Development and feasibility testing of an education program to improve knowledge and self-care among Aboriginal and Torres Strait Islander patients with heart failure

Background/Aim There is a 70% higher age-adjusted incidence of heart failure (HF) amongst Aboriginal and Torres Strait Islander people, three times more hospitalisations and twice as many deaths than non-Aboriginal people. There is a need to develop holistic yet individualised approaches in accord with the values of Aboriginal community healthcare to support patient education and self-care. The aim of this study was to re-design an existing HF educational resource (Fluid Watchers-Pacific Rim©) to be culturally safe for Aboriginal and Torres Strait Islander peoples, working in collaboration with the local community, and to conduct feasibility testing. Methods This study was conducted in two phases and utilised a mixed methods approach (qualitative and quantitative). Phase 1 of this study used action research methods to develop a culturally safe electronic resource to be provided to Aboriginal HF patients via a tablet computer. A HF expert panel adapted the existing resource to ensure it was evidence-based and contained appropriate language and images that reflects Aboriginal culture. A stakeholder group (which included Aboriginal workers and HF patients, as well as researchers and clinicians) then reviewed the resources and changes were made accordingly. In Phase 2, the new resource was tested on a sample of Aboriginal HF patients to assess feasibility and acceptability. Patient knowledge, satisfaction and self-care behaviours were measured using a before and after design with validated questionnaires. As this was a pilot test to determine feasibility, no statistical comparisons were made. Results - Phase 1: Throughout the process of resource development, two main themes emerged from the stakeholder consultation. These were the importance of identity, meaning that it was important to ensure that the resource accurately reflected the local community, with the appropriate clothing, skin tone and voice. The resource was adapted to reflect this and of the local community voiced the recordings for the resource. The other theme was comprehension; images were important and all text was converted to the first person and used plain language. - Phase 2: Five Aboriginal participants, mean age 61.6 ± 10.0 years, with NYHA Class III and IV heart failure were enrolled. Participants reported a high level of satisfaction with the resource (83.0%). HF knowledge (percentage of correct responses) increased from 48.0 ± 6.7% to 58.0 ± 9.7%, a 20.8% increase and results of the self-care index indicated that the biggest change was in patient confidence for self-care with a 95% increase in confidence score (46.7 ± 16.0 to 91.1 ± 11.5). Changes in management and maintenance scores varied between9275 patients. Conclusion By working in collaboration with HF experts, Aboriginal researchers and patients, a culturally safe HF resource has been developed for Aboriginal and Torres Strait Islander patients. Engaging Aboriginal researchers, capacity-building, and being responsive to local systems and structures enabled this pilot study to be successfully completed with the Aboriginal community and positive participant feedback demonstrated that the methodology used in this study was appropriate and acceptable; participants were able to engage with willingness and confidence.

Out-of-plane deformation and failure of masonry walls with various forms of reinforcement

Out-of-plane behaviour of mortared and mortarless masonry walls with various forms of reinforcement, including unreinforced masonry as a base case is examined using a layered shell element based explicit finite element modelling method. Wall systems containing internal reinforcement, external surface reinforcement and intermittently laced reinforced concrete members and unreinforced masonry panels are considered. Masonry is modelled as a layer with macroscopic orthotropic properties; external reinforcing render, grout and reinforcing bars are modelled as distinct layers of the shell element. Predictions from the layered shell model have been validated using several out-of-plane experimental datasets reported in the literature. The model is used to examine the effectiveness of two retrofitting schemes for an unreinforced masonry wall.

Optimal maintenance policy for equipment subject to random deterioration and random failure A modern control theory approach.

