Integrating data to facilitate clinical research : a case study

The integration of routine clinical administrative activities into ongoing rigorous clinical research poses challenges for both clinicians and researchers. This case study describes the development of a responsive database system used to facilitate comprehensive longitudinal research into the outcomes of patients waiting for hip and knee replacement surgery in a large public teaching hospital. The initial research procedure was paper-based, with manual patient matching and data entry. This process was time-consuming and associated with substantial risk of error and omissions, necessitating the design of a better system. An integrated database system was designed to receive daily electronic updates of the orthopaedic waiting-list and scheduled clinic and surgery dates. Using readily available software (Microsoft Access), new patients were identified through specifying inclusion and exclusion criteria which allowed rapid and complete recruitment at time of entry to the waiting-list. The integrated system specified the appropriate timing of multiple follow-up assessments, provided prompt information on recruitment for reporting purposes and integrated multiple linked research projects within one database. Seamless exporting of data to statistical programs for analysis was also enabled. This simple integrated approach facilitated efficient execution of a longitudinal study from recruitment to statistical analysis while maximising confidentiality and minimising resources required. This case study describes the development and design of a simple system which could be easily adapted for database management in hospital or clinic-based settings according to local requirements.

Overtraining or burnout : a training and psycho-behavioural case study

The aim of this article is to present case study data that challenges the popular conception that athlete burnout represents the ultimate outcome of overtraining. A young male triathlete (22 yrs) completed a comprehensive training diary, along with the Athlete Burnout Questionnaire (ABQ) and the Multi-component Training Distress Scale (MTDS) weekly from the commencement of pre-season training, until the end of the competitive season 45 weeks later. Results were analysed retrospectively upon completion of the season and followed up with semi-structured interviews with the coach and athlete. These longitudinal observations are the first to document an athlete who appears to have simultaneously become overtrained and developed athlete burnout as measured by the ABQ. Thus we are advocating a need for future research to clarify differences between these two training-stress syndromes, specifically in relation to their aetiology, to avoid misdiagnosis and to ensure appropriate treatment for athletes experiencing these conditions is provided.

Glaucomatous visual field progression with frequency-doubling technology and standard automated perimetry in a longitudinal prospective study

PURPOSE. To compare frequency-doubling technology (FDT) perimetry with standard automated perimetry (SAP) for detecting glaucomatous visual field progression in a longitudinal prospective study.

METHODS. One eye of patients with open-angle glaucoma was tested every 6 months with both FDT and SAP. A minimum of 6 examinations with each perimetric technique was required for inclusion. Visual field progression was determined by two methods: glaucoma change probability (GCP) analysis and linear regression analysis (LRA). For GCP, several criteria for progression were used. The number of locations required to classify progression with FDT compared with SAP, respectively, was 1:2 (least conservative), 1:3, 2:3, 2:4, 2:6, 2:7, 3:6, 3:7, and 3:10 (most conservative). The number of consecutive examinations required to confirm progression was 2-of-3, 2-of-2, and 3-of-3. For LRA, the progression criterion was any significant decline in mean threshold sensitivity over time in each of the following three visual field subdivisions: (1) all test locations, (2) locations in the central 10° and the superior and inferior hemifields, and (3) locations in each quadrant. Using these criteria, the proportion of patients classified as showing progression with each perimetric technique was calculated and, in the case of progression with both, the differences in time to progression were determined.

RESULTS. Sixty-five patients were followed for a median of 3.5 years (median number of examinations, 9). For the least conservative GCP criterion, 32 (49%) patients were found to have progressing visual fields with FDT and 32 (49%) patients with SAP. Only 16 (25%) patients showed progression with both methods, and in most of those patients, FDT identified progression before SAP (median, 12 months earlier). The majority of GCP progression criteria (15/27), classified more patients as showing progression with FDT than with SAP. Contrary to this, more patients showed progression with SAP than FDT, when analysed with LRA; e.g., using quadrant LRA 20 (31%) patients showed progression with FDT, 23 (35%) with SAP, and only 10 (15%) with both.

CONCLUSIONS. FDT perimetry detected glaucomatous visual field progression. However, the proportion of patients who showed progression with both FDT and SAP was small, possibly indicating that the two techniques identify different subgroups of patients. Using GCP, more patients showed progression with FDT than with SAP, yet the opposite occurred using LRA. As there is no independent qualifier of progression, FDT and SAP progression rates vary depending on the method of analysis and the criterion used.

