A summative scoring system for evaluation of human kinematic performance

Evaluation of human kinematic performance is essential in rehabilitation and skill assessment. These services are in high demand where the improvements made due to exercises need to be regularly assessed. In some relevant industries there is a need to evaluate their employee capabilities quantitatively for accident compensation and insurance purposes. In particular, these assessments are preferred to be based on more quantifiable measures in a standardized form ensuring accuracy, reliability, ease of use and anywhere anytime information to the clinician. Therefore, it is necessary to have an efficient mechanism for evaluation and assessment of human kinematic movements as the current motion matching and recognition algorithms fall short due to characteristically strict specifications required in numerous health care applications. In this paper, we propose a summative approach using a double integral to define a closeness between two trajectories typically generated by human movement. This approach can be considered as a spatial scoring mechanism in the evaluation of human kinematic performance as well as in movement recognition applications. Several experiments based on computer simulations as well as real data were set up to examine the performance of the proposed approach as a scoring mechanism for the evaluation of human kinematic performances. The results demonstrated better characterization of the movement assessment and motion recognition ability, with a recognition rate of 86.19%, than the currently used methods such as Gaussian mixture models and pose normalization employed in motion recognition tasks. Finally, we use the scoring mechanism to analyze the proximity in human kinematic performance.

Cost-effectiveness of a bivalent human papillomavirus vaccination program in Japan

Background Human papillomavirus (HPV) vaccines and their widespread adoption have the potential to relieve a large part of the burden of cervical cancer morbidity and mortality, particularly in countries that have low screening rates or, like Japan, lack a cohesive universal screening program. An economic evaluation was conducted to assess the cost-effectiveness of introducing a bivalent HPV vaccination program in Japan from a healthcare perspective. METHODS: A Markov model of the natural history of HPV infection that incorporates both vaccination and screening was developed for Japan. The modelled intervention, a bivalent HPV vaccine with a 100% lifetime vaccine efficacy and 80% vaccine coverage, given to a cohort of 12-year-old Japanese girls in conjunction with the current screening program, was compared with screening alone in terms of costs and effectiveness. A discount rate of 5% was applied to both costs and utilities where relevant. RESULTS: Vaccination alongside screening compared with screening alone is associated with an incremental cost-effectiveness ratio (ICER) of US$20315 per quality-adjusted-life-year gained if 80% coverage is assumed. The ICER at 5% coverage with the vaccine plus screening, compared with screening alone, is US$1158. CONCLUSION: The cost-effectiveness results suggest that the addition of a HPV vaccination program to Japan's cervical cancer screening program is highly likely to prove a cost-effective way to reduce the burden of cervical cancer, precancerous lesions and HPV16/18-related diseases.

Cost-analysis of teledentistry in residential aged care facilities

INTRODUCTION: The purpose of this research was to conduct a cost-analysis, from a public healthcare perspective, comparing the cost and benefits of face-to-face patient examination assessments conducted by a dentist at a residential aged care facility (RACF) situated in rural areas of the Australian state of Victoria, with two teledentistry approaches utilizing virtual oral examination.

METHODS: The costs associated with implementing and operating the teledentistry approach were identified and measured using 2014 prices in Australian dollars. Costs were measured as direct intervention costs and programme costs. A population of 100 RACF residents was used as a basis to estimate the cost of oral examination and treatment plan development for the traditional face-to-face model vs. two teledentistry models: an asynchronous review and treatment plan preparation; and real-time communication with a remotely located oral health professional.

RESULTS: It was estimated that if 100 residents received an asynchronous oral health assessment and treatment plan, the net cost from a healthcare perspective would be AU$32.35 (AU$27.19-AU$38.49) per resident. The total cost of the conventional face-to-face examinations by a dentist would be AU$36.59 ($30.67-AU$42.98) per resident using realistic assumptions. Meanwhile, the total cost of real-time remote oral examination would be AU$41.28 (AU$34.30-AU$48.87) per resident.

