Dissertations / Theses on the topic 'Clinical medicine Computer programs'
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Clark, Johanna M. "Empowerment of the Clinical Education Coordinator in the CAATE-Accredited Entry-Level Athletic Training Education Programs." Ohio University / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=ohiou1208535080.
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Gooch, P. "A modular, open-source information extraction framework for identifying clinical concepts and processes of care in clinical narratives." Thesis, City University London, 2012. http://openaccess.city.ac.uk/2112/.
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In this thesis, a synthesis is presented of the knowledge models required by clinical informa- tion systems that provide decision support for longitudinal processes of care. Qualitative research techniques and thematic analysis are novelly applied to a systematic review of the literature on the challenges in implementing such systems, leading to the development of an original conceptual framework. The thesis demonstrates how these process-oriented systems make use of a knowledge base derived from workflow models and clinical guidelines, and argues that one of the major barriers to implementation is the need to extract explicit and implicit information from diverse resources in order to construct the knowledge base. Moreover, concepts in both the knowledge base and in the electronic health record (EHR) must be mapped to a common ontological model. However, the majority of clinical guideline information remains in text form, and much of the useful clinical information residing in the EHR resides in the free text fields of progress notes and laboratory reports. In this thesis, it is shown how natural language processing and information extraction techniques provide a means to identify and formalise the knowledge components required by the knowledge base. Original contributions are made in the development of lexico-syntactic patterns and the use of external domain knowledge resources to tackle a variety of information extraction tasks in the clinical domain, such as recognition of clinical concepts, events, temporal relations, term disambiguation and abbreviation expansion. Methods are developed for adapting existing tools and resources in the biomedical domain to the processing of clinical texts, and approaches to improving the scalability of these tools are proposed and evalu- ated. These tools and techniques are then combined in the creation of a novel approach to identifying processes of care in the clinical narrative. It is demonstrated that resolution of coreferential and anaphoric relations as narratively and temporally ordered chains provides a means to extract linked narrative events and processes of care from clinical notes. Coreference performance in discharge summaries and progress notes is largely dependent on correct identification of protagonist chains (patient, clinician, family relation), pronominal resolution, and string matching that takes account of experiencer, temporal, spatial, and anatomical context; whereas for laboratory reports additional, external domain knowledge is required. The types of external knowledge and their effects on system performance are identified and evaluated. Results are compared against existing systems for solving these tasks and are found to improve on them, or to approach the performance of recently reported, state-of-the- art systems. Software artefacts developed in this research have been made available as open-source components within the General Architecture for Text Engineering framework.
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Savkov, Aleksandar Dimitrov. "Deciphering clinical text : concept recognition in primary care text notes." Thesis, University of Sussex, 2017. http://sro.sussex.ac.uk/id/eprint/68232/.
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Electronic patient records, containing data about the health and care of a patient, are a valuable source of information for longitudinal clinical studies. The General Practice Research Database (GPRD) has collected patient records from UK primary care practices since the late 1980s. These records contain both structured data (in the form of codes and numeric values) and free text notes. While the structured data have been used extensively in clinical studies, there are significant practical obstacles in extracting information from the free text notes. The main obstacles are data access restrictions, due to the presence of sensitive information, and the specific language of medical practitioners, which renders standard language processing tools ineffective. The aim of this research is to investigate approaches for computer analysis of free text notes. The research involved designing a primary care text corpus (the Harvey Corpus) annotated with syntactic chunks and clinically-relevant semantic entities, developing a statistical chunking model, and devising a novel method for applying machine learning for entity recognition based on chunk annotation. The tools produced would facilitate reliable information extraction from primary care patient records, needed for the development of clinically-related research. The three medical concept types targeted in this thesis could contribute to epidemiological studies by enhancing the detection of co-morbidities, and better analysing the descriptions of patient experiences and treatments. The main contributions of the research reported in this thesis are: guidelines for chunk and concept annotation of clinical text, an approach to maximising agreement between human annotators, the Harvey Corpus, a method for using a standard part-of-speech tagging model in clinical text chunking, and a novel approach to recognising clinically relevant medical concepts.
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Fulcher, TJ. "The development of an interlock and control system for a clinical proton therapy system." Thesis, Cape Technikon, 1995. http://hdl.handle.net/20.500.11838/1483.
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Thesis (Masters Diploma (Technology))--Cape Technikon, Cape Town, 1995The development of a 200 MeV clinical proton therapy facility at the National Accelerator Centre required an interlock and control system to supervise the delivery of radiation to a patient. The interlock and control system is responsible for ensunng that nobody enters the treatment vault during an irradiation, the extraction of the beamstop devices 'from the beam-line to allow the irradiation of the patient and the insertion of those beam-stop devices when an error condition is detected. Because of its nature, the interlock and control system should be designed so that in the event of an error condition being detected, it should fail to a safe state. This is achieved by modelling the interlock and control system with an appropriate modeling method. This thesis describes a graphical modelling method called Petri-nets, which was used to model the system, and the software developed from the model.
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Stretton, David. "The effect of governmental reimbursement policies on curriculum and programs in medical education through their impact on clinical organizations associated with colleges of medicine /." View abstract, 2005. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:3191720.
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Clamp, Susan Elizabeth. "The impact on and attitudes of society to computer-aided decision support systems in clinical medicine." Thesis, University of Leeds, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.417542.
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Curran, Mike. "Can a computer expert system aid the process of clinical decision-making in podiatry?" Thesis, University of Northampton, 2005. http://nectar.northampton.ac.uk/2688/.
