The clinical utility of a suite of continence assessment tools for use in residential aged care facilities

According to the Institute of Medicine of the National Academies, 80% of direct care in nursing homes in the USA is provided by workforce that has least formal education about patient care (1). This situation is echoed in Australian residential aged care facilities where the day-to-day management is largely provided by unregulated workers (i.e. nursing assistants, personal carers and nursing aides) and is overseen by registered nurses. Some facilities additionally have access to expert advice from continence nurse advisors. In order to assist the residential aged care workforce to provide continence care that is evidence-based, a team of researchers developed and trialled a suite of continence assessment tools that were mainly targeted to unregulated workers. This paper presents information on the development of the tools (Stage 1) and on their evaluation (Stage 2).

User-centered evaluation of a virtual environment training system : utility of user perception measures

This study assessed the utility of measures of Self-efficacy (SelfEfficacy) and Perceived VE efficacy (PVEefficacy) for quantifying how effective VEs are in procedural task training. SelfEfficacy and PVEefficacy have been identified as affective construct potentially underlying VE efficacy that is not evident from user task performance. The motivation for this study is to establish subjective measures of VE efficacy and investigate the relationship between PVEefficacy, SelfEfficacy and User task performance. Results demonstrated different levels of prior experience in manipulating 3D objects in gaming or computer environment (LOE3D) effects on task performance and user perception of VE efficacy. Regression analysis revealed LOE3D, SelfEfficacy,
PVEefficacy explain significant portions of the variance in VE efficacy. Results of the study provide further evidence that task performance may share relationships with PVEefficacy and SelfEfficacy, and that affective constructs, such as PVEefficacy, and SelfEfficacy may serve as alternative, subjective measures of task performance that account for VE efficacy.

Dual-random ensemble method for multi-label classification of biological data

This paper presents a dual-random ensemble multi-label classification method for classification of multi-label data. The method is formed by integrating and extending the concepts of feature subspace method and random k-label set ensemble multi-label classification method. Experiemental results show that the developed method outperforms the exisiting multi-lable classification methods on three different multi-lable datasets including the biological yeast and genbase datasets.

Random forest based lung nodule classification aided by clustering

An automated lung nodule detection system can help spot lung abnormalities in CT lung images. Lung nodule detection can be achieved using template-based, segmentation-based, and classification-based methods. The existing systems that include a classification component in their structures have demonstrated better performances than their counterparts. Ensemble learners combine decisions of multiple classifiers to form an integrated output. To improve the performance of automated lung nodule detection, an ensemble classification aided by clustering (CAC) method is proposed. The method takes advantage of the random forest algorithm and offers a structure for a hybrid random forest based lung nodule classification aided by clustering. Several experiments are carried out involving the proposed method as well as two other existing methods. The parameters of the classifiers are varied to identify the best performing classifiers. The experiments are conducted using lung scans of 32 patients including 5721 images within which nodule locations are marked by expert radiologists. Overall, the best sensitivity of 98.33% and specificity of 97.11% have been recorded for proposed system. Also, a high receiver operating characteristic (ROC) A_z of 0.9786 has been achieved.

A triple-random ensemble classification method for mining multi-label data

This paper presents a triple-random ensemble learning method for handling multi-label classification problems. The proposed method integrates and develops the concepts of random subspace, bagging and random k-label sets ensemble learning methods to form an approach to classify multi-label data. It applies the random subspace method to feature space, label space as well as instance space. The devised subsets selection procedure is executed iteratively. Each multi-label classifier is trained using the randomly selected subsets. At the end of the iteration, optimal parameters are selected and the ensemble MLC classifiers are constructed. The proposed method is implemented and its performance compared against that of popular multi-label classification methods. The experimental results reveal that the proposed method outperforms the examined counterparts in most occasions when tested on six small to larger multi-label datasets from different domains. This demonstrates that the developed method possesses general applicability for various multi-label classification problems.

Bargaining in the shadow of the Law - using utility functions to support legal negotiation

Most dispute resolution is settled by negotiation rather than litigation. However, such bargaining often occurs in the shadow of the law. To help support interest-based negotiation, we explore the use of utility functions to support negotiation analysis. We discuss in detail a utility function we have developed in the area of family-law mediation. This function is currently being used as the basis of an online dispute resolution system.

Pharmacy access to the emergency contraceptive pill : a national survey of a random sample of Australian women

Background : The emergency contraceptive pill (ECP) has the potential to assist in reducing unintended pregnancy and abortion rates. Since its rescheduling to pharmacy availability without prescription in Australia in January 2004, there is little information about Australian women's knowledge, attitudes and use of the ECP. The aim of this study was to measure the knowledge about the ECP and sociodemographic patterns of and barriers to use of the ECP.

Study Design : A cross-sectional study, using a computer-assisted telephone interview (CATI) survey conducted with a national random sample of 632 Australian women aged 16–35 years.

Results : Most women had heard of the ECP (95%) and 26% had used it. The majority of women agreed with pharmacy availability of the ECP (72%); however, only 48% were aware that it was available from pharmacies without a prescription. About a third (32%) believed the ECP to be an abortion pill. The most common reason for not using the ECP was that women did not think they were at risk of getting pregnant (57%). Logistic regression showed that women aged 20–29 years (OR 2.58; CI: 1.29–5.19) and 30–35 years (OR 3.16; CI: 1.47–6.80) were more likely to have used the ECP than those aged 16–19 years. Women with poor knowledge of the ECP were significantly less likely to have used it than those with very good knowledge (OR 0.28; CI: 0.09–0.77). Those in a de facto relationship (OR 2.21; CI: 1.27–3.85), in a relationship but not living with the partner (OR 2.46; 95% CI 1.31–4.63) or single women (OR 2.40; CI: 1.33–4.34) were more likely to have used the ECP than married women.

