763 resultados para hospital communication systems


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Over the past few years, the number of wireless networks users has been increasing. Until now, Radio-Frequency (RF) used to be the dominant technology. However, the electromagnetic spectrum in these region is being saturated, demanding for alternative wireless technologies. Recently, with the growing market of LED lighting, the Visible Light Communications has been drawing attentions from the research community. First, it is an eficient device for illumination. Second, because of its easy modulation and high bandwidth. Finally, it can combine illumination and communication in the same device, in other words, it allows to implement highly eficient wireless communication systems. One of the most important aspects in a communication system is its reliability when working in noisy channels. In these scenarios, the received data can be afected by errors. In order to proper system working, it is usually employed a Channel Encoder in the system. Its function is to code the data to be transmitted in order to increase system performance. It commonly uses ECC, which appends redundant information to the original data. At the receiver side, the redundant information is used to recover the erroneous data. This dissertation presents the implementation steps of a Channel Encoder for VLC. It was consider several techniques such as Reed-Solomon and Convolutional codes, Block and Convolutional Interleaving, CRC and Puncturing. A detailed analysis of each technique characteristics was made in order to choose the most appropriate ones. Simulink models were created in order to simulate how diferent codes behave in diferent scenarios. Later, the models were implemented in a FPGA and simulations were performed. Hardware co-simulations were also implemented to faster simulation results. At the end, diferent techniques were combined to create a complete Channel Encoder capable of detect and correct random and burst errors, due to the usage of a RS(255,213) code with a Block Interleaver. Furthermore, after the decoding process, the proposed system can identify uncorrectable errors in the decoded data due to the CRC-32 algorithm.

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In energy harvesting communications, users transmit messages using energy harvested from nature. In such systems, transmission policies of the users need to be carefully designed according to the energy arrival profiles. When the energy management policies are optimized, the resulting performance of the system depends only on the energy arrival profiles. In this dissertation, we introduce and analyze the notion of energy cooperation in energy harvesting communications where users can share a portion of their harvested energy with the other users via wireless energy transfer. This energy cooperation enables us to control and optimize the energy arrivals at users to the extent possible. In the classical setting of cooperation, users help each other in the transmission of their data by exploiting the broadcast nature of wireless communications and the resulting overheard information. In contrast to the usual notion of cooperation, which is at the signal level, energy cooperation we introduce here is at the battery energy level. In a multi-user setting, energy may be abundant in one user in which case the loss incurred by transferring it to another user may be less than the gain it yields for the other user. It is this cooperation that we explore in this dissertation for several multi-user scenarios, where energy can be transferred from one user to another through a separate wireless energy transfer unit. We first consider the offline optimal energy management problem for several basic multi-user network structures with energy harvesting transmitters and one-way wireless energy transfer. In energy harvesting transmitters, energy arrivals in time impose energy causality constraints on the transmission policies of the users. In the presence of wireless energy transfer, energy causality constraints take a new form: energy can flow in time from the past to the future for each user, and from one user to the other at each time. This requires a careful joint management of energy flow in two separate dimensions, and different management policies are required depending on how users share the common wireless medium and interact over it. In this context, we analyze several basic multi-user energy harvesting network structures with wireless energy transfer. To capture the main trade-offs and insights that arise due to wireless energy transfer, we focus our attention on simple two- and three-user communication systems, such as the relay channel, multiple access channel and the two-way channel. Next, we focus on the delay minimization problem for networks. We consider a general network topology of energy harvesting and energy cooperating nodes. Each node harvests energy from nature and all nodes may share a portion of their harvested energies with neighboring nodes through energy cooperation. We consider the joint data routing and capacity assignment problem for this setting under fixed data and energy routing topologies. We determine the joint routing of energy and data in a general multi-user scenario with data and energy transfer. Next, we consider the cooperative energy harvesting diamond channel, where the source and two relays harvest energy from nature and the physical layer is modeled as a concatenation of a broadcast and a multiple access channel. Since the broadcast channel is degraded, one of the relays has the message of the other relay. Therefore, the multiple access channel is an extended multiple access channel with common data. We determine the optimum power and rate allocation policies of the users in order to maximize the end-to-end throughput of this system. Finally, we consider the two-user cooperative multiple access channel with energy harvesting users. The users cooperate at the physical layer (data cooperation) by establishing common messages through overheard signals and then cooperatively sending them. For this channel model, we investigate the effect of intermittent data arrivals to the users. We find the optimal offline transmit power and rate allocation policy that maximize the departure region. When the users can further cooperate at the battery level (energy cooperation), we find the jointly optimal offline transmit power and rate allocation policy together with the energy transfer policy that maximize the departure region.

