Motorized cart

Motorized cart is known as an effective tool and timeless that help people carry heavy loads. For farmers, it has an especially vital tool for moving goods. Oil palm farmers typically uses the wheelbarrow to move the oil palm fruit (Figure 10.1). However, there is a lack of equipment that should be further enhanced in capabilities. Motorized carts that seek to add automation to wheelbarrow as it is to help people save manpower while using it. At present, oil palm plantation industry is among the largest in Malaysia. However, in an effort to increase the prestige of the industry to a higher level there are challenges to be faced. Shortage of workers willing to work the farm for harvesting oil palm has given pain to manage oil palm plantations. Many have complained about the difficulty of hiring foreign workers and a high cost. Although there are tools that can be used to collect or transfer the proceeds of oil palm fruits such as carts available. However, these tools still have the disadvantage that requires high manpower to operate. Moreover, it is not suitable for all land surfaces and limited cargo space. Workload and manpower dependence has an impact on farmers' income

Barriers and facilitators to HPV vaccination in primary care practices: A mixed methods study using the Consolidated Framework for Implementation Research

Abstract Background In the United States, the effective, safe huma papilloma virus (HPV) vaccine is underused and opportunities to prevent cancer continue to be missed. National guidelines recommend completing the 2–3 dose HPV vaccine series by age 13, well before exposure to the sexually transmitted virus. Accurate characterization of the facilitators and barriers to full implementation of HPV vaccine recommendations in the primary care setting could inform effective implementation strategies. Methods We used the Consolidated Framework for Implementation Research (CFIR) to systematically investigate and characterize factors that influence HPV vaccine use in 10 primary care practices (16 providers) using a concurrent mixed methods design. The CFIR was used to guide collection and analysis of qualitative data collected through in-person semi-structured interviews with the primary care providers. We analyzed HPV vaccine use with data abstracted from medical charts. Constructs that most strongly influenced vaccine use were identified by integrating the qualitative and quantitative data. Results Of the 72 CFIR constructs assessed, seven strongly distinguished and seven weakly distinguished between providers with higher versus lower HPV vaccine coverage. The majority of strongly distinguishing constructs were facilitators and were related to characteristics of the providers (knowledge and beliefs; self-efficacy; readiness for change), their perception of the intervention (relative advantage of vaccinating younger vs. older adolescents), and their process to deliver the vaccine (executing). Additional weakly distinguishing constructs that were facilitators were from outer setting (peer pressure; financial incentives), inner setting (networks and communications and readiness for implementation) and process (planning; engaging, and reflecting and evaluating). Two strongly distinguishing constructs were barriers to use, one from the intervention (adaptability of the age of initiation) and the other from outer setting (patient needs and resources). Conclusions Using CFIR to systematically examine the use of this vaccine in independent primary care practices enabled us to identify facilitators and barriers at the provider, interpersonal and practice level that need to be addressed in future efforts to increase vaccine use in such settings. Our findings suggest that implementation strategies that target the provider and help them to address multi-level barriers to HPV vaccine use merit further investigation

Latent Space Model for Multi-Modal Social Data

With the emergence of social networking services, researchers enjoy the increasing availability of large-scale heterogenous datasets capturing online user interactions and behaviors. Traditional analysis of techno-social systems data has focused mainly on describing either the dynamics of social interactions, or the attributes and behaviors of the users. However, overwhelming empirical evidence suggests that the two dimensions affect one another, and therefore they should be jointly modeled and analyzed in a multi-modal framework. The benefits of such an approach include the ability to build better predictive models, leveraging social network information as well as user behavioral signals. To this purpose, here we propose the Constrained Latent Space Model (CLSM), a generalized framework that combines Mixed Membership Stochastic Blockmodels (MMSB) and Latent Dirichlet Allocation (LDA) incorporating a constraint that forces the latent space to concurrently describe the multiple data modalities. We derive an efficient inference algorithm based on Variational Expectation Maximization that has a computational cost linear in the size of the network, thus making it feasible to analyze massive social datasets. We validate the proposed framework on two problems: prediction of social interactions from user attributes and behaviors, and behavior prediction exploiting network information. We perform experiments with a variety of multi-modal social systems, spanning location-based social networks (Gowalla), social media services (Instagram, Orkut), e-commerce and review sites (Amazon, Ciao), and finally citation networks (Cora). The results indicate significant improvement in prediction accuracy over state of the art methods, and demonstrate the flexibility of the proposed approach for addressing a variety of different learning problems commonly occurring with multi-modal social data.Comment: 12 pages, 7 figures, 2 table

XRay: Enhancing the Web's Transparency with Differential Correlation

Today's Web services - such as Google, Amazon, and Facebook - leverage user data for varied purposes, including personalizing recommendations, targeting advertisements, and adjusting prices. At present, users have little insight into how their data is being used. Hence, they cannot make informed choices about the services they choose. To increase transparency, we developed XRay, the first fine-grained, robust, and scalable personal data tracking system for the Web. XRay predicts which data in an arbitrary Web account (such as emails, searches, or viewed products) is being used to target which outputs (such as ads, recommended products, or prices). XRay's core functions are service agnostic and easy to instantiate for new services, and they can track data within and across services. To make predictions independent of the audited service, XRay relies on the following insight: by comparing outputs from different accounts with similar, but not identical, subsets of data, one can pinpoint targeting through correlation. We show both theoretically, and through experiments on Gmail, Amazon, and YouTube, that XRay achieves high precision and recall by correlating data from a surprisingly small number of extra accounts.Comment: Extended version of a paper presented at the 23rd USENIX Security Symposium (USENIX Security 14

The effectiveness of computerized clinical guidelines in the process of care: a systematic review

