Supporting Students with Learning Disabilities to Explore Linear Relationships using Online Learning Objects. 'Apoyando a estudiantes con problemas de aprendizaje para explorar relaciones lineales mediante el uso de objetos de aprendizaje en línea'.

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A proposal of a behavior-based control architecture with reinforcement learning for an autonomous underwater robot

Aquesta tesi proposa l'ús d'un seguit de tècniques pel control a alt nivell d'un robot autònom i també per l'aprenentatge automàtic de comportaments. L'objectiu principal de la tesis fou el de dotar d'intel·ligència als robots autònoms que han d'acomplir unes missions determinades en entorns desconeguts i no estructurats. Una de les premisses tingudes en compte en tots els passos d'aquesta tesis va ser la selecció d'aquelles tècniques que poguessin ésser aplicades en temps real, i demostrar-ne el seu funcionament amb experiments reals. El camp d'aplicació de tots els experiments es la robòtica submarina. En una primera part, la tesis es centra en el disseny d'una arquitectura de control que ha de permetre l'assoliment d'una missió prèviament definida. En particular, la tesis proposa l'ús de les arquitectures de control basades en comportaments per a l'assoliment de cada una de les tasques que composen la totalitat de la missió. Una arquitectura d'aquest tipus està formada per un conjunt independent de comportaments, els quals representen diferents intencions del robot (ex.: "anar a una posició", "evitar obstacles",...). Es presenta una recerca bibliogràfica sobre aquest camp i alhora es mostren els resultats d'aplicar quatre de les arquitectures basades en comportaments més representatives a una tasca concreta. De l'anàlisi dels resultats se'n deriva que un dels factors que més influeixen en el rendiment d'aquestes arquitectures, és la metodologia emprada per coordinar les respostes dels comportaments. Per una banda, la coordinació competitiva és aquella en que només un dels comportaments controla el robot. Per altra banda, en la coordinació cooperativa el control del robot és realitza a partir d'una fusió de totes les respostes dels comportaments actius. La tesis, proposa un esquema híbrid d'arquitectura capaç de beneficiar-se dels principals avantatges d'ambdues metodologies. En una segona part, la tesis proposa la utilització de l'aprenentatge per reforç per aprendre l'estructura interna dels comportaments. Aquest tipus d'aprenentatge és adequat per entorns desconeguts i el procés d'aprenentatge es realitza al mateix temps que el robot està explorant l'entorn. La tesis presenta també un estat de l'art d'aquest camp, en el que es detallen els principals problemes que apareixen en utilitzar els algoritmes d'aprenentatge per reforç en aplicacions reals, com la robòtica. El problema de la generalització és un dels que més influeix i consisteix en permetre l'ús de variables continues sense augmentar substancialment el temps de convergència. Després de descriure breument les principals metodologies per generalitzar, la tesis proposa l'ús d'una xarxa neural combinada amb l'algoritme d'aprenentatge per reforç Q_learning. Aquesta combinació proporciona una gran capacitat de generalització i una molt bona disposició per aprendre en tasques de robòtica amb exigències de temps real. No obstant, les xarxes neurals són aproximadors de funcions no-locals, el que significa que en treballar amb un conjunt de dades no homogeni es produeix una interferència: aprendre en un subconjunt de l'espai significa desaprendre en la resta de l'espai. El problema de la interferència afecta de manera directa en robòtica, ja que l'exploració de l'espai es realitza sempre localment. L'algoritme proposat en la tesi té en compte aquest problema i manté una base de dades representativa de totes les zones explorades. Així doncs, totes les mostres de la base de dades s'utilitzen per actualitzar la xarxa neural, i per tant, l'aprenentatge és homogeni. Finalment, la tesi presenta els resultats obtinguts amb la arquitectura de control basada en comportaments i l'algoritme d'aprenentatge per reforç. Els experiments es realitzen amb el robot URIS, desenvolupat a la Universitat de Girona, i el comportament après és el seguiment d'un objecte mitjançant visió per computador. La tesi detalla tots els dispositius desenvolupats pels experiments així com les característiques del propi robot submarí. Els resultats obtinguts demostren la idoneïtat de les propostes en permetre l'aprenentatge del comportament en temps real. En un segon apartat de resultats es demostra la capacitat de generalització de l'algoritme d'aprenentatge mitjançant el "benchmark" del "cotxe i la muntanya". Els resultats obtinguts en aquest problema milloren els resultats d'altres metodologies, demostrant la millor capacitat de generalització de les xarxes neurals.

