Referential hierarchies: A new look at some historical and typological patterns

This paper proposes a diachronic typology for the various patterns that have been referred to as Hierarchical Alignment or Inverse Alignment. Previous typological studies have tried to explain such patterns as grammatical reflections of a universal Referential Hierarchy, in which first person outranks second person outranks third person and humans outrank other animates outrank inanimates. However, our study shows that most of the formal properties of hierarchy-sensitive constructions are essentially predictable from their historical sources. We have identified three sources for hierarchical person marking, three for direction marking, two for obviative case marking, and one for hierarchical constituent ordering. These sources suggest that there is more than one explanation for hierarchical alignment: one is consistent with Givón’s claim that hierarchical patterns are a grammaticalization of generic topicality; another is consistent with DeLancey’s claim that hierarchies reflect the deictic distinction between present (1/2) and distant (3) participants; another is simply a new manifestation of a common asymmetrical pattern, the use of zero marking for third persons. More importantly, the evolution of hierarchical grammatical patterns does not reflect a consistent universal ranking of participants – at least in those cases where we can see (or infer) historical stages in the evolution of these properties, different historical stages appear to reflect different hierarchical rankings of participants, especially first and second person. This leads us to conclude that the diversity of hierarchical patterns is an artifact of grammatical change, and that in general, the presence of hierarchical patterns in synchronic grammars is not somehow conditioned by some more general universal hierarchy.

Ordering CT pulmonary angiography to exclude pulmonary embolism: defense versus evidence in the emergency room

To identify reasons for ordering computed tomography pulmonary angiography (CTPA), to identify the frequency of reasons for CTPA reflecting defensive behavior and evidence-based behavior, and to identify the impact of defensive medicine and of training about diagnosing pulmonary embolism (PE) on positive results of CTPA.

Reasons for ordering computed tomography scans of the head in patients with minor brain injury

Minor brain injury is a frequent condition. Validated clinical decision rules can help in deciding whether a computed tomogram (CT) of the head is required. We hypothesized that institutional guidelines are not frequently used, and that psychological factors are a common reason for ordering an unnecessary CT.

A review identifies and classifies reasons for ordering diagnostic tests

OBJECTIVE: To consider the reasons and context for test ordering by doctors when faced with an undiagnosed complaint in primary or secondary care. STUDY DESIGN AND SETTING: We reviewed any study of any design that discussed factors that may affect a doctor's decision to order a test. Articles were located through searches of electronic databases, authors' files on diagnostic methodology, and reference lists of relevant studies. We extracted data on: study design, type of analysis, setting, topic area, and any factors reported to influence test ordering. RESULTS: We included 37 studies. We carried out a thematic analysis to synthesize data. Five key groupings arose from this process: diagnostic factors, therapeutic and prognostic factors, patient-related factors, doctor-related factors, and policy and organization-related factors. To illustrate how the various factors identified may influence test ordering we considered the symptom low back pain and the diagnosis multiple sclerosis as examples. CONCLUSIONS: A wide variety of factors influence a doctor's decision to order a test. These are integral to understanding diagnosis in clinical practice. Traditional diagnostic accuracy studies should be supplemented with research into the broader context in which doctors perform their work.

Overthrowing the Tyranny of Alphabetical Ordering in Documentation Systems

Software developers are often unsure of the exact name of the API method they need to use to invoke the desired behavior. Most state-of-the-art documentation browsers present API artefacts in alphabetical order. Albeit easy to implement, alphabetical order does not help much: if the developer knew the name of the required method, he could have just searched for it in the first place. In a context where multiple projects use the same API, and their source code is available, we can improve the API presentation by organizing the elements in the order in which they are more likely to be used by the developer. Usage frequency data for methods is gathered by analyzing other projects from the same ecosystem and this data is used then to improve tools. We present a preliminary study on the potential of this approach to improve the API presentation by reducing the time it takes to find the method that implements a given feature. We also briefly present our experience with two proof-of-concept tools implemented for Smalltalk and Java.