In 2007 the Nursing and Midwifery Council (NMC) endorsed the use of simulation to replace up to three hundred hours of practice learning in the pre-registration nursing programme (NMC, 2007a). This decision was the impetus for this study as it raised questions regarding whether simulation could replace practice and whether simulated learning transferred to the practice setting. For the first time, the NMC proposal to replace practice hours with simulation has been critically analysed and the implications of this decision explored. A literature review demonstrated a lack of robust evidence to support the use of simulation in this way. This informed the development of this study’s research question and aims. A qualitative collective case study was chosen as the optimum research design to facilitate in-depth exploration of the use of simulation at a selected university in the North West of England. The in-depth qualitative case study incorporated multiple models of simulation, student cohorts, nurse educators and key informants which provided the most comprehensive analysis of viewpoints in any published research in the UK to date. Deeper understanding of the case arose from the use of multiple data collection methods: documentary analysis, participant observation and interviews which enabled findings to be triangulated and corroborated. Most importantly, because the simulation models used were comparable to those used by other education providers in the UK; there is a possibility of the transferability of findings which could be used to inform the development of simulation in the under-graduate nursing curriculum. This thesis develops an argument that there were three key assumptions made by the NMC when they endorsed the replacement of practice hours with simulation. The first is that there is a shared understanding in nursing regarding what simulation is. Secondly; that simulation is delivered in a ‘safe environment’ and finally that competence demonstrated in simulation transfers seamlessly to practice. This thesis has presented new knowledge and developed an argument for caution regarding the use of simulation in pre-registration nurse education. These findings challenge the assumptions made by the NMC and highlight issues for further consideration and exploration namely: the ambiguity regarding the concept of simulation, student safety during simulation, student perceptions of authenticity and finally the transfer of simulated learning to practice.

The Optical Imaging Laboratory has developed a hand-held optical imaging system that is capable of 3D tomographic imaging. However, the imaging system is limited by longer imaging times, and inaccuracy in the positional tracking of the hand-held probe. Hence, the objective is to improve the performance of the imaging system by improving imaging time and positional accuracy. This involves: (i) development of automated single Labview-based software towards near real-time imaging; and (ii) implementation of an alternative positional tracking device (optical) towards improved positional accuracy during imaging. Experimental studies were performed using cubical tissue phantoms (1% Liposyn solution) and 0.45-cc fluorescence target(s) placed under various conditions. The studies demonstrated a 90% reduction in the imaging time (now ~27 sec/image) and also an increase from 94% to 97% in the positional accuracy of the hand-held probe. Performance enhancements in the hand-held optical imaging system have improved its potential towards clinical breast imaging.

L’angioplastie coronarienne est une intervention guidée par rayons X et réalisée par voie endovasculaire qui restaure le diamètre des vaisseaux coronaires réduit par accumulation de corps gras au sein de leurs parois. Lors de cette procédure, un guide est introduit à partir d’une artère qui peut être située au poignet ou au niveau de l’aine. La technique consiste alors à amener dans le vaisseau pathologique un ballonnet gonflable dans la zone rétrécie, localisée grâce à l’injection préalable d’un produit de contraste. Le gonflement du ballonnet élargit l’artère et s’accompagne en général de la pose d’un stent, structure métallique capable de renforcer la paroi. Le geste clinique peut être facilité en intégrant aux images le détail de la nature de la paroi, information disponible avec un scanner 3D. Le but de cette thèse est de proposer une méthode de recalage déformable pour superposer cette information 3D à des images angiographiques 2D per-opératoire en déformant le modèle 3D afin qu’il suive la dynamique cardiaque capturée dans les images angiographiques. Nous introduisons un algorithme de segmentation capable de segmenter automatiquement les vaisseaux principaux dans ces images angiographiques. Ensuite, nous présentons une approche de suivi du vaisseau 3D pathologique dans une séquence 2D+t combinant appariements et déformation d’une courbe spline. Enfin, nous décrivons l’extension au suivi d'un arbre vasculaire 3D, représenté par un arbre dont les arcs sont des courbes splines, dans une séquence 2D+t. Nous avons privilégié les approches applicables avec une seule projection angiographique, bien adapté au déroulement usuel des procédures cliniques. La performance des algorithmes a fait l’objet d’évaluations quantitatives sur des données réelles incluant 30 images pour la segmentation et 23 séquences pour le recalage. / Coronary angioplasty is an X-ray guided intervention, which aims at recovering the diameter of coronary vessels when the accumulation of fat in the vessel wall reduced it. During this procedure, a guide-wire is inserted in the blood vessel located at the wrist or groin. This guide-wire brings into the pathologic vessel a balloon at the level of the fat accumulation, thanks to a previous contrast injection which highlights the lesion. The balloon is inflated and very frequently a thin mesh tube of metallic wires (stent), which is wrapped around the balloon, is then expanded during the balloon inflation. The procedure could benefit from additional information on the nature of the inner wall, available on 3D CT scan. The aim of the thesis is to propose a dynamic registration to superimpose this 3D information onto the intraoperative 2D angiographic sequence, by deforming the 3D model so that it can follow the cardiac motion captured thanks to the angiographic images. We introduce a segmentation algorithm able to automatically segment the main vessels of the angiographic images. Then, we present a tracking approach of the 3D pathologic vessel in a 2D+t sequence combining pairings and the deformation of a spline curve. Finally, we describe the extension to the 3D vascular tree tracking represented by a tree, whose edges are spline curves, in a 2D+t sequence. We favored approaches that are applicable to a single angiographic projection, which is well adapted to the usual process of clinical procedures. All the proposed methods have been tested on real data, consisting of 30 angiographic images for the segmentation algorithm and 23 angiographic sequences for the registration algorithms.

