A method for assessing fidelity of delivery of telephone behavioral support for smoking cessation.

Science.gov (United States)

Lorencatto, Fabiana; West, Robert; Bruguera, Carla; Michie, Susan

2014-06-01

Behavioral support for smoking cessation is delivered through different modalities, often guided by treatment manuals. Recently developed methods for assessing fidelity of delivery have shown that face-to-face behavioral support is often not delivered as specified in the service treatment manual. This study aimed to extend this method to evaluate fidelity of telephone-delivered behavioral support. A treatment manual and transcripts of 75 audio-recorded behavioral support sessions were obtained from the United Kingdom's national Quitline service and coded into component behavior change techniques (BCTs) using a taxonomy of 45 smoking cessation BCTs. Interrater reliability was assessed using percentage agreement. Fidelity was assessed by comparing the number of BCTs identified in the manual with those delivered in telephone sessions by 4 counselors. Fidelity was assessed according to session type, duration, counselor, and BCT. Differences between self-reported and actual BCT use were examined. Average coding reliability was high (81%). On average, 41.8% of manual-specified BCTs were delivered per session (SD = 16.2), with fidelity varying by counselor from 32% to 49%. Fidelity was highest in pre-quit sessions (46%) and for BCT "give options for additional support" (95%). Fidelity was lowest for quit-day sessions (35%) and BCT "set graded tasks" (0%). Session duration was positively correlated with fidelity (r = .585; p reliably coded in terms of BCTs. This can be used to assess fidelity to treatment manuals and to in turn identify training needs. The observed low fidelity underlines the need to establish routine procedures for monitoring delivery of behavioral support. PsycINFO Database Record (c) 2014 APA, all rights reserved.

NDT-based bridge condition assessment supported by expert tools

Science.gov (United States)

Bień, J.; KuŻawa, M.

2016-06-01

This paper is focused on the progress in the application of Expert Tools supporting integration of inspection and NDT testing findings in order to effectuate effective decision making by bridge owners. Possibilities of knowledge representation in the intelligent computer Expert Tools by means of the multi-level hybrid network technology are described. These multi-level hybrid networks can be built of neural, fuzzy and functional components depending on the problem that needs to be solved and on the type of available information. Application of the technology is illustrated by an example of the Bridge Evaluation Expert Function (BEEF) implemented in the Railway Bridge Management System "SMOK" operated by the Polish State Railways.

Mums 4 Mums: structured telephone peer-support for women experiencing postnatal depression. Pilot and exploratory RCT of its clinical and cost effectiveness

Directory of Open Access Journals (Sweden)

McKenzie-McHarg Kirstie

2011-03-01

Full Text Available Abstract Background Postnatal depression (PND can be experienced by 13% of women who give birth, and such women often exhibit disabling symptoms, which can have a negative effect on the mother and infant relationship, with significant consequences in terms of the child's later capacity for affect regulation. Research has shown that providing support to mothers experiencing PND can help reduce their depressive symptoms and improve their coping strategies. The Mums4Mums study aims to evaluate the impact of telephone peer-support for women experiencing PND. Methods/Design The study design adopts the MRC framework for the development and evaluation of complex interventions. Health visitors in Warwickshire and Coventry Primary Care Trusts are screening potential participants at the 8-week postnatal check using either the Edinburgh Postnatal Depression Scale (EPDS > = 10 or the three Whooley questions recommended by NICE (http://guidance.nice.org.uk/CG45. The Mums4Mums telephone support intervention is being delivered by trained peer-supporters over a period of four months. The primary outcome is depressive symptomatology as measured by the Edinburgh Postnatal Depression Scale. Secondary outcomes include mother-child interaction, dyadic adjustment, parenting sense of competence scale, and self-efficacy. Maternal perceptions of the telephone peer-support are being assessed using semi-structured interviews following the completion of the intervention. Discussion The proposed study will develop current innovative work in peer-led support interventions and telecare by applying existing expertise to a new domain (i.e. PND, testing the feasibility of a peer-led telephone intervention for mothers living with PND, and developing the relationship between the lay and clinical communities. The intervention will potentially benefit a significant number of patients and support a future application for a larger study to undertake a full evaluation of the clinical

The relationship between geographic remoteness and intentions to use a telephone support service among Australian men following radical prostatectomy.

Science.gov (United States)

Corboy, Denise; McLaren, Suzanne; Jenkins, Megan; McDonald, John

2014-11-01

The objective is to investigate the influence of characteristics related to place of residence (self-reliance and stoicism) on men's intentions to use a telephone support service following radical prostatectomy. A community sample of 447 prostate cancer patients (31% response), recruited via Medicare Australia, completed a survey to assess levels of self-reliance and stoicism, and beliefs about addressing emotional distress through using telephone support services. Results indicated that the model was a partially mediated model. Geographic remoteness was directly related to intention, and indirectly related through stoicism and subjective norms. Men from rural and remote areas in Australia might face particular challenges in seeking support following treatment for prostate cancer. These challenges appear to relate to the influence of stoic attitudes and normative expectations, than to issues of access and availability. Addressing stoic attitudes in the clinical setting, through normalising emotional reactions to cancer diagnosis and treatment, and the act of help-seeking for emotional support, may be beneficial. Copyright © 2014 John Wiley & Sons, Ltd.

An Expert support model for ex situ soil remediation

NARCIS (Netherlands)

Okx, J.P.; Frankhuizen, E.M.; Wit, de J.C.; Pijls, C.G.J.M.; Stein, A.

2000-01-01

This paper presents an expert support model recombining knowledge and experience obtained during ex situ soil remediation. To solve soil remediation problems, an inter-disciplinary approach is required. Responsibilities during the soil remediation process, however, are increasingly decentralised,

Using Your VOICE(S: Adding Telephonic Communication to Pharmacy Education

Directory of Open Access Journals (Sweden)

Lorin B Grieve

2017-06-01

Full Text Available Pharmacists utilize a myriad of communication methods to deliver patient care. One of the most prevalent communication methods is the telephone. The University of Pittsburgh School of Pharmacy created a novel instructional and assessment technique to enhance student pharmacist training experiences in telephonic communication within the PharmD curriculum. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties   Type: Note

Automatic seismic support design of piping system by an object oriented expert system

International Nuclear Information System (INIS)

Nakatogawa, T.; Takayama, Y.; Hayashi, Y.; Fukuda, T.; Yamamoto, Y.; Haruna, T.

1990-01-01

The seismic support design of piping systems of nuclear power plants requires many experienced engineers and plenty of man-hours, because the seismic design conditions are very severe, the bulk volume of the piping systems is hyge and the design procedures are very complicated. Therefore we have developed a piping seismic design expert system, which utilizes the piping design data base of a 3 dimensional CAD system and automatically determines the piping support locations and support styles. The data base of this system contains the maximum allowable seismic support span lengths for straight piping and the span length reduction factors for bends, branches, concentrated masses in the piping, and so forth. The system automatically produces the support design according to the design knowledge extracted and collected from expert design engineers, and using design information such as piping specifications which give diameters and thickness and piping geometric configurations. The automatic seismic support design provided by this expert system achieves in the reduction of design man-hours, improvement of design quality, verification of design result, optimization of support locations and prevention of input duplication. In the development of this system, we had to derive the design logic from expert design engineers and this could not be simply expressed descriptively. Also we had to make programs for different kinds of design knowledge. For these reasons we adopted the object oriented programming paradigm (Smalltalk-80) which is suitable for combining programs and carrying out the design work

The telephone in family practice | Furman | South African Medical ...

African Journals Online (AJOL)

In a time-and-motion study in family practice it was found that 35,8% of all patient contact was per telephone. The study further revealed that 12,3% of total practice time was spent on the telephone, stressing its importance as a useful tool. in family practice. The study supports others which suggest that 'telephone medicine' ...

An expert support model for in situ soil remediation

NARCIS (Netherlands)

Okx, J.P.; Stein, A.

2000-01-01

This article presents an expert support model for in situ soil remediation. It combines knowledge and experiences obtained from previous in situ soil remediations. The aim of this model is to optimise knowledge transfer among the various parties involved in contaminated site management. Structured

Is age a factor in the success or failure of remote monitoring in heart failure? Telemonitoring and structured telephone support in elderly heart failure patients.

Science.gov (United States)

Inglis, Sally C; Conway, Aaron; Cleland, John Gf; Clark, Robyn A

2015-06-01

There are few data regarding the effectiveness of remote monitoring for older people with heart failure. We conducted a post-hoc sub-analysis of a previously published large Cochrane systematic review and meta-analysis of relevant randomized controlled trials to determine whether structured telephone support and telemonitoring were effective in this population. A post hoc sub-analysis of a systematic review and meta-analysis that applied the Cochrane methodology was conducted. Meta-analyses of all-cause mortality, all-cause hospitalizations and heart failure-related hospitalizations were performed for studies where the mean or median age of participants was 70 or more years. The mean or median age of participants was 70 or more years in eight of the 16 (n=2659/5613; 47%) structured telephone support studies and four of the 11 (n=894/2710; 33%) telemonitoring studies. Structured telephone support (RR 0.80; 95% CI=0.63-1.00) and telemonitoring (RR 0.56; 95% CI=0.41-0.76) interventions reduced mortality. Structured telephone support interventions reduced heart failure-related hospitalizations (RR 0.81; 95% CI=0.67-0.99). Despite a systematic bias towards recruitment of individuals younger than the epidemiological average into the randomized controlled trials, older people with heart failure did benefit from structured telephone support and telemonitoring. These post-hoc sub-analysis results were similar to overall effects observed in the main meta-analysis. While further research is required to confirm these observational findings, the evidence at hand indicates that discrimination by age alone may be not be appropriate when inviting participation in a remote monitoring service for heart failure. © The European Society of Cardiology 2014.

Development of a selection support expert system of mathematical models for dynamic simulation of liquid-vapor two-phase flow

International Nuclear Information System (INIS)

Gofuku, Akio; Shimizu, Kenji; Sugano, Keiji; Morimoto, Takashi; Yoshikawa, Hidekazu; Wakabayashi, Jiro

1992-01-01

This paper deals with computerized supporting techniques of a numerical simulation of complex and large-scale engineering systems like nuclear power plants. As an example of the intelligent support systems of dynamic simulation, a prototype expert system is developed on an expert system development tool to support the selection of mathematical model which is a first step of numerical simulation and is required both wide expert knowledge and high-level decision making. The expert system supports the selection of liquid-vapor two phase flow models (fluid model and constitutive equations) consistent with simulation purpose and condition in the case of thermal-hydraulic simulation of nuclear power plants. The possibility of the expert system is examined for various selection support cases by both investigation of the appropriateness of the selection support logic and comparison between support results and decision results of several experts. (author)

Decision support systems and expert systems for risk and safety analysis

International Nuclear Information System (INIS)

Baybutt, P.

1986-01-01

During the last 1-2 years, rapid developments have occurred in the development of decision support systems and expert systems to aid in decision making related to risk and safety of industrial plants. These activities are most noteworthy in the nuclear industry where numerous systems are under development with implementation often being made on personal computers. An overview of some of these developments is provided, and an example of one recently developed decision support system is given. This example deals with CADET, a system developed to aid the U.S. Nuclear Regulatory Commission in making decisions related to the topical issue of source terms resulting from degraded core accidents in light water reactors. The paper concludes with some comments on the likely directions of future developments in decision support systems and expert systems to aid in the management of risk and safety in industrial plants. (author)

Parenting program versus telephone support for Mexican parents of children with acquired brain injury: A blind randomized controlled trial.

Science.gov (United States)

Chávez, Clara; Catroppa, Cathy; Hearps, Stephen J C; Yáñez-Téllez, Guillermina; Prieto-Corona, Belén; de León, Miguel A; García, Antonio; Sandoval-Lira, Lucero; Anderson, Vicki

2017-09-01

Acquired brain injury (ABI) during childhood typically causes behavior problems in the child and high levels of stress in the family. The aims of this study are: (1) to investigate the effectiveness and feasibility of a parenting intervention in improving behavior and self-regulation in Mexican children with ABI compared to telephone support; (2) to investigate the effectiveness and feasibility of a parenting intervention in improving parenting skills, parent self-efficacy and decreasing parental stress in parents of children with ABI compared to telephone support. Our secondary aims are (1) to explore the impact that parent characteristics have on the intervention outcomes; (2) to investigate if changes are maintained 3 months after the intervention. The research design is a blind randomized controlled trial (RCT). Eligible participants include children with a diagnosis of ABI, between 6 and 12 years of age, and their parents. Sixty-six children and their parents will be randomly allocated to either a parenting program group or telephone support group. The parenting program involves six face-to-face weekly group sessions of 2.5 h each. Participants in the control group receive an information sheet with behavioral strategies, and six weekly phone calls, in which strategies to improve academic skills are provided. Children and their parents are evaluated by blind assessors before the intervention, immediately after the intervention and 3-months post-intervention. This study will be the first to evaluate the efficacy and feasibility of a parenting program for Mexican parents of children with ABI. ACTRN12617000360314.

Clinical decision support improves quality of telephone triage documentation--an analysis of triage documentation before and after computerized clinical decision support.

Science.gov (United States)

North, Frederick; Richards, Debra D; Bremseth, Kimberly A; Lee, Mary R; Cox, Debra L; Varkey, Prathibha; Stroebel, Robert J

2014-03-20

Clinical decision support (CDS) has been shown to be effective in improving medical safety and quality but there is little information on how telephone triage benefits from CDS. The aim of our study was to compare triage documentation quality associated with the use of a clinical decision support tool, ExpertRN©. We examined 50 triage documents before and after a CDS tool was used in nursing triage. To control for the effects of CDS training we had an additional control group of triage documents created by nurses who were trained in the CDS tool, but who did not use it in selected notes. The CDS intervention cohort of triage notes was compared to both the pre-CDS notes and the CDS trained (but not using CDS) cohort. Cohorts were compared using the documentation standards of the American Academy of Ambulatory Care Nursing (AAACN). We also compared triage note content (documentation of associated positive and negative features relating to the symptoms, self-care instructions, and warning signs to watch for), and documentation defects pertinent to triage safety. Three of five AAACN documentation standards were significantly improved with CDS. There was a mean of 36.7 symptom features documented in triage notes for the CDS group but only 10.7 symptom features in the pre-CDS cohort (p < 0.0001) and 10.2 for the cohort that was CDS-trained but not using CDS (p < 0.0001). The difference between the mean of 10.2 symptom features documented in the pre-CDS and the mean of 10.7 symptom features documented in the CDS-trained but not using was not statistically significant (p = 0.68). CDS significantly improves triage note documentation quality. CDS-aided triage notes had significantly more information about symptoms, warning signs and self-care. The changes in triage documentation appeared to be the result of the CDS alone and not due to any CDS training that came with the CDS intervention. Although this study shows that CDS can improve documentation, further study is needed

Expert system for compressor maintenance support; Sistema especialista para apoio a manutencao de compressores

Energy Technology Data Exchange (ETDEWEB)

Silva, Jonny Carlos da [Universidade Federal de Santa Catarina (UFSC), Florianopolis, SC (Brazil). Dept. de Engenharia Mecanica; Caletti, Luciano [KEOHPS - Knowledge Engineering on Hydraulic and Pneumatic System, SC (Brazil); Luna, Paulo de T.M. [Universidade Regional de Blumenau - FURB, SC (Brazil)

2004-07-01

The performance of critical machines in industrial processes, such as compressors used in industrial plants, is fundamental for overall company operation. In this context, it becomes strategic the application of methods and tools to support the operation and maintenance of the most relevant process equipment. Among these computational tools are the Expert Systems, which aim to emulate the decision making process of human experts in a specific knowledge domain. In Oil and Gas domain, an example of such tools is the SEGRED project, which combines expert system techniques with dynamic simulation of transport and distribution natural gas networks. The SECOMP project, Expert System for Compressor Maintenance, is considered a spin-off of the SEGRED. Its objective is to develop an expert system to support maintenance activities, aiming to increase reliability, improve performance and reduce maintenance and operational costs. This article presents the first phase of the SECOMP project, which is related to the development of an expert system prototype for corrective maintenance of natural gas reciprocating compressors. The paper discusses the context of this knowledge domain, the prototype development and its potential contribution in an industrial environment. (author)

Expert system technology to support emergency response: its prospects and limitations

International Nuclear Information System (INIS)

Belardo, S.; Wallace, W.A.

1988-01-01

The capabilities for computer technologies to provide decision support in emergency response are now well recognized. The information flow prior to, during, and after potentially catastrophic events must be managed in order to have effective response. We feel strongly that computer technology can be a crucial component in this management process. We will first review a relatively new facet of computer technology - expert systems. We will then provide a conceptual framework for decision making under crisis, a situation typified by emergency response. We follow with a discussion of a prototype expert system for response to an accident at a nuclear power generation facility. Our final section discusses the potential advantages and limitations of expert system technology in emergency response. (author)

Efficacy and experiences of telephone counselling for informal carers of people with dementia.

Science.gov (United States)

Lins, Sabine; Hayder-Beichel, Daniela; Rücker, Gerta; Motschall, Edith; Antes, Gerd; Meyer, Gabriele; Langer, Gero

2014-09-01

Informal carers of people with dementia can suffer from depressive symptoms, emotional distress and other physiological, social and financial consequences. This review focuses on three main objectives:To:1) produce a quantitative review of the efficacy of telephone counselling for informal carers of people with dementia;2) synthesize qualitative studies to explore carers' experiences of receiving telephone counselling and counsellors' experiences of conducting telephone counselling; and3) integrate 1) and 2) to identify aspects of the intervention that are valued and work well, and those interventional components that should be improved or redesigned. The Cochrane Dementia and Cognitive Improvement Group's Specialized Register, The Cochrane Library, MEDLINE, MEDLINE in Process, EMBASE, CINAHL, PSYNDEX, PsycINFO, Web of Science, DIMDI databases, Springer database, Science direct and trial registers were searched on 3 May 2011 and updated on 25 February 2013. A Forward Citation search was conducted for included studies in Web of Science and Google Scholar. We used the Related Articles service of PubMed for included studies, contacted experts and hand-searched abstracts of five congresses. Randomised controlled trials (RCTs) or cross-over trials that compared telephone counselling for informal carers of people with dementia against no treatment, usual care or friendly calls for chatting were included evaluation of efficacy. Qualitative studies with qualitative methods of data collection and analysis were also included to address experiences with telephone counselling. Two authors independently screened articles for inclusion criteria, extracted data and assessed the quantitative trials with the Cochrane 'Risk of bias' tool and the qualitative studies with the Critical Appraisal Skills Program (CASP) tool. The authors conducted meta-analyses, but reported some results in narrative form due to clinical heterogeneity. The authors synthesised the qualitative data and

Report on a Program Evaluation of a Telephone Assisted Parenting Support Service for Families Living in Isolated Rural Areas.

Science.gov (United States)

Cann, Warren; Rogers, Helen; Worley, Greg

2003-01-01

This brief report evaluates a pilot project to deliver a telephone supported, self-directed parenting program to isolated families. The aim of the project was to promote the competence and confidence of parents experiencing early difficulties. Significant improvements were noted in child behavior, parenting style, parental depression, anxiety, and…

The effectiveness of telephone counselling and internet- and text-message-based support for smoking cessation

DEFF Research Database (Denmark)

Skov-Ettrup, Lise S; Dalum, Peter; Bech, Mickael

2016-01-01

counselling group compared with the booklet group (7.3% vs. 3.6%, OR=2.2 (95% CI 1.2-4.0)), There was no clear evidence of a difference in prolonged abstinence between the reactive telephone counselling group or the internet-based smoking cessation program and the booklet group: 1.8% vs. 3.6%, OR=0.8 (95% CI...... 0.6-1.2) and 5.3% vs. 3.6%, OR=1.6 (95% CI 0.8-3.0) respectively. In the proactive telephone counselling group, the cost per additional 12-month quitter compared with the booklet group was £644. CONCLUSIONS: Proactive telephone counselling was more effective than a self-help booklet in achieving......AIM: To compare the effectiveness of proactive telephone counselling, reactive telephone counselling and an internet- and text messages-based intervention with a self-help booklet for smoking cessation. DESIGN: A randomised controlled trial with equal allocation to four conditions: 1) Proactive...

Integrating clinicians, knowledge and data: expert-based cooperative analysis in healthcare decision support.

Science.gov (United States)

Gibert, Karina; García-Alonso, Carlos; Salvador-Carulla, Luis

2010-09-30

Decision support in health systems is a highly difficult task, due to the inherent complexity of the process and structures involved. This paper introduces a new hybrid methodology Expert-based Cooperative Analysis (EbCA), which incorporates explicit prior expert knowledge in data analysis methods, and elicits implicit or tacit expert knowledge (IK) to improve decision support in healthcare systems. EbCA has been applied to two different case studies, showing its usability and versatility: 1) Bench-marking of small mental health areas based on technical efficiency estimated by EbCA-Data Envelopment Analysis (EbCA-DEA), and 2) Case-mix of schizophrenia based on functional dependency using Clustering Based on Rules (ClBR). In both cases comparisons towards classical procedures using qualitative explicit prior knowledge were made. Bayesian predictive validity measures were used for comparison with expert panels results. Overall agreement was tested by Intraclass Correlation Coefficient in case "1" and kappa in both cases. EbCA is a new methodology composed by 6 steps:. 1) Data collection and data preparation; 2) acquisition of "Prior Expert Knowledge" (PEK) and design of the "Prior Knowledge Base" (PKB); 3) PKB-guided analysis; 4) support-interpretation tools to evaluate results and detect inconsistencies (here Implicit Knowledg -IK- might be elicited); 5) incorporation of elicited IK in PKB and repeat till a satisfactory solution; 6) post-processing results for decision support. EbCA has been useful for incorporating PEK in two different analysis methods (DEA and Clustering), applied respectively to assess technical efficiency of small mental health areas and for case-mix of schizophrenia based on functional dependency. Differences in results obtained with classical approaches were mainly related to the IK which could be elicited by using EbCA and had major implications for the decision making in both cases. This paper presents EbCA and shows the convenience of

Integrating clinicians, knowledge and data: expert-based cooperative analysis in healthcare decision support

Directory of Open Access Journals (Sweden)

García-Alonso Carlos

2010-09-01

Full Text Available Abstract Background Decision support in health systems is a highly difficult task, due to the inherent complexity of the process and structures involved. Method This paper introduces a new hybrid methodology Expert-based Cooperative Analysis (EbCA, which incorporates explicit prior expert knowledge in data analysis methods, and elicits implicit or tacit expert knowledge (IK to improve decision support in healthcare systems. EbCA has been applied to two different case studies, showing its usability and versatility: 1 Bench-marking of small mental health areas based on technical efficiency estimated by EbCA-Data Envelopment Analysis (EbCA-DEA, and 2 Case-mix of schizophrenia based on functional dependency using Clustering Based on Rules (ClBR. In both cases comparisons towards classical procedures using qualitative explicit prior knowledge were made. Bayesian predictive validity measures were used for comparison with expert panels results. Overall agreement was tested by Intraclass Correlation Coefficient in case "1" and kappa in both cases. Results EbCA is a new methodology composed by 6 steps:. 1 Data collection and data preparation; 2 acquisition of "Prior Expert Knowledge" (PEK and design of the "Prior Knowledge Base" (PKB; 3 PKB-guided analysis; 4 support-interpretation tools to evaluate results and detect inconsistencies (here Implicit Knowledg -IK- might be elicited; 5 incorporation of elicited IK in PKB and repeat till a satisfactory solution; 6 post-processing results for decision support. EbCA has been useful for incorporating PEK in two different analysis methods (DEA and Clustering, applied respectively to assess technical efficiency of small mental health areas and for case-mix of schizophrenia based on functional dependency. Differences in results obtained with classical approaches were mainly related to the IK which could be elicited by using EbCA and had major implications for the decision making in both cases. Discussion This

Telephone Exchange Maintenance

CERN Multimedia

2005-01-01

Urgent maintenance work on CERN telephone exchanges will be performed on 24 March from 6 a.m. to 8 a.m. Telephone services may be disrupted or even interrupted during this time. For more details, please contact us by email at Standard.Telephone@cern.ch.

A Knowledge-Based Expert System Using MFM Model for Operator Supporting

International Nuclear Information System (INIS)

Mo, Kun; Seong, Poong Hyun

2005-01-01

In this paper, a knowledge-based expert system using MFM (Multi-level Flow Modeling) is proposed for enhancing the operators' ability to cope with various situations in nuclear power plant. There are many complicated situations, in which regular and suitable operations should be done by operators accordingly. In order to help the operator to assess the situations promptly and accurately, and to regulate their operations according to these situations. it is necessary to develop an expert systems to help the operator for the fault diagnosis, alarm analysis, and operation results estimation for each operation. Many kinds of operator supporting systems focusing on different functions have been developed. Most of them used various methodologies for single diagnosis function or operation permission function. The proposed system integrated functions of fault diagnosis, alarm analysis and operation results estimation by the MFM basic algorithm for the operator supporting

Computer and telephone delivered interventions to support caregivers of people with dementia: a systematic review of research output and quality

Directory of Open Access Journals (Sweden)

Amy Waller

2017-11-01

Full Text Available Abstract Background To assess the scope, volume and quality of research on the acceptability, utilisation and effectiveness of telephone- and computer-delivered interventions for caregivers of people living with dementia. Methods Medline, EMBASE, CINAHL and Cochrane databases were searched (Jan 1990 – Dec 2016. Eligible papers were classified as data-based descriptive, measurement or intervention studies. Intervention studies were first categorised according to mode of delivery (e.g. telephone, computer; then assessed against the Effective Practice and Organisation of Care (EPOC methodological criteria for research design. Impact on health-related outcomes; and the acceptability, feasibility and utilisation of interventions were also assessed. Results The number of publications increased by 13% each year (p < 0.001. Half were descriptive studies (n = 92, 50% describing caregiver views on acceptability, access or utilization of technology. The remainder (n = 89, 48% reported on interventions designed to improve caregiver outcomes. Only 34 met EPOC design criteria. Interventions were delivered via computer (n = 10, multiple modalities (n = 9 or telephone (n = 15. Interventions that incorporated various elements of psycho-education, peer support, skills training and health assessments led to improvements in caregiver wellbeing. While largely acceptable, utilisation of computer-based interventions was variable, with use often decreasing over time. Conclusion Interventions delivered via telephone and computer have the potential to augment existing dementia care. High-quality trials are required to make clear recommendations about the types of interventions that are most effective. Those that provide caregivers with: access to practical strategies to manage care of the person with dementia and their own wellbeing, advice and support from peers and/or clinicians; and that target the dyad should be explored.

Best Strategies to Improve School-leavers' Knowledge of Nutrition and Food Systems: Views from Experts in Iran.

Science.gov (United States)

Sadegholvad, Sanaz; Yeatman, Heather; Omidvar, Nasrin; Parrish, Anne-Maree; Worsley, Anthony

2016-01-01

The research to date does not present an articulated approach to ensure nutrition and food systems education is systematically implemented within schools. This paper aimed to investigate food experts' views of the best strategies to improve school-leavers' knowledge of nutrition and food systems. In this qualitative study, 28 Iranian food and nutrition experts from four major provinces (Tehran, Fars, Isfahan, and Gilan) were selected and agreed to be interviewed. Required data were collected through in-depth, semi-structured, face-to-face, or telephone interviews and were analyzed thematically using NVivo. The experts' suggested strategies to improve Iranian school-leavers' knowledge of nutrition and food systems fell into three key themes: Policy, education processes, and supportive environments. Together they formed an overarching theme of a multileveled system approach for transferring knowledge. Development of a scaffolded education program could assist curriculum developers and policy makers to assess and update current nutrition and food systems education programs in schools. Insights gained about education initiatives in one country such as Iran can provide an important impetus to support nutrition and food system education more widely.

Total Telephone Tips.

Science.gov (United States)

Corder, Lloyd E.; And Others

This manual of telephone behavior tips for business and sales professionals offers ways to handle the disgruntled caller and makes suggestions on topics relevant to the telephone. The manual is divided into the following sections and subsections: (1) Common Courtesy (staff tips, answering the telephone, screening calls, transferring calls, taking…

SAMEX: A severe accident management support expert

International Nuclear Information System (INIS)

Park, Soo-Yong; Ahn, Kwang-Il

2010-01-01

A decision support system for use in a severe accident management following an incident at a nuclear power plant is being developed which is aided by a severe accident risk database module and a severe accident management simulation module. The severe accident management support expert (SAMEX) system can provide the various types of diagnostic and predictive assistance based on the real-time plant specific safety parameters. It consists of four major modules as sub-systems: (a) severe accident risk data base module (SARDB), (b) risk-informed severe accident risk data base management module (RI-SARD), (c) severe accident management simulation module (SAMS), and (d) on-line severe accident management guidance module (on-line SAMG). The modules are integrated into a code package that executes within a WINDOWS XP operating environment, using extensive user friendly graphics control. In Korea, the integrated approach of the decision support system is being carried out under the nuclear R and D program planned by the Korean Ministry of Education, Science and Technology (MEST). An objective of the project is to develop the support system which can show a theoretical possibility. If the system is feasible, the project team will recommend the radiation protection technical support center of a national regulatory body to implement a plant specific system, which is applicable to a real accident, for the purpose of immediate and various diagnosis based on the given plant status information and of prediction of an expected accident progression under a severe accident situation.

Telephone Service

CERN Multimedia

2005-01-01

As part of the upgrade of telephone services, the CERN exchange switches will be updated on Thursday 2 June between 7.00 p.m. and midnight. Telephone services may be affected and possibly even disrupted during this operation. 

Results of expert evaluation of problems of organization of ambulatory-polyclinic assistance

Directory of Open Access Journals (Sweden)

E. A. Finchenko

2017-01-01

polyclinics. The proportion of visits by patients to district doctors that could be resolved: on pre-hospital admission, is 24,7%, by telephone consultation, is 24,5%. Thus, the share of visits to district doctors, which could be resolved at a pre-hospital reception and by telephone consultation, is almost half (49,2%.The proportion of visits by patients to medical specialists that could be resolved by telephone consultation: between the district doctor and medical specialists is 11,2%, the number of patients by telephone by medical specialists is 12,4%. Thus, the share of visits by specialist doctors, which could be resolved by telephone consultation between the district doctor and specialist doctors and patient consultations by telephone by specialist doctors, is almost a quarter of all visits (23,6%.Discussion. The data obtained are in some ways consistent with the results of a number of authors who are optimizing outpatient care in terms of the unreasonableness of visits, the possibility of transferring part of the functions of primary general medical reception to specially trained middle medical personnel, using telephone consultations between patients and between doctors, etc.Conclusion. The results of the expert assessment of the organization of outpatient care helped to identify some approaches to optimizing its delivery in the territorial polyclinics. This is optimization of the work of district doctors; Transfer of a certain part of the functions performed by district doctors to district nurses and paramedics; The development of a system for counseling patients and district doctors by medical specialists of polyclinics and other medical organizations. 

Comparative effectiveness trial of family-supported smoking cessation intervention versus standard telephone counseling for chronically ill veterans using proactive recruitment

Directory of Open Access Journals (Sweden)

Bastian LA

2012-09-01

Full Text Available Lori A Bastian,1–3 Laura J Fish,4 Jennifer, M Gierisch,3,5 Lesley D Rohrer,3 Karen M Stechuchak,3 Steven C Grambow3,61Veterans Affairs Connecticut, West Haven, CT, USA; 2Department of Medicine, University of Connecticut Health Center, Farmington, CT, USA; 3Center for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, NC, USA; 4Duke Comprehensive Cancer Center, 5Department of Medicine, 6Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USAObjectives: Smoking cessation among patients with chronic medical illnesses substantially decreases morbidity and mortality. Chronically ill veteran smokers may benefit from interventions that assist them in harnessing social support from family and friends.Methods: We proactively recruited veteran smokers who had cancer, cardiovascular disease, or other chronic illnesses (diabetes, chronic obstructive pulmonary disease, hypertension and randomized them to either standard telephone counseling or family-supported telephone counseling focused on increasing support for smoking cessation from family and friends. Participants each received a letter from a Veterans Affairs physician encouraging them to quit smoking, a self-help cessation kit, five telephone counseling sessions, and nicotine replacement therapy, if not contraindicated. The main outcome was 7-day point prevalent abstinence at 5 months.Results: We enrolled 471 participants with mean age of 59.2 (standard deviation [SD] = 7.9 years. 53.0% were white, 8.5% were female, and 55.4% were married/living as married. Overall, 42.9% had cardiovascular disease, 34.2% had cancer, and 22.9% had other chronic illnesses. At baseline, participants were moderately dependent on cigarettes as measured by the Heaviness of Smoking Index (mean = 2.8, SD = 1.6, expressed significant depressive symptoms as measured by the Center for Epidemiological Studies Depression scale (54.8% > 10, and

Telephoning in English

CERN Document Server

Naterop, B Jean

1994-01-01

Many people have to use English on the telephone in the course of their work, either at the level of taking a simple message or involving more complex tasks such as requesting information. Telephoning in English provides an up-to-date and relevant context in which students from lower-intermediate level upwards can develop practical telephone skills. The course principally develops spoken interactive skills, but also includes reading material on telephone systems and techniques. As the material is not restricted to particular job functions, it is suitable for students in a wide range of business and administration fields.

Emotional first aid for a suicide crisis: comparison between Telephonic hotline and internet.

Science.gov (United States)

Gilat, Itzhak; Shahar, Golan

2007-01-01

The telephone and the internet have become popular sources of psychological help in various types of distress, including a suicide crisis. To gain more insight into the unique features of these media, we compared characteristics of calls to three technologically mediated sources of help that are part of the volunteer-based Israeli Association for Emotional First Aid (ERAN): Telephonic hotline (n = 4426), personal chat (n = 373) and an asynchronous online support group (n = 954). Threats of suicide were much more frequent among participants in the asynchronous support group than the telephone and personal chat. These findings encourage further research into suicide-related interpersonal exchanges in asynchronous online support groups.

A randomized control trial of the effect of negotiated telephone support on glycaemic control in young people with Type 1 diabetes

DEFF Research Database (Denmark)

Howells, L.; Wilson, A. C.; Skinner, T. C.

2002-01-01

Aim: To evaluate changes in self-efficacy for self-management in young people with Type 1 diabetes participating in a 'Negotiated Telephone Support' (NTS) intervention developed using the principles of problem solving and social learning theory. Methods: One-year RCT with 79 young people (male 39...

Telephone-Based Coaching.

Science.gov (United States)

Boccio, Mindy; Sanna, Rashel S; Adams, Sara R; Goler, Nancy C; Brown, Susan D; Neugebauer, Romain S; Ferrara, Assiamira; Wiley, Deanne M; Bellamy, David J; Schmittdiel, Julie A

2017-03-01

Many Americans continue to smoke, increasing their risk of disease and premature death. Both telephone-based counseling and in-person tobacco cessation classes may improve access for smokers seeking convenient support to quit. Little research has assessed whether such programs are effective in real-world clinical populations. Retrospective cohort study comparing wellness coaching participants with two groups of controls. Kaiser Permanente Northern California, a large integrated health care delivery system. Two hundred forty-one patients who participated in telephonic tobacco cessation coaching from January 1, 2011, to March 31, 2012, and two control groups: propensity-score-matched controls, and controls who participated in a tobacco cessation class during the same period. Wellness coaching participants received an average of two motivational interviewing-based coaching sessions that engaged the patient, evoked their reason to consider quitting, and helped them establish a quit plan. Self-reported quitting of tobacco and fills of tobacco cessation medications within 12 months of follow-up. Logistic regressions adjusting for age, gender, race/ethnicity, and primary language. After adjusting for confounders, tobacco quit rates were higher among coaching participants vs. matched controls (31% vs. 23%, p Coaching participants and class attendees filled tobacco-cessation prescriptions at a higher rate (47% for both) than matched controls (6%, p coaching was as effective as in-person classes and was associated with higher rates of quitting compared to no treatment. The telephonic modality may increase convenience and scalability for health care systems looking to reduce tobacco use and improve health.

Nurse-led telephone follow-up after total knee arthroplasty

DEFF Research Database (Denmark)

Szöts, Kirsten; Konradsen, Hanne; Solgaard, Søren

2015-01-01

AIM AND OBJECTIVES: To generate information on how telephone follow-up consultations, structured by nursing status according to the VIPS-model, functioned after total knee arthroplasty. The objectives were to unfold the content of the telephone follow-ups according to the structure for nursing...... status and to explore the patients' views of the telephone follow-ups. BACKGROUND: The length of stay in hospital following total knee arthroplasty has fallen markedly, and patients now have to be responsible for their recovery from a very early stage. After discharge, patients may experience a variety...... Telephone follow-up was valued by total knee arthroplasties patients as representing a holistic approach and providing adequate information, counselling and support after discharge to home. Three categories were identified with regard to the patients' views: 'A means for reflection and provision of adequate...

Patterns of Signs That Telephone Crisis Support Workers Associate with Suicide Risk in Telephone Crisis Line Callers.

Science.gov (United States)

Hunt, Tara; Wilson, Coralie; Caputi, Peter; Wilson, Ian; Woodward, Alan

2018-01-30

Signs of suicide are commonly used in suicide intervention training to assist the identification of those at imminent risk for suicide. Signs of suicide may be particularly important to telephone crisis-line workers (TCWs), who have little background information to identify the presence of suicidality if the caller is unable or unwilling to express suicidal intent. Although signs of suicide are argued to be only meaningful as a pattern, there is a paucity of research that has examined whether TCWs use patterns of signs to decide whether a caller might be suicidal, and whether these are influenced by caller characteristics such as gender. The current study explored both possibilities. Data were collected using an online self-report survey in a Australian sample of 137 TCWs. Exploratory factor analysis uncovered three patterns of suicide signs that TCWs may use to identify if a caller might be at risk for suicide (mood, hopelessness, and anger), which were qualitatively different for male and female callers. These findings suggest that TCWs may recognise specific patterns of signs to identify suicide risk, which appear to be influenced to some extent by the callers' inferred gender. Implications for the training of telephone crisis workers and others including mental-health and medical professionals, as well as and future research in suicide prevention are discussed.

The impact of using computer decision-support software in primary care nurse-led telephone triage: interactional dilemmas and conversational consequences.

Science.gov (United States)

Murdoch, Jamie; Barnes, Rebecca; Pooler, Jillian; Lattimer, Valerie; Fletcher, Emily; Campbell, John L

2015-02-01

Telephone triage represents one strategy to manage demand for face-to-face GP appointments in primary care. Although computer decision-support software (CDSS) is increasingly used by nurses to triage patients, little is understood about how interaction is organized in this setting. Specifically any interactional dilemmas this computer-mediated setting invokes; and how these may be consequential for communication with patients. Using conversation analytic methods we undertook a multi-modal analysis of 22 audio-recorded telephone triage nurse-caller interactions from one GP practice in England, including 10 video-recordings of nurses' use of CDSS during triage. We draw on Goffman's theoretical notion of participation frameworks to make sense of these interactions, presenting 'telling cases' of interactional dilemmas nurses faced in meeting patient's needs and accurately documenting the patient's condition within the CDSS. Our findings highlight troubles in the 'interactional workability' of telephone triage exposing difficulties faced in aligning the proximal and wider distal context that structures CDSS-mediated interactions. Patients present with diverse symptoms, understanding of triage consultations, and communication skills which nurses need to negotiate turn-by-turn with CDSS requirements. Nurses therefore need to have sophisticated communication, technological and clinical skills to ensure patients' presenting problems are accurately captured within the CDSS to determine safe triage outcomes. Dilemmas around how nurses manage and record information, and the issues of professional accountability that may ensue, raise questions about the impact of CDSS and its use in supporting nurses to deliver safe and effective patient care. Copyright © 2014 Elsevier Ltd. All rights reserved.

A Telephone Communication Skills Exercise for Veterinary Students: Experiences, Challenges, and Opportunities.

Science.gov (United States)

Grevemeyer, Bernard; Betance, Larry; Artemiou, Elpida

2016-01-01

Evidence from human medicine shows a rise in telephone communication in support of after-hours services and in providing medical advice, follow-up information, etc. While specific training programs are continuously being developed for human medical education, limited publications are available on training veterinary students in telephone communication. Presented is our method of introducing a telephone communication skills exercise to third-year veterinary students. The exercise progressed over three phases and currently follows the principles of the Calgary-Cambridge Guide. Challenges and improvements on implementing a telephone communication exercise are discussed. Within veterinary communication curricula, attention should be given to the specific communication skills required for successful telephone consultations. In the absence of visual nonverbal cues and prompts during a telephone interaction, communication skills must be applied with greater intent and attention to achieve an effective consultation outcome.

The effect of telehealth, telephone support or usual care on quality of life, mortality and healthcare utilization in elderly high-risk patients with multiple chronic conditions. A prospective study.

Science.gov (United States)

Valdivieso, Bernardo; García-Sempere, Anibal; Sanfélix-Gimeno, Gabriel; Faubel, Raquel; Librero, Julian; Soriano, Elisa; Peiró, Salvador

2018-04-25

To assess the effect of home based telehealth or structured telephone support interventions with respect to usual care on quality of life, mortality and healthcare utilization in elderly high-risk multiple chronic condition patients. 472 elderly high-risk patients with plurimorbidity in the region of Valencia (Spain) were recruited between June 2012 and May 2013, and followed for 12 months from recruitment. Patients were allocated to either: (a) a structured telephone intervention, a nurse-led case management program with telephone follow up every 15 days; (b) telehealth, which adds technology for remote self-management and the exchange of clinical data; or (c) usual care. Main outcome measures was quality of life measured by the EuroQol (EQ-5D) instrument, cognitive impairment, functional status, mortality and healthcare resource use. Inadequate randomization process led us to used propensity scores for adjusted analyses to control for imbalances between groups at baseline. EQ-5D score was significantly higher in the telehealth group compared to usual care (diff: 0.19, 0.08-0.30), but was not different to telephone support (diff: 0.04, -0.05 to 0.14). In adjusted analyses, inclusion in the telehealth group was associated with an additional 0.18 points in the EQ-5D score compared to usual care at 12 months (p<0.001), and with a gain of 0.13 points for the telephone support group (p<0.001). No differences in mortality or utilization were found, except for a borderline significant increase in General Practitioner visits. Telehealth was associated with better quality of life. Important limitations of the study and similarity of effects to telephone intervention call for careful endorsement of telemedicine. Clinicaltrials.gov (identifier: NCT02447562). Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

An Expert System for Supporting the Design and Selection of Mechanical Equipment for Recreational Crafts

Directory of Open Access Journals (Sweden)

T. Gonciarz

2014-06-01

Full Text Available Expert Systems can be defined as computer programs, whose main task is to simulate a human expert, usually in a narrow field of expertise. Expert Systems have experienced tremendous growth and popularity since their commercial introduction in the early 1970’s. Today, Expert Systems are used in business, science, engineering, manufacturing and other engineering applications such as planning, scheduling, diagnosing equipment failures and are used in almost every stage of the manufacturing process and also in medicine and many other fields. Expert Systems belong to the field of artificial intelligence. An intelligent computer program that uses knowledge and inference procedures to solve problems that are difficult enough to require significant human expertise for the solution. The purpose of this paper is to present an Expert System which assists with the design of yachts and supports the selection of mechanical equipment for yachts and includes knowledge in the field of yachting engineering. Using the presented Expert System reduces the time during the design and production preparation process.

THE PROJECT OF THE EXPERT SYSTEM TO SUPPORTING OF SELECTION OF PARTS AND ASSEMBLIES OF MACHINES

Directory of Open Access Journals (Sweden)

Sebastian RZYDZIK

2014-06-01

Full Text Available This paper the design of the expert system that supports mechanical engineer in the process of selecting the parts and assemblies was presented. In the description of the proposed expert system, was made reference to the general form of such systems, that consist of such components as: user interface, inference engine, knowledge base and database. It also, scenario that describes the steps of the use of the proposed expert system was presented. Finally, an example of the use the expert system during the selection of the components of the drive system was shown.

Role of telephone triage in obstetrics.

Science.gov (United States)

Manning, Nirvana Afsordeh; Magann, Everett F; Rhoads, Sarah J; Ivey, Tesa L; Williams, Donna J

2012-12-01

The telephone has become an indispensable method of communication in the practice of obstetrics. The telephone is one of the primary methods by which the patient makes her appointments and contacts her health care provider for advice, reassurance, and referrals. Current methods of telephone triage include personal at the physicians' office, telephone answering services, labor and delivery nurses, and a dedicated telephone triage system using algorithms. Limitations of telephone triage include the inability of the provider to see the patient and receive visual clues from the interaction and the challenges of obtaining a complete history over the telephone. In addition, there are potential safety and legal issues with telephone triage. To date, there is insufficient evidence to either validate or refute the use of a dedicated telephone triage system compared with a traditional system using an answering service or nurses on labor and delivery. Obstetricians and gynecologists, family physicians. After completing this CME activity, physicians should be better able to analyze the scope of variation in telephone triage across health care providers and categorize the components that go into a successful triage system, assess the current scope of research in telephone triage in obstetrics, evaluate potential safety and legal issues with telephone triage in obstetrics, and identify issues that should be addressed in any institution that is using or implementing a system of telephone triage in obstetrics.

One-Year Weight Loss with a Telephone-Based Lifestyle Program

Directory of Open Access Journals (Sweden)

Christina Holzapfel

2016-07-01

Full Text Available Objective: Telephone-based weight loss programs are offered as an alternative to face-to-face obesity treatments, but data on the effectiveness regarding weight loss are limited. Therefore, we evaluated a telephone-based lifestyle program in a real-world setting. Methods: The telephone-based intervention consists of regular phone calls providing individualized lifestyle recommendations, and delivery of printed materials. Anthropometric and metabolic data are collected by general practitioners or are self-reported. Results: Baseline data were available from 398 participants (61% men; weight 103.12 ± 14.21 kg; BMI 33.38 ± 2.83 kg/m2 and 1-year data from 258 (65% participants. In the completers, mean weight change was -4.25 ± 5.18 kg (p Conclusions: The telephone-based lifestyle program results in a moderate weight loss after 12 months, which may be comparable to face-to-face interventions. Telephone-based weight loss support is independent of time and location and represents a tool which is also accepted by men.

Effects of Nurse-Led Telephone-Based Supportive Interventions for Patients With Cancer: A Meta-Analysis.

Science.gov (United States)

Suh, Soon-Rim; Lee, Myung Kyung

2017-07-01

To evaluate the effects of nurse-led telephone-based supportive interventions (NTSIs) for patients with cancer.
. Electronic databases, including EMBASE®, MEDLINE, Google Scholar, 
Cochrane Library CENTRAL, ProQuest Medical Library, and CINAHL®, were searched through February 2016.
. 239 studies were identified; 16 were suitable for meta-analysis. Cochrane's risk of bias tool and the Comprehensive Meta-Analysis software were used.
. The authors performed a meta-analysis of 16 trials that met eligibility criteria. Thirteen randomized, controlled trials (RCTs) and three non-RCTs examined a total of 2,912 patients with cancer. Patients who received NTSIs were compared with those who received attentional control or usual care (no intervention).
. Telephone interventions delivered by a nurse in an oncology care setting reduced cancer symptoms with a moderate effect size (ES) (-0.33) and emotional distress with a small ES (-0.12), and improved self-care with a large ES (0.64) and health-related quality of life (HRQOL) with a small ES (0.3). Subgroup analyses indicated that the significant effects of NTSIs on cancer symptoms, emotional distress, and HRQOL were larger for studies that combined an application of a theoretical framework, had a control group given usual care, and used an RTC design.
. The findings suggest that an additional tiered evaluation that has a theoretical underpinning and high-quality methodology is required to confirm the efficacy of NTSI for adoption of specific care models.

Probabilistic safety assessment based expert systems in support of dynamic risk assessment

International Nuclear Information System (INIS)

Varde, P.V.; Sharma, U.L.; Marik, S.K.; Raina, V.K.; Tikku, A.C.

2006-01-01

Probabilistic Safety Assessment (PSA) studies are being performed, world over as part of integrated risk assessment for Nuclear Power Plants and in many cases PSA insight is utilized in support of decision making. Though the modern plants are built with inherent safety provisions, particularly to reduce the supervisory requirements during initial period into the accident, it is always desired to develop an efficient user friendly real-time operator advisory system for handling of plant transients/emergencies which would be of immense benefit for the enhancement of operational safety of the plant. This paper discusses an integrated approach for the development of operator support system. In this approach, PSA methodology and the insight obtained from PSA has been utilized for development of knowledge based or rule based experts system. While Artificial Neural Network (ANN) approach has been employed for transient identification, rule-base expert system shell environment was used for the development of diagnostic module in this system. Attempt has been made to demonstrate that this approach offers an efficient framework for addressing requirements related to handling of real-time/dynamic scenario. (author)

Psychotherapeutic intervention by telephone

Directory of Open Access Journals (Sweden)

Erika Mozer

2008-06-01

Full Text Available Erika Mozer1,2, Bethany Franklin1,3, Jon Rose11Department of Veterans Affairs, Palo Alto Health Care System, Palo Alto, CA, USA; 2PGSP Stanford PsyD Consortium Palo Alto, CA, USA; 3Pacific Graduate School of Psychology Palo Alto, California, USAAbstract: Psychotherapy conducted over the telephone has received increasing amounts of empirical attention given practical advantages that side-step treatment barriers encountered in traditional office-based care. The utility and efficacy of telephone therapy appears generalizable across diverse clinical populations seeking care in community-based hospital settings. Treatment barriers common to older adults suggest that telephone therapy may be an efficient and effective mental health resource for this population. This paper describes empirical studies of telehealth interventions and case examples with psychotherapy conducted via telephone on the Spinal Cord Injury Unit of the Palo Alto Veterans’ Administration. Telephone therapy as appears to be a viable intervention with the aging population.Keywords: telehealth, rural mental health, psychotherapy, healthcare delivery, telecare

1What do first-time mothers worry about? A study of usage patterns and content of calls made to a postpartum support telephone hotline

Directory of Open Access Journals (Sweden)

Naassan Georges

2010-10-01

Full Text Available Abstract Background Telephone hotlines designed to address common concerns in the early postpartum could be a useful resource for parents. Our aim was to test the feasibility of using a telephone as an intervention in a randomized controlled trial. We also aimed to test to use of algorithms to address parental concerns through a telephone hotline. Methods Healthy first-time mothers were recruited from postpartum wards of hospitals throughout Lebanon. Participants were given the number of a 24-hour telephone hotline that they could access for the first four months after delivery. Calls were answered by a midwife using algorithms developed by the study team whenever possible. Callers with medical complaints were referred to their physicians. Call patterns and content were recorded and analyzed. Results Eighty-four of the 353 women enrolled (24% used the hotline. Sixty percent of the women who used the service called more than once, and all callers reported they were satisfied with the service. The midwife received an average of three calls per day and most calls occurred during the first four weeks postpartum. Our algorithms were used to answer questions in 62.8% of calls and 18.6% of calls required referral to a physician. Of the questions related to mothers, 66% were about breastfeeding. Sixty percent of questions related to the infant were about routine care and 23% were about excessive crying. Conclusions Utilization of a telephone hotline service for postpartum support is highest in the first four weeks postpartum. Most questions are related to breastfeeding, routine newborn care, and management of a fussy infant. It is feasible to test a telephone hotline as an intervention in a randomized controlled trial. Algorithms can be developed to provide standardized answers to the most common questions.

Internet delivered transdiagnostic treatment with telephone support for pain patients with emotional comorbidity: a replicated single case study

Directory of Open Access Journals (Sweden)

Matilda Wurm

2017-12-01

Full Text Available In pain patients, comorbid emotional problems have been linked to negative outcomes, including suboptimal treatment gains. Developing parsimonious and accessible treatment options is therefore important. The overarching aim of this study was to test an internet delivered therapist guided transdiagnostic treatment with telephone support. An adapted version of the Unified Protocol for Transdiagnostic Treatments of Emotional Disorders was used as an intervention for pain patients with residual pain problems and comorbid emotional problems after having received a multimodal pain rehabilitation. The study used a replicated AB single case experimental design (N = 5; 3 females. Outcome measures were depressive and general anxiety symptoms, pain intensity, pain coping problems, and diagnostic status. Feasibility measures (completion and compliance and patient satisfaction were also assessed. Scores on Nonoverlap of All Pairs (NAP indicate a decrease of anxiety for three participants and a decrease of depression for four participants. Decreases were small and did not always reach statistical significance. Also, Tau-U scores could only confirm a reliable trend for one participant. Two out of four patients who were diagnosed with psychiatric disorders before treatment did no longer fulfill diagnostic criteria posttreatment. No improvements could be seen on pain problems. The treatment was feasible and patient satisfaction was high. Hence, while an internet delivered transdiagnostic treatment with telephone support may be a feasible and accepted secondary intervention for pain patients with comorbid emotional problems, the effects are unclear. The gap between high patient satisfaction and small changes in symptomatology should be explored further.

Cost-effectiveness analysis of telephone-based support for the management of pressure ulcers in people with spinal cord injury in India and Bangladesh.

Science.gov (United States)

Arora, M; Harvey, L A; Glinsky, J V; Chhabra, H S; Hossain, M S; Arumugam, N; Bedi, P K; Cameron, I D; Hayes, A J

2017-08-15

To determine from a societal perspective the cost-effectiveness and cost-utility of telephone-based support for management of pressure ulcers. Cost-effectiveness and cost-utility analysis of a randomised clinical trial. Tertiary centre in India and Bangladesh. An economic evaluation was conducted alongside a randomised clinical trial comparing 12 weeks of telephone-based support (intervention group) with usual care (control group). The analyses evaluated costs and health outcomes in terms of cm 2 reduction of pressure ulcers size and quality-adjusted life years (QALYs) gained. All costs were in Indian Rupees (INR) and then converted to US dollars (USD). The mean (95% confidence interval) between-group difference for the reduction in size of pressure ulcers was 0.53 (-3.12 to 4.32) cm 2 , favouring the intervention group. The corresponding QALYs were 0.027 (0.004-0.051), favouring the intervention group. The mean total cost per participant in the intervention group was INR 43 781 (USD 2460) compared to INR 42 561 (USD 2391) for the control group. The per participant cost of delivering the intervention was INR 2110 (USD 119). The incremental cost-effectiveness ratio was INR 2306 (USD 130) per additional cm 2 reduction in the size of the pressure ulcer and INR 44 915 (USD 2523) per QALY gained. In terms of QALYs, telephone-based support to help people manage pressure ulcers at home provides good value for money and has an 87% probability of being cost-effective, based on 3 times gross domestic product. Sensitivity analyses were performed using the overall cost data with and without productivity costs, and did not alter this conclusion.Spinal Cord advance online publication, 15 August 2017; doi:10.1038/sc.2017.87.