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The aim of this research was to invetigate the clinical decision-making processes used in podiatry and hence to investigate if a computer expert system could be used to aid the process of clinical decision-making. This was achieved through a sequence of four empirical studies. The initial study used card sorts to investigate seven expert podiatrists’ perceptions of and attitudes toward diagnostic aids, and in particular how podiatrists viewed expert systems. The results showed that expert systems are perceived as different in kind from other diagnostic aids such as X-rays or blood tests. The second study was conducted using one expert and one novice podiatrist and used a task analysis to investigate the types of tasks and skills undertaken by a podiatrist during the diagnosis of a patient in different clinical environments. The results indicate that the work is highly schematised and involves routine tasks such as nail care and callus reduction. In clinic, podiarists perform many tasks quickly. There was little difference between the number of tasks per minute undertaken in a general clinic and the number of tasks in a specialist diabetes clinic. Considering the speed of diagnosis, it is postulated that both expert and novice podiatrists’ use of schemata, pattern matching, and tacit and implicit knowledge dominates their diagnostic activity during consultations. The third study focused on how clinical reasoning and decision-making occur during consultations with a patient. Think-aloud protocols were used to investigate the differences in the clinical reasoning process between five expert and nine novice podiatrists. The speed of diagnosis and general lack of causal assertions suggest that use of schemata and tacit knowledge dominate the diagnosis process for both experts and novices. In a general setting, the novices produced four common clinical reasoning themes. These indicate that pattern recognition is a common method of diagnosis. However, there was an increase in the number of clinical reasoning themes used by experts in a specialist setting, indicating novice—expert differences. The fourth study used laddering interviews on a mixture of twelve NHS and private podiatrists to investigate why podiatrists used certain clinical reasoning themes. A hierarchical value map was derived, showing that, at an initial response level to the laddering questions, certain values were important: the palpation of the foot, building a picture of the foot condition, and being able to use clinical reasoning frequently and immediately. The emphases on palpation and immediacy of reasoning suggest that an expert system is unlikely to serve podiatrists’ needs in clinics. This research has provided a new understanding of the clinical reasoning processes used in podiatry. A podiatrist has a very busy timeline when diagnosing a patient and predominantly uses (and values) tacit knowledge, implicit learning, and compiled skills during consultations. There is little evidence for the need or desire for an expert system in clinical podiatry practice. However, if such an expert system were to be created, then: (a) it would have to be fast and non-intrusive so it can fit into a very busy consultation timeline, (b) it would need a knowledge base that could account for diagnosis of foot and leg conditions based on pattern recognition, and (c) it might be most valuable in the form of a decision support system for professional development that included the full range of expert diagnostic themes
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Yet, Barbaros. "Bayesian networks for evidence based clinical decision support." Thesis, Queen Mary, University of London, 2013. http://qmro.qmul.ac.uk/xmlui/handle/123456789/9096.
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Evidence based medicine (EBM) is defined as the use of best available evidence for decision making, and it has been the predominant paradigm in clinical decision making for the last 20 years. EBM requires evidence from multiple sources to be combined, as published results may not be directly applicable to individual patients. For example, randomised controlled trials (RCT) often exclude patients with comorbidities, so a clinician has to combine the results of the RCT with evidence about comorbidities using his clinical knowledge of how disease, treatment and comorbidities interact with each other. Bayesian networks (BN) are well suited for assisting clinicians making evidence-based decisions as they can combine knowledge, data and other sources of evidence. The graphical structure of BN is suitable for representing knowledge about the mechanisms linking diseases, treatments and comorbidities and the strength of relations in this structure can be learned from data and published results. However, there is still a lack of techniques that systematically use knowledge, data and published results together to build BNs. This thesis advances techniques for using knowledge, data and published results to develop and refine BNs for assisting clinical decision-making. In particular, the thesis presents four novel contributions. First, it proposes a method of combining knowledge and data to build BNs that reason in a way that is consistent with knowledge and data by allowing the BN model to include variables that cannot be measured directly. Second, it proposes techniques to build BNs that provide decision support by combining the evidence from meta-analysis of published studies with clinical knowledge and data. Third, it presents an evidence framework that supplements clinical BNs by representing the description and source of medical evidence supporting each element of a BN. Fourth, it proposes a knowledge engineering method for abstracting a BN structure by showing how each abstraction operation changes knowledge encoded in the structure. These novel techniques are illustrated by a clinical case-study in trauma-care. The aim of the case-study is to provide decision support in treatment of mangled extremities by using clinical expertise, data and published evidence about the subject. The case study is done in collaboration with the trauma unit of the Royal London Hospital.
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Shadabi, Fariba. "Medical outcome prediction : a hybrid artificial neural networks approach /." Canberra, 2007. http://erl.canberra.edu.au/public/adt-AUC20070816.130444/index.html.
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Thesis (PhD) -- University of Canberra, 2007.Thesis submitted in fulfilment of the requirements of the Degree of Doctor of Philosophy in Information Sciences and Engineering, University of Canberra, January 2007. Bibliography: leaves 110-127.
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Amal, Asiri. "Saudi Arabian Students in Postgraduate Dental Programs: Investigating Factors Associated with Burnout." Scholarly Commons, 2019. https://scholarlycommons.pacific.edu/uop_etds/3641.
