The specification and design of an interactive virtual environment for use in teacher training

The original concept was to create a 'simulation' which would provide trainee teachers, specializing in Information and Communications Technology (ICT) with the opportunity to explore a primary school environment. Within the simulation, factors affecting the development and implementation of ICT would be modelled so that trainees would be able to develop the skills, knowledge and understanding necessary to identify appropriate strategies to overcome the limitations. To this end, we have developed Allsorts Primary - the prototype of a simulated interactive environment, representing a typical primary school

Temperature measurement in children with cancer: an evaluation

There is little agreement as to the most appropriate thermometer, the anatomical site to carry out temperature measurement in children with cancer, or the type of thermometer preferred by the patients. The authors carried out this study to assess temperature measurement in children with cancer who were admitted for febrile episodes. The body temperatures of children with cancer who were admitted consecutively between January and October 2005 to the paediatric department because of febrile episodes were measured on admission and over the next 24–36 hours using an electronic thermometer sublingually as the standard reference site. These measurements were compared with those obtained with two ear-based thermometers, a forehead thermometer, and from the axilla (representing current practice). The parents were asked about the type of thermometer they used at home and the children were asked about the type of thermometer they preferred. There were 34 admissions during this period, of which 19 (56%) were confirmed as febrile. Altogether, 108 sets of temperature measurements were obtained, producing a total of 540 measurements from these admissions. Measurements with the two ear-based thermometers in febrile children achieved higher sensitivity than that with axillary and the forehead measurements. The ear-based thermometer was the most common type used at home while the forehead thermometer was the one preferred by the children. In conclusion, ear-based temperature measurements in febrile children were more accurate than axillary and forehead temperature measurements. The current practice of axillary temperature measurement needs to be re-considered.

An evaluation of a community matron service from the patients’ perspective

Community matrons are a relatively new government initiative aimed at case managing people with long-term conditions to reduce the number of emergency bed days used in hospitals. Although there have been extensive evaluations of similar case management projects, to date there has been little evaluation of the community matron's role and the perceptions patients have of this new service. One of the main Government agendas for care is to deliver a high quality service driven by the needs of the service users (DH, 2000). In order to drive this agenda, care is to deliver a high quality service driven by the needs of the service users (DH, 2000). In order to drive this agenda, it is important that the views and perceptions of people on the receiving end of the services are heard, valued and appropriate actions taken. This two part evaluative report sets out to explore how people with long-term conditions perceive the impact of community matrons and the differences this new service may have had on their lives. Questionnaires were sent to 100 patients who were currently being case-managed by a community matron to evaluate the community matron service from the patients' perspective. Part two reports on patients' perceptions of the community matron role and the influences of the role on their health.

An evaluation of the implementation of hand held health records with adults with learning disabilities: a cluster randomized controlled trial

Background: Personal health records were implemented with adults with learning disabilities (AWLD) to try to improve their health-care. Materials and Method: Forty GP practices were randomized to the Personal Health Profile (PHP) implementation or control group. Two hundred and one AWLD were interviewed at baseline and 163 followed up after 12 months intervention (PHP group). AWLD and carers of AWLD were employed as research interviewers. AWLD were full research participants. Results: Annual consultation rates in the intervention and control groups at baseline were low (2.3 and 2.6 visits respectively). A slightly greater increase occurred over the year in the intervention group 0.6 ()0.4 to 1.6) visits ⁄ year compared with controls. AWLD in PHP group reported more health problems at follow-up 0.9 (0.0 to 1.8). AWLD liked their PHP (92%) but only 63% AWLD and 55% carers reported PHP usage. Carers had high turnover (34%). Conclusions: No significant outcomes were achieved by the intervention.

Toward autonomous measurements of photosynthetic electron transport rates: An evaluation of active fluorescence-based measurements of photochemistry

This study presents a methods evaluation and intercalibration of active fluorescence-based measurements of the quantum yield ( inline image) and absorption coefficient ( inline image) of photosystem II (PSII) photochemistry. Measurements of inline image, inline image, and irradiance (E) can be scaled to derive photosynthetic electron transport rates ( inline image), the process that fuels phytoplankton carbon fixation and growth. Bio-optical estimates of inline image and inline image were evaluated using 10 phytoplankton cultures across different pigment groups with varying bio-optical absorption characteristics on six different fast-repetition rate fluorometers that span two different manufacturers and four different models. Culture measurements of inline image and the effective absorption cross section of PSII photochemistry ( inline image, a constituent of inline image) showed a high degree of correspondence across instruments, although some instrument-specific biases are identified. A range of approaches have been used in the literature to estimate inline image and are evaluated here. With the exception of ex situ inline image estimates from paired inline image and PSII reaction center concentration ( inline image) measurements, the accuracy and precision of in situ inline image methodologies are largely determined by the variance of method-specific coefficients. The accuracy and precision of these coefficients are evaluated, compared to literature data, and discussed within a framework of autonomous inline image measurements. This study supports the application of an instrument-specific calibration coefficient ( inline image) that scales minimum fluorescence in the dark ( inline image) to inline image as both the most accurate in situ measurement of inline image, and the methodology best suited for highly resolved autonomous inline image measurements.

An Evaluation of the Impact of the Prospective Payment System on Antidepressant Use in Nursing Home Residents

Objectives: To determine the impact of the prospective payment system (PPS) for skilled nursing facilities on the pharmacologic treatment of depression.

