Modeling intelligent agents for web-based information gathering

The recent emergence of intelligent agent technology and advances in information gathering have been the important steps forward in efficiently managing and using the vast amount of information now available on the Web to make informed decisions. There are, however, still many problems that need to be overcome in the information gathering research arena to enable the delivery of relevant information required by end users. Good decisions cannot be made without sufficient, timely, and correct information. Traditionally it is said that knowledge is power, however, nowadays sufficient, timely, and correct information is power. So gathering relevant information to meet user information needs is the crucial step for making good decisions. The ideal goal of information gathering is to obtain only the information that users need (no more and no less). However, the volume of information available, diversity formats of information, uncertainties of information, and distributed locations of information (e.g. World Wide Web) hinder the process of gathering the right information to meet the user needs. Specifically, two fundamental issues in regard to efficiency of information gathering are mismatch and overload. The mismatch means some information that meets user needs has not been gathered (or missed out), whereas, the overload means some gathered information is not what users need. Traditional information retrieval has been developed well in the past twenty years. The introduction of the Web has changed people's perceptions of information retrieval. Usually, the task of information retrieval is considered to have the function of leading the user to those documents that are relevant to his/her information needs. The similar function in information retrieval is to filter out the irrelevant documents (or called information filtering). Research into traditional information retrieval has provided many retrieval models and techniques to represent documents and queries. Nowadays, information is becoming highly distributed, and increasingly difficult to gather. On the other hand, people have found a lot of uncertainties that are contained in the user information needs. These motivate the need for research in agent-based information gathering. Agent-based information systems arise at this moment. In these kinds of systems, intelligent agents will get commitments from their users and act on the users behalf to gather the required information. They can easily retrieve the relevant information from highly distributed uncertain environments because of their merits of intelligent, autonomy and distribution. The current research for agent-based information gathering systems is divided into single agent gathering systems, and multi-agent gathering systems. In both research areas, there are still open problems to be solved so that agent-based information gathering systems can retrieve the uncertain information more effectively from the highly distributed environments. The aim of this thesis is to research the theoretical framework for intelligent agents to gather information from the Web. This research integrates the areas of information retrieval and intelligent agents. The specific research areas in this thesis are the development of an information filtering model for single agent systems, and the development of a dynamic belief model for information fusion for multi-agent systems. The research results are also supported by the construction of real information gathering agents (e.g., Job Agent) for the Internet to help users to gather useful information stored in Web sites. In such a framework, information gathering agents have abilities to describe (or learn) the user information needs, and act like users to retrieve, filter, and/or fuse the information. A rough set based information filtering model is developed to address the problem of overload. The new approach allows users to describe their information needs on user concept spaces rather than on document spaces, and it views a user information need as a rough set over the document space. The rough set decision theory is used to classify new documents into three regions: positive region, boundary region, and negative region. Two experiments are presented to verify this model, and it shows that the rough set based model provides an efficient approach to the overload problem. In this research, a dynamic belief model for information fusion in multi-agent environments is also developed. This model has a polynomial time complexity, and it has been proven that the fusion results are belief (mass) functions. By using this model, a collection fusion algorithm for information gathering agents is presented. The difficult problem for this research is the case where collections may be used by more than one agent. This algorithm, however, uses the technique of cooperation between agents, and provides a solution for this difficult problem in distributed information retrieval systems. This thesis presents the solutions to the theoretical problems in agent-based information gathering systems, including information filtering models, agent belief modeling, and collection fusions. It also presents solutions to some of the technical problems in agent-based information systems, such as document classification, the architecture for agent-based information gathering systems, and the decision in multiple agent environments. Such kinds of information gathering agents will gather relevant information from highly distributed uncertain environments.

The construction of power in family medicine bedside teaching: a video observation study

INTRODUCTION: Bedside teaching is essential for helping students develop skills, reasoning and professionalism, and involves the learning triad of student, patient and clinical teacher. Although current rhetoric espouses the sharing of power, the medical workplace is imbued with power asymmetries. Power is context-specific and although previous research has explored some elements of the enactment and resistance of power within bedside teaching, this exploration has been conducted within hospital rather than general practice settings. Furthermore, previous research has employed audio-recorded rather than video-recorded observation and has therefore focused on language and para-language at the expense of non-verbal communication and human-material interaction. METHODS: A qualitative design was adopted employing video- and audio-recorded observations of seven bedside teaching encounters (BTEs), followed by short individual interviews with students, patients and clinical teachers. Thematic and discourse analyses of BTEs were conducted. RESULTS: Power is constructed by students, patients and clinical teachers throughout different BTE activities through the use of linguistic, para-linguistic and non-verbal communication. In terms of language, participants construct power through the use of questions, orders, advice, pronouns and medical/health belief talk. With reference to para-language, participants construct power through the use of interruption and laughter. In terms of non-verbal communication, participants construct power through physical positioning and the possession or control of medical materials such as the stethoscope. CONCLUSIONS: Using this paper as a trigger for discussion, we encourage students and clinical teachers to reflect critically on how their verbal and non-verbal communication constructs power in bedside teaching. Students and clinical teachers need to develop their awareness of what power is, how it can be constructed and shared, and what it means for the student-patient-doctor relationship within bedside teaching.

