Extending the gaia methodology for the design and development of agent-based software systems

Over the past decade, agent-based computing has emerged as a new and popular paradigm for design, implementation and analysis of distributed information systems. In this paper, the participant researchers in Health Care Computing Group at University of Westminster concentrate on the agent-oriented methodology for the analysis and design of agentbased systems and identify how methodology can support both the levels of "agent structure" and of "agent society" in the agent-oriented software design and development process. The research reported here takes one leading agent-oriented methodology-Gaia, and then extended it by the creation of innovative design tools which aimed at better supporting application to real-world domains. In discussion section, agent-oriented methodology and AUML approaches are compared and evaluated in great detail; the strengths and weaknesses of the current agent-oriented methodology are explored and discussed; the importance of effectively using methodology to improve agents and their productivity potential also is emphasized. Finally, we draw conclusions from the work presented and the experience gained in this research and look into the future possible improvements on agent-oriented software engineering in the agent technology research field

Working with patients and the public to design an electronic health record interface: A qualitative mixed-methods study

Background Enabling patients to be active users of their own medical records may promote the delivery of safe, efficient care across settings. Patients are rarely involved in designing digital health record systems which may make them unsuitable for patient use. We aimed to develop an evidence-based electronic health record (EHR) interface and participatory design process by involving patients and the public. Methods Participants were recruited to multi-step workshops involving individual and group design activities. A mixture of quantitative and qualitative questionnaires and observational methods were used to collect participant perspectives on interface design and feedback on the workshop design process. Results 48 recruited participants identified several design principles and components of a patient-centred electronic medical record interface. Most participants indicated that an interactive timeline would be an appropriate way to depict a medical history. Several key principles and design components, including the use of specific colours and shapes for clinical events, were identified. Participants found the workshop design process utilised to be useful, interesting, enjoyable and beneficial to their understanding of the challenges of information exchange in healthcare. Conclusion Patients and the public should be involved in EHR interface design if these systems are to be suitable for use by patient-users. Workshops, as used in this study, can provide an engaging format for patient design input. Design principles and components highlighted in this study should be considered when patient-facing EHR design interfaces are being developed

Staff, drugs, research, TTIP, patients: how would Brexit affect the NHS?

Vote Leave are resting the NHS’s fate in the hands of the referendum, claiming that leaving the EU will save the NHS, supported by a letter from 50 health professionals. The Remain camp support the opposing view, with 200 health professionals supporting the Healthier in EU campaign. This briefing by (left to right) Elias Mossialos, Victoria Simpkin, Oliver Keown and Lord Darzi, while not an exhaustive list, aims to facilitate the debate by providing evidence to support or refute the key claims that are being made

SEAPAK user's guide, version 2.0. Volume 1: System description

The SEAPAK is a user interactive satellite data analysis package that was developed for the processing and interpretation of Nimbus-7/Coastal Zone Color Scanner (CZCS) and the NOAA Advanced Very High Resolution Radiometer (AVHRR) data. Significant revisions were made to version 1.0 of the guide, and the ancillary environmental data analysis module was expanded. The package continues to emphasize user friendliness and user interactive data analyses. Additionally, because the scientific goals of the ocean color research being conducted have shifted to large space and time scales, batch processing capabilities for both satellite and ancillary environmental data analyses were enhanced, thus allowing large quantities of data to be ingested and analyzed in background

SEAPAK user's guide, version 2.0. Volume 2: Descriptions of programs

The SEAPAK is a user-interactive satellite data analysis package that was developed for the processing and interpretation of Nimbus-7/Coastal Zone Color Scanner (CZCS) and the NOAA Advanced Very High Resolution Radiometer (AVHRR) data. Significant revisions were made since version 1.0, and the ancillary environmental data analysis module was greatly expanded. The package continues to be user friendly and user interactive. Also, because the scientific goals of the ocean color research being conducted have shifted to large space and time scales, batch processing capabilities for both satellite and ancillary environmental data analyses were enhanced, thus allowing for large quantities of data to be ingested and analyzed

Impact of providing patients access to electronic health records on quality and safety of care: a systematic review and meta-analysis

