Changes in reimbursement make it imperative for nurse managers to develop tools and methods to assist them to stay within budget. Disparity between planned staffing and required staffing often requires supplemental staffing and overtime. In addition, many states are now mandating staffing committees to demonstrate effective staff planning. This retrospective quantitative study developed an empirical method for building nursing unit staffing plans through the incorporation of patient acuity and patient turnover as adjustments towards planning nursing workload. The theoretical framework used to guide this study was structural contingency theory (SCT). Patient turnover was measured by Unit Activity Index (UAI). Patient acuity was measured using case mix index (CMI). Nursing workload was measured as hours per patient day (HPPD). The adjustment to HPPD was made through the derivation of a weight factor based on UAI and CMI. The study consisted of fourteen medical, surgical, and mixed medical-surgical units within a large academic healthcare center. Data from 3 fiscal years were used. This study found that there were significant, but generally weak correlations between UAI and CMI and HPPD. The method of deriving a weight factor for adjusting HPPD was not as important as the decision-making relative to when to adjust planned HPPD. In addition, the measure of unit activity index was simplified which will assist researchers to more easily calculate patient turnover. As a result of this study, nurse managers and will be better able to adjust and predict HPPD in cases where benchmarking has been problematic. Data-driven adjustments to HPPD based on UAI and CMI will assist the nurse manager to plan and budget resources more effectively.

La validité des simulateurs de conduite est une question essentielle pour étayer et valoriser les travaux visant à mieux comprendre les comportements de conduite. Alors que les dimensions subjective et comportementale de la validité ont été régulièrement étudiées, elles font face à certaines limites. A l’opposé, rares sont les études qui se sont intéressées à la validité psychologique des simulateurs. Cette dimension compare l'implication des mécanismes qui sous-tendent les comportements entre conduite réelle et virtuelle. De plus, très peu d’études ont confronté les différentes dimensions de la validité, alors que cela pourrait contribuer au développement d’une métrologie des environnements virtuels. C’est précisément à ce niveau que se situe ce travail de thèse, au cours duquel des mesures classiques de la validité comportementale (vitesse, contrôle latéral) ont été confrontées à des mesures de la validité psychologique examinée sous l’angle de la charge mentale en prenant notamment comme indicateur les clignements oculaires. L’objectif principal était de déterminer si le niveau de charge mentale diffère entre conduite sur route et conduite sur simulateur dans des cas où les comportements observés ne permettent pas de faire de distinction.Pour répondre à cette question, ce travail de thèse a été organisé autour de trois expériences réalisées sur simulateur de conduite et d’une étude sur route réelle. Les deux premières expériences visaient à mieux cerner l’effet de certains facteurs inhérents à la conduite sur route ouverte (trafic, environnement) sur les comportements de conduite et la charge mentale. La troisième expérience était quant à elle destinée à comparer la charge mentale induite par la conduite réelle et la conduite sur simulateur « bas coût », en confrontant cette mesure de la validité psychologique aux mesures comportementales classiques. Enfin, la quatrième expérience a porté sur les effets du retour d’effort du volant sur cette même charge mentale.Les principaux résultats ont mis en évidence un niveau de charge supérieur en conduite simulée par comparaison à la conduite en situation réelle, alors que certaines mesures comportementales (vitesse) n’étaient pas différentes. Cette charge accrue sur simulateur ne semble cependant pas trouver son origine dans le retour d’effort au volant, les modalités de retour testées n’ayant pas eu d’effet sur les indicateurs de la charge. Au final, ce travail confirme que la prise en compte de la validité psychologique, examinée ici sous l’angle de la charge mentale, présente un intérêt dans une démarche d’évaluation, dans le but de mieux cerner le positionnement des utilisateurs face à un dispositif de réalité virtuelle. Il ouvre ainsi des perspectives pour améliorer la validité des simulateurs de conduite. / The validity of driving simulators is an essential subject to support and highlight the works aiming to understand driving behaviours more thoroughly. While the subjective and behavioural dimensions of that validity have often been studied, they encounter a few limits. On the other hand, studies about simulators’ validity are fairly rare. This dimension compares the implication of mechanisms inherent in behaviours between real and virtual driving. Furthermore, very few studies have considered the various dimensions of validity at once, whereas it could contribute to the development of a metrology for virtual environments. This thesis is precisely about this, with confrontations between classical measurements of behavioural validity (speed, lateral control) and measurements of psychological validity, examined from the viewpoint of mental workload - using indicators such as eye blinking. The main objective was to ascertain whether the mental workload levels vary between road driving and simulated driving when the observed behaviours aren’t relevant to make a clear difference.To answer this question, this thesis has been organised around three experiences carried out on driving simulators and a comparison between actual road driving and low-cost simulated driving. Two of those experiences were conducted to finely analyse the effect of some factors inherent to open road driving (traffic, environment) on driving behaviours and mental workload. The third experience was made to compare the mental workload induced by real driving and low-cost simulator driving, by putting this psychological validity measurement against classical behavioural measurements. Lastly, the fourth experience focused on the effects of the driving wheel’s force-feedback on this same mental workload.The main results revealed a higher workload level on simulated driving than on real driving, while some behavioural measurements (speed) were not different. This increased workload with the simulator does not seem to stem from the wheel’s force-feedback, since the tested feedback methods did not have a repercussion on the workload levels. In the end, this work confirms that taking psychological validity - examined here from a mental workload viewpoint - does have an interest within an evaluation process to analyse in a finer fashion the mental state of users when faced with a virtual reality system. It creates prospects to improve the validity of driving simulators.

