Inadequate discharge planning for individuals with chronic illnesses or injuries is associated with increased readmissions to the hospital or rehabilitation facility where the original treatments were administered. To help ensure the recovery of discharged patients and avoid readmissions, discharge planners guide medication and care processes. The rate of readmissions was high in a stand-alone rehabilitation center due to ineffective discharge plans. Patients, family members, and caregivers lacked knowledge about medications, treatments, and self-care guidelines after the patient left the facility. The purpose of this project was to ascertain the impact of improved discharge processes using the (a) IDEAL Discharge Planning Overview, Process, and Checklist; (b) the teach-back Method training for discharge nurses; and (c) the Postdischarge Rehabilitation Services Follow-Up Tool incorporating telephone calls to all participants during Weeks 1, 2, and 4 postdischarge. Lewin's theory of planned change undergirded this project. According to Centers for Medicare and Medicaid Services data, the rate of readmissions among the 50 participants was 4.4%, compared with 6% (all-facility readmission rate) during the same quarter of the prior year. Findings from this project suggest that reductions in readmissions were associated with improvements in discharge planning, training of caregivers, and the use of national tools to standardize practices in reducing readmissions. The implication of this project for positive social change is that patient-centered inpatient rehabilitation care and patient-centered care following discharge may reduce readmissions, reduce costs, improve reimbursement, and reduce deterioration of patients' conditions postdischarge.

京都大学 / 0048 / 新制・課程博士 / 博士(工学) / 甲第19233号 / 工博第4068号 / 新制||工||1628(附属図書館) / 32232 / 京都大学大学院工学研究科社会基盤工学専攻 / (主査)教授 中川 一, 教授 藤田 正治, 准教授 川池 健司 / 学位規則第4条第1項該当 / Doctor of Philosophy (Engineering) / Kyoto University / DFAM

Wire electrical discharge machining (WEDM) is a precision machining process that uses electrical discharges struck between an axially moving wire electrode and the workpiece to remove material through melting and vaporization. WEDM is replacing traditional processes like broaching for machining safety-critical components such as the turbine disk in the manufacture of fuel-efficient jet engines. The main issue preventing the more widespread use of WEDM is that due to WEDM being less productive than broaching, it currently requires 6 WEDM machine tools to replace a single broaching machine to maintain the same throughput. The main factor limiting WEDM productivity is wire breakage. To increase the Cutting Rate (CR) more power is required, and increasing power also increases the likelihood of breakage. The goal of this research is to determine whether wires thicker than the conventional 0.25 mm diameter will both optimize the cutting rate and minimize breakage. Thicker wires will allow for an increase in the duty factor, with a significantly decreased incidence of wire breakage. Given that an increased wire diameter also increases the kerf width, this research seeks to identify the optimal wire diameter that maximizes the linear cutting rate. This research concluded that using wire of optimal diameter in WEDM increases the CR by as much as 400%. / Thesis / Master of Science in Mechanical Engineering (MSME) / In order to secure jet engine blades onto the engine, complex features called Firtree Root Forms (FTRF) are used. These features need to be very precisely cut in order for the engine to work at peak efficiency. Currently, industry is using a manufacturing process called broaching to machine these FTRFs, however broaches wear out over time, which causes imprecise cuts. The solution to this is to use Wire Electrical Discharge Machining (WEDM). The problem with WEDM is that it takes on average 6 machines to replace a single broaching machine in terms of productivity. The objective of this project is to increase the cutting speed (and thus productivity) of WEDM, and one of the ways to do that is to increase the electrode wire diameter. This allows for more power to be used in the machining process without the risk of wire breakage, which is a major problem when cutting with WEDM. The research presented in this thesis successfully demonstrates that using thicker wires in WEDM can cut as much as 400% faster than the wires currently in common use in industry.

