Defining the outcomes of community care: the perspectives of older people with dementia and their carers

There is growing recognition of the need for outcome measures which reflect the aims of services for people with dementia. The development and application of existing outcome measures has often marginalised people with dementia. ‘Experts’ and carers have been viewed as primary sources when identifying relevant outcomes or domains of quality of life, and proxy respondents have often been responsible for rating outcomes on the resulting measures. This paper reports a small consultation with people with dementia and their carers to identify the desired outcomes of community care. While there was considerable overlap in the outcomes identified by people with dementia and their carers, a number of limitations of relying solely on carers as proxy respondents were identified. A key outcome, which has been relatively neglected in previous work, was maximising a sense of autonomy. A range of outcomes related to the ways in which services are delivered were also identified. Future evaluative studies should encompass both quality-of-life outcomes and service-process outcomes (the impacts of the ways in which services are delivered) in addition to other outcome measures relevant to the aims and objectives of the service

Bayesian Analysis of Cell Nucleus Segmentation by a Viterbi Search Based Active Contour

An image segmentation scheme is shown to be exceptionally successful through the application of high-level knowledge of the required image objects (cell nuclei). By tuning the algorithm's single parameter, it is shown that the performance can be maximised for the dataset, but leads to individual failures that may require alternative choices. A second stage is introduced to process each of the resulting segmentations obtained by varying the parameter over the working range. This stage gives a Bayesian interpretation of the results which indicates the probable accuracy of each of the segmentations that can then be used to make a decision upon whether to accept or reject the segmentation

A methodology for quality control in cell nucleus segmentation

In order to achieve the very high accuracy rates required in unsupervised automated biomedical applications, it is often necessary to complement a successful segmentation algorithm with a robust error checking stage. The better the segmentation strategy, the less severe the error checking decisions need to be and the fewer correct segmentations that are discarded. These issues are dealt with in this paper in order to achieve 100% accuracy on a data set of 19946 cell nucleus images using an established segmentation scheme with a success rate of 99.47%. The method is based upon measuring changes in the final segmentation contour as the one parameter that governs its behaviour is varied. 1. Introduction remove potential artefacts based on shape and appearance that was capable of detecting some of the incorrectly segmented nuclei [9]. Nordin describes an algorithm that is able to report a failure at various levels of segmentation, as well as a separate artefact rejection stage [11]. McKenna used a neural network to preselect potential nuclei in scenes for subsequent segmentation. It was pointed out that a post-processing stage would also be necessary to filter out 'erroneously detected objects'[10]. A common trait in these techniques is the use of a separate process to view the output of the segmentation and to use shape and appearance measurements to classify the results as 'pass' (looks like a cell) or 'fail' (doesn't look like a cell). We have proposed a segmentation scheme that not only employs an algorithm with much better performance than previously reported [3], but also enables a confidence measure in the resulting segmentation to be given

The Tully-Fisher relation of intermediate redshift field and cluster galaxies from Subaru spectroscopy

We have carried out spectroscopic observations in 4 cluster fields using Subaru's FOCAS multi-slit spectrograph and obtained spectra for 103 bright disk field and cluster galaxies at $0.06 \le z \le 1.20$. Seventy-seven of these show emission lines, and 33 provide reasonably-secure determinations of the galaxies' rotation velocity. The rotation velocities, luminosities, colours and emission-line properties of these galaxies are used to study the possible effects of the cluster environment on the star-formation history of the galaxies. Comparing the Tully-Fisher relations of cluster and field galaxies at similar reshifts we find no measurable difference in rest-frame $B$-band luminosity at a given rotation velocity (the formal difference is $0.18\pm0.33$mag). The colours of the cluster emission line galaxies are only marginally redder in rest-frame $B-V$ (by $0.06\pm0.04$mag) than the field galaxies in our sample. Taken at face value, these results seem to indicate that bright star-forming cluster spirals are similar to their field counterparts in their star-formation properties. However, we find that the fraction of disk galaxies with absorption-line spectra (i.e., with no current star formation) is larger in clusters than in the field by a factor of $\sim3$--5. This suggests that the cluster environment has the overall effect of switching off star formation in (at least) some spiral galaxies. To interpret these observational results, we carry out simulations of the possible effects of the cluster environment on the star-formation history of disk galaxies and thus their photometric and spectroscopic properties. Finally, we evaluate the evolution of the rest-frame absolute $B$-band magnitude per unit redshift at fixed rotation velocity.Comment: 21 pages, 13 figures, accepted for publication in MNRA

Preliminary X-ray diffraction analysis of YqjH from Escherichia coli: a putative cytoplasmic ferri-siderophore reductase

YqjH is a cytoplasmic FAD-containing protein from Escherichia coli; based on homology to ViuB of Vibrio cholerae, it potentially acts as a ferri-siderophore reductase. This work describes its overexpression, purification, crystallization and structure solution at 3.0 A resolution. YqjH shares high sequence similarity with a number of known siderophore-interacting proteins and its structure was solved by molecular replacement using the siderophore-interacting protein from Shewanella putrefaciens as the search model. The YqjH structure resembles those of other members of the NAD(P)H:flavin oxidoreductase superfamily

