Comprehensive health assessment of shield tunnel structure based on prototype experiment

2018 ◽  
Vol 25 (3) ◽  
pp. 681-689 ◽  
Author(s):  
Pan Li ◽  
Ya-wei Zhang ◽  
Fu-yu Jiang ◽  
Hu Zheng
Keyword(s):  
Health Assessment ◽  
Shield Tunnel ◽  
Tunnel Structure ◽  
Comprehensive Health

scholarly journals Evaluation of a staff training programme to reimplement a comprehensive health assessment

2018 ◽  
Vol 7 (4) ◽  
pp. e000353 ◽  
Author(s):  
Luke A Turcotte ◽  
Jake Tran ◽  
Joshua Moralejo ◽  
Nancy Curtin-Telegdi ◽  
Leslie Eckel ◽  
...  
Keyword(s):  
Data Quality ◽  
Quality Assessment ◽  
Health Information ◽  
Health Assessment ◽  
Training Programme ◽  
Care Planning ◽  
Assessment Framework ◽  
High Quality ◽  
Data Quality Assessment ◽  
Comprehensive Health

BackgroundHealth information systems with applications in patient care planning and decision support depend on high-quality data. A postacute care hospital in Ontario, Canada, conducted data quality assessment and focus group interviews to guide the development of a cross-disciplinary training programme to reimplement the Resident Assessment Instrument–Minimum Data Set (RAI-MDS) 2.0 comprehensive health assessment into the hospital’s clinical workflows.MethodsA hospital-level data quality assessment framework based on time series comparisons against an aggregate of Ontario postacute care hospitals was used to identify areas of concern. Focus groups were used to evaluate assessment practices and the use of health information in care planning and clinical decision support. The data quality assessment and focus groups were repeated to evaluate the effectiveness of the training programme.ResultsInitial data quality assessment and focus group indicated that knowledge, practice and cultural barriers prevented both the collection and use of high-quality clinical data. Following the implementation of the training, there was an improvement in both data quality and the culture surrounding the RAI-MDS 2.0 assessment.ConclusionsIt is important for facilities to evaluate the quality of their health information to ensure that it is suitable for decision-making purposes. This study demonstrates the use of a data quality assessment framework that can be applied for quality improvement planning.

scholarly journals Comprehensive health assessment three months after recovery from acute COVID-19

2020 ◽  
Author(s):  
Bram van den Borst ◽  
Jeannette B Peters ◽  
Monique Brink ◽  
Yvonne Schoon ◽  
Chantal P Bleeker-Rovers ◽  
...  
Keyword(s):  
Health Status ◽  
Health Assessment ◽  
Test Body ◽  
Fat Free Mass ◽  
X Rays ◽  
Lung Diffusion ◽  
Diffusion Capacity ◽  
Comprehensive Health ◽  
Discharged Patients

Abstract Background Long-term health sequelae of COVID-19 may be multiple but have thus far not been systematically studied. Methods All patients discharged after COVID-19 from the Radboud university medical centre, Nijmegen, The Netherlands, were consecutively invited to a multidisciplinary outpatient facility. Also, non-admitted patients with mild disease but with symptoms persisting >6 weeks could be referred by general practitioners. Patients underwent a standardized assessment including measurements of lung function, chest CT/X-ray, 6-minute walking test, body composition, and questionnaires on mental, cognitive, health status and quality of life (QoL). Results 124 patients (age 59±14 years, 60% male) were included; 27 with mild, 51 with moderate, 26 with severe and 20 with critical disease. Lung diffusion capacity was below lower limit of normal in 42% of discharged patients. Ninety-nine percent of discharged patients had reduced ground-glass opacification on repeat CT imaging, and normal chest X-rays were found in 93% of patients with mild diseases. Residual pulmonary parenchymal abnormalities were present in 91% of discharged patients, and correlated with reduced lung diffusion capacity. Twenty-two percent had low exercise capacity, 19% low fat-free mass index, and problems in mental and/or cognitive function were found in 36% of the patients. Health status was generally poor, particularly in the domains functional impairment (64%), fatigue (69%) and QoL (72%). Conclusions This comprehensive health assessment revealed severe problems in several health domains in a substantial number of ex-COVID-19 patients. Longer follow-up studies are warranted to elucidate natural trajectories and to find predictors of complicated long-term trajectories of recovery.