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BACKGROUND: One year after the introduction of Information and Communication Technology (ICT) to support diagnostic imaging at our hospital, clinicians had faster and better access to radiology reports and images; direct access to Computed Tomography (CT) reports in the Electronic Medical Record (EMR) was particularly popular. The objective of this study was to determine whether improvements in radiology reporting and clinical access to diagnostic imaging information one year after the ICT introduction were associated with a reduction in the length of patients' hospital stays (LOS). METHODS: Data describing hospital stays and diagnostic imaging were collected retrospectively from the EMR during periods of equal duration before and one year after the introduction of ICT. The post-ICT period was chosen because of the documented improvement in clinical access to radiology results during that period. The data set was randomly split into an exploratory part used to establish the hypotheses, and a confirmatory part. The data was used to compare the pre-ICT and post-ICT status, but also to compare differences between groups. RESULTS: There was no general reduction in LOS one year after ICT introduction. However, there was a 25% reduction for one group - patients with CT scans. This group was heterogeneous, covering 445 different primary discharge diagnoses. Analyses of subgroups were performed to reduce the impact of this divergence. CONCLUSION: Our results did not indicate that improved access to radiology results reduced the patients' LOS. There was, however, a significant reduction in LOS for patients undergoing CT scans. Given the clinicians' interest in CT reports and the results of the subgroup analyses, it is likely that improved access to CT reports contributed to this reduction.

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BACKGROUND: Despite the fact that outreach and early warning systems (EWS) are an integral part of a hospital wide systems approach to improve the early identification and management of deteriorating patients on general hospital wards, the widespread implementation of these interventions in practice is not based on robust research evidence. OBJECTIVES: The primary objective was to determine the impact of critical care outreach services on hospital mortality rates. Secondary objectives included determining the effect of outreach services on intensive care unit (ICU) admission patterns, length of hospital stay and adverse events. SEARCH STRATEGY: The review authors searched the following electronic databases: EPOC Specialised Register, The Cochrane Central Register of Controlled Trials (CENTRAL) and other Cochrane databases (all on The Cochrane Library 2006, Issue 3), MEDLINE (1996-June week 3 2006), EMBASE (1974-week 26 2006), CINAHL (1982-July week 5 2006), First Search (1992-2005) and CAB Health (1990-July 2006); also reference lists of relevant articles, conference abstracts, and made contact with experts and critical care organisations for further information. SELECTION CRITERIA: Randomised controlled trials (RCTs), controlled clinical trials (CCTs), controlled before and after studies (CBAs) and interrupted time series designs (ITS) which measured hospital mortality, unanticipated ICU admissions, ICU readmissions, length of hospital stay and adverse events following implementation of outreach and EWS in a general hospital ward to identify deteriorating adult patients versus general hospital ward setting without outreach and EWS were included in the review. DATA COLLECTION AND ANALYSIS: Three review authors independently extracted data and two review authors assessed the methodological quality of the included studies. Meta-analysis was not possible due to heterogeneity. Summary statistics and descriptive summaries of primary and secondary outcomes are presented for each study. MAIN RESULTS: Two cluster-randomised control trials were included: one randomised at hospital level (23 hospitals in Australia) and one at ward level (16 wards in the UK). The primary outcome in the Australian trial (a composite score comprising incidence of unexpected cardiac arrests, unexpected deaths and unplanned ICU admissions) showed no statistical significant difference between control and medical emergency team (MET) hospitals (adjusted P value 0.640; adjusted odds ratio (OR) 0.98; 95% confidence interval (CI) 0.83 to 1.16). The UK-based trial found that outreach reduced in-hospital mortality (adjusted OR 0.52; 95% CI 0.32 to 0.85) compared with the control group. AUTHORS' CONCLUSIONS: The evidence from this review highlights the diversity and poor methodological quality of most studies investigating outreach. The results of the two included studies showed either no evidence of the effectiveness of outreach or a reduction in overall mortality in patients receiving outreach. The lack of evidence on outreach requires further multi-site RCT's to determine potential effectiveness.

