A Case-Based Reasoning Method with Rank Aggregation

NASA Astrophysics Data System (ADS)

Sun, Jinhua; Du, Jiao; Hu, Jian

2018-03-01

In order to improve the accuracy of case-based reasoning (CBR), this paper addresses a new CBR framework with the basic principle of rank aggregation. First, the ranking methods are put forward in each attribute subspace of case. The ordering relation between cases on each attribute is got between cases. Then, a sorting matrix is got. Second, the similar case retrieval process from ranking matrix is transformed into a rank aggregation optimal problem, which uses the Kemeny optimal. On the basis, a rank aggregation case-based reasoning algorithm, named RA-CBR, is designed. The experiment result on UCI data sets shows that case retrieval accuracy of RA-CBR algorithm is higher than euclidean distance CBR and mahalanobis distance CBR testing.So we can get the conclusion that RA-CBR method can increase the performance and efficiency of CBR.

Monitoring progression of clinical reasoning skills during health sciences education using the case method - a qualitative observational study.

PubMed

Orban, Kristina; Ekelin, Maria; Edgren, Gudrun; Sandgren, Olof; Hovbrandt, Pia; Persson, Eva K

2017-09-11

Outcome- or competency-based education is well established in medical and health sciences education. Curricula are based on courses where students develop their competences and assessment is also usually course-based. Clinical reasoning is an important competence, and the aim of this study was to monitor and describe students' progression in professional clinical reasoning skills during health sciences education using observations of group discussions following the case method. In this qualitative study students from three different health education programmes were observed while discussing clinical cases in a modified Harvard case method session. A rubric with four dimensions - problem-solving process, disciplinary knowledge, character of discussion and communication - was used as an observational tool to identify clinical reasoning. A deductive content analysis was performed. The results revealed the students' transition over time from reasoning based strictly on theoretical knowledge to reasoning ability characterized by clinical considerations and experiences. Students who were approaching the end of their education immediately identified the most important problem and then focused on this in their discussion. Practice knowledge increased over time, which was seen as progression in the use of professional language, concepts, terms and the use of prior clinical experience. The character of the discussion evolved from theoretical considerations early in the education to clinical reasoning in later years. Communication within the groups was supportive and conducted with a professional tone. Our observations revealed progression in several aspects of students' clinical reasoning skills on a group level in their discussions of clinical cases. We suggest that the case method can be a useful tool in assessing quality in health sciences education.

Case-based medical informatics

PubMed Central

Pantazi, Stefan V; Arocha, José F; Moehr, Jochen R

2004-01-01

Background The "applied" nature distinguishes applied sciences from theoretical sciences. To emphasize this distinction, we begin with a general, meta-level overview of the scientific endeavor. We introduce the knowledge spectrum and four interconnected modalities of knowledge. In addition to the traditional differentiation between implicit and explicit knowledge we outline the concepts of general and individual knowledge. We connect general knowledge with the "frame problem," a fundamental issue of artificial intelligence, and individual knowledge with another important paradigm of artificial intelligence, case-based reasoning, a method of individual knowledge processing that aims at solving new problems based on the solutions to similar past problems. We outline the fundamental differences between Medical Informatics and theoretical sciences and propose that Medical Informatics research should advance individual knowledge processing (case-based reasoning) and that natural language processing research is an important step towards this goal that may have ethical implications for patient-centered health medicine. Discussion We focus on fundamental aspects of decision-making, which connect human expertise with individual knowledge processing. We continue with a knowledge spectrum perspective on biomedical knowledge and conclude that case-based reasoning is the paradigm that can advance towards personalized healthcare and that can enable the education of patients and providers. We center the discussion on formal methods of knowledge representation around the frame problem. We propose a context-dependent view on the notion of "meaning" and advocate the need for case-based reasoning research and natural language processing. In the context of memory based knowledge processing, pattern recognition, comparison and analogy-making, we conclude that while humans seem to naturally support the case-based reasoning paradigm (memory of past experiences of problem-solving and powerful case matching mechanisms), technical solutions are challenging. Finally, we discuss the major challenges for a technical solution: case record comprehensiveness, organization of information on similarity principles, development of pattern recognition and solving ethical issues. Summary Medical Informatics is an applied science that should be committed to advancing patient-centered medicine through individual knowledge processing. Case-based reasoning is the technical solution that enables a continuous individual knowledge processing and could be applied providing that challenges and ethical issues arising are addressed appropriately. PMID:15533257

The role of professional knowledge in case-based reasoning in practical ethics.

PubMed

Pinkus, Rosa Lynn; Gloeckner, Claire; Fortunato, Angela

2015-06-01

The use of case-based reasoning in teaching professional ethics has come of age. The fields of medicine, engineering, and business all have incorporated ethics case studies into leading textbooks and journal articles, as well as undergraduate and graduate professional ethics courses. The most recent guidelines from the National Institutes of Health recognize case studies and face-to-face discussion as best practices to be included in training programs for the Responsible Conduct of Research. While there is a general consensus that case studies play a central role in the teaching of professional ethics, there is still much to be learned regarding how professionals learn ethics using case-based reasoning. Cases take many forms, and there are a variety of ways to write them and use them in teaching. This paper reports the results of a study designed to investigate one of the issues in teaching case-based ethics: the role of one's professional knowledge in learning methods of moral reasoning. Using a novel assessment instrument, we compared case studies written and analyzed by three groups of students whom we classified as: (1) Experts in a research domain in bioengineering. (2) Novices in a research domain in bioengineering. (3) The non-research group--students using an engineering domain in which they were interested but had no in-depth knowledge. This study demonstrates that a student's level of understanding of a professional knowledge domain plays a significant role in learning moral reasoning skills.

Worked Examples Leads to Better Performance in Analyzing and Solving Real-Life Decision Cases

ERIC Educational Resources Information Center

Cevik, Yasemin Demiraslan; Andre, Thomas

2012-01-01

This study compared the impact of three types of case-based methods (worked example, faded worked example, and case-based reasoning) on preservice teachers' (n=71) decision making and reasoning related to realistic classroom management situations. Participants in this study received a short-term implementation of one of these three major…

Toward translational incremental similarity-based reasoning in breast cancer grading

NASA Astrophysics Data System (ADS)

Tutac, Adina E.; Racoceanu, Daniel; Leow, Wee-Keng; Müller, Henning; Putti, Thomas; Cretu, Vladimir

2009-02-01

One of the fundamental issues in bridging the gap between the proliferation of Content-Based Image Retrieval (CBIR) systems in the scientific literature and the deficiency of their usage in medical community is based on the characteristic of CBIR to access information by images or/and text only. Yet, the way physicians are reasoning about patients leads intuitively to a case representation. Hence, a proper solution to overcome this gap is to consider a CBIR approach inspired by Case-Based Reasoning (CBR), which naturally introduces medical knowledge structured by cases. Moreover, in a CBR system, the knowledge is incrementally added and learned. The purpose of this study is to initiate a translational solution from CBIR algorithms to clinical practice, using a CBIR/CBR hybrid approach. Therefore, we advance the idea of a translational incremental similarity-based reasoning (TISBR), using combined CBIR and CBR characteristics: incremental learning of medical knowledge, medical case-based structure of the knowledge (CBR), image usage to retrieve similar cases (CBIR), similarity concept (central for both paradigms). For this purpose, three major axes are explored: the indexing, the cases retrieval and the search refinement, applied to Breast Cancer Grading (BCG), a powerful breast cancer prognosis exam. The effectiveness of this strategy is currently evaluated over cases provided by the Pathology Department of Singapore National University Hospital, for the indexing. With its current accuracy, TISBR launches interesting perspectives for complex reasoning in future medical research, opening the way to a better knowledge traceability and a better acceptance rate of computer-aided diagnosis assistance among practitioners.

A fuzzy case based reasoning tool for model based approach to rocket engine health monitoring

NASA Technical Reports Server (NTRS)

Krovvidy, Srinivas; Nolan, Adam; Hu, Yong-Lin; Wee, William G.

1992-01-01

In this system we develop a fuzzy case based reasoner that can build a case representation for several past anomalies detected, and we develop case retrieval methods that can be used to index a relevant case when a new problem (case) is presented using fuzzy sets. The choice of fuzzy sets is justified by the uncertain data. The new problem can be solved using knowledge of the model along with the old cases. This system can then be used to generalize the knowledge from previous cases and use this generalization to refine the existing model definition. This in turn can help to detect failures using the model based algorithms.

Short-term solar flare prediction using image-case-based reasoning

NASA Astrophysics Data System (ADS)

Liu, Jin-Fu; Li, Fei; Zhang, Huai-Peng; Yu, Da-Ren

2017-10-01

Solar flares strongly influence space weather and human activities, and their prediction is highly complex. The existing solutions such as data based approaches and model based approaches have a common shortcoming which is the lack of human engagement in the forecasting process. An image-case-based reasoning method is introduced to achieve this goal. The image case library is composed of SOHO/MDI longitudinal magnetograms, the images from which exhibit the maximum horizontal gradient, the length of the neutral line and the number of singular points that are extracted for retrieving similar image cases. Genetic optimization algorithms are employed for optimizing the weight assignment for image features and the number of similar image cases retrieved. Similar image cases and prediction results derived by majority voting for these similar image cases are output and shown to the forecaster in order to integrate his/her experience with the final prediction results. Experimental results demonstrate that the case-based reasoning approach has slightly better performance than other methods, and is more efficient with forecasts improved by humans.

Properties of inductive reasoning.

PubMed

Heit, E

2000-12-01

This paper reviews the main psychological phenomena of inductive reasoning, covering 25 years of experimental and model-based research, in particular addressing four questions. First, what makes a case or event generalizable to other cases? Second, what makes a set of cases generalizable? Third, what makes a property or predicate projectable? Fourth, how do psychological models of induction address these results? The key results in inductive reasoning are outlined, and several recent models, including a new Bayesian account, are evaluated with respect to these results. In addition, future directions for experimental and model-based work are proposed.

Application of artifical intelligence principles to the analysis of "crazy" speech.

PubMed

Garfield, D A; Rapp, C

1994-04-01

Artificial intelligence computer simulation methods can be used to investigate psychotic or "crazy" speech. Here, symbolic reasoning algorithms establish semantic networks that schematize speech. These semantic networks consist of two main structures: case frames and object taxonomies. Node-based reasoning rules apply to object taxonomies and pathway-based reasoning rules apply to case frames. Normal listeners may recognize speech as "crazy talk" based on violations of node- and pathway-based reasoning rules. In this article, three separate segments of schizophrenic speech illustrate violations of these rules. This artificial intelligence approach is compared and contrasted with other neurolinguistic approaches and is discussed as a conceptual link between neurobiological and psychodynamic understandings of psychopathology.

A public health decision support system model using reasoning methods.

PubMed

Mera, Maritza; González, Carolina; Blobel, Bernd

2015-01-01

Public health programs must be based on the real health needs of the population. However, the design of efficient and effective public health programs is subject to availability of information that can allow users to identify, at the right time, the health issues that require special attention. The objective of this paper is to propose a case-based reasoning model for the support of decision-making in public health. The model integrates a decision-making process and case-based reasoning, reusing past experiences for promptly identifying new population health priorities. A prototype implementation of the model was performed, deploying the case-based reasoning framework jColibri. The proposed model contributes to solve problems found today when designing public health programs in Colombia. Current programs are developed under uncertain environments, as the underlying analyses are carried out on the basis of outdated and unreliable data.

Performance of Case-Based Reasoning Retrieval Using Classification Based on Associations versus Jcolibri and FreeCBR: A Further Validation Study

NASA Astrophysics Data System (ADS)

Aljuboori, Ahmed S.; Coenen, Frans; Nsaif, Mohammed; Parsons, David J.

2018-05-01

Case-Based Reasoning (CBR) plays a major role in expert system research. However, a critical problem can be met when a CBR system retrieves incorrect cases. Class Association Rules (CARs) have been utilized to offer a potential solution in a previous work. The aim of this paper was to perform further validation of Case-Based Reasoning using a Classification based on Association Rules (CBRAR) to enhance the performance of Similarity Based Retrieval (SBR). The CBRAR strategy uses a classed frequent pattern tree algorithm (FP-CAR) in order to disambiguate wrongly retrieved cases in CBR. The research reported in this paper makes contributions to both fields of CBR and Association Rules Mining (ARM) in that full target cases can be extracted from the FP-CAR algorithm without invoking P-trees and union operations. The dataset used in this paper provided more efficient results when the SBR retrieves unrelated answers. The accuracy of the proposed CBRAR system outperforms the results obtained by existing CBR tools such as Jcolibri and FreeCBR.

Applying Case-Based Reasoning in Knowledge Management to Support Organizational Performance

ERIC Educational Resources Information Center

Wang, Feng-Kwei

2006-01-01

Research and practice in human performance technology (HPT) has recently accelerated the search for innovative approaches to supplement or replace traditional training interventions for improving organizational performance. This article examines a knowledge management framework built upon the theories and techniques of case-based reasoning (CBR)…

The Effect of a Case-Based Reasoning Instructional Model on Korean High School Students' Awareness in Climate Change Unit

ERIC Educational Resources Information Center

Jeong, Jinwoo; Kim, Hyoungbum; Chae, Dong-hyun; Kim, Eunjeong

2014-01-01

The purpose of this study is to investigate the effects of the case-based reasoning instructional model on learning about climate change unit. Results suggest that students showed interest because it allowed them to find the solution to the problem and solve the problem for themselves by analogy from other cases such as crossword puzzles in an…

An effective framework for finding similar cases of dengue from audio and text data using domain thesaurus and case base reasoning

NASA Astrophysics Data System (ADS)

Sandhu, Rajinder; Kaur, Jaspreet; Thapar, Vivek

2018-02-01

Dengue, also known as break-bone fever, is a tropical disease transmitted by mosquitoes. If the similarity between dengue infected users can be identified, it can help government's health agencies to manage the outbreak more effectively. To find similarity between cases affected by Dengue, user's personal and health information are the two fundamental requirements. Identification of similar symptoms, causes, effects, predictions and treatment procedures, is important. In this paper, an effective framework is proposed which finds similar patients suffering from dengue using keyword aware domain thesaurus and case base reasoning method. This paper focuses on the use of ontology dependent domain thesaurus technique to extract relevant keywords and then build cases with the help of case base reasoning method. Similar cases can be shared with users, nearby hospitals and health organizations to manage the problem more adequately. Two million case bases were generated to test the proposed similarity method. Experimental evaluations of proposed framework resulted in high accuracy and low error rate for finding similar cases of dengue as compared to UPCC and IPCC algorithms. The framework developed in this paper is for dengue but can easily be extended to other domains also.

Bringing explicit insight into cognitive psychology features during clinical reasoning seminars: a prospective, controlled study.

PubMed

Nendaz, Mathieu R; Gut, Anne M; Louis-Simonet, Martine; Perrier, Arnaud; Vu, Nu V

2011-04-01

Facets of reasoning competence influenced by an explicit insight into cognitive psychology features during clinical reasoning seminars have not been specifically explored. This prospective, controlled study, conducted at the University of Geneva Faculty of Medicine, Switzerland, assessed the impact on sixth-year medical students' patient work-up of case-based reasoning seminars, bringing them explicit insight into cognitive aspects of their reasoning. Volunteer students registered for our three-month Internal Medicine elective were assigned to one of two training conditions: standard (control) or modified (intervention) case-based reasoning seminars. These seminars start with the patient's presenting complaint and the students must ask the tutor for additional clinical information to progress through case resolution. For this intervention, the tutors made each step explicit to students and encouraged self-reflection on their reasoning processes. At the end of their elective, students' performances were assessed through encounters with two standardized patients and chart write-ups. Twenty-nine students participated, providing a total of 58 encounters. The overall differences in accuracy of the final diagnosis given to the patient at the end of the encounter (control 63% vs intervention 74%, p = 0.53) and of the final diagnosis mentioned in the patient chart (61% vs 70%, p = 0.58) were not statistically significant. The students in the intervention group significantly more often listed the correct diagnosis among the differential diagnoses in their charts (75% vs 97%, p = 0.02). This case-based clinical reasoning seminar intervention, designed to bring students insight into cognitive features of their reasoning, improved aspects of diagnostic competence.

Trust-Guided Behavior Adaptation Using Case-Based Reasoning

DTIC Science & Technology

2015-08-01

the same behaviors were evaluated in each set. To account for this, the similarity function looks at the overlap between the two sets and ignores...interruptions would reduce the cost of case genera- tion. 6 Related Work Existing approaches for measuring inverse trust differ from our own in that...where a case- based reasoning system considers the reliability of a case’s source, also takes trust into account . Our work also has sim- ilarities

Screening of pollution control and clean-up materials for river chemical spills using the multiple case-based reasoning method with a difference-driven revision strategy.

PubMed

Liu, Rentao; Jiang, Jiping; Guo, Liang; Shi, Bin; Liu, Jie; Du, Zhaolin; Wang, Peng

2016-06-01

In-depth filtering of emergency disposal technology (EDT) and materials has been required in the process of environmental pollution emergency disposal. However, an urgent problem that must be solved is how to quickly and accurately select the most appropriate materials for treating a pollution event from the existing spill control and clean-up materials (SCCM). To meet this need, the following objectives were addressed in this study. First, the material base and a case base for environment pollution emergency disposal were established to build a foundation and provide material for SCCM screening. Second, the multiple case-based reasoning model method with a difference-driven revision strategy (DDRS-MCBR) was applied to improve the original dual case-based reasoning model method system, and screening and decision-making was performed for SCCM using this model. Third, an actual environmental pollution accident from 2012 was used as a case study to verify the material base, case base, and screening model. The results demonstrated that the DDRS-MCBR method was fast, efficient, and practical. The DDRS-MCBR method changes the passive situation in which the choice of SCCM screening depends only on the subjective experience of the decision maker and offers a new approach to screening SCCM.

Secondary School Students' Understanding of Science and Their Socioscientific Reasoning

NASA Astrophysics Data System (ADS)

Karahan, Engin; Roehrig, Gillian

2017-08-01

Research in socioscientific issue (SSI)-based interventions is relatively new (Sadler in Journal of Research in Science Teaching 41:513-536, 2004; Zeidler et al. in Journal of Research in Science Teaching 46:74-101, 2009), and there is a need for understanding more about the effects of SSI-based learning environments (Sadler in Journal of Research in Science Teaching 41:513-536, 2004). Lee and Witz (International Journal of Science Education 31:931-960, 2009) highlighted the need for detailed case studies that would focus on how students respond to teachers' practices of teaching SSI. This study presents case studies that investigated the development of secondary school students' science understanding and their socioscientific reasoning within SSI-based learning environments. A multiple case study with embedded units of analysis was implemented for this research because of the contextual differences for each case. The findings of the study revealed that students' understanding of science, including scientific method, social and cultural influences on science, and scientific bias, was strongly influenced by their experiences in SSI-based learning environments. Furthermore, multidimensional SSI-based science classes resulted in students having multiple reasoning modes, such as ethical and economic reasoning, compared to data-driven SSI-based science classes. In addition to portraying how participants presented complexity, perspectives, inquiry, and skepticism as aspects of socioscientific reasoning (Sadler et al. in Research in Science Education 37:371-391, 2007), this study proposes the inclusion of three additional aspects for the socioscientific reasoning theoretical construct: (1) identification of social domains affecting the SSI, (2) using cost and benefit analysis for evaluation of claims, and (3) understanding that SSIs and scientific studies around them are context-bound.

Visualizing complex processes using a cognitive-mapping tool to support the learning of clinical reasoning.

PubMed

Wu, Bian; Wang, Minhong; Grotzer, Tina A; Liu, Jun; Johnson, Janice M

2016-08-22

Practical experience with clinical cases has played an important role in supporting the learning of clinical reasoning. However, learning through practical experience involves complex processes difficult to be captured by students. This study aimed to examine the effects of a computer-based cognitive-mapping approach that helps students to externalize the reasoning process and the knowledge underlying the reasoning process when they work with clinical cases. A comparison between the cognitive-mapping approach and the verbal-text approach was made by analyzing their effects on learning outcomes. Fifty-two third-year or higher students from two medical schools participated in the study. Students in the experimental group used the computer-base cognitive-mapping approach, while the control group used the verbal-text approach, to make sense of their thinking and actions when they worked with four simulated cases over 4 weeks. For each case, students in both groups reported their reasoning process (involving data capture, hypotheses formulation, and reasoning with justifications) and the underlying knowledge (involving identified concepts and the relationships between the concepts) using the given approach. The learning products (cognitive maps or verbal text) revealed that students in the cognitive-mapping group outperformed those in the verbal-text group in the reasoning process, but not in making sense of the knowledge underlying the reasoning process. No significant differences were found in a knowledge posttest between the two groups. The computer-based cognitive-mapping approach has shown a promising advantage over the verbal-text approach in improving students' reasoning performance. Further studies are needed to examine the effects of the cognitive-mapping approach in improving the construction of subject-matter knowledge on the basis of practical experience.

