Extension to UML-B Notation and Toolset

The UML-B notation has been created as an attempt to combine the success and ease of use of UML, with the verification and rigorous development capabilities of formal methods. However, the notation currently only supports a basic diagram set. To address this we have, in this project, designed and implemented a set of extensions to the UML-B notation that provide a much fuller software engineering experience, critically making UML-B more appealing to industry partners. These extensions comprise five new diagram types, which are aimed at supplying a broader range of design capabilities, such as conceptual Use-Case design and future integration with the ProB animator tool

The effect of previous wingate performance using one body region on subsequent wingate performance using a different body region

The 30 second Wingate Anaerobic Test (WAnT) is the gold standard measure of anaerobic performance. The present investigation aimed to determine if a previous WAnT using one body region significantly affected a subsequent WAnT using a different body region. Twelve male university students (n = 12, 23 ± 2 years, 84 ± 16.1 kg, 178.5 ± 7.4 cm) volunteered to complete two repeated WAnT protocols (either lower body WAnT followed by an upper body WAnTor vice versa) on two separate testing occasions. The upper body WAnT was conducted on a modified electromagnetically braked cycle ergometer using a flywheel braking force corresponding to 5% bodyweight. The lower body WAnT was conducted on an electronically braked cycle ergometer using a flywheel braking force corresponding to 7.5% bodyweight. Participants had a 1 minute rest period for transition between WAnTs. Data are reported as mean ± standard deviation. No significant differences were identified in power indices for the lower body between 30 s WAnTs. When the upper body WAnT was performed 2nd, absolute peak power (p < 0.01), mean power (p < 0.001) and relative mean power (p < 0.001) were significantly lower compared to when the upper body WAnT was performed 1st. The value of maximum revolutions per minute was significantly lower (p < 0.001) when the upper body WAnT was performed after the lower body WAnT, compared to when it was performed 1st (193.3 ± 11.4 1st vs 179.8 ± 14.4 2nd). Previous upper body sprint exercise does not significantly affect lower body sprint exercise; however, previous lower body sprint exercise severely compromises subsequent upper body sprint performance

Multi-Action Recognition via Stochastic Modelling of Optical Flow and Gradients

In this paper we propose a novel approach to multi-action recognition that performs joint segmentation and classification. This approach models each action using a Gaussian mixture using robust low-dimensional action features. Segmentation is achieved by performing classification on overlapping temporal windows, which are then merged to produce the final result. This approach is considerably less complicated than previous methods which use dynamic programming or computationally expensive hidden Markov models (HMMs). Initial experiments on a stitched version of the KTH dataset show that the proposed approach achieves an accuracy of 78.3%, outperforming a recent HMM-based approach which obtained 71.2%

Development of collector well gardens

Communal areas of southern Zimbabwe illustrate the problems now facing people and the environment in many semi-arid parts of Africa. Prime constraints on sustainable development are the low and erratic rainfall and the limited availability of ground and surface water resources. Rainfed crop production provides the main source of staple foodstuffs. However, increasing population densities, all too frequent droughts and declining productivity of existing croplands have led to cultivation of more marginal terrain which is better suited to other, less intensive forms of land use. In areas where sufficient water resources are available, large irrigation schemes have been constructed. However, such schemes have been beset by a wide range of technical, institutional and social problems. It has also been difficult to reconcile such schemes with traditional farming practices. In contrast, experience in the region has shown that informal or garden irrigation can be economically viable and appropriate to households, especially for women farmers, for whom it is already a traditional component of the farming system. In 1988, a programme of research was started in southern Zimbabwe, the main objectives of which were to study the feasibility of using shallow crystalline basement aquifers as a source of water for small-scale irrigation and to compare and develop methods of low-cost, high efficiency irrigation which would be suitable for use on small irrigated gardens. This paper gives a brief description of some elements of this programme. More information can be found in Lovell et al (1996) and Murata et al (1995)

A process model for developing integrated product-service offerings

Manufacturers are increasingly seeing the benefits of adopting a servitization strategy, however, literature reports that they face challenges developing new product-service offerings. Although a number of approaches have been proposed, they fail to distinguish the characteristics of products and service, they are typically sequential and exhibit variations in the level of detail proposed. Overcoming these knowledge gaps, a new development process model is proposed, consisting of 19 distinct processes. The process model was tested and recommendations for improvements are reported

