Patients' experience of coercive measures in psychiatric inpatient care : a literature study

Background: Psychiatric inpatient care and coercion measures are stigmatized areas which represent a special part of the healthcare, since it’s in conflict with the principle of the right to voluntary care and treatment. This creates complicated ethical dilemmas and challenges the integrity of the individual. Purpose: To investigate the patients' experience of coercion measures in psychiatric inpatient care. Method: The design of the study is a literature study. The literature were examined and analyzed and resulted in an overview of the research question. Results: To be exposed to a coercion measure can have both positive and negative impact on health. The most important factors for the experience of the coercion measure are information, treatment, communication, participation and the relation to the staff. Discussion: The patients do not in general seem to disapprove to the usage of the coercion measures and can understand that it´s for their own best in certain situations, although the clinical practice can be improved. The patients want a better communication, participation and relation to the staff.Bakgrund: Tvångsvård och tvångsåtgärder är ett stigmatiserat område som utgör en speciell del av hälso- och sjukvården eftersom det går emot principen om rätt till frivillig vård och behandling. Denna typ av vård skapar komplicerade etiska dilemman och kan ses som kränkande av individens integritet. Syfte: Att undersöka patienters upplevelse av tvångsåtgärder inom psykiatrisk slutenvård. Metod: Studiens design är en allmän litteraturstudie. Den utvalda litteraturen kvalitetsgranskades och analyserades vilket resulterade i en översikt av forskningsfrågan. Resultat: Att bli utsatt för en tvångsåtgärd kan ha både positiva och negativa effekter på måendet. De viktigaste faktorerna för hur tvångsåtgärden upplevs är information, bemötande, kommunikation, delaktighet och relation till personalen. Diskussion: Patienterna verkar i grunden inte vara emot att tvångsåtgärder förekommer och kan förstå att det i vissa situationer är för deras eget bästa. Tillämpandet i praktiken kan dock förbättras för att ge bästa effekt och önskat utfall. Patienterna efterfrågar mer kommunikation, en högre grad av delaktighet och en bättre relation med personalen

Asset Management of Existing Concrete Bridges Using Digital Twins and BIM: a State-of-the-Art Literature Review

The need to optimize investments in bridge maintenance has created a demand for improved bridge management systems (BMS). Outdated practices in bridge inspection and constant advances in information technology have also contributed to this demand. The use of Digital Twins (DT), although well established in other industries, is still incipient for asset management and structural analysis of bridges. There is a great deal of research on Building Information Modelling (BIM) for bridge inspection, but its post-construction potential is still under-explored. This study presents a state-of-the-art review of the literature on asset management for bridges using digital models such as BIM and digital twins. The review was conducting using a systematic approach. Despite the rapid increase in research on DT and the amount of existing research on BIM, several gaps remain to be addressed, such as the lack of consensus about the definition of digital twins, which has led to wrongful categorisation of digital models as DT. The complex data flow and software compatibility required to develop a functional DT have hindered the exploitation of their full potential so far. The integration of BIM post-construction to BMS and existing automation technologies can also significantly improve current practices of bridge management.Asset Management of Existing Concrete Bridges Using Digital Twins and BIM: a State-of-the-Art Literature ReviewpublishedVersio

Remote bridge inspection using optical methods

Routine bridge inspections usually consist of visual observations. These inspections are time-consuming and subjective. There is a need to identify new inspection techniques for infrastructure that reduce traffic disturbance, and improve the efficiency and reliability of the acquired data. This study compared the performance of three different imaging technologies for the three-dimensional (3D) geometric modelling of existing structures: terrestrial laser scanning, close-range photogrammetry, and infrared scanning. Each technology was used to assess six existing concrete railway bridges. The results suggest that all methods investigated can be used to create 3D models, however, with different level of completeness.Remote bridge inspection using optical methodspublishedVersio

Experimental assessment of Textile Reinforced Sprayed Mortar strengthening system for brickwork wallettes

This work explores the feasibility of strengthening masonry with Textile Reinforced Mortar (TRM) by projecting it to save application time. Nineteen tests on masonry samples strengthened with TRM have been carried out to assess this new application method. Different mortars and fibre grids were considered for studying their influence and applicability with this new technique. Three points bending tests have been performed on the specimens to compare the flexural strength between cases with manually applied mortar (TRM) and sprayed application (TRSM) of the mortar layer. It was noticed that the strengthening mortar has a significant influence on the failure mode. Results show a remarkable (between 2 and 6 times more) productivity increase when using TRSM and a load-bearing capacity rise for the cases with larger grid spacing and projectable mortar when using TRSM instead of TRM. Greater ductility values were also observed for the TRSM cases in comparison with the analogue TRM cases (same grid and mortar). (C) 2013 Elsevier Ltd. All rights reserved.Peer ReviewedPostprint (author’s final draft

