Objective: Vector coding is a non-linear data analysis technique that quantifies inter-segmental coordination and coordination variability. The traditional approach of reporting time-series data from vector coding can be problematic when overlaying multiple trials on the same illustration. The objective of this study was to describe and present novel data visualisations for displaying the coordination pattern, segmental dominancy, range of motion on an angle-angle diagram, and coordination variability. This allows for a comparison of data across multiple participants with a focus on single subject analysis.

Methods: Novel data visualisation techniques that involve the use of colour and data bars to map and profile coordination pattern and coordination variability data. The introduction and profiling of inter-data point range of motion quantifies range of motion of the dominant segment on an angle-angle plot and illustrates patterns of movement control. As an example, the dataset used the Istituto Ortopedico Rizzoli foot model to describe rearfoot-forefoot and shank-foot coordination during stance.

Results: The use of colour mapping provides the option to inspect an entire dataset and to compare data across multiple participants, groups, and segment couplings. Combining coupling angle mapping with segmental dominancy profiling offers an intuitive and instant summary on coupling angle distribution. The novel inclusion of inter-data point range of motion profiling provides meaning to the interpretation of segmental dominancy data and demonstrates distinct patterns of movement control.

Conclusions: The use of colour mapping and profiling techniques highlighted differences in coordination pattern and coordination variability data across several participants that questions the interpretation and relevance of reporting group data. Colour mapping and profiling techniques are ideal reporting methods to compliment prospective multiple single-subject design studies and to classify commonalities and differences in patterns of coordination and patterns of control between individuals or trials. The data visualisation approaches in the current study may provide further insight on overuse injuries, exercise prescription and rehabilitation interventions.

Keywords: Coordination; Coupling angle mapping; Segmental dominancy profiling; Variability; Vector coding.

Most nursing journals use two or three reviewers to help the editor decide on acceptance or rejection. Although this helps give the editor a wide range of perspectives for making the acceptance decision, it sometimes results in confusion if reviewers' comments conflict rather than compliment each other. This article describes strategies reviewers can use to prevent this problem and editors and authors can use to deal with the conflicts when they occur.

The CYBERLEGs Beta-Prosthesis is an active transfemoral prosthesis that can provide the full torque required for reproducing average level ground walking at both the knee and ankle in the sagittal plane. The prosthesis attempts to produce a natural level ground walking gait that approximates the joint torques and kinematics of a non-amputee while maintaining passively compliant joints, the stiffnesses of which were derived from biological quasi-stiffness measurements. The ankle of the prosthesis consists of a series elastic actuator with a parallel spring and the knee is composed of three different systems that must compliment each other to generate the correct joint behavior: a series elastic actuator, a lockable parallel spring and an energy transfer mechanism. Bench testing of this new prosthesis was completed and demonstrated that the device was able to create the expected torque-angle characteristics for a normal walker under ideal conditions. The experimental trials with four amputees walking on a treadmill to validate the behavior of the prosthesis proved that although the prosthesis could be controlled in a way that allowed all subjects to walk, the accurate timing and kinematic requirements of the output of the device limited the efficacy of using springs with quasi-static stiffnesses. Modification of the control and stiffness of the series springs could provide better performance in future work.

The article considers the developed techniques of detection of functional activity of components C1, C2, C3, C4 and membrane attacking complex of classical pathway and also factors B and D of alternative pathway of human complement using automated device measurement of immobilizing effect on infusorians Tetrahymena pyriformis. The techniques are based on application of artificially produced reagents containing all necessary components of compliment besides testing one. The mathematical mode of activities calculation is developed. The linear dependency of velocity of infusorians immobilizing from functional activities of testing component. The relevance of techniques is demonstrated by correlation of results derived using the proposed mode with the developed earlier hemolytic mode.

When landfill leachate, with or without biological pretreatment, is discharged to publically owned treatment works (POTWs), it can interfere with the installed treatment facilities. Biological treatment is ineffective for the removal of some of the bio-refractory organic matter, including UV₂₅₄ quenching substances. Fenton's reagent treatment for biologically treated landfill leachates is examined in this study as a polishing step to make landfill leachates acceptable to POTWs. The optimum conditions for the Fenton's reagent treatment are explored. The molecular weight and hydrophobic-hydrophilic nature based fractions of the Fenton's treated leachate samples are analyzed to provide insight into the leachate fractions targeted by the Fenton's reagent. The results indicate that Fenton's reagent can act as a good compliment to biological treatment as it can remove leachate fractions which are widely considered to be bio-refractory. It exhibited good UV₂₅₄ absorbance removal by removing larger molecular weight humic substances and thus, can help solve the UV₂₅₄ quenching problem due to leachates discharged to POTWs.

