3,237 research outputs found
A Model of Partnership Formation with Friction and Multiple Criteria
We present a model of partnership formation based on two discrete character traits. There are two classes of individual. Each individual observes a sequence of potential partners from the other class. The traits are referred to as attractiveness and character, respectively. All individuals prefer partners of high attractiveness and similar character. Attractiveness can be measured instantly. However, in order to observe the character of an individual, a costly interview (or date) is required. On observing the attractiveness of a prospective partner, an individual must decide whether he/she wishes to proceed to the interview stage. During the interview phase, the prospective pair observe each other's character and then decide whether they wish to form a pair. Mutual acceptance is required for both an interview to occur and a pair to form. An individual stops searching on nding a partner. A set of criteria based on the concept of a subgame perfect Nash equilibrium is used to define an equilibrium of this game. It is argued that under such a general formulation there may be multiple equilibria. For this reason, we define a specific formulation of the game, the so called symmetric version, which has a unique symmetric equilibrium. The form of this equilibrium has some similarities to the block separating equilibrium derived for classical models of two-sided mate choice and job search problems, but is essentially different.mutual mate choice, game theory, common preferences, homotypic preferences, subgame perfect equilibrium
Uplift Quadratic Program in Irish Electricity Price Setting
Bord Gis required a deeper insight into the dynamics of Uplift prices. The aim of the group was to apply a variety of analytical tools to the problem in order to satisfy Bord Gis requirements. The group conducted a KKT Optimality Analysis of the quadratic program used to determine the Uplift prices, performed statistical analysis to identify the binding constraints and their sensitives to the Uplift prices, simulated a synthetic stochastic process that is consistent with the Uplift pricing series and investigated alternative objective functions for the quadratic program
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Ejection Forces and Friction Coefficients from Injection Molding Experiments Using Rapid Tooling Inserts
Experiments have been performed with injection mold inserts made using solid freeform
fabrication processes in an effort to further study such applications for economic production of
small quantities of parts. Static friction coefficients were determined for HDPE and HIPS against
P-20 steel, sintered LaserForm ST-100, and stereolithography SL 5170 using the ASTM D 1894
standard. Injection mold inserts were constructed of the same three materials and were used to
inject cylindrical parts using HDPE and HIPS. Ejection forces were measured, and a model was
used to calculate ejection forces and apparent coefficients of static friction. Statistical analyses
were used to determine the effects of packing time, cooling time and packing pressure on
ejection force for the three insert types. This paper compares experimental and calculated
ejection forces, compares standard friction test results to calculated apparent coefficients of
friction, summarizes the statistical results, and comments on the feasibility of using rapid tooled
inserts for injection molding.Mechanical Engineerin
Investigation in haemodynamic stability during intermittent haemodialysis in the critically ill
No abstract available
An investigation into the effects of commencing haemodialysis in the critically ill
<b>Introduction:</b>
We have aimed to describe haemodynamic changes when haemodialysis is instituted in the critically ill. 3
hypotheses are tested: 1)The initial session is associated with cardiovascular instability, 2)The initial session is
associated with more cardiovascular instability compared to subsequent sessions, and 3)Looking at unstable
sessions alone, there will be a greater proportion of potentially harmful changes in the initial sessions compared
to subsequent ones.
<b>Methods:</b>
Data was collected for 209 patients, identifying 1605 dialysis sessions. Analysis was performed on hourly
records, classifying sessions as stable/unstable by a cutoff of >+/-20% change in baseline physiology
(HR/MAP). Data from 3 hours prior, and 4 hours after dialysis was included, and average and minimum values
derived. 3 time comparisons were made (pre-HD:during, during HD:post, pre-HD:post). Initial sessions were
analysed separately from subsequent sessions to derive 2 groups. If a session was identified as being unstable,
then the nature of instability was examined by recording whether changes crossed defined physiological ranges.
The changes seen in unstable sessions could be described as to their effects: being harmful/potentially harmful,
or beneficial/potentially beneficial.
<b>Results:</b>
Discarding incomplete data, 181 initial and 1382 subsequent sessions were analysed. A session was deemed to
be stable if there was no significant change (>+/-20%) in the time-averaged or minimum MAP/HR across time
comparisons. By this definition 85/181 initial sessions were unstable (47%, 95% CI SEM 39.8-54.2). Therefore
Hypothesis 1 is accepted. This compares to 44% of subsequent sessions (95% CI 41.1-46.3). Comparing these
proportions and their respective CI gives a 95% CI for the standard error of the difference of -4% to 10%.
Therefore Hypothesis 2 is rejected. In initial sessions there were 92/1020 harmful changes. This gives a
proportion of 9.0% (95% CI SEM 7.4-10.9). In the subsequent sessions there were 712/7248 harmful changes.
This gives a proportion of 9.8% (95% CI SEM 9.1-10.5). Comparing the two unpaired proportions gives a
difference of -0.08% with a 95% CI of the SE of the difference of -2.5 to +1.2. Hypothesis 3 is rejected. Fisher’s
exact test gives a result of p=0.68, reinforcing the lack of significant variance.
