Carstensen, Peter; Schmidt, Kjeld; Wiil, Uffe Kock
Many manufacturing enterprises are now trying to introduce various forms of flexible work organizations on the shop floor. However, existing computer-based production planning and control systems pose severe obstacles for autonomous working groups and other kinds of shop floor control to become r......-to-day production planning by supporting intelligent and responsible workers in their situated coordination activities on the shop floor....
Lazarou, Ioulietta; Karakostas, Anastasios; Stavropoulos, Thanos G; Tsompanidis, Theodoros; Meditskos, Georgios; Kompatsiaris, Ioannis; Tsolaki, Magda
Assistive technology, in the form of a smart home environment, is employed to support people with dementia. To propose a system for continuous and objective remote monitoring of problematic daily living activity areas and design personalized interventions based on system feedback and clinical observations for improving cognitive function and health-related quality of life. The assistive technology of the proposed system, including wearable, sleep, object motion, presence, and utility usage sensors, was methodically deployed at four different home installations of people with cognitive impairment. Detection of sleep patterns, physical activity, and activities of daily living, based on the collected sensor data and analytics, was available at all times through comprehensive data visualization solutions. Combined with clinical observation, targeted psychosocial interventions were introduced to enhance the participants' quality of life and improve their cognitive functions and daily functionality. Meanwhile, participants and their caregivers were able to visualize a reduced set of information tailored to their needs. Overall, paired-sample t-test analysis of monitored qualities revealed improvement for all participants in neuropsychological assessment. Moreover, improvement was detected from the beginning to the end of the trial, in physical condition and in the domains of sleep. Detecting abnormalities via the system, for example in sleep quality, such as REM sleep, has proved to be critical to assess current status, drive interventions, and evaluate improvements in a reliable manner. It has been proved that the proposed system is suitable to support clinicians to reliably drive and evaluate clinical interventions toward quality of life improvement of people with cognitive impairment.
Discusses issues connected with developing information systems for competitive intelligence support; defines the elements of an effective competitive information system; and summarizes issues affecting system design and implementation. Highlights include intelligence information; information needs; information sources; decision making; and…
V. A. Rybak
Full Text Available A new technology of intelligent decision support on Forex, including forming algorithms of trading signals, rules for the training sample based on technical indicators, which have the highest correlation with the price, the method of reducing the number of losing trades, is proposed. The last is based on an analysis of the wave structure of the market, while the beginning of the cycle (the wave number one is offered to be identified using Bill Williams Oscillator (Awesome oscillator. The process chain of constructing neuro-fuzzy model using software package MatLab is described.
This book presents different methods for analyzing the body language (movement, position, use of personal space, silences, pauses and tone, the eyes, pupil dilation or constriction, smiles, body temperature and the like) for better understanding people’s needs and actions, including biometric data gathering and reading. Different studies described in this book indicate that sufficiently much data, information and knowledge can be gained by utilizing biometric technologies. This is the first, wide-ranging book that is devoted completely to the area of intelligent decision support systems, biometrics technologies and their integrations. This book is designated for scholars, practitioners and doctoral and master’s degree students in various areas and those who are interested in the latest biometric and intelligent decision making support problems and means for their resolutions, biometric and intelligent decision making support systems and the theory and practice of their integration and the opportunities fo...
Zhou, Wengang; Satheesh, P
This book presents research on emerging computational intelligence techniques and tools, with a particular focus on new trends and applications in health care. Healthcare is a multi-faceted domain, which incorporates advanced decision-making, remote monitoring, healthcare logistics, operational excellence and modern information systems. In recent years, the use of computational intelligence methods to address the scale and the complexity of the problems in healthcare has been investigated. This book discusses various computational intelligence methods that are implemented in applications in different areas of healthcare. It includes contributions by practitioners, technology developers and solution providers.
National Aeronautics and Space Administration — The integration of the analysis tools with the advanced visualization capabilities in The Intelligent Flight Support System (IFSS) can provide a unique method for...
Hayashi, Toshifumi; Kamiyama, Masahiko
This paper presents an intelligent interlock design support system, called Handy. BWR plant interlocks have been designed on a conventional CAD system operating on a mini-computer based time sharing system. However, its ability to support interlock designers is limited, mainly due to the system not being capable of manipulating the interlock logic. Handy improves the design efficiency with consistent manipulation of the logic and drawings, interlock simulation, versatile database management, object oriented user interface, high resolution high speed graphics, and automatic interlock outlining with a design support expert system. Handy is now being tested by designers, and is expected to greatly contribute to their efficiency. (author)
Power, Daniel J
Competition is becoming more intense and decision makers are encountering increasing complexity, rapid change, and higher levels of risk. In many situations, the solution is more and better computerized decision support, especially analytics and business intelligence. Today managers need to learn about and understand computerized decision support. If a business is to succeed, managers must know much more about information technology solutions. This second edition of a powerful introductory book is targeted at busy managers and MBA students who need to grasp the basics of computerized decision support, including the following: What are analytics? What is a decision support system? How can managers identify opportunities to create innovative computerized support? Inside, the author addresses these questions and some 60 more fundamental questions that are key to understanding the rapidly changing realm of computerized decision support. In a short period of time, you'll "get up to speed" on decision support, anal...
Acampora, Giovanni; Cook, Diane J.; Rashidi, Parisa; Vasilakos, Athanasios V.
Ambient Intelligence (AmI) is a new paradigm in information technology aimed at empowering people’s capabilities by the means of digital environments that are sensitive, adaptive, and responsive to human needs, habits, gestures, and emotions. This futuristic vision of daily environment will enable innovative human-machine interactions characterized by pervasive, unobtrusive and anticipatory communications. Such innovative interaction paradigms make ambient intelligence technology a suitable candidate for developing various real life solutions, including in the health care domain. This survey will discuss the emergence of ambient intelligence (AmI) techniques in the health care domain, in order to provide the research community with the necessary background. We will examine the infrastructure and technology required for achieving the vision of ambient intelligence, such as smart environments and wearable medical devices. We will summarize of the state of the art artificial intelligence methodologies used for developing AmI system in the health care domain, including various learning techniques (for learning from user interaction), reasoning techniques (for reasoning about users’ goals and intensions) and planning techniques (for planning activities and interactions). We will also discuss how AmI technology might support people affected by various physical or mental disabilities or chronic disease. Finally, we will point to some of the successful case studies in the area and we will look at the current and future challenges to draw upon the possible future research paths. PMID:24431472
Acampora, Giovanni; Cook, Diane J; Rashidi, Parisa; Vasilakos, Athanasios V
Ambient Intelligence (AmI) is a new paradigm in information technology aimed at empowering people's capabilities by the means of digital environments that are sensitive, adaptive, and responsive to human needs, habits, gestures, and emotions. This futuristic vision of daily environment will enable innovative human-machine interactions characterized by pervasive, unobtrusive and anticipatory communications. Such innovative interaction paradigms make ambient intelligence technology a suitable candidate for developing various real life solutions, including in the health care domain. This survey will discuss the emergence of ambient intelligence (AmI) techniques in the health care domain, in order to provide the research community with the necessary background. We will examine the infrastructure and technology required for achieving the vision of ambient intelligence, such as smart environments and wearable medical devices. We will summarize of the state of the art artificial intelligence methodologies used for developing AmI system in the health care domain, including various learning techniques (for learning from user interaction), reasoning techniques (for reasoning about users' goals and intensions) and planning techniques (for planning activities and interactions). We will also discuss how AmI technology might support people affected by various physical or mental disabilities or chronic disease. Finally, we will point to some of the successful case studies in the area and we will look at the current and future challenges to draw upon the possible future research paths.
Bueno, Elaine Inacio, E-mail: email@example.com [Instituto Federal de Educacao, Ciencia e Tecnologia de Sao Paulo (IFSP), Sao Paulo, SP (Brazil); Pereira, Iraci Martinez, E-mail: firstname.lastname@example.org [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)
Computational Intelligence Systems have been widely applied in Monitoring and Fault Detection Systems in several processes and in different kinds of applications. These systems use interdependent components ordered in modules. It is a typical behavior of such systems to ensure early detection and diagnosis of faults. Monitoring and Fault Detection Techniques can be divided into two categories: estimative and pattern recognition methods. The estimative methods use a mathematical model, which describes the process behavior. The pattern recognition methods use a database to describe the process. In this work, an operator support system using Computational Intelligence Techniques was developed. This system will show the information obtained by different CI techniques in order to help operators to take decision in real time and guide them in the fault diagnosis before the normal alarm limits are reached. (author)
Bueno, Elaine Inacio; Pereira, Iraci Martinez
Computational Intelligence Systems have been widely applied in Monitoring and Fault Detection Systems in several processes and in different kinds of applications. These systems use interdependent components ordered in modules. It is a typical behavior of such systems to ensure early detection and diagnosis of faults. Monitoring and Fault Detection Techniques can be divided into two categories: estimative and pattern recognition methods. The estimative methods use a mathematical model, which describes the process behavior. The pattern recognition methods use a database to describe the process. In this work, an operator support system using Computational Intelligence Techniques was developed. This system will show the information obtained by different CI techniques in order to help operators to take decision in real time and guide them in the fault diagnosis before the normal alarm limits are reached. (author)
Possible forms of artificial intelligence (AI) support for quantum chemistry are discussed. Questions addressed include: what kind of support is desirable, what kind of support is feasible, what can we expect in the coming years. Advantages and disadvantages of current AI techniques are presented and it is argued that at present the memory-based systems are the most effective for large scale applications. Such systems may be used to predict the accuracy of calculations and to select the least expensive methods and basis sets belonging to the same accuracy class. Advantages of the Feature Space Mapping as an improvement on the memory based systems are outlined and some results obtained in classification problems given. Relevance of such classification systems to computational chemistry is illustrated with two examples showing similarity of results obtained by different methods that take electron correlation into account.
Fiscal 1998 survey report. Welfare equipment (Development of human friendly care support intelligent equipment / Development of home welfare equipment system); 1998 nendo chosa hokokusho. Fukushi kiki (human friendly kaigo shien chino kiki kaihatsu / zaitaku fukushi kiki system kaihatsu)
Since disabled persons increase with a progress of an aging society, while a care power decreases with a decrease in birth rate, development and practical use of the welfare equipment contributing to self-support of aged and handicapped persons, reduction of doctors' or therapists' burdens, and as a result, reduction of medical care costs are desirable. Among them, R and D and practical use are expected of the advanced welfare equipment and system based on human engineering technology contributing to improvement of lives of aged and handicapped persons, and support of nurses and cares of disabled persons. In fiscal 1998, on both human friendly care support intelligent equipment and home welfare equipment system, this project clarified essential technical issues based on the future view, selected some themes to be newly developed in the future, and surveyed and evaluated the details of their R and D concretely. For the former, 'heart disease diagnosis and treatment total support system,' and for the latter, 'body function rehabilitation support system' were surveyed. (NEDO)
Prangishvili, I.V.; Pashchenko, F.F.; Saprykin, E.M.
Problems related to creation and introduction at NPP of highly efficient and reliable systems for monitoring and control of working processes and intelligence-endowed systems of operator informational support (ISOIS) are considered. The main units included in ISOIS are considered. The main units included in ISOIS are described. The unit of current state monitoring provides information for the operator, which is necessary under concrete conditions for the process monitoring and control, so as to avoid emergencies and affers a program of actions in a dialogue mode for the operator. The identification unit is designed for the obtaining of assessed values of process parameters (neutron fields, temperatures, pressures) and basic equipment (reactivity coefficients, fuel rod weights, time of delay). The prediction unit evaluates the behaviour of process parameters and process state in various situations. 9 refs
Prof. dr. Jean Pierre Wilken
The research group Participation, Care and Support is part of the Research Centre for Social Innovation of Utrecht University for Applied Sciences. This is a transdisciplinary research centre, doing practice based research focused on relevant social issues, connecting different fields like social
Irina I. Kazmina
Full Text Available The article is devoted to intelligent support of educational processes at level of speciality with the help of information system. In this paper intelligent information system of Modern Humanitarian Academy is considered and three directions of development of intelligent support within the scope of developed information system are offered. These directions include: development of model of student, data mining of quality of teaching and prediction of quality of teaching in the future.
Achterbergh, J.M.I.M.; Khosrow-Pour, M.
Collecting and processing competitive intelligence for the purpose of strategy formulation are complex activities requiring deep insight in and models of the “organization in its environment.” These insights and models need to be not only shared between CI (competitive intelligence) practitioners
National Aeronautics and Space Administration — GRID has had a successfully completed Phase I 'Mobile Online Intelligent Decision Support System' (MOIDSS). The system developed into a total solution that supports...
Wollocko, Arthur B.; Farry, Michael P.; Stark, Robert F.
Modern military environments place an increased emphasis on the collection and analysis of intelligence at the tactical level. The deployment of analytical tools at the tactical level helps support the Warfighter's need for rapid collection, analysis, and dissemination of intelligence. However, given the lack of experience and staffing at the tactical level, most of the available intelligence is not exploited. Tactical environments are staffed by a new generation of intelligence analysts who are well-versed in modern collaboration environments and social networking. An opportunity exists to enhance tactical intelligence analysis by exploiting these personnel strengths, but is dependent on appropriately designed information sharing technologies. Existing social information sharing technologies enable users to publish information quickly, but do not unite or organize information in a manner that effectively supports intelligence analysis. In this paper, we present an alternative approach to structuring and supporting tactical intelligence analysis that combines the benefits of existing concepts, and provide detail on a prototype system embodying that approach. Since this approach employs familiar collaboration support concepts from social media, it enables new-generation analysts to identify the decision-relevant data scattered among databases and the mental models of other personnel, increasing the timeliness of collaborative analysis. Also, the approach enables analysts to collaborate visually to associate heterogeneous and uncertain data within the intelligence analysis process, increasing the robustness of collaborative analyses. Utilizing this familiar dynamic collaboration environment, we hope to achieve a significant reduction of time and skill required to glean actionable intelligence in these challenging operational environments.
The Missouri Department of Transportation (MoDOT) was awarded a grant from the FHWA Accelerated Innovation Deployment (AID) program, in 2016. MoDOT provided the required matching funds to support this Intelligent Compaction (IC) and Infrared Scanning...
This report documents the research project AHMCT IRIS Technical Support and Testing, : performed under contract 65A0275, Task ID 1777. It presents an overview of the Intelligent : Roadway Information System (IRIS), and its design and function. ...
Wicherts, J.M.; Borsboom, D.; Dolan, C.V.
Kanazawa (2008), Templer (2008), and Templer and Arikawa (2006) claimed to have found empirical support for evolutionary theories of race differences in intelligence by correlating estimates of national IQ with indicators of reproductive strategies, temperature, and geographic distance from Africa.
Franco de los Ríos, Camilo; Hougaard, Jens Leth; Nielsen, Kurt
Intelligent decision support should allow integrating human knowledge with efficient algorithms for making interpretable and useful recommendations on real world decision problems. Attitudes and preferences articulate and come together under a decision process that should be explicitly modeled...
Piantadosi, Steven T.; Kidd, Celeste
We present evidence that pressures for early childcare may have been one of the driving factors of human evolution. We show through an evolutionary model that runaway selection for high intelligence may occur when (i) altricial neonates require intelligent parents, (ii) intelligent parents must have large brains, and (iii) large brains necessitate having even more altricial offspring. We test a prediction of this account by showing across primate genera that the helplessness of infants is a particularly strong predictor of the adults’ intelligence. We discuss related implications, including this account’s ability to explain why human-level intelligence evolved specifically in mammals. This theory complements prior hypotheses that link human intelligence to social reasoning and reproductive pressures and explains how human intelligence may have become so distinctive compared with our closest evolutionary relatives. PMID:27217560
Fabio, Annamaria Di
Social support represents an important individual resource that has been associated with multiple indices of adaptive functioning and resiliency. Existing research has also identified an association between emotional intelligence (EI) and social support. The present study builds on prior research by investigating the contributions of ability based EI to social support, beyond the effects of fluid intelligence and personality traits. The Advanced Progressive Matrices, the Big Five Questionnaire, the Mayer Salovey Caruso EI test (MSCEIT), and the Multidimensional Scale of Perceived Social Support were administered to 149 Italian high school students. The results showed that ability based EI added significant incremental variance in explaining perceived social support, beyond the variance due to fluid intelligence and personality traits. The results underline the role of ability based EI in relation to perceived social support. Since ability based EI can be increased through specific training, the results of the present study highlight new possibilities for research and intervention in a preventive framework.
Neves-Silva, Rui; Jain, Lakhmi; Phillips-Wren, Gloria; Watada, Junzo; Howlett, Robert
This book contains a collection of innovative chapters emanating from topics raised during the 5th KES International Conference on Intelligent Decision Technologies (IDT), held during 2013 at Sesimbra, Portugal. The authors were invited to expand their original papers into a plethora of innovative chapters espousing IDT methodologies and applications. This book documents leading-edge contributions, representing advances in Knowledge-Based and Intelligent Information and Engineering System. It acknowledges that researchers recognize that society is familiar with modern Advanced Information Processing and increasingly expect richer IDT systems. Each chapter concentrates on the theory, design, development, implementation, testing or evaluation of IDT techniques or applications. Anyone that wants to work with IDT or simply process knowledge should consider reading one or more chapters and focus on their technique of choice. Most readers will benefit from reading additional chapters to access alternative techniq...
Cortés, Ulises; Annicchiarico, Roberta; Campana, Fabio; Vázquez-Salceda, Javier; Urdiales, Cristina; Canãmero, Lola; López, Maite; Sánchez-Marrè, Miquel; Di Vincenzo, Sarah; Caltagirone, Carlo
A project based on the integration of new technologies and artificial intelligence to develop a device--e-tool--for disabled patients and elderly people is presented. A mobile platform in intelligent environments (skilled-care facilities and home-care), controlled and managed by a multi-level architecture, is proposed to support patients and caregivers to increase self-dependency in activities of daily living.
Van De Graaff, Joe; Cameron, Austin
In an era of reform, providers are examining more forward-thinking business intelligence strategies, according to a recent study. Enterprise business intelligence tool sets offer a breadth of design and functionality that often are capable of serving the enterprise. One limitation of broader tool sets is that they may lack needed application-specific functionality or prebuilt healthcare content for a specific department.
Intelligent decision support system for operators of the supply department of oil and gas extracting industry. ... PROMOTING ACCESS TO AFRICAN RESEARCH ... abnormal situations, pre-crash sensing, industrial drilling, decision-making support systems. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT
Hanson, C W; Marshall, B E
To review the history and current applications of artificial intelligence in the intensive care unit. The MEDLINE database, bibliographies of selected articles, and current texts on the subject. The studies that were selected for review used artificial intelligence tools for a variety of intensive care applications, including direct patient care and retrospective database analysis. All literature relevant to the topic was reviewed. Although some of the earliest artificial intelligence (AI) applications were medically oriented, AI has not been widely accepted in medicine. Despite this, patient demographic, clinical, and billing data are increasingly available in an electronic format and therefore susceptible to analysis by intelligent software. Individual AI tools are specifically suited to different tasks, such as waveform analysis or device control. The intensive care environment is particularly suited to the implementation of AI tools because of the wealth of available data and the inherent opportunities for increased efficiency in inpatient care. A variety of new AI tools have become available in recent years that can function as intelligent assistants to clinicians, constantly monitoring electronic data streams for important trends, or adjusting the settings of bedside devices. The integration of these tools into the intensive care unit can be expected to reduce costs and improve patient outcomes.
Kathrin Rodríguez Llanes
Full Text Available Making decisions is complicated in a generalized way, the materials and humans resources of the entity we belong to depends on it, such as the fulfillment of its goals. But when the situations are complex, making decisions turns into a very difficult work, due to the great amount of aspects to consider when making the right choice. To make this efficiently the administration must to consult an important volume of information, which generally, is scattered and in any different formats. That’s why appears the need of developing software that crowd together all that information and be capable of, by using powerful search engines and process algorithms improve the good decisions making process. Considering previous explanation, a complete freeware developed product is proposed, this constitutes a generic and multi-platform solution, that using artificial intelligence techniques, specifically the cases based reasoning, gives the possibility to leaders of any institution or organism of making the right choice in any situation.With client-server architecture, this system is consumed from web as a service and it can be perfectly integrated with a management system or the geographic information system to facilitate the business process.
This book offers a state of the art collection covering themes related to Advanced Intelligent Computational Technologies and Decision Support Systems which can be applied to fields like healthcare assisting the humans in solving problems. The book brings forward a wealth of ideas, algorithms and case studies in themes like: intelligent predictive diagnosis; intelligent analyzing of medical images; new format for coding of single and sequences of medical images; Medical Decision Support Systems; diagnosis of Down’s syndrome; computational perspectives for electronic fetal monitoring; efficient compression of CT Images; adaptive interpolation and halftoning for medical images; applications of artificial neural networks for real-life problems solving; present and perspectives for Electronic Healthcare Record Systems; adaptive approaches for noise reduction in sequences of CT images etc.
Ali, A; Riaz, Zahid
This book is dedicated to applied computational intelligence and soft computing techniques with special reference to decision support in Cyber Physical Systems (CPS), where the physical as well as the communication segment of the networked entities interact with each other. The joint dynamics of such systems result in a complex combination of computers, software, networks and physical processes all combined to establish a process flow at system level. This volume provides the audience with an in-depth vision about how to ensure dependability, safety, security and efficiency in real time by making use of computational intelligence in various CPS applications ranging from the nano-world to large scale wide area systems of systems. Key application areas include healthcare, transportation, energy, process control and robotics where intelligent decision support has key significance in establishing dynamic, ever-changing and high confidence future technologies. A recommended text for graduate students and researche...
Diggelen, J. van; Broek, J. van den; Schraagen, J.M.C.; Waa, J.S. van der
This paper proposes a human-centered approach to Dynamic Position-ing systems which combines multiple technologies in an intelligent operator sup-port system (IOSS). IOSS allows the operator to be roaming and do other tasks in quiet conditions. When conditions become more demanding, the IOSS calls
Sereno, Bertrand; Boursinou, Eleni; Maxwell, Katrina; Angehrn, Albert
Sereno, B., Boursinou, E., Maxwell, K., & Angehrn, A. A. (2007). Supporting Social Interaction in Intelligent Competence Development Systems. In D. Griffiths, R. Koper & O. Liber (Eds.), Proceedings of the 2nd TENCompetence Open Workshop (pp. 29-35). January, 11-12, 2007, Manchester, United Kingdom.
As health care leader competencies continue to be refined and emphasized in health care administration educational programs, the "soft skills" of emotional intelligence have often been implied, but not included explicitly. The purpose of this study was to better understand what relationship, if any, could be identified between health care leader competencies and emotional intelligence. A quantitative correlational method of study was used, utilizing self-assessments and 360-degree assessments of both constructs. There were 43 valid participants in the study, representing the various types of health care delivery systems. Correlational analysis suggested there was a positive relationship; for each unit of increase in emotional intelligence, there was a 0.6 increase in overall health care leadership competence. This study did not suggest causation, but instead suggested that including the study and development of emotional intelligence in health care administration programs could have a positive impact on the degree of leader competence in graduates. Some curricula suggestions were provided, and further study was recommended.
This paper presents an advanced support system for Tactical Asset Allocation. Asset allocation explains over 90% of portfolio performance (Brinson, Hood and Beebower, 1988). Tactical asset allocation adjusts a strategic portfolio on the basis of short term market outlooks. The system includes
Abraham, Ajith; Siarry, Patrick; Sheng, Michael
This unique book dicusses the latest research, innovative ideas, challenges and computational intelligence (CI) solutions in sustainable computing. It presents novel, in-depth fundamental research on achieving a sustainable lifestyle for society, either from a methodological or from an application perspective. Sustainable computing has expanded to become a significant research area covering the fields of computer science and engineering, electrical engineering and other engineering disciplines, and there has been an increase in the amount of literature on aspects sustainable computing such as energy efficiency and natural resources conservation that emphasizes the role of ICT (information and communications technology) in achieving system design and operation objectives. The energy impact/design of more efficient IT infrastructures is a key challenge in realizing new computing paradigms. The book explores the uses of computational intelligence (CI) techniques for intelligent decision support that can be explo...
Full Text Available Chronic care consists of a sequence of actions to treat a specific clinical disorder over time as a function of the ways in which illness progresses and patients respond to management actions. Outcomes depend on physicians' skills to select the actions best suited for their patients and competent self-management. This paper presents the architecture of an intelligent partner system (IPS, which helps to provide doctors with relevant data and skills and empowers chronically ill patients with the information and confidence to manage their health wisely. The services of this intelligent system are presented as 'therapies' for the information-processing 'pathologies' associated with traditional chronic illness care.
This paper presents an advanced support system for Tactical Asset Allocation. Asset allocation explains over 90% of portfolio performance (Brinson, Hood and Beebower, 1988). Tactical asset allocation adjusts a strategic portfolio on the basis of short term market outlooks. The system includes aprediction model that forecasts quarterly excess returns on the S and PSOO, an optimization model that adjusts a user-specified strategic portfolio on thebasis of the excess return forecast, and a compo...
Phan, Sieu; Famili, Fazel; Liu, Ziying; Peña-Castillo, Lourdes
The advancement of omics technologies in concert with the enabling information technology development has accelerated biological research to a new realm in a blazing speed and sophistication. The limited single gene assay to the high throughput microarray assay and the laborious manual count of base-pairs to the robotic assisted machinery in genome sequencing are two examples to name. Yet even more sophisticated, the recent development in literature mining and artificial intelligence has allowed researchers to construct complex gene networks unraveling many formidable biological puzzles. To harness these emerging technologies to their full potential to medical applications, the Bio-intelligence program at the Institute for Information Technology, National Research Council Canada, aims to develop and exploit artificial intelligence and bioinformatics technologies to facilitate the development of intelligent decision support tools and systems to improve patient care - for early detection, accurate diagnosis/prognosis of disease, and better personalized therapeutic management.
The operational experience obtained with the various applications of the systems discussed in this paper shows that more consequent use of the systems will make detection and management of disturbances still more efficient and faster. This holds true both for a low level of process automation and for power plants with a high level of automation. As for conventional power plants, the trend clearly is towards higher degrees of automation and consequent application of supporting systems. Thus, higher availability and rapid failure management are achieved, at low effects on normal operation. These systems are monitoring and process control systems, expert systems, and systems for optimal use of the equipment, or systems for post-incident analyses and computer-assisted on-shift protocols, or operating manuals. (orig./CB) [de
Full Text Available Objectives. Automated, microprocessor-controlled, closed-loop mechanical ventilation has been used in our Medical Intensive Care Unit (MICU at the Hadassah Hebrew-University Medical Center for the past 15 years; for 10 years it has been the primary (preferred ventilator modality. Design and setting. We describe our clinical experience with adaptive support ventilation (ASV over a 6-year period, during which time ASV-enabled ventilators became more readily available and were used as the primary (preferred ventilators for all patients admitted to the MICU. Results. During the study period, 1 220 patients were ventilated in the MICU. Most patients (84% were ventilated with ASV on admission. The median duration of ventilation with ASV was 6 days. The weaning success rate was 81%, and tracheostomy was required in 13%. Sixty-eight patients (6% with severe hypoxia and high inspiratory pressures were placed on pressure-controlled ventilation, in most cases to satisfy a technical requirement for precise and conservative administration of inhaled nitric oxide. The overall pneumothorax rate was less than 3%, and less than 1% of patients who were ventilated only using ASV developed pneumothorax. Conclusions. ASV is a safe and acceptable mode of ventilation for complicated medical patients, with a lower than usual ventilation complication rate.
This paper identifies factors relevant to the design of intelligent support systems and their use for the provision of real-time diagnostic information. As such, it constitutes a followup to the state-of-the-art review that was previously published by Bernard and Washio on the utilization of expert systems within the nuclear industry. Some major differences between intelligent-support tools and conventional expert systems are enumerated. In summary, conventional expert systems that encode experimental knowledge in production rules are not suitable vehicle for the creation of operator support systems. The principal difficulty is the need for real-time operation. This in turn means that intelligent support systems will have knowledge bases derived from temporally accurate plant models, inference engines that permit revisions in the search process to accommodate revised data, and man-machine interfaces that do not require any human input. Such systems will be heavily instrumented, and the associated knowledge bases will require a hierarchical organization to emulate human approaches to analysis
杨保安; 马云飞; 俞莲
Intelligent Decision Support System (IISS) for Bank Loans Risk Classification (BLRC), based on the way of integration Artificial Neural Network (ANN) and Expert System (ES), is proposed. According to the feature of BLRC, the key financial and non-financial factors are analyzed. Meanwhile, ES and Model Base (MB) which contain ANN are designed . The general framework,interaction and integration of the system are given. In addition, how the system realizes BLRC is elucidated in detail.
Rotman, M.; John, M.
The radiation therapist, concerned with the disease process and all the technical intricacies of treatment, has usually not been involved in managing the supportive aspects of caring for the patient. Yet, of the team of medical specialists and allied health personnel required in oncology, the radiation therapist is the one most responsible for overseeing the total care of the cancer patient. At times this might include emotional support, prevention and correction of tissue dysfunction, augmentation of nutrition, metabolic and electrolyte regulation, rehabilitation, and vocational support. This chapter is a brief overview of a considerable volume of literature that has occupied the interest of a rather small group of physicians, nutritionists, and psychologists. The discussion highlights the special management problems of the normal-tissue effects of radiation, the related nutritional aspects of cancer care, and certain emotional and pathologic considerations
Stratton, R.C.; Town, G.G.
Improving nuclear reactor power plant operability is an ever-present concern for the nuclear industry. The definition of plant operability involves a complex interaction of the ideas of reliability, safety, and efficiency. This paper presents observations concerning the issues involved and the benefits derived from the implementation of a computer application which combines traditional computer applications with artificial intelligence (AI) methodologies. A system, the Component Configuration Control System (CCCS), is being installed to support nuclear reactor operations at the Experimental Breeder Reactor II
The overall goal for the design of Intelligent Decision Support Systems (IDSS) is to enhance understanding of the process under all operating conditions. For an IDSS to be effective, it must: select or generate the right information; produce reliable and consistent information; allow flexible and effective operator interaction; relate information presentation to current plant status and problems; and make the presentation at the right time. Several ongoing R and D programs try to design and build IDSSs. A particular example is the ESPRIT project Graphics and Knowledge Based Diaglogue for Dynamic Systems (GRADIENT). This project, the problems it addresses, and its uses, are discussed here
Su, Chuan-Jun; Chiang, Chang-Yu
As the elderly population has been rapidly expanding and the core tax-paying population has been shrinking, the need for adequate elderly health and housing services continues to grow while the resources to provide such services are becoming increasingly scarce. Thus, increasing the efficiency of the delivery of healthcare services through the use of modern technology is a pressing issue. The seamless integration of such enabling technologies as ontology, intelligent agents, web services, and cloud computing is transforming healthcare from hospital-based treatments to home-based self-care and preventive care. A ubiquitous healthcare platform based on this technological integration, which synergizes service providers with patients' needs to be developed to provide personalized healthcare services at the right time, in the right place, and the right manner. This paper presents the development and overall architecture of IAServ (the Intelligent Aging-in-place Home care Web Services Platform) to provide personalized healthcare service ubiquitously in a cloud computing setting to support the most desirable and cost-efficient method of care for the aged-aging in place. The IAServ is expected to offer intelligent, pervasive, accurate and contextually-aware personal care services. Architecturally the implemented IAServ leverages web services and cloud computing to provide economic, scalable, and robust healthcare services over the Internet.
Full Text Available As the elderly population has been rapidly expanding and the core tax-paying population has been shrinking, the need for adequate elderly health and housing services continues to grow while the resources to provide such services are becoming increasingly scarce. Thus, increasing the efficiency of the delivery of healthcare services through the use of modern technology is a pressing issue. The seamless integration of such enabling technologies as ontology, intelligent agents, web services, and cloud computing is transforming healthcare from hospital-based treatments to home-based self-care and preventive care. A ubiquitous healthcare platform based on this technological integration, which synergizes service providers with patients’ needs to be developed to provide personalized healthcare services at the right time, in the right place, and the right manner. This paper presents the development and overall architecture of IAServ (the Intelligent Aging-in-place Home care Web Services Platform to provide personalized healthcare service ubiquitously in a cloud computing setting to support the most desirable and cost-efficient method of care for the aged-aging in place. The IAServ is expected to offer intelligent, pervasive, accurate and contextually-aware personal care services. Architecturally the implemented IAServ leverages web services and cloud computing to provide economic, scalable, and robust healthcare services over the Internet.
This volume is a result of the fruitful and vivid discussions during the MedDecSup'2012 International Workshop bringing together a relevant body of knowledge, and new developments in the increasingly important field of medical informatics. This carefully edited book presents new ideas aimed at the development of intelligent processing of various kinds of medical information and the perfection of the contemporary computer systems for medical decision support. The book presents advances of the medical information systems for intelligent archiving, processing, analysis and search-by-content which will improve the quality of the medical services for every patient and of the global healthcare system. The book combines in a synergistic way theoretical developments with the practicability of the approaches developed and presents the last developments and achievements in medical informatics to a broad range of readers: engineers, mathematicians, physicians, and PhD students.
In a software system the size of the Space Station Software Support Environment (SSE), no one software development or implementation methodology is presently powerful enough to provide safe, reliable, maintainable, cost effective real time or near real time software. In an environment that must survive one of the most harsh and long life times, software must be produced that will perform as predicted, from the first time it is executed to the last. Many of the software challenges that will be faced will require strategies borrowed from Artificial Intelligence (AI). AI is the only development area mentioned as an example of a legitimate reason for a waiver from the overall requirement to use the Ada programming language for software development. The limits are defined of the applicability of the Ada language Ada Programming Support Environment (of which the SSE is a special case), and software engineering to AI solutions by describing a scenario that involves many facets of AI methodologies.
Barbosa, Viviane S. B.; Garcia, Luis G. U.; Caldwell, George
The need for continuous safety improvements and increased operational efficiency is driving the mining industry through a transition towards large-scale automation of operations, i.e., “intelligent mines”. The technology promises to remove human operators from harsh or dangerous conditions...... for unmanned mine operations. Although voice and narrowband data radios have been used for years to support several types of mining activities, such as fleet management (dispatch) and telemetry, the use of automated equipment introduces a new set of connectivity requirements and poses a set of challenges...... in terms of network planning, management and optimization. For example, the data rates required to support unmanned equipment, e.g. a teleoperated bulldozer, shift from a few kilobits/second to megabits/second due to live video feeds. This traffic volume is well beyond the capabilities of Professional...
This article deals with the implementation of Multiple Intelligences supported Project-Based learning in EFL/ESL Classrooms. In this study, after Multiple Intelligences supported Project-based learning was presented shortly, the implementation of this learning method into English classrooms. Implementation process of MI supported Project-based…
Loewen, Liz; Roudsari, Abdul
This paper outlines a systematic literature review undertaken to establish current evidence regarding the impact of Business Intelligence (BI) on health system decision making and organizational performance. The review also examined BI implementation factors contributing to these constructs. Following the systematic review, inductive content analysis was used to categorize themes within the eight articles identified. This study demonstrated there is little evidence based literature focused on BI impact on organizational decision making and performance within health care. There was evidence found that BI does improve decision making. Implementation success was found to be dependent on several factors, many of which relate to broader organizational culture and readiness.
A novel quality prediction method with mobile time window is proposed for small-batch producing process based on weighted least squares support vector regression (LS-SVR). The design steps and learning algorithm are also addressed. In the method, weighted LS-SVR is taken as the intelligent kernel, with which the small-batch learning is solved well and the nearer sample is set a larger weight, while the farther is set the smaller weight in the history data. A typical machining process of cutting bearing outer race is carried out and the real measured data are used to contrast experiment. The experimental results demonstrate that the prediction accuracy of the weighted LS-SVR based model is only 20%-30% that of the standard LS-SVR based one in the same condition. It provides a better candidate for quality prediction of small-batch producing process.
Full Text Available As the number of habitants of large cities is expanding, put greater pressure on city infrastructure delivering vital services, such as health, education, public safety and transport. These efforts are added to changing public demands for better information, better education, environmental programs, a more open government, lower maintenance costs and other housing options for older people. Therefore, to achieve these goals, it must take into account the quality of all services, but especially the quality of online services based on the use of modern information and communication technologies.The management of service quality on-line offers a performance evaluation and comparative analysis of indicators. He also works as a decision support to improve the quality of online services and increasing customer satisfaction, essential elements in an intelligent city.
Quinton, Stephen R.
The World Wide Web (WWW) provides learners and knowledge workers convenient access to vast stores of information, so much that present methods for refinement of a query or search result are inadequate - there is far too much potentially useful material. The problem often encountered is that users usually do not recognise what may be useful until they have progressed some way through the discovery, learning, and knowledge acquisition process. Additional support is needed to structure and identify potentially relevant information, and to provide constructive feedback. In short, support for learning is needed. The learning envisioned here is not simply the capacity to recall facts or to recognise objects. The focus is on learning that results in the construction of knowledge. Although most online learning platforms are efficient at delivering information, most do not provide tools that support learning as envisaged in this chapter. It is conceivable that Web-based learning environments can incorporate software systems that assist learners to form new associations between concepts and synthesise information to create new knowledge. This chapter details the rationale and theory behind a research study that aims to evolve Web-based learning environments into 'intelligent thinking' systems that respond to natural language human input. Rather than functioning simply as a means of delivering information, it is argued that online learning solutions will 1 day interact directly with students to support their conceptual thinking and cognitive development.
Full Text Available The widespread availability of high-quality Web-based content offers new potential for supporting teachers as designers of curricula and classroom activities. When coupled with a participatory Web culture and infrastructure, teachers can share their creations as well as leverage from the best that their peers have to offer to support a collective intelligence or crowdsourcing community, which we dub crowdteaching. We applied a collective intelligence framework to characterize crowdteaching in the context of a Web-based tool for teachers called the Instructional Architect (IA. The IA enables teachers to find, create, and share instructional activities (called IA projects for their students using online learning resources. These IA projects can further be viewed, copied, or adapted by other IA users. This study examines the usage activities of two samples of teachers, and also analyzes the characteristics of a subset of their IA projects. Analyses of teacher activities suggest that they are engaging in crowdteaching processes. Teachers, on average, chose to share over half of their IA projects, and copied some directly from other IA projects. Thus, these teachers can be seen as both contributors to and consumers of crowdteaching processes. In addition, IA users preferred to view IA projects rather than to completely copy them. Finally, correlational results based on an analysis of the characteristics of IA projects suggest that several easily computed metrics (number of views, number of copies, and number of words in IA projects can act as an indirect proxy of instructionally relevant indicators of the content of IA projects.
Snowden, Austyn; Stenhouse, Rosie; Young, Jenny; Carver, Hannah; Carver, Fiona; Brown, Norrie
Emotional Intelligence (EI), previous caring experience and mindfulness training may have a positive impact on nurse education. More evidence is needed to support the use of these variables in nurse recruitment and retention. To explore the relationship between EI, gender, age, programme of study, previous caring experience and mindfulness training. Cross sectional element of longitudinal study. 938year one nursing, midwifery and computing students at two Scottish Higher Education Institutes (HEIs) who entered their programme in September 2013. Participants completed a measure of 'trait' EI: Trait Emotional Intelligence Questionnaire Short Form (TEIQue-SF); and 'ability' EI: Schutte's et al. (1998) Emotional Intelligence Scale (SEIS). Demographics, previous caring experience and previous training in mindfulness were recorded. Relationships between variables were tested using non-parametric tests. Emotional intelligence increased with age on both measures of EI [TEIQ-SF H(5)=15.157 p=0.001; SEIS H(5)=11.388, p=0.044]. Females (n=786) scored higher than males (n=149) on both measures [TEIQ-SF, U=44,931, z=-4.509, pemotional intelligence. Mindfulness training was associated with higher 'ability' emotional intelligence. Implications for recruitment, retention and further research are explored. Copyright © 2014. Published by Elsevier Ltd.
B. Dolšak; M. Novak; J. Kaljun
It is becoming more and more evident that adding intelligence to existing computer aids, such as computer aided design systems, can lead to significant improvements in the effective and reliable performance of various engineering tasks, including design optimisation. This paper presents three different intelligent modules to be applied within a computer aided design optimisation cycle to enable more intelligent and less experience-dependent design performance.
Saeed, M.; Lieu, C.; Raber, G.; Mark, R. G.
Development and evaluation of Intensive Care Unit (ICU) decision-support systems would be greatly facilitated by the availability of a large-scale ICU patient database. Following our previous efforts with the MIMIC (Multi-parameter Intelligent Monitoring for Intensive Care) Database, we have leveraged advances in networking and storage technologies to develop a far more massive temporal database, MIMIC II. MIMIC II is an ongoing effort: data is continuously and prospectively archived from all ICU patients in our hospital. MIMIC II now consists of over 800 ICU patient records including over 120 gigabytes of data and is growing. A customized archiving system was used to store continuously up to four waveforms and 30 different parameters from ICU patient monitors. An integrated user-friendly relational database was developed for browsing of patients' clinical information (lab results, fluid balance, medications, nurses' progress notes). Based upon its unprecedented size and scope, MIMIC II will prove to be an important resource for intelligent patient monitoring research, and will support efforts in medical data mining and knowledge-discovery.
Jones, Valerie M.; Karagiannis, Georgios; Heemstra de Groot, S.M.
We present a vision of how ambient intelligent environments may be used in future to support the emergency services during first response to a major incident. A futuristic scenario is presented where, for each of the emergency services, Ambient Intelligence (AmI) technologies are used to support
Jones, Valerie M.; Karagiannis, Georgios; Heemstra de Groot, S.M.; Afifi, H.; Zeghlache, D.
We present a vision of how ambient intelligent environments may be used in future to support the emergency services during first response to a major incident. A futuristic scenario is presented where, for each of the emergency services, Ambient Intelligence (AmI) technologies are used to support
Hancock, Thomas M., III
This paper describes a Modular Artificial Intelligence Inference Engine System (MAIS) support tool that would provide health and status monitoring, cognitive replanning, analysis and support of on-orbit Space Station, Spacelab experiments and systems.
Tamaoki, Tetsuo; Yamamoto, Hiroki; Sato, Masuo; Yoshida, Megumu; Kaneko, Tomoko; Terunuma, Seiichi; Takatsuto, Hiroshi; Morimoto, Makoto.
An operation support system for the experimental fast reactor 'JOYO' was developed based on an intelligent alarm-handling. A specific feature of this system, called JOYCAT (JOYO Consulting and Analyzing Tool), is in its sequential processing structure that a uniform treatment by using design knowledge base is firstly applied for all activated alarms, and an exceptional treatment by using heuristic knowledge base is then applied only for the former results. This enables us to achieve real-time and flexible alarm-handling. The first alarm-handling determines the candidates of causal alarms, important alarms with which the operator should firstly cope, through identifying the cause-consequence relations among alarms based on the design knowledge base in which importance and activating conditions are described for each of 640 alarms in a frame format. The second alarm-handling makes the final judgement with the candidates by using the heuristic knowledge base described as production rules. Then, operation manuals concerning the most important alarms are displayed to operators. JOYCAT has been in commission since September of 1990, after a wide scope of validation tests by using an on-site full-scope training simulator. (author)
AI based Tutoring and Learning Path Adaptation are well known concepts in e-Learning scenarios today and increasingly applied in modern learning environments. In order to gain more flexibility and to enhance existing e-learning platforms, the OPUS One LMS Extension package will enable a generic Intelligent Tutored Adaptive Learning Environment, based on a holistic Multidimensional Instructional Design Model (PENTHA ID Model), allowing AI based tutoring and adaptation functionality to existing Web-based e-learning systems. Relying on "real time" adapted profiles, it allows content- / course authors to apply a dynamic course design, supporting tutored, collaborative sessions and activities, as suggested by modern pedagogy. The concept presented combines a personalized level of surveillance, learning activity- and learning path adaptation suggestions to ensure the students learning motivation and learning success. The OPUS One concept allows to implement an advanced tutoring approach combining "expert based" e-tutoring with the more "personal" human tutoring function. It supplies the "Human Tutor" with precise, extended course activity data and "adaptation" suggestions based on predefined subject matter rules. The concept architecture is modular allowing a personalized platform configuration.
Full Text Available Background: A supportive needs assessment is an essential component of any care program. There is no research evidence regarding the supportive care needs of cancer patients in Iran or other Middle Eastern countries. Aims: The aim of this study was to determine the supportive care needs of Iranian cancer patients. Materials and Methods: This descriptive study was conducted in a referral medical center in the northwest of Iran. A total of 274 cancer patients completed the Supportive Care Needs Survey (SCNS-59. Descriptive statistics were used for data analysis. Results: In 18 items of the SCNS, more than 50% of the participants reported that their needs were unmet. Most frequently, unmet needs were related to the health system, information, physical, and daily living domains, and most met needs were related to sexuality, patient care, and support domains. Conclusions: Iranian cancer patients experience many unmet needs and there is an urgent need for establishing additional supportive care services in Iran.
Full Text Available Business Intelligence (BI applications provide business information to drive decision support. Usability is one of the factors determining the optimal use and eventual benefit derived from BI applications. The documented need for more BI usability research together with the practical necessity for BI evaluation guidelines in the mining industry provides the rationale for this study. The purpose of the study was to investigate the usability evaluation of BI applications in the context of a coal mining organization. The research is guided by the question: How can existing usability criteria be customized to evaluate the usability of BI applications. The research design included user observation, heuristic evaluation and a survey. Based on observations made during user support on a BI application used at a coal mining organization a log of usability issues was compiled. The usability issues extracted from this log was compared and contrasted with general usability criteria from literature to synthesize an initial set of BI usability evaluation criteria. These criteria were used as the basis for a heuristic evaluation of the BI application used at the coal mining organization. The same BI application was also evaluated using the Software Usability Measurement Inventory (SUMI standardized questionnaire. The results from the two evaluations were triangulated and then compared with the BI user issues again to contextualize the findings and synthesize a validated and refined set of criteria. The main contribution of the study is the usability evaluation criteria for BI applications presented as guidelines. These guidelines deviate from existing evaluation guidelines in the emphasis on information architecture, learnability and operability.
Sojda, Richard S.
The number of trumpeter swans (Cygnus buccinator) breeding in the Tri-State area where Montana, Idaho, and Wyoming come together has declined to just a few hundred pairs. However, these birds are part of the Rocky Mountain Population which additionally has over 3,500 birds breeding in Alberta, British Columbia, Northwest Territories, and Yukon Territory. To a large degree, these birds seem to have abandoned traditional migratory pathways in the flyway. Waterfowl managers have been interested in decision support tools that would help them explore simulated management scenarios in their quest towards reaching population recovery and the reestablishment of traditional migratory pathways. I have developed a decision support system to assist biologists with such management, especially related to wetland ecology. Decision support systems use a combination of models, analytical techniques, and information retrieval to help develop and evaluate appropriate alternatives. Swan management is a domain that is ecologically complex, and this complexity is compounded by spatial and temporal issues. As such, swan management is an inherently distributed problem. Therefore, the ecological context for modeling swan movements in response to management actions was built as a multiagent system of interacting intelligent agents that implements a queuing model representing swan migration. These agents accessed ecological knowledge about swans, their habitats, and flyway management principles from three independent expert systems. The agents were autonomous, had some sensory capability, and could respond to changing conditions. A key problem when developing ecological decision support systems is empirically determining that the recommendations provided are valid. Because Rocky Mountain trumpeter swans have been surveyed for a long period of time, I was able to compare simulated distributions provided by the system with actual field observations across 20 areas for the period 1988
Huang, Chang-Qin; Duan, Ru-Lin; Tang, Yong; Zhu, Zhi-Ting; Yan, Yong-Jian; Guo, Yu-Qing
The semantic web brings a new opportunity for efficient information organization and search. To meet the special requirements of the educational field, this paper proposes an intelligent search engine enabled by educational semantic support service, where three kinds of searches are integrated into Educational Information Intelligent Search (EIIS)…
Based on artificial intelligence research, the frame based system for reasoning described in this paper is one of the components of an intelligent decision support system for an information system on petroleum resources and use which is being designed by the Information Methodology Research Project as the first step in the development of a…
The constructs of emotional intelligence, perceived social support and resilience have been primarily developed in a Western, individual-oriented societal context. The application of these constructs in Eastern cultures requires further investigation. The aim of the study was to examine the relationships among trait emotional intelligence,…
Nightingale, Suzanne; Spiby, Helen; Sheen, Kayleigh; Slade, Pauline
Over recent years there has been criticism within the United Kingdom's health service regarding a lack of care and compassion, resulting in adverse outcomes for patients. The impact of emotional intelligence in staff on patient health care outcomes has been recently highlighted. Many recruiters now assess emotional intelligence as part of their selection process for health care staff. However, it has been argued that the importance of emotional intelligence in health care has been overestimated. To explore relationships between emotional intelligence in health care professionals, and caring behaviour. To further explore any additional factors related to emotional intelligence that may impact upon caring behaviour. An integrative review design was used. Psychinfo, Medline, CINAHL Plus, Social Sciences Citation Index, Science Citation Index, and Scopus were searched for studies from 1995 to April 2017. Studies providing quantitative or qualitative exploration of how any healthcare professionals' emotional intelligence is linked to caring in healthcare settings were selected. Twenty two studies fulfilled the inclusion criteria. Three main types of health care professional were identified: nurses, nurse leaders, and physicians. Results indicated that the emotional intelligence of nurses was related to both physical and emotional caring, but emotional intelligence may be less relevant for nurse leaders and physicians. Age, experience, burnout, and job satisfaction may also be relevant factors for both caring and emotional intelligence. This review provides evidence that developing emotional intelligence in nurses may positively impact upon certain caring behaviours, and that there may be differences within groups that warrant further investigation. Understanding more about which aspects of emotional intelligence are most relevant for intervention is important, and directions for further large scale research have been identified. Copyright © 2018 Elsevier Ltd. All
Huang, Ean-Wen; Chiou, Shwu-Fen; Pan, Mei-Lien; Wu, Hua-Huan; Jiang, Jia-Rong; Lu, Yi-De
Rapid progress in information and communication technologies and the increasing popularity of healthcare-related applications has increased interest in the topic of intelligent medical care. This topic emphasizes the use of information and communication technologies to collect and analyze a variety of data in order to provide physicians and other healthcare professionals with clinical decision support. At present, so-called smart hospitals are the focal point of most intelligent-systems development activity, with little attention currently being focused on long-term care needs. The present article discusses the application of intelligent systems in the field of long-term care, especially in community and home-based models of care. System-implementation components such as the data entry interface components of mobile devices, the data transmission and synchronization components between the mobile device and file server, the data presentation, and the statistics analysis components are also introduced. These components have been used to develop long-term care service-related applications, including home health nursing, home-care services, meals on wheels, and assistive devices rental. We believe that the findings will be useful for the promotion of innovative long-term care services as well as the improvement of healthcare quality and efficiency.
