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Sample records for promis computerised adaptive

  1. Validation of Patient-Reported Outcomes Measurement Information System (PROMIS) computerized adaptive tests in cervical spine surgery.

    Science.gov (United States)

    Boody, Barrett S; Bhatt, Surabhi; Mazmudar, Aditya S; Hsu, Wellington K; Rothrock, Nan E; Patel, Alpesh A

    2018-03-01

    OBJECTIVE The Patient-Reported Outcomes Measurement Information System (PROMIS), which is funded by the National Institutes of Health, is a set of adaptive, responsive assessment tools that measures patient-reported health status. PROMIS measures have not been validated for surgical patients with cervical spine disorders. The objective of this project is to evaluate the validity (e.g., convergent validity, known-groups validity, responsiveness to change) of PROMIS computer adaptive tests (CATs) for pain behavior, pain interference, and physical function in patients undergoing cervical spine surgery. METHODS The legacy outcome measures Neck Disability Index (NDI) and SF-12 were used as comparisons with PROMIS measures. PROMIS CATs, NDI-10, and SF-12 measures were administered prospectively to 59 consecutive tertiary hospital patients who were treated surgically for degenerative cervical spine disorders. A subscore of NDI-5 was calculated from NDI-10 by eliminating the lifting, headaches, pain intensity, reading, and driving sections and multiplying the final score by 4. Assessments were administered preoperatively (baseline) and postoperatively at 6 weeks and 3 months. Patients presenting for revision surgery, tumor, infection, or trauma were excluded. Participants completed the measures in Assessment Center, an online data collection tool accessed by using a secure login and password on a tablet computer. Subgroup analysis was also performed based on a primary diagnosis of either cervical radiculopathy or cervical myelopathy. RESULTS Convergent validity for PROMIS CATs was supported with multiple statistically significant correlations with the existing legacy measures, NDI and SF-12, at baseline. Furthermore, PROMIS CATs demonstrated known-group validity and identified clinically significant improvements in all measures after surgical intervention. In the cervical radiculopathy and myelopathic cohorts, the PROMIS measures demonstrated similar responsiveness to the

  2. Item response theory, computerized adaptive testing, and PROMIS: assessment of physical function.

    Science.gov (United States)

    Fries, James F; Witter, James; Rose, Matthias; Cella, David; Khanna, Dinesh; Morgan-DeWitt, Esi

    2014-01-01

    Patient-reported outcome (PRO) questionnaires record health information directly from research participants because observers may not accurately represent the patient perspective. Patient-reported Outcomes Measurement Information System (PROMIS) is a US National Institutes of Health cooperative group charged with bringing PRO to a new level of precision and standardization across diseases by item development and use of item response theory (IRT). With IRT methods, improved items are calibrated on an underlying concept to form an item bank for a "domain" such as physical function (PF). The most informative items can be combined to construct efficient "instruments" such as 10-item or 20-item PF static forms. Each item is calibrated on the basis of the probability that a given person will respond at a given level, and the ability of the item to discriminate people from one another. Tailored forms may cover any desired level of the domain being measured. Computerized adaptive testing (CAT) selects the best items to sharpen the estimate of a person's functional ability, based on prior responses to earlier questions. PROMIS item banks have been improved with experience from several thousand items, and are calibrated on over 21,000 respondents. In areas tested to date, PROMIS PF instruments are superior or equal to Health Assessment Questionnaire and Medical Outcome Study Short Form-36 Survey legacy instruments in clarity, translatability, patient importance, reliability, and sensitivity to change. Precise measures, such as PROMIS, efficiently incorporate patient self-report of health into research, potentially reducing research cost by lowering sample size requirements. The advent of routine IRT applications has the potential to transform PRO measurement.

  3. Validation of Patient Reported Outcomes Measurement Information System (PROMIS) Computer Adaptive Tests (CATs) in the Surgical Treatment of Lumbar Spinal Stenosis.

    Science.gov (United States)

    Patel, Alpesh A; Dodwad, Shah-Nawaz M; Boody, Barrett S; Bhatt, Surabhi; Savage, Jason W; Hsu, Wellington K; Rothrock, Nan E

    2018-03-19

    Prospective, cohort study. Demonstrate validity of PROMIS physical function, pain interference, and pain behavior computer adaptive tests (CATs) in surgically treated lumbar stenosis patients. There has been increasing attention given to patient reported outcomes associated with spinal interventions. Historical patient outcome measures have inadequate validation, demonstrate floor/ceiling effects, and infrequently used due to time constraints. PROMIS is an adaptive, responsive NIH assessment tool that measures patient-reported health status. 98 consecutive patients were surgically treated for lumbar spinal stenosis and were assessed using PROMIS CATs, ODI, ZCQ and SF-12. Prior lumbar surgery, history of scoliosis, cancer, trauma, or infection were excluded. Completion time, preoperative assessment, 6 week and 3 month postoperative scores were collected. At baseline, 49%, 79%, and 81% of patients had PROMIS PB, PI, and PF scores greater than 1 SD worse than the general population. 50.6% were categorized as severely disabled, crippled, or bed bound by ODI. PROMIS CATs demonstrated convergent validity through moderate to high correlations with legacy measures (r = 0.35-0.73). PROMIS CATs demonstrated known groups validity when stratified by ODI levels of disability. ODI improvements of at least 10 points on average had changes in PROMIS scores in the expected direction (PI = -12.98, PB = -9.74, PF = 7.53). PROMIS CATs demonstrated comparable responsiveness to change when evaluated against legacy measures. PROMIS PB and PI decreased 6.66 and 9.62 and PROMIS PF increased 6.8 points between baseline and 3-months post-op (p validity, known groups validity, and responsiveness for surgically treated patients with lumbar stenosis to detect change over time and are more efficient than legacy instruments. 2.

  4. Use of PROMIS for Patients Undergoing Primary Total Shoulder Arthroplasty.

    Science.gov (United States)

    Dowdle, S Blake; Glass, Natalie; Anthony, Chris A; Hettrich, Carolyn M

    2017-09-01

    The Patient-Reported Outcomes Measurement Information System (PROMIS) consists of question banks for health domains through computer adaptive testing (CAT). For patients with glenohumeral arthritis, (1) there would be high correlation between traditional patient-reported outcome (PRO) measures and the PROMIS upper extremity item bank (PROMIS UE) and PROMIS physical function CAT (PROMIS PF CAT), and (2) PROMIS PF CAT would not demonstrate ceiling effects. Cohort study (diagnosis); Level of evidence, 3. Sixty-one patients with glenohumeral osteoarthritis were included. Each patient completed the American Shoulder and Elbow Surgeons (ASES) assessment form, Marx Shoulder Activity Scale, Short Form-36 physical function scale (SF-36 PF), EuroQol 5 Dimensions (EQ-5D) questionnaire, Western Ontario Osteoarthritis Shoulder (WOOS) index, PROMIS PF CAT, and the PROMIS UE. Correlation was defined as high (>0.7), moderate (0.4-0.6), or weak (0.2-0.3). Significant floor and ceiling effects were present if more than 15% of individuals scored the lowest or highest possible total score on any PRO. The PROMIS PF demonstrated excellent correlation with the SF-36 PF ( r = 0.81, P ceiling or floor effects observed. The mean number of items administered by the PROMIS PRO was 4. These data suggest that for a patient population with operative shoulder osteoarthritis, PROMIS UE and PROMIS PF CAT may be valid alternative PROs. Additionally, PROMIS PF CAT offers a decreased question burden with no ceiling effects.

  5. Use of PROMIS for Patients Undergoing Primary Total Shoulder Arthroplasty

    Science.gov (United States)

    Dowdle, S. Blake; Glass, Natalie; Anthony, Chris A.; Hettrich, Carolyn M.

    2017-01-01

    Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) consists of question banks for health domains through computer adaptive testing (CAT). Hypothesis: For patients with glenohumeral arthritis, (1) there would be high correlation between traditional patient-reported outcome (PRO) measures and the PROMIS upper extremity item bank (PROMIS UE) and PROMIS physical function CAT (PROMIS PF CAT), and (2) PROMIS PF CAT would not demonstrate ceiling effects. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Sixty-one patients with glenohumeral osteoarthritis were included. Each patient completed the American Shoulder and Elbow Surgeons (ASES) assessment form, Marx Shoulder Activity Scale, Short Form–36 physical function scale (SF-36 PF), EuroQol 5 Dimensions (EQ-5D) questionnaire, Western Ontario Osteoarthritis Shoulder (WOOS) index, PROMIS PF CAT, and the PROMIS UE. Correlation was defined as high (>0.7), moderate (0.4-0.6), or weak (0.2-0.3). Significant floor and ceiling effects were present if more than 15% of individuals scored the lowest or highest possible total score on any PRO. Results: The PROMIS PF demonstrated excellent correlation with the SF-36 PF (r = 0.81, P ceiling or floor effects observed. The mean number of items administered by the PROMIS PRO was 4. Conclusion: These data suggest that for a patient population with operative shoulder osteoarthritis, PROMIS UE and PROMIS PF CAT may be valid alternative PROs. Additionally, PROMIS PF CAT offers a decreased question burden with no ceiling effects. PMID:28944248

  6. Development of computerised adaptive testing (CAT) for the EORTC QLQ-C30 dimensions - general approach and initial results for physical functioning

    DEFF Research Database (Denmark)

    Petersen, Morten Aa; Groenvold, Mogens; Aaronson, Neil K

    2010-01-01

    Health-related quality of life (HRQOL) questionnaires should ideally be adapted to the individual patient and at the same time scores should be directly comparable across patients. This is achievable using a computerised adaptive test (CAT). Basing the CAT on an existing instrument enables measur...

  7. Applying modern psychometric techniques to melodic discrimination testing: Item response theory, computerised adaptive testing, and automatic item generation.

    Science.gov (United States)

    Harrison, Peter M C; Collins, Tom; Müllensiefen, Daniel

    2017-06-15

    Modern psychometric theory provides many useful tools for ability testing, such as item response theory, computerised adaptive testing, and automatic item generation. However, these techniques have yet to be integrated into mainstream psychological practice. This is unfortunate, because modern psychometric techniques can bring many benefits, including sophisticated reliability measures, improved construct validity, avoidance of exposure effects, and improved efficiency. In the present research we therefore use these techniques to develop a new test of a well-studied psychological capacity: melodic discrimination, the ability to detect differences between melodies. We calibrate and validate this test in a series of studies. Studies 1 and 2 respectively calibrate and validate an initial test version, while Studies 3 and 4 calibrate and validate an updated test version incorporating additional easy items. The results support the new test's viability, with evidence for strong reliability and construct validity. We discuss how these modern psychometric techniques may also be profitably applied to other areas of music psychology and psychological science in general.

  8. Computerising documentation

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    The nuclear power generation industry is faced with public concern and government pressures over safety, efficiency and risk. Operators throughout the industry are addressing these issues with the aid of a new technology - technical document management systems (TDMS). Used for strategic and tactical advantage, the systems enable users to scan, archive, retrieve, store, edit, distribute worldwide and manage the huge volume of documentation (paper drawings, CAD data and film-based information) generated in building, maintaining and ensuring safety in the UK's power plants. The power generation industry has recognized that the management and modification of operation critical information is vital to the safety and efficiency of its power plants. Regulatory pressure from the Nuclear Installations Inspectorate (NII) to operate within strict safety margins or lose Site Licences has prompted the need for accurate, up-to-data documentation. A document capture and management retrieval system provides a powerful cost-effective solution, giving rapid access to documentation in a tightly controlled environment. The computerisation of documents and plans is discussed in this article. (Author)

  9. The PROMIS physical function correlates with the QuickDASH in patients with upper extremity illness.

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    Overbeek, Celeste L; Nota, Sjoerd P F T; Jayakumar, Prakash; Hageman, Michiel G; Ring, David

    2015-01-01

    To assess disability more efficiently with less burden on the patient, the National Institutes of Health has developed the Patient Reported Outcomes Measurement Information System (PROMIS) Physical Function-an instrument based on item response theory and using computer adaptive testing (CAT). Initially, upper and lower extremity disabilities were not separated and we were curious if the PROMIS Physical Function CAT could measure upper extremity disability and the Quick Disability of Arm, Shoulder and Hand (QuickDASH). We aimed to find correlation between the PROMIS Physical Function and the QuickDASH questionnaires in patients with upper extremity illness. Secondarily, we addressed whether the PROMIS Physical Function and QuickDASH correlate with the PROMIS Depression CAT and PROMIS Pain Interference CAT instruments. Finally, we assessed factors associated with QuickDASH and PROMIS Physical Function in multivariable analysis. A cohort of 93 outpatients with upper extremity illnesses completed the QuickDASH and three PROMIS CAT questionnaires: Physical Function, Pain Interference, and Depression. Pain intensity was measured with an 11-point ordinal measure (0-10 numeric rating scale). Correlation between PROMIS Physical Function and the QuickDASH was assessed. Factors that correlated with the PROMIS Physical Function and QuickDASH were assessed in multivariable regression analysis after initial bivariate analysis. There was a moderate correlation between the PROMIS Physical Function and the QuickDASH questionnaire (r=-0.55, p<0.001). Greater disability as measured with the PROMIS and QuickDASH correlated most strongly with PROMIS Depression (r=-0.35, p<0.001 and r=0.34, p<0.001 respectively) and Pain Interference (r=-0.51, p<0.001 and r=0.74, p<0.001 respectively). The factors accounting for the variability in PROMIS scores are comparable to those for the QuickDASH except that the PROMIS Physical Function is influenced by other pain conditions while the QuickDASH is

  10. Performance of PROMIS for Healthy Patients Undergoing Meniscal Surgery.

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    Hancock, Kyle J; Glass, Natalie; Anthony, Chris A; Hettrich, Carolyn M; Albright, John; Amendola, Annunziato; Wolf, Brian R; Bollier, Matthew

    2017-06-07

    The Patient-Reported Outcomes Measurement Information System (PROMIS) was developed as an extensive question bank with multiple health domains that could be utilized for computerized adaptive testing (CAT). In the present study, we investigated the use of the PROMIS Physical Function CAT (PROMIS PF CAT) in an otherwise healthy population scheduled to undergo surgery for meniscal injury with the hypotheses that (1) the PROMIS PF CAT would correlate strongly with patient-reported outcome instruments that measure physical function and would not correlate strongly with those that measure other health domains, (2) there would be no ceiling effects, and (3) the test burden would be significantly less than that of the traditional measures. Patients scheduled to undergo meniscal surgery completed the PROMIS PF CAT, Knee injury and Osteoarthritis Outcome Score (KOOS), Marx Knee Activity Rating Scale, Short Form-36 (SF-36), and EuroQol-5 Dimension (EQ-5D) questionnaires. Correlations were defined as high (≥0.7), high-moderate (0.61 to 0.69), moderate (0.4 to 0.6), moderate-weak (0.31 to 0.39), or weak (≤0.3). If ≥15% respondents to a patient-reported outcome measure obtained the highest or lowest possible score, the instrument was determined to have a significant ceiling or floor effect. A total of 107 participants were analyzed. The PROMIS PF CAT had a high correlation with the SF-36 Physical Functioning (PF) (r = 0.82, p ceiling effects, with 0% of the participants achieving the lowest and highest score, respectively. The PROMIS PF CAT correlates strongly with currently used patient-reported outcome measures of physical function and demonstrates no ceiling effects for patients with meniscal injury requiring surgery. It may be a reasonable alternative to more burdensome patient-reported outcome measures.

  11. Migrating from a legacy fixed-format measure to CAT administration: calibrating the PHQ-9 to the PROMIS depression measures.

    Science.gov (United States)

    Gibbons, Laura E; Feldman, Betsy J; Crane, Heidi M; Mugavero, Michael; Willig, James H; Patrick, Donald; Schumacher, Joseph; Saag, Michael; Kitahata, Mari M; Crane, Paul K

    2011-11-01

    We provide detailed instructions for analyzing patient-reported outcome (PRO) data collected with an existing (legacy) instrument so that scores can be calibrated to the PRO Measurement Information System (PROMIS) metric. This calibration facilitates migration to computerized adaptive test (CAT) PROMIS data collection, while facilitating research using historical legacy data alongside new PROMIS data. A cross-sectional convenience sample (n = 2,178) from the Universities of Washington and Alabama at Birmingham HIV clinics completed the PROMIS short form and Patient Health Questionnaire (PHQ-9) depression symptom measures between August 2008 and December 2009. We calibrated the tests using item response theory. We compared measurement precision of the PHQ-9, the PROMIS short form, and simulated PROMIS CAT. Dimensionality analyses confirmed the PHQ-9 could be calibrated to the PROMIS metric. We provide code used to score the PHQ-9 on the PROMIS metric. The mean standard errors of measurement were 0.49 for the PHQ-9, 0.35 for the PROMIS short form, and 0.37, 0.28, and 0.27 for 3-, 8-, and 9-item-simulated CATs. The strategy described here facilitated migration from a fixed-format legacy scale to PROMIS CAT administration and may be useful in other settings.

  12. Computerised Axial Tomography (CAT)

    Science.gov (United States)

    1990-06-01

    Ministry of’ Defence, Defence Research Information Centre, UK. Computerised Axial Tomography ( CAT ) Report Secufty C"uMiauion tide Onadtiicadon (U. R, Cor S...DRIC T 8485 COMPUTERISED AXIAL TOMOGRAPHY ( CAT ) F.P. GENTILE, F. SABETTA, V. TRO1* ISS R 78/4.Rome, 1.5 Mlarch 1978 (from Italian) B Distribution(f...dello Radiazioni ISSN 0390--6477 F.P. GENTILE, F. SABETTA. V. TROI Computerised Axial Tomography ( CAT ) March 15, 1978). This paper is a review of

  13. PROMIS (Procurement Management Information System)

    Science.gov (United States)

    1987-01-01

    The PROcurement Management Information System (PROMIS) provides both detailed and summary level information on all procurement actions performed within NASA's procurement offices at Marshall Space Flight Center (MSFC). It provides not only on-line access, but also schedules procurement actions, monitors their progress, and updates Forecast Award Dates. Except for a few computational routines coded in FORTRAN, the majority of the systems is coded in a high level language called NATURAL. A relational Data Base Management System called ADABAS is utilized. Certain fields, called descriptors, are set up on each file to allow the selection of records based on a specified value or range of values. The use of like descriptors on different files serves as the link between the falls, thus producing a relational data base. Twenty related files are currently being maintained on PROMIS.

  14. Calibration of the Dutch-Flemish PROMIS Pain Behavior item bank in patients with chronic pain.

    Science.gov (United States)

    Crins, M H P; Roorda, L D; Smits, N; de Vet, H C W; Westhovens, R; Cella, D; Cook, K F; Revicki, D; van Leeuwen, J; Boers, M; Dekker, J; Terwee, C B

    2016-02-01

    The aims of the current study were to calibrate the item parameters of the Dutch-Flemish PROMIS Pain Behavior item bank using a sample of Dutch patients with chronic pain and to evaluate cross-cultural validity between the Dutch-Flemish and the US PROMIS Pain Behavior item banks. Furthermore, reliability and construct validity of the Dutch-Flemish PROMIS Pain Behavior item bank were evaluated. The 39 items in the bank were completed by 1042 Dutch patients with chronic pain. To evaluate unidimensionality, a one-factor confirmatory factor analysis (CFA) was performed. A graded response model (GRM) was used to calibrate the items. To evaluate cross-cultural validity, Differential item functioning (DIF) for language (Dutch vs. English) was evaluated. Reliability of the item bank was also examined and construct validity was studied using several legacy instruments, e.g. the Roland Morris Disability Questionnaire. CFA supported the unidimensionality of the Dutch-Flemish PROMIS Pain Behavior item bank (CFI = 0.960, TLI = 0.958), the data also fit the GRM, and demonstrated good coverage across the pain behavior construct (threshold parameters range: -3.42 to 3.54). Analysis showed good cross-cultural validity (only six DIF items), reliability (Cronbach's α = 0.95) and construct validity (all correlations ≥0.53). The Dutch-Flemish PROMIS Pain Behavior item bank was found to have good cross-cultural validity, reliability and construct validity. The development of the Dutch-Flemish PROMIS Pain Behavior item bank will serve as the basis for Dutch-Flemish PROMIS short forms and computer adaptive testing (CAT). © 2015 European Pain Federation - EFIC®

  15. Psychometric properties of the PROMIS Physical Function item bank in patients receiving physical therapy.

    Directory of Open Access Journals (Sweden)

    Martine H P Crins

    Full Text Available The Patient-Reported Outcomes Measurement Information System (PROMIS is a universally applicable set of instruments, including item banks, short forms and computer adaptive tests (CATs, measuring patient-reported health across different patient populations. PROMIS CATs are highly efficient and the use in practice is considered feasible with little administration time, offering standardized and routine patient monitoring. Before an item bank can be used as CAT, the psychometric properties of the item bank have to be examined. Therefore, the objective was to assess the psychometric properties of the Dutch-Flemish PROMIS Physical Function item bank (DF-PROMIS-PF in Dutch patients receiving physical therapy.Cross-sectional study.805 patients >18 years, who received any kind of physical therapy in primary care in the past year, completed the full DF-PROMIS-PF (121 items.Unidimensionality was examined by Confirmatory Factor Analysis and local dependence and monotonicity were evaluated. A Graded Response Model was fitted. Construct validity was examined with correlations between DF-PROMIS-PF T-scores and scores on two legacy instruments (SF-36 Health Survey Physical Functioning scale [SF36-PF10] and the Health Assessment Questionnaire Disability-Index [HAQ-DI]. Reliability (standard errors of theta was assessed.The results for unidimensionality were mixed (scaled CFI = 0.924, TLI = 0.923, RMSEA = 0.045, 1th factor explained 61.5% of variance. Some local dependence was found (8.2% of item pairs. The item bank showed a broad coverage of the physical function construct (threshold-parameters range: -4.28-2.33 and good construct validity (correlation with SF36-PF10 = 0.84 and HAQ-DI = -0.85. Furthermore, the DF-PROMIS-PF showed greater reliability over a broader score-range than the SF36-PF10 and HAQ-DI.The psychometric properties of the DF-PROMIS-PF item bank are sufficient. The DF-PROMIS-PF can now be used as short forms or CAT to measure the level of

  16. Reliability and Validity of Selected PROMIS Measures in People with Rheumatoid Arthritis.

    Directory of Open Access Journals (Sweden)

    Susan J Bartlett

    Full Text Available To evaluate the reliability and validity of 11 PROMIS measures to assess symptoms and impacts identified as important by people with rheumatoid arthritis (RA.Consecutive patients (N = 177 in an observational study completed PROMIS computer adapted tests (CATs and a short form (SF assessing pain, fatigue, physical function, mood, sleep, and participation. We assessed test-test reliability and internal consistency using correlation and Cronbach's alpha. We assessed convergent validity by examining Pearson correlations between PROMIS measures and existing measures of similar domains and known groups validity by comparing scores across disease activity levels using ANOVA.Participants were mostly female (82% and white (83% with mean (SD age of 56 (13 years; 24% had ≤ high school, 29% had RA ≤ 5 years with 13% ≤ 2 years, and 22% were disabled. PROMIS Physical Function, Pain Interference and Fatigue instruments correlated moderately to strongly (rho's ≥ 0.68 with corresponding PROs. Test-retest reliability ranged from .725-.883, and Cronbach's alpha from .906-.991. A dose-response relationship with disease activity was evident in Physical Function with similar trends in other scales except Anger.These data provide preliminary evidence of reliability and construct validity of PROMIS CATs to assess RA symptoms and impacts, and feasibility of use in clinical care. PROMIS instruments captured the experiences of RA patients across the broad continuum of RA symptoms and function, especially at low disease activity levels. Future research is needed to evaluate performance in relevant subgroups, assess responsiveness and identify clinically meaningful changes.

  17. Performance of the PROMIS in Patients After Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Scott, Elizabeth J; Westermann, Robert; Glass, Nathalie A; Hettrich, Carolyn; Wolf, Brian R; Bollier, Matthew J

    2018-05-01

    The Patient-Reported Outcomes Measurement Information System (PROMIS) is designed to advance patient-reported outcome (PRO) instruments by utilizing question banks for major health domains. To compare the responsiveness and construct validity of the PROMIS physical function computer adaptive test (PF CAT) with current PRO instruments for patients before and up to 2 years after anterior cruciate ligament (ACL) reconstruction. Cohort study (diagnosis); Level of evidence, 2. Initially, 157 patients completed the PROMIS PF CAT, Short Form-36 Health Survey (SF-36 physical function [PF] and general health [GH]), Marx Activity Rating Scale (MARS), Knee injury and Osteoarthritis Outcome Score (KOOS activities of daily living [ADL], sport, and quality of life [QOL]), and EuroQol-5 dimensions questionnaire (EQ-5D) at 6 weeks, 6 months, and 2 years after ACL reconstruction. Correlations between instruments, ceiling and floor effects, effect sizes (Cohen d ), and standardized response means to describe responsiveness were evaluated. Subgroup analyses compared participants with and without additional arthroscopic procedures using linear mixed models. At baseline, 6 weeks, and 6 months, the PROMIS PF CAT showed excellent or excellent-good correlations with the SF-36 PF ( r = 0.75-0.80, P ceiling or floor effects of all instruments tested, and patients answered, on average, 4 questions. There was no significant difference in baseline physical function scores between subgroups; at follow-up, all groups showed improvements in scores that were not statistically different. The PROMIS PF CAT is a valid tool to assess outcomes after ACL reconstruction up to 2 years after surgery, demonstrating the highest responsiveness to change with the fewest ceiling and floor effects and a low time burden among all instruments tested. The PROMIS PF CAT is a beneficial alternative for assessing physical function in adults before and after ACL reconstruction.

  18. PROMIS Pain Interference and Physical Function Scores Correlate With the Foot and Ankle Ability Measure (FAAM) in Patients With Hallux Valgus.

    Science.gov (United States)

    Nixon, Devon C; McCormick, Jeremy J; Johnson, Jeffrey E; Klein, Sandra E

    2017-11-01

    Traditional patient-reported outcome instruments like the Foot and Ankle Ability Measure (FAAM) quantify patient disability but often are limited by responder burden and incomplete questionnaires. The Patient-Reported Outcome Measurement Information System (PROMIS) overcomes such obstacles through computer-adaptive technology and can capture outcome data from various domains including physical and psychosocial function. Prior work has compared the FAAM with PROMIS physical function; however, there is little evidence comparing the association between foot and ankle-specific tools like the FAAM with more general outcomes measures of PROMIS pain interference and depression in foot and ankle conditions. (1) We asked whether there was a relationship between FAAM Activities of Daily Living (ADL) scores with PROMIS physical function, pain interference, and depression in patients with hallux valgus. (2) Additionally, we asked if we could identify specific factors that are associated with variance in FAAM and PROMIS physical function scores in patients with hallux valgus. Eighty-five new patients with either a primary or secondary diagnosis of hallux valgus based on clinic billing codes from July 2015 to February 2016 were retrospectively identified. Patients completed FAAM ADL paper-based surveys and electronic PROMIS questionnaires for physical function, pain interference, and depression from new patient visits at a single time. Spearman rho correlations were performed between FAAM ADL and PROMIS scores. Analyses then were used to identify differences in FAAM ADL and PROMIS physical function measures based on demographic variables. Stepwise linear regressions then determined which demographic and/or outcome variable(s) accounted for the variance in FAAM ADL and PROMIS physical function scores. FAAM scores correlated strongly with PROMIS physical function (r = 0.70, p hallux valgus. PROMIS tools allow for more-efficient data collection across multiple domains and, moving

  19. Validation of the alcohol use item banks from the Patient-Reported Outcomes Measurement Information System (PROMIS).

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    Pilkonis, Paul A; Yu, Lan; Dodds, Nathan E; Johnston, Kelly L; Lawrence, Suzanne M; Daley, Dennis C

    2016-04-01

    The Patient-Reported Outcomes Measurement Information System (PROMIS) includes five item banks for alcohol use. There are limited data, however, regarding their validity (e.g., convergent validity, responsiveness to change). To provide such data, we conducted a prospective study with 225 outpatients being treated for substance abuse. Assessments were completed shortly after intake and at 1-month and 3-month follow-ups. The alcohol item banks were administered as computerized adaptive tests (CATs). Fourteen CATs and one six-item short form were also administered from eight other PROMIS domains to generate a comprehensive health status profile. After modeling treatment outcome for the sample as a whole, correlates of outcome from the PROMIS health status profile were examined. For convergent validity, the largest correlation emerged between the PROMIS alcohol use score and the Alcohol Use Disorders Identification Test (r=.79 at intake). Regarding treatment outcome, there were modest changes across the target problem of alcohol use and other domains of the PROMIS health status profile. However, significant heterogeneity was found in initial severity of drinking and in rates of change for both abstinence and severity of drinking during follow-up. This heterogeneity was associated with demographic (e.g., gender) and health-profile (e.g., emotional support, social participation) variables. The results demonstrated the validity of PROMIS CATs, which require only 4-6 items in each domain. This efficiency makes it feasible to use a comprehensive health status profile within the substance use treatment setting, providing important prognostic information regarding abstinence and severity of drinking. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Calibration and Validation of the Dutch-Flemish PROMIS Pain Interference Item Bank in Patients with Chronic Pain.

    Science.gov (United States)

    Crins, Martine H P; Roorda, Leo D; Smits, Niels; de Vet, Henrica C W; Westhovens, Rene; Cella, David; Cook, Karon F; Revicki, Dennis; van Leeuwen, Jaap; Boers, Maarten; Dekker, Joost; Terwee, Caroline B

    2015-01-01

    The Dutch-Flemish PROMIS Group translated the adult PROMIS Pain Interference item bank into Dutch-Flemish. The aims of the current study were to calibrate the parameters of these items using an item response theory (IRT) model, to evaluate the cross-cultural validity of the Dutch-Flemish translations compared to the original English items, and to evaluate their reliability and construct validity. The 40 items in the bank were completed by 1085 Dutch chronic pain patients. Before calibrating the items, IRT model assumptions were evaluated using confirmatory factor analysis (CFA). Items were calibrated using the graded response model (GRM), an IRT model appropriate for items with more than two response options. To evaluate cross-cultural validity, differential item functioning (DIF) for language (Dutch vs. English) was examined. Reliability was evaluated based on standard errors and Cronbach's alpha. To evaluate construct validity correlations with scores on legacy instruments (e.g., the Disabilities of the Arm, Shoulder and Hand Questionnaire) were calculated. Unidimensionality of the Dutch-Flemish PROMIS Pain Interference item bank was supported by CFA tests of model fit (CFI = 0.986, TLI = 0.986). Furthermore, the data fit the GRM and showed good coverage across the pain interference continuum (threshold-parameters range: -3.04 to 3.44). The Dutch-Flemish PROMIS Pain Interference item bank has good cross-cultural validity (only two out of 40 items showing DIF), good reliability (Cronbach's alpha = 0.98), and good construct validity (Pearson correlations between 0.62 and 0.75). A computer adaptive test (CAT) and Dutch-Flemish PROMIS short forms of the Dutch-Flemish PROMIS Pain Interference item bank can now be developed.

  1. Calibration and Validation of the Dutch-Flemish PROMIS Pain Interference Item Bank in Patients with Chronic Pain.

    Directory of Open Access Journals (Sweden)

    Martine H P Crins

    Full Text Available The Dutch-Flemish PROMIS Group translated the adult PROMIS Pain Interference item bank into Dutch-Flemish. The aims of the current study were to calibrate the parameters of these items using an item response theory (IRT model, to evaluate the cross-cultural validity of the Dutch-Flemish translations compared to the original English items, and to evaluate their reliability and construct validity. The 40 items in the bank were completed by 1085 Dutch chronic pain patients. Before calibrating the items, IRT model assumptions were evaluated using confirmatory factor analysis (CFA. Items were calibrated using the graded response model (GRM, an IRT model appropriate for items with more than two response options. To evaluate cross-cultural validity, differential item functioning (DIF for language (Dutch vs. English was examined. Reliability was evaluated based on standard errors and Cronbach's alpha. To evaluate construct validity correlations with scores on legacy instruments (e.g., the Disabilities of the Arm, Shoulder and Hand Questionnaire were calculated. Unidimensionality of the Dutch-Flemish PROMIS Pain Interference item bank was supported by CFA tests of model fit (CFI = 0.986, TLI = 0.986. Furthermore, the data fit the GRM and showed good coverage across the pain interference continuum (threshold-parameters range: -3.04 to 3.44. The Dutch-Flemish PROMIS Pain Interference item bank has good cross-cultural validity (only two out of 40 items showing DIF, good reliability (Cronbach's alpha = 0.98, and good construct validity (Pearson correlations between 0.62 and 0.75. A computer adaptive test (CAT and Dutch-Flemish PROMIS short forms of the Dutch-Flemish PROMIS Pain Interference item bank can now be developed.

  2. Comparisons between written and computerised patient histories

    NARCIS (Netherlands)

    Quaak, Martien; Westerman, R. Frans; van Bemmel, Jan H.

    1987-01-01

    Patient histories were obtained from 99 patients in three different ways: by a computerised patient interview (patient record), by the usual written interview (medical record), and by the transcribed record, which was a computerised version of the medical record. Patient complaints, diagnostic

  3. Language-related differential item functioning between English and German PROMIS Depression items is negligible.

    Science.gov (United States)

    Fischer, H Felix; Wahl, Inka; Nolte, Sandra; Liegl, Gregor; Brähler, Elmar; Löwe, Bernd; Rose, Matthias

    2017-12-01

    To investigate differential item functioning (DIF) of PROMIS Depression items between US and German samples we compared data from the US PROMIS calibration sample (n = 780), a German general population survey (n = 2,500) and a German clinical sample (n = 621). DIF was assessed in an ordinal logistic regression framework, with 0.02 as criterion for R 2 -change and 0.096 for Raju's non-compensatory DIF. Item parameters were initially fixed to the PROMIS Depression metric; we used plausible values to account for uncertainty in depression estimates. Only four items showed DIF. Accounting for DIF led to negligible effects for the full item bank as well as a post hoc simulated computer-adaptive test (German general population sample was considerably lower compared to the US reference value of 50. Overall, we found little evidence for language DIF between US and German samples, which could be addressed by either replacing the DIF items by items not showing DIF or by scoring the short form in German samples with the corrected item parameters reported. Copyright © 2016 John Wiley & Sons, Ltd.

  4. Understanding health-related quality of life in caregivers of civilians and service members/veterans with traumatic brain injury: Establishing the reliability and validity of PROMIS Fatigue and Sleep Disturbance item banks.

    Science.gov (United States)

    Carlozzi, Noelle E; Ianni, Phillip A; Tulsky, David S; Brickell, Tracey A; Lange, Rael T; French, Louis M; Cella, David; Kallen, Michael A; Miner, Jennifer A; Kratz, Anna L

    2018-06-19

    To examine the reliability and validity of Patient Reported Outcomes Measurement Information System (PROMIS) measures of sleep disturbance and fatigue in TBI caregivers and to determine the severity of fatigue and sleep disturbance in these caregivers. Cross-sectional survey data collected through an online data capture platform. Four rehabilitation hospitals and Walter Reed National Military Medical Center. Caregivers (N=560) of civilians (n=344) and service member/veterans (n=216) with TBI. Not Applicable MAIN OUTCOME MEASURES: PROMIS sleep and fatigue measures administered as both computerized adaptive tests (CATs) and 4-item short forms (SFs). For both samples, floor and ceiling effects for the PROMIS measures were low (internal consistency was very good (all alphas ≥0.80), and test-retest reliability was acceptable (all r≥0.70 except for the fatigue CAT in the service member/veteran sample r=0.63). Convergent validity was supported by moderate correlations between the PROMIS and related measures. Discriminant validity was supported by low correlations between PROMIS measures and measures of dissimilar constructs. PROMIS scores indicated significantly worse sleep and fatigue for those caring for someone with high levels versus low levels of impairment. Findings support the reliability and validity of the PROMIS CAT and SF measures of sleep disturbance and fatigue in caregivers of civilians and service members/veterans with TBI. Copyright © 2018. Published by Elsevier Inc.

  5. PROMIS PF CAT Outperforms the ODI and SF-36 Physical Function Domain in Spine Patients.

    Science.gov (United States)

    Brodke, Darrel S; Goz, Vadim; Voss, Maren W; Lawrence, Brandon D; Spiker, William Ryan; Hung, Man

    2017-06-15

    The Oswestry Disability Index v2.0 (ODI), SF36 Physical Function Domain (SF-36 PFD), and PROMIS Physical Function CAT v1.2 (PF CAT) questionnaires were prospectively collected from 1607 patients complaining of back or leg pain, visiting a university-based spine clinic. All questionnaires were collected electronically, using a tablet computer. The aim of this study was to compare the psychometric properties of the PROMIS PF CAT with the ODI and SF36 Physical Function Domain in the same patient population. Evidence-based decision-making is improved by using high-quality patient-reported outcomes measures. Prior studies have revealed the shortcomings of the ODI and SF36, commonly used in spine patients. The PROMIS Network has developed measures with excellent psychometric properties. The Physical Function domain, delivered by Computerized Adaptive Testing (PF CAT), performs well in the spine patient population, though to-date direct comparisons with common measures have not been performed. Standard Rasch analysis was performed to directly compare the psychometrics of the PF CAT, ODI, and SF36 PFD. Spearman correlations were computed to examine the correlations of the three instruments. Time required for administration was also recorded. One thousand six hundred seven patients were administered all assessments. The time required to answer all items in the PF CAT, ODI, and SF-36 PFD was 44, 169, and 99 seconds. The ceiling and floor effects were excellent for the PF CAT (0.81%, 3.86%), while the ceiling effects were marginal and floor effects quite poor for the ODI (6.91% and 44.24%) and SF-36 PFD (5.97% and 23.65%). All instruments significantly correlated with each other. The PROMIS PF CAT outperforms the ODI and SF-36 PFD in the spine patient population and is highly correlated. It has better coverage, while taking less time to administer with fewer questions to answer. 2.

  6. Correlation of PROMIS Physical Function and Pain CAT Instruments With Oswestry Disability Index and Neck Disability Index in Spine Patients.

    Science.gov (United States)

    Papuga, Mark O; Mesfin, Addisu; Molinari, Robert; Rubery, Paul T

    2016-07-15

    A prospective and retrospective cross-sectional cohort analysis. The aim of this study was to show that Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive testing (CAT) assessments for physical function and pain interference can be efficiently collected in a standard office visit and to evaluate these scores with scores from previously validated Oswestry Disability Index (ODI) and Neck Disability Index (NDI) providing evidence of convergent validity for use in patients with spine pathology. Spinal surgery outcomes are highly variable, and substantial debate continues regarding the role and value of spine surgery. The routine collection of patient-based outcomes instruments in spine surgery patients may inform this debate. Traditionally, the inefficiency associated with collecting standard validated instruments has been a barrier to routine use in outpatient clinics. We utilized several CAT instruments available through PROMIS and correlated these with the results obtained using "gold standard" legacy outcomes measurement instruments. All measurements were collected at a routine clinical visit. The ODI and the NDI assessments were used as "gold standard" comparisons for patient-reported outcomes. PROMIS CAT instruments required 4.5 ± 1.8 questions and took 35 ± 16 seconds to complete, compared with ODI/NDI requiring 10 questions and taking 188 ± 85 seconds when administered electronically. Linear regression analysis of retrospective scores involving a primary back complaint revealed moderate to strong correlations between ODI and PROMIS physical function with r values ranging from 0.5846 to 0.8907 depending on the specific assessment and patient subsets examined. Routine collection of physical function outcome measures in clinical practice offers the ability to inform and improve patient care. We have shown that several PROMIS CAT instruments can be efficiently administered during routine clinical visits. The

  7. Dutch-Flemish translation of nine pediatric item banks from the Patient-Reported Outcomes Measurement Information System (PROMIS)®.

    Science.gov (United States)

    Haverman, Lotte; Grootenhuis, Martha A; Raat, Hein; van Rossum, Marion A J; van Dulmen-den Broeder, Eline; Hoppenbrouwers, Karel; Correia, Helena; Cella, David; Roorda, Leo D; Terwee, Caroline B

    2016-03-01

    The Patient-Reported Outcomes Measurement Information System (PROMIS(®)) is a new, state-of-the-art assessment system for measuring patient-reported health and well-being of adults and children. It has the potential to be more valid, reliable, and responsive than existing PROMs. The items banks are designed to be self-reported and completed by children aged 8-18 years. The PROMIS items can be administered in short forms or through computerized adaptive testing. This paper describes the translation and cultural adaption of nine PROMIS item banks (151 items) for children in Dutch-Flemish. The translation was performed by FACITtrans using standardized PROMIS methodology and approved by the PROMIS Statistical Center. The translation included four forward translations, two back-translations, three independent reviews (at least two Dutch, one Flemish), and pretesting in 24 children from the Netherlands and Flanders. For some items, it was necessary to have separate translations for Dutch and Flemish: physical function-mobility (three items), anger (one item), pain interference (two items), and asthma impact (one item). Challenges faced in the translation process included scarcity or overabundance of possible translations, unclear item descriptions, constructs broader/smaller in the target language, difficulties in rank ordering items, differences in unit of measurement, irrelevant items, or differences in performance of activities. By addressing these challenges, acceptable translations were obtained for all items. The Dutch-Flemish PROMIS items are linguistically equivalent to the original USA version. Short forms are now available for use, and entire item banks are ready for cross-cultural validation in the Netherlands and Flanders.

  8. Calibration of the PROMIS physical function item bank in Dutch patients with rheumatoid arthritis.

    Directory of Open Access Journals (Sweden)

    Martijn A H Oude Voshaar

    Full Text Available OBJECTIVE: To calibrate the Dutch-Flemish version of the PROMIS physical function (PF item bank in patients with rheumatoid arthritis (RA and to evaluate cross-cultural measurement equivalence with US general population and RA data. METHODS: Data were collected from RA patients enrolled in the Dutch DREAM registry. An incomplete longitudinal anchored design was used where patients completed all 121 items of the item bank over the course of three waves of data collection. Item responses were fit to a generalized partial credit model adapted for longitudinal data and the item parameters were examined for differential item functioning (DIF across country, age, and sex. RESULTS: In total, 690 patients participated in the study at time point 1 (T2, N = 489; T3, N = 311. The item bank could be successfully fitted to a generalized partial credit model, with the number of misfitting items falling within acceptable limits. Seven items demonstrated DIF for sex, while 5 items showed DIF for age in the Dutch RA sample. Twenty-five (20% items were flagged for cross-cultural DIF compared to the US general population. However, the impact of observed DIF on total physical function estimates was negligible. DISCUSSION: The results of this study showed that the PROMIS PF item bank adequately fit a unidimensional IRT model which provides support for applications that require invariant estimates of physical function, such as computer adaptive testing and targeted short forms. More studies are needed to further investigate the cross-cultural applicability of the US-based PROMIS calibration and standardized metric.

  9. Psychometric evaluation of the Patient-Reported Outcomes Measurement Information System (PROMIS) Nicotine Dependence Item Bank for use with electronic cigarettes.

    Science.gov (United States)

    Morean, Meghan; Krishnan-Sarin, Suchitra; Sussman, Steve; Foulds, Jonathan; Fishbein, Howard; Grana, Rachel; O'Malley, Stephanie S

    2018-01-02

    Psychometrically sound measures of e-cigarette dependence are lacking. We modified the PROMIS Nicotine Dependence Item Banks for use with e-cigarettes and evaluated the psychometrics of the 22-, 8- and 4-item adapted versions. 1009 adults who reported using e-cigarettes at least weekly completed an anonymous survey in Summer 2016 (50.2% male, 77.1% White, mean age 35.81 [10.71], 66.4% daily e-cigarette users, 72.6% current cigarette smokers). Psychometric analyses included confirmatory factor analysis, internal consistency, measurement invariance, examination of mean-level differences, convergent validity, and test-criterion relationships with e-cigarette use outcomes. All PROMIS-E versions had confirmable, internally consistent latent structures that were scalar invariant by sex, race, e-cigarette use (non-daily/daily), e-liquid nicotine content (no/yes), and current cigarette smoking status (no/yes). Daily e-cigarette users, nicotine e-liquid users, and cigarette smokers reported being more dependent on e-cigarettes than their counterparts. All PROMIS-E versions correlated strongly with one another, evidenced convergent validity with the Penn State E-cigarette Dependence Index and time to first e-cigarette use in the morning, and evidenced test-criterion relationships with vaping frequency, e-liquid nicotine concentration, and e-cigarette quit attempts. Similar results were observed when analyses were conducted within subsamples of exclusive e-cigarette users and duals-users of cigarettes and e-cigarettes. Each PROMIS-E version evidenced strong psychometric properties for assessing e-cigarette dependence in adults who either use e-cigarette exclusively or who are dual-users of cigarettes and e-cigarettes. However, results indicated little benefit of the longer versions over the 4-item PROMIS-E, which provides an efficient assessment of e-cigarette dependence. The availability of the novel, psychometrically sound PROMIS-E can further research on a wide range of

  10. Saving time with a computerised handbook

    International Nuclear Information System (INIS)

    Henrie, D.K.

    1993-01-01

    The DE/CAASE computerised engineering handbook (Desktop Engineering, Mahwah, NJ, USA) is a software tool designed to automate a wide variety of engineering tasks that are typically performed with an engineering handbook and hand calculator. It significantly reduces the time taken to perform these tasks. For example, instead of spending 60 minutes on determining section properties of composite sections in control room panels and other equipment by hand, it might take less than 5 minutes by using the computerised handbook. Similarly, mode shapes and frequencies of simple structures may take less than 10 minutes to calculate, compared with the hours it used to take. (author)

  11. An intragastric trichobezoar: computerised tomographic appearance.

    Directory of Open Access Journals (Sweden)

    Morris B

    2000-04-01

    Full Text Available A 26-year-old lady presented with a history of abdominal pain and distension since two months. The ultrasound examination showed an epigastric mass, which was delineated as a filling defect in the stomach on barium studies. The computerised tomographic scan showed a gastric mass with pockets of air in it, without post-contrast enhancement. This case highlights the characteristic appearance on computerised tomography of a bezoar within the stomach, a feature that is not commonly described in medical literature.

  12. Using PROMIS for measuring recovery after abdominal surgery: a pilot study

    Directory of Open Access Journals (Sweden)

    Eva van der Meij

    2018-02-01

    Full Text Available Abstract Background To assess the construct validity and responsiveness of the PROMIS Physical Function v1.2 short form 8b (PROMIS-PF, and the PROMIS Ability to Participate in Social Roles and Activities v2.0 short form 8a (PROMIS-APS in postoperative recovery. Methods An observational pilot study was conducted in which 30 patients participated, undergoing various forms of abdominal surgery. Patients completed the PROMIS-PF and PROMIS-APS, the Short Form 36 Health Survey (SF-36 and the World Health Organization Disability Assessment Schedule 2.0 (WHODAS at several time points before and after surgery. The construct validity and responsiveness of the two PROMIS short forms were evaluated by testing pre-defined hypotheses and were considered adequate when at least 75% of the data was consistent with the hypotheses. Construct validity was evaluated by calculating Spearman correlations and the responsiveness by calculating effect sizes. Results 6/7 (85.7% of the results were consistent with the hypotheses supporting the construct validity of the PROMIS-PF. For the PROMIS-APS this was the case in 7/15 (46.7% of the results. For the PROMIS-PF, 6/7 (85.7% of the results were consistent with the hypotheses, supporting responsiveness. Regarding the responsiveness of the PROMIS-APS, only 7 out of 13 (53.8% of these results were consistent with the hypotheses. Conclusions This study supported the construct validity and the responsiveness of the PROMIS-PF v1.2 short form 8b for measuring recovery in abdominal surgery. Considering the major advantages of PROMIS, we recommend the use of the PROMIS-PF in abdominal surgery.

  13. The PROMIS Physical Function item bank was calibrated to a standardized metric and shown to improve measurement efficiency.

    Science.gov (United States)

    Rose, Matthias; Bjorner, Jakob B; Gandek, Barbara; Bruce, Bonnie; Fries, James F; Ware, John E

    2014-05-01

    To document the development and psychometric evaluation of the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) item bank and static instruments. The items were evaluated using qualitative and quantitative methods. A total of 16,065 adults answered item subsets (n>2,200/item) on the Internet, with oversampling of the chronically ill. Classical test and item response theory methods were used to evaluate 149 PROMIS PF items plus 10 Short Form-36 and 20 Health Assessment Questionnaire-Disability Index items. A graded response model was used to estimate item parameters, which were normed to a mean of 50 (standard deviation [SD]=10) in a US general population sample. The final bank consists of 124 PROMIS items covering upper, central, and lower extremity functions and instrumental activities of daily living. In simulations, a 10-item computerized adaptive test (CAT) eliminated floor and decreased ceiling effects, achieving higher measurement precision than any comparable length static tool across four SDs of the measurement range. Improved psychometric properties were transferred to the CAT's superior ability to identify differences between age and disease groups. The item bank provides a common metric and can improve the measurement of PF by facilitating the standardization of patient-reported outcome measures and implementation of CATs for more efficient PF assessments over a larger range. Copyright © 2014. Published by Elsevier Inc.

  14. The Dutch-Flemish PROMIS Physical Function item bank exhibited strong psychometric properties in patients with chronic pain.

    Science.gov (United States)

    Crins, Martine H P; Terwee, Caroline B; Klausch, Thomas; Smits, Niels; de Vet, Henrica C W; Westhovens, Rene; Cella, David; Cook, Karon F; Revicki, Dennis A; van Leeuwen, Jaap; Boers, Maarten; Dekker, Joost; Roorda, Leo D

    2017-07-01

    The objective of this study was to assess the psychometric properties of the Dutch-Flemish Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function item bank in Dutch patients with chronic pain. A bank of 121 items was administered to 1,247 Dutch patients with chronic pain. Unidimensionality was assessed by fitting a one-factor confirmatory factor analysis and evaluating resulting fit statistics. Items were calibrated with the graded response model and its fit was evaluated. Cross-cultural validity was assessed by testing items for differential item functioning (DIF) based on language (Dutch vs. English). Construct validity was evaluated by calculation correlations between scores on the Dutch-Flemish PROMIS Physical Function measure and scores on generic and disease-specific measures. Results supported the Dutch-Flemish PROMIS Physical Function item bank's unidimensionality (Comparative Fit Index = 0.976, Tucker Lewis Index = 0.976) and model fit. Item thresholds targeted a wide range of physical function construct (threshold-parameters range: -4.2 to 5.6). Cross-cultural validity was good as four items only showed DIF for language and their impact on item scores was minimal. Physical Function scores were strongly associated with scores on all other measures (all correlations ≤ -0.60 as expected). The Dutch-Flemish PROMIS Physical Function item bank exhibited good psychometric properties. Development of a computer adaptive test based on the large bank is warranted. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Computerised tomography in tuberculous Addison's disease

    International Nuclear Information System (INIS)

    Perry, M.C.; Eason, R.J.; Croxson, M.S.

    1983-01-01

    The important contribution computerised tomography played in the diagnosis of tuberculous Addison's disease is described. While conventional radiographic methods of demonstrating this disease are often unhelpful, C.T. is an excellent technique for demonstrating the morphology of normal and abnormal adrenal glands

  16. Floor Effect of PROMIS Depression CAT Associated With Hasty Completion in Orthopaedic Surgery Patients.

    Science.gov (United States)

    Guattery, Jason M; Dardas, Agnes Z; Kelly, Michael; Chamberlain, Aaron; McAndrew, Christopher; Calfee, Ryan P

    2018-04-01

    The Patient Reported Outcomes Measurement Information System (PROMIS) was developed to provide valid, reliable, and standardized measures to gather patient-reported outcomes for many health domains, including depression, independent of patient condition. Most studies confirming the performance of these measures were conducted with a consented, volunteer study population for testing. Using a study population that has undergone the process of informed consent may be differentiated from the validation group because they are educated specifically as to the purpose of the questions and they will not have answers recorded in their permanent health record. (1) When given as part of routine practice to an orthopaedic population, do PROMIS Physical Function and Depression item banks produce score distributions different than those produced by the populations used to calibrate and validate the item banks? (2) Does the presence of a nonnormal distribution in the PROMIS Depression scores in a clinical population reflect a deliberately hasty answering of questions by patients? (3) Are patients who are reporting minimal depressive symptoms by scoring the minimum score on the PROMIS Depression Computer Adaptive Testing (CAT) distinct from other patients according to demographic data or their scores on other PROMIS assessments? Univariate descriptive statistics and graphic histograms were used to describe the frequency distribution of scores for the Physical Function and Depression item banks for all orthopaedic patients 18 years or older who had an outpatient visit between June 2015 and December 2016. The study population was then broken into two groups based on whether they indicated a lack of depressive symptoms and scored the minimum score (34.2) on the Depression CAT assessment (Floor Group) or not (Standard Group). The distribution of Physical Function CAT scores was compared between the two groups. Finally, a time-per-question value was calculated for both the Physical

  17. Performance of PROMIS Physical Function Compared with KOOS, SF-36, Eq5d And Marx Activity Scale in Patients Who Undergo ACL Reconstruction

    Science.gov (United States)

    Scott, Elizabeth; Glass, Natalie; Wolf, Brian R.; Hettrich, Carolyn M.; Bollier, Matthew

    2018-01-01

    Objectives: Anterior cruciate ligament reconstruction is a commonly performed orthopaedic procedure. PROMIS (Patient-Reported Outcome Measurement Information System) was developed by the National Institutes of Health in an effort to advance patient-reported outcome (PRO) instruments by developing question banks for major health domains. Our goal was to compare the responsiveness and construct validity of the PROMIS physical function (PF) computer adaptive test (CAT) with current PRO instruments utilized in patients who undergo anterior cruciate ligament reconstruction. Methods: A total of 174 patients ages 14-53 scheduled to undergo anterior cruciate ligament reconstruction were asked to complete PROMIS PF-CAT, Short Form-36 Health Survey (SF36-PF and -GH), Marx activity rating scale (Marx), Knee Injury and Osteoarthritis Score (KOOS-ADL, -Sport, -QOL), and the EuroQol five dimensions questionnaire (EQ5D) at their preoperative visit. These surveys were repeated at six weeks and six months after surgery. Correlations between PRO instruments was defined as excellent (>0.7), excellent-good (0.61-0.7), good (0.4-0.6), and poor (0.2-0.3) using Spearman Correlation Coefficients. The effect size (Cohen d) and standardized response mean (SRM) were used to describe the responsiveness of each PRO at the 6 week and 6 month follow-up visits and were defined as small (0.2), medium (0.5) and large (0.8). Ceiling and floor effects were defined as present if ≥15% of participants scored the highest or lowest score on a PRO, respectively. Subgroup analyses were performed comparing change in PRO scores at follow-up between participants with and without additional arthroscopic procedures (meniscal debridement and/or repair, microfracture, or OATS vs ACL reconstruction only) using linear mixed models. Results: There were excellent and excellent-good correlations between the PROMIS PF-CAT and physical function PROs including the SF36-PF (r=0.75-0.80, p0.05) to poor correlation with

  18. Comparing and transforming PROMIS utility values to the EQ-5D.

    Science.gov (United States)

    Hartman, John D; Craig, Benjamin M

    2018-03-01

    Summarizing patient-reported outcomes (PROs) on a quality-adjusted life year (QALY) scale is an essential component to any economic evaluation comparing alternative medical treatments. While multiple studies have compared PRO items and instruments based on their psychometric properties, no study has compared the preference-based summary of the EQ-5D-3L and Patient Reported Outcomes Measurement Information System (PROMIS-29) instruments. As part of this comparison, a major aim of this manuscript is to transform PROMIS-29 utility values to an EQ-5D-3L scale. A nationally representative survey of 2623 US adults completed the 29-item PROMIS health profile instrument (PROMIS-29) and the 3-level version of the EQ-5D instrument (EQ-5D-3L). Their responses were summarized on a health utility scale using published estimates. Using regression analysis, PROMIS-29 and EQ-5D-3L utility weights were compared with each other as well as with self-reported general health. PROMIS-29 utility weights were much lower than the EQ-5D-3L weights. However, a correlation coefficient of 0.769 between the utility values of the two instruments suggests that the main discordance is simply a difference in scale between the measures. It is also possible to map PROMIS-29 utility weights onto an EQ-5D-3L scale. EQ-5D-3L losses equal .1784 × (PROMIS-29 Losses) .7286 . The published estimates of the PROMIS-29 produce lower utility values than many other health instruments. Mapping the PROMIS-29 estimates to an EQ-5D-3L scale alleviates this issue and allows for a more straightforward comparison between the PROMIS-29 and other common health instruments.

  19. [Reliability of Primary Care computerised medication records].

    Science.gov (United States)

    García-Molina Sáez, Celia; Urbieta Sanz, Elena; Madrigal de Torres, Manuel; Piñera Salmerón, Pascual; Pérez Cárceles, María D

    2016-03-01

    To quantify and to evaluate the reliability of Primary Care (PC) computerised medication records of as an information source of patient chronic medications, and to identify associated factors with the presence of discrepancies. A descriptive cross-sectional study. General Referral Hospital in Murcia. Patients admitted to the cardiology-chest diseases unit, during the months of February to April 2013, on home treatment, who agreed to participate in the study. Evaluation of the reliability of Primary Care computerised medication records by analysing the concordance, by identifying discrepancies, between the active medication in these records and that recorded in pharmacist interview with the patient/caregiver. Identification of associated factors with the presence of discrepancies was analysed using a multivariate logistic regression. The study included a total of 308 patients with a mean of 70.9 years (13.0 SD). The concordance of active ingredients was 83.7%, and this decreased to 34.7% when taking the dosage into account. Discrepancies were found in 97.1% of patients. The most frequent discrepancy was omission of frequency (35.6%), commission (drug added unjustifiably) (14.6%), and drug omission (12.7%). Age older than 65 years (1.98 [1.08 to 3.64]), multiple chronic diseases (1.89 [1.04 to 3.42]), and have a narcotic or psychotropic drug prescribed (2.22 [1.16 to 4.24]), were the factors associated with the presence of discrepancies. Primary Care computerised medication records, although of undoubted interest, are not be reliable enough to be used as the sole source of information on patient chronic medications when admitted to hospital. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  20. Software for computerised analysis of cardiotocographic traces.

    Science.gov (United States)

    Romano, M; Bifulco, P; Ruffo, M; Improta, G; Clemente, F; Cesarelli, M

    2016-02-01

    Despite the widespread use of cardiotocography in foetal monitoring, the evaluation of foetal status suffers from a considerable inter and intra-observer variability. In order to overcome the main limitations of visual cardiotocographic assessment, computerised methods to analyse cardiotocographic recordings have been recently developed. In this study, a new software for automated analysis of foetal heart rate is presented. It allows an automatic procedure for measuring the most relevant parameters derivable from cardiotocographic traces. Simulated and real cardiotocographic traces were analysed to test software reliability. In artificial traces, we simulated a set number of events (accelerations, decelerations and contractions) to be recognised. In the case of real signals, instead, results of the computerised analysis were compared with the visual assessment performed by 18 expert clinicians and three performance indexes were computed to gain information about performances of the proposed software. The software showed preliminary performance we judged satisfactory in that the results matched completely the requirements, as proved by tests on artificial signals in which all simulated events were detected from the software. Performance indexes computed in comparison with obstetricians' evaluations are, on the contrary, not so satisfactory; in fact they led to obtain the following values of the statistical parameters: sensitivity equal to 93%, positive predictive value equal to 82% and accuracy equal to 77%. Very probably this arises from the high variability of trace annotation carried out by clinicians. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Development of six PROMIS pediatrics proxy-report item banks.

    Science.gov (United States)

    Irwin, Debra E; Gross, Heather E; Stucky, Brian D; Thissen, David; DeWitt, Esi Morgan; Lai, Jin Shei; Amtmann, Dagmar; Khastou, Leyla; Varni, James W; DeWalt, Darren A

    2012-02-22

    Pediatric self-report should be considered the standard for measuring patient reported outcomes (PRO) among children. However, circumstances exist when the child is too young, cognitively impaired, or too ill to complete a PRO instrument and a proxy-report is needed. This paper describes the development process including the proxy cognitive interviews and large-field-test survey methods and sample characteristics employed to produce item parameters for the Patient Reported Outcomes Measurement Information System (PROMIS) pediatric proxy-report item banks. The PROMIS pediatric self-report items were converted into proxy-report items before undergoing cognitive interviews. These items covered six domains (physical function, emotional distress, social peer relationships, fatigue, pain interference, and asthma impact). Caregivers (n = 25) of children ages of 5 and 17 years provided qualitative feedback on proxy-report items to assess any major issues with these items. From May 2008 to March 2009, the large-scale survey enrolled children ages 8-17 years to complete the self-report version and caregivers to complete the proxy-report version of the survey (n = 1548 dyads). Caregivers of children ages 5 to 7 years completed the proxy report survey (n = 432). In addition, caregivers completed other proxy instruments, PedsQL™ 4.0 Generic Core Scales Parent Proxy-Report version, PedsQL™ Asthma Module Parent Proxy-Report version, and KIDSCREEN Parent-Proxy-52. Item content was well understood by proxies and did not require item revisions but some proxies clearly noted that determining an answer on behalf of their child was difficult for some items. Dyads and caregivers of children ages 5-17 years old were enrolled in the large-scale testing. The majority were female (85%), married (70%), Caucasian (64%) and had at least a high school education (94%). Approximately 50% had children with a chronic health condition, primarily asthma, which was diagnosed or treated within 6

  2. Development of six PROMIS pediatrics proxy-report item banks

    Directory of Open Access Journals (Sweden)

    Irwin Debra E

    2012-02-01

    Full Text Available Abstract Background Pediatric self-report should be considered the standard for measuring patient reported outcomes (PRO among children. However, circumstances exist when the child is too young, cognitively impaired, or too ill to complete a PRO instrument and a proxy-report is needed. This paper describes the development process including the proxy cognitive interviews and large-field-test survey methods and sample characteristics employed to produce item parameters for the Patient Reported Outcomes Measurement Information System (PROMIS pediatric proxy-report item banks. Methods The PROMIS pediatric self-report items were converted into proxy-report items before undergoing cognitive interviews. These items covered six domains (physical function, emotional distress, social peer relationships, fatigue, pain interference, and asthma impact. Caregivers (n = 25 of children ages of 5 and 17 years provided qualitative feedback on proxy-report items to assess any major issues with these items. From May 2008 to March 2009, the large-scale survey enrolled children ages 8-17 years to complete the self-report version and caregivers to complete the proxy-report version of the survey (n = 1548 dyads. Caregivers of children ages 5 to 7 years completed the proxy report survey (n = 432. In addition, caregivers completed other proxy instruments, PedsQL™ 4.0 Generic Core Scales Parent Proxy-Report version, PedsQL™ Asthma Module Parent Proxy-Report version, and KIDSCREEN Parent-Proxy-52. Results Item content was well understood by proxies and did not require item revisions but some proxies clearly noted that determining an answer on behalf of their child was difficult for some items. Dyads and caregivers of children ages 5-17 years old were enrolled in the large-scale testing. The majority were female (85%, married (70%, Caucasian (64% and had at least a high school education (94%. Approximately 50% had children with a chronic health condition, primarily

  3. Multitasking in non-computerised and computerised versions of the Breakfast Task in healthy adult aging

    OpenAIRE

    Kozlowska, Maria Teresa

    2010-01-01

    Older adults demonstrate poor performance on standard executive tests. However, age-related deficits have been found only on a number of more realistic executive tests. The present study investigated age effects in multitasking, requiring a range of executive, as well as non-executive, cognitive functions. Previous study by Craik and Bialystok (2006) showed impaired performance of older adults on a computerised multitasking test, which simulated cooking breakfast. Participants were instructed...

