13 research outputs found

    Frequency and gender differences in the use of professional home care in late life: Findings from three German old-age cohorts

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    Aim: The aim of this study was to investigate the frequency of and the gender differences in the use of professional home care in Germany. Methods: We used harmonized data from three large cohort studies from Germany (“Healthy Aging: Gender-specific trajectories into the latest life”; AgeDifferent.de Platform). Data were available for 5,393 older individuals (75 years and older). Mean age was 80.2 years (SD: 4.1 years), 66.6% were female. Professional homecare outcome variables were use of outpatient nursing care, paid household assistance, and meals on wheels’ services. Logistic regression models were used, adjusting for important sociodemographic variables. Results: Altogether 5.2% of older individuals used outpatient nursing care (6.2% women and 3.2% men; p < 0.001), 24.2% used paid household assistance (26.1% women and 20.5% men; p < 0.001) and 4.4% used meals on wheels’ services (4.5% women and 4.0% men; p = 0.49). Regression analysis revealed that women had higher odds of using paid household assistance than men (OR = 1.48, 95% CI: [1.24–1.76]; p < 0.001), whereas they had lower odds of using meals on wheels’ services (OR = 0.64, 95% CI: [0.42–0.97]; p < 0.05). No statistically significant differences in using outpatient nursing care between women and men were found (OR = 1.26, 95% CI: [0.87–1.81]; p = 0.225). Further, the use of home care was mainly associated with health-related variables (e.g., stroke, Parkinson’s disease) and walking impairments. Conclusions: Our study showed that gender differences exist in using paid household assistance and in culinary dependency. For example, meals on wheels’ services are of great importance (e.g., for individuals living alone or for individuals with low social support). Gender differences were not identified regarding outpatient nursing care. Use of professional home care servicesmay contribute to maintaining autonomy and independence in old age

