Intelligent Computing for Big Data

Recent advances in artificial intelligence have the potential to further develop current big data research. The Special Issue on ‘Intelligent Computing for Big Data’ highlighted a number of recent studies related to the use of intelligent computing techniques in the processing of big data for text mining, autism diagnosis, behaviour recognition, and blockchain-based storage

Prevention and Management of Frailty

It is important to prevent and manage the frailty of the elderly because their muscle strength and physical activity decrease in old age, making them prone to falling, depression, and social isolation. In the end, they need to be admitted to a hospital or a nursing home. When successful aging fails and motor ability declines due to illness, malnutrition, or reduced activity, frailty eventually occurs. Once frailty occurs, people with frailty do not have the power to exercise or the power to move. The functions of the heart and muscles are deteriorated more rapidly when they are not used. Consequently, frailty goes through a vicious cycle. As one’s physical fitness is deteriorated, the person has less power to exercise, poorer cognitive functions, and inferior nutrition intake. Consequently, the whole body of the person deteriorates. Therefore, in addition to observational studies to identify risk factors for preventing aging, various intervention studies have been conducted to develop exercise programs and apply them to communities, hospitals, and nursing homes for helping the elderly maintain healthy lives. Until now, most aging studies have focused on physical frailty. However, social frailty and cognitive frailty affect senile health negatively just as much as physical frailty. Nevertheless, little is known about social frailty and cognitive frailty. This special issue includes original experimental studies, reviews, systematic reviews, and meta-analysis studies on the prevention of senescence (physical senescence, cognitive senescence, social senescence), high-risk group detection, differentiation, and intervention

Investigating disability-inclusion in social protection programmes in low- and middle-income countries, with case studies from Vietnam and Nepal

Background: Social protection is increasingly used by governments in low- and middle-income countries (LMICs) as a strategy for alleviating poverty “in all its forms”. People with disabilities are frequently targeted as key beneficiaries due to high levels of poverty and marginalisation. Little is known, however, on whether people with disabilities are accessing existing programmes, and whether these programmes adequately meet their needs. Aim: To explore the need for, access to and adequacy of social protection amongst people with disabilities in LMICs. Methods: Systematic reviews were used to compile and evaluate evidence from across LMICs on 1) the link between monetary poverty and disability, and 2) access to and impact of social protection amongst people with disabilities. Case studies were then undertaken in the districts of Cam Le, Vietnam and Tanahun, Nepal in 2016 to explore in-depth the need for, access to and adequacy of social protection amongst people with disabilities in these areas. Data was collected through population-based surveys (n=12,397, across both settings), with nested case-control studies of people with and without disabilities (n=359, each) matched by age, sex and location. Further, qualitative research was conducted with people with disabilities recruited from the surveys and key informants involved in the design or implementation of social protection. Need for social protection was assessed using monetary and multidimensional indicators of poverty amongst people with disabilities ages 15+. Access to social protection was measured through participation in disability-targeted and non-targeted programmes. Adequacy of social assistance was then evaluated by measuring levels of monetary and multidimensional poverty amongst social assistance recipients. All analyses compared indicators between people with and without disabilities, and amongst people without disabilities (e.g. recipients versus non-recipients). Key findings: Evidence from the systematic review and research in Nepal and Vietnam indicate a high need for social protection among people with disabilities. In the systematic review, 80% of the 150 included studies found a link between disability and economic poverty. In both Vietnam and Nepal, people with disabilities were more likely to be living in both monetary and multidimensional poverty compared to people without disabilities, and faced high disability-related extra costs. People with disabilities in Vietnam and Nepal were more likely to access social assistance compared to people without disabilities (Vietnam: aOR 9.6, 5.6-16.5; Nepal: aOR 3.0, 1.6-5.3). However, evidence from the case studies and from the systematic review indicate that many people with disabilities are not accessing social protection benefits for which they are eligible. Factors affecting access included the accessibility of the application process, complexity of disability assessment procedures, awareness of programmes and their eligibility requirements and the perceived utility of benefits. Further, the systematic review and research in Vietnam and Nepal indicated that social protection is often inadequate to protect many recipients with disabilities from poverty. For example, a quarter to a third of social assistance recipients with disabilities were living in monetary poverty and half were multidimensionally poor in Vietnam and Nepal. Social protection was particularly insufficient at promoting social inclusion amongst people with disabilities, as well as ensuring sustainable livelihoods. Conclusion: People with disabilities face a substantial need for social protection, given high levels of monetary and multidimensional poverty, in both absolute terms and relative to people without disabilities. However, many people with disabilities were not accessing programmes for which they were eligible, indicating a need to increase awareness of programmes and address barriers encountered during the application process. Further, evidence from this research indicates that more transformational approaches to social protection design and delivery are necessary, such as providing meaningful coverage for disability-related extra costs and addressing drivers of social exclusion

