Automatic Mallampati Classification Using Active Appearance Models

Difficult tracheal intubation assessment is an important research topic in anesthesia as failed intubations are important causes of mortality in anesthetic practice. The modified Mallampati score is widely used, alone or in conjunction with other criteria, to predict the difficulty of intubation. This work presents an automatic method to assess the modified Mallampati score from an image of a patient with the mouth wide open. For this purpose we propose an active appearance models (AAM) based method and use linear support vector machines (SVM) to select a subset of relevant features obtained using the AAM. This feature selection step proves to be essential as it improves drastically the performance of classification, which is obtained using SVM with RBF kernel and majority voting. We test our method on images of 100 patients undergoing elective surgery and achieve 97.9% accuracy in the leave-one-out crossvalidation test and provide a key element to an automatic difficult intubation assessment system.

Social freezing in Switzerland and worldwide--a blessing for women today?

This is a critical review of the medical, ethical, judicial and financial aspects of the so called "social freezing", the cryopreservation of a woman's oocytes for non-medical purposes. The possibility of storing the eggs of fertile women in order to prevent age-related fertility decline is being widely promoted by fertility centres and the lay press throughout the world. Research data has shown that social freezing should ideally be performed on women around 25 years of age in order to increase their chances of a future pregnancy. In reality, it is mostly performed after the age of 35. Unfortunately, social freezing is in general not a solution for the underlying societal problems to fit in with professionally active women and having children. It only delays the existing problems. Furthermore, it creates a lot of potential new problems. A great deal more should be undertaken to offer real solutions to the underlying societal problems which are in part: pre-school education, care in the event of childhood illness, and the many weeks of school holidays, acceptance of professionally active women having children, and more job offers with a workload <100%.). Furthermore, society should be informed about the decreasing chances of pregnancy with increasing maternal (and paternal) age as well as the increasing risks of miscarriage and obstetric/neonatal complications. Detailed information for woman considering social freezing is crucial. Every doctor, proposing social freezing to his patients, should be up to date with all these details. Follow-up studies on the outcome of these children are needed.

Multisensory facilitation of behavior in monkeys: effects of stimulus intensity.

Multisensory stimuli can improve performance, facilitating RTs on sensorimotor tasks. This benefit is referred to as the redundant signals effect (RSE) and can exceed predictions on the basis of probability summation, indicative of integrative processes. Although an RSE exceeding probability summation has been repeatedly observed in humans and nonprimate animals, there are scant and inconsistent data from nonhuman primates performing similar protocols. Rather, existing paradigms have instead focused on saccadic eye movements. Moreover, the extant results in monkeys leave unresolved how stimulus synchronicity and intensity impact performance. Two trained monkeys performed a simple detection task involving arm movements to auditory, visual, or synchronous auditory-visual multisensory pairs. RSEs in excess of predictions on the basis of probability summation were observed and thus forcibly follow from neural response interactions. Parametric variation of auditory stimulus intensity revealed that in both animals, RT facilitation was limited to situations where the auditory stimulus intensity was below or up to 20 dB above perceptual threshold, despite the visual stimulus always being suprathreshold. No RT facilitation or even behavioral costs were obtained with auditory intensities 30-40 dB above threshold. The present study demonstrates the feasibility and the suitability of behaving monkeys for investigating links between psychophysical and neurophysiologic instantiations of multisensory interactions.

Spatially selective implementation of the adiabatic T2 prep sequence for magnetic resonance angiography of the coronary arteries.

