Computer-based Support Research Articles

Simulation-Supported Wargaming for Assessing Force Structures

Wargaming is a key activity for gaining deeper insight into the strengths and weaknesses of future force structures in the course of their development and assessment. For more than a decade, the Norwegian Defence Research Establishment (Forsvarets forskningsinstitutt – FFI) has supported the Norwegian Army in conducting wargames for capability planning, with varying degrees of computer-based support. Throughout this period, these have evolved from what can be described as computer-assisted wargames to more realistic simulation-supported wargames. Moreover, to get a closer understanding of the deterrent effect of the force structures, which may not be observable during the actual gameplay, our emphasis has also shifted towards replicating the planning process more properly – and especially towards monitoring the planning process of the opposing force. For example, it has been important to examine the extent to which specific structure elements discourage the opposing force from taking certain actions. In this article, we describe our evolved methodology for simulation-supported wargaming, which includes a preparation phase; an execution phase, including a joint operational planning process; and an analysis phase. Furthermore, we discuss what type of data and results we are able to extract from the wargaming sessions, and present a set of what we have found to be best practices for how to conduct successful simulation-supported wargames.

TU73. GENETIC LIABILITIES OF SCHIZOPHRENIA RISK FACTORS AS POLYGENIC SCORES FOR CASE STATUS PREDICTION: APPLICATION AND BIAS EVALUATION IN A MULTI-ANCESTRY SETTING

Cloud-Based Design and Manufacturing is a service-oriented networked product development model in which service consumers are enabled to configure, select and utilize customized product realization services ranging from computer-aided engineering software to reconfigurable manufacturing systems. So far, this paradigm has mainly been tested for digital design and fabrication processes including the usual steps of designing an artefact with a CAD system to then have a prototype manufactured with a 3D printer. Unfortunately, a common mishap that can often be observed is that artefacts that look perfectly fine on the CAD computer screen come out severely misshaped on the 3D printer. In this paper, we first investigate and document this phenomenon and explain its root cause, which concerns a) the data transmitted to the 3D printer, b) inappropriate design features, and c) a mismatch between geometry requirements and printer capabilities. As more and more entrepreneurs, hobbyists in maker communities, and other not always fully trained individuals pursue their design and make ideas, there is a need for smart computer-based support to facilitate a successful design-to-print process. Such a digital DfM assistant might pop up to prompt a designer to modify identified critical areas of the design so that it can be printed with a chosen printer or alternatively propose another type of printer that may have the technical capabilities to accommodate the design in its current form. Acknowledging this need, we propose a two-stage smart manufacturability assistant. The first stage decomposes the digital model into a series of part features; the second stage of the model involved defining the capabilities of the 3D-printer. Finally, we begin to realize this manufacturability assistant by creating and evaluating a bespoke test part which can be used to define a machine-material capability map for an example FDM process.

Argumentation skills mediate the effect of peer argumentation on content knowledge in middle-school students.

There is compelling evidence that arguing with peers in educational contexts fosters students’ content knowledge and argumentation skills. Indeed, curricula have already been developed that, through tailored support for peer argumentation, promote both content knowledge and argumentation skills simultaneously. However, we do not yet know how to optimize the occurrence of peer argumentation, although there are suggestions in the literature that computers may have a role to play. Likewise, there are uncertainties about the mechanisms through which the benefits of peer argumentation are achieved, especially whether (and how) there is interdependence across the two types of benefit. In this paper, we report a quasi-experimental study randomized at class level, which addresses these two issues. A total of 502 fourth-grade students and 20 classes and teachers covered a module in science under three conditions: (1) using a curriculum that was already known to promote peer argumentation and content knowledge (standard support), (2) using the same curriculum but with additional computer-based support (computer-enhanced support), and (3) a routinely taught control group. Students’ argumentation skills and content knowledge were assessed. Content knowledge was assessed prior to and after the intervention, with immediate and delayed posttests. Multiple regression analyses showed that peer argumentation was indeed most frequent in the computer-enhanced condition. Moreover, on the basis of a multilevel path analysis, we found that individual contributions to peer argumentation had a direct effect on posttest argumentation skills and an indirect effect on posttest content knowledge, both immediate and delayed. The indirect effect of argumentation on delayed posttest content knowledge was mediated by immediate posttest knowledge and posttest argumentation skills. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Factors affecting the accuracy of nurse triage in tertiary care emergency departments.