Rough case-based reasoning system for continues casting

NASA Astrophysics Data System (ADS)

Su, Wenbin; Lei, Zhufeng

2018-04-01

The continuous casting occupies a pivotal position in the iron and steel industry. The rough set theory and the CBR (case based reasoning, CBR) were combined in the research and implementation for the quality assurance of continuous casting billet to improve the efficiency and accuracy in determining the processing parameters. According to the continuous casting case, the object-oriented method was applied to express the continuous casting cases. The weights of the attributes were calculated by the algorithm which was based on the rough set theory and the retrieval mechanism for the continuous casting cases was designed. Some cases were adopted to test the retrieval mechanism, by analyzing the results, the law of the influence of the retrieval attributes on determining the processing parameters was revealed. A comprehensive evaluation model was established by using the attribute recognition theory. According to the features of the defects, different methods were adopted to describe the quality condition of the continuous casting billet. By using the system, the knowledge was not only inherited but also applied to adjust the processing parameters through the case based reasoning method as to assure the quality of the continuous casting and improve the intelligent level of the continuous casting.

Intelligent Case Based Decision Support System for Online Diagnosis of Automated Production System

NASA Astrophysics Data System (ADS)

Ben Rabah, N.; Saddem, R.; Ben Hmida, F.; Carre-Menetrier, V.; Tagina, M.

2017-01-01

Diagnosis of Automated Production System (APS) is a decision-making process designed to detect, locate and identify a particular failure caused by the control law. In the literature, there are three major types of reasoning for industrial diagnosis: the first is model-based, the second is rule-based and the third is case-based. The common and major limitation of the first and the second reasonings is that they do not have automated learning ability. This paper presents an interactive and effective Case Based Decision Support System for online Diagnosis (CB-DSSD) of an APS. It offers a synergy between the Case Based Reasoning (CBR) and the Decision Support System (DSS) in order to support and assist Human Operator of Supervision (HOS) in his/her decision process. Indeed, the experimental evaluation performed on an Interactive Training System for PLC (ITS PLC) that allows the control of a Programmable Logic Controller (PLC), simulating sensors or/and actuators failures and validating the control algorithm through a real time interactive experience, showed the efficiency of our approach.

Emerging medical informatics with case-based reasoning for aiding clinical decision in multi-agent system.

PubMed

Shen, Ying; Colloc, Joël; Jacquet-Andrieu, Armelle; Lei, Kai

2015-08-01

This research aims to depict the methodological steps and tools about the combined operation of case-based reasoning (CBR) and multi-agent system (MAS) to expose the ontological application in the field of clinical decision support. The multi-agent architecture works for the consideration of the whole cycle of clinical decision-making adaptable to many medical aspects such as the diagnosis, prognosis, treatment, therapeutic monitoring of gastric cancer. In the multi-agent architecture, the ontological agent type employs the domain knowledge to ease the extraction of similar clinical cases and provide treatment suggestions to patients and physicians. Ontological agent is used for the extension of domain hierarchy and the interpretation of input requests. Case-based reasoning memorizes and restores experience data for solving similar problems, with the help of matching approach and defined interfaces of ontologies. A typical case is developed to illustrate the implementation of the knowledge acquisition and restitution of medical experts. Copyright © 2015 Elsevier Inc. All rights reserved.

Clinical reasoning and case-based decision making: the fundamental challenge to veterinary educators.

PubMed

May, Stephen A

2013-01-01

Confusion about the nature of human reasoning and its appropriate application to patients has hampered veterinary students' development of these skills. Expertise is associated with greater ability to deploy pattern recognition (type 1 reasoning), which is aided by progressive development of data-driven, forward reasoning (in contrast to scientific, backward reasoning), analytical approaches that lead to schema acquisition. The associative nature of type 1 reasoning makes it prone to bias, particularly in the face of "cognitive miserliness," when clues that indicate the need for triangulation with an analytical approach are ignored. However, combined reasoning approaches, from the earliest stages, are more successful than one approach alone, so it is important that those involved in curricular design and delivery promote student understanding of reasoning generally, and the situations in which reasoning goes awry, and develop students' ability to reason safely and accurately whether presented with a familiar case or with a case that they have never seen before.

Case-Based Analogical Reasoning: A Pedagogical Tool for Promotion of Clinical Reasoning

ERIC Educational Resources Information Center

Speicher, Timothy E.; Bell, Alexandra; Kehrhahn, Marijke; Casa, Douglas J.

2012-01-01

Context: One of the most common instructional methods utilized to promote learning transfer in health profession education is examination of a single patient case. However, in non-healthcare settings this practice has shown to be less effective in promoting learning than the examination of multiple cases with cueing. Objective(s): The primary…

A Framework of Combining Case-Based Reasoning with a Work Breakdown Structure for Estimating the Cost of Online Course Production Projects

ERIC Educational Resources Information Center

He, Wu

2014-01-01

Currently, a work breakdown structure (WBS) approach is used as the most common cost estimation approach for online course production projects. To improve the practice of cost estimation, this paper proposes a novel framework to estimate the cost for online course production projects using a case-based reasoning (CBR) technique and a WBS. A…

A Hybrid Approach Using Case-Based Reasoning and Rule-Based Reasoning to Support Cancer Diagnosis: A Pilot Study.

PubMed

Saraiva, Renata M; Bezerra, João; Perkusich, Mirko; Almeida, Hyggo; Siebra, Clauirton

2015-01-01

Recently there has been an increasing interest in applying information technology to support the diagnosis of diseases such as cancer. In this paper, we present a hybrid approach using case-based reasoning (CBR) and rule-based reasoning (RBR) to support cancer diagnosis. We used symptoms, signs, and personal information from patients as inputs to our model. To form specialized diagnoses, we used rules to define the input factors' importance according to the patient's characteristics. The model's output presents the probability of the patient having a type of cancer. To carry out this research, we had the approval of the ethics committee at Napoleão Laureano Hospital, in João Pessoa, Brazil. To define our model's cases, we collected real patient data at Napoleão Laureano Hospital. To define our model's rules and weights, we researched specialized literature and interviewed health professional. To validate our model, we used K-fold cross validation with the data collected at Napoleão Laureano Hospital. The results showed that our approach is an effective CBR system to diagnose cancer.

Signal Analysis of Automotive Engine Spark Ignition System using Case-Based Reasoning (CBR) and Case-based Maintenance (CBM)

NASA Astrophysics Data System (ADS)

Huang, H.; Vong, C. M.; Wong, P. K.

2010-05-01

With the development of modern technology, modern vehicles adopt electronic control system for injection and ignition. In traditional way, whenever there is any malfunctioning in an automotive engine, an automotive mechanic usually performs a diagnosis in the ignition system of the engine to check any exceptional symptoms. In this paper, we present a case-based reasoning (CBR) approach to help solve human diagnosis problem. Nevertheless, one drawback of CBR system is that the case library will be expanded gradually after repeatedly running the system, which may cause inaccuracy and longer time for the CBR retrieval. To tackle this problem, case-based maintenance (CBM) framework is employed so that the case library of the CBR system will be compressed by clustering to produce a set of representative cases. As a result, the performance (in retrieval accuracy and time) of the whole CBR system can be improved.

Working memory, reasoning, and expertise in medicine-insights into their relationship using functional neuroimaging.

PubMed

Hruska, Pam; Krigolson, Olav; Coderre, Sylvain; McLaughlin, Kevin; Cortese, Filomeno; Doig, Christopher; Beran, Tanya; Wright, Bruce; Hecker, Kent G

2016-12-01

Clinical reasoning is dependent upon working memory (WM). More precisely, during the clinical reasoning process stored information within long-term memory is brought into WM to facilitate the internal deliberation that affords a clinician the ability to reason through a case. In the present study, we examined the relationship between clinical reasoning and WM while participants read clinical cases with functional magnetic resonance imaging (fMRI). More specifically, we examined the impact of clinical case difficulty (easy, hard) and clinician level of expertise (2nd year medical students, senior gastroenterologists) on neural activity within regions of cortex associated with WM (i.e., the prefrontal cortex) during the reasoning process. fMRI was used to scan ten second-year medical students and ten practicing gastroenterologists while they reasoned through sixteen clinical cases [eight straight forward (easy) and eight complex (hard)] during a single 1-h scanning session. Within-group analyses contrasted the easy and hard cases which were then subsequently utilized for a between-group analysis to examine effects of expertise (novice > expert, expert > novice). Reading clinical cases evoked multiple neural activations in occipital, prefrontal, parietal, and temporal cortical regions in both groups. Importantly, increased activation in the prefrontal cortex in novices for both easy and hard clinical cases suggests novices utilize WM more so than experts during clinical reasoning. We found that clinician level of expertise elicited differential activation of regions of the human prefrontal cortex associated with WM during clinical reasoning. This suggests there is an important relationship between clinical reasoning and human WM. As such, we suggest future models of clinical reasoning take into account that the use of WM is not consistent throughout all clinical reasoning tasks, and that memory structure may be utilized differently based on level of expertise.

CDMBE: A Case Description Model Based on Evidence

PubMed Central

Zhu, Jianlin; Yang, Xiaoping; Zhou, Jing

2015-01-01

By combining the advantages of argument map and Bayesian network, a case description model based on evidence (CDMBE), which is suitable to continental law system, is proposed to describe the criminal cases. The logic of the model adopts the credibility logical reason and gets evidence-based reasoning quantitatively based on evidences. In order to consist with practical inference rules, five types of relationship and a set of rules are defined to calculate the credibility of assumptions based on the credibility and supportability of the related evidences. Experiments show that the model can get users' ideas into a figure and the results calculated from CDMBE are in line with those from Bayesian model. PMID:26421006

A viewpoint-based case-based reasoning approach utilising an enterprise architecture ontology for experience management

NASA Astrophysics Data System (ADS)

Martin, Andreas; Emmenegger, Sandro; Hinkelmann, Knut; Thönssen, Barbara

2017-04-01

The accessibility of project knowledge obtained from experiences is an important and crucial issue in enterprises. This information need about project knowledge can be different from one person to another depending on the different roles he or she has. Therefore, a new ontology-based case-based reasoning (OBCBR) approach that utilises an enterprise ontology is introduced in this article to improve the accessibility of this project knowledge. Utilising an enterprise ontology improves the case-based reasoning (CBR) system through the systematic inclusion of enterprise-specific knowledge. This enterprise-specific knowledge is captured using the overall structure given by the enterprise ontology named ArchiMEO, which is a partial ontological realisation of the enterprise architecture framework (EAF) ArchiMate. This ontological representation, containing historical cases and specific enterprise domain knowledge, is applied in a new OBCBR approach. To support the different information needs of different stakeholders, this OBCBR approach has been built in such a way that different views, viewpoints, concerns and stakeholders can be considered. This is realised using a case viewpoint model derived from the ISO/IEC/IEEE 42010 standard. The introduced approach was implemented as a demonstrator and evaluated using an application case that has been elicited from a business partner in the Swiss research project.

Cognition of an expert tackling an unfamiliar conceptual physics problem

NASA Astrophysics Data System (ADS)

Schuster, David; Undreiu, Adriana

2009-11-01

We have investigated and analyzed the cognition of an expert tackling a qualitative conceptual physics problem of an unfamiliar type. Our goal was to elucidate the detailed cognitive processes and knowledge elements involved, irrespective of final solution form, and consider implications for instruction. The basic but non-trivial problem was to find qualitatively the direction of acceleration of a pendulum bob at various stages of its motion, a problem originally studied by Reif and Allen. Methodology included interviews, introspection, retrospection and self-reported metacognition. Multiple facets of cognition were revealed, with different reasoning strategies used at different stages and for different points on the path. An account is given of the zigzag thinking paths and interplay of reasoning modes and schema elements involved. We interpret the cognitive processes in terms of theoretical concepts that emerged, namely: case-based, principle-based, experiential-intuitive and practical-heuristic reasoning; knowledge elements and schemata; activation; metacognition and epistemic framing. The complexity of cognition revealed in this case study contrasts with the tidy principle-based solutions we present to students. The pervasive role of schemata, case-based reasoning, practical heuristic strategies, and their interplay with physics principles is noteworthy, since these aspects of cognition are generally neither recognized nor taught. The schema/reasoning-mode perspective has direct application in science teaching, learning and problem-solving.

Intelligent design of permanent magnet synchronous motor based on CBR

NASA Astrophysics Data System (ADS)

Li, Cong; Fan, Beibei

2018-05-01

Aiming at many problems in the design process of Permanent magnet synchronous motor (PMSM), such as the complexity of design process, the over reliance on designers' experience and the lack of accumulation and inheritance of design knowledge, a design method of PMSM Based on CBR is proposed in order to solve those problems. In this paper, case-based reasoning (CBR) methods of cases similarity calculation is proposed for reasoning suitable initial scheme. This method could help designers, by referencing previous design cases, to make a conceptual PMSM solution quickly. The case retain process gives the system self-enrich function which will improve the design ability of the system with the continuous use of the system.

Combining knowledge discovery from databases (KDD) and case-based reasoning (CBR) to support diagnosis of medical images

NASA Astrophysics Data System (ADS)

Stranieri, Andrew; Yearwood, John; Pham, Binh

1999-07-01

The development of data warehouses for the storage and analysis of very large corpora of medical image data represents a significant trend in health care and research. Amongst other benefits, the trend toward warehousing enables the use of techniques for automatically discovering knowledge from large and distributed databases. In this paper, we present an application design for knowledge discovery from databases (KDD) techniques that enhance the performance of the problem solving strategy known as case- based reasoning (CBR) for the diagnosis of radiological images. The problem of diagnosing the abnormality of the cervical spine is used to illustrate the method. The design of a case-based medical image diagnostic support system has three essential characteristics. The first is a case representation that comprises textual descriptions of the image, visual features that are known to be useful for indexing images, and additional visual features to be discovered by data mining many existing images. The second characteristic of the approach presented here involves the development of a case base that comprises an optimal number and distribution of cases. The third characteristic involves the automatic discovery, using KDD techniques, of adaptation knowledge to enhance the performance of the case based reasoner. Together, the three characteristics of our approach can overcome real time efficiency obstacles that otherwise mitigate against the use of CBR to the domain of medical image analysis.

Ontology-Based Method for Fault Diagnosis of Loaders.

PubMed

Xu, Feixiang; Liu, Xinhui; Chen, Wei; Zhou, Chen; Cao, Bingwei

2018-02-28

This paper proposes an ontology-based fault diagnosis method which overcomes the difficulty of understanding complex fault diagnosis knowledge of loaders and offers a universal approach for fault diagnosis of all loaders. This method contains the following components: (1) An ontology-based fault diagnosis model is proposed to achieve the integrating, sharing and reusing of fault diagnosis knowledge for loaders; (2) combined with ontology, CBR (case-based reasoning) is introduced to realize effective and accurate fault diagnoses following four steps (feature selection, case-retrieval, case-matching and case-updating); and (3) in order to cover the shortages of the CBR method due to the lack of concerned cases, ontology based RBR (rule-based reasoning) is put forward through building SWRL (Semantic Web Rule Language) rules. An application program is also developed to implement the above methods to assist in finding the fault causes, fault locations and maintenance measures of loaders. In addition, the program is validated through analyzing a case study.

Ontology-Based Method for Fault Diagnosis of Loaders

PubMed Central

Liu, Xinhui; Chen, Wei; Zhou, Chen; Cao, Bingwei

2018-01-01

This paper proposes an ontology-based fault diagnosis method which overcomes the difficulty of understanding complex fault diagnosis knowledge of loaders and offers a universal approach for fault diagnosis of all loaders. This method contains the following components: (1) An ontology-based fault diagnosis model is proposed to achieve the integrating, sharing and reusing of fault diagnosis knowledge for loaders; (2) combined with ontology, CBR (case-based reasoning) is introduced to realize effective and accurate fault diagnoses following four steps (feature selection, case-retrieval, case-matching and case-updating); and (3) in order to cover the shortages of the CBR method due to the lack of concerned cases, ontology based RBR (rule-based reasoning) is put forward through building SWRL (Semantic Web Rule Language) rules. An application program is also developed to implement the above methods to assist in finding the fault causes, fault locations and maintenance measures of loaders. In addition, the program is validated through analyzing a case study. PMID:29495646

16 CFR 306.5 - Automotive fuel rating.

Code of Federal Regulations, 2010 CFR

2010-01-01

... fuels other than biodiesel blends and biomass-based diesel blends, you must possess a reasonable basis... the fuel, and in the case of biomass-based diesel blends, you must possess a reasonable basis, consisting of competent and reliable evidence, for the percentage of biomass-based diesel contained in the...

A personalized health-monitoring system for elderly by combining rules and case-based reasoning.

PubMed

Ahmed, Mobyen Uddin

2015-01-01

Health-monitoring system for elderly in home environment is a promising solution to provide efficient medical services that increasingly interest by the researchers within this area. It is often more challenging when the system is self-served and functioning as personalized provision. This paper proposed a personalized self-served health-monitoring system for elderly in home environment by combining general rules with a case-based reasoning approach. Here, the system generates feedback, recommendation and alarm in a personalized manner based on elderly's medical information and health parameters such as blood pressure, blood glucose, weight, activity, pulse, etc. A set of general rules has used to classify individual health parameters. The case-based reasoning approach is used to combine all different health parameters, which generates an overall classification of health condition. According to the evaluation result considering 323 cases and k=2 i.e., top 2 most similar retrieved cases, the sensitivity, specificity and overall accuracy are achieved as 90%, 97% and 96% respectively. The preliminary result of the system is acceptable since the feedback; recommendation and alarm messages are personalized and differ from the general messages. Thus, this approach could be possibly adapted for other situations in personalized elderly monitoring.

CABINS: Case-based interactive scheduler

NASA Technical Reports Server (NTRS)

Miyashita, Kazuo; Sycara, Katia

1992-01-01

In this paper we discuss the need for interactive factory schedule repair and improvement, and we identify case-based reasoning (CBR) as an appropriate methodology. Case-based reasoning is the problem solving paradigm that relies on a memory for past problem solving experiences (cases) to guide current problem solving. Cases similar to the current case are retrieved from the case memory, and similarities and differences of the current case to past cases are identified. Then a best case is selected, and its repair plan is adapted to fit the current problem description. If a repair solution fails, an explanation for the failure is stored along with the case in memory, so that the user can avoid repeating similar failures in the future. So far we have identified a number of repair strategies and tactics for factory scheduling and have implemented a part of our approach in a prototype system, called CABINS. As a future work, we are going to scale up CABINS to evaluate its usefulness in a real manufacturing environment.

Developing integrated clinical reasoning competencies in dental students using scaffolded case-based learning - empirical evidence.

PubMed

Postma, T C; White, J G

2016-08-01

This study provides empirical evidence of the development of integrated clinical reasoning in the discipline-based School of Dentistry, University of Pretoria, South Africa. Students were exposed to case-based learning in comprehensive patient care (CPC) in the preclinical year of study, scaffolded by means of the four-component instructional design model for complex learning. Progress test scores of third- to fifth-year dental students, who received case-based teaching and learning in the third year (2009-2011), were compared to the scores of preceding fourth- and fifth-year cohorts. These fourth- and fifth-year cohorts received content-based teaching concurrently with their clinical training in CPC. The progress test consisted of a complex case study and 32 MCQs on tracer conditions. Students had to gather the necessary information and had to make diagnostic and treatment-planning decisions. Preclinical students who participated in the case-based teaching and learning achieved similar scores compared to final-year students who received lecture-based teaching and learning. Final-year students who participated in the case-based learning made three more correct clinical decisions per student, compared to those who received content-based teaching. Students struggled more with treatment-planning than with diagnostic decisions. The scaffolded case-based learning appears to contribute to accurate clinical decisions when compared to lecture-based teaching. It is suggested that the development of integrated reasoning competencies starts as early as possible in a dental curriculum, perhaps even in the preclinical year of study. Treatment-planning should receive particular attention. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Case-Based Policy and Goal Recognition

DTIC Science & Technology

2015-09-30

or noisy. Ontanón et al. [8] use case-based reasoning (CBR) to model human driving vehicle control behaviors and skill level to reduce teen crash...Snodgrass, S., Bonfiglio, D., Winston, F.K., McDonald, C., Gonzalez, A.J.: Case-based prediction of teen driver behavior and skill. In: Pro- ceedings

Signal Analysis of Automotive Engine Spark Ignition System using Case-Based Reasoning (CBR) and Case-based Maintenance (CBM)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huang, H.; Vong, C. M.; Wong, P. K.

2010-05-21

With the development of modern technology, modern vehicles adopt electronic control system for injection and ignition. In traditional way, whenever there is any malfunctioning in an automotive engine, an automotive mechanic usually performs a diagnosis in the ignition system of the engine to check any exceptional symptoms. In this paper, we present a case-based reasoning (CBR) approach to help solve human diagnosis problem. Nevertheless, one drawback of CBR system is that the case library will be expanded gradually after repeatedly running the system, which may cause inaccuracy and longer time for the CBR retrieval. To tackle this problem, case-based maintenancemore » (CBM) framework is employed so that the case library of the CBR system will be compressed by clustering to produce a set of representative cases. As a result, the performance (in retrieval accuracy and time) of the whole CBR system can be improved.« less

Comparison of ethical judgments exhibited by clients and ethics consultants in Japan.