Telephone calls by individuals with cancer.

Science.gov (United States)

Flannery, Marie; McAndrews, Leanne; Stein, Karen F

2013-09-01

To describe symptom type and reporting patterns found in spontaneously initiated telephone calls placed to an ambulatory cancer center practice. Retrospective, descriptive. Adult hematology oncology cancer center. 563 individuals with a wide range of oncology diagnoses who initiated 1,229 telephone calls to report symptoms. Raw data were extracted from telephone forms using a data collection sheet with 23 variables obtained for each phone call, using pre-established coding criteria. A literature-based, investigator-developed instrument was used for the coding criteria and selection of which variables to extract. Symptom reporting, telephone calls, pain, and symptoms. A total of 2,378 symptoms were reported by telephone during the four months. At least 10% of the sample reported pain (38%), fatigue (16%), nausea (16%), swelling (12%), diarrhea (12%), dyspnea (10%), and anorexia (10%). The modal response was to call only one time and to report only one symptom (55%). Pain emerged as the symptom that most often prompted an individual to pick up the telephone and call. Although variation was seen in symptom reporting, an interesting pattern emerged with an individual reporting on a solitary symptom in a single telephone call. The emergence of pain as the primary symptom reported by telephone prompted educational efforts for both in-person clinic visit management of pain and prioritizing nursing education and protocol management of pain reported by telephone. Report of symptoms by telephone can provide nurses unique insight into patient-centered needs. Although pain has been an important focus of education and research for decades, it remains a priority for individuals with cancer. A wide range in symptom reporting by telephone was evident.

Rehabilitation after THR: Telephone interview and individual support versus visits in outpatient clinic

DEFF Research Database (Denmark)

Hørdam, Britta

2011-01-01

. Participating patients were allocated to a control group or an intervention group after discharge. The intervention group had telephone-interviews and individual counseling 2 and 8 months after THR, and the control group had conventional visit in outpatient clinic 3 months after THR. Outcome: Patients......Results from a RCT carried out from 2006 to 2007 including 180 patients aged 65 years and over based on patients´ self-rated health and by using telephone interviews and individual counseling as intervention 2 and 10 weeks after discharge had a significant improvement in patients´ self-rated health...... by using SF-36 scores within 3 months after surgery, whereas the control group had improvement after 9 months. Both groups had SF-36 filled out preoperatively and 3, 6 and 9 months after THR. In a new study a sub group was identified by having a reduction in general health during 12 months postoperatively...

Effects of enterostomal nurse telephone follow-up on postoperative adjustment of discharged colostomy patients.

Science.gov (United States)

Zhang, Jun-e; Wong, Frances Kam Yuet; You, Li-ming; Zheng, Mei-chun; Li, Qiong; Zhang, Bing-yan; Huang, Man-rong; Ye, Xin-Mei; Liang, Ming-juan; Liu, Jin-ling

2013-01-01

People with a new colostomy encounter many difficulties as they struggle to adjust to their ostomies. Nurse telephone follow-up is a convenient way to ensure continuity of care. There is a paucity of studies testing if nurse telephone follow-up can enhance adjustment of postdischarged colostomy patients. The purpose of this study was to evaluate the effect of enterostomal nurse telephone follow-up on the adjustment levels of discharged colostomy patients. This was a randomized controlled trial. Participants (n = 103) who had undergone colostomy operations in China were recruited and randomly assigned to the study or control group. Both the study and control groups received routine discharge care, whereas the study group received 2-3 nurse telephone calls in the follow-up period. The outcome measures included Ostomy Adjustment Scale, Stoma Self-efficacy Scale, satisfaction with care, and stoma complications. Results of this study indicated that participants in the study group had significantly better ostomy adjustment, higher stoma self-efficacy, higher satisfaction with care, and less stoma complications compared with those in the control group. This study provided evidence to support that enterostomal nurse telephone follow-up can improve patient ostomy adjustment level and other related outcomes. Nurse telephone follow-up is an effective intervention to support the adjustment of stoma patients after hospital discharge.

Expert system support and juridical quality

NARCIS (Netherlands)

Groothuis, Marga M.; Svensson, Jorgen S.; Breuker, J.; Leenes, R.E.; Winkels, R.

2000-01-01

This article discusses the use of expert systems as a means of achieving juridical quality within administrative organisations. Do these systems really improve the quality of decision making and provide the desired guarantees with respect to the correct treatment of clients?

ELAN - expert system supported information and management system for analytical laboratories

International Nuclear Information System (INIS)

Jaeschke, A.; Orth, H.; Zilly, G.

1990-08-01

The demand for high efficiency and short response time calls for the use of computer support in chemico-analytical laboratories. This is usually achieved by laboratory information and management systems covering the three levels of analytical instrument automation, laboratory operation support and laboratory management. The management component of the systems implemented up to now suffers from a lack of flexibility as far as unforeseen analytical investigations outside the laboratory routine work are concerned. Another drawback is the lack of adaptability with respect to structural changes in laboratory organization. It can be eliminated by the application of expert system structures and methods for the implementation of this system level. The ELAN laboratory information and management system has been developed on the basis of this concept. (orig.) [de

Expert system for operational personnel support during power unit operation control in regulation range

International Nuclear Information System (INIS)

Yanitskij, V.A.

1992-01-01

The problems met when developing the systems for NPP operator support in the process of power unit operation are considered. The expert system for NPP personnel intelligent support combining the properties belonging to the artificial intelligence systems including selection of the analysis method taking into account the concrete technological situation and capability of application of algothmic calculations of the equipment characteristics using the information accumulated during the system development, erection and operation is described

Model of experts for decision support in the diagnosis of leukemia patients.

Science.gov (United States)

Corchado, Juan M; De Paz, Juan F; Rodríguez, Sara; Bajo, Javier

2009-07-01

Recent advances in the field of biomedicine, specifically in the field of genomics, have led to an increase in the information available for conducting expression analysis. Expression analysis is a technique used in transcriptomics, a branch of genomics that deals with the study of messenger ribonucleic acid (mRNA) and the extraction of information contained in the genes. This increase in information is reflected in the exon arrays, which require the use of new techniques in order to extract the information. The purpose of this study is to provide a tool based on a mixture of experts model that allows the analysis of the information contained in the exon arrays, from which automatic classifications for decision support in diagnoses of leukemia patients can be made. The proposed model integrates several cooperative algorithms characterized for their efficiency for data processing, filtering, classification and knowledge extraction. The Cancer Institute of the University of Salamanca is making an effort to develop tools to automate the evaluation of data and to facilitate de analysis of information. This proposal is a step forward in this direction and the first step toward the development of a mixture of experts tool that integrates different cognitive and statistical approaches to deal with the analysis of exon arrays. The mixture of experts model presented within this work provides great capacities for learning and adaptation to the characteristics of the problem in consideration, using novel algorithms in each of the stages of the analysis process that can be easily configured and combined, and provides results that notably improve those provided by the existing methods for exon arrays analysis. The material used consists of data from exon arrays provided by the Cancer Institute that contain samples from leukemia patients. The methodology used consists of a system based on a mixture of experts. Each one of the experts incorporates novel artificial intelligence

Update of telephone exchange

CERN Multimedia

2006-01-01

As part of the upgrade of telephone services, the CERN switching centre will be updated on Wednesday 14 June between 8.00 p.m. and midnight. Telephone services may be disrupted and possibly even interrupted during this operation. We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

Optimal management of phenylketonuria: a centralized expert team is more successful than a decentralized model of care.

Science.gov (United States)

Camfield, Carol S; Joseph, Marissa; Hurley, Teresa; Campbell, Karen; Sanderson, Susan; Camfield, Peter R

2004-07-01

To compare phenylketonuria (PKU) management by a centralized, expert team in the Province of Nova Scotia (NS) with the decentralized approach in New Brunswick (NB). Retrospective chart review documented frequency of outpatient visits, phenylalanine (Phe) concentration, and medical formula use. Structured telephone interviews with the 8 regional NB dietitians (NB-D) documented their knowledge and support in PKU management. Patients with PKU (n=108; age, birth to 42 years) reside in NB (n=69) and NS (n=39). More were lost to contact in NB than in NS (9/69 vs 1/39) and more were completely off diet in NB than in NS (24/60 vs 1/38, P=.05). All 15 children 95% in NS. Mental handicap or borderline intelligence was common in both NB (44%) and NS (42%). All NB-D wished additional specialized medical, nursing, or social work assistance. PKU management appears to be more effective with an expert, coordinated team approach.

Supporting experts to handle tweet collections about significant events

NARCIS (Netherlands)

Hürriyetoglu, Ali; Oostdijk, Nelleke; Basar, Erkan; van den Bosch, A.; Frasincar, F.; Ittoo, A.; Nguyen, L.; Metais, E.

2017-01-01

We introduce Relevancer that processes a tweet set and enables generating an automatic classifier from it. Relevancer satisfies information needs of experts during significant events. Enabling experts to combine automatic procedures with expertise is the main contribution of our approach and the

Update of telephone exchange

CERN Multimedia

2006-01-01

As part of the upgrade of telephone services, the CERN switching centre will be updated on Monday 3 July between 8.00 p.m. and 3.00 a.m. Telephone services may be disrupted and possibly even interrupted during this operation.We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

Update of telephone exchange

CERN Multimedia

2006-01-01

As part of the upgrade of telephone services, the CERN switching centre will be updated on Monday 3 July between 8.00 p.m. and 3.00 a.m. Telephone services may be disrupted and possibly even interrupted during this operation. We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

Maintenance of the CERN telephone exchanges

CERN Multimedia

2007-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 8 p.m. and midnight on 20 November. Fixed-line telephone and audioconference services may be disrupted while the work is being carried out. However, the CCC and the fire brigade will be contactable at any time. Mobile telephony services (GSM) will not be affected by the maintenance work. For further details about the maintenance work, please contact the telephone switchboard on 76111 or by email to standard.telephone@cern.ch. Telecom Section IT/CS

Update of telephone exchange

CERN Multimedia

2006-01-01

As part of the upgrade of telephone services, the CERN switching centre will be updated on between Monday 23 October 8.00 p.m. and Tuesday 24 October 2.00 a.m. Telephone services may be disrupted and possibly even interrupted during this operation. We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

Upgrade of telephone exchange

CERN Multimedia

2006-01-01

As part of the upgrade of telephone services, work will be carried out on the CERN switching centre between Monday 23 October 8.00 p.m. and Tuesday 24 October 2.00 a.m. Telephone services may be disrupted and possibly even interrupted during this operation. We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

Proposal for the award of an industrial support contract for operation of the CERN telephone system

CERN Document Server

1999-01-01

This document concerns the award of an industrial support contract for operation of the CERN telephone system. Following a market survey carried out among 22 firms in eight Member States, a call for tenders (IT-2655/ST) was sent on 27 August 1999 to three firms and two consortia in four Member States. By the closing date, CERN had received three tenders from one firm and two consortia in three Member States. The Finance Committee is invited to agree to the negotiation of a contract with the consortium MERROW (UK) ? DCS (CH) the lowest bidder, for an initial period of three years from 1st January 2000, for a total amount not exceeding 850 000 Swiss francs, not subject to revision until 31 December 2000. The contract will include an option for two one-year extensions beyond the initial three-year period.

Systems configured to distribute a telephone call, communication systems, communication methods and methods of routing a telephone call to a service representative

Science.gov (United States)

Harris, Scott H.; Johnson, Joel A.; Neiswanger, Jeffery R.; Twitchell, Kevin E.

2004-03-09

The present invention includes systems configured to distribute a telephone call, communication systems, communication methods and methods of routing a telephone call to a customer service representative. In one embodiment of the invention, a system configured to distribute a telephone call within a network includes a distributor adapted to connect with a telephone system, the distributor being configured to connect a telephone call using the telephone system and output the telephone call and associated data of the telephone call; and a plurality of customer service representative terminals connected with the distributor and a selected customer service representative terminal being configured to receive the telephone call and the associated data, the distributor and the selected customer service representative terminal being configured to synchronize, application of the telephone call and associated data from the distributor to the selected customer service representative terminal.

Maintenance of the CERN telephone exchanges

CERN Multimedia

TS Department

2008-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 8 p.m. and midnight on 3 December. During this time, the fixed-line telephone and audio-conference services may be disrupted. However, the CCC and the Fire Brigade will be reachable at all times. Mobile telephone services (GSM) will not be affected by this work. For further details please contact mailto:Netops@cern.ch.

Maintenance of the CERN telephone exchanges

CERN Multimedia

TS Department

2008-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 8 p.m. and midnight on 3 December. During this time, the fixed-line telephone and audio-conference services may be disrupted. However, the CCC and the Fire Brigade will be reachable at all times. Mobile telephone services (GSM) will not be affected by this work. For further details please contact Netops@cern.ch.

The effects of a pedometer-based behavioral modification program with telephone support on physical activity and sedentary behavior in type 2 diabetes patients.

Science.gov (United States)

De Greef, Karlijn P; Deforche, Benedicte I; Ruige, Johannes B; Bouckaert, Jacques J; Tudor-Locke, Catrine E; Kaufman, Jean-Marc; De Bourdeaudhuij, Ilse M

2011-08-01

Effectiveness of a behavioral modification program on physical activity (PA) and sedentary behavior in diabetes patients. Ninety-two patients were randomly assigned to an intervention or control group. The 24-weeks intervention consisted of a face-to-face session, pedometer and seven telephone follow-ups. Mean selection criteria were 35-75 years; 25-35 kg/m(2); ≤ 12% HbA1c, treated for type 2 diabetes; no PA limitations. PA and sedentary behavior were measured by pedometer, accelerometer and questionnaire over the short- (24 weeks) and intermediate- (1 year) term. The intervention group increased their steps/day by 2744, their total PA by 23 min/day (pbehavior by 23 min/day (pbehavior (pbehavioral modification program with telephone support showed lasting positive effects on steps/day, PA and sedentary behavior. This study tested a convenient way to increase PA among type 2 diabetes patients. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Computer Based Expert Systems.

Science.gov (United States)

Parry, James D.; Ferrara, Joseph M.

1985-01-01

Claims knowledge-based expert computer systems can meet needs of rural schools for affordable expert advice and support and will play an important role in the future of rural education. Describes potential applications in prediction, interpretation, diagnosis, remediation, planning, monitoring, and instruction. (NEC)

Gym-based exercise and home-based exercise with telephone support have similar outcomes when used as maintenance programs in adults with chronic health conditions: a randomised trial

Directory of Open Access Journals (Sweden)

Paul Jansons

2017-07-01

Trial registration: ACTRN12610001035011. [Jansons P, Robins L, O’Brien L, Haines T (2017 Gym-based exercise and home-based exercise with telephone support have similar outcomes when used as maintenance programs in adults with chronic health conditions: a randomised trial. Journal of Physiotherapy 63: 154–160

Maintenance of the CERN telephone exchanges

CERN Multimedia

2007-01-01

Maintenance work on the CERN telephone exchanges will be performed on 10 July from 8 p.m. to midnight. During this intervention, the fixed telephone services, audioconference services and GSM calls made via the 333 prefix may be disrupted. However, the CCC and the fire brigade will be reachable at all times. For more details about this maintenance work, please call the telephone switchboard on 76111 or send an e-mail. Telecom SectionIT/CS

Maintenance of the CERN telephone exchanges

CERN Multimedia

2007-01-01

A maintenance of the CERN telephone exchanges will be performed on the 10th of July from 8 p.m. to midnight. During this intervention, the fixed telephone services, audioconference services, and GSM calls made via the 333 prefix may be disrupted. However, the CCC and the fire brigade will be reachable at any time. For more details about this maintenance, please contact the telephone switchboard at 76111 or by email. Telecom Section IT/CS

Guidelines for the verification and validation of expert system software and conventional software: Survey and documentation of expert system verification and validation methodologies. Volume 3

Energy Technology Data Exchange (ETDEWEB)

Groundwater, E.H.; Miller, L.A.; Mirsky, S.M. [Science Applications International Corp., McLean, VA (United States)

1995-03-01

This report is the third volume in the final report for the Expert System Verification and Validation (V&V) project which was jointly sponsored by the Nuclear Regulatory Commission and the Electric Power Research Institute. The ultimate objective is the formulation of guidelines for the V&V of expert systems for use in nuclear power applications. The purpose of this activity was to survey and document techniques presently in use for expert system V&V. The survey effort included an extensive telephone interviewing program, site visits, and a thorough bibliographic search and compilation. The major finding was that V&V of expert systems is not nearly as established or prevalent as V&V of conventional software systems. When V&V was used for expert systems, it was almost always at the system validation stage after full implementation and integration usually employing the non-systematic dynamic method of {open_quotes}ad hoc testing.{close_quotes} There were few examples of employing V&V in the early phases of development and only weak sporadic mention of the possibilities in the literature. There is, however, a very active research area concerning the development of methods and tools to detect problems with, particularly, rule-based expert systems. Four such static-testing methods were identified which were not discovered in a comprehensive review of conventional V&V methods in an earlier task.

Adherence to a Telephone-Supported Depression Self-Care Intervention for Adults With Chronic Physical Illnesses

Directory of Open Access Journals (Sweden)

Russell Simco

2015-02-01

Full Text Available We assessed adherence to and predictors of two components of a telephone-supported self-care intervention for depression among primary care adults aged 40 and above with chronic physical illnesses and comorbid depressive symptoms. Participants received a “toolkit” containing six self-care tools. Trained lay self-care “coaches” negotiated a contact schedule of up to weekly contacts. Study outcomes were levels of completion of the self-care tool and the coach contacts at the 2-month follow-up. Coaches reported the number of completed contacts. In all, 57 of 63 participants completed the 2-month follow-up. Of these, 67% completed at least 1 tool; the mean number of coach contacts was 5.7 (SD = 2.4 of a possible 9 contacts (63% adherence. Higher disease comorbidity and lower initial depression severity independently predicted better tool adherence. Findings suggest that people with chronic physical illnesses can achieve acceptable levels of adherence to a depression self-care intervention similar to those reported for other populations.

Maintenance of the telephone exchange in building 40

CERN Multimedia

2006-01-01

In order to secure the power supply of the telephone exchange in Building 40, maintenance work will be done on 18th December from 7.30 am to 8 am. During this intervention, the fixed telephone services in Building 39 and 40 will be interrupted. The fixed telephone services in other CERN buildings will not be affected by this maintenance. The mobile telephone services (GSM) will not be affected. For more details, please send your questions to Standard.Telephone@cern.ch Telecom Services IT/CS

Doctor-patient communication on the telephone.

Science.gov (United States)

Curtis, P; Evens, S

1989-01-01

Since its invention, the telephone has been an important tool in medical practice, particularly for primary care physicians. Approximately half the calls made to a physician's office during regular consulting hours are for clinical problems and most are handled effectively over the phone without an immediate office visit. Telephone encounters are generally very brief, and managing such calls requires a pragmatic approach that is often quite different from the approach taken in the office visit. The telephone encounter should be recognized and recorded as a specific medical interaction in the medical chart for both clinical and legal reasons. Effective telephone encounters depend on good communication skills; decision making regarding disposition is a major goal. The physician's perception of a medical problem may be different from the patient's; patients are frequently seeking advice and reassurance rather than diagnosis and treatment, and may call because of anxiety and psychological stress. For physicians and their families who are not prepared for after-hours telephone encounters, calls that interrupt more "legitimate" activities may result in anger or frustration for the physician and dissatisfaction for the patient.

7 CFR 1737.60 - Telephone loan budget.

Science.gov (United States)

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false Telephone loan budget. 1737.60 Section 1737.60... Cost Estimation Procedures § 1737.60 Telephone loan budget. (a) RUS shall prepare a “Telephone Loan Budget” (RUS Form 493) showing all costs for the proposed project and the amount of loan and nonloan...

Maintenance of the CERN telephone exchanges

CERN Multimedia

2007-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 8 p.m. and midnight on 20 November. Fixed-line telephone and audioconference services may be disrupted while the work is being carried out. However, the CCC and the fire brigade will be reachable at any time. Mobile telephony services (GSM) will not be affected by the maintenance work. For further details about the maintenance work, please contact the telephone switchboard on 76111 or by email. Telecom Section - IT/CS

Board composition and firm reputation: The role of business experts, support specialists and community influentials

Directory of Open Access Journals (Sweden)

Emma García-Meca

2018-04-01

Full Text Available The objective of this paper is to analyze the influence of board resource diversity on firm reputation. We classify board members as business experts, support specialists, political directors and other community influentials, in an effort to address whether business, technical expertise or political ties in the boardroom affect stakeholders’ opinion and, therefore, firm reputation.This study confirms that not all outside directors are equally effective in improving firm reputation, and that certain kinds of outside directors, especially business experts, help increase it. However, the findings note an inverted U-shaped non-linear relationship with these directors, which means that the effect of business experts on reputation is positive up to a point, after which the relationship becomes negative. The findings also evidence that, contrary to popular beliefs, directors with previous experience as politicians are not negatively viewed by stakeholders. Moreover, this type of community influential directors has positive effects on firm reputation in regulated firms as well as in those of the public work sector. JEL classification: G30, Keywords: Reputation, Board, Expertise, Corporate governance, Directors

Impact of a goal setting and decision support telephone coaching intervention on diet, psychosocial, and decision outcomes among people with type 2 diabetes.

Science.gov (United States)

Swoboda, Christine M; Miller, Carla K; Wills, Celia E

2017-07-01

Evaluate a 16-week decision support and goal-setting intervention to compare diet quality, decision, and diabetes-related outcomes to a control group. Adults with type 2 diabetes (n=54) were randomly assigned to an intervention or control group. Intervention group participants completed one in-person motivational interviewing and decision support session followed by seven biweekly telephone coaching calls. Participants reported previous goal attempts and set diet- and/or physical activity-related goals during coaching calls. Control group participants received information about local health care resources on the same contact schedule. There was a significant difference between groups for diabetes empowerment (p=0.045). A significant increase in diet quality, diabetes self-efficacy, and diabetes empowerment, and a significant decrease in diabetes distress and depressive symptoms (all p≤0.05) occurred in the intervention group. Decision confidence to achieve diet-related goals significantly improved from baseline to week 8 but then declined at study end (both p≤0.05). Setting specific diet-related goals may promote dietary change, and telephone coaching can improve psychosocial outcomes related to diabetes self-management. Informed shared decision making can facilitate progressively challenging yet attainable goals tailored to individuals' lifestyle. Decision coaching may empower patients to improve self-management practices and reduce distress. Copyright © 2017 Elsevier B.V. All rights reserved.

Expert system in PNC, 6

International Nuclear Information System (INIS)

Tsubota, Koji

1990-01-01

The application of Artificial Intelligence (AI) as a tool for mineral exploration started only a decade ago. The systems that have been reported are in the most cases the expert systems that can simulate the decision of the experts or help numerical calculation for more reasonable and/or fast decision making. PNC started the development of the expert system for uranium exploration in 1983. Since then, KOGITO, a expert system to find the favorability of the target area, has been developed. Two years ago, the second generation development, Intelligent Research Environment and Support System, IRESS was initiated aiming at the establishment of a total support system for a project evaluation. We will review our effort for development of our system and introduce the application of the Data directed Numerical method as a new tool to Ahnemland area in Australia. (author)

24 CFR 3285.704 - Telephone and cable TV.

Science.gov (United States)

2010-04-01

... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Telephone and cable TV. 3285.704....704 Telephone and cable TV. Refer to § 3285.906 for considerations pertinent to installation of telephone and cable TV. ...

Identifying the core competencies of mental health telephone triage.

Science.gov (United States)

Sands, Natisha; Elsom, Stephen; Gerdtz, Marie; Henderson, Kathryn; Keppich-Arnold, Sandra; Droste, Nicolas; Prematunga, Roshani K; Wereta, Zewdu W

2013-11-01

The primary aim of this study was to identify the core competencies of mental health telephone triage, including key role tasks, skills, knowledge and responsibilities, in which clinicians are required to be competent to perform safe and effective triage. Recent global trends indicate an increased reliance on telephone-based health services to facilitate access to health care across large populations. The trend towards telephone-based health services has also extended to mental health settings, evidenced by the growing number of mental health telephone triage services providing 24-hour access to specialist mental health assessment and treatment. Mental health telephone triage services are critical to the early identification of mental health problems and the provision of timely, appropriate interventions. In spite of the rapid growth in mental health telephone triage and the important role these services play in the assessment and management of mental illness and related risks, there has been very little research investigating this area of practice. An observational design was employed to address the research aims. Structured observations (using dual wireless headphones) were undertaken on 197 occasions of mental health telephone triage over a three-month period from January to March 2011. The research identified seven core areas of mental health telephone triage practice in which clinicians are required to be competent in to perform effective mental health telephone triage, including opening the call; performing mental status examination; risk assessment; planning and action; termination of call; referral and reporting; and documentation. The findings of this research contribute to the evidence base for mental health telephone triage by articulating the core competencies for practice. The mental health telephone triage competencies identified in this research may be used to define an evidence-based framework for mental health telephone triage practice that aims to

Cellular telephone use and cancer risk

DEFF Research Database (Denmark)

Schüz, Joachim; Jacobsen, Rune; Olsen, Jørgen H.

2006-01-01

BACKGROUND: The widespread use of cellular telephones has heightened concerns about possible adverse health effects. The objective of this study was to investigate cancer risk among Danish cellular telephone users who were followed for up to 21 years. METHODS: This study is an extended follow......-up of a large nationwide cohort of 420,095 persons whose first cellular telephone subscription was between 1982 and 1995 and who were followed through 2002 for cancer incidence. Standardized incidence ratios (SIRs) were calculated by dividing the number of observed cancer cases in the cohort by the number...... expected in the Danish population. RESULTS: A total of 14,249 cancers were observed (SIR = 0.95; 95% confidence interval [CI] = 0.93 to 0.97) for men and women combined. Cellular telephone use was not associated with increased risk for brain tumors (SIR = 0.97), acoustic neuromas (SIR = 0.73), salivary...

Guidelines for the verification and validation of expert system software and conventional software: Survey and documentation of expert system verification and validation methodologies. Volume 3

International Nuclear Information System (INIS)

Groundwater, E.H.; Miller, L.A.; Mirsky, S.M.

1995-03-01

This report is the third volume in the final report for the Expert System Verification and Validation (V ampersand V) project which was jointly sponsored by the Nuclear Regulatory Commission and the Electric Power Research Institute. The ultimate objective is the formulation of guidelines for the V ampersand V of expert systems for use in nuclear power applications. The purpose of this activity was to survey and document techniques presently in use for expert system V ampersand V. The survey effort included an extensive telephone interviewing program, site visits, and a thorough bibliographic search and compilation. The major finding was that V ampersand V of expert systems is not nearly as established or prevalent as V ampersand V of conventional software systems. When V ampersand V was used for expert systems, it was almost always at the system validation stage after full implementation and integration usually employing the non-systematic dynamic method of open-quotes ad hoc testing.close quotes There were few examples of employing V ampersand V in the early phases of development and only weak sporadic mention of the possibilities in the literature. There is, however, a very active research area concerning the development of methods and tools to detect problems with, particularly, rule-based expert systems. Four such static-testing methods were identified which were not discovered in a comprehensive review of conventional V ampersand V methods in an earlier task

Learning how to learn using simulation: Unpacking disguised feedback using a qualitative analysis of doctors' telephone talk.

Science.gov (United States)

Eppich, Walter J; Rethans, Jan-Joost; Dornan, Timothy; Teunissen, Pim W

2018-05-04

Telephone talk between clinicians represents a substantial workplace activity in postgraduate clinical education, yet junior doctors receive little training in goal-directed, professional telephone communication. To assess educational needs for telephone talk and develop a simulation-based educational intervention. Thematic analysis of 17 semi-structured interviews with doctors-in-training from various training levels and specialties. We identified essential elements to incorporate into simulation-based telephone talk, including common challenging situations for junior doctors as well as explicit and informal aspects that promote learning. These elements have implications for both junior doctors and clinical supervisors, including: (a) explicit teaching and feedback practices and (b) informal conversational interruptions and questions. The latter serve as "disguised" feedback, which aligns with recent conceptualizations of feedback as "performance relevant information". In addition to preparing clinical supervisors to support learning through telephone talk, we propose several potential educational strategies: (a) embedding telephone communication skills throughout simulation activities and (b) developing stand-alone curricular elements to sensitize junior doctors to "disguised" feedback during telephone talk as a mechanism to augment future workplace learning, i.e. 'learning how to learn' through simulation.

Network of mobile telephone communication: necessarily of 3. Millennium

International Nuclear Information System (INIS)

Dejana, V.; Dragan, M.; Nebojsa, V.; Simo, S.

2002-01-01

Mobile telephones have transformed the telecommunications industry. These devices can be used to make telephone calls from almost anywhere. There are two types, one has the antenna mounted on the handset and the other has the antenna mounted on a separate transmitter or, if the telephone is installed in a vehicle, mounted on the roof or rear window. Communication between a mobile telephone and the nearest base station is achieved by the microwave emissions from the antenna. Concerns have been raised about the type of mobile telephone that has the antenna in the handset. In this case, the antenna is very close to the user's head during normal use of the telephone and there is concern about the level of microwave emissions to which the brain is being exposed. Those telephones that have the antenna mounted elsewhere are of no concern, since exposure levels decrease rapidly with increasing distance from the antenna. Cordless telephones, which need to be operated within about 20 metres of a base unit that is connected directly to the telephone system, do not have any health concerns associated with their use because exposure levels are very low

Quasi-experimental trial of diabetes Self-Management Automated and Real-Time Telephonic Support (SMARTSteps) in a Medicaid managed care plan: study protocol.

Science.gov (United States)

Ratanawongsa, Neda; Handley, Margaret A; Quan, Judy; Sarkar, Urmimala; Pfeifer, Kelly; Soria, Catalina; Schillinger, Dean

2012-01-26

Health information technology can enhance self-management and quality of life for patients with chronic disease and overcome healthcare barriers for patients with limited English proficiency. After a randomized controlled trial of a multilingual automated telephone self-management support program (ATSM) improved patient-centered dimensions of diabetes care in safety net clinics, we collaborated with a nonprofit Medicaid managed care plan to translate research into practice, offering ATSM as a covered benefit and augmenting ATSM to promote medication activation. This paper describes the protocol of the Self-Management Automated and Real-Time Telephonic Support Project (SMARTSteps). This controlled quasi-experimental trial used a wait-list variant of a stepped wedge design to enroll 362 adult health plan members with diabetes who speak English, Cantonese, or Spanish and receive care at 4 publicly-funded clinics. Through language-stratified randomization, participants were assigned to four intervention statuses: SMARTSteps-ONLY, SMARTSteps-PLUS, or wait-list for either intervention. In addition to usual primary care, intervention participants received 27 weekly calls in their preferred language with rotating queries and response-triggered education about self-care, medication adherence, safety concerns, psychological issues, and preventive services. Health coaches from the health plan called patients with out-of-range responses for collaborative goal setting and action planning. SMARTSteps-PLUS also included health coach calls to promote medication activation, adherence and intensification, if triggered by ATSM-reported non-adherence, refill non-adherence from pharmacy claims, or suboptimal cardiometabolic indicators. Wait-list patients crossed-over to SMARTSteps-ONLY or -PLUS at 6 months. For participants who agreed to structured telephone interviews at baseline and 6 months (n = 252), primary outcomes will be changes in quality of life and functional status with

Verification and validation of decision support software: Expert Choice{trademark} and PCM{trademark}

Energy Technology Data Exchange (ETDEWEB)

Nguyen, Q.H.; Martin, J.D.

1994-11-04

This report documents the verification and validation of two decision support programs: EXPERT CHOICE{trademark} and PCM{trademark}. Both programs use the Analytic Hierarchy Process (AHP) -- or pairwise comparison technique -- developed by Dr. Thomas L. Saaty. In order to provide an independent method for the validating the two programs, the pairwise comparison algorithm was developed for a standard mathematical program. A standard data set -- selecting a car to purchase -- was used with each of the three programs for validation. The results show that both commercial programs performed correctly.

Comparison of Cardiopulmonary Resuscitation Quality Between Standard Versus Telephone-Basic Life Support Training Program in Middle-Aged and Elderly Housewives: A Randomized Simulation Study.

Science.gov (United States)

Kim, Tae Han; Lee, Yu Jin; Lee, Eui Jung; Ro, Young Sun; Lee, KyungWon; Lee, Hyeona; Jang, Dayea Beatrice; Song, Kyoung Jun; Shin, Sang Do; Myklebust, Helge; Birkenes, Tonje Søraas

2018-02-01

For cardiac arrests witnessed at home, the witness is usually a middle-aged or older housewife. We compared the quality of cardiopulmonary resuscitation (CPR) performance of bystanders trained with the newly developed telephone-basic life support (T-BLS) program and those trained with standard BLS (S-BLS) training programs. Twenty-four middle-aged and older housewives without previous CPR education were enrolled and randomized into two groups of BLS training programs. The T-BLS training program included concepts and current instruction protocols for telephone-assisted CPR, whereas the S-BLS training program provided training for BLS. After each training course, the participants simulated CPR and were assisted by a dispatcher via telephone. Cardiopulmonary resuscitation quality was measured and recorded using a mannequin simulator. The primary outcome was total no-flow time (>1.5 seconds without chest compression) during simulation. Among 24 participants, two (8.3%) who experienced mechanical failure of simulation mannequin and one (4.2%) who violated simulation protocols were excluded at initial simulation, and two (8.3%) refused follow-up after 6 months. The median (interquartile range) total no-flow time during initial simulation was 79.6 (66.4-96.9) seconds for the T-BLS training group and 147.6 (122.5-184.0) seconds for the S-BLS training group (P trained with the T-BLS training program showed shorter no-flow time and fewer interruptions during bystander CPR simulation assisted by a dispatcher.

Lunar phases and crisis center telephone calls.

Science.gov (United States)

Wilson, J E; Tobacyk, J J

1990-02-01

The lunar hypothesis, that is, the notion that lunar phases can directly affect human behavior, was tested by time-series analysis of 4,575 crisis center telephone calls (all calls recorded for a 6-month interval). As expected, the lunar hypothesis was not supported. The 28-day lunar cycle accounted for less than 1% of the variance of the frequency of crisis center calls. Also, as hypothesized from an attribution theory framework, crisis center workers reported significantly greater belief in lunar effects than a non-crisis-center-worker comparison group.

Impact of the telephone assistive device (TAD) on stuttering severity while speaking on the telephone.

Science.gov (United States)

Chambers, Nola

2009-01-01

There is extensive experimental evidence that altered auditory feedback (AAF) can have a clinically significant effect on the severity of speech symptoms in people who stutter. However, there is less evidence regarding whether these experimental effects can be observed in naturalistic everyday settings particularly when using the telephone. This study aimed to investigate the effectiveness of the Telephone Assistive Device (TAD), which is designed to provide AAF on the telephone to people who stutter, on reducing stuttering severity. Nine adults participated in a quasi-experimental study. Stuttering severity was measured first without and then with the device in participants' naturalistic settings while making and receiving telephone calls (immediate benefit). Participants were then allowed a week of repeated use of the device following which all measurements were repeated (delayed benefit). Overall, results revealed significant immediate benefits from the TAD in all call conditions. Delayed benefits in received and total calls were also significant. There was substantial individual variability in response to the TAD but none of the demographic or speech-related factors measured in the study were found to significantly impact the benefit (immediate or delayed) derived from the TAD. Results have implications for clinical decision making for adults who stutter.

Developing Expert System for Tuberculosis Diagnose to Support Knowledge Sharing in the Era of National Health Insurance System

Science.gov (United States)

Lidya, L.

2017-03-01

National Health Insurance has been implemented since 1st January 2014. A number of new policies have been established including multilevel referral system. The multilevel referral system classified health care center into three levels, it determined that the flow of patient treatment should be started from first level health care center. There are 144 kind of diseases that must be treat in the first level which mainly consists of general physicians. Unfortunately, competence of the physician in the first level may not fulfil the standard competence yet. To improved the physisians knowledge, government has created many events to accelerate knowledge sharing. However, it still needs times and many resources to give significan results. Expert system is kind of software that provide consulting services to non-expert users in accordance with the area of its expertise. It can improved effectivity and efficiency of knowledge sharing and learning. This research was developed a model of TB diagnose expert system which comply with the standard procedure of TB diagnosis and regulation. The proposed expert system has characteristics as follows provide facility to manage multimedia clinical data, supporting the complexity of TB diagnosis (combine rule-based and case-based expert system), interactive interface, good usability, multi-platform, evolutionary.

7 CFR 1744.63 - The telephone loan budget.

Science.gov (United States)

2010-01-01

... 7 Agriculture 11 2010-01-01 2010-01-01 false The telephone loan budget. 1744.63 Section 1744.63... Disbursement of Funds § 1744.63 The telephone loan budget. When the loan is made, RUS provides the borrower a Telephone Loan Budget, RUS Form 493. This budget divides the loan into budget accounts such as “Engineering...

Operational expert system applications in Europe

CERN Document Server

Zarri, Gian Piero

1992-01-01

Operational Expert System Applications in Europe describes the representative case studies of the operational expert systems (ESs) that are used in Europe.This compilation provides examples of operational ES that are realized in 10 different European countries, including countries not usually examined in the standard reviews of the field.This book discusses the decision support system using several artificial intelligence tools; expert systems for fault diagnosis on computerized numerical control (CNC) machines; and expert consultation system for personal portfolio management. The failure prob

Jess, the Java expert system shell

Energy Technology Data Exchange (ETDEWEB)

Friedman-Hill, E.J.

1997-11-01

This report describes Jess, a clone of the popular CLIPS expert system shell written entirely in Java. Jess supports the development of rule-based expert systems which can be tightly coupled to code written in the powerful, portable Java language. The syntax of the Jess language is discussed, and a comprehensive list of supported functions is presented. A guide to extending Jess by writing Java code is also included.

Telephone and Face-to-Face Interviews with Low-Income Males with Child Care Responsibilities Support Inclusion as a Target Audience in SNAP-Ed.

Science.gov (United States)

Krall, Jodi Stotts; Wamboldt, Patricia; Lohse, Barbara

2015-06-01

Federally funded nutrition programs mostly target females. Changes in family dynamics suggest low-income men have an important role in food management responsibilities. The purpose of this study was to inform nutrition education program planning to meet needs of lower-income males. Cross-sectional telephone and face-to-face interviews. Stratified random sample of men (n = 101), 18-59 years of age, with child care responsibilities, living in households participating in the Supplemental Nutrition Assistance Program and a convenience sample of adult males (n = 25) recruited from lower income venues. (1) Scripted telephone interviews about health status, eating behaviors, eating competence, food security, technology usage and topics and strategies for nutrition education. (2) In-person cognitive interviews during review of selected online nutrition education lessons. Nutrition education topics of interest, preferred educational strategies, influences on and barriers to intake, eating competence, critiques of online program content, graphics, format. Bivariate correlations, independent t tests, one-way analysis of variance or Chi square, as appropriate. Thematic analyses of cognitive interviews. Of telephone interviewees, 92.1% prepared meals/snacks for children and 54.5% made major household food decisions. Taste was the greatest influence on food selection and the greatest barrier to eating healthful foods. Topics of highest interest were "which foods are best for kids" and "how to eat more healthy foods." Preferred nutrition education strategies included online delivery. Online lessons were highly rated. Interactive components were recognized as particularly appealing; enhanced male centricity of lessons was supported. Findings provided compelling evidence for including needs specific to low-income males when planning, designing, and funding nutrition education programs.

Upgrade of the CERN telephone exchange

CERN Multimedia

2006-01-01

As part of the upgrade of telephone services, maintenance work will be carried out on the CERN switching centre between 8.00 p.m. and 10.00 p.m. on Monday 9 October. Telephone services may be disrupted and possibly even interrupted during this time. We apologise in advance for any inconvenience this may cause. CERN TELECOM Service

The presentation of expert testimony via live audio-visual communication.

Science.gov (United States)

Miller, R D

1991-01-01

As part of a national effort to improve efficiency in court procedures, the American Bar Association has recommended, on the basis of a number of pilot studies, increased use of current audio-visual technology, such as telephone and live video communication, to eliminate delays caused by unavailability of participants in both civil and criminal procedures. Although these recommendations were made to facilitate court proceedings, and for the convenience of attorneys and judges, they also have the potential to save significant time for clinical expert witnesses as well. The author reviews the studies of telephone testimony that were done by the American Bar Association and other legal research groups, as well as the experience in one state forensic evaluation and treatment center. He also reviewed the case law on the issue of remote testimony. He then presents data from a national survey of state attorneys general concerning the admissibility of testimony via audio-visual means, including video depositions. Finally, he concludes that the option to testify by telephone provides a significant savings in precious clinical time for forensic clinicians in public facilities, and urges that such clinicians work actively to convince courts and/or legislatures in states that do not permit such testimony (currently the majority), to consider accepting it, to improve the effective use of scarce clinical resources in public facilities.

NASA’s Universe of Learning: Engaging Subject Matter Experts to Support Museum Alliance Science Briefings

Science.gov (United States)

Marcucci, Emma; Slivinski, Carolyn; Lawton, Brandon L.; Smith, Denise A.; Squires, Gordon K.; Biferno, Anya A.; Lestition, Kathleen; Cominsky, Lynn R.; Lee, Janice C.; Rivera, Thalia; Walker, Allyson; Spisak, Marilyn

2018-06-01

NASA's Universe of Learning creates and delivers science-driven, audience-driven resources and experiences designed to engage and immerse learners of all ages and backgrounds in exploring the universe for themselves. The project is a unique partnership between the Space Telescope Science Institute, Caltech/IPAC, Jet Propulsion Laboratory, Smithsonian Astrophysical Observatory, and Sonoma State University and is part of the NASA SMD Science Activation Collective. The NASA’s Universe of Learning projects pull on the expertise of subject matter experts (scientist and engineers) from across the broad range of NASA Astrophysics themes and missions. One such project, which draws strongly on the expertise of the community, is the NASA’s Universe of Learning Science Briefings, which is done in collaboration with the NASA Museum Alliance. This collaboration presents a monthly hour-long discussion on relevant NASA astrophysics topics or events to an audience composed largely of informal educators from informal learning environments. These professional learning opportunities use experts and resources within the astronomical community to support increased interest and engagement of the informal learning community in NASA Astrophysics-related concepts and events. Briefings are designed to create a foundation for this audience using (1) broad science themes, (2) special events, or (3) breaking science news. The NASA’s Universe of Learning team engages subject matter experts to be speakers and present their science at these briefings to provide a direct connection to NASA Astrophysics science and provide the audience an opportunity to interact directly with scientists and engineers involved in NASA missions. To maximize the usefulness of the Museum Alliance Science Briefings, each briefing highlights resources related to the science theme to support informal educators in incorporating science content into their venues and/or interactions with the public. During this

Effects of automated smartphone mobile recovery support and telephone continuing care in the treatment of alcohol use disorder: study protocol for a randomized controlled trial.

Science.gov (United States)

McKay, James R; Gustafson, David H; Ivey, Megan; McTavish, Fiona; Pe-Romashko, Klaren; Curtis, Brenda; Oslin, David A; Polsky, Daniel; Quanbeck, Andrew; Lynch, Kevin G

2018-01-30

New smartphone communication technology provides a novel way to provide personalized continuing care support following alcohol treatment. One such system is the Addiction version of the Comprehensive Health Enhancement Support System (A-CHESS), which provides a range of automated functions that support patients. A-CHESS improved drinking outcomes over standard continuing care when provided to patients leaving inpatient treatment. Effective continuing care can also be delivered via telephone calls with a counselor. Telephone Monitoring and Counseling (TMC) has demonstrated efficacy in two randomized trials with alcohol-dependent patients. A-CHESS and TMC have complementary strengths. A-CHESS provides automated 24/7 recovery support services and frequent assessment of symptoms and status, but does not involve regular contact with a counselor. TMC provides regular and sustained contact with the same counselor, but no ongoing support between calls. The future of continuing care for alcohol use disorders is likely to involve automated mobile technology and counselor contact, but little is known about how best to integrate these services. To address this question, the study will feature a 2 × 2 design (A-CHESS for 12 months [yes/no] × TMC for 12 months [yes/no]), in which 280 alcohol-dependent patients in intensive outpatient programs (IOPs) will be randomized to one of the four conditions and followed for 18 months. We will determine whether adding TMC to A-CHESS produces fewer heavy drinking days than TMC or A-CHESS alone and test for TMC and A-CHESS main effects. We will determine the costs of each of the four conditions and the incremental cost-effectiveness of the three active conditions. Analyses will also examine secondary outcomes, including a biological measure of alcohol use, and hypothesized moderation and mediation effects. The results of the study will yield important information on improving patient alcohol use outcomes by integrating mobile

Effects of a Home-Based Telephone-Supported Physical Activity Program for Older Adult Veterans With Chronic Low Back Pain.

Science.gov (United States)

Goode, Adam P; Taylor, Shannon Stark; Hastings, Susan N; Stanwyck, Catherine; Coffman, Cynthia J; Allen, Kelli D

2018-05-01

Chronic low back pain (CLBP) is highly prevalent in older adults, leading to functional decline. The objective of this study was to evaluate physical activity (PA) only and PA plus cognitive-behavioral therapy for pain (CBT-P) among older adult veterans with CLBP. This study was a pilot randomized trial comparing a 12-week telephone-supported PA-only intervention group (PA group) or PA plus CBT-P intervention group (PA + CBT-P group) and a wait-list control group (WL group). The study setting was the Durham Veterans Affairs Health Care System. The study participants were 60 older adults with CLBP. The PA intervention included stretching, strengthening, and aerobic activities; CBT-P covered activity pacing, relaxation techniques, and cognitive restructuring. Feasibility measures included enrollment and completion metrics; acceptability was measured by completed phone calls. Primary outcomes included the Timed "Up & Go" Test and the PROMIS Health Assessment Questionnaire. Generalized linear mixed models were used to estimate changes within and between groups. Effect sizes were calculated with the Cohen d. Adverse effects were measured by self-report. The mean participant age was 70.3 years; 53% were not white, and 93% were men. Eighty-three percent of participants completed the study, and the mean number of completed phone calls was 10 (of 13). Compared with the results for the WL group, small to medium treatment effects were found for the intervention groups in the Timed "Up & Go" Test (PA group: -2.94 [95% CI = -6.24 to 0.35], effect size = -0.28; PA + CBT-P group: -3.26 [95% CI = -6.69 to 0.18], effect size = -0.31) and the PROMIS Health Assessment Questionnaire (PA group: -6.11 [95% CI = -12.85 to 0.64], effect size = -0.64; PA + CBT-P group: -4.10 [95% CI = -11.69 to 3.48], effect size = -0.43). Small treatment effects favored PA over PA + CBT-P. No adverse effects were noted. This was a pilot study, and a larger study is needed to verify the

A Laboratory Test Expert System for Clinical Diagnosis Support in Primary Health Care

Directory of Open Access Journals (Sweden)

Rodrigo Fernandez-Millan

2015-08-01

Full Text Available Clinical Decision Support Systems have the potential to reduce lack of communication and errors in diagnostic steps in primary health care. Literature reports have showed great advances in clinical decision support systems in the recent years, which have proven its usefulness in improving the quality of care. However, most of these systems are focused on specific areas of diseases. In this way, we propose a rule-based expert system, which supports clinicians in primary health care, providing a list of possible diseases regarding patient’s laboratory tests results in order to assist previous diagnosis. Our system also allows storing and retrieving patient’s data and the history of patient’s analyses, establishing a basis for coordination between the various health care levels. A validation step and speed performance tests were made to check the quality of the system. We conclude that our system could improve clinician accuracy and speed, resulting in more efficiency and better quality of service. Finally, we propose some recommendations for further research.

Expert system. Based advisory system for the operator's mental activities support

International Nuclear Information System (INIS)

Gieci, A.; Macko, J.; Mosny, J.

2000-01-01

The operator's mental activity is the most important part of his work. A processing of a large amount of the information by the operator is possible only if he/she possesses appropriate cognitive skills. To facilitate the novice's acquisition of the experienced operator's cognitive skills of the decision-making process a special type of the expert system was developed. The cognitive engineering's models and problem-solving methodology constitutes the basis of this expert system. The article gives an account of the prototype of the mentioned expert system developed to aid the whole mental activity of the nuclear power plant operator during his decision-making process. (author)

Evaluating the privacy properties of telephone metadata

Science.gov (United States)

Mayer, Jonathan; Mutchler, Patrick; Mitchell, John C.

2016-01-01

Since 2013, a stream of disclosures has prompted reconsideration of surveillance law and policy. One of the most controversial principles, both in the United States and abroad, is that communications metadata receives substantially less protection than communications content. Several nations currently collect telephone metadata in bulk, including on their own citizens. In this paper, we attempt to shed light on the privacy properties of telephone metadata. Using a crowdsourcing methodology, we demonstrate that telephone metadata is densely interconnected, can trivially be reidentified, and can be used to draw sensitive inferences. PMID:27185922

[COOP/WONCA: Reliability and validity of the test administered by telephone].

Science.gov (United States)

Pedrero-Pérez, Eduardo J; Díaz-Olalla, José Manuel

2016-01-01

The COOP/WONCA test was initially proposed as a self-report in which the answers were supported by drawings illustrating the state investigated. Subsequent studies have confirmed its usefulness as a mere verbal self-report face-to-face administered. No data have been found about its useful when administered by telephone interview. The aim of this study was to determine the psychometric properties of the COOP / WONCA test to measure Related Quality of Life (HRQoL) administered by telephone and compare them with those obtained in other forms of prior administration. Cross-sectional study on a random. City of Madrid. Random sample of 802 adult subjects, representative of the adult population in Madrid, obtained by stratification from the population census. Questionnaire COOP/WONCA with 9 ítems included in a broader battery, administered by telephone interview. The unrestricted factor analysis points to the unifactoriality of the scale, which measures a single latent construct (HRQOL), showing high internal consistency, not significantly different from those found by face-to-face administration, ruling out the existence of biases in the phone modality. The COOP/WONCA test appears as a reliable and valid measure of HRQOL and telephonic administration allows to assume no changes in the results, which can reduce costs in population studies, increasing efficiency without loss of quality in the information collected. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Maintenance of the CERN telephone exchanges

CERN Multimedia

IT/CS

2014-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 8 p.m. and 2 a.m. on 26 August.   Fixed-line telephone and audio-conference services may be disrupted during this intervention. Nevertheless, the CCC and the Fire Brigade will be reachable at any time. Mobile telephony services (GSM) will not be affected by the maintenance work.

Maintenance of the CERN telephone exchanges

CERN Multimedia

IT Department

2011-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 20h00 and 2h00 on the 16 November. Fixed-line telephone and audio-conference services may be disrupted during this intervention. Nevertheless, the CCC and the fire brigade will be reachable at any time. Mobile telephony services (GSM) will not be affected by the maintenance work. IT/CS

40 CFR 194.26 - Expert judgment.

Science.gov (United States)

2010-07-01

... CFR PART 191 DISPOSAL REGULATIONS Compliance Certification and Re-certification General Requirements... experts (by name and employer) involved in any expert judgment elicitation processes used to support the... judgment elicitation processes and the reasoning behind those results. Documentation of interviews used to...

Quasi-experimental trial of diabetes Self-Management Automated and Real-Time Telephonic Support (SMARTSteps in a Medicaid managed care plan: study protocol

Directory of Open Access Journals (Sweden)

Ratanawongsa Neda

2012-01-01

Full Text Available Abstract Background Health information technology can enhance self-management and quality of life for patients with chronic disease and overcome healthcare barriers for patients with limited English proficiency. After a randomized controlled trial of a multilingual automated telephone self-management support program (ATSM improved patient-centered dimensions of diabetes care in safety net clinics, we collaborated with a nonprofit Medicaid managed care plan to translate research into practice, offering ATSM as a covered benefit and augmenting ATSM to promote medication activation. This paper describes the protocol of the Self-Management Automated and Real-Time Telephonic Support Project (SMARTSteps. Methods/Design This controlled quasi-experimental trial used a wait-list variant of a stepped wedge design to enroll 362 adult health plan members with diabetes who speak English, Cantonese, or Spanish and receive care at 4 publicly-funded clinics. Through language-stratified randomization, participants were assigned to four intervention statuses: SMARTSteps-ONLY, SMARTSteps-PLUS, or wait-list for either intervention. In addition to usual primary care, intervention participants received 27 weekly calls in their preferred language with rotating queries and response-triggered education about self-care, medication adherence, safety concerns, psychological issues, and preventive services. Health coaches from the health plan called patients with out-of-range responses for collaborative goal setting and action planning. SMARTSteps-PLUS also included health coach calls to promote medication activation, adherence and intensification, if triggered by ATSM-reported non-adherence, refill non-adherence from pharmacy claims, or suboptimal cardiometabolic indicators. Wait-list patients crossed-over to SMARTSteps-ONLY or -PLUS at 6 months. For participants who agreed to structured telephone interviews at baseline and 6 months (n = 252, primary outcomes will be

Quasi-experimental trial of diabetes Self-Management Automated and Real-Time Telephonic Support (SMARTSteps) in a Medicaid managed care plan: study protocol

Science.gov (United States)

2012-01-01

Background Health information technology can enhance self-management and quality of life for patients with chronic disease and overcome healthcare barriers for patients with limited English proficiency. After a randomized controlled trial of a multilingual automated telephone self-management support program (ATSM) improved patient-centered dimensions of diabetes care in safety net clinics, we collaborated with a nonprofit Medicaid managed care plan to translate research into practice, offering ATSM as a covered benefit and augmenting ATSM to promote medication activation. This paper describes the protocol of the Self-Management Automated and Real-Time Telephonic Support Project (SMARTSteps). Methods/Design This controlled quasi-experimental trial used a wait-list variant of a stepped wedge design to enroll 362 adult health plan members with diabetes who speak English, Cantonese, or Spanish and receive care at 4 publicly-funded clinics. Through language-stratified randomization, participants were assigned to four intervention statuses: SMARTSteps-ONLY, SMARTSteps-PLUS, or wait-list for either intervention. In addition to usual primary care, intervention participants received 27 weekly calls in their preferred language with rotating queries and response-triggered education about self-care, medication adherence, safety concerns, psychological issues, and preventive services. Health coaches from the health plan called patients with out-of-range responses for collaborative goal setting and action planning. SMARTSteps-PLUS also included health coach calls to promote medication activation, adherence and intensification, if triggered by ATSM-reported non-adherence, refill non-adherence from pharmacy claims, or suboptimal cardiometabolic indicators. Wait-list patients crossed-over to SMARTSteps-ONLY or -PLUS at 6 months. For participants who agreed to structured telephone interviews at baseline and 6 months (n = 252), primary outcomes will be changes in quality of life and

Initial fieldwork for LWAZI: a telephone-based spoken dialog system for rural South Africa

CSIR Research Space (South Africa)

Gumede, T

2009-03-01

Full Text Available government information and services. Our interviews, focus group discussions and surveys revealed that Lwazi, a telephone-based spoken dialog system, could greatly support current South African government efforts to effectively connect citizens to available...

