Parametric preference functionals under risk in the gain domain: a Bayesian analysis

The performance of rank dependent preference functionals under risk is comprehensively evaluated using Bayesian model averaging. Model comparisons are made at three levels of heterogeneity plus three ways of linking deterministic and stochastic models: the differences in utilities, the differences in certainty equivalents and contextualutility. Overall, the"bestmodel", which is conditional on the form of heterogeneity is a form of Rank Dependent Utility or Prospect Theory that cap tures the majority of behaviour at both the representative agent and individual level. However, the curvature of the probability weighting function for many individuals is S-shaped, or ostensibly concave or convex rather than the inverse S-shape commonly employed. Also contextual utility is broadly supported across all levels of heterogeneity. Finally, the Priority Heuristic model, previously examined within a deterministic setting, is estimated within a stochastic framework, and allowing for endogenous thresholds does improve model performance although it does not compete well with the other specications considered.

Adding a treatment arm to an ongoing clinical trial: a review of methodology and practice

Incorporating an emerging therapy as a new randomisation arm in a clinical trial that is open to recruitment would be desirable to researchers, regulators and patients to ensure that the trial remains current, new treatments are evaluated as quickly as possible, and the time and cost for determining optimal therapies is minimised. It may take many years to run a clinical trial from concept to reporting within a rapidly changing drug development environment; hence, in order for trials to be most useful to inform policy and practice, it is advantageous for them to be able to adapt to emerging therapeutic developments. This paper reports a comprehensive literature review on methodologies for, and practical examples of, amending an ongoing clinical trial by adding a new treatment arm. Relevant methodological literature describing statistical considerations required when making this specific type of amendment is identified, and the key statistical concepts when planning the addition of a new treatment arm are extracted, assessed and summarised. For completeness, this includes an assessment of statistical recommendations within general adaptive design guidance documents. Examples of confirmatory ongoing trials designed within the frequentist framework that have added an arm in practice are reported; and the details of the amendment are reviewed. An assessment is made as to how well the relevant statistical considerations were addressed in practice, and the related implications. The literature review confirmed that there is currently no clear methodological guidance on this topic, but that guidance would be advantageous to help this efficient design amendment to be used more frequently and appropriately in practice. Eight confirmatory trials were identified to have added a treatment arm, suggesting that trials can benefit from this amendment and that it can be practically feasible; however, the trials were not always able to address the key statistical considerations, often leading to uninterpretable or invalid outcomes. If the statistical concepts identified within this review are considered and addressed during the design of a trial amendment, it is possible to effectively assess a new treatment arm within an ongoing trial without compromising the original trial outcomes.

Training on the use of a bespoke continuing professional development framework improves the quality of CPD records

BACKGROUND: Using continuing professional development (CPD) as part of the revalidation of pharmacy professionals has been proposed in the UK but not implemented. We developed a CPD Outcomes Framework (‘the framework’) for scoring CPD records, where the score range was -100 to +150 based on demonstrable relevance and impact of the CPD on practice. OBJECTIVE: This exploratory study aimed to test the outcome of training people to use the framework, through distance-learning material (active intervention), by comparing CPD scores before and after training. SETTING: Pharmacy professionals were recruited in the UK in Reading, Banbury, Southampton, Kingston-upon-Thames and Guildford in 2009. METHOD: We conducted a randomised, double-blinded, parallel-group, before and after study. The control group simply received information on new CPD requirements through the post; the active intervention group also received the framework and associated training. Altogether 48 participants (25 control, 23 active) completed the study. All participants submitted CPD records to the research team before and after receiving the posted resources. The records (n=226) were scored blindly by the researchers using the framework. A subgroup of CPD records (n=96) submitted first (before-stage) and rewritten (after-stage) were analysed separately. MAIN OUTCOME MEASURE: Scores for CPD records received before and after distributing group-dependent material through the post. RESULTS: Using a linear-regression model both analyses found an increase in CPD scores in favour of the active intervention group. For the complete set of records, the effect was a mean difference of 9.9 (95% CI = 0.4 to 19.3), p-value = 0.04. For the subgroup of rewritten records, the effect was a mean difference of 17.3 (95% CI = 5.6 to 28.9), p-value = 0.0048. CONCLUSION: The intervention improved participants’ CPD behaviour. Training pharmacy professionals to use the framework resulted in better CPD activities and CPD records, potentially helpful for revalidation of pharmacy professionals. IMPACT: • Using a bespoke Continuing Professional Development outcomes framework improves the value of pharmacy professionals’ CPD activities and CPD records, with the potential to improve patient care. • The CPD outcomes framework could be helpful to pharmacy professionals internationally who want to improve the quality of their CPD activities and CPD records. • Regulators and officials across Europe and beyond can assess the suitability of the CPD outcomes framework for use in pharmacy CPD and revalidation in their own setting.

