A critical evaluation of contrast susceptibility as a predictor of driving accident involvement

Contrast susceptibility is defined as the difference in visual acuity recorded for high and low contrast optotypes. Other researchers refer to this parameter as "normalised low contrast acuity". Pilot surveys have revealed that contrast susceptibility deficits are more strongly related to driving accident involvement than are deficits in high contrast visual acuity. It has been hypothesised that driving situation avoidance is purely based upon high contrast visual acuity. Hence, the relationship between high contrast visual acuity and accidents is masked by situation avoidance whilst drivers with contrast susceptibility deficits remain prone to accidents in poor visibility conditions. A national survey carried out to test this hypothesis provided no support for either the link between contrast susceptibility deficits and accidents involvement or the proposed hypothesis. Further, systematically worse contrast susceptibility scores emerged from vision screeners compared to wall mounted test charts. This discrepancy was not due to variations in test luminance or instrument myopia. Instead, optical imperfections inherent in vision screeners were considered to be responsible. Although contrast susceptibility is unlikely to provide a useful means of screening drivers' vision, previous research does provide support for its ability to detect visual deficits that may influence everyday tasks. In this respect, individual contrast susceptibility variations were found to reflect variations in the contrast sensitivity function - a parameter that provides a global estimate of human contrast sensitivity.

A comparison of the impact of avoidance cues in hazard avoidance during evaluation of text entry

The research presented in this paper is part of an ongoing investigation into how best to support meaningful lab-based evaluations of mobile technologies. In our previous work, we developed a hazard avoidance system for use during lab evaluations [1]; in the work reported here, we further assess the impact of this system, specifically in terms of the effect of avoidance cue type on speech-based text entry tasks.

Modelling in the evaluation of a manufacturing strategy

This thesis describes research that has developed the principles of a modelling tool for the analytical evaluation of a manufacturing strategy. The appropriate process of manufacturing strategy formulation is based on mental synthesis with formal planning processes supporting this role. Inherent to such processes is a stage where the effects of alternative strategies on the performance of a manufacturing system must be evaluated so that a choice of preferred strategy can be made. Invariably this evaluation is carried out by practitioners applying mechanisms of judgement, bargaining and analysis. Ibis thesis makes a significant and original contribution to the provision of analytical support for practitioners in this role. The research programme commences by defining the requirements of analytical strategy evaluation from the perspective of practitioners. A broad taxonomy of models has been used to identify a set of potentially suitable techniques for the strategy evaluation task. Then, where possible, unsuitable modelling techniques have been identified on the basis of evidence in the literature and discarded from this set. The remaining modelling techniques have been critically appraised by testing representative contemporary modelling tools in an industrially based experimentation programme. The results show that individual modelling techniques exhibit various limitations in the strategy evaluation role, though some combinations do appear to provide the necessary functionality. On the basis of this comprehensive and in-depth knowledge a modelling tool ' has been specifically designed for this task. Further experimental testing has then been conducted to verify the principles of this modelling tool. Ibis research has bridged the fields of manufacturing strategy formulation and manufacturing systems modelling and makes two contributions to knowledge. Firstly, a comprehensive and in-depth platform of knowledge has been established about modelling techniques in manufacturing strategy evaluation. Secondly, the principles of a tool that supports this role have been formed and verified.

Pulse oximetry screening for congenital heart defects in newborn infants:an evaluation of acceptability to mothers

