Decision support system for the diagnosis of schizophrenia disorders

Clinical decision support systems are useful tools for assisting physicians to diagnose complex illnesses. Schizophrenia is a complex, heterogeneous and incapacitating mental disorder that should be detected as early as possible to avoid a most serious outcome. These artificial intelligence systems might be useful in the early detection of schizophrenia disorder. The objective of the present study was to describe the development of such a clinical decision support system for the diagnosis of schizophrenia spectrum disorders (SADDESQ). The development of this system is described in four stages: knowledge acquisition, knowledge organization, the development of a computer-assisted model, and the evaluation of the system's performance. The knowledge was extracted from an expert through open interviews. These interviews aimed to explore the expert's diagnostic decision-making process for the diagnosis of schizophrenia. A graph methodology was employed to identify the elements involved in the reasoning process. Knowledge was first organized and modeled by means of algorithms and then transferred to a computational model created by the covering approach. The performance assessment involved the comparison of the diagnoses of 38 clinical vignettes between an expert and the SADDESQ. The results showed a relatively low rate of misclassification (18-34%) and a good performance by SADDESQ in the diagnosis of schizophrenia, with an accuracy of 66-82%. The accuracy was higher when schizophreniform disorder was considered as the presence of schizophrenia disorder. Although these results are preliminary, the SADDESQ has exhibited a satisfactory performance, which needs to be further evaluated within a clinical setting.

Identification of characteristics for successful university-company partnership development

The importance of university-company collaboration has increased during the last decades. The drivers for that are, on the one hand, changes in business logic of companies and on the other hand the decreased state funding of universities. Many companies emphasize joint research with universities as an enabling input to their development processes, which aim at creating new innovations, products and wealth. These factors have changed universities’ operations and they have adopted several practices of dynamic business organizations, such as strategic planning, monitoring and controlling methods of internal processes etc. The objective of this thesis is to combine different characteristics of successful university-company partnership and its development. The development process starts with identifying potential partners in the university’s interest group, which requires understanding the role of different partners in the innovation system. Next, in order to find a common development basis, matching the policy and strategy between partners is needed. The third phase is to combine the academic and industrial objectives of a joint project, which is a typical form of university-company collaboration. The optimum is a win-win situation where both partners, universities and companies, can get addedvalue. For the companies added value typically means access to new research results before their competitors. For the universities added value offers a possibility to carry on high level scientific work. The research output in the form of published scientific articles is evaluated by the international science community. Because the university-company partnership is often executed by joint projects, the different forms of this kind of projects is discussed in this study. The most challenging form of collaboration is a semi-open project model, which is not based on bilateral activities between universities and companies but on a consortium of several universities, research institutes and companies. The universities and companies are core actors in the innovation system. Thus the discussion of their roles and relations to public operators like publicly funded financiers is important. In the Finnish innovation system there are at least the following doers executing strategies and policies: EU, Academy of Finland and TEKES. In addition to these, Strategic Centres for Science, Technology and Innovation which are owned jointly by companies, universities and research organizations have a very important role in their fields of business. They transfer research results into commercial actions to generate wealth. The thesis comprises two parts. The first part consists of an overview of the study including introduction, literature review, research design, synthesis of findings and conclusions. The second part introduces four original research publications.

