Effective diagnosis of Alzheimer's disease by means of large margin-based methodology.

BACKGROUND Functional brain images such as Single-Photon Emission Computed Tomography (SPECT) and Positron Emission Tomography (PET) have been widely used to guide the clinicians in the Alzheimer's Disease (AD) diagnosis. However, the subjectivity involved in their evaluation has favoured the development of Computer Aided Diagnosis (CAD) Systems. METHODS It is proposed a novel combination of feature extraction techniques to improve the diagnosis of AD. Firstly, Regions of Interest (ROIs) are selected by means of a t-test carried out on 3D Normalised Mean Square Error (NMSE) features restricted to be located within a predefined brain activation mask. In order to address the small sample-size problem, the dimension of the feature space was further reduced by: Large Margin Nearest Neighbours using a rectangular matrix (LMNN-RECT), Principal Component Analysis (PCA) or Partial Least Squares (PLS) (the two latter also analysed with a LMNN transformation). Regarding the classifiers, kernel Support Vector Machines (SVMs) and LMNN using Euclidean, Mahalanobis and Energy-based metrics were compared. RESULTS Several experiments were conducted in order to evaluate the proposed LMNN-based feature extraction algorithms and its benefits as: i) linear transformation of the PLS or PCA reduced data, ii) feature reduction technique, and iii) classifier (with Euclidean, Mahalanobis or Energy-based methodology). The system was evaluated by means of k-fold cross-validation yielding accuracy, sensitivity and specificity values of 92.78%, 91.07% and 95.12% (for SPECT) and 90.67%, 88% and 93.33% (for PET), respectively, when a NMSE-PLS-LMNN feature extraction method was used in combination with a SVM classifier, thus outperforming recently reported baseline methods. CONCLUSIONS All the proposed methods turned out to be a valid solution for the presented problem. One of the advances is the robustness of the LMNN algorithm that not only provides higher separation rate between the classes but it also makes (in combination with NMSE and PLS) this rate variation more stable. In addition, their generalization ability is another advance since several experiments were performed on two image modalities (SPECT and PET).

An electronic portfolio for quantitative assessment of surgical skills in undergraduate medical education.

BACKGROUND We evaluated a newly designed electronic portfolio (e-Portfolio) that provided quantitative evaluation of surgical skills. Medical students at the University of Seville used the e-Portfolio on a voluntary basis for evaluation of their performance in undergraduate surgical subjects. METHODS Our new web-based e-Portfolio was designed to evaluate surgical practical knowledge and skills targets. Students recorded each activity on a form, attached evidence, and added their reflections. Students self-assessed their practical knowledge using qualitative criteria (yes/no), and graded their skills according to complexity (basic/advanced) and participation (observer/assistant/independent). A numerical value was assigned to each activity, and the values of all activities were summated to obtain the total score. The application automatically displayed quantitative feedback. We performed qualitative evaluation of the perceived usefulness of the e-Portfolio and quantitative evaluation of the targets achieved. RESULTS Thirty-seven of 112 students (33%) used the e-Portfolio, of which 87% reported that they understood the methodology of the portfolio. All students reported an improved understanding of their learning objectives resulting from the numerical visualization of progress, all students reported that the quantitative feedback encouraged their learning, and 79% of students felt that their teachers were more available because they were using the e-Portfolio. Only 51.3% of students reported that the reflective aspects of learning were useful. Individual students achieved a maximum of 65% of the total targets and 87% of the skills targets. The mean total score was 345 ± 38 points. For basic skills, 92% of students achieved the maximum score for participation as an independent operator, and all achieved the maximum scores for participation as an observer and assistant. For complex skills, 62% of students achieved the maximum score for participation as an independent operator, and 98% achieved the maximum scores for participation as an observer or assistant. CONCLUSIONS Medical students reported that use of an electronic portfolio that provided quantitative feedback on their progress was useful when the number and complexity of targets were appropriate, but not when the portfolio offered only formative evaluations based on reflection. Students felt that use of the e-Portfolio guided their learning process by indicating knowledge gaps to themselves and teachers.

Protocolo de investigación del atlas de mortalidad de las capitales de provincia de Andalucía y Cataluña (Proyecto AMCAC).

The aim of this work is to make known the multicentric project AMCAC, whose objective is to describe the geographical distribution of mortality from all causes in census groups of the provincial capitals of Andalusia and Catalonia during 1992-2002 and 1994-2000 respectively, and to study the relationship between the sociodemographic characteristics of the census groups and mortality. This is an ecological study in which the analytical unit is the census group. The data correspond to 298,731 individuals (152,913 men and 145,818 women) who died during the study periods in the towns of Almeria, Barcelona, Cadiz, Cordoba, Girona, Granada, Huelva, Jaen, Lleida, Malaga, Seville and Tarragona during the study periods. The dependent variable is the number of deaths observed per census group. The independent variables are the percentage of unemployment, illiteracy and manual workers. Estimation of the moderated relative risk and the study of the associations among the sociodemographic characteristics of the census groups and the mortality will be done for each town and each sex using the Besag-York-Mollie model. Dissemination of the results will help to improve and broaden knowledge about the population's health, and will provide an important starting point to establish the influence of contextual variables on the health of urban populations.