Participants' views of telephone interviews within a grounded theory study.

Science.gov (United States)

Ward, Kim; Gott, Merryn; Hoare, Karen

2015-12-01

To offer a unique contribution to the evolving debate around the use of the telephone during semistructured interview by drawing on interviewees' reflections on telephone interview during a grounded theory study. The accepted norm for qualitative interviews is to conduct them face-to-face. It is typical to consider collecting qualitative data via telephone only when face-to-face interview is not possible. During a grounded theory study, exploring users' experiences with overnight mask ventilation for sleep apnoea, the authors selected the telephone to conduct interviews. This article reports participants' views on semistructured interview by telephone. An inductive thematic analysis was conducted on data pertaining to the use of the telephone interview in a grounded theory study. The data were collected during 4 months of 2011 and 6 months in 2014. The article presents an inductive thematic analysis of sixteen participants' opinions about telephone interviewing and discusses these in relation to existing literature reporting the use of telephone interviews in grounded theory studies. Overall, participants reported a positive experience of telephone interviewing. From each participants reports we identified four themes from the data: being 'phone savvy; concentrating on voice instead of your face; easy rapport; and not being judged or feeling inhibited. By drawing on these data, we argue that the telephone as a data collection tool in grounded theory research and other qualitative methodologies need not be relegated to second best status. Rather, researchers can consider telephone interview a valuable first choice option. © 2015 John Wiley & Sons Ltd.

Telephone: The Old Technology that is Never Old

Directory of Open Access Journals (Sweden)

Olubunmi Philip Aborisade

2012-09-01

Full Text Available Telephone technology is a technology that stands the test of time. Since it was invented in 1876 by Alexander Graham Belle, it remains the technology of all time. This article reports the major finding of a recent research, how technology transforms citizen journalism business in Nigeria. According to the research, Telephone technology has over the years emerged the major tool with which ordinary citizens in Nigeria without journalism and media background or affiliation participate in the process of news gathering, reporting and distribution. Guided by the recent use of telephone around the world by ordinary citizens to report themselves during protests through different social media outlets-Facebook, Tweeter, Youtube, the article illuminates the evergreen nature of the telephone. The article therefore concluded that the telephone technology invented in 1876 has survived the test of time. Instead of being obsolete, it blends with emerging communications technology to improve on its performance.

[Potential selection bias in telephone surveys: landline and mobile phones].

Science.gov (United States)

Garcia-Continente, Xavier; Pérez-Giménez, Anna; López, María José; Nebot, Manel

2014-01-01

The increasing use of mobile phones in the last decade has decreased landline telephone coverage in Spanish households. This study aimed to analyze sociodemographic characteristics and health indicators by type of telephone service (mobile phone vs. landline or landline and mobile phone). Two telephone surveys were conducted in Spanish samples (February 2010 and February 2011). Multivariate logistic regression analyses were performed to analyze differences in the main sociodemographic characteristics and health indicators according to the type of telephone service available in Spanish households. We obtained 2027 valid responses (1627 landline telephones and 400 mobile phones). Persons contacted through a mobile phone were more likely to be a foreigner, to belong to the manual social class, to have a lower educational level, and to be a smoker than those contacted through a landline telephone. The profile of the population that has only a mobile phone differs from that with a landline telephone. Therefore, telephone surveys that exclude mobile phones could show a selection bias. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Maintenance of the CERN telephone exchanges

CERN Multimedia

IT Department

2009-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 8h30 and 17h30 on Saturday 9 May. Fixed-line telephone and audio-conference services may be disrupted during this intervention. Nevertheless, the CCC and the fire brigade will be reachable at any time. Mobile telephony services (GSM) will not be affected by the maintenance work. IT/CS/CS

The moral agency of institutions: effectively using expert nurses to support patient autonomy.

Science.gov (United States)

Charles, Sonya

2017-08-01

Patient autonomy-with an emphasis on informed consent and the right to refuse treatment-is a cornerstone of modern bioethics. Within discussions about patient autonomy, feminist bioethicists have argued for a relational approach to autonomy. Under a relational framework, we must look beyond the individual moment of choice to include the role relationships and specific contexts can play in supporting or undermining autonomy. Given the day-to-day interactions they have with patients, nurses play a significant role in helping patients understand the nature of their illnesses and make truly informed decisions. However, the skills of expert nurses also support patient autonomy in more subtle ways. Specifically, nurses develop skills of attunement that help them to find subtle ways to support patient autonomy. However, in order to effectively do this, nurses need institutions that support their professional autonomy. In this paper, I look at the ways nurses have been inhibited in their professional autonomy both as a profession and as individual practitioners. I argue that turning our attention to institutions and the role they play in supporting or undermining nurses' autonomy can help promote nurses' professional autonomy and thereby enhance patient autonomy. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Improvement of Metroliner Telephone Channel Capacity and Modeling of Telephone Channel Demands

Science.gov (United States)

1972-03-01

The channel capacity of the present Metroliner telephone system is analyzed and methods are proposed to increase that capacity without increasing the overall bandwidth. To determine the number of channels required, calculations have been carried out ...

Large Pelagics Telephone Survey

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Large Pelagics Telephone Survey (LPTS) collects fishing effort information directly from captains holding Highly Migratory Species (HMS) permits (required by...

Maintenance of the CERN telephone exchanges

CERN Multimedia

IT Department

2011-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 20h00 and midnight on the 21st of February in order to apply the latest software patches. Fixed-line telephone and audio-conference services may be disrupted during this intervention. Nevertheless, the CCC and the fire brigade will be reachable at any time. Mobile telephony services (GSM) will not be affected by the maintenance work. CS Group

ENERGY STAR Certified Telephones

Data.gov (United States)

U.S. Environmental Protection Agency — Certified models meet all ENERGY STAR requirements as listed in the Version 3.0 ENERGY STAR Program Requirements for Telephony (cordless telephones and VoIP...

Maintenance of the CERN telephone exchanges

CERN Multimedia

IT Department

2009-01-01

Maintenance work will be carried out on the CERN telephone exchanges between 20h00 and midnight on the 29th of July in order to apply the latest software patches. Fixed-line telephone and audio-conference services may be disrupted during this intervention. Nevertheless, the CCC and the fire brigade will be reachable at any time. Mobile telephony services (GSM) will not be affected by the maintenance work. IT/CS/CS

HOspitals and patients WoRking in Unity (HOW R U?): protocol for a prospective feasibility study of telephone peer support to improve older patients' quality of life after emergency department discharge.

Science.gov (United States)

Lowthian, Judy A; Lennox, Alyse; Curtis, Andrea; Dale, Jeremy; Browning, Colette; Smit, De Villiers; Wilson, Gillian; O'Brien, Debra; Rosewarne, Cate; Boyd, Lee; Garner, Cath; Cameron, Peter

2016-12-02

Older people presenting to an emergency department (ED) have a higher likelihood of social isolation, loneliness and depression; which are all associated with negative health outcomes and increased health service use, including higher rates of ED attendance. The HOW R U? study aims to ascertain the feasibility and acceptability of a postdischarge telephone support programme for older ED patients following discharge. The intervention, which aims to improve quality of life, will be delivered by hospital-based volunteers. A multicentre prospective uncontrolled feasibility study will enrol 50 community-dwelling patients aged ≥70 years with symptoms of loneliness or depression who are discharged home within 72 hours from the ED or acute medical ward. Participants will receive weekly supportive telephone calls over a 3-month period from a volunteer-peer. Feasibility will be assessed in terms of recruitment, acceptability of the intervention to participants and level of retention in the programme. Changes in level of loneliness (UCLA-3 item Loneliness Scale), mood (Geriatric Depression Scale-5 item) and health-related quality of life (EQ-5D-5L and EQ-VAS) will also be measured postintervention (3 months). Research ethics and governance committee approval has been granted for this study by each participating centre (reference: 432/15 and 12-09-11-15). Study findings will inform the design and conduct of a future multicentre randomised controlled trial of a postdischarge volunteer-peer telephone support programme to improve social isolation, loneliness or depressive symptoms in older patients. Results will be disseminated through peer-reviewed journal publication, and conference and seminar presentation. ACTRN12615000715572, Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Randomized Controlled Trial of Telephone-Delivered Cognitive Behavioral Therapy for Chronic Insomnia

Science.gov (United States)

Arnedt, J. Todd; Cuddihy, Leisha; Swanson, Leslie M.; Pickett, Scott; Aikens, James; Chervin, Ronald D.

2013-01-01

Study Objectives: To compare the efficacy of telephone-delivered cognitive-behavioral therapy for insomnia to an information pamphlet control on sleep and daytime functioning at pretreatment, posttreatment, and 12-wk follow-up. Design: Randomized controlled parallel trial. Setting: N/A. Participants: Thirty individuals with chronic insomnia (27 women, age 39.1 ± 14.4 years, insomnia duration 8.7 ± 10.7 years). Interventions: Cognitive behavioral therapy for insomnia (CBTI) delivered in up to eight weekly telephone sessions (CBTI-Phone, n = 15) versus an information pamphlet control (IPC, n = 15). Measurements and Results: Sleep/wake diary, sleep-related questionnaires (Insomnia Severity Index, Pittsburgh Sleep Quality Index, 16-item Dysfunctional Beliefs and Attitudes about Sleep), and daytime symptom assessments (fatigue, depression, anxiety, and quality of life) were completed at pretreatment, posttreatment, and 12-wk follow-up. Linear mixed models indicated that sleep/wake diary sleep efficiency and total sleep time improved significantly at posttreatment in both groups and remained stable at 12-wk follow-up. More CBTI-Phone than IPC patients showed posttreatment improvements in unhelpful sleep-related cognitions (P insomnia at follow-up (P insomnia. Future larger-scale studies with more diverse samples are warranted. Some individuals with insomnia may also benefit from pamphlet-delivered CBTI with brief telephone support. Citation: Arnedt JT; Cuddihy L; Swanson LM; Pickett S; Aikens J; Chervin RD. Randomized controlled trial of telephone-delivered cognitive behavioral therapy for chronic insomnia. SLEEP 2013;36(3):353-362. PMID:23450712

A Sandia telephone database system

Energy Technology Data Exchange (ETDEWEB)

Nelson, S.D.; Tolendino, L.F.

1991-08-01

Sandia National Laboratories, Albuquerque, may soon have more responsibility for the operation of its own telephone system. The processes that constitute providing telephone service can all be improved through the use of a central data information system. We studied these processes, determined the requirements for a database system, then designed the first stages of a system that meets our needs for work order handling, trouble reporting, and ISDN hardware assignments. The design was based on an extensive set of applications that have been used for five years to manage the Sandia secure data network. The system utilizes an Ingres database management system and is programmed using the Application-By-Forms tools.

Gym-based exercise was more costly compared with home-based exercise with telephone support when used as maintenance programs for adults with chronic health conditions: cost-effectiveness analysis of a randomised trial

Directory of Open Access Journals (Sweden)

Paul Jansons

2018-01-01

Registration: ACTRN12610001035011. [Jansons P, Robins L, O’Brien L, Haines T (2018 Gym-based exercise was more costly compared with home-based exercise with telephone support when used as maintenance programs for adults with chronic health conditions: cost-effectiveness analysis of a randomised trial. Journal of Physiotherapy 64: 48–54

Telephone versus face-to-face interviewing for household drug use surveys.

Science.gov (United States)

Aquilino, W S

1992-01-01

This research investigated the use of telephone versus face-to-face interviewing to gather data on the use of tobacco, alcohol, and illicit drugs. Telephone and personal drug use surveys of the 18-34 year-old household population were conducted in the state of New Jersey in 1986-1987. Survey modes were compared in terms of unit and item nonresponse rates, sample coverage, and levels of self-reported drug use. Results showed that the telephone survey achieved response rates lower than the personal survey, but comparable to telephone surveys of less threatening topics. Item nonresponse to sensitive drug questions was lower by phone than with the self-administered answer sheets in the personal mode. The exclusion of households without telephones in the telephone survey is a potential source of bias, and may lead to underestimation of alcohol and drug use for minority populations. After controlling for telephone status, the telephone survey furnished significantly lower drug use estimates on several indicators than the personal survey, with the largest mode differences found for Blacks.

Expert System for support of natural gas network management; Sistema especialista para gerenciamento de redes de gas natural: SEGRED

Energy Technology Data Exchange (ETDEWEB)

Silva, Jonny Carlos da [Universidade Federal de Santa Catarina (UFSC), Florianopolis, SC (Brazil); Hirano, Eduardo Wulff [Universidade Federal de Santa Catarina (UFSC), Florianopolis, SC (Brazil). Lab. de Hidraulica e Pneumatica (LASHIP); Moura, Newton Reis de [PETROBRAS, Rio de Janeiro, RJ (Brazil); Freire, Luiz Gustavo de Melo [PETROBRAS S.A., Pojuca, BA (Brazil). Unidade de Negocios de Gas Natural (UNGN)

2004-07-01

This work reports on the SEGRED project, which aims to develop an expert system for management of natural gas transportation networks. The system is currently being developed by LASHIP-UFSC in partnership with PETROBRAS/CENPES and TBG. The SEGRED system consists of an environment designed to support natural gas pipeline management by means of remote supervision of process parameters and analysis of the mutual interactions of those parameters by an expert system integrated to a dynamic simulator. The system is deployed through a process that contributes to making available for use the knowledge about functions such as line packing analysis and line break detection, thus enhancing the quality of execution of these tasks, which are related to the management of natural gas transportation network. The main benefits consist of promoting efforts to acquire and organize expert knowledge. This process contributes to the generation of a knowledge base with corporate technical memory, which can be made available in a permanent, expansible and useful way for decision-making. (author)

Telecommunications Policy Research Conference. Subsidies in Telephone Pricing Section. Papers.

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Telecommunications Policy Research Conference, Inc., Washington, DC.

Three papers consider the provision of telephone service to rural and/or low income customers. The first paper, "An Analysis of Telephone Penetration" (Alexander Belinfante), analyzes the relationship between telephone penetration (the proportion of households with phone service) and prices, household income, and other factors. This…

Choosing a New Telephone System for Your Medical Practice.

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Metherell, Brian

2016-01-01

E-mail may rule the world in other types of businesses, but for medical practices, the telephone remains the primary mode of communication with patients, specialists, and pharmacies. From making appointments to calling in prescriptions, telephones are essential to patient care. With technology changing very quickly and new capabilities coming into the medical practice, such as telemedicine and Skype, you need to know your options when choosing a new telephone system. The possibilities include on-site, cloud, and hybrid networked solutions. A wide variety of features and capabilities are available, from dozens of vendors. Of course, no matter what telephone solution you choose, you must meet regulatory compliance, particularly HIPAA, and Payment Card Industry Data Security Standard if you take credit cards. And it has to be affordable, reliable, and long lasting. This article explores what medical practices need to know when choosing a new business telephone system in order to find the right solutions for their businesses.

Cellular telephone use among primary school children in Germany

International Nuclear Information System (INIS)

Boehler, Eva; Schuez, Joachim

2004-01-01

Background: There is some concern about potential health risks of cellular telephone use to children. We assessed data on how many children own a cellular telephone and on how often they use it in a population-based sample. Methods: We carried out a cross-sectional study among children in their fourth elementary school year, with a median-age of 10 years. The study was carried out in Mainz (Germany), a city with about 200,000 inhabitants. The study base comprised all 37 primary schools in Mainz and near surroundings. Altogether, 1933 children from 34 primary schools took part in the survey (participation rate of 87.8%). Results: Roughly a third of all children (n = 671, 34.7%) reported to own a cellular telephone. Overall, 119 (6.2%) children used a cellular telephone for making calls at least once a day, 123 (6.4%) used it several times a week and 876 (45.3%) children used it only once in a while. The remaining 805 (41.6%) children had never used a cellular telephone. The probability of owning a cellular telephone among children was associated with older age, being male, having no siblings, giving full particulars to height and weight, more time spent watching TV and playing computer games, being picked up by their parents from school by car (instead of walking or cycling) and going to bed late. The proportion of cellular telephone owners was somewhat higher in classes with more children from socially disadvantaged families. Conclusions: Our study shows that both ownership of a cellular telephone as well as the regular use of it are already quite frequent among children in the fourth grade of primary school. With regard to potential long-term effects, we recommend follow-up studies with children

24 CFR 3285.906 - Telephone and cable TV.

Science.gov (United States)

2010-04-01

... URBAN DEVELOPMENT MODEL MANUFACTURED HOME INSTALLATION STANDARDS Optional Information for Manufacturer's Installation Instructions § 3285.906 Telephone and cable TV. It is recommended that the installation instructions explain that telephone and cable TV wiring should be installed in accordance with requirements of...

Expert Cold Structure Development

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Atkins, T.; Demuysere, P.

2011-05-01

The EXPERT Program is funded by ESA. The objective of the EXPERT mission is to perform a sub-orbital flight during which measurements of critical aero- thermodynamic phenomena will be obtained by using state-of-the-art instrumentation. As part of the EXPERT Flight Segment, the responsibility of the Cold Structure Development Design, Manufacturing and Validation was committed to the Belgian industrial team SONACA/SABCA. The EXPERT Cold Structure includes the Launcher Adapter, the Bottom Panel, the Upper Panel, two Cross Panels and the Parachute Bay. An additional Launcher Adapter was manufactured for the separation tests. The selected assembly definition and manufacturing technologies ( machined parts and sandwich panels) were dictated classically by the mass and stiffness, but also by the CoG location and the sensitive separation interface. Used as support for the various on-board equipment, the Cold Structure is fixed to but thermally uncoupled from the PM 1000 thermal shield. It is protect on its bottom panel by a thermal blanket. As it is a protoflight, analysis was the main tool for the verification. Low level stiffness and modal analysis tests have also been performed on the Cold Structure equipped with its ballast. It allowed to complete its qualification and to prepare SONACA/SABCA support for the system dynamic tests foreseen in 2011. The structure was finally coated with a thermal control black painting and delivered on time to Thales Alenia Space-Italy end of March 201.

MARBLE: A system for executing expert systems in parallel

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Myers, Leonard; Johnson, Coe; Johnson, Dean

1990-01-01

This paper details the MARBLE 2.0 system which provides a parallel environment for cooperating expert systems. The work has been done in conjunction with the development of an intelligent computer-aided design system, ICADS, by the CAD Research Unit of the Design Institute at California Polytechnic State University. MARBLE (Multiple Accessed Rete Blackboard Linked Experts) is a system of C Language Production Systems (CLIPS) expert system tool. A copied blackboard is used for communication between the shells to establish an architecture which supports cooperating expert systems that execute in parallel. The design of MARBLE is simple, but it provides support for a rich variety of configurations, while making it relatively easy to demonstrate the correctness of its parallel execution features. In its most elementary configuration, individual CLIPS expert systems execute on their own processors and communicate with each other through a modified blackboard. Control of the system as a whole, and specifically of writing to the blackboard is provided by one of the CLIPS expert systems, an expert control system.

Expert Systems: What Is an Expert System?

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Duval, Beverly K.; Main, Linda

1994-01-01

Describes expert systems and discusses their use in libraries. Highlights include parts of an expert system; expert system shells; an example of how to build an expert system; a bibliography of 34 sources of information on expert systems in libraries; and a list of 10 expert system shells used in libraries. (Contains five references.) (LRW)

The telephone effect: Overcoming initiation deficits in two settings.

Science.gov (United States)

Vickers, Kayci L; Keesler, Michael E; Williams, Kelli S; Charles, Jeremy Y; Hamilton, Roy H

2018-04-19

Disorders of motivation substantially impair an individual's ability to communicate with their families, therapists, and doctors. One method of overcoming initiation deficits is by utilizing the telephone effect, which is the ability for individuals with severe motivation deficits to communicate more readily when speaking on a telephone. However, little is available in the extant literature on how this effect works or how best to integrate this into patient care. This article aims to provide the first report of a proposed mechanism underlying the telephone effect and the first published procedures for eliciting this effect. This is largely a review article that also contains descriptions of clinical procedures for eliciting the telephone effect with 2 patient populations: acute inpatients following brain injury and dementia residents. A case vignette is also provided. We propose that the telephone effect is the result of an interaction between the patient and environment, and occurs because of Gibson's (1979) law of affordances. The use of this theory provides an explanation of the behaviors often observed when attempting to elicit this effect (i.e., disruption of the effect when using a cellular phone). Moreover, we argue that this can, and does, apply to social interactions as well. The telephone effect is an understudied phenomenon that provides a means of improving care for individuals with disorders of motivation. Future directions include systematic research into the telephone effect and further investigation of the mechanism underlying this effect. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Are UK radiologists satisfied with the training and support received in suspected child abuse?

International Nuclear Information System (INIS)

Leung, R.S.; Nwachuckwu, C.; Pervaiz, A.; Wallace, C.; Landes, C.; Offiah, A.C.

2009-01-01

Aim: To determine current practice and perceptions of the adequacy of training and support received for the reporting of skeletal surveys in suspected physical child abuse. Materials and methods: A list of telephone numbers of UK hospitals with a radiology department was obtained from Royal College of Radiologists. One hundred hospitals were then randomly selected for inclusion in the survey. An 18-item questionnaire was successfully administered to consultant radiologists from 84 departments. Results: Sixty-one percent of departments had a named radiologist to report their skeletal surveys, 16% assigned surveys to a random radiologist, and 23% referred them elsewhere. Only 52% of departments had a dedicated paediatric radiologist, thus in a significant proportion of departments (25%) initial reports on skeletal surveys for physical abuse were provided by non-paediatric radiologists. Fifteen percent did not have ready access to a paediatric radiology opinion. Sixty-one percent thought that the service could be improved. Expert evidence was provided by 5% of respondents. Seventy-three percent would never consider providing expert evidence, even if given adequate radiology and/or legal training. Conclusion: The survey shows significant dissatisfaction amongst consultant radiologists with the current service, confirms a low number of paediatric radiologists taking on this work, and suggests the potential to increase numbers of radiology child abuse experts by 27% if given improved training and support. Appropriate service and education strategies should be implemented.

Are UK radiologists satisfied with the training and support received in suspected child abuse?

Energy Technology Data Exchange (ETDEWEB)

Leung, R.S. [Department of Radiology, Great Ormond Street Hospital for Children, London (United Kingdom); Nwachuckwu, C. [Department of Paediatrics, Whipps Cross Hospital, London (United Kingdom); Pervaiz, A. [Department of Radiology, Great Ormond Street Hospital for Children, London (United Kingdom); Wallace, C.; Landes, C. [Department of Radiology, Royal Liverpool Childrens NHS Trust, Liverpool (United Kingdom); Offiah, A.C. [Department of Radiology, Great Ormond Street Hospital for Children, London (United Kingdom)], E-mail: OffiaA@gosh.nhs.uk

2009-07-15

Aim: To determine current practice and perceptions of the adequacy of training and support received for the reporting of skeletal surveys in suspected physical child abuse. Materials and methods: A list of telephone numbers of UK hospitals with a radiology department was obtained from Royal College of Radiologists. One hundred hospitals were then randomly selected for inclusion in the survey. An 18-item questionnaire was successfully administered to consultant radiologists from 84 departments. Results: Sixty-one percent of departments had a named radiologist to report their skeletal surveys, 16% assigned surveys to a random radiologist, and 23% referred them elsewhere. Only 52% of departments had a dedicated paediatric radiologist, thus in a significant proportion of departments (25%) initial reports on skeletal surveys for physical abuse were provided by non-paediatric radiologists. Fifteen percent did not have ready access to a paediatric radiology opinion. Sixty-one percent thought that the service could be improved. Expert evidence was provided by 5% of respondents. Seventy-three percent would never consider providing expert evidence, even if given adequate radiology and/or legal training. Conclusion: The survey shows significant dissatisfaction amongst consultant radiologists with the current service, confirms a low number of paediatric radiologists taking on this work, and suggests the potential to increase numbers of radiology child abuse experts by 27% if given improved training and support. Appropriate service and education strategies should be implemented.

AIDS and condoms in Brasilia: a telephone survey.

Science.gov (United States)

Chequer, P; VanOss Marín, B; Paiva, L; Hudes, E S; Piazza, T; Rodrigues, L; Hearst, N

1997-10-01

A telephone survey was conducted to measure AIDS knowledge, media usage and condom attitudes and behaviors among 500 adults aged 18 to 49 in Brasilia, as well as to evaluate the feasibility of the telephone survey method in a developing country. The response rate was 91.6%. Respondents had good knowledge about correct modes of HIV transmission and prevention but also believed HIV was transmitted through blood donation, public toilets, swimming pools, and mosquito bites. TV and newspapers were the most important sources of information on health matters and AIDS, though health workers were considered the most credible sources of such information. Only 19% of sexual encounters in the 4 weeks prior to the survey included condoms. Single and younger respondents and those with more positive attitudes used condoms more frequently. More work is needed to identify appropriate messages to motivate people to use condoms. Telephone surveys regarding AIDS and sexual attitudes and behaviors are feasible in Brasilia, a planned community with universal telephone coverage.

Telephone delivered interventions for reducing morbidity and mortality in people with HIV infection.

Science.gov (United States)

Gentry, Sarah; van-Velthoven, Michelle H M M T; Tudor Car, Lorainne; Car, Josip

2013-05-31

This is one of three Cochrane reviews examining the role of the telephone in HIV/AIDS services. Telephone interventions, delivered either by landline or mobile phone, may be useful in the management of people living with HIV (PLHIV) in many situations. Telephone delivered interventions have the potential to reduce costs, save time and facilitate more support for PLHIV. To assess the effectiveness of voice landline and mobile telephone delivered interventions for reducing morbidity and mortality in people with HIV infection. We searched The Cochrane Central Register of Controlled Trials, MEDLINE, PubMed Central, EMBASE, PsycINFO, ISI Web of Science, Cumulative Index to Nursing & Allied Health, World Health Organisation's The Global Health Library and Current Controlled Trials from 1980 to June 2011. We searched the following grey literature sources: Dissertation Abstracts International, Centre for Agriculture Bioscience International Direct Global Health database, The System for Information on Grey Literature Europe, The Healthcare Management Information Consortium database, Google Scholar, Conference on Retroviruses and Opportunistic Infections, International AIDS Society, AIDS Educational Global Information System and reference lists of articles. Randomised controlled trials (RCTs), quasi-randomised controlled trials, controlled before and after studies, and interrupted time series studies comparing the effectiveness of telephone delivered interventions for reducing morbidity and mortality in persons with HIV infection versus in-person interventions or usual care, regardless of demographic characteristics and in all settings. Both mobile and landline telephone interventions were included, but mobile phone messaging interventions were excluded. Two reviewers independently searched, screened, assessed study quality and extracted data. Primary outcomes were change in behaviour, healthcare uptake or clinical outcomes. Secondary outcomes were appropriateness of the

REXS : A financial risk diagnostic expert system

Directory of Open Access Journals (Sweden)

W. Richter

2012-01-01

Full Text Available

ENGLISH ABSTRACT: Artificial intelligence techniques are rapidly emerging as important contributors to more effective management. One of the greatest growth areas probably lies in the use of Expert System methodology for supporting managerial decision processes.
Existing Decision Support Systems often attempt to apply analytical techniques in combination with traditional data access and retrieval functions. One of the problems usually encountered while developing such decision support systems is the need to transform an unstructured problem environment into a structured analytical model. Using an expert system approach to strategic decision making in such unstructured problem environments may provide significant advantages.
The financial Risk diagnostic EXpert System (REXS concentrates on Financial Risk Analysis. Based on a Forecasting Model the system will, with the support of several expert system knowledge bases, attempt to evaluate the financial risk of a business and provide guidelines for improvement.

AFRIKAANSE OPSOMMING: Tegnieke gebaseer op Kunsmatige Intelligensie toon tans die belofte om belangrike bydraes te maak tot meerBestaande Besluitsteunstelsels poog dikwels om analitiese tegnieke en lradisionele datatoegang- en onttrekkingsfunksies te kombineer. Een van die probleme wat gewoonlik ondervind word gedurende die ontwikkeling van '0 besluitsteunstelsel bestaan uit die behoefte om 'n ongestruktueerde probleemomgewing te transformeer na 'n gestruktueerde analitiese model. 'n Ekspertstelselbenadering lot strategiese besluitneming in 'n ongeSlruktureerde probleemomgewing mag betekenisvolle voordele inhou.
Die "financial Risk diagnostic EXpert System (REXS" konsentreer op fmansiele risiko-analise. Uitgaande vanaf 'n Vooruitskattingsmode~ en deur gebruik te maak van verskeie ekspertstelselkennisbasisse, poog die stelsel om die fmansiele risiko van 'n onderneming te evalueer en riglyne vir moontlike verbetering

THE EFFECTS OF MOBILE TELEPHONING ON DRIVING PERFORMANCE

NARCIS (Netherlands)

BROOKHUIS, KA; DEVRIES, G; DEWAARD, D

The effects of telephoning while driving were studied in three different traffic conditions, i.e. in light traffic on a quiet motorway, in heavy traffic on a four-lane ring-road, and in city traffic. Twelve subjects, unfamiliar with mobile telephones, drove an instrumented vehicle for one hour each

Essential Nutrition and Food Systems Components for School Curricula: Views from Experts in Iran.

Science.gov (United States)

Sadegholvad, Sanaz; Yeatman, Heather; Omidvar, Nasrin; Parrish, Anne-Maree; Worsley, Anthony

2017-07-01

This study aimed to investigate food experts' views on important nutrition and food systems knowledge issues for education purposes at schools in Iran. In 2012, semi-structured, face-to-face or telephone interviews were conducted with twenty-eight acknowledged Iranian experts in food and nutrition fields. Participants were selected from four major provinces in Iran (Tehran, Isfahan, Fars and Gilan). Open-ended interview questions were used to identify nutrition and food systems knowledge issues, which experts considered as important to be included in school education programs. Qualitative interviews were analyzed thematically using NVivo. A framework of knowledge that would assist Iranian students and school-leavers to make informed decisions in food-related areas was developed, comprising five major clusters and several sub-clusters. Major knowledge clusters included nutrition basics; food production; every day food-related practices; prevalent nutritional health problems in Iran and improvement of students' ethical attitudes in the food domain. These findings provide a guide to curriculum developers and policy makers to assess current education curricula in order to optimize students' knowledge of nutrition and food systems.

Nutritional support and parenteral nutrition in cancer patients: An expert consensus report.

Science.gov (United States)

Ocón Bretón, María Julia; Luengo Pérez, Luis Miguel; Virizuela, Juan Antonio; Álvarez Hernández, Julia; Jiménez Fonseca, Paula; Cervera Peris, Mercedes; Sendrós Madroño, María José; Grande, Enrique; Camblor Álvarez, Miguel

2018-03-01

Malnutrition is a common medical problem in cancer patients with a negative impact on quality of life. The aim of this study was to address different issues related to nutritional management of cancer patients in clinical practice. A multidisciplinary group of experts in Medical Oncology, Pharmacy, and Endocrinology and Nutrition prepared a list of topics related to the nutritional status of cancer patients and grouped them into three blocks: nutritional support, parenteral nutrition (PN), and home PN (HPN). A literature review was made of articles published in Spanish, English and French until April 2017. This consensus emphasizes several key elements that help physicians standardize management of the nutritional status of cancer patients in clinical practice, and establishes common guidelines for indication, monitoring, nutritional requirements, and access routes to PN. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

PSG-EXPERT. An expert system for the diagnosis of sleep disorders.

Science.gov (United States)

Fred, A; Filipe, J; Partinen, M; Paiva, T

2000-01-01

This paper describes PSG-EXPERT, an expert system in the domain of sleep disorders exploring polysomnographic data. The developed software tool is addressed from two points of view: (1)--as an integrated environment for the development of diagnosis-oriented expert systems; (2)--as an auxiliary diagnosis tool in the particular domain of sleep disorders. Developed over a Windows platform, this software tool extends one of the most popular shells--CLIPS (C Language Integrated Production System) with the following features: backward chaining engine; graph-based explanation facilities; knowledge editor including a fuzzy fact editor and a rules editor, with facts-rules integrity checking; belief revision mechanism; built-in case generator and validation module. It therefore provides graphical support for knowledge acquisition, edition, explanation and validation. From an application domain point of view, PSG-Expert is an auxiliary diagnosis system for sleep disorders based on polysomnographic data, that aims at assisting the medical expert in his diagnosis task by providing automatic analysis of polysomnographic data, summarising the results of this analysis in terms of a report of major findings and possible diagnosis consistent with the polysomnographic data. Sleep disorders classification follows the International Classification of Sleep Disorders. Major features of the system include: browsing on patients data records; structured navigation on Sleep Disorders descriptions according to ASDA definitions; internet links to related pages; diagnosis consistent with polysomnographic data; graphical user-interface including graph-based explanatory facilities; uncertainty modelling and belief revision; production of reports; connection to remote databases.

Can smartphones enhance telephone-based cognitive assessment (TBCA)?

Science.gov (United States)

Kwan, Rick Yiu-Cho; Lai, Claudia Kam-Yuk

2013-12-12

TBCA has emerged to solve the limitations of administering cognitive assessments face-to-face. The recent development of telephones and knowledge advances in the area of cognitive impairment may affect the development of TBCA. The purpose of this paper is to discuss how smartphones can be used to enhance the applicability of TBCA, which has previously been administered by conventional telephone. This paper will first review, describe and critique the existing TBCA instruments. It will then discuss the recent developments in tele-technology, the popularity of tele-technology among the elderly, potential benefits and challenges in using smartphones for cognitive assessment, and possible future developments in this technology. In the systematic review, eighteen TBCA instruments were identified. They were found to be valid in differentiating between people with and without dementia. TBCA was previously found to be launched on a conventional telephone platform. The advances in understanding of cognitive impairment may demand that telephones be equipped with more advanced features. Recently, the development and penetration of smartphones among the elderly has been rapid. This may allow the smartphone to enhance its TBCA applicability by overcoming the limitations of the conventional telephone, rendering the TBCA more efficient in addressing the increasing demand and complexity of cognitive assessments in the future. However, more research and technology developments are needed before smartphones can become a valid platform for TBCA.

Can Smartphones Enhance Telephone-Based Cognitive Assessment (TBCA?

Directory of Open Access Journals (Sweden)

Rick Yiu-Cho Kwan

2013-12-01

Full Text Available TBCA has emerged to solve the limitations of administering cognitive assessments face-to-face. The recent development of telephones and knowledge advances in the area of cognitive impairment may affect the development of TBCA. The purpose of this paper is to discuss how smartphones can be used to enhance the applicability of TBCA, which has previously been administered by conventional telephone. This paper will first review, describe and critique the existing TBCA instruments. It will then discuss the recent developments in tele-technology, the popularity of tele-technology among the elderly, potential benefits and challenges in using smartphones for cognitive assessment, and possible future developments in this technology. In the systematic review, eighteen TBCA instruments were identified. They were found to be valid in differentiating between people with and without dementia. TBCA was previously found to be launched on a conventional telephone platform. The advances in understanding of cognitive impairment may demand that telephones be equipped with more advanced features. Recently, the development and penetration of smartphones among the elderly has been rapid. This may allow the smartphone to enhance its TBCA applicability by overcoming the limitations of the conventional telephone, rendering the TBCA more efficient in addressing the increasing demand and complexity of cognitive assessments in the future. However, more research and technology developments are needed before smartphones can become a valid platform for TBCA.

Implementing telephone triage in general practice: a process evaluation of a cluster randomised controlled trial.

Science.gov (United States)

Murdoch, Jamie; Varley, Anna; Fletcher, Emily; Britten, Nicky; Price, Linnie; Calitri, Raff; Green, Colin; Lattimer, Valerie; Richards, Suzanne H; Richards, David A; Salisbury, Chris; Taylor, Rod S; Campbell, John L

2015-04-10

Telephone triage represents one strategy to manage demand for face-to-face GP appointments in primary care. However, limited evidence exists of the challenges GP practices face in implementing telephone triage. We conducted a qualitative process evaluation alongside a UK-based cluster randomised trial (ESTEEM) which compared the impact of GP-led and nurse-led telephone triage with usual care on primary care workload, cost, patient experience, and safety for patients requesting a same-day GP consultation. The aim of the process study was to provide insights into the observed effects of the ESTEEM trial from the perspectives of staff and patients, and to specify the circumstances under which triage is likely to be successfully implemented. Here we report perspectives of staff. The intervention comprised implementation of either GP-led or nurse-led telephone triage for a period of 2-3 months. A qualitative evaluation was conducted using staff interviews recruited from eight general practices (4 GP triage, 4 Nurse triage) in the UK, implementing triage as part of the ESTEEM trial. Qualitative interviews were undertaken with 44 staff members in GP triage and nurse triage practices (16 GPs, 8 nurses, 7 practice managers, 13 administrative staff). Staff reported diverse experiences and perceptions regarding the implementation of telephone triage, its effects on workload, and on the benefits of triage. Such diversity were explained by the different ways triage was organised, the staffing models used to support triage, how the introduction of triage was communicated across practice staff, and by how staff roles were reconfigured as a result of implementing triage. The findings from the process evaluation offer insight into the range of ways GP practices participating in ESTEEM implemented telephone triage, and the circumstances under which telephone triage can be successfully implemented beyond the context of a clinical trial. Staff experiences and perceptions of telephone

Informational and analytical support of the state bodies activities (on the example of expert surveys in APR countries

Directory of Open Access Journals (Sweden)

L S Ruban

2016-12-01

Full Text Available Based on the expert surveys conducted within the international project “Dialogue Partnership as a Factor of Stability and Integration” (“Bridge between East and West” over ten years (2005-2014 and control interviews conducted in 2009 and 2015 in the longitude format (70% of experts were the same the author provides a comprehensive analysis of the situation in the Asia-Pacific region with the help of highly qualified experts and VIP-persons - decision-makers from 16 Asian-Pacific countries: Brunei-Darussalam, Vietnam, India, Indonesia, the People’s Republic of China, Republic of Korea, Mongolia, Myanmar, Nepal, the Russian Federation, Singapore, USA, Thailand, the Philippines and Japan. This study is not abstract or theoretical; it is a tool for informational and analytical support of the relevant state bodies of the Russian Federation responsible for the development of the situation in the Asia-Pacific region. The author analyzes the geopolitical balance of power and leadership in the region, its economic and energy situation, the level of security, risks and threats, the possibility of a military conflict so as to identify possible ways for the effective cooperation and coordination of interests of various countries in the region.

26 CFR 49.4251-4 - Prepaid telephone cards.

Science.gov (United States)

2010-04-01

...; adding value. (i) After using the card described in Example 2, P arranges with A by telephone to have 30... EXCISE TAXES FACILITIES AND SERVICES EXCISE TAXES Communications § 49.4251-4 Prepaid telephone cards. (a... section provides rules for the application of the section 4251 tax to PTCs. (b) Definitions. The following...

Expert Review of Pedagogical Activities at Therapeutic Recreation Camps

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Kiselev, N. N.; Kiseleva, E. V.

2015-01-01

An analysis of pedagogical expert reviews at children's therapeutic recreation camps in Novosibirsk Region shows that it is necessary to implement an expert review system that plays a supporting and developmental role. Such a system should allow teams of teachers to submit their work to expert review and to move forward by reflecting on their…

Cornell Mixing Zone Expert System

Science.gov (United States)

This page provides an overview Cornell Mixing Zone Expert System water quality modeling and decision support system designed for environmental impact assessment of mixing zones resulting from wastewater discharge from point sources

Modeling the Construct of an Expert Evidence-Adaptive Knowledge Base for a Pressure Injury Clinical Decision Support System

Directory of Open Access Journals (Sweden)

Peck Chui Betty Khong

2017-07-01

Full Text Available The selection of appropriate wound products for the treatment of pressure injuries is paramount in promoting wound healing. However, nurses find it difficult to decide on the most optimal wound product(s due to limited live experiences in managing pressure injuries resulting from successfully implemented pressure injury prevention programs. The challenges of effective decision-making in wound treatments by nurses at the point of care are compounded by the yearly release of wide arrays of newly researched wound products into the consumer market. A clinical decision support system for pressure injury (PI-CDSS was built to facilitate effective decision-making and selection of optimal wound treatments. This paper describes the development of PI-CDSS with an expert knowledge base using an interactive development environment, Blaze Advisor. A conceptual framework using decision-making and decision theory, knowledge representation, and process modelling guided the construct of the PI-CDSS. This expert system has incorporated the practical and relevant decision knowledge of wound experts in assessment and wound treatments in its algorithm. The construct of the PI-CDSS is adaptive, with scalable capabilities for expansion to include other CDSSs and interoperability to interface with other existing clinical and administrative systems. The algorithm was formatively evaluated and tested for usability. The treatment modalities generated after using patient-specific assessment data were found to be consistent with the treatment plan(s proposed by the wound experts. The overall agreement exceeded 90% between the wound experts and the generated treatment modalities for the choice of wound products, instructions, and alerts. The PI-CDSS serves as a just-in-time wound treatment protocol with suggested clinical actions for nurses, based on the best evidence available.

Best Strategies to Improve School-leavers’ Knowledge of Nutrition and Food Systems: Views from Experts in Iran

Science.gov (United States)

Sadegholvad, Sanaz; Yeatman, Heather; Omidvar, Nasrin; Parrish, Anne-Maree; Worsley, Anthony

2016-01-01

Background: The research to date does not present an articulated approach to ensure nutrition and food systems education is systematically implemented within schools. This paper aimed to investigate food experts’ views of the best strategies to improve school-leavers’ knowledge of nutrition and food systems. Methods: In this qualitative study, 28 Iranian food and nutrition experts from four major provinces (Tehran, Fars, Isfahan, and Gilan) were selected and agreed to be interviewed. Required data were collected through in-depth, semi-structured, face-to-face, or telephone interviews and were analyzed thematically using NVivo. Results: The experts’ suggested strategies to improve Iranian school-leavers’ knowledge of nutrition and food systems fell into three key themes: Policy, education processes, and supportive environments. Together they formed an overarching theme of a multileveled system approach for transferring knowledge. Conclusions: Development of a scaffolded education program could assist curriculum developers and policy makers to assess and update current nutrition and food systems education programs in schools. Insights gained about education initiatives in one country such as Iran can provide an important impetus to support nutrition and food system education more widely. PMID:27857832

Developing knowledge management systems with an active expert methodology

International Nuclear Information System (INIS)

Sandahl, K.

1992-01-01

Knowledge management, understood as the ability to store, distribute and utilize human knowledge in an organization, is the subject of this dissertation. In particular we have studied the design of methods and supporting software for this process. Detailed and systematic description of the design and development processes of three case-study implementations of knowledge management software are provided. The outcome of the projects is explained in terms of an active expert development methodology, which is centered around support for a domain expert to take substantial responsibility for the design and maintenance of a knowledge management system in a given area of application. Based on the experiences from the case studies and the resulting methodology, an environment for automatically supporting knowledge management was designed in the KNOWLEDGE-LINKER research project. The vital part of this architecture is a knowledge acquisition tool, used directly by the experts in creating and maintaining a knowledge base. An elaborated version of the active expert development methodology was then formulated as the result of applying the KNOWLEDGE-LINKER approach in a fourth case study. This version of the methodology is also accounted for and evaluated together within the supporting KNOWLEDGE-LINKER architecture. (au)

An expert support system for breast cancer diagnosis using color wavelet features.

Science.gov (United States)

Issac Niwas, S; Palanisamy, P; Chibbar, Rajni; Zhang, W J

2012-10-01

Breast cancer diagnosis can be done through the pathologic assessments of breast tissue samples such as core needle biopsy technique. The result of analysis on this sample by pathologist is crucial for breast cancer patient. In this paper, nucleus of tissue samples are investigated after decomposition by means of the Log-Gabor wavelet on HSV color domain and an algorithm is developed to compute the color wavelet features. These features are used for breast cancer diagnosis using Support Vector Machine (SVM) classifier algorithm. The ability of properly trained SVM is to correctly classify patterns and make them particularly suitable for use in an expert system that aids in the diagnosis of cancer tissue samples. The results are compared with other multivariate classifiers such as Naïves Bayes classifier and Artificial Neural Network. The overall accuracy of the proposed method using SVM classifier will be further useful for automation in cancer diagnosis.

Expert Graphics System Research in the Department of the Navy.

Science.gov (United States)

Duff, Jon M.

1987-01-01

Presents current trends in the development of expert systems within the Department of the Navy, particularly research into expert graphics systems intended to support the Authoring Instructional Methods (AIM) research project. Defines artificial intelligence and expert systems. Discusses the operations and functions of the Navy's intelligent…

The integration of expert knowledge in decision support systems for facility location planning

NARCIS (Netherlands)

Arentze, T.A.; Borgers, A.W.J.; Timmermans, H.J.P.

1995-01-01

The integration of expert systems in DSS has led to a new generation of systems commonly referred to as knowledge-based or intelligent DSS. This paper investigates the use of expert system technology for the development of a knowledge-based DSS for the planning of retail and service facilities. The

Telephone consultation for improving health of people living with or at risk of HIV: a systematic review.

Directory of Open Access Journals (Sweden)

Michelle H M M T van Velthoven

Full Text Available BACKGROUND: Low cost, effective interventions are needed to deal with the major global burden of HIV/AIDS. Telephone consultation offers the potential to improve health of people living with HIV/AIDS cost-effectively and to reduce the burden on affected people and health systems. The aim of this systematic review was to assess the effectiveness of telephone consultation for HIV/AIDS care. METHODS: We undertook a comprehensive search of peer-reviewed and grey literature. Two authors independently screened citations, extracted data and assessed the quality of randomized controlled trials which compared telephone interventions with control groups for HIV/AIDS care. Telephone interventions were voice calls with landlines or mobile phones. We present a narrative overview of the results as the obtained trials were highly heterogeneous in design and therefore the data could not be pooled for statistical analysis. RESULTS: The search yielded 3321 citations. Of these, nine studies involving 1162 participants met the inclusion criteria. The telephone was used for giving HIV test results (one trial and for delivering behavioural interventions aimed at improving mental health (four trials, reducing sexual transmission risk (one trial, improving medication adherence (two trials and smoking cessation (one trial. Limited effectiveness of the intervention was found in the trial giving HIV test results, in one trial supporting medication adherence and in one trial for smoking cessation by telephone. CONCLUSIONS: We found some evidence of the benefits of interventions delivered by telephone for the health of people living with HIV or at risk of HIV. However, only limited conclusions can be drawn as we only found nine studies for five different interventions and they mainly took place in the United States. Nevertheless, given the high penetration of low-cost mobile phones in countries with high HIV endemicity, more evidence is needed on how telephone consultation

Expert software for accident identification

International Nuclear Information System (INIS)

Dobnikar, M.; Nemec, T.; Muehleisen, A.

2003-01-01

Each type of an accident in a Nuclear Power Plant (NPP) causes immediately after the start of the accident variations of physical parameters that are typical for that type of the accident thus enabling its identification. Examples of these parameter are: decrease of reactor coolant system pressure, increase of radiation level in the containment, increase of pressure in the containment. An expert software enabling a fast preliminary identification of the type of the accident in Krsko NPP has been developed. As input data selected typical parameters from Emergency Response Data System (ERDS) of the Krsko NPP are used. Based on these parameters the expert software identifies the type of the accident and also provides the user with appropriate references (past analyses and other documentation of such an accident). The expert software is to be used as a support tool by an expert team that forms in case of an emergency at Slovenian Nuclear Safety Administration (SNSA) with the task to determine the cause of the accident, its most probable scenario and the source term. The expert software should provide initial identification of the event, while the final one is still to be made after appropriate assessment of the event by the expert group considering possibility of non-typical events, multiple causes, initial conditions, influences of operators' actions etc. The expert software can be also used as an educational/training tool and even as a simple database of available accident analyses. (author)

[Psychometric validation of the telephone memory test].

Science.gov (United States)

Ortiz, T; Fernández, A; Martínez-Castillo, E; Maestú, F; Martínez-Arias, R; López-Ibor, J J

1999-01-01

Several pathologies (i.e. Alzheimer's disease) that courses with memory alterations, appears in a context of impaired cognitive status and mobility. In recent years, several investigations were carried out in order to design short batteries that detect those subjects under risk of dementia. Some of this batteries were also design to be administrated over the telephone, trying to overcome the accessibility limitations of this patients. In this paper we present a battery (called Autotest de Memoria) essentially composed by episodic and semantic memory tests, administered both over the telephone and face to face. This battery was employed in the cognitive assessment of healthy controls and subjects diagnosed as probable Alzheimer's disease patients. Results show the capability of this battery in order to discriminate patients and healthy controls, a great sensibility and specificity, and a nearly absolute parallelism of telephone and face to face administrations. These data led us to claim the usefulness and practicality of our so called Memoria>.

Expert systems and computer based industrial systems

International Nuclear Information System (INIS)

Dunand, R.

1989-01-01

Framentec is the artificial intelligence subsidiary of FRAMATOME. It is involved in expert-system activities of Shells, developments, methodology and software for maintenance (Maintex) and consulting and methodology. Specific applications in the nuclear field are presented. The first is an expert system to assist in the piping support design prototype, the second is an expert system that assists an ultrasonic testing operator in determining the nature of a welding defect and the third is a welding machine diagnosis advisor. Maintex is a software tool to provide assistance in the repair of complex industrial equipment. (author)

47 CFR 42.6 - Retention of telephone toll records.

Science.gov (United States)

2010-10-01

... whether it is billing its own toll service customers for toll calls or billing customers for another... Section 42.6 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES... telephone toll records. Each carrier that offers or bills toll telephone service shall retain for a period...

Brain tumour risk in relation to mobile telephone use

DEFF Research Database (Denmark)

Johansen, Christoffer

2010-01-01

The rapid increase in mobile telephone use has generated concern about possible health risks related to radiofrequency electromagnetic fields from this technology.......The rapid increase in mobile telephone use has generated concern about possible health risks related to radiofrequency electromagnetic fields from this technology....

BWR recirculation pump diagnostic expert system

International Nuclear Information System (INIS)

Chiang, S.C.; Morimoto, C.N.; Torres, M.R.

2004-01-01

At General Electric (GE), an on-line expert system to support maintenance decisions for BWR recirculation pumps for nuclear power plants has been developed. This diagnostic expert system is an interactive on-line system that furnishes diagnostic information concerning BWR recirculation pump operational problems. It effectively provides the recirculation pump diagnostic expertise in the plant control room continuously 24 hours a day. The expert system is interfaced to an on-line monitoring system, which uses existing plant sensors to acquire non-safety related data in real time. The expert system correlates and evaluates process data and vibration data by applying expert rules to determine the condition of a BWR recirculation pump system by applying knowledge based rules. Any diagnosis will be automatically displayed, indicating which pump may have a problem, the category of the problem, and the degree of concern expressed by the validity index and color hierarchy. The rules incorporate the expert knowledge from various technical sources such as plant experience, engineering principles, and published reports. These rules are installed in IF-THEN formats and the resulting truth values are also expressed in fuzzy terms and a certainty factor called a validity index. This GE Recirculation Pump Expert System uses industry-standard software, hardware, and network access to provide flexible interfaces with other possible data acquisition systems. Gensym G2 Real-Time Expert System is used for the expert shell and provides the graphical user interface, knowledge base, and inference engine capabilities. (author)

Interactive water monitoring system accessible by cordless telephone

Science.gov (United States)

Volpicelli, Richard; Andeweg, Pierre; Hagar, William G.

1985-12-01

A battery-operated, microcomputer-controlled monitoring device linked with a cordless telephone has been developed for remote measurements. This environmental sensor is self-contained and collects and processes data according to the information sent to its on-board computer system. An RCA model 1805 microprocessor forms the basic controller with a program encoded in memory for data acquisition and analysis. Signals from analog sensing devices used to monitor the environment are converted into digital signals and stored in random access memory of the microcomputer. This remote sensing system is linked to the laboratory by means of a cordless telephone whose base unit is connected to regular telephone lines. This offshore sensing system is simply accessed by a phone call originating from a computer terminal in the laboratory. Data acquisition is initiated upon request: Information continues to be processed and stored until the computer is reprogrammed by another phone call request. Information obtained may be recalled by a phone call after the desired environmental measurements are finished or while they are in progress. Data sampling parameters may be reset at any time, including in the middle of a measurement cycle. The range of the system is limited only by existing telephone grid systems and by the transmission characteristics of the cordless phone used as a communications link. This use of a cordless telephone, coupled with the on-board computer system, may be applied to other field studies requiring data transfer between an on-site analytical system and the laboratory.

ELAN - expert system supported information and management system for analytical laboratories. ELAN - Expertengestuetztes Informationssystem fuer die Laboranalytik

Energy Technology Data Exchange (ETDEWEB)

Orth, H.; Zilly, G.

1990-05-01

The demand for high efficiency and short response time calls for the use of computer support in chemico-analytical laboratories. This is usually achieved by laboratory information and management systems covering the three levels of analytical instrument automation, laboratory operation support and laboratory management. The management component of the systems implemented up to now suffers from a lack of flexibility as far as unforeseen analytical investigations outside the laboratory routine work are concerned. Another drawback is the lack of adaptability with respect to structural changes in laboratory organization. It can be eliminated by the application of expert system structures and methods for the implementation of this system level. The ELAN laboratory information and management system has been developed on the basis of this concept. (orig.).

Implications of the Recommendations of the Expert Panel on Federal Support to Research and Development

Directory of Open Access Journals (Sweden)

Preston Manning

2012-03-01

Full Text Available Canada lags behind many of its First World counterparts when it comes to business innovation, and urgently needs to improve its performance if it is to remain competitive and attractive to investment. The Expert Panel Report on Federal Support to Research and Development has recommended several policy initiatives that governments need to enact to close the gap. This paper reviews all six major recommendations made by the Expert Panel and provides thorough assessments of each, with ample consideration given to their implications for the private sector. The two most promising are: (1 the consolidation of research and development spending programs at the federal level and (2 the adoption of smart procurement as a means of spurring innovation in the non-government sector. While some of the other recommendations need refinement and raise concerns about their impact on the economy, the message for government and business is clear: the former can and should facilitate Canadian business innovation by removing tax and regulatory burdens and facilitating better public-private cooperation, while the latter must make innovation a major part of corporate culture. This paper explains the consequences of the Panel’s recommendations for both sectors, identifies the deficiencies, and offers clear-eyed guidance for ameliorating them.

