113,365 research outputs found
Review of employment and skills: April 2011
"This Review has its foundation in the Leitch Report published in 2006, which recommended the development of an
“integrated employment and skills service to help people meet the challenges of the modern labour market” and
for the UK Commission for Employment and Skills to report on the changes required to deliver integrated services.
The UK Commission’s 2010-11 Grant in Aid Letter required: “The continuation of a Review that has as its focus
progress on integrating employment and skills systems”. This report covers England only. There will be separate
reporting for Wales and Scotland after the elections in May 2011." - Page 5
Event-Based Modeling with High-Dimensional Imaging Biomarkers for Estimating Spatial Progression of Dementia
Event-based models (EBM) are a class of disease progression models that can
be used to estimate temporal ordering of neuropathological changes from
cross-sectional data. Current EBMs only handle scalar biomarkers, such as
regional volumes, as inputs. However, regional aggregates are a crude summary
of the underlying high-resolution images, potentially limiting the accuracy of
EBM. Therefore, we propose a novel method that exploits high-dimensional
voxel-wise imaging biomarkers: n-dimensional discriminative EBM (nDEBM). nDEBM
is based on an insight that mixture modeling, which is a key element of
conventional EBMs, can be replaced by a more scalable semi-supervised support
vector machine (SVM) approach. This SVM is used to estimate the degree of
abnormality of each region which is then used to obtain subject-specific
disease progression patterns. These patterns are in turn used for estimating
the mean ordering by fitting a generalized Mallows model. In order to validate
the biomarker ordering obtained using nDEBM, we also present a framework for
Simulation of Imaging Biomarkers' Temporal Evolution (SImBioTE) that mimics
neurodegeneration in brain regions. SImBioTE trains variational auto-encoders
(VAE) in different brain regions independently to simulate images at varying
stages of disease progression. We also validate nDEBM clinically using data
from the Alzheimer's Disease Neuroimaging Initiative (ADNI). In both
experiments, nDEBM using high-dimensional features gave better performance than
state-of-the-art EBM methods using regional volume biomarkers. This suggests
that nDEBM is a promising approach for disease progression modeling.Comment: IPMI 201
End-of-Life Heart Failure Education With Staff Nurses; A Quality Improvement Project
Presented to the Faculty
of the University of Alaska Anchorage
in Partial Fulfillment of the Requirements
for the Degree of
MASTER OF SCIENCEHeart failure (HF) is a serious diagnosis and a major public health concern. The symptoms can
be exhausting and can vary from person to person with periods of acute exacerbations
requiring hospital admission. It is important for hospital staff nurses to be able to speak with
knowledge and comfort about end‐of‐life planning. The purpose of this quality improvement
project was to increase nurses’ awareness of the functional classification systems of HF, options
and timing for palliative care, and describe nurses’ intent to use the information in practice.
Nurses reported planning on using the information to “Be more Sensitive and Listen.” The
prevailing theme to barriers to implementing this into practice was “Not enough time and
discomfort.” Nurses who were comfortable having end‐of‐life discussions did not feel they had
enough time, and those who were not comfortable did not engage because of discomfort
toward the topic. Furthermore, recommendations from this study were the addition of a
supportive palliative care team to manage patients with HF.End-of-Life Heart Failure Education with Staff Nurses; A Quality Improvement Project / Abstract / Table of Contents / Project / Background and Significant / Project Purpose / Literature Review / Methods / Analysis and Findings / Dissemination / Discussion / Conclusion / Impact on Practice / References / Appendix A New York Heart Failure Classification System / Appendix B Plan-Do-Check-Act Cycle / Appendix C Consent Form / Appendix D IRB Approval Letter / Appendix E Permission Letter / Appendix F Pre-Education Survey / Appendix G Post-Education Survey / Appendix H Case Study #1 / Appendix I Case Study #2 / Appendix J 'Do' Phase Education Intervention Lesson Plan / Appendix K Themes from QI Projec
Cognitive impairment in older people: its implications for future demand for services and costs
This study aimed to make projections, for the next 30 years, of future numbers of older people with cognitive impairment, their demand for long-term care services and the future costs of their care under a range of specified assumptions. Cognitive impairment is one of the manifestations of dementia. The most common dementia syndrome is Alzheimer’s Disease (AD), followed by vascular dementia (Henderson and Jorm, 2000). It also set out to explore the factors that are likely to affect future long-term care expenditure associated with cognitive impairment. These factors include, not only future numbers of older people and future prevalence rates of cognitive impairment, but also trends in household composition, provision of informal care, patterns of care services and the unit costs of care
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