Model-based design of a pseudo-cogenerative heating system for e-boat battery cold start

Full-electric boats are an expression of recent advancements in the area of vessel electrifi-cation. The installed batteries can suffer from poor cold-start performance, especially in the frigid season and at higher latitudes, leading to driving power limitations immediately after startup. At state, the leading solution is to adopt a dedicated heater placed on the common cooling/heating circuit; this implies poor volume, weight, and cost figures, given the very limited duty cycle of such a part. The Heater-in-Converter (HiC) technology allows removing this specialized component, ex-ploiting the power electronics converters already available on board: HiC modulates their efficiency to produce valuable heat (pseudo-cogeneration). In this work, we use the model-based approach to design this system, which requires heating power minimization to fulfill power electronics limitations, while guaranteeing the user-expected startup time to full power. A multistage model is used to get the yearly vessel temperature distribution from latitude information and some additional data. Then, a lumped parameter for the cooling/heating circuit is used to determine the minimum required power as a function of the properties of the thermal interface material used for the battery coupling. The design is validated on a 1:5 test bench (battery power and energy), which demonstrates how the technology can be to scaled up to also fit different boats and battery sizes

Pressure injury progression and factors associated with different end-points in a home palliative care setting : a retrospective chart review study

CONTEXT: Patients with advanced illnesses show the highest prevalence for pressure injuries. In the palliative care setting, the ultimate goal is injury healing, but equally important is wound maintenance, wound palliation (wound-related pain and symptom management), and primary and secondary wound prevention. OBJECTIVES: To describe the course of healing for pressure injuries in a home palliative care setting according to different end-points, and to explore patient and caregiver characteristics and specific care activities associated with their achievement. METHODS: Four-year retrospective chart review of 669 patients cared for in a home palliative care service, of those 124 patients (18.5%) had at least one pressure injury with a survival rate less than or equal to six months. RESULTS: The proportion of healed pressure injuries was 24.4%. Of the injuries not healed, 34.0% were in a maintenance phase, whereas 63.6% were in a process of deterioration. Body mass index (P = 0.0014), artificial nutrition (P = 0.002), and age <70 years (P = 0.022) emerged as predictive factors of pressure injury complete healing. Artificial nutrition, age, male caregiver (P = 0.034), and spouse (P = 0.036) were factors significantly associated with a more rapid pressure injury healing. Continuous deep sedation was a predictive factor for pressure injury deterioration and significantly associated with a more rapid worsening. CONCLUSION: Pressure injury healing is a realistic aim in home palliative care, particularly for injuries not exceeding Stage II occurring at least two weeks before death. When assessing pressure injuries, our results highlight the need to also pay attention to artificial nutrition, continuous deep sedation, and the caregiver's role and gender

Condizioni di lavoro e intenzione di cambiare: risultati dello studio europeo Next in Italia

Introdution The nursing shortage is an increasing problem worldwide. The Nurses\u2019 Early Exit Study (NEXT) is aimed at investigating the reasons of premature departure from the nursing profession in 10 european countries including Italy. The present paper illustrates the main results concerning the Italian sample. Materials and methods: 56.406 registered nurses from the ten participant European countries filled in the questionnaires of the longitudinal investigation. Comparisons of the Italian socio-demographic characteristics and working conditions with that of the other European samples were performed. By means of multivariate linear regression analysis, the worse working conditions during the years 2002-2003 were examined in relation to health, well being and intent to leave during the years 2003-2004 . The risk to develop the intent to change ward/service or institution was evaluated by estimation of the odd-ratios. Results: Difficulties in asserting professional autonomy inside health institutions result from Italian investigation as the main reason of dissatisfaction and intent to change workplace or profession, particularly for the younger staff. Discussion: The results are explained in the framework of current theories that ascribes the responsibility of sustaining personnel autonomy to the organizations in order to maintain and improve their motivation, health and well being. Conclusion: Actions should be taken by institutions to ensure this right. Further reasearche could be useful to direct and sustain mentoring activities during younger nurses\u2019working practice