Utilization of Statistical Methods for Management in the Forest Industry

The strongest wish of the customer concerning chemical pulp features is consistent, uniform quality. Variation may be controlled and reduced by using statistical methods. However, studies addressing the application and benefits of statistical methods in forest product sector are scarce. Thus, the customer wish is the root cause of the motivation behind this dissertation. The research problem addressed by this dissertation is that companies in the chemical forest product sector require new knowledge for improving their utilization of statistical methods. To gain this new knowledge, the research problem is studied from five complementary viewpoints – challenges and success factors, organizational learning, problem solving, economic benefit, and statistical methods as management tools. The five research questions generated on the basis of these viewpoints are answered in four research papers, which are case studies based on empirical data collection. This research as a whole complements the literature dealing with the use of statistical methods in the forest products industry. Practical examples of the application of statistical process control, case-based reasoning, the cross-industry standard process for data mining, and performance measurement methods in the context of chemical forest products manufacturing are brought to the public knowledge of the scientific community. The benefit of the application of these methods is estimated or demonstrated. The purpose of this dissertation is to find pragmatic ideas for companies in the chemical forest product sector in order for them to improve their utilization of statistical methods. The main practical implications of this doctoral dissertation can be summarized in four points: 1. It is beneficial to reduce variation in chemical forest product manufacturing processes 2. Statistical tools can be used to reduce this variation 3. Problem-solving in chemical forest product manufacturing processes can be intensified through the use of statistical methods 4. There are certain success factors and challenges that need to be addressed when implementing statistical methods

Les chercheurs, leur discipline, leurs publics: l’orientation de la recherche en sciences sociales et humaines

Réalisé en association avec le Centre interuniversitaire de recherche sur la science et la technologie (CIRST).

Les effets des pratiques de leadership sur la performance de l’équipe : rôle médiateur de l’engagement des membres envers les objectifs d’équipe

Le but de cette recherche est la vérification des relations entre les pratiques de leadership et la performance de l’équipe. Nous nous concentrons sur deux pratiques de leadership distinctes : le leadership d’empowerment et le leadership autocratique. Cette recherche vise également à comprendre le rôle médiateur de l’engagement des membres envers les objectifs d’équipe dans ces relations. De plus, nous examinons la combinaison des deux pratiques de leadership chez un même responsable d’équipe, à savoir si l’adoption d’un style de leadership peut réduire ou amplifier l’effet de l’autre style de leadership. Les données de types secondaires ont été colligées auprès de 381 membres faisant partie de 101 équipes ainsi que des 101 supérieurs immédiats de ces équipes œuvrant dans une organisation de sécurité publique canadienne. Ces données ont été recueillies grâce à un questionnaire. Des analyses factorielles confirmatoires et des analyses de régression hiérarchique ont permis de vérifier nos huit hypothèses. Les résultats montrent que les pratiques de leadership sont modérément et significativement liées à la performance d’équipe. Les pratiques de leadership sont également liées fortement et significativement à l’engagement des membres envers les objectifs d’équipe. Par ailleurs, les résultats révèlent que l’engagement des membres envers les objectifs d’équipe joue un rôle médiateur complet dans la relation entre les pratiques de leadership et la performance d’équipe. Par contre, l’effet d’interaction entre les pratiques de leadership n’est pas significatif. La vérification du rôle médiateur de l’engagement des membres envers les objectifs d’équipe constitue un apport théorique dans la compréhension des équipes de travail. Sur le plan pratique, les résultats montrent que les responsables d’équipe ont intérêt à adopter des pratiques de gestion permettant l’atteinte des objectifs d’équipe tout en améliorant le sentiment d’engagement des membres et la performance d’équipe.