Contreras, Ivan; Vehi, Josep
Artificial intelligence methods in combination with the latest technologies, including medical devices, mobile computing, and sensor technologies, have the potential to enable the creation and delivery of better management services to deal with chronic diseases. One of the most lethal and prevalent chronic diseases is diabetes mellitus, which is characterized by dysfunction of glucose homeostasis. The objective of this paper is to review recent efforts to use artificial intelligence techniques to assist in the management of diabetes, along with the associated challenges. A review of the literature was conducted using PubMed and related bibliographic resources. Analyses of the literature from 2010 to 2018 yielded 1849 pertinent articles, of which we selected 141 for detailed review. We propose a functional taxonomy for diabetes management and artificial intelligence. Additionally, a detailed analysis of each subject category was performed using related key outcomes. This approach revealed that the experiments and studies reviewed yielded encouraging results. We obtained evidence of an acceleration of research activity aimed at developing artificial intelligence-powered tools for prediction and prevention of complications associated with diabetes. Our results indicate that artificial intelligence methods are being progressively established as suitable for use in clinical daily practice, as well as for the self-management of diabetes. Consequently, these methods provide powerful tools for improving patients' quality of life. ©Ivan Contreras, Josep Vehi. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 30.05.2018.
... to market, eliminate redundancy, and ease job stress. This thesis proposes a conceptual model for software process management decision support in the form of an intelligent software agent network...
Menizibeya Osain Welcome
Full Text Available Objectives : As an important element of national security, public health not only functions to provide adequate and timely medical care but also track, monitor, and control disease outbreak. The Nigerian health care had suffered several infectious disease outbreaks year after year. Hence, there is need to tackle the problem. This study aims to review the state of the Nigerian health care system and to provide possible recommendations to the worsening state of health care in the country. To give up-to-date recommendations for the Nigerian health care system, this study also aims at reviewing the dynamics of health care in the United States, Britain, and Europe with regards to methods of medical intelligence/surveillance. Materials and Methods : Databases were searched for relevant literatures using the following keywords: Nigerian health care, Nigerian health care system, and Nigerian primary health care system. Additional keywords used in the search were as follows: United States (OR Europe health care dynamics, Medical Intelligence, Medical Intelligence systems, Public health surveillance systems, Nigerian medical intelligence, Nigerian surveillance systems, and Nigerian health information system. Literatures were searched in scientific databases Pubmed and African Journals OnLine. Internet searches were based on Google and Search Nigeria. Results : Medical intelligence and surveillance represent a very useful component in the health care system and control diseases outbreak, bioattack, etc. There is increasing role of automated-based medical intelligence and surveillance systems, in addition to the traditional manual pattern of document retrieval in advanced medical setting such as those in western and European countries. Conclusion : The Nigerian health care system is poorly developed. No adequate and functional surveillance systems are developed. To achieve success in health care in this modern era, a system well grounded in routine
Gerits, L.; Derksen, J.J.L.; Verbruggen, A.B.P.M.
This paper reports on a two-year longitudinal study on the emotional intelligence profiles of 380 nurses caring for clients with highly frequent and extremely severe behaviour problems. The aim was to identify emotional intelligence cluster types for those nurses reporting the fewest symptoms of
Andersen, Peter Bach
This thesis seeks to apply the field of informatics to the intelligent integration of electric vehicles into the power system. The main goal is to release the potential of electric vehicles in relation to a reliable, economically efficient power system based on renewables. To make intelligent EV...... and services in which the electric vehicle may be best suited to participate. The next stakeholder investigated is the distribution system operator representing the low voltage grid. The challenge is assessed by considering a number of grid impacts studies. Next, a set of grid congestion mitigation strategies...
Van der Zwaan, J.M.; Dignum, V.; Jonker, C.M.
In everyday life, people frequently talk to others to help them deal with negative emotions. To some extent, everybody is capable of comforting other people, but so far conversational agents are unable to deal with this type of situation. To provide intelligent agents with the capability to give
Rabbani, Mohamad; Kanevsky, Jonathan; Kafi, Kamran; Chandelier, Florent; Giles, Francis J
Lung cancer is the leading cause of cancer death worldwide. In up to 57% of patients, it is diagnosed at an advanced stage and the 5-year survival rate ranges between 10%-16%. There has been a significant amount of research using machine learning to generate tools using patient data to improve outcomes. This narrative review is based on research material obtained from PubMed up to Nov 2017. The search terms include "artificial intelligence," "machine learning," "lung cancer," "Nonsmall Cell Lung Cancer (NSCLC)," "diagnosis" and "treatment." Recent studies support the use of computer-aided systems and the use of radiomic features to help diagnose lung cancer earlier. Other studies have looked at machine learning (ML) methods that offer prognostic tools to doctors and help them in choosing personalized treatment options for their patients based on molecular, genetics and histological features. Combining artificial intelligence approaches into health care may serve as a beneficial tool for patients with NSCLC, and this review outlines these benefits and current shortcomings throughout the continuum of care. We present a review of the various applications of ML methods in NSCLC as it relates to improving diagnosis, treatment and outcomes. © 2018 Stichting European Society for Clinical Investigation Journal Foundation.
Collins, Sarah; Klinkenberg-Ramirez, Stephanie; Tsivkin, Kira; Mar, Perry L; Iskhakova, Dina; Nandigam, Hari; Samal, Lipika; Rocha, Roberto A
Develop a prototype of an interprofessional terminology and information model infrastructure that can enable care planning applications to facilitate patient-centered care, learn care plan linkages and associations, provide decision support, and enable automated, prospective analytics. The study steps included a 3 step approach: (1) Process model and clinical scenario development, and (2) Requirements analysis, and (3) Development and validation of information and terminology models. Components of the terminology model include: Health Concerns, Goals, Decisions, Interventions, Assessments, and Evaluations. A terminology infrastructure should: (A) Include discrete care plan concepts; (B) Include sets of profession-specific concerns, decisions, and interventions; (C) Communicate rationales, anticipatory guidance, and guidelines that inform decisions among the care team; (D) Define semantic linkages across clinical events and professions; (E) Define sets of shared patient goals and sub-goals, including patient stated goals; (F) Capture evaluation toward achievement of goals. These requirements were mapped to AHRQ Care Coordination Measures Framework. This study used a constrained set of clinician-validated clinical scenarios. Terminology models for goals and decisions are unavailable in SNOMED CT, limiting the ability to evaluate these aspects of the proposed infrastructure. Defining and linking subsets of care planning concepts appears to be feasible, but also essential to model interprofessional care planning for common co-occurring conditions and chronic diseases. We recommend the creation of goal dynamics and decision concepts in SNOMED CT to further enable the necessary models. Systems with flexible terminology management infrastructure may enable intelligent decision support to identify conflicting and aligned concerns, goals, decisions, and interventions in shared care plans, ultimately decreasing documentation effort and cognitive burden for clinicians and
Keller, Richard M.
Scientific model-building can be a time-intensive and painstaking process, often involving the development of large and complex computer programs. Despite the effort involved, scientific models cannot easily be distributed and shared with other scientists. In general, implemented scientific models are complex, idiosyncratic, and difficult for anyone but the original scientific development team to understand. We believe that artificial intelligence techniques can facilitate both the model-building and model-sharing process. In this paper, we overview our effort to build a scientific modeling software tool that aids the scientist in developing and using models. This tool includes an interactive intelligent graphical interface, a high-level domain specific modeling language, a library of physics equations and experimental datasets, and a suite of data display facilities.
Bansler, Jørgen P.; Havn, Erling C.; Kensing, Finn
This paper describes work-in-progress to explore how informa-tion and communication technologies (ICT) can be designed and implemented to provide effective support of shared care programs. The purpose of the project is to develop generic models of shared care applications as well as organizational...
Sternberg, Robert J.
Intelligence is the ability to learn from experience and to adapt to, shape, and select environments. Intelligence as measured by (raw scores on) conventional standardized tests varies across the lifespan, and also across generations. Intelligence can be understood in part in terms of the biology of the brain—especially with regard to the functioning in the prefrontal cortex—and also correlates with brain size, at least within humans. Studies of the effects of genes and environment suggest that the heritability coefficient (ratio of genetic to phenotypic variation) is between .4 and .8, although heritability varies as a function of socioeconomic status and other factors. Racial differences in measured intelligence have been observed, but race is a socially constructed rather than biological variable, so such differences are difficult to interpret. PMID:22577301
Sternberg, Robert J
Intelligence is the ability to learn from experience and to adapt to, shape, and select environments. Intelligence as measured by (raw scores on) conventional standardized tests varies across the lifespan, and also across generations. Intelligence can be understood in part in terms of the biology of the brain-especially with regard to the functioning in the prefrontal cortex-and also correlates with brain size, at least within humans. Studies of the effects of genes and environment suggest that the heritability coefficient (ratio of genetic to phenotypic variation) is between .4 and .8, although heritability varies as a function of socioeconomic status and other factors. Racial differences in measured intelligence have been observed, but race is a socially constructed rather than biological variable, so such differences are difficult to interpret.
Muhammad Faisal Siddiqui
Full Text Available A wide interest has been observed in the medical health care applications that interpret neuroimaging scans by machine learning systems. This research proposes an intelligent, automatic, accurate, and robust classification technique to classify the human brain magnetic resonance image (MRI as normal or abnormal, to cater down the human error during identifying the diseases in brain MRIs. In this study, fast discrete wavelet transform (DWT, principal component analysis (PCA, and least squares support vector machine (LS-SVM are used as basic components. Firstly, fast DWT is employed to extract the salient features of brain MRI, followed by PCA, which reduces the dimensions of the features. These reduced feature vectors also shrink the memory storage consumption by 99.5%. At last, an advanced classification technique based on LS-SVM is applied to brain MR image classification using reduced features. For improving the efficiency, LS-SVM is used with non-linear radial basis function (RBF kernel. The proposed algorithm intelligently determines the optimized values of the hyper-parameters of the RBF kernel and also applied k-fold stratified cross validation to enhance the generalization of the system. The method was tested by 340 patients' benchmark datasets of T1-weighted and T2-weighted scans. From the analysis of experimental results and performance comparisons, it is observed that the proposed medical decision support system outperformed all other modern classifiers and achieves 100% accuracy rate (specificity/sensitivity 100%/100%. Furthermore, in terms of computation time, the proposed technique is significantly faster than the recent well-known methods, and it improves the efficiency by 71%, 3%, and 4% on feature extraction stage, feature reduction stage, and classification stage, respectively. These results indicate that the proposed well-trained machine learning system has the potential to make accurate predictions about brain abnormalities
Lee, Yune-Sang; Min, Nam Eun; Wingfield, Arthur; Grossman, Murray; Peelle, Jonathan E
The information contained in a sensory signal plays a critical role in determining what neural processes are engaged. Here we used interleaved silent steady-state (ISSS) functional magnetic resonance imaging (fMRI) to explore how human listeners cope with different degrees of acoustic richness during auditory sentence comprehension. Twenty-six healthy young adults underwent scanning while hearing sentences that varied in acoustic richness (high vs. low spectral detail) and syntactic complexity (subject-relative vs. object-relative center-embedded clause structures). We manipulated acoustic richness by presenting the stimuli as unprocessed full-spectrum speech, or noise-vocoded with 24 channels. Importantly, although the vocoded sentences were spectrally impoverished, all sentences were highly intelligible. These manipulations allowed us to test how intelligible speech processing was affected by orthogonal linguistic and acoustic demands. Acoustically rich speech showed stronger activation than acoustically less-detailed speech in a bilateral temporoparietal network with more pronounced activity in the right hemisphere. By contrast, listening to sentences with greater syntactic complexity resulted in increased activation of a left-lateralized network including left posterior lateral temporal cortex, left inferior frontal gyrus, and left dorsolateral prefrontal cortex. Significant interactions between acoustic richness and syntactic complexity occurred in left supramarginal gyrus, right superior temporal gyrus, and right inferior frontal gyrus, indicating that the regions recruited for syntactic challenge differed as a function of acoustic properties of the speech. Our findings suggest that the neural systems involved in speech perception are finely tuned to the type of information available, and that reducing the richness of the acoustic signal dramatically alters the brain's response to spoken language, even when intelligibility is high. Copyright © 2015 Elsevier
Granlien, Maren Fich; Simonsen, Jesper
: (1) Poor integration with the general practitioners' existing IT systems; (2) low compatibility with general practitioners' work ethic; (3) and discrepancy between the number of diabetes patients and the related need for shared care. We conclude that development of IT-supported shared care must...... the same challenges that led to the same problem: The secondary care sector quickly adopted the system while the primary sector was far more sceptical towards using it. In both cases, we observe a discrepancy of needs satisfied, especially with regard to the primary care sector and its general...
Ozbolt, Judy; Ozdas, Asli; Waitman, Lemuel R; Smith, Janis B; Brennan, Grace V; Miller, Randolph A
The application of principles and methods of cybernetics permits clinicians and managers to use feedback about care effectiveness and resource expenditure to improve quality and to control costs. Keys to the process are the specification of therapeutic goals and the creation of an organizational culture that supports the use of feedback to improve care. Daily feedback on the achievement of each patient's therapeutic goals provides tactical decision support, enabling clinicians to adjust care as needed. Monthly or quarterly feedback on aggregated goal achievement for all patients on a clinical pathway provides strategic decision support, enabling clinicians and managers to identify problems with supposed "best practices" and to test hypotheses about solutions. Work is underway at Vanderbilt University Medical Center to implement feedback loops in care and management processes and to evaluate the effects.
Full Text Available With the development of wireless sensor unit, and improvement of real-time and quality of wireless communication, the intelligent transportation control system employ these technologies to realize sensing, positioning, computing, and communication for voiding collisions. This paper discusses the framework of transportation control system, and emphases TDOA positioning algorithm and the new weighted least square optimization method. The simulation result shows that, our method achieves high-accuracy of positioning, which can satisfy the need of transportation control. Finally, we outline the urgent work need to address in the future.
Patterson, C; Sinkewich, M; Short, J; Callas, E
The first step in redesigning the health care delivery process for ambulatory care begins with the patient and the business processes that support the patient. Patient-related business processes include patient access, service documentation, billing, follow-up, collection, and payment. Access is the portal to the clinical delivery and care management process. Service documentation, charge capture, and payment and collection are supporting processes to care delivery. Realigned provider networks now demand realigned patient business services to provide their members/customers/patients with improved service delivery at less cost. Purchaser mandates for cost containment, health maintenance, and enhanced quality of care have created an environment where every aspect of the delivery system, especially ambulatory care, is being judged. Business processes supporting the outpatient are therefore being reexamined for better efficiency and customer satisfaction. Many health care systems have made major investments in their ambulatory care environment, but have pursued traditional supporting business practices--such as multiple access points, lack of integrated patient appointment scheduling and registration, and multiple patient bills. These are areas that are appropriate for redesign efforts--all with the customer's needs and convenience in mind. Similarly, setting unrealistic expectations, underestimating the effort required, and ignoring the human elements of a patient-focused business service redesign effort can sabotage the very sound reasons for executing such an endeavor. Pitfalls can be avoided if a structured methodology, coupled with a change management process, are employed. Deloitte & Touche Consulting Group has been involved in several major efforts, all with ambulatory care settings to assist with the redesign of their business practices to consider the patient as the driver, instead of the institution providing the care.
Stenhouse, Rosie; Snowden, Austyn; Young, Jenny; Carver, Fiona; Carver, Hannah; Brown, Norrie
Reports of poor nursing care have focused attention on values based selection of candidates onto nursing programmes. Values based selection lacks clarity and valid measures. Previous caring experience might lead to better care. Emotional intelligence (EI) might be associated with performance, is conceptualised and measurable. To examine the impact of 1) previous caring experience, 2) emotional intelligence 3) social connection scores on performance and retention in a cohort of first year nursing and midwifery students in Scotland. A longitudinal, quasi experimental design. Adult and mental health nursing, and midwifery programmes in a Scottish University. Adult, mental health and midwifery students (n=598) completed the Trait Emotional Intelligence Questionnaire-short form and Schutte's Emotional Intelligence Scale on entry to their programmes at a Scottish University, alongside demographic and previous caring experience data. Social connection was calculated from a subset of questions identified within the TEIQue-SF in a prior factor and Rasch analysis. Student performance was calculated as the mean mark across the year. Withdrawal data were gathered. 598 students completed baseline measures. 315 students declared previous caring experience, 277 not. An independent-samples t-test identified that those without previous caring experience scored higher on performance (57.33±11.38) than those with previous caring experience (54.87±11.19), a statistically significant difference of 2.47 (95% CI, 0.54 to 4.38), t(533)=2.52, p=.012. Emotional intelligence scores were not associated with performance. Social connection scores for those withdrawing (mean rank=249) and those remaining (mean rank=304.75) were statistically significantly different, U=15,300, z=-2.61, p$_amp_$lt;0.009. Previous caring experience led to worse performance in this cohort. Emotional intelligence was not a useful indicator of performance. Lower scores on the social connection factor were associated
Singh, Reetu; Mehfuz, Shabana; Kumar, Parmod
Distribution system is the means of revenue for electric utility. It needs to be restored at the earliest if any feeder or complete system is tripped out due to fault or any other cause. Further, uncertainty of the loads, result in variations in the distribution network's parameters. Thus, an intelligent algorithm incorporating hybrid fuzzy-grey relation, which can take into account the uncertainties and compare the sequences is discussed to analyse and restore the distribution system. The simulation studies are carried out to show the utility of the method by ranking the restoration plans for a typical distribution system. This algorithm also meets the smart grid requirements in terms of an automated restoration plan for the partial/full blackout of network.
Full Text Available The penetration of GSM capable devices is very high, especially in Europe. To exploit the potential of turning these mobile devices into dynamic data acquisition nodes that provides valuable data for Intelligent Transportation Systems (ITS, position information is needed. The paper describes the basic operation principles of the GSM system and provides an overview on the existing methods for deriving location data in the network. A novel positioning solution is presented that rely on handover (HO zone measurements; the zone geometry properties are also discussed. A new concept of HO zone sequence recognition is introduced that involves application of Probabilistic Deterministic Finite State Automata (PDFA. Both the potential commercial applications and the use of the derived position data in ITS is discussed for tracking vehicles and monitoring traffic flow. As a practical cutting edge example, the integration possibility of the technology in the SafeTRIP platform (developed in an EC FP7 project is presented.
Larin, Helene; Benson, Gerry; Wessel, Jean; Martin, Lynn; Ploeg, Jenny
In addition to having academic knowledge and clinical skills, health professionals need to be caring, ethical practitioners able to understand the emotional concerns of their patients and to effect change. The purpose of this study was to determine whether emotional-social intelligence, caring, leadership and moral judgment of health science…
González Aguña, Alexandra; Fernández Batalla, Marta; Cercas Duque, Adriana; Herrero Jaén, Sara; Monsalvo San Macario, Enrique; Jiménez Rodríguez, Ma Lourdes; Santamaría García, José Ma; Ramírez Sánchez, Sylvia Claudine; Vialart Vidal, Niurka; Condor Camara, Daniel Flavio
An ontology of care is a formal, explicit specification of a shared conceptualization. Constructing an ontology is a process that requires four elements: knowledge object, subject that knows, knowledge operation and result. These elements configure theframework to generate ontologies that can be used in Artificial Intelligence systems for care.
...) Investigative Support Center (ISC). Prior to 9/11, the national intelligence apparatus was littered with flaws, including lack of information sharing, interagency conflict, and autonomous operations...
Aziz, A.A.; Klein, M.C.A.; Treur, J.
Helping someone who is depressed can be very important to the depressed person. A number of supportive family members or friends can often make a big difference. This paper addresses how a social support network can be formed, taking the needs of the support recipient and the possibilities of the
Voss, Stefan; Sebastian, Hans-Jürgen; Pahl, Julia
Intelligent Decision Support and Big Data for Logistics and Supply Chain Management” features theoretical developments, real-world applications and information systems related to solving decision problems in logistics and supply chain management. Methods include optimization, heuristics, metaheur......Intelligent Decision Support and Big Data for Logistics and Supply Chain Management” features theoretical developments, real-world applications and information systems related to solving decision problems in logistics and supply chain management. Methods include optimization, heuristics......, metaheuristics and matheuristics, simulation, agent technologies, and descriptive methods. In a sense, we were and are representing the future of logistics over the years....
Full Text Available Existing approaches to support Multilingualism (ML in Business Intelligence (BI create problems for business users, present a number of challenges from the technical perspective, and lead to issues with logical dependence in the star schema. In this paper, we propose MLED_BI (Multilingual Enabled Design for Business Intelligence, a novel BI design approach to support the application of ML in BI Environment, which overcomes the issues and problems found with existing approaches. The approach is based on a revision of the data warehouse dimensional modelling approach and treats the Star Schema as a higher level entity. This paper describes MLED_BI and the validation and evaluation approach used.
Elkin, Peter L; Schlegel, Daniel R; Anderson, Michael; Komm, Jordan; Ficheur, Gregoire; Bisson, Leslie
Evoking strength is one of the important contributions of the field of Biomedical Informatics to the discipline of Artificial Intelligence. The University at Buffalo's Orthopedics Department wanted to create an expert system to assist patients with self-diagnosis of knee problems and to thereby facilitate referral to the right orthopedic subspecialist. They had two independent sports medicine physicians review 469 cases. A board-certified orthopedic sports medicine practitioner, L.B., reviewed any disagreements until a gold standard diagnosis was reached. For each case, the patients entered 126 potential answers to 26 questions into a Web interface. These were modeled by an expert sports medicine physician and the answers were reviewed by L.B. For each finding, the clinician specified the sensitivity (term frequency) and both specificity (Sp) and the heuristic evoking strength (ES). Heuristics are methods of reasoning with only partial evidence. An expert system was constructed that reflected the posttest odds of disease-ranked list for each case. We compare the accuracy of using Sp to that of using ES (original model, p < 0.0008; term importance * disease importance [DItimesTI] model, p < 0.0001: Wilcoxon ranked sum test). For patient referral assignment, Sp in the DItimesTI model was superior to the use of ES. By the fifth diagnosis, the advantage was lost and so there is no difference between the techniques when serving as a reminder system. Schattauer GmbH Stuttgart.
Researchers in military command and control (C2) have for several decades sought to help commanders by introducing automated, intelligent decision support systems. These systems are still not widely used, however, and some researchers argue that this may be due to those problems that are inherent in the relationship between the affordances of technology and the requirements by the specific contexts of work in military C2. In this thesis, we study some specific properties of three support tech...
In this paper, factors relevant to the design and acceptance of intelligent support systems for the operation of nuclear power plants are enumerated and discussed. The central premise is that conventional expert systems which encode experiential knowledge in production rules are not a suitable vehicle for the creation of practical operator support systems. The principal difficulty is the need for real-time operation. This in turn means that intelligent support systems will have knowledge bases derived from temporally accurate plant models, inference engines that permit revisions in the search process so as to accommodate revised or new data, and man-machine interfaces that do not require any human input. Such systems will have to be heavily instrumented and the associated knowledge bases will require a hierarchical organization so as to emulate human approaches to analysis. Issues related to operator acceptance of intelligent support tools are then reviewed. Possible applications are described and the relative merits of the machine- and human-centered approaches to the implementation of intelligent support systems are enumerated. The paper concludes with a plea for additional experimental evaluations
van de Wetering, Marianne D.; Schouten-van Meeteren, Netteke Y. N.
In developed countries the survival rate of children with cancer exceeds 75%. Optimal supportive care is necessary to deliver the burdensome treatment protocols. As the intensity of primary treatment has escalated, so have the side effects like myelosuppression and infection. Children who receive
... For Parents / Taking Care of You: Support for Caregivers What's in this article? The Caregiver's Dilemma Tips for Caregivers More Tips Getting Help ... there are moments when the sheer magnitude of what you're up against is so ... not alone. The Caregiver's Dilemma When you're the caregiver of a ...
Full Text Available Critical-care nurses often look after three or more critically-ill patients during a shift. The workload and emotional stress can lead to disharmony between the nurse’s body, mind and spirit. Nurses with a high emotional intelligence have less emotional exhaustion and psychosomatic symptoms; they enjoy better emotional health; gain more satisfaction from their actions (both at work and at home; and have improved relationships with colleagues at work. The question arises: what is the emotional intelligence of critical-care nurses? A quantitative survey was conducted. The target population was registered nurses working in critical-care units who attended the Critical Care Congress 2009 (N = 380. Data were collected with the use of the Trait Emotional Intelligence Short Form and analysed using the Statistical Package for the Social Sciences software. The sample (n= 220 was mainly a mature, female and professionally-experienced group of registered nurses. They held a variety of job descriptions within various critical-care units. Statistics indicated that the standard deviations were small and no aberrant aspects such as demographics skewed the findings. The conclusion was made that registered nurses who are older and that have more experience in critical care appear to have a higher range of emotional intelligence.
Branscum, Paul; Haider, Taj; Brown, David; Sharma, Manoj
Background: The theory of emotional intelligence (EI) has been developed to evaluate and highlight the importance of emotional health, especially on job performance. Purpose: No study has examined EI's role on the performance of public health educators; therefore, this study examined the role of EI and social support on the performance of health…
Donald Nute; Walter D. Potter; Frederick Maier; Jin Wang; Mark Twery; H. Michael Rauscher; Peter Knopp; Scott Thomasma; Mayukh Dass; Hajime Uchiyama
Decision making for forest ecosystem management can include the use of a wide variety of modeling tools. These tools include vegetation growth models, wildlife models, silvicultural models, GIS, and visualization tools. NED-2 is a robust, intelligent, goal-driven decision support system that integrates tools in each of these categories. NED-2 uses a blackboard...
Dullaert, Wout; Neutens, Tijs; Vanden Berghe, Greet; Vermeulen, Tijs; Vernimmen, Bert; Witlox, Frank
In this paper, an intelligent agent-based communication support platform for multimodal transport is developed. The rationale for doing so is found in the potential of such a system to increase cost efficiency, service and safety for different transport-related actors. Although, at present several
Liu, L.; Daniëls, H.A.M.; Johannesson, P.
Collaborative business intelligence supports risk assessment and in return enhances management control on a business network. Nonetheless, it needs an incentive basis in the first place before it can be implemented, that is, the value model. Starting from the managerial challenges which arise from
Aziz, A.A.; Klein, M.C.A.; Zhang, B.; Wang, Y.; Kinser, W.
This paper presents the design of an intelligent agent application aimed at supporting people with a cognitive vulnerability to prevent the onset of a depression. For this, a computational model of the cognitive processes around depression is used. The agent application uses the principles of
Ghavami, S.M.; Taleai, M.; Arentze, T.A.
This research presents an intelligent planning support system based on multi-agent systems for spatial urban land use planning. The proposed system consists of two main phases: a pre-negotiation phase and an automated negotiation phase. The pre-negotiation phase involves interaction between human
Over 400,000 children are in foster care in the United States, and more than 100,000 of them are waiting to be adopted. Yet many will age out of foster care into adulthood without an adoptive family. Teens and young adults aging out of foster care, even those with preparation and training for the transition, often do not fare well in young adulthood. Many face challenges in areas of education, employment, homelessness, finances, the criminal justice system, and meeting health and mental healthcare needs. Research demonstrates what only makes sense: teens with tangible support from meaningful adult relationships fare better than those without. This article describes an innovative program that connects teens in foster care with supportive adults through social events that can lead to meaningful long-term teen-adult connections - including friendships, mentoring, and even, in some cases, adoption. Pediatric nurses, aware of the challenges these teens face adjusting to adulthood, can begin to explore referral and support options for such teens in their own locales using the resources herein.
Full Text Available Background: Emotion and how people manage it is an important part of personality that would immensely affect their health. Investigations showed that emotional intelligence is significantly related to and can predict psychological health. Objective: To determine the effect of teaching emotional intelligence to intensive care unit nurses on their general health. Methods: This randomized clinical trial (registered as IRCT201208022812N9 was conducted on 52 of 200 in intensive care unit nurses affiliated to Shiraz University of Medical Sciences. They were recruited through purposeful convenience sampling and then randomly categorized into two groups. The intervention group members were trained in emotional intelligence. Bar-on emotional intelligence and Goldberg's general health questionnaires were administered to each participant before, immediately after, and one month after the intervention. Results: While the mean score of general health for the intervention group decreased from 25.4 before the intervention, to 18.1 immediately after the intervention and to 14.6 one month later, for the control group, it increased from 22.0, to 24.2 and to 26.5, respectively (p<0.001. Conclusion: Teaching emotional intelligence improved the general health of intensive care unit nurses.
Pediatric supportive care is an important aspect of cancer care as children and adolescents face unique challenges compared to adult patients. Learn more about supportive care for pediatric patients during and after treatment in this expert-reviewed summary.
Ajay Kumar Saxena
Full Text Available Electrical Power Network in recent time requires an intelligent, virtual environment based decision process for the coordination of all its individual elements and the interrelated tasks. Its ultimate goal is to achieve maximum productivity and efficiency through the efficient and effective application of generation, transmission, distribution, pricing and regulatory systems. However, the complexity of electrical power network and the presence of conflicting multiple goals and objectives postulated by various groups emphasized the need of an intelligent group decision support system approach in this field. In this paper, an Integrated Multimedia based Intelligent Group Decision Support System (IM1GDSS is presented, and its main components are analyzed and discussed. In particular attention is focused on the Data Base, Model Base, Central Black Board (CBB and Multicriteria Futuristic Decision Process (MFDP module. The model base interacts with Electrical Power Network Load Forecasting and Planning (EPNLFP Module; Resource Optimization, Modeling and Simulation (ROMAS Module; Electrical Power Network Control and Evaluation Process (EPNCAEP Module, and MFDP Module through CBB for strategic planning, management control, operational planning and transaction processing. The richness of multimedia channels adds a totally new dimension in a group decision making for Electrical Power Network. The proposed IMIGDSS is a user friendly, highly interactive group decision making system, based on efficient intelligent and multimedia communication support for group discussions, retrieval of content and multi criteria decision analysis.
Full Text Available The viability and success of modern enterprises are subject to the increasing dynamic of the economic environment, so they need to adjust rapidly their policies and strategies in order to respond to sophistication of competitors, customers and suppliers, globalization of business, international competition. Perhaps the most critical component for success of the modern enterprise is its ability to take advantage of all available information - both internal and external. Making sense of all this information, gaining value and competitive advantage through represents real challenges for the enterprise. The IT solutions designed to address these challenges have been developed in two different approaches: structured data management (Business Intelligence and unstructured content management (Knowledge Management. Integrating Business Intelligence and Knowledge Management in new software applications designated not only to store highly structured data and exploit it in real time but also to interpret the results and communicate them to decision factors provides real technological support for Strategic Management. Integrating Business Intelligence and Knowledge Management in order to respond to the challenges the modern enterprise has to deal with represents not only a "new trend" in IT, but a necessity in the emerging knowledge based economy. These hybrid technologies are already widely known in both scientific and practice communities as Competitive Intelligence. In the end of paper,a competitive datawarehouse design is proposed, in an attempt to apply business intelligence technologies to economic environment analysis making use of romanian public data sources.
Hayder Naser Khraibet
Full Text Available Intelligent Hypothermia Care System (IHCS is an intelligence system uses set of methodologies, algorithms, architectures and processes to determine where patients in a postoperative recovery area must be sent. Hypothermia is a significant concern after surgery. This paper utilizes the classification task in data mining to propose an intelligent technique to predict where to send a patient after surgery: intensive care unit, general floor or home. To achieve this goal, this paper evaluates the performance of decision tree algorithm, exemplifying the deterministic approach, against the AntMiner algorithm, exemplifying the heuristic approach, to choose the best approach in detecting the patient’s status. Results show the outperformance of the heuristic approach. The implication of this proposal will be twofold: in hypothermia treatment and in the application of ant colony optimization
Department of Veterans Affairs — The Primary Care Management Module (PCMM) was developed to assist VA facilities in implementing Primary Care. PCMM supports both Primary Care and non-Primary Care...
Full Text Available Human Computer Interaction is one of the pervasive application areas of computer science to develop with multimodal interaction for information sharings. The conversation agent acts as the major core area for developing interfaces between a system and user with applied AI for proper responses. In this paper, the interactive system plays a vital role in improving knowledge in the domain of health through the intelligent interface between machine and human with text and speech. The primary aim is to enrich the knowledge and help the user in the domain of health using conversation agent to offer immediate response with human companion feel.
Wu, J.S.; Apostolakis, G.E.; Okrent, D.
The purpose of this paper is to review the progress made in recent years in both the area of PRA as a support to AI applications and the area of AI applications in PRA. The emphasis is on the areas that have made some progress in the past few years, with a brief description of the methods and a discussion of the potential uses and weaknesses. Also included is a brief review of recent developments in the theory of uncertainty in the AI community that may impact uncertainty modeling in PRA. AI techniques could be applied to the related field of PRA in several ways. In this discussion, however, the scope is limited to emergency diagnosis and accident management, because these are the areas that have attracted most of the attention in recent years. The potential use of PRA as a support to these applications is discussed in detail, and this is followed by a survey of recent developments in these areas. (orig./GL)
Mohammadzadeh, Niloofar; Safdari, Reza
Studies of the causes of cancer, early detection, prevention or treatment need accurate, comprehensive, and timely cancer data. The clinical laboratory provides important cancer information needed for physicians which influence clinical decisions regarding treatment, diagnosis and patient monitoring. Poor communication between health care providers and clinical laboratory personnel can lead to medical errors and wrong decisions in providing cancer care. Because of the key impact of laboratory information on cancer diagnosis and treatment the quality of the tests, lab reports, and appropriate lab management are very important. A laboratory information management system (LIMS) can have an important role in diagnosis, fast and effective access to cancer data, decrease redundancy and costs, and facilitate the integration and collection of data from different types of instruments and systems. In spite of significant advantages LIMS is limited by factors such as problems in adaption to new instruments that may change existing work processes. Applications of intelligent software simultaneously with existing information systems, in addition to remove these restrictions, have important benefits including adding additional non-laboratory-generated information to the reports, facilitating decision making, and improving quality and productivity of cancer care services. Laboratory systems must have flexibility to change and have the capability to develop and benefit from intelligent devices. Intelligent laboratory information management systems need to benefit from informatics tools and latest technologies like open sources. The aim of this commentary is to survey application, opportunities and necessity of intelligent clinical laboratory as a tool to increase cancer care management productivity.
Galar Pascual, Diego
Artificial Intelligence Tools: Decision Support Systems in Condition Monitoring and Diagnosis discusses various white- and black-box approaches to fault diagnosis in condition monitoring (CM). This indispensable resource: Addresses nearest-neighbor-based, clustering-based, statistical, and information theory-based techniques Considers the merits of each technique as well as the issues associated with real-life application Covers classification methods, from neural networks to Bayesian and support vector machines Proposes fuzzy logic to explain the uncertainties associated with diagnostic processes Provides data sets, sample signals, and MATLAB® code for algorithm testing Artificial Intelligence Tools: Decision Support Systems in Condition Monitoring and Diagnosis delivers a thorough evaluation of the latest AI tools for CM, describing the most common fault diagnosis techniques used and the data acquired when these techniques are applied.
Arai, Hiroshi; Uota, Atsushi; Ishida, Hidenobu
'X-ray Diffraction AI Qualitative Analysis System' which can support analytical operation was developed. The purpose of this development is that even a beginner analyst can obtain the accurate results as well as specialists. This system has three new functions. The first one is to determine the suitable measuring conditions automatically for samples or analytical aim. The second is to guide the method of peak search. And, the third is to determine searching conditions same as measuring conditions. These were realized by applying experts' knowledge with 'AI techniques' and were added to our qualitative analysis systems. A beginner analyses through dialogue with this system, and can get the same results as a specialist would get. (author)
Banjar, Haneen; Adelson, David; Brown, Fred; Chaudhri, Naeem
The use of intelligent techniques in medicine has brought a ray of hope in terms of treating leukaemia patients. Personalized treatment uses patient's genetic profile to select a mode of treatment. This process makes use of molecular technology and machine learning, to determine the most suitable approach to treating a leukaemia patient. Until now, no reviews have been published from a computational perspective concerning the development of personalized medicine intelligent techniques for leukaemia patients using molecular data analysis. This review studies the published empirical research on personalized medicine in leukaemia and synthesizes findings across studies related to intelligence techniques in leukaemia, with specific attention to particular categories of these studies to help identify opportunities for further research into personalized medicine support systems in chronic myeloid leukaemia. A systematic search was carried out to identify studies using intelligence techniques in leukaemia and to categorize these studies based on leukaemia type and also the task, data source, and purpose of the studies. Most studies used molecular data analysis for personalized medicine, but future advancement for leukaemia patients requires molecular models that use advanced machine-learning methods to automate decision-making in treatment management to deliver supportive medical information to the patient in clinical practice.
Rongier, G.; Pankratius, V.
Mars is a key target for planetary exploration; a better understanding of its evolution and habitability requires roving in situ. Landing site selection is becoming more challenging for scientists as new instruments generate higher data volumes. The involved engineering and scientific constraints make site selection and the anticipation of possible onsite actions into a complex optimization problem: there may be multiple acceptable solutions depending on various goals and assumptions. Solutions must also account for missing data, errors, and potential biases. To address these problems, we propose an AI-informed decision support system that allows scientists, mission designers, engineers, and committees to explore alternative site selection choices based on data. In particular, we demonstrate first results of an exploratory case study using fuzzy logic and a simulation of a rover's mobility map based on the fast marching algorithm. Our system computes favorability maps of the entire planet to facilitate landing site selection and allows a definition of different configurations for rovers, science target priorities, landing ellipses, and other constraints. For a rover similar to NASA's Mars 2020 rover, we present results in form of a site favorability map as well as four derived exploration scenarios that depend on different prioritized scientific targets, all visualizing inherent tradeoffs. Our method uses the NASA PDS Geosciences Node and the NASA/ICA Integrated Database of Planetary Features. Under common assumptions, the data products reveal Eastern Margaritifer Terra and Meridiani Planum to be the most favorable sites due to a high concentration of scientific targets and a flat, easily navigable surface. Our method also allows mission designers to investigate which constraints have the highest impact on the mission exploration potential and to change parameter ranges. Increasing the elevation limit for landing, for example, provides access to many additional
Alice M K Wong
Full Text Available The key components of caring for the elderly are diet, living, transportation, education, and safety issues, and telemedical systems can offer great assistance. Through the integration of personal to community information technology platforms, we have developed a new Intelligent Comprehensive Interactive Care (ICIC system to provide comprehensive services for elderly care. The ICIC system consists of six items, including medical care (physiological measuring system, Medication Reminder, and Dr. Ubiquitous, diet, living, transportation, education (Intelligent Watch, entertainment (Sharetouch, and safety (Fall Detection. In this study, we specifically evaluated the users' intention of using the Medication Reminder, Dr. Ubiquitous, Sharetouch, and Intelligent Watch using a modified technological acceptance model (TAM. A total of 121 elderly subjects (48 males and 73 females were recruited. The modified TAM questionnaires were collected after they had used these products. For most of the ICIC units, the elderly subjects revealed great willingness and/or satisfaction in using this system. The elderly users of the Intelligent Watch showed the greatest willingness and satisfaction, while the elderly users of Dr. Ubiquitous revealed fair willingness in the dimension of perceived ease of use. The old-old age group revealed greater satisfaction in the dimension of result demonstrability for the users of the Medication Reminder as compared to the young-old and oldest-old age groups. The women revealed greater satisfaction in the dimension of perceived ease of use for the users of Dr. Ubiquitous as compared to the men. There were no statistically significant differences in terms of gender, age, and education level in the other dimensions. The modified TAM showed its effectiveness in evaluating the acceptance and characteristics of technologic products for the elderly user. The ICIC system offers a user-friendly solution in telemedical care and improves the
Wong, Alice M K; Chang, Wei-Han; Ke, Pei-Chih; Huang, Chun-Kai; Tsai, Tsai-Hsuan; Chang, Hsien-Tsung; Shieh, Wann-Yun; Chan, Hsiao-Lung; Chen, Chih-Kuang; Pei, Yu-Cheng
The key components of caring for the elderly are diet, living, transportation, education, and safety issues, and telemedical systems can offer great assistance. Through the integration of personal to community information technology platforms, we have developed a new Intelligent Comprehensive Interactive Care (ICIC) system to provide comprehensive services for elderly care. The ICIC system consists of six items, including medical care (physiological measuring system, Medication Reminder, and Dr. Ubiquitous), diet, living, transportation, education (Intelligent Watch), entertainment (Sharetouch), and safety (Fall Detection). In this study, we specifically evaluated the users' intention of using the Medication Reminder, Dr. Ubiquitous, Sharetouch, and Intelligent Watch using a modified technological acceptance model (TAM). A total of 121 elderly subjects (48 males and 73 females) were recruited. The modified TAM questionnaires were collected after they had used these products. For most of the ICIC units, the elderly subjects revealed great willingness and/or satisfaction in using this system. The elderly users of the Intelligent Watch showed the greatest willingness and satisfaction, while the elderly users of Dr. Ubiquitous revealed fair willingness in the dimension of perceived ease of use. The old-old age group revealed greater satisfaction in the dimension of result demonstrability for the users of the Medication Reminder as compared to the young-old and oldest-old age groups. The women revealed greater satisfaction in the dimension of perceived ease of use for the users of Dr. Ubiquitous as compared to the men. There were no statistically significant differences in terms of gender, age, and education level in the other dimensions. The modified TAM showed its effectiveness in evaluating the acceptance and characteristics of technologic products for the elderly user. The ICIC system offers a user-friendly solution in telemedical care and improves the quality of
Barbieri, Carlo; Molina, Manuel; Ponce, Pedro; Tothova, Monika; Cattinelli, Isabella; Ion Titapiccolo, Jasmine; Mari, Flavio; Amato, Claudia; Leipold, Frank; Wehmeyer, Wolfgang; Stuard, Stefano; Stopper, Andrea; Canaud, Bernard
Managing anemia in hemodialysis patients can be challenging because of competing therapeutic targets and individual variability. Because therapy recommendations provided by a decision support system can benefit both patients and doctors, we evaluated the impact of an artificial intelligence decision support system, the Anemia Control Model (ACM), on anemia outcomes. Based on patient profiles, the ACM was built to recommend suitable erythropoietic-stimulating agent doses. Our retrospective study consisted of a 12-month control phase (standard anemia care), followed by a 12-month observation phase (ACM-guided care) encompassing 752 patients undergoing hemodialysis therapy in 3 NephroCare clinics located in separate countries. The percentage of hemoglobin values on target, the median darbepoetin dose, and individual hemoglobin fluctuation (estimated from the intrapatient hemoglobin standard deviation) were deemed primary outcomes. In the observation phase, median darbepoetin consumption significantly decreased from 0.63 to 0.46 μg/kg/month, whereas on-target hemoglobin values significantly increased from 70.6% to 76.6%, reaching 83.2% when the ACM suggestions were implemented. Moreover, ACM introduction led to a significant decrease in hemoglobin fluctuation (intrapatient standard deviation decreased from 0.95 g/dl to 0.83 g/dl). Thus, ACM support helped improve anemia outcomes of hemodialysis patients, minimizing erythropoietic-stimulating agent use with the potential to reduce the cost of treatment. Copyright © 2016 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.
Lundstrøm, Louise Hyldborg; Johnsen, Anna Thit; Ross, Lone
Background. Cancer care usually involves several health professionals from different parts of the health care system. Often, the GP has an important role. Patients’ experiences of continuity and support may be related to characteristics of health care, disease or patients. Objectives. To investig......Background. Cancer care usually involves several health professionals from different parts of the health care system. Often, the GP has an important role. Patients’ experiences of continuity and support may be related to characteristics of health care, disease or patients. Objectives...... patients experienced suboptimal cross-sectorial cooperation and supportive care. Efforts to improve cancer care cooperation may focus on the possible supportive role of the...
Campbell, Merle Wayne
Intelligent decision systems have the potential to support and greatly amplify human decision-making across a number of industries and domains. However, despite the rapid improvement in the underlying capabilities of these "intelligent" systems, increasing their acceptance as decision aids in industry has remained a formidable challenge.…
Adler, Richard M.; Cottman, Bruce H.
Advanced automation is required to reduce costly human operations support requirements for complex space-based and ground control systems. Existing knowledge based technologies have been used successfully to automate individual operations tasks. Considerably less progress has been made in integrating and coordinating multiple operations applications for unified intelligent support systems. To fill this gap, SOCIAL, a tool set for developing Distributed Artificial Intelligence (DAI) systems is being constructed. SOCIAL consists of three primary language based components defining: models of interprocess communication across heterogeneous platforms; models for interprocess coordination, concurrency control, and fault management; and for accessing heterogeneous information resources. DAI applications subsystems, either new or existing, will access these distributed services non-intrusively, via high-level message-based protocols. SOCIAL will reduce the complexity of distributed communications, control, and integration, enabling developers to concentrate on the design and functionality of the target DAI system itself.
Computers have long been utilised in the legal environment. The main use of computers however, has merely been to automate office tasks. More exciting is the prospect of using artificial intelligence (AI) technology to create computers that can emulate the substantive legal jobs performed by lawyers, to create computers that can autonomously reason with the law to determine legal solutions, for example: structuring and support of Partnership for Peace (PfP) mandate. Such attempts have not bee...
Mezera, Filip; Křupka, Jiří
This article deals with decision-making support methods’ implementation in a medium size financial company with international operations. The objective of this article is to show the abilities of these methods to precise decision-making of management. At the beginning of this article there is briefly described the existing situation in this business sector in Central Europe. After that part Business Intelligence methods are described as well as the reasons while these methods have been introd...
Krech, M; Probst, P
The paper is concerned with personal theories of health care professionals about deficiencies in social intelligence of autistic persons. In the component-model of social intelligence means the ability of individuals or groups, to interact with each other in social situations. This contains social perception, social behavior as well as social conceptions and refers to emotional, cognitive and normative aspects. 33 interviewees, working as psychologists or teachers in kindergartens, schools or therapy institutions, are questioned by a half-standardized single interview concerning their beliefs about nonverbal social abilities, social perspective taking, and construction of a theory of mind in autistic persons. The major finding is: The impairments can be found in all aspects of social intelligence. Especially emotional handicaps, which are quoted by more than 80% of the interviewees, and low cognitive preconditions of mastering social stimuli, which are quoted by nearly all interviewees, are relevant. The subjective theories of the interviewees are in accordance to the models of parents as well as the models of the leading experts. The professional relationship to autistic persons and the practical experiences of the health care professionals lead to their specific personal theories of deficiencies in social intelligence of autistic people with wide consequences in respect to the professional contact with the autistic children and young adults.
Pediatric supportive care includes managing issues from the cancer diagnosis, through treatment, and into adult survivorship. Get detailed information addressing pediatric supportive care including psychologic, family, and end-of-life concerns in this clinician summary.
Conclusion: The EI of RNs commencing work in a critical care environment was indicative of a higher range of Global EI, with the well-being factor scoring the highest, followed by the emotionality factor, then self-control, with the sociability factor scoring the lowest.
Objectives. Automated, microprocessor-controlled, closed-loop mechanical ventilation has been used in our Medical Intensive Care Unit (MICU) at the Hadassah Hebrew-University Medical Center for the past 15 years; for 10 years it has been the primary (preferred) ventilator modality. Design and setting. We describe our ...
Cao, Hongliang; Xin, Ya; Yuan, Qiaoxia
To predict conveniently the biochar yield from cattle manure pyrolysis, intelligent modeling approach was introduced in this research. A traditional artificial neural networks (ANN) model and a novel least squares support vector machine (LS-SVM) model were developed. For the identification and prediction evaluation of the models, a data set with 33 experimental data was used, which were obtained using a laboratory-scale fixed bed reaction system. The results demonstrated that the intelligent modeling approach is greatly convenient and effective for the prediction of the biochar yield. In particular, the novel LS-SVM model has a more satisfying predicting performance and its robustness is better than the traditional ANN model. The introduction and application of the LS-SVM modeling method gives a successful example, which is a good reference for the modeling study of cattle manure pyrolysis process, even other similar processes. Copyright © 2015 Elsevier Ltd. All rights reserved.
Demetriadis, Stavros; Xhafa, Fatos
Adaptation and personalization have been extensively studied in CSCL research community aiming to design intelligent systems that adaptively support eLearning processes and collaboration. Yet, with the fast development in Internet technologies, especially with the emergence of new data technologies and the mobile technologies, new opportunities and perspectives are opened for advanced adaptive and personalized systems. Adaptation and personalization are posing new research and development challenges to nowadays CSCL systems. In particular, adaptation should be focused in a multi-dimensional way (cognitive, technological, context-aware and personal). Moreover, it should address the particularities of both individual learners and group collaboration. As a consequence, the aim of this book is twofold. On the one hand, it discusses the latest advances and findings in the area of intelligent adaptive and personalized learning systems. On the other hand it analyzes the new implementation perspectives for intelligen...
Sinkkonen, Hanna-Maija; Kyttälä, Minna
This study investigated Finnish young people's experiences of supportive housing. Supportive housing is an after-care programme that should support the transition from foster care to independent adulthood. It is directed mainly at young people who have been taken into foster care by social workers. The sample consisted of 39 young people (23…
Full Text Available Critical-care nurses often look after three or more critically-ill patients during a shift. The workload and emotional stress can lead to disharmony between the nurse’s body, mind and spirit. Nurses with a high emotional intelligence have less emotional exhaustion and psychosomatic symptoms; they enjoy better emotional health; gain more satisfaction from their actions (both at work and at home; and have improved relationships with colleagues at work. The question arises: what is the emotional intelligence of critical-care nurses? A quantitative survey was conducted. The target population was registered nurses working in critical-care units who attended the Critical Care Congress 2009 (N = 380. Data were collected with the use of the Trait Emotional Intelligence Short Form and analysed using the Statistical Package for the Social Sciences software. The sample (n = 220 was mainly a mature, female and professionally-experienced group of registered nurses. They held a variety of job descriptions within various critical-care units. Statistics indicated that the standard deviations were small and no aberrant aspects such as demographics skewed the findings. The conclusion was made that registered nurses who are older and that have more experience in critical care appear to have a higher range of emotional intelligence. Kritiekesorg-verpleegkundiges verpleeg dikwels drie of meer pasiënte wat kritiek siek is, tydens een skof. Die werkslading kan tot emosionele spanning ly wat ’n wanbalans tussen die liggaam, siel en gees van die verpleegkundiges laat ontstaan. Verpleekundiges met ’n hoë emosionele intelligensie ondervind minder emosionele uitbranding en psigosomatiese symptome. Hulle toon ’n beter emosionele gesondheid, ervaar meer werks- en tuisbevrediging en het beter verhoudings met hulle kollegas. The vraag wat ontstaan is ‘wat is die emosionel intelligensie van kritieksorg-verpleegkundiges?’ Die toeganglike populasie (N = 380 was
Lawal, Abiodun M; Idemudia, Erhabor S
Universally, nurses have been reported to be a group at high risk of workplace stress. However, nurses' responses to stressful situations at work could be the outcomes of individual differences and organisational factors. We examined the independent and joint contributions of four dimensions of emotional intelligence and perceived organisational support in work stress of nurses in a teaching hospital in Nigeria. The study was a cross-sectional survey research design, which selected 228 (41 male and 187 female nurses) nurses through the use of convenience sampling. Questionnaires comprising demographics with work stress, organisational support and emotional intelligence scales were administered to the sampled 228 nurses in the study. Data were analysed with the use of correlational matrix and hierarchical multiple regression. Self-emotion appraisal, others' emotion appraisal, use of emotion, regulation of emotion and perceived organisational support were found to have joint contributions to explaining work stress among nurses. Others' emotion appraisal, use of emotion and perceived organisational support were found to have independent relationships with work stress. Our findings stress that judgement of others' emotions, accurate use of emotion by nurses and support from management of the hospital are most important in explaining their reactions towards work-related stress.
