990 resultados para medical uncertainty
Resumo:
This paper presents a graph-based method to weight medical concepts in documents for the purposes of information retrieval. Medical concepts are extracted from free-text documents using a state-of-the-art technique that maps n-grams to concepts from the SNOMED CT medical ontology. In our graph-based concept representation, concepts are vertices in a graph built from a document, edges represent associations between concepts. This representation naturally captures dependencies between concepts, an important requirement for interpreting medical text, and a feature lacking in bag-of-words representations. We apply existing graph-based term weighting methods to weight medical concepts. Using concepts rather than terms addresses vocabulary mismatch as well as encapsulates terms belonging to a single medical entity into a single concept. In addition, we further extend previous graph-based approaches by injecting domain knowledge that estimates the importance of a concept within the global medical domain. Retrieval experiments on the TREC Medical Records collection show our method outperforms both term and concept baselines. More generally, this work provides a means of integrating background knowledge contained in medical ontologies into data-driven information retrieval approaches.
Resumo:
Reliable pollutant build-up prediction plays a critical role in the accuracy of urban stormwater quality modelling outcomes. However, water quality data collection is resource demanding compared to streamflow data monitoring, where a greater quantity of data is generally available. Consequently, available water quality data sets span only relatively short time scales unlike water quantity data. Therefore, the ability to take due consideration of the variability associated with pollutant processes and natural phenomena is constrained. This in turn gives rise to uncertainty in the modelling outcomes as research has shown that pollutant loadings on catchment surfaces and rainfall within an area can vary considerably over space and time scales. Therefore, the assessment of model uncertainty is an essential element of informed decision making in urban stormwater management. This paper presents the application of a range of regression approaches such as ordinary least squares regression, weighted least squares Regression and Bayesian Weighted Least Squares Regression for the estimation of uncertainty associated with pollutant build-up prediction using limited data sets. The study outcomes confirmed that the use of ordinary least squares regression with fixed model inputs and limited observational data may not provide realistic estimates. The stochastic nature of the dependent and independent variables need to be taken into consideration in pollutant build-up prediction. It was found that the use of the Bayesian approach along with the Monte Carlo simulation technique provides a powerful tool, which attempts to make the best use of the available knowledge in the prediction and thereby presents a practical solution to counteract the limitations which are otherwise imposed on water quality modelling.
Resumo:
This volume puts together the works of a group of distinguished scholars and active researchers in the field of media and communication studies to reflect upon the past, present, and future of new media research. The chapters examine the implications of new media technologies on everyday life, existing social institutions, and the society at large at various levels of analysis. Macro-level analyses of changing techno-social formation – such as discussions of the rise of surveillance society and the "fifth estate" – are combined with studies on concrete and specific new media phenomena, such as the rise of Pro-Am collaboration and "fan labor" online. In the process, prominent concepts in the field of new media studies, such as social capital, displacement, and convergence, are critically examined, while new theoretical perspectives are proposed and explicated. Reflecting the inter-disciplinary nature of the field of new media studies and communication research in general, the chapters interrogate into the problematic through a range of theoretical and methodological approaches. The book should offer students and researchers who are interested in the social impact of new media both critical reviews of the existing literature and inspirations for developing new research questions.
Resumo:
Objective: To determine the prevalence, severity, location, etiology, treatment, and healing of medical device-related pressure ulcers in intensive care patients for up to 7 days. Design: Prospective repeated measures study. Setting and participants: Patients in 6 intensive care units of 2 major medical centers, one each in Australia and the United States, were screened 1 day per month for 6 months. Those with device-related ulcers were followed daily up to 7 days. Outcome measures: Device-related ulcer prevalence, pain, infection, treatment, healing. Results: 15/483 patients had device-related ulcers and 9/15 with 11 ulcers were followed beyond screening. Their mean age was 60.5 years, most were men, over-weight, and at increased pressure ulcer risk. Endotracheal and nasogastric tubes were the cause of most device-related ulcers. Repositioning was the most frequent treatment. 4/11 ulcers healed within the 7 day observation period. Conclusion: Device-related ulcer prevalence was 3.1%, similar to that reported in the limited literature available, indicating an ongoing problem. Systematic assessment and repositioning of devices are the mainstays of care. We recommend continued prevalence determination and that nurses remain vigilant to prevent device-related ulcers, especially in patients with nasogastric and endotracheal tubes.
