FG) interviews with RNs. Data was collected over 28 days across four Australian metropolitan ICUs. Ethical approval was granted from the relevant hospital and university human research ethics committees. RNs were asked to complete a questionnaire following each episode of care (i.e. bed-bath) and then to attend one of three FG interviews: RNs with less than 2 years ICU experience; RNs with 2–5 years ICU experience; and RNs with greater than 5 years ICU experience. Results During the 28-day study period the four ICUs had 77.25 beds open. In phase one a total of 539 questionnaires were returned, representing 30.5% of episodes of patient bed-baths (based on 1767 bed occupancy and one bed-bath per patient per day). In 349 bed-bath episodes 54.7% patients were mechanically ventilated. The bed-bath was given between 02.00 and 06.00 h in 161 episodes (30%), took 15–30 min to complete (n = 195, 36.2%) and was completed within the last 8 h in 304 episodes (56.8%). Cleansing agents used were predominantly pH balanced soap or liquid soap and water (n = 379, 71%) in comparison to chlorhexidine impregnated sponges/cloths (n = 86, 16.1%) or other agents such as pre-packaged washcloths (n = 65, 12.2%). In 347 episodes (64.4%) emollients were not applied after the bed-bath. In phase two 12 FGs were conducted (three FGs at each ICU) with a total of 42 RN participants. Thematic analysis of FG transcripts across the three levels of RN ICU experience highlighted a transition of patient hygiene practice philosophy from shades of grey – falling in line for inexperienced clinicians to experienced clinicians concrete beliefs about patient bed-bath needs. Conclusions This study identified variation in process and products used in patient hygiene practices in four ICUs. Further study to improve patient outcomes is required to determine the appropriate timing of patient hygiene activities and cleansing agents used to improve skin integrity.

Integrating information literacy into higher education curricula : an IL curricular integration model

This study investigates a way to systematically integrate information literacy (IL) into an undergraduate academic programme and develops a model for integrating information literacy across higher education curricula. Curricular integration of information literacy in this study means weaving information literacy into an academic curriculum. In the associated literature, it is also referred to as the information literacy embedding approach or the intra-curricular approach. The key findings identified from this study are presented in 4 categories: the characteristics of IL integration; the key stakeholders in IL integration; IL curricular design strategies; and the process of IL curricular integration. Three key characteristics of the curricular integration of IL are identified: collaboration and negotiation, contextualisation and ongoing interaction with information. The key stakeholders in the curricular integration of IL are recognised as the librarians, the course coordinators and lecturers, the heads of faculties or departments, and the students. Some strategies for IL curricular design include: the use of IL policies and standards in IL curricular design; the combination of face to face and online teaching as an emerging trend; the use of IL assessment tools which play an important role in IL integration. IL can be integrated into the intended curriculum (what an institution expects its students to learn), the offered curriculum (what the teachers teach) and the received curriculum (what students actually learn). IL integration is a process of negotiation, collaboration and the implementation of the intended curriculum. IL can be integrated at different levels of curricula such as: institutional, faculty, departmental, course and class curriculum levels. Based on these key findings, an IL curricular integration model is developed. The model integrates curriculum, pedagogy and learning theories, IL theories, IL guidelines and the collaboration of multiple partners. The model provides a practical approach to integrating IL into multiple courses across an academic degree. The development of the model was based on the IL integration experiences of various disciplines in three universities and the implementation experience of an engineering programme at another university; thus it may be of interest to other disciplines. The model has the potential to enhance IL teaching and learning, curricular development and to implement graduate attributes in higher education. Sociocultural theories are applied to the research process and IL curricular design of this study. Sociocultural theories describe learning as being embedded within social events and occurring as learners interact with other people, objects, and events in a collaborative environment. Sociocultural theories are applied to explore how academic staff and librarians experience the curricular integration of IL; they also support collaboration in the curricular integration of IL and the development of an IL integration model. This study consists of two phases. Phase I (2007) was the interview phase where both academic staff and librarians at three IL active universities were interviewed. During this phase, attention was paid specifically to the practical process of curricular integration of IL and IL activity design. Phase II, the development phase (2007-2008), was conducted at a fourth university. This phase explores the systematic integration of IL into an engineering degree from Year 1 to Year 4. Learning theories such as sociocultural theories, Bloom’s Taxonomy and IL theories are used in IL curricular development. Based on the findings from both phases, an IL integration model was developed. The findings and the model contribute to IL education, research and curricular development in higher education. The sociocultural approach adopted in this study also extends the application of sociocultural theories to the IL integration process and curricular design in higher education.