The stochastic version of Pontryagin's maximum principle is applied to determine an optimal maintenance policy of equipment subject to random deterioration. The deterioration of the equipment with age is modelled as a random process. Next the model is generalized to include random catastrophic failure of the equipment. The optimal maintenance policy is derived for two special probability distributions of time to failure of the equipment, namely, exponential and Weibull distributions Both the salvage value and deterioration rate of the equipment are treated as state variables and the maintenance as a control variable. The result is illustrated by an example

A Success Story or a Failure? : Representing the European Integration in the Curricula and Textbooks of Five Countries

The economic, political and social face of Europe has been changing rapidly in the past decades. These changes are unique in the history of Europe, but not without challenges for the nation states. The support for the European integration varies among the countries. In order to understand why certain developments or changes are perceived as threatening or as desired by different member countries, we must consider the social representations of the European integration on the national level: how the EU is represented to its citizens in media and in educational systems, particularly in the curricula and textbooks. The current study is concerned with the social representations of the European integration in the curricula and school textbooks in five European countries: France, Britain, Germany, Finland and Sweden. Besides that, the first volume of the common Franco-German history textbook was analyzed, since it has been seen as a model for a common European history textbook. As the collective representations, values and identities are dominantly mediated and imposed through media and educational systems, the national curricula and textbooks make an interesting starting point for the study of the European integration and of national and European identities. The social representations theory provides a comprehensive framework for the study of the European integration. By analyzing the curricula and history and civics textbooks of major educational publishers, the study aimed to demonstrate what is written on the European integration and how it is portrayed how the European integration is understood, made familiar and concretized in the educational context in the five European countries. To grasp the phenomenon of the European integration in the textbooks in its entirety, it was investigated from various perspectives. The two analysis methods of content analysis, the automatic analysis with ALCESTE and a more qualitative theory-driven content analysis, were carried out to give a more vivid and multifaceted picture of the object of the research. The analysis of the text was complemented with the analysis of visual material. Drawing on quantitative and qualitative methods, the contents, processes, visual images, transformations and structures of the social representations of European integration, as well as the communicative styles of the textbooks were examined. This study showed the divergent social representations of the European integration, anchored in the nation states, in the five member countries of the European Union. The social representations were constructed around different central core elements: French Europe in the French textbooks, Ambivalent Europe in the British textbooks, Influential and Unifying EU in the German textbooks, Enabling and Threatening EU in the Finnish textbooks, Sceptical EU in the Swedish textbooks and EU as a World Model in the Franco-German textbook. Some elements of the representations were shared by all countries such as peace and economic aspects of the European cooperation, whereas other elements of representations were found more frequently in some countries than in others, such as ideological, threatening or social components of the phenomenon European integration. The study also demonstrated the linkage between social representations of the EU and national and European identities. The findings of this study are applicable to the study of the European integration, to the study of education, as well as to the social representation theory.

Sequential design of decentralized control systems

Our main result is a new sequential method for the design of decentralized control systems. Controller synthesis is conducted on a loop-by-loop basis, and at each step the designer obtains an explicit characterization of the class C of all compensators for the loop being closed that results in closed-loop system poles being in a specified closed region D of the s-plane, instead of merely stabilizing the closed-loop system. Since one of the primary goals of control system design is to satisfy basic performance requirements that are often directly related to closed-loop pole location (bandwidth, percentage overshoot, rise time, settling time), this approach immediately allows the designer to focus on other concerns such as robustness and sensitivity. By considering only compensators from class C and seeking the optimum member of that set with respect to sensitivity or robustness, the designer has a clearly-defined limited optimization problem to solve without concern for loss of performance. A solution to the decentralized tracking problem is also provided. This design approach has the attractive features of expandability, the use of only 'local models' for controller synthesis, and fault tolerance with respect to certain types of failure.

Regenerating Codes for Distributed Storage Networks

In a storage system where individual storage nodes are prone to failure, the redundant storage of data in a distributed manner across multiple nodes is a must to ensure reliability. Reed-Solomon codes possess the reconstruction property under which the stored data can be recovered by connecting to any k of the n nodes in the network across which data is dispersed. This property can be shown to lead to vastly improved network reliability over simple replication schemes. Also of interest in such storage systems is the minimization of the repair bandwidth, i.e., the amount of data needed to be downloaded from the network in order to repair a single failed node. Reed-Solomon codes perform poorly here as they require the entire data to be downloaded. Regenerating codes are a new class of codes which minimize the repair bandwidth while retaining the reconstruction property. This paper provides an overview of regenerating codes including a discussion on the explicit construction of optimum codes.

