314 research outputs found

    An approach to software cost estimation

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    A general procedure for software cost estimation in any environment is outlined. The basic concepts of work and effort estimation are explained, some popular resource estimation models are reviewed, and the accuracy of source estimates is discussed. A software cost prediction procedure based on the experiences of the Software Engineering Laboratory in the flight dynamics area and incorporating management expertise, cost models, and historical data is described. The sources of information and relevant parameters available during each phase of the software life cycle are identified. The methodology suggested incorporates these elements into a customized management tool for software cost prediction. Detailed guidelines for estimation in the flight dynamics environment developed using this methodology are presented

    Berom cultural beliefs and attitudes towards mental health problems in Nigeria: a mixed-methods study

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    Beliefs and attitudes are essential in mental health discourse. However, cultural beliefs and attitudes towards mental health problems (ATMHPs) among the Berom people of Nigeria are under-researched. The present studies made original contributions using the Cultural Identity Model (CIM) as predictors to investigate ATMHPs, and semi-structured interviews to further explain the potential impact of cultural beliefs on MHPs. In study-1, N = 140 participants responded to questionnaires on ATMHPs and were analysed using multivariate multiple regression in RStudio. Study-2 interviewed N = 13 participants (n = 7 laypeople; n = 6 practitioners). Interviews were recorded, transcribed and analysed thematically. Study-1 findings showed CIM as a non-significant predictor of ATMHPs. However, in study-2, four themes emerged: Cultural beliefs that MHPs are caused by spiritual forces; Berom indigenous preference for traditional healing; Christian religious healing in Berom communities; and Western-trained mental health practitioners' perception of lay service-users. The authors concluded that the Berom traditional and Christian religious healings are beneficial

    Repair of Oronasal Fistulae by Interposition of Multilayered Amniotic Membrane Allograft

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    Background: Oronasal fistulas are a frequent complication after cleft palate surgery. Numerous repair methods have been described, but wound-healing problems occur often. The authors investigated, for the first time, the suitability of multilayered amniotic membrane allograft for fistula repair in a laboratory experiment (part A), a swine model (part B), and an initial patient series (part C). Methods: In part A, one-, two-, and four-layer porcine and human amniotic membranes (n = 20 each) were fixed in a digital towing device and the force needed for rupture was determined. In part B, iatrogenic oronasal fistulas in 18 piglets were repaired with amniotic membrane allograft, autofetal amniotic membrane, or small intestinal submucosa (n = 6 each). Healing was evaluated by probing and visual inflammation control (no/moderate/strong) on postoperative days 3, 7, 10, and 76. Histological analysis was performed to visualize tissue architecture. In part C, four patients (two women and two men, ages 21 to 51 years) were treated with multilayered amniotic membrane allograft. Results: In part A, forces needed for amniotic membrane rupture increased with additional layers (p < 0.001). Human amniotic membrane was stronger than porcine membrane (p < 0.001). In part B, fistula closure succeeded in all animals treated with amniotic membrane with less inflammation than in the small intestinal submucosa group. One fistula remained persistent in the small intestinal submucosa group. In part C, all fistulas healed completely without inflammation. Conclusions: Amniotic membrane is an easily available biomaterial and can be used successfully for oronasal fistula repair. The multilayer technique and protective plates should be utilized to prevent membrane ruptures

    Fast evaluation of appointment schedules for outpatients in health care

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    We consider the problem of evaluating an appointment schedule for outpatients in a hospital. Given a fixed-length session during which a physician sees K patients, each patient has to be given an appointment time during this session in advance. When a patient arrives on its appointment, the consultations of the previous patients are either already finished or are still going on, which respectively means that the physician has been standing idle or that the patient has to wait, both of which are undesirable. Optimising a schedule according to performance criteria such as patient waiting times, physician idle times, session overtime, etc. usually requires a heuristic search method involving a huge number of repeated schedule evaluations. Hence, the aim of our evaluation approach is to obtain accurate predictions as fast as possible, i.e. at a very low computational cost. This is achieved by (1) using Lindley's recursion to allow for explicit expressions and (2) choosing a discrete-time (slotted) setting to make those expression easy to compute. We assume general, possibly distinct, distributions for the patient's consultation times, which allows us to account for multiple treatment types, as well as patient no-shows. The moments of waiting and idle times are obtained. For each slot, we also calculate the moments of waiting and idle time of an additional patient, should it be appointed to that slot. As we demonstrate, a graphical representation of these quantities can be used to assist a sequential scheduling strategy, as often used in practice

