549 research outputs found
End of life care in intensive care settings: a case study approach to explore decision making and processes. National Institute for Health Research, Research for Patient Benefit Programme PB-PG-0107-12274
Heuristic Approaches to Solve the Frequency Assignment Problem
The frequency assignment problem is a computationally hard problem with many applications including the mobile telephone industry and tactical communications. The problem may be modelled mathematically as a T-colouring problem for an undirected weighted graph; it is required to assign to each vertex a value from a given set such that for each edge the difference in absolute value between the values at the corresponding vertices is greater than or equal to the weight of the edge. This problem was solved using novel and existing metaheuristic algorithms and their relative successes were compared. Early work of this thesis used greedy, steepest descent and backtracking algorithms as a means of investigating the factors which influence the performance of an algorithm (selection of frequency, ordering of variables, provision of an incremental objective function). Later simulated annealing, tabu search and divide and conquer techniques were used and the results compared. A novel divide and conquer technique incorporating metaheuristics is described and results using test data based on real problems is presented. The divide and conquer technique (with either tabu search or simulated
annealing) was found to improve significantly upon the corresponding metaheuristic when implemented alone and acting on non-trivial scenarios. The results were significant and consistent. The divide and conquer (with simulated annealing) algorithm in particular was shown to be robust and efficient in its solution of the frequency assignment problems presented. The results presented in this thesis consistently out-perform those obtained by the Defence, Evaluation and Research Agency, Malvern. In addition this method lends itself to parallelisation since the problem is broken into smaller independent parts. The divide and conquer algorithm does not exploit knowledge of the constraint network and should be applicable to a number of different problem domains. Algorithms capable of solving the frequency assignment problem most effectively will become valuable as demand for the electromagnetic spectrum continues to grow
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Evaluating metabolites in patients with major depressive disorder who received mindfulness-based cognitive therapy and healthy controls using short echo MRSI at 7 Tesla.
ObjectivesOur aim was to evaluate differences in metabolite levels between unmedicated patients with major depressive disorder (MDD) and healthy controls, to assess changes in metabolites in patients after they completed an 8-week course of mindfulness-based cognitive therapy (MBCT), and to exam the correlation between metabolites and depression severity.Materials and methodsSixteen patients with MDD and ten age- and gender-matched healthy controls were studied using 3D short echo-time (20 ms) magnetic resonance spectroscopic imaging (MRSI) at 7 Tesla. Relative metabolite ratios were estimated in five regions of interest corresponding to insula, anterior cingulate cortex (ACC), caudate, putamen, and thalamus.ResultsIn all cases, MBCT reduced severity of depression. The ratio of total choline-containing compounds/total creatine (tCr) in the right caudate was significantly increased compared to that in healthy controls, while ratios of N-acetyl aspartate (NAA)/tCr in the left ACC, myo-inositol/tCr in the right insula, and glutathione/tCr in the left putamen were significantly decreased. At baseline, the severity of depression was negatively correlated with my-inositol/tCr in the left insula and putamen. The improvement in depression severity was significantly associated with changes in NAA/tCr in the left ACC.ConclusionsThis study has successfully evaluated regional differences in metabolites for patients with MDD who received MBCT treatment and in controls using 7 Tesla MRSI
The Communication Effectiveness of Scientist-Stakeholder Partnerships Addressing Agriculture and Natural Resources Issues: A Citation Analysis of the Florida Water and Climate Alliance
Public opinion on contentious agricultural and natural resource issues, such as climate change, has become more polarized and the science itself has sometimes been called into question. In response, academics and various types of stakeholders have formed organizational partnerships and collaborations to disseminate their science to inform the public and policy. These Scientist-Stakeholder Partnerships possess advantages such as technical expertise, however, such groups often face challenges in communicating effectively and establishing their reputation.
