Heart Failure Is A Major Health Concern

Heart Failure is a Major Health Concern
Heart Failure: Heart failure is a serious medical condition that is brought by the failure of the heart
to pump sufficient blood throughout the body at the right pressure. Generally, this condition is a
progressive and chronic disease in which the heart muscle is incapable to pump adequate blood for
all blood and oxygen needs of the body. Since the heart cannot keep up with its workload under this
condition, it attempts to make up for the failure through enlarging, developing more muscle mass,
and pumping faster. Enlarging involves stretching the heart chamber more in order to pump more
blood while developing more muscle mass occurs because of increase in size of the contracting cells
and pumping faster helps to enhance the heart's output ("About Heart Failure", n.d.). As a major
health problem, potential solutions for heart failure is a nursing focused plan that incorporates
identifying nursing goals, monitoring the patient, and specific nursing interventions.
Change Model Overview: One of the major approaches that can be used to address the problem of
heart failure is the change model introduced by Larrabee and Rosswurm. This model guides nurse
practitioners through a systematic procedure for the change to evidence–based practice. This is
realized through the model's recognition that converting research into practice needs a solid
foundation in change theory, principles of use of research, and utilizing standardized arrangement.
Assessment of the Need for Change:
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The Chicago Department Of Public Health
The Chicago Department of Public health exemplifies a public health department that is extremely
proactive and supportive of initiatives to eradicate or significantly decreasing the incidence of
STI/HIV /AIDS in the City of Chicago. To this end, the Chicago Department of Health monitors the
incidences of new cases in the city, while constantly monitoring the progression or regression of the
conditions of patients already affected by the HIV virus. Statistical data is collected through the
avenue set up for health care providers to report all pertinent information about newly diagnosed
HIV or an unusual turn of events with old HIV cases. furthermore, the Chicago Department of
Public health ( CDPH) through it monitoring programs is able identify threats, determine which
health care services is need by a community and the target population. For example in the month of
November their target segments were gays and bisexual African American men, because both
groups were disproportionately impacted by the HIV outbreak during the previous summer,
Impressively, the CDPH has links to addresses where HIV testing is done free of charge and reports
are confidential. Most importantly, the result is shared with the department to help the department
further enhance the efficiency of the HIV task force of the CDPH. Furthermore, the CDPH is very
efficient in the dissemination of information either through links on their website, advertisement, or
pamphlets to name a few.

Effects Of Obesity On The United States
Statement of the Problem Studying at a university is typically associated with students having a
greater autonomy over their choices in diet (namely, food preparation and purchasing) and increased
sedentary time due to studies. As a result, students face a greater risk of considerable weight gain.
Indeed, research studies have found that significant weight gain takes place during university. In
addition to decrease in physical activity, students are exposed to consuming commercially prepared
food and take–away meals. These factors lead to an increasing number of overweight young adults.
Statistically, in the U.S., the age range of biggest increase in obesity is amongst young adults, aged
18–29 years of age (Plotnikoff et al. 45). The University of Arizona is one of the most committed to
healthy lifestyle higher institutions in the United States. It is strongly dedicated to the provision of
healthy environment to individuals who take part in university activities. However, obesity has been
an issue here. A series of discussions conducted in focus groups with the university undergraduates
allowed distinguishing obesity as the most pressing health concern among its students. At the same
time, it has been proven that universities are appropriate settings to promote healthy lifestyles.
Respectively, the University of Arizona has been viewed as having the potential of engaging
students in weight loss programs. Analysis and Impact Analysis of the students'

Quality Improvement Strategies
QUALITY IMPROVEMENT STRATEGIES
KAPLAN UNIVERSITY
ERIC JAVIER
HA499 Unit 4 Assignment
Professor: Lisa Giarda
December 7, 2016
QUALITY IMPROVEMENT STRATEGIES
Healthcare facilities can use quality improvement techniques to guide in their decision making.
Quality improvement techniques include setting standards, monitoring performance and evaluating
outcomes. Once a standard of quality has been identified, using quality improvement techniques to
achieve that standard is important for healthcare facilities. Facilities can use quality improvement
techniques to guide the facility decisions. The status quo can be discouraged and decisions to accept
the challenge of improving can prevail. The challenge that organizations encounter ... Show more
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The philosophical elements are most important in CQI. The philosophical elements must be present
in order to constitute a CQI effort and at a minimum must include: 1. Strategic focus–Having a
mission, values, and objectives, 2. Customer focus–focus on both customer (patient, provider, payer)
satisfaction and outcomes. 3. Systems view–Based on analysis of the system influencing an
outcome. 4. Data–driven analysis. 5. Implementer involvement–Involving the owners of all
components of the system. 6. Multiple causation–Identifying all the multiple root causes. 7. Solution
identification–Seeks a set of solutions for better performance. 8. Process optimization–Optimizing a
delivery process 9. Continuing improvement–System to self–monitor even when a satisfactory
solution is obtained. 10. Organizational learning–To process improvement and personal growth.
Structural methods can include 1. Process improvement teams. 2.Use of one or more of flowcharts,
cause–and–effect diagrams, run charts, control charts. 3. Parallel organization–Development of a
separate management structure to set priorities. 4. Organizational leadership–to make the process
effective integrate CQI into the institution. 5. Statistical analysis. 6. Customer satisfaction measures.
7. Benchmarking–Use of benchmarking to identify best practices. 8. Redesign of processes from
scratch–Making sure that the end product conforms to customer

The Role Of Electronic And The Media
section barriers are discussed. In the context of this model, the role of electronic and media in
promoting awareness, willingness of nursing staff and review committee to revise policies and
curriculum, and cost and feasibility of infrastructural changes are discussed in detail.
Role of electronic and print media in promoting awareness: Any policy to gain momentum must
have public support. The public must be convinced of its importance through repeated exposure and
explained the repercussions of not implementing the policy. The role of print and electronic media
lacks in certain areas creating little value to any event or program that highlights the importance of
implementing fall–prevention programs through formal training of nursing staff.
Revision in current policies: Previous policies must be evaluated to assess the need and room for
revision before policy implementation. This is agenda entrance level of policy formulation model of
Cobb and Elder (1983). Current policies would be reviewed thoroughly to minimize conflicting
policy by the review board by the graduate student. The education departments are task with the
duties to write policies and implement all nursing related education at ARMC. The review board
will be established by a nursing committee and would be a time–consuming task. This critical task
of the review entails consistency, commitment, and motivation and is vulnerable to inadvertent
changes created by the institution.
Revision in current courses to