D'Angelo, Lorenzo T; Tarita, Eugeniu; Zywietz, Tosja K; Lueth, Tim C
In this contribution, a system for internet based, automated home care ECG upload and priorisation is presented for the first time. It unifies the advantages of existing telemonitoring ECG systems adding functionalities such as automated priorisation and usability for home care. Chronic cardiac diseases are a big group in the geriatric field. Most of them can be easily diagnosed with help of an electrocardiogram. A frequent or long-term ECG analysis allows early diagnosis of e.g. a cardiac infarction. Nevertheless, patients often aren't willing to visit a doctor for prophylactic purposes. Possible solutions of this problem are home care devices, which are used to investigate patients at home without the presence of a doctor on site. As the diffusion of such systems leads to a huge amount of data which has to be managed and evaluated, the presented approach focuses on an easy to use software for ECG upload from home, a web based management application and an algorithm for ECG preanalysis and priorisation.
Three-Point Suspension: In wind turbines with stall and pitch systems of every size the three-point suspension with clamping bushings of ESM is very common. It is the task of the vibration isolation to suspend the gearbox elastically on the main frame at two mounting points. Four-Point Suspension: Particularly in wind turbines of the multi-megawatt-class the four-point suspension is a more and more spreading system. The rotor shaft is supported by one bearing which is able to take the yaw and nodding torques or by two rotor shaft bearings. So all the torques except the driving torque are directly transferred to the main frame by the rotor shaft support. The gearbox has only one degree of freedom left. To avoid horizontal constraint forces on the gearbox with the four-point suspension normally multi-sandwich mounts or a pendulum support is used as both have a very low horizontal stiffness. One problem persists anyway: Due to assembly tolerances and main frame deformations because of nodding torques the gearbox has to withstand huge vertical constriant forces. Especially for wind turbines with four-point suspension ESM has developed a hydraulic gearbox support. Generator Suspension: In wind turbines with a gearbox and a fast running generator the generator is mounted to the main frame with normally four elastomeric generator mounts. Tuned Mass Dampers: Tuned mass dampers are used to reduce single tone vibrations in machines, buildings and other facilities. The function of a tuned mass damper is based on an oscillating mass which moves contrary to the spurious vibration and reduces it thereby. ESM has developed easy adjustable tuned mass dampers, which may be installed to a wind turbine easily if a wind turbine has problems with single tone vibrations. (orig.)
Constraint is a powerful representation to formulate and solve problems in design; a constraint-based approach to intelligent support of nuclear reactor design is proposed. We first discuss the features of the approach, and then present the architecture of a nuclear reactor design support system under development. In this design support system, the knowledge base contains constraints useful to structure the design space as object class definitions, and several types of constraint resolvers are provided as design support subsystems. The adopted method of constraint resolution are explained in detail. The usefulness of the approach is demonstrated using two design problems: Design window search and multiobjective optimization in nuclear reactor design. (orig./HP)
Yang, L; Frize, M; Eng, P; Walker, R; Catley, C
Recent studies in neonatal medicine, clinical nursing, and cognitive psychology have indicated the need to augment current decision-making practice in neonatal intensive care units with computerized, intelligent decision support systems. Rapid progress in artificial intelligence and knowledge management facilitates the design of collaborative ethical decision-support tools that allow clinicians to provide better support for parents facing inherently difficult choices, such as when to withdraw aggressive treatment. The appropriateness of using computers to support ethical decision-making is critically analyzed through research and literature review. In ethical dilemmas, multiple diverse participants need to communicate and function as a team to select the best treatment plan. In order to do this, physicians require reliable estimations of prognosis, while parents need a highly useable tool to help them assimilate complex medical issues and address their own value system. Our goal is to improve and structuralize the ethical decision-making that has become an inevitable part of modern neonatal care units. The paper contributes to clinical decision support by outlining the needs and basis for ethical decision support and justifying the proposed development efforts.
Lawrence, Vanessa; Banerjee, Sube
The Croydon care home support team (CHST) was developed in response to reports of patient abuse within long-term care. It presents a novel strategy for improving standards of care within care homes. A qualitative methodology was used to assess the perceived impact of the CHST. In-depth interviews were conducted with 14 care home managers and 24 members of care home staff across 14 care homes. Grounded theory principles guided the collection and analysis of the data. Reports of improved communication between staff, improved staff development and confidence, and improved quality of care point towards the effectiveness of the CHST model. The collaborative approach of the CHST was considered pivotal to its success and presented as an effective method of engaging care home managers and staff. The CHST adopted a systemic approach that placed an equal emphasis on the social, mental health and nursing needs of residents and aimed to address the whole culture of care within the individual homes. The data demonstrate the potential for specialist multi-disciplinary teams to raise standards of care across long-term care settings. Increased awareness of safeguarding issues, improved staff morale and communication and ongoing opportunities for discussion and problem solving promised to sustain improvements. Such services could be instrumental in meeting the government priority of preventing abuse among vulnerable adults.
Toyama, Hiroyuki; Mauno, Saija
Work-related resources can be positive antecedents of employee work engagement (WE) and creativity. Although trait emotional intelligence (EI) and social support may be crucial resources in nursing, their relationships with WE and creativity remain unclear. Hence, with special focus on the role of trait EI, we examined this relationship by applying the job demands-resources (JD-R) model. The participants were 489 eldercare nurses in Japan (female: n = 401; male: n = 88; age = 39.5 ± 11.0 year...
Batra, D.; Bowen, W.M.; Hill, T.R.; Weeks, K.D.
The concept of intelligent decision support has been discussed and explored in several recent papers, one of which has suggested the use of a Deep Knowledge Architecture. This paper explores this concept through application to a specific decision environment. The complex problems involved in nuclear waste disposal decisions provide an excellent test case. The resulting architecture uses an integrated, multi-level model base to represent the deep knowledge of the problem. Combined with the surface level knowledge represented by the database, the proposed knowledge base complements that of the decision-maker, allowing analysis at a range of levels of decisions which may also occur at a range of levels
Khorshid, M.; Hassan, H.; Abdel Latife, M.A.
Decision Support System (DSS) is an interactive, flexible and adaptable computer-based support system specially developed for supporting the solution of unstructured management problems  DSS has become widespread for oil industry domain in recent years. The computer-based DSS, which were developed and implemented in oil industry, are used to address the complex short-term planning and operational issues associated with downstream industry. Most of these applications concentrate on the data-centered tools, while the model-centered applications of DSS are still very limited up till now . This study develops an Intelligent Model-Based DSS for an integrated oil company, to help policy makers and petroleum planner in improving the effectiveness of the strategic planning in oil sector. This domain basically imposes semi-structured or unstructured decisions and involves a very complex modeling process
Rushton, Paula W; Mortenson, Ben W; Viswanathan, Pooja; Wang, Rosalie H; Miller, William C; Hurd Clarke, Laura
Long-term care (LTC) residents with cognitive impairments frequently experience limited mobility and participation in preferred activities. Although a power wheelchair could mitigate some of these mobility and participation challenges, this technology is often not prescribed for this population due to safety concerns. An intelligent power wheelchair (IPW) system represents a potential intervention that could help to overcome these concerns. The purpose of this study was to explore a) how residents experienced an IPW that used three different modes of control and b) what perceived effect the IPW would have on their daily lives. We interviewed 10 LTC residents with mild or moderate cognitive impairment twice, once before and once after testing the IPW. Interviews were conducted using a semi-structured interview guide, audio recorded and transcribed verbatim for thematic analyses. Our analyses identified three overarching themes: (1) the difference an IPW would make, (2) the potential impact of the IPW on others and (3) IPW-related concerns. Findings from this study confirm the need for and potential benefits of IPW use in LTC. Future studies will involve testing IPW improvements based on feedback and insights from this study. Implications for rehabilitation Intelligent power wheelchairs may enhance participation and improve safety and feelings of well-being for long-term care residents with cognitive impairments. Intelligent power wheelchairs could potentially have an equally positive impact on facility staff, other residents, and family and friends by decreasing workload and increasing safety.
Karimi, Leila; Leggat, Sandra G; Bartram, Timothy; Rada, Jiri
Emotional intelligence (EI) training is popular among human resource practitioners, but there is limited evidence of the impact of such training on health care workers. In the current article, we examine the effects of EI training on quality of resident care and worker well-being and psychological empowerment in an Australian aged care facility. We use Bar-On's (1997) conceptualization of EI. We used a quasiexperimental design in 2014-2015 with experimental (training) and control (nontraining) groups of 60 participants in each group in two geographically separate facilities. Our final poststudy sample size was 27 participants for the training group and 17 participants for the control group. Over a 6-month period, we examined whether staff improved their well-being, psychological empowerment, and job performance measured as enhanced quality of care (self-rated and client-rated) by applying skills in EI. The results showed significant improvement among workers in the training group for EI scores, quality of care, general well-being, and psychological empowerment. There were no significant differences for the control group. Through examining the impact of EI training on staff and residents of an aged care facility, we demonstrate the benefits of EI training for higher quality of care delivery. This study demonstrates the practical process through which EI training can improve the work experiences of aged care workers, as well as the quality of care for residents.
Town, G.G.; Stratton, R.C.
A computer application system is described which provides nuclear reactor power plant operators with an improved decision support system. This system combines traditional computer applications such as graphics display with artificial intelligence methodologies such as reasoning and diagnosis so as to improve plant operability. This paper discusses the issues, and a solution, involved with the system integration of applications developed using traditional and artificial intelligence languages
Stratton, R.C.; Town, G.G.
A computer application system is described which provides nuclear reactor power plant operators with an improved decision support system. This system combines traditional computer applications such as graphics display with artifical intelligence methodologies such as reasoning and diagnosis so as to improve plant operability. This paper discusses the issues, and a solution, involved with the system integration of applications developed using traditional and artificial intelligence languages
Bhavani, Selvaraj Rani; Senthilkumar, Jagatheesan; Chilambuchelvan, Arul Gnanaprakasam; Manjula, Dhanabalachandran; Krishnamoorthy, Ramasamy; Kannan, Arputharaj
The Internet has greatly enhanced health care, helping patients stay up-to-date on medical issues and general knowledge. Many cancer patients use the Internet for cancer diagnosis and related information. Recently, cloud computing has emerged as a new way of delivering health services but currently, there is no generic and fully automated cloud-based self-management intervention for breast cancer patients, as practical guidelines are lacking. We investigated the prevalence and predictors of cloud use for medical diagnosis among women with breast cancer to gain insight into meaningful usage parameters to evaluate the use of generic, fully automated cloud-based self-intervention, by assessing how breast cancer survivors use a generic self-management model. The goal of this study was implemented and evaluated with a new prototype called "CIMIDx", based on representative association rules that support the diagnosis of medical images (mammograms). The proposed Cloud-Based System Support Intelligent Medical Image Diagnosis (CIMIDx) prototype includes two modules. The first is the design and development of the CIMIDx training and test cloud services. Deployed in the cloud, the prototype can be used for diagnosis and screening mammography by assessing the cancers detected, tumor sizes, histology, and stage of classification accuracy. To analyze the prototype's classification accuracy, we conducted an experiment with data provided by clients. Second, by monitoring cloud server requests, the CIMIDx usage statistics were recorded for the cloud-based self-intervention groups. We conducted an evaluation of the CIMIDx cloud service usage, in which browsing functionalities were evaluated from the end-user's perspective. We performed several experiments to validate the CIMIDx prototype for breast health issues. The first set of experiments evaluated the diagnostic performance of the CIMIDx framework. We collected medical information from 150 breast cancer survivors from hospitals
Zijlmans, L J M; Embregts, P J C M; Gerits, L; Bosman, A M T; Derksen, J J L
Recent research addressed the relationship between staff behaviour and challenging behaviour of individuals with an intellectual disability (ID). Consequently, research on interventions aimed at staff is warranted. The present study focused on the effectiveness of a staff training aimed at emotional intelligence and interactions between staff and clients. The effects of the training on emotional intelligence, coping style and emotions of support staff were investigated. Participants were 214 support staff working within residential settings for individuals with ID and challenging behaviour. The experimental group consisted of 76 staff members, 138 staff members participated in two different control groups. A pre-test, post-test, follow-up control group design was used. Effectiveness was assessed using questionnaires addressing emotional intelligence, coping and emotions. Emotional intelligence of the experimental group changed significantly more than that of the two control groups. The experimental group showed an increase in task-oriented coping, whereas one control group did not. The results with regard to emotions were mixed. Follow-up data revealed that effects within the experimental group were still present four months after the training ended. A staff training aimed at emotional intelligence and staff-client interactions is effective in improving emotional intelligence and coping styles of support staff. However, the need for more research aiming at the relationship between staff characteristics, organisational factors and their mediating role in the effectiveness of staff training is emphasised. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Shin Young Heo
Full Text Available This paper presents a hybrid intelligent control method that enables frequency support control for permanent magnet synchronous generators (PMSGs wind turbines. The proposed method for a wind energy conversion system (WECS is designed to have PMSG modeling and full-scale back-to-back insulated-gate bipolar transistor (IGBT converters comprising the machine and grid side. The controller of the machine side converter (MSC and the grid side converter (GSC are designed to achieve maximum power point tracking (MPPT based on an improved hill climb searching (IHCS control algorithm and de-loaded (DL operation to obtain a power margin. Along with this comprehensive control of maximum power tracking mode based on the IHCS, a method for kinetic energy (KE discharge control of the supporting primary frequency control scheme with DL operation is developed to regulate the short-term frequency response and maintain reliable operation of the power system. The effectiveness of the hybrid intelligent control method is verified by a numerical simulation in PSCAD/EMTDC. Simulation results show that the proposed approach can improve the frequency regulation capability in the power system.
Shirley Jie Xuan Wang
Full Text Available This article addresses the possibility of incorporating intelligent decision support systems into reinsurance decision-making. This involves the insurance company and the reinsurance company, and is negotiated through reinsurance intermediaries. The article proposes a decision flow to model the reinsurance design and selection process. This article focuses on adopting more than one optimality criteria under a more generic combinational design of commonly used reinsurance products, i.e., proportional reinsurance and stop-loss reinsurance. In terms of methodology, the significant contribution of the study the incorporation of the well-established decision analysis tool multiple-attribute decision-making (MADM into the modelling of reinsurance selection. To illustrate the feasibility of incorporating intelligent decision supporting systems in the reinsurance market, the study includes a numerical case study using the simulation software @Risk in modeling insurance claims, as well as programming in MATLAB to realize MADM. A list of managerial implications could be drawn from the case study results. Most importantly, when choosing the most appropriate type of reinsurance, insurance companies should base their decisions on multiple measurements instead of single-criteria decision-making models so that their decisions may be more robust.
Macías Fernández, Antonio José; Gutiérrez-Castañeda, Carlos; Carmona González, Francisco Jesús; Crespillo Vílchez, Daniel
To examine the relationship between "Quality of Professional Life" and "Perceived Emotional Intelligence" and the relationship of both of these with the level of achievement of occupational objectives in the Costa del Sol Primary Health Care District. Multicentre descriptive cross-sectional observational study. The Costa del Sol Primary Health Care District in the province of Málaga. Sample of Employees of all categories in fixed and contracted employment in the Management Units of the Costa del Sol District. (N=303). Respondents 247 (81.5%) The data collected was that of the percentage of achievement of objectives in 2010 and the socio-demographic data of the participants, using ad hoc designed self-report questionnaires. The TMMS -24 questionnaire was used to measure the "Perceived Emotional Intelligence", with the following dimensions: Perception, comprehension, and emotional control, and the CVP-35 measuring: management support, work demands, and intrinsic motivation. Significant correlationas were observed between Quality of Professional Life and Emotional Intelligence in the Regulation (p<.01) and Comprehension categories (p<0.05). There were also significant correlations between the profession and the type of contract in the achievement of objectives (p<.005), and quality of professional life and type of contract (p<.05). The perceived quality of professional life is related to perception and regulation dimensions of Emotional Intelligence. Knowledge of emotion management methods should be promoted by management organisations for all employees. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.
Carrera, Percivil Melendez; Olver, Ian
Personalized medicine is revolutionizing the delivery of oncological care, promising benefits both at the patient and health system levels. The cost of targeted therapies, unfortunately, is becoming more expensive and unaffordable. Where supportive care in cancer concerns the prevention and
Bergeron, Pierrette; Hiller, Christine A.
Reviews the evolution of competitive intelligence since 1994, including terminology and definitions and analytical techniques. Addresses the issue of ethics; explores how information technology supports the competitive intelligence process; and discusses education and training opportunities for competitive intelligence, including core competencies…
Kaur, Devinder; Sambasivan, Murali; Kumar, Naresh
The purpose of this research is to study the impact of individual factors such as emotional intelligence (EI) and spiritual intelligence (SI) on the caring behavior of nurses. A cross-sectional survey using questionnaire was conducted by sampling 550 nurses working in seven major public hospitals in Malaysia. Data were analyzed using structural equation modeling (SEM). The main findings are: (1) critical existential thinking and transcendental awareness dimensions of SI have significant impacts on assurance of human presence dimension of caring behavior; (2) personal meaning production and conscious state expansion dimensions of SI have significant impacts on perception of emotion and managing own emotions dimensions of EI; and (3) managing own emotions dimension of EI has significant impacts on respectful deference to other and assurance of human presence dimensions of caring behavior of nurses. The results can be used to recruit and educate nurses. Copyright © 2015 Elsevier Inc. All rights reserved.
The aim of this article is to demonstrate how a novel yet important tool can facilitate family involvement in person-centred care, despite geographical distance. The author presents a case study as an in-depth example of the use of Skype in the context of palliative care at home. Skype enhanced family surveillance and symptom management, augmented shared decision making, provided a space for virtual bedside vigil, and ultimately provided the rapport necessary for optimal end of life care.
An investigation to find specific factors and how to cope psychologically with abnormal situations was made aiming at a construction of a supporting concept for intelligent responses. An experimental study on the relationship between the ideal man machine interface and operators' cognitive response way was made using the conventional simulator for a ship-propulsion reactor to improve the environment of user's interface. And the preparation and installing of simulation interfaces have been almost completed and the setting of equipments to make data is in progress. Concerning the supporting system for analyzing experimental data, the processing speed of the first version which has been developed in Japan Atomic Energy Research Institute was improved by modifying the program. (M.N.)
Kitamura, M.; Furukawa, H.; Sakuma, M.; Washio, T.
A general framework and guiding principles for development of intelligent operator support system in nuclear plants are proposed in this paper. The main principle is to provide advisory information to the operators through consensus of multiple agents each of which can conduct operational decision- making by focusing on mutually dissimilar symptoms obtained from the plant. The applicability and credibility of the operator support system are expected to be significantly improved by implementing the proposed scheme. An efficient procedure for diversifying the symptom descriptions was developed together with a method for autonomous consensus formation among the agents. A prototype system was developed for the subtask of fault diagnosis by emulating multiple neural networks as the diagnostic agents. The advantage of the proposed methodology over the conventional ones was clearly demonstrated through numerical evaluations simulating anomalies in a pressurized water reactor. (author)
Petrini, Maira; Pozzebon, Marlei
In this paper we explore the role of business intelligence (BI) in helping to support the management of sustainability in contemporary firms. The concepts of sustainability and corporate social responsibility (CSR) are among the most important themes to have emerged in the last decade at the global level. We suggest that BI methods and tools have an important but not yet well studied role to play in helping organizations implement and monitor sustainable and socially responsible business practices. Using grounded theory, the main contribution of our study is to propose a conceptual model that seeks to support the process of definition and monitoring of socio-environmental indicators and the relationship between their management and business strategy.
Recent legislation concerning personnel security has vastly increased the responsibility and accountability of the security manager. Access authorization, fitness for duty, and personnel security access programs require decisions regarding an individual's trustworthiness and reliability based on the findings of a background investigation. While these guidelines provide significant data and are useful as a tool, limited resources are available to the adjudicator of derogatory information on what is and is not acceptable in terms of granting access to sensitive areas of nuclear plants. The reason why one individual is deemed unacceptable and the next acceptable may be questioned and cause discriminatory accusations. This paper is continuation of discussion on workforce reliability, focusing on the use of artificial intelligence to support the decisions of a security manager. With this support, the benefit of previous decisions helps ensure consistent adjudication of background investigations
This paper uses the emergent theories of chaos and complexity to explore the self-management supportive care of chronic obstructive pulmonary disease (COPD) patients within the evolving primary care setting. It discusses the concept of self-management support, the complexity of the primary care context and consultations, smoking cessation, and the impact of acute exacerbations and action planning. The author hopes that this paper will enable the acquisition of new insight and better understanding in this clinical area, as well as support meaningful learning and facilitate more thoughtful, effective and high quality patient-centred care within the context of primary care.
Rees, Stephen Edward; Karbing, Dan Stieper; Allerød, Charlotte
Management of mechanical ventilation in intensive care patients is complicated by conflicting clinical goals. Decision support systems (DSS) may support clinicians in finding the correct balance. The objective of this study was to evaluate a computerized model-based DSS for its advice on inspired...
Sgandurra, Giuseppina; Bartalena, Laura; Cecchi, Francesca
BACKGROUND: CareToy is an intelligent system, inspired by baby gyms, aimed to provide an intensive, individualized, home-based and family-centred early intervention (EI) program. AIMS: A pilot study was carried out to explore the feasibility of CareToy intervention in preterm infants, aged 3....... An adequately powered randomized clinical trial is warranted....
Verdezoto, Nervo; Grönvall, Erik
This paper depicts findings from a project focusing on designing medicine management support for nonclinical settings. In particular, we discuss how we can support older adults across boundaries of care in planning, informing, reminding and documenting activities. Additionally, we present...
Gomez, Jorge; Garrido, Leonardo; Perez, Francisco
Intelligent Decision-Making Support Systems (i-DMSS) are specialized IT-based systems that support some or several phases of the individual, team, organizational or inter-organizational decision making process by deploying some or several intelligent mechanisms. This book pursues the following academic aims: (i) generate a compendium of quality theoretical and applied contributions in Intelligent Decision-Making Support Systems (i-DMSS) for engineering and management IT-based service systems (ITSS); (ii) diffuse scarce knowledge about foundations, architectures and effective and efficient methods and strategies for successfully planning, designing, building, operating, and evaluating i-DMSS for ITSS, and (iii) create an awareness of, and a bridge between ITSS and i-DMSS academicians and practitioners in the current complex and dynamic engineering and management ITSS organizational. The book presents a collection of 11 chapters referring to relevant topics for both IT service systems and i-DMSS including: pr...
Full Text Available While flood risk is evolving as one of the most imminent natural hazards and the shift from a reactive decision environment to a proactive one sets the basis of the latest thinking in flood management, the need to equip decision makers with necessary tools to think about and intelligently select options and strategies for flood management is becoming ever more pressing. Within this context, the Preparing for Extreme and Rare Events in Coastal Regions (PEARL intelligent knowledge-base (PEARL KB of resilience strategies is presented here as an environment that allows end-users to navigate from their observed problem to a selection of possible options and interventions worth considering within an intuitive visual web interface assisting advanced interactivity. Incorporation of real case studies within the PEARL KB enables the extraction of (evidence-based lessons from all over the word, while the KB’s collection of methods and tools directly supports the optimal selection of suitable interventions. The Knowledge-Base also gives access to the PEARL KB Flood Resilience Index (FRI tool, which is an online tool for resilience assessment at a city level available to authorities and citizens. We argue that the PEARL KB equips authorities with tangible and operational tools that can improve strategic and operational flood risk management by assessing and eventually increasing resilience, while building towards the strengthening of risk governance. The online tools that the PEARL KB gives access to were demonstrated and tested in the city of Rethymno, Greece.
Poza-Lujan, Jose-Luis; Posadas-Yagüe, Juan-Luis; Simó-Ten, José-Enrique; Simarro, Raúl; Benet, Ginés
This paper is part of a study of intelligent architectures for distributed control and communications systems. The study focuses on optimizing control systems by evaluating the performance of middleware through quality of service (QoS) parameters and the optimization of control using Quality of Control (QoC) parameters. The main aim of this work is to study, design, develop, and evaluate a distributed control architecture based on the Data-Distribution Service for Real-Time Systems (DDS) communication standard as proposed by the Object Management Group (OMG). As a result of the study, an architecture called Frame-Sensor-Adapter to Control (FSACtrl) has been developed. FSACtrl provides a model to implement an intelligent distributed Event-Based Control (EBC) system with support to measure QoS and QoC parameters. The novelty consists of using, simultaneously, the measured QoS and QoC parameters to make decisions about the control action with a new method called Event Based Quality Integral Cycle. To validate the architecture, the first five Braitenberg vehicles have been implemented using the FSACtrl architecture. The experimental outcomes, demonstrate the convenience of using jointly QoS and QoC parameters in distributed control systems.
Full Text Available This paper is part of a study of intelligent architectures for distributed control and communications systems. The study focuses on optimizing control systems by evaluating the performance of middleware through quality of service (QoS parameters and the optimization of control using Quality of Control (QoC parameters. The main aim of this work is to study, design, develop, and evaluate a distributed control architecture based on the Data-Distribution Service for Real-Time Systems (DDS communication standard as proposed by the Object Management Group (OMG. As a result of the study, an architecture called Frame-Sensor-Adapter to Control (FSACtrl has been developed. FSACtrl provides a model to implement an intelligent distributed Event-Based Control (EBC system with support to measure QoS and QoC parameters. The novelty consists of using, simultaneously, the measured QoS and QoC parameters to make decisions about the control action with a new method called Event Based Quality Integral Cycle. To validate the architecture, the first five Braitenberg vehicles have been implemented using the FSACtrl architecture. The experimental outcomes, demonstrate the convenience of using jointly QoS and QoC parameters in distributed control systems.
Saito, Yoshihito; Matsuo, Tokuro
Education institutions such as universities have a lot of information including book information, equipment administrative information, student information, and several others. The institutions also have multiple information in time series. As collective intelligence in campus, integrating and reusing these preserved information regarding career and taking a class, university can effectively support students' decision making of their getting jobs and subjects choice. Our purpose of support is to increase student's motivation. In this paper, we focus on course record and job information included in students' information, and propose the method to analyze correlation between a pattern of taking class and job lined up. Afterwards, we propose a support system regarding getting a job and taking class by using our proposed method. For a student who has his/her favorite job to get, the system supports his/her decision making of lecture choice by recommending a set of appropriate lecture groups. On another hand, for a student who does not have favorite job to get, the system supports his/her decision making of getting job by presenting appropriate job families related with lecture group in which he/she has ever taken. The contribution of this paper is showing a concrete method to reuse the campus collective information, implementing a system, and user perspectives.
Nagington, Maurice; Walshe, Catherine; Luker, Karen A
Quality of care is a prominent discourse in modern health-care and has previously been conceptualised in terms of ethics. In addition, the role of knowledge has been suggested as being particularly influential with regard to the nurse-patient-carer relationship. However, to date, no analyses have examined how knowledge (as an ethical concept) impinges on quality of care. Qualitative semi-structured interviews were conducted with 26 patients with palliative and supportive care needs receiving district nursing care and thirteen of their lay carers. Poststructural discourse analysis techniques were utilised to take an ethical perspective on the current way in which quality of care is assessed and produced in health-care. It is argued that if quality of care is to be achieved, patients and carers need to be able to redistribute and redevelop the knowledge of their services in a collaborative way that goes beyond the current ways of working. Theoretical works and extant research are then used to produce tentative suggestions about how this may be achieved. © 2015 The Authors Nursing Inquiry Published by John Wiley & Sons Ltd.
Luxton, David D
This paper identifies and reviews ethical issues associated with artificial intelligent care providers (AICPs) in mental health care and other helping professions. Specific recommendations are made for the development of ethical codes, guidelines, and the design of AICPs. Current developments in the application of AICPs and associated technologies are reviewed and a foundational overview of applicable ethical principles in mental health care is provided. Emerging ethical issues regarding the use of AICPs are then reviewed in detail. Recommendations for ethical codes and guidelines as well as for the development of semi-autonomous and autonomous AICP systems are described. The benefits of AICPs and implications for the helping professions are discussed in order to weigh the pros and cons of their use. Existing ethics codes and practice guidelines do not presently consider the current or the future use of interactive artificial intelligent agents to assist and to potentially replace mental health care professionals. AICPs present new ethical issues that will have significant ramifications for the mental health care and other helping professions. Primary issues involve the therapeutic relationship, competence, liability, trust, privacy, and patient safety. Many of the same ethical and philosophical considerations are applicable to use and design of AICPs in medicine, nursing, social work, education, and ministry. The ethical and moral aspects regarding the use of AICP systems must be well thought-out today as this will help to guide the use and development of these systems in the future. Topics presented are relevant to end users, AI developers, and researchers, as well as policy makers and regulatory boards. Published by Elsevier B.V.
'Supportive care' is a commonly used term in oncology; however, no consensus definition exists. This represents a barrier to communication in both the clinical and research settings. In this review, we propose a unifying conceptual framework for supportive care and discuss the proper use of this term in the clinical and research settings. A recent systematic review revealed several themes for supportive care: a focus on symptom management and improvement of quality of life, and care for patients on treatments and those with advanced stage disease. These findings are consistent with a broad definition for supportive care: 'the provision of the necessary services for those living with or affected by cancer to meet their informational, emotional, spiritual, social, or physical needs during their diagnostic, treatment, or follow-up phases encompassing issues of health promotion and prevention, survivorship, palliation, and bereavement.' Supportive care can be classified as primary, secondary, and tertiary based on the level of specialization. For example, palliative care teams provide secondary supportive care for patients with advanced cancer. Until a consensus definition is available for supportive care, this term should be clearly defined or cited whenever it is used.
A. V. Masloboev
Full Text Available The paper deals with engineering problems and application perspectives of virtual cognitive centers as intelligent systems for information support of interagency activities in the field of complex security management of regional development. A research prototype of virtual cognitive center for regional security management in crisis situations, implemented as hybrid cloud service based on IaaS architectural framework with the usage of multi-agent and web-service technologies has been developed. Virtual cognitive center is a training simulator software system and is intended for solving on the basis of distributed simulation such problems as: strategic planning and forecasting of risk-sustainable development of regional socioeconomic systems, agents of management interaction specification synthesis for regional components security in different crisis situations within the planning stage of joint anti-crisis actions.
Parnell, Gregory S.; Rowell, William F.; Valusek, John R.
In recent years there has been increasing interest in applying the computer based problem solving techniques of Artificial Intelligence (AI), Operations Research (OR), and Decision Support Systems (DSS) to analyze extremely complex problems. A conceptual framework is developed for successfully integrating these three techniques. First, the fields of AI, OR, and DSS are defined and the relationships among the three fields are explored. Next, a comprehensive adaptive design methodology for AI and OR modeling within the context of a DSS is described. These observations are made: (1) the solution of extremely complex knowledge problems with ill-defined, changing requirements can benefit greatly from the use of the adaptive design process, (2) the field of DSS provides the focus on the decision making process essential for tailoring solutions to these complex problems, (3) the characteristics of AI, OR, and DSS tools appears to be converging rapidly, and (4) there is a growing need for an interdisciplinary AI/OR/DSS education.
The research finality of this paper is how to support Authors to develop rule driven—subject oriented, adaptable course content, meta-rules—representing the disciplinary epistemology, model of teaching, Learning Path structure, and assessment parameters—for intelligent Tutoring actions in a personalized, adaptive e-Learning environment. The focus is to instruct the student to be a decision manager for himself, able to recognize the elements of a problem, select the necessary information with the perspective of factual choices. In particular, our research intends to provide some fundamental guidelines for the definition of didactical rules and logical relations, that Authors should provide to a cognitive Tutoring system through the use of an Instructional Design method (PENTHA Model) which proposes an educational environment, able to: increase productivity and operability, create conditions for a cooperative dialogue, developing participatory research activities of knowledge, observations and discoveries, customizing the learning design in a complex and holistic vision of the learning / teaching processes.
Jesus Angel Fernandez Canelas
Full Text Available The objective of this paper is to define a decision support system over SOX (Sarbanes-Oxley Act compatibility and quality of the Suppliers Selection Process based on Artificial Intelligence and Argumentation Theory knowledge and techniques. The present SOX Law, in effect nowadays, was created to improve financial government control over US companies. This law is a factor standard out United States due to several factors like present globalization, expansion of US companies, or key influence of US stock exchange markets worldwide. This paper constitutes a novel approach to this kind of problems due to following elements: (1 it has an optimized structure to look for the solution, (2 it has a dynamic learning method to handle court and control gonvernment bodies decisions, (3 it uses fuzzy knowledge to improve its performance, and (4 it uses its past accumulated experience to let the system evolve far beyond its initial state.
Naradasu Kumar Ravi
Full Text Available Diesel engine designers are constantly on the look-out for performance enhancement through efficient control of operating parameters. In this paper, the concept of an intelligent engine control system is proposed that seeks to ensure optimized performance under varying operating conditions. The concept is based on arriving at the optimum engine operating parameters to ensure the desired output in terms of efficiency. In addition, a Support Vector Machines based prediction model has been developed to predict the engine performance under varying operating conditions. Experiments were carried out at varying loads, compression ratios and amounts of exhaust gas recirculation using a variable compression ratio diesel engine for data acquisition. It was observed that the SVM model was able to predict the engine performance accurately.
Sànchez-Marrè, Miquel; Gilbert, Karina; Sojda, Rick S.; Steyer, Jean Philippe; Struss, Peter; Rodríguez-Roda, Ignasi; Voinov, A.A.; Jakeman, A.J.; Rizzoli, A.E.
There are inherent open problems arising when developing and running Intelligent Environmental Decision Support Systems (IEDSS). During daily operation of IEDSS several open challenge problems appear. The uncertainty of data being processed is intrinsic to the environmental system, which is being monitored by several on-line sensors and off-line data. Thus, anomalous data values at data gathering level or even uncertain reasoning process at later levels such as in diagnosis or decision support or planning can lead the environmental process to unsafe critical operation states. At diagnosis level or even at decision support level or planning level, spatial reasoning or temporal reasoning or both aspects can influence the reasoning processes undertaken by the IEDSS. Most of Environmental systems must take into account the spatial relationships between the environmental goal area and the nearby environmental areas and the temporal relationships between the current state and the past states of the environmental system to state accurate and reliable assertions to be used within the diagnosis process or decision support process or planning process. Finally, a related issue is a crucial point: are really reliable and safe the decisions proposed by the IEDSS? Are we sure about the goodness and performance of proposed solutions? How can we ensure a correct evaluation of the IEDSS? Main goal of this paper is to analyse these four issues, review some possible approaches and techniques to cope with them, and study new trends for future research within the IEDSS field.
Uribe, Gustavo A; Blobel, Bernd; López, Diego M; Schulz, Stefan
Chronic diseases such as Type 2 Diabetes Mellitus (T2DM) constitute a big burden to the global health economy. T2DM Care Management requires a multi-disciplinary and multi-organizational approach. Because of different languages and terminologies, education, experiences, skills, etc., such an approach establishes a special interoperability challenge. The solution is a flexible, scalable, business-controlled, adaptive, knowledge-based, intelligent system following a systems-oriented, architecture-centric, ontology-based and policy-driven approach. The architecture of real systems is described, using the basics and principles of the Generic Component Model (GCM). For representing the functional aspects of a system the Business Process Modeling Notation (BPMN) is used. The system architecture obtained is presented using a GCM graphical notation, class diagrams and BPMN diagrams. The architecture-centric approach considers the compositional nature of the real world system and its functionalities, guarantees coherence, and provides right inferences. The level of generality provided in this paper facilitates use case specific adaptations of the system. By that way, intelligent, adaptive and interoperable T2DM care systems can be derived from the presented model as presented in another publication.
Rees, Stephen Edward; Karbing, Dan Stieper; Allerød, Charlotte
Management of mechanical ventilation in intensive care patients is complicated by conflicting clinical goals. Decision support systems (DSS) may support clinicians in finding the correct balance. The objective of this study was to evaluate a computerized model-based DSS for its advice on inspired...... in cardiac output (CO) was evaluated. Compared to the baseline ventilator settings set as part of routine clinical care, the system suggested lower tidal volumes and inspired oxygen fraction, but higher frequency, with all suggestions and the model simulated outcome comparing well with the respiratory goals...
Bindoff, I; Stafford, A; Peterson, G; Kang, B H; Tenni, P
Drug-related problems (DRPs) are of serious concern worldwide, particularly for the elderly who often take many medications simultaneously. Medication reviews have been demonstrated to improve medication usage, leading to reductions in DRPs and potential savings in healthcare costs. However, medication reviews are not always of a consistently high standard, and there is often room for improvement in the quality of their findings. Our aim was to produce computerized intelligent decision support software that can improve the consistency and quality of medication review reports, by helping to ensure that DRPs relevant to a patient are overlooked less frequently. A system that largely achieved this goal was previously published, but refinements have been made. This paper examines the results of both the earlier and newer systems. Two prototype multiple-classification ripple-down rules medication review systems were built, the second being a refinement of the first. Each of the systems was trained incrementally using a human medication review expert. The resultant knowledge bases were analysed and compared, showing factors such as accuracy, time taken to train, and potential errors avoided. The two systems performed well, achieving accuracies of approximately 80% and 90%, after being trained on only a small number of cases (126 and 244 cases, respectively). Through analysis of the available data, it was estimated that without the system intervening, the expert training the first prototype would have missed approximately 36% of potentially relevant DRPs, and the second 43%. However, the system appeared to prevent the majority of these potential expert errors by correctly identifying the DRPs for them, leaving only an estimated 8% error rate for the first expert and 4% for the second. These intelligent decision support systems have shown a clear potential to substantially improve the quality and consistency of medication reviews, which should in turn translate into
Walling, Anne M; Tisnado, Diana; Ettner, Susan L; Asch, Steven M; Dy, Sydney M; Pantoja, Philip; Lee, Martin; Ahluwalia, Sangeeta C; Schreibeis-Baum, Hannah; Malin, Jennifer L; Lorenz, Karl A
Although recent randomized controlled trials support early palliative care for patients with advanced cancer, the specific processes of care associated with these findings and whether these improvements can be replicated in the broader health care system are uncertain. The aim of this study was to evaluate the occurrence of palliative care consultation and its association with specific processes of supportive care in a national cohort of Veterans using the Cancer Quality ASSIST (Assessing Symptoms Side Effects and Indicators of Supportive Treatment) measures. We abstracted data from 719 patients' medical records diagnosed with advanced lung, colorectal, or pancreatic cancer in 2008 over a period of three years or until death who received care in the Veterans Affairs Health System to evaluate the association of palliative care specialty consultation with the quality of supportive care overall and by domain using a multivariate regression model. All but 54 of 719 patients died within three years and 293 received at least one palliative care consult. Patients evaluated by a palliative care specialist at diagnosis scored seven percentage points higher overall (P specialist consultation is associated with better quality of supportive care in three advanced cancers, predominantly driven by improvements in information and care planning. This study supports the effectiveness of early palliative care consultation in three common advanced cancers within the Veterans Affairs Health System and provides a greater understanding of what care processes palliative care teams influence. Published by Elsevier Inc.
Delaware Valley Child Care Council, Philadelphia, PA.
This booklet outlines a number of options available to employers to enable them to better cope with child care issues that they and their employees face. Major options include: (1) flexible work policies, such as flexible scheduling, alternate work places, shorter work weeks, and the consolidating of sick leave, holidays, and vacation time into…
Full Text Available The aim of the research was to investigate the effects of multiple intelligences supported project-based learning and traditional foreign language-teaching environment on students' achievement and their attitude towards English lesson. The research was carried out in 2009 – 2010 education-instruction year in Karatli Sehit Sahin Yilmaz Elementary School, Nigde, Turkey. Totally 50 students in two different classes in the 5th grade of this school participated in the study. The results of the research showed a significant difference between the attitude scores of the experiment group and the control group. It was also found out that the multiple intelligences approach activities were more effective in thepositive development of the students’ attitudes. At the end of the research, it is revealed that the students who are educated by multiple intelligences supported project-based learning method are more successful and have a higher motivation level than the studentswho are educated by the traditional instructional methods.
Riha, P.; Smisek, P.
Appropriate nutritional support is an important part of comprehensive oncology treatment. The aim is to decrease the incidence of malnutrition. Malnourished patients are in higher risk of infectious and toxic complications, experience worse quality of life. Systematic survey of nutritional status and early nutritional intervention can eventually lead to better results of oncology treatment. We review the definitions, etiology and epidemiology of malnutrition, practical approaches to nutritional support of children with cancer. (author)
Zijlmans, Linda J M; Embregts, Petri J C M; Bosman, Anna M T
Working with clients who show challenging behavior can be emotionally demanding and stressful for support staff, because this behavior may cause a range of negative emotional reactions and feelings. These reactions are of negative influence on staff wellbeing and behavior. Research has focused on negative emotions of staff. However, a distinction between emotions and feelings has never been made in the research field of intellectual disabilities. Negative emotions and feelings may be regulated by emotional intelligence, a psychological construct that takes into account personal style and individual differences. The purpose of this study was to explore the relationship between emotional intelligence on the one hand and emotions and feelings on the other. Participants were 207 support staff serving clients with moderate to borderline intellectual disabilities and challenging behavior. Emotional intelligence, emotions, and feelings were measured with questionnaires. The results show that emotional intelligence, emotions, and feelings are related. However, found relationships were weak. Most significant relations were found between feelings and stress management and adaptation elements of emotional intelligence. Because the explored variables can change over time they call for a longitudinal research approach. Copyright © 2013 Elsevier Ltd. All rights reserved.
San Miguel, Jesús F; García-Sanz, Ramón
Despite substantial innovations in the treatment of multiple myeloma (MM), it remains an incurable disease. In addition, it is debatable whether the progress in survival is attributable simply to the therapy used to destroy the tumor clone or if it is also because of therapy designed to ameliorate disease complications. Supportive therapy has evolved greatly alongside general supportive measures used in hematologic malignancies (such as new antibiotics, antifungal agents, and growth factors) in addition to better indications in complementary treatments such as radiotherapy, dialysis, and surgery. However, in MM, several specific adjuvant therapies have also been introduced (eg, bisphosphonates and erythroid-stimulating factors), which have conferred a key role to supportive therapy in the general treatment of patients with MM.
Interactive CaringTV® is a Finnish innovation that was developed by Laurea University of Applied Sciences in 2006. CaringTV was developed through action research during three research projects. The aim of interactive CaringTV is to support the health and well-being of elderly people living in their own homes. The Safe Home project was based on action research, userdriven methods, and a case study. User-driven methods were applied in planning, implementing and evaluating the programme and eServices e.g. testing and evaluating peer support, including eConsultation as the methods for supporting clients´ coping with life in their own homes. Costeffectiveness and process modelling were studied through the case study. The user-driven approach and the collected data formed the basis for the interactive programme. The online CaringTV programme included content to: support everyday life for the elderly, safety, and activities of daily living, support social relationships, participate in rehabilitation and physical exercises, manage self-care, and health issues. Active participation in the CaringTV programme provided functional ability and everyday coping as well as a meaningful activity in everyday life. CaringTV is an interactive platform to support elderly in their everyday life and help them cope at home. User-driven methods enable participants´ active involvement in planning interactive and online programmes and eServices via CaringTV. The ultimate goal of the CaringTV is to support elderly´s health, wellbeing and interaction. CaringTV empowers elderly people to take responsibility for their own health care as part of healthy ageing.
Bas, Gökhan; Beyhan, Ömer
The aim of the research was to investigate the effects of multiple intelligences supported project-based learning and traditional foreign language-teaching environment on students' achievement and their attitude towards English lesson. The research was carried out in 2009-2010 education-instruction year in Karatli Sehit Sahin Yilmaz Elementary…
Worster, Brooke; Swartz, Kristine
With the emergence of telemedicine as a routine form of care in various venues, the opportunities to use technology to care for the most vulnerable, most ill cancer patients are extremely appealing. Increasingly, evidence supports early integration of palliative care with standard oncologic care, supported by recent NCCN guidelines to increase and improve access to palliative care. This review looks at the use of telemedicine to expand access to palliative care as well as provide better care for patients and families where travel is difficult, if not impossible. When telemedicine has been used, often in Europe, for palliative care, the results show improvements in symptom management, comfort with care as well as patient and family satisfaction. One barrier to use of telemedicine is the concerns with technology and technology-related complications in population that is often elderly, frail and not always comfortable with non-face-to-face physician care. There remain significant opportunities to explore this intersection of supportive care and telemedicine.
Full Text Available At present, information technologies (IT are intensively used all over the world in various sectors, and today medical institutions cannot do without them when organizing the process of medical diagnostic. The IT efficiency is determined by the degree of their intellectualization that is by including knowledge bases as their component and by the transition from data processing to the processing of knowledge. The efficiency of making decisions in various areas of activity is determined by the quality and quick delivery of information. Medicine constitutes no exception in this sense. The advanced level of computer technology, applied tools, diagnostics on the basis of automated systems of decision support made it possible to solve the tasks of assessing the state of the object at a qualitatively new level. The subject matter of this study is to ensure the mathematical support of the intelligent information system (IS of assessing the state of the object. The object is understood as a patient who came through a myocardial infarction (MI. The goal of the study is to develop mathematical support of the intelligent IS of assessing and predicting a patient’s condition. To achieve the stated goal, the following tasks were solved: statistically valid and uncorrelated signs were specified; these signs enable distinguishing the group of patients who survived from those who died, “decisive rules” were formulated for predicting the MI clinical outcome. In the process of the study, the mathematical IT of assessing the state of the object was developed. The following result was obtained: the suggested mathematical models for predicting the outcome of myocardial infarction that were developed with the use of the method of discriminant function and took into account human blood values can prevent sudden coronary death and improve the diagnostic efficiency. Conclusions. Mathematical models were developed to predict the state of the object in the event of
Within the IARPC Collaboration Team activities of 2016, Arctic in-situ and remote earth observations advanced topics such as :1) exploring the role for new and innovative autonomous observing technologies in the Arctic; 2) advancing catalytic national and international community based observing efforts in support of the National Strategy for the Arctic Region; and 3) enhancing the use of discovery tools for observing system collaboration such as the U.S. National Oceanic and Atmospheric Administration (NOAA) Arctic Environmental Response Management Application (ERMA) and the U.S. National Aeronautics and Space Administration (NASA) Arctic Collaborative Environment (ACE) project geo reference visualization decision support and exploitation internet based tools. Critical to the success of these earth observations for both in-situ and remote systems is the emerging of new and innovative data collection technologies and comprehensive modeling as well as enhanced communications and cyber infrastructure capabilities which effectively assimilate and dissemination many environmental intelligence products in a timely manner. The Arctic Collaborative Environment (ACE) project is well positioned to greatly enhance user capabilities for accessing, organizing, visualizing, sharing and producing collaborative knowledge for the Arctic.
Chin Neoh, Siew; Srisukkham, Worawut; Zhang, Li; Todryk, Stephen; Greystoke, Brigit; Peng Lim, Chee; Alamgir Hossain, Mohammed; Aslam, Nauman
This research proposes an intelligent decision support system for acute lymphoblastic leukaemia diagnosis from microscopic blood images. A novel clustering algorithm with stimulating discriminant measures (SDM) of both within- and between-cluster scatter variances is proposed to produce robust segmentation of nucleus and cytoplasm of lymphocytes/lymphoblasts. Specifically, the proposed between-cluster evaluation is formulated based on the trade-off of several between-cluster measures of well-known feature extraction methods. The SDM measures are used in conjuction with Genetic Algorithm for clustering nucleus, cytoplasm, and background regions. Subsequently, a total of eighty features consisting of shape, texture, and colour information of the nucleus and cytoplasm sub-images are extracted. A number of classifiers (multi-layer perceptron, Support Vector Machine (SVM) and Dempster-Shafer ensemble) are employed for lymphocyte/lymphoblast classification. Evaluated with the ALL-IDB2 database, the proposed SDM-based clustering overcomes the shortcomings of Fuzzy C-means which focuses purely on within-cluster scatter variance. It also outperforms Linear Discriminant Analysis and Fuzzy Compactness and Separation for nucleus-cytoplasm separation. The overall system achieves superior recognition rates of 96.72% and 96.67% accuracies using bootstrapping and 10-fold cross validation with Dempster-Shafer and SVM, respectively. The results also compare favourably with those reported in the literature, indicating the usefulness of the proposed SDM-based clustering method. PMID:26450665
Szatkowski, Gerard P.; Schultz, Roger
The feasibility, benefits, and risks associated with Artificial Intelligence (AI) Expert Systems applied to low cost space expendable launch vehicle systems are reviewed. This study is in support of the joint USAF/NASA effort to define the next generation of a heavy-lift Advanced Launch System (ALS) which will provide economical and routine access to space. The significant technical goals of the ALS program include: a 10 fold reduction in cost per pound to orbit, launch processing in under 3 weeks, and higher reliability and safety standards than current expendables. Knowledge-based system techniques are being explored for the purpose of automating decision support processes in onboard and ground systems for pre-launch checkout and in-flight operations. Issues such as: satisfying real-time requirements, providing safety validation, hardware and Data Base Management System (DBMS) interfacing, system synergistic effects, human interfaces, and ease of maintainability, have an effect on the viability of expert systems as a useful tool.
Kugo, Teruhiko; Nakagawa, Masayuki; Tsuchihashi, Keichiro
An intelligent reactor design system IRDS has been developed to support conceptual design of new type reactor cores in the fields of neutronics, thermal-hydraulics and fuel behavior. The features of IRDS are summarized as follows: 1) a variety of computer codes to cover various design tasks relevant to 'static' and 'burnup' problems are implemented, 2) all the information necessary to the codes implemented is unified in a data base, 3) several data and knowledge bases are referred to in order to proceed design process efficiently for non-expert users, 4) advanced man-machine interface to communicate with the system through an interactive and graphical user interface is equipped and 5) a function to search automatically a design window, which is defined as a feasible parameter range to satisfy design requirement and criteria is employed to support the optimization or satisfication process. Applicability and productivity of the system are demonstrated by the design study of fuel pin for new type FBR cores. (author)
Tenniglo, L J A; Loeffen, E A H; Kremer, L C M; Font-Gonzalez, A; Mulder, R L; Postma, A; Naafs-Wilstra, M C; Grootenhuis, M A; van de Wetering, M D; Tissing, W J E
Intensive therapies in pediatric malignancies increased survival rates but also occurrence of treatment-related morbidities. Therefore, supportive care fulfills an increasingly important role. In planning development of guidelines with incorporation of shared decision making, we noticed that little is known about the needs and preferences of patients and their parents. Our goals were therefore to investigate (1) which supportive care topics patients and parents regard as most important and (2) the preferred role they wish to fulfill in decision making. This qualitative study consisted of three focus groups (two traditional, one online) with patients and parents of two Dutch pediatric oncology centers. Data were transcribed as simple verbatim and analyzed using thematic analysis. Eleven adolescent patients and 18 parents shared detailed views on various aspects of supportive care. Themes of major importance were communication between patient and physician (commitment, accessibility, proactive attitude of physicians), well-timed provision of information, and the suitability and accessibility of psychosocial care. In contrast to prioritized supportive care topics by medical professionals, somatic issues (e.g., febrile neutropenia) were infrequently addressed. Patients and parents preferred to be actively involved in decision making in selected topics, such as choice of analgesics and anti-emetics, but not in, e.g., choice of antibiotics. Children with cancer and parents were provided a valuable insight into their views regarding supportive care and shared decision making. These results have important implications towards improving supportive care, both in selecting topics for guideline development and incorporating preferences of patients and parents herein.
