Background: Getting admitted to CCU is viewed as a stressful event by patients. However, numerous studies have indicated that nurses do not always accurately perceive the stressors of their clients. Therefore, it is important for nurses to know what seems most stressful from the patients‘ perspective so that appropriate nursing measures can be directed towards minimizing such stressors. Objectives: The purpose of this study was to explore the perception of CCU stressors experienced by patients from both patients and nurses perspective and to compare between them, identify the effect of socio-demographic characteristics of participant's on the level of stress perception and to what extent clinical guidelines fulfil CCU needs. Methodology: A mixed method approach (qualitative and quantitative) was applied. Purposive random sampling was used to recruit data. Ethical approval was obtained prior to data collection. Data was collected from three CCUs within the West and Northwest NHS Trusts. Participants who met the inclusion criteria were interviewed and asked to rank the Environmental Stressor Questionnaire (ESQ). Qualitative data was analyzed using Gorgi's method of analysis. A quantitative data was analyzed using the SPSS software version 15. Results: There was some consistency in the data where patients and nurses provided same ranking for CCU stressors. Consistently nurses ranked physiological stressors higher than psychological stressors. Patients showed consistency in the findings between what they ranked in the ESQ and their narratives more than their counterparts. Perception of stress was affected by participant's socio-demographic characteristics. A key finding is that the current guidelines do not serve patients and nurses needs. Conclusions: Nurses should be well equipped with knowledge and experience to overcome stressful situations. Educational programs should be made available for nurses to improve stress management. Nurses should assess patient's needs by applying effectively communication skills.

Output power of hydro power plant was modelled and an optimization algorithm was implemented in a tool for optimizing hydro power plants. The tool maximizes power output of a hydro power plant by distributing water over a set of active units in the power plant which will be used in planning of electricity production. This tool was built in a MATLAB environment, using the optimization toolbox, and a GUI was developed for Vattenfall. The optimization tool was based on the same architecture as the current tool used for this kind of optimization which is to be replaced by the work presented in this thesis. Therefore, the goal was to achieve the same optimal results as the current optimization tool. Power output of three of Vattenfall’s hydro power plants were computed and two of these plants were optimized. These power output results were compared to results from the optimization tool currently used. This showed differences within the inaccuracy of measurements of ≤ 0.3%. These three power plants proved that the new tool is sufficient to replace the current tool but further testing is recommended to be conducted on more of Vattenfall’s hydro power plants to prove its consistency.

O Sistema Nacional de Saúde (SNS) em Moçambique sofreu uma significativa degradação e fragilização, resultado em parte da guerra civil ocorrida por cerca de 20 anos, o país continua debatendo com problemas de fome, nudez e inúmeros outros socioeconômicos, que direta ou indiretamente afetam a saúde das populações, fato evidente nos dias de hoje, traduzido pelo difícil acesso a saúde das populações residentes em áreas rurais e urbanas. A cobertura no atendimento da saúde para as populações em cerca de 70%, residente na área rural, sob baixa renda, alto índice de analfabetismo, se caracteriza por deficiente no respeite a quantidade das unidades sanitárias disponíveis, e na falta de recursos humanos capazes de cobrir a demanda do País. A pesquisa que se propõe objetiva na busca de uma solução em curto prazo, tem por objeto levar a saúde às das comunidades rurais em áreas longínquas de difícil acesso ou com carência de unidades sanitárias, a partir de uma proposta Modelo de Unidade Sanitária Móvel, capaz de oferecer à população serviços de atendimentos básicos em cuidados primários e de prevenção. O modelo será definido com base nos resultados da análise feita ao SNS, tendo como pano de fundo: a população, doenças, indicadores social/saúde, recursos humanos, e impactos socioeconômicos. Que o resultado, além do proposto, seja aplicável no desenvolvimento do país, na melhoria e benefício das comunidades atendidas, e que partindo das diretrizes esboçadas, sirva de base para futuros projetos idêntica. O método de pesquisa que se pretende utilizar basear-se-á em levantamento bibliográfico e estudo caso a caso, com entrevistas a profissional e organizações que estejam atualmente envolvidas em ações idênticas, bem como a visita e eventual acompanhamento de expedições feitas pelas suas unidades. / The National Health Service (NHS) in Mozambique has suffered a significant degradation and weakening, in part as a result of the civil war tooked place for about 20 years, the country still struggling with problems of hunger, nakedness and numerous other socioeconomic factors, that directly or indirectly affect the health of populations, a fact evident today, translated by difficult access to the health of people living in rural and urban areas. The coverage in health care to populations, in about 70% residing in rural areas in low income, high illiteracy rate, is characterized by deficient in respecting the amount of available health facilities, and lack of human resources capable of cover the demand of the country. The research aims to propose a research of a short term solution, in order to bring health in rural communities in remote areas of difficult access or lack of health facilities, from a proposed Model of Mobile Health Unit capable of providing basic care services in primary care, and prevention to the population. The model will be defined on the results of analysis done on the NHS, having as backdrop: the population, disease, social indicators / health, human resources, and socio-economic impacts. As a result of the proposed addition, is applicable in the development of the country to improve and benefit the communities served, and using the guidelines outlined, serve for future similar projects. The research method intended to be used, will be based on a survey of publications and case studies, interviews with professionals and organizations currently involved in similar actions, as well as the visit and any follow-up mailings made by their units.