The Importance Of Mental Health
Mental health is an essential aspect of our overall health and well–being. Despite its importance,
mental healthcare is often overlooked and underfunded in most health systems. Worldwide the
disparity between the need for mental health treatment and the lack of provision results in many
persons suffering from severe mental disorders not receiving treatment for their disorders (WHO,
2013). The burden of mental disorders is felt most by low– and middle–income countries, with the
percentage of people with severe mental disorders not receiving treatment being significantly higher
at 76–85%, than that of high–income countries which is 35–50% (WHO, 2013). This also accounts
for a substantial proportion of the burden of disease in developing (low– and middle–income)
countries which impedes their economic and social development (De Silva & Roland, 2014). In
low–income and middle–income countries, many barriers impede the progress of mental health
services. These include structural barriers such as lack of available resources and attitudinal barriers
like stigma surrounding mental disorders (Saxena et al., 2007). In looking for solutions to these
barriers, innovative practices such the use of mHealth seemed promising. mHealth, which is the use
of mobile phones or technology in health care, has been used in low–income countries like Nepal to
provide post–abortion health care. With mobile phones being used widely across incomes, ages and
cultures, they have to the potential to be used

Essay On Robust Maintenance
Building Robust Damage Classifiers Using Computational Model Predictions to be used for
Structural Health Monitoring
Interim Report
Lewis Gunby
Introduction
In today's engineering world, the cost is becoming one of the most important factors when it comes
to the design of mechanical systems, such as bridges, aircraft, buildings, motor vehicles etc. When
designing the system, there are three distinguished methods to lower cost: reduce the initial cost of
building the product, lower the operating cost or increasing the longevity of the system, meaning the
expense of buying a replacement system will be less frequent. The first of these, reducing initial
cost, is shied away from for large–scale systems as is usually achieved by using cheaper ... Show
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2013).
This project aims to create a Structural Health Monitoring System that will detect and locate damage
in a structure using accelerometer sensors. The usual method to create a Structural Health
Monitoring System is to use machine learning techniques, by analysing changes in the dynamics of
structures in both healthy and damaged states. The issue with this technique is that vast amounts of
data needs to be collected through destructive testing which can be impossible for a system that is
only a one off (e.g. bridges, skyscrapers, etc.) or large individual product cost. The purpose for this
project is to obtain the necessary data using a computer model of a structure, simulating both
healthy and damaged states, to be used for machine learning techniques, removing the need for
destructive testing.
The Objectives I have set myself are:
1. Create a document reviewing current research papers, describing the methods used and their
findings, helping me with the methods used the achieve SHM, and to find gaps in the research out
there.
2. Create a simple model using Matlab, simulating the multi–storey structure which returns all the
natural frequencies from the numerical methods in the model.
3. Using the natural frequencies calculated in the Matlab Model from both a healthy model and a
model with damage simulated, create a classifier using the support vector

The Chicago Department Of Public Health
The Chicago Department of Public Health exemplifies a public health department that is extremely
proactive and supportive of initiatives to eradicate or significantly decrease the incidence of HIV in
the City of Chicago. To this end, the Chicago Department of Health monitors the incidences of new
cases in the city, while constantly monitoring the progression or regression of the conditions of
patients already affected by the HIV virus. Statistical data is collected through the avenue set up for
health care providers to report all pertinent information about newly diagnosed HIV or an unusual
turn of events with old HIV cases. furthermore, the Chicago Department of Public health ( CDPH)
through its monitoring programs is able to identify threats, determine which health care services are
need in a community and the target population. For example, in the month of November, their target
segments were gays and bisexual African American men because both groups were
disproportionately impacted by the HIV outbreak during the previous summer. Impressively, the
CDPH has links to addresses where HIV testing is done free of charge and reports are confidential.
Most importantly, the result is shared with the department to help the department further enhance the
efficiency of the HIV task force of the CDPH. Furthermore, the CDPH is very efficient in the
dissemination of information either through links on their website, advertisement, or pamphlets to
name a few. Moreover,

Health Monitoring Sensors And Health Care
Presently a days individuals from provincial ranges are confronting the wellbeing issues and Health
Care is troublesome assignment to keep up for them. In the majority of the provincial territories
Doctors are not accessible and individuals can 't come in the urban communities. So we are
attempting to address these issues in rustic division in our task. This venture shows a straightforward
wellbeing checking framework which is well material for country zones or in any Government
establishment. The framework gives a decent chance to accumulate and store wellbeing data around
one or more watched patients. We are wanting to outline a dependable and exact patient checking
framework for country part which can gauge the parameters like body temperature, Blood Pressure,
pulse and relaxing. It can send parameters of patient continuously. This undertaking gives an answer
for improving so as to upgrade the dependability and adaptability the execution and precise
estimation of above parameters of the patient and treat the beginning disease.
Keywords: Health monitoring sensors, AVR microcontroller , core JAVA software, Pc, printer etc.
INTRODUCTION
These days, the wellbeing checking in provincial division is a remarkable exploration region. All
through the world heaps of scientists and wellbeing organizations manage wellbeing observing. The
gathered data sets around a patient helps the specialists in the examination of wellbeing state
changes. As of now, there are numerous wellbeing

Flood Essay
Management before the floods in Malaysia is based on the Standard Operating Procedure (SOP ) as
determined by the NSC to agencies like Department of Irrigation and Drainage (DID), Public Works
Departments (JKR), Department of Meteorology and Local Authorities (PBT) includes two steps,
namely, structured and unstructured. Structural measures adopted in Malaysia are like dams and
dykes to control flood flows and non–structural measures are such as land use planning and flood
forecasting and warning systems to mitigate the effects of floods (Chan, 2012; Khalid, & Shafiai,
2015). Structural measures implemented to reduce the danger of flooding so as not to pose a greater
hazard to people in the flood plain. Agencies involved in the success of ... Show more content on
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In addition, the short message system (SMS) is also provided to warn employees of related
government agencies such as the Police, the Army, the Malaysian Meteorological Department
(JMM), Civil Defense Department, the Department, and National Security Division (BKN) in the
Prime Minister and other agencies involved (Jabatan Pengairan dan Saliran, 2013). The
Meteorological Department has also provided a weather forecast web site to facilitate public access
to current weather conditions. In 2001, Malaysia has introduced 'Manual Saliran Mesra Alam'
(MSMA) to be used as a tool in integrated flood management (Chan, 2012; Musa, Chan, Ku
Mahamud, Karim, & Zaini, 2013). In contrast, an example of which is seen nonstructural methods
are effective flood forecasting and warning system (Jabatan Pengairan dan Saliran, 2013). The
methods used for the management of flood disclosed before it has been shown that Malaysia has
certainly had an initiative to reduce the impact of floods on human health and life at risk areas.
Management of flood victims during and after the flooding situation in Malaysia also is based on
Directive No. 20. According to MKN (2012), during the current disaster management involves a
number of rescue agencies on the scene as the Special Search and Rescue Team Malaysia (SMART),
the Royal Malaysian Police (PDRM),

