861 resultados para waiting rooms
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Objectives. A large-scale survey of doses to patients undergoing the most frequent radiological examinations was carried out in health services in Sao Paulo (347 radiological examinations per 1 000 inhabitants), the most populous Brazilian state. Methods. A postal dosimetric kit with thermoluminescence dosimeters was used to evaluate the entrance surface dose (ESD) to patients. A stratified sampling technique applied to the national health database furnished important data on the distribution of equipment and the annual number of examinations. Chest, head (skull and sinus), and spine (cervical, thoracic, and lumbar) examinations were included in the trial. A total of 83 rooms and 868 patients were included, and 1 415 values of ESD were measured. Results. The data show large coefficients of variation in tube charge, giving rise to large variations in ESD values. Also, a series of high ESD values associated with unnecessary localizing fluoroscopy were detected. Diagnostic reference levels were determined, based on the 75th percentile (third quartile) of the ESD distributions. For adult patients, the diagnostic reference levels achieved are very similar to those obtained in international surveys. However, the situation is different for pediatric patients: the ESD values found in this survey are twice as large as the international recommendations for chest radiographs of children. Conclusions. Despite the reduced number of ESD values and rooms for the pediatric patient group, it is recommended that practices in chest examinations be revised and that specific national reference doses and image quality be established after a broader survey is carried out.
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Internet protocol TV (IPTV) is predicted to be the key technology winner in the future. Efforts to accelerate the deployment of IPTV centralized model which is combined of VHO, encoders, controller, access network and Home network. Regardless of whether the network is delivering live TV, VOD, or Time-shift TV, all content and network traffic resulting from subscriber requests must traverse the entire network from the super-headend all the way to each subscriber's Set-Top Box (STB).IPTV services require very stringent QoS guarantees When IPTV traffic shares the network resources with other traffic like data and voice, how to ensure their QoS and efficiently utilize the network resources is a key and challenging issue. For QoS measured in the network-centric terms of delay jitter, packet losses and bounds on delay. The main focus of this thesis is on the optimized bandwidth allocation and smooth datatransmission. The proposed traffic model for smooth delivering video service IPTV network with its QoS performance evaluation. According to Maglaris et al [5] First, analyze the coding bit rate of a single video source. Various statistical quantities are derived from bit rate data collected with a conditional replenishment inter frame coding scheme. Two correlated Markov process models (one in discrete time and one incontinuous time) are shown to fit the experimental data and are used to model the input rates of several independent sources into a statistical multiplexer. Preventive control mechanism which is to be include CAC, traffic policing used for traffic control.QoS has been evaluated of common bandwidth scheduler( FIFO) by use fluid models with Markovian queuing method and analysis the result by using simulator andanalytically, Which is measured the performance of the packet loss, overflow and mean waiting time among the network users.
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This thesis work concerns about the Performance evolution of peer to peer networks, where we used different distribution technique’s of peer distribution like Weibull, Lognormal and Pareto distribution process. Then we used a network simulator to evaluate the performance of these three distribution techniques.During the last decade the Internet has expanded into a world-wide network connecting millions of hosts and users and providing services for everyone. Many emerging applications are bandwidth-intensive in their nature; the size of downloaded files including music and videos can be huge, from ten megabits to many gigabits. The efficient use of network resources is thus crucial for the survivability of the Internet. Traffic engineering (TE) covers a range of mechanisms for optimizing operational networks from the traffic perspective. The time scale in traffic engineering varies from the short-term network control to network planning over a longer time period.Here in this thesis work we considered the peer distribution technique in-order to minimise the peer arrival and service process with three different techniques, where we calculated the congestion parameters like blocking time for each peer before entering into the service process, waiting time for a peers while the other peer has been served in the service block and the delay time for each peer. Then calculated the average of each process and graphs have been plotted using Matlab to analyse the results