Method for Accurate Unsupervised Cell Nucleus Segmentation

To achieve the extreme accuracy rates demanded by applications in unsupervised automated cytology, it is frequently necessary to supplement the primary segmentation algorithm with a segmentation quality control system. The more robust the segmentation strategy, the less severe the data pruning need be at the segmentation validation stage. These issues are addressed as we describe our cell nucleus segmentation strategy which is able to achieve 100% accurate segmentation from a data set of 19946 cell nucleus images by automatically discarding the most difficult cell images. The automatic quality checking is applied to enhance the performance of a robust energy minimisation based segmentation scheme which already achieved a 99.47% accurate segmentation rate

Galaxy bimodality versus stellar mass and environment

We analyse a z<0.1 galaxy sample from the Sloan Digital Sky Survey focusing on the variation of the galaxy colour bimodality with stellar mass and projected neighbour density Sigma, and on measurements of the galaxy stellar mass functions. The characteristic mass increases with environmental density from about 10^10.6 Msun to 10^10.9 Msun (Kroupa IMF, H_0=70) for Sigma in the range 0.1--10 per Mpc^2. The galaxy population naturally divides into a red and blue sequence with the locus of the sequences in colour-mass and colour-concentration index not varying strongly with environment. The fraction of galaxies on the red sequence is determined in bins of 0.2 in log Sigma and log mass (12 x 13 bins). The red fraction f_r generally increases continuously in both Sigma and mass such that there is a unified relation: f_r = F(Sigma,mass). Two simple functions are proposed which provide good fits to the data. These data are compared with analogous quantities in semi-analytical models based on the Millennium N-body simulation: the Bower et al. (2006) and Croton et al. (2006) models that incorporate AGN feedback. Both models predict a strong dependence of the red fraction on stellar mass and environment that is qualitatively similar to the observations. However, a quantitative comparison shows that the Bower et al. model is a significantly better match; this appears to be due to the different treatment of feedback in central galaxies.Comment: 19 pages, 17 figures; accepted by MNRAS, minor change

NAVIGATION PERFORMANCE IN HIGH EARTH ORBITS USING NAVIGATOR GPS RECEIVER

NASA GSFC has developed a GPS receiver that can acquire and track GPS signals with sensitivity significantly lower than conventional GPS receivers. This opens up the possibility of using GPS based navigation for missions in high altitude orbit, such as Geostationary Operational Environmental Satellites (GOES) in a geostationary orbit, and the Magnetospheric MultiScale (MMS) Mission, in highly eccentric orbits extending to 12 Earth radii and higher. Indeed much research has been performed to study the feasibility of using GPS navigation in high Earth orbits and the performance achievable. Recently, GSFC has conducted a series of hardware in-the-loop tests to assess the performance of this new GPS receiver in various high Earth orbits of interest. Tracking GPS signals to down to approximately 22-25 dB-Hz, including signals from the GPS transmitter side-lobes, steady-state navigation performance in a geostationary orbit is on the order of 10 meters. This paper presents the results of these tests, as well as sensitivity analysis to such factors as ionosphere masks, use of GPS side-lobe signals, and GPS receiver sensitivity

A One-Pass Extended Depth of Field Algorithm Based on the Over-Complete Discrete Wavelet Transform

In this paper we describe an algorithm for extended depth of field (EDF) imaging based on the over-complete discrete wavelet transform (OCDWT). We extend previous approaches by describing a, potentially real-time, algorithm that produces the EDF image after a single pass through the "stack" of focal plane images. In addition, we specifically study the effect of over-sampling on EDF reconstruction accuracy and show that a small degree of over-sampling considerably improves the quality of the EDF image

The development of a theory-based intervention to promote appropriate disclosure of a diagnosis of dementia

Background: The development and description of interventions to change professional practice are often limited by the lack of an explicit theoretical and empirical basis. We set out to develop an intervention to promote appropriate disclosure of a diagnosis of dementia based on theoretical and empirical work. Methods: We identified three key disclosure behaviours: finding out what the patient already knows or suspects about their diagnosis; using the actual words 'dementia' or 'Alzheimer's disease' when talking to the patient; and exploring what the diagnosis means to the patient. We conducted a questionnaire survey of older peoples' mental health teams (MHTs) based upon theoretical constructs from the Theory of Planned Behaviour (TPB) and Social Cognitive Theory (SCT) and used the findings to identify factors that predicted mental health professionals' intentions to perform each behaviour. We selected behaviour change techniques likely to alter these factors. Results: The change techniques selected were: persuasive communication to target subjective norm; behavioural modelling and graded tasks to target self-efficacy; persuasive communication to target attitude towards the use of explicit terminology when talking to the patient; and behavioural modelling by MHTs to target perceived behavioural control for finding out what the patient already knows or suspects and exploring what the diagnosis means to the patient. We operationalised these behaviour change techniques using an interactive 'pen and paper' intervention designed to increase intentions to perform the three target behaviours. Conclusion : It is feasible to develop an intervention to change professional behaviour based upon theoretical models, empirical data and evidence based behaviour change techniques. The next step is to evaluate the effect of such an intervention on behavioural intention. We argue that this approach to development and reporting of interventions will contribute to the science of implementation by providing replicable interventions that illuminate the principles and processes underlying change.This project is funded by UK Medical Research Council, Grant reference number G0300999. Jeremy Grimshaw holds a Canada Research Chair in Health Knowledge Transfer and Uptake. Jill Francis is funded by the Chief Scientist Office of the Scottish Government Health Directorate. The views expressed in this study are those of the authors