JPEG standard uniform quantization error modeling with applications to sequential and progressive operation modes

In this paper we propose a method for computing JPEG quantization matrices for a given mean square error or PSNR. Then, we employ our method to compute JPEG standard progressive operation mode definition scripts using a quantization approach. Therefore, it is no longer necessary to use a trial and error procedure to obtain a desired PSNR and/or definition script, reducing cost. Firstly, we establish a relationship between a Laplacian source and its uniform quantization error. We apply this model to the coefficients obtained in the discrete cosine transform stage of the JPEG standard. Then, an image may be compressed using the JPEG standard under a global MSE (or PSNR) constraint and a set of local constraints determined by the JPEG standard and visual criteria. Secondly, we study the JPEG standard progressive operation mode from a quantization based approach. A relationship between the measured image quality at a given stage of the coding process and a quantization matrix is found. Thus, the definition script construction problem can be reduced to a quantization problem. Simulations show that our method generates better quantization matrices than the classical method based on scaling the JPEG default quantization matrix. The estimation of PSNR has usually an error smaller than 1 dB. This figure decreases for high PSNR values. Definition scripts may be generated avoiding an excessive number of stages and removing small stages that do not contribute during the decoding process with a noticeable image quality improvement.

How Accurate Are Blood (or Breath) Tests for Identifying Self-Reported Heavy Drinking Among People with Alcohol Dependence?

AIMS: Managing patients with alcohol dependence includes assessment for heavy drinking, typically by asking patients. Some recommend biomarkers to detect heavy drinking but evidence of accuracy is limited. METHODS: Among people with dependence, we assessed the performance of disialo-carbohydrate-deficient transferrin (%dCDT, ≥1.7%), gamma-glutamyltransferase (GGT, ≥66 U/l), either %dCDT or GGT positive, and breath alcohol (> 0) for identifying 3 self-reported heavy drinking levels: any heavy drinking (≥4 drinks/day or >7 drinks/week for women, ≥5 drinks/day or >14 drinks/week for men), recurrent (≥5 drinks/day on ≥5 days) and persistent heavy drinking (≥5 drinks/day on ≥7 consecutive days). Subjects (n = 402) with dependence and current heavy drinking were referred to primary care and assessed 6 months later with biomarkers and validated self-reported calendar method assessment of past 30-day alcohol use. RESULTS: The self-reported prevalence of any, recurrent and persistent heavy drinking was 54, 34 and 17%. Sensitivity of %dCDT for detecting any, recurrent and persistent self-reported heavy drinking was 41, 53 and 66%. Specificity was 96, 90 and 84%, respectively. %dCDT had higher sensitivity than GGT and breath test for each alcohol use level but was not adequately sensitive to detect heavy drinking (missing 34-59% of the cases). Either %dCDT or GGT positive improved sensitivity but not to satisfactory levels, and specificity decreased. Neither a breath test nor GGT was sufficiently sensitive (both tests missed 70-80% of cases). CONCLUSIONS: Although biomarkers may provide some useful information, their sensitivity is low the incremental value over self-report in clinical settings is questionable.

Refractory intraretinal or subretinal fluid in neovascular age-related macular degeneration treated with intravitreal ranizubimab: Functional and Structural Outcome.

PURPOSE: To investigate the visual acuity results of eyes with neovascular age-related macular degeneration and refractory fluid despite monthly treatment with ranibizumab, and to investigate differences between refractory subretinal fluid and intraretinal cystic changes. METHODS: Retrospective chart review of consecutive treatment-refractory neovascular age-related macular degeneration, defined as persistent intraretinal or subretinal fluid despite monthly ranibizumab injections during 12 months or more. Data were evaluated for baseline characteristics, type and location of the refractory fluid, mean visual acuity change, number of injections, and the time point of first complete disappearance of all fluid on spectral domain optical coherence tomography. RESULTS: Seventy-six eyes (74 patients, mean age, 76.8 years) were identified. The mean follow-up was 33.6 months (range, 12-73 months). The mean number of injections was 11.4 in the first year and 27.7 over follow-up. The refractory fluid was located subfoveally in 61.8%. In 27 eyes (35.5%), the fluid resolved after a mean of 21.8 months (range, 13-49 months). Mean visual acuity increased by 9.0, 7.9, and 7.9 letters by Month 12, Month 24, and Month 36, respectively. Subgroup analysis revealed a higher risk for fibrosis (odds ratio, 3.30) or atrophy (odds ratio, 3.34) in patients with refractory cysts as compared with refractory subretinal fluid. Furthermore, refractory cysts showed a higher risk for a 10-letter visual acuity loss (P = 0.018). CONCLUSION: Fluid refractory to monthly treatment with ranibizumab for neovascular age-related macular degeneration still allowed for well-maintained visual improvement, even in subfoveal location. Late fluid resolution may occur. However, refractory cysts were associated with poorer anatomical and functional outcome than subretinal fluid.

