What do patients want to know? An empirical approach to explanation generation and validation

This article describes an empirical, user-centred approach to explanation design. It reports three studies that investigate what patients want to know when they have been prescribed medication. The question is asked in the context of the development of a drug prescription system called OPADE. The system is aimed primarily at improving the prescribing behaviour of physicians, but will also produce written explanations for indirect users such as patients. In the first study, a large number of people were presented with a scenario about a visit to the doctor, and were asked to list the questions that they would like to ask the doctor about the prescription. On the basis of the results of the study, a categorization of question types was developed in terms of how frequently particular questions were asked. In the second and third studies a number of different explanations were generated in accordance with this categorization, and a new sample of people were presented with another scenario and were asked to rate the explanations on a number of dimensions. The results showed significant differences between the different explanations. People preferred explanations that included items corresponding to frequently asked questions in study 1. For an explanation to be considered useful, it had to include information about side effects, what the medication does, and any lifestyle changes involved. The implications of the results of the three studies are discussed in terms of the development of OPADE's explanation facility.

Modeling the user knowledge by belief networks

This paper describes the user modeling component of EPIAIM, a consultation system for data analysis in epidemiology. The component is aimed at representing knowledge of concepts in the domain, so that their explanations can be adapted to user needs. The first part of the paper describes two studies aimed at analysing user requirements. The first one is a questionnaire study which examines the respondents' familiarity with concepts. The second one is an analysis of concept descriptions in textbooks and from expert epidemiologists, which examines how discourse strategies are tailored to the level of experience of the expected audience. The second part of the paper describes how the results of these studies have been used to design the user modeling component of EPIAIM. This module works in a two-step approach. In the first step, a few trigger questions allow the activation of a stereotype that includes a "body" and an "inference component". The body is the representation of the body of knowledge that a class of users is expected to know, along with the probability that the knowledge is known. In the inference component, the learning process of concepts is represented as a belief network. Hence, in the second step the belief network is used to refine the initial default information in the stereotype's body. This is done by asking a few questions on those concepts where it is uncertain whether or not they are known to the user, and propagating this new evidence to revise the whole situation. The system has been implemented on a workstation under UNIX. An example of functioning is presented, and advantages and limitations of the approach are discussed.

User interface standards for expert systems: are they appropriate?

In recent years there has been a growing debate over whether or not standards should be produced for user system interfaces. Those in favor of standardization argue that standards in this area will result in more usable systems, while those against argue that standardization is neither practical nor desirable. The present paper reviews both sides of this debate in relation to expert systems. It argues that in many areas guidelines are more appropriate than standards for user interface design.

Active networks: an evolution of the internet

Active Networks can be seen as an evolution of the classical model of packet-switched networks. The traditional and ”passive” network model is based on a static definition of the network node behaviour. Active Networks propose an “active” model where the intermediate nodes (switches and routers) can load and execute user code contained in the data units (packets). Active Networks are a programmable network model, where bandwidth and computation are both considered shared network resources. This approach opens up new interesting research fields. This paper gives a short introduction of Active Networks, discusses the advantages they introduce and presents the research advances in this field.

A randomised controlled trial of cognitive behaviour therapy for psychosis in a routine clinical service

Objective: To evaluate CBTp delivered by non-expert therapists, using CBT relevant measures. Methods: Participants (N=74) were randomised into immediate therapy or waiting list control groups. The therapy group was offered six months of therapy and followed up three months later. The waiting list group received therapy after waiting nine months (becoming the delayed therapy group). Results: Depression improved in the combined therapy group at both the end of therapy and follow-up. Other significant effects were found in only one of the two therapy groups (positive symptoms; cognitive flexibility; uncontrollability of thoughts) or one of the two timepoints (end of therapy: PANSS general symptoms, anxiety, suicidal ideation, social functioning, resistance to voices; follow-up: power beliefs about voices, negative symptoms). There was no difference in costs between the groups. Conclusions: The only robust improvement was in depression. Nevertheless, there were further encouraging but modest improvements in both emotional and cognitive variables, in addition to psychotic symptoms.

The soil-dwelling earthworm Allolobophora chlorotica modifies its burrowing behaviour in response to carbendazim applications

Carbendazim-amended soil was placed above or below unamended soil. Control tests comprised two layers of unamended soil. Allolobophora chlorotica earthworms were added to either the upper or the unamended soil. After 72 h vertical distributions of earthworms were compared between control and carbendazim-amended experiments. Earthworm distributions in the carbendazim-amended test containers differed significantly from the ‘normal’ distribution observed in the control tests. In the majority of the experiments, earthworms significantly altered their burrowing behaviour to avoid carbendazim. However, when earthworms were added to an upper layer of carbendazim-amended soil they remained in this layer. This non-avoidance is attributed to (1) the earthworms’ inability to sense the lower layer of unamended soil and (2) the toxic effect of carbendazim inhibiting burrowing. Earthworms modified their burrowing behaviour in response to carbendazim in the soil. This may explain anomalous results observed in pesticide field trials when carbendazim is used as a control substance.

The effect of incremental replacement of wheat with soya hulls in diets for Jersey cows on lactational performance, diet digestibility and feeding behaviour

Eight Jersey cows were used in two balanced 4 x 4 Latin Squares to investigate the effects of replacement of dietary starch with non-forage fibre on productivity, diet digestibility and feeding behaviour. Total-mixed rations consisted of maize silage, grass silage and a soyabean meal-based concentrate mixture, each at 250g/kg DM, with the remaining 250g consisting of cracked wheat/soya hulls (SH) in the ratios of 250:0, 167:83; 83:167 and 0:250 g, respectively, for treatments SH0, SH83, SH167 and SH250. Starch concentrations were 302, 248, 193 and 140g/kg DM, and NDF concentrations were 316, 355, 394 and 434g/kg DM, for treatments SHO, SH83, SH167 and SH250, respectively. Total eating time increased (p < 0.05) as SH inclusion increased, but total rumination time was unaffected. Digestibility of DM, organic matter and starch declined (p < 0.01) as SH inclusion increased, whilst digestibility of NDF and ADF increased (p < 0.01). Dry-matter intake tended to decline with increasing SH, whilst bodyweight, milk yield and fat and lactose concentrations were unaffected by treatment. Milk protein concentration decreased (p < 0.01) as SH level increased. Feed conversion efficiency improved (p < 0.05) as SH inclusion rose, but it was not possible to determine whether this was due to the increased fibre levels alone, or the favourable effect on rumen fermentation of decreasing starch levels. (c) 2006 Elsevier B.V. All rights reserved.