An Exploration of the Help-Seeking Experiences of Patients in an Allied Professions-Led Rapid Access Chest Pain Pathway – A Qualitative Study

Objective: A number of studies have explored delayed help-seeking practices for acute coronary syndrome (ACS) and have cited multiple intersecting factors which may play a role (e.g. attributing symptoms, age, gender, ethnicity and contextual influences). However, the pathway to diagnosis for suspected Coronary Heart Disease (CHD) symptoms in a Rapid Acess Chest Pain Clinic (RACPC) context is underexplored. The objective of this study was to explore patients’ help-seeking experiences of accessing RACPC services: from the point at which they notice and interpret symptoms to their decision to seek help from their GP, attend a RACPC, and receive a diagnosis Design: Qualitative study Setting: Interviews were conducted in RACPC at Queen Mary’s Roehampton Hospital, London, United Kingdom Participants: Maximium Variation sampling was used to recruit 30 participants referred to a RACPC, including 15 men and 15 women utilising sampling dimensions of age, ethnicity and occupation. Methods: Semi-structured interviews that focused on the patient experience of their pathway to diagnosis in RACPC. Thematic analysis was used to interpret the interview data. Results: The interpretation of symptoms was shaped by multiple factors; reluctance to seek help contributed to delay; with various factors acting as drivers as well as barriers to help-seeking; and referrals to RACPC were based on symptoms as well as patient need reassurance. Conclusion: We found complex issues shaped the patient decision-making when accessing the RACPC, including making sense of symptoms and help-seeking practices. These findings can be used to develop health promotion literature to encourage early help-seeking and improve of RACPC services

Trip purpose identification using pairwise constraints based semi-supervised clustering

Clustering of smart card data captured by automated fare collection (AFC) systems has traditionally been viewed as an unsupervised method. However, the small number of labelled data points in addition to the unlabelled smart card data can facilitate better partitioning and classification. In this paper, prior knowledge about the activities is translated into pairwise constraints and used in COP-KMEANS clustering algorithm to identify the trip purpose. The effectiveness of the method was evaluated by comparison of the results with the ground truth. The results demonstrate that semi-supervised clustering enhances the accuracy of the trip purpose identification

Correspondence

AbstractEur J Vasc Endovasc Surg 25, 596 (2003

Behavioural Analysis of Smart Card Data

Smart card data captured by automated fare collection (AFC) systems are a valuable resource for the analysis of human behaviour. The paper presents an approach of processing transit data for clustering analysis to identify user activities with similar characteristics. The effectiveness of the methods was evaluated using performance evaluation metrics. An external evaluation was used to compare the results with the ground truth. The results demonstrate that simple methods can produce good results when the input dataset used in the model is prepared and enriched with the most relevant features set

Numerical Study for a Marine Current Turbine Blade Performance under Varying Angle of Attack

Energy generation from marine currents is a promising technology for sustainable development. The success of using marine current turbines to tap the ocean hydrodynamic energy depends on predicting the hydrodynamic characteristics and performance of such turbines. This paper presents an analysis of the two-dimensional flow using commercial CFD software over a marine current turbine blade. The 2D flow is simulated for HF-SX NACA foil modified from S1210 NACA foil at various angles of attack with Reynolds number of 19×104, which represents the marine current flow. The hydrofoil is designed with considerations for lift and drag coefficients. The flow is simulated by solving the steady-state Navier-Stokes equations coupled with the k-ω shear stress transport (SST) turbulence model. The aim of this work is to study the effect of the angle of attack on the lift and drag coefficients. The computational domain is composed of non-homogenous structured meshing, with sufficient refinement of the domain near the foil blade in order to capture the boundary layer effects. Hence, all calculations are done at constant flow velocity while varying the angle attack for every model tested. The results have shown that the drag and lift coefficient, Cd and Cl coefficient increases with increasing the value of the angle of attack, ratio Cl/Cd curve related on performance at the peak 7o angle of attack

Trip purpose identification using pairwise constraints based semi-supervised clustering

Clustering of smart card data captured by automated fare collection (AFC) systems has traditionally been viewed as an unsupervised method. However,some additional information about human behaviour is available in addition to the smart card data points that can facilitate better partitioning of the data. In this paper, such prior knowledge is translated into pairwise constraints and used with the COPKMEANS clustering algorithm to identify user activities. The effectiveness of the method was evaluated using performance evaluation measures by comparison of the results with the ground truth. The results demonstrate that pairwise constraints significantly enhance the accuracy of the clusters

Cardiovascular risk in chronic myeloid leukaemia: A multidisciplinary consensus on screening and management

INTRODUCTION: Tyrosine kinase inhibitors (TKIs) have become the mainstay of treatment for chronic myeloid leukaemia (CML), but cardiovascular (CV) risk and exacerbation of underlying risk factors associated with TKIs have become widely debated. Real-world evidence reveals little application of CV risk factor screening or continued monitoring within UK CML management. This consensus paper presents practical recommendations to assist healthcare professionals in conducting CV screening/comorbidity management for patients receiving TKIs. METHODS: We conducted a multidisciplinary panel meeting and two iterative surveys involving 10 CML specialists: five haematologists, two cardio-oncologists, one vascular surgeon, one haemato-oncology pharmacist and one specialist nurse practitioner. RESULTS: The panel recommended that patients commencing second-/third-generation TKIs undergo formal CV risk assessment at baseline, with additional investigations and involvement of cardiologists/vascular surgeons for those with high CV risk. During treatment, patients should undergo CV monitoring, with the nature and frequency of testing dependent on TKI and baseline CV risk. For patients who develop CV adverse events, decision-making around TKI interruption, cessation or change should be multidisciplinary and balance CV and haematological risk. CONCLUSION: The panel anticipates these recommendations will support healthcare professionals in implementing CV risk screening and monitoring, broadly and consistently, and thereby help optimise TKI treatment for CML

Personal Informatics Tools Benefit from Combining Automatic and Manual Data Capture in the Long-Term

Harnessing the research opportunities provided by the large datasets generated by users of self-tracking technologies is a challenge for researchers of both human-computer interaction (HCI) and data science. While HCI is concerned with facilitating the insights gathered from data produced by self-tracking systems, data scientists rely on the quality of such data for training more accurate predictive models, which can sustain the flow of insightful data even after manual self-tracking is abandoned. In this position paper we consider the complementary roles that manual and automated data capture methods hold and argue that interdisciplinary collaborations are vital for advancing long-term self-tracking, the research and intervention opportunities that come with it, and provide a concrete example of where such collaborations would fit