Long-term cost-effectiveness of weight management in primary care

Background:  As obesity prevalence and health-care costs increase, Health Care providers must prevent and manage obesity cost-effectively.

Methods:  Using the 2006 NICE obesity health economic model, a primary care weight management programme (Counterweight) was analysed, evaluating costs and outcomes associated with weight gain for three obesity-related conditions (type 2 diabetes, coronary heart disease, colon cancer). Sensitivity analyses examined different scenarios of weight loss and background (untreated) weight gain.

Results:  Mean weight changes in Counterweight attenders was −3 kg and −2.3 kg at 12 and 24 months, both 4 kg below the expected 1 kg/year background weight gain. Counterweight delivery cost was £59.83 per patient entered. Even assuming drop-outs/non-attenders at 12 months (55%) lost no weight and gained at the background rate, Counterweight was ‘dominant’ (cost-saving) under ‘base-case scenario’, where 12-month achieved weight loss was entirely regained over the next 2 years, returning to the expected background weight gain of 1 kg/year. Quality-adjusted Life-Year cost was £2017 where background weight gain was limited to 0.5 kg/year, and £2651 at 0.3 kg/year. Under a ‘best-case scenario’, where weights of 12-month-attenders were assumed thereafter to rise at the background rate, 4 kg below non-intervention trajectory (very close to the observed weight change), Counterweight remained ‘dominant’ with background weight gains 1 kg, 0.5 kg or 0.3 kg/year.

Conclusion:  Weight management for obesity in primary care is highly cost-effective even considering only three clinical consequences. Reduced healthcare resources use could offset the total cost of providing the Counterweight Programme, as well as bringing multiple health and Quality of Life benefits.

A new method to rank fuzzy numbers using Dempster-Shafer theory with fuzzy targets

In this paper, an extended ranking method for fuzzy numbers, which is a synthesis of fuzzy targets and the Dempster-Shafer Theory (DST) of evidence, is devised. The use of fuzzy targets to reflect human viewpoints in fuzzy ranking is not new. However, different fuzzy targets can lead to contradictory fuzzy ranking results; making it difficult to reach a final decision. In this paper, the results from different viewpoints are treated as different sources of evidence, and Murphy's combination rule is used to aggregate the fuzzy ranking results. DST allows fuzzy numbers to be compared and ranked while preserving their uncertain and imprecise characteristics. In addition, a hybrid method consisting of fuzzy targets and DST with the Transferable Belief Model is formulated, which fulfils a number of important ordering properties. A series of empirical experiments with benchmark examples has been conducted and the experimental results clearly indicate the usefulness of the proposed method.

Rural nursing and health care reforms : building a social model

This article explores recent shifts in health-care policy and the implications for rural nursing in Australia. Health-care reforms have resulted in the implementation of a 'market forces' ideology, creating tensions between economic imperatives and the need for equity and greater access in rural service delivery. New models of health-service delivery have been developed that have significant implications for the way rural health care is defined, practised and received. The issues surrounding the context of rural nursing practice and service delivery are discussed.

A model for compressing probabilities in belief networks

Probabilistic reasoning with belief (Bayesian) networks is based on conditional probability matrices. Thus it suffers from NP-hard implementations. In particular, the amount of probabilistic information necessary for the computations is often overwhelming. So, compressing the conditional probability table is one of the most important issues faced by the probabilistic reasoning community. Santos suggested an approach (called linear potential functions) for compressing the information from a combinatorial amount to roughly linear in the number of random variable assignments. However, much of the information in Bayesian networks, in which there are no linear potential functions, would be fitted by polynomial approximating functions rather than by reluctantly linear functions. For this reason, we construct a polynomial method to compress the conditional probability table in this paper. We evaluated the proposed technique, and our experimental results demonstrate that the approach is efficient and promising.

The factors associated with the belief that vegetarian diets provide health benefits

The aim of this paper is to examine the factors associated with the belief that vegetarian diets provide health benefits. A random population mail survey about food choice was conducted among a sample of 1000 South Australians. An additional (non-random) survey of 106 vegetarians and semi-vegetarians was also conducted, giving a total of 707 participants from both samples. The main predictors of the belief that vegetarian diets provide health benefits for all respondents were found to be the belief that meat is neither healthy nor necessary and frequent searching for information on healthy eating. However, there were differences between vegetarians, non-vegetarians and semi-vegetarians. In particular, health issues were relatively more important for semi-vegetarians and vegetarians, while knowledge and convenience issues were most important for non-vegetarians. The results have important implications for public health. Many South Australians perceive that health benefits are associated with eating a vegetarian diet, which may also apply to plant-based diets in general. However, if non-vegetarians are to obtain some of the health benefits associated with the consumption of a plant-based diet, they require information on the preparation of quick and easy plant- based meals.

