Thrombolysis in myocardial infarction risk score in an observation unit setting.

OBJECTIVE: The Thrombolysis in Myocardial Infarction (TIMI) score is a validated tool for risk stratification of acute coronary syndrome. We hypothesized that the TIMI risk score would be able to risk stratify patients in observation unit for acute coronary syndrome. METHODS: STUDY DESIGN: Retrospective cohort study of consecutive adult patients placed in an urban academic hospital emergency department observation unit with an average annual census of 65,000 between 2004 and 2007. Exclusion criteria included elevated initial cardiac biomarkers, ST segment changes on ECG, unstable vital signs, or unstable arrhythmias. A composite of significant coronary artery disease (CAD) indicators, including diagnosis of myocardial infarction, percutaneous coronary intervention, coronary artery bypass surgery, or death within 30 days and 1 year, were abstracted via chart review and financial record query. The entire cohort was stratified by TIMI risk scores (0-7) and composite event rates with 95% confidence interval were calculated. RESULTS: In total 2228 patients were analyzed. Average age was 54.5 years, 42.0% were male. The overall median TIMI risk score was 1. Eighty (3.6%) patients had 30-day and 119 (5.3%) had 1-year CAD indicators. There was a trend toward increasing rate of composite CAD indicators at 30 days and 1 year with increasing TIMI score, ranging from a 1.2% event rate at 30 days and 1.9% at 1 year for TIMI score of 0 and 12.5% at 30 days and 21.4% at 1 year for TIMI ≥ 4. CONCLUSIONS: In an observation unit cohort, the TIMI risk score is able to risk stratify patients into low-, moderate-, and high-risk groups.

The framework for REVIEWS: an exploration into design principles for an electronic medical early warning system observation chart

The observation chart is for many health professionals (HPs) the primary source of objective information relating to the health of a patient. Information Systems (IS) research has demonstrated the positive impact of good interface design on decision making and it is logical that good observation chart design can positively impact healthcare decision making. Despite the potential for good observation chart design, there is a paucity of observation chart design literature, with the primary source of literature leveraging Human Computer Interaction (HCI) literature to design better charts. While this approach has been successful, this design approach introduces a gap between understanding of the tasks performed by HPs when using charts and the design features implemented in the chart. Good IS allow for the collection and manipulation of data so that it can be presented in a timely manner that support specific tasks. Good interface design should therefore consider the specific tasks being performed prior to designing the interface. This research adopts a Design Science Research (DSR) approach to formalise a framework of design principles that incorporates knowledge of the tasks performed by HPs when using observation charts and knowledge pertaining to visual representations of data and semiology of graphics. This research is presented in three phases, the initial two phases seek to discover and formalise design knowledge embedded in two situated observation charts: the paper-based NEWS chart developed by the Health Service Executive in Ireland and the electronically generated eNEWS chart developed by the Health Information Systems Research Centre in University College Cork. A comparative evaluation of each chart is also presented in the respective phases. Throughout each of these phases, tentative versions of a design framework for electronic vital sign observation charts are presented, with each subsequent iteration of the framework (versions Alpha, Beta, V0.1 and V1.0) representing a refinement of the design knowledge. The design framework will be named the framework for the Retrospective Evaluation of Vital Sign Information from Early Warning Systems (REVIEWS). Phase 3 of the research presents the deductive process for designing and implementing V0.1 of the framework, with evaluation of the instantiation allowing for the final iteration V1.0 of the framework. This study makes a number of contributions to academic research. First the research demonstrates that the cognitive tasks performed by nurses during clinical reasoning can be supported through good observation chart design. Secondly the research establishes the utility of electronic vital sign observation charts in terms of supporting the cognitive tasks performed by nurses during clinical reasoning. Third the framework for REVIEWS represents a comprehensive set of design principles which if applied to chart design will improve the usefulness of the chart in terms of supporting clinical reasoning. Fourth the electronic observation chart that emerges from this research is demonstrated to be significantly more useful than previously designed charts and represents a significant contribution to practice. Finally the research presents a research design that employs a combination of inductive and deductive design activities to iterate on the design of situated artefacts.

