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Bakgrund: Multiprofessionellt teamarbete används inom somatisk vård och primärvård. Attsamverka i team ingår i sjuksköterskans profession och är en av de sex kärnkompetensernainom professionen. Ett team samverkar gemensamt för att skapa en bättre vårdkvalité och högpatientsäkerhet. Det finns idag en del svårigheter med multiprofessionellt teamarbete enligtteammedlemmar.Syfte: Syftet med denna studie var att beskriva patienters upplevelse av detmultiprofessionella teamets arbete inom primärvård och somatisk vård, samt hur dettapåverkade dem.Metod: En litteraturöversikt baserad på tio kvalitativa artiklar hämtade från databasernaPubMed och CINAHL. Samtliga artiklar har kvalitetsgranskats och bedömts vara avmedelhög till hög kvalitet. En modifierad version av Graneheim och Lundmansinnehållsanalys har använts som stöd i vid analys av resultat.Resultat: I litteraturöversikten identifierades tre huvudgrupper: Teamets kommunikation,bemötande och begränsningar. Teamets kommunikation innefattar patienterna upplevelse avteamets interna kommunikation, teamets kommunikation med patienten och teametsinformationsöverföring till patienten, samt hur patienten påverkades av detta. Teametsbemötande innefattar patienternas upplevelse av hur teamet arbetade med personcentreringoch delaktighet samt vårdrelationen mellan teamet och patient, samt hur detta påverkadepatienten. Teamets begränsningar innefattar patienters upplevelse av teamet vidmultisjuklighet och tidsbrist, samt hur detta påverkade patienter.Slutsats: Resultat tyder på att multiprofessionellt teamarbete enligt patienter, har både bristeroch styrkor beroende på hur sammansvetsat teamet är samt vilka personer som ingår iteamet. Resultat visar att ett sammansvetsat team har en fungerande kommunikation ochupplever mindre stress, men svårare att samarbeta med hälso- och sjukvårdspersonal utanförteamet. Resultat visar även att personen bakom profession är avgörande för hurpersoncentrerad vården är / Background: Multidisciplinary teams are commonly utilized in hospitals. Team cooperationis an essential part of the nurse profession and one of the six core competencies for nurses. Ateam cooperates in order to create high quality health service and ensure patient safety. Todaythere exists some difficulties regarding teams working multidisciplinary, according to teammembers.Aim: The aim of this study was to investigate patients’ experience of a multidisciplinaryteam work in primary care and somatic care, and how it affected the patients.Method: A literature review based on ten qualitative articles retrieved from the databasesPubMed and CINAHL. All articles have been quality reviewed and received medium to highquality grade. A modified version of Graneheim och Lundmans content analysis was usedwhen analysing the results.Result: The literature review identified three categories and seven subcategories. The team'scommunication includes the patients' experience of the team's internal communication, theteam's communication with the patient and information to the patient, as well as how thepatient was affected by everything previously mentioned. The team's response is about thepatients' experience of how the team worked with a person-centered and participation-basedapproach, as well as the care relationship between the team and the patient, and how thisaffected the patient. The teams limmitations describes the patients' experience on how theteam handles of problems arising from multiple illnesses and lack of time, as well as how thisaffected patients.Conclusion: Results indicate that multi-professional teamwork, according to patients, hasboth shortcomings and strengths depending on the cohesiveness of the team, and on theindividuals taking part. A cohesive team has functioning comunication and experience lessstress, but have a harder time coworking with health care professionals outside of the team.Results also show that the person behind the profession is determining for the degree care isperson centered.

