A semi-structured interview to assess visual hallucinations in older people

OBJECTIVE: Visual hallucinations are under-reported by patients and are often undiscovered by health professionals. There is no gold standard available to assess hallucinations. Our objective was to develop a reliable, valid, semi-structured interview for identifying and assessing visual hallucinations in older people with eye disease and cognitive impairment. METHODS: We piloted the North-East Visual Hallucinations Interview (NEVHI) in 80 older people with visual and/or cognitive impairment (patient group) and 34 older people without known risks of hallucinations (control group). The informants of 11 patients were interviewed separately. We established face validity, content validity, criterion validity, inter-rater agreement and the internal consistency of the NEVHI, and assessed the factor structure for questions evaluating emotions, cognitions, and behaviours associated with hallucinations. RESULTS: Recurrent visual hallucinations were common in the patient group (68.8%) and absent in controls (0%). The criterion, face and content validities were good and the internal consistency of screening questions for hallucinations was high (Cronbach alpha: 0.71). The inter-rater agreements for simple and complex hallucinations were good (Kappa 0.72 and 0.83, respectively). Four factors associated with experiencing hallucinations (perceived control, pleasantness, distress and awareness) were identified and explained a total variance of 73%. Informants gave more 'don't know answers' than patients throughout the interview (p = 0.008), especially to questions evaluating cognitions and emotions associated with hallucinations (p = 0.02). CONCLUSIONS: NEVHI is a comprehensive assessment tool, helpful to identify the presence of visual hallucinations and to quantify cognitions, emotions and behaviours associated with hallucinations.

Semi-automatic segmentation of fetal cardiac cavities: progress towards an automated fetal echocardiogram

OBJECTIVE: To develop a novel application of a tool for semi-automatic volume segmentation and adapt it for analysis of fetal cardiac cavities and vessels from heart volume datasets. METHODS: We studied retrospectively virtual cardiac volume cycles obtained with spatiotemporal image correlation (STIC) from six fetuses with postnatally confirmed diagnoses: four with normal hearts between 19 and 29 completed gestational weeks, one with d-transposition of the great arteries and one with hypoplastic left heart syndrome. The volumes were analyzed offline using a commercially available segmentation algorithm designed for ovarian folliculometry. Using this software, individual 'cavities' in a static volume are selected and assigned individual colors in cross-sections and in 3D-rendered views, and their dimensions (diameters and volumes) can be calculated. RESULTS: Individual segments of fetal cardiac cavities could be separated, adjacent segments merged and the resulting electronic casts studied in their spatial context. Volume measurements could also be performed. Exemplary images and interactive videoclips showing the segmented digital casts were generated. CONCLUSION: The approach presented here is an important step towards an automated fetal volume echocardiogram. It has the potential both to help in obtaining a correct structural diagnosis, and to generate exemplary visual displays of cardiac anatomy in normal and structurally abnormal cases for consultation and teaching.

Droughts and famines: The underlying factors and the causal links among agro-pastoral households in semi-arid Makueni district, Kenya

Famines are often linked to drought in semi-arid areas of Sub-Saharan Africa where not only pastoralists, but also increasingly agro-pastoralists are affected. This study addresses the interplay between drought and famine in the rural semi-arid areas of Makueni district, Kenya, by examining whether, and how crop production conditions and agro-pastoral strategies predispose smallholder households to drought-triggered food insecurity. If this hypothesis holds, then approaches to deal with drought and famine have to target factors causing household food insecurity during non-drought periods. Data from a longitudinal survey of 127 households, interviews, workshops, and daily rainfall records (1961–2003) were analysed using quantitative and qualitative methods. This integrated approach confirms the above hypothesis and reveals that factors other than rainfall, like asset and labour constraints, inadequate policy enforcement, as well as the poverty-driven inability to adopt risk-averse production systems play a key role. When linking these factors to the high rainfall variability, farmer-relevant definitions and forecasts of drought have to be applied.