Development of miniaturized antennas and adaptive tuning solutions for body sensor network applications

Wireless Sensor Networks (WSNs) are currently having a revolutionary impact in rapidly emerging wearable applications such as health and fitness monitoring amongst many others. These types of Body Sensor Network (BSN) applications require highly integrated wireless sensor devices for use in a wearable configuration, to monitor various physiological parameters of the user. These new requirements are currently posing significant design challenges from an antenna perspective. This work addresses several design challenges relating to antenna design for these types of applications. In this thesis, a review of current antenna solutions for WSN applications is first presented, investigating both commercial and academic solutions. Key design challenges are then identified relating to antenna size and performance. A detailed investigation of the effects of the human body on antenna impedance characteristics is then presented. A first-generation antenna tuning system is then developed. This system enables the antenna impedance to be tuned adaptively in the presence of the human body. Three new antenna designs are also presented. A compact, low-cost 433 MHz antenna design is first reported and the effects of the human body on the impedance of the antenna are investigated. A tunable version of this antenna is then developed, using a higher performance, second-generation tuner that is integrated within the antenna element itself, enabling autonomous tuning in the presence of the human body. Finally, a compact sized, dual-band antenna is reported that covers both the 433 MHz and 2.45 GHz bands to provide improved quality of service (QoS) in WSN applications. To date, state-of-the-art WSN devices are relatively simple in design with limited antenna options available, especially for the lower UHF bands. In addition, current devices have no capability to deal with changing antenna environments such as in wearable BSN applications. This thesis presents several contributions that advance the state-of-the-art in this area, relating to the design of miniaturized WSN antennas and the development of antenna tuning solutions for BSN applications.

Near-real-time service provision during effusive crises at Etna and Stromboli: basis and implementation of satellite-based IR operations

Using the NEODAAS-Dundee AVHRR receiving station (Scotland), NEODAAS-Plymouth can provide calibrated brightness temperature data to end users or interim users in near-real time. Between 2000 and 2009 these data were used to undertake volcano hot spot detection, reporting and time-average discharge rate dissemination during effusive crises at Mount Etna and Stromboli (Italy). Data were passed via FTP, within an hour of image generation, to the hot spot detection system maintained at Hawaii Institute of Geophysics and Planetology (HIGP, University of Hawaii at Manoa, Honolulu, USA). Final product generation and quality control were completed manually at HIGP once a day, so as to provide information to onsite monitoring agencies for their incorporation into daily reporting duties to Italian Civil Protection. We here describe the processing and dissemination chain, which was designed so as to provide timely, useable, quality-controlled and relevant information for ‘one voice’ reporting by the responsible monitoring agencies.

Near-real-time service provision during effusive crises at Etna and Stromboli: basis and implementation of satellite-based IR operations

Using the NEODAAS-Dundee AVHRR receiving station (Scotland), NEODAAS-Plymouth can provide calibrated brightness temperature data to end users or interim users in near-real time. Between 2000 and 2009 these data were used to undertake volcano hot spot detection, reporting and time-average discharge rate dissemination during effusive crises at Mount Etna and Stromboli (Italy). Data were passed via FTP, within an hour of image generation, to the hot spot detection system maintained at Hawaii Institute of Geophysics and Planetology (HIGP, University of Hawaii at Manoa, Honolulu, USA). Final product generation and quality control were completed manually at HIGP once a day, so as to provide information to onsite monitoring agencies for their incorporation into daily reporting duties to Italian Civil Protection. We here describe the processing and dissemination chain, which was designed so as to provide timely, useable, quality-controlled and relevant information for ‘one voice’ reporting by the responsible monitoring agencies.

Overcoming Challenges to Service Innovation Process Implementation in an SME

This case study research reports on a small and medium-sized (SME) business-to-business (B2B) services firm implementing a novel new service development (NSD) process. It provides accounts of what occurred in practice in terms of the challenges to NSD process implementation and how the firm overcame these challenges. It also considers the implications for NSD in this and other firms’ innovation practices. This longitudinal case study (18 months) was conducted “inside” the case organization. It covered the entire innovation process from the initiation to the launch of a new service. The primary method may be viewed as participant observation. The research involved all those participating in the innovation system in the firm, including decision-makers, middle managers and employees at lower hierarchical levels and the firm’s external networks. Implications for researchers and managers focusing on structured innovation models for the services sector are also presented.