Shear strengthening of reinforced concrete beams with Hybrid Composite Plates (HCP) technique: experimental research and analytical model

This paper presents a study on the efficiency of Hybrid Composite Plates (HCPs) in enhancing the shear strength and stiffness of reinforced concrete (RC) beams. HCP is a thin plate of Strain Hardening Cementitious Composite (SHCC) reinforced with Carbon Fiber Reinforced Polymer (CFRP) laminates applied to the sides of reinforced concrete beams according to the Near Surface Mounted technique (NSM). Due to the excellent bond conditions between SHCC and CFRP laminates, these reinforcements provide the necessary tensile strength capacity to the HCP. To examine the efficiency of HCPs as a shear strengthening technique, a total of 17 RC beams are tested. Seven of these beams have a rectangular cross-section and ten have a T cross-section. The influence of the percentage and inclination of the CFRP laminates on the shear strengthening effectiveness of HCPs is investigated. Two different processes for applying the HCPs to the beams’ concrete substrate are examined: 1) using epoxy adhesive; and 2) using mechanical anchors in addition to the epoxy adhesive. It is demonstrated that when only epoxy adhesive is used, the shear strengthening contribution of the HCPs is limited by the tensile strength of the concrete substrate of the strengthened beams. When mechanical anchors are applied in addition to the epoxy adhesive, the shear strengthening potential of HCPs is fully mobilized. An analytical model is proposed to predict the shear strength of RC beams strengthened with HCPs. It is demonstrated that the analytical model predicts with good accuracy the shear strength of RC beams strengthened with HCPs.The study reported in this paper is part of the project “PrePam –Pre-fabricated thin panels using advanced materials for structural rehabilitation”, with the reference PTDC/ECM/114511/2009. The first author acknowledges the grant provided by this project

Mumindalen och katastrofhotet – En analys av karaktärerna i Tove Janssons litterära verk Kometen kommer (1968)

Uppsatsen analyserar nio utvalda karaktärer i Tove Janssons skönlitterära verk Kometen kommer (1968). Syftet med studien är att undersöka vilka förhållningssätt som karaktärerna uttrycker i förhållande till katastrofhotet i boken. Studien öppnar upp för en vidare diskussion om hur verket kan användas i undervisningssammanhang för att belysa och diskutera temat katastrofhantering i klassrummet. Uppsatsen har sin teoretiska utgångspunkt i Nikolajevas (2004) karaktärsteori som berör karaktärernas ontologiska status. Vidare utgår analysen från några teoretiska termer beskrivna av litteraturvetarna Nikolajeva (2004) och Kåreland (2015) som redskap i undersökningen. Analysen visar att de analyserade karaktärerna uttrycker varsitt individuellt förhållningssätt gentemot katastrofhotet som leder till diverse motsättningar under berättelsens gång. De olika förhållningssätten leder även till att karaktärerna möter individuella problem som i vissa fall äventyrar deras grundläggande livshållningar. Karaktärernas skilda hållningar leder till att berättelsens handling drivs framåt och nya vägar upptäcks. Janssons verk om kometen från den yttre rymden och hotet om jordens undergång har goda möjligheter att användas i undervisningssammanhang för att belysa och diskutera katastrofhantering i samhället

Concrete walls with cutout openings strengthened by FRP confinement

Redesigning buildings to improve their space efficiency and allow changes in use is often essential during their service lives to comply with shifts in living standards and functional demands. This may require the introduction of new openings in elements such as beams,walls, and slabs, which inevitably reduces their structural performance and hence requires repair or strengthening. However, there are uncertainties regarding both the effects of openings and the best remedial options for them. Here, the authors report on an experimental investigation of the effectiveness of fiber-reinforced polymer (FRP)–based strengthening for restoring the axial capacity of a solid RC wall after cutting openings. Nine half-scale specimens, designed to represent typical wall panels in residential buildings with and without door-type openings, were tested to failure. It was found that FRP-confinement and mechanical anchorages increased the axial capacity of walls with small and large openings (which had 25 and 50% reductions in cross-sectional area, respectively) by 34–50% and 13–27%, to 85–94.8% and 56.5–63.4% of their precutting capacity, respectively.acceptedVersio

