Alarmed: sensory approaches to improving medical alarm systems

Medical alarms sound incessantly, loudly, and dissonantly, contributing to an already noisy ICU and OR soundscape, and ultimately harming both patients and staff. Sometimes triggered in error, the sheer number of alarms distracts health care professionals and results in sensory overload that contributes to hospital staff’s alarm fatigue. In turn, staff become increasingly likely to ignore alarms instead of acting on them. Furthermore, the patients’ sensitivity to alarms disturbs their hospital stay, raises their stress levels, and impedes their recovery process, with sometimes lasting effects. This article considers the sensory effects of hospital alarms and possibilities for redesigning future alarm systems, with the goal of eventually creating a more calming, less stressful, and safer hospital soundscape environment for all.     

Test of parameter changes in a class of observation-driven models for count time series

Abstract

This paper investigates the parameter-change tests for a class of observation-driven models for count time series. We propose two cumulative sum (CUSUM) test procedures for detection of changes in model parameters. Under regularity conditions, the asymptotic null distributions of the test statistics are established. In addition, the integer-valued generalized autoregressive conditional heteroskedastic (INGARCH) processes with conditional negative binomial distributions are investigated. The developed techniques are examined through simulation studies and also are illustrated using an empirical example.     

德国选择党——疑欧势力的崛起与前景

德国选择党这支疑欧势力在现有的政党谱系中无法对号入座,却在德国政坛迅速崛起。本文分析该党目前的发展现状,从政党纲领、组织结构和政治动员等多方面探讨其成功原因,进而从政党生命周期理论出发,揭示这一新兴政党所处发展阶段及其对现有政党体制、尤其是右翼阵营的冲击,并研判该党的发展前景与制约因素。     

On the Status and Function of Judicial Justice in Social Governance Innovation

Social governance innovation is a basic requirement of China's socialist construction, and an important guarantee that people can live and work in peace and enjoy long-term stability and order. Strengthening and innovating social governance has great significance for the modernization of the national governance system and governance capacity, and this is where judicial justice plays a unique role at the level of government, society, and the individual. That is, judicial justice is the key to transforming governmental functions; the guarantee of a new-type social construction; and the guide to upgrading autonomy at the grass-roots level. To achieve judicial justice, we must popularize the idea of the rule of law, improve judicial work style and innovate judicial institutions.     

School beyond stratification: Internal goods,alienation, and an expanded sociology of education

Theory and Society - Sociologists of education often emphasize goods that result from a practice (external goods) rather than goods intrinsic to a practice (internal goods). The authors draw from...     

The Politics of Expanding Healthcare Access to the Poor and Informal Sectors

How do the politics of agenda setting and policy adoption operate in the arena of healthcare reform in the industrializing world? Literature on the twenty‐first‐century developmental state emphasizes the role of democratic competition and civil society in causing political parties to take up new agendas, while power resources theory stresses the role of left‐wing political parties and labor unions in policy adoption. Yet, core tenets of these theories have not been considered extensively in light of dynamics in the industrializing world. This article examines the politics of policy adoption in countries that have recently aimed to provide healthcare access and financial protection to the poor and people in the informal sector in Mexico and Turkey. In line with literature on the twenty‐first‐century developmental state, we find democratic competition to play an important role in causing political parties to take up new agendas. However, examination of the cases illuminates surprising dynamics that challenge important elements of sociological theory: right‐leaning political parties played important roles in adoption, while labor unions and left‐wing parties oppose reform in the cases. Public health‐minded physicians leading change teams played important roles in agenda setting and leading the process of implementation.     

Do Interactions Between Environmental Chemicals and the Human Microbiome Need to Be Considered in Risk Assessments?

One of the most dynamic and fruitful areas of current health‐related research concerns the various roles of the human microbiome in disease. Evidence is accumulating that interactions between substances in the environment and the microbiome can affect risks of disease, in both beneficial and adverse ways. Although most of the research has concerned the roles of diet and certain pharmaceutical agents, there is increasing interest in the possible roles of environmental chemicals. Chemical risk assessment has, to date, not included consideration of the influence of the microbiome. We suggest that failure to consider the possible roles of the microbiome could lead to significant error in risk assessment results. Our purpose in this commentary is to summarize some of the evidence supporting our hypothesis and to urge the risk assessment community to begin considering and influencing how results from microbiome‐related research could be incorporated into chemical risk assessments. An additional emphasis in our commentary concerns the distinct possibility that research on chemical–microbiome interactions will also reduce some of the significant uncertainties that accompany current risk assessments. Of particular interest is evidence suggesting that the microbiome has an influence on variability in disease risk across populations and (of particular interest to chemical risk) in animal and human responses to chemical exposure. The possible explanatory power of the microbiome regarding sources of variability could reduce what might be the most significant source of uncertainty in chemical risk assessment.     

HDDA: DataSifter: statistical obfuscation of electronic health records and other sensitive datasets

There are no practical and effective mechanisms to share high-dimensional data including sensitive information in various fields like health financial intelligence or socioeconomics without compromising either the utility of the data or exposing private personal or secure organizational information. Excessive scrambling or encoding of the information makes it less useful for modelling or analytical processing. Insufficient preprocessing may compromise sensitive information and introduce a substantial risk for re-identification of individuals by various stratification techniques. To address this problem, we developed a novel statistical obfuscation method (DataSifter) for on-the-fly de-identification of structured and unstructured sensitive high-dimensional data such as clinical data from electronic health records (EHR). DataSifter provides complete administrative control over the balance between risk of data re-identification and preservation of the data information. Simulation results suggest that DataSifter can provide privacy protection while maintaining data utility for different types of outcomes of interest. The application of DataSifter on a large autism dataset provides a realistic demonstration of its promise practical applications.