Automatic medical encoding with SNOMED categories

BACKGROUND: In this paper, we describe the design and preliminary evaluation of a new type of tools to speed up the encoding of episodes of care using the SNOMED CT terminology. METHODS: The proposed system can be used either as a search tool to browse the terminology or as a categorization tool to support automatic annotation of textual contents with SNOMED concepts. The general strategy is similar for both tools and is based on the fusion of two complementary retrieval strategies with thesaural resources. The first classification module uses a traditional vector-space retrieval engine which has been fine-tuned for the task, while the second classifier is based on regular variations of the term list. For evaluating the system, we use a sample of MEDLINE. SNOMED CT categories have been restricted to Medical Subject Headings (MeSH) using the SNOMED-MeSH mapping provided by the UMLS (version 2006). RESULTS: Consistent with previous investigations applied on biomedical terminologies, our results show that performances of the hybrid system are significantly improved as compared to each single module. For top returned concepts, a precision at high ranks (P0) of more than 80% is observed. In addition, a manual and qualitative evaluation on a dozen of MEDLINE abstracts suggests that SNOMED CT could represent an improvement compared to existing medical terminologies such as MeSH. CONCLUSION: Although the precision of the SNOMED categorizer seems sufficient to help professional encoders, it is concluded that clinical benchmarks as well as usability studies are needed to assess the impact of our SNOMED encoding method in real settings. AVAILABILITIES : The system is available for research purposes on: http://eagl.unige.ch/SNOCat

The influence of a virtual companion on amusement when watching funny films

We investigated the role of a virtual companion and trait cheerfulness on the elicitation of amusement. Ninety participants watched funny films in four conditions: either alone, with a virtual companion laughing or verbally expressing amusement at fixed time points (pre-scripted), or additionally joining the participant’s laughter (responsive companion). Amusement was assessed facially and vocally by coding Duchenne Displays and laughter vocalizations. Participants’ cheerful mood pre and post the film watching and positive experience were assessed. Results showed that high trait cheerful individuals generally experienced and expressed more amusement than low trait cheerful individuals. The presence of a virtual companion (compared to being alone) led to more laughter for individuals low in trait cheerfulness. Unexpectedly, the responsive companion did not elicit more amusement than the pre-scripted companion. The general disliking of virtual companions and gelotophobia related negatively to amusement. Amusement expressing virtual companions may be used in interventions aiming at eliciting positive responses, especially for individuals with higher thresholds for amusement.European Union Seventh Framework Programme (FP7/2007-2013) under Grant Agreement No. 27078

Personal and environmental factors associated with active commuting to school in Switzerland

Objective. To assess whether prevalence of active commuting and regular car trips to school varies across communities and language regions in Switzerland and to determine personal and environmental correlates. Methods. During the school year 2004/2005, 1345 parental questionnaires (response rate 65%) of children attending 1st, 4th and 8th grades were completed, 1031 could be linked to a GIS environmental database. A German-speaking, a French-speaking and a bilingual study area were included. Usual mode of transportation and frequency of regular car trips to school were assessed. Associations with personal and environmental factors were evaluated with multivariate regression models. Results. Seventy-eight percent of the children actively traveled to school. Twelve percent were regularly driven at least once a week by car. Major road crossings and distance were significantly related to usual mode of transportation, but not to regular car trips. Age, daycare attendance, parental safety concerns, number of cars in the household and belonging to French-speaking population were significantly associated with increased regular car trips. Conclusion. Objective predictors are main deciding factors for active commuting to school as main mode of transport whereas personal and lifestyle factors are important factors associated with frequency of car use. Not only objective but also differing cultural attitudes should be considered when promoting non-motorized travel

Alterations in energy balance from an exercise intervention with ad libitum food intake.

