Impact of non-pharmacological interventions on prevention and treatment of delirium in critically ill patients: protocol for a systematic review of quantitative and qualitative research

Background: Critically ill patients have an increased risk of developing delirium during their intensive care stay.To date, pharmacological interventions have not been shown to be effective for delirium management but non-pharmacological interventions have shown some promise. The aim of this systematic review is to identify effective non-pharmacological interventions for reducing the incidence or the duration of delirium in critically ill patients.

Methods: We will search MEDLINE, EMBASE, CINAHL, Web of Science, AMED, psycINFO and the Cochrane Library.We will include studies of critically ill adults and children. We will include randomised trials and controlled trials which measure the effectiveness of one or more non-pharmacological interventions in reducing incidence or duration ofdelirium in critically ill patients. We will also include qualitative studies that provide an insight into patients and their families’ experiences of delirium and non-pharmacological interventions. Two independent reviewers will assess studies for eligibility, extract data and appraise quality. We will conduct meta-analyses if possible or present results narratively.Qualitative studies will also be reviewed by two independent reviewers, and a specially designed quality assessment tool incorporating the CASP framework and the POPAY framework will be used to assess quality.

Discussion: Although non-pharmacological interventions have been studied in populations outside of intensive care units and multicomponent interventions have successfully reduced incidence and duration of delirium, no systematic review of non-pharmacological interventions specifically targeting delirium in critically ill patients have been undertaken to date. This systematic review will provide evidence for the development of a multicomponent intervention for delirium management of critically ill patients that can be tested in a subsequent multicentre randomised trial.

Appropriate complexity for the prediction of coastal and estuarine geomorphic behaviour at decadal to centennial scales

Coastal and estuarine landforms provide a physical template that not only accommodates diverse ecosystem functions and human activities, but also mediates flood and erosion risks that are expected to increase with climate change. In this paper, we explore some of the issues associated with the conceptualisation and modelling of coastal morphological change at time and space scales relevant to managers and policy makers. Firstly, we revisit the question of how to define the most appropriate scales at which to seek quantitative predictions of landform change within an age defined by human interference with natural sediment systems and by the prospect of significant changes in climate and ocean forcing. Secondly, we consider the theoretical bases and conceptual frameworks for determining which processes are most important at a given scale of interest and the related problem of how to translate this understanding into models that are computationally feasible, retain a sound physical basis and demonstrate useful predictive skill. In particular, we explore the limitations of a primary scale approach and the extent to which these can be resolved with reference to the concept of the coastal tract and application of systems theory. Thirdly, we consider the importance of different styles of landform change and the need to resolve not only incremental evolution of morphology but also changes in the qualitative dynamics of a system and/or its gross morphological configuration. The extreme complexity and spatially distributed nature of landform systems means that quantitative prediction of future changes must necessarily be approached through mechanistic modelling of some form or another. Geomorphology has increasingly embraced so-called ‘reduced complexity’ models as a means of moving from an essentially reductionist focus on the mechanics of sediment transport towards a more synthesist view of landform evolution. However, there is little consensus on exactly what constitutes a reduced complexity model and the term itself is both misleading and, arguably, unhelpful. Accordingly, we synthesise a set of requirements for what might be termed ‘appropriate complexity modelling’ of quantitative coastal morphological change at scales commensurate with contemporary management and policy-making requirements: 1) The system being studied must be bounded with reference to the time and space scales at which behaviours of interest emerge and/or scientific or management problems arise; 2) model complexity and comprehensiveness must be appropriate to the problem at hand; 3) modellers should seek a priori insights into what kind of behaviours are likely to be evident at the scale of interest and the extent to which the behavioural validity of a model may be constrained by its underlying assumptions and its comprehensiveness; 4) informed by qualitative insights into likely dynamic behaviour, models should then be formulated with a view to resolving critical state changes; and 5) meso-scale modelling of coastal morphological change should reflect critically on the role of modelling and its relation to the observable world.

Bereavement outcomes: a quantitative survey identifying risk factors in family carers bereaved through cancer.