Conclusions : Women in Australia have a high level of awareness of the ECP, but more information and education about how to use it and where to obtain it are still needed.

Investigating directionality for a media consumption construct : establishing the utility of confirmatory vanishing tetrad analysis

Purpose – When assessing the psychometric properties of measures and estimate relations among latent variables, many studies in the social sciences (including management and marketing) often fail to comprehensively appraise the directionality of indicants. Such failures can lead to model misspecification and inaccurate parameter estimates. The purpose of this paper is to apply a post hoc test called confirmatory vanishing tetrad analysis (CTA hereafter) to a single construct called mass media consumption information exposure, which antecedent studies conceptually posited to be a formative (causative) representation.
Design/methodology/approach – This paper analyses a consumer sample of 585 US respondents and applies the CTA test to a single construct by its inclusion in various matrices within a statistical analysis system-macro that takes into account nonnormal data characteristics. The matrices are derived from Mplus 5 through the estimation of a single-factor congeneric model. The CTA test calculates a test statistic similar to an asymptotic x2 distribution with degrees of freedom equal to the number of nonredundant tetrads tested.
Findings – The preliminary data analyses reveal that the data characteristics are nonnormal which is not uncommon in social research. The CTA results reveal that the reflective (emergent) item orientation cannot be fully ruled out as being the correct model representation. This is in contrast to prior theoretical conceptual work which would strongly support this construct being a formative representation.
Originality/value – Insofar as the authors are aware, there is no paper with a particular focus on how the CTA might not provide sound results with a demonstrated example. The paper makes a valuable contribution by discussing modelling philosophy and a procedure for directionality testing. The authors advocate the implementation of pre and post hoc tests as a key component of standard research practice.

Computational exploration of the biological basis of Black-Scholes expected utility function

It has often been argued that there exists an underlying biological basis of utility functions. Taking this line of argument a step further in this paper, we have aimed to computationally demonstrate the biological basis of the Black-Scholes functional form as applied to classical option pricing and hedging theory. The evolutionary optimality of the classical Black-Scholes function has been computationally established by means of a haploid genetic algorithm model. The objective was to minimize the dynamic hedging error for a portfolio of assets that is built to replicate the payoff from a European multi-asset option. The functional form that is seen to evolve over successive generations which best attains this optimization objective is the classical Black-Scholes function extended to a multiasset scenario.

Conjugated polymer−titania nanoparticle hybrid films : random lasing action and ultrasensitive detection of explosive vapors

We have first demonstrated that a random laser action generated by a hybrid film composed of a semiconducting organic polymer (SOP) and TiO₂ nanoparticles can be used to detect 2,4,6-trinitrotoluene (TNT) vapors. The hybrid film was fabricated by spin-casting SOP solution dispersed with nanosized TiO₂ particles on quartz glass. The SOP in the hybrid film functioned as both the gain medium and the sensory transducer. A random lasing action was observed with a certain pump power when the size (diameter of 50 nm) and concentration (8.9 - 10¹²/cm³) of TiO₂ nanoparticles were optimized. Measurements of fluorescence quenching behavior of the hybrid film in TNT vapor atmosphere (10 ppb) showed that attenuated lasing in optically pumped hybrid film displayed a sensitivity to vapors of explosives more than 20 times higher than was observed from spontaneous emission. This phenomenon has been explained with the four-level laser model. Since the sensory transducer used in the hybrid polymer/nanoparticles system could be replaced by other functional materials, the concept developed could be extended to more general domains of chemical or environment detection.

N-acetylcysteine for antioxidant therapy : pharmacology and clinical utility

Glutathione is an endogenous antioxidant and has a ubiquitous role in many of the body’s defences. Treatment with N -acetylcysteine (NAC) has been shown to increase levels of glutathione. NAC has been proposed as a treatment for several illnesses. Objectives : The efficacy and tolerability of NAC was examined across a range of conditions to evaluate the evidence supporting the use of NAC for each indication. Methods : A literature search was conducted using PubMed. Information was also collected from other online sources including the websites of the Therapeutic Goods Administration of Australia and the FDA. Results : Reports ranged from case studies to clinical trials. There is strong evidence to support the use of NAC for the treatment of paracetamol overdose and emerging evidence suggesting it has utility in psychiatric disorders, particularly schizophrenia and bipolar disorder. NAC is safe and well tolerated when administered orally but has documented risks with intravenous administration.

Olanzapine / fluoxetine combination for treatment resistant depression : efficacy and clinical utility

Antidepressant monotherapy is a first-line treatment for depression; however, not all sufferers will adequately respond to treatment. When treating a patient with treatment-resistant depression, the clinician needs to consider all factors which may contribute to an inadequate response to an antidepressant. These include accuracy of diagnosis and medication adherence, as well as the patient’s personality, lifestyle, life events and social circumstances. If it is determined that treatment resistance is due to failure of efficacy of antidepressant monotherapy, then an augmentation strategy using an atypical antipsychotic may be considered. Treatment using olanzapine/fluoxetine combination (OFC) is one of many options. Four randomized, acute-phase trials have suggested OFC is useful for reducing Montgomery–Åsberg Depression Rating Scale scores after inadequate response to antidepressant monotherapy. OFC has been useful at doses of olanzapine/fluoxetine 6/25, 6/50, 12/25 and 12/50 mg/day, with 1/5 mg/day suggested to be an ineffective dose. Treatment with OFC has been associated with some side effects, including weight gain and the metabolic syndrome, somnolence, dry mouth, increased appetite and headache. Treatment decisions therefore need to be made to balance the risks and benefits.