OBJECTIVES:The accuracy and duration of triage is vital in emergency departments. However, patient density, diversity of cases, and time pressure make triage difficult. Triage performed properly and at the right time prevents patients from experiencing any untoward incidents that may occur because of waiting. Therefore, the study aimed to share the data obtained from the Hospital Information Management System (HIMS) regarding the accuracy and duration of nurse triage in an adult emergency department.METHODS:This descriptive and cross-sectional study evaluated the accuracy and duration of triage decisions made by nurses for patients admitted to an adult emergency department between June 15 and July 15, 2019. Statistical analysis was performed using Statistical analysis was performed using SPSS software version 23.00.RESULTS:The study included the data of 7705 adult patients. The accuracy rate of nurse triage was 59.3% (n = 4566), and the average duration of triage was 1.52 ± 2.10 min. It was observed that the average duration of accurate triage decisions was longer in patients with triage category 3. A statistically significant relationship was determined between the accuracy of nurse triage and the duration of triage, years of seniority of the nurse, and shifts (P < 0.05).CONCLUSIONS:The accuracy and duration of nurse triage in the hospital where the study was conducted can be evaluated via the HIMS. In order to increase the accuracy of nurse triage in the emergency department, it is necessary to employ experienced and trained nurses, develop computer-based support systems, and increase the number of nurses working in shifts providing care to a large number of patients.

Testing the face validity and inter-rater agreement of a simple approach to drug-drug interaction evidence assessment.

A convenience sample of participants with professional experience evaluating DDI evidence was recruited. Participants independently evaluated pre-selected evidence items for 5 drug pairs using the new instrument. For each drug pair, participants labeled each evidence item as sufficient or insufficient to establish the existence of a DDI based on the evidence categories provided by the instrument. Participants also decided if the overall body of evidence supported a DDI involving the drug pair. Agreement was computed both at the evidence item and drug pair levels. A cut-off of≥70% was chosen as the agreement threshold for percent agreement, while a coefficient>0.6 was used as the cut-off for chance-corrected agreement. Open ended comments were collected and coded to identify themes related to the participants' experience using the novel approach. The face validity of the new instrument was established by two rounds of evaluation involving a total of 6 experts. Fifteen experts agreed to participate in the reliability assessment, and 14 completed the study. Participant agreement on the sufficiency of 22 of the 34 evidence items (65%) did not exceed the a priori agreement threshold. Similarly, agreement on the sufficiency of evidence for 3 of the 5 drug pairs (60%) was poor. Chance-corrected agreement at the drug pair level further confirmed the poor interrater reliability of the instrument (Gwet's AC1=0.24, Conger's Kappa=0.24). Participant comments suggested several possible reasons for the disagreements including unaddressed subjectivity in assessing an evidence item's type and study design, an infeasible separation of evidence evaluation from the consideration of clinical relevance, and potential issues related to the evaluation of DDI case reports. Even though the key findings were negative, the study's results shed light on how experts approach DDI evidence assessment, including the importance situating evidence assessment within the context of consideration of clinical relevance. Analysis of participant comments within the context of the negative findings identified several promising future research directions including: novel computer-based support for evidence assessment; formal evaluation of a more comprehensive evidence assessment approach that requires consideration of specific, explicitly stated, clinical consequences; and more formal investigation of DDI case report assessment instruments.

