Background Tube-feeding or nutritional support is a therapy for people who can’t get enough nutrition by eating or drinking. You may need it if you have difficulty swallowing, loss of appetite, are severely malnourished or have inability to absorb nutrients through your digestive system. There are several diagnoses associated with tube-feeding, depending on the persons diagnose and users state the user can be tied to the tube-feeding equipment from 3 to 18 hours a day. In Sweden there are around 1500-3000 adults in need of tube-feeding outside the hospitals.   Method This report is made by Cindy Sjöblom and is an individual student’s work. The project is her dissertation and final project at the two year Masters program Advanced Product Design at Umeå Institute of Design. The project has been executed during 20 weeks the spring 2015. The project is based on the design process which includes the following phases; Research & Analysing, Ideation & Concept’s and Detailing & Visualization. The Research & Analysis phase has included; Product analysis, user interviews & observations, market outlook, anatomical knowledge, problem listing and opportunity findings. The Ideation & Concept’s phase has included; Inspiration, persona creation, creative workshop, sketching, concepts creation, mock-up building, user testing & feedback. The Detailing & Visualization phase has included; 3D modelling, moodboard creation, sketching, final model building, photo shooting, video recording, documentation, presentation and a poster and exhibition stand at Umeå Institute of Design and at Semcon, Gothenburg. Result Tubie is an ambulatory tube-feeding system to facilitate an active everyday life for people in need of enteral nutrition. Tubie consists out of six parts; A nutrition pump and a wireless charging station, a nutrition bag and an external tubing, a wearable waist band and an application for a smart device to be able to control the pump. Unlike traditional enteral nutritions systems, Tubie is designed with a focus on the users in a home environment and their need for a more active lifestyle and discreet usage in social environments. Tubie is simply discreet due to its wearable features that allows the user to wear it underneath the clothing as well as control the pump via a smart device with an adaptable pre-alarm that sounds like any other text message or ring tone.

Yes / This paper demonstrates the practical application of process mapping principles as a model for evaluating NHS improvement. The NHS improvement in question was the merger of three crisis resolution teams within an NHS trust in 2012. The aims were to improve overall operational efficiency and enhance multidisciplinary working to meet operational targets. This paper examined changes following the merger to capture the effects of service improvement and the reality of the patient journey. Methods: A pooled cross-sectional approach, using six years of aggregated hospital data, was taken. To achieve operational efficiency, a process map of referrals, readmissions, length of stay and waiting times for crisis resolution team assessments was examined. Prevalence of clinical referral rates and disease classification before and after the merger were compared. Conclusion: Between 1 April 2009 and 30 March 2015, length of stay and readmissions for patients to crisis resolution team rates reduced. Operational sustainability and capacity was enhanced through the redistribution of clinical human resources. Multidisciplinary skill mix (e.g. through improved team composition) also improved.

Due to the worldwide people ageing phenomenon, the health care at home (home care), a more humanized and cost saving method, for elderly people and long term care, is nowadays more and more usual. The problem is to assure prompt help when needed. A surveillance system can be the solution to improve caregiver awareness and patient safeness. This work investigates the possibility of indoor sounds direction of arrival detection, selection and determination, attempting to find out signals of a patient fall or collapse. The sounds after an acoustic event are recorded using a microphone array. If they pass the selection criteria, they are processed by a Direction of Arrival (DOA) detection algorithm. Five DOA algorithms were implemented and evaluated empirically. Three of them are already known, nominally, Generalized Cross Correlation (GCC), Generalized Cross Correlation - Phase Transform (GCC-PHAT), Degenerate Unmixing and Estimation Technique (DUET), and two are proposed at this work, Atack Border Detector and Spectrogram Technique. Performances were evaluated by taking the home care perspective into account. / Devido ao fenômeno global do envelhecimento da populacão, o tratamento domiciliar - home care - torna-se mais comum a cada dia, especialmente para os casos de tratamentos longos, por tratar-se de um método terapêutico mais humano e econômico. O problema decorrente desta prática é como assegurar uma rápida intervenção caso necessário. Um sistema de vigilância médica pode ser a solução para manter os cuidadores informados e aumentar a segurança dos pacientes. Neste trabalho é investigada a possibilidade de se detectar, selecionar e determinar a direção de chegada de sons recebidos por sensores instalados em um ambiente interno, com o objetivo de diagnosticar uma situacão de emergência, tal como uma queda do paciente. Usando um arranjo de microfones, após a detecção de um evento acústico alvo, os sons são gravados para análise. Ao passarem pelo critério de seleção, os sons são processados por um algoritmo de estimação de ângulo de chegada - Direction of Arrival (DOA). Cinco estimadores de DOA foram implementados e comparados empiricamente, sendo tr es existentes, a saber, a Correlacão Cruzada Generalizada - Generalized Cross Correlation - (GCC), a Correlação Cruzada Generalizada com Transformação de Fase - Generalized Cross Correlation - Phase Transform - (GCC-PHAT), a Técnica de Estimação e Separação de Sinais Degenerados - Degenerate Unmixing and Estimation Technique - (DUET); e dois novos algoritmos propostos neste trabalho, tendo sido denominados Detector de Borda de Ataque e Técnica do Espectrograma. Ao final, através da perspectiva da televigilância médica, avaliou-se o desempenho dos mesmos.

