Understanding and Characterizing Shared Decision-Making and Behavioral Intent in Medical Uncertainty

Applying Theoretical Constructs to Address Medical Uncertainty Situations involving medical reasoning usually include some level of medical uncertainty. Despite the identification of shared decision-making (SDM) as an effective technique, it has been observed that the likelihood of physicians and patients engaging in shared decision making is lower in those situations where it is most needed; specifically in circumstances of medical uncertainty. Having identified shared decision making as an effective, yet often a neglected approach to resolving a lack of information exchange in situations involving medical uncertainty, the next step is to determine the way(s) in which SDM can be integrated and the supplemental processes that may facilitate its integration. SDM involves unique types of communication and relationships between patients and physicians. Therefore, it is necessary to further understand and incorporate human behavioral elements - in particular, behavioral intent - in order to successfully identify and realize the potential benefits of SDM. This paper discusses the background and potential interaction between the theories of shared decision-making, medical uncertainty, and behavioral intent. Identifying Shared Decision-Making Elements in Medical Encounters Dealing with Uncertainty A recent summary of the state of medical knowledge in the U.S. reported that nearly half (47%) of all treatments were of unknown effectiveness, and an additional 7% involved an uncertain tradeoff between benefits and harms. Shared decision-making (SDM) was identified as an effective technique for managing uncertainty when two or more parties were involved. In order to understand which of the elements of SDM are used most frequently and effectively, it is necessary to identify these key elements, and understand how these elements related to each other and the SDM process. The elements identified through the course of the present research were selected from basic principles of the SDM model and the “Data, Information, Knowledge, Wisdom” (DIKW) Hierarchy. The goal of this ethnographic research was to identify which common elements of shared decision-making patients are most often observed applying in the medical encounter. The results of the present study facilitated the understanding of which elements patients were more likely to exhibit during a primary care medical encounter, as well as determining variables of interest leading to more successful shared decision-making practices between patients and their physicians. Understanding Behavioral Intent to Participate in Shared Decision-Making in Medically Uncertain Situations Objective: This article describes the process undertaken to identify and validate behavioral and normative beliefs and behavioral intent of men between the ages of 45-70 with regard to participating in shared decision-making in medically uncertain situations. This article also discusses the preliminary results of the aforementioned processes and explores potential future uses of this information which may facilitate greater understanding, efficiency and effectiveness of doctor-patient consultations.Design: Qualitative Study using deductive content analysisSetting: Individual semi-structure patient interviews were conducted until data saturation was reached. Researchers read the transcripts and developed a list of codes.Subjects: 25 subjects drawn from the Philadelphia community.Measurements: Qualitative indicators were developed to measure respondents’ experiences and beliefs related to behavioral intent to participate in shared decision-making during medical uncertainty. Subjects were also asked to complete the Krantz Health Opinion Survey as a method of triangulation.Results: Several factors were repeatedly described by respondents as being essential to participate in shared decision-making in medical uncertainty. These factors included past experience with medical uncertainty, an individual’s personality, and the relationship between the patient and his physician.Conclusions: The findings of this study led to the development of a category framework that helped understand an individual’s needs and motivational factors in their intent to participate in shared decision-making. The three main categories include 1) an individual’s representation of medically uncertainty, 2) how the individual copes with medical uncertainty, and 3) the individual’s behavioral intent to seek information and participate in shared decision-making during times of medically uncertain situations.

An information model for lean, agile, resilient and green supply chain management

Dissertação para a obtenção de Grau de Mestre em Engenharia e Gestão Industrial

Conceptual knowledge discovery and data analysis

In this paper, we discuss Conceptual Knowledge Discovery in Databases (CKDD) in its connection with Data Analysis. Our approach is based on Formal Concept Analysis, a mathematical theory which has been developed and proven useful during the last 20 years. Formal Concept Analysis has led to a theory of conceptual information systems which has been applied by using the management system TOSCANA in a wide range of domains. In this paper, we use such an application in database marketing to demonstrate how methods and procedures of CKDD can be applied in Data Analysis. In particular, we show the interplay and integration of data mining and data analysis techniques based on Formal Concept Analysis. The main concern of this paper is to explain how the transition from data to knowledge can be supported by a TOSCANA system. To clarify the transition steps we discuss their correspondence to the five levels of knowledge representation established by R. Brachman and to the steps of empirically grounded theory building proposed by A. Strauss and J. Corbin.

