Retrospective checking of compliance with practice guidelines for acute stroke care: a novel experiment using openEHR’s Guideline Definition Language

BACKGROUND: Providing scalable clinical decision support (CDS) across institutions that use different electronic health record (EHR) systems has been a challenge for medical informatics researchers. The lack of commonly shared EHR models and terminology bindings has been recognised as a major barrier to sharing CDS content among different organisations. The openEHR Guideline Definition Language (GDL) expresses CDS content based on openEHR archetypes and can support any clinical terminologies or natural languages. Our aim was to explore in an experimental setting the practicability of GDL and its underlying archetype formalism. A further aim was to report on the artefacts produced by this new technological approach in this particular experiment. We modelled and automatically executed compliance checking rules from clinical practice guidelines for acute stroke care. METHODS: We extracted rules from the European clinical practice guidelines as well as from treatment contraindications for acute stroke care and represented them using GDL. Then we executed the rules retrospectively on 49 mock patient cases to check the cases’ compliance with the guidelines, and manually validated the execution results. We used openEHR archetypes, GDL rules, the openEHR reference information model, reference terminologies and the Data Archetype Definition Language. We utilised the open-sourced GDL Editor for authoring GDL rules, the international archetype repository for reusing archetypes, the open-sourced Ocean Archetype Editor for authoring or modifying archetypes and the CDS Workbench for executing GDL rules on patient data. RESULTS: We successfully represented clinical rules about 14 out of 19 contraindications for thrombolysis and other aspects of acute stroke care with 80 GDL rules. These rules are based on 14 reused international archetypes (one of which was modified), 2 newly created archetypes and 51 terminology bindings (to three terminologies). Our manual compliance checks for 49 mock patients were a complete match versus the automated compliance results. CONCLUSIONS: Shareable guideline knowledge for use in automated retrospective checking of guideline compliance may be achievable using GDL. Whether the same GDL rules can be used for at-the-point-of-care CDS remains unknown

Multidimensional model of successful aging and nursing terminologies: similarities for use in the clinical practice

Aim: To compare the domains of the Multidimensional Model of Successful Aging (MMSA)with the nursing terminologies, such as, NANDA International (NANDA-I), NursingInterventions Classification (NIC) and Nursing Outcomes Classification (NOC), in order tofind similarities among them.Method: Cross-mapping between MMSA and nursing terminologies in two stages: individualanalysis and comparison between the MMSA and the nursing terminologies, based on themapping process rules; consensus among researchers to validate the results.Results: All NOC and NIC domains were mapped with similarity in the MMSA domains, and12 of the 13 NANDA-I domains showed similarity to the MMSA domains. In addition,similarity was identified between MMSA and most classes of the three classifications.Conclusions: The similarity between MMSA, NANDA-I, NIC and NOC supported the ideathat the MMSA framework can be used in the nursing process to qualify the nursing practicein the elderly care.Keywords: Aging. Nursing process. Standardized nursing terminology

CHAPTER 8: DWIGHT READ: TOWARDS A NEW PARADIGM: FOLLOWED BY A DISCUSSION BETWEEN THE AUTHOR AND DWIGHT READ

Here I report on Dwight Read’s theory for a paradigm change in kinship anthropology which entails kinship terminologies being interpreted as symbolic computational systems based on kin-term products. I also report on how Read argues that different conceptualizations of sibling, either sibling resulting by descent from parent, or sibling viewed in terms of shared parentage, two cultural conceptions that are rendered – here exemplifying the masculine side – by the kin-term products, S o F = B [son of father = brother] or F o B = F [father of brother = father), lead to respectively building up a descriptive or a classificatory terminology. The chapter also deals with how Dwight Read accounts for the relationship between genealogical tracing and the working out of kin terms using kin-term products and how the logic of kin-term products is consistent with the extension of kin terms to kin-type categories beyond the primary ones.The paper also reports on a discussion between Dwight Read and the author, initiated by questions and observations from the latter, regarding different aspects of Read’s reasoning. Not exhaustively, to be mentioned here is the way kin relationships are concretely worked out using kin-term products, the model of the family space and the nuclear family, group marriage,  how the conceptualization of sibling in terms of shared parentage expressed through the kin-term product F o B = F [father o brother = father] relates to ethnographic data, the nature of the logic of kinship terminologies, the status of the structural equation S o F = B [son o father = brother] when used within the context of a classificatory terminology, the axiomatic nature of a number of kin-term products pertaining to specific kin terminologies, the equations pertaining to classificatory kinship terminologies that are  likely to algebraically reduce chains of kin-terms products, mapped from corresponding kin type strings, like “son of son of father of father of father” (S o S o F o F o F) is mapped from the collateral genealogical relations, father’s father’s father’s son’s son (fffss or fffbss) to an irreducible kin term, here father, which is the one native speakers use for the said genealogical connection.The discussion also addresses, taking the example of ancient Chinese dialects, the question of what should be the structural prerequisites for a transition from classificatory (Dravidian) terminologies into bifurcate collateral and descriptive terminologies, a transition that is often posited by a number of linguists and anthropologists. Finally, the discussion deals with the question as to whether the kinship terminologies of the world all ultimately derive from a pre-dispersal African Proto-Sapiens kinship terminology. Throughout these lines of discussion, the central question is raised as to why different cultural choices on how siblings are conceptualized were made that led to different human kinship terminologies and social structures

What Are Kinship Terminologies, and Why Do We Care? A Computational Approach to Analyzing Symbolic Domains

Kinship is a fundamental feature and basis of human societies. We describe a set of computational tools and services, the Kinship Algebra Modeler, and the logic that underlies these. These were developed to improve how we understand both the fundamental facts of kinship, and how people use kinship as a resource in their lives. Mathematical formalism applied to cultural concepts is more than an exercise in model building, as it provides a way to represent and explore logical consistency and implications. The logic underlying kinship is explored here through the kin term computations made by users of a terminology when computing the kinship relation one person has to another by referring to a third person for whom each has a kin term relationship. Kinship Algebra Modeler provides a set of tools, services and an architecture to explore kinship terminologies and their properties in an accessible manner

Analysis of equivalence mapping for terminology services

This paper assesses the range of equivalence or mapping types required to facilitate interoperability in the context of a distributed terminology server. A detailed set of mapping types were examined, with a view to determining their validity for characterizing relationships between mappings from selected terminologies (AAT, LCSH, MeSH, and UNESCO) to the Dewey Decimal Classification (DDC) scheme. It was hypothesized that the detailed set of 19 match types proposed by Chaplan in 1995 is unnecessary in this context and that they could be reduced to a less detailed conceptually-based set. Results from an extensive mapping exercise support the main hypothesis and a generic suite of match types are proposed, although doubt remains over the current adequacy of the developing Simple Knowledge Organization System (SKOS) Core Mapping Vocabulary Specification (MVS) for inter-terminology mapping

BACK TO KINSHIP III: A GENERAL INTRODUCTION

Back to Kinship III is the third Special Issue of the e-journal, Structure and Dynamics sponsored by the group, Kinship Circle. Each issue is dedicated to current kinship research.There are 5 articles in this Special Issue, covering a wide range of kinship research questions and topics The first two articles, by William Young and Warren Shapiro, respectively, employ ethnographic evidence as the reason for revising previous kinship ideas. The next two articles, by Robert Parkin and Dwight Read, respectively, focus on kinship terminology and revisit theoretical issues. The last article, by Alain Matthey de l’Etang, discusses theorizing by Dwight Read challenging the “received view” of kin terms being derived through a genealogical framework and proposing, in its place, that kin terms are structurally organized through a generative logic for the terminolog