  4. PROMIS GH (Patient-Reported Outcomes Measurement Information System Global Health) Scale in Stroke: A Validation Study.

    Science.gov (United States)

    Katzan, Irene L; Lapin, Brittany

    2018-01-01

    The International Consortium for Health Outcomes Measurement recently included the 10-item PROMIS GH (Patient-Reported Outcomes Measurement Information System Global Health) scale as part of their recommended Standard Set of Stroke Outcome Measures. Before collection of PROMIS GH is broadly implemented, it is necessary to assess its performance in the stroke population. The objective of this study was to evaluate the psychometric properties of PROMIS GH in patients with ischemic stroke and intracerebral hemorrhage. PROMIS GH and 6 PROMIS domain scales measuring same/similar constructs were electronically collected on 1102 patients with ischemic and hemorrhagic strokes at various stages of recovery from their stroke who were seen in a cerebrovascular clinic from October 12, 2015, through June 2, 2017. Confirmatory factor analysis was performed to evaluate the adequacy of 2-factor structure of component scores. Test-retest reliability and convergent validity of PROMIS GH items and component scores were assessed. Discriminant validity and responsiveness were compared between PROMIS GH and PROMIS domain scales measuring the same or related constructs. Analyses were repeated stratified by stroke subtype and modified Rankin Scale score validity was good with significant correlations between all PROMIS GH items and PROMIS domain scales ( P 0.5) was demonstrated for 8 of the 10 PROMIS GH items. Reliability and validity remained consistent across stroke subtype and disability level (modified Rankin Scale, <2 versus ≥2). PROMIS GH exhibits acceptable performance in patients with stroke. Our findings support International Consortium for Health Outcomes Measurement recommendation to use PROMIS GH as part of the standard set of outcome measures in stroke. © 2017 American Heart Association, Inc.

  5. Debating the utility of computerised neurocognitive testing in the ...

    African Journals Online (AJOL)

    computerised neurocognitive baseline testing in the sports concus- sion context,. 1 ... testing for athletes at this time is scientifically unfounded, financially irresponsible and .... medical management in respect of the sports concussive injury. It.

  6. Computerisation of procedures. Lessons learned and future perspectives

    International Nuclear Information System (INIS)

    O'Hara, J.; Pirus, D.; Nilsen, S.; Bisio, R.; Hulsund, J.-E.; Zhang, W.

    2003-07-01

    The computerisation of the procedures has been investigated for several years. Even though guidelines for such computerisation have been proposed, there is a need to extend and revise these guidelines. In this report, we look at what has been achieved so far, both within the Halden Project as well as within other organisations related to nuclear power plants. These experiences are often related to testing of particular computerised procedure systems either in research laboratories or in nuclear utilities. These activities have accumulated a body of general knowledge on the subject, as documented in other 'lessons learned' reports of the past. This report will extend this accepted body of knowledge. Furthermore, we identify the unresolved problems that need to be further studied to make usable computerised procedures for the future. The report identifies selected qualities that should be reinforced to make computerised procedure systems better. In particular, the integration aspect is emphasised. A flexible integration with the operator tasks and the remaining interfaces of the control room is important. Unless this integration is accomplished, the computerised procedures will not be functional. Another aspect of integration is combination with other systems inclusive those systems that deal with the plant documentation, electronic or paper based. This kind of integration is important to the safe and reliable operation of the plant. Good integration with plant documentation is instrumental in creating reliable QA of the procedures that covers the whole life cycle of the procedure. (Author). 48 refs., 12 figs., 2 tabs

  7. Prototype models for the MOIRA computerised system

    Energy Technology Data Exchange (ETDEWEB)

    Monte, Luigi [ENEA, Centro Ricerche Casaccia, Rome (Italy). Dipt. Ambiente; Hakanson, Lars [Uppsala, Univ. (Sweden). Institute of Earth Sciences; Brittain, John [Oslo, Univ. (Norway). Zoological Museum

    1997-06-01

    The main aim of the present report is to describe selected models and the principles of the Decision Analysis theory that will be applied to develop the model-based computerised system `MOIRA`. A dose model and a model for predicting radiocaesium migration in lakes and the effects of countermeasures to reduce the contamination levels in the components of lacustrine system are described in detail. The principles for developing prototype models for predicting the migration of {sup 90}Sr in lake abiotic and biotic components are discussed. The environmental models described in the report are based on the use of `collective parameters` which due to mutual compensation effects of different phenomena occurring in complex systems, show low variability when the environmental conditions change. Use of such `collective parameters` not only increases the predictive power of the models, but also increases the practical applicability of the model. Among the main results described in the report, the development of an objective hierarchy table for evaluating the effectiveness of a countermeasure when the economic, social and ecological impacts are accounted for, deserves special attention.

  8. Detection of left ventricular thrombi by computerised tomography

    International Nuclear Information System (INIS)

    Nair, C.K.; Sketch, M.H.; Mahoney, P.D.; Lynch, J.D.; Mooss, A.N.; Kenney, N.P.

    1981-01-01

    Sixteen patients suspected of having left ventricular mural thrombi were studied. All had suffered transmural myocardial infarction. Fifteen patients had a ventricular aneurysm. One had had systemic emboli. The mean length of time between the myocardial infarction and the study was 14.8 months, with a range of one month to 79 months. All patients underwent computerised tomography of the heart, M-mode echocardiography (M-mode), and two-dimensional echocardiography (2-D). Eight patients underwent left ventricular cineangiography. Five patients had surgical confirmation. Computerised tomography, two-dimensional, and M-mode echocardiography predicted left ventricular mural thrombi in 10, eight, and one of the 16 patients, respectively. Left ventricular cineangiography predicted left ventricular mural thrombi in four out of eight patients. Computerised tomography and left ventricular cineangiography correctly predicted the presence or absence of left ventricular thrombi in all five patients who underwent operation. In the same group, however, two-dimensional and M-mode echocardiography failed to predict the presence of thrombi in one and three patients, respectively. Among the 11 patients without surgical confirmation, one, in whom no left ventricular thrombi were shown by M-mode and two-dimensional echocardiography, was found to have thrombi on computerised tomography. In another, two-dimensional echocardiography was positive but this finding was not confirmed either by computerised tomography or by left ventricular angiography. (author)

  9. Evaluating PROMIS Physical Function Measures in Older Adults at Risk for Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Curtis Tatsuoka PhD

    2016-09-01

    Full Text Available Activities of daily living can be affected by cognitive decline. Self-report measurement of functioning is attractive due to ease of data collection, low cost, and accessibility via technology-assisted means, and for understanding patient perspective. A concern is with reliability of such measurement as cognitive decline occurs. We compared a widely used, self-report “legacy” measure of functioning, Lawton and Brody’s Instrumental Activities of Daily Living Scale (IADLS, with a subset of physical functioning items from the Patient-Reported Outcomes Measurement Information System (PROMIS. The study sample consisted of 304 individuals of varying cognitive status: normal, mild cognitive impairment (MCI, or early dementia. An expert consensus method was used to select PROMIS functional items most relevant to neurocognitive disorder and to identify major functional sub-domains. Selected PROMIS functional subscales and the IADLS were then evaluated with respect to cognitive status. Few PROMIS functional items were useful in identifying MCI, while we reaffirmed the utility of the IADLS. Also, even mild depression levels were found to have negative effects on functioning according to both PROMIS and IADLS.

  10. Examination of the PROMIS upper extremity item bank.

    Science.gov (United States)

    Hung, Man; Voss, Maren W; Bounsanga, Jerry; Crum, Anthony B; Tyser, Andrew R

    Clinical measurement. The psychometric properties of the PROMIS v1.2 UE item bank were tested on various samples prior to its release, but have not been fully evaluated among the orthopaedic population. This study assesses the performance of the UE item bank within the UE orthopaedic patient population. The UE item bank was administered to 1197 adult patients presenting to a tertiary orthopaedic clinic specializing in hand and UE conditions and was examined using traditional statistics and Rasch analysis. The UE item bank fits a unidimensional model (outfit MNSQ range from 0.64 to 1.70) and has adequate reliabilities (person = 0.84; item = 0.82) and local independence (item residual correlations range from -0.37 to 0.34). Only one item exhibits gender differential item functioning. Most items target low levels of function. The UE item bank is a useful clinical assessment tool. Additional items covering higher functions are needed to enhance validity. Supplemental testing is recommended for patients at higher levels of function until more high function UE items are developed. 2c. Copyright © 2016 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  11. PROMIS Physical Function Correlation With NDI and mJOA in the Surgical Cervical Myelopathy Patient Population.

    Science.gov (United States)

    Owen, Robert J; Zebala, Lukas P; Peters, Colleen; McAnany, Steven

    2018-04-15

    Retrospective review. To determine the correlation of Patient-Reported Outcomes Measurement Information System (PROMIS) physical function with Neck Disability Index (NDI) and Modified Japanese Orthopedic Association (mJOA) scores in the surgical cervical myelopathy patient population. Outcome measures such as NDI and mJOA are essential for analyzing treatments for cervical myelopathy. Administrative burdens impose limits on completion of these measures. The PROMIS group developed an outcome measure to improve reporting of patient symptoms and function and to reduce administrative burden. Despite early success, NDI and mJOA have not been compared with PROMIS in patients with cervical myelopathy. This study determines the correlation of NDI and mJOA with PROMIS in surgical patients with cervical myelopathy. A total of 60 patients with cervical myelopathy undergoing surgery were included. PROMIS, NDI, and mJOA were collected preoperatively, and in the first 6 months postoperatively. Correlations between NDI, mJOA, and PROMIS were quantified using Pearson correlation coefficients. Students t tests were used to test significance. All 60 (100%) of patients completed preoperative questionnaires. Fifty-five (92%) of patients completed initial follow-up questionnaires within the first 6 months. PROMIS physical function and NDI demonstrated a strong negative correlation at baseline and in initial follow-up (R = -0.69, -0.76). PROMIS and mJOA demonstrated a strong positive correlation at baseline and in initial follow-up (R = 0.61, 0.72). PROMIS physical function has a strong negative correlation with NDI and a strong positive correlation with mJOA at baseline and in the early postoperative course in patients undergoing surgery for cervical myelopathy. Surgeons may factor these outcomes into the delivery and interpretation of patient-reported outcome measures in this population. Use of PROMIS may improve completion of outcome measures in the office and reduce

  12. Do Computerised Training Programmes Designed to Improve Working Memory Work?

    Science.gov (United States)

    Apter, Brian J. B.

    2012-01-01

    A critical review of working memory training research during the last 10 years is provided. Particular attention is given to research that has attempted to investigate the efficacy of commercially marketed computerised training programmes such as "Cogmed" and "Jungle Memory". Claimed benefits are questioned on the basis that research methodologies…

  13. Computerised Accounting Software; A Curriculum That Enhances an Accounting Programme

    Science.gov (United States)

    Machera, Robert P.; Machera, Precious C.

    2017-01-01

    There has been an outcry in commerce and industry about students who fail to perform in the accounting department due to lack of "practical accounting skills". It is from this background that the researchers were motivated to investigate the impact of a Computerised Accounting Software Curriculum that enhances an Accounting Programme. At…

  14. Debating the utility of computerised neurocognitive testing in the ...

    African Journals Online (AJOL)

    The purpose of this article was to contribute to an argument regarding the utility of computerised baseline and follow-up neurocognitive testing within the sports concussion arena. Heated debate around this issue via a number of contributions has appeared recently in the journal Current Sports Medicine Reports, with its use ...

  15. Computerised decision support systems for healthcare professionals: an interpretative review.

    Science.gov (United States)

    Cresswell, Kathrin; Majeed, Azeem; Bates, David W; Sheikh, Aziz

    2012-01-01

    Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted. We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997-2010). The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS) Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations. Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits. Whilst the potential of clinical decision support systems in improving, in particular, practitioner performance is considerable, such technology may

  16. Using Linear Equating to Map PROMIS(®) Global Health Items and the PROMIS-29 V2.0 Profile Measure to the Health Utilities Index Mark 3.

    Science.gov (United States)

    Hays, Ron D; Revicki, Dennis A; Feeny, David; Fayers, Peter; Spritzer, Karen L; Cella, David

    2016-10-01

    Preference-based health-related quality of life (HR-QOL) scores are useful as outcome measures in clinical studies, for monitoring the health of populations, and for estimating quality-adjusted life-years. This was a secondary analysis of data collected in an internet survey as part of the Patient-Reported Outcomes Measurement Information System (PROMIS(®)) project. To estimate Health Utilities Index Mark 3 (HUI-3) preference scores, we used the ten PROMIS(®) global health items, the PROMIS-29 V2.0 single pain intensity item and seven multi-item scales (physical functioning, fatigue, pain interference, depressive symptoms, anxiety, ability to participate in social roles and activities, sleep disturbance), and the PROMIS-29 V2.0 items. Linear regression analyses were used to identify significant predictors, followed by simple linear equating to avoid regression to the mean. The regression models explained 48 % (global health items), 61 % (PROMIS-29 V2.0 scales), and 64 % (PROMIS-29 V2.0 items) of the variance in the HUI-3 preference score. Linear equated scores were similar to observed scores, although differences tended to be larger for older study participants. HUI-3 preference scores can be estimated from the PROMIS(®) global health items or PROMIS-29 V2.0. The estimated HUI-3 scores from the PROMIS(®) health measures can be used for economic applications and as a measure of overall HR-QOL in research.

  17. ProMIS Augmented Reality Training of Laparoscopic Procedures Face Validity

    NARCIS (Netherlands)

    Botden, Sanne M. B. I.; Buzink, Sonja N.; Schijven, Marlies P.; Jakimowicz, Jack J.

    2008-01-01

    Background: Conventional video trainers lack the ability to assess the trainee objectively, but offer modalities that are often missing in virtual reality simulation, such as realistic haptic feedback. The ProMIS augmented reality laparoscopic simulator retains the benefit of a traditional box

  18. ProMIS augmented reality training of laparoscopic procedures face validity

    NARCIS (Netherlands)

    Botden, Sanne M. B. I.; Buzink, Sonja N.; Schijven, Marlies P.; Jakimowicz, Jack J.

    2008-01-01

    BACKGROUND: Conventional video trainers lack the ability to assess the trainee objectively, but offer modalities that are often missing in virtual reality simulation, such as realistic haptic feedback. The ProMIS augmented reality laparoscopic simulator retains the benefit of a traditional box

  19. External Data and Attribute Hyperlink Programs for Promis*e(Registered Trademark)

    Science.gov (United States)

    Derengowski, Rich; Gruel, Andrew

    2001-01-01

    External Data and Attribute Hyperlink are computer programs that can be added to Promis*e(trademark) which is a commercial software system that automates routine tasks in the design (including drawing schematic diagrams) of electrical control systems. The programs were developed under the Stennis Space Center's (SSC) Dual Use Technology Development Program to provide capabilities for SSC's BMCS configuration management system which uses Promis*e(trademark). The External Data program enables the storage and management of information in an external database linked to a drawing. Changes can be made either in the database or on the drawing. Information that originates outside Promis*e(trademark) can be stored in custom fields that can be added to the database. Although this information is not available in Promis*e(trademark) printed drawings, it can be associated with symbols in the drawings, and can be retrieved through the drawings when the software is running. The Attribute Hyperlink program enables the addition of hyperlink information as attributes of symbols. This program enables the formation of a direct hyperlink between a schematic diagram and an Internet site or a file on a compact disk, on the user's hard drive, or on another computer on a network to which the user's computer is connected. The user can then obtain information directly related to the part (e.g., maintenance, or troubleshooting information) associated with the hyperlink.

  20. Calibration of the PROMIS Physical Function Item Bank in Dutch Patients with Rheumatoid Arthritis

    NARCIS (Netherlands)

    Oude Voshaar, M.A.H.; ten Klooster, P.M.; Glas, C.A.W.; Vonkeman, H.E.; Taal, E; Krishnan, E.; Moens, H.J.B.; Boers, M.; Terwee, C.B.; van Riel, P.L.C.M.; van de Laar, M.A.F.J.

    2014-01-01

    Objective: To calibrate the Dutch-Flemish version of the PROMIS physical function (PF) item bank in patients with rheumatoid arthritis (RA) and to evaluate cross-cultural measurement equivalence with US general population and RA data. Methods: Data were collected from RA patients enrolled in the

  1. Effectiveness of a computerised working memory training in adolescents with mild to borderline intellectual disabilities.

    Science.gov (United States)

    Van der Molen, M J; Van Luit, J E H; Van der Molen, M W; Klugkist, I; Jongmans, M J

    2010-05-01

    The goal of this study is to evaluate the effectiveness of a computerised working memory (WM) training on memory, response inhibition, fluid intelligence, scholastic abilities and the recall of stories in adolescents with mild to borderline intellectual disabilities attending special education. A total of 95 adolescents with mild to borderline intellectual disabilities were randomly assigned to either a training adaptive to each child's progress in WM, a non-adaptive WM training, or to a control group. Verbal short-term memory (STM) improved significantly from pre- to post-testing in the group who received the adaptive training compared with the control group. The beneficial effect on verbal STM was maintained at follow-up and other effects became clear at that time as well. Both the adaptive and non-adaptive WM training led to higher scores at follow-up than at post-intervention on visual STM, arithmetic and story recall compared with the control condition. In addition, the non-adaptive training group showed a significant increase in visuo-spatial WM capacity. The current study provides the first demonstration that WM can be effectively trained in adolescents with mild to borderline intellectual disabilities.

  2. Development of the NIH PROMIS ® Sexual Function and Satisfaction measures in patients with cancer.

    Science.gov (United States)

    Flynn, Kathryn E; Lin, Li; Cyranowski, Jill M; Reeve, Bryce B; Reese, Jennifer Barsky; Jeffery, Diana D; Smith, Ashley Wilder; Porter, Laura S; Dombeck, Carrie B; Bruner, Deborah Watkins; Keefe, Francis J; Weinfurt, Kevin P

    2013-02-01

    We describe the development and validation of the Patient-Reported Outcomes Measurement Information System(®) Sexual Function and Satisfaction (PROMIS(®) SexFS; National Institutes of Health) measures, version 1.0, for cancer populations. To develop a customizable self-report measure of sexual function and satisfaction as part of the U.S. National Institutes of Health PROMIS Network. Our multidisciplinary working group followed a comprehensive protocol for developing psychometrically robust patient-reported outcome measures including qualitative (scale development) and quantitative (psychometric evaluation) development. We performed an extensive literature review, conducted 16 focus groups with cancer patients and multiple discussions with clinicians, and evaluated candidate items in cognitive testing with patients. We administered items to 819 cancer patients. Items were calibrated using item-response theory and evaluated for reliability and validity. The PROMIS SexFS measures, version 1.0, include 81 items in 11 domains: Interest in Sexual Activity, Lubrication, Vaginal Discomfort, Erectile Function, Global Satisfaction with Sex Life, Orgasm, Anal Discomfort, Therapeutic Aids, Sexual Activities, Interfering Factors, and Screener Questions. In addition to content validity (patients indicate that items cover important aspects of their experiences) and face validity (patients indicate that items measure sexual function and satisfaction), the measure shows evidence for discriminant validity (domains discriminate between groups expected to be different) and convergent validity (strong correlations between scores on PROMIS and scores on conceptually similar older measures of sexual function), as well as favorable test-retest reliability among people not expected to change (interclass correlations from two administrations of the instrument, 1 month apart). The PROMIS SexFS offers researchers a reliable and valid set of tools to measure self-reported sexual function

  3. Computerised image analysis of biocrystallograms originating from agricultural products

    DEFF Research Database (Denmark)

    Andersen, Jens-Otto; Henriksen, Christian B.; Laursen, J.

    1999-01-01

    Procedures are presented for computerised image analysis of iocrystallogram images, originating from biocrystallization investigations of agricultural products. The biocrystallization method is based on the crystallographic phenomenon that when adding biological substances, such as plant extracts...... on up to eight parameters indicated strong relationships, with R2 up to 0.98. It is concluded that the procedures were able to discriminate the seven groups of images, and are applicable for biocrystallization investigations of agricultural products. Perspectives for the application of image analysis...

  4. Impact of National Institutes of Health Gastrointestinal PROMIS Measures in Clinical Practice: Results of a Multicenter Controlled Trial.

    Science.gov (United States)

    Almario, Christopher V; Chey, William D; Khanna, Dinesh; Mosadeghi, Sasan; Ahmed, Shahzad; Afghani, Elham; Whitman, Cynthia; Fuller, Garth; Reid, Mark; Bolus, Roger; Dennis, Buddy; Encarnacion, Rey; Martinez, Bibiana; Soares, Jennifer; Modi, Rushaba; Agarwal, Nikhil; Lee, Aaron; Kubomoto, Scott; Sharma, Gobind; Bolus, Sally; Spiegel, Brennan M R

    2016-11-01

    The National Institutes of Health (NIH) created the Patient Reported Outcomes Measurement Information System (PROMIS) to allow efficient, online measurement of patient-reported outcomes (PROs), but it remains untested whether PROMIS improves outcomes. Here, we aimed to compare the impact of gastrointestinal (GI) PROMIS measures vs. usual care on patient outcomes. We performed a pragmatic clinical trial with an off-on study design alternating weekly between intervention (GI PROMIS) and control arms at one Veterans Affairs and three university-affiliated specialty clinics. Adults with GI symptoms were eligible. Intervention patients completed GI PROMIS symptom questionnaires on an e-portal 1 week before their visit; PROs were available for review by patients and their providers before and during the clinic visit. Usual care patients were managed according to customary practices. Our primary outcome was patient satisfaction as determined by the Consumer Assessment of Healthcare Providers and Systems questionnaire. Secondary outcomes included provider interpersonal skills (Doctors' Interpersonal Skills Questionnaire (DISQ)) and shared decision-making (9-item Shared Decision Making Questionnaire (SDM-Q-9)). There were 217 and 154 patients in the GI PROMIS and control arms, respectively. Patient satisfaction was similar between groups (P>0.05). Intervention patients had similar assessments of their providers' interpersonal skills (DISQ 89.4±11.7 vs. 89.8±16.0, P=0.79) and shared decision-making (SDM-Q-9 79.3±12.4 vs. 79.0±22.0, P=0.85) vs. This is the first controlled trial examining the impact of NIH PROMIS in clinical practice. One-time use of GI PROMIS did not improve patient satisfaction or assessment of provider interpersonal skills and shared decision-making. Future studies examining how to optimize PROs in clinical practice are encouraged before widespread adoption.

  5. Computerised decision support systems for healthcare professionals: an interpretative review

    Directory of Open Access Journals (Sweden)

    Kathrin Cresswell

    2013-03-01

    Full Text Available Purpose Computerised decision support systems are designed to support clinicians in making decisions and thereby enhance the quality and safety of care. We aimed to undertake an interpretative review of the empirical evidence on computerised decision support systems, their contexts of use, and summarise evidence on the effectiveness of these tools and insights into how these can be successfully implemented and adopted.Methods We systematically searched the empirical literature to identify systematic literature reviews on computerised decision support applications and their impact on the quality and safety of healthcare delivery over a 13-year period (1997–2010. The databases searched included: MEDLINE, EMBASE, The Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, The Cochrane Central Register of Controlled Trials, The Cochrane Methodology Register, The Health Technology Assessment Database, and The National Health Service (NHS Economic Evaluation Database. To be eligible for inclusion, systematic reviews needed to address computerised decision support systems, and at least one of the following: impact on safety; quality; or organisational, implementation or adoption considerations.Results Our searches yielded 121 systematic reviews relating to eHealth, of which we identified 41 as investigating computerised decision support systems. These indicated that, whilst there was a lack of investigating potential risks, such tools can result in improvements in practitioner performance in the promotion of preventive care and guideline adherence, particularly if specific information is available in real time and systems are effectively integrated into clinical workflows. However, the evidence regarding impact on patient outcomes was less clear-cut with reviews finding either no, inconsistent or modest benefits.Conclusions Whilst the potential of clinical decision support systems in improving, in particular

  6. Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the design and operation of multi-center clinical trials: a qualitative research study.

    Science.gov (United States)

    Eisenstein, Eric L; Diener, Lawrence W; Nahm, Meredith; Weinfurt, Kevin P

    2011-12-01

    New technologies may be required to integrate the National Institutes of Health's Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators fell into two categories: acceptance by key regulators and the scientific community, and usability for researchers and clinicians. Issues reported by the coordinating center, participating sites, and study subjects were those faced when integrating new technologies into existing clinical trial systems. We then defined elements of a PROMIS Tool Kit required for integrating PROMIS into a multi-center clinical trial environment. The requirements identified in this study serve as a framework for future investigators in the design, development, implementation, and operation of PROMIS Tool Kit technologies.

  7. Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the Design and Operation of Multi-center Clinical Trials: a Qualitative Research Study

    OpenAIRE

    Eisenstein, Eric L.; Diener, Lawrence W.; Nahm, Meredith; Weinfurt, Kevin P.

    2010-01-01

    New technologies may be required to integrate the National Institutes of Health’s Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators ...

  8. Validation of the PROMIS Sleep Disturbance and Sleep-Related Impairment item banks in Dutch adolescents.

    Science.gov (United States)

    van Kooten, Jojanneke A M C; van Litsenburg, Raphaёle R L; Yoder, Whitney R; Kaspers, Gertjan J L; Terwee, Caroline B

    2018-04-16

    Sleep problems are common in adolescents and have a negative impact on daytime functioning. However, there is a lack of well-validated adolescent sleep questionnaires. The Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance and Sleep-Related Impairment item banks are well-validated instruments developed for and tested in adults. The aim of this study was to evaluate their structural validity in adolescents. Test and retest data were collected for the Dutch-Flemish V1.0 PROMIS Sleep Disturbance (27) and Sleep-Related Impairment (16 items) item banks from 1046 adolescents (11-19 years). Cross-validation methods, Confirmatory (CFA), and Exploratory Factor Analyses (EFA) were used. Fit indices and factor loadings were used to improve the models. The final models were assessed for model fit using retest data. The one-factor Sleep Disturbance (CFI = 0.795, TLI = 0.778, RMSEA = 0.117) and Sleep-Related Impairment (CFI = 0.897, TLI = 0.882, RMSEA = 0.156) models could not be replicated in adolescents. Cross-validation resulted in a final Sleep Disturbance model of 23 and a Sleep-Related Impairment model of 11 items. Retest data CFA showed adequate fit for the Sleep-Related Impairment-11 (CFI = 0.981, TLI = 0.976, RMSEA = 0.116). The Sleep Disturbance-23 model fit indices stayed below the recommended values (CFI = 0.895, TLI = 0.885, RMSEA = 0.105). While the PROMIS Sleep Disturbance-23 for adolescents and PROMIS Sleep-Related Impairment-11 for adolescents provide a framework to assess adolescent sleep, additional research is needed to replicate these findings in a larger and more diverse sample.

  9. The PROMIS fatigue item bank has good measurement properties in patients with fibromyalgia and severe fatigue.

    Science.gov (United States)

    Yost, Kathleen J; Waller, Niels G; Lee, Minji K; Vincent, Ann

    2017-06-01

    Efficient management of fibromyalgia (FM) requires precise measurement of FM-specific symptoms. Our objective was to assess the measurement properties of the Patient-Reported Outcome Measurement Information System (PROMIS) fatigue item bank (FIB) in people with FM. We applied classical psychometric and item response theory methods to cross-sectional PROMIS-FIB data from two samples. Data on the clinical FM sample were obtained at a tertiary medical center. Data for the U.S. general population sample were obtained from the PROMIS network. The full 95-item bank was administered to both samples. We investigated dimensionality of the item bank in both samples by separately fitting a bifactor model with two group factors; experience and impact. We assessed measurement invariance between samples, and we explored an alternate factor structure with the normative sample and subsequently confirmed that structure in the clinical sample. Finally, we assessed whether reporting FM subdomain scores added value over reporting a single total score. The item bank was dominated by a general fatigue factor. The fit of the initial bifactor model and evidence of measurement invariance indicated that the same constructs were measured across the samples. An alternative bifactor model with three group factors demonstrated slightly improved fit. Subdomain scores add value over a total score. We demonstrated that the PROMIS-FIB is appropriate for measuring fatigue in clinical samples of FM patients. The construct can be presented by a single score; however, subdomain scores for the three group factors identified in the alternative model may also be reported.

  10. Qualitative Development and Content Validation of the PROMIS Pediatric Sleep Health Items.

    Science.gov (United States)

    Bevans, Katherine B; Meltzer, Lisa J; De La Motte, Anna; Kratchman, Amy; Viél, Dominique; Forrest, Christopher B

    2018-04-25

    To develop the Patient Reported Outcome Measurement Information System (PROMIS) Pediatric Sleep Health item pool and evaluate its content validity. Participants included 8 expert sleep clinician-researchers, 64 children ages 8-17 years, and 54 parents of children ages 5-17 years. We started with item concepts and expressions from the PROMIS Sleep Disturbance and Sleep Related Impairment adult measures. Additional pediatric sleep health concepts were generated by expert (n = 8), child (n = 28), and parent (n = 33) concept elicitation interviews and a systematic review of existing pediatric sleep health questionnaires. Content validity of the item pool was evaluated with item translatability review, readability analysis, and child (n = 36) and parent (n = 21) cognitive interviews. The final pediatric Sleep Health item pool includes 43 items that assess sleep disturbance (children's capacity to fall and stay asleep, sleep quality, dreams, and parasomnias) and sleep-related impairments (daytime sleepiness, low energy, difficulty waking up, and the impact of sleep and sleepiness on cognition, affect, behavior, and daily activities). Items are translatable and relevant and well understood by children ages 8-17 and parents of children ages 5-17. Rigorous qualitative procedures were used to develop and evaluate the content validity of the PROMIS Pediatric Sleep Health item pool. Once the item pool's psychometric properties are established, the scales will be useful for measuring children's subjective experiences of sleep.

  11. Computerised CBT for depressed adolescents: Randomised controlled trial.

    Science.gov (United States)

    Smith, Patrick; Scott, Rebecca; Eshkevari, Ertimiss; Jatta, Fatoumata; Leigh, Eleanor; Harris, Victoria; Robinson, Alex; Abeles, Paul; Proudfoot, Judy; Verduyn, Chrissie; Yule, William

    2015-10-01

    Depression in adolescents is a common and impairing problem. Effective psychological therapies for depression are not accessed by most adolescents. Computerised therapy offers huge potential for improving access to treatment. To test the efficacy of Stressbusters, a Computerised-CBT (C-CBT) programme for depression in young people. Multi-site, schools-based, RCT of C-CBT compared to Waiting List, for young people (N = 112; aged 12-16) with significant symptoms of depression, using multiple-informants (adolescents, parents, teachers), with follow-up at 3 and 6 months. Relative to being on a Waiting List, C-CBT was associated with statistically significant and clinically meaningful improvements in symptoms of depression and anxiety according to adolescent self-report; and with a trend towards improvements in depression and anxiety according to parent-report. Improvements were maintained at follow-up. Treatment gains were similar for boys and girls across the participating age range. Treatment effect was partially mediated by changes in ruminative thinking. Teachers rated adolescents as having few emotional or behavioural problems, both before and after intervention. C-CBT had no detectable effect on academic attainment. In the month after intervention, young people who received C-CBT had significantly fewer absences from school than those on the Waiting List. C-CBT shows considerable promise for the treatment of mild-moderate depression in adolescents. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Computerised analysis of facial emotion expression in eating disorders

    Science.gov (United States)

    2017-01-01

    Background Problems with social-emotional processing are known to be an important contributor to the development and maintenance of eating disorders (EDs). Diminished facial communication of emotion has been frequently reported in individuals with anorexia nervosa (AN). Less is known about facial expressivity in bulimia nervosa (BN) and in people who have recovered from AN (RecAN). This study aimed to pilot the use of computerised facial expression analysis software to investigate emotion expression across the ED spectrum and recovery in a large sample of participants. Method 297 participants with AN, BN, RecAN, and healthy controls were recruited. Participants watched film clips designed to elicit happy or sad emotions, and facial expressions were then analysed using FaceReader. Results The finding mirrored those from previous work showing that healthy control and RecAN participants expressed significantly more positive emotions during the positive clip compared to the AN group. There were no differences in emotion expression during the sad film clip. Discussion These findings support the use of computerised methods to analyse emotion expression in EDs. The findings also demonstrate that reduced positive emotion expression is likely to be associated with the acute stage of AN illness, with individuals with BN showing an intermediate profile. PMID:28575109

  13. Computerised analysis of facial emotion expression in eating disorders.

    Science.gov (United States)

    Leppanen, Jenni; Dapelo, Marcela Marin; Davies, Helen; Lang, Katie; Treasure, Janet; Tchanturia, Kate

    2017-01-01

    Problems with social-emotional processing are known to be an important contributor to the development and maintenance of eating disorders (EDs). Diminished facial communication of emotion has been frequently reported in individuals with anorexia nervosa (AN). Less is known about facial expressivity in bulimia nervosa (BN) and in people who have recovered from AN (RecAN). This study aimed to pilot the use of computerised facial expression analysis software to investigate emotion expression across the ED spectrum and recovery in a large sample of participants. 297 participants with AN, BN, RecAN, and healthy controls were recruited. Participants watched film clips designed to elicit happy or sad emotions, and facial expressions were then analysed using FaceReader. The finding mirrored those from previous work showing that healthy control and RecAN participants expressed significantly more positive emotions during the positive clip compared to the AN group. There were no differences in emotion expression during the sad film clip. These findings support the use of computerised methods to analyse emotion expression in EDs. The findings also demonstrate that reduced positive emotion expression is likely to be associated with the acute stage of AN illness, with individuals with BN showing an intermediate profile.

  14. PROMIS Sleep Disturbance and Sleep-Related Impairment in Adolescents: Examining Psychometrics Using Self-Report and Actigraphy.

    Science.gov (United States)

    Hanish, Alyson E; Lin-Dyken, Deborah C; Han, Joan C

    The National Institutes of Health Patient-Reported Outcomes Measurement Information System (PROMIS) has self-reported health measures available for both pediatric and adult populations, but no pediatric measures are available currently in the sleep domains. The purpose of this observational study was to perform preliminary validation studies on age-appropriate, self-reported sleep measures in healthy adolescents. This study examined 25 healthy adolescents' self-reported daytime sleepiness, sleep disturbance, sleep-related impairment, and sleep patterns. Healthy adolescents completed a physical exam at the National Institutes of Health Clinical Center (Bethesda, MD), had no chronic medical conditions, and were not taking any chronic medications. The Cleveland Adolescent Sleepiness Questionnaire (CASQ), PROMIS Sleep Disturbance (v. 1.0; 8a), and PROMIS Sleep-Related Impairment (v. 1.0; 8b) questionnaires were completed, and sleep patterns were assessed using actigraphy. Total scores on the three sleep questionnaires were correlated (all Spearman's r > .70, p psychometrically sound sleep questionnaires. Findings suggest the potential research and clinical utility of adult versions of PROMIS sleep measures in adolescents. Future studies should include larger, more diverse samples and explore additional psychometric properties of PROMIS sleep measures to provide age-appropriate, validated, and reliable measures of sleep in adolescents.

  15. Comparative Responsiveness of the PROMIS Pain Interference Short Forms, Brief Pain Inventory, PEG, and SF-36 Bodily Pain Subscale.

    Science.gov (United States)

    Kean, Jacob; Monahan, Patrick O; Kroenke, Kurt; Wu, Jingwei; Yu, Zhangsheng; Stump, Tim E; Krebs, Erin E

    2016-04-01

    To compare the sensitivity to change and the responsiveness to intervention of the PROMIS Pain Interference short forms, Brief Pain Inventory (BPI), 3-item PEG scale, and SF-36 Bodily Pain subscale in a sample of patients with persistent musculoskeletal pain of moderate severity. Standardized response means, standardized effect sizes, and receiver operating curve analyses were used to assess change between baseline and 3-month assessments in 250 participants who participated in a randomized clinical effectiveness trial of collaborative telecare management for moderate to severe and persistent musculoskeletal pain. The BPI, PEG, and SF-36 Bodily Pain measures were more sensitive to patient-reported global change than the PROMIS Pain Interference short forms, especially for the clinically improved group, for which the change detected by the PROMIS short forms was not statistically significant. The BPI was more responsive to the clinical intervention than the SF-36 Bodily Pain and PROMIS Pain Interference measures. Post hoc analyses exploring these findings did not suggest that differences in content or rating scale structure (number of response options or anchoring language) adequately explained the observed differences in the detection of change. In this clinical trial, the BPI and PEG measures were better able to detect change than the SF-36 Bodily Pain and PROMIS Pain Interference measures.

  16. Computerised respiratory sounds can differentiate smokers and non-smokers.

    Science.gov (United States)

    Oliveira, Ana; Sen, Ipek; Kahya, Yasemin P; Afreixo, Vera; Marques, Alda

    2017-06-01

    Cigarette smoking is often associated with the development of several respiratory diseases however, if diagnosed early, the changes in the lung tissue caused by smoking may be reversible. Computerised respiratory sounds have shown to be sensitive to detect changes within the lung tissue before any other measure, however it is unknown if it is able to detect changes in the lungs of healthy smokers. This study investigated the differences between computerised respiratory sounds of healthy smokers and non-smokers. Healthy smokers and non-smokers were recruited from a university campus. Respiratory sounds were recorded simultaneously at 6 chest locations (right and left anterior, lateral and posterior) using air-coupled electret microphones. Airflow (1.0-1.5 l/s) was recorded with a pneumotachograph. Breathing phases were detected using airflow signals and respiratory sounds with validated algorithms. Forty-four participants were enrolled: 18 smokers (mean age 26.2, SD = 7 years; mean FEV 1 % predicted 104.7, SD = 9) and 26 non-smokers (mean age 25.9, SD = 3.7 years; mean FEV 1 % predicted 96.8, SD = 20.2). Smokers presented significantly higher frequency at maximum sound intensity during inspiration [(M = 117, SD = 16.2 Hz vs. M = 106.4, SD = 21.6 Hz; t(43) = -2.62, p = 0.0081, d z  = 0.55)], lower expiratory sound intensities (maximum intensity: [(M = 48.2, SD = 3.8 dB vs. M = 50.9, SD = 3.2 dB; t(43) = 2.68, p = 0.001, d z  = -0.78)]; mean intensity: [(M = 31.2, SD = 3.6 dB vs. M = 33.7,SD = 3 dB; t(43) = 2.42, p = 0.001, d z  = 0.75)] and higher number of inspiratory crackles (median [interquartile range] 2.2 [1.7-3.7] vs. 1.5 [1.2-2.2], p = 0.081, U = 110, r = -0.41) than non-smokers. Significant differences between computerised respiratory sounds of smokers and non-smokers have been found. Changes in respiratory sounds are often the earliest sign of disease. Thus, computerised respiratory sounds

  17. Construction Of A Computerised Information-Processing Test Battery

    Directory of Open Access Journals (Sweden)

    Johann M. Schepers

    2002-09-01

    Full Text Available The primary goal of the study was to construct a computerised information-processing test battery to measure choice reaction time for up to and including six bits of information, to measure discrimination reaction time with regard to colour patterns and form patterns, to measure rate of information processing with regard to perceptual stimuli and conceptual reasoning, and to develop a suitable scoring system for the respective tests. The battery of tests was applied to 58 pilots. Opsomming Die hoofdoel van die studie was om ‘n gerekenariseerde inligtingverwerkingstoets-battery te konstrueer om keusereaksietyd tot en met ses bis inligting te meet, om diskriminasie-reaksietyd ten opsigte van kleurpatrone en vormpatrone te meet, om tempo van inligtingverwerking ten opsigte van perseptuele stimuli en konseptuele redenering te meet en om ‘n gepaste nasienstelsel vir die onderskeie toetse te ontwikkel. Die battery toetse is op 58 vlieëniers toegepas

  18. Computerised cognitive-behavioural therapy for adults with intellectual disability: randomised controlled trial.

    Science.gov (United States)

    Cooney, Patricia; Jackman, Catherine; Coyle, David; O'Reilly, Gary

    2017-08-01

    Background Despite the evidence base for computer-assisted cognitive-behavioural therapy (CBT) in the general population, it has not yet been adapted for use with adults who have an intellectual disability. Aims To evaluate the utility of a CBT computer game for adults who have an intellectual disability. Method A 2 × 3 (group × time) randomised controlled trial design was used. Fifty-two adults with mild to moderate intellectual disability and anxiety or depression were randomly allocated to two groups: computerised CBT (cCBT) or psychiatric treatment as usual (TAU), and assessed at pre-treatment, post-treatment and 3-month follow-up. Forty-nine participants were included in the final analysis. Results A significant group × time interaction was observed on the primary outcome measure of anxiety (Glasgow Anxiety Scale for people with an Intellectual Disability), favouring cCBT over TAU, but not on the primary outcome measure of depression (Glasgow Depression Scale for people with a Learning Disability). A medium effect size for anxiety symptoms was observed at post-treatment and a large effect size was observed after follow-up. Reliability of Change Indices indicated that the intervention produced clinically significant change in the cCBT group in comparison with TAU. Conclusions As the first application of cCBT for adults with intellectual disability, this intervention appears to be a useful treatment option to reduce anxiety symptoms in this population. © The Royal College of Psychiatrists 2017.

  19. Danish translation of a physical function item bank from the Patient-Reported Outcome Measurement Information System (PROMIS)

    DEFF Research Database (Denmark)

    Schnohr, Christina W.; Rasmussen, Charlotte L.; Langberg, Henning

    2017-01-01

    of the Physical Function item bank into Danish. METHODS: We followed the PROMIS standard procedure, including: 1) two independent translations, 2) back translation, 3) independent reviews of translation quality, and 4) cognitive interviews with a representative sample of the adult population from the municipality...

  20. Intraocular pressure asymmetry-Topcon Computerised Tonometer CT-20.

    Science.gov (United States)

    Ntim-Amponsah, C T

    1997-01-01

    The Topcon Computerised Tonometer CT-20, a non-contact tonometer (NCT), was used to measure intraocular pressure (IOP) in mmHg in 1,226 subjects above the age of 30 years with no ocular pathology. The mean IOP was 14.41 mmHg and the standard deviation 3.43. The mean IOP far was higher in female (14.60) than male (14.22). This gender difference in the mean IOP was significant; t stat = 2.69, P < 0.5. Right IOP exceeded left IOP and this was highly significant in both male (t stat 4.03) and female (t stat 5.64) p < 0.01. This IOP asymmetry approximates a normal distribution. The mean of the differences (right-left IOP) and standard deviation for all subjects were 0.57 and 2.26 respectively. The range for the differences was- 10 to 10 mmHg. Asymmetry was greater in females than males (t stat = 2.05, p < 0.05). Knowledge of these statistics will help in decisions concerning glaucoma screening with NCT.

  1. Adaptation.

    Science.gov (United States)

    Broom, Donald M

    2006-01-01

    The term adaptation is used in biology in three different ways. It may refer to changes which occur at the cell and organ level, or at the individual level, or at the level of gene action and evolutionary processes. Adaptation by cells, especially nerve cells helps in: communication within the body, the distinguishing of stimuli, the avoidance of overload and the conservation of energy. The time course and complexity of these mechanisms varies. Adaptive characters of organisms, including adaptive behaviours, increase fitness so this adaptation is evolutionary. The major part of this paper concerns adaptation by individuals and its relationships to welfare. In complex animals, feed forward control is widely used. Individuals predict problems and adapt by acting before the environmental effect is substantial. Much of adaptation involves brain control and animals have a set of needs, located in the brain and acting largely via motivational mechanisms, to regulate life. Needs may be for resources but are also for actions and stimuli which are part of the mechanism which has evolved to obtain the resources. Hence pigs do not just need food but need to be able to carry out actions like rooting in earth or manipulating materials which are part of foraging behaviour. The welfare of an individual is its state as regards its attempts to cope with its environment. This state includes various adaptive mechanisms including feelings and those which cope with disease. The part of welfare which is concerned with coping with pathology is health. Disease, which implies some significant effect of pathology, always results in poor welfare. Welfare varies over a range from very good, when adaptation is effective and there are feelings of pleasure or contentment, to very poor. A key point concerning the concept of individual adaptation in relation to welfare is that welfare may be good or poor while adaptation is occurring. Some adaptation is very easy and energetically cheap and

  2. Adaptation

    International Development Research Centre (IDRC) Digital Library (Canada)

    building skills, knowledge or networks on adaptation, ... the African partners leading the AfricaAdapt network, together with the UK-based Institute of Development Studies; and ... UNCCD Secretariat, Regional Coordination Unit for Africa, Tunis, Tunisia .... 26 Rural–urban Cooperation on Water Management in the Context of.

  3. Method of administration of PROMIS scales did not significantly impact score level, reliability, or validity

    DEFF Research Database (Denmark)

    Bjorner, Jakob B; Rose, Matthias; Gandek, Barbara

    2014-01-01

    OBJECTIVES: To test the impact of the method of administration (MOA) on score level, reliability, and validity of scales developed in the Patient Reported Outcomes Measurement Information System (PROMIS). STUDY DESIGN AND SETTING: Two nonoverlapping parallel forms each containing eight items from......, no significant mode differences were found and all confidence intervals were within the prespecified minimal important difference of 0.2 standard deviation. Parallel-forms reliabilities were very high (ICC = 0.85-0.93). Only one across-mode ICC was significantly lower than the same-mode ICC. Tests of validity...... questionnaire (PQ), personal digital assistant (PDA), or personal computer (PC) and a second form by PC, in the same administration. Method equivalence was evaluated through analyses of difference scores, intraclass correlations (ICCs), and convergent/discriminant validity. RESULTS: In difference score analyses...

  4. The computerised procedure system COPMA and its user interface

    International Nuclear Information System (INIS)

    Krogsaeter, M.; Larsen, J.; Nilsen, S.; Oewre, F.

    1990-01-01

    At the OECD Halden Reactor Project, the COPMA system has been developed in order to investigate whether procedures can be executed more safety and efficiently if they are computerised, i.e. if the operator uses a CRT-based system instead of written manuals. Procedures are entered in a procedure data base using PED, a procedure editor. Each procedure is given a textual as well as a graphical representation. For the textual representation, the language PROLA is used, a language which has been designed for simple procedure specification. The COPMA online system lets the operator execute procedures that are stored in the procedure data base. The operator interface is a screen divided into non-overlapping windows each serving a different purpose. All commands to the system are given by moving a mouse device around and clicking buttons on top of the mouse. A procedure consists of steps, each step containing a number of instructions. The operator works on one activity at a time, an activity to be seen as a procedure instance. A graph shows the overall procedure (or activity) structure in a window and activity execution is traced in the graph. Another windows shows the instructions of the step currently being executed. The operator steps through the activity by selecting whether and how to execute the listed instructions. COPMA can maintain the status of several activities in parallel, so that the operator can easily switch between different activities. COPMA is linked to a PWR nuclear simulator over Ethernet using the TCP/IP protocol. This gives a number of advantages as compared to conventional written procedures, especially the fact that COPMA can help collect data from the procedure data base automatically

  5. A computerised automatic pellet inspection unit for FBTR fuel

    International Nuclear Information System (INIS)

    Ramakumar, M.S.; Mahule, K.N.; Ghosh, J.K.; Venkatesh, D.

    1984-01-01

    Physical inspection and certification of nuclear reactor fuel element components is an activity demanding utmost imagination and skill in devising accurate measuring systems. There is also need for remote handling, automation, rapid processing and inspection data print out when dealing with reactor fuel material. This report deals with an automatic computerised fuel pellet inspection system that has been developed in Radiometallurgy Division, B.A.R.C. to carry out dimensional and weight measurements on fuel pellets for the Fast Breeder Test Reactor (FBTR) at Kalpakkam near Madras. The system consists of several subsystems each developed especially for a specific purpose and as such items are not available off the shelf from manufacturers in India. If a general approach is adopted towards the report, there are many innovations and ideas that can be used in the automatic inspection of a variety of products in industry. As the system is fairly involved the report does not attempt to deal with detailed description of the equipment. The function of the system is to accept a certain quantity of fuel pellets in a bowl feeder, separate the pellets rejected owing to their exceeding dimensional and weight limits and form columns of accepted pellets. Dimensional and weight limits can be set as required and all inspection data are presented in a printed format. The system processes pellets at the rate of 15 per minute. The entire system can be run by operators with no special skills. The unit is currently in use for the inspection of mixed carbide fuel pellets for FBTR. (author)

  6. Computerised sepsis protocol management. Description of an early warning system.

    Science.gov (United States)

    de Dios, Begoña; Borges, Marcio; Smith, Timothy D; Del Castillo, Alberto; Socias, Antonia; Gutiérrez, Leticia; Nicolás, Jordi; Lladó, Bartolomé; Roche, Jose A; Díaz, Maria P; Lladó, Yolanda

    2018-02-01

    New strategies need to be developed for the early recognition and rapid response for the management of sepsis. To achieve this purpose, the Multidisciplinary Sepsis Team (MST) developed the Computerised Sepsis Protocol Management (PIMIS). The aim of this study was to evaluate the convenience of using PIMIS, as well as the activity of the MST. An analysis was performed on the data collected from solicited MST consultations (direct activation of PIMIS by attending physician or telephone request) and unsolicited ones (by referral from the microbiology laboratory or an automatic referral via the hospital vital signs recording software [SIDCV]), as well as the hospital department, source of infection, treatment recommendation, and acceptance of this. Of the 1,581 first consultations, 65.1% were solicited consultations (84.1% activation of PIMIS and 15.9% by telephone). The majority of unsolicited consultations were generated by the microbiology laboratory (95.2%), and 4.8% from the SIDCV. Referral from solicited consultations were generated sooner (5.63days vs 8.47days; P<.001) and came from clinical specialties rather than from the surgical ward (73.0% vs 39.1%; P<.001). A recommendation was made for antimicrobial prescription change in 32% of first consultations. The treating physician accepted 78.1% of recommendations. The high rate of solicited consultations and acceptance of recommended prescription changes suggest that a MST is seen as a helpful resource, and that PIMIS software is perceived to be useful and convenient to use, as it is the main source of referral. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  7. Quality of life and urolithiasis: the patient - reported outcomes measurement information system (PROMIS

    Directory of Open Access Journals (Sweden)

    Nishant Patel

    Full Text Available ABSTRACT Background: With a high rate of recurrence, urolithiasis is a chronic disease that impacts quality of life. The Patient Reported Outcomes Measurement Information System is an NIH validated questionnaire to assess patient quality of life. We evaluated the impact of urolithiasis on quality of life using the NIH-sponsored PROMIS-43 questionnaire. Materials and Methods: Patients reporting to the kidney stone clinic were interviewed to collect information on stone history and demographic information and were asked to complete the PROMIS-43 questionnaire. Quality of life scores were analyzed using gender and age matched groups for the general US population. Statistical comparisons were made based on demographic information and patient stone history. Statistical significance was P<0.05. Results: 103 patients completed the survey. 36% of respondents were male, the average age of the group was 52 years old, with 58% primary income earners, and 35% primary caregivers. 7% had never passed a stone or had a procedure while 17% passed 10 or more stones in their lifetime. Overall, pain and physical function were worse in patients with urolithiasis. Primary income earners had better quality of life while primary caregivers and those with other chronic medical conditions were worse. Patients on dietary and medical therapy had better quality of life scores. Conclusions: Urolithiasis patients subjectively have worse pain and physical function than the general population. The impact of pain on quality of life was greatest in those patients who had more stone episodes, underscoring the importance of preventive measures. Stone prevention measures improve quality of life.

  8. Incorporating PROMIS Symptom Measures into Primary Care Practice-a Randomized Clinical Trial.

    Science.gov (United States)

    Kroenke, Kurt; Talib, Tasneem L; Stump, Timothy E; Kean, Jacob; Haggstrom, David A; DeChant, Paige; Lake, Kittie R; Stout, Madison; Monahan, Patrick O

    2018-04-05

    Symptoms account for more than 400 million clinic visits annually in the USA. The SPADE symptoms (sleep, pain, anxiety, depression, and low energy/fatigue) are particularly prevalent and undertreated. To assess the effectiveness of providing PROMIS (Patient-Reported Outcome Measure Information System) symptom scores to clinicians on symptom outcomes. Randomized clinical trial conducted from March 2015 through May 2016 in general internal medicine and family practice clinics in an academic healthcare system. Primary care patients who screened positive for at least one SPADE symptom. After completing the PROMIS symptom measures electronically immediately prior to their visit, the 300 study participants were randomized to a feedback group in which their clinician received a visual display of symptom scores or a control group in which scores were not provided to clinicians. The primary outcome was the 3-month change in composite SPADE score. Secondary outcomes were individual symptom scores, symptom documentation in the clinic note, symptom-specific clinician actions, and patient satisfaction. Most patients (84%) had multiple clinically significant (T-score ≥ 55) SPADE symptoms. Both groups demonstrated moderate symptom improvement with a non-significant trend favoring the feedback compared to control group (between-group difference in composite T-score improvement, 1.1; P = 0.17). Symptoms present at baseline resolved at 3-month follow-up only one third of the time, and patients frequently still desired treatment. Except for pain, clinically significant symptoms were documented less than half the time. Neither symptom documentation, symptom-specific clinician actions, nor patient satisfaction differed between treatment arms. Predictors of greater symptom improvement included female sex, black race, fewer medical conditions, and receiving care in a family medicine clinic. Simple feedback of symptom scores to primary care clinicians in the absence of

  9. Cyborg practices: call-handlers and computerised decision support systems in urgent and emergency care.

    Science.gov (United States)

    Pope, Catherine; Halford, Susan; Turnbull, Joanne; Prichard, Jane

    2014-06-01

    This article draws on data collected during a 2-year project examining the deployment of a computerised decision support system. This computerised decision support system was designed to be used by non-clinical staff for dealing with calls to emergency (999) and urgent care (out-of-hours) services. One of the promises of computerised decisions support technologies is that they can 'hold' vast amounts of sophisticated clinical knowledge and combine it with decision algorithms to enable standardised decision-making by non-clinical (clerical) staff. This article draws on our ethnographic study of this computerised decision support system in use, and we use our analysis to question the 'automated' vision of decision-making in healthcare call-handling. We show that embodied and experiential (human) expertise remains central and highly salient in this work, and we propose that the deployment of the computerised decision support system creates something new, that this conjunction of computer and human creates a cyborg practice.

  10. Adapt

    Science.gov (United States)

    Bargatze, L. F.

    2015-12-01

    Active Data Archive Product Tracking (ADAPT) is a collection of software routines that permits one to generate XML metadata files to describe and register data products in support of the NASA Heliophysics Virtual Observatory VxO effort. ADAPT is also a philosophy. The ADAPT concept is to use any and all available metadata associated with scientific data to produce XML metadata descriptions in a consistent, uniform, and organized fashion to provide blanket access to the full complement of data stored on a targeted data server. In this poster, we present an application of ADAPT to describe all of the data products that are stored by using the Common Data File (CDF) format served out by the CDAWEB and SPDF data servers hosted at the NASA Goddard Space Flight Center. These data servers are the primary repositories for NASA Heliophysics data. For this purpose, the ADAPT routines have been used to generate data resource descriptions by using an XML schema named Space Physics Archive, Search, and Extract (SPASE). SPASE is the designated standard for documenting Heliophysics data products, as adopted by the Heliophysics Data and Model Consortium. The set of SPASE XML resource descriptions produced by ADAPT includes high-level descriptions of numerical data products, display data products, or catalogs and also includes low-level "Granule" descriptions. A SPASE Granule is effectively a universal access metadata resource; a Granule associates an individual data file (e.g. a CDF file) with a "parent" high-level data resource description, assigns a resource identifier to the file, and lists the corresponding assess URL(s). The CDAWEB and SPDF file systems were queried to provide the input required by the ADAPT software to create an initial set of SPASE metadata resource descriptions. Then, the CDAWEB and SPDF data repositories were queried subsequently on a nightly basis and the CDF file lists were checked for any changes such as the occurrence of new, modified, or deleted

  11. PROMYS – Programming synthetic networks for bio-based production of value chemicals – FP7 project

    DEFF Research Database (Denmark)

    Sommer, Morten Otto Alexander

    2017-01-01

    ) Synthetic pathway construction 2) Cell factory optimization 3) Control of populations during fermentation Ligand responsive regulation and selection systems will directly couple the presence of a desired chemical product or flux state within a cell, to the survival of the cell. As such, they allow......The global chemical industry is transitioning from petrochemical production processes to bio-based production processes. This transition creates a clear market need for technologies that reduce the development time and cost of cell factories. PROMYS will develop, validate and implement a novel...... will drastically accelerate the construction, optimization and performance of cell factories by enabling industrial users to impose non-natural objectives on the engineered cell factory. PROMYS will address three major challenges in metabolic engineering that limit the development of new cell factories: 1...

  12. The PROMIS Physical Function item bank was calibrated to a standardized metric and shown to improve measurement efficiency

    DEFF Research Database (Denmark)

    Rose, Matthias; Bjørner, Jakob; Gandek, Barbara

    2014-01-01

    OBJECTIVE: To document the development and psychometric evaluation of the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function (PF) item bank and static instruments. STUDY DESIGN AND SETTING: The items were evaluated using qualitative and quantitative methods. A total...... response model was used to estimate item parameters, which were normed to a mean of 50 (standard deviation [SD]=10) in a US general population sample. RESULTS: The final bank consists of 124 PROMIS items covering upper, central, and lower extremity functions and instrumental activities of daily living...... to identify differences between age and disease groups. CONCLUSION: The item bank provides a common metric and can improve the measurement of PF by facilitating the standardization of patient-reported outcome measures and implementation of CATs for more efficient PF assessments over a larger range....

  13. Assessing nicotine dependence in adolescent E-cigarette users: The 4-item Patient-Reported Outcomes Measurement Information System (PROMIS) Nicotine Dependence Item Bank for electronic cigarettes.

    Science.gov (United States)

    Morean, Meghan E; Krishnan-Sarin, Suchitra; S O'Malley, Stephanie

    2018-04-26

    Adolescent e-cigarette use (i.e., "vaping") likely confers risk for developing nicotine dependence. However, there have been no studies assessing e-cigarette nicotine dependence in youth. We evaluated the psychometric properties of the 4-item Patient-Reported Outcomes Measurement Information System Nicotine Dependence Item Bank for E-cigarettes (PROMIS-E) for assessing youth e-cigarette nicotine dependence and examined risk factors for experiencing stronger dependence symptoms. In 2017, 520 adolescent past-month e-cigarette users completed the PROMIS-E during a school-based survey (50.5% female, 84.8% White, 16.22[1.19] years old). Adolescents also reported on sex, grade, race, age at e-cigarette use onset, vaping frequency, nicotine e-liquid use, and past-month cigarette smoking. Analyses included conducting confirmatory factor analysis and examining the internal consistency of the PROMIS-E. Bivariate correlations and independent-samples t-tests were used to examine unadjusted relationships between e-cigarette nicotine dependence and the proposed risk factors. Regression models were run in which all potential risk factors were entered as simultaneous predictors of PROMIS-E scores. The single-factor structure of the PROMIS-E was confirmed and evidenced good internal consistency. Across models, larger PROMIS-E scores were associated with being in a higher grade, initiating e-cigarette use at an earlier age, vaping more frequently, using nicotine e-liquid (and higher nicotine concentrations), and smoking cigarettes. Adolescent e-cigarette users reported experiencing nicotine dependence, which was assessed using the psychometrically sound PROMIS-E. Experiencing stronger nicotine dependence symptoms was associated with characteristics that previously have been shown to confer risk for frequent vaping and tobacco cigarette dependence. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Optimised performance of industrial high resolution computerised tomography

    International Nuclear Information System (INIS)

    Maangaard, M.

    2000-01-01

    The purpose of non-destructive evaluation (NDE) is to acquire knowledge of the investigated sample. Digital x-ray imaging techniques such as radiography or computerised tomography (CT) produce images of the interior of a sample. The obtained image quality determines the possibility of detecting sample related features, e.g. details and flaws. This thesis presents a method of optimising the performance of industrial X-ray equipment for the imaging task at issue in order to obtain images with high quality. CT produces maps of the X-ray linear attenuation of the sample's interior. CT can produce two dimensional cross-section images or three-dimensional images with volumetric information on the investigated sample. The image contrast and noise depend on both the investigated sample and the equipment and settings used (X-ray tube potential, X-ray filtration, exposure time, etc.). Hence, it is vital to find the optimal equipment settings in order to obtain images of high quality. To be able to mathematically optimise the image quality, it is necessary to have a model of the X-ray imaging system together with an appropriate measure of image quality. The optimisation is performed with a developed model for an X-ray image-intensifier-based radiography system. The model predicts the mean value and variance of the measured signal level in the collected radiographic images. The traditionally used measure of physical image quality is the signal-to-noise ratio (SNR). To calculate the signal-to-noise ratio, a well-defined detail (flaw) is required. It was found that maximising the SNR leads to ambiguities, the optimised settings found by maximising the SNR were dependent on the material in the detail. When CT is performed on irregular shaped samples containing density and compositional variations, it is difficult to define which SNR to use for optimisation. This difficulty is solved by the measures of physical image quality proposed here, the ratios geometry

  15. Computerised Attention Training for Children with Intellectual and Developmental Disabilities: A Randomised Controlled Trial

    Science.gov (United States)

    Kirk, Hannah E.; Gray, Kylie M.; Ellis, Kirsten; Taffe, John; Cornish, Kim M.