Accessibility of Health Data Representations for Older Adults: Challenges and Opportunities for Design

Health data of consumer off-the-shelf wearable devices is often conveyed to users through visual data representations and analyses. However, this is not always accessible to people with disabilities or older people due to low vision, cognitive impairments or literacy issues. Due to trade-offs between aesthetics predominance or information overload, real-time user feedback may not be conveyed easily from sensor devices through visual cues like graphs and texts. These difficulties may hinder critical data understanding. Additional auditory and tactile feedback can also provide immediate and accessible cues from these wearable devices, but it is necessary to understand existing data representation limitations initially. To avoid higher cognitive and visual overload, auditory and haptic cues can be designed to complement, replace or reinforce visual cues. In this paper, we outline the challenges in existing data representation and the necessary evidence to enhance the accessibility of health information from personal sensing devices used to monitor health parameters such as blood pressure, sleep, activity, heart rate and more. By creating innovative and inclusive user feedback, users will likely want to engage and interact with new devices and their own data

Chinese herbal medicine for insomnia: evidence, practice and opinions

Evidence-based medicine (EBM) is a contemporary practice paradigm with a focus on improving outcomes of diagnosis and treatment through effective integration of the best available evidence, practitioners’ expertise and individual patients’ preference. In this project, Chinese herbal medicine (CHM) for insomnia is used as an example to illustrate the available evidence and identify CM practitioners’ attitudes, knowledge, skills, behaviours and barriers towards evidence-based practice (EBP). Understanding and addressing these factors will contribute to the enhancement of the practice of Chinese medicine (CM) as well as to set the priorities for CM education, research and policy development. CHM is increasingly used for insomnia in China and worldwide, and has been extensively researched and used in clinical practice. Therefore, it is a suitable exemplar providing insight into EBM in the context of CM practice. Insomnia is the most common sleep-wake disorder with notable health, social and economic burden. Cognitive and behavioural therapy for insomnia (CBT-i) and pharmacotherapy are commonly used to manage symptoms. However, many sufferers seek complementary and alternative medicine (CAM) to improve their sleep and to manage daytime dysfunction. As a form of CAM, Chinese medicine has a long history of use for insomnia and continues to be frequently utilised. Emerging preclinical and clinical evidence suggests that CHM may be beneficial for improving sleep quality. Despite the frequent use of CHM for insomnia it remains largely unclear if CM doctors use EBM to inform their clinical practice. Therefore, this project uses a step-wise approach to understand, firstly, the best available evidence of CHM for insomnia and secondly, to what extent is the evidence being translated into clinical practice. The present study consists of four components: 1) a systematic review (SR) of randomised controlled trials (RCTs); 2) a systematic analysis of the historical literature; 3) a quantitative survey of CM practitioners; and 4) a qualitative interview of CM practitioners. Part One: Current Clinical Evidence of CHM for Insomnia: A Systematic Review and Meta-Analysis This SR with meta-analysis answers the following research questions: Does CHM produce beneficial effects in people with insomnia in terms of sleep quality?’ Does CHM cause any adverse events in people with insomnia and, if so, what is the nature of the adverse events?’ Seventy-nine RCTs involving 7, 886 participants were included in the SR and 76 in the meta-analyses. Findings from this review revealed that CHM improves subjective sleep quality and quantity in people with insomnia. There was no significant difference between CM and the placebo with respect to the frequency and severity of adverse events. Firm conclusions could not be drawn on the comparative effectiveness between CHM and benzodiazepine drugs or psychotherapy due to heterogeneity and risks of bias in the included RCTs. Part Two: Traditional Use of CHM for Insomnia: A Systematic Analysis of the Historical Literature This part of the research answers the following research questions: What Chinese herbal formulae and individual herbs had been referenced and indicated for the treatment of insomnia in the historical literature?’ Is there a difference between traditional and contemporary use of CHM for insomnia and, if so, what are the implications for research and practice?’ The analysis revealed that there were 729 citations involving multi-herb formulae of CHM for insomnia. These herbal formulae were used for people with insomnia based on the CM diagnostic framework. Gender, age and concurrent conditions affected the formulae selection. There has been strong continuity with regard to the clinical application of the most common CHM formulae and herbs for insomnia. Varied CHM formulae might be used according to the distinct phenotypes, stages and severity of insomnia that were traditionally identified as a ‘Syndrome’ or ‘pattern’. By taking together the empirical use, contemporary practice and evidence, Suan zao ren tang and Wen dan tang were the most frequently used and potentially promising candidates for further evaluation and therapeutic development. Part Three: A Quantitative Survey of CM Practitioners Assessing the EBP of CHM for Insomnia This part of the research answers the following research question: What are the CM practitioners’ attitudes, knowledge, skills, behaviours and barriers related to the EBP of CHM for insomnia? A quantitative survey of CM practitioners from the two large academic bodies of CM in Guangdong Province (China) was undertaken. Most survey participants showed positive attitudes to EBM and acknowledged the necessity of applying EBM in the field of CHM for insomnia. More than half of the participants remained conservative about their overall knowledge and skills of EBM. Less than half of participants believed they had implemented EBP of CHM for insomnia, but they appeared to be inactive in seeking clinical practice guidelines to assist in their decision-making. The top barriers to EBP included insufficient high-quality evidence, inadequate research skills to understand EBM and a lack of generalisability of the research findings to patients. Thirteen potential factors were identified that related to EBP of CHM for insomnia. The logistic regression and factor analysis determined the essential factors explaining the behaviours related to EBP of CHM for insomnia, including motivation and goals and the knowledge and skills associated with EBM. Part Four: A Qualitative Interview of CM Practitioners Exploring Their Perspectives on EBM and EBP of CHM for Insomnia The final part of the research explores in greater details the way CM practitioners perceived EBM and their behaviours related to EBP of CHM for insomnia. A qualitative interview of the CM practitioners was conducted. All the interviewees showed positive attitudes to EBM and acknowledged the benefits of EBP of CHM for insomnia. Interviewees demonstrated their understanding of EBM was in line with the commonly understood definition. Also, they understood the importance of critical thinking when they applied senior practitioners’ experience in practice, though they acknowledged the benefits of apprenticeship to improving clinical practice. The barriers to applying contemporary evidence in CM practice were explained within the context of the directness, quality and production of evidence. As a unique characteristic of CM, the principle ‘individualised treatment’ was considered to influence the decision-making and utilisation of CM evidence in EBP. The interviewees indicated that they updated their knowledge of conventional medicine by reading the latest research and clinical practice guidelines. However, they updated their CM knowledge by reading the historical literature and apprenticeship to meet needs of enhancing their clinical practice because of their similarity to clinical scenarios. Based on findings from Parts 3 and 4, a theoretical framework useful for evidence-based CM practice (EBCMP) was constructed by mixed analyses of the quantitative survey (Part 3) and qualitative interview (Part 4). The framework included four factors to improve EBCMP, namely, 1) motivation and goals for EBM, 2) belief about the consequence of EBM, 3) fundamental training of EBM and 4) capacity of EBP. It also included two CM-specific obstacles to EBCMP, namely, 1) the indirectness of CM evidence and 2) the low-quality evidence of CM. Conclusion CHM has a long history of treating insomnia and related symptoms. The key formulae and individual herbs have been consistently used in both ancient and contemporary practice. A meta-analysis indicated that there was promising evidence on the benefit of CHM formulae for improving subjective sleep quality and quantity. When compared with current pharmacotherapy and/or psychotherapy, the effectiveness of CHM was uncertain due to the risk of bias and heterogeneity of the RCTs included in the analyses. Hence, caution should be given when translating these findings into clinical decision making. A survey and an interview of CM practitioners demonstrated their overall positive attitudes towards EBP on CHM for insomnia. Capacity building on EBM and the quality of clinical evidence of CM have been identified as major gaps for promoting EBP. Based on these findings, a theoretical framework has been proposed for enhancing EBCMP. Further evaluation on the effectiveness of this framework is required to strengthen the EBP in CHM for insomnia. Knowledge gained from this process will be transferrable to the global development of CM as a form of EBP that meets the public expectation of evidence generation, evaluation and translation (eGET)