An electronic portfolio for quantitative assessment of surgical skills in undergraduate medical education.

BACKGROUND We evaluated a newly designed electronic portfolio (e-Portfolio) that provided quantitative evaluation of surgical skills. Medical students at the University of Seville used the e-Portfolio on a voluntary basis for evaluation of their performance in undergraduate surgical subjects. METHODS Our new web-based e-Portfolio was designed to evaluate surgical practical knowledge and skills targets. Students recorded each activity on a form, attached evidence, and added their reflections. Students self-assessed their practical knowledge using qualitative criteria (yes/no), and graded their skills according to complexity (basic/advanced) and participation (observer/assistant/independent). A numerical value was assigned to each activity, and the values of all activities were summated to obtain the total score. The application automatically displayed quantitative feedback. We performed qualitative evaluation of the perceived usefulness of the e-Portfolio and quantitative evaluation of the targets achieved. RESULTS Thirty-seven of 112 students (33%) used the e-Portfolio, of which 87% reported that they understood the methodology of the portfolio. All students reported an improved understanding of their learning objectives resulting from the numerical visualization of progress, all students reported that the quantitative feedback encouraged their learning, and 79% of students felt that their teachers were more available because they were using the e-Portfolio. Only 51.3% of students reported that the reflective aspects of learning were useful. Individual students achieved a maximum of 65% of the total targets and 87% of the skills targets. The mean total score was 345 ± 38 points. For basic skills, 92% of students achieved the maximum score for participation as an independent operator, and all achieved the maximum scores for participation as an observer and assistant. For complex skills, 62% of students achieved the maximum score for participation as an independent operator, and 98% achieved the maximum scores for participation as an observer or assistant. CONCLUSIONS Medical students reported that use of an electronic portfolio that provided quantitative feedback on their progress was useful when the number and complexity of targets were appropriate, but not when the portfolio offered only formative evaluations based on reflection. Students felt that use of the e-Portfolio guided their learning process by indicating knowledge gaps to themselves and teachers.

Photoletter to the editor: Response of linear porokeratosis to photodynamic therapy in an 11-year-old girl.

Porokeratoses are a group of different entities that belong to the skin keratinization disorders. From the histological point of view the main and common characteristic of these disorders is the presence of compact parakeratotic columns known as cornoid lamellae. All varieties should be carefully treated and followed-up because of the risk of developing malignant epithelial tumors. We report the successful response to photodynamic therapy (PDT) in a pediatric patient diagnosed with linear porokeratosis.

Entrevista y urgencia social: un reto para las competencias profesionales del educador social

Si decimos que los seres humanos sólo son capaces de vivir como tales mediante la reconstrucción narrativa de sus experiencias, estamos teniendo en cuenta conceptos e ideas que recuerdan a algunos autores contemporáneos (Ricoeur, Gadamer) que defienden la importancia de ser reconocido como una creatura hecha de palabras. En la medida en que son interpretadas, traducidas, contextualizadas y ordenadas por los profesionales, la situación dialogal significativa cobra importancia. Desde esta perspectiva hemos planteado las asignaturas: Habilidades Sociales, Técnicas de Entrevista y Gestión de Situación de Crisis diseñadas para integrar los diferentes modelos teóricos y las variables que se presentan en la relación comunicativa con el usuario y en particular en la situación de entrevista. Se mostrará también el modo cómo en nuestro proceso formativo, basado en la simulación de situaciones, se fomenta el compromiso con el trabajo en equipo, la autocomprensión y enseña a crear un clima de trabajo cooperativo en el que se hace más eficaz la relación de ayuda. A través de la presentación en clase de un caso práctico en el cual se describen todos los procedimientos y las fases del que se compone el ejercicio de la práctica profesional –paso a paso-, se busca poner de manifiesto las competencias adquiridas, los modelos empleados y las habilidades sociales que han sido necesarias para afrontar con éxito la situación de urgencia social. Finalmente se deja abierta la cuestión sobre la manera en que incide y beneficia este aprendizaje en las futuras situaciones de manejo del estrés profesional (burn out).

Discriminant validity and test-retest reliability of a self-administered Internet-based questionnaire testing doctors' knowledge in evidence-based medicine.

