Physical inactivity remains the greatest public health problem of the 21st century : evidence, improved methods and solutions using the '7 investments that work' as a framework

In 2009, BJSM's first editorial argued that ‘Physical inactivity is the greatest public health problem of the 21st century’.1 The data supporting that claim have not yet been challenged. Now, 5 years after BJSM published its first dedicated ‘Physical Activity is Medicine’ theme issue (http://bjsm.bmj.com/content/43/1.toc) we are pleased to highlight 23 new contributions from six countries. This issue contains an analysis of the cost of physical inactivity from the US Centre for Diseases Control.2 We also report the cost-effectiveness of one particular physical activity intervention for adults.3

Power control and transmission scheduling for network utility maximization in wireless networks

We consider a joint power control and transmission scheduling problem in wireless networks with average power constraints. While the capacity region of a wireless network is convex, a characterization of this region is a hard problem. We formulate a network utility optimization problem involving time-sharing across different "transmission modes," where each mode corresponds to the set of power levels used in the network. The structure of the optimal solution is a time-sharing across a small set of such modes. We use this structure to develop an efficient heuristic approach to finding a suboptimal solution through column generation iterations. This heuristic approach converges quite fast in simulations, and provides a tool for wireless network planning.

A FRAMEWORK FOR THE ERROR ANALYSIS OF DISCONTINUOUS FINITE ELEMENT METHODS FOR ELLIPTIC OPTIMAL CONTROL PROBLEMS AND APPLICATIONS TO C-0 IP METHODS

In this article, an abstract framework for the error analysis of discontinuous Galerkin methods for control constrained optimal control problems is developed. The analysis establishes the best approximation result from a priori analysis point of view and delivers a reliable and efficient a posteriori error estimator. The results are applicable to a variety of problems just under the minimal regularity possessed by the well-posedness of the problem. Subsequently, the applications of C-0 interior penalty methods for a boundary control problem as well as a distributed control problem governed by the biharmonic equation subject to simply supported boundary conditions are discussed through the abstract analysis. Numerical experiments illustrate the theoretical findings.

Problem-solving and spatial working memory in patients with schizophrenia and with focal frontal and temporal lobe lesions

Problem-solving ability was investigated in 25 DSM-IIIR schizophrenic (SC) patients using the Tower of Hanoi (TOH) task. Their performance was compared to that of: (1) 22 patients with neurosurgical unilateral prefrontal lesions, 11 left (LF) and 10 right hemisphere (RF); (2) 38 patients with unilateral temporal lobectomies, 19 left (LT) and 19 right (RT); and (3) 44 matched control subjects. Like the RT and LF group, the schizophrenics were significantly impaired on the TOH. The deficit shown by the schizophrenic group was equivalent whether or not the problems to be solved included goal-subgoal conflicts, unlike the LF group who were impaired specifically on these problems. The nature of the SC deficit was also distinct from that of the RT group, in that the problem-solving deficit remained after controlling for the effects of spatial memory performance. This study indicates, therefore, that neither focal frontal nor temporal lobe damage sustained in adult life is a sufficient explanation for the problem-solving deficits found in patients with schizophrenia. (C) 1999 Elsevier Science B.V. All rights reserved.

"Should I prioritize medical problem solving or attentive listening?": the dilemmas and challenges that medical students experience when learning to conduct consultations

Objective: Communication skills can be trained alongside clinical reasoning, history taking or clinical examination skills. This is advocated as a solution to the low transfer of communication skills. Still, students have to integrate the knowledge/skills acquired during different curriculum parts in patient consultations at some point. How do medical students experience these integrated consultations within a simulated environment and in real practice when dealing with responsibility?

Methods: Six focus groups were conducted with (pre-)/clerkship students.

Results: Students were motivated to practice integrated consultations with simulated patients and felt like 'real physicians'. However, their focus on medical problem solving drew attention away from improving their communication skills. Responsibility for real patients triggered students' identity development. This identity formation guided the development of an own consultation style, a process that was hampered by conflicting demands of role models.

