A Construção do processo democrático de auto-avaliação institutucional na UNESP

O desenvolvimento de um processo democrático de avaliação institucional na UNESP, uma universidade multi-campus, envolveu três desafios: garantir o envolvimento de grupos representativos da comunidade no processo de avaliação; atribuir poder e responsabilidade a cada setor acadêmico e administrativo no processo de avaliação; criar uma cultura de auto-avaliação e reflexão que possibilitasse debate crítico e auto-gestão dos projetos acadêmicos. Com base nos termos de referência estabelecidos pela comunidade a CPA desenvolveu uma metodologia de avaliação democrática e investigativa, orientada para a auto-gestão e de natureza quali-quantitativa. Fundamentada em três enfoques teóricos de avaliação, o democrático, o de tomada de decisão e o crítico o processo envolveu três funções: a diagnóstica, a formativo-reflexiva e a de revisão crítica. Atualmente os usos dos resultados da avaliação para orientar políticas e decisões acadêmicas, especialmente nos cursos de graduação, evidenciam avanços no processo de internalização de cultura de avaliação orientada para auto-gestão.

Brazilian Students and Working Capital: An Analysis of Their Decisions When Using Virtual Market Business Games

This study aims to demonstrate that data from business games can be an important resource for improving efficiency and effectiveness of learning. The proposal presented here was developed from preliminary studies of data from Virtual Market games that pointed the possibility of identifying gaps in learning by analyzing the decisions of students. This proposal helps students to refine their learning processes and equips tutors with strategies for teaching and student assessment. The proposal also complements the group discussion and/or debriefing, which are widely used to enhance learning mediated by games. However, from a management perspective the model has the potential to be erroneous and miss opportunities, which cannot be detected because of the dependence on the characteristics of the individual, such as ability to communicate and work together. To illustrate the proposed technique, data sets from two business games were analyzed with the focus on managing working capital and it was found that students had difficulties managing this task. Similar trends were observed in all categories of students in the study-undergraduate, postgraduate and specialization. This discovery led us to the analysis of data for decisions made in the performance of the games, and it was determined that indicators could be developed that were capable of indentifying inconsistencies in the decisions. It was decided to apply some basic concepts of the finance management, such as management of the operational and non-operational expenditures, as well as production management concepts, such as the use of the production capacity. By analyzing the data from the Virtual Market games using the indicator concept, it was possible to detect the lack of domain knowledge of the students. Therefore, these indicators can be used to analyze the decisions of the players and guide them during the game, increasing their effectiveness and efficiency. As these indicators were developed from specific content, they can also be used to develop teaching materials to support learning. Viewed in this light, the proposal adds new possibilities for using business games in learning. In addition to the intrinsic learning that is achieved through playing the games, they also assist in driving the learning process. This study considers the applications and the methodology used.

O consentimento informado: Qual o seu real valor na prática médica?

Trata-se de um artigo que comenta sobre a real importância do Termo de Consentimento Informado na prática médica. Este documento tem sido cada vez mais usado como uma prática defensiva, a fim de constituir provas para defesa de um eventual processo judicial de responsabilidade médica, desvirtuando assim a idéia original, que seria a de respeitar a autonomia do paciente e delimitar a responsabilidade médica. O documento tem como objetivo mostrar que o médico cumpriu com seu dever de informar. Seu grande valor reside nos casos onde existam riscos de danos irreversíveis ao paciente. Conclui-se, porém, que um prontuário bem elaborado onde se inclui o registro das informações que foram transmitidas, bem como o grau de participação dos pacientes e seus familiares nas decisões terapêuticas, também deve ter valor ético e jurídico semelhante do TCI.

Comparison of visual inspection, radiographic examination, laser fluorescence and their combinations on treatment decisions for occlusal surfaces

Purpose: To compare visual inspection (VI), radiographic examination (RX) and the laser fluorescence device DIAGNOdent (L), as well as their combinations in vitro regarding treatment decisions for occlusal surfaces. Methods: 72 extracted human permanent teeth (molars and premolars) were used. Treatment decisions were recorded by three calibrated examiners, and the options available were fissure sealant and conservative restoration. For validation of treatment decisions, the teeth were sectioned and examined in a stereomicroscope. Thereafter, dental slices were scanned and the images were edited to facilitate classification of existing carious lesions. Intra and inter-examiner reproducibility for the determination of treatment plans were calculated using Cohen's kappa test (95%-CI). Sensitivity, specificity, positive and negative predictive values, and the area under the ROC curve were also calculated. Results: VI and L provided on average the greatest intra- and inter-examiner reproducibility, respectively. Although the combination of diagnostic methods may decrease both intra- and inter examiners reproducibility, combination of VI, L and RX resulted in the greatest sensitivity, being statistically superior to RX and L. There was more inter-examiner agreement for the option of restorative treatment, while the use of sealants as a treatment option yielded the lowest values. Negative predictive values were numerically inferior to positive predictive values, indicating that the examiners preferred not to restore a carious tooth than to proceed operatively in an intact tooth. The combination of the three methods studied showed the best results in determining treatment plans for occlusal surfaces, when compared to the other types of exams. on the other hand, radiographic examination and laser fluorescence were less efficient when used alone.

