The ethics of digital well-being: a multidisciplinary perspective

This chapter serves as an introduction to the edited collection of the same name, which includes chapters that explore digital well-being from a range of disciplinary perspectives, including philosophy, psychology, economics, health care, and education. The purpose of this introductory chapter is to provide a short primer on the different disciplinary approaches to the study of well-being. To supplement this primer, we also invited key experts from several disciplines—philosophy, psychology, public policy, and health care—to share their thoughts on what they believe are the most important open questions and ethical issues for the multi-disciplinary study of digital well-being. We also introduce and discuss several themes that we believe will be fundamental to the ongoing study of digital well-being: digital gratitude, automated interventions, and sustainable co-well-being

Epoprostenol (PGI2, Prostacyclin) During High‐Risk Hemodialysis: Preventing Further Bleeding Complications

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97231/1/j.1552-4604.1988.tb03222.x.pd

Natural Language, Mixed-Initiative Personal Assistant Agents

The increasing popularity and use of personal voice assistant technologies, such as Siri and Google Now, is driving and expanding progress toward the long-term and lofty goal of using artificial intelligence to build human-computer dialog systems capable of understanding natural language. While dialog-based systems such as Siri support utterances communicated through natural language, they are limited in the flexibility they afford to the user in interacting with the system and, thus, support primarily action-requesting and information-seeking tasks. Mixed-initiative interaction, on the other hand, is a flexible interaction technique where the user and the system act as equal participants in an activity, and is often exhibited in human-human conversations. In this paper, we study user support for mixed-initiative interaction with dialog-based systems through natural language using a bag-of-words model and k-nearest-neighbor classifier. We study this problem in the context of a toolkit we developed for automated, mixed-initiative dialog system construction, involving a dialog authoring notation and management engine based on lambda calculus, for specifying and implementing task-based, mixed-initiative dialogs. We use ordering at Subway through natural language, human-computer dialogs as a case study. Our results demonstrate that the dialogs authored with our toolkit support the end user\u27s completion of a natural language, human-computer dialog in a mixed-initiative fashion. The use of natural language in the resulting mixed-initiative dialogs afford the user the ability to experience multiple self-directed paths through the dialog and makes the flexibility in communicating user utterances commensurate with that in dialog completion paths---an aspect missing from commercial assistants like Siri

Understanding the psychosocial needs of breast cancer survivors in the United Arab Emirates: a qualitative study

Background: Breast cancer is the most common cancer among women in the United Arab Emirates; yet there is little known about the psychosocial concerns of the survivors. Research shows that meeting the psychosocial needs significantly contributes to cancer survivor’s wellbeing and potentially elevates the quality of the patient’s life. Therefore the study aims to understand the psychosocial needs of breast cancer survivors through a qualitative approach. Methods: A qualitative study was conducted using semi structured in-depth interviews among ten breast cancer survivors. The recorded texts were coded and salient themes were generated using an inductive approach. Thematic analysis of the interviews was done observing for meaning, repeating phrases and keywords. Results: Analysis yielded three major themes which included survivors’ living experience with breast cancer, concerns of breast cancer survivors and the survivors’ expectations of healthcare delivery or support needed. The breast cancer survivors had psychosocial concerns that are not well understood and addressed by the healthcare. The experiences, concerns and expectations differ from individuals and through the continuum of survivorship. Conclusion: Understanding the unmet psychosocial concerns of the cancer survivors is essential to design a structured survivorship program and offer timely and effective interventions. This would improve survivorship care in the country and offers opportunities to redesign cancer services towards patient-centred care

Imperforate anus with a rectovestibular fistula and pseudotail: a case report

<p>Abstract</p> <p>Introduction</p> <p>Human tails and pseudotails are rare sacrococcygeal lesions that are associated with a wide variety of anomalies and syndromes. Anorectal malformations are also relatively uncommon congenital defects that often occur in conjunction with syndromes or other congenital abnormalities. The anomalies associated with both disorders determine the timing and approach to surgical correction. We present an unusual case of a patient with both imperforate anus and a pseudotail in the absence of a syndrome or other associated anomalies and we emphasize the necessity of a thorough preoperative evaluation.</p> <p>Case presentation</p> <p>A Caucasian girl was born at term after an uncomplicated pregnancy and was noted at birth to have a skin-covered posterior midline mass and imperforate anus with a fistula to the vaginal vestibule. Ultrasound and magnetic resonance imaging revealed a predominately fatty lesion without presacral extension and ruled out associated spinal and cord abnormalities. The patient underwent diversion with colostomy and a mucous fistula in the newborn period as a fistulogram demonstrated a long fistulous tract to normal rectum and it was anticipated that anoplasty and resection of the mass would require extensive posterior dissection. The sacrococcygeal mass was removed during posterior sagittal anorectoplasty at the age of six weeks which was determined to be a pseudotail because of the composition of brown fat and cartilage. The patient is now 14 months old with normal bowel function after a colostomy takedown.</p> <p>Conclusion</p> <p>A comprehensive preoperative assessment and thoughtful operative plan were necessary in this unusual case because of the extensive differential diagnosis for sacrococcygeal masses in the newborn and the frequency of anomalies and syndromes associated with tail variants and imperforate anus. The pediatricians and neonatologists who initially evaluate such patients and the surgeons who correct these disorders must be aware of the potential pitfalls in their management.</p