Conclusion: Practicing complete consultations results in the dilemma of prioritizing medical problem solving above attention for patient communication. Integrated consultation training advances this dilemma to the pre-clerkship period. During clerkships this dilemma is heightened because real patients trigger empathy and responsibility, which invites students to define their role as doctor.

Practice Implications: When training integrated consultations, educators should pay attention to students' learning priorities and support the development of students' professional identity.

The effect of calculators on the numerical problem-solving skills and attitudes of primary students towards mathematics /

The purpose of this study was to determine the effect that calculators have on the attitudes and numerical problem-solving skills of primary students. The sample used for this research was one of convenience. The sample consisted of two grade 3 classes within the York Region District School Board. The students in the experimental group used calculators for this problem-solving unit. The students in the control group completed the same numerical problem-solving unit without the use of calculators. The pretest-posttest control group design was used for this study. All students involved in this study completed a computational pretest and an attitude pretest. At the end of the study, the students completed a computational posttest. Five students from the experimental group and five students from the control group received their posttests in the form of a taped interview. At the end of the unit, all students completed the attitude scale that they had received before the numerical problem-solving unit once again. Data for qualitative analysis included anecdotal observations, journal entries, and transcribed interviews. The constant comparative method was used to analyze the qualitative data. A t test was also performed on the data to determine whether there were changes in test and attitude scores between the control and experimental group. Overall, the findings of this study support the hypothesis that calculators improve the attitudes of primary students toward mathematics. Also, there is some evidence to suggest that calculators improve the computational skills of grade 3 students.

Problem solving and computer-assisted instruction in science education : analysis of research findings and the research process /

The quantitative component of this study examined the effect of computerassisted instruction (CAI) on science problem-solving performance, as well as the significance of logical reasoning ability to this relationship. I had the dual role of researcher and teacher, as I conducted the study with 84 grade seven students to whom I simultaneously taught science on a rotary-basis. A two-treatment research design using this sample of convenience allowed for a comparison between the problem-solving performance of a CAI treatment group (n = 46) versus a laboratory-based control group (n = 38). Science problem-solving performance was measured by a pretest and posttest that I developed for this study. The validity of these tests was addressed through critical discussions with faculty members, colleagues, as well as through feedback gained in a pilot study. High reliability was revealed between the pretest and the posttest; in this way, students who tended to score high on the pretest also tended to score high on the posttest. Interrater reliability was found to be high for 30 randomly-selected test responses which were scored independently by two raters (i.e., myself and my faculty advisor). Results indicated that the form of computer-assisted instruction (CAI) used in this study did not significantly improve students' problem-solving performance. Logical reasoning ability was measured by an abbreviated version of the Group Assessment of Lx)gical Thinking (GALT). Logical reasoning ability was found to be correlated to problem-solving performance in that, students with high logical reasoning ability tended to do better on the problem-solving tests and vice versa. However, no significant difference was observed in problem-solving improvement, in the laboratory-based instruction group versus the CAI group, for students varying in level of logical reasoning ability.Insignificant trends were noted in results obtained from students of high logical reasoning ability, but require further study. It was acknowledged that conclusions drawn from the quantitative component of this study were limited, as further modifications of the tests were recommended, as well as the use of a larger sample size. The purpose of the qualitative component of the study was to provide a detailed description ofmy thesis research process as a Brock University Master of Education student. My research journal notes served as the data base for open coding analysis. This analysis revealed six main themes which best described my research experience: research interests, practical considerations, research design, research analysis, development of the problem-solving tests, and scoring scheme development. These important areas ofmy thesis research experience were recounted in the form of a personal narrative. It was noted that the research process was a form of problem solving in itself, as I made use of several problem-solving strategies to achieve desired thesis outcomes.

