2,425 research outputs found
The Unfulfilled Potential of Data-Driven Decision Making in Agile Software Development
With the general trend towards data-driven decision making (DDDM),
organizations are looking for ways to use DDDM to improve their decisions.
However, few studies have looked into the practitioners view of DDDM, in
particular for agile organizations. In this paper we investigated the
experiences of using DDDM, and how data can improve decision making. An emailed
questionnaire was sent out to 124 industry practitioners in agile software
developing companies, of which 84 answered. The results show that few
practitioners indicated a widespread use of DDDM in their current decision
making practices. The practitioners were more positive to its future use for
higher-level and more general decision making, fairly positive to its use for
requirements elicitation and prioritization decisions, while being less
positive to its future use at the team level. The practitioners do see a lot of
potential for DDDM in an agile context; however, currently unfulfilled
Online Multi-Coloring with Advice
We consider the problem of online graph multi-coloring with advice.
Multi-coloring is often used to model frequency allocation in cellular
networks. We give several nearly tight upper and lower bounds for the most
standard topologies of cellular networks, paths and hexagonal graphs. For the
path, negative results trivially carry over to bipartite graphs, and our
positive results are also valid for bipartite graphs. The advice given
represents information that is likely to be available, studying for instance
the data from earlier similar periods of time.Comment: IMADA-preprint-c
How GPs value guidelines applied to patients with multimorbidity: A qualitative study
Objectives: To explore and describe the value general practitioner (GPs) attribute to medical guidelines when they are applied to patients with multimorbidity, and to describe which benefits GPs experience from guideline adherence in these patients. Also, we aimed to identify limitations from guideline adherence in patients with multimorbidity, as perceived by GPs, and to describe their empirical solutions to manage these obstacles.
Design: Focus group study with purposive sampling of participants. Focus groups were guided by an experienced moderator who used an interview guide. Interviews were transcribed verbatim. Data analysis was performed by two researchers using the constant comparison analysis technique and field notes were used in the analysis. Data collection proceeded until saturation was reached.
Setting: Primary care, eastern part of The Netherlands. Participants: Dutch GPs, heterogeneous in age, sex and academic involvement.
Results: 25 GPs participated in five focus groups. GPs valued the guidance that guidelines provide, but experienced shortcomings when they were applied to patients with multimorbidity. Taking these patients’ personal circumstances into account was regarded as important, but it was impeded by a consistent focus on guideline adherence. Preventative measures were considered less appropriate in (elderly) patients with multimorbidity. Moreover, the applicability of guidelines in patients with multimorbidity was questioned. GPs’ extensive practical experience with managing multimorbidity resulted in several empirical solutions, for example, using their ‘common sense’ to respond to the perceived shortcomings.
Conclusions: GPs applying guidelines for patients with multimorbidity integrate patient-specific factors in their medical decisions, aiming for patient-centred solutions. Such integration of clinical experience and best evidence is required to practise evidence-based medicine. More
flexibility in pay-for-performance systems is needed to
facilitate this integration. Several improvements in
guideline reporting are necessary to enhance the
applicability of guidelines in patients with multimorbidity
TAM receptor tyrosine kinase function and the immunopathology of liver disease.
Tyro3, Axl, MERTK (TAM) receptor tyrosine kinases are implicated in the regulation of the innate immune response through clearance of apoptotic cellular debris and control of cytokine signaling cascades. As a result they are pivotal in regulating the inflammatory response to tissue injury. Within the liver, immune regulatory signaling is employed to prevent the overactivation of innate immunity in response to continual antigenic challenge from the gastrointestinal tract. In this review we appraise current understanding of the role of TAM receptor function in the regulation of both innate and adaptive immunity, with a focus on its impact upon hepatic inflammatory pathology
Physical fitness in people with a spinal cord injury: the association with complications and duration of rehabilitation.
Objective: To assess the association between physical fitness and its recovery over time on the one hand, and complications and duration of phases of rehabilitation on the other. Design and setting: Prospective cohort study at eight rehabilitation centres. Subjects: People with a spinal cord injury were assessed four times: at the start of active rehabilitation (n = 110), three months later (n = 92), at discharge (n = 137) and a year after discharge from inpatient rehabilitation (n = 91). Main measures: Physical fitness was defined as aerobic capacity, determined at each occasion by the peak oxygen uptake (peak V
Equity in health care financing: The case of Malaysia
Background: Equitable financing is a key objective of health care systems. Its importance is
evidenced in policy documents, policy statements, the work of health economists and policy
analysts. The conventional categorisations of finance sources for health care are taxation, social
health insurance, private health insurance and out-of-pocket payments. There are nonetheless
increasing variations in the finance sources used to fund health care. An understanding of the equity
implications would help policy makers in achieving equitable financing.
Objective: The primary purpose of this paper was to comprehensively assess the equity of health
care financing in Malaysia, which represents a new country context for the quantitative techniques
used. The paper evaluated each of the five financing sources (direct taxes, indirect taxes,
contributions to Employee Provident Fund and Social Security Organization, private insurance and
out-of-pocket payments) independently, and subsequently by combined the financing sources to
evaluate the whole financing system.
Methods: Cross-sectional analyses were performed on the Household Expenditure Survey
Malaysia 1998/99, using Stata statistical software package. In order to assess inequality,
progressivity of each finance sources and the whole financing system was measured by Kakwani's
progressivity index.