    2016-01-01

    Background: Children with intellectual and developmental disabilities (IDD) experience heightened attention difficulties which have been linked to poorer cognitive, academic and social outcomes. Although, increasing research has focused on the potential of computerised cognitive training in reducing attention problems, limited studies have…

  16. Effectiveness of a Computerised Working Memory Training in Adolescents with Mild to Borderline Intellectual Disabilities

    Science.gov (United States)

    Van der Molen, M. J.; Van Luit, J. E. H.; Van der Molen, M. W.; Klugkist, I.; Jongmans, M. J.

    2010-01-01

    Background: The goal of this study is to evaluate the effectiveness of a computerised working memory (WM) training on memory, response inhibition, fluid intelligence, scholastic abilities and the recall of stories in adolescents with mild to borderline intellectual disabilities attending special education. Method: A total of 95 adolescents with…

  17. A New Computerised Advanced Theory of Mind Measure for Children with Asperger Syndrome: The ATOMIC

    Science.gov (United States)

    Beaumont, Renae B.; Sofronoff, Kate

    2008-01-01

    This study examined the ability of children with Asperger Syndrome (AS) to attribute mental states to characters in a new computerised, advanced theory of mind measure: The Animated Theory of Mind Inventory for Children (ATOMIC). Results showed that children with AS matched on IQ, verbal comprehension, age and gender performed equivalently on…

  18. Sample preparation and scanning protocol for computerised analysis of root length and diameter

    NARCIS (Netherlands)

    Bouma, T.J.; Nielsen, K.F.; Koutstaal, B.P.

    2000-01-01

    Root length and diameter distribution are important characteristics to be considered when describing and comparing root systems. Root length and root-diameter distribution may be obtained in two ways: by microscopical measurements, which are laborious, or by computerised analysis, which is fast but

  19. Effectiveness of a computerised working memory training in adolescents with mild to borderline intellectual disabilities

    NARCIS (Netherlands)

    van der Molen, M.J.; van Luit, J.E.H.; van der Molen, M.W.; Klugkist, I.; Jongmans, M.J.

    2010-01-01

    Background: The goal of this study is to evaluate the effectiveness of a computerised working memory (WM) training on memory, response inhibition, fluid intelligence, scholastic abilities and the recall of stories in adolescents with mild to borderline intellectual disabilities attending special

  20. Parametrisation of linear accelerator electron beam for computerised dosimetry calculations

    International Nuclear Information System (INIS)

    Millan, P.E.; Millan, S.; Hernandez, A.; Andreo, P.

    1979-01-01

    A previously published age-diffusion model has been adapted to obtain parameters for the Saggittaire linear accelerator electron beams. The calculations are shown and the results discussed. A comparison is presented between measured and predicted percentage depth doses for electron beams at various energies between 10 and 32 MeV. Theoretical isodose curves are compared, for an energy of 10 MeV, with experimental curves. The parameters obtained are used for computer electron isodose curve calculation in a program called FIJOE adapted from a previously published program. This program makes it possible to correct for irregular body contours, but not for internal inhomogeneities. (UK)

  1. A computerised programme for monitoring athletes' emotional stress ...

    African Journals Online (AJOL)

    Until the 1990s, rehabilitation interventions primarily addressed the physiological dimensions of sports injury. Although some athletes adapt psychologically to injury quite effectively, there appear to be many individuals who experience negative emotional responses after sustaining a sport-related injury. In the past ...

  2. The Quality of Life of Children Under Chiropractic Care Using PROMIS-25: Results from a Practice-Based Research Network.

    Science.gov (United States)

    Alcantara, Joel; Lamont, Andrea E; Ohm, Jeanne; Alcantara, Junjoe

    2018-04-01

    To characterize pediatric chiropractic and assess pediatric quality of life (QoL). A prospective cohort. Setting/Locations: Individual offices within a practice-based research network located throughout the United States. A convenience sample of children (8-17 years) under chiropractic care and their parents. Chiropractic spinal adjustments and adjunctive therapies. Survey instrument measuring sociodemographic information and correlates from the clinical encounter along with the Patient Reported Outcomes Measurement Information System (PROMIS)-25 to measure QoL (i.e., depression, anxiety, and pain interference). Sociodemographic and clinical correlates were analyzed using descriptive statistics (i.e., frequencies/percentages, means, and standard deviations). The PROMIS-25 data were analyzed using scoring manuals, converting raw scores to T score metric (mean = 50; SD = 10). A generalized linear mixed model was utilized to examine covariates (i.e., sex, number of visits, and motivation for care) that may have played an important role on the PROMIS outcome. The original data set consisted of 915 parent-child dyads. After data cleaning, a total of 881 parents (747 females, 134 males; mean age = 42.03 years) and 881 children (467 females and 414 males; mean age = 12.49 years) comprised this study population. The parents were highly educated and presented their child for mainly wellness care. The mean number of days and patient visits from baseline to comparative QoL measures was 38.12 days and 2.74 (SD = 2.61), respectively. After controlling for the effects of motivation for care, patient visits, duration of complaint, sex, and pain rating, significant differences were observed in the probability of experiencing problems (vs. no reported problems) across all QoL domains (Wald = 82.897, df = 4, p < 0.05). Post hoc comparisons demonstrated the children were less likely to report any symptoms of depression (Wald = 6.1474, df = 1

  3. Teaching the Repeated Prisoner's Dilemma with a Non-Computerised Adaptation of Axelrod's Tournament

    Science.gov (United States)

    Dennis, Catherine

    2015-01-01

    Darwin's theory of evolution is explicitly competitive, yet co-operation between individuals is a common phenomenon. The Prisoner's Dilemma model is central to the teaching of the evolution of co-operation. The best-known explorations of the Prisoner's Dilemma are the tournaments run by Robert Axelrod in the 1980s. Aimed at students of biological…

  4. [A computerised clinical decision-support system for the management of depression in Primary Care].

    Science.gov (United States)

    Aragonès, Enric; Comín, Eva; Cavero, Myriam; Pérez, Víctor; Molina, Cristina; Palao, Diego

    Despite its clinical relevance and its importance as a public health problem, there are major gaps in the management of depression. Evidence-based clinical guidelines are useful to improve processes and clinical outcomes. In order to make their implementation easier these guidelines have been transformed into computerised clinical decision support systems. In this article, a description is presented on the basics and characteristics of a new computerised clinical guideline for the management of major depression, developed in the public health system in Catalonia. This tool helps the clinician to establish reliable and accurate diagnoses of depression, to choose the best treatment a priori according to the disease and the patient characteristics. It also emphasises the importance of systematic monitoring to assess the clinical course, and to adjust therapeutic interventions to the patient's needs at all times. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  5. The computerised accountancy system (MYDAS) for irradiated components in RNL's Mayfair Laboratory at Culcheth

    International Nuclear Information System (INIS)

    Stansfield, R.G.; Baker, A.R.

    1985-09-01

    The computerised Mayfair Accountancy System (MYDAS) has been developed to account for irradiated components in the Mayfair Laboratory at Culcheth and supersedes a card-index system. The computerised system greatly improves the availability of the data held and it ensures, by means of extensive data validation programs, that the data accurately represent the current inventory of irradiated components in the Laboratory. The system has been implemented on the Risley ICL 2966 main-frame computer and uses an IDMS database to store the data. The computer is accessed through the facilities of the Transaction Processing Management System (TPMS) providing rapid and secure access to the database from several visual display units and printers simultaneously. (author)

  6. MOIRA: a computerised decision support system for the management of radionuclide contaminated freshwater ecosystems

    International Nuclear Information System (INIS)

    Gallego, Eduardo; Brittain, John E.; Hakanson, Lars; Heling, Rudie; Hofman, Dmitry; Monte, Luigi

    2004-01-01

    The radiation dose resulting from contamination of freshwater ecosystems due to the release of radioactive substances into the environment may be reduced by applying suitable countermeasures. Despite their benefits, intervention strategies may have detrimental effects of economic, ecological and social nature. Thus, it is of paramount importance to assess, by objective criteria, the global cost-benefit balance of different options. The MOIRA project (A MOdel based computerised system for management support to Identify optimal remedial strategies for Restoring radionuclide contaminated Aquatic ecosystems) has developed a user-friendly, computerised tool that will allow decision makers to choose optimal intervention strategies for freshwater ecosystems with different contamination scenarios. The aim of the paper is to briefly describe the main components of the MOIRA system and to demonstrate its application using real case based scenarios. (author)

  7. Comparing three methods of computerised cognitive training for older adults with subclinical cognitive decline.

    Science.gov (United States)

    Gooding, Amanda L; Choi, Jimmy; Fiszdon, Joanna M; Wilkins, Kirsten; Kirwin, Paul D; van Dyck, Christopher H; Devanand, Davangere; Bell, Morris D; Rivera Mindt, Monica

    2016-10-01

    Cognitive rehabilitation for mild cognitive impairment (MCI) and early Alzheimer's disease is readily available to the geriatric population. Initial evidence suggests that techniques incorporating motivational strategies to enhance treatment engagement may provide more benefit than computerised training alone. Seventy four adults with subclinical cognitive decline were randomly assigned to computerised cognitive training (CCT), Cognitive Vitality Training (CVT), or an Active Control Group (ACG), and underwent neuropsychological evaluations at baseline and four-month follow-up. Significant differences were found in changes in performance on the Modified Mini Mental State Examination (mMMSE) and measures of verbal learning and memory across treatment groups. Experimental groups showed greater preservation of functioning on the mMMSE than the ACG group, the CVT group performed better than the ACG group on one measure of verbal learning and both measures of verbal memory, and the CCT group performed better than the ACG group on one measure of verbal learning and one measure of verbal memory. There were no significant group differences between the CVT and CCT groups on measures of verbal learning or memory. It was concluded that computerised cognitive training may offer the most benefit when incorporated into a therapeutic milieu rather than administered alone, although both appear superior to more generic forms of cognitive stimulation.

  8. A systematic review of computerised serious educational games about alcohol and other drugs for adolescents.

    Science.gov (United States)

    Rodriguez, Daniel M; Teesson, Maree; Newton, Nicola C

    2014-03-01

    Serious educational games (SEG) have been shown to be effective in educating young people about a range of topics, including languages and maths. This paper identifies the use of computerised SEGs in education about alcohol and other drugs and reviews their impact on the prevention of alcohol and drug use. The Cochrane Library, EMBASE, MEDLINE, ERIC, Scopus, psychINFO, pubMED and DRUG databases were searched in February 2013. Additional publications were obtained from the reference lists of the relevant papers. Studies were included if they described an evaluation of a computerised SEG that targeted alcohol and/or other drugs and had been trialled with adolescents. Eight SEGs were identified targeting tobacco, alcohol, cannabis, methamphetamine, ecstasy, inhalants, cocaine and opioids. Six reported positive outcomes in terms of increased content knowledge and two reported increased negative attitudes towards the targeted drugs. Only one reported a decrease in the frequency of drug use. This is the first review of the efficacy of computerised SEGs for alcohol and other drugs for adolescents. Results suggest that SEGs can increase content knowledge of alcohol and other drugs. Evidence concerning impacts on negative attitudes and alcohol and drug use is limited, with few studies examining these outcomes. © 2013 Australasian Professional Society on Alcohol and other Drugs.

  9. Understanding Health-related Quality of Life in Caregivers of Civilians and Service Members/Veterans with Traumatic Brain Injury: Establishing the Reliability and Validity of PROMIS Mental Health Measures.

    Science.gov (United States)

    Carlozzi, Noelle E; Hanks, Robin; Lange, Rael T; Brickell D Psych, Tracey A; Ianni, Phillip A; Miner, Jennifer A; French Psy D, Louis M; Kallen, Michael A; Sander, Angelle M

    2018-06-19

    To provide important reliability and validity data to support the use of the PROMIS Mental Health measures in caregivers of civilians or service members/veterans with traumatic brain injury (TBI). Patient-reported outcomes surveys administered through an electronic data collection platform. Three TBI Model Systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility. 560 caregivers of individuals with a documented TBI (344 civilians and 216 military) INTERVENTION: Not Applicable MAIN OUTCOME MEASURES: PROMIS Anxiety, Depression, and Anger Item Banks RESULTS: Internal consistency for all of the PROMIS Mental Health item banks was very good (all α > .86) and three-week test retest reliability was good to adequate (ranged from .65 to .85). Convergent validity and discriminant validity of the PROMIS measures was also supported. Caregivers of individuals that were low functioning had worse emotional HRQOL (as measured by the three PROMIS measures) than caregivers of high functioning individuals, supporting known groups validity. Finally, levels of distress, as measured by the PROMIS measures, were elevated for those caring for low-functioning individuals in both samples (rates ranged from 26.2% to 43.6% for caregivers of low-functioning individuals). Results support the reliability and validity of the PROMIS Anxiety, Depression, and Anger item banks in caregivers of civilians and service members/veterans with TBI. Ultimately, these measures can be used to provide a standardized assessment of HRQOL as it relates to mental health in these caregivers. Copyright © 2018. Published by Elsevier Inc.

  10. Development and psychometric evaluation of the PROMIS Pediatric Life Satisfaction item banks, child-report, and parent-proxy editions.

    Science.gov (United States)

    Forrest, Christopher B; Devine, Janine; Bevans, Katherine B; Becker, Brandon D; Carle, Adam C; Teneralli, Rachel E; Moon, JeanHee; Tucker, Carole A; Ravens-Sieberer, Ulrike

    2018-01-01

    To describe the psychometric evaluation and item response theory calibration of the PROMIS Pediatric Life Satisfaction item banks, child-report, and parent-proxy editions. A pool of 55 life satisfaction items was administered to 1992 children 8-17 years old and 964 parents of children 5-17 years old. Analyses included descriptive statistics, reliability, factor analysis, differential item functioning, and assessment of construct validity. Thirteen items were deleted because of poor psychometric performance. An 8-item short form was administered to a national sample of 996 children 8-17 years old, and 1294 parents of children 5-17 years old. The combined sample (2988 children and 2258 parents) was used in item response theory (IRT) calibration analyses. The final item banks were unidimensional, the items were locally independent, and the items were free from impactful differential item functioning. The 8-item and 4-item short form scales showed excellent reliability, convergent validity, and discriminant validity. Life satisfaction decreased with declining socio-economic status, presence of a special health care need, and increasing age for girls, but not boys. After IRT calibration, we found that 4- and 8-item short forms had a high degree of precision (reliability) across a wide range (>4 SD units) of the latent variable. The PROMIS Pediatric Life Satisfaction item banks and their short forms provide efficient, precise, and valid assessments of life satisfaction in children and youth.

  11. Comparison of pediatric self reports and parent proxy reports utilizing PROMIS: Results from a chiropractic practice-based research network.

    Science.gov (United States)

    Alcantara, Joel; Ohm, Jeanne; Alcantara, Junjoe

    2017-11-01

    To measure the cross-informant variant of pediatric quality of life (QoL) based on self-reports and parent proxy measures. A secondary analysis of baseline data obtained from two independent studies measuring the QoL based on the pediatric PROMIS-25 self-report and the PROMIS parent-proxy items banks. A scoring manual associated raw scores to a T score metric (mean = 50; SD = 10). Reliability of QoL ratings utilized the ICC while comparison of mean T Scores utilized the unpaired t-test. A total of 289 parent-child dyads comprised our study responders. Average age for parents and children was 41.27 years and 12.52 years, respectively. The mean T score (child self-report: parent proxy) for each QoL domains were: mobility (50.82:52.58), anxiety (46.73:44.21), depression (45.18:43.60), fatigue (45.59:43.92), peer-relationships (52.15:52.88) and pain interference (47.47:44.80). Parents tend to over-estimate their child's QoL based on measures of anxiety, depression, fatigue, peer-relationships and pain interference. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Establishing a common metric for depressive symptoms: linking the BDI-II, CES-D, and PHQ-9 to PROMIS depression.

    Science.gov (United States)

    Choi, Seung W; Schalet, Benjamin; Cook, Karon F; Cella, David

    2014-06-01

    Interest in measuring patient-reported outcomes has increased dramatically in recent decades. This has simultaneously produced numerous assessment options and confusion. In the case of depressive symptoms, there are many commonly used options for measuring the same or a very similar concept. Public and professional reporting of scores can be confused by multiple scale ranges, normative levels, and clinical thresholds. A common reporting metric would have great value and can be achieved when similar instruments are administered to a single sample and then linked to each other to produce cross-walk score tables (e.g., Dorans, 2007; Kolen & Brennan, 2004). Using multiple procedures based on item response theory and equipercentile methods, we produced cross-walk tables linking 3 popular "legacy" depression instruments-the Center for Epidemiologic Studies Depression Scale (Radloff, 1977; N = 747), the Beck Depression Inventory-II (Beck, Steer, & Brown, 1996; N = 748), and the 9-item Patient Health Questionnaire (Kroenke, Spitzer, & Williams, 2001; N = 1,120)-to the depression metric of the National Institutes of Health (NIH) Patient-Reported Outcomes Measurement Information System (PROMIS; Cella et al., 2010). The PROMIS Depression metric is centered on the U.S. general population, matching the marginal distributions of gender, age, race, and education in the 2000 U.S. census (Liu et al., 2010). The linking relationships were evaluated by resampling small subsets and estimating confidence intervals for the differences between the observed and linked PROMIS scores; in addition, PROMIS cutoff scores for depression severity were estimated to correspond with those commonly used with the legacy measures. Our results allow clinicians and researchers to retrofit existing data of 3 popular depression measures to the PROMIS Depression metric and vice versa.

  13. Qualitative Evaluation of Pediatric Pain Behavior, Quality, and Intensity Item Candidates and the PROMIS Pain Domain Framework in Children With Chronic Pain.

    Science.gov (United States)

    Jacobson, C Jeffrey; Kashikar-Zuck, Susmita; Farrell, Jennifer; Barnett, Kimberly; Goldschneider, Ken; Dampier, Carlton; Cunningham, Natoshia; Crosby, Lori; DeWitt, Esi Morgan

    2015-12-01

    As initial steps in a broader effort to develop and test pediatric pain behavior and pain quality item banks for the Patient-Reported Outcomes Measurement Information System (PROMIS), we used qualitative interview and item review methods to 1) evaluate the overall conceptual scope and content validity of the PROMIS pain domain framework among children with chronic/recurrent pain conditions, and 2) develop item candidates for further psychometric testing. To elicit the experiential and conceptual scope of pain outcomes across a variety of pediatric recurrent/chronic pain conditions, we conducted 32 semi-structured individual and 2 focus-group interviews with children and adolescents (8-17 years), and 32 individual and 2 focus-group interviews with parents of children with pain. Interviews with pain experts (10) explored the operational limits of pain measurement in children. For item bank development, we identified existing items from measures in the literature, grouped them by concept, removed redundancies, and modified the remaining items to match PROMIS formatting. New items were written as needed and cognitive debriefing was completed with the children and their parents, resulting in 98 pain behavior (47 self, 51 proxy), 54 quality, and 4 intensity items for further testing. Qualitative content analyses suggest that reportable pain outcomes that matter to children with pain are captured within and consistent with the pain domain framework in PROMIS. PROMIS pediatric pain behavior, quality, and intensity items were developed based on a theoretical framework of pain that was evaluated by multiple stakeholders in the measurement of pediatric pain, including researchers, clinicians, and children with pain and their parents, and the appropriateness of the framework was verified. Copyright © 2015 American Pain Society. Published by Elsevier Inc. All rights reserved.

  14. System requirements for a computerised patient record information system at a busy primary health care clinic

    Directory of Open Access Journals (Sweden)

    PJ Blignaut

    2001-09-01

    Full Text Available A prototyping approach was used to determine the essential system requirements of a computerised patient record information system for a typical township primary health care clinic. A pilot clinic was identified and the existing manual system and business processes in this clinic was studied intensively before the first prototype was implemented. Interviews with users, incidental observations and analysis of actual data entered were used as primary techniques to refine the prototype system iteratively until a system with an acceptable data set and adequate functionalities were in place. Several non-functional and user-related requirements were also discovered during the prototyping period.

  15. Cauda equina syndrome complicating ankylosing spondylitis: use of electromyography and computerised tomography in diagnosis.

    Science.gov (United States)

    Young, A; Dixon, A; Getty, J; Renton, P; Vacher, H

    1981-06-01

    A case of the cauda equina syndrome complicating ankylosing spondylitis (AS) is described. An unusual feature of this case was the relapsing and remitting nature of the condition, but there is sufficient evidence to explain the clinical picture on the basis of a recurrent intraspinal inflammatory process. The clinical and radiological features are similar to those of a further 28 reported in the literature. An electromyogram (EMG) proved important in defining the extent of neurological involvement. Computerised tomography (CT) showed marked laminar erosion and no bony exit foramen encroachment. We believe that the clinical diagnosis of this condition can be adequately confirmed with plain radiology, EMG, and CT scan.

  16. Cognitive interviewing methodology in the development of a pediatric item bank: a patient reported outcomes measurement information system (PROMIS study

    Directory of Open Access Journals (Sweden)

    DeWalt Darren A

    2009-01-01

    Full Text Available Abstract Background The evaluation of patient-reported outcomes (PROs in health care has seen greater use in recent years, and methods to improve the reliability and validity of PRO instruments are advancing. This paper discusses the cognitive interviewing procedures employed by the Patient Reported Outcomes Measurement Information System (PROMIS pediatrics group for the purpose of developing a dynamic, electronic item bank for field testing with children and adolescents using novel computer technology. The primary objective of this study was to conduct cognitive interviews with children and adolescents to gain feedback on items measuring physical functioning, emotional health, social health, fatigue, pain, and asthma-specific symptoms. Methods A total of 88 cognitive interviews were conducted with 77 children and adolescents across two sites on 318 items. From this initial item bank, 25 items were deleted and 35 were revised and underwent a second round of cognitive interviews. A total of 293 items were retained for field testing. Results Children as young as 8 years of age were able to comprehend the majority of items, response options, directions, recall period, and identify problems with language that was difficult for them to understand. Cognitive interviews indicated issues with item comprehension on several items which led to alternative wording for these items. Conclusion Children ages 8–17 years were able to comprehend most item stems and response options in the present study. Field testing with the resulting items and response options is presently being conducted as part of the PROMIS Pediatric Item Bank development process.

  17. Computerised mirror therapy with Augmented Reflection Technology for early stroke rehabilitation: clinical feasibility and integration as an adjunct therapy.

    Science.gov (United States)

    Hoermann, Simon; Ferreira Dos Santos, Luara; Morkisch, Nadine; Jettkowski, Katrin; Sillis, Moran; Devan, Hemakumar; Kanagasabai, Parimala S; Schmidt, Henning; Krüger, Jörg; Dohle, Christian; Regenbrecht, Holger; Hale, Leigh; Cutfield, Nicholas J

    2017-07-01

    New rehabilitation strategies for post-stroke upper limb rehabilitation employing visual stimulation show promising results, however, cost-efficient and clinically feasible ways to provide these interventions are still lacking. An integral step is to translate recent technological advances, such as in virtual and augmented reality, into therapeutic practice to improve outcomes for patients. This requires research on the adaptation of the technology for clinical use as well as on the appropriate guidelines and protocols for sustainable integration into therapeutic routines. Here, we present and evaluate a novel and affordable augmented reality system (Augmented Reflection Technology, ART) in combination with a validated mirror therapy protocol for upper limb rehabilitation after stroke. We evaluated components of the therapeutic intervention, from the patients' and the therapists' points of view in a clinical feasibility study at a rehabilitation centre. We also assessed the integration of ART as an adjunct therapy for the clinical rehabilitation of subacute patients at two different hospitals. The results showed that the combination and application of the Berlin Protocol for Mirror Therapy together with ART was feasible for clinical use. This combination was integrated into the therapeutic plan of subacute stroke patients at the two clinical locations where the second part of this research was conducted. Our findings pave the way for using technology to provide mirror therapy in clinical settings and show potential for the more effective use of inpatient time and enhanced recoveries for patients. Implications for Rehabilitation Computerised Mirror Therapy is feasible for clinical use Augmented Reflection Technology can be integrated as an adjunctive therapeutic intervention for subacute stroke patients in an inpatient setting Virtual Rehabilitation devices such as Augmented Reflection Technology have considerable potential to enhance stroke rehabilitation.

  18. The integration of computerised accounting in the accounting curriculum as an educational learning curve for students entering the business world

    Directory of Open Access Journals (Sweden)

    Elmarie Papageorgiou

    2014-06-01

    Full Text Available At universities, educating students on real-life practices is one of the key drivers in a changing academic environment. Academic institutions encourage the study of the learning environment and ensure that appropriate strategies are in place for educating students. A first-year Accounting I student stated the importance of computerised accounting: ‘Computerised accounting is used in the workplace and therefore using it in varsity, grants students a view on how things will be after completion of their respective degrees.’ Accordingly, the purpose of this study was to empirically investigate the perceived acquisition of information technology (IT knowledge and determine the skills required for students to convert the knowledge gained into actions as a learning curve for accounting students entering the business world. The results indicated that students’ knowledge of Accounting I increased with the integration of computerised Accounting in the Accounting I Curriculum.

  19. Clinical and cost-effectiveness of computerised cognitive behavioural therapy for depression in primary care: Design of a randomised trial

    Directory of Open Access Journals (Sweden)

    Severens Johan L

    2008-06-01

    Full Text Available Abstract Background Major depression is a common mental health problem in the general population, associated with a substantial impact on quality of life and societal costs. However, many depressed patients in primary care do not receive the care they need. Reason for this is that pharmacotherapy is only effective in severely depressed patients and psychological treatments in primary care are scarce and costly. A more feasible treatment in primary care might be computerised cognitive behavioural therapy. This can be a self-help computer program based on the principles of cognitive behavioural therapy. Although previous studies suggest that computerised cognitive behavioural therapy is effective, more research is necessary. Therefore, the objective of the current study is to evaluate the (cost- effectiveness of online computerised cognitive behavioural therapy for depression in primary care. Methods/Design In a randomised trial we will compare (a computerised cognitive behavioural therapy with (b treatment as usual by a GP, and (c computerised cognitive behavioural therapy in combination with usual GP care. Three hundred mild to moderately depressed patients (aged 18–65 will be recruited in the general population by means of a large-scale Internet-based screening (N = 200,000. Patients will be randomly allocated to one of the three treatment groups. Primary outcome measure of the clinical evaluation is the severity of depression. Other outcomes include psychological distress, social functioning, and dysfunctional beliefs. The economic evaluation will be performed from a societal perspective, in which all costs will be related to clinical effectiveness and health-related quality of life. All outcome assessments will take place on the Internet at baseline, two, three, six, nine, and twelve months. Costs are measured on a monthly basis. A time horizon of one year will be used without long-term extrapolation of either costs or quality of life

  20. The SMile Card: a computerised data card for multiple sclerosis patients. SMile Card Scientific Board.

    Science.gov (United States)

    Mancardi, G L; Uccelli, M M; Sonnati, M; Comi, G; Milanese, C; De Vincentiis, A; Battaglia, M A

    2000-04-01

    The SMile Card was developed as a means for computerising clinical information for the purpose of transferability, accessibility, standardisation and compilation of a national database of demographic and clinical information about multiple sclerosis (MS) patients. In many European countries, centres for MS are organised independently from one another making collaboration, consultation and patient referral complicated. Only the more highly advanced clinical centres, generally located in large urban areas, have had the possibility to utilise technical possibilities for improving the organisation of patient clinical and research information, although independently from other centres. The information system, developed utilising the Visual Basic language for Microsoft Windows 95, stores information via a 'smart card' in a database which is initiated and updated utilising a microprocessor, located at each neurological clinic. The SMile Card, currently being tested in Italy, permits patients to carry with them all relevant medical information without limitations. Neurologists are able to access and update, via the microprocessor, the patient's entire medical history and MS-related information, including the complete neurological examination and laboratory test results. The SMile Card provides MS patients and neurologists with a complete computerised archive of clinical information which is accessible throughout the country. In addition, data from the SMile Card system can be exported to other database programs.

  1. Effectiveness of a computerised assessment tool to prompt individuals with diabetes to be more active in consultations

    DEFF Research Database (Denmark)

    Barnard, Katharine D.; Cradock, Sue; Parkin, Tracy

    2007-01-01

    The objective of this study was to assess whether using a computerised touch screen assessment tool prior to outpatient consultation makes patients more active in the consultation. In a non-randomised control group design, immediately after consultations, which were recorded, patients and profess...

  2. Clinical effectiveness of online computerised cognitive-behavioural therapy without support for depression in primary care: randomised trial

    NARCIS (Netherlands)

    de Graaf, L.E.; Gerhards, S.A.H.; Arntz, A.; Riper, H.; Metsemakers, J.F.M.; Evers, S.M.; Severens, J.L.; Widdershoven, G.A.M.; Huibers, M.J.H.

    2009-01-01

    BACKGROUND: Computerised cognitive-behavioural therapy (CCBT) might offer a solution to the current undertreatment of depression. AIMS: To determine the clinical effectiveness of online, unsupported CCBT for depression in primary care. METHOD: Three hundred and three people with depression were

  3. Re-evaluation of Magnetic Resonance and Computerised Tomographic Imaging in Neuro-Ophthalmic Patients in an Academic Centre

    NARCIS (Netherlands)

    Koekoek, Clarence G. J.; Meiners, Linda C.; Pott, Jan Willem R.

    The aim of the study is to report the frequency of missed diagnoses on magnetic resonance and computerised tomographic imaging in neuro-ophthalmic patients who were referred to an academic ophthalmology department, with apparent normal imaging. The authors included all neuro-ophthalmic patients,

  4. PENGARUH PENAMBAHAN BIOAKTIVATOR EM4 DAN PROMI DALAM PEMBUATAN PUPUK CAIR ORGANIK DARI SAMPAH ORGANIK RUMAH TANGGA

    Directory of Open Access Journals (Sweden)

    Marlinda

    2015-10-01

    Full Text Available Utilization of household organic waste each year is increasing due to various problems will arise such as air pollution, can have an impact of the disease and the danger of flooding. Waste that can be used are organic waste such as leftover vegetables, fruits, leftover dried leaves and twigs. Household organic waste is the most widely used in daily life because of the need for food so that the quantity is more and more produced and will accumulate because the ground is not capable of degrading in significant amounts, so as to damage the environment in the form of air pollution (odor and can cause impact disease. Along with the impact of the organic waste to be treated in a household environment prior to turning it into more useful forms such as liquid organic fertilizer. Liquid fertilizers are more easily absorbed by plants and in the form konsetrat so it is more economical because it can be diluted. This research aims to use household organic waste into liquid fertilizer and see the impact of bio-activator EM4 and Promi to manufacture liquid fertilizer from organic C content. The method used in the form of waste materials vegetables such as kale, mustard greens, spinach and carrots as well as dried leaves 300 g cleaned and cut into small pieces and then put in the composter before fermentation in lightly mist or moistened with a bio-activator before hand and then fermented for 7 days , The fermentation process is done with a variety of bio-activator 2.5 mL, 5 mL, 7.5 mL, 10 mL, and 12.5 mL. Organic liquid fertilizer produced by using EM4 and Promi can be used as a bio-activator in fertilizer use but bio-activator EM4 provide more effective work in mengdegradasi organic waste to produce high levels of organic C approximately 23% compared to bio-activator Compromise approximately 18% and so is the content of other compounds EM4 such as nitrogen for 3.8%, 3.0% P2O5 content of K2O content of 4.2% and 3.2% Compromise Nitrogen levels, levels of 2

  5. Ethical issues related to computerised family medical histories in sickle cell disease: Inforare.

    Science.gov (United States)

    Franrenet, Sandra; Duchange, Nathalie; Galactéros, Fréderic; Quantin, Catherine; Cohen, Olivier; Nzouakou, Ruben; Sudraud, Sophie; Hervé, Christian; Moutel, Grégoire

    2010-10-01

    The Inforare project aims to set up a system for the sharing of clinical and familial data, in order to study how genes are related to the severity of sickle cell disease. While the computerisation of clinical records represents a valuable research goal, an ethical framework is necessary to guarantee patients' protection and their rights in this developing field. Issues relating to patient information during the Inforare study were analysed by the steering committee. Several major concerns were discussed by the committee and formalized in the patients' information letter: educating patients to aid the recruitment of family members, rules of confidentiality and the disclosure of aggregate, individual and unexpected research results. This paper presents the main issues addressed.

  6. Dosimetry and Image Quality in Control Studies in Computerised Tomography Realized to Paediatric Patients

    International Nuclear Information System (INIS)

    Hernandez, M. R.; Gamboa-deBuen, I.; Dies, P.; Rickards, J.; Ruiz, C.

    2008-01-01

    Computerised tomography (CT) is a favourite method of medical diagnosis. Its use has thus increased rapidly throughout the world, particularly in studies relating to children. However to avoid administering unnecessarily high doses of radiation to paediatric patients it is important to have correct dose reference levels to minimize risk. The research is being developed within the public health sector at the Hospital Infantil de Mexico ''Dr. Federico Gomez.'' We measured the entrance surface air kerma (K P ) in paediatric patients, during the radiological studies of control in CT (studies of head, thorax and abdomen). Phantom was used to evaluate image quality as the tomograph requires a high resolution image in order to operate at its optimum level

  7. Geospatial Data for Computerisation of Public Administration in the Czech Republic

    Science.gov (United States)

    Cada, V.; Mildorf, T.

    2011-08-01

    The main aim of the eGovernment programme in the Czech Republic is to enhance the efficiency of public administration. The Digital Map of Public Administration (DMVS) should be composed of digital orthophotographs of the Czech Republic, digital and digitised cadastral maps, digital purpose cadastral map (ÚKM) and a technical map of municipality, if available. The DMVS project is a part of computerisation of public administration in the Czech Republic. The project enhances the productivity of government administration and also simplifies the processes between citizens and public administration. The DMVS project, that should be compliant with the INSPIRE (Infrastructure for Spatial Information in the European Community) initiative, generates definite demand for geodata on the level of detail of land data model. The user needs that are clearly specified and required are not met due to inconsistencies in terminology, data management and level of detail.

  8. Micro-computerised tomography optimisation for the measurement of bone mineral density around titanium dental implants

    International Nuclear Information System (INIS)

    Park, C.; Swain, M.; Duncan, W.

    2010-01-01

    Titanium dental implants (screws) are commonly used to replace missing teeth by forming a biological union with bone ('osseointegration'). Micro-computerised tomography (μCT) may be useful for measuring bone mineral density around dental implants. Major issues arise because of various artefacts that occur with polychromatic X-rays associated bench type instruments that may compromise interpretation of the observations. In this study various approaches to minimise artefacts such as; beam hardening, filtering and edge effects are explored with a homogeneous polymeric material, Teflon, with and without an implant present. The implications of the limitations of using such polychromatic μCT systems to quantify bone mineral density adjacent to the implant are discussed. (author)

  9. Principles for the development and implementation of the moira computerised system

    Energy Technology Data Exchange (ETDEWEB)

    Monte, L [ENEA, Centro Ricerche Casaccia, Rome (Italy). Dip. Ambiente; Brittain, J E [Oslo Univ. (Norway). LFI Zoological Museum

    1999-12-31

    The present report is composed of a set of articles written by the patterns of the MOIRA project (a model based computerized system for management support to identify optimal remedial strategies for restoring radionuclide contaminated aquatic ecosystems and drainage areas). The project aims to describe and analyse computerised methodologies for the identification of the countermeasures in fresh water systems contaminated by radioactive substances. The structure of the MOIRA software and the criteria for the objective evaluation of the ecological impact of the countermeasures applied to lakes (defined by the `Lake Ecosystem Index`, which is used in the Multi attribute Decision Analysis process developed for MOIRA) are described in detail. A preliminary classification of the countermeasures in relation to their potential effectiveness and feasibility and a classification of the main European species of fishes of radioecological importance are presented. The described methodologies have been applied to the Norwegian lake Heimdalsvatn to demonstrate the feasibility of the MOIRA system. Two further articles in the report describe the principles for the development of a model for predicting the radionuclide migration from urban areas to fresh water systems and the migration of radionuclides in rivers. [Italiano] Lo scopo del presente rapporto, composto da articoli preparati dai ricercatori che partecipano al progetto MOIRA (A MODEL BASED COMPUTERISED SYSTEM FOR MANAGEMENT SUPPORT TO IDENTIFY OPTIMAL REMEDIAL STRATEGIES FOR RESTORING RADIONUCLIDE CONTAMINATED AQUATIC ECOSYSTEMS AND DRAINAGE AREAS), e` la descrizione e l`analisi delle metodologie computerizzate che consentono l`identificazione di contromisure atte a ridurre i livelli di contaminazione radioattiva di sistemi acquatici continentali. In particolare vengono descritte la struttura del software MOIRA e i criteri per una valutazione oggettiva dell`impatto ecologico delle contromisure applicate a sistem,i lacustri

  10. TEM validation of immunohistochemical staining prior to assessment of tumour angiogenesis by computerised image analysis

    International Nuclear Information System (INIS)

    Killingsworth, M.C.

    2002-01-01

    Full text: Counts of microvessel density (MVD) within solid tumours have been shown to be an independent predictor of outcome with higher counts generally associated with a worse prognosis. These assessments are commonly performed on immunoperoxidase stained (IPX) sections with antibodies to CD34, CD31 and Factor VIII-related antigen routinely used as vascular markers. Tumour vascular density is thought to reflect the demand the growing neoplasm is placing on its feeding blood supply. Vascular density also appears to be associated with spread of invasive cells to distant sites. The present study of tumour angiogenesis in prostate cancer specimens aims to assess new vessel growth in addition to MVD counts. The hypothesis being that an assessment which takes into account vascular migration and proliferation as well as the number of patent vessels present may have improved predictive power over assessments based on MVD counts alone. We are employing anti-CD34 stained IPX sections which are digitally photographed and assessed by a computerised image analysis system. Our aim is to develop parameters whereby tumour angiogenesis may be assessed at the light microscopic level and then correlated with existing histological methods of tumour assessment such as Gleason grading. In order to use IPX stained sections for angiogenic assessment validation and understanding of the anti-CD34 immunostaining pattern was necessary. This involved the following steps: i) Morphological assessment of angiogenic changes present in tumour blood vessels. Morphological changes in endothelial cells and pericytes indicative of angiogenic activation are generally below the level of resolution available with light microscopy. TEM examination revealed endothelial cell budding, pericyte retraction, basement membrane duplication and endothelial sprout formation in capillaries and venules surrounding tumour glands. This information assisted with the development of parameters by which IPX sections

  11. Principles for the development and implementation of the moira computerised system

    Energy Technology Data Exchange (ETDEWEB)

    Monte, L. [ENEA, Centro Ricerche Casaccia, Rome (Italy). Dip. Ambiente; Brittain, J.E. [Oslo Univ. (Norway). LFI Zoological Museum

    1998-12-31

    The present report is composed of a set of articles written by the patterns of the MOIRA project (a model based computerized system for management support to identify optimal remedial strategies for restoring radionuclide contaminated aquatic ecosystems and drainage areas). The project aims to describe and analyse computerised methodologies for the identification of the countermeasures in fresh water systems contaminated by radioactive substances. The structure of the MOIRA software and the criteria for the objective evaluation of the ecological impact of the countermeasures applied to lakes (defined by the `Lake Ecosystem Index`, which is used in the Multi attribute Decision Analysis process developed for MOIRA) are described in detail. A preliminary classification of the countermeasures in relation to their potential effectiveness and feasibility and a classification of the main European species of fishes of radioecological importance are presented. The described methodologies have been applied to the Norwegian lake Heimdalsvatn to demonstrate the feasibility of the MOIRA system. Two further articles in the report describe the principles for the development of a model for predicting the radionuclide migration from urban areas to fresh water systems and the migration of radionuclides in rivers. [Italiano] Lo scopo del presente rapporto, composto da articoli preparati dai ricercatori che partecipano al progetto MOIRA (A MODEL BASED COMPUTERISED SYSTEM FOR MANAGEMENT SUPPORT TO IDENTIFY OPTIMAL REMEDIAL STRATEGIES FOR RESTORING RADIONUCLIDE CONTAMINATED AQUATIC ECOSYSTEMS AND DRAINAGE AREAS), e` la descrizione e l`analisi delle metodologie computerizzate che consentono l`identificazione di contromisure atte a ridurre i livelli di contaminazione radioattiva di sistemi acquatici continentali. In particolare vengono descritte la struttura del software MOIRA e i criteri per una valutazione oggettiva dell`impatto ecologico delle contromisure applicate a sistem,i lacustri

  12. Initial report of the cancer Patient-Reported Outcomes Measurement Information System (PROMIS) sexual function committee: review of sexual function measures and domains used in oncology.

    Science.gov (United States)

    Jeffery, Diana D; Tzeng, Janice P; Keefe, Francis J; Porter, Laura S; Hahn, Elizabeth A; Flynn, Kathryn E; Reeve, Bryce B; Weinfurt, Kevin P

    2009-03-15

    For this report, the authors described the initial activities of the Cancer Patient-Reported Outcomes Measurement Information System (PROMIS)-Sexual Function domain group, which is part of the National Institutes of Health Roadmap Initiative to develop brief questionnaires or individually tailored assessments of quality-of-life domains. Presented are a literature review of sexual function measures used in cancer populations and descriptions of the domains found in those measures. By using a consensus-driven approach, an electronic bibliographic search was conducted for articles that were published from 1991 to 2007, and 486 articles were identified for in-depth review. In total, 257 articles reported the administration of a psychometrically evaluated sexual function measure to individuals who were diagnosed with cancer. Apart from the University of California-Los Angeles Prostate Cancer Index, the International Index of Erectile Function, and the Female Sexual Function Index, the 31 identified measures have not been tested widely in cancer populations. Most measures were multidimensional and included domains related to the sexual response cycle and to general sexual satisfaction. The current review supports the need for a flexible, psychometrically robust measure of sexual function for use in oncology settings and strongly justifies the development of the PROMIS-Sexual Function instrument. When the PROMIS-Sexual Function instrument is available publicly, cancer clinicians and researchers will have another measure with which to assess patient-reported sexual function outcomes in addition to the few legacy measures that were identified through this review. Copyright (c) 2009 American Cancer Society.

  13. Computerised therapies for anxiety and depression in children and young people: a systematic review and meta-analysis.

    Science.gov (United States)

    Pennant, Mary E; Loucas, Christina E; Whittington, Craig; Creswell, Cathy; Fonagy, Peter; Fuggle, Peter; Kelvin, Raphael; Naqvi, Sabrina; Stockton, Sarah; Kendall, Tim

    2015-04-01

    One quarter of children and young people (CYP) experience anxiety and/or depression before adulthood, but treatment is sometimes unavailable or inadequate. Self-help interventions may have a role in augmenting treatment and this work aimed to systematically review the evidence for computerised anxiety and depression interventions in CYP aged 5-25 years old. Databases were searched for randomised controlled trials and 27 studies were identified. For young people (12-25 years) with risk of diagnosed anxiety disorders or depression, computerised CBT (cCBT) had positive effects for symptoms of anxiety (SMD -0.77, 95% CI -1.45 to -0.09, k = 6, N = 220) and depression (SMD -0.62, 95% CI -1.13 to -0.11, k = 7, N = 279). In a general population study of young people, there were small positive effects for anxiety (SMD -0.15, 95% CI -0.26 to -0.03; N = 1273) and depression (SMD -0.15, 95% CI -0.26 to -0.03; N = 1280). There was uncertainty around the effectiveness of cCBT in children (5-11 years). Evidence for other computerised interventions was sparse and inconclusive. Computerised CBT has potential for treating and preventing anxiety and depression in clinical and general populations of young people. Further program development and research is required to extend its use and establish its benefit in children. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Design, implementation and functional aspects of the control and instrumentation systems of computerised remote operated sludge lancing equipment

    International Nuclear Information System (INIS)

    Aparna, J.; Mehra, K.S.; Sharma, B.S.V.G.; Mohan, L.R.

    2005-01-01

    The computerised and remote operated sludge lancing equipment (SLE) uses high velocity narrow water jets for dislodging and removal of hard and strongly adhesive sludge from the secondary side tube sheet of mushroom type steam generators of Indian PHWRs. During the years of plant operation, corrosion products and other solids deposit in the form of sludge on the tube sheet of steam generators. The sludge formation not only affects adversely the steam generator performance but also diminishes its service life if left unchecked

  15. Rehabilitation of awareness of deficits in patients with traumatic brain injury applying a user-friendly computerised intervention approach

    LENUS (Irish Health Repository)

    Morgan, Dr Jacinta

    2010-01-01

    Objective : Awareness of errors is an important prerequisite in rehabilitation. Few studies have investigated rehabilitation of error awareness following acquired brain injury. Pilot research has shown that receiving feedback about errors during a computerised task of sustained attention improves performance in patients who have sustained a traumatic brain injury. In this study, a computer-based intervention training programme aimed at improving error awareness was developed. \\r\

  16. The design, construction and implementation of a computerised trauma registry in a developing South African metropolitan trauma service.

    Science.gov (United States)

    Laing, G L; Bruce, J L; Aldous, C; Clarke, D L

    2014-01-01

    The Pietermaritzburg Metropolitan Trauma Service formerly lacked a robust computerised trauma registry. This made surgical audit difficult for the purpose of quality of care improvement and development. We aimed to design, construct and implement a computerised trauma registry within our service. Twelve months following its implementation, we sought to examine and report on the quality of the registry. Formal ethical approval to maintain a computerised trauma registry was obtained prior to undertaking any design and development. Appropriate commercial software was sourced to develop this project. The registry was designed as a flat file. A flat file is a plain text or mixed text and binary file which usually contains one record per line or physical record. Thereafter the registry file was launched onto a secure server. This provided the benefits of access security and automated backups. Registry training was provided to clients by the developer. The exercise of data capture was then integrated into the process of service delivery, taking place at the endpoint of patient care (discharge, transfer or death). Twelve months following its implementation, the compliance rates of data entry were measured. The developer of this project managed to design, construct and implement an electronic trauma registry into the service. Twelve months following its implementation the data were extracted and audited to assess the quality. A total of 2640 patient entries were captured onto the registry. Compliance rates were in the order of eighty percent and client satisfaction rates were high. A number of deficits were identified. These included the omission of weekend discharges and underreporting of deaths. The construction and implementation of the computerised trauma registry was the beginning of an endeavour to continue improvements in the quality of care within our service. The registry provided a reliable audit at twelve months post implementation. Deficits and limitations were

  17. The impact of integrated prevention and treatment on child malnutrition and health: the PROMIS project, a randomized control trial in Burkina Faso and Mali.

    Science.gov (United States)

    Huybregts, Lieven; Becquey, Elodie; Zongrone, Amanda; Le Port, Agnes; Khassanova, Regina; Coulibaly, Lazare; Leroy, Jef L; Rawat, Rahul; Ruel, Marie T

    2017-03-09

    Evidence suggests that both preventive and curative nutrition interventions are needed to tackle child acute malnutrition (AM) in developing countries. In addition to reducing the incidence of AM, providing preventive interventions may also help increase attendance (and coverage) of AM screening, a major constraint in the community-based management of child acute malnutrition (CMAM) model. There is a paucity of evidence-based strategies to deliver integrated preventive and curative interventions effectively and affordably at scale. The aim of the Innovative Approaches for the Prevention of Childhood Malnutrition (PROMIS) study is to assess the feasibility, quality of implementation, effectiveness and cost-effectiveness of an integrated child malnutrition prevention and treatment intervention package implemented through a community-based platform in Mali and a facility-based platform in Burkina Faso. The PROMIS intervention entails a comprehensive preventive package offered on a monthly basis to caregivers of children, while children are screened for acute malnutrition (AM). The package consists of behavior change communication on essential nutrition and hygiene actions, and monthly preventive doses of small quantity lipid-based nutrient supplements (SQ-LNS) for children aged 6 to 23.9 months. Positive AM cases are referred to treatment services offered by first-line health services according to the CMAM model. The PROMIS intervention will be evaluated using a mixed methods approach. The impact study encompasses two types of study design: i) repeated cross-sectional surveys conducted at baseline and at endline after 24 months of program implementation and ii) a longitudinal study with a monthly follow-up for 18 months. Primary study impact measures include the incidence and endpoint prevalence of AM, AM screening coverage and treatment compliance. A process evaluation will assess the feasibility and quality of implementation of the intervention guided by country

  18. The impact of integrated prevention and treatment on child malnutrition and health: the PROMIS project, a randomized control trial in Burkina Faso and Mali

    Directory of Open Access Journals (Sweden)

    Lieven Huybregts

    2017-03-01

    Full Text Available Abstract Background Evidence suggests that both preventive and curative nutrition interventions are needed to tackle child acute malnutrition (AM in developing countries. In addition to reducing the incidence of AM, providing preventive interventions may also help increase attendance (and coverage of AM screening, a major constraint in the community-based management of child acute malnutrition (CMAM model. There is a paucity of evidence-based strategies to deliver integrated preventive and curative interventions effectively and affordably at scale. The aim of the Innovative Approaches for the Prevention of Childhood Malnutrition (PROMIS study is to assess the feasibility, quality of implementation, effectiveness and cost-effectiveness of an integrated child malnutrition prevention and treatment intervention package implemented through a community-based platform in Mali and a facility-based platform in Burkina Faso. Methods/Design The PROMIS intervention entails a comprehensive preventive package offered on a monthly basis to caregivers of children, while children are screened for acute malnutrition (AM. The package consists of behavior change communication on essential nutrition and hygiene actions, and monthly preventive doses of small quantity lipid-based nutrient supplements (SQ-LNS for children aged 6 to 23.9 months. Positive AM cases are referred to treatment services offered by first-line health services according to the CMAM model. The PROMIS intervention will be evaluated using a mixed methods approach. The impact study encompasses two types of study design: i repeated cross-sectional surveys conducted at baseline and at endline after 24 months of program implementation and ii a longitudinal study with a monthly follow-up for 18 months. Primary study impact measures include the incidence and endpoint prevalence of AM, AM screening coverage and treatment compliance. A process evaluation will assess the feasibility and quality of

  19. Epidemiological study of brucellosis in eight Greek villages using a Computerised Mapping Programme

    International Nuclear Information System (INIS)

    Hadjichristodoulou, Ch.; Papatheodorou, Ch.; Soteriades, E.; Panagakos, G.; Kastritis, I.; Goutziana, G.; Charvalos, E.; Tselentis, Y.

    1999-01-01

    A Computerised Mapping Programme (CMP) was created step by step to cover all the needs of a cross sectional population survey conducted in eight villages of Fokida, a rural area of central Greece. The maps of Greece (boundary) and the topographical maps of the eight villages were created using the CMP. A volunteer sample of 1121 out of 2607 inhabitants of the study area participated in the population survey. The participants were tested for brucellosis using serological tests (ELISA and Rose Bengal) and the intradermal reaction test. A questionnaire was used to obtain information concerning the risk factors for brucellosis. The risk factors found through statistical analysis were occupation (RR: 5.81, p < 0.00001), consumption of raw milk (RR: 1.98, p < 0.001) and unpasteurized fresh cheese (RR: 2.13, p < 0.01). The same factors were indicated by the CMP. The CMP also indicated manure-contaminated playgrounds in residential yards as a potential risk factor for children. The origin and dissemination were delineated using time-space association display. The CMP proved to be a useful tool in this epidemiological study

  20. Computerised Analysis of Telemonitored Respiratory Sounds for Predicting Acute Exacerbations of COPD.

    Science.gov (United States)

    Fernandez-Granero, Miguel Angel; Sanchez-Morillo, Daniel; Leon-Jimenez, Antonio

    2015-10-23

    Chronic obstructive pulmonary disease (COPD) is one of the commonest causes of death in the world and poses a substantial burden on healthcare systems and patients' quality of life. The largest component of the related healthcare costs is attributable to admissions due to acute exacerbation (AECOPD). The evidence that might support the effectiveness of the telemonitoring interventions in COPD is limited partially due to the lack of useful predictors for the early detection of AECOPD. Electronic stethoscopes and computerised analyses of respiratory sounds (CARS) techniques provide an opportunity for substantial improvement in the management of respiratory diseases. This exploratory study aimed to evaluate the feasibility of using: (a) a respiratory sensor embedded in a self-tailored housing for ageing users; (b) a telehealth framework; (c) CARS and (d) machine learning techniques for the remote early detection of the AECOPD. In a 6-month pilot study, 16 patients with COPD were equipped with a home base-station and a sensor to daily record their respiratory sounds. Principal component analysis (PCA) and a support vector machine (SVM) classifier was designed to predict AECOPD. 75.8% exacerbations were early detected with an average of 5 ± 1.9 days in advance at medical attention. The proposed method could provide support to patients, physicians and healthcare systems.

  1. Development and impact of computerised decision support systems for clinical management of depression: A systematic review.

    Science.gov (United States)

    Triñanes, Yolanda; Atienza, Gerardo; Louro-González, Arturo; de-las-Heras-Liñero, Elena; Alvarez-Ariza, María; Palao, Diego J

    2015-01-01

    One of the proposals for improving clinical practice is to introduce computerised decision support systems (CDSS) and integrate these with electronic medical records. Accordingly, this study sought to systematically review evidence on the effectiveness of CDSS in the management of depression. A search was performed in Medline, EMBASE and PsycInfo, in order to do this. The quality of quantitative studies was assessed using the SIGN method, and qualitative studies using the CASPe checklist. Seven studies were identified (3 randomised clinical trials, 3 non-randomised trials, and one qualitative study). The CDSS assessed incorporated content drawn from guidelines and other evidence-based products. In general, the CDSS had a positive impact on different aspects, such as the screening and diagnosis, treatment, improvement in depressive symptoms and quality of life, and referral of patients. The use of CDSS could thus serve to optimise care of depression in various scenarios by providing recommendations based on the best evidence available and facilitating decision-making in clinical practice. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

  2. Computerised Analysis of Telemonitored Respiratory Sounds for Predicting Acute Exacerbations of COPD

    Directory of Open Access Journals (Sweden)

    Miguel Angel Fernandez-Granero

    2015-10-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is one of the commonest causes of death in the world and poses a substantial burden on healthcare systems and patients’ quality of life. The largest component of the related healthcare costs is attributable to admissions due to acute exacerbation (AECOPD. The evidence that might support the effectiveness of the telemonitoring interventions in COPD is limited partially due to the lack of useful predictors for the early detection of AECOPD. Electronic stethoscopes and computerised analyses of respiratory sounds (CARS techniques provide an opportunity for substantial improvement in the management of respiratory diseases. This exploratory study aimed to evaluate the feasibility of using: (a a respiratory sensor embedded in a self-tailored housing for ageing users; (b a telehealth framework; (c CARS and (d machine learning techniques for the remote early detection of the AECOPD. In a 6-month pilot study, 16 patients with COPD were equipped with a home base-station and a sensor to daily record their respiratory sounds. Principal component analysis (PCA and a support vector machine (SVM classifier was designed to predict AECOPD. 75.8% exacerbations were early detected with an average of 5 ± 1.9 days in advance at medical attention. The proposed method could provide support to patients, physicians and healthcare systems.

  3. Diagnostic ranking of computerised tomography in mediastinal diseases depending on their localisation

    Energy Technology Data Exchange (ETDEWEB)

    Sommer, B.; Doppman, J.L.; Mayr, B.; Rienmueller, R.; Lissner, J.; Stelter, W.

    1981-04-01

    The diagnostic ranking and importance of computerised tomography was examined in 116 with abnormal findings in the mediastinal region, and was compared with conventional, non-invasive X-ray examinations. This method also yielded significant CT-specific additional information in the anterior mediastinum in 74.4% of the cases, in the mesomediastinum in 69.1%, in the posterior mediastinum in 79.2% in the upper thoracic aperture in 94.4% and in the paracardial region in 100% of the cases. The hilar region is an exception; in 68.8% of the cases, both methods were rated equal, whereas in 28.1% of the cases assessment via the CT method was even inferior. The specific additional information furnshed by the CT method justifies a wider application of CT in solving the following problems concerning the mediastinum: Clarification of a suspected but not yet established space-occupying growth in the mediastinum, before using invasive diagnostic methods such as mediastinoscopy and angiography; staging of an already identified primary mediastinal tumor or malignant lymphoma; in case of suspected changes in the large mediastinal vessels before employing angiography; on-target in the following diseases: bronchogenic carcinoma (because of improved pretherapeutic staging according to the TNM system), myasthenia gravis and identification of thymoma, hyperparathyroidism with suspected dystopic parathyroid glands.

  4. The diagnostic ranking of computerised tomography in mediastinal diseases depending on their localisation

    International Nuclear Information System (INIS)

    Sommer, B.; Doppman, J.L.; Mayr, B.; Rienmueller, R.; Lissner, J.; Stelter, W.

    1981-01-01

    The diagnostic ranking and importance of computerised tomography was examined in 116 with abnormal findings in the mediastinal region, and was compared with conventional, non-invasive X-ray examinations. This method also yielded significant CT-specific additional information in the anterior mediastinum in 74.4% of the cases, in the mesomediastinum in 69.1%, in the posterior mediastinum in 79.2% in the upper thoracic aperture in 94.4% and in the paracardial region in 100% of the cases. The hilar region is an exception; in 68.8% of the cases, both methods were rated equal, whereas in 28.1% of the cases assessment via the CT method was even inferior. The specific additional information furnshed by the CT method justifies a wider application of CT in solving the following problems concerning the mediastinum: Clarification of a suspected but not yet established space-occupying growth in the mediastinum, before using invasive diagnostic methods such as mediastinoscopy and angiography; staging of an already identified primary mediastinal tumor or malignant lymphoma; in case of suspected changes in the large mediastinal vessels before employing angiography; on-target in the following diseases: bronchogenic carcinoma (because of improved pretherapeutic staging according to the TNM system), myasthenia gravis and identification of thymoma, hyperparathyroidism with suspected dystopic parathyroid glands. (orig.) [de

  5. Colonoscopy and computerised tomography scan are not sufficient to localise right sided colonic lesions accurately.

    LENUS (Irish Health Repository)

    Solon, Jacqueline Gemma

    2009-11-23

    : Aim: accurate pre-operative localisation of colonic lesions is critical especially in laparoscopic colectomy where tactile localisation is absent particularly in screen-detected tumours. The study aimed to evaluate the accuracy of colonoscopy and double-contrast computerised tomography (CT) to localise lesions treated by right hemicolectomy. Method: a retrospective chart review was performed of patients treated by right hemicolectomy under the colorectal service between July 2003 and October 2006. Pre-operative tumour location determined by CT scan and colonoscopy were compared with the intra-operative and histopathologic findings. Results: of 101 patients, 73 (73%) were for adenoma or cancer, with a final diagnosis of adenocarcinoma in 59 (59%). Pre-operative localisation was inaccurate in 29% of lesions using both CT and colonoscopy. In the transverse colon colonoscopy alone was only 37.5% accurate, increasing to 62.5% when information from the CT scan was added. Conclusion: pre-operative localisation of right-sided colon cancers using colonoscopy and CT scanning is unreliable in at least 29% of cases. Inaccurate localisation of transverse colon tumours risks inadequate lymphadenectomy with an adverse cancer outcome. Pre-operative abdominal CT scan improves accuracy but endoscopic tattoo localisation should be employed routinely especially in patients undergoing laparoscopic resection.

  6. Development of the PROMIS positive emotional and sensory expectancies of smoking item banks.

    Science.gov (United States)

    Tucker, Joan S; Shadel, William G; Edelen, Maria Orlando; Stucky, Brian D; Li, Zhen; Hansen, Mark; Cai, Li

    2014-09-01

    The positive emotional and sensory expectancies of cigarette smoking include improved cognitive abilities, positive affective states, and pleasurable sensorimotor sensations. This paper describes development of Positive Emotional and Sensory Expectancies of Smoking item banks that will serve to standardize the assessment of this construct among daily and nondaily cigarette smokers. Data came from daily (N = 4,201) and nondaily (N =1,183) smokers who completed an online survey. To identify a unidimensional set of items, we conducted item factor analyses, item response theory analyses, and differential item functioning analyses. Additionally, we evaluated the performance of fixed-item short forms (SFs) and computer adaptive tests (CATs) to efficiently assess the construct. Eighteen items were included in the item banks (15 common across daily and nondaily smokers, 1 unique to daily, 2 unique to nondaily). The item banks are strongly unidimensional, highly reliable (reliability = 0.95 for both), and perform similarly across gender, age, and race/ethnicity groups. A SF common to daily and nondaily smokers consists of 6 items (reliability = 0.86). Results from simulated CATs indicated that, on average, less than 8 items are needed to assess the construct with adequate precision using the item banks. These analyses identified a new set of items that can assess the positive emotional and sensory expectancies of smoking in a reliable and standardized manner. Considerable efficiency in assessing this construct can be achieved by using the item bank SF, employing computer adaptive tests, or selecting subsets of items tailored to specific research or clinical purposes. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Assessment of the psychometrics of a PROMIS item bank: self-efficacy for managing daily activities.

    Science.gov (United States)

    Hong, Ickpyo; Velozo, Craig A; Li, Chih-Ying; Romero, Sergio; Gruber-Baldini, Ann L; Shulman, Lisa M

    2016-09-01

    The aim of this study is to investigate the psychometrics of the Patient-Reported Outcomes Measurement Information System self-efficacy for managing daily activities item bank. The item pool was field tested on a sample of 1087 participants via internet (n = 250) and in-clinic (n = 837) surveys. All participants reported having at least one chronic health condition. The 35 item pool was investigated for dimensionality (confirmatory factor analyses, CFA and exploratory factor analysis, EFA), item-total correlations, local independence, precision, and differential item functioning (DIF) across gender, race, ethnicity, age groups, data collection modes, and neurological chronic conditions (McFadden Pseudo R (2) less than 10 %). The item pool met two of the four CFA fit criteria (CFI = 0.952 and SRMR = 0.07). EFA analysis found a dominant first factor (eigenvalue = 24.34) and the ratio of first to second eigenvalue was 12.4. The item pool demonstrated good item-total correlations (0.59-0.85) and acceptable internal consistency (Cronbach's alpha = 0.97). The item pool maintained its precision (reliability over 0.90) across a wide range of theta (3.70), and there was no significant DIF. The findings indicated the item pool has sound psychometric properties and the test items are eligible for development of computerized adaptive testing and short forms.

