Water Infrastructure in Cuba: A Seminar

This flyer promotes the event "Water Infrastructure in Cuba: A Seminar" , cosponsored by FlU's College of Engineering and Computing, Applied Research Center, Global Water for Sustainability Program, Latin American and Caribbean Center, and the Cuban American Association of Civil Engineers.

The effects of advanced practice nurses (APNs) as intensivists in a surgical intensive care unit (SICU) on patient outcomes, healthcare charges, and apn intensivist services in the SICU

Intensive Care Units (ICUs) account for over 10 percent of all US hospital beds, have over 4.4 million patient admissions yearly, approximately 360,000 deaths, and account for close to 30% of acute care hospital costs. The need for critical care services has increased due to an aging population and medical advances that extend life. The result is efforts to improve patient outcomes, optimize financial performance, and implement models of ICU care that enhance quality of care and reduce health care costs. This retrospective chart review study examined the dose effect of APN Intensivists in a surgical intensive care unit (SICU) on differences in patient outcomes, healthcare charges, SICU length of stay, charges for APN intensivist services, and frequency of APNs special initiatives when the SICU was staffed by differing levels of APN Intensivist staffing over four time periods (T1-T4) between 2009 and 2011. The sample consisted of 816 randomly selected (204 per T1-T4) patient chart data. Study findings indicated reported ventilator associated pneumonia (VAP) rates, ventilator days, catheter days and catheter associated urinary tract infection (CAUTI) rates increased at T4 (when there was the lowest number of APN Intensivists), and there was increased pressure ulcer incidence in first two quarters of T4. There was no statistically significant difference in post-surgical glycemic control (M = 142.84, SD = 40.00), t (223) = 1.40, p = .17, and no statistically significant difference in the SICU length of stay among the time-periods (M = 3.27, SD = 3.32), t (202) = 1.02, p = .31. Charges for APN services increased over the 4 time periods from $11,268 at T1 to $51,727 at T4 when a system to capture APN billing was put into place. The number of new APN initiatives declined in T4 as the number of APN Intensivists declined. Study results suggest a dose effect of APN Intensivists on important patient health outcomes and on the number of APNs initiatives to prevent health complications in the SICU. ^

Development of distributed generation infrastructure for microgrid connectivity to operational power systems

Distributed Generation (DG) from alternate sources and smart grid technologies represent good solutions for the increase in energy demands. Employment of these DG assets requires solutions for the new technical challenges that are accompanied by the integration and interconnection into operational power systems. A DG infrastructure comprised of alternate energy sources in addition to conventional sources, is developed as a test bed. The test bed is operated by synchronizing, wind, photovoltaic, fuel cell, micro generator and energy storage assets, in addition to standard AC generators. Connectivity of these DG assets is tested for viability and for their operational characteristics. The control and communication layers for dynamic operations are developed to improve the connectivity of alternates to the power system. A real time application for the operation of alternate sources in microgrids is developed. Multi agent approach is utilized to improve stability and sequences of actions for black start are implemented. Experiments for control and stability issues related to dynamic operation under load conditions have been conducted and verified.

Pressure ulcers and nutritional deficits in elderly long-term care patients : effects of a comprehensive nutritional program on pressure ulcer healing, length of hospital stay and charges to patients

The elderly are at the highest risk of developing pressure ulcers that result in prolonged hospitalization, high health care costs, increased mortality, and decreased quality of life. The burden of pressure ulcers will intensify because of a rapidly increasing elderly population in the United States (US). Poor nutrition is a major predictor of pressure ulcer formation. The purpose of this study was to examine the effects of a comprehensive, interdisciplinary nutritional protocol on: 1) pressure ulcer wound healing 2) length of hospital stays, and 3) charges for pressure ulcer management. Using a pre-intervention/post intervention quasi-experimental design the study sample was composed of 100 patients 60 years or older, admitted with or acquiring a pressure ulcer. A pre-intervention group (n= 50) received routine pressure ulcer care (standard diet, dressing changes, and equipment). A post-intervention group received routine care plus an interdisciplinary nutrition intervention (physical therapy, speech therapy, occupational therapy, added protein and calories to the diet). Research questions were analyzed using descriptive statistics, frequencies, Chi-Square Tests, and T-tests. Findings indicated that the comprehensive, interdisciplinary nutritional protocol had a significant effect on the rate of wound healing in Week3 and Week4, total hospital length of stay (pre-intervention M= 43.2 days, SD=31.70 versus M=31.77, SD=12.02 post-intervention), and pressure ulcer length of stay (pre-intervention 25.28 days, SD5.60 versus 18.40 days, SD 5.27 post-intervention). Although there was no significant difference in total charges for the pre-intervention group ($727,245.00) compared to the post-intervention group ($702,065.00), charges for speech (m=$5885.12, SD=$332.55), pre albumin (m=$808.52,SD= $332.55), and albumin($278 .88, SD=55.00) were higher in the pre-intervention group and charges for PT ($5721.26, SD$3655.24) and OT($2544 .64, SD=1712.863) were higher in the post-intervention group. Study findings indicate that this comprehensive nutritional intervention was effective in improving pressure ulcer wound healing, decreasing both hospital length of stay for treatment of pressure ulcer and total hospital length of stay while showing no significant additional charges for treatment of pressure ulcers.

