The positioning of palliative care in acute care: A multiperspective qualitative study in the context of metastatic melanoma

Objective: The positioning and meaning of palliative care within the healthcare system lacks clarity which adds a level of complexity to the process of transition to palliative care. This study explores the transition to the palliative care process in the acute care context of metastatic melanoma. Method: A theoretical framework drawing on interpretive and critical traditions informs this research. The pragmatism of symbolic interactionism and the critical theory of Habermas brought a broad orientation to the research. Integration of the theoretical framework and grounded-theory methods facilitated data generation and analysis of 29 interviews with patients, family carers, and healthcare professionals. Results: The key analytical findings depict a scope of palliative care that was uncertain for users of the system and for those working within the system. Becoming “palliative” is not a defined event; nor is there unanimity around referral to a palliative care service. As such, ambiguity and tension contribute to the difficulties involved in negotiating the transition to palliative care. Significance of Results: Our findings point to uncertainty around the scopes of practice in the transition to palliative care. The challenge in the transition process lies in achieving greater coherency of care within an increasingly specialized healthcare system. The findings may not only inform those within a metastatic melanoma context but may contribute more broadly to palliative practices within the acute care setting.

A note on the choice of interfacial friction angle

Estimates of interfacial friction angle (delta) are necessary for the design of retaining structures and deep foundations, Recommendations in the literature regarding delta values are often contradictory and are therefore not easy to apply in geotechnical design, A critical examination of past studies in terms of data generation techniques used and conclusions drawn indicates that two distinctly different test procedures/techniques have been evolved. The interfacial situation in practice can also be categorized into two broad types, These two types of interface problems in geotechnical engineering are (a) the structure is placed on the free surface of prepared fill (type A situation) and (b) the fill is placed against the material surface which functions as a confined boundary (type B situation), The friction angle delta depends on the surface roughness of the construction material, But in the type A situation, it is independent of density and its limiting maximum value (delta(lim)) is the critical state friction angle phi(cv). In the type B situation, it is dependent on density of the fill and its limiting maximum value is the peak angle of internal friction phi(p) of the fill.

Common Ground Method of Current Injection in Electrical Impedance Tomography

Surface electrodes are essentially required to be switched for boundary data collection in electrical impedance tomography (Ell). Parallel digital data bits are required to operate the multiplexers used, generally, for electrode switching in ELT. More the electrodes in an EIT system more the digital data bits are needed. For a sixteen electrode system. 16 parallel digital data bits are required to operate the multiplexers in opposite or neighbouring current injection method. In this paper a common ground current injection is proposed for EIT and the resistivity imaging is studied. Common ground method needs only two analog multiplexers each of which need only 4 digital data bits and hence only 8 digital bits are required to switch the 16 surface electrodes. Results show that the USB based data acquisition system sequentially generate digital data required for multiplexers operating in common ground current injection method. The profile of the boundary data collected from practical phantom show that the multiplexers are operating in the required sequence in common ground current injection protocol. The voltage peaks obtained for all the inhomogeneity configurations are found at the accurate positions in the boundary data matrix which proved the sequential operation of multiplexers. Resistivity images reconstructed from the boundary data collected from the practical phantom with different configurations also show that the entire digital data generation module is functioning properly. Reconstructed images and their image parameters proved that the boundary data are successfully acquired by the DAQ system which in turn indicates a sequential and proper operation of multiplexers.

Dynamic multi-relational Chinese restaurant process for analyzing influences on users in social media

We study the problem of analyzing influence of various factors affecting individual messages posted in social media. The problem is challenging because of various types of influences propagating through the social media network that act simultaneously on any user. Additionally, the topic composition of the influencing factors and the susceptibility of users to these influences evolve over time. This problem has not been studied before, and off-the-shelf models are unsuitable for this purpose. To capture the complex interplay of these various factors, we propose a new non-parametric model called the Dynamic Multi-Relational Chinese Restaurant Process. This accounts for the user network for data generation and also allows the parameters to evolve over time. Designing inference algorithms for this model suited for large scale social-media data is another challenge. To this end, we propose a scalable and multi-threaded inference algorithm based on online Gibbs Sampling. Extensive evaluations on large-scale Twitter and Face book data show that the extracted topics when applied to authorship and commenting prediction outperform state-of-the-art baselines. More importantly, our model produces valuable insights on topic trends and user personality trends beyond the capability of existing approaches.

