Learning to manage complexity through simulation: students' challenges and possible strategies

Many have called for medical students to learn how to manage complexity in healthcare. This study examines the nuances of students' challenges in coping with a complex simulation learning activity, using concepts from complexity theory, and suggests strategies to help them better understand and manage complexity.Wearing video glasses, participants took part in a simulation ward-based exercise that incorporated characteristics of complexity. Video footage was used to elicit interviews, which were transcribed. Using complexity theory as a theoretical lens, an iterative approach was taken to identify the challenges that participants faced and possible coping strategies using both interview transcripts and video footage.Students' challenges in coping with clinical complexity included being: a) unprepared for 'diving in', b) caught in an escalating system, c) captured by the patient, and d) unable to assert boundaries of acceptable practice.Many characteristics of complexity can be recreated in a ward-based simulation learning activity, affording learners an embodied and immersive experience of these complexity challenges. Possible strategies for managing complexity themes include: a) taking time to size up the system, b) attuning to what emerges, c) reducing complexity, d) boundary practices, and e) working with uncertainty. This study signals pedagogical opportunities for recognizing and dealing with complexity.

Point of view filming and the elicitation interview

Face-to-face interviews are a fundamental research tool in qualitative research. Whilst this form of data collection can provide many valuable insights, it can often fall short of providing a complete picture of a research subject's experiences. Point of view (PoV) interviewing is an elicitation technique used in the social sciences as a means of enriching data obtained from research interviews. Recording research subjects' first person perspectives, for example by wearing digital video glasses, can afford deeper insights into their experiences. PoV interviewing can promote making visible the unverbalizable and does not rely as much on memory as the traditional interview. The use of such relatively inexpensive technology is gaining interest in health profession educational research and pedagogy, such as dynamic simulation-based learning and research activities. In this interview, Dr Gerry Gormley (a medical education researcher) talks to Dr Jonathan Skinner (an anthropologist with an interest in PoV interviewing), exploring some of the many crossover implications with PoV interviewing for medical education research and practice.

An Electric Vehicle Dispatch Module for Demand-Side Energy Participation

The penetration of the electric vehicle (EV) has increased rapidly in recent years mainly as a consequence of advances in transport technology and power electronics and in response to global pressure to reduce carbon emissions and limit fossil fuel consumption. It is widely acknowledged that inappropriate provision and dispatch of EV charging can lead to negative impacts on power system infrastructure. This paper considers EV requirements and proposes a module which uses owner participation, through mobile phone apps and on-board diagnostics II (OBD-II), for scheduled vehicle charging. A multi-EV reference and single-EV real-time response (MRS2R) online algorithm is proposed to calculate the maximum and minimum adjustable limits of necessary capacity, which forms part of decision-making support in power system dispatch. The proposed EV dispatch module is evaluated in a case study and the influence of the mobile app, EV dispatch trending and commercial impact is explored.

Validade científica de conhecimento epidemiológico gerado com base no estudo Saúde Bucal Brasil 2003

NARVAI, Paulo Capel et al. Validade científi ca de conhecimento epidemiológico gerado com base no estudo Saúde Bucal Brasil 2003. Caderno de saúde pública, Rio de Janeiro, v. 26, n. 4, p. 647-670, abr. 2010.

Preventing suicide: a global imperative.

Every 40 seconds a person dies by suicide somewhere in the world. "Preventing suicide: a global imperative" is the first WHO report of its kind. It aims to increase awareness of the public health significance of suicide and suicide attempts, to make suicide prevention a higher priority on the global public health agenda, and to encourage and support countries to develop or strengthen comprehensive suicide prevention strategies in a multi-sectoral public health approach. The report provides a global knowledge base on suicide and suicide attempts as well as actionable steps for countries based on their current resources and context to move forward in suicide prevention.

Artificial Neural Network and Neutron Aplication in a Volume Fraction Calculation in Annular and Stratified Multiphase System

Multiphase flows, type oil–water-gas are very common among different industrial activities, such as chemical industries and petroleum extraction, and its measurements show some difficulties to be taken. Precisely determining the volume fraction of each one of the elements that composes a multiphase flow is very important in chemical plants and petroleum industries. This work presents a methodology able to determine volume fraction on Annular and Stratified multiphase flow system with the use of neutrons and artificial intelligence, using the principles of transmission/scattering of fast neutrons from a 241Am-Be source and measurements of point flow that are influenced by variations of volume fractions. The proposed geometries used on the mathematical model was used to obtain a data set where the thicknesses referred of each material had been changed in order to obtain volume fraction of each phase providing 119 compositions that were used in the simulation with MCNP-X –computer code based on Monte Carlo Method that simulates the radiation transport. An artificial neural network (ANN) was trained with data obtained using the MCNP-X, and used to correlate such measurements with the respective real fractions. The ANN was able to correlate the data obtained on the simulation with MCNP-X with the volume fractions of the multiphase flows (oil-water-gas), both in the pattern of annular flow as stratified, resulting in a average relative error (%) for each production set of: annular (air= 3.85; water = 4.31; oil=1.08); stratified (air=3.10, water 2.01, oil = 1.45). The method demonstrated good efficiency in the determination of each material that composes the phases, thus demonstrating the feasibility of the technique.