The thesis consists of two coherent projects. The first project presents the results of evaluating salinity tolerance in barley using growth curve analysis where different growth trajectories are observed within barley families. The study of salinity tolerance in plants is crucial to understanding plant growth and productivity. Because fully-automated smarthouses with conveyor systems allow non-destructive and high-throughput phenotyping of large number of plants, it is now possible to apply advanced statistical tools to analyze daily measurements and to study salinity tolerance. To compare different growth patterns of barley variates, we use functional data analysis techniques to analyze the daily projected shoot areas. In particular, we apply the curve registration method to align all the curves from the same barley family in order to summarize the family-wise features. We also illustrate how to use statistical modeling to account for spatial variation in microclimate in smarthouses and for temporal variation across runs, which is crucial for identifying traits of the barley variates. In our analysis, we show that the concentrations of sodium and potassium in leaves are negatively correlated, and their interactions are associated with the degree of salinity tolerance. The second project studies change-points detection methods in extremes when multiple time series data are available. Motived by the scientific question of whether the chances to experience extreme weather are different in different seasons of a year, we develop a change-points detection model to study changes in extremes or in the tail of a distribution. Most of existing models identify seasons from multiple yearly time series assuming a season or a change-point location remains exactly the same across years. In this work, we propose a random effect model that allows the change-point to vary from year to year, following a given distribution. Both parametric and nonparametric methods are developed for detecting single and multiple change-points, and their performance is compared by simulation studies. The proposed method is illustrated using sea surface temperature data and the tail distributions before and after the change-point from two models, with and without random effects are compared.

The aim of my thesis was research of the ophthalmology images processing. These methods contains image filtration, detection of important points in the image and registration. Image adjustment and the follow up registration is very important to find some deseases (e.g. glaucoma, where is a change of nervous threads going from retina ). For the image changes and registrations was made computer programme (Matlab, Graphical User Interface), where the user can try the different methods decribed in teoretical part of thesis.

Ce travail porte sur la modélisation de problèmes liés au recalage d'images. Le recalage consiste à trouver une déformation optimale de sorte qu'une image déformée s'aligne sur une image de référence. Il s'agit d'une technique que l'on rencontre dans de nombreux domaines, comme l'imagerie médicale, la comparaison de données ou le suivi de formes. Le premier chapitre se concentre sur le problème de préservation de la topologie. Cette condition de préservation de la topologie est importante lorsque la déformation recherchée traduit des propriétés physiques des objets soumis à la déformation. Les chapitres suivants proposent la construction de différentes méthodes de recalage d'images fondées sur la théorie de l'élasticité non linéaire. En effet, les objets à apparier sont supposés être des matériaux hyper-élastiques. Différents termes d'attaches aux données ont été explorés ainsi que deux modèles conjoints de segmentation et recalage. / This work focuses on the modelling of problems related to image registration. Image registration consists in finding an optimal deformation such that a deformed image is aligned with a reference image. It is an important task encountered in a large range of applications such as medical imaging, comparison of data or shape tracking. The first chapter concerns the problem of topology preservation. This condition of topology preservation is important when the sought deformation reflects physical properties of the objects to be distorted. The following chapters propose several methods of image registration based on the nonlinear elasticity theory. Indeed, the objects to be matched are modelled as hyperelastic materials. Different fidelity terms have been investigated as well as two joint segmentation/registration models.