Exploring Service Innovation Practices Through a Longitudinal Ethnographic Case Study

Case study research has the advantage of investigating issues that are embedded within the context of the case. A novel approach to investigation of the implementation of service innovation process has been adopted through a longitudinal ethnographic case study. This approach was found useful, as the outcome of the study was intended to be an in-depth understanding of firm’s current innovation practices and its consequences with the implementation of a novel business process. In this applied research, an array of longitudinal data was generated chiefly through the technique of participant-observation. Participant-observation as a qualitative or naturalistic method has its roots in ethnographic research. Participant-observation involves “participating in the social world, in whatever role, and reflecting on the products of that participation” (Hammersley & Atkinson, 1983, p.16). This method offers a degree of understanding of the context under study that can come only from personal experience. In this presentation, I discuss the role of the researcher-practitioner as participant-observer and the usefulness of ethnographic case study methodology and participant-observation technique to investigating service innovation practices that are embedded within the context-specific setting of the case.

Scale and ecosystem services: how do observation, management, and analysis shift with scale—lessons from Québec

Ecosystem service assessment and management are shaped by the scale at which they are conducted; however, there has been little systematic investigation of the scales associated with ecosystem service processes, such as production, benefit distribution, and management. We examined how social-ecological spatial scale impacts ecosystem service assessment by comparing how ecosystem service distribution, trade-offs, and bundles shift across spatial scales. We used a case study in Québec, Canada, to analyze the scales of production, consumption, and management of 12 ecosystem services and to analyze how interactions among 7 of these ecosystem services change across 3 scales of observation (1, 9, and 75 km²). We found that ecosystem service patterns and interactions were relatively robust across scales of observation; however, we identified 4 different types of scale mismatches among ecosystem service production, consumption, and management. Based on this analysis, we have proposed 4 aspects of scale that ecosystem service assessments should consider.

Étude théorique des principaux modèles de la pratique du service social personnel

Le service social d'aujourd'hui est confronté à de nouvelles réalités. Nous devons faire face quotidiennement à de nouvelles valeurs qui se heurtent à notre fonctionnement individuel et social. Il faut en arriver à pouvoir composer avec ces nouveaux éléments. Citons par exemple le rôle de la femme qui prend de plus en plus d'importance dans la structure sociale, les étudiants, les travailleurs et les assistés sociaux qui revendiquent leurs droits par des moyens de pressions de plus en plus convaincants, le couple qui ne vit plus exclusivement pour la procréation, l'avortement qui fait l'objet de prises de positions très controversées et enfin le système dans son entier qui est remis en question par certains. Le service social personnel qui agit à un niveau individuel d'intervention se doit de faire face à ces nouvelles réalités et de découvrir des méthodes de travail qui conviennent à cette situation. C'est dans ce contexte que nous entreprenons cette étude. Au Québec, le service social, comme la plupart des sciences sociales, possède un passé qui date de moins d'un siècle. Et dans ces différents domaines comme dans d'autres, nous subissons l'influence de nos voisins du sud. Depuis quelques années, on a tendance à identifier globalement le service social personnel à deux types d'approches: une première communément appelée l'approche traditionnelle à long terme et la seconde appelée l'approche court terme. Ces deux méthodes d'intervention constituaient le guide de référence de ce qu'on appelait le casework. Celui-ci est identifié au Québec par divers termes, soient ceux d'intervention clinique, d'intervention sociale individuelle ou encore de service social personnel. Ces différentes terminologies désignent l'activité du service social auprès des individus et des petits groupes. Si l'on considère le domaine de l'intervention clinique d'une façon plus approfondie, on constate que depuis quelques années, sous l'influence des sciences du comportement et des sciences sociales ainsi qu'à partir de l'expérience de la pratique du service social personnel, se sont développés de nouveaux modèles de pratique. Nous constatons que ces modèles sont peu connus au Québec. Les milieux universitaires commencent à s'y intéresser et les milieux de la pratique en subiront l'influence dans quelques années. Nous croyons qu'un approfondissement de ces modèles pourra vraisemblablement améliorer les méthodes d'action et par conséquent la qualité des services rendus s'y verra peut-être augmentée. Cette étude découle d'un besoin d'explorer le champ des connaissances de l'intervention clinique. Cette exploration pourra conséquemment être utile à ceux qui voudront bien s'en servir. Ce besoin d'améliorer l'état de nos connaissances en service social personnel ressort de certaines observations qui démontrent que plusieurs approches en intervention clinique sont peu connues. Afin de clarifier et d'améliorer notre connaissance théorique des modèles d'intervention clinique, nous procéderons à l'exploration de neuf de ceux-ci. Pour orienter notre observation, nous partirons de variables que nous définirons ultérieurement. Ces variables vont nous guider dans la cueillette des données et dans la présentation de modèles. Avant de présenter systématiquement les modèles, il y aura un chapitre sur la position du problème et un second sur la méthodologie employée. La partie centrale qui traite des approches sera suivie d'une étude comparative.