49 CFR 195.52 - Telephonic notice of certain accidents.

Science.gov (United States)

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Telephonic notice of certain accidents. 195.52... TRANSPORTATION OF HAZARDOUS LIQUIDS BY PIPELINE Annual, Accident, and Safety-Related Condition Reporting § 195.52 Telephonic notice of certain accidents. (a) At the earliest practicable moment following discovery of a...

Maintaining clinical governance when giving telephone advice.

Science.gov (United States)

Alazawi, William; Agarwal, Kosh; Suddle, Abid; Aluvihare, Varuna; Heneghan, Michael A

2013-10-01

Delivering excellent healthcare depends on accurate communication between professionals who may be in different locations. Frequently, the first point of contact with the liver unit at King's College Hospital (KCH) is through a telephone call to a specialist registrar or liver fellow, for whom no case notes are available in which to record information. The aim of this study was to improve the clinical governance of telephone referrals and to generate contemporaneous records that could be easily retrieved and audited. An electronic database for telephone referrals and advice was designed and made securely available to registrars in our unit. Service development in a tertiary liver centre that receives referrals from across the UK and Europe. Demographic and clinical data were recorded prospectively and analysed retrospectively. Data from 350 calls were entered during 5 months. The information included the nature and origin of the call (200 from 75 different institutions), disease burden and severity of disease among the patients discussed with KCH, and outcome of the call. The majority of cases were discussed with consultants or arrangements were made for formal review at KCH. A telephone referrals and advice database provides clinical governance, serves as a quality indicator and forms a contemporaneous record at the referral centre. Activity data and knowledge of disease burden help to tailor services to the needs of referrers and commissioners. We recommend implementation of similar models in other centres that give extramural verbal advice.

Automatic Smoker Detection from Telephone Speech Signals

DEFF Research Database (Denmark)

Poorjam, Amir Hossein; Hesaraki, Soheila; Safavi, Saeid

2017-01-01

This paper proposes an automatic smoking habit detection from spontaneous telephone speech signals. In this method, each utterance is modeled using i-vector and non-negative factor analysis (NFA) frameworks, which yield low-dimensional representation of utterances by applying factor analysis...... method is evaluated on telephone speech signals of speakers whose smoking habits are known drawn from the National Institute of Standards and Technology (NIST) 2008 and 2010 Speaker Recognition Evaluation databases. Experimental results over 1194 utterances show the effectiveness of the proposed approach...... for the automatic smoking habit detection task....

HOspitals and patients WoRking in Unity (HOW R U?): protocol for a prospective feasibility study of telephone peer support to improve older patients' quality of life after emergency department discharge

OpenAIRE

Lowthian, Judy A; Lennox, Alyse; Curtis, Andrea; Dale, Jeremy; Browning, Colette; Smit, De Villiers; Wilson, Gillian; O'Brien, Debra; Rosewarne, Cate; Boyd, Lee; Garner, Cath; Cameron, Peter

2016-01-01

Introduction Older people presenting to an emergency department (ED) have a higher likelihood of social isolation, loneliness and depression; which are all associated with negative health outcomes and increased health service use, including higher rates of ED attendance. The HOW R U? study aims to ascertain the feasibility and acceptability of a postdischarge telephone support programme for older ED patients following discharge. The intervention, which aims to improve quality of life, will be...

20 CFR 638.516 - Laundry, mail, and telephone service.

Science.gov (United States)

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Laundry, mail, and telephone service. 638.516... PROGRAM UNDER TITLE IV-B OF THE JOB TRAINING PARTNERSHIP ACT Center Operations § 638.516 Laundry, mail, and telephone service. (a) The center operator shall provide adequate laundry services and supplies at...

Is there a bias against telephone interviews in qualitative research?

Science.gov (United States)

Novick, Gina

2008-08-01

Telephone interviews are largely neglected in the qualitative research literature and, when discussed, they are often depicted as a less attractive alternative to face-to-face interviewing. The absence of visual cues via telephone is thought to result in loss of contextual and nonverbal data and to compromise rapport, probing, and interpretation of responses. Yet, telephones may allow respondents to feel relaxed and able to disclose sensitive information, and evidence is lacking that they produce lower quality data. This apparent bias against telephone interviews contrasts with a growing interest in electronic qualitative interviews. Research is needed comparing these modalities, and examining their impact on data quality and their use for studying varying topics and populations. Such studies could contribute evidence-based guidelines for optimizing interview data. 2008 Wiley Periodicals, Inc

Bandwidth Extension of Telephone Speech Aided by Data Embedding

Directory of Open Access Journals (Sweden)

Sagi Ariel

2007-01-01

Full Text Available A system for bandwidth extension of telephone speech, aided by data embedding, is presented. The proposed system uses the transmitted analog narrowband speech signal as a carrier of the side information needed to carry out the bandwidth extension. The upper band of the wideband speech is reconstructed at the receiving end from two components: a synthetic wideband excitation signal, generated from the narrowband telephone speech and a wideband spectral envelope, parametrically represented and transmitted as embedded data in the telephone speech. We propose a novel data embedding scheme, in which the scalar Costa scheme is combined with an auditory masking model allowing high rate transparent embedding, while maintaining a low bit error rate. The signal is transformed to the frequency domain via the discrete Hartley transform (DHT and is partitioned into subbands. Data is embedded in an adaptively chosen subset of subbands by modifying the DHT coefficients. In our simulations, high quality wideband speech was obtained from speech transmitted over a telephone line (characterized by spectral magnitude distortion, dispersion, and noise, in which side information data is transparently embedded at the rate of 600 information bits/second and with a bit error rate of approximately . In a listening test, the reconstructed wideband speech was preferred (at different degrees over conventional telephone speech in of the test utterances.

Bandwidth Extension of Telephone Speech Aided by Data Embedding

Directory of Open Access Journals (Sweden)

David Malah

2007-01-01

Full Text Available A system for bandwidth extension of telephone speech, aided by data embedding, is presented. The proposed system uses the transmitted analog narrowband speech signal as a carrier of the side information needed to carry out the bandwidth extension. The upper band of the wideband speech is reconstructed at the receiving end from two components: a synthetic wideband excitation signal, generated from the narrowband telephone speech and a wideband spectral envelope, parametrically represented and transmitted as embedded data in the telephone speech. We propose a novel data embedding scheme, in which the scalar Costa scheme is combined with an auditory masking model allowing high rate transparent embedding, while maintaining a low bit error rate. The signal is transformed to the frequency domain via the discrete Hartley transform (DHT and is partitioned into subbands. Data is embedded in an adaptively chosen subset of subbands by modifying the DHT coefficients. In our simulations, high quality wideband speech was obtained from speech transmitted over a telephone line (characterized by spectral magnitude distortion, dispersion, and noise, in which side information data is transparently embedded at the rate of 600 information bits/second and with a bit error rate of approximately 3⋅10−4. In a listening test, the reconstructed wideband speech was preferred (at different degrees over conventional telephone speech in 92.5% of the test utterances.

Nursing intervention by telephone interviews of patients aged over 65 years after total hip replacement improves health status: a randomised clinical trial Nursing intervention by telephone interviews of patients aged over 65 years after total hip replacement improves health status: a randomised

DEFF Research Database (Denmark)

Hørdam, Britta

2010-01-01

and over by using telephone support and counselling 2 and 10 weeks after surgery compared with a control group receiving conventional care and treatment. Design: A randomised clinical trial focusing on patients' health status by using short-form 36 at 4 weeks preoperatively and 3 and 9 months...... postoperatively was carried out. Sample: 180 patients aged 65 years and over were randomised 4 weeks preoperatively to either control or intervention groups. Measurements: both groups received conventional surgical treatment, but the intervention group was interviewed by telephone 2 and 10 weeks after surgery......Nursing intervention by telephone interviews of patients aged over 65 years after total hip replacement improves health status: a randomised clinical trial Objective: We hypothesised that all areas of health status after total hip replacement could be improved in patients aged over 65 years...

39 CFR 6.4 - Attendance by conference telephone call.

Science.gov (United States)

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Attendance by conference telephone call. 6.4 Section 6.4 Postal Service UNITED STATES POSTAL SERVICE THE BOARD OF GOVERNORS OF THE U.S. POSTAL SERVICE MEETINGS (ARTICLE VI) § 6.4 Attendance by conference telephone call. For regularly scheduled meetings of...

Evaluating telephone follow-up of a mail survey of community pharmacies.

Science.gov (United States)

Westrick, Salisa C; Mount, Jeanine K

2007-06-01

Mail and telephone are commonly used modes of survey with pharmacists. Research conducted using general population surveys consistently describes mail surveys as being less expensive but yielding lower response rates than telephone surveys. However, findings obtained from the general population may not be generalizable to pharmacist surveys. This study evaluates the effectiveness of telephone follow-up of mail survey nonrespondents by comparing the 2 survey modes on response rates, cooperation rates, cost per sample unit, and cost per usable response and evaluating potential nonresponse bias in the context of immunization activities. A census mail survey of 1,143 Washington State community pharmacies and a follow-up telephone survey of 262 randomly selected mail survey nonrespondents were compared. Both surveys included the same 15 yes/no-type questions to ask respondents about their pharmacy's involvement in immunization activities. The mail survey yielded a response rate 1 of 26.7% and a cooperation rate 1 of 26.7%, compared with 83.6% and 87.8%, respectively, for the follow-up telephone survey. With respect to cost per sample unit, the mail survey was the least expensive option ($1.20). However, when comparing cost per usable response, the mail survey was the most expensive ($4.37), and the follow-up telephone survey without an advance notification was the least expensive ($1.99). Furthermore, results suggest the presence of nonresponse bias: compared with pharmacies participating in the follow-up telephone survey, pharmacies participating in the mail survey were more likely to be involved in in-house immunization services but less likely to be involved in outsourced services. The telephone survey achieved higher outcome rates with reduced cost per usable response. A telephone survey is a viable mode that holds promise in pharmacy practice research. Maximizing response rates and assessing potential nonresponse bias should be a standard practice among pharmacy

Price competition between an expert and a non-expert

OpenAIRE

Bouckaert, J.M.C.; Degryse, H.A.

1998-01-01

This paper characterizes price competition between an expert and a non-expert. In contrast with the expert, the non-expert’s repair technology is not always successful. Consumers visit the expert after experiencing an unsuccessful match at the non-expert. This re-entry affects the behaviour of both sellers. For low enough probability of successful repair at the non-expert, all consumers first visit the non-expert, and a ‘timid-pricing’ equilibrium results. If the non-expert’s repair technolog...

Cooperative expert system reasoning for waste remediations

International Nuclear Information System (INIS)

Bohn, S.J.; Pennock, K.A.; Franklin, A.L.

1991-12-01

The United States Department of Energy (DOE) is facing a large task in completing Remedial Investigations and Feasibility Studies (RI/FS) for hazardous waste sites across the nation. One of the primary objectives of an RI/FS is the specification of viable sequences of technology treatment trains which can provide implementable site solutions. We present a methodology which integrates expert system technology within an object-oriented framework to create a cooperative reasoning system designed to provide a comprehensive list of these implementable solutions. The system accomplishes its goal of specifying technology trains by utilizing a ''team'' of expert system objects. The system distributes the problem solving among the individual expert objects, and then coordinates the combination of individual decisions into a joint solution. Each expert object possesses the knowledge of an expert in a particular technology. An expert object can examine the parameters and characteristics of the waste site, seek information and support from other expert objects, and then make decisions concerning its own applicability. This methodology has at least two primary benefits. First, the creation of multiple expert objects provides a more direct mapping from the actual process to a software system, making the system easier to build. Second, the distribution of the inferencing among a number of loosely connected expert objects allows for a more robust and maintainable final product

Willingness to pay for rural telephone services: Implications for rural ...

African Journals Online (AJOL)

WTP) for rural telephone services and the implications on poverty reduction in Southeast Nigeria. The key research problem was the inability of the telephone providers or regulatory agencies to estimate the amount the people were willing to pay ...

Call Us: Development of a Library Telephone Enquiry Service

Science.gov (United States)

Burke, Liz; Beranek, Lea

2006-01-01

The authors detail the trial and piloting of a telephone enquiry service (TES) at the Bundoora Campus Library at La Trobe University in order to attempt to resolve the balance between telephone and face-to-face enquiries at the library service desk. They investigated various options throughout 2001 and 2002 and settled on a centralised service…

75 FR 21979 - NRC Region II Address and Main Telephone Number Changes

Science.gov (United States)

2010-04-27

... Region II Address and Main Telephone Number Changes AGENCY: Nuclear Regulatory Commission. ACTION: Final... address for its Region II office and to update the main telephone number. The Region II office move and... update the NRC Region II office street address and office main telephone number. The physical location of...

Can Smartphones Enhance Telephone-Based Cognitive Assessment (TBCA)?

OpenAIRE

Rick Yiu-Cho Kwan; Claudia Kam-Yuk Lai

2013-01-01

TBCA has emerged to solve the limitations of administering cognitive assessments face-to-face. The recent development of telephones and knowledge advances in the area of cognitive impairment may affect the development of TBCA. The purpose of this paper is to discuss how smartphones can be used to enhance the applicability of TBCA, which has previously been administered by conventional telephone. This paper will first review, describe and critique the existing TBCA instruments. It will then di...

Cordless telephone use: implications for mobile phone research.

Science.gov (United States)

Redmayne, Mary; Inyang, Imo; Dimitriadis, Christina; Benke, Geza; Abramson, Michael J

2010-04-01

Cordless and mobile (cellular) telephone use has increased substantially in recent years causing concerns about possible health effects. This has led to much epidemiological research, but the usual focus is on mobile telephone radiofrequency (RF) exposure only despite cordless RF being very similar. Access to and use of cordless phones were included in the Mobile Radiofrequency Phone Exposed Users Study (MoRPhEUS) of 317 Year 7 students recruited from Melbourne, Australia. Participants completed an exposure questionnaire-87% had a cordless phone at home and 77% owned a mobile phone. There was a statistically significant positive relationship (r = 0.38, p < 0.01) between cordless and mobile phone use. Taken together, this increases total RF exposure and its ratio in high-to-low mobile users. Therefore, the design and analysis of future epidemiological telecommunication studies need to assess cordless phone exposure to accurately evaluate total RF telephone exposure effects.

Quantitative and qualitative analysis of the expert and non-expert opinion in fire risk in buildings

International Nuclear Information System (INIS)

Hanea, D.M.; Jagtman, H.M.; Alphen, L.L.M.M. van; Ale, B.J.M.

2010-01-01

Expert judgment procedure is a method very often used in the area of risk assessments of complex systems or processes to fill in quantitative data. Although it has been proved to be a very reliable source of information when no other data are available, the choice of experts is always questioned. When the available data are limited, the seed questions cover only partially the domains of expertise, which may cause problems. Expertise is assessed not covering the full object of study but only those topics for which seed questions can be formulated. The commonly used quantitative analysis of an expert judgment exercise is combined with a qualitative analysis. The latter adds more insights to the relation between the assessor's field and statistical knowledge and their performance in an expert judgment. In addition the qualitative analysis identifies different types of seed questions. Three groups of assessors with different levels of statistical and domain knowledge are studied. The quantitative analysis shows no differences between field experts and non-experts and no differences between having advanced statistical knowledge or not. The qualitative analysis supports these findings. In addition it is found that especially technical questions are answered with larger intervals. Precaution is required when using seed questions for which the real value can be calculated, which was the case for one of the seed questions.

Effectiveness and cost-effectiveness of telephone-based support versus usual care for treatment of pressure ulcers in people with spinal cord injury in low-income and middle-income countries: study protocol for a 12-week randomised controlled trial.

Science.gov (United States)

Arora, Mohit; Harvey, Lisa Anne; Hayes, Alison Joy; Chhabra, Harvinder Singh; Glinsky, Joanne Valentina; Cameron, Ian Douglas; Lavrencic, Lucija; Arumugam, Narkeesh; Hossain, Sohrab; Bedi, Parneet Kaur

2015-07-28

Pressure ulcers are a common and severe complication of spinal cord injury, particularly in low-income and middle-income countries where people often need to manage pressure ulcers alone and at home. Telephone-based support may help people in these situations to manage their pressure ulcers. The aim of this study is to determine the effectiveness and cost-effectiveness of telephone-based support to help people with spinal cord injury manage pressure ulcers at home in India and Bangladesh. A multicentre (3 sites), prospective, assessor-blinded, parallel, randomised controlled trial will be undertaken. 120 participants with pressure ulcers on the sacrum, ischial tuberosity or greater trochanter of the femur secondary to spinal cord injury will be randomly assigned to a Control or Intervention group. Participants in the Control group will receive usual community care. That is, they will manage their pressure ulcers on their own at home but will be free to access whatever healthcare support they can. Participants in the Intervention group will also manage their pressure ulcers at home and will also be free to access whatever healthcare support they can, but in addition they will receive weekly telephone-based support and advice for 12 weeks (15-25 min/week). The primary outcome is the size of the pressure ulcer at 12 weeks. 13 secondary outcomes will be measured reflecting other aspects of pressure ulcer resolution, depression, quality of life, participation and satisfaction with healthcare provision. An economic evaluation will be run in parallel and will include a cost-effectiveness and a cost-utility analysis. Ethical approval was obtained from the Institutional Ethics Committee at each site. The results of this study will be disseminated through publications and presented at national and international conferences. ACTRN12613001225707. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

Telephone-Directory Program

Science.gov (United States)

Vlahos, William

2005-01-01

eDirectory is a computer program that makes it possible to view entries in the Jet Propulsion Laboratory (JPL) telephone directory by use of PalmPilot(TradeMark) (or equivalent) personal digital assistants. When one uses eDirectory, a single click causes the downloading of a current copy of the directory (which is updated nightly) from a server. The downloaded directory data can be sorted and searched. The program can append a "JPL" category and save directory information in a file that can be imported into the Palm Desktop(TradeMark) software.

SELF: expert system for supporting verification of network operating constraints in power transmission planning

Energy Technology Data Exchange (ETDEWEB)

Cicoria, R; Migliardi, P [Ente Nazionale per l` Energia Elettrica, Milan (Italy); Pogliano, P [Centro Informazioni Studi Esperienze (CISE), Milan (Italy)

1995-06-01

Performing planned studies into very large HV transmission systems is a very complex task which requires the use of simulation models and the application of the heuristic acquired by expert palnners during previous studies. The ENEL Electric Research Center and the CISE Artificial Intelligence Section have developed a knowledge-based system, named SELF, which is aimed at supporting the transmission system palnner. SELF is capable of assisting the engineer both in finding the convergence of the load flow calculation and determining solutions that respect active power, voltage and VAR operating constraints. This paper describes the overall architecture of the system and shows its integration in a larger planning environment called SPIRA, currently utilized at ENEL. More details are given on the least completed modules, the redispatching and network reinforcement subsystems which deal with active power constraint verification.

Expert systems and nuclear safety

International Nuclear Information System (INIS)

Beltracchi, L.

1990-01-01

The US Nuclear Regulatory Commission (NRC) and the Electric Power Research Institute have initiated a broad-based exploration of means to evaluate the potential applications of expert systems in the nuclear industry. This exploratory effort will assess the use of expert systems to augment the diagnostic and decision-making capabilities of personnel with the goal of enhancing productivity, reliability, and performance. The initial research effort is the development and documentation of guidelines for verifying and validating (V and V) expert systems. An initial application of expert systems in the nuclear industry is to aid operations and maintenance personnel in decision-making tasks. The scope of the decision aiding covers all types of cognitive behavior consisting of skill, rule, and knowledge-based behavior. For example, procedure trackers were designed and tested to support rule-based behavior. Further, these systems automate many of the tedious, error-prone human monitoring tasks, thereby reducing the potential for human error. The paper version of the procedure contains the knowledge base and the rules and thus serves as the basis of the design verification of the procedure tracker. Person-in-the-loop tests serve as the basis for the validation of a procedure tracker. When conducting validation tests, it is important to ascertain that the human retains the locus of control in the use of the expert system

Expert systems: an alternative paradigm

Energy Technology Data Exchange (ETDEWEB)

Coombs, M.; Alty, J.

1984-01-01

There has recently been a significant effort by the AI community to interest industry in the potential of expert systems. However, this has resulted in far fewer substantial applications projects than might be expected. This article argues that this is because human experts are rarely required to perform the role that computer-based experts are programmed to adopt. Instead of being called in to answer well-defined problems, they are more often asked to assist other experts to extend and refine their understanding of a problem area at the junction of their two domains of knowledge. This more properly involves educational rather than problem-solving skills. An alternative approach to expert system design is proposed based upon guided discovery learning. The user is provided with a supportive environment for a particular class of problem, the system predominantly acting as an adviser rather than directing the interaction. The environment includes a database of domain knowledge, a set of procedures for its application to a concrete problem, and an intelligent machine-based adviser to judge the user's effectiveness and advise on strategy. The procedures focus upon the use of user generated explanations both to promote the application of domain knowledge and to expose understanding difficulties. Simple database PROLOG is being used as the subject material for the prototype system which is known as MINDPAD. 30 references.

Expert Oracle GoldenGate

CERN Document Server

Prusinski, Ben; Chung, Richard

2011-01-01

Expert Oracle GoldenGate is a hands-on guide to creating and managing complex data replication environments using the latest in database replication technology from Oracle. GoldenGate is the future in replication technology from Oracle, and aims to be best-of-breed. GoldenGate supports homogeneous replication between Oracle databases. It supports heterogeneous replication involving other brands such as Microsoft SQL Server and IBM DB2 Universal Server. GoldenGate is high-speed, bidirectional, highly-parallelized, and makes only a light impact on the performance of databases involved in replica

Home medication support for childhood cancer: family-centered design and testing.

Science.gov (United States)

Walsh, Kathleen E; Biggins, Colleen; Blasko, Deb; Christiansen, Steven M; Fischer, Shira H; Keuker, Christopher; Klugman, Robert; Mazor, Kathleen M

2014-11-01

Errors in the use of medications at home by children with cancer are common, and interventions to support correct use are needed. We sought to (1) engage stakeholders in the design and development of an intervention to prevent errors in home medication use, and (2) evaluate the acceptability and usefulness of the intervention. We convened a multidisciplinary team of parents, clinicians, technology experts, and researchers to develop an intervention using a two-step user-centered design process. First, parents and oncologists provided input on the design. Second, a parent panel and two oncology nurses refined draft materials. In a feasibility study, we used questionnaires to assess usefulness and acceptability. Medication error rates were assessed via monthly telephone interviews with parents. We successfully partnered with parents, clinicians, and IT experts to develop Home Medication Support (HoMeS), a family-centered Web-based intervention. HoMeS includes a medication calendar with decision support, a communication tool, adverse effect information, a metric conversion chart, and other information. The 15 families in the feasibility study gave HoMeS high ratings for acceptability and usefulness. Half recorded information on the calendar to indicate to other caregivers that doses were given; 34% brought it to the clinic to communicate with their clinician about home medication use. There was no change in the rate of medication errors in this feasibility study. We created and tested a stakeholder-designed, Web-based intervention to support home chemotherapy use, which parents rated highly. This tool may prevent serious medication errors in a larger study. Copyright © 2014 by American Society of Clinical Oncology.

[Screening for dementia using telephone interviews. An evaluation and reliability study of the Telephone Interview for Cognitive Status (TICS) in its modified German version].

Science.gov (United States)

Matrisch, M; Trampisch, U; Klaassen-Mielke, R; Pientka, L; Trampisch, H J; Thiem, U

2012-04-01

To assess cognitive impairment or dementia in epidemiologic studies using telephone interviews for data acquisition, valid, reliable and short instruments suitable for telephone administration are required. For the Telephone Interview for Cognitive Status (TICS) in its modified German version, the only instrument used in Germany so far, more data on reliability and practicability are needed. Participants were recruited in the offices of nine primary care physicians. Data from 197 participants (115 females, mean age 78.5±4.1 years) who were tested by telephone and in the office by means of the Mini-Mental State Examination (MMSE) were used for the evaluation. For assessing reliability, a group of 91 participants (55 females, mean age 78.1±4.1 years) was contacted twice during 30 days to be tested during a telephone interview by means of the TICS in its modified German version. The intraclass correlation coefficient (ICC), a measure of reliability, was 0.67 [95% confidence interval (CI): 0.53; 0.77]. The Bland-Altman plot did not reveal any relationship between the variability of the difference between repeated measures and the total amount of the measure. For the overall TICS score, no differences were found between repeated measurements. However, the tasks recall of the word list and counting backwards showed some improvement in the repeated tests. TICS and MMSE showed only moderate correlation, with a correlation coefficient of 0.48 (95% CI: 0.36; 0.58). TICS values were dependent on age and educational level of the person tested. The TICS in its modified German version appears to be of acceptable reliability for the assessment of cognitive impairment during a telephone interview. TICS values depend on age and educational level of the person tested. TICS and MMSE correlate only moderately.

Openings and Closings in Telephone Conversations between Native Spanish Speakers.

Science.gov (United States)

Coronel-Molina, Serafin M.

1998-01-01

A study analyzed the opening and closing sequences of 11 dyads of native Spanish-speakers in natural telephone conversations conducted in Spanish. The objective was to determine how closely Hispanic cultural patterns of conduct for telephone conversations follow the sequences outlined in previous research. It is concluded that Spanish…

Maintenance of the telephone exchange in building 40

CERN Multimedia

2006-01-01

In order to secure the power supply of the telephone exchange in building 40, a maintenance will be done on the 18th of December from 7.30 am to 8 am. During this intervention, the fixed telephony services in building 39 and 40 will be interrupted. The fixed telephony services in other CERN buildings won't be affected by this maintenance. The mobile telephony services (GSM) won't be affected. For more details, please send your questions to Standard.Telephone@cern.ch Telecom Services IT/CS

Expert Consensus Survey on Digital Health Tools for Patients With Serious Mental Illness: Optimizing for User Characteristics and User Support.

Science.gov (United States)

Hatch, Ainslie; Hoffman, Julia E; Ross, Ruth; Docherty, John P

2018-06-12

Digital technology is increasingly being used to enhance health care in various areas of medicine. In the area of serious mental illness, it is important to understand the special characteristics of target users that may influence motivation and competence to use digital health tools, as well as the resources and training necessary for these patients to facilitate the use of this technology. The aim of this study was to conduct a quantitative expert consensus survey to identify key characteristics of target users (patients and health care professionals), barriers and facilitators for appropriate use, and resources needed to optimize the use of digital health tools in patients with serious mental illness. A panel of 40 experts in digital behavioral health who met the participation criteria completed a 19-question survey, rating predefined responses on a 9-point Likert scale. Consensus was determined using a chi-square test of score distributions across three ranges (1-3, 4-6, 7-9). Categorical ratings of first, second, or third line were designated based on the lowest category into which the CI of the mean ratings fell, with a boundary >6.5 for first line. Here, we report experts' responses to nine questions (265 options) that focused on (1) user characteristics that would promote or hinder the use of digital health tools, (2) potential benefits or motivators and barriers or unintended consequences of digital health tool use, and (3) support and training for patients and health care professionals. Among patient characteristics most likely to promote use of digital health tools, experts endorsed interest in using state-of-the-art technology, availability of necessary resources, good occupational functioning, and perception of the tool as beneficial. Certain disease-associated signs and symptoms (eg, more severe symptoms, substance abuse problems, and a chaotic living situation) were considered likely to make it difficult for patients to use digital health tools

Politics or law: what is more in the approaches of public expert monopoly?

Directory of Open Access Journals (Sweden)

Оксана Михайлівна Калужна

2018-03-01

It is concluded that the model of judicial expert support of legal proceedings in Ukraine, that is established by «judicial reform» (Law No. 2147-VIII in the wording that will come into force on March 18, 2018 is a milestone in its historical development, which certainly should be modified depending on its effectiveness and the demand of the society, public, professional and state institutions. So public forensic expert monopoly is not an ideal model of forensic expert support of justice because of corporate and political interests, corruption component, abuse of forensic experts etc. Therefore, it will undergo a review and transformation.

Maintenance of CERN telephone exchanges

CERN Multimedia

2005-01-01

A maintenance of CERN telephone exchanges will be performed on 21st, 22nd, 23rd, 24th of September from 7 p.m. to 9 p.m. Disturbances or even interruptions of telephony services may occur during this lapse of time. We apology in advance for any inconveniences that this may cause.

Telephone based weight loss intervention: Relevance for developing countries.

Science.gov (United States)

Ayisi Addo, Sandra; Steiner-Asiedu, Matilda

2018-02-08

Obesity is a major public health challenge not only for developed but developing countries as well. The World Health Organization recommends the immediate use of effective, efficient and widely accessible weight loss interventions. Telephone based weight loss intervention could provide a cheaper and wider reach of obese participants. Previous systematic reviews on telephone based weight loss interventions either excluded studies that had obese participants with co-morbidities or were silent on their inclusion. Obese/overweight individuals with co-morbidities constitute an important population in any weight loss intervention study due to the strong association of obesity with major chronic health conditions. This paper, reviews the efficacy of telephone based weight loss intervention solely in overweight/obese individuals with obesity related diseases and discusses its relevance for developing countries.

Heuristics in Managing Complex Clinical Decision Tasks in Experts' Decision Making.

Science.gov (United States)

Islam, Roosan; Weir, Charlene; Del Fiol, Guilherme

2014-09-01

Clinical decision support is a tool to help experts make optimal and efficient decisions. However, little is known about the high level of abstractions in the thinking process for the experts. The objective of the study is to understand how clinicians manage complexity while dealing with complex clinical decision tasks. After approval from the Institutional Review Board (IRB), three clinical experts were interviewed the transcripts from these interviews were analyzed. We found five broad categories of strategies by experts for managing complex clinical decision tasks: decision conflict, mental projection, decision trade-offs, managing uncertainty and generating rule of thumb. Complexity is created by decision conflicts, mental projection, limited options and treatment uncertainty. Experts cope with complexity in a variety of ways, including using efficient and fast decision strategies to simplify complex decision tasks, mentally simulating outcomes and focusing on only the most relevant information. Understanding complex decision making processes can help design allocation based on the complexity of task for clinical decision support design.

Efficacy of Telephone Information and Advice on Welfare: the Need for Realist Evaluation

OpenAIRE

Harding, Andrew; Parker, Jonathan; Hean, Sarah; Hemingway, Ann

2018-01-01

In the context of increased marketisation in welfare provision, formal information and advice (I&A) is widely assumed to enable users, as consumers, to make informed choices about services, support and care. There is emerging evidence that telephone I&A services represent important ways of providing such services. This article proposes a framework that identifies key areas of focus delineating the efficacy of I&A, which is then used in a comprehensive literature review to critique existing re...

Tumour risk associated with use of cellular telephones or cordless desktop telephones

OpenAIRE

Hardell, Lennart; Mild, Kjell Hansson; Carlberg, Michael; Söderqvist, Fredrik

2006-01-01

Abstract Background The use of cellular and cordless telephones has increased dramatically during the last decade. There is concern of health problems such as malignant diseases due to microwave exposure during the use of these devices. The brain is the main target organ. Methods Since the second part of the 1990's we have performed six case-control studies on this topic encompassing use of both cellular and cordless phones as well as other exposures. Three of the studies concerned brain tumo...

NESSUS/EXPERT - An expert system for probabilistic structural analysis methods

Science.gov (United States)

Millwater, H.; Palmer, K.; Fink, P.

1988-01-01

An expert system (NESSUS/EXPERT) is presented which provides assistance in using probabilistic structural analysis methods. NESSUS/EXPERT is an interactive menu-driven expert system that provides information to assist in the use of the probabilistic finite element code NESSUS/FEM and the fast probability integrator. NESSUS/EXPERT was developed with a combination of FORTRAN and CLIPS, a C language expert system tool, to exploit the strengths of each language.

Emergency telephone consultations: a new course for medical students.

Science.gov (United States)

Schaufelberger, Mireille; Harris, Michael; Frey, Peter

2012-12-01

Using the telephone for consultations is now common practice. Although there is a clear need for specific training for telephone consultations, it is uncommon for it to be taught in medical school. A practical course on emergency telephone consultations (ECTs) was designed for the medical degree course at the University of Bern Medical School. During the module, each of the volunteer fifth-year medical students had to perform two simulated telephone consultations. Medical students in their first year of medical school acted as simulated patients (SPs), and they gave immediate feedback to the participants. Nineteen per cent of fifth-year students voluntarily undertook the ETC course. The course was rated 'very informative' by 68 per cent of the participants, and 'informative' by 32 per cent. Ninety-four per cent of the attendees recorded a personal learning gain, and 68 per cent suggested that the course should be obligatory. All the participants thought that the SPs played their roles realistically. In their rating of the ETC, the fifth-year students gave it a mean mark of 5.5 (out of a maximum of 6), suggesting that they thought it had been very successful. Students became aware of their need for ETC training through the course itself, and they recommended that it should be obligatory. The ETC pilot received a highly positive response from lead clinicians who anticipated a rising number of telephone consultations, and who have to deal with trainees who have not been taught about how to deal with ETCs. As a result, the Faculty of Medicine decided to make the course obligatory. © Blackwell Publishing Ltd 2012.

Telephone Care Management of Fall Risk:: A Feasibility Study.

Science.gov (United States)

Phelan, Elizabeth A; Pence, Maureen; Williams, Barbara; MacCornack, Frederick A

2017-03-01

Care management has been found to be more effective than usual care for some chronic conditions, but few studies have tested care management for prevention of elder falls. This study aimed to assess the feasibility and preliminary efficacy of telephone care management of older adults presenting for medical attention due to a fall. The setting was an independent practice association in western Washington serving 1,300 Medicare Advantage-insured patients. Patients aged ≥65 years treated for a fall in an emergency department or their primary care provider's office were contacted via telephone by a care manager within 48 hours of their fall-related visit and invited to participate in a telephone-administered interview to identify modifiable fall risk factors and receive recommendations and follow-up to address identified risk factors. Data from care manager records, patient medical records, and healthcare claims for the first 6 months (November 2009-April 2010) of program implementation were analyzed in 2011. The feasibility of screening and management of fall risk factors over the telephone and the effect on medically attended falls were assessed. Twenty-two patients eligible for fall care management were reached and administered the protocol. Administration took 15-20 minutes and integrated easily with the care manager's other responsibilities. Follow-through on recommendations varied, from 45% for those for whom exercise participation was recommended to 100% for other recommendations. No medically attended falls occurred over 6 months of follow-up. Telephone care management of fall risk appears feasible and may reduce falls requiring medical attention. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

GYNOTEL: telephone advice to gynaecological surgical patients after discharge.

Science.gov (United States)

Caljouw, Monique A A; Hogendorf-Burgers, Marja E H J

2010-12-01

To investigate in surgical gynaecological patients the types of health problems arising or persisting up to six weeks after discharge and the effectiveness of telephone advice. The decreasing length of hospital stay has increased the need for specific instructions about the postdischarge period. Telephone advice could be a valuable tool to address this problem. To our knowledge, postdischarge health problems and the value of telephone advice have not been investigated among gynaecological patients. Randomised controlled trial. Gynaecological patients expected to stay in the ward longer than 24 hour were invited to participate. A pilot study showed that wound healing, pain, mobility, urination, defecation and vaginal bleeding were the most common health problems postdischarge. Based on that information, guidelines were formulated that were used by trained nurses to give telephone advice to the intervention group (n=235), in addition to the usual care. The control group of gynaecological patients (n=233) received usual care only. Of all 468 participants, about 50% were operated for general gynaecology. At discharge, wound pain (56%), mobility problems (54%) and constipation (27%) were the most frequently mentioned problems in both groups. Participants who completely followed the advice with regard to wound healing (p=0.02), pain (p=0.01), vaginal bleeding (p=0.03) and mobility (p=0.04) experienced greater improvement than participants who did not follow, or only partly followed, the advice. The telephone advice appears to make a significant contribution to help gynaecological surgical patients to solve or reduce their postdischarge health problems. The positive effect of such advice can be interpreted as an improvement in the quality of life of the postoperative gynaecological patient. © 2010 Blackwell Publishing Ltd.

THE COPYRIGHT ON THE INTELLECTUAL PROPERTY EXPERT REPORT. CONSEQUENCES

Directory of Open Access Journals (Sweden)

Raul Sorin Fântână

2013-11-01

Full Text Available Currently, according to the law, the expert is treated as a witness, and the expertise - presented as a report - is treated as a work implemented in support of justice only. Referring to the intellectual property, an expert report is often a research work with pronounced character of investigation. According to the copyright law, such a unique work should be cited even in the court device resolution, scientifically commented, as bibliographical source. The immediate consequence in support of the act of justice is that, unlike the jurisprudence - which in many countries is not a source of law, having an informative character only, a written report - especially the technical work – cannot be commented by any court. Evaluated as technical work, an expert report on the one hand should be treated as such - cited - by the courts of law and on the other hand implemented according to the rules imposed in the scientific works: documented, with a minimum number of references to and quotations from serious sources, including previous expert reports from completed files. We think that such an approach of the expert report would lead to a significant improvement of the justice act at least in Business Law.

The Impact of Caller Gender on Telephone Crisis-Helpline Workers' Interpretation of Suicidality in Caller Vignettes.

Science.gov (United States)

Hunt, Tara; Wilson, Coralie J; Caputi, Peter; Wilson, Ian; Woodward, Alan

2018-04-23

Telephone crisis-line workers (TCWs) are trained in a variety of techniques and skills to facilitate the identification of suicidal callers. One factor that may influence the implementation of these skills is gender. This study used an experimental design to explore whether helpline callers being identified as male or female is associated with TCWs’ ratings of callers’ potential for suicide risk and TCWs’ intention to use support- or intervention-oriented skills with callers. Data were collected using an online self-report survey in an Australian sample of 133 TCWs. The results suggest that under some circumstances the callers’ gender might influence TCWs’ intention to use intervention-oriented skills with the caller. Implications for the training of telephone crisis workers, and those trained in suicide prevention more broadly are discussed.

Low-Income Demand for Local Telephone Service: Effects of Lifeline and Linkup

OpenAIRE

Daniel Ackerberg; Michael Riordan; Gregory Rosston; Bradley Wimmer

2008-01-01

A comprehensive data set on local telephone service prices is used to evaluate the effect of Lifeline and Linkup programs on the telephone penetration rates of low-income households in the United States. Lifeline and Linkup programs respectively subsidize the monthly subscription and initial installation charges of eligible low-income households. Telephone penetration rates are explained by an estimated nonlinear function of local service characteristics (including subsidized prices) and the ...

Innovation on Energy Power Technology (22)Challenge to Development of Expert System stored Knowledge of Expert Power Network Operators

Science.gov (United States)

Sakaguchi, Hideharu

Do you remember an expert system? I think there are various impressions about the system. For example, some might say “It reminds me of old days”. On the other hand, some might say “It was really troublesome”. About 25 years ago, from late 1980s to the middle of 1990s, when the Showa era was about to change into the Heisei Era, artificial intelligence boomed. Research and development for an expert system which was equipped with expertise and worked as smart as expert, was advanced in various fields. Our company also picked up the system as the new system which covered weak point of conventional computer technology. We started research and development in 1984, and installed an expert system in a SCADA system, which started operating in March 1990 in the Fukuoka Integrated Control Center. In this essay, as an electric power engineer who involved in development at that time, I introduce the situation and travail story about developing an expert system which support restorative actions from the outage and overload condition of power networks.

Strategies for Suicide Intervention by Telephone.

Science.gov (United States)

Hinson, Jennifer

1982-01-01

Describes techniques helpful for telephone counselors dealing with suicide intervention, including reinstating control, reducing anxiety through problem clarification, and providing hope by active listening and tolerance of dispositions. The use of time-outs and detective work is also discussed. (JAC)

Survey on the Use of Mobile Telephone for Micro and Small ...

International Development Research Centre (IDRC) Digital Library (Canada)

Survey on the Use of Mobile Telephone for Micro and Small Business ... In Ghana, as in other developing countries, mobile telephones are pervasive, and used ... to announce that the first call for applications for the new Early Career Women.

Gesturing on the Telephone: Independent Effects of Dialogue and Visibility

Science.gov (United States)

Bavelas, Janet; Gerwing, Jennifer; Sutton, Chantelle; Prevost, Danielle

2008-01-01

Speakers often gesture in telephone conversations, even though they are not visible to their addressees. To test whether this effect is due to being in a dialogue, we separated visibility and dialogue with three conditions: face-to-face dialogue (10 dyads), telephone dialogue (10 dyads), and monologue to a tape recorder (10 individuals). For the…

Telephone switchboard closure | 19 December

CERN Multimedia

2014-01-01

Exceptionally, the telephone switchboard will close at 4 p.m. on Friday, 19 December, instead of the usual time of 6 p.m., to allow time for closing all systems properly before the annual closure. Therefore, switchboard operator assistance to transfer calls from/to external lines will stop. All other phone services will run as usual.

Expert system for liquid low-level waste management

International Nuclear Information System (INIS)

Ferrada, J.J.

1992-01-01

An expert system prototype has been developed to support system analysis activities at the Oak Ridge National Laboratory (ORNL) for waste management tasks. This expert system will aid in prioritizing radioactive waste streams for treatment and disposal by evaluating the severity and treatability of the problem as well as the final waste form. The objectives of the expert system development included: (1) collecting information on process treatment technologies for liquid low-level waste (LLLW) that can be incorporated in the knowledge base of the expert system, and (2) producing a prototype that suggests processes and disposal technologies for the ORNL LLLW system. The concept under which the expert system has been designed is integration of knowledge. There are many sources of knowledge (data bases, text files, simulation programs, etc.) that an expert would regularly consult in order to solve a problem of liquid waste management. The expert would normally know how to extract the information from these different sources of knowledge. The general scope of this project would be to include as much pertinent information as possible within the boundaries of the expert system. As a result, the user, who may not be an expert in every aspect of liquid waste management, may be able to apply the content of the information to a specific waste problem. This paper gives the methodological steps to develop the expert system under this general framework

The expert's guide to mealtime interventions - A Delphi method survey.

Science.gov (United States)

Conchin, Simone; Carey, Sharon

2017-09-27

Prevalence of malnutrition and a myriad of barriers to adequate oral diet in hospitalised patients warrants further investment to improve the patient mealtime experience. The aim of this study was to explore barriers and enablers to implementing effective mealtime interventions and develop a process framework to guide clinicians and researchers in the area. Potential experts in the area of hospital mealtime intervention were identified as having published in this field of work within the Australasian setting. Further information was sought by email and telephone communication on professional background; research experience; interest; and capacity to participate. Recruited participants were surveyed using a modified Delphi method to establish opinion and experience in the area of mealtime interventions. Results were collated and content was coded using a thematic analysis approach by the primary researcher and two additional reviewers. Thirty-two Australian authors in the area of mealtime interventions within the hospital environment were identified from publication. Twenty-one participants were able to be contacted and nineteen of these consented to enrol in the study. Participants included those from a dietetic (n = 14), nursing (n = 4) and medical (n = 1) background. Participants were deemed to have expert knowledge if they had significant involvement in the published research and demonstrated a deep level of understanding of hospital mealtime interventions. All participants provided key insights into barriers to oral intake in the hospital environment and suggestions for interventions to address these barriers. From the survey, an eight step framework to guide mealtime interventions was developed. Hospital mealtime interventions are complex processes. Interventions should be implemented after careful consideration of the local context and baseline data; and tailored to address barriers. Roles and responsibilities for nutrition care should be clear and

Speech perception and communication ability over the telephone by Mandarin-speaking children with cochlear implants.

Science.gov (United States)

Wu, Che-Ming; Liu, Tien-Chen; Wang, Nan-Mai; Chao, Wei-Chieh

2013-08-01

(1) To understand speech perception and communication ability through real telephone calls by Mandarin-speaking children with cochlear implants and compare them to live-voice perception, (2) to report the general condition of telephone use of this population, and (3) to investigate the factors that correlate with telephone speech perception performance. Fifty-six children with over 4 years of implant use (aged 6.8-13.6 years, mean duration 8.0 years) took three speech perception tests administered using telephone and live voice to examine sentence, monosyllabic-word and Mandarin tone perception. The children also filled out a questionnaire survey investigating everyday telephone use. Wilcoxon signed-rank test was used to compare the scores between live-voice and telephone tests, and Pearson's test to examine the correlation between them. The mean scores were 86.4%, 69.8% and 70.5% respectively for sentence, word and tone recognition over the telephone. The corresponding live-voice mean scores were 94.3%, 84.0% and 70.8%. Wilcoxon signed-rank test showed the sentence and word scores were significantly different between telephone and live voice test, while the tone recognition scores were not, indicating tone perception was less worsened by telephone transmission than words and sentences. Spearman's test showed that chronological age and duration of implant use were weakly correlated with the perception test scores. The questionnaire survey showed 78% of the children could initiate phone calls and 59% could use the telephone 2 years after implantation. Implanted children are potentially capable of using the telephone 2 years after implantation, and communication ability over the telephone becomes satisfactory 4 years after implantation. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Effects of Using Licensed Practical Nurses to Assist with Telephone Consultation Management

National Research Council Canada - National Science Library

Wiley, Jennifer L

2006-01-01

.... The study compared means of pre- and post-implementation provider overall job satisfaction, provider satisfaction with the telephone consult process, average daily hours providers spent on telephone...

Evaluation of a telephone advice nurse in a nursing faculty managed pediatric community clinic.

Science.gov (United States)

Beaulieu, Richard; Humphreys, Janice

2008-01-01

Nurse-managed health centers face increasing obstacles to financial viability. Efficient use of clinic resources and timely and appropriate patient care are necessary for sustainability. A registered nurse with adequate education and support can provide high-quality triage and advice in community-based practice sites. The purpose of this program evaluation was to examine the effect of a telephone advice nurse service on parent/caregiver satisfaction and access to care. A quasi-experimental separate pre-post sample design study investigated parent/caregiver satisfaction with a telephone advice nurse in an urban pediatric nurse-managed health center. The clinic medical information system was used to retrieve client visit data prior to the service and in the first year of the program. Statistically significant differences were found on two items from the satisfaction with the advice nurse survey: the reason for calling (P decision making (P nurse may increase both parent/caregiver and provider satisfaction and access to care.

75 FR 13471 - Telephone Consumer Protection

Science.gov (United States)

2010-03-22

... Consumer Protection Act (TCPA) that would harmonize those rules with the Federal Trade Commission's (FTC's... Consumer Protection Act (TCPA) that would harmonize those rules with the Federal Trade Commission's (FTC's...] Telephone Consumer Protection AGENCY: Federal Communications Commission. ACTION: Proposed rule. SUMMARY: In...

Expert systems

International Nuclear Information System (INIS)

Haldy, P.A.

1988-01-01

The definitions of the terms 'artificial intelligence' and 'expert systems', the methodology, areas of employment and limits of expert systems are discussed. The operation of an expert system is described, especially the presentation and organization of knowledge as well as interference and control. Methods and tools for expert system development are presented and their application in nuclear energy are briefly addressed. 7 figs., 2 tabs., 6 refs

Epidemiological Safety Surveillance of Cellular Telephones in the US (invited paper)

International Nuclear Information System (INIS)

Dreyer, N.A.; Loughlin, J.E.; Rothman, K.J.

1999-01-01

In 1994 a surveillance programme was initiated to monitor the effects of exposure to the human head from radiofrequency waves, such as those emitted from handheld cellular telephones. Cellular carriers contributed information about 1.5 million telephone account holders, their phones and two months of data on minutes used and number of calls. Cellular telephone manufacturers provided data that allowed classification of phones as analogue or digital and a handheld or mobile (car or bag) for 67% of the phones. Thus far 1,021,767 individuals have been identified who had at least one active cellular telephone account in 1994 and/or 1995 and who used either a handheld (41%) or a mobile (59%) phone during the study period, but not both. Seventy-four per cent of the cohort had used their cellular phone for ≥2 years, and 30% for ≥3 years. (author)

Decisions, Decisions: A Schema for Expert Decisionmaking.

Science.gov (United States)

Stape, Christopher J.

1999-01-01

Presents a schema for expert decisionmaking that can be used as a performance support tool. The ringshaped schema can be used in two ways: (1) beginning at the center with problemsetting and working outward to other supporting factors, or (2) skimming over the factors located in the outer ring to find a topic related to information about the…

47 CFR 22.925 - Prohibition on airborne operation of cellular telephones.

Science.gov (United States)

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Prohibition on airborne operation of cellular... CARRIER SERVICES PUBLIC MOBILE SERVICES Cellular Radiotelephone Service § 22.925 Prohibition on airborne operation of cellular telephones. Cellular telephones installed in or carried aboard airplanes, balloons or...

Recruiting to Clinical Trials on the Telephone - a randomized controlled trial

DEFF Research Database (Denmark)

Foss, Kim Thestrup; Kjærgaard, Jesper; Stensballe, Lone Graff

2016-01-01

BACKGROUND: Informed consent is an essential element of clinical research. Obtaining consent, however, may be challenging. The use of the telephone for giving information and obtaining consent may be practical but little formal research has been done. METHODS: We examined the use of the telephone...

Evaluation of a wireless audio streaming accessory to improve mobile telephone performance of cochlear implant users.

Science.gov (United States)

Wolfe, Jace; Morais Duke, Mila; Schafer, Erin; Cire, George; Menapace, Christine; O'Neill, Lori

2016-01-01

The objective of this study was to evaluate the potential improvement in word recognition in quiet and in noise obtained with use of a Bluetooth-compatible wireless hearing assistance technology (HAT) relative to the acoustic mobile telephone condition (e.g. the mobile telephone receiver held to the microphone of the sound processor). A two-way repeated measures design was used to evaluate differences in telephone word recognition obtained in quiet and in competing noise in the acoustic mobile telephone condition compared to performance obtained with use of the CI sound processor and a telephone HAT. Sixteen adult users of Nucleus cochlear implants and the Nucleus 6 sound processor were included in this study. Word recognition over the mobile telephone in quiet and in noise was significantly better with use of the wireless HAT compared to performance in the acoustic mobile telephone condition. Word recognition over the mobile telephone was better in quiet when compared to performance in noise. The results of this study indicate that use of a wireless HAT improves word recognition over the mobile telephone in quiet and in noise relative to performance in the acoustic mobile telephone condition for a group of adult cochlear implant recipients.

75 FR 78269 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Telephone...

Science.gov (United States)

2010-12-15

... for OMB Review; Comment Request; Telephone Point of Purchase Survey ACTION: Notice. SUMMARY: The... information collection request (ICR) titled, ``Telephone Point of Purchase Survey,'' to the Office [email protected] . SUPPLEMENTARY INFORMATION: The purpose of the Telephone Point of Purchase Survey is to...

CONFUSION WITH TELEPHONE NUMBERS

CERN Multimedia

Telecom Service

2002-01-01

he area code is now required for all telephone calls within Switzerland. Unfortunately this is causing some confusion. CERN has received complaints that incoming calls intended for CERN mobile phones are being directed to private subscribers. This is caused by mistakenly dialing the WRONG code (e.g. 022) in front of the mobile number. In order to avoid these problems, please inform your correspondents that the correct numbers are: 079 201 XXXX from Switzerland; 0041 79 201 XXXX from other countries. Telecom Service

[Topics on Which Relatives of Persons with Dementia Seek Counseling Over Telephone or Email: Current Results of a Nationwide Counseling Service of the German Alzheimer Society].

Science.gov (United States)

Pendergrass, Anna; Weiß, Saskia; Gräßel, Elmar

2018-04-19

Since 15 years, the Alzheimer 's Telephone of the German Alzheimer Society (Deutsche Alzheimer Gesellschaft e.V.; DAlzG), a nationwide psychosocial counseling service, has been offering support for people with dementia (PwD) and their families. The aim of this study was to evaluate: a) why informal PwD caregivers seek telephone counseling, b) whether these telephone calls are one-time counseling or long-term support, and c) whether the telephone inquiries differ from the email-based inquiries with regard to the addressed issues. The data are based on the inquiries of 3,744 informal caregivers, which consulted the DAlzG in 2015. Sociodemographic data on the informal caregivers and the PwD, the characteristics of the telephone call, and the topics addressed in the email inquiries were collected. 70.3% of the callers were female. Most of them (59.9%) were the children (in-law) of and half of them (49.7%) lived with PwD. More than two-thirds of the callers (70%) were seeking help in dealing with the person with dementia (e. g. challenging behavior) and 36.5% of the relatives needed recommendations for further local help and assistance. In the third place, the calls were related to financial and legal topics (23.5%). 92.2% of the calls were one-time consultations. The addressed issues in the email inquiries did not significantly differ from the topics discussed over the telephone. On many topics there is a need for further "on site" consultation. Doctors and other health professionals should therefore be actively involved in counseling relatives of PwD. © Georg Thieme Verlag KG Stuttgart · New York.

Expert Systems

OpenAIRE

Lucas, P.J.F.

2005-01-01

Expert systems mimic the problem-solving activity of human experts in specialized domains by capturing and representing expert knowledge. Expert systems include a knowledge base, an inference engine that derives conclusions from the knowledge, and a user interface. Knowledge may be stored as if-then rules, orusing other formalisms such as frames and predicate logic. Uncertain knowledge may be represented using certainty factors, Bayesian networks, Dempster-Shafer belief functions, or fuzzy se...

Assessment of real exposure to GSM mobile telephones using the SYRPOM

International Nuclear Information System (INIS)

Picard, D.; Fouquet, L.; Chauvin, S.

2013-01-01

A mobile telephone user's exposure to the radio-frequency electromagnetic field depends heavily on the power their telephone radiates, which can vary widely according to requests from the base station. This study presents the design and development of a system called System for Radiated Power Measurement (SYRPOM), which measures the power radiated by a mobile telephone. This study also describes the tests carried out on the system itself and gives the results of two measuring campaigns it has been possible to perform in this way. The first such campaign consisted of assessing the mean power received by a typical mobile telephone user carrying out various activities. The second campaign was aimed at (1) comparing the mean radiated power when stationary and when moving and (2) assessing and contrasting different models of handsets in terms of the mean radiated power. The SYRPOM has proved to be a flexible, easy-to-use high-performance and innovative tool for carrying out this kind of studies. (authors)

Effect of Nurse-Led Telephone Follow ups (Tele-Nursing) on Depression, Anxiety and Stress in Hemodialysis Patients.

