A web application for follow-up of results from a mobile device test battery for parkinson’s disease patients

Background: A test battery consisting of self-assessments and motor tests (tapping and spiral drawing) was developed for a hand computer with touch screen in a telemedicine setting. Objectives: To develop and evaluate a web-based system that delivers decision support information to the treating clinical staff for assessing PD symptoms in their patients based on the test battery data. Methods: The test battery is currently being used in a clinical trial (DAPHNE, EudraCT No. 2005-002654-21) by sixty five patients with advanced Parkinson’s disease (PD) on 9991 test occasions (four tests per day during in all 362 week-long test periods) at nine clinics around Sweden. Test results are sent continuously from the hand unit over a mobile net to a central computer and processed with statistical methods. They are summarized into scores for different dimensions of the symptom state and an ‘overall test score’ reflecting the overall condition of the patient during a test period. The information in the web application is organized and presented graphically in a way that the general overview of the patient performance per test period is emphasized. Focus is on the overall test score, symptom dimensions and daily summaries. In a recent preliminary user evaluation, the web application was demonstrated to the fifteen study nurses who had used the test battery in the clinical trial. At least one patient per clinic was shown. Results: In general, the responses from nurses were positive. They claimed that the test results shown in the system were consistent with their own clinical observations. They could follow complications, changes and trends within their patients. Discussion: In conclusion, the system is able to summarise the various time series of motor test results and self-assessments during test periods and present them in a useful manner. Its main contribution is a novel and reliable way to capture and easily access symptom information from patients’ home environment. The convenient access to current symptom profile as well as symptom history provides a basis for individualized evaluation and adjustment of treatments.

En applikationsinfrastruktur för massutskick av e-post

In today's society it is becoming more and more important with direct marketing. Some of the direct marketing is done through e-mail, in which companies see an easy way to advertise himself. I did this thesis work at WebDoc Systems. They have a product that creates web documents directly in your browser, also called CMS. The CMS has a module for sending mass e-mail, but this module does not function properly and WebDoc Systems customers are dissatisfied with that part of the product. The problem with the module was that sometimes it didn't send the e-mail, and that it was not possible to obtain some form of follow-up information on the e-mail. The goal of this work was to develop a Web service that could easily send e-mail to many receivers, just as easily be able to view statistics on how mailing has gone. The first step was to do a literature review to get a good picture of available programming platforms, but also to be able create a good application infrastructure. The next step was to implement this design and improve it over time by using an iterative development methodology. The result was an application infrastructure that consists of three main parts and a plugin interface. The parts that were implemented were a Web service application, a Web application and a Windows service application. The three elements cooperate with each other and share a database, and plugins.

Teknik för en flerskiktadwebbapplikation

The report analyses if some common problems can be avoided by using modern technology. As a reference system “Fartygsrapporteringssystemet” is used. It is an n-tier web application built with modern technology at time, 2003-2004. The aim is to examine whether ASP.Net MVC, Windows Communication Foundation, Workflow Foundation and SQL Server 2005 Service Broker can be used to create an n-tier web application which also communicate with other systems and facilitate automated testing. The report describes the construction of a prototype in which the presentation layer uses ASP.Net MVC to separate presentation and business logic. Communication with the business layer is done through the Windows Communication Foundation. Hard coded processes are broken out and dealt with by Workflow Foundation. Asynchronous communication with other systems is done by using Microsoft SQL Server 2005 Service Broker. The results of the analysis is that these techniques can be used to create a n-tier web application, but that ASP.Net MVC, which at present only available in a preview release, is not sufficiently developed yet.

Identification of cause of impairment in spiral drawings, using non-stationary feature extraction approach

Parkinson’s disease is a clinical syndrome manifesting with slowness and instability. As it is a progressive disease with varying symptoms, repeated assessments are necessary to determine the outcome of treatment changes in the patient. In the recent past, a computer-based method was developed to rate impairment in spiral drawings. The downside of this method is that it cannot separate the bradykinetic and dyskinetic spiral drawings. This work intends to construct the computer method which can overcome this weakness by using the Hilbert-Huang Transform (HHT) of tangential velocity. The work is done under supervised learning, so a target class is used which is acquired from a neurologist using a web interface. After reducing the dimension of HHT features by using PCA, classification is performed. C4.5 classifier is used to perform the classification. Results of the classification are close to random guessing which shows that the computer method is unsuccessful in assessing the cause of drawing impairment in spirals when evaluated against human ratings. One promising reason is that there is no difference between the two classes of spiral drawings. Displaying patients self ratings along with the spirals in the web application is another possible reason for this, as the neurologist may have relied too much on this in his own ratings.

