Doctor-Patient Knowledge Transfer: Innovative Technologies and Policy Implications

The aim of this study was to empirically investigate the barriers in doctor-patient communication and knowledge transfer and the role of innovative technologies in overcoming these barriers. We applied qualitative research methods. Our results show that patients extensively use information sources, primarily the Internet before the visits. Patients regularly apply a self-diagnosis regarding their diseases. This implies several risks as many of them are not able to properly interpret the found information and at the same time the information might not be reliable. To overcome these risks efforts are required within the fields of technology developments for making web sites more reliable and improvement of the health culture of patients, as well. Our research identified the most significant barriers of doctor-patient communication including limited time, the patients’ distress, inadequate health culture and prior knowledge, as well as poor communication skills of some clinicians. Technology might help clinicians to use their limited time more effectively. In the long term, innovative technology solutions might take over some tasks of the health care personnel if they provide reliable health information adapted to the patient’s health, emotional and psychosocial status. Barriers of access to the new technology should be identified and addressed otherwise it would increase the already existing knowledge gap between patients and doctors.

A planning model for needs analysis for subacute care

The purpose of this study is to produce a model to be used by state regulating agencies to assess demand for subacute care. In accomplishing this goal, the study refines the definition of subacute care, demonstrates a method for bed need assessment, and measures the effectiveness of this new level of care. This was the largest study of subacute care to date. Research focused on 19 subacute units in 16 states, each of which provides high-intensity rehabilitative and/or restorative care carried out in a high-tech unit. Each of the facilities was based in a nursing home, but utilized separate staff, equipment, and services. Because these facilities are under local control, it was possible to study regional differences in subacute care demand.^ Using this data, a model for predicting demand for subacute care services was created, building on earlier models submitted by John Whitman for the American Hospital Association and Robin E. MacStravic. The Broderick model uses the "bootstrapping" method and takes advantage of high technology: computers and software, databases in business and government, publicly available databases from providers or commercial vendors, professional organizations, and other information sources. Using newly available sources of information, this new model addresses the problems and needs of health care planners as they approach the challenges of the 21st century. ^

Integration and querying of heterogeneous, autonomous, distributed database systems

Today, databases have become an integral part of information systems. In the past two decades, we have seen different database systems being developed independently and used in different applications domains. Today's interconnected networks and advanced applications, such as data warehousing, data mining & knowledge discovery and intelligent data access to information on the Web, have created a need for integrated access to such heterogeneous, autonomous, distributed database systems. Heterogeneous/multidatabase research has focused on this issue resulting in many different approaches. However, a single, generally accepted methodology in academia or industry has not emerged providing ubiquitous intelligent data access from heterogeneous, autonomous, distributed information sources. ^ This thesis describes a heterogeneous database system being developed at High-performance Database Research Center (HPDRC). A major impediment to ubiquitous deployment of multidatabase technology is the difficulty in resolving semantic heterogeneity. That is, identifying related information sources for integration and querying purposes. Our approach considers the semantics of the meta-data constructs in resolving this issue. The major contributions of the thesis work include: (i) providing a scalable, easy-to-implement architecture for developing a heterogeneous multidatabase system, utilizing Semantic Binary Object-oriented Data Model (Sem-ODM) and Semantic SQL query language to capture the semantics of the data sources being integrated and to provide an easy-to-use query facility; (ii) a methodology for semantic heterogeneity resolution by investigating into the extents of the meta-data constructs of component schemas. This methodology is shown to be correct, complete and unambiguous; (iii) a semi-automated technique for identifying semantic relations, which is the basis of semantic knowledge for integration and querying, using shared ontologies for context-mediation; (iv) resolutions for schematic conflicts and a language for defining global views from a set of component Sem-ODM schemas; (v) design of a knowledge base for storing and manipulating meta-data and knowledge acquired during the integration process. This knowledge base acts as the interface between integration and query processing modules; (vi) techniques for Semantic SQL query processing and optimization based on semantic knowledge in a heterogeneous database environment; and (vii) a framework for intelligent computing and communication on the Internet applying the concepts of our work. ^

