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At least 1,351 records · Page 75Linked to original sources
PubMed2004

Combining FDI and AI approaches within causal-model-based diagnosis.

This paper presents a model-based diagnostic method designed in the context of process supervision. It has been inspired by both artificial intelligence and control theory. AI contributes tools for qualitative modeling, including causal modeling, whose aim is to split a complex process into elementary submodels. Control theory, within the framework of fault detection and isolation (FDI), provides numerical models for generating and testing residuals, and for taking into account inaccuracies in the model, unknown disturbances and noise. Consistency-based reasoning provides a logical foundation for diagnostic reasoning and clarifies fundamental assumptions, such as single fault and exoneration. The diagnostic method presented in the paper benefits from the advantages of all these approaches. Causal modeling enables the method to focus on sufficient relations for fault isolation, which avoids combinatorial explosion. Moreover, it allows the model to be modified easily without changing any aspect of the diagnostic algorithm. The numerical submodels that are used to detect inconsistency benefit from the precise quantitative analysis of the FDI approach. The FDI models are studied in order to link this method with DX component-oriented reasoning. The recursive on-line use of this algorithm is explained and the concept of local exoneration is introduced.

Algorithms↗
PubMed2004

Possible conflicts: a compilation technique for consistency-based diagnosis.

Consistency-based diagnosis is one of the most widely used approaches to model-based diagnosis within the artificial intelligence community. It is usually carried out through an iterative cycle of behavior prediction, conflict detection, candidate generation, and candidate refinement. In that process conflict detection has proven to be a nontrivial step from the theoretical point of view. For this reason, many approaches to consistency-based diagnosis have relied upon some kind of dependency-recording. These techniques have had different problems, specially when they were applied to diagnose dynamic systems. Recently, offline dependency compilation has established itself as a suitable alternative approach to online dependency-recording. In this paper we propose the possible conflict concept as a compilation technique for consistency-based diagnosis. Each possible conflict represents a subsystem within system description containing minimal analytical redundancy and being capable to become a conflict. Moreover, the whole set of possible conflicts can be computed offline with no model evaluation. Once we have formalized the possible conflict concept, we explain how possible conflicts can be used in the consistency-based diagnosis framework, and how this concept can be easily extended to diagnose dynamic systems. Finally, we analyze its relation to conflicts in the general diagnosis engine (GDE) framework and compare possible conflicts with other compilation techniques, especially with analytical redundancy relations (ARRs) obtained through structural analysis. Based on results from these comparisons we provide additional insights in the work carried out within the BRIDGE community to provide a common framework for model-based diagnosis for both artificial intelligence and control engineering approaches.

Algorithms↗
PubMed2004

A bridged diagnostic method for the monitoring of polymorphic discrete-event systems.

Diagnosis of discrete-event systems (DESs) is a challenging problem that has been tackled both by automatic control and artificial intelligence communities. The relevant approaches share similarities, including modeling by automata, compositional modeling, and model-based reasoning. This paper aims to bridge two complementary approaches from these communities, namely, the diagnoser approach and the active system approach, respectively. The more significant shortcomings of such approaches are, on the one side, the need for the generation of the global system model and, on the other, the lack of monitoring capabilities. The former makes the application of the diagnoser approach prohibitive in real contexts, where the system model is too large to be generated, even offline. The latter requires the completion of the system observation before starting the diagnostic task, thereby, making the monitoring of the system. impossible. The bridged diagnostic method subsumes, to a large extent on the peculiarities of the two approaches and is capable of coping with an extended class of DESs that integrate both synchronous and asynchronous behavior. The bridge is built by extending the active system approach by means of several enhanced techniques, which eventually, allow the efficient monitoring of polymorphic DESs. Upon the occurrence of each system message, two pieces of diagnostic information are generated, namely, the snapshot and historic diagnostic sets. While the former accounts for the faults pertinent to the newly generated message only, the latter is based on the whole sequence of messages yielded by the system during operation.

Algorithms↗
PubMed2004

Conflicts versus analytical redundancy relations: a comparative analysis of the model based diagnosis approach from the artificial intelligence and automatic control perspectives.

Two distinct and parallel research communities have been working along the lines of the model-based diagnosis approach: the fault detection and isolation (FDI) community and the diagnostic (DX) community that have evolved in the fields of automatic control and artificial intelligence, respectively. This paper clarifies and links the concepts and assumptions that underlie the FDI analytical redundancy approach and the DX consistency-based logical approach. A formal framework is proposed in order to compare the two approaches and the theoretical proof of their equivalence together with the necessary and sufficient conditions is provided.

Algorithms↗
PubMed1997

Bioethics and law: a developmental perspective.