  8. MOIRA: a computerised decision support system for the restoration of radionuclide contaminated freshwater ecosystems

    International Nuclear Information System (INIS)

    Gallego, Eduardo; Brittain, J.E.; Hakanson, Lars; Heling, Rudie; Hofman, Dmitry; Monte, Luigi

    2000-01-01

    The radiation dose resulting from contamination of freshwater ecosystems due to the release of radioactive substances into the environment may be reduced by applying suitable countermeasures. The options for intervention are wide-ranging and can be broadly grouped into three main categories: chemical, physical and social countermeasures. In some cases, a combination of actions -or even the no action- may be the optimal strategy. Despite their benefits, intervention strategies may have detrimental effects of economic, ecological and social nature. Thus, it is of paramount importance to assess, by objective criteria, the global cost-benefit balance of different options. The MOIRA project (A MOdel based computerised system for management support to Identity optimal remedial strategies for Restoring radionuclide contaminated Aquatic ecosystems, European Commission contract FI4P-CT96-0036) has developed a user-friendly, computerised tool that will allow decision makers to choose optimal intervention strategies for freshwater ecosystems with different contamination scenarios. To achieve that goal, the MOIRA software system -apart from a user-friendly interface- incorporates several innovative aspects: - eographical information system (GIS) and databases to get to get the values of the model parameters at different locations in Europe. - redictive ecosystem models for the behaviour of radionuclides (namely Cs-137 and Sr-90) in catchments, lakes and rivers, complemented with models of the effect of the countermeasures on the environmental contamination levels. These models are based on an extensive use of aggregate parameters' that summarise, in single quantities, the effects of a variety of environmental processes. Methods for critical model testing, sensitivity and uncertainty analyses have been applied to them getting a high reliability. - cosystem index (EI) to handle the influence chemical remedial measures may have on the structure, reproduction and biomass of key

  9. The effectiveness of computerised decision support on antibiotic use in hospitals: A systematic review

    Science.gov (United States)

    2017-01-01

    Background Inappropriate antimicrobial use has been shown to be an important determinant of the emergence of antimicrobial resistance (AMR). Health information technology (HIT) in the form of Computerised Decision Support (CDS) represents an option for improving antimicrobial prescribing and containing AMR. Objectives To evaluate the evidence for CDS in improving quantitative and qualitative measures of antibiotic prescribing in inpatient hospital settings. Methods A systematic literature search was conducted of articles published from inception to 20th December 2014 using eight electronic databases: MEDLINE, EMBASE, PUBMED, Web of Science, CINAHL, Cochrane Library, HMIC and PsychINFo. An updated systematic literature search was conducted from January 1st 2015 to October 1st 2016 using PUBMED. The search strategy used combinations of the following terms: (electronic prescribing) OR (clinical decision support) AND (antibiotic or antibacterial or antimicrobial) AND (hospital or secondary care or inpatient). Studies were evaluated for quality using a 10-point rating scale. Results Eighty-one studies were identified matching the inclusion criteria. Seven outcome measures were evaluated: adequacy of antibiotic coverage, mortality, volume of antibiotic usage, length of stay, antibiotic cost, compliance with guidelines, antimicrobial resistance, and CDS implementation and uptake. Meta-analysis of pooled outcomes showed CDS significantly improved the adequacy of antibiotic coverage (n = 13; odds ratio [OR], 2.11 [95% CI, 1.67 to 2.66, p ≤ 0.00001]). Also, CDS was associated with marginally lowered mortality (n = 20; OR, 0.85 [CI, 0.75 to 0.96, p = 0.01]). CDS was associated with lower antibiotic utilisation, increased compliance with antibiotic guidelines and reductions in antimicrobial resistance. Conflicting effects of CDS on length of stay, antibiotic costs and system uptake were also noted. Conclusions CDS has the potential to improve the adequacy of antibiotic

  10. A comparison of scoring models for computerised mental health screening for federal prison inmates.

    Science.gov (United States)

    Martin, Michael S; Wamboldt, Ashley D; O'Connor, Shannon L; Fortier, Julie; Simpson, Alexander I F

    2013-02-01

    There are high rates of mental disorder in correctional environments, so effective mental health screening is needed. Implementation of the computerised mental health screen of the Correctional Service of Canada has led to improved identification of offenders with mental health needs but with high rates of false positives. The goal of this study is to evaluate the use of an iterative classification tree (ICT) approach to mental health screening compared with a simple binary approach using cut-off scores on screening tools. A total of 504 consecutive admissions to federal prison completed the screen and were also interviewed by a mental health professional. Relationships between screening results and more extended assessment and clinical team discussion were tested. The ICT was more parsimonious in identifying probable 'cases' than standard binary screening. ICT was also highly accurate at detecting mental health needs (AUC=0.87, 95% CI 0.84-0.90). The model identified 118 (23.4%) offenders as likely to need further assessment or treatment, 87% of whom were confirmed cases at clinical interview. Of the 244 (48.4%) offenders who were screened out, only 9% were clinically assessed as requiring further assessment or treatment. Standard binary screening was characterised by more false positives and a comparable false negative rate. The use of ICTs to interpret screening data on the mental health of prisoners needs further evaluation in independent samples in Canada and elsewhere. This first evaluation of the application of such an approach offers the prospect of more effective and efficient use of the scarce resource of mental health services in prisons. Although not required, the use of computers can increase the ease of implementing an ICT model. Copyright © 2013 John Wiley & Sons, Ltd.

  11. Mortality Benefits of Antibiotic Computerised Decision Support System: Modifying Effects of Age

    Science.gov (United States)

    Chow, Angela L. P.; Lye, David C.; Arah, Onyebuchi A.

    2015-11-01

    Antibiotic computerised decision support systems (CDSSs) are shown to improve antibiotic prescribing, but evidence of beneficial patient outcomes is limited. We conducted a prospective cohort study in a 1500-bed tertiary-care hospital in Singapore, to evaluate the effectiveness of the hospital’s antibiotic CDSS on patients’ clinical outcomes, and the modification of these effects by patient factors. To account for clustering, we used multilevel logistic regression models. One-quarter of 1886 eligible inpatients received CDSS-recommended antibiotics. Receipt of antibiotics according to CDSS’s recommendations seemed to halve mortality risk of patients (OR 0.54, 95% CI 0.26-1.10, P = 0.09). Patients aged ≤65 years had greater mortality benefit (OR 0.45, 95% CI 0.20-1.00, P = 0.05) than patients that were older than 65 (OR 1.28, 95% CI 0.91-1.82, P = 0.16). No effect was observed on incidence of Clostridium difficile (OR 1.02, 95% CI 0.34-3.01), and multidrug-resistant organism (OR 1.06, 95% CI 0.42-2.71) infections. No increase in infection-related readmission (OR 1.16, 95% CI 0.48-2.79) was found in survivors. Receipt of CDSS-recommended antibiotics reduced mortality risk in patients aged 65 years or younger and did not increase the risk in older patients. Physicians should be informed of the benefits to increase their acceptance of CDSS recommendations.

  12. Targeted computerised tomography scanning of the ankle syndesmosis with low dose radiation exposure

    Energy Technology Data Exchange (ETDEWEB)

    Kotwal, Rahul [Princess of Wales Hospital, Bridgend (United Kingdom); Rath, Narendra [Royal Gwent Hospital, Newport (United Kingdom); Paringe, Vishal; Hemmadi, Sandeep; Thomas, Rhys; Lyons, Kath [University Hospital of Wales, Cardiff (United Kingdom)

    2016-03-15

    To devise a new protocol for targeted CT scanning of the distal tibiofibular syndesmosis with minimal radiation exposure to patients. We also aimed to correlate the reduction of the syndesmosis as seen on CT scans with the functional outcome of patients. Prospective study. Forty adults undergoing surgical stabilisation of an acute distal tibiofibular syndesmosis injury were recruited. A targeted five-cut computerised tomography scan protocol was developed. The radiation exposure to the patient with this protocol was only 0.002 mSv. Scans were performed 12 weeks after surgery. The contralateral ankle of every patient was used as a control to determine the accuracy of the reduction of the syndesmosis for that individual patient. American Orthopaedic Foot and Ankle Society (AOFAS) scores were obtained at a minimum of 1 year after surgery. After considering the exclusions, 36 patients formed the study group. A wide variation was observed in the anatomy of the normal syndesmosis. If we considered a difference of more than 2 mm between the normal and injured syndesmosis relationship as significant, 15 (41.6 %) of our patients had a significant difference between the injured and normal sides. AOFAS scores were available for 13 of these patients and were good to excellent in 11(84.6 %). Our study describes a reliable new CT scanning technique for the distal tibiofibular syndesmosis using only five cuts and a low-radiation-dose protocol. Clinical correlation of the findings on the scan with functional outcomes suggests that routine post-operative CT of the syndesmosis is probably not justified. (orig.)

  13. The effectiveness of computerised decision support on antibiotic use in hospitals: A systematic review.

    Directory of Open Access Journals (Sweden)

    Christopher E Curtis

    Full Text Available Inappropriate antimicrobial use has been shown to be an important determinant of the emergence of antimicrobial resistance (AMR. Health information technology (HIT in the form of Computerised Decision Support (CDS represents an option for improving antimicrobial prescribing and containing AMR.To evaluate the evidence for CDS in improving quantitative and qualitative measures of antibiotic prescribing in inpatient hospital settings.A systematic literature search was conducted of articles published from inception to 20th December 2014 using eight electronic databases: MEDLINE, EMBASE, PUBMED, Web of Science, CINAHL, Cochrane Library, HMIC and PsychINFo. An updated systematic literature search was conducted from January 1st 2015 to October 1st 2016 using PUBMED. The search strategy used combinations of the following terms: (electronic prescribing OR (clinical decision support AND (antibiotic or antibacterial or antimicrobial AND (hospital or secondary care or inpatient. Studies were evaluated for quality using a 10-point rating scale.Eighty-one studies were identified matching the inclusion criteria. Seven outcome measures were evaluated: adequacy of antibiotic coverage, mortality, volume of antibiotic usage, length of stay, antibiotic cost, compliance with guidelines, antimicrobial resistance, and CDS implementation and uptake. Meta-analysis of pooled outcomes showed CDS significantly improved the adequacy of antibiotic coverage (n = 13; odds ratio [OR], 2.11 [95% CI, 1.67 to 2.66, p ≤ 0.00001]. Also, CDS was associated with marginally lowered mortality (n = 20; OR, 0.85 [CI, 0.75 to 0.96, p = 0.01]. CDS was associated with lower antibiotic utilisation, increased compliance with antibiotic guidelines and reductions in antimicrobial resistance. Conflicting effects of CDS on length of stay, antibiotic costs and system uptake were also noted.CDS has the potential to improve the adequacy of antibiotic coverage and marginally decrease mortality in

  14. Targeted computerised tomography scanning of the ankle syndesmosis with low dose radiation exposure

    International Nuclear Information System (INIS)

    Kotwal, Rahul; Rath, Narendra; Paringe, Vishal; Hemmadi, Sandeep; Thomas, Rhys; Lyons, Kath

    2016-01-01

    To devise a new protocol for targeted CT scanning of the distal tibiofibular syndesmosis with minimal radiation exposure to patients. We also aimed to correlate the reduction of the syndesmosis as seen on CT scans with the functional outcome of patients. Prospective study. Forty adults undergoing surgical stabilisation of an acute distal tibiofibular syndesmosis injury were recruited. A targeted five-cut computerised tomography scan protocol was developed. The radiation exposure to the patient with this protocol was only 0.002 mSv. Scans were performed 12 weeks after surgery. The contralateral ankle of every patient was used as a control to determine the accuracy of the reduction of the syndesmosis for that individual patient. American Orthopaedic Foot and Ankle Society (AOFAS) scores were obtained at a minimum of 1 year after surgery. After considering the exclusions, 36 patients formed the study group. A wide variation was observed in the anatomy of the normal syndesmosis. If we considered a difference of more than 2 mm between the normal and injured syndesmosis relationship as significant, 15 (41.6 %) of our patients had a significant difference between the injured and normal sides. AOFAS scores were available for 13 of these patients and were good to excellent in 11(84.6 %). Our study describes a reliable new CT scanning technique for the distal tibiofibular syndesmosis using only five cuts and a low-radiation-dose protocol. Clinical correlation of the findings on the scan with functional outcomes suggests that routine post-operative CT of the syndesmosis is probably not justified. (orig.)

  15. Ethnicity Recording in Primary Care Computerised Medical Record Systems: An Ontological Approach

    Directory of Open Access Journals (Sweden)

    Zayd Tippu

    2017-03-01

    Full Text Available Background Ethnicity recording within primary care computerised medical record (CMR systems is suboptimal, exacerbated by tangled taxonomies within current coding systems. Objective To develop a method for extending ethnicity identification using routinely collected data. Methods We used an ontological method to maximise the reliability and prevalence of ethnicity information in the Royal College of General Practitioner’s Research and Surveillance database. Clinical codes were either directly mapped to ethnicity group or utilised as proxy markers (such as language spoken from which ethnicity could be inferred. We compared the performance of our method with the recording rates that would be identified by code lists utilised by the UK pay for the performance system, with the help of the Quality and Outcomes Framework (QOF. Results Data from 2,059,453 patients across 110 practices were included. The overall categorisable ethnicity using QOF codes was 36.26% (95% confidence interval (CI: 36.20%–36.33%. This rose to 48.57% (CI:48.50%–48.64% using the described ethnicity mapping process. Mapping increased across all ethnic groups. The largest increase was seen in the white ethnicity category (30.61%; CI: 30.55%–30.67% to 40.24%; CI: 40.17%–40.30%. The highest relative increase was in the ethnic group categorised as the other (0.04%; CI: 0.03%–0.04% to 0.92%; CI: 0.91%–0.93%. Conclusions This mapping method substantially increases the prevalence of known ethnicity in CMR data and may aid future epidemiological research based on routine data.

  16. The computerisation of Australian general practice 1998_2001 - what did we get for AU$15 000 000?

    Directory of Open Access Journals (Sweden)

    Michael Kidd

    2002-03-01

    Full Text Available In 1998 the Commonwealth government provided AU$15 000 000 towards a three-year project to support the computerisation of Australian general practice. This initiative was carried forward by the peak national body for information technology in general practice, the General Practice Computing Group (GPCG. This paper describes the activities of the GPCG, how this money was spent, and includes the evaluation of this three-year project which has resulted in computers on the desktops of the majority of Australia's GPs.

  17. Developing the Coach Analysis and Intervention System (CAIS): establishing validity and reliability of a computerised systematic observation instrument.

    Science.gov (United States)

    Cushion, Christopher; Harvey, Stephen; Muir, Bob; Nelson, Lee

    2012-01-01

    We outline the evolution of a computerised systematic observation tool and describe the process for establishing the validity and reliability of this new instrument. The Coach Analysis and Interventions System (CAIS) has 23 primary behaviours related to physical behaviour, feedback/reinforcement, instruction, verbal/non-verbal, questioning and management. The instrument also analyses secondary coach behaviour related to performance states, recipient, timing, content and questioning/silence. The CAIS is a multi-dimensional and multi-level mechanism able to provide detailed and contextualised data about specific coaching behaviours occurring in complex and nuanced coaching interventions and environments that can be applied to both practice sessions and competition.

  18. Kristološki naglasci govora o Božjem milosrđu u promišljanjima izabranih crkvenih otaca

    OpenAIRE

    Filić, Andrea

    2017-01-01

    Polazišno pitanje ovoga članka, nadahnuto tvrdnjama Waltera Kaspera, glasi: Ako milosrđe po definiciji u sebi nužno uključuje trpljenje može li se, dok držimo sigurnim da je netrpljivost jedna od bitnih vlastitosti božanske naravi, o njemu uopće govoriti, kako Kasper potiče, kao o temeljnom Božjem svojstvu i odrednici Božje biti? To se pitanje i odgovor na nj obrađuje pod kristološkim vidom i to na temelju promišljanja izabranih crkvenih otaca u čijim djelima pronalazimo govor o Božjem milosr...

  19. Dutch translation and cross-cultural adaptation of the PROMIS® physical function item bank and cognitive pre-test in Dutch arthritis patients.

    Science.gov (United States)

    Oude Voshaar, Martijn Ah; Ten Klooster, Peter M; Taal, Erik; Krishnan, Eswar; van de Laar, Mart Afj

    2012-03-05

    Patient-reported physical function is an established outcome domain in clinical studies in rheumatology. To overcome the limitations of the current generation of questionnaires, the Patient-Reported Outcomes Measurement Information System (PROMIS®) project in the USA has developed calibrated item banks for measuring several domains of health status in people with a wide range of chronic diseases. The aim of this study was to translate and cross-culturally adapt the PROMIS physical function item bank to the Dutch language and to pretest it in a sample of patients with arthritis. The items of the PROMIS physical function item bank were translated using rigorous forward-backward protocols and the translated version was subsequently cognitively pretested in a sample of Dutch patients with rheumatoid arthritis. Few issues were encountered in the forward-backward translation. Only 5 of the 124 items to be translated had to be rewritten because of culturally inappropriate content. Subsequent pretesting showed that overall, questions of the Dutch version were understood as they were intended, while only one item required rewriting. Results suggest that the translated version of the PROMIS physical function item bank is semantically and conceptually equivalent to the original. Future work will be directed at creating a Dutch-Flemish final version of the item bank to be used in research with Dutch speaking populations.

  20. Evaluating measurement invariance across assessment modes of phone interview and computer self-administered survey for the PROMIS measures in a population-based cohort of localized prostate cancer survivors.

    Science.gov (United States)

    Wang, Mian; Chen, Ronald C; Usinger, Deborah S; Reeve, Bryce B

    2017-11-01

    To evaluate measurement invariance (phone interview vs computer self-administered survey) of 15 PROMIS measures responded by a population-based cohort of localized prostate cancer survivors. Participants were part of the North Carolina Prostate Cancer Comparative Effectiveness and Survivorship Study. Out of the 952 men who took the phone interview at 24 months post-treatment, 401 of them also completed the same survey online using a home computer. Unidimensionality of the PROMIS measures was examined using single-factor confirmatory factor analysis (CFA) models. Measurement invariance testing was conducted using longitudinal CFA via a model comparison approach. For strongly or partially strongly invariant measures, changes in the latent factors and factor autocorrelations were also estimated and tested. Six measures (sleep disturbance, sleep-related impairment, diarrhea, illness impact-negative, illness impact-positive, and global satisfaction with sex life) had locally dependent items, and therefore model modifications had to be made on these domains prior to measurement invariance testing. Overall, seven measures achieved strong invariance (all items had equal loadings and thresholds), and four measures achieved partial strong invariance (each measure had one item with unequal loadings and thresholds). Three measures (pain interference, interest in sexual activity, and global satisfaction with sex life) failed to establish configural invariance due to between-mode differences in factor patterns. This study supports the use of phone-based live interviewers in lieu of PC-based assessment (when needed) for many of the PROMIS measures.

  1. A computerised out-patient medical records programme based on the Summary Time-Oriented Record (STOR) System.

    Science.gov (United States)

    Cheong, P Y; Goh, L G; Ong, R; Wong, P K

    1992-12-01

    Advances in microcomputer hardware and software technology have made computerised outpatient medical records practical. We have developed a programme based on the Summary Time-Oriented Record (STOR) system which complements existing paper-based record keeping. The elements of the Problem Oriented Medical Record (POMR) System are displayed in two windows within one screen, namely, the SOAP (Subjective information, Objective information, Assessments and Plans) elements in the Reason For Encounter (RFE) window and the problem list with outcomes in the Problem List (PL) window. Context sensitive child windows display details of plans of management in the RFE window and clinical notes in the PL window. The benefits of such innovations to clinical decision making and practice based research and its medico-legal implications are discussed.

  2. [Evaluation of residual osteomuscular function using computerised movement analysis for building sector workers: specificity and technical problem].

    Science.gov (United States)

    D'Orso, M I; Centemeri, R; Latocca, R; Riva, M; Cesana, G

    2012-01-01

    Occupational Health Doctors active in building sector firms frequently have to evaluate residual workers' osteomuscular function in patients coming back to work after an accident happened during work time or free time. Definition of their specific individual work suitability is usually carried out utilizing semeiotic tests in which subjective evaluation of every single Medical Doctor is real important in definition of final results and this fact can cause legal controversies. In our research we describe the application of computerised movement analysis on 10 workers of building sector. In every patient examined this technical method has been able to study objectively the tridimensional ranges of motion of most important osteomuscular districts. The possibility to have an objective evaluation of residual osteomuscular function has a relevant importance both in definition of workers' work suitability at the moment in which they start again their activities and in possible future legal conflicts.

  3. Investigating a computerised test of the Stroop effect extended by inclusion of a third, more difficult task.

    Science.gov (United States)

    Federmann, Rolf; Goldsmith, Robert; Bäckström, Martin

    2007-04-01

    A validation study of a computerised test recently developed involving the Stroop effect, extended here by inclusion of a third, more difficult test series, is presented. Three groups of men belonging to the Swedish armed forces and adjudged to differ in their qualifications (20, 32, and 19 men of levels 1, 2, and 3, respectively) and a fourth group of 18 men convicted of serious crimes of violence were given this test, termed the Stress Strategy Test. Discriminant analysis of the test's 12 variables (four for each of the three test series) yielded a discriminant power of 65% for the total group, highest for the level 1 group (80%) and for the nonmilitary group (72%), results substantially better than obtained for the original version of the test with use of similar subject groups.

  4. Substantial reduction of inappropriate tablet splitting with computerised decision support: a prospective intervention study assessing potential benefit and harm

    Directory of Open Access Journals (Sweden)

    Quinzler Renate

    2009-06-01

    Full Text Available Abstract Background Currently ambulatory patients break one in four tablets before ingestion. Roughly 10% of them are not suitable for splitting because they lack score lines or because enteric or modified release coating is destroyed impairing safety and effectiveness of the medication. We assessed impact and safety of computerised decision support on the inappropriate prescription of split tablets. Methods We performed a prospective intervention study in a 1680-bed university hospital. Over a 15-week period we evaluated all electronically composed medication regimens and determined the fraction of tablets and capsules that demanded inappropriate splitting. In a subsequent intervention phase of 15 weeks duration for 10553 oral drugs divisibility characteristics were indicated in the system. In addition, an alert was generated and displayed during the prescription process whenever the entered dosage regimen demanded inappropriate splitting (splitting of capsules, unscored tablets, or scored tablets unsuitable for the intended fragmentation. Results During the baseline period 12.5% of all drugs required splitting and 2.7% of all drugs (257/9545 required inappropriate splitting. During the intervention period the frequency of inappropriate splitting was significantly reduced (1.4% of all drugs (146/10486; p = 0.0008. In response to half of the alerts (69/136 physicians adjusted the medication regimen. In the other half (67/136 no corrections were made although a switch to more suitable drugs (scored tablets, tablets with lower strength, liquid formulation was possible in 82% (55/67. Conclusion This study revealed that computerised decision support can immediately reduce the frequency of inappropriate splitting without introducing new safety hazards.

  5. Adaptação transcultural e validação da escala de Saúde Global do PROMIS para a língua portuguesa

    Directory of Open Access Journals (Sweden)

    Camila Eugênia Zumpano

    Full Text Available Resumo: O objetivo deste estudo foi realizar a adaptação transcultural da escala de Saúde Global do Patient-Reported Outcomes Measurement Information System (PROMIS para a língua portuguesa. Os dez itens sobre Saúde Global foram adaptados transculturalmente por meio do método proposto pelo Functional Assessment of Chronic Illness Therapy (FACIT. A versão final do instrumento para a língua portuguesa foi autoadministrada em 1.010 participantes no Brasil. A precisão da escala foi verificada usando-se a análise dos efeitos piso e teto, confiabilidade da consistência interna e confiabilidade teste-reteste. Utilizou-se a análise fatorial exploratória e confirmatória para avaliação da validade de construto e dimensionalidade do instrumento. A calibração dos itens foi realizada por meio do Modelo de Resposta Gradual proposto por Samejima. Quatro itens globais necessitaram de ajustes após a realização do pré-teste. A análise das propriedades psicométricas demonstrou que a escala de Saúde Global tem boa confiabilidade, com coeficiente alfa de Cronbach de 0,83 e coeficiente de correlação intraclasse de 0,89. As análises fatorial exploratória e confirmatória revelaram um bom ajuste ao modelo previamente estabelecido de duas dimensões. As escalas de Saúde Física Global e Saúde Mental Global apresentaram uma boa cobertura do traço latente, de acordo com o Modelo de Resposta Gradual. Os itens Saúde Global do PROMIS para a língua portuguesa apresentaram equivalência em relação à versão original e propriedades psicométricas satisfatórias para a aplicação direcionada à população brasileira na prática clínica e em pesquisas.

  6. Advancing beyond the system: telemedicine nurses' clinical reasoning using a computerised decision support system for patients with COPD - an ethnographic study.

    Science.gov (United States)

    Barken, Tina Lien; Thygesen, Elin; Söderhamn, Ulrika

    2017-12-28

    Telemedicine is changing traditional nursing care, and entails nurses performing advanced and complex care within a new clinical environment, and monitoring patients at a distance. Telemedicine practice requires complex disease management, advocating that the nurses' reasoning and decision-making processes are supported. Computerised decision support systems are being used increasingly to assist reasoning and decision-making in different situations. However, little research has focused on the clinical reasoning of nurses using a computerised decision support system in a telemedicine setting. Therefore, the objective of the study is to explore the process of telemedicine nurses' clinical reasoning when using a computerised decision support system for the management of patients with chronic obstructive pulmonary disease. The factors influencing the reasoning and decision-making processes were investigated. In this ethnographic study, a combination of data collection methods, including participatory observations, the think-aloud technique, and a focus group interview was employed. Collected data were analysed using qualitative content analysis. When telemedicine nurses used a computerised decision support system for the management of patients with complex, unstable chronic obstructive pulmonary disease, two categories emerged: "the process of telemedicine nurses' reasoning to assess health change" and "the influence of the telemedicine setting on nurses' reasoning and decision-making processes". An overall theme, termed "advancing beyond the system", represented the connection between the reasoning processes and the telemedicine work and setting, where being familiar with the patient functioned as a foundation for the nurses' clinical reasoning process. In the telemedicine setting, when supported by a computerised decision support system, nurses' reasoning was enabled by the continuous flow of digital clinical data, regular video-mediated contact and shared decision

  7. The Melbourne East Monash General Practice Database (MAGNET: Using data from computerised medical records to create a platform for primary care and health services research

    Directory of Open Access Journals (Sweden)

    Danielle Mazza

    2016-07-01

    Full Text Available The Melbourne East MonAsh GeNeral PracticE DaTabase (MAGNET research platform was launched in 2013 to provide a unique data source for primary care and health services research in Australia.  MAGNET contains information from the computerised records of 50 participating general practices and includes data from the computerised medical records of more than 1,100,000 patients.  The data extracted is patient-level episodic information and includes a variety of fields related to patient demographics and historical clinical information, along with the characteristics of the participating general practices.  While there are limitations to the data that is currently available, the MAGNET research platform continues to investigate other avenues for improving the breadth and quality of data, with the aim of providing a more comprehensive picture of primary care in Australia

  8. The Melbourne East Monash General Practice Database (MAGNET): Using data from computerised medical records to create a platform for primary care and health services research.

    Science.gov (United States)

    Mazza, Danielle; Pearce, Christopher; Turner, Lyle Robert; De Leon-Santiago, Maria; McLeod, Adam; Ferriggi, Jason; Shearer, Marianne

    2016-07-04

    The Melbourne East MonAsh GeNeral PracticE DaTabase (MAGNET) research platform was launched in 2013 to provide a unique data source for primary care and health services research in Australia.  MAGNET contains information from the computerised records of 50 participating general practices and includes data from the computerised medical records of more than 1,100,000 patients.  The data extracted is patient-level episodic information and includes a variety of fields related to patient demographics and historical clinical information, along with the characteristics of the participating general practices.  While there are limitations to the data that is currently available, the MAGNET research platform continues to investigate other avenues for improving the breadth and quality of data, with the aim of providing a more comprehensive picture of primary care in Australia.

  9. Application of computerised penile arterial waveform analysis in the diagnosis of arteriogenic impotence. An initial study in potent and impotent men.

    Science.gov (United States)

    Desai, K M; Gingell, J C; Skidmore, R; Follett, D H

    1987-11-01

    A new method is described for evaluating arteriogenic impotence by means of noninvasive quantification of penile Doppler arterial waveforms using computerised analysis based on the Laplace Transform model. The haemodynamic changes occurring during a papaverine-induced erection in healthy potent volunteers have been recorded by this technique, which has also been shown to be capable of discriminating between a normal and an abnormal penile arterial supply in an initial study of potent and impotent men.

  10. Understanding the acceptability of e-mental health--attitudes and expectations towards computerised self-help treatments for mental health problems.

    Science.gov (United States)

    Musiat, Peter; Goldstone, Philip; Tarrier, Nicholas

    2014-04-11

    E-mental health and m-mental health include the use of technology in the prevention, treatment and aftercare of mental health problems. With the economical pressure on mental health services increasing, e-mental health and m-mental health could bridge treatment gaps, reduce waiting times for patients and deliver interventions at lower costs. However, despite the existence of numerous effective interventions, the transition of computerised interventions into care is slow. The aim of the present study was to investigate the acceptability of e-mental health and m-mental health in the general population. An advisory group of service users identified dimensions that potentially influence an individual's decision to engage with a particular treatment for mental health problems. A large sample (N = 490) recruited through email, flyers and social media was asked to rate the acceptability of different treatment options for mental health problems on these domains. Results were analysed using repeated measures MANOVA. Participants rated the perceived helpfulness of an intervention, the ability to motivate users, intervention credibility, and immediate access without waiting time as most important dimensions with regard to engaging with a treatment for mental health problems. Participants expected face-to-face therapy to meet their needs on most of these dimensions. Computerised treatments and smartphone applications for mental health were reported to not meet participants' expectations on most domains. However, these interventions scored higher than face-to-face treatments on domains associated with the convenience of access. Overall, participants reported a very low likelihood of using computerised treatments for mental health in the future. Individuals in this study expressed negative views about computerised self-help intervention and low likelihood of use in the future. To improve the implementation and uptake, policy makers need to improve the public perception of such

  11. Understanding the acceptability of e-mental health - attitudes and expectations towards computerised self-help treatments for mental health problems

    OpenAIRE

    Musiat, Peter; Goldstone, Philip; Tarrier, Nicholas

    2014-01-01

    Background E-mental health and m-mental health include the use of technology in the prevention, treatment and aftercare of mental health problems. With the economical pressure on mental health services increasing, e-mental health and m-mental health could bridge treatment gaps, reduce waiting times for patients and deliver interventions at lower costs. However, despite the existence of numerous effective interventions, the transition of computerised interventions into care is slow. The aim of...

  12. Feasibility and effectiveness of a cognitive remediation programme with original computerised cognitive training and group intervention for schizophrenia: a multicentre randomised trial.

    Science.gov (United States)

    Matsuda, Yasuhiro; Morimoto, Tsubasa; Furukawa, Shunichi; Sato, Sayaka; Hatsuse, Norifumi; Iwata, Kazuhiko; Kimura, Mieko; Kishimoto, Toshifumi; Ikebuchi, Emi

    2018-04-01

    Devising new methods to improve neurocognitive impairment through cognitive remediation is an important research goal. We developed an original computer programme termed the Japanese Cognitive Rehabilitation Programme for Schizophrenia (JCORES) that provides cognitive practice across a broad range of abilities. The current study examined for the first time whether a cognitive remediation programme, including both computerised cognitive training using JCORES and group intervention such as enhancing meta-cognition and teaching strategies, is more effective than treatment as usual for improving neurocognitive and social functioning. Sixty-two outpatients with schizophrenia were randomised to either a cognitive remediation group or a control group. Participants engaged in two computerised cognitive training sessions and one group meeting per week for 12 weeks. The average number of total sessions attended (computerised cognitive practice + group intervention) was 32.3 (89.7%). The cognitive remediation group showed significantly more improvements in verbal memory, composite score of the Brief Assessment of Cognition in Schizophrenia, Japanese version (BACS-J), and general psychopathology on the Positive and Negative Syndrome Scale (PANSS) than the control group. These findings demonstrate that a cognitive remediation programme is feasible in Japan and is a more effective way to improve neurocognitive functioning and psychiatric symptoms.

  13. Patient Dashboard: the use of a colour-coded computerised clinical reminder in Whanganui regional general practices.

    Science.gov (United States)

    McMenamin, John; Nicholson, Rick; Leech, Ken

    2011-12-01

    Clinical reminders have been shown to help general practice achieve an increase in some preventive care items, especially if they identify a patient's eligibility for the target item, prompt clinicians at the right time, provide a fast link to management tools and facilitate clinical recording. WRPHO has introduced the Patient Dashboard clinical reminder and monitored its impact on health targets. This paper reports the impact of a computerised colour-coded clinical reminder on achieving agreed health targets in Whanganui regional practices. Patient Dashboard was developed from previous versions in Auckland and Northland and provided to Whanganui regional practices with Primary Health Organisation (PHO) support. The Dashboard was linked with existing and new clinical management tools which automatically updated clinical records. Data from practices was pooled by Whanganui Regional Primary Health Organisation and target achievement rates reported over 15 months. Over the initial 15 months of Patient Dashboard use, recording of smoking status increased from 74% to 82% and of alcohol use from 15% to 47%. Screening for diabetes increased from 62% to 74%, cardiovascular risk assessment from 20% to 43%, cervical screening from 71% to 79%, and breast screening from 60% to 80%. Patient Dashboard was associated with increased performance indicators both for those targets which were part of a PHO programme and for targets without additional support.

  14. SCAN- a maintenance-free flowrate meter with direct digital read-out for computerised control applications in radiochemical plants

    Energy Technology Data Exchange (ETDEWEB)

    Shah, B V; Siddiqui, I A; Theyyunni, T K [Process Engineering and Systems Division, Bhabha Atomic Research Centre, Mumbai (India)

    1994-06-01

    In radiochemical plants, the choice of flowrate sensor is subject to stringent requirements of fail-safe design and freedom from maintenance. The SCAN remote digital direct indicating flowrate meter described in this paper was developed to meet the requirements of flowrate and transmitting it to the control room, and to a computerised control system. SCAN is designed on the principle that flowrate through an orifice is a function of the head of liquid acting upon it. SCAN consists of a small chamber which receives the flow, and discharges it through an orifice located in bottom. The level of liquid in the pot represents the flowrate of the input stream. SCAN has been developed into an accurate, rugged and practical device by refinements in the design of internals, and by introducing a special end-section which makes the calibration insensitive to location. An important feature of SCAN is that it is passive, maintenance free, fail-safe device and contains no moving parts. There is no liquid hold up in the SCAN when idle, which is a desirable feature for the radiochemical plant environment. (author). 3 figs., 2 tabs.

  15. Development of state computerised accounting system for nuclear material in the Slovak Republic and the Czech Republic towards 2000

    International Nuclear Information System (INIS)

    Bezak, S.; Bencova, A.; Cisar, V.; Zajicova, M.; Bilek, J.; Olsansky, J.

    1999-01-01

    The presentation describes the evaluation of computerised system for processing of safeguards data and reporting to the IAEA in the Slovak Republic and in the Czech Republic in accordance with their Safeguards Agreements. The attention is given to the first code for processing of accounting data, established and operated in the Nuclear Research Institute in Rez in 1980. Further it is concentrated on the code ZARUKY, developed as a tool for control of and accounting for nuclear material at the State level in 1992, created on the database system CLIPPER-5 in operational system MS-DOS and operated until now. The general intention is to show and clarify main problems connected with the year 2000 and to share this experience with other colleagues. Possible ways for solution of these problems are listed and necessary regulatory role of the SSACs is presented. Also the main requirements for new code, which should communicate with the database of operators and reflect all limitations specified in their permissions, which should be a system with fully satisfactory safety, strictly defined confidentiality and should allow the access of several users in parallel is described. As a new component of this afford the requirements for reporting in accordance with the Protocol Additional to the Safeguard Agreement is mentioned. It is presented that the code in WINDOWS operation system on a database system ORACLE accepting also new date format 'YYYYMMDD' would meet all of these requirements. (author)

  16. The use of computerised tomography guided percutaneous fine needle aspiration in the evaluation of solitary pulmonary nodules.

    LENUS (Irish Health Repository)

    Khan, K A

    2012-02-01

    The evaluation of a solitary pulmonary nodule (SPN) has changed over the years with increased access to percutaneous computerised tomography (CT) guided fine needle aspiration (FNA), where bronchoscopy is unhelpful. The aim of our study was to evaluate the sample adequacy, diagnostic and complication rate of CT-FNA of a SPN at our academic teaching hospital over an 18 month period. CT-FNA was performed by a radiologist, with a cytopathologist in attendance to confirm the adequacy of the sample obtained. The size of the nodule, sample material and adequacy, diagnosis and complications were recorded. A total of 101 patients were included, 54 male and the mean age was 68 +\\/- 11 years. The mean size of the SPN was 2.3 cm (range 1-11 cm). 56 (56%) patients had a right SPN, 45 (45%) had a left SPN. CT-FNA was diagnostic in 80 (80%) patients and non-diagnostic in 21 (20%) patients. The sample was insufficient for immunocytochemistry, although the morphological appearance was diagnostic in 20 (25%) of the 80 patients. Pneumothorax occurred in 26\\/101 (26%) patients post CT-FNA, of these 7 (27%) required chest drain insertion, while 19 (73%) were managed conservatively. CT FNA is a useful tool for the diagnosis of a SPN, with our diagnostic accuracy comparable to that reported in the literature. However, CT-FNA may not provide adequate sample volume to perform ancillary testing and has a moderate complication rate.

  17. Integrating the Radiology Information System with Computerised Provider Order Entry: The Impact on Repeat Medical Imaging Investigations.

    Science.gov (United States)

    Vecellio, Elia; Georgiou, Andrew

    2016-01-01

    Repeat and redundant procedures in medical imaging are associated with increases in resource utilisation and labour costs. Unnecessary medical imaging in some modalities, such as X-Ray (XR) and Computed Tomography (CT) is an important safety issue because it exposes patients to ionising radiation which can be carcinogenic and is associated with higher rates of cancer. The aim of this study was to assess the impact of implementing an integrated Computerised Provider Order Entry (CPOE)/Radiology Information System (RIS)/Picture Archiving and Communications System (PACS) system on the number of XR and CT imaging procedures (including repeat imaging requests) for inpatients at a large metropolitan hospital. The study found that patients had an average 0.47 fewer XR procedures and 0.07 fewer CT procedures after the implementation of the integrated system. Part of this reduction was driven by a lower rate of repeat procedures: the average inpatient had 0.13 fewer repeat XR procedures within 24-hours of the previous identical XR procedure. A similar decrease was not evident for repeat CT procedures. Reduced utilisation of imaging procedures (especially those within very short intervals from the previous identical procedure, which are more likely to be redundant) has implications for the safety of patients and the cost of medical imaging services.

  18. Analysis of differential item functioning in the depression item bank from the Patient Reported Outcome Measurement Information System (PROMIS: An item response theory approach

    Directory of Open Access Journals (Sweden)

    JOSEPH P. EIMICKE

    2009-06-01

    Full Text Available The aims of this paper are to present findings related to differential item functioning (DIF in the Patient Reported Outcome Measurement Information System (PROMIS depression item bank, and to discuss potential threats to the validity of results from studies of DIF. The 32 depression items studied were modified from several widely used instruments. DIF analyses of gender, age and education were performed using a sample of 735 individuals recruited by a survey polling firm. DIF hypotheses were generated by asking content experts to indicate whether or not they expected DIF to be present, and the direction of the DIF with respect to the studied comparison groups. Primary analyses were conducted using the graded item response model (for polytomous, ordered response category data with likelihood ratio tests of DIF, accompanied by magnitude measures. Sensitivity analyses were performed using other item response models and approaches to DIF detection. Despite some caveats, the items that are recommended for exclusion or for separate calibration were "I felt like crying" and "I had trouble enjoying things that I used to enjoy." The item, "I felt I had no energy," was also flagged as evidencing DIF, and recommended for additional review. On the one hand, false DIF detection (Type 1 error was controlled to the extent possible by ensuring model fit and purification. On the other hand, power for DIF detection might have been compromised by several factors, including sparse data and small sample sizes. Nonetheless, practical and not just statistical significance should be considered. In this case the overall magnitude and impact of DIF was small for the groups studied, although impact was relatively large for some individuals.

  19. Generalizable items and modular structure for computerised physician staffing calculation on intensive care units.

    Science.gov (United States)

    Weiss, Manfred; Marx, Gernot; Iber, Thomas

    2017-08-04

    Intensive care medicine remains one of the most cost-driving areas within hospitals with high personnel costs. Under the scope of limited budgets and reimbursement, realistic needs are essential to justify personnel staffing. Unfortunately, all existing staffing models are top-down calculations with a high variability in results. We present a workload-oriented model, integrating quality of care, efficiency of processes, legal, educational, controlling, local, organisational and economic aspects. In our model, the physician's workload solely related to the intensive care unit depends on three tasks: Patient-oriented tasks, divided in basic tasks (performed in every patient) and additional tasks (necessary in patients with specific diagnostic and therapeutic requirements depending on their specific illness, only), and non patient-oriented tasks. All three tasks have to be taken into account for calculating the required number of physicians. The calculation tool further allows to determine minimal personnel staffing, distribution of calculated personnel demand regarding type of employee due to working hours per year, shift work or standby duty. This model was introduced and described first by the German Board of Anesthesiologists and the German Society of Anesthesiology and Intensive Care Medicine in 2008 and since has been implemented and updated 2012 in Germany. The modular, flexible nature of the Excel-based calculation tool should allow adaption to the respective legal and organizational demands of different countries. After 8 years of experience with this calculation, we report the generalizable key aspects which may help physicians all around the world to justify realistic workload-oriented personnel staffing needs.

  20. Development and validation of the Psychological Adaptation Scale (PAS): use in six studies of adaptation to a health condition or risk.

    Science.gov (United States)

    Biesecker, Barbara B; Erby, Lori H; Woolford, Samuel; Adcock, Jessica Young; Cohen, Julie S; Lamb, Amanda; Lewis, Katie V; Truitt, Megan; Turriff, Amy; Reeve, Bryce B

    2013-11-01

    We introduce The Psychological Adaptation Scale (PAS) for assessing adaptation to a chronic condition or risk and present validity data from six studies of genetic conditions. Informed by theory, we identified four domains of adaptation: effective coping, self-esteem, social integration, and spiritual/existential meaning. Items were selected from the PROMIS "positive illness impact" item bank and adapted from the Rosenberg self-esteem scale to create a 20-item scale. Each domain included five items, with four sub-scale scores. Data from studies of six populations: adults affected with or at risk for genetic conditions (N=3) and caregivers of children with genetic conditions (N=3) were analyzed using confirmatory factor analyses (CFA). CFA suggested that all but five posited items converge on the domains as designed. Invariance of the PAS amongst the studies further suggested it is a valid and reliable tool to facilitate comparisons of adaptation across conditions. Use of the PAS will standardize assessments of adaptation and foster understanding of the relationships among related health outcomes, such as quality of life and psychological well-being. Clinical interventions can be designed based on PAS data to enhance dimensions of psychological adaptation to a chronic health condition or risk. Published by Elsevier Ireland Ltd.

  1. Computerised clinical decision support systems to improve medication safety in long-term care homes: a systematic review.

    Science.gov (United States)

    Marasinghe, Keshini Madara

    2015-05-12

    Computerised clinical decision support systems (CCDSS) are used to improve the quality of care in various healthcare settings. This systematic review evaluated the impact of CCDSS on improving medication safety in long-term care homes (LTC). Medication safety in older populations is an important health concern as inappropriate medication use can elevate the risk of potentially severe outcomes (ie, adverse drug reactions, ADR). With an increasing ageing population, greater use of LTC by the growing ageing population and increasing number of medication-related health issues in LTC, strategies to improve medication safety are essential. Databases searched included MEDLINE, EMBASE, Scopus and Cochrane Library. Three groups of keywords were combined: those relating to LTC, medication safety and CCDSS. One reviewer undertook screening and quality assessment. Overall findings suggest that CCDSS in LTC improved the quality of prescribing decisions (ie, appropriate medication orders), detected ADR, triggered warning messages (ie, related to central nervous system side effects, drug-associated constipation, renal insufficiency) and reduced injury risk among older adults. CCDSS have received little attention in LTC, as attested by the limited published literature. With an increasing ageing population, greater use of LTC by the ageing population and increased workload for health professionals, merely relying on physicians' judgement on medication safety would not be sufficient. CCDSS to improve medication safety and enhance the quality of prescribing decisions are essential. Analysis of review findings indicates that CCDSS are beneficial, effective and have potential to improve medication safety in LTC; however, the use of CCDSS in LTC is scarce. Careful assessment on the impact of CCDSS on medication safety and further modifications to existing CCDSS are recommended for wider acceptance. Due to scant evidence in the current literature, further research on implementation and

  2. Minimally disruptive medicine is needed for patients with multimorbidity: time to develop computerised medical record systems to meet this requirement

    Directory of Open Access Journals (Sweden)

    Peter Schattner

    2015-02-01

    Full Text Available Background Minimally disruptive medicine (MDM is proposed as a method for more appropriately managing people with multiple chronic disease. Much clinical management is currently single disease focussed, with people with multimorbidity being managed according to multiple single disease guidelines. Current initiatives to improve care include education about individual conditions and creating an environment where multiple guidelines might be simultaneously supported. The patientcentred medical home (PCMH is an example of the latter. However, educational programmes and PCMH may increase the burden on patients.Problem The cumulative workload for patients in managing the impact of multiple disease-specific guidelines is only relatively recently recognised. There is an intellectual vacuum as to how best to manage multimorbidity and how informatics might support implementing MDM. There is currently no alternative to multiple singlecondition- specific guidelines and a lack of certainty, should the treatment burden need to be reduced, as to which guideline might be ‘dropped’.Action The best information about multimorbidity is recorded in primary care computerised medical record (CMR systems and in an increasing number of integrated care organisations. CMR systems have the potential to flag individuals who might be in greatest need. However, CMR systems may also provide insights into whether there are ameliorating factors that might make it easier for them to be resilient to the burden of care. Data from such CMR systems might be used to develop the evidence base about how to better manage multimorbidity.Conclusions There is potential for these information systems to help reduce the management burden on patients and clinicians. However, substantial investment in research-driven CMR development is needed if we are to achieve this.

  3. A national survey of health service infrastructure and policy impacts on access to computerised CBT in Scotland

    Directory of Open Access Journals (Sweden)

    Kenicer David

    2012-09-01

    Full Text Available Abstract Background NICE recommends computerised cognitive behavioural therapy (cCBT for the treatment of several mental health problems such as anxiety and depression. cCBT may be one way that services can reduce waiting lists and improve capacity and efficiency. However, there is some doubt about the extent to which the National Health Service (NHS in the UK is embracing this new health technology in practice. This study aimed to investigate Scottish health service infrastructure and policies that promote or impede the implementation of cCBT in the NHS. Methods A telephone survey of lead IT staff at all health board areas across Scotland to systematically enquire about the ability of local IT infrastructure and IT policies to support delivery of cCBT. Results Overall, most of the health boards possess the required software to use cCBT programmes. However, the majority of NHS health boards reported that they lack dedicated computers for patient use, hence access to cCBT at NHS sites is limited. Additionally, local policy in the majority of boards prevent staff from routinely contacting patients via email, skype or instant messenger, making the delivery of short, efficient support sessions difficult. Conclusions Conclusions: Overall most of the infrastructure is in place but is not utilised in ways that allow effective delivery. For cCBT to be successfully delivered within a guided support model, as recommended by national guidelines, dedicated patient computers should be provided to allow access to online interventions. Additionally, policy should allow staff to support patients in convenient ways such as via email or live chat. These measures would increase the likelihood of achieving Scottish health service targets to reduce waiting time for psychological therapies to 18 weeks.

  4. Developing a national computerised absence monitoring and management system to reduce nursing student attrition: evaluation of staff and student perspectives.

    Science.gov (United States)

    Currie, Kay; McCallum, Jacqueline; Murray, John; Scott, Janine; Strachan, Evelyn; Yates, Lynda; Wright, Marty

    2014-05-01

    Reducing avoidable nursing student attrition is an international challenge. A pattern of falling attendance is recognised as a frequent precursor to withdrawal from nursing programmes. To address concerns regarding nursing student attrition, the Scottish Government implemented a pilot project for a centralised Computerised Absence Management and Monitoring System (CAMMS). The CAMMS adopted an 'assertive outreach' approach, contacting students every two weeks via colour coded letters to tell them whether their attendance was 'excellent', 'good, but potentially causing concern'; or 'warning; attendance concerns/contact academic staff for support'. This article reports key findings from an evaluation of CAMMS. To explore the perceived impact of CAMMS on student support and attrition, from the perspectives of academic and administrative staff and students. Mixed methods evaluation design. Three large geographically dispersed Schools of Nursing in Scotland. 83 students; 20 academic staff; and 3 lead administrators. On-line cohort survey of academic staff and students; structured interviews with lead administrators. Findings reflected a spectrum of negative and positive views of CAMMS. Students who are attending regularly seem pleased that their commitment is recognised. Lecturers who teach larger groups report greater difficulty getting to know students individually and acknowledge the benefit of identifying potential attendance concerns at an early stage. Conversely, some students who received a 'warning' letter were frequently annoyed or irritated, rather than feeling supported. Increased staff workload resulted in negative perceptions and a consequent reluctance to use CAMMS. However, students who were causing concern reported subsequent improvement in attendance. CAMMS has the potential to identify 'at-risk' students at an early stage; however, the system should have flexibility to tailor automatically generated letters in response to individual circumstances, to

  5. Automation in an addiction treatment research clinic: computerised contingency management, ecological momentary assessment and a protocol workflow system.

    Science.gov (United States)

    Vahabzadeh, Massoud; Lin, Jia-Ling; Mezghanni, Mustapha; Epstein, David H; Preston, Kenzie L

    2009-01-01

    A challenge in treatment research is the necessity of adhering to protocol and regulatory strictures while maintaining flexibility to meet patients' treatment needs and to accommodate variations among protocols. Another challenge is the acquisition of large amounts of data in an occasionally hectic environment, along with the provision of seamless methods for exporting, mining and querying the data. We have automated several major functions of our outpatient treatment research clinic for studies in drug abuse and dependence. Here we describe three such specialised applications: the Automated Contingency Management (ACM) system for the delivery of behavioural interventions, the transactional electronic diary (TED) system for the management of behavioural assessments and the Protocol Workflow System (PWS) for computerised workflow automation and guidance of each participant's daily clinic activities. These modules are integrated into our larger information system to enable data sharing in real time among authorised staff. ACM and the TED have each permitted us to conduct research that was not previously possible. In addition, the time to data analysis at the end of each study is substantially shorter. With the implementation of the PWS, we have been able to manage a research clinic with an 80 patient capacity, having an annual average of 18,000 patient visits and 7300 urine collections with a research staff of five. Finally, automated data management has considerably enhanced our ability to monitor and summarise participant safety data for research oversight. When developed in consultation with end users, automation in treatment research clinics can enable more efficient operations, better communication among staff and expansions in research methods.

  6. Computerised training improves cognitive performance in chronic pain: a participant-blinded randomised active-controlled trial with remote supervision.

    Science.gov (United States)

    Baker, Katharine S; Georgiou-Karistianis, Nellie; Lampit, Amit; Valenzuela, Michael; Gibson, Stephen J; Giummarra, Melita J

    2018-04-01

    Chronic pain is associated with reduced efficiency of cognitive performance, and few studies have investigated methods of remediation. We trialled a computerised cognitive training protocol to determine whether it could attenuate cognitive difficulties in a chronic pain sample. Thirty-nine adults with chronic pain (mean age = 43.3, 61.5% females) were randomised to an 8-week online course (3 sessions/week from home) of game-like cognitive training exercises, or an active control involving watching documentary videos. Participants received weekly supervision by video call. Primary outcomes were a global neurocognitive composite (tests of attention, speed, and executive function) and self-reported cognition. Secondary outcomes were pain (intensity; interference), mood symptoms (depression; anxiety), and coping with pain (catastrophising; self-efficacy). Thirty participants (15 training and 15 control) completed the trial. Mixed model intention-to-treat analyses revealed significant effects of training on the global neurocognitive composite (net effect size [ES] = 0.43, P = 0.017), driven by improved executive function performance (attention switching and working memory). The control group reported improvement in pain intensity (net ES = 0.65, P = 0.022). Both groups reported subjective improvements in cognition (ES = 0.28, P = 0.033) and catastrophising (ES = 0.55, P = 0.006). Depression, anxiety, self-efficacy, and pain interference showed no change in either group. This study provides preliminary evidence that supervised cognitive training may be a viable method for enhancing cognitive skills in persons with chronic pain, but transfer to functional and clinical outcomes remains to be demonstrated. Active control results suggest that activities perceived as relaxing or enjoyable contribute to improved perception of well-being. Weekly contact was pivotal to successful program completion.

  7. Computerised cognitive behavioural therapy for the treatment of depression in people with multiple sclerosis: external pilot trial

    Directory of Open Access Journals (Sweden)

    Cooper Cindy L

    2011-12-01

    Full Text Available Abstract Background People with multiple sclerosis (MS are at high risk of depression. We undertook a pilot trial of computerised cognitive behavioural therapy (CCBT for the treatment of depression in people with MS to test the feasibility of undertaking a full trial. Methods Participants with a diagnosis of MS and clinical levels of depression were recruited through out-patient clinics and postal screening questionnaires at two UK centres and randomised to CCBT or usual care. Clinical outcomes included the Beck Depression Inventory (BDI-II and Multiple Sclerosis Impact Scale (MSIS-29 at baseline, 8 and 21 weeks. Feasibility outcomes included: recruitment rate; reasons for refusal, withdrawal and dropout; feasibility and acceptability of the proposed outcome measures; sample size estimation and variation in and preferences for service delivery. Results Twenty-four participants were recruited. The recruitment rate, calculated as the proportion of those invited to fill in a screening questionnaire who were consented into the trial, was 4.1%. Recruitment through out-patient clinics was somewhat slower than through screening questionnaire mail-out but the overall recruitment yield was similar. Of the 12 patients in the CCBT arm, 9 (75% completed at least four, and 6 completed all 8 CCBT sessions. For completers, the median time (IQR to complete all eight CCBT sessions was 15 (13 to 20 weeks. Participants expressed concern about the face validity of the Beck Depression Inventory II for the measurement of self-reported depression in people with MS. The MSIS-29 was the patient-reported outcome measure which participants felt best reflected their concerns. The estimated sample size for a full trial is between 180 and 390 participants. NHS partners were not delivering CCBT in community facilities and participants preferred to access CCBT at home, with no one expressing a preference for use of CCBT in an alternative location. Conclusions A definitive

  8. Interface design recommendations for computerised clinical audit and feedback: Hybrid usability evidence from a research-led system.

    Science.gov (United States)

    Brown, Benjamin; Balatsoukas, Panos; Williams, Richard; Sperrin, Matthew; Buchan, Iain

    2016-10-01

    Audit and Feedback (A&F) is a widely used quality improvement technique that measures clinicians' clinical performance and reports it back to them. Computerised A&F (e-A&F) system interfaces may consist of four key components: (1) Summaries of clinical performance; (2) Patient lists; (3) Patient-level data; (4) Recommended actions. There is a lack of evidence regarding how to best design e-A&F interfaces; establishing such evidence is key to maximising usability, and in turn improving patient safety. To evaluate the usability of a novel theoretically-informed and research-led e-A&F system for primary care (the Performance Improvement plaN GeneratoR: PINGR). (1) Describe PINGR's design, rationale and theoretical basis; (2) Identify usability issues with PINGR; (3) Understand how these issues may interfere with the cognitive goals of end-users; (4) Translate the issues into recommendations for the user-centred design of e-A&F systems. Eight experienced health system evaluators performed a usability inspection using an innovative hybrid approach consisting of five stages: (1) Development of representative user tasks, Goals, and Actions; (2) Combining Heuristic Evaluation and Cognitive Walkthrough methods into a single protocol to identify usability issues; (3) Consolidation of issues; (4) Severity rating of consolidated issues; (5) Analysis of issues according to usability heuristics, interface components, and Goal-Action structure. A final list of 47 issues were categorised into 8 heuristic themes. The most error-prone heuristics were 'Consistency and standards' (13 usability issues; 28% of the total) and 'Match between system and real world' (n=10, 21%). The recommended actions component of the PINGR interface had the most usability issues (n=21, 45%), followed by patient-level data (n=5, 11%), patient lists (n=4, 9%), and summaries of clinical performance (n=4, 9%). The most error-prone Actions across all user Goals were: (1) Patient selection from a list; (2) Data

  9. Support and Assessment for Fall Emergency Referrals (SAFER 1: cluster randomised trial of computerised clinical decision support for paramedics.

    Directory of Open Access Journals (Sweden)

    Helen Anne Snooks

    Full Text Available To evaluate effectiveness, safety and cost-effectiveness of Computerised Clinical Decision Support (CCDS for paramedics attending older people who fall.Cluster trial randomised by paramedic; modelling.13 ambulance stations in two UK emergency ambulance services.42 of 409 eligible paramedics, who attended 779 older patients for a reported fall.Intervention paramedics received CCDS on Tablet computers to guide patient care. Control paramedics provided care as usual. One service had already installed electronic data capture.Effectiveness: patients referred to falls service, patient reported quality of life and satisfaction, processes of care.Further emergency contacts or death within one month.Costs and quality of life. We used findings from published Community Falls Prevention Trial to model cost-effectiveness.17 intervention paramedics used CCDS for 54 (12.4% of 436 participants. They referred 42 (9.6% to falls services, compared with 17 (5.0% of 343 participants seen by 19 control paramedics [Odds ratio (OR 2.04, 95% CI 1.12 to 3.72]. No adverse events were related to the intervention. Non-significant differences between groups included: subsequent emergency contacts (34.6% versus 29.1%; OR 1.27, 95% CI 0.93 to 1.72; quality of life (mean SF12 differences: MCS -0.74, 95% CI -2.83 to +1.28; PCS -0.13, 95% CI -1.65 to +1.39 and non-conveyance (42.0% versus 36.7%; OR 1.13, 95% CI 0.84 to 1.52. However ambulance job cycle time was 8.9 minutes longer for intervention patients (95% CI 2.3 to 15.3. Average net cost of implementing CCDS was £208 per patient with existing electronic data capture, and £308 without. Modelling estimated cost per quality-adjusted life-year at £15,000 with existing electronic data capture; and £22,200 without.Intervention paramedics referred twice as many participants to falls services with no difference in safety. CCDS is potentially cost-effective, especially with existing electronic data capture.ISRCTN Register ISRCTN

  10. Improving antibiotic prescribing for adults with community acquired pneumonia: Does a computerised decision support system achieve more than academic detailing alone? – a time series analysis

    Directory of Open Access Journals (Sweden)

    Black James F

    2008-07-01

    Full Text Available Abstract Background The ideal method to encourage uptake of clinical guidelines in hospitals is not known. Several strategies have been suggested. This study evaluates the impact of academic detailing and a computerised decision support system (CDSS on clinicians' prescribing behaviour for patients with community acquired pneumonia (CAP. Methods The management of all patients presenting to the emergency department over three successive time periods was evaluated; the baseline, academic detailing and CDSS periods. The rate of empiric antibiotic prescribing that was concordant with recommendations was studied over time comparing pre and post periods and using an interrupted time series analysis. Results The odds ratio for concordant therapy in the academic detailing period, after adjustment for age, illness severity and suspicion of aspiration, compared with the baseline period was OR = 2.79 [1.88, 4.14], p Conclusion Deployment of a computerised decision support system was associated with an early improvement in antibiotic prescribing practices which was greater than the changes seen with academic detailing. The sustainability of this intervention requires further evaluation.

  11. IMPACT OF A COMPUTERISED OUTPATIENT PRESCRIPTION PRINTING SYSTEM (COPPS) ON MELATONIN PRESCRIBING IN A COMMUNITY CHILD HEALTH CLINIC.

    Science.gov (United States)

    Webb, Liz; Skingle, Jum

    2016-09-01

    COPPS is a computerised outpatient prescription printing system for WP10 prescriptions. It aims to improve the quality and safety of service, as patients will be provided with a legible, complete prescription to take to a community pharmacy of their choice. Patients requiring specialist medicines will have their medicines dispensed more promptly by the hospital pharmacy or medicines home care provider. The software ensures prescriptions contain all the required information to allow safe dispensing, reducing frequency of delays. Hospital pharmacy staff have more time to explain their medicines to patients, promoting shared decision making and improved adherence leading to better health outcomes and reduced waste and harm; provide information at the time of prescribing to increase adherence to agreed care pathways and prescribing practice. It facilitates attribution of prescribing, improves governance and is more easily audited and reported; capture the costs of medicines dispensed for out-patients which will be measured using information from the hospital pharmacy computer system and CASPA.The aim of this audit was to evaluate the effect the introduction of COPPS has had on compliance with the UHB formulary, local melatonin pathway and its impact on expenditure for melatonin within the community child health clinic. The pathway states that the starting dose is 2 mg Circadin® tablet or liquid melatonin 1 mg/1 ml if necessary for individual patients. Community Child Health prescribing data shows their highest expenditure is on melatonin. This was therefore chosen to test the impact of COPPS for a pilot study.Six months prescribing data (September 14-March 15) was obtained from COPPS. This was compared to data obtained for WP10's from hospital forms analysis for the same months the previous year (September 13-March 14) RESULTS: A 55% reduction was seen in the prescribing of non-formulary melatonin and a reduction in expenditure on melatonin by 18% or £16

  12. Adaptação transcultural dos Bancos de Itens de Ansiedade e Depressão do Patient-Reported Outcomes Measurement Information System (PROMIS para língua portuguesa

    Directory of Open Access Journals (Sweden)

    Natália Fontes Caputo de Castro

    2014-04-01

    Full Text Available O Patient-Reported Outcome Measurement Information System (PROMIS, estruturado em domínios físicos e psicossociais, superou lacunas ao propor nova ferramenta de avaliação de resultados aplicáveis às doenças crônicas com base em técnicas avançadas de estatística (TRI e testes adaptativos computadorizados (CAT. O objetivo do estudo foi adaptar culturalmente os Bancos de Itens de Ansiedade e Depressão do PROMIS para a língua portuguesa. O processo seguiu rigorosas recomendações do FACIT por meio da tradução avançada, reconciliação, retrotradução, revisão do FACIT, revisores independentes, finalização das etapas pelo FACIT, pré-teste e incorporação dos resultados do pré- teste. A versão traduzida foi pré-testada em dez pacientes, sendo necessária a modificação nos itens 3, 46 e 53 de Ansiedade e no item 46 de Depressão. As alterações alcançaram a equivalência de significado e a versão final foi compatível com as habilidades linguísticas e culturais da população brasileira. Concluiu-se que a versão traduzida é semântica e conceitualmente equivalente aos originais.

  13. Prism adaptation does not alter object-based attention in healthy participants

    Science.gov (United States)

    Bultitude, Janet H.

