Impact of IPMOE on nursing tasks in the medical ward: A time-motion study

Introduction:The In-patient Medication Order Entry System (IPMOE) was first implemented in the medical ward of Princess Margaret Hospital,Hong Kong.It was a local developed close-loop system including prescription,dispensing and administration modules.Evaluation on its impact on nursing tasks would be important for practice improvement and subsequent system enhancement.Objective:The study was conducted to quantify the nursing times across medication-associated tasks for paper-based MAR and computer-based IPMOE,including change in the tasks and time patterns before and after IPMOE implementation.Methods:This was a prospective observation study in medical wards before (Jan 2014-Jun 2014) and after (Mar 2015-Jun 2015) the implementation of IPMOE.We conducted 8-hr observation studies of individual nurses with a customized application to time various pre-categorized nursing tasks.Statistical inferences and interrupted time series analysis was performed to identify the change in the intercept and trends over time after implementation.Result:The average number of medication-related tasks was significantly reduced from 61.07 to 29.81,a reduction of 31.26 episodes per duty (P < 0.001,95% CI 22.9-39.63).The time for the medication-related tasks was reduced from 32 min (SD =21.57) to 26.57 min (SD =11.35) and the medication administration time increased from 37.93 min (SD-14.78) to 44.37 min (SD 19.45),but there was no overall significant difference in the time spent on each duty (P =0.315) between the two groups.An improving trend in the delayed effect was observed (P =0.03),which indicated a run-in period for new application was needed in clinical setting.Conclusion:Our study had shown the time motion observation could be applied to measure the impact of the IPMOE in a busy clinical setting.Through classification of activities,validation,objective measurement and longitudinal evaluation,the method could be applied in various systems as well as different clinical settings in measure efficiency.

On a Compound Poisson Risk Model Perturbed by Brownian Motion with Variable Premium and Tail Dependence between Claims Amounts and Inter-Claim Time

This paper considers the compound Poisson risk model perturbed by Brownian motion with variable premium and dependence between claims amounts and inter-claim times via Spearman copula. It is assumed that the insurance company’s portfolio is governed by two classes of policyholders. On the one hand, the first class where the amount of claims is high, and on the other hand, the second class where the amount of claims is low, this difference in claim amounts has significant implications for the insurance company’s pricing and risk management strategies. When policyholders are in the first class, they pay an insurance premium of a constant amount c1 and when they are in the second class, the premium paid is a constant amount c2 such that c1 > c2. The nature of claims (low or high) is measured via random thresholds . The study in this work will focus on the determination of the integro-differential equations satisfied by Gerber-Shiu functions and their Laplace transforms in the risk model perturbed by Brownian motion with variable premium and dependence between claims amounts and inter-claim times via Spearman copula. .

The Theory Study of the Influence of the Topography on the Cold Frontal Motion

In order to study the characteristics of cold frontal motion over the arbitrary topography, the velocity of cold frontal movement is derived by using the one layer shallow-water model. The results show that there exist the retardation in upwind side and rapid descent in the lee slope when the cold front crosses the topography.

A Computer Vision-Based Model for Automatic Motion Time Study

Motion time study is employed by manufacturing industries to determine operation time.An accurate estimate of operation time is crucial for effective process improvement and production planning.Traditional motion time study is conducted by human analysts with stopwatches,which may be exposed to human errors.In this paper,an automated time study model based on computer vision is proposed.The model integrates a convolutional neural network,which analyzes a video of a manual operation to classify work elements in each video frame,with a time study model that automatically estimates the work element times.An experiment is conducted using a grayscale video and a color video of a manual assembly operation.The work element times from the model are statistically compared to the reference work element time values.The result shows no statistical difference among the time data,which clearly demonstrates the effectiveness of the proposed model.

Effectiveness of an amino acid beverage formulation in diarrheapredominant irritable bowel syndrome:A pragmatic real-world study

