Discovering new kinds of patient safety incidents

Every year, large numbers of patients in National Health Service (NHS) care suffer because of a patient safety incident. The National Patient Safety Agency (NPSA) collects large amounts of data describing individual incidents. As well as being described by categorical and numerical variables, each incident is described using free text. The aim of the work was to find quite small groups of similar incidents, which were of types that were previously unknown to the NPSA. A model of the text was produced, such that the position of each incident reflected its meaning to the greatest extent possible. The basic model was the vector space model. Dimensionality reduction was carried out in two stages: unsupervised dimensionality reduction was carried out using principal component analysis, and supervised dimensionality reduction using linear discriminant analysis. It was then possible to look for groups of incidents that were more tightly packed than would be expected given the overall distribution of the incidents. The process for assessing these groups had three stages. Firstly, a quantitative measure was used, allowing a large number of parameter combinations to be examined. The groups found for an ‘optimum’ parameter combination were then divided into categories using a qualitative filtering method. Finally, clinical experts assessed the groups qualitatively. The transition probabilities model was also examined: this model was based on the empirical probabilities that two word sequences were seen in the text. An alternative method for dimensionality reduction was to use information about the subjective meaning of a small sample of incidents elicited from experts, producing a mapping between high and low dimensional models of the text. The analysis also included the direct use of the categorical variables to model the incidents, and empirical analysis of the behaviour of high dimensional spaces

Is the Curious Child Universal? Examining the Frequency and Types of Questions Asked by Turkish Preschoolers’ from Middle-class and Low-income Families

The purpose of this study was three-fold: 1) to examine the frequency and types of questions asked by mother-child dyads from middle-class and low-income Turkish families during a storybook reading activity, and to see whether they change by SES and age 2) to examine the frequency and types of questions asked by Turkish preschoolers from middle-class and low-income families in a question elicitation task and to see whether they change by SES and age, 3) to investigate whether mother-child conversations, particularly mothers’ questions and explanations, help children acquire an “exploratory stance” and contribute to their learning from more knowledgeable others.I carried out three studies to examine children’s question-asking behavior. Study 1 examined the frequency and types of questions asked by 71 mother-child dyads (36 middle-class) during a storybook reading activity at home. The findings revealed no difference in the frequency and the types of mothers and children’s questions across age and SES groups. There was a strong positive association between mothers’ information-seeking questions and children’s information-seeking questions.Study 2 examined the frequency and the types of questions asked by Turkish preschoolers in a question-elicitation task about novel animals and objects to see whether children ask information-seeking questions and whether there were differences in the quantity and type of questions they asked depending on the scripted answers they received from the experimenter (informative vs. non-informative) across two experimental conditions. Seventy one children from Study 1 and 34 more children participated in this study (105 children; 55 middle-class) The findings indicated that children were more likely to ask questions when they received informative answers than non-informative answers. There were also significant SES differences; children from middle-class families asked more questions than children from low-income families. There were no age differences; 3-, 4- and 5-year-olds asked similar number of questions.Study 3 complemented Study 1 and 2 by examining whether mothers’ explanatory talk about improbable and impossible events was related to children’s judgments and explanations about similar events. The same participants from the first study participated in this study (71 mother-child dyads, 35 middle-class). Children first read a booklet with improbable and impossible events with their mothers and then participated in a child judgment task with the experimenter. There were no SES and age differences in mothers’ questions and explanations in the mother-child booklet task. In the child judgment task, children from low-income families judged improbable and impossible events to be possible more frequently than children from middle-class families, and provided more non-informative explanations for their judgments than children from middle-class families. Also, there was a negative association between mothers’ explanations-seeking questions and hypothetical explanations and children’s “yes, it is possible” judgments in the low-income sample. This finding indicates that in the low-income sample, mothers who questioned and speculated more about why improbable and impossible events can or cannot happen had children who judged these events as not possible more frequently.In sum, the present study provided evidence for the universal and socioculturally variable features of children’s question-asking behavior across two SES groups in the Turkish cultural context. It also highlighted the importance of investigating mother-child conversations in relation to children’s question-asking behavior

Classroom discourse analysis: gender in Algerian EFL classroom interaction

This thesis investigates the role of gender in Algerian EFL (English as a Foreign Language) classroom interaction. Its main foci are twofold. First, it investigates gender patterns in both teacher- student discourse and student- teacher discourse to explore the potential effect of teacher differential treatment and gender differences in classroom language interaction. Second, it examines the gendered classroom discourses and their relation to the wider social context. Based on a broad qualitative research design, the data was obtained through a broad ethnographic approach to classroom observation along with transcripts of audio recordings of the classroom observation, semi structured interviews with the students, and field notes. The study took place in two EFL classrooms consisting of 23 women and man students along with their woman and man teachers of two different subjects (Oral Expression and Phonology, respectively) at the university level. The data was analysed based on different approaches namely, an adopted version of Tsui (1994) framework, and CDA. The main conclusions drawn from the study is that woman students interacted more with both teachers while the man students rarely contributed to the interaction. This is argued to be related to power relation and gendered ideologies in the society. For the teachers’ discourse, the discourse acts used by both teachers demonstrated that the woman teacher enacted power overtly while the man teacher enacted power covertly during the classroom sessions. The analysis also demonstrated that the classroom was a site for constructing and perpetuating gendered discourses such as ‘gender differences discourse’, ‘back-row students’, and ‘diligent women students discourse’