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Burnout related to emotional and physical study or work demands affects an individual’s performance and well being. This study focused on Saudi Arabian dental residents studying in the United States and the United Kingdom who are faced with many challenges in pursuit of a higher education degree. A survey including demographic and MBI questions was distributed to assess this population’s level of burnout. The Maslach Burnout inventory (MBI) was has been widely used in the literature to assess three components of burnout: emotional exhaustion (EE), depersonalization (DEP), and (diminished) personal accomplishment (PA). Potential predictors of burnout level, tested for statistical significance, included: (1) country (US vs UK), (2) hours of work, (3) sponsorship status, (4) marital status (5) gender and (6) prior work experience. Using multiple regression analyses, those found to predict EE included hours of work, sponsorship status, and gender. Only gender was found to predict PA. None of the variables were predictive of DEP. Moreover, after controlling for the demographic variables, the country where studying did not help account for level of burnout. Limitations of the study, implications for practice and suggestions for further research are offered in the discussion.
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Gil-Herrera, Eleazar. "Classification Models in Clinical Decision Making." Scholar Commons, 2013. http://scholarcommons.usf.edu/etd/4895.
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In this dissertation, we present a collection of manuscripts describing the development of prognostic models designed to assist clinical decision making. This work is motivated by limitations of commonly used techniques to produce accessible prognostic models with easily interpretable and clinically credible results. Such limitations hinder prognostic model widespread utilization in medical practice.
Our methodology is based on Rough Set Theory (RST) as a mathematical tool for clinical data anal- ysis. We focus on developing rule-based prognostic models for end-of life care decision making in an effort to improve the hospice referral process. The development of the prognostic models is demonstrated using a retrospective data set of 9,103 terminally ill patients containing physiological characteristics, diagnostic information and neurological function values.
We develop four RST-based prognostic models and compare them with commonly used classification techniques including logistic regression, support vector machines, random forest and decision trees in terms of characteristics related to clinical credibility such as accessibility and accuracy. RST based models show comparable accuracy with other methodologies while providing accessible models with a structure that facilitates clinical interpretation. They offer both more insight into the model process and more opportunity for the model to incorporate personal information of those making and being affected by the decision.
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Rodríguez, Loya Salvador. "A standards-based ICT framework to enable a service-oriented approach to clinical decision support." Thesis, University of Sussex, 2015. http://sro.sussex.ac.uk/id/eprint/53243/.
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This research provides evidence that standards based Clinical Decision Support (CDS) at the point of care is an essential ingredient of electronic healthcare service delivery. A Service Oriented Architecture (SOA) based solution is explored, that serves as a task management system to coordinate complex distributed and disparate IT systems, processes and resources (human and computer) to provide standards based CDS. This research offers a solution to the challenges in implementing computerised CDS such as integration with heterogeneous legacy systems. Reuse of components and services to reduce costs and save time. The benefits of a sharable CDS service that can be reused by different healthcare practitioners to provide collaborative patient care is demonstrated. This solution provides orchestration among different services by extracting data from sources like patient databases, clinical knowledge bases and evidence-based clinical guidelines (CGs) in order to facilitate multiple CDS requests coming from different healthcare settings. This architecture aims to aid users at different levels of Healthcare Delivery Organizations (HCOs) to maintain a CDS repository, along with monitoring and managing services, thus enabling transparency. The research employs the Design Science research methodology (DSRM) combined with The Open Group Architecture Framework (TOGAF), an open source group initiative for Enterprise Architecture Framework (EAF). DSRM's iterative capability addresses the rapidly evolving nature of workflows in healthcare. This SOA based solution uses standards-based open source technologies and platforms, the latest healthcare standards by HL7 and OMG, Decision Support Service (DSS) and Retrieve, Update Locate Service (RLUS) standard. Combining business process management (BPM) technologies, business rules with SOA ensures the HCO's capability to manage its processes. This architectural solution is evaluated by successfully implementing evidence based CGs at the point of care in areas such as; a) Diagnostics (Chronic Obstructive Disease), b) Urgent Referral (Lung Cancer), c) Genome testing and integration with CDS in screening (Lynch's syndrome). In addition to medical care, the CDS solution can benefit organizational processes for collaborative care delivery by connecting patients, physicians and other associated members. This framework facilitates integration of different types of CDS ideal for the different healthcare processes, enabling sharable CDS capabilities within and across organizations.
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Barkenbush, Mark Joseph 1962. "A database system for managing the clinical activity of the faculty and residents of the Department of Anesthesiology at University Medical Center." Thesis, The University of Arizona, 1987. http://hdl.handle.net/10150/276636.
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A computerized data base system for managing clinical activity of faculty and residents has been developed and tested in The Department of Anesthesiology, University Medical Center, Tucson, AZ. Using d-Base III+ and an IBM PC AT the system provides the department residents with tabulated data on a monthly and year-to-date basis, which can be easily transposed onto annual clinical activity reports required by The American Board of Anesthesiology. The system maintains a clinical activity history for the faculty, which allows for equitable work scheduling. The system also tabulates anesthesia equipment usage and problems. The system has been in operation since October, 1987 with residents and faculty receiving clinical activity reports on a monthly basis. System operation requires 10 to 12 hours of secretarial time weekly.
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Doby, Cynthia Funnye. "Awareness of Clinical Laboratory Sciences and Shortage of Clinical Laboratory Scientists in the 21st Century." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3095.
