LEÓN, JOSÉ CLAUDIO DE Y SRA. [Material gráfico]

Copia digital. Madrid : Ministerio de Educación, Cultura y Deporte, 201

The need for nursing instruction in patients receiving steroid pulse therapy for the treatment of autoimmune diseases and the effect of instruction on patient knowledge

<p>Abstract</p> <p>Background</p> <p>Many patients who receive steroid pulse therapy go home the same day or the day after steroid administration. Nursing instructions are important for improving patient knowledge related to their diseases and treatments, but the short hospital stay often prevents complete education and guidance regarding the given therapy. The purpose of this study was to investigate the need for nursing instruction in patients receiving steroid pulse therapy for the treatment of autoimmune diseases and the effect of instruction on patient knowledge of their disease and treatment.</p> <p>Methods</p> <p>Patients with systemic lupus erythematosus (SLE) and systemic sclerosis receiving steroid pulse therapy (N = 63) were recruited from a medical center in Taipei. A structured questionnaire was used for data collection before and after nursing instruction, and 1 week as well as 2 weeks after therapy. The need for nursing instruction and knowledge levels were validated using Cronbach's α reliability test.</p> <p>Results</p> <p>There was a significant difference (<it>P </it>< 0.001) in the need for nursing instruction among the 4 time points. There was a positive correlation between the need for nursing instruction and body weight change, frequency of treatment, and distress, but there was a negative correlation with knowledge level (β = -0.012, <it>P </it>= 0.003) regarding symptoms. The knowledge level of subjects after nursing instruction was significantly higher than before nursing instruction (80 ± 14.31 vs. 70.06 ± 17.23, <it>P </it>< 0.001).</p> <p>Conclusions</p> <p>This study indicates that nursing instruction is needed by patients receiving steroid pulse therapy, and that by designing and administering nursing instructions according to the priority of patient symptoms, nurses can improve patient knowledge related to their diseases and treatments. In addition, the need for nursing instruction can be affected by patient characteristics.</p

Bi-objective robust optimization of machined surface quality and productivity under vibrations limitation

In this contribution, a bi-objective robust optimization of cutting parameters, with the taking into account uncertainties inherent in the tool wear and the tool deflection for a turning operation is presented. In a first step, we proceed to the construction of substitution models that connect the cutting parameters to the variables of interest based on design of experiments. Our two objectives are the best machined surface quality and the maximum productivity under consideration of limitations related to the vibrations and the range of the three cutting parameters. Then, using the developed genetic algorithm that based on a robust evaluation mechanism of chromosomes by Monte-Carlo simulations, the influence and interest of the uncertainties integration in the machining optimization is demonstrated. After comparing the classical and robust Pareto fronts, A surface quality less efficient but robust can be obtained with the consideration of uncontrollable factors or uncertainties unlike that provides the deterministic and classical optimization for the same values of productivity

Bi-objective robust optimization of machined surface quality and productivity under vibrations limitation

International audienc