Quality of experience evaluation of voice communication: an affect-based approach

Voice communication systems such as Voice-over IP (VoIP), Public Switched Telephone Networks, and Mobile Telephone Networks, are an integral means of human tele-interaction. These systems pose distinctive challenges due to their unique characteristics such as low volume, burstiness and stringent delay/loss requirements across heterogeneous underlying network technologies. Effective quality evaluation methodologies are important for system development and refinement, particularly by adopting user feedback based measurement. Presently, most of the evaluation models are system-centric (Quality of Service or QoS-based), which questioned us to explore a user-centric (Quality of Experience or QoE-based) approach as a step towards the human-centric paradigm of system design. We research an affect-based QoE evaluation framework which attempts to capture users' perception while they are engaged in voice communication. Our modular approach consists of feature extraction from multiple information sources including various affective cues and different classification procedures such as Support Vector Machines (SVM) and k-Nearest Neighbor (kNN). The experimental study is illustrated in depth with detailed analysis of results. The evidences collected provide the potential feasibility of our approach for QoE evaluation and suggest the consideration of human affective attributes in modeling user experience.

A planning model for needs analysis for subacute care

The purpose of this study is to produce a model to be used by state regulating agencies to assess demand for subacute care. In accomplishing this goal, the study refines the definition of subacute care, demonstrates a method for bed need assessment, and measures the effectiveness of this new level of care. This was the largest study of subacute care to date. Research focused on 19 subacute units in 16 states, each of which provides high-intensity rehabilitative and/or restorative care carried out in a high-tech unit. Each of the facilities was based in a nursing home, but utilized separate staff, equipment, and services. Because these facilities are under local control, it was possible to study regional differences in subacute care demand. Using this data, a model for predicting demand for subacute care services was created, building on earlier models submitted by John Whitman for the American Hospital Association and Robin E. MacStravic. The Broderick model uses the "bootstrapping" method and takes advantage of high technology: computers and software, databases in business and government, publicly available databases from providers or commercial vendors, professional organizations, and other information sources. Using newly available sources of information, this new model addresses the problems and needs of health care planners as they approach the challenges of the 21st century.

Integration and querying of heterogeneous, autonomous, distributed database systems

Today, databases have become an integral part of information systems. In the past two decades, we have seen different database systems being developed independently and used in different applications domains. Today's interconnected networks and advanced applications, such as data warehousing, data mining & knowledge discovery and intelligent data access to information on the Web, have created a need for integrated access to such heterogeneous, autonomous, distributed database systems. Heterogeneous/multidatabase research has focused on this issue resulting in many different approaches. However, a single, generally accepted methodology in academia or industry has not emerged providing ubiquitous intelligent data access from heterogeneous, autonomous, distributed information sources. This thesis describes a heterogeneous database system being developed at Highperformance Database Research Center (HPDRC). A major impediment to ubiquitous deployment of multidatabase technology is the difficulty in resolving semantic heterogeneity. That is, identifying related information sources for integration and querying purposes. Our approach considers the semantics of the meta-data constructs in resolving this issue. The major contributions of the thesis work include: (i.) providing a scalable, easy-to-implement architecture for developing a heterogeneous multidatabase system, utilizing Semantic Binary Object-oriented Data Model (Sem-ODM) and Semantic SQL query language to capture the semantics of the data sources being integrated and to provide an easy-to-use query facility; (ii.) a methodology for semantic heterogeneity resolution by investigating into the extents of the meta-data constructs of component schemas. This methodology is shown to be correct, complete and unambiguous; (iii.) a semi-automated technique for identifying semantic relations, which is the basis of semantic knowledge for integration and querying, using shared ontologies for context-mediation; (iv.) resolutions for schematic conflicts and a language for defining global views from a set of component Sem-ODM schemas; (v.) design of a knowledge base for storing and manipulating meta-data and knowledge acquired during the integration process. This knowledge base acts as the interface between integration and query processing modules; (vi.) techniques for Semantic SQL query processing and optimization based on semantic knowledge in a heterogeneous database environment; and (vii.) a framework for intelligent computing and communication on the Internet applying the concepts of our work.