In coronary magnetic resonance angiography, a magnetization-preparation scheme for T2 -weighting (T2 Prep) is widely used to enhance contrast between the coronary blood-pool and the myocardium. This prepulse is commonly applied without spatial selection to minimize flow sensitivity, but the nonselective implementation results in a reduced magnetization of the in-flowing blood and a related penalty in signal-to-noise ratio. It is hypothesized that a spatially selective T2 Prep would leave the magnetization of blood outside the T2 Prep volume unaffected and thereby lower the signal-to-noise ratio penalty. To test this hypothesis, a spatially selective T2 Prep was implemented where the user could freely adjust angulation and position of the T2 Prep slab to avoid covering the ventricular blood-pool and saturating the in-flowing spins. A time gap of 150 ms was further added between the T2 Prep and other prepulses to allow for in-flow of a larger volume of unsaturated spins. Consistent with numerical simulation, the spatially selective T2 Prep increased in vivo human coronary artery signal-to-noise ratio (42.3 ± 2.9 vs. 31.4 ± 2.2, n = 22, P < 0.0001) and contrast-to-noise-ratio (18.6 ± 1.5 vs. 13.9 ± 1.2, P = 0.009) as compared to those of the nonselective T2 Prep. Additionally, a segmental analysis demonstrated that the spatially selective T2 Prep was most beneficial in proximal and mid segments where the in-flowing blood volume was largest compared to the distal segments. Magn Reson Med, 2013. © 2012 Wiley Periodicals, Inc.

Socio-cultural determinants of adiposity and physical activity in preschool children: a cross-sectional study.

Both individual socio-cultural determinants such as selected parental characteristics (migrant background, low educational level and workload) as well as the regional environment are related to childhood overweight and physical activity (PA). The purpose of the study was to compare the impact of distinct socio-cultural determinants such as the regional environment and selected parental characteristics on adiposity, PA and motor skills in preschool children. Forty preschools (N = 542 children) of two culturally different urban regions (German and French speaking part of Switzerland) participated in the study (Ballabeina Study). Outcome measures included adiposity (BMI and skinfold thickness), objectively measured sedentary activities and PA (accelerometers) and agility performance (obstacle course). Parental characteristics (migrant status, educational level and workload) were assessed by questionnaire. Children from the French speaking areas had higher adiposity, lower levels of total and of more intense PA, were more sedentary and less agile than children from the German speaking regions (percent differences for all outcome parameters except for BMI ≥10%; all p ≤ 0.04). Differences in skinfold thickness, sedentary activities and agility, but not in PA, were also found between children of Swiss and migrant parents, though they were ≤8% (p ≤ 0.02). While paternal workload had no effect, maternal workload and parental education resulted in differences in some PA measures and/or agility performance (percent differences in both: ≤9%, p ≤ 0.008), but not in adiposity or sedentary activities (p = NS). Regional differences in skinfold thickness, PA, sedentary activities and agility performance persisted after adjustment for parental socio-cultural characteristics, parental BMI and, where applicable, children's skinfolds (all p ≤ 0.01). The regional environment, especially the broader social environment, plays a prominent role in determining adiposity, PA and motor skills of young children and should be implicated in the prevention of obesity and promotion of PA in children. clinicaltrials.gov NCT00674544.

In Search of Corporate Renewal: How to Benefit from Corporate Venturing?