The purpose of this study was to determine the effects of physical exertion upon the heart rates and workload levels of five selected male freshman basketball players at Utah State University during actual game competition. One hour prior to each of the ten home basketball games, two E&M Surface Electrodes were mounted to the chest of the test subject with disposable double-sided adhesive washers. A biotelemetry transmitter, used for sending electrical signals from the player to a biotelemetry receive r and polygraph, was placed in a plastic sack and taped to the beltline of the subjects athletic supporter. The telemetry receiver and polygraph were located behind the Utah State University team bench. One subject was tested per game and each subject was tested twice throughout the study. The same subject was tested once every fifth home game. The data was collected with a polygraph, by means of radiotelemetry, and recorded according to mean heart (beats per minute), mean volume of oxygen (liters per minute), and mean workload (kilopondmeters per minute), which were the measurements used for the data in the statistical design. In each of these three categories, consideration and comparisons were made of: (A) offensive play, (B) ball handling, (C) defensive play, (D) defense on the ball, (E) fastbreak, (F) shooting, (G) scoring, and (H) rebounding. Data, concerning mean volume of oxygen and mean workload, were processed according to Astrand's Nomogram. A two way analysis of variance test was applied to the data to determine the significant difference between the variables. Another statistical analysis that was conducted on the data was a Newman Keuls Sequential Range Test for determining the significant difference between the eight different game situations studied throughout this study. The two way analysis of variance showed that there was a significant difference at the .05 level of confidence in the mean heart rate, mean volume of oxygen, and mean workload levels of the five subjects during the game situations mentioned above. The Newman Keuls Sequential Range Test indicated that a significant difference occurred at the .05 level between the ball handling activities (fastbreak, ball handling, and shooting) and the non-ball handling activities (rebounding, scoring, defense on the ball, defensive play, and offensive play). Also, this test showed that no significant difference occurred at the .05 level within the two groups of activities mentioned above.

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<p>The advancement of robotic-assisted surgery (RAS) has revolutionized the field by enabling surgeons to perform intricate procedures with enhanced precision, improved depth perception, and more precise control. Despite these advancements, current RAS systems still rely on teleoperation, where surgeons control the robots remotely. The complexity of the master-slave control mechanism, along with the technical challenges involved, can impose significant mental workloads on surgeons. As excessive mental workload (MWL) can adversely affect performance and increase the likelihood of errors, addressing operator mental overload has become crucial for successful operation in RAS. To tackle this problem, there has been increased interest in developing robots that can provide operators with varying levels of assistance based on their MWL (i.e., adaptive system) during task execution. However, the research in this area is notably limited, primarily due to two key factors: the absence of a real-time MWL assessment framework and the lack of effective intervention strategies to mitigate MWL in RAS.</p> <p>This Ph.D. dissertation aims to fill these gaps by designing the adaptive system in RAS and exploring its impact on surgical task performance. The dissertation comprises three studies. The first study demonstrated the feasibility of the adaptive system in RAS by introducing an MWL-triggered semi-autonomous suction tool as a proof-of-concept. Building upon the insights gained from the first study, the second study focused on enhancing the adaptive system's adaptability to more complex RAS tasks. In particular, the second study proposed a task-independent MWL model that had potential to be applied to various RAS tasks. Additionally, more intelligent interventions were investigated. Furthermore, the third study aimed to investigate the benefits of adaptive system in RAS training by introducing a personalized and adaptive training program based on human MWL profile. The findings of this dissertation revealed evidence supporting the effectiveness of the adaptive system in moderating subjects’ MWL, and its potential in enhancing task performance in RAS. This dissertation highlights the potential of incorporating adaptive systems into future RAS platforms, so that to provide valuable support and assistance to surgeons during critical moments and facilitate surgical training by identifying and addressing the specific needs of surgeons.</p>