Strengthening of concrete structures by the use of mineral based composites : system and design models for flexure and shear

A great number of society's resources are invested in existing concrete structures, such as bridges, tunnels, different kind of buildings etc. All of these structures have both an expected function and an expected life span. However, both the function and the life span can be influenced by external factors, e.g. degradation and altered load situations. Further influencing aspects could be mistakes in design or during the construction phase. Repairing and/or strengthening these structures could maintain or increase the function as well as the life span.To strengthen concrete structures by using adhesively bonded fibres or fibre reinforced polymers (FRP) has been shown to be an excellent way of improving the load bearing capacity. The most common adhesive used for this type of strengthening is epoxies. Unfortunately, there are some drawbacks with the use of epoxy adhesives such as diffusion tightness, poor thermal compatibility with concrete and requirements for a safe working environment which might lead to allergic reactions if proper protective clothing is not used. A further limiting factor is the requirement on the surrounding temperature at application. A commonly recommended minimum temperature at the time for application is 10°C, which makes the preparations regarding application during colder seasons much more complicated. However, some of these drawbacks could be reduced by substituting the epoxy adhesive for a mineral-based bonding agent with similar material properties as concrete.The strengthening system and also the topic of this thesis is termed "mineral-based composites" (MBC). The MBC consists in this context of grids of carbon FRP with high tensile strength that are bonded to an existing concrete surface by the use of a cement based bonding agent.The scientific approach in this thesis includes analytical methods to describe load bearing capacity for the strengthened concrete structure in both flexure and shear. The analytical approaches are then verified against experimental results. Above the theoretical and experimental performance of the MBC system a review of state of the art research has been made in order to collate and map existing mineral-based strengthening systems other than the MBC system.To develop and verify the theoretical models and to compare the performance of the MBC system to other possible designs of mineral-based strengthening systems, six papers are appended in the thesis. - The first paper describes the performance of the MBC system when used in flexural strengthening. The experimental program in this paper consists of a concrete slab strengthened with both the MBC system and epoxy based system. In addition, a parametric study was made on small scale beam specimens to evaluate the performance of using different cement-based bonding agents.- The second paper describes the performance of the MBC system when used as shear strengthening. This study consists of experimental results of 23 reinforced concrete beams with different concrete qualities, internal shear reinforcement ratios together with different variations of the CFRP grid design and mineralbased bonding agents. In addition, a comparison is also made to traditional epoxy-based strengthening. This paper also has an analytical approach to estimate the shear resistance.- The third paper describes existing mineral-based strengthening systems and how these perform in comparison to the proposed MBC strengthening system in shear and flexure.- The fourth paper maps different possibilities to design and combine various materials in order to obtain a mineral-based strengthening system. This paper also consists of experimental research on the tensile behaviour of the MBC system when using high performance fibre reinforced cementitious bonding agents (engineered cementitious composites - ECC). In addition, these results and discussions are also coupled to the observations made in flexural and shear strengthening.- The fifth paper gives suggestions on how to estimate the shear bearing capacity of MBC strengthened concrete beams. The suggested shear design approaches are mainly based on traditional shear design models based on truss analogy, but one design presented is based on the compression field theory.- The sixth and last paper describes the strain development in a shear strengthened concrete beam both with and without the MBC system. All of the results from the investigations made in this thesis indicate that the MBC system contributes to increasing the load bearing capacity for strengthened concrete structures considerably. It is also shown that the MBC system can give competitive strengthening effects compared to existing epoxy bonded strengthening systems. From the experimental investigations on the shear strengthened beams it is shown that the strains in the shear span are lowered compared to a non strengthened specimen. This reduction of strains is also shown in the transition zone between the development of macro cracks from micro cracks. The suggested analytical approach in order to estimate the load bearing capacity of strengthened concrete structures in both flexure and shear indicates that realistic estimations