Observational research and verbal protocol methods

This paper describes observational research and verbal protocols methods, how these methods are applied and integrated within different contexts, and how they complement each other. The first case study focuses on nurses’ interaction during bandaging of patients’ lower legs. To maintain research rigor a triangulation approach was applied that links observations of current procedures, ‘talk-aloud’ protocol during interaction and retrospective protocol. Maps of interactions demonstrated that some nurses bandage more intuitively than others. Nurses who bandage intuitively assemble long sequences of bandaging actions while nurses who bandage less intuitively ‘focus-shift’ in between bandaging actions. Thus different levels of expertise have been identified. The second case study consists of two laboratory experiments. It focuses on analysing and comparing software and product design teams and how they approached a design problem. It is based on the observational and verbal data analysis. The coding scheme applied evolved during the analysis of the activity of each team and is identical for all teams. The structure of knowledge captured from the analysis of the design team maps of interaction is identified. The significance of this work is within its methodological approach. The maps of interaction are instrumental for understanding the activities and interactions of the people observed. By examining the maps of interaction, it is possible to draw conclusions about interactions, structure of knowledge captured and level of expertise. This research approach is transferable to other design domains. Designers will be able to transfer the interaction maps outcomes to systems and services they design.

Uncertainty analysis of pollutant build-up modelling based on a Bayesian Weighted Least Squares approach

Reliable pollutant build-up prediction plays a critical role in the accuracy of urban stormwater quality modelling outcomes. However, water quality data collection is resource demanding compared to streamflow data monitoring, where a greater quantity of data is generally available. Consequently, available water quality data sets span only relatively short time scales unlike water quantity data. Therefore, the ability to take due consideration of the variability associated with pollutant processes and natural phenomena is constrained. This in turn gives rise to uncertainty in the modelling outcomes as research has shown that pollutant loadings on catchment surfaces and rainfall within an area can vary considerably over space and time scales. Therefore, the assessment of model uncertainty is an essential element of informed decision making in urban stormwater management. This paper presents the application of a range of regression approaches such as ordinary least squares regression, weighted least squares Regression and Bayesian Weighted Least Squares Regression for the estimation of uncertainty associated with pollutant build-up prediction using limited data sets. The study outcomes confirmed that the use of ordinary least squares regression with fixed model inputs and limited observational data may not provide realistic estimates. The stochastic nature of the dependent and independent variables need to be taken into consideration in pollutant build-up prediction. It was found that the use of the Bayesian approach along with the Monte Carlo simulation technique provides a powerful tool, which attempts to make the best use of the available knowledge in the prediction and thereby presents a practical solution to counteract the limitations which are otherwise imposed on water quality modelling.

A comparative analysis of risk stratification tools for emergency department patients with chest pain

Background: Appropriate disposition of emergency department (ED) patients with chest pain is dependent on clinical evaluation of risk. A number of chest pain risk stratification tools have been proposed. The aim of this study was to compare the predictive performance for major adverse cardiac events (MACE) using risk assessment tools from the National Heart Foundation of Australia (HFA), the Goldman risk score and the Thrombolysis in Myocardial Infarction risk score (TIMI RS). Methods: This prospective observational study evaluated ED patients aged ≥30 years with non-traumatic chest pain for which no definitive non-ischemic cause was found. Data collected included demographic and clinical information, investigation findings and occurrence of MACE by 30 days. The outcome of interest was the comparative predictive performance of the risk tools for MACE at 30 days, as analyzed by receiver operator curves (ROC). Results: Two hundred eighty-one patients were studied; the rate of MACE was 14.1%. Area under the curve (AUC) of the HFA, TIMI RS and Goldman tools for the endpoint of MACE was 0.54, 0.71 and 0.67, respectively, with the difference between the tools in predictive ability for MACE being highly significant [chi2 (3) = 67.21, N = 276, p < 0.0001]. Conclusion: The TIMI RS and Goldman tools performed better than the HFA in this undifferentiated ED chest pain population, but selection of cutoffs balancing sensitivity and specificity was problematic. There is an urgent need for validated risk stratification tools specific for the ED chest pain population.