PubMed

Nagao, Noriko; Kadooka, Yasuhiro; Asai, Atsushi

2014-03-04

Healthcare professionals must make decisions for patients based on ethical considerations. However, they rely on clinical ethics consultations (CEC) to review ethical justifications of their decisions. CEC consultants support the cases reviewed and guide medical care. When both healthcare professionals and CEC consultants face ethical problems in medical care, how is their judgment derived? How do medical judgments differ from the ethical considerations of CECs? This study examines CECs in Japan to identify differences in the ethical judgment of clients and CEC consultants. The CEC request and response documents of all 60 cases reviewed across Japan between October 2006 and the end of October 2011 were classified in terms of the presence of decisional capacity in the patient. We conducted a qualitative content analysis of the differences in reasoning between client and CEC consultants. Reasoned judgments were verified in individual cases to classify the similarities or differences of opinion between CEC clients and teams. As the result of classification of the decisional capacity and the difference of opinion regarding medical care, the most frequent category was 25 cases (41.7%) of "uncertain decisional capacity," and 23 cases (38.3%) of "withholding of decision-making." A chi-square analysis was performed on presence of decisional capacity and agreement in decision-making, yielding a statistically significant difference (p < 0.05). The CEC consultants' reasoning was based on "patient's preference was ambiguous," "validity of family as a surrogate," "estimation of patient preference," and "patient's best interest," whereas the CEC client's reasoning was based on "consistent family preference was shown/not shown" and "appropriate therapeutic methods to manage patient safety." Differences in opinions were found in cases classified according to decisional capacity. Furthermore, the reasoning behind judgments differed between CEC clients and CEC consultants. The reasoning of CEC consultants was critical and reflective, while for clients it was situational and pragmatic.

A prototype case-based reasoning human assistant for space crew assessment and mission management

NASA Technical Reports Server (NTRS)

Owen, Robert B.; Holland, Albert W.; Wood, Joanna

1993-01-01

We present a prototype human assistant system for space crew assessment and mission management. Our system is based on case episodes from American and Russian space missions and analog environments such as polar stations and undersea habitats. The general domain of small groups in isolated and confined environments represents a near ideal application area for case-based reasoning (CBR) - there are few reliable rules to follow, and most domain knowledge is in the form of cases. We define the problem domain and outline a unique knowledge representation system driven by conflict and communication triggers. The prototype system is able to represent, index, and retrieve case studies of human performance. We index by social, behavioral, and environmental factors. We present the problem domain, our current implementation, our research approach for an operational system, and prototype performance and results.

[Teaching of clinical reasoning to medical students using prototypical clinical cases].

PubMed

Montaldo L, Gustavo; Herskovic L, Pedro

2013-07-01

Clinical reasoning is the most important competente in the training process of a physician. To develop a method for teaching clinical reasoning based on prototypes of clinical cases. The study was conducted on sixty-four third year medical students. The study and control groups attended lectures and tutorial sessions with patients. The study group attended additionally discussion seminars of prototypical clinical cases. A clinical reasoning test was applied at the start and end of the learning period to both groups. At the end of the study, the opinions of students of the study group were collected in a focus group. After the learning period, both groups significantly increased their clinical reasoning skills. However, the improvement in the study group was more than double than that of the control group. The absolute improvement in the study group was 30.9%. Students interviewed in the focus group were unanimous in expressing their satisfaction in each and every aspect discussed. The teaching of clinical reasoning to third year medical students by means of pattern recognition in seminars with clinical cases improved significantly their skills.

Examining Preservice Teachers' Decision Behaviors and Individual Differences in Three Online Case-Based Approaches

ERIC Educational Resources Information Center

Cevik, Yasemin Demiraslan; Andre, Thomas

2013-01-01

This study compared the impact of three types of case-based methods (case-based reasoning, worked example, and faded worked example) on preservice teachers' (n = 71) interaction with decision tasks and whether decision related measures (task difficulty, mental effort, decision making performance) were associated with the differences in student…

ROENTGEN: case-based reasoning and radiation therapy planning.

PubMed Central

Berger, J.

1992-01-01

ROENTGEN is a design assistant for radiation therapy planning which uses case-based reasoning, an artificial intelligence technique. It learns both from specific problem-solving experiences and from direct instruction from the user. The first sort of learning is the normal case-based method of storing problem solutions so that they can be reused. The second sort is necessary because ROENTGEN does not, initially, have an internal model of the physics of its problem domain. This dependence on explicit user instruction brings to the forefront representational questions regarding indexing, failure definition, failure explanation and repair. This paper presents the techniques used by ROENTGEN in its knowledge acquisition and design activities. PMID:1482869

Is there a role for assent or dissent in animal research?

PubMed

Kantin, Holly; Wendler, David

2015-10-01

Current regulations and widely accepted principles for animal research focus on minimizing the burdens and harms of research on animals. However, these regulations and principles do not consider a possible role for assent or dissent in animal research. Should investigators solicit the assent or respect the dissent of animals who are used in research, and, if so, under what circumstances? In this article we pursue this question and outline the relevant issues that bear on the answer. We distinguish two general reasons for respecting the preferences of research participants regarding whether they participate in research-welfare-based reasons and agency-based reasons. We argue that there are welfare-based reasons for researchers to consider, and in some cases respect, the dissent of all animals used in research. After providing a brief account of the nature of agency-based reasons, we argue that there is good reason to think that these reasons apply to at least chimpanzees. We argue that there is an additional reason for researchers to respect the dissent-and, when possible, solicit the assent-of any animal to whom agency-based reasons apply.

Longitudinal Assessment of Progress in Reasoning Capacity and Relation with Self-Estimation of Knowledge Base

ERIC Educational Resources Information Center

Collard, Anne; Mélot, France; Bourguignon, Jean-Pierre

2015-01-01

The aim of the study was to investigate progress in reasoning capacity and knowledge base appraisal in a longitudinal analysis of data from summative evaluation throughout a medical problem-based learning curriculum. The scores in multidisciplinary discussion of a clinical case and multiple choice questionnaires (MCQs) were studied longitudinally…

The application of hybrid artificial intelligence systems for forecasting

NASA Astrophysics Data System (ADS)

Lees, Brian; Corchado, Juan

1999-03-01

The results to date are presented from an ongoing investigation, in which the aim is to combine the strengths of different artificial intelligence methods into a single problem solving system. The premise underlying this research is that a system which embodies several cooperating problem solving methods will be capable of achieving better performance than if only a single method were employed. The work has so far concentrated on the combination of case-based reasoning and artificial neural networks. The relative merits of artificial neural networks and case-based reasoning problem solving paradigms, and their combination are discussed. The integration of these two AI problem solving methods in a hybrid systems architecture, such that the neural network provides support for learning from past experience in the case-based reasoning cycle, is then presented. The approach has been applied to the task of forecasting the variation of physical parameters of the ocean. Results obtained so far from tests carried out in the dynamic oceanic environment are presented.

Supervised machine learning algorithms to diagnose stress for vehicle drivers based on physiological sensor signals.

PubMed

Barua, Shaibal; Begum, Shahina; Ahmed, Mobyen Uddin

2015-01-01

Machine learning algorithms play an important role in computer science research. Recent advancement in sensor data collection in clinical sciences lead to a complex, heterogeneous data processing, and analysis for patient diagnosis and prognosis. Diagnosis and treatment of patients based on manual analysis of these sensor data are difficult and time consuming. Therefore, development of Knowledge-based systems to support clinicians in decision-making is important. However, it is necessary to perform experimental work to compare performances of different machine learning methods to help to select appropriate method for a specific characteristic of data sets. This paper compares classification performance of three popular machine learning methods i.e., case-based reasoning, neutral networks and support vector machine to diagnose stress of vehicle drivers using finger temperature and heart rate variability. The experimental results show that case-based reasoning outperforms other two methods in terms of classification accuracy. Case-based reasoning has achieved 80% and 86% accuracy to classify stress using finger temperature and heart rate variability. On contrary, both neural network and support vector machine have achieved less than 80% accuracy by using both physiological signals.

The Effects of Successful versus Failure-Based Cases on Argumentation while Solving Decision-Making Problems

ERIC Educational Resources Information Center

Tawfik, Andrew; Jonassen, David

2013-01-01

Solving complex, ill-structured problems may be effectively supported by case-based reasoning through case libraries that provide just-in-time domain-specific principles in the form of stories. The cases not only articulate previous experiences of practitioners, but also serve as problem-solving narratives from which learners can acquire meaning.…

Teaching clinical reasoning: case-based and coached.

PubMed

Kassirer, Jerome P

2010-07-01

Optimal medical care is critically dependent on clinicians' skills to make the right diagnosis and to recommend the most appropriate therapy, and acquiring such reasoning skills is a key requirement at every level of medical education. Teaching clinical reasoning is grounded in several fundamental principles of educational theory. Adult learning theory posits that learning is best accomplished by repeated, deliberate exposure to real cases, that case examples should be selected for their reflection of multiple aspects of clinical reasoning, and that the participation of a coach augments the value of an educational experience. The theory proposes that memory of clinical medicine and clinical reasoning strategies is enhanced when errors in information, judgment, and reasoning are immediately pointed out and discussed. Rather than using cases artificially constructed from memory, real cases are greatly preferred because they often reflect the false leads, the polymorphisms of actual clinical material, and the misleading test results encountered in everyday practice. These concepts foster the teaching and learning of the diagnostic process, the complex trade-offs between the benefits and risks of diagnostic tests and treatments, and cognitive errors in clinical reasoning. The teaching of clinical reasoning need not and should not be delayed until students gain a full understanding of anatomy and pathophysiology. Concepts such as hypothesis generation, pattern recognition, context formulation, diagnostic test interpretation, differential diagnosis, and diagnostic verification provide both the language and the methods of clinical problem solving. Expertise is attainable even though the precise mechanisms of achieving it are not known.

38 CFR 36.4279 - Extensions and reamortizations.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... (a) Provided the debtor(s) is (are) a reasonable credit risk(s), as determined by the holder based... debtor(s), be extended in the event of default, to avoid imminent default, or in any other case where the...) is (are) a reasonable credit risk(s), as determined by the holder based upon review of the debtor's...

Clinical reasoning of junior doctors in emergency medicine: a grounded theory study.

PubMed

Adams, E; Goyder, C; Heneghan, C; Brand, L; Ajjawi, R

2017-02-01

Emergency medicine (EM) has a high case turnover and acuity making it a demanding clinical reasoning domain especially for junior doctors who lack experience. We aimed to better understand their clinical reasoning using dual cognition as a guiding theory. EM junior doctors were recruited from six hospitals in the south of England to participate in semi-structured interviews (n=20) and focus groups (n=17) based on recall of two recent cases. Transcripts were analysed using a grounded theory approach to identify themes and to develop a model of junior doctors' clinical reasoning in EM. Within cases, clinical reasoning occurred in three phases. In phase 1 (case framing), initial case cues and first impressions were predominantly intuitive, but checked by analytical thought and determined the urgency of clinical assessment. In phase 2 (evolving reasoning), non-analytical single cue and pattern recognitions were common which were subsequently validated by specific analytical strategies such as use of red flags. In phase 3 (ongoing uncertainty) analytical self-monitoring and reassurance strategies were used to precipitate a decision regarding discharge. We found a constant dialectic between intuitive and analytical cognition throughout the reasoning process. Our model of clinical reasoning by EM junior doctors illustrates the specific contextual manifestations of the dual cognition theory. Distinct diagnostic strategies are identified and together these give EM learners and educators a framework and vocabulary for discussion and learning about clinical reasoning. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Virtual patients design and its effect on clinical reasoning and student experience: a protocol for a randomised factorial multi-centre study.

PubMed

Bateman, James; Allen, Maggie E; Kidd, Jane; Parsons, Nick; Davies, David

2012-08-01

Virtual Patients (VPs) are web-based representations of realistic clinical cases. They are proposed as being an optimal method for teaching clinical reasoning skills. International standards exist which define precisely what constitutes a VP. There are multiple design possibilities for VPs, however there is little formal evidence to support individual design features. The purpose of this trial is to explore the effect of two different potentially important design features on clinical reasoning skills and the student experience. These are the branching case pathways (present or absent) and structured clinical reasoning feedback (present or absent). This is a multi-centre randomised 2 x 2 factorial design study evaluating two independent variables of VP design, branching (present or absent), and structured clinical reasoning feedback (present or absent).The study will be carried out in medical student volunteers in one year group from three university medical schools in the United Kingdom, Warwick, Keele and Birmingham. There are four core musculoskeletal topics. Each case can be designed in four different ways, equating to 16 VPs required for the research. Students will be randomised to four groups, completing the four VP topics in the same order, but with each group exposed to a different VP design sequentially. All students will be exposed to the four designs. Primary outcomes are performance for each case design in a standardized fifteen item clinical reasoning assessment, integrated into each VP, which is identical for each topic. Additionally a 15-item self-reported evaluation is completed for each VP, based on a widely used EViP tool. Student patterns of use of the VPs will be recorded.In one centre, formative clinical and examination performance will be recorded, along with a self reported pre and post-intervention reasoning score, the DTI. Our power calculations indicate a sample size of 112 is required for both primary outcomes. This trial will provide robust evidence to support the effectiveness of different designs of virtual patients, based on student performance and evaluation. The cases and all learning materials will be open access and available on a Creative Commons Attribution-Share-Alike license.

Technology-based strategies for promoting clinical reasoning skills in nursing education.

PubMed

Shellenbarger, Teresa; Robb, Meigan

2015-01-01

Faculty face the demand of preparing nursing students for the constantly changing health care environment. Effective use of online, classroom, and clinical conferencing opportunities helps to enhance nursing students' clinical reasoning capabilities needed for practice. The growth of technology creates an avenue for faculty to develop engaging learning opportunities. This article presents technology-based strategies such as electronic concept mapping, electronic case histories, and digital storytelling that can be used to facilitate clinical reasoning skills.

Emotional reasoning and parent-based reasoning in normal children.

PubMed

Morren, Mattijn; Muris, Peter; Kindt, Merel

2004-01-01

A previous study by Muris, Merckelbach, and Van Spauwen demonstrated that children display emotional reasoning irrespective of their anxiety levels. That is, when estimating whether a situation is dangerous, children not only rely on objective danger information but also on their own anxiety-response. The present study further examined emotional reasoning in children aged 7-13 years (N = 508). In addition, it was investigated whether children also show parent-based reasoning, which can be defined as the tendency to rely on anxiety-responses that can be observed in parents. Children completed self-report questionnaires of anxiety, depression, and emotional and parent-based reasoning. Evidence was found for both emotional and parent-based reasoning effects. More specifically, children's danger ratings were not only affected by objective danger information, but also by anxiety-response information in both objective danger and safety stories. High levels of anxiety and depression were significantly associated with the tendency to rely on anxiety-response information, but only in the case of safety scripts.

Comparison of ethical judgments exhibited by clients and ethics consultants in Japan

PubMed Central

2014-01-01

Background Healthcare professionals must make decisions for patients based on ethical considerations. However, they rely on clinical ethics consultations (CEC) to review ethical justifications of their decisions. CEC consultants support the cases reviewed and guide medical care. When both healthcare professionals and CEC consultants face ethical problems in medical care, how is their judgment derived? How do medical judgments differ from the ethical considerations of CECs? This study examines CECs in Japan to identify differences in the ethical judgment of clients and CEC consultants. Methods The CEC request and response documents of all 60 cases reviewed across Japan between October 2006 and the end of October 2011 were classified in terms of the presence of decisional capacity in the patient. We conducted a qualitative content analysis of the differences in reasoning between client and CEC consultants. Reasoned judgments were verified in individual cases to classify the similarities or differences of opinion between CEC clients and teams. Results As the result of classification of the decisional capacity and the difference of opinion regarding medical care, the most frequent category was 25 cases (41.7%) of “uncertain decisional capacity,” and 23 cases (38.3%) of “withholding of decision-making.” A chi-square analysis was performed on presence of decisional capacity and agreement in decision-making, yielding a statistically significant difference (p < 0.05). The CEC consultants’ reasoning was based on “patient’s preference was ambiguous,” “validity of family as a surrogate,” “estimation of patient preference,” and “patient’s best interest,” whereas the CEC client’s reasoning was based on “consistent family preference was shown/not shown” and “appropriate therapeutic methods to manage patient safety.” Conclusion Differences in opinions were found in cases classified according to decisional capacity. Furthermore, the reasoning behind judgments differed between CEC clients and CEC consultants. The reasoning of CEC consultants was critical and reflective, while for clients it was situational and pragmatic. PMID:24592932

Case based reasoning in criminal intelligence using forensic case data.

PubMed

Ribaux, O; Margot, P

2003-01-01

A model that is based on the knowledge of experienced investigators in the analysis of serial crime is suggested to bridge a gap between technology and methodology. Its purpose is to provide a solid methodology for the analysis of serial crimes that supports decision making in the deployment of resources, either by guiding proactive policing operations or helping the investigative process. Formalisation has helped to derive a computerised system that efficiently supports the reasoning processes in the analysis of serial crime. This novel approach fully integrates forensic science data.

Case-Based Plan Recognition Using Action Sequence Graphs

DTIC Science & Technology

2014-10-01

resized as necessary. Similarly, trace- based reasoning (Zarka et al., 2013) and episode -based reasoning (Sánchez-Marré, 2005) store fixed-length...is a goal state of Π, where satisfies has the same semantics as originally laid out in Ghallab, Nau & Traverso (2004). Action 0 is ...Although there are syntactic similarities between planning encoding graphs and action sequence graphs, important semantic differences exist because the

An ontological case base engineering methodology for diabetes management.

PubMed

El-Sappagh, Shaker H; El-Masri, Samir; Elmogy, Mohammed; Riad, A M; Saddik, Basema

2014-08-01

Ontology engineering covers issues related to ontology development and use. In Case Based Reasoning (CBR) system, ontology plays two main roles; the first as case base and the second as domain ontology. However, the ontology engineering literature does not provide adequate guidance on how to build, evaluate, and maintain ontologies. This paper proposes an ontology engineering methodology to generate case bases in the medical domain. It mainly focuses on the research of case representation in the form of ontology to support the case semantic retrieval and enhance all knowledge intensive CBR processes. A case study on diabetes diagnosis case base will be provided to evaluate the proposed methodology.

A robot sets a table: a case for hybrid reasoning with different types of knowledge

NASA Astrophysics Data System (ADS)

Mansouri, Masoumeh; Pecora, Federico

2016-09-01

An important contribution of AI to Robotics is the model-centred approach, whereby competent robot behaviour stems from automated reasoning in models of the world which can be changed to suit different environments, physical capabilities and tasks. However models need to capture diverse (and often application-dependent) aspects of the robot's environment and capabilities. They must also have good computational properties, as robots need to reason while they act in response to perceived context. In this article, we investigate the use of a meta-CSP-based technique to interleave reasoning in diverse knowledge types. We reify the approach through a robotic waiter case study, for which a particular selection of spatial, temporal, resource and action KR formalisms is made. Using this case study, we discuss general principles pertaining to the selection of appropriate KR formalisms and jointly reasoning about them. The resulting integration is evaluated both formally and experimentally on real and simulated robotic platforms.

Reasonable Accommodation Information Tracking System

EPA Pesticide Factsheets

The Reasonable Accommodation Information Tracking System (RAITS) is a case management system that allows the National Reasonable Accommodation Coordinator (NRAC) and the Local Reasonable Accommodation Coordinators (LORAC) to manage information related to Reasonable Accommodation (RA) requests. It provides a data base system in compliance with Executive Order 13164 and required by the Equal Employment Opportunity Commission (EEOC) Regulations and American Federation of Government Employees (AFGE) Bargaining Unit as described in the AFGE National Reasonable Accommodation Procedures. It is a tool that was internally developed in Lotus Notes to track requests for reasonable accommodation and was custom-configured to meet EPA's specific needs and infrastructure.

Implementation of a Clinical Reasoning Course in the Internal Medicine trimester of the final year of undergraduate medical training and its effect on students' case presentation and differential diagnostic skills.

PubMed

Harendza, Sigrid; Krenz, Ingo; Klinge, Andreas; Wendt, Ulrike; Janneck, Matthias

2017-01-01

Background: Clinical reasoning, comprising the processes of clinical thinking, which form the basis of medical decisions, constitutes a central competence in the clinical routine on which diagnostic and therapeutic steps are based. In medical curricula in Germany, clinical reasoning is currently taught explicitly only to a small extend. Therefore, the aim of this project was to develop and implement a clinical reasoning course in the final year of undergraduate medical training. Project description: A clinical reasoning course with six learning units and 18 learning objectives was developed, which was taught by two to four instructors on the basis of 32 paper cases from the clinical practice of the instructors. In the years 2011 to 2013, the course of eight weeks with two hours per week was taught seven times. Before the first and after the last seminar, the participating students filled out a self-assessment questionnaire with a 6-point Likert scale regarding eight different clinical reasoning skills. At the same times, they received a patient case with the assignment to prepare a case presentation and differential diagnoses. Results: From 128 participating students altogether, 42 complete data sets were available. After the course, participants assessed themselves significantly better than before the course in all eight clinical reasoning skills, for example in "Summarizing and presentation of a paper case" or in the "Skill to enumerate differential diagnoses" (p<0.05). The greatest increase occurred in the skill to recognize typical cognitive errors in medicine and to identify risk situations for their occurrence (pre: 2.98±0.92 and retro-pre: 2.64±1.01, respectively, versus post: 4.38±0.88). Based on the ratio of number of words used per keywords used the problem presentation of the paper case was significantly more focused after the course (p=0.011). A significant increase in the number of gathered differential diagnoses was not detected after the course. Conclusion: The newly developed and established Clinical Reasoning Course leads to a gain in the desired skills from the students' self-assessment perspective and to a more structured case presentation. To establish better options to exercise clinical reasoning, a longitudinal implementation in the medical curriculum seems to be desirable. Faculty training would be useful to implement the concept as standardized as possible.

