Comparison of the traditional pharmaceutical validation method versus an assisted pharmaceutical validation in hospitalized patients

Objective: To analyze pharmaceutical interventions that have been carried out with the support of an automated system for validation of treatments vs. the traditional method without computer support. Method: The automated program, ALTOMEDICAMENTOS® version 0, has 925 052 data with information regarding approximately 20 000 medicines, analyzing doses, administration routes, number of days with such a treatment, dosing in renal and liver failure, interactions control, similar drugs, and enteral medicines. During eight days, in four different hospitals (high complexity with over 1 000 beds, 400-bed intermediate, geriatric and monographic), the same patients and treatments were analyzed using both systems. Results: 3,490 patients were analyzed, with 42 155 different treatments. 238 interventions were performed using the traditional system (interventions 0.56% / possible interventions) vs. 580 (1.38%) with the automated one. Very significant pharmaceutical interventions were 0.14% vs. 0.46%; significant was 0.38% vs. 0.90%; non-significant was 0.05% vs. 0.01%, respectively. If both systems are simultaneously used, interventions are performed in 1.85% vs. 0.56% with just the traditional system. Using only the traditional model, 30.5% of the possible interventions are detected, whereas without manual review and only the automated one, 84% of the possible interventions are detected. Conclusions: The automated system increases pharmaceutical interventions between 2.43 to 3.64 times. According to the results of this study the traditional validation system needs to be revised relying on automated systems. The automated program works correctly in different hospitals.

A Metamodel for Collaboration Formalization

Part 11: Reference and Conceptual Models

O SIVICC como um sistema dissuasor da ilicitude e de apoio à atividade operacional da GNR

O objeto de estudo da presente investigação é o SIVICC. Sendo o objetivo geral demonstrar o seu desempenho organizacional nos domínios da dissuasão da ilicitude, do apoio à decisão e do suporte à atividade operacional da GNR, procurando adicionar e aprofundar conhecimento teórico e empírico. Em termos de metodologia optámos por uma estratégia de investigação qualitativa e relativamente ao desenho da pesquisa optou-se pela transversal. Os métodos e técnicas utilizadas foram as entrevistas semiestruturadas com a respetiva análise de conteúdo e a análise documental. Como resultado principal destacamos que, com base numa doutrina assente em princípios centrados em rede e no empirismo resultante das entrevistas efetuadas, o SIVICC proporciona superioridade de informação resultando numa consciência situacional partilhada da organização, o que conduz a melhores efeitos operacionais, que contribuem na prossecução da segurança de Portugal e da UE, através de uma efetiva vigilância diária e controlo do mar territorial e zona costeira. Concluímos que o SIVICC promove um apoio importante na tomada de decisão e suporta eficazmente e eficientemente a atividade operacional da GNR, que se vai refletir numa vantagem competitiva sobre o adversário que é persuadido a mudar os seus comportamentos através da dissuasão que o sistema proporciona. Abstract: The study object of this research is the SIVICC. The overall goal is to prove their organizational performance in the areas of deterrence of unlawful, in decision support and in supporting the operational activities of the GNR, attempting to add and deepen theoretical and empirical knowledge. In terms of methodology we chose a qualitative research strategy and for the design of research we chose the transversal. The methods and techniques used were semi-structured interviews with the respective content analysis and document analysis. The main result we highlight, based on a doctrine sustained on principles of centered network operations and a result empiricism of conducted interviews, that the SIVICC provides information superiority resulting in a shared situational awareness of the organization, leading to better operational effects that contribute to the pursuit security in Portugal and in the EU, through effective daily monitoring and control of the territorial sea and coastal zone. We conclude that the SIVICC promotes an important support decision making and supports effectively and efficiently operational activity of the GNR, which will reflect a competitive advantage over the adversary who is persuaded to change their behavior through deterrence that the system provides.