Design and Implementation of a Cloud Infrastructure for Distributed Scientific Calculation

Cloud computing enables independent end users and applications to share data and pooled resources, possibly located in geographically distributed Data Centers, in a fully transparent way. This need is particularly felt by scientific applications to exploit distributed resources in efficient and scalable way for the processing of big amount of data. This paper proposes an open so- lution to deploy a Platform as a service (PaaS) over a set of multi- site data centers by applying open source virtualization tools to facilitate operation among virtual machines while optimizing the usage of distributed resources. An experimental testbed is set up in Openstack environment to obtain evaluations with different types of TCP sample connections to demonstrate the functionality of the proposed solution and to obtain throughput measurements in relation to relevant design parameters.

UMA NARRATIVA MIDIATIZADA DO COTIDIANO: As charges de Política Internacional de Angeli (2001-2012)

Esta pesquisa se insere nas discussões sobre comunicação midiática nas interações sociais. Traz como tema a charge enquanto narrativa midiatizada do cotidiano, a partir de um estudo de natureza bibliográfica e de um exercício de aplicação no qual foram estudadas as charges de Angeli reunidas na coletânea O lixo da história, publicada pela editora Companhia das Letras. Dentre os autores e teorias trabalhadas destacam-se: a conceituação de narrativa, proposta por Luiz Gonzaga Motta; a ideia da midiatização da sociedade, a partir da discussão de José Luiz Braga; a teoria de mediações culturais de Jesús Martin-Barbero; os estudos de cotidiano de Michel de Certeau; e o entendimento de cultura, fundamentado nos Estudos Culturais. A partir das leituras e análise realizadas, a pesquisa trouxe a tona as percepções de que a charge é uma narrativa do absurdo e narrativa absurda de um momento histórico, de maneira a inseri-la enquanto monumento historiográfico do cotidiano. Assim como é feito com as narrativas jornalísticas, a charge demanda uma visão crítica, observando não apenas a sua forma, mas sim o seu contexto.

Financing infrastructure development : time to unshackle the bonds?

The authors would like to thank the RICS for their financial support of the project and the numerous respondents who gave so freely of their time. Part of the research was supported by a grant from the Hong Kong-Scotland Partners in Post-Doctoral Research Scheme sponsored by the Research Grants Council of Hong Kong and the Scottish Government (S-HKU701/13).

Vibration based health monitoring of civil infrastructure using energy harvesting techniques

The use of structural health monitoring of civil structures is ever expanding and by assessing the dynamical condition of structures, informed maintenance management can be conducted at both individual and network levels. With the continued growth of information age technology, the potential arises for smart monitoring systems to be integrated with civil infrastructure to provide efficient information on the condition of a structure. The focus of this thesis is the integration of smart technology with civil infrastructure for the purposes of structural health monitoring. The technology considered in this regard are devices based on energy harvesting materials. While there has been considerable focus on the development and optimisation of such devices using steady state loading conditions, their applications for civil infrastructure are less known. Although research is still in initial stages, studies into the uses associated with such applications are very promising. Through the use of the dynamical response of structures to a variety of loading conditions, the energy harvesting outputs from such devices is established and the potential power output determined. Through a power variance output approach, damage detection of deteriorating structures using the energy harvesting devices is investigated. Further applications of the integration of energy harvesting devices with civil infrastructure investigated by this research includes the use of the power output as a indicator for control. Four approaches are undertaken to determine the potential applications arising from integrating smart technology with civil infrastructure, namely • Theoretical analysis to determine the applications of energy harvesting devices for vibration based health monitoring of civil infrastructure. • Laboratory experimentation to verify the performance of different energy harvesting configurations for civil infrastructure applications. • Scaled model testing as a method to experimentally validate the integration of the energy harvesting devices with civil infrastructure. • Full scale deployment of energy harvesting device with a bridge structure. These four approaches validate the application of energy harvesting technology with civil infrastructure from a theoretical, experimental and practical perspective.