Promoting student case creation to enhance instruction of clinical reasoning skills: a pilot feasibility study.

PubMed

Chandrasekar, Hamsika; Gesundheit, Neil; Nevins, Andrew B; Pompei, Peter; Bruce, Janine; Merrell, Sylvia Bereknyei

2018-01-01

It is a common educational practice for medical students to engage in case-based learning (CBL) exercises by working through clinical cases that have been developed by faculty. While such faculty-developed exercises have educational strengths, there are at least two major drawbacks to learning by this method: the number and diversity of cases is often limited; and students decrease their engagement with CBL cases as they grow accustomed to the teaching method. We sought to explore whether student case creation can address both of these limitations. We also compared student case creation to traditional clinical reasoning sessions in regard to tutorial group effectiveness, perceived gains in clinical reasoning, and quality of student-faculty interaction. Ten first-year medical students participated in a feasibility study wherein they worked in small groups to develop their own patient case around a preassigned diagnosis. Faculty provided feedback on case quality afterwards. Students completed pre- and post-self-assessment surveys. Students and faculty also participated in separate focus groups to compare their case creation experience to traditional CBL sessions. Students reported high levels of team engagement and peer learning, as well as increased ownership over case content and understanding of clinical reasoning nuances. However, students also reported decreases in student-faculty interaction and the use of visual aids ( P < 0.05). The results of our feasibility study suggest that student-generated cases can be a valuable adjunct to traditional clinical reasoning instruction by increasing content ownership, encouraging student-directed learning, and providing opportunities to explore clinical nuances. However, these gains may reduce student-faculty interaction. Future studies may be able to identify an improved model of faculty participation, the ideal timing for incorporation of this method in a medical curriculum, and a more rigorous assessment of the impact of student case creation on the development of clinical reasoning skills.

Promoting student case creation to enhance instruction of clinical reasoning skills: a pilot feasibility study

PubMed Central

Chandrasekar, Hamsika; Gesundheit, Neil; Nevins, Andrew B; Pompei, Peter; Bruce, Janine; Merrell, Sylvia Bereknyei

2018-01-01

Background It is a common educational practice for medical students to engage in case-based learning (CBL) exercises by working through clinical cases that have been developed by faculty. While such faculty-developed exercises have educational strengths, there are at least two major drawbacks to learning by this method: the number and diversity of cases is often limited; and students decrease their engagement with CBL cases as they grow accustomed to the teaching method. We sought to explore whether student case creation can address both of these limitations. We also compared student case creation to traditional clinical reasoning sessions in regard to tutorial group effectiveness, perceived gains in clinical reasoning, and quality of student–faculty interaction. Methods Ten first-year medical students participated in a feasibility study wherein they worked in small groups to develop their own patient case around a preassigned diagnosis. Faculty provided feedback on case quality afterwards. Students completed pre- and post-self-assessment surveys. Students and faculty also participated in separate focus groups to compare their case creation experience to traditional CBL sessions. Results Students reported high levels of team engagement and peer learning, as well as increased ownership over case content and understanding of clinical reasoning nuances. However, students also reported decreases in student–faculty interaction and the use of visual aids (P < 0.05). Conclusion The results of our feasibility study suggest that student-generated cases can be a valuable adjunct to traditional clinical reasoning instruction by increasing content ownership, encouraging student-directed learning, and providing opportunities to explore clinical nuances. However, these gains may reduce student–faculty interaction. Future studies may be able to identify an improved model of faculty participation, the ideal timing for incorporation of this method in a medical curriculum, and a more rigorous assessment of the impact of student case creation on the development of clinical reasoning skills. PMID:29692641

Case-based clinical reasoning in feline medicine: 1: Intuitive and analytical systems.

PubMed

Canfield, Paul J; Whitehead, Martin L; Johnson, Robert; O'Brien, Carolyn R; Malik, Richard

2016-01-01

This is Article 1 of a three-part series on clinical reasoning that encourages practitioners to explore and understand how they think and make case-based decisions. It is hoped that, in the process, they will learn to trust their intuition but, at the same time, put in place safeguards to diminish the impact of bias and misguided logic on their diagnostic decision-making. This first article discusses the relative merits and shortcomings of System 1 thinking (immediate and unconscious) and System 2 thinking (effortful and analytical). Articles 2 and 3, to appear in the March and May 2016 issues of JFMS, respectively, will examine managing cognitive error, and use of heuristics (mental short cuts) and illness scripts in diagnostic reasoning. © The Author(s) 2016.

"For Some Reason, I'm Just Tired": Women Domestic Workers Persisting in Community-Based Programmes

ERIC Educational Resources Information Center

Cuban, Sondra

2007-01-01

A study of women migrant domestic workers in the USA and their reasons for participating and persisting in community-based literacy and ESOL programmes is presented. Case studies and themes were developed about the women's experiences of work life and how it connected to their programme participation. The findings revealed that the women had…

Applying temporal abstraction and case-based reasoning to predict approaching influenza waves.

PubMed

Schmidt, Rainer; Gierl, Lothar

2002-01-01

The goal of the TeCoMed project is to send early warnings against forthcoming waves or even epidemics of infectious diseases, especially of influenza, to interested practitioners, pharmacists etc. in the German federal state Mecklenburg-Western Pomerania. The forecast of these waves is based on written confirmations of unfitness for work of the main German health insurance company. Since influenza waves are difficult to predict because of their cyclic but not regular behaviour, statistical methods based on the computation of mean values are not helpful. Instead, we have developed a prognostic model that makes use of similar former courses. Our method combines Case-based Reasoning with Temporal Abstraction to decide whether early warning is appropriate.

Design of a Golf Swing Injury Detection and Evaluation open service platform with Ontology-oriented clustering case-based reasoning mechanism.

PubMed

Ku, Hao-Hsiang

2015-01-01

Nowadays, people can easily use a smartphone to get wanted information and requested services. Hence, this study designs and proposes a Golf Swing Injury Detection and Evaluation open service platform with Ontology-oritened clustering case-based reasoning mechanism, which is called GoSIDE, based on Arduino and Open Service Gateway initative (OSGi). GoSIDE is a three-tier architecture, which is composed of Mobile Users, Application Servers and a Cloud-based Digital Convergence Server. A mobile user is with a smartphone and Kinect sensors to detect the user's Golf swing actions and to interact with iDTV. An application server is with Intelligent Golf Swing Posture Analysis Model (iGoSPAM) to check a user's Golf swing actions and to alter this user when he is with error actions. Cloud-based Digital Convergence Server is with Ontology-oriented Clustering Case-based Reasoning (CBR) for Quality of Experiences (OCC4QoE), which is designed to provide QoE services by QoE-based Ontology strategies, rules and events for this user. Furthermore, GoSIDE will automatically trigger OCC4QoE and deliver popular rules for a new user. Experiment results illustrate that GoSIDE can provide appropriate detections for Golfers. Finally, GoSIDE can be a reference model for researchers and engineers.

Expert system for web based collaborative CAE

NASA Astrophysics Data System (ADS)

Hou, Liang; Lin, Zusheng

2006-11-01

An expert system for web based collaborative CAE was developed based on knowledge engineering, relational database and commercial FEA (Finite element analysis) software. The architecture of the system was illustrated. In this system, the experts' experiences, theories and typical examples and other related knowledge, which will be used in the stage of pre-process in FEA, were categorized into analysis process and object knowledge. Then, the integrated knowledge model based on object-oriented method and rule based method was described. The integrated reasoning process based on CBR (case based reasoning) and rule based reasoning was presented. Finally, the analysis process of this expert system in web based CAE application was illustrated, and an analysis example of a machine tool's column was illustrated to prove the validity of the system.

An Intelligent Case-Based Help Desk Providing Web-Based Support for EOSDIS Customers

NASA Technical Reports Server (NTRS)

Mitchell, Christine M.; Thurman, David A.

1998-01-01

This paper describes a project that extends the concept of help desk automation by offering World Wide Web access to a case-based help desk. It explores the use of case-based reasoning and cognitive engineering models to create an 'intelligent' help desk system, one that learns. It discusses the AutoHelp architecture for such a help desk and summarizes the technologies used to create a help desk for NASA data users.

Retrieval with Clustering in a Case-Based Reasoning System for Radiotherapy Treatment Planning

NASA Astrophysics Data System (ADS)

Khussainova, Gulmira; Petrovic, Sanja; Jagannathan, Rupa

2015-05-01

Radiotherapy treatment planning aims to deliver a sufficient radiation dose to cancerous tumour cells while sparing healthy organs in the tumour surrounding area. This is a trial and error process highly dependent on the medical staff's experience and knowledge. Case-Based Reasoning (CBR) is an artificial intelligence tool that uses past experiences to solve new problems. A CBR system has been developed to facilitate radiotherapy treatment planning for brain cancer. Given a new patient case the existing CBR system retrieves a similar case from an archive of successfully treated patient cases with the suggested treatment plan. The next step requires adaptation of the retrieved treatment plan to meet the specific demands of the new case. The CBR system was tested by medical physicists for the new patient cases. It was discovered that some of the retrieved cases were not suitable and could not be adapted for the new cases. This motivated us to revise the retrieval mechanism of the existing CBR system by adding a clustering stage that clusters cases based on their tumour positions. A number of well-known clustering methods were investigated and employed in the retrieval mechanism. Results using real world brain cancer patient cases have shown that the success rate of the new CBR retrieval is higher than that of the original system.

Implementation of a Clinical Reasoning Course in the Internal Medicine trimester of the final year of undergraduate medical training and its effect on students' case presentation and differential diagnostic skills

PubMed Central

Harendza, Sigrid; Krenz, Ingo; Klinge, Andreas; Wendt, Ulrike; Janneck, Matthias

2017-01-01

Background: Clinical reasoning, comprising the processes of clinical thinking, which form the basis of medical decisions, constitutes a central competence in the clinical routine on which diagnostic and therapeutic steps are based. In medical curricula in Germany, clinical reasoning is currently taught explicitly only to a small extend. Therefore, the aim of this project was to develop and implement a clinical reasoning course in the final year of undergraduate medical training. Project description: A clinical reasoning course with six learning units and 18 learning objectives was developed, which was taught by two to four instructors on the basis of 32 paper cases from the clinical practice of the instructors. In the years 2011 to 2013, the course of eight weeks with two hours per week was taught seven times. Before the first and after the last seminar, the participating students filled out a self-assessment questionnaire with a 6-point Likert scale regarding eight different clinical reasoning skills. At the same times, they received a patient case with the assignment to prepare a case presentation and differential diagnoses. Results: From 128 participating students altogether, 42 complete data sets were available. After the course, participants assessed themselves significantly better than before the course in all eight clinical reasoning skills, for example in “Summarizing and presentation of a paper case” or in the “Skill to enumerate differential diagnoses” (p<0.05). The greatest increase occurred in the skill to recognize typical cognitive errors in medicine and to identify risk situations for their occurrence (pre: 2.98±0.92 and retro-pre: 2.64±1.01, respectively, versus post: 4.38±0.88). Based on the ratio of number of words used per keywords used the problem presentation of the paper case was significantly more focused after the course (p=0.011). A significant increase in the number of gathered differential diagnoses was not detected after the course. Conclusion: The newly developed and established Clinical Reasoning Course leads to a gain in the desired skills from the students’ self-assessment perspective and to a more structured case presentation. To establish better options to exercise clinical reasoning, a longitudinal implementation in the medical curriculum seems to be desirable. Faculty training would be useful to implement the concept as standardized as possible. PMID:29226234

Evidence in clinical reasoning: a computational linguistics analysis of 789,712 medical case summaries 1983-2012.

PubMed

Seidel, Bastian M; Campbell, Steven; Bell, Erica

2015-03-21

Better understanding of clinical reasoning could reduce diagnostic error linked to 8% of adverse medical events and 30% of malpractice cases. To a greater extent than the evidence-based movement, the clinical reasoning literature asserts the importance of practitioner intuition—unconscious elements of diagnostic reasoning. The study aimed to analyse the content of case report summaries in ways that explored the importance of an evidence concept, not only in relation to research literature but also intuition. The study sample comprised all 789,712 abstracts in English for case reports contained in the database PUBMED for the period 1 January 1983 to 31 December 2012. It was hypothesised that, if evidence and intuition concepts were viewed by these clinical authors as essential to understanding their case reports, they would be more likely to be found in the abstracts. Computational linguistics software was used in 1) concept mapping of 21,631,481 instances of 201 concepts, and 2) specific concept analyses examining 200 paired co-occurrences for 'evidence' and research 'literature' concepts. 'Evidence' is a fundamentally patient-centred, intuitive concept linked to less common concepts about underlying processes, suspected disease mechanisms and diagnostic hunches. In contrast, the use of research literature in clinical reasoning is linked to more common reasoning concepts about specific knowledge and descriptions or presenting features of cases. 'Literature' is by far the most dominant concept, increasing in relevance since 2003, with an overall relevance of 13% versus 5% for 'evidence' which has remained static. The fact that the least present types of reasoning concepts relate to diagnostic hunches to do with underlying processes, such as what is suspected, raises questions about whether intuitive practitioner evidence-making, found in a constellation of dynamic, process concepts, has become less important. The study adds support to the existing corpus of research on clinical reasoning, by suggesting that intuition involves a complex constellation of concepts important to how the construct of evidence is understood. The list of concepts the study generated offers a basis for reflection on the nature of evidence in diagnostic reasoning and the importance of intuition to that reasoning.

Priority-setting and hospital strategic planning: a qualitative case study.

PubMed

Martin, Douglas; Shulman, Ken; Santiago-Sorrell, Patricia; Singer, Peter

2003-10-01

To describe and evaluate the priority-setting element of a hospital's strategic planning process. Qualitative case study and evaluation against the conditions of 'accountability for reasonableness' of a strategic planning process at a large urban university-affiliated hospital. The hospital's strategic planning process met the conditions of 'accountability for reasonableness' in large part. Specifically: the hospital based its decisions on reasons (both information and criteria) that the participants felt were relevant to the hospital; the number and type of participants were very extensive; the process, decisions and reasons were well communicated throughout the organization, using multiple communication vehicles; and the process included an ethical framework linked to an effort to evaluate and improve the process. However, there were opportunities to improve the process, particularly by giving participants more time to absorb the information relevant to priority-setting decisions, more time to take difficult decisions and some means to appeal or revise decisions. A case study linked to an evaluation using 'accountability for reasonableness' can serve to improve priority-setting in the context of hospital strategic planning.

The harms of enhancement and the conclusive reasons view.

PubMed

Douglas, Thomas

2015-01-01

Many critics of bioenhancement go to considerable lengths to establish the existence of reasons against pursuing bioenhancements but do little to establish the absence of reasons in favor. This suggests that they accept what Allen Buchanan has called the conclusive reasons view (CRV). According to this view, our reasons against bioenhancement are obviously decisive, so there is no need to balance them against countervailing reasons. Buchanan criticizes the CRV by showing that the reasons most commonly adduced against bioenhancement are not decisive, or, at least, not obviously so. In this article, I suggest that both Buchanan and the authors to whom he is responding underestimate the strength of the case for the CRV. There are, I argue, harm-based reasons against bioenhancement that provide stronger support to the CRV than the reasons that have most often been adduced by critics of enhancement. However, I then argue that even these harm-based reasons are not obviously decisive. Thus, I ultimately agree with Buchanan about the falsity of the CRV, though I disagree with him about the reasons for its falsity.

Script-theory virtual case: A novel tool for education and research.

PubMed

Hayward, Jake; Cheung, Amandy; Velji, Alkarim; Altarejos, Jenny; Gill, Peter; Scarfe, Andrew; Lewis, Melanie

2016-11-01

Context/Setting: The script theory of diagnostic reasoning proposes that clinicians evaluate cases in the context of an "illness script," iteratively testing internal hypotheses against new information eventually reaching a diagnosis. We present a novel tool for teaching diagnostic reasoning to undergraduate medical students based on an adaptation of script theory. We developed a virtual patient case that used clinically authentic audio and video, interactive three-dimensional (3D) body images, and a simulated electronic medical record. Next, we used interactive slide bars to record respondents' likelihood estimates of diagnostic possibilities at various stages of the case. Responses were dynamically compared to data from expert clinicians and peers. Comparative frequency distributions were presented to the learner and final diagnostic likelihood estimates were analyzed. Detailed student feedback was collected. Over two academic years, 322 students participated. Student diagnostic likelihood estimates were similar year to year, but were consistently different from expert clinician estimates. Student feedback was overwhelmingly positive: students found the case was novel, innovative, clinically authentic, and a valuable learning experience. We demonstrate the successful implementation of a novel approach to teaching diagnostic reasoning. Future study may delineate reasoning processes associated with differences between novice and expert responses.

Case-based Reasoning for Automotive Engine Performance Tune-up

NASA Astrophysics Data System (ADS)

Vong, C. M.; Huang, H.; Wong, P. K.

2010-05-01

The automotive engine performance tune-up is greatly affected by the calibration of its electronic control unit (ECU). The ECU calibration is traditionally done by trial-and-error method. This traditional method consumes a large amount of time and money because of a large number of dynamometer tests. To resolve this problem, case based reasoning (CBR) is employed, so that an existing and effective ECU setup can be adapted to fit another similar class of engines. The adaptation procedure is done through a more sophisticated step called case-based adaptation (CBA) [1, 2]. CBA is an effective knowledge management tool, which can interactively learn the expert adaptation knowledge. The paper briefly reviews the methodologies of CBR and CBA. Then the application to ECU calibration is described via a case study. With CBR and CBA, the efficiency of calibrating an ECU can be enhanced. A prototype system has also been developed to verify the usefulness of CBR in ECU calibration.

A Novel Method of Case Representation and Retrieval in CBR for E-Learning

ERIC Educational Resources Information Center

Khamparia, Aditya; Pandey, Babita

2017-01-01

In this paper we have discussed a novel method which has been developed for representation and retrieval of cases in case based reasoning (CBR) as a part of e-learning system which is based on various student features. In this approach we have integrated Artificial Neural Network (ANN) with Data mining (DM) and CBR. ANN is used to find the…

Learning material recommendation based on case-based reasoning similarity scores

NASA Astrophysics Data System (ADS)

Masood, Mona; Mokmin, Nur Azlina Mohamed

2017-10-01

A personalized learning material recommendation is important in any Intelligent Tutoring System (ITS). Case-based Reasoning (CBR) is an Artificial Intelligent Algorithm that has been widely used in the development of ITS applications. This study has developed an ITS application that applied the CBR algorithm in the development process. The application has the ability to recommend the most suitable learning material to the specific student based on information in the student profile. In order to test the ability of the application in recommending learning material, two versions of the application were created. The first version displayed the most suitable learning material and the second version displayed the least preferable learning material. The results show the application has successfully assigned the students to the most suitable learning material.

Physiological sensor signals classification for healthcare using sensor data fusion and case-based reasoning.

PubMed

Begum, Shahina; Barua, Shaibal; Ahmed, Mobyen Uddin

2014-07-03

Today, clinicians often do diagnosis and classification of diseases based on information collected from several physiological sensor signals. However, sensor signal could easily be vulnerable to uncertain noises or interferences and due to large individual variations sensitivity to different physiological sensors could also vary. Therefore, multiple sensor signal fusion is valuable to provide more robust and reliable decision. This paper demonstrates a physiological sensor signal classification approach using sensor signal fusion and case-based reasoning. The proposed approach has been evaluated to classify Stressed or Relaxed individuals using sensor data fusion. Physiological sensor signals i.e., Heart Rate (HR), Finger Temperature (FT), Respiration Rate (RR), Carbon dioxide (CO2) and Oxygen Saturation (SpO2) are collected during the data collection phase. Here, sensor fusion has been done in two different ways: (i) decision-level fusion using features extracted through traditional approaches; and (ii) data-level fusion using features extracted by means of Multivariate Multiscale Entropy (MMSE). Case-Based Reasoning (CBR) is applied for the classification of the signals. The experimental result shows that the proposed system could classify Stressed or Relaxed individual 87.5% accurately compare to an expert in the domain. So, it shows promising result in the psychophysiological domain and could be possible to adapt this approach to other relevant healthcare systems.

Protection as care: moral reasoning and moral orientation among ethnically and socioeconomically diverse older women.