    Investigating the evolution of modularity in neural networks

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    Thesis (MEng)--Stellenbosch University, 2020.ENGLISH ABSTRACT: Neural networks are not inherently interpretable as a direct consequence of their operating principle and the high dimensional opacity of their internal computations. The neural network interpretability problem is detrimental to reliability, meaningful human-AI interaction and the ethics of deployment. The problem can be approached from the perspective of neural modularity which frames a modular network as one that contains any number of disjoint subnetworks and identifies an interpretable modular network as one that groups its internal representations within such subnetworks in an explanative, task specific way. This study aims to investigate how neural modularity evolves and how it can benefit interpretability. HyperNEAT under connectivity constraints is the chosen neuroevolutionary method, and the following key points of research are investigated with respect to the evolution of neural modularity: general substrates, a variety of connection cost and novel input competition constraints, HyperNEAT modifications based on CPPN disjoints, and the interaction between lifetime and evolutionary learning with neuron nomination given the inclusion of a training phase. The results indicate that the connectivity constraints successfully promote the evolution of neural modularity across a variety of tasks on a general substrate and show that the novel input competition constraints are competitive with the established connection costs as a means of driving the evolution of neural modularity. The HyperNEAT modifications based on CPPN disjoints did not benefit the evolution of neural modularity. Investigating the interaction between lifetime and evolutionary learning with neuron nomination links greater concurrency between the processes that determine a network’s form and function with higher levels of evolved neural modularity for the connection cost constraints. The interpretability assessment shows that while the evolved networks’ interpretable qualities are task dependent, two connectivity constraints deliver statistically different functional module overlap distributions. This study highlights new possibilities for future research and contributes to the knowledge basis on evolving neural modularity by showing that input competition constraints are competitive with connection cost constraints, by examining how the interaction between lifetime and evolutionary learning influences the evolution of neural modularity as well as looking at the interpretable qualities of the evolved networks.AFRIKAANSE OPSOMMING: Neurale netwerke is nie inherent interpreteerbaar nie as 'n gevolg van hulle werkbeginsel en die hoë dimensionele ondeursigtigheid van hulle interne berekeninge. Die neurale netwerk interpreteerbaarheidsprobleem is nadelig tot betroubaarheid, betekenisvolle mens-AI-interaksie en die etiek van ontplooiing. Die probleem kan benader word vanuit die perspektief van neurale modulariteit. 'n Modulêre netwerk bevat 'n aantal afwykende subnetwerke. 'n Interpreteerbare modulêre netwerk is 'n neurale netwerk met interne voorstellings wat binne sulke afwykende subnetwerke op 'n verklarende en taakspesifieke manier groepeer is. Hierdie studie ondersoek hoe neurale modulariteit ontwikkel en hoe dit interpreteerbaarheid kan bevoordeel. HyperNEAT met konnektiwiteitsbeperkings is die gekose neuro-evolusionêre metode en die volgende navorsing sleutelpunte word ondersoek met betrekking tot die evolusie van neurale modulariteit: (1) algemene raamwerke, (2) 'n verskeidenheid van verbindingskoste en nuwe insetkompetisiebeperkings, (3) HyperNEAT-modifikasies gebaseer op CPPNafwykings, en (4) die interaksie tussen lewenslange en evolusionêre leer met neuronenominasie gegewe die insluiting van 'n opleidingsfase. Die resultate dui daarop dat die konnektiwiteitsbeperkings die evolusie van neurale modulariteit oor 'n verskeidenheid take op 'n algemene raamwerk suksesvol bevorder en toon dat die nuwe insetkompetisiebeperkings mededingend is met die vasgestelde verbindingskoste as 'n manier om die evolusie van neurale modulariteit te dryf. Die HyperNEAT-modifikasies gebaseer op CPPN-afwykings het nie die ontwikkeling van neurale modulariteit bevoordeel nie. Die ondersoek van interaksie tussen leeftyd en evolusionêre leer met neuronenominasie dui aan dat hoër neurale modulariteits vlakke met verbindingskoste veroorsaak word 'n groter mate van samewerking tussen die prosesse wat die vorm en funksie van 'n netwerk bepaal. Die interpretasie evaluering toon aan dat alhoewel die ontwikkelde netwerke se interpreteerbare eienskappe taakafhanklik is, die funksie-oorvleuel van twee konnektiwiteitsbeperkings oorvleuel is statisties verskillend. Hierdie studie belig nuwe moontlikhede vir toekomstige navorsing en dra by tot die kennisbasis oor die ontwikkeling van neurale modulariteit deur aan te toon dat insetkompetisiebeperkings mededingend is met verbindingskoste beperkings, deur te ondersoek hoe die interaksie tussen leeftyd en evolusionêre leer die ontwikkeling van neurale modulariteit beïnvloed, sowel as die ondersoek van die interpreteerbare eienskappe van die ontwikkelde netwerke

    Factors Affecting the Transition from Paper to Digital Data Collection for Mobile Tuberculosis Active Case Finding in Low Internet Access Settings in Pakistan

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    Between September 2020 and March 2021, Mercy Corps piloted hybrid digital (CAPI) and paper-based (PAPI) data collection as part of its tuberculosis (TB) active case finding strategy. Data were collected using CAPI and PAPI at 140 TB chest camps in low Internet access areas of Punjab and Khyber Pakhtunkhwa provinces in Pakistan. PAPI data collection was performed primarily during the camp and entered using a tailor-performed CAPI tool after camps. To assess the feasibility of this hybrid approach, quality of digital records were measured against the paper &ldquo;gold standard&rdquo;, and user acceptance was evaluated through focus group discussions. Completeness of digital data varied by indicator, van screening team, and month of implementation: chest camp attendees and pulmonary TB cases showed the highest CAPI/PAPI completeness ratios (1.01 and 0.96 respectively), and among them, all forms of TB diagnosis and treatment initiation were lowest (0.63 and 0.64 respectively). Vans entering CAPI data with high levels of completeness generally did so for all indicators, and significant differences in mean indicator completeness rates between PAPI and CAPI were observed between vans. User feedback suggested that although the CAPI tool required practice to gain proficiency, the technology was appreciated and will be better perceived once double entry in CAPI and PAPI can transition to CAPI only. CAPI data collection enables data to be entered in a more timely fashion in low-Internet-access settings, which will enable more rapid, evidence-based program steering. The current system in which double data entry is conducted to ensure data quality is an added burden for staff with many activities. Transitioning to a fully digital data collection system for TB case finding in low-Internet-access settings requires substantial investments in M&amp;E support, shifts in data reporting accountability, and technology to link records of patients who pass through separate data collection stages during chest camp events