Knowledge, attitudes and beliefs of parents regarding fever in children: a Danish interview study

Aim: Fever and febrile illness are some of the most common conditions managed by parents. The aim of this study was to examine the knowledge, attitudes and beliefs of parents around fever in children under five years of age. Methods: Between July and August 2014, a convenience sample of parents was invited to participate in this study in Copenhagen, Denmark. Results were analysed thematically using a constant comparison method. Results: Twenty-one parents participated in the study. Five themes emerged from the data: parental concern, help-seeking behaviour, parental knowledge, parent fever management practices and initiatives. Parents used a range of information sources to obtain their knowledge on management of fever; however, due to issues of trust with these sources, reassurance was often sought from healthcare practitioners. There was a desire amongst most parents for initiatives to be introduced which provide general information on how to manage fever in children. Conclusion: Parents were very concerned when their child was febrile and instigated practices obtained from accessible information sources. This study has identified a need for specific and reliable information initiatives to be introduced as a means of reducing parental concern and ensuring evidence-based strategies for managing a child with fever.

Storytelling and story testing in domestication

The domestication of plants and animals marks one of the most significant transitions in human, and indeed global, history. Traditionally, study of the domestication process was the exclusive domain of archaeologists and agricultural scientists; today it is an increasingly multidisciplinary enterprise that has come to involve the skills of evolutionary biologists and geneticists. Although the application of new information sources and methodologies has dramatically transformed our ability to study and understand domestication, it has also generated increasingly large and complex datasets, the interpretation of which is not straightforward. In particular, challenges of equifinality, evolutionary variance, and emergence of unexpected or counter-intuitive patterns all face researchers attempting to infer past processes directly from patterns in data. We argue that explicit modeling approaches, drawing upon emerging methodologies in statistics and population genetics, provide a powerful means of addressing these limitations. Modeling also offers an approach to analyzing datasets that avoids conclusions steered by implicit biases, and makes possible the formal integration of different data types. Here we outline some of the modeling approaches most relevant to current problems in domestication research, and demonstrate the ways in which simulation modeling is beginning to reshape our understanding of the domestication process.

Investigative journalism in Mexico: between ideals and realities. The case of Morelia

The aim of this paper is to analyse the state of the investigative journalism in Mexico, especially the one that is practiced at the local level in the provinces. That is, this research is based upon a case study conducted in Morelia, the capital city of the state of Michoacán. The empirical evidence will show that there is an evident divergence regarding the practice of the investigative journalism: on the one hand, journalists are aware of what this concept involves and they consider that they practice it on a regular basis; but, on the other, the content analysis prove otherwise. In other words, the account of what is actually printed significantly differs from the news workers’ perceptions, because the former shows a poorly developed journalistic investigation practice.

El uso de la documentación con una nueva formación política: Podemos

Esta investigación pretende analizar, desde un punto de vista documental, el tratamiento periodístico dado por los principales medios impresos españoles a las informaciones sobre el nuevo partido político Podemos en el momento de su eclosión. Podemos es un fenómeno social que en muy breve espacio de tiempo cambió los parámetros políticos de España. Por ello, queremos conocer cómo los principales medios de comunicación elaboraron sus informaciones en ese contexto de novedad que supuso su aparición. La documentación es el pilar de la información periodística de calidad, razón por la que nos servimos de ella para medir, dentro del marco de nuestra investigación, la calidad del periodismo que se practicó con dicha formación política.

Supervisão colaborativa para uma educação inclusiva : um estudo com professores do ensino regular