In most Western countries, health law [and] bioethics are strongly intertwined. This strong connection is the result of some specific factors that, in the early years of these disciplines, facilitated a rapid development of both. In this paper, I analyze these factors and construe a development theory existing of three phases, or ideal-typical models. In the moralistic-paternalistic model, there is almost no health law of explicit medical ethics, and the little law there is is usually based on traditional morality, combined with paternalist motives. The objections to this model are that its paternalism and moralism are unacceptable, that it is too static and knows no external control mechanisms. In the liberal model, which is now dominant in most Western countries, law and ethics closely cooperate and converge, both disciplines use the same framework for analysis: they are product-oriented rather than practice-oriented; they use the same conceptual categories, they focus on minimally decent rather than the ideal, and they are committed to the same substantive normative theory in which patient autonomy and patient rights are central. However, each of these four characteristics also results in a certain one-sidedness. In some countries, a third model is emerging. In this postliberal model, health law is more modest and acknowledges its inherent and normative limits, whereas ethics takes a richer and most ambitious self image. As a result health law and ethics will partly diverge again.

Bioethical Issues↗
PubMed2002

What can the social sciences contribute to the study of ethics? Theoretical, empirical and substantive considerations.

This article seeks to establish that the social sciences have an important contribution to make to the study of ethics. The discussion is framed around three questions: (i) what theoretical work can the social sciences contribute to the understanding of ethics? (ii) what empirical work can the social sciences contribute to the understanding of ethics? And (iii) how does this theoretical and empirical work combine, to enhance the understanding of ethics, as a field of analysis and debate, is socially constituted and situated? Through these questions the argument goes beyond the now commonly cited objection to the over-simplistic division between normative and descriptive ethics (that assigns the social sciences the 'handmaiden' role of simply providing the 'facts'). In extending this argument, this article seeks to establish, more firmly and in more detail, that: (a) the social sciences have a longstanding theoretical interest analysing the role that a concern with ethics plays in explanations of social change, social organisation and social action; (b) the explanations that are based on the empirical investigations conducted by social scientists exemplify the interplay of epistemological and methodological analyses so that our understanding of particular substantive issues is extended beyond the conventional questions raised by ethicists, and (c) through this combination of theoretical and empirical work, social scientists go beyond the specific ethical questions of particular practices to enquire further into the social processes that lie behind the very designation of certain matters as being 'ethical issues.'

Behavioral Research↗
PubMed2003

Bioethics, theology, and social change.

Recent years have witnessed a concern among theological bioethicists that secular debate has grown increasingly "thin," and that "thick" religious traditions and their spokespersons have been correspondingly excluded. This essay disputes that analysis. First, religious and theological voices compete for public attention and effectiveness with the equally "thick" cultural traditions of modern science and market capitalism. The distinctive contribution of religion should be to emphasize social justice in access to the benefits of health care, challenging the for-profit global marketing of research and biotechnology to wealthy consumers. Second, religion and theology have been and are still socially effective in sponsoring activism for practical change, both locally and globally. This claim will be supported with specific examples; with familiar concepts like subsidiarity and "middle axioms"; and with recent analyses of "participatory democracy" and of emerging, decentralized forms of global governance.

Bioethics↗
PubMed2003

How can research organizations more effectively transfer research knowledge to decision makers?

Five questions--What should be transferred to decision makers? To whom should it be transferred? By whom? How? With what effect?--provide an organizing framework for a knowledge transfer strategy. Opportunities for improving how research organizations transfer research knowledge can be found in the differences between the answers suggested by our understanding of the research literature and those provided by research-organization directors asked to describe what they do. In Canada, these opportunities include developing actionable messages for decision makers (only 30 percent of research organizations frequently or always do this), developing knowledge-uptake skills in target audiences and knowledge-transfer skills in research organizations (only 20 to 22 percent frequently or always do this), and evaluating the impact of knowledge-transfer activities (only 8 to 12 percent frequently or always conduct an evaluation). Research funders can help research organizations take advantage of these opportunities.

Canada↗
PubMed2006

Quality of requests for serum digoxin concentrations: experience from an Australian regional health service.

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT: * Therapeutic drug monitoring of serum digoxin concentrations (SDC) is considered useful in enhancing the therapeutic benefits of digoxin and minimizing the incidence of adverse drug reactions. * The quality of requests for SDC has been reported to be generally unsatisfactory. However, studies have focused on few information parameters. * A better knowledge of these issues might be useful to target appropriate areas of weakness within heathcare systems. WHAT THIS STUDY ADDS: * The poor quality of the information in SDC requests involves a wide range of codes from the contact details of the requester to the time interval between the last dose of digoxin and blood sampling. * Misuse of the therapeutic drug monitoring service is common across different specialties and healthcare settings. AIMS: To assess the quality of the information provided with serum digoxin concentration (SDC) requests received by a therapeutic drug monitoring service in a regional health service. METHODS: We conducted a retrospective audit of a consecutive series of 685 SDC requests during a 7-month period. Information regarding (i) contact details, (ii) reasons for request, (iii) dose, (iv) route of administration, (v) concurrent therapy, (vi) treatment duration and (vii) time interval between the last dose and sampling was reviewed and coded as appropriate or inappropriate/missing. Data were analysed according to the origin of request, i.e. from different specialties/wards (emergency department and critical care, cardiology and coronary care unit, medicine and aged care, surgery, and general/private practice) and healthcare settings (teaching hospital, geriatric hospital and general/private practice). RESULTS: The quality of SDC requests was generally poor across different specialties and healthcare settings. The information provided for the coded parameters was appropriate only in 19.1% (i), 6.4% (ii), 54.7% (iii), 45.8% (iv), 12.8% (v), 32.9% (vi) and 47.1% (vii) of cases. No SDC request was complete in all the information codes. SDC requests from general/private practice lacked more often details regarding the dose (information provided in 46.7% of requests, P = 0.007 vs. other specialties; P = 0.02 vs. other settings) and the route of administration (20.0%, P < 0.001 vs. other specialties and vs. other settings). SDC requests from the emergency department and critical care unit lacked more often details regarding the treatment duration (22.6%, P < 0.001 vs. other specialties) and the time interval between the last dose and blood sampling (40.1%, P = 0.01 vs. other specialties). CONCLUSIONS: The quality of the information in SDC requests is poor across different specialties and healthcare settings. Educational strategies to ensure the appropriate use of this service are urgently needed.