Nature inspired optimization techniques for the design optimization of laminated composite structures using failure criteria

The design optimization of laminated composites using naturally inspired optimization techniques such as vector evaluated particle swarm optimization (VEPSO) and genetic algorithms (GA) are used in this paper. The design optimization of minimum weight of the laminated composite is evaluated using different failure criteria. The failure criteria considered are maximum stress (MS), Tsai-Wu (TW) and failure mechanism based (FMB) failure criteria. Minimum weight of the laminates are obtained for different failure criteria using VEPSO and GA for different combinations of loading. From the study it is evident that VEPSO and GA predict almost the same minimum weight of the laminate for the given loading. Comparison of minimum weight of the laminates by different failure criteria differ for some loading combinations. The comparison shows that FMBFC provide better results for all combinations of loading. (C) 2010 Elsevier Ltd. All rights reserved.

Performability of automated manufacturing systems with centralized material handling

We present a framework for performance evaluation of manufacturing systems subject to failure and repair. In particular, we determine the mean and variance of accumulated production over a specified time frame and show the usefulness of these results in system design and in evaluating operational policies for manufacturing systems. We extend this analysis for lead time as well. A detailed performability study is carried out for the generic model of a manufacturing system with centralized material handling. Several numerical results are presented, and the relevance of performability analysis in resolving system design issues is highlighted. Specific problems addressed include computing the distribution of total production over a shift period, determining the shift length necessary to deliver a given production target with a desired probability, and obtaining the distribution of Manufacturing Lead Time, all in the face of potential subsystem failures.

Orientational relaxation in dipolar systems: How much do we understand the role of correlations

Dipolar systems, both liquids and solids, constitute a class of naturally abundant systems that are important in all branches of natural science. The study of orientational relaxation provides a powerful method to understand the microscopic properties of these systems and, fortunately, there are many experimental tools to study orientational relaxation in the condensed phases. However, even after many years of intense research, our understanding of orientational relaxation in dipolar systems has remained largely imperfect. A major hurdle towards achieving a comprehensive understanding is the long range and complex nature of dipolar interactions which also made reliable theoretical study extremely difficult. These difficulties have led to the development of continuum model based theories, which although they provide simple, elegant expressions for quantities of interest, are mostly unsatisfactory as they totally neglect the molecularity of inter-molecular interactions. The situation has improved in recent years because of renewed studies, led by computer simulations. In this review, we shall address some of the recent advances, with emphasis on the work done in our laboratory at Bangalore. The reasons for the failure of the continuum model, as revealed by the recent Brownian dynamics simulations of the dipolar lattice, are discussed. The main reason is that the continuum model predicts too fast a decay of the torque-torque correlation function. On the other hand, a perturbative calculation, based on Zwanzig's projection operator technique, provides a fairly satisfactory description of the single particle orientational dynamics for not too strongly polar dipolar systems. A recently developed molecular hydrodynamic theory that properly includes the effects of intermolecular orientational pair correlations provides an even better description of the single-particle orientational dynamics. We also discuss the rank dependence of the dielectric friction. The other topics reviewed here includes dielectric relaxation and solvation dynamics, as they are intimately connected with orientational relaxation. Recent molecular dynamics simulations of the dipolar lattice are also discussed. The main theme of the present review is to understand the effects of intermolecular interactions on orientational relaxation. The presence of strong orientational pair correlation leads to a strong coupling between the single particle and the collective dynamics. This coupling can lead to rich dynamical properties, some of which are detailed here, while a major part remains yet unexplored.

Performability Analysis of Fork-Join Queueing Systems

Fork-join queueing systems offer a natural modelling paradigm for parallel processing systems and for assembly operations in automated manufacturing. The analysis of fork-join queueing systems has been an important subject of research in recent years. Existing analysis methodologies-both exact and approximate-assume that the servers are failure-free. In this study, we consider fork-join queueing systems in the presence of server failures and compute the cumulative distribution of performability with respect to the response time of such systems. For this, we employ a computational methodology that uses a recent technique based on randomization. We compare the performability of three different fork-join queueing models proposed in the literature: the distributed model, the centralized splitting model, and the split-merge model. The numerical results show that the centralized splitting model offers the highest levels of performability, followed by the distributed splitting and split-merge models.