The Influence of Age and Sex on Genetic Associations with Adult Body Size and Shape: A Large-Scale Genome-Wide Interaction Study.

Genome-wide association studies (GWAS) have identified more than 100 genetic variants contributing to BMI, a measure of body size, or waist-to-hip ratio (adjusted for BMI, WHRadjBMI), a measure of body shape. Body size and shape change as people grow older and these changes differ substantially between men and women. To systematically screen for age- and/or sex-specific effects of genetic variants on BMI and WHRadjBMI, we performed meta-analyses of 114 studies (up to 320,485 individuals of European descent) with genome-wide chip and/or Metabochip data by the Genetic Investigation of Anthropometric Traits (GIANT) Consortium. Each study tested the association of up to ~2.8M SNPs with BMI and WHRadjBMI in four strata (men ≤50y, men >50y, women ≤50y, women >50y) and summary statistics were combined in stratum-specific meta-analyses. We then screened for variants that showed age-specific effects (G x AGE), sex-specific effects (G x SEX) or age-specific effects that differed between men and women (G x AGE x SEX). For BMI, we identified 15 loci (11 previously established for main effects, four novel) that showed significant (FDR<5%) age-specific effects, of which 11 had larger effects in younger (<50y) than in older adults (≥50y). No sex-dependent effects were identified for BMI. For WHRadjBMI, we identified 44 loci (27 previously established for main effects, 17 novel) with sex-specific effects, of which 28 showed larger effects in women than in men, five showed larger effects in men than in women, and 11 showed opposite effects between sexes. No age-dependent effects were identified for WHRadjBMI. This is the first genome-wide interaction meta-analysis to report convincing evidence of age-dependent genetic effects on BMI. In addition, we confirm the sex-specificity of genetic effects on WHRadjBMI. These results may provide further insights into the biology that underlies weight change with age or the sexually dimorphism of body shape.

Market orientation and performance in entrepreneurial SMEs

Market orientation is the organizational culture that creates the necessary behaviors for continuous additional value for customers and thus continuous superior performance for the business. The field of market orientation has been studied repeatedly during the past two decades. Yet research has concentrated on large firms in large domestic markets creating a need for diversifying research. The master’s thesis at hand examined the general incidence of market orientation among SMEs from five different industries as well as its consequences on SME performance. The empirical part of the thesis was conducted with a web-based survey that resulted in 255 responses. The data of the survey was analyzed by statistical analysis. The incidence of market orientation varied among dimensions and market orientation did not show any direct effect on firm performance. Customer orientation was the only dimension that showed a direct (positive) effect. On the contrary, moderating effects were found which indicate that the effect of market orientation in SMEs is influenced by other factors that should receive further attention. Also industry specific differences were discovered and should be further examined.

Surgically-treated Hip Fracture in older People. With Special Emphasis on Mortality Analysis

Hip fractures are associated with significant morbidity and mortality. Cervical and trochanteric fractures have a different morphometry, surgical treatment, and outcome. Polypharmacy, common in older people, is associated with increased mortality. The risk factors for mortality can be identified based on cause-of-death analysis. In this population-based study, 461 older, surgically in 1999-2000 treated hip fracture patients were enrolled. Incidence, morphometry, medication, mortality, and cause-of-death were analysed. Hip fractures were most commonly sustained by women, occurred mostly indoors, and often in institutions. One in four patients had sustained a previous fracture. Routine clinical radiographs revealed no differences in the hip geometry between hip fracture types. Age-adjusted mortality was higher in men than in women during the follow-up. Chronic lung disease and male sex were predictors of mortality after cervical fracture. In men, potent anticholinergics were associated with excess age-adjusted mortality. Men were more likely to die from circulatory disease and dementia after hip fracture than women. Mortality after hip fracture was 3-fold higher than that of the general population, including every cause-of-death class. Fracture prevention in institutions and homes, indoor safety measures, and treatment of chronic lung diseases should be encouraged. Hip morphometry analyses require more accurate measures than that provided by routine radiographs. Careful use of potent anticholinergics may reduce mortality. Compared to the general population, excess mortality after hip fracture was evident up to 9 years after hip fracture. Cause-of-death analysis indicates that all major comorbidities require optimal treatment after hip fracture surgery.