User perspectives on the Swedish Maternal Health Care Register

Background: Established in 1999, the Swedish Maternal Health Care Register (MHCR) collects data on pregnancy, birth, and the postpartum period for most pregnant women in Sweden. Antenatal care (ANC) midwives manually enter data into the Web-application that is designed for MHCR. The aim of this study was to investigate midwives? experiences, opinions and use of the MHCR. Method: A national, cross-sectional, questionnaire survey, addressing all Swedish midwives working in ANC, was conducted January to March 2012. The questionnaire included demographic data, preformed statements with six response options ranging from zero to five (0 = totally disagree and 5 = totally agree), and opportunities to add information or further clarification in the form of free text comments. Parametric and non-parametric methods and logistic regression analyses were applied, and content analysis was used for free text comments. Results: The estimated response rate was 53.1%. Most participants were positive towards the Web-application and the included variables in the MHCR. Midwives exclusively engaged in patient-related work tasks perceived the register as burdensome (70.3%) and 44.2% questioned the benefit of the register. The corresponding figures for midwives also engaged in administrative supervision were 37.8% and 18.5%, respectively. Direct electronic transfer of data from the medical records to the MHCR was emphasised as significant future improvement. In addition, the midwives suggested that new variables of interest should be included in the MHCR ? e.g., infertility, outcomes of previous pregnancy and birth, and complications of the index pregnancy. Conclusions: In general, the MHCR was valued positively, although perceived as burdensome. Direct electronic transfer of data from the medical records to the MHCR is a prioritized issue to facilitate the working situation for midwives. Finally, the data suggest that the MHCR is an underused source for operational planning and quality assessment in local ANC centres.

Extern Web-service-lösning vid SSAB Tunnplåt i Borlänge- för kommunikation med sina distributions lager

Detta examensarbete har utförts på SSAB- Tunnplåt i Borlänge under vårterminen 2004 och omfattar 10 veckors arbete.SSAB sköter idag sin kommunikation med distributionslagren via fax, telefon eller e-post. Eftersom detta är ett ganska tidskrävande kommunikationssätt, vill SSAB ha en smidigare och snabbare kommunikationslösning. Den lösning som SSAB vill ha är en extern Web-service-lösning för att upprätta en säker kommunikation med sina distributionslager.Parallellt med byggandet av Web-service-lösningen arbetades en förvaltningsmodell fram. Den beskriver hur förvaltningsorganisationen med dess rutiner kan se ut vid implementering av lösningen.För att skapa en säker förbindelse med Web-servicen skall en webbklient användas som i sin tur anropar en COM+ komponent. Detta för att kunna skicka med certifikatet ifrån webbklienten till webbservern där Web-servicen ligger. COM+ komponenten måste få tillgång till en användarprofil när den kommunicerar med Web-servicen. Detta för att kunna upprätta en SSL-förbindelse i det inledande skedet. SSL-förbindelsen skall läggas i den VPN-tunnel som mVPN tillhandahåller via WSSAL.

Web Services – för enklare användning av karttjänster

Detta arbete har bedrivits i syfte att kartlägga funktionalitet, teknik och användningsområde gällande Web Services. Innehållet utgör således en teoretisk utvärdering av Web Services, samt tester av grundläggande programmeringslösningar. De frågor arbetet ämnar besvara är hur en Web Services på lämpligt sätt kan baseras på en befintlig tjänst, samt på vilket sätt denna Web Services kan göra aktuell tjänst lättare att använda. Dessutom belyses eventuella problem som kan uppstå i samband med denna Web Services-anpassning. I syfte att presentera ett lösningsförslag på ovan nämnda frågor granskades, via en litteraturstudie, ett antal informatikrelaterade begrepp liksom faktorer förknippade med kommersiell verksamhet på Internet. Erhållen teoretisk fakta analyserades via empiriskt arbete. Resultaten av analysen indikerar att en Web Services baserad på karttjänsten MapService kan innebära vissa fördelar för det aktuella företaget såväl som för deras kunder. Att bredda tjänsteutbudet med en marknadsdominerande standard innebär vissa fördelar för ett företag, inte minst i form av ett potentiellt större kundunderlag. Kundens vinster utgörs främst av för ändamålet utformade toolkits. Dessa hjälpmedel och verktyg underlättar implementationen av aktuell tjänst. Den ansats som här valts, att designa Web Servicen som en parser (tolk/konverterare) vars huvudsakliga syfte är att förmedla kommunikation mellan användare och befintlig tjänst, har vissa fördelar. Främst det faktum att redan befintlig funktionalitet kan utnyttjas. All kommunikation mellan användare och server hanteras av Web Servicen, som enligt denna princip utgör ett nytt gränssnitt med vilket tjänsten MapService kan användas. Till följd av det omfattande teoretiska utredningsarbetet har detta arbete inte genererat några prototyper, annat än på ett teoretiskt plan. Det problem som återstår är att utreda exakt hur ovan nämnda parser skall vara utformad, för att sedan implementera all funktionalitet som en helhet.

