119 research outputs found
An ontology-based nurse call management system (oNCS) with probabilistic priority assessment
<p>Abstract</p> <p>Background</p> <p>The current, place-oriented nurse call systems are very static. A patient can only make calls with a button which is fixed to a wall of a room. Moreover, the system does not take into account various factors specific to a situation. In the future, there will be an evolution to a mobile button for each patient so that they can walk around freely and still make calls. The system would become person-oriented and the available context information should be taken into account to assign the correct nurse to a call.</p> <p>The aim of this research is (1) the design of a software platform that supports the transition to mobile and wireless nurse call buttons in hospitals and residential care and (2) the design of a sophisticated nurse call algorithm. This algorithm dynamically adapts to the situation at hand by taking the profile information of staff members and patients into account. Additionally, the priority of a call probabilistically depends on the risk factors, assigned to a patient.</p> <p>Methods</p> <p>The <it>ontology-based Nurse Call System (oNCS) </it>was developed as an extension of a <it>Context-Aware Service Platform</it>. An ontology is used to manage the profile information. Rules implement the novel nurse call algorithm that takes all this information into account. Probabilistic reasoning algorithms are designed to determine the priority of a call based on the risk factors of the patient.</p> <p>Results</p> <p>The <it>oNCS </it>system is evaluated through a prototype implementation and simulations, based on a detailed dataset obtained from Ghent University Hospital. The arrival times of nurses at the location of a call, the workload distribution of calls amongst nurses and the assignment of priorities to calls are compared for the <it>oNCS </it><it>system </it>and the current, place-oriented nurse call system. Additionally, the performance of the system is discussed.</p> <p>Conclusions</p> <p>The execution time of the nurse call algorithm is on average 50.333 ms. Moreover, the <it>oNCS system </it>significantly improves the assignment of nurses to calls. Calls generally have a nurse present faster and the workload-distribution amongst the nurses improves.</p
Temporal Artery versus Bladder Thermometry during Adult Medical-Surgical Intensive Care Monitoring: An Observational Study
Abstract
Background
We sought to evaluate agreement between a new and widely implemented method of temperature measurement in critical care, temporal artery thermometry and an established method of core temperature measurement, bladder thermometry as performed in clinical practice.
Methods
Temperatures were simultaneously recorded hourly (n = 736 observations) using both devices as part of routine clinical monitoring in 14 critically ill adult patients with temperatures ranging â„1°C prior to consent.
Results
The mean difference between temporal artery and bladder temperatures measured was -0.44°C (95% confidence interval, -0.47°C to -0.41°C), with temporal artery readings lower than bladder temperatures. Agreement between the two devices was greatest for normothermia (36.0°C to < 38.3°C) (mean difference -0.35°C [95% confidence interval, -0.37°C to -0.33°C]). The temporal artery thermometer recorded higher temperatures during hypothermia (< 36°C) (mean difference 0.66°C [95% confidence interval, 0.53°C to 0.79°C]) and lower temperatures during hyperthermia (â„38.3°C) (mean difference -0.90°C [95% confidence interval, -0.99°C to -0.81°C]). The sensitivity for detecting fever (core temperature â„38.3°C) using the temporal artery thermometer was 0.26 (95% confidence interval, 0.20 to 0.33), and the specificity was 0.99 (95% confidence interval, 0.98 to 0.99). The positive likelihood ratio for fever was 24.6 (95% confidence interval, 10.7 to 56.8); the negative likelihood ratio was 0.75 (95% confidence interval, 0.68 to 0.82).
