Automatic spiral analysis for objective assessment of motor symptoms in Parkinson's disease

Objective: To develop a method for objective quantification of PD motor symptoms related to Off episodes and peak dose dyskinesias, using spiral data gathered by using a touch screen telemetry device. The aim was to objectively characterize predominant motor phenotypes (bradykinesia and dyskinesia), to help in automating the process of visual interpretation of movement anomalies in spirals as rated by movement disorder specialists. Background: A retrospective analysis was conducted on recordings from 65 patients with advanced idiopathic PD from nine different clinics in Sweden, recruited from January 2006 until August 2010. In addition to the patient group, 10 healthy elderly subjects were recruited. Upper limb movement data were collected using a touch screen telemetry device from home environments of the subjects. Measurements with the device were performed four times per day during week-long test periods. On each test occasion, the subjects were asked to trace pre-drawn Archimedean spirals, using the dominant hand. The pre-drawn spiral was shown on the screen of the device. The spiral test was repeated three times per test occasion and they were instructed to complete it within 10 seconds. The device had a sampling rate of 10Hz and measured both position and time-stamps (in milliseconds) of the pen tip. Methods: Four independent raters (FB, DH, AJ and DN) used a web interface that animated the spiral drawings and allowed them to observe different kinematic features during the drawing process and to rate task performance. Initially, a number of kinematic features were assessed including ‘impairment’, ‘speed’, ‘irregularity’ and ‘hesitation’ followed by marking the predominant motor phenotype on a 3-category scale: tremor, bradykinesia and/or choreatic dyskinesia. There were only 2 test occasions for which all the four raters either classified them as tremor or could not identify the motor phenotype. Therefore, the two main motor phenotype categories were bradykinesia and dyskinesia. ‘Impairment’ was rated on a scale from 0 (no impairment) to 10 (extremely severe) whereas ‘speed’, ‘irregularity’ and ‘hesitation’ were rated on a scale from 0 (normal) to 4 (extremely severe). The proposed data-driven method consisted of the following steps. Initially, 28 spatiotemporal features were extracted from the time series signals before being presented to a Multilayer Perceptron (MLP) classifier. The features were based on different kinematic quantities of spirals including radius, angle, speed and velocity with the aim of measuring the severity of involuntary symptoms and discriminate between PD-specific (bradykinesia) and/or treatment-induced symptoms (dyskinesia). A Principal Component Analysis was applied on the features to reduce their dimensions where 4 relevant principal components (PCs) were retained and used as inputs to the MLP classifier. Finally, the MLP classifier mapped these components to the corresponding visually assessed motor phenotype scores for automating the process of scoring the bradykinesia and dyskinesia in PD patients whilst they draw spirals using the touch screen device. For motor phenotype (bradykinesia vs. dyskinesia) classification, the stratified 10-fold cross validation technique was employed. Results: There were good agreements between the four raters when rating the individual kinematic features with intra-class correlation coefficient (ICC) of 0.88 for ‘impairment’, 0.74 for ‘speed’, 0.70 for ‘irregularity’, and moderate agreements when rating ‘hesitation’ with an ICC of 0.49. When assessing the two main motor phenotype categories (bradykinesia or dyskinesia) in animated spirals the agreements between the four raters ranged from fair to moderate. There were good correlations between mean ratings of the four raters on individual kinematic features and computed scores. The MLP classifier classified the motor phenotype that is bradykinesia or dyskinesia with an accuracy of 85% in relation to visual classifications of the four movement disorder specialists. The test-retest reliability of the four PCs across the three spiral test trials was good with Cronbach’s Alpha coefficients of 0.80, 0.82, 0.54 and 0.49, respectively. These results indicate that the computed scores are stable and consistent over time. Significant differences were found between the two groups (patients and healthy elderly subjects) in all the PCs, except for the PC3. Conclusions: The proposed method automatically assessed the severity of unwanted symptoms and could reasonably well discriminate between PD-specific and/or treatment-induced motor symptoms, in relation to visual assessments of movement disorder specialists. The objective assessments could provide a time-effect summary score that could be useful for improving decision-making during symptom evaluation of individualized treatment when the goal is to maximize functional On time for patients while minimizing their Off episodes and troublesome dyskinesias.