Social connection and practice-dependence: some recent developments in the global justice literature

This review essay discusses two recent attempts to reform the framework in which issues of international and global justice are discussed: Iris Marion Young’s ‘social connection’ model and the practice-dependent approach, here exemplified by Ayelet Banai, Miriam Ronzoni and Christian Schemmel’s edited collection. I argue that while Young’s model may fit some issues of international or global justice, it misconceives the problems that many of them pose. Indeed, its difficulties point precisely in the direction of practice dependence as it is presented by Banai et al. I go on to discuss what seem to be the strengths of that method, and particularly Banai et al.’s defence of it against the common claim that it is biased towards the status quo. I also discuss Andrea Sangiovanni and Kate MacDonald’s contributions to the collection.

A Computer Vision Framework For Finger-Tapping Evaluation In Parkinson's Disease

Objective: To define and evaluate a Computer-Vision (CV) method for scoring Paced Finger-Tapping (PFT) in Parkinson's disease (PD) using quantitative motion analysis of index-fingers and to compare the obtained scores to the UPDRS (Unified Parkinson's Disease Rating Scale) finger-taps (FT). Background: The naked-eye evaluation of PFT in clinical practice results in coarse resolution to determine PD status. Besides, sensor mechanisms for PFT evaluation may cause patients discomfort. In order to avoid cost and effort of applying wearable sensors, a CV system for non-invasive PFT evaluation is introduced. Methods: A database of 221 PFT videos from 6 PD patients was processed. The subjects were instructed to position their hands above their shoulders besides the face and tap the index-finger against the thumb consistently with speed. They were facing towards a pivoted camera during recording. The videos were rated by two clinicians between symptom levels 0-to-3 using UPDRS-FT. The CV method incorporates a motion analyzer and a face detector. The method detects the face of testee in each video-frame. The frame is split into two images from face-rectangle center. Two regions of interest are located in each image to detect index-finger motion of left and right hands respectively. The tracking of opening and closing phases of dominant hand index-finger produces a tapping time-series. This time-series is normalized by the face height. The normalization calibrates the amplitude in tapping signal which is affected by the varying distance between camera and subject (farther the camera, lesser the amplitude). A total of 15 features were classified using K-nearest neighbor (KNN) classifier to characterize the symptoms levels in UPDRS-FT. The target ratings provided by the raters were averaged. Results: A 10-fold cross validation in KNN classified 221 videos between 3 symptom levels with 75% accuracy. An area under the receiver operating characteristic curves of 82.6% supports feasibility of the obtained features to replicate clinical assessments. Conclusions: The system is able to track index-finger motion to estimate tapping symptoms in PD. It has certain advantages compared to other technologies (e.g. magnetic sensors, accelerometers etc.) for PFT evaluation to improve and automate the ratings

Vocational English in policy and practice

The aim of this licentiate thesis is to examine how, and in what ways, vocational English is a part of English language teaching in the Building and Construc­tion Programme in Sweden, and what the influences are for such pedagogy. The main research question is how policy documents relate to the views of teachers and their educational practice regarding vocational English. The study consists of two parts: a textual policy analysis of the three latest upper secondary school reforms in Sweden (Lgy 70, Lpf 94, and Gy 2011), and semi-structured interviews with practicing English teachers in the Building and Construction Programme. The interviews are categorised by using Spradley’s (1979) semantic relationships and taxonomies. Balls’ (Ball, 1993) and Ozga’s (1990; 2000) concept of policy enactment is used in the analysis as well as Bernstein’s (1990; 2000) theoretical framework of classification, framing, and horizontal and vertical discourse. The results show that five of the six teachers in the interviews work with vocational English in some way. The study also shows that there is a distinct gap between policy and practice. Several of the teachers have the notion that they are supposed to work with vocational English and that it must be written down in policy somewhere. The greatest influence on the teaching for these teachers are their students, either indirectly or directly. Further, the study shows that different frame factors such as time poverty hinders the teachers from reading policy texts and cooperating with the vocational teachers in the Building and Construction Programme.

