Fractional-Order Sensing and Control: Embedding the Nonlinear Dynamics of Robot Manipulators into the Multidimensional Scaling Method

This paper studies the use of multidimensional scaling (MDS) to assess the performance of fractional-order variable structure controllers (VSCs). The test bed consisted of a revolute planar robotic manipulator. The fractional derivatives required by the VSC can be obtained either by adopting numerical real-time signal processing or by using adequate sensors exhibiting fractional dynamics. Integer (fractional) VCS and fractional (integer) sliding mode combinations with different design parameters were tested. Two performance indices based in the time and frequency domains were adopted to compare the system states. The MDS generated the loci of objects corresponding to the tested cases, and the patterns were interpreted as signatures of the system behavior. Numerical experiments illustrated the feasibility and effectiveness of the approach for assessing and visualizing VSC systems.

A map of desire: multidimensional scaling of men's sexual interest in male and female children and adults

BACKGROUND

Men sexually interested in children of a specific combination of maturity and sex tend to show some lesser interest in other categories of persons. Patterns of men's sexual interest across erotic targets' categories of maturity and sex have both clinical and basic scientific implications.

METHOD

We examined the structure of men's sexual interest in adult, pubescent, and prepubescent males and females using multidimensional scaling (MDS) across four datasets, using three large samples and three indicators of sexual interest: phallometric response to erotic stimuli, sexual offense history, and self-reported sexual attraction. The samples were highly enriched for men sexually interested in children and men accused of sexual offenses.

RESULTS

Results supported a two-dimensional MDS solution, with one dimension representing erotic targets' biological sex and the other dimension representing their sexual maturity. The dimension of sexual maturity placed adults and prepubescent children on opposite ends, and pubescent children intermediate. Differences between men's sexual interest in adults and prepubescent children of the same sex were similar in magnitude to the differences between their sexual interest in adult men and women. Sexual interest in adult men was no more associated with sexual interest in boys than sexual interest in adult women was associated with sexual interest in girls.

CONCLUSIONS

Erotic targets' sexual maturity and biological sex play important roles in men's preferences, which are predictive of sexual offending. The magnitude of men's preferences for prepubescent children v. adults of their preferred sex is large.

Identification of Enhancers and Promoters in the Genome by Multidimensional Scaling

The positions of enhancers and promoters on genomic DNA remain poorly understood. Chromosomes cannot be observed during the cell division cycle because the genome forms a chromatin structure and spreads within the nucleus. However, high-throughput chromosome conformation capture (Hi-C) measures the physical interactions of genomes. In previous studies, DNA extrusion loops were directly derived from Hi-C heat maps. Multidimensional Scaling (MDS) is used in this assessment to more precisely locate enhancers and promoters. MDS is a multivariate analysis method that reproduces the original coordinates from the distance matrix between elements. We used Hi-C data of cultured osteosarcoma cells and applied MDS as the distance matrix of the genome. In addition, we selected columns 2 and 3 of the orthogonal matrix U as the desired structure. Overall, the DNA loops from the reconstructed genome structure contained bioprocesses involved in transcription, such as the pre-transcriptional initiation complex and RNA polymerase II initiation complex, and transcription factors involved in cancer, such as Foxm1 and CREB3. Therefore, our results are consistent with the biological findings. Our method is suitable for identifying enhancers and promoters in the genome.

Object Positioning Algorithm Based on Multidimensional Scaling and Optimization for Synthetic Gesture Data Generation

This work studies the feasibility of a novel two-step algorithm for infrastructure and object positioning, using pairwise distances. The proposal is based on the optimization algorithms, Scaling-by-Majorizing-a-Complicated-Function and the Limited-Memory-Broyden-Fletcher-Goldfarb-Shannon. A qualitative evaluation of these algorithms is performed for 3D positioning. As the final stage, smoothing filtering techniques are applied to estimate the trajectory, from the previously obtained positions. This approach can also be used as a synthetic gesture data generator framework. This framework is independent from the hardware and can be used to simulate the estimation of trajectories from noisy distances gathered with a large range of sensors by modifying the noise properties of the initial distances. The framework is validated, using a system of ultrasound transceivers. The results show this framework to be an efficient and simple positioning and filtering approach, accurately reconstructing the real path followed by the mobile object while maintaining low latency. Furthermore, these capabilities can be exploited by using the proposed algorithms for synthetic data generation, as demonstrated in this work, where synthetic ultrasound gesture data are generated.