DISCUSSION: Teledental asynchronous patient assessments were the lowest cost service model. Access to oral health professionals is generally low in RACFs; however, the real-time consultation could potentially achieve better outcomes due to two-way communication between the nurse and a remote oral health professional via health promotion/disease prevention delivered in conjunction with the oral examination.

Evaluation of two instruments of perceived symptom intensity in palliative care patients in an outpatient clinic

AIMS AND OBJECTIVES: To evaluate the test-retest stability in assessments of perceived symptom intensity on the Edmonton Symptom Assessment System-revised and the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative. The possible interchangeability between the instruments and the patients' experiences of completing the instruments were also studied. BACKGROUND: The two instruments assess the same symptoms, but the symptom intensity is assessed on 11-point numerical scales on the Edmonton Symptom Assessment System-revised and on four-point verbal descriptive scales on the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative. Both instruments are commonly used; however, uncertainty exists about which instrument should be recommended and about the interchangeability of the instruments. DESIGN: This study used a test-retest design with inter-scale comparisons. METHODS: Data from 54 patients with cancer who were receiving palliative care in an oncology outpatient clinic were self-reported by the patients in the clinic, at home and when patients returned to the clinic. RESULTS: The assessments on the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative verbal rating scales showed a higher level of test-retest stability than the assessments on the Edmonton Symptom Assessment System-revised numerical scoring scales, indicating higher reliability. The correspondence between the verbal categories and the numerical scores of symptom intensity were low because different verbal categories were used by patients who assessed the same numerical score. CONCLUSIONS: The test-retest stability in the assessments was higher on the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative and the results show that assessments on the two instruments could not be used interchangeably. Therefore, the symptom instrument chosen must be specified and unchanged within a patient to improve efficacy in clinical practice. RELEVANCE TO CLINICAL PRACTICE: The Edmonton Symptom Assessment System-revised or the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire Core 15 Palliative can be used for initial assessments of patients, but should not be compared or used interchangeably. It is vitally important to have individual follow-up for all patients who score an instrument.

High performance PP/SEBS/CNF composites: evaluation of mechanical, thermal degradation, and crystallization properties

Nanocomposites comprising carbon nanofibers (CNF) were prepared and evaluated in terms of morphology, mechanical performance, thermal stability and crystallization properties. It was found that addition of CNF reinforced polypropylene (PP) matrix by marginally increasing the strength and modulus, but at the expense of toughness and ductility. To improve the toughness of the composites, polystyrene-block-poly(ethylene-ran-butylene)-block-polystyrene (SEBS) was used. Presence of SEBS remarkably improved the toughness and ductility of the composites. The optimum level of reinforcement was observed at 0.1 wt% of CNF in the composites. Phase morphology studies revealed that at this concentration, CNF were well dispersed in polymer phases and beyond it, agglomeration occurred. PP/SEBS/CNF (0.1 wt%) nanocomposites exhibited good strength, excellent toughness and decent modulus, which make them suitable for cost effective, light-weight, tough and stiff material for engineering applications. It was observed that thermal stability of composites is only marginally improved whereas crystallinity of PP drastically reduced by the addition of CNF.

Economic evaluation of price discounts and skill-building strategies on purchase and consumption of healthy food and beverages: The SHELf randomized controlled trial

