Explainer: An interactive Agent for Explaining the Diagnosis of Cardiac Arrhythmia Generated by IK-DCBRC

Interactions between medical applications and users involve a high level of trust, since many complex, automated applications are integrated and involve critical domains in which public health is paramount. Although uncertainty decreases the accuracy and trust of such medical applications under these circumstances, explanation-aware computing becomes crucial in improving the efficiency of these applications. This paper describes an intelligent agent that interacts with users to provide meaningful explanations of previous diagnoses supported by IK-DCBRC. The agent ensures intelligent interactions with users via a rule-based system that generates appropriate explanations according to the selected level of abstraction and the detected cardiac arrhythmia. The paper also describes a particular medical application, that is, cardiac arrhythmia with automatic diagnoses supported by the case-based reasoning classifier, IK-DCBRC

Mechanical Ventilation

The therapeutic alliance has been found to predict psychotherapy outcome in numerous studies. However, critics maintain that the therapeutic alliance is a by-product of prior symptomatic improvements. Moreover, almost all alliance research to date has used differences between patients in alliance as predictor of outcome, and results of such analyses do not necessarily mean that improving the alliance with a given patient will improve outcome (i.e., a within-patient effect). In a sample of 646 patients (76% women, 24% men) in primary care psychotherapy, the effect of working alliance on next session symptom level was analyzed using multilevel models. The Clinical Outcomes in Routine Evaluation–Outcome Measure was used to measure symptom level, and the patient version of the Working Alliance Inventory–Short form revised (Hatcher & Gillaspy, 2006) was used to measure alliance. There was evidence for a reciprocal causal model, in which the alliance predicted subsequent change in symptoms while prior symptom change also affected the alliance. The alliance effect varied considerably between patients. This variation was partially explained by patients with personality problems showing stronger alliance effect. These results indicate that the alliance is not just a by-product of prior symptomatic improvements, even though improvement in symptoms is likely to enhance the alliance. Results also point to the importance of therapists paying attention to ruptures and repair of the therapy alliance. Generalization of results may be limited to relatively brief primary care psychotherapy

Online courses for healthcare professionals: is there a role for social learning?

Background: All UK postgraduate medical trainees receive supervision from trained supervisors. Training has traditionally been delivered via face to face courses, but with increasing time pressures and complex shift patterns, access to these is difficult. To meet this challenge, we developed a two-week massive open online course (MOOC) for faculty development of clinical supervisors. Summary of Work: The MOOC was developed by a group of experienced medical educators and delivered via the FutureLearn (FL) platform which promotes social learning through interaction. This facilitates building of communities of practice, learner interaction and collaboration. We explored learner perceptions of the course, in particular the value of social learning in the context of busy healthcare professionals. We analysed responses to pre- and post-course surveys for each run of the MOOC in 2015, FL course statistics, and learner discussion board comments. Summary of Results: Over 2015, 7,225 learners registered for the course, though 6% left the course without starting. Of the 3,055 learners who began the course, 35% (1073/3055) were social learners who interacted with other participants. Around 31% (960/3055) learners participated fully in the course; this is significantly higher than the FL average of 22%. Survey responses suggest that 68% learners worked full-time, with over 75% accessing the course at home or while commuting, using laptops, smart phones and tablet devices. Discussion: Learners found the course very accessible due to the bite-sized videos, animations, etc which were manageable at the end of a busy working day. Inter-professional discussions and social learning made the learning environment more engaging. Discussion were rated as high quality as they facilitated sharing of narratives and personal reflections, as well as relevant resources. Conclusion: Social learning added value to the course by promoting sharing of resources and improved interaction between learners within the online environment. Take Home Messages: 1) MOOCs can provide faculty development efficiently with a few caveats. 2) Social learning added a new dimension to the online environment