can be made. The flexural design is straightforward while the shear design is more intricate. It is however concluded that a simple and safe design could be made based on the "additional" approach using a 45° truss.En betydande del av samhällets tillgångar är investerade i vår existerande infrastruktur som t ex järnvägsbroar, vägbroar, tunnlar, dammar,, fastigheter etc. En majoritet av dessa konstruktioner är byggda av armerad betong. Samtliga av dessa betongkonstruktioner har både en förväntad funktion och en förväntad livslängd. Men både funktionen och livslängden kan komma att ändras på grund av yttre påverkande faktorer som till exempel nedbrytning och förändrade belastningsförhållanden. Ytterligare kan vara tidiga misstag i projekteringsfasen eller under själva uppförandet. Genom reparation och/eller förstärkning kan både funktion och livslängd hos dessa konstruktioner ofta återställas eller till och med uppgraderas. Förstärkning av betongkonstruktioner genom att limma fast kolfiberväv eller kolfiberkompositer har visat sig vara en bra och tillförlitlig metod för att öka bärförmågan hos befintliga konstruktioner. Det lim som till största delen används vid denna typ av förstärkning är epoxilim. Dessvärre har epoxilim vissa nackdelar, så som diffusionstäthet, dålig termisk kompabilitet med betong och krav på skyddad arbetsmiljö. Ytterligare en begränsande faktor är kravet på omgivande temperatur vid limning. Vissa av dessa nackdelar kan reduceras genom att byta ut epoxilimmet mot en mineralbaserad vidhäftningsprodukt med egenskaper liknande betongens.Förstärkningssystemet som omfattas av denna avhandling har benämningen "mineralbaserade kompositer" (MBC) och omfattar kolfibernät med hög draghållfasthet som fästs på befintlig betongkonstruktion med ett cementbaserat bruk.Det vetenskapliga förfarandet i denna avhandling omfattar analytiska metoder för att beskriva bärförmågan för den förstärkta betongkonstruktionen i både böjning och tvärkraft. De analytiska metoderna är sedan verifierade mot laboratorieförsök. Utöver de teoretiska och experimentella resultaten för MBC systemet så ingår även en aktuell granskning och kartläggning av existerande mineralbaserade förstärkningssystem och därmed möjliga materialkombinationer och utformningar, dvs. andra än MBC systemet.Avhandlingen består av en litteraturstudie och sex bifogade artiklar.Den första artikeln beskriver hur MBC system uppför sig vid förstärkning i böjning. I denna artikel ingår provning av en större betongplatta som förstärkts med MBC systemet och epoxibaserade system samt en parametersstudie på småskaliga provkroppar med MBC systemet och olika cementbaserade bruk.Den andra artikeln beskriver hur förstärkningssystemet presterar vid förstärkning i tvärkraft. Denna studie omfattar experimentella resultat på 23 balkar med olika betongkvalitéer, armeringsmängd samt olika variationer av MBC systemet och jämförelse mot traditionell epoxibaserad förstärkning. Dessutom innehåller denna artikel en analytisk uppskattning av tvärkraftskapaciteten.Den tredje artikeln beskriver olika existerande förstärkningssystem och hur dessa presterar i jämförelse med MBC systemet i böjning och tvärkraft.Den fjärde artikeln kartlägger olika möjligheter till att kombinera material i mineralbaserade förstärkningssystem för att optimera dessa system. Dessutom ingår även experimentella försök med ett högpresterande fiberförstärkt cementbruk (ECC). Denna artikel omfattar även resultat och diskussion om MBC systemets beteende i enaxligt drag, brottenergiupptagande förmåga samt hur dessa observationer kopplas till iakttagelser i böj- och tvärkraftsförstärkning.Den femte artikeln behandlar en rekommendation till dimensionering för tvärkraft av MBC systeme baserat på traditionella dimensioneringsmetoder med fackverksteori samt en ny tillämpning baserat på tryckfältsteori.Det sjätte bidraget beskriver hur töjningsutvecklingen sker i tvärkraft för betongbalkar med och utan MBC systemet.Resultaten från dessa undersökningar indikerar på att MBC systemet bidrar till att öka bärförmågan hos förstärkta betongelement och att denna ökning kan i vissa avseenden jämföras mot epoxibaserad förstärkning. Det är även visat att MBC systemet, i tvärkraftsförstärkning, bidrar till att minska töjningar i det armerade betongtvärsnittet i övergångszonen mellan tillväxten av mikrosprickor till makro sprickor samt att töjningarna reduceras även under öppningen av makrosprickor. Analytiska metoder för att uppskatta bärförmåga för förstärkning i böjning och tvärkraft är redovisade och dessa indikerar på att realistiska uppskattningar är möjliga. Dimensionering av bärförmågan i böjning är relativt enkel medan dimensionering i tvärkraft är lite mer komplicerad. En av slutsatserna gällande tvärkraftsdimensioneringen är att det är möjligt på ett enkelt sätt använda befintliga dimensionerings anvisningar grundade i "additions" principen för att uppnå en säker uppskattning av bärförmågan i tvärkraft.Godkänd; 2009; 20090313 (thojoh); DISPUTATION Ämnesområde: Konstruktionsteknik Opponent: Professor Thanasis C Triantafillou, University of Patras, Grekland Ordförande: Professor Björn Täljsten, Technical University of Denmark och Luleå tekniska universitet Tid: Fredag den 24 april 2009, kl 10.00 Plats: F 1031, Luleå tekniska universite