    2013-01-01

    Hemispatial neglect (‘neglect’) is a disabling condition that can follow damage to the right side of the brain, in which patients show difficulty in responding to or orienting towards objects and events that occur on the left side of space. Symptoms of neglect can manifest in both space- and object-based frames of reference. Although patients can show a combination of these two forms of neglect, they are considered separable and have distinct neurological bases. In recent years considerable evidence has emerged to demonstrate that spatial symptoms of neglect can be reduced by an intervention called prism adaptation. Patients point towards objects viewed through prismatic lenses that shift the visual image to the right. Approximately five minutes of repeated pointing results in a leftward recalibration of pointing and improved performance on standard clinical tests for neglect. The understanding of prism adaptation has also been advanced through studies of healthy participants, in whom adaptation to leftward prismatic shifts results in temporary neglect-like performance. Here we examined the effect of prism adaptation on the performance of healthy participants who completed a computerised test of space- and object-based attention. Participants underwent adaptation to leftward- or rightward-shifting prisms, or performed neutral pointing according to a between-groups design. Significant pointing after-effects were found for both prism groups, indicating successful adaptation. In addition, the results of the computerised test revealed larger reaction-time costs associated with shifts of attention between two objects compared to shifts of attention within the same object, replicating previous work. However there were no differences in the performance of the three groups, indicating that prism adaptation did not influence space- or object-based attention for this task. When combined with existing literature, the results are consistent with the proposal that prism

  14. Pathological investigation of caries and occlusal pulpar exposure in donkey cheek teeth using computerised axial tomography with histological and ultrastructural examinations.

    Science.gov (United States)

    Toit, Nicole du; Burden, Faith A; Kempson, Sue A; Dixon, Padraic M

    2008-12-01

    Post-mortem examination of 16 donkey cheek teeth (CT) with caries (both peripheral and infundibular) and pulpar exposure were performed using computerised axial tomography (CAT), histology and scanning electron microscopy. CAT imaging was found to be useful to assess the presence and extent of caries and pulp exposure in individual donkey CT. Histology identified the loss of occlusal secondary dentine, and showed pulp necrosis in teeth with pulpar exposure. Viable pulp was present more apically in one exposed pulp horn, with its occlusal aspect sealed off from the exposed aspect of the pulp horn by a false pulp stone. Scanning electron microscopy showed the amelo-cemental junction to be a possible route of bacterial infection in infundibular cemental caries. The basic pathogenesis of dental caries in donkeys appears very similar to its description in other species.

  15. Adaptive Education.

    Science.gov (United States)

    Anderson, Lorin W.

    1979-01-01

    Schools have devised several ways to adapt instruction to a wide variety of student abilities and needs. Judged by criteria for what adaptive education should be, most learning for mastery programs look good. (Author/JM)

  16. Adaptive Lighting

    DEFF Research Database (Denmark)

    Petersen, Kjell Yngve; Søndergaard, Karin; Kongshaug, Jesper

    2015-01-01

    Adaptive Lighting Adaptive lighting is based on a partial automation of the possibilities to adjust the colour tone and brightness levels of light in order to adapt to people’s needs and desires. IT support is key to the technical developments that afford adaptive control systems. The possibilities...... offered by adaptive lighting control are created by the ways that the system components, the network and data flow can be coordinated through software so that the dynamic variations are controlled in ways that meaningfully adapt according to people’s situations and design intentions. This book discusses...... differently into an architectural body. We also examine what might occur when light is dynamic and able to change colour, intensity and direction, and when it is adaptive and can be brought into interaction with its surroundings. In short, what happens to an architectural space when artificial lighting ceases...

  17. Demonstrating the effectiveness of body armour: a pilot prospective computerised surface wound mapping trial performed at the Role 3 hospital in Afghanistan.

    Science.gov (United States)

    Breeze, Johno; Allanson-Bailey, L S; Hepper, A E; Midwinter, M J

    2015-03-01

    Modern body armour clearly reduces injury incidence and severity, but evidence to actually objectively demonstrate this effect is scarce. Although the Joint Theatre Trauma Registry (JTTR) alone cannot relate injury pattern to body armour coverage, the addition of computerised Surface Wound Mapping (SWM) may enable this utility. Surface wound locations of all UK and NATO coalition soldiers, Afghan National Army and Police and local nationals injured by explosively propelled fragments and treated in the Role 3 UK-led Field Hospital in Camp Bastion, Afghanistan, between 8 July and 20 October 2012 were prospectively recorded. The Abbreviated Injury Scores (AIS) and relative risk of casualties sustaining injuries under a type of body armour were compared with those that did not wear that armour. Casualties wearing a combat helmet were 2.7 times less likely to sustain a fragmentation wound to the head than those that were unprotected (mean AIS of 2.9 compared with 4.1). Casualties wearing a body armour vest were 4.1 times less likely to sustain a fragmentation wound to the chest or abdomen than those that were unprotected (mean AIS of 2.9 compared with 3.9). Casualties wearing pelvic protection were 10 times less likely to sustain a fragmentation wound to the pelvis compared with those that were unprotected (mean AIS of 3.4 compared with 3.9). Computerised SWM has objectively demonstrated the ability of body armour worn on current operations in Afghanistan to reduce wound incidence and severity. We recognise this technique is limited in that it only records the surface wound location and may be specific to this conflict. However, gathering electronic SWM at the same time as recording injuries for the JTTR was simple, required little extra time and therefore we would recommend its collection during future conflicts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. ADAPT Dataset

    Data.gov (United States)

    National Aeronautics and Space Administration — Advanced Diagnostics and Prognostics Testbed (ADAPT) Project Lead: Scott Poll Subject Fault diagnosis in electrical power systems Description The Advanced...

  19. Ambiguous Adaptation

    DEFF Research Database (Denmark)

    Møller Larsen, Marcus; Lyngsie, Jacob

    2017-01-01

    We investigate the connection between contract duration, relational mechanisms, and premature relationship termination. Based on an analysis of a large sample of exchange relationships in the global service-provider industry, we argue that investments in either longer contract duration or more in...... ambiguous reference points for adaption and thus increase the likelihood of premature termination by restricting the parties' set of adaptive actions....

  20. Climate adaptation

    Science.gov (United States)

    Kinzig, Ann P.

    2015-03-01

    This paper is intended as a brief introduction to climate adaptation in a conference devoted otherwise to the physics of sustainable energy. Whereas mitigation involves measures to reduce the probability of a potential event, such as climate change, adaptation refers to actions that lessen the impact of climate change. Mitigation and adaptation differ in other ways as well. Adaptation does not necessarily have to be implemented immediately to be effective; it only needs to be in place before the threat arrives. Also, adaptation does not necessarily require global, coordinated action; many effective adaptation actions can be local. Some urban communities, because of land-use change and the urban heat-island effect, currently face changes similar to some expected under climate change, such as changes in water availability, heat-related morbidity, or changes in disease patterns. Concern over those impacts might motivate the implementation of measures that would also help in climate adaptation, despite skepticism among some policy makers about anthropogenic global warming. Studies of ancient civilizations in the southwestern US lends some insight into factors that may or may not be important to successful adaptation.

  1. Adaptive steganography

    Science.gov (United States)

    Chandramouli, Rajarathnam; Li, Grace; Memon, Nasir D.

    2002-04-01

    Steganalysis techniques attempt to differentiate between stego-objects and cover-objects. In recent work we developed an explicit analytic upper bound for the steganographic capacity of LSB based steganographic techniques for a given false probability of detection. In this paper we look at adaptive steganographic techniques. Adaptive steganographic techniques take explicit steps to escape detection. We explore different techniques that can be used to adapt message embedding to the image content or to a known steganalysis technique. We investigate the advantages of adaptive steganography within an analytical framework. We also give experimental results with a state-of-the-art steganalysis technique demonstrating that adaptive embedding results in a significant number of bits embedded without detection.

  2. Adaptive Lighting

    DEFF Research Database (Denmark)

    Petersen, Kjell Yngve; Søndergaard, Karin; Kongshaug, Jesper

    2015-01-01

    the investigations of lighting scenarios carried out in two test installations: White Cube and White Box. The test installations are discussed as large-scale experiential instruments. In these test installations we examine what could potentially occur when light using LED technology is integrated and distributed......Adaptive Lighting Adaptive lighting is based on a partial automation of the possibilities to adjust the colour tone and brightness levels of light in order to adapt to people’s needs and desires. IT support is key to the technical developments that afford adaptive control systems. The possibilities...... differently into an architectural body. We also examine what might occur when light is dynamic and able to change colour, intensity and direction, and when it is adaptive and can be brought into interaction with its surroundings. In short, what happens to an architectural space when artificial lighting ceases...

  3. Retention index of thallium-201 single photon emission computerised tomography (SPECT) as an indicator of metastasis in adenocarcinoma of the lung.

    Science.gov (United States)

    Takekawa, H.; Itoh, K.; Abe, S.; Ogura, S.; Isobe, H.; Sukou, N.; Furudate, M.; Kawakami, Y.

    1994-01-01

    We examined the relationship between the retention of thallium-201 (201Tl) on a delayed scan and the metastatic potential of adenocarcinomas of the lung. We studied 43 patients with adenocarcinoma of the lung and divided them into two groups according to the presence or absence of lymph node metastasis. 201Tl single photon emission computerised tomography (SPECT) was conducted twice: 15 min (early scan) and 120 min (delayed scan) after intravenous injection of 3 mCi of 201Tl chloride. We calculated the retention index in order to evaluate the degree of 201Tl retention in the primary tumour. The retention indices were significantly higher in the group that was positive for lymph node metastasis than in the negative group. In adenocarcinomas with high metastatic potential, 201Tl SPECT demonstrated slow washout or increased retention on the delayed scan. The retention index of 201Tl SPECT is a useful indicator of metastatic potential, thereby facilitating the prediction of prognosis, and provides insight into the relationship between 201Tl uptake and malignancy. This is the first report demonstrating a significant relationship between the retention of 201Tl SPECT and lymph node metastasis. Images Figure 1 PMID:8054281

  4. The design and implementation of an Interactive Computerised Decision Support Framework (ICDSF) as a strategy to improve nursing students' clinical reasoning skills.

    Science.gov (United States)

    Hoffman, Kerry; Dempsey, Jennifer; Levett-Jones, Tracy; Noble, Danielle; Hickey, Noelene; Jeong, Sarah; Hunter, Sharyn; Norton, Carol

    2011-08-01

    This paper describes the conceptual design and testing of an Interactive Computerised Decision Support Framework (ICDSF) which was constructed to enable student nurses to "think like a nurse." The ICDSF was based on a model of clinical reasoning. Teaching student nurses to reason clinically is important as poor clinical reasoning skills can lead to "failure-to rescue" of deteriorating patients. The framework of the ICDSF was based on nursing concepts to encourage deep learning and transferability of knowledge. The principles of active student participation, situated cognition to solve problems, authenticity, and cognitive rehearsal were used to develop the ICDSF. The ICDSF was designed in such a way that students moved through it in a step-wise fashion and were required to achieve competency at each step before proceeding to the next. The quality of the ICDSF was evaluated using a questionairre survey, students' written comments and student assessment measures on a pilot and the ICDSF. Overall students were highly satisfied with the clinical scenarios of the ICDSF and believed they were an interesting and useful way to engage in authentic clinical learning. They also believed the ICDSF was useful in developing cognitive skills such as clinical reasoning, problem-solving and decision-making. Some reported issues were the need for good technical support and the lack of face to face contact when using e-learning. Some students also believed the ICDSF was less useful than actual clinical placements. Copyright © 2010 Elsevier Ltd. All rights reserved.

  5. Adaptation Insights

    International Development Research Centre (IDRC) Digital Library (Canada)

    Addressing Climate Change Adaptation in Africa through Participatory Action Research. A Regional Observatory ... while the average annual rainfall recorded between. 1968 and 1999 was .... the region of Thies. For sustainability reasons, the.

  6. Adaptation Stories

    International Development Research Centre (IDRC) Digital Library (Canada)

    By Reg'

    adaptation to climate change from various regions of the Sahel. Their .... This simple system, whose cost and maintenance were financially sustainable, brought ... method that enables him to learn from experience and save time, which he ...

  7. Is adaptation. Truly an adaptation? Is adaptation. Truly an adaptation?

    Directory of Open Access Journals (Sweden)

    Thais Flores Nogueira Diniz

    2008-04-01

    Full Text Available The article begins by historicizing film adaptation from the arrival of cinema, pointing out the many theoretical approaches under which the process has been seen: from the concept of “the same story told in a different medium” to a comprehensible definition such as “the process through which works can be transformed, forming an intersection of textual surfaces, quotations, conflations and inversions of other texts”. To illustrate this new concept, the article discusses Spike Jonze’s film Adaptation. according to James Naremore’s proposal which considers the study of adaptation as part of a general theory of repetition, joined with the study of recycling, remaking, and every form of retelling. The film deals with the attempt by the scriptwriter Charles Kaufman, cast by Nicholas Cage, to adapt/translate a non-fictional book to the cinema, but ends up with a kind of film which is by no means what it intended to be: a film of action in the model of Hollywood productions. During the process of creation, Charles and his twin brother, Donald, undergo a series of adventures involving some real persons from the world of film, the author and the protagonist of the book, all of them turning into fictional characters in the film. In the film, adaptation then signifies something different from itstraditional meaning. The article begins by historicizing film adaptation from the arrival of cinema, pointing out the many theoretical approaches under which the process has been seen: from the concept of “the same story told in a different medium” to a comprehensible definition such as “the process through which works can be transformed, forming an intersection of textual surfaces, quotations, conflations and inversions of other texts”. To illustrate this new concept, the article discusses Spike Jonze’s film Adaptation. according to James Naremore’s proposal which considers the study of adaptation as part of a general theory of repetition

  8. A computerised information system for the processing of borehole data with regard to uranium sources in the Republic of South Africa

    International Nuclear Information System (INIS)

    Grant, M.A.; Maritz, F.I.

    1981-01-01

    The various mining companies in the Republic of South Africa are under legal obligation to supply data concerning uranium resources to the Atomic Energy Board. As the process of manually summarising data and retrieving information for a great number of boreholes is a time-consuming and tedious task, a computerised system was needed to supply this information in a meaningful manner. Following a thorough systems analysis, a database information system was designed. Application programs were developed for the input, processing and tabulation of the data. This report describes the data-base organisation, consisting of a network of master and transaction files. A master file contains one or more keys which are used to input data into or extract data from a transaction file. Master and transaction files are normally linked by means of a linkpath, but in this application it was necessary to define some master files as unlinked units. The input into the database consists of administrative, stratigraphic and lithological data as well as data of gold, uranium, silver, thorium, platinum, sulphur and molybdenum mineralisation. Five types of data cards were developed to record the abovementioned information. Examples of the various data cards are contained in the report. On retrieving data the user of this system has several options regarding the sequence in which information is retrieved and the contents of the tables. The procedure to be used and the various options ar summarised in detail. The appendices summarise the utility programs, supporting job-control language and code lists. The program was written in PL/1 and the database is the TOTAL DATA BASE MANAGEMENT SYSTEM - RELEASE 8,0 from CINCOM SYSTEMS, INC [af

  9. Using computerised surface wound mapping to compare the potential medical effectiveness of Enhanced Protection Under Body Armour Combat Shirt collar designs.

    Science.gov (United States)

    Breeze, John; Allanson-Bailey, L C; Hunt, N C; Delaney, R; Hepper, A E; Lewis, E A

    2015-03-01

    Protecting the neck from explosively propelled fragments has traditionally been achieved through a collar attached to the ballistic vest. An Enhanced Protection Under Body Armour Combat Shirt (EP-UBACS) collar has been identified as an additional method of providing neck protection but limited evidence as to its potential medical effectiveness exists to justify its procurement. Entry wound locations and resultant medical outcomes were determined using Abbreviated Injury Scale (AIS) for all fragmentation neck wounds sustained by UK soldiers between 01 January 2010 and 31 December 2011. Data were prospectively entered into a novel computerised tool base and comparisons made between three EP-UBACS neck collar designs in terms of predicted reduction in AIS scores. All collars reduced AIS scores, with the greatest reduction provided by designs incorporating increased standoff from the neck and an additional semi-circle of ballistic material underneath the collar at the front and back. This technique confirms that reinforcing the neck collar of an EP-UBACS would be expected to reduce injury severity from neck wounds. However, without knowledge of entry wound locations for injuries to other body areas as well as the use of AIS scores without clinical or pathological verification its further use in the future may be limited. The ability to overlay any armour design onto a standardised human was potentially the most useful part of this tool and we would recommend developing this technique using underlying anatomical structures and not just the skin surface. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Adults with an epilepsy history fare significantly worse on positive mental and physical health than adults with other common chronic conditions-Estimates from the 2010 National Health Interview Survey and Patient Reported Outcome Measurement System (PROMIS) Global Health Scale.

    Science.gov (United States)

    Kobau, Rosemarie; Cui, Wanjun; Zack, Matthew M

    2017-07-01

    Healthy People 2020, a national health promotion initiative, calls for increasing the proportion of U.S. adults who self-report good or better health. The Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health Scale (GHS) was identified as a reliable and valid set of items of self-reported physical and mental health to monitor these two domains across the decade. The purpose of this study was to examine the percentage of adults with an epilepsy history who met the Healthy People 2020 target for self-reported good or better health and to compare these percentages to adults with history of other common chronic conditions. Using the 2010 National Health Interview Survey, we compared and estimated the age-standardized prevalence of reporting good or better physical and mental health among adults with five selected chronic conditions including epilepsy, diabetes, heart disease, cancer, and hypertension. We examined response patterns for physical and mental health scale among adults with these five conditions. The percentages of adults with epilepsy who reported good or better physical health (52%) or mental health (54%) were significantly below the Healthy People 2020 target estimate of 80% for both outcomes. Significantly smaller percentages of adults with an epilepsy history reported good or better physical health than adults with heart disease, cancer, or hypertension. Significantly smaller percentages of adults with an epilepsy history reported good or better mental health than adults with all other four conditions. Health and social service providers can implement and enhance existing evidence-based clinical interventions and public health programs and strategies shown to improve outcomes in epilepsy. These estimates can be used to assess improvements in the Healthy People 2020 Health-Related Quality of Life and Well-Being Objective throughout the decade. Published by Elsevier Inc.

  11. Prism adaptation does not alter object-based attention in healthy participants [v1; ref status: indexed, http://f1000r.es/210

    Directory of Open Access Journals (Sweden)

    Janet H. Bultitude

    2013-11-01

    Full Text Available Hemispatial neglect (‘neglect’ is a disabling condition that can follow damage to the right side of the brain, in which patients show difficulty in responding to or orienting towards objects and events that occur on the left side of space. Symptoms of neglect can manifest in both space- and object-based frames of reference. Although patients can show a combination of these two forms of neglect, they are considered separable and have distinct neurological bases. In recent years considerable evidence has emerged to demonstrate that spatial symptoms of neglect can be reduced by an intervention called prism adaptation. Patients point towards objects viewed through prismatic lenses that shift the visual image to the right. Approximately five minutes of repeated pointing results in a leftward recalibration of pointing and improved performance on standard clinical tests for neglect. The understanding of prism adaptation has also been advanced through studies of healthy participants, in whom adaptation to leftward prismatic shifts results in temporary neglect-like performance. Here we examined the effect of prism adaptation on the performance of healthy participants who completed a computerised test of space- and object-based attention. Participants underwent adaptation to leftward- or rightward-shifting prisms, or performed neutral pointing according to a between-groups design. Significant pointing after-effects were found for both prism groups, indicating successful adaptation. In addition, the results of the computerised test revealed larger reaction-time costs associated with shifts of attention between two objects compared to shifts of attention within the same object, replicating previous work. However there were no differences in the performance of the three groups, indicating that prism adaptation did not influence space- or object-based attention for this task. When combined with existing literature, the results are consistent with the

  12. Strategic Adaptation

    DEFF Research Database (Denmark)

    Andersen, Torben Juul

    2015-01-01

    This article provides an overview of theoretical contributions that have influenced the discourse around strategic adaptation including contingency perspectives, strategic fit reasoning, decision structure, information processing, corporate entrepreneurship, and strategy process. The related...... concepts of strategic renewal, dynamic managerial capabilities, dynamic capabilities, and strategic response capabilities are discussed and contextualized against strategic responsiveness. The insights derived from this article are used to outline the contours of a dynamic process of strategic adaptation....... This model incorporates elements of central strategizing, autonomous entrepreneurial behavior, interactive information processing, and open communication systems that enhance the organization's ability to observe exogenous changes and respond effectively to them....

  13. Adaptive Lighting

    DEFF Research Database (Denmark)

    Petersen, Kjell Yngve; Kongshaug, Jesper; Søndergaard, Karin

    2015-01-01

    offered by adaptive lighting control are created by the ways that the system components, the network and data flow can be coordinated through software so that the dynamic variations are controlled in ways that meaningfully adapt according to people’s situations and design intentions. This book discusses...... to be static, and no longer acts as a kind of spatial constancy maintaining stability and order? Moreover, what new potentials open in lighting design? This book is one of four books that is published in connection with the research project entitled LED Lighting; Interdisciplinary LED Lighting Research...

  14. Adaptive test

    DEFF Research Database (Denmark)

    Kjeldsen, Lars Peter; Eriksen, Mette Rose

    2010-01-01

    Artikelen er en evaluering af de adaptive tests, som blev indført i folkeskolen. Artiklen sætter særligt fokus på evaluering i folkeskolen, herunder bidrager den med vejledning til evaluering, evalueringsværktøjer og fagspecifkt evalueringsmateriale.......Artikelen er en evaluering af de adaptive tests, som blev indført i folkeskolen. Artiklen sætter særligt fokus på evaluering i folkeskolen, herunder bidrager den med vejledning til evaluering, evalueringsværktøjer og fagspecifkt evalueringsmateriale....

  15. Is adaptation. Truly an adaptation?

    Directory of Open Access Journals (Sweden)

    Thais Flores Nogueira Diniz

    2006-04-01

    Full Text Available The article begins by historicizing film adaptation from the arrival of cinema, pointing out the many theoretical approaches under which the process has been seen: from the concept of “the same story told in a different medium” to a comprehensible definition such as “the process through which works can be transformed, forming an intersection of textual surfaces, quotations, conflations and inversions of other texts”. To illustrate this new concept, the article discusses Spike Jonze’s film Adaptation. according to James Naremore’s proposal which considers the study of adaptation as part of a general theory of repetition, joined with the study of recycling, remaking, and every form of retelling. The film deals with the attempt by the scriptwriter Charles Kaufman, cast by Nicholas Cage, to adapt/translate a non-fictional book to the cinema, but ends up with a kind of film which is by no means what it intended to be: a film of action in the model of Hollywood productions. During the process of creation, Charles and his twin brother, Donald, undergo a series of adventures involving some real persons from the world of film, the author and the protagonist of the book, all of them turning into fictional characters in the film. In the film, adaptation then signifies something different from itstraditional meaning.

  16. Adaptation is...

    International Development Research Centre (IDRC) Digital Library (Canada)

    IDRC

    vital sector is under threat. While it is far from the only development challenge facing local farmers, extreme variations in the climate of West Africa in the past several decades have dealt the region a bad hand. Drought and flood now follow each other in succession. Adaptation is... “The floods spoiled our harvests and we.

  17. Ambiguous Adaptation

    DEFF Research Database (Denmark)

    Møller Larsen, Marcus; Lyngsie, Jacob

    and reciprocal adaptation of informal governance structure create ambiguity in situations of contingencies, which, subsequently, increases the likelihood of premature relationship termination. Using a large sample of exchange relationships in the global service provider industry, we find support for a hypothesis...

  18. Hedonic "adaptation"

    Directory of Open Access Journals (Sweden)

    Paul Rozin

    2008-02-01

    Full Text Available People live in a world in which they are surrounded by potential disgust elicitors such as ``used'' chairs, air, silverware, and money as well as excretory activities. People function in this world by ignoring most of these, by active avoidance, reframing, or adaptation. The issue is particularly striking for professions, such as morticians, surgeons, or sanitation workers, in which there is frequent contact with major disgust elicitors. In this study, we study the ``adaptation'' process to dead bodies as disgust elicitors, by measuring specific types of disgust sensitivity in medical students before and after they have spent a few months dissecting a cadaver. Using the Disgust Scale, we find a significant reduction in disgust responses to death and body envelope violation elicitors, but no significant change in any other specific type of disgust. There is a clear reduction in discomfort at touching a cold dead body, but not in touching a human body which is still warm after death.

  19. Adaptation Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Huq, Saleemul

    2011-11-15

    Efforts to help the world's poor will face crises in coming decades as climate change radically alters conditions. Action Research for Community Adapation in Bangladesh (ARCAB) is an action-research programme on responding to climate change impacts through community-based adaptation. Set in Bangladesh at 20 sites that are vulnerable to floods, droughts, cyclones and sea level rise, ARCAB will follow impacts and adaptation as they evolve over half a century or more. National and international 'research partners', collaborating with ten NGO 'action partners' with global reach, seek knowledge and solutions applicable worldwide. After a year setting up ARCAB, we share lessons on the programme's design and move into our first research cycle.

  20. Adaptable positioner

    International Nuclear Information System (INIS)

    Labrador Pavon, I.

    1993-01-01

    This paper describes the circuits and programs in assembly language, developed to control the two DC motors that give mobility to a mechanical arm with two degrees of freedom. As a whole, the system is based in a adaptable regulator designed around a 8 bit microprocessor that, starting from a mode of regulation based in the successive approximation method, evolve to another mode through which, only one approximation is sufficient to get the right position of each motor. (Author) 22 fig. 6 ref

  1. Adaptive positioner

    International Nuclear Information System (INIS)

    Labrador Pavon, I.

    1993-01-01

    This paper describes the circuits and programs in assembly language, developed to control the two DC motors that give mobility to a mechanical arm with two degrees of freedom. As a whole, the system is based in a adaptable regulator designed around a 8 bit microprocessor that, starting from a mode of regulation based in the successive approximation method, evolve to another mode through which, only one approximation is sufficient to get the right position of each motor. (Author) 6 refs

  2. Computerised therapy for depression with clinician vs. assistant and brief vs. extended phone support: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Gega Lina

    2012-08-01

    Full Text Available Abstract Background Computerised cognitive behaviour therapy (cCBT involves standardised, automated, interactive self-help programmes delivered via a computer. Randomised controlled trials (RCTs and observational studies have shown than cCBT reduces depressive symptoms as much as face-to-face therapy and more than waiting lists or treatment as usual. cCBT’s efficacy and acceptability may be influenced by the “human” support offered as an adjunct to it, which can vary in duration and can be offered by people with different levels of training and expertise. Methods/design This is a two-by-two factorial RCT investigating the effectiveness, cost-effectiveness and acceptability of cCBT supplemented with 12 weekly phone support sessions are either brief (5–10 min or extended (20–30 min and are offered by either an expert clinician or an assistant with no clinical training. Adults with non-suicidal depression in primary care can self-refer into the study by completing and posting to the research team a standardised questionnaire. Following an assessment interview, eligible referrals have access to an 8-session cCBT programme called Beating the Blues and are randomised to one of four types of support: brief-assistant, extended-assistant, brief-clinician or extended-clinician. A sample size of 35 per group (total 140 is sufficient to detect a moderate effect size with 90% power on our primary outcome measure (Work and Social Adjustment Scale; assuming a 30% attrition rate, 200 patients will be randomised. Secondary outcome measures include the Beck Depression and Anxiety Inventories and the PHQ-9 and GAD-7. Data on clinical outcomes, treatment usage and patient experiences are collected in three ways: by post via self-report questionnaires at week 0 (randomisation and at weeks 12 and 24 post-randomisation; electronically by the cCBT system every time patients log-in; by phone during assessments, support sessions and exit interviews. Discussion

  3. Computerised therapy for depression with clinician vs. assistant and brief vs. extended phone support: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Gega, Lina; Swift, Louise; Barton, Garry; Todd, Gillian; Reeve, Nesta; Bird, Kelly; Holland, Richard; Howe, Amanda; Wilson, Jon; Molle, Jo

    2012-08-27

    Computerised cognitive behaviour therapy (cCBT) involves standardised, automated, interactive self-help programmes delivered via a computer. Randomised controlled trials (RCTs) and observational studies have shown than cCBT reduces depressive symptoms as much as face-to-face therapy and more than waiting lists or treatment as usual. cCBT's efficacy and acceptability may be influenced by the "human" support offered as an adjunct to it, which can vary in duration and can be offered by people with different levels of training and expertise. This is a two-by-two factorial RCT investigating the effectiveness, cost-effectiveness and acceptability of cCBT supplemented with 12 weekly phone support sessions are either brief (5-10 min) or extended (20-30 min) and are offered by either an expert clinician or an assistant with no clinical training. Adults with non-suicidal depression in primary care can self-refer into the study by completing and posting to the research team a standardised questionnaire. Following an assessment interview, eligible referrals have access to an 8-session cCBT programme called Beating the Blues and are randomised to one of four types of support: brief-assistant, extended-assistant, brief-clinician or extended-clinician.A sample size of 35 per group (total 140) is sufficient to detect a moderate effect size with 90% power on our primary outcome measure (Work and Social Adjustment Scale); assuming a 30% attrition rate, 200 patients will be randomised. Secondary outcome measures include the Beck Depression and Anxiety Inventories and the PHQ-9 and GAD-7. Data on clinical outcomes, treatment usage and patient experiences are collected in three ways: by post via self-report questionnaires at week 0 (randomisation) and at weeks 12 and 24 post-randomisation; electronically by the cCBT system every time patients log-in; by phone during assessments, support sessions and exit interviews. The study's factorial design increases its efficiency by allowing the

  4. Adaptive ethnography

    DEFF Research Database (Denmark)

    Berth, Mette

    2005-01-01

    This paper focuses on the use of an adaptive ethnography when studying such phenomena as young people's use of mobile media in a learning perspective. Mobile media such as PDAs and mobile phones have a number of affordances which make them potential tools for learning. However, before we begin to...... formal and informal learning contexts. The paper also proposes several adaptive methodological techniques for studying young people's interaction with mobiles.......This paper focuses on the use of an adaptive ethnography when studying such phenomena as young people's use of mobile media in a learning perspective. Mobile media such as PDAs and mobile phones have a number of affordances which make them potential tools for learning. However, before we begin...... to design and develop educational materials for mobile media platforms we must first understand everyday use and behaviour with a medium such as a mobile phone. The paper outlines the research design for a PhD project on mobile learning which focuses on mobile phones as a way to bridge the gap between...

  5. Computerised decision support systems in order communication for diagnostic, screening or monitoring test ordering: systematic reviews of the effects and cost-effectiveness of systems.

    Science.gov (United States)

    Main, C; Moxham, T; Wyatt, J C; Kay, J; Anderson, R; Stein, K

    2010-10-01

    Order communication systems (OCS) are computer applications used to enter diagnostic and therapeutic patient care orders and to view test results. Many potential benefits of OCS have been identified including improvements in clinician ordering patterns, optimisation of clinical time, and aiding communication processes between clinicians and different departments. Many OCS now include computerised decision support systems (CDSS), which are information systems designed to improve clinical decision-making. CDSS match individual patient characteristics to a computerised knowledge base, and software algorithms generate patient-specific recommendations. To investigate which CDSS in OCS are in use within the UK and the impact of CDSS in OCS for diagnostic, screening or monitoring test ordering compared to OCS without CDSS. To determine what features of CDSS are associated with clinician or patient acceptance of CDSS in OCS and what is known about the cost-effectiveness of CDSS in diagnostic, screening or monitoring test OCS compared to OCS without CDSS. A generic search to identify potentially relevant studies for inclusion was conducted using MEDLINE, EMBASE, Cochrane Controlled Trials Register (CCTR), CINAHL (Cumulative Index to Nursing and Allied Health Literature), DARE (Database of Abstracts of Reviews of Effects), Health Technology Assessment (HTA) database, IEEE (Institute of Electrical and Electronic Engineers) Xplore digital library, NHS Economic Evaluation Database (NHS EED) and EconLit, searched between 1974 and 2009 with a total of 22,109 titles and abstracts screened for inclusion. CDSS for diagnostic, screening and monitoring test ordering OCS in use in the UK were identified through contact with the 24 manufacturers/suppliers currently contracted by the National Project for Information Technology (NpfIT) to provide either national or specialist decision support. A generic search to identify potentially relevant studies for inclusion in the review was

  6. Quest for a Computerised Semantics.

    Science.gov (United States)

    Leslie, Adrian R.

    The objective of this thesis was to colligate the various strands of research in the literature of computational linguistics that have to do with the computational treatment of semantic content so as to encode it into a computerized dictionary. In chapter 1 the course of mechanical translation (1947-1960) and quantitative linguistics is traced to…

  7. Computerised tomography in radiotherapy planning

    International Nuclear Information System (INIS)

    Badcock, P.C.

    1983-01-01

    This study evaluates the effectiveness of computed tomography as an adjunct to radiotherapy planning. Until recently, acquisition of accurate data concerning tumour anatomy lagged behind other developments in radiotherapy. With the advent of computer-tomography (CT), these data can be displayed and transmitted to a treatment planning computer. It is concluded that the greatest inaccuracies in the radiation treatment of patients are to be found in both the inadequate delineation of the target volume within the patient and changes in body outline relative to the target volume over the length of the irradiated volume. The technique was useful in various subgroups (pelvic, intra-thoracic and chest-wall tumours) and for those patients being treated palliatively. With an estimated improvement in cure rate of 4.5% and cost-effective factors of between 3.3 and 5, CT-assisted radiotherapy planning appears to be a worthwhile procedure. (orig.)

  8. Adaptive therapy.

    Science.gov (United States)

    Gatenby, Robert A; Silva, Ariosto S; Gillies, Robert J; Frieden, B Roy

    2009-06-01

    A number of successful systemic therapies are available for treatment of disseminated cancers. However, tumor response is often transient, and therapy frequently fails due to emergence of resistant populations. The latter reflects the temporal and spatial heterogeneity of the tumor microenvironment as well as the evolutionary capacity of cancer phenotypes to adapt to therapeutic perturbations. Although cancers are highly dynamic systems, cancer therapy is typically administered according to a fixed, linear protocol. Here we examine an adaptive therapeutic approach that evolves in response to the temporal and spatial variability of tumor microenvironment and cellular phenotype as well as therapy-induced perturbations. Initial mathematical models find that when resistant phenotypes arise in the untreated tumor, they are typically present in small numbers because they are less fit than the sensitive population. This reflects the "cost" of phenotypic resistance such as additional substrate and energy used to up-regulate xenobiotic metabolism, and therefore not available for proliferation, or the growth inhibitory nature of environments (i.e., ischemia or hypoxia) that confer resistance on phenotypically sensitive cells. Thus, in the Darwinian environment of a cancer, the fitter chemosensitive cells will ordinarily proliferate at the expense of the less fit chemoresistant cells. The models show that, if resistant populations are present before administration of therapy, treatments designed to kill maximum numbers of cancer cells remove this inhibitory effect and actually promote more rapid growth of the resistant populations. We present an alternative approach in which treatment is continuously modulated to achieve a fixed tumor population. The goal of adaptive therapy is to enforce a stable tumor burden by permitting a significant population of chemosensitive cells to survive so that they, in turn, suppress proliferation of the less fit but chemoresistant

  9. Adaptive management

    DEFF Research Database (Denmark)

    Rist, Lucy; Campbell, Bruce Morgan; Frost, Peter

    2013-01-01

    Adaptive management (AM) emerged in the literature in the mid-1970s in response both to a realization of the extent of uncertainty involved in management, and a frustration with attempts to use modelling to integrate knowledge and make predictions. The term has since become increasingly widely used...... in scientific articles, policy documents and management plans, but both understanding and application of the concept is mixed. This paper reviews recent literature from conservation and natural resource management journals to assess diversity in how the term is used, highlight ambiguities and consider how...... the concept might be further assessed. AM is currently being used to describe many different management contexts, scales and locations. Few authors define the term explicitly or describe how it offers a means to improve management outcomes in their specific management context. Many do not adhere to the idea...

  10. The value of FDG positron emission tomography/computerised tomography (PET/CT) in pre-operative staging of colorectal cancer: a systematic review and economic evaluation.

    Science.gov (United States)

    Brush, J; Boyd, K; Chappell, F; Crawford, F; Dozier, M; Fenwick, E; Glanville, J; McIntosh, H; Renehan, A; Weller, D; Dunlop, M

    2011-09-01

    In the UK, colorectal cancer (CRC) is the third most common malignancy (behind lung and breast cancer) with 37,514 cases registered in 2006: around two-thirds (23,384) in the colon and one-third (14,130) in the rectum. Treatment of cancers of the colon can vary considerably, but surgical resection is the mainstay of treatment for curative intent. Following surgical resection, there is a comprehensive assessment of the tumour, it's invasion characteristics and spread (tumour staging). A number of imaging modalities are used in the pre-operative staging of CRCs including; computerised tomography (CT), magnetic resonance imaging, ultrasound imaging and positron emission tomography (PET). This report examines the role of CT in combination with PET scanning (PET/CT 'hybrid' scan). The research objectives are: to evaluate the diagnostic accuracy and therapeutic impact of fluorine-18-deoxyglucose (FDG) PET/CT for the pre-operative staging of primary, recurrent and metastatic cancer using systematic review methods; undertake probabilistic decision-analytic modelling (using Monte Carlo simulation); and conduct a value of information analysis to help inform whether or not there is potential worth in undertaking further research. For each aspect of the research - the systematic review, the handsearch study and the economic evaluation - a database was assembled from a comprehensive search for published and unpublished studies, which included database searches, reference lists search and contact with experts. In the systematic review prospective and retrospective patient series (diagnostic cohort) and randomised controlled trials (RCTs) were eligible for inclusion. Both consecutive series and series that are not explicitly reported as consecutive were included. Two reviewers extracted all data and applied the criteria independently and resolved disagreements by discussion. Data to populate 2 × 2 contingency tables consisting of the number of true positives, true negatives

  11. Supporting Adaptive and Adaptable Hypermedia Presentation Semantics

    NARCIS (Netherlands)

    D.C.A. Bulterman (Dick); L. Rutledge (Lloyd); L. Hardman (Lynda); J.R. van Ossenbruggen (Jacco)

    1999-01-01

    textabstractHaving the content of a presentation adapt to the needs, resources and prior activities of a user can be an important benefit of electronic documents. While part of this adaptation is related to the encodings of individual data streams, much of the adaptation can/should be guided by the

  12. Adaptation illustrations: Chapter 4

    Science.gov (United States)

    Maria Janowiak; Patricia Butler; Chris Swanston; Matt St. Pierre; Linda. Parker

    2012-01-01

    In this chapter, we demonstrate how the Adaptation Workbook (Chapter 3) can be used with the Adaptation Strategies and Approaches (Chapter 2) to develop adaptation tactics for two real-world management issues. The two illustrations in this chapter are intended to provide helpful tips to managers completing the Adaptation Workbook, as well as to show how the anticipated...

  13. Adaptive Modular Playware

    DEFF Research Database (Denmark)

    Lund, Henrik Hautop; Þorsteinsson, Arnar Tumi

    2011-01-01

    In this paper, we describe the concept of adaptive modular playware, where the playware adapts to the interaction of the individual user. We hypothesize that there are individual differences in user interaction capabilities and styles, and that adaptive playware may adapt to the individual user...

  14. Resilience through adaptation

    NARCIS (Netherlands)

    Broeke, ten Guus; Voorn, van George A.K.; Ligtenberg, Arend; Molenaar, Jaap

    2017-01-01

    Adaptation of agents through learning or evolution is an important component of the resilience of Complex Adaptive Systems (CAS). Without adaptation, the flexibility of such systems to cope with outside pressures would be much lower. To study the capabilities of CAS to adapt, social simulations

  15. Expressing Adaptation Strategies Using Adaptation Patterns

    Science.gov (United States)

    Zemirline, N.; Bourda, Y.; Reynaud, C.

    2012-01-01

    Today, there is a real challenge to enable personalized access to information. Several systems have been proposed to address this challenge including Adaptive Hypermedia Systems (AHSs). However, the specification of adaptation strategies remains a difficult task for creators of such systems. In this paper, we consider the problem of the definition…

  16. Adaptive Learning in Medical Education: The Final Piece of Technology Enhanced Learning?

    Science.gov (United States)

    Sharma, Neel; Doherty, Iain; Dong, Chaoyan

    2017-09-01

    Technology enhanced learning (TEL) is now common practice in the field of medical education. One of the primary examples of its use is that of high fidelity simulation and computerised mannequins. Further examples include online learning modules, electronic portfolios, virtual patient interactions, massive open online courses and the flipped classroom movement. The rise of TEL has occurred primarily due to the ease of internet access enabling the retrieval and sharing of information in an instant. Furthermore, the compact nature of internet ready devices such as smartphones and laptops has meant that access to information can occur anytime and anywhere. From an educational perspective however, the current utilisation of TEL has been hindered by its lack of understanding of learners' needs. This is concerning, particularly as evidence highlights that during medical training, each individual learner has their own learning requirements and often achieves competency at different rates. In view of this, there has been interest in ensuring TEL is more learner aware and that the learning process should be more personalised. Adaptive learning can aim to achieve this by ensuring content is delivered according to the needs of the learner. This commentary highlights the move towards adaptive learning and the benefits of such an intervention.

  17. Adaptive Rationality, Adaptive Behavior and Institutions

    Directory of Open Access Journals (Sweden)

    Volchik Vyacheslav, V.

    2015-12-01

    Full Text Available The economic literature focused on understanding decision-making and choice processes reveals a vast collection of approaches to human rationality. Theorists’ attention has moved from absolutely rational, utility-maximizing individuals to boundedly rational and adaptive ones. A number of economists have criticized the concepts of adaptive rationality and adaptive behavior. One of the recent trends in the economic literature is to consider humans irrational. This paper offers an approach which examines adaptive behavior in the context of existing institutions and constantly changing institutional environment. It is assumed that adaptive behavior is a process of evolutionary adjustment to fundamental uncertainty. We emphasize the importance of actors’ engagement in trial and error learning, since if they are involved in this process, they obtain experience and are able to adapt to existing and new institutions. The paper aims at identifying relevant institutions, adaptive mechanisms, informal working rules and practices that influence actors’ behavior in the field of Higher Education in Russia (Rostov Region education services market has been taken as an example. The paper emphasizes the application of qualitative interpretative methods (interviews and discourse analysis in examining actors’ behavior.

  18. Uncertainty in adaptive capacity

    International Nuclear Information System (INIS)

    Neil Adger, W.; Vincent, K.

    2005-01-01

    The capacity to adapt is a critical element of the process of adaptation: it is the vector of resources that represent the asset base from which adaptation actions can be made. Adaptive capacity can in theory be identified and measured at various scales, from the individual to the nation. The assessment of uncertainty within such measures comes from the contested knowledge domain and theories surrounding the nature of the determinants of adaptive capacity and the human action of adaptation. While generic adaptive capacity at the national level, for example, is often postulated as being dependent on health, governance and political rights, and literacy, and economic well-being, the determinants of these variables at national levels are not widely understood. We outline the nature of this uncertainty for the major elements of adaptive capacity and illustrate these issues with the example of a social vulnerability index for countries in Africa. (authors)

  19. Adaptive Multimedia Retrieval: Semantics, Context, and Adaptation

    DEFF Research Database (Denmark)

    This book constitutes the thoroughly refereed post-conference proceedings of the 10th International Conference on Adaptive Multimedia Retrieval, AMR 2012, held in Copenhagen, Denmark, in October 2012. The 17 revised full papers presented were carefully reviewed and selected from numerous submissi......This book constitutes the thoroughly refereed post-conference proceedings of the 10th International Conference on Adaptive Multimedia Retrieval, AMR 2012, held in Copenhagen, Denmark, in October 2012. The 17 revised full papers presented were carefully reviewed and selected from numerous...... submissions. The papers cover topics of state of the art contributions, features and classification, location context, language and semantics, music retrieval, and adaption and HCI....

  20. Adaptation to climate change

    NARCIS (Netherlands)

    Carmin, J.; Tierney, K.; Chu, E.; Hunter, L.M.; Roberts, J.T.; Shi, L.; Dunlap, R.E.; Brulle, R.J.

    2015-01-01

    Climate change adaptation involves major global and societal challenges such as finding adequate and equitable adaptation funding and integrating adaptation and development programs. Current funding is insufficient. Debates between the Global North and South center on how best to allocate the

  1. Adaptation and Cultural Diffusion.

    Science.gov (United States)

    Ormrod, Richard K.

    1992-01-01

    Explores the role of adaptation in cultural diffusion. Explains that adaptation theory recognizes the lack of independence between innovations and their environmental settings. Discusses testing and selection, modification, motivation, and cognition. Suggests that adaptation effects are pervasive in cultural diffusion but require a broader, more…

  2. Adaptive user interfaces

    CERN Document Server

    1990-01-01

    This book describes techniques for designing and building adaptive user interfaces developed in the large AID project undertaken by the contributors.Key Features* Describes one of the few large-scale adaptive interface projects in the world* Outlines the principles of adaptivity in human-computer interaction

  3. Resilience through adaptation.

    Directory of Open Access Journals (Sweden)

    Guus A Ten Broeke

    Full Text Available Adaptation of agents through learning or evolution is an important component of the resilience of Complex Adaptive Systems (CAS. Without adaptation, the flexibility of such systems to cope with outside pressures would be much lower. To study the capabilities of CAS to adapt, social simulations with agent-based models (ABMs provide a helpful tool. However, the value of ABMs for studying adaptation depends on the availability of methodologies for sensitivity analysis that can quantify resilience and adaptation in ABMs. In this paper we propose a sensitivity analysis methodology that is based on comparing time-dependent probability density functions of output of ABMs with and without agent adaptation. The differences between the probability density functions are quantified by the so-called earth-mover's distance. We use this sensitivity analysis methodology to quantify the probability of occurrence of critical transitions and other long-term effects of agent adaptation. To test the potential of this new approach, it is used to analyse the resilience of an ABM of adaptive agents competing for a common-pool resource. Adaptation is shown to contribute positively to the resilience of this ABM. If adaptation proceeds sufficiently fast, it may delay or avert the collapse of this system.

  4. Resilience through adaptation.

    Science.gov (United States)

    Ten Broeke, Guus A; van Voorn, George A K; Ligtenberg, Arend; Molenaar, Jaap

    2017-01-01

    Adaptation of agents through learning or evolution is an important component of the resilience of Complex Adaptive Systems (CAS). Without adaptation, the flexibility of such systems to cope with outside pressures would be much lower. To study the capabilities of CAS to adapt, social simulations with agent-based models (ABMs) provide a helpful tool. However, the value of ABMs for studying adaptation depends on the availability of methodologies for sensitivity analysis that can quantify resilience and adaptation in ABMs. In this paper we propose a sensitivity analysis methodology that is based on comparing time-dependent probability density functions of output of ABMs with and without agent adaptation. The differences between the probability density functions are quantified by the so-called earth-mover's distance. We use this sensitivity analysis methodology to quantify the probability of occurrence of critical transitions and other long-term effects of agent adaptation. To test the potential of this new approach, it is used to analyse the resilience of an ABM of adaptive agents competing for a common-pool resource. Adaptation is shown to contribute positively to the resilience of this ABM. If adaptation proceeds sufficiently fast, it may delay or avert the collapse of this system.

  5. Behavioural strategy: Adaptability context

    Directory of Open Access Journals (Sweden)

    Piórkowska Katarzyna

    2016-05-01

    Full Text Available The paper is embedded in the following fields: strategic management in terms of behavioural strategy concept, adaptability construct, and micro-foundations realm as well as organizational theory and psychology. Moreover, the paper concerns to some extent a multi-level approach in strategic management involving individual, team, and organizational level. The aim of the paper is to contribute to extend, on one hand, the ascertainment set in the field of behavioural strategy as behavioural strategy encompasses a mindboggling diversity of topics and methods and its conceptual unity has been hard to achieve (Powell, Lovallo, Fox 2011, p. 1371, and on the other hand, to order mixed approaches to adaptability especially to gain insights on micro-level adapting processes (individual adaptability and adaptive performance in terms of the multi-level approach. The method that has been used is literature studies and the interference is mostly deductive. The structure of the manuscript is four-fold. The first part involves the considerations in the field of adaptability and adaptive performance at the individual level. The issues of adaptability and adaptive performance at the team level have been presented in the second part. The third part encompasses the organizational adaptability assertions. Finally, the conclusion, limitations of the considerations highlighted as well as the future research directions have been emphasized. The overarching key finding is that the behavioural strategy concept may constitute the boundary spanner in exploring and explaining adaptability phenomenon at different levels of analysis.

  6. Adaptive protection scheme

    Directory of Open Access Journals (Sweden)

    R. Sitharthan

    2016-09-01

    Full Text Available This paper aims at modelling an electronically coupled distributed energy resource with an adaptive protection scheme. The electronically coupled distributed energy resource is a microgrid framework formed by coupling the renewable energy source electronically. Further, the proposed adaptive protection scheme provides a suitable protection to the microgrid for various fault conditions irrespective of the operating mode of the microgrid: namely, grid connected mode and islanded mode. The outstanding aspect of the developed adaptive protection scheme is that it monitors the microgrid and instantly updates relay fault current according to the variations that occur in the system. The proposed adaptive protection scheme also employs auto reclosures, through which the proposed adaptive protection scheme recovers faster from the fault and thereby increases the consistency of the microgrid. The effectiveness of the proposed adaptive protection is studied through the time domain simulations carried out in the PSCAD⧹EMTDC software environment.

  7. Technology transfer for adaptation

    Science.gov (United States)

    Biagini, Bonizella; Kuhl, Laura; Gallagher, Kelly Sims; Ortiz, Claudia

    2014-09-01

    Technology alone will not be able to solve adaptation challenges, but it is likely to play an important role. As a result of the role of technology in adaptation and the importance of international collaboration for climate change, technology transfer for adaptation is a critical but understudied issue. Through an analysis of Global Environment Facility-managed adaptation projects, we find there is significantly more technology transfer occurring in adaptation projects than might be expected given the pessimistic rhetoric surrounding technology transfer for adaptation. Most projects focused on demonstration and early deployment/niche formation for existing technologies rather than earlier stages of innovation, which is understandable considering the pilot nature of the projects. Key challenges for the transfer process, including technology selection and appropriateness under climate change, markets and access to technology, and diffusion strategies are discussed in more detail.

  8. Origins of adaptive immunity.

    Science.gov (United States)

    Liongue, Clifford; John, Liza B; Ward, Alister

    2011-01-01

    Adaptive immunity, involving distinctive antibody- and cell-mediated responses to specific antigens based on "memory" of previous exposure, is a hallmark of higher vertebrates. It has been argued that adaptive immunity arose rapidly, as articulated in the "big bang theory" surrounding its origins, which stresses the importance of coincident whole-genome duplications. Through a close examination of the key molecules and molecular processes underpinning adaptive immunity, this review suggests a less-extreme model, in which adaptive immunity emerged as part of longer evolutionary journey. Clearly, whole-genome duplications provided additional raw genetic materials that were vital to the emergence of adaptive immunity, but a variety of other genetic events were also required to generate some of the key molecules, whereas others were preexisting and simply co-opted into adaptive immunity.

  9. METHOD OF ADAPTIVE MAGNETOTHERAPY

    OpenAIRE

    Rudyk, Valentine Yu.; Tereshchenko, Mykola F.; Rudyk, Tatiana A.

    2016-01-01

    Practical realization of adaptive control in magnetotherapy apparatus acquires an actual importance on the modern stage of development of magnetotherapy.The structural scheme of method of adaptive impulsive magnetotherapy and algorithm of adaptive control of feed-back signal during procedure of magnetotherapy is represented.A feed-back in magnetotherapy complex will be realized with control of magnetic induction and analysis of man's physiological indexes (temperature, pulse, blood prassure, ...

  10. Quantifying the Adaptive Cycle.

    Directory of Open Access Journals (Sweden)

    David G Angeler

    Full Text Available The adaptive cycle was proposed as a conceptual model to portray patterns of change in complex systems. Despite the model having potential for elucidating change across systems, it has been used mainly as a metaphor, describing system dynamics qualitatively. We use a quantitative approach for testing premises (reorganisation, conservatism, adaptation in the adaptive cycle, using Baltic Sea phytoplankton communities as an example of such complex system dynamics. Phytoplankton organizes in recurring spring and summer blooms, a well-established paradigm in planktology and succession theory, with characteristic temporal trajectories during blooms that may be consistent with adaptive cycle phases. We used long-term (1994-2011 data and multivariate analysis of community structure to assess key components of the adaptive cycle. Specifically, we tested predictions about: reorganisation: spring and summer blooms comprise distinct community states; conservatism: community trajectories during individual adaptive cycles are conservative; and adaptation: phytoplankton species during blooms change in the long term. All predictions were supported by our analyses. Results suggest that traditional ecological paradigms such as phytoplankton successional models have potential for moving the adaptive cycle from a metaphor to a framework that can improve our understanding how complex systems organize and reorganize following collapse. Quantifying reorganization, conservatism and adaptation provides opportunities to cope with the intricacies and uncertainties associated with fast ecological change, driven by shifting system controls. Ultimately, combining traditional ecological paradigms with heuristics of complex system dynamics using quantitative approaches may help refine ecological theory and improve our understanding of the resilience of ecosystems.

  11. Adaptation in Living Systems

    Science.gov (United States)

    Tu, Yuhai; Rappel, Wouter-Jan

    2018-03-01

    Adaptation refers to the biological phenomenon where living systems change their internal states in response to changes in their environments in order to maintain certain key functions critical for their survival and fitness. Adaptation is one of the most ubiquitous and arguably one of the most fundamental properties of living systems. It occurs throughout all biological scales, from adaptation of populations of species over evolutionary time to adaptation of a single cell to different environmental stresses during its life span. In this article, we review some of the recent progress made in understanding molecular mechanisms of cellular-level adaptation. We take the minimalist (or the physicist) approach and study the simplest systems that exhibit generic adaptive behaviors, namely chemotaxis in bacterium cells (Escherichia coli) and eukaryotic cells (Dictyostelium). We focus on understanding the basic biochemical interaction networks that are responsible for adaptation dynamics. By combining theoretical modeling with quantitative experimentation, we demonstrate universal features in adaptation as well as important differences in different cellular systems. Future work in extending the modeling framework to study adaptation in more complex systems such as sensory neurons is also discussed.

  12. The purpose of adaptation.

    Science.gov (United States)

    Gardner, Andy

    2017-10-06

    A central feature of Darwin's theory of natural selection is that it explains the purpose of biological adaptation. Here, I: emphasize the scientific importance of understanding what adaptations are for, in terms of facilitating the derivation of empirically testable predictions; discuss the population genetical basis for Darwin's theory of the purpose of adaptation, with reference to Fisher's 'fundamental theorem of natural selection'; and show that a deeper understanding of the purpose of adaptation is achieved in the context of social evolution, with reference to inclusive fitness and superorganisms.

  13. Management for adaptation

    Science.gov (United States)

    John Innes; Linda A. Joyce; Seppo Kellomaki; Bastiaan Louman; Aynslie Ogden; Ian Thompson; Matthew Ayres; Chin Ong; Heru Santoso; Brent Sohngen; Anita Wreford

    2009-01-01

    This chapter develops a framework to explore examples of adaptation options that could be used to ensure that the ecosystem services provided by forests are maintained under future climates. The services are divided into broad areas within which managers can identify specific management goals for individual forests or landscapes. Adaptation options exist for the major...

  14. Introduction: Adapting Idols

    NARCIS (Netherlands)

    Joost Bruin; dr. Koos Zwaan

    2012-01-01

    Introduction book Adapting Idols Since the first series of Pop Idol aired in the UK just over a decade ago, Idols television shows have been broadcast in more than forty countries all over the world. In all those countries the global Idols format has been adapted to local cultures and production

  15. Transition and adaptation

    DEFF Research Database (Denmark)

    Andrade, Stefan Bastholm

    2015-01-01

    This article analyses how Danish farm families adapted to harsh and changing conditions in the period after the great western agricultural crisis in the early 1980s. Drawing on Bourdieu's concepts of habitus and adaptation, I analyse the creation and consolidation of different class fractions amo...

  16. Adaptive Wavelet Transforms

    Energy Technology Data Exchange (ETDEWEB)

    Szu, H.; Hsu, C. [Univ. of Southwestern Louisiana, Lafayette, LA (United States)

    1996-12-31

    Human sensors systems (HSS) may be approximately described as an adaptive or self-learning version of the Wavelet Transforms (WT) that are capable to learn from several input-output associative pairs of suitable transform mother wavelets. Such an Adaptive WT (AWT) is a redundant combination of mother wavelets to either represent or classify inputs.

  17. Successfully Adapting to Change.

    Science.gov (United States)

    Baird, James R.

    1989-01-01

    Describes methods used to successfully adapt to reductions in budget allocations in the University of Utah's Instructional Media Services Department. Three main areas of concern are addressed: morale and staff development; adapting to change in the areas of funding, control, media priorities, and technology; and planning for the future. (LRW)

  18. Behavioral Adaptation and Acceptance

    NARCIS (Netherlands)

    Martens, M.H.; Jenssen, G.D.

    2012-01-01

    One purpose of Intelligent Vehicles is to improve road safety, throughput, and emissions. However, the predicted effects are not always as large as aimed for. Part of this is due to indirect behavioral changes of drivers, also called behavioral adaptation. Behavioral adaptation (BA) refers to

  19. Human pathogen avoidance adaptations

    NARCIS (Netherlands)

    Tybur, J.M.; Lieberman, D.

    2016-01-01

    Over the past few decades, researchers have become increasingly interested in the adaptations guiding the avoidance of disease-causing organisms. Here we discuss the latest developments in this area, including a recently developed information-processing model of the adaptations underlying pathogen

  20. Financing climate change adaptation

    NARCIS (Netherlands)

    Bouwer, L.M.; Aerts, J.C.J.H.

    2006-01-01

    This paper examines the topic of financing adaptation in future climate change policies. A major question is whether adaptation in developing countries should be financed under the 1992 United Nations Framework Convention on Climate Change (UNFCCC), or whether funding should come from other sources.

  1. Adaptation investments and homeownership

    DEFF Research Database (Denmark)

    Hansen, Jørgen Drud; Skak, Morten

    2008-01-01

    the home through a supplementary investment. Ownership offers low costs of adaptation, but has high contract costs compared with renting. Consumers simultaneously decide housing demand and tenure, and because of the different cost structure only consumers with strong preferences for individual adaptation...

  2. Adaptation investments and homeownership

    DEFF Research Database (Denmark)

    Hansen, Jørgen Drud; Skak, Morten

    2008-01-01

    by adapting the home through a supplementary investment. Ownership offers low costs of adaptation, but has high contract costs compared with renting. Consumers simultaneously choose housing demand and tenure, and because of the different cost structure only consumers with strong preferences for individual...

  3. Turbine system and adapter

    Science.gov (United States)

    Hogberg, Nicholas Alvin; Garcia-Crespo, Andres Jose

    2017-05-30

    A turbine system and adapter are disclosed. The adapter includes a turbine attachment portion having a first geometry arranged to receive a corresponding geometry of a wheelpost of a turbine rotor, and a bucket attachment portion having a second geometry arranged to receive a corresponding geometry of a root portion of a non-metallic turbine bucket. Another adapter includes a turbine attachment portion arranged to receive a plurality of wheelposts of a turbine rotor, and a bucket attachment portion arranged to receive a plurality of non-metallic turbine buckets having single dovetail configuration root portions. The turbine system includes a turbine rotor wheel configured to receive metal buckets, at least one adapter secured to at least one wheelpost on the turbine rotor wheel, and at least one non-metallic bucket secured to the at least one adapter.

  4. Adaptive noise cancellation

    International Nuclear Information System (INIS)

    Akram, N.

    1999-01-01

    In this report we describe the concept of adaptive noise canceling, an alternative method of estimating signals corrupted by additive noise of interference. The method uses 'primary' input containing the corrupted signal and a 'reference' input containing noise correlated in some unknown way with the primary noise, the reference input is adaptively filtered and subtracted from the primary input to obtain the signal estimate. Adaptive filtering before subtraction allows the treatment of inputs that are deterministic or stochastic, stationary or time variable. When the reference input is free of signal and certain other conditions are met then noise in the primary input can be essentially eliminated without signal distortion. It is further shown that the adaptive filter also acts as notch filter. Simulated results illustrate the usefulness of the adaptive noise canceling technique. (author)

  5. Inhabiting Adaptive Architecture

    Directory of Open Access Journals (Sweden)

    Holger Schnädelbach

    2017-12-01

    Full Text Available Adaptive Architecture concerns buildings that are specifically designed to adapt to their inhabitants and to their environments. Work in this space has a very long history, with a number of adaptive buildings emerging during the modernist period, such as Rietveld’s Schröder house, Gaudi’s Casa Batlló and Chareau's Maison de Verre. Such early work included manual adaptivity, even if that was motor-assisted. Today, buildings have started to combine this with varying degrees of automation and designed-for adaptivity is commonplace in office buildings and eco homes, where lighting, air conditioning, access and energy generation respond to and influence the behaviour of people, and the internal and external climate.

  6. Appraising Adaptive Management

    Directory of Open Access Journals (Sweden)

    Kai N. Lee

    1999-12-01

    Full Text Available Adaptive management is appraised as a policy implementation approach by examining its conceptual, technical, equity, and practical strengths and limitations. Three conclusions are drawn: (1 Adaptive management has been more influential, so far, as an idea than as a practical means of gaining insight into the behavior of ecosystems utilized and inhabited by humans. (2 Adaptive management should be used only after disputing parties have agreed to an agenda of questions to be answered using the adaptive approach; this is not how the approach has been used. (3 Efficient, effective social learning, of the kind facilitated by adaptive management, is likely to be of strategic importance in governing ecosystems as humanity searches for a sustainable economy.

  7. Adaptive signal processor

    Energy Technology Data Exchange (ETDEWEB)

    Walz, H.V.

    1980-07-01

    An experimental, general purpose adaptive signal processor system has been developed, utilizing a quantized (clipped) version of the Widrow-Hoff least-mean-square adaptive algorithm developed by Moschner. The system accommodates 64 adaptive weight channels with 8-bit resolution for each weight. Internal weight update arithmetic is performed with 16-bit resolution, and the system error signal is measured with 12-bit resolution. An adapt cycle of adjusting all 64 weight channels is accomplished in 8 ..mu..sec. Hardware of the signal processor utilizes primarily Schottky-TTL type integrated circuits. A prototype system with 24 weight channels has been constructed and tested. This report presents details of the system design and describes basic experiments performed with the prototype signal processor. Finally some system configurations and applications for this adaptive signal processor are discussed.

