Strengthening the Practices of an Agile Methodology?

An investigation into how the software development process in an agile environment (Extreme Programming) can be aided by intelligent software, leading to the development of a tool that will automate the process of standardising and clarifying source code. The tool will also speed up and aid the testing process, by producing test objects based on the source code, and by providing full test tracking, without having a negative impact on the development process. By making the coding and testing processes more automated, the research aims to evaluate the following hypotheses: 1. That the programmer\u27s productivity can be increased by the use of such a tool 1. That the standardised and clarified source code can reinforce the practices of Collective Code Ownership, Refactoring and Pair Programming 1. That automated testing can reinforce the practices of Code Ownership, Refactoring, Small Releases and Continuous Integration, as stated by Beck (2000)

Developing Data Literacy for Data Enabled Student Success

Tapping in to the potential benefits of learning analytics requires staff and students in higher education to be proficient in data literacy. This poster reports on a project to review and identify professional development needs for learning analytics, with an emphasis on the effective use of learning data to promote student success. We report on the development of an evidence based strategy and implementation plan that addresses the skills gaps and professional development requirements of students and higher education staff who teach or lead teaching and learning enhancement. The outputs will enable upskilling of staff and also facilitate students to be more aware, and make greater use of, their own data ‘footprint’. This facilitates the development of important life skills such as self-regulation and self actualisation. In the broader institutional context, this should have the resulting impact of more widespread adoption of evidence based decisions that support student success initiatives

Clinical supervision: A panacea for missed care

© 2020 John Wiley & Sons Ltd Aim: Clinical supervision is proposed as a solution-focused approach that supports nurses in busy health care environments, helping address the mounting incidents of missed care. Background: The pervasive nature of missed nursing care is concerning. The growing body of evidence on missed care predominantly focuses on types and causes. However, the effectiveness of solution-focused interventions used to reduce incidents of missed care has received less attention. Methods: Drawing on the literature, it is proposed that clinical supervision supports personal and professional development, positive working environments and quality patient care outcomes, and therefore reduces missed care incidents. Results: Clinical supervision fosters a supportive working environment where opportunities to critically reflect on caring values are provided, commitment to improving standards of care is nurtured, and courage to challenge care standards is encouraged. Conclusion: In an era of reports highlighting declining standards of nursing care and a wealth of evidence highlighting the benefits of clinical supervision, it remains underused in many areas of nursing. Implications for Nursing Management: Nurse managers need to recognize the value of clinical supervision in improving standards of nursing care and assume leadership in its successful implementation

Rivastigmine: an open-label, observational study of safety and effectiveness in treating patients with Alzheimer's disease for up to 5 years

BACKGROUND: Rivastigmine, a butyl- and acetylcholinesterase inhibitor, is approved for symptomatic treatment of Alzheimer's disease (AD). Data supporting the safety and efficacy of second-generation cholinesterase inhibitors, such as rivastigmine, are available for treatment up to 1 year, with limited data up to 2 1/2 years. The purpose of this report is to present safety and effectiveness data for rivastigmine therapy in patients with mild to moderately severe AD receiving treatment for up to 5 years. METHODS: An observational approach was used to study 37 patients with originally mild to moderate AD receiving rivastigmine as a therapy for AD in an open-label extension (ENA713, B352 Study Group, 1998). RESULTS: The initial trial demonstrated rivastigmine was well-tolerated and effective in terms of cognition, global functioning and activities of daily living. In this open label extension, high-dose rivastigmine therapy was safe and well tolerated over a 5-year period. Two thirds of the participants still enrolled at week 234 were in the original high-dose rivastigmine group during the double-blind phase, suggesting that early therapy may confer some benefit in delaying long-term progression of symptoms. CONCLUSIONS: Long-term cholinesterase inhibition therapy with rivastigmine was well tolerated, with no dropouts due to adverse effects past the initial titration period. Early initiation of treatment, with titration to high-dose therapy, may have an advantage in delaying progression of the illness

Climate and predation dominate juvenile and adult recruitment in a turtle with temperature-dependent sex determination

Conditions experienced early in life can influence phenotypes in ecologically important ways, as exemplified by organisms with environmental sex determination. For organisms with temperature-dependent sex determination (TSD), variation in nest temperatures induces phenotypic variation that could impact population growth rates. In environments that vary over space and time, how does this variation influence key demographic parameters (cohort sex ratio and hatchling recruitment) in early life stages of populations exhibiting TSD? We leverage a 17-year data set on a population of painted turtles, Chrysemys picta, to investigate how spatial variation in nest vegetation cover and temporal variation in climate influence early life-history demography. We found that spatial variation in nest cover strongly influenced nest temperature and sex ratio, but was not correlated with clutch size, nest predation, total nest failure, or hatching success. Temporal variation in climate influenced percentage of total nest failure and cohort sex ratio, but not depredation rate, mean clutch size, or mean hatching success. Total hatchling recruitment in a year was influenced primarily by temporal variation in climate-independent factors, number of nests constructed, and depredation rate. Recruitment of female hatchlings was determined by stochastic variation in nest depredation and annual climate and also by the total nest production. Overall population demography depends more strongly on annual variation in climate and predation than it does on the intricacies of nest-specific biology. Finally, we demonstrate that recruitment of female hatchlings translates into recruitment of breeding females into the population, thus linking climate (and other) effects on early life stages to adult demographics

Innovation in assessment: building student confidence in preparation for unfamiliar assessment methods

Innovative assessment methods in which students are active participants promote deeper learning. A group debate and a webfolio were implemented as methods of assessment in the 2015 undergraduate midwifery curriculum, with the assessment tools being evaluated by students. Thematic analysis of the evaluations showed students enjoyed undertaking innovative methods of assessment, they developed confidence and engaged meaningfully with the content to be assessed. Students also commented they developed multiple skills required for future professional practice as a midwife. Thorough preparation of students to undertake an innovative method of assessment however is vital in fostering student confidence

