A Bayesian network hybrid model for representing accident and emergency waiting times

The paper introduces a new modeling approach that represents the waiting times in an accident and emergency (A&E) department in a UK based national health service (NHS) hospital. The technique uses Bayesian networks to capture the heterogeneity of arriving patients by representing how patient covariates interact to influence their waiting times in the department. Such waiting times have been reviewed by the NHS as a means of investigating the efficiency of A&E departments (emergency rooms) and how they operate. As a result activity targets are now established based on the patient total waiting times with much emphasis on trolley waits.

Adolescent men’s pregnancy resolution choices in relation to an unintended pregnancy: A comparative analysis of adolescent men in three countries.

This paper investigates adolescent men's pregnancy resolution choices in Australia, Ireland and Italy. It addresses two main gaps in the literature: the lack of research on (adolescent) men's views on unintended pregnancy and pregnancy resolution; and the lack of international comparative case studies on men and reproductive choices. Consistent with theories of the transformation of intimacies in society and the growth of individualization, the results suggest that adolescent men are interested in the effect of an unintended pregnancy on their individual biographies as well as the effect on their girlfriend's health and well-being. However, Australian male adolescents were much more likely to choose abortion than Italian or Irish adolescents, suggesting adolescent males have also internalized country level debates surrounding abortion. Methodologically, the paper demonstrates an innovative approach to data-collection using a computer-based interactive drama to facilitate participants' deliberation and responses. It was shown to engage a large number of adolescent men and is likely to have wider generalisability in developing international comparative research on the topic, as well as applications for health promotion.

Electrical estimulation of retinal pigment epithelial cells

We investigated and characterized the effect of externally applied electric fields (EF) on retinal pigment epithelial (RPE) cells by exposing primary cultures of human RPE cells (hRPE) and those from the ARPE19 immortalized cell line to various strengths of EF (EF-treated cells) or to no EF (control cells) under different conditions including presence or absence of serum and gelatin and following wounding. We evaluated changes in RPE cell behavior in response to EF by using a computer based image capture and analysis system (Metamorph). We found that RPE cells responded to externally applied EFs by preferential orientation perpendicular to the EF vector, directed migration towards the anode, and faster translocation rate than control, untreated cells. These responses were voltage-dependent. Responses were observed even at low voltages, of 50-300 mV. Furthermore, the migration of hRPE cell sheets generated by wounding of confluent monolayers of cells at early and late confluence could be manipulated by the application of EF, with directed migration towards the anode observed at both sides of the wounded hRPE. In conclusion, RPE cell behaviour can be controlled by an externally applied EF. The potential for externally applied EF to be used as a therapeutic strategy in the management of selected retinal diseases warrants further investigation. © 2010 Elsevier Ltd.

Association of retinal arteriolar dilatation with lower verbal memory::The Edinburgh Type 2 Diabetes Study

Abstract


AIMS/HYPOTHESIS:

Retinal vascular calibre changes may reflect early subclinical microvascular disease in diabetes. Because of the considerable homology between retinal and cerebral microcirculation, we examined whether retinal vascular calibre, as a proxy of cerebral microvascular disease, was associated with cognitive function in older people with type 2 diabetes.

METHODS:

A cross-sectional analysis of 954 people aged 60-75 years with type 2 diabetes from the population-based Edinburgh Type 2 Diabetes Study was performed. Participants underwent standard seven-field binocular digital retinal photography and a battery of seven cognitive function tests. The Mill Hill Vocabulary Scale was used to estimate pre-morbid cognitive ability. Retinal vascular calibre was measured from an image field with the optic disc in the centre using a validated computer-based program.

RESULTS:

After age and sex adjustment, larger retinal arteriolar and venular calibres were significantly associated with lower scores for the Wechsler Logical Memory test, with standardised regression coefficients -0.119 and -0.084, respectively (p?<?0.01), but not with other cognitive tests. There was a significant interaction between sex and retinal vascular calibre for logical memory. In male participants, the association of increased retinal arteriolar calibre with logical memory persisted (p?<?0.05) when further adjusted for vocabulary, venular calibre, depression, cardiovascular risk factors and macrovascular disease. In female participants, this association was weaker and not significant.

CONCLUSIONS/INTERPRETATION:

Retinal arteriolar dilatation was associated with poorer memory, independent of estimated prior cognitive ability in older men with type 2 diabetes. The sex interaction with stronger findings in men requires confirmation. Nevertheless, these data suggest that impaired cerebral arteriolar autoregulation in smooth muscle cells, leading to arteriolar dilatation, may be a possible pathogenic mechanism in verbal declarative memory decrements in people with diabetes.

