Depression and its assessment among stroke patients and their caregivers

Approximately one-third of stroke patients experience depression. Stroke also has a profound effect on the lives of caregivers of stroke survivors. However, depression in this latter population has received little attention. In this study the objectives were to determine which factors are associated with and can be used to predict depression at different points in time after stroke; to compare different depression assessment methods among stroke patients; and to determine the prevalence, course and associated factors of depression among the caregivers of stroke patients. A total of 100 consecutive hospital-admitted patients no older than 70 years of age were followed for 18 months after having their first ischaemic stroke. Depression was assessed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R), Beck Depression Inventory (BDI), Hamilton Rating Scale (HRSD), Visual Analogue Mood Scale (VAMS), Clinical Global Impression (CGI) and caregiver ratings. Neurological assessments and a comprehensive neuropsychological test battery were performed. Depression in caregivers was assessed by BDI. Depressive symptoms had early onsets in most cases. Mild depressive symptoms were often persistent with little change during the 18-month follow-up, although there was an increase in major depression over the same time interval. Stroke severity was associated with depression especially from 6 to 12 months post-stroke. At the acute phase, older patients were at higher risk of depression, and a higher proportion of men were depressed at 18 months post-stroke. Of the various depression assessment methods, none stood clearly apart from the others. The feasibility of each did not differ greatly, but prevalence rates differed widely according to the different criteria. When compared against DSM-III-R criteria, sensitivity and specificity were acceptable for the CGI, BDI, and HRSD. The CGI and BDI had better sensitivity than the more specific HRSD. The VAMS seemed not to be a reliable method for assessing depression among stroke patients. The caregivers often rated patients depression as more severe than did the patients themselves. Moreover, their ratings seemed to be influenced by their own depression. Of the caregivers, 30-33% were depressed. At the acute phase, caregiver depression was associated with the severity of the stroke and the older age of the patient. The best predictor of caregiver depression at later follow-up was caregiver depression at the acute phase. The results suggest that depression should be assessed during the early post-stroke period and that the follow-up of those at risk of poor emotional outcome should be extended beyond the first year post-stroke. Further, the assessment of well-being of the caregivers of stroke patients should be included as a part of a rehabilitation plan for stroke patients.

Ecological consequences of genetic modifications - an invasion analysis approach

Biological invasions are considered as one of the greatest threats to biodiversity, as they may lead to disruption and homogenization of natural communities, and in the worst case, to native species extinctions. The introduction of gene modified organisms (GMOs) to agricultural, fisheries and forestry practices brings them into contact with natural populations. GMOs may appear as new invasive species if they are able to (1) invade into natural habitats or (2) hybridize with their wild relatives. The benefits of GMOs, such as increased yield or decreased use of insecticides or herbicides in cultivation, may thus be reduced due the potential risks they may cause. A careful ecological risk analysis therefore has to precede any responsible GMO introduction. In this thesis I study ecological invasion in relation to GMOs, and what kind of consequences invasion may have in natural populations. A set of theoretical models that combine life-history evolution, population dynamics, and population genetics were developed for the hazard identification part of ecological risks assessment of GMOs. In addition, the potential benefits of GMOs in management of an invasive pest were analyzed. In the first study I showed that a population that is fluctuating due to scramble-type density dependence (due to, e.g., nutrient competition in plants) may be invaded by a population that is relatively more limited by a resource (e.g., light in plants) that is a cause of contest-type density dependence. This result emphasises the higher risk of invasion in unstable environments. The next two studies focused on escape of a growth hormone (GH) transgenic fish into a natural population. The results showed that previous models may have given too pessimistic a view of the so called Trojan gene -effect, where the invading genotype is harmful for the population as a whole. The previously suggested population extinctions did not occur in my studies, since the changes in mating preferences caused by the GH-fish were be ameliorated by decreased level of competition. The GH-invaders may also have to exceed a threshold density before invasion can be successful. I also showed that the prevalence of mature parr (aka. sneaker) strategy among GH-fish may have clear effect on invasion outcome. The fourth study assessed the risks and developed methods against the invasion of the Colorado Potato Beetle (CPB, Leptinotarsa decemlineata). I showed that the eradication of CPB is most important for the prevention of their establishment, but the cultivation of transgenic Bt-potato could also be effective. In general, my results emphasise that invasion of transgenic species or genotypes to be possible under certain realistic conditions and resulting in competitive exclusion, population decline through outbreeding depression and genotypic displacement of native species. Ecological risk assessment should regard the decline and displacement of the wild genotype by an introduced one as a consequence that is as serious as the population extinction. It will also be crucial to take into account different kinds of behavioural differences among species when assessing the possible hazards that GMOs may cause if escaped. The benefits found of GMO crops effectiveness in pest management may also be too optimistic since CPB may evolve resistance to Bt-toxin. The models in this thesis could be further applied in case specific risk assessment of GMOs by supplementing them with detailed data of the species biology, the effect of the transgene introduced to the species, and also the characteristics of the populations or the environments in the risk of being invaded.

