Annotation: The diploma thesis focuses on cooperative activities connected with methods of critical thinking in the teaching of music education. I follow up on my annual paper dealing with cooperative games in primary school education. In my previous teaching practice, I focused on group teaching. It is the co-operative activities that offer a synergy of a particular group of pupils, thus not only helping to achieve learning objectives, but also strengthening the positive relationships among pupils within the group. The cooperation offers scope for the development of critical thinking among pupils. In conjunction with other alternative forms of learning, it develops the pupil's musical abilities more effectively (unlike normal frontal education). I started to devote myself to this topic mainly because I did not meet with a similarly invigorating approach in my previous practice in schools. It was a strong motivation for me to explore this issue and try it practically. I would like to give my teacher colleagues new insights into the concept of music education. The work explains the basic concepts of cooperative teaching. It brings the methods and forms of teaching that are appropriate for the development of the necessary key competencies. My goal will not be to focus on all the key competencies the pupil...

There has been a long line of studies concerning the nexus between R&D expenditure and Economic Performance. However, there has been little research on this nexus on a regional level in Germany. This paper aims to analyse the relationship between R&D expenditure (total, business sector and public sector each) and GDP per capita at a regional level in Germany for the time period 2000-2017. The method of estimation employed in fixed effects panel regression analysis. It is found that total R&D expenditure and regional GDP per capita have an insiginificant relationship, but a negtiavely significant one when a lagged value of R&D expenditure is considered. The relationship between public R&D expenditure and regional GDP per capita is significantly negative, whereas the relationship between business sector R&D expenditure and regional GDP per capita is insignificant. Further scope for research could include analysing the effect of regional innovation clusters and the role of R&D strategy in improving the economic performance of regions in Germany.

The Boston accent is one of the most famous accents in the United States and is known for its non-rhoticity, which essentially means that Bostonians do not normally pronounce their r’s after vowels. While most Boston locals would tell you to ‘pahk the cah ova hea’ when you arrive in the city, not every Bostonian has the same level of non-rhoticity; this variation is due to a number of different factors, but arguably one of the most interesting factors, which this paper focuses on, is gender. This study looks into how Boston non-rhoticity differs between males and females, as well the theories that explain these potential differences. This is done by collecting and analyzing the speech of Boston locals, following two previous studies on the same topic. In addition to gender, types of speech and other social factors are also analyzed. The biggest finding of this study is that there is a statistically significant difference in non-rhoticity between males and females, with females pronouncing more r’s, which supports one previous study and opposes another, and also supports the linguistic theory that women tend to exhibit more standardized speech than men.

Atlas-Based Segmentation of medical images is an image analysis task which involves labelling a desired anatomy or set of anatomy from images generated by medical imaging modalities. The overall goal of atlas-based segmentation is to assist radiologists in the detection and diagnosis of diseases. By extracting the relevant anatomy from medical images and presenting it in an appropriate view, their work-flow can be optimised. This portfolio-style thesis discusses the research projects carried out in order to evaluate the applicability of atlas-based methods to a variety of medical imaging problems. The thesis describes how atlas-based methods have been applied to heart segmentation, to extract the heart for further cardiac analysis from cardiac CT images, to kidney segmentation, to prepare the kidney for automated perfusion measurements, and to coronary vessel tracking, in order to improve on the quality of tracking algorithms. This thesis demonstrates how state of the art atlas-based segmentation techniques can be applied successfully to a range of clinical problems in different imaging modalities. Each application has been tested using not only standard experimentation principles, but also by clinically-trained personnel to evaluate its efficacy. The success of these methods is such that some of the described applications have since been deployed in commercial products. While exploring these applications, several techniques based on published literature were explored and tailored to suit each individual application. This thesis describes in detail the methods used for each application in turn, recognising the state of the art, and outlines the author's contribution in every application.