O cuidado prestado pela família à criança portadora de encefalopatia hipóxico-isquêmica no contexto domiciliar: contribuições para a enfermagem

Os avanços tecnológicos ocorridos nas últimas três décadas na área da saúde têm garantido a sobrevivência de crianças nascidas extremamente prematuras ou asfíxicas, o que acabou gerando as chamadas crianças com necessidades especiais de saúde, dentre elas, as portadoras de encefalopatia hipóxico-isquêmica. A encefalopatia acomete as crianças em graus variados requerendo cuidados específicos, o que implica na inclusão de suas famílias nas ações de cuidados a criança quando no domicílio. Objeto de estudo: o cuidado prestado pela família à criança portadora de encefalopatia hipóxico-isquêmica no contexto domiciliar. Objetivos: descrever as demandas de cuidados da criança portadora de encefalopatia no domicílio, identificar as práticas de cuidados desenvolvidas pelos familiares cuidadores junto a essas crianças e discutir os desafios determinados por esses cuidados para os familiares cuidadores de criança com encefalopatia no domicílio. Metodologia: pesquisa qualitativa, desenvolvida a partir do método criativo sensível, utilizando a dinâmica corpo-saber no domicílio de cinco grupos de familiares cuidadores, totalizando doze familiares. O período de geração dos dados ocorreu de fevereiro a abril de 2014. Os dados foram analisados a partir da análise de discurso, em sua corrente francesa, e interpretados à luz da concepção freiriana, com destaque para os conceitos de crítica reflexiva, processo de conscientização e educação dialógica e o cuidado centrado na família. Resultados: as práticas de cuidados dos familiares apontaram modificações nos cuidados habituais de alimentação, higiene, desenvolvimento e medicamentoso. Na prática da alimentação, os familiares expressaram suas condutas frente à alimentação por via oral ou por gastrostomia e suas crenças e atitudes frente a essas práticas alimentares. Quanto à higiene, revelaram a necessidade de adaptações na prática habitual do banho. No que se refere aos cuidados voltados ao desenvolvimento, apontaram o lazer e as brincadeiras como elementos adjuvantes ao favorecimento do desenvolvimento infantil. O cuidado medicamentoso emergiu como parte do universo das famílias, apontando a necessidade dos profissionais de saúde, em especial, os da enfermagem, incluírem esta temática em suas pautas de orientações. Quanto aos desafios vividos pelos familiares, esses estiveram relacionados ao medo e a inexperiência no cuidar da criança, ao enfrentamento e a aceitação da necessidade especial de saúde, a necessidade de uma rede de solidariedade cooperando nas dificuldades econômicas e ao atendimento em saúde por diferentes profissionais e especialidades. Conclusão: as múltiplas dimensões de cuidados apresentadas pelas crianças com necessidades especiais de saúde apontam para o profissional de enfermagem a necessidade de desenvolver seu papel educador junto aos familiares pautado na dialogicidade e horizontalidade facilitando, assim, a relação com os estes, em benefício da criança e promovendo a aproximação profissional/família, O estudo assinala a necessidade de dos profissionais de saúde, em especial, o enfermeiro, perceberem a família como um elemento chave no processo de cuidar da criança com necessidades especiais de saúde quando no domicílio.

an efficient method to generate feasible paths for basis path testing

Basis path testing is a very powerful structural testing criterion. The number of test paths equals to the cyclomatic complexity of program defined by McCabe. Traditional test generation methods select the paths either without consideration of the constraints of variables or interactively. In this note, an efficient method is presented to generate a set of feasible basis paths. The experiments show that this method can generate feasible basis paths for real-world C programs automatically in acceptable time.

a constraint solver and its application to path feasibility analysis

Many testing methods are based on program paths. A well-known problem with them is that some paths are infeasible. To decide the feasibility of paths, we may solve a set of constraints. In this paper, we describe constraint-based tools that can be used for this purpose. They accept constraints expressed in a natural form, which may involve variables of different types such as integers, Booleans, reals and fixed-size arrays. The constraint solver is an extension of a Boolean satisfiability checker and it makes use of a linear programming package. The solving algorithm is described, and examples are given to illustrate the use of the tools. For many paths in the testing literature, their feasibility can be decided in a reasonable amount of time.

一种基于Messy GA的结构测试数据自动生成方法

结构性测试是标识测试用例的基本方法之一．由于程序语言的复杂性以及被测程序的多样性，自动生成结构测试数据的一种有效方法是根据程序运行结果指导生成过程，通过不断迭代，生成符合要求的测试数据集．提出一种基于Messy GA的结构测试数据自动生成方法，将测试覆盖率表示为测试输入集X的函数F（X），并利用Messy GA不需要染色体模式排列的先验知识即可进行优化求解的性质对F（X）的进行迭代寻优，进一步提高了搜索的并行性，并最终提高测试覆盖率．对一组标准测试程序和若干实际应用程序的实验结果表明，较之现有基于遗传算法的生成方法，该方法能够以更高的效率生成更高质量的测试数据，并适用于较大规模的程序．