Este trabalho, desenvolvido por uma professora de educação especial no contexto onde exerce funções, resultou da vontade de aprofundar o conhecimento sobre as dinâmicas de trabalho entre os professores do Ensino Regular e entre estes e o professor de Educação Especial. Desta forma elaborámos um projeto de investigação com o propósito de aprofundar o conhecimento sobre estas dinâmicas, no âmbito de uma oficina de formação, dinamizada pela investigadora, realizada no contexto de trabalho dos participantes. Neste âmbito, foi proporcionado um conjunto de experiências vivenciadas em conjunto, procurando contribuir para novas perspetivas teóricas sobre o conhecimento, bem como o envolvimento dos participantes em situações empíricas que lhes permitissem aplicar esses conhecimentos na resolução de problemas concretos emergentes no seu contexto de trabalho. A estratégia formativa baseou-se na colaboração como factor de desenvolvimento e de aprendizagem, surgindo como relevante e necessário o envolvimento dos formandos em processos de investigação da própria prática. A formação, na modalidade de Oficina, foi promovida através do Centro de Formação da Instituição onde a escola, um estabelecimento de ensino particular e cooperativo, se integra. Neste âmbito foi acreditada pelo Conselho Científico-Pedagógico da Formação Contínua e envolveu dezasseis professores do 1.º, 2.º e 3.º ciclos do ensino básico. A formação desenvolveuse em duas fases - a primeira fase, constituída por 4 sessões, teve lugar entre maio e julho de 2011, e a segunda fase, igualmente constituída por 4 sessões, teve lugar de setembro a novembro de 2011, num total de 25 horas presenciais e 25 horas não presenciais. Trata-se de um estudo com uma dupla intencionalidade – formativa e investigativa – no qual se procura compreender (i) a relação entre as estratégias de formação e supervisão promovidas pela professora de educação especial e o desenvolvimento de dinâmicas de trabalho colaborativo entre os participantes (ii) e o impacto dessas dinâmicas no desenvolvimento profissional e nas suas práticas, tendo em vista a promoção de uma educação inclusiva. Configura-se como estudo de caso, na variante de multicaso apresentando, ainda, algumas características de investigação-ação. No âmbito deste estudo, utilizámos um conjunto diverso e complementar de procedimentos investigativos, nomeadamente, o inquérito por questionário aplicado a todos os participantes no início e no fim da oficina de formação; o inquérito por questionário de avaliação das sessões, tendo por base os objetivos do estudo; a entrevista semi-estruturada, realizada a quatro docentes do 1º CEB que constituem os subcasos e o portfolio reflexivo individual dos mesmos, os quais se constituem como estratégia de formação e de investigação. Recorreu-se, ainda, como fontes de informação secundária, ao Teaching portfolio do investigador, às videogravações das sessões de formação, aos registos em vídeo de alguns episódios relativos à intervenção dos formandos em sala de aula e aos projetos de investigação-ação, bem como aos dados recolhidos na entrevista dirigida ao Diretor do estabelecimento de educação e ensino, depois de concluído o programa de formação. Os resultados da análise parecem evidenciar a existência de dinâmicas colaborativas e um clima de inter-ajuda que caraterizou a interação ocorrida na formação, em torno de casos concretos, os quais tiveram um impacto significativo sobre o pensamento e a prática dos participantes. Todo o processo desenvolvido parece ter dado lugar à partilha de saberes e à procura conjunta de soluções para os problemas, tendo contribuído para que os professores passassem a ser mais interventivos, evidenciando novas aprendizagens e uma maior consciencialização do conceito de educação para todos e do que esta implica. Os resultados parecem ainda revelar o desenvolvimento de uma parceria estratégica entre os professores do ensino regular e a professora de educação especial, a qual passou a ser aceite como uma pessoa que pode ajudar a encontrar soluções para os problemas que surgem na sala de aula, de forma a garantir a inclusão de todos os alunos e não apenas dos que têm necessidades educativas especiais.

Enhancing business English terminology through concept mapping

Given the need of a growing internationalization of business, to have a good command of English is, most of the times important for the development of technical (specific) competences. It is, thus, critical that professionals use accurate terminology to set grounds for a well-succeeded communication. Furthermore, business communication is increasingly moving to ICT-mediated sets and professionals have to be able to promptly adjust to these needs, resorting to trustworthy online information sources, but also using technologies that better serve their business purposes. In this scenario, the main objective of this study is to find evidence as to the utility of concept mapping as a teaching and learning strategy for the appropriation of business English terminology, enabling students to use English more efficiently as language of communication in business context. This study was based on a case study methodology, mainly of exploratory nature. Participants were students (n= 30) enrolled in the subject English Applied to Management II at Águeda School of Technology and Management – University of Aveiro (2013/14 edition). They were asked to create and peer review two concept maps (cmaps), one individually and another in pairs. The data gathered were treated and analysed resorting qualitative (content analysis) and to quantitative (descriptive statistical analysis) techniques. Results of the data analysis unveil that the use of a collaborative concept mapping tool promotes the development of linguistic competences as to the use of business terminology, but also of communication and collaboration competences. Besides, it was also a very important motivation element in the students’ engagement with the subject content.