Frajo-Apor, Beatrice; Pardeller, Silvia; Kemmler, Georg; Hofer, Alex
Emotional Intelligence (EI) and resilience may be considered as prerequisites for mental health professionals caring for patients with serious mental illness (SMI), since they are often exposed to severe emotional stress during daily work. Accordingly, this cross-sectional study assessed both EI and resilience and their interrelationship in 61 individuals belonging to an assertive outreach team for patients suffering from SMI compared 61 control subjects without healthcare-related working conditions. EI was assessed by means of the German version of the Mayer-Salovey-Caruso-Emotional-Intelligence Test (MSCEIT), resilience was assessed using the German version of the Resilience Scale. Both groups showed an average level of EI in all categories of the MSCEIT and indicated high levels of resilience. They did not differ significantly from each other, neither in terms of EI nor resilience. Correlation analysis revealed a positive association between EI and resilience, albeit small in magnitude. Our results suggest that mental health professionals are not more resilient and therefore not more 'protected' from stressors than the general population. Though this finding warrants cautious interpretation, the positive correlation between EI and resilience suggests that EI may be a potential target for education and training in order to strengthen resilience even in healthy individuals and vice versa.
American Association for Artificial inteligence A! ............. Artificial inteliigence AMC ............ Unt:ed States Army Maeriel Comand ASL...block number) FIELD GROUP SUB-GROUP Artificial Intelligence, Expert Systems Automated Aids to Testing 9. ABSTRACT (Continue on reverse if necessary and...identify by block number) This report covers the application of Artificial Intelligence-Techniques to the problem of creating automated tools to
Gerits, Linda; Derksen, Jan J. L.; Verbruggen, Antoine B.
The emotional intelligence profiles, gender differences, and adaptive success of 380 Dutch nurses caring for people with mental retardation and accompanying severe behavior problems are reported. Data were collected with the Bar-On Emotional Quotient Inventory, Utrecht-Coping List, Utrecht-Burnout Scale, MMPI-2, and GAMA. Absence due to illness…
Johnsen, Helle; Blom, Karina Fischer; Lee, Anne
eHealth solutions are increasingly implemented in antenatal care to enhance women's involvement. The main aim of this study was to evaluate women's assessment of autonomy supportive care during the antenatal care visits among low-risk pregnant women. An intervention study was conducted including...... a control group attending standard antenatal care and an intervention group having access to an eHealth knowledge base, in addition to standard care. A total of 87 women were included in the control group and a total of 121 women in the intervention group. Data were collected using an online questionnaire 2...... weeks after participants had given birth. Data were analyzed using χ tests and Wilcoxon rank sums. Use of an eHealth knowledge base was associated with statistically significant higher scores for women's overall assessment of antenatal care visits, the organization of antenatal care visits, confidence...
Liquang Geng; Chan, C.W.; Zhi Chen; Huang, G.H.
Groundwater and soil contamination resulted from LNAPLs (light nonaqueous phase liquids) spills and leakage in petroleum industry is currently one of the major environmental concerns in North America. Numerous site remediation technologies have been developed and implemented in the last two decades. They are classified as ex-situ and in-situ remediation techniques. One of the problems associated with ex-situ remediation is the cost of operation. In recent years, in-situ techniques have acquired popularity. However, the selection of the optimal techniques is difficult and insufficient expertise in the process may result in large inflation of expenses. This study presents an expert system (ES) for the management of petroleum contaminated sites in which a variety of artificial intelligence (AI) techniques were used to construct a support tool for site remediation decision-making. This paper presents the knowledge engineering processes of knowledge acquisition, conceptual design, and system implementation. The results from some case studies indicate that the expert system can generate cost-effective remediation alternatives to assist decision-makers. (Author)
Chandra, Charu; Smirnov, Alexander V.
The interest in consumer-focused virtual enterprises (VE) decision-making problem is growing fast. The purpose of this type of enterprise is to transform incomplete information about customer orders and available resources into-co-ordinated plans for production and replenishment of goods and services in the temporal network formed by collaborating units. This implies that information in the consumer-focused VE can be shared via Internet, Intranet, and Extranet for business-to-consumer (B2C), business-to-business service (B2B-S), and business-to-business goods (B2B-G) transactions. One of the goals of Internet-Based Management (e-management) is to facilitate transfer and sharing of data and knowledge in the context of enterprise collaboration. This paper discusses a generic framework of e-management that integrates intelligent information support group-decision making, and agreement modeling for a VE network. It offers the platform for design and modeling of diverse implementation strategies related to the type of agreement, optimization policies, decision-making strategies, organization structures, and information sharing strategies and mechanisms, and business policies for the VE.
Full Text Available Ontologies and corresponding knowledge bases can be quite successfully used for many tasks that rely on domain knowledge and semantic structures, which should be available for machine processing and sharing. Using SPARQL queries for retrieval of required elements from ontologies and knowledge bases, can significantly simplify modeling of arbitrary structures of concepts and data, and implementation of required functionalities. This paper describes developed ontology for support of Research Centre for testing of active substances that conducts scientific experiments. According to created ontology corresponding knowledge base was made and populated with real experimental data. Developed ontology and knowledge base are directly used for an intelligent system of experiment search which is based on many criteria from ontology. Proposed system gets the desired search result, which is actually an experiment in the form of a written report. Presented solution and implementation are very flexible and adaptable, and can be used as kind of a template by similar information system dealing with biological or similar complex system.
Full Text Available One of the existing natural and environmental uses in Aceh (Indonesia is tourism. One of the aspects that determine the development and sustainability of tourism is the institutional and community aspects. Sustainable tourism is a picture of the ecosystem sustainability and socio-economic development of the community. This study aims to reveal and find local wisdom practices and explore local knowledge owned by Sabang Island community in the management and conservation of the environment so as to support the realization of sustainable tourism. This study uses rationalistic paradigm and uses qualitative research method. The data that has been collected is analyzed descriptively. Local wisdom and local knowledge are reflected in how society has a unique way of looking at and understanding nature and interacting with it. In the Aceh community, there are customary institutions that regulate the rules or interactions of the community with the environment, including “panglima laot”, “keujreun blang”, “peutua seuneubok”, “pawang glee or peutua uteun”, “haria peukan” and “syahbanda”. Local wisdom and local knowledge have great potential in maintaining, preserving and sustainability of the environment used by communities to meet their living needs. Ecological, social and religious intelligence formed through local wisdom and local knowledge can be an aspect in maintaining environmental sustainability in order to build sustainable tourism on Sabang Island.
Gage-Bouchard, Elizabeth A
Recent research has focused attention on the role of patients' and clinicians' cultural skills and values in generating inequalities in health care experiences. Yet, examination of how social structural factors shape people's abilities to build, refine, and leverage strategies for navigating the health care system have received less attention. In this paper I place focus on one such social structural factor, social support, and examine how social support operates as a flexible resource that helps people navigate the health care system. Using the case of families navigating pediatric cancer care this study combines in-depth interviews with parents of pediatric cancer patients (N = 80), direct observation of clinical interactions between families and physicians (N = 73), and in-depth interviews with pediatric oncologists (N = 8). Findings show that physicians assess parental visibility in the hospital, medical vigilance, and adherence to their child's treatment and use these judgments to shape clinical decision-making. Parents who had help from their personal networks had more agility in balancing competing demands, and this allowed parents to more effectively meet institutional expectations for appropriate parental involvement in the child's health care. In this way, social support served as a flexible resource for some families that allowed parents to more quickly adapt to the demands of caring for a child with cancer, foster productive interpersonal relationships with health care providers, and play a more active role in their child's health care. Copyright © 2017 Elsevier Ltd. All rights reserved.
Dougherty, Andrew W.
Metal oxides are a staple of the sensor industry. The combination of their sensitivity to a number of gases, and the electrical nature of their sensing mechanism, make the particularly attractive in solid state devices. The high temperature stability of the ceramic material also make them ideal for detecting combustion byproducts where exhaust temperatures can be high. However, problems do exist with metal oxide sensors. They are not very selective as they all tend to be sensitive to a number of reduction and oxidation reactions on the oxide's surface. This makes sensors with large numbers of sensors interesting to study as a method for introducing orthogonality to the system. Also, the sensors tend to suffer from long term drift for a number of reasons. In this thesis I will develop a system for intelligently modeling metal oxide sensors and determining their suitability for use in large arrays designed to analyze exhaust gas streams. It will introduce prior knowledge of the metal oxide sensors' response mechanisms in order to produce a response function for each sensor from sparse training data. The system will use the same technique to model and remove any long term drift from the sensor response. It will also provide an efficient means for determining the orthogonality of the sensor to determine whether they are useful in gas sensing arrays. The system is based on least squares support vector regression using the reciprocal kernel. The reciprocal kernel is introduced along with a method of optimizing the free parameters of the reciprocal kernel support vector machine. The reciprocal kernel is shown to be simpler and to perform better than an earlier kernel, the modified reciprocal kernel. Least squares support vector regression is chosen as it uses all of the training points and an emphasis was placed throughout this research for extracting the maximum information from very sparse data. The reciprocal kernel is shown to be effective in modeling the sensor
Chen, Hui-Ling; Yang, Bo; Wang, Gang; Wang, Su-Jing; Liu, Jie; Liu, Da-You
Breast cancer is becoming a leading cause of death among women in the whole world, meanwhile, it is confirmed that the early detection and accurate diagnosis of this disease can ensure a long survival of the patients. In this paper, a swarm intelligence technique based support vector machine classifier (PSO_SVM) is proposed for breast cancer diagnosis. In the proposed PSO-SVM, the issue of model selection and feature selection in SVM is simultaneously solved under particle swarm (PSO optimization) framework. A weighted function is adopted to design the objective function of PSO, which takes into account the average accuracy rates of SVM (ACC), the number of support vectors (SVs) and the selected features simultaneously. Furthermore, time varying acceleration coefficients (TVAC) and inertia weight (TVIW) are employed to efficiently control the local and global search in PSO algorithm. The effectiveness of PSO-SVM has been rigorously evaluated against the Wisconsin Breast Cancer Dataset (WBCD), which is commonly used among researchers who use machine learning methods for breast cancer diagnosis. The proposed system is compared with the grid search method with feature selection by F-score. The experimental results demonstrate that the proposed approach not only obtains much more appropriate model parameters and discriminative feature subset, but also needs smaller set of SVs for training, giving high predictive accuracy. In addition, Compared to the existing methods in previous studies, the proposed system can also be regarded as a promising success with the excellent classification accuracy of 99.3% via 10-fold cross validation (CV) analysis. Moreover, a combination of five informative features is identified, which might provide important insights to the nature of the breast cancer disease and give an important clue for the physicians to take a closer attention. We believe the promising result can ensure that the physicians make very accurate diagnostic decision in
William CS CHO
Full Text Available Complementary and alternative medicine has been increasingly utilized by cancer patients in developed countries. Among the various forms of complementary and alternative medicine, Traditional Chinese Medicine is one of the few that has a well constructed theoretical framework and established treatment approaches for diseases including cancer. Recent research has revealed growing evidence suggesting that Traditional Chinese Medicine is effective in the supportive care of cancer patients during and after major conventional cancer treatments. This paper succinctly summarizes some published clinical evidence and meta-analyses which support the usage of various Traditional Chinese Medicine treatment strategies including Chinese herbal medicine, acupuncture and Qigong in supportive cancer care.
able to construct a checklist of a clinical and physiologic model and then a computerised decision support system that will perform two functions: the...the provision of nutritional therapy, and assessment of use by nursing and physician staff KEYWORDS Nutrition, severe burn, decision support... clinical testing. Checklist and Decision Support in Nutritional Care for Burned Patients Proposal Number: 12340011 W81XWH-12-2-0074 PI: Steven E
Xia, B; Wang, J H; Xiao, Y M; Liu, K Y; Yang, X D; Ge, L H
It has been demonstrated that anesthetics exposure may lead to neurocognitive impairment in developing brain of animal models. However, for the limitation that the animal models cannot fully mimic the dose and duration in clinical settings especially for dental general anesthesia, the clinical significance of anesthetics exposure on developing central nervous system remains undetermined. Therefore, we conducted the current study in order to observe the fluctuation of intelligence quotient (IQ) after the administration of dental general anesthesia comparing to that before surgery. We conducted the current study in order to observe the fluctuation of intelligence quotient (IQ) after the administration of dental general anesthesia compared with that before surgery. Thirty two patients, ASA I, who were exposed to dental general anesthesia in Department of Pediatric Dentistry Peking University School and Hospital of Stomatology, aged 4 to 6.5 years, were enrolled in this prospective study. Patients with severe learning difficulties or communication disorders were excluded. Written and informed consent was obtained from each patients' family which was fully explained of the purpose and method of study. Their intelligence quotients were evaluated with the Chinese Wechsler young children scale of intelligence (Urban version) before and 2 weeks after dental anesthesia. They were treated by experienced pediatric dentists and the sevoflurane, propofol and nitrous oxide were used for general anesthesia by anesthetist. Articaine hydrochloride and epinephrine tartrate injections were used for their pulp treatment or extraction. The examiners and scorers for IQ had technical training in the test administration. All the patients were tested by the same examiner and with standardized guide language. Each subtest was scored according to the tool review. Verbal IQ and performance IQ consisted of relevant 5 subtests and full scale IQ. Statistical analyses were performed by SPSS 18
Ye, Jiawen; Yeung, Dannii Y; Liu, Elaine S C; Rochelle, Tina L
Past research has often focused on the effects of emotional intelligence and received social support on subjective well-being yet paid limited attention to the effects of provided social support. This study adopted a longitudinal design to examine the sequential mediating effects of provided and received social support on the relationship between trait emotional intelligence and subjective happiness. A total of 214 Hong Kong Chinese undergraduates were asked to complete two assessments with a 6-month interval in between. The results of the sequential mediation analysis indicated that the trait emotional intelligence measured in Time 1 indirectly influenced the level of subjective happiness in Time 2 through a sequential pathway of social support provided for others in Time 1 and social support received from others in Time 2. These findings highlight the importance of trait emotional intelligence and the reciprocal exchanges of social support in the subjective well-being of university students. © 2018 International Union of Psychological Science.
Balmus, Andra Bianca; Iacob, Maria Eugenia; van Sinderen, Marten J.; van Busschbach, Murk
Working towards gaining competitive advantage and establishing stable relationships with their supply chain intermediaries, fast moving consumer goods companies are currently focusing their attention on intelligent, goal-based funds investment. Traditional trade promotion management systems (TPMS),
Rommel P. Sergio
Full Text Available This research paper discusses the profile of emotional intelligence, work/family conflict, and work values among 437 purposively selected customer service representatives (CSRs from the Middle East, Iran, Pakistan, Russia, India, and the Philippines. Moreover, the study leads to a set of organizational change development programs to assist organizations to cope with their diversity concerns. The descriptive, comparative-correlational methods were employed as this paper also aims to find the correlates of emotional intelligence such as work/family conflict, and work values. The researchers utilized several instruments, namely the Demographic Profile Sheet, Emotional Competence Inventory, Work/Family Conflict Scale, and Work Values Inventory. The general findings reveal that there is a significant relationship between emotional intelligence and work/family conflict, particularly on the areas of self- management, social awareness and relationship management; whereas, there is a significant relationship between emotional intelligence (particularly on the clusters of self- management, social awareness and relationship management and work values (specifically in the areas of management, achievement, supervisory relations, way of life, and independence. The organizational development support programs with emphasis on diversity management have been recommended to set future directions for call center organizations involved in the study.
Full Text Available This paper reviews issues of reliability and efficiency upgrades of power systems functions by means of a widespread implementation of intelligent electronic devices (IED in various purposes supporting synchrophasor measurement technology. Thus, such issues as IED’s operational analysis in the conditions of electromagnetic and electromechanical transient processes and synthesis of digital filters that improve static and dynamic responses of these devices play an important role in their development.
This paper reviews issues of reliability and efficiency upgrades of power systems functions by means of a widespread implementation of intelligent electronic devices (IED) in various purposes supporting synchrophasor measurement technology. Thus, such issues as IED’s operational analysis in the conditions of electromagnetic and electromechanical transient processes and synthesis of digital filters that improve static and dynamic responses of these devices play an important role in their devel...
Hui, David; De La Cruz, Maxine; Mori, Masanori; Parsons, Henrique A; Kwon, Jung Hye; Torres-Vigil, Isabel; Kim, Sun Hyun; Dev, Rony; Hutchins, Ronald; Liem, Christiana; Kang, Duck-Hee; Bruera, Eduardo
Commonly used terms such as "supportive care," "best supportive care," "palliative care," and "hospice care" were rarely and inconsistently defined in the palliative oncology literature. We conducted a systematic review of the literature to further identify concepts and definitions for these terms. We searched MEDLINE, PsycInfo, EMBASE, and CINAHL for published peer-reviewed articles from 1948 to 2011 that conceptualized, defined, or examined these terms. Two researchers independently reviewed each citation for inclusion and then extracted the concepts/definitions when available. Dictionaries/textbooks were also searched. Nine of 32 "SC/BSC," 25 of 182 "PC," and 12 of 42 "HC" articles focused on providing a conceptual framework/definition. Common concepts for all three terms were symptom control and quality-of-life for patients with life-limiting illness. "SC" focused more on patients on active treatment compared to other categories (9/9 vs. 8/37) and less often involved interdisciplinary care (4/9 vs. 31/37). In contrast, "HC" focused more on volunteers (6/12 vs. 6/34), bereavement care (9/12 vs. 7/34), and community care (9/12 vs. 6/34). Both "PC" and "SC/BSC" were applicable earlier in the disease trajectory (16/34 vs. 0/9). We found 13, 24, and 17 different definitions for "SC/BSC," "PC," and "HC," respectively. "SC/BSC" was the most variably defined, ranging from symptom management during cancer therapy to survivorship care. Dictionaries/textbooks showed similar findings. We identified defining concepts for "SC/BSC," "PC," and "HC" and developed a preliminary conceptual framework unifying these terms along the continuum of care to help build consensus toward standardized definitions.
Orr, Shlomo; Meystel, Alexander M.
Despite remarkable new developments in stochastic hydrology and adaptations of advanced methods from operations research, stochastic control, and artificial intelligence, solutions of complex real-world problems in hydrogeology have been quite limited. The main reason is the ultimate reliance on first-principle models that lead to complex, distributed-parameter partial differential equations (PDE) on a given scale. While the addition of uncertainty, and hence, stochasticity or randomness has increased insight and highlighted important relationships between uncertainty, reliability, risk, and their effect on the cost function, it has also (a) introduced additional complexity that results in prohibitive computer power even for just a single uncertain/random parameter; and (b) led to the recognition in our inability to assess the full uncertainty even when including all uncertain parameters. A paradigm shift is introduced: an adaptation of new methods of intelligent control that will relax the dependency on rigid, computer-intensive, stochastic PDE, and will shift the emphasis to a goal-oriented, flexible, adaptive, multiresolutional decision support system (MRDS) with strong unsupervised learning (oriented towards anticipation rather than prediction) and highly efficient optimization capability, which could provide the needed solutions of real-world aquifer management problems. The article highlights the links between past developments and future optimization/planning/control of hydrogeologic systems. Malgré de remarquables nouveaux développements en hydrologie stochastique ainsi que de remarquables adaptations de méthodes avancées pour les opérations de recherche, le contrôle stochastique, et l'intelligence artificielle, solutions pour les problèmes complexes en hydrogéologie sont restées assez limitées. La principale raison est l'ultime confiance en les modèles qui conduisent à des équations partielles complexes aux paramètres distribués (PDE) à une
Pesántez-Avilés, Fernando; Cevallos-León Wong, Verónica; Robles-Bykbaev, Vladimir; Borck-Vintimilla, Estefanía.; Flores-Andrade, Santiago; Pineda-Villa, Yenner; Pacurucu-Pacurucu, Ana
When children are taken apart from their parents because of many violence situations, they are taken to foster homes, where they share place with kids who have lived similar situations. United Nations Children's Fund (2014) refer that Children who have been abused or neglected, often may have low self-esteem and other emotional problems, which can lead, at worst, to risky behaviors and self-harm . They also could tend to internalize that behavior, repeating the pattern of violence and abuse as a response to their environment. In this line, the latest estimates provided by SOS Children's Village International show a global complex picture: around 24 million of children in the world live in foster homes, one billion of children live in conflict-affected areas; and, furthermore, there is a lack of mental health professionals in most of the countries. On those grounds, in this paper we propose an intelligent ecosystem to provide support for psychologists during the psychodiagnosis and intervention with children, especially the ones who are in foster homes. Currently, the system is able to automatically determine some psychological traits, according to responses provided by each patient. One part of the diagnostic system is based on two psychological tests: the Draw-A-Person test and the Draw-A-Family test. The results obtained on the first stage let the system establish different challenges according to the skills that the evaluated child needs to develop. Our proposed approach was tested in a population of 124 children (93 school students, and 31 living in shelters), and has achieved encouraging results (80% of precision in patient's profile determination).
Müller, Veronika; Tamási, Lilla; Gálffy, Gabriella; Losonczy, György
Active oncotherapy, combination chemotherapy of lung cancer is accompanied with many side effects which may impair patients' quality of life and compromise the effectiveness of chemotherapy. Most side effects of chemotherapy are preventable or treatable with optimal supportive care which enhances success in patient care and treatment. The aim of this review is to summarize the most important conditions that may be associated with combined chemotherapy of lung cancer from the practical point of view.
Ferranti, Jeffrey M; Langman, Matthew K; Tanaka, David; McCall, Jonathan; Ahmad, Asif
Healthcare is increasingly dependent upon information technology (IT), but the accumulation of data has outpaced our capacity to use it to improve operating efficiency, clinical quality, and financial effectiveness. Moreover, hospitals have lagged in adopting thoughtful analytic approaches that would allow operational leaders and providers to capitalize upon existing data stores. In this manuscript, we propose a fundamental re-evaluation of strategic IT investments in healthcare, with the goal of increasing efficiency, reducing costs, and improving outcomes through the targeted application of health analytics. We also present three case studies that illustrate the use of health analytics to leverage pre-existing data resources to support improvements in patient safety and quality of care, to increase the accuracy of billing and collection, and support emerging health issues. We believe that such active investment in health analytics will prove essential to realizing the full promise of investments in electronic clinical systems.
Shared electronic health and social care records in some service systems are already showing some of the benefits of digital technology and digital data for integrating health and social care. These records are one example of the beginning "digitalisation" of services that gives a glimpse of the potential of digital technology and systems for building coordinated and individualized integrated care. Yet the promise has been greater than the benefits, and progress has been slow compared to other industries. This paper describes for non-technical readers how information technology was used to support integrated care schemes in six EU services, and suggests practical ways forward to use the new opportunities to build person-centered integrated care.
Frize, Monique; Yang, Lan; Walker, Robin C; O'Connor, Annette M
This research is built on the belief that artificial intelligence estimations need to be integrated into clinical social context to create value for health-care decisions. In sophisticated neonatal intensive care units (NICUs), decisions to continue or discontinue aggressive treatment are an integral part of clinical practice. High-quality evidence supports clinical decision-making, and a decision-aid tool based on specific outcome information for individual NICU patients will provide significant support for parents and caregivers in making difficult "ethical" treatment decisions. In our approach, information on a newborn patient's likely outcomes is integrated with the physician's interpretation and parents' perspectives into codified knowledge. Context-sensitive content adaptation delivers personalized and customized information to a variety of users, from physicians to parents. The system provides structuralized knowledge translation and exchange between all participants in the decision, facilitating collaborative decision-making that involves parents at every stage on whether to initiate, continue, limit, or terminate intensive care for their infant.
Kanerva, A; Kivinen, T; Lammintakanen, J
Communication is important for safe and quality health care. The study provides needed insight on the communication elements that support patient safety from the psychiatric care view. Fluent information transfer between the health care professionals and care units is important for care planning and maintaining practices. Information should be documented and implemented accordingly. Communication should happen in an open communication culture that enables discussion, the opportunity to have debriefing discussions and the entire staff can feel they are heard. For effective communication, it is also important that staff are active themselves in information collecting about the essential information needed in patient care. In mental health nursing, it is important to pay attention to all elements of communication and to develop processes concerning communication in multidisciplinary teams and across unit boundaries. The study aims to describe which communication elements support patient safety in psychiatric inpatient care from the viewpoint of the nursing staff. Communication is an essential part of care and one of the core competencies of the psychiatric care. It enables safe and quality patient care. Errors in health care are often connected with poor communication. The study brings needed insight from the psychiatric care view to the topic. The data were gathered from semi-structured interviews in which 26 nurses were asked to describe the elements that constitute patient safety in psychiatric inpatient care. The data were analysed inductively from the viewpoint of communication. The descriptions connected with communication formed a main category of communication elements that support patient safety; this main category was made up of three subcategories: fluent information transfer, open communication culture and being active in information collecting. Fluent information transfer consists of the practical implementation of communication; open communication
O'Hare, Daniel G
The possibility of medical-moral controversy in contemporary health care delivery is occasioned by the interfacing of expanding technology with both professional and personal value systems, frequent and significant knowledge deficits on the part of health care consumers, and increased circumspection of and economic constraints experienced by health care providers. Particularly in an era of increasing regulatory mandates and the frequent and lamentable decrease in the availability of human, natural, and institutional resources, an understanding of the function of ethical analysis is indigenous to care, which is simultaneously medically appropriate and morally indicated. But while a familiarity with and an appreciation of the potential contribution of ethical reasoning is essential in all health care delivery, it assumes critical importance in supportive care. In that venue, where the rigors and demands of aggressively therapeutic interventions have ceased and the goal and the demeanor of care have shifted to the palliative mode, heightened attention to the principles of medical ethics is necessary for the balancing of rights and responsibilities for health care consumers and providers alike. This issue ultimately can be singularly salient in providing care that is patient centered and directed. Individuals acting as moral agents, suggesting what "ought" to be done in a given situation, either for themselves or as they are involved in rendering or supporting decisions proffered for or by other moral agents, particularly those in extremis, those in the throes of terminal illness following the collapse of the curative mode, need recourse to principles to facilitate their reasoning. Although the employment of each principle of medical ethics offers guidelines for reflection on the most comprehensive and appropriate care, it is attention to autonomy, informed consent, and beneficence that promotes the most effective supportive care. For even as the question of medical
Blaschke, Sarah; O'Callaghan, Clare C; Schofield, Penelope
Given preliminary evidence for positive health outcomes related to contact with nature for cancer populations, research is warranted to ascertain possible strategies for incorporating nature-based care opportunities into oncology contexts as additional strategies for addressing multidimensional aspects of cancer patients' health and recovery needs. The objective of this study was to consolidate existing research related to nature-based supportive care opportunities and generate a conceptual framework for discerning relevant applications in the supportive care setting. Drawing on research investigating nature-based engagement in oncology contexts, a two-step analytic process was used to construct a conceptual framework for guiding nature-based supportive care design and future research. Concept analysis methodology generated new representations of understanding by extracting and synthesising salient concepts. Newly formulated concepts were transposed to findings from related research about patient-reported and healthcare expert-developed recommendations for nature-based supportive care in oncology. Five theoretical concepts (themes) were formulated describing patients' reasons for engaging with nature and the underlying needs these interactions address. These included: connecting with what is genuinely valued, distancing from the cancer experience, meaning-making and reframing the cancer experience, finding comfort and safety, and vital nurturance. Eight shared patient and expert recommendations were compiled, which address the identified needs through nature-based initiatives. Eleven additional patient-reported recommendations attend to beneficial and adverse experiential qualities of patients' nature-based engagement and complete the framework. The framework outlines salient findings about helpful nature-based supportive care opportunities for ready access by healthcare practitioners, designers, researchers and patients themselves. © Article author(s) (or their
Full Text Available The aim of the research was to investigate the effects of multiple intelligences supported project-based learning and traditional foreign language-teaching environment on students’ achievement and their attitude towards English lesson. The research was carried out in 2009 – 2010 education-instruction year in Karatli Sehit Sahin Yilmaz Elementary School, Nigde, Turkey. Totally 50 students in two different classes in the 5th grade of this school participated in the study. The results of the research showed a significant difference between the attitude scores of the experiment group and the control group. It was also found out that the multiple intelligences approach activities were more effective in the positive development of the students’ attitudes. At the end of the research, it is revealed that the students who are educated by multiple intelligences supported project-based learning method are more successful and have a higher motivation level than the students who are educated by the traditional instructional methods.
Scotté, F; Hervé, C; Oudard, S; Bugat, M E; Bugat, R; Farsi, F; Namer, M; Tourani, J M; Tournigand, C; Yazbek, G; Richard, S; Krakowski, I
Supportive care in cancer (SCC) was further enhanced in the Second National Cancer Act decreed in December 2009. The aim of our study was to assess current SCC efficacy. The French speaking association for supportive care in cancer (AFSOS) conducted an observational study to evaluate practices, organisations and information given to patients. A specific 32 point questionnaire was sent to 1621 French physicians (MDs) caring for cancer patients. Three different organisations were evaluated: the individual MDs, the transversal team and its particular structure specialised in global patient care specifically developed at comprehensive cancer centres - CCC. During their disease, 68% of patients received SCC, which was more available during the palliative period (90%) than at the diagnosis (44%). Our results found that 71% of cancer departments had a specific interdisciplinary cross-team to provide SCC, particularly in CCC (62%; p=0.01) while 37% had specific inpatient units. A specific organisation dedicated to home care was greater in CCC than in public or private centres (69%, 45%, 20% respectively; p=0.01). Adverse event information was performed more by an oncologist than other specialists (p=0.01). Our results suggest that the specific SCC organisation could be a useful management tool to improve supportive care for cancer patients. Copyright © 2012 Elsevier Ltd. All rights reserved.
Draper, Kevin; Gourevitch, Rebecca; Cross, Dori A.; Scholle, Sarah Hudson
Objective Consensus that enhanced teamwork is necessary for efficient and effective primary care delivery is growing. We sought to identify how electronic health records (EHRs) facilitate and pose challenges to primary care teams as well as how practices are overcoming these challenges. Methods Practices in this qualitative study were selected from those recognized as patient-centered medical homes via the National Committee for Quality Assurance 2011 tool, which included a section on practice teamwork. We interviewed 63 respondents, ranging from physicians to front-desk staff, from 27 primary care practices ranging in size, type, geography, and population size. Results EHRs were found to facilitate communication and task delegation in primary care teams through instant messaging, task management software, and the ability to create evidence-based templates for symptom-specific data collection from patients by medical assistants and nurses (which can offload work from physicians). Areas where respondents felt that electronic medical record EHR functionalities were weakest and posed challenges to teamwork included the lack of integrated care manager software and care plans in EHRs, poor practice registry functionality and interoperability, and inadequate ease of tracking patient data in the EHR over time. Discussion Practices developed solutions for some of the challenges they faced when attempting to use EHRs to support teamwork but wanted more permanent vendor and policy solutions for other challenges. Conclusions EHR vendors in the United States need to work alongside practicing primary care teams to create more clinically useful EHRs that support dynamic care plans, integrated care management software, more functional and interoperable practice registries, and greater ease of data tracking over time. PMID:25627278
O'Malley, Ann S; Draper, Kevin; Gourevitch, Rebecca; Cross, Dori A; Scholle, Sarah Hudson
Consensus that enhanced teamwork is necessary for efficient and effective primary care delivery is growing. We sought to identify how electronic health records (EHRs) facilitate and pose challenges to primary care teams as well as how practices are overcoming these challenges. Practices in this qualitative study were selected from those recognized as patient-centered medical homes via the National Committee for Quality Assurance 2011 tool, which included a section on practice teamwork. We interviewed 63 respondents, ranging from physicians to front-desk staff, from 27 primary care practices ranging in size, type, geography, and population size. EHRs were found to facilitate communication and task delegation in primary care teams through instant messaging, task management software, and the ability to create evidence-based templates for symptom-specific data collection from patients by medical assistants and nurses (which can offload work from physicians). Areas where respondents felt that electronic medical record EHR functionalities were weakest and posed challenges to teamwork included the lack of integrated care manager software and care plans in EHRs, poor practice registry functionality and interoperability, and inadequate ease of tracking patient data in the EHR over time. Practices developed solutions for some of the challenges they faced when attempting to use EHRs to support teamwork but wanted more permanent vendor and policy solutions for other challenges. EHR vendors in the United States need to work alongside practicing primary care teams to create more clinically useful EHRs that support dynamic care plans, integrated care management software, more functional and interoperable practice registries, and greater ease of data tracking over time. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association.
Alejandro Baldominos Gómez
Full Text Available This paper presents DataCare, a solution for intelligent healthcare management. This product is able not only to retrieve and aggregate data from different key performance indicators in healthcare centers, but also to estimate future values for these key performance indicators and, as a result, fire early alerts when undesirable values are about to occur or provide recommendations to improve the quality of service. DataCare’s core processes are built over a free and open-source cross-platform document-oriented database (MongoDB, and Apache Spark, an open-source cluster-computing framework. This architecture ensures high scalability capable of processing very high data volumes coming at fast speed from a large set of sources. This article describes the architecture designed for this project and the results obtained after conducting a pilot in a healthcare center. Useful conclusions have been drawn regarding how key performance indicators change based on different situations, and how they affect patients’ satisfaction.
Mitchell, Pamela R.
Background: Communication skills are important to the pursuit of increased self-determination in individuals with disabilities. The aim of this investigation was to gather information about communication supports in state-run residential care facilities in Ohio, and to compare findings with a previous investigation on this topic examining such…
Full Text Available Hypertriglyceridemia is a rare cause of pancreatitis. In treatment pancreatic rest, lifestyle changes, medications (fibrates, n-3 polyunsaturated fatty acids, and nicotinic acid are essential. Many experimental treatment modalities have been reported as insulin and heparin infusion and plasmapheresis. In this study we present the hypertriglyceridemia-induced pancreatitis treated with supportive care.
Cheah, Whye Lian; Ling, Ngok Chuo; Chang, Kam Hock
This cross-sectional study aimed to determine the prevalence of unmet supportive care needs among prostate cancer patients. The cross-sectional study was conducted among all prostate cancer patients at the Sarawak General Hospital. Interview was done using the Supportive Care Needs Survey-Short Form (SCNS-SF) and the Health Service Utilization Questionnaires (HSUQ). Data were analysed using Statistical Package for the Social Sciences (SPSS) 20. A total of ninety-five patients participated, with majority were aged 65 and above and of primary educational level. The two most frequently reported unmet supportive care needs were "informed about cancer which is under control or diminishing" and "informed about things you can do to help yourself to get well" under the domain Health System and Information. Respondents who were older (65 years and above) had significant lower unmet needs in psychology (P<0.01), and sexuality compared to the younger group below 65 years (P<0.01). Except for physical and daily living, respondents with primary school level had significant lower unmet needs in all domains compared to secondary school level. Respondents with known stages of cancer had higher unmet needs in all domains compared to those who did not know. Healthcare providers should provide more responsive, emotionally sensitive and client-centered care to patients with prostate cancer, particularly in the area of Health System and Information, and psychological support.
Chao, Minston; Shih, Chih-Ting; Hsu, Shu-Fen
Most previous studies on the relationship between occupational burnout and the quality of care among nurses have used self-reported data on the quality of care from nurses, thus rendering evaluating the relationship between burnout and the quality of care difficult. Hospitals increasingly hire contract nurses and high turnover rates remain a concern. Little is known about whether nurses' emotional intelligence and demographic factors such as contract status, tenure, and marital status affect the quality of care when burnout occurs. This study investigated the relationship between burnout and patient-rated quality of care and investigated the moderating role of emotional intelligence and demographic variables. Hierarchical moderated regression was used to analyze 98 sets of paired data obtained from nurses and their patients at a teaching hospital in northern Taiwan. The results suggest that occupational burnout has a less unfavorable effect on the quality of care from permanent, married, and senior nurses. Nursing management should pay particular attention to retaining permanent, married, and senior nurses. To ensure a sustainable nursing workforce in the future, newly graduated registered nurses should have access to permanent positions and opportunities for long-term professional development. In addition, married nurses should be provided with flexible work-family arrangements to ensure their satisfaction in the nursing profession. © 2015 Japan Academy of Nursing Science.
Haas, Karen S.
Many companies today consider employer-sponsored child care a viable solution to problems facing employees who are also parents. Companies can choose from many program options, each with particular benefits for employer and employees. This manual highlights what is presently happening in employer-supported child care, particularly the cost…
Prior studies indicate that trait emotional intelligence (EI) is associated negatively with loneliness. However, the mechanisms underlying the relationship are not clear. This study assessed whether both self-esteem and social support mediated the associations between trait EI and loneliness. 469 Chinese undergraduate participants whose age ranged from 18 to 23 years (208 women) were asked to complete four self-report questionnaires, including the Wong Law Emotional Intelligence Scale, the Social and Emotional Loneliness Scale, the Rosenberg Self-esteem Scale, and the Multi-Dimensional Scale of Perceived Social Support. Analyses indicated that self-esteem and social support fully mediated the associations between trait EI and loneliness. Effect contrasts indicated that the specific indirect effect through social support was significantly greater than that through self-esteem. Moreover, a multiple-group analysis indicated that no path differed significantly by sex. These results suggest that social support is more important than self-esteem in the association between trait EI and loneliness. Furthermore, both sexes appear to share the same mechanism underlying this association.
Kirkcaldy, Bruce; Furnham, Adrian; Siefen, Georg
A sample of around 2,500 adolescents in a child and adolescent psychiatry clinic in the region of Munster, Germany had their intelligence assessed. Family size (total number of siblings within a family) was significantly correlated with intelligence score categories (-0.08 and -0.19 for males and females). First borns and only children displayed…
Feng, Mingyu; Roschelle, Jeremy; Heffernan, Neil; Fairman, Janet; Murphy, Robert
Much research has been done on the development of an intelligent tutoring system (ITS), and small empirical studies have demonstrated the effectiveness of ITS at promoting student learning. However, large-scale implementation of ITS in school settings has not been researched thoroughly. In this paper, we describe an ongoing randomized controlled…
Di Fabio, Annamaria; Kenny, Maureen E.
Emotional intelligence (EI) has emerged in recent research as a teachable skill that is distinct from personality and is relevant to scholastic and work success and progress in career development. This study adds to that research by examining the relationship of performance and self-report measures of EI and personality traits with perceived…
Bourgarel, Sophie; Piteau-Delord, Monique
To analyse the logic for the distribution of home care services for disabled children (SESSAD) in a context of under-equipment. Questionnaire-based survey of 75 units (82% of the region's SESSAD units) concerning patient transport. Equipment and transport mapping. Support units for disabled children are often set up in the housing facilities that contributed to their creation. These sites are sometimes situated a long way from densely populated regions, thereby generating unnecessary travel times and expenses. Chronic under-equipment makes these sites viable, as the various units are always full, despite their distance from the children for whom they provide support. Mapping illustrates the extensive recruitment zones overlapping several units managing similar patients. The major revision of accreditation of these units, planned for 2017, could lead to redefinition of geographical zones of accreditations. New unit opening procedures based on ARS calls for tenders may help to improve the geographical distribution of this supportive care.
Jauk, Emanuel; Benedek, Mathias; Dunst, Beate; Neubauer, Aljoscha C.
The relationship between intelligence and creativity has been subject to empirical research for decades. Nevertheless, there is yet no consensus on how these constructs are related. One of the most prominent notions concerning the interplay between intelligence and creativity is the threshold hypothesis, which assumes that above-average intelligence represents a necessary condition for high-level creativity. While earlier research mostly supported the threshold hypothesis, it has come under fire in recent investigations. The threshold hypothesis is commonly investigated by splitting a sample at a given threshold (e.g., at 120 IQ points) and estimating separate correlations for lower and upper IQ ranges. However, there is no compelling reason why the threshold should be fixed at an IQ of 120, and to date, no attempts have been made to detect the threshold empirically. Therefore, this study examined the relationship between intelligence and different indicators of creative potential and of creative achievement by means of segmented regression analysis in a sample of 297 participants. Segmented regression allows for the detection of a threshold in continuous data by means of iterative computational algorithms. We found thresholds only for measures of creative potential but not for creative achievement. For the former the thresholds varied as a function of criteria: When investigating a liberal criterion of ideational originality (i.e., two original ideas), a threshold was detected at around 100 IQ points. In contrast, a threshold of 120 IQ points emerged when the criterion was more demanding (i.e., many original ideas). Moreover, an IQ of around 85 IQ points was found to form the threshold for a purely quantitative measure of creative potential (i.e., ideational fluency). These results confirm the threshold hypothesis for qualitative indicators of creative potential and may explain some of the observed discrepancies in previous research. In addition, we obtained
Sumi, Yasunori; Ozawa, Nobuyoshi; Miura, Hiroko; Miura, Hisayuki; Toba, Kenji
The purpose of this study was to ascertain the current statuses and problems of dental home care patients by surveying the oral care status and needs of patients in the home medical care support ward at the National Center for Geriatrics and Gerontology. Patients that required continuous oral management even after discharge from the hospital were referred to local dental clinics to receive home dental care. We investigated the suitability and problems associated with such care, and identified the dental care needs of home patients and the status of local care coordination, including those in hospitals. The subjects were 82 patients. We ascertained their general condition and oral status, and also investigated the problems associated with patients judged to need specialized oral care by a dentist during oral treatment. Patients who required continuous specialized oral care after discharge from hospital were referred to dental clinics that could provide regular care, and the problems at the time of referral were identified. Dry mouth was reported by many patients. A large number of patients also needed specialized dental treatment such as the removal of dental calculus or tooth extraction. Problems were seen in oral function, with 38 of the patients (46%) unable to gargle and 23 (28%) unable to hold their mouths open. About half of the patients also had dementia, and communication with these patients was difficult. Of the 43 patients who were judged to need continuing oral care after discharge from hospital, their referral to a dental clinic for regular care was successful for 22 (51%) patients and unsuccessful for 21 (49%) patients. The reasons for unsuccessful referrals included the fact that the family, patient, nurse, or caregiver did not understand the need for specialized oral care. The present results suggest the need for specialized oral treatment in home medical care. These findings also suggest that coordinating seamless dental care among primary physicians
Xu, Peng; Wang, Jianye; Yang, Minghan; Wang, Weitian; Bai, Yunqing; Song, Yong
Highlights: • We development an operator support method based on intelligent dynamic interlock. • We offer an integrated aid system to reduce the working strength of operators. • The method can help operators avoid dangerous, irreversible operation. • This method can be used in the fusion research reactor in the further. - Abstract: In nuclear systems, operators have to carry out corrective actions when abnormal situations occur. However, operators might make mistakes under pressure. In order to avoid serious consequences of the human errors, a new method for operators support based on intelligent dynamic interlock was proposed. The new method based on full digital instrumentation and control system, contains real-time alarm analysis process, decision support process and automatic safety interlock process. Once abnormal conditions occur, necessary safety interlock parameter based on analysis of real-time alarm and decision support process can be loaded into human-machine interfaces and controllers automatically, and avoid human errors effectively. Furthermore, the new method can make recommendations for further use and development of this technique in nuclear power plant or fusion research reactor.
Snowden, John A; Ahmedzai, Sam H; Ashcroft, John; D'Sa, Shirley; Littlewood, Timothy; Low, Eric; Lucraft, Helen; Maclean, Rhona; Feyler, Sylvia; Pratt, Guy; Bird, Jennifer M
Supportive care plays an increasingly important role in the modern management of multiple myeloma. While modern treatments have significantly prolonged overall and progression free survival through improved disease control, the vast majority of patients remain incurable, and live with the burden of the disease itself and the cumulative side effects of treatments. Maintenance of quality of life presents challenges at all stages of the disease from diagnosis through the multiple phases of active treatment to the end of life. Written on behalf of the British Committee for Standards in Haematology (BCSH) and the UK Myeloma Forum (UKMF), these evidence based guidelines summarize the current national consensus for supportive and symptomatic care in multiple myeloma in the following areas; pain management, peripheral neuropathy, skeletal complications, infection, anaemia, haemostasis and thrombosis, sedation, fatigue, nausea, vomiting, anorexia, constipation, diarrhoea, mucositis, bisphosphonate-induced osteonecrosis of the jaw, complementary therapies, holistic needs assessment and end of life care. Although most aspects of supportive care can be supervised by haematology teams primarily responsible for patients with multiple myeloma, multidisciplinary collaboration involving specialists in palliative medicine, pain management, radiotherapy and surgical specialities is essential, and guidance is provided for appropriate interdisciplinary referral. These guidelines should be read in conjunction with the BCSH/UKMF Guidelines for the Diagnosis and Management of Multiple Myeloma 2011. © 2011 Blackwell Publishing Ltd.
Kurian, Benji T; Trivedi, Madhukar H; Grannemann, Bruce D; Claassen, Cynthia A; Daly, Ella J; Sunderajan, Prabha
In 2004, results from The Texas Medication Algorithm Project (TMAP) showed better clinical outcomes for patients whose physicians adhered to a paper-and-pencil algorithm compared to patients who received standard clinical treatment for major depressive disorder (MDD). However, implementation of and fidelity to the treatment algorithm among various providers was observed to be inadequate. A computerized decision support system (CDSS) for the implementation of the TMAP algorithm for depression has since been developed to improve fidelity and adherence to the algorithm. This was a 2-group, parallel design, clinical trial (one patient group receiving MDD treatment from physicians using the CDSS and the other patient group receiving usual care) conducted at 2 separate primary care clinics in Texas from March 2005 through June 2006. Fifty-five patients with MDD (DSM-IV criteria) with no significant difference in disease characteristics were enrolled, 32 of whom were treated by physicians using CDSS and 23 were treated by physicians using usual care. The study's objective was to evaluate the feasibility and efficacy of implementing a CDSS to assist physicians acutely treating patients with MDD compared to usual care in primary care. Primary efficacy outcomes for depression symptom severity were based on the 17-item Hamilton Depression Rating Scale (HDRS(17)) evaluated by an independent rater. Patients treated by physicians employing CDSS had significantly greater symptom reduction, based on the HDRS(17), than patients treated with usual care (P < .001). The CDSS algorithm, utilizing measurement-based care, was superior to usual care for patients with MDD in primary care settings. Larger randomized controlled trials are needed to confirm these findings. clinicaltrials.gov Identifier: NCT00551083.
Perneger, Thomas V; Hudelson, Patricia M
The purpose of this study was to identify factors associated with the public's preference for financing health care according to people's ability to pay. The authors compared voters' support in 26 Swiss cantons for a legislative proposal to replace regionally rated health insurance premiums (current system) with premiums proportional to income and wealth, and co-financed through the value added tax. The vote took place in May 2003, and the initiative was rejected, with only 27 percent of support nationwide. However, support varied more than threefold, from 13 to 44 percent, among cantons. In multivariate analysis, support was most strongly correlated with the approval rate of the 1994 law on health insurance, which strengthened solidarity between the sick and the healthy. More modest associations were seen between support for the initiative and the health insurance premium of 2003, and proportions of elderly and urban residents in the population. Hence support for more social financing of health care was best explained by past preference for a social health insurance system in the local community.
Malucelli, Andreia; Otemaier, Kelly Rafaela; Bonnet, Marcel; Cubas, Marcia Regina; Garcia, Telma Ribeiro
It is an unquestionable fact, the importance, relevance and necessity of implementing the Nursing Care Systematization in the different environments of professional practice. Considering it as a principle, emerged the motivation for the development of an information system to support the Nursing Care Systematization, based on Nursing Process steps and Human Needs, using the diagnoses language, nursing interventions and outcomes for professional practice documentation. This paper describes the methodological steps and results of the information system development - requirements elicitation, modeling, object-relational mapping, implementation and system validation.
Hsu, Lewis L.; Green, Nancy S.; Ivy, E. Donnell; Neunert, Cindy; Smaldone, Arlene; Johnson, Shirley; Castillo, Sheila; Castillo, Amparo; Thompson, Trevor; Hampton, Kisha; Strouse, John J.; Stewart, Rosalyn; Hughes, TaLana; Banks, Sonja; Smith-Whitley, Kim; King, Allison; Brown, Mary; Ohene-Frempong, Kwaku; Smith, Wally R.; Martin, Molly
Community health workers are increasingly recognized as useful for improving health care and health outcomes for a variety of chronic conditions. Community health workers can provide social support, navigation of health systems and resources, and lay counseling. Social and cultural alignment of community health workers with the population they serve is an important aspect of community health worker intervention. Although community health worker interventions have been shown to improve patient-centered outcomes in underserved communities, these interventions have not been evaluated with sickle cell disease. Evidence from other disease areas suggests that community health worker intervention also would be effective for these patients. Sickle cell disease is complex, with a range of barriers to multifaceted care needs at the individual, family/friend, clinical organization, and community levels. Care delivery is complicated by disparities in health care: access, delivery, services, and cultural mismatches between providers and families. Current practices inadequately address or provide incomplete control of symptoms, especially pain, resulting in decreased quality of life and high medical expense. The authors propose that care and care outcomes for people with sickle cell disease could be improved through community health worker case management, social support, and health system navigation. This report outlines implementation strategies in current use to test community health workers for sickle cell disease management in a variety of settings. National medical and advocacy efforts to develop the community health workforce for sickle cell disease management may enhance the progress and development of “best practices” for this area of community-based care. PMID:27320471
Sergio Cantoreggi speaks to Henry Ireland, Commissioning Editor: Sergio Cantoreggi, PhD, is the Chief Scientific Officer and Global Head of Research and Development of the Helsinn Group, a mid-sized pharmaceutical company headquartered in Lugano, Switzerland, and focused on providing cancer supportive care solutions to oncology patients worldwide. Dr Cantoreggi has overall responsibility for all R&D activities of the Helsinn Group and has contributed to six major regulatory approvals of cancer supportive care agents in the USA, Europe and Japan. Dr Cantoreggi joined Helsinn Healthcare in 2000 as drug development scientist and was appointed Head of R&D in 2005. In 2010, he was promoted to his current role. From 1994 to 2000 he worked as toxicologist and regulatory scientist for Du Pont, Sandoz and Novartis. Prior to joining industry, Dr Cantoreggi completed a postdoctoral fellowship and earned a Master of Science degree in chemistry and a Doctoral degree in natural sciences with a thesis on the mechanism of chemical carcinogenesis from the Swiss Federal Institute of Technology in Zürich, Switzerland. Sergio Cantoreggi discusses Helsinn's role in cancer supportive care, describing current treatment options for patients, the company's pipeline and Helsinn's work in supporting the field as a whole.
Hong, Matthew K.; Wilcox, Lauren; Machado, Daniel; Olson, Thomas A.; Simoneaux, Stephen F.
Adolescents with complex chronic illnesses, such as cancer and blood disorders, must partner with family and clinical caregivers to navigate risky procedures with life-altering implications, burdensome symptoms and lifelong treatments. Yet, there has been little investigation into how technology can support these partnerships. We conducted 38 in-depth interviews (15 with teenage adolescents with chronic forms of cancer and blood disorders, 15 with their parents, and eight with clinical caregivers) along with nine non-participant observations of clinical consultations to better understand common challenges and needs that could be supported through design. Participants faced challenges primarily concerning: 1) teens’ limited participation in their care, 2) communicating emotionally-sensitive information, and 3) managing physical and emotional responses. We draw on these findings to propose design goals for sociotechnical systems to support teens in partnering in their care, highlighting the need for design to support gradually evolving partnerships in care. PMID:28164178
Liao, Pei-Hung; Hsu, Pei-Ti; Chu, William; Chu, Woei-Chyn
This study applied artificial intelligence to help nurses address problems and receive instructions through information technology. Nurses make diagnoses according to professional knowledge, clinical experience, and even instinct. Without comprehensive knowledge and thinking, diagnostic accuracy can be compromised and decisions may be delayed. We used a back-propagation neural network and other tools for data mining and statistical analysis. We further compared the prediction accuracy of the previous methods with an adaptive-network-based fuzzy inference system and the back-propagation neural network, identifying differences in the questions and in nurse satisfaction levels before and after using the nursing information system. This study investigated the use of artificial intelligence to generate nursing diagnoses. The percentage of agreement between diagnoses suggested by the information system and those made by nurses was as much as 87 percent. When patients are hospitalized, we can calculate the probability of various nursing diagnoses based on certain characteristics. © The Author(s) 2013.
