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Diagnostic accuracy of the 4AT for delirium detection in older adults: systematic review and meta-analysis
No full textObjective: Detection of delirium in hospitalised older adults is recommended in national and international guidelines.
The 4 ‘A’s Test (4AT) is a short (<2 minutes) instrument for delirium detection that is used internationally as a standard
tool in clinical practice. We performed a systematic review and meta-analysis of diagnostic test accuracy of the 4AT for
delirium detection.
Methods: We searched MEDLINE, EMBASE, PsycINFO, CINAHL, clinicaltrials.gov and the Cochrane Central Register
of Controlled Trials, from 2011 (year of 4AT release on the website www.the4AT.com) until 21 December 2019. Inclusion
criteria were: older adults (≥65 years); diagnostic accuracy study of the 4AT index test when compared to delirium reference
standard (standard diagnostic criteria or validated tool). Methodological quality was assessed using the Quality Assessment
of Diagnostic Accuracy Studies-2 tool. Pooled estimates of sensitivity and specificity were generated from a bivariate random
effects model.
Results: Seventeen studies (3,702 observations) were included. Settings were acute medicine, surgery, a care home and the
emergency department. Three studies assessed performance of the 4AT in stroke. The overall prevalence of delirium was 24.2%
(95% CI 17.8–32.1%; range 10.5–61.9%). The pooled sensitivity was 0.88 (95% CI 0.80–0.93) and the pooled specificity
was 0.88 (95% CI 0.82–0.92). Excluding the stroke studies, the pooled sensitivity was 0.86 (95% CI 0.77–0.92) and the pooled specificity was 0.89 (95% CI 0.83–0.93). The methodological quality of studies varied but was moderate to good
overall.
Conclusions: The 4AT shows good diagnostic test accuracy for delirium in the 17 available studies. These findings support
its use in routine clinical practice in delirium detection
Embedded Reddit - An investigation into improved information extraction from Reddit through word embeddings
No full textSocial media has increasingly become a de facto source of information for people seeking to inform themselves on current events. Traditionally there has always been a centralised source such as news-papers or news broadcasts which are curated by editors to ensure information integrity, social media sourced information may not have been created with the same investigative rigour that one would find from an official source. Natural Language Processing (NLP) is used for automated extraction of information from text. However, it has been developed on standardised text and so does not perform as well in noisy environments, as one would find in social media sourced text. This thesis aims to address this by exploring pre-processing approaches to improve the representation of the data.In addition to being a noisy source of information, social media sourced information contains many comments that agree, disagree and some that would not be applicable to a given information need.The first experiment aims to address this by linking comments with information found from an official source. A comparison is made between Reddit and Twitter as potential sources of auxiliary information. In this thesis Reddit is used as the social media source of information. This thesis documents how one can connect comments made on-line with official sources. Issues that arise from this are related to intended meaning; how does one know what context a term is used in when comments have been extracted from a thread of similar comments? Through use of graphs it is shown how term embedding can be created from social media content to extrapolate meaning in comments. Utilising principles of distributional semantics one can increase the cohesion of a number of related comments by defining their intended use. This is commonly referred to as Word Sense Disambiguation (WSD).There are a number of issues that one must address when relying on social media data, such as an abundance of diverse opinion that is expressed in an ad hoc manner. It is challenging to determine which comments contain pertinent information for a user. Additionally, one is faced with other NLP issues such as: sense disambiguation, accurate topic extraction and text processing in addition to social media related issues such as poor grammar, misspelling and use of colloquial language. The second experiment addresses this issue by creating more cohesion in clusters of comments. This can facilitate knowledge extraction by identifying highly related comments which
can be aggregated with the aim of identifying some consensus.The third experiment looks to build on the second by doing a deeper analysis on the created clusters. Comment length is considered and an introduction of more in-depth analysis on the results of the proposed pre-processing approach is made. In creating greater cluster cohesion a graph-based approach for representing data is employed. This differs from many alternative approaches that look to create word embeddings to capture context, which would ordinarily be done through a vector representation of information. Through use of a graph representation, it is possible to retain a lot of the information of the original text that can later be queried for more clarification. In the final experiment I look at employing a graph-based method, analysing the impact of altering various parameters such as stopword removal, reference expansion, acronym expansion, stemming and use of sentence deliminators to inform graph construction. Taken together this thesis looks to model information found on social media sources for extracting pertinent information. The application of such an approach could be used to rapidly inform oneself on an event in real tim
Implementing school-based social and emotional learning programmes: Recommendations from research (Practice brief)
No full text[No abstract available
Residential ventilation and health
No full textAIVC Technical Note 68 (TN 68) "Residential Ventilation and Health is one of the outcomes of the work performed under the framework of AIVC s project Ventilation & Health and benefited from contributions by several authors and many structured discussions held during specific sessions at AIVC events. TN 68 summarised studies that prioritise pollutants in the indoor environment and presented a summary of pollutants driving the indoor health risks and their sources. The document also described methods to reduce exposures of contaminants using different control strategies with a special emphasis on the role of ventilation. To ease the dissemination of this key AIVC publication, the AIVC Board agreed to develop this Ventilation Information Paper (VIP) briefly presenting the technical note s key outcomes.