Background: Introducing neonatal screening procedures may not be readily accepted by parents and may increase anxiety. The acceptability of pulse oximetry screening to parents has not been previously reported. Objective: To assess maternal acceptability of pulse oximetry screening for congenital heart defects and to identify factors predictive of participation in screening. Design and setting: A questionnaire was completed by a cross-sectional sample of mothers whose babies were recruited into the PulseOx Study which investigated the test accuracy of pulse oximetry screening. Participants: A total of 119 mothers of babies with false-positive (FP) results, 15 with true-positive and 679 with true-negative results following screening. Main outcome measures: Questionnaires included measures of satisfaction with screening, anxiety, depression and perceptions of test results. Results: Participants were predominantly satisfied with screening. The anxiety of mothers given FP results was not significantly higher than that of mothers given true-negative results (median score 32.7 vs 30.0, p=0.09). White British/Irish mothers were more likely to participate in screening, with a decline rate of 5%; other ethnic groups were more likely to decline with the largest increase in declining being for Black African mothers (21%, OR 4.6, 95% CI 3.8 to 5.5). White British mothers were also less anxious (p<0.001) and more satisfied (p<0.001) than those of other ethnicities Conclusions: Pulse oximetry screening was acceptable to mothers and FP results were not found to increase anxiety. Factors leading to differences in participation and satisfaction across ethnic groups need to be identified so that staff can support parents appropriately.

A comparison of the impact of avoidance cues in hazard avoidance during evaluation of text entry

The research presented in this paper is part of an ongoing investigation into how best to support meaningful lab-based evaluations of mobile technologies. In our previous work, we developed a hazard avoidance system for use during lab evaluations [1]; in the work reported here, we further assess the impact of this system, specifically in terms of the effect of avoidance cue type on speech-based text entry tasks.

Finding qualitative research: an evaluation of search strategies

Background Qualitative research makes an important contribution to our understanding of health and healthcare. However, qualitative evidence can be difficult to search for and identify, and the effectiveness of different types of search strategies is unknown. Methods Three search strategies for qualitative research in the example area of support for breast-feeding were evaluated using six electronic bibliographic databases. The strategies were based on using thesaurus terms, free-text terms and broad-based terms. These strategies were combined with recognised search terms for support for breast-feeding previously used in a Cochrane review. For each strategy, we evaluated the recall (potentially relevant records found) and precision (actually relevant records found). Results A total yield of 7420 potentially relevant records was retrieved by the three strategies combined. Of these, 262 were judged relevant. Using one strategy alone would miss relevant records. The broad-based strategy had the highest recall and the thesaurus strategy the highest precision. Precision was generally poor: 96% of records initially identified as potentially relevant were deemed irrelevant. Searching for qualitative research involves trade-offs between recall and precision. Conclusions These findings confirm that strategies that attempt to maximise the number of potentially relevant records found are likely to result in a large number of false positives. The findings also suggest that a range of search terms is required to optimise searching for qualitative evidence. This underlines the problems of current methods for indexing qualitative research in bibliographic databases and indicates where improvements need to be made.

Accommodating special needs users in the evaluation of an m-Learning application:a case study

Adult illiteracy rates are alarmingly high worldwide. The portability, affordability, and ease of use of mobile (or handheld) devices offer a realistic opportunity to provide novel, context-sensitive literacy resources to adults with limited literacy skills. To this end, we developed the concept of ALEX – a mobile Adult Literacy support application for EXperiential learning (Lumsden et al., 2005). On the basis of a medium-fidelity prototype of this application, we conducted an evaluation of ALEX using participants from our in tended user group. This evaluation had two goals: (a) to assess the usefulness of the ALEX concept and the usability of its current design; and (b) to reflect on the appropriateness of our evaluation process given the literacy-related needs of our participants. This paper outlines our approach to this evaluation as well as the results we obtained and our reflections on the process.

