Conhecimento da doença renal crônica entre médicos conforme as diretrizes práticas

INTRODUCTION: Chronic kidney disease (CKD) is a global health problem, with increasing prevalence in its terminal stage and one of the factors that can contribute is the failure to recognize the disease and its risk factors. OBJECTIVE: To evaluate the knowledge of medical residents (MR) and medical preceptors (MP) in hospitals in the Federal University of Rio Grande do Norte in Natal-RN - Brazil, on the DRC, based on the policy of the Kidney Disease Improving Global Outcomes (KDIGO ). METHODS: Cross-sectional study where 64 MR (R1 = 32; R2 = 15; R3 = 17) and 63 MP answered a questionnaire divided into seven sessions that addressed aspects of the DRC since the setting up referral to a nephrologist. RESULTS: Only 20 participants (15.7%) reported using any guidelines for the management of CKD. The scores obtained by session were: Definition and classification (46.1 ± 47.8); Risk factors (70.5 ± 27.9); Laboratory evaluation (58.2 ± 8.8); Clinical action plan (57.6 ± 19.9); Reduction in proteinuria (68.3 ± 15.0); Complications (64.8 ± 19.9); Referral to a nephrologist (73.0 ± 44.6). There was a statistically significant difference between the knowledge of MR and MP in the sessions: Laboratory evaluation (MR 61.5 ± 8.4 vs 54.8 ± 7.9 MP; p <0.001); Reduction in proteinuria (73.1 ± 11.4 vs MR MP 63.5 ± 16.7; p <0.001) and Referral to a nephrologist (MR 81.2 ± 39.3 vs 64.5 ± 48.2 MP; p = 0.035). Among the MR, the R2 obtained the best score (63.9 ± 22.6 vs R1 R2 R3 71.9 ± 17.2 vs 63.5 ± 22.5, p = 0.445). It identified a low percentage of success of the doctors on the definition of CKD (MP = 46%; R1 = 40.6%; R2 = 60%; R3 = 52.9%; p = 0.623) and classification (MP = 34.9%; R1 = 53.1%, R2 = 60%; R3 = 52.9%; p = 0.158). CONCLUSION: The study showed that most doctors do not use any guidelines for clinical management of CKD and that there are gaps in knowledge on the subject, even among physicians who work in the university environment. In this sense, we propose the realization of mini-workshops for participants and students from boarding UFRN, using Case-Based Learning Strategy (CBL), with small group discussion, to strengthen the incorporation of CKD guidelines in undergraduate teaching and in clinical medical practice in general.

Conhecimento da doença renal crônica entre médicos conforme as diretrizes práticas

INTRODUCTION: Chronic kidney disease (CKD) is a global health problem, with increasing prevalence in its terminal stage and one of the factors that can contribute is the failure to recognize the disease and its risk factors. OBJECTIVE: To evaluate the knowledge of medical residents (MR) and medical preceptors (MP) in hospitals in the Federal University of Rio Grande do Norte in Natal-RN - Brazil, on the DRC, based on the policy of the Kidney Disease Improving Global Outcomes (KDIGO ). METHODS: Cross-sectional study where 64 MR (R1 = 32; R2 = 15; R3 = 17) and 63 MP answered a questionnaire divided into seven sessions that addressed aspects of the DRC since the setting up referral to a nephrologist. RESULTS: Only 20 participants (15.7%) reported using any guidelines for the management of CKD. The scores obtained by session were: Definition and classification (46.1 ± 47.8); Risk factors (70.5 ± 27.9); Laboratory evaluation (58.2 ± 8.8); Clinical action plan (57.6 ± 19.9); Reduction in proteinuria (68.3 ± 15.0); Complications (64.8 ± 19.9); Referral to a nephrologist (73.0 ± 44.6). There was a statistically significant difference between the knowledge of MR and MP in the sessions: Laboratory evaluation (MR 61.5 ± 8.4 vs 54.8 ± 7.9 MP; p <0.001); Reduction in proteinuria (73.1 ± 11.4 vs MR MP 63.5 ± 16.7; p <0.001) and Referral to a nephrologist (MR 81.2 ± 39.3 vs 64.5 ± 48.2 MP; p = 0.035). Among the MR, the R2 obtained the best score (63.9 ± 22.6 vs R1 R2 R3 71.9 ± 17.2 vs 63.5 ± 22.5, p = 0.445). It identified a low percentage of success of the doctors on the definition of CKD (MP = 46%; R1 = 40.6%; R2 = 60%; R3 = 52.9%; p = 0.623) and classification (MP = 34.9%; R1 = 53.1%, R2 = 60%; R3 = 52.9%; p = 0.158). CONCLUSION: The study showed that most doctors do not use any guidelines for clinical management of CKD and that there are gaps in knowledge on the subject, even among physicians who work in the university environment. In this sense, we propose the realization of mini-workshops for participants and students from boarding UFRN, using Case-Based Learning Strategy (CBL), with small group discussion, to strengthen the incorporation of CKD guidelines in undergraduate teaching and in clinical medical practice in general.