Science.gov (United States)

Kargar Jahromi, Marzieh; Javadpour, Shohreh; Taheri, Leila; Poorgholami, Farzad

2015-07-26

Depressive and anxious patients on hemodialysis have a higher risk of death and hospitalizations. The aim of this study was to evaluate the effect of nurse-led telephone follow ups (tele-nursing) on depression, anxiety and stress in hemodialysis patients. The subjects of the study who were selected based on double blind randomized clinical trial consisted of 60 patients with advanced chronic renal disease treated with hemodialysis. The patients were placed in two groups of 30 individuals. Before the intervention, a questionnaire was completed by patients.  There was no telephone follow up in the control group and the patients received only routine care in the hospital. The participants allocated to the intervention group received telephone follow-up 30 days after dialysis shift, in addition to conventional treatment. Every session lasted 30 minutes, as possible. Then the DASS scale was filled out by the patients after completion of study by two groups. Significant differences were observed between the two groups in the posttest regarding the dimensions scores of DASS scale. The result of this trial is expected to provide new knowledge to support the effective follow-up for hemodialysis patient in order to improve their emotional and health status.

78 FR 78389 - Agency Information Collection Activities; Submission for OMB Review; Comment Request; Telephone...

Science.gov (United States)

2013-12-26

... for OMB Review; Comment Request; Telephone Point of Purchase Survey ACTION: Notice. SUMMARY: The... request (ICR) revision titled, ``Telephone Point of Purchase Survey,'' to the Office of Management and... seeks to make minor modifications to the Telephone Point of Purchase Survey (TPOPS) and extend its PRA...

Validation of a telephone screening test for Alzheimer's disease.

Science.gov (United States)

Camozzato, Ana Luiza; Kochhann, Renata; Godinho, Claudia; Costa, Amanda; Chaves, Marcia L

2011-03-01

Financial constraints, mobility issues, medical conditions, crime in local areas can make cognitive assessment difficult for elders and telephone interviews can be a good alternative. This study was carried out to evaluate the reliability, validity and clinical utility of a Brazilian telephone version of the Mini Mental State Examination (Braztel-MMSE) in a community sample of healthy elderly participants and AD patients. The MMSE and the Braztel-MMSE were applied to 66 AD patients and 67 healthy elderly participants. The test-retest reliability was strong and significant (r = .92, p = .01), and the correlation between the Braztel-MMSE and the MMSE were significant (p = .01) and strong (r = .92). The general screening ability of the Braztel-MMSE was high (AUC = 0.982; CI95% = 0.964-1.001). This telephone version can therefore be used as a screening measure for dementia in older adults that need neuropsychological screening and cannot present for an evaluation.

Post-operative telephone review is cost-effective and acceptable to patients.

LENUS (Irish Health Repository)

Gray, R T

2012-02-01

INTRODUCTION: Patients undergoing selective minor emergency and elective procedures are followed up by a nurse-led structured telephone review six weeks post-operatively in our hospital. Our study objectives were to review patients\\' satisfaction, assess cost-effectiveness and compare our practice with other surgical units in Northern Ireland (NI). PATIENTS AND METHODS: Completed telephone follow-up forms were reviewed retrospectively for a three-year period and cost savings calculated. Fifty patients were contacted prospectively by telephone using a questionnaire to assess satisfaction of this follow-up. A postal questionnaire was sent to 68 general and vascular surgeons in NI, assessing individual preferences for patient follow-up. RESULTS: A total of 1378 patients received a telephone review from September 2005 to September 2008. One thousand one hundred and seventy-seven (85.4%) were successfully contacted, while 201 (14.6%) did not respond despite multiple attempts. One hundred and forty-seven respondents (10.7%) required further outpatient follow-up, thereby saving 1231 outpatient reviews, equivalent to pound41,509 per annum. Thirty-nine (78%) patients expected post-operative follow-up, with 29 (58%) expecting this in the outpatient department. However, all patients were satisfied with the nurse-led telephone review. Fifty-three (78%) consultants responded. Those who always, or occasionally, review patients post-operatively varies according to the operation performed, ranging from 2.2% appendicectomy patients to 40.0% for varicose vein surgery. CONCLUSION: Current practice in NI varies, but a significant proportion of patients are not routinely reviewed. This study confirmed that patients expect post-operative follow-up. A nurse-led telephone review service is acceptable to patients, cost-effective and reduces the number of unnecessary outpatient reviews.

Rheumatology telephone advice line - experience of a Portuguese department.

Science.gov (United States)

Ferreira, R; Marques, A; Mendes, A; da Silva, J A

2015-01-01

Telephone helplines for patients are tool for information and advice. They can contribute to patient's satisfaction with care and to the effectiveness and safety of treatments. In order to achieve this, they need to be adequately adapted to the target populations, as to incorporate their abilities and expectations. a) Evaluate the adherence of patients to a telephone helpline managed by nurses in a Portuguese Rheumatology Department, b) Analyse the profile of users and their major needs, c) Analyse the management of calls by the nurses. The target population of this phone service are the patients treated at Day Care Hospital and Early Arthritis Clinic of our department. Nurses answered phone calls immediately between 8am and 4pm of working days. In the remaining hours messages were recorded on voice mail and answered as soon as possible. Details of the calls were registered in a dedicated sheet and patients were requested permission to use data to improve the service, with respect for their rights of confidentiality, anonymity and freedom of decision. In 18 months 173 calls were made by 79 patients, with a mean age of 47.9 years (sd=9.13). Considering the proportions of men and women in the target population, it was found that men called more frequently (M= 32.7% vs F= 20.4%, p=.016). The reasons for these calls can be divided into three categories: instrumental help, such as the request for results of complementary tests or rescheduling appointments (43.9% of calls); counselling on side effects or worsening of the disease/pain (31.2 %); counselling on therapy management (24.9%). Neither sex nor patient age were significantly related to these reasons for calling. Nurses resolved autonomously half (50.3%) of the calls and in 79.8% of the cases there was no need for patient referral to other health services. About a quarter of patients adhered to the telephone helpline.. Patients called to obtain support in the management of disease and therapy or to report side

CONFUSION WITH TELEPHONE NUMBERS

CERN Multimedia

Telecom Service

2002-01-01

The area code is now required for all telephone calls within Switzerland. Unfortunately this is causing some confusion. CERN has received complaints that incoming calls intended for CERN mobile phones are being directed to private subscribers. This is caused by mistakenly dialing the WRONG code (e.g. 022) in front of the mobile number. In order to avoid these problems, please inform your correspondents that the correct numbers are: 079 201 XXXX from Switzerland; 0041 79 201 XXXX from other countries. Telecom Service  

[Nutritional support and parenteral nutrition in the oncological patient: an expert group consensus report].

Science.gov (United States)

Camblor-Álvarez, Miguel; Ocón-Bretón, María Julia; Luengo-Pérez, Luis Miguel; Viruzuela, Juan Antonio; Sendrós-Maroño, María José; Cervera-Peris, Mercedes; Grande, Enrique; Álvarez-Hernández, Julia; Jiménez-Fonseca, Paula

2018-01-10

Malnutrition is a frequent medical problem of cancer patients that negatively impacts their quality of life. To analyze and respond to different issues related to the nutritional management of cancer patients in the clinical setting. A multidisciplinary group of experts in Medical Oncology, Pharmacy, and Nutrition developed a list of topics related to the nutritional status of cancer patients, which were grouped into three blocks: Nutritional support; Parenteral nutrition (PN); and Home PN (HPN) in cancer patients. A literature search, which included articles published in Spanish, English, and French until February 2017, was carried out. The document was organized as a questionnaire with those questions that, according to the panel's criteria, could generate greater controversy or doubt. Of the 18 questions addressed, 9 focused on nutritional support: 5 were related to PN and 4 about HPN. Among the different recommendations, the panel emphasized that in the cancer patient, PN is indicated mainly when it is not possible to use the digestive tract and/or oral feeding and/or enteral nutrition is not sufficient or possible. Additionally, the objective of the HPN is to improve or maintain the nutritional status of a patient at home. This document seeks to lay down a set of recommendations and to identify key issues that may be useful for the nutritional management of cancer Patients.

Expert - Non-expert differences in visual behaviour during alpine slalom skiing.

Science.gov (United States)

Decroix, Marjolein; Wazir, Mohd Rozilee Wazir Norjali; Zeuwts, Linus; Deconinck, Frederik F J A; Lenoir, Matthieu; Vansteenkiste, Pieter

2017-10-01

The aim of this study was to investigate visual behaviour of expert and non-expert ski athletes during an alpine slalom. Fourteen non-experts and five expert slalom skiers completed an alpine slalom course in an indoor ski slope while wearing a head-mounted eye tracking device. Experts completed the slalom clearly faster than non-experts, but no significant difference was found in timing and position of the turn initiation. Although both groups already looked at future obstacles approximately 0,5s before passing the upcoming pole, the higher speed of experts implied that they shifted gaze spatially earlier in the bend than non-experts. Furthermore, experts focussed more on the second next pole while non-expert slalom skiers looked more to the snow surface immediately in front of their body. No difference was found in the fixation frequency, average fixation duration, and quiet eye duration between both groups. These results suggest that experts focus on the timing of their actions while non-experts still need to pay attention to the execution of these actions. These results also might suggest that ski trainers should instruct non-experts and experts to focus on the next pole and, shift their gaze to the second next pole shortly before reaching it. Based on the current study it seems unadvisable to instruct slalom skiers to look several poles ahead during the actual slalom. However, future research should test if these results still hold on a real outdoor slope, including multiple vertical gates. Copyright © 2017 Elsevier B.V. All rights reserved.

Application of expert systems in damage assessment of reinforced concrete structures

International Nuclear Information System (INIS)

Fazel Zarandi, M. H.; Sobhani, J.

2003-01-01

Expert systems are receiving great attentions in construction industry to support decision making processes in diagnostics, design, repair and rehabilitation of the structures. Although several expert systems have been examined in engineering since the 1970's, their applications in construction industry are rate. This was largely due to the lack of expert system tools available to represent the domain knowledge. Lack of flexibility, applicability, and robustness of the classical models, have forced the scientists to discover the ability of the expert systems in problem solving of civil engineering. This paper present an expert system for diagnosis the deterioration of concrete structures. This expert system emphasizes on cracking distress in reinforced concrete elements. A case study has been presented to examine and evaluate the proposed expert system. The system demonstrates a straightforward method for diagnosing the cause of reinforced concrete elements cracking

Effects of a Mail and Telephone Intervention on Breast Health Behaviors

Science.gov (United States)

Bowen, Deborah J.; Powers, Diane

2010-01-01

This study evaluated a mail and telephone intervention to improve breast health behaviors while maintaining quality of life. Women recruited from the general public were randomized to a stepped-intensity intervention consisting of mailings, telephone calls, and counseling (if requested or appropriate given a woman's genetic risk for breast cancer)…

Bundling the value of discharge telephone calls and leader rounding.

Science.gov (United States)

Setia, Nina; Meade, Christine

2009-03-01

Discharge telephone calls made by hospital staff provide invaluable opportunities to prevent adverse events, improve quality of care, and increase patient satisfaction. Similarly, the effect of rounding on patients can improve clinical quality and improve both patient and staff satisfaction. The author discusses how the combination of implementing both nurse leader rounding and discharge telephone calls simultaneously produced powerful positive outcomes in satisfaction and patient quality of care.

Weighting Strategies for Combining Data from Dual-Frame Telephone Surveys: Emerging Evidence from Australia

Directory of Open Access Journals (Sweden)

Baffour Bernard

2016-09-01

Full Text Available Until quite recently, telephone surveys have typically relied on landline telephone numbers. However, with the increasing popularity and affordability of mobile phones, there has been a surge in households that do not have landline connections. Additionally, there has been a decline in the response rates and population coverage of landline telephone surveys, creating a challenge to collecting representative social data. Dual-frame telephone surveys that use both landline and mobile phone sampling frames can overcome the incompleteness of landline-only telephone sampling. However, surveying mobile phone users introduces new complexities in sampling, nonresponse measurement and statistical weighting. This article examines these issues and illustrates the consequences of failing to include mobile-phone-only users in telephone surveys using data from Australia. Results show that there are significant differences in estimates of populations’ characteristics when using information solely from the landline or mobile telephone sample. These biases in the population estimates are significantly reduced when data from the mobile and landline samples are combined and appropriate dual-frame survey estimators are used. The optimal choice of a dual-frame estimation strategy depends on the availability of good-quality information that can account for the differential patterns of nonresponse by frame.

Cooperating expert systems for space station power distribution management

International Nuclear Information System (INIS)

Nguyen, T.A.; Chiou, W.C.

1986-01-01

In a complex system such as the manned Space Station, it is deemed necessary that many expert systems must perform tasks in a concurrent and cooperative manner. An important question to arise is: what cooperative-task-performing models are appropriate for multiple expert systems to jointly perform tasks. The solution to this question will provide a crucial automation design criteria for the Space Station complex systems architecture. Based on a client/server model for performing tasks, the authors have developed a system that acts as a front-end to support loosely-coupled communications between expert systems running on multiple Symbolics machines. As an example, they use the two ART*-based expert systems to demonstrate the concept of parallel symbolic manipulation for power distribution management and dynamic load planner/scheduler in the simulated Space Station environment. This on-going work will also explore other cooperative-task-performing models as alternatives which can evaluate inter and intra expert system communication mechanisms. It will serve as a testbed and a bench-marking tool for other Space Station expert subsystem communication and information exchange

Cooperating Expert Systems For Space Station Power Distribution Management

Science.gov (United States)

Nguyen, T. A.; Chiou, W. C.

1987-02-01

In a complex system such as the manned Space Station, it is deem necessary that many expert systems must perform tasks in a concurrent and cooperative manner. An important question arise is: what cooperative-task-performing models are appropriate for multiple expert systems to jointly perform tasks. The solution to this question will provide a crucial automation design criteria for the Space Station complex systems architecture. Based on a client/server model for performing tasks, we have developed a system that acts as a front-end to support loosely-coupled communications between expert systems running on multiple Symbolics machines. As an example, we use two ART*-based expert systems to demonstrate the concept of parallel symbolic manipulation for power distribution management and dynamic load planner/scheduler in the simulated Space Station environment. This on-going work will also explore other cooperative-task-performing models as alternatives which can evaluate inter and intra expert system communication mechanisms. It will be served as a testbed and a bench-marking tool for other Space Station expert subsystem communication and information exchange.

An expert system technology for work authorization information systems

International Nuclear Information System (INIS)

Munchausen, J.H.; Glazer, K.A.

1988-01-01

This paper describes the effort by Southern California Edison Company (SCE) and the Electric Power Research Institute (EPRI) to develop an expert systems work station designed to support the San Onofre Nuclear Generating Station (SONGS). The expert systems work station utilizes IntelliCorp KEE (Knowledge Engineering Environment) and EPRI-IntelliCorp PLEXSYS (PLant EXpert SYStem) technology, and SCE Piping and Instrumentation Diagrams (P and ID's) and host-based computer applications to assist plant operations and maintenance personnel in the development of safety tagout boundaries. Of significance in this venture is the merging of conventional computer applications technology with expert systems technology. The EPRI PLEXSYS work station will act as a front-end for the SONGS Tagout Administration and Generation System (TAGS), a conventional CICS/COBOL mainframe computer application

Improving Posthospital Discharge Telephone Reach Rates Through Prehospital Discharge Face-to-Face Meetings.

Science.gov (United States)

Vergara, Franz H; Sheridan, Daniel J; Sullivan, Nancy J; Budhathoki, Chakra

The purpose of this study was to determine whether a face-to-face meeting with patients by a telephonic case manager prehospital discharge would result in increased telephone follow-up (TFU) reach rates posthospital discharge. Acute care adult medicine inpatient units. A quasiexperimental design was utilized. Two adult inpatient medicine units were selected as the intervention and comparison groups. The framework of the study is the transitions theory. A convenience sampling technique was used, whereby 88 eligible patients on the intervention unit received face-to-face meetings prehospital discharge whereas 123 patients on the comparison unit received standard care (no face-to-face meetings). Cross-tabulation and chi-square tests were employed to examine the association of face-to-face meeting intervention and TFU reach rates. Implementing brief (face-to-face meetings by a telephonic case manager prehospital discharge resulted in a TFU reach rate of 87% on the intervention unit, whereas the comparison unit only had a 58% TFU reach rate (p communication with more patients posthospital discharge. A brief prehospital discharge face-to-face meeting with patients assisted them to understand the reasons for a posthospital discharge telephone call, identified the best times to call using accurate telephone numbers, and taught patients how best to prepare for the call. In addition, by meeting patients face-to-face, the telephonic case manager was no longer an unknown person on the telephone asking them questions about their medical condition. These factors combined may have significantly helped to increase TFU reach rates.

Mapping crime scenes and cellular telephone usage

CSIR Research Space (South Africa)

Schmitz, Peter MU

2000-12-01

Full Text Available This paper describes a method that uses a desktop geographical information system (GIS) to plot cellular telephone conversations made when crimes are committed, such as hijackings, hostage taking, kidnapping, rape and murder. The maps produced...

Diagnosing battery behavior with an expert system in Prolog

International Nuclear Information System (INIS)

Kirkwood, N.; Weeks, D.J.

1986-01-01

Power for the Hubble Space Telescope comes from a system of 20 solar panel assemblies (SPAs) and six nickel-cadmium batteries. The HST battery system is simulated by the HST Electrical Power System (EPS) testbed at Marshall Space Flight Center. The Nickel Cadmium Battery Expert System (NICBES) is being used to diagnose faults of the testbed system, evaluate battery status and provide decision support for the engineer. Extensive telemetry of system operating conditions is relayed through a DEC LSI-11, and sent on to an IBM PC-AT. A BASIC program running on the PC monitors the flow of data, figures cell divergence and recharge ratio and stores these values, along with other selected data, for use by the expert system. The expert system is implemented in the logic programming language Prolog. It has three modes of operation: fault diagnosis, status and advice, and decision support. An alert or failure of the system will trigger a diagnosis by the system to assist the operator. The operator can also request battery status information as well as a number of plots and histograms of recent battery behavior. Trends in EOC and EOD voltage, recharge ratio and divergence are used by the expert system in its analysis of battery status. A future enhancement to the system includes the statistical prediction of battery life. Incorporating learning into the expert system is another possible enhancement; This is a difficult task, but one which could promise great rewards in improved battery performance

A theory of expert leadership (TEL) in psychiatry.

Science.gov (United States)

Goodall, Amanda H

2016-06-01

Leaders' technical competence - 'expert knowledge' - has been shown in many settings to be associated with better organizational performance. In universities, for example, there is longitudinal evidence that research-focused scholars make the best leaders; results from a hospital study show that doctors instead of professional managers are most closely associated with the best performing institutions. To explain these patterns, and raise hypotheses, a theory of expert leadership (TEL) has been developed that might explain these patterns. In this paper the framework for expert leadership is applied to psychiatry. The TEL proposes that psychiatric leaders, as opposed to non-expert managers, improve organizational performance through several channels. First, experts' knowledge influences organizational strategy. Second, having been 'one of them', a psychiatrist understands how to create the optimal work environment for psychiatric teams, through appropriate goal-setting, evaluation and support. These factors are positively associated with workers' wellbeing and performance. Third, exceptional psychiatrist-leaders are likely to set high standards for hiring. Fourth, leaders' credibility extends their influence among core workers, and also signals organizational priorities to stakeholders. Finally, a necessary prerequisite of TEL is that expert leaders have direct executive power inclusive of budgetary and strategic oversight. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Work on the CERN telephone exchanges

CERN Multimedia

2006-01-01

Corrective maintenance work on the CERN telephone exchanges will be carried out on 13th March 2006, resulting in service interruptions across the west area of the Meyrin site between 9.00 p.m. and 11.00 p.m. We apologise for any inconvenience this may cause. CERN TELECOM Service Tel.: 76111 GSM: 160101

Maintenance of CERN telephone exchanges - erratum

CERN Document Server

2005-01-01

The next maintenance of CERN telephone exchanges will be performed on 19th, 20th, 21st, and 22nd of September from 7 p.m. to 9 p.m. Disturbances or even interruptions of telephony services may occur during this lapse of time. We apology in advance for any inconveniences that this may cause.

47 CFR 36.331 - Information origination/termination expenses-Account 6310 (Class B telephone companies); Accounts...

Science.gov (United States)

2010-10-01

... telephone companies). (a) The expenses in this account are classified as follows: (1) Other Information... 47 Telecommunication 2 2010-10-01 2010-10-01 false Information origination/termination expenses-Account 6310 (Class B telephone companies); Accounts 6311, 6341, 6351, and 6362 (Class A telephone...

ROSIE: A Programming Environment for Expert Systems

Science.gov (United States)

1985-10-01

ence on Artificial Inteligence , Tbilisi, USSR, 1975. Fain, J., D. Gorlin, F. Hayes-Roth, S. Rosenschein, H. Sowizral, and D. Waterman, The ROSIE Language...gramming environment for artificial intelligence (AI) applications. It provides particular support for designing expert systems, systems that embody

Expert ease

Energy Technology Data Exchange (ETDEWEB)

1984-04-01

Expert-ease allows the most inexperienced of computer users to build an expert system in a matter of hours. It is nothing more or less than a computer based problem-solving system. It allows the expert to preserve his or her knowledge in the form of rules, which can be applied to problems put to the system by the non-expert. The crucial piece of software at the heart of Expert-Ease extracts rules from data, and is called the analogue concept learning system. It was developed by Intelligent Terminals Ltd. and supplied to Export Software International to be incorporated into a commercially attractive package for business users. The resulting product runs on the Act Sirius and the IBM PC and compatibles. It is a well conceived and polished product with a popular appeal that should ensure widespread acceptance even at a cost of >1500 plus vat.

Expert System

DEFF Research Database (Denmark)

Hildebrandt, Thomas Troels; Cattani, Gian Luca

2016-01-01

An expert system is a computer system for inferring knowledge from a knowledge base, typically by using a set of inference rules. When the concept of expert systems was introduced at Stanford University in the early 1970s, the knowledge base was an unstructured set of facts. Today the knowledge b...... for the application of expert systems, but also raises issues regarding privacy and legal liability....

Mobile and cordless telephones, serum transthyretin and the blood-cerebrospinal fluid barrier: a cross-sectional study

Directory of Open Access Journals (Sweden)

Carlberg Michael

2009-04-01

Full Text Available Abstract Background Whether low-intensity radiofrequency radiation damages the blood-brain barrier has long been debated, but little or no consideration has been given to the blood-cerebrospinal fluid barrier. In this cross-sectional study we tested whether long-term and/or short-term use of wireless telephones was associated with changes in the serum transthyretin level, indicating altered transthyretin concentration in the cerebrospinal fluid, possibly reflecting an effect of radiation. Methods One thousand subjects, 500 of each sex aged 18–65 years, were randomly recruited using the population registry. Data on wireless telephone use were assessed by a postal questionnaire and blood samples were analyzed for serum transthyretin concentrations determined by standard immunonephelometric techniques on a BN Prospec® instrument. Results The response rate was 31.4%. Logistic regression of dichotomized TTR serum levels with a cut-point of 0.31 g/l on wireless telephone use yielded increased odds ratios that were statistically not significant. Linear regression of time since first use overall and on the day that blood was withdrawn gave different results for males and females: for men significantly higher serum concentrations of TTR were seen the longer an analogue telephone or a mobile and cordless desktop telephone combined had been used, and in contrast, significantly lower serum levels were seen the longer an UMTS telephone had been used. Adjustment for fractions of use of the different telephone types did not modify the effect for cumulative use or years since first use for mobile telephone and DECT, combined. For women, linear regression gave a significant association for short-term use of mobile and cordless telephones combined, indicating that the sooner blood was withdrawn after the most recent telephone call, the higher the expected transthyretin concentration. Conclusion In this hypothesis-generating descriptive study time since first

30 CFR 56.12069 - Lightning protection for telephone wires and ungrounded conductors.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Lightning protection for telephone wires and... NONMETAL MINES Electricity § 56.12069 Lightning protection for telephone wires and ungrounded conductors... lightning shall be equipped with suitable lightning arrestors of approved type within 100 feet of the point...

30 CFR 57.12069 - Lightning protection for telephone wires and ungrounded conductors.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Lightning protection for telephone wires and... AND NONMETAL MINES Electricity Surface Only § 57.12069 Lightning protection for telephone wires and... exposed to lightning shall be equipped with suitable lightning arrestors of approved type within 100 feet...

Comparison of a new expert elicitation model with the Classical Model, equal weights and single experts, using a cross-validation technique

Energy Technology Data Exchange (ETDEWEB)

Flandoli, F. [Dip.to di Matematica Applicata, Universita di Pisa, Pisa (Italy); Giorgi, E. [Dip.to di Matematica Applicata, Universita di Pisa, Pisa (Italy); Istituto Nazionale di Geofisica e Vulcanologia, Sezione di Pisa, via della Faggiola 32, 56126 Pisa (Italy); Aspinall, W.P. [Dept. of Earth Sciences, University of Bristol, and Aspinall and Associates, Tisbury (United Kingdom); Neri, A., E-mail: neri@pi.ingv.it [Istituto Nazionale di Geofisica e Vulcanologia, Sezione di Pisa, via della Faggiola 32, 56126 Pisa (Italy)

2011-10-15

The problem of ranking and weighting experts' performances when quantitative judgments are being elicited for decision support is considered. A new scoring model, the Expected Relative Frequency model, is presented, based on the closeness between central values provided by the expert and known values used for calibration. Using responses from experts in five different elicitation datasets, a cross-validation technique is used to compare this new approach with the Cooke Classical Model, the Equal Weights model, and individual experts. The analysis is performed using alternative reward schemes designed to capture proficiency either in quantifying uncertainty, or in estimating true central values. Results show that although there is only a limited probability that one approach is consistently better than another, the Cooke Classical Model is generally the most suitable for assessing uncertainties, whereas the new ERF model should be preferred if the goal is central value estimation accuracy. - Highlights: > A new expert elicitation model, named Expected Relative Frequency (ERF), is presented. > A cross-validation approach to evaluate the performance of different elicitation models is applied. > The new ERF model shows the best performance with respect to the point-wise estimates.

Considerations in development of expert systems for real-time space applications

Science.gov (United States)

Murugesan, S.

1988-01-01

Over the years, demand on space systems has increased tremendously and this trend will continue for the near future. Enhanced capabilities of space systems, however, can only be met with increased complexity and sophistication of onboard and ground systems. Artificial Intelligence and expert system techniques have great potential in space applications. Expert systems could facilitate autonomous decision making, improve in-orbit fault diagnosis and repair, enhance performance and reduce reliance on ground support. However, real-time expert systems, unlike conventional off-line consultative systems, have to satisfy certain special stringent requirements before they could be used for onboard space applications. Challenging and interesting new environments are faced while developing expert system space applications. This paper discusses the special characteristics, requirements and typical life cycle issues for onboard expert systems. Further, it also describes considerations in design, development, and implementation which are particularly important to real-time expert systems for space applications.

Feasibility and Acceptability of a Web-Based Treatment with Telephone Support for Postpartum Women With Anxiety: Randomized Controlled Trial.

Science.gov (United States)

Ashford, Miriam T; Olander, Ellinor K; Rowe, Heather; Fisher, Jane Rw; Ayers, Susan

2018-04-20

Postpartum anxiety can have adverse effects on the mother and child if left untreated. Time constraints and stigma are common barriers to postpartum treatment. Web-based treatments offer potential flexibility and anonymity. What Am I Worried About (WaWa) is a self-guided treatment based on cognitive-behavioral and mindfulness principles for women experiencing postpartum anxiety. WaWa was developed in Australia and consists of 9 modules with optional weekly telephone support. WaWa was adapted to a Web-based version for use in England (Internet-based What Am I Worried About, iWaWa). This study aimed to investigate the feasibility (engagement and usability) and acceptability (usefulness, satisfaction, and helpfulness) of iWaWa among English postpartum women with anxiety. Postpartum (parenting styles. Despite interest in iWaWa, the results suggest that both the study and iWaWa were not feasible in the current format. However, this first trial provides useful evidence about treatment format and content preferences that can inform iWaWa's future development, as well as research and development of Web-based postpartum anxiety treatments, in general, to optimize adherence. ClinicalTrials.gov NCT02434406; https://clinicaltrials.gov/ct2/show/NCT02434406 (Archived by WebCite at http://www.webcitation.org/6xTq7Bwmd). ©Miriam T Ashford, Ellinor K Olander, Heather Rowe, Jane RW Fisher, Susan Ayers. Originally published in JMIR Mental Health (http://mental.jmir.org), 20.04.2018.

Cognitive and Physical Demands of Activities of Daily Living in Older Adults: Validation of Expert Panel Ratings.

Science.gov (United States)

Fong, Tamara G; Gleason, Lauren J; Wong, Bonnie; Habtemariam, Daniel; Jones, Richard N; Schmitt, Eva M; de Rooij, Sophia E; Saczynski, Jane S; Gross, Alden L; Bean, Jonathan F; Brown, Cynthia J; Fick, Donna M; Gruber-Baldini, Ann L; O'Connor, Margaret; Tabloski, Patrica A; Marcantonio, Edward R; Inouye, Sharon K

2015-07-01

Difficulties with performance of functional activities may result from cognitive and/or physical impairments. To date, there has not been a clear delineation of the physical and cognitive demands of activities of daily living. To quantify the relative physical and cognitive demands required to complete typical functional activities in older adults. Expert panel survey. Web-based platform. Eleven experts from 8 academic medical centers and 300 community-dwelling elderly adults age 70 and older scheduled for elective noncardiac surgery from 2 academic medical centers. Sum scores of expert ratings were calculated and then validated against objective data collected from a prospective longitudinal study. Correlation between expert ratings and objective neuropsychologic tests (memory, language, complex attention) and physical measures (gait speed and grip strength) for performance-based tasks. Managing money, self-administering medications, using the telephone, and preparing meals were rated as requiring significantly more cognitive demand, whereas walking and transferring, moderately strenuous activities, and climbing stairs were assessed as more physically demanding. Largely cognitive activities correlated with objective neuropsychologic performance (r = 0.13-0.23, P cognitive and/or physical demand for completing a specific task adds an additional dimension to standard measures of functional assessment. This additional information may significantly influence decisions about rehabilitation, postacute care needs, treatment plans, and caregiver education. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Telephone reminders reduced the non-attendance rate in a gastroenterology outpatient clinic.

Science.gov (United States)

Jeppesen, Maja Haunstrup; Ainsworth, Mark Andrew

2015-06-01

Non-attendance is a global health-care problem. The aim of the present study was 1) to investigate if a telephone reminder could reduce the non-attendance rate, 2) to study reasons for non-attendance and 3) to evaluate if a permanent implementation would be economically advantageous in a gastroenterology outpatient clinic like ours. This was a comparative intervention study with a historical control group in a gastroenterology outpatient clinic. The study lasted six months. Patients with a scheduled appointment in the first three-month period received no reminder (control group, n = 2,705). Patients in the following three-month period were reminded by telephone one weekday in advance of their appointment, when possible (intervention group, n = 2,479). Non-attending patients in the intervention group received a questionnaire. Based on the results, a financial cost-benefit analysis was made. In the intervention group, 1,577 (64%) patients answered the reminder telephone call. The non-attendance rate was significantly lower in the intervention group (6.1%) than in the control group (10.5%) (p < 0.00001). Only 1.3% of the patients who answered the reminder turned out to be non-attendees. The most common explanation for non-attendance in the intervention group was forgetfulness (39%). The reminder telephone call was cost-effective. In this outpatient clinic, telephone reminders were cost-effective and significantly reduced the non-attendance rate by 43%.

EXPERT SYSTEMS

OpenAIRE

Georgiana Marin; Mihai Catalin Andrei

2011-01-01

In recent decades IT and computer systems have evolved rapidly in economic informatics field. The goal is to create user friendly information systems that respond promptly and accurately to requests. Informatics systems evolved into decision assisted systems, and such systems are converted, based on gained experience, in expert systems for creative problem solving that an organization is facing. Expert systems are aimed at rebuilding human reasoning on the expertise obtained from experts, sto...

Modeling Auditory-Haptic Interface Cues from an Analog Multi-line Telephone

Science.gov (United States)

Begault, Durand R.; Anderson, Mark R.; Bittner, Rachael M.

2012-01-01

The Western Electric Company produced a multi-line telephone during the 1940s-1970s using a six-button interface design that provided robust tactile, haptic and auditory cues regarding the "state" of the communication system. This multi-line telephone was used as a model for a trade study comparison of two interfaces: a touchscreen interface (iPad)) versus a pressure-sensitive strain gauge button interface (Phidget USB interface controllers). The experiment and its results are detailed in the authors' AES 133rd convention paper " Multimodal Information Management: Evaluation of Auditory and Haptic Cues for NextGen Communication Dispays". This Engineering Brief describes how the interface logic, visual indications, and auditory cues of the original telephone were synthesized using MAX/MSP, including the logic for line selection, line hold, and priority line activation.

75 FR 8112 - In the Matter of Certain Mobile Telephones and Wireless Communication Devices Featuring Digital...

Science.gov (United States)

2010-02-23

... importation of certain mobile telephones and wireless communication devices featuring digital cameras, and... importation of certain mobile telephones or wireless communication devices featuring digital cameras, or... INTERNATIONAL TRADE COMMISSION [Inv. No. 337-TA-703] In the Matter of Certain Mobile Telephones...

Expert and competent non-expert visual cues during simulated diagnosis in intensive care.

Science.gov (United States)

McCormack, Clare; Wiggins, Mark W; Loveday, Thomas; Festa, Marino

2014-01-01

The aim of this study was to examine the information acquisition strategies of expert and competent non-expert intensive care physicians during two simulated diagnostic scenarios involving respiratory distress in an infant. Specifically, the information acquisition performance of six experts and 12 competent non-experts was examined using an eye-tracker during the initial 90 s of the assessment of the patient. The results indicated that, in comparison to competent non-experts, experts recorded longer mean fixations, irrespective of the scenario. When the dwell times were examined against specific areas of interest, the results revealed that competent non-experts recorded greater overall dwell times on the nurse, where experts recorded relatively greater dwell times on the head and face of the manikin. In the context of the scenarios, experts recorded differential dwell times, spending relatively more time on the head and face during the seizure scenario than during the coughing scenario. The differences evident between experts and competent non-experts were interpreted as evidence of the relative availability of task-specific cues or heuristics in memory that might direct the process of information acquisition amongst expert physicians. The implications are discussed for the training and assessment of diagnostic skills.

76 FR 20989 - National Committee on Vital and Health Statistics: Meeting

Science.gov (United States)

2011-04-14

... proposals and recommendations from individual, organizational and association subject matter experts. The... recommendations on several operating rules and standards related to HIPAA transactions. This meeting will support... Prevention, 3311 Toledo Road, Room 2402, Hyattsville, Maryland 20782, telephone (301) 458-4245. Information...

Design and implementation of an interactive website to support long-term maintenance of weight loss.

Science.gov (United States)

Stevens, Victor J; Funk, Kristine L; Brantley, Phillip J; Erlinger, Thomas P; Myers, Valerie H; Champagne, Catherine M; Bauck, Alan; Samuel-Hodge, Carmen D; Hollis, Jack F

2008-01-25

For most individuals, long-term maintenance of weight loss requires long-term, supportive intervention. Internet-based weight loss maintenance programs offer considerable potential for meeting this need. Careful design processes are required to maximize adherence and minimize attrition. This paper describes the development, implementation and use of a Web-based intervention program designed to help those who have recently lost weight sustain their weight loss over 1 year. The weight loss maintenance website was developed over a 1-year period by an interdisciplinary team of public health researchers, behavior change intervention experts, applications developers, and interface designers. Key interactive features of the final site include social support, self-monitoring, written guidelines for diet and physical activity, links to appropriate websites, supportive tools for behavior change, check-in accountability, tailored reinforcement messages, and problem solving and relapse prevention training. The weight loss maintenance program included a reminder system (automated email and telephone messages) that prompted participants to return to the website if they missed their check-in date. If there was no log-in response to the email and telephone automated prompts, a staff member called the participant. We tracked the proportion of participants with at least one log-in per month, and analyzed log-ins as a result of automated prompts. The mean age of the 348 participants enrolled in an ongoing randomized trial and assigned to use the website was 56 years; 63% were female, and 38% were African American. While weight loss data will not be available until mid-2008, website use remained high during the first year with over 80% of the participants still using the website during month 12. During the first 52 weeks, participants averaged 35 weeks with at least one log-in. Email and telephone prompts appear to be very effective at helping participants sustain ongoing website use

Emotion Analysis of Telephone Complaints from Customer Based on Affective Computing

OpenAIRE

Gong, Shuangping; Dai, Yonghui; Ji, Jun; Wang, Jinzhao; Sun, Hai

2015-01-01

Customer complaint has been the important feedback for modern enterprises to improve their product and service quality as well as the customer's loyalty. As one of the commonly used manners in customer complaint, telephone communication carries rich emotional information of speeches, which provides valuable resources for perceiving the customer's satisfaction and studying the complaint handling skills. This paper studies the characteristics of telephone complaint speeches and proposes an anal...

The carbon footprint of behavioural support services for smoking cessation.

Science.gov (United States)

Smith, Anna Jo Bodurtha; Tennison, Imogen; Roberts, Ian; Cairns, John; Free, Caroline

2013-09-01

To estimate the carbon footprint of behavioural support services for smoking cessation: text message support, telephone counselling, group counselling and individual counselling. Carbon footprint analysis. Publicly available data on National Health Service Stop Smoking Services and per unit carbon emissions; published effectiveness data from the txt2stop trial and systematic reviews of smoking cessation services. Carbon dioxide equivalents (CO2e) per 1000 smokers, per lifetime quitter, and per quality-adjusted life year gained, and cost-effectiveness, including social cost of carbon, of smoking cessation services. Emissions per 1000 participants were 8143 kg CO2e for text message support, 8619 kg CO2e for telephone counselling, 16 114 kg CO2e for group counselling and 16 372 kg CO2e for individual counselling. Emissions per intervention lifetime quitter were 636 (95% CI 455 to 958) kg CO2e for text message support, 1051 (95% CI 560 to 2873) kg CO2e for telephone counselling, 1143 (95% CI 695 to 2270) kg CO2e for group counselling and 2823 (95% CI 1688 to 6549) kg CO2e for individual counselling. Text message, telephone and group counselling remained cost-effective when cost-effectiveness analysis was revised to include the environmental and economic cost of damage from carbon emissions. All smoking cessation services had low emissions compared to the health gains produced. Text message support had the lowest emissions of the services evaluated. Smoking cessation services have small carbon footprints and were cost-effective after accounting for the societal costs of greenhouse gas emissions.

Direct and Mediated Relationships Between Participation in a Telephonic Health Coaching Program and Health Behavior, Life Satisfaction, and Optimism.

Science.gov (United States)

Sears, Lindsay E; Coberley, Carter R; Pope, James E

2016-07-01

The aim of this study was to examine the direct and mediated effects of a telephonic health coaching program on changes to healthy behaviors, life satisfaction, and optimism. This longitudinal correlational study of 4881 individuals investigated simple and mediated relationships between participation in a telephonic health risk coaching program and outcomes from three annual Well-being Assessments. Program participation was directly related to improvements in healthy behaviors, life satisfaction and optimism, and indirect effects of coaching on these variables concurrently and over a one-year time lag were also supported. Given previous research that improvements to life satisfaction, optimism, and health behaviors are valuable for individuals, employers, and communities, a clearer understanding of intervention approaches that may impact these outcomes simultaneously can drive greater program effectiveness and value on investment.

Nurse-initiated telephone follow-up on patients with chronic obstructive pulmonary disease improves patient empowerment, but cannot prevent readmissions

DEFF Research Database (Denmark)

Lavesen, Marie; Ladelund, Steen; Frederiksen, Addie J

2016-01-01

INTRODUCTION: Readmissions reduce quality of life and increase mortality. Furthermore, disease severity and shortened length of stay make it difficult to support disease management during admission. The aim of this study was to explore whether telephone follow-up after discharge may reduce...... readmission rates, lower mortality and improve disease management in patients with chronic obstructive pulmonary disease (COPD). METHODS: This was a randomised controlled trial (n = 224) with nurse-initiated telephone intervention after discharge. On day 30, questionnaires about health status and perceptions...... of disease management were completed. Readmission and death were recorded on days 30 and 84. RESULTS: There was no significant difference in readmission rates, but significant differences in patients' assessment of own perception of managing dyspnoea, lung symptoms, ability to react to signs of exacerbation...

Nurse-initiated telephone follow-up on patients with chronic obstructive pulmonary disease improves patient empowerment, but cannot prevent readmissions

DEFF Research Database (Denmark)

Karlsson, Marie Lavesen; Ladelund, Steen; Frederiksen, Addie Just

2016-01-01

Introduction: Readmissions reduce quality of life and increase mortality. Furthermore, disease severity and shortened length of stay make it difficult to support disease management during admission. The aim of this study was to explore whether telephone follow-up after discharge may reduce...... readmission rates, lower mortality and improve disease management in patients with chronic obstructive pulmonary disease (COPD). 
Methods: This was a randomised controlled trial (n = 224) with nurse-initiated telephone intervention after discharge. On day 30, questionnaires about health status and perceptions...... of disease management were completed. Readmission and death were recorded on days 30 and 84. Results: There was no significant difference in readmission rates, but significant differences in patients’ assessment of own perception of managing dyspnoea, lung symptoms, ability to react to signs of exacerbation...

Prediction of response to antiretroviral therapy by human experts and by the EuResist data-driven expert system (the EVE study).

Science.gov (United States)

Zazzi, M; Kaiser, R; Sönnerborg, A; Struck, D; Altmann, A; Prosperi, M; Rosen-Zvi, M; Petroczi, A; Peres, Y; Schülter, E; Boucher, C A; Brun-Vezinet, F; Harrigan, P R; Morris, L; Obermeier, M; Perno, C-F; Phanuphak, P; Pillay, D; Shafer, R W; Vandamme, A-M; van Laethem, K; Wensing, A M J; Lengauer, T; Incardona, F

2011-04-01

The EuResist expert system is a novel data-driven online system for computing the probability of 8-week success for any given pair of HIV-1 genotype and combination antiretroviral therapy regimen plus optional patient information. The objective of this study was to compare the EuResist system vs. human experts (EVE) for the ability to predict response to treatment. The EuResist system was compared with 10 HIV-1 drug resistance experts for the ability to predict 8-week response to 25 treatment cases derived from the EuResist database validation data set. All current and past patient data were made available to simulate clinical practice. The experts were asked to provide a qualitative and quantitative estimate of the probability of treatment success. There were 15 treatment successes and 10 treatment failures. In the classification task, the number of mislabelled cases was six for EuResist and 6-13 for the human experts [mean±standard deviation (SD) 9.1±1.9]. The accuracy of EuResist was higher than the average for the experts (0.76 vs. 0.64, respectively). The quantitative estimates computed by EuResist were significantly correlated (Pearson r=0.695, Pexperts. However, the agreement among experts was only moderate (for the classification task, inter-rater κ=0.355; for the quantitative estimation, mean±SD coefficient of variation=55.9±22.4%). With this limited data set, the EuResist engine performed comparably to or better than human experts. The system warrants further investigation as a treatment-decision support tool in clinical practice. © 2010 British HIV Association.

Classification of Listeria monocytogenes persistence in retail delicatessen environments using expert elicitation and machine learning.

Science.gov (United States)

Vangay, P; Steingrimsson, J; Wiedmann, M; Stasiewicz, M J

2014-10-01

Increasing evidence suggests that persistence of Listeria monocytogenes in food processing plants has been the underlying cause of a number of human listeriosis outbreaks. This study extracts criteria used by food safety experts in determining bacterial persistence in the environment, using retail delicatessen operations as a model. Using the Delphi method, we conducted an expert elicitation with 10 food safety experts from academia, industry, and government to classify L. monocytogenes persistence based on environmental sampling results collected over six months for 30 retail delicatessen stores. The results were modeled using variations of random forest, support vector machine, logistic regression, and linear regression; variable importance values of random forest and support vector machine models were consolidated to rank important variables in the experts' classifications. The duration of subtype isolation ranked most important across all expert categories. Sampling site category also ranked high in importance and validation errors doubled when this covariate was removed. Support vector machine and random forest models successfully classified the data with average validation errors of 3.1% and 2.2% (n = 144), respectively. Our findings indicate that (i) the frequency of isolations over time and sampling site information are critical factors for experts determining subtype persistence, (ii) food safety experts from different sectors may not use the same criteria in determining persistence, and (iii) machine learning models have potential for future use in environmental surveillance and risk management programs. Future work is necessary to validate the accuracy of expert and machine classification against biological measurement of L. monocytogenes persistence. © 2014 Society for Risk Analysis.

Expert and Competent Non-Expert Visual Cues during Simulated Diagnosis in Intensive Care

Directory of Open Access Journals (Sweden)

Clare eMcCormack

2014-08-01

Full Text Available The aim of this study was to examine the information acquisition strategies of expert and competent non-expert intensive care physicians during two simulated diagnostic scenarios involving respiratory distress in an infant. Specifically, the information acquisition performance of six experts and 12 competent non-experts was examined using an eye tracker during the initial 90 seconds of the assessment of the patient. The results indicated that, in comparison to competent non-experts, experts recorded longer mean fixations, irrespective of the scenario. When the dwell times were examined against specific areas of interest, the results revealed that competent non-experts recorded greater overall dwell times on the nurse, where experts recorded relatively greater dwell times on the head and face of the manikin. In the context of the scenarios, experts recorded differential dwell times, spending relatively more time on the head and face during the seizure scenario than during the coughing scenario. The differences evident between experts and competent non-experts were interpreted as evidence of the relative availability of task-specific cues or heuristics in memory that might direct the process of information acquisition amongst expert physicians. The implications are discussed for the training and assessment of diagnostic skills.

Internet-based CBT for depression with and without telephone tracking in a national helpline: randomised controlled trial.

Directory of Open Access Journals (Sweden)

Louise Farrer

Full Text Available BACKGROUND: Telephone helplines are frequently and repeatedly used by individuals with chronic mental health problems and web interventions may be an effective tool for reducing depression in this population. AIM: To evaluate the effectiveness of a 6 week, web-based cognitive behaviour therapy (CBT intervention with and without proactive weekly telephone tracking in the reduction of depression in callers to a helpline service. METHOD: 155 callers to a national helpline service with moderate to high psychological distress were recruited and randomised to receive either Internet CBT plus weekly telephone follow-up; Internet CBT only; weekly telephone follow-up only; or treatment as usual. RESULTS: Depression was lower in participants in the web intervention conditions both with and without telephone tracking compared to the treatment as usual condition both at post intervention and at 6 month follow-up. Telephone tracking provided by a lay telephone counsellor did not confer any additional advantage in terms of symptom reduction or adherence. CONCLUSIONS: A web-based CBT program is effective both with and without telephone tracking for reducing depression in callers to a national helpline. TRIAL REGISTRATION: Controlled-Trials.comISRCTN93903959.

The Efficacy of Internet-Based Mindfulness Training and Cognitive-Behavioral Training With Telephone Support in the Enhancement of Mental Health Among College Students and Young Working Adults: Randomized Controlled Trial.

Science.gov (United States)

Mak, Winnie Ws; Chio, Floria Hn; Chan, Amy Ty; Lui, Wacy Ws; Wu, Ellery Ky

2017-03-22

College students and working adults are particularly vulnerable to stress and other mental health problems, and mental health promotion and prevention are needed to promote their mental health. In recent decades, mindfulness-based training has demonstrated to be efficacious in treating physical and psychological conditions. The aim of our study was to examine the efficacy of an Internet-based mindfulness training program (iMIND) in comparison with the well-established Internet-based cognitive-behavioral training program (iCBT) in promoting mental health among college students and young working adults. This study was a 2-arm, unblinded, randomized controlled trial comparing iMIND with iCBT. Participants were recruited online and offline via mass emails, advertisements in newspapers and magazines, announcement and leaflets in primary care clinics, and social networking sites. Eligible participants were randomized into either the iMIND (n=604) or the iCBT (n=651) condition. Participants received 8 Web-based sessions with information and exercises related to mindfulness or cognitive-behavioral principles. Telephone or email support was provided by trained first tier supporters who were supervised by the study's research team. Primary outcomes included mental and physical health-related measures, which were self-assessed online at preprogram, postprogram, and 3-month follow-up. Among the 1255 study participants, 213 and 127 completed the post- and 3-month follow-up assessment, respectively. Missing data were treated using restricted maximum likelihood estimation. Both iMIND (n=604) and iCBT (n=651) were efficacious in improving mental health, psychological distress, life satisfaction, sleep disturbance, and energy level. Both Internet-based mental health programs showed potential in improving the mental health from pre- to postassessment, and such improvement was sustained at the 3-month follow-up. The high attrition rate in this study suggests the need for refinement

An assessesment of telephone assistance systems for caregivers of patients with Alzheimer's disease.

Science.gov (United States)

Garzón-Maldonado, F J; Gutiérrez-Bedmar, M; Serrano-Castro, V; Requena-Toro, M V; Padilla-Romero, L; García-Casares, N

Telephone assistance is a common practice in neurology, although there are only a few studies about this type of healthcare. We have evaluated a Telephone Assistance System (TAS) for caregivers of patients with Alzheimer's disease (AD) from 2 points of view: financially and according to the level of satisfaction of the caregiver. 97 patients with a diagnosis of AD according to NINCDS-ADRDA criteria and their 97 informal caregivers were selected. We studied cost differences between on-site assistance and telephone assistance (TAS) for 12 months. We used a self-administered questionnaire to assess the level of satisfaction of caregivers at the end of the study period. TAS savings amounted to 80.05 ± 27.07 euros per user. 73.6% of the caregivers consider TAS a better or much better system than on-site assistance, while only 2.6% of the caregivers considered TAS a worse or much worse system than on-site assistance. Telephone assistance systems are an efficient healthcare resource for monitoring patients with AD in neurology departments. Furthermore, the level of user satisfaction was high. We therefore consider that telephone assistance service should be offered by healthcare services. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Telephone Encounters Predict Future High Financial Expenditures in Inflammatory Bowel Disease Patients: A 3-Year Prospective Observational Study.

Science.gov (United States)

Click, Benjamin; Anderson, Alyce M; Ramos Rivers, Claudia; Koutroubakis, Ioannis E; Hashash, Jana G; Dunn, Michael A; Schwartz, Marc; Swoger, Jason; Barrie, Arthur; Szigethy, Eva; Regueiro, Miguel; Schoen, Robert E; Binion, David G

2018-04-01

Telephone activity is essential in management of complex chronic diseases including inflammatory bowel disease (IBD). Telephone encounters logged in the electronic medical record have recently been proposed as a surrogate marker of disease activity and impending health care utilization; however, the association between telephone calls and financial expenditures has not been evaluated. We performed a 3-year prospective observational study of telephone encounters logged at a tertiary referral IBD center. We analyzed patient demographics, disease characteristics, comorbidities, clinical activity, and health care financial charges by telephone encounter frequency. Eight hundred one patients met inclusion criteria (52.3% female; mean age, 44.1 y), accounted for 12,669 telephone encounters, and accrued $70,513,449 in charges over 3 years. High telephone encounter frequency was associated with female gender (P=0.003), anxiety/depression (Pfinancial charges the following year after controlling for demographic, utilization, and medication covariates. Increased telephone encounters are associated with significantly higher health care utilization and financial expenditures. Increased call frequency is predictive of future health care spending. Telephone encounters are a useful tool to identify patients at risk of clinical deterioration and large financial expense.

Telephone-Based Coaching: A Comparison of Tobacco Cessation Programs in an Integrated Health Care System

Science.gov (United States)

Boccio, Mindy; Sanna, Rashel S.; Adams, Sara R.; Goler, Nancy C.; Brown, Susan D.; Neugebauer, Romain S.; Ferrara, Assiamira; Wiley, Deanne M.; Bellamy, David J.; Schmittdiel, Julie A.

2016-01-01

Purpose Many Americans continue to smoke, increasing their risk of disease and premature death. Both telephone-based counseling and in-person tobacco cessation classes may improve access for smokers seeking convenient support to quit. Little research has assessed whether such programs are effective in real-world clinical populations. Design Retrospective cohort study comparing wellness coaching participants with two groups of controls. Setting Kaiser Permanente, Northern California (KPNC), a large integrated health care delivery system. Subjects 241 patients who participated in telephonic tobacco cessation coaching from 1/1/2011–3/31/2012, and two control groups: propensity-score matched controls, and controls who participated in a tobacco cessation class during the same period. Wellness coaching participants received an average of two motivational interviewing based coaching sessions that engage the patient, evoke their reason to consider quitting and help them establish a quit plan. Measures Self-reported quitting of tobacco and fills of tobacco cessation medications within 12 months of follow-up. Analysis Logistic regressions adjusting for age, gender, race/ethnicity, and primary language. Results After adjusting for confounders, tobacco quit rates were higher among coaching participants vs. matched controls (31% vs. 23%, PCoaching participants and class attendees filled tobacco-cessation prescriptions at a higher rate (47% for both) than matched controls (6%, Pcoaching was as effective as in-person classes and was associated with higher rates of quitting compared to no treatment. The telephonic modality may increase convenience and scalability for health care systems looking to reduce tobacco use and improve health. PMID:26559720

Expert Opinions on Nutrition Issues in Clinical Dentistry.

Science.gov (United States)

Palmer, Carole A.; And Others

1990-01-01

A survey of 79 experts in dental nutrition sought consensus on the appropriate scope of nutrition in clinical dentistry. Results support the need for greater attention to nutrition issues in dental schools and better models for nutrition interventions in dental practice. (Author/MSE)

When may doctors give nurses telephonic treatment instructions?

African Journals Online (AJOL)

When is it legal for doctors to give nurses telephonic treatment instructions? ... telemedicine? Telemedicine is defined as 'the practice of medicine, from a distance, ... [6] Therefore, if in such circumstances the doctors cannot reach the patients in ...

Plutonium - the ultrapoison? An expert's opinion about an expert opinion

International Nuclear Information System (INIS)

Stoll, W.; Becker, K.