Advantages And Disadvantages Of Nsme Techniques
1.5 Advantages of SHM as compared with the current techniques Because of the risk with
hydrostatic testing of further damaging the pipeline, there is a clear advantage of non–destructive
techniques over destructive ones. The advantages of NDE techniques are obvious. Most importantly,
there is very little risk of the structure incurring damage during a particular test. In addition, the
various NDE techniques typically yield very detailed results regarding the status of the structure.
Although NDE techniques have several advantages over destructive testing methods, there are still
some key disadvantages to these techniques. The primary disadvantage with forms of NDE
involving pipelines is that the sensing mechanism used is typically only temporarily ... Show more
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This aspect of the testing increases the potential cost of NDE techniques. The most common NDE
techniques implement a sensing mechanism which is sent down the interior of the pipeline. With oil
pipelines, the contents of the pipeline provide coupling between the transducer and the pipe
material, so the contents need not be removed. With natural gas pipelines, however, the gas provides
poor coupling, which may require that the pipeline be filled with a coupling material, such as water.
Because of this rather expensive complication, NDE techniques are not commonly used with natural
gas pipelines. In addition, geometry of the pipeline limits the ability to use certain NDE techniques.
The sensing mechanism is limited by the size in which it can be efficiently packaged, meaning that
the techniques can only be used with pipes with a diameter larger than approximately 3–in (8–cm).
The geometry of pipe bends and fittings can also limit the compatibility of these techniques. The
geometry of the pipeline prevented the implementation of internal NDE techniques, forcing the
operator to use less reliable techniques. Therefore, the corrosion went undetected and resulted in the
eventual failure and explosion of the natural gas

American Infant Mortality
This is compared to 1.2 percent of infant deaths from all black couples. This is a significant
difference when talking about infant deaths between races and there is still a difference when we
look at couples with one black parent and one white parent. The percentage was 0.7 percent for a
white mother and black father or vice versa. When we look at the time frame of 1998–2006, the
percentages in all groups dropped by only 0.1 percent (El–Sayed, Paczkowski, Rutherford, Keyes, &
Galea, 2015). Based off this study we can infer that black couples have a higher risk of having an
infant die. According to the National Vital Statistics Reports, in 2013 Non–Hispanic Black had the
highest infant mortality rate in the United States with 11.11 deaths per ... Show more content on
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Globally the World Health Organization is tackling infant mortality through social determinants
collaborated in the article, Impact of Non–Health Policies on Infant Mortality Through the Social
Determinants Pathway. In this article studies performed in India indicate that poverty and income
are associated to their infant mortality rates. What India has done is employed the government's
Mahatma Gandhi National Rural Employment Guarantee Act to target " unemployment and
underemployment, and therefore poverty, by providing at least 100 days of guaranteed paid
employment every year to households whose adult members volunteer to do unskilled manual work"
(Nair, 2011). This program is designed to have a domino effect on the economy by income,
structural, and behavioral elements such as "better housing and living conditions, food security,
access to clean water and proper sanitation, access to health care, infant care and feeding practices
that influence the proximal risk factors of infant mortality – malnutrition, diarrhoea and acute
respiratory infections"(Nair, 2011). Evidence of this program on the effects of infant mortality are
premature and not calculate yet, however India's government is confident that it will achieve its
intended target of reducing infant

Information On The Data Security
Useless Information
The Data security is usually referred to as the confidentiality, accessibility, and truthfulness of data.
Which means, all the practices and procedures that are in place to guarantee the information is not
used or accessed by unauthorized individuals or parties. The Data security ensures that the
information is correct and reliable and is obtainable when those with authorized access need it.
There are many policies which cover the data security, but the three that I will mention are, Ensuring
Data Security Accountability, which means that the company needs to make sure that its IT staff,
workforce, and management are conscious of their responsibilities and what the organization
expected of them. There are various ... Show more content on Helpwriting.net ...
If the employee is dissatisfied, the ability to access the organization's resources can be highly
damaging. The security policy should elect specific IT team members to screen and control user
accounts prudently, which would avoid any illegal action from occurring.
Part 1
The hospital tends to have data systems for data collection and commentary, the workers who are
used to gathering registration and admissions information, and an organizational culture that is
familiar with the tools of value improvement, they are comparatively well positioned to collect
patients ' demographic information. The recommendations for enhancements the basics included in
the plan of audit trails and data quality monitoring plans within the hospital are,
First, The Six Sigma, usually intended as a professional plan, includes refining, scheming, and
monitoring procedure to minimalize or remove excess while enhancing gratification and increasing
financial steadiness. The performance of a procedure–or the process competence–is used to ration
enhancement by associating the baseline process competence (before development) with the process
competence after directing possible solutions for quality development.
The Second recommendation for improvement monitoring programs within the hospital is Quality
improvement projects and studies intended to make helpful changes in health care processes to
implementation favorable

Dysphagia Case Studies
2.1 Dysphagia
Dysphagia is the medical term for the symptom of difficulty in eating and swallowing solid and/or
liquid foods (Germain et al., 2006). It occurs when there is a problem with the neural control or the
structures involved in any part of the swallowing process (National Institutes of Health, 2012).
These problems make it hard for dysphagia people to moves food and liquids from mouth toward
the stomach.
It is estimated that dysphagia affects 18 million adults and millions of children in the United States
and 45% – 87% of residents in long term care (Agency for Health Care Policy and Research, 1999;
Langmore, 1994; Steele et al., 1997). Dysphagia is common in people who are elderly or who have
had a neurological event such as a stroke ... Show more content on Helpwriting.net ...
Videofluoroscopic evaluation is the most common method diagnosis of dysphagia. It is used to
record an X–ray video of individual swallowing liquid boluses with various concentrations and
volumes of barium sulfate particles (Logenmann, 1997). The patient is given a radiopaque barium
sulphate suspension and his or her ability to swallow is monitored using videofluorscopy. The
radiographic video could determine bolus transit time and direction, bolus clearance, various
structural movement of the hyoid, upper esophageal sphincter, tongue, mandible and larynx. These
measurements would provide an indication of a patient swallowing ability at mealtime (Logenmann,
1997; Schulze–Delrieu et al., 1997). If the patient exhibits aspiration or excessive residue,
intervention strategies like altering the volume or apparent viscosity of liquids are introduced to
improve swallowing (Logenmann,