A Study on Consumers' Visual Image Evaluation of Wrist Wearables

This study aimed to investigate consumers’ visual image evaluation of wrist wearables based on Kansei engineering. A total of 8 representative samples were screened from 99 samples using the multidimensional scaling (MDS) method. Five groups of adjectives were identified to allow participants to express their visual impressions of wrist wearable devices through a questionnaire survey and factor analysis. The evaluation of eight samples using the five groups of adjectives was analyzed utilizing the triangle fuzzy theory. The results showed a relatively different evaluation of the eight samples in the groups of “fashionable and individual” and “rational and decent”, but little distinction in the groups of “practical and durable”, “modern and smart” and “convenient and multiple”. Furthermore, wrist wearables with a shape close to a traditional watch dial (round), with a bezel and mechanical buttons (moderate complexity) and asymmetric forms received a higher evaluation. The acceptance of square- and elliptical-shaped wrist wearables was relatively low. Among the square- and rectangular-shaped wrist wearables, the greater the curvature of the chamfer, the higher the acceptance. Apparent contrast between the color of the screen and the casing had good acceptance. The influence of display size on consumer evaluations was relatively small. Similar results were obtained in the evaluation of preferences and willingness to purchase. The results of this study objectively and effectively reflect consumers’ evaluation and potential demand for the visual images of wrist wearables and provide a reference for designers and industry professionals.

Investigating the Use of Telemedicine for Digitally Mediated Delegation in Team-Based Primary Care: Mixed Methods Study

Background

Owing to the shortage of medical professionals, as well as demographic and structural challenges, new care models have emerged to find innovative solutions to counter medical undersupply. Team-based primary care using medical delegation appears to be a promising approach to address these challenges; however, it demands efficient communication structures and mechanisms to reinsure patients and caregivers receive a delegated, treatment-related task. Digital health care technologies hold the potential to render these novel processes effective and demand driven.

Objective

The goal of this study is to recreate the daily work routines of general practitioners (GPs) and medical assistants (MAs) to explore promising approaches for the digital moderation of delegation processes and to deepen the understanding of subjective and perceptual factors that influence their technology assessment and use.

Methods

We conducted a combination of 19 individual and group interviews with 12 GPs and 14 MAs, seeking to identify relevant technologies for delegation purposes as well as stakeholders’ perceptions of their effectiveness. Furthermore, a web-based survey was conducted asking the interviewees to order identified technologies based on their assessed applicability in multi-actor patient care. Interview data were analyzed using a three-fold inductive coding procedure. Multidimensional scaling was applied to analyze and visualize the survey data, leading to a triangulation of the results.

Results

Our results suggest that digital mediation of delegation underlies complex, reciprocal processes and biases that need to be identified and analyzed to improve the development and distribution of innovative technologies and to improve our understanding of technology use in team-based primary care. Nevertheless, medical delegation enhanced by digital technologies, such as video consultations, portable electrocardiograms, or telemedical stethoscopes, can counteract current challenges in primary care because of its unique ability to ensure both personal, patient-centered care for patients and create efficient and needs-based treatment processes.

Conclusions

Technology-mediated delegation appears to be a promising approach to implement innovative, case-sensitive, and cost-effective ways to treat patients within the paradigm of primary care. The relevance of such innovative approaches increases with the tremendous need for differentiated and effective care, such as during the ongoing COVID-19 pandemic. For the successful and sustainable adoption of innovative technologies, MAs represent essential team members. In their role as mediators between GPs and patients, MAs are potentially able to counteract patients’ resistance toward using innovative technology and compensate for patients’ limited access to technology and care facilities.