The development of the comprehensive health assessment tool for young offenders within the secure estate

2014 ◽  
Vol 25 (1) ◽  
pp. 1-25 ◽  
Author(s):  
Prathiba Chitsabesan ◽  
Charlotte Lennox ◽  
Louise Theodosiou ◽  
Heather Law ◽  
Sue Bailey ◽  
...  
Keyword(s):  
Assessment Tool ◽  
Health Assessment ◽  
Young Offenders ◽  
Comprehensive Health

scholarly journals Evaluating the Implementation of Health Checks for Adults With Intellectual and Developmental Disabilities in Primary Care: The Importance of Organizational Context

2016 ◽  
Vol 54 (2) ◽  
pp. 136-150 ◽  
Author(s):  
Janet Durbin ◽  
Avra Selick ◽  
Ian Casson ◽  
Laurie Green ◽  
Natasha Spassiani ◽  
...  
Keyword(s):  
Primary Care ◽  
Developmental Disabilities ◽  
Organizational Context ◽  
Health Assessment ◽  
Health Check ◽  
Intellectual And Developmental Disabilities ◽  
Preventative Care ◽  
Sustainable Implementation ◽  
Comprehensive Health ◽  
Core Components

Abstract Compared to other adults, those with intellectual and developmental disabilities have more health issues, yet are less likely to receive preventative care. One strategy that has shown success in increasing prevention activities and early detection of illness is the periodic comprehensive health assessment (the health check). Effectively moving evidence into practice is a complex process that often receives inadequate attention. This qualitative study evaluates the implementation of the health check at two primary-care clinics in Ontario, Canada, and the influence of the clinic context on implementation decisions. Each clinic implemented the same core components; however, due to contextual differences, some components were operationalized differently. Adapting to the setting context is important to ensuring successful and sustainable implementation.

scholarly journals Reinforcement Effects of Isolation Piles on the Adjacent Existing Tunnel in Building Construction

2019 ◽  
Vol 2019 ◽  
pp. 1-21 ◽  
Author(s):  
Aijun Yao ◽  
Jian Lu ◽  
Yanfei Guo ◽  
Jiantao Zhang ◽  
Haifeng Guo
Keyword(s):  
Horizontal Displacement ◽  
Building Construction ◽  
Shield Tunnel ◽  
Engineering Practice ◽  
Burial Depth ◽  
Tunnel Structure ◽  
Reinforcement Effect ◽  
Foundation Pit ◽  
Pile Spacing ◽  
Pile Diameter

Similar material model test and numerical simulation method were used to study the reinforcement effect of isolation piles on the existing shield tunnel structure in the adjacent building construction for analyzing foundation pit excavation and new building construction approaching existing shield tunnel engineering. The numerical simulation orthogonal experiment was used to optimize four isolation pile parameters. The conclusions were obtained as follows: (1) Isolation piles could share horizontal load of the soil at the rear side of the support structure and reduce horizontal displacement of the soil. As a result, maximum horizontal displacement of the tunnel structure and differences in horizontal displacement between the tunnel structure roof and the floor after foundation pit excavation and building loading were decreased. The horizontal displacement and torsional deformation of the tunnel structure toward the direction of the foundation pit were controlled, and the increase in internal forces of the transverse tunnel structure was also restrained. (2) At the elevation above the tunnel roof, the increase in burial depth of the isolation pile top slightly affected the reinforcement effect on the tunnel structure. The increase in burial depth of the isolation pile bottom could improve the reinforcement effect. Thus, burial depth of the isolation pile bottom should be properly increased in the engineering practice. The reduction in pile spacing could improve the reinforcement effect. Accordingly, pile spacing should be properly selected in the engineering practice. With the increase of diameter of the isolation pile, the reinforcement effect of isolation piles increased obviously. (3) Pile diameter had the greatest influence on the reinforcement effect of isolation piles, followed by burial depth of the pile bottom, pile spacing, and burial depth of the pile top. Orthogonal experiments indicated the following optimal parameter values: a pile diameter of 1.2 m, a burial depth of the pile bottom of 2H, a pile spacing of 1.6 m, and a burial depth of the pile top of 0.75Z.

scholarly journals Vibration Response Characteristics of the Cross Tunnel Structure