Multidisciplinary interactions are expected to play a significant role in the design of future high-performance aircraft (Blended-Wing Body, Truss-Braced wing, High Speed Civil transport, High-Altitude Long Endurance aircraft and future military aircraft). Also, the availability of supercomputers has made it now possible to employ high-fidelity models (Computational Fluid Dynamics for fluids and detailed finite element models for structures) at the preliminary design stage. A necessary step at that stage is to calculate the wing angle-of-attack at which the wing will generate the desired lift for the specific flight maneuver. Determination of this angle, a simple affair when the wing is rigid and the flow regime linear, becomes difficult when the wing is flexible and the flow regime non-linear. To solve this inherently nonlinear problem, a Newton's method type algorithm is developed to simultaneously calculate the deflection and the angle of attack. The present algorithm requires the sensitivity of the aerodynamic pressure with respect to each of the generalized displacement coordinates needed to represent the structural displacement. This sensitivity data is easy to determine analytically when the flow regime is linear. The present algorithm uses a finite difference method to obtain these sensitivities and thus requires only the pressure data and the surface geometry from the aerodynamic model. This makes it ideally suited for nonlinear aerodynamics for which it is difficult to obtain the sensitivity analytically. The present algorithm requires the CFD code to be run for each of the generalized coordinates. Therefore, to reduce the number of generalized coordinates considerably, we employ the modal superposition approach to represent the structural displacements. Results available for the Aeroelastic Research Wing (ARW) are used to evaluate the performance of the modal superposition approach. Calculations are made at a fixed angle of attack and the results are compared to both the experimental results obtained at NASA Langley Research Center, and computational results obtained by the researchers at NASA Ames Research Center. Two CFD codes are used to demonstrate the modular nature of this research. Similarly, two separate Finite Element codes are used to generate the structural data, demonstrating that the algorithm is not dependent on using specific codes. The developed algorithm is tested for a wing, used for in-house aeroelasticity research at Boeing (previously McDonnell Douglas) Long Beach. The trim angle of attack is calculated for a range of desired lift values. In addition to the Newton's method algorithm, a non derivative method (NDM) based on fixed point iteration, typical of fixed angle of attack calculations in aeroelasticity, is employed. The NDM, which has been extended to be able to calculate trim angle of attack, is used for one of the cases. The Newton's method calculation converges in fewer iterations, but requires more CPU time than the NDM method. The NDM, however, results in a slightly different value of the trim angle of attack. It should be noted that NDM will converge in a larger number of iterations as the dynamic pressure increases. For one value of the desired lift, both viscous and inviscid results were generated. The use of the inviscid flow model while not resulting in a markedly different value for the trim angle of attack, does result in a noticeable difference both in the wing deflection and the span loading when compared to the viscous results. A crude (coarse-grain) parallel methodology was used in some of the calculations in this research. Although the codes were not parallelized, the use of modal superposition made it possible to compute the sensitivity terms on different processors of an IBM SP/2. This resulted in a decrease in wall clock time for these calculations. However, even with the parallel methodology, the CPU times involved may be prohibitive (approximately 5 days per Newton iteration) to any practical application of this method for wing analysis and design. Future work must concentrate on reducing these CPU times. Two possibilities: (i) The use of alternative basis vectors to further reduce the number of basis vectors used to represent the structural displacement, and (ii) The use of more efficient methods for obtaining the flow field sensitivities. The former will reduce the number of CFD analyses required the latter the CPU time per CFD analysis. NOTE: (03/2007) An updated copy of this ETD was added after there were patron reports of problems with the file. / Ph. D.

