Experience with Learning Agents which Manage Internet-Based Information

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Effectiveness of Community versus Hospital Eye Service follow-up for patients with neovascular age-related macular degeneration with quiescent disease (ECHoES): a virtual non-inferiority trial

OBJECTIVES: To compare the ability of ophthalmologists versus optometrists to correctly classify retinal lesions due to neovascular age-related macular degeneration (nAMD).

DESIGN: Randomised balanced incomplete block trial. Optometrists in the community and ophthalmologists in the Hospital Eye Service classified lesions from vignettes comprising clinical information, colour fundus photographs and optical coherence tomographic images. Participants' classifications were validated against experts' classifications (reference standard).

SETTING: Internet-based application.

PARTICIPANTS: Ophthalmologists with experience in the age-related macular degeneration service; fully qualified optometrists not participating in nAMD shared care.

INTERVENTIONS: The trial emulated a conventional trial comparing optometrists' and ophthalmologists' decision-making, but vignettes, not patients, were assessed. Therefore, there were no interventions and the trial was virtual. Participants received training before assessing vignettes.

MAIN OUTCOME MEASURES: Primary outcome-correct classification of the activity status of a lesion based on a vignette, compared with a reference standard. Secondary outcomes-potentially sight-threatening errors, judgements about specific lesion components and participants' confidence in their decisions.

RESULTS: In total, 155 participants registered for the trial; 96 (48 in each group) completed all assessments and formed the analysis population. Optometrists and ophthalmologists achieved 1702/2016 (84.4%) and 1722/2016 (85.4%) correct classifications, respectively (OR 0.91, 95% CI 0.66 to 1.25; p=0.543). Optometrists' decision-making was non-inferior to ophthalmologists' with respect to the prespecified limit of 10% absolute difference (0.298 on the odds scale). Optometrists and ophthalmologists made similar numbers of sight-threatening errors (57/994 (5.7%) vs 62/994 (6.2%), OR 0.93, 95% CI 0.55 to 1.57; p=0.789). Ophthalmologists assessed lesion components as present less often than optometrists and were more confident about their classifications than optometrists.

CONCLUSIONS: Optometrists' ability to make nAMD retreatment decisions from vignettes is not inferior to ophthalmologists' ability. Shared care with optometrists monitoring quiescent nAMD lesions has the potential to reduce workload in hospitals.

TRIAL REGISTRATION NUMBER: ISRCTN07479761; pre-results registration.

“Enjoy your baby” Internet-based CBT for mothers with babies: a feasibility randomised control trial

Background: Postnatal depression is a global health problem with lasting effects on the family. Government policy is focussed on early intervention and increasing access to psychological therapies. There is a growing evidence base for the use of computerised CBT packages and this study investigated the feasibility of a CBT-based self-help internet intervention for new mothers. Objective: To assess the ability to recruit mothers, deliver an internet course, obtain follow-up data and evaluate what mothers think of the course. Design: A feasibility randomised control design was used to compare a waiting list control group (delayed access= DA) to the Enjoy Your Baby course (immediate access= IA). Measures were administered at baseline and 8 week follow-up. Methods: Adverts were placed in the Metro freesheet, on charity web pages, on social media, posters were put up in the community, and leaflets were handed out at mother and baby groups. Participants had to be 18 years old or over with a child less than 18 months old. The IA arm was given access to the course straight away. After 8 weeks all participants were asked to recomplete the original measures and those in the IA arm also gave feedback on the course. Participants in the DA arm were given access after recompleting the questionnaires. Due to a lack of follow-up data a small discussion group was conducted. Intervention: The course contains 4 core modules including helping mothers understand why they feel the way they do and helping them build closeness to their babies. Additional modules, worksheets and homework tasks were available. The DA group were given a list of additional support resources and services, and encouraged to seek additional help if required. All participants received weekly automated emails for 12 weeks as they worked through the course. It was not possible to deliver individualised support. 34 Results: Despite using a number of recruitment strategies, recruitment was lower and slower than anticipated, and attrition was high. 41 women, primarily recruited via the internet, were randomised (IA n=21, DA n=20). No significant differences were observed between participants in either arm at baseline and no statistically significant differences were identified when the demographics and baseline measures of participants who logged-on to the course were compared to those who did not, or when participants who completed follow-up measures were compared to those who did not. Pre and post intervention scores on the EPDS approached statistical significance (P=.059, r=.444) favouring the intervention arm. The discussion group suggested strengths of the course and recommended areas for improvement, including making the course more mobile friendly. Conclusion: Internet interventions show promise; however it is difficult to recruit mothers, engagement is low and attrition high. A number of recommendations are made and a further pilot or an internal pilot of a larger substantive study should be conducted to confirm recruitment and retention. Trial ID: ISRCTN90927910.