Knowledge and information evaluation practice: an exploratory study in a construction firm

There are a number of challenges associated with managing knowledge and information in construction organizations delivering major capital assets. These include the ever-increasing volumes of information, losing people because of retirement or competitors, the continuously changing nature of information, lack of methods on eliciting useful knowledge, development of new information technologies and changes in management and innovation practices. Existing tools and methodologies for valuing intangible assets in fields such as engineering, project management and financial, accounting, do not address fully the issues associated with the valuation of information and knowledge. Information is rarely recorded in a way that a document can be valued, when either produced or subsequently retrieved and re-used. In addition there is a wealth of tacit personal knowledge which, if codified into documentary information, may prove to be very valuable to operators of the finished asset or future designers. This paper addresses the problem of information overload and identifies the differences between data, information and knowledge. An exploratory study was conducted with a leading construction consultant examining three perspectives (business, project management and document management) by structured interviews and specifically how to value information in practical terms. Major challenges in information management are identified. An through-life Information Evaluation methodology (IEM) is presented to reduce information overload and to make the information more valuable in the future.

Information access law and disclosing of information by joint-stock companies in Brazil: open data and Extensible Business Reporting Language (XBRL) standard

The strategic management of information plays a fundamental role in the organizational management process since the decision-making process depend on the need for survival in a highly competitive market. Companies are constantly concerned about information transparency and good practices of corporate governance (CG) which, in turn, directs relations between the controlling power of the company and investors. In this context, this article presents the relationship between the disclosing of information of joint-stock companies by means of using XBRL, the open data model adopted by the Brazilian government, a model that boosted the publication of Information Access Law (Lei de Acesso à Informação), nº 12,527 of 18 November 2011. Information access should be permeated by a mediation policy in order to subsidize the knowledge construction and decision-making of investors. The XBRL is the main model for the publishing of financial information. The use of XBRL by means of new semantic standard created for Linked Data, strengthens the information dissemination, as well as creates analysis mechanisms and cross-referencing of data with different open databases available on the Internet, providing added value to the data/information accessed by civil society.

Nanoinformatics knowledge infrastructures: bringing efficient information management to nanomedical research

Nanotechnology represents an area of particular promise and significant opportunity across multiple scientific disciplines. Ongoing nanotechnology research ranges from the characterization of nanoparticles and nanomaterials to the analysis and processing of experimental data seeking correlations between nanoparticles and their functionalities and side effects. Due to their special properties, nanoparticles are suitable for cellular-level diagnostics and therapy, offering numerous applications in medicine, e.g. development of biomedical devices, tissue repair, drug delivery systems and biosensors. In nanomedicine, recent studies are producing large amounts of structural and property data, highlighting the role for computational approaches in information management. While in vitro and in vivo assays are expensive, the cost of computing is falling. Furthermore, improvements in the accuracy of computational methods (e.g. data mining, knowledge discovery, modeling and simulation) have enabled effective tools to automate the extraction, management and storage of these vast data volumes. Since this information is widely distributed, one major issue is how to locate and access data where it resides (which also poses data-sharing limitations). The novel discipline of nanoinformatics addresses the information challenges related to nanotechnology research. In this paper, we summarize the needs and challenges in the field and present an overview of extant initiatives and efforts.

Bridging the gap between closed and open data. System proposal for the Portuguese Legislation