A catch-free stock assessment model with application to goliath grouper (Epinephelus itajara) off southern Florida

Many modern stock assessment methods provide the machinery for determining the status of a stock in relation to certain reference points and for estimating how quickly a stock can be rebuilt. However, these methods typically require catch data, which are not always available. We introduce a model-based framework for estimating reference points, stock status, and recovery times in situations where catch data and other measures of absolute abundance are unavailable. The specif ic estimator developed is essentially an age-structured production model recast in terms relative to pre-exploitation levels. A Bayesian estimation scheme is adopted to allow the incorporation of pertinent auxiliary information such as might be obtained from meta-analyses of similar stocks or anecdotal observations. The approach is applied to the population of goliath grouper (Epinephelus itajara) off southern Florida, for which there are three indices of relative abundance but no reliable catch data. The results confirm anecdotal accounts of a marked decline in abundance during the 1980s followed by a substantial increase after the harvest of goliath grouper was banned in 1990. The ban appears to have reduced fishing pressure to between 10% and 50% of the levels observed during the 1980s. Nevertheless, the predicted fishing mortality rate under the ban appears to remain substantial, perhaps owing to illegal harvest and depth-related release mortality. As a result, the base model predicts that there is less than a 40% chance that the spawning biomass will recover to a level that would produce a 50% spawning potential ratio.

Ex-ante assessment of integrated aquaculture-agriculture adoption and impact in Southern Malawi

There are increasing requirements for impact assessment by development partners in order to increase the accountability and effectiveness of research and development projects. Impact assessment research has been dominated by conventional economic methods. This context challenges agricultural research organizations to develop and apply alternative impact assessment methods incorporating economic, social, and environmental impact components. In this study, we use the Tradeoff Analysis for Multi-Dimensional Impact Assessment (TOA-MD) model to evaluate the impact of integrated aquaculture-agriculture (IAA) adoption in Malawi. The study demonstrated that with a minimal data set, the TOA-MD model can be applied to predict and assess the adoption rates of new technologies and practices as well as their economic and non-economic impacts.

Improving methods and indicators for evaluating coastal water eutrophication: a pilot study in the Gulf of Maine

Study Goals and Objectives: 1) Improve existing nutrient-related eutrophication assessment methods, updating (from early 1990s to early 2000s) the eutrophication assessment for systems included in the study with the improved method. 2) Develop a human-use/socioeconomic indicator to complement the assessment indicator. The human-use indicator was developed to evaluate costs of nutrient-related degradation in coastal waters and to put the issue into a broader context relevant to the interested public and legislators as well as to scientists. 3) Project objectives included collecting existing water quality data, developing an accessible database appropriate for application to a national study, and applying the assessment methods to 14 coastal systems – nine systems north of Cape Cod and five systems south. The geographical distribution of systems was used to examine potential regional differences in condition. 4) The intent is to use the lessons learned in this pilot study on a national scale to guide completion of an update of the 1999 National Estuarine Eutrophication Assessment.