C程序测试数据生成与死循环检测研究

软件测试是保证软件质量的重要手段. 随着软件技术的发展, 软件的规模越来越大, 程序的复杂度也逐渐增加. 软件测试也由原来的人工操作逐渐走向自动化. 自动化软件测试已经成为国内外软件工程研究的热点之一. 本文研究了自动软件测试中的两个问题, 它们分别属于自动测试数据生成和错误查找两方面. 主要贡献如下: 本文提出了一种对含有字符串和字符串函数调用的C语言程序自动生成测试数据的方法. 具体做法是将C语言程序中的字符变量看成是取值范围在0~255之间的整数, 并使用字符数组来表示字符串, 同时将字符串函数建模成一阶逻辑公式和赋值语句. 通过使用前置条件和后置条件来描述函数调用语句, 将程序中的字符串函数调用语句替换成逻辑公式和赋值语句, 之后使用路径分析技术自动生成程序的测试数据. 此外, 本文还实现了一个自动化工具, 能够为真实的C程序自动生成测试数据. 另一方面, 本文还提出了一种自动检查程序中是否含有死循环的方法. 该方法基于静态代码分析, 结合了循环展开和路径可行性分析技术. 具体做法是首先通过遍历控制流图生成待查循环的检验路径, 之后通过分析检验路径的可行性以及路径之间的联系, 判断这些路径是否符合死循环模式. 在此基础上, 本文实现了原型工具, 并对一组基准程序进行测试. 实验结果表明, 工具能高效地检测出C语言程序中的死循环, 准确率较高. 工具的自动化程度较高, 能处理复杂的控制流以及嵌套的循环.

Secure Communications in Smart Grid: Networking and Protocols

The key attributes of a smarter power grid include: pervasive interconnection of smart devices; extensive data generation and collection; and rapid reaction to events across a widely dispersed physical infrastructure. Modern telecommunications technologies are being deployed across power systems to support these monitoring and control capabilities. To enable interoperability, several new communications protocols and standards have been developed over the past 10 to 20 years. These continue to be refined, even as new systems are rolled out.

This new hyper-connected communications infrastructure provides an environment rich in sub-systems and physical devices that are attractive to cyber-attackers. Indeed, as smarter grid operations become dependent on interconnectivity, the communications network itself becomes a target. Consequently, we examine cyber-attacks that specifically target communications, particularly state-of-the-art standards and protocols. We further explore approaches and technologies that aim to protect critical communications networks against intrusions, and to monitor for, and detect, intrusions that infiltrate Smart Grid systems.

I must walk through the gate : an ontological necessity

This research is a self-study into my life as an athlete, elementary school teacher, leamer, and as a teacher educator/academic. Throughout the inquiry, I explore how my beliefs and values infused my lived experiences and ultimately influenced my constructivist, humanist, and ultimately my holistic teaching and learning practice which at times disrupted the status quo. I have written a collection of narratives (data generation) which embodied my identity as an unintelligent student/leamer, a teacher/learner, an experiential learner, a tenacious participant, and a change agent to name a few. As I unpack my stories and hermeneutically reconstruct their intent, I question their meaning as I explore how I can improve my teaching and learning practice and potentially effect positive change when instructing beginning teacher candidates at a Faculty of Education. At the outset I situate my story and provide the necessary political, social, and cultural background information to ground my research. I follow this with an in depth look at the elements that interconnect the theoretical framework of this self-study by presenting the notion of writing at the boundaries through auto ethnography (Ellis, 2000; Ellis & Bochner, 2004) and writing as a method of inquiry (Richardson, 2000). The emergent themes of experiential learning, identity, and embodied knowing surfaced during the data generation phase. I use the Probyn' s (1990) .. metaphor of locatedness to unpack these themes and ponder the question, Where is experience located? I deepen the exploration by layering Drake's (2007) KnowlDo/Be framework alongside locatedness and offer descriptions of learning moments grounded in pedagogical theories. In the final phase, I introduce thirdspace theory (Bhabha, 1994; Soja, 1996) as a space that allowed me to puzzle educational dilemmas and begin to reconcile the binaries that existed in my life both personally, and professionally. I end where I began by revisiting the questions that drove this study. In addition, Ireflect upon the writing process and the challenges that I encountered while immersed in this approach and contemplate the relevance of conducting a self-study. I leave the reader with what is waiting for me on the other side of the gate, for as Henry James suggested, "Experience is never limited, and it is never complete."