Development of a high-speed sensing and detection system for automatic removal of packages with leaky seals from a high-speed food processing and packaging line

Contamination of packaged foods due to micro-organisms entering through air leaks can cause serious public health issues and cost companies large amounts of money due to product recalls, consumer impact and subsequent loss of market share. The main source of contamination is leaks in packaging which allow air, moisture and microorganisms to enter the package. In the food processing and packaging industry worldwide, there is an increasing demand for cost effective state of the art inspection technologies that are capable of reliably detecting leaky seals and delivering products at six-sigma. The new technology will develop non-destructive testing technology using digital imaging and sensing combined with a differential vacuum technique to assess seal integrity of food packages on a high-speed production line. The cost of leaky packages in Australian food industries is estimated close to AUD $35 Million per year. Contamination of packaged foods due to micro-organisms entering through air leaks can cause serious public health issues and cost companies large sums of money due to product recalls, compensation claims and loss of market share. The main source of contamination is leaks in packaging which allow air, moisture and micro-organisms to enter the package. Flexible plastic packages are widely used, and are the least expensive form of retaining the quality of the product. These packets can be used to seal, and therefore maximise, the shelf life of both dry and moist products. The seals of food packages need to be airtight so that the food content is not contaminated due to contact with microorganisms that enter as a result of air leakage. Airtight seals also extend the shelf life of packaged foods, and manufacturers attempt to prevent food products with leaky seals being sold to consumers. There are many current NDT (non-destructive testing) methods of testing the seal of flexible packages best suited to random sampling, and for laboratory purposes. The three most commonly used methods are vacuum/pressure decay, bubble test, and helium leak detection. Although these methods can detect very fine leaks, they are limited by their high processing time and are not viable in a production line. Two nondestructive in-line packaging inspection machines are currently available and are discussed in the literature review. The detailed design and development of the High-Speed Sensing and Detection System (HSDS) is the fundamental requirement of this project and the future prototype and production unit. Successful laboratory testing was completed and a methodical design procedure was needed for a successful concept. The Mechanical tests confirmed the vacuum hypothesis and seal integrity with good consistent results. Electrically, the testing also provided solid results to enable the researcher to move the project forward with a certain amount of confidence. The laboratory design testing allowed the researcher to confirm theoretical assumptions before moving into the detailed design phase. Discussion on the development of the alternative concepts in both mechanical and electrical disciplines enables the researcher to make an informed decision. Each major mechanical and electrical component is detailed through the research and design process. The design procedure methodically works through the various major functions both from a mechanical and electrical perspective. It opens up alternative ideas for the major components that although are sometimes not practical in this application, show that the researcher has exhausted all engineering and functionality thoughts. Further concepts were then designed and developed for the entire HSDS unit based on previous practice and theory. In the future, it would be envisaged that both the Prototype and Production version of the HSDS would utilise standard industry available components, manufactured and distributed locally. Future research and testing of the prototype unit could result in a successful trial unit being incorporated in a working food processing production environment. Recommendations and future works are discussed, along with options in other food processing and packaging disciplines, and other areas in the non-food processing industry.

Workflow patterns as a means to model task succession in games – a preliminary case study

Over about the last decade, people involved in game development have noted the need for more formal models and tools to support the design phase of games. It is argued that the present lack of such formal tools is currently hindering knowledge transfer among designers. Formal visual languages, on the other hand, can help to more effectively express, abstract and communicate game design concepts. Moreover, formal tools can assist in the prototyping phase, allowing designers to reason about and simulate game mechanics on an abstract level. In this paper we present an initial investigation into whether workflow patterns – which have already proven to be effective for modeling business processes – are a suitable way to model task succession in games. Our preliminary results suggest that workflow patterns show promise in this regard but some limitations, especially in regard to time constraints, currently restrict their potential.

