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

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

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

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

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

Outbreak of West Nile virus causing severe neurological involvement in children, Nuba Mountains, Sudan, 2002.

An atypical outbreak of West Nile virus (WNV) occurred in Ngorban County, South Kordophan, Sudan, from May to August 2002. We investigated the epidemic and conducted a case-control study in the village of Limon. Blood samples were obtained for cases and controls. Patients with obvious sequelae underwent cerebrospinal fluid (CSF) sampling as well. We used enzyme-linked immunosorbent assay (ELISA) and neutralization tests for laboratory diagnosis and identified 31 cases with encephalitis, four of whom died. Median age was 36 months. Bivariate analysis did not reveal any significant association with the risk factors investigated. Laboratory analysis confirmed presence of IgM antibodies caused by WNV in eight of 13 cases, indicative of recent viral infection. The unique aspects of the WNW outbreak in Sudan, i.e. disease occurrence solely among children and the clinical domination of encephalitis, involving severe neurological sequelae, demonstrate the continuing evolution of WNV virulence. The spread of such a virus to other countries or continents cannot be excluded

Changes in Cognition over a 16.1 km Cycling Time Trial using Think Aloud Protocol: Preliminary Evidence.

Objectives: This study investigated cognitions of cyclists during a competitive time trial (TT) event using Think Aloud (TA) protocol analysis. Design: Single group, observational design. Method: Fifteen male and three female cyclists from the North West of England verbalised their thoughts throughout an outdoor competitive 16.1 km cycling time trial (Level 2 TA). Verbalisations were recorded using iVue Horizon 1080P camera glasses. Data was transcribed verbatim, analysed using deductive content analysis and grouped into themes: (i) Pain And Discomfort (Fatigue, Pain), (ii) External Feedback (Time, Speed, Heart Rate), (iii) Environment (Surroundings, Traffic and Other Cyclists), (iv) Pace and Distance (Pace, Distance). The number of verbalisations within each theme were analysed by distance quartile using Friedman tests to examine changes in cognitions over time. Results: Associative themes, including Fatigue and Pain, were verbalised more frequently in the earlier stages of the TT and less in the final quartile, whereas verbalisations about Distance significantly increased in the last quartile. Conclusions: This study demonstrates how a novel data collection method can capture in-event cognitions of endurance athletes. It provides an important extension to previous literature, showing how individuals may process and attend to information over time during an exercise bout. Future research should establish the relationship between performance and cognitive processes

Imaging Coulomb Islands in a Quantum Hall Interferometer

In the Quantum Hall regime, near integer filling factors, electrons should only be transmitted through spatially-separated edge states. However, in mesoscopic systems, electronic transmission turns out to be more complex, giving rise to a large spectrum of magnetoresistance oscillations. To explain these observations, recent models put forward that, as edge states come close to each other, electrons can hop between counterpropagating edge channels, or tunnel through Coulomb islands. Here, we use scanning gate microscopy to demonstrate the presence of quantum Hall Coulomb islands, and reveal the spatial structure of transport inside a quantum Hall interferometer. Electron islands locations are found by modulating the tunneling between edge states and confined electron orbits. Tuning the magnetic field, we unveil a continuous evolution of active electron islands. This allows to decrypt the complexity of high magnetic field magnetoresistance oscillations, and opens the way to further local scale manipulations of quantum Hall localized states