An Exploratory Study of Patient Falls

Debate continues between the contribution of education level and clinical expertise in the nursing practice environment. Research suggests a link between Baccalaureate of Science in Nursing (BSN) nurses and positive patient outcomes such as lower mortality, decreased falls, and fewer medication errors. Purpose: To examine if there a negative correlation between patient falls and the level of nurse education at an urban hospital located in Midwest Illinois during the years 2010-2014? Methods: A retrospective crosssectional cohort analysis was conducted using data from the National Database of Nursing Quality Indicators (NDNQI) from the years 2010-2014. Sample: Inpatients aged ≥ 18 years who experienced a unintentional sudden descent, with or without injury that resulted in the patient striking the floor or object and occurred on inpatient nursing units. Results: The regression model was constructed with annual patient falls as the dependent variable and formal education and a log transformed variable for percentage of certified nurses as the independent variables. The model overall is a good fit, F (2,22) = 9.014, p = .001, adj. R2 = .40. Conclusion: Annual patient falls will decrease by increasing the number of nurses with baccalaureate degrees and/or certifications from a professional nursing board-governing body

Sanitation in the Circular Economy: Transformation to a Commercially Valuable, Self-sustaining, Biological System

In 2016 the Toilet Board Coalition ran a Feasibility Study to explore the potential role of Sanitation in the Circular Economy. The following questions were at the centre of our inquiry:- Are there products or materials of value being upcycled from toilet resources?- Are there scalable business models to deliver sustainable supply of these products to the market?- Is there commercial interest and demand from large industrial operations to become buyers into the system? This paper presents the findings of our study in the form of a thought piece on the topic of sanitation in the Circular Economy. Our intent is to present a number of business opportunity spaces, where we believe that value has been left on the table and customer needs unmet, which we recommend are to be explored further in the decade ahead.

Climate change, gender, youth and nutrition situation analysis - Uganda

Situational analyais of climate change, gender, youth and nutrition in Uganda

Climate change, gender, youth and nutrition situation analysis - Uganda

Situational analyais of climate change, gender, youth and nutrition in Uganda

A Proposed Architecture for Big Data Driven Supply Chain Analytics

Advancement in information and communication technology (ICT) has given rise to explosion of data in every field of operations. Working with the enormous volume of data (or Big Data, as it is popularly known as) for extraction of useful information to support decision making is one of the sources of competitive advantage for organizations today. Enterprises are leveraging the power of analytics in formulating business strategy in every facet of their operations to mitigate business risk. Volatile global market scenario has compelled the organizations to redefine their supply chain management (SCM). In this paper, we have delineated the relevance of Big Data and its importance in managing end to end supply chains for achieving business excellence. A Big Data-centric architecture for SCM has been proposed that exploits the current state of the art technology of data management, analytics and visualization. The security and privacy requirements of a Big Data system have also been highlighted and several mechanisms have been discussed to implement these features in a real world Big Data system deployment in the context of SCM. Some future scope of work has also been pointed out. Keyword: Big Data, Analytics, Cloud, Architecture, Protocols, Supply Chain Management, Security, Privacy.Comment: 24 pages, 4 figures, 3 table

Optimizing transportation systems and logistics network configurations : From biased-randomized algorithms to fuzzy simheuristics