Future-proofed energy design for dwellings: Case studies from England and application to the Code for Sustainable Homes

This paper investigates 'future-proofing' as an unexplored yet all-important aspect in the design of low-energy dwellings. It refers particularly to adopting lifecycle thinking and accommodating risks and uncertainties in the selection of fabric energy efficiency measures and low or zero-carbon technologies. Based on a conceptual framework for future-proofed design, the paper first presents results from the analysis of two 'best practice' housing developments in England; i.e., North West Cambridge in Cambridge and West Carclaze and Baal in St. Austell, Cornwall. Second, it examines the 'Energy and CO2 Emissions' part of the Code for Sustainable Homes to reveal which design criteria and assessment methods can be practically integrated into this established building certification scheme so that it can become more dynamic and future-oriented.Practical application: Future-proofed construction is promoted implicitly within the increasingly stringent building regulations; however, there is no comprehensive method to readily incorporate futures thinking into the energy design of buildings. This study has a three-fold objective of relevance to the building industry:Illuminating the two key categories of long-term impacts in buildings, which are often erroneously treated interchangeably:- The environmental impact of buildings due to their long lifecycles.- The environment's impacts on buildings due to risks and uncertainties affecting the energy consumption by at least 2050. This refers to social, technological, economic, environmental and regulatory (predictable or unknown) trends and drivers of change, such as climate uncertainty, home-working, technology readiness etc.Encouraging future-proofing from an early planning stage to reduce the likelihood of a prematurely obsolete building design.Enhancing established building energy assessment methods (certification, modelling or audit tools) by integrating a set of future-oriented criteria into their methodologies. © 2012 The Chartered Institution of Building Services Engineers.

A conceptual framework for future-proofing the energy performance of buildings

This paper presents a review undertaken to understand the concept of 'future-proofing' the energy performance of buildings. The long lifecycles of the building stock, the impacts of climate change and the requirements for low carbon development underline the need for long-term thinking from the early design stages. 'Future-proofing' is an emerging research agenda with currently no widely accepted definition amongst scholars and building professionals. In this paper, it refers to design processes that accommodate explicitly full lifecycle perspectives and energy trends and drivers by at least 2050, when selecting energy efficient measures and low carbon technologies. A knowledge map is introduced, which explores the key axes (or attributes) for achieving a 'future-proofed' energy design; namely, coverage of sustainability issues, lifecycle thinking, and accommodating risks and uncertainties that affect the energy consumption. It is concluded that further research is needed so that established building energy assessment methods are refined to better incorporate future-proofing. The study follows an interdisciplinary approach and is targeted at design teams with aspirations to achieve resilient and flexible low-energy buildings over the long-term. © 2012 Elsevier Ltd.

Teaching, learning and assessment in MSc. Databases units at University of Greenwich

In this paper we look at ways of delivering and assessing learning on database units offered on higher degree programmes (MSc) in the School of Computing and Mathematical Sciences at the University of Greenwich. Of critical importance is the teaching methods employed for verbal disposition, practical laboratory exercises and a careful evaluation of assessment methods and assessment tools in view of the fact that databases involve not only database design but also use of practical tools, such as database management systems (DBMSs) software, human designers, database administrators (DBA) and end users. Our goal is to clearly identify potential key success factors in delivering and assessing learning in both practical and theoretical aspects of database course units.

Two Birds, One Stone: Combining Student Assessment and Socio-Legal Research

We describe here a method of assessment for students. A number of short-comings of traditional assessment methods, especially essays and examinations, are discussed and an alternative assessment method, the student project, is suggested. The method aims not just to overcome the short-comings of more traditional methods, but also to provide over-worked and under-resourced academics with viable primary data for socio-legal research work. Limitations to the method are discussed, with proposals for minimising the impact of these limitations. The whole �student project� approach is also discussed with reference to the Quality Assurance Agency benchmark standards for law degrees, standards which are expected of all institutions in the UK.

Welfare risk assessment:The benefits and common pitfalls

Risk is defined as a situation involving exposure to danger. Risk assessment by nature characterises the probability of a negative event occurring and quantifies the consequences of such an event. Risk assessment is increasingly being used in the field of animal welfare as a means of drawing comparisons between multiple welfare problems within and between species and identifying those that should be prioritised by policy-makers, either because they affect a large proportion of the population or because they have particularly severe consequences for those affected. The assessment of risk is typically based on three fundamental factors: intensity of consequences, duration affected by consequences and prevalence. However, it has been recognised that these factors alone do not give a complete picture of a hazard and its associated consequences. Rather, to get a complete picture, it is important to also consider information about the hazard itself: probability of exposure to the hazard and duration of exposure to the hazard. The method has been applied to a variety of farmed species (eg poultry, dairy cows, farmed fish), investigating housing, husbandry and slaughter procedures, as well as companion animals, where it has been used to compare inherited defects in pedigree dogs and horses. To what extent can we trust current risk assessment methods to get the priorities straight? How should we interpret the results produced by such assessments? Here, the potential difficulties and pitfalls of the welfare risk assessment method will be discussed: (i) the assumption that welfare hazards are independent; (ii) the problem of quantifying the model parameters; and (iii) assessing and incorporating variability and uncertainty into welfare risk assessments. © 2012 Universities Federation for Animal Welfare.

