Steve George - Academia.edu (original) (raw)

Papers by Steve George

Pacific Rim Conference on Multimedia, Dec 15, 2003

Compression algorithms have a constant tradeoff between higher compression ratios at the cost of ... more Compression algorithms have a constant tradeoff between higher compression ratios at the cost of better quality. The number of bits assigned in the standard MPEG encoders is controlled by the signal to masking thresholds and the scalefactor calculations performed in the psychoacoustic model of the algorithm. The developed algorithm assigns lower bits to audio samples without significant degradation in quality.

Journal of Cardiovascular Magnetic Resonance, 2015

Epidemiology and community health

2015 Integrated Communication, Navigation and Surveillance Conference (ICNS), 2015

Single POC for All-Things UAS • To promote UAS-NAS integration, the FAA established a division-le... more Single POC for All-Things UAS • To promote UAS-NAS integration, the FAA established a division-level organization reporting to the Director of Flight Standards • Single agency executive focal point • Matrixed organization with staff from Air Traffic and Flight Standards • Primary sponsoring office for FAA UAS research and development • Coordinates Certificate of Waiver or Authorization (COA) processing • Publishes UAS Civil Integration Roadmap • Processes Section 333 petitions for exemption.

British journal of cancer, Jan 9, 2006

To investigate the relationship between survival in colorectal cancer patients and the number of ... more To investigate the relationship between survival in colorectal cancer patients and the number of lymph nodes examined by a pathologist, previously attributed to stage migration, we used data from a cohort of 5174 colorectal cancer patients recruited between September 1991 and August 1994, and followed-up for 5 years. We selected cases with data present on all prognostic variables, and stratified them into three groups by number of nodes examined. We made a multivariate survival comparison using a Cox regression model. In all, there were 3592 cases with data present on all prognostic variables. Patients who had >10 nodes identified had a significant survival advantage over those who had 5-10 identified, who had in turn a similar advantage over those with 0-4 identified (P<0.001). This effect was present in the whole group and at all Dukes' stages, although statistically significant only in stages B (P=0.004) and C (P=0.019). The effect remained after adjustment in a Cox reg...

The International Journal of Human Rights, 1998

‘Everyone has the right to a standard of living adequate for the health and well being of himself... more ‘Everyone has the right to a standard of living adequate for the health and well being of himself and of his family’ (Article 25, Universal Declaration of Human Rights). In this article, we examine the past determinants of health in the United Kingdom, the rise of public health and the impact medical technology has had on health. We discuss the

International Journal of Nursing Studies, 1992

This paper takes a broad view of the work involved in pilot studies of evaluation research. Drawi... more This paper takes a broad view of the work involved in pilot studies of evaluation research. Drawing on their experience of preparation for a field experiment in a British Accident and Emergency department, which was to evaluate the effectiveness of a nurse triage system, the authors stress the importance of careful observation of the system to be studied, in the environment in which it is to be studied. In addition, the usual evaluations of research instruments which comprise formal pilot studies are included.

BACKGROUND Construction of new homes and businesses is a continuous process in rapidly growing ur... more BACKGROUND Construction of new homes and businesses is a continuous process in rapidly growing urban areas such as the Dallas metropolis. Post-construction landscaping is usually approached from only the plant-selection viewpoint and little effort is devoted to the severely disturbed soil. Subsoil and construction debris are often mixed with or completely replace the original top soil. Although ornamental plants and turf grasses planted in these disturbed soils may perform well in the short term due to abundant watering and fertilization, they frequently decline with time when heat and drought stress become prevalent. Dairy manure compost (DMC) is a readily available soil organic matter amendment in many areas due to the presence of large dairy operations. These dairy operations need alternative ways to dispose of their manure because soils surrounding the diary operations are often elevated in soil P. Consequently, dairy farmers and state regulatory agencies are considering urban m...