Employee perceptions of work-life balance and formal and informal approaches to work-life management: a case study of China's pharmaceutical sector

This thesis examines Chinese employees’ perceptions and experience of work-life balance (WLB) and the relationship between management’s formal application of WLB policies and practices, and the reality experienced by the employee. WLB in China has been largely neglected in WLB and HRM literature to date. However, WLB as a socially constructed concept is a worthy topic to be researched in China, given the dynamic external environment and unique management context. The development of HRM within Chinese organisations also provides opportunities for examining WLB approaches in relation to organisational policies and practices. The research strategy is based upon a pragmatist methodological approach and utilises mixed methods research derived from a deductive theoretical framework. A single case study of two Chinese State-owned Enterprises (SOEs) in the pharmaceutical sector is used. The research conducted led to the collection of 312 valid survey responses and 23 semistructured interviews, supported by (limited) documentary sources. In responding to current WLB literature, this adoption of mixed methodology allows an examination and analysis of WLB issues in a non-western context in depth and breadth. The research finds; first, there is no consensus over what WLB means in China. It would appear that employees experience unsustainable WLB due to long working hours, work intensification and limited formal work-life support. Despite this, the dominant views of employees indicate a relatively positive WLB in the sense of work life integration and enrichment. Secondly, Chinese employees’ WLB is rarely considered in strategic HRM. Formal approaches to work-life management rarely exist and are not followed. Consequently, most WLB solutions are reached informally through line management, which can be seen as a double-edged sword in influencing employees’ WLB and organisational development. The key contribution of this research lies in providing an understanding of WLB within the Chinese context, critically assessing the appropriateness of Anglo-American WLB literature to China. It also contributes to providing a critical insight into the demand for, as well as the development and effectiveness of, formal and informal approaches to worklife management within Chinese organisations. The insights also raise important issues for Chinese policymakers and HR practitioners over the management of WLB

Population-Environment Dynamics: Transitions and Sustainability

The attached material is a pdf made from the website cited above. Collection of student papers with an introduction by the authors/editors: from a Population-Environment Dynamics course taught in 1998 in the School of Natural Resources and Environment, NRE545, and cross-listed in the Population Planning and International Health Program of the School of Public Health. Student authors: Marnie Boardman, Lewis Garvin, Asli Gocmen, Taufik Hanafi, Natalie Henry, Martha Masterton, Sujata Narayan, Mark Schmidt, Chandra Sivakumar, Jennifer Talbot, Michael Tiefel, Christina Welter, Moira Zellner.http://deepblue.lib.umich.edu/bitstream/2027.42/60129/1/545_1998.pd