Wireless Sensor Network For Subsurface Infrastructure...
"WIRELESS SENSOR NETWORK FOR SUBSURFACE INFRASTRUCTURE MONITORING"
FINAL REPORT
BY RAFAEL AMORIM VIANA DE MOURA, WIDENER UNIVERSITY
ENGR–400–UNDERGRADUATE ENGR RESEARCH–C–15/SU1
ACADEMIC TRAINING – SUMMER 2015
Table of Content
1. Project Scope and Objectives 3
2. Introduction 3
3. The Project 5
3.1. Wireless communication between ZigBee RF modules 5
3.1.1. Fio v3 6
3.1.2. XBee, XBee Explorer and the Bi–directional communication 7
3.1.3. Accelerometer 9
3.1.4. Software 9
3.1.5. Point–to–Point Communication 11
3.1.6. Netwotk Level Communication 15
3.1.7. Calibrating and Testing the Accelerometer 18
3.1.8. Data Log 22
4. Discussion 23
5. Conclusion 23
6. Future Directions 23
7. References 24
Table of Figures
Figure 1. Wireless Sensor Project...........................................................................5
Figure 2. Fio v3–ATmega32U4. SparkFun website........................................................6
Figure 3. Interface with the XBee radio. SparkFun website...........................................6
Figure 4. Fio v3 simply plug in a battery. SparkFun website............................................7
Figure 5. XBee Pro 63mW Wire Antenna – Series 2B (ZigBee Mesh). SparkFun website
......................................................................................................................7
Figure 6. SparkFun XBee Explorer USB. SparkFun website........................................8
Figure 7. SparkFun XBee Explorer Dongle. SparkFun website.....................................8

Figure 8. Interface between XBee and XBee Explorer................................................8
Figure 9. SparkFun Triple Axis Accelerometer Breakout – ADXL335. SparkFun

Job Design And Job Enrichment
Job design and job enrichment are two important factors for managers to understand and implement
in their operations. Circumstances change within a job, company, and culture quite frequently. This
changes the procedures followed by employees. Added tasks and different polices can increase job
stress and effect performance. To stay ahead of these issues it is recommended to perform a frequent
analysis of goal setting, job structure, and organizational context. In the case study we reviewed we
found that different principles of goal setting can be applied. Re–engineering and restructuring are
two aspects that are completed by administration. Administration can set new goals by expanding
into different businesses, applying new systems, changing department's missions, and revising
policies. Restructuring is achieved by changing the organizational structure. Often times this is done
to review processes in order to increase efficiency and cost effectiveness. Department manager's
goals are typically within the realm of work and job redesign. These redesigns focus on a re–
arrangement of departments efforts. Changing work processes, procedures, and task structure.
Focusing and monitoring these goals enable companies to avoid certain matters. Job structure are
the types of tasks, characteristics, and demands of a certain job. Often time's job structure is
impacted heavily by our external environment in business. New regulations, products, services, and

The National Institute Of Mental Health
In 2013, the National Institute of Mental Health (NIMH) broadly launched the Research Domain
Criteria project (RDoC). The purpose of RDoC is to provide a working framework to advance
dimensional approaches of classifying psychopathology on the basis of observable behaviors and
neurobiological measures (National Institute of Mental Health, 2013). Reflecting on the last thirty
years, incredible progress has been made in understanding brain–behavior relationships in numerous
mental disorders. The continued interdisciplinary work of geneticists, cognitive and affective
neuroscientists, and behavioral researchers has not only expanded our knowledge of biological
causal and maintenance factors, but has also provided the field with a strong ... Show more content
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Within each of these broad domains the project details more specific constructs and subconstructs.
For example, the construct effortful control is nested under the cognitive systems domain. Effortful
control is then further elaborated into subconstructs such as goal selection, updating, and
performance monitoring. Over the next few years, NIMH will be conducting a series of workshops
focused on further refining the definition of the broad domains of functioning and respective
dimensional constructs and subconstructs covered within each domain. Additionally, these workshop
groups are tasked with organizing and disseminating gold standard measures or indicators of
analyses for the previously mentioned areas of study (e.g., genes, neural circuitry, physiology).
Performance on these variables will then be used to classify research participants in future studies.
This approach would replace the current systems designated by the Diagnostic and Statistical
Manual of Mental Disorders (DSM–5; American Psychiatric Association, 2013) and the
International Statistical Classification of Diseases and Related Health Problems (ICD–10; WHO,
1992). In comparing the RDoC initiative to the DSM–5 and ICD–10 diagnostic approaches, RDoC
is noticeably unique in three principal ways. The RDoC project and respective framework are
envisioned as a dimensional system that spans in range from typical to atypical.

Substance Abuse Among Teenagers : A Survey
Substance Abuse Among Teenagers
Hannah is a fifteen year old girl who was recently sent to a rehabilitation center for the result of
abuse of prescription medication. 6.1 million high school students currently use addictive
substances, and like Hannah, 1 in 3 of them are addicted ("National Study Reveals,"2011). Although
the number of teens using these drugs are decreasing, the numbers are still dangerously high. Due to
it's high risk of addiction, dangerous consequences, and growing availability, substance abuse
among teenagers is a serious trend being presented among all United States adolescence.
A survey entitled "Monitoring the Future" was conducted among 8th, 10th, and 12th graders
throughout the United States in 2014 ("Monitoring The Future 2014,"2014). Compared to 2009, the
results showed a decrease in alcohol use, showing 9% of eighth graders, 23.5% of sophomores, and
37.4% of seniors have drank alcohol in the past month. Whereas there has been a decrease in binge
drinking also, for since 1998, where 31.5% of seniors consumed five or more drinks in a row in the
past two weeks, the 2014 results showed a decrease to 19.4% ("Monitoring The Future 2014,"2014).
Along with these positive declines in results, cigarette smoking is at it's lowest rate in the survey 's
history. Unfortunately, while these results all show a positive decline and an optimistic future for the
teenagers of America, not all results turned out this way. Other forms of tobacco use are gaining

Design A Wireless Sensor Nodes Using Fpga For Fire...
The aim of this paper is to design a wireless sensor node using FPGA for fire monitoring and
control. FPGA is used in the wireless sensor node design in order to enhance the processing
capabilities of the system to meet the target applications. The sensor nodes in a wireless sensor
network are normally microcontroller based which are having inadequate computational capacity
related to various applications. This paper describes the selection, specification and comprehension
of a wireless sensor node using the field programmable gate array (FPGA) based architecture for an
early detection of hazards (e.g. smoke and fire). The FPGAs in its place are more proficient for
complex computations in compare to microcontrollers. Another benefit of using FPGA is also due to
its reconfigurable characteristic without changing the hardware itself. The node is implemented
using Spartan 3A FPGA board from Xilinx. A design of simple hardware circuit with different type
of fire sensors enables every user to use this wireless fire security system. The FPGA will constantly
supervise all the sensors and if it senses any security trouble then the FPGA will send the
information to the PC central monitoring station wirelessly using Zigbee technology. The system is
based on the Lab VIEW software.
Keywords– FPGA; Wireless Sensor Network (WSN); Temperature sensor; Smoke sensor; Fire
sensor; Zigbee; LabVIEW.
I. INTRODUCTION
The wireless sensor nodes are the fundamental constituent in a wireless sensor