The ever-growing demand for cyber-physical infrastructures has significantly affected worldwide energy consumption and environmental sustainability over the past two decades. Although the average heat load of the computing infrastructures has increased, the supportive capacity of cooling infrastructures requires further improvement. Consequently, energy-efficient cooling architectures, real-time load management, and waste heat utilization strategies have gained attention in the data center (DC) industry. In this dissertation, essential aspects of cooling system modularization, workload management, and waste-heat utilization were addressed. At first, benefits of several legacy and modular DCs were assessed from the viewpoint of the first and second laws of thermodynamics. A computational fluid dynamics simulation-informed thermodynamic energy-exergy formulation captured equipment-level inefficiencies for various cooling architectures and scenarios. Furthermore, underlying reasons and possible strategies to reduce dominant exergy loss components were suggested. Subsequently, strategies to manage cooling parameters and IT workload were developed for the DCs with rack-based and row-based cooling systems. The goal of these management schemes was to fulfill either single or multiple objectives such as energy, exergy, and computing efficiencies. Thermal models coupled to optimization problems revealed the non-trivial tradeoffs across various objective functions and operation parameters. Furthermore, the scalability of the proposed approach for a larger DC was demonstrated. Finally, a waste heat management strategy was developed for new-age infrastructures containing both air- and liquid-cooled servers, one of the critical issues in the DC industry. Exhaust hot water from liquid-cooled servers was used to drive an adsorption chiller, which in turn produced chilled water required for the air-handler units of the air-cooled system. This strategy significantly reduced the energy consumption of existing compression chillers. Furthermore, economic and environmental assessments were performed to discuss the feasibility of this solution for the DC community. The work also investigated the potential tradeoffs between waste heat recovery and computing efficiencies. / Thesis / Doctor of Philosophy (PhD)

Scheduling algorithm is the algorithm to allocate system resources among processes and data flows. Joint channel-assignment and workload-based (CAWS) is a recently developed algorithm for scheduling in the downlink of multi-channel wireless systems, such as OFDM. Compared to well known algorithms, CAWS algorithm has been proved to throughput optimal with flow-level dynamics. In this master thesis project, we design a system that accounts for power control and for the characteristics of common radio channels. We evaluate the efficiency of the algorithm under a diverse set of conditions. We also do analysis of CAWS algorithm under different traffic density.

Bakgrund: Säker vård innebär att sjuksköterskor ska arbeta förebyggande mot att minskaoch förhindra vårdskador, vilket både Svensk sjuksköterskeförening ochPatientsäkerhetslagen omnämner. Det är en viktig del i det dagliga omvårdnadsarbetet försjuksköterskor att bedriva patientsäker omvårdnad. Trots att det ingår både ikompetensbeskrivningen och svensk lagstiftning drabbas över 100 000 patienter årligen avnågon form av vårdskada i Sverige.Syfte: Syftet med denna litteraturöversikt är att undersöka hur sjuksköterskor upplever attarbetsbelastningen påverkar patientsäkerheten på akutmottagningar.Metod: Examensarbetet utfördes som en litteraturöversikt där 15 kvalitativa vetenskapligaartiklar inkluderades. Databaserna som användes när artiklarna söktes fram var CINAHL ochPubMed. De artiklar som inkluderades var publicerade mellan åren 2011 - 2021.Resultat: Sjuksköterskorna upplevde flera områden som bidrog till brister ipatientsäkerheten där tidsbrist och teamarbete var de mest framträdande. Andra områden somvar bidragande var svårarbetad arbetsmiljö, konsekvenser av personalbrist och bristandekommunikation. Sammantaget av dessa områden kunde utgöra svårigheter försjuksköterskorna att arbeta patientsäkert och prioritera den grundläggande omvårdnaden.Slutsats: Sjuksköterskor är ofta medvetna om patientens risker och hur det förebyggandearbetet ska gå till för att undvika vårdskada, men det som visas i resultatet tyder på att det ärområden som påverkar patientsäkerheten. Det som i grund och botten skapar vårdskador är attsjuksköterskorna inte har tid att vara noggrann i sitt arbete. Sammanfattningsvis pekarresultatet på att det finns ett glapp mellan den forskning som finns om patientsäkerhet och hurverksamheten är utformad och strukturerad. / Background: Nurses must work to reduce and prevent injuries caused by healthcare thatsafe care entails, which both Svensk sjuksköterskeförening and Patientsäkerhetslagenmention. It is an important part of the daily care for nurses to conduct patient-safe care.Despite the fact that it is included in both the competence description and Swedish legislation,more than 100,000 patients suffer from some form of healthcare injury annually in Sweden.Aim: The aim is to explore how nurses experience that the workload affects patient safety inemergency departments.Method: This study was conducted as a literature review which included 15 qualitativearticles. The databases used when searching for the articles were CINAHL and PubMed. Thearticles that were included were published between the years 2011 - 2021.Results: The nurses experienced several factors that contributed to deficiency in patientsafety, where lack of time and teamwork were the most outstanding. Other factors that werecontributed were difficult work environment, staff shortages and lack of communication.Overall, these factors made it difficult for the nurses to work patient safely and prioritize basiccare.Conclusions: Nurses are often aware of the patient's risks and how the preventive workshould be done to avoid injuries, but what is shown in the results indicates surroundingfactors. What basically creates care injuries is that the nurses do not have time to be accuratein their work. In summary, the results indicate that there is a gap between the research thatexists on patient safety and how the organization is designed and structured.