Association of a disintegrin and metalloprotease 33 (ADAM33) gene polymorphisms with the risk of COPD: An updated meta-analysis of 2,644 cases and 4,804 controls

A series of observational studies have been made to investigate the association of the ADAM33 gene polymorphisms with the risk of COPD, but their results were conflicting. Therefore, we performed an updated meta-analysis to quantitatively summarize the associations of ADAM33 gene polymorphisms with the risk of COPD. Thirteen case–control studies referring to nine SNPs were identified: V4 (rs2787094), T+1 (rs2280089), T2 (rs2280090), T1 (rs2280091), S2 (rs528557), S1 (rs3918396), Q−1 (rs612709), F+1 (rs511898) and ST+5 (rs597980). A dominant model (AA+Aa vs. aa), recessive model (AA vs. Aa+aa), additive model (AA vs. aa) and allelic model (A vs. a) were used to evaluate the association of ADAM33 polymorphism with the risk of COPD. The results indicated that significant associations were found for ADAM33 T1, T2, S1, Q−1, F+1 and ST+5 polymorphisms associated with the risk of COPD in different populations. However, no significant associations were found for V4, T+1 and S2 polymorphisms with the risk of COPD in all genetic models, even in the subgroup analysis by ethnicity. This meta-analysis provided evidence that the ADAM33 T1, T2, S1, Q−1, F+1 and ST+5 six locus polymorphisms association with the risk of COPD. Furthermore, T2, Q−1 and ST+5 indicated an association with the risk of COPD in the European populations, whereas T1, T2, S1, F+1 and Q−1 indicated an association with the risk of COPD in the Asian populations.

Triaging older major trauma patients in the emergency department: An observational study

Background The objective of this study was to compare the triage category assigned to older trauma patients with younger trauma patients upon arrival to the emergency department. The focus was to examine whether older major trauma patients were less likely to be assigned an emergency triage category on arrival to the emergency department after controlling for relevant demographics, injury characteristics and injury severity. Methods This was an observational study using data from the Queensland Trauma Registry. All trauma patients aged 15 years and older who presented to contributing hospitals between 1 January 2005 and 31 December 2009 with an Injury Severity Score (ISS)>15 were included. Logistic regression analysis examined the odds of assignment to emergency (Australasian Triage Scale (ATS) 1 or 2) versus urgent (ATS 3–5) treatment for patients across various age categories after adjustment for relevant demographics, injury characteristics and injury severity. Results The study used data on 6923 patients with a median (IQR) age of 43 (26–62) years and a mortality of 11.4% (95% CI 10.7% to 12.2%). Compared with individuals aged 15–34, the adjusted odds of being assigned an ATS category 1 or 2 were 30% lower (OR=0.68, 95% CI 0.57 to 0.81) for individuals aged 55–75 years and were 50% lower (OR=0.46, 95% CI 0.37 to 0.56) for individuals aged 75 years or older. Conclusions Among patients with an ISS>15, older major trauma patients were less likely to be assigned an emergency triage category compared with younger patients. This suggests that the elderly may be undertriaged and provides a potential area of study for reducing mortality and morbidity in older

Change to costs and lengths of stay in the emergency department and the Brisbane protocol: An observational study

- Objective To compare health service cost and length of stay between a traditional and an accelerated diagnostic approach to assess acute coronary syndromes (ACS) among patients who presented to the emergency department (ED) of a large tertiary hospital in Australia. - Design, setting and participants This historically controlled study analysed data collected from two independent patient cohorts presenting to the ED with potential ACS. The first cohort of 938 patients was recruited in 2008–2010, and these patients were assessed using the traditional diagnostic approach detailed in the national guideline. The second cohort of 921 patients was recruited in 2011–2013 and was assessed with the accelerated diagnostic approach named the Brisbane protocol. The Brisbane protocol applied early serial troponin testing for patients at 0 and 2 h after presentation to ED, in comparison with 0 and 6 h testing in traditional assessment process. The Brisbane protocol also defined a low-risk group of patients in whom no objective testing was performed. A decision tree model was used to compare the expected cost and length of stay in hospital between two approaches. Probabilistic sensitivity analysis was used to account for model uncertainty. - Results Compared with the traditional diagnostic approach, the Brisbane protocol was associated with reduced expected cost of $1229 (95% CI −$1266 to $5122) and reduced expected length of stay of 26 h (95% CI −14 to 136 h). The Brisbane protocol allowed physicians to discharge a higher proportion of low-risk and intermediate-risk patients from ED within 4 h (72% vs 51%). Results from sensitivity analysis suggested the Brisbane protocol had a high chance of being cost-saving and time-saving. - Conclusions This study provides some evidence of cost savings from a decision to adopt the Brisbane protocol. Benefits would arise for the hospital and for patients and their families.

Intraseasonal Variation of the Summer Monsoon I:Observational Aspects

Within the summer monsoon, the circulation and rainfall over the Indian region exhibit large variations over the synoptic scale of 3-7 days and the supersynoptic scales of 10 days and longer. In this paper we discuss some facets of intraseasonal variation on the supersynoptic scale on the basis of existing observational studies and some new analysis. The major variation of the summer monsoon rainfall on this scale is the active-break cycle. The deep convection over the Indian region on a typical day in the active phase is organized over thousands of kilometers in the zonal direction and is associated with a tropical convergence zone (TCZ). The intraseasonal variations on the supersynoptic scale are also coherent on these scales and are related to the space-time variation of the large-scale TCZ. The latitudinal distribution of the occurrence of the TCZ is bimodal with the primary mode over the heated continent and a secondary mode over the ocean. The variation of the continental TCZ is generally out of phase with that of the oceanic TCZ. During the active spells, the TCZ persists over the continent in the monsoon zone. The revival from breaks occurs either by northward propagation of the TCZ over the equatorial Indian Ocean or by genesis of a disturbance in the monsoon zone (often as a result of westward propagations from W. Pacific). The mechanisms governing the fluctuation between active spells and breaks, the interphase transition and the complex interactions of the TCZ over the Indian subcontinent with the TCZ over the equatorial Indian Ocean and the W. Pacific, have yet to be completely understood.

