52 research outputs found

    Using MapReduce Streaming for Distributed Life Simulation on the Cloud

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    Distributed software simulations are indispensable in the study of large-scale life models but often require the use of technically complex lower-level distributed computing frameworks, such as MPI. We propose to overcome the complexity challenge by applying the emerging MapReduce (MR) model to distributed life simulations and by running such simulations on the cloud. Technically, we design optimized MR streaming algorithms for discrete and continuous versions of Conway’s life according to a general MR streaming pattern. We chose life because it is simple enough as a testbed for MR’s applicability to a-life simulations and general enough to make our results applicable to various lattice-based a-life models. We implement and empirically evaluate our algorithms’ performance on Amazon’s Elastic MR cloud. Our experiments demonstrate that a single MR optimization technique called strip partitioning can reduce the execution time of continuous life simulations by 64%. To the best of our knowledge, we are the first to propose and evaluate MR streaming algorithms for lattice-based simulations. Our algorithms can serve as prototypes in the development of novel MR simulation algorithms for large-scale lattice-based a-life models.https://digitalcommons.chapman.edu/scs_books/1014/thumbnail.jp

    Assessment of dysphagia in people with Parkinson’s disease, multiple sclerosis and muscular dystrophy

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    Introduction Previous research has shown that patients with Parkinson’s disease (PD), multiple sclerosis (MS) and muscular dystrophy (MD) are known to be at risk of dysphagia and could benefit from dysphagia screening. The aim of this study was to describe the use of dysphagia screening and assessment procedures amongst patients with neurological conditions when they have an unplanned admission to hospital. Methods Two methods of data collection were used in this study. The first method was a prospective observational study to determine the use of dysphagia screening and assessment procedures amongst patients with Parkinson’s disease, multiple sclerosis and muscular dystrophy. The second, qualitative study examined clinicians’ perceptions of the factors that influenced the decision to screen for dysphagia in people with neurological conditions and the difficulties experienced. Data were collected from clinicians using semi-structured in-depth interviews. Potential interventions to improve the management of dysphagia in these conditions were identified. Results Two hundred patients were recruited to the observational study. Thirty four percent (n=68) of this group underwent a swallow screening assessment (SSA) during the first week of admission and 93% (n=63) of these were judged to have dysphagia. Amongst those who were not assessed initially (n=132), a further 77% (n=101) were found to have dysphagia. Twenty people took part in the interview study including doctors, health care assistants, nurses and therapists. Clinicians reported that the factors which underpinned their decision to screen for dysphagia included pre-existing swallowing difficulties, recognition of symptoms, staff/relative anxiety, communication difficulties and the presenting complaint and diagnosis. However, clinicians reported that their limited knowledge, clinical competencies in swallow screening, a lack of confidence and resources, affected their practice and use of dysphagia screening and assessments. Clinicians noted a number of interventions that could improve the management of dysphagia when patients are admitted to hospital and these included: training in dysphagia screening; development of dysphagia pathways or guidelines; provision of an alert system, introduction of on-call speech and language therapy services; and research funding. Discussions and Conclusions The findings of this study suggest that screening for dysphagia does not occur routinely when patients with neurological conditions are admitted to hospital for an acute condition. This means that opportunities to detect treatable causes of potentially life-threatening complications are being missed. Many inter-related factors were reported to account for this practice and these related primarily to limited knowledge and confidence and the limited accessibility of speech and language therapists outside usual working hours. Interventions to improve routine dysphagia screening should help to reduce the incidence of avoidable complications and perhaps shorten length of stay. Dysphagia pathways or guidelines are needed to support effective management in acute hospital settings

    Investigation of mobile devices usage and mobile augmented reality applications among older people

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    Mobile devices such as tablets and smartphones have allow users to communicate, entertainment, access information and perform productivity. However, older people are having issues to utilise mobile devices that may affect their quality of life and wellbeing. There are some potentials of mobile Augmented Reality (AR) applications to increase older users mobile usage by enhancing their experience and learning. The study aims to investigate mobile devices potential barriers and influence factors in using mobile devices. It also seeks to understand older people issues in using AR applications

    Assessment of dysphagia in people with Parkinson’s disease, multiple sclerosis and muscular dystrophy