OBJECTIVE: Pricing strategies are a promising approach for promoting healthier dietary choices. However, robust evidence of the cost-effectiveness of pricing manipulations on dietary behaviour is limited. We aimed to assess the cost-effectiveness of a 20% price reduction on fruits and vegetables and a combined skills-based behaviour change and price reduction intervention. DESIGN AND METHODS: Cost-effectiveness analysis from a societal perspective was undertaken for the randomized controlled trial Supermarket Healthy Eating for Life (SHELf). Female shoppers in Melbourne, Australia were randomized to: (1) skill-building (n = 160); (2) price reductions (n = 161); (3) combined skill-building and price reduction (n = 161); or (4) control group (n = 161). The intervention was implemented for three months followed by a six month follow-up. Costs were measured in 2012 Australian dollars. Fruit and vegetable purchasing and consumption were measured in grams/week. RESULTS: At three months, compared to control participants, price reduction participants increased vegetable purchases by 233 g/week (95% CI 4 to 462, p = 0.046) and fruit purchases by 364 g/week (95% CI 95 to 633, p = 0.008). Participants in the combined group purchased 280 g/week more fruits (95% CI 27 to 533, p = 0.03) than participants in the control group. Increases were not maintained six-month post intervention. No effect was noticed in the skill-building group. Compared to the control group, the price reduction intervention cost an additional A$2.3 per increased serving of vegetables purchased per week or an additional A$3 per increased serving of fruit purchased per week. The combined intervention cost an additional A$12 per increased serving of fruit purchased per week compared to the control group. CONCLUSIONS: A 20% discount on fruits and vegetables was effective in promoting overall fruit and vegetable purchases during the period the discount was active and may be cost-effective. The price discount program gave better value for money than the combined price reduction and skill-building intervention. The SHELf trial is registered with Current Controlled Trials Registration ISRCTN39432901.

The role of Transaction Cost Economics in information technology outsourcing research : a meta-analysis of the choice of contract type

Two recent reviews report that the empirical findings in information technology outsourcing (ITO) research are frequently inconsistent with the prevailing dominant analytical framework of transaction cost economics (TCE). While employing similar methodologies, the two reviews propose different strategies to resolve the inconsistencies. One is to improve the methodological rigor, specifically, the operationalization of TCE constructs. The other is to abandon TCE in favor of a new analytical framework. This paper presents a meta-analysis of the empirical findings on the choice of contract type as a function of task uncertainty. The results support both strategies. Refining the operationalization of TCE constructs, specifically of task uncertainty, would have improved the reliability of findings on TCE-based relationships between task uncertainty and the choice of contract type. However, independent of such methodological improvements, TCE is of limited relevance in recent ITO research for predicting the choice of contract type. Generalizing these findings, we conclude that ITO research requires a new analytical framework to further develop the theory of ITO and to provide sound guidance to the ITO industry.

Reliability-aware distributed computing scheduling policy

One of the primary issues associated with the efficient and effective utilization of distributed computing is resource management and scheduling. As distributed computing resource failure is a common occurrence, the issue of deploying support for integrated scheduling and fault-tolerant approaches becomes paramount importance. To this end, we propose a fault-tolerant dynamic scheduling policy that loosely couples dynamic job scheduling with job replication scheme such that jobs are efficiently and reliably executed. The novelty of the proposed algorithm is that it uses passive replication approach under high system load and active replication approach under low system loads. The switch between these two replication methods is also done dynamically and transparently. Performance evaluation of the proposed fault-tolerant scheduler and a comparison with similar fault-tolerant scheduling policy is presented and shown that the proposed policy performs better than the existing approach.

Evaluation of numerical procedures to determine seismic response of structures under influence of soil-structure interaction

In this study, the accuracy and reliability of fully nonlinear method against equivalent linear method for dynamic analysis of soil-structure interaction is investigated comparing the predicted results of both numerical procedures with the results of experimental shaking table tests. An enhanced numerical soil-structure model has been developed which treats the behaviour of the soil and the structure with equal rigour. The soil-structural model comprises a 15 storey structural model resting on a soft soil inside a laminar soil container. The structural model was analysed under three different conditions: (i) fixed base model performing conventional time history dynamic analysis, (ii) flexible base model (considering full soil-structure interaction) conducting equivalent linear dynamic analysis, and (iii) flexible base model performing fully nonlinear dynamic analysis. The results of the above mentioned three cases in terms of lateral storey deflections and inter-storey drifts are determined and compared with the experimental results of shaking table tests. Comparing the experimental results with the numerical analysis predictions, it is noted that equivalent linear method of dynamic analysis underestimates the inelastic seismic response of mid-rise moment resisting building frames resting on soft soils in comparison to the fully nonlinear dynamic analysis method. Thus, inelastic design procedure, using equivalent linear method, cannot adequately guarantee the structural safety for mid-rise building frames resting on soft soils. However, results obtained from the fully nonlinear method of analysis fit the experimental results reasonably well. Therefore, this method is recommended to be used by practicing engineers.