Resumo:
The ultimate goal of an access control system is to allocate each user the precise level of access they need to complete their job - no more and no less. This proves to be challenging in an organisational setting. On one hand employees need enough access to the organisation’s resources in order to perform their jobs and on the other hand more access will bring about an increasing risk of misuse - either intentionally, where an employee uses the access for personal benefit, or unintentionally, through carelessness or being socially engineered to give access to an adversary. This thesis investigates issues of existing approaches to access control in allocating optimal level of access to users and proposes solutions in the form of new access control models. These issues are most evident when uncertainty surrounding users’ access needs, incentive to misuse and accountability are considered, hence the title of the thesis. We first analyse access control in environments where the administrator is unable to identify the users who may need access to resources. To resolve this uncertainty an administrative model with delegation support is proposed. Further, a detailed technical enforcement mechanism is introduced to ensure delegated resources cannot be misused. Then we explicitly consider that users are self-interested and capable of misusing resources if they choose to. We propose a novel game theoretic access control model to reason about and influence the factors that may affect users’ incentive to misuse. Next we study access control in environments where neither users’ access needs can be predicted nor they can be held accountable for misuse. It is shown that by allocating budget to users, a virtual currency through which they can pay for the resources they deem necessary, the need for a precise pre-allocation of permissions can be relaxed. The budget also imposes an upper-bound on users’ ability to misuse. A generalised budget allocation function is proposed and it is shown that given the context information the optimal level of budget for users can always be numerically determined. Finally, Role Based Access Control (RBAC) model is analysed under the explicit assumption of administrators’ uncertainty about self-interested users’ access needs and their incentives to misuse. A novel Budget-oriented Role Based Access Control (B-RBAC) model is proposed. The new model introduces the notion of users’ behaviour into RBAC and provides means to influence users’ incentives. It is shown how RBAC policy can be used to individualise the cost of access to resources and also to determine users’ budget. The implementation overheads of B-RBAC is examined and several low-cost sub-models are proposed.
Resumo:
This paper draws upon the current situation within Japanese Higher Education. In particular the paper focuses on educational reforms and how they relate to the notions of Yutori Kyoiku which constituted a major attempt by Japanese education to develop individual student capacity. A clear subtext of the recent neo-liberal reform agenda is a desire to incorporated free-market ideals into the Japanese educational system. This paper raises several important problems connected to the reforms such as the decrease in classroom hours, changes to the contents of textbooks and a growing discrepancy in academic skills between students in different localities. These education reforms have impacted on notions of Yutori Kyoiku through the continuation of nationally standardized testing and changes directed at controlling the practices of classroom teachers. While acknowledging the current Japanese cabinet’s (DP) education policy has been inherited from an earlier LDP government, the paper points to similarities between the current reforms and the iconic Meiji era reforms of the late 1800s.
Resumo:
Measures of semantic similarity between medical concepts are central to a number of techniques in medical informatics, including query expansion in medical information retrieval. Previous work has mainly considered thesaurus-based path measures of semantic similarity and has not compared different corpus-driven approaches in depth. We evaluate the effectiveness of eight common corpus-driven measures in capturing semantic relatedness and compare these against human judged concept pairs assessed by medical professionals. Our results show that certain corpus-driven measures correlate strongly (approx 0.8) with human judgements. An important finding is that performance was significantly affected by the choice of corpus used in priming the measure, i.e., used as evidence from which corpus-driven similarities are drawn. This paper provides guidelines for the implementation of semantic similarity measures for medical informatics and concludes with implications for medical information retrieval.
Resumo:
This qualitative study of women with non-insulin dependent diabetes mellitus (NIDDM) examined constructions of their diabetes management and socio-familial relationships as potential sources of support. Semi-structured interview data was collected from 16 women. The transcripts were analysed with the aim of examining the ways in which Sender relations structured women's accounts of health-related behaviours. Women talked about themselves as wives, mothers, being pregnant and parenting, and friends of other women in ways that demonstrated how caring for others impeded their capacity to care for themselves. Meeting the food preferences of husbands and dietary requirements of diabetic husbands were dominant themes in women's accounts of marriage, and in various ways women justified their husbands' lack of support. Furthermore, the care of others during pregnancy and parenting was also an obstacle to women caring for themselves. An awareness of the gender politics inherent within social and family contexts is crucial to improving the effectiveness of medical advice for diabetes management.