As provas de decisão na seleção dos quadros permanentes nos ramos das Forças Armadas

O presente trabalho, subordinado ao tema “As provas de decisão na seleção dos quadros permanentes nos Ramos das Forças Armadas”, enquadra-se no Mestrado Integrado em Ciências Militares, e procura estudar a importância das provas de decisão no processo de seleção dos quadros permanentes das Forças Armadas Portuguesas. Do concurso de admissão aos diferentes Estabelecimentos de Ensino Superior Público Universitário Militar, consta uma prova de Aptidão Física que inclui provas físicas e provas de decisão. O tema emergiu devido ao facto de as Forças Armadas Portuguesas se debaterem com o problema do insucesso na realização em algumas provas físicas por parte dos candidatos. Apesar dos responsáveis pela seleção terem consciência deste insucesso, reconhecem que muitos candidatos que não conseguem ultrapassar algumas das provas físicas têm capacidades para as superar. Nesta pesquisa qualitativa, através da realização de entrevistas semiestruturadas a alguns militares com funções e/ou experiências diferentes, procurámos comparar diferentes perspetivas sobre Prova de Aptidão Física e enquadrar a importância das provas no processo de ingresso nos quadros permanentes, numa dinâmica positiva que visou produzir informação pertinente sobre esta temática. Foi utilizado o método indutivo, assente numa abordagem de pesquisa qualitativa, cuja natureza é a investigação aplicada. Concluiu-se que as Provas de Decisão podem ser iguais para as três academias, e Provas de Aptidão Física dos três ramos podem ser realizadas conjuntamente, integrando as Prova de Decisão, de modo a otimizar a utilização dos recursos das Forças Armadas Portuguesas; a análise permitiu caraterizar Prova de Decisão e propor alterações ao processo de seleção dos candidatos.

DEVELOPMENT AND VALIDATION OF THE ANTERIOR CRUCIATE LIGAMENT INJURY-RISK-ESTIMATION QUIZ (ACL-IQ)

Over 2 million Anterior Cruciate Ligament (ACL) injuries occur annually worldwide resulting in considerable economic and health burdens (e.g., suffering, surgery, loss of function, risk for re-injury, and osteoarthritis). Current screening methods are effective but they generally rely on expensive and time-consuming biomechanical movement analysis, and thus are impractical solutions. In this dissertation, I report on a series of studies that begins to investigate one potentially efficient alternative to biomechanical screening, namely skilled observational risk assessment (e.g., having experts estimate risk based on observations of athletes movements). Specifically, in Study 1 I discovered that ACL injury risk can be accurately and reliably estimated with nearly instantaneous visual inspection when observed by skilled and knowledgeable professionals. Modern psychometric optimization techniques were then used to develop a robust and efficient 5-item test of ACL injury risk prediction skill—i.e., the ACL Injury-Risk-Estimation Quiz or ACL-IQ. Study 2 cross-validated the results from Study 1 in a larger representative sample of both skilled (Exercise Science/Sports Medicine) and un-skilled (General Population) groups. In accord with research on human expertise, quantitative structural and process modeling of risk estimation indicated that superior performance was largely mediated by specific strategies and skills (e.g., ignoring irrelevant information), independent of domain general cognitive abilities (e.g., metal rotation, general decision skill). These cognitive models suggest that ACL-IQ is a trainable skill, providing a foundation for future research and applications in training, decision support, and ultimately clinical screening investigations. Overall, I present the first evidence that observational ACL injury risk prediction is possible including a robust technology for fast, accurate and reliable measurement—i.e., the ACL-IQ. Discussion focuses on applications and outreach including a web platform that was developed to house the test, provide a repository for further data collection, and increase public and professional awareness and outreach (www.ACL-IQ.org). Future directions and general applications of the skilled movement analysis approach are also discussed.

Twelve Certain Men: The Impact of Emotional Appraisals on Juror Decision-Making

Our jury system is predicated upon the expectation that jurors engage in systematic processing when considering evidence and making decisions. They are instructed to interpret facts and apply the appropriate law in a fair, dispassionate manner, free of all bias, including that of emotion. However, emotions containing an element of certainty (e.g., anger and happiness, which require little cognitive effort in determining their source) can often lead people to engage in superficial, heuristic-based processing. Compare this to uncertain emotions (e.g., hope and fear, which require people to seek out explanations for their emotional arousal), which instead has the potential to lead them to engage in deeper, more systematic processing. The purpose of the current research is in part to confirm past research (Tiedens & Linton, 2001; Semmler & Brewer, 2002) that uncertain emotions (like fear) can influence decision-making towards a more systematic style of processing, whereas more certain emotional states (like anger) will lead to a more heuristic style of processing. Studies One, Two, and Three build upon this prior research with the goal of improving methodological rigor through the use of film clips to reliably induce emotions, with awareness of testimonial details serving as measures of processing style. The ultimate objective of the current research was to explore this effect in Study Four by inducing either fear, anger, or neutral emotion in mock jurors, half of whom then followed along with a trial transcript featuring eight testimonial inconsistencies, while the other participants followed along with an error-free version of the same transcript. Overall rates of detection for these inconsistencies was expected to be higher for the uncertain/fearful participants due to their more effortful processing compared to certain/angry participants. These expectations were not fulfilled, with significant main effects only for the transcript version (with or without inconsistencies) on overall inconsistency detection rates. There are a number of plausible explanations for these results, so further investigation is needed.