Nationella minoriteter i historieundervisningen : bilder av romer i Utbildningsradions program under perioden 1975-2013

In 2000 when Sweden signed the Framework Convention for the Protection of National Minorities the Roma minority became one of the acknowledged national minorities in the country. It meant that the rights of the Roma mi-nority would be safeguarded and the knowledge of its history and culture would be spread. In that context, the Swedish school, with its founded as-signment of democracy, was given an important role. The education was to communicate the multicultural values of the society and to make visible the history and culture of the Roma minority. The school books used in teaching today do not meet these demands. The view of the Roma minority given in school books is often inadequate and simplified. The present study will therefore examine a different type of edu-cational material used in schools and teaching, The Swedish Educational Broadcasting Company‟s programs of history and social studies regarding the Roma minority. Starting in postcolonial theory as well as critical dis-course analysis the study examines how the picture of the Roma cultural and ethnic identity in the Swedish Educational Broadcasting Company‟s material has been displayed and possibly changed during the period of 1975 to 2013. The results show a picture of Roma which, both in form and content, con-sists of some clearly demarcated discursive categories. The obvious continui-ty of the categories gives a picture of static and invariable Roma identity. At the same time this unambiguous picture is broken both by giving the existing discourses new meaning and also adding new discourses. The complexity and nuances become more prominent and the Roma identity is integrated in common Swedish history telling. The changes in the view of Roma, given by the Swedish Educational Broadcasting Company, can mainly be explained by the change of the Swedish immigration and minority policy and, as a conse-quence of this, the change of the school‟s mission regarding knowledge communication of Sweden as a multicultural country.

Capability outcomes from educational and ICT capability inputs : an analysis of ICT use in informal education in Kenya

In the field of Information and Communication Technologies for Development (ICT4D) ICT use in education is well studied. Education is often seen as a pre-requisite for development and ICTs are believed to aid in education, e.g. to make it more accessible and to increase its quality. In this paper we study the access and use of ICT in a study circle (SC) education program in the south coast of Kenya. The study is qualitative reporting results based on interviews and observations with SC participants, government officers and SC coordinators and teachers. The study builds on the capability approach perspective of development where individuals’ opportunities and ability to live a life that they value are focused. The aim of the study is to investigate the capability outcomes enabled through the capability inputs access and use of ICT in education as well as the factors that enabled and/or restricted the outcomes. Findings show that many opportunities have been enabled such as an increase in the ability to generate an income, learning benefits, community development and basic human development (e.g. literacy and self-confidence). However, conversion factors such as a poorly developed infrastructure and poor IT literacy prevent many of the individuals from taking full advantage of the ICT and the opportunities it enables. 

Automatic spiral analysis for objective assessment of motor symptoms in Parkinson's disease

A challenge for the clinical management of advanced Parkinson’s disease (PD) patients is the emergence of fluctuations in motor performance, which represents a significant source of disability during activities of daily living of the patients. There is a lack of objective measurement of treatment effects for in-clinic and at-home use that can provide an overview of the treatment response. The objective of this paper was to develop a method for objective quantification of advanced PD motor symptoms related to off episodes and peak dose dyskinesia, using spiral data gathered by a touch screen telemetry device. More specifically, the aim was to objectively characterize motor symptoms (bradykinesia and dyskinesia), to help in automating the process of visual interpretation of movement anomalies in spirals as rated by movement disorder specialists. Digitized upper limb movement data of 65 advanced PD patients and 10 healthy (HE) subjects were recorded as they performed spiral drawing tasks on a touch screen device in their home environment settings. Several spatiotemporal features were extracted from the time series and used as inputs to machine learning methods. The methods were validated against ratings on animated spirals scored by four movement disorder specialists who visually assessed a set of kinematic features and the motor symptom. The ability of the method to discriminate between PD patients and HE subjects and the test-retest reliability of the computed scores were also evaluated. Computed scores correlated well with mean visual ratings of individual kinematic features. The best performing classifier (Multilayer Perceptron) classified the motor symptom (bradykinesia or dyskinesia) with an accuracy of 84% and area under the receiver operating characteristics curve of 0.86 in relation to visual classifications of the raters. In addition, the method provided high discriminating power when distinguishing between PD patients and HE subjects as well as had good test-retest reliability. This study demonstrated the potential of using digital spiral analysis for objective quantification of PD-specific and/or treatment-induced motor symptoms.