Background: Enabling patients to die in their preferred place is important but achieving preferred place of death may increase the informal carer’s risk into bereavement. Aim: to determine risk factors of family carers bereaved through cancer in Northern Ireland. Design: These results form part of a larger QUALYCARE-NI study which used postal questionnaires to capture quantitative data on carer’s bereavement scores using the Texas Revised Inventory of Grief. Setting/participants: Participants were individuals who: registered the death of a person between 1st December 2011 and 31st May 2012; where cancer (defined by ICD10 codes C00-D48) was the primary cause; where the deceased was over 18 years of age and death occurred at home, hospice, nursing home or hospital in Northern Ireland. Participants were approached in confidence by the Demography and Methodology Branch of the Northern Ireland Statistics and Research Agency. Those wishing to decline participation were invited to return the reply slip. Non-responders received a second questionnaire six weeks after initial invitation. Results indicated that risk factors positively influencing bereavement outcomes included patients having no preference for place of death and carers remaining in employment pre or post bereavement. In contrast, patients dying in hospital, carers stopping work, being of lower socio-economic status and close kinship to the deceased negatively impacted on bereavement scores. Family carers should be adequately supported to continue in employment; priority should be given to assessing the financial needs of families from lower socio-economic areas; and bereavement support should focus on close relatives of the deceased.

Transposing Musical Skill: Sonification of movement as concurrent augmented feedback enhances learning in a bimanual task

Concurrent feedback provided during acquisition can enhance performance of novel tasks. The ‘guidance hypothesis’ predicts that feedback provision leads to dependence and poor performance in its absence. However, appropriately-structured feedback information provided through sound (‘sonification’) may not be subject to this effect. We test this directly using a rhythmic bimanual shape-tracing task in which participants learned to move at a 4:3 timing ratio. Sonification of movement and demonstration was compared to two other learning conditions: (1) sonification of task demonstration alone and (2) completely silent practice (control). Sonification of movement emerged as the most effective form of practice, reaching significantly lower error scores than control. Sonification of solely the demonstration, which was expected to benefit participants by perceptually unifying task requirements, did not lead to better performance than control. Good performance was maintained by participants in the sonification condition in an immediate retention test without feedback, indicating that the use of this feedback can overcome the guidance effect. On a 24-hour retention test, performance had declined and was equal between groups. We argue that this and similar findings in the feedback literature are best explained by an ecological approach to motor skill learning which places available perceptual information at the highest level of importance.

Identification of reliable reference genes for quantitative gene expression in the Mozambique tilapia, Oreochromis mossambicus

Dissertação de mest., Biologia Marinha (Aquacultura), Faculdade de Ciências e Tecnologia, Univ. do Algarve, 2010

Medium-term prospects for portuguese agriculture under health check Proposals: a quantitative analysis with the CAPRI modelling system

The challenges of Common Agricultural Policy are driven by internal and external factors, such as the budgetary constraints, the budget reform, the globalization and the world financial crisis. According to this work results, CAP will continue its evolution from a sectorial to a territorial approach, with a slow re-balance of its two pillars. The Portuguese agriculture will slowly adjust itself to the disappearance of prices and markets policy and the reinforcement of rural development policy. As in the past, agriculture will accommodate the reform effects and adjust to a new framework without sudden brakes or disclosers.

Die Nutzung des Gefällt mir-Buttons auf Organisationsprofilen : eine quantitative Studie zur Erfassung der Nutzungsmotive und des Verlaufs von Gefällt mir-Verknüpfungen zwischen Usern und Organisationen im Online-Netzwerk Facebook

Die Nutzung des Like-Buttons wurde bisher nur oberflächlich und vor allem auf den US-Raum begrenzt erforscht. Dabei lag der Fokus ausschließlich auf wirtschaftlich orientierten Unternehmen und dem monetären Wert, den ein Fan für dieses hat. In der vorliegenden Untersuchung wird eine erweiterte Perspektive gewählt. Aus Sicht deutschsprachiger Nutzer wird erforscht, welche Motive und Bedürfnisse eine Person dazu veranlassen, sich freiwillig per Gefällt-mir zu verknüpfen. Hierzu wird der Uses and Gratifications-Ansatz herangezogen. Es stehen nicht Unternehmen, sondern generell alle Formen von Organisationen im Fokus. Gleichzeitig wird untersucht, wie diese Beziehungen verlaufen: Welche Erwartungen stellen Fans? Welche Handlungen nehmen sie wie häufig vor und welchen Effekt hat eine Fanbeziehung auf die Einstellung eines Nutzers gegenüber einer Organisation? Die Motive hinter der Nutzung des Gefällt mir-Buttons sind umfangreicher, als es bisherige Forschung vermuten ließ. Fans wollen informiert werden, sie wollen ihr Gefallen schnell und einfach bekunden und sich durch die Verknüpfung selbst darstellen. Weniger wichtig, aber dennoch von Relevanz sind die Motive der Partizipation und Unterstützung, der Empfehlung, der Vorteilssuche, der Unterhaltung sowie der Netzwerkerweiterung und Gruppenzugehörigkeit. Die Verwendung des Like-Buttons dient somit der Befriedigung einer ganzen Reihe von Nutzungsbedürfnissen. Der Verlauf der Beziehungen zwischen Organisationen und Usern ist eher von Passivität geprägt. Fans wollen zwar informiert werden und stellen konkrete Ansprüche an die Art und Form von Organisationsmeldungen, sie wollen aber nur selten wirklich direkt mit einem Unternehmen, einem Verein o.ä. interagieren. Langweilen die Meldungen einer Organisation, werden zu viele oder nicht relevante Informationen an die Fans weitergeben, zögern diese nicht, eine Verknüpfung zu beenden. Ein Effekt der Fanschaft auf die Einstellung von Nutzern gegenüber der jeweiligen Organisation konnte nur bedingt festgestellt werden. Letztere zieht einen Gewinn nicht aus einer erhöhten Ausgabebereitschaft seiner Fans, sondern aus deren stärkerer Aufmerksamkeit gegenüber Organisationsmeldungen.