Resumo:
Objective: To explore the range of meanings about the role of support for patients with hepatitis C by examining medical specialists' perceptions. Method: The study employed a qualitative, open-ended interview design and was conducted in four major teaching hospitals in Adelaide, South Australia. Eight participants (three infectious disease physicians, four gastroenterologists, one hepatologist), selected through purposive sampling, were interviewed about general patient support, their role in support provision, the role of non-medical support and their reasons for not using support services. Results: Main themes included a focus on support as information provision and that patient education is best carried out by a medical specialist. The use of support services was defined as the patient's decision. Participants identified four key periods when patients would benefit from support; during diagnosis, failure to meet treatment criteria, during interferon treatment and following treatment failure. Conclusions: It was concluded that while barriers exist to the establishment of partnerships between specialists and other support services, this study has identified clear points at which future partnerships could be established. Implications: A partnership approach to developing support for patients with hepatitis C offers a systematic framework to facilitate the participation of health professionals and the community in an important area of public health.
Resumo:
New venture growth is a central topic in entrepreneurship research. Although sales growth is emerging as the most commonly used measure of growth for emerging ventures, employment growth has also been used frequently. However, empirical research demonstrates that there are only very low to moderately sized correlations between the two (Delmar et aL, 2003; Weinzimmer, et al., 1998). In addition) sales growth and employment growth respond differently to a wide variety of criteria (Baum et al., 2001; Delmar et al., 2003). In this study we use transaction cost economics (Williamson, 1996) as a theoretical base to examine transaction cost influences on the addition of new employees as emerging ventures experience sales growth. \\le theorize that transaction cost economics variables will moderate the relationship between sales growth and employment growth. W'e develop and test hypotheses related to asset specificity, behavioral uncertainty, and the influence of resource munificence on the strength of the sales growth/ employment growth relationship. Asset specificity is theorized to be a positive moderator of the relationship between sales growth and employment growth. When the behavioral uncertainty associated with adding new employees is greater than that of outsourcing or subcontracting, it is hypothesized to be a negative moderator of the sales growth/employment growth relationship. We also hypothesize that resource scarcity will strengthen those relationships.
Resumo:
Morris' (1986) analysis of the factors affecting project success and failure is considered in relation to the psychology of judgement under uncertainty. A model is proposed whereby project managers may identify the specific circumstances in which human decision-making is prone to systematic error, and hence may apply a number of de-biasing techniques.
Resumo:
Meanings and descriptions of menopause have shifted focus over the past century and a half; more particularly the past sixty years has seen a shift from descriptions of hormone decline and its relation to ageing, femininity and symptoms of menopause since the 1960's to the possibility for preventive medicine afforded by menopause. Medicine is not a static field in its construction of menopause. It has changed, not least by its engagement (positively or negatively) with critique from both within (epidemiological) and without (feminist and social sciences). In this review we identify three recent changes: (1) Increasing concern with women's decision-making. (2) The emergence from within medicine of the rejection of the use of language which defines menopause as a condition of deficiency. (3) New insights from postmodern and poststructural analyses of menopause that examine the epistemological foundations of medical and feminist concepts of menopause and contest fixed descriptions of the experience of menopause. Key aspects of a ‘medical menopause’ nevertheless remain constant: menopause is a loss of hormones that results in predictable effects and risks and may be ameliorated by hormone replacement therapy. A question therefore emerges about how and to what effect medical practitioners have engaged with critiques of the medical menopause?
Resumo:
The construction of menopause as a long-term risk to health and the adoption of discourses of prevention has made necessary a decision by women about medical treatment; specifically regarding the use of hormone replacement therapy. In a study of general practitioners’ accounts of menopause and treatment in Australia, women's ‘choice’, ‘informed decision-making’ and ‘empowerment’ were key themes through which primary medical care for women at menopause was presented. These accounts create a position for women defined by the concept of individual choice and an ethic of autonomy. These data are a basis for theorising more generally in this paper. We critically examine the construct of ‘informed decision-making’ in relation to several approaches to ethics including bioethics and a range of feminist ethics. We identify the intensification of power relations produced by an ethic of autonomy and discuss the ways these considerations inform a feminist ethics of decision-making by women. We argue that an ‘ethic of autonomy’ and an ‘offer of choice’ in relation to health care for women at menopause, far from being emancipatory, serves to intensify power relations. The dichotomy of choice, to take or not to take hormone replacement therapy, is required to be a choice and is embedded in relations of power and bioethical discourse that construct meanings about what constitutes decision-making at menopause. The deployment of the principle of autonomy in medical practice limits decision-making by women precisely because it is detached from the construction of meaning and the self and makes invisible the relations of power of which it is a part.