Psychometric Properties Of Responses By Clinicians And Older Adults To A 6-Item Hebrew Version Of The Hamilton Depression Rating Scale (HAM-D6)

Background The Hamilton Depression Rating Scale (HAM-D) is commonly used as a screening instrument, as a continuous measure of change in depressive symptoms over time, and as a means to compare the relative efficacy of treatments. Among several abridged versions, the 6-item HAM-D6 is used most widely in large degree because of its good psychometric properties. The current study compares both self-report and clinician-rated versions of the Hebrew version of this scale. Methods A total of 153 Israelis 75 years of age on average participated in this study. The HAM-D6 was examined using confirmatory factor analytic (CFA) models separately for both patient and clinician responses. Results Reponses to the HAM-D6 suggest that this instrument measures a unidimensional construct with each of the scales’ six items contributing significantly to the measurement. Comparisons between self-report and clinician versions indicate that responses do not significantly differ for 4 of the 6 items. Moreover, 100% sensitivity (and 91% specificity) was found between patient HAM-D6 responses and clinician diagnoses of depression. Conclusion These results indicate that the Hebrew HAM-D6 can be used to measure and screen for depressive symptoms among elderly patients

AG2U -- Autonomous Grading Under Uncertainties

Surface grading, the process of leveling an uneven area containing pre-dumped sand piles, is an important task in the construction site pipeline. This labour-intensive process is often carried out by a dozer, a key machinery tool at any construction site. Current attempts to automate surface grading assume perfect localization. However, in real-world scenarios, this assumption fails, as agents are presented with imperfect perception, which leads to degraded performance. In this work, we address the problem of autonomous grading under uncertainties. First, we implement a simulation and a scaled real-world prototype environment to enable rapid policy exploration and evaluation in this setting. Second, we formalize the problem as a partially observable markov decision process and train an agent capable of handling such uncertainties. We show, through rigorous experiments, that an agent trained under perfect localization will suffer degraded performance when presented with localization uncertainties. However, an agent trained using our method will develop a more robust policy for addressing such errors and, consequently, exhibit a better grading performance.Comment: 8 Page

Towards Autonomous Grading In The Real World

In this work, we aim to tackle the problem of autonomous grading, where a dozer is required to flatten an uneven area. In addition, we explore methods for bridging the gap between a simulated environment and real scenarios. We design both a realistic physical simulation and a scaled real prototype environment mimicking the real dozer dynamics and sensory information. We establish heuristics and learning strategies in order to solve the problem. Through extensive experimentation, we show that although heuristics are capable of tackling the problem in a clean and noise-free simulated environment, they fail catastrophically when facing real world scenarios. As the heuristics are capable of successfully solving the task in the simulated environment, we show they can be leveraged to guide a learning agent which can generalize and solve the task both in simulation and in a scaled prototype environment.Comment: 7 pages, Accepted to IEEE-IROS202

Impact of hypoglycaemia on patient-reported outcomes from a global, 24-country study of 27,585 people with type 1 and insulin-treated type 2 diabetes

Aims: Data on the impact of hypoglycaemia on patients' daily lives and diabetes self-management, particularly in developing countries, are lacking. The aim of this study was to assess fear of, and responses to, hypoglycaemia experienced by patients globally. Materials and methods: This non-interventional, multicentre, 4-week prospective study using self-assessment questionnaires and patient diaries consisted of 27,585 patients, >= 18 years, with type 1 diabetes (n = 8022) or type 2 diabetes (n = 19,563) treated with insulin for > 12 months, at 2004 sites in 24 countries worldwide. Results: Increased blood glucose monitoring (69.7%) and seeking medical assistance (62.0%) were the most common responses in the 4 weeks following hypoglycaemic events for patients with type 1 diabetes and type 2 diabetes, respectively. Approximately 44% of patients with type 1 diabetes or type 2 diabetes increased calorie intake in response to a hypoglycaemic episode. Following hypoglycaemia, 3.9% (type 1 diabetes) and 6.2% (type 2 diabetes) of patients took leave from work or study. Regional differences in fear of, and responses to, hypoglycaemia were evident - in particular, a lower level of hypoglycaemic fear and utilisation of healthcare resources in Northern Europe and Canada. Conclusions: Hypoglycaemia has a major impact on patients and their behaviour. These global data for the first time reveal regional variations in response to hypoglycaemia and highlight the importance of patient education and management strategies. (C) 2017 The Authors. Published by Elsevier Ireland Ltd. This is an open access article under thePeer reviewe

Rates and predictors of hypoglycaemia in 27 585 people from 24 countries with insulin-treated type 1 and type 2 diabetes : the global HAT study

Aims: To determine the global extent of hypoglycaemia experienced by patients with diabetes using insulin, as there is a lack of data on the prevalence of hypoglycaemia in developed and developing countries. Methods: This non-interventional, multicentre, 6-month retrospective and 4-week prospective study using self-assessment questionnaire and patient diaries included 27 585 patients, aged >= 18 years, with type 1 diabetes (T1D; n = 8022) or type 2 diabetes (T2D; n = 19 563) treated with insulin for > 12 months, at 2004 sites in 24 countries worldwide. The primary endpoint was the proportion of patients experiencing at least one hypoglycaemic event during the observational period. Results: During the prospective period, 83.0% of patients with T1D and 46.5% of patients with T2D reported hypoglycaemia. Rates of any, nocturnal and severe hypoglycaemia were 73.3 [95% confidence interval (CI) 72.6-74.0], 11.3 (95% CI 11.0-11.6) and 4.9 (95% CI 4.7-5.1) events/patient-year for T1D and 19.3 (95% CI 19.1-19.6), 3.7 (95% CI 3.6-3.8) and 2.5 events/patient-year (95% CI 2.4-2.5) for T2D, respectively. The highest rates of any hypoglycaemia were observed in Latin America for T1D and Russia for T2D. Glycated haemoglobin level was not a significant predictor of hypoglycaemia. Conclusions: We report hypoglycaemia rates in a global population, including those in countries without previous data. Overall hypoglycaemia rates were high, with large variations between geographical regions. Further investigation into these differences may help to optimize therapy and reduce the risk of hypoglycaemia.Peer reviewe

Poor glycemic control as a reason for referral of diabetes patients to specialists in Israel

Aims/introduction: Family physicians face the dilemma of when to refer patients with diabetes to specialists. This study examined attitudes of family physicians to referring patients with poor glucose control to diabetes specialists. Materials and methods: At continuous medical education courses, family physicians were asked to respond anonymously, as to whether they generally manage the diabetes of their patients, and specifically those with poor glycemic control (HbA1c>9.0%). Results: Of 470 respondents, 426 (90%) reported that they generally manage their patients’ diabetes; 202 (43%) reported that they manage the diabetes of patients with HbA1c>9.0%. Board certification in family medicine and affiliation to a health maintenance organization, but not sex, age, years of professional experience, or the proportion of patients with diabetes at their clinics, were associated with referral practices. Conclusions: Family medicine residency and organizational support appear to promote treatment by family physicians of patients with poorly controlled diabetes in the primary care setting