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Quality : what does it mean in Acute Medicine and how do we measure it?
No full textAcute Medicine is a specialty that is not defined by a single organ system and sits at the interface between primary and secondary care. In order to document improvements in the quality of care delivered a system of metrics is required.A number of frameworks for measurements exist to quantify quality of care at the level of patients, teams and organisations, such as measures of population health, patient satisfaction and cost per patient. Measures can capture whether care is safe, effective, patient-centred, timely, efficient and equitable. Measurement in Acute Medicine is challenged by the often-transient nature of the contact between Acute Medicine clinicians and patients, the lack of diagnostic labels, a low degree of standardisation and difficulties in capturing the patient experience in the context.In a time of increasing ecological and financial constraints, reflecting about the most appropriate metrics to document the impact of Acute Medicine is required
Developing the understanding of data-relationships and digital surveillance through collaborative activities between an IT professional and users of communications technologies
No full textThis research revolves around the civil liberties issue of attainment of insight into digital surveillance. Thanks to recurring news headlines featuring Wikileaks, GCHQ, Edward Snowden, Russian hacking, Cambridge Analytica, and fake news, public discourse around privacy, surveillance, and trust has been nurtured. Experts in this discourse argue that digital-surveillance by both business and state should be a concern to individuals and that they should have an insight into what is happening to the data they generate.This research is grounded in work as an I.T. professional working in the higher education domain. The thesis describes activities that provide an insight into data analysis practices and documents the journey of understanding how these activities can become an intervention that makes technology politically 'real'. Using a critical realist perspective, the researcher is able to identify phenomena and aspects of the problem domain, recontextualising them to produce new models of understanding.Among the outputs of this research are repeatable strategies for running activities to develop the understanding of digital surveillance. During the development of these strategies, it was found that an approach of merely teaching how openly available statistical methods work does not appear to engage the vast majority of learners. The thesis puts forward a type of intervention where freely available statistical methods are applied to community-created data from the digital-commons.The new models of understanding and intervention strategies can form the basis of an effective model for active engagement in issues facing society
Development of a positive group intervention for coexisting problems: A mixed methods study
No full textSubstance misuse commonly coexists with psychological disorder (dual diagnosis) making the problems more complex and the symptoms augmented with far-reaching negative consequences. Despite the wide range of support that treats both problems, clients often relapse. This study was the first empirical attempt to investigate how positive psychology can facilitate recovery by not focusing merely on the disorders but exploring and enhancing the positive aspects of clients’ lives moving them toward optimal human functioning. A mixed methods approach was applied to test a 12-week positive group intervention in two groups of service users (n=10) with coexisting disorders at an outpatient addiction service to explore the feasibility and acceptability of a positive approach in their recovery. Participants seemed to have benefitted from the programme, all positive concepts were found relevant, and the intervention was found feasible and acceptable by service users. It was concluded that a strengths-based positive approach has the potential to serve as a useful adjunct to the treatment of coexisting problems. Implications for treatment are discussed in terms of how positive psychology may be helpful in long-term recovery by providing alternative strategies to cope with mental illness and a substitute for the love, nurturing, and belonging that substances appear to offer to individuals
Multi-commodity Optimization of Peer-to-peer Energy Trading Resources in Smart Grid
No full textUtility maximization is a major priority of prosumers participating in peer-to-peer energy trading and sharing (P2P-ETS). However, as more distributed energy resources integrate into the distribution network, the impact of the communication link becomes significant. We present a multi-commodity formulation that allows the dual-optimization of energy and communication resources in P2P-ETS. On one hand, the proposed algorithm minimizes the cost of energy generation and communication delay. On the other hand, it also maximizes the global utility of prosumers with fair resource allocation. We evaluate the algorithm in a variety of realistic conditions including a time-varying communication network with signal delay signal loss. The results show that the convergence is achieved in a fewer number of time steps than the previously proposed algorithms. It is further observed that the entities with a higher willingness to trade the energy acquire more satisfactions than others
True Grit: How Important is the Concept of Grit for Education? A Narrative Literature Review
No full textAn abundance of literature exists that explores the potential applications of grit in predicting several academic outcomes. Regardless, the concept of grit has been heavily criticised due to the number of inconsistencies among current research. Fully understanding the usefulness of grit in an educational context is a worthwhile pursuit and could yield incredibly influential implications. The current narrative review aimed to address and explore these inconsistencies to determine the true impact of grit on the academic outcomes of school students. Such that, it aimed to establish whether grit was useful in improving outcomes such as academic achievement, attendance and retention. Research posits that grit is a strong predictor of academic outcomes for many, but not all, students. Furthermore, it seems that the predictive abilities of grit can be enhanced by concentrating on the perseverance of efforts component of grit, rather than overall grit. While the importance of grit's perseverance component has been confirmed; there are several recommendations for future research. Likewise, a number of inconsistencies are discussed relating to grits practical applications within an educational context. Cultivating grittiness, specifically perseverance of efforts, in student populations would reap huge rewards. Indeed, the educational rewards for students would be substantial, as well as the financial benefits for schools and educating institutions. The usefulness of cultivating a perseverance of efforts i