An internet-based control engineering laboratory

This paper presents LABNET, an internet-based remote laboratory for control engineering education developed at UEM-University. At present, the remote laboratory integrates three basic physical systems (level control, temperature control and ship stabilizing system). In this paper, the LABNET architecture is presented and discussed in detail. Issues concerned with concurrent user access, local or remote feedback, automatic report generating and reusing of experiment’s templates have been addressed. Furthermore, the experiences gained developing, testing and using the system will be also presented and their consequences for future design.

Transportation Program Management System, HR-394, 2003

HR-394 was a software and database development project. Via funding provided by the Iowa Highway Research Board, the Iowa County Engineer's Association Service Bureau oversaw the planning and implementation of an Internet based application that supports two major local-government transportation project activities: Project programming and Development tracking. The goals were to reduce errors and inconsistencies, speed up the processes, link people to both project data and each other, and build a framework that could eventually support a 'paperless' work flow. The work started in 1999 and initial development was completed by the fall of 2002. Since going live, several 'piggy back' applications have been required to make the Programming side better fit actual work procedures. This part of the system has proven adequate but will be rewritten in 2004 to make it easier to use. The original development side module was rejected by the users and so had to be rewritten in 2003. The second version has proven much better, is heavily used, and is interconnected with Iowa DOT project data systems. Now that the system is in operation, it will be maintained and operated by the ICEA Service Bureau as an ongoing service function.

Teknologiat ja toteutustavat palvelukeskeiseen arkkitehtuuriin perustuvassa Internet-pohjaisessajärjestelmässä

Palvelukeskeiseen arkkitehtuuriin perustuvia järjestelmiä voidaan kehittää käyttämällä useita vaihtoehtoisia teknologioita. Toteuttamiseen parhaiten soveltuvia teknologioita ovat erilaiset standardikokoelmat, jotka tukevat useiden toisistaan toteutustavaltaan poikkeavien järjestelmien yhdistämistä käyttämällä standardeihin perustuvia rajapintoja. Täten kyseiset kokoelmat tukevat laajojen, useista erillisistä osista koostuvien palvelujärjestelmien kehittämistä. Tässä työssä selvitetään mikä palvelukeskeinen arkkitehtuuri on sekä millaisia komponentteja ja teknologioita kyseiseen arkkitehtuuriin perustuvan palvelujärjestelmän toteuttamiseen tarvitaan. Tavoitteena on esitellä palvelukeskeinen arkkitehtuuri ja siihen liittyvät teknologiat sekä suunnitella korkealla tasolla kyseisiä teknologioita hyödyntävä integraatioalusta käyttäjien ja useiden palvelun tarjoajien yhdistämiseksi. Työn tuloksena syntyvän teknologiaselvitysraportin selvitysluonteen vuoksi työssä ei suunnitella tarkasti toteutettavaa järjestelmää vaan ainoastaanpohjustetaan järjestelmän suunnittelua sekä esitellään siihen liittyviä arkkitehtuuri- ja toteutusmahdollisuuksia. Internet-pohjainen palvelukeskeiseen arkkitehtuuriin perustuva järjestelmä voi perustua suoriinverkon välisiin yhteyksiin tai vaihtoehtoisesti erityyppisiin välitason sovelluksiin. Välitason sovellukset mahdollistavat niiden tyypistä riippuen järjestelmän erilaisten lisäominaisuuksien toteuttamisen ja tukevat useita yleisimpiä palvelukeskeisiä teknologioita. Työn tuloksena syntyneen teknologiaselvityksen perusteella näistä teknologioista Web-palvelu -arkkitehtuuri ja siihen liittyvät menetelmät soveltuvat parhaiten suunniteltavan järjestelmän rakenneosiksi. Järjestelmän tarkemmat toteutustavat riippuvat myöhemmin määriteltävistä yksityiskohtaisista vaatimuksista sekä valittavasta välitason ohjelmiston toteutuksesta.