BACKGROUND Amino-acid based medical foods have shown promise in alleviating symptoms of drug induced gastrointestinal side effects;particularly,diarrhea-predominant symptoms.Irritable bowel syndrome(IBS)is a gastrointestinal disorder that affects up to 9% of people globally,with diarrhea predominant IBS(IBS-D)being the most prevalent subtype.Further trials are needed to explore potential added benefits when integrated into standard care for IBS-D.AIM To assess the effectiveness of an amino acid-based medical food as an adjunct to standard of care for adults with IBS-D.METHODS This is a pragmatic,real world,open label,single arm study comparing a 2-week baseline assessment to a 2-week intervention period.One hundred adults,aged 18 to 65 years,with IBS-D,according to Rome IV criteria,were enrolled after completing a 2-week baseline assessment period and received a 2-week supply of an amino acid based medical food which was consumed at home twice daily on top of their standard of care.The primary outcome was an assessment of tolerability after 2-weeks of consumption,while secondary outcomes included changes in stool consistency(Bristol Stool Form Scale),severity of abdominal pain&discomfort,symptoms of urgency,Global Improvement Survey(GIS),and the IBS severity scoring system(IBS-SSS).RESULTS The test product was well-tolerated as each participant successfully completed the full 14-day trial,and there were no instances of dropouts or discontinuation of the study product reported.Forty percent of participants achieved a 50% or more reduction in the number of days with type 6-7 bowel movements(IBS-D stool consistency responders).Fifty-three percent of participants achieved a clinically meaningful reduction of 30% in mean weekly pain scores,and 55%experienced the same for mean weekly discomfort scores(IBS-D pain and discomfort responders).Participants experienced a mean-109.4(95% confidence interval:-130.1,-88.8)point reduction on the IBS-SSS and 52% experienced a minimally clinically important difference of>95 points.An IBS-SSS category shift from severe to moderate or mild occurred in 69% of participants.For functional symptoms,76% of participants reported symptom relief on the GIS.CONCLUSION The amino acid-based medical food was well-tolerated,when added to the standard of care,and demonstrated improvements in both overall IBS symptom severity and IBS-D symptoms within just 2 wk.

中原学离新时代中国学、世界中国学还有多远

中原文化、黄河文化是中华文明总进程的核心和引领者。担负新时代新的文化使命,建设中华民族现代文明,创造人类文明新形态,要求我们从构建中国自主知识体系的高度来定位、研究中原文化、黄河文化,推进中原文化、黄河文化的学问化、学术化、学科化、学派化表达,不断提升中华文化的影响力。在新时代中国学、世界中国学视野下,中原学要确立中华民族现代文明、人类文明新形态两个研究方向,回答好习近平新时代中国特色社会主义思想是中华文化和中国精神的时代精华、中国道路与中华文明道路的关系、在中国式现代化的基础上深化中原学研究、推动中原学的国际化表达等四个核心问题。如此,中原学才能超越地域范畴,从中原之学走向中国之学、世界之学。

格物于曲式,致知以分析——孟文涛教授《音乐结构与曲式分析》忆要

文章回忆孟文涛教授并及曲式教学的有关情况,从“新名、格物、致知、唯源”四方面,述及孟公《音乐结构与曲式分析》一书之要,包括其改革之思、拓深之举、创新之意、特色之处。文章认为该书有利曲式学和音乐分析学的发展进步。

基于遥感GIS信息融合的测绘机器人滑模跟踪控制系统

测绘机器人是实现测绘自动化的执行设备,测绘机器人的工作空间更为复杂,给机器人的跟踪控制工作带来较大挑战;为提高测绘机器人跟踪控制效果,设计了基于遥感GIS信息融合的测绘机器人滑模跟踪控制系统;加设遥感信息采集器和GIS信息采集器,改装遥感GIS信息处理器以及滑模跟踪控制器,完成硬件系统的优化设计;考虑信息结构以及信息之间的逻辑关系,构建系统数据库,为遥感GIS信息提供充足的存储空间;根据测绘任务生成机器人滑模移动轨迹,作为机器人的控制目标;采集测绘机器人实时遥感与GIS信息,利用遥感GIS信息融合技术跟踪机器人实时位姿,比对位姿跟踪结果与生成的控制目标,计算滑模跟踪控制量,完成系统的测绘机器人滑模跟踪控制软件功能优化;系统测试结果表明:设计系统的控制误差平均值为1.9 m,抖振幅值为0.8 dB,具有较好的控制效果。

论空间转向:关于空间形式、空间批评与地理批评的概述

空间形式几乎是所有时代和所有文化共有的文学经验与文学阐释的重要方面。空间首先是一个物理的观念,极早成为欧几里得几何学的基本内容。欧洲物理学、哲学、形而上学关于空间及其属性的争论持续了2000多年。空间、地理空间、社会空间、空间形式、空间批评、空间转向是一组相互关联的人文观念。1945年约瑟夫·弗兰克提出了现代文学中的空间形式。空间批评发生于1950-1980年代,巴什拉尔、勒菲弗尔、福柯、詹明信、曼德尔、哈维等从人文地理学、马克思主义、文化批评理论等角度越来越多地关注了空间理论。“空间转向”发生于1990年前后。21世纪初期,其革新的学者范式及其方法迅速从人文地理学扩展/散播到哲学、文学、艺术研究诸领域。