1989-01-01

In an expert opinion written by Professor H. Kuni, Marburg, for the North Rhine-Westphalian state government, plutonium is called by far the most dangerous element in the Periodic Table. The Marburg medical expert holds that even improved legal instruments are unable to warrant effective protection of the workers handling this material, in the light of the present standards of industrial safety, because of radiological conditions and measuring problems with plutonium isotopes. In this article by an internationally renowned expert in the field, the ideas expressed in the expert opinion about the toxicity of plutonium, the cause-and-effect relationship in radiation damage by plutonium, and recent findings about the toxicity are subjected to a critical review. On the basis of results of radiation protection and of case studies, the statements in the expert opinion are contrasted with facts which make them appear in a very different light. (orig./RB) [de

Expert system isssues in automated, autonomous space vehicle rendezvous

Science.gov (United States)

Goodwin, Mary Ann; Bochsler, Daniel C.

1987-01-01

The problems involved in automated autonomous rendezvous are briefly reviewed, and the Rendezvous Expert (RENEX) expert system is discussed with reference to its goals, approach used, and knowledge structure and contents. RENEX has been developed to support streamlining operations for the Space Shuttle and Space Station program and to aid definition of mission requirements for the autonomous portions of rendezvous for the Mars Surface Sample Return and Comet Nucleus Sample return unmanned missions. The experience with REMEX to date and recommendations for further development are presented.

The Expert Project Management System (EPMS)

Science.gov (United States)

Silverman, Barry G.; Diakite, Coty

1986-01-01

Successful project managers (PMs) have been shown to rely on 'intuition,' experience, and analogical reasoning heuristics. For new PMs to be trained and experienced PMs to avoid repeating others' mistakes, it is necessary to make the knowledge and heuristics of successful PMs more widely available. The preparers have evolved a model of PM thought processes over the last decade that is now ready to be implemented as a generic PM aid. This aid consists of a series of 'specialist' expert systems (CRITIC, LIBRARIAN, IDEA MAN, CRAFTSMAN, and WRITER) that communicate with each other via a 'blackboard' architecture. The various specialist expert systems are driven to support PM training and problem solving since any 'answers' they pass to the blackboard are subjected to conflict identification (AGENDA FORMULATOR) and GOAL SETTER inference engines.

Telephone information-memory-concentration test used in evaluating cognitive function of patients with nasopharyngeal carcinoma after radiotherapy

International Nuclear Information System (INIS)

Qin Ling; Yang Xiaoye; Li Ling; Deng Zhuoxia

2009-01-01

Objective: To investigate the telephone information-memory-concentration test (TIMCT) in evaluating the cognitive function of patients with nasopharyngeal carcinoma (NPC) after radiotherapy. Methods: The cognitive function were evaluated by TIMCT and mini mental state examination (MMSE) in 2 weeks for 30 normal persons and 90 NPC patients. And the 90 NPC patients were divided into the 3 months, 2 years and 5 years after radiotherapy groups. All patients were carried out firstly face to face interview and telephone interview 1 time after 2 weeks. Results: The correlation coefficient of all groups between TIMCT(telephone) and TIMCT (face to face) were bigger (R=0.850) when MMSE wasn't control variable. And the correlation coefficients between TIMCT (telephone) and TIMCT (face to face) were lower (R=0.366) when MMSE was control variable. As for examining time was classification factor, TIMCT (telephone) and TIMCT (face to face) were analyzed by partial correlation analysis. Only normal group was correlated with group of 3 months after radiotherapy and group of 2 years after radiotherapy wasn't correlated with group of 5 years after radiotherapy (R=0.447,0.970,0.200 and 0.062). In addition, the difference plot of TIMCT(telephone) and TIMCT (face to face) indicated that telephone was consistent with face to face interview (MMSE≥28). Both telephone and face to face interview reflected the cognitive function downtrend of research objects. Conclusions: TIMCT (telephone), TIMCT(face to face) and MMSE (face to face) can reflect cognitive function downterend of patients with NPC after radiotherapy. But TIMCT(telephone) used in clinical screening cognitive function impairment of patients with NPC after radiotherapy should be improved further. (authors)

Expert status and performance.

Directory of Open Access Journals (Sweden)

Mark A Burgman

Full Text Available Expert judgements are essential when time and resources are stretched or we face novel dilemmas requiring fast solutions. Good advice can save lives and large sums of money. Typically, experts are defined by their qualifications, track record and experience. The social expectation hypothesis argues that more highly regarded and more experienced experts will give better advice. We asked experts to predict how they will perform, and how their peers will perform, on sets of questions. The results indicate that the way experts regard each other is consistent, but unfortunately, ranks are a poor guide to actual performance. Expert advice will be more accurate if technical decisions routinely use broadly-defined expert groups, structured question protocols and feedback.

Work on the CERN telephone exchanges

CERN Multimedia

2004-01-01

Corrective maintenance work on the CERN telephone exchanges will be carried out on 23 September 2004, resulting in interruptions of service across the whole CERN site between 6:00 a.m. and 8:00 a.m. and from 7:00 p.m. onwards. We apologise for any inconvenience this may cause. CERN TELECOM Service Tel.: 76111 GSM: 160026- 163610 Calls between GSM mobile phones will not be affected.

Patient-Provider Communication: Does Electronic Messaging Reduce Incoming Telephone Calls?

Science.gov (United States)

Dexter, Eve N; Fields, Scott; Rdesinski, Rebecca E; Sachdeva, Bhavaya; Yamashita, Daisuke; Marino, Miguel

2016-01-01

Internet-based patient portals are increasingly being implemented throughout health care organizations to enhance health and optimize communication between patients and health professionals. The decision to adopt a patient portal requires careful examination of the advantages and disadvantages of implementation. This study aims to investigate 1 proposed advantage of implementation: alleviating some of the clinical workload faced by employees. A retrospective time-series analysis of the correlation between the rate of electronic patient-to-provider messages-a common attribute of Internet-based patient portals-and incoming telephone calls. The rate of electronic messages and incoming telephone calls were monitored from February 2009 to June 2014 at 4 economically diverse clinics (a federally qualified health center, a rural health clinic, a community-based clinic, and a university-based clinic) related to 1 university hospital. All 4 clinics showed an increase in the rate of portal use as measured by electronic patient-to-provider messaging during the study period. Electronic patient-to-provider messaging was significantly positively correlated with incoming telephone calls at 2 of the clinics (r = 0.546, P electronic patient-to-provider messaging was associated with increased use of telephone calls in 2 of the study clinics. While practices are increasingly making the decision of whether to implement a patient portal as part of their system of care, it is important that the motivation behind such a change not be based on the idea that it will alleviate clinical workload. © Copyright 2016 by the American Board of Family Medicine.

Towards effective telephone-based delivery of government services

CSIR Research Space (South Africa)

Barnard, E

2003-09-01

Full Text Available Government regulations have combined with a tremendous growth in prepaid cellular telephony to bring telephone connectivity to an unprecedented number of South African citizens – thus creating an ideal platform for delivering services to a wide...

World Health Organization Estimates of the Relative Contributions of Food to the Burden of Disease Due to Selected Foodborne Hazards: A Structured Expert Elicitation.

Science.gov (United States)

Hald, Tine; Aspinall, Willy; Devleesschauwer, Brecht; Cooke, Roger; Corrigan, Tim; Havelaar, Arie H; Gibb, Herman J; Torgerson, Paul R; Kirk, Martyn D; Angulo, Fred J; Lake, Robin J; Speybroeck, Niko; Hoffmann, Sandra

2016-01-01

The Foodborne Disease Burden Epidemiology Reference Group (FERG) was established in 2007 by the World Health Organization (WHO) to estimate the global burden of foodborne diseases (FBDs). This estimation is complicated because most of the hazards causing FBD are not transmitted solely by food; most have several potential exposure routes consisting of transmission from animals, by humans, and via environmental routes including water. This paper describes an expert elicitation study conducted by the FERG Source Attribution Task Force to estimate the relative contribution of food to the global burden of diseases commonly transmitted through the consumption of food. We applied structured expert judgment using Cooke's Classical Model to obtain estimates for 14 subregions for the relative contributions of different transmission pathways for eleven diarrheal diseases, seven other infectious diseases and one chemical (lead). Experts were identified through international networks followed by social network sampling. Final selection of experts was based on their experience including international working experience. Enrolled experts were scored on their ability to judge uncertainty accurately and informatively using a series of subject-matter specific 'seed' questions whose answers are unknown to the experts at the time they are interviewed. Trained facilitators elicited the 5th, and 50th and 95th percentile responses to seed questions through telephone interviews. Cooke's Classical Model uses responses to the seed questions to weigh and aggregate expert responses. After this interview, the experts were asked to provide 5th, 50th, and 95th percentile estimates for the 'target' questions regarding disease transmission routes. A total of 72 experts were enrolled in the study. Ten panels were global, meaning that the experts should provide estimates for all 14 subregions, whereas the nine panels were subregional, with experts providing estimates for one or more subregions

World Health Organization Estimates of the Relative Contributions of Food to the Burden of Disease Due to Selected Foodborne Hazards: A Structured Expert Elicitation.

Directory of Open Access Journals (Sweden)

Tine Hald

Full Text Available The Foodborne Disease Burden Epidemiology Reference Group (FERG was established in 2007 by the World Health Organization (WHO to estimate the global burden of foodborne diseases (FBDs. This estimation is complicated because most of the hazards causing FBD are not transmitted solely by food; most have several potential exposure routes consisting of transmission from animals, by humans, and via environmental routes including water. This paper describes an expert elicitation study conducted by the FERG Source Attribution Task Force to estimate the relative contribution of food to the global burden of diseases commonly transmitted through the consumption of food.We applied structured expert judgment using Cooke's Classical Model to obtain estimates for 14 subregions for the relative contributions of different transmission pathways for eleven diarrheal diseases, seven other infectious diseases and one chemical (lead. Experts were identified through international networks followed by social network sampling. Final selection of experts was based on their experience including international working experience. Enrolled experts were scored on their ability to judge uncertainty accurately and informatively using a series of subject-matter specific 'seed' questions whose answers are unknown to the experts at the time they are interviewed. Trained facilitators elicited the 5th, and 50th and 95th percentile responses to seed questions through telephone interviews. Cooke's Classical Model uses responses to the seed questions to weigh and aggregate expert responses. After this interview, the experts were asked to provide 5th, 50th, and 95th percentile estimates for the 'target' questions regarding disease transmission routes. A total of 72 experts were enrolled in the study. Ten panels were global, meaning that the experts should provide estimates for all 14 subregions, whereas the nine panels were subregional, with experts providing estimates for one or more

GIS Supported Landslide Susceptibility Modeling at Regional Scale: An Expert-Based Fuzzy Weighting Method

Directory of Open Access Journals (Sweden)

Christos Chalkias

2014-04-01

Full Text Available The main aim of this paper is landslide susceptibility assessment using fuzzy expert-based modeling. Factors that influence landslide occurrence, such as elevation, slope, aspect, lithology, land cover, precipitation and seismicity were considered. Expert-based fuzzy weighting (EFW approach was used to combine these factors for landslide susceptibility mapping (Peloponnese, Greece. This method produced a landslide susceptibility map of the investigated area. The landslides under investigation have more or less same characteristics: lateral based and downslope shallow movement of soils or rocks. The validation of the model reveals, that predicted susceptibility levels are found to be in good agreement with the past landslide occurrences. Hence, the obtained landslide susceptibility map could be acceptable, for landslide hazard prevention and mitigation at regional scale.

Does expert perceptual anticipation transfer to a dissimilar domain?

Science.gov (United States)

Müller, Sean; McLaren, Michelle; Appleby, Brendyn; Rosalie, Simon M

2015-06-01

The purpose of this experiment was to extend theoretical understanding of transfer of learning by investigating whether expert perceptual anticipation skill transfers to a dissimilar domain. The capability of expert and near-expert rugby players as well as novices to anticipate skill type within rugby (learning sport) was first examined using a temporal occlusion paradigm. Participants watched video footage of an opponent performing rugby skill types that were temporally occluded at different points in the opponent's action and then made a written prediction. Thereafter, the capability of participants to transfer their anticipation skill to predict pitch type in baseball (transfer sport) was examined. Participants watched video footage of a pitcher throwing different pitch types that were temporally occluded and made a written prediction. Results indicated that expert and near-expert rugby players anticipated significantly better than novices across all occlusion conditions. However, none of the skill groups were able to transfer anticipation skill to predict pitch type in baseball. The findings of this paper, along with existing literature, support the theoretical prediction that transfer of perceptual anticipation is expertise dependent and restricted to similar domains. (c) 2015 APA, all rights reserved).

Medical Expert Systems Survey

OpenAIRE

Abu-Nasser, Bassem S.

2017-01-01

International audience; There is an increased interest in the area of Artificial Intelligence in general and expert systems in particular. Expert systems are rapidly growing technology. Expert systems are a branch of Artificial Intelligence which is having a great impact on many fields of human life. Expert systems use human expert knowledge to solve complex problems in many fields such as Health, science, engineering, business, and weather forecasting. Organizations employing the technology ...

Inter-expert and intra-expert reliability in sleep spindle scoring

DEFF Research Database (Denmark)

Wendt, Sabrina Lyngbye; Welinder, Peter; Sørensen, Helge Bjarup Dissing

2015-01-01

Objectives To measure the inter-expert and intra-expert agreement in sleep spindle scoring, and to quantify how many experts are needed to build a reliable dataset of sleep spindle scorings. Methods The EEG dataset was comprised of 400 randomly selected 115 s segments of stage 2 sleep from 110...... with higher reliability than the estimation of spindle duration. Reliability of sleep spindle scoring can be improved by using qualitative confidence scores, rather than a dichotomous yes/no scoring system. Conclusions We estimate that 2–3 experts are needed to build a spindle scoring dataset...... with ‘substantial’ reliability (κ: 0.61–0.8), and 4 or more experts are needed to build a dataset with ‘almost perfect’ reliability (κ: 0.81–1). Significance Spindle scoring is a critical part of sleep staging, and spindles are believed to play an important role in development, aging, and diseases of the nervous...

Determining and Analyzing Public Support for Gifted Education.

Science.gov (United States)

Karnes, Frances A.; Riley, Tracy L.

1997-01-01

Statewide support for gifted education was assessed through a public opinion telephone survey with 400 respondents in one state. Results indicated general support for specialized programs, except residential schools, for gifted children. Appropriate public relations strategies utilizing such survey results are suggested. (DB)

Web-based expert system for foundry pollution prevention

Science.gov (United States)

Moynihan, Gary P.

2004-02-01

Pollution prevention is a complex task. Many small foundries lack the in-house expertise to perform these tasks. Expert systems are a type of computer information system that incorporates artificial intelligence. As noted in the literature, they provide a means of automating specialized expertise. This approach may be further leveraged by implementing the expert system on the internet (or world-wide web). This will allow distribution of the expertise to a variety of geographically-dispersed foundries. The purpose of this research is to develop a prototype web-based expert system to support pollution prevention for the foundry industry. The prototype system identifies potential emissions for a specified process, and also provides recommendations for the prevention of these contaminants. The system is viewed as an initial step toward assisting the foundry industry in better meeting government pollution regulations, as well as improving operating efficiencies within these companies.

CosmoQuest: Supporting Subject Matter Experts in Broadening the Impacts of their Work beyond their Institutional Walls.

Science.gov (United States)

Noel-Storr, J.; Buxner, S.; Grier, J.; Gay, P.

2016-12-01

CosmoQuest is a virtual research facility, which, like its physical counterparts, provides tools for scientists to acquire reduced data products (thanks to our cadre of citizen scientists working to analyze images and produce results online), and also to participate in education and outreach activities either directly through CosmoQuest activities (such as CosmoAcademy and the Educators' Zone) or with the support of CosmoQuest. Here, we present our strategies to inspire, engage and support Subject Matter Experts (SMEs - Scientists, Engineers, Technologists and Mathematicians) in activities outside of their institutions, and beyond college classroom teaching. We provide support for SMEs who are interested in increasing the impacts of their science knowledge and expertise by interacting with people online, or in other venues outside of their normal work environment. This includes a broad spectrum of opportunities for those interested in hosting webinars; running short courses for the public; using Facebook, Twitter or other social media to communicate science; or other diverse activities such as supporting an open house, science fair, or star party. As noted by Katheryn Woods-Townsend and colleagues, "...face-to-face interactions with scientists allowed students to view scientists as approachable and normal people, and to begin to understand the range of scientific areas and careers that exist. Scientists viewed the scientist-student interactions as a vehicle for science communication" (2015). As CosmoQuest fosters these relationships, it We present a framework for SMEs which combine opportunities for continuing professional development (virtually and in person at conferences) with ongoing online support, creating a dynamic professional learning network. The goal of this is to deepen SME capacity-knowledge, attitudes and behaviors-both encouraging and empowering them to connect to broader audiences in new ways.

Addition of telephone coaching to a physiotherapist-delivered physical activity program in people with knee osteoarthritis: A randomised controlled trial protocol

Science.gov (United States)

2012-01-01

Background Knee osteoarthritis (OA) is one of the most common and costly chronic musculoskeletal conditions world-wide and is associated with substantial pain and disability. Many people with knee OA also experience co-morbidities that further add to the OA burden. Uptake of and adherence to physical activity recommendations is suboptimal in this patient population, leading to poorer OA outcomes and greater impact of associated co-morbidities. This pragmatic randomised controlled trial will investigate the clinical- and cost-effectiveness of adding telephone coaching to a physiotherapist-delivered physical activity intervention for people with knee OA. Methods/Design 168 people with clinically diagnosed knee OA will be recruited from the community in metropolitan and regional areas and randomly allocated to physiotherapy only, or physiotherapy plus nurse-delivered telephone coaching. Physiotherapy involves five treatment sessions over 6 months, incorporating a home exercise program of 4–6 exercises (targeting knee extensor and hip abductor strength) and advice to increase daily physical activity. Telephone coaching comprises 6–12 telephone calls over 6 months by health practitioners trained in applying the Health Change Australia (HCA) Model of Health Change to provide behaviour change support. The telephone coaching intervention aims to maximise adherence to the physiotherapy program, as well as facilitate increased levels of participation in general physical activity. The primary outcomes are pain measured by an 11-point numeric rating scale and self-reported physical function measured by the Western Ontario and McMaster Universities Osteoarthritis Index subscale after 6 months. Secondary outcomes include physical activity levels, quality-of-life, and potential moderators and mediators of outcomes including self-efficacy, pain coping and depression. Relative cost-effectiveness will be determined from health service usage and outcome data. Follow

Addition of telephone coaching to a physiotherapist-delivered physical activity program in people with knee osteoarthritis: A randomised controlled trial protocol

Directory of Open Access Journals (Sweden)

Bennell Kim L

2012-12-01

Full Text Available Abstract Background Knee osteoarthritis (OA is one of the most common and costly chronic musculoskeletal conditions world-wide and is associated with substantial pain and disability. Many people with knee OA also experience co-morbidities that further add to the OA burden. Uptake of and adherence to physical activity recommendations is suboptimal in this patient population, leading to poorer OA outcomes and greater impact of associated co-morbidities. This pragmatic randomised controlled trial will investigate the clinical- and cost-effectiveness of adding telephone coaching to a physiotherapist-delivered physical activity intervention for people with knee OA. Methods/Design 168 people with clinically diagnosed knee OA will be recruited from the community in metropolitan and regional areas and randomly allocated to physiotherapy only, or physiotherapy plus nurse-delivered telephone coaching. Physiotherapy involves five treatment sessions over 6 months, incorporating a home exercise program of 4–6 exercises (targeting knee extensor and hip abductor strength and advice to increase daily physical activity. Telephone coaching comprises 6–12 telephone calls over 6 months by health practitioners trained in applying the Health Change Australia (HCA Model of Health Change to provide behaviour change support. The telephone coaching intervention aims to maximise adherence to the physiotherapy program, as well as facilitate increased levels of participation in general physical activity. The primary outcomes are pain measured by an 11-point numeric rating scale and self-reported physical function measured by the Western Ontario and McMaster Universities Osteoarthritis Index subscale after 6 months. Secondary outcomes include physical activity levels, quality-of-life, and potential moderators and mediators of outcomes including self-efficacy, pain coping and depression. Relative cost-effectiveness will be determined from health service usage and outcome

Telephone reminders reduced the non-attendance rate in a gastroenterology outpatient clinic

DEFF Research Database (Denmark)

Jeppesen, Maja Haunstrup; Ainsworth, Mark Andrew

2015-01-01

in a gastroenterology outpatient clinic like ours. METHODS: This was a comparative intervention study with a historical control group in a gastroenterology outpatient clinic. The study lasted six months. Patients with a scheduled appointment in the first three-month period received no reminder (control group, n = 2......,705). Patients in the following three-month period were reminded by telephone one weekday in advance of their appointment, when possible (intervention group, n = 2,479). Non-attending patients in the intervention group received a questionnaire. Based on the results, a financial cost-benefit analysis was made......-attendees. The most common explanation for non-attendance in the intervention group was forgetfulness (39%). The reminder telephone call was cost-effective. CONCLUSION: In this outpatient clinic, telephone reminders were cost-effective and significantly reduced the non-attendance rate by 43%....

Exploring Culture from a Distance: The Utility of Telephone Interviews in Qualitative Research

Science.gov (United States)

Lechuga, Vicente M.

2012-01-01

Qualitative studies that utilize telephone interviews, as a primary data collection mode, often are not discussed in the qualitative research literature. Data excerpts from a study that sought to understand the culture of for-profit universities are used to illustrate the types of data that can be garnered through telephone interviews. In…

Gender and the Telephone: Voice and Emotions Shaping and Gendering Space

Directory of Open Access Journals (Sweden)

Mona Livholts

2013-01-01

Full Text Available In the field of communication studies, the topic of telephony and the gendering of space via voice and emotions has received limited attention. The focus of this article is how telephone conversations are mediated by voice and emotions, which in turn shape and gender social space. The methodology is a collaborative autoethnographic design based on diary notes and memory work. Two central themes emerge from the findings that explain how space becomes gendered when using the telephone: (a the voice and relations of power, and (b the interstices between work, caring, and the telephone. Our findings reveal the central role of work and caring and how these spaces constantly are being traversed and transformed as the mobile phone becomes an important appendage for sensory perceptions of hearing/listening/voice. We argue that these themes point toward the crucial impact of emotions in the construction of multiple and gendered spatialities of telephony.

77 FR 43858 - Certain Mobile Telephones and Wireless Communication Devices Featuring Digital Cameras, and...

Science.gov (United States)

2012-07-26

... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-703] Certain Mobile Telephones and Wireless Communication Devices Featuring Digital Cameras, and Components Thereof; Determination To Review... importation, and the sale within the United States after importation of certain mobile telephones and wireless...

Real time expert systems

International Nuclear Information System (INIS)

Asami, Tohru; Hashimoto, Kazuo; Yamamoto, Seiichi

1992-01-01

Recently, aiming at the application to the plant control for nuclear reactors and traffic and communication control, the research and the practical use of the expert system suitable to real time processing have become conspicuous. In this report, the condition for the required function to control the object that dynamically changes within a limited time is presented, and the technical difference between the real time expert system developed so as to satisfy it and the expert system of conventional type is explained with the actual examples and from theoretical aspect. The expert system of conventional type has the technical base in the problem-solving equipment originating in STRIPS. The real time expert system is applied to the fields accompanied by surveillance and control, to which conventional expert system is hard to be applied. The requirement for the real time expert system, the example of the real time expert system, and as the techniques of realizing real time processing, the realization of interruption processing, dispersion processing, and the mechanism of maintaining the consistency of knowledge are explained. (K.I.)

An expert system for improving nuclear emergency response

International Nuclear Information System (INIS)

Salame-Alfie, A.; Goldbogen, G.C.; Ryan, R.M.; Wallace, W.A.; Yeater, M.L.

1987-01-01

The accidents at TMI-2 and Chernobyl have produced initiatives aimed at improving nuclear plant emergency response capabilities. Among them are the development of emergency response facilities with capabilities for the acquisition, processing, and diagnosis of data which are needed to help coordinate plant operations, engineering support and management under emergency conditions. An effort in this direction prompted the development of an expert system. EP (EMERGENCY PLANNER) is a prototype expert system that is intended to help coordinate the overall management during emergency conditions. The EP system was built using the GEN-X expert system shell. GEN-X has a variety of knowledge representation mechanisms including AND/OR trees, Decision trees, and IF/THEN tables, and runs on an IBM PC-XT or AT computer or compatible. Among the main features, EP is portable, modular, user friendly, can interact with external programs and interrogate data bases. The knowledge base is made of New York State (NYS) Procedures for Emergency Classification, NYS Radiological Emergency Preparedness Plan (REPP) and knowledge from experts of the NYS Radiological Emergency Preparedness Group and the Office of Radiological Health and Chemistry of the New York Power Authority (NYPA)

Computer-assisted expert case definition in electronic health records.

Science.gov (United States)

Walker, Alexander M; Zhou, Xiaofeng; Ananthakrishnan, Ashwin N; Weiss, Lisa S; Shen, Rongjun; Sobel, Rachel E; Bate, Andrew; Reynolds, Robert F

2016-02-01

To describe how computer-assisted presentation of case data can lead experts to infer machine-implementable rules for case definition in electronic health records. As an illustration the technique has been applied to obtain a definition of acute liver dysfunction (ALD) in persons with inflammatory bowel disease (IBD). The technique consists of repeatedly sampling new batches of case candidates from an enriched pool of persons meeting presumed minimal inclusion criteria, classifying the candidates by a machine-implementable candidate rule and by a human expert, and then updating the rule so that it captures new distinctions introduced by the expert. Iteration continues until an update results in an acceptably small number of changes to form a final case definition. The technique was applied to structured data and terms derived by natural language processing from text records in 29,336 adults with IBD. Over three rounds the technique led to rules with increasing predictive value, as the experts identified exceptions, and increasing sensitivity, as the experts identified missing inclusion criteria. In the final rule inclusion and exclusion terms were often keyed to an ALD onset date. When compared against clinical review in an independent test round, the derived final case definition had a sensitivity of 92% and a positive predictive value of 79%. An iterative technique of machine-supported expert review can yield a case definition that accommodates available data, incorporates pre-existing medical knowledge, is transparent and is open to continuous improvement. The expert updates to rules may be informative in themselves. In this limited setting, the final case definition for ALD performed better than previous, published attempts using expert definitions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

'Putting Life in Years' (PLINY) telephone friendship groups research study: pilot randomised controlled trial.

Science.gov (United States)

Mountain, Gail A; Hind, Daniel; Gossage-Worrall, Rebecca; Walters, Stephen J; Duncan, Rosie; Newbould, Louise; Rex, Saleema; Jones, Carys; Bowling, Ann; Cattan, Mima; Cairns, Angela; Cooper, Cindy; Edwards, Rhiannon Tudor; Goyder, Elizabeth C

2014-04-24

Loneliness in older people is associated with poor health-related quality of life (HRQoL). We undertook a parallel-group randomised controlled trial to evaluate the effectiveness and cost-effectiveness of telephone befriending for the maintenance of HRQoL in older people. An internal pilot tested the feasibility of the trial and intervention. Participants aged >74 years, with good cognitive function, living independently in one UK city were recruited through general practices and other sources, then randomised to: (1) 6 weeks of short one-to-one telephone calls, followed by 12 weeks of group telephone calls with up to six participants, led by a trained volunteer facilitator; or (2) a control group. The main trial required the recruitment of 248 participants in a 1-year accrual window, of whom 124 were to receive telephone befriending. The pilot specified three success criteria which had to be met in order to progress the main trial to completion: recruitment of 68 participants in 95 days; retention of 80% participants at 6 months; successful delivery of telephone befriending by local franchise of national charity. The primary clinical outcome was the Short Form (36) Health Instrument (SF-36) Mental Health (MH) dimension score collected by telephone 6 months following randomisation. We informed 9,579 older people about the study. Seventy consenting participants were randomised to the pilot in 95 days, with 56 (80%) providing valid primary outcome data (26 intervention, 30 control). Twenty-four participants randomly allocated to the research arm actually received telephone befriending due to poor recruitment and retention of volunteer facilitators. The trial was closed early as a result. The mean 6-month SF-36 MH scores were 78 (SD 18) and 71 (SD 21) for the intervention and control groups, respectively (mean difference, 7; 95% CI, -3 to 16). Recruitment and retention of participants to a definitive trial with a recruitment window of 1 year is feasible. For

The vulcain N expert fire system

International Nuclear Information System (INIS)

Roche, A.

1989-03-01

The Institute for Nuclear Safety and Protection (IPSN) has begun work on an expert system to aid in the diagnosis of fire hazards in nuclear installations. This system is called Vulcain N and is designed as a support tool for the analyses carried out by the IPSN. Vulcain N, is based on the Vulcain expert system already developed by Bertin for its own needs and incorporates the specific rules and know-how of the IPSN experts. The development of Vulcain N began in October 1986 with the drawing up of the technical specifications, and should be completed by the end of 1988. Vulcain N brings together knowledge from a number of different domains: the locations of the combustible materials, the thermal characteristics of the combustible materials and of the walls of the room, the ventilation conditions and, finally, knowledge of fire experts concerning the development of fire. The latter covers four levels of expert knowledge: standards and their associated calculations, the simplified physics of the fire enabling more precise values to be obtained for the figures given by the standards, the rules and knowledge which enables a certain number of deductions to be made concerning the development of the fire, and a numerical simulation code which can be used to monitor the variation of certain characteristic parameters with time. For a given fire out-break scenario, Vulcain N performs diagnosis of different aspects: development of fire, effect of ventilation, emergency action possibilities, propagation hazards, etc. Owing to its flexibility, it can be used in the analysis of fire hazards to simulate a number of possible scenarios and to very rapidly deduce the essential, predominant factors. It will also be used to assist in drafting emergency procedures for application in facilities with nuclear hazards

Expert2OWL: A Methodology for Pattern-Based Ontology Development.

Science.gov (United States)

Tahar, Kais; Xu, Jie; Herre, Heinrich

2017-01-01

The formalization of expert knowledge enables a broad spectrum of applications employing ontologies as underlying technology. These include eLearning, Semantic Web and expert systems. However, the manual construction of such ontologies is time-consuming and thus expensive. Moreover, experts are often unfamiliar with the syntax and semantics of formal ontology languages such as OWL and usually have no experience in developing formal ontologies. To overcome these barriers, we developed a new method and tool, called Expert2OWL that provides efficient features to support the construction of OWL ontologies using GFO (General Formal Ontology) as a top-level ontology. This method allows a close and effective collaboration between ontologists and domain experts. Essentially, this tool integrates Excel spreadsheets as part of a pattern-based ontology development and refinement process. Expert2OWL enables us to expedite the development process and modularize the resulting ontologies. We applied this method in the field of Chinese Herbal Medicine (CHM) and used Expert2OWL to automatically generate an accurate Chinese Herbology ontology (CHO). The expressivity of CHO was tested and evaluated using ontology query languages SPARQL and DL. CHO shows promising results and can generate answers to important scientific questions such as which Chinese herbal formulas contain which substances, which substances treat which diseases, and which ones are the most frequently used in CHM.

Telephone based cognitive-behavioral screening for frontotemporal changes in patients with amyotrophic lateral sclerosis (ALS).

Science.gov (United States)

Christodoulou, Georgia; Gennings, Chris; Hupf, Jonathan; Factor-Litvak, Pam; Murphy, Jennifer; Goetz, Raymond R; Mitsumoto, Hiroshi

Our objective was to establish a valid and reliable battery of measures to evaluate frontotemporal dementia (FTD) in patients with ALS over the telephone. Thirty-one subjects were administered either in-person or by telephone-based screening followed by the opposite mode of testing two weeks later, using a modified version of the UCSF Cognitive Screening Battery. Equivalence testing was performed for in-person and telephone based tests. The standard ALS Cognitive Behavioral Screen (ALS-CBS) showed statistical equivalence at the 5% significance level compared to a revised phone version of the ALS-CBS. In addition, the Controlled Oral Word Association Test (COWAT) and Center for Neurologic Study-Lability Scale (CNS-LS) were also found to be equivalent at the 5% and 10% significance level, respectively. Similarly, the Mini-Mental State Examination (MMSE) and the well-established Telephone Interview for Cognitive Status (TICS) were also statistically equivalent. Equivalence could not be claimed for the ALS-Frontal Behavioral Inventory (ALS-FBI) caregiver interview and the Written Verbal Fluency Index (WVFI). In conclusion, our study suggests that telephone-based versions of the ALS-CBS, COWAT, and CNS-LS may offer clinicians valid tools to detect frontotemporal changes in the ALS population. Development of telephone based cognitive testing for ALS could become an integral resource for population based research in the future.

An expert system for a local planning environment

NARCIS (Netherlands)

Meester, G.J.; Meester, G.J.

1993-01-01

In this paper, we discuss the design of an Expert System (ES) that supports decision making in a Local Planning System (LPS) environment. The LPS provides the link between a high level factory planning system (rough cut capacity planning and material coordination) and the actual execution of jobs on

Patients' general satisfaction with telephone counseling by pharmacists and effects on satisfaction with information and beliefs about medicines: Results from a cluster randomized trial.

Science.gov (United States)

Kooy, Marcel Jan; Van Geffen, Erica C G; Heerdink, Eibert R; Van Dijk, Liset; Bouvy, Marcel L

2015-06-01

Assess effects of pharmacists' counseling by telephone on patients' satisfaction with counseling, satisfaction with information and beliefs about medicines for newly prescribed medicines. A cluster randomized trial in Dutch community pharmacies. Patients ≥18 years were included when starting with antidepressants, bisphosphonates, RAS-inhibitors or statins. The intervention comprised counseling by telephone to address barriers to adherent behavior. It was supported by an interview protocol. Controls received usual care. Outcomes were effects on beliefs about medication, satisfaction with information and counseling. Data was collected with a questionnaire. Responses of 211 patients in nine pharmacies were analyzed. More intervention arm patients were satisfied with counseling (adj. OR 2.2 (95% CI 1.3, 3.6)). Patients with counseling were significantly more satisfied with information on 4 items, had less concerns and less frequently had a 'skeptical' attitude towards medication (adj. OR 0.5 (0.3-0.9)). Effects on most outcomes were more pronounced in men than in women. Telephone counseling by pharmacists improved satisfaction with counseling and satisfaction with information on some items. It had a small effect on beliefs about medicines. Pharmacists can use counseling by telephone, but more research is needed to find out which patients benefit most. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Call Centre- Computer Telephone Integration

Directory of Open Access Journals (Sweden)

Dražen Kovačević

2012-10-01

Full Text Available Call centre largely came into being as a result of consumerneeds converging with enabling technology- and by the companiesrecognising the revenue opportunities generated by meetingthose needs thereby increasing customer satisfaction. Regardlessof the specific application or activity of a Call centre, customersatisfaction with the interaction is critical to the revenuegenerated or protected by the Call centre. Physical(v, Call centreset up is a place that includes computer, telephone and supervisorstation. Call centre can be available 24 hours a day - whenthe customer wants to make a purchase, needs information, orsimply wishes to register a complaint.

A framework for building real-time expert systems

Science.gov (United States)

Lee, S. Daniel

1991-01-01

The Space Station Freedom is an example of complex systems that require both traditional and artificial intelligence (AI) real-time methodologies. It was mandated that Ada should be used for all new software development projects. The station also requires distributed processing. Catastrophic failures on the station can cause the transmission system to malfunction for a long period of time, during which ground-based expert systems cannot provide any assistance to the crisis situation on the station. This is even more critical for other NASA projects that would have longer transmission delays (e.g., the lunar base, Mars missions, etc.). To address these issues, a distributed agent architecture (DAA) is proposed that can support a variety of paradigms based on both traditional real-time computing and AI. The proposed testbed for DAA is an autonomous power expert (APEX) which is a real-time monitoring and diagnosis expert system for the electrical power distribution system of the space station.

The Bandung neurosurgery patient outcomes project, Indonesia (Part II): Patient pathways and feasibility and acceptability of telephone follow-up.

Science.gov (United States)

Sutiono, Agung Budi; Faried, Ahmad; McAllister, Susan; Ganefianty, Amelia; Sarjono, Kalih; Arifin, Muhammad Zafrullah; Derrett, Sarah

2018-01-01

Support of neurosurgery patients following discharge from hospital is important. Currently, little is known about patients' in low- and middle-income countries before and after their hospital treatment. This companion paper reports patients' pathways before and after hospital admission and the feasibility of following up this ill-patient population by telephone. Eligible patients were aged ≥18 years admitted to the Neurosurgery Department in Dr. Hasan Sadikin Hospital-a regional referral hospital in Bandung City, Indonesia. Clinical data were collected on admission by clinicians. In-person interviews were undertaken with a clinical research nurse 1 to 2 days pre-discharge, and telephone follow-up interviews at 1, 2, and 3 months post-discharge. Information was also collected on pathways prior to admission and following discharge. The number of contact attempts for each patient interview was documented, as was the overall acceptability of undertaking a telephone interview. Of 178 patients discharged from hospital, 12 later died. Of the remaining 166 patients, 95% were able to be followed up to 3 months. Two-thirds of patients had been referred from another hospital. Patients came from, and were discharged to, locations throughout the West Java region. At the 1-month interview, 84% participants reported that they had had a follow-up consultation with a health professional-mostly with a neurosurgeon. This study has shown that, with a neurosurgery nurse delegated to the role, it is feasible to conduct follow-up telephone interviews with patients after discharge from a neurosurgery ward and that in fact such follow-up was appreciated by patients. Copyright © 2017 John Wiley & Sons, Ltd.

Telephonic screening and brief intervention for alcohol misuse among workers contacting the employee assistance program: A feasibility study.

Science.gov (United States)

McPherson, Tracy L; Goplerud, Eric; Derr, Dennis; Mickenberg, Judy; Courtemanche, Sherry

2010-11-01

Substantial empirical support exists for alcohol screening, brief intervention, and referral to treatment (SBIRT) in medical, but not non-medical settings such as the workplace. Workplace settings remain underutilised for delivering evidenced-based health services. This research aims to translate medical research into behavioural health-care practice in a telephonic call centre acting as a point of entry into an Employee Assistance Program (EAP). The goal of the study is to examine the feasibility of implementing routine telephonic alcohol SBIRT in an EAP call centre and assess whether routine SBIRT results in increased identification of workers who misuse alcohol. The design was pretest-posttest, one-group, pre-experimental. An alcohol SBIRT program developed based on World Health Organization recommendations was implemented in one EAP call centre serving one large employer. Workers were offered screening using the Alcohol Use Disorder Identification Test (AUDIT) during intake, brief counselling using motivational interviewing, referral to counselling, and follow-up. At 5 months, 93% of workers contacting the EAP completed the AUDIT-C: 40% prescreened positive and 52% went on to screen at moderate or high risk for an alcohol problem. Overall identification rate (18%) approached general US population estimates. Most agreed to follow-up and three-quarters set an appointment for face-to-face counselling. Integration of routine alcohol SBIRT into EAP practice is feasible in telephonic delivery systems and increases identification and opportunity for brief motivational counselling. When SBIRT is seamlessly integrated workers are willing to answer questions about alcohol and participate in follow-up.[McPherson TL, Goplerud E, Derr D, Mickenberg J, Courtemanche S. Telephonic screening and brief intervention for alcohol misuse among workers contacting the employee assistance program: A feasibility study. © 2010 Australasian Professional Society on Alcohol and other Drugs.

Online-Expert: An Expert System for Online Database Selection.

Science.gov (United States)

Zahir, Sajjad; Chang, Chew Lik

1992-01-01

Describes the design and development of a prototype expert system called ONLINE-EXPERT that helps users select online databases and vendors that meet users' needs. Search strategies are discussed; knowledge acquisition and knowledge bases are described; and the Analytic Hierarchy Process (AHP), a decision analysis technique that ranks databases,…

Being an expert

International Nuclear Information System (INIS)

Brechet, Y.; Musseau, O.; Bruna, G.; Sperandio, M.; Roulleaux-Dugage, M.; Andrieux, S.; Metteau, L.

2014-01-01

This series of short articles are dedicated to the role of the expert in the enterprise. There is an important difference between a scientific counsellor and an expert, the expert, recognized by his peers, can speak publicly in his field of expertise but has a duty of transparency while the job of a scientific counsellor requires confidentiality. The making and the use of an expert in an enterprise requires a dedicated organization. The organization of the expertise in 5 enterprises in nuclear industry are considered: CEA (French Alternative Energies and Atomic Energy Commission), IRSN (Institute of Radioprotection and Nuclear Safety), AREVA, ANDRA (National Radioactive Waste Management Agency) and EDF (Electricity of France)

Telephone counselling by nurses in Norwegian primary care out-of-hours services: a cross-sectional study.

Science.gov (United States)

Midtbø, Vivian; Raknes, Guttorm; Hunskaar, Steinar

2017-09-06

The primary care out-of-hours (OOH) services in Norway are characterized by high contact rates by telephone. The telephone contacts are handled by local emergency medical communication centres (LEMCs), mainly staffed by registered nurses. When assessment by a medical doctor is not required, the nurse often handles the contact solely by nurse telephone counselling. Little is known about this group of contacts. Thus, the aim of this study was to investigate characteristics of encounters with the OOH services that are handled solely by nurse telephone counselling. Nurses recorded ICPC-2 reason for encounter (RFE) codes and patient characteristics of all patients who contacted six primary care OOH services in Norway during 2014. Descriptive statistics and frequency analyses were applied. Of all telephone contacts (n = 61,441), 23% were handled solely by nurse counselling. Fever was the RFE most frequently handled (7.3% of all nurse advice), followed by abdominal pain, cough, ear pain and general symptoms. Among the youngest patients, 32% of the total telephone contacts were resolved by nurse advice compared with 17% in the oldest age group. At night, 31% of the total telephone contacts were resolved solely by nurse advice compared with 21% during the day shift and 23% in the evening. The share of nurse advice was higher on weekdays compared to weekends (mean share 25% versus 20% respectively). This study shows that nurses make a significant contribution to patient management in the Norwegian OOH services. The findings indicate which conditions nurses should be able to handle by telephone, which has implications for training and routines in the LEMCs. There is the potential for more nurse involvement in several of the RFEs with a currently low share of nurse counselling.

Intelligent technology for construction of tutoring integrated expert systems: new aspects

Directory of Open Access Journals (Sweden)

Galina V. Rybina

2017-01-01

Full Text Available The main aim of this paper is to acquaint readers of the journal “Open Education” with the accumulated experience of construction and practical use in the educational process of Cybernetics Department of the National Research Nuclear University MEPhI of a special class of intelligent tutoring systems, based on the architectures of tutoring integrated expert systems. The development is carried out on the problem-oriented methodology basis and intelligent software environment of AT-TECHNOLOGY workbench. They provide automation of support of all the stages of construction and maintenance of the life cycle of such systems.In the context of basic models, methods, algorithms and tools that implement the conceptual foundations of a problem-oriented methodology, and which are evolutionarily developed and experimentally investigated in the process of constructing various architectures of training integrated expert systems, including webbased ones, some features of the generalized model of intellectual learning and its components are considered (in particular, the competence-based model of the trainee, the adaptive tutoring model, the ontology model of the course /discipline et al. as well as methods and means of their realization in the current versions of tutoring integrated expert systems.In current versions of tutoring integrated expert systems examples of implementation of typical intelligent tutoring problems are described for the generalized ontology “Intelligent systems and technologies” (individual planning of the method of studying the training course, intelligent analysis of training tasks, intelligent support for decision making.A brief description of the conceptual foundations of the model of the intelligent software environment of the AT-TECHNOLOGY workbench is given and a description of some components of the model is presented with a focus on the basic components – intelligent planner, standard design procedures and reusable

Telephone health services in the field of rare diseases: a qualitative interview study examining the needs of patients, relatives, and health care professionals in Germany.

Science.gov (United States)

Babac, Ana; Frank, Martin; Pauer, Frédéric; Litzkendorf, Svenja; Rosenfeldt, Daniel; Lührs, Verena; Biehl, Lisa; Hartz, Tobias; Storf, Holger; Schauer, Franziska; Wagner, Thomas O F; Graf von der Schulenburg, J-Matthias

2018-02-09

Rare diseases are, by definition, very serious and chronic diseases with a high negative impact on quality of life. Approximately 350 million people worldwide live with rare diseases. The resulting high disease burden triggers health information search, but helpful, high-quality, and up-to-date information is often hard to find. Therefore, the improvement of health information provision has been integrated in many national plans for rare diseases, discussing the telephone as one access option. In this context, this study examines the need for a telephone service offering information for people affected by rare diseases, their relatives, and physicians. In total, 107 individuals participated in a qualitative interview study conducted in Germany. Sixty-eight individuals suffering from a rare disease or related to somebody with rare diseases and 39 health care professionals took part. Individual interviews were conducted using a standardized semi-structured questionnaire. Interviews were analysed using the qualitative content analysis, triangulating patients, relatives, and health care professionals. The fulfilment of qualitative data processing standards has been controlled for. Out of 68 patients and relatives and 39 physicians, 52 and 18, respectively, advocated for the establishment of a rare diseases telephone service. Interviewees expected a helpline to include expert staffing, personal contact, good availability, low technical barriers, medical and psychosocial topics of counselling, guidance in reducing information chaos, and referrals. Health care professionals highlighted the importance of medical topics of counselling-in particular, differential diagnostics-and referrals. Therefore, the need for a national rare diseases helpline was confirmed in this study. Due to limited financial resources, existing offers should be adapted in a stepwise procedure in accordance with the identified attributes.

78 FR 53684 - Misuse of Internet Protocol (IP) Captioned Telephone Service; Telecommunications Relay Services...

Science.gov (United States)

2013-08-30

..., and during regular business hours at the FCC Reference Information Center, Portals II, 445 12th Street... and persons using end user telephone equipment, such as a standard phone, smartphone, or computer. 2... displayed on a captioned telephone device, a computer, or a smartphone. The service also provides captions...

Telephone screening for mild cognitive impairment in hispanics using the Alzheimer's questionnaire.

Science.gov (United States)

Salazar, Ricardo; Velez, Carlos E; Royall, Donald R

2014-01-01

BACKGROUND/STUDY CONTEXT: There is a need for a simple and reliable screening test to detect individuals with mild cognitive impairment (MCI). The authors analyzed the relationship between performance of the Alzheimer's Questionnaire (AQ), an informant-rated measure of dementia-related behaviors, relative to the Telephone Interview for Cognitive Status-modified (TICS-m), Memory Impairment Scale-telephone version (MIS-t), and the Telephone Executive Assessment (TEXAS) as predictors of MCI. Comparative cross-sectional design, with data collected from participants in the Texas Alzheimer's Research and Care Consortium's (TARCC) San Antonio site. One-hundred percent of our sample was Hispanic. The San Antonio subset of TARCC sample is highly enriched with Mexican Americans (MAs). Fifty-five percent of the interviews were conducted in Spanish. Of the 184 persons enrolled, 124 were normal controls (NCs), and 60 participants had MCI. MCI status and Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) were determined through clinical consensus and performed blind to telephone assessments. Controlling for age, gender, education, and language of interview, the association between telephone measures and CDR-SOB was evaluated by multivariate regression. AQ scores were not affected by education, gender, and language of interview, but subject's age did show a positive correlation with informant AQ ratings. The AQ predicted CDR-SOB independently of the cognitive measures, adding variance above and beyond demographics. The TICS-m and the TEXAS appear to have additive value in improving the detection of cognitively impaired patients. The MIS-t failed to contribute significantly to CDR-SOB, independent of the other measures. The AQ may have utility as a culture-fair telephone screening for MCI. The AQ was able to modestly distinguish MCI from NCs. The TEXAS adds variance to a model of dementia severity independent of the AQ, suggesting that the latter may weakly assess that

Environmental factors and puberty timing: Expert panel research needs

Science.gov (United States)

An expert panel reviewed the literature on endocrine disrupting chemicals (EDCs), body size and puberty. The panel concluded that available experimental animal and human data support a possible role of EDCs and body size in relation to alterations in pubertal onset and progressio...

Expert system for maintenance management of a boiling water reactor power plant

International Nuclear Information System (INIS)

Hong Shen; Liou, L.W.; Levine, S.; Ray, A.; Detamore, M.

1992-01-01

An expert system code has been developed for the maintenance of two boiling water reactor units in Berwick, Pennsylvania, that are operated by the Pennsylvania Power and Light Company (PP and L). The objective of this expert system code, where the knowledge of experienced operators and engineers is captured and implemented, is to support the decisions regarding which components can be safely and reliably removed from service for maintenance. It can also serve as a query-answering facility for checking the plant system status and for training purposes. The operating and maintenance information of a large number of support systems, which must be available for emergencies and/or in the event of an accident, is stored in the data base of the code. It identifies the relevant technical specifications and management rules for shutting down any one of the systems or removing a component from service to support maintenance. Because of the complexity and time needed to incorporate a large number of systems and their components, the first phase of the expert system develops a prototype code, which includes only the reactor core isolation coolant system, the high-pressure core injection system, the instrument air system, the service water system, and the plant electrical system. The next phase is scheduled to expand the code to include all other systems. This paper summarizes the prototype code and the design concept of the complete expert system code for maintenance management of all plant systems and components

System Experts and Decision Making Experts in Transdisciplinary Projects

Science.gov (United States)

Mieg, Harald A.

2006-01-01

Purpose: This paper aims at a better understanding of expert roles in transdisciplinary projects. Thus, the main purpose is the analysis of the roles of experts in transdisciplinary projects. Design/methodology/approach: The analysis of the ETH-UNS case studies from the point of view of the psychology of expertise and the sociology of professions…

3D images and expert system

International Nuclear Information System (INIS)

Hasegawa, Jun-ichi

1998-01-01

This paper presents an expert system called 3D-IMPRESS for supporting applications of three dimensional (3D) image processing. This system can automatically construct a 3D image processing procedure based on a pictorial example of the goal given by a user. In the paper, to evaluate the performance of the system, it was applied to construction of procedures for extracting specific component figures from practical chest X-ray CT images. (author)

Validation of a brief telephone battery for neurocognitive assessment of patients with pulmonary arterial hypertension

Directory of Open Access Journals (Sweden)

Palevsky Harold I

2005-04-01

Full Text Available Abstract Background The effects of pulmonary arterial hypertension on brain function are not understood, despite patients' frequent complaints of cognitive difficulties. Using clinical instruments normally administered during standard in-person assessment of neurocognitive function in adults, we assembled a battery of tests designed for administration over the telephone. The purpose was to improve patient participation, facilitate repeated test administration, and reduce the cost of research on the neuropsychological consequences of acute and chronic cardiorespiratory diseases. We undertook this study to validate telephone administration of the tests. Methods 23 adults with pulmonary arterial hypertension underwent neurocognitive assessment using both standard in-person and telephone test administration, and the results of the two methods compared using interclass correlations. Results For most of the tests in the battery, scores from the telephone assessment correlated strongly with those obtained by in-person administration of the same tests. Interclass correlations between 0.5 and 0.8 were observed for tests that assessed attention, memory, concentration/working memory, reasoning, and language/crystallized intelligence (p ≤ 0.05 for each. Interclass correlations for the Hayling Sentence Completion test of executive function approached significance (p = 0.09. All telephone tests were completed within one hour. Conclusion Administration of this neurocognitive test battery by telephone should facilitate assessment of neuropsychological deficits among patients with pulmonary arterial hypertension living across broad geographical areas, and may be useful for monitoring changes in neurocognitive function in response to PAH-specific therapy or disease progression.

The effect of telephone-based cognitive-behavioural therapy on parenting stress: A randomised controlled trial.

Science.gov (United States)

Ngai, Fei Wan; Wong, Paul Wai-Ching; Chung, Ka Fai; Leung, Kwok Yin

2016-07-01

Objective Stress related to parenting has detrimental effects on the well-being of children, parents and the family system as a whole. There are limited studies about the efficacy of cognitive-behavioural therapy delivered by telephone in reducing parenting stress. The present study investigates the effect of telephone-based cognitive-behavioural therapy on parenting stress at six weeks and six months postpartum. This is a multi-site randomised controlled trial. A total of 397 Chinese mothers at risk of postnatal depression were randomly assigned to receive either telephone-based cognitive-behavioural therapy or routine postpartum care. Parental stress was assessed by the Parenting Stress Index Short Form at six weeks and six months postpartum. The findings revealed that mothers who had received telephone-based cognitive-behavioural therapy showed significantly lower levels of parenting stress than women only receiving routine postpartum care at six weeks (mean difference=9.42, 95% confidence interval 5.85-12.99, pparenting and reducing stress during the transition period. Integration of telephone-based cognitive-behavioural therapy into routine postpartum care might facilitate positive adaptation in particular for mothers at risk of postnatal depression. Copyright © 2016. Published by Elsevier Inc.

Disclosure of Sexual Intercourse by Teenagers: Agreement Between Telephone Survey Responses and Annual Visit Disclosures

Science.gov (United States)

Alexander, Stewart C.; Fortenberry, J. Dennis; Pollak, Kathryn I.; Østbye, Truls; Bravender, Terrill; Tulsky, James A.; Dolor, Rowena; Shields, Cleveland G.

2015-01-01

Background Physicians can help guide teenagers in their emerging sexuality; however, teens rarely inform physicians about their sexual activity. Methods We audio-recorded annual visits between 365 teenagers and 49 physicians. sexual intercourse. Recordings were coded for teenage disclosures about previous sexual intercourse. We measured agreement between telephone survey responses and annual visit disclosures, and examined factors associated with agreement between the two. Results Fifty-six teenagers (15%) reported previous sexual intercourse in either the telephone survey or to their physician. Among those who reported sexual intercourse, 57% shared this information to both the telephone survey and their physician (κ = .72, confidence interval = 0.63–0.82). Conclusions Although a slight majority of teenagers disclosed their sexual activity to both the telephone survey and their doctor, a significant number disclosed to just one source. PMID:25857726

Assisting the visually impaired to deal with telephone interview jobs using information and commutation technology.

Science.gov (United States)

Yeh, Fung-Huei; Yang, Chung-Chieh

2014-12-01

This study proposed a new information and commutation technology assisted blind telephone interview (ICT-ABTI) system to help visually impaired people to do telephone interview jobs as normal sighted people and create more diverse employment opportunities for them. The study also used an ABAB design to assess the system with seven visually impaired people. As the results, they can accomplish 3070 effective telephone interviews per month independently. The results also show that working performance of the visually impaired can be improved effectively with appropriate design of operation working flow and accessible software. The visually impaired become productive, lucrative, and self-sufficient by using ICT-ABTI system to do telephone interview jobs. The results were also shared through the APEC Digital Opportunity Center platform to help visually impaired in Philippines, Malaysia and China. Copyright © 2014 Elsevier Ltd. All rights reserved.