Depression predicts future emergency hospital admissions in primary care patients with chronic physical illness

PublishedObjective More than 15 million people currently suffer from a chronic physical illness in England. The objective of this study was to determine whether depression is independently associated with prospective emergency hospital admission in patients with chronic physical illness. Method 1860 primary care patients in socially deprived areas of Manchester with at least one of four exemplar chronic physical conditions completed a questionnaire about physical and mental health, including a measure of depression. Emergency hospital admissions were recorded using GP records for the year before and the year following completion of the questionnaire. Results The number of patients who had at least one emergency admission in the year before and the year after completion of the questionnaire were 221/1411 (15.7%) and 234/1398 (16.7%) respectively. The following factors were independently associated with an increased risk of prospective emergency admission to hospital; having no partner OR 1.49 (95% CI 1.04 to 2.15); having ischaemic heart disease OR 1.60 (95% CI 1.04 to 2.46); having a threatening experience OR 1.16 (95% CI 1.04 to 1.29) per experience; depression OR 1.58 (95% CI 1.04 to 2.40); emergency hospital admission in year prior to questionnaire completion OR 3.41 (95% CI (1.98 to 5.86). Conclusion To prevent potentially avoidable emergency hospital admissions, greater efforts should be made to detect and treat co-morbid depression in people with chronic physical illness in primary care, with a particular focus on patients who have no partner, have experienced threatening life events, and who have had a recent emergency hospital admission.National Institute for Health Research (NIHR

Characteristics of effective collaborative care for treatment of depression: a systematic review and meta-regression of 74 randomised controlled trials

This is a freely-available open access publication. Please cite the published version which is available via the DOI link in this record.BACKGROUND: Collaborative care is a complex intervention based on chronic disease management models and is effective in the management of depression. However, there is still uncertainty about which components of collaborative care are effective. We used meta-regression to identify factors in collaborative care associated with improvement in patient outcomes (depressive symptoms) and the process of care (use of anti-depressant medication). METHODS AND FINDINGS: Systematic review with meta-regression. The Cochrane Collaboration Depression, Anxiety and Neurosis Group trials registers were searched from inception to 9th February 2012. An update was run in the CENTRAL trials database on 29th December 2013. Inclusion criteria were: randomised controlled trials of collaborative care for adults ≥18 years with a primary diagnosis of depression or mixed anxiety and depressive disorder. Random effects meta-regression was used to estimate regression coefficients with 95% confidence intervals (CIs) between study level covariates and depressive symptoms and relative risk (95% CI) and anti-depressant use. The association between anti-depressant use and improvement in depression was also explored. Seventy four trials were identified (85 comparisons, across 21,345 participants). Collaborative care that included psychological interventions predicted improvement in depression (β coefficient -0.11, 95% CI -0.20 to -0.01, p = 0.03). Systematic identification of patients (relative risk 1.43, 95% CI 1.12 to 1.81, p = 0.004) and the presence of a chronic physical condition (relative risk 1.32, 95% CI 1.05 to 1.65, p = 0.02) predicted use of anti-depressant medication. CONCLUSION: Trials of collaborative care that included psychological treatment, with or without anti-depressant medication, appeared to improve depression more than those without psychological treatment. Trials that used systematic methods to identify patients with depression and also trials that included patients with a chronic physical condition reported improved use of anti-depressant medication. However, these findings are limited by the observational nature of meta-regression, incomplete data reporting, and the use of study aggregates.NIH

Promoting physical activity and physical function in people with long-term conditions by primary care:the Function First realist synthesis with co-design