This paper describes the compilation of a monograph on benefits realisation of maternity information systems from maternity services around England and Wales. It was compiled to compliment a monograph produced in June 1995 on Nursing Information Systems. The paper summarises the structure of the monograph and outlines the concept of benefits realisation. The examples featured in the monograph are not "true" benefits realisation studies and many of the accounts are anecdotal in nature. However, the paper suggests that midwives do benefit from using a maternity information system particularly in the areas of auditing practice, effortless retrieval of statistics, less duplication of data entry, summaries of care and research purposes. Managers also benefit from some of these functions and those relating to estimating workload and allocation of resources. It is suggested that any benefits for staff and management should also benefit clients and improve the provision of the maternity services.

More than 95 per cent of patients in Wales report that they feel respected by nursing staff, according to a national audit of Welsh hospitals.

OBJECTIVE

In the present study, we evaluated the electroencephalogram (EEG) and auditory N100 potential (N100) before and during propofol-induced sedation. The aim was to test whether using EEG and N100 the level of sedation may be evaluated.

METHODS

Twenty-nine cardiac surgery patients were studied. The EEG signal and the N100 potential were recorded at awake one day before the cardiac operation and two times after the operation, when the clinical level of postoperative propofol sedation was considered deep (Ramsay Score 6) and moderate (Ramsay Score 4). Discriminant analysis was used to select those spectral EEG and/or N100 variables which would predict the correct level of sedation best. The final classification was based on canonical discriminant functions and Mahalanobis' distance.

RESULTS

The spectral EEG variables (slow/fast-ratio, delta, and beta2 powers) predicted the correct level of sedation with 81% (canonical discriminant functions) and 80% (Mahalanobis' distance) accuracy. Similarly, the N100 (amplitude, latency, and the first principal component) predicted the correct level of sedation with 91% and 92% accuracy, and the combination of the EEG and N100 with 96% and 93% accuracy.

CONCLUSIONS

Our findings suggest that the combined use of EEG and N100 may help to differentiate the propofol-induced sedation levels, and thus be a useful compliment to clinical sedation scales.

Seven community-dwelling, mildly and moderately mentally retarded adults participated in a group social skills training program designed to improve conversational skills. A group multiple-baseline design was used. Conversational components trained were asking questions about the conversational partner, giving compliments, and appropriately disclosing information about oneself. Training sessions consisted of instructions, modeling, and behavioral rehearsal. Assessment during baseline and treatment consisted of recording conversations between subject dyads after each session. Generalization of training was assessed during baseline and treatment and at 1-month, 3-month, and 6-month follow-ups by recording conversations between subjects and novel, nonretarded persons. Behavioral ratings of the tapes indicated substantial improvements in the targeted behaviors as a function of training. Subjective social validity ratings of pretraining and posttraining generalization tapes by community volunteers reflected improvements in their social perceptions of subjects as a function of training. The results suggest that community-dwelling, mentally retarded adults can be taught to make changes in their conversational behavior that are viewed positively by others living in their communities.

Use of digital communication technologies (DCT) shows promise for enhancing outcomes and efficiencies in asthma care management. However, little is known about the impact of DCT interventions on healthcare personnel requirements and costs, thus making it difficult for providers and health systems to understand the value of these interventions. This study evaluated the differences in healthcare personnel requirements and costs between usual asthma care (UC) and a DCT intervention (Breathewell) aimed at maintaining guidelines-based asthma care while reducing health care staffing requirements. We used data from a pragmatic, randomized controlled trial conducted in a large integrated health system involving 14,978 patients diagnosed with asthma. To evaluate differences in staffing requirements and cost between Breathewell and UC needed to deliver guideline-based care we used electronic health record (EHR) events, provider time tracking surveys, and invoicing. Differences in cost were reported at the patient and health system level. The Breathewell intervention significantly reduced personnel requirements with a larger percentage of participants requiring no personnel time (45% vs. 5%, p < .001) and smaller percentage of participants requiring follow-up outreach (44% vs. 68%, p < .001). Extrapolated to the total health system, cost for the Breathewell intervention was $16,278 less than usual care. The intervention became cost savings at a sample size of at least 957 patients diagnosed with asthma. At the population level, using DCT to compliment current asthma care practice presents an opportunity to reduce healthcare personnel requirements while maintaining population-based asthma control measures.