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The purpose of this assignment at SSAB Tunnplåt in Borlänge was mainly to investigate and describe the circumstances for the spare parts stored in storage facilities within the area of operation. Even new facilities which could serve as storage rooms and their opportunities for storing spare parts were an important part of the investigation. This because of the need for improved storing of spare parts. Furthermore, market offers where reviewed for storage of spare parts in more tailored designs. The work will culminate in proposals for improvement which is of importance for the development surrounding the storage and handling of spare parts. This is since the design and management of existing storage facilities is not perceived as satisfactory with regards to spare parts characteristics. Moreover, the amount of stock locations is too few in relation to the actual need. The approach used to achieve objectives of the work was an advanced mapping for collection of vital data. The mapping consisted of interviews with involved parties, both internal and external, for the most comprehensive picture of the problems as possible. In addition, a literature survey was conducted to identify possible options for the objectives of the work as well as a personal study of existing and new storage facilities. Furthermore, the market offers for improved conditions in storage rooms were examined. A clear picture of internal logistics and warehouse activities for spare parts at SSAB Tunnplåt has been obtained during this work. From this picture, it is concluded that work in and around storage facilities can be made more efficient. SSAB Tunnplåt should additionally make efforts in the storage facilities for better use of the available storage space. A number of proposals for improvement for each studied storage facility and spare parts management in general have been conducted. These proposals for improvement include presentations to improve the design of the studied storage facilities towards enabling more stock locations. The proposals also include additional equipment for handling spare parts, scrap handling, as well as expansions of the maintenance system which supports activities in the spare parts management.
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Bergkvist insjön AB is a sawmill yard which is capable of producing 350,000 cubic meter of timber every year this requires lot of internal resources. Sawmill operations can be classified as unloading, sorting, storage and production of timber. In the company we have trucks arriving at random they have to be unloaded and sent back at the earliest to avoid queuing up of trucks creating a problem for truck owners. The sawmill yard has to operate with two log stackers that does several tasks including transporting the logs from trucks to measurement station where the logs will be sorted into classes and dropped into pockets from pockets to the sorted timber yard where they are stored and finally from there to sawmill for final processing. The main issue that needs to be answered here is the lining up trucks that are waiting to be unload, creating a problem for both sawmill as well as the truck owners and given huge production volume, it is certain that handling of resources is top priority. A key challenge in handling of resources would be unloading of trucks and finding a way to optimize internal resources.To address this problem i have experimented on different ways of using internal resources, i have designed different cases, in case 1 we have both the log stackers working on sawmill and measurement station. The main objective of having this case is to make sawmill and measurement station to work all the time. Then in case 2, i have divided the work between both the log stackers, one log stacker will be working on sawmill and pocket_control and second log stacker will be working on measurement station and truck. Then in case 3 we have only one log stacker working on all the agents, this case was designed to reduce cost of production, as the experiment cannot be done in real-time due to operational cost, for this purpose simulation is used, preliminary investigation into simulation results suggested that case 2 is the best option has it reduced waiting time of trucks considerably when compared with other cases and it showed 50% increase in optimizing internal resources.
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Internet protocol TV (IPTV) is predicted to be the key technology winner in the future. Efforts to accelerate the deployment of IPTV centralized model which is combined of VHO, encoders, controller, access network and Home network. Regardless of whether the network is delivering live TV, VOD, or Time-shift TV, all content and network traffic resulting from subscriber requests must traverse the entire network from the super-headend all the way to each subscriber's Set-Top Box (STB). IPTV services require very stringent QoS guarantees When IPTV traffic shares the network resources with other traffic like data and voice, how to ensure their QoS and efficiently utilize the network resources is a key and challenging issue. For QoS measured in the network-centric terms of delay jitter, packet losses and bounds on delay. The main focus of this thesis is on the optimized bandwidth allocation and smooth data transmission. The proposed traffic model for smooth delivering video service IPTV network with its QoS performance evaluation. According to Maglaris et al [5] first, analyze the coding bit rate of a single video source. Various statistical quantities are derived from bit rate data collected with a conditional replenishment inter frame coding scheme. Two correlated Markov process models (one in discrete time and one in continuous time) are shown to fit the experimental data and are used to model the input rates of several independent sources into a statistical multiplexer. Preventive control mechanism which is to be including CAC, traffic policing used for traffic control. QoS has been evaluated of common bandwidth scheduler( FIFO) by use fluid models with Markovian queuing method and analysis the result by using simulator and analytically, Which is measured the performance of the packet loss, overflow and mean waiting time among the network users.