基于双Leap Motion的三维可视化交互方法研究

由于Leap Motion硬件设备识别范围和其图像识别算法的局限性,当交互手势中手指平面平行于Leap Motion视觉探测方向时容易因产生手指混叠现象,降低手势识别的精度而影响交互体验.为解决手指遮挡问题提高交互体验,提出在不同角度设置双Leap Motion的方法.首先垂直设置双Leap Motion于预定位置;然后对上边Leap Motion探测数据进行矩阵转换;最后对双Leap Motion数据进行数据融合计算,得到手势运动类型.一系列用户对比实验结果表明,该方法在减少手指混叠现象、提高易用性方面有明显作用,具有实际应用价值.

装配整体式结构模具成型结合面剪切性能试验研究

为提高装配整体式结构中结合面的粘结性能和施工效率,提出一种模具成型结合面。通过Z形直剪试验研究了三种不同成型方式结合面的抗剪性能,主要对比了模具成型和传统成型方式结合面的破坏模式和承载力。结果表明,所有的试件均表现为典型的剪切破坏特征。三种成型方式中,水洗露骨料结合面的抗剪承载力最高,其次是模具成型、凿毛结合面。模具成型与水洗露骨料结合面的抗剪承载力相差1.56%。试件达到峰值承载力前结合面连接钢筋发挥作用较小,界面间抗剪承载力主要取决于粘结力、骨料咬合以及摩擦作用。试件达到峰值承载力后钢筋屈服,随着结合面相对位移的不断增大,钢筋销栓作用和剪摩擦作用主要提供界面间承载力。

基于生态系统理论的帕金森病患者及照护者居家康复运动影响因素的质性研究

目的探讨帕金森病患者及其照护者对居家康复锻炼的真实体验,深入挖掘居家康复的影响因素,为提高帕金森病患者居家康复质量提供参考依据。方法采用描述性质性研究,选取16对居家康复锻炼的帕金森病患者及其主要照护者进行半结构式访谈,基于Bronfenbrenner生态系统理论模型、利用主题分析法和配对分析法对访谈资料进行分析和提炼主题。结果提炼出微系统——帕金森病患者个体特质(疾病现状与进展、心理弹性与应对方式、创伤后成长、运动自我效能与动机)、中系统——家庭抗逆力系统(主要照护者微系统特质、家庭信念系统、家庭组织模式、家庭沟通过程)、外系统——相关社会领域及宏系统——文化环境4个主题。结论帕金森病患者居家康复运动受多种因素的影响,患者及其家庭应充分激发个体主观能动性、重视主要照护者照护功能、调动家庭抗逆力实现家庭复原、合理利用社会资源,医疗教育等社会领域应充分聚焦专科性发展、建立支持系统协同实现帕金森病患者居家康复。

多维曲面成形运动规划中三维模型数据处理研究

多维曲面成形过程中三维模型读取和空间目标点的求解效率对提高成形速度具有重要影响作用。随着STL模型复杂度提升,三角面片数量相应增加,计算复杂度大幅增长,求解效率降低,运动规划和图案映射过程计算难度也随之增加。针对上述问题基于深度学习方法提出一种三维模型数据处理及运动规划方法,并与传统的计算规划方法进行对比。实验结果表明,所提方法能有效提升曲面打印中模型数据点定位速度2倍以上,定位速度随求解点数据量增加而提升,且对模型顶点数增加具有鲁棒性,大大提升运动规划速度,为多维曲面成形运动规划求解提供新思路,适用于大规模数据计算且可被用于直接交互现实的生产制造任务。

基于UG NX/Motion的电脑横机成圈机构建模与仿真

针对国产电脑横机与国外产品相比技术差距较为明显,缺乏系统的理论分析等问题,对电脑横机成圈机件进行建模研究,以提升电脑横机的整机性能。基于UG NX/Motion建立了成圈机件的瞬态力学模型,分析三角对导针片垂直方向上冲击力的变化。结合UG NX分析软件对成圈机构进行运动仿真,分析成圈过程中导针片的位移、速度以及加速度的变化情况,以提高织针的运动稳定性。并通过实验研究分析成圈过程中导针片的位移、速度以及加速度变化。结果表明,有限元分析的结果与实际运动情况相一致,验证了成圈机件的瞬态动力学分析的正确性,为电脑横机的设计与优化提供了理论参考。