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    Introduction Previous research has shown that patients with Parkinson’s disease (PD), multiple sclerosis (MS) and muscular dystrophy (MD) are known to be at risk of dysphagia and could benefit from dysphagia screening. The aim of this study was to describe the use of dysphagia screening and assessment procedures amongst patients with neurological conditions when they have an unplanned admission to hospital. Methods Two methods of data collection were used in this study. The first method was a prospective observational study to determine the use of dysphagia screening and assessment procedures amongst patients with Parkinson’s disease, multiple sclerosis and muscular dystrophy. The second, qualitative study examined clinicians’ perceptions of the factors that influenced the decision to screen for dysphagia in people with neurological conditions and the difficulties experienced. Data were collected from clinicians using semi-structured in-depth interviews. Potential interventions to improve the management of dysphagia in these conditions were identified. Results Two hundred patients were recruited to the observational study. Thirty four percent (n=68) of this group underwent a swallow screening assessment (SSA) during the first week of admission and 93% (n=63) of these were judged to have dysphagia. Amongst those who were not assessed initially (n=132), a further 77% (n=101) were found to have dysphagia. Twenty people took part in the interview study including doctors, health care assistants, nurses and therapists. Clinicians reported that the factors which underpinned their decision to screen for dysphagia included pre-existing swallowing difficulties, recognition of symptoms, staff/relative anxiety, communication difficulties and the presenting complaint and diagnosis. However, clinicians reported that their limited knowledge, clinical competencies in swallow screening, a lack of confidence and resources, affected their practice and use of dysphagia screening and assessments. Clinicians noted a number of interventions that could improve the management of dysphagia when patients are admitted to hospital and these included: training in dysphagia screening; development of dysphagia pathways or guidelines; provision of an alert system, introduction of on-call speech and language therapy services; and research funding. Discussions and Conclusions The findings of this study suggest that screening for dysphagia does not occur routinely when patients with neurological conditions are admitted to hospital for an acute condition. This means that opportunities to detect treatable causes of potentially life-threatening complications are being missed. Many inter-related factors were reported to account for this practice and these related primarily to limited knowledge and confidence and the limited accessibility of speech and language therapists outside usual working hours. Interventions to improve routine dysphagia screening should help to reduce the incidence of avoidable complications and perhaps shorten length of stay. Dysphagia pathways or guidelines are needed to support effective management in acute hospital settings

    Proceedings of 30th Annual ARCOM Conference, vol 1

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    Aquatic therapy for children with Duchenne muscular dystrophy: a pilot feasibility randomised controlled trial and mixed-methods process evaluation.

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    BACKGROUND: Duchenne muscular dystrophy (DMD) is a rare disease that causes the progressive loss of motor abilities such as walking. Standard treatment includes physiotherapy. No trial has evaluated whether or not adding aquatic therapy (AT) to land-based therapy (LBT) exercises helps to keep muscles strong and children independent. OBJECTIVES: To assess the feasibility of recruiting boys with DMD to a randomised trial evaluating AT (primary objective) and to collect data from them; to assess how, and how well, the intervention and trial procedures work. DESIGN: Parallel-group, single-blind, randomised pilot trial with nested qualitative research. SETTING: Six paediatric neuromuscular units. PARTICIPANTS: Children with DMD aged 7-16 years, established on corticosteroids, with a North Star Ambulatory Assessment (NSAA) score of 8-34 and able to complete a 10-m walk without aids/assistance. Exclusions: > 20% variation between baseline screens 4 weeks apart and contraindications. INTERVENTIONS: Participants were allocated on a 1 : 1 ratio to (1) optimised, manualised LBT (prescribed by specialist neuromuscular physiotherapists) or (2) the same plus manualised AT (30 minutes, twice weekly for 6 months: active assisted and/or passive stretching regime; simulated or real functional activities; submaximal exercise). Semistructured interviews with participants, parents (n = 8) and professionals (n = 8) were analysed using Framework analysis. An independent rater reviewed patient records to determine the extent to which treatment was optimised. A cost-impact analysis was performed. Quantitative and qualitative data were mixed using a triangulation exercise. MAIN OUTCOME MEASURES: Feasibility of recruiting 40 participants in 6 months, participant and therapist views on the acceptability of the intervention and research protocols, clinical outcomes including NSAA, independent assessment of treatment optimisation and intervention costs. RESULTS: Over 6 months, 348 children were screened - most lived too far from centres or were enrolled in other trials. Twelve (30% of target) were randomised to AT (n = 8) or control (n = 4). People in the AT (n = 8) and control (n = 2: attrition because of parental report) arms contributed outcome data. The mean change in NSAA score at 6 months was -5.5 [standard deviation (SD) 7.8] for LBT and -2.8 (SD 4.1) in the AT arm. One boy suffered pain and fatigue after AT, which resolved the same day. Physiotherapists and parents valued AT and believed that it should be delivered in community settings. The independent rater considered AT optimised for three out of eight children, with other children given programmes that were too extensive and insufficiently focused. The estimated NHS costs of 6-month service were between £1970 and £2734 per patient. LIMITATIONS: The focus on delivery in hospitals limits generalisability. CONCLUSIONS: Neither a full-scale frequentist randomised controlled trial (RCT) recruiting in the UK alone nor a twice-weekly open-ended AT course delivered at tertiary centres is feasible. Further intervention development research is needed to identify how community-based pools can be accessed, and how families can link with each other and community physiotherapists to access tailored AT programmes guided by highly specialised physiotherapists. Bayesian RCTs may be feasible; otherwise, time series designs are recommended. TRIAL REGISTRATION: Current Controlled Trials ISRCTN41002956. FUNDING: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 27. See the NIHR Journals Library website for further project information
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