Spatial Epidemiology: Current Approaches and Future Challenges

Spatial epidemiology is the description and analysis of geographic variations in disease with respect to demographic, environmental, behavioral, socioeconomic, genetic, and infectious risk factors. We focus on small-area analyses, encompassing disease mapping, geographic correlation studies, disease clusters, and clustering. Advances in geographic information systems, statistical methodology, and availability of high-resolution, geographically referenced health and environmental quality data have created unprecedented new opportunities to investigate environmental and other factors in explaining local geographic variations in disease. They also present new challenges. Problems include the large random component that may predominate disease rates across small areas. Though this can be dealt with appropriately using Bayesian statistics to provide smooth estimates of disease risks, sensitivity to detect areas at high risk is limited when expected numbers of cases are small. Potential biases and confounding, particularly due to socioeconomic factors, and a detailed understanding of data quality are important. Data errors can result in large apparent disease excess in a locality. Disease cluster reports often arise nonsystematically because of media, physician, or public concern. One ready means of investigating such concerns is the replication of analyses in different areas based on routine data, as is done in the United Kingdom through the Small Area Health Statistics Unit (and increasingly in other European countries, e.g., through the European Health and Environment Information System collaboration). In the future, developments in exposure modeling and mapping, enhanced study designs, and new methods of surveillance of large health databases promise to improve our ability to understand the complex relationships of environment to health

Principal component analysis of dietary and lifestyle patterns in relation to risk of subtypes of esophageal and gastric cancer

Purpose To carry out pattern analyses of dietary and lifestyle factors in relation to risk of esophageal and gastric cancers. Methods We evaluated risk factors for esophageal adenocarcinoma (EA), esophageal squamous cell carcinoma (ESCC), gastric cardia adenocarcinoma (GCA), and other gastric cancers (OGA) using data from a population-based case-control study conducted in Connecticut, New Jersey, and western Washington state. Dietary/lifestyle patterns were created using principal component analysis (PCA). The impact of the resultant scores on cancer risk was estimated through logistic regression. Results PCA identified six patterns: meat/nitrite, fruit/vegetable, smoking/alcohol, legume/meat alternate, GERD/BMI, and fish/vitamin C. Risk of each cancer under study increased with rising meat/nitrite score. The risk of EA increased with increasing GERD/BMI score, and the risk of ESCC rose with increasing smoking/alcohol score and decreasing gastroesophageal reflux disease (GERD)/body mass index (BMI) score. Fruit/vegetable scores were inversely associated with EA, ESCC, and GCA. Conclusions PCA may provide a useful approach for summarizing extensive dietary/lifestyle data into fewer interpretable combinations that discriminate between cancer cases and controls. The analyses suggest that meat/nitrite intake is associated with an elevated risk of each cancer under study, whereas fruit/vegetable intake reduces the risk of EA, ESCC, and GCA. GERD/obesity was confirmed as risk factors for EA and smoking/alcohol as risk factors for ESCC

Food group intake and risk of subtypes of esophageal and gastric cancer

Incidence rates for adenocarcinomas of the esophagus and gastric cardia have been increasing rapidly, while rates for non‐cardia gastric adenocarcinoma and esophageal squamous cell carcinoma have declined. We examined food group intake as a risk factor for subtypes of esophageal and gastric cancers in a multicenter, population‐based case–control study in Connecticut, New Jersey and western Washington state. Associations between food groups and risk were estimated using adjusted odds ratios (OR), based on increasing intake of one serving per day. Total vegetable intake was associated with decreased risk of esophageal adenocarcinoma (OR = 0.85, 95% CI = 0.75, 0.96). Conversely, total meat intake was associated with increased risk of esophageal adenocarcinoma (OR = 1.43, 95% CI = 1.11, 1.83), gastric cardia adenocarcinoma (OR = 1.37, 95% CI = 1.08, 1.73) and noncardia gastric adenocarcinoma (OR = 1.39, 95% CI = 1.12, 1.71), with red meat most strongly associated with esophageal adenocarcinoma risk (OR = 2.49, 95% CI = 1.39, 4.46). Poultry was most strongly associated with gastric cardia adenocarcinoma (OR = 1.89, 95% CI = 1.15, 3.11) and noncardia gastric adenocarcinoma (OR = 1.90, 95% CI = 1.19, 3.03). High‐fat dairy was associated with increased risk of both esophageal and gastric cardia adenocarcinoma. Higher intake of meats, particularly red meats, and lower intake of vegetables were associated with an increased risk of esophageal adenocarcinoma, while higher intake of meats, particularly poultry, and high‐fat dairy was associated with increased risk of gastric cardia adenocarcinoma