Development of a Prototype for Early Identification Children with Specific Learning Disabilities

Early identification of children who may at risk of having difficulties in learning is crucial in order to assist them in overcoming barriers to learn. The adoption of computer related information technology has been greatly explored to support specific learning disabilities children. However, current computer-based support systems are lacking to guide parents and teachers with information about the children with the specific learning disabilities. The early awareness of learning disabilities problems will help the parents and teachers to take suitable action for their children’s academic and social development. Thus in this paper, a computer-based prototype for early identification children with specific learning disabilities using ontology (e-SLD) is developed and evaluated in terms of its usability based on Unified Theory of Acceptance and Use of Technology (UTAUT) factors. The research methodology consists of two main phases including software development life cycle and usability testing. The findings shows positive feedbacks of the prototype in terms of its usability, in which the average of 70% of the respondents agreed with the system’s performance expectancy, 72% of the respondents agreed with the system in terms of its effort expectancy, 68% of the respondents agreed with the system in terms of its social influence and around 72% of the respondents agreed that e-SLD is a tool to screening and recommending suitable activity of specific learning disabilities children.

An intelligent computer-based framework for integrating emotions and aerodynamics in sportsbike design

In today's competitive market it is critical to understand how product design connects with the consumer emotionally. Therefore, design engineers must adopt a design for emotion (DFe) approach, whilst applying fundamental principles to enhance the performance of complex artefacts, such as sportsbikes. A sportsbike cannot be designed based on aesthetics only, but rather on a balance between aesthetics and aerodynamic performance, as the design of the outer body itself is what ultimately affects the drag and lift properties. Within this context, a framework for an intelligent computer-based support system was developed, aimed at supporting designers to take emotions and aerodynamics when developing sportsbikes. A proof of concept computerbased tool was implemented and evaluated. Qualitative results gathered from an evaluation conducted with eight practicing product development stakeholders, provide a degree of evidence that the proposed framework is useful in designing sportsbikes with more emotional value and enhanced aerodynamic characteristics.

Nationwide Epidemiological Study of Knowledge, Attitudes, and Practices Study of Greek General Practitioners Related to Screening.

Background:We aimed to assess general practitioners’ (GPs) knowledge, attitudes, and practices (KAPs) toward screening recommendation guidelines of the United States Preventive Services Task Force (USPSTF).Methods:The survey was conducted during a 6-month period in a stratified random sample of GPs, drawn from a national database of GPs in Greece. Participants were queried about their knowledge, attitudes, and self-reported practice patterns regarding screening in a primary care setting. Sociodemographic characteristics associated with vague screening practicing were identified using multivariable logistic regression models.Results:A total of 299 participants agreed and underwent telephonic survey (response rate: 78.2%). GPs agreed on the key role of population-based screening in improving patient care, and nine out of ten reported that their performance would be improved with the adoption of computer-based support systems in clinical practice. GPs, older than 50 years of age, those who those practicing for more than 15 years and GPs working in private sector, were less likely to comply with screening recommendations. Latent class analysis revealed that male physicians and those working in public sector were more likely to comply with USPSTF recommendations.Conclusions:Our findings highlight the need of educational intervention programs for GPs in order to promote the implementation of national evidence-based screening recommendation statements in clinical practice.

An Integrated Information and Decision-Support System for the Management of Mass Casualty Incidents

Mass casualty incidents are a challenging safety-critical domain with high complexity, where management and decision-making can make the difference between life and death. As current paper-based tools and software solutions have severe limitations, we examine the use of integrated computer-based support systems in this domain. Instead of being primarily focused on the replacement of paper-based tools, we are looking for additional value of computer systems to support the incident commanders by providing appropriate presentations and offering assistance functions with different automation approaches. For this purpose, we are developing modular software components that can be combined to an integrated system for the management of casualties. We use a user-centered design approach. Therefore, the needs and abilities of prospective users were analyzed thoroughly and considered in system design. This includes interviews and field observations as well as formative evaluations of prototypes. This article summarizes our research for such an integrated management system for MCIs.