Physical outcome measurements via the Internet: reliability at two Internet speeds

We have developed a software application to enable interactive rehabilitation via the Internet. The reliability of the telemedicine application was examined by comparing it with face-to-face assessment. The physical outcome measures assessed were knee range of motion, quadriceps muscle strength, limb girth and an assessment of gait. One therapist performed both in-person and Internet-based measurements of all outcome measures on 20 normal subjects. There was good agreement between the two techniques (the 95% limits of agreement included zero for all the variables studied). Internet assessments were conducted at two bandwidths: ISDN at 128 kbit/s and the telephone network at 17 kbit/s. Bandwidth had no significant influence on any of the measures. This study suggests that Internet-based physiotherapy interventions delivered to the home are suitable for further development.

Estudo de Funcionalidades HTML5 para um Editor de Imagem na Internet

Hoje em dia existem múltiplas aplicações multimédia na Internet, sendo comum qualquer website apresentar mais de uma forma de visualização de informação além do texto como, por exemplo: imagens, áudio, vídeo e animação. Com aumento do consumo e utilização de Smartphone e Tablets, o volume de tráfego de internet móvel tem vindo a crescer rapidamente, bem como o acesso à internet através da televisão. As aplicações web-based ganham maior relevância devido à maior partilha ou consumo de conteúdos multimédia, com ou sem edição ou manipulação da mesma, através de redes sociais, como o Facebook. Neste documento é apresentado o estudo de alternativas HTML5 e a implementação duma aplicação web-based no âmbito do Mestrado de Engenharia Informática, ramo de Sistemas Gráficos e Multimédia, no Instituto Superior Engenharia do Porto (ISEP). A aplicação tem como objetivo a edição e manipulação de imagens, tanto em desktop como em dispositivos móveis, sendo este processo exclusivamente feito no lado do cliente, ou seja, no Browser do utilizador. O servidor é usado somente para o armazenamento da aplicação. Durante o desenvolvimento do projeto foi realizado um estudo de soluções de edição e manipulação de imagem existentes no mercado, com a respetiva análise de comparação e apresentadas tecnologias Web modernas como HTML5, CSS3 e JavaScript, que permitirão desenvolver o protótipo. Posteriormente, serão apresentadas, detalhadamente, as várias fases do desenvolvimento de um protótipo, desde a análise do sistema, à apresentação do protótipo e indicação das tecnologias utilizadas. Também serão apresentados os resultados dos inquéritos efetuados a um grupo de pessoas que testaram esse protótipo. Finalmente, descrever-se-á de forma mais exaustiva, a implementação e serão apontadas dificuldades encontradas ao longo do desenvolvimento, bem como indicadas futuras melhorias a introduzir.

Dépistage et intervention brève par internet pour la consommation d'alcool a risque: www.alcooquizz.ch [Web-based screening and brief intervention for unhealthy alcohol use: www.alcooquizz.ch].

Many individuals with unhealthy alcohol use have few or no contact with the health care system and are therefore unlikely to receive information or a brief intervention from a health care professional. Consequently, many Internet-based interventions have been developed. These interventions can reach a large population. We present in this report www.alcooquizz.ch, a website providing tailored feedback and information on alcohol use and its consequences. In six months and a half, more than 15000 individuals visited the website. It appropriately targets individuals with unhealthy alcohol use and users' satisfaction was high. Internet is a valuable option to provide health related information and secondary prevention interventions for unhealthy alcohol use.

