Protocol for a randomised blocked design study using telephone and text-messaging to support cardiac patients with diabetes : a cross cultural international collaborative project

Background The prevalence of type 2 diabetes is rising internationally. Patients with diabetes have a higher risk of cardiovascular events accounting for substantial premature morbidity and mortality, and health care expenditure. Given healthcare workforce limitations, there is a need to improve interventions that promote positive self-management behaviours that enable patients to manage their chronic conditions effectively, across different cultural contexts. Previous studies have evaluated the feasibility of including telephone and Short Message Service (SMS) follow up in chronic disease self-management programs, but only for single diseases or in one specific population. Therefore, the aim of this study is to evaluate the feasibility and short-term efficacy of incorporating telephone and text messaging to support the care of patients with diabetes and cardiac disease, in Australia and in Taiwan. Methods/design A randomised controlled trial design will be used to evaluate a self-management program for people with diabetes and cardiac disease that incorporates the use of simple remote-access communication technologies. A sample size of 180 participants from Australia and Taiwan will be recruited and randomised in a one-to-one ratio to receive either the intervention in addition to usual care (intervention) or usual care alone (control). The intervention will consist of in-hospital education as well as follow up utilising personal telephone calls and SMS reminders. Primary short term outcomes of interest include self-care behaviours and self-efficacy assessed at baseline and four weeks. Discussion If the results of this investigation substantiate the feasibility and efficacy of the telephone and SMS intervention for promoting self management among patients with diabetes and cardiac disease in Australia and Taiwan, it will support the external validity of the intervention. It is anticipated that empirical data from this investigation will provide valuable information to inform future international collaborations, while providing a platform for further enhancements of the program, which has potential to benefit patients internationally.

Innovations in dietary interventions : Use of a photographic food diary method and telephone linked computerized care in chronic disease

Access to dietetic care is important in chronic disease management and innovative technologies assists in this purpose. Photographic dietary records (PhDR) using mobile phones or cameras are valid and convenient for patients. Innovations in providing dietary interventions via telephone and computer can also inform dietetic practice. Three studies are presented. A mobile phone method was validated by comparing energy intake (EI) to a weighed food record and a measure of energy expenditure (EE) obtained using the doubly labelled water technique in 10 adults with T2 diabetes. The level of agreement between mean (±sd) energy intake mobile phone (8.2±1.7 MJ) and weighed record (8.5±1.6 MJ) was high (p=0.392), however EI/EE for both methods gave similar levels of under-reporting (0.69 and 0.72). All subjects preferred using the mobile phone vs. weighed record. Nineteen individuals with Parkinsons disease kept 3-day PhDRs on three occasions using point-and-shoot digital cameras over a 12 week period. The camera was rated as easy to use by 89%, keeping a PhDR was considered acceptable by 94% and none would rather use a “pen and paper” method. Eighty-three percent felt confident to use the camera again to record intake. An interactive, automated telephone system designed to coach people with T2 diabetes to adopt and maintain diabetes self-care behaviours, including nutrition, showed trends for improvements in total fat, saturated fat and vegetable intake of the intervention group compared to control participants over 6 months. Innovative technologies are acceptable to patients with chronic conditions and can be incorporated into dietetic care.

Augmenting traversability maps with ultra-wideband radar to enhance obstacle detection in vegetated environments

Operating in vegetated environments is a major challenge for autonomous robots. Obstacle detection based only on geometric features causes the robot to consider foliage, for example, small grass tussocks that could be easily driven through, as obstacles. Classifying vegetation does not solve this problem since there might be an obstacle hidden behind the vegetation. In addition, dense vegetation typically needs to be considered as an obstacle. This paper addresses this problem by augmenting probabilistic traversability map constructed from laser data with ultra-wideband radar measurements. An adaptive detection threshold and a probabilistic sensor model are developed to convert the radar data to occupancy probabilities. The resulting map captures the fine resolution of the laser map but clears areas from the traversability map that are induced by obstacle-free foliage. Experimental results validate that this method is able to improve the accuracy of traversability maps in vegetated environments.

Reconstruction of the ancestral marsupial karyotype from comparative gene maps

BACKGROUND: The increasing number of assembled mammalian genomes makes it possible to compare genome organisation across mammalian lineages and reconstruct chromosomes of the ancestral marsupial and therian (marsupial and eutherian) mammals. However, the reconstruction of ancestral genomes requires genome assemblies to be anchored to chromosomes. The recently sequenced tammar wallaby (Macropus eugenii) genome was assembled into over 300,000 contigs. We previously devised an efficient strategy for mapping large evolutionarily conserved blocks in non-model mammals, and applied this to determine the arrangement of conserved blocks on all wallaby chromosomes, thereby permitting comparative maps to be constructed and resolve the long debated issue between a 2n=14 and 2n=22 ancestral marsupial karyotype. RESULTS: We identified large blocks of genes conserved between human and opossum, and mapped genes corresponding to the ends of these blocks by fluorescence in situ hybridization (FISH). A total of 242 genes was assigned to wallaby chromosomes in the present study, bringing the total number of genes mapped to 554 and making it the most densely cytogenetically mapped marsupial genome. We used these gene assignments to construct comparative maps between wallaby and opossum, which uncovered many intrachromosomal rearrangements, particularly for genes found on wallaby chromosomes X and 3. Expanding comparisons to include chicken and human permitted the putative ancestral marsupial (2n=14) and therian mammal (2n=19) karyotypes to be reconstructed. CONCLUSIONS: Our physical mapping data for the tammar wallaby has uncovered the events shaping marsupial genomes and enabled us to predict the ancestral marsupial karyotype, supporting a 2n=14 ancestor. Futhermore, our predicted therian ancestral karyotype has helped to understand the evolution of the ancestral eutherian genome.