Public Health, 1994

A census of single homeless people was carried out over a single 12-hour period in Sheffield. Pla... more A census of single homeless people was carried out over a single 12-hour period in Sheffield. Places of residence of homeless people were identified by local workers with homeless people. Participants completed a questionnaire designed to provide data relating to their demography, employment history, contact with welfare agencies, social status, prison history, past and family medical history, contact with health services, perceived health status as measured by the Nottingham Health Profile, and anxiety and depression measured using the Foulds Delusions Symptoms States Inventory/State of Anxiety and Depression DSSI/sAD. Three hundred and seventy-nine single homeless individuals were contacted. Reliable data were available on 340. The population was heterogeneous with respect to perceived health status, but it was significantly worse than a standard London population on all dimensions. Those with a self-reported history of psychiatric illness had a significantly worse perceived health status on all dimensions than those without such a history. Those reporting a history of admission to psychiatric hospital had a significatly worse status in two dimensions: mobility, reflecting greater age, and more significantly social isolation, consistent with findings in other de-institutionalised populations. Anxiety and depression, measured using the Foulds sAD scale, was raised in all groups in the study, but did not differentiate between those with and without a self-reported psychiatric history, or between those with and without a self-reported history of psychiatric admisssion. This suggests that these symptoms are a result rather than a cause of homelessness, and that a broad social solution to mental illness in homeless people is needed in addition to specffic medical interventions.

Physiotherapy, 2007

Objectives: To explore the range, drivers and perspectives of extended or enhanced practitioner r... more Objectives: To explore the range, drivers and perspectives of extended or enhanced practitioner roles within physiotherapy. Data sources: Nineteen electronic databases, hand searches, bibliography scanning and personal contact were used to identify published and unpublished resources. Review methods: A systematic review using an expanded approach. Resources were included if they discussed extended scope of practice (ESP, intervention) in physiotherapy (profession) and outcome (for patients, other health professionals, and health services delivery) irrespective of patient group, language, year of publication (up to 2005), study design, or health care systems evaluated. All resources were screened against formal inclusion criteria for relevance. Information from relevant resources was extracted and details were entered into an Access database. Results: 152 Physiotherapy-related resources were identified, including seven which met appropriate quality standards (using Cochrane methodology). A meta-analysis was not performed due to the paucity of RCTs. Conclusions Drivers for the roles in the 152 resources mainly included local or national service demands (34%). Most ESP roles reported included a form of non-invasive assessment (47%) or non-invasive treatment (37%) of patients that was more traditionally carried out by medical colleagues. None of the resources including data were a) unsupportive of ESP or b) mainly expressing concerns. This review has demonstrated overwhelming support 4 for ESP; the vast majority of resources were supportive of ESP despite being largely descriptive or discursive in nature (76%). There is an urgent need for robust research in order to evaluate the expansion of ESP roles, underpin further development of those roles and, strengthen the evidence base of ESP in physiotherapy.

In snow and ice, internal layers are created by changes in the ambient conditions at the time of ... more In snow and ice, internal layers are created by changes in the ambient conditions at the time of deposition, and represent contrasts in density, electrical conductivity, and ice crystal orientation. By identifying and tracing internal layers in ground penetrating radar (GPR) measurements of the Antarctic snow cover, these layers can be used to measure snow accumulation over time. This is particularly relevant for determining the Antarctic mass balance, as the areal coverage can be greatly expanded from the common, but potentially unrepresentative, point measurements from firn-cores, snow pits, or stake farms. This presentation discusses high-resolution GPR data acquired at three research sites in the vicinity of Scott Base (Antarctica), each site being characterised by different snow and surface properties. The first two sites examined, are located on the flat McMurdo Ice Shelf in zones with significantly different wind and accumulation patterns. The final site is located on the low...

