4 research outputs found
Metadata, the undiscovered treasure box for book recommender systems for children: What traits can be inferred from book’s descriptive and structural metadata which could support the designers of books recommender systems for children?
No full textThis study examines traits that may be derived from book metadata and identifies statistically signifi- cant patterns and trends in order to assist recom- mender system designers for children’s books in selecting the most important traits to take into ac- count. This research focuses on descriptive such as publish year and structural metadata such as the chapters’ count. We rely on data from two different data sets, Goodreads and Wikisource.The findings of this study, such as the fact that there is a relationship between the number of pages and the reader’s age, may have an impact on the design of recommender systems for children’s books.This is all with the respect to the fact that children are a vulnerable audience, making it challenging to not infringe on their privacy while gathering infor- mation that can be used in statistical experiments in many fields such as education and health.CSE3000 Research ProjectComputer Science and Engineerin
A novel approach for instant implementation of Raman-based PAT with integrated real-time process control
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Exploring the context and potential benefits of implementing an Intermittent Preventive Treatment for malaria in infants (IPTi) in Papua New Guinea
No full textSummary: Background
Intermittent preventive treatment (IPTi) is an intervention aiming to reduce the
risk of malaria in infants. Its concept is to deliver a full treatment course of
antimalarial drugs to infants, three or four times during the first year of life,
following the expanded program of immunization (EPI) schedule and regardless
of clinical malaria episodes.
Mainly Sulphadoxine/pyrimthamine (SP) was studied and demonstrated to
reduce the risk of malaria by 30% in Africa, where Plasmodium falciparum (Pf) is
the predominant species. No study has been carried out in regions of the world
with a significant burden of non-Pf infections. There is therefore a need to
investigate the potential benefits of IPTi in areas, such as Papua New Guinea
(PNG), highly endemic for Plasmodium vivax (Pv) malaria.
Apart from efficacy, which is the corner stone of an intervention, it is essential to
have a clear picture of the context in which such an intervention might be
implemented. Indeed, determinants of effectiveness such as the malaria context
(epidemiology and case management), the acceptability and the access to the
intervention need to be investigated prior to the implementation of IPTi.
The present study investigates the efficacy of IPTi in PNG as well as some key
aspects of infant’s health in PNG that might help to understand the context in
which IPTi could be implemented.
Methods
Randomized controlled trial investigating the protective efficacy of 4 doses of SP
associated to 3 days of artesunate (SP-AS3) or 3 days of amodiaquine (SP-AQ3)
given at 3-month intervals during the first year of life. Most of infants were
followed-up for an additional 12 months. The study took place in Madang and
Maprik (PNG) from 2006 to 2010, but only the Madang cohort was used for the
IPTi efficacy analyses.
Making use of the morbidity passive case detection of the trial, the following
aspects of infant’s health in PNG were investigated:
· Effectiveness of treating infants with a unified treatment
(artemther/lumefantrine, AL) for Pf & Pv malaria based on the result of the
rapid diagnostic test (RDT)
· The incidence of common illnesses based on RDT and syndromic
definitions of diseases and the impact of IPTi on them.
· The performances of the integrated management childhood illness (IMCI)
supplemented with RDT & IPTi for the management of common
syndromes/diseases in PNG.
The acceptability of IPTi was also assed alongside the drug trial.
Findings
1605 infants 3 months old were enrolled in the IPTi trial, 1125 in Madang and 480
in Maprik. The intention-to-treat relative risk (RR) at 15 months of age (Madang
site only) was 0.72 (95%CI, 0.57 - 0.90) on all malaria episodes with SP-AQ3 and
0.88 (95%CI, 0.70 - 1.10) with SP-AS3, overall p=0.017. Using SP-AQ3, the RR
was 0.63 (95%CI, 0.45 - 0.88) on Pf and 0.78 (95%CI, 0.60 - 1.01) on Pv. No
difference was observed in the incidence of overall morbidity, severe diseases
and non-malarial illnesses between the placebo and IPTI intervention arms.
Fewer deaths were observed in the treatment arms compared to placebo:
placebo=8, SP-AQ3=1 and SP-AS3=3.
7223 fever episodes occurred (in Madang and Maprik) during the study and 5670
had a negative RDT result. Out of them, 133 (3.4%) re-attended the clinic within
7 days for fever, and 1 died of lower respiratory tract infection (LRTI). 23 (0.6%)
infants re-presented with a severe illness (4 with positive BS and/or RDT). 1728
children with positive RDT results were treated with artemether/lumefantrine (AL).
30 (1.7%) re-attended within 7 days for fever, none died.
Out of the total cohort, incidence rates (episodes/child/year) for common
syndromes/diseases were: 0.85 (95%CI, 0.81-0.90) for LRTI, 0.72 (95%CI, 0.65-
0.93) for gastroenteritis (GI), 0.62 for malaria (95%CI, 0.58 - 0.66) and 0.08
(95%CI, 0.07-0.09) for otitis.
