941 resultados para forensic medical examination
Resumo:
The analysis of scientific data is integral to materials engineering and science. The correlation between measured variables is often quantified by estimating the coefficient of determination or the r2 value. This is the recognised procedure for determining linear relationships. The authors review the derivation of the r2 value and derive an associated quantity, termed the relative deviation (RD), which is the ratio of the root mean square of the deviations about the fitted line to the root mean square of the deviations about the y bar line expressed as a percentage. The relative deviation has an advantage over the coefficient of determination in that it has greater numerical sensitivity to changes in the spread of data about the fitted line, especially when the scatter is small. In addition, the relative deviation is able to define, in percentage terms, the reduction in scatter when different independent variables are correlated with a common dependent variable. Four case studies in the materials field (aggregate crushing value, Atterberg limits, permeability and creep of asphalt) from work carried out at the Queensland Main Roads Department are presented to show the use of the new parameter RD.
Resumo:
Innovation is a critical factor in ensuring commercial success within the area of medical technology. Biotechnology and Healthcare developments require huge financial and resource investment, in-depth research and clinical trials. Consequently, these developments involve a complex multidisciplinary structure, which is inherently full of risks and uncertainty. In this context, early technology assessment and 'proof of concept' is often sporadic and unstructured. Existing methodologies for managing the feasibility stage of medical device development are predominantly suited to the later phases of development and favour detail in optimisation, validation and regulatory approval. During these early phases, feasibility studies are normally conducted to establish whether technology is potentially viable. However, it is not clear how this technology viability is currently measured. This paper aims to redress this gap through the development of a technology confidence scale, as appropriate explicitly to the feasibility phase of medical device design. These guidelines were developed from analysis of three recent innovation studies within the medical device industry.
Resumo:
In a hospital environment that demands a careful balance between commercial and clinical interests, the extent to which physicians are involved in hospital leadership varies greatly. This paper assesses the influence of the extent of this involvement on staff-to-patient ratios. Using data gathered from 604 hospitals across Germany, this study evidences the positive relationship between a full-time medical director (MD) or heavily involved part-time MD and a higher staff-to-patient ratio. The data allows us to control for a range of confounding variables, such as size, rural/urban location, ownership structure, and case-mix. The results contribute to the sparse body of empirical research on the effect of clinical leadership on organizational outcomes.
Resumo:
Technology roadmapping has been used to strategise the development of energy technologies. However, there have been limited roadmapping applications that analyse the emergence of a new energy technology that then forms a new industry and propels broad-based low-carbon economic growth. This paper, therefore, attempts to develop a roadmapping framework by integrating the lifecycle analysis tool, in order to strategise the emergence of dimethyl ether, an alternative energy based on advanced engineering technologies such as carbon capture and storage. This paper compares two scenarios of dimethyl ether vs. diesel and finds that the superiority of dimethyl ether will not arise until 2030, when the complementary engineering technologies become available. This proposed framework can also be generalised to other clean energy industries, and we anticipate our paper will spark inspiration for roadmapping and strategising the 'right' technologies for the growth of Chinese energy industries. Copyright © 2012 Inderscience Enterprises Ltd.
Resumo:
Polymeric fibrous scaffolds have been considered as replacements for load-bearing soft tissues, because of their ability to mimic the microstructure of natural tissues. Poor toughness of fibrous materials results in failure, which is an issue of importance to both engineering and medical practice. The toughness of fibrous materials depends on the ability of the microstructure to develop toughening mechanisms. However, such toughening mechanisms are still not well understood, because the detailed evolution at the microscopic level is difficult to visualize. A novel and simple method was developed, namely, a sample-taping technique, to examine the detailed failure mechanisms of fibrous microstructures. This technique was compared with in situ fracture testing by scanning electron microscopy. Examination of three types of fibrous networks showed that two different failure modes occurred in fibrous scaffolds. For brittle cracking in gelatin electrospun scaffolds, the random network morphology around the crack tip remained during crack propagation. For ductile failure in polycaprolactone electrospun scaffolds and nonwoven fabrics, the random network deformed via fiber rearrangement, and a large number of fiber bundles formed across the region in front of the notch tip. These fiber bundles not only accommodated mechanical strain, but also resisted crack propagation and thus toughened the fibrous scaffolds. Such understanding provides insight for the production of fibrous materials with enhanced toughness.
Resumo:
OBJECTIVE: This study identifies the stakeholders who have a role in medical device purchasing within the wider system of health-care delivery and reports on their particular challenges to promote patient safety during purchasing decisions. METHODS: Data was collected through observational work, participatory workshops, and semi-structured qualitative interviews, which were analyzed and coded. The study takes a systems-based and engineering design approach to the study. Five hospitals took part in this study, and the participants included maintenance, training, clinical end-users, finance, and risk departments. RESULTS: The main stakeholders for purchasing were identified to be staff from clinical engineering (Maintenance), device users (Clinical), device trainers (Training), and clinical governance for analyzing incidents involving devices (Risk). These stakeholders display varied characteristics in terms of interpretation of their own roles, competencies for selecting devices, awareness and use of resources for purchasing devices, and attitudes toward the purchasing process. The role of "clinical engineering" is seen by these stakeholders to be critical in mediating between training, technical, and financial stakeholders but not always recognized in practice. CONCLUSIONS: The findings show that many device purchasing decisions are tackled in isolation, which is not optimal for decisions requiring knowledge that is currently distributed among different people within different departments. The challenges expressed relate to the wider system of care and equipment management, calling for a more systemic view of purchasing for medical devices.