In the application of stereotactic radiosurgery for treatment of brain tumors it is imperative that patients are positioned with sub-millimetre accuracy so as to not damage surrounding healthy tissue during treatment. We investigate how feasible the technique of digitally reconstructed radiographs is as a registration method for patient positioning in this type of high-accuracy application. In particular, since most registration methods based on said technique only rely on two simultaneous projection angles seldom reaching high enough accuracy, we consider any arbitrary amount and observe its effects on the registration accuracy. Three different approaches are considered for how multiple projections can be combined into one single metric. The results seem to indicate that although computed tomography yields accuracies well within the boundaries for stereotactic radiosurgery, cone beam computed tomography in its current state does not. Possible reasons explaining the difference include problems with reconstruction artifacts in the model and inadequate metrics. / Inom tillämpningen av stereotaktisk strålkirurgi för behandling av hjärntumörer är det absolut nödvändigt att patienter positioneras inom millimeternoggrannhet för att undvika skada hos närliggande vävnad vid behandling. Vi undersöker hur trolig tekniken om digitaliserade återskapande röntgenbilder är som en registreringsmetod för patientpositionering i den här typen av mycket noggranna applikationer. Framförallt betraktas godtyckligt många projektionsvinklar och observerar dess effekt på registreringsnoggrannheten, eftersom de flesta tidigare presenterade registreringsmetoderna endast är baserade på två projektionsvinklar och sällan uppfyller det krav som ställs på noggrannhet. Tre olika tillvägagångssätt betraktas för hur flertalet projektionsvinklar kan kombineras till ett enda avståndsmått. Resultaten verkar tyda på att datortomografi medför noggrannheter väl inom ramen för stereotaktisk strålkirurgi, medan konstråledatortomografi i sitt nuvarande tillstånd inte verkar göra detta. Anledningar till denna olikhet tros vara problem med rekonstruktionsartefakter i modellen och otillräckliga avståndsmått.

Over 30 000 liver, abdomen, and thigh slices have been acquired by computed tomography for the SCAPIS and IGT study. To utilise the full potential of the large cohort and enable statistical pixel-wise body composition analysis and visualisation of associations with other biomarkers, a point-to-point correspondence between the scans is needed. For this purpose, an inter-subject image registration pipeline that combines the low-level information from CT images with high-level information from segmentation masks have been developed. It uses tissue-specific regularisation and processes images efficiently. The pipeline was used to deform 4603 CT scans of each slice into a respective common reference space in less than 30 hours. All but the ribs in the liver slices and the intra abdominal region of the abdomen were generally registered correctly. Vector and intensity magnitude errors indicating inverse consistency were on average less than 2.5 mm and 40 Hounsfield units respectively. The method may serve as a starting point for statistical pixel-wise body composition analysis, its association with non-imaging data, as well as saliency mapping analysis of the three-slice CT scans from the large SCAPIS and IGT cohorts.

Image-guided neurosurgery interventions are becoming sur- gical procedure routines. We suggest a novel method for automatic marker localization in X-ray images for Leksell SurgiPlan® which is an image-based neurosergical treat- ment planning software provided by Elekta Instrument AB. We implemented an algorithm for fiducial marker localiza- tion based on feature detection, classification and prior geo- metrical knowledge of the markers. Automatic localization ca help to decrease the human error associated with manual registration of these fiducial markers which is the current applied method for X-ray images in Leksell SurgiPlan®.

Con el transcurrir del tiempo, las transacciones vehiculares a través de la compra-venta se han vuelto más frecuentes y sencillas, a su vez segura, pues los propietarios registran estas transacciones en el Registro de Propiedad Vehicular para obtener la seguridad jurídica. A la par de este hecho, surge también la conducta preventiva de los propietarios de los vehículos que deciden comprar una Póliza de seguro vehicular para proteger su unidad frente a los riesgos que se puedan presentar. Si bien el propietario ha sido diligente en inscribir la transferencia vehicular y asegurar su unidad ante un eventual siniestro, hemos identificado, dos desventajas para el asegurado/propietario: (i) Este puede adquirir un bien sin conocer que el costo de la unidad ha sido cuantificada como cero, pues fue declarado como pérdida total por una compañía aseguradora, de lo cual no se tiene conocimiento debido a que no contamos con esa información de forma accesible, y (ii) De existir un siniestro la aseguradora rechazaría la cobertura por aplicación Cláusula de Exclusión expresa o por Declaración reticente o falsa, En el presente trabajo, proponemos como solución al problema la incorporación al Registro de Propiedad Vehicular de los Registros Públicos, la Obligación de las Aseguradoras de reportar la pérdida total del vehículo de tal forma que el registrador la pueda considerar como parte de la publicidad de las características de las unidades. / Over time, vehicle transactions through purchase and sale have become more frequent and simple, and at the same time safe, because the owners register these transactions in the Vehicle Property Registry to obtain legal security. At the same time, the preventive behavior of the owners who decide to buy a vehicle insurance policy to protect their unit against the risks. Although the owner has been diligent in registering the vehicle transfer and insuring his unit in the event of a loss, we have identified two disadvantages for the insured/owner: (i) The owner can acquire a property without knowing that the cost of the unit has been quantified as zero, since it was declared a total loss by an insurance company, of which we have no knowledge due to the fact that we do not have that information in an accessible manner, and (ii) If there is a claim, the insurance company would reject the coverage due to the application of an express Exclusion Clause or a reluctant or false statement. In the present work, we propose as a solution to the problem, the incorporation to the Registry of Vehicle Property of the Public Registries, the Obligation of the Insurers to report the total loss of the vehicle in such a way the person who registers, can consider it as part of the publicity of the characteristics of the units. / Trabajo de investigación