A Computer-Based Support System for Cooperative Tasks in Nursing Homes

Different studies have shown the benefits of a cooperative activities programme for the elderly. Members of a group with similar abilities or disabilities are often encouraged by having the opportunity to share their experiences, knowledge, or opinions. Nevertheless, when caregivers try to plan specific cooperative activities, different aspects, as the individual needs of each person, should be taken into account, which notably increases the complexity of that planification. This paper proposes a computer-based support tool for recreational therapists which facilitates the management task of grouping elderly people into cooperative groups for existing activities. To do this, an iterative learning process is proposed allowing the formation of proper distributions of elderly people into activities.

Innovations and Computer-based Support: Illustrated by Five Cases

Introduction: This article discusses four alternative transportation links between China and Europe – the classical sea route through the Suez Canal, the N.S.E. (Artic) train passage through Russia, and ship and train via Genova – in terms of transportation costs, time spent, and reliability. Conclusion: It is concluded that the classical sea-route via Suez is likely to remain the preferred one for most shippers for a long time, when it comes to its relatively low cost, as well as increasingly improved time feature.

Improving student expectations of learning in a problem-based environment

Despite the continuing popularity of problem-based learning (PBL) approaches in higher education worldwide, concerns have been raised regarding a decrease in effectiveness. Unrealistic expectations of students about the nature of learning in a PBL setting may lead to ineffective use of self-regulated learning strategies, in turn leading to suboptimal learning during self-study. In this study, we tested the effects of a workshop aimed at aligning students' perceptions and expectations of their learning environment to those of the university as expressed in faculty training programs. First-year PBL medical students were randomly assigned to either a control condition (n = 26) or a contrast (workshop) condition (n = 19), designed to enable them to compare and contrast their expectations to those of the university. Results showed no significant differences between conditions in students' reported use of SRL strategies, but indicated a differential development in students' intentions to take responsibility for their own learning, with students in the contrast condition reporting an increase in these intentions as a result of the intervention. The intervention did not have a differential effect for students with different pretest scores. We discuss how optimization of the PBL environment can inform the design of online, computer-based support tools.

Methodological and computer-based support for choosing underground utility networks renovation method

The article is devoted to the methodological and software tools for choosing organizational and technological solutions to maintain sewage collectors in an operable state to increase their service life. Such a tool must take into account a set of factors that affect the operation of sewer collectors and form a system, the implementation of which would improve the existing principles of monitoring the status of sewer collectors, identify effective organization and technological solutions of their renovation by taking into account factors that affect their safe operation, the facilities risk of accidents categories, conditions and parameters of works performance. For determining the optimal options for the renovation of the sewer collector using the developed mathematical and computer models, the results of problems solving were generalized: one-criterion optimization subject to the choice of one repair method; one-criterion optimization subject to the choice of different repair methods for the areas; multicriterion optimization.

Machine learning in laboratory medicine: waiting for the flood?

This review focuses on machine learning and on how methods and models combining data analytics and artificial intelligence have been applied to laboratory medicine so far. Although still in its infancy, the potential for applying machine learning to laboratory data for both diagnostic and prognostic purposes deserves more attention by the readership of this journal, as well as by physician-scientists who will want to take advantage of this new computer-based support in pathology and laboratory medicine.

Educators’ perspectives on facilitating computer-assisted speech intervention in early childhood settings