As healthcare continues to face scrutiny related to the cost and quality of patient care, organizations are challenged with providing the right care to patients in the right setting. Some healthcare organizations are implementing observation units to provide appropriate care to a specific subset of patients. The purpose of this project was to develop education for nursing staff who will work on the dedicated observation unit and are unfamiliar with the care requirements. Benner's novice-to-expert theory was used as the framework for the project. This theorist posits that nurses transitioning to a new area require new knowledge and skills to help guide their practice. The education program was based on available evidence, including peer-reviewed journals, consensus white papers, evidence-based studies, and expert opinion. The evidence was organized and analyzed using the Johns Hopkins nursing evidence-based practice model. An educational product for staff members new to an observation unit was developed and shared with stakeholders, including professional development staff, hospital administration, nurse managers, and nursing staff for questions and feedback; feedback was incorporated into the final product. The recommendation is for the education to be incorporated into the orientation for nurses who will work on an observation unit. The project holds significance for the field of nursing practice as it may support the educational needs of nursing staff working on an observation unit in the local setting as well as other acute care setting and benefits hospitals and patients by leading to improved patient care and nurse retention. The project can foster positive social change by improving practice at the local level and on a broader level if other organizations use the education.

There are much economic and financial data which are restricted by some bounds, such as expenditure shares, unemployment, norminal interest rate, or target zone exchange rate. How to interpret and analyze time series whose behaviors can be well approximated by means of integrated processes, I(1), but are ¡§limited¡¨ in the sense that their range is constrained by fixed bounded is what this thesis develops. One method to analyze bounded variable of this paper is ¡§The Bounded Unit Root¡¨ which provided by Cavaliere (2005), and the other is using Gibbs sampling simulation and trying to recover the part of hidden variables. We would examin some empirical problems that has often been tackled in the literature and we give three time series which include Danish kron/Deutshe mark, Belgium Franc/ Deutshe mark, and Japan 1 mouth interbank interest rate for examples. We conclude that these three time series data are I(0) in classical unit root test framework, but are all I(1) in The Bounded Unit Root test framework. And the results of Gibbs sampling simulation are that Danish kron/Deutshe mark and Belgium Franc/ Deutshe mark are I(0), but Japan 1 mouth interbank interest rate is I(1).