The document starts with an overview of pollutants in domestic dwellings that have been measured, prioritizes pollutants for mitigation in the indoor environment and identifies potential health outcomes. Furthermore, it describes control strategies to reduce health effects from these and other pollutants, including different strategies to reduce exposure and the role of ventilation. The last part of the document lists the research needs
Reducing Sedentary Behaviour in the Workplace: A Theory-led Multicomponent Intervention
No full textThere is strong evidence demonstrating that there is a relationship between greater time spent in sedentary behaviour (SB) and greater all-cause mortality, cardiovascular disease mortality and incidence, type 2 diabetes incidence, and incidence of colon, endometrial, and lung cancer. The use of multi-level interventions developed using participative approaches targeted at specific at-risk subgroups can be helpful in reducing SB.
Objectives and methods
The aim of this PhD research was to develop, implement and evaluate an evidence-based pilot intervention to reduce SB in an adult male population, guided by the socio-ecological model throughout. A multiphase mixed method design was applied to achieve four objectives. The first was to describe the prevalence and correlates of domain-specific prolonged SB using secondary analysis of an Irish cohort dataset. The second objective was to explore the barriers and facilitators to reducing SB in the workplace setting in which most SB occurs using a qualitative approach. The third objective was to adopt a qualitative participatory approach in the development of a workplace pilot intervention to reduce SB in two worksites, with managers and employees. The fourth objective was to test the acceptability and feasibility of a small-scale theory-based intervention to reduce SB in a workplace population using mixed methodology to collect objective and subjective data. The primary outcomes of the study were acceptability and feasibility of assessments, study procedures and processes from an employee and management perspective, recruitment and retention, and a qualitative evaluation of participants perspectives of the intervention overall.
Main findings
The results of Study 1 revealed that Irish adults (n= 7,328) self-reported a median daily sitting time of 450 minutes/day (7.5 hours), and the workplace was the context in which most sitting occurred (>3 hours/day). Males, with third level educational attainment, with professional occupations, and who lived in an urban location reported the longest sitting times (mean 497.6 mins/day; SD 192). The findings informed the choice of the target population and setting of Study 2, which explored professional men s perceptions of the barriers and facilitators to reducing workplace SB. Study 2 demonstrated that the primary barrier to reducing workplace SB in professional men (n=23) was the primacy of work, we have to get through the day s work so that s the reality at the end of the day . The main facilitating factor was the motivation to break up prolonged sedentary behaviour as a result of the increased awareness of the dangers garnered from the education session, and the level of PA needed to attenuate the risks, that you have to do 70-90 minutes a day of exercise to offset 6 hours of sitting down, I mean that s pretty stark . Ensuring minimal impact on work productivity and capacity was an important facilitator to employees and managers, as long as we can fit in that and everyone is still as productive as they are today, or more in some ways hopefully, I don t have an issue .