The introduction of RDT led to a high accuracy of “on site” malaria diagnosis (К
=0.99). On the opposite, the clinical diagnosis accuracy for others syndromes
was poor: К=0.47 for LRTI, К=0.52 for GI and К= 0.52 for otitis.
25% of illness episodes were inappropriately treated: 6% did not receive
antibiotics when they should have and 19% received antibiotics when they should
not have (according to recommendations). The prescription’s rate of antibiotics
was 56% when the RDT for malaria was negative and 16% when the RDT was
positive (p<0.001). The acceptability of IPTi appears to be good in Melanesian
populations.
Conclusion
The use of RDT and artemether/lumefantrine is a safe and effective strategy for
the management of malaria cases in PNG and could be implemented very easily.
IPTi has demonstrated its efficacy to reduce both Pf and Pv episodes. However,
the apparent absence of benefit on the overall morbidity and on severe illnesses
is a concern and mitigates the interest of implementing this intervention in PNG.
Furthermore, other factors such as a low EPI coverage and rapidly changing
malaria endemicity due to the recent introduction in PNG of insecticide treated
nets (ITN) and artemisinin combination therapies (ACT) are likely to jeopardize
the potential benefits of IPTi in PNG. ---------- Zusammenfassung:
Hintergrund
Intermittent preventive treatment in infants (IPTi) ist eine Intervention mit dem
Ziel, das Risiko von Malaria bei Kleinkindern zu reduzieren. Sein Konzept ist den
Säuglingen Behandlung mit Malariamedikamenten, drei oder viermal während
des ersten Lebensjahres, nach dem Zeitplan des Erweitertens Programms der
Immunisierung (EPI) und unabhängig von klinischen Malaria Episoden.
Haupsächlich Sulfadoxin/pyrimthamine (SP) wurde studiert und zeigte, dass das
Risiko von Malaria um 30% in Afrika reduziert wurde, wo Plasmodium falciparum
(Pf) die vorherrschende Spezies ist. Keine Studie wurde in den Regionen der
Welt mit einer signifikanten Belastung durch nicht-Pf-Infektionen durchgeführt. Es
besteht daher ein Bedarf, die potenziellen Vorteile der IPTi in Bereichen wie
Papua-Neuguinea (PNG), hoch endemisch für Plasmodium vivax (Pv) Malaria,
zu untersuchen.
Abgesehen von Wirksamkeit, die der Grundstein für eine Intervention ist, ist es
wichtig, ein klares Bild des Kontextes zu haben, in dem ein solcher Eingriff
durchgeführt werden könnte. Tatsächlich, Determinante der Wirksamkeit wie der
Malariakontext (Epidemiologie und Case Management), die Akzeptanz und der
Zugang auf die Intervention, muss vor der Durchführung von IPTi untersucht
werden.
Die vorliegende Studie untersucht die Wirksamkeit von IPTi in PNG sowie einige
der wichtigsten Aspekte der kindlichen Gesundheit von Kleinkindern in PNG, die
helfen könnten, den Kontext, in dem IPTi implementiert werden könnte, zu
verstehen.
Methoden
Randomisierte kontrollierte Studie, die die schützende Wirkung untersucht von
vier Dosen von SP und 3 Tagen von Artesunat (SP-AS3) oder 3 Tage von
Amodiaquin (SP-AQ3) in 3-monatigen Abständen, gegeben während des ersten
Lebensyahres. Die meisten Kinder wurden für weitere 12 Monate beobachtet.
Die Studie fand in Madang und Maprik (PNG) von 2006 bis 2010 statt, aber nur
die Madang Kohorte wurde für die IPTi Wirksamkeit Analyse verwendet.
Folgende Aspekte der Gesundheit der Kleinkinder in PNG wurden untersucht,
indem die passiven Fälle der Studie registriert wurden:
• Wirksamkeit der Behandlung von Säuglingen mit einer einheitlichen
Behandlung (artemther / Lumefantrin, AL) für Pf & Pv Malaria, dem Ergebnis des
rapid diagnostic test (RDT) nach.
• Die Inzidenz von gewöhnlichen Krankheiten nach RDT und syndromalen
Definitionen von Krankheiten und die Auswirkungen von IPTi auf ihnen.
• Die Leistungen des integrierten Managementsystems Kinderkrankheiten (IMCI)
ergänzt mit RDT & IPTi für die Bewirtschaftung der gewöhnlichen Syndrome / in
PNG.
Die Akzeptanz von IPTi wurde während dieser Studie bestimmt .
Resultate
1605 3-Monate alt Säuglinge wurden in die IPTi Studie eingezogen, 1125 in
Madang und 480 in Maprik. Intention-to-treat relative Risiko (RR) bei 15 Monaten
alt betrug 0.72 (95% CI, 0.57 bis 0.90) auf allen Malariaepisoden mit SP-AQ3
und 0.88 (95% CI, 0.70 bis 1.10) mit SP-AS3, Insgesamt p = 0.017. Mit SP-AQ3
wurde das RR 0.63 (95% CI, 0.45 bis 0.88) auf Pf und 0.78 (95% CI, 0.60 bis
1.01) auf Pv. Es wurde kein Unterschied in der Inzidenz von insgesamter
Morbidität, schwere Erkrankungen und nicht-Malaria-Erkrankungen zwischen der
Placebo-und IPTi Intervention Arme beobachtet. Nur wenige Todesfälle wurden
in den Behandlungsgruppen im Vergleich zu Placebo beobachtet: Placebo = 8,
SP-AQ3 = 1 und SP-AS3 = 3 ist.