PubMed

Dakin, Emily

2014-01-01

This study examined moral reasoning among ethnically and socioeconomically diverse older women based on the care and justice moral orientations reflecting theoretical frameworks developed by Carol Gilligan and Lawrence Kohlberg, respectively. A major gap in this area of research and theory development has been the lack of examination of moral reasoning in later life. This study addressed this gap by assessing socioeconomically and ethnically diverse older women's reasoning in response to ethical dilemmas showing conflict between autonomy, representative of Kohlberg's justice orientation, and protection, representative of Gilligan's care orientation. The dilemmas used in this study came from adult protective services (APS), the U.S. system that investigates and intervenes in cases of elder abuse and neglect. Subjects were 88 African American, Latina, and Caucasian women age 60 or over from varying socioeconomic status backgrounds who participated in eight focus groups. Overall, participants favored protection over autonomy in responding to the case scenarios. Their reasoning in responding to these dilemmas reflected an ethic of care and responsibility and a recognition of the limitations of autonomy. This reasoning is highly consistent with the care orientation. Variations in the overall ethic of care and responsibility based on ethnicity and SES also are discussed. Copyright © 2013. Published by Elsevier Inc.

Discovering relevance knowledge in data: a growing cell structures approach.

PubMed

Azuaje, F; Dubitzky, W; Black, N; Adamson, K

2000-01-01

Both information retrieval and case-based reasoning systems rely on effective and efficient selection of relevant data. Typically, relevance in such systems is approximated by similarity or indexing models. However, the definition of what makes data items similar or how they should be indexed is often nontrivial and time-consuming. Based on growing cell structure artificial neural networks, this paper presents a method that automatically constructs a case retrieval model from existing data. Within the case-based reasoning (CBR) framework, the method is evaluated for two medical prognosis tasks, namely, colorectal cancer survival and coronary heart disease risk prognosis. The results of the experiments suggest that the proposed method is effective and robust. To gain a deeper insight and understanding of the underlying mechanisms of the proposed model, a detailed empirical analysis of the models structural and behavioral properties is also provided.

16 CFR 306.5 - Automotive fuel rating.

Code of Federal Regulations, 2011 CFR

2011-01-01

... fuels other than biodiesel blends and biomass-based diesel blends, you must possess a reasonable basis... alternative liquid automotive fuel that you must disclose. In the case of biodiesel blends, you must possess a reasonable basis, consisting of competent and reliable evidence, for the percentage of biodiesel contained in...

Male/Female Differences in Perceptions and Effects of Hostile Environment Sexual Harassment: "Reasonable" Assumptions?

ERIC Educational Resources Information Center

Thacker, Rebecca A.; Gohmann, Stephen F.

1993-01-01

Discusses the "reasonable woman" standard in sexual harassment cases and gender-based differences in defining harassment. Investigates the issue of these differences in the emotional and psychological effects of hostile environments, using data from a survey of 8,523 public employees. (SK)

GhostWriter-2.0: Product Reviews with Case-Based Support

NASA Astrophysics Data System (ADS)

Bridge, Derek; Healy, Paul

A lot of user-generated content on the Web takes the form of records of personal experiences. Case-Based Reasoning offers a way of helping one user to reuse another's experiences from the Web. In this paper, we present GhostWriter-2.0, a Case-Based Reasoning system that supports a user who is writing a product review. GhostWriter-2.0 makes suggestions to the user, in the form of short phrases that are mined from other reviews. The purpose of the suggestions is to prompt the user to write a more comprehensive and helpful review than she might otherwise have done. We explain how GhostWriter-2.0's case base is populated with relevant and helpful reviews from Amazon. We show how it extracts and scores phrases in these reviews to decide which to suggest to the user.We report a trial with real users, in which users made greater use of GhostWriter-2.0's suggested phrases than they did of phrases suggested by a system that used a more random form of selection.

Case-Based Reasoning in Mixed Paradigm Settings and with Learning

DTIC Science & Technology

1994-04-30

Learning Prototypical Cases OFF-BROADWAY, MCI and RMHC -* are three CBR-ML systems that learn case prototypes. We feel that methods that enable the...at Irvine Machine Learning Repository, including heart disease and breast cancer databases. OFF-BROADWAY, MCI and RMHC -* made the following notable

Case-based clinical reasoning in feline medicine: 3: Use of heuristics and illness scripts.

PubMed

Whitehead, Martin L; Canfield, Paul J; Johnson, Robert; O'Brien, Carolyn R; Malik, Richard

2016-05-01

This is Article 3 of a three-part series on clinical reasoning that encourages practitioners to explore and understand how they think and make case-based decisions. It is hoped that, in the process, they will learn to trust their intuition but, at the same time, put in place safeguards to diminish the impact of bias and misguided logic on their diagnostic decision-making. Article 1, published in the January 2016 issue of JFMS, discussed the relative merits and shortcomings of System 1 thinking (immediate and unconscious) and System 2 thinking (effortful and analytical). In Article 2, published in the March 2016 issue, ways of managing cognitive error, particularly the negative impact of bias, in making a diagnosis were examined. This final article explores the use of heuristics (mental short cuts) and illness scripts in diagnostic reasoning. © The Author(s) 2016.

Case-based clinical reasoning in feline medicine: 2: Managing cognitive error.

PubMed

Canfield, Paul J; Whitehead, Martin L; Johnson, Robert; O'Brien, Carolyn R; Malik, Richard

2016-03-01

This is Article 2 of a three-part series on clinical reasoning that encourages practitioners to explore and understand how they think and make case-based decisions. It is hoped that, in the process, they will learn to trust their intuition but, at the same time, put in place safeguards to diminish the impact of bias and misguided logic on their diagnostic decision-making. Article 1, published in the January 2016 issue of JFMS, discussed the relative merits and shortcomings of System 1 thinking (immediate and unconscious) and System 2 thinking (effortful and analytical). This second article examines ways of managing cognitive error, particularly the negative impact of bias, when making a diagnosis. Article 3, to appear in the May 2016 issue, explores the use of heuristics (mental short cuts) and illness scripts in diagnostic reasoning. © The Author(s) 2016.

Major Anthropogenic Causes for and Outcomes of Wild Animal Presentation to a Wildlife Clinic in East Tennessee, USA, 2000–2011

PubMed Central

Schenk, Ashley N.; Souza, Marcy J.

2014-01-01

To determine the reasons for presentation and outcome of wildlife cases in East Tennessee, a retrospective analysis was performed using 14,303 records from cases presented to the wildlife clinic of the University of Tennessee Veterinary Teaching Hospital between 2000 and 2011. The cases were first categorized into amphibian/non-avian reptile, mammal, or avian and then classified into groups based on the primary admitting/presenting sign. There are a variety of reasons animals were presented to the clinic, and some were directly or indirectly anthropogenic in origin, including cat related, dog related, hit by automobile, and other human encounters leading to trauma; of the cases reviewed, 4,443 (31.1%) presented for one of these 4 reasons. Overall case fatality risk in regard to these 4 admitting/presenting signs was 0.519 for the amphibian/non-avian reptile cases, 0.675 for mammal cases, and 0.687 for avian cases. This study confirms the importance of monitoring wildlife morbidity and mortality and of focusing efforts to reduce the anthropogenic threat on native habitats and resident wildlife populations. PMID:24686490

Emotional reasoning and parent-based reasoning in non-clinical children, and their prospective relationships with anxiety symptoms.

PubMed

Morren, Mattijn; Muris, Peter; Kindt, Merel; Schouten, Erik; van den Hout, Marcel

2008-12-01

Emotional and parent-based reasoning refer to the tendency to rely on personal or parental anxiety response information rather than on objective danger information when estimating the dangerousness of a situation. This study investigated the prospective relationships of emotional and parent-based reasoning with anxiety symptoms in a sample of non-clinical children aged 8-14 years (n = 122). Children completed the anxiety subscales of the Revised Children's Anxiety and Depression Scale (Muris et al. Clin Psychol Psychother 9:430-442, 2002) and provided danger ratings of scenarios that systematically combined objective danger and objective safety information with anxiety-response and positive-response information. These measurements were repeated 10 months later (range 8-11 months). Emotional and parent-based reasoning effects emerged on both occasions. In addition, both effects were modestly stable, but only in case of objective safety. Evidence was found that initial anxiety levels were positively related to emotional reasoning 10 months later. In addition, initial levels of emotional reasoning were positively related to anxiety at a later time, but only when age was taken into account. That is, this relationship changed with increasing age from positive to negative. No significant prospective relationships emerged between anxiety and parent-based reasoning. As yet the clinical implications of these findings are limited, although preliminary evidence indicates that interpretation bias can be modified to decrease anxiety.

Using a Recommendation System to Support Problem Solving and Case-Based Reasoning Retrieval

ERIC Educational Resources Information Center

Tawfik, Andrew A.; Alhoori, Hamed; Keene, Charles Wayne; Bailey, Christian; Hogan, Maureen

2018-01-01

In case library learning environments, learners are presented with an array of narratives that can be used to guide their problem solving. However, according to theorists, learners struggle to identify and retrieve the optimal case to solve a new problem. Given the challenges novice face during case retrieval, recommender systems can be embedded…

Case-Based Planning: An Integrated Theory of Planning, Learning and Memory

DTIC Science & Technology

1986-10-01

rtvoeoo oldo II nocomtmry and Idonltly by block numbor) planning Case-based reasoning learning Artificial Intelligence 20. ABSTRACT (Conllnum...Computational Model of Analogical Prob- lem Solving, Proceedings of the Seventh International Joint Conference on Artificial Intelligence ...Understanding and Generalizing Plans., Proceedings of the Eight Interna- tional Joint Conference on Artificial Intelligence , IJCAI, Karlsrhue, Germany

[Reasons for consulting related to skin-bleaching products used by 104 women in Brazzaville].

PubMed

Gathse, A; Obengui; Ibara, J R

2005-12-01

A prospective survey has been carried out in the Brazzaville (Congo) dermatology service in order to specify dermatosis linked to the use of bleaching agents in 104 Congolese women consulting for this problem. The used bleaching agents were topical corticoids based products for 40 cases, hydroquinone for 32 cases, and hydroquinone associated with topical dermocorticoids for 32 cases. Acne was the most frequent motive for consulting (24%), followed by the paradoxical peri-orbital hyperpigmentation (21.1%), profuse mycosis (16.3%) and vibices(8.6%). The results of this survey were not superimposable to those of Dakar where infectious dermatosis were the first reason for consulting.

Finding clusters of similar events within clinical incident reports: a novel methodology combining case based reasoning and information retrieval

PubMed Central

Tsatsoulis, C; Amthauer, H

2003-01-01

A novel methodological approach for identifying clusters of similar medical incidents by analyzing large databases of incident reports is described. The discovery of similar events allows the identification of patterns and trends, and makes possible the prediction of future events and the establishment of barriers and best practices. Two techniques from the fields of information science and artificial intelligence have been integrated—namely, case based reasoning and information retrieval—and very good clustering accuracies have been achieved on a test data set of incident reports from transfusion medicine. This work suggests that clustering should integrate the features of an incident captured in traditional form based records together with the detailed information found in the narrative included in event reports. PMID:14645892

Advantages of video trigger in problem-based learning.

PubMed

Chan, Lap Ki; Patil, Nivritti G; Chen, Julie Y; Lam, Jamie C M; Lau, Chak S; Ip, Mary S M

2010-01-01

Traditionally, paper cases are used as 'triggers' to stimulate learning in problem-based learning (PBL). However, video may be a better medium because it preserves the original language, encourages the active extraction of information, avoids depersonalization of patients and allows direct observation of clinical consultations. In short, it exposes the students to the complexity of actual clinical problems. The study aims to find out whether students and facilitators who are accustomed to paper cases would prefer video triggers or paper cases and the reasons for their preference. After students and facilitators had completed a video PBL tutorial, their responses were measured by a structured questionnaire using a modified Likert scale. A total of 257 students (92%) and 26 facilitators (100%) responded. The majority of students and facilitators considered that using video triggers could enhance the students' observational powers and clinical reasoning, help them to integrate different information and better understand the cases and motivate them to learn. They found PBL using video triggers more interesting and preferred it to PBL using paper cases. Video triggers are preferred by both students and facilitators over paper cases in PBL.

Irrelevance Reasoning in Knowledge Based Systems

NASA Technical Reports Server (NTRS)

Levy, A. Y.

1993-01-01

This dissertation considers the problem of reasoning about irrelevance of knowledge in a principled and efficient manner. Specifically, it is concerned with two key problems: (1) developing algorithms for automatically deciding what parts of a knowledge base are irrelevant to a query and (2) the utility of relevance reasoning. The dissertation describes a novel tool, the query-tree, for reasoning about irrelevance. Based on the query-tree, we develop several algorithms for deciding what formulas are irrelevant to a query. Our general framework sheds new light on the problem of detecting independence of queries from updates. We present new results that significantly extend previous work in this area. The framework also provides a setting in which to investigate the connection between the notion of irrelevance and the creation of abstractions. We propose a new approach to research on reasoning with abstractions, in which we investigate the properties of an abstraction by considering the irrelevance claims on which it is based. We demonstrate the potential of the approach for the cases of abstraction of predicates and projection of predicate arguments. Finally, we describe an application of relevance reasoning to the domain of modeling physical devices.

University Teachers' Job Dissatisfaction: Application of Two-Factor Theory--A Case of Pakistani Education System

ERIC Educational Resources Information Center

Mir, Imran Anwar

2012-01-01

This qualitative case study presents the reasons of teachers' job dissatisfaction in the government educational institutes in Pakistan. This case study is based on the two factor theory of Herzberg. The results of this case study reveal four core factors that cause job dissatisfaction among teachers in the public sector universities in developing…

iCBLS: An interactive case-based learning system for medical education.

PubMed

Ali, Maqbool; Han, Soyeon Caren; Bilal, Hafiz Syed Muhammad; Lee, Sungyoung; Kang, Matthew Jee Yun; Kang, Byeong Ho; Razzaq, Muhammad Asif; Amin, Muhammad Bilal

2018-01-01

Medical students should be able to actively apply clinical reasoning skills to further their interpretative, diagnostic, and treatment skills in a non-obtrusive and scalable way. Case-Based Learning (CBL) approach has been receiving attention in medical education as it is a student-centered teaching methodology that exposes students to real-world scenarios that need to be solved using their reasoning skills and existing theoretical knowledge. In this paper, we propose an interactive CBL System, called iCBLS, which supports the development of collaborative clinical reasoning skills for medical students in an online environment. The iCBLS consists of three modules: (i) system administration (SA), (ii) clinical case creation (CCC) with an innovative semi-automatic approach, and (iii) case formulation (CF) through intervention of medical students' and teachers' knowledge. Two evaluations under the umbrella of the context/input/process/product (CIPP) model have been performed with a Glycemia study. The first focused on the system satisfaction, evaluated by 54 students. The latter aimed to evaluate the system effectiveness, simulated by 155 students. The results show a high success rate of 70% for students' interaction, 76.4% for group learning, 72.8% for solo learning, and 74.6% for improved clinical skills. Copyright © 2017 Elsevier B.V. All rights reserved.

DERMA: A Melanoma Diagnosis Platform Based on Collaborative Multilabel Analog Reasoning

PubMed Central

Golobardes, Elisabet; Corral, Guiomar; Puig, Susana; Malvehy, Josep

2014-01-01

The number of melanoma cancer-related death has increased over the last few years due to the new solar habits. Early diagnosis has become the best prevention method. This work presents a melanoma diagnosis architecture based on the collaboration of several multilabel case-based reasoning subsystems called DERMA. The system has to face up several challenges that include data characterization, pattern matching, reliable diagnosis, and self-explanation capabilities. Experiments using subsystems specialized in confocal and dermoscopy images have provided promising results for helping experts to assess melanoma diagnosis. PMID:24578629

What's in a Label? Is Diagnosis the Start or the End of Clinical Reasoning?

PubMed

Ilgen, Jonathan S; Eva, Kevin W; Regehr, Glenn

2016-04-01

Diagnostic reasoning has received substantial attention in the literature, yet what we mean by "diagnosis" may vary. Diagnosis can align with assignment of a "label," where a constellation of signs, symptoms, and test results is unified into a solution at a single point in time. This "diagnostic labeling" conceptualization is embodied in our case-based learning curricula, published case reports, and research studies, all of which treat diagnostic accuracy as the primary outcome. However, this conceptualization may oversimplify the richly iterative and evolutionary nature of clinical reasoning in many settings. Diagnosis can also represent a process of guiding one's thoughts by "making meaning" from data that are intrinsically dynamic, experienced idiosyncratically, negotiated among team members, and rich with opportunities for exploration. Thus, there are two complementary constructions of diagnosis: 1) the correct solution resulting from a diagnostic reasoning process, and 2) a dynamic aid to an ongoing clinical reasoning process. This article discusses the importance of recognizing these two conceptualizations of "diagnosis," outlines the unintended consequences of emphasizing diagnostic labeling as the primary goal of clinical reasoning, and suggests how framing diagnosis as an ongoing process of meaning-making might change how we think about teaching and assessing clinical reasoning.

Illness script development in pre-clinical education through case-based clinical reasoning training

PubMed Central

Keemink, Yvette; van Dijk, Savannah; ten Cate, Olle

2018-01-01

Objectives To assess illness script richness and maturity in preclinical students after they attended a specifically structured instructional format, i.e., a case based clinical reasoning (CBCR) course. Methods In a within-subject experimental design, medical students who had finished the CBCR course participated in an illness script experiment. In the first session, richness and maturity of students’ illness scripts for diseases discussed during the CBCR course were compared to illness script richness and maturity for similar diseases not included in the course. In the second session, diagnostic performance was tested, to test for differences between CBCR cases and non-CBCR cases. Scores on the CBCR course exam were related to both experimental outcomes. Results Thirty-two medical students participated. Illness script richness for CBCR diseases was almost 20% higher than for non-CBCR diseases, on average 14.47 (SD=3.25) versus 12.14 (SD=2.80), respectively (p<0.001). In addition, students provided more information on Enabling Conditions and less on Fault-related aspects of the disease. Diagnostic performance was better for the diseases discussed in the CBCR course, mean score 1.63 (SD=0.32) versus 1.15 (SD=0.29) for non-CBCR diseases (p<0.001). A significant correlation of exam results with recognition of CBCR cases was found (r=0.571, p<0.001), but not with illness script richness (r=–0.006, p=NS). Conclusions The CBCR-course fosters early development of clinical reasoning skills by increasing the illness script richness and diagnostic performance of pre-clinical students. However, these results are disease-specific and therefore we cannot conclude that students develop a more general clinical reasoning ability. PMID:29428911

Illness script development in pre-clinical education through case-based clinical reasoning training.

PubMed

Keemink, Yvette; Custers, Eugene J F M; van Dijk, Savannah; Ten Cate, Olle

2018-02-09

To assess illness script richness and maturity in preclinical students after they attended a specifically structured instructional format, i.e., a case based clinical reasoning (CBCR) course. In a within-subject experimental design, medical students who had finished the CBCR course participated in an illness script experiment. In the first session, richness and maturity of students' illness scripts for diseases discussed during the CBCR course were compared to illness script richness and maturity for similar diseases not included in the course. In the second session, diagnostic performance was tested, to test for differences between CBCR cases and non-CBCR cases. Scores on the CBCR course exam were related to both experimental outcomes. Thirty-two medical students participated. Illness script richness for CBCR diseases was almost 20% higher than for non-CBCR diseases, on average 14.47 (SD=3.25) versus 12.14 (SD=2.80), respectively (p<0.001). In addition, students provided more information on Enabling Conditions and less on Fault-related aspects of the disease. Diagnostic performance was better for the diseases discussed in the CBCR course, mean score 1.63 (SD=0.32) versus 1.15 (SD=0.29) for non-CBCR diseases (p<0.001). A significant correlation of exam results with recognition of CBCR cases was found (r=0.571, p<0.001), but not with illness script richness (r=-0.006, p=NS). The CBCR-course fosters early development of clinical reasoning skills by increasing the illness script richness and diagnostic performance of pre-clinical students. However, these results are disease-specific and therefore we cannot conclude that students develop a more general clinical reasoning ability.

Applications of artificial intelligence 1993: Knowledge-based systems in aerospace and industry; Proceedings of the Meeting, Orlando, FL, Apr. 13-15, 1993

NASA Technical Reports Server (NTRS)

Fayyad, Usama M. (Editor); Uthurusamy, Ramasamy (Editor)

1993-01-01

The present volume on applications of artificial intelligence with regard to knowledge-based systems in aerospace and industry discusses machine learning and clustering, expert systems and optimization techniques, monitoring and diagnosis, and automated design and expert systems. Attention is given to the integration of AI reasoning systems and hardware description languages, care-based reasoning, knowledge, retrieval, and training systems, and scheduling and planning. Topics addressed include the preprocessing of remotely sensed data for efficient analysis and classification, autonomous agents as air combat simulation adversaries, intelligent data presentation for real-time spacecraft monitoring, and an integrated reasoner for diagnosis in satellite control. Also discussed are a knowledge-based system for the design of heat exchangers, reuse of design information for model-based diagnosis, automatic compilation of expert systems, and a case-based approach to handling aircraft malfunctions.

