Pneumonia and influenza: specific considerations in care homes

This review provides an update on current evidence surrounding epidemiology, treatment and prevention of lower respiratory tract infection, with special reference to pneumonia and influenza, in care home residents. The care home sector is growing and provides a unique ecological niche for infections, housing frail older people with multiple comorbidities and frequent contact with healthcare services. There are therefore considerations in the epidemiology and management of these conditions which are specific to care homes. Opportunities for prevention, in the form of vaccination strategies and improving oral hygiene, may reduce the burden of these diseases in the future. Work is needed to research these infections specifically in the care home setting and this article highlights current gaps in our knowledge.

Is Experts' Knowledge Modular?

This paper explores, both with empirical data and with computer simulations, the extent to which modularity characterises experts' knowledge. We discuss a replication of Chase and Simon's (1973) classic method of identifying 'chunks', i.e., perceptual patterns stored in memory and used as units. This method uses data about the placement of pairs of items in a memory task and consists of comparing latencies between these items and the number and type of relations they share. We then compare the human data with simulations carried out with CHREST, a computer model of perception and memory. We show that the model, based upon the acquisition of a large number of chunks, accounts for the human data well. This is taken as evidence that human knowledge is organised in a modular fashion.

'On the Application of Hierarchical Coevolutionary Genetic Algorithms: Recombination and Evaluation Partners'

This paper examines the use of a hierarchical coevolutionary genetic algorithm under different partnering strategies. Cascading clusters of sub-populations are built from the bottom up, with higher-level sub-populations optimising larger parts of the problem. Hence higher-level sub-populations potentially search a larger search space with a lower resolution whilst lower-level sub-populations search a smaller search space with a higher resolution. The effects of different partner selection schemes amongst the sub-populations on solution quality are examined for two constrained optimisation problems. We examine a number of recombination partnering strategies in the construction of higher-level individuals and a number of related schemes for evaluating sub-solutions. It is shown that partnering strategies that exploit problem-specific knowledge are superior and can counter inappropriate (sub-) fitness measurements.

Knowledge discovery in hyper-heuristic using case-based reasoning on course timetabling

This paper presents a new hyper-heuristic method using Case-Based Reasoning (CBR) for solving course timetabling problems. The term Hyper-heuristics has recently been employed to refer to 'heuristics that choose heuristics' rather than heuristics that operate directly on given problems. One of the overriding motivations of hyper-heuristic methods is the attempt to develop techniques that can operate with greater generality than is currently possible. The basic idea behind this is that we maintain a case base of information about the most successful heuristics for a range of previous timetabling problems to predict the best heuristic for the new problem in hand using the previous knowledge. Knowledge discovery techniques are used to carry out the training on the CBR system to improve the system performance on the prediction. Initial results presented in this paper are good and we conclude by discussing the con-siderable promise for future work in this area.

RoMEO Studies 8: self-archiving: the logic behind the colour-coding used in the Copyright Knowledge Bank

Purpose – The purpose of this research is to show how the self-archiving of journal papers is a major step towards providing open access to research. However, copyright transfer agreements (CTAs) that are signed by an author prior to publication often indicate whether, and in what form, self-archiving is allowed. The SHERPA/RoMEO database enables easy access to publishers' policies in this area and uses a colour-coding scheme to classify publishers according to their self-archiving status. The database is currently being redeveloped and renamed the Copyright Knowledge Bank. However, it will still assign a colour to individual publishers indicating whether pre-prints can be self-archived (yellow), post-prints can be self-archived (blue), both pre-print and post-print can be archived (green) or neither (white). The nature of CTAs means that these decisions are rarely as straightforward as they may seem, and this paper describes the thinking and considerations that were used in assigning these colours in the light of the underlying principles and definitions of open access. Approach – Detailed analysis of a large number of CTAs led to the development of controlled vocabulary of terms which was carefully analysed to determine how these terms equate to the definition and “spirit” of open access. Findings – The paper reports on how conditions outlined by publishers in their CTAs, such as how or where a paper can be self-archived, affect the assignment of a self-archiving colour to the publisher. Value – The colour assignment is widely used by authors and repository administrators in determining whether academic papers can be self-archived. This paper provides a starting-point for further discussion and development of publisher classification in the open access environment.