Background As people age and accumulate long-term conditions, their physical activity and physical function declines, resulting in disability and loss of independence. Primary care is well placed to empower individuals and communities to reduce this decline; however, the best approach is uncertain. Objectives To develop a programme theory to explain the mechanisms through which interventions improve physical activity and physical function in people with long-term conditions in different primary care contexts, and to co-design a prototype intervention. Data sources Systematic literature searches of relevant databases with forwards and backwards citation tracking, grey literature searches and further purposive searches were conducted. Qualitative data were collected through workshops and interviews. Design Realist evidence synthesis and co-design for primary care service innovation. Setting Primary care in Wales and England. Participants Stakeholders included people with long-term conditions, primary care professionals, people working in relevant community roles and researchers. Methods The realist evidence synthesis combined evidence from varied sources of literature with the views, experiences and ideas of stakeholders. The resulting context, mechanism and outcome statements informed three co-design workshops and a knowledge mobilisation workshop for primary care service innovation. Results Five context, mechanism and outcome statements were developed. (1) Improving physical activity and function is not prioritised in primary care (context). If the practice team culture is aligned to the elements of physical literacy (mechanism), then physical activity promotion will become routine and embedded in usual care (outcome). (2) Physical activity promotion is inconsistent and unco-ordinated (context). If specific resources are allocated to physical activity promotion (in combination with a supportive practice culture) (mechanism), then this will improve opportunities to change behaviour (outcome). (3) People with long-term conditions have varying levels of physical function and physical activity, varying attitudes to physical activity and differing access to local resources that enable physical activity (context). If physical activity promotion is adapted to individual needs, preferences and local resources (mechanism), then this will facilitate a sustained improvement in physical activity (outcome). (4) Many primary care practice staff lack the knowledge and confidence to promote physical activity (context). If staff develop an improved sense of capability through education and training (mechanism), then they will increase their engagement with physical activity promotion (outcome). (5) If a programme is credible with patients and professionals (context), then trust and confidence in the programme will develop (mechanism) and more patients and professionals will engage with the programme (outcome). A prototype multicomponent intervention was developed. This consisted of resources to nurture a culture of physical literacy, materials to develop the role of a credible professional who can promote physical activity using a directory of local opportunities and resources to assist with individual behaviour change. Limitations Realist synthesis and co-design is about what works in which contexts, so these resources and practice implications will need to be modified for different primary care contexts. Conclusions We developed a programme theory to explain how physical activity could be promoted in primary care in people with long-term conditions, which informed a prototype intervention. Future work A future research programme could further develop the prototype multicomponent intervention and assess its acceptability in practice alongside existing schemes before it is tested in a feasibility study to inform a future randomised controlled trial. Study registration This study is registered as PROSPERO CRD42018103027. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 9, No. 16. See the NIHR Journals Library website for further project information. </jats:sec

Assessing mental health service user and carer involvement in physical health care planning: The development and validation of a new patient-reported experience measure

BackgroundPeople living with serious mental health conditions experience increased morbidity due to physical health issues driven by medication side-effects and lifestyle factors. Coordinated mental and physical healthcare delivered in accordance with a care plan could help to reduce morbidity and mortality in this population. Efforts to develop new models of care are hampered by a lack of validated instruments to accurately assess the extent to which mental health services users and carers are involved in care planning for physical health.ObjectiveTo develop a brief and accurate patient-reported experience measure (PREM) capable of assessing involvement in physical health care planning for mental health service users and their carers.MethodsWe employed psychometric and statistical techniques to refine a bank of candidate questionnaire items, derived from qualitative interviews, into a valid and reliable measure involvement in physical health care planning. We assessed the psychometric performance of the item bank using modern psychometric analyses. We assessed unidimensionality, scalability, fit to the partial credit Rasch model, category threshold ordering, local dependency, differential item functioning, and test-retest reliability. Once purified of poorly performing and erroneous items, we simulated computerized adaptive testing (CAT) with 15, 10 and 5 items using the calibrated item bank.ResultsIssues with category threshold ordering, local dependency and differential item functioning were evident for a number of items in the nascent item bank and were resolved by removing problematic items. The final 19 item PREM had excellent fit to the Rasch model fit (x2 = 192.94, df = 1515, P = .02, RMSEA = .03 (95% CI = .01-.04). The 19-item bank had excellent reliability (marginal r = 0.87). The correlation between questionnaire scores at baseline and 2-week follow-up was high (r = .70, P DiscussionWe developed a flexible patient reported outcome measure to quantify service user and carer involvement in physical health care planning. We demonstrate the potential to substantially reduce assessment length whilst maintaining reliability by utilizing CAT