A Design Theory for Intelligent Clinical Decision Support

Poor or inadequate design of intelligent clinical decision support systems (ICDSS) can result in low adoption and use of these systems. These are some of the prevalent factors stimulating physician resistance. This resistance facilitates low physician involvement and creates a lack of trust in these systems. This is addressed through the development of a design theory for ICDSS. This is demonstrated through mapping and identifying extant literature in the context of the socio-technical model (STM). The gaps were identified through the relationships of the STM and developed into characteristics that are translated into meta-requirements informing design principles. The primary result of this research includes a design theory for ICDSS development. The developed design theory motivates and enables efficient ICDSS development, physician adoption, and more effective patient care. The design theory will also provide managers and researchers deeper insight into designing ICDSS to further improve physician adoption and use of ICDSS

The value of electrical stimulation as an exercise training modality

Voluntary exercise is the traditional way of improving performance of the human body in both the healthy and unhealthy states. Physiological responses to voluntary exercise are well documented. It benefits the functions of bone, joints, connective tissue, and muscle. In recent years, research has shown that neuromuscular electrical stimulation (NMES) simulates voluntary exercise in many ways. Generically, NMES can perform three major functions: suppression of pain, improve healing of soft tissues, and produce muscle contractions. Low frequency NMES may gate or disrupt the sensory input to the central nervous system which results in masking or control of pain. At the same time NMES may contribute to the activation of endorphins, serotonin, vasoactive intestinal polypeptides, and ACTH which control pain and may even cause improved athletic performances. Soft tissue conditions such as wounds and inflammations have responded very favorably to NMES. NMES of various amplitudes can induce muscle contractions ranging from weak to intense levels. NMES seems to have made its greatest gains in rehabilitation where directed muscle contractions may improve joint ranges of motion correct joint contractures that result from shortening muscles; control abnormal movements through facilitating recruitment or excitation into the alpha motoneuron in orthopedically, neurologically, or healthy subjects with intense sensory, kinesthetic, and proprioceptive information; provide a conservative approach to management of spasticity in neurological patients; by stimulation of the antagonist muscle to a spastic muscle stimulation of the agonist muscle, and sensory habituation; serve as an orthotic substitute to conventional bracing used with stroke patients in lieu of dorsiflexor muscles in preventing step page gait and for shoulder muscles to maintain glenohumeral alignment to prevent subluxation; and of course NMES is used in maintaining or improving the performance or torque producing capability of muscle. NMES in exercise training is our major concern

Measurement of mechanical vibrations excited in aluminium resonators by 0.6 GeV electrons

We present measurements of mechanical vibrations induced by 0.6 GeV electrons impinging on cylindrical and spherical aluminium resonators. To monitor the amplitude of the resonator's vibrational modes we used piezoelectric ceramic sensors, calibrated by standard accelerometers. Calculations using the thermo-acoustic conversion model, agree well with the experimental data, as demonstrated by the specific variation of the excitation strengths with the absorbed energy, and with the traversing particles' track positions. For the first longitudinal mode of the cylindrical resonator we measured a conversion factor of 7.4 +- 1.4 nm/J, confirming the model value of 10 nm/J. Also, for the spherical resonator, we found the model values for the L=2 and L=1 mode amplitudes to be consistent with our measurement. We thus have confirmed the applicability of the model, and we note that calculations based on the model have shown that next generation resonant mass gravitational wave detectors can only be expected to reach their intended ultra high sensitivity if they will be shielded by an appreciable amount of rock, where a veto detector can reduce the background of remaining impinging cosmic rays effectively.Comment: Tex-Article with epsfile, 34 pages including 13 figures and 5 tables. To be published in Rev. Scient. Instr., May 200