Literature Review Paper On Concussions
One of the principal problems for defining and diagnosing concussion, is that there is not a
universally acceptable definition for concussion. In the article, the author refers to concussion as a
"mild traumatic brain injury (MTBI) that results in a temporary loss of neurologic function without
apparent structural damage, and may or may not involve loss of consciousness (LOC)" (Mennella,
2016). Concussions are considered a great concern in healthcare because according to the Center for
Diseases Control (CDC) it is estimated that there are 1.6 to 3.8 million sports–related concussions in
the United States every year (CDC, 2017). And according to the article there is also around of
52,000 deaths every year (Mennella, 2016). Although it is estimated that the number of cases could
be higher because researchers found that the lack of well–defined and accepted definition of
concussion, can cause that many times concussion could be misdiagnosed. For this reason, it is
extremely important that organizations work in finding a broadly accepted definition of concussion,
in order to have a better and accurate estimate of the number of cases.
The purpose of the article by Hillary Mennella (2016) is to find the best practices regarding
evaluation and monitoring of concussion, in order to reduce the number of death and reduce the
number of post–traumatic concussion symptoms. The review of the literature is designate to identify
common symptoms, people at risk for suffering from a

The Importance of Developing Renewable Energy in Europe
In recent years, Europe has been faced with the problem of continuous urbanization and excessive
energy consumption, closing in on exhaustion of available energy resources. In view of this, the
notions of sustainability and resilience have become paramount in resource management and
policy–making. Within such a context, renewable energies play a key role in the global energy pool.
Amongst these, wind energy production accounts for almost half (43%) of the global generating
capacity [1]. Nonetheless, despite its obvious merits, the "Big Wind industry" comes with a number
of potential shortcomings largely relating to the short life–span of these components and the lack of
efficient operation and maintenance (Ο&Μ) planning schemes. The latter ... Show more content on
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Problem–specific, cost–benefit analyses have not been conducted in detail, in order to provide
significant indications that the benefits of SHM systems outweigh their cost. In this respect, one
should mind that stakeholders, managers and infrastructure operators need simple and reliable tools
in the form of "yes/no actions", or "green/red buttons". Unavoidably, this implies that SHM systems
should be transformed from complex research–oriented measurement campaigns into robust,
integrated solutions that accompany the structure throughout its life–cycle. Our goal is to address
the aforementioned bottlenecks, maximizing the return on investment for such facilities by
extending the useable lifetime through a smart monitoring implementation. In a nutshell, the
proposed project has the following main objectives: 1. We will propose a new monitoring paradigm
for WT facilities which features optimal sensor placement, i.e., minimally used instrumentation for
extraction of the necessary amount of key response quantities in an effort to track these systems
from cradle–to–grave. 2. Based on this sensory feedback and data collection, we will develop data
processing methodologies relying on SHM, for the extraction of metrics for LCA both in the short
term (damage, anomalies and extreme events detection) and in the long–term (deterioration, fatigue
and defective

The Structural Health Monitoring Systems
Abstract Structural health monitoring systems frequently use optimisation algorithms to update or
identify system parameters in structural dynamics. In this study, an implementation of similar
updating techniques is developed for thermal non–destructive material inspection using adaptive
response surfaces to approximate experimental parameters (thermal conductivity, convective heat
transfer & excitation timing) for updating a finite element model. The use of thermal models results
in high non–linearities in parameter influences and parameter updating accuracies, which are
discussed. In this work, adaptive response surface methods are compared using interpolation,
piecewise spline and polynomial regression functions. In this paper, the most widely used
optimisation routines for structural dynamics are compared and validated on a thermal case with
multiple independent parameters. The influence of the choice of optimisation parameters is
discussed and compared between the different optimisation routines. Finally, a well–suited data
reduction technique is investigated which transforms the data set to a smaller, focused response
model in each optimisation loop and delivers a proper regression accuracy. It is demonstrated that
the use of interpolating regression delivers more accurate parameter estimations in contrast to
structural dynamic updating where polynomial regression delivers superior results.
1 Introduction
Computer simulation is an economic and fast way to determine

What Is The Development Of Vibration-Based Damage...
A damaged structure can potentially threaten the safety and economical use of the system, and even
if it is not detected in the early stage, it may bring about structural failure over the time. Therefore,
devising effective non–destructive damage detection methods has been the center of atten– tion in
civil engineering studies during the last decades [1]. These methods can be classified as local and
global techniques. Since local methods, such as the X–ray, magnetic particle, ultrasound etc., are
limited to detecting damage on or near the surface of structures, the need for global damage
detection techniques, which can be used for complex structures, has resulted in development of
vibration–based damage detec– tion methods (VBDD). The ... Show more content on
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In model–based methods, generally, there are two models. A refer– ence model, which is a well–
correlated model of the undamaged struc– ture. An updated model that reproduces the measured
responses under the damage states by modifying the structural properties like mass, stiffness,
damping, etc. Making comparison between these two models provide damage location and severity.
Apart from this fact that structural mod– els in these methods are Structural Matrix, Finite Element
(FE), Mapping or Meta Models, updated models can be modified in a direct way or in an iterative
one. Although, model–based methods have physical mean– ings and are easier to be interpreted
compared with abstract mathemati– cal features, they are unfortunately computationally intensive
and time– consuming. Thus, they are not usually practical for online damage detec– tion and
structural health monitoring (SHM), particularly where structures are large and complex and there
are a lot of simplification and uncertain– ties in simulation of structure and circumstances [1].
School of Civil Engineering, Iran University of Science and Technology. To address this issue, a
novel direct model–based damage detection method is proposed. The main part of this method is
Simple Adaptive Control (SAC) algorithm, so it is called briefly SAC/DD method. The SAC
algorithm is introduced by Sobel et al. [2], then it is developed by Barkana and Kaufman [3] and
Wen and Balas [4]. Furthermore, Barkana and Guenz [5] expanded