Remarkable Lives: Zoe Riley in conversation with Jerome Carson
No full textThe purpose of this paper is to provide a profile of Zoe Riley.Using a case study approach, Zoe provides an account of her background and is then interviewed by Jerome.Zoe’s account reveals a remarkable resilience, developed through adversity, but nurtured by the love of her grandparents.Mental illness surrounded Zoe when she was growing up. Her own mother experienced years of distress. Her grandfather effectively was her father. Despite the childhood adversity, and her own teenage problems, she came though it all. These are the stories you read about in textbooks.Zoe reminds us that people in distress want to find connection. They don’t want us sitting there writing notes and not even looking at them! We talk about “wounded healers.” Dr Glenn Roberts said that his own bouts of depression made it easier for him to sit with people in similar turmoil. The value of peer support has been under-rated by many.It is of course a truism to say that everyone’s journey of recovery is unique. I know Zoe has already touched the lives of many people. I am sure she has so much more to contribute
Meaning of fabric orthoses to long-term users with multiple sclerosis: An interpretative phenomenological analysis
No full textBackground: Fabric orthoses are elasticated garments designed to provide support to the musculoskeletal system. They may benefit people with multiple sclerosis; however, in this population, their acceptability is largely unexplored.Objectives: This study aimed to explore the meaning that fabric orthoses hold for people with multiple sclerosis and factors influencing acceptability.Study Design: This is a qualitative study using an interpretative phenomenological analysis to explore the meaning ascribed to lived experience.Methods: Four people with multiple sclerosis participated in face-to-face semi-structured interviews. Two used upper limb orthotic sleeves for involuntary movement control, one used orthotic shorts, and one used a soft ankle brace. Three participants had fabric orthoses they no longer used. Themes were validated by peer review.Findings: Two themes were identified. "Giving back control" describes how perceived physical benefits, such as decreased involuntary movement and improved stability, led to important benefits in autonomy and self-image. Orthoses were not worn longer-term where self-image was not improved. "Learning to live with an orthosis" captures the way in which participants learnt from experience over months or years how to maximize effectiveness and overcome disadvantages. Acceptability was determined specific to the contexts in which the orthoses were used, with the social appropriateness of appearance and the demands of tasks being important considerations.Conclusions: Fabric orthoses can be acceptable to people with multiple sclerosis. Professionals should be mindful of the active learning process that users engage in as they learn about the pros and cons of orthotic use. Further research into effectiveness is needed
Optimising Total Productive Maintenance (TPM) and asset management strategies through Artificial Intelligence (AI) technologies: the development and enhancement of Abu Dhabi power networks
No full textMaintenance has a significant impact on the business strategy of power organisations. Maintenance of power plants aims to promote safe, cost effective, and reliable electricity supplies. This kind of maintenance has complex activities and requires highly skilled maintenance staff; therefore, proper utilisation of technology is critical to achieve both plant safety and availability. The implementation of modern maintenance strategies has a positive impact on improving reliability and performance of power assets. Total Productive Maintenance (TPM) is an ideal approach to support the development and implementation of operation performance improvement.Implementation of TPM programmes needs effective leadership and strategic planning skills. However, there has been almost no research applied in this area within Middle-East power plants. The power industry in the United Arab Emirates is in the early stages adapting proactive maintenance programmes, and the aim of this research is to thus investigate the critical factors that affect successful implementation of TPM programme in the Abu Dhabi power industry environment. The study is focused in the unique context of Abu Dhabi power organisations, and seeks to formulate critical success factors and enablers for overcoming barriers and obstacles to successful TPM implementation. To achieve the aim of this research, the researcher utilises a design of exploratory sequential mixed methods, starting with a qualitative approach. Semi-structured interviews were conducted with 16 employees, (including senior management, middle managers and senior engineers) to identify the technical and cultural barriers that could affect TPM implementation across power plants. The quantitative approach included a questionnaire which was distributed to 250 employees, comprising engineers, maintenance planners, technicians, and operators using a hand-delivered questionnaire. Structural equation modelling, using partial least squares path analysis (SmartPLS software version 3.0), was performed to test the hypothesised model. A sample of both approaches comprising three participant organisations was selected based on their experience in operations and maintenance of power plants, particularly in the power sector and included power generation, transmission as well as distribution organisations. In short, the empirical results confirmed the role of organisational culture and structural