Meeting the Housing and Service Needs of Seniors Act of 2005 : report (to accompany S. 705) (including cost estimate of the Congressional Budget Office).

"November 15, 2005."

Modelling the population cost-effectiveness of current and evidence-based optimal treatment for anxiety disorders

Background. The present paper describes a component of a large Population cost-effectiveness study that aimed to identify the averted burden and economic efficiency of current and optimal treatment for the major mental disorders. This paper reports on the findings for the anxiety disorders (panic disorder/agoraphobia, social phobia, generalized anxiety disorder, post-traumatic stress disorder and obsessive-compulsive disorder). Method. Outcome was calculated as averted 'years lived with disability' (YLD), a population summary measure of disability burden. Costs were the direct health care costs in 1997-8 Australian dollars. The cost per YLD averted (efficiency) was calculated for those already in contact with the health system for a mental health problem (current care) and for a hypothetical optimal care package of evidence-based treatment for this same group. Data sources included the Australian National Survey of Mental Health and Well-being and published treatment effects and unit costs. Results. Current coverage was around 40% for most disorders with the exception of social phobia at 21%. Receipt of interventions consistent with evidence-based care ranged from 32% of those in contact with services for social phobia to 64% for post-traumatic stress disorder. The cost of this care was estimated at $400 million, resulting in a cost per YLD averted ranging from $7761 for generalized anxiety disorder to $34 389 for panic/agoraphobia. Under optimal care, costs remained similar but health gains were increased substantially, reducing the cost per YLD to < $20 000 for all disorders. Conclusions. Evidence-based care for anxiety disorders would produce greater population health gain at a similar cost to that of current care, resulting in a substantial increase in the cost-effectiveness of treatment.

Applying ontologies to business and systems modelling techniques and perspectives: Lessons learned

For many years in the area of business systems analysis and design, practitioners and researchers alike have been searching for some comprehensive basis on which to evaluate, compare, and engineer techniques that are promoted for use in the modelling of systems' requirements. To date, while many frameworks, factors, and facets have been forthcoming, none appear to be based on a sound theory. In light of this dilemma, over the last 10 years, attention has been devoted by researchers to the use of ontology to provide some theoretical basis for the advancement of the business systems modelling discipline. This paper outlines how we have used a particular ontology for this purpose over the last five years. In particular we have learned that the understandability and the applicability of the selected ontology must be clear for IS professionals, the results of any ontological evaluation must be tempered by economic efficiency considerations of the stakeholders involved, and ontologies may have to be focused for the business purpose and type of user involved in the modelling situation.

Web-based screening and brief intervention for hazardous drinking: a double-blind randomized controlled trial

Background Strong evidence exists for the efficacy of screening and brief intervention for reducing hazardous drinking. However, problems have been highlighted with respect to its implementation in health-care systems, not least of which is a reluctance of some doctors to discuss alcohol proactively with their patients. Aims To determine the efficacy of a novel web-based screening and brief intervention (e-SBI) to reduce hazardous drinking. Design A double-blind randomized controlled trial. Setting A university student health service. Participants A total of 16 7 students (17-26 years) were recruited in the reception area and completed a 3-minute web-based screen including the Alcohol Use Disorder Identifiation Test (AUDIT) questionnaire. Of these, 112 tested positive, and 104 (52 females) who consented to follow-up were included in the trial. Measurements Drinking frequency, typical occasion quantity, total volume, heavy episode frequency (females > 80 g ethanol, males > 120 g ethanol), number of personal problems, an academic problems score. Intervention Participants were randomized to 10-15 minutes of web-based assessment and personalized feedback on their drinking (intervention, n = 5 1) or to a leaflet-only control group (n = 5 3). Findings Mean baseline AUDIT scores for control and intervention groups were 16.6 (SD = 6.0) and 16.6 (SD = 5.7). At 6 weeks, participants receiving e-SBI reported significantly lower total consumption (geometric mean ratio = 0.74; 9 5 % confidence interval: 0.56-0.96), lower heavy episode frequency (0.63; 0.42-0.92) and fewer personal problems (0.70; 0.54-0.91). At 6 months personal problems remained lower (0.76; 0.60-0.97), although consumption did not differ significantly. At 6 months, academic problems were lower in the intervention group relative to controls (0.72; 0.51-1.02). Conclusions e-SBI reduced hazardous drinking among university students, to an extent similar to that found for practitioner-delivered brief interventions in the general population. e-SBI offers promise as a strategy to reduce alcohol-related harm in a way that is non-intrusive, appealing to the target group, and capable of being incorporated into primary care. Research is required to replicate the findings, to determine the duration of intervention effects, and to investigate the mechanisms by which the intervention operates.

Do process modelling techniques get better? A comparative ontological analysis of BPMN

Current initiatives in the field of Business Process Management (BPM) strive for the development of a BPM standard notation by pushing the Business Process Modeling Notation (BPMN). However, such a proposed standard notation needs to be carefully examined. Ontological analysis is an established theoretical approach to evaluating modelling techniques. This paper reports on the outcomes of an ontological analysis of BPMN and explores identified issues by reporting on interviews conducted with BPMN users in Australia. Complementing this analysis we consolidate our findings with previous ontological analyses of process modelling notations to deliver a comprehensive assessment of BPMN.