    Frequency and gender differences in the use of professional home care in late life: Findings from three German old-age cohorts

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    Aim: The aim of this study was to investigate the frequency of and the gender differences in the use of professional home care in Germany. Methods: We used harmonized data from three large cohort studies from Germany (“Healthy Aging: Gender-specific trajectories into the latest life”; AgeDifferent.de Platform). Data were available for 5,393 older individuals (75 years and older). Mean age was 80.2 years (SD: 4.1 years), 66.6% were female. Professional homecare outcome variables were use of outpatient nursing care, paid household assistance, and meals on wheels’ services. Logistic regression models were used, adjusting for important sociodemographic variables. Results: Altogether 5.2% of older individuals used outpatient nursing care (6.2% women and 3.2% men; p < 0.001), 24.2% used paid household assistance (26.1% women and 20.5% men; p < 0.001) and 4.4% used meals on wheels’ services (4.5% women and 4.0% men; p = 0.49). Regression analysis revealed that women had higher odds of using paid household assistance than men (OR = 1.48, 95% CI: [1.24–1.76]; p < 0.001), whereas they had lower odds of using meals on wheels’ services (OR = 0.64, 95% CI: [0.42–0.97]; p < 0.05). No statistically significant differences in using outpatient nursing care between women and men were found (OR = 1.26, 95% CI: [0.87–1.81]; p = 0.225). Further, the use of home care was mainly associated with health-related variables (e.g., stroke, Parkinson’s disease) and walking impairments. Conclusions: Our study showed that gender differences exist in using paid household assistance and in culinary dependency. For example, meals on wheels’ services are of great importance (e.g., for individuals living alone or for individuals with low social support). Gender differences were not identified regarding outpatient nursing care. Use of professional home care servicesmay contribute to maintaining autonomy and independence in old age

    Frequency and gender differences in the use of professional home care in late life: Findings from three German old-age cohorts

    No full text
    Aim: The aim of this study was to investigate the frequency of and the gender differences in the use of professional home care in Germany. Methods: We used harmonized data from three large cohort studies from Germany (“Healthy Aging: Gender-specific trajectories into the latest life”; AgeDifferent.de Platform). Data were available for 5,393 older individuals (75 years and older). Mean age was 80.2 years (SD: 4.1 years), 66.6% were female. Professional homecare outcome variables were use of outpatient nursing care, paid household assistance, and meals on wheels’ services. Logistic regression models were used, adjusting for important sociodemographic variables. Results: Altogether 5.2% of older individuals used outpatient nursing care (6.2% women and 3.2% men; p < 0.001), 24.2% used paid household assistance (26.1% women and 20.5% men; p < 0.001) and 4.4% used meals on wheels’ services (4.5% women and 4.0% men; p = 0.49). Regression analysis revealed that women had higher odds of using paid household assistance than men (OR = 1.48, 95% CI: [1.24–1.76]; p < 0.001), whereas they had lower odds of using meals on wheels’ services (OR = 0.64, 95% CI: [0.42–0.97]; p < 0.05). No statistically significant differences in using outpatient nursing care between women and men were found (OR = 1.26, 95% CI: [0.87–1.81]; p = 0.225). Further, the use of home care was mainly associated with health-related variables (e.g., stroke, Parkinson’s disease) and walking impairments. Conclusions: Our study showed that gender differences exist in using paid household assistance and in culinary dependency. For example, meals on wheels’ services are of great importance (e.g., for individuals living alone or for individuals with low social support). Gender differences were not identified regarding outpatient nursing care. Use of professional home care servicesmay contribute to maintaining autonomy and independence in old age

    Metabolic actions of natriuretic peptides and therapeutic potential in the metabolic syndrome

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