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In comparison with Si-based converters, the emerging Medium Voltage (MV) SiC-based converters can achieve higher blocking voltage capability, lower on-resistance, faster switching speed with less switching related losses and run under higher temperature. Thus, theoretically, it can achieve much higher power density, which becomes very promising for future power transmission and distribution. However, in order to achieve the desired high power density, insulation system of the MV SiC-based converter must be compact. Therefore, challenges for the insulation system gradually appeared, as the insulation size becomes smaller and the Electric field (E-field) intensity significantly increases. Under such high E-field intensity, it is necessary and important to eliminate Partial Discharge (PD) for such power converters, since the converter system is vulnerable to PDs. Developing an insulation design, assessment and online monitoring method to help reach a compact and PD free insulation system for MV SiC-based converters is a goal of this work. General insulation design and assessment guidelines based on experimental PD investigation and physics-based model –Experimental PD investigation is completed for internal void discharge, surface discharge, and point discharge representative coupons under square excitations. Based on the data and the existing knowledge about PD mechanisms, widely accepted PD models are selected. Using these physics-based models, simulation results can demonstrate the major features observed in the experiments. With the experimental data and valid PD models, several general insulation design and assessment guidelines are proposed, which could be further applied during converter prototypes development. Partial Discharge elimination methodology and design examples – By using the laminated bus as the design example, internal void evaluation and analysis method is demonstrated. Then, targeting the internal PD-free design with reasonable insulation thickness, several insulation improvement methods are applied and experimentally verified by using representative coupons. After understanding the possible ways for evaluating and eliminating internal voids, a PCB-based planar bus is designed and fabricated, which shows great insulation improvement after experimental verification. In order to eliminate PDs in the air and shrink the insulation distance, three ways for managing E-field distribution in air are demonstrated by three examples. First, by using the interconnections among the power modules, Rogowski-based current-sensing board, and the laminated bus as an example, E-field distribution can be estimated by Finite Element Analysis (FEA) and its management can be achieved by geometrical modifications. Second, for the one-turn inductor, a methodology is demonstrated that builds a coaxial insulation structure with proper termination technology in order to squeeze air out of the insulation system. Finally, E-field shielding technology is applied along the heatsink edges in order to make the E-field distribution uniform and to shrink the insulation distance between the heatsink and the cooling system. After improving the insulation, this work shrinks the converter unit size by around 50% while maintaining its PD-free status under normal operation conditions. Besides the significant increase in power density and weight reduction, the entire converter system has less ringing and better current-sharing performance due to reductions of the parasitic inductance. Partial Discharge online monitoring via acoustic and photon detection methods –Targeting the online monitoring and even localization of surface discharge for power converter applications, two novel types of sensors have been proposed and fabricated. In order to verify the concepts, one example with experimental results has been given for each type of sensor. The experimental data demonstrates that such sensors can be placed inside the converter and online monitoring can be realized for surface or corona discharges by capturing either the acoustic signal or the photons that are generated by discharge events. / Doctor of Philosophy / A unproper designed insulation system can take more than 50% volume of Medium Voltage (MV) SiC-based converters and have significant internal or external Partial Discharge (PD), which can not only accelerate the insulation aging but also risk to multiple aspects of the converter system. Therefore, developing an insulation design, assessment and online monitoring method to help reach a compact and PD free insulation system for MV SiC-based converters is a goal of this work. Experimental PD investigation is completed for internal void discharge, surface discharge, and point discharge representative coupons under square excitations. Several general insulation design and assessment guidelines are proposed based on the experimental PD investigation and physics-based explanations, which are further applied during converter prototypes development. Then, PD elimination methodology is developed and demonstrated by design examples. By using the laminated bus as an example, internal void evaluation and analysis method is demonstrated. Then, targeting the internal PD-free design with reasonable insulation thickness, several insulation improvement methods are applied and experimentally verified by using representative coupons. In order to eliminate PDs in air and shrink the insulation distance, three ways for managing E-field distribution in air are demonstrated by three examples. First, by using the interconnections among the power modules, Rogowski-based current-sensing board, and the laminated bus as an example, E-field distribution can be estimated by Finite Element Analysis (FEA) and its management can be achieved by geometrical modifications. Second, for the one-turn inductor, a coaxial insulation structure with proper termination technology in order to squeeze air out of the insulation system is demonstrated. Finally, E-field shielding technology is applied along the heatsink edges in order to make the E-field distribution uniform and to shrink the insulation distance between the heatsink and the cooling system. After improving the insulation, this work shrinks the converter unit size by around 50% while maintaining its PD-free status under normal operation conditions. Besides the significant increase in power density and weight reduction, the entire converter system has less ringing and better current-sharing performance due to reductions of the parasitic inductance. Targeting the PD online monitoring for power converter applications, two novel types of sensors have been proposed and fabricated. In order to verify the concepts, one example with experimental results has been given for each type of sensor. The experimental data demonstrates that such sensors can be placed inside the converter and online monitoring can be realized for surface or corona discharges by capturing either the acoustic signal or the photons that are generated by discharge events.