Searching the world wide web for local services and facilities: A review on the patterns of location-based queries

Many queries sent to search engines refer to specific locations in the world. Location-based queries try to find local services and facilities around the user’s environment or in a particular area. This paper reviews the specifications of geospatial queries and discusses the similarities and differences between location-based queries and other queries. We introduce nine patterns for location-based queries containing either a service name alone or a service name accompanied by a location name. Our survey indicates that at least 22% of the Web queries have a geospatial dimension and most of these can be considered as location-based queries. We propose that location-based queries should be treated different from general queries to produce more relevant results.

Superstring: A scalable service discovery protocol for the wide-area pervasive environment

Arguably, the world has become one large pervasive computing environment. Our planet is growing a digital skin of a wide array of sensors, hand-held computers, mobile phones, laptops, web services and publicly accessible web-cams. Often, these devices and services are deployed in groups, forming small communities of interacting devices. Service discovery protocols allow processes executing on each device to discover services offered by other devices within the community. These communities can be linked together to form a wide-area pervasive environment, allowing processes in one p u p tu interact with services in another. However, the costs of communication and the protocols by which this communication is mediated in the wide-area differ from those of intra-group, or local-area, communication. Communication is an expensive operation for small, battery powered devices, but it is less expensive for servem and workstations, which have a constant power supply and 81'e connected to high bandwidth networks. This paper introduces Superstring, a peer to-peer service discovery protocol optimised fur use in the wide-area. Its goals are to minimise computation and memory overhead in the face of large numbers of resources. It achieves this memory and computation scalability by distributing the storage cost of service descriptions and the computation cost of queries over multiple resolvers.

Data driven ontology evaluation

The evaluation of ontologies is vital for the growth of the Semantic Web. We consider a number of problems in evaluating a knowledge artifact like an ontology. We propose in this paper that one approach to ontology evaluation should be corpus or data driven. A corpus is the most accessible form of knowledge and its use allows a measure to be derived of the ‘fit’ between an ontology and a domain of knowledge. We consider a number of methods for measuring this ‘fit’ and propose a measure to evaluate structural fit, and a probabilistic approach to identifying the best ontology.

Background and foreground knowledge in dynamic ontology construction

Ontologies have become a key component in the Semantic Web and Knowledge management. One accepted goal is to construct ontologies from a domain specific set of texts. An ontology reflects the background knowledge used in writing and reading a text. However, a text is an act of knowledge maintenance, in that it re-enforces the background assumptions, alters links and associations in the ontology, and adds new concepts. This means that background knowledge is rarely expressed in a machine interpretable manner. When it is, it is usually in the conceptual boundaries of the domain, e.g. in textbooks or when ideas are borrowed into other domains. We argue that a partial solution to this lies in searching external resources such as specialized glossaries and the internet. We show that a random selection of concept pairs from the Gene Ontology do not occur in a relevant corpus of texts from the journal Nature. In contrast, a significant proportion can be found on the internet. Thus, we conclude that sources external to the domain corpus are necessary for the automatic construction of ontologies.

The ontology: Chimaera or Pegasus

In the context of the needs of the Semantic Web and Knowledge Management, we consider what the requirements are of ontologies. The ontology as an artifact of knowledge representation is in danger of becoming a Chimera. We present a series of facts concerning the foundations on which automated ontology construction must build. We discuss a number of different functions that an ontology seeks to fulfill, and also a wish list of ideal functions. Our objective is to stimulate discussion as to the real requirements of ontology engineering and take the view that only a selective and restricted set of requirements will enable the beast to fly.

An incremental tri-partite approach to ontology learning

In this paper we present a new approach to ontology learning. Its basis lies in a dynamic and iterative view of knowledge acquisition for ontologies. The Abraxas approach is founded on three resources, a set of texts, a set of learning patterns and a set of ontological triples, each of which must remain in equilibrium. As events occur which disturb this equilibrium various actions are triggered to re-establish a balance between the resources. Such events include acquisition of a further text from external resources such as the Web or the addition of ontological triples to the ontology. We develop the concept of a knowledge gap between the coverage of an ontology and the corpus of texts as a measure triggering actions. We present an overview of the algorithm and its functionalities.

Handling and communicating uncertainty in chained geospatial web services

Recent developments in service-oriented and distributed computing have created exciting opportunities for the integration of models in service chains to create the Model Web. This offers the potential for orchestrating web data and processing services, in complex chains; a flexible approach which exploits the increased access to products and tools, and the scalability offered by the Web. However, the uncertainty inherent in data and models must be quantified and communicated in an interoperable way, in order for its effects to be effectively assessed as errors propagate through complex automated model chains. We describe a proposed set of tools for handling, characterizing and communicating uncertainty in this context, and show how they can be used to 'uncertainty- enable' Web Services in a model chain. An example implementation is presented, which combines environmental and publicly-contributed data to produce estimates of sea-level air pressure, with estimates of uncertainty which incorporate the effects of model approximation as well as the uncertainty inherent in the observational and derived data.