民间造型艺术在形态构成教学实践中的运用探索——以云南大学视觉传达设计专业为例

以云南大学视觉传达设计专业形态构成课为例,探索民间造型艺术在艺术设计类基础教学实践中的运用。在形态构成的教学实践中,带领学生进行田野调查,从民族民间造型艺术出发,强调文化传承与民族审美特性,引导学生将民间造型艺术中的点、线、面、体等形态元素,按照视觉规律和审美法则进行创造性的组合,通过对形态构成多维度的学习,加深学生对抽象元素的理解与认知,开拓学生基于民族认同的视觉创新意识,为形态构成的教学提供新的思路与策略。

金属桶生产线中凸轮运动规律曲线的优化设计

针对凸轮运动规律曲线优化设计中描述线型单一导致的优化幅度有限和普适性差的问题,提出一种将分段曲线应用于优化设计的方法,该分段曲线由七次多项式线型和傅里叶线型组成。利用凸轮机构的设计参数构建多项式型或傅里叶型运动规律曲线,在较优曲线周围以一定分度生成点阵解集;以整体跃度最小化为目标,通过蚁群算法从解集中选取最优位移约束点,确定各段曲线描述方式;将所有条件代入分段曲线模型,计算出最优凸轮运动规律曲线。该方法应用于金属桶提手成型装置优化设计的效果良好。以5组随机设计参数的凸轮机构为例,通过该运动学分析结果表明,相比单一线型,该方法可降低10%以上的整体跃度,并具有普适性。

近十年国内虚拟位移现象研究述评

国内语言学界对于虚拟位移现象的研究,从一开始的跨语言对比研究到近几年不断兴起的汉语本体研究和认知研究,有了较大发展。近十年国内虚拟位移现象的研究主题涉及汉语虚拟位移判定、概念要素特征和编码形式描写、汉语虚拟位移语体性质以及不同视角的认知阐释研究等,但汉语虚拟位移判定的基础性问题尚未厘清,且多以书面语为主。今后需拓展虚拟位移现象的研究视野和领域,推进跨学科交叉研究。

气浮垫的误差均化能力研究

为探究小孔节流气浮轴承的误差均化能力的主要影响因素,建立单个气浮垫的误差运动模型,并利用所定义的均化系数研究气浮垫误差运动、导轨条形状误差和气浮垫结构参数三者之间的定量关系。研究表明:对于长波长的导轨条形状误差(波数为0~1),当波数逐渐增加时,均化系数从1逐渐降低到接近0;对于短波长的导轨条形状误差(波数为1~10),当波数靠近或者等于正整数时,均化系数取接近于0的最小值;当波数靠近或者等于正整数加0.5时,均化系数取小于0.25的局部最大值;结构参数中,封气边宽度对误差均化能力有很大影响,气垫间隙和小孔节流器孔径对误差均化能力基本无影响;当移动速度小于10 000 mm/s时,移动速度对误差均化能力的影响微弱。

船用颗粒阻尼能量损耗特性影响研究

颗粒阻尼技术作为抑制低频振动的重要方式,可应用于抑制船舶低频振动。为探索颗粒阻尼器的耗能机理,本文基于离散单元法对颗粒阻尼器在不同振幅、不同填充比、不同振动频率下的运动状态和耗能进行研究。结果表明:颗粒在填充比为50%的工况下,在不同振动频率和振幅激励时颗粒的运动状态比较丰富,出现了不规律的耗能现象;填充比为70%、90%时,颗粒的耗能随着振动的幅值和频率的增加而增加,特别是在颗粒填充比为70%、振动频率为120 Hz、振幅为5 mm的情况下,颗粒的耗能达到了顶峰。在损耗因子方面,振幅在1~4 mm时90%填充比要明显高于50%、70%填充比;在振幅为5 mm时,90%填充比低于70%填充比而高于50%填充比。

数字人文视域下报刊文学翻译研究现状回顾与反思

本研究对报刊连载文学翻译研究现状进行了梳理,指出了一些具有代表性的研究视角及其对报刊翻译领域开发的多元面向,着重指出了连载文学翻译研究的不足及其局限性。基于这一现状,本文继而探讨了20世纪中叶人文学科多领域出现的数字人文转向,并指出21世纪之交兴起的期刊学将为翻译学带来研究方法与视角的启发。由此提出了,连载文学翻译研究,特别是早期中文报刊连载文学翻译研究,可以如何利用数字人文趋势,有哪些可以采用的多元方法与工具。