Significance of the Philosophy of Family-Centered Care in the

The philosophy of family-centered care is “an approach to the planning, delivery, and evaluation of healthcare that is grounded in mutually beneficial partnerships among patients, families and healthcare practitioners” (Children’s Hospital of Philadelphia, 1996-2008). The word “family” refers to “two or more persons who are related in any way-biologically, legally, or emotionally” (Institute for Family-Centered Care). It is patients and families, who define those included in their families, which usually in pediatrics includes parents or guardians.

Patient-centered medical home technology effects on hypertension and diabetes control

Background: Hypertension and Diabetes is a public health and economic concern in the United States. The utilization of medical home concepts increases the receipt of preventive services, however, do they also increase adherence to treatments? This study examined the effect of patient-centered medical home technologies such as the electronic health record, clinical support system, and web-based care management in improving health outcomes related to hypertension and diabetes. Methods: A systematic review of the literature used a best evidence synthesis approach to address the general question " Do patient-centered medical home technologies have an effect of diabetes and hypertension treatment?" This was followed by an evaluation of specific examples of the technologies utilized such as computer-assisted recommendations and web-based care management provided by the patient's electronic health record. Ebsco host, Ovid host, and Google Scholar were the databases used to conduct the literature search. Results: The initial search identified over 25 studies based on content and quality that implemented technology interventions to improve communication between provider and patient. After further assessing the articles for risk of bias and study design, 13 randomized controlled studies were chosen. All of the studies chosen were conducted in various primary care settings in both private practices and hospitals between the years 2000 and 2007. The sample sizes of the studies ranged from 42 to 2924 participants. The mean age for all of the studies ranged from 56 to 71 years. The percent women in the studies ranged from one to 78 percent. Over one-third of the studies did not provide the racial composition of the participants. For the seven studies that did provide information about the ethnic composition, 64% of the intervention participants were White. All of the studies utilized some type of web-based or computer-based communication to manage hypertension or diabetes care. Findings on outcomes were mixed, with nine out of 13 studies showing no significant effect on outcomes examined, and four of the studies showing significant and positive impact on health outcomes related to hypertension or diabetes Conclusion: Although the technologies improved patient and provider satisfaction, the outcomes measures such as blood pressure control and glucose control were inconclusive. Further research is needed with diverse ethnic and SES population to investigate the role of patient-centered technologies on hypertension and diabetes control. Also, further research is needed to investigate the effects of innovative medical home technologies that can be used by both patients and providers to increase quality of communication concerning adherence to treatments.^

Formalizing a Conceptual Framework of Work Domain Knowledge

Background: The failure rate of health information systems is high, partially due to fragmented, incomplete, or incorrect identification and description of specific and critical domain requirements. In order to systematically transform the requirements of work into real information system, an explicit conceptual framework is essential to summarize the work requirements and guide system design. Recently, Butler, Zhang, and colleagues proposed a conceptual framework called Work Domain Ontology (WDO) to formally represent users’ work. This WDO approach has been successfully demonstrated in a real world design project on aircraft scheduling. However, as a top level conceptual framework, this WDO has not defined an explicit and well specified schema (WDOS) , and it does not have a generalizable and operationalized procedure that can be easily applied to develop WDO. Moreover, WDO has not been developed for any concrete healthcare domain. These limitations hinder the utility of WDO in real world information system in general and in health information system in particular. Objective: The objective of this research is to formalize the WDOS, operationalize a procedure to develop WDO, and evaluate WDO approach using Self-Nutrition Management (SNM) work domain. Method: Concept analysis was implemented to formalize WDOS. Focus group interview was conducted to capture concepts in SNM work domain. Ontology engineering methods were adopted to model SNM WDO. Part of the concepts under the primary goal “staying healthy” for SNM were selected and transformed into a semi-structured survey to evaluate the acceptance, explicitness, completeness, consistency, experience dependency of SNM WDO. Result: Four concepts, “goal, operation, object and constraint”, were identified and formally modeled in WDOS with definitions and attributes. 72 SNM WDO concepts under primary goal were selected and transformed into semi-structured survey questions. The evaluation indicated that the major concepts of SNM WDO were accepted by 41 overweight subjects. SNM WDO is generally independent of user domain experience but partially dependent on SNM application experience. 23 of 41 paired concepts had significant correlations. Two concepts were identified as ambiguous concepts. 8 extra concepts were recommended towards the completeness of SNM WDO. Conclusion: The preliminary WDOS is ready with an operationalized procedure. SNM WDO has been developed to guide future SNM application design. This research is an essential step towards Work-Centered Design (WCD).