A web based decision support system for status assessment in advanced parkinson

The purpose of this work is to develop a web based decision support system, based onfuzzy logic, to assess the motor state of Parkinson patients on their performance in onscreenmotor tests in a test battery on a hand computer. A set of well defined rules, basedon an expert’s knowledge, were made to diagnose the current state of the patient. At theend of a period, an overall score is calculated which represents the overall state of thepatient during the period. Acceptability of the rules is based on the absolute differencebetween patient’s own assessment of his condition and the diagnosed state. Anyinconsistency can be tracked by highlighted as an alert in the system. Graphicalpresentation of data aims at enhanced analysis of patient’s state and performancemonitoring by the clinic staff. In general, the system is beneficial for the clinic staff,patients, project managers and researchers.

Integration av webbaserat analysprogram och kartprogram : Integration of web based analysis-software andmap-software

I takt med att GIS (Grafiska InformationsSystem) blir allt vanligare och mer användarvänligt har WM-data sett att kunder skulle ha intresse i att kunna koppla information från sin verksamhet till en kartbild. Detta för att lättare kunna ta till sig informationen om hur den geografiskt finns utspridd över ett område för att t.ex. ordna effektivare tranporter. WM-data, som det här arbetet är utfört åt, avser att ta fram en prototyp som sedan kan visas upp för att påvisa för kunder och andra intressenter att detta är möjligt att genomföra genom att skapa en integration mellan redan befintliga system. I det här arbetet har prototypen tagits fram med skogsindustrin och dess lager som inriktning. Befintliga program som integrationen ska skapas mellan är båda webbaserade och körs i en webbläsare. Analysprogrammet som ska användas heter Insikt och är utvecklat av företaget Trimma, kartprogrammet heter GIMS som är WM-datas egna program. Det ska vara möjligt att i Insikt analysera data och skapa en rapport. Den ska sedan skickas till GIMS där informationen skrivs ut på kartan på den plats som respektive information hör till. Det ska även gå att välja ut ett eller flera områden i kartan och skicka till Insikt för att analysera information från enbart de utvalda områdena. En prototyp med önskad funktionalitet har under arbetets gång tagits fram, men för att ha en säljbar produkt är en del arbeta kvar. Prototypen har visats för ett antal intresserade som tyckte det var intressant och tror att det är något som skulle kunna användas flitigt inom många områden.

Studie av web to print samt kartläggning av kunders behov för tillämpning av systemet CiPublisher

Customers put their printing suppliers to severe claims for shorter production time and faster deliveries.Printers always look for new solutions to increase the satisfaction of their customers. Oneexample of such a solution is web to print, where the customers book their printed matters atInternet.The solution involves design of printed matter by using templates that are made unique for thecustomer's printed matter. Web to print is suitable for reiterated printed matters. By using templatesthe customer doesn´t have to redo their layout for every new edition. Bromma tryck AB hasinvested the system CiPublisher, which is applied for the customer to make their printed matter atInternet.The purpose of the examination work is to investigate the needs of the customers of Brommatryck for a web to print solution and how such a system should be adapted.The result shows that the customer who is in need of a web to print solution wish such a system tobe easy managed and also usable. The customer inquiry also shows that most of the customers primarydesire for start using such a solution is that it will save time and also simplify the process formanufacturing of printing matters.