Is age a factor in the success or failure of remote monitoring in heart failure? Telemonitoring and structured telephone support in elderly heart failure patients

Background There are few data regarding the effectiveness of remote monitoring for older people with heart failure. We conducted a post-hoc sub-analysis of a previously published large Cochrane systematic review and meta-analysis of relevant randomized controlled trials to determine whether structured telephone support and telemonitoring were effective in this population. Methods A post hoc sub-analysis of a systematic review and meta-analysis that applied the Cochrane methodology was conducted. Meta-analyses of all-cause mortality, all-cause hospitalizations and heart failure-related hospitalizations were performed for studies where the mean or median age of participants was 70 or more years. Results The mean or median age of participants was 70 or more years in eight of the 16 (n=2,659/5,613; 47%) structured telephone support studies and four of the 11 (n=894/2,710; 33%) telemonitoring studies. Structured telephone support (RR 0.80; 95% CI=0.63-1.00) and telemonitoring (RR 0.56; 95% CI=0.41-0.76) interventions reduced mortality. Structured telephone support interventions reduced heart failure-related hospitalizations (RR 0.81; 95% CI=0.67-0.99). Conclusion Despite a systematic bias towards recruitment of individuals younger than the epidemiological average into the randomized controlled trials, older people with heart failure did benefit from structured telephone support and telemonitoring. These post-hoc sub-analysis results were similar to overall effects observed in the main meta-analysis. While further research is required to confirm these observational findings, the evidence at hand indicates that discrimination by age alone may be not be appropriate when inviting participation in a remote monitoring service for heart failure.

Linkage maps in pea

We have analyzed segregation patterns of markers among the late generation progeny of several crosses of pea. From the patterns of association of these markers we have deduced linkage orders. Salient features of these linkages are discussed, as is the relationship between the data presented here and previously published genetic and cytogenetic data.

Developing a multidimensional scale of customer-oriented deviance (COD)

Although frontline employees' bending of organizational rules and norms for customers is an important phenomenon, marketing scholars to date only broadly describe over-servicing behaviors and provide little distinction among deviant behavioral concepts. Drawing on research on pro-social and pro-customer behaviors and on studies of positive deviance, this paper develops and validates a multi-faceted, multi-dimensional construct term customer-oriented deviance. Results from two samples totaling 616 frontline employees (FLEs) in the retail and hospitality industries demonstrate that customer-oriented deviance is a four-dimensional construct with sound psychometric properties. Evidence from a test of a theoretical model of key antecedents establishes nomological validity with empathy/perspective-taking, risk-taking propensity, role conflict, and job autonomy as key predictors. Results show that the dimensions of customer-oriented deviance are distinct and have significant implications for theory and practice.

Shared generation of pseudo-random functions with cumulative maps

In Crypto’95, Micali and Sidney proposed a method for shared generation of a pseudo-random function f(·) among n players in such a way that for all the inputs x, any u players can compute f(x) while t or fewer players fail to do so, where 0 ≤ t < u ≤ n. The idea behind the Micali-Sidney scheme is to generate and distribute secret seeds S = s1, . . . , sd of a poly-random collection of functions, among the n players, each player gets a subset of S, in such a way that any u players together hold all the secret seeds in S while any t or fewer players will lack at least one element from S. The pseudo-random function is then computed as where f s i (·)’s are poly-random functions. One question raised by Micali and Sidney is how to distribute the secret seeds satisfying the above condition such that the number of seeds, d, is as small as possible. In this paper, we continue the work of Micali and Sidney. We first provide a general framework for shared generation of pseudo-random function using cumulative maps. We demonstrate that the Micali-Sidney scheme is a special case of this general construction.We then derive an upper and a lower bound for d. Finally we give a simple, yet efficient, approximation greedy algorithm for generating the secret seeds S in which d is close to the optimum by a factor of at most u ln 2.

Lose yourself in books no more - interactive maps show the way

This article explores the use of digital technology such as interactive maps to enhance books.

A speaker rediarization scheme for improving diarization in large two-speaker telephone datasets

In this paper we propose a novel scheme for carrying out speaker diarization in an iterative manner. We aim to show that the information obtained through the first pass of speaker diarization can be reused to refine and improve the original diarization results. We call this technique speaker rediarization and demonstrate the practical application of our rediarization algorithm using a large archive of two-speaker telephone conversation recordings. We use the NIST 2008 SRE summed telephone corpora for evaluating our speaker rediarization system. This corpus contains recurring speaker identities across independent recording sessions that need to be linked across the entire corpus. We show that our speaker rediarization scheme can take advantage of inter-session speaker information, linked in the initial diarization pass, to achieve a 30% relative improvement over the original diarization error rate (DER) after only two iterations of rediarization.

Experience the sights & sounds of Cape Breton, Nova Scotia

A travel article about Nova Scotia, and the area's annual Celtic music festival. I ARRIVED in Cape Breton on the occasion of the Fibre Festival, run not only by the South Haven Guild of Weavers but also the Baddeck Quilters Guild. And yet I might not have noticed that it was on, had it not been for a car, shrouded entirely by a quilt cover, that was parked outside the Volunteer Fire Department Hall. I was on my way to the Alexander Graham Bell Museum a little further along Baddeck's main street. But I stopped, for who wouldn't stop to look at the various fibres of Cape Breton. The hall had been divided between weavers and quilters. Naturally, I left hoping that one day this ancient divide might be healed...