Utilização de mapas conceituais como ferramenta de ensino para o desenvolvimento do raciocínio clínico no curso de medicina da Universidade Federal do Rio Grande do Norte

BACKGROUND: Among the wide range of skills displayed by a medical doctor is undoubtedly the need to use cohesive and well grounded clinical reasoning in order for medical care to be indeed effective. It is in this respect that conceptual maps emerge; these are a methodological innovation that allows a comprehensive, panoramic and associative outlook of theoretical content, making it more practical and applicable to the reality of clinical observation. Promoting learning, learning resources and a feedback system between professor and students, as well as assessing and monitoring the performance of students during their academic training, are the main features of this tool. OBJETIVE: Assess the use of conceptual maps as a teaching-learning tool in the training of undergraduate medical students at Universidade Federal do Rio Grande do Norte (UFRN). METHODOLOGY: Interventional, randomized, cross-sectional study conducted with students from the 3rd and 5th periods of the medical course at UFRN, during the second semester of 2014, totaling 86 participants, divided into two groups: GI (intervention – clinical case resolution with a conceptual map) and GII (control – clinical case resolution without a conceptual map) in each period. RESULTS: The use of conceptual maps to teach liver failure syndrome resulted in a statistically significant cognitive gain for G1 students from the 5th period (GI: 6.8±1.6 and 8.0±1.5, p = 0.024; GII: 7.2±2.1 and 8.0±1.7, p = 0.125, pre and post-intermediate means, respectively), a result not observed in the period 3rd (GI: 7.7±1.3 and 8.0±1.4, p = 0.501; GII: 6.7±1.8 and 7.8±1.8; p=0.068, pre and post-intermediate means, respectively). Students in the 3 rd period gave better responses to the first clinical case, with a larger number of suitable concepts and crosslinks, when they used conceptual maps (GI: 91.3±13.15 and GII: 64.84±22.84, p=0,002). Students in the 5th period exhibited better clinical reasoning and more complete responses using the tool (p=0,01). Most of the students were not aware of the tool (53.8% from the 3rd period and 65.3% from the 5th period). Among those who knew about conceptual maps, most (59.3%) had only used them during high school, 14.8% had never used them and only seven students (25.9%) used them during the medical course. Analysis of open responses, obtained in process assessment showed clear satisfaction and enthusiasm with learning about the new tool, and frequent suggestions to use it at other moments in the course. Assessment of learning profile, using the VARK questionnaire, showed that most students from both periods exhibited a multimodal style. CONCLUSION: Despite their scant knowledge regarding the tool, good acceptability and understanding was observed in the study participants. The conceptual maps allowed cognitive gains, better responses and clinical reasoning in teaching liver failure syndrome to 5th period students.

Réactions du chef de PME après utilisation d'un système d'évaluation multi-source