Predicting feed quality - chemical analysis and in vitro evaluation

As the ideal method of assessing the nutritive value of a feedstuff, namely offering it to the appropriate class of animal and recording the production response obtained, is neither practical nor cost effective a range of feed evaluation techniques have been developed. Each of these balances some degree of compromise with the practical situation against data generation. However, due to the impact of animal-feed interactions over and above that of feed composition, the target animal remains the ultimate arbitrator of nutritional value. In this review current in vitro feed evaluation techniques are examined according to the degree of animal-feed interaction. Chemical analysis provides absolute values and therefore differs from the majority of in vitro methods that simply rank feeds. However, with no host animal involvement, estimates of nutritional value are inferred by statistical association. In addition given the costs involved, the practical value of many analyses conducted should be reviewed. The in sacco technique has made a substantial contribution to both understanding rumen microbial degradative processes and the rapid evaluation of feeds, especially in developing countries. However, the numerous shortfalls of the technique, common to many in vitro methods, the desire to eliminate the use of surgically modified animals for routine feed evaluation, paralleled with improvements in in vitro techniques, will see this technique increasingly replaced. The majority of in vitro systems use substrate disappearance to assess degradation, however, this provides no information regarding the quantity of derived end-products available to the host animal. As measurement of volatile fatty acids or microbial biomass production greatly increases analytical costs, fermentation gas release, a simple and non-destructive measurement, has been used as an alternative. However, as gas release alone is of little use, gas-based systems, where both degradation and fermentation gas release are measured simultaneously, are attracting considerable interest. Alternative microbial inocula are being considered, as is the potential of using multi-enzyme systems to examine degradation dynamics. It is concluded that while chemical analysis will continue to form an indispensable part of feed evaluation, enhanced use will be made of increasingly complex in vitro systems. It is vital, however, the function and limitations of each methodology are fully understood and that the temptation to over-interpret the data is avoided so as to draw the appropriate conclusions. With careful selection and correct application in vitro systems offer powerful research tools with which to evaluate feedstuffs. (C) 2003 Elsevier B.V. All rights reserved.

Forecasting with difference and trend stationary models

Although difference-stationary (DS) and trend-stationary (TS) processes have been subject to considerable analysis, there are no direct comparisons for each being the data-generation process (DGP). We examine incorrect choice between these models for forecasting for both known and estimated parameters. Three sets of Monte Carlo simulations illustrate the analysis, to evaluate the biases in conventional standard errors when each model is mis-specified, compute the relative mean-square forecast errors of the two models for both DGPs, and investigate autocorrelated errors, so both models can better approximate the converse DGP. The outcomes are surprisingly different from established results.

Pooling of forecasts

We consider forecasting using a combination, when no model coincides with a non-constant data generation process (DGP). Practical experience suggests that combining forecasts adds value, and can even dominate the best individual device. We show why this can occur when forecasting models are differentially mis-specified, and is likely to occur when the DGP is subject to location shifts. Moreover, averaging may then dominate over estimated weights in the combination. Finally, it cannot be proved that only non-encompassed devices should be retained in the combination. Empirical and Monte Carlo illustrations confirm the analysis.

Dialekter och röstigenkänning : Ett röstigenkännings-API:s förmåga att uppfatta svenska dialekters kännetecken och röstkombinationer

Allt eftersom utvecklingen går framåt inom applikationer och system så förändras också sättet på vilket vi interagerar med systemet på. Hittills har navigering och användning av applikationer och system mestadels skett med händerna och då genom mus och tangentbord. På senare tid så har navigering via touch-skärmar och rösten blivit allt mer vanligt. Då man ska styra en applikation med hjälp av rösten är det viktigt att vem som helst kan styra applikationen, oavsett vilken dialekt man har. För att kunna se hur korrekt ett röstigenkännings-API (Application Programming Interface) uppfattar svenska dialekter så initierades denna studie med dokumentstudier om dialekters kännetecken och ljudkombinationer. Dessa kännetecken och ljudkombinationer låg till grund för de ord vi valt ut till att testa API:et med. Varje dialekt fick alltså ett ord uppbyggt för att vara extra svårt för API:et att uppfatta när det uttalades av just den aktuella dialekten. Därefter utvecklades en prototyp, närmare bestämt en android-applikation som fungerade som ett verktyg i datainsamlingen. Då arbetet innehåller en prototyp och en undersökning så valdes Design and Creation Research som forskningsstrategi med datainsamlingsmetoderna dokumentstudier och observationer för att få önskat resultat. Data samlades in via observationer med prototypen som hjälpmedel och med hjälp av dokumentstudier. Det empiriska data som registrerats via observationerna och med hjälp av applikationen påvisade att vissa dialekter var lättare för API:et att uppfatta korrekt. I vissa fall var resultaten väntade då vissa ord uppbyggda av ljudkombinationer i enlighet med teorin skulle uttalas väldigt speciellt av en viss dialekt. Ibland blev det väldigt låga resultat på just dessa ord men i andra fall förvånansvärt höga. Slutsatsen vi drog av detta var att de ord vi valt ut med en baktanke om att de skulle få låga resultat för den speciella dialekten endast visade sig stämma vid två tillfällen. Det var istället det ord innehållande sje- och tje-ljud som enligt teorin var gemensamma kännetecken för alla dialekter som fick lägst resultat överlag.