On the Behaviour of K-Means Clustering of a Dissimilarity Matrix by Means of Full Multidimensional Scaling

In this article, we analyse the usefulness of multidimensional scaling in relation to performing K-means clustering on a dissimilarity matrix, when the dimensionality of the objects is unknown. In this situation, traditional algorithms cannot be used, and so K-means clustering procedures are being performed directly on the basis of the observed dissimilarity matrix. Furthermore, the application of criteria originally formulated for two-mode data sets to determine the number of clusters depends on their possible reformulation in a one-mode situation. The linear invariance property in K-means clustering for squared dissimilarities, together with the use of multidimensional scaling, is investigated to determine the cluster membership of the observations and to address the problem of selecting the number of clusters in K-means for a dissimilarity matrix. In particular, we analyse the performance of K-means clustering on the full dimensional scaling configuration and on the equivalently partitioned configuration related to a suitable translation of the squared dissimilarities. A Monte Carlo experiment is conducted in which the methodology examined is compared with the results obtained by procedures directly applicable to a dissimilarity matrix.

The Unfolding Method to Explore Health-Related Quality of Life Constructs in a Chinese General Population

OBJECTIVES

Health-related quality of life (HRQOL) is a complicated concept that can be measured using multiple health items. Although HRQOL is closely associated with people's subjective assessment of their own health, a limited number of studies have investigated which health items are considered most important and relevant by the general population. Even fewer empirical studies have investigated how HRQOL is understood in non-Western populations. This study used multidimensional unfolding analysis in a Chinese general population to explore the constructs of HRQOL.

METHODS

A scoping review of Chinese generic HRQOL measures and a series of qualitative interviews produced a list of 42 potentially important health items in a Chinese cultural setting; 110 Chinese participants in face-to-face interviews ranked the health items from most important to least important. Responses were coded into a rectangular 110 × 42 matrix, and multidimensional unfolding was conducted to analyze participants' preferences for health items.

RESULTS

It was found that demographic characteristics and one's health condition affected views of HRQOL. Meanwhile, 3 health items were considered to be most important across the whole sample: sleep quality, body constitution, and spiritual appearance.

CONCLUSION

This study used a novel approach to explore how people coming from a Chinese cultural setting may perceive HRQOL and which aspects of HRQOL are most important to them. The study shows that multidimensional unfolding is a feasible approach to assess preferences in a general population. Future studies using this approach are recommended to further explore the constructs of HRQOL in other general populations.

The Scientific Impact Derived From the Disciplinary Profiles

The disciplinary profiles of the mean citation rates across 22 research areas were analyzed for 107 countries/territories that published at least 3,000 papers that exceeded the entrance thresholds for the Essential Science Indicators (ESI; Clarivate Analytics) during the period from January 1, 2009 to December 31, 2019. The matrix of pairwise differences between any two profiles was analyzed with a non-metric multidimensional scaling (MDS) algorithm, which recovered a two-dimensional geometric space describing these differences. These two dimensions, Dim1 and Dim2, described 5,671 pairwise differences between countries' disciplinary profiles with a sufficient accuracy (stress = 0.098). A significant correlation (r = 0.81, N = 107, p < 0.0001) was found between Dim1 and the Indicator of a Nation's Scientific Impact (INSI), which was computed as a composite of the average and the top citation rates. The scientific impact ranking of countries derived from the pairwise differences between disciplinary profiles seems to be more accurate and realistic compared with more traditional citation indices.

Assessing Various Control Samples for Microarray Gene Expression Profiling of Laryngeal Squamous Cell Carcinoma

Selection of optimal control samples is crucial in expression profiling tumor samples. To address this issue, we performed microarray expression profiling of control samples routinely used in head and neck squamous cell carcinoma studies: human bronchial and tracheal epithelial cells, squamous cells obtained by laser uvulopalatoplasty and tumor surgical margins. We compared the results using multidimensional scaling and hierarchical clustering versus tumor samples and laryngeal squamous cell carcinoma cell lines. A general observation from our study is that the analyzed cohorts separated according to two dominant factors: “malignancy”, which separated controls from malignant samples and “cell culture-microenvironment” which reflected the differences between cultured and non-cultured samples. In conclusion, we advocate the use of cultured epithelial cells as controls for gene expression profiling of cancer cell lines. In contrast, comparisons of gene expression profiles of cancer cell lines versus surgical margin controls should be treated with caution, whereas fresh frozen surgical margins seem to be appropriate for gene expression profiling of tumor samples.