The impact of user charges on patient choice of healthcare services in Ireland

This research assesses the impact of user charges in the context of consumer choice to ascertain how user charges in healthcare impact on patient behaviour in Ireland. Quantitative data is collected from a subset of the population in walk-in Urgent Care Clinics and General Practitioner surgeries to assess their responses to user charges and whether user charges are a viable source of part-funding healthcare in Ireland. Examining the economic theories of Becker (1965) and Grossman (1972), the research has assessed the impact of user charges on patient choice in terms of affordability and accessibility in healthcare. The research examined a number of private, public and part-publicly funded healthcare services in Ireland for which varying levels of user charges exist depending on patients’ healthcare cover. Firstly, the study identifies the factors affecting patient choice of privately funded walk-in Urgent Care Clinics in Ireland given user charges. Secondly, the study assesses patient response to user charges for a mainly public or part-publicly provided service; prescription drugs. Finally, the study examines patients’ attitudes towards the potential application of user charges for both public and private healthcare services when patient choice is part of a time-money trade-off, convenience choice or preference choice. These services are valued in the context of user charges becoming more prevalent in healthcare systems over time. The results indicate that the impact of user charges on healthcare services vary according to socio-economic status. The study shows that user charges can disproportionately affect lower income groups and consequently lead to affordability and accessibility issues. However, when valuing the potential application of user charges for three healthcare services (MRI scans, blood tests and a branded over a generic prescription drug), this research indicates that lower income individuals are willing to pay for healthcare services, albeit at a lower user charge than higher income earners. Consequently, this study suggests that user charges may be a feasible source of part-financing Irish healthcare, once the user charge is determined from the patients’ perspective, taking into account their ability to pay.

The Effects of Advanced Practice Nurses (APNs) as Intensivists in a Surgical Intensive Care Unit (SICU) on Patient Outcomes, Healthcare Charges, and APN Intensivist Services in the SICU

Intensive Care Units (ICUs) account for over 10 percent of all US hospital beds, have over 4.4 million patient admissions yearly, approximately 360,000 deaths, and account for close to 30% of acute care hospital costs. The need for critical care services has increased due to an aging population and medical advances that extend life. The result is efforts to improve patient outcomes, optimize financial performance, and implement models of ICU care that enhance quality of care and reduce health care costs. This retrospective chart review study examined the dose effect of APN Intensivists in a surgical intensive care unit (SICU) on differences in patient outcomes, healthcare charges, SICU length of stay, charges for APN intensivist services, and frequency of APNs special initiatives when the SICU was staffed by differing levels of APN Intensivist staffing over four time periods (T1-T4) between 2009 and 2011. The sample consisted of 816 randomly selected (204 per T1-T4) patient chart data. Study findings indicated reported ventilator associated pneumonia (VAP) rates, ventilator days, catheter days and catheter associated urinary tract infection (CAUTI) rates increased at T4 (when there was the lowest number of APN Intensivists), and there was increased pressure ulcer incidence in first two quarters of T4. There was no statistically significant difference in post-surgical glycemic control (M = 142.84, SD= 40.00), t (223) = 1.40, p = .17, and no statistically significant difference in the SICU length of stay among the time-periods (M= 3.27, SD = 3.32), t (202) = 1.02, p= .31. Charges for APN services increased over the 4 time periods from $11,268 at T1 to $51,727 at T4 when a system to capture APN billing was put into place. The number of new APN initiatives declined in T4 as the number of APN Intensivists declined. Study results suggest a dose effect of APN Intensivists on important patient health outcomes and on the number of APNs initiatives to prevent health complications in the SICU.

Place-Based Evaluation for Infrastructure and Spatial Projects: An Introduction

This book brings together experts in the fields of spatial planning, landuse and infrastructure management to explore the emerging agenda of spatially-oriented integrated evaluation. It weaves together the latest theories, case studies, methods, policy and practice to examine and assess the values, impacts, benefits and the overall success in integrated land-use management. In doing so, the book clarifies the nature and roles of evaluation and puts forward guidance for future policy and practice.

Islamic Infrastructure Finance and Sustainable Development Goals

This was a very interesting discussion with the pioneers of Islamic finance regarding infrastructure finance and the sustainable development goals.

Implementation of a drive-by monitoring system for transport infrastructure utilising GNSS

Ageing and deterioration of infrastructure is a challenge facing transport authorities. In particular, there is a need for increased bridge monitoring in order to provide adequate maintenance, prioritise allocation of funds and guarantee acceptable levels of transport safety. Existing bridge structural health monitoring (SHM) techniques typically involve direct instrumentation of the bridge with sensors and equipment for the measurement of properties such as frequencies of vibration. These techniques are important as they can indicate the deterioration of the bridge condition. However, they can be labour intensive and expensive due to the requirement for on-site installations. In recent years, alternative low-cost indirect vibrationbased SHM approaches have been proposed which utilise the dynamic response of a vehicle to carry out “drive-by” pavement and/or bridge monitoring. The vehicle is fitted with sensors on its axles thus reducing the need for on-site installations. This paper investigates the use of low-cost sensors incorporating global navigation satellite systems (GNSS) for implementation of the drive-by system in practice, via field trials with an instrumented vehicle. The potential of smartphone technology to be harnessed for drive by monitoring is established, while smartphone GNSS tracking applications are found to compare favourably in terms of accuracy, cost and ease of use to professional GNSS devices.