Modelling in the evaluation of a manufacturing strategy

This thesis describes research that has developed the principles of a modelling tool for the analytical evaluation of a manufacturing strategy. The appropriate process of manufacturing strategy formulation is based on mental synthesis with formal planning processes supporting this role. Inherent to such processes is a stage where the effects of alternative strategies on the performance of a manufacturing system must be evaluated so that a choice of preferred strategy can be made. Invariably this evaluation is carried out by practitioners applying mechanisms of judgement, bargaining and analysis. Ibis thesis makes a significant and original contribution to the provision of analytical support for practitioners in this role. The research programme commences by defining the requirements of analytical strategy evaluation from the perspective of practitioners. A broad taxonomy of models has been used to identify a set of potentially suitable techniques for the strategy evaluation task. Then, where possible, unsuitable modelling techniques have been identified on the basis of evidence in the literature and discarded from this set. The remaining modelling techniques have been critically appraised by testing representative contemporary modelling tools in an industrially based experimentation programme. The results show that individual modelling techniques exhibit various limitations in the strategy evaluation role, though some combinations do appear to provide the necessary functionality. On the basis of this comprehensive and in-depth knowledge a modelling tool ' has been specifically designed for this task. Further experimental testing has then been conducted to verify the principles of this modelling tool. Ibis research has bridged the fields of manufacturing strategy formulation and manufacturing systems modelling and makes two contributions to knowledge. Firstly, a comprehensive and in-depth platform of knowledge has been established about modelling techniques in manufacturing strategy evaluation. Secondly, the principles of a tool that supports this role have been formed and verified.

Modelling in the evaluation of a manufacturing strategy

This thesis describes research that has developed the principles of a modelling tool for the analytical evaluation of a manufacturing strategy. The appropriate process of manufacturing strategy formulation is based on mental synthesis with formal planning processes supporting this role. Inherent to such processes is a stage where the effects of alternative strategies on the performance of a manufacturing system must be evaluated so that a choice of preferred strategy can be made. Invariably this evaluation is carried out by practitioners applying mechanisms of judgement, bargaining and analysis. Ibis thesis makes a significant and original contribution to the provision of analytical support for practitioners in this role. The research programme commences by defining the requirements of analytical strategy evaluation from the perspective of practitioners. A broad taxonomy of models has been used to identify a set of potentially suitable techniques for the strategy evaluation task. Then, where possible, unsuitable modelling techniques have been identified on the basis of evidence in the literature and discarded from this set. The remaining modelling techniques have been critically appraised by testing representative contemporary modelling tools in an industrially based experimentation programme. The results show that individual modelling techniques exhibit various limitations in the strategy evaluation role, though some combinations do appear to provide the necessary functionality. On the basis of this comprehensive and in-depth knowledge a modelling tool ' has been specifically designed for this task. Further experimental testing has then been conducted to verify the principles of this modelling tool. Ibis research has bridged the fields of manufacturing strategy formulation and manufacturing systems modelling and makes two contributions to knowledge. Firstly, a comprehensive and in-depth platform of knowledge has been established about modelling techniques in manufacturing strategy evaluation. Secondly, the principles of a tool that supports this role have been formed and verified.

GPs' perspectives on managing the NHS Health Check in primary care:a qualitative evaluation of implementation in one area of England

OBJECTIVES: To evaluate the implementation of the National Health Service (NHS) Health Check programme in one area of England from the perspective of general practitioners (GPs). DESIGN: A qualitative exploratory study was conducted with GPs and other healthcare professionals involved in delivering the NHS Health Check and with patients. This paper reports the experience of GPs and focuses on the management of the Heath Check programme in primary care. SETTING: Primary care surgeries in the Heart of Birmingham region (now under the auspices of the Birmingham Cross City Clinical Commissioning Group) were invited to take part in the larger scale evaluation. This study focuses on a subset of those surgeries whose GPs were willing to participate. PARTICIPANTS: 9 GPs from different practices volunteered. GPs served an ethnically diverse region with areas of socioeconomic deprivation. Ethnicities of participant GPs included South Asian, South Asian British, white, black British and Chinese. METHODS: Individual semistructured interviews were conducted with GPs face to face or via telephone. Thematic analysis was used to analyse verbatim transcripts. RESULTS: Themes were generated which represent GPs' experiences of managing the NHS Health Check: primary care as a commercial enterprise; 'buy in' to concordance in preventive healthcare; following protocol and support provision. These themes represent the key issues raised by GPs. They reveal variability in the implementation of NHS Health Checks. GPs also need support in allocating resources to the Health Check including training on how to conduct checks in a concordant (or collaborative) way. CONCLUSIONS: The variability observed in this small-scale evaluation corroborates existing findings suggesting a need for more standardisation. Further large-scale research is needed to determine how that could be achieved. Work needs to be done to further develop a concordant approach to lifestyle advice which involves tailored individual goal setting rather than a paternalistic advice-giving model.

