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author:("Nayak, abhava")
1.  A causal model for fluctuating sugar levels in diabetes patients 
The Australasian Medical Journal  2012;5(9):497-502.
Background
Causal models of physiological systems can be immensely useful in medicine as they may be used for both diagnostic and therapeutic reasoning.
Aim
In this paper we investigate how an agent may use the theory of belief change to rectify simple causal models of changing blood sugar levels in diabetes patients.
Method
We employ the semantic approach to belief change together with a popular measure of distance called Dalal distance between different state descriptions in order to implement a simple application that simulates the effectiveness of the proposed method in helping an agent rectify a simple causal model.
Results
Our simulation results show that distance-based belief change can help in improving the agent’s causal knowledge. However, under the current implementation there is no guarantee that the agent will learn the complete model and the agent may at times get stuck in local optima.
Conclusion
Distance-based belief change can help in refining simple causal models such as the example in this paper. Future work will include larger state-action spaces, better distance measures and strategies for choosing actions.
doi:10.4066/AMJ.2012.1392
PMCID: PMC3477778  PMID: 23115584
Belief Change; Belief Update; Belief Revision; Causal Models; Glucose Metabolism; Diabetes
2.  Marriage, Sex, and Hydrocele: An Ethnographic Study on the Effect of Filarial Hydrocele on Conjugal Life and Marriageability from Orissa, India 
Background
Lymphatic filariasis (LF), a leading cause of permanent and long-term disability, affects 120 million people globally. Hydrocele, one of the chronic manifestations of LF among 27 million people worldwide, causes economic and psychological burdens on patients and their families. The present study explores and describes the impact of hydrocele on sexual and marital life as well as on marriageability of hydrocele patients from rural areas of Orissa, an eastern state of India.
Methodology/Principal Findings
This paper is based on ethnographic data collected through focus group discussions and in-depth interviews with hydrocele patients, wives of hydrocele patients, and other participants from the community. The most worrisome effect of hydrocele for patients and their wives was the inability to have a satisfactory sexual life. The majority of patients (94%) expressed their incapacity during sexual intercourse, and some (87%) reported pain in the scrotum during intercourse. A majority of hydrocele patients' wives (94%) reported dissatisfaction in their sexual life. As a result of sexual dissatisfaction and physical/economic burden, communication has deteriorated between the couples and they are not living happily. This study also highlights the impact on marriageability. The wives of hydrocele patients said that a hydrocele patient is the “last choice” and that girls show reluctance to marry hydrocele patients. In some cases, the patients were persuaded by their wives to remove hydrocele by surgery (hydrocelectomy).
Conclusions/Significance
The objective of the morbidity management arm of the Global Programme to Eliminate LF should be to increase access to hydrocelectomy, as hydrocelectomy is the recommended intervention. Though the study area is covered by the programme, like in other endemic areas, hydrocelectomy has not been emphasised by the national LF elimination programme. The policy makers and programme managers should be sensitised by utilising this type of research finding.
Author Summary
Lymphatic filariasis, the second leading cause of permanent and long-term disability, affects 120 million people globally. Hydrocele, an accumulation of fluid in the scrotum that causes it to swell, is one of the chronic manifestations of LF among men and there are about 27 million men with hydrocele worldwide. We conducted ethnographic interviews and discussions with patients, women whose husbands have hydrocele, and the general public in a rural community of eastern India. The study describes how hydrocele impacts patients' sexual and marital life. It reveals the most worrisome effect of hydrocele for patients and their wives due to the inability to have a satisfactory sexual life. Patients expressed their incapacity during sexual intercourse. A majority of hydrocele patients' wives reported that their married life became burdened and couples were not living happily. This study also highlights the impact on marriageability, and some women expressed that a hydrocele patient is the “last choice”. In some cases, the patients were persuaded by their wives to remove hydrocele by surgery (hydrocelectomy). Hence, access to hydrocelectomy has to be strengthened under the Global Programme to Eliminate Lymphatic Filariasis, which is operational in several endemic areas in the world. Also, this activity may be integrated with primary healthcare services and interventions of other neglected tropical diseases.
doi:10.1371/journal.pntd.0000414
PMCID: PMC2666802  PMID: 19381283

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