2016 ◽  
Vol 2016 ◽  
pp. 1-16 ◽  
Author(s):  
Jinxing Lai ◽  
Kaiyun Wang ◽  
Junling Qiu ◽  
Fangyuan Niu ◽  
Junbao Wang ◽  
...  
Keyword(s):  
High Speed ◽  
Three Dimensional ◽  
Time History ◽  
Element Model ◽  
Vibration Response ◽  
Shield Tunnel ◽  
Tunnel Structure ◽  
Response Characteristics ◽  
Vehicle Load ◽  
Metro Tunnel

It is well known that the tunnel structure will lose its function under the long-term repeated function of the vibration effect. A prime example is the Xi’an cross tunnel structure (CTS) of Metro Line 2 and the Yongningmen tunnel, where the vibration response of the tunnel vehicle load and metro train load to the structure of shield tunnel was analyzed by applying the three-dimensional (3D) dynamic finite element model. The effect of the train running was simulated by applying the time-history curves of vibration force of the track induced by wheel axles, using the fitted formulas for vehicle and train vibration load. The characteristics and the spreading rules of vibration response of metro tunnel structure were researched from the perspectives of acceleration, velocity, displacement, and stress. It was found that vehicle load only affects the metro tunnel within 14 m from the centre, and the influence decreases gradually from vault to spandrel, haunch, and springing. The high-speed driving effect of the train can be divided into the close period, the rising period, the stable period, the declining period, and the leaving period. The stress at haunch should be carefully considered. The research results presented for this case study provide theoretical support for the safety of vibration response of Metro Line 2 structure.

A checklist for comprehensive health assessment for the over 70's

2002 ◽  
Vol 21 (1) ◽  
pp. 14-20 ◽  
Author(s):  
Julie E. Byles ◽  
Meredith A. Tavener ◽  
Patrick E B. Fitzgerald ◽  
Balakrishnan R. Hair ◽  
Nick Higginbotham ◽  
...  
Keyword(s):  
Health Assessment ◽  
Comprehensive Health

Capecitabine (Cap) and oxaliplatin (Ox) in elderly and/or frail patients with metastatic colorectal cancer: The FOCUS2 trial

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 9030-9030 ◽  
Author(s):  
M. T. Seymour ◽  
T. S. Maughan ◽  
H. S. Wasan ◽  
A. E. Brewster ◽  
S. F. Shepherd ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Primary Endpoint ◽  
Performance Status ◽  
Health Assessment ◽  
Progression Free Survival ◽  
Full Dose ◽  
Frail Patients ◽  
Comprehensive Health ◽  
Dose Combination

9030 Background: Elderly/frail patients, though commonly treated, are under-represented in clinical trials. Evidence is needed to guide choices of drugs and doses in this population. Methods: FOCUS2 is a multicenter, 2x2 factorial randomized trial for patients with unpretreated metastatic colorectal cancer judged unfit for full-dose combination chemotherapy. After comprehensive health assessment (CHA), randomization was to: (A) simplified LV5FU2 infusional fluorouracil/leucovorin (FU); (B) OxFU; (C) Cap; or (D) OxCap. In each case, starting doses were 80% standard, with an option to escalate to full-dose at 6 weeks (wk). The factorial questions were: (A+B v C+D) - does replacing FU with Cap improve quality of life (QL)? (primary endpoint: improved global QL at 12 wk [QLQ-C30]); and (A+C v B+D) - how much does Ox improve efficacy in this population? (primary endpoint: progression-free survival (PFS). Results: 460 patients were randomized, 22% < 70 yrs; 35% 70–75 yrs; 43% > 75 yrs. 22% were performance status (PS) 0; 49% PS1; 29% PS2. Primary comparisons: (see table ): global QL did not favor Cap over FU. Comparison of PFS favored the addition of oxaliplatin but did not reach significance (HR 0.87, 95% CI 0.71–1.06, p=0.16). Secondary comparisons: Compared with FU, Cap did not affect RR, PFS or 60-day mortality, but it increased the risk of gr =3 toxicity. Oxaliplatin significantly improved RECIST response (RR) by wk 12, did not increase gr =3 toxicity or 60-day mortality, but reduced the chance of improved QL at 12 wk. Conclusion: In this frail elderly population, substituting Cap for FU did not improve overall QL or efficacy, and significantly increased toxicity. Addition of Ox gave significantly higher anticancer activity without increasing toxicity, but at the cost of some reduction in QL at 12 wk. Planned analyses include correlating baseline CHA with treatment outcome. [Table: see text] [Table: see text]

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