Gas data transmission system by satellite telephone; Systeme de transmission de donnees sur le gaz utilisant le telephone par satellite

Energy Technology Data Exchange (ETDEWEB)

Ogasawara, S.; Tanji, A. [Dengineer Co., Ltd (Japan); Akiyama, S. [Buyo Gas Company (Japan)

2000-07-01

Dengineer Co., Ltd. and Buyo Gas Co., Ltd. had been developing and using the data and alarm transmission system by public telephone since 1984, that was first practical use in Japan. It is very important for business management that adjusts the production value of gas by measuring gas pressures in each governor. Also, it is indispensable to know the accident of gas leakage or abnormal gas pressure quickly. But this convenient system is not spread yet in Japanese market cause of the following reasons. - Take time and cost for installation of terminal station. - Terminal station is apt to damage by thunder. - Big disaster must stop working this system. In order to solve those problems, we have developed and tested the system organized of the satellite telephone system and solar cells for power. This system will be very useful for wide place, not only Japanese market but also the area, which has no electricity and phone. Also, it will be convenient for international rescue as is able to access it from the foreign countries. (authors)

A national survey of public support for restrictions on youth access to tobacco.

Science.gov (United States)

Bailey, W J; Crowe, J W

1994-10-01

A national telephone survey was conducted to measure public support for seven proposals to restrict youth access to tobacco products, including increases in the cigarette excise tax. A random digit dialing survey, using computer-assisted telephone interviews and a two-stage Mitofsky-Waksberg design, was used to generate and replace telephone numbers and to select individuals from within households. More than 94% of respondents believed cigarette smoking by children and adolescents to be a "very serious" or "somewhat serious" problem. Most respondents expressed support for all the proposed measures to restrict youth access to tobacco products (fines for sellers, fines for youthful violators, licensing of all tobacco vendors, restrictions on cigarette vending machines, ban on sponsorship of youth-oriented events, and ban on all tobacco advertising), and for increases in the cigarette excise tax.

Comparing Costs of Telephone versus Face-to-Face Extended Care Programs for the Management of Obesity in Rural Settings

Science.gov (United States)

Radcliff, Tiffany A.; Bobroff, Linda B.; Lutes, Lesley D.; Durning, Patricia E.; Daniels, Michael J.; Limacher, Marian C.; Janicke, David M.; Martin, A. Daniel; Perri, Michael G.

2012-01-01

Background A major challenge following successful weight loss is continuing the behaviors required for long-term weight maintenance. This challenge may be exacerbated in rural areas with limited local support resources. Objective This study describes and compares program costs and cost-effectiveness for 12-month extended care lifestyle maintenance programs following an initial 6-month weight loss program. Design A 1-year prospective controlled randomized clinical trial. Participants/Setting The study included 215 female participants age 50 or older from rural areas who completed an initial 6-month lifestyle program for weight loss. The study was conducted from June 1, 2003, to May 31, 2007. Intervention The intervention was delivered through local Cooperative Extension Service offices in rural Florida. Participants were randomly-assigned to a 12-month extended care program using either individual telephone counseling (n=67), group face-to-face counseling (n=74), or a mail/control group (n=74). Main Outcome Measures Program delivery costs, weight loss, and self-reported health status were directly assessed through questionnaires and program activity logs. Costs were estimated across a range of enrollment sizes to allow inferences beyond the study sample. Statistical Analyses Performed Non-parametric and parametric tests of differences across groups for program outcomes were combined with direct program cost estimates and expected value calculations to determine which scales of operation favored alternative formats for lifestyle maintenance. Results Median weight regain during the intervention year was 1.7 kg for participants in the face-to-face format, 2.1 kg for the telephone format, and 3.1 kg for the mail/control format. For a typical group size of 13 participants, the face-to-face format had higher fixed costs, which translated into higher overall program costs ($420 per participant) when compared to individual telephone counseling ($268 per participant) and

Expert auditors’ services classification

OpenAIRE

Jolanta Wisniewska

2013-01-01

The profession of an expert auditor is a public trust occupation with a distinctive feature of taking responsibility for actions in the public interest. The main responsibility of expert auditors is performing financial auditing; however, expert auditors are prepared to carry out different tasks which encompass a wide plethora of financial and auditing services for different kinds of institutions and companies. The aim of the article is first of all the description of expert auditors’ service...

Gender portrayals in telephone books for gay community versus Pacific-Bell Yellow Pages.

Science.gov (United States)

Waugh, I M; Rienzi, B M

1998-12-01

Photographic images (N = 2,700) from three 1997 Pacific-Bell Yellow Pages (n = 1,976) and from three 1996-97 gay, lesbian, and bisexual community telephone books (n = 724) were classified into three groups by visible features (definite male, definite female, and gender nonspecific). The latter were excluded. The proportion of male photographic images was larger in gay community books than in Pacific-Bell telephone books.

Persons with Alzheimer's Disease Make Phone Calls Independently Using a Computer-Aided Telephone System

Science.gov (United States)

Perilli, Viviana; Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Cassano, Germana; Cordiano, Noemi; Pinto, Katia; Minervini, Mauro G.; Oliva, Doretta

2012-01-01

This study assessed whether four patients with a diagnosis of Alzheimer's disease could make independent phone calls via a computer-aided telephone system. The study was carried out according to a non-concurrent multiple baseline design across participants. All participants started with baseline during which the telephone system was not available,…

‘Putting Life in Years’ (PLINY) telephone friendship groups research study: pilot randomised controlled trial

Science.gov (United States)

2014-01-01

Background Loneliness in older people is associated with poor health-related quality of life (HRQoL). We undertook a parallel-group randomised controlled trial to evaluate the effectiveness and cost-effectiveness of telephone befriending for the maintenance of HRQoL in older people. An internal pilot tested the feasibility of the trial and intervention. Methods Participants aged >74 years, with good cognitive function, living independently in one UK city were recruited through general practices and other sources, then randomised to: (1) 6 weeks of short one-to-one telephone calls, followed by 12 weeks of group telephone calls with up to six participants, led by a trained volunteer facilitator; or (2) a control group. The main trial required the recruitment of 248 participants in a 1-year accrual window, of whom 124 were to receive telephone befriending. The pilot specified three success criteria which had to be met in order to progress the main trial to completion: recruitment of 68 participants in 95 days; retention of 80% participants at 6 months; successful delivery of telephone befriending by local franchise of national charity. The primary clinical outcome was the Short Form (36) Health Instrument (SF-36) Mental Health (MH) dimension score collected by telephone 6 months following randomisation. Results We informed 9,579 older people about the study. Seventy consenting participants were randomised to the pilot in 95 days, with 56 (80%) providing valid primary outcome data (26 intervention, 30 control). Twenty-four participants randomly allocated to the research arm actually received telephone befriending due to poor recruitment and retention of volunteer facilitators. The trial was closed early as a result. The mean 6-month SF-36 MH scores were 78 (SD 18) and 71 (SD 21) for the intervention and control groups, respectively (mean difference, 7; 95% CI, -3 to 16). Conclusions Recruitment and retention of participants to a definitive trial with a

A profile of communication in primary care physician telephone consultations: application of the Roter Interaction Analysis System.

Science.gov (United States)

Innes, Michael; Skelton, John; Greenfield, Sheila

2006-05-01

Telephone consultations are a part of everyday practice, there is surprisingly little research on the subject. To describe the variation of consulting skills within a body of telephone consultations in primary care, highlighting the performance of one method of assessing the process of the consultation-- the Roter Interaction Analysis System-- with telephone consultations. Cross sectional study of 43 recordings of telephone consultations with GPs. One rural county in the Midlands. Recordings were made of 8 GPs, purposively selected for maximum variance in one region of the UK. Forty-three consultations were coded using the Roter Interaction Analysis System. From the descriptive categories, six composite categories were compiled reflecting a number of domains of interaction in a consultation: rapport, data gathering, patient education and counselling, partnership building, doctor dominance and patient-centredness. Analysis of variance was undertaken to explain variations between consultations for the different domains. Comparison was made to findings from similar work for face-to-face consultations. These telephone consultations feature more biomedical information exchange than psychosocial or affective communication. Length of interaction accounts for much of the variation seen between consultations in the domains of rapport, data gathering, patient education and counselling and partnership. Male doctors are more patient centred in this study. There is the suggestion of more doctor dominance and a less patient-centred approach when comparisons are made with previous work on face-to-face consultations. Although the telephone is increasingly being used to provide care, this study highlights the fact that telephone consultations cannot be taken as equivalent to those conducted face to face. More work needs to be done to delineate the features of telephone consultations.

Use of Occupancy Models to Evaluate Expert Knowledge-based Species-Habitat Relationships

Directory of Open Access Journals (Sweden)

Monica N. Iglecia

2012-12-01

Full Text Available Expert knowledge-based species-habitat relationships are used extensively to guide conservation planning, particularly when data are scarce. Purported relationships describe the initial state of knowledge, but are rarely tested. We assessed support in the data for suitability rankings of vegetation types based on expert knowledge for three terrestrial avian species in the South Atlantic Coastal Plain of the United States. Experts used published studies, natural history, survey data, and field experience to rank vegetation types as optimal, suitable, and marginal. We used single-season occupancy models, coupled with land cover and Breeding Bird Survey data, to examine the hypothesis that patterns of occupancy conformed to species-habitat suitability rankings purported by experts. Purported habitat suitability was validated for two of three species. As predicted for the Eastern Wood-Pewee (Contopus virens and Brown-headed Nuthatch (Sitta pusilla, occupancy was strongly influenced by vegetation types classified as "optimal habitat" by the species suitability rankings for nuthatches and wood-pewees. Contrary to predictions, Red-headed Woodpecker (Melanerpes erythrocephalus models that included vegetation types as covariates received similar support by the data as models without vegetation types. For all three species, occupancy was also related to sampling latitude. Our results suggest that covariates representing other habitat requirements might be necessary to model occurrence of generalist species like the woodpecker. The modeling approach described herein provides a means to test expert knowledge-based species-habitat relationships, and hence, help guide conservation planning.

Disparities in the Use of Internet and Telephone Medication Refills among Linguistically Diverse Patients.

Science.gov (United States)

Moreno, Gerardo; Lin, Elizabeth H; Chang, Eva; Johnson, Ron L; Berthoud, Heidi; Solomon, Cam C; Morales, Leo S

2016-03-01

Health systems are increasingly implementing remote telephone and Internet refill systems to enhance patient access to medication refills. Remote refill systems may provide an effective approach for improving medication non-adherence, but more research is needed among patients with limited English proficiency with poor access to remote refill systems. To compare the use of remote medication refill systems among limited-English-proficiency (LEP) and English-proficient (EP) patients with chronic conditions. Cross-sectional survey in six languages/dialects (English, Cantonese, Mandarin, Korean, Vietnamese, and Spanish) of 509 adults with diabetes, hypertension, or hyperlipidemia. Primary study outcomes were self-reported use of 1) Internet refills, 2) telephone refills, and 3) any remote refill system. LEP was measured by patient self-identification of a primary language other than English and a claims record of use of an interpreter. Other measures were age, gender, education, years in the U.S., insurance, health status, chronic conditions, and number of prescribed medications. Analyses included multivariable logistic regression weighted for survey non-response. Overall, 33.1 % of patients refilled their medications by telephone and 31.6 % by Internet. Among LEP patients (n = 328), 31.5 % refilled by telephone and 21.2 % by Internet, compared with 36.7 % by telephone and 52.7 % by Internet among EP patients (n = 181). Internet refill by language groups were as follows: English (52.7 %), Cantonese (34.9 %), Mandarin (17.4 %), Korean (16.7 %), Vietnamese (24.4 %), and Spanish (12.6 %). Compared to EP patients, LEP patients had lower use of any remote refill system (adjusted odds ratio [AOR] 0.18; p use any remote medication refill system. Increased reliance on current systems for remote medication refills may increase disparities in health outcomes affecting LEP patients with poor access to telephone and Internet medication refills.

An Expert System for Diagnosing Eye Diseases using Forward Chaining Method

Science.gov (United States)

Munaiseche, C. P. C.; Kaparang, D. R.; Rompas, P. T. D.

2018-02-01

Expert System is a system that seeks to adopt human knowledge to the computer, so that the computer can solve problems which are usually done by experts. The purpose of medical expert system is to support the diagnosis process of physicians. It considers facts and symptoms to provide diagnosis. This implies that a medical expert system uses knowledge about diseases and facts about the patients to suggest diagnosis. The aim of this research is to design an expert system application for diagnosing eye diseases using forward chaining method and to figure out user acceptance to this application through usability testing. Eye is selected because it is one of the five senses which is very sensitive and important. The scope of the work is extended to 16 types of eye diseases with 41 symptoms of the disease, arranged in 16 rules. The computer programming language employed was the PHP programming language and MySQL as the Relational Database Management System (RDBMS). The results obtained showed that the expert system was able to successfully diagnose eye diseases corresponding to the selected symptoms entered as query and the system evaluation through usability testing showed the expert system for diagnosis eye diseases had very good rate of usability, which includes learnability, efficiency, memorability, errors, and satisfaction so that the system can be received in the operational environment.

Comparing online and telephone survey results in the context of a skin cancer prevention campaign evaluation.

Science.gov (United States)

Hollier, L P; Pettigrew, S; Slevin, T; Strickland, M; Minto, C

2017-03-01

A large proportion of health promotion campaign evaluation research has historically been conducted via telephone surveys. However, there are concerns about the continued viability of this form of surveying in providing relevant and representative data. Online surveys are an increasingly popular alternative, and as such there is a need to assess the comparability between data collected using the two different methods to determine the implications for longitudinal comparisons. The present study compared these survey modes in the context of health promotion evaluation research. Data were collected via computer-assisted telephone interviewing and an online panel. In total, 688 and 606 respondents aged between 14 and 45 years completed the online and telephone surveys, respectively. Online respondents demonstrated higher awareness of the advertisement, rated the advertisement as more personally relevant and had better behavioural outcomes compared with the telephone respondents. The results indicate significant differences between the telephone and online surveys on most measures used to assess the effectiveness of a health promotion advertising campaign. Health promotion practitioners could consider the combination of both methods to overcome the deterioration in telephone survey response rates and the likely differences in respondent outcomes. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Expert systems development: some problems, motives and issues in an exploratory study

International Nuclear Information System (INIS)

Mehdi Sagheb-Tehrani.

1993-10-01

Even though expert systems (ES) have been in use since the early eighties, there is a remarkable lack of a strong theoretical base for handling expert systems development problems. There is a requirement in the ES field for theories or explanatory models to formulate propositions, to conduct research and interpret findings in a coherent way. This work presents an exploratory investigation designed to identify some problems, motives and issues associated with developing expert systems. Totally, twenty-five expert systems were developed by various organizations which participated in the study. The study attempts to provide evidence that either supports or refutes the anecdotes, gossips and speculations currently being spread through the academic journals dealing with the expert systems development in organizations. This study provides evidence that knowledge acquisition is indeed the bottleneck of expert systems development. It also points out that most expert systems are still in the prototype stage, and that current expert systems are mostly used for aiding the decision making of less skilled domain personnel and to a lesser extent for advice to experts. The rationale behind these uses seems to be the search by organizations for better decision making in the hope of improving competitiveness. A conceptual model of expert systems development is introduced based upon theoretical studies and the findings of this study from which some hypotheses are drawn. The main objective of the model is to contribute to a larger theoretical framework. Another aim is to create a broader theoretical framework for expert systems development in order to implement such systems more successfully. The results of the study confirm that the linkages of various concepts involved in the expert systems development process are very important for the design of a successful expert system project

Mobile telephones: a comparison of radiated power between 3G VoIP calls and 3G VoCS calls.

Science.gov (United States)

Jovanovic, Dragan; Bragard, Guillaume; Picard, Dominique; Chauvin, Sébastien

2015-01-01

The purpose of this study is to assess the mean RF power radiated by mobile telephones during voice calls in 3G VoIP (Voice over Internet Protocol) using an application well known to mobile Internet users, and to compare it with the mean power radiated during voice calls in 3G VoCS (Voice over Circuit Switch) on a traditional network. Knowing that the specific absorption rate (SAR) is proportional to the mean radiated power, the user's exposure could be clearly identified at the same time. Three 3G (High Speed Packet Access) smartphones from three different manufacturers, all dual-band for GSM (900 MHz, 1800 MHz) and dual-band for UMTS (900 MHz, 1950 MHz), were used between 28 July and 04 August 2011 in Paris (France) to make 220 two-minute calls on a mobile telephone network with national coverage. The places where the calls were made were selected in such a way as to describe the whole range of usage situations of the mobile telephone. The measuring equipment, called "SYRPOM", recorded the radiation power levels and the frequency bands used during the calls with a sampling rate of 20,000 per second. In the framework of this study, the mean normalised power radiated by a telephone in 3G VoIP calls was evaluated at 0.75% maximum power of the smartphone, compared with 0.22% in 3G VoCS calls. The very low average power levels associated with use of 3G devices with VoIP or VoCS support the view that RF exposure resulting from their use is far from exceeding the basic restrictions of current exposure limits in terms of SAR.

Expert System for Diagnostics and Status Monitoring of NPP Water Chemistry Condition

International Nuclear Information System (INIS)

Shvedova, M.N.; Kritski, V.G.; Zakharova, S.V.; Nikolaev, F.V.; Benediktov, V.B.

2002-01-01

Water chemistry condition (WCC) has been the subject of constant study and improvement up to the present day. It is connected with the presence of a direct relationship between the violation of water chemistry regulation on the one hand and components reliability of the circuit's equipment and cost-effectiveness of their operation on the other. It dictates the necessity to apply different optimization methods in the field of monitoring and use of information - analytical and diagnostic systems to assess WCC quality, control and support. By now NPP experts have broad experience in revealing and removing the causes of WCC disturbances. However this knowledge is often of an intuitive, non-classified nature, scattered among various working documents, which makes their transfer difficult. Based on what has been mentioned above, special attention is currently being paid to the problem of creating expert diagnostic systems for supporting the optimum WCC. The existing developments in this field (DIWA, Smart chem Works, the water quality control system at the Onagava NPP etc. [1,3,4,5] are based on wide use of experts' knowledge. Such expert diagnostic systems for supporting WCC refer to the new generation of intellectual control methods, which allow the incorporation of the latest achievements both in the field of water chemistry simulation and in the field of artificial intelligence and computer technologies. LI 'VNIPIET' employees have, for several years, been developing an expert diagnostic system for supporting WCC and status monitoring of RBMK - reactor NPPs [2]. This system has not only conveniently organized the traditional functions of information acquisition and storage, a complete presentation of information in the form of tables, graphs of a dynamical changes of parameters and formation regular reports, diagnostic functions and issuing recommendations on WCC correction, but it also allows the assessment of confidence in the diagnosis made, relying on a wide

Telephone-delivered psychoeducational intervention for Hong Kong Chinese dementia caregivers: a single-blinded randomized controlled trial

Directory of Open Access Journals (Sweden)

Kwok T

2013-09-01

Full Text Available Timothy Kwok,1,2 Bel Wong,2 Isaac Ip,2 Kenny Chui,2 Daniel Young,2 Florence Ho2 1Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region; 2Jockey Club Centre for Positive Ageing, Hong Kong, Special Administrative Region Purpose: Many family caregivers of persons with dementia (PWD are unable to participate in community center-based caregiver support services because of logistical constraints. This study evaluated the effectiveness of a telephone-delivered psychoeducational intervention for family caregivers of PWD in alleviating caregiver burden and enhancing caregiving self-efficacy. Subjects and methods: In a single-blinded randomized controlled trial, 38 family caregivers of PWD were randomly allocated into an intervention group or a control group. The intervention group received psychoeducation from a registered social worker over the phone for 12 sessions. Caregivers in the control group were given a DVD containing educational information about dementia caregiving. Outcomes of the intervention were measured by the Chinese versions of the Zarit Burden Interview and the Revised Scale for Caregiving Self-efficacy. Mann–Whitney U tests were used to compare the differences between the intervention and control groups. Results: The level of burden of caregivers in the intervention group reduced significantly compared with caregivers in the control group. Caregivers in the intervention group also reported significantly more gain in self-efficacy in obtaining respite than the control group. Conclusion: A structured telephone intervention can benefit dementia caregivers in terms of self-efficacy and caregiving burden. The limitations of the research and recommendations for intervention are discussed. Keywords: telephone intervention, psychoeducation, dementia caregivers

System control module diagnostic Expert Assistant

Science.gov (United States)

Flores, Luis M.; Hansen, Roger F.

1990-01-01

The Orbiter EXperiments (OEX) Program was established by NASA's Office of Aeronautics and Space Technology (OAST) to accomplish the precise data collection necessary to support a complete and accurate assessment of Space Transportation System (STS) Orbiter performance during all phases of a mission. During a mission, data generated by the various experiments are conveyed to the OEX System Control Module (SCM) which arranges for and monitors storage of the data on the OEX tape recorder. The SCM Diagnostic Expert Assistant (DEA) is an expert system which provides on demand advice to technicians performing repairs of a malfunctioning SCM. The DEA is a self-contained, data-driven knowledge-based system written in the 'C' Language Production System (CLIPS) for a portable micro-computer of the IBM PC/XT class. The DEA reasons about SCM hardware faults at multiple levels; the most detailed layer of encoded knowledge of the SCM is a representation of individual components and layouts of the custom-designed component boards.

Integrating Expert Knowledge into Mapping Ecosystem Services Trade-offs for Sustainable Forest Management

Directory of Open Access Journals (Sweden)

Adrienne Grêt-Regamey

2013-09-01

Full Text Available Mountain ecosystems are highly sensitive to global change. In fact, the continued capacity of mountain regions to provide goods and services to society is threatened by the impact of environmental changes on ecosystems. Although mapping ecosystem services values is known to support sustainable resource management, the integration of spatially explicit local expert knowledge on ecosystem dynamics and social responses to global changes has not yet been integrated in the modeling process. This contribution demonstrates the importance of integrating local knowledge into the spatially explicit valuation of ecosystem services. Knowledge acquired by expert surveys flows into a GIS-based Bayesian Network for valuing forest ecosystem services under a land-use and a climate change scenario in a case study in the Swiss Alps. Results show that including expert knowledge in ecosystem services mapping not only reduces uncertainties considerably, but also has an important effect on the ecosystem services values. Particularly the iterative process between integrating expert knowledge into the modeling process and mapping ecosystem services guarantees a continuous improvement of ecosystem services values maps while opening a new way for mutual learning between scientists and stakeholders which might support adaptive resource management.

Employees' views on home-based, after-hours telephone triage by Dutch GP cooperatives.

Science.gov (United States)

Backhaus, Ramona; van Exel, Job; de Bont, Antoinette

2013-11-04

Dutch out-of-hours (OOH) centers find it difficult to attract sufficient triage staff. They regard home-based triage as an option that might attract employees. Specially trained nurses are supposed to conduct triage by telephone from home for after-hours medical care. The central aim of this research is to investigate the views of employees of OOH centers in The Netherlands on home-based telephone triage in after-hours care. The study is a Q methodology study. Triage nurses, general practitioners (GPs) and managers of OOH centers ranked 36 opinion statements on home-based triage. We interviewed 10 participants to help develop and validate the statements for the Q sort, and 77 participants did the Q sort. We identified four views on home-based telephone triage. Two generally favor home-based triage, one highlights some concerns and conditions, and one opposes it out of concern for quality. The four views perceive different sources of credibility for nurse triagists working from home. Home-based telephone triage is a controversial issue among triage nurses, GPs and managers of OOH centers. By identifying consensus and dissension among GPs, triagists, managers and regulators, this study generates four perspectives on home-based triage. In addition, it reveals the conditions considered important for home-based triage.

Short assessment of the Big Five: robust across survey methods except telephone interviewing.

Science.gov (United States)

Lang, Frieder R; John, Dennis; Lüdtke, Oliver; Schupp, Jürgen; Wagner, Gert G

2011-06-01

We examined measurement invariance and age-related robustness of a short 15-item Big Five Inventory (BFI-S) of personality dimensions, which is well suited for applications in large-scale multidisciplinary surveys. The BFI-S was assessed in three different interviewing conditions: computer-assisted or paper-assisted face-to-face interviewing, computer-assisted telephone interviewing, and a self-administered questionnaire. Randomized probability samples from a large-scale German panel survey and a related probability telephone study were used in order to test method effects on self-report measures of personality characteristics across early, middle, and late adulthood. Exploratory structural equation modeling was used in order to test for measurement invariance of the five-factor model of personality trait domains across different assessment methods. For the short inventory, findings suggest strong robustness of self-report measures of personality dimensions among young and middle-aged adults. In old age, telephone interviewing was associated with greater distortions in reliable personality assessment. It is concluded that the greater mental workload of telephone interviewing limits the reliability of self-report personality assessment. Face-to-face surveys and self-administrated questionnaire completion are clearly better suited than phone surveys when personality traits in age-heterogeneous samples are assessed.

28 CFR 540.103 - Inmate telephone calls to attorneys.

Science.gov (United States)

2010-07-01

... attorneys when the inmate demonstrates that communication with attorneys by correspondence, visiting, or... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Inmate telephone calls to attorneys. 540.103 Section 540.103 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INSTITUTIONAL...

Chinese academic experts' assessment for forest bio-energy development in China

International Nuclear Information System (INIS)

Qu Mei; Ahponen, Pirkkoliisa; Tahvanainen, Liisa; Pelkonen, Paavo

2010-01-01

The aim of this study was to assess the current situation of the forest bio-energy development in China. This assessment is based on opinions of Chinese academic experts. Key drivers and uncertainties regarding the implementation, and the strategies for the future practices in the development of forest bio-energy were investigated. In addition, the purpose of this study was also to determine whether there is a consensus among the experts concerning forest bio-energy and if this consensus agrees with policy-makers in China. A thorough assessment was conducted using a two-round Delphi survey of sixty-one bio-energy experts in China. The results revealed the advantages, potential problems, and the experts' recommendations for the future development. Furthermore, the experts agreed that the Chinese government plays a dominant role in the development process of forest bio-energy in the country. The experts recognized that the process of developing forest bio-energy is a challenging task both domestically and globally. At the same time they also highlighted the potential benefits of developing forest bio-energy in China during the next ten years. The outcomes of this study could be used to give advice to policy-makers and to support the implementation of the future forest bio-energy policies in China.

Strategies for adding adaptive learning mechanisms to rule-based diagnostic expert systems

Science.gov (United States)

Stclair, D. C.; Sabharwal, C. L.; Bond, W. E.; Hacke, Keith

1988-01-01

Rule-based diagnostic expert systems can be used to perform many of the diagnostic chores necessary in today's complex space systems. These expert systems typically take a set of symptoms as input and produce diagnostic advice as output. The primary objective of such expert systems is to provide accurate and comprehensive advice which can be used to help return the space system in question to nominal operation. The development and maintenance of diagnostic expert systems is time and labor intensive since the services of both knowledge engineer(s) and domain expert(s) are required. The use of adaptive learning mechanisms to increment evaluate and refine rules promises to reduce both time and labor costs associated with such systems. This paper describes the basic adaptive learning mechanisms of strengthening, weakening, generalization, discrimination, and discovery. Next basic strategies are discussed for adding these learning mechanisms to rule-based diagnostic expert systems. These strategies support the incremental evaluation and refinement of rules in the knowledge base by comparing the set of advice given by the expert system (A) with the correct diagnosis (C). Techniques are described for selecting those rules in the in the knowledge base which should participate in adaptive learning. The strategies presented may be used with a wide variety of learning algorithms. Further, these strategies are applicable to a large number of rule-based diagnostic expert systems. They may be used to provide either immediate or deferred updating of the knowledge base.

LESPRO - an expert system for the decision support in determination and suggestion of protective measures

International Nuclear Information System (INIS)

Bohunova, J.; Duranova, T.; Hatar, E.

2000-01-01

A prototype expert system for advising emergency procedures for nuclear regulatory authority has been developed. The expert system ESPRO is known as goal oriented rule-based knowledge system. The system is based on emergency procedures developed in VUJE Trnava, Inc. for use by the Emergency Response Centre (ERC) of the Slovak Nuclear Regulatory Authority (NRA). The operation interpretation module uses the knowledge base of emergency procedures for the evaluation of source term and determination and suggestion of protective measures which is represented in the form of a Petri net model. Its verification and validation was done on the basis of the results of two exercises: joint exercise of ERC staff with Slovak Army Headquarters and full scale Mochovce NPP emergency exercise with use of the Mochovce NPP simulator. (author)

The potential for expert system support in solving the pressurized water reactor fuel shuffling problem

International Nuclear Information System (INIS)

Rothleder, B.M.; Poetschat, G.R.; Faught, W.S.; Eich, V.J.

1988-01-01

The fuel shuffling problem is posed by the need to reposition partially burned assemblies to achieve minimum X-Y pin power peaks reload cycles of pressurized water reactors. This problem is a classic artificial intelligence (AI) problem and is highly suitable for AI expert system solution assistance, in contrast to the conventional solution, which ultimately depends solely on trial and error. Such a fuel shuffling assistant would significantly reduce engineering and computer execution time for conventional loading patterns and, much more importantly, even more significantly for low-leakage loading patterns. A successful hardware/software demonstrator has been introduced, paving the way for development of a broadly expert system program. Such a program, upon incorporating the recently developed technique perverse depletion, would provide a directed path for solving the low-leakage problem

Neural network-based expert system for severe accident management

International Nuclear Information System (INIS)

Klopp, G.T.; Silverman, E.B.

1992-01-01

This paper presents the results of the second phase of a three-phase Severe Accident Management expert system program underway at Commonwealth Edison Company (CECo). Phase I successfully demonstrated the feasibility of Artificial Neural Networks to support several of the objectives of severe accident management. Simulated accident scenarios were generated by the Modular Accident Analysis Program (MAAP) code currently in use by CECo as part of their Individual Plant Evaluations (IPE)/Accident Management Program. The primary objectives of the second phase were to develop and demonstrate four capabilities of neural networks with respect to nuclear power plant severe accident monitoring and prediction. The results of this work would form the foundation of a demonstration system which included expert system performance features. These capabilities included the ability to: (1) Predict the time available prior to support plate (and reactor vessel) failure; (2) Calculate the time remaining until recovery actions were too late to prevent core damage; (3) Predict future parameter values of each of the MAAP parameter variables; and (4) Detect simulated sensor failure and provide best-value estimates for further processing in the presence of a sensor failure. A variety of accident scenarios for the Zion and Dresden plants were used to train and test the neural network expert system. These included large and small break LOCAs as well as a range of transient events. 3 refs., 1 fig., 1 tab

An Investigation of Marketing via Mobile Devices - Attitudes of Croatian Marketing Experts

OpenAIRE

Dobrinić, Damir; Dvorski, Stjepan; Bosilj, Neven

2008-01-01

Marketing activities supported by mobile devices offer great opportunities for direct communication with consumers without the barriers of time, place, location and other. This article explores opinions and expectations Croatian marketing experts have towards use of m-advertising and other available advertising media, where we take the perspective of marketing experts to predict the future of m-marketing and m-advertising in Croatia. The paper also discusses the relevance of m-advertising and...

[Adaptation and convergent validity of a telephone-based Mini-Mental State Examination].

Science.gov (United States)

Garre-Olmo, Josep; Lax-Pericall, Carme; Turro-Garriga, Oriol; Soler-Cors, Olga; Monserrat-Vila, Sílvia; Vilalta-Franch, Joan; Taylor, Joy L; López-Pousa, Secundino

2008-06-21

To adapt to Spanish and to determine the convergent validity of a Telephone Mini-Mental State Examination (t-MMSE) in order to assess the cognitive functions in Alzheimer's disease (AD) patients. Prospective and observational study of a clinical sample consisting of patients with dementia from a memory clinic. Consecutive sampling of participants was used and convergent validity of the t-MMSE and MMSE scores was determined using several statistics measures. Patients were randomly assigned depending on the administration of the in-person/telephone test (MMSE and t-MMSE) or telephone/in-person (t-MMSE and MMSE) test within a 1- to 7-day interval. The effect of the confusion variables (age, gender, years of education, dementia severity, presence or absence of hearing impairment and administration order) on the concordance between the in-person and telephone MMSE versions was analysed. After translating and retranslating the t-MMSE, of 141 participants, 77.47% subjects completed the protocol of the study. For the total score, the statistics for the convergent validity suggested a high consistency, independently of the order of test administration (intraclass correlation coefficient = 0.87, Spearman's rho = 0.77); for the all subscores, it suggested moderate and good correlations. The difference between subscores did not range more than 1 point in any case. Confusion variables did not affect the variability of the performance scores between t-MMSE and MMSE. The t-MMSE can be used as a good tool to estimate the MMSE score of patients with dementia.

All in One Stop? The Accessibility of Work Support Programs at One-Stop Centers.

Science.gov (United States)

Richer, Elise; Kubo, Hitomi; Frank, Abbey

The accessibility of work support programs at one-stop centers was examined in a study during which 33 telephone directors or managers of one-stop centers in 22 states were interviewed by telephone. The interviews established the existence of extensive differences between one-stop centers from the standpoint of all aspects of their operation,…

Telephone interventions for adherence to colpocytological examination

Directory of Open Access Journals (Sweden)

Thais Marques Lima

Full Text Available ABSTRACT Objective: to test the effects of behavioral and educational intervention by telephone on adherence of women with inappropriate periodicity to colpocytological examination. Method: quasi-experimental study with a sample of 524 women, selected with the following inclusion criteria: be aged between 25 and 64 years, have initiated sexual activity, have inappropriate periodicity of examination and have mobile or landline phone. The women were divided into two groups for application of behavioral and educational intervention by telephone. It was used an intervention script according to the principles of Motivational Interviewing. Results: on comparing the results before and after the behavioral and educational interventions, it was found that there was a statistically significant change (p = 0.0283 with increase of knowledge of women who participated in the educational intervention. There was no change in the attitude of women of any of the groups and there was an increase of adherence to colpocytological examination in both groups (p < 0.0001, with greater adherence of women participating in the behavioral group (66.8%. Conclusion: the behavioral and educational interventions by phone were effective in the adherence of women to colpocytological examination, representing important strategies for permanent health education and promotion of care for the prevention of cervical cancer.

How clear is transparent? Reporting expert reasoning in legal cases

NARCIS (Netherlands)

Sjerps, M.J.; Berger, C.E.H.

2012-01-01

Experts providing evidence in legal cases are universally recommended to be transparent, particularly in their reasoning, so that legal practitioners can critically check whether the conclusions are adequately supported by the results. However, when exploring the practical meaning of this

Telephone reminders reduced the non-attendance rate in a gastroenterology outpatient clinic

DEFF Research Database (Denmark)

Jeppesen, Maja Haunstrup; Ainsworth, Mark Andrew

2015-01-01

INTRODUCTION: Non-attendance is a global health-care problem. The aim of the present study was 1) to investigate if a telephone reminder could reduce the non-attendance rate, 2) to study reasons for non-attendance and 3) to evaluate if a permanent implementation would be economically advantageous......,705). Patients in the following three-month period were reminded by telephone one weekday in advance of their appointment, when possible (intervention group, n = 2,479). Non-attending patients in the intervention group received a questionnaire. Based on the results, a financial cost-benefit analysis was made...

Hungarian experience in the role of a Technical Support Organization - Expert support and R and D activities in nuclear safeguards and forensics, participation in international cooperation

International Nuclear Information System (INIS)

Szeles, E.; Kovacs, A.; Biro, T.

2010-01-01

The Institute of Isotopes (IoI) of the Hungarian Academy of Sciences has been - since the mid-fifties - engaged not only in basic and applied research related to the use of radioisotopes in Hungary but also in the production, trade and safety of radioisotopes supported by the central accountancy at national level. Based on its experience and capabilities the technical tasks of nuclear safeguards and forensics have been delegated to the Institute by governmental decrees. Thus the Institute is one of the Technical Support Organizations of the Hungarian Atomic Energy Authority (HAEA) providing expert support in the areas mentioned above and maintaining the central isotope registry. An Agreement between HAEA and IoI specifies both routine and R and D activities supporting authority functions. These include the development and application of both non-destructive (i.e. gamma spectrometry, neutron-coincidence counting and laser ablation inductively coupled plasma mass spectrometry) and destructive (i.e. inductively coupled plasma mass spectrometry) analytical methods to satisfy domestic needs as well as to explore novel methods both for safeguards and nuclear forensics purposes. Methods have been developed to identify and quantify nuclear material in fresh and spent fuel assemblies and to characterize seized or found nuclear material of unknown origin and also environmental samples. The validation of these measurement methods have been performed in inter-laboratory comparisons organized by the Joint Research Centers of the European Union and by other international organizations such as IAEA and the International Technical Working Group on Nuclear Smuggling (ITWG). The presentation describes TSO activities both at domestic level and in potential international cooperation initiatives. The need of regional cooperation is emphasized discussing advantages and difficulties. (author)

Contribution of a fuzzy expert system to regulatory impact analysis

Directory of Open Access Journals (Sweden)

Marco Antônio da Cunha

2015-09-01

Full Text Available Regulatory Impact Analysis (RIA has been consolidating in Brazilian regulatory agencies throughout the last decades. The RIA methodology aims to examine the regulatory process, measure the costs and benefits generated, as well as other effects of social, political or economic nature caused by a new or an existing regulation. By analysing each regulatory option, the expert or regulator faces a myriad of variables, usually of qualitative nature, that are difficult to measure and with a high degree of uncertainty. This research complements the existing literature, given the scarcity of decision support models in RIA that – regardless of the problem treated – incorporate the tacit knowledge of the regulation expert. This paper proposes an exploratory approach using a Fuzzy Expert System, which therefore helps to enrich the decision process in the final stage of comparison of the regulatory options.

77 FR 66935 - Telephone Consumer Protection Act of 1991

Science.gov (United States)

2012-11-08

... FEDERAL COMMUNICATIONS COMMISSION 47 CFR Part 64 [CG Docket No. 02-278; FCC 12-21] Telephone Consumer Protection Act of 1991 AGENCY: Federal Communications Commission. ACTION: Final rule; correction...: Karen Johnson, Consumer and Governmental Affairs Bureau, Consumer Policy Division, at (202) 418- 7706 or...

Willingness to Pay for Rural Telephone Services: Implications for ...

African Journals Online (AJOL)

Global Approaches to Extension Practice: A Journal of Agricultural Extension ... This study assessed Willingness to Pay (WTP) for rural telephone services and the implications for agricultural technology transfer in Southeast Nigeria. ... The sample was made up of 240 agro-based entrepreneurs and 60 extension staff.

Applicability of structured telephone monitoring to follow up heart ...

African Journals Online (AJOL)

Pilly Chillo

Keywords: heart failure, structured telephone, home monitoring, Tanzania ... in a parallel increase in HF admissions and a major impact on health care systems. ... was entered in Statistical Package for Social Sciences (SPSS) version 20 software for analysis. ..... Failure (DIAL): study design and preliminary observations.

Diffusion and Advertising: The German Telephone Campaign

OpenAIRE

Hermann Simon; Karl-Heinz Sebastian

1987-01-01

The goal of the present paper is to investigate the influence of advertising on the diffusion of new telephones in West Germany. Several alternative ways of integrating advertising into the well-known Bass-diffusion-model are suggested and empirically tested. The econometric investigation yields results which are consistent with the behavioral assumption. A model which assumes that advertising mainly influenced the demand of imitators is accepted as the most valid representation of reality. T...

Development of nickel hydrogen battery expert system

Science.gov (United States)

Shiva, Sajjan G.

1990-01-01

The Hubble Telescope Battery Testbed employs the nickel-cadmium battery expert system (NICBES-2) which supports the evaluation of performances of Hubble Telescope spacecraft batteries and provides alarm diagnosis and action advice. NICBES-2 also provides a reasoning system along with a battery domain knowledge base to achieve this battery health management function. An effort to modify NICBES-2 to accommodate nickel-hydrogen battery environment in testbed is described.

Dignity and Deferral Narratives as Strategies in Facilitated Technology-Based Support Groups for People with Advanced Cancer

Directory of Open Access Journals (Sweden)

Annette F. Street

2012-01-01

Full Text Available This paper examines the value of facilitated telephone and online support groups for palliative care. Telephone interviews were conducted with twenty people living with advanced cancer who had participated in either a telephone or online support group facilitated by the Cancer Council Victoria, Melbourne, Australia. Two dominant participant narratives emerged: a focus on dying with dignity or an interest in deferring discussion of death and dying to focus on the present. Despite the different approaches, participants found the technology-based support groups to be accessible and safe environments in which to discuss difficult topics in privacy. Technology-based strategies provide opportunities for health professionals to provide social and emotional care to more people by moving beyond individualised care and facilitate peer-to-peer support at the end of life, especially to those with specific needs. Such options are feasible for palliative care services to set up and acceptable to a group of clients, especially for younger clients or those socially or geographically isolated.

Fuel cells for telephone networks

International Nuclear Information System (INIS)

Wells, J.D.; Scott, D.S.

1993-01-01

Critical telephone network systems are currently protected from electric utility power failures by a backup system consisting of lead-acid batteries and an engine-alternator. It is considered here an alternate power system where less expensive off-peak commercial electricity electrolyses water, while fuel cells draw continuously on the stored gas products to provide direct current for the protected equipment. The lead acid batteries are eliminated. The benefits and costs of the existing and alternate systems in scenarios with various system efficiencies, capital costs, and electric utility rates and incentives, are compared. In today's conditions, the alternate system is not economical; however, cost and performance feasibility domains are identified. 2 figs., 4 tabs., 12 refs

CLIPS/Ada: An Ada-based tool for building expert systems

Science.gov (United States)

White, W. A.

1990-01-01

Clips/Ada is a production system language and a development environment. It is functionally equivalent to the CLIPS tool. CLIPS/Ada was developed in order to provide a means of incorporating expert system technology into projects where the use of the Ada language had been mandated. A secondary purpose was to glean information about the Ada language and its compilers. Specifically, whether or not the language and compilers were mature enough to support AI applications. The CLIPS/Ada tool is coded entirely in Ada and is designed to be used by Ada systems that require expert reasoning.

Expert system and knowledge acquisition technology in ENEA program on nuclear and conventional energy production processes

International Nuclear Information System (INIS)

Balducelli, C.; Federico, A.; Sapia, R.Di.

1990-01-01

On the basis of some experiences performed in ENEA (Thermal Reactor Department) revelant to the project and development of experts systems to support the operator activities in nuclear and conventional energy production processes, the paper tries to point out the outline of a 'generic' plant operator cognitive structure. For this type of expert systems an implementation strategy and a knowledge elicitation methodology are proposed with the intention of giving a support to the knowledge engineer work

Delegating Decisions to Experts

Science.gov (United States)

Li, Hao; Suen, Wing

2004-01-01

We present a model of delegation with self-interested and privately informed experts. A team of experts with extreme but opposite biases is acceptable to a wide range of decision makers with diverse preferences, but the value of expertise from such a team is low. A decision maker wants to appoint experts who are less partisan than he is in order…

75 FR 6704 - In the Matter of Certain Mobile Telephones and Wireless Communication Devices Featuring Digital...

Science.gov (United States)

2010-02-10

... States after importation of certain mobile telephones and wireless communication devices featuring... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-663] In the Matter of Certain Mobile Telephones and Wireless Communication Devices Featuring Digital Cameras, and Components Thereof; Notice of...

75 FR 65654 - In the Matter of: Certain Mobile Telephones and Wireless Communication Devices Featuring Digital...

Science.gov (United States)

2010-10-26

... States after importation of certain mobile telephones and wireless communication devices featuring... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-703] In the Matter of: Certain Mobile Telephones and Wireless Communication Devices Featuring Digital Cameras, and Components Thereof;Notice of...

Teaching adolescents with severe disabilities to use the public telephone.

Science.gov (United States)

Test, D W; Spooner, F; Keul, P K; Grossi, T

1990-04-01

Two adolescents with severe disabilities served as participants in a study conducted to train in the use of the public telephone to call home. Participants were trained to complete a 17-step task analysis using a training package which consisted of total task presentation in conjunction with a four-level prompting procedure (i.e., independent, verbal, verbal + gesture, verbal + guidance). All instruction took place in a public setting (e.g., a shopping mall) with generalization probes taken in two alternative settings (e.g., a movie theater and a convenience store). A multiple probe across individuals design demonstrated the training package was successful in teaching participants to use the telephone to call home. In addition, newly acquired skills generalized to the two untrained settings. Implications for community-based training are discussed.

An inquiry into chiropractors' intention to treat adolescent idiopathic scoliosis: a telephone survey.

Science.gov (United States)

Feise, R J

2001-01-01

The primary aim of this study was to (1) determine the clinical management approach of practicing chiropractors with regard to patients with adolescent idiopathic scoliosis and (2) measure the response rate of a telephone survey. A survey instrument was developed and pretested, and a case-specific clinical vignette was generated for a hypothetical typical 12-year-old girl with adolescent idiopathic scoliosis. The instrument addressed 3 domains: the specific management of idiopathic scoliosis, elements guiding the general selection of treatment recommendations, and demographics of respondents. The sample frame consisted of 62,000 US chiropractors, of whom 165 were randomly selected for the survey sample. Interviews were conducted by telephone through use of the tested survey instrument. The response rate was 69% (114/165). Of the 51 nonrespondents, 15 did not have a listed business telephone number and 24 were not in active practice. The response rate of those who met the inclusion criteria (practicing chiropractor with a listed telephone number) was 90% (114/126). The gender, chiropractic college, and years in practice of respondents in this survey were similar to those of respondents in 3 other national surveys. In general, the respondents would provide 6 months of "intensive" chiropractic therapy, then follow the patient for 4 years (near skeletal maturity). Eighty-two percent of respondents named diversified technique as their primary adjustive treatment, 87% would use exercise, and 30% would use electric muscle stimulation as an adjunct to manual therapy. Most surveyed chiropractors would use similar methods (frequency and length of treatment, manipulation technique, and exercise) in the treatment of patients with adolescent idiopathic scoliosis. A high response rate to a national survey can be achieved through use of telephone contact.

Telephone-Based Cognitive-Behavioral Screening for Frontotemporal Changes in Patients with Amyotrophic Lateral Sclerosis (ALS)

Science.gov (United States)

Christodoulou, Georgia; Gennings, Chris; Hupf, Jonathan; Factor-Litvak, Pam; Murphy, Jennifer; Goetz, Raymond R.; Mitsumoto, Hiroshi

2017-01-01

Objective To establish a valid and reliable battery of measures to evaluate frontotemporal dementia (FTD) in patients with ALS over the phone. Methods Thirty-one subjects were administered either in-person or telephone-based screening followed by the opposite mode of testing two weeks later, using a modified version of the UCSF Cognitive Screening Battery. Results Equivalence testing was performed for in-person and telephone-based tests. The standard ALS Cognitive Behavioral Screen (ALS-CBS) showed statistical equivalence at the 5% significance level when compared to a revised phone-version of the ALS-CBS. In addition, the Controlled Oral Word Association Test (COWAT) and Center for Neurologic Study-Lability Scale (CNS-LS) were also found to be equivalent at the 5% and 10% significance level respectively. Similarly, the Mini-Mental State Examination (MMSE) and the well-established Telephone Interview for Cognitive Status (TICS) were also statistically equivalent. Equivalence could not be claimed for the ALS-Frontal Behavioral Inventory (ALS-FBI) caregiver interview and the Written Verbal Fluency Index (WVFI). Conclusions Our study suggests that telephone-based versions of the ALS-CBS, COWAT, and CNS-LS may offer clinicians valid tools to detect frontotemporal changes in the ALS population. Development of telephone-based cognitive testing for ALS could become an integral resource for population-based research in the future. PMID:27121545

47 CFR 64.1505 - Restrictions on collect telephone calls.

Science.gov (United States)

2010-10-01

... SERVICES (CONTINUED) MISCELLANEOUS RULES RELATING TO COMMON CARRIERS Interstate Pay-Per-Call and Other Information Services § 64.1505 Restrictions on collect telephone calls. (a) No common carrier shall provide interstate transmission or billing and collection services to an entity offering any service within the scope...

Applicability of structured telephone monitoring to follow up heart ...

African Journals Online (AJOL)

Over 90% of the contacted patients gave valuable information regarding their clinical status. Conclusion: Majority of HF patients can be contacted and provide valuable clinical information through mobile phones within a month post discharge from the national hospital in Tanzania. Structured telephone monitoring could be ...

Impact of in-home behavioral management versus telephone support to reduce depressive symptoms and perceived stress in Chinese caregivers: results of a pilot study.

Science.gov (United States)

Gallagher-Thompson, Dolores; Gray, Heather L; Tang, Paulette C Y; Pu, Chun Yu; Leung, Laurie Y L; Wang, Peng-Chih; Tse, Collins; Hsu, Shannon; Kwo, Elizabeth; Tong, Hui-Qi; Long, James; Thompson, Larry W

2007-05-01

Recent work has shown that Chinese Americans caring for a family member with dementia experience considerable psychological distress. However, few studies evaluate treatments for them. This study evaluated the efficacy of in-home intervention, based on cognitive behavior therapy principles, to relieve stress and depression in female Chinese American caregivers (CGs). Fifty-five CGs who met inclusion criteria were randomly assigned to a telephone support condition (TSC) or to an in-home behavioral management program (IHBMP) for 4 months. In the TSC, biweekly calls were made and relevant material was mailed. In the IHBMP, specific psychological skills were taught to deal with caregiving stress. CGs were assessed before and after treatment. Outcome measures evaluated overall perceived stress, caregiving-specific stress, and depressive symptoms. CGs in IHBMP were less bothered by caregiving-specific stressors and had lower depression levels than CGs in TSC. There was no difference in overall stress. CGs with low baseline level of self-efficacy for obtaining respite benefited from IHBMP, but showed little improvement in the TSC. CGs with higher self-efficacy benefited from both treatments. This intervention is promising and warrants replication in future studies. Additional research is needed to evaluate longer-term effects and to identify individual differences associated with improvement.

Application of expert systems

Energy Technology Data Exchange (ETDEWEB)

Basden, A

1983-11-01

This article seeks to bring together a number of issues relevant to the application of expert systems by discussing their advantages and limitations, their roles and benefits, and the influence that real-life applications might have on the design of expert systems software. Part of the expert systems strategy of one major chemical company is outlined. Because it was in constructing one particular expert system that many of these issues became important this system is described briefly at the start of the paper and used to illustrate much of the later discussion. It is of the plausible-inference type and has application in the field of materials engineering. 22 references.

Artificial Intelligence and Expert Systems in Medicine and Their Ability to Prediction as Therapy Planning Systems by CADIAG-2 Algorithm

OpenAIRE

Mohammad Madadpour Inallou; Zeinab Ajurlou; Bahman Mehri

2012-01-01

Expert Systems in Medicine is a collection, storage, retrieval, communication and processing of medical data for the purposes of interpretation, inference, decision-support, research and so other purposes in medicine. Expert System is an interactive computer-based decision tool that uses both facts and heuristics to solve difficult decision problems based on knowledge acquired from an expert. Expert systems provide expert advice and guidance in a wide variety of activities, from computer diag...

Cellular telephones measure activity and lifespace in community-dwelling adults: proof of principle.

Science.gov (United States)

Schenk, Ana Katrin; Witbrodt, Bradley C; Hoarty, Carrie A; Carlson, Richard H; Goulding, Evan H; Potter, Jane F; Bonasera, Stephen J

2011-02-01

To describe a system that uses off-the-shelf sensor and telecommunication technologies to continuously measure individual lifespace and activity levels in a novel way. Proof of concept involving three field trials of 30, 30, and 21 days. Omaha, Nebraska, metropolitan and surrounding rural region. Three participants (48-year-old man, 33-year-old woman, and 27-year-old male), none with any functional limitations. Cellular telephones were used to detect in-home position and in-community location and to measure physical activity. Within the home, cellular telephones and Bluetooth transmitters (beacons) were used to locate participants at room-level resolution. Outside the home, the same cellular telephones and global positioning system (GPS) technology were used to locate participants at a community-level resolution. Physical activity was simultaneously measured using the cellular telephone accelerometer. This approach had face validity to measure activity and lifespace. More importantly, this system could measure the spatial and temporal organization of these metrics. For example, an individual's lifespace was automatically calculated across multiple time intervals. Behavioral time budgets showing how people allocate time to specific regions within the home were also automatically generated. Mobile monitoring shows much promise as an easily deployed system to quantify activity and lifespace, important indicators of function, in community-dwelling adults. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

Counselor Expert System | Debretsion | Zede Journal

African Journals Online (AJOL)

An expert system plays an important role on alleviating primarily shortage of experts in a specific area of interest. With the help of an expert system, personnel with little expertise can solve problems that require expert knowledge. In this paper all major aspects of an expert system development have been presented.

Pitfalls when implementing nurse-led annual telephone calls to replace outpatient visits for Inflammatory Bowel Disease patients

DEFF Research Database (Denmark)

Jakobsen, Dorrit; Bager, Palle; Hentze, Runa

Background: In Denmark, patients with Inflammatory Bowel Disease (IBD) and disease in remission are mainly seen on a regularly basis in outpatient clinics, by gastroenterologists. Replacing the regular visits with annual telephone calls performed by IBD nurses seems beneficial, both for the patie......Background: In Denmark, patients with Inflammatory Bowel Disease (IBD) and disease in remission are mainly seen on a regularly basis in outpatient clinics, by gastroenterologists. Replacing the regular visits with annual telephone calls performed by IBD nurses seems beneficial, both...... for the patients and for the outpatient clinic. The purpose of this study was to identify potential barriers and pitfalls in the planning and implementation phase of a nurse-led telephone service. Methods: Preparations prior to introducing the annual telephone calls were done in 2010. From January 2011 all...... eligible IBD patients were shifted from regularly visits to annual telephone calls performed by an IBD nurse. As the intervention contained of several sub-elements and the elements were subject to adjustment during implementation, the intervention was regarded as a Complex Intervention. All the elements...

WWW expert system on producer gas cleaning

Energy Technology Data Exchange (ETDEWEB)

Schouten, E.J.; Lammers, G.; Beenackers, A.A.C.M. [University of Groningen (Netherlands)

1999-07-01

The University of Groningen (RUG) has developed an expert system on cleaning of biomass producer gas. This work was carried out in close co-operation with the Biomass Technology Group B.V. (BTG) in Enschede, The Netherlands within the framework of the EC supported JOR3-CT95-0084 project. The expert system was developed as a tool for the designer-engineer of downstream gas cleaning equipment and consists of an information package and a flowsheet package. The packages are integrated in a client/server system. The flowsheeting package of the expert system has been designed for the evaluation of different gas cleaning methods. The system contains a number of possible gas cleaning devices such as: cyclone, fabric filter, ceramic filter, venturi scrubber and catalytic cracker. The user can select up to five cleaning steps in an arbitrary order for his specific gas cleaning problem. After specification of the required design parameters, the system calculates the main design characteristics of the cleaning device. The information package is a collection of HTML{sup TM} files. It contains a large amount of information, tips, experience data, literature references and hyperlinks to other interesting Internet sites. This information is arranged per cleaning device. (orig.)