242 páginasTransportation and logistics (T&L) are currently highly relevant functions in any competitive industry. Locating facilities or distributing goods to hundreds or thousands of customers are activities with a high degree of complexity, regardless of whether facilities and customers are placed all over the globe or in the same city. A countless number of alternative strategic, tactical, and operational decisions can be made in T&L systems; hence, reaching an optimal solution –e.g., a solution with the minimum cost or the maximum profit– is a really difficult challenge, even by the most powerful existing computers. Approximate methods, such as heuristics, metaheuristics, and simheuristics, are then proposed to solve T&L problems. They do not guarantee optimal results, but they yield good solutions in short computational times. These characteristics become even more important when considering uncertainty conditions, since they increase T&L problems’ complexity. Modeling uncertainty implies to introduce complex mathematical formulas and procedures, however, the model realism increases and, therefore, also its reliability to represent real world situations. Stochastic approaches, which require the use of probability distributions, are one of the most employed approaches to model uncertain parameters. Alternatively, if the real world does not provide enough information to reliably estimate a probability distribution, then fuzzy logic approaches become an alternative to model uncertainty. Hence, the main objective of this thesis is to design hybrid algorithms that combine fuzzy and stochastic simulation with approximate and exact methods to solve T&L problems considering operational, tactical, and strategic decision levels. This thesis is organized following a layered structure, in which each introduced layer enriches the previous one.El transporte y la logística (T&L) son actualmente funciones de gran relevancia en cual quier industria competitiva. La localización de instalaciones o la distribución de mercancías a cientos o miles de clientes son actividades con un alto grado de complejidad, indepen dientemente de si las instalaciones y los clientes se encuentran en todo el mundo o en la misma ciudad. En los sistemas de T&L se pueden tomar un sinnúmero de decisiones al ternativas estratégicas, tácticas y operativas; por lo tanto, llegar a una solución óptima –por ejemplo, una solución con el mínimo costo o la máxima utilidad– es un desafío realmente di fícil, incluso para las computadoras más potentes que existen hoy en día. Así pues, métodos aproximados, tales como heurísticas, metaheurísticas y simheurísticas, son propuestos para resolver problemas de T&L. Estos métodos no garantizan resultados óptimos, pero ofrecen buenas soluciones en tiempos computacionales cortos. Estas características se vuelven aún más importantes cuando se consideran condiciones de incertidumbre, ya que estas aumen tan la complejidad de los problemas de T&L. Modelar la incertidumbre implica introducir fórmulas y procedimientos matemáticos complejos, sin embargo, el realismo del modelo aumenta y, por lo tanto, también su confiabilidad para representar situaciones del mundo real. Los enfoques estocásticos, que requieren el uso de distribuciones de probabilidad, son uno de los enfoques más empleados para modelar parámetros inciertos. Alternativamente, si el mundo real no proporciona suficiente información para estimar de manera confiable una distribución de probabilidad, los enfoques que hacen uso de lógica difusa se convier ten en una alternativa para modelar la incertidumbre. Así pues, el objetivo principal de esta tesis es diseñar algoritmos híbridos que combinen simulación difusa y estocástica con métodos aproximados y exactos para resolver problemas de T&L considerando niveles de decisión operativos, tácticos y estratégicos. Esta tesis se organiza siguiendo una estructura por capas, en la que cada capa introducida enriquece a la anterior. Por lo tanto, en primer lugar se exponen heurísticas y metaheurísticas sesgadas-aleatorizadas para resolver proble mas de T&L que solo incluyen parámetros determinísticos. Posteriormente, la simulación Monte Carlo se agrega a estos enfoques para modelar parámetros estocásticos. Por último, se emplean simheurísticas difusas para abordar simultáneamente la incertidumbre difusa y estocástica. Una serie de experimentos numéricos es diseñada para probar los algoritmos propuestos, utilizando instancias de referencia, instancias nuevas e instancias del mundo real. Los resultados obtenidos demuestran la eficiencia de los algoritmos diseñados, tanto en costo como en tiempo, así como su confiabilidad para resolver problemas realistas que incluyen incertidumbre y múltiples restricciones y condiciones que enriquecen todos los problemas abordados.Doctorado en Logística y Gestión de Cadenas de SuministrosDoctor en Logística y Gestión de Cadenas de Suministro

How 5G wireless (and concomitant technologies) will revolutionize healthcare?

The need to have equitable access to quality healthcare is enshrined in the United Nations (UN) Sustainable Development Goals (SDGs), which defines the developmental agenda of the UN for the next 15 years. In particular, the third SDG focuses on the need to “ensure healthy lives and promote well-being for all at all ages”. In this paper, we build the case that 5G wireless technology, along with concomitant emerging technologies (such as IoT, big data, artificial intelligence and machine learning), will transform global healthcare systems in the near future. Our optimism around 5G-enabled healthcare stems from a confluence of significant technical pushes that are already at play: apart from the availability of high-throughput low-latency wireless connectivity, other significant factors include the democratization of computing through cloud computing; the democratization of Artificial Intelligence (AI) and cognitive computing (e.g., IBM Watson); and the commoditization of data through crowdsourcing and digital exhaust. These technologies together can finally crack a dysfunctional healthcare system that has largely been impervious to technological innovations. We highlight the persistent deficiencies of the current healthcare system and then demonstrate how the 5G-enabled healthcare revolution can fix these deficiencies. We also highlight open technical research challenges, and potential pitfalls, that may hinder the development of such a 5G-enabled health revolution

Food, Brexit and Northern Ireland: Critical Issues

This report is the third in our Food Brexit Briefing series. It argues that the absence of serious consideration of food flows into, out of and through Northern Ireland is a significant policy omission in the ongoing Brexit negotiations. There has been much talk of the importance of Northern Ireland, but next to no detailed attention to the food implications of Brexit for Northern Ireland. The report makes the case that there is an urgent need to get down to detail over border arrangements, contingency planning and resource allocation. This is too important to leave to last-minute makeshift or muddle. Food is central to the economy of Northern Ireland, and the continuing supply of safe, high quality, healthy food is currently dependent on the absence of border controls between Northern Ireland, the Republic of Ireland, Great Britain and the rest of the European Union. Hundreds of thousands of tonnes of food criss-cross these borders every year. They are currently free from inspection because of shared, underpinning EU Single Market regulation. An unplanned or mishandled food border imposition is likely to have powerful, destabilising consequences for the integrated nature of food supply, trade and access within Northern Ireland for many years to come. It would raise important challenges for food safety, put jobs at risk, potentially constrain Northern Ireland’s access to health-supporting foods such as fruit and vegetables, and create opportunities for food fraud and crime. The report, by Gary McFarlane and Tony Lewis, both senior environmental health professionals and officers of the Chartered Institute of Environmental Health, and Professor Tim Lang, of the Centre for Food Policy at City, University of London, is based on a thorough review of food flows into, from and through Northern Ireland, and the practical experience of its authors. The report dismisses talk of ‘technological fixes’ to help maintain the smooth flow of goods as vague, unavailable now and unrealistic. It calls for all the governments and bodies involved in food and Brexit – the European Union, United Kingdom, Republic of Ireland, Scotland, Wales and Northern Ireland itself – to set political differences aside in order to resolve the considerable practical challenges of cross-border food traffic. The authors make more than 30 recommendations to help that process