Changing Viewpoint: Case Indexing by Introspective Questioning

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What Makes Online Grocers Work? A Case Study Analysis of Factors Contributing to Online Grocery Store Profitability

This research examined the factors contributing to the performance of online grocers prior to, and following, the 2000 dot.com collapse. The primary goals were to assess the relationship between a company’s business model(s) and its performance in the online grocery channel and to determine if there were other company and/or market related factors that could account for company performance. To assess the primary goals, a case based theory building process was utilized. A three-way cross-case analysis comprising Peapod, GroceryWorks, and Tesco examined the common profit components, the structural category (e.g., pure-play, partnership, and hybrid) profit components, and the idiosyncratic profit components related to each specific company. Based on the analysis, it was determined that online grocery store business models could be represented at three distinct, but hierarchically, related levels. The first level was termed the core model and represented the basic profit structure that all online grocers needed in order to conduct operations. The next model level was termed the structural model and represented the profit structure associated with the specific business model configuration (i.e., pure-play, partnership, hybrid). The last model level was termed the augmented model and represented the company’s business model when idiosyncratic profit components were included. In relation to the five company related factors, scalability, rate of expansion, and the automation level were potential candidates for helping to explain online grocer performance. In addition, all the market structure related factors were deemed possible candidates for helping to explain online grocer performance. The study concluded by positing an alternative hypothesis concerning the performance of online grocers. Prior to this study, the prevailing wisdom was that the business models were the primary cause of online grocer performance. However, based on the core model analysis, it was hypothesized that the customer relationship activities (i.e., advertising, promotions, and loyalty program tie-ins) were the real drivers of online grocer performance.

Sentiment classification with case-base approach

L’augmentation de la croissance des réseaux, des blogs et des utilisateurs des sites d’examen sociaux font d’Internet une énorme source de données, en particulier sur la façon dont les gens pensent, sentent et agissent envers différentes questions. Ces jours-ci, les opinions des gens jouent un rôle important dans la politique, l’industrie, l’éducation, etc. Alors, les gouvernements, les grandes et petites industries, les instituts universitaires, les entreprises et les individus cherchent à étudier des techniques automatiques fin d’extraire les informations dont ils ont besoin dans les larges volumes de données. L’analyse des sentiments est une véritable réponse à ce besoin. Elle est une application de traitement du langage naturel et linguistique informatique qui se compose de techniques de pointe telles que l’apprentissage machine et les modèles de langue pour capturer les évaluations positives, négatives ou neutre, avec ou sans leur force, dans des texte brut. Dans ce mémoire, nous étudions une approche basée sur les cas pour l’analyse des sentiments au niveau des documents. Notre approche basée sur les cas génère un classificateur binaire qui utilise un ensemble de documents classifies, et cinq lexiques de sentiments différents pour extraire la polarité sur les scores correspondants aux commentaires. Puisque l’analyse des sentiments est en soi une tâche dépendante du domaine qui rend le travail difficile et coûteux, nous appliquons une approche «cross domain» en basant notre classificateur sur les six différents domaines au lieu de le limiter à un seul domaine. Pour améliorer la précision de la classification, nous ajoutons la détection de la négation comme une partie de notre algorithme. En outre, pour améliorer la performance de notre approche, quelques modifications innovantes sont appliquées. Il est intéressant de mentionner que notre approche ouvre la voie à nouveaux développements en ajoutant plus de lexiques de sentiment et ensembles de données à l’avenir.