Can simple mobile phone applications provide reliable counts of respiratory rates in sick infants and children? An initial evaluation of three new applications

BACKGROUND: Respiratory rate is an important sign that is commonly either not recorded or recorded incorrectly. Mobile phone ownership is increasing even in resource-poor settings. Phone applications may improve the accuracy and ease of counting of respiratory rates. OBJECTIVES: The study assessed the reliability and initial users' impressions of four mobile phone respiratory timer approaches, compared to a 60-second count by the same participants. METHODS: Three mobile applications (applying four different counting approaches plus a standard 60-second count) were created using the Java Mobile Edition and tested on Nokia C1-01 phones. Apart from the 60-second timer application, the others included a counter based on the time for ten breaths, and three based on the time interval between breaths ('Once-per-Breath', in which the user presses for each breath and the application calculates the rate after 10 or 20 breaths, or after 60s). Nursing and physiotherapy students used the applications to count respiratory rates in a set of brief video recordings of children with different respiratory illnesses. Limits of agreement (compared to the same participant's standard 60-second count), intra-class correlation coefficients and standard errors of measurement were calculated to compare the reliability of the four approaches, and a usability questionnaire was completed by the participants. RESULTS: There was considerable variation in the counts, with large components of the variation related to the participants and the videos, as well as the methods. None of the methods was entirely reliable, with no limits of agreement better than -10 to +9 breaths/min. Some of the methods were superior to the others, with ICCs from 0.24 to 0.92. By ICC the Once-per-Breath 60-second count and the Once-per-Breath 20-breath count were the most consistent, better even than the 60-second count by the participants. The 10-breath approaches performed least well. Users' initial impressions were positive, with little difference between the applications found. CONCLUSIONS: This study provides evidence that applications running on simple phones can be used to count respiratory rates in children. The Once-per-Breath methods are the most reliable, outperforming the 60-second count. For children with raised respiratory rates the 20-breath version of the Once-per-Breath method is faster, so it is a more suitable option where health workers are under time pressure.

A text analytics evaluation of a first-year engineering project-based unit

In the undergraduate engineering program at Griffith University in Australia, the unit 1006ENG Design and Professional Skills aims to provide an introduction to engineering design and professional practice through a project-based learning (PBL) approach to problem solving. It provides students with an experience of PBL in the first-year of their programme. The unit comprises an underpinning lecture series, design work including group project activities, an individual computer-aided drawing exercise/s and an oral presentation. Griffith University employs a ‘Student Experience of Course’ (SEC) online survey as part of its student evaluation of teaching, quality improvement and staff performance management processes. As well as numerical response scale items, it includes the following two questions inviting open-ended text responses from students: i) What did you find particularly good about this course? and ii) How could this course be improved? The collection of textual data in in student surveys is commonplace, due to the rich descriptions of respondent experiences they can provide at relatively low cost. However, historically these data have been underutilised because they are time consuming to analyse manually, and there has been a lack of automated tools to exploit such data efficiently. Text analytics approaches offer analysis methods that result in visual representations of comment data that highlight key individual themes in these data and the relationships between those themes. We present a text analytics-based evaluation of the SEC open-ended comments received in the first two years of offer of the PBL unit 1006ENG. We discuss the results obtained in detail. The method developed and documented here is a practical and useful approach to analysing/visualising open-ended comment data that could be applied by others with similar comment data sets.