employee empowerment in participation of autonomous maintenance. Furthermore, this research is the first empirical study to examine the potential impact of organisational culture and structural empowerment on autonomous maintenance (operators) participation in maintenance activities in the context of the Abu Dhabi power industry.A novel approach combining TPM with prognostic and RCM models has been developed. The researcher utilised a simulation approach (ReliaSoft’s Weibull simulation + Availability Workbench (AWB) Monte Carlo simulation) to appraise the impact of effective prognostic techniques and examine the role of reliability centred maintenance (RCM) on successful participation of autonomous maintenance (operators) in power plants using maintenance optimisation models based on artificial intelligence (AI) technologies. Historical data (degradation measurements + maintenance costs) from power transformers for critical power distribution substations were collated to conduct the simulation approach. The analysis is based on degradation analysis, and failure mode effective and criticality analysis (FMECA). Based on the analysis, remaining useful life (RUL) of critical power assets (transformer paper insulation) was determined and preventive maintenance (PM) intervals and costs of transformer tap changers (OLTCs) were optimised. Simulation results are presented to verify the analytical approach and validate proposed operational procedures. The proposed maintenance optimisation models performed good simulation results, and the latter show that the proposed models are really a new contribution in the area of TPM implementation in the power industry. Moreover, the integration of AI technologies with TPM implementation has enhanced the practice and theory of autonomous maintenance empowerment across power plants. The novelty of model is to build a proposed approach and solution based on operational steps and utilisation of a simulation model to empower and enable operator’s participation in maintenance activities in the power industry. With respect to the simulation results of power transformers, the findings can contribute towards improved equipment operations and successful implementation of TPM in power organisations. Furthermore, based on the study findings cumulatively, an innovative operational framework with detailed plans for TPM implementation was developed and formulated. This research has made several original contributions to knowledge in the parlance of maintenance management, with particular reference to TPM implementation across Abu Dhabi-based power industry organisations. The main contribution is the demonstration and establishment of a sound practical approach and model to integrate methods and principles of AI technologies within prognostic, RCM and TPM to support operators in decision making through identifying new policies for machine maintenance or assessment and enhancement of existing maintenance plans and costs. The model also delivers guidelines to operators for executing a practical, operational framework for TPM implementation
Numerical and experimental investigation of the flow separation over NREL's S822 aerofoil and its control by suction and blowing
No full textIn this study, a numerical and experimental investigation for the flow separation over 170 mm chord, the NREL S822 aerofoil low Reynolds number wind turbine blade aerofoil section has been investigated at 15.8 m/s wind speed using suction and blowing techniques for the locations between 0.15 and 0.41 of the chord to improve aerodynamic characteristics of a wind turbine rotor blade. In a numerical study, two-dimensional aerofoil (i.e. NREL S822), using Shear Stress Transport (SST (
γ
−
Re
θ
)) turbulence model, is presented. Careful selection for the number of mesh was considered through an iterative process to achieve the optimum mesh number resulted in optimum values for the ratio of lift to drag coefficients (
C
L
/
C
D
). Values of the lift coefficient, drag coefficient, and separation location were investigated at an angle of attack 18°. Flow separation is monitored and predicted within the numerical results at the tested angles, which has been compared with the experimental results and should a fair agreement. The results revealed that the aerodynamic characteristics of NERL S822 aerofoil would be improved using the suction technique more than the suction and blowing techniques and there is a delay of flow separation with the increase of blowing or suction volumetric flow rate. Using these two techniques and careful selection of the mesh numbers with the right angle of attack can improve the aerofoil characteristics and therefore lead to improve the turbine performance characteristics
Achieving Sustainable Development Goal 6 in Developing Countries: Challenges and Opportunities
No full textThis research assessed challenges versus opportunities for achieving Sustainable Developing Goal 6 in developing countries. Collective methods were used to harvest data, including a questionnaire survey, interactive focus group discussion, site visits to some water projects, and analysis of three case studies, including Nigeria, Nepal, and Iraq. Results indicated that most developing countries’ financial resources are insufficient to manage water and sanitation facilities safely. It also revealed gaps in short-to-longer term capacity building programs and institutional arrangements, lack of effective involvement of local academics, nongovernmental agencies, private sector, women, youth, and vulnerable communities in the decision-making process, lack of public awareness strategy, and inefficient use of water are dominating the scene of the water and environment sectors in developing countries. Moreover, results cited that corruption in some countries is one of the critical factors that slowed down the implementation of improved water and sanitation services, which left these countries years off the track to achieving SDG6. Furthermore, results disclosed that efficient use and management of water at local level, sub-national and national scales is indispensable to address the growing imbalance between water demands and supply and climate change impacts, including the increase in frequency/severity of floods and droughts. Therefore, SDG6 targets should be incorporated into national, sub-national, and local plans, policies, and strategies