Solving the Vehicle Routing Problem with Genetic ALgorithm and Simulated Annealing

This Thesis Work will concentrate on a very interesting problem, the Vehicle Routing Problem (VRP). In this problem, customers or cities have to be visited and packages have to be transported to each of them, starting from a basis point on the map. The goal is to solve the transportation problem, to be able to deliver the packages-on time for the customers,-enough package for each Customer,-using the available resources- and – of course - to be so effective as it is possible.Although this problem seems to be very easy to solve with a small number of cities or customers, it is not. In this problem the algorithm have to face with several constraints, for example opening hours, package delivery times, truck capacities, etc. This makes this problem a so called Multi Constraint Optimization Problem (MCOP). What’s more, this problem is intractable with current amount of computational power which is available for most of us. As the number of customers grow, the calculations to be done grows exponential fast, because all constraints have to be solved for each customers and it should not be forgotten that the goal is to find a solution, what is best enough, before the time for the calculation is up. This problem is introduced in the first chapter: form its basics, the Traveling Salesman Problem, using some theoretical and mathematical background it is shown, why is it so hard to optimize this problem, and although it is so hard, and there is no best algorithm known for huge number of customers, why is it a worth to deal with it. Just think about a huge transportation company with ten thousands of trucks, millions of customers: how much money could be saved if we would know the optimal path for all our packages.Although there is no best algorithm is known for this kind of optimization problems, we are trying to give an acceptable solution for it in the second and third chapter, where two algorithms are described: the Genetic Algorithm and the Simulated Annealing. Both of them are based on obtaining the processes of nature and material science. These algorithms will hardly ever be able to find the best solution for the problem, but they are able to give a very good solution in special cases within acceptable calculation time.In these chapters (2nd and 3rd) the Genetic Algorithm and Simulated Annealing is described in details, from their basis in the “real world” through their terminology and finally the basic implementation of them. The work will put a stress on the limits of these algorithms, their advantages and disadvantages, and also the comparison of them to each other.Finally, after all of these theories are shown, a simulation will be executed on an artificial environment of the VRP, with both Simulated Annealing and Genetic Algorithm. They will both solve the same problem in the same environment and are going to be compared to each other. The environment and the implementation are also described here, so as the test results obtained.Finally the possible improvements of these algorithms are discussed, and the work will try to answer the “big” question, “Which algorithm is better?”, if this question even exists.

Beating the blues after cancer : randomised control trial of a tele-based psychological intervention for high distress patients and carers

Background : The diagnosis and treatment of cancer is a major life stress such that approximately 35% of patients experience persistent clinically significant distress and carers often experience even higher distress than patients. This paper presents the design of a two arm randomised controlled trial with patients and carers who have elevated psychological distress comparing minimal contact self management vs. an individualised tele-based cognitive behavioural intervention.

Methods/design : 140 patients and 140 carers per condition (560 participants in total) will been recruited after being identified as high distress through caller screening at two community-based cancer helplines and randomised to 1) a single 30-minute telephone support and education session with a nurse counsellor with self management materials 2) a tele-based psychologist delivered five session individualised cognitive behavioural intervention. Session components will include stress reduction, problem-solving, cognitive challenging and enhancing relationship support and will be delivered weekly. Participants will be assessed at baseline and 3, 6 and 12 months after recruitment. Outcome measures include: anxiety and depression, cancer specific distress, unmet psychological supportive care needs, positive adjustment, overall Quality of life.

Discussion : The study will provide recommendations about the efficacy and potential economic value of minimal contact self management vs. tele-based psychologist delivered cognitive behavioural intervention to facilitate better psychosocial adjustment and mental health for people with cancer and their carers.