Caminhos que estruturam cidades: redes técnicas de transporte sobre trilhos e a conformação intra-urbana de Natal

The railroad, from 1870 and on, becomes an usual complaining in the press s and politician elite s speeches, especially because of Natal s geographic isolation. The implantation of two railroads in the capital territory Estrada de Ferro de Natal a Nova Cruz, afterwards part of Great Western Railway Company network, and Estrada de Ferro Central do Rio Grande do Norte had serious implications in the urban environment. While railroad s structures were already consolidated, other transportation mechanisms were being implanted in the first decades of the 20th century, such as trams lines, which, by the way, was a transport modal that also used rails as a dislocation meaning. Considering these questions, we may ask: how come railroads and tramways demands, roads and buildings had influenced the internal organization of Natal? We work with the general hypothesis that the influence of technical networks, composed by tramways and railroads, over Natal s urban space happened in a diversified way, sometimes consolidating social aspects in certain areas, sometimes improving the occupation of others. The impact over the city s territory also happens in a diversified way between the buildings/railroad s complexes and the pathways. The different scale of the train in comparison to the trams velocity, size, noise level, flow, among others is also a cause to the different consequences in urban environment. The main objective of this work is to understand the role of circulation technical networks in the construction process of urban space in Natal, as a way to contribute to the urban historiography about the subject. The time frame adopted, between 1881 and 1937, marks the time path of railroads and tramways in Rio Grande do Norte: 1881 is the year of railroad s first section inauguration from Natal to São José do Mipibu as well of the railroad complex in the Republic Square in Natal; the year of 1937 marks the beginning of tramways declination process in the city. At this time railroads and tramways had to face more intensively the competition of motor vehicles. The theory reference adopted is based on concepts and analysis of authors, such as Flávio Villaça and Roberto Lobato Corrêa references to the concepts of urban structure , localization and accessibility and Gabriel Dupuy to explain the concept of urban technical networks . These references reveal the conflict of different realities in the urban universe interests and values which is an important factor about the construction of urban space. The information sources used were from two distinctive natures: primary, journals of the time studied and official government reports, and secondary, based on other works about the subject. It was also used by this study iconographic source, especially images from the data base of the research group História da Cidade, do Território e do Urbanismo .

Medications, youth therapeutic cultures and performance consumptions: a sociological approach

This article analyses performance consumptions among young people. The theme is explored along two main axes. The first concerns the social heterogeneity in this field, considered on two levels: the different purposes for those investments - cognitive/mental and physical performance; and the different social contexts - university and work - where performance practices and dispositions may be fostered. The second axis explores the roles of pharmacological and natural consumptions, and their interrelationship, in the dissemination of these practices. The empirical data for this analysis were drawn from an ongoing research project on performance consumptions among young people (aged 18-29 years) in Portugal, including both university students and young workers without university education. The results correspond to the stage of extensive research, for which a questionnaire was organised at a national level, using non-proportional quota sampling. On the one hand, they show that (a) there is a hierarchy of acceptance of consumptions according to their purposes, with cognitive/mental performance showing higher acceptance and (b) both pharmaceuticals and natural products are consumed for every type of performance investment. On the other, the comparison between students and workers introduces a certain heterogeneity in this general backdrop, both in terms of the purposes for their consumptions and their opting for natural or pharmacological resources. These threads of heterogeneity will prompt a discussion of the dynamics of pharmaceuticalisation within the field of performance, in particular how therapeutic cultures may be changing in terms of the way individuals relate to medications, expanding their uses in social life.