The value of storytelling

Considering the embodied carbon in existing buildings where expenditure has already occurred, the retrofitting of existing buildings presents a significant opportunity to reduce the carbon footprint of our built environment. In Australia there is also a renewed awareness of the importance of our cultural heritage and the adaptive reuse of our historic buildings is increasingly discussed as a preservation strategy. The ‘design’ phase in building projects is credited with providing “an unparalleled window of opportunity to address environmental objectives” and fostering sustainable development, with up to 80% of overall environmental impacts determined by the decisions made at this stage. Both design and built environment professionals appreciate that a holistic and ‘whole systems’ approach is key in enabling transformation. The design process often comprises of many divergent and convergent activities, many of which seek to understand the people and context. The design process for heritage building adaptive reuse projects revolves around producing or referring to a conservation management plan that articulates what is and isn't heritage fabric. In an Australian context, and according to literature and the emerging results of a series of semi-structured interviews undertaken with designers of such projects, the key themes integral to success are: business case, vision, communication & collaboration, values, and storytelling.

Model updating of real structures with ambient vibration data

It is important to develop reliable finite element models for real structures not only in the design phase but also for the structural health monitoring and structural maintenance purposes. This paper describes the experience of the authors in using ambient vibration model identification techniques together with model updating tools to develop reliable finite element models of real civil engineering structures. Case studies of two real structures are presented in this paper. One is a 10 storey concrete building which is considered as a non-slender structure with complex boundary conditions. The other is a single span concrete foot bridge which is also a relatively inflexible planar structure with complex boundary conditions. Both structures are located at the Queensland University of Technology (QUT) and equipped with continuous structural health monitoring systems.

RETHROTTLE: Execution Throttling in the REDEFINE SoC Architecture

REDEFINE is a reconfigurable SoC architecture that provides a unique platform for high performance and low power computing by exploiting the synergistic interaction between coarse grain dynamic dataflow model of computation (to expose abundant parallelism in applications) and runtime composition of efficient compute structures (on the reconfigurable computation resources). We propose and study the throttling of execution in REDEFINE to maximize the architecture efficiency. A feature specific fast hybrid (mixed level) simulation framework for early in design phase study is developed and implemented to make the huge design space exploration practical. We do performance modeling in terms of selection of important performance criteria, ranking of the explored throttling schemes and investigate effectiveness of the design space exploration using statistical hypothesis testing. We find throttling schemes which give appreciable (24.8%) overall performance gain in the architecture and 37% resource usage gain in the throttling unit simultaneously.

Comparative studies of transient and steady state analysis for a typical 765kV/400kV EHV transmission system in Indian power system

This paper describes an approach for the analysis and design of 765kV/400kV EHV transmission system which is a typical expansion in Indian power grid system, based on the analysis of steady state and transient over voltages. The approach for transmission system design is iterative in nature. The first step involves exhaustive power flow analysis, based on constraints such as right of way, power to be transmitted, power transfer capabilities of lines, existing interconnecting transformer capabilities etc. Acceptable bus voltage profiles and satisfactory equipment loadings during all foreseeable operating conditions for normal and contingency operation are the guiding criteria. Critical operating strategies are also evolved in this initial design phase. With the steady state over voltages obtained, comprehensive dynamic and transient studies are to be carried out including switching over voltages studies. This paper presents steady state and switching transient studies for alternative two typical configurations of 765kV/400 kV systems and the results are compared. Transient studies are carried out to obtain the peak values of 765 kV transmission systems and are compared with the alternative configurations of existing 400 kV systems.

Petri net-based modeling of a class of complex digital systems

We present through the use of Petri Nets, modeling techniques for digital systems realizable using FPGAs. These Petri Net models are used for logic validation at the logic design phase. The technique is illustrated by modeling practical circuits. Further, the utility of the technique with respect to timing analysis of the modeled digital systems is considered. Copyright (C) 1997 Elsevier Science Ltd

Estabilidade de talude com efeito sísmico a partir dos métodos de equilíbrio limite e de elementos finitos.

A Costa Peruana apresenta alta atividade sísmica, tornando imprescindível a execução de análises de estabilidade que considerem os eventos sísmicos. Com o desenvolvimento de novas ferramentas numéricas, a análise dinâmica está se tornando cada vez mais importante e usual na fase de projeto, não se justificando mais a execução de análises estáticas em locais tão vulneráveis a sismos. A presente dissertação tem como objetivo realizar a análise da estabilidade dos Penhascos de Lima, Peru, considerando quatro taludes distintos, em uma região bastante afetada por abalos sísmicos. As análises foram executadas pelos métodos de equilíbrio limite, elementos finitos e pseudo-estático, buscando-se uma comparação entre os diferentes métodos. O trabalho apresenta uma descrição completa dos taludes em estudo, uma avaliação da condição sismológica da região e finalmente a estabilidade dos Penhascos de Lima, fazendo uso dos programas computacionais Slide (método do equilíbrio limite) e Plaxis (método dos elementos finitos) em 2D. Os resultados mostraram que os três métodos adotados forneceram fatores de segurança compatíveis, principalmente quando se considera perfis menos estratificados. Para perfis homogêneos, as diferenças obtidas foram da ordem de 0,5 a 1,0 %. As análises ressaltaram a importância de considerar a condição dinâmica, e mostraram-se bastante sensíveis aos valores de carga sísmica adotado.