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We present data structures and algorithms for sets and some generalizations thereof (fuzzy sets, multisets, and fuzzy multisets) available for R through the sets package. Fuzzy (multi-)sets are based on dynamically bound fuzzy logic families. Further extensions include user-definable iterators and matching functions. (authors' abstract)

A health information system (HIS) plays an important role in ensuring that reliable and timely health information is available for operational and strategic decision making that saves lives and enhances health. Despite their importance for evidence-based decisions, health information systems in many developing countries are weak, fragmented and often focused exclusively on disease-specific programme areas. There is a broad consensus in the literature that strengthening of national HIS is desirable. An integrated HIS will provide the basis for public health professionals to look at the health system from broader more comprehensive points of view. The routine health information system (RHIS) in Palestine does not store data at the case level but aggregates them at the Facility level only. Additionally, establishment of multiple information databases in different Ministry of Health (MoH) departments causes incompatibility between the different databases and ineffective use of information. This study examines the availability and the utilisation of information in support of health care organisation and delivery in Palestine which entailed an assessment of the current situation to identify determinants of the RHIS performance. The Palestinian Ministry of Health at the Ministry, District and Facility levels was the study setting while systems and staff operating at these three levels were the target population. Employing a purposive sampling method a total of 123 respondents participated in the study. Performance of Routine Information System Management (PRISM) framework and its four tools package was used to assess the performance of RHIS at the Palestinian MoH. The PRISM framework empirically tests the relationships among technical, behavioural and organisational determinants on health management information system (HMIS) process and performance. Data quality is measured in terms of accuracy and completeness at the Facility level. However, at Ministry HMIS and District levels it is measured in terms of timeliness, data accuracy and completeness. Data quality was good at the Ministry HMIS level. However, data completeness and accuracy at the District level were good while timeliness was immeasurable on the basis of currently adopted procedures. At the Facility level, data completeness and data accuracy were only acceptable. Use of information was poor at all three levels; the Ministry HMIS level, District and Facility. The displaying of updated data on mother‘s health, child health, Facility utilisation, and disease 12 surveillance at both the District level and at the Facility levels were poor. RHIS processes at the Ministry HMIS level were good. However, they were poor at the two levels of District and Facility. Overall, technical and behavioural determinants fared poorly at all three levels while organisational determinants at the Ministry HMIS level were very good for RHIS governance and planning but were poor for supervision, training and finance. These findings provide evidence on the need to establish a national RHIS the utilisation of which is made legally compulsory for all. Investing heavily and systematically in building relevant staff capacity and technical infrastructure to improve performance is a key conclusion from this project.

This thesis is about the measurement of health care output and the relationship between health care outcomes, physician practice patterns and individual physician characteristics within a very specific and particular health care sector, the health care sector on the Islands of Malta. Chapter 2 focuses on the appropriateness of introducing a Diagnosis Related Group (DRG) casemix classification system on Maltese data. A number of tests are applied to gauge the ability of Grouper software to capture the heterogeneity between the obtained DRG groups and the degree of homogeneity gained in explaining resource use from the grouping of cases by DRG categories. This serves to provide a measure of health care ‘output’ whilst providing a tool to help describe and manage resource use. Chapter 3 of this thesis explores differences in the expected relationship between volume and competing risk outcomes and whether this relationship varies in view of different consultant job contract conditions. Finally, Chapter 4 of this thesis studies the behaviour of individual consultants working in the context of the specific incentives and work practices of the Maltese health care system. The role of the specific consultant job contract type is investigated to explain heterogeneity arising among treatment practice patterns over two specific periods related to the patients’ stay at the hospital: the first two days of hospital stay and their remaining stay.

Objectives: This project seeks to reduce duplication of effort in finding data for NHS healthcare quality indicators, to resolve issues identified in previous efforts to develop quality-monitoring ontologies and to identify areas for future computer-interpretable quality indicator development for the United Kingdom’s Department of Health and National Health Service (NHS). Outcomes will include specification of inclusion and exclusion criteria for a set of healthcare quality indicators, along with categorisation beyond screening and prevention and identification of levels of indicator relationships Methodology: Following an exploration of potential methods for ontology development, Methontology was the method chosen to develop the ontology. This involved a conceptual analysis to inform the development of an ontology for a 2009 set of healthcare quality indicators made available on the NHS Information Centre website. Indicators were categorised by NHS Dimension, NHS-specified clinical pathway and by United States Institute of Medicine purpose. Relationships between indicators were identified, as well as an initial set of inclusion and exclusion criteria. Protégé 3.4.1 was the platform used to develop a pilot ontology. Results: NHS quality indicators that share some of the same criteria were made searchable, along with broader and narrower related criteria. Up to six layers of inclusion and exclusion criteria were specified and incorporated into the ontology. Search capabilities were created for indicators originating from the same source and from more than one source, along with indicators assigned to specific care pathways. It was shown that indicators have purposes other than prevention and screening, rendering Arden Syntax, intended for computer-interpretable guidelines and previously tested on a specialised set of healthcare quality indicators, unsuitable for a large, diverse set of quality indicators. A large number, 222, of quality indicators with different purposes justified the development of a separate ontology. Conclusions: This ontology could reduce duplication of effort in finding data for NHS healthcare quality indicators. There is potential to link to components of queries currently in use in the NHS, as an interim step away from the need to develop separate queries for each indicator. Areas for future computer- interpretable quality indicator development include resolving Electronic Health Record compatibility issues and improved indicator metadata quality. The ontology could be useful to NHS indicator developers, NHS data xtractors and vendors of electronic health records who supply to the NHS.