Lot sizing and furnace scheduling in small foundries

A lot sizing and scheduling problem prevalent in small market-driven foundries is studied. There are two related decision levels: (1) the furnace scheduling of metal alloy production, and (2) moulding machine planning which specifies the type and size of production lots. A mixed integer programming (MIP) formulation of the problem is proposed, but is impractical to solve in reasonable computing time for non-small instances. As a result, a faster relax-and-fix (RF) approach is developed that can also be used on a rolling horizon basis where only immediate-term schedules are implemented. As well as a MIP method to solve the basic RF approach, three variants of a local search method are also developed and tested using instances based on the literature. Finally, foundry-based tests with a real-order book resulted in a very substantial reduction of delivery delays and finished inventory, better use of capacity, and much faster schedule definition compared to the foundry's own practice. © 2006 Elsevier Ltd. All rights reserved.

Solving the multiobjective environmental/economic dispatch problem using weighted sum and ε-constraint strategies and a predictor-corrector primal-dual interior point method

This paper proposes a technique for solving the multiobjective environmental/economic dispatch problem using the weighted sum and ε-constraint strategies, which transform the problem into a set of single-objective problems. In the first strategy, the objective function is a weighted sum of the environmental and economic objective functions. The second strategy considers one of the objective functions: in this case, the environmental function, as a problem constraint, bounded above by a constant. A specific predictor-corrector primal-dual interior point method which uses the modified log barrier is proposed for solving the set of single-objective problems generated by such strategies. The purpose of the modified barrier approach is to solve the problem with relaxation of its original feasible region, enabling the method to be initialized with unfeasible points. The tests involving the proposed solution technique indicate i) the efficiency of the proposed method with respect to the initialization with unfeasible points, and ii) its ability to find a set of efficient solutions for the multiobjective environmental/economic dispatch problem.

A Language to Formalize and to Operationalize Problem-solving Strategies of Structured Knowledge Models

This paper describes a proposal of a language called Link which has been designed to formalize and operationalize problem solving strategies. This language is used within a software environment called KSM (Knowledge Structure Manager) which helps developers in formulating and operationalizing structured knowledge models. The paper presents both its syntax and dynamics, and gives examples of well-known problem-solving strategies of reasoning formulated using this language.

Stochastic control strategies and adaptive critic methods

Adaptive critic methods have common roots as generalizations of dynamic programming for neural reinforcement learning approaches. Since they approximate the dynamic programming solutions, they are potentially suitable for learning in noisy, nonlinear and nonstationary environments. In this study, a novel probabilistic dual heuristic programming (DHP) based adaptive critic controller is proposed. Distinct to current approaches, the proposed probabilistic (DHP) adaptive critic method takes uncertainties of forward model and inverse controller into consideration. Therefore, it is suitable for deterministic and stochastic control problems characterized by functional uncertainty. Theoretical development of the proposed method is validated by analytically evaluating the correct value of the cost function which satisfies the Bellman equation in a linear quadratic control problem. The target value of the critic network is then calculated and shown to be equal to the analytically derived correct value.

Solving the Task Assignment Problem with a Variable Neighborhood Search

In this paper a variable neighborhood search (VNS) approach for the task assignment problem (TAP) is considered. An appropriate neighborhood scheme along with a shaking operator and local search procedure are constructed specifically for this problem. The computational results are presented for the instances from the literature, and compared to optimal solutions obtained by the CPLEX solver and heuristic solutions generated by the genetic algorithm. It can be seen that the proposed VNS approach reaches all optimal solutions in a quite short amount of computational time.

The role of exploration and critical decision making and problem solving in making life choices

Although the literature on the types of abilities and processes that contribute to identity formation has been growing, the research has been mainly descriptive/correlational. This dissertation conducted an experimental investigation of the role of two theoretically distinct processes (exploration and critical problem solving) in identity formation, one of the first to be reported. The experimental training design (pre-post, training versus control) used in this study was intended to promote identity development by fostering an increase in the use of exploration and critical problem solving with respect to making life choices. Participants included 53 psychology students from a large urban university randomly assigned to each group. The most theoretically significant finding was that the intervention was successful in inducing change in the ability to use critical skills in resolving life decisions, as well as effecting a positive change in identity status. ^