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Smart healthcare is a complex domain for systems integration due to human and technical factors and heterogeneous data sources involved. As a part of smart city, it is such a complex area where clinical functions require smartness of multi-systems collaborations for effective communications among departments, and radiology is one of the areas highly relies on intelligent information integration and communication. Therefore, it faces many challenges regarding integration and its interoperability such as information collision, heterogeneous data sources, policy obstacles, and procedure mismanagement. The purpose of this study is to conduct an analysis of data, semantic, and pragmatic interoperability of systems integration in radiology department, and to develop a pragmatic interoperability framework for guiding the integration. We select an on-going project at a local hospital for undertaking our case study. The project is to achieve data sharing and interoperability among Radiology Information Systems (RIS), Electronic Patient Record (EPR), and Picture Archiving and Communication Systems (PACS). Qualitative data collection and analysis methods are used. The data sources consisted of documentation including publications and internal working papers, one year of non-participant observations and 37 interviews with radiologists, clinicians, directors of IT services, referring clinicians, radiographers, receptionists and secretary. We identified four primary phases of data analysis process for the case study: requirements and barriers identification, integration approach, interoperability measurements, and knowledge foundations. Each phase is discussed and supported by qualitative data. Through the analysis we also develop a pragmatic interoperability framework that summaries the empirical findings and proposes recommendations for guiding the integration in the radiology context.

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The radio communication system is one of the most critical system of the overall satellite platform: it often represents the only way of communication, between a spacecraft and the Ground Segment or among a constellation of satellites. This thesis focuses on specific innovative architectures for on-board and on-ground radio systems. In particular, this work is an integral part of a space program started in 2004 at the University of Bologna, Forlì campus, which led to the completion of the microsatellite ALMASat-1, successfully launched on-board the VEGA maiden flight. The success of this program led to the development of a second microsatellite, named ALMASat-EO, a three-axis stabilized microsatellite able to capture images of the Earth surface. Therefore, the first objective of this study was focused on the investigation of an innovative, efficient and low cost architecture for on-board radio communication systems. The TT&C system and the high data rate transmitter for images downlink design and realization are thoroughly described in this work, together with the development of the embedded hardware and the adopted antenna systems. Moreover, considering the increasing interest in the development of constellations of microsatellite, in particular those flying in close formations, a careful analysis has been carried out for the development of innovative communication protocols for inter-satellite links. Furthermore, in order to investigate the system aspects of space communications, a study has been carried out at ESOC having as objective the design, implementation and test of two experimental devices for the enhancement of the ESA GS. Thus, a significant portion of this thesis is dedicated to the description of the results of a method for improving the phase stability of GS radio frequency equipments by means of real-time phase compensation and a new way to perform two antennas arraying tracking using already existing ESA tracking stations facilities.

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Any new hospital communication architecture has to support existing services, but at the same time new added features should not affect normal tasks. This article deals with issues regarding old and new systems’ interoperability, as well as the effect the human factor has in a deployed architecture. It also presents valuable information, which is a product of a real scenario. Tracking services are also tested in order to monitor and administer several medical resources.