  8. Adaptive signal processor

    International Nuclear Information System (INIS)

    Walz, H.V.

    1980-07-01

    An experimental, general purpose adaptive signal processor system has been developed, utilizing a quantized (clipped) version of the Widrow-Hoff least-mean-square adaptive algorithm developed by Moschner. The system accommodates 64 adaptive weight channels with 8-bit resolution for each weight. Internal weight update arithmetic is performed with 16-bit resolution, and the system error signal is measured with 12-bit resolution. An adapt cycle of adjusting all 64 weight channels is accomplished in 8 μsec. Hardware of the signal processor utilizes primarily Schottky-TTL type integrated circuits. A prototype system with 24 weight channels has been constructed and tested. This report presents details of the system design and describes basic experiments performed with the prototype signal processor. Finally some system configurations and applications for this adaptive signal processor are discussed

  9. 75 FR 57859 - Specially Adapted Housing and Special Home Adaptation

    Science.gov (United States)

    2010-09-23

    ... Home Adaptation AGENCY: Department of Veterans Affairs. ACTION: Final rule. SUMMARY: The Department of... specially adapted housing and special home adaptation grants. This final rule incorporates certain... regulations pertaining to eligibility for specially adapted housing (SAH) grants and special home adaptation...

  10. Dynamical adaptation in photoreceptors.

    Directory of Open Access Journals (Sweden)

    Damon A Clark

    Full Text Available Adaptation is at the heart of sensation and nowhere is it more salient than in early visual processing. Light adaptation in photoreceptors is doubly dynamical: it depends upon the temporal structure of the input and it affects the temporal structure of the response. We introduce a non-linear dynamical adaptation model of photoreceptors. It is simple enough that it can be solved exactly and simulated with ease; analytical and numerical approaches combined provide both intuition on the behavior of dynamical adaptation and quantitative results to be compared with data. Yet the model is rich enough to capture intricate phenomenology. First, we show that it reproduces the known phenomenology of light response and short-term adaptation. Second, we present new recordings and demonstrate that the model reproduces cone response with great precision. Third, we derive a number of predictions on the response of photoreceptors to sophisticated stimuli such as periodic inputs, various forms of flickering inputs, and natural inputs. In particular, we demonstrate that photoreceptors undergo rapid adaptation of response gain and time scale, over ∼ 300[Formula: see text] ms-i. e., over the time scale of the response itself-and we confirm this prediction with data. For natural inputs, this fast adaptation can modulate the response gain more than tenfold and is hence physiologically relevant.

  11. Introduction to adaptive arrays

    CERN Document Server

    Monzingo, Bob; Haupt, Randy

    2011-01-01

    This second edition is an extensive modernization of the bestselling introduction to the subject of adaptive array sensor systems. With the number of applications of adaptive array sensor systems growing each year, this look at the principles and fundamental techniques that are critical to these systems is more important than ever before. Introduction to Adaptive Arrays, 2nd Edition is organized as a tutorial, taking the reader by the hand and leading them through the maze of jargon that often surrounds this highly technical subject. It is easy to read and easy to follow as fundamental concept

  12. [Adaptive optics for ophthalmology].

    Science.gov (United States)

    Saleh, M

    2016-04-01

    Adaptive optics is a technology enhancing the visual performance of an optical system by correcting its optical aberrations. Adaptive optics have already enabled several breakthroughs in the field of visual sciences, such as improvement of visual acuity in normal and diseased eyes beyond physiologic limits, and the correction of presbyopia. Adaptive optics technology also provides high-resolution, in vivo imaging of the retina that may eventually help to detect the onset of retinal conditions at an early stage and provide better assessment of treatment efficacy. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  13. Adaptive algebraic reconstruction technique

    International Nuclear Information System (INIS)

    Lu Wenkai; Yin Fangfang

    2004-01-01

    Algebraic reconstruction techniques (ART) are iterative procedures for reconstructing objects from their projections. It is proven that ART can be computationally efficient by carefully arranging the order in which the collected data are accessed during the reconstruction procedure and adaptively adjusting the relaxation parameters. In this paper, an adaptive algebraic reconstruction technique (AART), which adopts the same projection access scheme in multilevel scheme algebraic reconstruction technique (MLS-ART), is proposed. By introducing adaptive adjustment of the relaxation parameters during the reconstruction procedure, one-iteration AART can produce reconstructions with better quality, in comparison with one-iteration MLS-ART. Furthermore, AART outperforms MLS-ART with improved computational efficiency

  14. SpotADAPT

    DEFF Research Database (Denmark)

    Kaulakiene, Dalia; Thomsen, Christian; Pedersen, Torben Bach

    2015-01-01

    by Amazon Web Services (AWS). The users aiming for the spot market are presented with many instance types placed in multiple datacenters in the world, and thus it is difficult to choose the optimal deployment. In this paper, we propose the framework SpotADAPT (Spot-Aware (re-)Deployment of Analytical...... of typical analytical workloads and real spot price traces. SpotADAPT's suggested deployments are comparable to the theoretically optimal ones, and in particular, it shows good cost benefits for the budget optimization -- on average SpotADAPT is at most 0.3% more expensive than the theoretically optimal...

  15. Split-mouth and parallel-arm trials to compare pain with intraosseous anaesthesia delivered by the computerised Quicksleeper system and conventional infiltration anaesthesia in paediatric oral healthcare: protocol for a randomised controlled trial.

    Science.gov (United States)

    Smaïl-Faugeron, Violaine; Muller-Bolla, Michèle; Sixou, Jean-Louis; Courson, Frédéric

    2015-07-10

    Local anaesthesia is commonly used in paediatric oral healthcare. Infiltration anaesthesia is the most frequently used, but recent developments in anaesthesia techniques have introduced an alternative: intraosseous anaesthesia. We propose to perform a split-mouth and parallel-arm multicentre randomised controlled trial (RCT) comparing the pain caused by the insertion of the needle for the injection of conventional infiltration anaesthesia, and intraosseous anaesthesia by the computerised QuickSleeper system, in children and adolescents. Inclusion criteria are patients 7-15 years old with at least 2 first permanent molars belonging to the same dental arch (for the split-mouth RCT) or with a first permanent molar (for the parallel-arm RCT) requiring conservative or endodontic treatment limited to pulpotomy. The setting of this study is the Department of Paediatric Dentistry at 3 University dental hospitals in France. The primary outcome measure will be pain reported by the patient on a visual analogue scale concerning the insertion of the needle and the injection/infiltration. Secondary outcomes are latency, need for additional anaesthesia during the treatment and pain felt during the treatment. We will use a computer-generated permuted-block randomisation sequence for allocation to anaesthesia groups. The random sequences will be stratified by centre (and by dental arch for the parallel-arm RCT). Only participants will be blinded to group assignment. Data will be analysed by the intent-to-treat principle. In all, 160 patients will be included (30 in the split-mouth RCT, 130 in the parallel-arm RCT). This protocol has been approved by the French ethics committee for the protection of people (Comité de Protection des Personnes, Ile de France I) and will be conducted in full accordance with accepted ethical principles. Findings will be reported in scientific publications and at research conferences, and in project summary papers for participants. Clinical

  16. The impact of a computerised test of attention and activity (QbTest) on diagnostic decision-making in children and young people with suspected attention deficit hyperactivity disorder: single-blind randomised controlled trial.

    Science.gov (United States)

    Hollis, Chris; Hall, Charlotte L; Guo, Boliang; James, Marilyn; Boadu, Janet; Groom, Madeleine J; Brown, Nikki; Kaylor-Hughes, Catherine; Moldavsky, Maria; Valentine, Althea Z; Walker, Gemma M; Daley, David; Sayal, Kapil; Morriss, Richard

    2018-04-26

    Diagnosis of attention deficit hyperactivity disorder (ADHD) relies on subjective methods which can lead to diagnostic uncertainty and delay. This trial evaluated the impact of providing a computerised test of attention and activity (QbTest) report on the speed and accuracy of diagnostic decision-making in children with suspected ADHD. Randomised, parallel, single-blind controlled trial in mental health and community paediatric clinics in England. Participants were 6-17 years-old and referred for ADHD diagnostic assessment; all underwent assessment-as-usual, plus QbTest. Participants and their clinician were randomised to either receive the QbTest report immediately (QbOpen group) or the report was withheld (QbBlind group). The primary outcome was number of consultations until a diagnostic decision confirming/excluding ADHD within 6-months from baseline. Health economic cost-effectiveness and cost utility analysis was conducted. Assessing QbTest Utility in ADHD: A Randomised Controlled Trial was registered at ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT02209116). One hundred and thirty-two participants were randomised to QbOpen group (123 analysed) and 135 to QbBlind group (127 analysed). Clinicians with access to the QbTest report (QbOpen) were more likely to reach a diagnostic decision about ADHD (hazard ratio 1.44, 95% CI 1.04-2.01). At 6-months, 76% of those with a QbTest report had received a diagnostic decision, compared with 50% without. QbTest reduced appointment length by 15% (time ratio 0.85, 95% CI 0.77-0.93), increased clinicians' confidence in their diagnostic decisions (odds ratio 1.77, 95% CI 1.09-2.89) and doubled the likelihood of excluding ADHD. There was no difference in diagnostic accuracy. Health economic analysis showed a position of strict dominance; however, cost savings were small suggesting that the impact of providing the QbTest report within this trial can best be viewed as 'cost neutral'. QbTest may increase the

  17. Is computerised CBT really helpful for adult depression?-A meta-analytic re-evaluation of CCBT for adult depression in terms of clinical implementation and methodological validity.

    Science.gov (United States)

    So, Mirai; Yamaguchi, Sosei; Hashimoto, Sora; Sado, Mitsuhiro; Furukawa, Toshi A; McCrone, Paul

    2013-04-15

    Depression is a major cause of disability worldwide, and computerised cognitive behavioural therapy (CCBT) is expected to be a more augmentative and efficient treatment. According to previous meta-analyses of CCBT, there is a need for a meta-analytic revaluation of the short-term effectiveness of this therapy and for an evaluation of its long-term effects, functional improvement and dropout. Five databases were used (MEDLINE, PsycINFO, EMBASE, CENTRAL and CiNii). We included all RCTs with proper concealment and blinding of outcome assessment for the clinical effectiveness of CCBT in adults (aged 18 and over) with depression. Using Cohen's method, the standard mean difference (SMD) for the overall pooled effects across the included studies was estimated with a random effect model. The main outcome measure and the relative risk of dropout were included in the meta-analysis. Fourteen trials met the inclusion criteria, and sixteen comparisons from these were used for the largest meta-analysis ever. All research used appropriate random sequence generation and Intention-to-Treat analyses (ITT), and employed self-reported measures as the primary outcome. For the sixteen comparisons (2807 participants) comparing CCBT and control conditions, the pooled SMD was -0.48 [95% IC -0.63 to -0.33], suggesting similar effect to the past reviews. Also, there was no significant clinical effect at long follow-up and no improvement of function found. Furthermore, a significantly higher drop-out rate was found for CCBT than for controls. When including studies without BDI as a rating scale and with only modern imputation as sensitivity analysis, the pooled SMD remained significant despite the reduction from a moderate to a small effect. Significant publication bias was found in a funnel plot and on two tests (Begg's p = 0.09; Egger's p = 0.01). Using a trim and fill analysis, the SMD was -0.32 [95% CI -0.49 to -0.16]. Despite a short-term reduction in depression at post-treatment, the

  18. Computerised Decision Support Systems for the management of freshwater radioecological emergencies: assessment of the state-of-the-art with respect to the experiences and needs of end-users

    International Nuclear Information System (INIS)

    Hofman, D.; Monte, L.; Boyer, P.; Brittain, J.; Donchyts, G.; Gallego, E.; Gheorghiu, D.; Hakanson, L.; Heling, R.; Kerekes, A.; Kocsy, G.; Lepicard, S.; Slavik, O.; Slavnicu, D.; Smith, J.; Zheleznyak, M.

    2011-01-01

    Assessment of the environmental and radiological consequences of a nuclear accident requires the management of a great deal of data and information as well as the use of predictive models. Computerised Decision Support Systems (CDSS) are essential tools for this kind of complex assessment and for assisting experts with a rational decision process. The present work focuses on the assessment of the main features of selected state-of-the-art CDSS for off-site management of freshwater ecosystems contaminated by radionuclides. This study involved both developers and end-users of the assessed CDSS and was based on practical customisation exercises, installation and application of the decision systems. Potential end-users can benefit from the availability of several ready-to-use CDSS that allow one to run different kinds of models aimed at predicting the behaviour of radionuclides in aquatic ecosystems, evaluating doses to humans, assessing the effectiveness of different kinds of environmental management interventions and ranking these interventions, accounting for their social, economic and environmental impacts. As a result of the present assessment, the importance of CDSS 'integration' became apparent: in many circumstances, different CDSS can be used as complementary tools for the decision-making process. The results of this assessment can also be useful for the future development and improvement of the CDSS. - Research highlights: →The present work focuses on the assessment of the main features of selected state-of-the-art CDSS for the off-site management of freshwater ecosystems contaminated by radionuclides. →Potential end-users can benefit from a number of complementary open, freely-available and ready-to-use CDSS based on validated environmental models aimed at predicting the migration of radionuclides in the aquatic environment, evaluating the doses to man, assessing the effectiveness of different environmental feasible restoration strategies and

  19. The process of organisational adaptation through innovations, and organisational adaptability

    OpenAIRE

    Tikka, Tommi

    2010-01-01

    This study is about the process of organisational adaptation and organisational adaptability. The study generates a theoretical framework about organisational adaptation behaviour and conditions that have influence on success of organisational adaptation. The research questions of the study are: How does an organisation adapt through innovations, and which conditions enhance or impede organisational adaptation through innovations? The data were gathered from five case organisations withi...

  20. Adaptive digital filters

    CERN Document Server

    Kovačević, Branko; Milosavljević, Milan

    2013-01-01

    Adaptive Digital Filters” presents an important discipline applied to the domain of speech processing. The book first makes the reader acquainted with the basic terms of filtering and adaptive filtering, before introducing the field of advanced modern algorithms, some of which are contributed by the authors themselves. Working in the field of adaptive signal processing requires the use of complex mathematical tools. The book offers a detailed presentation of the mathematical models that is clear and consistent, an approach that allows everyone with a college level of mathematics knowledge to successfully follow the mathematical derivations and descriptions of algorithms.   The algorithms are presented in flow charts, which facilitates their practical implementation. The book presents many experimental results and treats the aspects of practical application of adaptive filtering in real systems, making it a valuable resource for both undergraduate and graduate students, and for all others interested in m...

  1. Adaptive Trajectory Design

    Data.gov (United States)

    National Aeronautics and Space Administration — Adaptive Trajectory Design (ATD) is an original concept for quick and efficient end-to-end trajectory designs using proven piece-wise dynamical methods. With ongoing...

  2. Radio-adaptive response

    International Nuclear Information System (INIS)

    Ikushima, Takaji

    1991-01-01

    An adaptive response to radiation stress was found in cultured Chinese hamster V79 cells, as a suppressed induction of micronuclei (MNs) and sister chromatid exchanges (SCEs) in the cells conditioned by very low doses. The important characteristics of the novel chromosomal response, called radio-adaptive response (RAR), that have newly emerged in this study are: 1) Low doses of beta-rays from tritiated water (HTO) as well as tritiated thymidine can cause the RAR. 2) Thermal neutrons, a high LET radiation, can not act as tritium beta-rays or gamma-rays. 3) The RAR expression is suppressed by an inhibition of protein synthesis. 4) Several proteins are newly synthesized concurrently with the RAR expression after adapting doses, viewed by two-dimensional electrophoresis of cellular proteins. These results suggest that the RAR is an adaptive chromosomal DNA repair induced by very low doses of low LET radiations under restricted conditions, accompanying the inducible specific gene expression. (author)

  3. Adaptations in Play

    DEFF Research Database (Denmark)

    Jørgensen, Ida Kathrine Hammeleff

    2017-01-01

    2010). Such adaptations make use of different strategies for capturing the various aspects of their source. Talisman: Digital Edition (Nomad Games 2014) largely adopts the same primary mechanics of the board game Talisman (Fantasy Flight Games 2008) while StarCraft: The Board Game (Fantasy Flight Games...... from television or cinema (Woods 2012). Furthermore, since the early days of digital games, tabletop games have served as a source of inspiration for many video-game designers, and more recently we have seen the occurrence of tabletop game adaptations of popular video-games such as StarCraft (Blizzard...... similarities and differences equally and thus challenges the ‘ideology of fidelity’ that has long permeated the field of adaption studies. This presentation explores adaptations between digital and non-digital games. This analysis is inspired by intermedial studies (e.g. Elleström 2010) that distinguishes...

  4. Adaptive Spectral Doppler Estimation

    DEFF Research Database (Denmark)

    Gran, Fredrik; Jakobsson, Andreas; Jensen, Jørgen Arendt

    2009-01-01

    . The methods can also provide better quality of the estimated power spectral density (PSD) of the blood signal. Adaptive spectral estimation techniques are known to pro- vide good spectral resolution and contrast even when the ob- servation window is very short. The 2 adaptive techniques are tested......In this paper, 2 adaptive spectral estimation techniques are analyzed for spectral Doppler ultrasound. The purpose is to minimize the observation window needed to estimate the spectrogram to provide a better temporal resolution and gain more flexibility when designing the data acquisition sequence...... and compared with the averaged periodogram (Welch’s method). The blood power spectral capon (BPC) method is based on a standard minimum variance technique adapted to account for both averaging over slow-time and depth. The blood amplitude and phase estimation technique (BAPES) is based on finding a set...

  5. Adaptive Processes in Hearing

    DEFF Research Database (Denmark)

    Santurette, Sébastien; Christensen-Dalsgaard, Jakob; Tranebjærg, Lisbeth

    2018-01-01

    , and is essential to achieve successful speech communication, correct orientation in our full environment, and eventually survival. These adaptive processes may differ in individuals with hearing loss, whose auditory system may cope via ‘‘readapting’’ itself over a longer time scale to the changes in sensory input...... induced by hearing impairment and the compensation provided by hearing devices. These devices themselves are now able to adapt to the listener’s individual environment, attentional state, and behavior. These topics related to auditory adaptation, in the broad sense of the term, were central to the 6th...... International Symposium on Auditory and Audiological Research held in Nyborg, Denmark, in August 2017. The symposium addressed adaptive processes in hearing from different angles, together with a wide variety of other auditory and audiological topics. The papers in this special issue result from some...

  6. Adaptation and Influence

    DEFF Research Database (Denmark)

    Paster, Thomas

    on influence. These two dimensions - adaptation and influence - result in four ideal types: business-dominated social compromise, imposed social compromise, business dominance, and political confrontation. Examples from German welfare state history illustrate these four types. The paper suggests...

  7. Adapt or Die

    DEFF Research Database (Denmark)

    Brody, Joshua Eric; Larsen, Kasper Green

    2015-01-01

    In this paper, we study the role non-adaptivity plays in maintaining dynamic data structures. Roughly speaking, a data structure is non-adaptive if the memory locations it reads and/or writes when processing a query or update depend only on the query or update and not on the contents of previously...... read cells. We study such non-adaptive data structures in the cell probe model. This model is one of the least restrictive lower bound models and in particular, cell probe lower bounds apply to data structures developed in the popular word-RAM model. Unfortunately, this generality comes at a high cost......: the highest lower bound proved for any data structure problem is only polylogarithmic. Our main result is to demonstrate that one can in fact obtain polynomial cell probe lower bounds for non-adaptive data structures. To shed more light on the seemingly inherent polylogarithmic lower bound barrier, we study...

  8. Adaptive Multilevel Monte Carlo Simulation

    KAUST Repository

    Hoel, H; von Schwerin, E; Szepessy, A; Tempone, Raul

    2011-01-01

    . An adaptive algorithm for ordinary, stochastic and partial differential equations. In Recent advances in adaptive computation, volume 383 of Contemp. Math., pages 325–343. Amer. Math. Soc., Providence, RI, 2005.). This form of the adaptive algorithm generates

  9. Climate Adaptation in Europe

    International Nuclear Information System (INIS)

    Parry, M.; McGlade, J.; Verschoor, M.; Isoard, S.; Anema, K.; Boer, J.; Cowan, C.; Collins, R.; Smeets, M.

    2009-01-01

    At the Conference of Parties in Copenhagen, Denmark, December 7-18, 2009 Change Magazine will present a special issue on 'Climate Adaptation in Europe'. The magazine contains articles on climate policy strategies in European countries and cross-border studies on climate change, articles on climate adaptation in the Alps, on water quality as a bottleneck for the agricultural sector, and drought in the mediterranean countries. How will member countries in the European Union tackle the climate crisis?.

  10. Network and adaptive sampling

    CERN Document Server

    Chaudhuri, Arijit

    2014-01-01

    Combining the two statistical techniques of network sampling and adaptive sampling, this book illustrates the advantages of using them in tandem to effectively capture sparsely located elements in unknown pockets. It shows how network sampling is a reliable guide in capturing inaccessible entities through linked auxiliaries. The text also explores how adaptive sampling is strengthened in information content through subsidiary sampling with devices to mitigate unmanageable expanding sample sizes. Empirical data illustrates the applicability of both methods.

  11. Adaptation and perceptual norms

    Science.gov (United States)

    Webster, Michael A.; Yasuda, Maiko; Haber, Sara; Leonard, Deanne; Ballardini, Nicole

    2007-02-01

    We used adaptation to examine the relationship between perceptual norms--the stimuli observers describe as psychologically neutral, and response norms--the stimulus levels that leave visual sensitivity in a neutral or balanced state. Adapting to stimuli on opposite sides of a neutral point (e.g. redder or greener than white) biases appearance in opposite ways. Thus the adapting stimulus can be titrated to find the unique adapting level that does not bias appearance. We compared these response norms to subjectively defined neutral points both within the same observer (at different retinal eccentricities) and between observers. These comparisons were made for visual judgments of color, image focus, and human faces, stimuli that are very different and may depend on very different levels of processing, yet which share the property that for each there is a well defined and perceptually salient norm. In each case the adaptation aftereffects were consistent with an underlying sensitivity basis for the perceptual norm. Specifically, response norms were similar to and thus covaried with the perceptual norm, and under common adaptation differences between subjectively defined norms were reduced. These results are consistent with models of norm-based codes and suggest that these codes underlie an important link between visual coding and visual experience.

  12. The Climate Adaptation Frontier

    Energy Technology Data Exchange (ETDEWEB)

    Preston, Benjamin L [ORNL

    2013-01-01

    Climate adaptation has emerged as a mainstream risk management strategy for assisting in maintaining socio-ecological systems within the boundaries of a safe operating space. Yet, there are limits to the ability of systems to adapt. Here, we introduce the concept of an adaptation frontier , which is defined as a socio-ecological system s transitional adaptive operating space between safe and unsafe domains. A number of driving forces are responsible for determining the sustainability of systems on the frontier. These include path dependence, adaptation/development deficits, values conflicts and discounting of future loss and damage. The cumulative implications of these driving forces are highly uncertain. Nevertheless, the fact that a broad range of systems already persist at the edge of their frontiers suggests a high likelihood that some limits will eventually be exceeded. The resulting system transformation is likely to manifest as anticipatory modification of management objectives or loss and damage. These outcomes vary significantly with respect to their ethical implications. Successful navigation of the adaptation frontier will necessitate new paradigms of risk governance to elicit knowledge that encourages reflexive reevaluation of societal values that enable or constrain sustainability.

  13. Learning to Adapt. Organisational Adaptation to Climate Change Impacts

    International Nuclear Information System (INIS)

    Berkhout, F.; Hertin, J.; Gann, D.M.

    2006-01-01

    Analysis of human adaptation to climate change should be based on realistic models of adaptive behaviour at the level of organisations and individuals. The paper sets out a framework for analysing adaptation to the direct and indirect impacts of climate change in business organisations with new evidence presented from empirical research into adaptation in nine case-study companies. It argues that adaptation to climate change has many similarities with processes of organisational learning. The paper suggests that business organisations face a number of obstacles in learning how to adapt to climate change impacts, especially in relation to the weakness and ambiguity of signals about climate change and the uncertainty about benefits flowing from adaptation measures. Organisations rarely adapt 'autonomously', since their adaptive behaviour is influenced by policy and market conditions, and draws on resources external to the organisation. The paper identifies four adaptation strategies that pattern organisational adaptive behaviour

  14. Computerised Analysis, Interpretation, Storage and Retrieval of ...

    African Journals Online (AJOL)

    1974-06-08

    Jun 8, 1974 ... research. This whole process is time-consuming for both tech- nicians and ... ECG directly from the patient, make an automatic graphic recording on ..... reasoned that the electrocardiographic interpretation is better done by a ...

  15. A method of computerised isotope dynamic proctography

    International Nuclear Information System (INIS)

    Papachrysostomou, M.; Ferrington, C.; Merrick, M.V.; Smith, A.N.; Western General Hospital, Edinburgh; Griffin, T.M.J.

    1992-01-01

    Patients with long-standing constipation were examined by radioisotope proctography. A radiolabelled synthetic potato mash was inserted intrarectally and the dynamic changes during simulated defaecation recorded using a gamma-camera. Computer images from the stored data illustrate changes in the anorectal angle and pelvic floor. The median (and 95% confidence intervals) of the anorectal angles were: At rest 105deg (101deg, 116deg), on voluntary contraction of the pelvic floor by 'squeezing' 91deg (81deg, 98deg), on straining 120deg (107deg, 137deg) and during evacuation 126deg (116deg, 153deg). The pelvic floor movements were: Pelvic floor ascent on voluntary contraction 28 mm (9, 34 mm), pelvic floor descent on straining -8 mm (-14, -4 mm) and descent during evacuation -27 mm (-34, -11 mm). Useful additions to previous methods are measurement of the completeness of rectal evacuation 58% (42, 77 mm), the defaecation time 64 s (50, 138 s) and the defaecation rate 0.9%/s (0.4, 1.4%/s). (orig.)

  16. Computerised Screening for Dyslexia in Adults

    Science.gov (United States)

    Singleton, Chris; Horne, Joanna; Simmons, Fiona

    2009-01-01

    Identifying dyslexia in adulthood presents particular challenges because of complicating factors such as acquisition of compensatory strategies, differing degrees of intervention and the problem of distinguishing dyslexic adults from those whose literacy difficulties have non-cognitive causes. One of the implications is that conventional literacy…

  17. Computerised safeguards in Kazakhstan and its problems

    International Nuclear Information System (INIS)

    Yeligbayeva, G.Zh.

    1999-01-01

    Hereby will be described the Kazakhstan computerized safeguards system. Kazakhstan Atomic Energy Agency (KAEA) developed guides concerning of Y2K problem for facilities. The results of preliminary analyze of this problem are presented. (author)

  18. Automation, Computerisation and Future Employment in Singapore

    OpenAIRE

    Lee, King Fuei

    2016-01-01

    Digitalization is expected to radically change the prospects of the types of occupations that will be needed in the future. This research note examines the susceptibility of jobs to computerization and automation in Singapore by drawing on the methodology and initial data in Frey and Osborne (2013). We find that about one-quarter of Singaporean employment is at high risk of computerization. This places the country as having one of the lowest proportions of jobs under high risk internationally...

  19. Adapting Activity and Participation (The ADAPT intervention program)

    DEFF Research Database (Denmark)

    von Bülow, Cecilie

    Præsentation af et ergoterapeutisk gruppebaseret program, ADAPT programmet. ADAPT programmet er designet på baggrund af evidens samt understøttet af ergoterapeutiske teorier og modeller......Præsentation af et ergoterapeutisk gruppebaseret program, ADAPT programmet. ADAPT programmet er designet på baggrund af evidens samt understøttet af ergoterapeutiske teorier og modeller...

  20. Solar Adaptive Optics

    Directory of Open Access Journals (Sweden)

    Thomas R. Rimmele

    2011-06-01

    Full Text Available Adaptive optics (AO has become an indispensable tool at ground-based solar telescopes. AO enables the ground-based observer to overcome the adverse effects of atmospheric seeing and obtain diffraction limited observations. Over the last decade adaptive optics systems have been deployed at major ground-based solar telescopes and revitalized ground-based solar astronomy. The relatively small aperture of solar telescopes and the bright source make solar AO possible for visible wavelengths where the majority of solar observations are still performed. Solar AO systems enable diffraction limited observations of the Sun for a significant fraction of the available observing time at ground-based solar telescopes, which often have a larger aperture than equivalent space based observatories, such as HINODE. New ground breaking scientific results have been achieved with solar adaptive optics and this trend continues. New large aperture telescopes are currently being deployed or are under construction. With the aid of solar AO these telescopes will obtain observations of the highly structured and dynamic solar atmosphere with unprecedented resolution. This paper reviews solar adaptive optics techniques and summarizes the recent progress in the field of solar adaptive optics. An outlook to future solar AO developments, including a discussion of Multi-Conjugate AO (MCAO and Ground-Layer AO (GLAO will be given.

  1. Solar Adaptive Optics.

    Science.gov (United States)

    Rimmele, Thomas R; Marino, Jose

    Adaptive optics (AO) has become an indispensable tool at ground-based solar telescopes. AO enables the ground-based observer to overcome the adverse effects of atmospheric seeing and obtain diffraction limited observations. Over the last decade adaptive optics systems have been deployed at major ground-based solar telescopes and revitalized ground-based solar astronomy. The relatively small aperture of solar telescopes and the bright source make solar AO possible for visible wavelengths where the majority of solar observations are still performed. Solar AO systems enable diffraction limited observations of the Sun for a significant fraction of the available observing time at ground-based solar telescopes, which often have a larger aperture than equivalent space based observatories, such as HINODE. New ground breaking scientific results have been achieved with solar adaptive optics and this trend continues. New large aperture telescopes are currently being deployed or are under construction. With the aid of solar AO these telescopes will obtain observations of the highly structured and dynamic solar atmosphere with unprecedented resolution. This paper reviews solar adaptive optics techniques and summarizes the recent progress in the field of solar adaptive optics. An outlook to future solar AO developments, including a discussion of Multi-Conjugate AO (MCAO) and Ground-Layer AO (GLAO) will be given. Supplementary material is available for this article at 10.12942/lrsp-2011-2.

  2. Solar tomography adaptive optics.

    Science.gov (United States)

    Ren, Deqing; Zhu, Yongtian; Zhang, Xi; Dou, Jiangpei; Zhao, Gang

    2014-03-10

    Conventional solar adaptive optics uses one deformable mirror (DM) and one guide star for wave-front sensing, which seriously limits high-resolution imaging over a large field of view (FOV). Recent progress toward multiconjugate adaptive optics indicates that atmosphere turbulence induced wave-front distortion at different altitudes can be reconstructed by using multiple guide stars. To maximize the performance over a large FOV, we propose a solar tomography adaptive optics (TAO) system that uses tomographic wave-front information and uses one DM. We show that by fully taking advantage of the knowledge of three-dimensional wave-front distribution, a classical solar adaptive optics with one DM can provide an extra performance gain for high-resolution imaging over a large FOV in the near infrared. The TAO will allow existing one-deformable-mirror solar adaptive optics to deliver better performance over a large FOV for high-resolution magnetic field investigation, where solar activities occur in a two-dimensional field up to 60'', and where the near infrared is superior to the visible in terms of magnetic field sensitivity.

  3. An Adaptive Robot Game

    DEFF Research Database (Denmark)

    Hansen, Søren Tranberg; Svenstrup, Mikael; Dalgaard, Lars

    2010-01-01

    The goal of this paper is to describe an adaptive robot game, which motivates elderly people to do a regular amount of physical exercise while playing. One of the advantages of robot based games is that the initiative to play can be taken autonomously by the robot. In this case, the goal is to im......The goal of this paper is to describe an adaptive robot game, which motivates elderly people to do a regular amount of physical exercise while playing. One of the advantages of robot based games is that the initiative to play can be taken autonomously by the robot. In this case, the goal...... is to improve the mental and physical state of the user by playing a physical game with the robot. Ideally, a robot game should be simple to learn but difficult to master, providing an appropriate degree of challenge for players with different skills. In order to achieve that, the robot should be able to adapt...

  4. Engineering Adaptive Web Applications

    DEFF Research Database (Denmark)

    Dolog, Peter

    2007-01-01

    suit the user profile the most. This paper summarizes the domain engineering framework for such adaptive web applications. The framework provides guidelines to develop adaptive web applications as members of a family. It suggests how to utilize the design artifacts as knowledge which can be used......Information and services on the web are accessible for everyone. Users of the web differ in their background, culture, political and social environment, interests and so on. Ambient intelligence was envisioned as a concept for systems which are able to adapt to user actions and needs....... With the growing amount of information and services, the web applications become natural candidates to adopt the concepts of ambient intelligence. Such applications can deal with divers user intentions and actions based on the user profile and can suggest the combination of information content and services which...

  5. The adaptability of teams

    DEFF Research Database (Denmark)

    Jørgensen, Frances; Boer, Harry

    2006-01-01

    on the proper alignment between the structuring of the work processes and characteristics of the external context (Lawrence & Lorsch, 1967) – it provides a unique opportunity to explore the adaptation process in practice. The paper contributes to the development of contingency theory by lending support...... to the premise that “fit” between an organization’s external context and its internal structure may enhance performance, but also to the suggestion that the adaptation process may be asymmetric (Moon et al., 2004). Further, the paper contributes to practice by highlighting both the opportunities and risks...

  6. Adaptive radar resource management

    CERN Document Server

    Moo, Peter

    2015-01-01

    Radar Resource Management (RRM) is vital for optimizing the performance of modern phased array radars, which are the primary sensor for aircraft, ships, and land platforms. Adaptive Radar Resource Management gives an introduction to radar resource management (RRM), presenting a clear overview of different approaches and techniques, making it very suitable for radar practitioners and researchers in industry and universities. Coverage includes: RRM's role in optimizing the performance of modern phased array radars The advantages of adaptivity in implementing RRMThe role that modelling and

  7. Exploring adaptive program behavior

    DEFF Research Database (Denmark)

    Bonnichsen, Lars Frydendal; Probst, Christian W.

    Modern computer systems are increasingly complex, with ever changing bottlenecks. This makes it difficult to ensure consistent performance when porting software, or even running it. Adaptivity, ie, switching between program variations, and dynamic recompilation have been suggested as solutions....... Both solutions come at a cost; adaptivity issues a runtime overhead and requires more design effort, while dynamic recompilation takes time to perform. In this project, we plan to investigate the possibilities, limitations, and benefits of these techniques. This abstract covers our thoughts on how...

  8. Adaptive metric kernel regression

    DEFF Research Database (Denmark)

    Goutte, Cyril; Larsen, Jan

    2000-01-01

    Kernel smoothing is a widely used non-parametric pattern recognition technique. By nature, it suffers from the curse of dimensionality and is usually difficult to apply to high input dimensions. In this contribution, we propose an algorithm that adapts the input metric used in multivariate...... regression by minimising a cross-validation estimate of the generalisation error. This allows to automatically adjust the importance of different dimensions. The improvement in terms of modelling performance is illustrated on a variable selection task where the adaptive metric kernel clearly outperforms...

  9. Adaptive Metric Kernel Regression

    DEFF Research Database (Denmark)

    Goutte, Cyril; Larsen, Jan

    1998-01-01

    Kernel smoothing is a widely used nonparametric pattern recognition technique. By nature, it suffers from the curse of dimensionality and is usually difficult to apply to high input dimensions. In this paper, we propose an algorithm that adapts the input metric used in multivariate regression...... by minimising a cross-validation estimate of the generalisation error. This allows one to automatically adjust the importance of different dimensions. The improvement in terms of modelling performance is illustrated on a variable selection task where the adaptive metric kernel clearly outperforms the standard...

  10. How Harmful are Adaptation Restrictions

    OpenAIRE

    Bruin, de, K.C.; Dellink, R.B.

    2009-01-01

    The dominant assumption in economic models of climate policy remains that adaptation will be implemented in an optimal manner. There are, however, several reasons why optimal levels of adaptation may not be attainable. This paper investigates the effects of suboptimal levels of adaptation, i.e. adaptation restrictions, on the composition and level of climate change costs and on welfare. Several adaptation restrictions are identified and then simulated in a revised DICE model, extended with ad...

  11. To what extent can behaviour change techniques be identified within an adaptable implementation package for primary care? A prospective directed content analysis.

    Science.gov (United States)

    Glidewell, Liz; Willis, Thomas A; Petty, Duncan; Lawton, Rebecca; McEachan, Rosemary R C; Ingleson, Emma; Heudtlass, Peter; Davies, Andrew; Jamieson, Tony; Hunter, Cheryl; Hartley, Suzanne; Gray-Burrows, Kara; Clamp, Susan; Carder, Paul; Alderson, Sarah; Farrin, Amanda J; Foy, Robbie

    2018-02-17

    Interpreting evaluations of complex interventions can be difficult without sufficient description of key intervention content. We aimed to develop an implementation package for primary care which could be delivered using typically available resources and could be adapted to target determinants of behaviour for each of four quality indicators: diabetes control, blood pressure control, anticoagulation for atrial fibrillation and risky prescribing. We describe the development and prospective verification of behaviour change techniques (BCTs) embedded within the adaptable implementation packages. We used an over-lapping multi-staged process. We identified evidence-based, candidate delivery mechanisms-mainly audit and feedback, educational outreach and computerised prompts and reminders. We drew upon interviews with primary care professionals using the Theoretical Domains Framework to explore likely determinants of adherence to quality indicators. We linked determinants to candidate BCTs. With input from stakeholder panels, we prioritised likely determinants and intervention content prior to piloting the implementation packages. Our content analysis assessed the extent to which embedded BCTs could be identified within the packages and compared them across the delivery mechanisms and four quality indicators. Each implementation package included at least 27 out of 30 potentially applicable BCTs representing 15 of 16 BCT categories. Whilst 23 BCTs were shared across all four implementation packages (e.g. BCTs relating to feedback and comparing behaviour), some BCTs were unique to certain delivery mechanisms (e.g. 'graded tasks' and 'problem solving' for educational outreach). BCTs addressing the determinants 'environmental context' and 'social and professional roles' (e.g. 'restructuring the social and 'physical environment' and 'adding objects to the environment') were indicator specific. We found it challenging to operationalise BCTs targeting 'environmental context

  12. Hybrid Adaptive Flight Control with Model Inversion Adaptation

    Science.gov (United States)

    Nguyen, Nhan

    2011-01-01

    This study investigates a hybrid adaptive flight control method as a design possibility for a flight control system that can enable an effective adaptation strategy to deal with off-nominal flight conditions. The hybrid adaptive control blends both direct and indirect adaptive control in a model inversion flight control architecture. The blending of both direct and indirect adaptive control provides a much more flexible and effective adaptive flight control architecture than that with either direct or indirect adaptive control alone. The indirect adaptive control is used to update the model inversion controller by an on-line parameter estimation of uncertain plant dynamics based on two methods. The first parameter estimation method is an indirect adaptive law based on the Lyapunov theory, and the second method is a recursive least-squares indirect adaptive law. The model inversion controller is therefore made to adapt to changes in the plant dynamics due to uncertainty. As a result, the modeling error is reduced that directly leads to a decrease in the tracking error. In conjunction with the indirect adaptive control that updates the model inversion controller, a direct adaptive control is implemented as an augmented command to further reduce any residual tracking error that is not entirely eliminated by the indirect adaptive control.

  13. Robust Optimal Adaptive Control Method with Large Adaptive Gain

    Science.gov (United States)

    Nguyen, Nhan T.

    2009-01-01

    In the presence of large uncertainties, a control system needs to be able to adapt rapidly to regain performance. Fast adaptation is referred to the implementation of adaptive control with a large adaptive gain to reduce the tracking error rapidly. However, a large adaptive gain can lead to high-frequency oscillations which can adversely affect robustness of an adaptive control law. A new adaptive control modification is presented that can achieve robust adaptation with a large adaptive gain without incurring high-frequency oscillations as with the standard model-reference adaptive control. The modification is based on the minimization of the Y2 norm of the tracking error, which is formulated as an optimal control problem. The optimality condition is used to derive the modification using the gradient method. The optimal control modification results in a stable adaptation and allows a large adaptive gain to be used for better tracking while providing sufficient stability robustness. Simulations were conducted for a damaged generic transport aircraft with both standard adaptive control and the adaptive optimal control modification technique. The results demonstrate the effectiveness of the proposed modification in tracking a reference model while maintaining a sufficient time delay margin.

  14. Adapt or Become Extinct!

    DEFF Research Database (Denmark)

    Goumas, Georgios; McKee, Sally A.; Själander, Magnus

    2011-01-01

    boundaries (walls) for applications which limit software development (parallel programming wall), performance (memory wall, communication wall) and viability (power wall). The only way to survive in such a demanding environment is by adaptation. In this paper we discuss how dynamic information collected...

  15. Adaptive LQG controller tuning

    Czech Academy of Sciences Publication Activity Database

    Novák, Miroslav; Böhm, Josef; Nedoma, Petr; Tesař, Ludvík

    2003-01-01

    Roč. 150, č. 6 (2003), s. 655-665 ISSN 1350-2379 R&D Projects: GA ČR GA102/02/0204; GA AV ČR IBS1075102 Institutional research plan: CEZ:AV0Z1075907 Keywords : adaptive controller * LQG controller * controller design Subject RIV: JB - Sensors, Measurment, Regulation Impact factor: 0.745, year: 2003

  16. Adaptive Architectural Envelope

    DEFF Research Database (Denmark)

    Foged, Isak Worre; Kirkegaard, Poul Henning

    2010-01-01

    . The general scopes of this paper are to develop a new adaptive kinetic architectural structure, particularly a reconfigurable architectural structure which can transform body shape from planar geometries to hyper-surfaces using different control strategies, i.e. a transformation into more than one or two...

  17. Engineering Adaptive Applications

    DEFF Research Database (Denmark)

    Dolog, Peter

    for a domain.In this book, we propose a new domain engineering framework which extends a development process of Web applications with techniques required when designing such adaptive customizable Web applications. The framework is provided with design abstractions which deal separately with information served...

  18. Capabilities for Strategic Adaptation

    DEFF Research Database (Denmark)

    Distel, Andreas Philipp

    This dissertation explores capabilities that enable firms to strategically adapt to environmental changes and preserve competitiveness over time – often referred to as dynamic capabilities. While dynamic capabilities being a popular research domain, too little is known about what these capabiliti...

  19. Adaptive municipal electronic forms

    NARCIS (Netherlands)

    Kuiper, Pieternel; van Dijk, Elisabeth M.A.G.; Bondarouk, Tatiana; Ruel, Hubertus Johannes Maria; Guiderdoni-Jourdain, Karine; Oiry, Ewan

    Adaptation of electronic forms (e-forms) seems to be a step forward to reduce the burden for people who fill in forms. Municipalities more and more offer e-forms online that can be used by citizens to request a municipal product or service or by municipal employees to place a request on behalf of a

  20. Stimuli-Adaptable Materials

    DEFF Research Database (Denmark)

    Frankær, Sarah Maria Grundahl

    The work presented in this Thesis deals with the development of a stimuli-adaptable polymer material based on the UV-induced dimerisation of cinnamic acid and its derivatives. It is in the nature of an adhesive to adhere very well to its substrate and therefore problems can arise upon removal...

  1. The governance of adaptation

    NARCIS (Netherlands)

    Huitema, Dave; Adger, William Neil; Berkhout, Frans; Massey, Eric; Mazmanian, Daniel; Munaretto, Stefania; Plummer, Ryan; Termeer, Katrien

    2016-01-01

    The governance of climate adaptation involves the collective efforts of multiple societal actors to address problems, or to reap the benefits, associated with impacts of climate change. Governing involves the creation of institutions, rules and organizations, and the selection of normative

  2. Asynchronous LMS adaptive equalization

    NARCIS (Netherlands)

    Bergmans, J.W.M.; Lin, M.Y.; Modrie, D.; Otte, R.

    2005-01-01

    Digital data receivers often operate at a fixed sampling rate 1/Ts that is asynchronous to the baud rate 1/T. A digital equalizer that processes the incoming signal will also operate in the asynchronous clock domain. Existing adaptation techniques for this equalizer involve an error sequence ek that

  3. Controlling smart grid adaptivity

    OpenAIRE

    Toersche, Hermen; Nykamp, Stefan; Molderink, Albert; Hurink, Johann L.; Smit, Gerardus Johannes Maria

    2012-01-01

    Methods are discussed for planning oriented smart grid control to cope with scenarios with limited predictability, supporting an increasing penetration of stochastic renewable resources. The performance of these methods is evaluated with simulations using measured wind generation and consumption data. Forecast errors are shown to affect worst case behavior in particular, the severity of which depends on the chosen adaptivity strategy and error model.

  4. ADAM: ADaptive Autonomous Machine

    NARCIS (Netherlands)

    van Oosten, Daan C.; Nijenhuis, Lucas F.J.; Bakkers, André; Vervoort, Wiek

    1996-01-01

    This paper describes a part of the development of an adaptive autonomous machine that is able to move in an unknown world extract knowledge out of the perceived data, has the possibility to reason, and finally has the capability to exchange experiences and knowledge with other agents. The agent is

  5. Adaptive sequential controller

    Energy Technology Data Exchange (ETDEWEB)

    El-Sharkawi, Mohamed A. (Renton, WA); Xing, Jian (Seattle, WA); Butler, Nicholas G. (Newberg, OR); Rodriguez, Alonso (Pasadena, CA)

    1994-01-01

    An adaptive sequential controller (50/50') for controlling a circuit breaker (52) or other switching device to substantially eliminate transients on a distribution line caused by closing and opening the circuit breaker. The device adaptively compensates for changes in the response time of the circuit breaker due to aging and environmental effects. A potential transformer (70) provides a reference signal corresponding to the zero crossing of the voltage waveform, and a phase shift comparator circuit (96) compares the reference signal to the time at which any transient was produced when the circuit breaker closed, producing a signal indicative of the adaptive adjustment that should be made. Similarly, in controlling the opening of the circuit breaker, a current transformer (88) provides a reference signal that is compared against the time at which any transient is detected when the circuit breaker last opened. An adaptive adjustment circuit (102) produces a compensation time that is appropriately modified to account for changes in the circuit breaker response, including the effect of ambient conditions and aging. When next opened or closed, the circuit breaker is activated at an appropriately compensated time, so that it closes when the voltage crosses zero and opens when the current crosses zero, minimizing any transients on the distribution line. Phase angle can be used to control the opening of the circuit breaker relative to the reference signal provided by the potential transformer.

  6. Adaptive sequential controller

    Science.gov (United States)

    El-Sharkawi, Mohamed A.; Xing, Jian; Butler, Nicholas G.; Rodriguez, Alonso

    1994-01-01

    An adaptive sequential controller (50/50') for controlling a circuit breaker (52) or other switching device to substantially eliminate transients on a distribution line caused by closing and opening the circuit breaker. The device adaptively compensates for changes in the response time of the circuit breaker due to aging and environmental effects. A potential transformer (70) provides a reference signal corresponding to the zero crossing of the voltage waveform, and a phase shift comparator circuit (96) compares the reference signal to the time at which any transient was produced when the circuit breaker closed, producing a signal indicative of the adaptive adjustment that should be made. Similarly, in controlling the opening of the circuit breaker, a current transformer (88) provides a reference signal that is compared against the time at which any transient is detected when the circuit breaker last opened. An adaptive adjustment circuit (102) produces a compensation time that is appropriately modified to account for changes in the circuit breaker response, including the effect of ambient conditions and aging. When next opened or closed, the circuit breaker is activated at an appropriately compensated time, so that it closes when the voltage crosses zero and opens when the current crosses zero, minimizing any transients on the distribution line. Phase angle can be used to control the opening of the circuit breaker relative to the reference signal provided by the potential transformer.

  7. The use of computer adaptive tests in outcome assessments following upper limb trauma.

    Science.gov (United States)

    Jayakumar, P; Overbeek, C; Vranceanu, A-M; Williams, M; Lamb, S; Ring, D; Gwilym, S

    2018-06-01

    Aims Outcome measures quantifying aspects of health in a precise, efficient, and user-friendly manner are in demand. Computer adaptive tests (CATs) may overcome the limitations of established fixed scales and be more adept at measuring outcomes in trauma. The primary objective of this review was to gain a comprehensive understanding of the psychometric properties of CATs compared with fixed-length scales in the assessment of outcome in patients who have suffered trauma of the upper limb. Study designs, outcome measures and methodological quality are defined, along with trends in investigation. Materials and Methods A search of multiple electronic databases was undertaken on 1 January 2017 with terms related to "CATs", "orthopaedics", "trauma", and "anatomical regions". Studies involving adults suffering trauma to the upper limb, and undergoing any intervention, were eligible. Those involving the measurement of outcome with any CATs were included. Identification, screening, and eligibility were undertaken, followed by the extraction of data and quality assessment using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria. The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria and reg istered (PROSPERO: CRD42016053886). Results A total of 31 studies reported trauma conditions alone, or in combination with non-traumatic conditions using CATs. Most were cross-sectional with varying level of evidence, number of patients, type of study, range of conditions and methodological quality. CATs correlated well with fixed scales and had minimal or no floor-ceiling effects. They required significantly fewer questions and/or less time for completion. Patient-Reported Outcomes Measurement Information System (PROMIS) CATs were the most frequently used, and the use of CATs is increasing. Conclusion Early studies show valid and reliable outcome measurement with CATs

  8. Time to adapt

    International Nuclear Information System (INIS)

    Parry, M.

    2008-01-01

    As every month goes by it becomes increasingly clear that we will need to adapt to climate change. Of course, early action needs to be taken to mitigate it by reducing emissions of greenhouse gases, but this must be complemented by investment in adaptation in the places most affected. The sooner we put resources into adaptation the less damage will be sustained. The latest assessment by the Intergovernmental Panel on Climate Change (IPCC) came to the new conclusion that the effects of climate change are occurring now. The Earth has already warmed by 0.5 degrees C due to increases in atmospheric greenhouse gases, and we can observe the effects of this on every continent - most troublingly the current drying and warming in Africa's Sahelian region, and the effects of sea-level rise on coastal flood plains and small islands. Inevitably, some adaptation is also occurring now but little of this is planned and almost no additional resources have yet been deployed toward it. Some further warming is inevitable. Even if we were to cut emissions both immediately and so enormously that greenhouse gas concentrations in the atmosphere are stabilised at current levels - an impossible task - a temperature increase of a further 0.6 degrees C would still be inevitable due to thermal lag of the oceans and atmosphere. So 1.1 degrees C of climate change is the very least that we should plan for. The impacts from such an increase will probably include: reduced water availability - with consequent falls in agricultural productivity - in the dry tropics; increased coastal flooding; and increased morbidity and mortality from heat waves and droughts. Adaptation is the only way of avoiding or reducing these

  9. Adaptation: Needs, Financing and Institutions

    Energy Technology Data Exchange (ETDEWEB)

    Klein, Richard J.T.; Kartha, Sivan; Persson, Aasa; Watkiss, Paul; Ackerman, Frank; Downing, Thomas E.; Kjellen, Bo; Schipper, Lisa (Stockholm Environment Institute, Stockholm (SE))

    2008-07-01

    Regardless of the efforts put into mitigation, some impacts of climate change are already unavoidable. Adaptation to climate change has therefore become a key component of domestic climate policy, along with mitigation. Adaptation has also become key to the success of global climate policy. Without an agreement on supporting adaptation in developing countries, there will be no agreement on mitigation. Strong mitigation efforts make it more likely that adaptation will be effective and affordable. The world cannot rely on adaptation alone: it would eventually lead to a level of climate change to which adaptation is no longer feasible. Government action is needed to create an enabling environment for adaptation. This includes removing existing financial, legal, institutional and knowledge barriers to adaptation, and strengthening the capacity of people and organisations to adapt. The success of adaptation relies on the success of development, and vice versa. Poverty reduction, good governance, education, environmental protection, health and gender equality all contribute to adaptive capacity. Substantially more money is needed to support adaptation in developing countries. Current levels of funding will soon have to be scaled up by two orders of magnitude (from US$ hundreds of million to US$ tens of billion per year). An agreement on adaptation in Copenhagen in 2009 will need to include concrete steps towards a strengthened knowledge base for adaptation, substantially more funding for developing countries, and enhanced adaptation planning and implementation at the national level. Recommendations: Developed countries should accept a transparent, principle-based allocation of responsibility for adaptation funding, resulting in adequate, new and additional money to support adaptation programmes in developing countries. Levies on carbon market transactions and auctioning emission permits are two existing mechanisms of generating new and additional funds consistent with

  10. Adaptive control for accelerators

    International Nuclear Information System (INIS)

    Eaton, L.E.; Jachim, S.P.; Natter, E.F.

    1991-01-01

    This patent describes an adaptive feedforward control loop is provided to stabilize accelerator beam loading of the radio frequency field in an accelerator cavity during successive pulses of the beam into the cavity. A digital signal processor enables an adaptive algorithm to generate a feedforward error correcting signal functionally determined by the feedback error obtained by a beam pulse loading the cavity after the previous correcting signal was applied to the cavity. Each cavity feedforward correcting signal is successively stored in the digital processor and modified by the feedback error resulting from its application to generate the next feedforward error correcting signal. A feedforward error correcting signal is generated by the digital processor in advance of the beam pulse to enable a composite correcting signal and the beam pulse to arrive concurrently at the cavity

  11. Adaptive semantics visualization

    CERN Document Server

    Nazemi, Kawa

    2016-01-01

    This book introduces a novel approach for intelligent visualizations that adapts the different visual variables and data processing to human’s behavior and given tasks. Thereby a number of new algorithms and methods are introduced to satisfy the human need of information and knowledge and enable a usable and attractive way of information acquisition. Each method and algorithm is illustrated in a replicable way to enable the reproduction of the entire “SemaVis” system or parts of it. The introduced evaluation is scientifically well-designed and performed with more than enough participants to validate the benefits of the methods. Beside the introduced new approaches and algorithms, readers may find a sophisticated literature review in Information Visualization and Visual Analytics, Semantics and information extraction, and intelligent and adaptive systems. This book is based on an awarded and distinguished doctoral thesis in computer science.

  12. Designing Adaptive Web Applications

    DEFF Research Database (Denmark)

    Dolog, Peter

    2008-01-01

    Learning system to study a discipline. In business to business interaction, different requirements and parameters of exchanged business requests might be served by different services from third parties. Such applications require certain intelligence and a slightly different approach to design. Adpative web......The unique characteristic of web applications is that they are supposed to be used by much bigger and diverse set of users and stakeholders. An example application area is e-Learning or business to business interaction. In eLearning environment, various users with different background use the e......-based applications aim to leave some of their features at the design stage in the form of variables which are dependent on several criteria. The resolution of the variables is called adaptation and can be seen from two perspectives: adaptation by humans to the changed requirements of stakeholders and dynamic system...

  13. Adaptive control for accelerators

    Science.gov (United States)

    Eaton, Lawrie E.; Jachim, Stephen P.; Natter, Eckard F.

    1991-01-01

    An adaptive feedforward control loop is provided to stabilize accelerator beam loading of the radio frequency field in an accelerator cavity during successive pulses of the beam into the cavity. A digital signal processor enables an adaptive algorithm to generate a feedforward error correcting signal functionally determined by the feedback error obtained by a beam pulse loading the cavity after the previous correcting signal was applied to the cavity. Each cavity feedforward correcting signal is successively stored in the digital processor and modified by the feedback error resulting from its application to generate the next feedforward error correcting signal. A feedforward error correcting signal is generated by the digital processor in advance of the beam pulse to enable a composite correcting signal and the beam pulse to arrive concurrently at the cavity.

  14. Adaptive method of lines

    CERN Document Server

    Saucez, Ph

    2001-01-01

    The general Method of Lines (MOL) procedure provides a flexible format for the solution of all the major classes of partial differential equations (PDEs) and is particularly well suited to evolutionary, nonlinear wave PDEs. Despite its utility, however, there are relatively few texts that explore it at a more advanced level and reflect the method''s current state of development.Written by distinguished researchers in the field, Adaptive Method of Lines reflects the diversity of techniques and applications related to the MOL. Most of its chapters focus on a particular application but also provide a discussion of underlying philosophy and technique. Particular attention is paid to the concept of both temporal and spatial adaptivity in solving time-dependent PDEs. Many important ideas and methods are introduced, including moving grids and grid refinement, static and dynamic gridding, the equidistribution principle and the concept of a monitor function, the minimization of a functional, and the moving finite elem...

  15. Adaptive Large Neighbourhood Search

    DEFF Research Database (Denmark)

    Røpke, Stefan

    Large neighborhood search is a metaheuristic that has gained popularity in recent years. The heuristic repeatedly moves from solution to solution by first partially destroying the solution and then repairing it. The best solution observed during this search is presented as the final solution....... This tutorial introduces the large neighborhood search metaheuristic and the variant adaptive large neighborhood search that dynamically tunes parameters of the heuristic while it is running. Both heuristics belong to a broader class of heuristics that are searching a solution space using very large...... neighborhoods. The tutorial also present applications of the adaptive large neighborhood search, mostly related to vehicle routing problems for which the heuristic has been extremely successful. We discuss how the heuristic can be parallelized and thereby take advantage of modern desktop computers...

  16. Science with Adaptive Optics

    CERN Document Server

    Brandner, Wolfgang; ESO Workshop

    2005-01-01

    The field of Adaptive Optics (AO) for astronomy has matured in recent years, and diffraction-limited image resolution in the near-infrared is now routinely achieved by ground-based 8 to 10m class telescopes. This book presents the proceedings of the ESO Workshop on Science with Adaptive Optics held in the fall of 2003. The book provides an overview on AO instrumentation, data acquisition and reduction strategies, and covers observations of the sun, solar system objects, circumstellar disks, substellar companions, HII regions, starburst environments, late-type stars, the galactic center, active galaxies, and quasars. The contributions present a vivid picture of the multitude of science topics being addressed by AO in observational astronomy.

  17. Bacterial surface adaptation

    Science.gov (United States)

    Utada, Andrew

    2014-03-01

    Biofilms are structured multi-cellular communities that are fundamental to the biology and ecology of bacteria. Parasitic bacterial biofilms can cause lethal infections and biofouling, but commensal bacterial biofilms, such as those found in the gut, can break down otherwise indigestible plant polysaccharides and allow us to enjoy vegetables. The first step in biofilm formation, adaptation to life on a surface, requires a working knowledge of low Reynolds number fluid physics, and the coordination of biochemical signaling, polysaccharide production, and molecular motility motors. These crucial early stages of biofilm formation are at present poorly understood. By adapting methods from soft matter physics, we dissect bacterial social behavior at the single cell level for several prototypical bacterial species, including Pseudomonas aeruginosa and Vibrio cholerae.

  18. Unconsciously triggered conflict adaptation.

    Science.gov (United States)

    van Gaal, Simon; Lamme, Victor A F; Ridderinkhof, K Richard

    2010-07-09

    In conflict tasks such as the Stroop, the Eriksen flanker or the Simon task, it is generally observed that the detection of conflict in the current trial reduces the impact of conflicting information in the subsequent trial; a phenomenon termed conflict adaptation. This higher-order cognitive control function has been assumed to be restricted to cases where conflict is experienced consciously. In the present experiment we manipulated the awareness of conflict-inducing stimuli in a metacontrast masking paradigm to directly test this assumption. Conflicting response tendencies were elicited either consciously (through primes that were weakly masked) or unconsciously (strongly masked primes). We demonstrate trial-by-trial conflict adaptation effects after conscious as well as unconscious conflict, which could not be explained by direct stimulus/response repetitions. These findings show that unconscious information can have a longer-lasting influence on our behavior than previously thought and further stretch the functional boundaries of unconscious cognition.

  19. Unconsciously triggered conflict adaptation.

    Directory of Open Access Journals (Sweden)

    Simon van Gaal

    Full Text Available In conflict tasks such as the Stroop, the Eriksen flanker or the Simon task, it is generally observed that the detection of conflict in the current trial reduces the impact of conflicting information in the subsequent trial; a phenomenon termed conflict adaptation. This higher-order cognitive control function has been assumed to be restricted to cases where conflict is experienced consciously. In the present experiment we manipulated the awareness of conflict-inducing stimuli in a metacontrast masking paradigm to directly test this assumption. Conflicting response tendencies were elicited either consciously (through primes that were weakly masked or unconsciously (strongly masked primes. We demonstrate trial-by-trial conflict adaptation effects after conscious as well as unconscious conflict, which could not be explained by direct stimulus/response repetitions. These findings show that unconscious information can have a longer-lasting influence on our behavior than previously thought and further stretch the functional boundaries of unconscious cognition.

  20. RODOS database adapter

    International Nuclear Information System (INIS)

    Xie Gang

    1995-11-01

    Integrated data management is an essential aspect of many automatical information systems such as RODOS, a real-time on-line decision support system for nuclear emergency management. In particular, the application software must provide access management to different commercial database systems. This report presents the tools necessary for adapting embedded SQL-applications to both HP-ALLBASE/SQL and CA-Ingres/SQL databases. The design of the database adapter and the concept of RODOS embedded SQL syntax are discussed by considering some of the most important features of SQL-functions and the identification of significant differences between SQL-implementations. Finally fully part of the software developed and the administrator's and installation guides are described. (orig.) [de

  1. Adaptivity in GRAPPLE: Adaptation in any way you like (Poster)

    NARCIS (Netherlands)

    De Bra, P.M.E.; Smits, D.; Pechenizkiy, M.; Vasilyeva, E.; Bonk, C.J.; et al., xx

    2008-01-01

    GRAPPLE is an EU funded IST FP7 project that brings together a group of researchers into adaptive learning technology and environments and developers of learning management systems (LMSs), in order to offer adaptive learning as a standard feature of future LMSs. This paper presents the adaptation

  2. Generic adaptation framework for unifying adaptive web-based systems

    NARCIS (Netherlands)

    Knutov, E.

    2012-01-01

    The Generic Adaptation Framework (GAF) research project first and foremost creates a common formal framework for describing current and future adaptive hypermedia (AHS) and adaptive webbased systems in general. It provides a commonly agreed upon taxonomy and a reference model that encompasses the

  3. Learning to adapt: Organisational adaptation to climate change impacts

    NARCIS (Netherlands)

    Berkhout, F.G.H.; Hertin, J.; Gann, D.M.