Evaluation of low vision services on the quality of life of individuals with age-related macular degeneration

Background: Age-related macular degeneration (ARMD) is a major cause of irreversible visual loss in the elderly and a significant threat to their quality of life. Although low vision services often improve the functional outcomes of individuals with macular disease, it remains unclear whether or not they have any impact on quality of life. The principal aim of this study was to determine the effect of a hospital-based low vision clinic on the quality of life of individuals with ARMD. Methods: Forty patients with ARMD attended the low vision clinic at Milton Keynes University Hospital. Quality of life was measured with the vision-specific Low Vision Quality of Life (LVQOL) questionnaire and the general health EuroQol (EQ-5D-5L) questionnaire. Measures were completed at baseline (time zero, T0), and at three- (T3) and six-month (T6) follow-up visits. Results: The near visual acuity of individuals attending the low vision clinic for the first time improved significantly between visits T0 and T3 (p=0.005), reflecting the practiced use of their newly-dispensed low vision aids. As expected, there was no significant change in near acuity over this time period for existing patients. For both new and existing patients, a significant increase in LVQOL score was evident between visits T0 and T3, with a further significant improvement between T3 and T6. Similarly, there was a significant decrease in EQ-5D-5L questionnaire scores between visits T0 and T6. Conclusions: The higher LVQOL scores obtained at the end of the study period (T6) provide evidence that low vision services at Milton Keynes University Hospital served to improve patient quality of life. The reduction in EQ-5D-5L scores over the same time period suggests that low vision services also provide for an improvement in general health-related quality of life. Impact: The findings support the cause of low vision services to improve not only the vision and functional outcomes of individuals with macular disease but also their quality of life. Moreover, the findings suggest that a more efficient allocation of resources at low vision clinics may be possible through the standardisation of patient follow-up frequency.

Evaluation of a six-week professional education curriculum designed to retain registered psychiatric nurses

During the past few years there has been a drastic shortage of registered nurses in the field. The shortage appears to have affected the field of psychiatric mental health nursing most intensely. The psychiatric nursing shortage is a multifaceted problem grounded in decreasing federal funds for advanced clinical training, inadequate undergraduate psychiatric experiences, lack of a well prepared articulate role model, the integrated curriculum and the confusion and blurring associated with the roles and functions of the psychiatric mental health nurse.^ This dissertation will describe the current nursing shortage; the decline in enrollment to nursing programs; the history of psychiatric nursing as a discipline; the shortage of psychiatric mental health nurses; factors contributing to the psychiatric nursing shortage and a plan for a solution to the nursing shortage in psychiatry.^ The paper focuses on an evaluation conducted on an internship curriculum designed to facilitate effective nursing care in the treatment of clients who exhibit emotional problems. The purpose of this study was to attract and retain nurses to employment opportunities in four Hospital Corporation of America (HCA) facilities, using a six week internship program.^ The study will yield an analysis of the effect of combining psychodynamic principles and knowledge with skills in the clinical area. The demands of educational practice have been merged with the discipline of psychiatric nursing in the development of this curriculum. ^

An evaluation of child welfare inservice training: The relative effectiveness of substance abuse content in improving worker knowledge and attitudes