Faith and reason and physician-assisted suicide.

PubMed

Kaczor, Christopher

1998-08-01

Aquinas's conception of the relationship of faith and reason calls into question the arguments and some of the conclusions advanced in contributions to the debate on physician-assisted suicide by David Thomasma and H. Tristram Engelhardt. An understanding of the nature of theology as based on revelation calls into question Thomasma's theological argument in favor of physician-assisted suicide based on the example of Christ and the martyrs. On the other hand, unaided reason calls into question his assumptions about the nature of death as in some cases a good for the human person. Finally, if Aquinas is right about the relationship of faith and reason, Engelhardt's sharp contrast between "Christian" and "secular" approaches to physician-assisted suicide needs reconsideration, although his conclusions about physician-assisted suicide would find support.

The GIS map coloring support decision-making system based on case-based reasoning and simulated annealing algorithm

NASA Astrophysics Data System (ADS)

Deng, Shuang; Xiang, Wenting; Tian, Yangge

2009-10-01

Map coloring is a hard task even to the experienced map experts. In the GIS project, usually need to color map according to the customer, which make the work more complex. With the development of GIS, more and more programmers join the project team, which lack the training of cartology, their coloring map are harder to meet the requirements of customer. From the experience, customers with similar background usually have similar tastes for coloring map. So, we developed a GIS color scheme decision-making system which can select color schemes of similar customers from case base for customers to select and adjust. The system is a BS/CS mixed system, the client side use JSP and make it possible for the system developers to go on remote calling of the colors scheme cases in the database server and communicate with customers. Different with general case-based reasoning, even the customers are very similar, their selection may have difference, it is hard to provide a "best" option. So, we select the Simulated Annealing Algorithm (SAA) to arrange the emergence order of different color schemes. Customers can also dynamically adjust certain features colors based on existing case. The result shows that the system can facilitate the communication between the designers and the customers and improve the quality and efficiency of coloring map.

Defaults, context, and knowledge: alternatives for OWL-indexed knowledge bases.

PubMed

Rector, A

2004-01-01

The new Web Ontology Language (OWL) and its Description Logic compatible sublanguage (OWL-DL) explicitly exclude defaults and exceptions, as do all logic based formalisms for ontologies. However, many biomedical applications appear to require default reasoning, at least if they are to be engineered in a maintainable way. Default reasoning has always been one of the great strengths of Frame systems such as Protégé. Resolving this conflict requires analysis of the different uses for defaults and exceptions. In some cases, alternatives can be provided within the OWL framework; in others, it appears that hybrid reasoning about a knowledge base of contingent facts built around the core ontology is necessary. Trade-offs include both human factors and the scaling of computational performance. The analysis presented here is based on the OpenGALEN experience with large scale ontologies using a formalism, GRAIL, which explicitly incorporates constructs for hybrid reasoning, numerous experiments with OWL, and initial work on combining OWL and Protégé.

PDA: A coupling of knowledge and memory for case-based reasoning

NASA Technical Reports Server (NTRS)

Bharwani, S.; Walls, J.; Blevins, E.

1988-01-01

Problem solving in most domains requires reference to past knowledge and experience whether such knowledge is represented as rules, decision trees, networks or any variant of attributed graphs. Regardless of the representational form employed, designers of expert systems rarely make a distinction between the static and dynamic aspects of the system's knowledge base. The current paper clearly distinguishes between knowledge-based and memory-based reasoning where the former in its most pure sense is characterized by a static knowledge based resulting in a relatively brittle expert system while the latter is dynamic and analogous to the functions of human memory which learns from experience. The paper discusses the design of an advisory system which combines a knowledge base consisting of domain vocabulary and default dependencies between concepts with a dynamic conceptual memory which stores experimental knowledge in the form of cases. The case memory organizes past experience in the form of MOPs (memory organization packets) and sub-MOPs. Each MOP consists of a context frame and a set of indices. The context frame contains information about the features (norms) common to all the events and sub-MOPs indexed under it.

Watch what happens: using a web-based multimedia platform to enhance intraoperative learning and development of clinical reasoning.

PubMed

Fingeret, Abbey L; Martinez, Rebecca H; Hsieh, Christine; Downey, Peter; Nowygrod, Roman

2016-02-01

We aim to determine whether observed operations or internet-based video review predict improved performance in the surgery clerkship. A retrospective review of students' usage of surgical videos, observed operations, evaluations, and examination scores were used to construct an exploratory principal component analysis. Multivariate regression was used to determine factors predictive of clerkship performance. Case log data for 231 students revealed a median of 25 observed cases. Students accessed the web-based video platform a median of 15 times. Principal component analysis yielded 4 factors contributing 74% of the variability with a Kaiser-Meyer-Olkin coefficient of .83. Multivariate regression predicted shelf score (P < .0001), internal clinical skills examination score (P < .0001), subjective evaluations (P < .001), and video website utilization (P < .001) but not observed cases to be significantly associated with overall performance. Utilization of a web-based operative video platform during a surgical clerkship is an independently associated with improved clinical reasoning, fund of knowledge, and overall evaluation. Thus, this modality can serve as a useful adjunct to live observation. Copyright © 2016 Elsevier Inc. All rights reserved.

A fuzzy-ontology-oriented case-based reasoning framework for semantic diabetes diagnosis.

PubMed

El-Sappagh, Shaker; Elmogy, Mohammed; Riad, A M

2015-11-01

Case-based reasoning (CBR) is a problem-solving paradigm that uses past knowledge to interpret or solve new problems. It is suitable for experience-based and theory-less problems. Building a semantically intelligent CBR that mimic the expert thinking can solve many problems especially medical ones. Knowledge-intensive CBR using formal ontologies is an evolvement of this paradigm. Ontologies can be used for case representation and storage, and it can be used as a background knowledge. Using standard medical ontologies, such as SNOMED CT, enhances the interoperability and integration with the health care systems. Moreover, utilizing vague or imprecise knowledge further improves the CBR semantic effectiveness. This paper proposes a fuzzy ontology-based CBR framework. It proposes a fuzzy case-base OWL2 ontology, and a fuzzy semantic retrieval algorithm that handles many feature types. This framework is implemented and tested on the diabetes diagnosis problem. The fuzzy ontology is populated with 60 real diabetic cases. The effectiveness of the proposed approach is illustrated with a set of experiments and case studies. The resulting system can answer complex medical queries related to semantic understanding of medical concepts and handling of vague terms. The resulting fuzzy case-base ontology has 63 concepts, 54 (fuzzy) object properties, 138 (fuzzy) datatype properties, 105 fuzzy datatypes, and 2640 instances. The system achieves an accuracy of 97.67%. We compare our framework with existing CBR systems and a set of five machine-learning classifiers; our system outperforms all of these systems. Building an integrated CBR system can improve its performance. Representing CBR knowledge using the fuzzy ontology and building a case retrieval algorithm that treats different features differently improves the accuracy of the resulting systems. Copyright © 2015 Elsevier B.V. All rights reserved.

A prognostic model for temporal courses that combines temporal abstraction and case-based reasoning.

PubMed

Schmidt, Rainer; Gierl, Lothar

2005-03-01

Since clinical management of patients and clinical research are essentially time-oriented endeavours, reasoning about time has become a hot topic in medical informatics. Here we present a method for prognosis of temporal courses, which combines temporal abstractions with case-based reasoning. It is useful for application domains where neither well-known standards, nor known periodicity, nor a complete domain theory exist. We have used our method in two prognostic applications. The first one deals with prognosis of the kidney function for intensive care patients. The idea is to elicit impairments on time, especially to warn against threatening kidney failures. Our second application deals with a completely different domain, namely geographical medicine. Its intention is to compute early warnings against approaching infectious diseases, which are characterised by irregular cyclic occurrences. So far, we have applied our program on influenza and bronchitis. In this paper, we focus on influenza forecast and show first experimental results.

INCORPORATING NONCHEMICAL STRESSORS INTO CUMMULATIVE RISK ASSESSMENTS

EPA Science Inventory

The risk assessment paradigm has begun to shift from assessing single chemicals using "reasonable worst case" assumptions for individuals to considering multiple chemicals and community-based models. Inherent in community-based risk assessment is examination of all stressors a...

Evolution of Students' Reasoning Skills on a Two Year Basis in a PBL Curriculum in Medicine.

ERIC Educational Resources Information Center

Bedard, Denis; And Others

A 2-year study at the University of Sherbrooke (Quebec) investigated the changes in six medical students' clinical reasoning processes as they participated in a problem-based learning (PBL) curriculum. In each year, students performed a think-aloud protocol with two medical case problems to solve, one in cardiology and one in urology. In the…

Risk Factors Analysis and Death Prediction in Some Life-Threatening Ailments Using Chi-Square Case-Based Reasoning (χ2 CBR) Model.

PubMed

Adeniyi, D A; Wei, Z; Yang, Y

2018-01-30

A wealth of data are available within the health care system, however, effective analysis tools for exploring the hidden patterns in these datasets are lacking. To alleviate this limitation, this paper proposes a simple but promising hybrid predictive model by suitably combining the Chi-square distance measurement with case-based reasoning technique. The study presents the realization of an automated risk calculator and death prediction in some life-threatening ailments using Chi-square case-based reasoning (χ 2 CBR) model. The proposed predictive engine is capable of reducing runtime and speeds up execution process through the use of critical χ 2 distribution value. This work also showcases the development of a novel feature selection method referred to as frequent item based rule (FIBR) method. This FIBR method is used for selecting the best feature for the proposed χ 2 CBR model at the preprocessing stage of the predictive procedures. The implementation of the proposed risk calculator is achieved through the use of an in-house developed PHP program experimented with XAMP/Apache HTTP server as hosting server. The process of data acquisition and case-based development is implemented using the MySQL application. Performance comparison between our system, the NBY, the ED-KNN, the ANN, the SVM, the Random Forest and the traditional CBR techniques shows that the quality of predictions produced by our system outperformed the baseline methods studied. The result of our experiment shows that the precision rate and predictive quality of our system in most cases are equal to or greater than 70%. Our result also shows that the proposed system executes faster than the baseline methods studied. Therefore, the proposed risk calculator is capable of providing useful, consistent, faster, accurate and efficient risk level prediction to both the patients and the physicians at any time, online and on a real-time basis.

Combining bimodal presentation schemes and buzz groups improves clinical reasoning and learning at morning report.

PubMed

Balslev, Thomas; Rasmussen, Astrid Bruun; Skajaa, Torjus; Nielsen, Jens Peter; Muijtjens, Arno; De Grave, Willem; Van Merriënboer, Jeroen

2014-12-11

Abstract Morning reports offer opportunities for intensive work-based learning. In this controlled study, we measured learning processes and outcomes with the report of paediatric emergency room patients. Twelve specialists and 12 residents were randomised into four groups and discussed the same two paediatric cases. The groups differed in their presentation modality (verbal only vs. verbal + text) and the use of buzz groups (with vs. without). The verbal interactions were analysed for clinical reasoning processes. Perceptions of learning and judgment of learning were reported in a questionnaire. Diagnostic accuracy was assessed by a 20-item multiple-choice test. Combined bimodal presentation and buzz groups increased the odds ratio of clinical reasoning to occur in the discussion of cases by a factor of 1.90 (p = 0.013), indicating superior reasoning for buzz groups working with bimodal materials. For specialists, a positive effect of bimodal presentation was found on perceptions of learning (p < 0.05), and for residents, a positive effect of buzz groups was found on judgment of learning (p < 0.005). A positive effect of bimodal presentation on diagnostic accuracy was noted in the specialists (p < 0.05). Combined bimodal presentation and buzz group discussion of emergency cases improves clinicians' clinical reasoning and learning.

26 CFR 1.924(a)-1T - Temporary regulations; definition of foreign trading gross receipts.

Code of Federal Regulations, 2010 CFR

2010-04-01

... related services furnished by the FSC (as described in this paragraph (d)(2)). In the case of a sale... the sale. In the case of a lease, reasonable expectations at the time of the lease are based on the... determined under the facts and circumstances of each case without regard to whether— (A) The services are...

Cognitive problem solving patterns of medical students correlate with success in diagnostic case solutions.

PubMed

Kiesewetter, Jan; Ebersbach, René; Görlitz, Anja; Holzer, Matthias; Fischer, Martin R; Schmidmaier, Ralf

2013-01-01

Problem-solving in terms of clinical reasoning is regarded as a key competence of medical doctors. Little is known about the general cognitive actions underlying the strategies of problem-solving among medical students. In this study, a theory-based model was used and adapted in order to investigate the cognitive actions in which medical students are engaged when dealing with a case and how patterns of these actions are related to the correct solution. Twenty-three medical students worked on three cases on clinical nephrology using the think-aloud method. The transcribed recordings were coded using a theory-based model consisting of eight different cognitive actions. The coded data was analysed using time sequences in a graphical representation software. Furthermore the relationship between the coded data and accuracy of diagnosis was investigated with inferential statistical methods. The observation of all main actions in a case elaboration, including evaluation, representation and integration, was considered a complete model and was found in the majority of cases (56%). This pattern significantly related to the accuracy of the case solution (φ = 0.55; p<.001). Extent of prior knowledge was neither related to the complete model nor to the correct solution. The proposed model is suitable to empirically verify the cognitive actions of problem-solving of medical students. The cognitive actions evaluation, representation and integration are crucial for the complete model and therefore for the accuracy of the solution. The educational implication which may be drawn from this study is to foster students reasoning by focusing on higher level reasoning.

Problem-Oriented Corporate Knowledge Base Models on the Case-Based Reasoning Approach Basis

NASA Astrophysics Data System (ADS)

Gluhih, I. N.; Akhmadulin, R. K.

2017-07-01

One of the urgent directions of efficiency enhancement of production processes and enterprises activities management is creation and use of corporate knowledge bases. The article suggests a concept of problem-oriented corporate knowledge bases (PO CKB), in which knowledge is arranged around possible problem situations and represents a tool for making and implementing decisions in such situations. For knowledge representation in PO CKB a case-based reasoning approach is encouraged to use. Under this approach, the content of a case as a knowledge base component has been defined; based on the situation tree a PO CKB knowledge model has been developed, in which the knowledge about typical situations as well as specific examples of situations and solutions have been represented. A generalized problem-oriented corporate knowledge base structural chart and possible modes of its operation have been suggested. The obtained models allow creating and using corporate knowledge bases for support of decision making and implementing, training, staff skill upgrading and analysis of the decisions taken. The universal interpretation of terms “situation” and “solution” adopted in the work allows using the suggested models to develop problem-oriented corporate knowledge bases in different subject domains. It has been suggested to use the developed models for making corporate knowledge bases of the enterprises that operate engineer systems and networks at large production facilities.

Scientific Reasoning and Its Relationship with Problem Solving: The Case of Upper Primary Science Teachers

ERIC Educational Resources Information Center

Alshamali, Mahmoud A.; Daher, Wajeeh M.

2016-01-01

This study aimed at identifying the levels of scientific reasoning of upper primary stage (grades 4-7) science teachers based on their use of a problem-solving strategy. The study sample (N = 138; 32 % male and 68 % female) was randomly selected using stratified sampling from an original population of 437 upper primary school teachers. The…

Diagnosis support system based on clinical guidelines: comparison between case-based fuzzy cognitive maps and Bayesian networks.

PubMed

Douali, Nassim; Csaba, Huszka; De Roo, Jos; Papageorgiou, Elpiniki I; Jaulent, Marie-Christine

2014-01-01

Several studies have described the prevalence and severity of diagnostic errors. Diagnostic errors can arise from cognitive, training, educational and other issues. Examples of cognitive issues include flawed reasoning, incomplete knowledge, faulty information gathering or interpretation, and inappropriate use of decision-making heuristics. We describe a new approach, case-based fuzzy cognitive maps, for medical diagnosis and evaluate it by comparison with Bayesian belief networks. We created a semantic web framework that supports the two reasoning methods. We used database of 174 anonymous patients from several European hospitals: 80 of the patients were female and 94 male with an average age 45±16 (average±stdev). Thirty of the 80 female patients were pregnant. For each patient, signs/symptoms/observables/age/sex were taken into account by the system. We used a statistical approach to compare the two methods. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Evicase: an evidence-based case structuring approach for personalized healthcare.

PubMed

Carmeli, Boaz; Casali, Paolo; Goldbraich, Anna; Goldsteen, Abigail; Kent, Carmel; Licitra, Lisa; Locatelli, Paolo; Restifo, Nicola; Rinott, Ruty; Sini, Elena; Torresani, Michele; Waks, Zeev

2012-01-01

The personalized medicine era stresses a growing need to combine evidence-based medicine with case based reasoning in order to improve the care process. To address this need we suggest a framework to generate multi-tiered statistical structures we call Evicases. Evicase integrates established medical evidence together with patient cases from the bedside. It then uses machine learning algorithms to produce statistical results and aggregators, weighted predictions, and appropriate recommendations. Designed as a stand-alone structure, Evicase can be used for a range of decision support applications including guideline adherence monitoring and personalized prognostic predictions.

Clinical reasoning and population health: decision making for an emerging paradigm of health care.

PubMed

Edwards, Ian; Richardson, Barbara

2008-01-01

Chronic conditions now provide the major disease and disability burden facing humanity. This development has necessitated a reorientation in the practice skills of health care professions away from hospital-based inpatient and outpatient care toward community-based management of patients with chronic conditions. Part of this reorientation toward community-based management of chronic conditions involves practitioners' understanding and adoption of a concept of population health management based on appropriate theoretical models of health care. Drawing on recent studies of expertise in physiotherapy, this article proposes a clinical reasoning and decision-making framework to meet these challenges. The challenge of population and community-based management of chronic conditions also provides an opportunity for physiotherapists to further clarify a professional epistemology of practice that embraces the kinds of knowledge and clinical reasoning processes used in physiotherapy practice. Three case studies related to the management of chronic musculoskeletal pain in different populations are used to exemplify the range of epistemological perspectives that underpin community-based practice. They illustrate the link between conceptualizations of practice problems and knowledge sources that are used as a basis for clinical reasoning and decision making as practitioners are increasingly required to move between the clinic and the community.

Nurses' reasoning process during care planning taking pressure ulcer prevention as an example. A think-aloud study.

PubMed

Funkesson, Kajsa Helena; Anbäcken, Els-Marie; Ek, Anna-Christina

2007-09-01

Nurses' clinical reasoning is of great importance for the delivery of safe and efficient care. Pressure ulcer prevention allows a variety of aspects within nursing to be viewed. The aim of this study was to describe both the process and the content of nurses' reasoning during care planning at different nursing homes, using pressure ulcer prevention as an example. A qualitative research design was chosen. Seven different nursing homes within one community were included. Eleven registered nurses were interviewed. The methods used were think-aloud technique, protocol analysis and qualitative content analysis. Client simulation illustrating transition was used. The case used for care planning was in three parts covering the transition from hospital until 3 weeks in the nursing home. Most nurses in this study conducted direct and indirect reasoning in a wide range of areas in connection with pressure ulcer prevention. The reasoning focused different parts of the nursing process depending on part of the case. Complex assertations as well as strategies aiming to reduce cognitive strain were rare. Nurses involved in direct nursing care held a broader reasoning than consultant nurses. Both explanations and actions based on older ideas and traditions occurred. Reasoning concerning pressure ulcer prevention while care planning was dominated by routine thinking. Knowing the person over a period of time made a more complex reasoning possible. The nurses' experience, knowledge together with how close to the elderly the nurses work seem to be important factors that affect the content of reasoning.

Collaborative Interactivity and Integrated Thinking in Brazilian Business Schools Using Cognitive Flexibility Hypertexts: The Panteon Project

ERIC Educational Resources Information Center

Lima, Marcos; Koehler, Matthew J.; Spiro, Rand J.

2004-01-01

In this article, we discuss how the Harvard Method of case study, Interactive Communication Technologies, and Cognitive Flexibility Theory may contribute to case-based learning about business decision-making. In particular, we are interested in designing learning environments that foster critical thinking, creativity, and reasoning that entertains…

Conflict monitoring in dual process theories of thinking.