<b>Conclusions:</b>
Our results reject the claims that using haemodialysis is an inherently unstable choice of therapy. Although
proportionally more of the initial sessions are classed as unstable, the majority of MAP and HR changes are
beneficial in nature
Physical outcome measure for critical care patients following intensive care discharge
Introduction: The aim of this study was to evaluate the most suitable
physical outcome measures to be used with critical care patients following
discharge. ICU survivors experience physical problems
such as reduced exercise capacity and intensive care acquired
weakness. NICE guideline ‘Rehabilitation after critical illness’ (1) recommends
the use of outcome measures however does not provide
any specific guidance. A recent Cochrane review noted wide variability
in measures used following ICU discharge (2).
Methods: Discharged ICU patients attended a five week multidisciplinary
programme. Patients’ physical function was assessed during
the programme, at 6 months and 12 months post discharge. Three
outcome measures were included in the initial two cohorts. The Six
Minute Walk Test (6MWT) and the Incremental Shuttle Walk test
(ISWT) were chosen as they have been used within the critical care
follow up setting (2). The Chester Step Test (CST) is widely thought
to be a good indicator of ability to return to work (one of the programmes
primary aims). Ethics approval was waived as the
programme was part of a quality improvement initiative.
Results: Data was collected for the initial patients attending the
programme (n = 13), median age was 52 (IQR = 38-72), median ICU
LOS was 19 days (IQR = 4-91), median APACHE II was 23 (IQR = 19-41)
and 11 were men. One patient was so physically debilitated that the
CST or ISWT could not be completed however a score was achieved
using the 6MWT. Another patient almost failed to achieve level 1 of
the ISWT. Subsequent patients for this project (total n = 47) have all
therefore been tested using the 6MWT. Good inter-rater and intrarater
reliability and validity have been reported for the 6MWT (3).
Conclusions: Exercise capacity measurement is not achievable for
some patients with either the ISWT or the CST due to the severity of
their physical debilitation. Anxiety, post-traumatic stress disorder and
depression are common psychological problems post discharge (4),
therefore using a test with a bleep is not appropriate. Therefore, the 6MWT is the most appropriate physical outcome measure to be used
with critical care patients post discharge
Classification of pain and its treatment at an intensive care rehabilitation clinic
Introduction
Treatment in an Intensive Care Unit (ICU) often necessitates uncomfortable
and painful procedures for patients throughout their admission.
There is growing evidence to suggest that chronic pain is
becoming increasingly recognised as a long term problem for patients
following an ICU admission [1]. Intensive Care Syndrome: Promoting
Independence and Return to Employment (InS:PIRE) is a five
week rehabilitation programme for patients and their caregivers after
ICU discharge at Glasgow Royal Infirmary. This study investigated the
incidence and location of chronic pain in patients discharged from ICU
and classified the analgesics prescribed according to the World Health
Organization analgesic
Methods
The InS:PIRE programme involved individual sessions for patients and
their caregivers with a physiotherapist and a pharmacist along with
interventions from medical, nursing, psychology and community services.
The physiotherapist documented the incidence and pain location
during the assessment. The pharmacist recorded all analgesic medications
prescribed prior to admission and at their clinic visit. The patient’s
analgesic medication was classified according to the WHO pain ladder
from zero to three, zero being no pain medication and three being
treatment with a strong opioid. Data collected was part of an evaluation
of a quality improvement initiative, therefore ethics approval was
waived.
Results
Data was collected from 47 of the 48 patients who attended the rehabilitation
clinic (median age was 52 (IQR, 44-57) median ICU LOS
was 15 (IQR 9-25), median APACHE II was 23 (IQR 18-27) and 32 of
the patients were men (67 %)). Prior to admission to ICU 43 % of patients
were taking analgesics and this increased to 81 % at the time
of their clinic visit. The number of patients at step two and above on
the WHO pain ladder also increased from 34 % to 56 %.
Conclusions
Of the patients seen at the InS:PIRE clinic two-thirds stated that they
had new pain since their ICU admission. Despite the increase in the
number and strength of analgesics prescribed, almost a quarter of
patients still complained of pain at their clinic visit. These results confirm
that pain continues to be a significant problem in this patient
group. Raising awareness in primary care of the incidence of chronic
pain and improving its management is essential to the recovery
process following an ICU admission
The incidence, severity, timing and circadian variation of hypophosphataemia in Glasgow Royal Infirmary Intensive Care Unit [poster]
No abstract available
Explaining anomalous responses to treatment in the Intensive Care Unit
The Intensive Care Unit (ICU) provides treatment to critically ill patients. When a patient does not respond as expected to such treatment it can be challenging for clinicians, especially junior clinicians, as they may not have the relevant experience to understand the patient’s anomalous response. Datasets for 10 patients from Glasgow Royal Infirmary’s ICU have been made available to us. We asked several ICU clinicians to review these datasets and to suggest sequences which include anomalous or unusual reactions to treatment. Further, we then asked two ICU clinicians if they agreed with their colleagues’ assessments, and if they did to provide possible explanations for these anomalous sequences. Subsequently we have developed a system which is able to replicate the clinicians’ explanations based on the knowledge contained in its several ontologies; further the system can suggest additional explanations which will be evaluated by the senior consultant
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