Uudet Internet -kehitysvälineet.

Diplomityön tavoitteena on tutkia uusia Internet-kehitysvälineitä ja arvioida näiden soveltuvuutta eri käyttötarkoituksiin. Tarkasteltavana ja testattavana on kaksi hieman erilaista välinettä, SilverStream ja WebSphere. Kehitysvälineitä arvioidaan työssä käyttämällä mm. seuraavia kriteereitä: skaalautuvuus, tietoturva, teknologiaratkaisut, avoimuus, hallittavuus ja suorituskyky. Lisäksi työn lopussa verrataan välineitä keskenään saatujen tulosten perusteella.

The Architecture of a Fourth Generation Mobile Network

Neljännen sukupolven mobiiliverkot yhdistävät saumattomasti televerkot, Internetin ja niiden palvelut. Alkuperin Internetiä käytettiin vain paikallaan pysyviltä tietokoneilta perinteisten televerkkojen tarjotessa puhelin- ja datapalveluita. Neljännen sukupolven mobiiliverkkojen käyttäjät voivat käyttää sekä Internetiin perustuvia että perinteisten televerkkojen palveluita liikkuessaankin. Tämä diplomityö esittelee neljännen sukupolven mobiiliverkon yleisen arkkitehtuurin. Arkkitehtuurin perusosat kuvaillaan ja arkkitehtuuria verrataan toisen ja kolmannen sukupolven mobiiliverkkoihin. Aiheeseen liittyvät Internet-standardit esitellään ja niiden soveltuvuutta mobiiliverkkoihin pohditaan. Langattomia, lyhyen kantaman nopeita liitäntäverkkotekniikoita esitellään. Neljännen sukupolven mobiiliverkoissa tarvittavia päätelaitteiden ja käyttäjien liikkuvuuden hallintamenetelmiä esitellään. Esitelty arkkitehtuuri perustuu langattomiin, lyhyen kantaman nopeisiin liitäntäverkkotekniikoihin ja Internet-standardeihin. Arkkitehtuuri mahdollistaa yhteydet toisiin käyttäjiin ilman tietoa heidän senhetkisestä päätelaitteesta tai sijainnista. Internetin palveluitavoidaan käyttää missä tahansa neljännen sukupolven mobiiliverkon alueella. Yleiskäytöistä liikkuvuuden hallintamenetelmää yhden verkon alueelle ehdotetaan. Menetelmää voidaan käyttää yhdessä esitellyn arkkitehtuurin kanssa.

Identification d’une architecture à base de composants dans une application orientée objets à l’aide d’une analyse dynamique

Un système, décrit avec un grand nombre d'éléments fortement interdépendants, est complexe, difficile à comprendre et à maintenir. Ainsi, une application orientée objet est souvent complexe, car elle contient des centaines de classes avec de nombreuses dépendances plus ou moins explicites. Une même application, utilisant le paradigme composant, contiendrait un plus petit nombre d'éléments, faiblement couplés entre eux et avec des interdépendances clairement définies. Ceci est dû au fait que le paradigme composant fournit une bonne représentation de haut niveau des systèmes complexes. Ainsi, ce paradigme peut être utilisé comme "espace de projection" des systèmes orientés objets. Une telle projection peut faciliter l'étape de compréhension d'un système, un pré-requis nécessaire avant toute activité de maintenance et/ou d'évolution. De plus, il est possible d'utiliser cette représentation, comme un modèle pour effectuer une restructuration complète d'une application orientée objets opérationnelle vers une application équivalente à base de composants tout aussi opérationnelle. Ainsi, La nouvelle application bénéficiant ainsi, de toutes les bonnes propriétés associées au paradigme composants. L'objectif de ma thèse est de proposer une méthode semi-automatique pour identifier une architecture à base de composants dans une application orientée objets. Cette architecture doit, non seulement aider à la compréhension de l'application originale, mais aussi simplifier la projection de cette dernière dans un modèle concret de composant. L'identification d'une architecture à base de composants est réalisée en trois grandes étapes: i) obtention des données nécessaires au processus d'identification. Elles correspondent aux dépendances entre les classes et sont obtenues avec une analyse dynamique de l'application cible. ii) identification des composants. Trois méthodes ont été explorées. La première utilise un treillis de Galois, la seconde deux méta-heuristiques et la dernière une méta-heuristique multi-objective. iii) identification de l'architecture à base de composants de l'application cible. Cela est fait en identifiant les interfaces requises et fournis pour chaque composant. Afin de valider ce processus d'identification, ainsi que les différents choix faits durant son développement, j'ai réalisé différentes études de cas. Enfin, je montre la faisabilité de la projection de l'architecture à base de composants identifiée vers un modèle concret de composants.