Résumé : Dans une ère de concurrence économique accrue, les organisations éprouvent de plus en plus le besoin de mesurer le rendement de leurs employés, y compris celui de leurs dirigeants. À cette fin, l'évaluation demeure un outil de gestion privilégié. Au nombre des systèmes d'évaluation existants, le feed-back multi-source (FMS) — ou feed-back 360°— est en progression. Malheureusement, on ne connaît pas encore très bien l'incidence de ce type de système, la littérature étant plutôt muette sur ce qu'il donne concrètement et, particulièrement, sur la réaction des évalués subséquemment à l'obtention de leur rapport d'évaluation. Il ressort néanmoins de certaines études que les dirigeants, et surtout, les chefs se sentent laissés à eux-mêmes quant à l'évaluation de leurs compétences. Il y a quelques années, à la demande du Groupement des chefs d'entreprise du Québec (GCEQ), un instrument de type multi-source a été conçu par le Laboratoire de recherche sur la performance des entreprises (LaRePe), afin de mesurer spécifiquement la performance des chefs d'entreprise comme leader. À ce stade-ci, les promoteurs désirent mieux comprendre l'incidence de l'utilisation de leur outil : le PDG-Leadership. Pour combler les lacunes de la littérature, et aussi pour répondre au besoin du GCEQ, la présente thèse porte sur la réaction des chefs à la suite de la réception de leur rapport d'évaluation. L'objet de la recherche est double : il s'agit d'examiner les variables qui influencent le fait que les évalués entreprennent des actions à la suite de leur feed-back (considération théorique) et, d'autre part, de connaître davantage ces actions entreprises bref, ce que le système de feed-back multi-source XFMS) donne vraiment (considération pratique). Afin de mener à bien la recherche, une résidence a été réalisée. Elle a fourni le contexte pour élaborer un questionnaire d'enquête s'appliquant particulièrement aux chefs d'entreprise. L'enquête a permis de rejoindre 351 dirigeants ayant été évalués au moins une fois par l'entremise du PDG-Leadership. De ce nombre, 87 répondants, membres du Groupement se sont manifestés. Le cadre conceptuel utilisé consiste en une adaptation du modèle proposé par Smither, London et Reilly (2005a). comporte sept variables, desquelles ont été tirées cinq hypothèses de recherche. Quatre hypothèses ont été rejetées alors qu'une autre ne s'est avérée supportée que pour le groupe constitué des femmes faisant partie de l'échantillon. De plus, il est intéressant de constater que ce n'est pas le feed-back (rapport) qui déclenche l'acceptation puis les actions, mais une attitude personnelle représentée par la possibilité d'un changement perçue (V4). Chez les chefs, il ne se produit donc pas de réaction en chaîne comme le suppose le modèle théorique utilisé. Il semble que ce soit plutôt la possibilité de changement perçu qui est à la base du fait d'entreprendre des actions, laquelle s'apparente au sentiment d'auto-efficacité défini par Bandura (2007). Les données recueillies auront aussi servies à générer de nouvelles connaissances et à faire ressortir une liste de 112 actions que les chefs disent avoir engagées à la suite de l'obtention de leur rapport d'évaluation. Cette liste a permis de faire une catégorisation des actions posées. Les actions qu'ils entreprennent sont toutefois davantage dirigées vers l'amélioration de l'organisation que vers leur propre amélioration. Il s'agit là, d'une des contributions de la présente thèse.||Abstract : In a context of intense economic competition, organizations are increasingly using instruments of performance evaluation. The multi-source feedback or 360 [degrees] is one of those. The literature seems still silent on what type of evaluation is really about the reaction it generates among evaluated. In response to a request from the Groupement des chefs d'entreprise du Québec (GCEQ), a System of multi-source assessment was designed by the Laboratoire de recherche sur la performance des entreprises (LaRePe). The PDG-Leadership, specifically used to measure the skills of managers of SMLs as a leader. After some years of use, developers want to better understand its impact in order to improve it and make it even better. To address these theoretical and practical considérations, a survey was conducted among 87 business leaders from Quebec who had already been assessed using this tool. This research bas the purpose, the validation of a preliminary model proposed by Smither, London, and Reilly, 2005a, to examine the variables that influence that evaluated undertake actions as a result of their feedback and the other, to know these actions, in short, that the System of feed-back multi-source (FMS) really. From the analysis of data collected, a list of 112 shares was established. In turn, this led to a categorization of actions taken. Although the FMS system is effective, it should be noted that entrepreneurs seem to react differently from other catégories assessed.

An investigation of online acoustic information for elite rowers in on-water training conditions

Presenting acoustic information has become increasingly interesting for technique training and control in various sports. In elite rowing, acoustic feedback is a new and promising application to optimize the boat's forward motion. This paper describes the potential of acoustic information which represents the movement-relevant information on the boat's forward motion for rowing and its implementation as online acoustic feedback during on-water training sessions. The first significant results were encouraging and support the intention to implement the acoustic information regularly into training processes for elite athletes. © Faculty of Education. University of Alicante.

Holistic Design In High-Speed Optical Interconnects

Integrated circuit scaling has enabled a huge growth in processing capability, which necessitates a corresponding increase in inter-chip communication bandwidth. As bandwidth requirements for chip-to-chip interconnection scale, deficiencies of electrical channels become more apparent. Optical links present a viable alternative due to their low frequency-dependent loss and higher bandwidth density in the form of wavelength division multiplexing. As integrated photonics and bonding technologies are maturing, commercialization of hybrid-integrated optical links are becoming a reality. Increasing silicon integration leads to better performance in optical links but necessitates a corresponding co-design strategy in both electronics and photonics. In this light, holistic design of high-speed optical links with an in-depth understanding of photonics and state-of-the-art electronics brings their performance to unprecedented levels. This thesis presents developments in high-speed optical links by co-designing and co-integrating the primary elements of an optical link: receiver, transmitter, and clocking.