    A family of diameter-based eigenvalue bounds for quantum graphs

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    We establish a sharp lower bound on the first non-trivial eigenvalue of the Laplacian on a metric graph equipped with natural (i.e., continuity and Kirchhoff) vertex conditions in terms of the diameter and the total length of the graph. This extends a result of, and resolves an open problem from, [J. B. Kennedy, P. Kurasov, G. Malenov\'a and D. Mugnolo, Ann. Henri Poincar\'e 17 (2016), 2439--2473, Section 7.2], and also complements an analogous lower bound for the corresponding eigenvalue of the combinatorial Laplacian on a discrete graph. We also give a family of corresponding lower bounds for the higher eigenvalues under the assumption that the total length of the graph is sufficiently large compared with its diameter. These inequalities are sharp in the case of trees.Comment: Substantial revision of v1. The main result, originally for the first eigenvalue, has been generalised to the higher ones. The title has been changed and the proofs substantially reorganised to reflect the new result, and a section containing concluding remarks has been adde

    Withdrawn, strong, kind, but de-gendered: Non-disabled South Africans’ stereotypes concerning persons with physical disabilities

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    The present paper examines stereotyping in relation to physical disability and gender in the South Africa. Cross-sectional data for the present study were gathered using free response items in a large survey (n = 1990) examining the attitudes of people without disability towards different facetsof sexuality and disability. The most prominent stereotypes found in thepresent study were those which characterised PWPD as withdrawn and shy, SuperCrips, or happy, funny, and kind. The findings in the present papersuggest that stereotypes of PWPD are not overwhelmingly de-sexualising, but are undifferentiated by gender

    ‘Disability and HIV in Africa: Breaking the barriers to sexual health care’

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    Three decades in to the HIV pandemic, the issues affecting people with disabilities remains less known. Increasing attention has been given to this overlooked population when it comes to HIV prevention, treatment and care. This is related to the significant unmet sexual and reproductive health care needs facing people with disabilities worldwide. This article discusses the barriers to sexual health for people with disabilities in Africa, and presents an argument about how mainstream HIV prevention work and research does not adequately attend to the sorts of systemic barriers that exclude people with disabilities, which a more targeted, and critical approach could

    Normative references of heart rate variability and salivary alpha-amylase in a healthy young male population