Researching the Use of Communication Technologies in Higher Education Institutions in Portugal

This paper describes a research which main purpose was identifying and characterizing the use of Communication Technologies by Portuguese Public Higher Education Institutions to support learning activities. An analysis model was created and used to develop a nationwide online survey used to collect data from students, teachers and institutional managers. The results show that institutional policies and resources are in place and being used to support learning; learning management systems and interpersonal communication technologies are intensely used and widely adopted; and that there are gender differences as far as the students' use of Communication Technologies is concerned. The results of this project provide a useful insight on the use of Communication Technologies by Portuguese Public Higher Education Institutions and give valuable information for ongoing decision making processes regarding the institutional adoption and development of learning models that take advantage of these technologies.

Detection and Grading of Prostate Cancer in Temporal Enhanced Ultrasound using Convolutional Neural Networks

Prostate cancer is the most common non-dermatological cancer amongst men in the developed world. The current definitive diagnosis is core needle biopsy guided by transrectal ultrasound. However, this method suffers from low sensitivity and specificity in detecting cancer. Recently, a new ultrasound based tissue typing approach has been proposed, known as temporal enhanced ultrasound (TeUS). In this approach, a set of temporal ultrasound frames is collected from a stationary tissue location without any intentional mechanical excitation. The main aim of this thesis is to implement a deep learning-based solution for prostate cancer detection and grading using TeUS data. In the proposed solution, convolutional neural networks are trained to extract high-level features from time domain TeUS data in temporally and spatially adjacent frames in nine in vivo prostatectomy cases. This approach avoids information loss due to feature extraction and also improves cancer detection rate. The output likelihoods of two TeUS arrangements are then combined to form our novel decision support system. This deep learning-based approach results in the area under the receiver operating characteristic curve (AUC) of 0.80 and 0.73 for prostate cancer detection and grading, respectively, in leave-one-patient-out cross-validation. Recently, multi-parametric magnetic resonance imaging (mp-MRI) has been utilized to improve detection rate of aggressive prostate cancer. In this thesis, for the first time, we present the fusion of mp-MRI and TeUS for characterization of prostate cancer to compensates the deficiencies of each image modalities and improve cancer detection rate. The results obtained using TeUS are fused with those attained using consolidated mp-MRI maps from multiple MR modalities and cancer delineations on those by multiple clinicians. The proposed fusion approach yields the AUC of 0.86 in prostate cancer detection. The outcomes of this thesis emphasize the viable potential of TeUS as a tissue typing method. Employing this ultrasound-based intervention, which is non-invasive and inexpensive, can be a valuable and practical addition to enhance the current prostate cancer detection.

Investigating key decision problems to optimize the operation and maintenance strategy of offshore wind farms

This paper investigates three decision problems with potential to optimize operation and maintenance and logistics strategies for offshore wind farms: the timing of pre-determined jack-up vessel campaigns; selection of crew transfer vessel fleet; and timing of annual services. These problems are compared both in terms of potential cost reduction and the stochastic variability and associated uncertainty of the outcome. Pre-determined jack-up vessel campaigns appear to have a high cost reduction potential but also a higher stochastic variability than the other decision problems. The paper also demonstrates the benefits and difficulties of considering problems together rather than solving them in isolation.