An Assessment of Professional Development for Astronomy and Physics Faculty: Expanding Our Vision of How to Support Faculty's Learning About Teaching

In this thesis, we will explore approaches to faculty instructional change in astronomy and physics. We primarily focus on professional development (PD) workshops, which are a central mechanism used within our community to help faculty improve their teaching. Although workshops serve a critical role for promoting more equitable instruction, we rarely assess them through careful consideration of how they engage faculty. To encourage a shift towards more reflective, research-informed PD, we developed the Real-Time Professional Development Observation Tool (R-PDOT), to document the form and focus of faculty's engagement during workshops. We then analyze video-recordings of faculty's interactions during the Physics and Astronomy New Faculty Workshop, focusing on instances where faculty might engage in pedagogical sense-making. Finally, we consider insights gained from our own local, team-based effort to improve a course sequence for astronomy majors. We conclude with recommendations for PD leaders and researchers.

A multiagent based strategy for detecting attacks in databases in a distributed mode

This paper presents a distributed hierarchical multiagent architecture for detecting SQL injection attacks against databases. It uses a novel strategy, which is supported by a Case-Based Reasoning mechanism, which provides to the classifier agents with a great capacity of learning and adaptation to face this type of attack. The architecture combines strategies of intrusion detection systems such as misuse detection and anomaly detection. It has been tested and the results are presented in this paper.

Staff and students co-creating curricula in UK higher education: exploring process and evidencing value

Student engagement in learning and teaching is receiving a growing level of interest from policy makers, researchers, and practitioners. This includes opportunities for staff and students to co-create curricula, yet there are few examples within current literature which describe and critique this form of staff-student collaboration (Bovill (2013a), Healey et al (2014), Cook-Sather et al (2014). The competing agendas of neoliberalism and critical, radical pedagogies influence the policy and practice of staff and students co-creating curricula and, consequently, attempt to appropriate the purpose of it in different ways. Using case-based research methodology, my study presents analysis of staff and students co-creating curricula within seven universities. This includes 17 examples of practice across 14 disciplines. Using an inductive approach, I have examined issues relating to definitions of practice, conceptualisations of curricula, perceptions of value, and the relationship between practice and institutional strategy. I draw upon an interdisciplinary body of literature to provide the conceptual foundations for my research. This has been necessary to address the complexity of practice and includes literature relating to student engagement in learning and teaching, conceptual models of curriculum in higher education, approaches to evidencing value and impact, and critical theory and radical pedagogies. The study makes specific contributions to the wider scholarly debate by highlighting the importance of dialogue and conversational scholarship as well as identifying with participants what matters as well as what works as a means to evidence the value of collaborations. It also presents evidence of a new model of co-creating curricula and additional approaches to conceptualising curricula to facilitate collaboration. Analysis of macro and micro level data shows enactment of dialogic pedagogies within contexts of technical-rational strategy formation and implementation.

Screening a Case Base for Stroke Disease Detection

Stroke stands for one of the most frequent causes of death, without distinguishing age or genders. Despite representing an expressive mortality fig-ure, the disease also causes long-term disabilities with a huge recovery time, which goes in parallel with costs. However, stroke and health diseases may also be prevented considering illness evidence. Therefore, the present work will start with the development of a decision support system to assess stroke risk, centered on a formal framework based on Logic Programming for knowledge rep-resentation and reasoning, complemented with a Case Based Reasoning (CBR) approach to computing. Indeed, and in order to target practically the CBR cycle, a normalization and an optimization phases were introduced, and clustering methods were used, then reducing the search space and enhancing the cases re-trieval one. On the other hand, and aiming at an improvement of the CBR theo-retical basis, the predicates` attributes were normalized to the interval 0…1, and the extensions of the predicates that match the universe of discourse were re-written, and set not only in terms of an evaluation of its Quality-of-Information (QoI), but also in terms of an assessment of a Degree-of-Confidence (DoC), a measure of one`s confidence that they fit into a given interval, taking into account their domains, i.e., each predicate attribute will be given in terms of a pair (QoI, DoC), a simple and elegant way to represent data or knowledge of the type incomplete, self-contradictory, or even unknown.

