Psoriasis today: experiences of healthcare and impact on quality of life in a major UK cohort

Aim: To establish how people with psoriasis in the United Kingdom today experience living with their condition including diagnosis, treatment, healthcare provision and impact on daily life. Background: Psoriasis is a debilitating long-term inflammatory skin disease which can result in severe itching, discomfort and soreness, and may be associated with problems beyond the specific symptoms related to the skin. For many it is accompanied by difficult-to-manage treatment regimes, emotional distress and a negative impact on their quality of life and psychosocial functioning. To date there is little published information about the health experiences of people in the United Kingdom with psoriasis. Methods A postal self-administered questionnaire was completed by members of the Psoriasis Association and the responses analysed (n=1564). Findings The findings suggest some similarities to surveys in other nations, but specifically highlighted that patients feel under-informed and are dissatisfied with current treatment regimes. Responses provided an insight into aspects of the condition that treatments should be targeting. Specific areas of negative impact on psychosocial functioning were identified, including the lack of available support for those experiencing emotional distress. The research provides important information about how the care of patients with psoriasis can be improved, especially at primary care level. This includes: improved training in psoriasis knowledge and awareness at general practitioner level and greater use of dermatology specialist nurses in primary care settings; more effective and manageable treatment regimes that target visible areas and general well-being; greater support for emotional distress and psychosocial functioning.Peer reviewedFinal Accepted Versio

Knowledge management and history

Capitalisation of the history of a technology, a technique or a concept within an industrial company is relevant to historians. However it largely exceeds the historical problems from a Knowledge Management point of view. In this context, it can be the subject of specific approaches especially Knowledge Engineering. However, it faces two types of difficulties: - The techniques in History have few modelling tools, and are even rather reticent with the use of such tools. - Knowledge Engineering doesn't often address historical knowledge modelling, for tracing knowledge evolution. It is however possible to develop robust and validated methods, tools and techniques which take into account these two approaches, which, if they function in synergy, appear rich and fertile.History, MASK, Knowledge management, Knowledge engineering, History of techniques

Contrainte sur la mémoire immédiate des groupes intonatifs comme principe de structuration de la prosodie

Mémoire numérisé par la Direction des bibliothèques de l'Université de Montréal

Le chunking perceptif de la parole : sur la nature du groupement temporel et son effet sur la mémoire immédiate