Evaluation of a treatment program for individuals with an intellectual disability who have high risk behaviours

In the past two decades numerous programs have emerged to treat individuals with developmental disabilities who have sexual offending behaviours. There has, however been very few studies that systematically examine the effectiveness of long term treatment with this population. The present research examines the therapeutic outcomes of a multi-modal behaviour approach with six individuals with intellectual disabilities previously charged with sexual assault. The participants also exhibited severe behavioural challenges that included verbal aggression, physical aggression, destruction and self-injury. These six participants (5 males, 1 female) were admitted to a Long Term Residential Treatment Program (LTRTP), due to the severity of their behaviours and due to their lack of treatment success in other programs. Individualized treatment plans focused on the reduction of maladaptive behaviours and the enhancing of skills such as positive coping strategies, socio-sexual knowledge, life skills, recreation and leisure skills. The treatment program also included psychiatric, psychological, medical, behavioural and educational interventions. The participants remained in the Long Term Residential Treatment Program (LTRTP) program from 181 to 932 days (average of 1.5 years). Pre and post treatment evaluations were conducted using the following tools: frequency of target behaviours, Psychopathology Inventory for Mentally Retarded Adults (PIMRA), Emotional Problems Scale (EPS), Socio-Sexual Knowledge and Attitudes Assessment Tool (SSKAAT-R) and Quality of Life Questionnaire (QOL-Q). Recidivism rates and the need for re-hospitalization were also noted for each participant. By offering high levels of individualized interventions, all six participants showed a 37 % rate of reduction in maladaptive behaviours with zero to low rates of inappropriate sexualbehaviour, there were no psychiatric hospitalizations, and there was no recidivism for 5 of 6 participants. In addition, medication was reduced. Mental health scores on the PIMRA were reduced across all participants by 25 % and scores on the Quality of Life Questionnaire increased for all participants by an average of 72 %. These findings add to and build upon the existing literature on long term treatment benefits for individuals with a intellectual disability who sexually offend. By utilizing an individualized and multimodal treatment approach to reduce severe behavioural challenges, not only can the maladaptive behaviours be reduced, but adaptive behaviours can be increased, mental health concerns can be managed, and overall quality of life can be improved.

A Study of role conflict, role ambiguity, locus of control, job satisfaction and participation in decision making among front-line vocational service workers for mentally retarded adults

This study was an investigation of individual and organizational factors, as perceived by front-line vocational service workers from Adult Rehabilitation Centres (ARC Industries) for mentally retarded adults. The specific variables which were measured included role conflict/role ambiguity (role factors), internal/external locus of control (individual differences), job satisfaction with work and supervision (job attitudes) and participation in deci~ion making (organizational factor). The exploration of these constructs was conducted by means of self-report questionnaires which were completed by sixty-nine out of a total of ninety front-line employees. The surveys were distributed in booklet form to nine distinct rehabilitation facilities from St. Catharines, West Lincoln, Greater Niagara, Port Colborne, WeIland, Fort Erie, Hamilton, Guelph and Brantford. The survey data was evaluated by the statisti.cal Package for the Social Sciences (SPSS) which used the Pearson Product Moment Correlation procedure and a compar~son of means test. A comparison of correlation coefficients test was also conducted. This statistical procedure was calculated mathematically. The results obtained from the statistical evaluation confirmed the prediction that self-reported measures of participation in decision making and satisfaction (work and supervision) would be negatively correlated with role conflict and role ambiguity. As well, the speculation that perceived satisfaction (work and supervision) would be positively correlated with participation in decision making was empirically supported. Internal and external locus of control did not contribute to a significant difference in r~sponses to role perceptions (conflict and ambiguity) , satisfaction (work and supervision) or the correlational relationship between participation in decision making and satisfaction (work and supervision). Overall, the findings from this study substantiated the importance of examining employee perceptions in the workplace and the interrelationships among individual and organizational variables. This research was considered a contribution to the general area of occupational stress and to the study of individuals in work organizations.