This study selected Florida Water and Climate Alliance (FWCA) as an example of this type of organization and used citation analysis to measure communication effectiveness and impact. The findings suggested FWCA members were productive in authoring and being cited in academic publications. Many FWCA articles were cited by other members of the organization, suggesting an organization’s members can help create a body of literature around the organization’s interest areas. This study demonstrated the use of citation analysis as a method of evaluating the communication effectiveness of scientist-stakeholder partnerships/self-directed organizations. To be more effective with external audiences, it is recommended that such organizations invest in developing and promoting their identity, core messages and visibility with key audiences and consider moving beyond member generated efforts to work with an agricultural communications practitioner. Future research should examine public awareness and media visibility of such organizations
Identifying Injection Drug Users at Risk of Nonfatal Overdose
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75145/1/j.1553-2712.2007.tb01846.x.pd
Development and Implementation of an Influenza Point-of-Care Testing Service in a Chain Community Pharmacy Setting
Point-of-care testing is becoming increasingly commonplace in community pharmacy settings. These tests are often used in the management of chronic disease, such as blood sugar, hemoglobin A1c and lipid levels, but can also be used for acute conditions such as influenza infection and group A streptococcus pharyngitis. When used for these acute infections, point-of-care tests can allow for pharmacist-initiated treatment. In this study, an influenza point-of-care testing service was developed and implemented in a chain community pharmacy setting and a retrospective review was conducted to assess the service. Of patients tested, 29% tested positive for influenza A and/or B; 92% of patients testing positive received a prescription as a result. While health insurance cannot be billed for the service due to current pharmacy reimbursement practices, this did not appear to negatively affect patient willingness to participate. As point-of-care testing services become more commonplace in community pharmacy settings, patient awareness will similarly increase and allow for more widespread access to acute outpatient care
The lift industry in Hong Kong : regulatory action and capacity building
published_or_final_versionPolitics and Public AdministrationMasterMaster of Public Administratio
Measurement of low‐density lipoprotein cholesterol levels in primary and secondary prevention patients: Insights from the PALM registry
Background The 2013 American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults recommended testing low-density lipoprotein cholesterol ( LDL -C) to identify untreated patients with LDL -C ≥190 mg/dL, assess lipid-lowering therapy adherence, and consider nonstatin therapy. We sought to determine whether clinician lipid testing practices were consistent with these guidelines. Methods and Results The PALM (Patient and Provider Assessment of Lipid Management) registry enrolled primary and secondary prevention patients from 140 US cardiology, endocrinology, and primary care offices in 2015 and captured demographic data, lipid treatment history, and the highest LDL -C level in the past 2 years. Core laboratory lipid levels were drawn at enrollment. Among 7627 patients, 2787 (36.5%) had no LDL -C levels measured in the 2 years before enrollment. Patients without chart-documented LDL -C levels were more often women, nonwhite, uninsured, and non-college graduates (all P\u3c0.01). Patients without prior lipid testing were less likely to receive statin treatment (72.6% versus 76.0%; P=0.0034), a high-intensity statin (21.5% versus 24.3%; P=0.016), nonstatin lipid-lowering therapy (24.8% versus 27.3%; P=0.037), and had higher core laboratory LDL -C levels at enrollment (median 97 versus 92 mg/dL; P\u3c0.0001) than patients with prior LDL -C testing. Of 166 individuals with core laboratory LDL -C levels ≥190 mg/dL, 36.1% had no LDL -C measurement in the prior 2 years, and 57.2% were not on a statin at the time of enrollment. Conclusions In routine clinical practice, LDL -C testing is associated with higher-intensity lipid-lowering treatment and lower achieved LDL -C level
Analyzing Media Coverage of Agricultural Health and Safety Issues
Farming, by the very nature of the occupation, is riddled with uncertainty. The risks associated with the agriculture industry are just as diverse as the industry itself. For all risks, one challenge is the development and dissemination of safety communication materials tailored for diverse audiences. Valkenburg, Semetko, and Vreese (1999) examined common frames used in news media. Their analysis pointed to four commonly used news frames: conflict, human interest, responsibility and economic consequences. The purpose of this study was to describe the agricultural and health safety issues discussed in Florida news media during the year 2016, discussing the prominence of the frames outlined by Valkenburg et al. (1999). In this study, the most prominent frame was the human interest frame, followed by responsibility, economic consequences, and conflict. Frames carry a great deal of weight in shaping individuals’ opinions, attitudes, and actions towards agriculturally based messages; therefore it is essential for agricultural communicators to understand the framing of agricultural health and safety issues. Acknowledging the frames used in the reporting of agricultural issues allows agricultural communicators to enter into informed interactions with media outlets and better prepare the resources they provide to them. These framing analyses also provide agricultural communicators with a solid foundation on which to best position and frame their messaging on behalf of the industry. Further research is recommended to examine frames from an audience perspective and to investigate the impact of human interest frames in the presentation of agricultural news articles
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