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Retiring baby boomers and the lack of interest and awareness among college students to enroll in an accredited Clinical Laboratory Science (CLS) program have created a shortage of CLS professionals in the 21st century. The U.S. Bureau of Labor Statistics predicts 18,000 CLS vacancies by 2018. However, only about 5,000 students graduate from accredited CLS programs each year. The purpose of this study was to explore students' perceptions of allied health professions and factors that influenced students and CLS professionals to select CLS as a profession. Bandura's social cognitive career theory served as the theoretical framework for this phenomenological study. Convenient purposeful sampling was used to select the 7 CLS professionals, 5 high school students, and 5 college students in the Chicago area. Participants took part in either a 30- to 60-minute group session or a 45- to 90-minute semi structured interview. Qualitative analysis included open axial coding to identify emerging patterns and themes from the transcripts. Findings revealed that the perceptions of both high school and college students' knew little about the CLS profession, and factors influencing CLS as a career choice included interests in science, health care, and family. CLS professionals indicated their interests in science and a high demand for CLS services in the workforce led them to pursue careers in the field. Implications for social change include improving professional-development programs for student awareness of allied health professions and mitigating the shortage of clinical laboratory scientists.
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Anya, Obinna. "Practice-centred e-health system design for cross-boundary clinical decision support." Thesis, University of Liverpool, 2012. http://livrepository.liverpool.ac.uk/9053/.
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The idea of cross-boundary clinical decision support has the potential to transform the design of future work environments for e-health through a connected healthcare system that allows for harnessing of information and peer opinion across geographical boundaries for better decision-making. The trouble, however, is that the use of healthcare information in decision-making usually occurs within the context of a complex structure of clinical work practices that is often shaped by a wide range of factors, including organisational culture, local work contexts, socially constructed traditions of actions, experiences and patients’ circumstances. They vary across geographical boundaries, and have remained largely unaccounted for in the design of current e-health systems. As a result, achieving the visions of e-health, particularly in relation to cross-boundary clinical decision support, requires a rethinking of key clinical and organisational processes in a manner that accommodates work practice as a fundamental part of how clinicians work and make decisions in the real-world. This thesis investigates the concept of work practice as a design requirement for cross-boundary clinical decision support systems in e-health. It is argued that the task of enabling informed decision support across geographical boundaries in e-health can be enhanced through an understanding, and a formal characterisation, of work practices in various healthcare work contexts, and a specification of how practice can be used, managed and transformed to suit various clinical problem situations and patients’ needs. This research takes a clinical practice-centred approach to inform e-health system design, and draws on the concept of work practice and cultural-historical theory in social science as well as situation awareness in order to describe the local traditions of actions that guide clinicians’ work in the real world. It contributes a coherent conceptual architecture comprising a practice-centred awareness model for cross-boundary awareness, a frame-based technique, named PracticeFrame, for formalising and representing work practice for system design, and ContextMorph, for adaptively transforming a suggestion across work boundaries to suit a user’s local work context and practices. An in-depth user-informed requirements capture was used to gain an understanding of clinical work practices for designing e-health system for cross-boundary decision support. A proof of concept prototype, named CaDHealth, which is based on the Brahms work practice modelling tool and includes a work practice visualisation model, named the practice display, was developed and used to conduct user-based evaluation. The evaluation revealed that incorporating practice-centred awareness enhances usefulness, acceptance and user adoption of e-health systems for cross-boundary clinical decision support.
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Chang, Andrew Yee. "A web accessible clinical patient information networked system." CSUSB ScholarWorks, 2006. https://scholarworks.lib.csusb.edu/etd-project/2980.
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Developed with the intention to make the patient data storage system in the clinical outpatient area more efficient, this system stores all pertinent and relevant patient data such as lab results, patient history and X-ray images. The system is accessible via the internet as well as operable over a local area network (LAN). The intended audience for this program is essentially the clinical staff (e.g., physicians, nursing staff, secretarial staff). The computer program was developed using Java Server Pages (JSP) and utilizes the Oracle 9i database.
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Schladen, Manon Maitland. "Formative Research on an Instructional Design Theory for Virtual Patients in Clinical Education: A Pressure Ulcer Prevention Clinical Reasoning Case." NSUWorks, 2015. http://nsuworks.nova.edu/gscis_etd/35.
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Despite advances in health care over the past decades, medical errors and omissions remain significant threats to patient safety and health. A large number of these mistakes are made by trainees, persons who are just beginning to build the case-based experiences that will transform them from novices to expert practitioners. Clinicians use both intuitive and deductive problem-solving skills in caring for patients and they acquire expertise in applying these skills through interaction with many and varied cases.
The contemporary heath care environment, with decreased lengths of stay for patients and reduced duty hours for trainees, makes getting optimal patient exposure difficult. Virtual patients (VPs), online, interactive patient cases, may help close the case exposure gap. Evidence has shown that VPs improve clinical reasoning skills, but no formal instructional design theory of VPs has been advanced. The goal was to conduct formative research to develop an instructional design theory of VPs to help novice clinicians cultivate clinical reasoning and diagnostic skills. The instructional design theory, goal-based scenarios (GBS), grounded in the learning theory, Case-based Reasoning, provided methods that promised to be appropriate to the goal.
An existing, two-module, multimedia VP, Matt Lane, A Pressure Ulcer Prevention Virtual Patient, was tested with 10 medical trainees to determine which methods of GBS it incorporated and which of its methods were not part of GBS. Leaners' experience of what worked and didn't work to promote learning in the VP was analyzed. The VP was found to incorporate all GBS methods and one significant method, the Life Model, that was not part of GBS. The Life Model Method involved replicating, with a high degree of fidelity, the experiences of a real patient in creating the VP scenario.
Recommendations for customization of GBS for VPs included more explicit advertisement of learning goals and leverage of Internet search engines to provide just-in-time resources to support problem-solving. Incorporation of the Life Model was also recommended along with the Simplifying Conditions Method from Elaboration Theory to manage the complexity inherent in the Life Model. The resultant, enhanced GBS theory may be particularly relevant in teaching patient-centered care.