Ship-Mounted Real-Time Surface Observational System on board Indian Vessels for Validation and Refinement of Model Forcing Fields

A network of ship-mounted real-time Automatic Weather Stations integrated with Indian geosynchronous satellites Indian National Satellites (INSATs)] 3A and 3C, named Indian National Centre for Ocean Information Services Real-Time Automatic Weather Stations (I-RAWS), is established. The purpose of I-RAWS is to measure the surface meteorological-ocean parameters and transmit the data in real time in order to validate and refine the forcing parameters (obtained from different meteorological agencies) of the Indian Ocean Forecasting System (INDOFOS). Preliminary validation and intercomparison of analyzed products obtained from the National Centre for Medium Range Weather Forecasting and the European Centre for Medium-Range Weather Forecasts using the data collected from I-RAWS were carried out. This I-RAWS was mounted on board oceanographic research vessel Sagar Nidhi during a cruise across three oceanic regimes, namely, the tropical Indian Ocean, the extratropical Indian Ocean, and the Southern Ocean. The results obtained from such a validation and intercomparison, and its implications with special reference to the usage of atmospheric model data for forcing ocean model, are discussed in detail. It is noticed that the performance of analysis products from both atmospheric models is similar and good; however, European Centre for Medium-Range Weather Forecasts air temperature over the extratropical Indian Ocean and wind speed in the Southern Ocean are marginally better.

Forest observational studies in India: Past developments and considerations for the future

Long term forest research sites in India, going by different names including Linear Tree Increment Plots, Linear Increment Plots, Linear Sample Plots and Permanent Preservation Plots, cover diverse plant communities and environmental conditions. Presently, some of these long-term observational studies are functional, some are disturbed and others have almost been lost. The accumulated data will become increasingly important in the context of environmental modelling and climate change, especially if the plots and data can be maintained and/or revived. This contribution presents the history and current state of forest research plots in India, including details of locations and re-measurements. We provide a brief introduction of the National Forest Inventory (NFI), Preservation Plots in natural forests, the 50-ha Mudumalai Forest Dynamics Plot as part of the Centre for Tropical Forest Science and Smithsonian Institution Global Earth Observatories network (CTFS-SIGEO), and research plots established in plantations for tree growth studies and modelling. We also present some methodological details including assessment and analysis for two types of observational studies, the Tree Count Plots (TCP) and Tree Re-measurement Plots (TRP). Arguments are presented in favour of enumeration and analysis methods which are consistent with current approaches in forest ecological research. (c) 2013 Elsevier B.V. All rights reserved.

Observational and theoretical advances in cosmological foreground emission

Observational and theoretical work towards the separation of foreground emission from the cosmic microwave background is described. The bulk of this work is in the design, construction, and commissioning of the C-Band All-Sky Survey (C-BASS), an experiment to produce a template of the Milky Way Galaxy's polarized synchrotron emission. Theoretical work is the derivation of an analytical approximation to the emission spectrum of spinning dust grains.

The performance of the C-BASS experiment is demonstrated through a preliminary, deep survey of the North Celestial Pole region. A comparison to multiwavelength data is performed, and the thermal and systematic noise properties of the experiment are explored. The systematic noise has been minimized through careful data processing algorithms, implemented both in the experiment's Field Programmable Gate Array (FPGA) based digital backend and in the data analysis pipeline. Detailed descriptions of these algorithms are presented.

The analytical function of spinning dust emission is derived through the application of careful approximations, with each step tested against numerical calculations. This work is intended for use in the parameterized separation of cosmological foreground components and as a framework for interpreting and comparing the variety of anomalous microwave emission observations.

Removing observational noise from fisheries-independent time series data using ARIMA models

Abundance indices derived from fishery-independent surveys typically exhibit much higher interannual variability than is consistent with the within-survey variance or the life history of a species. This extra variability is essentially observation noise (i.e. measurement error); it probably reflects environmentally driven factors that affect catchability over time. Unfortunately, high observation noise reduces the ability to detect important changes in the underlying population abundance. In our study, a noise-reduction technique for uncorrelated observation noise that is based on autoregressive integrated moving average (ARIMA) time series modeling is investigated. The approach is applied to 18 time series of finfish abundance, which were derived from trawl survey data from the U.S. northeast continental shelf. Although the a priori assumption of a random-walk-plus-uncorrelated-noise model generally yielded a smoothed result that is pleasing to the eye, we recommend that the most appropriate ARIMA model be identified for the observed time series if the smoothed time series will be used for further analysis of the population dynamics of a species.