An analysis of grammatical errors by children with cochlear implants

Spontaneous writing samples of deaf children with cochlear implants were analyzed for syntactic errors and other descriptive characteristics. These results were compared to a small sample of writings from hearing children.

Students who are deaf/hard of hearing with learning challenges: Strategies for classroom instruction

This paper discusses the prevalence of children who are deaf or hard of hearing with additional learning challenges and the need for further trainings for strategies to better serve this population.

Errors associated with the preparation of aseptic products in UK hospital pharmacies: lessons from the national aseptic error reporting scheme

Background Pharmacy aseptic units prepare and supply injectables to minimise risks. The UK National Aseptic Error Reporting Scheme has been collecting data on pharmacy compounding errors, including near-misses, since 2003. Objectives The cumulative reports from January 2004 to December 2007, inclusive, were analysed. Methods The different variables of product types, error types, staff making and detecting errors, stage errors detected, perceived contributory factors, and potential or actual outcomes were presented by cross-tabulation of data. Results A total of 4691 reports were submitted against an estimated 958 532 items made, returning 0.49% as the overall error rate. Most of the errors were detected before reaching patients, with only 24 detected during or after administration. The highest number of reports related to adult cytotoxic preparations (40%) and the most frequently recorded error was a labelling error (34.2%). Errors were mostly detected at first check in assembly area (46.6%). Individual staff error contributed most (78.1%) to overall errors, while errors with paediatric parenteral nutrition appeared to be blamed on low staff levels more than other products were. The majority of errors (68.6%) had no potential patient outcomes attached, while it appeared that paediatric cytotoxic products and paediatric parenteral nutrition were associated with greater levels of perceived patient harm. Conclusions The majority of reports were related to near-misses, and this study highlights scope for examining current arrangements for checking and releasing products, certainly for paediatric cytotoxic and paediatric parenteral nutrition preparations within aseptic units, but in the context of resource and capacity constraints.

Errors associated with preparation of adult and paediatric parenteral nutrition in UK hospital pharmacies

Rationale: In UK hospitals, the preparation of all total parenteral nutrition (TPN) products must be made in the pharmacy as TPNs are categorised as high-risk injectables (NPSA/2007/20). The National Aseptic Error Reporting Scheme has been collecting data on pharmacy compounding errors in the UK since August 2003. This study reports on types of error associated with the preparation of TPNs, including the stage at which these were identified and potential and actual patient outcomes. Methods: Reports of compounding errors for the period 1/2004 - 3/2007 were analysed on an Excel spreadsheet. Results: Of a total of 3691 compounding error reports, 674 (18%) related to TPN products; 548 adult vs. 126 paediatric. A significantly higher proportion of adult TPNs (28% vs. 13% paediatric) were associated with labelling errors and a significantly higher proportion of paediatric TPNs (25% vs. 15% adult) were associated with incorrect transcriptions (Chi-Square Test; p<0.005). Labelling errors were identified equally by pharmacists (42%) and technicians (48%) with technicians detecting mainly at first check and pharmacists at final check. Transcription errors were identified mainly by technicians (65% vs. 27% pharmacist) at first check. Incorrect drug selection (13%) and calculation errors (9%) were associated with adult and paediatric TPN preparations in the same ratio. One paediatric TPN error detected at first check was considered potentially catastrophic; 31 (5%) errors were considered of major and 38 (6%) of moderate potential consequence. Five errors (2 moderate, 1 minor) were identified during or after administration. Conclusions: While recent UK patient safety initiatives are aimed at improving the safety of injectable medicines in clinical areas, the current study highlights safety problems that exist within pharmacy production units. This could be used in the creation of an error management tool for TPN compounding processes within hospital pharmacies.

