Continuity of patient care in day surgery

Continuity is a part of high-quality patient care. The purpose of this study was to analyse what factors are important in the continuity of patients’ care, and how well continuity is achieved in different stages of the care of day surgical patients. Day surgery has become significantly more prevalent in the past few decades, and in order for it to be carried out successfully, continuity in care is particularly essential. The study was carried out in two stages. In the first stage (2001–2005) of the study, continuity was examined through a review of literature from the perspective of critical pathways, naming the continuity categories of time flow, coordination flow, caring relationship flow, and information flow. The first stage also entailed an analysis of matters important to the patient and problems concerning the achievement of care continuity, carried out by interviewing 25 day surgical patients. In the second stage (2006–2015), the degree to which the continuity of day surgical patient care was achieved was analysed from the perspective of patients (n=203, 58%) and nurses working in day surgery units (n=83, 69%), and suggestions for developing the continuity of day surgery patient care were made. In this study continuity of care was examined through a review of literature from the perspective of critical pathways, naming the continuity categories of time flow, coordination flow, caring relationship flow, and information flow. Within these categories, several important factors for the patient were found. According to both patients and nurses, continuity of care is generally achieved to a high degree. Continuity of care is improved by patients being acquainted with and meeting the staff attending to them (nurse and surgeon) before and after the operation. From patients’ perspective, there is room for improvement especially in terms of being admitted to care and in the carer-patient relationship. From nurses’ perspective, there is room for improvement in terms of the smoothness of care. Nurses evaluated the continuity of care to be the least successful before and after the operation. An extensive social and health care reform is planned in Finland in the coming years, aiming to enhance social and health care services and to create smoothly functioning service and care. As a topic of further study supporting the development of the service system, it is important to follow the patient’s progress throughout the entire chain of care, e.g. as a case study. On the other hand, there is also a need to study the views of nurses and other health care professionals in health care, e.g. in primary health care.

Finding Methods for Recognizing and Classifying Spare Part Criticality – Case Full Deposit Stripping Machines

The aim of this Master’s thesis is to find a method for classifying spare part criticality in the case company. Several approaches exist for criticality classification of spare parts. The practical problem in this thesis is the lack of a generic analysis method for classifying spare parts of proprietary equipment of the case company. In order to find a classification method, a literature review of various analysis methods is required. The requirements of the case company also have to be recognized. This is achieved by consulting professionals in the company. The literature review states that the analytic hierarchy process (AHP) combined with decision tree models is a common method for classifying spare parts in academic literature. Most of the literature discusses spare part criticality in stock holding perspective. This is relevant perspective also for a customer orientated original equipment manufacturer (OEM), as the case company. A decision tree model is developed for classifying spare parts. The decision tree classifies spare parts into five criticality classes according to five criteria. The criteria are: safety risk, availability risk, functional criticality, predictability of failure and probability of failure. The criticality classes describe the level of criticality from non-critical to highly critical. The method is verified for classifying spare parts of a full deposit stripping machine. The classification can be utilized as a generic model for recognizing critical spare parts of other similar equipment, according to which spare part recommendations can be created. Purchase price of an item and equipment criticality were found to have no effect on spare part criticality in this context. Decision tree is recognized as the most suitable method for classifying spare part criticality in the company.

Controlling full penetration in MAG welding by the application of infrared thermography and neural network

In this study, an infrared thermography based sensor was studied with regard to usability and the accuracy of sensor data as a weld penetration signal in gas metal arc welding. The object of the study was to evaluate a specific sensor type which measures thermography from solidified weld surface. The purpose of the study was to provide expert data for developing a sensor system in adaptive metal active gas (MAG) welding. Welding experiments with considered process variables and recorded thermal profiles were saved to a database for further analysis. To perform the analysis within a reasonable amount of experiments, the process parameter variables were gradually altered by at least 10 %. Later, the effects of process variables on weld penetration and thermography itself were considered. SFS-EN ISO 5817 standard (2014) was applied for classifying the quality of the experiments. As a final step, a neural network was taught based on the experiments. The experiments show that the studied thermography sensor and the neural network can be used for controlling full penetration though they have minor limitations, which are presented in results and discussion. The results are consistent with previous studies and experiments found in the literature.

30/5/20, Memorial Day au cimetière américain de Suresnes : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59472

30/5/20, Memorial Day au cimetière américain de Suresnes : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59473

4/7/20, Independence day [jardin des Tuileries, tribune officielle] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59902

4/7/20, Independence day [jardin des Tuileries, tribune officielle] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59904

3/7/20, Independence day [défilé de troupes françaises près de la statue de Washington, place d'Iéna] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59909

4/7/20, Independence day [jardin des Tuileries, défilé d'orphelins de la guerre] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 59903

Kindergartners' perceptions of bullying /

Currently, few studies address what kindergarten children think about bullying behaviour and explore whether or not they perceive bullying as a prevalent concern in their day-to-day school activities. This study described 15 Canadian kindergarten students' graphic and narrative representations (drawings and stories) of their bullying experiences. The content of students' drawings and stories were analyzed to explore how kindergarten children perceived bullying within the context of their lives. Coding categories were developed to analyze the kindergartners' perceptions, and emerging themes were also explored. In general, findings showed that kindergartners perceive bullying situations as occurring during one-to-one peer interaction and not within social group situations. Results are discussed in relation to educational implications.