Biallelic interferon regulatory factor 8 mutation: A complex immunodeficiency syndrome with dendritic cell deficiency, monocytopenia, and immune dysregulation

Background: The homozygous K108E mutation of interferon regulatory factor 8 (IRF8) is reported to cause dendritic cell (DC) and monocyte deficiency. However, more widespread immune dysfunction is predicted from the multiple roles ascribed to IRF8 in immune cell development and function. Objective: We sought to describe the effect on hematopoiesis and immunity of the compound heterozygous R83C/R291Q mutation of IRF8, which is present in a patient with recurrent viral infection, granuloproliferation, and intracerebral calcification. Methods: Variant IRF8 alleles were identified by means of exome sequencing, and their function was tested by using reporter assays. The cellular phenotype was studied in detail by using flow cytometry, functional immunologic assay transcriptional profiling, and antigen receptor profiling. Results: Both mutations affected conserved residues, and R291Q is orthologous to R294, which is mutated in the BXH2 IRF8-deficient mouse. R83C showed reduced nuclear translocation, and neither mutant was able to regulate the Ets/IRF composite element or interferon-stimulated response element, whereas R291Q retained BATF/JUN interactions. DC deficiency and monocytopenia were observed in blood, dermis, and lung lavage fluid. Granulocytes were consistently increased, dysplastic, and hypofunctional. Natural killer cell development and maturation were arrested. TH1, TH17, and CD8+ memory T-cell differentiation was significantly reduced, and T cells did not express CXCR3. B-cell development was impaired, with fewer memory cells, reduced class-switching, and lower frequency and complexity of somatic hypermutation. Cell-specific gene expression was widely disturbed in interferon- and IRF8-regulated transcripts. Conclusions: This analysis defines the clinical features of human biallelic IRF8 deficiency, revealing a complex immunodeficiency syndrome caused by DC and monocyte deficiency combined with widespread immune dysregulation

Antipsychotic treatment resistance in first-episode psychosis: prevalence, subtypes and predictors

Background: We examined longitudinally the course and predictors of treatment resistance in a large cohort of first-episode psychosis (FEP) patients from initiation of antipsychotic treatment. We hypothesized that antipsychotic treatment resistance is: (a) present at illness onset; and (b) differentially associated with clinical and demographic factors. Method: The study sample comprised 323 FEP patients who were studied at first contact and at 10-year follow-up. We collated clinical information on severity of symptoms, antipsychotic medication and treatment adherence during the follow-up period to determine the presence, course and predictors of treatment resistance. Results: From the 23% of the patients, who were treatment resistant, 84% were treatment resistant from illness onset. Multivariable regression analysis revealed that diagnosis of schizophrenia, negative symptoms, younger age at onset, and longer duration of untreated psychosis predicted treatment resistance from illness onset. Conclusions: The striking majority of treatment-resistant patients do not respond to first-line antipsychotic treatment even at time of FEP. Clinicians must be alert to this subgroup of patients and consider clozapine treatment as early as possible during the first presentation of psychosis

Bad Practice in Erosion Management: The Southern Sicily Case Study

This case study from Sicily illustrates a common sequence of events where one unwise action was countered with another, which in turn created additional problems. The situation arose through strong political interference and ignorance (or lack of concern) regarding the environmental impacts of human interventions on the shoreline and by the public perception that government has a duty to protect private property. The poor design and location of ports and harbours produced infilling problems and huge updrift accretion with concomitant downdrift erosion. The human-induced coastal retreat was counteracted by the progressive emplacement of breakwaters creating a “domino” effect. On many occasions these were constructed to protect unplanned and illegal (in the sense that they do not conform to planning regulations) beachfront summer houses. Without the presence of these structures, there would have been no need for publicly funded intervention. Furthermore, only a narrow coastal belt close to the shoreline is used by bathers on the wide beaches formed updrift of ports and harbours and in the lee of breakwaters, most of the accreted beach being unused or partially occupied by tourist developments. Thus beach users and municipalities acquired some benefits from beach accretion at specific sites, the opposite being true in eroding areas

Cognitive performance at first episode of psychosis and the relationship with future treatment resistance: Evidence from an international prospective cohort study

Background: Antipsychotic treatment resistance affects up to a third of individuals with schizophrenia, with recent research finding systematic biological differences between antipsychotic resistant and responsive patients. Our aim was to determine whether cognitive impairment at first episode significantly differs between future antipsychotic responders and resistant cases. Methods: Analysis of data from seven international cohorts of first-episode psychosis (FEP) with cognitive data at baseline (N = 683) and follow-up data on antipsychotic treatment response: 605 treatment responsive and 78 treatment resistant cases. Cognitive measures were grouped into seven cognitive domains based on the pre-existing literature. We ran multiple imputation for missing data and used logistic regression to test for associations between cognitive performance at FEP and treatment resistant status at follow-up. Results: On average patients who were future classified as treatment resistant reported poorer performance across most cognitive domains at baseline. Univariate logistic regressions showed that antipsychotic treatment resistance cases had significantly poorer IQ/general cognitive functioning at FEP (OR = 0.70, p = .003). These findings remained significant after adjusting for additional variables in multivariable analyses (OR = 0.76, p = .049). Conclusions: Although replication in larger studies is required, it appears that deficits in IQ/general cognitive functioning at first episode are associated with future treatment resistance. Cognitive variables may be able to provide further insight into neurodevelopmental factors associated with treatment resistance or act as early predictors of treatment resistance, which could allow prompt identification of refractory illness and timely interventions