Lightweight dynamic vehicle models oriented to vehicle electrification

The paper deals with the development of fast and lightweight vehicle dynamics models oriented to the vehicle electrification. Two models are created, as they are concerned with different accuracy levels. The first one is very essential: it consists of three dynamics, that is full vehicle, front wheels and rear wheels; regularised Coulomb friction model is adopted. The second model is more advanced since it comprehends the vertical dynamics due to the suspension system and tyre friction model comes from Pacejka’s theory. The dynamics models are subsequently compared with a very sophisticated and accurate model developed thanks to Chrono::Engine (C::E): because C::E is a powerful and reliable software, this process can be considered as a first validation of the more essential vehicle descriptions. Afterwards, models are connected to an electric powertrain to evaluate the effects of the different mechanical models with respect to the same electric system; this also aims to estimate the characteristic quantities of the electric domain

Gli outcomes dell'assistenza infermieristica: progettazione di un sistema di valutazione in area intensiva=The nursing outcomes: a project for an evaluation system in critical care

Scopo: elaborare un sistema di valutazione degli outcomes raggiunti sui pazienti dell\u2019area intensiva mediante l\u2019integrazione del Modello delle Prestazioni Infermieristiche e della Nursing Outcomes Classification (NOC). Metodo: lo studio, di tipo quali-quantitativo, \ue8 stato realizzato mediante la somministrazione di due questionari nei quali si chiedeva ai partecipanti di identificare i problemi di salute dei pazienti e gli interventi infermieristici ritenuti pi\uf9 frequenti in area intensiva, secondo il Modello delle Prestazioni Infermieristiche e di scegliere dalla NOC gli esiti congruenti con le competenze infermieristiche acquisite nel contesto formativo, con la pratica infermieristica in ambito clinico, con la tipologia dei pazienti e il contesto. In seguito, ciascuna scala Likert associata ai NOC selezionati \ue8 stata rielaborata ex novo, integrata dalla definizione di ciascun livello di compromissione e testata per affidabilit\ue0 mediante la statistica K di Cohen. Risultati: sono stati identificati 40 problemi di salute del paziente, 352 atti infermieristici, 28 NOC e sono state rielaborate ex novo 33 scale Likert, testate per affidabilit\ue0 su 61 pazienti (1 = K > 0,80; I.C. 95%). Questo studio ha permesso di elaborare un set di esiti condivisi, aderenti al contesto dell\u2019area intensiva, espresso con un unico linguaggio e fruibile mediante la documentazione infermieristica informatizzata. Conclusioni: il nuovo sistema di documentazione dell\u2019assistenza infermieristica rappresenta, per l\u2019area intensiva, un avanzamento rispetto alla situazione precedente poich\ue9 caratterizzato dall\u2019identificazione del problema di salute del paziente, dalla scelta degli atti orientati alla risoluzione del problema e dalla pianificazione dei risultati, mediante l\u2019uso di scale di valutazione.Aim: to develop an assessment tool of nursing care outcomes in critical care combining the Performance Nursing Model and the Nursing Outcomes Classification (NOC). Methods. A qualitative and quantitative study was realized through the administration of two questionnaires. Participants were asked to identify patients\u2019 health problems and the most frequent nursing interventions in critical care, according to the Performance Nursing Model and to choose among the NOC which outcomes were congruent with nursing skills acquired during the training environment, with nursing practice in the clinical setting, with the type of patients and the context. Consequently, each Likert scale associated with the selected NOC was reprocessed from start, integrated with the definition of each level of impairment and tested for reliability, by using Cohen\u2019s K statistics. Results: 40 health problems, 352 nursing actions, 28 NOC were identified and reprocessed from start, 33 Likert scales were tested for reliability on 61 patients (1 = K> 0.80, 95% CI). This study allowed us to develop a set of shared outcomes, adhering to the context of critical care, expressed with a common language and accessible through computerized nursing documentation. Conclusions: the new system of documentation of nursing care represents an improvement in critical care nursing. It is characterized by the identification of the health problem, the choice of actions aimed to the resolution of the problem and the planning of the results with the use of rating scales