Establishing a sexual identity: case studies of learners with autism and learning difficulties

The physical and emotional changes that occur in adolescence are part of the process of sexual maturity. These changes occur irrespective of ability and are often aligned with psychological and social factors. When the nature of a disability has an inherent limitation in social awareness, as is the case for individuals with autism, the achievement of personal sexual identity can become much more complex. Challenges in supporting individuals in this respect can be caused by the sensitive aspects of inappropriate behaviour, the abstract nature of teaching the topic, and the general reluctance on the part of parents and staff to discuss sexuality in individuals with disabilities. This article explores how a residential school addressed this gap. It provides details of how this need was met for seven students and the process undertaken to involve staff, parents and other stakeholders to establish ongoing support.

Protocol for the PINCER trial: a cluster randomised trial comparing the effectiveness of a pharmacist-led IT-based intervention with simple feedback in reducing rates of clinically important errors in medicines management in general practices

Background: Medication errors are an important cause of morbidity and mortality in primary care. The aims of this study are to determine the effectiveness, cost effectiveness and acceptability of a pharmacist-led information-technology-based complex intervention compared with simple feedback in reducing proportions of patients at risk from potentially hazardous prescribing and medicines management in general (family) practice. Methods: Research subject group: "At-risk" patients registered with computerised general practices in two geographical regions in England. Design: Parallel group pragmatic cluster randomised trial. Interventions: Practices will be randomised to either: (i) Computer-generated feedback; or (ii) Pharmacist-led intervention comprising of computer-generated feedback, educational outreach and dedicated support. Primary outcome measures: The proportion of patients in each practice at six and 12 months post intervention: - with a computer-recorded history of peptic ulcer being prescribed non-selective non-steroidal anti-inflammatory drugs - with a computer-recorded diagnosis of asthma being prescribed beta-blockers - aged 75 years and older receiving long-term prescriptions for angiotensin converting enzyme inhibitors or loop diuretics without a recorded assessment of renal function and electrolytes in the preceding 15 months. Secondary outcome measures; These relate to a number of other examples of potentially hazardous prescribing and medicines management. Economic analysis: An economic evaluation will be done of the cost per error avoided, from the perspective of the UK National Health Service (NHS), comparing the pharmacist-led intervention with simple feedback. Qualitative analysis: A qualitative study will be conducted to explore the views and experiences of health care professionals and NHS managers concerning the interventions, and investigate possible reasons why the interventions prove effective, or conversely prove ineffective. Sample size: 34 practices in each of the two treatment arms would provide at least 80% power (two-tailed alpha of 0.05) to demonstrate a 50% reduction in error rates for each of the three primary outcome measures in the pharmacist-led intervention arm compared with a 11% reduction in the simple feedback arm. Discussion: At the time of submission of this article, 72 general practices have been recruited (36 in each arm of the trial) and the interventions have been delivered. Analysis has not yet been undertaken.

Learning and memory in holocaust survivors with posttraumatic stress disorder

Background: Impairments in explicit memory have been observed in Holocaust survivors with posttraumatic stress disorder. Methods: To evaluate which memory components are preferentially affected, the California Verbal Learning Test was administered to Holocaust survivors with (n = 36) and without (n = 26) posttraumatic stress disorder, and subjects not exposed to the Holocaust (n = 40). Results: Posttraumatic stress disorder subjects showed impairments in learning and short-term and delayed retention compared to nonexposed subjects; survivors without posttraumatic stress disorder did not. Impairments in learning, but not retention, were retained after controlling fir intelligence quotient. Older age was associated with poorer learning and memory performance in the posttraumatic stress disorder group only. Conclusions: The most robust impairment observed in posttraumatic stress disorder was in verbal learning, which may be a risk factor for or consequence of chronic posttraumatic stress disorder. The negative association between performance and age may reflect accelerated cognitive decline in posttraumatic stress disorder.

Effective e-learning integration with traditional learning in a blended learning environment

E-Learning is an emerging tool that uses advanced technology to provide training and development in higher education and within industry. Its rapid growth has been facilitated by the Internet and the massive opportunities in global education. The aim of this study is to consider how effective and efficient e-learning is when integrated with traditional learning in a blended learning environment. The study will provide a comparison between purist ELearning and Blended learning environment. The paper will also provide directions for the blended learning environment which can be used by all the three main stakeholder student, tutors and institution to make strategic decision about the learning and teaching initiatives. The paper concludes that blended learning approaches offer the most flexible and scalable route to E-Learning.