Translating evidence-based guidelines to improve feedback practices: the interACT case study

BACKGROUND: There has been a substantial body of research examining feedback practices, yet the assessment and feedback landscape in higher education is described as 'stubbornly resistant to change'. The aim of this paper is to present a case study demonstrating how an entire programme's assessment and feedback practices were re-engineered and evaluated in line with evidence from the literature in the interACT (Interaction and Collaboration via Technology) project. METHODS: Informed by action research the project conducted two cycles of planning, action, evaluation and reflection. Four key pedagogical principles informed the re-design of the assessment and feedback practices. Evaluation activities included document analysis, interviews with staff (n = 10) and students (n = 7), and student questionnaires (n = 54). Descriptive statistics were used to analyse the questionnaire data. Framework thematic analysis was used to develop themes across the interview data. RESULTS: InterACT was reported by students and staff to promote self-evaluation, engagement with feedback and feedback dialogue. Streamlining the process after the first cycle of action research was crucial for improving engagement of students and staff. The interACT process of promoting self-evaluation, reflection on feedback, feedback dialogue and longitudinal perspectives of feedback has clear benefits and should be transferable to other contexts. CONCLUSIONS: InterACT has involved comprehensive re-engineering of the assessment and feedback processes using educational principles to guide the design taking into account stakeholder perspectives. These principles and the strategies to enact them should be transferable to other contexts.

Isolated Islands? Memory of the Holocaust in Formal and Non-Formal Education. The Case Study of Post-Communist Poland

Existing studies revealed several conflicts around the memory of the Holocaust in Poland: between understanding the need to teach about the Holocaust and indifference toward anti-Jewish graffiti; a conflict around the perception of Polish help to Jews; and the competing images of Polish and Jewish suffering during World War II. Those conflicts will be addressed in the paper as reflecting educational gaps in the Polish education system (lack of bad memory). This paper will look at the consciousness of young Poles, in terms of attitudes toward Jews, the Holocaust and memory of the Holocaust. The data presented are the preliminary results of the author’s longitudinal study „Attitudes of Young Poles toward the Jews and the Holocaust”. Quantitative and qualitative studies include field studies and participant observation of educational projects in Tykocin, Treblinka, Warsaw, Lublin, Bodzentyn and Kielce. The paper will present some components of the development of education about the Holocaust in Poland. There is a need to evaluate the attempt to bring back the memory of Jewish neighbours in some of the states of Central and Eastern Europe, a process with an ongoing effort to renovate monuments, destroyed cemeteries and synagogues. The number and scope of such initiatives in Poland indicate that civic institutions and individuals are intensifying their efforts to teach their fellow citizens about the Holocaust, however their impact should be assessed in detail.

Family Preservation Services to At-Risk Families: A Macro Case Study

Although the literature has provided many critiques of research done on family preservation programs, these critiques have usually been limited to the studies ' assumptions, approach, or methodology. Because of the nature of these critiques, suggestions for future research in this field of practice have been scattered throughout the literature and have not benefited from a wider historical perspective. This paper examines the historical evolution of family preservation studies in child welfare and suggests future directions for research in the field. Among the suggestions the authors posit are (1) research questions should be framed by what we know about improvements in the lives of families and children served by family preservation programs; (2) future explorations should include areas that have received relatively little attention in current research, including the impact of organizational conditions on service fidelity and worker performance; (3) newer treatment models, particularly those that provide both intensive services during a crisis period and less intensive services for maintenance, should be tested; (4) data collection points in longitudinal studies should be guided by theory, and measures should change over time to reflect the theoretically expected changes in families; (5) complex measures of placement prevention and other measures that capture changes in family functioning, child well-being, and child safety, should be utilized to obtain a full picture of program effects; and (6) multiple informants should be used to provide data about program effectiveness. In addition, the authors will argue that the field should carefully consider the amount of change that should be expected from the service models delivered.

Network Dynamics in Natural Resource Governance: A Case Study of Swiss Landscape Management

Structural characteristics of social networks have been recognized as important factors of effective natural resource governance. However, network analyses of natural resource governance most often remain static, even though governance is an inherently dynamic process. In this article, we investigate the evolution of a social network of organizational actors involved in the governance of natural resources in a regional nature park project in Switzerland. We ask how the maturation of a governance network affects bonding social capital and centralization in the network. Applying separable temporal exponential random graph modeling (STERGM), we test two hypotheses based on the risk hypothesis by Berardo and Scholz (2010) in a longitudinal setting. Results show that network dynamics clearly follow the expected trend toward generating bonding social capital but do not imply a shift toward less hierarchical and more decentralized structures over time. We investigate how these structural processes may contribute to network effectiveness over time.