Esta dissertação apresenta uma proposta de sistema capaz de preencher a lacuna entre documentos legislativos em formato PDF e documentos legislativos em formato aberto. O objetivo principal é mapear o conhecimento presente nesses documentos de maneira a representar essa coleção como informação interligada. O sistema é composto por vários componentes responsáveis pela execução de três fases propostas: extração de dados, organização de conhecimento, acesso à informação. A primeira fase propõe uma abordagem à extração de estrutura, texto e entidades de documentos PDF de maneira a obter a informação desejada, de acordo com a parametrização do utilizador. Esta abordagem usa dois métodos de extração diferentes, de acordo com as duas fases de processamento de documentos – análise de documento e compreensão de documento. O critério utilizado para agrupar objetos de texto é a fonte usada nos objetos de texto de acordo com a sua definição no código de fonte (Content Stream) do PDF. A abordagem está dividida em três partes: análise de documento, compreensão de documento e conjunção. A primeira parte da abordagem trata da extração de segmentos de texto, adotando uma abordagem geométrica. O resultado é uma lista de linhas do texto do documento; a segunda parte trata de agrupar os objetos de texto de acordo com o critério estipulado, produzindo um documento XML com o resultado dessa extração; a terceira e última fase junta os resultados das duas fases anteriores e aplica regras estruturais e lógicas no sentido de obter o documento XML final. A segunda fase propõe uma ontologia no domínio legal capaz de organizar a informação extraída pelo processo de extração da primeira fase. Também é responsável pelo processo de indexação do texto dos documentos. A ontologia proposta apresenta três características: pequena, interoperável e partilhável. A primeira característica está relacionada com o facto da ontologia não estar focada na descrição pormenorizada dos conceitos presentes, propondo uma descrição mais abstrata das entidades presentes; a segunda característica é incorporada devido à necessidade de interoperabilidade com outras ontologias do domínio legal, mas também com as ontologias padrão que são utilizadas geralmente; a terceira característica é definida no sentido de permitir que o conhecimento traduzido, segundo a ontologia proposta, seja independente de vários fatores, tais como o país, a língua ou a jurisdição. A terceira fase corresponde a uma resposta à questão do acesso e reutilização do conhecimento por utilizadores externos ao sistema através do desenvolvimento dum Web Service. Este componente permite o acesso à informação através da disponibilização de um grupo de recursos disponíveis a atores externos que desejem aceder à informação. O Web Service desenvolvido utiliza a arquitetura REST. Uma aplicação móvel Android também foi desenvolvida de maneira a providenciar visualizações dos pedidos de informação. O resultado final é então o desenvolvimento de um sistema capaz de transformar coleções de documentos em formato PDF para coleções em formato aberto de maneira a permitir o acesso e reutilização por outros utilizadores. Este sistema responde diretamente às questões da comunidade de dados abertos e de Governos, que possuem muitas coleções deste tipo, para as quais não existe a capacidade de raciocinar sobre a informação contida, e transformá-la em dados que os cidadãos e os profissionais possam visualizar e utilizar.

Recomendações personalizadas de alunos em sistemas de hipermédia adaptativa educacional usando Data Mining

O aumento de tecnologias disponíveis na Web favoreceu o aparecimento de diversas formas de informação, recursos e serviços. Este aumento aliado à constante necessidade de formação e evolução das pessoas, quer a nível pessoal como profissional, incentivou o desenvolvimento área de sistemas de hipermédia adaptativa educacional - SHAE. Estes sistemas têm a capacidade de adaptar o ensino consoante o modelo do aluno, características pessoais, necessidades, entre outros aspetos. Os SHAE permitiram introduzir mudanças relativamente à forma de ensino, passando do ensino tradicional que se restringia apenas ao uso de livros escolares até à utilização de ferramentas informáticas que através do acesso à internet disponibilizam material didático, privilegiando o ensino individualizado. Os SHAE geram grande volume de dados, informação contida no modelo do aluno e todos os dados relativos ao processo de aprendizagem de cada aluno. Facilmente estes dados são ignorados e não se procede a uma análise cuidada que permita melhorar o conhecimento do comportamento dos alunos durante o processo de ensino, alterando a forma de aprendizagem de acordo com o aluno e favorecendo a melhoria dos resultados obtidos. O objetivo deste trabalho foi selecionar e aplicar algumas técnicas de Data Mining a um SHAE, PCMAT - Mathematics Collaborative Educational System. A aplicação destas técnicas deram origem a modelos de dados que transformaram os dados em informações úteis e compreensíveis, essenciais para a geração de novos perfis de alunos, padrões de comportamento de alunos, regras de adaptação e pedagógicas. Neste trabalho foram criados alguns modelos de dados recorrendo à técnica de Data Mining de classificação, abordando diferentes algoritmos. Os resultados obtidos permitirão definir novas regras de adaptação e padrões de comportamento dos alunos, poderá melhorar o processo de aprendizagem disponível num SHAE.