Performance assessment of cascade control loopswith non-Gaussian disturbances using entropy information

Cascade control is one of the routinely used control strategies in industrial processes because it can dramatically improve the performance of single-loop control, reducing both the maximum deviation and the integral error of the disturbance response. Currently, many control performance assessment methods of cascade control loops are developed based on the assumption that all the disturbances are subject to Gaussian distribution. However, in the practical condition, several disturbance sources occur in the manipulated variable or the upstream exhibits nonlinear behaviors. In this paper, a general and effective index of the performance assessment of the cascade control system subjected to the unknown disturbance distribution is proposed. Like the minimum variance control (MVC) design, the output variances of the primary and the secondary loops are decomposed into a cascade-invariant and a cascade-dependent term, but the estimated ARMA model for the cascade control loop based on the minimum entropy, instead of the minimum mean squares error, is developed for non-Gaussian disturbances. Unlike the MVC index, an innovative control performance index is given based on the information theory and the minimum entropy criterion. The index is informative and in agreement with the expected control knowledge. To elucidate wide applicability and effectiveness of the minimum entropy cascade control index, a simulation problem and a cascade control case of an oil refinery are applied. The comparison with MVC based cascade control is also included.

Trophic assessment in chinese coastal systems

Dissertação mest., Gestão da Água e da Costa, Universidade do Algarve, 2007

Expert Insight into the Assessment of Competence in Cognitive–behavioural Therapy: a Qualitative Exploration of Experts' Experiences, Opinions and Recommendations

To offer insight into how cognitive–behavioural therapy (CBT) competence is defined, measured and evaluated and to highlight ways in which the assessment of CBT competence could be further improved, the current study utilizes a qualitative methodology to examine CBT experts’ (N = 19) experiences of conceptualizing and assessing the competence of CBT therapists. Semi-structured interviews were used to explore participants’ experiences of assessing the competence of CBT therapists. Interview transcripts were then analysed using interpretative phenomenological analysis in order to identify commonalities and differences in the way CBT competence is evaluated. Four superordinate themes were identified: (i) what to assess, the complex and fuzzy concept of CBT competence; (ii) how to assess CBT competence, selecting from the toolbox of assessment methods; (iii) who is best placed to assess CBT competence, expertise and independence; and (iv) pitfalls, identifying and overcoming assessment biases. Priorities for future research and ways in which the assessment of CBT competence could be further improved are discussed in light of these findings.

Models and tools for value systems analysis in collaborative environments

Dissertation to obtain the degree of Doctor in Electrical and Computer Engineering, specialization of Collaborative Networks

Student self-assessment a feedback seeking strategy through competence evaluation

There is a body of literature that suggests that student self-assessment is a main goal in higher education (Boud et al., 1995; Tan, 2008); moreover new forms of work organization require a high level of skills and competences. The efforts to deal with competence gaps could be developed at many levels, such as employers, educational institutions, individuals and public agents. Employers could put into practice competence development programs to moderate these gaps. Educational institutions can restructure the curriculum to support students in attaining the competences that are essential in the labour market. Individuals themselves may deploy their resources (time and money) in general or specific competence training. Further, government agencies could fund competence promotion programs. Such challenges for education drive change in learning curricula and method, to properly include the competences required for developing global workers who can move beyond basic competence, to enhanced flexibility and adaptability. In performance assessment methods, there is a shift from the traditional exam-based assessments to more innovative task assessment, which considers performance in multiple different tasks carry out by students. ICTs make it technologically feasible to carry out a complete and complex selfassessment of competences, which provides immediate results to students or other recipients. In the case of students, the evaluation of competences is relevant as developing competences is part - if not all - of the objectives of education. Therefore, it is an important element of the quality of educational organizations (e.g., universities), and of their organizational success. Further, educational organizations may put special emphasis on some differentiating competences, which can be a means of positioning and differentiation from competitors. Competence assessment is an instrument to make students conscious of their strengths and weaknesses, leading to higher motivation to develop their own learning career