Investigating heuristic evaluation as a methodology for evaluating pedagogical software: An analysis employing three case studies

This paper looks specifically at how to develop light weight methods of evaluating pedagogically motivated software. Whilst we value traditional usability testing methods this paper will look at how Heuristic Evaluation can be used as both a driving force of Software Engineering Iterative Refinement and end of project Evaluation. We present three case studies in the area of Pedagogical Software and show how we have used this technique in a variety of ways. The paper presents results and reflections on what we have learned. We conclude with a discussion on how this technique might inform on the latest developments on delivery of distance learning. © 2014 Springer International Publishing

Digital Quantum Simulation with Rydberg Atoms

We discuss in detail the implementation of an open-system quantum simulator with Rydberg states of neutral atoms held in an optical lattice. Our scheme allows one to realize both coherent as well as dissipative dynamics of complex spin models involving many-body interactions and constraints. The central building block of the simulation scheme is constituted by a mesoscopic Rydberg gate that permits the entanglement of several atoms in an efficient, robust and quick protocol. In addition, optical pumping on ancillary atoms provides the dissipative ingredient for engineering the coupling between the system and a tailored environment. As an illustration, we discuss how the simulator enables the simulation of coherent evolution of quantum spin models such as the two-dimensional Heisenberg model and Kitaev's toric code, which involves four-body spin interactions. We moreover show that in principle also the simulation of lattice fermions can be achieved. As an example for controlled dissipative dynamics, we discuss ground state cooling of frustration-free spin Hamiltonians.Comment: submitted to special issue "Quantum Information with Neutral Particles" of "Quantum Information Processing

Improving Working Conditions to Promote Worker Safety, Health and Wellbeing for Low-Wage Workers: The Workplace Organizational Health Study

This paper addresses a significant gap in the literature by describing a study that tests the feasibility and efficacy of an organizational intervention to improve working conditions, safety, and wellbeing for low-wage food service workers. The Workplace Organizational Health Study tests the hypothesis that an intervention targeting the work organization and environment will result in improvements in workers’ musculoskeletal disorders and wellbeing. This ongoing study is being conducted in collaboration with a large food service company. Formative evaluation was used to prioritize outcomes, assess working conditions, and define essential intervention elements. The theory-driven intervention is being evaluated in a proof-of-concept trial, conducted to demonstrate feasibility and potential efficacy using a cluster randomized design. Ten worksites were randomly assigned to intervention or control conditions. The 13-month intervention uses a comprehensive systems approach to improve workplace policies and practices. Using principles of participatory engagement, the intervention targets safety and ergonomics; work intensity; and job enrichment. The evaluation will provide a preliminary assessment of estimates of the intervention effect on targeted outcomes and inform understanding of the intervention implementation across worksites. This study is expected to provide insights on methods to improve working conditions in support of the safety and wellbeing of low-wage workers

Does anaesthesia cause postoperative cognitive dysfunction? A randomised study of regional versus general anaesthesia in 438 elderly patients

Keywords:anesthesia;cognitive function;complications;postoperative period;regional anesthesia;surgery Background: Postoperative cognitive dysfunction (POCD) is a common complication after cardiac and major non-cardiac surgery with general anaesthesia in the elderly. We hypothesized that the incidence of POCD would be less with regional anaesthesia rather than general. Methods: We included patients aged over 60 years undergoing major non-cardiac surgery. After giving written informed consent, patients were randomly allocated to general or regional anaesthesia. Cognitive function was assessed using four neuropsychological tests undertaken preoperatively and at 7 days and 3 months postoperatively. POCD was defined as a combined Z score >1.96 or a Z score >1.96 in two or more test parameters. Results: At 7 days, POCD was found in 37/188 patients (19.7%, [14.3–26.1%]) after general anaesthesia and in 22/176 (12.5%, [8.0–18.3%]) after regional anaesthesia, P = 0.06. After 3 months, POCD was present in 25/175 patients (14.3%, [9.5–20.4%]) after general anaesthesia vs. 23/165 (13.9%, [9.0–20.2%]) after regional anaesthesia, P = 0.93. The incidence of POCD after 1 week was significantly greater after general anaesthesia when we excluded patients who did not receive the allocated anaesthetic: 33/156 (21.2%[15.0–28.4%]) vs. 20/158 (12.7%[7.9–18.9%]) (P = 0.04). Mortality was significantly greater after general anaesthesia (4/217 vs. 0/211 (P <0.05)). Conclusion: No significant difference was found in the incidence of cognitive dysfunction 3 months after either general or regional anaesthesia in elderly patients. Thus, there seems to be no causative relationship between general anaesthesia and long-term POCD. Regional anaesthesia may decrease mortality and the incidence of POCD early after surgery

The Association of Diabetes and Obesity With Prostate Cancer Progression: HCaP-NC

BACKGROUND: The role of race in modifying the association among diabetes, obesity, and prostate cancer (CaP) progression is not well studied. We evaluated diabetes and obesity in association with time to CaP progression in White Americans (Whites) and Black Americans (Blacks). METHODS: Our study sample consisted of 363 White and 284 Black research participants from the Health Care Access and CaP Treatment in North Carolina (HCaP-NC) cohort. The association between self-reported diabetes or obesity and CaP progression (mean follow-up time approximately 5 years) was assessed using Cox proportional hazards modeling, with adjustment for potential confounders. Stratum-specific hazard ratio (HR) estimates for Whites and Blacks were evaluated. RESULTS: Self-reported diabetes was not associated with CaP progression in the cohort as a whole (HR: 0.86, 95%CI: 0.54, 1.35), or among racially defined groups (Whites, HR: 1.03, 95%CI: 0.50, 2.13 or Blacks, HR: 0.77, 95%CI: 0.43, 1.39). Obesity was positively associated with CaP progression among Whites, in models including (HR: 1.79, 95%CI: 1.08, 2.97), and excluding (HR: 1.80, 95%CI: 1.09, 2.96) diabetes as a covariate. No association was observed between obesity and CaP progression in Blacks or the cohort as whole. CONCLUSIONS: Self-reported diabetes was not associated with CaP progression In HCaP-NC. Obesity was associated with CaP progression only among White research participants