Knowledge-based management systems for the police force

Knowledge-Based Management Systems enable new ways to process and analyse knowledge to gain better insights to solve a problem and aid in decision making. In the police force such systems provide a solution for enhancing operations and improving client administration in terms of knowledge management. The main objectives of every police officer is to ensure the security of life and property, promote lawfulness, and avert and distinguish wrongdoing. The administration of knowledge and information is an essential part of policing, and the police ought to be proactive in directing both explicit and implicit knowledge, whilst adding to their abilities in knowledge sharing. In this paper the potential for a knowledge based system for the Mauritius police was analysed, and recommendations were also made, based on requirements captured from interviews with several long standing officers, and surveying of previous works in the area.

Versioning Concept Schemes for Persistent Retrieval

Things change. Words change, meaning changes and use changes both words and meaning. In information access systems this means concept schemes such as thesauri or clas- sification schemes change. They always have. Concept schemes that have survived have evolved over time, moving from one version, often called an edition, to the next. If we want to manage how words and meanings - and as a conse- quence use - change in an effective manner, and if we want to be able to search across versions of concept schemes, we have to track these changes. This paper explores how we might expand SKOS, a World Wide Web Consortium (W3C) draft recommendation in order to do that kind of tracking.The Simple Knowledge Organization System (SKOS) Core Guide is sponsored by the Semantic Web Best Practices and Deployment Working Group. The second draft, edited by Alistair Miles and Dan Brickley, was issued in November 2005. SKOS is a “model for expressing the basic structure and content of concept schemes such as thesauri, classification schemes, subject heading lists, taxonomies, folksonomies, other types of controlled vocabulary and also concept schemes embedded in glossaries and terminologies” in RDF. How SKOS handles version in concept schemes is an open issue. The current draft guide suggests using OWL and DCTERMS as mechanisms for concept scheme revision.As it stands an editor of a concept scheme can make notes or declare in OWL that more than one version exists. This paper adds to the SKOS Core by introducing a tracking sys- tem for changes in concept schemes. We call this tracking system vocabulary ontogeny. Ontogeny is a biological term for the development of an organism during its lifetime. Here we use the ontogeny metaphor to describe how vocabularies change over their lifetime. Our purpose here is to create a conceptual mechanism that will track these changes and in so doing enhance information retrieval and prevent document loss through versioning, thereby enabling persistent retrieval.

Ontologies and the Semantic Web: Problems and Perspectives for LIS Professionals

Many years have passed since Berners-Lee envi- sioned the Web as it should be (1999), but still many information professionals do not know their precise role in its development, especially con- cerning ontologies –considered one of its main elements. Why? May it still be a lack of under- standing between the different academic commu- nities involved (namely, Computer Science, Lin- guistics and Library and Information Science), as reported by Soergel (1999)? The idea behind the Semantic Web is that of several technologies working together to get optimum information re- trieval performance, which is based on proper resource description in a machine-understandable way, by means of metadata and vocabularies (Greenberg, Sutton and Campbell, 2003). This is obviously something that Library and Information Science professionals can do very well, but, are we doing enough? When computer scientists put on stage the ontology paradigm they were asking for semantically richer vocabularies that could support logical inferences in artificial intelligence as a way to improve information retrieval systems. Which direction should vocabulary development take to contribute better to that common goal? The main objective of this paper is twofold: 1) to identify main trends, issues and problems con- cerning ontology research and 2) to identify pos- sible contributions from the Library and Information Science area to the development of ontologies for the semantic web. To do so, our paper has been structured in the following manner. First, the methodology followed in the paper is reported, which is based on a thorough literature review, where main contributions are analysed. Then, the paper presents a discussion of the main trends, issues and problems concerning ontology re- search identified in the literature review. Recom- mendations of possible contributions from the Library and Information Science area to the devel- opment of ontologies for the semantic web are finally presented.

Function, Purpose, Predication, and Context of Information Organization Frameworks

This paper outlines the purposes, predications, functions, and contexts of information organization frameworks; including: bibliographic control, information retrieval, resource discovery, resource description, open access scholarly indexing, personal information management protocols, and social tagging in order to compare and contrast those purposes, predications, functions, and contexts. Information organization frameworks, for the purpose of this paper, consist of information organization systems (classification schemes, taxonomies, ontologies, bibliographic descriptions, etc.), methods of conceiving of and creating the systems, and the work processes involved in maintaining these systems. The paper first outlines the theoretical literature of these information organization frameworks. In conclusion, this paper establishes the first part of an evaluation rubric for a function, predication, purpose, and context analysis.