L'effet des normes d'équipe sur le leadership partagé

La présente recherche a pour objectif principal d’étudier l’effet que peuvent exercer les normes d’équipe sur le leadership partagé au sein des équipes de travail. Nous voulions vérifier les relations entre trois normes proposées par Day (2007) comme influençant de façon significative le partage du leadership dans les équipes. Il s’agit de la distance hiérarchique, de la sécurité psychologique et de l’orientation vers l’apprentissage. Cette recherche vise également à vérifier l’effet modérateur, d’une part, de l’interdépendance au travail et, d’autre part, celui de la complexité de la tâche sur les relations entre les normes d’équipe et le leadership partagé. Cette recherche se base sur des données secondaires qui ont été recueillies par Vincent Rousseau (professeur à l’Université de Montréal) et Caroline Aubé (professeure à HEC Montréal) auprès de 394 membres appartenant à 77 équipes et auprès de 77 supérieurs immédiats de ces mêmes équipes. L’ensemble de ces participants travaille dans une organisation de sécurité publique canadienne. Les données ont été collectées en utilisant la méthode du questionnaire. Des analyses de régressions ont été utilisées pour vérifier les hypothèses de cette étude. Les résultats montrent que la distance hiérarchique, la sécurité psychologique et l’orientation vers l’apprentissage sont significativement liées au leadership partagé. Ces normes d’équipe sont également fortement reliées entre elles. Les résultats n’ont, cependant, pas permis de confirmer l’effet modérateur de l’interdépendance au travail et de la complexité de la tâche sur les relations entre les normes d’équipe et le leadership partagé. Globalement, les résultats montrent que les gestionnaires tireront avantage à encourager les normes d’équipe associées à une faible distance hiérarchique, à une forte sécurité psychologique et à une orientation davantage axée sur l’apprentissage afin de faciliter l’exercice du leadership partagé et ce, en vue d’améliorer la performance des équipes et de l’organisation.

Local model predictive control experiences with differential driven wheeled mobile robots

This work extends a previously developed research concerning about the use of local model predictive control in differential driven mobile robots. Hence, experimental results are presented as a way to improve the methodology by considering aspects as trajectory accuracy and time performance. In this sense, the cost function and the prediction horizon are important aspects to be considered. The aim of the present work is to test the control method by measuring trajectory tracking accuracy and time performance. Moreover, strategies for the integration with perception system and path planning are briefly introduced. In this sense, monocular image data can be used to plan safety trajectories by using goal attraction potential fields

Evaluación de una herramienta educativa en conocimiento de donación y trasplante de órganos y tejidos en Colombia

El trasplante de órganos es considerado uno de los avances más significativos de la medicina moderna y es un procedimiento cada vez más exitoso en términos de supervivencia de los pacientes, siendo actualmente la mejor opción de tratamiento para los pacientes con innumerables patologías. El proceso de donación es insuficiente para cubrir las necesidades de trasplante de la población, por lo tanto, se hace necesario el desarrollo de nuevas estrategias para fortalecer la experiencia y efectividad de los programas existentes. La falta de conocimiento de los profesionales de la salud, su percepción y actitud hacia temas relacionados con el proceso de donación, pueden convertirlos en facilitadores o barreras para la identificación de potenciales donantes. Por esta razón, los recursos disponibles, las actitudes hacia la donación, la legislación y conocimiento de los procesos involucrados en la donación de tejidos y órganos son críticos. Dada la influencia de los profesionales de salud se definen los objetivos de este proyecto de tesis: determinar cuál es el conocimiento y las habilidades de los profesionales de la salud encargados de los trasplantes de órganos y de tejidos en la regional 1, evaluados mediante una herramienta educativa para contribuir a mejorar un programa eficiente de Donación de Órganos y tejidos y así mismo, fijar recomendaciones en aras de aumentar las tasas de donación, con especial énfasis en la actividad hospitalaria en el país. METODOLOGIA Se realizó un estudio basado en el análisis de la evaluación de conocimientos del proceso donación- trasplante de órganos y tejidos en el personal de salud participante en la herramienta educativa llamada “Curso taller primer respondiente del potencial donante de órganos y tejidos”. Este curso incluía un formato evaluativo que fue diligenciado de manera anónima por los participantes antes y después de recibir el contenido del curso. El estudio se desarrolló en personal de la Salud de IPS pertenecientes a la Regional I, de la Red Nacional de donación y trasplantes de órganos y tejidos. Con el fin de evidenciar si existen diferencias en el conocimiento de los participantes del curso antes y después de asistir al mismo, se utilizó la prueba de McNemar (p< 0.05). RESULTADOS Entre julio del 2011 y junio del 2012, se realizó el “Curso taller primer respondiente del potencial donante de órganos y tejidos” y se obtuvieron 303 encuestados incluidos médicos, enfermeras y auxiliares de enfermería. Al inicio del curso las respuestas acertadas con relación a legislación, selección del donante, muerte encefálica y mantenimiento del donante estuvieron alrededor del 50%. No fue posible detectar la profesión que pudiese generar riesgo en la detección del donante y los procesos asociados. Posterior al curso, el 72% de las preguntas se respondieron de manera correcta, lo que representa un incremento estadísticamente significativo. Este cambio evidenció significancia estadística al usar la prueba de McNemar y arrojar un valor de p=0.00. .DISCUSIÓN El personal de salud participante en el curso taller proveniente de unidades involucradas como generadoras de donantes muestra un déficit de conocimientos del proceso donación trasplantes lo que puede convertirlos en limitantes para dicho proceso