The population cost-effectiveness of delivering universal and indicated school-based interventions to prevent the onset of major depression among youth in Australia

AIMS: School-based psychological interventions encompass: universal interventions targeting youth in the general population; and indicated interventions targeting youth with subthreshold depression. This study aimed to: (1) examine the population cost-effectiveness of delivering universal and indicated prevention interventions to youth in the population aged 11-17 years via primary and secondary schools in Australia; and (2) compare the comparative cost-effectiveness of delivering these interventions using face-to-face and internet-based delivery mechanisms. METHODS: We reviewed literature on the prevention of depression to identify all interventions targeting youth that would be suitable for implementation in Australia and had evidence of efficacy to support analysis. From this, we found evidence of effectiveness for the following intervention types: universal prevention involving group-based psychological interventions delivered to all participating school students; and indicated prevention involving group-based psychological interventions delivered to students with subthreshold depression. We constructed a Markov model to assess the cost-effectiveness of delivering universal and indicated interventions in the population relative to a 'no intervention' comparator over a 10-year time horizon. A disease model was used to simulate epidemiological transitions between three health states (i.e., healthy, diseased and dead). Intervention effect sizes were based on meta-analyses of randomised control trial data identified in the aforementioned review; while health benefits were measured as Disability-adjusted Life Years (DALYs) averted attributable to reductions in depression incidence. Net costs of delivering interventions were calculated using relevant Australian data. Uncertainty and sensitivity analyses were conducted to test model assumptions. Incremental cost-effectiveness ratios (ICERs) were measured in 2013 Australian dollars per DALY averted; with costs and benefits discounted at 3%. RESULTS: Universal and indicated psychological interventions delivered through face-to-face modalities had ICERs below a threshold of $50 000 per DALY averted. That is, $7350 per DALY averted (95% uncertainty interval (UI): dominates - 23 070) for universal prevention, and $19 550 per DALY averted (95% UI: 3081-56 713) for indicated prevention. Baseline ICERs were generally robust to changes in model assumptions. We conducted a sensitivity analysis which found that internet-delivered prevention interventions were highly cost-effective when assuming intervention effect sizes of 100 and 50% relative to effect sizes observed for face-to-face delivered interventions. These results should, however, be interpreted with caution due to the paucity of data. CONCLUSIONS: School-based psychological interventions appear to be cost-effective. However, realising efficiency gains in the population is ultimately dependent on ensuring successful system-level implementation.

EVALUATION OF POTENTIAL TRANSLOAD FACILITY LOCATIONS IN THE UPPER PENINSULA (UP) OF MICHIGAN

Shippers want to improve their transportation efficiency and rail transportation has the potential to provide an economical alternative to trucking, but it also has potential drawbacks. The pressure to optimize transportation supply chain logistics has resulted in growing interest in multimodal alternatives, such as a combination of truck and rail transportation, but the comparison of multimodal and modal alternatives can be complicated. Shippers in Michigan’s Upper Peninsula (UP) face similar challenges. Adding to the challenge is the distance from major markets and the absence of available facilities for transloading activities. This study reviewed three potential locations for a transload facility (Nestoria, Ishpeming, and Amasa) where truck shipments could be transferred to rail and vice versa. These locations were evaluated on the basis of transportation costs for shippers when compared to the use of single mode transportation by truck to Wisconsin, Chicago, Minneapolis, and Sault Ste. Marie. In addition to shipping costs, the study also evaluated the potential impact of future carbon emission penalties on the shipping cost and the effects of changing fuel prices on shipping cost. The study used data obtained from TRANSEARCH database (2009) and found that although there were slight differences between percent savings for the three locations, any of them could provide potential benefits for movements to Chicago and Minneapolis, as long as final destination could be accessed by rail for delivery. Short haul movements of less than 200 miles (Wisconsin and Sault Ste. Marie) were not cost effective for multimodal transport. The study also found that for every dollar increase in fuel price, cost savings from multimodal option increased by three to five percent, but the inclusion of emission costs would only add one to two percent additional savings. Under a specific case study that addressed shipments by Northern Hardwoods, the most distant locations in Wisconsin would also provide cost savings, partially due to the possibility of using Michigan trucks with higher carrying capacity for the initial movement from the facility to transload location. In addition, Minneapolis movements were found to provide savings for Northern Hardwoods, even without final rail access.