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This paper investigates the impact of carrier frequency offset (CFO) on Single Carrier wireless communication systems with Frequency Domain Equalization (SC-FDE). We show that CFO in SC-FDE systems causes irrecoverable channel estimation error, which leads to inter-symbol-interference (ISI). The impact of CFO on SC-FDE and OFDM is compared in the presence of CFO and channel estimation errors. Closed form expressions of signal to interference and noise ratio (SINR) are derived for both systems, and verified by simulation results. We find that when channel estimation errors are considered, SC-FDE is similarly or even more sensitive to CFO, compared to OFDM. In particular, in SC-FDE systems, CFO mainly deteriorates the system performance via degrading the channel estimation. Both analytical and simulation results highlight the importance of accurate CFO estimation in SC-FDE systems.

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OBJECTIVES: To compare three different methods of falls reporting and examine the characteristics of the data missing from the hospital incident reporting system. DESIGN: Fourteen-month prospective observational study nested within a randomized controlled trial. SETTING: Rehabilitation, stroke, medical, surgical, and orthopedic wards in Perth and Brisbane, Australia. PARTICIPANTS: Fallers (n5153) who were part of a larger trial (1,206 participants, mean age 75.1 � 11.0). MEASUREMENTS: Three falls events reporting measures: participants’ self-report of fall events, fall events reported in participants’ case notes, and falls events reported through the hospital reporting systems. RESULTS: The three reporting systems identified 245 falls events in total. Participants’ case notes captured 226 (92.2%) falls events, hospital incident reporting systems captured 185 (75.5%) falls events, and participant selfreport captured 147 (60.2%) falls events. Falls events were significantly less likely to be recorded in hospital reporting systems when a participant sustained a subsequent fall, (P5.01) or when the fall occurred in the morning shift (P5.01) or afternoon shift (P5.01). CONCLUSION: Falls data missing from hospital incident report systems are not missing completely at random and therefore will introduce bias in some analyses if the factor investigated is related to whether the data ismissing.Multimodal approaches to collecting falls data are preferable to relying on a single source alone.

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Gay community media functions as a system with three nodes, in which the flows of information and capital theoretically benefit all parties: the gay community gains a sense of cohesion and citizenship through media; the gay media outlets profit from advertisers’ capital; and advertisers recoup their investments in lucrative ‘pink dollar’ revenue. But if a necessary corollary of all communication systems is error or noise, where—and what—are the errors in this system? In this paper we argue that the ‘error’ in the gay media system is Queerness, and that the gay media system ejects (in a process of Kristevan abjection) these Queer identities in order to function successfully. We examine the ways in which Queer identities are excluded from representation in such media through a discourse and content analysis of The Sydney Star Observer (Australia’s largest gay and lesbian paper). First, we analyse the way Queer bodies are excluded from the discourses that construct and reinforce both the ideal gay male body and the notions of homosexual essence required for that body to be meaningful. We then argue that abject Queerness returns in the SSO’s discourses of public health through the conspicuous absence of the AIDS-inflicted body (which we read as the epitome of the abject Queer), since this absence paradoxically conjures up a trace of that which the system tries to expel. We conclude by arguing that because the ‘Queer error’ is integral to the SSO, gay community media should practise a politics of Queer inclusion rather than exclusion.

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Utilization of multiport-antennas represents an appropriate way for the mitigation of multi-path fading in wireless communication systems. However, to obtain low correlation between the signals from different antenna ports and to prevent gain reduction by cross-talk, large antenna elements spacing is expected. Polarization diversity allows signal separation even with small antenna spacing. Although it is effective, polarization diversity alone does not suffice once the number of antennas exceeds the number of orthogonal polarizations. This paper presents an approach which combines a novel array concept with the use of dual polarization. The theory is verified by a compact dual polarized patch antenna array, which consists of four elements and a decoupling network.