Journal of Advanced Nursing, 1997

Advanced neonatal nurse practitioners in the United Kingdom: where are they and what do they do? ... more Advanced neonatal nurse practitioners in the United Kingdom: where are they and what do they do? The former Wessex region was the first in England to institute an advanced neonatal nurse practitioner (ANNP) course within the United Kingdom (UK), and at the time of this survey three cohorts had completed the course. The role has been developed over several years in the North American health care system, where it has been shown that ANNPs have the ability to perform as competently and efficiently as junior doctors. It is a major development both in neonatal care and nursing. Following a review of the literature on ANNPs, this paper details the distribution of ANNPs in the UK, and reports on a survey undertaken by the authors, which examined the function, clinical grading and source of funding of ANNPs, as well as examining the ANNPs' view of their role and challenges they have encountered. provided the impetus for the development of an expanded I NTRODUCTI ON role in the nursing of the sick neonate. During the past two decades, neonatology has grown into a speciality that provides acute care for the sick newborn THE NURSE PRACTITIONER infant and is distinct from mainstream paediatrics both professionally and in its knowledge base. Advances in our The earliest mention of the nurse practitioner role appears in North American literature of the 1960s. Aimed at meet-basic knowledge of pathophysiology in the neonate and developments in technology have contributed to a drop in ing the shortage of available medical staff, such roles were often perceived as substitutions for doctors. Nurse prac-perinatal mortality and, most noticeably, to the survival of a higher proportion of infants born preterm (Svenningsen titioners were first used in primary care, often in rural areas where recruitment of doctors was difficult. Read & 1992). The management of such sick and dependent babies has become increasingly complex and intensive, and along George (1994) described several studies where such roles were used in differing settings and reported that 'no sig-with technological developments have come changes in professional roles and aspirations and in economic nificant differences in outcome were found for patients in similar categories treated by a nurse practitioner or phys-demands for health care provision. Together, these have ician'. They identified that patient compliance with treatment and overall satisfaction were significantly greater

Health Expectations, 2006

Objective To establish which generic attributes of general practice out-of-hours health services ... more Objective To establish which generic attributes of general practice out-of-hours health services are important to the public. Methods A discrete choice experiment postal survey conducted in three English general practitioner (GP) cooperatives. A total of 871 individuals aged 20-70 years registered with a GP. Outcomes were preferences for, and trade-offs between: time to making initial contact, time waiting for advice/treatment, informed of expected waiting time, type of contact, professional providing advice, chance contact relieves anxiety, and utility estimates for valuing current models of care. Results Response rate was 37%. Respondents valued out-of-hours contact for services for reducing anxiety but this was not the only attribute of importance. They had preferences for the way in which services were organized and valued information about expected waiting time, supporting findings from elsewhere. Participants were most willing to make trade-offs between waiting time and professional person. Of the predicted utility for three models of care utility was higher for fully integrated call management. Conclusions Greater utility might be achieved if existing services are re-configured more in line with the government's fully integrated call management model. Because the attributes were described in generic terms, the findings can be applied more generally to the plethora of models that exist (and many that might exist in the future). The approach used is important for achieving greater public involvement in how health services develop. Few experiments have elicited public preferences for health services in the UK to date. This study showed valid preferences were expressed but there were problems obtaining representative views from the public.

Health & Social Care in the Community, 2001

Objective To examine the unmet needs of informal carers of community dwelling disabled people and... more Objective To examine the unmet needs of informal carers of community dwelling disabled people and to compare their perspectives to those of disabled people and nominated professionals. It was hypothesised that a poor recognition of carers' needs could have implications for carers' wellbeing and thus their ability to maintain their caring role. Need was defined as a service or a resource that would confer a health or rehabilitation gain. Design Face to face interviews with carers and disabled participants, telephone interviews with professionals (Southern England). Disabled participants had been selected randomly from two disability registers.

European Journal of Cancer, 2010

There is a lack of instruments that focus on the specific health-related quality of life (HRQOL) ... more There is a lack of instruments that focus on the specific health-related quality of life (HRQOL) issues that affect older people with cancer. The aim of this study was to develop a HRQOL questionnaire module to supplement the European Organisation for Research and Treatment of Cancer (EORTC) core questionnaire, the EORTC QLQ-C30 for older (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;70years) patients with cancer.