Introduction: In patients with myocardial infarction (MI), regional left ventricular contractile function has important prognostic value. Displacement ENcoding with Stimulated Echoes (DENSE) is an MRI technique which has been developed to allow quantitative assessment of myocardial strain. To date, much of the research performed with DENSE has been methods development, and its application in a routine clinical setting has been incompletely investigated. The purpose of the research presented within this thesis was to investigate variations in strain within the healthy heart, and then to assess the in vivo performance of DENSE strain imaging in acute and chronic myocardial infarction (MI). Methods: 80 healthy subjects (M:F = 40:40, age 43 +/- 17 years) were recruited from the community. 50 male patients (age 56 +/- 10 years) were recruited from the clinical service and scanned within 7 days of myocardial infarction (“acute MI”), and invited to return for a follow-up scan after 6 months (“chronic MI”). MR imaging was performed on a 1.5T Siemens Avanto scanner, using an imaging protocol which included DENSE, cine, late gadolinium enhancement (LGE, patients only) and T2-weighted imaging acquired from left ventricular (LV) short-axis slices in both basal and mid-ventricular positions, which were divided into 6 segments for analysis. The percentage of LGE and T2 hyperenhancement within each segment were calculated, and the area at risk (acute MI) and myocardial salvage index (chronic MI) were determined. DENSE images were analysed to obtain values for strain parameters relating to circumferential strain (Ecc). Strain measurements obtained from healthy subjects were used to investigate the variations in Ecc with age, gender, slice position and myocardial segment. Strain measurements obtained from MI patients were used to investigate the relationships between Ecc and the extent of myocardial infarction, area at risk and/or salvage, and to determine whether DENSE strain measurements are informative in acute and chronic MI. Results: Comparison of DENSE strain measurements in healthy subjects revealed statistically significant differences between males and females, and between measurements obtained from basal and mid-ventricular short-axis slice positions. These differences must be taken into account to allow appropriate analysis of DENSE data in patients. DENSE was found to be informative in both acute and chronic MI. At both time points, strain measurements can be used to distinguish between myocardial segments with 0%, <50% and >50% infarction. There is the potential for the development of reference ranges which could be applied to strain measurements from future MI patients to allow assessment of the extent of infarction. In acute MI, four additional applications were identified: i) comparison with references ranges, established from strain measurements in healthy subjects, can be used to identify the presence of infarction with high specificity and moderate to high sensitivity, ii) peak Ecc can be used to distinguish between segments categorised as remote and adjacent, iii) strain measurements in the acute setting may provide prognostic information relating to the potential progression or recovery of contractile abnormalities in the chronic setting, iv) peak Ecc may allow a preliminary assessment of LV ejection fraction. Sensitivity for the detection of injured but non-infarcted segments was low. In chronic MI, two additional applications were identified: i) strain recovery can be detected in infarcted myocardial segments, and also in non-infarcted segments which are located adjacent to infarcted segments, which could improve identification of changes in contractile function compared to conventional qualitative analysis of cine imaging, ii) strain measurements can be used to distinguish between segments in which the extent of infarction has increased and those in which it has decreased. The relationships with myocardial salvage index were not found to be informative. Conclusions: DENSE images were successfully acquired and analysed from both healthy subjects and patients with myocardial infarction, which indicates that the technique is feasible in different clinical settings. DENSE strain measurements were found to be informative in both acute and chronic MI, and can provide insight into the presence and extent of infarction and the progression or recovery of contractile abnormalities.