Fused floating-point arithmetic units such as a floating-point fused Dot-Product (fused DP) and a floating-point fused Add-Subtract (fused AS) are employed for the implementation of the butterfly unit of the FFT due to their characteristics of low power and less area. In addition, the fused DP has less delay and lower error. Among the elements of the fused DP, two internal mantissa multipliers occupy the largest area and consume the largest power. A Multiple-Constant Multiplier (MCM) architecture has high speed, low power consumption, and small area compared to a conventional multiplier. The MCM is used for the internal mantissa multiplier, providing a solution for low power and high performance. Despite the benefits of the MCM, it lacks precision compared to a conventional multiplier. Due to this, the butterfly unit using the MCM has higher error. In this report, a new architecture of the butterfly unit has been designed by merging conventional MCMs. The new architecture provides two options. It either reduces the error or it lowers the power compared to a conventional MCM butterfly unit. / text

Programinės įrangos testavimas yra kritinė viso kūrimo proceso dalis. Kokybe privalo rūpintis ne vien testuotojai. Programuotojai turi naudoti įvairias kokybės užtikrinimo technikas, tokias kaip statinė kodo analizė (kodo peržiūra) ir vienetų testavimas. Kartais programuotojai praleidžia kodo testavimą arba atlieka tik paviršutinį testavimą, nes tai užimą jų laiką. Automatiniai testavimo įrankiai suteikia galimybes testavimo kaštų sumažinimui. Sukurta daug įvairių testavimo atvejų generavimo technikų naudojant specializuotus įrankius. Testavimo atvejų generavimo tikslas yra pasiekti kuo didesnį kodo padengimą ir rasti netikėtas klaidas. Daugumoje atvejų yra neįmanoma pasiekti visišką kodo padengimą, naudojant vien generuotus testavimo atvejus. Reikalingi testavimo atvejai, parašyti žmogaus. Logiška pakartotinai naudoti testus, kuriais buvo ištestuoti panašūs metodai anksčiau. Šiame darbe analizuojama testų pakartotino panaudojimo problema. Siūlomas sprendimas yra paremtas vienetų testų saugojimu ir pakartotinu panaudojimu lyginant testuojamą metodą ir jau ištestuotą, kuris turi išsaugotus vienetų testus. Siūlomas metodas turėtų būti naudojamas kartu su vienetų testų generavimo įrankiais. / Software testing is critical part in software development. Not only testers are responsible for software quality. Programmers should use quality assurance techniques as code static analysis (code review) and unit testing. Sometimes developers omit testing their code or perform just superficial testing because unit testing consumes development time. Automated unit testing tools provide the way for reducing of testing costs. There are various techniques for generating test cases by using specialized tools. The goal of generation of tests cases is to achieve higher code coverage and expose unexpected errors. In many cases it is impossible to achieve full code coverage by using only generated test cases. Then manual efforts are needed. It is reasonable to reuse unit tests for method similar to that already tested. This work helps to analyse unit test reusability problem. The approach presented is based on unit test storing and reusing by comparing current testing method and method that has saved tests. This method should be used in combination with particular unit test generation tool.