Recent transonic airliner designs have generally converged upon a common cantilever low-wing configuration. It is unlikely that further large strides in performance are possible without a significant departure from the present design paradigm. One such alternative configuration is the strut-braced wing, which uses a strut for wing bending load alleviation, allowing increased aspect ratio and reduced wing thickness to increase the lift to drag ratio. The thinner wing has less transonic wave drag, permitting the wing to unsweep for increased areas of natural laminar flow and further structural weight savings. High aerodynamic efficiency translates into reduced fuel consumption and smaller, quieter, less expensive engines with lower noise pollution. A Multidisciplinary Design Optimization (MDO) approach is essential to understand the full potential of this synergistic configuration due to the strong interdependency of structures, aerodynamics and propulsion. NASA defined a need for a 325-passenger transport capable of flying 7500 nautical miles at Mach 0.85 for a 2010 date of entry into service. Lockheed Martin Aeronautical systems (LMAS), our industry partner, placed great emphasis on realistic constraints, projected technology levels, manufacturing and certification issues. Numerous design challenges specific to the strut-braced wing became apparent through the interactions with LMAS, and modifications had to be made to the Virginia Tech code to reflect these concerns, thus contributing realism to the MDO results. The SBW configuration is 9.2-17.4% lighter, burns 16.2-19.3% less fuel, requires 21.5-31.6% smaller engines and costs 3.8-7.2% less than equivalent cantilever wing aircraft. / Master of Science

Yes / A recent initiative in hospital settings is the patient safety huddle (PSH): a brief multidisciplinary meeting held to highlight patient safety issues and actions to mitigate identified risks. The authors studied eight ward teams that had sustained PSHs for over 2 years in order to identify key contributory factors. Methods: Unannounced observations of the PSH on eight acute wards in one UK hospital were undertaken. Interviews and focus groups were also conducted. These were recorded and transcribed for framework analysis. Findings: A range of factors contributes to the sustainability of the PSH including a high degree of belief and consensus in purpose, adaptability, determination, multidisciplinary team involvement, a non-judgemental space, committed leadership and consistent reward and celebration. Conclusion: The huddles studied have developed and been shaped over time through a process of trial and error, and persistence. Overall this study offers insights into the factors that contribute to this sustainability.

The aviation industry is growing at a steady rate but presently, the industry is highly dependent on fossil fuel. As the world is running out of fossil fuels and the wide-spread acceptance of climate change due to carbon emissions, both the governments and industry are spending a significant amount of resources on research to reduce the weight and hence the fuel consumption of commercial aircraft. A commercial fixed-wing aircraft wing consists of spars which are beams running in span-wise direction, carrying the flight loads and ribs which are panels with holes attached to the spars to preserve the outer airfoil shape of the wing. Kapania et al. at Virginia Tech proposed the concept of reducing the weight of aircraft wing using unconventional design of the internal structure consisting of curvilinear spars and ribs (known as SpaRibs) for enhanced performance. A research code, EBF3GLWingOpt, was developed by the Kapania Group. at Virginia Tech to find the best configuration of SpaRibs in terms of weight saving for given flight conditions. However, this software had a number of limitations and it can only create and analyze limited number of SpaRibs configurations. In this work, the limitations of the EBF3GLWingOpt code has been identified and new algorithms have been developed to make is robust and analyze larger number of SpaRibs configurations. The code also has the capability to create cut-outs in the SpaRibs for passage of fuel pipes and wirings. This new version of the code can be used to find best SpaRibs configuration for multiple objectives such as reduction of weight and increase flutter velocity. The code is developed in Python language and it has parallel computational capabilities. The wing is modeled using commercial FEA software, MSC.PATRAN and analyzed using MSC.NASTRAN which are from within EBF3GLWingOpt. Using this code a significant weight reduction for a transport aircraft wing has been achieved. / PHD

The Horizon Simulation Framework (HSF) is an open-source community driven mod- eling and simulation tool developed over 15 years by a lineage of Cal Poly graduate students. The tool excels in its flexibility to model an assortment of complex systems, with prebuilt modeling elements available for the simulation of space missions. A high-level simulation tool like HSF lends itself to an agile development cycle as system constraints can be quickly identified through day in the life simulation of the modeled system. The objective of the work presented in this thesis is to refactor the way in which several modeling elements are loaded in the simulation framework. A focus is placed on improving how relationships between various modeling elements are initialized to allow the flow of information between distant assets that was previously not possible. Further improvements were made to the framework with the objective of standardizing how information is communicated from user input files to locations in the framework that depend on the inputs. After implementing these updates, a demonstration scenario was created to validate the developments implemented.