Early childhood educators are frequently called on to support preschool-aged children with speech sound disorders and to engage these children in activities that target their speech production. This study explored factors that acted as facilitators and/or barriers to the provision of computer-based support for children with speech sound disorders (SSD) in early childhood centres. Participants were 23 early childhood educators at 13 centres who participated in the Sound Start Study, a randomized controlled trial that examined the effectiveness of the Phoneme Factory Sound Sorter® (PFSS) computer program (Wren and Roulstone, 2013). Following the trial, participants completed a telephone interview discussing their experiences implementing the program. Transcripts from the interviews were analysed and three categories emerged as factors that influenced the provision of support: (1) personal factors that related to the children (engagement with PFSS, inclusion/exclusion experience), peers, and educators (service provision, educator engagement, support of child PFSS use); (2) environmental factors that related to policies and philosophies (child-centred practice, technology), the physical environment (inclusion/exclusion), and logistics (time, technology); and (3) program factors that related specifically to PFSS (program format, specific games, game duration). In order to best meet the needs of children, parents, educators, and clinicians, these factors need to be taken into consideration in the provision of speech and language therapy services in early childhood centres.

Smart Manufacturability Analysis for Digital Product Development

Cloud-Based Design and Manufacturing is a service-oriented networked product development model in which service consumers are enabled to configure, select and utilize customized product realization services ranging from computer-aided engineering software to reconfigurable manufacturing systems. So far, this paradigm has mainly been tested for digital design and fabrication processes including the usual steps of designing an artefact with a CAD system to then have a prototype manufactured with a 3D printer. Unfortunately, a common mishap that can often be observed is that artefacts that look perfectly fine on the CAD computer screen come out severely misshaped on the 3D printer. In this paper, we first investigate and document this phenomenon and explain its root cause, which concerns a) the data transmitted to the 3D printer, b) inappropriate design features, and c) a mismatch between geometry requirements and printer capabilities. As more and more entrepreneurs, hobbyists in maker communities, and other not always fully trained individuals pursue their design and make ideas, there is a need for smart computer-based support to facilitate a successful design-to-print process. Such a digital DfM assistant might pop up to prompt a designer to modify identified critical areas of the design so that it can be printed with a chosen printer or alternatively propose another type of printer that may have the technical capabilities to accommodate the design in its current form. Acknowledging this need, we propose a two-stage smart manufacturability assistant. The first stage decomposes the digital model into a series of part features; the second stage of the model involved defining the capabilities of the 3D-printer. Finally, we begin to realize this manufacturability assistant by creating and evaluating a bespoke test part which can be used to define a machine-material capability map for an example FDM process.

Are Your Patients Using ‘Digital Supplements’?

Are Your Patients Using ‘Digital Supplements’?

Value–value load diagram: a graphical tool for lean–green performance assessment

Integrated assessment of operational and environmental performance of the production system requires mapping of all the processes and activities in the form of their resource utilisation efficiency. Prior research indicates that most lean assessment tools and techniques have studied operational dimensions ignoring environmental aspect as a part of the assessment tool. Moreover, movement towards the greener production system has become a key strategic consideration for organisations to maintain a competitive edge and to remain as market winners. Continuous assessment in both, lean and green, dimensions is crucial in improving the overall performance through efficient utilisation of the available resources. In lean environment, value stream mapping (VSM) allows assessment of operational performance through identification of non-value adding activities in time units but fails to integrate inefficiencies related to material and energy utilisation. The tool-like material flow cost accounting (MFCA) is able to assess the environmental performance through physical and monetary evaluation of material flow within the production system. This paper presents, a novel tool, value–value load diagram (VVLD), for modelling and evaluating the operational (lean) and environmental (green) performance of the production system. VVLD graphically represents resource consumption, value addition and performance improvement opportunities within the production system by integrating VSM, MFCA and pinch analysis methodology. VVLD permits evaluation of the lean–green performance in terms of the eco-leanness index and also exposes the improvement opportunities by pinch point location. Some common generic scenarios for improvement in the eco-leanness index are demonstrated using VVLD. Application of VVLD along with the developed computer-based support system (CBSS) is demonstrated for a manufacturing SME in India, allowing the managers to evaluate and tune their processes for improved resource utilisation efficiency.