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Followers of three world religions, Judaism, Christianity and Islam are waiting for the Messiah. Muslims are even waiting for aspiritual leader al-Mahdi. Two different persons claimed the title of al-Mahdi, at the end of the nineteenth century. Theyappeared almost at the same time, at the totally different places of the earth, with a completely different message and underthe rule of the British colonial power. The aim of the study is to compare the both religious figures, Mirza Ghulam Ahmadfrom India and Muhammad Ahmad from Sudan regarding their different messages, to illustrate the social, political andreligious factors that lead to the entirely different profile and image of these two men and how their organizations havedeveloped after their death up till today. The result shows that the Sudanese Mahdi Muhammad Ahmad claimed hisMahdiship in the year 1881. He became a political leader in a time when Sudan was under the rule of a colonial power. Hetook advantage of the religion for personal purposes and tried to liberate his native country Sudan. The contemporaryMuslim clergy criticized him for his claim because the content of the Hadith traditions did not support his claim ofMahdiship. He maintained his sole right for the interpretation of religion and of the laws of Sharia. He made changes even inthe chief pillars of Islam by asserting that Jehad with sword was more imperative than the pilgrimage journey to Mecca. Heasserted that the Prophet Muhammad himself had entrusted him to launch the holy war against the non-believers. He hadimmense ambitions which were never fulfilled since he suddenly died four years after his claim for Mahdiship, in June 1885.This day his followers are organized as a political party in Sudan with a modest roll in the Sudanese politics. The IndianMahdi Mirza Ghulam Ahmad claimed in 1889 to be Mahdi, Mujaddid, Muhaddas, Messiah and a Prophet at a time of socialand political peace, though Islam as a religion was firmly pushed by the Hindu and Christian missionaries. He had no politicalambitions at all and was utterly loyal to the British colonial power. His mission was to crush the Cross and to demonstrateIslam’s excellence over all the religions of the world through overwhelming arguments. He proclaimed that Jesus was humanand a Prophet and not the son of God. Jesus survived from the cross and died a natural death after he had lived for manyyears. Ahmad claimed that God had commanded him to put stop to the religious wars. The contemporary Muslim clergyblamed him for being an imposter, melancholic and hypochondriac who had self invented the divine revelations. He died year1908, nineteen years after his claim and the communion he found is established today in more than hundred countries of theworld. Reasons for the breakdown of mission of the Sudanese Mahdi were that his objectives were political and he challengedthe colonial power with the sword. Another decisive factor was his sudden death merely four years after the beginning of hismission. Reasons for the success of Indian Mahdi were that his objectives were purely religious and he was wholly loyal to theforeign government. He survived nineteen years after the beginning of his mission which made it possible for him to create acommunion based on solid grounds. His followers continued on the same path and never engaged in local politics where everthey lived. For further studies it will be of great interest to study the life of Mirza Ghulam Ahmad and objectively examine thearguments he presented in support of his divine appointment. Furthermore it is enriching to study the organization andactivities of the Ahmadiyya Muslim community to explore if they are in accordance with the basic principles of Ahmad.