Understanding the "black box" of a health-promotion program : keys to enable health among older persons aging in the context of migration

Although the need to make health services more accessible to persons who have migrated has been identified, knowledge about health-promotion programs (HPPs) from the perspective of older persons born abroad is lacking. This study explores the design experiences and content implemented in an adapted version of a group-based HPP developed in a researcher-community partnership. Fourteen persons aged 70-83 years or older who had migrated to Sweden from Finland or the Balkan Peninsula were included. A grounded theory approach guided the data collection and analysis. The findings showed how participants and personnel jointly helped raise awareness. The participants experienced three key processes that could open doors to awareness: enabling community, providing opportunities to understand and be understood, and confirming human values and abilities. Depending on how the HPP content and design are being shaped by the group, the key processes could both inhibit or encourage opening doors to awareness. Therefore, this study provides key insights into how to enable health by deepening the understanding of how the exchange of health-promoting messages is experienced to be facilitated or hindered. This study adds to the scientific knowledge base of how the design and content of HPP may support and recognize the capabilities of persons aging in the context of migration.

A Visibility Analysis of the Cape Wind Project

Cape Wind has proposed a wind farm of 130 turbines on Horseshoe Shoal in the center of Nantucket Sound. A prominent concern about the project is the impact the visibility of the turbines will have on the region's tourism industry and property values. It is feared that their presence will diminish the value of the pristine coastline that has attracted vacationers to Cape Cod for generations. In this project, we assess the extent to which Cape Cod, Martha's Vineyard, and Nantucket will be visually affected by the wind farm. It was completed using a Viewshed Analysis in the GIS program, ArcMap, from the surface, mean, and maximum height of the towers. These Viewsheds were combined to give a comprehensive perspective of which areas are able to see the highest percent of the wind farm. Finally, a weighted land use value was applied to the Viewshed to account for the impact of land use on the ability to see the project. The objective of this analysis is to provide a visual representation of how great an influence the wind farm will in fact have on Cape Cod.

A Preliminary Habitat Suitability Analysis for the Restoration of South China Tigers in the Hupingshan Reserve, China

The South China tiger, Panthera tigris amoyensis, once roamed the greater part of southern China. However, expanding human populations and other anthropogenic effects have resulted in the extinction of the wild population. The Chinese government has expressed interest in a reintroduction program for this species of tigers. Recent studies suggest that the Hupingshan preserve is potentially a good candidate for a tiger reintroduction program. Hupingshan is located on the border of the Hunan and Hubei provinces in Southern China. This study was a preliminary habitat suitability analysis, for the restoration of South China tigers in the Hupingshan reserve, China. ArcGIS 9.0 was used to develop a model that combined roads, railroads, slope, land cover, park classification, and population density. The tiger habitat suitability analysis was performed by weighting and combining the various layers. Preliminary results suggest that the Hupingshan reserve is suitable habitat for the reintroduction of South China tigers.

RWater – A Cyber Enabled Tool For Hydrologic Modeling And Analysis

Existing distributed hydrologic models are complex and computationally demanding for using as a rapid-forecasting policy-decision tool, or even as a class-room educational tool. In addition, platform dependence, specific input/output data structures and non-dynamic data-interaction with pluggable software components inside the existing proprietary frameworks make these models restrictive only to the specialized user groups. RWater is a web-based hydrologic analysis and modeling framework that utilizes the commonly used R software within the HUBzero cyber infrastructure of Purdue University. RWater is designed as an integrated framework for distributed hydrologic simulation, along with subsequent parameter optimization and visualization schemes. RWater provides platform independent web-based interface, flexible data integration capacity, grid-based simulations, and user-extensibility. RWater uses RStudio to simulate hydrologic processes on raster based data obtained through conventional GIS pre-processing. The program integrates Shuffled Complex Evolution (SCE) algorithm for parameter optimization. Moreover, RWater enables users to produce different descriptive statistics and visualization of the outputs at different temporal resolutions. The applicability of RWater will be demonstrated by application on two watersheds in Indiana for multiple rainfall events.