Cooperative Localization Using Distance Measurements for Mobile Nodes

This paper considers the two-dimensional (2D) anchorless localization problem for sensor networks in global positioning system (GPS)-denied environments. We present an efficient method, based on the multidimensional scaling (MDS) algorithm, in order to estimate the positions of the nodes in the network using measurements of the inter-node distances. The proposed method takes advantage of the mobility of the nodes to address the location ambiguity problem, i.e., rotation and flip ambiguity, which arises in the anchorless MDS algorithm. Knowledge of the displacement of the moving node is used to produce an analytical solution for the noise-free case. Subsequently, a least squares estimator is presented for the noisy scenario and the associated closed-form solution derived. The simulations show that the proposed algorithm accurately and efficiently estimates the locations of nodes, outperforming alternative methods.

Color Space Geometry Uncovered with Magnetoencephalography

The geometry that describes the relationship among colors, and the neural mechanisms that support color vision, are unsettled. Here, we use multivariate analyses of measurements of brain activity obtained with magnetoencephalography to reverse-engineer a geometry of the neural representation of color space. The analyses depend upon determining similarity relationships among the spatial patterns of neural responses to different colors and assessing how these relationships change in time. We evaluate the approach by relating the results to universal patterns in color naming. Two prominent patterns of color naming could be accounted for by the decoding results: the greater precision in naming warm colors compared to cool colors evident by an interaction of hue and lightness, and the preeminence among colors of reddish hues. Additional experiments showed that classifiers trained on responses to color words could decode color from data obtained using colored stimuli, but only at relatively long delays after stimulus onset. These results provide evidence that perceptual representations can give rise to semantic representations, but not the reverse. Taken together, the results uncover a dynamic geometry that provides neural correlates for color appearance and generates new hypotheses about the structure of color space.

Indicating Care Process Quality: A Multidimensional Scaling Analysis

BACKGROUND AND PURPOSE

Resident assessments are analyzed by multidimensional scaling.

METHODS

We analyzed observer-based real care and support time in four facilities with 209 residents during two working days; resident, organizational data and pairs of residents were assessed by registered and assistant nurses regarding the dissimilarity of resident pairs. Registered- and assistant nurses dissimilarity assessments are compared to criteriabased nursing management assessment.

RESULTS

The fits of management criteria matrices as external restrictions are higher in registered nurses' than in assistant nurses' assessments. These differences disappear with low staffing.

CONCLUSION

The influence of qualification levels on assessment is affected by staffing. Low complexity of Assistant Nurses assessments is connected to higher nursing care and support time in groups of demanding residents.

Similarity as a Window on the Dimensions of Object Representation

Hebart et al. recently analysed 1.5 million human similarity judgments and found that natural objects are described by a small set of interpretable dimensions. Such large-scale analyses offer new opportunities to characterise how people represent their knowledge, but also challenges, including scaling to even larger data sets and integrating accounts of semantic representation.

Fractal and Entropy Analysis of the Dow Jones Index Using Multidimensional Scaling

Financial time series have a fractal nature that poses challenges for their dynamical characterization. The Dow Jones Industrial Average (DJIA) is one of the most influential financial indices, and due to its importance, it is adopted as a test bed for this study. The paper explores an alternative strategy to the standard time analysis, by joining the multidimensional scaling (MDS) computational tool and the concepts of distance, entropy, fractal dimension, and fractional calculus. First, several distances are considered to measure the similarities between objects under study and to yield proper input information to the MDS. Then, the MDS constructs a representation based on the similarity of the objects, where time can be viewed as a parametric variable. The resulting plots show a complex structure that is further analyzed with the Shannon entropy and fractal dimension. In a final step, a deeper and more detailed assessment is achieved by associating the concepts of fractional calculus and entropy. Indeed, the fractional-order entropy highlights the results obtained by the other tools, namely that the DJIA fractal nature is visible at different time scales with a fractional order memory that permeates the time series.

