Towards a Personalised Health System

This paper presents a Personalized Healthcare System (PHS), a decision support tool that can adapt to changing conditions, such as aging and illness, in individual patients. The system consists of three components: a unique personalised profile, a collection of web based tools and a web based repository for managing interactions between clinicians and tools. The proposed system makes extensive use of software agents, both for collecting the initial information required to construct a personalized profile and for transporting the information needed to use the on-line decision support tools. The paper discusses the operation of a PHS and suggests possible implementation issues

Decision time for clinical decision support systems

Clinical decision support systems are interactive software systems designed to assist clinicians with decision making tasks, such as determining a diagnosis or recommending a treatment for a patient. Clinical decision support systems are a widely researched topic in the Computer Science community but their inner workings are less well understood by and known to clinicians. In this article we provide a brief explanation of clinical decision support systems and provide some examples of real world systems. We also describe some of the challenges to implementing these systems in clinical environments and posit some of the reasons for limited adoption of decision support systems in practice. We aim to engage clinicians in the development of decision support system that can meaningfully help with their decision making tasks and open up a discussion about the future of automated clinical decision support as a part of healthcare delivery

“I wish I’d told them”: a qualitative study examining the unmet psychosexual needs of prostate cancer patients during follow-up after treatment

<b>Objective</b> To gain insight into patients' experiences of follow-up care after treatment for prostate cancer and identify unmet psychosexual needs.<p></p> <b>Methods</b> Semi-structured interviews were conducted with a purposive sample of 35 patients aged 59-82 from three UK regions. Partners were included in 18 interviews. Data were analyzed using constant comparison. <p></p> <b>Results</b> (1) Psychosexual problems gained importance over time, (2) men felt they were rarely invited to discuss psychosexual side effects within follow-up appointments and lack of rapport with health care professionals made it difficult to raise problems themselves, (3) problems were sometimes concealed or accepted and professionals' attempts to explore potential difficulties were resisted by some, and (4) older patients were too embarrassed to raise psychosexual concerns as they felt they would be considered 'too old' to be worried about the loss of sexual function.<p></p> <b>Conclusion</b> Men with prostate cancer, even the very elderly, have psychosexual issues for variable times after diagnosis. These are not currently always addressed at the appropriate time for the patient.Practice implications Assessments of psychosexual problems should take place throughout the follow-up period, and not only at the time of initial treatment. Further research examining greater willingness or reluctance to engage with psychosexual interventions may be particularly helpful in designing future intervention

Experimental observation of oscillating and interacting matter wave dark solitons

We report on the generation, subsequent oscillation and interaction of a pair of matter wave dark solitons. These are created by releasing a Bose-Einstein condensate from a double well potential into a harmonic trap in the crossover regime between one dimension (1D) and three dimensions (3D). The oscillation of the solitons is observed and the frequency is in quantitative agreement with simulations using the Gross-Pitaevskii equation. An effective particle picture is developed and reveals that the deviation of the observed frequencies from the asymptotic prediction $\nu_{z}/\sqrt{2}$, where $\nu_{z}$ is the longitudinal trapping frequency, results from the dimensionality of the system and the interaction between the solitons.Comment: 5 pages, 3 figure

Multiple atomic dark solitons in cigar-shaped Bose-Einstein condensates

We consider the stability and dynamics of multiple dark solitons in cigar-shaped Bose-Einstein condensates (BECs). Our study is motivated by the fact that multiple matter-wave dark solitons may naturally form in such settings as per our recent work [Phys. Rev. Lett. 101, 130401 (2008)]. First, we study the dark soliton interactions and show that the dynamics of well-separated solitons (i.e., ones that undergo a collision with relatively low velocities) can be analyzed by means of particle-like equations of motion. The latter take into regard the repulsion between solitons (via an effective repulsive potential) and the confinement and dimensionality of the system (via an effective parabolic trap for each soliton). Next, based on the fact that stationary, well-separated dark multi-soliton states emerge as a nonlinear continuation of the appropriate excited eigensates of the quantum harmonic oscillator, we use a Bogoliubov-de Gennes analysis to systematically study the stability of such structures. We find that for a sufficiently large number of atoms, multiple soliton states may be dynamically stable, while for a small number of atoms, we predict a dynamical instability emerging from resonance effects between the eigenfrequencies of the soliton modes and the intrinsic excitation frequencies of the condensate. Finally we present experimental realizations of multi-soliton states including a three-soliton state consisting of two solitons oscillating around a stationary one.Comment: 17 pages, 11 figure

The future of North American trade policy: lessons from NAFTA

This repository item contains a single issue of the Pardee Center Task Force Reports, a publication series that began publishing in 2009 by the Boston University Frederick S. Pardee Center for the Study of the Longer-Range Future.This Task Force Report written by an international group of trade policy experts calls for significant reforms to address adverse economic, environmental, labor and societal impacts created by the 1994 North American Free Trade Agreement (NAFTA). The report is intended to contribute to the discussion and decisions stemming from ongoing reviews of proposed reforms to NAFTA as well as to help shape future trade agreements. It offers detailed proposals on topics including services, manufacturing, agriculture, investment, intellectual property, labor, environment, and migration. Fifteen years after NAFTA was enacted, there is widespread agreement that the trade treaty among the United States, Canada and Mexico has fallen short of its stated goals. While proponents credit the agreement with stimulating the flow of goods, services, and investment among the North American countries, critics in all three countries argue that this has not brought improvements in the standards of living of most people. Rather than triggering a convergence across the three nations, NAFTA has accentuated the economic and regulatory asymmetries that had existed among the three countries. [TRUNCATED

Dispersive magnetic excitations in the S=1 antiferromagnet Ba3_3Mn2_2O8_8

We present powder inelastic neutron scattering measurements of the S=1 dimerized antiferromagnet Ba$_3$Mn$_2$O$_8$. The $T=1.4$ K magnetic spectrum exhibits a spin-gap of $\Delta \approx 1.0$ meV and a dispersive spectrum with a bandwidth of approximately 1.5 meV. Comparison to coupled dimer models describe the dispersion and scattering intensity accurately and determine the exchange constants in Ba$_3$Mn$_2$O$_8$. The wave vector dependent scattering intensity confirms the proposed S=1 dimer bond. Temperature dependent measurements of the magnetic excitations indicate the presence of both singlet-triplet and thermally activated triplet-quintet excitations.Comment: 8 pages, 8 figures, Submitted to Physical Review B, Resubmited versio

Regulating Clothing Outwork: A Sceptic's View

By applying the strategies of international anti-sweatshop campaigns to the Australian context, recent regulations governing home-based clothing production hold retailers responsible for policing the wages and employment conditions of clothing outworkers who manufacture clothing on their behalf. This paper argues that the new approach oversimplifies the regulatory challenge by assuming (1) that Australian clothing production is organised in a hierarchical ‘buyer-led’ linear structure in which core retail firms have the capacity to control their suppliers’ behaviour; (2) that firms act as unitary moral agents; and (3) that interventions imported from other times and places are applicable to the contemporary Australian context. After considering some alternative regulatory approaches, the paper concludes that the new regulatory strategy effectively privatises responsibility for labour market conditions – a development that cries out for further debate

Energy spectra of the ocean's internal wave field: theory and observations

The high-frequency limit of the Garrett and Munk spectrum of internal waves in the ocean and the observed deviations from it are shown to form a pattern consistent with the predictions of wave turbulence theory. In particular, the high frequency limit of the Garrett and Munk spectrum constitutes an {\it exact} steady state solution of the corresponding kinetic equation.Comment: 4 pages, one color figur