Despite the rapid change in today's business environment there are relatively few studies about corporate renewal. This study aims for its part at filling that research gap by studying the concepts of strategy, corporate renewal, innovation and corporate venturing. Its purpose is to enhance our understanding of how established companies operating in dynamic and global environment can benefit from their corporate venturing activities. The theoretical part approaches the research problem in corporate and venture levels. Firstly, it focuses on mapping the determinants of strategy and suggests using industry, location, resources, knowledge, structure and culture, market, technology and business model to assess the environment and using these determinants to optimize speed and magnitude of change.Secondly, it concludes that the choice of innovation strategy is dependent on the type and dimensions of innovation and suggests assessing market, technology, business model as well as novelty and complexity related to each of them for choosing an optimal context for developing innovations further. Thirdly, it directsattention on processes through which corporate renewal takes place. On corporate level these processes are identified as strategy formulation, strategy formation and strategy implementation. On the venture level the renewal processes are identified as learning, leveraging and nesting. The theoretical contribution of this study, the framework of strategic corporate venturing, joins corporate and venture level management issues together and concludes that strategy processes and linking processes are the mechanism through which continuous corporate renewaltakes place. The framework of strategic corporate venturing proposed by this study is a new way to illustrate the role of corporate venturing as a purposefullybuilt, different view of a company's business environment. The empirical part extended the framework by enhancing our understanding of the link between corporate renewal and corporate venturing in its real life environment in three Finnish companies: Metso, Nokia and TeliaSonera. Characterizing companies' environmentwith the determinants of strategy identified in this study provided a structured way to analyze their competitive position and renewal challenges that they arefacing. More importantly the case studies confirmed that a link between corporate renewal and corporate venturing exists and found out that the link is not as straight forward as indicated by the theory. Furthermore, the case studies enhanced the framework by indicating a sequence according to which the processes work. Firstly, the induced strategy processes strategy formulation and strategy implementation set the scene for corporate venturing context and management processes and leave strategy formation for the venture. Only after that can strategies formed by ventures come back to the corporate level - and if found viable in the corporate level be formalized through formulation and implementation. With the help of the framework of strategic corporate venturing the link between corporaterenewal and corporate venturing can be found and managed. The suggested response to the continuous need for change is continuous renewal i.e. institutionalizing corporate renewal in the strategy processes of the company. As far as benefiting from venturing is concerned the answer lies in deliberately managing venturing in a context different to the mainstream businesses and establishing efficientlinking processes to exploit the renewal potential of individual ventures.

Charges de travail et santé perçue de la "génération sandwich"

La coexistence des charges professionnelles, familiales, et d'aide à des ascendants expose la Génération Sandwich (GS) à des risques potentiels pour sa santé. Toutefois, les connaissances sur la GS sont insuffisantes pour permettre aux infirmières du secteur de la santé au travail de développer des interventions en promotion de la santé basées sur des preuves. Ce manque de clarté est préoccupant au vu de certaines tendances sociodémographiques. La présente étude vise à dresser le portrait des travailleurs de la GS en examinant les liens entre leurs caractéristiques, leurs charges co-existantes et leur santé perçue. Pour ce faire, nous avons développé un cadre de référence salutogénique. puis, nous l'avons utilisé pour conduire une recherche descriptive corrélationnelle transversale. un questionnaire électronique a permis de récolter les données de 826 employés d'une administration publique suisse. L'examen a montré que 23.5 % de l'échantillon appartenait à la GS. Cette appartenance ne dépendait pas du sexe. la charge de travail totale (70.5 h/sem) de la GS différait significativement de celle du reste de l'échantillon (62.8 h/sem). Nous n'avons pas trouvé de relation entre cette charge totale et la santé physique ou mentale des femmes. En revanche, il y avait une relation négative entre cette charge totale et la santé physique des hommes, et cette relation était proche du seuil de significativité pour la santé mentale de ces derniers. Grâce à une analyse soucieuse de faire évoluer favorablement les inégalités de genre (gender-transformative), cette étude fournit des pistes pour fonder des interventions préventives en faveur de la santé des membres de la GS.

Sickness certification in primary care: a survey on views and practices among Swiss physicians.

QUESTIONS UNDER STUDY: Studies from several countries (Scandinavia, United Kingdom) report that general practitioners (GPs) experience problems in sickness certification. Our study explored views of Swiss GPs towards sickness certification, their practice and experience, professional skills and problematic interactions with patients. METHODS: We conducted an online survey among GPs throughout Switzerland, exploring behaviour of physicians, patients and employers with regard to sickness certification; GPs' views about sickness certification; required competences for certifying sickness absence, and approaches to advance their competence. We piloted the questionnaire and disseminated it through the networks of the five Swiss academic institutes for primary care. RESULTS: We received 507 valid responses (response rate 50%). Only 43/507 GPs experienced sickness certification as problematic per se, yet 155/507 experienced problems in sickness certification at least once a week. The 507 GPs identified estimating a long-term prognosis about work capacity (64%), handling conflicts with patients (54%), and determining the reduction of work capacity (42%) as problematic. Over 75% would welcome special training opportunities, e.g., on sickness certifications during residency (93%), in insurance medicine (81%), and conflict management (80%). CONCLUSION: Sickness certification as such does not present a major problem to Swiss GPs, which contrasts with the experience in Scandinavian countries and in the UK. Swiss GPs did identify specific tasks of sickness certification as problematic. Training opportunities on sick-leave certification and insurance medicine in general were welcomed.