nÃo hà / MudanÃas que aconteceram no sÃculo XX, permitiram que avanÃos tecnolÃgicos aumentassem a sobrevida diante de doenÃas anteriormente incurÃveis e processos patolÃgicos irreversÃveis. No entanto, a busca incessante pela cura, alÃm de levar ao aumento da sobrevida, tambÃm gerou a obstinaÃÃo terapÃutica, ou seja, medidas terapÃuticas fÃteis diante de evoluÃÃo inexorÃvel para a morte, impactando em indicadores como Ãndice de satisfaÃÃo do cliente e cuidadores, tempo mÃdio de permanÃncia, elevaÃÃo de custos, bem como em prejuÃzo na distribuiÃÃo equitativa de recursos. No inÃcio dos anos 90, a limitaÃÃo do suporte de vida (LSV) comeÃou a ser estudada e considerada, em paÃses da Europa, Estados Unidos, Canadà e Austrlia, como forma de assistir os pacientes nesses casos, uma vez que as medidas terapÃuticas nÃo mais trariam benefÃcios, mas gerariam prolongamento do sofrimento e do processo de morrer. No Brasil, contudo, os estudos sÃo limitados e os dados referentes ao Nordeste do paÃs sÃo ainda muito escassos. O objetivo do estudo foi caracterizar as condutas mÃdicas que antecederam o Ãbito de pacientes em UTI pediÃtrica e neonatal em um hospital de referÃncia do Nordeste Brasileiro. Foram estudados 86 prontuÃrios de pacientes que morreram nas referidas UTIs no perÃodo de dezembro/09 a novembro/10. Apenas 3,5% dos Ãbitos ocorreram apÃs LSV registrada em prontuÃrio, destes 33,7% tinham doenÃa crÃnica associada, sendo as neoplasias as mais comuns. As causas de Ãbito mais comuns foram sepse (23,5%), falÃncia de mÃltiplos ÃrgÃos (18,8%), insuficiÃncia respiratÃria (12,9%), cardiopatias congÃnitas (8,2%) e as outras causas somaram 36,6%. A maior parte dos pacientes morreu apÃs aumento das medidas de suporte avanÃado de vida, considerando as ultimas 24h antes do Ãbito: drogas vasoativas (59,3% 24h antes e 70,9% no momento do Ãbito); VentilaÃÃo mecÃnica (89,5% 24h antes e 95,2% no momento do Ãbito). Enquanto as medidas de cuidados e conforto nÃo tiveram a mesma expressÃo, tendo um aumento irrelevante: sedaÃÃo (39,5% 24h antes e 43% no momento do Ãbito); analgesia (60% 24h antes e 60,5% no momento do Ãbito). As manobras de ressuscitaÃÃo cardiopulmonar foram registradas em 4,7% 48h antes do Ãbito, 29,1% 24h antes e 69,4% no momento do Ãbito. O uso de adrenalina foi registrado em 55,4% antes do Ãbito. Conclui-se que a LSV ainda nÃo à frequentemente considerada como uma alternativa de assistÃncia de final de vida a pacientes pediÃtricos e neonatais no Estado do CearÃ, onde as condutas mais prevalentes incluem o incremento do suporte avanÃado de vida em detrimento das medidas de conforto e cuidados paliativos. Comparando-se com estudos do Sul e Sudeste do paÃs, evidencia-se uma grande diferenÃa, onde se observam uma maior prevalÃncia de LSV e cuidados paliativos para pacientes em fase terminal, o que denota prÃticas mais humanas e de maior qualidade na assistÃncia. / Changes around the world at the XX century allowed new technologies to improve the possibilities of surviving in so many cases of sickness that were incurable before. Besides the benefits it brought, other consequences have come together specially futility, in other words futile therapeutic measures when the cure is impossible and the death is inevitable. These facts have influence in client satisfaction, lengh of stay and costs elevation. Since 1990 life support limitation (LSL) started to be considered in Europe, United States, Canada and Austrlia to assist patients in terminal conditions to whom curative practices wouldnât bring any benefit. In Brazil there is a limited number of studies and the data from the Northeastern are even less. The aim of this study was to describe the medical practices before death in patients in PICU and NICU at a reference pediatric hospital in Brazilian Northeastern. Data were collected from 86 medical charts. Only 3.5% of LSL was registered. 33.7% of patients had some chronic disease and neoplasic ones were more comons. The main causes of death were: sepsis (23.5%), MDOS (18.8%), respiratory failure (12.9%), congenital heart disease (8.2%) and the other causes 36.6% together. Most of patients died after increment in vasoatives administration, considering the final 24 hours before death (59.3% 24h before, 70.9% at the momento of death). Mechanical ventilation (89.5% 24h before, 95.2% at the moment). In the other hand palliative care and pain control were not so frequent as could be expected: sedative (39.5 24h before, 43% at the moment) analgesic (60% 24h before, 60.5% at the moment). CPR was offered in 4.7% of patients 48h before death, 29.1% 24h before and 69.4% at the moment of death. Adrenaline was used in 55.4% at the moment of death. These data show that LSL is not a frequente alternative to assist terminal patients at PICU and NICU in Brazilian Northeastern, where more prevalent practices are to maintain life support instead of offer palliative care and pain control. At Southern and Southeastern practice include LSL and palliative care more frequently, what suggests better practices of the end-of-life care.