Ajay Kumar Saxena; S. 0. Bhatnagar; P. K Saxena
Electrical Power Network in recent time requires an intelligent, virtual environment based decision process for the coordination of all its individual elements and the interrelated tasks. Its ultimate goal is to achieve maximum productivity and efficiency through the efficient and effective application of generation, transmission, distribution, pricing and regulatory systems. However, the complexity of electrical power network and the presence of conflicting multiple goals and objectives p...
Taylor, Patrick C.; Baker, Noel C.
Earth's climate is changing and will continue to change into the foreseeable future. Expected changes in the climatological distribution of precipitation, surface temperature, and surface solar radiation will significantly impact agriculture. Adaptation strategies are, therefore, required to reduce the agricultural impacts of climate change. Climate change projections of precipitation, surface temperature, and surface solar radiation distributions are necessary input for adaption planning studies. These projections are conventionally constructed from an ensemble of climate model simulations (e.g., the Coupled Model Intercomparison Project 5 (CMIP5)) as an equal weighted average, one model one vote. Each climate model, however, represents the array of climate-relevant physical processes with varying degrees of fidelity influencing the projection of individual climate variables differently. Presented here is a new approach, termed the "Intelligent Ensemble, that constructs climate variable projections by weighting each model according to its ability to represent key physical processes, e.g., precipitation probability distribution. This approach provides added value over the equal weighted average method. Physical process metrics applied in the "Intelligent Ensemble" method are created using a combination of NASA and NOAA satellite and surface-based cloud, radiation, temperature, and precipitation data sets. The "Intelligent Ensemble" method is applied to the RCP4.5 and RCP8.5 anthropogenic climate forcing simulations within the CMIP5 archive to develop a set of climate change scenarios for precipitation, temperature, and surface solar radiation in each USDA Farm Resource Region for use in climate change adaptation studies.
Tenório, Josceli Maria; Hummel, Anderson Diniz; Cohrs, Frederico Molina; Sdepanian, Vera Lucia; Pisa, Ivan Torres; de Fátima Marin, Heimar
Celiac disease (CD) is a difficult-to-diagnose condition because of its multiple clinical presentations and symptoms shared with other diseases. Gold-standard diagnostic confirmation of suspected CD is achieved by biopsying the small intestine. To develop a clinical decision-support system (CDSS) integrated with an automated classifier to recognize CD cases, by selecting from experimental models developed using intelligence artificial techniques. A web-based system was designed for constructing a retrospective database that included 178 clinical cases for training. Tests were run on 270 automated classifiers available in Weka 3.6.1 using five artificial intelligence techniques, namely decision trees, Bayesian inference, k-nearest neighbor algorithm, support vector machines and artificial neural networks. The parameters evaluated were accuracy, sensitivity, specificity and area under the ROC curve (AUC). AUC was used as a criterion for selecting the CDSS algorithm. A testing database was constructed including 38 clinical CD cases for CDSS evaluation. The diagnoses suggested by CDSS were compared with those made by physicians during patient consultations. The most accurate method during the training phase was the averaged one-dependence estimator (AODE) algorithm (a Bayesian classifier), which showed accuracy 80.0%, sensitivity 0.78, specificity 0.80 and AUC 0.84. This classifier was integrated into the web-based decision-support system. The gold-standard validation of CDSS achieved accuracy of 84.2% and k=0.68 (pdiagnosis. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.
Full Text Available Not only can the icing coat on transmission line cause the electrical fault of gap discharge and icing flashover but also it will lead to the mechanical failure of tower, conductor, insulators, and others. It will bring great harm to the people’s daily life and work. Thus, accurate prediction of ice thickness has important significance for power department to control the ice disaster effectively. Based on the analysis of standard support vector machine, this paper presents a weighted support vector machine regression model based on the similarity (WSVR. According to the different importance of samples, this paper introduces the weighted support vector machine and optimizes its parameters by hybrid swarm intelligence optimization algorithm with the particle swarm and ant colony (PSO-ACO, which improves the generalization ability of the model. In the case study, the actual data of ice thickness and climate in a certain area of Hunan province have been used to predict the icing thickness of the area, which verifies the validity and applicability of this proposed method. The predicted results show that the intelligent model proposed in this paper has higher precision and stronger generalization ability.
Maastrup, Ragnhild; Bojesen, Susanne Nordby; Kronborg, Hanne
Background: The incidence of breastfeeding of preterm infants is affected by the support provided at the hospital and in the neonatal intensive care unit (NICU). However, policies and guidelines promoting breastfeeding vary both nationally and internationally. Objectives: The aim of this survey...... was to describe breastfeeding support in Danish NICUs, where approximately 98% of mothers initiate lactation. Methods: A national survey of all 19 Danish NICUs was conducted in 2009. Four NICUs were at designated Baby-Friendly hospitals, and 5 had a lactation consultant. In all NICUs, it was possible for some...... parents to stay overnight; 2 units had short restrictions on parents' presence. Five NICUs had integrated postpartum care for mothers. Breastfeeding policies, written guidelines, and systematic breastfeeding training for the staff were common in most NICUs. Seventeen NICUs recommended starting breast milk...
Beauvais, Audrey; Stewart, Julie G; DeNisco, Susan
Understanding factors that influence spiritual well-being may improve nurses' spiritual caregiving. This study examined relationships between emotional intelligence (EI) and spiritual well-being (SWB) in undergraduate and graduate nursing students. Using the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) and the spiritual well-being scale (SWBS) relationships were found between managing emotion and spiritual well-being, and managing emotion and existential well-being. Implications for education and practice are discussed.
Gorbenko, Ksenia O.; Fraze, Taressa; Lewis, Valerie A.
INTRODUCTION Accountable care organizations (ACOs) are a value-based payment model in the United States rooted in holding groups of healthcare providers financially accountable for the quality and total cost of care of their attributed population. To succeed in reaching their quality and efficiency goals, ACOs implement a variety of care delivery changes, including workforce redesign. Patient support personnel (PSP)—non-physician staff such as care coordinators, community health workers, and others—are critical to restructuring care delivery. Little is known about how ACOs are redesigning their patient support personnel in terms of responsibilities, location, and evaluation. METHODS We conducted semi-structured one-hour interviews with 25 executives at 16 distinct ACOs. The interviews were recorded, transcribed, and coded for themes, using a qualitative coding and analysis process. RESULTS ACOs deployed PSP to perform four clusters of responsibilities: care provision, care coordination, logistical help with transportation, and social and emotional support. ACOs deployed these personnel strategically across settings (primary care, inpatient services, emergency department, home care and community) depending on their population needs. Most ACOs used personnel with the same level of training across settings. Few ACOs planned to conduct a comprehensive evaluation of their PSP to optimize their value. DISCUSSION ACO strategies in workforce redesign indicate a shift from a physician-centered to a team-based approach. Employing personnel with varying levels of clinical training to perform different tasks can help further optimize care delivery. More robust evaluation of the deployment of PSP and their performance is needed to demonstrate cost-saving benefits of workforce redesign. PMID:28217305
Seashore, J. H.
Nutritional support is an integral and essential part of the management of 5-10 percent of hospitalized children. Children in the intensive care unit are particularly likely to develop malnutrition because of the nature and duration of their illness, and their inability to eat by mouth. This article reviews the physiology of starvation and the development of malnutrition in children. A method of estimating the nutritional requirements of children is presented. The techniques of nutritional su...
Fiveash, Barb; Nay, Rhonda
The purpose of this study was to identify how healthcare clients achieve and maintain a sense of control over their health. The literature review conducted refers to: (i) key definitions of control, (ii) locus of control, and (iii) control and wellbeing. Participants with a range of acute and chronic health conditions and who had been hospitalised at some point were selected for the study. Symbolic interactionism (Blumer, 1969) and modified grounded theory of Strauss & Corbin (1998) provided the frameworks for this study. During the six month study period, data were collected from sixty participants and included interviews, participant observation, reviewing participants' records (nursing care plans, nursing notes and case histories), the nursing units' philosophy, organisational charts, policies and procedures, annual reports, consumer brochures and any other relevant information sources. Findings from the study indicated that participants moved from feeling vulnerable to having a sense of control through to being purposefully active. Vulnerability was associated with: (i) having limited choices in respect to their health, (ii) lacking adequate health information to make choices, (iii) being ignored by health providers with respect to their needs, and (iv) lacking friend/family supports. Purposefully activating was associated with three major categories: (i) reflecting, (ii) being self-determiningly involved and (iii) normalising. Findings from this study could be used by health care clients who want a sense of control over their health care, and also by health care providers who wish to support clients in the healthcare process.
Coughlin, Mary; Gibbins, Sharyn; Hoath, Steven
This paper is a discussion of evidence-based core measures for developmental care in neonatal intensive care units. Inconsistent definition, application and evaluation of developmental care have resulted in criticism of its scientific merit. The key concept guiding data organization in this paper is the United States of America's Joint Commission's concept of 'core measures' for evaluating and accrediting healthcare organizations. This concept is applied to five disease- and procedure-independent measures based on the Universe of Developmental Care model. Electronically accessible, peer reviewed studies on developmental care published in English were culled for data supporting the selected objective core measures between 1978 and 2008. The quality of evidence was based on a structured predetermined format that included three independent reviewers. Systematic reviews and randomized control trials were considered the strongest level of evidence. When unavailable, cohort, case control, consensus statements and qualitative methods were considered the strongest level of evidence for a particular clinical issue. Five core measure sets for evidence-based developmental care were evaluated: (1) protected sleep, (2) pain and stress assessment and management, (3) developmental activities of daily living, (4) family-centred care, and (5) the healing environment. These five categories reflect recurring themes that emerged from the literature review regarding developmentally supportive care and quality caring practices in neonatal populations. This practice model provides clear metrics for nursing actions having an impact on the hospital experience of infant-family dyads. Standardized disease-independent core measures for developmental care establish minimum evidence-based practice expectations and offer an objective basis for cross-institutional comparison of developmental care programmes.
Forgionne, G A
The paper reports a decision support system (DSS) that enables health plan administrators to quickly and easily: (1) manage relevant medical care market (consumer preference and competitors' program) information and (2) convert the information into appropriate medical care delivery and/or payment policies. As the paper demonstrates, the DSS enables providers to design cost efficient and market effective medical care programs. The DSS provides knowledge about subscriber preferences, customer desires, and the program offerings of the competition. It then helps administrators structure a medical care plan in a way that best meets consumer needs in view of the competition. This market effective plan has the potential to generate substantial amounts of additional revenue for the program. Since the system's data base consists mainly of the provider's records, routine transactions, and other readily available documents, the DSS can be implemented at a nominal incremental cost. The paper also evaluates the impact of the information system on the general financial performance of existing dental and mental health plans. In addition, the paper examines how the system can help contain the cost of providing medical care while providing better services to more potential beneficiaries than current approaches.
Alstveit, Marit; Severinsson, Elisabeth; Karlsen, Bjørg
The World Health Organization calls on health professionals to support women in combining maternity and work. The aim of this study was to explore midwives' and public health nurses' perceptions of supporting employed women to balance work and family life during pregnancy and early motherhood. An exploratory design, including multistage focus group interviews, was used. The focus group consisted of five midwives and one public health nurse who was working in maternity care. The data were analyzed by using qualitative content analysis. The comprehensive theme, "empowering the women when they are in 'another' state of normality", was based on two themes, "being in dialogue with the women" and "supporting the women to manage daily activities". The first theme was based on the subthemes, "perceiving the women to be in 'another' state of normality" and "providing an open atmosphere for dialogue", while the second subtheme was based on "confirming self-esteem" and "suggesting adjustments at work". The midwives and public health nurse empowered the women by enhancing their ability to carry out the self-care that was necessary in order to manage both their work and family life. Collaboration between maternity healthcare providers and employers should be developed in order to support employed women. © 2011 Blackwell Publishing Asia Pty Ltd.
Tomlinson, Deborah; Bartels, Ute; Gammon, Janet; Hinds, Pamela S; Volpe, Jocelyne; Bouffet, Eric; Regier, Dean A; Baruchel, Sylvain; Greenberg, Mark; Barrera, Maru; Llewellyn-Thomas, Hilary; Sung, Lillian
The choice between palliative chemotherapy (defined as the use of cytotoxic medications delivered intravenously for the purpose of our study) and supportive care alone is one of the most difficult decisions in pediatric oncology, yet little is known about the preferences of parents and health care professionals. We compared the strength of these preferences by considering children's quality of life and survival time as key attributes. In addition, we identified factors associated with the reported preferences. We included parents of children whose cancer had no reasonable chance of being cured and health care professionals in pediatric oncology as participants in our study. We administered separate interviews to parents and to health care professionals. Visual analogue scales were shown to respondents to illustrate the anticipated level of the child's quality of life, the expected duration of survival and the probability of cure (shown only to health care professionals). Respondents were then asked which treatment option they would favour given these baseline attributes. In addition, respondents reported what factors might affect such a decision and ranked all factors identified in order of importance. The primary measure was the desirability score for supportive care alone relative to palliative chemotherapy, as obtained using the threshold technique. A total of 77 parents and 128 health care professionals participated in our study. Important factors influencing the decision between therapeutic options were child quality-of-life and survival time among both parents and health care professionals. Hope was particularly important to parents. Parents significantly favoured chemotherapy (42/77, 54.5%) compared with health care professionals (20/128, 15.6%; p parents' desire for supportive care; for health care professionals, the opinions of parents and children were significant factors influencing this decision. Compared with health care professionals, parents more
Lynn, J; O'Connor, M A; Dulac, J D; Roach, M J; Ross, C S; Wasson, J H
To develop an alternative healthcare benefit (called MediCaring) and to assess the preferences of older Medicare beneficiaries concerning this benefit, which emphasizes more home-based and supportive health care and discourages use of hospitalization and aggressive treatment. To evaluate the beneficiaries' ability to understand and make a choice regarding health insurance benefits; to measure their likelihood to change from traditional Medicare to the new MediCaring benefit; and to determine the short-term stability of that choice. Focus groups of persons aged 65+ and family members shaped the potential MediCaring benefit. A panel of 50 national experts critiqued three iterations of the benefit. The final version was test marketed by discussing it with 382 older people (men > or = 75 years and women > or = 80 years) in their homes. Telephone surveys a few days later, and again 1 month after the home interview, assessed the potential beneficiaries' understanding and preferences concerning MediCaring and the stability of their responses. Focus groups were held in community settings in New Hampshire, Washington, DC, Cleveland, OH, and Columbia, SC. Test marketing occurred in New Hampshire, Cleveland, OH; Columbia, SC, and Los Angeles, CA. Focus group participants were persons more than 65 years old (11 focus groups), healthcare providers (9 focus groups), and family decision-makers (3 focus groups). Participants in the in-home informing (test marketing group) were persons older than 75 years who were identified through contact with a variety of services. Demographics, health characteristics, understanding, and preferences. Focus group beneficiaries between the ages of 65 and 74 generally wanted access to all possible medical treatment and saw MediCaring as a need of persons older than themselves. Those older than age 80 were mostly in favor of it. Test marketing participants understood the key points of the new benefit: 74% generally liked it, and 34% said they would
Janet, J.; Natesan, T. R.; Santhosh, Ramamurthy; Ibramsha, Mohideen
An intelligent decision support tool to the Radiologist in telemedicine is described. Medical prescriptions are given based on the images of cyst that has been transmitted over computer networks to the remote medical center. The digital image, acquired by sonography, is converted into an intensity image. This image is then subjected to image preprocessing which involves correction methods to eliminate specific artifacts. The image is resized into a 256 x 256 matrix by using bilinear interpolation method. The background area is detected using distinct block operation. The area of the cyst is calculated by removing the background area from the original image. Boundary enhancement and morphological operations are done to remove unrelated pixels. This gives us the cyst volume. This segmented image of the cyst is sent to the remote medical center for analysis by Knowledge based artificial Intelligent Decision Support System (KIDSS). The type of cyst is detected and reported to the control mechanism of KIDSS. Then the inference engine compares this with the knowledge base and gives appropriate medical prescriptions or treatment recommendations by applying reasoning mechanisms at the remote medical center.
Thaís Araújo Barbosa
Full Text Available Objective: to understand and identify the support network and social support from the perspective of families of children with chronic conditions. Methods: a qualitative study, with content analysis of 134 records, followed by ten semi-structured interviews. Results: the analysis has revealed that the primary caregiver, the mother, participates in a network of limited support, only with the help of her husband, children, grandparents and the child´s godparents. They also have a social network through a multidisciplinary team, which in some cases is not effective. Conclusion: families have a deficient and limited support network and the demand for care rely only on the support of the husband, grandparents, children, and godparents. Social networking refers to the philanthropic institutions, while the aid of public service, basic health unit is basic.
Yoshikawa, H.; Gofuku, A.
A concept of object-oriented intelligent CAD/CAE environment is proposed for the conceptual designing of advanced nuclear reactor system. It is composed of (i) object-oriented frame-structure database which represents the hierarchical relationship of the composite elements of reactor core and the physical properties, and (ii) object-oriented modularization of the elementary calculation processes, which are needed for reactor core design analysis. As an example practise, an object-oriented frame structure is constructed for representing a 3D configuration of a special fuel element of a space reactor design, by using a general-purpose expert system shell ESHELL/X. (author)
Dagliati, Arianna; Sacchi, Lucia; Tibollo, Valentina; Cogni, Giulia; Teliti, Marsida; Martinez-Millana, Antonio; Traver, Vicente; Segagni, Daniele; Posada, Jorge; Ottaviano, Manuel; Fico, Giuseppe; Arredondo, Maria Teresa; De Cata, Pasquale; Chiovato, Luca; Bellazzi, Riccardo
To describe the development, as part of the European Union MOSAIC (Models and Simulation Techniques for Discovering Diabetes Influence Factors) project, of a dashboard-based system for the management of type 2 diabetes and assess its impact on clinical practice. The MOSAIC dashboard system is based on predictive modeling, longitudinal data analytics, and the reuse and integration of data from hospitals and public health repositories. Data are merged into an i2b2 data warehouse, which feeds a set of advanced temporal analytic models, including temporal abstractions, care-flow mining, drug exposure pattern detection, and risk-prediction models for type 2 diabetes complications. The dashboard has 2 components, designed for (1) clinical decision support during follow-up consultations and (2) outcome assessment on populations of interest. To assess the impact of the clinical decision support component, a pre-post study was conducted considering visit duration, number of screening examinations, and lifestyle interventions. A pilot sample of 700 Italian patients was investigated. Judgments on the outcome assessment component were obtained via focus groups with clinicians and health care managers. The use of the decision support component in clinical activities produced a reduction in visit duration (P ≪ .01) and an increase in the number of screening exams for complications (P < .01). We also observed a relevant, although nonstatistically significant, increase in the proportion of patients receiving lifestyle interventions (from 69% to 77%). Regarding the outcome assessment component, focus groups highlighted the system's capability of identifying and understanding the characteristics of patient subgroups treated at the center. Our study demonstrates that decision support tools based on the integration of multiple-source data and visual and predictive analytics do improve the management of a chronic disease such as type 2 diabetes by enacting a successful
Dutton, Julie; McCaskill, Kelly; Alton, Sarah; Levesley, Maria; Hemingway, Cath; Farndon, Lisa
Diabetes is a common long-term condition affecting many people many of whom require support with their insulin injections at home. These injections are often carried out by community nurses if individuals are unable to self-manage their condition. This paper describes a pilot project where health care support workers were trained to administer insulin at home for suitable patients. Four patients took part in the pilot study and two support workers were trained to give the insulin injections. The project was evaluated well by all those who took part. It freed up 80 hours of nursing time while also providing the support workers with an extended scope of practice and associated increased in job satisfaction. No untoward medication errors were reported as a result of this initiative. This project will now be rolled out to the wider nursing teams with a staggered approach to the delivery of the training to ensure there is not a detrimental effect on patient care.
Full Text Available Abstract Background - Prehospital care is classified into ALS- (advanced life support and BLS- (basic life support levels according to the methods used. ALS-level prehospital care uses invasive methods, such as intravenous fluids, medications and intubation. However, the effectiveness of ALS care compared to BLS has been questionable. Aim - The aim of this systematic review is to compare the effectiveness of ALS- and BLS-level prehospital care. Material and methods - In a systematic review, articles where ALS-level prehospital care was compared to BLS-level or any other treatment were included. The outcome variables were mortality or patient's health-related quality of life or patient's capacity to perform daily activities. Results - We identified 46 articles, mostly retrospective observational studies. The results on the effectiveness of ALS in unselected patient cohorts are contradictory. In cardiac arrest, early cardiopulmonary resuscitation and defibrillation are essential for survival, but prehospital ALS interventions have not improved survival. Prehospital thrombolytic treatment reduces mortality in patients having a myocardial infarction. The majority of research into trauma favours BLS in the case of penetrating trauma and also in cases of short distance to a hospital. In patients with severe head injuries, ALS provided by paramedics and intubation without anaesthesia can even be harmful. If the prehospital care is provided by an experienced physician and by a HEMS organisation (Helicopter Emergency Medical Service, ALS interventions may be beneficial for patients with multiple injuries and severe brain injuries. However, the results are contradictory. Conclusions - ALS seems to improve survival in patients with myocardial infarction and BLS seems to be the proper level of care for patients with penetrating injuries. Some studies indicate a beneficial effect of ALS among patients with blunt head injuries or multiple injuries. There is
Gaardboe, Rikke; Svejvig, Per
This study investigates the critical success factors for individuals’ use of business intelligence (BI) in health care organizations. We also examine the organizational impact of BI. We develop a model that expands DeLone and McLean’s IS success model to include task characteristics. To analyze....... Second, we investigated the organizational impact through semi-structured interviews. We identified two user types—system users and information users—and we found that BI is used for financial reporting, improving patient progress, and enhancing learning in hospitals. Future research should focus...
Andrés Felipe Ardila Rodríguez
Full Text Available The training strategies developed for the social support program bring deficits in accessibility to the chronic ill patients (EC and the CASSA-UDEC’s caretaker (CASSA-UDEC: Centre for Social Health Care at Universidad de Cundinamarca they do not have time to commute, hindering their legal relationship established by the contract. For this reason, a remote care platform (PTD was developed to support users at CASSA-UDEC improving aspects related to coverage, cost, quality, access and appropriation of information from caregivers and chronic ill patients. The design was based on gerontological constructs identifying features such as modularity, object size, usability, ergonomics, and some others, providing a friendly platform for the user with dynamic, modular and high usability content. The Platform provides a space for interaction and aid, which works as a dynamic entity in the job done by CASSA-UDEC giving support in the development of activities, expanding its coverage, access; all thanks to the benefits offered in a virtual mode.
Sebaa, Abderrazak; Nouicer, Amina; Tari, AbdelKamel; Tarik, Ramtani; Abdellah, Ouhab
A study about healthcare resources can improve decisions regarding the allotment and mobilization of medical resources and to better guide future investment in the health sector. The aim of this work was to design and implement a decision support system to improve medical resources allocation of Bejaia region. To achieve the retrospective cohort study, we integrated existing clinical databases from different Bejaia department health sector institutions (an Algerian department) to collect information about patients from January 2015 through December 2015. Data integration was performed in a data warehouse using the multi-dimensional model and OLAP cube. During implementation, we used Microsoft SQL server 2012 and Microsoft Excel 2010. A medical decision support platform was introduced, and was implemented during the planning stages allowing the management of different medical orientations, it provides better apportionment and allotment of medical resources, and ensures that the allocation of health care resources has optimal effects on improving health. In this study, we designed and implemented a decision support system which would improve health care in Bejaia department to especially assist in the selection of the optimum location of health center and hospital, the specialty of the health center, the medical equipment and the medical staff.
Maastrup, Ragnhild; Bojesen, Susanne Norby; Kronborg, Hanne; Hallström, Inger
The incidence of breastfeeding of preterm infants is affected by the support provided at the hospital and in the neonatal intensive care unit (NICU). However, policies and guidelines promoting breastfeeding vary both nationally and internationally. The aim of this survey was to describe breastfeeding support in Danish NICUs, where approximately 98% of mothers initiate lactation. A national survey of all 19 Danish NICUs was conducted in 2009. Four NICUs were at designated Baby-Friendly hospitals, and 5 had a lactation consultant. In all NICUs, it was possible for some parents to stay overnight; 2 units had short restrictions on parents' presence. Five NICUs had integrated postpartum care for mothers. Breastfeeding policies, written guidelines, and systematic breastfeeding training for the staff were common in most NICUs. Seventeen NICUs recommended starting breast milk expression within 6 hours after birth, and mothers were encouraged to double pump. Most NICUs aimed to initiate skin-to-skin contact the first time the parents were in the NICU, and daily skin-to-skin contact was estimated to last for 2-4 hours in 63% and 4-8 hours in 37% of the units. The use of bottle-feeding was restricted. The Danish NICUs described the support of breastfeeding as a high priority, which was reflected in the recommended policies for breast milk pumping, skin-to-skin contact, and the parents' presence in the NICU, as well as in the restricted use of bottle-feeding. However, support varied between units, and not all units supported optimal breastfeeding.
Waalkens, Maaike; Aleven, Vincent; Taatgen, Niels
Intelligent tutoring systems (ITS) support students in learning a complex problem-solving skill. One feature that makes an ITS architecturally complex, and hard to build, is support for strategy freedom, that is, the ability to let students pursue multiple solution strategies within a given problem.
Martin, Suzanne; Kelly, Greg; Kernohan, W George; McCreight, Bernadette; Nugent, Christopher
The integration of smart home technology to support health and social care is acquiring an increasing global significance. Provision is framed within the context of a rapidly changing population profile, which is impacting on the number of people requiring health and social care, workforce availability and the funding of healthcare systems. To explore the effectiveness of smart home technologies as an intervention for people with physical disability, cognitive impairment or learning disability, who are living at home, and to consider the impact on the individual's health status and on the financial resources of health care. We searched the following databases for primary studies: (a) the Cochrane Effective Practice and Organisation of Care (EPOC) Group Register, (b) the Cochrane Central Register of Controlled Trials (CENTRAL), (The Cochrane Library, issue 1, 2007), and (c) bibliographic databases, including MEDLINE (1966 to March 2007), EMBASE (1980 to March 2007) and CINAHL (1982 to March 2007). We also searched the Database of Abstracts of Reviews of Effectiveness (DARE). We searched the electronic databases using a strategy developed by the EPOC Trials Search Co-ordinator. We included randomised controlled trials (RCTs), quasi-experimental studies, controlled before and after studies (CBAs) and interrupted time series analyses (ITS). Participants included adults over the age of 18, living in their home in a community setting. Participants with a physical disability, dementia or a learning disability were included. The included interventions were social alarms, electronic assistive devices, telecare social alert platforms, environmental control systems, automated home environments and 'ubiquitous homes'. Outcome measures included any objective measure that records an impact on a participant's quality of life, healthcare professional workload, economic outcomes, costs to healthcare provider or costs to participant. We included measures of service satisfaction
Flokstra - de Blok BMJ
Full Text Available Bertine MJ Flokstra - de Blok,1,2 Thys van der Molen,1,2 Wianda A Christoffers,3 Janwillem WH Kocks,1,2 Richard L Oei,4 Joanne NG Oude Elberink,2,4 Emmy M Roerdink,5 Marie Louise Schuttelaar,3 Jantina L van der Velde,1,2 Thecla M Brakel,1,6 Anthony EJ Dubois2,5 1Department of General Practice, 2GRIAC Research Institute, 3Department of Dermatology, 4Department of Allergology, 5Department of Pediatric Pulmonology and Pediatric Allergy, University of Groningen, University Medical Center Groningen, 6Teaching Unit, Department of Social Psychology, University of Groningen, Groningen, The Netherlands Background: Management of allergic patients in the population is becoming more difficult because of increases in both complexity and prevalence. Although general practitioners (GPs are expected to play an important role in the care of allergic patients, they often feel ill-equipped for this task. Therefore, the aim of this study was to develop an allergy management support system (AMSS for primary care. Methods: Through literature review, interviewing and testing in secondary and primary care patients, an allergy history questionnaire was constructed by allergists, dermatologists, GPs and researchers based on primary care and specialists’ allergy guidelines and their clinical knowledge. Patterns of AMSS questionnaire responses and specific immunoglobulin E (sIgE-test outcomes were used to identify diagnostic categories and develop corresponding management recommendations. Validity of the AMSS was investigated by comparing specialist (gold standard and AMSS diagnostic categories. Results: The two-page patient-completed AMSS questionnaire consists of 12 (mainly multiple choice questions on symptoms, triggers, severity and medication. Based on the AMSS questionnaires and sIgE-test outcome of 118 patients, approximately 150 diagnostic categories of allergic rhinitis, asthma, atopic dermatitis, anaphylaxis, food allergy, hymenoptera allergy and other
Patient-centredness is a core value of general practice; it is defined as the interpersonal processes that support the holistic care of individuals. To date, efforts to demonstrate their relationship to patient outcomes have been disappointing, whilst some studies suggest values may be more rhetoric than reality. Contextual issues influence the quality of patient-centred consultations, impacting on outcomes. The legitimate use of knowledge, or evidence, is a defining aspect of modern practice, and has implications for patient-centredness. Based on a critical review of the literature, on my own empirical research, and on reflections from my clinical practice, I critique current models of the use of knowledge in supporting individualised care. Evidence-Based Medicine (EBM), and its implementation within health policy as Scientific Bureaucratic Medicine (SBM), define best evidence in terms of an epistemological emphasis on scientific knowledge over clinical experience. It provides objective knowledge of disease, including quantitative estimates of the certainty of that knowledge. Whilst arguably appropriate for secondary care, involving episodic care of selected populations referred in for specialist diagnosis and treatment of disease, application to general practice can be questioned given the complex, dynamic and uncertain nature of much of the illness that is treated. I propose that general practice is better described by a model of Interpretive Medicine (IM): the critical, thoughtful, professional use of an appropriate range of knowledges in the dynamic, shared exploration and interpretation of individual illness experience, in order to support the creative capacity of individuals in maintaining their daily lives. Whilst the generation of interpreted knowledge is an essential part of daily general practice, the profession does not have an adequate framework by which this activity can be externally judged to have been done well. Drawing on theory related to the
Ellor, Susan V; Pagano-Young, Teri Ann; Avgeropoulos, Nicholas G
Glioblastoma is a brain tumor condition marked by rapid neurological and clinical demise, resulting in disproportionate disability for those affected. Caring for this group of patients is complex, intense, multidisciplinary in nature, and fraught with the need for expensive treatments, surveillance imaging, physician follow-up, and rehabilitative, psychological, and social support interventions. Few of these patients return to the workforce for any meaningful time frame, and because of the enormity of the financial burden that patients, their caregivers, and society face, utilization reviews become the focus of ethical scrutiny. © 2014 American Society of Law, Medicine & Ethics, Inc.
Recently (chemo-)radiotherapy has been widely used in head and neck cancer with definite evidence. As long survivor has increased, social problems associated with late toxicity have become more. Late toxicities induced by radiotherapy for head and neck lesion are often severe. Xerostomia is one of the severe late toxicities conventionally and dysphagia after chemoradiotherapy is a new topic. Some industrial development (ex. Intensity Modulated Radiotherapy: IMRT) play a great role in toxicity management. Multidisciplinary approach (cooperation between not only physicians but also nurses and dentists) is necessary to control toxicities. The research of supportive care will be needed same as definitive treatment in the future. (author)
Hepburn, Charlotte Moore; Cohen, Eyal; Bhawra, Jasmin; Weiser, Natalie; Hayeems, Robin Z; Guttmann, Astrid
The transition from paediatric to adult care is associated with poor clinical outcomes, increased costs and low patient and family satisfaction. However, little is known about health system strategies to streamline and safeguard care for youth transitioning to adult services. Moreover, the needs of children and youth are often excluded from broader health system reform discussions, leaving this population especially vulnerable to system 'disintegration'. (1) To explore the international policy profile of paediatric-to-adult care transitions, and (2) to document policy objectives, initiatives and outcomes for jurisdictions publicly committed to addressing transition issues. An international policy scoping review of all publicly available government documents detailing transition-related strategies was completed using a web-based search. Our analysis included a comparable cohort of nine wealthy Organisation for Economic Co-operation and Development (OECD) jurisdictions with Beveridge-style healthcare systems (deemed those most likely to benefit from system-level transition strategies). Few jurisdictions address transition of care issues in either health or broader social policy documents. While many jurisdictions refer to standardised practice guidelines, a few report the intention to use powerful policy levers (including physician remuneration and non-physician investments) to facilitate the uptake of best practice. Most jurisdictions do not address the policy infrastructure required to support successful transitions, and rigorous evaluations of transition strategies are rare. Despite the well-documented risks and costs associated with a poor transition from paediatric to adult care, little policy attention has been paid to this issue. We recommend that healthcare providers engage health system planners in the design and evaluation of system-level, policy-sensitive transition strategies. Published by the BMJ Publishing Group Limited. For permission to use (where not
Bianchi, P.H.; Baptista Filho, B.D.
The monitoring task in nuclear power plants is of crucial importance with respect to safety and efficient operation. The operators have a wide range of variables to observe and analyze; the quantity of variables and their behavior determine the time they have to take correct decisions. The complexity of such aspects in a nuclear power plant influences both, the plant operational efficiency and the general safety issues. This paper describes an experimental system developed by the authors which aims to assist the operators of nuclear power plants to take quick and safe decisions. The system maps the status of plant and helps the operators to make quick judgments by using artificial intelligence methods. The method makes use of a small set of monitored variables and presents a map of the plant status in a friendly manner. This system uses an architecture that has multiple self-organizing maps to perform these tasks. (author)
Dadashi, Nastaran; Wilson, John R; Golightly, David; Sharples, Sarah
Technological and organisational advances have increased the potential for remote access and proactive monitoring of the infrastructure in various domains and sectors - water and sewage, oil and gas and transport. Intelligent Infrastructure (II) is an architecture that potentially enables the generation of timely and relevant information about the state of any type of infrastructure asset, providing a basis for reliable decision-making. This paper reports an exploratory study to understand the concepts and human factors associated with II in the railway, largely drawing from structured interviews with key industry decision-makers and attachment to pilot projects. Outputs from the study include a data-processing framework defining the key human factors at different levels of the data structure within a railway II system and a system-level representation. The framework and other study findings will form a basis for human factors contributions to systems design elements such as information interfaces and role specifications.
Bianchi, Paulo H.; Baptista Filho, Benedito D., E-mail: email@example.com, E-mail: firstname.lastname@example.org [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)
The monitoring task in nuclear power plants is of crucial importance with respect to safety and efficient operation. The operators have a wide range of variables to observe and analyze; the quantity of variables and their behavior determine the time they have to take correct decisions. The complexity of such aspects in a nuclear power plant influences both, the plant operational efficiency and the general safety issues. This paper describes an experimental system developed by the authors which aims to assist the operators of nuclear power plants to take quick and safe decisions. The system maps the status of plant and helps the operators to make quick judgments by using artificial intelligence methods. The method makes use of a small set of monitored variables and presents a map of the plant status in a friendly manner. This system uses an architecture that has multiple self-organizing maps to perform these tasks. (author)
Full Text Available Nowadays, there are molecular biology techniques providing information related to cervical cancer and its cause: the human Papillomavirus (HPV, including DNA microarrays identifying HPV subtypes, mRNA techniques such as nucleic acid based amplification or flow cytometry identifying E6/E7 oncogenes, and immunocytochemistry techniques such as overexpression of p16. Each one of these techniques has its own performance, limitations and advantages, thus a combinatorial approach via computational intelligence methods could exploit the benefits of each method and produce more accurate results. In this article we propose a clinical decision support system (CDSS, composed by artificial neural networks, intelligently combining the results of classic and ancillary techniques for diagnostic accuracy improvement. We evaluated this method on 740 cases with complete series of cytological assessment, molecular tests, and colposcopy examination. The CDSS demonstrated high sensitivity (89.4%, high specificity (97.1%, high positive predictive value (89.4%, and high negative predictive value (97.1%, for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+. In comparison to the tests involved in this study and their combinations, the CDSS produced the most balanced results in terms of sensitivity, specificity, PPV, and NPV. The proposed system may reduce the referral rate for colposcopy and guide personalised management and therapeutic interventions.
Blanco, Jesús; García, Andrés; Morenas, Javier de Las
Energy saving has become a major concern for the developed society of our days. This paper presents a Wireless Sensor and Actuator Network (WSAN) designed to provide support to an automatic intelligent system, based on the Internet of Things (IoT), which enables a responsible consumption of energy. The proposed overall system performs an efficient energetic management of devices, machines and processes, optimizing their operation to achieve a reduction in their overall energy usage at any given time. For this purpose, relevant data is collected from intelligent sensors, which are in-stalled at the required locations, as well as from the energy market through the Internet. This information is analysed to provide knowledge about energy utilization, and to improve efficiency. The system takes autonomous decisions automatically, based on the available information and the specific requirements in each case. The proposed system has been implanted and tested in a food factory. Results show a great optimization of energy efficiency and a substantial improvement on energy and costs savings.
Bountris, Panagiotis; Haritou, Maria; Pouliakis, Abraham; Margari, Niki; Kyrgiou, Maria; Spathis, Aris; Pappas, Asimakis; Panayiotides, Ioannis; Paraskevaidis, Evangelos A; Karakitsos, Petros; Koutsouris, Dimitrios-Dionyssios
Nowadays, there are molecular biology techniques providing information related to cervical cancer and its cause: the human Papillomavirus (HPV), including DNA microarrays identifying HPV subtypes, mRNA techniques such as nucleic acid based amplification or flow cytometry identifying E6/E7 oncogenes, and immunocytochemistry techniques such as overexpression of p16. Each one of these techniques has its own performance, limitations and advantages, thus a combinatorial approach via computational intelligence methods could exploit the benefits of each method and produce more accurate results. In this article we propose a clinical decision support system (CDSS), composed by artificial neural networks, intelligently combining the results of classic and ancillary techniques for diagnostic accuracy improvement. We evaluated this method on 740 cases with complete series of cytological assessment, molecular tests, and colposcopy examination. The CDSS demonstrated high sensitivity (89.4%), high specificity (97.1%), high positive predictive value (89.4%), and high negative predictive value (97.1%), for detecting cervical intraepithelial neoplasia grade 2 or worse (CIN2+). In comparison to the tests involved in this study and their combinations, the CDSS produced the most balanced results in terms of sensitivity, specificity, PPV, and NPV. The proposed system may reduce the referral rate for colposcopy and guide personalised management and therapeutic interventions.
Full Text Available Wind speed/power has received increasing attention around the earth due to its renewable nature as well as environmental friendliness. With the global installed wind power capacity rapidly increasing, wind industry is growing into a large-scale business. Reliable short-term wind speed forecasts play a practical and crucial role in wind energy conversion systems, such as the dynamic control of wind turbines and power system scheduling. In this paper, an intelligent hybrid model for short-term wind speed prediction is examined; the model is based on cross correlation (CC analysis and a support vector regression (SVR model that is coupled with brainstorm optimization (BSO and cuckoo search (CS algorithms, which are successfully utilized for parameter determination. The proposed hybrid models were used to forecast short-term wind speeds collected from four wind turbines located on a wind farm in China. The forecasting results demonstrate that the intelligent hybrid models outperform single models for short-term wind speed forecasting, which mainly results from the superiority of BSO and CS for parameter optimization.
Zeiler, W.; Wortel, W.; Houten, van M.A.; Hommelberg, M.P.F.; Kamphuis, I.G.; Jelsma, J.; Oliveira Fernandes, de E.; Gameiro da Silva, M.; Rosado Pinto, J.
Buildings are built for users, so the user preferences and their behaviour should become leading in building services control strategy. The paper reviews 3 projects on intelligent process control. The insights of these projects were combined into a new technology; FACT, Forgiving Agent Comfort
Zysberg, Leehu; Levy, Anat; Zisberg, Anna
Two studies describe the development of the Audiovisual Test of Emotional Intelligence (AVEI), aimed at candidate selection in educational settings. Study I depicts the construction of the test and the preliminary examination of its psychometric properties in a sample of 92 college students. Item analysis allowed the modification of problem items,…
Röhrig, R; Rüth, R
Patient data management systems (PDMS) may improve the quality of clinical documentation in intensive care medicine. In addition to the documentation, many PDMS offer the clinicians support for clinical decisions and workflow. The data recorded by the PDMS are available for data analysis to support administrative responsibilities (e.g., reimbursement, personnel management, quality management) or scientific questions. Within this process, semantic interoperability is a cornerstone for the integration of the PDMS into the IT infrastructure of the hospital, and the connection of medical devices is an essential precondition. Thus, a medical terminology system, like LOINC or SNOMED CT, is required, but are generally not widely used. This is partly caused by the fact that the effort necessary to implement a standard vocabulary is not equally shared between the sending and receiving systems. The solution could be medical devices that send LOINC-coded data. The experience of implementing LOINC into medical devices and information systems teaches us that more research and development of new functionalities for clinical information systems and PDMS to display and process (LOINC) coded data are needed.
Datta, Shoumen Palit Austin
The elusive quest for intelligence in artificial intelligence prompts us to consider that instituting human-level intelligence in systems may be (still) in the realm of utopia. In about a quarter century, we have witnessed the winter of AI (1990) being transformed and transported to the zenith of tabloid fodder about AI (2015). The discussion at hand is about the elements that constitute the canonical idea of intelligence. The delivery of intelligence as a pay-per-use-service, popping out of ...
Although current systems for continuous glucose monitoring (CGM) are the result of progressive technological improvement, and although a beneficial effect on glucose control has been demonstrated, few patients are using them. Something similar has happened to telemedicine (TM); in spite of the long-term experience, which began in the early 1980s, no TM system has been widely adopted, and presential visits are still almost the only way diabetologists and patients communicate. The hypothesis developed in this article is that neither CGM nor TM will ever be routinely implemented separately, and their consideration as essential elements for standard diabetes care will one day come from their integration as parts of a telemedical monitoring platform. This platform, which should include artificial intelligence for giving decision support to patients and physicians, will represent the core of a more complex global agent for diabetes care, which will provide control algorithms and risk analysis among other essential functions. © 2010 Diabetes Technology Society.
Williams, Kristen G; Patel, Kayla T; Stausmire, Julie M; Bridges, Christy; Mathis, Mary W; Barkin, Jennifer L
The relationship between maternal mental health and infant development has been established in the literature. The Neonatal Intensive Care Unit (NICU) is a particularly challenging environment for new mothers as several natural processes are disrupted. The objective of this study is to elucidate protective factors and environmental deficits associated with the NICU. The experiences of forty-six ( n = 46) mothers of infants admitted to a Level III NICU in the Midwestern United States, who responded to a related open-ended question, were analyzed thematically. Five themes related to the NICU environment emerged as being either stressful or helpful: (1) amount and quality of communication with medical staff, (2) bedside manner of medical staff, (3) feeling alienated from infant's care, (4) support from other NICU mothers and families, and (5) NICU Physical Environment and Regulations. There is a need for medical staff training on awareness, communication, empathy, and other behaviors that might improve maternal (and parental) experiences in the NICU. The physical environment, including rules and regulations of the NICU, should be reexamined with family comfort in mind in addition to the clinical care of the infant.
Yu, Peter; Artz, David; Warner, Jeremy
ASCO's vision for cancer care in 2030 is built on the expanding importance of panomics and big data, and envisions enabling better health for patients with cancer by the rapid transformation of systems biology knowledge into cancer care advances. This vision will be heavily dependent on the use of health information technology for computational biology and clinical decision support systems (CDSS). Computational biology will allow us to construct models of cancer biology that encompass the complexity of cancer panomics data and provide us with better understanding of the mechanisms governing cancer behavior. The Agency for Healthcare Research and Quality promotes CDSS based on clinical practice guidelines, which are knowledge bases that grow too slowly to match the rate of panomic-derived knowledge. CDSS that are based on systems biology models will be more easily adaptable to rapid advancements and translational medicine. We describe the characteristics of health data representation, a model for representing molecular data that supports data extraction and use for panomic-based clinical research, and argue for CDSS that are based on systems biology and are algorithm-based.
Singh, Harpreet; Yadav, Gautam; Mallaiah, Raghuram; Joshi, Preetha; Joshi, Vinay; Kaur, Ravneet; Bansal, Suneyna; Brahmachari, Samir K
Neonatal period represents first 28 days of life, which is the most vulnerable time for a child's survival especially for the preterm babies. High neonatal mortality is a prominent and persistent problem across the globe. Non-availability of trained staff and infrastructure are the major recognized hurdles in the quality care of these neonates. Hourly progress growth charts and reports are still maintained manually by nurses along with continuous calculation of drug dosage and nutrition as per the changing weight of the baby. iNICU (integrated Neonatology Intensive Care Unit) leverages Beaglebone and Intel Edison based IoT integration with biomedical devices in NICU i.e. monitor, ventilator and blood gas machine. iNICU is hosted on IBM Softlayer based cloud computing infrastructure and map NICU workflow in Java based responsive web application to provide translational research informatics support to the clinicians. iNICU captures real time vital parameters i.e. respiration rate, heart rate, lab data and PACS amounting for millions of data points per day per child. Stream of data is sent to Apache Kafka layer which stores the same in Apache Cassandra NoSQL. iNICU also captures clinical data like feed intake, urine output, and daily assessment of child in PostgreSQL database. It acts as first Big Data hub (of both structured and unstructured data) of neonates across India offering temporal (longitudinal) data of their stay in NICU and allow clinicians in evaluating efficacy of their interventions. iNICU leverages drools based clinical rule based engine and deep learning based big data analytical model coded in R and PMML. iNICU solution aims to improve care time, fills skill gap, enable remote monitoring of neonates in rural regions, assists in identifying the early onset of disease, and reduction in neonatal mortality.
Chen, Yen-Lin; Chiang, Hsin-Han; Yu, Chao-Wei; Chiang, Chuan-Yen; Liu, Chuan-Ming; Wang, Jenq-Haur
This study develops and integrates an efficient knowledge-based system and a component-based framework to design an intelligent and flexible home health care system. The proposed knowledge-based system integrates an efficient rule-based reasoning model and flexible knowledge rules for determining efficiently and rapidly the necessary physiological and medication treatment procedures based on software modules, video camera sensors, communication devices, and physiological sensor information. This knowledge-based system offers high flexibility for improving and extending the system further to meet the monitoring demands of new patient and caregiver health care by updating the knowledge rules in the inference mechanism. All of the proposed functional components in this study are reusable, configurable, and extensible for system developers. Based on the experimental results, the proposed intelligent homecare system demonstrates that it can accomplish the extensible, customizable, and configurable demands of the ubiquitous healthcare systems to meet the different demands of patients and caregivers under various rehabilitation and nursing conditions.
Full Text Available This study develops and integrates an efficient knowledge-based system and a component-based framework to design an intelligent and flexible home health care system. The proposed knowledge-based system integrates an efficient rule-based reasoning model and flexible knowledge rules for determining efficiently and rapidly the necessary physiological and medication treatment procedures based on software modules, video camera sensors, communication devices, and physiological sensor information. This knowledge-based system offers high flexibility for improving and extending the system further to meet the monitoring demands of new patient and caregiver health care by updating the knowledge rules in the inference mechanism. All of the proposed functional components in this study are reusable, configurable, and extensible for system developers. Based on the experimental results, the proposed intelligent homecare system demonstrates that it can accomplish the extensible, customizable, and configurable demands of the ubiquitous healthcare systems to meet the different demands of patients and caregivers under various rehabilitation and nursing conditions.
Johnston, S Claiborne
Artificial intelligence and other forms of information technology are only just beginning to change the practice of medicine. The pace of change is expected to accelerate as tools improve and as demands for analyzing a rapidly growing body of knowledge and array of data increase. The medical students of today will practice in a world where information technology is sophisticated and omnipresent. In this world, the tasks of memorization and analysis will be less important to them as practicing physicians. On the other hand, the non-analytical, humanistic aspects of medicine-most importantly, the art of caring-will remain a critical function of the physician, and facility with improving systems of care will be required. Communication, empathy, shared decision making, leadership, team building, and creativity are all skills that will continue to gain importance for physicians. These skills should be further prioritized in medical school curricula to produce an even more effective physician for the future.
Personal navigators (PN) have been studied for about a decade in different fields and applications, such as safety and rescue operations, security and emergency services, and police and military applications. The common goal of all these applications is to provide precise and reliable position, velocity, and heading information of each individual in various environments. In the PN system developed in this dissertation, the underlying assumption is that the system does not require pre-existing infrastructure to enable pedestrian navigation. To facilitate this capability, a multisensor system concept, based on the Global Positioning System (GPS), inertial navigation, barometer, magnetometer, and a human pedometry model has been developed. An important aspect of this design is to use the human body as navigation sensor to facilitate Dead Reckoning (DR) navigation in GPS-challenged environments. The system is designed predominantly for outdoor environments, where occasional loss of GPS lock may happen; however, testing and performance demonstration have been extended to indoor environments. DR navigation is based on a relative-measurement approach, with the key idea of integrating the incremental motion information in the form of step direction (SD) and step length (SL) over time. The foundation of the intelligent navigation system concept proposed here rests in exploiting the human locomotion pattern, as well as change of locomotion in varying environments. In this context, the term intelligent navigation represents the transition from the conventional point-to-point DR to dynamic navigation using the knowledge about the mechanism of the moving person. This approach increasingly relies on integrating knowledge-based systems (KBS) and artificial intelligence (AI) methodologies, including artificial neural networks (ANN) and fuzzy logic (FL). In addition, a general framework of the quality control for the real-time validation of the DR processing is proposed, based on a
Gooding, Judith S; Cooper, Liza G; Blaine, Arianna I; Franck, Linda S; Howse, Jennifer L; Berns, Scott D
Family-centered care (FCC) has been increasingly emphasized as an important and necessary element of neonatal intensive care. FCC is conceptualized as a philosophy with a set of guiding principles, as well as a cohort of programs, services, and practices that many hospitals have embraced. Several factors drive the pressing need for family-centered care and support of families of infants in NICUs, including the increase in the number of infants in NICUs; growth in diversity of the population and their concurrent needs; identification of parental and familial stress and lack of parenting confidence; and gaps in support for families, as identified by parents and NICU staff. We explore the origins of and advances in FCC in the NICU and identify various delivery methods and aspects of FCC and family support in the NICU. We examine the research and available evidence supporting FCC in the NICU and offer recommendations for increased dissemination and for future study. Copyright © 2011 Elsevier Inc. All rights reserved.
Víctor Manuel Flores Fonseca
Full Text Available Circulatory systems diseases are one of the most important causes of death in Chilean population according to a report presented by the Chilean National Bureau of Statistics (INE. Undoubtedly, these sad numbers arise an opportunity to analyse ways to improve this situation. Personalized Medicine is a new approach used to adapt standard medical treatments to individual characteristics of patients. Currently, several kinds of personalized-medicine software applications are building using Artificial Intelligent techniques and supported by techniques as Cloud Computing and Big Data. This architecture provides complex and varied information access, such as clinical data, genome data, patients’ treatment or drugs information, among others. This document describes a proposal to produce a method for generating and sharing medical information, particularly of maligned tumors in Chile. The prototype will be developed within the framework of the personalized medicine.