Given the seriousness of substance abuse as a child welfare problem, the purpose of this study was to examine the relative effectiveness of an inservice training curriculum for child welfare workers. The training was designed to improve worker knowledge and attitudes in working with substance abusing families. Seventy (70) child welfare workers from public and private agencies in two south Florida counties participated in a pretest/posttest control group design that also trained and retested the control group. The literature review supports that the general preparedness of child welfare workers for the issues presented by substance abusing families is in question. Confounding this problem is a lack of understanding of substance abuse dynamics, worker biases, and predispositions. The two research hypotheses focused on whether inservice training could increase worker knowledge and improve worker attitudes in working with this population. Training delivery was in the form of a five-day inservice focusing on an array of substance abuse knowledge and attitudinal topics. Separate knowledge and attitude instruments were developed for the research and were administered, before and after training, to a purposive sample of participants that were randomly assigned to the experimental and control groups. The data analysis supported the research hypotheses but raised a question. Specifically, the experimental group demonstrated significant improvement in posttest scores on both instruments after receiving the training; whereas the control group, with training withheld, also demonstrated a significant improvement at posttest, but only on the knowledge instrument. Although the question was unanswered, when examined at a more critical significance level, only the experimental group remained significant. The hypotheses were reconfirmed when, after training and retesting, the control group also displayed significant improvement on both instruments. The findings support the conclusion that this substance abuse inservice was effective in improving worker knowledge and attitudes regarding working with substance abusing families. As an implication for social work practice, it suggests that similar inservice training can be a viable training resource when formal substance abuse training is unavailable. Additional research is suggested regarding to what degree increased substance abuse knowledge and improved worker attitudes correlate with improved practice.

An evaluation of English language instruction in universities/colleges in Taiwan

The purpose of this study is about to survey the effectiveness of English teaching in universities/colleges in Taiwan and provide suggestions to the educational authorities for upgrading or improving the English language teaching techniques or methods currently in use. On the one hand, the suggestions of English teachers in universities/colleges are the main concerns in this study. On the other hand, equal attention is given to the opinions and learning attitudes of the students, including the interaction between the teachers and the students.^ A social investigation methodology, consisting of questionnaire and data analysis, is devoted to this evaluation and analysis of teaching effectiveness. Among the significant findings reported in this study is the fact that both students and teachers consider evaluation of teaching effectiveness as a very important aspect of English Language programs at the university/college level. Another significant finding is that students are less concerned about the grades earned or awarded in English Language courses and more concerned about how much they learned in these classes.^ The analysis and suggestions based on the results for English teaching evaluation of universities/colleges in this dissertation can help teachers modify their teaching techniques and methods, the students to adjust their learning attitudes, and the authorities to schematize the English teaching plan that can facilitate the teaching goals to be realized. ^

Design and evaluation of a consulting system for database design

Database design is a difficult problem for non-expert designers. It is desirable to assist such designers during the problem solving process by means of a knowledge based (KB) system. A number of prototype KB systems have been proposed, however there are many shortcomings. Few have incorporated sufficient expertise in modeling relationships, particularly higher order relationships. There has been no empirical study that experimentally tested the effectiveness of any of these KB tools. Problem solving behavior of non-experts, whom the systems were intended to assist, has not been one of the bases for system design. In this project a consulting system for conceptual database design that addresses the above short comings was developed and empirically validated.^ The system incorporates (a) findings on why non-experts commit errors and (b) heuristics for modeling relationships. Two approaches to knowledge base implementation--system restrictiveness and decisional guidance--were used and compared in this project. The Restrictive approach is proscriptive and limits the designer's choices at various design phases by forcing him/her to follow a specific design path. The Guidance system approach which is less restrictive, provides context specific, informative and suggestive guidance throughout the design process. The main objectives of the study are to evaluate (1) whether the knowledge-based system is more effective than a system without the knowledge-base and (2) which knowledge implementation--restrictive or guidance--strategy is more effective. To evaluate the effectiveness of the knowledge base itself, the two systems were compared with a system that does not incorporate the expertise (Control).^ The experimental procedure involved the student subjects solving a task without using the system (pre-treatment task) and another task using one of the three systems (experimental task). The experimental task scores of those subjects who performed satisfactorily in the pre-treatment task were analyzed. Results are (1) The knowledge based approach to database design support lead to more accurate solutions than the control system; (2) No significant difference between the two KB approaches; (3) Guidance approach led to best performance; and (4) The subjects perceived the Restrictive system easier to use than the Guidance system. ^