Flexible and supportive management staff was a key facilitator for employees to reduce their SB at an organisational level. Employees acknowledged, [managers] encourage us to do various things to achieve that and make us happier, if you re happier, you re healthier . At an environmental level, the restrictive traditional work desk was a barrier to movement, and an an alternative as opposed to sitting was sought by participants to aid the reduction of occupational SB. Active sitting as opposed to reduced sitting was favoured by the participants, [if] there s things you can do while you re at your desk, while still getting through your work, [I d be] 100% be behind it .
The results of the participative approach in Study 2 confirmed that participants were supportive of each proposed intervention component, and of the study overall. Participants confirmed the appropriateness of the pedal device, It s a very good idea. It s very subtle . The mHealth component using a physical activity tracker watch and its associated platform to target behaviour change techniques was of interest and deemed acceptable to the participants in both worksites. The study design and measures overall were concluded as acceptable, context-appropriate and suitable to the target users in both worksites, they re not invasive in your life or in your working day so I can t see any barriers, I can only see benefits to be honest .
The pilot feasibility study was developed using the socio-ecological model. The results of Study 3 showed that the intervention, as well as the trial processes were somewhat acceptable and feasible to conduct (n=21). Trial-related accelerometry outcome measures were collected from 85.5% of participants. Recruitment rate was 40% at cluster level, and at an individual level 73.3% of target sample were recruited. Retention was 95% from baseline to post-intervention (8-weeks). The main intervention benefit was an increase of the awareness of the dangers of SB, at both management and employee level, definitely think because we were doing the study it would make you think about moving . Minimal impact on productivity from pedalling was observed from a management perspective, is it disrupting their productivity? I have to say they were doing it as they were working . The main intervention barriers were time priorities and the sometimes uncomfortable ergonomic set up of the pedal machine, with some participants expressing that this was too difficult to overcome at times and would require assistance in future studies. Mean cycling time was 27 minutes/day (SD 10.23) in the intervention period. Workplace SB was reduced by 20.4 minutes/day, and total weekday SB reduced by 45.7 minutes/day in the intervention period compared to the control period.
Conclusion
This intervention was the first of its kind to specifically target this at-risk sub-group population and address the main influences of workplace SB pertinent to them. This PhD research presents a formative, iterative, participatory, and evidence-based multicomponent approach that was guided by the socio-ecological model at all stages of the research design, development, and evaluation. The study has demonstrated the acceptability of a multicomponent intervention to reduce workplace SB in professional men. However, considerable assistance with the ergonomic set-up of the pedal device, and automatic recording of pedalling bouts are required before future implementation as an initiative to reduce workplace SB. This thesis provides important exploratory findings, and key considerations for researchers to utilise in behaviour change interventions to reduce occupational SB, detailing barriers and issues that should be attended to in future evaluations
A Non-Intrusive and Incremental Approach to Enabling Direct Communications in RPC-based Grid Programming Systems
No full textThis paper advocates a non-intrusive and incremental approach to enabling existing Grid programming systems with new features. In particular, it presents a software component enabling NetSolve applications with direct communications between remote tasks. The software component is a supplementary one working on the top of the basic NetSolve system. Its design also allows remote tasks to be freely mixed in a single application, independent on whether each particular task is enabled for direct communications or not. Experiments with this software are also presented
Protein Backbone Angle Prediction in Multidimensional φ-ψ Space
