Trauma care across the globe has evolved greatly over the years. However, trauma remains a major contributor to morbidity and mortality as the third leading cause of death in the United States. It also accounts for a considerable portion of healthcare costs. In light of this, and in order to reduce its adverse impacts, appropriate and effective management is necessary. Emergency Medicine, Trauma Surgery, Interventional Radiology and many other specialties contribute to the acute care of patients in the setting of trauma. Other areas of medicine have shown that a clearly outlined multidisciplinary approach to management can lead to better outcomes and shorter hospital stays, specifically where it pertains to rapid response situations. Interventional Radiology has been found to be effective in managing trauma patients presenting with abdominopelvic injury but a clear approach to when they should be involved has yet to be developed. In fact, studies have shown that precise decision making regarding surgical versus non-operative management of trauma patients is essential to providing appropriate care and improving patient outcomes. In order to accomplish this, Interventional Radiology and Trauma Surgery need to have a prompt, active and collaborative dialogue when patients present with such injuries. A description and analysis of the current approach to management of patients with abdominopelvic trauma and subsequent outcomes at a Level 1 Trauma Center will provide valuable insight into how to establish a protocol that could lead to better selection of minimally invasive interventions and in turn improved patient outcomes. / 2022-02-24T00:00:00Z

The diploma is about the topic of multidisciplinarity in community care of people with mentally illness. I chose this topic because I meet clients who have lived for various periods of time knowing that they suffer of mental illness. Over time, I began deeply perceive how mental illnesses affect all areas of client's lives. In the modern sense of community-based psychiatric services, multidisciplinary cooperation should become a provider of more comprehensive, better quality and more effective services for people with mental illness who require health care, but also social care that facilitates inclusion in the society of people who suffer of mental illness. Multidisciplinary collaboration is an interdisciplinary collaboration in social and health services, illustrates different theories that use various terminologies. The collaboration of experts from different disciplines, in addition to the term multidisciplinary, can be referred also as interdisciplinary or intersectoral. Another reason for choosing the topic of the thesis is the increas of discussions and even practical steps within the Strategy of Psychiatric Reform in the Czech Republic. An integral part of the thesis is an introduction to mental health issues, it's history and current planned transformation, which is a priority within the...

Research in the field of entrepreneurship education suggested the need for more studies that focus on the characteristics of the pathways to entrepreneurship education. Previous empirical work in this field has largely been driven by uncovering the link between entrepreneurship education and its impact on students, while fewer researchers have focused on the alignment between the components that constitute entrepreneurship education. The purpose of this mixed methods study was to explore the contextual factors affecting entrepreneurship courses (design and delivery) and their subsequent effects on student perceptions of entrepreneurship and entrepreneurship education across multidisciplinary programmes within a higher education institution. A key aspect of this study was to determine whether students across disciplines were inspired and stimulated by the content and pedagogical aspects of their courses. In this mixed method convergent parallel design study, the qualitative component consisted of semi-structured interviews, presenting the narrative of ten educators teaching in entrepreneurship education. For the quantitative component, survey questionnaires were administered to a sample of 640 students across multidisciplinary programmes at a higher education institution. These surveys were designed to capture the student perceptions of entrepreneurship and entrepreneurship education, as well as their experience of the entrepreneurship course. Key findings of this research identified four factors affecting entrepreneurship education courses within the higher education institution as those of: course design and delivery; institutional impact; educator aspect and the student aspect. Analysis of the student aspect established the influence of contextual factors affecting student perception including: employment aspirations; prior exposure to entrepreneurship education; socio-cultural influence; employment confidence and student experience of the course. This study proposed a conceptual model presenting a framework for teaching in entrepreneurship that highlights the need for an alignment between the factors affecting entrepreneurship education. This conceptual framework therefore provides a map for (a) higher education institutions aiming to implement entrepreneurship education without assimilating its entrepreneurial flavour, (b) curriculum designers of multi-disciplinary programmes and course planners of entrepreneurship education, and (c) educators in entrepreneurship education aiming to develop not only their teaching practice in this field but also enhance their career trajectory in an fast evolving field of education. Firstly, this study contributes to the growing field of research in entrepreneurship education as it is offered within the higher education system, particularly in South Africa where keen efforts are directed at improving and developing this field through current and ongoing initiatives and implementation plans. Secondly, this research also offers an insight into the challenges faced by educators teaching in entrepreneurship, the positioning of entrepreneurship education courses, particularly within multidisciplinary programmes taught at university level and the dynamic of the student input factor. Considering these insights could provide opportunities for improving entrepreneurship education curricula within the higher education institution, not only from a course design perspective but also in the way courses are delivered. Further expectations from this research would be to promote the status of institutionalised entrepreneurship education courses within the higher education community and to acknowledge the written and unwritten role and expectations of educators in this field. This should encourage opportunities for faculty training and development in entrepreneurial learning, benefitting both educator and student.