Carlson, Eve B; Spain, David A; Muhtadie, Luma; McDade-Montez, Liz; Macia, Kathryn S
Family members of intensive care unit (ICU) patients are sometimes highly distressed and report lower satisfaction with communication and emotional support from staff. Within a study of emotional responses to traumatic stress, associations between family distress and satisfaction with aspects of ICU care were investigated. In 29 family members of trauma patients who stayed in an ICU, we assessed symptoms of depression and posttraumatic stress disorder (PTSD) during ICU care. Later, family members rated staff communication, support, and skills and their overall satisfaction with ICU care. Ratings of staff competence and skills were significantly higher than ratings of frequency of communication, information needs being met, and support. Frequency of communication and information needs being met were strongly related to ratings of support (rs = .75-.77) and staff skills (rs = .77-.85), and aspects of satisfaction and communication showed negative relationships with symptoms of depression (rs = -.31 to -.55) and PTSD (rs = -.17 to -.43). Although satisfaction was fairly high, family member distress was negatively associated with several satisfaction variables. Increased understanding of the effects of traumatic stress on family members may help staff improve communication and increase satisfaction of highly distressed family members. Published by Elsevier Inc.
Borchardt, G. C.
The Simple Tool for Automated Reasoning program (STAR) is an interactive, interpreted programming language for the development and operation of artificial intelligence (AI) application systems. STAR provides an environment for integrating traditional AI symbolic processing with functions and data structures defined in compiled languages such as C, FORTRAN and PASCAL. This type of integration occurs in a number of AI applications including interpretation of numerical sensor data, construction of intelligent user interfaces to existing compiled software packages, and coupling AI techniques with numerical simulation techniques and control systems software. The STAR language was created as part of an AI project for the evaluation of imaging spectrometer data at NASA's Jet Propulsion Laboratory. Programming in STAR is similar to other symbolic processing languages such as LISP and CLIP. STAR includes seven primitive data types and associated operations for the manipulation of these structures. A semantic network is used to organize data in STAR, with capabilities for inheritance of values and generation of side effects. The AI knowledge base of STAR can be a simple repository of records or it can be a highly interdependent association of implicit and explicit components. The symbolic processing environment of STAR may be extended by linking the interpreter with functions defined in conventional compiled languages. These external routines interact with STAR through function calls in either direction, and through the exchange of references to data structures. The hybrid knowledge base may thus be accessed and processed in general by either side of the application. STAR is initially used to link externally compiled routines and data structures. It is then invoked to interpret the STAR rules and symbolic structures. In a typical interactive session, the user enters an expression to be evaluated, STAR parses the input, evaluates the expression, performs any file input
Borchardt, G. C.
The Simple Tool for Automated Reasoning program (STAR) is an interactive, interpreted programming language for the development and operation of artificial intelligence (AI) application systems. STAR provides an environment for integrating traditional AI symbolic processing with functions and data structures defined in compiled languages such as C, FORTRAN and PASCAL. This type of integration occurs in a number of AI applications including interpretation of numerical sensor data, construction of intelligent user interfaces to existing compiled software packages, and coupling AI techniques with numerical simulation techniques and control systems software. The STAR language was created as part of an AI project for the evaluation of imaging spectrometer data at NASA's Jet Propulsion Laboratory. Programming in STAR is similar to other symbolic processing languages such as LISP and CLIP. STAR includes seven primitive data types and associated operations for the manipulation of these structures. A semantic network is used to organize data in STAR, with capabilities for inheritance of values and generation of side effects. The AI knowledge base of STAR can be a simple repository of records or it can be a highly interdependent association of implicit and explicit components. The symbolic processing environment of STAR may be extended by linking the interpreter with functions defined in conventional compiled languages. These external routines interact with STAR through function calls in either direction, and through the exchange of references to data structures. The hybrid knowledge base may thus be accessed and processed in general by either side of the application. STAR is initially used to link externally compiled routines and data structures. It is then invoked to interpret the STAR rules and symbolic structures. In a typical interactive session, the user enters an expression to be evaluated, STAR parses the input, evaluates the expression, performs any file input
Full Text Available Esta pesquisa buscou investigar a contribuição das ferramentas da tecnologia da informação, especificamente as de Business Intelligence (BI, para a área de controladoria exercer sua função de suprir o processo decisório com as informações úteis por ele requeridas. O estudo foi conduzido através de pesquisa de campo, especialmente de um estudo de caso, em que o assunto pôde ser analisado em detalhes. Para tanto, foram aplicadas entrevistas, orientadas por um roteiro construído para esse fim e por um protocolo previamente elaborado para o estudo, bem como foram analisados documentos internos, registros em arquivos e observação direta como fonte de evidências. O período de abrangência da análise dos dados foi de agosto de 2003 a dezembro de 2005, tendo sido possível observar a situação da empresa objeto do estudo antes e depois da implementação das ferramentas de BI. Após a análise das entrevistas, dos indicadores das áreas e de seu impacto no resultado global da empresa, concluiu-se que as referidas ferramentas podem auxiliar a controladoria na função de prover informações confiáveis, úteis e tempestivas ao processo decisório, por meio de sua flexibilização e dinamicidade, proporcionando, como conseqüência, a melhoria dos resultados das áreas organizacionais, bem como da empresa como um todo.This research examined the contribution of tools provided by Information Technology and specifically Business Intelligence (BI, for the controllership area to perform its function of supporting the decision-making process with useful information. The study was carried out through a field research, specifically a case study, in which the subject could be analyzed in detail. Therefore, interviews were held, guided by a structured script and by a previously elaborated form. Internal documents, files and direct observations were also analyzed as sources of evidence. The period covered by data analysis was from August 2003
Araki, Shunsuke; Saito, Tomoko; Ichikawa, Saori; Saito, Kaori; Takada, Tsuzumi; Noguchi, Satoko; Yamada, Miki; Nakagawa, Fumi
Advances in treatment in neonatal intensive care units (NICU) for preterm and sick newborns have improved the mortality rate of patients, but admission to the NICU may disrupt parent-infant interaction, with adverse consequences for infants and their families because of physical, psychological, and emotional separation. The concept of family centered care (FCC), in which family members are part of the care team and infants are close to the family, is important and has become popular in NICU. In 2013, we created a team called "Kodomo-Kazoku Mannaka" to promote FCC in Japan, and visited the NICU at Uppsala University Hospital in Sweden, which is internationally famous for FCC. Since this fruitful visit, we have been promoting FCC in Japan by exhibitions and presentations of the FCC ideas at academic conferences and using internet services. A questionnaire survey conducted in 2015 revealed that the importance and the benefits of FCC in NICU are recognized, although there are some barriers to FCC in each facility. It is hard to change facilities and social systems right away, but it is easier and more important to change people's minds. Our role is to spread the concept of FCC and to help each facility find its own way to adopt it. We will continue to make efforts encourage to promote FCC in Japan.
Full Text Available In this paper, we propose a novel approach utilizing a professional Social network (Pro Social Network and a new coordination protocol (CordiNet. Our motivation behind this article is to convince Small and Medium Enterprises managers that current organizations have chosen to use Enterprise 2.0 tools because these latter have demonstrated remarkable innovation as well as successful collaboration and collective intelligence. The particularity of our work is that is allows employer to share diagnosis and fault repair procedures on the basis of some modeling agents. In fact, each enterprise is represented by a container of agents to ensure a secured and confidential information exchange between intra employers, and a central main container to connect all enterprises’ containers for a social information exchange. Enterprise’s container consists of a Checker Enterprise Agent (ChEA, a Coordinator Enterprise Agent (CoEA and a Search Enterprise Agent (SeEA. Whereas the central main container comprises its proper agents such as Selection Agent (SA, and a Supervisor Agent (SuA. JADE platform is used to allow agents to communicate and collaborate. The FIPA-ACL performatives have been extended for this purpose. We conduct some experiments to demonstrate the feasibility of our approach.
Jones, Randolph M; Arkin, Ron; Sidki, Nahid
...). The system enable unmanned combat and support vehicles to achieve significant new levels of autonomy, mobility, rapid response, coordination and effectiveness, while simultaneously enriching human...
Åhlfeldt, Rose-Mharie; Persson, Anne; Rexhepi, Hanife; Wåhlander, Kalle
This article presents and illustrates the main features of a proposed process-oriented approach for patient information distribution in future health care information systems, by using a prototype of a process support system. The development of the prototype was based on the Visuera method, which includes five defined steps. The results indicate that a visualized prototype is a suitable tool for illustrating both the opportunities and constraints of future ideas and solutions in e-Health. The main challenges for developing and implementing a fully functional process support system concern both technical and organizational/management aspects. © The Author(s) 2015.
Environmentally friendly and comfortable buildings are a much sought after goal in today's architectural practice. In order to improve energy consumption of buildings without sacrificing indoor comfort, careful consideration of design decisions is needed. Simulation tools provide a solution to
Magelssen, Morten; Gjerberg, Elisabeth; Lillemoen, Lillian; Førde, Reidun; Pedersen, Reidar
Through the Norwegian ethics project, ethics activities have been implemented in the health and care sector in more than 200 municipalities. To study outcomes of the ethics activities and examine which factors promote and inhibit significance and sustainability of the activities. Two online questionnaires about the municipal ethics activities. Participants and research context: A total of 137 municipal contact persons for the ethics project answered the first survey (55% response rate), whereas 217 ethics facilitators responded to the second survey (33% response rate). Ethical considerations: Based on informed consent, the study was approved by the Data Protection Official of the Norwegian Social Science Data Services. Around half of the respondents found the ethics project to have been highly significant for daily professional practice. Outcomes include better handling of ethical challenges, better employee cooperation, better service quality, and better relations to patients and next of kin. Factors associated with sustainability and/or significance of the activities were sufficient support from stakeholders, sufficient available time, and ethics facilitators having sufficient knowledge and skills in ethics and access to supervision. This study shows that ethics initiatives can be both sustainable and significant for practice. There is a need to create regional or national structures for follow-up and develop more comprehensive ethics training for ethics facilitators. It is both possible and potentially important to implement clinical ethics support activities in community health and care services systematically on a large scale. Future ethics initiatives in the community sector should be designed in light of documented promoting and inhibiting factors.
Melles, M; Freudenthal, A; de Ridder, H
This study investigates how future informatics applications can support and challenge intensive care nurses (ICU nurses) to grow and learn continuously. To this end a research-and-design tool is introduced which is based on a model of the nursing process that starts from the idea that a nurse fulfills three different roles: the role of practitioner (using information immediately to base actions upon), the role of scholar (using information later on to learn from) and the role of human (coping with stress and dealing with emotions). In this paper the focus is on the scholar role. Twenty-eight intensive care staff members from six different hospitals were asked to recount an imposing experience from the perspective of each role. Regarding the scholar role, the participants mentioned 77 learning strategies they adopt for individual as well as organizational learning. Individual learning concerned reflection on former patient cases, reflection on current patient cases to anticipate a change in the patient's condition and reflection on personal behavior and decisions. Organizational learning concerned reflection on former patient cases. Examples of specific strategies were formal team evaluations focused on procedure and understanding the perspective of team members, being present at autopsies, and giving feedback on the nursing skills of colleagues. Based on these strategies design implications are defined for future nursing informatics applications, which will be presented.
Tenório, Josceli Maria; Hummel, Anderson Diniz; Cohrs, Frederico Molina; Sdepanian, Vera Lucia; Pisa, Ivan Torres; de Fátima Marin, Heimar
Background Celiac disease (CD) is a difficult-to-diagnose condition because of its multiple clinical presentations and symptoms shared with other diseases. Gold-standard diagnostic confirmation of suspected CD is achieved by biopsying the small intestine. Objective To develop a clinical decision–support system (CDSS) integrated with an automated classifier to recognize CD cases, by selecting from experimental models developed using intelligence artificial techniques. Methods A web-based system was designed for constructing a retrospective database that included 178 clinical cases for training. Tests were run on 270 automated classifiers available in Weka 3.6.1 using five artificial intelligence techniques, namely decision trees, Bayesian inference, k-nearest neighbor algorithm, support vector machines and artificial neural networks. The parameters evaluated were accuracy, sensitivity, specificity and area under the ROC curve (AUC). AUC was used as a criterion for selecting the CDSS algorithm. A testing database was constructed including 38 clinical CD cases for CDSS evaluation. The diagnoses suggested by CDSS were compared with those made by physicians during patient consultations. Results The most accurate method during the training phase was the averaged one-dependence estimator (AODE) algorithm (a Bayesian classifier), which showed accuracy 80.0%, sensitivity 0.78, specificity 0.80 and AUC 0.84. This classifier was integrated into the web-based decision–support system. The gold-standard validation of CDSS achieved accuracy of 84.2% and k = 0.68 (p < 0.0001) with good agreement. The same accuracy was achieved in the comparison between the physician’s diagnostic impression and the gold standard k = 0. 64 (p < 0.0001). There was moderate agreement between the physician’s diagnostic impression and CDSS k = 0.46 (p = 0.0008). Conclusions The study results suggest that CDSS could be used to help in diagnosing CD, since the algorithm tested achieved excellent
Federal Laboratory Consortium — The Intelligent Optics Laboratory supports sophisticated investigations on adaptive and nonlinear optics; advancedimaging and image processing; ground-to-ground and...
Postma, A; Van Leeuwen, EF; Gerritsen, EJA; Roord, JJ; De vries-Hospers, HG
The Dutch Childhood Leukemia Study Group celebrated its 20th anniversary by conducting a nationwide survey on supportive care for children with leukemia. Pediatricians were asked about daily practice and current perceptions with regard to supportive care. The results are discussed and compared to
Bini, Stefano A
This article was presented at the 2017 annual meeting of the American Association of Hip and Knee Surgeons to introduce the members gathered as the audience to the concepts behind artificial intelligence (AI) and the applications that AI can have in the world of health care today. We discuss the origin of AI, progress to machine learning, and then discuss how the limits of machine learning lead data scientists to develop artificial neural networks and deep learning algorithms through biomimicry. We will place all these technologies in the context of practical clinical examples and show how AI can act as a tool to support and amplify human cognitive functions for physicians delivering care to increasingly complex patients. The aim of this article is to provide the reader with a basic understanding of the fundamentals of AI. Its purpose is to demystify this technology for practicing surgeons so they can better understand how and where to apply it. Copyright © 2018 Elsevier Inc. All rights reserved.
McMurray, Josephine; Strudwick, Gillian; Forchuk, Cheryl; Morse, Adam; Lachance, Jessica; Baskaran, Arani; Allison, Lauren; Booth, Richard
Intelligent assistive technologies that complement and extend human abilities have proliferated in recent years. Service robots, home automation equipment, and other digital assistant devices possessing artificial intelligence are forms of assistive technologies that have become popular in society. Older adults (>55 years of age) have been identified by industry, government, and researchers as a demographic who can benefit significantly from the use of intelligent assistive technology to support various activities of daily living. The purpose of this scoping review is to summarize the literature on the importance of the concept of "trust" in the adoption of intelligent assistive technologies to assist aging in place by older adults. Using a scoping review methodology, our search strategy will examine the following databases: ACM Digital Library, Allied and Complementary Medicine Database (AMED), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, PsycINFO, Scopus, and Web of Science. Two reviewers will independently screen the initial titles obtained from the search, and these results will be further inspected by other members of the research team for inclusion in the review. This review will provide insights into how the concept of trust is actualized in the adoption of intelligent assistive technology by older adults. Preliminary sensitization to the literature suggests that the concept of trust is fluid, unstable, and intimately tied to the type of intelligent assistive technology being examined. Furthermore, a wide range of theoretical lenses that include elements of trust have been used to examine this concept. This review will describe the concept of trust in the adoption of intelligent assistive technology by older adults, and will provide insights for practitioners, policy makers, and technology vendors for future practice. ©Josephine McMurray, Gillian Strudwick, Cheryl Forchuk, Adam Morse, Jessica Lachance, Arani Baskaran, Lauren
Wong, Lung-Hsiang; Looi, Chee-Kit
The notion of a system adapting itself to provide support for learning has always been an important issue of research for technology-enabled learning. One approach to provide adaptivity is to use social navigation approaches and techniques which involve analysing data of what was previously selected by a cluster of users or what worked for…
Taylor, C. James
The paper describes the utility of a low cost, 1 m2 by 2 m forced ventilation, micro-climate test chamber, for the support of research and teaching in mechatronics. Initially developed for the evaluation of a new ventilation rate controller, the fully instrumented chamber now provides numerous learning opportunities and individual projects for both undergraduate and postgraduate research students.
Netjes, M.; Reijers, H.A.; Aalst, van der W.M.P.; Siau, K.
Abstract. Business Process Management (BPM) systems provide a broad range of facilities to enact and manage operational business processes. Ideally, these systems should provide support for the complete BPM life-cycle: (re)design, configuration, execution, control, and diagnosis by the FileNet P8
Akay, Altug; Dragomir, Andrei; Erlandsson, Bjorn-Erik
Intelligently extracting knowledge from social media has recently attracted great interest from the Biomedical and Health Informatics community to simultaneously improve healthcare outcomes and reduce costs using consumer-generated opinion. We propose a two-step analysis framework that focuses on positive and negative sentiment, as well as the side effects of treatment, in users' forum posts, and identifies user communities (modules) and influential users for the purpose of ascertaining user opinion of cancer treatment. We used a self-organizing map to analyze word frequency data derived from users' forum posts. We then introduced a novel network-based approach for modeling users' forum interactions and employed a network partitioning method based on optimizing a stability quality measure. This allowed us to determine consumer opinion and identify influential users within the retrieved modules using information derived from both word-frequency data and network-based properties. Our approach can expand research into intelligently mining social media data for consumer opinion of various treatments to provide rapid, up-to-date information for the pharmaceutical industry, hospitals, and medical staff, on the effectiveness (or ineffectiveness) of future treatments.
healthcare system, and also to other SMs and Veterans by way of a variety of social networking tools (e.g., 2nd Life, Facebook, etc.). The user can progress... CyberPsychology and Behavior 8, 3 (2005), 187-211.  T. Parsons & A.A. Rizzo, Affective Outcomes of Virtual Reality Exposure Therapy for Anxiety...VH System for Providing Healthcare Information and Support508  G. Riva, Virtual Reality in Psychotherapy: Review, CyberPsychology and Behavior 8
Approaches to Computational Support 6.1 Paradigms and Methods In today’s open-world environment, historical paradigms and methods that rely on deep ...focused on methods of this type, with a deep basis on argumentation-based principles. One clear example of these remarks is shown in the writing of...Proceedings of the 5th 2013 Forum on Information Retrieval Evaluation  Dan Roth and Wen -tau Yih. Integer linear programming inference for
Bennett, Casey; Doub, Tom; Selove, Rebecca
Objectives: Electronic health records (EHRs) are only a first step in capturing and utilizing health-related data - the challenge is turning that data into useful information. Furthermore, EHRs are increasingly likely to include data relating to patient outcomes, functionality such as clinical decision support, and genetic information as well, and, as such, can be seen as repositories of increasingly valuable information about patients' health conditions and responses to treatment over time. ...
Schaap, Feija; Dijkstra, Geke; Fokkens, Andrea; Reijneveld, Sijmen; Finnema, Evelyn
Background: The number of people with intellectual disability and dementia in-creases; this combination causes behavioural changes. Dementia Care Mapping (DCM) supports staff in dementia care in nursing homes and may be useful in intel-lectual disability-care. This qualitative study examines the
Ben Rabah, N; Saddem, R; Carre-Menetrier, V; Ben Hmida, F; Tagina, M
Diagnosis of Automated Production System (APS) is a decision-making process designed to detect, locate and identify a particular failure caused by the control law. In the literature, there are three major types of reasoning for industrial diagnosis: the first is model-based, the second is rule-based and the third is case-based. The common and major limitation of the first and the second reasonings is that they do not have automated learning ability. This paper presents an interactive and effective Case Based Decision Support System for online Diagnosis (CB-DSSD) of an APS. It offers a synergy between the Case Based Reasoning (CBR) and the Decision Support System (DSS) in order to support and assist Human Operator of Supervision (HOS) in his/her decision process. Indeed, the experimental evaluation performed on an Interactive Training System for PLC (ITS PLC) that allows the control of a Programmable Logic Controller (PLC), simulating sensors or/and actuators failures and validating the control algorithm through a real time interactive experience, showed the efficiency of our approach. (paper)
Spruit, M.; Vroon, R.; Batenburg, R.
This research contributes to the domain of long-term care by exploring knowledge discovery techniques based on a large dataset and guided by representative information needs to better manage both quality of care and financial spendings, as a next step towards more mature healthcare business
Spruit, M.R.; Vroon, R.; Batenburg, R.S.
This research contributes to the domain of long-term care by exploring knowledge discovery techniques based on a large dataset and guided by representative information needs to better manage both quality of care and financial spendings, as a next step towards more mature healthcare business
Kuru, Kaya; Niranjan, Mahesan; Tunca, Yusuf; Osvank, Erhan; Azim, Tayyaba
In general, medical geneticists aim to pre-diagnose underlying syndromes based on facial features before performing cytological or molecular analyses where a genotype-phenotype interrelation is possible. However, determining correct genotype-phenotype interrelationships among many syndromes is tedious and labor-intensive, especially for extremely rare syndromes. Thus, a computer-aided system for pre-diagnosis can facilitate effective and efficient decision support, particularly when few similar cases are available, or in remote rural districts where diagnostic knowledge of syndromes is not readily available. The proposed methodology, visual diagnostic decision support system (visual diagnostic DSS), employs machine learning (ML) algorithms and digital image processing techniques in a hybrid approach for automated diagnosis in medical genetics. This approach uses facial features in reference images of disorders to identify visual genotype-phenotype interrelationships. Our statistical method describes facial image data as principal component features and diagnoses syndromes using these features. The proposed system was trained using a real dataset of previously published face images of subjects with syndromes, which provided accurate diagnostic information. The method was tested using a leave-one-out cross-validation scheme with 15 different syndromes, each of comprised 5-9 cases, i.e., 92 cases in total. An accuracy rate of 83% was achieved using this automated diagnosis technique, which was statistically significant (pbenefits of using hybrid image processing and ML-based computer-aided diagnostics for identifying facial phenotypes. Copyright © 2014. Published by Elsevier B.V.
Eriksson, Henrik; Salzmann-Erikson, Martin
Today's parents seek out social support on the Internet. A key motivation behind the choice to go online is the need for more experience based information. In recent years, new fathers have increasingly taken on an active parental role. Men's support for their caring activities for infants on the Internet needs attention. The aim was to describe communication about caring activities for infants among men who visited an Internet-based forum for fathers and elaborate on the dimensions of support available in the forum. An archival and cross-sectional observational forum study was undertaken using principles for conducting ethnographic research online: "nethnography". A total of 1203 pages of data from an Internet forum for fathers were gathered and analysed. Support for a caring fatherhood in cyberspace can be understood as fathers' communicating encouragement, confirmation and advice. The findings show that important ways of providing support through the forum included a reciprocal sharing of concerns - how to be a better father - in relation to caring for an infant. Concerns for their child's well-being and shared feelings of joy and distress in everyday life were recurrent supportive themes in the communication. Information gained from contacting others in similar situations is one important reason for the fathers' use of the Internet. Support offered in this kind of forum can be considered as a complement to formal support. Professionals can use it to provide choices for fathers who are developing themselves as caregivers without downplaying the parental support offered by formal health care regimes. FURTHER RESEARCH: Online support will probably be one of the main supporting strategies for fathers in Scandinavia. Caring and nursing researchers need to closely monitor support activities that develop, and over time, as these ill likely become an important source of support for people. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic
Mayo, Anna T; Woolley, Anita Williams
Teams offer the potential to achieve more than any person could achieve working alone; yet, particularly in teams that span professional boundaries, it is critical to capitalize on the variety of knowledge, skills, and abilities available. This article reviews research from the field of organizational behavior to shed light on what makes for a collectively intelligent team. In doing so, we highlight the importance of moving beyond simply including smart people on a team to thinking about how those people can effectively coordinate and collaborate. In particular, we review the importance of two communication processes: ensuring that team members with relevant knowledge (1) speak up when one's expertise can be helpful and (2) influence the team's work so that the team does its collective best for the patient. © 2016 American Medical Association. All Rights Reserved.
Bromer, Juliet; Bibbs, Tonya
Family child care (FCC) providers often experience isolation from other early childhood and child care professionals. Yet, research suggests that providers who network with other providers, engage with community resources, and belong to support groups tend to offer higher quality child care. For example, the Family Child Care Network Impact Study…
Pierce, S. A.; Wagner, K.; Schwartz, S.; Gentle, J. N., Jr.
Critical water resources face the effects of historic drought, increased demand, and potential contamination, the need has never been greater to develop resources to effectively communicate conservation and protection across a broad audience and geographical area. The Watermark application and macro-analysis methodology merges topical analysis of context rich corpus from policy texts with multi-attributed solution sets from integrated models of water resource and other subsystems, such as mineral, food, energy, or environmental systems to construct a scalable, robust, and reproducible approach for identifying links between policy and science knowledge bases. The Watermark application is an open-source, interactive workspace to support science-based visualization and decision making. Designed with generalization in mind, Watermark is a flexible platform that allows for data analysis and inclusion of large datasets with an interactive front-end capable of connecting with other applications as well as advanced computing resources. In addition, the Watermark analysis methodology offers functionality that streamlines communication with non-technical users for policy, education, or engagement with groups around scientific topics of societal relevance. The technology stack for Watermark was selected with the goal of creating a robust and dynamic modular codebase that can be adjusted to fit many use cases and scale to support usage loads that range between simple data display to complex scientific simulation-based modelling and analytics. The methodology uses to topical analysis and simulation-optimization to systematically analyze the policy and management realities of resource systems and explicitly connect the social and problem contexts with science-based and engineering knowledge from models. A case example demonstrates use in a complex groundwater resources management study highlighting multi-criteria spatial decision making and uncertainty comparisons.
Lombardo, Vincenzo; Piana, Fabrizio; Mimmo, Dario
The geologic mapping process requires the organization of data according to the general knowledge about the objects, namely the geologic units, and to the objectives of a graphic representation of such objects in a map, following an established model of geotectonic evolution. Semantics can greatly help such a process in two concerns: the provision of a terminological base to name and classify the objects of the map; on the other, the implementation of a machine-readable encoding of the geologic knowledge base supports the application of reasoning mechanisms and the derivation of novel properties and relations about the objects of the map. The OntoGeonous initiative has built a terminological base of geological knowledge in a machine-readable format, following the Semantic Web tenets and the Linked Data paradigm. The major knowledge sources of the OntoGeonous initiative are GeoScience Markup Language schemata and vocabularies (through its last version, GeoSciML 4, 2015, published by the IUGS CGI Commission) and the INSPIRE "Data Specification on Geology" directives (an operative simplification of GeoSciML, published by INSPIRE Thematic Working Group Geology of the European Commission). The Linked Data paradigm has been exploited by linking (without replicating, to avoid inconsistencies) the already existing machine-readable encoding for some specific domains, such as the lithology domain (vocabulary Simple Lithology) and the geochronologic time scale (ontology "gts"). Finally, for the upper level knowledge, shared across several geologic domains, we have resorted to NASA SWEET ontology. The OntoGeonous initiative has also produced a wiki that explains how the geologic knowledge has been encoded from shared geoscience vocabularies (https://www.di.unito.it/wikigeo/). In particular, the sections dedicated to axiomatization will support the construction of an appropriate data base schema that can be then filled with the objects of the map. This contribution will discuss
Full Text Available Intelligence has increasingly been becoming a desirable human trait, so she scientists from different fields devote it a lot of attention. We were interested in the interconnectedness of intelligence, musical activities and family environment in ninth graders. Correlations were determined with the differences in student achievement in measuring educative components of general intellectual abilities with standard progressive matrices (SPM. The survey results confirm that intelligence, musical activities and musical family environment significantly correlated with each other. The study included 177 randomly selected ninth graders from six basic schools in the region of Primorska.
Full Text Available Health condition is a vital factor affecting printing quality for a 3D printer. In this work, an attitude monitoring approach is proposed to diagnose the fault of the delta 3D printer using support vector machines (SVM. An attitude sensor was mounted on the moving platform of the printer to monitor its 3-axial attitude angle, angular velocity, vibratory acceleration and magnetic field intensity. The attitude data of the working printer were collected under different conditions involving 12 fault types and a normal condition. The collected data were analyzed for diagnosing the health condition. To this end, the combination of binary classification, one-against-one with least-square SVM, was adopted for fault diagnosis modelling by using all channels of attitude monitoring data in the experiment. For comparison, each one channel of the attitude monitoring data was employed for model training and testing. On the other hand, a back propagation neural network (BPNN was also applied to diagnose fault using the same data. The best fault diagnosis accuracy (94.44% was obtained when all channels of the attitude monitoring data were used with SVM modelling. The results indicate that the attitude monitoring with SVM is an effective method for the fault diagnosis of delta 3D printers.
This system enables a driver to park the car at a predetermined spot without the driver seeing the outside scene. The system shows on a driver seat display the steps that the driver is to follow and thereby supports the driver when visibility is poor, when the parking space is difficult to approach, when the driver is a novice, or when the driver is aged. The system ensures accurate positioning of the car by showing the steering direction and angle, the car speed, and the force of braking to the driver. For this purpose, the system knows the absolute car position by the use of an RFID (Radio Frequency Identification) tag which is a kind of IC (Integrated Circuit) card and D-GPS (Differential-Global Positioning System), grasps the relative car position by the use of a gyroscope, and collects data from plural sensors, which are complementary to each other, such as a car-speed sensor and a steering sensor. (translated by NEDO)
He, Kun; Yang, Zhijun; Bai, Yun; Long, Jianyu; Li, Chuan
Health condition is a vital factor affecting printing quality for a 3D printer. In this work, an attitude monitoring approach is proposed to diagnose the fault of the delta 3D printer using support vector machines (SVM). An attitude sensor was mounted on the moving platform of the printer to monitor its 3-axial attitude angle, angular velocity, vibratory acceleration and magnetic field intensity. The attitude data of the working printer were collected under different conditions involving 12 fault types and a normal condition. The collected data were analyzed for diagnosing the health condition. To this end, the combination of binary classification, one-against-one with least-square SVM, was adopted for fault diagnosis modelling by using all channels of attitude monitoring data in the experiment. For comparison, each one channel of the attitude monitoring data was employed for model training and testing. On the other hand, a back propagation neural network (BPNN) was also applied to diagnose fault using the same data. The best fault diagnosis accuracy (94.44%) was obtained when all channels of the attitude monitoring data were used with SVM modelling. The results indicate that the attitude monitoring with SVM is an effective method for the fault diagnosis of delta 3D printers. PMID:29690641
He, Kun; Yang, Zhijun; Bai, Yun; Long, Jianyu; Li, Chuan
Health condition is a vital factor affecting printing quality for a 3D printer. In this work, an attitude monitoring approach is proposed to diagnose the fault of the delta 3D printer using support vector machines (SVM). An attitude sensor was mounted on the moving platform of the printer to monitor its 3-axial attitude angle, angular velocity, vibratory acceleration and magnetic field intensity. The attitude data of the working printer were collected under different conditions involving 12 fault types and a normal condition. The collected data were analyzed for diagnosing the health condition. To this end, the combination of binary classification, one-against-one with least-square SVM, was adopted for fault diagnosis modelling by using all channels of attitude monitoring data in the experiment. For comparison, each one channel of the attitude monitoring data was employed for model training and testing. On the other hand, a back propagation neural network (BPNN) was also applied to diagnose fault using the same data. The best fault diagnosis accuracy (94.44%) was obtained when all channels of the attitude monitoring data were used with SVM modelling. The results indicate that the attitude monitoring with SVM is an effective method for the fault diagnosis of delta 3D printers.
Pelentsov, Lemuel J; Laws, Thomas A; Esterman, Adrian J
Parents caring for a child with a rare disease report unmet needs, the origins of which are varied and complex. Few studies have systematically attempted to identify the supportive care needs of parents with a child with a rare disease comprehensively. We have used the widely accepted Supportive Care Needs Framework (SCNF) as the structure for this review. The purpose of the current review was to identify the supportive care needs of parents with a child with a rare disease, irrespective of condition. We conducted a scoping study review comprising 29 studies (1990-2014) to identify and examine the research literature related to the supportive care needs of parents, and to compare these needs with the seven domains outlined in the SCNF. Most common needs cited were social needs (72% of papers), followed by informational needs (65% of papers) and emotional needs (62% of papers), with the most common parental needs overall being information about their child's disease, emotional stress, guilt and uncertainty about their child's future health care needs, parents own caring responsibilities and the need for more general support. A paucity of studies exists that explore the supportive care needs of parents of a child with a rare disease. The SCNF only partially reflects the breadth and type of needs of these parents, and a preliminary revised framework has been suggested. Further research is required in this area, particularly empirical research to amend or confirm the suggested new framework. Copyright © 2015 Elsevier Inc. All rights reserved.
DeJournett, Leon; DeJournett, Jeremy
Effective glucose control in the intensive care unit (ICU) setting has the potential to decrease morbidity and mortality rates which should in turn lead to decreased health care expenditures. Current ICU-based glucose controllers are mathematically derived, and tend to be based on proportional integral derivative (PID) or model predictive control (MPC). Artificial intelligence (AI)-based closed loop glucose controllers may have the ability to achieve control that improves on the results achieved by either PID or MPC controllers. We conducted an in silico analysis of an AI-based glucose controller designed for use in the ICU setting. This controller was tested using a mathematical model of the ICU patient's glucose-insulin system. A total of 126 000 unique 5-day simulations were carried out, resulting in 107 million glucose values for analysis. For the 7 control ranges tested, with a sensor error of ±10%, the following average results were achieved: (1) time in control range, 94.2%, (2) time in range 70-140 mg/dl, 97.8%, (3) time in hyperglycemic range (>140 mg/dl), 2.1%, and (4) time in hypoglycemic range (artificial pancreas system for use in the ICU setting. © 2016 Diabetes Technology Society.
Miyake, Hiroshi; Masuzawa, Hideaki
A medical consultation system has been developed that encompasses knowledge of various specialties. The system is designed to be used by general practitioners, and inhabitants themselves. It has the characteristics of ; 1. The input task of complaints is simplified by use of multiple choice questionaires. 2. The system advices the person whether to seek medical help or not, and if so, the degree of urgency, and from what type of practitioner or specialist. 3. It supplies the doctor information regarding essential symptoms and possible diagnosis. 4. The system offer easy tools to make a medical consultation system to the specialists themselves. This system is intended as an answer to the common problem of uncertainty on the part of both inhabitants and doctors as to the area of medical speciality that applies to a given disease.
Sidebottom, Abbey C; Hellerstedt, Wendy L; Harrison, Patricia A; Jones-Webb, Rhonda J
We examined associations of depressive symptoms and social support with late and inadequate prenatal care in a low-income urban population. The sample was prenatal care patients at five community health centers. Measures of depressive symptoms, social support, and covariates were collected at prenatal care entry. Prenatal care entry and adequacy came from birth certificates. We examined outcomes of late prenatal care and less than adequate care in multivariable models. Among 2341 study participants, 16% had elevated depressive symptoms, 70% had moderate/poor social support, 21% had no/low partner support, 37% had late prenatal care, and 29% had less than adequate prenatal care. Women with both no/low partner support and elevated depressive symptoms were at highest risk of late care (AOR 1.85, CI 1.31, 2.60, p care (AOR 0.74, CI 0.54, 1.10, p = 0.051). Women with moderate/high depressive symptoms were less likely to experience less than adequate care compared to women with low symptoms (AOR 0.73, CI 0.56, 0.96, p = 0.022). Social support and partner support were negatively associated with indices of prenatal care use. Partner support was identified as protective for women with depressive symptoms with regard to late care. Study findings support public health initiatives focused on promoting models of care that address preconception and reproductive life planning. Practice-based implications include possible screening for social support and depression in preconception contexts.
Dannielle E. Kelley
Full Text Available Most social support research has examined support from an individual patient perspective and does not model the broader social context of support felt by caregivers. Understanding how social support networks may complement healthcare services is critical, considering the aging population, as social support networks may be a valuable resource to offset some of the demands placed on the healthcare system. We sought to identify how caregivers' perceived organizational and interpersonal support from their social support network influences care-recipient health.We created a dyadic dataset of care-recipient and caregivers from the first two rounds of the National Health and Aging Trends survey (2011, 2012 and the first round of the associated National Study of Caregivers survey (2011. Using structural equation modeling, we explored how caregivers' perceived social support is associated with caregiver confidence to provide care, and is associated with care-recipient health outcomes at two time points. All data were analyzed in 2016.Social engagement with members from caregivers' social support networks was positively associated with caregiver confidence, and social engagement and confidence were positively associated with care-recipient health at time 1. Social engagement positively predicted patient health at time 2 controlling for time 1. Conversely, use of organizational support negatively predicted care-recipient health at time 2.Care-recipients experience better health outcomes when caregivers are able to be more engaged with members of their social support network. Keywords: Informal caregiving, Social support, Social support network, Patient-caregiver dyads
Full Text Available Background & Aim: Intensive care units (ICUs are recognized as stressful environments. The objective of this study was to determine the effects of emotional intelligence education items on job related stress on physicians and nurses who work in intensive care units at hospitals of Yerevan, Armenia. Methods: A interventional study design was implemented with 106 registered hospital physicians and nurses, who were widely distributed all the way through. Case group was taught about 15 E.I items. For data collection, the 20-question Berger situational (overt anxiety questionnaire, the 20-item personality (covert anxiety questionnaire, and the Bar-on emotional intelligence questionnaire with 133 questions were used. Statistical descriptive methods, chi-square (X2 and t-tests were used to analyze data. Results: The research achievements revealed that the average score of the case group`s situational anxiety was 46.59 before intervention, which decreased to 39.95 after the training of the items of emotional intelligence. The average score of situational anxiety of control group was 44.32 before intervention which increased to 44.76 after examination. There was a meaningful statistical difference between case and control group after education of emotional intelligence`s items (p=0.001. Conclusion: Results of the current study showed that physicians and nurses experience high level of stress. The ability to effectively deal with emotion intelligence and emotional information in the workplace assists employees in coping with occupational stress and should be developed in stress managing trainings.
Kaplan, Sandra J.; Skolnik, Louise; Turnbull, Ayme
This paper reviews the research on youth empowerment in seven child welfare programmatic areas. A lack of studies specifically focused on the empowerment of youth in foster care was found. Conceptual perspectives and existing data, however, suggest that the empowerment of youth in and transitioning out of care is essential and should be overtly…
This article defines assisted living, discusses the pros and cons of limited regulation, scope of service, Aging-in-Place partnerships, and how home care agencies can work with assisted-living facilities to provide care. It also examines a study on assisted living in six states that is funded by the Robert Wood Johnson Foundation.
Duker, Leah I. Stein
Supportive care in oncology helps people cope with cancer and its psychological, physical, and emotional side effects. However, cancer survivors report dissatisfaction with supportive care and a need for more psychosocial and self-management services. Occupational therapy practitioners represent an integral part of the supportive care team because their scope of practice emphasizes function. Through a focus on function, practitioners address the full spectrum of physical and psychosocial care. Currently, conceptualizations of occupational therapy for cancer survivors often focus solely on physical interventions and, therefore, do not represent the unique involvement of the profession in supportive oncology care. We advocate for a focused framework for occupational therapy practitioners in oncology as experts in function and providers of both physical and psychosocial treatments. Barriers to a focus on function are identified, and strategies are suggested for expanding involvement for the profession in supportive oncology care. PMID:27295001
Sleight, Alix G; Duker, Leah I Stein
Supportive care in oncology helps people cope with cancer and its psychological, physical, and emotional side effects. However, cancer survivors report dissatisfaction with supportive care and a need for more psychosocial and self-management services. Occupational therapy practitioners represent an integral part of the supportive care team because their scope of practice emphasizes function. Through a focus on function, practitioners address the full spectrum of physical and psychosocial care. Currently, conceptualizations of occupational therapy for cancer survivors often focus solely on physical interventions and, therefore, do not represent the unique involvement of the profession in supportive oncology care. We advocate for a focused framework for occupational therapy practitioners in oncology as experts in function and providers of both physical and psychosocial treatments. Barriers to a focus on function are identified, and strategies are suggested for expanding involvement for the profession in supportive oncology care. Copyright © 2016 by the American Occupational Therapy Association, Inc.
Kiley Wei-Jen Loh
Full Text Available Despite being a relatively young nation, Singapore has established itself as a leading multifaceted medical hub, both regionally and globally. Although Singapore continues to pursue excellence in oncology care, cancer supportive care and survivorship care remain in the infancy stage. In an effort to advance this important aspect of oncology care in Singapore, the first cancer supportive and survivorship care forum was held in December 2016, involving 74 oncology practitioners. The primary goals of this forum were to raise awareness of the importance of cancer supportive and survivorship care and to provide a platform for oncology practitioners of diverse backgrounds to converge and address the challenges associated with the delivery of cancer supportive and survivorship care in Singapore. Key challenges identified during this forum included, but were not limited to, care fragmentation in an oncologist-centric model of care, poor integration of allied health and rehabilitation services, passive engagement of community partners, lack of specialized skill sets and knowledge in supportive and survivorship care, and patient-related barriers such as poor health literacy. The survivorship care model commonly used in Singapore places an imbalanced emphasis on surveillance for cancer recurrence and second primary cancers, with little attention given to the supportive and survivorship needs of the survivors. In summary, these challenges set the stage for the development and use of a more survivor-centric model, one that focuses not only on cancer surveillance, but also on the broad and unique physical and psychosocial needs of survivors of cancer in Singapore.
Kelley, Dannielle E; Lewis, Megan A; Southwell, Brian G
Most social support research has examined support from an individual patient perspective and does not model the broader social context of support felt by caregivers. Understanding how social support networks may complement healthcare services is critical, considering the aging population, as social support networks may be a valuable resource to offset some of the demands placed on the healthcare system. We sought to identify how caregivers' perceived organizational and interpersonal support from their social support network influences care-recipient health. We created a dyadic dataset of care-recipient and caregivers from the first two rounds of the National Health and Aging Trends survey (2011, 2012) and the first round of the associated National Study of Caregivers survey (2011). Using structural equation modeling, we explored how caregivers' perceived social support is associated with caregiver confidence to provide care, and is associated with care-recipient health outcomes at two time points. All data were analyzed in 2016. Social engagement with members from caregivers' social support networks was positively associated with caregiver confidence, and social engagement and confidence were positively associated with care-recipient health at time 1. Social engagement positively predicted patient health at time 2 controlling for time 1. Conversely, use of organizational support negatively predicted care-recipient health at time 2. Care-recipients experience better health outcomes when caregivers are able to be more engaged with members of their social support network.
Sandtorv, Lisbeth B; Haugland, Siren; Elgen, Irene
Prenatal exposure to substances, including alcohol, opiates, and a number of illicit drugs, may have a negative impact on fetal development. Studies have shown that substance exposure can influence a child's neurodevelopment and the need for care and supportive measures. In this study, we aimed to investigate the care status and the level of supportive measures in school-aged children prenatally exposed to alcohol and other substances. This study included children aged between 6 and 14 years who were referred to Haukeland University Hospital in Norway with developmental impairment and a history of prenatal substance exposure. Participants were classified according to their main prenatal exposure to either alcohol or other substances. Information on care status and supportive measures was obtained from medical records and participants' caregivers. We also compared the use of supportive measures for children placed into foster care before and after 1 year of age. A total of 111 (87% of 128 referrals) eligible children participated in the study. Of these 111 children, 96 (86%) were in foster care, of whom 29 (30%) were placed into foster care during their first year of life and 83 out of 90 (92%) had supportive measures, including reinforced foster care and school or social support. A high proportion of the sample lived in foster care and received supportive measures. Findings may reflect an increased need of care and support in school-aged children with prenatal substance exposure, highlighting the importance of awareness among caregivers and public agencies.
Douglas, Heather E; Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I
Introduction: There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to su...
Plas, A.G.M. van der; Francke, A.L.; Deliens, L.; Jansen, W.J.J.; Vissers, K.C.; Onwuteaka-Philipsen, B.D.
Introduction: Case managers have been introduced in primary palliative care in the Netherlands; these are nurses with expertise in palliative care who offer support to patients and informal care givers. The case manager provides support in addition to the care provided by the home care nurse and
Dauwerse, L.M.; van der Dam, S.; Abma, T.A.
Ethics support is called for to improve the quality of care in elderly institutions. Various forms of ethics support are presented, but the needs for ethics support remain unknown. Using a mixed-methods design, this article systematically investigates the specific needs for ethics support in elderly
Heather E Douglas
Full Text Available Introduction: There is limited evidence of the benefits of information and communication technology (ICT to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Methods: Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Results: Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. Conclusions: There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients.
Douglas, Heather E; Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I
There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients.
Georgiou, Andrew; Tariq, Amina; Prgomet, Mirela; Warland, Andrew; Armour, Pauline; Westbrook, Johanna I
Introduction: There is limited evidence of the benefits of information and communication technology (ICT) to support integrated aged care services. Objectives: We undertook a case study to describe carelink+, a centralised client service management ICT system implemented by a large aged and community care service provider, Uniting. We sought to explicate the care-related information exchange processes associated with carelink+ and identify lessons for organisations attempting to use ICT to support service integration. Methods: Our case study included seventeen interviews and eleven observation sessions with a purposive sample of staff within the organisation. Inductive analysis was used to develop a model of ICT-supported information exchange. Results: Management staff described the integrated care model designed to underpin carelink+. Frontline staff described complex information exchange processes supporting coordination of client services. Mismatches between the data quality and the functions carelink+ was designed to support necessitated the evolution of new work processes associated with the system. Conclusions: There is value in explicitly modelling the work processes that emerge as a consequence of ICT. Continuous evaluation of the match between ICT and work processes will help aged care organisations to achieve higher levels of ICT maturity that support their efforts to provide integrated care to clients. PMID:29042851
Park, Sang Min; Kim, Young Jin; Kim, Samyong; Choi, Jong Soo; Lim, Ho-Yeong; Choi, Youn Seon; Hong, Young Seon; Kim, Si-Young; Heo, Dae Seog; Kang, Ki Moon; Jeong, Hyun Sik; Lee, Chang Geol; Moon, Do Ho; Choi, Jin-Young; Kong, In Sik; Yun, Young Ho
Family caregivers play an important role in caring for cancer patients, but the impact of caregivers' unmet needs on the quality of end-of-life (EOL) care they deliver and on their workplace performance are less understood. We identified 1,662 family caregivers of cancer patients who had died at any of 17 hospitals in Korea during 2004. The caregivers answered a telephone questionnaire about needs that were not met when they delivered terminal cancer care and how those unmet their needs affected their workplace performance; they also answered the Quality Care Questionnaire-End of Life (QCQ-EOL). Compared with caregivers who did not have unmet needs, caregivers who had unmet needs for symptom management, financial support, or community support showed poorer QCQ-EOL scores (P < 0.01). Caregivers who had unmet needs for financial support (adjusted odds ratio (aOR) = 7.55; 95% confidential interval (CI) 3.80-15.00), psychosocial support (aOR = 6.24; 95% CI 2.95-13.05), symptom management (aOR = 3.21; 95% CI 2.26-4.54), community support (aOR = 3.82; 95% CI 2.38-6.11), or religious support (aOR = 4.55; 95% CI 1.84-11.26) were more likely to experience work limitations. Caregivers of patients receiving conventional hospital care were more likely to have unmet needs for symptom management (aOR = 1.21; 95% CI 1.00-1.47), psychosocial support (aOR = 1.99; 95% CI 1.37-2.88), and religious support (aOR = 1.73; 95% CI 1.08-2.78) than those of patients receiving palliative hospice care. Caregivers' unmet needs negatively affected both the quality of EOL care they delivered and their workplace performance. More investment in caregiver support and public policies that meet caregiver needs are needed, and hospice use should be encouraged.
Hill, Michelle; Kirby, Judy
Diabetes education for the home care population requires expert knowledge to be available at the point-of-care, the patient's home. This poster displays a model for Web-based diabetes education and decision support for the home care nurse. The system utilizes the line of reasoning (LOR) model to organize and represent expert decision-making thought processes.
Graaf, I.M. de; Onrust, S.A.; Haverman, M.C.C.; Janssens, J.M.A.M.
The present study evaluated two primary care parenting interventions. First, we evaluated the most widely used Dutch practices for primary care parenting support. Second, we assessed the applicability of the Primary Care Triple P approach, which is now being utilized in a wide variety of primary
Tilley, Lorna; Cameron, Tony
The Index of Care is a web-based application designed to support the recently proposed four-stage 'bioarchaeology of care' methodology for identifying and interpreting health-related care provision in prehistory. The Index offers a framework for guiding researchers in 'thinking through' the steps of a bioarchaeology of care analysis; it continuously prompts consideration of biological and archaeological evidence relevant to care provision; it operationalises key concepts such as 'disability' and 'care'; and it encourages transparency in the reasoning underlying conclusions, facilitating review. This paper describes the aims, structure and content of the Index, and provides an example of its use. The Index of Care is freely available on-line; it is currently in active development, and feedback is sought to improve its utility and usability. This is the first time in bioarchaeology that an instrument for examining behaviour as complex as caregiving has been proposed. Copyright © 2014 Elsevier Inc. All rights reserved.
Conclusions: The results of the study showed that mother–infant attachment improved by increasing mothers' satisfaction of supportive nursing care. Therefore, it seems necessary to increase maternal satisfaction through given nursing care support, in order to promote mother–infant attachment.
Khanare, Fumane P.; de Lange, Naydene
The voices of school children who are orphaned and vulnerable are more often than not missing from conversations about their care and support at school. In a rural ecology this is even more so the case. This article draws on a study with school children in rural KwaZulu-Natal and explores their constructions of care and support in the age of HIV…
Norinder, Maria; Goliath, Ida; Alvariza, Anette
Patients who receive palliative home care are in need of support from family members, who take on great responsibility related to caregiving but who often feel unprepared for this task. Increasing numbers of interventions aimed at supporting family members in palliative care have been described and evaluated. It is not known whether and how these interventions actually affect the care or support provided to a patient, even though it has been suggested that family members would be likely to provide better care and support and thus allow for positive experiences for patients. However, this has not been studied from the perspective of the patients themselves. The objective of our study was to explore patients' experiences of care and support at home after family members' participation in a psychoeducational intervention during palliative care. Our study took a qualitative approach, and interviews were conducted with 11 patients whose family members had participated in a psychoeducational intervention during palliative home care. The interviews were analyzed employing interpretive description. Patients' experiences were represented by three themes: "safe at home," "facilitated and more honest communication," and "feeling like a unit of care." Patients felt that their needs were better met and that family members became more confident at home without risking their own health. Patients felt relieved when family members were given the opportunity to talk and reflect with others and hoped that the intervention would contribute to more honest communications between themselves and their family members. Further, it was of great importance to patients that family members receive attention from and be confirmed and supported by healthcare professionals. Our findings show how an intervention targeted at family members during palliative home care also benefits the patients.