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    <p>Abstract</p> <p>Background</p> <p>This study aimed to present normative reference values of heart rate variability and salivary alpha-amylase in a healthy young male population with a particular focus on their distribution and reproducibility.</p> <p>Methods</p> <p>The short-term heart rate variability of 417 young healthy Japanese men was studied. Furthermore, salivary alpha-amylase was measured in 430 men. The average age of the subjects were 21.9 years with standard deviation of 1.6 years. Interindividual variations in heart rate variability indices and salivary alpha-amylase levels were plotted as histograms. Data are presented as the mean, median, standard deviation, coefficient of variation, skewness, kurtosis, and fifth and 95th percentiles of each physiological index.</p> <p>Results</p> <p>Mean recorded values were heart period 945.85 ms, log-transformed high frequency component 9.84 ln-ms<sup>2</sup>, log-transformed low frequency component 10.42 ln-ms<sup>2</sup>, log-transformed low frequency to high frequency ratio 0.58 ln-ratio, standard deviation of beat-to-beat interval 27.17 ms and root mean square of successive difference 37.49 ms. The mean value of raw salivary alpha-amylase was 17.48 U/mL, square root salivary alpha-amylase 3.96 sqrt[U/mL] and log-transformed salivary alpha-amylase 2.65 ln[U/mL]. Log-transformed heart rate variability indices exhibited almost symmetrical distributions; however, time-domain indices of heart rate variability (standard deviation of beat-to-beat interval and root mean square of successive difference) exhibited right-skewed (positive skewness) distributions. A considerable right-skewed distribution was observed for raw salivary alpha-amylase. Logarithmic transformation improved the distribution of salivary alpha-amylase, although square root transformation was insufficient. The day-to-day reproducibility of these indices was assessed using intraclass correlation coefficients. Intraclass correlation coefficients of most heart rate variability and salivary indices were approximately 0.5 to 0.6. Intraclass correlation coefficients of raw salivary markers were approximately 0.6, which was similar to those of heart rate variability; however, log transformation of the salivary markers did not considerably improve their reproducibility. Correlations between sympathetic indicators of heart rate variability and salivary alpha-amylase were not observed.</p> <p>Conclusion</p> <p>Because the sample population examined in this study involved limited age and gender variations, the present results were independent of these factors and were indicative of pure interindividual variation.</p

    EMPOWERED trial: protocol for a randomised control trial of digitally supported, highly personalised and measurement-based care to improve functional outcomes in young people with mood disorders

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    Objectives Many adolescents and young adults with emerging mood disorders do not achieve substantial improvements in education, employment, or social function after receiving standard youth mental health care. We have developed a new model of care referred to as 'highly personalised and measurement-based care' (HP&MBC). HP&MBC involves repeated assessment of multidimensional domains of morbidity to enable continuous and personalised clinical decision-making. Although measurement-based care is common in medical disease management, it is not a standard practice in mental health. This clinical effectiveness trial tests whether HP&MBC, supported by continuous digital feedback, delivers better functional improvements than standard care and digital support. Method and analysis This controlled implementation trial is a PROBE study (Prospective, Randomised, Open, Blinded End-point) that comprises a multisite 24-month, assessor-blinded, follow-up study of 1500 individuals aged 15-25 years who present for mental health treatment. Eligible participants will be individually randomised (1:1) to 12 months of HP&MBC or standardised clinical care. The primary outcome measure is social and occupational functioning 12 months after trial entry, assessed by the Social and Occupational Functioning Assessment Scale. Clinical and social outcomes for all participants will be monitored for a further 12 months after cessation of active care. Ethics and dissemination This clinical trial has been reviewed and approved by the Human Research Ethics Committee of the Sydney Local Health District (HREC Approval Number: X22-0042 & 2022/ETH00725, Protocol ID: BMC-YMH-003-2018, protocol version: V.3, 03/08/2022). Research findings will be disseminated through peer-reviewed journals, presentations at scientific conferences, and to user and advocacy groups. Participant data will be deidentified. Trial registration number ACTRN12622000882729

    Salivary biomarkers of HPA axis and autonomic activity in adults with intellectual disability with and without stereotyped and self-injurious behavior disorders

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    Salivary levels of biomarkers for the hypothalamic–pituitary–adrenal axis (HPA; cortisol) and sympatho-adreno-medullary system (SAM; α-amylase) were measured in 51 adults (57% male) with neurodevelopmental disorders associated with intellectual disability (i.e., mental retardation) and chronic self-injurious behavior (SIB) and compared with matched controls without SIB. Cortisol levels differed significantly (p < 0.01) between the SIB and control group (SIB > control). Within-group analyses showed significant differences (p < 0.05) in levels of salivary α-amylase between individuals with SIB and those with SIB meeting criteria for stereotyped movement disorder (SMD; SIB + SMD > SIB). Salivary α-amylase was significantly correlated with frequency of stereotypy among the SIB group (r = 0.36, p < 0.05). These preliminary findings warrant further exploration into the role of the SAM system in the pathophysiology of SIB and related repetitive behaviors among individuals with neurodevelopmental disorders associated with intellectual disability
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