Code and readme of a MATLAB-based graphical user interface program for computing functionals of the geopotential

We present a novel graphical user interface program GrafLab (GRAvity Field LABoratory) for spherical harmonic synthesis (SHS) created in MATLAB®. This program allows to comfortably compute 38 various functionals of the geopotential up to ultra-high degrees and orders of spherical harmonic expansion. For the most difficult part of the SHS, namely the evaluation of the fully normalized associated Legendre functions (fnALFs), we used three different approaches according to required maximum degree: (i) the standard forward column method (up to maximum degree 1800, in some cases up to degree 2190); (ii) the modified forward column method combined with Horner's scheme (up to maximum degree 2700); (iii) the extended-range arithmetic (up to an arbitrary maximum degree). For the maximum degree 2190, the SHS with fnALFs evaluated using the extended-range arithmetic approach takes only approximately 2-3 times longer than its standard arithmetic counterpart, i.e. the standard forward column method. In the GrafLab, the functionals of the geopotential can be evaluated on a regular grid or point-wise, while the input coordinates can either be read from a data file or entered manually. For the computation on a regular grid we decided to apply the lumped coefficients approach due to significant time-efficiency of this method. Furthermore, if a full variance-covariance matrix of spherical harmonic coefficients is available, it is possible to compute the commission errors of the functionals. When computing on a regular grid, the output functionals or their commission errors may be depicted on a map using automatically selected cartographic projection.

Deforesting Europe: pollen-inferred Holocene land cover change using the 'pseudobiomization' approach

Maps of continental-scale land cover are utilized by a range of diverse users but whilst a range of products exist that describe present and recent land cover in Europe, there are currently no datasets that describe past variations over long time-scales. User groups with an interest in past land cover include the climate modelling community, socio-ecological historians and earth system scientists. Europe is one of the continents with the longest histories of land conversion from forest to farmland, thus understanding land cover change in this area is globally significant. This study applies the pseudobiomization method (PBM) to 982 pollen records from across Europe, taken from the European Pollen Database (EPD) to produce a first synthesis of pan-European land cover change for the period 9000 BP to present, in contiguous 200 year time intervals. The PBM transforms pollen proportions from each site to one of eight land cover classes (LCCs) that are directly comparable to the CORINE land cover classification. The proportion of LCCs represented in each time window provides a spatially aggregated record of land cover change for temperate and northern Europe, and for a series of case study regions (western France, the western Alps, and the Czech Republic and Slovakia). At the European scale, the impact of Neolithic food producing economies appear to be detectable from 6000 BP through reduction in broad-leaf forests resulting from human land use activities such as forest clearance. Total forest cover at a pan-European scale moved outside the range of previous background variability from 4000 BP onwards. From 2200 BP land cover change intensified, and the broad pattern of land cover for preindustrial Europe was established by 1000 BP. Recognizing the timing of anthropogenic land cover change in Europe will further the understanding of land cover-climate interactions, and the origins of the modern cultural landscape.

Guidelines for Accessibility to Microblogging: an Integral Approach

Microblogging is one of the most popular user-generated media, hence its accessibility has a large impact for users. However, the accessibility of this medium is poor in practice, due to the combination of bad practices by different agents ranging from the providers that host microblogging services to prosumers that post contents to them. Here we present an accessibility-oriented model of microblogging services, analyze the impact of its components, and propose guidelines for each of them to meet accessibility requirements. In particular, we base on an study we have performed on Twitter, one of the most-relevant microblogging platform, to identify good and bad practices in microblogging content generation regarding accessibility in microblogging content generation.

A New End-User Composition Model to Empower Knowledge Workers to Develop Rich Internet Applications

Enabling real end-user programming development is the next logical stage in the evolution of Internetwide service-based applications. Even so, the vision of end users programming their own web-based solutions has not yet materialized. This will continue to be so unless both industry and the research community rise to the ambitious challenge of devising an end-to-end compositional model for developing a new age of end-user web application development tools. This paper describes a new composition model designed to empower programming-illiterate end users to create and share their own off-the-shelf rich Internet applications in a fully visual fashion. This paper presents the main insights and outcomes of our research and development efforts as part of a number of successful European Union research projects. A framework implementing this model was developed as part of the European Seventh Framework Programme FAST Project and the Spanish EzWeb Project and allowed us to validate the rationale behind our approach.

End-User Development Success Factors and their Application to Composite Web Development Environments

The Future Internet is expected to be composed of a mesh of interoperable Web services accessed from all over the Web. This approach has not yet caught on since global user-service interaction is still an open issue. Successful composite applications rely on heavyweight service orchestration technologies that raise the bar far above end-user skills. The weakness lies in the abstraction of the underlying service front-end architecture rather than the infrastructure technologies themselves. In our opinion, the best approach is to offer end-to-end composition from user interface to service invocation, as well as an understandable abstraction of both building blocks and a visual composition technique. In this paper we formalize our vision with regard to the next-generation front-end Web technology that will enable integrated access to services, contents and things in the Future Internet. We present a novel reference architecture designed to empower non-technical end users to create and share their own self-service composite applications. A tool implementing this architecture has been developed as part of the European FP7 FAST Project and EzWeb Project, allowing us to validate the rationale behind our approach.