Expertise and forms of knowledge in the government of families

This paper examines the relationship between the state and the individual in relation to an aspect of mundane family life – the feeding of babies and young children. The nutritional status of children has long been a matter of national concern and infant feeding is an aspect of family life that has been subjected to substantial state intervention. It exemplifies the imposition upon women the ‘biologico-moral responsibility’ for the welfare of children (Foucault 1991b). The state’s attempts to influence mothers’ feeding practices operate largely through education and persuasion. Through an elaborate state-sponsored apparatus, a strongly medicalised expert discourse is disseminated to mothers. This discourse warns mothers of the risks of certain feeding practices and the benefits of others. It constrains mothers through a series of ‘quiet coercions’ (Foucault 1991c) which seek to render them self-regulating subjects. Using data from a longitudinal interview study, this paper explores how mothers who are made responsible in these medical discourses around child nutrition, engage with, resist and refuse expert advice. It examines, in particular, the rhetorical strategies which mothers use to defend themselves against the charges of maternal irresponsibility that arise when their practices do not conform to expert medical recommendations.

"Ordinary people only": knowledge, representativeness and the publics of public participation in healthcare

Public involvement in healthcare is a prominent policy in countries across the economically developed world. A growing body of academic literature has focused on public participation, often presenting dichotomies between good and bad practice: between initiatives that offer empowerment and those constrained by consumerism, or between those which rely for recruitment on self-selecting members of the public, and those including a more broad-based, statistically representative group. In this paper I discuss the apparent tensions between differing rationales for participation, relating recent discussions about the nature of representation in public involvement to parallel writings about the contribution of laypeople’s expertise and experience. In the academic literature, there is, I suggest, a thin line between democratic justifications for involvement, suggesting a representative role for involved publics, and technocratic ideas about the potential ‘expert’ contributions of particular subgroups of the public. Analysing recent policy documents on participation in healthcare in England, I seek moreover to show how contemporary policy transcends both categories, demanding complex roles of involved publics which invoke various qualities seen as important in governing the interface between state and society. I relate this to social-theoretical perspectives on the relationship between governmental authority and citizens in late-modern society.

Reconfiguring or reproducing intra-professional boundaries? Specialist expertise, generalist knowledge and the ‘modernization’ of the medical workforce

Efforts to ‘modernize’ the clinical workforce of the English National Health Service have sought to reconfigure the responsibilities of professional groups in pursuit of more effective, joined-up service provision. Such efforts have met resistance from professions eager to protect their jurisdictions, deploying legitimacy claims familiar from the insights of the sociology of professions. Yet to date few studies of professional boundaries have grounded these insights in the specific context of policy challenges to the inter- and intra-professional division of labour, in relation the medical profession and other health-related occupations. In this paper we address this gap by considering the experience of newly instituted general practitioners (family physicians) with a special interest (GPSIs) in genetics, introduced to improve genetics knowledge and practice in primary care. Using qualitative data from four comparative case studies, we discuss how an established intra-professional division of labour within medicine—between clinical geneticists and GPs—was opened, negotiated and reclosed in these sites. We discuss the contrasting attitudes towards the nature of genetics knowledge and its application of GPSIs and geneticists, and how these were used to advance conflicting visions of what the nascent GPSI role should involve. In particular, we show how the claims to knowledge of geneticists and GPSIs interacted with wider policy pressures to produce a rather more conservative redistribution of power and responsibility across the intra-professional boundary than the rhetoric of modernization might suggest.

PCA 4 DCA: the application of principal component analysis to the Dendritic Cell Algorithm

As one of the newest members in the field of articial immune systems (AIS), the Dendritic Cell Algorithm (DCA) is based on behavioural models of natural dendritic cells (DCs). Unlike other AIS, the DCA does not rely on training data, instead domain or expert knowledge is required to predetermine the mapping between input signals from a particular instance to the three categories used by the DCA. This data preprocessing phase has received the criticism of having manually over-fitted the data to the algorithm, which is undesirable. Therefore, in this paper we have attempted to ascertain if it is possible to use principal component analysis (PCA) techniques to automatically categorise input data while still generating useful and accurate classication results. The integrated system is tested with a biometrics dataset for the stress recognition of automobile drivers. The experimental results have shown the application of PCA to the DCA for the purpose of automated data preprocessing is successful.

Health, hygiene and biosecurity: tribal knowledge claims in the UK poultry industry

Since 1997 the world has been facing the threat of a human influenza pandemic that may be caused by an avian virus and the poultry industry around the globe has been grappling with the highly pathogenic strain of avian influenza H5N1, or in more informal terms bird flu. The UK poultry industry has lived with and through this threat and its consequences since 2005. This study investigates knowledge claims about health, hygiene and biosecurity as tools to ward off the threat from this virus. It takes a semi-ethnographic and discourse analytic approach to analyse a small corpus of semi-structured interviews carried out in the wake of one of the most publicised outbreaks of H5N1 in Suffolk in 2007. It reveals that claims about what best to do to protect flocks against the risk of disease are divided along lines imposed on the one hand by the structure of the industry and on the other by more 'tribal' lines drawn by knowledge and belief systems about purity and dirt, health and hygiene.