Minimally Invasive Surgery (MIS) is a surgical technique involving small incisions performed by an endoscope and several long, thin instruments. Because of its minimally invasive nature, MIS minimizes complications and speeds up recovery time compared to the traditional surgery. Unfortunately, from a surgeon's perspective, MIS is much more challenging than conventional surgery. Because the limited vision and sensing feedbacks, MIS a difficult skill for medical students and residents to master.There has been some research on the effectiveness of different kinds of training and guidance. Surgical simulation is increasingly perceived as a valuable addition to traditional medical training methods, although most existing simulators have limitations stemming from either a lack of objective performance assessment or an insufficient relation to the operating room reality.The objective of this research is to design and realize a novel prototype that advances the state of the art in surgical training, assessment, and guidance for MIS. The prototype features micro-sensors embedded into the instruments employed for simulation training. The system provides multiple training scenarios, a high fidelity training environment, repeatable, structured exercises, and objective performance assessment capabilities.The proposed Situational Awareness Enhancing System (SAES) uses a unified framework incorporating perception, comprehension, and projection software modules that provide feedback during the exercises and enable evaluation of the training procedure.A multiple sensor data fusion method was developed to help surgeons efficiently acquire information in real time. The output, "Hybridview", is produced by fusing the information from digital camera and magnetic position sensors, and shows an overlay of the positions of organs and objects with the trajectory of instruments. An intelligent inference engine was designed to formulate an objective standard based on the expertise of senior surgeons and to provide an accurate scoring method. A multi-level fuzzy inference engine and new performance metrics were implemented.To demonstrate the feasibility of the proposed training system, numerous experiments were conducted. The results show that the situational awareness training system for MIS is useful and efficient.

We know things about the world in spite of our cognitive limitations and imperfections. Occasions of stress impact memory retrieval, resources for attention can be depleted by non-epistemic factors, and our visual system has limited resolution and discriminatory ability. Yet we know many propositions, ranging from the mundane to the arcane, and we often are able to know that we know these things. In this dissertation I explore the relationship between our cognitive limitations and the limits to what we know, and what we know that we know. I begin by considering a simple model of knowledge. Because it is difficult (perhaps impossible) to have intuitions about many higher-order or iterative knowledge claims ("I know that you know that she knows that I know that ..."), a modeling approach can help clarify and explain how various cognitive limitations impact knowledge and higher-order knowledge. In Chapter 2 I discuss the epistemic requirements for the rational coordination of our actions. While it may seem that coordination is rational only if each coordinating member has what may be called "common knowledge" of some relevant proposition, the model of knowledge I employ helps show the informational complexity of common knowledge. I argue that common knowledge is unattainable. In Chapter 3 I discuss epistemic closure. Perfectly ideal agents may know every deductive consequence of what they know, but if the aim is to understand how deduction extends human knowledge then it is necessary to model our cognitive access to information. In Chapter 4 I turn to the issue of higher-order or iterative knowledge. I argue that memory limitations and various information processing errors all result in failures of higher-order knowledge. The argument I give does not require epistemic closure or a principle of self-knowledge. I conclude, in Chapter 5, by discussing interpretive issues for models of knowledge and I discuss our awareness of what we know and what we do not know.

Idag börjar personliga tränare kännas igen som en stor del av friskvården och har nu uppmärksammats vara en resurs för att främja hälsa. Syftet med detta arbete är att studera personliga tränares erfarenhet av hälsa när det kommer till utbildning, sin egen hälsa och hälsa i relation till sitt yrke. Det genomfördes fem individuella intervjuer med personliga tränare för att samla in material. Intervjuerna transkriberades och resultatet tematiserades där kärncitat valdes ut för att illustrera var tema. Resultatet analyserades och diskuterades utifrån dessa teman med en teoretisk utgångspunkt komponerad genom begrepp av Pierre Bourdieu. Resultatet av intervjuerna visar på en helhetsyn av hälsa. Hälsan ses som en resurs för att kunna leva livet. Den hälsa de olika personliga tränarna upplever är något som formats under livs- och yrkeserfarenhet. Under sina utbildningar till PT (personlig tränare) upplevde ingen av informanterna att deras syn på hälsa förändrades. Det fanns även en frånvaro i utbildningarna av vad hälsa är. Det framgår att hälsoarbetet är en strävan efter att må bra. Detta genom att finna det som gör att en mår bra men även finna det som skapar ohälsa och behandla detta. Personliga tränare jobbar med ett helhetsperspektiv på hälsa. Det framgår även att de under sina respektive utbildningar inte erhöll något lärande i vad hälsa är eller innebär. Under utbildningarna förändrades inte heller deras syn på hälsa. I arbetet med sina klienter framgår det att de både jobbar utifrån vad som skapar hälsa respektive ohälsa, men att det som skapar hälsa är i fokus. Den breda synen på hälsa kan bidra i hälsoarbetet då den erbjuder möjligheten att lättare identifiera påverkningsfaktorer av hälsa respektive ohälsa hos kunderna.