    2006-01-01

    Analysis of human adaptation to climate change should be based on realistic models of adaptive behaviour at the level of organisations and individuals. The paper sets out a framework for analysing adaptation to the direct and indirect impacts of climate change in business organisations with new

  4. Driving Meaningful Adaptation Action through an Adaptation Market Mechanism

    Energy Technology Data Exchange (ETDEWEB)

    Butzengeiger-Geyer, Sonja; Koehler, Michel; Michaelowa, Axel

    2011-07-01

    Approaches and criteria for allocating adaptation funds vary significantly among current sources - UN-backed funds and bilateral cooperation - and to some extent lack transparency and consistency. Such funding risks being spent in a haphazard way that repeats many of the mistakes made in development assistance over the past decades. An Adaptation Market Mechanism (AMM) could contribute to efficient allocation of adaptation funds, promote adaptation activities by private and public actors through additional financial incentives, and raise additional and reliable adaptation money. This would help to avoid future public criticism of the effectiveness and efficiency of spending adaptation funding.The proposed AMM would specify mandatory adaptation targets, on international, regional or domestic level. Participants who achieve their targets either by generating adaptation units or by buying them in the market would incentivize private, commercial and institutional actors to develop adaptation projects that create verified adaptation units. A universally accepted and verifiable trading unit applicable to all types of adaptation activities would help to maximize the cost reduction potential for the AMM. We suggest applying net present value (NPV) for property saved; Disability Adjusted Life Years Saved (DALYS) for health benefits; and potentially a separate unit to consider the environmental benefits of an adaptation activity.(Author)

  5. Adaptive positioner; Posicionador adaptativo

    Energy Technology Data Exchange (ETDEWEB)

    Labrador Pavon, I

    1993-07-01

    This paper describes the circuits and programs in assembly language, developed to control the two DC motors that give mobility to a mechanical arm with two degrees of freedom. As a whole, the system is based in a adaptable regulator designed around a 8 bit microprocessor that, starting from a mode of regulation based in the successive approximation method, evolve to another mode through which, only one approximation is sufficient to get the right position of each motor. (Author) 6 refs.

  6. Adaptive Wireless Multimedia Services

    OpenAIRE

    Yi, Xiaokun

    2006-01-01

    Context-awareness is a hot topic in mobile computing currently. A lot of importance is being attached to facilitating the user of various mobile computing devices to provide services that are more “user-centric”. One aspect of context-awareness is to perceive variations in available resources, and to make decisions based on the feedback to enable applications to automatically adapt to the current environment. For Voice over IP (VoIP) software phones (softphones), variations in network perform...

  7. Adaptive optics ophthalmoscopy.

    Science.gov (United States)

    Roorda, Austin; Duncan, Jacque L

    2015-11-01

    This review starts with a brief history and description of adaptive optics (AO) technology, followed by a showcase of the latest capabilities of AO systems for imaging the human retina and an extensive review of the literature on where AO is being used clinically. The review concludes with a discussion on future directions and guidance on usage and interpretation of images from AO systems for the eye.

  8. Adaptive optics ophthalmoscopy

    OpenAIRE

    Roorda, Austin; Duncan, Jacque L.

    2015-01-01

    This review starts with a brief history and description of adaptive optics (AO) technology, followed by a showcase of the latest capabilities of AO systems for imaging the human retina and an extensive review of the literature on where AO is being used clinically. The review concludes with a discussion on future directions and guidance on usage and interpretation of images from AO systems for the eye.

  9. Adaptive structures flight experiments

    Science.gov (United States)

    Martin, Maurice

    The topics are presented in viewgraph form and include the following: adaptive structures flight experiments; enhanced resolution using active vibration suppression; Advanced Controls Technology Experiment (ACTEX); ACTEX program status; ACTEX-2; ACTEX-2 program status; modular control patch; STRV-1b Cryocooler Vibration Suppression Experiment; STRV-1b program status; Precision Optical Bench Experiment (PROBE); Clementine Spacecraft Configuration; TECHSAT all-composite spacecraft; Inexpensive Structures and Materials Flight Experiment (INFLEX); and INFLEX program status.

  10. Adaptive Backoff Synchronization Techniques

    Science.gov (United States)

    1989-07-01

    Percentage of synchronization and non- synchronisation references that cause invalidations in directory schemes with 2, 3, 4, 5, and 64 pointers...processors to arrive. The slight relative increase of synchronisation overhead in all cases when going from two to five pointers is because synchronization ...MASSACHUSETTS INSTITUTE OF TECHNOLOGY VLSI PUBLICATIONS q~JU VLSI Memo No. 89-547 It July 1989 Adaptive Backoff Synchronization Techniques Anant

  11. Adaptive building skin structures

    International Nuclear Information System (INIS)

    Del Grosso, A E; Basso, P

    2010-01-01

    The concept of adaptive and morphing structures has gained considerable attention in the recent years in many fields of engineering. In civil engineering very few practical applications are reported to date however. Non-conventional structural concepts like deployable, inflatable and morphing structures may indeed provide innovative solutions to some of the problems that the construction industry is being called to face. To give some examples, searches for low-energy consumption or even energy-harvesting green buildings are amongst such problems. This paper first presents a review of the above problems and technologies, which shows how the solution to these problems requires a multidisciplinary approach, involving the integration of architectural and engineering disciplines. The discussion continues with the presentation of a possible application of two adaptive and dynamically morphing structures which are proposed for the realization of an acoustic envelope. The core of the two applications is the use of a novel optimization process which leads the search for optimal solutions by means of an evolutionary technique while the compatibility of the resulting configurations of the adaptive envelope is ensured by the virtual force density method

  12. Radio-adaptive response

    International Nuclear Information System (INIS)

    Ikushima, T.

    1992-01-01

    An adaptive response to radiation stress was found as a suppressed induction of chromosomal damage including micronuclei and sister chromatid exchanges in cultured Chinese hamster V79 cells pre-exposed to very low doses of ionizing radiations. The mechanism underlying this novel chromosomal response, called 'radio-adaptive response (RAR)' has been studied progressively. The following results were obtained in recent experiments. 1. Low doses of β-rays from tritiated water (HTO) as well as tritium-thymidine can cause RAR. 2. Thermal neutrons, a high LET radiation, can not act as tritium β-rays or γ-rays. 3. The RAR expression is suppressed not only by the treatment with an inhibitor of protein synthesis but also by RNA synthesis inhibition. 4. Several proteins are newly synthesized concurrently with the RAR expression after the adapting doses, viewed by two-dimensional electrophoresis of cellular proteins. These results suggests that the RAR might be a cellular stress response to a signal produced preferentially by very low doses of low LET radiation under restricted conditions, accompany the inducible specific gene expression. (author)

  13. Cold-Adapted Enzymes

    Science.gov (United States)

    Georlette, D.; Bentahir, M.; Claverie, P.; Collins, T.; D'amico, S.; Delille, D.; Feller, G.; Gratia, E.; Hoyoux, A.; Lonhienne, T.; Meuwis, M.-a.; Zecchinon, L.; Gerday, Ch.

    In the last few years, increased attention has been focused on enzymes produced by cold-adapted micro-organisms. It has emerged that psychrophilic enzymes represent an extremely powerful tool in both protein folding investigations and for biotechnological purposes. Such enzymes are characterised by an increased thermosensitivity and, most of them, by a higher catalytic efficiency at low and moderate temperatures, when compared to their mesophilic counterparts. The high thermosensitivity probably originates from an increased flexibility of either a selected area of the molecular edifice or the overall protein structure, providing enhanced abilities to undergo conformational changes during catalysis at low temperatures. Structure modelling and recent crystallographic data have allowed to elucidate the structural parameters that could be involved in this higher resilience. It was demonstrated that each psychrophilic enzyme adopts its own adaptive strategy. It appears, moreover, that there is a continuum in the strategy of protein adaptation to temperature, as the previously mentioned structural parameters are implicated in the stability of thermophilic proteins. Additional 3D crystal structures, site-directed and random mutagenesis experiments should now be undertaken to further investigate the stability-flexibility-activity relationship.

  14. Adaptive Leadership in Digital Transformation

    DEFF Research Database (Denmark)

    Hansen, Anne Mette; Kræmmergaard, Pernille; Mathiassen, Lars

    2012-01-01

    Leaders’ ability to quickly adapt IT practices is especially critical in today’s increasingly turbulent environment with frequent changes in the competitive and technological landscape. However, developing such adaptive leadership is a difficult and complex process. Often, underlying assumptions...

  15. Evolution of adaptation mechanisms: Adaptation energy, stress, and oscillating death.

    Science.gov (United States)

    Gorban, Alexander N; Tyukina, Tatiana A; Smirnova, Elena V; Pokidysheva, Lyudmila I

    2016-09-21

    In 1938, Selye proposed the notion of adaptation energy and published 'Experimental evidence supporting the conception of adaptation energy.' Adaptation of an animal to different factors appears as the spending of one resource. Adaptation energy is a hypothetical extensive quantity spent for adaptation. This term causes much debate when one takes it literally, as a physical quantity, i.e. a sort of energy. The controversial points of view impede the systematic use of the notion of adaptation energy despite experimental evidence. Nevertheless, the response to many harmful factors often has general non-specific form and we suggest that the mechanisms of physiological adaptation admit a very general and nonspecific description. We aim to demonstrate that Selye׳s adaptation energy is the cornerstone of the top-down approach to modelling of non-specific adaptation processes. We analyze Selye׳s axioms of adaptation energy together with Goldstone׳s modifications and propose a series of models for interpretation of these axioms. Adaptation energy is considered as an internal coordinate on the 'dominant path' in the model of adaptation. The phenomena of 'oscillating death' and 'oscillating remission' are predicted on the base of the dynamical models of adaptation. Natural selection plays a key role in the evolution of mechanisms of physiological adaptation. We use the fitness optimization approach to study of the distribution of resources for neutralization of harmful factors, during adaptation to a multifactor environment, and analyze the optimal strategies for different systems of factors. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. How Harmful are Adaptation Restrictions

    NARCIS (Netherlands)

    Bruin, de K.C.; Dellink, R.B.

    2009-01-01

    The dominant assumption in economic models of climate policy remains that adaptation will be implemented in an optimal manner. There are, however, several reasons why optimal levels of adaptation may not be attainable. This paper investigates the effects of suboptimal levels of adaptation, i.e.

  17. Adaptation : A Partially Automated Approach

    NARCIS (Netherlands)

    Manjing, Tham; Bukhsh, F.A.; Weigand, H.

    2014-01-01

    This paper showcases the possibility of creating an adaptive auditing system. Adaptation in an audit environment need human intervention at some point. Based on a case study this paper focuses on automation of adaptation process. It is divided into solution design and validation parts. The artifact

  18. Building adaptive capacity in Assam

    Directory of Open Access Journals (Sweden)

    Soumyadeep Banerjee

    2015-05-01

    Full Text Available A starting point for adapting to longer-term climate change could be adaptation to short-term climate variability and extreme events. Making more informed choices about the use of remittances can enhance the adaptive capacity of remittance-receiving households.

  19. Attention modulates visual size adaptation.

    Science.gov (United States)

    Kreutzer, Sylvia; Fink, Gereon R; Weidner, Ralph

    2015-01-01

    The current study determined in healthy subjects (n = 16) whether size adaptation occurs at early, i.e., preattentive, levels of processing or whether higher cognitive processes such as attention can modulate the illusion. To investigate this issue, bottom-up stimulation was kept constant across conditions by using a single adaptation display containing both small and large adapter stimuli. Subjects' attention was directed to either the large or small adapter stimulus by means of a luminance detection task. When attention was directed toward the small as compared to the large adapter, the perceived size of the subsequent target was significantly increased. Data suggest that different size adaptation effects can be induced by one and the same stimulus depending on the current allocation of attention. This indicates that size adaptation is subject to attentional modulation. These findings are in line with previous research showing that transient as well as sustained attention modulates visual features, such as contrast sensitivity and spatial frequency, and influences adaptation in other contexts, such as motion adaptation (Alais & Blake, 1999; Lankheet & Verstraten, 1995). Based on a recently suggested model (Pooresmaeili, Arrighi, Biagi, & Morrone, 2013), according to which perceptual adaptation is based on local excitation and inhibition in V1, we conclude that guiding attention can boost these local processes in one or the other direction by increasing the weight of the attended adapter. In sum, perceptual adaptation, although reflected in changes of neural activity at early levels (as shown in the aforementioned study), is nevertheless subject to higher-order modulation.

  20. On Adaptive vs. Non-adaptive Security of Multiparty Protocols

    DEFF Research Database (Denmark)

    Canetti, Ran; Damgård, Ivan Bjerre; Dziembowski, Stefan

    2001-01-01

    highlights of our results are: – - According to the definition of Dodis-Micali-Rogaway (which is set in the information-theoretic model), adaptive and non-adaptive security are equivalent. This holds for both honest-but-curious and Byzantine adversaries, and for any number of parties. – - According......Security analysis of multiparty cryptographic protocols distinguishes between two types of adversarialsettings: In the non-adaptive setting, the set of corrupted parties is chosen in advance, before the interaction begins. In the adaptive setting, the adversary chooses who to corrupt during...... the course of the computation. We study the relations between adaptive security (i.e., security in the adaptive setting) and non-adaptive security, according to two definitions and in several models of computation. While affirming some prevailing beliefs, we also obtain some unexpected results. Some...

  1. Understanding climate change adaptation and adaptive capacity: synthesis report

    Energy Technology Data Exchange (ETDEWEB)

    Patino, L. [Policy Research Initiative, Government of Canada, Ottawa, ON (Canada)

    2010-09-15

    In 2007, the Natural Resources Canada (NRCan) Climate Change Impacts and Adaptation Division (CCIAD) offered its support to research projects that were involved in understanding and improving adaptation and adaptive capacity and contributed to climate change decision-making and policy development in Canada. 20 research projects were commissioned by the CCIAD. With the collaboration of NRCan, the principal findings raised by the commissioned projects were synthesized by the Policy Research Initiative (PRI). Common themes and main messages are introduced in this synthesis report, and policy and program aspects that promote adaptive capacity to climate change in Canada are identified. Common themes and important messages emerging from the research projects, as well as the processes and barriers to adaptation and adaptive capacity identified in the commissioned projects, were discussed during a workshop held in Ottawa in 2009. Five main themes and four common barriers to adaptation were found. 25 refs.

  2. Adaptability Responding Effectively to Change

    CERN Document Server

    (CCL), Center for Creative Leadership; Calarco, Allan

    2011-01-01

    In today's business world, the complexity and pace of change can be daunting. Adaptability has become recognized as a necessary skill for leaders to develop to be effective in this environment. Even so, leaders rarely know what they can do to become more adaptable and foster adaptability in others. This guidebook contributes to a greater understanding of adaptability and the cognitive, emotional, and dispositional flexibility it requires. Leaders will learn how to develop their adaptability and to become more effective for themselves, the people they lead, and their organizations.

  3. Error signals driving locomotor adaptation

    DEFF Research Database (Denmark)

    Choi, Julia T; Jensen, Peter; Nielsen, Jens Bo

    2016-01-01

    Locomotor patterns must be adapted to external forces encountered during daily activities. The contribution of different sensory inputs to detecting perturbations and adapting movements during walking is unclear. Here we examined the role of cutaneous feedback in adapting walking patterns to force...... walking (Choi et al. 2013). Sensory tests were performed to measure cutaneous touch threshold and perceptual threshold of force perturbations. Ankle movement were measured while subjects walked on the treadmill over three periods: baseline (1 min), adaptation (1 min) and post-adaptation (3 min). Subjects...

  4. Adaptive filtering prediction and control

    CERN Document Server

    Goodwin, Graham C

    2009-01-01

    Preface1. Introduction to Adaptive TechniquesPart 1. Deterministic Systems2. Models for Deterministic Dynamical Systems3. Parameter Estimation for Deterministic Systems4. Deterministic Adaptive Prediction5. Control of Linear Deterministic Systems6. Adaptive Control of Linear Deterministic SystemsPart 2. Stochastic Systems7. Optimal Filtering and Prediction8. Parameter Estimation for Stochastic Dynamic Systems9. Adaptive Filtering and Prediction10. Control of Stochastic Systems11. Adaptive Control of Stochastic SystemsAppendicesA. A Brief Review of Some Results from Systems TheoryB. A Summary o

  5. Low power adaptive synchronizer

    Energy Technology Data Exchange (ETDEWEB)

    Sadowski, Greg

    2018-02-20

    A circuit adapts to the occurrence of metastable states. The circuit inhibits passing of the metastable state to circuits that follow, by clock gating the output stage. In order to determine whether or not to gate the clock of the output stage, two detect circuits may be used. One circuit detects metastability and another circuit detects metastability resolved to a wrong logic level. The results from one or both detector circuits are used to gate the next clock cycle if needed, waiting for the metastable situation to be resolved.

  6. Adaptive intrusion data system

    International Nuclear Information System (INIS)

    Johnson, C.S.

    1976-01-01

    An Adaptive Intrusion Data System (AIDS) was developed to collect data from intrusion alarm sensors as part of an evaluation system to improve sensor performance. AIDS is a unique digital data compression, storage, and formatting system. It also incorporates capability for video selection and recording for assessment of the sensors monitored by the system. The system is software reprogrammable to numerous configurations that may be utilized for the collection of environmental, bi-level, analog and video data. The output of the system is digital tapes formatted for direct data reduction on a CDC 6400 computer, and video tapes containing timed tagged information that can be correlated with the digital data

  7. Skeletal adaptations to bipedalism

    Directory of Open Access Journals (Sweden)

    Vasiljević Perica

    2014-01-01

    Full Text Available Bipedalism is the main characteristic of humans. During evolutin bipedalism emerged probably as an adaptation to a changing environment. Major changes in skeletal system included femur, pelvis, skull and spine. The significance of bipedal locomotion: Bipedalism freed the forelimbs for carrying objects, creation and usage of tools. In the upright position animals have a broader view of the environment and the early detection of predators is crucial for survival. Bipedal locomotion makes larger distances easier to pass, which is very important in the migration of hominids.

  8. Complex adaptive systems ecology

    DEFF Research Database (Denmark)

    Sommerlund, Julie

    2003-01-01

    In the following, I will analyze two articles called Complex Adaptive Systems EcologyI & II (Molin & Molin, 1997 & 2000). The CASE-articles are some of the more quirkyarticles that have come out of the Molecular Microbial Ecology Group - a groupwhere I am currently making observational studies....... They are the result of acooperation between Søren Molin, professor in the group, and his brother, JanMolin, professor at Department of Organization and Industrial Sociology atCopenhagen Business School. The cooperation arises from the recognition that bothmicrobial ecology and sociology/organization theory works...

  9. Agente adaptable y aprendizaje

    Directory of Open Access Journals (Sweden)

    Arturo Angel Lara Rivero

    2013-05-01

    Full Text Available En este trabajo se contrasta el concepto de agente programado con el de agente complejo adaptable, se presenta una nueva visión ligada al aprendizaje y la estructura del agente. La imagen del agente se analiza considerando los modelos internos, la práctica, el concepto de rutina y la influencia en su comportamiento, y la importancia del aprendizaje ex ante y ex post. Por último se muestra que la resolución de problemas está sujeta a restricciones del agente y se describen las formas de explorar el espacio de soluciones mediante tres tipos de exploración: exhaustiva, aleatoria y selectiva.

  10. Adaptive projective filters

    International Nuclear Information System (INIS)

    Dikusar, N.D.

    1993-01-01

    The new approach to solving of the finding problem is proposed. The method is based on Discrete Projective Transformations (DPT), the List Square Fitting (LSF) and uses the information feedback in tracing for linear or quadratic track segments (TS). The fast and stable with respect to measurement errors and background points recurrent algorithm is suggested. The algorithm realizes the family of digital adaptive projective filters (APF) with known nonlinear weight functions-projective invariants. APF can be used in adequate control systems for collection, processing and compression of data, including tracking problems for the wide class of detectors. 10 refs.; 9 figs

  11. Laser adaptive holographic hydrophone

    Energy Technology Data Exchange (ETDEWEB)

    Romashko, R V; Kulchin, Yu N; Bezruk, M N; Ermolaev, S A [Institute of Automation and Control Processes, Far Eastern Branch of the Russian Academy of Sciences, Vladivostok (Russian Federation)

    2016-03-31

    A new type of a laser hydrophone based on dynamic holograms, formed in a photorefractive crystal, is proposed and studied. It is shown that the use of dynamic holograms makes it unnecessary to use complex optical schemes and systems for electronic stabilisation of the interferometer operating point. This essentially simplifies the scheme of the laser hydrophone preserving its high sensitivity, which offers the possibility to use it under a strong variation of the environment parameters. The laser adaptive holographic hydrophone implemented at present possesses the sensitivity at a level of 3.3 mV Pa{sup -1} in the frequency range from 1 to 30 kHz. (laser hydrophones)

  12. Adaptability and evolution.

    Science.gov (United States)

    Bateson, Patrick

    2017-10-06

    The capacity of organisms to respond in their own lifetimes to new challenges in their environments probably appeared early in biological evolution. At present few studies have shown how such adaptability could influence the inherited characteristics of an organism's descendants. In part, this has been because organisms have been treated as passive in evolution. Nevertheless, their effects on biological evolution are likely to have been important and, when they occurred, accelerated the pace of evolution. Ways in which this might have happened have been suggested many times since the 1870s. I review these proposals and discuss their relevance to modern thought.

  13. Practical adaptive quantum tomography

    Science.gov (United States)

    Granade, Christopher; Ferrie, Christopher; Flammia, Steven T.

    2017-11-01

    We introduce a fast and accurate heuristic for adaptive tomography that addresses many of the limitations of prior methods. Previous approaches were either too computationally intensive or tailored to handle special cases such as single qubits or pure states. By contrast, our approach combines the efficiency of online optimization with generally applicable and well-motivated data-processing techniques. We numerically demonstrate these advantages in several scenarios including mixed states, higher-dimensional systems, and restricted measurements. http://cgranade.com complete data and source code for this work are available online [1], and can be previewed at https://goo.gl/koiWxR.

  14. Adaptive Optical Scanning Holography

    Science.gov (United States)

    Tsang, P. W. M.; Poon, Ting-Chung; Liu, J.-P.

    2016-01-01

    Optical Scanning Holography (OSH) is a powerful technique that employs a single-pixel sensor and a row-by-row scanning mechanism to capture the hologram of a wide-view, three-dimensional object. However, the time required to acquire a hologram with OSH is rather lengthy. In this paper, we propose an enhanced framework, which is referred to as Adaptive OSH (AOSH), to shorten the holographic recording process. We have demonstrated that the AOSH method is capable of decreasing the acquisition time by up to an order of magnitude, while preserving the content of the hologram favorably. PMID:26916866

  15. Smartphone adapters for digital photomicrography.

    Science.gov (United States)

    Roy, Somak; Pantanowitz, Liron; Amin, Milon; Seethala, Raja R; Ishtiaque, Ahmed; Yousem, Samuel A; Parwani, Anil V; Cucoranu, Ioan; Hartman, Douglas J

    2014-01-01

    Photomicrographs in Anatomic Pathology provide a means of quickly sharing information from a glass slide for consultation, education, documentation and publication. While static image acquisition historically involved the use of a permanently mounted camera unit on a microscope, such cameras may be expensive, need to be connected to a computer, and often require proprietary software to acquire and process images. Another novel approach for capturing digital microscopic images is to use smartphones coupled with the eyepiece of a microscope. Recently, several smartphone adapters have emerged that allow users to attach mobile phones to the microscope. The aim of this study was to test the utility of these various smartphone adapters. We surveyed the market for adapters to attach smartphones to the ocular lens of a conventional light microscope. Three adapters (Magnifi, Skylight and Snapzoom) were tested. We assessed the designs of these adapters and their effectiveness at acquiring static microscopic digital images. All adapters facilitated the acquisition of digital microscopic images with a smartphone. The optimal adapter was dependent on the type of phone used. The Magnifi adapters for iPhone were incompatible when using a protective case. The Snapzoom adapter was easiest to use with iPhones and other smartphones even with protective cases. Smartphone adapters are inexpensive and easy to use for acquiring digital microscopic images. However, they require some adjustment by the user in order to optimize focus and obtain good quality images. Smartphone microscope adapters provide an economically feasible method of acquiring and sharing digital pathology photomicrographs.

  16. Adaptation in Collaborative Governance Regimes

    Science.gov (United States)

    Emerson, Kirk; Gerlak, Andrea K.

    2014-10-01

    Adaptation and the adaptive capacity of human and environmental systems have been of central concern to natural and social science scholars, many of whom characterize and promote the need for collaborative cross-boundary systems that are seen as flexible and adaptive by definition. Researchers who study collaborative governance systems in the public administration, planning and policy literature have paid less attention to adaptive capacity specifically and institutional adaptation in general. This paper bridges the two literatures and finds four common dimensions of capacity, including structural arrangements, leadership, knowledge and learning, and resources. In this paper, we focus on institutional adaptation in the context of collaborative governance regimes and try to clarify and distinguish collaborative capacity from adaptive capacity and their contributions to adaptive action. We posit further that collaborative capacities generate associated adaptive capacities thereby enabling institutional adaptation within collaborative governance regimes. We develop these distinctions and linkages between collaborative and adaptive capacities with the help of an illustrative case study in watershed management within the National Estuary Program.

  17. Face adaptation improves gender discrimination.

    Science.gov (United States)

    Yang, Hua; Shen, Jianhong; Chen, Juan; Fang, Fang

    2011-01-01

    Adaptation to a visual pattern can alter the sensitivities of neuronal populations encoding the pattern. However, the functional roles of adaptation, especially in high-level vision, are still equivocal. In the present study, we performed three experiments to investigate if face gender adaptation could affect gender discrimination. Experiments 1 and 2 revealed that adapting to a male/female face could selectively enhance discrimination for male/female faces. Experiment 3 showed that the discrimination enhancement induced by face adaptation could transfer across a substantial change in three-dimensional face viewpoint. These results provide further evidence suggesting that, similar to low-level vision, adaptation in high-level vision could calibrate the visual system to current inputs of complex shapes (i.e. face) and improve discrimination at the adapted characteristic. Copyright © 2010 Elsevier Ltd. All rights reserved.

  18. The Adaptation Finance Gap Report

    DEFF Research Database (Denmark)

    UNEP’s Adaptation Gap Report series focuses on Finance, Technology and Knowledge gaps in climate change adaptation. It compliments the Emissions Gap Report series, and explores the implications of failing to close the emissions gap. The report builds on a 2014 assessment by the United Nations...... Environment Programme (UNEP), which laid out the concept of ‘adaptation gaps’ and outlined three such gaps: technology, finance and knowledge. The 2016 Adaptation Gap Report assesses the difference between the financial costs of adapting to climate change in developing countries and the amount of money...... actually available to meet these costs – a difference known as the “adaptation finance gap”. Like the 2014 report, the 2016 report focuses on developing countries, where adaptation capacity is often the lowest and needs the highest, and concentrates on the period up to 2050. The report identifies trends...

  19. Science of adaptation to climate change and science for adaptation

    Directory of Open Access Journals (Sweden)

    Rob eSwart

    2014-07-01

    Full Text Available Adaptation to climate change has gained a prominent place next to mitigation on global, national and local policy agendas. However, while an abundance of adaptation strategies, plans and programmes have been developed, progress in turning these into action has been slow. The development of a sound knowledge basis to support adaptation globally is suggested to accelerate progress, but has lagged behind. The emphasis in both current and newly proposed programmes is very much on practice-oriented research with strong stakeholder participation. This paper supports such practice-oriented research, but argues that this is insufficient to support adaptation policy and practice in a productive manner. We argue that there is not only a need for science for adaptation, but also a science of adaptation. The paper argues that participatory, practice-oriented research is indeed essential, but has to be complemented by and connected to more fundamental inquiry and concept development, which takes into account knowledge that has been developed in disciplinary sciences and on issues other than climate change adaptation. At the same time, the level and method of participation in science for adaptation should be determined on the basis of the specific project context and goals. More emphasis on science of adaptation can lead to improved understanding of the conditions for successful science for adaptation.

  20. From “Crash!” to Crash: Adapting the Adaptation

    Directory of Open Access Journals (Sweden)

    Ljubica Matek

    2017-12-01

    Full Text Available The paper focuses on J.G. Ballard’s various adaptations of his own material related to the issue of the sexual and sensual nature of an automobile crash, and suggests that adaptation is one of the key methods in art and literature which can be used as a means of contemplating and developing various aesthetic and political ideas. Ballard’s short story “Crash!” was first published in the ICA’s (Institute of Contemporary Arts Eventsheet in February 1969, and later became a chapter of his experimental novel The Atrocity Exhibition (1970. At the same time, Ballard adapts the idea into the “Crashed Cars” exhibition (1970 in London. The short story was then adapted into a short film, Crash!, directed by Harley Cokeliss (1971 and starring Ballard himself, to be finally adapted into the novel Crash (1973. Ballard’s adaptation of his initial ideas across literary forms and media testifies to the importance of adaptation as a process and method of creating art. Thus, rather than suggesting that adaptations merely “breathe life” into the written word, the paper points to the conclusion that the form and content are mutually influential and that, in this case, the novel itself is an adaptation, rather than a hypotext (which it becomes in 1996 to David Cronenberg as he adapts it to film. The complexity of the relationship between the source text and its many adaptations has already contributed to the deconstruction, in Derrida’s terms, of the hierarchy (opposition between the original and the copy. Rather, Ballard’s crossmedial and transmedial adaptations of his own ideas show how, as Ray would suggest, an adaptation cites the source and grafts it into a new context, giving it a new function, both aesthetic and political.

  1. Adaptation, allometry, and hypertension.

    Science.gov (United States)

    Weder, A B; Schork, N J

    1994-08-01

    Essential hypertension is a "disease of civilization" but has a clear genetic component. From an evolutionary perspective, persistence in the human genome of elements capable of raising blood pressure presupposes their adaptive significance. Recently, two hypotheses that explicitly appeal to selectionist arguments, the "slavery" and "thrifty gene" theories, have been forwarded. We find neither completely successful, and we advance an alternative explanation of the adaptive importance of genes responsible for hypertension. We propose that blood pressure rises during childhood and adolescence to subserve homeostatic needs of the organism. Specifically, we contend that blood pressure is a flexible element in the repertoire of renal homeostatic mechanisms serving to match renal function to growth. The effect of modern diet and lifestyle on human growth stimulates earlier and more vigorous development, straining biologically necessary relationships between renal and general somatic growth and requiring compensation via homeostatic mechanisms preserved during evolution. Prime among such mechanisms is blood pressure, which rises as a compensation to maintain renal function in the face of greater growth. Since virtually all members of acculturated societies share in the modern lifestyle, the demands imposed by accelerated growth and development result in a populational shift to higher blood pressures, with a consequent increase in the prevalence of hypertension. We propose that hypertension is the product of maladaptation of highly genetically conserved mechanisms subserving important biological homeostatic needs. Elucidation of the mechanisms underlying hypertension will require approaches that examine the developmental processes linking growth to blood pressure.

  2. Adaptability and climate change

    International Nuclear Information System (INIS)

    Sprague, M.W.

    1991-01-01

    The potential social, economic and environmental impacts of climate change are reviewed, with emphasis on agricultural implications. Impact analyses must be done on the scale of watersheds or river basins. For agriculture, climate change effects on water resources are likely to be more important than temperature changes, and climatic variability is also equally important. Another set of critical climatic variables are the frequencies, magnitudes and timing of extreme events such as floods, droughts, etc. A carbon dioxide enriched atmosphere will increase water use efficiency and confer increased tolerance to drought, salinity and air pollution. Better understanding and accounting is required for the effects of increased carbon dioxide on all plant life, including crops. Adaptability of agriculture to change must be taken into account in predicting impacts of climate change, with technological innovation and infrastructure giving agriculture a dynamic nature. Limitations and adaptations must be considered when formulating public policy, to ensure that marginal costs do not exceed marginal benefits. Monoculture plantation forests may be the most efficient sinks of atmospheric carbon dioxide, yet widespread reliance on them may harm biological diversity. Actions the U.S. is currently taking under a no-regrets policy are summarized

  3. Adaptive Bacterial Foraging Optimization

    Directory of Open Access Journals (Sweden)

    Hanning Chen

    2011-01-01

    Full Text Available Bacterial Foraging Optimization (BFO is a recently developed nature-inspired optimization algorithm, which is based on the foraging behavior of E. coli bacteria. Up to now, BFO has been applied successfully to some engineering problems due to its simplicity and ease of implementation. However, BFO possesses a poor convergence behavior over complex optimization problems as compared to other nature-inspired optimization techniques. This paper first analyzes how the run-length unit parameter of BFO controls the exploration of the whole search space and the exploitation of the promising areas. Then it presents a variation on the original BFO, called the adaptive bacterial foraging optimization (ABFO, employing the adaptive foraging strategies to improve the performance of the original BFO. This improvement is achieved by enabling the bacterial foraging algorithm to adjust the run-length unit parameter dynamically during algorithm execution in order to balance the exploration/exploitation tradeoff. The experiments compare the performance of two versions of ABFO with the original BFO, the standard particle swarm optimization (PSO and a real-coded genetic algorithm (GA on four widely-used benchmark functions. The proposed ABFO shows a marked improvement in performance over the original BFO and appears to be comparable with the PSO and GA.

  4. Modeling adaptive and non-adaptive responses to environmental change

    DEFF Research Database (Denmark)

    Coulson, Tim; Kendall, Bruce E; Barthold, Julia A.

    2017-01-01

    , with plastic responses being either adaptive or non-adaptive. We develop an approach that links quantitative genetic theory with data-driven structured models to allow prediction of population responses to environmental change via plasticity and adaptive evolution. After introducing general new theory, we...... construct a number of example models to demonstrate that evolutionary responses to environmental change over the short-term will be considerably slower than plastic responses, and that the rate of adaptive evolution to a new environment depends upon whether plastic responses are adaptive or non-adaptive....... Parameterization of the models we develop requires information on genetic and phenotypic variation and demography that will not always be available, meaning that simpler models will often be required to predict responses to environmental change. We consequently develop a method to examine whether the full...

  5. Distinguishing Byproducts from Non-Adaptive Effects of Algorithmic Adaptations

    Directory of Open Access Journals (Sweden)

    Justin H. Park

    2007-01-01

    Full Text Available I evaluate the use of the byproduct concept in psychology, particularly the adaptation-byproduct distinction that is commonly invoked in discussions of psychological phenomena. This distinction can be problematic when investigating algorithmic mechanisms and their effects, because although all byproducts may be functionless concomitants of adaptations, not all incidental effects of algorithmic adaptations are byproducts (although they have sometimes been labeled as such. I call attention to Sperber's (1994 distinction between proper domains and actual domains of algorithmic mechanisms. Extending Sperber's distinction, I propose the terms adaptive effects and non-adaptive effects, which more accurately capture the phenomena of interest to psychologists and prevent fruitless adaptation-versus-byproduct debates.

  6. Adaptation improves face trustworthiness discrimination

    Directory of Open Access Journals (Sweden)

    Bruce D Keefe

    2013-06-01

    Full Text Available Adaptation to facial characteristics, such as gender and viewpoint, has been shown to both bias our perception of faces and improve facial discrimination. In this study, we examined whether adapting to two levels of face trustworthiness improved sensitivity around the adapted level. Facial trustworthiness was manipulated by morphing between trustworthy and untrustworthy prototypes, each generated by morphing eight trustworthy and eight untrustworthy faces respectively. In the first experiment, just-noticeable differences (JNDs were calculated for an untrustworthy face after participants adapted to an untrustworthy face, a trustworthy face, or did not adapt. In the second experiment, the three conditions were identical, except that JNDs were calculated for a trustworthy face. In the third experiment we examined whether adapting to an untrustworthy male face improved discrimination to an untrustworthy female face. In all experiments, participants completed a two-interval forced-choice adaptive staircase procedure, in which they judged which face was more untrustworthy. JNDs were derived from a psychometric function fitted to the data. Adaptation improved sensitivity to faces conveying the same level of trustworthiness when compared to no adaptation. When adapting to and discriminating around a different level of face trustworthiness there was no improvement in sensitivity and JNDs were equivalent to those in the no adaptation condition. The improvement in sensitivity was found to occur even when adapting to a face with different gender and identity. These results suggest that adaptation to facial trustworthiness can selectively enhance mechanisms underlying the coding of facial trustworthiness to improve perceptual sensitivity. These findings have implications for the role of our visual experience in the decisions we make about the trustworthiness of other individuals.

  7. Relative performance of commonly used physical function questionnaires in rheumatoid arthritis and a patient-reported outcomes measurement information system computerized adaptive test

    NARCIS (Netherlands)

    Oude Voshaar, Antonius H.; ten Klooster, Peter M.; Glas, Cornelis A.W.; Vonkeman, Harald Erwin; Krishnan, Eswar; van de Laar, Mart A F J

    2014-01-01

    OBJECTIVE: To evaluate and compare the measurement precision and sensitivity to change of the Health Assessment Questionnaire disability index (HAQ DI), the Short Form 36 physical functioning scale (PF-10), and simulated Patient-Reported Outcomes Measurement Information System (PROMIS) physical

  8. Adaptive Discrete Hypergraph Matching.

    Science.gov (United States)

    Yan, Junchi; Li, Changsheng; Li, Yin; Cao, Guitao

    2018-02-01

    This paper addresses the problem of hypergraph matching using higher-order affinity information. We propose a solver that iteratively updates the solution in the discrete domain by linear assignment approximation. The proposed method is guaranteed to converge to a stationary discrete solution and avoids the annealing procedure and ad-hoc post binarization step that are required in several previous methods. Specifically, we start with a simple iterative discrete gradient assignment solver. This solver can be trapped in an -circle sequence under moderate conditions, where is the order of the graph matching problem. We then devise an adaptive relaxation mechanism to jump out this degenerating case and show that the resulting new path will converge to a fixed solution in the discrete domain. The proposed method is tested on both synthetic and real-world benchmarks. The experimental results corroborate the efficacy of our method.

  9. Genomics and fish adaptation

    Directory of Open Access Journals (Sweden)

    Agostinho Antunes

    2015-12-01

    Full Text Available The completion of the human genome sequencing in 2003 opened a new perspective into the importance of whole genome sequencing projects, and currently multiple species are having their genomes completed sequenced, from simple organisms, such as bacteria, to more complex taxa, such as mammals. This voluminous sequencing data generated across multiple organisms provides also the framework to better understand the genetic makeup of such species and related ones, allowing to explore the genetic changes underlining the evolution of diverse phenotypic traits. Here, recent results from our group retrieved from comparative evolutionary genomic analyses of varied fish species will be considered to exemplify how gene novelty and gene enhancement by positive selection might have been determinant in the success of adaptive radiations into diverse habitats and lifestyles.

  10. Radio-adaptive response

    International Nuclear Information System (INIS)

    Ikushima, T.

    1992-01-01

    Knowledge about cellular events in mammalian cells exposed to low doses of ionizing radiation is meager. Recent works showed that human lymphocytes become resistant to radiation-induced chromosomal damage after exposure to low doses of ionizing radiation. Experimental evidence for radio-adaptive response (RAR) in cultured mammalian cells was obtained. Exposure to very low doses of gamma-rays or tritium beta-rays make cells less susceptible to the induction of micronuclei and sister chromatid exchanges by subsequent higher doses. Many important characteristics of the novel response suggest that RAR is a stress response resulting in the enhanced repair of chromosomal DNA damage in cell under restricted conditions. Experiments are still in progress in order to elucidate the molecular basis for RAR processes. (author). 13 refs.; 2 figs., 1 tab

  11. Climate Change Adaptation

    DEFF Research Database (Denmark)

    Hudecz, Adriána

    The European Union ROADEX Project 1998 – 2012 was a trans-national roads co-operation aimed at developing ways for interactive and innovative management of low traffic volume roads throughout the cold climate regions of the Northern Periphery Area of Europe. Its goals were to facilitate co......-operation and research into the common problems of the Northern Periphery. This report is an output of the ROADEX “Implementing Accessibility” project (2009-2012). It gives a summary of the results of research into adaptation measures to combat climate change effects on low volume roads in the Northern Periphery...... causes changes in other climatic variables such as rainfall, humidity and wind speed that impact on the functioning of infrastructure such road networks. This paper discusses the climate changes predicted by the world’s meteorological organisations and considers how these may impact on the public...

  12. Adapting to climate change

    DEFF Research Database (Denmark)

    Arndt, Channing; Strzepek, Kenneth; Tarp, Finn

    2011-01-01

    Mozambique, like many African countries, is already highly susceptible to climate variability and extreme weather events. Climate change threatens to heighten this vulnerability. In order to evaluate potential impacts and adaptation options for Mozambique, we develop an integrated modeling...... framework that translates atmospheric changes from general circulation model projections into biophysical outcomes via detailed hydrologic, crop, hydropower and infrastructure models. These sector models simulate a historical baseline and four extreme climate change scenarios. Sector results are then passed...... down to a dynamic computable general equilibrium model, which is used to estimate economy-wide impacts on national welfare, as well as the total cost of damages caused by climate change. Potential damages without changes in policy are significant; our discounted estimates range from US2.3 to US2.3toUS7...

  13. Adaptive Playware in Physical Games

    DEFF Research Database (Denmark)

    Lund, Henrik Hautop; Thorsteinsson, Arnar Tumi

    2011-01-01

    that the activity automatically will match the capability of the individual user. With small test groups, we investigate how different age groups and gender groups physically interact with some playware games, and find indications of differences between the groups. Despite the small test set, the results...... are a proof of existence of differences and of the need for adaptation, and therefore we investigate adaptation as an important issue for playware. With simple playware games, we show that the adaptation will speed the physical game up and down to find the appropriate level that matches the reaction speed......We describe how playware and games may adapt to the interaction of the individual user. We hypothesize that in physical games there are individual differences in user interaction capabilities and styles, and that adaptive playware may adapt to the individual user’s capabilities, so...

  14. Adapting Playware to Rehabilitation Practices

    DEFF Research Database (Denmark)

    Nielsen, Camilla Balslev; Lund, Henrik Hautop

    2011-01-01

    We describe how playware and games may become adaptive to the interaction of the individual user and how therapists use this adaptation property to apply modular interactive tiles in rehabilitation practices that demand highly individualized training. Therapists may use the interactive modular...... patients modulating exercises and difficulty levels. We also find that in physical games there are individual differences in patient interaction capabilities and styles, and that modularity allows the therapist to adapt exercises to the individual patient’s capabilities....

  15. Adaptive Mesh Refinement in CTH

    International Nuclear Information System (INIS)

    Crawford, David

    1999-01-01

    This paper reports progress on implementing a new capability of adaptive mesh refinement into the Eulerian multimaterial shock- physics code CTH. The adaptivity is block-based with refinement and unrefinement occurring in an isotropic 2:1 manner. The code is designed to run on serial, multiprocessor and massive parallel platforms. An approximate factor of three in memory and performance improvements over comparable resolution non-adaptive calculations has-been demonstrated for a number of problems

  16. Maritime adaptive optics beam control

    OpenAIRE

    Corley, Melissa S.

    2010-01-01

    The Navy is interested in developing systems for horizontal, near ocean surface, high-energy laser propagation through the atmosphere. Laser propagation in the maritime environment requires adaptive optics control of aberrations caused by atmospheric distortion. In this research, a multichannel transverse adaptive filter is formulated in Matlab's Simulink environment and compared to a complex lattice filter that has previously been implemented in large system simulations. The adaptive fil...

  17. Adaptive Automation Design and Implementation

    Science.gov (United States)

    2015-09-17

    with an automated system to a real-world adaptive au- tomation system implementation. There have been plenty of adaptive automation 17 Adaptive...of systems without increasing manpower requirements by allocating routine tasks to automated aids, improving safety through the use of au- tomated ...between intermediate levels of au- tomation , explicitly defining which human task a given level automates. Each model aids the creation and classification

  18. Considerations about expected a posteriori estimation in adaptive testing: adaptive a priori, adaptive correction for bias, and adaptive integration interval.

    Science.gov (United States)

    Raiche, Gilles; Blais, Jean-Guy

    2009-01-01

    In a computerized adaptive test, we would like to obtain an acceptable precision of the proficiency level estimate using an optimal number of items. Unfortunately, decreasing the number of items is accompanied by a certain degree of bias when the true proficiency level differs significantly from the a priori estimate. The authors suggest that it is possible to reduced the bias, and even the standard error of the estimate, by applying to each provisional estimation one or a combination of the following strategies: adaptive correction for bias proposed by Bock and Mislevy (1982), adaptive a priori estimate, and adaptive integration interval.

  19. Adaptive Wireless Transceiver, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Wireless technologies are an increasingly attractive means for spatial data, input, manipulation, and distribution. Mobitrum is proposing an innovative Adaptive...

  20. Adaptive Motion Compensation in Radiotherapy

    CERN Document Server

    Murphy, Martin J

    2011-01-01

    External-beam radiotherapy has long been challenged by the simple fact that patients can (and do) move during the delivery of radiation. Recent advances in imaging and beam delivery technologies have made the solution--adapting delivery to natural movement--a practical reality. Adaptive Motion Compensation in Radiotherapy provides the first detailed treatment of online interventional techniques for motion compensation radiotherapy. This authoritative book discusses: Each of the contributing elements of a motion-adaptive system, including target detection and tracking, beam adaptation, and pati

  1. Enhanced attention amplifies face adaptation.

    Science.gov (United States)

    Rhodes, Gillian; Jeffery, Linda; Evangelista, Emma; Ewing, Louise; Peters, Marianne; Taylor, Libby

    2011-08-15

    Perceptual adaptation not only produces striking perceptual aftereffects, but also enhances coding efficiency and discrimination by calibrating coding mechanisms to prevailing inputs. Attention to simple stimuli increases adaptation, potentially enhancing its functional benefits. Here we show that attention also increases adaptation to faces. In Experiment 1, face identity aftereffects increased when attention to adapting faces was increased using a change detection task. In Experiment 2, figural (distortion) face aftereffects increased when attention was increased using a snap game (detecting immediate repeats) during adaptation. Both were large effects. Contributions of low-level adaptation were reduced using free viewing (both experiments) and a size change between adapt and test faces (Experiment 2). We suggest that attention may enhance adaptation throughout the entire cortical visual pathway, with functional benefits well beyond the immediate advantages of selective processing of potentially important stimuli. These results highlight the potential to facilitate adaptive updating of face-coding mechanisms by strategic deployment of attentional resources. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Adaptive filtering and change detection

    CERN Document Server

    Gustafsson, Fredrik

    2003-01-01

    Adaptive filtering is a classical branch of digital signal processing (DSP). Industrial interest in adaptive filtering grows continuously with the increase in computer performance that allows ever more conplex algorithms to be run in real-time. Change detection is a type of adaptive filtering for non-stationary signals and is also the basic tool in fault detection and diagnosis. Often considered as separate subjects Adaptive Filtering and Change Detection bridges a gap in the literature with a unified treatment of these areas, emphasizing that change detection is a natural extensi

  3. Bridging recommendation and adaptation: Generic Adaptation Framework - Twittomender compliance study

    NARCIS (Netherlands)

    Hannon, J.; Knutov, E.; De Bra, P.M.E.; Pechenizkiy, M.; McCarthy, K.; Smyth, B.; Pechenizkiy, M.; Knutov, E.; Yudelson, M.; Abel, F.; Houben, G.J.P.M.; Herder, E.

    2012-01-01

    In this paper we consider Recommender System (RS) modeling in terms of Adaptive Hypermedia Systems (AHS) and investigate AHS and RS functionality compliance in terms of common features, functionality, building blocks and composition of the system. We bring up complementary aspects of adaptation,

  4. Adaptive Behaviour Assessment System: Indigenous Australian Adaptation Model (ABAS: IAAM)

    Science.gov (United States)

    du Plessis, Santie

    2015-01-01

    The study objectives were to develop, trial and evaluate a cross-cultural adaptation of the Adaptive Behavior Assessment System-Second Edition Teacher Form (ABAS-II TF) ages 5-21 for use with Indigenous Australian students ages 5-14. This study introduced a multiphase mixed-method design with semi-structured and informal interviews, school…

  5. Computerized adaptive testing item selection in computerized adaptive learning systems

    NARCIS (Netherlands)

    Eggen, Theodorus Johannes Hendrikus Maria; Eggen, T.J.H.M.; Veldkamp, B.P.

    2012-01-01

    Item selection methods traditionally developed for computerized adaptive testing (CAT) are explored for their usefulness in item-based computerized adaptive learning (CAL) systems. While in CAT Fisher information-based selection is optimal, for recovering learning populations in CAL systems item

  6. Success and adaptation

    CERN Multimedia

    2013-01-01

    Yesterday morning, the last colliding proton beams of 2013 were extracted from the LHC, heralding the start of the machine’s first long shutdown (LS1) and crowning its first three glorious years of running. I hardly need to tell the CERN community what a fabulous performance all the people running the machine, the experiments, the computing and all supporting infrastructures put in. Those people are you, and you all know very well what a great job everyone did.   Nevertheless, I would like to express my thanks to all the people who made this first LHC run such a success. Re-measuring the whole Standard Model in such a short period, and then completing it with the discovery of what looks increasingly like the Higgs boson, is no mean feat. What I’d like to focus on today is another aspect of our field: its remarkable ability to adapt. When I started out in research, experiments involved a handful of people and lasted a few years at most. The timescale for the development of ...

  7. Development of a computerised version of the Children's Gambling Task for the evaluation of affective decision-making in Brazilian preschool children Desenvolvimento de uma versão computadorizada da Children's Gambling Task para avaliação da tomada de decisão afetiva em crianças pré-escolares brasileiras

    Directory of Open Access Journals (Sweden)

    Fernanda Mata

    2013-03-01

    Full Text Available Despite the large number of instruments developed to assess the more purely cognitive executive functions in Brazilian children, few studies have developed instruments for the assessment of the most motivational components of these functions. The primary aim of this study was to develop a computerised version of the Children's Gambling Task (CGT to assess affective decision-making in preschoolers. The present study also aimed to investigate whether this version of the task is sensitive to developmental changes across the preschool period and to examine gender differences in decision-making. We administered the CGT and the Columbia Mental Maturity Scale (CMMS to 137 Brazilian children between the ages of three and five years old. Age differences between three-and four-year-olds, but not between four-and five-year-olds were found. Gender differences were not found. From this preliminary study, the computerised version of the CGT for Brazilian child population proved to be suitable for Brazilian child population.Apesar do grande número de instrumentos desenvolvidos para avaliação das funções executivas mais puramente cognitivas em crianças brasileiras, há poucos estudos que desenvolveram medidas para avaliação dos componentes mais motivacionais dessas funções. O principal objetivo deste estudo foi desenvolver uma versão computadorizada da Children's Gambling Task (CGT para avaliação da tomada de decisão afetiva em crianças pré-escolares. Também se buscou avaliar se a versão desenvolvida é capaz de discriminar grupos etários e examinar as diferenças entre gêneros na tomada de decisão. A versão brasileira da CGT e a Escala de Maturidade Mental Colúmbia foram aplicadas em 137 crianças de três a cinco anos. Observou-se que crianças de quatro e cinco anos obtiveram desempenho superior às de três, entretanto não houve diferença entre o desempenho das crianças de quatro e cinco anos, nem entre meninos e meninas. A partir

  8. for water adaptation in Uganda

    International Development Research Centre (IDRC) Digital Library (Canada)

    Results 11 - 20 of 1643 ... Adapting to climate change in rural Colombia : the role of water ... in identifying and communicating the importance of specific areas within watersheds. ... project developed an information and communication system employing a mix of ... Using demand side management to adapt to water scarcity and ...

  9. Dynamic adaption of vascular morphology

    DEFF Research Database (Denmark)

    Okkels, Fridolin; Jacobsen, Jens Christian Brings

    2012-01-01

    The structure of vascular networks adapts continuously to meet changes in demand of the surrounding tissue. Most of the known vascular adaptation mechanisms are based on local reactions to local stimuli such as pressure and flow, which in turn reflects influence from the surrounding tissue. Here ...

  10. Adaptation Research in Rehabilitation Counseling

    Science.gov (United States)

    Parker, Randall M.

    2007-01-01

    This paper reviews current research concerning psychosocial adaptation to chronic illness and disability and presents recommendations for future development of theories in this area. First, those who craft or adapt theories must use nondisabling, respectful, and empowering language. Rehabilitation professionals must avoid terms that connote…

  11. AdapterRemoval v2

    DEFF Research Database (Denmark)

    Schubert, Mikkel; Lindgreen, Stinus; Orlando, Ludovic Antoine Alexandre

    2016-01-01

    BACKGROUND: As high-throughput sequencing platforms produce longer and longer reads, sequences generated from short inserts, such as those obtained from fossil and degraded material, are increasingly expected to contain adapter sequences. Efficient adapter trimming algorithms are also needed to p...

  12. Tracking adaptation and measuring development

    Energy Technology Data Exchange (ETDEWEB)

    Brooks, Nick; Anderson, Simon; Ayers, Jessica; Burton, Ian; Tellam, Ian

    2011-11-15

    This is the first paper in the new IIED Climate Change Working Paper series. As adaptation to climate change becomes the focus of increasing attention and the target of significant spending, there is a growing need for frameworks and tools that enable organisations to track and assess the outcomes of adaptation interventions. This paper presents a coherent framework for climate change adaptation programming, including potential indicators, or indicator categories/types, for tracking and evaluating the success of adaptation support and adaptation interventions. The paper begins with a discussion of some of the key issues related to the evaluation of adaptation, and outlines some of the main difficulties and constraints with respect to the development of adaptation indicators. Next, an evaluation framework is proposed and indicator categories or 'domains' are identified. Lastly, key conclusions are provided and a theory of change is outlined that shows how development and use of the framework could lead to more effective adaptation investments for climate resilient development.

  13. Adaptive Management of Environmental Flows

    Science.gov (United States)

    Webb, J. Angus; Watts, Robyn J.; Allan, Catherine; Conallin, John C.

    2018-03-01

    Adaptive management enables managers to work with complexity and uncertainty, and to respond to changing biophysical and social conditions. Amid considerable uncertainty over the benefits of environmental flows, governments are embracing adaptive management as a means to inform decision making. This Special Issue of Environmental Management presents examples of adaptive management of environmental flows and addresses claims that there are few examples of its successful implementation. It arose from a session at the 11th International Symposium on Ecohydraulics held in Australia, and is consequently dominated by papers from Australia. We classified the papers according to the involvement of researchers, managers and the local community in adaptive management. Five papers report on approaches developed by researchers, and one paper on a community-led program; these case studies currently have little impact on decision making. Six papers provide examples involving water managers and researchers, and two papers provide examples involving water managers and the local community. There are no papers where researchers, managers and local communities all contribute equally to adaptive management. Successful adaptive management of environmental flows occurs more often than is perceived. The final paper explores why successes are rarely reported, suggesting a lack of emphasis on reflection on management practices. One major challenge is to increase the documentation of successful adaptive management, so that benefits of learning extend beyond the project where it takes place. Finally, moving towards greater involvement of all stakeholders is critical if we are to realize the benefits of adaptive management for improving outcomes from environmental flows.

  14. Adaptivity in Professional Printing Systems

    NARCIS (Netherlands)

    Verriet, J.H.; Basten, T; Hamberg, R.; Reckers, F.J.; Somers, L.

    2013-01-01

    There is a constant pressure on developers of embedded systems to simultaneously increase system functionality and to decrease development costs. Aviable way to obtain a better system performance with the same physical hardware is adaptivity: a system should be able to adapt itself to dynamically

  15. Adaptive Municipal e-forms

    NARCIS (Netherlands)

    Kuiper, P.M.; van Dijk, Elisabeth M.A.G.; Boerma, A.K.; Weibelzahl, S.; Cristea, A.

    2006-01-01

    Adaptation of electronic forms seems to be a step forward to reduce the burden for people who fill in forms. Municipalities more and more offer eforms online that can be used to request a municipal product or service. To create adaptive e-forms that satisfy the need of end-users, involvement of

  16. Center for Adaptive Optics | Software

    Science.gov (United States)

    Optics Software The Center for Adaptive Optics acts as a clearing house for distributing Software to Institutes it gives specialists in Adaptive Optics a place to distribute their software. All software is shared on an "as-is" basis and the users should consult with the software authors with any

  17. Career adaptability and career entrenchment

    NARCIS (Netherlands)

    Zacher, Hannes; Ambiel, Rodolfo A.M.; Noronha, Ana Paula Porto

    2015-01-01

    Career adaptability constitutes a resource that can help employees to effectively manage career changes and challenges. The goal of this study was to investigate the relationship between the two higher-order constructs of career adaptability and career entrenchment (i.e., the perceived inability

  18. Interdisciplinarity in Adapted Physical Activity

    Science.gov (United States)

    Bouffard, Marcel; Spencer-Cavaliere, Nancy

    2016-01-01

    It is commonly accepted that inquiry in adapted physical activity involves the use of different disciplines to address questions. It is often advanced today that complex problems of the kind frequently encountered in adapted physical activity require a combination of disciplines for their solution. At the present time, individual research…

  19. The adaptation to climate change

    International Nuclear Information System (INIS)

    Van Gameren, Valentine; Weikmans, Romain; Zaccai, Edwin

    2014-01-01

    The authors address the issue of adaptation to climate change. They first address the physical aspects related to this issue: scenarios of temperature evolution, main possible impacts. Then, they address the social impacts related to climate risks, and the adaptation strategies which aim at reducing the exposure and vulnerability of human societies, or at increasing their resilience. Some examples of losses of human lives and of economic damages due to recent catastrophes related to climate change are evoked. The authors address the international framework, the emergence of an international regime on climate, the quite recent emergence of adaptation within international negotiations in 2001, the emergence of the idea of a support to developing countries. National and local policies are presented in the next chapter (in the European Union, the Netherlands which are faced with the issue of sea level rise, programs in developing countries) and their limitations are also outlined. The next chapter addresses the adaptation actions performed by private actors (enterprises, households, associations, civil society, and so on) with example of vulnerability, and adaptation opportunities and possibilities in some specific sectors. The last chapter presents a typology of actions of adaptation, indicators of adaptation to climate change, and examples of mistaken adaptation

  20. Adaptive control of robotic manipulators

    Science.gov (United States)

    Seraji, H.

    1987-01-01

    The author presents a novel approach to adaptive control of manipulators to achieve trajectory tracking by the joint angles. The central concept in this approach is the utilization of the manipulator inverse as a feedforward controller. The desired trajectory is applied as an input to the feedforward controller which behaves as the inverse of the manipulator at any operating point; the controller output is used as the driving torque for the manipulator. The controller gains are then updated by an adaptation algorithm derived from MRAC (model reference adaptive control) theory to cope with variations in the manipulator inverse due to changes of the operating point. An adaptive feedback controller and an auxiliary signal are also used to enhance closed-loop stability and to achieve faster adaptation. The proposed control scheme is computationally fast and does not require a priori knowledge of the complex dynamic model or the parameter values of the manipulator or the payload.

  1. What Drives Business Model Adaptation?

    DEFF Research Database (Denmark)

    Saebi, Tina; Lien, Lasse B.; Foss, Nicolai Juul

    2017-01-01

    Business models change as managers not only innovate business models, but also engage in more mundane adaptation in response to external changes, such as changes in the level or composition of demand. However, little is known about what causes such business model adaptation. We employ threat......-rigidity as well as prospect theory to examine business model adaptation in response to external threats and opportunities. Additionally, drawing on the behavioural theory of the firm, we argue that the past strategic orientation of a firm creates path dependencies that influence the propensity of the firm...... to adapt its business model. We test our hypotheses on a sample of 1196 Norwegian companies, and find that firms are more likely to adapt their business model under conditions of perceived threats than opportunities, and that strategic orientation geared towards market development is more conducive...

  2. Strategy for Climate Change Adaptation

    DEFF Research Database (Denmark)

    Rasmussen, Torben Valdbjørn

    2013-01-01

    . This absence of an agreement calls for adaptation to climate change. Emphasis should be put on buildings, as they play a vital economic and social role in society and are vulnerable to climate change. Therefore, the building stock deserves its own policy and implementation plans as well as tools that enable...... adequate and cost-efficient adaptation to climate change. This paper explains the need for climate change adaptation of the building stock and suggests a pattern for a strategic approach to how to reach the climate change adaptation needed. The suggested and presented need of a strategic approach is based...... on three main initiatives consisting of the need to examine the potential impacts of climate change on the building stock, the need to assess and develop a roadmap of current and future adaptation measures that can withstand the effects of climate change, and the need to engage relevant stakeholders...

  3. Strategy for Climate Change Adaptation

    DEFF Research Database (Denmark)

    Rasmussen, Torben Valdbjørn

    2014-01-01

    . This absence of an agreement calls for adaptation to climate change. Emphasis should be put on buildings, as they play a vital economic and social role in society and are vulnerable to climate change. Therefore, the building stock deserves its own policy and implementation plans as well as tools that enable...... adequate and cost-efficient adaptation to climate change. This paper explains the need for climate change adaptation of the building stock and suggests a pattern for a strategic approach to how to reach the climate change adaptation needed. The suggested and presented need of a strategic approach is based...... on three main initiatives consisting of the need to examine the potential impacts of climate change on the building stock, the need to assess and develop a roadmap of current and future adaptation measures that can withstand the effects of climate change, and the need to engage relevant stakeholders...

  4. Adaptive capacity of the Adjusted Clinical Groups Case-Mix System to the cost of primary healthcare in Catalonia (Spain): a observational study.

    Science.gov (United States)

    Sicras-Mainar, Antoni; Velasco-Velasco, Soledad; Navarro-Artieda, Ruth; Prados-Torres, Alexandra; Bolibar-Ribas, Buenaventura; Violan-Fors, Concepción

    2012-01-01

    To describe the adaptive capacity of the Adjusted Clinical Groups (ACG) system to the cost of care in primary healthcare centres in Catalonia (Spain). Retrospective study (multicentres) conducted using computerised medical records. 13 primary care teams in 2008 were included. All patients registered in the study centres who required care between 1 January and 31 December 2008 were finally studied. Patients not registered in the study centres during the study period were excluded. Demographic (age and sex), dependent (cost of care) and case-mix variables were studied. The cost model for each patient was established by differentiating the fixed and variable costs. To evaluate the adaptive capacity of the ACG system, Pearson's coefficient of variation and the percentage of outliers were calculated. To evaluate the explanatory power of the ACG system, the authors used the coefficient of determination (R(2)). The number of patients studied was 227 235 (frequency: 5.9 visits per person per year), with a mean of 4.5 (3.2) episodes and 8.1 (8.2) visits per patient per year. The mean total cost was €654.2. The explanatory power of the ACG system was 36.9% for costs (56.5% without outliers). 10 ACG categories accounted for 60.1% of all cases and 19 for 80.9%. 5 categories represented 71% of poor performance (N=78 887, 34.7%), particularly category 0300-Acute Minor, Age 6+ (N=26 909, 11.8%), which had a coefficient of variation =139% and 6.6% of outliers. The ACG system is an appropriate manner of classifying patients in routine clinical practice in primary healthcare centres in Catalonia, although improvements to the adaptive capacity through disaggregation of some categories according to age groups and, especially, the number of acute episodes in paediatric patients would be necessary to reduce intra-group variation.