O Sistema Nacional de Saúde (SNS) em Moçambique sofreu uma significativa degradação e fragilização, resultado em parte da guerra civil ocorrida por cerca de 20 anos, o país continua debatendo com problemas de fome, nudez e inúmeros outros socioeconômicos, que direta ou indiretamente afetam a saúde das populações, fato evidente nos dias de hoje, traduzido pelo difícil acesso a saúde das populações residentes em áreas rurais e urbanas. A cobertura no atendimento da saúde para as populações em cerca de 70%, residente na área rural, sob baixa renda, alto índice de analfabetismo, se caracteriza por deficiente no respeite a quantidade das unidades sanitárias disponíveis, e na falta de recursos humanos capazes de cobrir a demanda do País. A pesquisa que se propõe objetiva na busca de uma solução em curto prazo, tem por objeto levar a saúde às das comunidades rurais em áreas longínquas de difícil acesso ou com carência de unidades sanitárias, a partir de uma proposta Modelo de Unidade Sanitária Móvel, capaz de oferecer à população serviços de atendimentos básicos em cuidados primários e de prevenção. O modelo será definido com base nos resultados da análise feita ao SNS, tendo como pano de fundo: a população, doenças, indicadores social/saúde, recursos humanos, e impactos socioeconômicos. Que o resultado, além do proposto, seja aplicável no desenvolvimento do país, na melhoria e benefício das comunidades atendidas, e que partindo das diretrizes esboçadas, sirva de base para futuros projetos idêntica. O método de pesquisa que se pretende utilizar basear-se-á em levantamento bibliográfico e estudo caso a caso, com entrevistas a profissional e organizações que estejam atualmente envolvidas em ações idênticas, bem como a visita e eventual acompanhamento de expedições feitas pelas suas unidades. / The National Health Service (NHS) in Mozambique has suffered a significant degradation and weakening, in part as a result of the civil war tooked place for about 20 years, the country still struggling with problems of hunger, nakedness and numerous other socioeconomic factors, that directly or indirectly affect the health of populations, a fact evident today, translated by difficult access to the health of people living in rural and urban areas. The coverage in health care to populations, in about 70% residing in rural areas in low income, high illiteracy rate, is characterized by deficient in respecting the amount of available health facilities, and lack of human resources capable of cover the demand of the country. The research aims to propose a research of a short term solution, in order to bring health in rural communities in remote areas of difficult access or lack of health facilities, from a proposed Model of Mobile Health Unit capable of providing basic care services in primary care, and prevention to the population. The model will be defined on the results of analysis done on the NHS, having as backdrop: the population, disease, social indicators / health, human resources, and socio-economic impacts. As a result of the proposed addition, is applicable in the development of the country to improve and benefit the communities served, and using the guidelines outlined, serve for future similar projects. The research method intended to be used, will be based on a survey of publications and case studies, interviews with professionals and organizations currently involved in similar actions, as well as the visit and any follow-up mailings made by their units.

DCU2 (Drive Control Unit 2) is an important control system used in applications for train systems that are configured by a set of parameters. Traditionally, parameterization is conducted by using an excel workbook during the software development. The parameters are set up and further export the parameters to the compilation step. Such approach has a number of disadvantages, e.g., delays on the validation and verification steps, system configuration overhead, and suboptimal system reliability generated by the parameter configurations. To improve the parameterization process, this thesis implements a model-based software architecture approach and automotive industry standards via rapid prototyping by using scrum methodology. We do this by using Matlab/Simulink, TDL (Time Description Language) and UML (Unified Modeling Language) architectural description languages to enable different views of the software architecture. We then develop different prototypes that implement ASAM (Association for Standardization of Automation and Measuring Systems) standards like XCP protocol over Ethernet (code ASAM MCD-1 XCP V1.1.0) and ASAP2 (code ASAM MCD-2 MC) in every scrum sprint. An evaluation then shows that the thesis successfully implements previously defined standards that use commercial tools from e.g., Vector, proving that the parameter‟s unit control can be handled via online calibration and measurement, leading to a significant improvement in Bombardier‟s software development process in a distributed development environment.