Social network analysis applied to knowledge creation and transfer in the portuguese agricultural R&D field: an exploratory study

Paper presented at the 9th European Conference on Knowledge Management, Southampton Solent University, Southampton, UK, 4-5 Sep. 2008. URL: http://academic-conferences.org/eckm/eckm2008/eckm08-home.htm

Geography of the Information Society

All every day activities take place in space. And it is upon this that all information and knowledge revolve. The latter are the key elements in the organisation of territories. Their creation, use and distribution should therefore occur in a balanced way throughout the whole territory in order to allow all individuals to participate in an egalitarian society, in which the flow of knowledge can take precedence over the flow of interests. The information society depends, to a large extent, on the technological capacity to disseminate information and, consequently, the knowledge throughout territory, thereby creating conditions which allow a more balanced development, from the both the social and economic points of view thus avoiding the existence of info-exclusion territories. Internet should therefore be considered more than a mere technology, given that its importance goes well beyond the frontiers of culture and society. It is already a part of daily life and of the new forms of thinking and transmitting information, thus making it a basic necessity essential, for a full socio-economic development. Its role as a platform of creation and distribution of content is regarded as an indispensable element for education in today’s society, since it makes information a much more easily acquired benefit.”…in the same way that the new technologies of generation and distribution of energy allowed factories and large companies to establish themselves as the organisational bases of industrial society, so the internet today constitutes the technological base of the organisational form that characterises the Information Era: the network” (CASTELLS, 2004:15). The changes taking place today in regional and urban structures are increasingly more evident due to a combination of factors such as faster means of transport, more efficient telecommunications and other cheaper and more advanced technologies of information and knowledge. Although their impact on society is obvious, society itself also has a strong influence on the evolution of these technologies. And although physical distance has lost much of the responsibility it had towards explaining particular phenomena of the economy and of society, other aspects such as telecommunications, new forms of mobility, the networks of innovation, the internet, cyberspace, etc., have become more important, and are the subject of study and profound analysis. The science of geographical information, allows, in a much more rigorous way, the analysis of problems thus integrating in a much more balanced way, the concepts of place, of space and of time. Among the traditional disciplines that have already found their place in this process of research and analysis, we can give special attention to a geography of new spaces, which, while not being a geography of ‘innovation’, nor of the ‘Internet’, nor even ‘virtual’, which can be defined as one of the ‘Information Society’, encompassing not only the technological aspects but also including a socio-economic approach. According to the last European statistical data, Portugal shows a deficit in terms of information and knowledge dissemination among its European partners. Some of the causes are very well identified - low levels of scholarship, weak investments on innovation and R&D (both private and public sector) - but others seem to be hidden behind socio-economical and technological factors. So, the justification of Portugal as the case study appeared naturally, on a difficult quest to find the major causes to territorial asymmetries. The substantial amount of data needed for this work was very difficult to obtain and for the islands of Madeira and Azores was insufficient, so only Continental Portugal was considered for this study. In an effort to understand the various aspects of the Geography of the Information Society and bearing in mind the increasing generalised use of information technologies together with the range of technologies available for the dissemination of information, it is important to: (i) Reflect on the geography of the new socio-technological spaces. (ii) Evaluate the potential for the dissemination of information and knowledge through the selection of variables that allow us to determine the dynamic of a given territory or region; (iii) Define a Geography of the Information Society in Continental Portugal.

The impact of driving styles on fuel consumption: a data-warehouse-and-data-mining-based discovery process

This paper discusses the results of applied research on the eco-driving domain based on a huge data set produced from a fleet of Lisbon's public transportation buses for a three-year period. This data set is based on events automatically extracted from the control area network bus and enriched with GPS coordinates, weather conditions, and road information. We apply online analytical processing (OLAP) and knowledge discovery (KD) techniques to deal with the high volume of this data set and to determine the major factors that influence the average fuel consumption, and then classify the drivers involved according to their driving efficiency. Consequently, we identify the most appropriate driving practices and styles. Our findings show that introducing simple practices, such as optimal clutch, engine rotation, and engine running in idle, can reduce fuel consumption on average from 3 to 5l/100 km, meaning a saving of 30 l per bus on one day. These findings have been strongly considered in the drivers' training sessions.

Semantic relations extraction from unstructured information for domain ontologies enrichment