Hypoglycaemia is a very common side-effect of insulin therapy for diabetes and directly affects cognitive function. It can be identified by the onset of symptoms and by blood glucose monitoring. Impaired awareness of hypoglycaemia is an acquired syndrome in people with insulin-treated diabetes. The definitions, frequency, causes, treatment and prevention of clinical hypoglycaemia and the effects on, and moderators of, cognitive function will be discussed. Two studies have examined the effects of hypoglycaemia on tests of particular cognitive domains in subjects with and without type 1 diabetes. Three further studies have examined the frequency of hypoglycaemia in people with and without impaired awareness, the prevalence of impaired awareness of hypoglycaemia (IAH) and have compared methods of assessing awareness of hypoglycaemia. In study 1 the effect of acute hypoglycaemia on psychomotor function was examined in healthy volunteers (n =20) and adults with type 1 diabetes (n=16). Although acute hypoglycaemia caused significant impairment of several psychomotor functions in nondiabetic adults, a lower magnitude of impairment was observed in those with type 1 diabetes. The potential mechanisms behind this are discussed. In study 2 the effect of acute hypoglycaemia on a simple two-choice reaction time test, which has a model with validated performance parameters, was examined in 14 nondiabetic volunteers. Application of the validated model to the results of this task revealed that hypoglycaemia affected central processing and was not related to the amount of evidence required to make a decision or to peripheral and motor processes. This study is the first to use this method to dissect the effects of hypoglycaemia on cognition and enhances understanding of the mechanism underlying neuroglycopenia in adults. In Study 3 the methods of evaluating awareness of hypoglycaemia were compared in people with type 1 diabetes. Good concordance in clinical characteristics and frequency of biochemical hypoglycaemia was observed between the methods described by Gold et al and Clarke et al but not with a Danish method. In study 4 continuous glucose monitoring (CGM) and home blood glucose monitoring were performed prospectively for 12 months in people with and without IAH. Those with IAH had a 1.6-fold higher incidence of biochemical hypoglycaemia as demonstrated by blood glucose monitoring, but CGM did not identify patients with IAH. In study 5 the prevalence of IAH in a large clinic population with type 1 diabetes was estimated and compared with earlier assessments. The overall prevalence was 20%.

The cognitive model of BDD (Veale, 2004) proposes high levels of self-objectification (viewing and treating oneself as an object) as an important maintaining factor; however, to date this construct has not been empirically measured in this population. In addition, recent models of the self (Damasio, 2010) point towards the central role of interoceptive awareness (IA; the ability to identify bodily signals) in developing a sense of self. Low levels of IA have been associated to body dissatisfaction, eating disorders and depression. The aim of this study was to investigate the role of self-objectification and interoceptive awareness in patients with BDD. Three groups of participants with BDD (n=14), anxiety (n=23), and non-clinical participants (n=23) completed a heartbeat detection task to measure levels of IA under two conditions: blank screen and while facing a mirror in order to also explore the impact of self-focus attention on IA. Levels of self-objectification and self-focussed attention were measured through self-report questionnaires. Statistical comparisons between groups indicated significantly lower levels of IA in the BDD group at blank screen only when compared to the non-clinical group. In the mirror condition the BDD group had significantly lower IA scores than both control groups. Furthermore, the BDD group reported significantly higher self-objectification than the non-clinical group, and there was a trend towards the group scoring at a higher level than the anxiety group. Across groups there was no significant relationship between levels of IA in either condition, and self-reported levels of self-objectification or self-focussed attention. The results support the role of self-objectification in BDD and points towards the potential contribution of somatoperception. The theoretical and clinical implications of these findings, the limitations of the methodology employed, and suggestions for future research are discussed.