Case study on mobile applications UX: effect of the usage of a crosss-platform development framework

Cross-platform development frameworks for mobile applications promise important advantages in cost cuttings and easy maintenance, posing as a very good option for organizations interested in the design of mobile applications for several platforms. Given that platform conventions are especially important for the User eXperience (UX) of mobile applications, the usage of framework where the same code defines the behavior of the app in different platforms could have negative impact in the UX. The objetive of this study is comparing the cross-platform and the native approach for being able to determine if the selected development approach has any impact on the users in terms of UX. To be able to set a base line under this subject, study on cross-platform frameworks was performed to select the most appropriate one from a UX point of view. In order to achieve the objectives of this work, two development teams have developed two versions of the same application; one using framework that generates Android and iOS versions automatically, and another team developing native versions of the same application. The alternative versions for each platform have been evaluated with 37 users with a combination of a laboratory usability test and a longitudinal study. The results show that differences are minimal in the Android version, but in iOS, even if a reasonable good UX can be obtained with the usage of this framework by an UX-conscious design team, a higher level of UX can be obtained directly developing in native code.

A case study on cross-platform development frameworks for mobile applications and UX

Cross-platform development frameworks for mobile applications promise important advantages in cost cuttings and easy maintenance, posing as a very good option for organizations interested in the design of mobile applications for several platforms. Given that platform conventions are especially important for the User eXperience (UX) of mobile applications, the usage of a framework where the same code defines the behavior of the app in different platforms could have a negative impact in the UX. This paper describes a study where two independent teams have designed two different versions of a mobile application, one using a framework that generates Android and iOS versions automatically, and another team using native tools. The alternative versions for each platform have been evaluated with 37 users with a combination of a laboratory usability test and a longitudinal study. The results show that differences are minimal in the Android platform, but in iOS, even if a reasonably good UX can be obtained with the usage of this framework by an UX-conscious design team, a higher level of UX can be obtained directly developing with a native tool.

Phase progression throughout the therapeutic process : longitudinal case studies

Tese de doutoramento, Psicologia (Psicologia Clínica), Universidade de Lisboa, Faculdade de Psicologia, 2016

The efficiency of four transtibial suspension systems: a malformation case study

This work was developed in the form of a case study to measure the efficiency of gait and conclude if the tested suspension systems differ in the efficiency in a various tested transtibial prostheses,based on the data provided by radiologic images, indirect calorimetry and perception of the patient. Introduction - The suspension system and the stump adjustment to the socket plays an important role in the functionality of the prosthesis, the mobility of the amputee and overall satisfaction with the device. The comfort and functional effectiveness of the prosthesis are closely related. The harmony between the residual limb and prosthesis is crucial to that this meets its function and enable effective March and allow the amputated the continuity of their Daily day activities, keeping the stump functional. Comfort and functional effectiveness of the prosthesis are closely related, suspension systems should prevent excessive longitudinal and rotational transverse displacement of the stump within the socket, these systems should help stabilize and enhance the connection of the prosthesis to the residual limb, reducing the pistonning, increased proprioception and providing a more natural gait.

Depositional conditions on an alluvial fan at the turn of the Weichselian to the Holocene – a case study in the Żmigród Basin, southwest Poland

Presented are the results of research into the fluvio-aeolian sedimentary succession at the site of Postolin in the Żmigród Basin, southwest Poland. Based on lithofacies analysis, textural analysis, Thermoluminescence and Infrared-Optical Stimulated Luminescence dating and GIS analysis, three lithofacies units were recognised and their stratigraphic suc- cession identified: 1) the lower unit was deposited during the Pleni-Weichselian within a sand-bed braided river fun- ctioning under permafrost conditions within the central part of the alluvial fan; 2) the middle unit is the result of aeolian deposition and fluvial redeposition on the surface of the fan during long-term permafrost and progressive decrease of humidity of the climate at the turn of the Pleni- to the Late Weichselian; 3) the upper unit accumulated following the development of longitudinal dunes at the turn of the Late Weichselian to the Holocene; the development of dunes was interrupted twice by the form being stabilised by vegetation and soil development.