Multivariate Statistical Analysis and Odor-Taste Network To Reveal Odor-Taste Associations

Odor-taste association has been successfully applied to enhance taste perception in foods with low sugar or low salt content. Nevertheless, selecting odor descriptors with a given associated taste remains a challenge. In the aim to look for odors able to enhance some specific taste, we tested different multivariate analyses to find links between taste descriptors and odor descriptors, starting from a set of data previously obtained using gas chromatography/olfactometry-associated taste: 68 odorant zones described with 41 odor descriptors and 4 taste-associated descriptors (sweetness, saltiness, bitterness, and sourness). A partial least square analysis allowed for identification of odors associated with a specific taste. For instance, odors described as either fruity, sweet, strawberry, candy, floral, or orange are associated with sweetness, while odors described as either toasted, potato, sulfur, or mushroom are associated with saltiness. A network representation allowed for visualization of the links between odor and taste descriptors. As an example, a positive association was found between butter odor and both saltiness and sweetness. Our approach provided a visualization tool of the links between odor and taste description and could be used to select odor-active molecules with a potential taste enhancement effect based on their odor descriptors.

The Action System Model: A Typology of Spanish Homicides

The Action System model offers a scientific foundation to the differentiation and classification of crimes, based on behavioral indicators, allowing the establishment of relationships between the actions carried out by the offender on the crime scene and their characteristics. Although it was originally developed for application to fires, its utility has been tested in distinct criminal typologies, with few studies having considered homicides. The objective of this study was to examine the effectiveness and validity of the Action System model to differentiate thematically between the structure of the homicides and to create a typology of simple homicides in Spain, based on the relationships between the modus operandi, characteristics of the victims and characteristics of the offenders. The sample consisted of 448 homicides. Four homicide typologies were identified: Expressive, Adaptive, Integrative and Conservative, which represent 87.5% of the studied cases. Expressive homicides are impulsive, with offenders having criminal records and previously knowing their victims. Adaptive homicides are linked to robberies and sexual aggressions, in which the victim and offender are strangers. Integrative homicides take place in the family environment, specifically female offenders and femicides. Conservative homicides are very well planned, highlighting the presence of post mortem actions. The findings of this work suggest that the Action System model is a useful theoretical framework for the identification of variations in criminal behavior and understanding of the psychological processes underlying the homicides. These results have practical implications in the academic setting, since they offer a global perspective as to how simple homicides in Spain may be differentiated, also within the framework of criminal profiling, specifically, suspect prioritization.

The Barts Explanatory Model Inventory for Dementia: An item reduction approach based on responses from South Asian communities

BACKGROUND

Cultural differences in how the symptoms, causes, consequences, and treatments of dementia are understood and interpreted by South Asian people are a commonly expressed reason for late- or nonuse of mental health and care services. However, systematic collection of information on South Asian perceptions of dementia is hindered by a lack of appropriate instrumentation.

OBJECTIVES

To produce a shortened version of the Barts Explanatory Model Inventory for Dementia (BEMI-D) schedule.

METHODS

A two stage item reduction approach was employed first using multidimensional scaling categorizing items as core, intermediate, or outlier. Then, item review was undertaken using three criteria: literature importance, clinical face validity, and sub-group prevalence. The analysis followed a nonmetric multidimensional scaling method based on a two-way proximity matrix.

RESULTS

The original BEMI-D had 197 items allocated to four checklists: symptoms, causes, consequences, and treatments. The two stage item reduction approach resulted in the removal of 75 items. These reductions were achieved across all four checklists in relatively equal proportions. There was no evidence of substantive content loss in the revised schedule. The reduced version of the schedule comprises 122 items.

CONCLUSIONS

A condensed version of the BEMI-D is more efficient as an assessment schedule that captures the culturally diverse perceptions of memory problems for South Asians offering a balanced trade-off between feasibility of use and content validity.

Combining Associations Between Emotional Intelligence, Work Motivation, and Organizational Justice With Counterproductive Work Behavior: A Profile Analysis via Multidimensional Scaling (PAMS) Approach

The need for better incorporation of the construct emotional intelligence (EI) into counterproductive work behavior (CWB) research may be achieved via a unified conceptual framework. Accordingly, the purpose of this paper is to use the Profile Analysis via Multidimensional Scaling (PAMS) approach, and a conceptual framework that unifies motivational process with antecedents and outcomes, to assess differences in EI concerning a variety of constructs: organizational justice, CWB, emotional exhaustion, job satisfaction, and intrinsic motivation. Employing established scales within a framework unifying CWB, intrinsic motivation, EI, organizational justice, and outcome constructs, two EI-based profiles displayed associations with CWB based on responses from 3,293 employees. Both the first core profile, high overall justice and low emotional intelligence, and the second core profile, high emotional intelligence and low work motivation, displayed associations with interpersonal deviance and organizational deviance, as well as emotional exhaustion and job satisfaction. The results are discussed with respect to possible underlying theory and an overarching unified motivation framework that incorporates goal choice, intrinsic motivation, antecedents, and outcomes. We also provide directions for future research and implications for managers in the workplace based on heuristic conceptual frameworks that combine multiple motivational perspectives into a unified model.