Spatial and temporal measurements using polyoxometalate, enzymatic and biofilm layers on a CMOS 0.35 μm 64 X 64-pixel I.S.F.E.T. array sensor

This thesis presents the achievements and scientific work conducted using a previously designed and fabricated 64 x 64-pixel ion camera with the use of a 0.35 μm CMOS technology. We used an array of Ion Sensitive Field Effect Transistors (ISFETs) to monitor and measure chemical and biochemical reactions in real time. The area of our observation was a 4.2 x 4.3 mm silicon chip while the actual ISFET array covered an area of 715.8 x 715.8 μm consisting of 4096 ISFET pixels in total with a 1 μm separation space among them. The ion sensitive layer, the locus where all reactions took place was a silicon nitride layer, the final top layer of the austriamicrosystems 0.35 μm CMOS technology used. Our final measurements presented an average sensitivity of 30 mV/pH. With the addition of extra layers we were able to monitor a 65 mV voltage difference during our experiments with glucose and hexokinase, whereas a difference of 85 mV was detected for a similar glucose reaction mentioned in literature, and a 55 mV voltage difference while performing photosynthesis experiments with a biofilm made from cyanobacteria, whereas a voltage difference of 33.7 mV was detected as presented in literature for a similar cyanobacterial species using voltamemtric methods for detection. To monitor our experiments PXIe-6358 measurement cards were used and measurements were controlled by LabVIEW software. The chip was packaged and encapsulated using a PGA-100 chip carrier and a two-component commercial epoxy. Printed circuit board (PCB) has also been previously designed to provide interface between the chip and the measurement cards.

Pre-service home economics teachers’ attitudes on selected aspects of practical teaching

This paper presents the results of a study conducted among pre-service home economics teachers from the Faculty of Education of the University of Ljubljana with different levels of practical experience in teaching. The pre-service Home Economics teachers in the 3rd year of their studies had just completed their first class of teaching experience in contrast to the pre-service teachers from the 4th year of their faculty studies, who had conducted more teaching lessons. The results showed that the 4th-year pre-service teachers had fewer doubts and problems concerning the planning and conducting of a lesson. They also statistically significantly agreed that they are sufficiently prepared to teach than the 3rd-year pre-service teachers are. The results showed that the majority of the pre-service teachers agreed that the feedback from their colleagues was helpful for their professional development. The results suggest the importance of practical teaching experience in the context of professional development and the intention to continue a career in education. However, the results also revealed some critical points in the teacher’s development of competency. The results suggest problems related to the application of theoretical knowledge on the children’s development in practice and pro problems related to classroom management in specific situations. (DIPF/Orig.)

the plenoptic sensor

In this thesis, we will introduce the innovative concept of a plenoptic sensor that can determine the phase and amplitude distortion in a coherent beam, for example a laser beam that has propagated through the turbulent atmosphere.. The plenoptic sensor can be applied to situations involving strong or deep atmospheric turbulence. This can improve free space optical communications by maintaining optical links more intelligently and efficiently. Also, in directed energy applications, the plenoptic sensor and its fast reconstruction algorithm can give instantaneous instructions to an adaptive optics (AO) system to create intelligent corrections in directing a beam through atmospheric turbulence. The hardware structure of the plenoptic sensor uses an objective lens and a microlens array (MLA) to form a mini “Keplerian” telescope array that shares the common objective lens. In principle, the objective lens helps to detect the phase gradient of the distorted laser beam and the microlens array (MLA) helps to retrieve the geometry of the distorted beam in various gradient segments. The software layer of the plenoptic sensor is developed based on different applications. Intuitively, since the device maximizes the observation of the light field in front of the sensor, different algorithms can be developed, such as detecting the atmospheric turbulence effects as well as retrieving undistorted images of distant objects. Efficient 3D simulations on atmospheric turbulence based on geometric optics have been established to help us perform optimization on system design and verify the correctness of our algorithms. A number of experimental platforms have been built to implement the plenoptic sensor in various application concepts and show its improvements when compared with traditional wavefront sensors. As a result, the plenoptic sensor brings a revolution to the study of atmospheric turbulence and generates new approaches to handle turbulence effect better.