When decisions on homologous structures cause ambiguous taxa relationships: the Neomorphinae (Aves, Cuculidae) example

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

In Vitro Evaluation of ICDAS and Radiographic Examination of Occlusal Surfaces and Their Association With Treatment Decisions

This in vitro study evaluated the performance of visual (International Caries Detection and Assessment System [ICDAS]) and radiographic (bitewing [BW]) examinations for occlusal caries detection and their associations with treatment decision (TD). Permanent teeth (n=104) with occlusal surfaces varying from sound to cavitated were selected. Sites were identified from 10x occlusal surface photographs. Standardized bitewing (BW) radiographs were taken. Four dentists with at least five years of experience scored all teeth twice (one-week interval) for ICDAS (0-6), BW (0=sound, 1=caries restricted to enamel, 2=caries in outer third dentin, 3=caries in inner third dentin), and TD (0=no treatment, 1=sealant, 2=microabrasion and sealant, 3=round bur sealant, 4a=resin, 4b=amalgam). Histological validation was performed by observation under a light microscope, with lesions classified on a five-point scale. Intraexaminer and inter-examiner repeatability were assessed using two-way tables and intraclass correlation coefficients (ICCs). Comparisons between percentage correct, specificity, sensitivity, and area under the receiver-operating characteristic (ROC) curve were performed using bootstrap analyses. ICCs for intraexaminer and interexaminer repeatability indicated good repeatability for each examiner, ranging from 0.78 to 0.88, and among examiners, ranging from 0.74 to 0.81. Correlation between ICDAS and TD was 0.85 and between BW and TD was 0.78. Correlation between the methods and histological scores was moderate (0.63 for ICDAS and 0.61 for BW). The area under the ROC curve was significantly greater for ICDAS than for BW (p<0.0001). ICDAS had significantly lower specificity than BW did (p=0.0269, 79% vs 94%); however, sensitivity was much higher for ICDAS than for BW (p<0.0001, 83% vs 44%). Data from this investigation suggested that the visual examination (ICDAS) showed better performance than radiographic examination for occlusal caries detection. The ICDAS was strongly associated with TD. Although the correlation between the ICDAS and BW was lower, it is still valuable in the clinical decision-making process.

Strategies to model scheduling decisions to plan the soft drink production process

In this paper we present a mixed integer model that integrates lot sizing and lot scheduling decisions for the production planning of a soft drink company. The main contribution of the paper is to present a model that differ from others in the literature for the constraints related to the scheduling decisions. The proposed strategy is compared to other strategies presented in the literature.

Model of a game for improving integrated decisions in production management

This paper presents the results obtained with a business game whose model represents the decision making process related to two moments at an industrial company. The first refers to the project of the industrial plant, and the second to its management. The game model was conceived so the player's first decision would establish capacity and other parameters such as quantities of each product to produce, marketing expenses, research and development, quality, advertising, salaries, if purchases will be made in installments or in cash, if there will be credit sales and how many installments will be allowed and the number of workers in the assembly area. An experiment was conducted with employees of a Brazilian company. Data obtained indicate that the players have lack of contents, especially in finances. Although these results cannot be generalized, they confirm prior results with undergraduate and graduate students and they indicate the need for reinforcement in this undergraduate area. © 2012 Springer-Verlag.

Análise das variáveis demográficas, sociais, econômicas e culturais no processo de tomada de decisão: estudo em pacientes oncológicos avançados, cuidadores e médicos

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Mapeamento das evidências do grupo de odontologia da Colaboração Cochrane pra condutas em saúde

Pós-graduação em Bases Gerais da Cirurgia - FMB

Aportes da filosofia da ciência na formação inicial de professores de Química e a mobilização do saber e do saber fazer na construção das representações científicas

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Anticoagulant treatment for subsegmental pulmonary embolism

