MAKING PEOPLE AWARE OF DEVIATIONS FROM STANDARDS IN HEALTH CARE

In this paper we consider the role of standards as a means for interoperability among members of different communities. If we consider, in particular, the healthcare domain, there is an increasing number of efforts to develop explicit and formal representations of medical concepts so as to provide a common infrastructure for the reuse of clinical information and for the integration and the sharing of medical knowledge across the world. A critical issue raises when local customizations of standards are used as standards. If this occurs, standards are no more able to guarantee their supportive function to interoperability. To overcome this problem we propose a solution aiming at making members of different facilities aware of the changes occurred locally in a standard. At architectural level, we propose to build a layer that acts upon the interface of the application by which the articulation of activities across organizational boundaries is mediated (e.g., an handing over between different healthcare facilities). At application level, we provide practitioners with a common visual notation allowing them enrich the artifacts that mediate inter-articulation, by means of a reference to a standard, e.g. a schema of intervention. We claim that this increased awareness can support different people in aligning practices with standards and making standards effective means for coordination and interoperability. Furthermore, we report a case focusing on such a layer and visual notation by which to enrich the interface of the information system that mediates the handingover between an Emergency Service and a hospital emergency department

第792回 千葉医学会例会・第二内科例会 35.

Many studies have focused on Type A and Type D personality types in the context of cardiovascular diseases (CVDs), but nothing is known about how these personality types combine to create new profiles. The present study aimed to develop a typology of Type A and Type D personality in two groups of patients affected by and at risk for coronary disease. The study involved 711 patients: 51.6% with acute coronary syndrome, 48.4% with essential hypertension (mean age = 56.4 years; SD = 9.7 years; 70.7% men). Cluster analysis was applied. External variables, such as socio-demographic, psychological, lifestyle, and clinical parameters, were assessed. Six groups, each with its own unique combined personality profile scores, were identified: Type D, Type A-Negatively Affected, Not Type A-Negatively Affected, Socially Inhibited-Positively Affected, Not Socially Inhibited, and Not Type A-Not Type D. The Type A-Negatively Affected cluster and, to a lesser extent, the Type D cluster, displayed the worst profile: namely higher total cardiovascular risk index, physical inactivity, higher anxiety and depression, and lower self-esteem, optimism, and health status. Identifying combined personality profiles is important in clinical research and practice in cardiovascular diseases. Practical implications are discussed

Combining Interface Agents and Situated Agents for Deploying Adaptive Web Applications

Abstract. A web site presents a graph–like spatial structure composed of pages connected by hyperlinks. This structure may represent an environment in which situated agents associated to visitors of the web site are positioned and moved in order to monitor their navigation. This paper presents a heterogeneous multiagent system supporting the collection of information related to user’s behaviour in a web site by specific situated reactive user agents. The acquired information is then exploited by interface agents supporting advanced adaptive functionalities based on the history of user’s movement in the web site environment.

Putting the Gaming Experience at the Center of the Therapy—The Video Game Therapy^® Approach

Video games have been increasingly used as a form of therapy for various mental health conditions. Research has shown that video games can be used to treat conditions such as depression, anxiety, PTSD, and addiction. One of the main benefits of video games in therapy is that they can provide a sense of engagement and immersion that traditional therapy methods may lack. Additionally, video games can teach valuable skills such as problem solving, decision making, and coping strategies. Video games can also simulate real-life scenarios, allowing individuals to practice and improve social skills in a safe and controlled environment. Furthermore, video games can provide feedback and track progress objectively and quantifiably. This paper proposes an approach, the Video Game Therapy® (VGT®) approach, where game experience is put at the center of the therapy in a tailored way, connecting the individual patient’s personality, the therapy’s goals, and the suggested type of video game through the Myers Briggs Type Indicator (MBTI).VGT®’s core assumption is that playing video games could facilitate patients in reaching conditions where traditional methodologies and therapeutic approaches could work best. VGT® was elaborated according to the Adlerian therapy vision and, consequently, the different phases of Adlerian therapy and VGT® match. Despite the use of video games in psychotherapy might have some adverse effects in specific cases, VGT® is currently used in three associations with positive results in promoting emotional experimentation and literacy, social feeling, sense of identity, and activating cognitive processes. Future developments include expanding the use of VGT® further to validate such results from a statistical point of view