Adaptive coatings based on polyaniline for direct 2D observation of diffusion processes in microfluidic systems

[EN] Therefore the understanding and proper evaluation of the flow and mixing behaviour at microscale becomes a very important issue. In this study, the diffusion behaviour of two reacting solutions of HCI and NaOH were directly observed in a glass/polydimethylsiloxane microfluidic device using adaptive coatings based on the conductive polymer polyaniline that are covalently attached to the microchannel walls. The two liquid streams were combined at the junction of a Y-shaped microchannel, and allowed to diffuse into each other and react. The results showed excellent correlation between optical observation of the diffusion process and the numerical results. A numerical model which is based on finite volume method (FVM) discretisation of steady Navier-Stokes (fluid flow) equations and mass transport equations without reactions was used to calculate the flow variables at discrete points in the finite volume mesh element. The high correlation between theory and practical data indicates the potential of such coatings to monitor diffusion processes and mixing behaviour inside microfluidic channels in a dye free environment.

Sextant. A spatial data infrastructure for marine environments

At national and European levels, in various projects, data products are developed to provide end-users and stakeholders with homogeneously qualified observation compilation or analysis. Ifremer has developed a spatial data infrastructure for marine environment, called Sextant, in order to manage, share and retrieve these products for its partners and the general public. Thanks to the OGC and ISO standard and INSPIRE compliance, the infrastructure provides a unique framework to federate homogeneous descriptions and access to marine data products processed in various contexts, at national level or European level for DG research (SeaDataNet), DG Mare (EMODNET) and DG Growth (Copernicus MEMS). The discovery service of Sextant is based on the metadata catalogue. The data description is normalized according to ISO 191XX series standards and Inspire recommendations. Access to the catalogue is provided by the standard OGC service, Catalogue Service for the Web (CSW 2.0.2). Data visualization and data downloading are available through standard OGC services, Web Map Services (WMS) and Web Feature Services (WFS). Several OGC services are provided within Sextant, according to marine themes, regions and projects. Depending on the file format, WMTS services are used for large images, such as hyperspectral images, or NcWMS services for gridded data, such as climatology models. New functions are developped to improve the visualization, analyse and access to data, eg : data filtering, online spatial processing with WPS services and acces to sensor data with SOS services.

Ensemble Stream Model for Data-Cleaning in Sensor Networks

Ensemble Stream Modeling and Data-cleaning are sensor information processing systems have different training and testing methods by which their goals are cross-validated. This research examines a mechanism, which seeks to extract novel patterns by generating ensembles from data. The main goal of label-less stream processing is to process the sensed events to eliminate the noises that are uncorrelated, and choose the most likely model without over fitting thus obtaining higher model confidence. Higher quality streams can be realized by combining many short streams into an ensemble which has the desired quality. The framework for the investigation is an existing data mining tool. First, to accommodate feature extraction such as a bush or natural forest-fire event we make an assumption of the burnt area (BA*), sensed ground truth as our target variable obtained from logs. Even though this is an obvious model choice the results are disappointing. The reasons for this are two: One, the histogram of fire activity is highly skewed. Two, the measured sensor parameters are highly correlated. Since using non descriptive features does not yield good results, we resort to temporal features. By doing so we carefully eliminate the averaging effects; the resulting histogram is more satisfactory and conceptual knowledge is learned from sensor streams. Second is the process of feature induction by cross-validating attributes with single or multi-target variables to minimize training error. We use F-measure score, which combines precision and accuracy to determine the false alarm rate of fire events. The multi-target data-cleaning trees use information purity of the target leaf-nodes to learn higher order features. A sensitive variance measure such as f-test is performed during each node’s split to select the best attribute. Ensemble stream model approach proved to improve when using complicated features with a simpler tree classifier. The ensemble framework for data-cleaning and the enhancements to quantify quality of fitness (30% spatial, 10% temporal, and 90% mobility reduction) of sensor led to the formation of streams for sensor-enabled applications. Which further motivates the novelty of stream quality labeling and its importance in solving vast amounts of real-time mobile streams generated today.