Development of a Robust Multicriteria Classification Model for Monitoring the Postoperative Behaviour of Heart Patients

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia occurring in 2% of the general population, while the assuming projected incidence in 2050 will rise to 4.3%. This paper presents a multicriteria methodology for the development of a model for monitoring the post‐operative behaviour of patients who have received treatment for AF. The model classifies the patients in seven categories according to their relapse risk, on the basis of seven criteria related to the AF type and pathology conditions, the treatment received by the patients and their medical history. The analysis is based on an extension of the UTilités Additives DIScriminantes (UTADIS) method, through the introduction of a two‐stage model development procedure that minimizes the number and the magnitude of the misclassifications. The analysis is based on a sample of 116 patients who had pulmonary veins isolation in a Greek public hospital. The classification accuracy of the best fitted models scores between 71% and 84%. Copyright © 2015 John Wiley & Sons, Ltd.     

Suitability and context for brief therapy

Abstract

The main point of this paper is that a client's suitability for brief or time-limited therapy is determined by various factors, including context. There is still agreement on the validity of Malan's selection criteria, which included ‘mild illness, recent onset, high motivation and response to trial interpretation’, yet many additional issues have since emerged and need to be considered. For instance, the counsellor's suitability, training and work experience, the counsellor's assessment skills and ability to establish a dynamic focus, the clients' capacity for self-reflection, their ego strength and their response to a trial therapy in the first session. Then there is the importance of the various contexts in which nowadays much brief counselling is offered free to clients, whether in education, at the workplace, in primary healthcare settings or by charitable organizations. This means that issues of money and markets have come to the fore and an initial differential assessment needs to be carried out in order to decide which method or model of therapy is best for the client. Matching the counsellor's personality to the needs and to the pathology of the client, and matching the treatment to the client's developmental stage or life stage crises are other aspects of the work, which determine the issue of suitability. In the end as always there is much that remains unknown about what works for whom and how the client's decision to take up help is made.     

Invited Review—Survey of Value‐Focused Thinking: Applications,Research Developments and Areas for Future Research

Criteria are the central focus of multi‐criteria decision analysis. Many authors have suggested using our values (or preferences) to define the criteria we use to evaluate alternatives. Value‐focused thinking (VFT) is an important philosophy that advocates a more fundamental view of values in our decision making in our private and professional lives. VFT proponents advocate starting first with our values and then using our values to create decision opportunities, evaluate alternatives and finally develop improved alternatives. It has been 20 years since VFT was first introduced by Ralph Keeney. This paper surveys the VFT literature to provide a comprehensive summary of the significant applications, describe the main research developments and identify areas for future research. We review the scope and magnitude of VFT applications and the key developments in theory since VFT was introduced in 1992 and found 89 papers written in 29 journals from 1992 to 2010. We develop about 20 research questions that include the type of article (application, theory, case study, etc.), the size of the decision space (which, when given, ranged from $200K to billions of dollars), the contribution documented in the article (application benefits) and the research contributions (categorized by preferences, uncertainties and alternatives). After summarizing the answers to these questions, we conclude the paper with suggestions for improving VFT applications and potential future research. We found a large number of significant VFT applications and several useful research contributions. We also found an increasing number of VFT papers written by international authors. Copyright © 2012 John Wiley & Sons, Ltd.     

An Approach to Multi‐Criteria Decision Problems Under Severe Uncertainty

Solving complex decision problems is a demanding task; it requires determining and evaluating the consequences of decision alternatives. To this end, uncertain factors that can only partly be influenced by the decision makers, and their interdependencies need to be considered. Scenarios focus on this part of the decision problem; they enable a systematic exploration of a multitude of possible future developments that are relevant for the decision including external events and decisions made. Scenarios are particularly useful when the problem is pervaded by severe uncertainties that cannot be quantified. For the evaluation of alternatives, multiple objectives and the potentially diverging preferences of the involved actors need to be respected. Multi‐criteria decision analysis aims at structuring the problem, evaluating the alternatives and supporting decision makers pursuing multiple goals. We propose an approach integrating scenarios and multi‐criteria decision analysis that focuses on the robustness of alternatives in complex, dynamic, uncertain and time‐bound situations. In this integrated framework, the scenarios provide the basis for evaluating a set of alternatives. Ideally, the set of scenarios considered captures all possible future developments. To appropriately explore this set, formal or analytical approaches to scenario construction generate a large number of scenarios. This challenges the decision makers' information‐processing capacity. To support them in managing the richness of information, a two‐fold approach that uses selection and aggregation is presented. By using a selection method, the scenarios that are deemed most relevant are identified, and their evaluations are presented in detail to decision makers. This approach is complemented by an aggregation of scenario evaluations on the basis of the decision makers' preferences. We present two approaches to facilitate the preference elicitation process. Copyright © 2013 John Wiley & Sons, Ltd.     