Better understanding is needed regarding the effects of exercise alone, without any imposed dietary regimens, as a single tool for body-weight regulation. Thus, we evaluated the effects of an 8-week increase in activity energy expenditure (AEE) on ad libitum energy intake (EI), body mass and composition in healthy participants with baseline physical activity levels (PAL) in line with international recommendations. Forty-six male adults (BMI = 19·7-29·3 kg/m(2)) participated in an intervention group, and ten (BMI = 21·0-28·4 kg/m(2)) in a control group. Anthropometric measures, cardiorespiratory fitness, EI, AEE and exercise intensity were recorded at baseline and during the 1st, 5th and 8th intervention weeks, and movement was recorded throughout. Body composition was measured at the beginning and at the end of the study, and resting energy expenditure was measured after the study. The intervention group increased PAL from 1·74 (se 0·03) to 1·93 (se 0·03) (P < 0·0001) and cardiorespiratory fitness from 41·4 (se 0·9) to 45·7 (se 1·1) ml O2/kg per min (P = 0·001) while decreasing body mass (-1·36 (se 0·2) kg; P = 0·001) through adipose tissue mass loss (ATM) (-1·61 (se 0·2) kg; P = 0·0001) compared with baseline. The control group did not show any significant changes in activity, body mass or ATM. EI was unchanged in both groups. The results indicate that in normal-weight and overweight men, increasing PAL from 1·7 to 1·9 while keeping EI ad libitum over an 8-week period produces a prolonged negative energy balance. Replication using a longer period (and/or more intense increase in PAL) is needed to investigate if and at what body composition the increase in AEE is met by an equivalent increase in EI

Recognising resilience factors among people living with HIV seeking to adopt

This article discusses the challenges faced by people living with HIV in the adoption process, looking especially at resilience factors. Resilience is framed in the context of HIV-related infertility that motivates people living with HIV to apply for adoption. The article draws on psychological definitions of resilience and presents four factors that promote and sustain it: individual strengths, good health management, social network and wider recognition in society. This is illustrated by a case study. The study emphasises that ‘the prospective adoptive child’ should always be at the centre of any assessments and encourages social workers to consider sensitive and inclusive practice when assessing prospective adopters living with HIV

Moving Forward in Fostering Humour: Towards Training Lighter Forms of Humour in Multicultural Contexts

The following theoretical position paper has the aim to outline two important future directions of humour intervention research. Firstly, existing humour trainings have not differentiated explicitly between different uses of humour or humour that may be virtuous or not. Within the realm of Positive Psychology, all virtuous forms of humour need to be identified and interventions developed that aim at fostering these benevolent/lighter forms. Secondly, most humour trainings have been adapted and conducted in one cultural context. Future trainings should consider cross-cultural perspectives to allow for comparative research and practice. Thus, the current paper first gives an overview on the extant literature on the distinction between lighter and darker forms of humour, as well as showing how humour can serve the virtues proposed by Peterson and Seligman (2004). Then, we elaborate on the findings on humour and well-being, as well as findings on existing humour interventions. The second section starts with open questions and hypotheses on how a new generation of trainings targeting lighter forms of humour could look like. Then, we discuss (potential) cultural differences in humour and how this may affect the design of interventions. When aiming for cross-cultural adaptations of the same humour program, several challenges have to be overcome, such as the term “humour” not having the same meaning in every culture, and cultural rules on what can be laughed at

Mood Induction in Depressive Patients: A Comparative Multidimensional Approach

Anhedonia, reduced positive affect and enhanced negative affect are integral characteristics of major depressive disorder (MDD). Emotion dysregulation, e.g. in terms of different emotion processing deficits, has consistently been reported. The aim of the present study was to investigate mood changes in depressive patients using a multidimensional approach for the measurement of emotional reactivity to mood induction procedures. Experimentally, mood states can be altered using various mood induction procedures. The present study aimed at validating two different positive mood induction procedures in patients with MDD and investigating which procedure is more effective and applicable in detecting dysfunctions in MDD. The first procedure relied on the presentation of happy vs. neutral faces, while the second used funny vs. neutral cartoons. Emotional reactivity was assessed in 16 depressed and 16 healthy subjects using self-report measures, measurements of electrodermal activity and standardized analyses of facial responses. Positive mood induction was successful in both procedures according to subjective ratings in patients and controls. In the cartoon condition, however, a discrepancy between reduced facial activity and concurrently enhanced autonomous reactivity was found in patients. Relying on a multidimensional assessment technique, a more comprehensive estimate of dysfunctions in emotional reactivity in MDD was available than by self-report measures alone and this was unsheathed especially by the mood induction procedure relying on cartoons. The divergent facial and autonomic responses in the presence of unaffected subjective reactivity suggest an underlying deficit in the patients' ability to express the felt arousal to funny cartoons. Our results encourage the application of both procedures in functional imaging studies for investigating the neural substrates of emotion dysregulation in MDD patients. Mood induction via cartoons appears to be superior to mood induction via faces and autobiographical material in uncovering specific emotional dysfunctions in MDD