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The aim of this study was to investigate how electricallyheated houses can be converted to using wood pellet and solarheating. There are a large number of wood pellet stoves on themarket. Many stoves have a water jacket, which gives anopportunity to distribute the heat to domestic hot water and aradiator heating system. Three typical Swedish houses with electric resistanceheating have been studied. Fourteen different system conceptsusing wood pellet stoves and solar heating systems have beenevaluated. The systems and the houses have been simulated indetail using TRNSYS. The houses have been divided in up to 10different zones and heat transfer by air circulation throughdoorways and open doors have been simulated. The pellet stoveswere simulated using a recently developed TRNSYS component,which models the start- and stop phases, emissions and thedynamic behaviour of the stoves. The model also calculates theCO-emissions. Simulations were made with one stove without awater jacket and two stoves with different fractions of thegenerated heat distributed in the water circuit. Simulations show that the electricity savings using a pelletstove are greatly affected by the house plan, the systemchoice, if the internal doors are open or closed and thedesired level of comfort. Installing a stove with awater-jacket connected to a radiator system and a hot waterstorage has the advantage that heat can be transferred todomestic hot water and be distributed to other rooms. Suchsystems lead to greater electricity savings, especially inhouses having a traditional layout. It was found that not allrooms needed radiators and that it was more effective in mostcases t use a stove with a higher fraction of the heatdistributed by the water circuit. The economic investigation shows that installing a woodpellet stove without a water jacket gives the lowest totalenergy- and capital costs in the house with an open plan (fortoday's energy prices and the simulated comfort criteria). Inthe houses with a traditional layout a pellet stove givesslightly higher costs than the reference house having onlyelectrical resistance heating due to the fact that less heatingcan be replaced. The concepts including stoves with a waterjacket all give higher costs than the reference system, but theconcept closest to be economical is a system with a bufferstore, a stove with a high fraction of the heat distributed bythe water circuit, a new water radiator heating system and asolar collector. Losses from stoves can be divided into: flue gas lossesincluding leakage air flow when the stove is not in operation;losses during start and stop phases; and losses due to a highair factor. An increased efficiency of the stoves is importantboth from a private economical point of view, but also from theperspective that there can be a lack of bio fuel in the nearfuture also in Sweden. From this point of view it is alsoimportant to utilize as much solar heat as possible. Theutilization of solar heat is low in the simulated systems,depending on the lack of space for a large buffer store. The simulations have shown that the annual efficiency ismuch lower that the nominal efficiency at full power. Thesimulations have also shown that changing the control principlefor the stove can improve efficiency and reduce theCO-emissions. Today's most common control principle for stovesis the on/off control, which results in many starts and stopsand thereby high CO-emissions. A more advanced control varyingthe heating rate from maximum to minimum to keep a constantroom temperature reduces the number of starts and stops andthereby the emissions. Also the efficiency can be higher withsuch a control, and the room temperature will be kept at a moreconstant temperature providing a higher comfort.
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Abstract At Ångström Laboratory, one of the largest campuses at Uppsala University, the Library and the Student Services Office merged in November 2012. This merger is a pilot project to improve service for students and faculty. Ångström Laboratory has around 900 staff and almost 10,000 students, of whom most also spend time at other campuses. In this paper we describe the background and the implementation of the pilot project. One of the main reasons for moving together was the wish to gather together all kinds of student services, including the distribution of written examinations in one place. The central location and open environment of the Library made it a good choice. The heart of the Library and Student Services is an open office consisting of two service desks located in the library area. There are silent study areas; computers for searching and printing, an area for relaxing with newspapers and journals, meeting rooms and offices for the staff. The result is a lively place with a cosy atmosphere. As the Library and the Student Services still belong to different parts of the University we are now starting to find out how best to collaborate. To understand more we log all the questions we get and the services we deliver. We also have meetings together and use the same lunch room to get to know each other and our different functions. We will define which matters can be solved in common, and how we can back each other up when necessary.