Latent Feature Extraction for Process Data via Multidimensional Scaling

Computer-based interactive items have become prevalent in recent educational assessments. In such items, detailed human-computer interactive process, known as response process, is recorded in a log file. The recorded response processes provide great opportunities to understand individuals' problem solving processes. However, difficulties exist in analyzing these data as they are high-dimensional sequences in a nonstandard format. This paper aims at extracting useful information from response processes. In particular, we consider an exploratory analysis that extracts latent variables from process data through a multidimensional scaling framework. A dissimilarity measure is described to quantify the discrepancy between two response processes. The proposed method is applied to both simulated data and real process data from 14 PSTRE items in PIAAC 2012. A prediction procedure is used to examine the information contained in the extracted latent variables. We find that the extracted latent variables preserve a substantial amount of information in the process and have reasonable interpretability. We also empirically prove that process data contains more information than classic binary item responses in terms of out-of-sample prediction of many variables.

Characterizing Y-STRs in the Evaluation of Population Differentiation Using the Mean of Allele Frequency Difference between Populations

Y-chromosomal short tandem repeats (Y-STRs) are widely used in human research for the evaluation of population substructure or population differentiation. Previous studies show that several haplotype sets can be used for the evaluation of population differentiation. However, little is known about whether each Y-STR in these sets performs well during this procedure. In this study, a total of 20,927 haplotypes of a Yfiler Plus set were collected from 41 global populations. Different configurations were observed in multidimensional scaling (MDS) plots based on pairwise genetic distances evaluated using a Yfiler set and a Yfiler Plus set, respectively. Subsequently, 23 single-copy Y-STRs were characterized in the evaluation of population differentiation using the mean of allele frequency difference (mAFD) between populations. Our results indicated that DYS392 had the largest mAFD value (0.3802) and YGATAH4 had the smallest value (0.1845). On the whole, larger pairwise genetic distances could be obtained using the set with the top fifteen markers from these 23 single-copy Y-STRs, and clear clustering or separation of populations could be observed in the MDS plot in comparison with those using the set with the minimum fifteen markers. In conclusion, the mAFD value is reliable to characterize Y-STRs for efficiency in the evaluation of population differentiation.

Multidimensional Timbre Spaces of Cochlear Implant Vocoded and Non-vocoded Synthetic Female Singing Voices

Many post-lingually deafened cochlear implant (CI) users report that they no longer enjoy listening to music, which could possibly contribute to a perceived reduction in quality of life. One aspect of music perception, vocal timbre perception, may be difficult for CI users because they may not be able to use the same timbral cues available to normal hearing listeners. Vocal tract resonance frequencies have been shown to provide perceptual cues to voice categories such as baritone, tenor, mezzo-soprano, and soprano, while changes in glottal source spectral slope are believed to be related to perception of vocal quality dimensions such as fluty vs. brassy. As a first step toward understanding vocal timbre perception in CI users, we employed an 8-channel noise-band vocoder to test how vocoding can alter the timbral perception of female synthetic sung vowels across pitches. Non-vocoded and vocoded stimuli were synthesized with vibrato using 3 excitation source spectral slopes and 3 vocal tract transfer functions (mezzo-soprano, intermediate, soprano) at the pitches C4, B4, and F5. Six multi-dimensional scaling experiments were conducted: C4 not vocoded, C4 vocoded, B4 not vocoded, B4 vocoded, F5 not vocoded, and F5 vocoded. At the pitch C4, for both non-vocoded and vocoded conditions, dimension 1 grouped stimuli according to voice category and was most strongly predicted by spectral centroid from 0 to 2 kHz. While dimension 2 grouped stimuli according to excitation source spectral slope, it was organized slightly differently and predicted by different acoustic parameters in the non-vocoded and vocoded conditions. For pitches B4 and F5 spectral centroid from 0 to 2 kHz most strongly predicted dimension 1. However, while dimension 1 separated all 3 voice categories in the vocoded condition, dimension 1 only separated the soprano stimuli from the intermediate and mezzo-soprano stimuli in the non-vocoded condition. While it is unclear how these results predict timbre perception in CI listeners, in general, these results suggest that perhaps some aspects of vocal timbre may remain.