Medical Database
Medical Mission: The replacement of the current paper–based or stand–alone legacy medical history
database system in Medical Affairs Department with a web–based database system so that doctors,
medical researchers, medical institutions, and patients will be benefited from data collection and
information sharing efficiency. A fully equipped and designed database could process almost any
type of data presented to it. The goals are as follows:
(a) A data model to explain its functional requirements and to produce a formal description (b) A
conceptual schema of all the data generated in the enterprise and how it was all related (c) A
database structural design to define its technical requirements.
As a medical database usually is a part of ... Show more content on Helpwriting.net ...
It provides better manage care for patients and provide better health care by:
Providing up–to–date, accurate and complete patients information at the point of care
Enabling speedy access to records of patient for more coordinated, efficient care
Sharing of information with patients and other clinicians in a secure manner
Helping providers by more effectively diagnosing patients, reducing medical errors, and providing
safer care
Improving provider and patient communication, as well as health care convenience
Enabling safer, more steadfast prescribing
Helping promote clear, complete documentation and precise, updated coding and billing
Enhancing privacy and security of patient data
Helping providers to improve productivity and work–life balance
Enabling providers to increase productivity and meet their business goals
Reducing costs through less paperwork, enhanced safety, reduced duplication of testing, and
improved health.
Weaknesses:
Identity theft can be facilitated by not having properly secured records. Catastrophic local server
failure can lose recorded data in practice without having a robust backup plan in place to keep things
running even after

The Definition Of Health Policy Essay
This report will discussed the definition of health policy, the process of making a policy, the laws
and legislations involve, the healthcare advocacy of professionals in politics and decision–making,
and lastly, explore the advantages and drawbacks of 2 types of decision making models. The
learning outcome of this report will further explore and better understand widely the process how
the government of any nation undergo a certain procedure before arriving to an outcome.
What is Policy? It is defined as a concept of coherent ideas or method of action selected by the
government to guide and carry out such course of action with a common long–term objectives
affecting a certain outcome1. These policies are formulated and implemented by the government to
influence and resolve major decisions requiring actions and activities for long term purposes that is
widely accessible.
Health Policy are reforms of decisions, actions, and strategies to attain a particular health care goals
within the society. WHO (2016) defines health care policy to create specific goals and targets where
short and long term are met for future purposes2. It is a framework for health care professionals to
build an agreement which informs them. For instance the National Drug Policy 2015–2020, is a
current health care policy made by the Ministry of Health in New Zealand, where certain strategies
and practices that counteracts with alcohol and drug issues. The Policy is a guide in decision
making, prioritising

Demming Total Quality Management Model
40 years ago, Donabedian by observing the structure, the process and the results suggested that
measures the quality of care. Structural measures are health insurance, hospital bed capacity and
advanced education and access to resources such as the number of nurses, availability, and quality
assessment. The process measurements are evaluated by the delivery of health care providers, such
as clinical and using the guidelines for the treatment of diabetes. Measurement result shows the final
result of health care, and can be influenced by the action and environmental factors. For example,
mortality, patient satisfaction, and an improved state.
After 20 years, health care leaders have borrowed a technique for manufacturing enterprises in
Japan after World War II reconstruction work in Deming. Deming, Total Quality Management ...
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This is the method used by the Institute for Healthcare Improvement widely faster cycle
improvements. The purpose of the PDSA quality improvement effort is to set up a functional or
causal relationship between (specific behavior and capabilities) and a change in the processing
result.
Six Sigma improves the design, the original design business strategies, optimize satisfaction and
minimize waste while increasing the financial stability or include monitoring the process of
elimination.
Developed by VA's National Center for Patient Safety, health failure mode and effects analysis
(HFMEA) tool is used for risk assessment.
RCA, a similar process is to identify the root cause a tendency of the problems. Important events
technology potential and techniques used to evaluate the risks that may be used every time the
individual factors suspected not the way to understand human error event is generated. After that,
information is collected by event led the cause and

Personal Statement For Sop For Structural Engineering
A five–foot five–inch replica of the Empire State Building that I stacked entirely with playing cards
back in high school was the first time I appreciated the subtleties involved in creating complex card
structures. I gradually progressed to stacking domes and a full–sized stadium, but the way this tower
held together fascinated me, and I realized that there was much more going on in addition to the
seemingly obvious concept of maintaining the right balance. After all, nothing could be that simple.
Likewise, after four years of undergraduate studies in civil engineering, it seems to me I have barely
scratched its surface. A graduate school will allow me to delve deep and let me explore the finer
aspects of the field. Furthermore, this is crucial in terms of achieving my long–term goal of pursuing
a PhD to carve out a career in industrial research.
I am applying to pursue a course in Structural Engineering because it provides an ideal background
to broaden my perspective and give me the opportunity to work on my current research interests that
lie in the fields of earthquake engineering, bridge engineering and structural control & ... Show
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Puttaswamy (Sri Venkateshwara College of Engineering, Bangalore). With the help of professors
from the Department of Electronics, I worked on understanding the piezoelectric effect of Lead
Zirconate Titanate (PZT) disks. I was also responsible for designing and testing prototype concrete
slabs embedded with PZT disks under moving vehicular loads. The tests resulted in extremely
minute voltages being generated roads in the future. Overall, this was an incredible experience
which not only made me realize the scope of piezoelectric material but also helped me further my
understanding of concrete technology. Moreover, I was exposed to other possible applications of
piezoelectric material in the form of sensors for health monitoring of

Advantages And Disadvantages Of NDT
F2. NON DESTRUCTIVE EVALUATION TESTS: Various non–damaging assessment (NDE) tests
for solid individuals are accessible to focus in–situ quality and nature. Some of these tests are
exceptionally valuable in appraisal of harm to RCC structures subjected to erosion, substance
assault, and fire and because of different reasons. The term 'non damaging' is utilized to show that it
doesn't impede the expected execution of the auxiliary part being tried/explored. The nondestructive
assessment have been comprehensively characterized under two general classifications viz 'in–situ
field test' and 'lab test'. These tests have been put under five classifications relying upon the reason
for test as under: 1. In–situ Concrete Strength 2. Chemical Attack 3. Corrosion Activity 4. Fire
Damage 5. Structural Integrity/Soundness Assortment of NDT systems have been produced and are
accessible for examination and assessment of diverse parameters identified with quality, toughness
and general nature of cement. Every system has some quality and some shortcoming. In this manner
reasonable methodology would be to utilize more than one strategy in mix so that the quality of one
remunerates the shortcoming of the other. The different NDT techniques for testing solid are
recorded underneath – A. For strength estimation of concrete (i) Rebound hammer test (ii)
Ultrasonic Pulse ... Show more content on Helpwriting.net ...
Reveal hidden defects during the operational service of structures before a collapse occurs. 2. AE
technique possesses high sensitivity and ability to locate the damage and 3. AE method lies in the
fact that the damage can be detected in real time. 4. AE measurement is highly efficient due to its
ability to warn of crack growth. 5. The analysis of AE activity and the knowledge of its changes
improve the lifetime prognosis, and reduce the overall maintenance costs. 3.0 Summary The
potential of smart materials in structural applications has been clearly