Assessing physical fitness and physical activity in population-based surveys

Edited by Thomas F. Drury.Includes bibliographical references and index.National Center for Health Statistics. Assessing Physical Fitness and Physical Activity in Population-Based Surveys. Thomas F. Drury, ed. DHHS pub. No, (PHS) 89-1253. Public Health Service. Washington. U.S. Government Printing Office. 1989Part I. Historical Perspectives -- 1. General Population Surveys of the National Center for Health Statistics: An Overview / Nancy D. Pearce -- 2. Cardiovascular Endurance, Strength, and Lung Function Tests in the National Health and Nutrition Examination Surveys / Arthur J. McDowell -- 3. Assessments of Body Composition, Dietary Patterns, and Nutritional Status in the National Health Examination Surveys and National Health and Nutrition Examination Surveys / Dorothy Blair,Jean-Pierre Habicht,andLeeAlekel -- -- Part II. Fundamental Perspectives on Health-Related Physical Fitness and Cardiopulmonary -- Health -- 4. Design Issues and Alternatives in Assessing Physical Fitness Among Apparently Healthy Adults in a Health Examination Survey of the General Population / Jack H. Wilmore -- 5. An Integrative Approach to the Noninvasive Assessment of Cardiovascular and Respiratory Function During Exercise / Karlman Wasserman -- -- Part III. Fundamental Perspectives on Energy Balance, Dietary Patterns, and Physical Activity -- 6. General Considerations Related to Assessing Energy Turnover: Energy Intake or Energy Expenditure / E. R. Buskirk -- 7. Issues Related to Measuring Energy Balance for the National Health and Nutrition Examination Survey / Dorothy Blair -- 8. Measuring Dietary Patterns in Surveys of Physical Fitness and Activity / Catherine E. Woteki -- 9. Design Issues and Alternatives in Assessing Physical Activity in General Population Surveys / Thomas Stephens -- -- Part IV. Special Subpopulation Issues -- 10. Fitness and Activity Assessment of Children and Adolescents / Oded Bar-Or -- 11, Evaluating Fitness and Activity Assessments From the National Children and Youth Fitness Studies I and II / James G. Ross -- 12. Assessing Fitness and Activity Patterns of Women in General Population Studies / Barbara L. Drinkwater -- 13. Exercise Testing and Physical Activity Assessment of Persons with Selected Cardiac Conditions / Nanette Kass Wenger -- 14. Health-Related Fitness of the Older Adult / Everett L. Smith and Catherine Gilligan -- -- Part V. Lessons From Community, National, and International Studies -- 15. Lessons from Tecumseh on the Assessment of Physical Activity and Fitness / Henry J. Montoye -- 16. Fitness and Activity Assessments Among U.S.Army Populations: Implications for NCHS General Population Surveys / James A. Vogel -- 17. Fitness and Activity Measurement in the 1981 Canada Fitness Survey / Thomas Stephens and Cora Lynn Craig -- 18. An International Perspective on Critical Issues in Fitness Testing of U.S. Adults / Roy J. Shephard -- -- Part VI. Contexts of Evaluation -- 19. Genetic Considerations in Physical Fitness / Robert M. Malina and Claude Bouchard -- 20. Biochemical Correlates of Fitness and Exercise / William L. Haskell -- 21. Evaluating the Health Effects of Demanding Work on and off the Job / James S. House and David A. Stiti -- 22. Effects of Physical Activity and Fitness on Health / Arthur S. Leon -- 23. Measurement and Evaluation of Health Behaviors in Relationship to Physical Fitness and Physical Activity Patterns / Steven N. Blair and Harold W. Kohl -- 24. Evaluating Interrelationships Among Physical Fitness and Activity Assessments / Ronald E. LaPorte -- 25. Cardiovascular Epidemiological Research Uses of Fitness Assessments / Erika S. Sivarajan and Victor F. Froelicher -- 26. Epidemiologic Uses of General Population Assessments of Physical Activity Patterns / Robert T. Hyde and Ralph S. Paffenbarger, Jr. -- -- Part VII. Measurement and Analysis Strategies -- 27. Use of Latent VariableModels in Measuring Physical Fitness and Physical Activity / George W. Bohrnstedt and Joseph Lucke -- 28. Applying Regression and Factor Analysis of Categorical Variables to Fitness and Exercise Data / Bengt Muthen and Lynn Short -- 29. Latent Class Analysis / Allan L. McCutcheon -- -- Appendix. Framingham Leisure Time Physical Activity Questionnaire / Andrew L. Dannenberg and Peter W. F. Wilson1989833

Proceedings of the 2018 Canadian Society for Mechanical Engineering (CSME) International Congress

Published proceedings of the 2018 Canadian Society for Mechanical Engineering (CSME) International Congress, hosted by York University, 27-30 May 2018

Fast track: The practice of drug development and regulatory innovation in the late Twentieth Century U.S

This thesis examines the laws and regulations created in the 1980s and 1990s in the U.S. to hasten development, evaluation, and approval of drugs to treat serious and lifethreatening diseases, and to allow access of seriously ill patients to investigational drugs on a pre-market approval basis. Using detailed historical exposition in tandem with the social-theoretic tools of the sociology of scientific knowledge (SSK), and particularly Barnes’s account of meaning finitism, this thesis examines the social origin, definition, and case-by-case application of conceptual categories in the regulatory oversight of drug development and approval. With this approach, rules and standards for drug approval are shown not to be fossilised machinery for decision-making, but rather living, socially produced and maintained, inherently revisable resources for action. Key conclusions from this study are that: the regulatory actions taken to confront AIDS in the 1980s, often considered to be a radical break with previous practice, had their conceptual origins in the 1960s and 1970s; rule-making is often constitutionally related to a creative process of rule-‘breaking’; tacit processes of consensus outside of, and prior to, formal consensus mechanisms for rule-making are often fundamental to the rule-making process, resulting in de facto ‘rules’ on which later, formal rule-writing can be based; as predicted by finitism, newly created categories of action in drug development and approval require reinterpretation of underlying concepts in related existing categories. The thesis also demonstrates the flexibility and revisable nature of existing conceptual resources for application to current circumstances, consistent with a finitist view of knowledge. While the conclusions of this research are based on only one area of regulation, they are suggestive for more general descriptions of regulatory action. Contemporary theories of regulation are typically designed as economic models or are viewed through traditional categories of law and political science. As a result, they tend to abstract reality, ignoring day-to-day administrative practice, idealizing the nature of rule-following and rulemaking, and ignoring tacit processes of consensus. This thesis brings an interdisciplinary perspective to the theory of regulation, suggesting the outlines of a ‘social’ theory of regulation more fully sensitive to the empirical reality of the social process of rule-making and rule-breaking in contemporary regulation

Ohio State University Bulletin

Classes available for students to enroll in during the 2004-2005 academic year for The Ohio State University