The Maturation of Agile Software Development Principles and Practice: Observations on Successive Industrial Studies in 2010 and 2012

The agile model of software development has been mainstream for several years, and is now in a phase where its principles and practices are maturing. The purpose of this paper is to describe the results of an industry survey aimed at understanding how maturation is progressing. The survey was taken across 40 software development companies in Northern Ireland at the beginning of 2012. The paper describes the design of the survey and examines maturity by comparing the results obtained in 2012 with those from a study of agile adoption in the same region in 2010. Both surveys aimed to achieve comprehensive coverage of a single area rather than rely on a voluntary sample. The main outcome from the work is a collection of ‘insights’ into the nature and practice of agile development, the main two of which are reported in this paper.

Starbog: The Garden Virtuoso and the Turing Machine

This article will discuss a recent ensemble composition entitled Starbog which was toured and broadcast in Britain in 2006 . The composition of Starbog focused on developing working methods which combined computer-based techniques (using OpenMusic) with more subconscious means of generating musical ideas. The challenge in achieving this was as much aesthetic/philosophical as it was technical and the present article is intending as a ‘sounding’ which focuses on the influence OpenMusic has had on the composer’s music, rather than documenting the nature of the often simple application of algorithms.

The relationship between specific cognitive impairment and behaviour in Prader-Willi syndrome

Background

Individuals with Prader-Willi syndrome (PWS) have been shown to demonstrate a particular cognitive deficit in attention switching and high levels of preference for routine and temper outbursts. This study assesses whether a specific pathway between a cognitive deficit and behaviour via environmental interaction can exist in individuals with PWS.

Methods

Four individuals with PWS participated in a series of three single-case experiments including laboratory-based and natural environment designs. Cognitive (computer-based) challenges placed varying demands on attention switching or controlled for the cognitive demands of the tasks while placing no demands on switching. Unexpected changes to routines or expectations were presented in controlled games, or imposed on participants' natural environments and compared with control conditions during which no unexpected changes occurred. Behaviour was observed and heart rate was measured.

Results

Participants showed significantly increased temper outburst related behaviours during cognitive challenges that placed demands on attention switching, relative to the control cognitive challenges. Participants showed significantly increased temper outburst related behaviours when unexpected changes occurred in an experimental or the natural environment compared with when no changes occurred.

Conclusions

Difficult behaviours that could be triggered reliably in an individual by a specific cognitive demand could also be triggered via manipulation of the environment. Results suggest that a directional relationship between a specific cognitive deficit and behaviour, via environmental interaction, can exist in individuals with PWS.

Semi batch learning with store management using enhanced conjugate gradient

This paper explores the performance of sliding-window based training, termed as semi batch, using multilayer perceptron (MLP) neural network in the presence of correlated data. The sliding window training is a form of higher order instantaneous learning strategy without the need of covariance matrix, usually employed for modeling and tracking purposes. Sliding-window framework is implemented to combine the robustness of offline learning algorithms with the ability to track online the underlying process of a function. This paper adopted sliding window training with recent advances in conjugate gradient direction with application of data store management e.g. simple distance measure, angle evaluation and the novel prediction error test. The simulation results show the best convergence performance is gained by using store management techniques. © 2012 Springer-Verlag.

Discrete Conditional Phase-type Model Utilising a Multiclass Support Vector Machine for the Prediction of Retinopathy of Prematurity

Retinopathy of prematurity (ROP) is a rare disease in which retinal blood vessels of premature infants fail to develop normally, and is one of the major causes of childhood blindness throughout the world. The Discrete Conditional Phase-type (DC-Ph) model consists of two components, the conditional component measuring the inter-relationships between covariates and the survival component which models the survival distribution using a Coxian phase-type distribution. This paper expands the DC-Ph models by introducing a support vector machine (SVM), in the role of the conditional component. The SVM is capable of classifying multiple outcomes and is used to identify the infant's risk of developing ROP. Class imbalance makes predicting rare events difficult. A new class decomposition technique, which deals with the problem of multiclass imbalance, is introduced. Based on the SVM classification, the length of stay in the neonatal ward is modelled using a 5, 8 or 9 phase Coxian distribution.

Learning about probability from text and tables: Do color coding and labeling through an interactive-user interface help?

