With comfort and dignity and support: An evaluation of the Hospice at Home service delivered by Milford Care Centre

Copyright @ 2011 University of LimerickMilford Care Centre is the lead organisation that provides a comprehensive range of services for the elderly and palliative care patients in the Mid West Region. In tandem with the growing requirement for specialist palliative care in the community, it expanded its existing and limited community-based services in 2006 to include a specialist ‘Hospice at Home’ service for patients who require palliative care in their own homes. With inputs from a multi-disciplinary clinical team, the Hospice at Home Service delivered by Milford Care Centre represents the first service of its kind within the Republic of Ireland. The Hospice at Home Service is supported by funding from the HSE and donations from the public, as well as a significant donation from The Atlantic Philanthropies. A condition of the funding from The Atlantic Philanthropies was that the Service would be evaluated, thus providing Milford Care Centre with research information regarding various of aspects of the service, including the viewpoints of carers and patients. In 2009, Milford Care Centre commissioned the University of Limerick to undertake an independent evaluation of the Hospice at Home Service, with the aim of examining whether it offered a viable and effective model for delivering a range of palliative care services to patients and their families in the community. The evaluation was conducted between February 2009 and June 2011. It should be noted that an evaluation of the cost effectiveness of the Service was also commissioned and will be undertaken by another group

Next steps for drowning prevention in rural and remote Australia: A systematic review of the literature

Objective: To examine unintentional drowning by remoteness in Australia. Design: A systematic review of both peer-reviewed and grey literature published between January 1990 and December 2019 (inclusive). Method: Using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, MEDLINE (Ovid), PubMed, EMBASE, Scopus, PsycINFO (ProQuest), SPORTDiscus and Google Scholar were searched for studies exploring fatal and non-fatal unintentional drowning by remoteness. Epidemiological data, common factors and prevention strategies were extracted and mapped to Australian standard geographical classifications (major cities, inner regional, outer regional, remote and very remote). Level of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation and prevention strategies aligned to the hierarchy of control. Result: Thirty-two studies satisfied inclusion criteria (66% reporting epidemiology; 59% risk factors; and 44% prevention strategies). All (100%) included studies were assessed very low against Grading of Recommendations Assessment, Development and Evaluation. Findings indicate rural populations (ie, excluding major cities) have higher rates of drowning positively correlated with increasing remoteness. Common factors included age (child), natural water bodies, undertaking boating and watercraft activities and alcohol consumption. While a range of prevention strategies has been proposed, only one study outlined a rural drowning prevention strategy which had been implemented and evaluated. Strategies were generally low on the hierarchy of control. Conclusion: Rural populations are proportionately overrepresented in drowning statistics. Proposed prevention strategies have unknown efficacy. Greater research into rural drowning of Australians is needed especially exploring behavioural motivations, program delivery, cost-effectiveness and evaluation. Development and use of a standard definition for remoteness are recommended. Rural populations use water extensively; therefore, there is an urgent need to keep them safe

Examination of the suitability of collecting in event cognitive processes using Think Aloud protocol in golf.

Two studies examined the use of think aloud (TA) protocol as a means for collecting data of cognitive processes during performance in golf. In study 1, TA was employed to examine if different verbalisation (Level 2 or Level 3 TA) instructions influence performance of high and low skilled golfers. Participants performed 30 putts using TA at either Level 2, Level 3, or no verbalization condition. Although Level 3 verbalization produced a higher volume of verbal data than Level 2, TA at either level 2 or 3 did not impair putting performance compared to no verbalization. Study 2 examined the congruence between data collected via TA at Level 3 and cued retrospective recall of cognitive processes during golf performance. Experienced golfers performed six holes of golf whilst engaging in Level 3 TA. After performance, three semi-structured retrospective interviews were conducted (ten minutes after performance, 24 hours after performance and 48 hours after performance). A comparison of the themes identified large discrepancies between the information reported during TA and at interview, with only 38-41% similarity in variables reported to influence decision making on each hole. Both studies suggest TA is a valuable method for recording cognitive processes of individuals during task performance. TA provides richer verbal data regarding decisions than cued retrospective recall, and TA does not negatively impact performance