Elaborative interrogation as a learning technique for students with learning disabilities

This study examined whether or not students with learning disabilities could effectively use a question and answer strategy known as elaborative interrogation. This technique involved students answering why they thought facts based on familiar animal stories were true. Thirty students from a provincial demonstration high school (for students with learning disabilities) were assigned to one of two study conditions, (a) elaborative interrogation or (b) reading for understanding. Three students, one from the experimental condition and two from the control did not complete the study. Both conditions required that the students learn 36 facts concerning six familiar animals. Immediately following the study session the students completed a free-recall test, a matched association test and a questionnaire regarding their perceived difficulty of the animal stories. After 30 days a matched association test was completed. The oneway ANOVA, 2 x 2 split plot ANOVA and Tukey's Honestly Significant Test were used to determine significance. There was no significant difference in the two conditions for free recall retention. There were significant differences in the elaborative interrogation condition for the immediate matched association test and for the 30-day matched association test. The probability of the students' responses in the elaborative interrogation were measured to determine the effects of adequate responses on long-term retention. It was found that the adequate responses were more likely to promote retention than inadequate responses. In conclusion, long-term retention of factual information was significantly better in the elaborative interrogation condition in comparison to the reading for understanding control. For future research, the dependent measure, free recall should be given both verbally and in written format. In addition, extra time should be allowed for processing of the new information to occur.

Making the transition from secondary to post-secondary education : a retrospective study of students with learning disabilities

The purpose of this study was to investigate what students with Learning Disabilities perceive are the personal characteristics they possess and services they require to assist them to complete secondary school and to continue their education in a postsecondary setting. Twenty-one students (12 female and 9 male) participated in the study which consisted of an interview and completion of a questionnaire. The central findings were as follows: 1) the participants perceived that personal characteristics were important in secondary school and still remain of importance at th~ postsecondary level; 2) Many of the typical accommodations and services supposed to be provided in secondary schools were not provided to the participants in this study; 3) the participants believed that they had more academic than social problems. Recommendations for future research in this field are based on findings related to the transition of LD students from secondary school to postsecondary education.

Examining the inclusion experiences of students with intellectual disabilities : a study focusing on the transition from elementary to secondary school

Transitioning from elementary to secondary school is a major event in adolescents' lives and can be associated with academic, social, and emotional challenges (Shaffer, 2005; Sirsch, 2003). Considerably less research has focused on the transitional experiences of students with intellectual disabilities (lD) as they enter secondary school and the role of educational inclusion in this process (Noland, Cason, & Lincoln, 2007). Conceivably, students with ID who leave inclusive elementary schools, where they have been educated alongside their peers without ID, and who enter segregated secondary educational placements may experience unique social and emotional challenges (Farmer, Pearl, & Van Acker, 1996; Fryxell & Kennedy, 1995; Shaffer, 2005). This study examined the transitional experiences of 6 students with ID and the role of educational inclusion, with a focus on elementary to secondary school transitions from inclusive to segregated settings and vice versa. This study included the collection of multiple sources of data. Semi-structured interviews with 6 caregivers and students with ID were conducted. Students' Individual Education Transitional Plans were discussed in caregivers' interviews to determine how they shaped students' educational inclusion experiences (Ontario Ministry of Education & Training, 1999/2000/2004). Parts ofthe following questionnaires were "qualitized" (Tashakkori & Teddlie, 1998) and administered orally: "Youth Self-Report" (YSR; Achenbach, 2001 c) and "Child Behaviour Checklist Caregivers Form" (CBLC/6-18; Achenbach, 200la). The findings of this study contribute to the literature on educational inclusion by highlighting the positive/negative social and emotional impact of congruent and incongruent transitional experiences of students with ID and the role of educational inclusion.

