Automated patient monitoring system

Radio-linked patient monitoring system collects several channels of physiological data from as many as 64 hospital patients and transmits the data in digital form to a central control station. The system consists of a central control station and battery-operated patient units comprising small strap-on electronics packages

Assessing the impact of health technology assessment in the Netherlands

Copyright © Cambridge University Press 2008Objectives: Investments in health research should lead to improvements in health and health care. This is also the remit of the main HTA program in the Netherlands. The aims of this study were to assess whether the results of this program have led to such improvements and to analyze how best to assess the impact from health research.Methods: We assessed the impact of individual HTA projects by adapting the "payback framework" developed in the United Kingdom. We conducted dossier reviews and sent a survey to principal investigators of forty-three projects awarded between 2000 and 2003. We then provided an overview of documented output and outcome that was assessed by ten HTA experts using a scoring method. Finally, we conducted five case studies using information from additional dossier review and semistructured key informant interviews.Results: The findings confirm that the payback framework is a useful approach to assess the impact of HTA projects. We identified over 101 peer reviewed papers, more than twenty-five PhDs, citations of research in guidelines (six projects), and implementation of new treatment strategies (eleven projects). The case studies provided greater depth and understanding about the levels of impact that arise and why and how they have been achieved.Conclusions: It is generally too early to determine whether the HTA program led to actual changes in healthcare policy and practice. However, the results can be used as a baseline measurement for future evaluation and can help funding organizations or HTA agencies consider how to assess impact, possibly routinely. This, in turn, could help inform research strategies and justify expenditure for health research.This research is funded by ZonMw, the Netherlands organization for health research and development (project 945-15-001)

Fine Scale Features of Turbulent Shear Flows

This thesis presents an investigation into kinematic features of fine scale turbulence in free shear flows. In particular it seeks to examine the interaction between the different length scales present in shear flow turbulence as well as the interaction between the strain-rate tensor and the rotation tensor, which are the symmetric and skew-symmetric components of the velocity gradient tensor respectively. A new multi-scale particle image velocimetry (PIV) technique is developed that is capable of resolving the flow at two different dynamic ranges, centred on inertial range scales and on dissipative range scales, simultaneously. This data is used to examine the interaction between large-scale fluctuations, of the order of the integral scale, and inertial and dissipative range fluctuations. The large-scale fluctuations are observed to have an amplitude and frequency modulation effect on the small scales, and the small scales are shown to have a slight effect on the large scales, illustrating the two way nature of the energy cascade. A mechanism whereby integral scale rollers leave behind a wake of intense small-scale fluctuations is proposed. The interaction between strain and rotation is examined with regards to the rate of enstrophy amplification (ωiSijωj). It is found that the mechanism that is responsible for the nature of enstrophy amplification is the alignment tendency between the extensive strain-rate eigenvector and the vorticity vector. This mechanism is also observed to be scale dependent for ωiSijωj > 0, but independent for ωiSijωj < 0. This is subsequently confirmed with new dual-plane stereoscopic PIV experiments performed as part of this study. Finally, computational data is used to examine the effect of experimental noise and variation of spatial resolution on the observation and understanding of this strain - rotation interaction

Terror management theory and politeness : the effects of mortality salience on preferences for proper linguistic etiquette

Terror management theorists propose that people experience death anxiety when reminded of their death and defend against it by engaging in symbolic psychological defenses through cultural identification. Language is an integral component of culture and the human experience. A study was conducted to examine the effects of mortality salience on people’s evaluations of the cultural norm of linguistic politeness. It was hypothesized that participants who had their mortality made salient would downgrade impoliteness and show more favor toward politeness when evaluating requests and persons and rating their likelihood of compliance with the requests in comparison to control participants. The data did not support the hypotheses. Study limitations, theoretical considerations, and future avenues for research are discussed.Department of Psychological ScienceThesis (M.A.