Age-Dependent Fragility and Life-Cycle Cost Analysis of Timber and Steel Distribution Poles Subjected to Hurricanes

Power distribution systems are susceptible to extreme damage from natural hazards especially hurricanes. Hurricane winds can knock down distribution poles thereby causing damage to the system and power outages which can result in millions of dollars in lost revenue and restoration costs. Timber has been the dominant material used to support overhead lines in distribution systems. Recently however, utility companies have been searching for a cost-effective alternative to timber poles due to environmental concerns, durability, high cost of maintenance and need for improved aesthetics. Steel has emerged as a viable alternative to timber due to its advantages such as relatively lower maintenance cost, light weight, consistent performance, and invulnerability to wood-pecker attacks. Both timber and steel poles are prone to deterioration over time due to decay in the timber and corrosion of the steel. This research proposes a framework for conducting fragility analysis of timber and steel poles subjected to hurricane winds considering deterioration of the poles over time. Monte Carlo simulation was used to develop the fragility curves considering uncertainties in strength, geometry and wind loads. A framework for life-cycle cost analysis is also proposed to compare the steel and timber poles. The results show that steel poles can have superior reliability and lower life-cycle cost compared to timber poles, which makes them suitable substitutes.

WATER USE AND SYSTEM RELIABILITY UNDER DIESELGENERATOR AND SOLAR PHOTOVOLTAIC POWERED PUMPING SYSTEMS: A CASE STUDY OF SOLLA TOGO

Access to improved potable water sources is recognized as one of the key factors in improving health and alleviating global poverty. In recently years, substantial investments have been made internationally in potable water infrastructure projects, allowing 2.3 billion people to gain access to potable water from 1990-2012. One such project was planned and installed in Solla, Togo, a rural village in the northern part of the country, from 2010-2012. Ethnographic studies revealed that, while the community has access to potable water, an estimated 45% of the village’s 1500 residents still rely on unprotected sources for drinking and cooking. Additionally, inequality in system use based on income level was revealed, with the higher income groups accessing the system more regularly than lower income groups. Cost, as well as the availability of cheaper sources, was identified as the main deterrent from using the new water distribution system. A new water-pricing scheme is investigated here with the intention of making the system accessible to a greater percentage of the population. Since 2012, a village-level water committee has been responsible for operations and maintenance (O&M), fulfilling the community management model that is recommended by many development theorists in order to create sustainable projects. The water committee received post-construction support, mostly in the form of technical support during system breakdowns, from the Togolese Ministry of Water and Sanitation (MWSVH). While this support has been valuable in maintaining a functional water supply system in Solla, the water committee still has managerial challenges, particularly with billing and fee collection. As a result, the water committee has only received 2% - 25% of the fees owed at each private connection and public tap stand, making their finances vulnerable when future repairs and capital replacements are necessary. A new management structure is proposed by the MWSVH that will pay utilities workers a wage and will hire an accountant in order to improve the local management and increase revenue. This proposal is analyzed under the new water pricing schemes that are presented. Initially, the rural water supply system was powered by a diesel-generator, but in 2013, a solar photo-voltaic power supply was installed. The new system proved a fiscal improvement for the village water committee, since it drastically reduced their annual O&M costs. However, the new system pumps a smaller volume of water on a daily basis and did not meet the community’s water needs during the dry season of 2014. A hydraulic network model was developed to investigate the system’s reliability under diesel-generator (DGPS) and solar photovoltaic (PVPS) power supplies. Additionally, a new system layout is proposed for the PVPS that allows pumping directly into the distribution line, circumventing the high head associated with pumping solely to the storage tank. It was determined that this new layout would allow for a greater volume of water to be provided to the demand points over the course of a day, meeting a greater fraction of the demand than with the current layout.