Aims and objectives  This study aimed to determine the discriminant validity and the test-retest reliability of a questionnaire testing the impact of evidence-based medicine (EBM) training on doctors' knowledge and skills. Methods  Questionnaires were sent electronically to all doctors working as residents and chief residents in two French speaking hospital networks in Switzerland. Participants completed the questionnaire twice, within a 4-week interval. The discriminant validity was examined in comparing doctors' performance according to their reported EBM previous training. Proportion of agreement between both sessions of the questionnaire, Cohen's kappa and 'uniform kappa' determined its test-retest reliability. Results  The participation rate was 9.8%/7.1% to first/second session. Performance increased according to the level of doctors' previous training in EBM. The observed proportion of agreement between both sessions was over 70% for 14/19 questions, and the 'uniform kappa' was superior to 0.60 for 15/19 questions. Conclusion  The discriminant validity and test-retest reliability of the questionnaire were satisfying. The low participation rate did not prevent the study from achieving its aims.

An ontology to clarify homology-related concepts.

Although homology is a fundamental concept in biology and is one of the shared channels of communication universal to all biology, it is difficult to find a consensus definition. Indeed, the interpretations of homology have changed as biology has progressed. New terms, such as paramorphism, have been introduced into the literature with mixed success. In addition, different research fields operate with different definitions of homology, for example the mechanistic usage of evo-devo is not strictly historical and would not be acceptable in cladistics. This makes a global understanding of homology complex, whereas the integration of evolutionary concepts into bioinformatics and genomics is increasingly important. We propose an ontology organizing homology and related concepts and hope this solution will also facilitate the integration and sharing of knowledge among the community.

Free-and open source software for a course on network management: authoring and enactment of scripts based on collaborative learning strategies

This paper describes a Computer-Supported Collaborative Learning (CSCL) case study in engineering education carried out within the context of a network management course. The case study shows that the use of two computing tools developed by the authors and based on Free- and Open-Source Software (FOSS) provide significant educational benefits over traditional engineering pedagogical approaches in terms of both concepts and engineering competencies acquisition. First, the Collage authoring tool guides and supports the course teacher in the process of authoring computer-interpretable representations (using the IMS Learning Design standard notation) of effective collaborative pedagogical designs. Besides, the Gridcole system supports the enactment of that design by guiding the students throughout the prescribed sequence of learning activities. The paper introduces the goals and context of the case study, elaborates onhow Collage and Gridcole were employed, describes the applied evaluation methodology, anddiscusses the most significant findings derived from the case study.

Developing an Effective Construction Training Program for Hispanic Supervisors and Craft Workers, January 2004

Hispanics make up a growing percentage of the craft workers entering the construction industry, and this has created several challenges for American construction companies. This study addresses the situation by investigating training needs for Hispanic construction craft workers and developing a training program for them within the industry. In order to evaluate current craft workers’ conditions within the construction industry, Iowa State University researchers conducted a survey, with 98 Hispanic craft workers as respondents from 10 construction companies, to determine current working conditions. The results confirm that the language barrier is an obstacle for both the Hispanic workers and the English-speaking employees involved in construction projects. As a part of this research, two training courses were designed to help both American construction companies and their Hispanic labor force to overcome the barriers that keep them from succeeding safely and productively. A training course titled English as a Second Language Survival Course was developed to facilitate basic communication between Hispanic workers and their American supervisors using construction-focused terminology. This course was delivered once as a trial run for a two-hour duration and twice for a full-length duration of eight hours. Important feedback was obtained from participants as part of the evaluations of the course. “How much of the course contents will be useful in your working environment” was asked; 40% of workers said “all of it” and 60% said “most of it.” Another question was “Was it worth taking the time to attend the course?” to which 94% answered “definitely” and 6% answered “yes.” A second training course titled Stepping Up to Supervisor Course for Hispanic Construction Workers was also developed to provide an effective tool to help companies promote those Hispanic craft workers whose willingness and skills meet the requirements to advance to a supervisory position in an American construction company. This course will be offered in the spring of 2004.