Comparative Analysis of Adolescent Pregnancy in Central America, Mexico and South Carolina

This paper addresses the issue of adolescent pregnancy in Mexico, Central America and South Carolina and implications for social work practice with immigrant communities. The paper is based on current literature and on cross-national, on-line survey of local and international pregnancy prevention programs. The paper analyzes and discusses various psychosocial causes of pregnancy in adolescents, including: limited opportunities for formal education, infrequent open discussions about sexual health, rising costs of adequate birth control, and difficulty in obtaining contraceptives in remote locations. This research paper analyzes current statistics on the effectiveness of existing projects and programs and compares and contrasts research about the validity and efficacy of these programs in both South Carolina and abroad. Finally, the paper addresses implications for social work practice with adolescents in immigrant communities.

An Environmental Analysis Corroborating PDA and the Winthrop Example

Libraries seek active ways to innovate amidst macroeconomic shifts, growing online education to help alleviate ever-growing schedule conflicts as students juggle jobs and course schedules, as well as changing business models in publishing and evolving information technologies. Patron-driven acquisition (PDA), also known as demand-driven acquisition (DDA), offers numerous strengths in supporting university curricula in the context of these significant shifts. PDA is a business model centered on short-term loans and subsequent purchases of ebooks resulting directly from patrons' natural use stemming from their discovery of the ebooks in library catalogs where the ebooks' bibliographic records are loaded at regular intervals established between the library and ebook supplier. Winthrop University's PDA plan went live in October 2011, and this article chronicles the philosophical and operational considerations, the in-library collaboration, and technical preparations in concert with the library system vendor and ebook supplier. Short-term loan is invoked after a threshold is crossed, typically number of pages or time spent in the ebook. After a certain number of short-term loans negotiated between the library and ebook supplier, the next short-term loan becomes an automatic purchase after which the library owns the ebook in perpetuity. Purchasing options include single-user and multi-user licenses. Owing to high levels of need in college and university environments, Winthrop chose the multi-user license as the preferred default purchase. Only where multi-user licenses are unavailable does the automatic purchase occur with single-user title licenses. Data on initial use between October 2011 and February 2013 reveal that of all PDA ebooks viewed, only 30% crossed the threshold into short-term loans. Of all triggered short-term loans, Psychology was the highest-using. Of all ebook views too brief to trigger short-term loans, Business was the highest-using area. Although the data are still too young to draw conclusions after only a few months, thought-provoking usage differences between academic disciplines have begun to emerge. These differences should be considered in library plans for the best possible curricular support for each academic program. As higher education struggles with costs and course-delivery methods libraries have an enduring lead role.

Evaluating Department Chair and Program Director Compensation

This brief examines compensation policies for department chairs and program directors at public institutions, with a particular focus on the factors that determine compensation. The report includes an analysis of department chairs and program director responsibilities, monetary compensation, and non-monetary compensation.

An assessment of criteria to evaluate the graduate education program in Brazil

This study sought to identify criteria adequate for the evaluation of graduate programs in Brazil. A survey was the means for collecting the ratings and rankings given by faculty members at selected Brazilian graduate programs. A questionnaire using Likerttype and ranking items asked the importance attributed by each respondent to each of the 109 items listed. The data analysis reported in this dissertation indicates that the most highly rated criteria and indicators were: (1) Library: current periodicals; (2) Facilities: classrooms and laboratories; (3) Library: books and monographs; (4) Academic Environment: discussion, investigation, and expression; and (5) Facilities: research space and equipment. The study presents the means and standard deviations obtained for each indicator and also includes some figures obtained for a relational analysis. This dissertation was developed to provide useful information to educational planners, policy makers, administrators, and evaluators involved in Brazilian higher education or comparative studies. It is suggested that additional investigations concentrate on more specific and in-depth analysis and interpretation of the policymaking processes, i.e., on the study of social facts or organizational and academic variables in their relationships with aspects of the educational system. The appendices section includes a facsimile of the questionnaire and additional data.