Advances in mobile communication, computing and positioning technologies allow the real-time acquisition of continuously changing locations of moving objects, e.g., users carrying location-aware mobile devices. The geocontextual analysis of these locations of users can reveal valuable mobile consumer patterns and enable a number of promising Business Intelligence (BI) services and desirable intelligent Location-Based Services (LBSes). However, as some exact user locations can be extremely sensitive while others can be used to link the users to his or her real-world identity, location traces of users must be anonymized.To facilitate these promising BI services and desirable intelligent LBS in a privacy preserving manner, the present paper proposes an Anonymous Mobile Consumer Analysis Platform (AMCAP) that based on the geocontextual analysis of anonymized location traces, in four phases, derives mobile consumer characteristics of its users in terms of Anomymous Mobile Consumer Profiles (AMCPs) and information about the dynamically changing spatio-temporal distribution of the users that is recorded in a spatio- temporal data warehouse of Anonymous Mobile Consumer Types (AMCTs). In the first phase, based on a number of spatio-temporal criteria the platform probabilistically associates a user’s generalized location, that is represented by an anonymization region with activity types that activity centers in the anonymization region can facilitate. In the second phase, based on the activity type inferred in phase one, the platform, in an online and incremental fashion, summarizes an Anonymous Mobile Consumer Profile (AMCP) for each of the users. In the third phase, the platform periodically groups the users based on their AMCPs into a number Anonymous Mobile Consumer Types (AMCTs). Finally, in the fourth phase, in order to capture the dynamically changing spatio-temporal distribution of the consumers and their characteristics, the platform, in an online and incremental fashion, records the frequency and duration of the visits of different AMCTs to different spatio-temporal regions.The AMCAP is empirically evaluated on the simulated movements of a subset of the population of Copenhagen, Denmark. Experiments regarding the accuracy of the AMCP construction reveal that the proposed activity type inference from anomymized regions is effective and can predict the actual activity of the users with an accuracy of 0.75 and a κ- value of 0.73. AMCPs are clustered into 7 AMCTs. The quality of AMCTs is evaluated by comparing it with Actual Consumer Types (ACTs) which are extracted from Actual Consumer Profiles (ACPs). In both the AMCPs and ACPs, the optimal number of clusters is 7. Meaning thereby that although AMCPs are blurred, they do not loose their inherent property of being clustered into the same of number of types as ACPs. The Adjusted Rand Index (ARI) (a measurement for similarity between two grouping of objects) between the AMCTs and ACTs is 0.3 which is significantly higher than the random assignment where ARI value is -0.0000247. Computational performance evaluations show that a relational DBMS-based prototype implementation of the AMCAP on a single machine can process 50,000 anonymization rectangles in 20 seconds. Based on the assumption that during any given 5-minute interval no more than 10% of the users submit an anonymization region, it is extrapolated that the prototype is capable to perform in real-time the geocontextual analysis (i.e., phases 1, 2, and 4) of anonymized location traces of 7 million users. Finally, to illustrate the utility of the information that is derived by the AMCAP a number of derived BI services are discussed.

The approach taken by the College of Business and Technology at East Tennessee State University uses multidisciplinary teams to develop an assessment process that unifies the organization's culture to focus on assurance of learning. The theoretical literatures in change management processes and organizational culture are the foundations for the design of the assessment process that spans seven diverse departments and satisfies the requirements of multiple disciplinary accreditors. Lessons learned and recommendations for others are shared.