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Singh, Jitendra, and Tracy Eisenschenk. "A Thematic Analysis of the Attitudes and Perceptions of Faculty Towards Inclusion of Interprofessional Education in Healthcare Curriculum." Digital Commons @ East Tennessee State University, 2021. https://dc.etsu.edu/ijhse/vol8/iss1/1.
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This qualitative study aimed to explore attitudes and perceptions of faculty towards inclusion of interprofessional education (IPE) in healthcare curriculum. Efforts were made to explore faculty members’ definition of IPE, significance of including IPE in content and curriculum and resources available to implement such initiatives in healthcare education programs. Further, challenges faced while including IPE in curriculum were also explored. Face to face semi structured interviews were conducted, and a six-step thematic analysis framework was utilized to analyze the collected data. Further, four dimension criteria was utilized to establish the rigor of the study. Eleven participants across undergraduate and graduate health profession programs participated in in-depth semi structured interviews. Findings suggest that faculty defined IPE through the framework of teamwork, the integration of clinical and non-clinical health-based disciplines, and as a means to foster experiential learning. Faculty identified organizational support, culture, the healthcare industry, administration, and accreditation as both resources and barriers to the successful implementation of IPE. Because there is paucity of research on IPE in clinical and non-clinical health disciplines, this research can provide practical tips to both academic administrators and faculty members.
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Piao, Zhenhui. "INTERACTIVE CLINICAL EVENT PATTERN MINING AND VISUALIZATION USING INSURANCE CLAIMS DATA." UKnowledge, 2018. https://uknowledge.uky.edu/cs_etds/70.
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With exponential growth on a daily basis, there is potentially valuable information hidden in complex electronic medical records (EMR) systems. In this thesis, several efficient data mining algorithms were explored to discover hidden knowledge in insurance claims data. The first aim was to cluster three levels of information overload(IO) groups among chronic rheumatic disease (CRD) patient groups based on their clinical events extracted from insurance claims data. The second aim was to discover hidden patterns using three renowned pattern mining algorithms: Apriori, frequent pattern growth(FP-Growth), and sequential pattern discovery using equivalence classes(SPADE). The SPADE algorithm was found to be the most efficient method for the dataset used. Finally, a prototype system named myDietPHIL was developed to manage clinical events for CRD patients’ and visualize the relationships of frequent clinical events. The system has been tested and visualization of relationships could facilitate patient education.
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Vũ, John Huân. "Software Internationalization: A Framework Validated Against Industry Requirements for Computer Science and Software Engineering Programs." DigitalCommons@CalPoly, 2010. https://digitalcommons.calpoly.edu/theses/248.
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View John Huân Vũ's thesis presentation at http://youtu.be/y3bzNmkTr-c.
In 2001, the ACM and IEEE Computing Curriculum stated that it was necessary to address "the need to develop implementation models that are international in scope and could be practiced in universities around the world." With increasing connectivity through the internet, the move towards a global economy and growing use of technology places software internationalization as a more important concern for developers. However, there has been a "clear shortage in terms of numbers of trained persons applying for entry-level positions" in this area. Eric Brechner, Director of Microsoft Development Training, suggested five new courses to add to the computer science curriculum due to the growing "gap between what college graduates in any field are taught and what they need to know to work in industry." He concludes that "globalization and accessibility should be part of any course of introductory programming," stating:
A course on globalization and accessibility is long overdue on college campuses. It is embarrassing to take graduates from a college with a diverse student population and have to teach them how to write software for a diverse set of customers. This should be part of introductory software development. Anything less is insulting to students, their family, and the peoples of the world.
There is very little research into how the subject of software internationalization should be taught to meet the major requirements of the industry. The research question of the thesis is thus, "Is there a framework for software internationalization that has been validated against industry requirements?" The answer is no. The framework "would promote communication between academia and industry ... that could serve as a common reference point in discussions." Since no such framework for software internationalization currently exists, one will be developed here. The contribution of this thesis includes a provisional framework to prepare graduates to internationalize software and a validation of the framework against industry requirements. The requirement of this framework is to provide a portable and standardized set of requirements for computer science and software engineering programs to teach future graduates.
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Wu, Mei. "Detection of aberrant events in RNA for clinical diagnostics." Thesis, Uppsala universitet, Institutionen för biologisk grundutbildning, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-448361.
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Rare diseases are estimated to affect 3.75% of the global population, which roughly translates to 300 million affected individuals. A large proportion of patients still do not have their diagnosis and current approaches such as chromosomal microarray (CMA), whole exome sequencing (WES), and whole genome sequencing (WGS) that targets DNA and the exome aims to resolve that very first step. RNA-seq serves as a powerful approach complementing the aforementioned methods that have reached a plateau in the diagnostic yield. RNA-seq can facilitate the finding of aberrant events that appear during transcription e.g., splicing, changes in gene expression and monoallelic expression. In this study, we aimed to establish RNA-seq analysis pipelines and evaluate whether RNA-seq could be utilized to enhance diagnostic yield. A total of 47 clinical samples were analysed along with the publicly controlled GEAUVADIS dataset to evaluate the potential of RNA-seq in a clinical setting. The pilot pipeline used, an RNA-seq analysis wrapper around Detection of RNA Outlier Pipeline (DROP), used detected a highly ranked splicing variant in a positive control control sample that was hard to identify in a WGS analysis. The remaining two other positive control other two control samples with aberrant expression were also detected by the pipeline. Additionally, the pipeline gave a manageable list of candidate genes per affected sample in the population along with corroborating graphs that can support the decision-making for clinicians. The results of this pipeline proved successful for integrating RNA-seq and thustherefore, we expect anticipate an increase in diagnosis.