A conceptual model for recruitment and retention : allied health workforce enhancement in Western Victoria, Australia

Attracting and retaining allied health professionals in rural areas is a recognised problem in both Australia and overseas. Predicted increases in health needs will require strategic actions to enhance the rural workforce and its ability to deliver the required services. A range of factors in different domains has been associated with recruitment and retention in the allied health workforce. For example, factors can be related to the nature of the work, the personal needs, or the way an organisation is led. Some factors cannot be changed (eg geographical location of extended family) whereas others can be influenced (eg education, support, management styles). Recruitment and retention of allied health professionals is a challenging problem that deserves attention in all domains and preparedness to actively change established work practices, both individually as well as collectively, in order to cater for current and predicted health needs. Changes to enhance workforce outcomes can be implemented and evaluated using a cyclic model. The Allied Health Workforce Enhancement Project of the Greater Green Triangle University Department of Rural Health (GGT UDRH) is working towards increasing the number of allied health professionals in the south west of Victoria. Based on themes identified in the literature, an interactive model is being developed that addresses recruitment and retention factors in three domains: (1) personal or individual; (2) organisation; and (3) community.

Development of a collaborative model to improve school health promotion in the Netherlands

In recent decades, school health promotion programs have been developing into whole-school health approaches. This has been accompanied by a greater understanding among health promoters of the core-business of schools, namely education, and how health promotion objectives can be integrated into this task. Evidence of the positive impact of school health promotion on health risk behavior of students is increasing. This article focuses on the processes and initial results of developing a collaborative model tailored for whole-school health in the Netherlands, named schoolBeat. The Dutch situation is characterized by fragmentation, a variety of health and welfare groups supporting schools, and a lack of sound integrated youth policies. A literature review, observations, and stakeholder consultation provided a clear picture of the current situation in school health promotion, and factors limiting a comprehensive and needs-based approach to school health. This revealed that a health promotion team within a school is fundamental to an effective approach to tailored school health promotion. A respected member of school staff should chair this team. To strengthen the link with the school care team, the school care coordinator should be a member of both teams. To provide coordinated support to all schools in a region, participating organizations decided to share advisory tasks. These tasks are included in the regular health promotion work of their staff. This means working with one advisor representing all school-health organizations per school, and using a comprehensive overview of possible support and projects promoting health. Empowering schools in needs assessments and comprehensive school health promotion is an important element of the developed approach. This article concludes with an examination of emerging issues in evaluating collaborative school health support during the first 18 months of development, and implementation and future perspectives regarding sustainable collaboration and quality improvement.

A qualitative study exploring barriers to a model of shared care for pre-school children`s oral health

Objective To explore the oral health beliefs and practices of primary health care professionals which may act as barriers to the development of a model of shared care for the oral health of pre-school children.

Design Qualitative focus group discussions and semi-structured interviews.

Setting Four rural local government areas in Victoria, Australia, 2003.

Subjects and methods Subjects: maternal and child health nurses, general medical practitioners, dental professionals and paediatricians working in the four local government areas. Data collection: discipline specific focus groups and semi-structured interviews. Data analysis: transcription, coding, clustering and thematic analysis.

Results Several strong themes emerged from the data. All participants agreed that dental caries is a significant health issue for young children and their families. Beliefs about the aetiology of dental caries and its prevention were variable and often simplistic, focusing predominantly on diet. Dental professionals did not believe that they had a primary role in the oral health of pre-school aged children but that others particularly maternal and child health nurses did. However other health care professionals were not confident in assuming this role.

Conclusions This study has identified important barriers and possible strategies for the development of an integrated and shared approach to preventing dental caries in pre-school aged children. Clear and consistent oral health information and agreed roles and responsibilities need to be developed.

Reviewing the learning organisation model in a child and adolescent mental health service

From 1995 onwards, a child and adolescent mental health service (CAMHS) applied Senge's learning organisation model. This review compared service performance with that of peer services 5 years later and explored whether any differences were associated with the application of this model. The comparison methodology used quantitative analysis of external data from the Department of Human Services, together with qualitative analysis of material including interviews with CAMHS directors and service managers. Results showed high evaluation activity and high quality, efficiency and efficacy of care compared with other services. Several restraints to the optimal application of the model were identified, including inadequate training of new managers, service overload, major external organisational change and limited investment in information systems. Other outcomes are discussed.