Southwestern Gotland has a relatively diverse bedrock where both sandstone, limestone and marl areexposed. The purpose of the survey has been to investigate differences in coastal erosion regarding thecontent of the bedrock. This was done by taking samples from 9 different locations which were laterexamined in point load tests and a slake durability test. A GIS-analysis was also done where the coastalarea in old aerial images and modern orthophotos were compared. The results showed that the sandstoneand marl samples were approximately equally prone to break and that limestone was less prone. Theslake durability test showed that sandstone from one site had the least resistance to abrasion, sandstonefrom the marl areas had greater resistance and that the limestone area had marginally greater resistancethan the marl areas. The GIS analysis indicated that the sandstone and marl areas had a relatively highsensitivity to coastal erosion and that the limestone area was not particularly exposed to coastal erosion. / Sydvästra Gotland har en relativt mångfaldig berggrund där både sandsten, kalksten och märgelstenexponeras. Arbetets syfte har varit att undersöka skillnader i kusterosion med avseende på berggrundensinnehåll. Detta utfördes genom att ta prov från 9 olika lokaler som senare undersöktes i punktlasttestoch nötningstest. En GIS-analys utfördes även där kustområdet i äldre flygfoton och modernaortofotona jämfördes. Resultatet indikerade att sandstens- och märgelstensproverna hade ungefärligenlika stor benägenhet att brytas och att kalksten har mindre benägenhet. Nötningstester visade attsandsten från en lokal hade minst motståndskraft mot nötning, att sandsten från märgelstensområdenahade större motståndskraft och att kalkstensområdet hade marginellt större än märgelstensområdena.Enligt GIS-analysen hade sandstens- och märgelstensområdena en relativt stor känslighet förkusterosion och att kalkstensområdet inte var särskilt utsatt för kusterosion.

As engineering systems grow in complexity so too must the design tools that we use evolve and allow for decision makers to efficiently ask questions of their model and obtain meaningful answers. The process of whitespace exploration has recently been developed to aid in engineering design and provide insight into a design space where traditional design exploration methods may fail. In an effort to further the research and development of whitespace exploration algorithms, a software package called Thalia has been created to allow for automated data collection and experimentation with the whitespace exploration methodology. In this work, whitespace exploration is defined and the current state of the art of whitespace exploration algorithms is reviewed. The whitespace exploration library Thalia along with a collection of benchmarking cases are described in detail. A set of experiments on the benchmark cases are run and analyzed to further understand the behavior of the algorithm and outline initial performance results which can later be used for comparison to aid in improving the methodology.

First year death rates remain unacceptable high for the end-stage renal disease (ESRD) population. New effective methods are vital to improve first year morbidity and mortality outcomes for the population transitioning from Stage 4 chronic kidney disease (CKD) to ESRD)/Stage 5 CKD. Based on current methods, evidence-based recommendations made by nephrology providers are frequently not heeded by patients in Stage 4 CKD. Low levels of patient knowledge, self-efficacy, and a poor ability to self-manage CKD negatively influence a patient’s ability to follow provider recommendations. The group visit (GV) intervention has demonstrated improvements in disease-related outcomes through increased levels of patient knowledge, self-efficacy, and disease self-management for other chronic diseasses such as diabetes and congestive heart failure (CHF). No data are available for the use of GVs in CKD The purpose of the study was to develop and test a nurse practitioner-facilitated chronic CKD GV model versus usual nephrology care for Stage 4 CKD patients (knowledge, selfefficacy/self-management, physiological data, and satisfaction). As classified by the National Kidney Foundation’s (NKF) staging system, Stage 4 CKD is considered severe kidney disease, with a decrease in the functional capacity of the kidney as determined by a glomerular filtration rate (GFR) of 15-30 ml/min. It is common for patients with Stage 4 CKD to progress to Stage 5 CKD/end-stage renal disease (ESRD), requiring dialysis or transplantation to survive. Preliminary instrumentation and feasibility studies were conducted prior to a pilot study of a CKD GV model. The development and validation of the Stage 4 CKD Knowledge Instrument was completed with 59 Stage 4 patients. Findings supported reliability (KuderRichardson-20 [KR] = .89) and content validity (I-CVI = .97, S-CVI= 1.0) Feasibility of the CKD GV model was assessed with a single group, pretest-posttest design using a convenience iv sample of eight Stage 4 patients. Results demonstrated an improvement in knowledge of CKD from a median of 69% to 86% (p =.012). No improvements were noted in self-efficacy scores (p = .230). GV satisfaction ranged from very good to excellent. Feasibility was supported by a high retention rate (100%). No barriers to participant recruitment or GV implementation were encountered. The pilot study used a two-group, repeated measures experimental design, with a sample of 30 Stage 4 CKD patients from two office locations of an outpatient nephrology practice. Patients were randomized to the GV intervention or to usual nephrology care. CKD-knowledge, self-efficacy, and self-management scores were collected at baseline, six months, and nine months. Physiological data were measured at baseline, six months, and nine months. GV satisfaction was obtained after the completion of GVs (six months). Nephrology practice satisfaction was obtained from by both groups at nine months. MANOVA for repeated measures was calculated for data collected at the three time points. Twenty-six of 30 patients completed the study, with four patients ineligible to complete the study due to progression to ESRD and dialysis initiation. GV attendance was 92%. CKD knowledge was statistically improved for both groups (F(1.498, 34.446) = 6.363, P = .008). While not statistically significant, a favorable upward trend in the mean scores for the subscales of self-management (communication, partnership in care, and self-care) was demonstrated in the GV patients, with a lack of improvement found in the usual care group for these subscales. Selfefficacy scores revealed a non-significant improvement in mean scores for the GV patients during the GVs, not seen with usual care patients. GV satisfaction was again high with the vast majority of patients requesting use of GVs in their future nephrology care. v Current methods of intervention in the Stage 4 CKD population have made little impact on reducing first-year ESRD mortality and morbidity rates. Opportunities to intervene in the poor outcomes begin in the predialysis care of Stage 4 patients. Based on the documented success of multidisciplinary approaches in predialysis care, of GVs in other chronic diseases, and of chronic illness care based on the CCM, a high probability for success exists with the application of GVs in CKD. Although limited by a small sample size, promising improvements in the subscales of disease self-management, self-efficacy, CKD knowledge, and high satisfaction with the GV model for GV participants were revealed in this study. Further research is warranted for the CKD GV model on a larger randomized sample in other locations. Much needed data would be provided on which to base decisions for use of the CKD GV intervention in the predialysis care of Stage 4 patients.