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Hasselgren, Mikael. "Epidemiological Aspects of Asthma in Primary Care : Special Reference to Prevalence, Clinical Detection and Validation." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-6144.
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Berenschot, David. "A Descriptive Study of the Elderly in California Substance Abuse Treatment Programs." CSUSB ScholarWorks, 2017. https://scholarworks.lib.csusb.edu/etd/549.
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As gerontologists may know, there are a great deal of studies and a variety of academic literature on the misuse of alcohol and prescription medication amongst the elderly population. While there is a plethora of information on alcohol and prescription misuse, there is little reported data about the prevalence of other substance misuse experienced by this population. This study aims to help to fill that gap in the data by using quantitative methods to describe the scope of substance abuse of individuals 55-years or older. This study utilizes data from the Treatment Data Set Admission (TEDS-A). The TEDS-A is a public data set which includes admissions data from multiple substance abuse treatment facilities associated with the Substance Abuse and Mental Health Services Association (SAMHSA). This is a regional study, therefore this study focuses only on individuals 55-years or older who have been admitted into substance abuse treatment facilities in the state of California in the year 2014.
The TEDS-A is a data set that is supported and conducted by members of SAMHSA. Most of their public data sets, including the TEDS-A, can be accessed on their website (https://www.datafiles.samhsa.gov/study/treatment-episode-data-set-admissions-teds-2014-nid16949). The data available in the TEDS-A involves a number of admission questions, including demographic data, reasons for intake, primary through tertiary substance concerns, questions regarding social status, information on medical insurance, and more.
This study looks at the descriptive frequencies of the use of alcohol, crack/cocaine, marijuana/hashish, heroin, other opiates & synthetics, methamphetamine, and other substances. The study includes 13,512 cases, of which 9966 (73.8%) of cases were male, 3539 (26.2%) were female, and 7 (0.1%) were missing and/or invalid. The results of the data suggests that, while alcohol abuse is a problem, those over 55 are admitted into substance abuse clinics for many other reasons, not just alcohol abuse.
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Krive, Jacob. "Effectiveness of Evidence-Based Computerized Physician Order Entry Medication Order Sets Measured by Health Outcomes." NSUWorks, 2013. http://nsuworks.nova.edu/gscis_etd/202.
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In the past three years, evidence based medicine emerged as a powerful force in an effort to improve quality and health outcomes, and to reduce cost of care. Computerized physician order entry (CPOE) applications brought safety and efficiency features to clinical settings, including ease of ordering medications via pre-defined sets. Order sets offer promise of standardized care beyond convenience features through evidence-based practices built upon a growing and powerful knowledge of clinical professionals to achieve potentially more consistent health outcomes with patients and to reduce frequency of medical errors, adverse drug effects, and unintended side effects during treatment. While order sets existed in paper form prior to the introduction of CPOE, their true potential was only unleashed with support of clinical informatics, at those healthcare facilities that installed CPOE systems and reap rewards of standardized care.
Despite ongoing utilization of order sets at facilities that implemented CPOE, there is a lack of quantitative evidence behind their benefits. Comprehensive research into their impact requires a history of electronic medical records necessary to produce large population samples to achieve statistically significant results. The study, conducted at a large Midwest healthcare system consisting of several community and academic hospitals, was aimed at quantitatively analyzing benefits of the order sets applied to prevent venous thromboembolism (VTE) and treat pneumonia, congestive heart failure (CHF), and acute myocardial infarction (AMI) - testing hospital mortality, readmission, complications, and length of stay (LOS) as health outcomes.
Results indicated reduction of acute VTE rates among non-surgical patients in the experimental group, while LOS and complications benefits were inconclusive. Pneumonia patients in the experimental group had lower mortality, readmissions, LOS, and complications rates. CHF patients benefited from order sets in terms of mortality and LOS, while there was no sufficient data to display results for readmissions and complications. Utilization of AMI order sets was insufficient to produce statistically significant results. Results will (1) empower health providers with evidence to justify implementation of order sets due to their effectiveness in driving improvements in health outcomes and efficiency of care and (2) provide researchers with new ideas to conduct health outcomes research.
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Arvidsson, Emma. "Skiljer sig blinkfrekvensen vid läsning på olika medier?" Thesis, Linnéuniversitetet, Institutionen för medicin och optometri (MEO), 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-76021.