Anti-Arrhythmia Agents↗
PubMed1996

Who has the power? Some problems and issues affecting the nursing care of dying patients.

Nurses play a central role in the care of dying people, yet they may find themselves marginalized, devalued or in conflict with other health professionals. This paper examines a number of problems and issues related to nursing power and control in the workplace. The factors we consider are: the relative effects of personal and structural influences; the 'medicalization' of dying; the demands and challenges of interdisciplinary work; ethical issues raised by euthanasia and AIDS; patients' rights to make informed decisions about their care; philosophies and policies of health care.

Ethics, Nursing↗
PubMed2004

Value of professional collaboration in the care of children with cancer and their families.

The aim of this study is to describe professionals' perception of collaboration and their evaluation of a professional collaborative model for children with cancer in mid-Norway. Health and non-health professionals from the families' home communities were invited to participate in the study. The selection was based upon professionals working with children treated for cancer at the Department of Paediatrics, University Hospital in Trondheim between 1990 and 1996. Ninety-one of 142 eligible professionals (64%) responded to a questionnaire. Both health and non-health professionals agreed that collaboration takes care of the family's situation (76%) as well as broadening their own knowledge (77%). Two-thirds considered they had received enough information necessary for follow-up care, however, only 28% believed that families were confident that professionals had this knowledge. More than 80% of professionals considered collaborative meetings and support groups, essential elements of the model, as being effective methods for follow-up care. However, only 39% of professionals had participated in collaborative meetings and 46% in support groups. In addition, only 26% received systematic supervision. Health and non-health professionals regard collaboration as being valuable in follow-up care for children, their families and professionals themselves. However, our results suggest areas of potential improvement in the existing model.

Adaptation, Psychological↗
PubMed2006

Bridging the gap: the development of knowledge briefings at the health and social care interface.

The move to more evidence-based practice has been a recent and much-advocated feature of public policy, especially in health and social care. An essential element of this approach is to make available summaries of evidence in an understandable form, which can then be used to support decision-making in planning and practice. The present paper describes the development of just such a set of information digests for the health and social care interface. A distinct divide exists between the knowledge bases usually accessed by practitioners and professionals in these two fields, even though they often share populations and concerns. The authors describe the challenges and processes of developing a set of briefing documents summarising policy and research literature on health and social care topics. The paper introduces the project and its intentions, and describes the development and application of the conceptual basis and production methodology behind the briefings. The issues raised by summarising research evidence on potentially controversial topics within the limits of a briefing are also discussed.

Clinical Competence↗
PubMed1990

Natural sociology and moral questions in nursing: can there be a relationship?

This paper argues that the current sources of material for the debate of moral questions in health care in general and nursing in particular, are inadequate. The current bases of nursing's knowledge and values are explored, and the conclusion drawn that reliance upon theory developed by other disciplines has led to theories which are wholly inappropriate to explain either how nursing is practised or even how it ought to be. A case is made that naturalistic sociological methods such as participant observation have the greatest possibilities to describe and explain moral conduct in nursing. Further, these methods can produce a view of reality more consistent with the experiences and feelings of the patients or clients and other health workers. It would seem that data and theory generated using this perspective could better inform the debates of moral philosophers than the currently dominant sources of their case material, the views of the medical and legal professions.

Casuistry↗
PubMed1992

Ethical reasoning in nurses' and physicians' stories about care episodes.

Twenty-three registered nurses and nine physicians reported 43 stories about ethically difficult care situations. Themes in nurses' and physicians' stories were described by means of narrative ethical theory. It turned out that nurses and physicians related different kinds of stories. They also seemed to use different kinds of ethical reasoning. This result was interpreted as mainly connected to the fact that the two professions have different tasks to accomplish and are trained in disciplines with different foci; nursing and medicine. The need to find a common frame story covering the two professional stories was stressed.

Adult↗