Methods: We used a quasi-experimental study comparing the pharmacological treatment rates for depression in the pre-PPS period (1997) to the post-PPS period (2000) in 8149 residents with documented depression living in over 500 nursing facilities in Ohio. Logistic regression models adjusting for clustering effects of residents residing in homes using generalized estimating equations provided estimates of the PPS effect on use of any antidepressant and the use of selective serotonin reuptake inhibitors (SSRIs). We evaluated the extent to which the PPS effect was modified by organizational characteristics, including structural characteristics, resource characteristics, and staff resources available in the homes.

Results: Overall, there was no difference in the likelihood of any antidepressant [odds ratio (OR), 1.05; 95% confidence interval (CI), 0.93 to 1.18, resident-adjusted model] or an SSRI being used (OR, 0.98; 95% CI, 0.86 to 1.12, resident-adjusted model) after the introduction of PPS compared with 1997 when this reimbursement system was not in place (referent group). These trends did not appear to be modified substantially by organizational characteristics.

Conclusion: Although PPS did not appear to have influenced the treatment of depression in nursing homes, systems that provide checks and balances in relation to PPS are warranted.

An evaluation of cyclooxygenase-2 as a prognostic biomarker in mid-gut carcinoid tumours

Background/Aims:Mid-gut carcinoids (MGC) are the most common of the gastrointestinal carcinoid tumours. There is a lack of reliable prognostic indicators for MGC. Cox-2 and Bcl-2 were evaluated as prognostic biomarkers in a cohort of well-characterised non-appendiceal MGC. Methods: Tissue from the primary MGC tumours of 37 patients was subjected to immunohistochemical detection of Cox-2 and Bcl-2. In 9 cases tissue from secondary lesions was also examined. The study assessed whether tumour-associated Cox-2 and Bcl-2 expression were related to patient survival. Results: Cox-2 expression was demonstrated in 30/36 primary tumours. When all tumours were analysed Cox-regression analysis indicated a trend towards worsening survival with increasing Cox-2 histoscore (intensity x proportion; hazard ratio 1.53, 95%CI 0.93, 2.52; p=0.09). Analysis of Cox-2 positive tumours revealed a highly significant association between increasing histoscore and decreased survival (hazard ratio 3.03, 95%CI 1.33, 6.91, p=0.008). Tumour-associated Bcl-2 expression had no effect on patient survival (hazard ratio 1.12, 95% CI 0.42, 2.99 p=0.82). There was no significant association between Cox-2 and Bcl-2 expression (ï?£2 p=0.16), or Cox-2 histoscore and Bcl-2 expression (MWU p=0.59). Analysis of the Cox-2 histoscores of primary tumours and their corresponding secondary lesions, revealed a statistically significant trend towards increasing histoscore in the latter (Wilcoxon p=0.04). Conclusions: This study has provided evidence that Cox-2 expression in primary MGC may be associated with a more negative prognostic outlook.

Neural modelling, control and optimisation of an industrial grinding process

This paper describes the development of neural model-based control strategies for the optimisation of an industrial aluminium substrate disk grinding process. The grindstone removal rate varies considerably over a stone life and is a highly nonlinear function of process variables. Using historical grindstone performance data, a NARX-based neural network model is developed. This model is then used to implement a direct inverse controller and an internal model controller based on the process settings and previous removal rates. Preliminary plant investigations show that thickness defects can be reduced by 50% or more, compared to other schemes employed. (c) 2004 Elsevier Ltd. All rights reserved.

Targeting social need in a divided society: an evaluation of a community-based adult education initiative

This article examines the impact of a community-based adult education initiative designed to target social need in Northern Ireland. Set against a backdrop of extreme civil unrest and disadvantageous socio-economic conditions a cohort of adults was identified to participate in a personal and social development programme. The initiative was funded from Peace and Reconciliation resources made available to Northern Ireland by the European Union. High levels of unemployment and negativity about previous learning experiences were characteristic features among participants. An evaluation of the effectiveness of the programme was carried out and a follow-up qualitative survey ensued 6 months after the completion of the training. Results indicate that the learner-centred methodology was effective in providing a gateway to further education and training and enhancing participants' self-esteem, confidence, motivation, tolerance, social skills, community involvement and

An evaluation of a domiciliary blood transfusion serivce for palliative care patients in Northern Ireland

Marie Curie Cancer Care (MCCC) is a national charitable organisation which provides specialist palliative care services to patients with cancer and other life limiting illnesses. Marie Curie Nursing Service (MCNS) provides nursing services to patients in their own homes. The administration of blood transfusions to palliative care patients is required to improve symptom management and quality of life; however this procedure often results in unnecessary hospital admissions. Recognising that the majority of patients wish to be cared for and die in their own home, and with National Guidance recommending that specialist palliative care services should be provided to patients in their preferred place of care, a recent service initiative by MCNS was domiciliary blood transfusions. Whilst this is not a new service within domiciliary care, this pilot project aimed to capture patient views to evaluate this service initiative. Telephone interviews were conducted, using a questionnaire, with 11 patients who had received the service. Findings indicated positive evaluation of the service. Domiciliary blood transfusions helped to avoid unnecessary hospital admissions, the quality of life of patients and their families was improved in the palliative phase of illness and they received the service in their preferred place of care.