Knowledge translation in Uganda : a qualitative study of Ugandan midwives' and managers' perceived relevance of the sub-elements of the context cornerstone in the PARIHS framework

BACKGROUND: A large proportion of the annual 3.3 million neonatal deaths could be averted if there was a high uptake of basic evidence-based practices. In order to overcome this 'know-do' gap, there is an urgent need for in-depth understanding of knowledge translation (KT). A major factor to consider in the successful translation of knowledge into practice is the influence of organizational context. A theoretical framework highlighting this process is Promoting Action on Research Implementation in Health Services (PARIHS). However, research linked to this framework has almost exclusively been conducted in high-income countries. Therefore, the objective of this study was to examine the perceived relevance of the subelements of the organizational context cornerstone of the PARIHS framework, and also whether other factors in the organizational context were perceived to influence KT in a specific low-income setting. METHODS: This qualitative study was conducted in a district of Uganda, where focus group discussions and semi-structured interviews were conducted with midwives (n = 18) and managers (n = 5) within the catchment area of the general hospital. The interview guide was developed based on the context sub-elements in the PARIHS framework (receptive context, culture, leadership, and evaluation). Interviews were transcribed verbatim, followed by directed content analysis of the data. RESULTS: The sub-elements of organizational context in the PARIHS framework--i.e., receptive context, culture, leadership, and evaluation--also appear to be relevant in a low-income setting like Uganda, but there are additional factors to consider. Access to resources, commitment and informal payment, and community involvement were all perceived to play important roles for successful KT. CONCLUSIONS: In further development of the context assessment tool, assessing factors for successful implementation of evidence in low-income settings--resources, community involvement, and commitment and informal payment--should be considered for inclusion. For low-income settings, resources are of significant importance, and might be considered as a separate subelement of the PARIHS framework as a whole.

Local politico-administrative perspectives on quality improvement based on national registry data in Sweden : a qualitative study using the Consolidated Framework for Implementation Research.

Background. Through a national policy agreement, over 167 million Euros will be invested in the Swedish National Quality Registries (NQRs) between 2012 and 2016. One of the policy agreement¿s intentions is to increase the use of NQR data for quality improvement (QI). However, the evidence is fragmented as to how the use of medical registries and the like lead to quality improvement, and little is known about non-clinical use. The aim was therefore to investigate the perspectives of Swedish politicians and administrators on quality improvement based on national registry data. Methods. Politicians and administrators from four county councils were interviewed. A qualitative content analysis guided by the Consolidated Framework for Implementation Research (CFIR) was performed. Results. The politicians and administrators perspectives on the use of NQR data for quality improvement were mainly assigned to three of the five CFIR domains. In the domain of intervention characteristics, data reliability and access in reasonable time were not considered entirely satisfactory, making it difficult for the politico-administrative leaderships to initiate, monitor, and support timely QI efforts. Still, politicians and administrators trusted the idea of using the NQRs as a base for quality improvement. In the domain of inner setting, the organizational structures were not sufficiently developed to utilize the advantages of the NQRs, and readiness for implementation appeared to be inadequate for two reasons. Firstly, the resources for data analysis and quality improvement were not considered sufficient at politico-administrative or clinical level. Secondly, deficiencies in leadership engagement at multiple levels were described and there was a lack of consensus on the politicians¿ role and level of involvement. Regarding the domain of outer setting, there was a lack of communication and cooperation between the county councils and the national NQR organizations. Conclusions. The Swedish experiences show that a government-supported national system of well-funded, well-managed, and reputable national quality registries needs favorable local politico-administrative conditions to be used for quality improvement; such conditions are not yet in place according to local politicians and administrators.

