Recommendations on compiling test datasets for evaluating artificial intelligence solutions in pathology.

Artificial intelligence (AI) solutions that automatically extract information from digital histology images have shown great promise for improving pathological diagnosis. Prior to routine use, it is important to evaluate their predictive performance and obtain regulatory approval. This assessment requires appropriate test datasets. However, compiling such datasets is challenging and specific recommendations are missing. A committee of various stakeholders, including commercial AI developers, pathologists, and researchers, discussed key aspects and conducted extensive literature reviews on test datasets in pathology. Here, we summarize the results and derive general recommendations on compiling test datasets. We address several questions: Which and how many images are needed? How to deal with low-prevalence subsets? How can potential bias be detected? How should datasets be reported? What are the regulatory requirements in different countries? The recommendations are intended to help AI developers demonstrate the utility of their products and to help pathologists and regulatory agencies verify reported performance measures. Further research is needed to formulate criteria for sufficiently representative test datasets so that AI solutions can operate with less user intervention and better support diagnostic workflows in the future.

Three silver linings in the cloud of old age: an autobiographical perspective.

Through the author's experiences as a gerontological social worker, graduate student in gerontology, and gerontology professor, the author discovered not only the cloud of old age, but three silver linings.

Gay aging.

The oldest of the baby boomers (boomers) were age 63 in 2009 and on the verge of retirement. This cohort has had a history of making societal changes throughout its life cycle, and it is unlikely that retirement, as we know it, will remain unscathed. This article highlights two events-the Stonewall Inn riots and two prominent professional associations removing homosexuality from their list of personality disorders-and how they occurred early enough in the gay boomers life cycle to change their attitudes, behaviors, and lifestyles. This article introduces the reader to a broad array of facts, research findings, and issues that inform the topic of gay aging. A summary of the discrimination and legal concerns affecting the gay community are also highlighted. Two influential community programs are identified: Services and Advocacy for Gay Elders (SAGE) and the American Society on Aging's LGBT Aging Issues Network (LAIN). Gerontological educators need to be sensitive to the needs, desires, and resources of the coming cohort of gay boomers, who are more likely to advocate for responsive services, organizations, and policies than the current cohort of gay older adults.

Health contract in the classroom.

A health contract is a technique used by health professionals to help clients achieve a health goal. This article describes a course, "Changing Health Behaviors," in which a health contract strategy is taught and practiced with older adults. The health contract can also be included as a smaller educational component within a gerontology course that covers risk factors such as sedentary behavior or nutritional deficiency, counseling or health education techniques, or program development. Gerontology students who complete a degree or certificate program may enter a variety of venues in which a health contract can be a useful tool with older clients.

Life review: implementation, theory, research, and therapy.

A selective literature review of publications on life review generated ideas on implementation, theory, research, and therapy. The review begins by differentiating life review from reminiscence, and summarizing ways to conduct a life review. A dozen theories that have been influenced by the life review technique are presented, with a focus placed on Erikson's Stages of Psychosocial Development. Erikson's theory has not only been influenced by the life review, it has had a major impact on life review research. Three research topics are discussed: Erikson's ego integrity versus despair in old age, demographical differences in the practice of life reviews, and the impact of conducting life reviews on staff in institutional settings. Most practitioners of life reviews are institutional staff, university students, and family members, many of whom have had limited prior training. The prospect of a certified life review training program is discussed.

Health contract with sedentary older adults.

PURPOSE: Health educators used health contracts with sedentary older adults for the purpose of increasing exercise or physical activity. DESIGN AND METHODS: Two health educators helped 25 sedentary older adults complete health contracts, and then they conducted follow-up evaluations. The percentage of scheduled exercise sessions successfully completed by older adults was calculated. Participants were asked if each of five components of the health contract-motivation, goal setting, social support, memory techniques, and problem solving-was helpful in achieving their exercise goals. RESULTS: Of the 25 participants, 20 achieved at least 75% of their exercise goals and 15 had a 100% success rate. Most of the older adults reported that several behavioral, social, and cognitive strategies were helpful to them. IMPLICATIONS: This technique may be applied by health educators or clinicians in a variety of settings and can be focused on one of several potential risk factors.

Health promotion directory: development, distribution, and utilization.

In response to repeated questions from older adults in the community about health resources, a health promotion directory was created. To enhance the development and distribution of the directory, the authors reviewed the literature and received input from unpaid consultants--both health professionals and a diverse group of older adults. To assess the utilization of the directory, the authors obtained a purposive sample, comparing 43 African American older adults, with low income and educational levels, with 118 mostly Anglo American (96%) older adults with a higher educational level. The African American group members were significantly more likely to contact one of the resources listed in the health directory. This may be due to a variety of factors, including the increased contact time that the authors had spent with these older adults or the greater need that older adults with low income and education levels may have for the information in the directory.

Wellness general of the United States: a creative approach to promote family and community health.

This article offers a creative approach to promote family and community health, beginning with the conversion of the office of Surgeon General of the United States into the Wellness General of the United States. The content ranges from federal initiatives to promote quality health research to individuals and families who will be the beneficiaries at medical clinics and community health programs. The proposal recommends changes to institutions and policies, including junk food taxes, the National Institutes of Health, the United States Preventive Services Task Force, the Healthy People 2010 initiative, the Health Plan Employer Data and Information Set, the Medicare Coverage Advisory Committee, state health mandates, local health plans, community medical clinics, and community health programs. The goal is to stimulate ideas and actions among policymakers, researchers, practitioners, educators, and students.