Dans de nombreux comportements qui reposent sur le rappel et la production de séquences, des groupements temporels émergent spontanément, créés par des délais ou des allongements. Ce « chunking » a été observé tant chez les humains que chez certains animaux et plusieurs auteurs l’attribuent à un processus général de chunking perceptif qui est conforme à la capacité de la mémoire à court terme. Cependant, aucune étude n’a établi comment ce chunking perceptif s’applique à la parole. Nous présentons une recension de la littérature qui fait ressortir certains problèmes critiques qui ont nui à la recherche sur cette question. C’est en revoyant ces problèmes qu’on propose une démonstration spécifique du chunking perceptif de la parole et de l’effet de ce processus sur la mémoire immédiate (ou mémoire de travail). Ces deux thèmes de notre thèse sont présentés séparément dans deux articles. Article 1 : The perceptual chunking of speech: a demonstration using ERPs Afin d’observer le chunking de la parole en temps réel, nous avons utilisé un paradigme de potentiels évoqués (PÉ) propice à susciter la Closure Positive Shift (CPS), une composante associée, entre autres, au traitement de marques de groupes prosodiques. Nos stimuli consistaient en des énoncés et des séries de syllabes sans sens comprenant des groupes intonatifs et des marques de groupements temporels qui pouvaient concorder, ou non, avec les marques de groupes intonatifs. Les analyses démontrent que la CPS est suscitée spécifiquement par les allongements marquant la fin des groupes temporels, indépendamment des autres variables. Notons que ces marques d’allongement, qui apparaissent universellement dans la langue parlée, créent le même type de chunking que celui qui émerge lors de l’apprentissage de séquences par des humains et des animaux. Nos résultats appuient donc l’idée que l’auditeur chunk la parole en groupes temporels et que ce chunking perceptif opère de façon similaire avec des comportements verbaux et non verbaux. Par ailleurs, les observations de l’Article 1 remettent en question des études où on associe la CPS au traitement de syntagmes intonatifs sans considérer les effets de marques temporels. Article 2 : Perceptual chunking and its effect on memory in speech processing:ERP and behavioral evidence Nous avons aussi observé comment le chunking perceptif d’énoncés en groupes temporels de différentes tailles influence la mémoire immédiate d’éléments entendus. Afin d’observer ces effets, nous avons utilisé des mesures comportementales et des PÉ, dont la composante N400 qui permettait d’évaluer la qualité de la trace mnésique d’éléments cibles étendus dans des groupes temporels. La modulation de l’amplitude relative de la N400 montre que les cibles présentées dans des groupes de 3 syllabes ont bénéficié d’une meilleure mise en mémoire immédiate que celles présentées dans des groupes plus longs. D’autres mesures comportementales et une analyse de la composante P300 ont aussi permis d’isoler l’effet de la position du groupe temporel (dans l’énoncé) sur les processus de mise en mémoire. Les études ci-dessus sont les premières à démontrer le chunking perceptif de la parole en temps réel et ses effets sur la mémoire immédiate d’éléments entendus. Dans l’ensemble, nos résultats suggèrent qu’un processus général de chunking perceptif favorise la mise en mémoire d’information séquentielle et une interprétation de la parole « chunk par chunk ».In numerous behaviors involving the learning and production of sequences, temporal groups emerge spontaneously, created by delays or a lengthening of elements. This chunking has been observed across behaviors of both humans and animals and is taken to reflect a general process of perceptual chunking that conforms to capacity limits of short-term memory. Yet, no research has determined how perceptual chunking applies to speech. We provide a literature review that bears out critical problems, which have hampered research on this question. Consideration of these problems motivates a principled demonstration that aims to show how perceptual chunking applies to speech and the effect of this process on immediate memory (or “working memory”). These two themes are presented in separate papers in the format of journal articles. Paper 1: The perceptual chunking of speech: a demonstration using ERPs To observe perceptual chunking on line, we use event-related potentials (ERPs) and refer to the neural component of Closure Positive Shift (CPS), which is known to capture listeners’ responses to marks of prosodic groups. The speech stimuli were utterances and sequences of nonsense syllables, which contained intonation phrases marked by pitch, and both phrase-internal and phrase-final temporal groups marked by lengthening. Analyses of CPSs show that, across conditions, listeners specifically perceive speech in terms of chunks marked by lengthening. These lengthening marks, which appear universally in languages, create the same type of chunking as that which emerges in sequence learning by humans and animals. This finding supports the view that listeners chunk speech in temporal groups and that this perceptual chunking operates similarly for speech and non-verbal behaviors. Moreover, the results question reports that relate CPS to intonation phrasing without considering the effects of temporal marks. Paper 2: Perceptual chunking and its effect on memory in speech processing: ERP and behavioral evidence We examined how the perceptual chunking of utterances in terms of temporal groups of differing size influences immediate memory of heard speech. To weigh these effects, we used behavioural measures and ERPs, especially the N400 component, which served to evaluate the quality of the memory trace for target lexemes heard in the temporal groups. Variations in the amplitude of the N400 showed a better memory trace for lexemes presented in groups of 3 syllables compared to those in groups of 4 syllables. Response times along with P300 components revealed effects of position of the chunk in the utterance. This is the first study to demonstrate the perceptual chunking of speech on-line and its effects on immediate memory of heard elements. Taken together the results suggest that a general perceptual chunking enhances a buffering of sequential information and a processing of speech on a chunk-by-chunk basis

Perceptual chunking and its effect on memory in speech processing: ERP and behavioral evidence

We examined how perceptual chunks of varying size in utterances can influence immediate memory of heard items (monosyllabic words). Using behavioral measures and event-related potentials (N400) we evaluated the quality of the memory trace for targets taken from perceived temporal groups (TGs) of three and four items. Variations in the amplitude of the N400 showed a better memory trace for items presented in TGs of three compared to those in groups of four. Analyses of behavioral responses along with P300 components also revealed effects of chunk position in the utterance. This is the first study to measure the online effects of perceptual chunks on the memory trace of spoken items. Taken together, the N400 and P300 responses demonstrate that the perceptual chunking of speech facilitates information buffering and a processing on a chunk-by-chunk basis

Aboriginal girls circle: enhancing connectedness and promoting resilience for Aboriginal girls

This report presents an evaluation of the Aboriginal Girls’ Circle, an intervention targeted to increase social connection, participation and self-confidence amongst Aboriginal girls attending secondary schools. Overview The Aboriginal Girls’ Circle (AGC) is an intervention targeted to increase social connection, participation and self- confidence amongst Aboriginal girls attending secondary schools. Researchers from the University of Western Sydney (UWS)’s School of Education sought to evaluate the AGC pilot undertaken at Dubbo College and to provide recommendations for the program’s further development. The following specific aims were outlined for this pilot research. 1. To determine the effects of the AGC for participants’ resilience, connectedness, self-concept and cultural identity, 2. To investigate and track the development of culturally appropriate tools and methods for measuring these constructs, and 3. To evaluate the relative effectiveness of various components of the program and implementation processes. Ethical protocols for working with Aboriginal communities were an important aspect of the research design, which was approved by the UWS Human Research Ethics Committee and by the by the NSW Department of Education and Communities. The research was undertaken in two stages, beginning with a consultation process that sought the views of community Elders, the AGC program developers and key school-based personnel. The first stage of the research involved field observations of the AGC in action, together with a series of interviews and focus groups involving participants, group leaders, community Elders and school staff. The second stage used quantitative methods to measure the effects of the program on key variables relating to student connectedness, resilience, cultural identity and self-concept