Liderança Organizacional – Os Atributos do perfil dos Líder Cabo - Verdiano

A liderança tem sido um tema central na literatura organizacional sendo definida e operacionalizada de variadíssimas formas, tendo por base funções desempenhadas e/ou comportamentos apresentados, agrupados em diversos conceitos, surgindo muitas vezes sob formas de categorias bipolares apresentadas como contraditórias. Decorrendo da complexidade do ambiente, do desempenho de competências inovadores, do desenvolvimento das sociedades, do desenvolvimento das novas tecnologias, no quadro da globalização que conquista o mundo actual, novas competências são requeridas para conduta das organizações ao contorno da crise e da condução ao sucesso. Surge a necessidade em conceptualizar a liderança tendo por base este novo paradigma. Torna-se necessário utilizar instrumentos fiáveis e adaptados ao contexto cultural e organizacional de cada país. O objectivo deste trabalho é identificar os perfis de liderança existentes em Cabo Verde, identificando ainda os atributos/valores culturais que influenciam as práticas organizacionais e os tipos de comportamentos dos líderes de Cabo Verde. Leadership has been a strong core subject on the organizational literature being defined and operationalized in several ways, and based on functions performed and/or on presented behaviours, gathered according to numerous concepts, and often emerging as bipolar categories presented as contradictory. Due to the environmental complexities, to the innovating skills performance, to the society’s development and the new technologies evolution, in the context of globalization sweeping today’s world, new competencies are required for the organizations to overcome the present crisis situation and consequently achieve success. There’s a need to create a leadership concept based on this new paradigm. It becomes necessary to use trustworthy and adapted tools to each country’s cultural and organizational context. This paper goal is to identify the Capeverdian existing leadership profile, recognizing the cultural attributes/values that may influence the organizational practices and the behaviour types found amongst the Capeverdian leaders.

Technologies of birth and models of midwifery care

This article is based on a study of a reform in the organisation of maternity services in the United Kingdom, which aimed towards developing a more woman-centred model of care. After decades of fragmentation and depersonalisation of care, associated with the shift of birth to a hospital setting, pressure by midwives and mothers prompted government review and a relatively radical turnaround in policy. However, the emergent model of care has been profoundly influenced by concepts and technologies of monitoring. The use of such technologies as ultrasound scans, electronic foetal monitoring and oxytocic augmentation of labour, generally supported by epidural anaesthesia for pain relief, have accompanied the development of a particular ecological model of birth – often called active management –, which is oriented towards the idea of an obstetric norm. Drawing on analysis of women’s narrative accounts of labour and birth, this article discusses the impact on women’s embodiment in birth, and the sources of information they use about the status of their own bodies, their labour and that of the child. It also illustrates how the impact on women’s experiences of birth may be mediated by a relational model of support, through the provision of caseload midwifery care.

Social representation of Alzheimer's disease for family caregivers: stressful and rewarding

Abstract OBJECTIVE To understand the content of Social Representation (SR) of family caregivers of Alzheimer's disease patients. METHOD Interviews were conducted with 26 caregivers and analyzed by the ALCESTE software. RESULTS The SR content was structured in two thematic axes called Daily Life and Care and Medical and Emotional Concepts and Outcomes. The first axis creates images related to the routine of interaction with the sick person, and contains a description of care procedures, experiences, and practices applied every day. The second is composed of subjective and conceptual aspects that make up the social representation of Alzheimer's disease, with meanings related to the emotional, medical, and biological contexts. CONCLUSION Due to the importance of topics related to patients' dependence and the personal and emotional consequences of the disease, overload is the main content of the SR of Alzheimer's disease for caregivers, and the understanding of these SR by health professionals should support the planning of interventions addressing this group of individuals.

Resolució de problemes i mètode de raonament en l'educació matemàtica

Des del principi dels temps històrics, la Matemàtica s'ha generat en totes les civilitzacions sobre la base de la resolució de problemes pràctics.Tanmateix, a partir del període grec la Història ens mostra la necessitat de fer un pas més endavant: l'evolució històrica de la Matemàtica situa els mètodes de raonament com a eix central de la recerca en Matemàtica. A partir d'una ullada als objectius i mètodes de treball d'alguns autors cabdals en la Història dels conceptes matemàtics postulem l'aprenentatge de les formes de raonament matemàtic com l'objectiu central de l'educació matemàtica, i la resolució de problemes com el mitjà més eficient per a coronar aquest objectiu.English version.From the beginning of the historical times, mathematics has been generated in all the civilizations on the base of the resolution of practical problems. Nevertheless, from the greek period History shows us the necessity to take one more step: the historical evolution of mathematics locates the methods of reasoning as the central axis of the research in mathematics. Glancing over the objectives and methods of work used bysome fundamental authors in the History of the mathematical concepts we postulated the learning of the forms of mathematical reasoning like the central objective of the mathematical education, and the resolution of problems as the most efficient way to carry out this objective.

Optimal management of microgrids

Desenvolupament dels models matemàtics necessaris per a controlar de forma òptima la microxarxa existent als laboratoris del Institut de Recerca en Energia de Catalunya. Els algoritmes s'implementaran per tal de simular el comportament i posteriorment es programaran directament sobre els elements de la microxarxa per verificar el seu correcte funcionament.. Desenvolupament dels models matemàtics necessaris per a controlar de forma òptima la microxarxa existent als laboratoris del Institut de Recerca en Energia de Catalunya. Els algoritmes s'implementaran per tal de simular el comportament i posteriorment es programaran directament sobre els elements de la microxarxa per verificar el seu correcte funcionament.