Resumo:
Polymeric fibrous scaffolds have been considered as replacements for load-bearing soft tissues, because of their ability to mimic the microstructure of natural tissues. Poor toughness of fibrous materials results in failure, which is an issue of importance to both engineering and medical practice. The toughness of fibrous materials depends on the ability of the microstructure to develop toughening mechanisms. However, such toughening mechanisms are still not well understood, because the detailed evolution at the microscopic level is difficult to visualize. A novel and simple method was developed, namely, a sample-taping technique, to examine the detailed failure mechanisms of fibrous microstructures. This technique was compared with in situ fracture testing by scanning electron microscopy. Examination of three types of fibrous networks showed that two different failure modes occurred in fibrous scaffolds. For brittle cracking in gelatin electrospun scaffolds, the random network morphology around the crack tip remained during crack propagation. For ductile failure in polycaprolactone electrospun scaffolds and nonwoven fabrics, the random network deformed via fiber rearrangement, and a large number of fiber bundles formed across the region in front of the notch tip. These fiber bundles not only accommodated mechanical strain, but also resisted crack propagation and thus toughened the fibrous scaffolds. Such understanding provides insight for the production of fibrous materials with enhanced toughness. © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.
Resumo:
This study proposes a new product development (NPD) model that aims to improve the effectiveness of innovative NPD in the medical devices. By adopting open innovation theory and applying an in-depth investigation methodology, this paper proposes a knowledge cluster that improves the integration of interdisciplinary human resources and enhances the acquirement of innovative technologies. A knowledge cluster approach helps gather, organise, synthesise, and accumulate knowledge in order to become the impetus for innovation. Although enterprises are no longer the principals of research and development, they should still be capable of integrating professional physicians, external groups, and individuals through the knowledge cluster platform. However, in order to support an effective NPD model, enterprises should provide adequate incentives and trust to external individuals or groups willing to contribute their expertise and knowledge to this knowledge cluster platform. Copyright © 2013 Inderscience Enterprises Ltd.
Resumo:
BACKGROUND: A large proportion of students identify statistics courses as the most anxiety-inducing courses in their curriculum. Many students feel impaired by feelings of state anxiety in the examination and therefore probably show lower achievements. AIMS: The study investigates how statistics anxiety, attitudes (e.g., interest, mathematical self-concept) and trait anxiety, as a general disposition to anxiety, influence experiences of anxiety as well as achievement in an examination. SAMPLE: Participants were 284 undergraduate psychology students, 225 females and 59 males. METHODS: Two weeks prior to the examination, participants completed a demographic questionnaire and measures of the STARS, the STAI, self-concept in mathematics, and interest in statistics. At the beginning of the statistics examination, students assessed their present state anxiety by the KUSTA scale. After 25 min, all examination participants gave another assessment of their anxiety at that moment. Students' examination scores were recorded. Structural equation modelling techniques were used to test relationships between the variables in a multivariate context. RESULTS: Statistics anxiety was the only variable related to state anxiety in the examination. Via state anxiety experienced before and during the examination, statistics anxiety had a negative influence on achievement. However, statistics anxiety also had a direct positive influence on achievement. This result may be explained by students' motivational goals in the specific educational setting. CONCLUSIONS: The results provide insight into the relationship between students' attitudes, dispositions, experiences of anxiety in the examination, and academic achievement, and give recommendations to instructors on how to support students prior to and in the examination.
Resumo:
Biodegradable polymers can be applied to a variety of implants for controlled and local drug delivery. The aim of this study is to develop a biodegradable and nanoporous polymeric platform for a wide spectrum of drug-eluting implants with special focus on stent-coating applications. It was synthesized by poly(DL-lactide-co-glycolide) (PLGA 65:35, PLGA 75:25) and polycaprolactone (PCL) in a multilayer configuration by means of a spin-coating technique. The antiplatelet drug dipyridamole was loaded into the surface nanopores of the platform. Surface characterization was made by atomic force microscopy (AFM) and spectroscopic ellipsometry (SE). Platelet adhesion and drug-release kinetic studies were then carried out. The study revealed that the multilayer films are highly nanoporous, whereas the single layers of PLGA are atomically smooth and spherulites are formed in PCL. Their nanoporosity (pore diameter, depth, density, surface roughness) can be tailored by tuning the growth parameters (eg, spinning speed, polymer concentration), essential for drug-delivery performance. The origin of pore formation may be attributed to the phase separation of polymer blends via the spinodal decomposition mechanism. SE studies revealed the structural characteristics, film thickness, and optical properties even of the single layers in the triple-layer construct, providing substantial information for drug loading and complement AFM findings. Platelet adhesion studies showed that the dipyridamole-loaded coatings inhibit platelet aggregation that is a prerequisite for clotting. Finally, the films exhibited sustained release profiles of dipyridamole over 70 days. These results indicate that the current multilayer phase therapeutic approach constitutes an effective drug-delivery platform for drug-eluting implants and especially for cardiovascular stent applications.