Saari, Margaret; Patterson, Erin; Kelly, Shawna; Tourangeau, Ann E
To meet increasing demand for home care, the role of personal support workers (PSWs) is shifting from providing primarily personal and supportive care to include care activities previously provided by regulated health professionals (RHPs). Much of the research examining this shift focuses on specialty programmes, with few studies investigating the daily care being provided by PSWs, frequency of care activities being provided by PSWs, and characteristics of the population receiving more complex tasks. Between January and April 2015, a review of 517 home-care service user charts was undertaken in Ontario, Canada, to: (1) describe the range of tasks being performed by PSWs in home care, (2) identify tasks transferred by RHPs to PSWs, and (3) examine characteristics of service users receiving transferred care. Findings indicate that normally, PSWs provide personal and supportive care commensurate with their training. However, in approximately one quarter of care plans reviewed, PSWs also completed more complex care activities transferred to them by RHPs. Service users receiving transferred care were older and had higher levels of cognitive and functional impairment. Although there is potential for the expansion of home-care services through increased utilisation of PSWs, healthcare leadership must ensure that the right provider is being utilised at the right time and in the right place to ensure safe and effective quality care. Thus, several actions are recommended: PSW core competencies be clearly articulated, processes used to transfer care activities from RHPs to PSWs be standardised and a team-based approach to the delivery of home-care services be considered. Utilisation of a team-based model can help establish positive relationships among home-care providers, provide increased support for PSWs, allow for easier scheduling of initial training and ensure regular reassessments of PSW competence among PSWs providing added skills. © 2017 John Wiley & Sons Ltd.
Salmi, Riikka; Tolvanen, Mimmi; Suhonen, Riitta; Lahti, Satu; Närhi, Timo
Increasing number of older adults lives in their own homes, but needs help in many daily routines. Domiciliary care nursing staff (DCNS) is often needed to support oral home care. However, information of nursing staff's knowledge, skills and activity in this task is sparse. The study aimed to assess DCNS knowledge, perceived skills and activities to support oral home care of older domiciliary care clients. The study was conducted among DCNS in one of the largest cities in Finland. All DCNS members (n = 465) received a questionnaire with 14 multiple choice and open questions regarding the perceived skills, knowledge and activities of oral health guidance of older domiciliary care clients. In total, 115 (25%) DCNS members returned the questionnaires. Frequencies, percentages, means and standard deviations were used to describe the samples and study variables. DCNS was categorised according to age and working years for group comparisons, which were assessed with chi-squared test. Knowledge concerning oral health was mostly on a high level. Around 50% of DCNS considered their knowledge regarding dental prosthesis hygiene as sufficient. Of the DCNS, 67% informed that they had received education on oral health care. However, over 50% of the DCNS had a need for further education in issues related to oral home care. DCNS were active in supporting most oral and prosthesis hygiene means, yet less in guidance concerning toothbrushing. Activity to support cleaning the interdental spaces was the weakest, in which only 12% of the respondents considered having average or excellent skills. Younger DCNS had better knowledge on oral home care due to recent education, but older staff members were more skilful in performing oral hygiene measures. There is a need for structured instructions and training on oral home care for DCNS. Oral home care should be taken into account more often and regularly. © 2018 Nordic College of Caring Science.
Laleci Erturkmen, Gokce Banu; Yuksel, Mustafa; Sarigul, Bunyamin; Lilja, Mikael; Chen, Rong; Arvanitis, Theodoros N
Older age is associated with an increased accumulation of multiple chronic conditions. The clinical management of patients suffering from multiple chronic conditions is very complex, disconnected and time-consuming with the traditional care settings. Integrated care is a means to address the growing demand for improved patient experience and health outcomes of multimorbid and long-term care patients. Care planning is a prevalent approach of integrated care, where the aim is to deliver more personalized and targeted care creating shared care plans by clearly articulating the role of each provider and patient in the care process. In this paper, we present a method and corresponding implementation of a semi-automatic care plan management tool, integrated with clinical decision support services which can seamlessly access and assess the electronic health records (EHRs) of the patient in comparison with evidence based clinical guidelines to suggest personalized recommendations for goals and interventions to be added to the individualized care plans.
Nicholson, Caroline; Morrow, Elizabeth M; Hicks, Allan; Fitzpatrick, Joanne
Growing numbers of older people living with frailty and chronic health conditions are being referred to hospitals with acute care needs. Supportive care is a potentially highly relevant and clinically important approach which could bridge the practice gap between curative models of care and palliative care. However, future interventions need to be informed and underpinned by existing knowledge of supportive care. To identify and build upon existing theories and evidence about supportive care, specifically in relation to the hospital care of older people with frailty, to inform future interventions and their evaluation. An integrative review was used to identify and integrate theory and evidence. Electronic databases (Cochrane Medline, EMBASE and CIHAHL) were searched using the key term 'supportive care'. Screening identified studies employing qualitative and/or quantitative methods published between January 1990 and December 2015. Citation searches, reference checking and searches of the grey literature were also undertaken. Literature searches identified 2733 articles. After screening, and applying eligibility criteria based on relevance to the research question, studies were subject to methodological quality appraisal. Findings from included articles (n=52) were integrated using synthesis of themes. Relevant evidence was identified across different research literatures, on clinical conditions and contexts. Seven distinct themes of the synthesis were identified, these were: Ensuring fundamental aspects of care are met, Communicating and connecting with the patient, Carer and family engagement, Building up a picture of the person and their circumstances, Decisions and advice about best care for the person, Enabling self-help and connection to wider support, and Supporting patients through transitions in care. A tentative integrative model of supportive care for frail older people is developed from the findings. The findings and model developed here will inform
Hartley, Lou Ann
Implementing technology in the clinical setting is not a project but rather a journey in transforming care delivery. As nursing leaders in healthcare and patient care support organizations embrace technology to drive reforms in quality and efficiency, growing opportunities exist to share experiences between these industries. This department submission describes the journey to nursing shared governance from the perspective of an information technology-based company realizing the goal of supporting patient care.
...-profit HCPs' access to advanced telecommunications and information services. Participants in the Pilot... construction of state or regional broadband health care networks and of the cost of advanced telecommunications... purpose of this funding is to maintain the status quo and to avoid unnecessary churn for the Pilot...
Chappell, Neena L.
Compares differences between elderly who use formal home care services and those who do not. Data revealed users as less healthy and less active and as receiving more assistance from both formal and informal sources. Suggests that formal and informal services complement rather than substitute for one another. (NRB)
... an essential part of 21st century medical care. Whether it is used for transmitting electronic health... conferencing for telemedicine or training, access to broadband for medical providers saves lives while lowering... electronic health records (EHRs) avoids duplicative medical tests and errors in prescriptions, and gives...
Schmidt, K.; Gensichen, J.; Petersen, J.J.; Szecsenyi, J.; Walther, M.; Williams, G.; Freund, T.
OBJECTIVES: There is a growing need for studies to measure how patients feel supported in their autonomy. The Health Care Climate Questionnaire (HCCQ) is an instrument to assess the physician's support to motivate the patient to take personal responsibility for his/her health. The aim of this study
The purpose of the study was two-fold: (1) to examine the relationships among self-care, social support, and quality of life in adult cancer patients receiving radiotherapy while the selected basic conditioning factors of age, marital and socio-economic status, living arrangement, stage and site of cancer were statistically controlled; and (2) to test a theoretical model which postulated that (a) quality of life was predicted jointly by the selected basic conditioning factors, social support and self-care, and (b) self-care was predicted jointly by the selected basic conditioning factors and social support. A convenience sample of 112 adult cervical and head/neck cancer patients receiving radiotherapy was obtained from radiotherapy outpatient clinic in three hospitals located in Bangkok, Thailand. Results of the study indicated positive relationships among self-care, social support, and quality of life. Socio-economic status, site of cancer, and self-care were significant predictors for reported quality of life. Social support appeared to be a significant predictor of quality of life indirectly through self-care. Socio-economic status and social support were also significant predictors of self-care, whereas, stage and site of cancer seemed to predict self-care indirectly through social support
Vamos, T; Siegler, A
Action planning methods used in intelligent robot control are discussed. Planning is accomplished through environment understanding, environment representation, task understanding and planning, motion analysis and man-machine communication. These fields are analysed in detail. The frames of an intelligent motion planning system are presented. Graphic simulation of the robot's environment and motion is used to support the planning. 14 references.
Weld, Daniel S.; Bansal, Gagan
Since Artificial Intelligence (AI) software uses techniques like deep lookahead search and stochastic optimization of huge neural networks to fit mammoth datasets, it often results in complex behavior that is difficult for people to understand. Yet organizations are deploying AI algorithms in many mission-critical settings. In order to trust their behavior, we must make it intelligible --- either by using inherently interpretable models or by developing methods for explaining otherwise overwh...
Full Text Available The foster care system in Poland has recently undergone many changes on the basis of new legislation. It has been presented as a part of the work with the child and its family towards reintegration of the child’s family. However, in order for the aim of foster care to be achieved in this form, it is necessary to integrate work with the child and its family with all the elements of the local environment. Similar assumptions are the basis of the pedagogical concept of the environmental educational system by Stanisław Kowalski. The article presents how to implement pedagogical objectives through legal solutions, which emphasize the integration of the local environment.
Zijlmans, L. J. M.; Embregts, P. J. C. M.; Gerits, L.; Bosman, A. M. T.; Derksen, J. J. L.
Background: Recent research addressed the relationship between staff behaviour and challenging behaviour of individuals with an intellectual disability (ID). Consequently, research on interventions aimed at staff is warranted. The present study focused on the effectiveness of a staff training aimed at emotional intelligence and interactions…
It has been my experience that parents are willing and open to express their voices to promote and advocate for music therapy services for their terminally ill children. By listening to parents' voices when providing care for terminally ill children, much can be done to ease the suffering of children and families at the end of life (Widger & Wilkins, 2004). My music therapy masters research at the University of Melbourne with Dr. Katrina McFerran will investigate bereaved parents' experie...
Khan, Mohammad; Abraham, Ajith
This book demonstrates the success of Ambient Intelligence in providing possible solutions for the daily needs of humans. The book addresses implications of ambient intelligence in areas of domestic living, elderly care, robotics, communication, philosophy and others. The objective of this edited volume is to show that Ambient Intelligence is a boon to humanity with conceptual, philosophical, methodical and applicative understanding. The book also aims to schematically demonstrate developments in the direction of augmented sensors, embedded systems and behavioral intelligence towards Ambient Intelligent Networks or Smart Living Technology. It contains chapters in the field of Ambient Intelligent Networks, which received highly positive feedback during the review process. The book contains research work, with in-depth state of the art from augmented sensors, embedded technology and artificial intelligence along with cutting-edge research and development of technologies and applications of Ambient Intelligent N...
McCoy, Sandra I; Strauss, Ronald P; MacDonald, Pia D M; Leone, Peter A; Eron, Joseph J; Miller, William C
Many adults in the USA enter primary care late in the course of HIV infection, countering the clinical benefits of timely HIV services and missing opportunities for risk reduction. Our objective was to determine if perceived social support was associated with delay entering care after an HIV diagnosis. Two hundred and sixteen patients receiving primary care at a large, university-based HIV outpatient clinic in North Carolina were included in the study. Dimensions of functional social support (emotional/informational, tangible, affectionate, and positive social interaction) were quantified with a modified Medical Outcomes Study Social Support Scale and included in proportional hazards models to determine their effect on delays seeking care. The median delay between diagnosis and entry to primary care was 5.9 months. Levels of social support were high but only positive social interaction was moderately associated with delayed presentation in adjusted models. The effect of low perceived positive social interaction on the time to initiation of primary care differed by history of alcoholism (no history of alcoholism, hazard ratio (HR): 1.43, 95% confidence interval (CI): 0.88, 2.34; history of alcoholism, HR: 0.71, 95% CI: 0.40, 1.28). Ensuring timely access to HIV care remains a challenge in the southeastern USA. Affectionate, tangible, and emotional/informational social support were not associated with the time from diagnosis to care. The presence of positive social interaction may be an important factor influencing care-seeking behavior after diagnosis.
Venturato, Lorraine; Drew, Liz
Contemporary health care environments are increasingly challenged by issues associated with the recruitment and retention of qualified nursing staff. This challenge is particularly felt by residential aged care providers, with registered nurse (RN) numbers already limited and resident acuity rapidly rising. As a result, aged care service providers are increasingly exploring creative and alternative models of care. This article details exploratory research into a pre-existing, alternative model of care in a medium sized, regional residential aged care facility. Research findings suggest that the model of care is complex and multi-faceted and is an example of an integrated model of care. As a result of the implementation of this model of care a number of shifts have occurred in the practice experiences and clinical culture within this facility. Results suggest that the main benefits of this model are: (1) increased opportunities for RNs to engage in clinical leadership and proactive care management; (2) improved management and communication in relation to work processes and practices; and (3) enhanced recruitment and retention of both RNs and care workers.
Full Text Available The main objective of this paper is to explore the potentials of assistive technologies to support seniors’ independent living. The work looks at two salient aspects of utilizing technologies for elderly, namely direct support and empowering technologies. The research undertakes a comprehensive analysis of attempts that have been made through investigation of the literature. For this purpose, a realist review of relevant papers published since 2000 has been conducted. The paper concludes that although much research in this area targets the direct support for older adults, the effective use of technologies to maintain seniors’ physical and cognitive abilities requires further investigations. This can provide avenues of opportunities that would empower seniors for their independent living.
Cui, Yanyan; Gong, Dongwei; Yang, Bo; Chen, Hua; Tu, Ming-Hsiang; Zhang, Chaonan; Li, Huan; Liang, Naiwen; Jiang, Liping; Chang, Polun
Comprehensive Geriatric Assessments (CGAs) have been recommended to be used for better monitoring the health status of elder residents and providing quality care. This study reported how our nurses perceived the usability of CGA component of a mobile integrated-care long term care support system developed in China. We used the Continuity Assessment Record and Evaluation (CARE), developed in the US, as the core CGA component of our Android-based support system, in which apps were designed for all key stakeholders for delivering quality long term care. A convenience sample of 18 subjects from local long term care facilities in Shanghai, China were invited to assess the CGA assessment component in terms of Technology Acceptance Model for Mobile based on real field trial assessment. All (100%) were satisfied with the mobile CGA component. 88.9% perceived the system was easy to learn and use. 99.4% showed their willingness to use for their work. We concluded it is technically feasible to implement a CGA-based mobile integrated care support system in China.
Miura, Kousei; Kadone, Hideki; Koda, Masao; Abe, Tetsuya; Kumagai, Hiroshi; Nagashima, Katsuya; Mataki, Kentaro; Fujii, Kengo; Noguchi, Hiroshi; Funayama, Toru; Kawamoto, Hiroaki; Sankai, Yoshiyuki; Yamazaki, Masashi
Work-related low back pain is a serious socioeconomic problem. This study examined whether HAL for Care Support, which is a newly developed wearable robot, would decrease lumbar fatigue and improve lifting performance during repetitive lifting movements. Eighteen healthy volunteers (11 men, 7 women) performed repetitive stoop lifting movements of a cardboard box weighing 12 kg as many times as possible. The first lifting trial was executed without HAL for Care Support, and the second was with it. We evaluated the VAS of lumbar fatigue as the lumbar load and the number of lifts and the lifting time as lifting performance. Without HAL for Care Support, the mean VAS of lumbar fatigue, the number of lifts and lifting time were 68 mm, 60 and 230 s; with HAL for Care Support, they were 51 mm, 87 and 332 s, respectively. Both lifting performance measures were significantly improved by using HAL for Care Support (Fig. 2). A power analysis showed that there was sufficient statistical power for the VAS of lumbar fatigue (0.99), the number of lifts (0.92), and lifting time (0.93). All participants performed their repetitive lifting trials safely. There were no adverse events caused by using HAL for Care Support. In conclusion, the HAL for Care Support can decrease lumbar load and improve the lifting performance during repetitive stoop lifting movements in healthy adults. Copyright © 2018. Published by Elsevier Ltd.
Full Text Available Christa L Cook,1 Shantrel Canidate,2 Nicole Ennis,3 Robert L Cook4 1Department of Family, Community, and Health System Science, College of Nursing, 2Social and Behavioral Science, College of Public Health and Health Profession, 3Department of Clinical and Health Psychology, College of Public Health and Health Professions, 4Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA Purpose: Despite recommendations for early entry into human immunodeficiency virus (HIV care, many people diagnosed with HIV delay seeking care. Multiple types of social support (ie, cognitive, emotional, and tangible are often needed for someone to transition into HIV care, but a lack of emotional support at diagnosis may be the reason why some people fail to stay engaged in care. Thus, the purpose of this study was to identify how people living with HIV conceptualized emotional support needs and delivery at diagnosis. Method: We conducted a secondary analysis of qualitative data from 27 people living with HIV, many of whom delayed entry into HIV care. Results: Participants described their experiences seeking care after an HIV diagnosis and identified components of emotional support that aided entry into care – identification, connection, and navigational presence. Many participants stated that these types of support were ideally delivered by peers with HIV. Conclusion: In clinical practice, providers often use an HIV diagnosis as an opportunity to educate patients about HIV prevention and access to services. However, this type of social support may not facilitate engagement in care if emotional support needs are not met. Keywords: linkage to care, engagement in care, social support, qualitative
NASA also seeks to advance American education by employing the technology utilization process to develop a computerized, artificial intelligence-based Intelligent Tutoring System (ITS) to help high school and college physics students. The tutoring system is designed for use with the lecture and laboratory portions of a typical physics instructional program. Its importance lies in its ability to observe continually as a student develops problem solutions and to intervene when appropriate with assistance specifically directed at the student's difficulty and tailored to his skill level and learning style. ITS originated as a project of the Johnson Space Center (JSC). It is being developed by JSC's Software Technology Branch in cooperation with Dr. R. Bowen Loftin at the University of Houston-Downtown. Program is jointly sponsored by NASA and ACOT (Apple Classrooms of Tomorrow). Other organizations providing support include Texas Higher Education Coordinating Board, the National Research Council, Pennzoil Products Company and the George R. Brown Foundation. The Physics I class of Clear Creek High School, League City, Texas are providing the classroom environment for test and evaluation of the system. The ITS is a spinoff product developed earlier to integrate artificial intelligence into training/tutoring systems for NASA astronauts flight controllers and engineers.
‘Jading’ is a process of exhaustion in which apathy and cynicism replace the drive to be responsive and caring. ‘Burnout’ a term first coined in the psychology literature in 1974 was based on Graham Greene’s novel ‘A Burnt-Out Case1. It is the umbrella description for disengagement in the workplace setting characterised by withdrawal, denial and inefficiency. There is an alienation from the pressures of work. Marshall and Kasman2 defined it as ‘the loss of motivation for creative thought’. It is the opposite of engagement which is associated with energy and optimism. People who experience all 3 symptoms- emotional exhaustion, negative attitude towards patients, reduced sense of personal accomplishment- have the greatest degree of burnout. It doesn’t get better by being ignored. These processes have serious consequences for the individual involved and the hospital that they work in. The doctor underperforms and the Unit becomes dysfunctional There is decreased quality of care, increased absenteeism, and high staff turnover. There is an inability to make decisions and a failure to set priorities.
Lu, Huimin; Li, Yujie; Chen, Min; Kim, Hyoungseop; Serikawa, Seiichi
Artificial intelligence (AI) is an important technology that supports daily social life and economic activities. It contributes greatly to the sustainable growth of Japan's economy and solves various social problems. In recent years, AI has attracted attention as a key for growth in developed countries such as Europe and the United States and developing countries such as China and India. The attention has been focused mainly on developing new artificial intelligence information communication ...
Full Text Available Background. Self-management support and team-based care are essential elements of the Chronic Care Model but are often limited by staff availability and reimbursement. Mobile phones are a promising platform for improving chronic care but there are few examples of successful health system implementation. Program Development. An iterative process of program design was built upon a pilot study and engaged multiple institutional stakeholders. Patients identified having a “human face” to the pilot program as essential. Stakeholders recognized the need to integrate the program with primary and specialty care but voiced concerns about competing demands on clinician time. Program Description. Nurse administrators at a university-affiliated health plan use automated text messaging to provide personalized self-management support for member patients with diabetes and facilitate care coordination with the primary care team. For example, when a patient texts a request to meet with a dietitian, a nurse-administrator coordinates with the primary care team to provide a referral. Conclusion. Our innovative program enables the existing health system to support a de novo care management program by leveraging mobile technology. The program supports self-management and team-based care in a way that we believe engages patients yet meets the limited availability of providers and needs of health plan administrators.
Cabitza, Federico; Alderighi, Camilla; Rasoini, Raffaele; Gensini, Gian Franco
Decisional support systems based on machine learning (ML) in medicine are gaining a growing interest as some recent articles have highlighted the high diagnostic accuracy exhibited by these systems in specific medical contexts. However, it is implausible that any potential advantage can be obtained without some potential drawbacks. In light of the current gaps in medical research about the side effects of the application of these new AI systems in medical practice, in this article we summarize the main unexpected consequences that may result from the widespread application of "oracular" systems, that is highly accurate systems that cannot give reasonable explanations of their advice as those endowed with predictive models developed with ML techniques usually are. These consequences range from the intrinsic uncertainty in the data that are used to train and feed these systems, to the inadequate explainability of their output; through the risk of overreliance, deskilling and context desensitization of their end-users. Although some of these issues may be currently hard to evaluate due to the still scarce adoption of these decisional systems in medical practice, we advocate the study of these potential consequences also for a more informed policy of approval beyond hype and disenchantment.
Floris, Lucia; Irion, Olivier; Bonnet, Jocelyne; Politis Mercier, Maria-Pia; de Labrusse, Claire
According to the woman-centred care model, continuous care by a midwife has a positive impact on satisfaction. Comprehensive support is a model of team midwifery care implemented in the large Geneva University Hospitals in Switzerland, which has organised shared care according to the biomedical model of practice. This model of care insures a follow up by a specific group of midwives, during perinatal period. The goal of this study was to evaluate the satisfaction and outcomes of the obstetric and neonatal care of women who received comprehensive support during pregnancy, childbirth and the postpartum period, and compare them to women who received shared care. This was a prospective comparative study between two models of care in low risk pregnant women. The satisfaction and outcomes of care were evaluated using the French version of the Women's Experiences Maternity Care Scale, two months after giving birth. In total, 186 women in the comprehensive support group and 164 in the control group returned the questionnaire. After adjustment, the responses of those in the comprehensive support programme were strongly associated with optimal satisfaction, and they had a significantly lower epidural rate. No differences were observed between the two groups in the mode of delivery. The satisfaction relative to this support programme was associated with a birth plan for intrapartum and postnatal care. Team midwifery had a positive impact on satisfaction, with no adverse effects on the obstetric and neonatal outcomes, when compared to shared care. Copyright © 2017 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
Full Text Available Background: The practical difficulties for patients with stroke include lack of information about their condition, poor knowledge of the services and benefits available. Specialist Stroke nurses provide education and support services for people with Stroke in many health care systems. A key goal is helping and empowering unable people to self-manage their stroke and supporting caregivers of these valnurable population, too. Objective: The objective of this review was to assess the role of specialist nurse in care for patients following a stroke and their caregivers support. Search methods: The databases CINAHL, PubMed, Science Direct and Synergy were searched from 1988 to 2017 using the keywords Stroke, Specialist Nurse, Care, Caregivers and support. Bibliographies of relevant papers were searched, and hand searching of relevant publications was undertaken to identify additional Studies. Selection criteria: All studies of the effects of a specialist nurse practitioner on short and long term stroke outcomes were included in the review. Data collection and analysis: Three investigators performed data extraction and quality scoring independently; any discrepancies were resolved by consensus. Findings: Stroke, Specialist Nurse, Care, Caregivers concepts and labels are defined and measured in different and often contradictory ways by using 31 founded study. Conclusions: The findings indicate a dissonance in the views of different stakeholders within the care system. The division of labour associated with nursing care and specialist nurse requires further exploration. The contrasting paradigms of health care professionals and people with stroke regarding models of disability were highlighted. Stroke, like other chronic illnesses, requires substantial nursing care. There is a growing number of specialist nurses in the workforce, however, little is known how their role interfaces with other nurses.
droit du Canada), telle que représentée par le ministre de la Défense nationale, 2014 Abstract …….. This report presents the results of...documents coming from the international military community (doctrine, manuals) as well as from the academia (scientific papers). From this analysis, a...References .....  US Military, “US Joint Intelligence Preparation of the Operational Environment”, Joint Publication 2-01.3, 16 June
Beck, Anne Marie; Gøgsig Christensen, Annette; Stenbæk Hansen, Birthe
Objective To assess the effect of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care identified with the validated Eating Validation Scheme (EVS). Methods An 11 wk cluster randomized trial with a home-care (3 clusters) or nursing home (3 clusters.......3] versus 1.3 [0.5], P = 0.021) was observed. There was a almost significant difference in mortality (2% versus 13%, P = 0.079). Conclusions Multidisciplinary nutritional support in older adults in nursing home and home-care could have a positive effect on quality of life, muscle strength, and oral care....... means of EuroQol-5D-3L), physical performance (30-seconds chair stand), nutritional status (weight and hand-grip strength), oral care, fall incidents, hospital admissions, rehabilitation stay, moving to nursing homes (participants from home-care), and mortality. Results Respectively, 55 (46 from 2 home...
Hunt, Earl B
Artificial Intelligence provides information pertinent to the fundamental aspects of artificial intelligence. This book presents the basic mathematical and computational approaches to problems in the artificial intelligence field.Organized into four parts encompassing 16 chapters, this book begins with an overview of the various fields of artificial intelligence. This text then attempts to connect artificial intelligence problems to some of the notions of computability and abstract computing devices. Other chapters consider the general notion of computability, with focus on the interaction bet
Hashimoto, H. [The University of Tokyo, Tokyo (Japan). Institute of Industrial Science
Intelligent mechatronics (IM) was explained as follows: a study of IM essentially targets realization of a robot namely, but in the present stage the target is a creation of new values by intellectualization of machine, that is, a combination of the information infrastructure and the intelligent machine system. IM is also thought to be constituted of computers positively used and micromechatronics. The paper next introduces examples of IM study, mainly those the author is concerned with as shown below: sensor gloves, robot hands, robot eyes, tele operation, three-dimensional object recognition, mobile robot, magnetic bearing, construction of remote controlled unmanned dam, robot network, sensitivity communication using neuro baby, etc. 27 figs.
van der Dam, Sandra; Molewijk, Bert; Widdershoven, Guy A M; Abma, Tineke A
Clinical ethics support mechanisms in healthcare are increasing but little is known about the specific developments in elderly care. The aim of this paper is to present a systematic literature review on the characteristics of existing ethics support mechanisms in institutional elderly care. A review was performed in three electronic databases (Pubmed, CINAHL/PsycINFO, Ethxweb). Sixty papers were included in the review. The ethics support mechanisms are classified in four categories: 'institutional bodies' (ethics committee and consultation team); 'frameworks' (analytical tools to assist care professionals); 'educational programmes and moral case deliberation'; and 'written documents and policies'. For each category the goals, methods and ways of organising are described. Ethics support often serves several goals and can be targeted at various levels: case, professional or organisation. Over the past decades a number of changes have taken place in the development of ethics support in elderly care. Considering the goals, ethics support has become more outreaching and proactive, aiming to qualify professionals to integrate ethics in daily care processes. The approaches in clinical ethics support have become more diverse, more focused on everyday ethical issues and better adapted to the concrete learning style of the nursing staff. Ethics support has become less centrally organised and more connected to local contexts and primary process within the organisation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
McCoy, Sandra I.; Strauss, Ronald P.; MacDonald, Pia D. M.; Leone, Peter A.; Eron, Joseph J.; Miller, William C.
Many adults in the United States enter primary care late in the course of HIV infection, countering the clinical benefits of timely HIV services and missing opportunities for risk reduction. Our objective was to determine if perceived social support was associated with delay entering care after an HIV diagnosis. Two hundred sixteen patients receiving primary care at a large, university-based HIV outpatient clinic in North Carolina were included in the study. Dimensions of functional social su...
M Berkan Sesen
Full Text Available Survival prediction and treatment selection in lung cancer care are characterised by high levels of uncertainty. Bayesian Networks (BNs, which naturally reason with uncertain domain knowledge, can be applied to aid lung cancer experts by providing personalised survival estimates and treatment selection recommendations. Based on the English Lung Cancer Database (LUCADA, we evaluate the feasibility of BNs for these two tasks, while comparing the performances of various causal discovery approaches to uncover the most feasible network structure from expert knowledge and data. We show first that the BN structure elicited from clinicians achieves a disappointing area under the ROC curve of 0.75 (± 0.03, whereas a structure learned by the CAMML hybrid causal discovery algorithm, which adheres with the temporal restrictions, achieves 0.81 (± 0.03. Second, our causal intervention results reveal that BN treatment recommendations, based on prescribing the treatment plan that maximises survival, can only predict the recorded treatment plan 29% of the time. However, this percentage rises to 76% when partial matches are included.
Ghana’s slow progress towards attaining millennium development goal 5 has been associated with gaps in quality of care, particularly quality of clinical decision making for clients. This thesis reviews the relevance and effect of clinical decision making support tools on pregnancy outcomes. Relevance of three clinical decision making support tools available to frontline providers of care in the Greater Accra region is discussed. These are routine maternal health service delivery data populati...
Often ethically complex, end-of-life situations can mean nursing teams are confronted with a refusal of care. Through a representative clinical situation, a nurse describes the support provided by a multidisciplinary team, in the home, to comply with the wishes of a person at the end of life, support the family, anticipate possible difficulties and organise adapted care which respects all those concerned. Copyright © 2018 Elsevier Masson SAS. All rights reserved.
Design goals and design directions are formulated for the (digital) support of non-technical nursing tasks and skills in the intensive care unit (ICU), such as organizing work, evaluating care, coping with stress and dealing with poor team dynamics. A conceptual framework for ICU nursing was
Cnossen, Ingrid C; van Uden-Kraan, Cornelia F; Eerenstein, Simone E J; Jansen, Femke; Witte, Birgit I; Lacko, Martin; Hardillo, José A; Honings, Jimmie; Halmos, Gyorgy B; Goedhart-Schwandt, Noortje L Q; de Bree, Remco; Leemans, C René; Verdonck-de Leeuw, Irma M
PURPOSE: The purpose of this study was to investigate the feasibility of an online self-care education program supporting early rehabilitation of patients after total laryngectomy (TLPs) and factors associated with satisfaction. METHODS: Health care professionals (HCPs) were invited to participate
Cnossen, Ingrid C; van Uden-Kraan, Cornelia F.; Eerenstein, Simone E J; Jansen, Femke; Witte, Birgit I.; Lacko, Martin; Hardillo, José A U; Honings, Jimmie; Halmos, Gyorgy B; Goedhart-Schwandt, Noortje L Q; de Bree, Remco; Leemans, C René; Leeuw, Irma M Verdonck de
PURPOSE: The purpose of this study was to investigate the feasibility of an online self-care education program supporting early rehabilitation of patients after total laryngectomy (TLPs) and factors associated with satisfaction. METHODS: Health care professionals (HCPs) were invited to participate
Bromer, Juliet; Henly, Julia R.
This paper presents a qualitative investigation of the work-family support roles of a sample of 29 child care providers serving low-income families in the Chicago area (16 family, friend, and neighbor providers (FFN), 7 licensed family child care providers (FCC), and 6 center-based teachers). Providers report offering low-income parents…
Salazar, Amy M.; Jones, Kevin R.; Emerson, John C.; Mucha, Lauren
Young people transitioning from foster care to college experience unique identities and circumstances that make being successful in college especially challenging. We used qualitative survey data from 248 college graduates who were formerly in foster care to explore the strengths, challenges, and supports they experienced while in college that…
Kortteisto, Tiina; Komulainen, Jorma; Kunnamo, Ilkka
implementation of eCDS requires time and repeated supportive input. Primary care professionals need time and training for adapting eCDS in their daily routine. In addition, the eCDS content should be tailored to fulfil different professionals’ information needs in primary care practice....
Cnossen, Ingrid C; van Uden-Kraan, Cornelia F; Eerenstein, Simone E J; Jansen, Femke; Witte, Birgit I; Lacko, Martin; Hardillo, José A; Honings, Jimmie; Halmos, Gyorgy B; Goedhart-Schwandt, Noortje L Q; de Bree, Remco; Leemans, C René; Leeuw, Irma M Verdonck-de
The purpose of this study was to investigate the feasibility of an online self-care education program supporting early rehabilitation of patients after total laryngectomy (TLPs) and factors associated with satisfaction. Health care professionals (HCPs) were invited to participate and to recruit
Scott, Anne; Doughty, Carolyn
The concept of "care" has been fraught with negative connotations within the disability movement; the concepts of empowerment, choice and control have been developed as alternatives. The peer-support movement in the mental health sector draws from this tradition, and is uncomfortable with the provision of care. Drawing on the feminist ethic of…
Bäckström, Caroline A; Mårtensson, Lena B; Golsäter, Marie H; Thorstensson, Stina A
Pregnant women are not always satisfied with the professional support they receive during their midwifery care. More knowledge is needed to understand what professional support pregnant women need for childbirth and parenting. Childbearing and the transition to becoming a parent is a sensitive period in one's life during which one should have the opportunity to receive professional support. Professional support does not always correspond to pregnant women's needs. To understand pregnant women's needs for professional support within midwifery care, it is crucial to further illuminate women's experiences of this support. To explore pregnant women's perceptions of professional support in midwifery care. A qualitative study using semi-structured interviews. Fifteen women were interviewed during gestational weeks 36-38. Data was analysed using phenomenography. The women perceived professional support in midwifery care to be reassuring and emotional, to consist of reliable information, and to be mediated with pedagogical creativity. The professional support facilitated new social contacts, partner involvement and contributed to mental preparedness. The findings of the study were presented in six categories and the category Professional support contributes to mental preparedness was influenced by the five other categories. Pregnant women prepare for childbirth and parenting by using several different types of professional support in midwifery care: a strategy that could be described as piecing together a puzzle. When the women put the puzzle together, each type of professional support works as a valuable piece in the whole puzzle. Through this, professional support could contribute to women's mental preparedness for childbirth and parenting. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.
Monterosso, Leanne; Kristjanson, Linda J
To obtain feedback from parents of children who died from cancer about their understanding of palliative care, their experiences of palliative and supportive care received during their child's illness, and their palliative and supportive care needs. A qualitative study with semi-structured interviews. 24 parents from Perth (n = 10), Melbourne (n = 5), Brisbane (n = 5) and Sydney (n = 4). Five Australian tertiary paediatric oncology centres. Results Parents whose children died from cancer live within a context of chronic uncertainty and apprehension. Parents construed palliative care negatively as an independent process at the end of their children's lives rather than as a component of a wider and continuous process where children and their families are offered both curative and palliative care throughout the cancer trajectory. The concept of palliative care was perceived to be misunderstood by key health professionals involved in the care of the child and family. The importance and therapeutic value of authentic and honest relationships between health professionals and parents, and between health professionals and children were highlighted as a critical aspect of care. Also highlighted was the need to include children and adolescents in decision making, and for the delivery of compassionate end-of-life care that is sensitive to the developmental needs of the children, their parents and siblings. There is a need for health professionals to better understand the concept of palliative care, and factors that contribute to honest, open, authentic and therapeutic relationships of those concerned in the care of the dying child. This will facilitate a better understanding by both parents and their children with cancer, and acceptance of the integration of palliative and supportive care in routine cancer care.
Gould, Heather; Perrucci, Alissa; Barar, Rana; Sinkford, Danielle; Foster, Diana Greene
Little is known about how patient education and emotional support is provided at abortion facilities. This pilot study documents 27 facilities' practices in this aspect of abortion care. We conducted confidential telephone interviews with staff from 27 abortion facilities about their practices. The majority of facilities reported they rely primarily on trained nonclinician staff to educate patients and provide emotional support. As part of their informed consent and counseling processes, facilities reported that staff always provide patients with information about the procedure (96%), assess the certainty of their abortion decisions (92%), assess their feelings and provide emotional support (74%), and provide contraceptive health education (92%). Time spent providing these components of care varied across facilities and patients. When describing their facility's care philosophy, many respondents expressed support for "patient-centered," "supportive," "nonjudgmental" care. Eighty-two percent agreed that it is the facility's role to provide counseling for emotional issues related to abortion. All facilities valued informed consent, patient education, and emotional support. Although the majority of facilities considered counseling for emotional issues to be a part of their role, some did not. Future research should examine patients' preferences regarding abortion care and counseling and how different approaches to care affect women's emotional well-being after having an abortion. This information is important in light of current, widespread legislative efforts that aim to regulate abortion counseling, which are being proposed without an understanding of patient needs or facility practices. Copyright © 2012 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
Fishman, Jessica M; Greenberg, Patricia; Bagga, Margy Barbieri; Casarett, David; Propert, Kathleen
When attempting to share information about comfort-oriented care, many use "palliative," "supportive," and "hospice" care terminology interchangeably, but we lack evidence about the effects of using these different terms. This study was designed to test whether the use of "palliative," "supportive," or "hospice" terminology can improve the dissemination of information among breast cancer patients-a large and growing oncology population. Design, Setting, and Measurement: This experimental study was conducted at a major U.S. hospital serving a diverse population. Patients visiting a cancer clinic encountered opportunities to learn more about cancer care. They were offered health materials that were described as reporting on "palliative," "supportive," or "hospice" care and the primary outcome was whether a patient decided to select or reject each. As a secondary outcome, the study measured the patient's level of interest in receiving each. Compared with alternatives, materials labeled as "supportive" care were most likely to be selected and considered valuable (p value information labeled as being about "supportive" care was significantly more likely to be selected. If these effects are supported by additional research, there may be low-cost, highly feasible changes in language choice that increase the dissemination of relevant health information.
Tamers, Sara L.; Beresford, Shirley A.A.; Thompson, Beti; Zheng, Yingye; Cheadle, Allen D.
Objectives To explore the association of baseline co-worker social support with follow-up measures of health care use and sickness absence. Methods Data were obtained on 1,240 employees from 33 worksites, through Promoting Activity and Changes in Eating, a group randomized weight maintenance trial. Co-worker social support, health care utilization, and absenteeism were assessed via a self-reported questionnaire. Generalized Estimating Equations were employed using STATA version 10. Results Higher baseline co-worker social support was significantly associated with a greater number of doctors’ visits (p = 0.015). Co-worker social support was unrelated to number of hospitalizations, emergency room visits, or absenteeism. Conclusions The relationship between co-worker social support and health care utilization and absenteeism is complex and uncertain. Future studies should measure more specific outcomes, incorporate important mediating variables, and distill how social networks influence these outcomes. PMID:21685798
Haney, Linda L; Wright, Laurette
Applying management concepts from marketing and business sources can assist critical care units with establishing a planned change in the way nurses perform manual handling tasks, and thus, help insure that it is sustained.
Conclusions Patients and HCPs welcomed the introduction of agent technology to the delivery of health care. Widespread use will depend more on the trust patients place in their own GP than on technological issues.
We discuss the thesis that the implementation of a moral code in the behaviour of artificial intelligent systems needs a specific form of human and artificial intelligence, not just an abstract intelligence. We present intelligence as a system with an internal structure and the structural levels of the moral system, as well as certain characteristics of artificial intelligent agents which can/must be treated as 1- individual entities (with a complex, specialized, autonomous or selfdetermined,...
Ranade-Kharkar, Pallavi; Weir, Charlene; Norlin, Chuck; Collins, Sarah A; Scarton, Lou Ann; Baker, Gina B; Borbolla, Damian; Taliercio, Vanina; Del Fiol, Guilherme
Identify and describe information needs and associated goals of physicians, care coordinators, and families related to coordinating care for medically complex children and youth with special health care needs (CYSHCN). We conducted 19 in-depth interviews with physicians, care coordinators, and parents of CYSHCN following the Critical Decision Method technique. We analyzed the interviews for information needs posed as questions using a systematic content analysis approach and categorized the questions into information need goal types and subtypes. The Critical Decision Method interviews resulted in an average of 80 information needs per interview. We categorized them into 6 information need goal types: (1) situation understanding, (2) care networking, (3) planning, (4) tracking/monitoring, (5) navigating the health care system, and (6) learning, and 32 subtypes. Caring for CYSHCN generates a large amount of information needs that require significant effort from physicians, care coordinators, parents, and various other individuals. CYSHCN are often chronically ill and face developmental challenges that translate into intense demands on time, effort, and resources. Care coordination for CYCHSN involves multiple information systems, specialized resources, and complex decision-making. Solutions currently offered by health information technology fall short in providing support to meet the information needs to perform the complex care coordination tasks. Our findings present significant opportunities to improve coordination of care through multifaceted and fully integrated informatics solutions. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: email@example.com
Verkaik, Renate; van Antwerpen-Hoogenraad, Paulien; de Veer, Anke; Francke, Anneke; Huis In Het Veld, Judith
Background Self-management in patients and family caregivers confronted with dementia is not self-evident. Self-management skills may be limited because of the progressive cognitive decline of the patient and because family caregivers are often also very aged. Self-management support by nursing staff is therefore of paramount importance. Objectives To gain insight into how nursing staff perceive their self-management support tasks, and how they put them into practice. Research questions are: 'What are the opinions and experiences of Dutch nursing staff working in home care or residential elderly care regarding self-management support for people with dementia and their family caregivers?' and 'Do nursing staff feel sufficiently trained and skilled for self-management support?'. Methods A mixed methods approach was used, combining cross-sectional quantitative survey data from 206 Dutch nursing professionals with qualitative interviews among 12 nursing staff working in home care or residential elderly care in The Netherlands. Results Nursing staff working in home care experienced self-management support of people with dementia as a part of their job and as an attractive task. They consider 'helping people with dementia to maintain control over their lives by involving them in decisions in daily care' the essence of self-management support. Nursing staff saw family caregivers as their main partners in providing self-management support to the patient. They were less aware that family caregivers themselves might also need self-management support. Nursing staff often felt insufficiently trained to give adequate self-management support. RN's and CNA's did not differ in their opinions, experiences and training needs. Conclusions Nursing staff in home care do consider self-management support an important and attractive task in dementia care. Their skills for providing self-management support to patients with dementia and family caregivers need improvement. Recommendations
Hajli, M Nick; Shanmugam, Mohana; Hajli, Ali; Khani, Amir Hossein; Wang, Yichuan
The emergence of Web 2.0 technologies has already been influential in many industries, and Web 2.0 applications are now beginning to have an impact on health care. These new technologies offer a promising approach for shaping the future of modern health care, with the potential for opening up new opportunities for the health care industry as it struggles to deal with challenges including the need to cut costs, the increasing demand for health services and the increasing cost of medical technology. Social media such as social networking sites are attracting more individuals to online health communities, contributing to an increase in the productivity of modern health care and reducing transaction costs. This study therefore examines the potential effect of social technologies, particularly social media, on health care development by adopting a social support/transaction cost perspective. Viewed through the lens of Information Systems, social support and transaction cost theories indicate that social media, particularly online health communities, positively support health care development. The results show that individuals join online health communities to share and receive social support, and these social interactions provide both informational and emotional support.
Stuck, Rachel E; Rogers, Wendy A
As the population of older adults increase so will the need for care providers, both human and robot. Trust is a key aspect to establish and maintain a successful older adult-care provider relationship. However, due to trust volatility it is essential to understand it within specific contexts. This proposed mixed methods study will explore what dimensions of trust emerge as important within the human-human and human-robot dyads in older adults and care providers. First, this study will help identify key qualities that support trust in a care provider relationship. By understanding what older adults perceive as needing to trust humans and robots for various care tasks, we can begin to provide recommendations based on user expectations for design to support trust.
Larsen, Simon Bo
of the patient in collaboration with patient and home care clinicians. My main research method has been qualitative analysis of the empirical results generated during an experimental project using Participatory Design (PD) to investigate potential futures in the treatment of patients with diabetic foot ulcers...... the need arises for moving treatment and care involving specialised knowledge from the hospital to the home. In this dissertation I use the term Home Care" for the multidisciplinary investigation of how this movement can be supported with technology enabling the expert to carry on a treatment in the home...... approach that I outline in this dissertation. Furthermore I describe the results of the project contributing to three related scientific fields: home care technologies, telemedicine and computer supported cooperative work (CSCW). The main conclusion towards home care technologies is that the many visionary...
The "Supportive Housing for Homeless Families: Foster Care Outcomes and Best Practices" report describes the outcome evaluation of Cottage Housing Incorporated's Serna Village program in Sacramento, California. Serna Village is a supportive housing program serving homeless families. Outcomes from the program illustrate that it is…
Emmanuel Joseph Fong
Full Text Available Background. Recognizing the needs of cancer survivors is one of the important aspects in healthcare delivery. This study aimed to determine the prevalence of unmet supportive care needs and its associated factors among the breast cancer survivors of community-based support group in Kuching, Sarawak. Materials and Methods. This was a cross-sectional study using Supportive Care Needs Survey (SCNS-SF34. All the members of community-based breast cancer support groups in Kuching were invited. A total of 101 respondents were face-to-face interviewed after the consent was obtained. Data was entered and analyzed using SPSS version 20. Results. The respondents endorsed health system and information domain with the highest mean score (2.48; 95% CI: 2.32–2.64. Top 10 items with “moderate to high” level unmet needs had a prevalence of 14.9% to 34.7% of respondents indicating need. Significantly higher level of unmet needs was associated with survivors who were younger (less than 60 years old, had higher education attainment, were unemployed, had survival duration of up to 5 years, and were undergoing active treatment. Conclusion. Systematic delivery of health information which is targeted, culturally sensitive, and linguistically appropriate for addressing younger age, education level, employment status, length of survivorship, and treatment stage should be considered not only at hospital-based setting but also at the community-based support groups.
Schaap, Feija D; Fokkens, Andrea S; Dijkstra, Geke J; Reijneveld, Sijmen A; Finnema, Evelyn J
The number of people with intellectual disability and dementia increases; this combination causes behavioural changes. Dementia Care Mapping (DCM) supports staff in dementia care in nursing homes and may be useful in intellectual disability-care. This qualitative study examines the feasibility of DCM for older people with intellectual disability and dementia. The present authors obtained data in focus groups and interviews with professional users and analysed using a framework for feasibility studies. With experts in dementia and intellectual disability researches, the present authors determined the overall feasibility. DCM was found to be feasible in intellectual disability-care, regarding five domains of feasibility. Staff reported DCM to be useful and valuable and addresses to their demand for skills and knowledge. All professional users found DCM feasible in intellectual disability-care, which was confirmed by experts. DCM is feasible in intellectual disability-care. When fully tailored to intellectual disability-care, DCM is useful and provides opportunities to assess its effectiveness. © 2018 The Authors. Journal of Applied Research in Intellectual Disabilities Published by John Wiley & Sons Ltd.
Jefford, Michael; Gough, Karla; Drosdowsky, Allison; Russell, Lahiru; Aranda, Sanchia; Butow, Phyllis; Phipps-Nelson, Jo; Young, Jane; Krishnasamy, Mei; Ugalde, Anna; King, Dorothy; Strickland, Andrew; Franco, Michael; Blum, Robert; Johnson, Catherine; Ganju, Vinod; Shapiro, Jeremy; Chong, Geoffrey; Charlton, Julie; Haydon, Andrew; Schofield, Penelope
Colorectal cancer (CRC) and its treatments can cause distressing sequelae. We conducted a multicenter randomized controlled trial aiming to improve psychological distress, supportive care needs (SCNs), and quality of life (QOL) of patients with CRC. The intervention, called SurvivorCare (SC), comprised educational materials, needs assessment, survivorship care plan, end-of-treatment session, and three follow-up telephone calls. At the end of treatment for stage I-III CRC, eligible patients were randomized 1:1 to usual care (UC) or to UC plus SC. Distress (Brief Symptom Inventory 18), SCNs (Cancer Survivors' Unmet Needs measure), and QOL (European Organization for Research and Treatment of Cancer [EORTC] QOL questionnaires C30 and EORTC CRC module CR29) were assessed at baseline and at 2 and 6 months (follow-up 1 [FU1] and FU2, respectively). The primary hypothesis was that SC would have a beneficial effect on distress at FU1. The secondary hypotheses were that SC would have a beneficial effect on (a) SCN and QOL at FU1 and on (b) distress, SCNs, and QOL at FU2. A total of 15 items assessed experience of care. Of 221 patients randomly assigned, 4 were ineligible for the study and 1 was lost to FU, leaving 110 in the UC group and 106 in the SC group. Patients' characteristics included the following: median age, 64 years; men, 52%; colon cancer, 56%; rectal cancer, 35%; overlapping sites of disease, 10%; stage I disease, 7%; stage II, 22%; stage III, 71%. Baseline distress and QOL scores were similar to population norms. Between-group differences in distress at FU1 (primary outcome) and at FU2, and SCNs and QOL at FU1 and FU2 were small and nonsignificant. Patients in the SC group were more satisfied with survivorship care than those in the UC group (significant differences on 10 of 15 items). The addition of SC to UC did not have a beneficial effect on distress, SCNs, or QOL outcomes, but patients in the SC group were more satisfied with care. Some survivors of
Northcott, Sarah; Hilari, Katerina
There is often a need for increased support following a stroke. This study explored what types of support are provided by different network members and what support functions are most valued. Adults with first stroke were recruited from a stroke unit and participated in in-depth interviews 8-15 months poststroke. Framework Analysis was used to build thematic and explanatory accounts of the data. Twenty-nine participants took part. Main themes to emerge were as follows: the spouse was the most important provider of support; children were a relatively stable source of support, although many participants expressed reservations about worrying a child; relatives and friends typically provided social companionship and emotional support rather than on-going practical support. The only universally valued support function was the sense that someone was concerned and cared. Other valued functions were as follows: social companionship including everyday social "chit chat"; practical support provided sensitively; and, for many, sharing worries and sensitive encouragement. The manner and context in which support was provided was important: support was easiest to receive when it communicated concern, and was part of a reciprocal, caring relationship. As well as measuring supportive acts, researchers and clinicians should consider the manner and context of support. Implications for rehabilitation The manner in which support was provided mattered: support was easier to receive when it communicated concern. The spouse was the most important source of all support functions; children, relatives and friends were important providers of emotional and social companionship support. Researchers and clinicians should not only focus on what support is received, but also the context (e.g., contribution, reciprocity, quality of relationship) and manner (e.g., responsiveness, sensitivity) of the support.
Rachel E. Stuck
Full Text Available The older adult population is increasing worldwide, leading to an increased need for care providers. An insufficient number of professional caregivers will lead to a demand for robot care providers to mitigate this need. Trust is an essential element for older adults and robot care providers to work effectively. Trust is context dependent. Therefore, we need to understand what older adults would need to trust robot care providers, in this specific home-care context. This mixed methods study explored what older adults, who currently receive assistance from caregivers, perceive as supporting trust in robot care providers within four common home-care tasks: bathing, transferring, medication assistance, and household tasks. Older adults reported three main dimensions that support trust: professional skills, personal traits, and communication. Each of these had subthemes including those identified in prior human-robot trust literature such as ability, reliability, and safety. In addition, new dimensions perceived to impact trust emerged such as the robot’s benevolence, the material of the robot, and the companionability of the robot. The results from this study demonstrate that the older adult-robot care provider context has unique dimensions related to trust that should be considered when designing robots for home-care tasks.
Skinner, T. Chas; John, Mary; Hampson, Sarah E.