Esimiestoiminnan vaikutukset lyhytaikaisiin sairauspoissaoloihin

Yrityksissä on viimeisten vuosien aikana alettu keskustella enemmän sairauspoissaoloista. Ne muodostavat monissa yrityksissä merkittävän kuluerän. Monissa yrityksissä joudutaan käsittelemään sairauspoissaoloja jollakin tavalla. Jokaisella yrityksellä on olemassa toimintatapoja lyhytaikaisten sairauspoissaolojen vähentämiseksi. Toimintatavoilla on tarkoitus tukea esimiehiä käsittelemään työntekijöiden poissaoloja. Työntekijöiden sairauspoissaolot, työkykyyn ja työstä suoriutumiseen liittyvät asiat ovat helpompia käsitellä toimintamallien avulla. Esimiestoiminnalla on todettu olevan yhteys lyhytaikaisiin sairauspoissaoloihin. On lyhytaikaisia sairauspoissaoloja esimiehistä riippumattomistakin syistä, mutta niiden esiintyessä usein, saattaa taustalla olla jokin muu tekijä kuin sairaus. Tämän tutkimuksen avulla oli selvittää eniten lyhytaikaisia sairauspoissaolojen omaavien myymälöiden työtyytyväisyyttä ja onko esimiestoiminnalla selkeä yhteys poissaoloihin. Yrityksellä on käytössään erilaisia toimintamalleja lyhytaikaisiin poissaoloihin ja niiden vähentämiseen. Tutkimuksen avulla pyrittiin huomaamaan onko jokaisessa myymälässä samat toimintamallit.

Collaborative reflection : supporting one practitioner's development of online learning communities /

This is a study of one participant's reflective practice as she worked to develop online communities in a face-to-face science course. Her process of reflective practice was examined in order to address factors that influenced her learning path, and the benefits and challenges of collaborative action research. These research goals were pursued using a collaborative action research methodology, initially chosen for its close match with Schon's (1983) model of reflective practice. The participant's learning fit vnth Mezirow's (1991) model of transformative learning. She began with beliefs that matched her goals, and she demonstrated significant learning in three areas. First, she demonstrated instrumental learning around the constraints of workload and time, and achieving online learning community indicators. Second, she demonstrated communicative learning that helped her to see her own needs for feedback and communication more clearly, and how other process partners had been a support to her. Third, her emancipatory learning saw her revisiting and questioning her goals. It was through the reflective conversation during the planned meetings and the researcher's reframing and interrogation of that reflection that the participant was able to clarify and extend her thinking, and in so doing, critically reflect on her practice as she worked to develop online learning communities. In this way, the collaborative action research methodology was an embodiment of co-constructivism through collaborative reflective practice. Schon's (1983) model of reflective practice positions a lone practitioners moving through cycles ofplan-act-observe-reflect. The results fi"om this study suggest that collaboration is an important piece of the reflective practice model.