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Fan culture is a subculture that has developed explosively on the internet over the last decades. Fans are creating their own films, translations, fiction, fan art, blogs, role play and also various forms that are all based on familiar popular culture creations like TV-series, bestsellers, anime, manga stories and games. In our project, we analyze two of these subculture genres, fan fiction and scanlation. Amateurs, and sometimes professional writers, create new stories by adapting and developing existing storylines and characters from the original. In this way, a "network" of texts occurs, and writers step into an intertextual dialogue with established writers such as JK Rowling (Harry Potter) and Stephanie Meyer (Twilight). Literary reception and creation then merge into a rich reciprocal creative activity which includes comments and feedback from the participators in the community. The critical attitude of the fans regarding quality and the frustration at waiting for the official translation of manga books led to the development of scanlation, which is an amateur translation of manga distributed on the internet. Today, young internet users get involved in conceptual discussions of intertextuality and narrative structures through fan activity. In the case of scanlation, the scanlators practice the skills and techniques of translating in an informal environment. This phenomenon of participatory culture has been observed by scholars and it is concluded that they contribute to the development of a student’s literacy and foreign language skills. Furthermore, there is no doubt that the fandom related to Japanese cultural products such as manga, anime and videogames is one of the strong motives for foreign students to start learning Japanese. This is something to take into pedagogical consideration when we develop web-based courses. Fan fiction and fan culture make it possible to have an intensive transcultural dialogue between participators throughout the world and is of great interest when studying the interaction between formal and informal learning that puts the student in focus
A systematic review of triage-related interventions to improve patient flow in emergency departments
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Background Overcrowding in emergency departments is a worldwide problem. A systematic literature review was undertaken to scientifically explore which interventions improve patient flow in emergency departments. Methods A systematic literature search for flow processes in emergency departments was followed by assessment of relevance and methodological quality of each individual study fulfilling the inclusion criteria. Studies were excluded if they did not present data on waiting time, length of stay, patients leaving the emergency department without being seen or other flow parameters based on a nonselected material of patients. Only studies with a control group, either in a randomized controlled trial or in an observational study with historical controls, were included. For each intervention, the level of scientific evidence was rated according to the GRADE system, launched by a WHO-supported working group. Results The interventions were grouped into streaming, fast track, team triage, point-of-care testing (performing laboratory analysis in the emergency department), and nurse-requested x-ray. Thirty-three studies, including over 800,000 patients in total, were included. Scientific evidence on the effect of fast track on waiting time, length of stay, and left without being seen was moderately strong. The effect of team triage on left without being seen was relatively strong, but the evidence for all other interventions was limited or insufficient. Conclusions Introducing fast track for patients with less severe symptoms results in shorter waiting time, shorter length of stay, and fewer patients leaving without being seen. Team triage, with a physician in the team, will probably result in shorter waiting time and shorter length of stay and most likely in fewer patients leaving without being seen. There is only limited scientific evidence that streaming of patients into different tracks, performing laboratory analysis in the emergency department or having nurses to request certain x-rays results in shorter waiting time and length of stay.
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Bakgrund: Vårdpersonalen på en akutmottagning har stora krav på sig, ansvar för många patienter och måste fatta många egna beslut, ibland med mycket kort betänketid. Vårdpersonalen möter många olika patienter med olika problem och personligheter, och måste bemöta varje patient så att denne känner sig bekräftad och sedd. Syfte: Syftet med litteraturöversikten är att undersöka patienters upplevelse av att vårdas på en akutmottagning. Metod: Artiklar till arbetet har söks i olika databaser. Aktuella artiklar har lästs och relevanta fynd har markerats, för att analyseras och sammanställa ett resultat. Resultat: Analysen resulterade i tre underrubriker: Information, Bemötande och Vårdmiljö, med uppdelning av positiva och negativa upplevelser. Många patienter var nöjda med vården, men hade låga förväntningar från början. Patienterna har förstående för personalens tuffa arbetsmiljö, men önskade att få bättre information om väntetid och undersökningar. De tyckte att väntetiden var för lång, och kände sig ofta ensamma och övergivna. Slutsats: Mycket behöver förändras för att patienterna ska få en mer positiv upplevelse av akuten. Detta arbeta kan hjälpa till att belysa vilka punkter som vården måste arbeta extra mycket med för att patienterna ska känna sig trygga, exempelvis bättre information om väntetider och ett bemötande där sjusköterskan ser hela patienten.