Teaching sexual abuse prevention skills to two children with intellectual disabilities through game play

The current study examined the effectiveness of a sexual abuse prevention program developed locally for children with intellectual disabilities. The program package included a board game with informational storybooks that were designed to be used in a family setting. Additionally, this research sought to determine if parents could be effective at presenting the sexual abuse pr~vention materials to their children. A multiple baseline across behaviours design was used with two participants with a diagnosis of autism. Through role play scenarios as well as verbal knowledge tests, it was determined that the program was effective at teaching the participants the skills presented for self protection. It was also determined that the skills learned were generalized to scenarios that were untrained during the game play. Finally, with additional supports, it was determined that parents were able to effectively teach their children the required skills.

Family attitudes toward the deinstitutionalization of individuals with developmental disabilities in Ontario : a quality of life analysis

The deinstitutionalization of individuals with developmental disabilities to community-based residential services is a pervasive international trend. Although controversial, the remaining three institutions in Ontario were closed in March of 2009. Since these closures, there has been limited research on the effects of deinstitutionalization. The following retrospective study evaluated family perceptions of the impact of deinstitutionalization on the quality of life of fifty-five former residents one year post-closure utilizing a survey design and conceptual quality of life framework. The methods used to analyze the survey results included descriptive statistical analyses and thematic analyses. Overall, the results suggest that most family members are satisfied with community placement and supports, and report an improved quality of life for their family member with a developmental disability. These findings were consistent with previously published studies demonstrating the short-term and long-term benefits of community living for most individuals with developmental disabilities and their families.

A Description of Psychotropic Medication Use in Institution and Community Settings in Ontario.

This study examined patterns of psychotropic medication use among 120 participants with intellectual disabilities (ID) who used to live in facilities and now reside in community-based settings in Ontario. There were significantly more participants taking psychotropic medication in the community (83.30/0) than in the facility (74.2%). Of those who showed change, 4.2% were taking medication in the facility but not in the community, and 13.3% were taking medications in the community but not in the facility. While significantly more participants in the community were taking antipsychotic and antidepressant medications, there was no significant increase in psychiatric diagnoses after relocation. Additionally, PRN use was significantly reduced in the comlnunity while daily medication use was significantly higher. The most common PRN in both settings was lorazepam and the most common antipsychotics were risperidone, quetiapine and olanzapine.

The Social Enterprise as an Alternative Work Option for Persons with Developmental Disabilities: A Case Study of Staff Perspectives at Common Ground Co-operative

Traditional employment options for persons with developmental disabilities are lacking. Employment options available for persons with developmental disabilities are reflective of the medical and social model perspectives of disability; with segregated and supported employment reinforcing the idea that persons with developmental disabilities are incapable and competitive employment missing the necessary accommodations for persons to be successful. This study examined social enterprises as an alternative employment option that can balance both medical and social model perspectives by accommodating for weaknesses or limitations and recognizing the strengths and capabilities of persons with developmental disabilities in the workplace. Moreover, this study is part of a broader case study which is examining the nature and impacts of a social enterprise, known as Common Ground Co-operative (CGC), which supports five social purpose businesses that are owned and operated by persons with developmental disabilities. This study is part of the Social Business and Marginalized Social Groups Community-University Research Alliance. To date, a case study has been written describing the nature and impacts of CGC and its related businesses from the perspectives of the Partners, board members, funders and staff (Owen, Readhead, Bishop, Hope & Campbell, in press & Readhead, 2012). The current study used a descriptive case study approach to provide a detailed account of the perceptions and opinions of CGC staff members who support each of the Partners in the five related businesses. Staff members were chosen for the focus of this study because of the integral role that they play in the successful outcomes of the persons they support. This study was conducted in two phases. In the first phase five staff members were interviewed. During this stage of interviews, several themes were presented which needed to be examined in further detail, specifically staff stress and burnout and duty of care for business Partners versus the promotion of their autonomy. A second phase of interviews was then conducted with one individual participant and a focus group of seven. During both interview phases, Staff participants described an employment model that creates a non-judgemental environment for the business Partners that promotes their strengths, accommodates for their limitations, provides educational opportunities and places the responsibility for the businesses on the persons with developmental disabilities cultivating equality and promoting independence. Staff described the nature of their role including risk factors for stress, the protective factors that buffer stress, and the challenges associated with balancing many role demands. Issues related to the replication of this social enterprise model are described.