The broad use of information systems within organizations has led to an increased appreciation of the need to ensure that all users be aware of basic concepts in Information Assurance (IA). The Department of Defense (DOD) addressed the idea of user awareness in DOD Directive 8750.1. This directive requires that all users of DOD information systems undergo an initial IA awareness orientation followed by annual refresher instruction. This thesis created a CyberCIEGE campaign for the Naval Postgraduate School's CyberCIEGE project that will fulfill Navy requirements to meet DOD Directive 8750.1. The first portion of this thesis is an analysis of four IA programs and products. Requirements for Navy IA awareness and training products were developed from this analysis. The second part of this thesis is a description of two CyberCIEGE scenarios that were created to fulfill these requirements. The first scenario focuses on basic IA awareness and emphasizes information that the Navy should reinforce. The scenario is intended for all users of Navy information systems. The second scenario is intended for technical users and addresses more advanced concepts and technical considerations. The technical user scenario emphasizes skill application and problem solving.

The IEEE 802.16-2004 wireless standard is a robust, wireless, longhaul solution for connecting remotely located, forward operating bases. Proof of concept for this capability is the NPS OFDM testbed for the research and support of the communications and collaborative processes between tactical operators within a wireless network. This thesis will attempt to develop strategies for implementing network management, establish a performance baseline for the NPS testbed and define the acceptable metrics for QoS. Field experimentation scenarios, network performance management tools and modeling tools are the techniques that we are using to assess the operation of 802.16 NPS testbed for its quality requirements. A baseline is conducted to record the state of the network operation and investigate the operational guidelines and conditions for the network to support collaborative applications. The baseline provides good organization, status monitoring and planning capabilities that will help in troubleshooting future failures. Using OPNET Modeler ACE we examine the network traffic flow and diagnose performance issues for critical applications. Finally, we develop appropriate policies to fine-tune network behavior within a holistic ad hoc collaborative environment.

Master of Agribusiness / Department of Agricultural Economics / Dustin L. Pendell / This research focuses on the cattle producer’s overall awareness of an internal deworming product available in the U.S. cattle market. Parasitism in cattle can be very costly for the producer, and identifying a need for deworming is instrumental to the decision-making process for animal health protocols. The additional cost of deworming products can be beneficial for profitability for cattle producers when used properly. Likewise, when there is no proven need for deworming products in certain operations, the additional cost is an unnecessary expense that can be avoided. Proper awareness and education regarding deworming products and the benefits they can provide is one crucial piece to improving herd health, better rates of gain, and increased profitability. The main objective of this study is to determine the awareness of non-handling formulations of Safe-Guard. To understand and assess awareness, a survey was used. A population of participants was developed and asked to participate in the survey either online or in hard copy. A binary logit is used to analyze how cattle producers make decisions in adopting animal health products into their operations. Influencing factors of operation type, size, location, producer’s age, and information sources are used in the assessment. Factors that were the most influential to the decision-making processes for producers were discussions with veterinarians, nutritionists, and animal health sales representatives. In addition to face-to-face discussions with neighboring producers/friends, industry meetings, and reading industry journals and publications were also important. These producers were aware of a few formulations of Safe-Guard, and used them within the previous twelve months of taking the survey. However, participants were generally unaware of the product, and its different formulations. Upon review of the assessed unawareness of the product formulations, it is apparent that the company needs to identify and select a better way to make producers aware. Different approaches to targeted marketing campaigns and more in depth product training for the animal health company’s sales representatives should be implemented to increase awareness and sales.

The ability of marital partners to directly change a currently unhappy marriage to a happy one may be a function of each individual's conscious awareness of the topography, frequency, and other parameters of his own behaviors, as well as the effects or consequences these behaviors bring to bear on his spouse. This study was an attempt to combine the use of relevant behavioral awareness and a token economy to rehabilitate a marriage in crisis.

This paper examines factors associated with awareness of the EU energy labels of household appliances and the factors associated with the choice of appliance energy class using a dataset of 2136 households in Bulgaria, Czech Republic, Hungary, and Romania. The results for five major appliances indicate that household knowledge of energy use increases label awareness, while households with a large share of elderly decrease label awareness. Factors that influence awareness of energy labels have a limited impact on appliance energy class choice. Significant country differences also exist. Romania shows higher household propensities to be aware of the energy class of appliances than Czech Republic, while Bulgaria shows lower propensities of label awareness compared to the benchmark of Czech Republic.