Data collection in Internet environment in social representations studies

The present study aimed at comparing social representations structures concerning data collection procedures: through internet forms, diffused in the WWW, and through conventional paper and pencil questionnaire methods. overall 893 individuals participated in the research, 58% of whom were female. A total of 217 questionnaires about the social representation on football (soccer) and 218 about the representation on aging were answered by Brazilian university students in classrooms. Electronic versions of the same instrument were diffused through an internet forum linked to the same university. There were 238 answers for the football questionnaire and 230 for the aging one. The instrument asked participants to indicate five words or expressions related to one of the social objects. Sample characteristics and structural analyses were carried out separately for the two data collection procedures. data indicated that internet-based research allows for higher sample diversity, but it is essential to guarantee the adoption of measures that can select only desired participants. Results also pointed out the need to take into account the nature of the social object to be investigated through internet research on representations, seeking to avoid self-selection effects, which can bias results, as it seems to have happened with the football social object.

Application of dried blood spots to determine vitamin D status in a large nutritional study with unsupervised sampling: the Food4Me project

An efficient and robust method to measure vitamin D (25-hydroxy vitamin D3 (25(OH)D3) and 25-hydroxy vitamin D2 in dried blood spots (DBS) has been developed and applied in the pan-European multi-centre, internet-based, personalised nutrition intervention study Food4Me. The method includes calibration with blood containing endogenous 25(OH)D3, spotted as DBS and corrected for haematocrit content. The methodology was validated following international standards. The performance characteristics did not reach those of the current gold standard liquid chromatography-MS/MS in plasma for all parameters, but were found to be very suitable for status-level determination under field conditions. DBS sample quality was very high, and 3778 measurements of 25(OH)D3 were obtained from 1465 participants. The study centre and the season within the study centre were very good predictors of 25(OH)D3 levels (P<0·001 for each case). Seasonal effects were modelled by fitting a sine function with a minimum 25(OH)D3 level on 20 January and a maximum on 21 July. The seasonal amplitude varied from centre to centre. The largest difference between winter and summer levels was found in Germany and the smallest in Poland. The model was cross-validated to determine the consistency of the predictions and the performance of the DBS method. The Pearson's correlation between the measured values and the predicted values was r 0·65, and the sd of their differences was 21·2 nmol/l. This includes the analytical variation and the biological variation within subjects. Overall, DBS obtained by unsupervised sampling of the participants at home was a viable methodology for obtaining vitamin D status information in a large nutritional study.

LiLEDDA – a six step forum-based netnographic research method for nursing and caring sciences

Internet research methods in nursing science are less developed than in other sciences. We choose to present an approach to conducting nursing research on an internet-based forum. This paper presents LiLEDDA, a six-step forum-based netnographic research method for nursing science. The steps consist of: 1. Literature review and identification of the research question(s); 2. Locating the field(s) online; 3. Ethical considerations; 4. Data gathering; 5. Data analysis and interpretation; and 6. Abstractions and trustworthiness. Traditional research approaches are limiting when studying non-normative and non-mainstream life-worlds and their cultures. We argue that it is timely to develop more up-to-date research methods and study designs applicable to nursing science that reflect social developments and human living conditions that tend to be increasingly online-based.