Learning from visual representations is enhanced when learners appropriately integrate corresponding visual and verbal information. This study examined the effects of two methods of promoting integration, color coding and labeling, on learning about probabilistic reasoning from a table and text. Undergraduate students (N = 98) were randomly assigned to learn about probabilistic reasoning from one of 4 computer-based lessons generated from a 2 (color coding/no color coding) by 2 (labeling/no labeling) between-subjects design. Learners added the labels or color coding at their own pace by clicking buttons in a computer-based lesson. Participants' eye movements were recorded while viewing the lesson. Labeling was beneficial for learning, but color coding was not. In addition, labeling, but not color coding, increased attention to important information in the table and time with the lesson. Both labeling and color coding increased looks between the text and corresponding information in the table. The findings provide support for the multimedia principle, and they suggest that providing labeling enhances learning about probabilistic reasoning from text and tables

Improving allied health professionals' research implementation behaviours for children with cerebral palsy: protocol for a before-after study

BACKGROUND: Cerebral palsy is a permanent disorder of posture and movement caused by disturbances in the developing brain. It affects approximately 1 in every 500 children in developed countries and is the most common form of childhood physical disability. People with cerebral palsy may also have problems with speech, vision and hearing, intellectual difficulties and epilepsy. Health and therapy services are frequently required throughout life, and this care should be effective and evidence informed; however, accessing and adopting new research findings into day-to-day clinical practice is often delayed.

METHODS/DESIGN: This 3-year study employs a before and after design to evaluate if a multi-strategy intervention can improve research implementation among allied health professionals (AHPs) who work with children and young people with cerebral palsy and to establish if children's health outcomes can be improved by routine clinical assessment. The intervention comprises (1) knowledge brokering with AHPs, (2) access to an online research evidence library, (3) provision of negotiated evidence-based training and education, and (4) routine use of evidence-based measures with children and young people aged 3-18 years with cerebral palsy. The study is being implemented in four organisations, with a fifth organisation acting as a comparison site, across four Australian states. Effectiveness will be assessed using questionnaires completed by AHPs at baseline, 6, 12 and 24 months, and by monitoring the extent of use of evidence-based measures. Children's health outcomes will be evaluated by longitudinal analyses.

DISCUSSION: Government, policy makers and service providers all seek evidence-based information to support decision-making about how to distribute scarce resources, and families are seeking information to support intervention choices. This study will provide knowledge about what constitutes an efficient, evidence-informed service and which allied health interventions are implemented for children with cerebral palsy.

TRIAL REGISTRATION: Trial is not a controlled healthcare intervention and is not registered.

Principles and Practical Grouping for the Use of Drill and Practice Programs

A previous paper showed that young children performed better when working as individuals rather than in pairs on a drill and practice program. This paper reports an analysis of behaviour and talk for individuals and single sex pairs using a computer-based drill and practice activity to explain differences in performance. Results indicated that individuals were more likely to be task-focused and to complete tasks successfully than children working in pairs. Differences were found in off-task activity, behaviours and type of talk. Grouping and verbal interaction are discussed in relation to the type of task/program that children are asked to undertake, and how both task and peer presence may constrain the child's task focus and performance when reinforcing pre-existing knowledge.

The personality attributes and leisure activities of the internet users: a Taiwanese case study

This study aims to examine the relationship between the personality attributes of Internet users and their leisure activities. A questionnaire survey was undertaken which revealed that most Internet users are single males aged between 21-30 belonging to the lower income groups, employed in information technology or related fields. The personality attributes of the sample showed a tendency towards a mixed locus control category. The survey indicated that the preferred leisure activities of this population group are reading, collecting and computer-based activities. However, ‘movement’ and collecting were the only leisure activities to show a significant correlation with the users’ personality attributes.

Learner’s satisfaction within a breast imaging eLearning course for radiographers

Background: An asynchronous eLearning system was developed for radiographers in order to promote a better knowledge about senology and mammography. Objectives: to assess the learners’ satisfaction. Methods: Target population included radiographers and radiogr aphy students, in order to assess eLearning satisfaction according to different experience levels in breast imaging. Satisfaction was measured through a questionnaire developed especially for eLearning systems, using a seven - point Likert scale. Main topics related are content, interface, personalization and learning community. Results: Overall, 85% of learners were satisfied with the course and 87,5% considered that the course is successful. Main areas that were evaluated by most learners in a positive way were interface and content (between six and seven - point); on the other hand, learning community presented a wider distribution of answers . Conclusions: The course provides an overall high degree of learner satisfaction, thus providing more effective knowle dge gain on breast imaging for radiographers.