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In cooperative communication systems, several wireless communication terminals collaborate to form a virtual-multiple antenna array system and exploit the spatial diversity to achieve a better performance. This thesis proposes a practical slotted protocol for cooperative communication systems with half-duplex single antennas. The performance of the proposed slotted cooperative communication protocol is evaluated in terms of the pairwise error probability and the bit error rate. The proposed protocol achieves the multiple-input single-output performance bound with a novel relay ordering and scheduling strategy.

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The contemporary working environment is being rapidly reshaped by technological, industrial and political forces. Increased global competitiveness and an emphasis on productivity have led to the appearance of alternative methods of employment, such as part-time, casual and itinerant work, allowing greater flexibility. This allows for the development of a core permanent staff and the simultaneous utilisation of casual staff according to business needs. Flexible workers across industries are generally referred to as the non-standard workforce and full-time permanent workers as the standard workforce. Even though labour flexibility favours the employer, increased opportunity for flexible work has been embraced by women for many reasons, including the gender struggle for greater economic independence and social equality. Consequently, the largely female nursing industry, both nationally and internationally, has been caught up in this wave of change. This ageing workforce has been at the forefront of the push for flexibility with recent figures showing almost half the nursing workforce is employed in non-standard capacity. In part, this has allowed women to fulfil caring roles outside their work, to ease off nearing retirement and to supplement the family income. More significantly, however, flexibility has developed as an economic management initiative, as a strategy for cost constraint. The result has been the development of a dual workforce and as suggested by Pocock, Buchanan and Campbell (2004), associated deep-seated resentment and the marginalisation of part-time and casual workers by their full-time colleagues and managers. Additionally, as nursing currently faces serious recruitment and retention problems there is urgent need to understand the factors which are underlying present discontent in the nursing profession. There is an identified gap in nursing knowledge surrounding the issues relating to recruitment and retention. Communication involves speaking, listening, reading and writing and is an interactive process which is central to the lives of humans. Workplace communication refers to human interaction, information technology, and multimedia and print. It is the means to relationship building between workers, management, and their external environment and is critical to organisational effectiveness. Communication and language are integral to nursing performance (Hall, 2005), in twenty-four hour service however increasing fragmentation due to part-time and casual work in the nursing industry means that effective communication management has become increasingly difficult. More broadly it is known that disruption to communication systems impacts negatively on consumer outcomes. Because of this gap in understanding how nurses view their contemporary nursing world, an interpretative ethnographic study which progressed to a critical ethnographic study, based on the conceptual framework of constructionism and interpretativism was used. The study site was a division within an acute health care facility, and the relationship between increasing casualisation of the nursing workforce and the experiences of communication of standard and non-standard nurses was explored. For this study, full-time standard nurses were those employed to work in a specific unit for forty hours per week. Non-standard nurses were those employed part-time in specific units or those nurses employed to work as relief pool nurses for shift short falls where needed. Nurses employed by external agencies, but required to fill in for shifts at the facility were excluded from this research. This study involved an analysis of observational, interview and focus group data of standard and non-standard nurses within this facility. Three analytical findings - the organisation of nursing work; constructing the casual nurse as other; and the function of space, situate communication within a broader discussion about non-standard work and organisational culture. The study results suggest that a significant culture of marginalisation exists for nurses who work in a non-standard capacity and that this affects communication for nurses and has implications for the quality of patient care. The discussion draws on the seven elements of marginalisation described by Hall, Stephen and Melius (1994). The arguments propose that these elements underpin a culture which supports remnants of the historically gendered stereotype "the good nurse" and these cultural values contribute to practices and behaviour which marginalise all nurses, particularly those who work less than full-time. Gender inequality is argued to be at the heart of marginalising practices because of long standing subordination of nurses by the powerful medical profession, paralleling historical subordination of women in society. This has denied nurses adequate representation and voice in decision making. The new knowledge emanating from this study extends current knowledge of factors surrounding recruitment and retention and as such contributes to an understanding of the current and complex nursing environment.