Strengthening of concrete structures by the use of mineral based composites

Strengthening of concrete structures with epoxy bonded carbon fiber reinforced polymers (CFRP) has been proved to be an excellent strengthening technique. However, using epoxy adhesives for bonding do contain some disadvantages such as diffusion closeness, thermal incompatibility to the base concrete, regulations regarding the working environment and minimum application temperature. Some of these drawbacks can be lessened by substituting the epoxy to a polymer reinforced mortar as the bonding agent. A new acronym for strengthening concrete structures with CFRP and polymer reinforced mortars is introduced, mineral based composites (MBC). This thesis presents experimental tests for both flexural strengthening and shear strengthening techniques using CFRP grids and polymer modified mortar as the bonding agent are presented. Flexural strengthening using the MBC system was designed as a pilot study to evaluate suitability of different mortars with different mechanical properties. The outcome of the pilot study on flexural strengthened small scale concrete beams gave indications on the choice of mortar used in the MBC system. A total amount of 21 concrete beams with and without shear strengthening subjected to four-point bending is evaluated in the thesis. The concrete beams were 4.5 m long and had a rectangular cross section of 180 x 500 mm. A number of parameters were varied for these beam specimens namely; concrete strength, shear reinforcement design, mortar properties, grid design and the addition of flexural strengthening using Near Surface Mounted Reinforcement (NSMR). Considering the steel shear reinforcement, three different variations were utilized; no shear reinforcement, a stirrup distance of 250 mm and 350 mm respectively. The results from the experimental study of the shear capacity using MBC on beams with no shear reinforcement indicates that strengthening concrete structures with the MBC system has competitive properties compared to epoxy bonded strengthening techniques. The MBC system reached 97% of the ultimate load achieved by a strengthening system with vertically applied epoxy bonded carbon fibre sheets. The ultimate failure load was increased with the increase of carbon fibre amount in the grid. Using a grid with small distance between the CFRP tows generated a higher first visible shear crack load. A simplified analytical design proposal to estimate the shear resistance contribution of the MBC strengthening system is proposed in the thesis. Reasonable results were obtained compared to experimental ultimate failure loads. Strains were monitored in the longitudinal steel reinforcement and the steel stirrups for the beams with internal steel shear reinforcement. Here it as clear that the use of the MBC strengthening system reduces the strains in the steel stirrups. Further, photmetric strain measurement on the surface of the strengthening system was also assessed. The use of the MBC strengthening system also reduces the prinicpal strain at the surface of the shear strengthening system. It can be concluded that the MBC strengthening system has great potentials to strengthen concrete structures. Further research are however needed in both development of the materials includedGodkänd; 2007; 20070309 (pafi

Axially Loaded RC Walls with Cutout Openings Strengthened with FRCM Composites

Abstract: Upgrading existing buildings to new functional requirements may require new openings that can weaken the structure, prompting the need for strengthening. In such cases traditional strengthening solutions, such as creating a reinforced concrete (RC) or steel frame around the opening, imply long-term restrictions in the use of the structure compared to solutions that use externally bonded composites. Two fabricreinforced cementitious matrix (FRCM) composites were used in this study to restore the capacity of panels with newly created door type openings to that of a solid panel. Five half-scale RC panels acting as two-way action compression members were tested to failure. Two full-field optical deformation measurement systems were used to monitor and analyze the global structural response of each tested panel (i.e., crack pattern, failure mechanism, and displacement/strain fields). The performance of existing design methods for RC panels has been assessed in comparison with the experimental results. The capacity of strengthened panels with small openings (450 × 1,050 mm)was entirely restored to that of the solid panel. However, for panels with large openings (900 × 1,050 mm), only 75% of the solid panel’s capacity was restored. The capacity of the strengthened panels was about 175 and 150% higher compared to that of reference panels with small and large openings, respectively.Axially Loaded RC Walls with Cutout Openings Strengthened with FRCM CompositesacceptedVersio