Disability and Rehabilitation, 2007

The study was conducted in Hampshire, Wiltshire, Derbyshire and Nottinghamshire in the United Kin... more The study was conducted in Hampshire, Wiltshire, Derbyshire and Nottinghamshire in the United Kingdom and in North Holland in the Netherlands.

BMJ, 2005

Objectives To quantify service integration achieved in the national exemplar programme for single... more Objectives To quantify service integration achieved in the national exemplar programme for single call access to out of hours care through NHS Direct, and its effect on the wider health system. Design Observational before and after study of demand, activity, and trends in the use of other health services. Participants 34 general practice cooperatives with NHS Direct partners (exemplars): four were case exemplars; 10 control cooperatives. Setting England. Main outcome measures Extent of integration; changes in demand, activity, and trends in emergency ambulance transports; attendances at emergency departments, minor injuries units, and NHS walk-in centres; and emergency admissions to hospital in the first year. Results Of 31 distinct exemplars, 21 (68%) integrated all out of hours call management. Nine (29%) achieved single call access for all patients. In the only case exemplar where direct comparison was possible, a higher proportion of telephone calls were handled by cooperative nurses before integration than by NHS Direct afterwards (2622/6687 (39%) v 2092/7086 (30%): P < 0.0001). Other case exemplars did not achieve 30%. A small but significant downturn in overall demand for care seen in two case exemplars was also seen in the control cooperatives. The number of emergency ambulance transports increased in three of the four case exemplars after integration, reaching statistical significance in two (5%, − 0.02% to 10%, P = 0.06; 6%, 1% to 12%, P = 0.02; 7%, 3% to 12%, P = 0.001). This was always accompanied by a significant reduction in the number of calls to the integrated service. Conclusion Most exemplars achieved integration of call management but not single call access for patients. Most patients made at least two telephone calls to contact NHS Direct, and then waited for a nurse to call back. Evidence for transfer of demand from case exemplars to 999 ambulance services may be amenable to change, but NHS Direct may not have sufficient capacity to support national implementation of the programme.

BMJ, 1992

Objective-To determine the distribution and scope of nurse practitioner schemes in accident and e... more Objective-To determine the distribution and scope of nurse practitioner schemes in accident and emergency departments in England and Wales; to describe the caseloads of doctors and nurse practitioners on two representative days; and to estimate the number of patients managed by nurse practitioners in the year to 31 March 1991. Design-A postal survey of accident and emergency departments and a content analysis of case notes of new patients attending a representative sample of accident and emergency departments on two days. Setting-All accident and emergency departments in England and Wales. Participants-Survey: 560 nurses in charge of accident and emergency departments. Census: case notes of 5814 patients in 37 accident and emergency departments. Main outcome measures-Survey: number of accident and emergency departments with nurse practitioner schemes. Census: demographic and clinical characteristics of new patients attending and whether nurse practitioner or doctor made diagnoses and ordered investigations, treatments, referrals, discharges. Results-513 replies (92%) from 465 surveyed functioning accident and emergency departments and 48 departments recently closed. 27 (6%) departments used designated nurse practitioners and 159 (34%) "unofficial" nurse practitioners. Only 530 (9%) of the 5814 patients in the census were managed entirely or mainly by nurse practitioners, with higher proportions in ophthalmic departments (nearly 30%) and minor casualty departments (over 40%) than in major departments (3%). Most patients managed by nurse practitioners (86%) had minor trauma. In the year ending 31 March 1991 an estimated 390 000 (95% confidence interval 260 000 to 520 000) patients out of a total of 12-5 million (3.1%, 2-1% to 4.1%) were clinically managed by a nurse practitioner. Conclusions-Designated nurse practitioner schemes are rare. The volume and range of nurse practitioner work in major general accident and emergency departments is small compared with those in specialised and minor accident and emergency departments.