Health aspects of cellular mobile telephones

International Nuclear Information System (INIS)

Garn, H.

1996-01-01

Cellular mobile telephones are one of the main topics among health aspects of electromagnetic fields. In many countries, the number of people opposing communication towers is on the rise. Lawsuits against telecommunication and power line companies have been filed. All this makes people doubt the safety of electromagnetic fields. With respect to cellular phones, there are two scenarios: * Exposure of the operators of hand-held terminals (HHT). * Exposure of the general public from base stations (BS). In the first case, the transmit antenna of the HHT is very close to the human body. For normal operation, the distance will roughly be 2 - 3 cm. The transmitter power of the HHT is comparatively low, but there is a considerable fraction of the radiated electromagnetic energy penetrating the tissue. Considering the second case, BS transmitter powers are by a factor of 100-1000 higher, but the distance between antenna and the human body is by a factor of 1000-100,000 greater, as far as areas of unrestricted public access are concerned. As the power density of an electromagnetic wave decreases inversely proportional to the square of the distance, exposure of the public is always significantly (by many orders of magnitude) lower than exposure of operators of HHTs. Some well-known interaction mechanisms of microwave radiation with the human body have been very well-established today. In some other areas, there is still a need for further research. This paper summarizes present knowledge on human safety with mobile telephone systems. (author)

76 FR 17965 - In the Matter of Certain Mobile Telephones and Wireless Communication Devices Featuring Digital...

Science.gov (United States)

2011-03-31

... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-703] In the Matter of Certain Mobile Telephones and Wireless Communication Devices Featuring Digital Cameras, and Components Thereof Notice of... for importation, and the sale within the United States after importation of certain mobile telephones...

75 FR 44282 - In the Matter of Certain Mobile Telephones and Wireless Communication Devices Featuring Digital...

Science.gov (United States)

2010-07-28

... INTERNATIONAL TRADE COMMISSION [Investigation No. 337-TA-703] In the Matter of Certain Mobile Telephones and Wireless Communication Devices Featuring Digital Cameras, and Components Thereof; Notice of... for importation, and the sale within the United States after importation of certain mobile telephones...

Expert Panel Elicitation

Energy Technology Data Exchange (ETDEWEB)

Jensen, M. [Swedish Radiation Protection Authority, Stockholm (Sweden). Dept. of Waste Management and Environmental Protection; Hora, S.C. [Univ. of Hawaii, Hilo, HI (United States)

2005-09-15

Scientists are now frequently in a situation where data cannot be easily assessed, since they may have conflicting or uncertain sources. While expert judgment reflects private choices, it is possible both reduce the personal aspect as well as in crease confidence in the judgments by using formal protocols for choice and elicitation of experts. A full-scale elicitation made on seismicity following glaciation, now in its late phase and presented here in a preliminary form, illustrates the value of the technique and some essential issues in connection with the decision to launch such a project. The results show an unusual low variation between the experts.

Telephone versus usual care in management of acute whiplash ...

African Journals Online (AJOL)

Whiplash associated disorder (WAD) is a common and costly condition, and recommended management includes advice to “act as usual” and exercise. Providing this treatment through a telephonic intervention may help to improve access to care, and reduce costs. This pilot study assessed: (1) the effectiveness of a ...

Evaluation of food provision and nutrition support at the London 2012 Olympic Games: the opinion of sports nutrition experts.

Science.gov (United States)

Pelly, Fiona; Meyer, Nanna L; Pearce, Jeni; Burkhart, Sarah J; Burke, Louise M

2014-12-01

The aim of this study was to evaluate the food provision and nutrition support at the London 2012 Olympic (OG) and Paralympic Games (PG) from the perspective of sports nutrition experts attending the event. Participants (n = 15) were asked to complete an online survey and rate on a Likert scale menu qualities, food safety, sustainability practices, nutrition labeling, and provision for cultural needs, dietary regimes and specific situations. Open-ended responses were incorporated to explore expert opinion and areas for improvement. Participants rated their overall experience of the food provision as 7.6 out of 10 (range 5 to 10), with the majority (n = 11) rating it greater than 7. The variety, accessibility, presentation, temperature, and freshness of menu items rated as average to good. A below average rating was received for recovery food and beverages, provision of food for traveling to other venues, taking suitable snacks out of the dining hall and provision of food at other venues. However, the variety and accessibility of choices for Ramadan, and provision of post-competition food were rated highly. A number of comments were received about the lack of gluten free and lower energy/fat items. The inclusion of allergens on nutrition labeling was considered more important than nutrient content. While dietetic review of the menu in advance of the OG and PG is clearly a valuable process that has resulted in improvements in the food supply, there are still areas that need to be addressed that are currently not implemented during the event.

Empirical guidelines for forest management decision support systems based on the past experiences of the expert's community

Energy Technology Data Exchange (ETDEWEB)

Marques, A. F.; Ficko, A.; Kangas, A.; Rosset, C.; Ferreti, F.; Rasinmaki, J.; Packalen, T.; Gordom, S.

2013-09-01

Aim of the study: Decision support systems for forest management (FMDSS) have been developed world wide to account for a broad range of forest ecosystems, management goals and organizational frameworks (e.g. the wiki page of the FORSYS project reports 62 existing FMDSSs from 23 countries). The need to enhance the collaboration among this diverse community of developers and users fostered the rise of new group communication processes that could capture useful knowledge from past experiences in order to efficiently provide it to new FMDSS development efforts. Material and methods: This paper presents and tests an exploratory process aiming to identify the empirical guidelines assisting developers and users of FMDSS. This process encompasses a Delphi survey built upon the consolidation of the lessons-learned statements that summarize the past experiences of the experts involved in the FORSYS project. The experts come from 34 countries and have diverse interests, ranging from forest planners, IT developers, social scientists studying participatory planning, and researchers with interests in knowledge management and in quantitative models for forest planning. Main results: The proposed 37 empirical guidelines that group 102 lessons-learned cover a broad range of issues including the DSS development cycle, involvement of the stakeholders, methods, models and knowledge based techniques in use. Research highlights: These results may be used for improving new FMDSS development processes, teaching and training and further suggest new features of FMDSS and future research topics. Furthermore, the guidelines may constitute a knowledge repository that may be continuously improved by a community of practice. (Author)

Is a nurse-led telephone intervention a viable alternative to nurse-led home care and standard care for patients receiving oral capecitabine? Results from a large prospective audit in patients with colorectal cancer.

Science.gov (United States)

Craven, Olive; Hughes, Carol Anne; Burton, Amy; Saunders, Mark P; Molassiotis, Alex

2013-05-01

Home care nursing has been shown to be a valuable service for patients receiving oral chemotherapy; however, associated costs can be high and telephone-based services may be more cost-effective options. This prospective audit explored the usefulness of a nurse-led telephone intervention for supporting cancer patients treated with Capecitabine, comparing historical findings from a randomised trial evaluating a home-based intervention over standard care with a modified nurse-led telephone follow-up intervention. Self-reported toxicity and service use were assessed in 298 patients who received nurse-led telephone follow-up, compared with historical data from 164 patients (81 receiving standard care and 83 home care intervention). Findings suggested that nurse-led telephone follow-up can potentially lead to reduced toxicity (chest pain, vomiting, oral mucositis, nausea, insomnia) when compared with standard care, and that it has a similar impact on the management of some symptoms when compared with home care (i.e. vomiting, oral mucositis), although it was not as effective as the home care intervention for other toxicities (diarrhoea and insomnia). These encouraging findings need to be explored further using a randomised trial design before we reach any conclusions. Further research should also include a health economics study to assess the cost-effectiveness of the telephone-based services for patients receiving oral chemotherapy. © 2013 Blackwell Publishing Ltd.

Expert System Model for Educational Personnel Selection

Directory of Open Access Journals (Sweden)

Héctor A. Tabares-Ospina

2013-06-01

Full Text Available The staff selection is a difficult task due to the subjectivity that the evaluation means. This process can be complemented using a system to support decision. This paper presents the implementation of an expert system to systematize the selection process of professors. The management of software development is divided into 4 parts: requirements, design, implementation and commissioning. The proposed system models a specific knowledge through relationships between variables evidence and objective.

Telephone-administered psychotherapy in combination with antidepressant medication for the acute treatment of major depressive disorder.

Science.gov (United States)

Corruble, Emmanuelle; Swartz, Holly A; Bottai, Thierry; Vaiva, Guillaume; Bayle, Frank; Llorca, Pierre-Michel; Courtet, Philippe; Frank, Ellen; Gorwood, Philip

2016-01-15

Telephone-administered psychotherapies (T-P) provided as an adjunct to antidepressant medication may improve response rates in major depressive disorder (MDD). The goal of this study was to compare telephone-administered social rhythm therapy (T-SRT) and telephone-administered intensive clinical management (T-ICM) as adjuncts to antidepressant medication for MDD. A secondary goal was to compare T-P with Treatment as Usual (TAU) as adjunctive treatment to medication for MDD. 221 adult out-patients with MDD, currently depressed, were randomly assigned to 8 sessions of weekly T-SRT (n=110) or T-ICM (n=111), administered as an adjunct to agomelatine. Both psychotherapies were administered entirely by telephone, by trained psychologists who were blind to other aspects of treatment. The 221 patients were a posteriori matched with 221 depressed outpatients receiving TAU (controls). The primary outcome measure was the percentage of responders at 8 weeks post-treatment. No significant differences were found between T-SRT and T-ICM. But T-P was associated with higher response rates (65.4% vs 54.8%, p=0.02) and a trend toward higher remission rates (33.2% vs 25.1%; p=0.06) compared to TAU. Short term study. This study is the first assessing the short-term effects of an add-on, brief, telephone-administered psychotherapy in depressed patients treated with antidepressant medication. Eight sessions of weekly telephone-delivered psychotherapy as an adjunct to antidepressant medication resulted in improved response rates relative to medication alone. Copyright © 2015 Elsevier B.V. All rights reserved.

The Role of the Team in Managing Telephone Consultation in Dialectical Behavior Therapy: Three Case Examples

Science.gov (United States)

Koons, Cedar R.

2011-01-01

Standard, outpatient Dialectical Behavior Therapy (DBT) includes the provision of intersession telephone contact between the therapist and the client to reduce suicidal crisis behaviors, enhance skills generalization, and reduce alienation and conflict in the therapeutic relationship. Therapists providing telephone consultation need the help of…

Sleep-spindle detection: crowdsourcing and evaluating performance of experts, non-experts and automated methods

DEFF Research Database (Denmark)

Warby, Simon C.; Wendt, Sabrina Lyngbye; Welinder, Peter

2014-01-01

to crowdsource spindle identification by human experts and non-experts, and we compared their performance with that of automated detection algorithms in data from middle- to older-aged subjects from the general population. We also refined methods for forming group consensus and evaluating the performance...... of event detectors in physiological data such as electroencephalographic recordings from polysomnography. Compared to the expert group consensus gold standard, the highest performance was by individual experts and the non-expert group consensus, followed by automated spindle detectors. This analysis showed...... that crowdsourcing the scoring of sleep data is an efficient method to collect large data sets, even for difficult tasks such as spindle identification. Further refinements to spindle detection algorithms are needed for middle- to older-aged subjects....

Surgical experts: born or made?

Science.gov (United States)

Sadideen, Hazim; Alvand, Abtin; Saadeddin, Munir; Kneebone, Roger

2013-01-01

The concept of surgical expertise and the processes involved in its development are topical, and there is a constant drive to identify reliable measures of expert performance in surgery. This review explores the notion of whether surgical experts are "born" or "made", with reference to educational theory and pertinent literature. Peer-reviewed publications, books, and online resources on surgical education, expertise and training were reviewed. Important themes and aspects of expertise acquisition were identified in order to better understand the concept of a surgical expert. The definition of surgical expertise and several important aspects of its development are highlighted. Innate talent plays an important role, but is insufficient on its own to produce a surgical expert. Multiple theories that explore motor skill acquisition and memory are relevant, and Ericsson's theory of the development of competence followed by deliberate self-practice has been especially influential. Psychomotor and non-technical skills are necessary for progression in the current climate in light of our training curricula; surgical experts are adaptive experts who excel in these. The literature suggests that surgical expertise is reached through practice; surgical experts are made, not born. A deeper understanding of the nature of expert performance and its development will ensure that surgical education training programmes are of the highest possible quality. Surgical educators should aim to develop an expertise-based approach, with expert performance as the benchmark. Copyright © 2013 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

Law for nuclear experts only

Energy Technology Data Exchange (ETDEWEB)

Wagner, H [Kernforschungszentrum Karlsruhe G.m.b.H. (Germany, F.R.)

1980-02-01

The Federal Ministry of the Interior is preparing an ordinance on expert consultants under the Atomic Energy Act which, among other topics, is to include legal norms for the criteria to be met by experts in terms of non-partisanship, training, capabilities, technical equipment and cooperation in expert organizations of members of various scientific and technical disciplines. A summary of general criteria relating to the qualification, selection and status of experts called in by the legislative and executive branches and by courts of law, which could be organized as a series of guidelines without any original qualities of legal norms, could be recommended in view of the increasing quantitative and qualitative importance of experts. However, passing an ordinance merely fixing and putting into concrete terms the image of an 'expert under the Atomic Energy Act' is intolerable, because the status of scientific and technical experts by far extends beyond the field of nuclear law in our industrial society characterized by a far reaching division of labor. Weak points in the organization of expert services are not confined to technology or nuclear power. Separate rules establishing legal norms are not convincing also for reasons of technology policy and legal policy as well as for those of social psychology and practice.

Expert Systems for the Analytical Laboratory.

Science.gov (United States)

de Monchy, Allan R.; And Others

1988-01-01

Discusses two computer problem solving programs: rule-based expert systems and decision analysis expert systems. Explores the application of expert systems to automated chemical analyses. Presents six factors to consider before using expert systems. (MVL)

Experts as facilitators for the implementation of social media in the library?: a social network approach

OpenAIRE

Vanwynsberghe, Hadewijch; Boudry, Elke; Vanderlinde, Ruben; Verdegem, Pieter

2014-01-01

Purpose – Based on the social capital theory, we assume that personal and professional experts are both relevant to people’s competence development. However, to date, there is little empirical evidence of how professional experts can support, or impede, people in learning how to deal with social media. The goal of this study is to examine the role and position of social media experts in the distribution of information on social media within the library as organization. Design/ methodology/...

77 FR 34233 - Telephone Consumer Protection Act of 1991

Science.gov (United States)

2012-06-11

... initiator of the message, to be a nuisance and an invasion of privacy; and (3) individuals' privacy rights... are made by the consumer's loan servicer, because the primary motivation of the calling party is to... challenged as TCPA violations because the primary motivation appears to be sending a telephone solicitation...

Computer tablet or telephone? A randomised controlled trial exploring two methods of collecting data from drug and alcohol outpatients.

Science.gov (United States)

Hobden, Breanne; Bryant, Jamie; Carey, Mariko; Sanson-Fisher, Rob; Oldmeadow, Christopher

2017-08-01

Both computerised and telephone surveys have potential advantages for research data collection. The current study aimed to determine the: (i) feasibility, (ii) acceptability, and (iii) cost per completed survey of computer tablet versus telephone data collection for clients attending an outpatient drug and alcohol treatment clinic. Two-arm randomised controlled trial. Clients attending a drug and alcohol outpatient clinic in New South Wales, Australia, were randomised to complete a baseline survey via computer tablet in the clinic or via telephone interview within two weeks of their appointment. All participants completed a three-month follow-up survey via telephone. Consent and completion rates for the baseline survey were significantly higher in the computer tablet condition. The time taken to complete the computer tablet survey was lower (11min) than the telephone condition (17min). There were no differences in the proportion of consenters or completed follow-up surveys between the two conditions at the 3-month follow-up. Acceptability was high across both modes of data collection. The cost of the computer tablet condition was $67.52 greater per completed survey than the telephone condition. There is a trade-off between computer tablet and telephone data collection. While both data collection methods were acceptable to participants, the computer tablet condition resulted in higher consent and completion rates at baseline, therefore yielding greater external validity, and was quicker for participants to complete. Telephone data collection was however, more cost-effective. Researchers should carefully consider the mode of data collection that suits individual study needs. Copyright © 2017 Elsevier Ltd. All rights reserved.

Voice-band Modem: A Device to Transmit Data over Telephone ...

Indian Academy of Sciences (India)

over Telephone Networks. 2. Advanced Ideas ... transmitted signal power and No is the noise power spec- ... power distribution over all frequencies, and the samples of noise .... Figure 3, dmin=2fl, and average signal energy, assum- ing that ...

An enquiry into the prospects of mobile telephone for agricultural ...

African Journals Online (AJOL)

LPhidza

KEYWORDS: Mobile phones, agricultural information, global system for mobile ... rural services (i.e. agricultural extension) more efficient and cost-effective. 2. ... adoption of mobile telephones, evaluation research has however .... Distribution of respondents by religion. Religion. Frequencies Percentages. Christian. Islam.

Telephone counseling for the public after the Fukushima Daiichi Nuclear Power Plant accident

International Nuclear Information System (INIS)

Horiguchi, T.; Kojima, K.; Itoh, T.

2011-01-01

After the Fukushima Daiichi Nuclear Power Plant accident, Kinki University Atomic Energy Research Institute provided telephone counseling services in order to respond the public's growing concerns about radiation and nuclear energy. Three telephone lines were newly installed for the counseling and the number of consultation marked 705 between March 24 and April 2. In this report, by summarizing the contents of the counseling, we will show what the public concerned about shortly after the accident and report how we responded to the concerns. (author)

Expert system application for prioritizing preventive actions for shift work: shift expert.

Science.gov (United States)

Esen, Hatice; Hatipoğlu, Tuğçen; Cihan, Ahmet; Fiğlali, Nilgün

2017-09-19

Shift patterns, work hours, work arrangements and worker motivations have increasingly become key factors for job performance. The main objective of this article is to design an expert system that identifies the negative effects of shift work and prioritizes mitigation efforts according to their importance in preventing these negative effects. The proposed expert system will be referred to as the shift expert. A thorough literature review is conducted to determine the effects of shift work on workers. Our work indicates that shift work is linked to demographic variables, sleepiness and fatigue, health and well-being, and social and domestic conditions. These parameters constitute the sections of a questionnaire designed to focus on 26 important issues related to shift work. The shift expert is then constructed to provide prevention advice at the individual and organizational levels, and it prioritizes this advice using a fuzzy analytic hierarchy process model, which considers comparison matrices provided by users during the prioritization process. An empirical study of 61 workers working on three rotating shifts is performed. After administering the questionnaires, the collected data are analyzed statistically, and then the shift expert produces individual and organizational recommendations for these workers.

In the public interest: assessing expert and stakeholder influence in public deliberation about biobanks.

Science.gov (United States)

MacLean, Samantha; Burgess, Michael M

2010-07-01

Providing technical and experiential information without overwhelming participants' perspectives presents a major challenge to public involvement in policy decisions. This article reports the design and analysis of a case study on incorporating expert and stakeholder knowledge without including them as deliberators, while supporting deliberative participants' ability to introduce and critically assess different perspectives. Analysis of audio-recorded deliberations illustrates how expert and stakeholder knowledge was cited, criticized and incorporated into deliberations. In conclusion, separating experts and stakeholders from deliberations may be an important prima facie principle when the goal is to enhance citizen representation on technical issues and related policy.

Responding to Expert Arguments. Emerging Lay Topoi in Focus Group Interviews on GM-Crops

DEFF Research Database (Denmark)

Horsbøl, Anders

2009-01-01

interaction (Myers 2004), in casu in focus groups interviews with both GM-experts and lay persons without specific knowledge on GM-crops. The paper analyses the lay persons' responses to persuasive expert utterances as inventive contributions to the discussion, not just as reactions showing either support...... or rejection. That is, the paper analyses the topoi, the argumentative ‘places', realized by the lay persons in dealing with and making sense of the new knowledge presented by the experts. Finally, the paper identifies the social identities as participants in a public debate, which are enacted by the lay...

Pre-surgery evaluations by telephone decrease travel and cost for families of children with cerebral palsy.

Science.gov (United States)

Robinson, John D; Prochaska, John D; Yngve, David A

2017-01-01

Children with cerebral palsy need highly specialized care. This can be very burdensome for families, particularly in large rural states, due to the need for long-distance travel to appointments. In this study, children undergoing the selective percutaneous myofascial lengthening surgery utilized a telephone-based telemedicine evaluation to assess for surgical eligibility. The goal was to avoid a separate preoperative clinic visit weeks before the surgery. If possible, eligibility was determined by telephone, and then, the patient could be scheduled for a clinic visit and possible surgery the next day, saving the family a trip. The purposes of the study were to calculate estimated reductions in miles traveled, in travel expenses, and in carbon emissions and to determine whether the telephone assessment was accurate and effective in determining eligibility for surgery. From 2010 to 2012, 279 patients were retrospectively reviewed, and of those, 161 mailed four-page questionnaire and anteroposterior pelvis X-ray followed by a telephone conference. Geographic information system methods were used to geocode patients by location. Savings in mileage and travel costs were calculated. From 2014 to 2015, 195 patients were additionally studied to determine accuracy and effectiveness. The telephone prescreening method saved 106,070 miles in transportation over 3 years, a 38% reduction with US$55,326 in savings. Each family saved an average of 658 (standard deviation = 340) miles of travel and US$343.64 (standard deviation = US$178) in travel expenses. For each increase of 10 miles in distance from the health center, the odds of a patient utilizing telephone screening increased by 10% (odds ratio: 1.101, 95% confidence interval: 1.073-1.129, p < 0.001). After the telephone prescreening, 86% were determined to be likely candidates for the procedure. For 14%, a clinic visit only was scheduled, and they were not scheduled for surgery. Families seeking specialized

Comparing a telephone- and a group-delivered diabetes prevention program

DEFF Research Database (Denmark)

S, Lim; Dunbar, James; Versace, Vin

2017-01-01

Aims To explore the acceptability of a telephone- or a group-delivered diabetes prevention program for women with previous gestational diabetes and to compare the characteristics associated with program engagement. Methods Postpartum women participated in a lifestyle modification program delivere...

Accident diagnosis system based on real-time decision tree expert system

Science.gov (United States)

Nicolau, Andressa dos S.; Augusto, João P. da S. C.; Schirru, Roberto

2017-06-01

Safety is one of the most studied topics when referring to power stations. For that reason, sensors and alarms develop an important role in environmental and human protection. When abnormal event happens, it triggers a chain of alarms that must be, somehow, checked by the control room operators. In this case, diagnosis support system can help operators to accurately identify the possible root-cause of the problem in short time. In this article, we present a computational model of a generic diagnose support system based on artificial intelligence, that was applied on the dataset of two real power stations: Angra1 Nuclear Power Plant and Santo Antônio Hydroelectric Plant. The proposed system processes all the information logged in the sequence of events before a shutdown signal using the expert's knowledge inputted into an expert system indicating the chain of events, from the shutdown signal to its root-cause. The results of both applications showed that the support system is a potential tool to help the control room operators identify abnormal events, as accidents and consequently increase the safety.

The stabbing of Amelia (or how was extinguished the married women discrimination from the argentinian telephone service

Directory of Open Access Journals (Sweden)

Dora Barrancos

2008-04-01

Full Text Available This paper highlights the tracks of Amelia C. Her life story as switchboard is relevant to understand the women' s discrimination in laboral market in the early twentieth century. This article will be focused on the marital satatus as pattern of female exclusion. The strategy used by Amelia against that pattern, although individual and even desperate, detonated a series of revisions of existing legislation that were supported by different groups in society. The corpus is based on records of the telephone company in which Amelia was employed for several years and the impact of their strategies in the local press.

DAQExpert - An expert system to increase CMS data-taking efficiency

CERN Document Server

Andre, Jean-marc Olivier; Branson, James; Chaze, Olivier; Cittolin, Sergio; Contescu, Cristian; Darlea, Georgiana Lavinia; Deldicque, Christian; Demiragli, Zeynep; Dobson, Marc; Doualot, Nicolas; Erhan, Samim; Fulcher, Jonathan Richard; Gigi, Dominique; Gladki, Maciej Szymon; Glege, Frank; Gomez Ceballos, Guillelmo; Hegeman, Jeroen Guido; Holzner, Andre Georg; Janulis, Mindaugas; Lettrich, Michael; Meijers, Franciscus; Meschi, Emilio; Mommsen, Remigius; Morovic, Srecko; O'Dell, Vivian; Orn, Samuel Johan; Orsini, Luciano; Papakrivopoulos, Ioannis; Paus, Christoph Maria Ernst; Petrova, Petia; Petrucci, Andrea; Pieri, Marco; Rabady, Dinyar Sebastian; Racz, Attila; Reis, Thomas; Sakulin, Hannes; Schwick, Christoph; Simelevicius, Dainius; Vougioukas, Michail; Zejdl, Petr

2017-01-01

The efficiency of the Data Acquisition (DAQ) of the Compact Muon Solenoid (CMS) experiment for LHC Run 2 is constantly being improved. A~significant factor affecting the data taking efficiency is the experience of the DAQ operator. One of the main responsibilities of the DAQ operator is to carry out the proper recovery procedure in case of failure of data-taking. At the start of Run 2, understanding the problem and finding the right remedy could take a considerable amount of time (up to many minutes). Operators heavily relied on the support of on-call experts, also outside working hours. Wrong decisions due to time pressure sometimes lead to an additional overhead in recovery time. To increase the efficiency of CMS data-taking we developed a new expert system, the DAQExpert, which provides shifters with optimal recovery suggestions instantly when a failure occurs. DAQExpert is a~web application analyzing frequently updating monitoring data from all DAQ components and identifying problems based on expert knowl...

Experts in science and society

CERN Document Server

Gigerenzer, Gerd

2004-01-01

In today's complex world, we have come to rely increasingly on those who have expertise in specific areas and can bring their knowledge to bear on crucial social, political and scientific questions. Taking the viewpoint that experts are consulted when there is something important at stake for an individual, a group, or society at large, Experts in Science and Society explores expertise as a relational concept. How do experts balance their commitment to science with that to society? How does a society actually determine that a person has expertise? What personal traits are valued in an expert? From where does the expert derive authority? What makes new forms of expertise emerge? These and related questions are addressed from a wide range of areas in order to be inclusive, as well as to demonstrate similarities across areas. Likewise, in order to be culturally comparative, this volume includes examples and discussions of experts in different countries and even in different time periods. The topics include the r...

Expert system in PNC, 5

International Nuclear Information System (INIS)

Tobita, Yoshimasa; Yamaguchi, Takashi; Matsumoto, Mitsuo; Ono, Kiyoshi.

1990-01-01

The computer code system which can evaluate the mass balance and cycle cost in nuclear fuel cycle has been developing a PNC using an artificial intelligence technique. This system is composed of the expert system, data base and analysis codes. The expert system is the most important one in the system and the content of the expert system is explained in this paper. The expert system has the three functions. The first is the function of understanding the meaning of user's questions by natural language, the second is the function of selecting the best way to solve the problem given by the user using the knowledge which is already installed in the system, and the last is the function of answering the questions. The knowledge of the experts installed in the expert system is represented by the frame-type rules. Therefore, the knowledge will be simply added to the system, and consequently the system will be easily extended. (author)

Spacecraft command and control using expert systems

Science.gov (United States)

Norcross, Scott; Grieser, William H.

1994-01-01

This paper describes a product called the Intelligent Mission Toolkit (IMT), which was created to meet the changing demands of the spacecraft command and control market. IMT is a command and control system built upon an expert system. Its primary functions are to send commands to the spacecraft and process telemetry data received from the spacecraft. It also controls the ground equipment used to support the system, such as encryption gear, and telemetry front-end equipment. Add-on modules allow IMT to control antennas and antenna interface equipment. The design philosophy for IMT is to utilize available commercial products wherever possible. IMT utilizes Gensym's G2 Real-time Expert System as the core of the system. G2 is responsible for overall system control, spacecraft commanding control, and spacecraft telemetry analysis and display. Other commercial products incorporated into IMT include the SYBASE relational database management system and Loral Test and Integration Systems' System 500 for telemetry front-end processing.

A telephone questionnaire in order to assess functional outcome after post-traumatic limb salvage surgery: Development and preliminary validation.

Science.gov (United States)

Wulterkens, Leonie; Aurégan, Jean-Charles; Letellier, Thomas; Mebtouche, Nasser; Levante, Stéphane; Cottin, Philippe; Bégué, Thierry

2015-12-01

Post-traumatic limb salvage surgery is challenging and evaluation of the results remains arduous. No questionnaire specifically assessing functional outcome after post-traumatic limb salvage surgery of the lower extremity exists. Due to regionalization of specialized care, the patients' travel time to the hospital increases. To overcome a higher patients' travel burden, patients' follow up by telephone is an option. We aimed to develop a telephone questionnaire in order to assess functional outcome after post-traumatic limb salvage surgery of the lower extremity. From a review of scores of functional assessment of the lower limb surgery, we have developed a telephone questionnaire. A prospective study was performed to validate this telephone questionnaire. Twenty patients were included. The participants were called to complete the telephone questionnaire twice with an interval of a week. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was completed during the second telephone call. The internal consistency was analyzed by the Cronbach's alpha (α). With the outcome scores of both completions, the test-retest reliability was analyzed by the interclass correlation coefficient (ICC) 2,k with a 95% confidence interval (95% CI). The outcome scores of the second telephone questionnaire and the WOMAC questionnaire were used for the construct validity analysis by the Spearman's rank correlation coefficient (r(s)) with a 95% CI. The internal consistency analysis revealed a α=0.62 which improved to α=0.92 after removing one question from the telephone questionnaire. The final version of the telephone questionnaire comprises 32 questions, divided in 3 subscales: function, daily life and psychology. The total score varies between 0 and 86 points. The test-retest reliability was ICC 2,k=0.93 (95% CI: 0.82-0.97) and the construct validity was r(s)=0.92 (95% CI: 0.81-0.97). We present a specific telephone questionnaire in order to assess functional

Experts on public trial

DEFF Research Database (Denmark)

Blok, Anders

2007-01-01

a case study of the May 2003 Danish consensus conference on environmental economics as a policy tool, the article reflects on the politics of expert authority permeating practices of public participation. Adopting concepts from the sociology of scientific knowledge (SSK), the conference is seen......-than-successful defense in the citizen perspective. Further, consensus conferences are viewed alternatively as "expert dissent conferences," serving to disclose a multiplicity of expert commitments. From this perspective, some challenges for democratizing expertise through future exercises in public participation...

Expert System for the LHC CMS Cathode Strip Chambers (CSC) detector

Energy Technology Data Exchange (ETDEWEB)

Rapsevicius, Valdas, E-mail: valdas.rapsevicius@cern.ch [Fermi National Accelerator Laboratory, Batavia, IL (United States); Vilnius University, Didlaukio g. 47-325, LT-08303 Vilnius (Lithuania); Juska, Evaldas, E-mail: evaldas.juska@cern.ch [Fermi National Accelerator Laboratory, Batavia, IL (United States)

2014-02-21

Modern High Energy Physics experiments are of high demand for a generic and consolidated solution to integrate and process high frequency data streams by applying experts' knowledge and inventory configurations. In this paper we present the Expert System application that was built for the Compact Muon Solenoid (CMS) Cathode Strip Chambers (CSC) detector at the Large Hadron Collider (LHC) aiming to support the detector operations and to provide integrated monitoring. The main building blocks are the integration platform, rule-based complex event processing engine, ontology-based knowledge base, persistent storage and user interfaces for results and control.

For whom bell toils: medical imaging by telephone.

Science.gov (United States)

Kuhfeld, A W

1991-01-01

The use of the induction balance, which was invented by Alexander Graham Bell to cancel out line interference on his telephone, to determine the location of bullets inside the human body is discussed. Experiments conducted to locate a bullet in the body of US President Garfield, who had been shot by an assassin in 1881, are described. The trials on Garfield were unsuccessful, but the approach was later perfected by Bell.

Reflection group on 'Expert Culture'

International Nuclear Information System (INIS)

Eggermont, G.

2000-01-01

As part of SCK-CEN's social sciences and humanities programme, a reflection group on 'Expert Culture' was established. The objectives of the reflection group are: (1) to clarify the role of SCK-CEN experts; (2) to clarify the new role of expertise in the evolving context of risk society; (3) to confront external views and internal SCK-CEN experiences on expert culture; (4) to improve trust building of experts and credibility of SCK-CEN as a nuclear actor in society; (5) to develop a draft for a deontological code; (6) to integrate the approach in training on assertivity and communication; (7) to create an output for a topical day on the subject of expert culture. The programme, achievements and perspectives of the refection group are summarised

Evaluation of Web-Based Ostomy Patient Support Resources.

Science.gov (United States)

Pittman, Joyce; Nichols, Thom; Rawl, Susan M

To evaluate currently available, no-cost, Web-based patient support resources designed for those who have recently undergone ostomy surgery. Descriptive, correlational study using telephone survey. The sample comprised 202 adults who had ostomy surgery within the previous 24 months in 1 of 5 hospitals within a large healthcare organization in the Midwestern United States. Two of the hospitals were academic teaching hospitals, and 3 were community hospitals. The study was divided into 2 phases: (1) gap analysis of 4 Web sites (labeled A-D) based on specific criteria; and (2) telephone survey of individuals with an ostomy. In phase 1, a comprehensive checklist based on best practice standards was developed to conduct the gap analysis. In phase 2, data were collected from 202 participants by trained interviewers via 1-time structured telephone interviews that required approximately 30 minutes to complete. Descriptive analyses were performed, along with correlational analysis of relationships among Web site usage, acceptability and satisfaction, demographic characteristics, and medical history. Gap analysis revealed that Web site D, managed by a patient advocacy group, received the highest total content score of 155/176 (88%) and the highest usability score of 31.7/35 (91%). Two hundred two participants completed the telephone interview, with 96 (48%) reporting that they used the Internet as a source of information. Sixty participants (30%) reported that friends or family member had searched the Internet for ostomy information on their behalf, and 148 (75%) indicated they were confident they could get information about ostomies on the Internet. Of the 90 participants (45%) who reported using the Internet to locate ostomy information, 73 (82%) found the information on the Web easy to understand, 28 (31%) reported being frustrated during their search for information, 24 (27%) indicated it took a lot of effort to get the information they needed, and 39 (43%) were

Expert Systems: An Overview for Teacher-Librarians.

Science.gov (United States)

Orwig, Gary; Barron, Ann

1992-01-01

Provides an overview of expert systems for teacher librarians. Highlights include artificial intelligence and expert systems; the development of the MYCIN medical expert system; rule-based expert systems; the use of expert system shells to develop a specific system; and how to select an appropriate application for an expert system. (11 references)…

Verbal Therapeutic Behavior of Expert Psychoanalytically Oriented, Gestalt, and Behavior Therapists.

Science.gov (United States)

Brunink, Sharon A.; Schroeder, Harold E.

1979-01-01

Findings indicated that expert therapists were similar in their communication of empathy, the basis for their therapeutic relationships. Theoretical orientation, however, differentially influenced use of direct guidance and facilitative techniques, interview content, therapist self-disclosure, therapist initiative, and supportive therapy climate.…

Accuracy and interobserver agreement between MR-non-expert radiologists and MR-experts in reading MRI for suspected appendicitis

Energy Technology Data Exchange (ETDEWEB)

Leeuwenburgh, Marjolein M.N., E-mail: m.m.leeuwenburgh@amc.uva.nl [Department of Surgery, Academic Medical Center, University of Amsterdam (Netherlands); Department of Radiology, Academic Medical Center, University of Amsterdam (Netherlands); Wiarda, Bart M. [Department of Radiology, Alkmaar Medical Center, Alkmaar (Netherlands); Jensch, Sebastiaan [Department of Radiology, Sint Lucas Andreas Hospital, Amsterdam (Netherlands); Wouter van Es, H. [Department of Radiology, Sint Antonius Hospital, Nieuwegein (Netherlands); Stockmann, Hein B.A.C. [Department of Surgery, Kennemer Gasthuis, Haarlem (Netherlands); Gratama, Jan Willem C. [Department of Radiology, Gelre Hospitals, Apeldoorn (Netherlands); Cobben, Lodewijk P.J. [Department of Radiology, Haaglanden Medical Center, Leidschendam (Netherlands); Bossuyt, Patrick M.M. [Department of Clinical Epidemiology, Academic Medical Center, University of Amsterdam (Netherlands); Boermeester, Marja A. [Department of Surgery, Academic Medical Center, University of Amsterdam (Netherlands); Stoker, Jaap [Department of Radiology, Academic Medical Center, University of Amsterdam (Netherlands)

2014-01-15

Objective: To compare accuracy and interobserver agreement between radiologists with limited experience in the evaluation of abdominal MRI (non-experts), and radiologists with longer MR reading experience (experts), in reading MRI in patients with suspected appendicitis. Methods: MR imaging was performed in 223 adult patients with suspected appendicitis and read independently by two members of a team of eight MR-inexperienced radiologists, who were trained with 100 MR examinations previous to this study (non-expert reading). Expert reading was performed by two radiologists with a larger abdominal MR experience (>500 examinations) in consensus. A final diagnosis was assigned after three months based on all available information, except MRI findings. We estimated MRI sensitivity and specificity for appendicitis and for all urgent diagnoses separately. Interobserver agreement was evaluated using kappa statistics. Results: Urgent diagnoses were assigned to 147 of 223 patients; 117 had appendicitis. Sensitivity for appendicitis was 0.89 by MR-non-expert radiologists and 0.97 in MR-expert reading (p = 0.01). Specificity was 0.83 for MR-non-experts versus 0.93 for MR-expert reading (p = 0.002). MR-experts and MR-non-experts agreed on appendicitis in 89% of cases (kappa 0.78). Accuracy in detecting urgent diagnoses was significantly lower in MR-non-experts compared to MR-expert reading: sensitivity 0.84 versus 0.95 (p < 0.001) and specificity 0.71 versus 0.82 (p = 0.03), respectively. Agreement on urgent diagnoses was 83% (kappa 0.63). Conclusion: MR-non-experts have sufficient sensitivity in reading MRI in patients with suspected appendicitis, with good agreement with MR-expert reading, but accuracy of MR-expert reading was higher.

Accuracy and interobserver agreement between MR-non-expert radiologists and MR-experts in reading MRI for suspected appendicitis

International Nuclear Information System (INIS)

Leeuwenburgh, Marjolein M.N.; Wiarda, Bart M.; Jensch, Sebastiaan; Wouter van Es, H.; Stockmann, Hein B.A.C.; Gratama, Jan Willem C.; Cobben, Lodewijk P.J.; Bossuyt, Patrick M.M.; Boermeester, Marja A.; Stoker, Jaap

2014-01-01

Objective: To compare accuracy and interobserver agreement between radiologists with limited experience in the evaluation of abdominal MRI (non-experts), and radiologists with longer MR reading experience (experts), in reading MRI in patients with suspected appendicitis. Methods: MR imaging was performed in 223 adult patients with suspected appendicitis and read independently by two members of a team of eight MR-inexperienced radiologists, who were trained with 100 MR examinations previous to this study (non-expert reading). Expert reading was performed by two radiologists with a larger abdominal MR experience (>500 examinations) in consensus. A final diagnosis was assigned after three months based on all available information, except MRI findings. We estimated MRI sensitivity and specificity for appendicitis and for all urgent diagnoses separately. Interobserver agreement was evaluated using kappa statistics. Results: Urgent diagnoses were assigned to 147 of 223 patients; 117 had appendicitis. Sensitivity for appendicitis was 0.89 by MR-non-expert radiologists and 0.97 in MR-expert reading (p = 0.01). Specificity was 0.83 for MR-non-experts versus 0.93 for MR-expert reading (p = 0.002). MR-experts and MR-non-experts agreed on appendicitis in 89% of cases (kappa 0.78). Accuracy in detecting urgent diagnoses was significantly lower in MR-non-experts compared to MR-expert reading: sensitivity 0.84 versus 0.95 (p < 0.001) and specificity 0.71 versus 0.82 (p = 0.03), respectively. Agreement on urgent diagnoses was 83% (kappa 0.63). Conclusion: MR-non-experts have sufficient sensitivity in reading MRI in patients with suspected appendicitis, with good agreement with MR-expert reading, but accuracy of MR-expert reading was higher

Applying technology to the treatment of cannabis use disorder: comparing telephone versus Internet delivery using data from two completed trials.

Science.gov (United States)

Rooke, Sally E; Gates, Peter J; Norberg, Melissa M; Copeland, Jan

2014-01-01

Technology-based interventions such as those delivered by telephone or online may assist in removing significant barriers to treatment seeking for cannabis use disorder. Little research, however, has addressed differing technology-based treatments regarding their comparative effectiveness, and how user profiles may affect compliance and treatment satisfaction. This study addressed this issue by examining these factors in online (N=225) versus telephone (N=160) delivered interventions for cannabis use, using data obtained from two previously published randomized controlled trials conducted by the current authors. Several differences emerged including stronger treatment effects (medium to large effect sizes in the telephone study versus small effect sizes in the Web study) and lower dropout in the telephone intervention (38% vs. 46%). Additionally, around half of the telephone study participants sought concurrent treatment, compared with 2% of participants in the Web study. Demographics and predictors of treatment engagement, retention and satisfaction also varied between the studies. Findings indicate that both telephone and Web-based treatments can be effective in assisting cannabis users to quit or reduce their use; however, participant characteristics may have important implications for treatment preference and outcome, with those who elect telephone-based treatment experiencing stronger outcomes. Thus, participant preference may shape study populations, adherence, and outcome. © 2013 Elsevier Inc. All rights reserved.

A proof-of-concept transient diagnostic expert system for BWRs [Boiling Water Reactors

International Nuclear Information System (INIS)

Yoshida, K.; Naser, J.A.

1988-05-01

A proof-of-concept transient diagnostic expert system has been developed to identify the cause and the type of an abnormal transient in a boiling water nuclear power plant. For this expert system development, the calculational results of the simulation code RETRAN were used as the knowledge source. The knowledge extracted from the RETRAN analyses was transformed into IF-THEN rules in the knowledge base for the expert system. An important feature of this expert system is the introduction of certainty factors to allow diagnosis even in the cases where data may be either missing or marked as invalid. To increase the capability of this diagnostic system to distinguish between similiar transients, backward chaining reasoning is used to support the forward chaining reasoning with certainty factors. Through this effort, it has been demonstrated that an expert system can be successfully used to create a transient diagnostic system. It has also successfully demonstrated that RETRAN can be used as the knowledge source for developing the knowledge base of the diagnostic system

Intelligent programs-expert systems

Energy Technology Data Exchange (ETDEWEB)

Gledhill, V X

1982-01-01

In recent years, computer scientists have developed what are called expert systems. These programs have three fundamental components: a knowledge base, which changes with experience; an inference engine which enables the program to make decisions; and an interface that allows the program to communicate with the person using the system. Expert systems have been developed successfully in areas such as medical diagnosis, geology, and computer maintenance. This paper describes the evolution and basic principles of expert systems and give some examples of their use.

NPPO-TINA: An expert system acting as catalyst for decision-making processes of the reactor operator

International Nuclear Information System (INIS)

Gieci, A.; Gyarfas, F.

1991-01-01

The prototype of the NPPO-TINA expert system (Nuclear Power Plant Operation-Transparent Inference Architecture) is described. This system has been developed to support the entire decision-making intellectual activity in the control of complex technological processes. One of the ways leading to human-machine symbiosis in the integrated cognitive system is outlined. The starting model of the situation in which the operator's problem-solving task begins is described. The characteristics of human behavior in decision-making are analyzed, and the moments are explained of the most suitable use of the expert system to support the whole intellectual activity, in knowledge-based decision-making by way of problem solving. The TINA environment for the formation of expert systems is described, including the hierarchic dynamic inference control. The process of building up the NPPO-TINA expert system is outlined, and the results of testing the system prototype on the problem of an accident of the nuclear power plant primary circuit due to a failure of the coolant make-up pumps are given. (Z.S.). 10 figs., 11 refs

Influenza like illness monitoring in adults of the State Capitals and Federal District in Brazil by telephone survey.

Science.gov (United States)

Reis, Priscilleyne Ouverney; Iser, Betine Pinto Moehlecke; Souza, Líbia Roberta de Oliveira; Yokota, Renata Tiene de Carvalho; de Almeida, Walquiria Aparecida Ferreira; Bernal, Regina Tomie Ivata; Malta, Deborah Carvalho; de Oliveira, Wanderson Kleber; Penna, Gerson Oliveira

2011-09-01

In order to estimate the prevalence of influenza like illness (ILI) in adults from all state capitals and geographic regions in Brazil, a periodical monitoring of ILI cases by the national telephone survey (VIGITEL) was carried out in 2010. A cross-sectional study with 47,876 telephone interviews in the state capitals and Federal District, a probabilistic sample of adult population (>18 years-old) with landline telephone. Questions concerning the results of ILI cases and pandemic influenza (H1N1) 2009, from January 10 to November 30, were analyzed. The proportion of cases stratified by sociodemographic characteristics and Brazilian geographic region was weighted with data from the National Survey with Household Sampling (PNAD) 2008. The prevalence of ILI cases in the last 30 days before interview was 31.2% (95%CI 30.2-32.2%) for all state capitals and the Federal District. This prevalence was higher among women, young adults (18 to 29 years-old) and individuals with 9 to 11 years of schooling. According to the geographic region analysis, Northern Brazil presented the highest prevalence of ILI cases. A tendency to increase with further decrease was observed among the geographic regions, except the Northeast. Need for health care assistance was reported by 26.8% (95%CI 25.1-28.5) from ILI cases. Among ILI cases that sought health care assistance, 2.6% (95%CI 1.8-3.4) reported pandemic influenza (H1N1) 2009 medical suspicion. The results of this survey supported influenza surveillance as it provided timeliness and useful surveillance information, which were not captured by the traditional surveillance system, as the occurrence of ILI and need of health care assistance.

After Mobile Phones Surpassing Telephones%当手机蹿至老大时

Institute of Scientific and Technical Information of China (English)

马斌; 张英

2004-01-01

According to the statistic of MII, the number of phone user in the whole country of China has reached 0.512 billion in 2003, with 91.85 million new users added between January and October. The newly-added users include 40.917 million telephone users and 50.933 million mobile phone users. And the total number of telephone users has reached 0.2551 billion, mobile phone users 0.2569 billion. Up to now the number of mobile phone users has surpassed that of telephone users. The surpassing is a new landmark in the development of China telecom industry. At the same time the surpassing is not just a common event, but it will bring great influence to the development pattern of our telecom industry, regulation of government in the future, mobile communications and fixed network carriers. And so in this issue "New Telecom Salon" focuses on what the surpassing will bring to telecom industry in all aspects. The specialists in the industry are invited to discuss all related things about this subject.

The value of participatory development to support antimicrobial stewardship with a clinical decision support system

NARCIS (Netherlands)

Beerlage-de Jong, Nienke; Wentzel, Jobke; Hendrix, Ron; van Gemert-Pijnen, Lisette

2017-01-01

Background: Current clinical decision support systems (CDSSs) for antimicrobial stewardship programs (ASPs) are guideline- or expert-driven. They are focused on (clinical) content, not on supporting real-time workflow. Thus, CDSSs fail to optimally support prudent antimicrobial prescribing in daily

The value of participatory development to support antimicrobial stewardship with a clinical decision support system

NARCIS (Netherlands)

Beerlage-de Jong, Nienke; Wentzel, M.J.; Hendrix, Ron; van Gemert-Pijnen, Julia E.W.C.

Background Current clinical decision support systems (CDSSs) for antimicrobial stewardship programs (ASPs) are guideline- or expert-driven. They are focused on (clinical) content, not on supporting real-time workflow. Thus, CDSSs fail to optimally support prudent antimicrobial prescribing in daily

Telephone Coaching to Enhance a Home-Based Physical Activity Program for Knee Osteoarthritis: A Randomized Clinical Trial.

Science.gov (United States)

Bennell, Kim L; Campbell, Penny K; Egerton, Thorlene; Metcalf, Ben; Kasza, Jessica; Forbes, Andrew; Bills, Caroline; Gale, Janette; Harris, Anthony; Kolt, Gregory S; Bunker, Stephen J; Hunter, David J; Brand, Caroline A; Hinman, Rana S

2017-01-01

To investigate whether simultaneous telephone coaching improves the clinical effectiveness of a physiotherapist-prescribed home-based physical activity program for knee osteoarthritis (OA). A total of 168 inactive adults ages ≥50 years with knee pain on a numeric rating scale ≥4 (NRS; range 0-10) and knee OA were recruited from the community and randomly assigned to a physiotherapy (PT) and coaching group (n = 84) or PT-only (n = 84) group. All participants received five 30-minute consultations with a physiotherapist over 6 months for education, home exercise, and physical activity advice. PT+coaching participants also received 6-12 telephone coaching sessions by clinicians trained in behavioral-change support for exercise and physical activity. Primary outcomes were pain (NRS) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC; score range 0-68]) at 6 months. Secondary outcomes were these same measures at 12 and 18 months, as well as physical activity, exercise adherence, other pain and function measures, and quality of life. Analyses were intent-to-treat with multiple imputation for missing data. A total of 142 (85%), 136 (81%), and 128 (76%) participants completed 6-, 12-, and 18-month measurements, respectively. The change in NRS pain (mean difference 0.4 unit [95% confidence interval (95% CI) -0.4, 1.3]) and in WOMAC function (1.8 [95% CI -1.9, 5.5]) did not differ between groups at 6 months, with both groups showing clinically relevant improvements. Some secondary outcomes related to physical activity and exercise behavior favored PT+coaching at 6 months but generally not at 12 or 18 months. There were no between-group differences in most other outcomes. The addition of simultaneous telephone coaching did not augment the pain and function benefits of a physiotherapist-prescribed home-based physical activity program. © 2016, American College of Rheumatology.

Physical Therapists, Telephone Coaches, and Patients With Knee Osteoarthritis: Qualitative Study About Working Together to Promote Exercise Adherence.

Science.gov (United States)

Hinman, Rana S; Delany, Clare M; Campbell, Penelope K; Gale, Janette; Bennell, Kim L

2016-04-01

Integrated models of care are recommended for people with knee osteoarthritis (OA). Exercise is integral to management, yet exercise adherence is problematic. Telephone-based health coaching is an attractive adjunct to physical therapist-prescribed exercise that may improve adherence. Little is known about the perceptions and interpretations of physical therapists, telephone coaches, and patients engaged in this model of care. The purpose of this study was to explore how stakeholders (physical therapists, telephone coaches, and patients) experienced, and made sense of, being involved in an integrated program of physical therapist-supervised exercise and telephone coaching for people with knee OA. A cross-sectional qualitative design drawing from symbolic interactionism was used. Semistructured interviews with 10 physical therapists, 4 telephone coaches, and 6 patients with painful knee OA. Interviews were audiorecorded, transcribed, and analyzed using thematic analysis informed by grounded theory. Four themes emerged: (1) genuine interest and collaboration, (2) information and accountability, (3) program structure, and (4) roles and communication in teamwork. Patients reported they appreciated personalized, genuine interest from therapists and coaches and were aware of their complementary roles. A collaborative approach, with defined roles and communication strategies, was identified as important for effectiveness. All participants highlighted the importance of sharing information, monitoring, and being accountable to others. Coaches found the lack of face-to-face contact with patients hampered relationship building. Therapists and coaches referred to the importance of teamwork in delivering the intervention. The small number of physical therapists and telephone coaches who delivered the intervention may have been biased toward favorable experiences with the intervention and may not be representative of their respective professions. Integrated physical therapy and

Under-triage in telephone consultation is related to non-normative symptom description and interpersonal communication

DEFF Research Database (Denmark)

Gamst-Jensen, Hejdi; Lippert, Freddy K; Egerod, Ingrid

2017-01-01

BACKGROUND: Telephone consultation and triage are used to limit the workload on emergency departments. Lack of visual cues and clinical tests put telephone consultations to a disadvantage compared to face-to-face consultations increasing the risk of under-triage. Under-triage occurs in telephone...... triage; however why under-triage happens is not explored yet. The aim of the study was to describe situations of under-triage in context, to assess the quality of under-triaged calls, and to identify communication patterns contributing to under-triage in a regional OOH service in the capital region...... (19%), respiratory (15%) and all others (42%). Thematic analysis of the voice logs suggested that inadequate communication and non-normative symptom description contributed to under-triage. DISCUSSION: The incidence of potentially under-triage is low (0.04%). However, the over...

A demonstration of expert systems applications in transportation engineering : volume I, transportation engineers and expert systems.

Science.gov (United States)

1987-01-01

Expert systems, a branch of artificial-intelligence studies, is introduced with a view to its relevance in transportation engineering. Knowledge engineering, the process of building expert systems or transferring knowledge from human experts to compu...

Assessment of mental health and illness by telephone survey: experience with an Alberta mental health survey.

Science.gov (United States)

Patten, Scott B; Adair, Carol E; Williams, Jeanne Va; Brant, Rollin; Wang, Jian Li; Casebeer, Ann; Beauséjour, Pierre

2006-01-01

Mental health is an emerging priority for health surveillance. It has not been determined that the existing data sources can adequately meet surveillance needs. The objective of this project was to explore the use of telephone surveys as a means of collecting supplementary surveillance information. A computer-assisted telephone interview was administered to 5,400 subjects in Alberta. The interview included a set of brief, validated measures for evaluating mental disorder prevalence and related variables. The individual subject response rate was 78 percent, but a substantial number of refusals occurred at the initial household contact. The age and sex distribution of the study sample differed from that of the provincial population prior to weighting. Prevalence proportions did not vary substantially across administrative health regions. There is a potential role for telephone data collection in mental health surveillance, but these results highlight some associated methodological challenges. They also draw into question the importance of regional variation in mental disorder prevalence--which might otherwise have been a key advantage of telephone survey methodologies.

A middle class image of society: a study of undercoverage and nonresponse bias in a telephone survey

NARCIS (Netherlands)

Goor, van H.; Rispens, S.

2004-01-01

We studied undercoverage and nonresponse in a telephone survey among the population of the City ofGroningen, the Netherlands. The original sample, drawn from the municipal population register,contained 7000 individuals. For 37 percent of them, the telephone company was unable to produce a