The Role Of Leadership And Management On The Healthcare...
Introduction
Throughout the enforcement history, leaders have utilized several styles for leading employees. The
environment of health care has made an amazing progress in identifying the future values and
factors which are necessary for making certain changes to attain noticeable and significant
advancements crosswise a several services. The styles of Leadership and Management must
effectively use to carry out clear changes and for attaining particular actions. This makes an
important real improvement in the healthcare and social environment. It is a very complex process
to make efficient and effective completion of advancement and change as a dynamic area which
takes mentioned time to make action for particular management and leadership programs, there are
unique to all organizations usually. Every firm requires some changes and improvements programs
to become successful in different sectors.
To attain organizational improvement, Leadership is a key factor in the success of healthcare
sectors. Professional efficient leaders enable advancements within the organization and capable to
predict the way in which an organization must go towards by means of service delivery like user
involvements of great service as well as direct their organization on the right track. An essential
factor is to have a programmed ideology or purpose concerning employees to carry out system
improvements. The scope must be set by the management to make these improvements and it is
responsibility of

Linkage To Care
In total 54 studies with information on linkages to HIV care were reviewed. Of these, 6 referenced
health departments, 12 were program related documents, 1 surveillance report from CDC and others
were published peer–reviewed literature. Articles ranged from 2001 to 2015 and included program
assessment or evaluations, longitudinal studies, cross–sectional studies, and policy briefs. Programs
and interventions targeted populations at higher risk of exposure to HIV/AIDS including persons
living with HIV/AIDS, incarcerated persons either in or out of prison. None of the titles of the study
included engagement of "local health departments" and "linkage to care", however, 23 titles
included the word link or linkages to care. 13 studies evaluated ... Show more content on
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(Mugavero, Amico, Horn, & Thompson, 2013) (Craw, et al., 2008).
One structural factor that facilitated linkage to care was having HIV medical care providers
collocated at the agency providing the case management intervention. This finding suggests that the
accessibility of medical services during initial case management or referral activities is an important
structural factor that promotes entry into care. Another factor that was associated with receiving HIV
medical care was the number of case management sessions that participants attended (Craw, et al.,
2008).
Outreach and public health investigation have been found to increase the likelihood of entering and
maintaining primary care. Public health departments using HIV/AIDS case registry data often use
evidence of CD4 cell count and viral load measurements as markers of linkage (Zetola, et al.,

A Short Note On Tier E Health Monitoring System
5. Two–Tier e–Health Monitoring System This paper proposes another structural engineering for e–
Health cell phones eliminating so as to observe framework the outsider server in the framework.
Distributed computing is proposed to be incorporated with the framework for effective information
stockpiling and snappy access in patient records. This structural planning is intended to improve the
security level of the e–Health observing framework and to ensure the classification of the patients '
information. By wiping out the outsider server in the information transmission process, we can keep
the e–Health framework from potential vulnerabilities that can happen amid the information
transmission from the patients to the specialists. E–Health cell phones observing framework can
upgrade the nature of human services by coordinating the utilization of Internet correspondence with
patient–specialist treatment. 6. An Approach of a Decision Support and Home Monitoring System
for Patients with Neurological Disorders using Internet of Things Concepts The Internet of Things
and data and CommunicationTechnologies connected being developed of medicinal services
frameworks have achieved a developmental procedure. This paper presentsthe advancement of a
coordinated astute framework for Parkinson 's illness Screening.The Decision Support and Home
Monitoring System aredesigned to help and bolster doctors in finding, home checking, restorative
treatment, therapeutic solutions, recovery and

Kinesiologists
IKON is Australia's leading, specialist provider of therapeutic and human services training and is
dedicated to advancing knowledge and understanding in humanistic studies through vocational and
higher education, leadership and practice. The IKON Institute aims to produce graduates who are
enabled to continually develop their own potential, and whose skills, knowledge and therapeutic
client–centred practice contribute to the creation of an international community of people and
practitioners committed to social change, community building and individual healing. At IKON,
you'll gain more than a nationally recognised qualification, you'll gain a rewarding career where you
can make a positive difference in your life and the lives of others. What ... Show more content on
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The kinesiology approach examines 'unresolved stress reactions' in a person and provides techniques
intended to help the body's natural healing process. Some of the techniques available to
Kinesiologists include: acupressure lymphatic massage hypertonic muscle release attention to reflex,
trigger and body points nutritional advice remedies, such as flower essences and homeopathics The
Diploma of Kinesiology at IKON The Diploma of Kinesiology will give you the opportunity to gain
skills and work with clients to gain a greater understanding of what their body is trying to tell us.
This course is particularly relevant for people that want to work in health fields where an integrated
mind body medicine approach is useful – such as working with people with long term chronic
conditions, structural and pain related conditions, life change and psychological states, and children
and adults to improve learning. The training explores the relationship between the mind and the
body simultaneously, addressing issues deep within the mind through counselling

Energy Efficient Sensor Placement For Monitoring
www.mdpi.com/journal/sensors
Conference Proceedings Paper – Sensors and Applications
Energy Efficient Sensor Placement for Monitoring
Structural Health
Mohammed Najeeb A 1,* and Vrinda Gupta 2 1 M.Tech. Student, Department of Electronics and
Communication Engineering, National Institute of Technology Kurukshetra, Haryana, India; E–
Mail: mohdnajeeb4u@gmail.com 2 Associate Professor, Department of Electronics and
Communication Engineering, National Institute of Technology, Kurukshetra, Haryana, India; E–
Mail: vrindag16@yahoo.com
* Author to whom correspondence should be addressed; E–Mail: mohdnajeeb4u@gmail.com
Published: 1 June 2014
Abstract: Wireless sensor networks (WSN) have large scope in structural health monitoring (SHM)
applications such as monitoring strength of buildings, bridges, tunnels etc. But WSN based SHM
need to face many challenges to get the same performance as its counterpart, the wired network.
Placement of sensor nodes has an important role in WSN based SHM, as it needs to find a high
quality position, so that it satisfies monitoring requirements and WSN challenges like energy
efficiency, connectivity, fault tolerance and reliability. Monitoring quality could be obtained by
sensor placement using effective independence method (SPEM) by maximizing fisher information
matrix (placement quality indicator) which is used for sensor placement in Civil engineering
structures, but it does not guarantee any WSN requirements. This paper therefore focuses on an