Activity modeling in practice: a case-based guide to human-centered software engineering

The purpose of this study was to identify whether activity modeling framework supports problem analysis and provides a traceable and tangible connection from the problem identification up to solution modeling. Methodology validation relied on a real problem from a Portuguese teaching syndicate (ASPE), regarding courses development and management. The study was carried out with a perspective to elaborate a complete tutorial of how to apply activity modeling framework to a real world problem. Within each step of activity modeling, we provided a summary elucidation of the relevant elements required to perform it, pointed out some improvements and applied it to ASPE’s real problem. It was found that activity modeling potentiates well structured problem analysis as well as provides a guiding thread between problem and solution modeling. It was concluded that activity-based task modeling is key to shorten the gap between problem and solution. The results revealed that the solution obtained using activity modeling framework solved the core concerns of our customer and allowed them to enhance the quality of their courses development and management. The principal conclusion was that activity modeling is a properly defined methodology that supports software engineers in problem analysis, keeping a traceable guide among problem and solution.

O Gênero requerimento na perspectiva sociorretórica: análise da produção de graduandos no ambiente acadêmico-administrativo da UFRN

In administrative settings of public institutions, many activities are conducted through writing practices. Concerning this, writing is always connected to an activity we intend to perform. Among those practices, the genre request consists of an instrument through which the requirer addresses to an institution in order to request something under the support of legislation. Considering our work experience in a public institution of higher education, we elected - as object of our research - the genre request produced by undergraduates within the administrative domain of the Federal University of Rio Grande do Norte (UFRN) due to its importance in this context. For this, the theoretical framework adopted refers to the socio-rethorical conception of genre studies, which understands the genre as forms as rhetorically typified action (MILLER, 2009a; SWALES, 1990; BAZERMAN, 2009). Regarding methodology, it is a research associated to a qualitative approach (BODGAN; BIKLEN, 1994; CHIZZOTTI, 2010) whose discussion inserts into the field of Applied Linguistics. The data were generated from samples of requests and their users replies in questionnaires, interviews and verbal protocols of writing. The data analysis is based on the ethnographic methods of genre analysis postulated by Devitt, Reiff and Bawarshi (apud JOHNS et al., 2006). These analyses indicated that the requests are not always fully accomplished due to a lack of comprehension about the genre and its rhetorical situation on the part of the producers. It must probably happen - among other reasons - because these students may not have understood that several factors, such as: context, audience and purpose, affect the text production. We believe that one possibility to make the practice of this genre more efficient is to develop a more simple and practical way of elaborating requests, taking the needs imposed by the rhetorical situation as a basis

Análise textual dos discursos: responsabilidade enunciativa no texto jurídico

This investigation aims at describing, analyzing and interpreting the Commitment in Initial Petitions, which is a genre circumscribed in the judicial domain. For this purpose, we have chosen sections, facts as found and relevant law , sections of the petition, with the understanding that, in this way, respectively, the narration of events, which gives margin to the propositioning to the judicial action, and the exposition of the law that upholds the author s intention. We base our discussion on the field of Linguistics, more precisely, Textual Discourse Analysis (TDA), whose theoretical basis is derived from Textual Linguistics (TL) and Enunciative Linguistics. We foreground, particularly, the way in which the author of texts, objects of analysis, use discursive strategies that evidence ER. The relevance of this study, then, is in the formation of a critique of the judicial text, as it conceives of a dialogical approach to the point of view, raising not only questions about the way in which a linguistic instance conceives an object of discourse, but also considering questions of language inherent to technical writing and, in this aspect, contributing to the work of those operating in Law about the many ways ER is formed in the body of a petition. We selected two categories to analyze that, according to Adam (2011), characterize the degree of ER in the textual material of the propositional enunciations: the different types of representation of speech and the indications of profile of mediators. In this sense, with this task as an objective, we base our study regarding point of view on Rabatel (2003, 2009a, 2010) with relation to the enunciative approach, including the study of PDV in polyphonic and dialogical theoretical framework to study the ER from different types of speech representations that conceive forms of transmission of discourse and the role of the enunciating subject, mainly the responsibility and the prerogative by the propositional contents. In the same way, intending to study the indications of the mediator profiles, we observed the postulations of Guentchéva (1994, 1996), which develop the notion of mediative grammatical categories, of which permit the linguistic marking of distance and engagement of the enunciator with regard to the information expressed. The methodology we adopted was based on qualitative research, of an interpretive and introspective nature, in light of the fact that his study focuses on processes and strategies underlying language use. The corpus of the research is comprised of Initial Petitions, which gave rise to actions originating in the Civil Court of Currais Novos County RN. The data analysis shows that an object of discourse is always perspective oriented and presents the point of view of one or more enunciators. Consequently, the producer of a text, using the PDV of other enunciators, influences and establishes the argumentative orientation of the text. In the same way, it evidences the relevance of the use of mediated constructions in the judicial text, as they function as strategies attenuated to the responsibility of the producer of the text with what is said, and at the same time points to a discourse of authority through the entrance of the sources of law. Moreover, it reveals the documental and international importance of this practice, at the same time that it exposes the compositional and normative difficulties with regard to legal and linguistic aspects