No full textA significant step towards establishing the structure and function of a protein is the prediction of the local conformation of the polypeptide chain. In this article we present systems for the prediction of 3 new alphabets of local structural motifs. The motifs are built by applying multidimensional scaling (MDS) and clustering to pair-wise angular distances for multiple φ-ψ angle values collected from high-resolution protein structures. The predictive systems, based on ensembles of bidirectional recurrent neural network architectures, and trained on a large non-redundant set of protein structures, achieve 72%, 66% and 60% correct structural motif prediction on an independent test set for di-peptides (6 classes), tripeptides (8 classes) and tetra-peptides (14 classes), respectively, 28-30% above base-line statistical predictors. To demonstrate that structural motif predictions contain relevant structural information, we build a further system, based on ensembles of two-layered bidirectional recurrent neural networks, to map structural motif predictions into traditional 3-class (helix, strand, coil) secondary structure. This system achieves 79.5% correct prediction using the “hard” CASP 3-class assignment, and 81.4% with a more lenient assignment, outperforming a sophisticated state-of-the-art predictor (Porter) trained in the same experimental conditions. All the predictive systems will be provided free of charge to academic users and made publicly available at the address http://distill.ucd.ie/.Health Research BoardIrish Research Council for Science, Engineering and TechnologyScience Foundation IrelandUCD President’s Award 200
A higher-order programmable amplitude and timing error shaping bandpass DEM for Nyquist-rate D/A converters
No full textThis paper presents a programmable amplitude and timing error shaping bandpass dynamic- element-matching (DEM) for Nyquist-rate D/A converters. Amplitude and timing-skew errors are shaped using two different loop-filters employed within the DEM structure. The systematic-duty-cycle errors are eliminated from the DAC spectrum using a controlled set of \u27ON\u27 transitions for any choice of the input-signal over the Nyquist band. The loop-filter order within the DEM can be selected to 2, 4 or 6 and the DAC errors can be shaped over a narrow or wide band for any choice of center-frequency. This work demonstrates that for a 12bit segmented Nyquist DAC (5T-7B), the in-band SFDR and IMD3 is >80dBs for the DEM configurationsSUBMITTEDnon-peer-reviewe
Application of the CDIO Standard for teaching the Architectural Composition Subject with a practice competition about green architecture at Ho Chi Minh City University of Technology, Vietnam
No full textInnovative teaching methods is a matter of great concern to many universities in Vietnam, especially in the context that higher education in the world is changing and requiring higher standards of graduates. To meet the needs of businesses and keep up with the sustainable education standards in the world, universities in Vietnam have to make improvements in teaching methods. CDIO is an international standard system for training engineering students that has been applied in many developed countries around the world. In Vietnam, the Ho Chi Minh City University of Technology (HUTECH) has started to implement this method and this has brought positive results. This article introduces the experience of applying CDIO in university teaching around the world, as well as solutions for applying CDIO in teaching the Architectural Composition Subject for architecture students at the Faculty of Architecture and Art. The end result of this is that second-year students groups will complete a competition for architectural design called: "Feeling the natural beauty in the heart of the city - Finding the natural awakening design solutions" by TOTO Information Center organized, inspired by an architect Takaharu Tezuka from Japan. The purpose of this application is to improve teaching quality, improve the curriculum to help students approach practical architectural competitions, and ensure they can meet the requirements of sustainable design after graduation
Conceptualizing Industry 4.0 readiness model dimensions: an exploratory sequential mixed-method study
No full textPurpose
Organizations use Industry 4.0 readiness models to evaluate their preparedness prior to the implementation of Industry 4.0. Though there are many studies on Industry 4.0 readiness models, the dimensions of readiness differ. Besides, there is no study empirically validating the readiness model in different sectors or types of organization. The purpose of this study is to conceptualize the dimensions of the Industry 4.0 readiness model and subsequently evaluate the criticality of these dimensions in manufacturing, service, small and medium-sized enterprises (SMEs) and large enterprises (LEs).
Design/methodology/approach
The study uses an exploratory sequential mixed method design. In phase one, 37 senior managers participated through a purposive sampling frame. In phase two, 70 senior managers participated in an online survey.
Findings
The results of the study indicated that the Industry 4.0 readiness model has 10 dimensions. Further, the criticality of the dimensions as applied to different sectors and type of organizations is put forward. This study will help manufacturing, services, SMEs and LEs to evaluate Industry 4.0 readiness before commencing the deployment of Industry 4.0.
Practical implications
The findings can be very beneficial for Industry 4.0 practitioners and senior managers in different organisations to understand what readiness dimensions need to be considered prior to implementation of Industry 4.0 technology.
Originality/value
This paper makes an attempt to conceptualize the Industry 4.0 readiness model and utilizes an exploratory mixed method for critically evaluating the dimensions related to the model