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Syfte: Syftet med den här studien var att undersöka om Spontaneous Eye Blink Rate (SEBR) skiljde sig åt vid läsning på utskrivet papper, surfplatta eller smartphone. Det jämfördes också huruvida fullständiga och ofullständiga blinkningar skiljde sig åt vid läsning på de olika medierna. Metod: Deltagarna (n=29) fick läsa tre olika texter på utskrivet papper, surfplatta och smartphone samtidigt som de filmades. I efterhand granskades samtliga videos två gånger för att räkna fullständiga blinkningar, ofullständiga blinkningar och totalt antal blinkningar (SEBR). Resultat: Den här studien visade att där finns en signifikant skillnad av totalt antal blinkningar vid läsning på utskrivet papper och surfplatta (p=0,03), där blinkningar/minut sjönk med 14,9% vid läsning på utskrivet papper, jämfört med surfplatta. För ofullständiga blinkningar fanns en statistiskt signifikant skillnad mellan utskrivet papper och surfplatta (p=0,02), där antalet ofullständiga blinkningar/minut ökade med 30,0% vid läsning på surfplatta, jämfört med utskrivet papper. Vid läsning på surfplatta och smartphone fanns en signifikant skillnad gällande ofullständiga blinkningar (p=0,01), där antalet ofullständiga blinkningar/minut ökade med 42% vid läsning på surfplattan, jämfört med smartphone. Slutsats: Spontaneous Eye Blink Rate skiljer sig vid läsning på papper och surfplatta. Ofullständiga blinkningar är flest vid läsning på surfplatta. Inga signifikanta skillnader finns mellan utskrivet papper och smartphone.Purpose: The purpose of this study was to evaluate whether Spontaneous Eye Blink Rate (SEBR) differ when reading on hard copy, tablet or smartphone. Complete and incomplete blinks were also evaluated to see if there were any differences regarding the hard copy, tablet and smartphone. Methods: The participants read three different texts on hard copy, tablet and smartphone while they were being filmed. Afterwards, each video was analysed twice in order to count complete blinks, incomplete blinks and total blink rate (SEBR). Results: This study showed that there is a significant difference in total blink rate between reading on hard copy and tablet (p=0.03), where blinks/minute decreased by 14.9% for the hard copy condition. There was also a significant difference in incomplete blinks regarding the two devices (p=0.02), where incomplete blinks increased by 30.0% when reading on tablet. Tablet and smartphone reading also resulted in a significant difference, where incomplete blinks increased by 42% when reading on tablet (p=0.01). Conclusion: Spontaneous Eye Blink Rate differ when reading on hard copy and tablet. Incomplete blinks increase when reading on tablet. No significant differences are found between hard copy and smartphone.
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Amylon, Lisa. "Jämförelse av ögonansträngning vid läsning på papper och på mobilskärm." Thesis, Linnéuniversitetet, Institutionen för medicin och optometri (MEO), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-85465.
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Syfte: Syftet med den här studien var att jämföra Digital Eye Strain-symptom mellan läsning på papper och mobiltelefon. Att undersöka om det som tidigare studier har visat i skillnad mellan läsning på papper och en datorskärm även gäller mobiltelefoner och hur mycket våra ögon påverkas när det gäller ansträngning, trötthet och andra ögonrelaterade symptom. Metod: Deltagarna (n=16) fick läsa i 20 minuter tyst, antingen på papper eller en smartphone-skärm. Avståndet fick de själva bestämma. De läste samma bok med samma typsnitt och storlek på båda medierna. Direkt efter de hade läst i 20 minuter fick de fylla i ett frågeformulär som bestod av tio frågor kring deras upplevda ögonsymptom under uppgiften. Resultat: Studien visade på signifikanta skillnader i medelvärdet mellan papper och mobiltelefon på tre av symptomen: suddig syn vid tittande på texten (p=0,016), ansträngda ögon (p=0,023) samt trötta ögon (p=0,015). I alla tre fallen var symptompoängen högre efter läsning på mobilskärm än efter läsning på papper. Det fanns ingen signifikant skillnad mellan de övriga sju symptomen. Det var även en signifikant skillnad i läsavstånd med ett betydligt mindre avstånd till mobiltelefonen än till pappret. Slutsats: Studien visar att symptomen efter användning av mobiltelefon upplevs som svårare än efter läsning på papper. De tre symptom som skilde sig signifikant var alla högre efter läsning på mobilskärmen.Purpose: The purpose of this study was to compare Digital Eye Strain DES-symptoms after reading on a printed hardcopy versus a smartphone. To understand if results obtained from earlier studies that have showed DES when reading in from computer also applies to smartphones. Methods: 16 participants in the study were asked to read a Swedish book quietly for 20 minutes, either on a hardcopy or on a smartphone. The participants were told to use their normal working distance while reading from book or smartphone. They read the same book with the same textsize and font in both conditions. Directly after reading the participants completed a written questionnaire that consisted of ten questions about their level of ocular discomfort during the task. Results: This study showed significant differences in mean symptom scores between printed hardcopy and smartphone on three of the symptoms; blurred vision while viewing the text (p=0,016), eyestrain (0,023) and tired eyes (0,015). In all three cases the symptoms were higher during smartphone use. No significant differences were found between the other seven symptoms. There were a significant difference in reading distance, smartphone were held closer than the hardcopy. Conclusion: This study shows that the symptoms after smartphone use is perceived as more severe than after reading on a hardcopy. The three symptoms that showed a significant difference were all higher after smartphone use.
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Yang, Lili. "Joint models for longitudinal and survival data." Thesis, 2014. http://hdl.handle.net/1805/4666.
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Indiana University-Purdue University Indianapolis (IUPUI)Epidemiologic and clinical studies routinely collect longitudinal measures of multiple outcomes. These longitudinal outcomes can be used to establish the temporal order of relevant biological processes and their association with the onset of clinical symptoms. In the first part of this thesis, we proposed to use bivariate change point models for two longitudinal outcomes with a focus on estimating the correlation between the two change points. We adopted a Bayesian approach for parameter estimation and inference. In the second part, we considered the situation when time-to-event outcome is also collected along with multiple longitudinal biomarkers measured until the occurrence of the event or censoring. Joint models for longitudinal and time-to-event data can be used to estimate the association between the characteristics of the longitudinal measures over time and survival time. We developed a maximum-likelihood method to joint model multiple longitudinal biomarkers and a time-to-event outcome. In addition, we focused on predicting conditional survival probabilities and evaluating the predictive accuracy of multiple longitudinal biomarkers in the joint modeling framework. We assessed the performance of the proposed methods in simulation studies and applied the new methods to data sets from two cohort studies.
National Institutes of Health (NIH) Grants R01 AG019181, R24 MH080827, P30 AG10133, R01 AG09956.
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McCallum, Glen. "EGADSS: a clinical decision support system for use in a service-oriented architecture." Thesis, 2006. http://hdl.handle.net/1828/2296.