From Aristotle to Arendt : a phenomenological exploration of forms of knowledge and practice in the context of child protection social work in the UK

This paper attempts to explore the relationship between different forms of knowledge and the kinds of activity that arise from them within child protection social work practice. The argument that social work is more than either ‘science’ or ‘art’ but distinctly ‘practice’ is put through a historical description of the development of Aristotle’s views of the forms of knowledge and Hannah Arendt’s later conceptualisations as detailed in The Human Condition (1958). The paper supports Arendt’s privileging of Praxis over Theoria within social work and further draws upon Arendt’s distinctions between Labour, Work and Action to delineate between different forms of social work activity. The author highlights dangers in social work relying too heavily on technical knowledge and the use of theory as a tool in seeking to understand and engage with the people it serves and stresses the importance of a phenomenological approach to research and practice as a valid, embodied form of knowledge. The argument further explores the constructions of service users that potentially arise from different forms of social work activity and cautions against over-prescriptive use of ‘outcomes’ based practice that may reduce the people who use services to products or consumables. The author concludes that social work action inevitably involves trying to understand humans in a complex and dynamic way that requires engagement and to seek new meanings for individual humans

Actigraph Accelerometer-Defined Boundaries for Sedentary Behaviour and Physical Activity Intensities in 7 Year Old Children

Background: Accurate objective assessment of sedentary and physical activity behaviours during childhood is integral to the understanding of their relation to later health outcomes, as well as to documenting the frequency and distribution of physical activity within a population.Purpose: To calibrate the Actigraph GT1M accelerometer, using energy expenditure (EE) as the criterion measure, to define thresholds for sedentary behaviour and physical activity categories suitable for use in a large scale epidemiological study in young children.Methods: Accelerometer-based assessments of physical activity (counts per minute) were calibrated against EE measures (kcal.kg(-1).hr(-1)) obtained over a range of exercise intensities using a COSMED K4b(2) portable metabolic unit in 53 seven-year-old children. Children performed seven activities: lying down viewing television, sitting upright playing a computer game, slow walking, brisk walking, jogging, hopscotch and basketball. Threshold count values were established to identify sedentary behaviour and light, moderate and vigorous physical activity using linear discriminant analysis (LDA) and evaluated using receiver operating characteristic (ROC) curve analysis.Results: EE was significantly associated with counts for all non-sedentary activities with the exception of jogging. Threshold values for accelerometer counts (counts. minute(-1)) were = 3841 for light, moderate and vigorous physical activity respectively. The area under the ROC curves for discrimination of sedentary behaviour and vigorous activity were 0.98. Boundaries for light and moderate physical activity were less well defined (0.61 and 0.60 respectively). Sensitivity and specificity were higher for sedentary (99% and 97%) and vigorous (95% and 91%) than for light (60% and 83%) and moderate (61% and 76%) thresholds.Conclusion: The accelerometer cut points established in this study can be used to classify sedentary behaviour and to distinguish between light, moderate and vigorous physical activity in children of this age

Social work students as community partners in a family intervention programme

Summary: This paper describes the findings from the evaluation of a UK initiative which engaged social work students as community partners within an educational based family intervention programme. Fourteen social work students in the first year of a BA (Hons) were placed in the programme to meet the volunteering requirements of their 'Community Project'. By engaging with the community-based family programme at an early stage in their education, students experienced the benefits of interventions, focussing on sustainability, citizenship and parent participation. We describe the approach and discuss the evaluation outcomes to illustrate the potential of utilising co-learning with families in social work education. In taking up the role of community partners, students observed first-hand the value of incorporating horizontal relationships into their learning and experienced direct knowledge exchange with service users at an early stage in their training. Findings: The findings suggest that this experience enabled students to connect with conceptualisations of macro alongside micro practice in their professional development as social workers. Further, connecting critical social theories with the direct experience of families promoted the learners own empowerment and conscientization. Application: This provided a means of embedding social work values and aspirations towards social justice in their future practice orientation