In the first part of this thesis a 3D-integrated CMOS/Silicon-photonic receiver will be presented. The electronic chip features a novel design that employs a low-bandwidth TIA front-end, double-sampling and equalization through dynamic offset modulation. Measured results show -14.9dBm of sensitivity and energy efficiency of 170fJ/b at 25Gb/s. The same receiver front-end is also used to implement source-synchronous 4-channel WDM-based parallel optical receiver. Quadrature ILO-based clocking is employed for synchronization and a novel frequency-tracking method that exploits the dynamics of IL in a quadrature ring oscillator to increase the effective locking range. An adaptive body-biasing circuit is designed to maintain the per-bit-energy consumption constant across wide data-rates. The prototype measurements indicate a record-low power consumption of 153fJ/b at 32Gb/s. The receiver sensitivity is measured to be -8.8dBm at 32Gb/s.

Next, on the optical transmitter side, three new techniques will be presented. First one is a differential ring modulator that breaks the optical bandwidth/quality factor trade-off known to limit the speed of high-Q ring modulators. This structure maintains a constant energy in the ring to avoid pattern-dependent power droop. As a first proof of concept, a prototype has been fabricated and measured up to 10Gb/s. The second technique is thermal stabilization of micro-ring resonator modulators through direct measurement of temperature using a monolithic PTAT temperature sensor. The measured temperature is used in a feedback loop to adjust the thermal tuner of the ring. A prototype is fabricated and a closed-loop feedback system is demonstrated to operate at 20Gb/s in the presence of temperature fluctuations. The third technique is a switched-capacitor based pre-emphasis technique designed to extend the inherently low bandwidth of carrier injection micro-ring modulators. A measured prototype of the optical transmitter achieves energy efficiency of 342fJ/bit at 10Gb/s and the wavelength stabilization circuit based on the monolithic PTAT sensor consumes 0.29mW.

Lastly, a first-order frequency synthesizer that is suitable for high-speed on-chip clock generation will be discussed. The proposed design features an architecture combining an LC quadrature VCO, two sample-and-holds, a PI, digital coarse-tuning, and rotational frequency detection for fine-tuning. In addition to an electrical reference clock, as an extra feature, the prototype chip is capable of receiving a low jitter optical reference clock generated by a high-repetition-rate mode-locked laser. The output clock at 8GHz has an integrated RMS jitter of 490fs, peak-to-peak periodic jitter of 2.06ps, and total RMS jitter of 680fs. The reference spurs are measured to be –64.3dB below the carrier frequency. At 8GHz the system consumes 2.49mW from a 1V supply.

Controlling chaos in a Lorenz-like system using feedback

We demonstrate that the dynamics of an autonomous chaotic laser can be controlled to a periodic or steady state under self-synchronization. In general, past the chaos threshold the dependence of the laser output on feedback applied to the pump is submerged in the Lorenz-like chaotic pulsation. However there exist specific feedback delays that stabilize the chaos to periodic behavior or even steady state. The range of control depends critically on the feedback delay time and amplitude. Our experimental results are compared with the complex Lorenz equations which show good agreement.

Mutual feedback in e-portfolio assessment : an approach to the netfolio system

Peer-reviewed

Effectiveness of visual feedback provided by an electromagnetic articulograph (EMA) system: training vowel production in individuals with hearing impairment

An electromagnetic articulograph (EMA) system was used to provide a participant with congenital hearing loss visual biofeedback information on speech production. Five normally hearing listeners reported a change in their perception of the speech sound /æ/ in the various conditions of the study.

Information system evolvability, feedback and pattern languages

Information systems for business are frequently heavily reliant on software. Two important feedback-related effects of embedding software in a business process are identified. First, the system dynamics of the software maintenance process can become complex, particularly in the number and scope of the feedback loops. Secondly, responsiveness to feedback can have a big effect on the evolvability of the information system. Ways have been explored to provide an effective mechanism for improving the quality of feedback between stakeholders during software maintenance. Understanding can be improved by using representations of information systems that are both service-based and architectural in scope. The conflicting forces that encourage change or stability can be resolved using patterns and pattern languages. A morphology of information systems pattern languages has been described to facilitate the identification and reuse of patterns and pattern languages. The kind of planning process needed to achieve consensus on a system's evolution is also considered.