Length of Stay in Intensive Care Units - A Case Base Evaluation

As a matter of fact, an Intensive Care Unit (ICU) stands for a hospital facility where patients require close observation and monitoring. Indeed, predicting Length-of-Stay (LoS) at ICUs is essential not only to provide them with improved Quality-of-Care, but also to help the hospital management to cope with hospital resources. Therefore, in this work one`s aim is to present an Artificial Intelligence based Decision Support System to assist on the prediction of LoS at ICUs, which will be centered on a formal framework based on a Logic Programming acquaintance for knowledge representation and reasoning, complemented with a Case Based approach to computing, and able to handle unknown, incomplete, or even contradictory data, information or knowledge.

Healthcare Computer Reasoning Addressing Chronically Ill Societies Using IoT: Deep Learning AI to the Rescue of Home-Based Healthcare

The authors present a proposal to develop intelligent assisted living environments for home based healthcare. These environments unite the chronical patient clinical history sematic representation with the ability of monitoring the living conditions and events recurring to a fully managed Semantic Web of Things (SWoT). Several levels of acquired knowledge and the case based reasoning that is possible by knowledge representation of the health-disease history and acquisition of the scientific evidence will deliver, through various voice based natural interfaces, the adequate support systems for disease auto management but prominently by activating the less differentiated caregiver for any specific need. With these capabilities at hand, home based healthcare providing becomes a viable possibility reducing the institutionalization needs. The resulting integrated healthcare framework will provide significant savings while improving the generality of health and satisfaction indicators.

A Case-base Approach to Workforces’ Satisfaction Assessment

It is well known that human resources play a valuable role in a sustainable organizational development. Indeed, this work will focus on the development of a decision support system to assess workers’ satisfaction based on factors related to human resources management practices. The framework is built on top of a Logic Programming approach to Knowledge Representation and Reasoning, complemented with a Case Based approach to computing. The proposed solution is unique in itself, once it caters for the explicit treatment of incomplete, unknown, or even self-contradictory information, either in terms of a qualitative or quantitative setting. Furthermore, clustering methods based on similarity analysis among cases were used to distinguish and aggregate collections of historical data or knowledge in order to reduce the search space, therefore enhancing the cases retrieval and the overall computational process.

Archetype change in professional organizations: Survey evidence from large law firms

This paper examines the proposition that the traditional archetype of the professional partnership is said to have changed into a more 'business-like' entity, the managed professional business. It broadens the restricted case sample base on which much of the evidence has been adduced, by developing a survey questionnaire through which 197 large British law firms were sampled. Change, consistent with the notion of a more commercially oriented and consciously managed organization, is concentrated in the market-facing area of the firm but coexists with areas of continuity in the governance of the firm and its strategic management. The findings reveal a more managerial form of organization in which the core elements of the traditional form of professional organization have not been transformed. These results contest the assertion of either transformational or sedimented change found in other, case-based research and suggest that archetype change needs theoretically to be distinguished from the general phenomenon of greater managerialism within the professional service firm.

Making distance learning E.R.O.T.I.C.: Applying interpretation principles to distance learning

Distance learners are self-directed learners traditionally taught via study books, collections of readings, and exercises to test understanding of learning packages. Despite advances in e-Learning environments and computer-based teaching interfaces, distance learners still lack opportunities to participate in exercises and debates available to classroom learners, particularly through non-text based learning techniques. Effective distance teaching requires flexible learning opportunities. Using arguments developed in interpretation literature, we argue that effective distance learning must also be Entertaining, Relevant, Organised, Thematic, Involving and Creative—E.R.O.T.I.C. (after Ham, 1992). We discuss an experiment undertaken with distance learners at The University of Queensland Gatton Campus, where we initiated an E.R.O.T.I.C. external teaching package aimed at engaging distance learners but using multimedia, including but not limited to text-based learning tools. Student responses to non-text media were positive.

Mixed-integer nonlinear approach for the optimal scheduling of a head-dependent hydro chain

This paper is on the problem of short-term hydro scheduling (STHS), particularly concerning a head-dependent hydro chain We propose a novel mixed-integer nonlinear programming (MINLP) approach, considering hydroelectric power generation as a nonlinear function of water discharge and of the head. As a new contribution to eat her studies, we model the on-off behavior of the hydro plants using integer variables, in order to avoid water discharges at forbidden areas Thus, an enhanced STHS is provided due to the more realistic modeling presented in this paper Our approach has been applied successfully to solve a test case based on one of the Portuguese cascaded hydro systems with a negligible computational time requirement.