Redes Interorganizacionais: um estudo sobre partilha e utilização do conhecimento em organizações da Rede Associativa Empresarial da Região Centro de Portugal

Tese de doutoramento em Psicologia, na especialidade de Psicologia das Organizações, do Trabalho e dos Recursos Humanos

Gestão da informação: um estudo de caso em um instituto de pesquisa tecnológica

Each two years the amount of available information in the world double. This is the Information Age, where the success depends on what one knows, not on what one has. A new economy appears with the capacity to generate, to store, to process and to apply effectively the knowledge, based on information, determining the companies productivity and competitiveness.The objective of this work is to understand the information management model of a technological research institute - CTGÁS (Gas Technology Center). The research has been done focused on the 5 main processes and the 15 support processes of the organization value chain , aiming to understand the information management in the organization based on Davenport´s Information Management model (1998). Therefore, it was necessary to identify how the necessary information for the organizational processes accomplishment are determined, obtained, distributed and used by the organization. The research can be classified as descriptive, regarding to its aims, and as a case study, related to the research ways. Interviews with the managers of the organization value chain processes have been carried through, with the objective to identify how they perceive the Information Management process that circulates in the organizational processes. Complementarily, a documentary research has been carried through, associated to the direct observation and procedures and actions follow up, involving the Information Management. The data treatment and analysis have been done from the authors theoretical support and from the managers interviews analysis, documents and processes observed by the researcher in the organization. It was noticed that the organization has raised its level of information needs that are not difficult to be determined and are satisfactorily obtained and distributed, although the majority of them are not structuralized, automatized or even classified regarding to its confidence. These peaces of information have good quality and are important, however they reflect a medium dependence on external and informal information, besides being used only in its great majority for people to know what and how to do something

Foreclosure Counseling with Latino Households: Policy Assumptions in a Changing Demographic Landscape

Thesis (Ph.D.)--University of Washington, 2016-08

Validade científica de conhecimento epidemiológico gerado com base no estudo Saúde Bucal Brasil 2003

NARVAI, Paulo Capel et al. Validade científi ca de conhecimento epidemiológico gerado com base no estudo Saúde Bucal Brasil 2003. Caderno de saúde pública, Rio de Janeiro, v. 26, n. 4, p. 647-670, abr. 2010.

Les échos de la "Comédie" dans le "Chemin de Long Estude" de Christine de Pizan

Alors qu’elle se trouve au Mont Parnasse, la narratrice du Chemin de Long Estude de Christine de Pizan affirme reconnaître l’endroit pour l’avoir déjà lu chez Dante. Cette mention surprend considérant la quasi absence de la Comédie dans la littérature française de la fin du Moyen Âge, et si la tradition critique a eu tendance à y voir la revendication d’un projet mimétique, où le poème de Christine de Pizan serait une tentative d’imitation de la Comédie, les nombreux échos dantesques de l’oeuvre témoignent à l’inverse d’un important travail d’appropriation, en mettant systématiquement l’accent sur l’acquisition du savoir et l’inscription dans une filiation intellectuelle. Plus qu’une recension, le présent mémoire aspire à faire le point sur les présences de la Comédie dans le Chemin de Long Estude de même qu’à inscrire ces dernières dans un réseau. Cela amène non seulement à considérer l’oeuvre de Christine de Pizan dans sa totalité, mais aussi en regard des considérations littéraires de l’époque. Dans le premier cas, les renvois à Dante permettent de réfléchir au projet général de l’oeuvre, alors que le poème italien, plus que de représenter un idéal à reproduire, participe à une conquête de l’ordre par le savoir, aux côtés de la Consolation de Philosophie de Boèce et du Chemin de Long Estude lui-même. Dans le second cas, le fait de fonder le travail d’écriture sur la lecture préalable d’un auteur italien témoigne de la bibliophilie du siècle et de l’importance de la lecture, mais aussi de l’émergence timide de nouvelles autorités vernaculaires.

Abordagem do paciente com Cardiopatia Isquémica em consulta de Medicina Dentária

Nos últimos anos com a evolução dos sistemas de saúde tem-se verificado uma melhoria na qualidade dos serviços médicos prestados, conduzindo a uma esperança média de vida mais longa. Muitas patologias, apesar de patentes, são tratadas e/ou controladas de modo a permitir que a população possa adquirir um estilo de vida normal. As doenças cardiovasculares com o seu carácter multidimensional, têm consequências graves para o cidadão comum, para a sociedade e para o sistema de saúde, o que determina que sejam encaradas como um dos mais importantes problemas de saúde pública, problema este que urge minorar. Dentro das doenças cardiovasculares, a cardiopatia isquémica tem um significado relevante, uma vez que, engloba condições que necessitam de cuidados médicos especiais, em situações de emergência, como o enfarte agudo do miocárdio e a angina de peito (estável e instável). O médico dentista deve estar atento ao doente com cardiopatia isquémica, tendo em conta os cuidados especiais em consultório dentário que o mesmo necessita. A recolha de uma anamnese detalhada e história clínica atualizada, são fundamentais para o sucesso do tratamento dentário. O médico dentista deverá estar habilitado para atuar em situações de emergência e ter o consultório devidamente equipado, de forma a agir em conformidade com estes possíveis eventos.