Organizational analysis of building projects

The principles of organization theory are applied to the organization of construction projects. This is done by proposing a framework for modelling the whole process of building procurement. This consists of a framework for describing the environments within which construction projects take place. This is followed by the development of a series of hypotheses about the organizational structure of construction projects. Four case studies are undertaken, and the extent to which their organizational structure matches the model is compared to the level of success achieved by each project. To this end there is a systematic method for evaluating the success of building project organizations, because any conclusions about the adequacy of a particular organization must be related to the degree of success achieved by that organization. In order to test these hypotheses, a mapping technique is developed. The technique offered is a development of a technique known as Linear Responsibility Analysis, and is called "3R analysis" as it deals with roles, responsibilities and relationships. The analysis of the case studies shows that they tended to suffer due to inappropriate organizational structure. One of the prevailing problems of public sector organization is that organizational structures are inadequately defined, and too cumbersome to respond to environmental demands on the project. The projects tended to be organized as rigid hierarchies, particularly at decision points, when what was required was a more flexible, dynamic and responsive organization. The study concludes with a series of recommendations; including suggestions for increasing the responsiveness of construction project organizations, and reducing the lead-in times for the inception periods.

Uptake of a free coronary heart disease risk screening programme in community pharmacy: the Healthy Heart Assessment service

Introduction Health promotion (HP) aims to enhance good health while preventing ill-health at three levels of activity; primary (preventative), secondary (diagnostic) and tertiary (management).1 It can range from simple provision of health education to ongoing support, but the effectiveness of HP is ultimately dependent on its ability to influence change. HP as part of the Community Pharmacy Contract (CPC) aims to increase public knowledge and target ‘hard-to-reach’ individuals by focusing mainly on primary and tertiary HP. The CPC does not include screening programmes (secondary HP) as a service. Coronary heart disease (CHD) is a significant cause of morbidity and mortality in the UK. While there is evidence to support the effectiveness of some community pharmacy HP strategies in CHD, there is paucity of research in relation to screening services.2 Against this background, Alliance Pharmacy introduced a free CHD risk screening programme to provide tailored HP advice as part of a participant–pharmacist consultation. The aim of this study is to report on the CHD risk levels of participants and to provide a qualitative indication of consultation outcomes. Methods Case records for 12 733 people who accessed a free CHD risk screening service between August 2004 and April 2006 offered at 217 community pharmacies were obtained. The service involved initial self-completion of the Healthy Heart Assessment (HHA) form and measurement of height, weight, body mass index, blood pressure, total cholesterol and highdensity lipoprotein levels by pharmacists to calculate CHD risk.3 Action taken by pharmacists (lifestyle advice, statin recommendation or general practitioner (GP) referral) and qualitative statements of advice were recorded, and a copy provided to the participants. The service did not include follow-up of participants. All participants consented to taking part in evaluations of the service. Ethical committee scrutiny was not required for this service development evaluation. Results Case records for 10 035 participants (3658 male) were evaluable; 5730 (57%) were at low CHD risk (<15%); 3636 (36%) at moderate-to-high CHD risk (≥15%); and 669 (7%) had existing heart disease. A significantly higher proportion of male (48% versus 30% female) participants were at moderate- to-high risk of CHD (chi-square test; P < 0.005). A range of outcomes resulted from consultations. Lifestyle advice was provided irrespective of participants’ CHD risk or existing disease. In the moderate-to-high-risk group, of which 52% received prescribed medication, lifestyle advice was recorded for 62%, 16% were referred and 34% were advised to have a re-assessment. Statin recommendations were made in 1% of all cases. There was evidence of supportive and motivational statements in the advice recorded. Discussion Pharmacists were able to identify individuals’ level of CHD risk and provide them with bespoke advice. Identification of at-risk participants did not automatically result in referrals or statin recommendation. One-third of those accessing the screening service had moderate-to-high risk of CHD, a significantly higher proportion of whom were men. It is not known whether these individuals had been previously exposed to HP but presumably by accessing this service they may have contemplated change. As effectiveness of HP advice will depend among other factors on ability to influence change, future consultations may need to explore patients’ attitude towards change in relation to the Trans Theoretical Model4 to better tailor HP advice. The high uptake of the service by those at moderate-to-high CHD risk indicates a need for this type of screening programme in community pharmacy, perhaps specifically to reach men who access medical services less.