Evaluating three self-help smoking cessation interventions for post-secondary smokers : a randomized controlled trial on six Ontario campuses

Objective. Smoking prevalence is highest among the young adult cohort. Postsecondary students are no exception. Although many students intend to quit smoking, no research has established what methods best promote reductions in, or complete abstinence from smoking. This randomized controlled trial examined the effectiveness of three self-help smoking cessation interventions. Method. On six post-secondary campuses, 483 smokers who voluntarily accessed Leave The Pack Behind (a tobacco control initiative) were randomly assigned to one of three smoking cessation interventions: One Step At A Time (a 2-booklet, *gold standard' program for adults); Smoke|Quit (a newly-developed 2-booklet program for young adult students); and usual care (a 'Quit Kit' containing a booklet on stress management, information about pharmacological quitting aides and novelty items). All participants also received one proactive telephone support call from a peer counsellor. During the study, 85 participants withdrew. The final sample of 216 students who completed baseline questionnaires and 12-week follow-up telephone interviews was representative of the initial sample in terms of demographic characteristics, and smokingquitting- related variables. Results. Whether participants quit smoking depended upon treatment condition, ^(2, N=2\6) = 6.34, p = .04, with Smoke|Quit producing more successfijl quitters (18.4%) than One Step At A Time (4.5%) or the Quit Kit (1 1.4%). On average, participants had quit 53.46 days, with no significant difference across treatments. Selfefficacy also increased. Use of the intervention or other quitting aides was not associated with treatment condition. Among the 191 participants who did not quit smoking, treatment condition did not influence outcomes. Overall, 46.2% had made a quit attempt. Significant decreases in weekly tobacco consumption and increases in self-efficacy to resist smoking were observed from baseline to follow-up. Conclusion. Post-secondary institutions represent a potentially final opportunity for age-targeted interventions. Self-help resources tailored to students' social and contextual characteristics will have considerable more impact than stage-only tailored interventions. Both reduction and abstinence outcomes should be emphasized to positively support students to stop smoking.

Perceptions of some teachers about the similarities and/or differences in teaching online versus in a classroom environment /

The introduction of computer and communications technology, and particularly the internet, into education has opened up some new possibilities for teaching and learning. Courses designed and delivered in an online environment offer the possibility of highly interactive and individually focussed teaching and learning experiences. However, online courses also present new challenges for both teachers and students. A qualitative study was conducted to explore teachers' perceptions about the similarities and differences in teaching in the online and face-to-face (F2F) environments. Focus group discussions were held with 5 teachers; 2 teachers were interviewed in depth. The participants, 3 female and 2 male, were full-time teachers from a large College of Applied Arts & Technology in southern Ontario. Each of them had over 10 years of F2F teaching experience and each had been involved in the development and teaching of at least one online course. i - -; The study focussed on how teaching in the online environment compares with teaching in the F2F environment, what roles teachers and students adopt in each setting, what learning communities mean online and F2F and how they are developed, and how institutional policies, procedures, and infrastructure affect teaching and learning F2F and online. This study was emic in nature, that is the teachers' words determine the themes identified throughout the study. The factors identified as affecting teaching in an online environment included teacher issues such as course design, motivation to teach online, teaching style, role, characteristics or skills, and strategies. Student issues as perceived by the teachers included learning styles, role, and characteristics or skills. As well, technology issues such as a reliable infrastructure, clear role and responsibilities for maintaining the infrastructure, support, and multimedia capability affected teaching online. Finally, administrative policies and procedures, including teacher selection and training, registration and scheduling procedures, intellectual property and workload policies, and the development and communication of a comprehensive strategic plan were found to impact on teaching online. The teachers shared some of the benefits they perceived about teaching online as well as some of the challenges they had faced and challenges they perceived students had faced online. Overall, the teachers feh that there were more similarities than differences in teaching between the two environments, with the main differences being the change from F2F verbal interactions involving body language to online written interactions without body language cues, and the fundamental reliance on technology in the online environment. These findings support previous research in online teaching and learning, and add teachers' perspectives on the factors that stay the same and the factors that change when moving from a F2F environment to an online environment.