Conclusions
Temporal artery thermometry produces somewhat surprising disagreement with an established method of core temperature measurement and should not to be used in situations where body temperature needs to be measured with accuracy
PatientnÀrmre vÄrd: En observationsstudie av sjuksköterskans tid för patientnÀra vÄrd
Instrumento de medida de carga de trabalho dos profissionais de SaĂșde na Atenção PrimĂĄria: desenvolvimento e validação
Use of patientsâ classification instruments: analysis of the brazilian production of knowledge
Objective To analyze the production of scientific knowledge about the use of patientsâ classification instruments in care and management practice in Brazil. Method Integrative literature review with databases search in: Latin American and Caribbean Literature on Health Sciences (LILACS), Medical Literature Analysis and Retrieval System on-line (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and SCOPUS, between January 2002 through December 2013. Results 1,194 studies were found, 31 met the inclusion criteria. We observed a higher number of studies in the category care plans and workload (n=15), followed by the category evaluation of psychometric properties (n=14). Conclusion Brazilian knowledge production has not yet investigated some purposes of using instruments for classifying patients in professional nursing practice. The identification of unexplored areas can guide future research on the topic
Organic Digital Circuits by Technology Improvement and Robust Digital Design (Organische digitale schakelingen door technologieverbeteringen en robuust digitaal ontwerp)
Thin-film transistors are omnipresent in our daily lives mostly acting as switches in an active matrix for displays. This dissertation focuses mainly on the integration of such thin-film transistors in digital circuits targeting future applications that require large area or flexible substrates. The first chapter makes a comparison between different thin-film transistor technologies. Amongst these, organic and metal-oxide transistors are two next-generation technology candidates that can be fabricated at low process temperatures yielding good performance.
The integration of these technologies into basic logic gates can be done usingunipolar or complementary logic families. Unipolar technologies have only one semiconductor type available, while a complementary technology combines p-transistors with n-transistors. In case of unipolar technologies, we can distinguish between zero-VGS-load logic and diode-load logic. Both unipolar topologies exhibit a limited noise margin compared to complementary logic. This noise margin can be improved by utilizing dual-gate transistors that enable the availability of multiple threshold voltages. Complementary logic results in the best circuit metrics, both from static and dynamic point of view. The second best option, especially from static point of view, is dual-gate zero-VGS-load logic.
Organic and metal-oxide transistors suffer from a certain parameter variability that finally limits the circuit s integration density. Designs can cope with such parameter variation. In this work, we have performed Monte Carlo simulations to evaluate within-die variations and estimate the circuit s yield. Moreover, corner analysis can be performed taking into accountdie-to-die variation. For dual-gate technologies, the back gate can be used as adaptive back-gate control for threshold voltage compensation, both to take within-die and die-to-die variation into account.
Finally, we have elaborated in this work on two design cases: the first onebeing low-cost, item-level RFID tags and the second one an 8-bit organic microprocessor. The goal of the first design case is to demonstrate that, despite the lower intrinsic performance of organic and metal-oxide electronics, plastic RFID tags could meet specifications and requirementsset for monocrystalline silicon based RFID tags. The second case details an 8-bit microprocessor on foil that has been designed using a gate-level design flow, as a consequence of the choice of logic type being robust dual-gate zero-VGS-load logic gates.status: publishe
Large scale integration of flexible non-volatile, re-addressable memories using P(VDF-TrFE) and amorphous oxide transistors
Ferroelectric polymers and amorphous metal oxide semiconductors have emerged as important materials for re-programmable non-volatile memories and high-performance, flexible thin-film transistors, respectively. However, realizing sophisticated transistor memory arrays has proven to be a challenge, and demonstrating reliable writing to and reading from such a large scale memory has thus far not been demonstrated. Here, we report an integration of ferroelectric, P(VDF-TrFE), transistor memory arrays with thin-film circuitry that can address each individual memory element in that array. n-type indium gallium zinc oxide is used as the active channel material in both the memory and logic thin-film transistors. The maximum process temperature is 200 °C, allowing plastic films to be used as substrate material. The technology was scaled up to 150 mm wafer size, and offers good reproducibility, high device yield and low device variation. This forms the basis for successful demonstration of memory arrays, read and write circuitry, and the integration of these
Large scale integration of flexible non-volatile, re-addressable memories using P(VDF-TrFE) and amorphous oxide transistors
Ferroelectric polymers and amorphous metal oxide semiconductors have emerged as important materials for re-programmable non-volatile memories and high-performance, flexible thin-film transistors, respectively. However, realizing sophisticated transistor memory arrays has proven to be a challenge, and demonstrating reliable writing to and reading from such a large scale memory has thus far not been demonstrated. Here, we report an integration of ferroelectric, P(VDF-TrFE), transistor memory arrays with thin-film circuitry that can address each individual memory element in that array. n-type indium gallium zinc oxide is used as the active channel material in both the memory and logic thin-film transistors. The maximum process temperature is 200 °C, allowing plastic films to be used as substrate material. The technology was scaled up to 150 mm wafer size, and offers good reproducibility, high device yield and low device variation. This forms the basis for successful demonstration of memory arrays, read and write circuitry, and the integration of these. cop. 2015 IOP Publishing Ltd
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