Excluding Lynch syndrome in a female patient with metachronous DNA mismatch repair deficient colon- and ovarian cancer

Genome Instability and Cance

Who makes the decision regarding the treatment of clinically localized prostate cancer-the patient or physician?: Results from a population-based study

Background: The current study examined how patients' sociodemographic, cancer-related, and subjective affective factors impacted their role in treatment decision-making. Methods: The patient sample (N = 788) was taken from a prospective follow-up study of a population-based cohort. Participants included 343 African American and 445 Caucasian-American patients with clinically localized prostate cancer. Multinomial logistic regression was used to investigate relations between the explanatory variables and the nominal 3-level decision-making variable: patient-only, patient-physician shared, and physician-only. Results: Approximately 41% of patients reported patient-only decision-making, 45% reported shared decision-making, and 13% reported physician-only decision-making. The odds of patient-only over physician-only decision-making were greater for younger men (vs those aged ≥ 65 years) (odds ratio [OR], 1.68; 95% confidence interval [95% CI], 1.03-2.74), and were less for men with high (vs low) cancer aggressiveness (OR,0.29; 95% CI, 0.15-0.55). The odds of shared over physician-only decision-making were less for men with high (vs low) cancer aggressiveness (OR, 0.40; 95% CI, 0.22-0.73). Greater odds of patient-only and shared decision-making also were found to be associated with greater concerns about the physical impact of treatment and having enough time for decision-making and lower scores of receiving advice from others. Conclusions: The findings of the current study indicate that, to facilitate a more patient-oriented decision-making process regarding treatment in those with clinically localized prostate cancer, clinicians need to tailor their interventions according to patient age and cancer aggressiveness, help reduce patient concerns and misconceptions regarding the physical impact of treatments, allow sufficient time for patients to consider treatment options, and assist patients in balancing advice and information received from different sources

The complexity of screening PMS2 in DNA isolated from formalin-fixed paraffin-embedded material

Germline variants in the DNA mismatch repair (MMR) gene PMS2 cause 1-14% of all Lynch Syndrome cancers. Correct variant analysis of PMS2 is complex due to the presence of multiple pseudogenes and the occurrence of gene conversion. The analysis complexity increases in highly fragmented DNA from formalin-fixed paraffin-embedded (FFPE) tissue. Here we describe a reliable approach to detect true PMS2 variants in fragmented DNA. A custom NGS panel designed for FFPE tissue was used targeting four MMR genes, POLE and POLD1. Amplicon design for PMS2 was based on the position of paralogous sequence variants (PSVs) that distinguish PMS2 from its pseudogenes. PMS2 variants in exons 1-11 can be correctly curated based on this information. For exons 12-15 this is less reliable as these undergo gene conversion. Using this method, we screened PMS2 variants in 125 MMR-deficient tumors. Of the 125 tumors tested, six were unexplained MMR-deficient tumors with solitary PMS2 protein expression loss. In these six tumors two unclassified variants (class 3) and five variants likely affecting function (class 4/5) were detected in PMS2. One microsatellite unstable tumor with positive staining for all MMR proteins was found to carry a frameshift PMS2 variant (class 5). No class 4 or class 5 PMS2 variants were detected in tumors with other patterns of MMR protein expression loss.Molecular tumour pathology - and tumour geneticsMTG2 - Moleculaire genetica van gastrointestinale tumore

Financial Toxicity among Patients with Bladder Cancer: Reasons for Delay in Care and Effect on Quality of Life

Purpose: Costly surveillance and treatment of bladder cancer can lead to financial toxicity, a treatment related financial burden. Our objective was to define the prevalence of financial toxicity among patients with bladder cancer and identify delays in care and its effect on health related quality of life. Materials and Methods: We identified patients with bladder cancer in the University of North Carolina Health Registry/Cancer Survivorship Cohort. Financial toxicity was defined as agreement with having “to pay more for medical care than you can afford.” Health related quality of life was measured using general and cancer specific validated questionnaires. Statistical analyses were performed using the Fisher exact test and the Student t-test. Results: A total of 138 patients with bladder cancer were evaluated. Median age was 66.9 years, 75% of the patients were male and 89% were white. Of the participants 33 (24%) endorsed financial toxicity. Participants who were younger (p = 0.02), black (p = 0.01), reported less than a college degree (p = 0.01) and had noninvasive disease (p = 0.04) were more likely to report financial toxicity. On multivariable analysis only age was a significant predictor of financial toxicity. Patients who endorsed financial toxicity were more likely to report delaying care (39% vs 23%, p = 0.07) due to the inability to take time off work or afford general expenses. On general health related quality of life questionnaires patients with financial toxicity reported worse physical and mental health (p = 0.03 and <0.01, respectively), and lower cancer specific health related quality of life (p = 0.01), physical well-being (p = 0.01) and functional well-being (p = 0.05). Conclusions: Financial toxicity is a major concern among patients with bladder cancer. Younger patients were more likely to experience financial toxicity. Those who endorsed financial toxicity experienced delays in care and poorer health related quality of life, suggesting that treatment costs should have an important role in medical decision making