Uma avaliacão fenomenográfica dos cursos suecos baseados na web

O propósito deste texto é discutir a avaliação de um curso superior oferecido por uma universidade sueca. Para tanto, parti de uma análise das avaliações feitas pelos estudantes, no ano de 2011-2012, quanto ao conteúdo, as aulas ministrada e a relação estabelecida entre o professor e os estudantes. O curso analisado foi o de Brasil Contemporâneo, da Universidade de Dalarna. O curso é oferecido na forma EBW e faz parte da graduação em Português.       As conclusões alcançadas e fundamentadas na análise do questionários  apontam para uma necessidade de uma sistematização do conteúdo e de uma melhor exposição do mesmo. Os estudantes, na sua maoria estrangeiros, têm uma percepção sobre a realidade brasileira que ao se contrapor à literatura do curso leva-os a reverem e a redefinirem a imagem que os mesmos tinham sobre o Brasil. Entrentanto, as avaliações apontam para a necessidade de desenvolvimento e formento de trabalhos em grupos que auxiliam na aprendizagem dos estudantes. Esta é um importante desáfio dos cursos baseados na Web, na rede de ensino superior sueca.

A web-based system for visualizing upper limb motor performance of Parkinson’s disease patients

Objective To design, develop and set up a web-based system for enabling graphical visualization of upper limb motor performance (ULMP) of Parkinson’s disease (PD) patients to clinicians. Background Sixty-five patients diagnosed with advanced PD have used a test battery, implemented in a touch-screen handheld computer, in their home environment settings over the course of a 3-year clinical study. The test items consisted of objective measures of ULMP through a set of upper limb motor tests (finger to tapping and spiral drawings). For the tapping tests, patients were asked to perform alternate tapping of two buttons as fast and accurate as possible, first using the right hand and then the left hand. The test duration was 20 seconds. For the spiral drawing test, patients traced a pre-drawn Archimedes spiral using the dominant hand, and the test was repeated 3 times per test occasion. In total, the study database consisted of symptom assessments during 10079 test occasions. Methods Visualization of ULMP The web-based system is used by two neurologists for assessing the performance of PD patients during motor tests collected over the course of the said study. The system employs animations, scatter plots and time series graphs to visualize the ULMP of patients to the neurologists. The performance during spiral tests is depicted by animating the three spiral drawings, allowing the neurologists to observe real-time accelerations or hesitations and sharp changes during the actual drawing process. The tapping performance is visualized by displaying different types of graphs. Information presented included distribution of taps over the two buttons, horizontal tap distance vs. time, vertical tap distance vs. time, and tapping reaction time over the test length. Assessments Different scales are utilized by the neurologists to assess the observed impairments. For the spiral drawing performance, the neurologists rated firstly the ‘impairment’ using a 0 (no impairment) – 10 (extremely severe) scale, secondly three kinematic properties: ‘drawing speed’, ‘irregularity’ and ‘hesitation’ using a 0 (normal) – 4 (extremely severe) scale, and thirdly the probable ‘cause’ for the said impairment using 3 choices including Tremor, Bradykinesia/Rigidity and Dyskinesia. For the tapping performance, a 0 (normal) – 4 (extremely severe) scale is used for first rating four tapping properties: ‘tapping speed’, ‘accuracy’, ‘fatigue’, ‘arrhythmia’, and then the ‘global tapping severity’ (GTS). To achieve a common basis for assessment, initially one neurologist (DN) performed preliminary ratings by browsing through the database to collect and rate at least 20 samples of each GTS level and at least 33 samples of each ‘cause’ category. These preliminary ratings were then observed by the two neurologists (DN and PG) to be used as templates for rating of tests afterwards. In another track, the system randomly selected one test occasion per patient and visualized its items, that is tapping and spiral drawings, to the two neurologists. Statistical methods Inter-rater agreements were assessed using weighted Kappa coefficient. The internal consistency of properties of tapping and spiral drawing tests were assessed using Cronbach’s α test. One-way ANOVA test followed by Tukey multiple comparisons test was used to test if mean scores of properties of tapping and spiral drawing tests were different among GTS and ‘cause’ categories, respectively. Results When rating tapping graphs, inter-rater agreements (Kappa) were as follows: GTS (0.61), ‘tapping speed’ (0.89), ‘accuracy’ (0.66), ‘fatigue’ (0.57) and ‘arrhythmia’ (0.33). The poor inter-rater agreement when assessing “arrhythmia” may be as a result of observation of different things in the graphs, among the two raters. When rating animated spirals, both raters had very good agreement when assessing severity of spiral drawings, that is, ‘impairment’ (0.85) and irregularity (0.72). However, there were poor agreements between the two raters when assessing ‘cause’ (0.38) and time-information properties like ‘drawing speed’ (0.25) and ‘hesitation’ (0.21). Tapping properties, that is ‘tapping speed’, ‘accuracy’, ‘fatigue’ and ‘arrhythmia’ had satisfactory internal consistency with a Cronbach’s α coefficient of 0.77. In general, the trends of mean scores of tapping properties worsened with increasing levels of GTS. The mean scores of the four properties were significantly different to each other, only at different levels. In contrast from tapping properties, kinematic properties of spirals, that is ‘drawing speed’, ‘irregularity’ and ‘hesitation’ had a questionable consistency among them with a coefficient of 0.66. Bradykinetic spirals were associated with more impaired speed (mean = 83.7 % worse, P < 0.001) and hesitation (mean = 77.8% worse, P < 0.001), compared to dyskinetic spirals. Both these ‘cause’ categories had similar mean scores of ‘impairment’ and ‘irregularity’. Conclusions In contrast from current approaches used in clinical setting for the assessment of PD symptoms, this system enables clinicians to animate easily and realistically the ULMP of patients who at the same time are at their homes. Dynamic access of visualized motor tests may also be useful when observing and evaluating therapy-related complications such as under- and over-medications. In future, we foresee to utilize these manual ratings for developing and validating computer methods for automating the process of assessing ULMP of PD patients.