  5. Changes in frontal-parietal activation and math skills performance following adaptive number sense training: preliminary results from a pilot study.

    Science.gov (United States)

    Kesler, Shelli R; Sheau, Kristen; Koovakkattu, Della; Reiss, Allan L

    2011-08-01

    Number sense is believed to be critical for math development. It is putatively an implicitly learned skill and may therefore have limitations in terms of being explicitly trained, particularly in individuals with altered neurodevelopment. A case series study was conducted using an adaptive, computerised programme that focused on number sense and general problem-solving skills. The study was designed to investigate training effects on performance as well as brain function in a group of children with Turner syndrome who are at risk for math difficulties and altered development of math-related brain networks. Standardised measurements of math and math-related cognitive skills as well as functional magnetic resonance imaging (fMRI) were used to assess behavioural and neurobiological outcomes following training. Participants demonstrated significantly increased basic math skills, including number sense, and calculation as well as processing speed, cognitive flexibility and visual-spatial processing skills. With the exception of calculation, increased scores also were clinically significant (i.e., recovered) based on reliable change analysis. Participants additionally demonstrated significantly increased bilateral parietal lobe activation and decreased frontal-striatal and mesial temporal activation following the training programme. These findings show proof of concept for an accessible training approach that may be potentially associated with improved number sense, math and related skills, as well as functional changes in math-related neural systems, even among individuals at risk for altered brain development.

  6. An adaptive signal-processing approach to online adaptive tutoring.

    Science.gov (United States)

    Bergeron, Bryan; Cline, Andrew

    2011-01-01

    Conventional intelligent or adaptive tutoring online systems rely on domain-specific models of learner behavior based on rules, deep domain knowledge, and other resource-intensive methods. We have developed and studied a domain-independent methodology of adaptive tutoring based on domain-independent signal-processing approaches that obviate the need for the construction of explicit expert and student models. A key advantage of our method over conventional approaches is a lower barrier to entry for educators who want to develop adaptive online learning materials.

  7. Preventing academic difficulties in preterm children: a randomised controlled trial of an adaptive working memory training intervention - IMPRINT study.

    Science.gov (United States)

    Pascoe, Leona; Roberts, Gehan; Doyle, Lex W; Lee, Katherine J; Thompson, Deanne K; Seal, Marc L; Josev, Elisha K; Nosarti, Chiara; Gathercole, Susan; Anderson, Peter J

    2013-09-16

    Very preterm children exhibit difficulties in working memory, a key cognitive ability vital to learning information and the development of academic skills. Previous research suggests that an adaptive working memory training intervention (Cogmed) may improve working memory and other cognitive and behavioural domains, although further randomised controlled trials employing long-term outcomes are needed, and with populations at risk for working memory deficits, such as children born preterm.In a cohort of extremely preterm (memory and attention 2 weeks', 12 months' and 24 months' post-intervention, and to investigate training related neuroplasticity in working memory neural networks 2 weeks' post-intervention. This double-blind, placebo-controlled, randomised controlled trial aims to recruit 126 extremely preterm/extremely low birthweight 7-year-old children. Children attending mainstream school without major intellectual, sensory or physical impairments will be eligible. Participating children will undergo an extensive baseline cognitive assessment before being randomised to either an adaptive or placebo (non-adaptive) version of Cogmed. Cogmed is a computerised working memory training program consisting of 25 sessions completed over a 5 to 7 week period. Each training session takes approximately 35 minutes and will be completed in the child's home. Structural, diffusion and functional Magnetic Resonance Imaging, which is optional for participants, will be completed prior to and 2 weeks following the training period. Follow-up assessments focusing on academic skills (primary outcome), working memory and attention (secondary outcomes) will be conducted at 2 weeks', 12 months' and 24 months' post-intervention. To our knowledge, this study will be the first randomised controlled trial to (a) assess the effectiveness of Cogmed in school-aged extremely preterm/extremely low birthweight children, while incorporating advanced imaging techniques to investigate neural changes

  8. Effect of Metformin on Potassium-adapted and Non- adapted ...

    African Journals Online (AJOL)

    determined. Results: The blood glucose of the potassium-adapted diabetic group was not significantly reduced on treatment ... whom dietary carbohydrate restriction has not controlled .... significantly different from the metformin-treated group.

  9. Adaptive Augmenting Control and Launch Vehicle Adaptive Control Flight Experiments

    Data.gov (United States)

    National Aeronautics and Space Administration — Researchers at NASA Armstrong are working to further the development of an adaptive augmenting control algorithm (AAC). The AAC was developed to improve the...

  10. Social-psychological specific of individual adaptation

    OpenAIRE

    Ovsyanik, Olga

    2012-01-01

    There is analyzing of specific of social-psychological adaptation person by model of adaptation. Structure model of adaptation of women of our age group, which was named “adaptation complex” was made by theoretic analyzes of problem of adaptation adult.

  11. Countermeasures to Enhance Sensorimotor Adaptability

    Science.gov (United States)

    Bloomberg, J. J.; Peters, B. T.; Mulavara, A. P.; Brady, R. A.; Batson, C. C.; Miller, C. A.; Cohen, H. S.

    2011-01-01

    During exploration-class missions, sensorimotor disturbances may lead to disruption in the ability to ambulate and perform functional tasks during the initial introduction to a novel gravitational environment following a landing on a planetary surface. The goal of our current project is to develop a sensorimotor adaptability (SA) training program to facilitate rapid adaptation to novel gravitational environments. We have developed a unique training system comprised of a treadmill placed on a motion-base facing a virtual visual scene that provides an unstable walking surface combined with incongruent visual flow designed to enhance sensorimotor adaptability. We have conducted a series of studies that have shown: Training using a combination of modified visual flow and support surface motion during treadmill walking enhances locomotor adaptability to a novel sensorimotor environment. Trained individuals become more proficient at performing multiple competing tasks while walking during adaptation to novel discordant sensorimotor conditions. Trained subjects can retain their increased level of adaptability over a six months period. SA training is effective in producing increased adaptability in a more complex over-ground ambulatory task on an obstacle course. This confirms that for a complex task like walking, treadmill training contains enough of the critical features of overground walking to be an effective training modality. The structure of individual training sessions can be optimized to promote fast/strategic motor learning. Training sessions that each contain short-duration exposures to multiple perturbation stimuli allows subjects to acquire a greater ability to rapidly reorganize appropriate response strategies when encountering a novel sensory environment. Individual sensory biases (i.e. increased visual dependency) can predict adaptive responses to novel sensory environments suggesting that customized training prescriptions can be developed to enhance

  12. Resource-adaptive cognitive processes

    CERN Document Server

    Crocker, Matthew W

    2010-01-01

    This book investigates the adaptation of cognitive processes to limited resources. The central topics of this book are heuristics considered as results of the adaptation to resource limitations, through natural evolution in the case of humans, or through artificial construction in the case of computational systems; the construction and analysis of resource control in cognitive processes; and an analysis of resource-adaptivity within the paradigm of concurrent computation. The editors integrated the results of a collaborative 5-year research project that involved over 50 scientists. After a mot

  13. Racism in America through adaptation

    OpenAIRE

    Munk, Jakob; Jakobsen, Sebastian; Chung, Jacinta; Schulze, Anja; Papakonstantinou, Vaitza

    2015-01-01

    This study examines the adaptation of the movie 12 Years a Slave from the memoir of Solomon Northup. In order to analyse the adaptation, several theories will be used as guidelines for our research such as adaptation theories and film techniques. The analysis will lead through the different chapters of the book focusing on atmosphere, characters and religion. The main themes dealt with in the book as well as the movie will be linked with the events which unfolded in Ferguson and Baltimore. In...

  14. Farming System Evolution and Adaptive Capacity: Insights for Adaptation Support

    Directory of Open Access Journals (Sweden)

    Jami L. Dixon

    2014-02-01

    Full Text Available Studies of climate impacts on agriculture and adaptation often provide current or future assessments, ignoring the historical contexts farming systems are situated within. We investigate how historical trends have influenced farming system adaptive capacity in Uganda using data from household surveys, semi-structured interviews, focus-group discussions and observations. By comparing two farming systems, we note three major findings: (1 similar trends in farming system evolution have had differential impacts on the diversity of farming systems; (2 trends have contributed to the erosion of informal social and cultural institutions and an increasing dependence on formal institutions; and (3 trade-offs between components of adaptive capacity are made at the farm-scale, thus influencing farming system adaptive capacity. To identify the actual impacts of future climate change and variability, it is important to recognize the dynamic nature of adaptation. In practice, areas identified for further adaptation support include: shift away from one-size-fits-all approach the identification and integration of appropriate modern farming method; a greater focus on building inclusive formal and informal institutions; and a more nuanced understanding regarding the roles and decision-making processes of influential, but external, actors. More research is needed to understand farm-scale trade-offs and the resulting impacts across spatial and temporal scales.

  15. Climate change and adaptation policy

    Energy Technology Data Exchange (ETDEWEB)

    Smith, Jamie [Policy Research Initiative, Ottawa, ON (Canada); Lavender, B. [Natural Resources Canada, Ottawa, ON (Canada); Smit, B. [Guelph Univ., ON (Canada). Dept. of Geography; Burton, I.

    2001-12-31

    In this document the authors indicate that some level of adaptation will be required as climate change affects our lives. They narrowed their examination to three sectors of Canadian society: human health, agriculture, and northern communities and infrastructure. Within each sector they discussed the policy research needs and the adaptation problems to be expected. Uncertainties remain concerning the magnitude of climate change, its timing and consequences, and further research is required to reduce the uncertainties. Canada presents certain vulnerabilities, and to enhance and improve the resilience of the population toward climate change, some adaptation measures must be put in place to reduce the vulnerabilities. Confidence will come as a by-product of the leadership required to bring about the required adaptation measures, and cooperation is a must between all levels of government, the private sector and society to reach agreement.

  16. Adaptive hybrid control of manipulators

    Science.gov (United States)

    Seraji, H.

    1987-01-01

    Simple methods for the design of adaptive force and position controllers for robot manipulators within the hybrid control architecuture is presented. The force controller is composed of an adaptive PID feedback controller, an auxiliary signal and a force feedforward term, and it achieves tracking of desired force setpoints in the constraint directions. The position controller consists of adaptive feedback and feedforward controllers and an auxiliary signal, and it accomplishes tracking of desired position trajectories in the free directions. The controllers are capable of compensating for dynamic cross-couplings that exist between the position and force control loops in the hybrid control architecture. The adaptive controllers do not require knowledge of the complex dynamic model or parameter values of the manipulator or the environment. The proposed control schemes are computationally fast and suitable for implementation in on-line control with high sampling rates.

  17. Genetic Algorithms for Case Adaptation

    Energy Technology Data Exchange (ETDEWEB)

    Salem, A M [Computer Science Dept, Faculty of Computer and Information Sciences, Ain Shams University, Cairo (Egypt); Mohamed, A H [Solid State Dept., (NCRRT), Cairo (Egypt)

    2008-07-01

    Case based reasoning (CBR) paradigm has been widely used to provide computer support for recalling and adapting known cases to novel situations. Case adaptation algorithms generally rely on knowledge based and heuristics in order to change the past solutions to solve new problems. However, case adaptation has always been a difficult process to engineers within (CBR) cycle. Its difficulties can be referred to its domain dependency; and computational cost. In an effort to solve this problem, this research explores a general-purpose method that applying a genetic algorithm (GA) to CBR adaptation. Therefore, it can decrease the computational complexity of the search space in the problems having a great dependency on their domain knowledge. The proposed model can be used to perform a variety of design tasks on a broad set of application domains. However, it has been implemented for the tablet formulation as a domain of application. The proposed system has improved the performance of the CBR design systems.

  18. Climate change mitigation through adaptation

    NARCIS (Netherlands)

    Hof, Anouschka R.; Dymond, Caren C.; Mladenoff, David J.

    2017-01-01

    Climate change is projected to have negative implications for forest ecosystems and their dependent communities and industries. Adaptation studies of forestry practices have focused on maintaining the provisioning of ecosystem services; however, those practices may have implications for climate

  19. Adapting playware to multiple players

    DEFF Research Database (Denmark)

    Þorsteinsson, Arnar Tumi; Lund, Henrik Hautop; Mastorakis, Nikos

    2011-01-01

    With the creation of playware as intelligent hardware and software that creates play, it is possible to adapt the play tool to the individual user, and even to multiple users playing at the same time with the play tool. In this paper, we show how it is possible to implement adaptivity in modular...... to such differences, and argues that adaptivity is needed to make games fit to the individual users in both single-player games and multi-player games. As a case study, we implemented such adaptivity on modular interactive tiles for the single-user game ColorTimer, and for the multiple-user games PingPong, in which...

  20. Feature-level domain adaptation

    DEFF Research Database (Denmark)

    Kouw, Wouter M.; Van Der Maaten, Laurens J P; Krijthe, Jesse H.

    2016-01-01

    -level domain adaptation (flda), that models the dependence between the two domains by means of a feature-level transfer model that is trained to describe the transfer from source to target domain. Subsequently, we train a domain-adapted classifier by minimizing the expected loss under the resulting transfer...... modeled via a dropout distribution, which allows the classiffier to adapt to differences in the marginal probability of features in the source and the target domain. Our experiments on several real-world problems show that flda performs on par with state-of-the-art domainadaptation techniques.......Domain adaptation is the supervised learning setting in which the training and test data are sampled from different distributions: training data is sampled from a source domain, whilst test data is sampled from a target domain. This paper proposes and studies an approach, called feature...

  1. Externalizing Research Through Adaptive Frameworks

    DEFF Research Database (Denmark)

    Vedel, Jane Bjørn; Irwin, Alan; Høngaard Andersen, Peter

    2013-01-01

    Adaptive approaches to collaborations between industry and academic research institutions can enable both parties to achieve their goals more effectively. Here, we discuss our experience with such approaches and suggest recommendations for addressing the associated management challenges....

  2. Human whole body cold adaptation.

    NARCIS (Netherlands)

    Daanen, Hein A.M.; Van Marken Lichtenbelt, Wouter D.

    2016-01-01

    Reviews on whole body human cold adaptation generally do not distinguish between population studies and dedicated acclimation studies, leading to confusing results. Population studies show that indigenous black Africans have reduced shivering thermogenesis in the cold and poor cold induced

  3. Genetic Algorithms for Case Adaptation

    International Nuclear Information System (INIS)

    Salem, A.M.; Mohamed, A.H.

    2008-01-01

    Case based reasoning (CBR) paradigm has been widely used to provide computer support for recalling and adapting known cases to novel situations. Case adaptation algorithms generally rely on knowledge based and heuristics in order to change the past solutions to solve new problems. However, case adaptation has always been a difficult process to engineers within (CBR) cycle. Its difficulties can be referred to its domain dependency; and computational cost. In an effort to solve this problem, this research explores a general-purpose method that applying a genetic algorithm (GA) to CBR adaptation. Therefore, it can decrease the computational complexity of the search space in the problems having a great dependency on their domain knowledge. The proposed model can be used to perform a variety of design tasks on a broad set of application domains. However, it has been implemented for the tablet formulation as a domain of application. The proposed system has improved the performance of the CBR design systems

  4. Terrain Adaptive Reconfiguration of Mobility

    Data.gov (United States)

    National Aeronautics and Space Administration — Develop an algorithm (and software) to automatically adapt a reconfigurable robot to different types of terrains for improved mobility, that compared to SOA:...

  5. Training Adaptability in Digital Skills

    National Research Council Canada - National Science Library

    Hess-Kosa, Kathleen

    2001-01-01

    .... As outlined in this Phase I report, Aptima and the Group for Organizational Effectiveness (gOE) have lain the groundwork for an innovative, computer-based, digital-skills training package designed to increase the adaptability of digital skills...

  6. Adaptive oxide electronics: A review

    Science.gov (United States)

    Ha, Sieu D.; Ramanathan, Shriram

    2011-10-01

    Novel information processing techniques are being actively explored to overcome fundamental limitations associated with CMOS scaling. A new paradigm of adaptive electronic devices is emerging that may reshape the frontiers of electronics and enable new modalities. Creating systems that can learn and adapt to various inputs has generally been a complex algorithm problem in information science, albeit with wide-ranging and powerful applications from medical diagnosis to control systems. Recent work in oxide electronics suggests that it may be plausible to implement such systems at the device level, thereby drastically increasing computational density and power efficiency and expanding the potential for electronics beyond Boolean computation. Intriguing possibilities of adaptive electronics include fabrication of devices that mimic human brain functionality: the strengthening and weakening of synapses emulated by electrically, magnetically, thermally, or optically tunable properties of materials.In this review, we detail materials and device physics studies on functional metal oxides that may be utilized for adaptive electronics. It has been shown that properties, such as resistivity, polarization, and magnetization, of many oxides can be modified electrically in a non-volatile manner, suggesting that these materials respond to electrical stimulus similarly as a neural synapse. We discuss what device characteristics will likely be relevant for integration into adaptive platforms and then survey a variety of oxides with respect to these properties, such as, but not limited to, TaOx, SrTiO3, and Bi4-xLaxTi3O12. The physical mechanisms in each case are detailed and analyzed within the framework of adaptive electronics. We then review theoretically formulated and current experimentally realized adaptive devices with functional oxides, such as self-programmable logic and neuromorphic circuits. Finally, we speculate on what advances in materials physics and engineering may

  7. Cardiovascular adaptations to exercise training

    DEFF Research Database (Denmark)

    Hellsten, Ylva; Nyberg, Michael

    2016-01-01

    Aerobic exercise training leads to cardiovascular changes that markedly increase aerobic power and lead to improved endurance performance. The functionally most important adaptation is the improvement in maximal cardiac output which is the result of an enlargement in cardiac dimension, improved...... and peripheral cardiovascular adaptations with a focus on humans, but also covers animal data. © 2016 American Physiological Society. Compr Physiol 6:1-32, 2016....

  8. Climate change adaptation in Ethiopia

    DEFF Research Database (Denmark)

    Weldegebriel, Zerihun Berhane; Prowse, Martin

    Ethiopia is vulnerable to climate change due to its limited development and dependence on agriculture. Social protection schemes like the Productive Safety Net Programme (PSNP) can play a positive role in promoting livelihoods and enhancing households’ risk management. This article examines......, they suggest the PSNP may not be helping smallholders diversify income sources in a positive manner for climate adaptation. The article concludes by arguing for further investigation of the PSNP’s influence on smallholders’ adaptation strategies....

  9. Adaptive designs in clinical trials

    Directory of Open Access Journals (Sweden)

    Suresh Bowalekar

    2011-01-01

    Full Text Available In addition to the expensive and lengthy process of developing a new medicine, the attrition rate in clinical research was on the rise, resulting in stagnation in the development of new compounds. As a consequence to this, the US Food and Drug Administration released a critical path initiative document in 2004, highlighting the need for developing innovative trial designs. One of the innovations suggested the use of adaptive designs for clinical trials. Thus, post critical path initiative, there is a growing interest in using adaptive designs for the development of pharmaceutical products. Adaptive designs are expected to have great potential to reduce the number of patients and duration of trial and to have relatively less exposure to new drug. Adaptive designs are not new in the sense that the task of interim analysis (IA/review of the accumulated data used in adaptive designs existed in the past too. However, such reviews/analyses of accumulated data were not necessarily planned at the stage of planning clinical trial and the methods used were not necessarily compliant with clinical trial process. The Bayesian approach commonly used in adaptive designs was developed by Thomas Bayes in the 18th century, about hundred years prior to the development of modern statistical methods by the father of modern statistics, Sir Ronald A. Fisher, but the complexity involved in Bayesian approach prevented its use in real life practice. The advances in the field of computer and information technology over the last three to four decades has changed the scenario and the Bayesian techniques are being used in adaptive designs in addition to other sequential methods used in IA. This paper attempts to describe the various adaptive designs in clinical trial and views of stakeholders about feasibility of using them, without going into mathematical complexities.

  10. Adaptive designs in clinical trials.

    Science.gov (United States)

    Bowalekar, Suresh

    2011-01-01

    In addition to the expensive and lengthy process of developing a new medicine, the attrition rate in clinical research was on the rise, resulting in stagnation in the development of new compounds. As a consequence to this, the US Food and Drug Administration released a critical path initiative document in 2004, highlighting the need for developing innovative trial designs. One of the innovations suggested the use of adaptive designs for clinical trials. Thus, post critical path initiative, there is a growing interest in using adaptive designs for the development of pharmaceutical products. Adaptive designs are expected to have great potential to reduce the number of patients and duration of trial and to have relatively less exposure to new drug. Adaptive designs are not new in the sense that the task of interim analysis (IA)/review of the accumulated data used in adaptive designs existed in the past too. However, such reviews/analyses of accumulated data were not necessarily planned at the stage of planning clinical trial and the methods used were not necessarily compliant with clinical trial process. The Bayesian approach commonly used in adaptive designs was developed by Thomas Bayes in the 18th century, about hundred years prior to the development of modern statistical methods by the father of modern statistics, Sir Ronald A. Fisher, but the complexity involved in Bayesian approach prevented its use in real life practice. The advances in the field of computer and information technology over the last three to four decades has changed the scenario and the Bayesian techniques are being used in adaptive designs in addition to other sequential methods used in IA. This paper attempts to describe the various adaptive designs in clinical trial and views of stakeholders about feasibility of using them, without going into mathematical complexities.

  11. Human whole body cold adaptation.

    OpenAIRE

    Daanen, Hein A.M.; Van Marken Lichtenbelt, Wouter D.

    2016-01-01

    ABSTRACT Reviews on whole body human cold adaptation generally do not distinguish between population studies and dedicated acclimation studies, leading to confusing results. Population studies show that indigenous black Africans have reduced shivering thermogenesis in the cold and poor cold induced vasodilation in fingers and toes compared to Caucasians and Inuit. About 40,000?y after humans left Africa, natives in cold terrestrial areas seems to have developed not only behavioral adaptations...

  12. Adaptive Regularization of Neural Classifiers

    DEFF Research Database (Denmark)

    Andersen, Lars Nonboe; Larsen, Jan; Hansen, Lars Kai

    1997-01-01

    We present a regularization scheme which iteratively adapts the regularization parameters by minimizing the validation error. It is suggested to use the adaptive regularization scheme in conjunction with optimal brain damage pruning to optimize the architecture and to avoid overfitting. Furthermo......, we propose an improved neural classification architecture eliminating an inherent redundancy in the widely used SoftMax classification network. Numerical results demonstrate the viability of the method...

  13. Adaptive Liquid Crystal Windows

    Energy Technology Data Exchange (ETDEWEB)

    Taheri, Bahman; Bodnar, Volodymyr

    2011-12-31

    Energy consumption by private and commercial sectors in the U.S. has steadily grown over the last decade. The uncertainty in future availability of imported oil, on which the energy consumption relies strongly, resulted in a dramatic increase in the cost of energy. About 20% of this consumption are used to heat and cool houses and commercial buildings. To reduce dependence on the foreign oil and cut down emission of greenhouse gases, it is necessary to eliminate losses and reduce total energy consumption by buildings. To achieve this goal it is necessary to redefine the role of the conventional windows. At a minimum, windows should stop being a source for energy loss. Ideally, windows should become a source of energy, providing net gain to reduce energy used to heat and cool homes. It is possible to have a net energy gain from a window if its light transmission can be dynamically altered, ideally electronically without the need of operator assistance, providing optimal control of the solar gain that varies with season and climate in the U.S. In addition, the window must not require power from the building for operation. Resolution of this problem is a societal challenge and of national interest and will have a broad global impact. For this purpose, the year-round, allclimate window solution to provide an electronically variable solar heat gain coefficient (SHGC) with a wide dynamic range is needed. AlphaMicron, Inc. (AMI) developed and manufactured 1ft × 1ft prototype panels for the world’s first auto-adjusting Adaptive Liquid Crystal Windows (ALCWs) that can operate from sunlight without the need for external power source and demonstrate an electronically adjustable SHGC. This novel windows are based on AlphaMicron’s patented e-Tint® technology, a guesthost liquid crystal system implemented on flexible, optically clear plastic films. This technology is suitable both for OEM and aftermarket (retro-fitting) lamination to new and existing windows. Low level of

  14. Fair adaptation to climate change

    International Nuclear Information System (INIS)

    Paavola, Jouni; Adger, W. Neil

    2006-01-01

    This article identifies social justice dilemmas associated with the necessity to adapt to climate change, examines how they are currently addressed by the climate change regime, and proposes solutions to overcome prevailing gaps and ambiguities. We argue that the key justice dilemmas of adaptation include responsibility for climate change impacts, the level and burden sharing of assistance to vulnerable countries for adaptation, distribution of assistance between recipient countries and adaptation measures, and fair participation in planning and making decisions on adaptation. We demonstrate how the climate change regime largely omits responsibility but makes a general commitment to assistance. However, the regime has so far failed to operationalise assistance and has made only minor progress towards eliminating obstacles for fair participation. We propose the adoption of four principles for fair adaptation in the climate change regime. These include avoiding dangerous climate change, forward-looking responsibility, putting the most vulnerable first and equal participation of all. We argue that a safe maximum standard of 400-500 ppm of CO 2 concentrations in the atmosphere and a carbon tax of $20-50 per carbon equivalent ton could provide the initial instruments for operationalising the principles. (author)

  15. Adaptive capture of expert knowledge

    Energy Technology Data Exchange (ETDEWEB)

    Barrett, C.L.; Jones, R.D. [Los Alamos National Lab., NM (United States); Hand, Un Kyong [Los Alamos National Lab., NM (United States)]|[US Navy (United States)

    1995-05-01

    A method is introduced that can directly acquire knowledge-engineered, rule-based logic in an adaptive network. This adaptive representation of the rule system can then replace the rule system in simulated intelligent agents and thereby permit further performance-based adaptation of the rule system. The approach described provides both weight-fitting network adaptation and potentially powerful rule mutation and selection mechanisms. Nonlinear terms are generated implicitly in the mutation process through the emergent interaction of multiple linear terms. By this method it is possible to acquire nonlinear relations that exist in the training data without addition of hidden layers or imposition of explicit nonlinear terms in the network. We smoothed and captured a set of expert rules with an adaptive network. The motivation for this was to (1) realize a speed advantage over traditional rule-based simulations; (2) have variability in the intelligent objects not possible by rule-based systems but provided by adaptive systems: and (3) maintain the understandability of rule-based simulations. A set of binary rules was smoothed and converted into a simple set of arithmetic statements, where continuous, non-binary rules are permitted. A neural network, called the expert network, was developed to capture this rule set, which it was able to do with zero error. The expert network is also capable of learning a nonmonotonic term without a hidden layer. The trained network in feedforward operation is fast running, compact, and traceable to the rule base.

  16. Adapting agriculture to climate change.

    Science.gov (United States)

    Howden, S Mark; Soussana, Jean-François; Tubiello, Francesco N; Chhetri, Netra; Dunlop, Michael; Meinke, Holger

    2007-12-11

    The strong trends in climate change already evident, the likelihood of further changes occurring, and the increasing scale of potential climate impacts give urgency to addressing agricultural adaptation more coherently. There are many potential adaptation options available for marginal change of existing agricultural systems, often variations of existing climate risk management. We show that implementation of these options is likely to have substantial benefits under moderate climate change for some cropping systems. However, there are limits to their effectiveness under more severe climate changes. Hence, more systemic changes in resource allocation need to be considered, such as targeted diversification of production systems and livelihoods. We argue that achieving increased adaptation action will necessitate integration of climate change-related issues with other risk factors, such as climate variability and market risk, and with other policy domains, such as sustainable development. Dealing with the many barriers to effective adaptation will require a comprehensive and dynamic policy approach covering a range of scales and issues, for example, from the understanding by farmers of change in risk profiles to the establishment of efficient markets that facilitate response strategies. Science, too, has to adapt. Multidisciplinary problems require multidisciplinary solutions, i.e., a focus on integrated rather than disciplinary science and a strengthening of the interface with decision makers. A crucial component of this approach is the implementation of adaptation assessment frameworks that are relevant, robust, and easily operated by all stakeholders, practitioners, policymakers, and scientists.

  17. Action to Support Practices Implement Research Evidence (ASPIRE): protocol for a cluster-randomised evaluation of adaptable implementation packages targeting 'high impact' clinical practice recommendations in general practice.

    Science.gov (United States)

    Willis, Thomas A; Hartley, Suzanne; Glidewell, Liz; Farrin, Amanda J; Lawton, Rebecca; McEachan, Rosemary R C; Ingleson, Emma; Heudtlass, Peter; Collinson, Michelle; Clamp, Susan; Hunter, Cheryl; Ward, Vicky; Hulme, Claire; Meads, David; Bregantini, Daniele; Carder, Paul; Foy, Robbie

    2016-02-29

    There are recognised gaps between evidence and practice in general practice, a setting which provides particular challenges for implementation. We earlier screened clinical guideline recommendations to derive a set of 'high impact' indicators based upon criteria including potential for significant patient benefit, scope for improved practice and amenability to measurement using routinely collected data. We aim to evaluate the effectiveness and cost-effectiveness of a multifaceted, adaptable intervention package to implement four targeted, high impact recommendations in general practice. The research programme Action to Support Practice Implement Research Evidence (ASPIRE) includes a pair of pragmatic cluster-randomised trials which use a balanced incomplete block design. Clusters are general practices in West Yorkshire, United Kingdom (UK), recruited using an 'opt-out' recruitment process. The intervention package adapted to each recommendation includes combinations of audit and feedback, educational outreach visits and computerised prompts with embedded behaviour change techniques selected on the basis of identified needs and barriers to change. In trial 1, practices are randomised to adapted interventions targeting either diabetes control or risky prescribing and those in trial 2 to adapted interventions targeting either blood pressure control in patients at risk of cardiovascular events or anticoagulation in atrial fibrillation. The respective primary endpoints comprise achievement of all recommended target levels of haemoglobin A1c (HbA1c), blood pressure and cholesterol in patients with type 2 diabetes, a composite indicator of risky prescribing, achievement of recommended blood pressure targets for specific patient groups and anticoagulation prescribing in patients with atrial fibrillation. We are also randomising practices to a fifth, non-intervention control group to further assess Hawthorne effects. Outcomes will be assessed using routinely collected data

  18. Adaptive Multilevel Monte Carlo Simulation

    KAUST Repository

    Hoel, H

    2011-08-23

    This work generalizes a multilevel forward Euler Monte Carlo method introduced in Michael B. Giles. (Michael Giles. Oper. Res. 56(3):607–617, 2008.) for the approximation of expected values depending on the solution to an Itô stochastic differential equation. The work (Michael Giles. Oper. Res. 56(3):607– 617, 2008.) proposed and analyzed a forward Euler multilevelMonte Carlo method based on a hierarchy of uniform time discretizations and control variates to reduce the computational effort required by a standard, single level, Forward Euler Monte Carlo method. This work introduces an adaptive hierarchy of non uniform time discretizations, generated by an adaptive algorithmintroduced in (AnnaDzougoutov et al. Raùl Tempone. Adaptive Monte Carlo algorithms for stopped diffusion. In Multiscale methods in science and engineering, volume 44 of Lect. Notes Comput. Sci. Eng., pages 59–88. Springer, Berlin, 2005; Kyoung-Sook Moon et al. Stoch. Anal. Appl. 23(3):511–558, 2005; Kyoung-Sook Moon et al. An adaptive algorithm for ordinary, stochastic and partial differential equations. In Recent advances in adaptive computation, volume 383 of Contemp. Math., pages 325–343. Amer. Math. Soc., Providence, RI, 2005.). This form of the adaptive algorithm generates stochastic, path dependent, time steps and is based on a posteriori error expansions first developed in (Anders Szepessy et al. Comm. Pure Appl. Math. 54(10):1169– 1214, 2001). Our numerical results for a stopped diffusion problem, exhibit savings in the computational cost to achieve an accuracy of ϑ(TOL),from(TOL−3), from using a single level version of the adaptive algorithm to ϑ(((TOL−1)log(TOL))2).

  19. An Adaptive Critic Approach to Reference Model Adaptation

    Science.gov (United States)

    Krishnakumar, K.; Limes, G.; Gundy-Burlet, K.; Bryant, D.

    2003-01-01

    Neural networks have been successfully used for implementing control architectures for different applications. In this work, we examine a neural network augmented adaptive critic as a Level 2 intelligent controller for a C- 17 aircraft. This intelligent control architecture utilizes an adaptive critic to tune the parameters of a reference model, which is then used to define the angular rate command for a Level 1 intelligent controller. The present architecture is implemented on a high-fidelity non-linear model of a C-17 aircraft. The goal of this research is to improve the performance of the C-17 under degraded conditions such as control failures and battle damage. Pilot ratings using a motion based simulation facility are included in this paper. The benefits of using an adaptive critic are documented using time response comparisons for severe damage situations.

  20. Rate Adaptive OFDMA Communication Systems

    International Nuclear Information System (INIS)

    Abdelhakim, M.M.M.

    2009-01-01

    Due to the varying nature of the wireless channels, adapting the transmission parameters, such as code rate, modulation order and power, in response to the channel variations provides a significant improvement in the system performance. In the OFDM systems, Per-Frame adaptation (PFA) can be employed where the transmission variables are fixed over a given frame and may change from one frame to the other. Subband (tile) loading offers more degrees of adaptation such that each group of carriers (subband) uses the same transmission parameters and different subbands may use different parameters. Changing the code rate for each tile in the same frame, results in transmitting multiple codewords (MCWs) for a single frame. In this thesis a scheme is proposed for adaptively changing the code rate of coded OFDMA systems via changing the puncturing rate within a single codeword (SCW). In the proposed structure, the data is encoded with the lowest available code rate then it is divided among the different tiles where it is punctured adaptively based on some measure of the channel quality for each tile. The proposed scheme is compared against using multiple codewords (MCWs) where the different code rates for the tiles are obtained using separate encoding processes. For bit interleaved coded modulation architecture two novel interleaving methods are proposed, namely the puncturing dependant interleaver (PDI) and interleaved puncturing (IntP), which provide larger interleaving depth. In the PDI method the coded bits with the same rate over different tiles are grouped for interleaving. In IntP structure the interleaving is performed prior to puncturing. The performance of the adaptive puncturing technique is investigated under constant bit rate constraint and variable bit rate. Two different adaptive modulation and coding (AMC) selection methods are examined for variable bit rate adaptive system. The first is a recursive scheme that operates directly on the SNR whereas the second

  1. Molecular evolution and thermal adaptation

    Science.gov (United States)

    Chen, Peiqiu

    2011-12-01

    In this thesis, we address problems in molecular evolution, thermal adaptation, and the kinetics of adaptation of bacteria and viruses to elevated environmental temperatures. We use a nearly neutral fitness model where the replication speed of an organism is proportional to the copy number of folded proteins. Our model reproduces the distribution of stabilities of natural proteins in excellent agreement with experiment. We find that species with high mutation rates tend to have less stable proteins compared to species with low mutation rate. We found that a broad distribution of protein stabilities observed in the model and in experiment is the key determinant of thermal response for viruses and bacteria. Our results explain most of the earlier experimental observations: striking asymmetry of thermal response curves, the absence of evolutionary trade-off which was expected but not found in experiments, correlation between denaturation temperature for several protein families and the Optimal Growth Temperature (OGT) of their carrier organisms, and proximity of bacterial or viral OGTs to their evolutionary temperatures. Our theory quantitatively and with high accuracy described thermal response curves for 35 bacterial species. The model also addresses the key to adaptation is in weak-link genes (WLG), which encode least thermodynamically stable essential proteins in the proteome. We observe, as in experiment, a two-stage adaptation process. The first stage is a Luria-Delbruck type of selection, whereby rare WLG alleles, whose proteins are more stable than WLG proteins of the majority of the population (either due to standing genetic variation or due to an early acquired mutation), rapidly rise to fixation. The second stage constitutes subsequent slow accumulation of mutations in an adapted population. As adaptation progresses, selection regime changes from positive to neutral: Selection coefficient of beneficial mutations scales as a negative power of number of

  2. Adaptive evolution in ecological communities.

    Directory of Open Access Journals (Sweden)

    Martin M Turcotte

    Full Text Available Understanding how natural selection drives evolution is a key challenge in evolutionary biology. Most studies of adaptation focus on how a single environmental factor, such as increased temperature, affects evolution within a single species. The biological relevance of these experiments is limited because nature is infinitely more complex. Most species are embedded within communities containing many species that interact with one another and the physical environment. To understand the evolutionary significance of such ecological complexity, experiments must test the evolutionary impact of interactions among multiple species during adaptation. Here we highlight an experiment that manipulates species composition and tracks evolutionary responses within each species, while testing for the mechanisms by which species interact and adapt to their environment. We also discuss limitations of previous studies of adaptive evolution and emphasize how an experimental evolution approach can circumvent such shortcomings. Understanding how community composition acts as a selective force will improve our ability to predict how species adapt to natural and human-induced environmental change.

  3. Protein Adaptations in Archaeal Extremophiles

    Science.gov (United States)

    Reed, Christopher J.; Lewis, Hunter; Trejo, Eric; Winston, Vern; Evilia, Caryn

    2013-01-01

    Extremophiles, especially those in Archaea, have a myriad of adaptations that keep their cellular proteins stable and active under the extreme conditions in which they live. Rather than having one basic set of adaptations that works for all environments, Archaea have evolved separate protein features that are customized for each environment. We categorized the Archaea into three general groups to describe what is known about their protein adaptations: thermophilic, psychrophilic, and halophilic. Thermophilic proteins tend to have a prominent hydrophobic core and increased electrostatic interactions to maintain activity at high temperatures. Psychrophilic proteins have a reduced hydrophobic core and a less charged protein surface to maintain flexibility and activity under cold temperatures. Halophilic proteins are characterized by increased negative surface charge due to increased acidic amino acid content and peptide insertions, which compensates for the extreme ionic conditions. While acidophiles, alkaliphiles, and piezophiles are their own class of Archaea, their protein adaptations toward pH and pressure are less discernible. By understanding the protein adaptations used by archaeal extremophiles, we hope to be able to engineer and utilize proteins for industrial, environmental, and biotechnological applications where function in extreme conditions is required for activity. PMID:24151449

  4. Protein Adaptations in Archaeal Extremophiles

    Directory of Open Access Journals (Sweden)

    Christopher J. Reed

    2013-01-01

    Full Text Available Extremophiles, especially those in Archaea, have a myriad of adaptations that keep their cellular proteins stable and active under the extreme conditions in which they live. Rather than having one basic set of adaptations that works for all environments, Archaea have evolved separate protein features that are customized for each environment. We categorized the Archaea into three general groups to describe what is known about their protein adaptations: thermophilic, psychrophilic, and halophilic. Thermophilic proteins tend to have a prominent hydrophobic core and increased electrostatic interactions to maintain activity at high temperatures. Psychrophilic proteins have a reduced hydrophobic core and a less charged protein surface to maintain flexibility and activity under cold temperatures. Halophilic proteins are characterized by increased negative surface charge due to increased acidic amino acid content and peptide insertions, which compensates for the extreme ionic conditions. While acidophiles, alkaliphiles, and piezophiles are their own class of Archaea, their protein adaptations toward pH and pressure are less discernible. By understanding the protein adaptations used by archaeal extremophiles, we hope to be able to engineer and utilize proteins for industrial, environmental, and biotechnological applications where function in extreme conditions is required for activity.

  5. Adaptive evolution of molecular phenotypes

    International Nuclear Information System (INIS)

    Held, Torsten; Nourmohammad, Armita; Lässig, Michael

    2014-01-01

    Molecular phenotypes link genomic information with organismic functions, fitness, and evolution. Quantitative traits are complex phenotypes that depend on multiple genomic loci. In this paper, we study the adaptive evolution of a quantitative trait under time-dependent selection, which arises from environmental changes or through fitness interactions with other co-evolving phenotypes. We analyze a model of trait evolution under mutations and genetic drift in a single-peak fitness seascape. The fitness peak performs a constrained random walk in the trait amplitude, which determines the time-dependent trait optimum in a given population. We derive analytical expressions for the distribution of the time-dependent trait divergence between populations and of the trait diversity within populations. Based on this solution, we develop a method to infer adaptive evolution of quantitative traits. Specifically, we show that the ratio of the average trait divergence and the diversity is a universal function of evolutionary time, which predicts the stabilizing strength and the driving rate of the fitness seascape. From an information-theoretic point of view, this function measures the macro-evolutionary entropy in a population ensemble, which determines the predictability of the evolutionary process. Our solution also quantifies two key characteristics of adapting populations: the cumulative fitness flux, which measures the total amount of adaptation, and the adaptive load, which is the fitness cost due to a population's lag behind the fitness peak. (paper)

  6. Email Adaptation for Conflict Handling

    DEFF Research Database (Denmark)

    Lee, Joyce Yi‐Hui; Panteli, Niki; Bülow, Anne Marie

    2018-01-01

    This paper explores the context of email‐based communication in anestablished but fragile, inter‐organisational partnership, which wasoften overlain with conflict. Drawing upon adaptation theory, thisstudy explores how participants adapt to the use of email to handleconflict. Extensive data were...... obtained during a 6‐month field studyof a case of cross‐border inter‐organisational collaboration in EastAsia. We observed that the individuals involved in the cross‐borderpartnership used email as a lean form of communication to stopcovert conflict from explicitly emerging. In contrast to prior researchon...... the leanness of email in managing conflict, we found that underthe described conflict situation the very leanness of emailwas appreciated and thus, exploited by those concerned tomanage the conflict situation. Specifically, we identified 4 keyconflict‐triggered adaptation strategies, namely...

  7. Quantum Transduction with Adaptive Control

    Science.gov (United States)

    Zhang, Mengzhen; Zou, Chang-Ling; Jiang, Liang

    2018-01-01

    Quantum transducers play a crucial role in hybrid quantum networks. A good quantum transducer can faithfully convert quantum signals from one mode to another with minimum decoherence. Most investigations of quantum transduction are based on the protocol of direct mode conversion. However, the direct protocol requires the matching condition, which in practice is not always feasible. Here we propose an adaptive protocol for quantum transducers, which can convert quantum signals without requiring the matching condition. The adaptive protocol only consists of Gaussian operations, feasible in various physical platforms. Moreover, we show that the adaptive protocol can be robust against imperfections associated with finite squeezing, thermal noise, and homodyne detection, and it can be implemented to realize quantum state transfer between microwave and optical modes.

  8. Recommendation System for Adaptive Learning.

    Science.gov (United States)

    Chen, Yunxiao; Li, Xiaoou; Liu, Jingchen; Ying, Zhiliang

    2018-01-01

    An adaptive learning system aims at providing instruction tailored to the current status of a learner, differing from the traditional classroom experience. The latest advances in technology make adaptive learning possible, which has the potential to provide students with high-quality learning benefit at a low cost. A key component of an adaptive learning system is a recommendation system, which recommends the next material (video lectures, practices, and so on, on different skills) to the learner, based on the psychometric assessment results and possibly other individual characteristics. An important question then follows: How should recommendations be made? To answer this question, a mathematical framework is proposed that characterizes the recommendation process as a Markov decision problem, for which decisions are made based on the current knowledge of the learner and that of the learning materials. In particular, two plain vanilla systems are introduced, for which the optimal recommendation at each stage can be obtained analytically.

  9. Quantum Transduction with Adaptive Control.

    Science.gov (United States)

    Zhang, Mengzhen; Zou, Chang-Ling; Jiang, Liang

    2018-01-12

    Quantum transducers play a crucial role in hybrid quantum networks. A good quantum transducer can faithfully convert quantum signals from one mode to another with minimum decoherence. Most investigations of quantum transduction are based on the protocol of direct mode conversion. However, the direct protocol requires the matching condition, which in practice is not always feasible. Here we propose an adaptive protocol for quantum transducers, which can convert quantum signals without requiring the matching condition. The adaptive protocol only consists of Gaussian operations, feasible in various physical platforms. Moreover, we show that the adaptive protocol can be robust against imperfections associated with finite squeezing, thermal noise, and homodyne detection, and it can be implemented to realize quantum state transfer between microwave and optical modes.

  10. Training Adaptive Decision-Making.

    Energy Technology Data Exchange (ETDEWEB)

    Abbott, Robert G.; Forsythe, James C.

    2014-10-01

    Adaptive Thinking has been defined here as the capacity to recognize when a course of action that may have previously been effective is no longer effective and there is need to adjust strategy. Research was undertaken with human test subjects to identify the factors that contribute to adaptive thinking. It was discovered that those most effective in settings that call for adaptive thinking tend to possess a superior capacity to quickly and effectively generate possible courses of action, as measured using the Category Generation test. Software developed for this research has been applied to develop capabilities enabling analysts to identify crucial factors that are predictive of outcomes in fore-on-force simulation exercises.

  11. Time-adaptive quantile regression

    DEFF Research Database (Denmark)

    Møller, Jan Kloppenborg; Nielsen, Henrik Aalborg; Madsen, Henrik

    2008-01-01

    and an updating procedure are combined into a new algorithm for time-adaptive quantile regression, which generates new solutions on the basis of the old solution, leading to savings in computation time. The suggested algorithm is tested against a static quantile regression model on a data set with wind power......An algorithm for time-adaptive quantile regression is presented. The algorithm is based on the simplex algorithm, and the linear optimization formulation of the quantile regression problem is given. The observations have been split to allow a direct use of the simplex algorithm. The simplex method...... production, where the models combine splines and quantile regression. The comparison indicates superior performance for the time-adaptive quantile regression in all the performance parameters considered....

  12. On the Adaptiveness of Quicksort

    DEFF Research Database (Denmark)

    Brodal, Gerth Stølting; Fagerberg, Rolf; Moruz, Gabriel

    2005-01-01

    are adaptive, i.e. they have a complexity analysis which is better for inputs which are nearly sorted, according to some specified measure of presortedness. Quicksort is not among these, as it uses Omega(n log n) comparisons even when the input is already sorted. However, in this paper we demonstrate...... empirically that the actual running time of Quicksort is adaptive with respect to the presortedness measure Inv. Differences close to a factor of two are observed between instances with low and high Inv value. We then show that for the randomized version of Quicksort, the number of element swaps performed...... is provably adaptive with respect to the measure Inv. More precisely, we prove that randomized Quicksort performs expected O(n(1+log (1+Inv/n))) element swaps, where Inv denotes the number of inversions in the input sequence. This result provides a theoretical explanation for the observed behavior, and gives...

  13. Now, think again about adaptation

    Energy Technology Data Exchange (ETDEWEB)

    Tarlock, A [Chicago-Kent College of Law (USA)

    1992-01-01

    The paper concentrates on three problems with adaptation to global warming that are often overlooked. First, adaptation is based on the ideology of scientific progress, a faith that is open to question. Second, the degree of friction in the proposed institutional responses is often underestimated so institutions may not perform as expected. Third, many institutions have no fair and adequate mechanism to deal with global warming. In these cases, adaptation is the adoption of a no action strategy. The philosophical basis for the first objection is discussed. Then the second and third objections are illustrated with two problems: the reallocation of western water and the use of land use controls to protect coastal and inland areas from the adverse consequences of global climate change. 63 refs.

  14. Europe adapts to climate change: Comparing National Adaptation Strategies

    DEFF Research Database (Denmark)

    Biesbroek, G. Robbert; Swart, Rob J.; Carter, Timothy R.

    2010-01-01

    For the last two decades, European climate policy has focused almost exclusively on mitigation of climate change. It was only well after the turn of the century, with impacts of climate change increasingly being observed, that adaptation was added to the policy agenda and EU Member States started...

  15. Adapting Playware to Rehabilitation Practices

    DEFF Research Database (Denmark)

    Nielsen, Camilla Balslev; Lund, Henrik Hautop

    2012-01-01

    We describe how playware and games may become adaptive to the interaction of the individual user and how therapists use this adaptation property to apply modular interactive tiles in rehabilitation practices that demand highly individualized training. Therapists may use the interactive modular......’s lung (COLD) patients and stroke patients in hospitals and in the private homes of patients and elderly. Through a qualitative research methodology of the new practice with the tiles, we find that therapists are using the modular aspect of the tiles for personalized training of a vast variety of elderly...

  16. Rapid Adaptation in Digital Transformation

    DEFF Research Database (Denmark)

    Hansen, Anne Mette; Kræmmergaard, Pernille; Mathiassen, Lars

    2011-01-01

    landscape. In this article, we share insights gained from two public sector organizations in which IS and business leaders used the Participatory Process Model (PPM) designed by the authors to share their assumptions about IS leadership, challenge existing IT strategies and collaboration patterns and adapt...... the organization’s digitization approach. We demonstrate in detail how the leaders within these two organizations were engaged and offer recommendations for how other organizations can use the PPM to rapidly adapt their approaches to digital transformation through more effective IS leadership roles....

  17. Adaptive Management Fitness of Watersheds

    Directory of Open Access Journals (Sweden)

    Ignacio Porzecanski

    2012-09-01

    Full Text Available Adaptive management (AM promises to improve our ability to cope with the inherent uncertainties of managing complex dynamic systems such as watersheds. However, despite the increasing adherence and attempts at implementation, the AM approach is rarely successful in practice. A one-size-fits-all AM strategy fails because some watersheds are better positioned at the outset to succeed at AM than others. We introduce a diagnostic tool called the Index of Management Condition (IMC and apply it to twelve diverse watersheds in order to determine their AM "fitness"; that is, the degree to which favorable adaptive management conditions are in place in a watershed.

  18. Model of aircraft noise adaptation

    Science.gov (United States)

    Dempsey, T. K.; Coates, G. D.; Cawthorn, J. M.

    1977-01-01

    Development of an aircraft noise adaptation model, which would account for much of the variability in the responses of subjects participating in human response to noise experiments, was studied. A description of the model development is presented. The principal concept of the model, was the determination of an aircraft adaptation level which represents an annoyance calibration for each individual. Results showed a direct correlation between noise level of the stimuli and annoyance reactions. Attitude-personality variables were found to account for varying annoyance judgements.

  19. Adapting agriculture with traditional knowledge

    Energy Technology Data Exchange (ETDEWEB)

    Swiderska, Krystyna; Reid, Hannah [IIED, London (United Kingdom); Song, Yiching; Li, Jingsong [Centre for Chinese Agriculutral Policy (China); Mutta, Doris [Kenya Forestry Research Institute (Kenya)

    2011-10-15

    Over the coming decades, climate change is likely to pose a major challenge to agriculture; temperatures are rising, rainfall is becoming more variable and extreme weather is becoming a more common event. Researchers and policymakers agree that adapting agriculture to these impacts is a priority for ensuring future food security. Strategies to achieve that in practice tend to focus on modern science. But evidence, both old and new, suggests that the traditional knowledge and crop varieties of indigenous peoples and local communities could prove even more important in adapting agriculture to climate change.

  20. Adaptive approaches to biosecurity governance.

    Science.gov (United States)

    Cook, David C; Liu, Shuang; Murphy, Brendan; Lonsdale, W Mark

    2010-09-01

    This article discusses institutional changes that may facilitate an adaptive approach to biosecurity risk management where governance is viewed as a multidisciplinary, interactive experiment acknowledging uncertainty. Using the principles of adaptive governance, evolved from institutional theory, we explore how the concepts of lateral information flows, incentive alignment, and policy experimentation might shape Australia's invasive species defense mechanisms. We suggest design principles for biosecurity policies emphasizing overlapping complementary response capabilities and the sharing of invasive species risks via a polycentric system of governance. © 2010 Society for Risk Analysis

  1. Utilisation of diagnostic computerised tomography imaging and immediate clinical outcomes in older people with stroke before and after introduction of the National Service Framework for older people. A comparative study of hospital-based stroke registry data (1997-2003): Norfolk experience.

    Science.gov (United States)

    Myint, Phyo K; Vowler, Sarah L; Redmayne, Oliver; Fulcher, Robert A

    2006-07-01

    how the National Service Framework (NSF) for older people in England might be associated with changes in clinically relevant stroke outcome has not been investigated. We looked for changes in computerised tomography (CT) scan rate, inpatient case-fatality rate (CFR), length of acute hospital stay and discharge destination for older people with stroke, compared with their younger counterparts, for a period before, and after, the introduction of the NSF. two periods, 4 years before and 2 years after the publication of the NSF, were selected to compare the above outcomes between three age categories: or = 85 years of age. Annual summary data for these periods were compared for the magnitude of changes in all age categories for all outcomes measured between pre- and post-NSF periods. n = 5,219. Utilisation of CT imaging had increased in all age groups post-NSF, with the most significant improvement in the oldest group. This change was associated with a greater proportion of people who had CT in this age group being discharged home in the post-NSF period. There was no change in the mortality from stroke in any age group during the study. Although the length of acute hospital stay increased, this was associated with a higher percentage of home discharges particularly in > 65-year olds, suggesting better clinical outcome in those who survived. in this single-centre analysis, the post-NSF period appeared to be associated with improvement in outcome in older people with stroke. Continual monitoring using stroke registry data may help to assess whether these effects are sustained in the longer term.

  2. Adaptive behavior of children with visual impairment

    OpenAIRE

    Anđelković Marija

    2014-01-01

    Adaptive behavior includes a wide range of skills necessary for independent, safe and adequate performance of everyday activities. Practical, social and conceptual skills make the concept of adaptive behavior. The aim of this paper is to provide an insight into the existing studies of adaptive behavior in persons with visual impairment. The paper mainly focuses on the research on adaptive behavior in children with visual impairment. The results show that the acquisition of adaptive skills is ...

  3. Sleep facilitates long-term face adaptation

    OpenAIRE

    Ditye, Thomas; Javadi, Amir Homayoun; Carbon, Claus-Christian; Walsh, Vincent

    2013-01-01

    Adaptation is an automatic neural mechanism supporting the optimization of visual processing on the basis of previous experiences. While the short-term effects of adaptation on behaviour and physiology have been studied extensively, perceptual long-term changes associated with adaptation are still poorly understood. Here, we show that the integration of adaptation-dependent long-term shifts in neural function is facilitated by sleep. Perceptual shifts induced by adaptation to a distorted imag...

  4. Psychological adaptation after peripartum cardiomyopathy

    DEFF Research Database (Denmark)

    de Wolff, Mie; Ersbøll, Anne Schjødt; Hegaard, Hanne

    2018-01-01

    of regaining psychological balance and wellbeing (i.e. psychological adaptation) after having experienced severe peripartum morbidity. DESIGN: A qualitative exploratory research design was applied to guide the study. Data was collected through in-depth, semi-structured, face-toface telephone and e...

  5. Adaptation strategies in the Netherlands

    NARCIS (Netherlands)

    Gupta, J.; Klostermann, J.E.M.; Bergsma, E.; Jong, P.; Albrecht, E.; Schmidt, M.; Mißler-Behr, M.; Spyra, S.P.N.

    2014-01-01

    Although climate change has been prominently featured on the global scientific and political agendas since the World Climate Conference in 1979 (WCC 1979), the specific importance of adaptation to climate change has only been underlined about 20 years later. The Netherlands, because it lies largely

  6. Adaptation portfolios in water management

    NARCIS (Netherlands)

    Aerts, J.C.J.H.; Botzen, W.J.W.; Werners, S.

    2015-01-01

    This study explores how Modern Portfolio Theory (MPT) can guide investment decisions in integrated water resources management (IWRM) and climate change adaptation under uncertainty. The objectives of the paper are to: (i) explain the concept of diversification to reduce risk, as formulated in MPT;

  7. Adaptive Control Of Remote Manipulator

    Science.gov (United States)

    Seraji, Homayoun

    1989-01-01

    Robotic control system causes remote manipulator to follow closely reference trajectory in Cartesian reference frame in work space, without resort to computationally intensive mathematical model of robot dynamics and without knowledge of robot and load parameters. System, derived from linear multivariable theory, uses relatively simple feedforward and feedback controllers with model-reference adaptive control.

  8. (SAGE): Adopt, adapt, or contextualise?

    African Journals Online (AJOL)

    and time-consuming and requires CPG knowledge ... Step 4. Consider whether to adopt, adapt or contextualise. Step 4.1 Adopt. Decide to .... review. PLoS One 2013;8:e82915. http://dx.doi.org/10.1371/journal.pone.0082915. 14. AGREE ...

  9. Alternative adaptive immunity in invertebrates

    DEFF Research Database (Denmark)

    Kurtz, Joachim; Armitage, Sophie Alice Octavia

    2006-01-01

    Vertebrate adaptive immunity is characterized by challenge-specific long-term protection. This specific memory is achieved through the vast diversity of somatically rearranged immunological receptors such as antibodies. Whether or not invertebrates are capable of a comparable phenotypic plasticity...

  10. Research for climate change adaptation

    International Development Research Centre (IDRC) Digital Library (Canada)

    Corey Piccioni

    These impacts are ulti- ... While more needs to be done to reduce greenhouse gases globally, communities, ... tion and water capture/storage) and protecting people and assets in areas that are at ... drainage and early warning systems). ... 250+ adaptation options stemming from IDRC-funded research since 2006 for use by ...

  11. Livelihood Resilience and Adaptive Capacity

    DEFF Research Database (Denmark)

    Thulstrup, Andreas Waaben

    2015-01-01

    This article analyses the implementation and outcomes of national development programs in a mountainous commune in Vietnam. The article traces the history of State intervention and the capacity of households and the community to adapt to change. The assessment reveals unintended consequences of t...

  12. Enhancing Brigade Combat Team Adaptability

    Science.gov (United States)

    2010-06-11

    Developing Learning Infrastructures (Training, Education , Practice, Research, Doctrine) -Create a shared vision -Build the business case (assess/Buy...To effectively respond to the characteristics of the operational environment, Brigade Combat Teams must be able to learn constantly from experience...behavior. Organizational adaptive behavior consists of three supporting emergent behaviors which are: self-organization, learning , and organizational

  13. Physiological adaptation in desert birds

    NARCIS (Netherlands)

    Williams, JB; Tieleman, BI; Williams, Joseph B.

    We call into question the idea that birds have not evolved unique physiological adaptations to desert environments. The rate at which desert larks metabolize energy is lower than in mesic species within the same family, and this lower rate of living translates into a lower overall energy requirement

  14. Adaptive protection algorithm and system

    Science.gov (United States)

    Hedrick, Paul [Pittsburgh, PA; Toms, Helen L [Irwin, PA; Miller, Roger M [Mars, PA

    2009-04-28

    An adaptive protection algorithm and system for protecting electrical distribution systems traces the flow of power through a distribution system, assigns a value (or rank) to each circuit breaker in the system and then determines the appropriate trip set points based on the assigned rank.

  15. The sources of adaptive variation.

    Science.gov (United States)

    Charlesworth, Deborah; Barton, Nicholas H; Charlesworth, Brian

    2017-05-31

    The role of natural selection in the evolution of adaptive phenotypes has undergone constant probing by evolutionary biologists, employing both theoretical and empirical approaches. As Darwin noted, natural selection can act together with other processes, including random changes in the frequencies of phenotypic differences that are not under strong selection, and changes in the environment, which may reflect evolutionary changes in the organisms themselves. As understanding of genetics developed after 1900, the new genetic discoveries were incorporated into evolutionary biology. The resulting general principles were summarized by Julian Huxley in his 1942 book Evolution: the modern synthesis Here, we examine how recent advances in genetics, developmental biology and molecular biology, including epigenetics, relate to today's understanding of the evolution of adaptations. We illustrate how careful genetic studies have repeatedly shown that apparently puzzling results in a wide diversity of organisms involve processes that are consistent with neo-Darwinism. They do not support important roles in adaptation for processes such as directed mutation or the inheritance of acquired characters, and therefore no radical revision of our understanding of the mechanism of adaptive evolution is needed. © 2017 The Author(s).

  16. Adaptive and integrated water management

    NARCIS (Netherlands)

    Pahl-Wostl, C.; Kabat, P.; Möltgen, J.

    2007-01-01

    Sustainable water management is a key environmental challenge of the 21st century. Developing and implementing innovative management approaches and how to cope with the increasing complexity and uncertainties was the theme of the first International Conference on Adaptive and Integrated Water

  17. Private sector finance for adaptation

    NARCIS (Netherlands)

    Atteridge, A.; Pauw, W.P.; Terpstra, P.; Bedini, F.; Bosi, L; Costella, C.

    2016-01-01

    An emphasis on private finance has emerged in climate finance discussions, particularly in the context of international climate change negotiations. This is partly because the overall volume of finance needed to support adaptation in developing countries is beyond what many expect public finance to

  18. Dramaturgies of Adaptive Lighting Design

    DEFF Research Database (Denmark)

    Petersen, Kjell Yngve

    2017-01-01

    The changes from static to dynamic, and further to adaptive behaviours in architectural lighting design asks for a re-interpretation of the relation between the environment and the engaged experiencing human; i.e. the architecture and the inhabitant. To grasp the many factors involved, and to focus...

  19. The ABC Adaptive Fusion Architecture

    DEFF Research Database (Denmark)

    Bunde-Pedersen, Jonathan; Mogensen, Martin; Bardram, Jakob Eyvind

    2006-01-01

    and early implementation of a systemcapable of adapting to its operating environment, choosingthe best fit combination of the client-server and peerto-peer architectures. The architecture creates a seamlessintegration between a centralized hybrid architecture and adecentralized architecture, relying on what...

  20. How Large Asexual Populations Adapt

    Science.gov (United States)

    Desai, Michael

    2007-03-01

    We often think of beneficial mutations as being rare, and of adaptation as a sequence of selected substitutions: a beneficial mutation occurs, spreads through a population in a selective sweep, then later another beneficial mutation occurs, and so on. This simple picture is the basis for much of our intuition about adaptive evolution, and underlies a number of practical techniques for analyzing sequence data. Yet many large and mostly asexual populations -- including a wide variety of unicellular organisms and viruses -- live in a very different world. In these populations, beneficial mutations are common, and frequently interfere or cooperate with one another as they all attempt to sweep simultaneously. This radically changes the way these populations adapt: rather than an orderly sequence of selective sweeps, evolution is a constant swarm of competing and interfering mutations. I will describe some aspects of these dynamics, including why large asexual populations cannot evolve very quickly and the character of the diversity they maintain. I will explain how this changes our expectations of sequence data, how sex can help a population adapt, and the potential role of ``mutator'' phenotypes with abnormally high mutation rates. Finally, I will discuss comparisons of these predictions with evolution experiments in laboratory yeast populations.