Structure matters: Adoption of structured classification Approach in the context of cognitive presence classification

Within online learning communities, receiving timely and meaningful insights into the quality of learning activities is an important part of an effective educational experience. Commonly adopted methods – such as the Community of Inquiry framework – rely on manual coding of online discussion transcripts, which is a costly and time consuming process. There are several efforts underway to enable the automated classification of online discussion messages using supervised machine learning, which would enable the real-time analysis of interactions occurring within online learning communities. This paper investigates the importance of incorporating features that utilise the structure of on-line discussions for the classification of "cognitive presence" – the central dimension of the Community of Inquiry framework focusing on the quality of students' critical thinking within online learning communities. We implemented a Conditional Random Field classification solution, which incorporates structural features that may be useful in increasing classification performance over other implementations. Our approach leads to an improvement in classification accuracy of 5.8% over current existing techniques when tested on the same dataset, with a precision and recall of 0.630 and 0.504 respectively.

Tissue engineered humanized bone supports human hematopoiesis in vivo

Advances in tissue-engineering have resulted in a versatile tool-box to specifically design a tailored microenvironment for hematopoietic stem cells (HSCs) in order to study diseases that develop within this setting. However, most current in vivo models fail to recapitulate the biological processes seen in humans. Here we describe a highly reproducible method to engineer humanized bone constructs that are able to recapitulate the morphological features and biological functions of the HSC niches. Ectopic implantation of biodegradable composite scaffolds cultured for 4 weeks with human mesenchymal progenitor cells and loaded with rhBMP-7 resulted in the development of a chimeric bone organ including a large number of human mesenchymal cells which were shown to be metabolically active and capable of establishing a humanized microenvironment supportive of the homing and maintenance of human HSCs. A syngeneic mouse-to-mouse transplantation assay was used to prove the functionality of the tissue-engineered ossicles. We predict that the ability to tissue engineer a morphologically intact and functional large-volume bone organ with a humanized bone marrow compartment will help to further elucidate physiological or pathological interactions between human HSCs and their native niches.

Hierarchically structured porous poly(2-oxazoline) hydrogels

A new method for fabricating hydrogels with intricate control over hierarchical 3D porosity using micro-fiber porogens is presented. Melt electrospinning writing of poly(ε-caprolactone) is used to create the sacrificial template leading to hierarchical structuring consisting of pores inside the denser poly(2-oxazoline) hydrogel mesh. This versatile approach provides new opportunities to create well-defined multilevel control over interconnected pores with diameters in the lower micrometer range inside hydrogels with potential applications as cell scaffolds with tunable diffusion and transport of, e.g. nutrients, growth factors or therapeutics.

Ongoing poor management of medicines in the older-aged living independently in a rental retirement village

Background In a low socioeconomic status, small, rental retirement village, we have shown the older-aged managed their medicines poorly [1]. Objective As the number of participants was only 25, and the population in the rental retirement village turns over regularly; our objective was to determine whether the findings were consistent and ongoing. Methods We returned to the rental retirement villages after one and two years, and reassessed the management of medicines, using the same semi-structured interview method. Main outcome measure The main outcome measure was the perception of present and ongoing adherence. Results Although similar numbers (23-25) participated in the studies in 2011-2013, the actual participants changed with only 3 being interviewed on 3 occasions. Nevertheless, the findings over the 3 years were similar: less than 50% of the participants were adherent at the time of the study and unlikely to have problems in the next 6-12 months; only 50% had a good knowledge of their illnesses. Conclusions The management of medicines by the older-aged living in a low socioeconomic, rental retirement village is poor, and this finding is ongoing and consistent. This supports the need for extra assistance and resources for the older-aged, living in rental retirement villages, to manage their medicines.

Principles to guide sustainable implementation of extended-scope-of-practice physiotherapy workforce redesign initiatives in Australia: Stakeholder perspectives, barriers, supports, and incentives

Sustainable implementation of new workforce redesign initiatives requires strategies that minimize barriers and optimize supports. Such strategies could be provided by a set of guiding principles. A broad understanding of the concerns of all the key stakeholder groups is required before effective strategies and initiatives are developed. Many new workforce redesign initiatives are not underpinned by prior planning, and this threatens their uptake and sustainability. This study reports on a cross-sectional qualitative study that sought the perspectives of representatives of key stakeholders in a new workforce redesign initiative (extended-scope-of-practice physiotherapy) in one Australian tertiary hospital. The key stakeholder groups were those that had been involved in some way in the development, management, training, funding, and/or delivery of the initiative. Data were collected using semistructured questions, answered individually by interview or in writing. Responses were themed collaboratively, using descriptive analysis. Key identified themes comprised: the importance of service marketing; proactively addressing barriers; using readily understood nomenclature; demonstrating service quality and safety, monitoring adverse events, measuring health and cost outcomes; legislative issues; registration; promoting viable career pathways; developing, accrediting, and delivering a curriculum supporting physiotherapists to work outside of the usual scope; and progression from "a good idea" to established service. Health care facilities planning to implement new workforce initiatives that extend scope of usual practice should consider these issues before instigating workforce/model of care changes. © 2014 Morris et al.