PubMed

De Neys, Wim; Glumicic, Tamara

2008-03-01

Popular dual process theories have characterized human thinking as an interplay between an intuitive-heuristic and demanding-analytic reasoning process. Although monitoring the output of the two systems for conflict is crucial to avoid decision making errors there are some widely different views on the efficiency of the process. Kahneman [Kahneman, D. (2002). Maps of bounded rationality: A perspective on intuitive judgement and choice. Nobel Prize Lecture. Retrieved January 11, 2006, from: http://nobelprize.org/nobel_prizes/economics/laureates/2002/kahnemann-lecture.pdf] and Evans [Evans, J. St. B. T. (1984). Heuristic and analytic processing in reasoning. British Journal of Psychology, 75, 451-468], for example, claim that the monitoring of the heuristic system is typically quite lax whereas others such as Sloman [Sloman, S. A. (1996). The empirical case for two systems of reasoning. Psychological Bulletin, 119, 3-22] and Epstein [Epstein, S. (1994). Integration of the cognitive and psychodynamic unconscious. American Psychologists, 49, 709-724] claim it is flawless and people typically experience a struggle between what they "know" and "feel" in case of a conflict. The present study contrasted these views. Participants solved classic base rate neglect problems while thinking aloud. In these problems a stereotypical description cues a response that conflicts with the response based on the analytic base rate information. Verbal protocols showed no direct evidence for an explicitly experienced conflict. As Kahneman and Evans predicted, participants hardly ever mentioned the base rates and seemed to base their judgment exclusively on heuristic reasoning. However, more implicit measures of conflict detection such as participants' retrieval of the base rate information in an unannounced recall test, decision making latencies, and the tendency to review the base rates indicated that the base rates had been thoroughly processed. On control problems where base rates and description did not conflict this was not the case. Results suggest that whereas the popular characterization of conflict detection as an actively experienced struggle can be questioned there is nevertheless evidence for Sloman's and Epstein's basic claim about the flawless operation of the monitoring. Whenever the base rates and description disagree people will detect this conflict and consequently redirect attention towards a deeper processing of the base rates. Implications for the dual process framework and the rationality debate are discussed.

Case Studies of Secondary School Teachers Designing Socioscientific Issues-Based Instruction and Their Students' Socioscientific Reasoning

NASA Astrophysics Data System (ADS)

Karahan, Engin

Addressing socioscientific issues (SSI) has been one of the main focuses in science education since the Science, Technology, and Society (STS) movement in the 1970s (Levinson, 2006); however, teaching controversial socioscientific issues has always been challenging for teachers (Dillon, 1994; Osborne, Duschl, & Fairbrother, 2002). Although teachers exhibit positive attitudes for using controversial socioscientific issues in their science classrooms, only a small percentage of them actually incorporate SSI content into their science curricula on a regular basis (Sadler, Amirshokoohi, Kazempour, & Allspaw, 2006; Lee & Witz, 2009). The literature in science education has highlighted the signi?cant relationships among teacher beliefs, teaching practices, and student learning (Bryan & Atwater, 2002; King, Shumow, & Lietz, 2001; Lederman, 1992). Despite the fact that the case studies present a relatively detailed picture of teachers' values and motivations for teaching SSI (e.g. Lee, 2006; Lee & Witz, 2009; Reis & Galvao, 2004), these studies still miss the practices of these teachers and potential outcomes for their students. Therefore, there is a great need for in-depth case studies that would focus on teachers' practices of designing and teaching SSI-based learning environments, their deeper beliefs and motivations for teaching SSI, and their students' response to these practices (Lee, 2006). This dissertation is structured as three separate, but related, studies about secondary school teachers' experiences of designing and teaching SSI-based classes and their students' understanding of science and SSI reasoning. The case studies in this dissertation seek answers for (1) teachers' practices of designing and teaching SSI-based instruction, as well as its relation to their deeper personal beliefs and motivations to teach SSI, and (2) how their students respond to their approaches of teaching SSI in terms of their science understanding and SSI reasoning. The first paper presents case studies of three secondary science teachers within three high schools located along the Minnesota River Basin. The findings of this study documented the experiences of the participant teachers, as well as the contextual influences on those experiences. The second paper presents a case study of a science teacher and a social studies teacher which describes how these two teachers collaboratively designed and taught an environmental ethics class. The results of this study documented teachers' ways of sharing responsibilities, bringing their content and pedagogical expertise, and promoting the agency of their students in the environmental ethics class. The final paper in this dissertation presents case studies of secondary school students who were the participants in the SSI-based science classes described in the first two studies. The results of this study provided evidence for participant students' understanding of science and their socioscientific reasoning, as well as how they were influenced by the instructional decisions their teachers made.

Content-related interactions and methods of reasoning within self-initiated organic chemistry study groups

NASA Astrophysics Data System (ADS)

Christian, Karen Jeanne

2011-12-01

Students often use study groups to prepare for class or exams; yet to date, we know very little about how these groups actually function. This study looked at the ways in which undergraduate organic chemistry students prepared for exams through self-initiated study groups. We sought to characterize the methods of social regulation, levels of content processing, and types of reasoning processes used by students within their groups. Our analysis showed that groups engaged in predominantly three types of interactions when discussing chemistry content: co-construction, teaching, and tutoring. Although each group engaged in each of these types of interactions at some point, their prevalence varied between groups and group members. Our analysis suggests that the types of interactions that were most common depended on the relative content knowledge of the group members as well as on the difficulty of the tasks in which they were engaged. Additionally, we were interested in characterizing the reasoning methods used by students within their study groups. We found that students used a combination of three content-relevant methods of reasoning: model-based reasoning, case-based reasoning, or rule-based reasoning, in conjunction with one chemically-irrelevant method of reasoning: symbol-based reasoning. The most common way for groups to reason was to use rules, whereas the least common way was for students to work from a model. In general, student reasoning correlated strongly to the subject matter to which students were paying attention, and was only weakly related to student interactions. Overall, results from this study may help instructors to construct appropriate tasks to guide what and how students study outside of the classroom. We found that students had a decidedly strategic approach in their study groups, relying heavily on material provided by their instructors, and using the reasoning strategies that resulted in the lowest levels of content processing. We suggest that instructors create more opportunities for students to explore model-based reasoning, and to create opportunities for students to be able to co-construct in a collaborative manner within the context of their organic chemistry course.

Teaching and Assessing Clinical Reasoning Skills.

PubMed

Modi, Jyoti Nath; Anshu; Gupta, Piyush; Singh, Tejinder

2015-09-01

Clinical reasoning is a core competency expected to be acquired by all clinicians. It is the ability to integrate and apply different types of knowledge, weigh evidence critically and reflect upon the process used to arrive at a diagnosis. Problems with clinical reasoning often occur because of inadequate knowledge, flaws in data gathering and improper approach to information processing. Some of the educational strategies which can be used to encourage acquisition of clinical reasoning skills are: exposure to a wide variety of clinical cases, activation of previous knowledge, development of illness scripts, sharing expert strategies to arrive at a diagnosis, forcing students to prioritize differential diagnoses; and encouraging reflection, metacognition, deliberate practice and availability of formative feedback. Assessment of clinical reasoning abilities should be done throughout the training course in diverse settings. Use of scenario based multiple choice questions, key feature test and script concordance test are some ways of theoretically assessing clinical reasoning ability. In the clinical setting, these skills can be tested in most forms of workplace based assessment. We recommend that clinical reasoning must be taught at all levels of medical training as it improves clinician performance and reduces cognitive errors.

Systematizing Scaffolding for Problem-Based Learning: A View from Case-Based Reasoning

ERIC Educational Resources Information Center

Tawfik, Andrew A.; Kolodner, Janet L.

2016-01-01

Current theories and models of education often argue that instruction is best administered when knowledge is situated within a context. Problem-based learning (PBL) provides an approach to education that has particularly powerful affordances for learning disciplinary content and practices by solving authentic problems within a discipline. However,…

Organising the Chemistry of Question-Based Learning: A Case Study

ERIC Educational Resources Information Center

de Jesus, Helena Pedrosa; de Souza, Francisle Neri; Teixeira-Dias, Jose J. C.; Watts, Mike

2005-01-01

Designing inquiry-based-learning with and for university students develops problem-solving skills and logical reasoning, as well as reflective thinking. It involves working as a member of a team, questioning, being creative, shaping the skills for continued intellectual development. It is argued that inquiry-based group work is one of the most…

Influx: A Tool and Framework for Reasoning under Uncertainty

DTIC Science & Technology

2015-09-01

Interfaces to external programs Not all types of problems are naturally suited to being entirely modelled and implemented within Influx1. In general... development pertaining to the implementation of the reasoning tool and specific applications are not included in this document. RELEASE LIMITATION...which case a probability is supposed to reflect the subjective belief of an agent for the problem at hand ( based on its experience and/or current state

Purpose, Processes, Partnerships, and Products: 4Ps to advance Participatory Socio-Environmental Modeling

NASA Astrophysics Data System (ADS)

Gray, S. G.; Voinov, A. A.; Jordan, R.; Paolisso, M.

2016-12-01

Model-based reasoning is a basic part of human understanding, decision-making, and communication. Including stakeholders in environmental model building and analysis is an increasingly popular approach to understanding environmental change since stakeholders often hold valuable knowledge about socio-environmental dynamics and since collaborative forms of modeling produce important boundary objects used to collectively reason about environmental problems. Although the number of participatory modeling (PM) case studies and the number of researchers adopting these approaches has grown in recent years, the lack of standardized reporting and limited reproducibility have prevented PM's establishment and advancement as a cohesive field of study. We suggest a four dimensional framework that includes reporting on dimensions of: (1) the Purpose for selecting a PM approach (the why); (2) the Process by which the public was involved in model building or evaluation (the how); (3) the Partnerships formed (the who); and (4) the Products that resulted from these efforts (the what). We highlight four case studies that use common PM software-based approaches (fuzzy cognitive mapping, agent-based modeling, system dynamics, and participatory geospatial modeling) to understand human-environment interactions and the consequences of environmental changes, including bushmeat hunting in Tanzania and Cameroon, agricultural production and deforestation in Zambia, and groundwater management in India. We demonstrate how standardizing communication about PM case studies can lead to innovation and new insights about model-based reasoning in support of environmental policy development. We suggest that our 4P framework and reporting approach provides a way for new hypotheses to be identified and tested in the growing field of PM.

Unified modeling language and design of a case-based retrieval system in medical imaging.

PubMed Central

LeBozec, C.; Jaulent, M. C.; Zapletal, E.; Degoulet, P.

1998-01-01

One goal of artificial intelligence research into case-based reasoning (CBR) systems is to develop approaches for designing useful and practical interactive case-based environments. Explaining each step of the design of the case-base and of the retrieval process is critical for the application of case-based systems to the real world. We describe herein our approach to the design of IDEM--Images and Diagnosis from Examples in Medicine--a medical image case-based retrieval system for pathologists. Our approach is based on the expressiveness of an object-oriented modeling language standard: the Unified Modeling Language (UML). We created a set of diagrams in UML notation illustrating the steps of the CBR methodology we used. The key aspect of this approach was selecting the relevant objects of the system according to user requirements and making visualization of cases and of the components of the case retrieval process. Further evaluation of the expressiveness of the design document is required but UML seems to be a promising formalism, improving the communication between the developers and users. Images Figure 6 Figure 7 PMID:9929346

Unified modeling language and design of a case-based retrieval system in medical imaging.

PubMed

LeBozec, C; Jaulent, M C; Zapletal, E; Degoulet, P

1998-01-01

One goal of artificial intelligence research into case-based reasoning (CBR) systems is to develop approaches for designing useful and practical interactive case-based environments. Explaining each step of the design of the case-base and of the retrieval process is critical for the application of case-based systems to the real world. We describe herein our approach to the design of IDEM--Images and Diagnosis from Examples in Medicine--a medical image case-based retrieval system for pathologists. Our approach is based on the expressiveness of an object-oriented modeling language standard: the Unified Modeling Language (UML). We created a set of diagrams in UML notation illustrating the steps of the CBR methodology we used. The key aspect of this approach was selecting the relevant objects of the system according to user requirements and making visualization of cases and of the components of the case retrieval process. Further evaluation of the expressiveness of the design document is required but UML seems to be a promising formalism, improving the communication between the developers and users.

Using Bayesian networks to guide the assessment of new evidence in an appeal case

PubMed Central

Smit, Nadine M.; Lagnado, David A.; Morgan, Ruth M.; Fenton, Norman E.

2016-01-01

When new forensic evidence becomes available after a conviction there is no systematic framework to help lawyers to determine whether it raises sufficient questions about the verdict in order to launch an appeal. This paper presents such a framework driven by a recent case, in which a defendant was convicted primarily on the basis of audio evidence, but where subsequent analysis of the evidence revealed additional sounds that were not considered during the trial. The framework is intended to overcome the gap between what is generally known from scientific analyses and what is hypothesized in a legal setting. It is based on Bayesian networks (BNs) which have the potential to be a structured and understandable way to evaluate the evidence in a specific case context. However, BN methods suffered a setback with regards to the use in court due to the confusing way they have been used in some legal cases in the past. To address this concern, we show the extent to which the reasoning and decisions within the particular case can be made explicit and transparent. The BN approach enables us to clearly define the relevant propositions and evidence, and uses sensitivity analysis to assess the impact of the evidence under different assumptions. The results show that such a framework is suitable to identify information that is currently missing, yet clearly crucial for a valid and complete reasoning process. Furthermore, a method is provided whereby BNs can serve as a guide to not only reason with incomplete evidence in forensic cases, but also identify very specific research questions that should be addressed to extend the evidence base and solve similar issues in the future. PMID:27376015

Using Bayesian networks to guide the assessment of new evidence in an appeal case.

PubMed

Smit, Nadine M; Lagnado, David A; Morgan, Ruth M; Fenton, Norman E

2016-05-25

When new forensic evidence becomes available after a conviction there is no systematic framework to help lawyers to determine whether it raises sufficient questions about the verdict in order to launch an appeal. This paper presents such a framework driven by a recent case, in which a defendant was convicted primarily on the basis of audio evidence, but where subsequent analysis of the evidence revealed additional sounds that were not considered during the trial. The framework is intended to overcome the gap between what is generally known from scientific analyses and what is hypothesized in a legal setting. It is based on Bayesian networks (BNs) which have the potential to be a structured and understandable way to evaluate the evidence in a specific case context. However, BN methods suffered a setback with regards to the use in court due to the confusing way they have been used in some legal cases in the past. To address this concern, we show the extent to which the reasoning and decisions within the particular case can be made explicit and transparent. The BN approach enables us to clearly define the relevant propositions and evidence, and uses sensitivity analysis to assess the impact of the evidence under different assumptions. The results show that such a framework is suitable to identify information that is currently missing, yet clearly crucial for a valid and complete reasoning process. Furthermore, a method is provided whereby BNs can serve as a guide to not only reason with incomplete evidence in forensic cases, but also identify very specific research questions that should be addressed to extend the evidence base and solve similar issues in the future.

16 CFR 306.5 - Automotive fuel rating.

Code of Federal Regulations, 2014 CFR

2014-01-01

... alternative liquid automotive fuels other than biodiesel blends and biomass-based diesel blends, you must... of biodiesel blends, you must possess a reasonable basis, consisting of competent and reliable evidence, for the percentage of biodiesel contained in the fuel, and in the case of biomass-based diesel...

16 CFR 306.5 - Automotive fuel rating.

Code of Federal Regulations, 2013 CFR

2013-01-01

... alternative liquid automotive fuels other than biodiesel blends and biomass-based diesel blends, you must... of biodiesel blends, you must possess a reasonable basis, consisting of competent and reliable evidence, for the percentage of biodiesel contained in the fuel, and in the case of biomass-based diesel...

16 CFR 306.5 - Automotive fuel rating.

Code of Federal Regulations, 2012 CFR

2012-01-01

... alternative liquid automotive fuels other than biodiesel blends and biomass-based diesel blends, you must... of biodiesel blends, you must possess a reasonable basis, consisting of competent and reliable evidence, for the percentage of biodiesel contained in the fuel, and in the case of biomass-based diesel...

Building Better Decision-Support by Using Knowledge Discovery.

ERIC Educational Resources Information Center

Jurisica, Igor

2000-01-01

Discusses knowledge-based decision-support systems that use artificial intelligence approaches. Addresses the issue of how to create an effective case-based reasoning system for complex and evolving domains, focusing on automated methods for system optimization and domain knowledge evolution that can supplement knowledge acquired from domain…

Improving the learning of clinical reasoning through computer-based cognitive representation.

PubMed

Wu, Bian; Wang, Minhong; Johnson, Janice M; Grotzer, Tina A

2014-01-01

Objective Clinical reasoning is usually taught using a problem-solving approach, which is widely adopted in medical education. However, learning through problem solving is difficult as a result of the contextualization and dynamic aspects of actual problems. Moreover, knowledge acquired from problem-solving practice tends to be inert and fragmented. This study proposed a computer-based cognitive representation approach that externalizes and facilitates the complex processes in learning clinical reasoning. The approach is operationalized in a computer-based cognitive representation tool that involves argument mapping to externalize the problem-solving process and concept mapping to reveal the knowledge constructed from the problems. Methods Twenty-nine Year 3 or higher students from a medical school in east China participated in the study. Participants used the proposed approach implemented in an e-learning system to complete four learning cases in 4 weeks on an individual basis. For each case, students interacted with the problem to capture critical data, generate and justify hypotheses, make a diagnosis, recall relevant knowledge, and update their conceptual understanding of the problem domain. Meanwhile, students used the computer-based cognitive representation tool to articulate and represent the key elements and their interactions in the learning process. Results A significant improvement was found in students' learning products from the beginning to the end of the study, consistent with students' report of close-to-moderate progress in developing problem-solving and knowledge-construction abilities. No significant differences were found between the pretest and posttest scores with the 4-week period. The cognitive representation approach was found to provide more formative assessment. Conclusions The computer-based cognitive representation approach improved the learning of clinical reasoning in both problem solving and knowledge construction.

Improving the learning of clinical reasoning through computer-based cognitive representation

PubMed Central

Wu, Bian; Wang, Minhong; Johnson, Janice M.; Grotzer, Tina A.

2014-01-01

Objective Clinical reasoning is usually taught using a problem-solving approach, which is widely adopted in medical education. However, learning through problem solving is difficult as a result of the contextualization and dynamic aspects of actual problems. Moreover, knowledge acquired from problem-solving practice tends to be inert and fragmented. This study proposed a computer-based cognitive representation approach that externalizes and facilitates the complex processes in learning clinical reasoning. The approach is operationalized in a computer-based cognitive representation tool that involves argument mapping to externalize the problem-solving process and concept mapping to reveal the knowledge constructed from the problems. Methods Twenty-nine Year 3 or higher students from a medical school in east China participated in the study. Participants used the proposed approach implemented in an e-learning system to complete four learning cases in 4 weeks on an individual basis. For each case, students interacted with the problem to capture critical data, generate and justify hypotheses, make a diagnosis, recall relevant knowledge, and update their conceptual understanding of the problem domain. Meanwhile, students used the computer-based cognitive representation tool to articulate and represent the key elements and their interactions in the learning process. Results A significant improvement was found in students’ learning products from the beginning to the end of the study, consistent with students’ report of close-to-moderate progress in developing problem-solving and knowledge-construction abilities. No significant differences were found between the pretest and posttest scores with the 4-week period. The cognitive representation approach was found to provide more formative assessment. Conclusions The computer-based cognitive representation approach improved the learning of clinical reasoning in both problem solving and knowledge construction. PMID:25518871

Improving the learning of clinical reasoning through computer-based cognitive representation.

PubMed

Wu, Bian; Wang, Minhong; Johnson, Janice M; Grotzer, Tina A

2014-01-01

Clinical reasoning is usually taught using a problem-solving approach, which is widely adopted in medical education. However, learning through problem solving is difficult as a result of the contextualization and dynamic aspects of actual problems. Moreover, knowledge acquired from problem-solving practice tends to be inert and fragmented. This study proposed a computer-based cognitive representation approach that externalizes and facilitates the complex processes in learning clinical reasoning. The approach is operationalized in a computer-based cognitive representation tool that involves argument mapping to externalize the problem-solving process and concept mapping to reveal the knowledge constructed from the problems. Twenty-nine Year 3 or higher students from a medical school in east China participated in the study. Participants used the proposed approach implemented in an e-learning system to complete four learning cases in 4 weeks on an individual basis. For each case, students interacted with the problem to capture critical data, generate and justify hypotheses, make a diagnosis, recall relevant knowledge, and update their conceptual understanding of the problem domain. Meanwhile, students used the computer-based cognitive representation tool to articulate and represent the key elements and their interactions in the learning process. A significant improvement was found in students' learning products from the beginning to the end of the study, consistent with students' report of close-to-moderate progress in developing problem-solving and knowledge-construction abilities. No significant differences were found between the pretest and posttest scores with the 4-week period. The cognitive representation approach was found to provide more formative assessment. The computer-based cognitive representation approach improved the learning of clinical reasoning in both problem solving and knowledge construction.

The clustering-based case-based reasoning for imbalanced business failure prediction: a hybrid approach through integrating unsupervised process with supervised process

NASA Astrophysics Data System (ADS)

Li, Hui; Yu, Jun-Ling; Yu, Le-An; Sun, Jie

2014-05-01

Case-based reasoning (CBR) is one of the main forecasting methods in business forecasting, which performs well in prediction and holds the ability of giving explanations for the results. In business failure prediction (BFP), the number of failed enterprises is relatively small, compared with the number of non-failed ones. However, the loss is huge when an enterprise fails. Therefore, it is necessary to develop methods (trained on imbalanced samples) which forecast well for this small proportion of failed enterprises and performs accurately on total accuracy meanwhile. Commonly used methods constructed on the assumption of balanced samples do not perform well in predicting minority samples on imbalanced samples consisting of the minority/failed enterprises and the majority/non-failed ones. This article develops a new method called clustering-based CBR (CBCBR), which integrates clustering analysis, an unsupervised process, with CBR, a supervised process, to enhance the efficiency of retrieving information from both minority and majority in CBR. In CBCBR, various case classes are firstly generated through hierarchical clustering inside stored experienced cases, and class centres are calculated out by integrating cases information in the same clustered class. When predicting the label of a target case, its nearest clustered case class is firstly retrieved by ranking similarities between the target case and each clustered case class centre. Then, nearest neighbours of the target case in the determined clustered case class are retrieved. Finally, labels of the nearest experienced cases are used in prediction. In the empirical experiment with two imbalanced samples from China, the performance of CBCBR was compared with the classical CBR, a support vector machine, a logistic regression and a multi-variant discriminate analysis. The results show that compared with the other four methods, CBCBR performed significantly better in terms of sensitivity for identifying the minority samples and generated high total accuracy meanwhile. The proposed approach makes CBR useful in imbalanced forecasting.