The Structural Effects of Modality on the Rise of Symbolic Language: A Rebuttal of Evolutionary Accounts and a Laboratory Demonstration

Why does symbolic communication in humans develop primarily in an oral medium, and how do theories of language origin explain this? Non-human primates, despite their ability to learn and use symbolic signs, do not develop symbols as in oral language. This partly owes to the lack of a direct cortico-motoneuron control of vocalizations in these species compared to humans. Yet such modality-related factors that can impinge on the rise of symbolic language are interpreted differently in two types of evolutionary storylines. (1) Some theories posit that symbolic language originated in a gestural modality, as in “sign languages.” However, this overlooks work on emerging sign and spoken languages showing that gestures and speech shape signs differently. (2) In modality-dependent theories, some emphasize the role of iconic sounds, though these lack the efficiency of arbitrary symbols. Other theorists suggest that ontogenesis serves to identify human-specific mechanisms underlying an evolutionary shift from pitch varying to orally modulated vocalizations (babble). This shift creates numerous oral features that can support efficient symbolic associations. We illustrate this principle using a sound-picture association task with 40 learners who hear words in an unfamiliar language (Mandarin) with and without a filtering of oral features. Symbolic associations arise more rapidly and accurately for sounds containing oral features compared to sounds bearing only pitch features, an effect also reported in experiments with infants. The results imply that, beyond a competence to learn and use symbols, the rise of symbolic language rests on the types of signs that a modality of expression affords

UNDERSTANDING RISK FACTORS OF ELDERLY INPATIENT FALLS USING CONTEXTUAL MODEL

The field of Information Systems is about bridging the digital and information divide. Advances in the digital world enable information to be stored and structured in a manner that facilitates effective use of the information for future modelling purposes. Elderly inpatient falls are a common global phenomenon, and an inpatient fall incident can have severe consequences for the patient, caregivers and the healthcare provider. An inpatient fall can result from many causes and its risk can be increased through the combination of these causes. Many risk factors of elderly inpatient falls have been reported in various papers in the literature. However, a logical comprehensive categorisation of all these factors does not currently exist. The objective of this research in progress is to come up with a generic categorisation of the risk factors for elderly inpatient falls alongside the usage of a contextual model to illustrate the inherent interactions amongst these various factors. In addition, we found that the effect of the interaction amongst some risk factors is time dependent which also needs to be incorporated in the contextual model. Such comprehensive categorisation and contextual risk model will help health providers in the process of profiling of an elderly inpatient with respect to his/her fall risk. It is useful to experts in health informatics in formulating models to automate this process

Time‐trends in rates of hospital admission of adolescents for violent, self‐inflicted or drug/alcohol‐related injury in England and Scotland, 2005‐2011:Population‐based analysis

Background: Incidence of emergency admissions for violent injury in 10- to 18-year olds decreased in England and Scotland between 2005 and 2011, but more steeply in Scotland. To generate hypotheses about causes of these differences, we determined whether trends were consistent across admissions for three common types of adversity-related injury (violent, self-inflicted and drug/alcohol-related). / Methods: Emergency admissions to NHS hospitals were captured using Hospital Episode Statistics and Scottish Morbidity Records. Adversity-related injury was defined using ICD-10 codes. Analyses were stratified by sex/age groups (10-12, 13-15 and 16-18 years) and adjusted for background trends in admissions for injury. / Results: During 2005-2011, rates declined in all sex/age groups in Scotland (reductions adjusted for background trends ranged from -22.0 to -103.7/100 000) and in girls and boys aged <16 years in England (adjusted reductions -12.0 to -49.9/100 000). However, these rates increased in England for both sexes aged 16-18 years (adjusted increases, girls 71.8/100 000; boys 28.0/100 000). However, throughout 2005-11 overall rates remained relatively similar in England and Scotland for both sexes aged <16 years, and remained higher in Scotland for both sexes aged 16-18 years. / Conclusions: A greater decline in the rates of emergency admissions for adversity-related injury for adolescents in Scotland compared with England could signal more effective policies in Scotland for reducing violence, self-harm, drug/alcohol misuse