Based in internet growth, through semantic web, together with communication speed improvement and fast development of storage device sizes, data and information volume rises considerably every day. Because of this, in the last few years there has been a growing interest in structures for formal representation with suitable characteristics, such as the possibility to organize data and information, as well as the reuse of its contents aimed for the generation of new knowledge. Controlled Vocabulary, specifically Ontologies, present themselves in the lead as one of such structures of representation with high potential. Not only allow for data representation, as well as the reuse of such data for knowledge extraction, coupled with its subsequent storage through not so complex formalisms. However, for the purpose of assuring that ontology knowledge is always up to date, they need maintenance. Ontology Learning is an area which studies the details of update and maintenance of ontologies. It is worth noting that relevant literature already presents first results on automatic maintenance of ontologies, but still in a very early stage. Human-based processes are still the current way to update and maintain an ontology, which turns this into a cumbersome task. The generation of new knowledge aimed for ontology growth can be done based in Data Mining techniques, which is an area that studies techniques for data processing, pattern discovery and knowledge extraction in IT systems. This work aims at proposing a novel semi-automatic method for knowledge extraction from unstructured data sources, using Data Mining techniques, namely through pattern discovery, focused in improving the precision of concept and its semantic relations present in an ontology. In order to verify the applicability of the proposed method, a proof of concept was developed, presenting its results, which were applied in building and construction sector.

Implantación de un proyecto de Knowledge Center con una herramienta comercial (Synera)

En una empresa les dades es poden transformar en coneixement; aquest projecte explica com es poden convertir les dades, mitjançant una eina comercial, en coneixement que els serveixi per a prendre decisions respecte de la seva política comercial, de màrqueting i de distribució del producte. A més, també demostra que la implementació d'aquest projecte en l'empresa repercutirà positivament en el seu futur.

Delivery Chain Management in the Elevator Industry

Tämän työn tarkoituksena oli kehittää toimintamalli, joka yhdenmukaistaisi Kone Elevators:in modernisointiliikealueen logistiset käytännöt. Toimintamalli luotiin kartoittamalla euroopan maayksiköiden nykyisiä logistisia käytäntöjä sekä perehtymällä asiaankuuluvaan kirjallisuuteen, case study:ihin sekä sähköisiin artikkeleihin. Tärkeää osaa työssä esittivät maayksiköiden sekä Koneen toimittajayksiköiden edustajien haastattelut. Haastatteluiden tuloksia vertailtiin ja analysoitiin. Niiden pohjalta huomattiin, että logistiset toimintatavat vaihtelevat maittain. Ongelmat ovat kuitenkin hyvin samanlaisia; tiedonkulun katkot toimitusprosessin aikana. Muiden Koneen liikealueiden toimintatapoja tutkimalla, haastattelujen tuloksia käyttämällä sekä kirjallisuustutkimuksen pohjalta muodostettiin näkemys parhaasta toimintatapamallista. Modernisointiliikealueen toimitusprosessi tullee perustumaan keskitettyyn ohjaukseen, mutta paikalliseen koordinointiin. Se tullee hyväksikäyttämään ulkoistetun logistiikan tarjoamia mahdollisuuksia sekä sähköistä tiedonsiirtoa. Fyysiselle siirrolle tarjotaan kolmea vaihtoehtoa, joista maayksiköt voivat valita tilanteeseen parhaiten sopivan.

Governance of Healthcare Data: International Standards and Recommendations

In the global phenomenon, the aging population becomes a critical issue. Data and information concerning elderly citizens are increasing and are not well organized. In addition, these unstructured data and information cause the problems for decision makers. Since we live in a digital world, Information Technology is considered to be a tool in order to solve problems. Data, information, and knowledge are crucial components to facilitate success in IT service system. Therefore, it is necessary to study how to organize or to govern data from various sources related elderly citizens. The research is conducted due to the fact that there is no internationally accepted holistic framework for governance of data. The research limits the scope to study on the healthcare domain; however, the results can be applied to the other areas. The research starts with an ongoing research of Dahlberg and Nokkala (2015) as a theory. It explains the classification of existing data sources and their characteristics with the focus on managerial perspectives. Then the studies of existing frameworks at international and national level organizations have been performed to show the current frameworks, which have been used and are useful in compiling data on elderly citizens. The international organizations in this research are selected based on their reputations and the reliability to obtain information. The selected countries at national level provide different point of views between two countries. Australia is a forerunner in IT governance while Thailand is the country which the author has familiar knowledge of the current situation. Considered the discussions of frameworks at international and national organizations level illustrate the main characteristics of each framework. At international organization level gives precedence to the interoperability of exchanging data and information between different parties. Whereas at national level shows the importance of the acknowledgement of using frameworks throughout the country in order to make the frameworks to be effective. After the studies of both international and national organization levels, the thesis shows the summarized tables to answer the fitness to the proposed framework by Dahlberg and Nokkala whether the framework help to consolidate data from various sources with different formats, hierarchies, structures, velocities, and other attributes of data storages. In addition, suggestions and recommendations will be proposed for the future research.