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Almost one in ten of every hospital admission in Canada is caused by our own health care system. Steps must be taken to reduce medical errors. One proven way to reduce medical errors is through the use of Clinical Decision Support (CDS) Systems. CDS systems provide point of care alerts to clinicians that are based on pre-defined rules (e.g. if patient allergic to drug then do not administer drug). a significant issue with CDS Systems is that they are very expensive for a hospital to develop and maintain, thereby preventing widespread adoption.
We have designed and implemented EGADSS, the Evidence-based Guideline And Decision Support System. EGADSS is designed for use as part of a service-oriented architecture. By centralising the development and maintenance of a CDS system (possibly by a governing authority), more providers can afford to adopt them. Indeed we have interfaced EGADSS with two clients systems. In addition, EGADSS can easily be adopted by other EMRs.
We also evaluated the suitability of Arden Syntax, HL7's Clinical Guideline Encoding standard, for use in a service-oriented CDS environment. We identify several language features that should be standardised.
Most importantly, we show how to build a CDS system for use in a service-oriented architecture. EGADSS has been tested with 5 test guidelines and several patient profiles to verify that it behaves correctly.
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"Evaluating The Effect Of Physician Residency And Fellowship Programs On Surgical Outcomes For Coronary Artery Bypass Grafting Procedures In The State Of Florida." Tulane University, 2014.
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Averitt, Amelia Jean. "Machine Learning Methods for Causal Inference with Observational Biomedical Data." Thesis, 2020. https://doi.org/10.7916/d8-je06-eh12.
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Causal inference -- the process of drawing a conclusion about the impact of an exposure on an outcome -- is foundational to biomedicine, where it is used to guide intervention. The current gold-standard approach for causal inference is randomized experimentation, such as randomized controlled trials (RCTs). Yet, randomized experiments, including RCTs, often enforce strict eligibility criteria that impede the generalizability of causal knowledge to the real world. Observational data, such as the electronic health record (EHR), is often regarded as a more representative source from which to generate causal knowledge. However, observational data is non-randomized, and therefore causal estimates from this source are susceptible to bias from confounders. This weakness complicates two central tasks of causal inference: the replication or evaluation of existing causal knowledge and the generation of new causal knowledge. In this dissertation I (i) address the feasibility of observational data to replicate existing causal knowledge and (ii) present new methods for the generation of causal knowledge with observational data, with a focus on the causal tasks of comparing an outcome between two cohorts and the estimation of attributable risks of exposures in a causal system.
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Gonçalves, Filipe Manuel Carvalho Rodrigues Bravo. "Computer-interpretable guidelines in decision support systems: creation and editing of clinical protocols for automatic Interpretation." Master's thesis, 2016. http://hdl.handle.net/1822/47796.
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Dissertação de mestrado em Engenharia Informática (área de especialização em Sistemas Inteligentes)Currently in the health sector there is a growing need to standardize and promote the improvement of clinical practice in order to reduce costs, which requires a solution that will allow these goals to be more easily achieved. To this end, the solution that gathers the current interest is the use of clinical protocols and promoting conformity with practices contained in them. Clinical protocols aim to improve the quality of the clinical process, reducing variations in clinical practice and reducing health care costs. In order to be effective, these parameters must be integrated into the care flow and provide specific advice to a patient, regardless of time or place. Thus, their formalization as Computer-Interpretable Guidelines (CIG) makes possible the development of decision support systems based on CIGs, which may have a greater impact on the behavior of health professionals. However, the absence of a general pattern in terms of CIG often hinders progress in the development of these systems. Currently available tools for creating and editing clinical protocols for automatic interpretation are not functional or user-friendly. Most of them are academic projects developed in obsolete languages. As a means to solve this issue, this dissertation project presents an user-friendly tool that manages the creation and editing of CIGs, without requiring the user to have programming knowledge, and through the use of interfaces that are simple and intuitive.
Atualmente no setor da saúde há uma crescente necessidade de padronizar e promover a melhoria das práticas clínicas com o intuito de reduzir custos, o que exige uma solução que permita que estes objetivos sejam mais facilmente atingidos. Para o efeito, a solução que mais desperta o interesse atualmente é a utilização de protocolos clínicos e reforço da conformidade com as práticas que neles são recomendadas. Os protocolos clínicos visam melhorar a qualidade do processo clínico, reduzindo as variações da prática clínica e reduzindo os custos de saúde. De forma a serem eficazes, devem ser integrados no fluxo de atendimento e prestar aconselhamento específico para um paciente, independentemente do tempo ou local onde se encontram. Assim, a sua formalização como Computer-Interpretable Guidelines (CIGs) torna possível o desenvolvimento de sistemas de apoio à decisão baseados em CIGs, que apresentam uma maior capacidade de afetar o comportamento dos profissionais de saúde. Contudo, a inexistência de um padrão generalizado a nível das CIGs dificulta muitas vezes o progresso no desenvolvimento destes sistemas. As ferramentas atualmente disponíveis para a criação e edição de protocolos clínicos para interpretação automática não são funcionais ou de fácil utilização. Como meio de resolver esta questão, neste projeto de dissertação propõe-se o desenvolvimento de uma ferramenta user-friendly capaz de gerir a criação e edição de CIGs, sem a necessidade do utilizador apresentar conhecimentos de programação, e através do uso de interfaces que sejam simples e intuitivas.
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Poon, Alex D. "Optimizing the task of menu selection for large controlled vocabularies." 1996. http://books.google.com/books?id=BvLaAAAAMAAJ.
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