Using the Journalistic Metaphor to Design User Interfaces That Explain Sensor Data

Facilitating general access to data from sensor networks (including traffic, hydrology and other domains) increases their utility. In this paper we argue that the journalistic metaphor can be effectively used to automatically generate multimedia presentations that help non-expert users analyze and understand sensor data. The journalistic layout and style are familiar to most users. Furthermore, the journalistic approach of ordering information from most general to most specific helps users obtain a high-level understanding while providing them the freedom to choose the depth of analysis to which they want to go. We describe the general characteristics and architectural requirements for an interactive intelligent user interface for exploring sensor data that uses the journalistic metaphor. We also describe our experience in developing this interface in real-world domains (e.g., hydrology).

Evaluation of a User-Adapted Spoken Language Dialogue System: Measuring the Relevance of the Contextual Information Sources

We present an evaluation of a spoken language dialogue system with a module for the management of userrelated information, stored as user preferences and privileges. The flexibility of our dialogue management approach, based on Bayesian Networks (BN), together with a contextual information module, which performs different strategies for handling such information, allows us to include user information as a new level into the Context Manager hierarchy. We propose a set of objective and subjective metrics to measure the relevance of the different contextual information sources. The analysis of our evaluation scenarios shows that the relevance of the short-term information (i.e. the system status) remains pretty stable throughout the dialogue, whereas the dialogue history and the user profile (i.e. the middle-term and the long-term information, respectively) play a complementary role, evolving their usefulness as the dialogue evolves.

Dense Map Inference with User-Defined Priors: From Priorlets to Scan Eigenvariations

When mapping is formulated in a Bayesian framework, the need of specifying a prior for the environment arises naturally. However, so far, the use of a particular structure prior has been coupled to working with a particular representation. We describe a system that supports inference with multiple priors while keeping the same dense representation. The priors are rigorously described by the user in a domain-specific language. Even though we work very close to the measurement space, we are able to represent structure constraints with the same expressivity as methods based on geometric primitives. This approach allows the intrinsic degrees of freedom of the environment’s shape to be recovered. Experiments with simulated and real data sets will be presented

User-definable resource bounds analysis for logic programs

We present a static analysis that infers both upper and lower bounds on the usage that a logic program makes of a set of user-definable resources. The inferred bounds will in general be functions of input data sizes. A resource in our approach is a quite general, user-defined notion which associates a basic cost function with elementary operations. The analysis then derives the related (upper- and lower-bound) resource usage functions for all predicates in the program. We also present an assertion language which is used to define both such resources and resourcerelated properties that the system can then check based on the results of the analysis. We have performed some preliminary experiments with some concrete resources such as execution steps, bytes sent or received by an application, number of files left open, number of accesses to a datábase, number of calis to a procedure, number of asserts/retracts, etc. Applications of our analysis include resource consumption verification and debugging (including for mobile code), resource control in parallel/distributed computing, and resource-oriented specialization.

User-definable resource usage bounds analysis for java bytecode

Automatic cost analysis of programs has been traditionally concentrated on a reduced number of resources such as execution steps, time, or memory. However, the increasing relevance of analysis applications such as static debugging and/or certiflcation of user-level properties (including for mobile code) makes it interesting to develop analyses for resource notions that are actually application-dependent. This may include, for example, bytes sent or received by an application, number of files left open, number of SMSs sent or received, number of accesses to a datábase, money spent, energy consumption, etc. We present a fully automated analysis for inferring upper bounds on the usage that a Java bytecode program makes of a set of application programmer-deflnable resources. In our context, a resource is defined by programmer-provided annotations which state the basic consumption that certain program elements make of that resource. From these deflnitions our analysis derives functions which return an upper bound on the usage that the whole program (and individual blocks) make of that resource for any given set of input data sizes. The analysis proposed is independent of the particular resource. We also present some experimental results from a prototype implementation of the approach covering a signiflcant set of interesting resources.

A simple approach to distributed objects in prolog

We present the design of a distributed object system for Prolog, based on adding remote execution and distribution capabilities to a previously existing object system. Remote execution brings RPC into a Prolog system, and its semantics is easy to express in terms of well-known Prolog builtins. The final distributed object design features state mobility and user-transparent network behavior. We sketch an implementation which provides distributed garbage collection and some degree of tolerance to network failures. We provide a preliminary study of the overhead of the communication mechanism for some test cases.

A Keyword-driven approach for generating OWL DL conformance test data

The conformance of semantic technologies has to be systematically evaluated to measure and verify the real adherence of these technologies to the Semantic Web standards. Currente valuations of semantic technology conformance are not exhaustive enough and do not directly cover user requirements and use scenarios, which raises the need for a simple, extensible and parameterizable method to generate test data for such evaluations. To address this need, this paper presents a keyword-driven approach for generating ontology language conformance test data that can be used to evaluate semantic technologies, details the definition of a test suite for evaluating OWL DL conformance using this approach,and describes the use and extension of this test suite during the evaluation of some tools.