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The purpose of this article was to illuminate existing educational ideologies in the Swedish fiddler movement (Spelmansrörelsen) 1923-1927. This period was characterized by the organization and to some extent institutionalization of Swedish folk music. Furthermore, the purpose was to discuss the results in relation to the folk music education of today. The empirical data was taken from the journal Hembygden, which was a magazine for scholars, enthusiasts and practitioners of folk music. Theoretically, the study was based on a concept of ideology developed by Sven-Eric Liedman: in every time there are two basic forms of identifiable ideology, manifest and latent. From the empirical material as a whole (around 900 articles), a selection was made to find articles dealing with aspects of learning among the fiddlers (33 articles). After content analysis the following themes were generated: Fiddlers’ repertoire, Fiddlers’ masters, Rooms for learning, Learning formation. The writers in Hembygden often emphasized the autodidactic aspects of learning and especially the importance of learning by ear. This manifest ideology of authenticity presumed that learning directly from another fiddler by playing together was to prefer to formal schooling. In spite of a tendency towards more ensemble playing, the folk music education of today in Sweden is characterized by a similar retrospective ideology as in the 1920s.
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This paper seeks to answer the research question "How does the flipped classroom affect students’ learning strategies?" In e-learning research, several studies have focused on how students and teachers perceive the flipped classroom approach. In general, these studies have reported pleasing results. Nonetheless, few, if any, studies have attempted to find out the potential effects of the flipped classroom approach on how students learn. This study was based on two cases: 1) a business modelling course and 2) a research methodology course. In both cases, participating students were from information systems courses at Dalarna University in Sweden. Recorded lectures replaced regular lectures. The recorded lectures were followed by seminars that focused on the learning content of each lecture in various ways. Three weeks after the final seminar, we arranged for two focus group interviews to take place in each course, with 8 to 10 students participating in each group. We asked open questions on how the students thought they had been affected and more dedicated questions that were generated from a literature study on the effects of flipped classroom courses. These questions dealt with issues about mobility, the potential for repeating lectures, formative feedback, the role of seminars, responsibility, empowerment, lectures before seminars, and any problems encountered. Our results show that, in general, students thought differently about learning after the courses in relation to more traditional approaches, especially regarding the need to be more active. Most students enjoyed the mobility aspect and the accessibility of recorded lectures, although a few claimed it demanded a more disciplined attitude. Most students also expressed a feeling of increased activity and responsibility when participating in seminars. Some even felt empowered because they could influence seminar content. The length of and possibility to navigate in recorded lectures was also considered important. The arrangement of the seminar rooms should promote face-to-face discussions. Finally, the types of questions and tasks were found to affect the outcomes of the seminars. The overall conclusion with regard to students’ learning strategies is that to be an active, responsible, empowered, and critical student you have to be an informed student with possibilities and mandate to influence how, where and when to learn and be able to receive continuous feedback during the learning process. Flipped classroom can support such learning.
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Bakgrund: På en akutmottagning kommer patienter i olika tillstånd och behov. Det är sjuksköterskan som ofta gör de första bedömningarna och därför är det av stor vikt att bemötandet från sjuksköterskan är positivt för att skapa trygghet. Ökat patientflöde och långa väntetider är några faktorer som är påvisade att kunna påverka upplevelsen för patienterna av sin vistelse på akutmottagningen. Syfte: Syftet med litteraturöversikten var att beskriva faktorer som påverkar patienters upplevelse av omvårdnad under sin vistelse på akutmottagning. Metod: Studien genomfördes som en litteraturöversikt. Databaserna CINAHL och PubMed användes för att söka efter artiklar. Resultat: Sex underkategorier valdes ut: bemötande, delaktighet, information, väntetid, kommunikation och kontinuitet, sjuksköterskans kunskap och kompetens. Resultatet visade att många patienter ansåg att sjuksköterskan var skicklig i sina arbetsuppgifter och var nöjda med bemötandet från sjuksköterskan, men att långa väntetider och bristande information påverkade upplevelsen av omvårdnad. Det fanns en tydlig önskan över att få mer information om sin väntetid, behandling och undersökningar. Brister i detta, skapade en otrygghet och en känsla av vara bortglömd hos patienterna. Slutsats: Sjuksköterskor på en akutmottagning behöver besitta en stor kommunikationsförmåga. Detta för att kunna ge patienterna en så bra upplevelse som möjligt. Slutsatser av resultatet har påvisat att det krävs förbättring inom flera områden för att ge patienter en bättre upplevelse av omvårdnaden under sin vistelse på akutmottagningen.