The dangers of hanging baskets: 'Regulatory myths' and media representations of health and safety regulation

The successful enforcement of health and safety regulation is reliant upon the ability of regulatory agencies to demonstrate the legitimacy of the system of regulatory controls. While 'big cases' are central to this process, there are also significant legitimatory implications associated with 'minor' cases, including media-reported tales of pettiness and heavy-handedness in the interpretation and enforcement of the law. The popular media regularly report stories of 'regulatory unreasonableness', and they can pass quickly into mainstream public knowledge. A story's appeal becomes more important than its factual veracity; they are a form of 'regulatory myth'. This paper discusses the implications of regulatory myths for health and safety regulators, and analyses their challenges for regulators, paying particular attention to the Health and Safety Executive (HSE) which has made concerted efforts to address regulatory myths attaching to its activities. It will be shown that such stories constitute sustained normative challenges to the legitimacy of the regulator, and political challenges to the burgeoning regulatory state, because they reflect some of the key concerns of late-modern society.

Are informed citizens more trusting? Transparency of performance data and trust towards a British police force

In Britain, substantial cuts in police budgets alongside controversial handling of incidents such as politically sensitive enquiries, public disorder and relations with the media have recently triggered much debate about public knowledge and trust in the police. To date, however, little academic research has investigated how knowledge of police performance impacts citizens’ trust. We address this long-standing lacuna by exploring citizens’ trust before and after exposure to real performance data in the context of a British police force. The results reveal that being informed of performance data affects citizens’ trust significantly. Furthermore, direction and degree of change in trust are related to variations across the different elements of the reported performance criteria. Interestingly, the volatility of citizens’ trust is related to initial performance perceptions (such that citizens with low initial perceptions of police performance react more significantly to evidence of both good and bad performance than citizens with high initial perceptions), and citizens’ intentions to support the police do not always correlate with their cognitive and affective trust towards the police. In discussing our findings, we explore the implications of how being transparent with performance data can both hinder and be helpful in developing citizens’ trust towards a public organisation such as the police. From our study, we pose a number of ethical challenges that practitioners face when deciding what data to highlight, to whom, and for what purpose.