Quality control, validation and user feedback of the European Flood Alert System (EFAS)

The quality control, validation and verification of the European Flood Alert System (EFAS) are described. EFAS is designed as a flood early warning system at pan-European scale, to complement national systems and provide flood warnings more than 2 days before a flood. On average 20–30 alerts per year are sent out to the EFAS partner network which consists of 24 National hydrological authorities responsible for transnational river basins. Quality control of the system includes the evaluation of the hits, misses and false alarms, showing that EFAS has more than 50% of the time hits. Furthermore, the skills of both the meteorological as well as the hydrological forecasts are evaluated, and are included here for a 10-year period. Next, end-user needs and feedback are systematically analysed. Suggested improvements, such as real-time river discharge updating, are currently implemented.

Development of a Real-time Formative Feedback Student Response System

This paper is focusing IT-supported real-time formative feedback in a classroom context. The development of a Student and Teacher Response System (STRS) is described. Since there are a number of obstacles for effective interaction in large classes, IT can be used to support the teachers aim to find out if students understand the lecture and accordingly adjust the content and design of the lecture. The system can be used for formative assessment before, during, and after a lecture. It is also possible for students to initiate interaction during lectures by posing questions anonymously. The main contributions of the paper are a) the description of the interactive real-time system and b) the development process behind it.

Tayloring Brazil: a system dynamics model for monetary policy feedback

The thesis introduces a system dynamics Taylor rule model of new Keynesian nature for monetary policy feedback in Brazil. The nonlinear Taylor rule for interest rate changes con-siders gaps and dynamics of GDP growth and inflation. The model closely tracks the 2004 to 2011 business cycle and outlines the endogenous feedback between the real interest rate, GDP growth and inflation. The model identifies a high degree of endogenous feedback for monetary policy and inflation, while GDP growth remains highly exposed to exogenous eco-nomic conditions. The results also show that the majority of the monetary policy moves during the sample period was related to GDP growth, despite higher coefficients of inflation parameters in the Taylor rule. This observation challenges the intuition that inflation target-ing leads to a dominance of monetary policy moves with respect to inflation. Furthermore, the results suggest that backward looking price-setting with respect to GDP growth has been the dominant driver of inflation. Moreover, simulation exercises highlight the effects of the new BCB strategy initiated in August 2011 and also consider recession and inflation avoid-ance versions of the Taylor rule. In methodological terms, the Taylor rule model highlights the advantages of system dynamics with respect to nonlinear policies and to the stock-and-flow approach. In total, the strong historical fit and some counterintuitive observations of the Taylor rule model call for an application of the model to other economies.

Towards a ground navigation system based in visual feedback provided by a mini UAV

This paper addresses initial efforts to develop a navigation system for ground vehicles supported by visual feedback from a mini aerial vehicle. A visual-based algorithm computes the ground vehicle pose in the world frame, as well as possible obstacles within the ground vehicle pathway. Relying on that information, a navigation and obstacle avoidance system is used to re-plan the ground vehicle trajectory, ensuring an optimal detour. Finally, some experiments are presented employing a unmanned ground vehicle (UGV) and a low cost mini unmanned aerial vehicle (UAV).

A Web-based Support System for Providing Effective Monitoring, Feedback and Evaluation in Project Management Education

This work introduces a web-based learning environment to facilitate learning in Project Management. The proposed web-based support system integrates methodological procedures and information systems, allowing to promote learning among geographically-dispersed students. Thus, students who are enrolled in different universities at different locations and attend their own project management courses, share a virtual experience in executing and managing projects. Specific support systems were used or developed to automatically collect information about student activities, making it possible to monitor the progress made on learning and assess learning performance as established in the defined rubric.

Premature Sister Chromatid Separation Is Poorly Detected by the Spindle Assembly Checkpoint as a Result of System-Level Feedback

Sister chromatid cohesion, mediated by the cohesin complex, is essential for faithful mitosis. Nevertheless, evidence suggests that the surveillance mechanism that governs mitotic fidelity, the spindle assembly checkpoint (SAC), is not robust enough to halt cell division when cohesion loss occurs prematurely. The mechanism behind this poor response is not properly understood. Using developing Drosophila brains, we show that full sister chromatid separation elicits a weak checkpoint response resulting in abnormal mitotic exit after a short delay. Quantitative live-cell imaging approaches combined with mathematical modeling indicate that weak SAC activation upon cohesion loss is caused by weak signal generation. This is further attenuated by several feedback loops in the mitotic signaling network. We propose that multiple feedback loops involving cyclin-dependent kinase 1 (Cdk1) gradually impair error-correction efficiency and accelerate mitotic exit upon premature loss of cohesion. Our findings explain how cohesion defects may escape SAC surveillance.