<h1>Sammanfattning</h1><p>Syftet med denna kvalitativa studie är att undersöka klienters erfarenheter av två former av missbruksvård. De undersökta verksamheterna är Alkohol- och narkotikagruppen, vilket är en öppenvårdsverksamhet i Lindesberg, samt Stiftelsen Bergslagsgårdar i Örebro, som bland annat arbetar med familjehemsvård för vuxna.</p><p>Intervjuer har utförts med åtta klienter mellan 25 till 58 år, varav fyra berördes från varje verksamhet. Den kontextuella missbruksbakgrunden var varierad.</p><p>Den semistrukturerade intervjuguiden har utformats utifrån studiens syfte, frågeställningar och tolkningsram. De teoretiska utgångspunkter som tillämpats är identitet, social värld samt copingstrategier. Tidigare forskning har studerats inom missbruksvård, motivation, tvång och frivillighet samt vilka nyckelingredienserna är för en lyckad missbruksvård.</p><p> </p><p>Resultat och analys har uppdelats i tre teman:</p><p> </p><p>1)      Synpunkter på vården,</p><p>2)      Upprätthållande av missbruksfrihet</p><p>3)      Social tillhörighet och förändring.</p><p> </p><p>Resultatet indikerar en genomgående positiv inställning hos klienterna till vårdformerna och att motivationen är viktig för resultatet av vården. Motivationen har uppkommit antingen före vården inletts eller under vårdtiden, antingen som en följd av sociala förhållanden eller genom relationen till behandlaren. Slutligen antyder resultatet att kombinationen av vård tillsammans med någon annan social omständighet samverkat till upprätthållandet av missbruksfrihet.</p> / <h1>Abstract</h1><p>The aim of this qualitative study is to examine client experience of two kinds of addiction treatment. The examined organisations were The Alcohol and Narcotic Group, which is an out-patient program in Lindesberg, and The Foundation of Bergslagsgårdar in Örebro, which specialises in family home treatment for adults.</p><p>Interviews were conducted with eight clients between 25 to 58 years of ages, with four clients taken from each organisation. Each client had a contextual substance abuse variation. A semi-structured interview guide was formulated according to the aim of the study and the research questions, within an interpretive framework. The implemented theoretical contexts used are identity, social world and coping strategies. This study builds upon previous research pertaining to addiction treatments, motivation, forced or voluntarily care, and effective key ingredients within addiction treatments.</p><p> </p><p>The result and analysis have been divided into three themes:</p><p>1)      Opinions about treatment</p><p>2)      Maintaining freedom from substance abuse</p><p>3)      Social inclusion and change</p><p>The result indicates that client attitude is consistently positive towards treatment and that motivation is important for rehabilitation. Client motivation arises either before the treatment's start or during its duration, as a consequence of social conditions and/or through interaction with care givers. The result emphasises that a combination of care treatments coupled with other social conditions have produced clients with the ability to maintain freedom from substance abuse.</p>

Sammanfattning Syftet med denna kvalitativa studie är att undersöka klienters erfarenheter av två former av missbruksvård. De undersökta verksamheterna är Alkohol- och narkotikagruppen, vilket är en öppenvårdsverksamhet i Lindesberg, samt Stiftelsen Bergslagsgårdar i Örebro, som bland annat arbetar med familjehemsvård för vuxna. Intervjuer har utförts med åtta klienter mellan 25 till 58 år, varav fyra berördes från varje verksamhet. Den kontextuella missbruksbakgrunden var varierad. Den semistrukturerade intervjuguiden har utformats utifrån studiens syfte, frågeställningar och tolkningsram. De teoretiska utgångspunkter som tillämpats är identitet, social värld samt copingstrategier. Tidigare forskning har studerats inom missbruksvård, motivation, tvång och frivillighet samt vilka nyckelingredienserna är för en lyckad missbruksvård.   Resultat och analys har uppdelats i tre teman:   1)      Synpunkter på vården, 2)      Upprätthållande av missbruksfrihet 3)      Social tillhörighet och förändring.   Resultatet indikerar en genomgående positiv inställning hos klienterna till vårdformerna och att motivationen är viktig för resultatet av vården. Motivationen har uppkommit antingen före vården inletts eller under vårdtiden, antingen som en följd av sociala förhållanden eller genom relationen till behandlaren. Slutligen antyder resultatet att kombinationen av vård tillsammans med någon annan social omständighet samverkat till upprätthållandet av missbruksfrihet. / Abstract The aim of this qualitative study is to examine client experience of two kinds of addiction treatment. The examined organisations were The Alcohol and Narcotic Group, which is an out-patient program in Lindesberg, and The Foundation of Bergslagsgårdar in Örebro, which specialises in family home treatment for adults. Interviews were conducted with eight clients between 25 to 58 years of ages, with four clients taken from each organisation. Each client had a contextual substance abuse variation. A semi-structured interview guide was formulated according to the aim of the study and the research questions, within an interpretive framework. The implemented theoretical contexts used are identity, social world and coping strategies. This study builds upon previous research pertaining to addiction treatments, motivation, forced or voluntarily care, and effective key ingredients within addiction treatments.   The result and analysis have been divided into three themes: 1)      Opinions about treatment 2)      Maintaining freedom from substance abuse 3)      Social inclusion and change The result indicates that client attitude is consistently positive towards treatment and that motivation is important for rehabilitation. Client motivation arises either before the treatment's start or during its duration, as a consequence of social conditions and/or through interaction with care givers. The result emphasises that a combination of care treatments coupled with other social conditions have produced clients with the ability to maintain freedom from substance abuse.

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