Development of a comprehensive software engineering environment

The generation of a set of tools for software lifecycle is a recurring theme in the software engineering literature. The development of such tools and their integration into a software development environment is a difficult task because of the magnitude (number of variables) and the complexity (combinatorics) of the software lifecycle process. An initial development of a global approach was initiated in 1982 as the Software Development Workbench (SDW). Continuing efforts focus on tool development, tool integration, human interfacing, data dictionaries, and testing algorithms. Current efforts are emphasizing natural language interfaces, expert system software development associates and distributed environments with Ada as the target language. The current implementation of the SDW is on a VAX-11/780. Other software development tools are being networked through engineering workstations

Overview of Clostridium difficile infection: implications for China

The incidence and severity of Clostridium difficile infection (CDI) have dramatically increased in the Western world in recent years. In contrast, CDI is rarely reported in China, possibly due to under-diagnosis. This article briefly summarizes CDI incidence, management and preventive strategies. The authors intend to raise awareness of this disease among Chinese physicians and health workers, in order to minimize the medical and economic burden of a potential epidemic in the future

protocol

Background Clinical trials on caries lesion management use an abundance of outcomes, hampering comparison or combination of different study results and their efficient translation into clinical practice. Core outcome sets are an agreed standardized collection of outcomes which should be measured and reported in all trials for a specific clinical area. We aim to develop a core outcome set for trials investigating management of caries lesions in primary or permanent teeth conducted in primary or secondary care encompassing all stages of disease. Methods To identify existing outcomes, trials on prevention and trials on management of caries lesions will be screened systematically in four databases. Screening, extraction and deduplication will be performed by two researchers until consensus is reached. The definition of the core outcome set will by based on an e-Delhi consensus process involving key stakeholders namely patients, dentists, clinical researchers, health economists, statisticians, policy-makers and industry representatives. For the first stage of the Delphi process, a patient panel and a separate panel consisting of researchers, clinicians, teachers, industry affiliated researchers, policy- makers, and other interested parties will be held. An inclusive approach will be taken to involve panelists from a wide variety of socio-economic and geographic backgrounds. Results from the first round will be summarized and fed back to individuals for the second round, where panels will be combined and allowed to modify their scoring in light of the full panel’s opinion. Necessity for a third round will be dependent on the outcome of the first two. Agreement will be measured via defined consensus rules; up to a maximum of seven outcomes. If resources allow, we will investigate features that influence decision making for different groups. Discussion By using an explicit, transparent and inclusive multi-step consensus process, the planned core outcome set should be justifiable, relevant and comprehensive. The dissemination and application of this core outcome set should improve clinical trials on managing caries lesions and allow comparison, synthesis and implementation of scientific data

Development of the Murine Periodontium. I. Role of Basement Membrane in Formation of a Mineralized Tissue on the Developing Root Dentin Surface

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141263/1/jper0095.pd

'HeART of Stroke (HoS)', a community-based Arts for Health group intervention to support self-confidence and psychological well-being following a stroke: protocol for a randomised controlled feasibility study

Introduction Over 152 000 people in the UK have strokes annually and a third experience residual disability. Low mood also affects a third of stroke survivors; yet psychological support is poor. While Arts for Health interventions have been shown to improve well-being in people with mild-to-moderate depression post-stroke, their role in helping people regain sense of self, well-being and confidence has yet to be evaluated. The main aim of this study is to explore the feasibility of conducting a pragmatic multicentre randomised controlled trial to assess the effectiveness and cost-effectiveness of an Arts for Health group intervention (‘HeART of Stroke’ (HoS)) for stroke survivors. HoS is a 10-session artist-facilitated group intervention held in the community over 14 weeks. It offers a non-judgemental, supportive environment for people to explore sense of self, potentially enhancing well-being and confidence. Methods and analysis Sixty-four people, up to 2 years post-stroke, recruited via secondary care research staff or community stroke/rehabilitation teams in two UK centres will be randomised to either HoS plus usual care or usual care only. Self-reported outcomes, measured at baseline and approximately 5 months postrandomisation, will include stroke-related, well-being, mood, self-esteem, quality of life and process measures. Analyses will focus on estimating key feasibility parameters (eg, rates of recruitment, retention, intervention attendance). We will develop outcome and resource use data collection methods to inform an effectiveness and cost-effectiveness analysis in the future trial. Interviews, with a sample of participants, will explore the acceptability of the intervention and study processes, as well as experiences of the HoS group. Ethics and dissemination National Health Service (NHS), Research and Development and University ethical approvals have been obtained. Two peer-reviewed journal publications are planned plus one service user led publication. Findings will be disseminated at key national conferences, local stakeholder events and via institutional websites.This paper presents independent research funded by the National Institute for Health Research (NIHR) under its Research for Patient Benefit (RfPB) Programme (Grant Reference Number PB-PG-0212-27054)