In the last few decades India has advanced socioeconomically due to the rapid growth of industries and automobile sector. This in turn increases the use of fossil fuel and diesel. The atmosphere gets polluted due to the harmful substances, which comes from the burning of fuel. These pollutants can be in the form of gaseous, liquid or solid particulate. Air pollution, both indoor and outdoor, is a significant cause of health problems worldwide. In the automobile sector diesel engine exhaust is the major contributor for the air pollution amounting to about 60%. Exhaust generally contains oxides of Carbon, Nitrogen, Sulfur, Soot, Oil mist etc. Due to the heavy consumption of diesel as a fuel there is an urgent need to control diesel exhaust. Successful control of emissions from combustion engines particularly from diesel engines is yet to be achieved. The conventional techniques which are available to control emission now are either difficult to operate or does not satisfy the stringent emission standards. Among the major pollutants of diesel exhaust NOx is one of the pollutants to be taken care of as it is the major contributor for acid rain, photochemical smog etc. Further the NOx cause health problems leading to respiratory diseases, pneumonia, asthma etc. Till date, despite improvement in aftertreatment technologies, diesel engine continues to emit large amounts of NOx. The failure of conventional techniques lead to the development of non-conventional techniques such as high voltage electric discharge based plasma which has already been proved to be economical and highly efficient in Industrial Electrostatic Precipitators. Till now all the research regarding control of NOx has been done at the laboratory level using conventional DC and rotary spark gap based high voltage power supply. However, this is not a feasible option for Automobiles. The objective of this thesis is, therefore, to design and fabricate a solar powered high voltage power supply to be retrofitted into a vehicle. This leads to the development of power supply which will be of smaller size & capable of supplying high voltage to the gas treatment reactor. In the present work emphasis has been made on the design and development of a DC/HVAC power unit based on switch mode power supply approach. The thesis mainly presents the following issues:  Design & fabrication of solar powered high voltage high frequency power supply for the production of Electric Discharge Plasma.  Actual diesel exhausts treatment with the Electric Discharge Plasma.  Exhaust treatment with conventional 3 way CAT.  Exhaust treatment with cascaded plasma & catalyst/adsorbent system  Comparative analysis. The high voltage power supply gives an output of 16kV peak to peak at 12.2 kHz with a 50W power rating. This high frequency high voltage is applied to the gas treatment reactor and studies on actual diesel exhaust cleaning were carried out. It was observed that there was substantial improvement in the NOx removal under this high frequency AC application when compared to conventional 3-way catalytic converter. Studies have also been carried out at different engine loads and a comparative analysis has been made by cascading the NTP with adsorbents & catalysts and results as discussed in detail.

The thesis is divided into theoretical and practical part. The theoretical part includes issues associated with runoff and discharge, methods for discharge measurement and measurements of uncertainties. The practical part of the thesis describes a specific process flow measurement in Kopaninský and Jenínský stream. There is a familiarization with the water flow velocity measurement and comparison methods of volume measurement discharge with continuous measurement. The results of the practical part served to refine the rainfall-runoff processes in research catchment areas. Refined values of the flow rate were used as input data for the calculation of the runoff coefficient and for quantifying the losses of nutrients from the catchment areas. Calculation of the runoff coefficient and nutrient losses were compared for the original and the revised equation discharge curve. Volume measurement discharge has shown that the different conditions above measurement weir during continuous monitoring lead to the uncertainties of measurement. That´s why one has to approach to each flowmeasurement individually and consider the situation in a particular installation.