Evaluating the implementation and use of the regional cancer plan in Western Sweden through concept mapping

QUALITY PROBLEM OR ISSUE

Within healthcare, policy documents are often used to strategically standardize, streamline or change how general health issues are managed for a specific patient group or treatment. Despite significant effort in developing policy and strategic planning documents, these may not have the intended impact and their value has long been questioned by practitioners.

CHOICE OF SOLUTION

To identify barriers and affordances for the implementation and use of a strategic plan for cancer care in the Western Sweden Healthcare Region, we used Concept Mapping; a participatory mixed method approach to inquiry consisting of both qualitative and quantitative tasks intended to elicit and integrate the diverse perspectives of multiple stakeholders.

IMPLEMENTATION

The study was carried out between April and October 2017 and consisted of several sequential data collection steps: idea generation, sorting and rating ideas for importance and feasibility. Stakeholders from different levels and professions in cancercare participated, but the number varied in the separate steps of data collection: idea generation (n = 112), sorting (n = 16) and rating (n = 38).

EVALUATION

A concept map visualized seven areas that stakeholders throughout the cancer-care process considered necessary to address in order to enable the implementation of the plan. Skills provision was considered the most important cluster but also rated as least feasible. A consistent theme emerged that information, or lack thereof, might be a barrier for the plan being put into action to a greater extent in the cancer-care units. Nine actionable ideas rated highly on both importance and feasibility were presented as a go-zone.

LESSONS LEARNED

Our results suggest that efforts might be better spent on ensuring information about and accessibility to strategic documents throughout the organization, rather than frequently updating them or producing new ones. Having sufficient skills provision seems to be the prerequisite for successful implementation.

Time frame, problem specificity, and framing: the implicit structures of questions about memory in older adults

Objective: Self-reported memory complaints in older adults are common and may be an early indicator of future cognitive decline or dementia. However, there is wide variety in self-reported memory items that lack consensus on what they intend to measure. This study explored the perspectives of older adults on items currently used to assess self-reported memory.Method: A convenience sample of community dwelling older adults (n = 51) completed a free card sorting task of 16 commonly used items assessing self-reports of memory problems. Multidimensional scaling (MDS) was used to extract dimensions that describe the similarities among the self-reported items. Visual maps were created to interpret the content of each dimension and validity of the dimensions was checked using the labels provided by the participants.Results: Three underlying dimensions describing the items were identified: time frame, problem specificity, and framing. These dimensions were supported by participant provided labels.Conclusion: The three identified dimensions suggest that the commonly used self-reported memory items assess substantively different aspects of the same broad concept. To avoid inconsistencies in assessing self-reported memory problems in older adults, we recommend researchers specify the aspects of memory problems that they are interested in and link their items to those aspects. In addition, they should develop items that are a good match to their research question rather than simply selecting items that are commonly used or appear to have high face validity.

Successful Suicide Screening in the Pediatric Emergency Department: Youth, Parent, Researcher, and Clinician Perspectives

The purpose of this study was to include youth, parents, researchers, and clinicians in the identification of feasible and acceptable strategies for teen suicide screening in the pediatric emergency department (ED). Concept mapping methodology was used to elicit stakeholder responses. Regarding the most important result of suicide screening for teens in the pediatric ED, suicide prevention and education for parents, friends, and community members was rated easiest to implement, while short- and long-term follow-up and treatment was rated most important. In terms of successful suicide screening for teens in the pediatric ED, provision of resources and information was rated most feasible, and a safe, friendly, private screening environment was rated most important. The concept maps can be used to align suicide risk screening with the priorities and recommendations of pediatric ED stakeholders.