O Processo de Concessão dos Sistemas de Transporte de Massa na Região Metropolitana do Rio de Janeiro: Implicações na Organização e na Gestão de Transporte de Passageiros

O presente estudo procurou descrever e analisar o contexto em que se desenvolveu o processo de concessão dos sistemas de transporte de massa na Região Metropolitana do Rio de Janeiro, promovido pelo Programa Estadual de Desestatização ¿ PED, na gestão governamental compreendida entre os anos de 1995 e 1998, bem como avaliar suas implicações sobre o modelo de organização e gestão do transporte público regional então vigente. Seu desenvolvimento enfatizou três aspectos desse processo: a caracterização do cenário anterior à proposta de mudança, a análise substantiva da política representada pelo programa de concessões e a avaliação do novo cenário criado como conseqüência do programa. Sua metodologia pautou-se em consulta bibliográfica, volumosa análise documental, observação dos fatos e entrevistas desestruturadas com administradores e técnicos envolvidos no processo. Seus resultados evidenciaram as limitações dos modelos de análise e de planejamento tradicionalmente adotados para a formulação das políticas setoriais, a precariedade dos sistemas de transporte de passageiros regionais e a situação pelos sistemas de metrô, trens e barcas, consubstanciando um ambiente propício às propostas de sua transferência à gestão privada. Evidenciaram, ainda, que a iniciativa foi influenciada pelo contexto dos projetos de reforma do Estado patrocinados pelo Banco Mundial (BIRD), desenvolvendo-se sem referências relevantes na comunidade técnica setorial e gerando um cenário institucional frágil diante da tarefa de gerir os contratos dela resultantes. Embora pautado em estratégias de retomada de investimentos condizentes com as diretrizes do Plano de Transporte de Massa ¿ PTM, elaborado em 1994, a insipiência do programa não permite constatar, ainda tendências significativas no desempenho dos sistemas concedidos. São evidentes, entretanto, seus reflexos na desentruturação do modelo de gestão pública do transporte metropolitano sob responsabilidade do Estado.

Análise do processo de implantação do balanced scorecard: o caso do painel corporativo de uma empresa brasileira do setor público

Um assunto cada vez mais recorrente na literatura sobre administração é a questão dos modismos de gestão. Nos anos 90 se observou a euforia em torno da gestão pela qualidade total (TQM) e a explosão da reengenharia de processos, que veio junto com a terceirização. Em seguida emergiu o conceito de core-competencies ou competências essências que deu origem à revolução da gestão baseada em competências. Surgido nos anos 90, a partir de pesquisas acadêmicas, o Balanced Scorecard (BSC) aparece como uma nova tecnologia de gestão que rapidamente foi difundida e passou a ser utilizada por uma extensa gama de organizações. A recente utilização dessa tecnologia de gestão e o excesso de euforia sobre o tema trazem a tona o questionamento sobre a correta utilização da mesma. Sendo assim, essa pesquisa se dedica a fazer uma análise sobre a utilização do BSC em uma empresa brasileira do setor público frente à metodologia proposta pela literatura. Os resultados da pesquisa demonstraram que os motivos que levaram a empresa em questão a escolher o BSC como tecnologia de gestão e a construção do BSC foram coerentes com a metodologia proposta pela literatura. Por fim a pesquisa também revelou dois resultados inesperados: primeiro um possível fator de sucesso na utilização do BSC não encontrado na literatura; e segundo uma certa peculiaridade quanto a adoção dessa tecnologia de gestão em empresas do setor público.

O processo de desenvolvimento de sistemas de gestão em organizações hospitalares e a importancia da profissionalização de seus dirigentes : considerações a partir de um processo de consultoria no Hospital Evandro Chagas

Este trabalho trata do processo de transformação do sistema de gestão do Hospital Evandro Chagas/Fiocruz. Enfoca as características das organizações hospitalares públicas e os desafios de coordenação do trabalho médico e de pesquisa, tomando aquele Hospital como referência para reflexão. Apresenta e discute os princípios de organização de sistemas de gestão a partir das compreensões do planejamento estratégico-situacional e da teoria das macroorganizações de Carlos Matus. Finalmente, considera que o processo de desenvolvimento gerencial das organizações hospitalares, a partir da experiência em foco, deve ser compreendido em pelo menos duas dimensões mutuamente condicionantes: a primeira, ao nível do aperfeiçoamento das estruturas e métodos gerenciais; e a segunda, ao nível da profissionalização dos dirigentes hospitalares.