ECG诊断左室肥厚的临床价值

比较ECG的Sokolow-lyon标准和Cornell标准对诊断左室肥厚的敏感性和特异性,以评价其在高血压左室肥厚（Left Ventricular Hypertrophy,LVH）中的诊断价值。对188例高血压患者,根据超声心动图（Uhrasoniccardiogram,UCG）检查结果有无LVH分组,分别计算So...     

On receiving what has gone astray, on finding what has got lost

Disturbing emotions that act as bodily cryptograms waiting to be deciphered are currently understood as intra-psychic trauma. The author briefly discusses Fordham's concepts of deintegration and primitive identity, as well as early patterns of mother-infant attunement to describe how the empathic capacity of the analyst is dramatically challenged in helping patients to give birth to unbearable emotions that remain an undifferentiated entity. Referring to Ogden's understanding of the mechanism of projective identification, the author will explore how unconscious mental processes in the analyst and the patient can work at re-activating failures in the deintegrative process. Clinical material is presented to show how unconscious psychic events that affect the patient but cannot be known consciously can be born into mind by the analytic couple.     

What is conceptual research in psychoanalysis?1

The development of psychoanalysis as a science and clinical practice has always relied heavily on various forms of conceptual research. Thus, conceptual research has clarifi ed, formulated and reformulated psychoanalytic concepts permitting to better shape the fi ndings emerging in the clinical setting. By enhancing clarity and explicitness in concept usage it has facilitated the integration of existing psychoanalytic thinking as well as the development of new ways of looking at clinical and extraclinical data. Moreover, it has offered conceptual bridges to neighbouring disciplines particularly interested in psychoanalysis, e.g. philosophy, sociology, aesthetics, history of art and literature, and more recently cognitive science/neuroscience. In the present phase of psychoanalytic pluralism, of worldwide scientifi c communication among psychoanalysts irrespective of language differences and furthermore of an intensifying dialogue with other disciplines, the relevance of conceptual research is steadily increasing. Yet, it still often seems insuffi ciently clear how conceptual research can be differentiated from clinical and empirical research in psychoanalysis. Therefore, the Subcommittee for Conceptual Research of the IPA presents some of its considerations on the similarities and the differences between various forms of clinical and extraclinical research, their specifi c aims, quality criteria and thus their specifi c chances as well as their specifi c limitations in this paper. Examples taken from six issues of the International Journal of Psychoanalysis in 2002‐3 serve as illustrations for seven different subtypes of conceptual research.     

Evaluating interobserver reliability of interval data

Previous recommendations to employ occurrence, nonoccurrence, and overall estimates of interobserver reliability for interval data are reviewed. A rationale for comparing obtained reliability to reliability that would result from a random-chance model is explained. Formulae and graphic functions are presented to allow for the determination of chance agreement for each of the three indices, given any obtained per cent of intervals in which a response is recorded to occur. All indices are interpretable throughout the range of possible obtained values for the per cent of intervals in which a response is recorded. The level of chance agreement simply changes with changing values. Statistical procedures that could be used to determine whether obtained reliability is significantly superior to chance reliability are reviewed. These procedures are rejected because they yield significance levels that are partly a function of sample sizes and because there are no general rules to govern acceptable significance levels depending on the sizes of samples employed.     

Language, moral order and political praxis

The paper argues that the debate between objectivist criticism and postmodern critique represents a fracturing of the modes of mundane social and linguistic practice. The two together miss the open-textured character of language-in-use and the reflexive properties of situated human practice. Both difference and agreement are grounded in the multiplicity of criteria that are a feature of the logical grammar of language, and therefore of everyday praxis, including that of critique. To escape the duality of foundationalism on the one hand, and radical relativism on the other, attention to the praxiological details of human action and reasoning is needed. The paper draws on Wittgensteinian philosophy and ethnomethodological studies of reasoning to make its case.