Biology Reference
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allocation of resources. Along the same continuum is the opportunity to
intercept messages through an automated system and triage accordingly
with role-based agents. Dov Te'eni (2006) notes that “the complexity of imple-
menting communicative action grows with the need for coordination, the
contextual demands (norms and values) and the use of scarce resources.”
The introduction of role-based agents (automated triage) could mitigate the
contextual demands between the sender and receiver. How systems can log
copies of “free text” for communication exchange could be another option
for early outbreak detection and to ensure timely and effective response. A
monitoring system could then leverage data mining techniques to identify
patterns within log files in preparation of future crisis. The same log files
could be analyzed for plain language training improvements. At present the
next steps of this research have been expedited with the novel influenza A
(H1N1) pandemic and preparedness initiatives for the fall of 2009.
To collect a sample of “free text” responses and establish a baseline for use
with different responder roles and different levels of ICT experience, a Web-
based training application was developed. The emphasis of the application was
to study user behavior, response, and training effectiveness (refer to Section 7.4.
Simulating SMS Text Messaging for Training) when using “free text” in 160
character chunks to mirror the SMS exchange limit. The training application,
which was field tested in the spring of 2007, used a bottom-up approach and
proposed to increase community responder readiness and improve message
response (accuracy/content) when using SMS text messaging to communicate
from a mobile device. The study participants within the community were in a
role that is considered a “feeder” to public health systems. At present, the out-
put of each training task is being analyzed for patterns that could translate into
triage options for the community responder role. With plain language training,
similarities can be identified and assessed over time the more plain language
is used. The task responses are based on a crisis scenario that runs from start
to finish for the entire training session. The study revealed that with mini-
mal training, practitioner's (community responders) use of plain language did
show significant improvement. The inter-rater reliability and coding of “free
text” responses also revealed the importance and need for situation awareness
training. Data mining methods and feeder systems with accumulated data
such as over-the-counter (OTC) medicine purchases, emergency room visits,
ambulance responses, and absenteeism have also been investigated for use in
biosurveillance and early outbreak detection.
With respect to biosurveillance systems, the exchange of “free text” to iden-
tify early/potential cases and its impact to create panic should not be over-
looked. Jurisdictional authorization, such as state legislatures in the United
States must also be considered (Halperin, Baker, and Monson 1992). So as to
expand on the premise of surveillance, which “was restricted, in public health
pract ices, to watch i ng contact of serious com mu n icable diseases, such as small-
pox, to detect early symptoms so that prompt isolation could be instituted,” to
now include chronic diseases, occupational safety, and health, environmental
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