The experiences of working carers of older people regarding access to a web‐based family care support network offered by a municipality

Policy makers in Sweden and other European Member States pay increasing attention as to how best support working carers; carers juggling providing unpaid family care for older family members while performing paid work. Exploring perceived benefits and challenges with web-based information and communication technologies as a means of supporting working carers' in their caregiving role, this paper draws on findings from a qualitative study. The study aimed to describe working carers' experiences of having access to the web-based family care support network 'A good place' (AGP) provided by the municipality to support those caring for an older family member. Content analysis of interviews with nine working carers revealed three themes: A support hub, connections to peers, personnel and knowledge; Experiencing ICT support as relevant in changing life circumstances; and Upholding one's personal firewall. Findings indicate that the web-based family care support network AGP is an accessible, complementary means of support. Utilising support while balancing caregiving, work obligations and responsibilities was made easier with access to AGP; enabling working carers to access information, psychosocial support and learning opportunities. In particular, it provided channels for carers to share experiences with others, to be informed, and to gain insights into medical and care issues. This reinforced working carers' sense of competence, helping them meet caregiving demands and see positive aspects in their situation. Carers' low levels of digital skills and anxieties about using computer-based support were barriers to utilising web-based support and could lead to deprioritising of this support. However, to help carers overcome these barriers and to better match web-based support to working carers' preferences and situations, web-based support must be introduced in a timely manner and must more accurately meet each working carer's unique caregiving needs.

Features of Computer-Based Decision Aids: Systematic Review, Thematic Synthesis, and Meta-Analyses.

BackgroundPatient information and education, such as decision aids, are gradually moving toward online, computer-based environments. Considerable research has been conducted to guide content and presentation of decision aids. However, given the relatively new shift to computer-based support, little attention has been given to how multimedia and interactivity can improve upon paper-based decision aids.ObjectiveThe first objective of this review was to summarize published literature into a proposed classification of features that have been integrated into computer-based decision aids. Building on this classification, the second objective was to assess whether integration of specific features was associated with higher-quality decision making.MethodsRelevant studies were located by searching MEDLINE, Embase, CINAHL, and CENTRAL databases. The review identified studies that evaluated computer-based decision aids for adults faced with preference-sensitive medical decisions and reported quality of decision-making outcomes. A thematic synthesis was conducted to develop the classification of features. Subsequently, meta-analyses were conducted based on standardized mean differences (SMD) from randomized controlled trials (RCTs) that reported knowledge or decisional conflict. Further subgroup analyses compared pooled SMDs for decision aids that incorporated a specific feature to other computer-based decision aids that did not incorporate the feature, to assess whether specific features improved quality of decision making.ResultsOf 3541 unique publications, 58 studies met the target criteria and were included in the thematic synthesis. The synthesis identified six features: content control, tailoring, patient narratives, explicit values clarification, feedback, and social support. A subset of 26 RCTs from the thematic synthesis was used to conduct the meta-analyses. As expected, computer-based decision aids performed better than usual care or alternative aids; however, some features performed better than others. Integration of content control improved quality of decision making (SMD 0.59 vs 0.23 for knowledge; SMD 0.39 vs 0.29 for decisional conflict). In contrast, tailoring reduced quality of decision making (SMD 0.40 vs 0.71 for knowledge; SMD 0.25 vs 0.52 for decisional conflict). Similarly, patient narratives also reduced quality of decision making (SMD 0.43 vs 0.65 for knowledge; SMD 0.17 vs 0.46 for decisional conflict). Results were varied for different types of explicit values clarification, feedback, and social support.ConclusionsIntegration of media rich or interactive features into computer-based decision aids can improve quality of preference-sensitive decision making. However, this is an emerging field with limited evidence to guide use. The systematic review and thematic synthesis identified features that have been integrated into available computer-based decision aids, in an effort to facilitate reporting of these features and to promote integration of such features into decision aids. The meta-analyses and associated subgroup analyses provide preliminary evidence to support integration of specific features into future decision aids. Further research can focus on clarifying independent contributions of specific features through experimental designs and refining the designs of features to improve effectiveness.