Computerised Diagnostic Decision Support System for the Classification of Pre-Invasive Cervical Squamous Lesions.

Previous studies have revealed considerable interobserver and intraobserver variation in the histological classification of preinvasive cervical squamous lesions. The aim of the present study was to develop a decision support system (DSS) for the histological interpretation of these lesions. Knowledge and uncertainty were represented in the form of a Bayesian belief network that permitted the storage of diagnostic knowledge and, for a given case, the collection of evidence in a cumulative manner that provided a final probability for the possible diagnostic outcomes. The network comprised 8 diagnostic histological features (evidence nodes) that were each independently linked to the diagnosis (decision node) by a conditional probability matrix. Diagnostic outcomes comprised normal; koilocytosis; and cervical intraepithelial neoplasia (CIN) 1, CIN II, and CIN M. For each evidence feature, a set of images was recorded that represented the full spectrum of change for that feature. The system was designed to be interactive in that the histopathologist was prompted to enter evidence into the network via a specifically designed graphical user interface (i-Path Diagnostics, Belfast, Northern Ireland). Membership functions were used to derive the relative likelihoods for the alternative feature outcomes, the likelihood vector was entered into the network, and the updated diagnostic belief was computed for the diagnostic outcomes and displayed. A cumulative probability graph was generated throughout the diagnostic process and presented on screen. The network was tested on 50 cervical colposcopic biopsy specimens, comprising 10 cases each of normal, koilocytosis, CIN 1, CIN H, and CIN III. These had been preselected by a consultant gynecological pathologist. Using conventional morphological assessment, the cases were classified on 2 separate occasions by 2 consultant and 2 junior pathologists. The cases were also then classified using the DSS on 2 occasions by the 4 pathologists and by 2 medical students with no experience in cervical histology. Interobserver and intraobserver agreement using morphology and using the DSS was calculated with K statistics. Intraobserver reproducibility using conventional unaided diagnosis was reasonably good (kappa range, 0.688 to 0.861), but interobserver agreement was poor (kappa range, 0.347 to 0.747). Using the DSS improved overall reproducibility between individuals. Using the DSS, however, did not enhance the diagnostic performance of junior pathologists when comparing their DSS-based diagnosis against an experienced consultant. However, the generation of a cumulative probability graph also allowed a comparison of individual performance, how individual features were assessed in the same case, and how this contributed to diagnostic disagreement between individuals. Diagnostic features such as nuclear pleomorphism were shown to be particularly problematic and poorly reproducible. DSSs such as this therefore not only have a role to play in enhancing decision making but also in the study of diagnostic protocol, education, self-assessment, and quality control. (C) 2003 Elsevier Inc. All rights reserved.

A novel trochoidal analyzer for the Belfast EBIT

Presently, Queens University Belfast is constructing a unique permanent magnet EBIT which grants unparalleled access to the photons from the trap region. However measurements of ions would still require their transfer through the collector to other measurement areas. To allow more representative sampling, a new in situ analyzer is proposed to be situated immediately at the collector end of the trap region. This analyzer may detect ions by expanding the radius of their cyclotron motion using electric fields until the ions strike Microsphere Plates (MSPs). It may also be possible by using trochoidal motion to detect product electrons. This is important as these have never been detected before in an EBIT. The preliminary design is described in this paper. (c) 2005 Elsevier B.V. All rights reserved.

A new device for the study of electron-ion interactions: The Belfast EBIT

An electron beam ion trap ( EBIT) has been designed and is currently under construction for use in atomic physics experiments at the Queen's University, Belfast. In contrast to traditional EBITs where pairs of superconducting magnets are used, a pair of permanent magnets will be used to compress the electron beam. The permanent magnets have been designed in conjunction with bespoke vacuum ports to give unprecedented access for photon detection. Furthermore, the bespoke vacuum ports facillitate a versatile, reconfigurable trap structure able to accommodate various in-situ detectors and in-line charged particle analysers. Although the machine will have somewhat lower specifications than many existing EBITs in terms of beam current density, it is hoped that the unique features will facilitate a number of hitherto impossible studies involving interactions between electrons and highly charged ions. In this article the new machine's design is outlined along with some suggestions of the type of process to be studied once the construction is completed.

Towards a person-centred ‘culture’: the use of community development approaches in the Independent Youth Counselling Service in West Belfast

This paper is drawn from a qualitative study of clients, counsellors and the supervisors views of the value and impact of the Independent Youth Counselling Service (IYCS) in West Belfast. Data collection combined semi-structured interviews, focus groups and an open-ended questionnaire. The findings indicate the significance of factors above and beyond the person-centred counselling experience, in maximising the potential for growth and development for clients and counsellors. This holistic approach to counselling service provision employs a body of community development processes, which collectively combine to embed the counselling service in a complementary principled approach. This paper explores how these community development features bolster the counselling experience to promote a culture of person-centeredness, thereby increasing the empowerment of the client.

Key issues in the study of new and alternative social movements in Spain: The Left, Identity and Globalizing Processes

This article highlights the importance of dedicating a whole special issue on New and Alternative Social movements in Spain. It sets the basis for this endeavour by emphasizing the importance of the 2004, unexpected, electoral victory of the Spanish socialists, and the subsequent satisfaction of the important demands promoted by certain social movements actors and Spanish society in general (the withdrawal of Spanish troops from Iraq, the cancellation of the National Hydrological Plan and the Legalization of same sex marriages. The view supported is that these developments signify the end of a protest cycle, which could have the same effect with the early 1980s socialist victory. After a discussion around the low associationalism that characterizes Spanish society and recent experience of authoritarianism, it is suggested that it is time for the study of new and alternative social movements in Spain and other south European societies to move beyond the emphasis on exceptionality but appreciate differences by focusing on the available political opportunities and the identity of social movement actors. The remainder of the article is dedicated to introducing the contributing articles.

The history of neurology in Belfast: the first hundred years.

No abstract