The physiology of inscription : Foucault's genealogy as curative science

In ''Nietzsche, Genealogy, History," Foucault suggests that genealogy is a sort of "curative science." The genealogist must be a physiologist and a pathologist as well as an historian, for his task is to decipher the marks that power relations and historical events leave on the subjugated body; "he must be able to diagnose the illnesses of the body, its conditions of weakness and strength, its breakdowns and resistances, to be in a position to judge philosophical discourse." But this claim seems to be incongruent with another major task of genealogy. After all, genealogy is supposed to show us that the things we take to be absolute are in fact discontinuous and historically situated: "Nothing in man-not even his body-is sufficiently stable to serve as the basis for self-recognition or for understanding other men." If this is true, then the subjugated body can never be restored to a healthy state because it has no essential or original nature. There are no universal standards by which we can even distinguish between healthy and unhealthy bodies. So in what sense is genealogy to be a "curative science"? In my thesis, I try to elucidate the complex relationship between genealogy and the body. I argue that genealogy can be a curative science even while it "multiplies our body and sets it against itself." Ifwe place a special emphasis on the role that transgression plays in Foucault's genealogical works, then the healthy body is precisely the body that resists universal standards and classifications. If genealogy is to be a curative science, then it must restore to the subjugated body an "identity" that transgresses its own limits and that constitutes itself, paradoxically, in the very effacement of identity. In the first chapter of my thesis, I examine the body's role as "surface of the inscription of events." Power relations inscribe on and around the body an identity or subjectivity that appears to be unified and universal, but which is in fact disparate and historically situated. The "subjected" body is the sick and pathologically weak body. In Chapters 2 and 3, I describe how it is possible for the unhealthy body to become healthy by resisting the subjectivity that has been inscribed upon it. Chapter 4 explains how Foucault's later works fit into this characterization of genealogy

What's the difference under the gown? : new professors' development as university teachers

This study explores how new university teachers develop a teaching identity. Despite the significance ofteaching, which usually comprises 40% of a Canadian academic's workload, few new professors have any formal preparation for that aspect of their role. Discipline-specific education for postsecondary professors is a well-defined path; graduates applying for faculty positions will have the terminal degree to attest to their knowledge and skill conducting research in the discipline. While teaching is usually given the same workload balance as research, it is not clear how professors create themselves as teaching professionals. Drawing on Kelly's (1955) personal construct theory and Kegan's (1982, 1994) model ofdevelopmental constructivism through differentiation and integration, this study used a phenomenographic framework~(Marton, 1986, 1994; Trigwell & Prosser, 1996) to investigate the question of how new faculty members construe their identity as university teachers. Further, my own role development as researcher was used as an additional lens through which to view the study results. The study focused particularly on the challenges and supports to teaching role development and outlines recommendations the participants made for supporting other newcomers. In addition, the variations and similarities in the results suggest a developmental model to conceptions ofteaching roles, one in which teaching, research, and service roles are viewed as more integrated over time. Developing a teacher identity was seen as a progression on a hierarchical model similar to Maslow's (1968) hierarchy of needs.

Why I am not a teacher: a self-study examining why I made the decision to exit the teaching profession /

A good teacher was once described as being like a candle; consuming itself to light the way for others (Author unknown). But as Knox (2005) says, far too many yoimg flames flicker out before they ever get the opportvmity to bum their brightest. This self-study explores the phenomenon of teacher attrition through the stories and lived experiences of one elementary teacher. I strive throughout this self-study to delve deeper into the significance of my story and lived experiences in order to enhance our understanding of why teachers exit the profession. As a result, the guiding question throughout the study is, "Why do teachers, particularly those who have only taught for a few years, leave the classrooms they worked so hard to enter?" Through the writing of a narrative entitled Sarah 's Story, I was able to identify and give voice to a story openly sharing the feelings of despair; disappointment, frustration and disillusionment. This study has identified areas of tension that lead to dissatisfaction, discontent, and teacher disillusionment. It confronts the issues of complexity, uncertainty, and conflict that are experienced in teaching. It discusses the puzzling, powerfiil and upsetting experiences, highlighting the importance of talk between all members of the education system.