Evaluating retraining rules for semi-supervised learning in neural network based cursive word recognition

Training a system to recognize handwritten words is a task that requires a large amount of data with their correct transcription. However, the creation of such a training set, including the generation of the ground truth, is tedious and costly. One way of reducing the high cost of labeled training data acquisition is to exploit unlabeled data, which can be gathered easily. Making use of both labeled and unlabeled data is known as semi-supervised learning. One of the most general versions of semi-supervised learning is self-training, where a recognizer iteratively retrains itself on its own output on new, unlabeled data. In this paper we propose to apply semi-supervised learning, and in particular self-training, to the problem of cursive, handwritten word recognition. The special focus of the paper is on retraining rules that define what data are actually being used in the retraining phase. In a series of experiments it is shown that the performance of a neural network based recognizer can be significantly improved through the use of unlabeled data and self-training if appropriate retraining rules are applied.

Semi-Automated Creation of Converged iTV Services: From Macromedia Director Simulations to Services Ready for Broadcast

While sound and video may capture viewers' attention, interaction can captivate them. This has not been available prior to the advent of Digital Television. In fact, what lies at the heart of the Digital Television revolution is this new type of interactive content, offered in the form of interactive Television (iTV) services. On top of that, the new world of converged networks has created a demand for a new type of converged services on a range of mobile terminals (Tablet PCs, PDAs and mobile phones). This paper aims at presenting a new approach to service creation that allows for the semi-automatic translation of simulations and rapid prototypes created in the accessible desktop multimedia authoring package Macromedia Director into services ready for broadcast. This is achieved by a series of tools that de-skill and speed-up the process of creating digital TV user interfaces (UI) and applications for mobile terminals. The benefits of rapid prototyping are essential for the production of these new types of services, and are therefore discussed in the first section of this paper. In the following sections, an overview of the operation of content, service, creation and management sub-systems is presented, which illustrates why these tools compose an important and integral part of a system responsible of creating, delivering and managing converged broadcast and telecommunications services. The next section examines a number of metadata languages candidates for describing the iTV services user interface and the schema language adopted in this project. A detailed description of the operation of the two tools is provided to offer an insight of how they can be used to de-skill and speed-up the process of creating digital TV user interfaces and applications for mobile terminals. Finally, representative broadcast oriented and telecommunication oriented converged service components are also introduced, demonstrating how these tools have been used to generate different types of services.

How to Improve the Production Process for interactive TV with semi-formal Methods

The central question for this paper is how to improve the production process by closing the gap between industrial designers and software engineers of television(TV)-based User Interfaces (UI) in an industrial environment. Software engineers are highly interested whether one UI design can be converted into several fully functional UIs for TV products with different screen properties. The aim of the software engineers is to apply automatic layout and scaling in order to speed up and improve the production process. However, the question is whether a UI design lends itself for such automatic layout and scaling. This is investigated by analysing a prototype UI design done by industrial designers. In a first requirements study, industrial designers had created meta-annotations on top of their UI design in order to disclose their design rationale for discussions with software engineers. In a second study, five (out of ten) industrial designers assessed the potential of four different meta-annotation approaches. The question was which annotation method industrial designers would prefer and whether it could satisfy the technical requirements of the software engineering process. One main result is that the industrial designers preferred the method they were already familiar with, which therefore seems to be the most effective one although the main objective of automatic layout and scaling could still not be achieved.

How do subordinate and dominant species in semi-natural mountain grasslands relate to productivity and land-use change?

Changes in agricultural practices of semi-natural mountain grasslands are expected to modify plant community structure and shift dominance patterns. Using vegetation surveys of 11 sites in semi-natural grasslands of the Swiss Jura and Swiss and French Alps, we determined the relative contribution of dominant, subordinate and transient plant species in grazed and abandoned communities and observed their changes along a gradient of productivity and in response to abandonment of pasturing. The results confirm the humpbacked diversity–productivity relationship in semi-natural grassland, which is due to the increase of subordinate species number at intermediate productivity levels. Grazed communities, at the lower or higher end of the species diversity gradient, suffered higher species loss after grazing abandonment. Species loss after abandonment of pasturing was mainly due to a higher reduction in the number of subordinate species, as a consequence of the increasing proportion of dominant species. When plant biodiversity maintenance is the aim, our results have direct implications for the way grasslands should be managed. Indeed, while intensification and abandonment have been accelerated since few decades, our findings in this multi-site analysis confirm the importance of maintaining intermediate levels of pasturing to preserve biodiversity.