Recours aux services de soutien formel par les parents immigrants d’un enfant en situation de handicap

Les parents immigrants d’un enfant en situation de handicap présentent davantage de sources de vulnérabilité que d’autres parents. Cette situation peut diminuer le temps disponible et altérer leur implication dans le programme de réadaptation de leur enfant. L’objectif de cette thèse doctorale est de déterminer les attentes et les besoins en services de soutien formel de ces parents, afin de leur proposer une aide adaptée à leurs conditions de vie, et ceci, au fur et à mesure que l’enfant grandit. D’abord, une étude de la portée des écrits scientifiques est menée dans le but de mieux cerner les connaissances existantes en lien avec le recours aux services de soutien par les parents immigrants (chapitre 1). Les vingt publications sélectionnées indiquent que l’aide pour trouver de l’information s’avère la plus requise, que ce soit au sujet de la condition de l’enfant, du fonctionnement sociosanitaire et éducatif du pays d’accueil, ou encore des services de soutien. En outre, la transmission de ces informations peut se compliquer en cas de non-maîtrise de la langue du pays d’accueil ou lorsque des interculturelles apparaissent entre les parents immigrants et les différents intervenants rencontrés. Quant au non-recours aux aides formelles, il semble principalement dû à l’inadéquation entre l’aide concrète et les attentes des parents, au soutien informel reçu, à la méconnaissance des opportunités d’obtenir des services d’aide destinés aux parents, ou encore à un épuisement non ressenti. Compte tenu du nombre restreint d’écrits scientifiques recensés, des entrevues semi-dirigées sont conduites auprès de 28 parents immigrants d’un enfant en situation de handicap dans la province du Québec (Canada) dans le cadre d’une recherche de plus grande envergure portant sur la communication avec les intervenants en petite enfance (chapitre 2). Le but de cette deuxième étude est de mieux saisir l’utilisation des services de soutien formel par les parents immigrants et les facteurs influençant leurs choix. Il faut préciser que les propos recueillis restent très centrés sur les services destinés à l’enfant. Le soutien pour recevoir des informations et l’accompagnement à la décision apparaissent comme les aides formelles les plus utilisées par les participants, suivies du soutien à l’éducation, de l’écoute active et de l’aide financière. Cinq facteurs semblent guider le recours au soutien formel qui est destiné aux parents, soit : (1) leur perception de la condition de leur enfant, (2) l’accès à l’information, (3) leurs stratégies et leur capacité d’agir, (4) l’implication du réseau informel, et (5) leur perception de leur besoin de services de soutien. Suite à ces résultats, de nouvelles entrevues semi-dirigées sont menées auprès de huit parents immigrants d’enfants d’âges différents à Montréal et à Québec. Cette démarche permet d’approfondir le thème du recours au soutien formel destiné aux parents, et ce, au fur et à mesure que l’enfant grandit (chapitre 3). Le guide d’entretien conçu pour cette étude met l’emphase sur les attentes et les besoins des parents immigrants afin d’atteindre un équilibre dans toutes les sphères de leur vie. Suite à une analyse thématique exploratoire du discours des parents et par l’application d’un modèle de stress et de coping, sept principales sources de stress sont mises en évidence : (1) le parcours migratoire, (2) la condition de l’enfant, (3) l’organisation sociosanitaire du pays d’accueil, (4) l’insertion professionnelle, (5) la relation de couple, (6) le réseau social, et (7) l’état de santé du parent. Afin de faire face à ces circonstances difficiles, les parents immigrants recourent principalement à de l’aide financière, du soutien pour obtenir des informations, de l’accompagnement à la décision, de l’aide en éducation et pour le transport. La satisfaction exprimée varie, notamment en raison des divergences entre les attentes et les services obtenus (soutien en éducation, écoute active, services de garde), ainsi qu’en termes de quantité d’aide reçue (soutien financier, informations, accompagnement à la décision). Un modèle théorique original est proposé afin d’illustrer le contexte parental en termes d’attentes, de besoins et de recours au soutien. Si certains moments de la vie de l’enfant peuvent entraîner un stress supplémentaire pour les parents (annonce du diagnostic, arrivée à l’école, transition à l’âge adulte), le parcours migratoire semble davantage expliquer le recours aux aides formelles.