Alien Registration- Buxton, Verna R. (Madison, Somerset County)

https://digitalmaine.com/alien_docs/6795/thumbnail.jp

How do they do it? Understanding back office efficiency savings made by English councils

Purpose – The purpose of this paper is to illustrate the back office efficiency savings made by English councils during the 2004 Spending Review (SR04) period in order to consider the relationship between service delivery, audit and inspection and, efficiency programmes in local government. It considers three research questions: the use of secondary data, the relationship between efficiency savings and contextual factors, and the influence of audit and inspection in delivering efficient public services. Design/methodology/approach – Through statistical analysis the paper discusses the secondary analysis of publicly available sets of administrative data about local councils in England. These datasets are the annual efficiency statements (AES) taken from records made by each council. The paper discusses through the analysis of the AES the degree of efficiency savings and service improvements in English councils and whether efficiency savings are influenced by internal or external contextual factors. Findings – The paper illustrates that secondary data is a useful source of data, but finds that although councils have achieved the efficiency savings set there is no relationship with the contextual factors. The paper considers the influence of audit and inspection, suggesting that the focus has been on meeting the target rather than local needs. Originality/value – This paper aims to contribute to the debate regarding the use of performance indicators, audit and inspection and efficiency achievement within local government. The paper starts to explore the implication in the UK where, after a decade of use, the influence of these is reducing dramatically

Facets and Typed Relations as Tools for Reasoning Processes in Information Retrieval

Faceted arrangement of entities and typed relations for representing different associations between the entities are established tools in knowledge representation. In this paper, a proposal is being discussed combining both tools to draw inferences along relational paths. This approach may yield new benefit for information retrieval processes, especially when modeled for heterogeneous environments in the Semantic Web. Faceted arrangement can be used as a se-lection tool for the semantic knowledge modeled within the knowledge repre-sentation. Typed relations between the entities of different facets can be used as restrictions for selecting them across the facets

Does responsibility affect the public valuation of health care interventions? A relative valuation approach to health care safety

This article is available open access through the publisher’s website at the link below. Copyright © 2012, International Society for Pharmacoeconomics and Outcomes Research (ISPOR).Objective - Health services often spend more on safety interventions than seems cost-effective. This study investigates whether the public value safety-related health care improvements more highly than the same improvements in contexts where the health care system is not responsible. Method - An online survey was conducted to elicit the relative importance placed on preventing harms caused by 1) health care (hospital-acquired infections, drug administration errors, injuries to health care staff), 2) individuals (personal lifestyle choices, sports-related injuries), and 3) nature (genetic disorders). Direct valuations were obtained from members of the public by using a person trade-off or “matching” method. Participants were asked to choose between two preventative interventions of equal cost and equal health benefit per person for the same number of people, but differing in causation. If participants indicated a preference, their strength of preference was measured by using person trade-off. Results - Responses were obtained from 1030 people, reflecting the sociodemographic mix of the UK population. Participants valued interventions preventing hospital-acquired infections (1.31) more highly than genetic disorders (1.0), although drug errors were valued similarly to genetic disorders (1.07), and interventions to prevent injury to health care staff were given less weight than genetic disorders (0.71). Less weight was also given to interventions related to lifestyle (0.65) and sports injuries (0.41). Conclusion - Our results suggest that people do not attach a simple fixed premium to “safety-related” interventions but that preferences depend more subtly on context. The use of the results of such public preference surveys to directly inform policy would therefore be premature.Brunel University

Spatial evolution of the turbulent/turbulent interface geometry in a cylinder wake

This study aims to examine the spatial evolution of the geometrical features of the turbulent/turbulent interface (TTI) in a cylinder wake. The wake is exposed to various turbulent backgrounds in which the turbulence intensity and the integral length scale are independently varied and comparisons to a turbulent/non-turbulent interface (TNTI) are drawn. The turbulent wake was marked with a high-Schmidt-number ($Sc$) scalar and a planar laser induced fluorescence (PLIF) experiment was carried out to capture the interface between the wake and the ambient flow from $x/d$ = 5 to 40 where $x$ is the streamwise coordinate from the centre of the cylinder and $d$ is the cylinder's diameter. It is found that the TTI generally spreads faster toward the ambient flow than the TNTI. A transition region of the interfaces' spreading is found at $x/d \approx 15$, after which the interfaces propagate at a slower rate than previously (upstream) and the mean interface positions of both TNTI and TTI scale with the local wake half-width. The location of both the TNTI and TTI have non-Gaussian probability density functions (PDFs) in the near wake because of the influence of the large-scale coherent motions present within the flow. Further downstream, after the large-scale coherent motions have dissipated, the TNTI position PDF does become Gaussian. For the first time we explore the spatial variation of the ``roughness'' of the TTI, quantified via the fractal dimension, from near field to far field. The length scale in the background flow has a profound effect on the TTI fractal dimension in the near wake, whilst the turbulence intensity only becomes important for the fractal dimension farther downstream