Female administrators and the mentors who give them full support /

A looming attrition rate, a steady increase in the number of women in administration, and a lack of Canadian research all provided the rationale for this study. The problem in this study was to investigate the needs and challenges of new female administrators and to examine the role that mentors play in addressing these issues. This study also explored the perceived benefits of having a mentor. This study examined the inductive year of 33 female administrators from 3 Ontario school boards. It was a qualitative and quantitative design, using questionnaire and interview data. It was found that the majority felt that they struggled with biases and expectations that were gender specific. The challenges that were perceived to be most prevalent were categorized into 4 thematic areas: Maintaining Balance, Feeling Pressured, The Perceptions of Others, and Being Challenged by Others. Regarding the benefits of mentoring, the participants perceived mentoring to be most beneficial in terms of professional growth, followed by learning how to run a school, and then career advancement. The significance of this study was threefold: it had theoretical implications as well as implications for practice and future research. Suggestions included: facilitating longitudinal relationships, having the board become more actively involved in facilitating the relationship, and implementing an internship program. This study attempted to extend the current literature by theorizing that a mentorship is cyclical in nature. Future research could include program design and implementation, as well as providing consistent and accessible mentoring opportunities for all.

The perceptions of play among educators in kindergarten and grade one classrooms /

This qualitative study focuses on the role of play in primary education, and was designed to determine and understand the perceptions of play among primary educators who are teachers in kindergarten and grade one classrooms. In attempting to understand how primary educators use play in their classrooms, the following findings emerged. Educators struggle in primary grades to support play in the classroom because of a lack of a clear understanding of what play is. Further, teachers face several oppositions to using play in the classroom. Much of the opposition arises from a concern for classroom management as well as negative parental views towards play. Additionally, the teachers from this study feel that there is limited support available for them to implement a curriculum that includes play. Despite support from academic research, indicating that children, particularly in the primary grades, benefit greatly from play, the place for play in the curriculum is not secure. In this study, strategies that would assist and support primary educators in using play in their classrooms are suggested.

An empirical study of in-school and out-of-school day care

The purpose of this study was to determine if there were differences between in-school and out-of-school day care centres. Five centres housed in public schools and five housed in other locations were selected for the research. Aquality assessment was administered in each centre which examined the following components - physical environment, adult social structure and socia-emotional environment, children's socia-emotional environment, cognitive stimulation program and toys and equipment. Quantitative analysis using simple t-tests showed a significant difference between in-school and out-of-school day cares for the physical environment variable. Differences approached significance for the children's socia-emotional environment variable as well as overall quality. Qualitative analysis using a triangulated methodology revealed noticeable differences for every variable. The researcher concluded that both the quality of the physical environment and the capabilities of the administrators strongly influence the quality of the day care environment. This study also included an assessment of children's attitude toward learning. No significant difference was found between in-school and out-of-school centres.

Interactions of diploid embryonal carcinoma cells and normal cell mass cells with 2.5 day mouse embryos following aggregation

Spontaneous teratocarcinomas are ovarian or testicular tumors which have their origins in germ cells. The tumors contain a disorganized array of benign differentiated cells as well as an undifferentiated population of malignant stem cells, the embryonal carcinoma or EC cells. These pluripotent stem cells in tissue culture share many properties with the transient pluripotent cells of the early embryo, and might therefore serve as models for the investigation of developmental events ill vitro. The property of EC cells of prime interest in this study is an in vivo phenomenon. Certain EC cell lines are known to be regulated ill vivo and to differentiate normally in association with normal embryonic cells, resulting in chimeric mice. These mice have two genetically distinct cell populations, one of which is derived from the originally malignant EC cells. This has usually been accomplished by injection of the EC cells into the Day 3 blastocyst. In this study, the interactions between earlier stage embryos and EC cells have been tested by aggregating clumps of EC cells with Day 2 embryos. The few previous aggregation studies produced a high degree of abnormality in chimeric embryos, but the EC cells employed had known chromosomal abnormalities. In this study, two diploid EC cell lines (P19 and Pi0) were aggregated with 2.5 day mouse embryos, and were found to behave quite differently in the embryonic environment. P19 containing aggregates generally resorbed early, and the few embryos recovered at midgestation were normal and non-chimeric. Pi0 containing aggregates survived in high numbers to midgestation, and the Pi0 cells were very successful in colonizing the embryo. All these embryos were chimeric, and the contribution by the EC cells to each chimera was very high. However, these heavily chimeric embryos were all abnormal. Blastocyst injection had previously produced some abnormal embryos with high Pl0 contributions in addition to the live born mice, which had lower EC contributions. This study now adds more support to the hypothesis that high EC contributions may be incompatible with normal development. The possibility that the abnormalities were due to the mixing of temporally asynchronous embryonic cell types in the aggregates was tested by aggregating normal pluripotent cells taken from 3.5 day embryos with 2.5 day embryos. Early embryo loss was very high, and histological studies showed that the majority of these embryos died by 6.5 days development. Some embryos escaped this early death such that some healthy chimeras were recovered, in contrast to recovery of abnormal chimeric embryos following Pl0-morula aggregations, and non-chimeric embryos following P19-morula aggregations. This somewhat surprising adverse effect on development following aggregation of normal cell types suggests that there are developmental difficulties associated with the mixing of asynchronous cell types in aggregates. However, the greater magnitude of the adverse effects when the aggregates contained tumor derived cells suggests that EC cells should not be considered the complete equivalent of the pluripotent cells of the early embryo.