The need for cost-effectiveness analyses of antimicrobial stewardship programmes: A structured review

The cost effectiveness of antimicrobial stewardship (AMS) programmes was reviewed in hospital settings of Organisation for Economic Co-operation and Development (OECD) countries, and limited to adult patient populations. In each of the 36 studies, the type of AMS strategy and the clinical and cost outcomes were evaluated. The main AMS strategy implemented was prospective audit with intervention and feedback (PAIF), followed by the use of rapid technology, including rapid polymerase chain reaction (PCR)-based methods and matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) technology, for the treatment of bloodstream infections. All but one of the 36 studies reported that AMS resulted in a reduction in pharmacy expenditure. Among 27 studies measuring changes to health outcomes, either no change was reported post-AMS, or the additional benefits achieved from these outcomes were not quantified. Only two studies performed a full economic evaluation: one on a PAIF-based AMS intervention; and the other on use of rapid technology for the selection of appropriate treatment for serious Staphylococcus aureus infections. Both studies found the interventions to be cost effective. AMS programmes achieved a reduction in pharmacy expenditure, but there was a lack of consistency in the reported cost outcomes making it difficult to compare between interventions. A failure to capture complete costs in terms of resource use makes it difficult to determine the true cost of these interventions. There is an urgent need for full economic evaluations that compare relative changes both in clinical and cost outcomes to enable identification of the most cost-effective AMS strategies in hospitals.

Web crippling tests of hollow flange channel beams with flanges fastened to supports under two flange load cases

Thin-walled steel hollow flange channel beams known as LiteSteel beam (LSB) sections were developed for use as joists and bearers in various flooring systems. However, they are subjected to specific buckling and failure modes, one of them being web crippling. Despite considerable research in this area, much of the current design predictions for cold-formed steel sections are not directly applicable to LSBs. This is due to the geometry of the LSB, which consists of two closed rectangular hollow flanges, and its unique residual stress characteristics and initial geometric imperfections. Hence an experimental study was conducted to investigate the web crippling behaviour and capacities of LSBs with their flanges fastened to supports. Thirty nine web crippling tests were conducted under two flange load cases (End Two Flange (ETF) and Interior Two Flange (ITF)). Test results showed that for ETF load case the web crippling capacities increased by 50% on average while they increased by 97% for ITF load case when flanges were fastened to supports. Comparison of the ultimate web crippling capacities from tests showed that AS/NZS 4600 and AISI S100 web crippling design equations are conservative for LSB sections with flanges fastened to supports under ETF and ITF load cases. Hence new equations were proposed to determine the web crippling capacities of LSBs with flanges fastened to supports. This paper presents the details of the experimental study into the web crippling behaviour of LSB sections with their flanges fastened under ETF and ITF load cases, and the results.

Automated Discovery of Structured Process Models: Discover Structured vs. Discover and Structure

This paper addresses the problem of discovering business process models from event logs. Existing approaches to this problem strike various tradeoffs between accuracy and understandability of the discovered models. With respect to the second criterion, empirical studies have shown that block-structured process models are generally more understandable and less error-prone than unstructured ones. Accordingly, several automated process discovery methods generate block-structured models by construction. These approaches however intertwine the concern of producing accurate models with that of ensuring their structuredness, sometimes sacrificing the former to ensure the latter. In this paper we propose an alternative approach that separates these two concerns. Instead of directly discovering a structured process model, we first apply a well-known heuristic technique that discovers more accurate but sometimes unstructured (and even unsound) process models, and then transform the resulting model into a structured one. An experimental evaluation shows that our “discover and structure” approach outperforms traditional “discover structured” approaches with respect to a range of accuracy and complexity measures.

Social networks and use of social supports of minority elders in East Harlem

Considerable empirical research substantiates the importance of social networks on health and well-being in later life. A study of ethnic minority elders living in two low income public housing buildings in East Harlem was undertaken to gain an understanding of the relationship between their health status and social networks. Findings demonstrate that elders with supportive housing had better psychological outcomes and used significantly more informal supports when in need. However, elders with serious health problems had poorer outcomes regardless of their level of social support. This study highlights the potential of supportive living environments to foster social integration and to optimise formal and informal networks.