A review of expert systems for chromatography

Expert systems for chromatography are reviewed. A taxonomy is proposed that allows present (and future) expert systems in this area to be classified and facilitates an understanding of their inter-relationship. All the systems are described focusing on the reasons for their development, what their purpose was and how they were to be used. The engineering methods, knowledge representations, tools and architectures used for the systems are compared and contrasted in a discussion covering all the stages of the development life cycle of expert systems. The review reveals that too often developers of expert systems for chromatography do not justify their decisions on engineering matters and that the literature suggests that many ideas advocated by knowledge engineers are not being used

The Association of Cigarette Smoking With Depression and Anxiety: A Systematic Review

BACKGROUND: Many studies report a positive association between smoking and mental illness. However, the literature remains mixed regarding the direction of this association. We therefore conducted a systematic review evaluating the association of smoking and depression and/or anxiety in longitudinal studies. METHODS: Studies were identified by searching PubMed, Scopus, and Web of Science and were included if they: (1) used human participants, (2) were longitudinal, (3) reported primary data, (4) had smoking as an exposure and depression and/or anxiety as an outcome, or (5) had depression and/or anxiety as the exposure and smoking as an outcome. RESULTS: Outcomes from 148 studies were categorized into: smoking onset, smoking status, smoking heaviness, tobacco dependence, and smoking trajectory. The results for each category varied substantially, with evidence for positive associations in both directions (smoking to later mental health and mental health to later smoking) as well as null findings. Overall, nearly half the studies reported that baseline depression/anxiety was associated with some type of later smoking behavior, while over a third found evidence that a smoking exposure was associated with later depression/anxiety. However, there were few studies directly supporting a bidirectional model of smoking and anxiety, and very few studies reporting null results. CONCLUSIONS: The literature on the prospective association between smoking and depression and anxiety is inconsistent in terms of the direction of association most strongly supported. This suggests the need for future studies that employ different methodologies, such as Mendelian randomization (MR), which will allow us to draw stronger causal inferences. Implications: We systematically reviewed longitudinal studies on the association of different aspects of smoking behavior with depression and anxiety. The results varied considerably, with evidence for smoking both associated with subsequent depression and anxiety, and vice versa. Few studies supported a bidirectional relationship, or reported null results, and no clear patterns by gender, ethnicity, clinical status, length to follow-up, or diagnostic test. Suggesting that despite advantages of longitudinal studies, they cannot alone provide strong evidence of causality. Therefore, future studies investigating this association should employ different methods allowing for stronger causal inferences to be made, such as MR

Towards an expert system for enantioseparations: induction of rules using machine learning

A commercially available machine induction tool was used in an attempt to automate the acquisition of the knowledge needed for an expert system for enantioseparations by High Performance Liquid Chromatography using Pirkle-type chiral stationary phases (CSPs). Various rule-sets were induced that recommended particular CSP chiral selectors based on the structural features of an enantiomer pair. The results suggest that the accuracy of the optimal rule-set is 63% + or - 3% which is more than ten times greater than the accuracy that would have resulted from a random choice

Uncertainty assessment in river flow projections for Ethiopia’s Upper Awash Basin using multiple GCMs and hydrological models

Uncertainty in climate change impacts on river discharge in the Upper Awash Basin, Ethiopia, is assessed using five MIKE SHE hydrological models, six CMIP5 general circulation models (GCMs) and two representative concentration pathways (RCP) scenarios for the period 2071–2100. Hydrological models vary in their spatial distribution and process representations of unsaturated and saturated zones. Very good performance is achieved for 1975–1999 (NSE: 0.65–0.8; r: 0.79–0.93). GCM-related uncertainty dominates variability in projections of high and mean discharges (mean: –34% to +55% for RCP4.5,–2% to +195% for RCP8.5). Although GCMs dominate uncertainty in projected low flows, inter-hydrological model uncertainty is considerable (RCP4.5: –60% to +228%, RCP8.5: –86% to +337%). Analysis of variance uncertainty attribution reveals that GCM-related uncertainty occupies, on average, 68% of total uncertainty for median and high flows and hydrological models no more than 1%. For low flows, hydrological model uncertainty occupies, on average, 18% of total uncertainty; GCM-related uncertainty remains substantial (average: 28%)