Project Organization And Management Structure
Project organization and Management Structure: As the experimental methods are complementary to
each other, but are not critically interdependent, the cooperative design of my research plans will
greatly facilitate my ability to accomplish the specific aims. To monitor the progress and project
quality, I will conduct meetings with Prof. Battaglia on a bi–weekly basis, write monthly reports that
can be incorporated into peer–reviewed publications, and present my research outcomes at lab group
meetings on a quarterly term. This way I can keep on a self–consistent project monitoring process
and receive essential feedback from Prof. Battaglia and my prospective colleagues in the laboratory
on a regular basis. My primary experimental components (objectives 2, 3, and 4) can move forward
synergistically via this approach of using feedback and reinforcing the steady quality management
process. I will personally manage the scientific and technical aspects of the proposal, including
acquiring data, analyzing results, and writing manuscripts for publication. The UCL European
Research and Innovation Office (ERIO), specifically steering the management of EU awards, will
help me manage the financial part of the project. Risks that might endanger reaching objectives and
the contingency plans: The primary risk concerns: a) structural integrity of polymersomes, b) sample
compatibility with spectroscopic approaches a) Sample preparation issues could include alternation
of

How to Prevent Accidents in Nursing Homes
Bridgewater Nursing Home is a small 43 bed facility that focuses on an entire spectrum of care from
physical, clinical, emotional and spiritual (Nursing Home Ratings, 2014.). Each resident of
Bridgewater Nursing Home receive nursing care around the clock with some services including
respite care, short–term care, long–term care and hospice support etc. (Nursing Home Rating, 2014).
Moreover, the mission at Bridgewater Nursing Home and Rehabilitation Center medical staff is to
show comfort to the residents and their families. Now even though this nursing home and
rehabilitation center is said to show the upmost care for their residences deficiencies has caused
violations with a 'penalty fine of $6,500' according to the U.S. Centers for Medicare and Medicaid
(Trismen, 2013).
The problems at Bridgewater Nursing Home of Bridgewater, MA started in 2010 when a resident
was given a hot dog even though they were not allow solid foods (Trismen, 2013). This resident
later died from choking. Another resident at the same nursing home suffered from second–degree
burns from a spilled cup of tea that was improperly microwave by a staff nurse. Furthermore,
another resident wandered away from the nursing home and went unnoticed for several hours
(Trismen, 2013). Although, this was only three accidents it caused a preventable death, burns and a
resident from wandering from nursing home site.
How can this nursing home accomplish safety precautions to protect the residents? As a public
health

An Installation Of A Structural Health Monitoring System
Early detection of such failures will definitely save many lives and decrease the number of injuries.
This can improve the public safety and provide more reliable economical feature. Eventually, the
increased awareness of the economic and social effects of such degradation especially under
extreme events intensifies the need for advanced SHM, damage detection, and damage localization
tools. Consequently, SHM systems are basically used to monitor the structures' behavior during the
events of vibrations or natural excitation (earthquakes, winds and live loading). Moreover, in 2002
some building design codes mandate that structures should have an installation of a structural health
monitoring system especially those located in high ... Show more content on Helpwriting.net ...
The following paragraphs discuss a review on SHM basically monitoring bridge performance. The
first example is the monitoring of the Tsing Ma Bridge and Kap Shui Mun Bridge in Hong Kong
[10]. A large amount of sensors include temperature sensors, strain gauges, displacement,
anemometer, and accelerometers were installed on the bridge. These sensors were installed to
monitor the bridge dynamic response in terms of displacement, acceleration, wind, and temperature.
Approximately 320 channels of sensors were used in Tsing Ma Bridge [11].These sensors produced
about 65 M Bytes of data every hour in an attempt toward in–depth monitoring. This SHM system
was able to monitor the structural health of the bridge and provide reliable information for civil
engineers to plan accordingly for inspection visits.
Another example of SHM is the Bill Emerson Memorial Bridge located in Cape Girardeau,
Missouri. That long term SHM system included 84 accelerometers channels [12]. This system was
installed to evaluate the dynamic response of the bridge under seismic activities.
One of the eminent examples of infrastructure SHM is that of the Golden Gate Bridge in San
Francisco, California. The SHM system deployed 28 accelerometers where 12 of them were located
on the main span, 6 on the side span and 10 on the pier–lower

The Middle-Range Theory Of Self-Care Of Chronic Illness
As of 2012, approximately half of all adults in the United States (U.S.) had at least one chronic
health condition and one fourth had more than one chronic health condition (Ward, Schiller, &
Goodman, 2014). Self–care is recognized to be an important component in the management of
chronic illnesses (Ausili, Masotto, Dall'Ora, Salvini, & Di Mauro, 2014; Coleman & Newton, 2005;
Kennedy, Rogers, & Bower, 2007). As knowledge in this area grows, there is a need for theories to
guide research and practice. The middle–range theory of self–care of chronic illness (MRTS–CCI) is
a theory intended to clarify the concepts, assumptions, propositions, and factors affecting self–care
in the context of chronic illness (Riegel, Jaarsma, & Strömberg, 2012). ... Show more content on
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It states, "Patients who engage in self–care that is purposive but unreflective are limited in their
ability to master self–care in complex situations" (Riegel et al., 2012, p. 200). The authors describe a
relationship between processes of decision making and reflection, and sufficient or insufficient self–
care. The description includes instances where individuals are unreflective, yet achieve sufficient
self–care; however, they contend that the "ideal combination for a person with chronic illness is
purposive, reflective, sufficient and reasoned self–care" (Riegel et al., 2012, p. 195). These
relationships remain ambiguous because if sufficient self–care is achieved, no explanation or
sources are provided for why reflective sufficient self–care is more desirable. The description of this
relationship does not follow the rules of deductive reasoning and is, therefore, not

A Brief Note On Concentration And Surface Water
Estimating Bifenthrin Concentration in Surface water in Urban Sacramento.
Introduction
Pyrethroid insecticides have replaced organophosphates (OP) insecticides, such as, diazinon and
chlorpyrifos for structural pest control and landscape maintenance in most urban environments in
the United States in recent times. Pyrethroids are manufactured derivatives of pyrethrins, which are
natural insecticides that are produced by certain species of chrysanthemum. These insecticides are
neurotoxins and focus on the central nervous system of insects', thereby, making it exceptionally
viable in pest control. These chemicals are broadly utilized by professional applicators to keep pests
out of structures either as landscape application, or as perimeter treatments. Other than professional
applications which are documented, pyrethroids are also incorporated in many pest control products
that are designed for homeowners and available at retail stores, however the utilization of these
items are not all around reported documented (Moran, 2006). The combination of these uses
(professionals and homeowners) aids in the increase presence of pyrethroids on urban landscape and
structures which are later washed–off to urban creeks. The most commonly suspected modes of
transport of pesticide residues from urban application sites to downstream pesticide contamination is
by means of irrigation (dry) or runoff (rain).
In spite of the fact that pyrethroid insecticides are present in a wide variety of

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