Results: Results showed that Malaysia's predominantly tax-financed system was slightly
progressive with a Kakwani's progressivity index of 0.186. The net progressive effect was produced
by four progressive finance sources (in the decreasing order of direct taxes, private insurance
premiums, out-of-pocket payments, contributions to EPF and SOCSO) and a regressive finance
source (indirect taxes).
Conclusion: Malaysia's two tier health system, of a heavily subsidised public sector and a user
charged private sector, has produced a progressive health financing system. The case of Malaysia
exemplifies that policy makers can gain an in depth understanding of the equity impact, in order to
help shape health financing strategies for the nation
Mixed Feelings of Children and Adolescents with Unilateral Congenital Below Elbow Deficiency: An Online Focus Group Study
The existing literature is inconsistent about the psychosocial functioning of children and adolescents with Unilateral Congenital Below Elbow Deficiency (UCBED). The objective of this qualitative study was to explore the psychosocial functioning of children and adolescents with UCBED in terms of their feelings about the deficiency and what helps them to cope with those feelings. Additionally, the perspectives of prosthesis wearers and non-wearers were compared, as were the perspectives of children, adolescents, parents and health professionals. Online focus group interviews were carried out with 42 children and adolescents (aged 8–12, 13–16 and 17–20), 16 parents and 19 health professionals. Questions were asked about psychosocial functioning, activities, participation, prosthetic use or non-use, and rehabilitation care. This study concerned remarks about psychosocial functioning. Children and adolescents with UCBED had mixed feelings about their deficiency. Both negative and positive feelings were often felt simultaneously and mainly depended on the way people in the children’s environment reacted to the deficiency. People staring affected the children negatively, while support from others helped them to cope with the deficiency. Wearing a prosthesis and peer-to-peer contact were also helpful. Non-wearers tended to be more resilient than prosthesis wearers. Wearers wore their prosthesis for cosmetic reasons and to prevent them from negative reactions from the environment. We recommend that rehabilitation teams make parents aware of their great influence on the psychosocial functioning of their child with UCBED, to adjust or extend the currently available psychosocial help, and to encourage peer-to-peer contact
Functional outcome and quality of life 5 and 12.5 years after aneurysmal subarachnoid haemorrhage
Patients who recover from aneurysmal subarachnoid haemorrhage (SAH) often remain disabled or have persisting symptoms with a reduced quality of life (QoL). We assessed functional outcome and QoL 5 and 12.5 years after SAH. In a consecutive series of 64 patients with mean age at SAH of 51 years, initial outcome assessments had been performed at 4 and 18 months after SAH. At the initial and current outcome assessments, functional outcome was measured with the modified Rankin Scale (mRS) and QoL with the SF-36 and a visual analogue scale (VAS). We studied the change in outcome measurements over time. We used the non-parametric Wilcoxon test to compare differences in mRS grades and calculated differences with corresponding 95% confidence intervals in the domain scores of the SF-36 and the VAS. After 5 years, seven patients had died and five patients had missing data. Compared with the 4-month follow-up, the mRS had improved in 29 of the 52 patients, remained similar in 19 patients. The overall QoL (SF-36 domains and VAS score) was better. At 12.5 years an additional six patients had died. Compared to the 4-month study, 25 of the 46 remaining patients had improved mRS, 12 had remained the same and in nine patients the mRS had worsened. Between the 5 and the 12.5 years follow-up, the improvement in mRS had decreased but patients reported overall a better QoL. Among long-time survivors, QoL may improve more than a decade after SAH
The unfulfilled potential of data-driven decision making in agile software development
With the general trend towards data-driven decision making (DDDM), organizations are looking for ways to use DDDM to improve their decisions. However, few studies have looked into the practitioners view of DDDM, in particular for agile organizations. In this paper we investigated the experiences of using DDDM, and how data can improve decision making. An emailed questionnaire was sent out to 124 industry practitioners in agile software developing companies, of which 84 answered. The results show that few practitioners indicated a wide-spread use of DDDM in their current decision making practices. The practitioners were more positive to its future use for higher-level and more general decision making, fairly positive to its use for requirements elicitation and prioritization decisions, while being less positive to its future use at the team level. The practitioners do see a lot of potential for DDDM in an agile context; however, currently unfulfilled
Net1 and Myeov: computationally identified mediators of gastric cancer
Gastric adenocarcinoma (GA) is a significant cause of mortality worldwide. The molecular mechanisms of GA remain poorly characterised. Our aim was to characterise the functional activity of the computationally identified genes, NET 1 and MYEOV in GA. Digital Differential Display was used to identify genes altered expression in GA-derived EST libraries. mRNA levels of a subset of genes were quantitated by qPCR in a panel of cell lines and tumour tissue. The effect of pro- and anti-inflammatory stimuli on gene expression was investigated. Cell proliferation and invasion were measured using in an in-vitro GA model following inhibition of expression using siRNA. In all, 23 genes not previously reported in association with GA were identified. Two genes, Net1 and Myeov, were selected for further analysis and increased expression was detected in GA tissue compared to paired normal tissue using quantitative PCR. siRNA-mediated downregulation of Net1 and Myeov resulted in decreased proliferation and invasion of gastric cancer cells in vitro. These functional studies highlight a putative role for NET1 and Myeov in the development and progression of gastric cancer. These genes may provide important targets for intervention in GA, evidenced by their role in promoting invasion and proliferation, key phenotypic hallmarks of cancer cells
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