Um framework baseado em modelos para desenvolvimento de sistemas multimídia distribuídos autoadaptativos

Distributed multimedia systems have highly variable characteristics, resulting in new requirements while new technologies become available or in the need for adequacy in accordance with the amount of available resources. So, these systems should provide support for dynamic adaptations in order to adjust their structures and behaviors at runtime. This paper presents an approach to adaptation model-based and proposes a reflective and component-based framework for construction and support of self-adaptive distributed multimedia systems, providing many facilities for the development and evolution of such systems, such as dynamic adaptation. The propose is to keep one or more models to represent the system at runtime, so some external entity can perform an analysis of these models by identifying problems and trying to solve them. These models integrate the reflective meta-level, acting as a system self-representation. The framework defines a meta-model for description of self-adaptive distributed multimedia applications, which can represent components and their relationships, policies for QoS specification and adaptation actions. Additionally, this paper proposes an ADL and architecture for model-based adaptation. As a case study, this paper presents some scenarios to demonstrate the application of the framework in practice, with and without the use of ADL, as well as check some characteristics related to dynamic adaptation

Um framework de agentes de recomendação para sistemas Web

The World Wide Web has been consolidated over the last years as a standard platform to provide software systems in the Internet. Nowadays, a great variety of user applications are available on the Web, varying from corporate applications to the banking domain, or from electronic commerce to the governmental domain. Given the quantity of information available and the quantity of users dealing with their services, many Web systems have sought to present recommendations of use as part of their functionalities, in order to let the users to have a better usage of the services available, based on their profile, history navigation and system use. In this context, this dissertation proposes the development of an agent-based framework that offers recommendations for users of Web systems. It involves the conception, design and implementation of an object-oriented framework. The framework agents can be plugged or unplugged in a non-invasive way in existing Web applications using aspect-oriented techniques. The framework is evaluated through its instantiation to three different Web systems

Educação de professores da universidade no contexto de interação universidade-escola

Este artigo apresenta resultados de uma pesquisa sobre a formação de professores da universidade que atuam em licenciaturas de Física, Biologia e Matemática, procurando compreendê-la a partir de sua participação em um projeto de formação continuada de professores da rede pública de ensino. O referencial teórico, apoiado em Pierre Bourdieu e Paulo Freire, possibilitou a constituição de instrumentos para caracterizar o processo de formação como construção coletiva de uma estrutura formativa. Para isso, foi necessário considerar tanto a interação de professores da universidade entre si como aquela entre eles e os professores da escola. Os resultados revelaram que o envolvimento dos professores da universidade no projeto possibilitou-lhes a produção de conhecimento em um domínio para o qual normalmente não são chamados a fazê-lo, na prática da vida universitária, a saber: a docência.

Ceramic materials in dentistry: historical evolution and current practice

Dental ceramics are presented within a simplifying framework allowing for facile understanding of their development, composition and indications. Engineering assessments of clinical function are dealt with and literature is reviewed on the clinical behaviour of all-ceramic systems. Practical aspects are presented regarding the choice and use of dental ceramics to maximize aesthetics and durability, emphasizing what we know and how we know it.