, well-being, and social support. Results: Perceived impact of diabetes and supportive family and friends were prospectively predictive of participants' well-being measures. Although support from family and friends was predictive of better dietary self-care, this relationship was mediated by personal...... of diabetes are important determinants of both dietary self-care and well-being. In addition, personal models may serve to mediate the relationship between social support and dietary behavior.......Objectives: To examine whether peer support and illness representation mediate the link between family support, self-management and well-being. Method: Fifty-two adolescents (12-18 years old) with Type I diabetes were recruited and followed over 6 months, completing assessments of self- management...
SOUTHWELL, EDWIN T.; GARCIA, MARIE L.; MEYERS, CHARLES E.
The(mu)ChemLab(trademark) Laboratory Directed Research and Development (LDRD) Grand Challenge project began in October 1996 and ended in September 2000. The technical managers of the(mu)ChemLab(trademark) project and the LDRD office, with the support of a consultant, conducted a competitive technical and market demand intelligence analysis of the(mu)ChemLab(trademark). The managers used this knowledge to make project decisions and course adjustments. CTI/MDI positively impacted the project's technology development, uncovered potential technology partnerships, and supported eventual industry partner contacts. CTI/MDI analysis is now seen as due diligence and the(mu)ChemLab(trademark) project is now the model for other Sandia LDRD Grand Challenge undertakings. This document describes the CTI/MDI analysis and captures the more important ''lessons learned'' of this Grand Challenge project, as reported by the project's management team
Moja, Lorenzo; Polo Friz, Hernan; Capobussi, Matteo; Kwag, Koren; Banzi, Rita; Ruggiero, Francesca; González-Lorenzo, Marien; Liberati, Elisa Giulia; Mangia, Massimo; Nyberg, Peter; Kunnamo, Ilkka; Cimminiello, Claudio; Vighi, Giuseppe; Grimshaw, Jeremy; Bonovas, Stefanos
Computerized decision support systems (CDSSs) are information technology-based software that provide health professionals with actionable, patient-specific recommendations or guidelines for disease diagnosis, treatment, and management at the point-of-care. These messages are intelligently filtered to enhance the health and clinical care of patients. CDSSs may be integrated with patient electronic health records (EHRs) and evidence-based knowledge. We designed a pragmatic randomized controlled trial to evaluate the effectiveness of patient-specific, evidence-based reminders generated at the point-of-care by a multi-specialty decision support system on clinical practice and the quality of care. We will include all the patients admitted to the internal medicine department of one large general hospital. The primary outcome is the rate at which medical problems, which are detected by the decision support software and reported through the reminders, are resolved (i.e., resolution rates). Secondary outcomes are resolution rates for reminders specific to venous thromboembolism (VTE) prevention, in-hospital all causes and VTE-related mortality, and the length of hospital stay during the study period. The adoption of CDSSs is likely to increase across healthcare systems due to growing concerns about the quality of medical care and discrepancy between real and ideal practice, continuous demands for a meaningful use of health information technology, and the increasing use of and familiarity with advanced technology among new generations of physicians. The results of our study will contribute to the current understanding of the effectiveness of CDSSs in primary care and hospital settings, thereby informing future research and healthcare policy questions related to the feasibility and value of CDSS use in healthcare systems. This trial is seconded by a specialty trial randomizing patients in an oncology setting (ONCO-CODES). ClinicalTrials.gov, https://clinicaltrials.gov/ct2
Conte, Kathleen P.; Schure, Marc B.; Goins, R. Turner
Objectives This study examined social support and identified demographic and health correlates among American Indians aged 55 years and older. Methods Data were derived from the Native Elder Care Study, a cross-sectional study of 505 community-dwelling American Indians aged ≥55 years. Social support was assessed using the Medical Outcomes Study Social Support Survey measure (MOS-SSS) of which psychometric properties were examined through factor analyses. Logistic regression analyses were used to identify associations between age, sex, educational attainment, marital status, depressive symptomatology, lower body physical functioning, and chronic pain and social support. Results Study participants reported higher levels of affectionate and positive interaction social support (88.2% and 81.8%, respectively) than overall (75.9%) and emotional (69.0%) domains. Increased age, being married/partnered, and female sex were associated with high social support in the final model. Decreased depressive symptomatology was associated with high overall, affectionate, and positive interaction support, and decreased chronic pain with affectionate support. The count of chronic conditions and functional disability were not associated with social support. Conclusions Overall, we found high levels of social support for both men and women in this population, with the oldest adults in our study exhibiting the highest levels of social support. Strong cultural values of caring for older adults and a historical tradition of community cooperation may explain this finding. Future public health efforts may be able to leverage social support to reduce health disparities and improve mental and physical functioning. PMID:25322933
Haas, Sheila A; Vlasses, Frances; Havey, Julia
There are multiple demands and challenges inherent in establishing staffing models in ambulatory heath care settings today. If health care administrators establish a supportive physical and interpersonal health care environment, and develop high-performing interprofessional teams and staffing models and electronic documentation systems that track performance, patients will have more opportunities to receive safe, high-quality evidence-based care that encourages patient participation in decision making, as well as provision of their care. The health care organization must be aligned and responsive to the community within which it resides, fully invested in population health management, and continuously scanning the environment for competitive, regulatory, and external environmental risks. All of these challenges require highly competent providers willing to change attitudes and culture such as movement toward collaborative practice among the interprofessional team including the patient.
Bettle, Amanda; Latimer, Margot; Fernandez, Conrad; Hughes, Jean
Children with acute lymphoblastic leukemia experience pain from the disease, treatment, and procedures. Parents can be effective in managing their child's pain, but little is systematically known about how they do this. Appreciative inquiry was used to frame the study within a strengths-based lens and interpretive descriptive methods were used to describe pain sources, parents' pain care role, and key structures supporting parents pain care involvement. Eight paediatric oncology clinic nurses and 10 parents participated. Six key themes per group were identified. Parent themes included establishing therapeutic relationships, relearning how to care for my child, overcoming challenges and recognizing pain, learning parent specific strategies, empowering to take active pain care role, and maintaining relationships. Nurse themes included establishing therapeutic relationships, preparing parents to care for their child, facilitating pain assessment, teaching parents best pain care, empowering parents, and maintaining relationships. These findings can be used to guide clinical practice and future research.
Full Text Available Introduction: In African countries, respiratory infections and severe sepsis are common causes of respiratory failure and mortality in children under five years of age. Mortality and morbidity in these children could be reduced with adequate respiratory support in the emergency care setting. The purpose of this review is to describe management priorities in the emergency care of critically ill children presenting with respiratory problems. Basic and advanced respiratory support measures are described for implementation according to available resources, work load and skill-levels. Methods: We did a focused search of respiratory support for critically ill children in resource-limited settings over the past ten years, using the search tools PubMed and Google Scholar, the latest WHO guidelines, international âAdvanced Paediatric Life Supportâ guidelines and paediatric critical care textbooks. Results: The implementation of triage and rapid recognition of respiratory distress and hypoxia with pulse oximetry is important to correctly identify critically ill children with increased risk of mortality in all health facilities in resource constrained settings. Basic, effective airway management and respiratory support are essential elements of emergency care. Correct provision of supplemental oxygen is safe and its application alone can significantly improve the outcome of critically ill children. Non-invasive ventilatory support is cost-effective and feasible, with the potential to improve emergency care packages for children with respiratory failure and other organ dysfunctions. Non-invasive ventilation is particularly important in severely under-resourced regions unable to provide intubation and invasive mechanical ventilation support. Malnutrition and HIV-infection are important co-morbid conditions, associated with increased mortality in children with respiratory dysfunction. Discussion: A multi-disciplinary approach is required to optimise
Douglas, Tracy; Redley, Bernice; Ottmann, Goetz
To describe the support needs of parents caring for a child with an intellectual disability in the first year of life. Parents of children with intellectual disabilities face significant challenges during the first year of their child's life which is an important developmental period not previously addressed in the literature. The provision of support by health professionals, particularly nurses and midwives, during this crucial period can impact on parental well-being and on the health and developmental outcomes of their children. However, parents often feel unsupported. The study used a qualitative descriptive methodology. Semi-structured interviews were conducted with parents of eleven children with an intellectual disability in Victoria, Australia, during 2014. Interviews were digitally recorded, transcribed verbatim and analysed using thematic data analysis. Three key areas of support need were identified to assist parents to provide effective care for their child with an intellectual disability in the first year of life: (1) emotional support as parents adjusted to their role of caring for a child with an intellectual disability; (2) information support as they embarked on a quest for knowledge; and (3) support to facilitate their connection to peer networks. The findings highlighted inconsistent provision of support for parents. This study informs health professionals about how to provide holistic, timely support to parents of children with intellectual disabilities in the first year of life. There is an urgent need to review how nurses and midwives can provide relevant support that is responsive to parents' needs. © 2016 John Wiley & Sons Ltd.
Bindels, Jill; Cox, Karen; De La Haye, Jean; Mevissen, Ger; Heijing, Servé; van Schayck, Onno C P; Widdershoven, Guy; Abma, Tineke A
The objective of this study was to evaluate whether care provided in the care programmes matched the needs of older people. Care programmes were implemented in primary-care settings in the Netherlands to identify frail older people and to prevent further deterioration of health. In total, 23 older people participated in in-depth interviews. Within this study, three older people participated as co-researchers; they gathered and analysed the data together with the academic researchers. Content analysis was used to analyse the data. Two categories emerged from the data: 'Losing connections' and 'Receiving support to reconnect.' 'Losing connections' reflects the needs of older people and 'Receiving support to reconnect' reflects their experience and the appreciated aspects of the provided care. A relationship of trust with the practice nurse (PN) appeared to be an important aspect of care, as it fostered the sharing of feelings and issues other than physical or medical problems that could not be shared with the general practitioner. The PNs are experienced as connectors, who help to restore feelings of connectedness and older peoples' access to resources in the community. The relationship with the PN was experienced as valuable because of the feelings of 'connectedness' it created. Through this connectedness, older people could discuss feelings of loneliness, depression and frustration in receiving and acquiring the appropriate resources and services with the PNs. Furthermore, the relationship with the PN helped the older people to gain access to other health professionals and services. The results imply that care for frail older people should include an awareness of the importance of the trusting relationship. Nurses can play a vital role in creating a trusting relationship and are able to bridge the gap between older people and other professionals and services. © 2014 John Wiley & Sons Ltd.
Higgins, P; Murray, M L; Williams, E M
This descriptive, retrospective study examined levels of self-esteem, social support, and satisfaction with prenatal care in 193 low-risk postpartal women who obtained adequate and inadequate care. The participants were drawn from a regional medical center and university teaching hospital in New Mexico. A demographic questionnaire, the Coopersmith self-esteem inventory, the personal resource questionnaire part 2, and the prenatal care satisfaction inventory were used for data collection. Significant differences were found in the level of education, income, insurance, and ethnicity between women who received adequate prenatal care and those who received inadequate care. Women who were likely to seek either adequate or inadequate prenatal care were those whose total family income was $10,000 to $19,999 per year and high school graduates. Statistically significant differences were found in self-esteem, social support, and satisfaction between the two groups of women. Strategies to enhance self-esteem and social support have to be developed to reach women at risk for receiving inadequate prenatal care.
Abidli, Yamine; Piette, Danielle; Casini, Annalisa
There is a broad consensus on the importance for health professionals to support co-active patients. However, in practice, very few "patient care partnership" approaches have been developed. We hypothesized that the lack of investment in supporting patient care partnerships is due to the lack of interest in the skills needed by caregivers to provide such support. This paper intends to address thisgap. The patient care partnership method is studied, adapted and developed from existing models. It complements, harmonizes and integrates various schools of thought arising from the need to place the patient at the center of care and life in general. The patient care partnership method includes 7 stages during which the professional accompanies the patient through the process of care. The methodological approach for training professionals is designed to ensure that professionals experience the change as well as its difficulties of the change they expect from the patient in the care relationship. This method now needs to be validated by the experience of other professionals in order define the limits of application and to allow further development.
Rogers, M; Zach, L; An, Y; Dalrymple, P
This paper reports on work carried out to elicit information needs at a trans-disciplinary, nurse-managed health care clinic that serves a medically disadvantaged urban population. The trans-disciplinary model provides a "one-stop shop" for patients who can receive a wide range of services beyond traditional primary care. However, this model of health care presents knowledge sharing challenges because little is known about how data collected from the non-traditional services can be integrated into the traditional electronic medical record (EMR) and shared with other care providers. There is also little known about how health information technology (HIT) can be used to support the workflow in such a practice. The objective of this case study was to identify the information needs of care providers in order to inform the design of HIT to support knowledge sharing and distributed decision making. A participatory design approach is presented as a successful technique to specify requirements for HIT applications that can support a trans-disciplinary model of care. Using this design approach, the researchers identified the information needs of care providers working at the clinic and suggested HIT improvements to integrate non-traditional information into the EMR. These modifications allow knowledge sharing among care providers and support better health decisions. We have identified information needs of care providers as they are relevant to the design of health information systems. As new technology is designed and integrated into various workflows it is clear that understanding information needs is crucial to acceptance of that technology.
Lennox, Nicholas; Van Driel, Mieke L; van Dooren, Kate
The vast health inequities experienced by people with intellectual disability remain indisputable. Persistent and contemporary challenges exist for primary healthcare providers and researchers working to contribute to improvements to the health and well-being of people with intellectual disability. Over two decades after the only review of supports for primary healthcare providers was published, this paper contributes to an evolving research agenda that aims to make meaningful gains in health-related outcomes for this group. The present authors updated the existing review by searching the international literature for developments and evaluations of multinational models of care. Based on our review, we present three strategies to support primary healthcare providers: (i) effectively using what we know, (ii) considering other strategies that offer support to primary healthcare professionals and (iii) researching primary health care at the system level. Strengthening primary care by supporting equitable provision of health-related care for people with intellectual disability is a much needed step towards improving health outcomes among people with intellectual disability. More descriptive quantitative and qualitative research, as well as intervention-based research underpinned by rigorous mixed-methods evaluating these strategies at the primary care level, which is sensitive to the needs of people with intellectual disability will assist primary care providers to provide better care and achieve better health outcomes. Many people with intellectual disability have poor health. The authors reviewed what has been written by other researchers about how to improve the health of people with intellectual disability. In the future, people who support adults with intellectual disability should continue doing what they do well, think of other ways to improve health, and do more research about health. At all times, the needs of people with intellectual disability should be the
Battersby, Malcolm; Von Korff, Michael; Schaefer, Judith; Davis, Connie; Ludman, Evette; Greene, Sarah M; Parkerton, Melissa; Wagner, Edward H
Recommendations to improve self-management support and health outcomes for people with chronic conditions in primary care settings are provided on the basis of expert opinion supported by evidence for practices and processes. Practices and processes that could improve self-management support in primary care were identified through a nominal group process. In a targeted search strategy, reviews and meta-analyses were then identifed using terms from a wide range of chronic conditions and behavioral risk factors in combination with Self-Care, Self-Management, and Primary Care. On the basis of these reviews, evidence-based principles for self-management support were developed. The evidence is organized within the framework of the Chronic Care Model. Evidence-based principles in 12 areas were associated with improved patient self-management and/or health outcomes: (1) brief targeted assessment, (2) evidence-based information to guide shared decision-making, (3) use of a nonjudgmental approach, (4) collaborative priority and goal setting, (5) collaborative problem solving, (6) self-management support by diverse providers, (7) self-management interventions delivered by diverse formats, (8) patient self-efficacy, (9) active followup, (10) guideline-based case management for selected patients, (11) linkages to evidence-based community programs, and (12) multifaceted interventions. A framework is provided for implementing these principles in three phases of the primary care visit: enhanced previsit assessment, a focused clinical encounter, and expanded postvisit options. There is a growing evidence base for how self-management support for chronic conditions can be integrated into routine health care.
Hack, Thomas F; Crooks, Dauna; Plohman, James; Kepron, Emma
The purpose of this study was to conduct a historical review of psycho-oncology and supportive care research in Canada using citation analysis and to review the clinical impact of the research conducted by the most highly cited researchers. The lifetime journal publication records of 109 psycho-oncology and supportive care researchers in Canada were subject to citation analysis using the Scopus database, based on citations since 1996 of articles deemed relevant to psychosocial oncology and supportive care, excluding self-citations. Three primary types of analysis were performed for each individual: the number of citations for each journal publication, a summative citation count of all published articles, and the Scopus h-index. The top 20 psycho-oncology/supportive care researchers for each of five citation categories are presented: the number of citations for all publications; the number of citations for first-authored publications; the most highly cited first-authored publications; the Scopus h-index for all publications; and the Scopus h-index for first-authored publications. The three most highly cited Canadian psycho-oncology researchers are Dr. Kerry Courneya (University of Alberta), Dr. Lesley Degner, (University of Manitoba), and Dr. Harvey Chochinov (University of Manitoba). Citation analysis is useful for examining the research performance of psycho-oncology and supportive care researchers and identifying leaders among them.
Bérubé, Sarah; Mouillard, Florine; Amesse, Claudine; Sultan, Serge
In pediatric hemophilia, caregivers are facing unique challenges to adherence and self-care in children and adolescents with hemophilia. Hemophilia treatment requires adequate prophylaxis and on-demand treatment, as well as a clear behavioral strategy to limit risk-taking in terms of physical exercise and diet. Medication adherence rates of hemophilia patients have been reported to decrease during late childhood and adolescence. In the developing child, moving safely from parent-care to self-care is one of the greatest challenges of integrative care within this domain. There is a clear need for initiatives designed to increase an individual's motivation for treatment and self-care activities. Among motivational approaches, the self-determination perspective offers a useful framework to explain how the transition to self-care can be facilitated. We discuss how motivation regarding hemophilia treatment may be increased through parental autonomy support and we offer examples of applied communication techniques to facilitate autonomy-supportive caregiving. Although it has not yet been tested in the context of hemophilia, these communication techniques could potentially help caregivers promote adherence and self-care in children. Confronted by unique challenges to adherence and self-care, caregivers of children with hemophilia should move from an exclusive focus on illness-management education to an integrative strategy, including motivation-enhancing communication. The self-determination perspective provides important proximal objectives (e.g. autonomy support) to maintain optimal adherence in adolescents as they move from parent-care to self-care. Future research initiatives should address the practice of these communication techniques and evaluate them in the context of hemophilia.
Igor Vyacheslavovich Buzaev
Full Text Available Objective: The continuous uninterrupted feedback system is the essential part of any well-organized system. We propose aLYNX concept that is a possibility to use an artificial intelligence algorithm or a neural network model in decision-making system so as to avoid possible mistakes and to remind the doctors to review tactics once more in selected cases. Method: aLYNX system includes: registry with significant factors, decisions and results; machine learning process based on this registry data; the use of the machine learning results as the adviser. We show a possibility to build a computer adviser with a neural network model for making a choice between coronary aortic bypass surgery (CABG and percutaneous coronary intervention (PCI in order to achieve a higher 5-year survival rate in patients with angina based on the experience of 5107 patients. Results: The neural network was trained by 4679 patients who achieved 5-year survival. Among them, 2390 patients underwent PCI and 2289 CABG. After training, the correlation coefficient (r of the network was 0.74 for training, 0.67 for validation, 0.71 for test and 0.73 for total. Simulation of the neural network function has been performed after training in the two groups of patients with known 5-year outcome. The disagreement rate was significantly higher in the dead patient group than that in the survivor group between neural network model and heart team [16.8% (787/4679 vs. 20.3% (87/428, P = 0.065]. Conclusion: The study shows the possibility to build a computer adviser with a neural network model for making a choice between CABG and PCI in order to achieve a higher 5-year survival rate in patients with angina. Keywords: Coronary artery bypass grafting, Percutaneous coronary intervention, Artificial intelligence, Decision making
Strauss, Shiela M.; Munoz-Plaza, Corrine; Tiburcio, Nelson J.; Maisto, Stephen A.; Conigliaro, Joseph; Gwadz, Marya; Lunievicz, Joseph; Norman, Robert
Although HIV care providers are strategically situated to support their patients’ alcohol reduction efforts, many do not do so, sometimes failing to view this support as consistent with their roles. Using data collected from 112 HIV providers in 7 hospital-based HIV Care Centers in the NYC metropolitan area, this paper examines the correlates of providers’ role legitimacy as patients’ alcohol reduction supporters. Results indicate that providers (1) responsible for a very large number of patients and (2) those with limited confidence in their own ability to give this assistance, but high confidence in their program's ability to do so, were less likely to have a high level of role legitimacy as patients’ alcohol reduction supporters. Findings suggest the types of providers to target for alcohol reduction support training. PMID:20556238
SIGINT), human intelligence (HUMINT), open source intelligence , ( OSINT ), and measurement and signatures intelligence (MASINT). All sources progress...the underlying principles of MASINT technologies and the operators and analysts who have intelligence questions that MASINT sources may be able to...integrity, analysts should instead use these sources of MASINT in support of less time-sensitive intelligence problems. Through creative or
Information Technology Quarterly, 1985
This issue of "Information Technology Quarterly" is devoted to the theme of "Artificial Intelligence." It contains two major articles: (1) Artificial Intelligence and Law" (D. Peter O'Neill and George D. Wood); (2) "Artificial Intelligence: A Long and Winding Road" (John J. Simon, Jr.). In addition, it contains two sidebars: (1) "Calculating and…
Full Text Available Type 2 diabetes mellitus is a major public health problem with many elements, such as self-care and social support, that could be interacting with its evolution. Nevertheless, there is no evidence of association between these two elements. Thus, this study aims to determine the relationship between medical, nutritional and physical activity self-care, perceived social support and duration of the disease. A cross-sectional Study was conducted on 126 people with diabetes with a mean age of 55 (±10.4 years old. The Summary of Diabetes Self-Care Activities Scale and the Medical Outcomes Study (MOS Social Support Survey were applied. Social support, specifically the instrumental one, may generate negative effects by limiting self-care behavior of a person. Based on these findings, it is possible to conclude that social support does not always turn out to be beneficial for people: having more instrumental support generates dependency and no responsibility on the diet.
Qian, Yi; Hou, Zhiyuan; Wang, Wei; Zhang, Donglan; Yan, Fei
Initiatives on integrated care between hospitals and community health centers (CHCs) have been introduced to transform the current fragmented health care delivery system into an integrated system in China. Up to date no research has analyzed in-depth the experiences of these initiatives based on perspectives from various stakeholders. This study analyzed the integrated care pilot in Hangzhou City by investigating stakeholders' perspectives on its design features and supporting environment, their acceptability of this pilot, and further identifying the enabling and constraining factors that may influence the implementation of the integrated care reform. The qualitative study was carried out based on in-depth interviews and focus group discussions with 50 key informants who were involved in the policy-making process and implementation. Relevant policy documents were also collected for analysis. The pilot in Hangzhou was established as a CHC-led delivery system based on cooperation agreement between CHCs and hospitals to deliver primary and specialty care together for patients with chronic diseases. An innovative learning-from-practice mentorship system between specialists and general practitioners was also introduced to solve the poor capacity of general practitioners. The design of the pilot, its governance and organizational structure and human resources were enabling factors, which facilitated the integrated care reform. However, the main constraining factors were a lack of an integrated payment mechanism from health insurance and a lack of tailored information system to ensure its sustainability. The integrated care pilot in Hangzhou enabled CHCs to play as gate-keeper and care coordinator for the full continuum of services across the health care providers. The government put integrated care a priority, and constructed an efficient design, governance and organizational structure to enable its implementation. Health insurance should play a proactive role, and
Reblin, Maija; Otis-Green, Shirley; Ellington, Lee; Clayton, Margaret F
Although there is growing recognition of the importance of integrating spirituality within health care, there is little evidence to guide clinicians in how to best communicate with patients and family about their spiritual or existential concerns. Using an audio-recorded home hospice nurse visit immediately following the death of a patient as a case-study, we identify spiritually-sensitive communication strategies. The nurse incorporates spirituality in her support of the family by 1) creating space to allow for the expression of emotions and spiritual beliefs and 2) encouraging meaning-based coping, including emphasizing the caregivers' strengths and reframing negative experiences. Hospice provides an excellent venue for modeling successful examples of spiritual communication. Health care professionals can learn these techniques to support patients and families in their own holistic practice. All health care professionals benefit from proficiency in spiritual communication skills. Attention to spiritual concerns ultimately improves care. © The Author(s) 2014.
Achterbergh, J.M.I.M.; Vriens, D.J.; Vriens, D.J.
In this chapter, we explore the role of simulation games for intelligence activities. Although games have been used in intelligence activities, the contribution of building and using simulation games to Competitive Intelligence has, to our knowledge, not been examined thoroughly. In this chapter we
Franklin, Brandi E.; Crisler, S. Crile; Shappley, Rebekah; Armour, Meri M.; McCommon, Dana T.; Ferry, Robert J.
OBJECTIVE The study seeks to improve access for underserved patients via novel integration of Pedi-Flite (a critical care transport team) and to validate whether this safely enhances diabetes care and effectively expands the endocrine workforce. RESEARCH DESIGN AND METHODS The study retrospectively analyzed pager service use in a cohort of established diabetic patients (n = 979) after inception of Pedi-Flite support. Outcomes included incidence and severity of recurrent diabetic ketoacidosis ...
Fitzmaurice, D A; Hobbs, F D; Murray, E T; Bradley, C P; Holder, R
BACKGROUND: Increasing indications for oral anticoagulation has led to pressure on general practices to undertake therapeutic monitoring. Computerized decision support (DSS) has been shown to be effective in hospitals for improving clinical management. Its usefulness in primary care has previously not been investigated. AIM: To test the effectiveness of using DSS for oral anticoagulation monitoring in primary care by measuring the proportions of patients adequately controlled, defined as with...
Gillard, Steve; Edwards, Christine; White, Sarah; White, Rachel; Adams, Katie; Davies, Lucy; Green, Katherine; Kettle, Trevor; Lathlean, Judith; Lucock, Mike; Miller, Stephen; Minogue, Virginia; Nugent, Christine; Simons, Lucy; Turner, Kati
Background\\ud The Department of Health has prioritised the need to support individuals in the care they take to maintain their own mental health (2005). Research onthe effectiveness of a variety of self care interventions has been reviewed (DH 2007). Challenges to changing from a culture of ‘doing for’ to ‘doing\\ud with’ have been identified (Wilson 2005).\\ud \\ud We use a theoretical framework derived from organisational research to explore how health service organisations change (Edwards 200...
Pétala Tuani Candido de Oliveira Salvador
Full Text Available ABSTRACT Objective: to describe the content validation process of a Virtual Learning Object to support the teaching of nursing care systematization to nursing professionals. Method: methodological study, with quantitative approach, developed according to the methodological reference of Pasquali's psychometry and conducted from March to July 2016, from two-stage Delphi procedure. Results: in the Delphi 1 stage, eight judges evaluated the Virtual Object; in Delphi 2 stage, seven judges evaluated it. The seven screens of the Virtual Object were analyzed as to the suitability of its contents. The Virtual Learning Object to support the teaching of nursing care systematization was considered valid in its content, with a Total Content Validity Coefficient of 0.96. Conclusion: it is expected that the Virtual Object can support the teaching of nursing care systematization in light of appropriate and effective pedagogical approaches.
Full Text Available Effective methods of secondary prevention after stroke or TIA are available but adherence to recommended evidence-based treatments is often poor. The study aimed to determine the quality of secondary prevention in usual care and to develop a stepwise modeled support program.Two consecutive cohorts of patients with acute minor stroke or TIA undergoing usual outpatient care versus a secondary prevention program were compared. Risk factor control and medication adherence were assessed in 6-month follow-ups (6M-FU. Usual care consisted of detailed information concerning vascular risk factor targets given at discharge and regular outpatient care by primary care physicians. The stepwise modeled support program additionally employed up to four outpatient appointments. A combination of educational and behavioral strategies was employed.168 patients in the observational cohort who stated their openness to participate in a prevention program (mean age 64.7 y, admission blood pressure (BP: 155/84 mmHg and 173 patients participating in the support program (mean age 67.6 y, BP: 161/84 mmHg were assessed at 6 months. Proportions of patients with BP according to guidelines were 50% in usual-care and 77% in the support program (p<0.01. LDL<100 mg/dl was measured in 62 versus 71% (p = 0.12. Proportions of patients who stopped smoking were 50 versus 79% (p<0.01. 72 versus 89% of patients with atrial fibrillation were on oral anticoagulation (p = 0.09.Risk factor control remains unsatisfactory in usual care. Targets of secondary prevention were met more often within the supported cohort. Effects on (cerebro-vascular recurrence rates are going to be assessed in a multicenter randomized trial.
Lancman, Selma; Gonçalves, Rita Maria de Abreu; Cordone, Nicole Guimarães; Barros, Juliana de Oliveira
To understand the organization of and the working conditions in family health care support centers, as well as subjective experiences related to work in two of these centers. This was a case study carried out during 2011 and 2012 in two family health care support centers in Sao Paulo, Southeastern Brazil. Data were collected and analyzed using two theoretical-methodological references from ergonomics and work psychodynamics influenced, respectively, by ergonomic work analysis, developed based on open observations of a variety of tasks and on interviews and in practice in work psychodynamics, carried out using think tanks about the work. The work of the Family Health Care Support Centers in question is constituted on the bases of complex, diversified actions to be shared among the various professionals and teams involved. Innovative technological tools, which are not often adopted by primary health care professionals, are used and the parameters and productivity measures do not encompass the specificity and the complexity of the work performed. These situations require constant organizational rearrangement, especially between the Family Health Care Support Centers and the Family Health Care Teams, causing difficulties in carrying out the work as well as in constituting the identity of the professionals studied. The study attempts to lend greater visibility to the work processes at the Family Health Care Support Centers in order to contribute to advances in public policy on primary healthcare. It is important to stress that introducing changes at work, which affect both its organization and work conditions, is above all a commitment, which to be effective, must be permanent and must involve the different levels of hierarchy.
Codier, Estelle; Codier, David
A significant body of research suggests there is a correlation between measured emotional intelligence (EI) abilities and performance in nursing. The four critical elements of EI, namely the abilities to identify emotions correctly in self and others, using emotions to support reasoning, understanding emotions and managing emotions, apply to emergency care settings and are important for safe patient care, teamwork, retention and burnout prevention. This article describes 'emotional labour' and the importance of EI abilities for emergency nurses, and suggests that such abilities should be considered core competencies for the profession.
Katbamna, Savita; Bhakta, Padma; Ahmad, Waqar; Baker, Richard; Parker, Gillian
BACKGROUND: Demographic and socioeconomic changes have increased policy interest in informal carers. However, despite the multicultural nature of British society, most research in this field has been in majority communities. AIM: To explore the role of the primary health care team (PHCT) in supporting carers from British South Asian communities. DESIGN OF STUDY: Qualitative study. SETTING: Four South Asian communities in Leicestershire and West Yorkshire. METHODS: Focus groups and in-depth in...
Brady, Anne-Marie; Ennis, Shauna; Prendergast, Maebh; Quirke, Mary; Bhangu, Jas; Lynch, Aine; Byrne, Gobnait
Introduction: The out-of-hours period is associated with less favourable patient health outcomes as well as unpredictable workloads and reduced support structures for clinical activity. In particular, appropriate skill mix, staff numbers, resources, communication structures and access to diagnostic services can influence patient safety and risk. As part of continued efforts to improve patient care and hospital management, one major academic hospital is in Ireland has been engaged in work re-d...
Gupta, Avirup; Craig, Tom K J
People suffering from schizophrenia have markedly increased physical morbidity and mortality. A poor diet and sedentary lifestyle make a significant contribution to this ill health. Healthcare professionals need to include assessments of diet and to promote a 'healthy living' lifestyle. To describe the dietary habits and cardiovascular risk factors of people with chronic schizophrenia living in supported accommodation and to audit the provision of cardiovascular health screening in this population. The dietary habits of 69 people with chronic schizophrenia living in community settings were assessed. Tobacco smoking, body mass indices and waist circumference were also measured. The dietary behaviour of patients living in high care settings with care staff present every day was compared with those in low care settings. Residents in both levels of care made poor dietary choices. Patients in high care were consuming more fast food than those in low care. The dietary habits of men and women in both levels of care were worse than reported by surveys of the general population in England. All patients had seen their GP in the previous year though only 3 had received diabetes screening and fewer than half had lipid profiles. People with schizophrenia do not improve their diet just by the provision of healthy food as was the case in high care settings. Secondary care services must address physical health monitoring as well as mental health if the increased mortality of patients with schizophrenia is to be addressed effectively. More effective interventions are necessary to improve and sustain a healthy diet.
Grace Haeson Park
Full Text Available Background: A major effort is underway to integrate primary and community care in Canada's western province of British Columbia and in Fraser Health, its largest health authority. Integrated care is a critical component of Fraser Health's planning, to meet the challenges of caring for a growing, elderly population that is presenting more complex and chronic medical conditions. Description of integrated practice: An integrated care model partners family physicians with community-based home health case managers to support frail elderly patients who live at home. It is resulting in faster response times to patient needs, more informed assessments of a patient's state of health and pro-active identification of emerging patient issues. Early results: The model is intended to improve the quality of patient care and maintain the patients’ health status, to help them live at home confidently and safely, as long as possible. Preliminary pilot data measuring changes in home care services is showing positive trends when it comes to extending the length of a person's survival/tenure in the community (living in their home vs. admitted to residential care or deceased. Conclusion: Fraser Health's case manager–general practitioner partnership model is showing promising results including higher quality, appropriate, coordinated and efficient care; improved patient, caregiver and physician interactions with the system; improved health and prevention of acute care visits by senior adult patients.
Svetlana A. Mukhortova
Full Text Available Improving the quality of medical care is a priority in countries with developed and developing health care system. There are various approaches to improve the quality and safety of patient’s care, as well as various strategies to encourage hospitals to achieve this goal. The purpose of the presented literature review was to analyze existing experience of the implementation of technology of supportive supervision in health care facilities to improve the quality of hospital care delivery. The data sources for publication were obtained from the following medical databases: PubMed, Cochrane Library, Medscape, e-library, and books on the topic of the review written by experts. The article discusses the results of the research studies demonstrating the successes and failures of supportive supervision technology application. Implementation of supportive supervision in medical facilities based on generalized experience of different countries is a promising direction in improving the quality of medical care delivery. This technology opens up opportunities to improve skills and work quality of the staff at pediatric hospitals in the Russian Federation.
Estabrooks, Carole A; Morgan, Debra G; Squires, Janet E; Boström, Anne-Marie; Slaughter, Susan E; Cummings, Greta G; Norton, Peter G
Defining what constitutes a resident care unit in nursing home research is both a conceptual and practical challenge. The aim of this paper is to provide evidence in support of a definition of care unit in nursing homes by demonstrating: (1) its feasibility for use in data collection, (2) the acceptability of aggregating individual responses to the unit level, and (3) the benefit of including unit level data in explanatory models. An observational study design was used. Research (project) managers, healthcare aides, care managers, nursing home administrators and directors of care from thirty-six nursing homes in the Canadian prairie provinces of Alberta, Saskatchewan and Manitoba provided data for the study. A definition of care unit was developed and applied in data collection and analyses. A debriefing session was held with research managers to investigate their experiences with using the care unit definition. In addition, survey responses from 1258 healthcare aides in 25 of the 36 nursing homes in the study, that had more than one care unit, were analyzed using a multi-level modeling approach. Trained field workers administered the Alberta Context Tool (ACT), a 58-item self-report survey reflecting 10 organizational context concepts, to healthcare aides using computer assisted personal interviews. To assess the appropriateness of obtaining unit level scores, we assessed aggregation statistics (ICC(1), ICC(2), η², and ω²), and to assess the value of using the definition of unit in explanatory models, we performed multi-level modeling. In 10 of the 36 nursing homes, the care unit definition developed was used to align the survey data (for analytic purposes) to specific care units as designated by our definition, from that reported by the facility administrator. The aggregation statistics supported aggregating the healthcare aide responses on the ACT to the realigned unit level. Findings from the multi-level modeling further supported unit level aggregation. A
Shared electronic health and social care records in some service systems are already showing some of the benefits of digital technology and digital data for integrating health and social care. These records are one example of the beginning “digitalisation” of services that gives a glimpse of the potential of digital technology and systems for building coordinated and individualized integrated care. Yet the promise has been greater than the benefits, and progress has been slow compared to other industries. This paper describes for non-technical readers how information technology was used to support integrated care schemes in six EU services, and suggests practical ways forward to use the new opportunities to build person-centered integrated care. PMID:29588629
Full Text Available Shared electronic health and social care records in some service systems are already showing some of the benefits of digital technology and digital data for integrating health and social care. These records are one example of the beginning “digitalisation” of services that gives a glimpse of the potential of digital technology and systems for building coordinated and individualized integrated care. Yet the promise has been greater than the benefits, and progress has been slow compared to other industries. This paper describes for non-technical readers how information technology was used to support integrated care schemes in six EU services, and suggests practical ways forward to use the new opportunities to build person-centered integrated care.
Crespo, Richard; Shrewsberry, Molly
The purpose of this article is to expand the understanding of self-management support by describing factors that contribute to implementing a comprehensive self-management program in primary care. Four rural health centers in medically underserved areas participated in a study to document the implementation of a self-management program. This program consisted of a social marketing plan and decision-making tools to guide patients in making self-management behavior changes. The stages of change constructs of the transtheoretical model were used to design the social marketing plan. Key informant interviews were conducted at 6-month and 9-month intervals to document the implementation process. A standardized set of questions was used in the interviews. The data from the interviews were analyzed using content analysis techniques. One of the principle findings is that self-management support requires putting a system in place, not just adding a new component to primary care. The health centers that fully implemented the self-management program made an organizational commitment to keep self-management on the agenda in management meetings, clinical staff set the example by adopting self-management behaviors, and patient self-management support was implemented in multiple patient care venues. Primary care centers with limited financial resources are able to integrate self-management support into their system of chronic illness care.
Clarkson, Paul; Hughes, Jane; Roe, Brenda; Giebel, Clarissa M; Jolley, David; Poland, Fiona; Abendstern, Michele; Chester, Helen; Challis, David
The aim of this study was to explicate the outcomes of home support interventions for older people with dementia and/or their carers to inform clinical practice, policy and research. Most people with dementia receive support at home. However, components and effectiveness of home support interventions have been little explored. Systematic review with narrative summary. Electronic searches of published studies in English using PubMed, Cochrane Central Register of Controlled Trials, PsychINFO, CINAHL, Applied Social Science Index and CSA Social Services Abstracts. Databases and sources were searched from inception to April 2014 with no date restrictions to locate studies. The PRISMA statement was followed and established systematic review methods used. Using 14 components of care for people with dementia and their carers, identified previously, data across studies were synthesized. Interventions were grouped and described and effectiveness ratings applied. Qualitative studies were synthesized using key themes. Seventy studies (four qualitative) were included. Most were directed to carers and of high quality. Seven interventions for carers and two for people with dementia were identified, covering 81% of studies. Those relating to daily living, cognitive training and physical activity for people with dementia were absent. Measures of effectiveness were influenced mainly by the intensity (duration and frequency) of interventions. Those containing education, social support and behaviour management appeared most effective. These interventions reflect emergent patterns of home support. Research is required to identify effective interventions linked to the stage of dementia, which can be applied as part of routine clinical care. © 2017 John Wiley & Sons Ltd.
Marschollek, Michael; Bott, Oliver J; Wolf, Klaus-H; Gietzelt, Matthias; Plischke, Maik; Madiesh, Moaaz; Song, Bianying; Haux, Reinhold
The demographic change with a rising proportion of very old people and diminishing resources leads to an intensification of the use of telemedicine and home care concepts. To provide individualized decision support, data from different sources, e.g. vital signs sensors and home environmental sensors, need to be combined and analyzed together. Furthermore, a standardized decision support approach is necessary. The aim of our research work is to present a laboratory prototype home care architecture that integrates data from different sources and uses a decision support system based on the HL7 standard Arden Syntax for Medical Logical Modules. Data from environmental sensors connected to a home bus system are stored in a data base along with data from wireless medical sensors. All data are analyzed using an Arden engine with the medical knowledge represented in Medical Logic Modules. Multi-modal data from four different sensors in the home environment are stored in a single data base and are analyzed using an HL7 standard conformant decision support system. Individualized home care decision support must be based on all data available, including context data from smart home systems and medical data from electronic health records. Our prototype implementation shows the feasibility of using an Arden engine for decision support in a home setting. Our future work will include the utilization of medical background knowledge for individualized decision support, as there is no one-size-fits-all knowledge base in medicine.
Alhuwail, Dari; Koru, Güneş; Mills, Mary Etta
In the United States, home care clinicians often start the episode of care devoid of relevant fall-risk information. By collecting and analyzing qualitative data from 30 clinicians in one home health agency, this case study aimed to understand how the currently adopted information technology solutions supported the clinicians' fall-risk management (FRM) information domains, and explored opportunities to adopt other solutions to better support FRM. The currently adopted electronic health record system and fall-reporting application served only some information domains with a limited capacity. Substantial improvement in addressing the FRM information domains is possible by effectively modifying the existing solutions and purposefully adopting new solutions.
Nyman, Samuel Robert; Innes, Anthea; Heward, Michelle
This study explored the social care and support needs of people with dementia and visual impairment, and the barriers and facilitators for meeting these needs. Twenty-six semi-structured interviews were conducted: 21 joint and 5 individual interviews with the person with dementia and visual impairment (n=4) or their family/paid carer (n=1). Interviews were analysed thematically. Three themes are presented. (1) Social care needs: having dementia can reduce an individual's ability to cope with their visual impairment, and lead to increased dependency and reduced daily stimulation. (2) Barriers to using technology to meet social care needs: difficulties were reported with learning to use unfamiliar technology and the cost of visual impairment aids, and for some, the presence of dementia made visual impairment aids unusable and vice versa. (3) Familiarity as a facilitator for meeting social care needs: living at home or taking furnishings and ornaments into a new home facilitated independence, and continuity of paid carers/volunteers facilitated the caring relationship between the individual and staff/volunteer. Care workers will better serve older people if they are aware of the social care and support needs that arise from having both dementia and visual impairment.
Vuik, Sabine I; Mayer, Erik K; Darzi, Ara
Integrated care aims to organize care around the patient instead of the provider. It is therefore crucial to understand differences across patients and their needs. Segmentation analysis that uses big data can help divide a patient population into distinct groups, which can then be targeted with care models and intervention programs tailored to their needs. In this article we explore the potential applications of patient segmentation in integrated care. We propose a framework for population strategies in integrated care-whole populations, subpopulations, and high-risk populations-and show how patient segmentation can support these strategies. Through international case examples, we illustrate practical considerations such as choosing a segmentation logic, accessing data, and tailoring care models. Important issues for policy makers to consider are trade-offs between simplicity and precision, trade-offs between customized and off-the-shelf solutions, and the availability of linked data sets. We conclude that segmentation can provide many benefits to integrated care, and we encourage policy makers to support its use. Project HOPE—The People-to-People Health Foundation, Inc.
Full Text Available Abstract Background Indigenous Australians experience disproportionately high prevalence of, and morbidity and mortality from chronic illness such as diabetes, renal disease and cardiovascular disease. Improving the understanding of how Indigenous primary care systems are organised to deliver chronic illness care will inform efforts to improve the quality of care for Indigenous people. Methods This cross-sectional study was conducted in 12 Indigenous communities in Australia's Northern Territory. Using the Chronic Care Model as a framework, we carried out a mail-out survey to collect information on material, financial and human resources relating to chronic illness care in participating health centres. Follow up face-to-face interviews with health centre staff were conducted to identify successes and difficulties in the systems in relation to providing chronic illness care to community members. Results Participating health centres had distinct areas of strength and weakness in each component of systems: 1 organisational influence – strengthened by inclusion of chronic illness goals in business plans, appointment of designated chronic disease coordinators and introduction of external clinical audits, but weakened by lack of training in disease prevention and health promotion and limited access to Medicare funding; 2 community linkages – facilitated by working together with community organisations (e.g. local stores and running community-based programs (e.g. "health week", but detracted by a shortage of staff especially of Aboriginal health workers working in the community; 3 self management – promoted through patient education and goal setting with clients, but impeded by limited focus on family and community-based activities due to understaffing; 4 decision support – facilitated by distribution of clinical guidelines and their integration with daily care, but limited by inadequate access to and support from specialists; 5 delivery system
Neville, Ron G; Greene, Alexandra C; Lewis, Sue
To explore patient and health care professional (HCP) views towards the use of multi-agent computer systems in their GP practice. Qualitative analysis of in-depth interviews and analysis of transcriptions. Urban health centre in Dundee, Scotland. Five representative healthcare professionals and 11 patients. Emergent themes from interviews revealed participants' attitudes and beliefs, which were coded and indexed. Patients and HCPs had similar beliefs, attitudes and views towards the implementation of multi-agent systems (MAS). Both felt modern communication methods were useful to supplement, not supplant, face-to-face consultations between doctors and patients. This was based on the immense trust these patients placed in their doctors in this practice, which extended to trust in their choice of communication technology and security. Rapid access to medical information increased patients' sense of shared partnership and self-efficacy. Patients and HCPs expressed respect for each other's time and were keen to embrace technology that made interactions more efficient, including for the altruistic benefit of others less technically competent. Patients and HCPs welcomed the introduction of agent technology to the delivery of health care. Widespread use will depend more on the trust patients place in their own GP than on technological issues.
Schäfer, Nicole; Karutz, Harald; Schenk, Olaf
Background Advances in neonatal care have reduced mortality but increased morbidity in babies born pre-maturely or after high-risk pregnancies. However, this often increases the burden on the family and the parents in particular. A systematic review of the literature was conducted that demonstrated the importance of psychosocial support for parents of children in neonatal care. Methods A systematic search of Pubmed, Psyndex, CINAHI and medpilot was conducted. Reference lists of the included articles were also searched for relevant publications. A free-text search found further publications. Together, 78 publications (from 1975-2015) were included in our review. Results A shift from a biomedical model and child-centred treatment to family-centred care has already taken place in neonatal care. However, there is still a considerable gap between theory and practice. Although there is awareness of the need for psychosocial support of parents, the focus of day-to-day care is still on medical interventions and life-supporting treatment for the child. In particular, while the importance of an assessment of needs as a basis for family-centred psychosocial support appears to be well-known, validated screening instruments are rarely used. In addition, the demand for psychosocial support of parents is not just solely determined by the child's medical risk. Conclusions The results highlight the challenges of delivering individualised psychosocial support to families within a healthcare system of limited resources, with practitioners having to take into account the developing parent-child relationship as well as health economics. In future, psychosocial support should be based on evidence rather than intuition. Attachment theory and research, and health psychology can contribute to this development. © Georg Thieme Verlag KG Stuttgart · New York.
Rønn, Kira Vrist
Questions concerning what constitutes a morally justified conduct of intelligence activities have received increased attention in recent decades. However, intelligence ethics is not yet homogeneous or embedded as a solid research field. The aim of this article is to sketch the state of the art...... of intelligence ethics and point out subjects for further scrutiny in future research. The review clusters the literature on intelligence ethics into two groups: respectively, contributions on external topics (i.e., the accountability of and the public trust in intelligence agencies) and internal topics (i.......e., the search for an ideal ethical framework for intelligence actions). The article concludes that there are many holes to fill for future studies on intelligence ethics both in external and internal discussions. Thus, the article is an invitation – especially, to moral philosophers and political theorists...
Guest, Ella; Griffiths, Catrin; Harcourt, Diana
A burn can have a significant and long-lasting psychosocial impact on a patient and their family. The National Burn Care Standards (2013) recommend psychosocial support should be available in all UK burn services; however, little is known about how it is provided. The current study aimed to explore experiences of psychosocial specialists working in UK burn care, with a focus on the challenges they experience in their role. Semi-structured telephone interviews with eight psychosocial specialists (two psychotherapists and six clinical psychologists) who worked within UK burn care explored their experiences of providing support to patients and their families. Thematic analysis revealed two main themes: burn service-related experiences and challenges reflected health professionals having little time and resources to support all patients; reduced patient attendance due to them living large distances from service; psychosocial appointments being prioritised below wound-related treatments; and difficulties detecting patient needs with current outcome measures. Therapy-related experiences and challenges outlined the sociocultural and familial factors affecting engagement with support, difficulties treating patients with pre-existing mental health conditions within the burn service and individual differences in the stage at which patients are amenable to support. Findings provide an insight into the experiences of psychosocial specialists working in UK burn care and suggest a number of ways in which psychosocial provision in the NHS burn service could be developed.
Full Text Available Countries aiming to reduce their tuberculosis (TB burden by 2035 to the levels envisaged by the World Health Organization End TB Strategy need to innovate, with approaches such as digital health (electronic and mobile health in support of patient care, surveillance, programme management, training and communication. Alongside the large-scale roll-out required for such interventions to make a significant impact, products must stay abreast of advancing technology over time. The integration of artificial intelligence into new software promises to make processes more effective and efficient, endowing them with a potential hitherto unimaginable. Users can benefit from artificial intelligence-enabled pattern recognition software for tasks ranging from reading radiographs to adverse event monitoring, sifting through vast datasets to personalise a patient's care plan or to customise training materials. Many experts forecast the imminent transformation of the delivery of healthcare services. We discuss how artificial intelligence and machine learning could revolutionise the management of TB.
Doshi, Riddhi; Falzon, Dennis; Thomas, Bruce V; Temesgen, Zelalem; Sadasivan, Lal; Migliori, Giovanni Battista; Raviglione, Mario
Countries aiming to reduce their tuberculosis (TB) burden by 2035 to the levels envisaged by the World Health Organization End TB Strategy need to innovate, with approaches such as digital health (electronic and mobile health) in support of patient care, surveillance, programme management, training and communication. Alongside the large-scale roll-out required for such interventions to make a significant impact, products must stay abreast of advancing technology over time. The integration of artificial intelligence into new software promises to make processes more effective and efficient, endowing them with a potential hitherto unimaginable. Users can benefit from artificial intelligence-enabled pattern recognition software for tasks ranging from reading radiographs to adverse event monitoring, sifting through vast datasets to personalise a patient's care plan or to customise training materials. Many experts forecast the imminent transformation of the delivery of healthcare services. We discuss how artificial intelligence and machine learning could revolutionise the management of TB.
Falzon, Dennis; Thomas, Bruce V.; Temesgen, Zelalem; Sadasivan, Lal; Raviglione, Mario
Countries aiming to reduce their tuberculosis (TB) burden by 2035 to the levels envisaged by the World Health Organization End TB Strategy need to innovate, with approaches such as digital health (electronic and mobile health) in support of patient care, surveillance, programme management, training and communication. Alongside the large-scale roll-out required for such interventions to make a significant impact, products must stay abreast of advancing technology over time. The integration of artificial intelligence into new software promises to make processes more effective and efficient, endowing them with a potential hitherto unimaginable. Users can benefit from artificial intelligence-enabled pattern recognition software for tasks ranging from reading radiographs to adverse event monitoring, sifting through vast datasets to personalise a patient's care plan or to customise training materials. Many experts forecast the imminent transformation of the delivery of healthcare services. We discuss how artificial intelligence and machine learning could revolutionise the management of TB. PMID:28656130
Mar 5, 2018 ... environments of human life exposed to great dangers such as support and repair in .... intelligent control interfaces, network quality of service, shared resources and ..... Artificial Intelligence series, volume 6556, p. 336-349 ...
Nijholt, Antinus; Reidsma, Dennis; Poppe, Ronald Walter; Aghajan, H.; López-Cózar Delgado, R.; Augusto, J.C.
In future ambient intelligence (AmI) environments we assume intelligence embedded in the environment and its objects (floors, furniture, mobile robots). These environments support their human inhabitants in their activities and interactions by perceiving them through sensors (proximity sensors,