Redaktören har ordet : Sociologisk Forskning, Web of Science och Sociological Abstracts

Sociologisk Forsknings digitala arkiv

Pedagogical methods in web-based language teaching-mapping

The purpose of this presentation is to introduce the research project progress in “the mapping of pedagogical methods in web-based language teaching" by Högskolan Dalarna (Dalarna University). This project will identify the differences in pedagogical methods that are used for online language classes. The pedagogical method defined in this project is what the teachers do to ensure students attain the learning outcomes, for example, planning, designing courses, leading students, knowing students' abilities, implementing activities, etc. So far the members of this project have analyzed the course plans (in the language department at Dalarna University) and categorized the learning outcomes. A questionnaire was constructed based on the learning outcomes and then either sent out remotely to teachers or completed face to face through interviews. The answers provided to the questionnaires enabled the project to identify many differences in how language teachers interact with their students but also, the way of giving feedback, motivating and helping students, types of class activities and materials used. This presentation introduces the progress of the project and identifies the challenges at the language department at Dalarna University. Finally, the advantages and problems of online language proficiency courses will be discussed and suggestions made for future improvement.

Teacher’s leadership in web-based language courses in Dalarna University, Sweden

The purpose of this presentation is to discuss how teacher’s leadership can be used as a teaching method in web based language education. The environments that offer online courses provide a wide field for discussion on the contact between teacher and student. My intention is to contribute to the debate on teacher leadership in online courses. In my earlier studies on leadership, I have explored how some religious leaders affected different social movements in Brazil during the military dictatorship (1964-1985). Pruth (2004) by examining the three kinds of legitimacy described by Max Weber I aimed at seeing and analyzing how religious leaders used different teaching methods to explain their messages to ordinary citizens. Thus my research showed how educational leadership is a way to get people to reach their goals. I became interested in the subject teacher’s leadership whenI participated in a survey of the teaching methods of language courses in Dalarna University which is funded by the NGL Center of Dalarna University. In  this project, we have made interviews with the teachers, undertaken the course plans (in the language department at Dalarna University) and categorized the learning outcomes. A questionnaire was constructed based on the learning outcomes and then either sent out remotely to teachers or completed face to face through interviews. The answers provided to the questionnaires enabled the  project to identify many differences in how language teachers interact with their students but  also, the way of giving feedback, motivating and helping students, types of class activities and materials used. This made me aware of how teachers use their leadership or not in their teaching. My focus is to look at the relationship between teachers and students as an important part of the development and quality of online courses. The teacher's performance on campus is different from online courses. I want to understand how the contact between teachers and students in online courses develop and look at how students can make use of this contact and what influence the teacher's leadership has on the ability for the students to achieve the goals of their course