Objective To evaluate the impact of sharing electronic health records (EHRs) with patients and map it across six domains of quality of care (ie, patient-centredness, effectiveness, efficiency, timeliness, equity and safety). Design Systematic review and meta-analysis. Data sources CINAHL, Cochrane, Embase, HMIC, Medline/PubMed and PsycINFO, from 1997 to 2017. Eligibility criteria Randomised trials focusing on adult subjects, testing an intervention consisting of sharing EHRs with patients, and with an outcome in one of the six domains of quality of care. Data analysis The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Title and abstract screening were performed by two pairs of investigators and assessed using the Cochrane Risk of Bias Tool. For each domain, a narrative synthesis of the results was performed, and significant differences in results between low risk and high/unclear risk of bias studies were tested (t-test, p<0.05). Continuous outcomes evaluated in four studies or more (glycated haemoglobin (HbA1c), systolic blood pressure (SBP) and diastolic blood pressure (DBP)) were pooled as weighted mean difference (WMD) using random effects meta-analysis. Sensitivity analyses were performed for low risk of bias studies, and long-term interventions only (lasting more than 12 months). Results Twenty studies were included (17 387 participants). The domain most frequently assessed was effectiveness (n=14), and the least were timeliness and equity (n=0). Inconsistent results were found for patient-centredness outcomes (ie, satisfaction, activation, self-efficacy, empowerment or health literacy), with 54.5% of the studies (n=6) demonstrating a beneficial effect. Meta-analyses showed a beneficial effect in effectiveness by reducing absolute values of HbA1c (unit: %; WMD=−0.316; 95% CI −0.540 to −0.093, p=0.005, I2=0%), which remained significant in the sensitivity analyses for low risk of bias studies (WMD= −0.405; 95% CI −0.711 to −0.099), and long-term interventions only (WMD=−0.272; 95% CI −0.482 to −0.062). A significant reduction of absolute values of SBP (unit: mm Hg) was found but lost in sensitivity analysis for studies with low risk of bias (WMD= −1.375; 95% CI −2.791 to 0.041). No significant effect was found for DBP (unit: mm Hg; WMD=−0.918; 95% CI −2.078 to 0.242, p=0.121, I2=0%). Concerning efficiency, most studies (80%, n=4) found either a reduction of healthcare usage or no change. A beneficial effect was observed in a range of safety outcomes (ie, general adherence, medication safety), but not in medication adherence. The proportion of studies reporting a beneficial effect did not differ between low risk and high/unclear risk studies, for the domains evaluated. Discussion Our analysis supports that sharing EHRs with patients is effective in reducing HbA1c levels, a major predictor of mortality in type 2 diabetes (mean decrease of −0.405, unit: %) and could improve patient safety. More studies are necessary to enhance meta-analytical power and assess the impact in other domains of care. Protocol registration http://www.crd.york.ac.uk/PROSPERO (CRD42017070092)

Does body contouring after bariatric weight loss enhance quality of life? A systematic review of QOL studies

Massive weight loss following bariatric surgery can result in excess tissue, manifesting as large areas of redundant skin that can be managed by body contouring surgery. This study aims to quantify the effects of body contouring surgery on indicators of quality of life in post-bariatric patients. A systematic review and meta-analysis of the literature revealed on indices of quality of life in post-bariatric patients, before and after body contouring surgery. Body contouring surgery resulted in statistically significant improvements in physical functioning, psychological wellbeing and social functioning, as well as a reduction in BMI. Body contouring surgery offers a strategy to improve quality of life in patients suffering from the functional and psychosocial consequences of excess skin after bariatric surgery

Can self-management programmes change healthcare utilisation in COPD?: A systematic review and framework analysis

Objective The study aims to evaluate the ability of self-management programmes to change the healthcare-seeking behaviours of people with Chronic Obstructive Pulmonary Disease (COPD), and any associations between programme design and outcomes. Methods A systematic search of the literature returned randomised controlled trials of SMPs for COPD. Change in healthcare utilisation was the primary outcome measure. Programme design was analysed using the Theoretical Domains Framework (TDF). Results A total of 26 papers described 19 SMPs. The most common utilisation outcome was hospitalisation (n = 22). Of these, 5 showed a significant decrease. Two theoretical domains were evidenced in all programmes: skills and behavioural regulation. All programmes evidenced at least 5 domains. However, there was no clear association between TDF domains and utilisation. Overall, study quality was moderate to poor. Conclusion This review highlights the need for more alignment in the goals, design, and evaluation of SMPs. Specifically, the TDF could be used to guide programme design and evaluation in future. Practice implications Practices have a reasonable expectation that interventions they adopt will provide patient benefit and value for money. Better design and reporting of SMP trials would address their ability to do so

Healthcare data mining: predicting inpatient length of stay

Data mining approaches have been widely applied in the field of healthcare. At the same time it is recognized that most healthcare datasets are full of missing values. In this paper we apply decision trees, Naive Bayesian classifiers and feature selection methods to a geriatric hospital dataset in order to predict inpatient length of stay, especially for the long stay patients