Preliminary evaluation of conceptual mechanical designs

Computational Design has traditionally required a great deal of geometrical and parametric data. This data can only be supplied at stages later than conceptual design, typically the detail stage, and design quality is given by some absolute fitness function. On the other hand, design evaluation offers a relative measure of design quality that requires only a sparse representation. Quality, in this case, is a measure of how well a design will complete its task.

The research intends to address the question: "Is it possible to evaluate a mechanical design at the conceptual design phase and be able to make some prediction of its quality?" Quality can be interpreted as success in the marketplace, success in performing the required task, or some other user requirement. This work aims to determine a minimum level of representation such that conceptual designs can be usefully evaluated without needing to capture detailed geometry. This representation will form the model for the conceptual designs that are being considered for evaluation. The method to be developed will be a case-based evaluation system, that uses a database of previous designs to support design exploration. The method will not be able to support novel design as case-based design implies the model topology must be fixed.

Explosion pressure prediction via polynomial mathematical correlation based on advanced CFD Modelling

Computational Fluid Dynamics CFD can be used as a powerful tool supporting engineers throughout the steps of the design. The combination of CFD with response surface methodology can play an important role in such cases. During the conceptual engineering design phase, a quick response is always a matter of urgency. During this phase even a sketch of the geometrical model is rare. Therefore, the utilisation of typical response surface developed for congested and confined environment rather than CFD can be an important tool to help the decision making process, when the geometrical model is not available, provided that similarities can be considered when taking into account the characteristic of the geometry in which the response surface was developed. The present work investigates how three different types of response surfaces behave when predicting overpressure in accidental scenarios based on CFD input. First order, partial second order and complete second order polynomial expressions are investigated. The predicted results are compared with CFD findings for a classical offshore experiment conducted by British Gas on behalf of Mobil and good agreement is observed for higher order response surfaces. The higher order response surface calculations are also compared with CFD calculations for a typical offshore module and good agreement is also observed. © 2011 Elsevier Ltd.

Review of computational aeroacoustics for application in electronics cooler noise

A review of computational aeroacoustics (CCA) was made for application in electronics cooler noise. Computational aeroacoustics encompasses all numerical methods where the purposes is to predict the noise emissions from a simulated flow. Numerical simulation of the flow inside and around heat sinks and fans can lead to a prediction of the emitted noise while they are still in the design phase. Direct CCA is theoretically the best way to predict flow-based acoustic phenomena numerically. It is typically used only for low-frequency sound prediction. The boundary element method offers low computational cost and does not use a computational grid, but instead use vortex-surface calculations to determine tonal noise. Axial fans are commonly used to increase the airflow and thus the heat transfer over the heat sinks within the computer cases. Very detailed source simulations in the fan and heat sink region coupled with the use of analogy methods could result in excellent simulation results with a reasonable computational effort.

水下滑翔机器人载体外形设计与优化

借助流体动力计算软件CFX和Matlab,对水下滑翔机器人载体外形进行设计和优化.通过对 4种载体方案的分析计算和运动仿真,最终得到了一种比较合理的外形方案.研究结果表明,采用CFX流体动力计算软件对于研究水下机器人载体的外形结构,尤其是在方案设计阶段在外形流体动力设计中具有重要的作用,可缩短研制周期、降低设计成本.

CFX与USAERO的水下机器人操纵性仿真计算研究

研究了借助计算流体力学软件CFX与USAERO对水下机器人的操纵性进行仿真计算的方法,并将仿真计算结果与模型试验结果对比,验证仿真计算的可行性,指出仿真计算的适用范围.该方法可以对某些现实中难以进行的操纵性试验进行仿真计算,对于研究水下机器人的操纵性尤其是在方案设计阶段的操纵性设计和降低试验成本有一定的现实意义.