Requirements verification is typically the costliest part of the systems engineering design process. In the commercial aircraft industry, as the software and hardware design evolves, it must be verified to conform to requirements. In addition, when new design releases are made, regression analysis must be performed which usually requires repeat testing. To streamline verification, a suite of automated verification tools is described in this document which can reduce the test effort. This test suite can be qualified to be used to verify systems at any DO-178B design assurance level. Some of the software tools are briefly described below. There are major advantages of this automated verification effort. The tools can either be internally developed by a company or purchased "off the shelf", depending upon budget and staff constraints. Every automated test case can be run with the click of a button and failures caused by human factors are reduced. The station can be qualified per DO-178B guidelines, and can also be expanded to support ARINC 429, AFDX, Ethernet, and MIL-STD-1553 interfaces. The expansion of these test programs would enable the creation of a universal avionics test suite with minimal cost and a reduction of the overall program verification effort. The following is a presentation of an automated test station capable of reducing verification time and cost. The hardware and software aspects needed to create the test station are examined. Also, steps are provided to help guide a designer through the tool qualification process. Lastly, a full suite of test functions are included that can be implemented and customized to verify a wide range of avionics communication characteristics.

The purpose of this work is to help bridge the gap between aircraft conceptual design and analysis. Much work is needed, but distilling essential characteristics from a design and collecting them in an easily accessible format that is amenable to use by inexpensive analysis tools is a significant contribution to this goal. Toward that end, four types of reduced-fidelity or degenerate geometric representations have been defined and implemented in VSP, a parametric geometry modeler. The four types are degenerate surface, degenerate plate, degenerate stick, and degenerate point, corresponding to three-, two-, one-, and zero- dimensional representations of underlying geometry, respectively. The information contained in these representations was targeted specifically at lifting line, vortex lattice, equivalent beam, and equivalent plate theories, with the idea that suitability for interface with these methods would imply suitability for use with many other analysis techniques. The ability to output this information in two plain text formats— comma separated value and Matlab script—has also been implemented in VSP, making it readily available for use. A modified Cessna 182 wing created in VSP was used to test the suitability of degenerate geometry to interface with the four target analysis techniques. All four test cases were easily completed using the information contained in the degenerate geometric types, and similar techniques utilizing different degenerate geometries produced similar results. The following work outlines the theoretical underpinnings of degenerate geometry and the fidelity-reduction process. It also describes in detail how the routines that create degenerate geometry were implemented in VSP and concludes with the analysis test cases, stating their results and comparing results among different techniques.