BackgroundAcute pulmonary embolism (PE) is a common cause of death, accounting for 50,000 to 200,000 deaths annually. It is the third most common cause of mortality among the cardiovascular diseases, after coronary artery disease and stroke.The advent of multi-detector computed tomographic pulmonary angiography (CTPA) has allowed better assessment of PE regarding visualisation of the peripheral pulmonary arteries, increasing its rate of diagnosis. More cases of peripheral PEs, such as isolated subsegmental PE (SSPE) and incidental PE, have thereby been identified. These two conditions are usually found in patients with few or none of the classic PE symptoms such as haemoptysis or pleuritic pain, acute dyspnoea or circulatory collapse. However, in patients with reduced cardio-pulmonary (C/P) reserve the classic PE symptoms can be found with isolated SSPEs. Incidental SSPE is found casually in asymptomatic patients, usually by diagnostic imaging performed for other reasons (for example routine CT for cancer staging in oncologic patients).Traditionally, all PEs are anticoagulated in a similar manner independent of the location, number and size of the thrombi. It has been suggested that many patients with SSPE may be treated without benefit, increasing adverse events by possible unnecessary use of anticoagulants.Patients with isolated SSPE or incidental PE may have a more benign clinical presentation compared with those with proximal PEs. However, the clinical significance in patients and their prognosis have to be studied to evaluate whether anticoagulation therapy is required.ObjectivesTo assess the effectiveness and safety of anticoagulation therapy versus no intervention in patients with isolated subsegmental pulmonary embolism (SSPE) or incidental SSPE.Search methodsThe Cochrane Peripheral Vascular Diseases Group Trials Search Co-ordinator searched the Specialised Register (last searched October 2013) and CENTRAL (2013, Issue 9). MEDLINE, EMBASE, LILACS and clinical trials databases were also searched (October 2013).Selection criteriaRandomised controlled trials of anticoagulation therapy versus no intervention in patients with SSPE or incidental SSPE.Data collection and analysisTwo review authors inspected all citations to ensure reliable selection. We planned for two review authors to independently extract data and to assess the methodological quality of identified trials using the criteria recommended in the Cochrane Handbook for Systematic Reviews of Interventions.Main resultsNo studies were identified that met the inclusion criteria.Authors' conclusionsThere is no randomised controlled trial evidence for the effectiveness and safety of anticoagulation therapy versus no intervention in patients with isolated subsegmental pulmonary embolism (SSPE) or incidental SSPE, and therefore we can not draw any conclusions. Well-conducted research is required before informed practice decisions can be made.

Utilização do método AHP para análise de alterações de projetos, em instalações hospitalares

Customer focus , high competitiveness and striving for excellence in quality of service are some of the main features of the current market . Planned and make decisions with greater certainty is no longer an option a few years . The current managers are seeking ways to eliminate waste and increase financial and productive profitability of your company in order to achieve higher performance at a lower cost . The AHP is one of the main concepts of this goal by providing an analysis on multiple criteria , enhancing decision-making and enhancing the gains , with a technique that is designed to take into account all the key criteria for choosing an alternative , according to the perspective of the designer as both suppliers and customers . Emerging as a new way to minimize errors , and make an informed and consistent decision. The use of this method in construction projects is a recent phenomenon , which has much to be explored , an intense analysis of the processes is required to enable it to consider the concepts and present a consistent and grounded proposal

Multicollinearity and financial constraint in investment decisions: a bayesian generalized ridge regression

This paper addresses the investment decisions considering the presence of financial constraints of 373 large Brazilian firms from 1997 to 2004, using panel data. A Bayesian econometric model was used considering ridge regression for multicollinearity problems among the variables in the model. Prior distributions are assumed for the parameters, classifying the model into random or fixed effects. We used a Bayesian approach to estimate the parameters, considering normal and Student t distributions for the error and assumed that the initial values for the lagged dependent variable are not fixed, but generated by a random process. The recursive predictive density criterion was used for model comparisons. Twenty models were tested and the results indicated that multicollinearity does influence the value of the estimated parameters. Controlling for capital intensity, financial constraints are found to be more important for capital-intensive firms, probably due to their lower profitability indexes, higher fixed costs and higher degree of property diversification.

Health professionals ethical and legal liability on patient’s inadequate clarification in order to obtain free and informed consent

It is required that patients are provided information about therapeutic possibilities, showing the risks, benefits, prognosis and costs of each possible and indicated alternative. This is an ethical and legal resolution. However, health professionals possess the clinical/technical/scientific knowledge and determine what information will be (or not) provided. The patient in question decides to undergo a treatment, providing his/her free and informed consent on the basis of the data presented. Unfortunately, some professionals may not provide all the information necessary for making an informed decision or, after obtaining the consent of the patient, may provide him information that causes the patient to give up on the treatment initially accepted. Such information, if relevant, and not a supervening fact, should have been provided initially. However, the information may not be entirely true, and bring the patient, for instance, to decide based on inadequately presented risks. The craniofacial rehabilitation of the temporomandibular joint (TMJ) by means of TMJ prosthesis, is indicated in many situations. Often, patients in need of such prostheses have aesthetic and functional problems and the rehabilitation expectations run high. This work presents a case and discusses ethical and legal issues, including the liability of partial and inadequate information to a patient.