Measuring the coherence of normal and aphasic discourse production in Chinese using rhetorical structure theory (RST)

The study investigated the difference in discourse coherence between healthy speakers and speakers with anomic aphasia using Rhetorical Structure Theory (RST). The effect of genre types on coherence and potential factors contributing to the differences were also examined. Fifteen native Cantonese participants of anomic aphasia and their control matched in age, education and gender participated. Sixty language samples were obtained using the story-telling and sequential description tasks of the Cantonese AphasiaBank protocol. Twenty naïve listeners provided subjective ratings on the coherence, completeness, correctness of order, and clarity of each speech sample. Results demonstrated that the control group showed significantly higher production fluency, total number of discourse units, and fewer errors than the aphasia group. Controls used a richer set of relations than the aphasic group, particularly those to describe settings, to express causality, and to elaborate. The aphasic group tended to omit more essential information content and was rated with significantly lower coherence and clarity than controls. The findings suggested that speakers with anomic aphasia had reduced proportion of essential information content, lower degree of elaboration, and more structural disruptions than the controls, which may have contributed to the reduced overall discourse coherence.published_or_final_versionSpeech and Hearing SciencesBachelorBachelor of Science in Speech and Hearing Science

Master of Science in Speech-Language Pathology

thesisThis investigation examined the effect of repeated sampling (i.e., test- retest) produced within the context of discourse elicited by the Nicholas and Brookshire (1993) discourse elicitation and language analysis procedures. The Nicholas and Brookshire (1993) Correct Information Units (CIUs) are extensively used in aphasic literature to gauge treatment outcomes, but few researchers have examined the temporal stability of this language measure in individuals with aphasia. Eighteen individuals with aphasia produced language samples over three sampling times. A repeated measures, group design was used to examine the stability of language measures over repeated sampling occasions. The following measurements were calculated and compared: total number of CIUs, percent CIU productivity, number of CIU nouns, number of CIU verbs, open class CIU words, CIU closed class words, well-formed sentences, and lexical diversity. Values for correlation coefficients were used to assess group stability of performance and standard error of measurement was used to assess individual stability of performance. Measures stable enough to use in group research included number of words, number of CIUs, percent CIUs, number of CIU nouns, number of CIU verbs, number of CIU open class words, and number of CIU closed class words. At the individual level, no participants achieved stability in performance across all measures, but 1 participant achieved stability in performance for all but CIU open class words. The majority of the participants were not stable in performance for the majority of the measures. Researchers and clinicians using the Nicholas and Brookshire (1993) language elicitation system can expect stability in performance for the examined language measures in groups of participants. For individuals, performance for the examined language measures is expected to be not stable in performance for some and stable in performance for others

An ontological view in telemedicine.

The verification and validation of information system models impact on the adequacy and appropriateness of using the value of telemedicine services for continuously optimizing healthcare outcomes. We have defined a methodology to help the modeling and rigorous analysis of the requirements of information systems in telemedicine. On one hand, this methodology will be based on a formal representation of requirements (systemic, generic domain, etc.) within a knowledge base that will be a requirements repository. On the other hand, this methodology will use conceptual graphs for the formalization of ontology of activities and the production of arguments related to the formal verification of models built from this ontology. We describe an example illustrating the engagement of conceptual graph procedures to model the contextual situations in the telemedicine development. We also discuss the way in which ethical issues will actually take place in telemedicine applications

Fuzzy Inference Systems for Risk Appraisal in Military Operational Planning

Advances in computing and mathematical techniques have given rise to increasingly complex models employed in the management of risk across numerous disciplines. While current military doctrine embraces sound practices for identifying, communicating, and mitigating risk, the complex nature of modern operational environments prevents the enumeration of risk factors and consequences necessary to leverage anything beyond rudimentary risk models. Efforts to model military operational risk in quantitative terms are stymied by the interaction of incomplete, inadequate, and unreliable knowledge. Specifically, it is evident that joint and inter-Service literature on risk are inconsistent, ill-defined, and prescribe imprecise approaches to codifying risk. Notably, the near-ubiquitous use of risk matrices (along with other qualitative methods), are demonstrably problematic at best, and downright harmful at worst, due to misunderstanding and misapplication of their quantitative implications. The use of fuzzy set theory is proposed to overcome the pervasive ambiguity of risk modeling encountered by today’s operational planners. Fuzzy logic is adept at addressing the problems caused by imperfect and imprecise knowledge, entangled causal relationships, and the linguistic input of expert opinion. To this end, a fuzzy inference system is constructed for the purpose of risk appraisal in military operational planning