The aim of the diploma thesis was the diagnostics of plasma generated in the atmosphere simulating conditions on Mars. This diploma thesis is focused on the simulation of Mars’ atmosphere at atmospheric pressure and normal laboratory temperature. Due to the similar conditions of Mars' atmosphere with Earth, this planet has been explored in the past as well as up to now. Mars' atmosphere is composed mostly of carbon dioxide, which makes up more than 90 % of Mars' atmosphere. A glow discharge generated in a special reactor at atmospheric pressure at a flow of pure CO2 was used to simulate the atmosphere of Mars. Part of the measurement was performed only in pure CO2 with changing current of 20, 25, 30, 35 and 40 mA. Part of the measurements was focused on the study of the effect of the addition of various gases, such as nitrogen, hydrogen and methane, at changes in their flow rates of 1, 2, 3, 4 and 5 sccm. The products formed in the special reactor were analysed using a mass spectrometer with proton ionization and with a flight time analyser. Optical emission spectrometry was used for plasma diagnostics and composition. Mainly simple aliphatic hydrocarbons, alcohols, aldehydes, and ketones were detected. With increasing flow rates of the individual gases, more complex aromatic compounds with higher molecular weights were formed. Corresponding mass and optical emission spectra were measured simultaneously.

The main object of this thesis is the diagnostics of the diaphragm discharge generated in water solutions containing supporting electrolytes (mostly NaCl), and description of particular processes before and after discharge breakdown by DC non-pulsed voltage up to 2 kV. Although many applications of electric discharge in liquids have been developed during the last years, the exact mechanism of the discharge ignition is not sufficiently known up to now. Based on this reason, this work is focused on the investigation of processes before the discharge ignition, breakdown parameters and the discharge itself both in the irregular and stable regime. The theoretical part of the work presents proposed mechanisms of the discharge generation in water solutions including the description of particular kinds of known discharges. Diaphragm discharge is one of many possible configurations of electrical discharges in liquids. In fact, electrical discharge in water forms non-thermal plasma, which is generated by high voltage, and many physical and chemical processes are started in plasma channels (so-called streamers). Among physical processes, high electrical field, shock waves and last but not least emission of electromagnetic radiation in visible and ultra-violet radiation belongs. The most important chemical processes are generation of various active species as hydrogen peroxide, and OH radical. Three batch plasma reactors using a diaphragm configuration with different total volume (4 l, 100 ml and 50 ml) are employed in the presented work. The discharge is created in an orifice (a pin-hole) in the dielectric barrier separating two electrode parts of the reactor. DC non-pulsed high voltage up to 4 kV is used for the discharge generation. Electrodes are made of stainless steel or platinum, and they are installed in parallel to the diaphragm in a variable distance from the dielectric barrier in each reactor part. The dielectric barrier is made of PET or Shapal-MTM ceramics with the variable thickness (0.2?2 mm). One pin hole st the diaphragm center with diameter of 0.2?1.5 mm are used in contemporary experiments. Time resolved characteristics of current and voltage are recorded using four-channel oscilloscope which detected their output values. Parameters are measured by the constantly increasing DC voltage with a step of 100 V. The solutions containing sodium chloride electrolyte are used at five different conductivities. Recorded time resolved characteristics determine breakdown moment, and describe current and voltage in particular parts within the static current-voltage curve. The breakdown appeared at lower applied voltage when the electrode distance is enhanced. However, the electrode distances higher than 4 cm does not induce any significant change of the breakdown voltage. The influence of pin-hole diameter is less obvious in the studied range, but a slight enhancement of breakdown voltage is observed with the increasing pin-hole diameter. Current-voltage characteristic curve moves towards lower voltage with the diaphragm thickness enhancement. The work compares the influence of conductivity change on current-voltage characteristics as well as the effect of inorganic salt kind. By the conductivity enhancement, the measured current-voltage curve moves towards lower voltage which means that the breakdown voltage is decreased. Sizes of the reactors do not have any effect on the processes before and after discharge breakdown.

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