Effect of Positive Behavioral Interventions and Supports on Middle School Students’ Discipline

Research has documented that a pervasive problem affecting today’s schools is disruptive student behavior and the long-term, negative outcomes associated with the use of out-of-school suspensions (OSS) to address it. The program, Positive Behavioral Interventions and Supports (PBIS), was implemented in a local middle school with a diverse student population at which there was a history of student discipline problems in an effort to improve student behavior and reduce discipline referrals. Guided by Skinner’s theory of behaviorism, the purpose of this quantitative study was to examine the effect that PBIS had on the following discipline-related variables: number of office discipline referrals, number of incidents resulting in OSS, and total number of days of OSS. This ex post facto, quasi-experimental study analyzed preimplementation and postimplementation discipline data from 180 students (88 6th–7th grade students and 92 7th–8th grade students) to determine the effect of PBIS on discipline-related variables at this diverse, high-needs school. Repeated measures t test results indicated the PBIS program had a positive effect on discipline, as evidenced by significantly lower numbers of disciplinary referrals and lower numbers of incidents resulting in OSS; but there was no significant difference in the number of days of OSS per OSS incident. Findings indicate that PBIS can serve as a behavior support that may promote positive student behavior and improve discipline. Overall, PBIS is a valuable program that, with proper implementation and continuous monitoring of student outcomes, can support students’ behavioral success thereby promoting positive social change in the education environment over time

Comparator choice in cariology trials limits conclusions on the comparative effectiveness of caries interventions

Comparator choice has been found one major factor impacting on the overall evidence supporting clinical interventions. We performed social network analysis on trials on the prevention/management of caries/carious lesions, hypothesizing that certain comparators are proportionally over-investigated, and others under-investigated, and that comparisons within comparator classes are preferred over comparisons between classes. A systematic review of randomized controlled trials on the prevention/management of caries/existing carious lesions was carried out. All comparators were classified at each of three levels of granularity, becoming more detailed with each level; (a) degree of invasiveness (non-, micro- or invasive), (b) the specific non-invasive, micro-invasive or invasive approach, (c) the actual material or technique used. Social network analysis was used to evaluate trial networks. Searching electronic databases found 4,774 articles of which 765 were relevant and 605 were included. The networks for all levels were polygonal. There was a high degree of separation of comparisons in prevention versus management trials. Invasive comparators were tested most frequently (number of comparators: 611), mainly in management trials. Non-invasive comparators were tested next often (474), mainly in caries prevention. Micro-invasive strategies were tested next often (233), in both prevention and management trials. On more granular levels, few interventions dominated the networks. Regardless of the level, the majority of trials compared within, not between classes. Prevention trials were mainly conducted in children (number of trials in adults/children/both: 37/241/11), while those on managing lesions were conducted in both children and adults (117/179/21). Comparator choice in cariology trials is driven by indication, and limits conclusions on the true comparative effectiveness of all strategies. There are a variety of comparators that have not been, but should be, compared to one another, which should be addressed by future trials. Factors underlying trialists’ comparator choice need to be identified

Outcomes in Trials for Management of Caries Lesions (OuTMaC):protocol

Background Clinical trials on caries lesion management use an abundance of outcomes, hampering comparison or combination of different study results and their efficient translation into clinical practice. Core outcome sets are an agreed standardized collection of outcomes which should be measured and reported in all trials for a specific clinical area. We aim to develop a core outcome set for trials investigating management of caries lesions in primary or permanent teeth conducted in primary or secondary care encompassing all stages of disease. Methods To identify existing outcomes, trials on prevention and trials on management of caries lesions will be screened systematically in four databases. Screening, extraction and deduplication will be performed by two researchers until consensus is reached. The definition of the core outcome set will by based on an e-Delhi consensus process involving key stakeholders namely patients, dentists, clinical researchers, health economists, statisticians, policy-makers and industry representatives. For the first stage of the Delphi process, a patient panel and a separate panel consisting of researchers, clinicians, teachers, industry affiliated researchers, policy-makers, and other interested parties will be held. An inclusive approach will be taken to involve panelists from a wide variety of socio-economic and geographic backgrounds. Results from the first round will be summarized and fed back to individuals for the second round, where panels will be combined and allowed to modify their scoring in light of the full panel’s opinion. Necessity for a third round will be dependent on the outcome of the first two. Agreement will be measured via defined consensus rules; up to a maximum of seven outcomes. If resources allow, we will investigate features that influence decision making for different groups. Discussion By using an explicit, transparent and inclusive multi-step consensus process, the planned core outcome set should be justifiable, relevant and comprehensive. The dissemination and application of this core outcome set should improve clinical trials on managing caries lesions and allow comparison, synthesis and implementation of scientific data. Trial registration Registered 12 April 2015 at COMET (http://www.comet-initiative.org