<p>Abstract</p> <p>Background</p> <p>Clinical practice guidelines have been developed aiming to improve the quality of care. The implementation of the computerized clinical guidelines (CCG) has been supported by the development of computerized clinical decision support systems.</p> <p>This systematic review assesses the impact of CCG on the process of care compared with non-computerized clinical guidelines.</p> <p>Methods</p> <p>Specific features of CCG were studied through an extensive search of scientific literature, querying electronic databases: Pubmed/Medline, Embase and Cochrane Controlled Trials Register. A multivariable logistic regression was carried out to evaluate the association of CCG's features with positive effect on the process of care.</p> <p>Results</p> <p>Forty-five articles were selected. The logistic model showed that Automatic provision of recommendation in electronic version as part of clinician workflow (Odds Ratio [OR]= 17.5; 95% confidence interval [CI]: 1.6-193.7) and Publication Year (OR = 6.7; 95%CI: 1.3-34.3) were statistically significant predictors.</p> <p>Conclusions</p> <p>From the research that has been carried out, we can conclude that after implementation of CCG significant improvements in process of care are shown. Our findings also suggest clinicians, managers and other health care decision makers which features of CCG might improve the structure of computerized system.</p

Framework, principles and recommendations for utilising participatory methodologies in the co-creation and evaluation of public health interventions

Background: Due to the chronic disease burden on society, there is a need for preventive public health interventions to stimulate society towards a healthier lifestyle. To deal with the complex variability between individual lifestyles and settings, collaborating with end-users to develop interventions tailored to their unique circumstances has been suggested as a potential way to improve effectiveness and adherence. Co-creation of public health interventions using participatory methodologies has shown promise but lacks a framework to make this process systematic. The aim of this paper was to identify and set key principles and recommendations for systematically applying participatory methodologies to co-create and evaluate public health interventions. Methods: These principles and recommendations were derived using an iterative reflection process, combining key learning from published literature in addition to critical reflection on three case studies conducted by research groups in three European institutions, all of whom have expertise in co-creating public health interventions using different participatory methodologies. Results: Key principles and recommendations for using participatory methodologies in public health intervention co-creation are presented for the stages of: Planning (framing the aim of the study and identifying the appropriate sampling strategy); Conducting (defining the procedure, in addition to manifesting ownership); Evaluating (the process and the effectiveness) and Reporting (providing guidelines to report the findings). Three scaling models are proposed to demonstrate how to scale locally developed interventions to a population level. Conclusions: These recommendations aim to facilitate public health intervention co-creation and evaluation utilising participatory methodologies by ensuring the process is systematic and reproducible

Randomised Trial to Evaluate the Effectiveness and Impact of Offering Postvisit Decision Support and Assistance in Obtaining Physician-Recommended Colorectal Cancer Screening: The e-Assist: Colon Health Study - A Protocol Study

INTRODUCTION: How to provide practice-integrated decision support to patients remains a challenge. We are testing the effectiveness of a practice-integrated programme targeting patients with a physician recommendation for colorectal cancer (CRC) screening. METHODS AND ANALYSIS: In partnership with healthcare teams, we developed \u27e-assist: Colon Health\u27, a patient-targeted, postvisit CRC screening decision support programme. The programme is housed within an electronic health record (EHR)-embedded patient portal. It leverages a physician screening recommendation as the cue to action and uses the portal to enrol and intervene with patients. Programme content complements patient-physician discussions by encouraging screening, addressing common questions and assisting with barrier removal. For evaluation, we are using a randomised trial in which patients are randomised to receive e-assist: Colon Health or one of two controls (usual care plus or usual care). Trial participants are average-risk, aged 50-75 years, due for CRC screening and received a physician order for stool testing or colonoscopy. Effectiveness will be evaluated by comparing screening use, as documented in the EHR, between trial enrollees in the e-assist: Colon Health and usual care plus (CRC screening information receipt) groups. Secondary outcomes include patient-perceived benefits of, barriers to and support for CRC screening and patient-reported CRC screening intent. The usual care group will be used to estimate screening use without intervention and programme impact at the population level. Differences in outcomes by study arm will be estimated with hierarchical logit models where patients are nested within physicians. ETHICS AND DISSEMINATION: All trial aspects have been approved by the Institutional Review Board of the health system in which the trial is being conducted. We will disseminate findings in diverse scientific venues and will target clinical and quality improvement audiences via other venues. The intervention could serve as a model for filling the gap between physician recommendations and patient action. TRIAL REGISTRATION NUMBER: NCT02798224; Pre-results

Marriage and divorce: changes and their driving forces

We document key facts about marriage and divorce, comparing trends through the past 150 years and outcomes across demographic groups and countries. While divorce rates have risen over the past 150 years, they have been falling for the past quarter century. Marriage rates have also been falling, but more strikingly, the importance of marriage at different points in the life cycle has changed, reflecting rising age at first marriage, rising divorce followed by high remarriage rates, and a combination of increased longevity with a declining age gap between husbands and wives. Cohabitation has also become increasingly important, emerging as a widely used step on the path to marriage. Out-of-wedlock fertility has also risen, consistent with declining "shotgun marriages." Compared with other countries, marriage maintains a central role in American life. We present evidence on some of the driving forces causing these changes in the marriage market: the rise of the birth control pill and women's control over their own fertility; sharp changes in wage structure, including a rise in inequality and partial closing of the gender wage gap; dramatic changes in home production technologies; and the emergence of the internet as a new matching technology. We note that recent changes in family forms demand a reassessment of theories of the family and argue that consumption complementarities may be an increasingly important component of marriage. Finally, we discuss how these facts should inform family policy debates.Public policy