Measurement of stressful postures during daily activities: An observational study with older people.

This study measured the postures of older people during cooking and laundry. A sample of men and women aged 75+ years (n=27) was recruited and observed in a home-like environment. Postures were recorded with a measurement system in an objective and detailed manner. The participants were videotaped to be able to see where 'critical' postures occurred, as defined by a trunk inclination of ≥60°. Analysis of data was facilitated by specially developed software. Critical postures accounted for 3% of cooking and 10% of laundry, occurring primarily during retrieving from and putting in lower cabinets, the refrigerator, laundry basket or washing machine as well as disposing into the waste bin. These tasks involve a great variation in postural changes and pose a particular risk to older people. The results suggest that the use of stressful postures may decrease efficiency and increase fatigue, eventually leading to difficulties with daily activities. The specific tasks identified during which critical postures occurred should be targeted by designers in order to improve the activities. A few examples are given of how better design can reduce or eliminate some of the postural constraints.

Analysis of current induced by long internal solitary waves in stratified ocean

An approximate theoretical expression for the current induced by long internal solitary waves is presented when the ocean is continuously or two-layer stratified. Particular attention is paid to characterizing velocity fields in terms of magnitude, flow components, and their temporal evolution/spatial distribution. For the two-layer case, the effects of the upper/lower layer depths and the relative layer density difference upon the induced current are further studied. The results show that the horizontal components are basically uniform in each layer with a shear at the interface. In contrast, the vertical counterparts vary monotonically in the direction of the water depth in each layer while they change sign across the interface or when the wave peak passes through. In addition, though the vertical components are generally one order of magnitude smaller than the horizontal ones, they can never be neglected in predicting the heave response of floating platforms in gravitationally neutral balance. Comparisons are made between the partial theoretical results and the observational field data. Future research directions regarding the internal wave induced flow field are also indicated.

Interannual horizontal heat advection in the surface mixed layer over the equatorial Pacific Ocean: assimilation versus TAO analysis

The interannual anomalies of horizontal heat advection in the surface mixed layer over the equatorial Pacific Ocean in an assimilation experiment are studied and compared with existing observational analyses. The assimilation builds upon a hindcast study that has produced a good simulation of the observed equatorial currents and optimizes the simulation of the Reynolds sea surface temperature (SST) data. The comparison suggests that the assimilation has improved the simulation of the interannual horizontal heat advection of the surface mixed layer significantly. During periods of interrupted current measurements, the assimilation is shown to produce more meaningful anomalies of the heat advection than the interpolation of the observational data does. The assimilation also shows that the eddy heat flux due to the correlation between high-frequency current and SST variations, which is largely overlooked by the existing observational analyses, is important for the interannual SST balance over the equatorial Pacific. The interannual horizontal heat advection anomalies are found to be sensitive to SST errors where oceanic currents are strong, which is a challenge for ENSO prediction. The study further suggests that the observational analyses of the tropical SST balance based on the TAO and the Reynolds SST data contain significant errors due to the large gradient errors in the Reynolds SST data, which are amplified into the advection anomalies by the large equatorial currents.

The prognosis of incurable cachectic cancer patients on home parenteral nutrition: A multi-centre observational study with prospective follow-up of 414 patients

Background: The role of home parenteral nutrition (HPN) in incurable cachectic cancer patients unable to eat is extremely controversial. The aim of this study is to analyse which factors can influence the outcome. Patients and methods: We studied prospectively 414 incurable cachectic (sub)obstructed cancer patients receiving HPN and analysed the association between patient or clinical characteristics and surviving status. Results: Median weight loss, versus pre-disease and last 6-month period, was 24% and 16%, respectively. Median body mass index was 19.5, median KPS was 60, median life expectancy was 3 months. Mean/median survival was 4.7/3.0 months; 50.0% and 22.9% of patients survived 3 and 6 months, respectively. At the multivariable analysis, the variables significantly associated with 3- and 6-month survival were Glasgow Prognostic Score (GPS) and KPS, and GPS, KPS and tumour spread, respectively. By the aggregation of the significant variables, it was possible to dissect several classes of patients with different survival probabilities. Conclusions: The outcome of cachectic incurable cancer patients on HPN is not homogeneous. It is possible to identify groups of patients with a ≥6-month survival (possibly longer than that allowed in starvation). The indications for HPN can be modulated on these clinical/biochemical indices. © The Author 2013. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.