Keywords: Digital communication technology; Direct costs; Health care resources; Implementation; Short acting beta-agonist; Technology intervention.

In social interactions, speakers often use their tone of voice ("prosody") to communicate their interpersonal stance to pragmatically mark an ironic intention (e.g., sarcasm). The neurocognitive effects of prosody as listeners process ironic statements in real time are still poorly understood. In this study, 30 participants judged the friendliness of literal and ironic criticisms and compliments in the absence of context while their electrical brain activity was recorded. Event-related potentials reflecting the uptake of prosodic information were tracked at two time points in the utterance. Prosody robustly modulated P200 and late positivity amplitudes from utterance onset. These early neural responses registered both the speaker's stance (positive/negative) and their intention (literal/ironic). At a later timepoint (You are such a great/horrible cook), P200, N400, and P600 amplitudes were all greater when the critical word valence was congruent with the speaker's vocal stance, suggesting that irony was contextually facilitated by early effects from prosody. Our results exemplify that rapid uptake of salient prosodic features allows listeners to make online predictions about the speaker's ironic intent. This process can constrain their representation of an utterance to uncover nonliteral meanings without violating contextual expectations held about the speaker, as described by parallel-constraint satisfaction models.

Keywords: ERPs; Irony; Nonliteral meanings; Speech communication; Vocal expression.

Grutters et al recently investigated the role of early health economic modelling of health technologies by undertaking a secondary analysis of health economic modelling assessments performed by their group. Our commentary offers a broad perspective on the potential utility of early health economic modelling to inform health technology assessment (HTA) and decision-making around reimbursement of new health technologies. Further we provide several examples to compliment Grutters and colleagues' observations.

Keywords: Australia; Early Assessment; Health Economic Modelling; Health Technology Assessment; Reimbursement.

Questionnaire returns for 225 homosexual and 233 heterosexual adult women revealed 115 cases of rape or attempted rape. Data from 78 follow-up questionnaires are summarized. About the same proportion of lesbians and heterosexuals, age 16 or over, were the object of rape. The lesbians tended to reject all men as sexual partners or companions, while the heterosexuals tended to blame themselves for not being careful. Some of the heterosexual women, age 16 to 18, interpreted the rape as a compliment to their sexual attractiveness. Girls under 16 whose assailant was a stranger are, as adults, as frequently homosexual as heterosexual. Sixteen of the 17 girls, age 4 to 16, molested or seduced (6 for a long time) by a relative or close family friend are lesbians as adults. The subjects' attitudes about the incient were highly determined by parental reactions. Inferences are drawn about the rapists' attitudes toward women.

Recent observations suggest that many physicians do not consider the bedside cardiac examination as a valuable tool in patient care. Internists, hospitalists, emergency department physicians, cardiologists, physician assistants, and nurse practitioners were interviewed to ascertain their current practice in completing the cardiac examination. In addition, we surveyed patients in a cardiology practice concerning their attitudes about the cardiac physical examination. The study found that a significant number of practitioners failed to carry out a basic cardiac examination. Most patients do not have their chest exposed. It is unusual for the patient to be examined in the lateral decubitus position or for maneuvers to be used to evaluate the significance of a murmur. Most patients were more confident in the physician when a bedside examination was carried out, and they expect to undress for the examination. Half of the patients were more secure when they were undressed if there was a attendant of the same gender in the room. Review of the medical literature suggests that when a skilled examiner completes the bedside cardiac examination, it has an excellent sensitivity and specificity to recognize clinically significant cardiac disorders. A thorough cardiac bedside examination can make an echocardiogram unnecessary in some patients and compliment the echo in every patient. In conclusion, the bedside cardiac examination is a valuable diagnostic aid for diagnosing heart disease. If on the teaching wards and in the medical journals more emphasis is placed on the importance of physical findings for diagnosing heart disease, more physicians will make the effort to perform a thorough examination.