Machine learning methods for quantitative structure-property relationship modeling

Tese de doutoramento, Informática (Bioinformática), Universidade de Lisboa, Faculdade de Ciências, 2014

Design and Qualitative/Quantitative Analysis of Multi-Agent Spatial Simulation Library

Thesis (Master's)--University of Washington, 2012

Quantitative evaluation of three reconfiguration strategies on FPGAs: a case study

Reconfigurable computing is becoming an important new alternative for implementing computations. Field programmable gate arrays (FPGAs) are the ideal integrated circuit technology to experiment with the potential benefits of using different strategies of circuit specialization by reconfiguration. The final form of the reconfiguration strategy is often non-trivial to determine. Consequently, in this paper, we examine strategies for reconfiguration and, based on our experience, propose general guidelines for the tradeoffs using an area-time metric called functional density. Three experiments are set up to explore different reconfiguration strategies for FPGAs applied to a systolic implementation of a scalar quantizer used as a case study. Quantitative results for each experiment are given. The regular nature of the example means that the results can be generalized to a wide class of industry-relevant problems based on arrays.

Brain-Based Individual Difference Measures of Reading Skill in Deaf and Hearing Adults

Thesis (Ph.D.)--University of Washington, 2015

A quantitative evaluation of three hand drying methods and the potential for dissemination of virus particles into the environment

The importance of hand hygiene in reducing the spread of pathogens has been long established and this has been highlighted recently in initiatives such as the NHS’s ‘clean your hands’ campaign. However, much of the focus on hand hygiene has concerned effective hand washing; there has been less emphasis on hand drying and its role in hygienic practices. This study aimed to compare three hand drying methods namely paper towels, a warm air dryer and a jet air dryer for their relative ability to disseminate virus particles into the washroom environment during hand drying. A bacteriophage model was used to compare these methods; hands were artificially contaminated with MS2 phage and dried using each device. Both air sampling and contact plates were assessed and a plaque assay was used to quantify virus dissemination. Samples were collected at set times, heights, angles and distances around each device. Both air sampling and contact plate results indicated that the jet air dryer produced significantly more virus dispersal than either paper towels or the warm air dryer in terms of quantity, distance travelled and the time spent circulating in the air around the device and potentially in the washroom environment.

Accessing Planktothrix species diversity and associated toxins using quantitative real-time PCR in natural waters

Tese de Doutoramento em Biologia apresentada à Faculdade de Ciências da Universidade do Porto, 2015.

Experiments on new polymer based mortars filled with FRP waste recyclates - a quantitative analysis

Glass fibre-reinforced plastics (GFRP) have been considered inherently difficult to recycle due to both: cross-linked nature of thermoset resins, which cannot be remolded, and complex composition of the composite itself. Presently, most of the GFRP waste is landfilled leading to negative environmental impacts and supplementary added costs. With an increasing awareness of environmental matters and the subsequent desire to save resources, recycling would convert an expensive waste disposal into a profitable reusable material. In this study, efforts were made in order to recycle grinded GFRP waste, proceeding from pultrusion production scrap, into new and sustainable composite materials. For this purpose, GFRP waste recyclates, were incorporated into polyester based mortars as fine aggregate and filler replacements at different load contents and particle size distributions. Potential recycling solution was assessed by mechanical behaviour of resultant GFRP waste modified polymer mortars. Results revealed that GFRP waste filled polymer mortars present improved flexural and compressive behaviour over unmodified polyester based mortars, thus indicating the feasibility of the waste reuse in polymer mortars and concrete. © 2011, Advanced Engineering Solutions.