7223 Fieberepisode (in Madang und Maprik) sind während der Studie
aufgetreten und 5670 hatten einen negativen RDT. Aus ihnen, 133 (3.4%)
besuchten die Klinik innerhalb von 7 Tagen bei Fieber wieder und 1 starb an
unteren Atemwegeinfektion (LRTI). 23 (0.6%) Säuglinge kamen erneut mit einer
schweren Krankheit (4 mit positiven BS und / oder RDT). 1728 Kinder mit
positiven RDT Ergebnissen wurden mit Artemether / Lumefantrin (AL) behandelt.
30 (1.7%) besuchten die klinik innerhalb von 7 Tagen bei Fieber wieder, keiner
starb.
Von der insgesamten Kohorte waren Inzidenzraten (Episode / Kind / Jahr) für
gemeinsame Syndrome / Krankenheiten : 0.85 (95% CI, 0.81-0.90) für LRTI, 0.72
(95% CI, 0.65-0.93) für Gastroenteritis (GI), 0.62 f!ur malaria (95%CI, 0.58 - 0.66)
und 0.08 (95% CI, 0.07-0.09) für Otitis.
Die Einführung von RDT führte zu einer hohen Genauigkeit von "on site"
Malaria-Diagnose (К = 0.99). Im gegenteil, war die Genauigkeit klinischer
Diagnose für andere Syndrome schlecht : К = 0.47 für LRTI, К = 0.52 für GI und
К = 0.52 für Otitis.
25% der Krankheitsepisoden wurden unsachgemäß behandelt: 6% erhielten
keine Antibiotica, wenn sie sie haben sollten und 19% erhielten Antibiotika, wenn
sie sie nicht haben sollten (den Empfehlungen nach). Die Verschreibung von
Antibiotika war 56% wenn der RDT für Malaria negative war und 16% wenn der
RDT postiv war (p <0.001). Die Akzeptanz für IPTi scheint in melanesischen
Bevölkerung gut zu sein.
Schlussvolgernd
Die Verwendung von RDT und Artemether / Lumefantrin ist eine sichere und
wirksame Strategie für die Verwaltung der Malariafälle in PNG und könnte sehr
leicht realisiert werden. IPTi hat seine Wirksamkeit demonstriet, sowohl Pf und
Pv Episoden zu reduzieren. Allerdings ist die offensichtliche Abwesenheit von
Vorteilen auf die gesamte Morbidität und auf schwere Krankheiten ein Anliegen,
und mildert das Interesse der Durchführung dieser Intervention in PNG. Darüber
hinaus gibt es andere Faktoren, wie eine niedrige EPI Berichterstattung und die
sich rasch verändernde Malaria endemizität durch die kürzliche Einführung in
PNG von Insektiziden behandelte Moskitonetze (ITN) und Artemisinin-
Kombinationstherapien (ACT), die die potenziellen Vorteile der IPTi in PNG
gefährden könnten
What do students learn about functions? : a cross cultural study in England and Malaysia
No full textThis research study investigates the concept of function developed by a sample of
secondary and university students in England and Malaysia studying mathematics as
one of their subjects. It shows that whilst students may be able to do the 'mechanical'
parts of this concept, their grasp of the 'theoretical' nature of the function concept may
be tenuous and inconsistent.
The hypothesis is that students develop 'prototypes' for the function concept in much
the same way as they develop prototypes for concepts in everyday life. The definition
of the function concept, though given in the curriculum, proves to be inoperative, with
their understanding of the concept reliant on properties of familiar prototype examples:
those having regular shaped graphs, such as x2 or sinx, those often encountered
(possibly erroneously), such as a circle, those in which y is defined as an explicit
formula in x, and so on.
The results of the study in England revealed that even when the function concept was
taught through the formal definition, the experiences which followed led to various
prototypical conceptions. Investigations also show significant misconceptions. For
example, three-quarters of a sample of students starting a university mathematics course
considered that a constant function was not a function in either its graphical or algebraic
forms, and three quarters thought that a circle is a function.
The extension of the study in Malaysia was made with the hypothesis that there is a
significant difference between the concept as perceived to be taught and as actually
learned by the students. Although the intended curriculum emphasises conceptual
understanding, in the perceived curriculum (curriculum as understood by the teachers),
only 45% of the teachers follow this approach. The tested curriculum as reflected in the
public examination questions, only emphasises the procedural skills and the results of
the learned curriculum show that learning of functions is more consistent with the
theory of prototypical learning. Students in Malaysia develop their own idiosyncratic
mental prototypes for the function concept in much the same way as those students in
the UK