Link failure detection for maintaining session continuity in packet data networks

A link failure in the path of a virtual circuit in a packet data network will lead to premature disconnection of the circuit by the end-points. A soft failure will result in degraded throughput over the virtual circuit. If these failures can be detected quickly and reliably, then appropriate rerouteing strategies can automatically reroute the virtual circuits that use the failed facility. In this paper, we develop a methodology for analysing and designing failure detection schemes for digital facilities. Based on errored second data, we develop a Markov model for the error and failure behaviour of a T1 trunk. The performance of a detection scheme is characterized by its false alarm probability and the detection delay. Using the Markov model, we analyse the performance of detection schemes that use physical layer or link layer information. The schemes basically rely upon detecting the occurrence of severely errored seconds (SESs). A failure is declared when a counter, that is driven by the occurrence of SESs, reaches a certain threshold.For hard failures, the design problem reduces to a proper choice;of the threshold at which failure is declared, and on the connection reattempt parameters of the virtual circuit end-point session recovery procedures. For soft failures, the performance of a detection scheme depends, in addition, on how long and how frequent the error bursts are in a given failure mode. We also propose and analyse a novel Level 2 detection scheme that relies only upon anomalies observable at Level 2, i.e. CRC failures and idle-fill flag errors. Our results suggest that Level 2 schemes that perform as well as Level 1 schemes are possible.

Integrated Reservoir Operation Modeling for Irrigation Systems - A Multi-Objective Approach

An integrated reservoir operation model is presented for developing effective operational policies for irrigation water management. In arid and semi-arid climates, owing to dynamic changes in the hydroclimatic conditions within a season, the fixed cropping pattern with conventional operating policies, may have considerable impact on the performance of the irrigation system and may affect the economics of the farming community. For optimal allocation of irrigation water in a season, development of effective mathematical models may guide the water managers in proper decision making and consequently help in reducing the adverse effects of water shortage and crop failure problems. This paper presents a multi-objective integrated reservoir operation model for multi-crop irrigation system. To solve the multi-objective model, a recent swarm intelligence technique, namely elitist-mutated multi-objective particle swarm optimisation (EM-MOPSO) has been used and applied to a case study in India. The method evolves effective strategies for irrigation crop planning and operation policies for a reservoir system, and thereby helps farming community in improving crop benefits and water resource usage in the reservoir command area.

A design methodology for selecting and placement of sensors in multimedia surveillance systems

This paper addresses the problem of how to select the optimal number of sensors and how to determine their placement in a given monitored area for multimedia surveillance systems. We propose to solve this problem by obtaining a novel performance metric in terms of a probability measure for accomplishing the task as a function of set of sensors and their placement. This measure is then used to find the optimal set. The same measure can be used to analyze the degradation in system 's performance with respect to the failure of various sensors. We also build a surveillance system using the optimal set of sensors obtained based on the proposed design methodology. Experimental results show the effectiveness of the proposed design methodology in selecting the optimal set of sensors and their placement.

Pre-emptive queue processing scheme for handovers in mobile cellular communication systems

A new scheme for minimizing handover failure probability in mobile cellular communication systems is presented. The scheme involves a reassignment of priorities for handover requests enqueued in adjacent cells to release a channel for a handover request which is about to fail. Performance evaluation of the new scheme carried out by computer simulation of a four-cell highway cellular system has shown a considerable reduction in handover failure probability

AdFT: An Adaptive Framework for Fault Tolerance on Large Scale Systems using Application Malleability

Exascale systems of the future are predicted to have mean time between failures (MTBF) of less than one hour. Malleable applications, where the number of processors on which the applications execute can be changed during executions, can make use of their malleability to better tolerate high failure rates. We present AdFT, an adaptive fault tolerance framework for long running malleable applications to maximize application performance in the presence of failures. AdFT framework includes cost models for evaluating the benefits of various fault tolerance actions including checkpointing, live-migration and rescheduling, and runtime decisions for dynamically selecting the fault tolerance actions at different points of application execution to maximize performance. Simulations with real and synthetic failure traces show that our approach outperforms existing fault tolerance mechanisms for malleable applications yielding up to 23% improvement in application performance, and is effective even for petascale systems and beyond.