Distributed Deliberative Recommender Systems

NASA Astrophysics Data System (ADS)

Recio-García, Juan A.; Díaz-Agudo, Belén; González-Sanz, Sergio; Sanchez, Lara Quijano

Case-Based Reasoning (CBR) is one of most successful applied AI technologies of recent years. Although many CBR systems reason locally on a previous experience base to solve new problems, in this paper we focus on distributed retrieval processes working on a network of collaborating CBR systems. In such systems, each node in a network of CBR agents collaborates, arguments and counterarguments its local results with other nodes to improve the performance of the system's global response. We describe D2ISCO: a framework to design and implement deliberative and collaborative CBR systems that is integrated as a part of jcolibritwo an established framework in the CBR community. We apply D2ISCO to one particular simplified type of CBR systems: recommender systems. We perform a first case study for a collaborative music recommender system and present the results of an experiment of the accuracy of the system results using a fuzzy version of the argumentation system AMAL and a network topology based on a social network. Besides individual recommendation we also discuss how D2ISCO can be used to improve recommendations to groups and we present a second case of study based on the movie recommendation domain with heterogeneous groups according to the group personality composition and a group topology based on a social network.

The role of ethics in information technology decisions: a case-based approach to biomedical informatics education.

PubMed

Anderson, James G

2004-03-18

The purpose of this paper is to propose a case-based approach to instruction regarding ethical issues raised by the use of information technology (IT) in healthcare. These issues are rarely addressed in graduate degree and continuing professional education programs in health informatics. There are important reasons why ethical issues need to be addressed in informatics training. Ethical issues raised by the introduction of information technology affect practice and are ubiquitous. These issues are frequently among the most challenging to young practitioners who are ill prepared to deal with them in practice. First, the paper provides an overview of methods of moral reasoning that can be used to identify and analyze ethical problems in health informatics. Second, we provide a framework for defining cases that involve ethical issues and outline major issues raised by the use of information technology. Specific cases are used as examples of new dilemmas that are posed by the introduction of information technology in healthcare. These cases are used to illustrate how ethics can be integrated with the other elements of informatics training. The cases discussed here reflect day-to-day situations that arise in health settings that require decisions. Third, an approach that can be used to teach ethics in health informatics programs is outlined and illustrated.

Single-Case Analysis to Determine Reasons for Failure of Behavioral Treatment via Telehealth

ERIC Educational Resources Information Center

Schieltz, Kelly M.; Romani, Patrick W.; Wacker, David P.; Suess, Alyssa N.; Huang, Pei; Berg, Wendy K.; Lindgren, Scott D.; Kopelman, Todd G.

2018-01-01

Functional communication training (FCT) is a widely used and effective function-based treatment for problem behavior. The purpose of this article is to present two cases in which FCT was unsuccessful in reducing the occurrence of problem behavior displayed by two young children with an autism spectrum disorder. Both children received the same…

Learning to Think Spatially in an Undergraduate Interdisciplinary Computational Design Context: A Case Study

ERIC Educational Resources Information Center

Ben Youssef, Belgacem; Berry, Barbara

2012-01-01

Spatial thinking skills are vital for success in everyday living and work, not to mention the centrality of spatial reasoning in scientific discoveries, design-based disciplines, medicine, geosciences and mathematics to name a few. This case study describes a course in spatial thinking and communicating designed and delivered by an…

Differences in clinical reasoning among nurses working in highly specialised paediatric care.

PubMed

Andersson, Nina; Klang, Birgitta; Petersson, Gunilla

2012-03-01

The aim of the study was to examine differences in clinical reasoning among novice, experienced and specialist paediatric nurses. Highly specialised paediatric care requires specific knowledge and ongoing skill performance of the nurses employed. There is a lack of research in how paediatric nurses manage the daily care problems they encounter and how they acquire the skills required to give patients the best possible care. More knowledge is needed about how paediatric nurses with different experience and education reason and communicate about paediatric patient situations. The study was based on six recorded group discussions of a fictitious, but realistic paediatric case. Three categories of nurses: novices (n = 7), experienced (n = 7) and specialists (n = 7) from a paediatric hospital participated. A qualitative content analysis approach was chosen to examine differences in clinical reasoning. Several themes were uncovered: child's social situation, child abuse and the child's illness, qualitative differences emerged in how the nurses discussed the case. Three approaches were identified: a task-oriented approach (novices and experienced), an action-oriented approach (novices and experienced) and hypothesis-oriented approach (specialists) while discussing the case. When comparing nurses in three competence groups, it was established that the groups with extensive experience and specialist education reasoned differently than the other groups. Between the novice and experienced groups, no obvious differences were found. Thus, the importance of experience alone for the development of competence is still an open question. Experience combined with further education appears important for developing professional competence in paediatric care. Nurses' reasoning in clinical paediatric care is related to experience and training. © 2012 Blackwell Publishing Ltd.

Increasing the Runtime Speed of Case-Based Plan Recognition

DTIC Science & Technology

2015-05-01

number of situations that the robot might reasonably be expected to encounter. This requires ef- ficient indexing schemes to ensure that plan retrieval...collection of information if it does not display a currently valid OMB control number . 1. REPORT DATE MAY 2015 2. REPORT TYPE 3. DATES COVERED 00...00-2015 to 00-00-2015 4. TITLE AND SUBTITLE Increasing the Runtime Speed of Case-Based Plan Recognition 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c

Ontology-Based Learner Categorization through Case Based Reasoning and Fuzzy Logic

ERIC Educational Resources Information Center

Sarwar, Sohail; García-Castro, Raul; Qayyum, Zia Ul; Safyan, Muhammad; Munir, Rana Faisal

2017-01-01

Learner categorization has a pivotal role in making e-learning systems a success. However, learner characteristics exploited at abstract level of granularity by contemporary techniques cannot categorize the learners effectively. In this paper, an architecture of e-learning framework has been presented that exploits the machine learning based…

Developing Metacognition: A Basis for Active Learning

ERIC Educational Resources Information Center

Vos, Henk; de Graaff, E.

2004-01-01

The reasons to introduce formats of active learning in engineering (ALE) such as project work, problem-based learning, use of cases, etc. are mostly based on practical experience, and sometimes from applied research on teaching and learning. Such research shows that students learn more and different abilities than in traditional formats of…

Hybrid Filtering in Semantic Query Processing

ERIC Educational Resources Information Center

Jeong, Hanjo

2011-01-01

This dissertation presents a hybrid filtering method and a case-based reasoning framework for enhancing the effectiveness of Web search. Web search may not reflect user needs, intent, context, and preferences, because today's keyword-based search is lacking semantic information to capture the user's context and intent in posing the search query.…

[Acquiring skills in malignant hyperthermia crisis management: comparison of high-fidelity simulation versus computer-based case study].

PubMed

Mejía, Vilma; Gonzalez, Carlos; Delfino, Alejandro E; Altermatt, Fernando R; Corvetto, Marcia A

The primary purpose of this study was to compare the effect of high fidelity simulation versus a computer-based case solving self-study, in skills acquisition about malignant hyperthermia on first year anesthesiology residents. After institutional ethical committee approval, 31 first year anesthesiology residents were enrolled in this prospective randomized single-blinded study. Participants were randomized to either a High Fidelity Simulation Scenario or a computer-based Case Study about malignant hyperthermia. After the intervention, all subjects' performance in was assessed through a high fidelity simulation scenario using a previously validated assessment rubric. Additionally, knowledge tests and a satisfaction survey were applied. Finally, a semi-structured interview was done to assess self-perception of reasoning process and decision-making. 28 first year residents finished successfully the study. Resident's management skill scores were globally higher in High Fidelity Simulation versus Case Study, however they were significant in 4 of the 8 performance rubric elements: recognize signs and symptoms (p = 0.025), prioritization of initial actions of management (p = 0.003), recognize complications (p = 0.025) and communication (p = 0.025). Average scores from pre- and post-test knowledge questionnaires improved from 74% to 85% in the High Fidelity Simulation group, and decreased from 78% to 75% in the Case Study group (p = 0.032). Regarding the qualitative analysis, there was no difference in factors influencing the student's process of reasoning and decision-making with both teaching strategies. Simulation-based training with a malignant hyperthermia high-fidelity scenario was superior to computer-based case study, improving knowledge and skills in malignant hyperthermia crisis management, with a very good satisfaction level in anesthesia residents. Copyright © 2018 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Intertwining evidence- and model-based reasoning in physics sensemaking: An example from electrostatics

NASA Astrophysics Data System (ADS)

Russ, Rosemary S.; Odden, Tor Ole B.

2017-12-01

Our field has long valued the goal of teaching students not just the facts of physics, but also the thinking and reasoning skills of professional physicists. The complexity inherent in scientific reasoning demands that we think carefully about how we conceptualize for ourselves, enact in our classes, and encourage in our students the relationship between the multifaceted practices of professional science. The current study draws on existing research in the philosophy of science and psychology to advocate for intertwining two important aspects of scientific reasoning: using evidence from experimentation and modeling. We present a case from an undergraduate physics course to illustrate how these aspects can be intertwined productively and describe specific ways in which these aspects of reasoning can mutually reinforce one another in student learning. We end by discussing implications for this work for instruction in introductory physics courses and for research on scientific reasoning at the undergraduate level.

A case-based reasoning system based on weighted heterogeneous value distance metric for breast cancer diagnosis.

PubMed

Gu, Dongxiao; Liang, Changyong; Zhao, Huimin

2017-03-01

We present the implementation and application of a case-based reasoning (CBR) system for breast cancer related diagnoses. By retrieving similar cases in a breast cancer decision support system, oncologists can obtain powerful information or knowledge, complementing their own experiential knowledge, in their medical decision making. We observed two problems in applying standard CBR to this context: the abundance of different types of attributes and the difficulty in eliciting appropriate attribute weights from human experts. We therefore used a distance measure named weighted heterogeneous value distance metric, which can better deal with both continuous and discrete attributes simultaneously than the standard Euclidean distance, and a genetic algorithm for learning the attribute weights involved in this distance measure automatically. We evaluated our CBR system in two case studies, related to benign/malignant tumor prediction and secondary cancer prediction, respectively. Weighted heterogeneous value distance metric with genetic algorithm for weight learning outperformed several alternative attribute matching methods and several classification methods by at least 3.4%, reaching 0.938, 0.883, 0.933, and 0.984 in the first case study, and 0.927, 0.842, 0.939, and 0.989 in the second case study, in terms of accuracy, sensitivity×specificity, F measure, and area under the receiver operating characteristic curve, respectively. The evaluation result indicates the potential of CBR in the breast cancer diagnosis domain. Copyright © 2017 Elsevier B.V. All rights reserved.

Process-Based Governance in Public Administrations Using Activity-Based Costing

NASA Astrophysics Data System (ADS)

Becker, Jörg; Bergener, Philipp; Räckers, Michael

Decision- and policy-makers in public administrations currently lack on missing relevant information for sufficient governance. In Germany the introduction of New Public Management and double-entry accounting enable public administrations to get the opportunity to use cost-centered accounting mechanisms to establish new governance mechanisms. Process modelling in this case can be a useful instrument to help the public administrations decision- and policy-makers to structure their activities and capture relevant information. In combination with approaches like Activity-Based Costing, higher management level can be supported with a reasonable data base for fruitful and reasonable governance approaches. Therefore, the aim of this article is combining the public sector domain specific process modelling method PICTURE and concept of activity-based costing for supporting Public Administrations in process-based Governance.

Candida endophthalmitis after heroin abuse.

PubMed

Malecaze, F; Arne, J L; Bec, P; Séguéla, J P; Linas, M D; Recco, P; Béssières, M H

1985-11-01

Three cases of ocular candidosis involving heroin abusers have been observed in 1983 in Toulouse department of ophthalmology. These three patients had used iranian brown heroin. Twenty similar cases have been published in these last years. This new pathology can be explained on two reasons. The first is that the drug abusers have some immunity pertubation; however, immunity exploration in these patients does not reveal any immunodeficiency. The second reason, certainly more important, is the method of using heroin. The diagnosis of Candida endophthalmitis of course based on clinical context must be proved by biological tests. Candida albicans is never identified in aqueous humor. For this reason, it seems very interesting to detect anti-candida antibodies in aqueous humor. It has been used as methods of dosage laser Nephelemetry for IgG and immunofluorescence for candidosis antibodies. The criterion used is similar to the toxoplasmosis coefficient established by Desmonts (3). In two cases, this test was the only way that permits us to have certitude of candidosis ocular diagnosis. Otherwise the observations show that anterior chamber punction is more significant when there is an anterior uveitis.

Argumentation and Equity in Inquiry-Based Science Instruction: Reasoning Patterns of Teachers and Students

NASA Astrophysics Data System (ADS)

Irish, Tobias E. L.

This multiple case study explores issues of equity in science education through an examination of how teachers' reasoning patterns compare with students' reasoning patterns during inquiry-based lessons. It also examines the ways in which teachers utilize students' cultural and linguistic resources, or funds of knowledge, during inquiry-based lessons and the ways in which students utilize their funds of knowledge, during inquiry-based lessons. Three middle school teachers and a total of 57 middle school students participated in this study. The data collection involved classroom observations and multiple interviews with each of the teachers individually and with small groups of students. The findings indicate that the students are capable of far more complex reasoning than what was elicited by the lessons observed or what was modeled and expected by the teachers, but that during the inquiry-based lessons they conformed to the more simplistic reasoning patterns they perceived as the expected norm of classroom dialogue. The findings also indicate that the students possess funds of knowledge that are relevant to science topics, but very seldom use these funds in the context of their inquiry-based lessons. In addition, the teachers in this study very seldom worked to elicit students' use of their funds in these contexts. The few attempts they did make involved the use of analogies, examples, or questions. The findings from this study have implications for both teachers and teacher educators in that they highlight similarities and differences in reasoning that can help teachers establish instructional congruence and facilitate more equitable science instruction. They also provide insight into how students' cultural and linguistic resources are utilized during inquiry-based science lessons.

Problem Representation, Background Evidence, Analysis, Recommendation: An Oral Case Presentation Tool to Promote Diagnostic Reasoning.

PubMed

Carter, Cristina; Akar-Ghibril, Nicole; Sestokas, Jeff; Dixon, Gabrina; Bradford, Wilhelmina; Ottolini, Mary

2018-03-01

Oral case presentations provide an opportunity for trainees to communicate diagnostic reasoning at the bedside. However, few tools exist to enable faculty to provide effective feedback. We developed a tool to assess diagnostic reasoning and communication during oral case presentations. Published by Elsevier Inc.

Clinical Reasoning Tasks and Resident Physicians: What Do They Reason About?

PubMed

McBee, Elexis; Ratcliffe, Temple; Goldszmidt, Mark; Schuwirth, Lambert; Picho, Katherine; Artino, Anthony R; Masel, Jennifer; Durning, Steven J

2016-07-01

A framework of clinical reasoning tasks thought to occur in a clinical encounter was recently developed. It proposes that diagnostic and therapeutic reasoning comprise 24 tasks. The authors of this current study used this framework to investigate what internal medicine residents reason about when they approach straightforward clinical cases. Participants viewed three video-recorded clinical encounters portraying common diagnoses. After each video, participants completed a post encounter form and think-aloud protocol. Two authors analyzed transcripts from the think-aloud protocols using a constant comparative approach. They conducted iterative coding of the utterances, classifying each according to the framework of clinical reasoning tasks. They evaluated the type, number, and sequence of tasks the residents used. Ten residents participated in the study in 2013-2014. Across all three cases, the residents employed 14 clinical reasoning tasks. Nearly all coded tasks were associated with framing the encounter or diagnosis. The order in which residents used specific tasks varied. The average number of tasks used per case was as follows: Case 1, 4.4 (range 1-10); Case 2, 4.6 (range 1-6); and Case 3, 4.7 (range 1-7). The residents used some tasks repeatedly; the average number of task utterances was 11.6, 13.2, and 14.7 for, respectively, Case 1, 2, and 3. Results suggest that the use of clinical reasoning tasks occurs in a varied, not sequential, process. The authors provide suggestions for strengthening the framework to more fully encompass the spectrum of reasoning tasks that occur in residents' clinical encounters.

The effect of multiple external representations (MERs) worksheets toward complex system reasoning achievement

NASA Astrophysics Data System (ADS)

Sumarno; Ibrahim, M.; Supardi, Z. A. I.

2018-03-01

The application of a systems approach to assessing biological systems provides hope for a coherent understanding of cell dynamics patterns and their relationship to plant life. This action required the reasoning about complex systems. In other sides, there were a lot of researchers who provided the proof about the instructional successions. They involved the multiple external representations which improved the biological learning. The researcher conducted an investigation using one shoot case study design which involved 30 students in proving that the MERs worksheets could affect the student's achievement of reasoning about complex system. The data had been collected based on test of reasoning about complex system and student's identification result who worked through MERs. The result showed that only partially students could achieve reasoning about system complex, but their MERs skill could support their reasoning ability of complex system. This study could bring a new hope to develop the MERs worksheet as a tool to facilitate the reasoning about complex system.

Generic project definitions for improvement of health care delivery: a case-based approach.

PubMed

Niemeijer, Gerard C; Does, Ronald J M M; de Mast, Jeroen; Trip, Albert; van den Heuvel, Jaap

2011-01-01

The purpose of this article is to create actionable knowledge, making the definition of process improvement projects in health care delivery more effective. This study is a retrospective analysis of process improvement projects in hospitals, facilitating a case-based reasoning approach to project definition. Data sources were project documentation and hospital-performance statistics of 271 Lean Six Sigma health care projects from 2002 to 2009 of general, teaching, and academic hospitals in the Netherlands and Belgium. Objectives and operational definitions of improvement projects in the sample, analyzed and structured in a uniform format and terminology. Extraction of reusable elements of earlier project definitions, presented in the form of 9 templates called generic project definitions. These templates function as exemplars for future process improvement projects, making the selection, definition, and operationalization of similar projects more efficient. Each template includes an explicated rationale, an operationalization in the form of metrics, and a prototypical example. Thus, a process of incremental and sustained learning based on case-based reasoning is facilitated. The quality of project definitions is a crucial success factor in pursuits to improve health care delivery. We offer 9 tried and tested improvement themes related to patient safety, patient satisfaction, and business-economic performance of hospitals.

[The reasons why 13 MK1 attachment were re-fabricated and some methods for improvement].

PubMed

Wu, Zhi-hong; Zhang, Xue-jun; Zhao, Jun

2013-12-01

To investigate the reasons why 13 MK1 attachment were re-fabricated and to suggest some improvement methods. Mechanics and denture production technology were reviewed in 13 cases with MK1 attachment denture to determine the causes of failure. In some cases, MK1 attachments were poorly designed, while in other cases problems were found during denture design and production process due to limited experiences at the initial stage. MK1 attachments were re-done based on the specific cause and the outcome was good after 1-1.5 years of follow-up. When using MK1 attachment, prosthodontists should be familiar with the characteristics and indications of MK1 attachment. Meanwhile, we should strengthen doctor-patient communication and follow up patients timely to improve the success rate of MK1 attached denture repair.

Interface between psychiatry and the law on the issue of murder.

PubMed

Bell, C C

1980-11-01

Not guilty by reason of insanity is a legal defense of murder. The acquittal of such an act is based on the court finding that the crime was due to the defendant's mental illness and not to criminal intent. The author presents characteristic case histories, as seen by him in the role of expert witness, that may serve as paradigms when the doctrine "not guilty by reason of insanity" is an appropriate defense.

Interface Between Psychiatry and the Law on the Issue of Murder

PubMed Central

Bell, Carl C.

1980-01-01

Not guilty by reason of insanity is a legal defense of murder. The acquittal of such an act is based on the court finding that the crime was due to the defendant's mental illness and not to criminal intent. The author presents characteristic case histories, as seen by him in the role of expert witness, that may serve as paradigms when the doctrine “not guilty by reason of insanity” is an appropriate defense. PMID:7441789

You Want Me To Do What? The Cultural and Psychological Struggle of Putting a Course Online.

ERIC Educational Resources Information Center

Anderson, Sharon K.; Middleton, Val

2002-01-01

Presents a case study of the development of a Web-based online course. Discusses the culture of online instruction; conflicts in course development; presenting students with reasons for Web-based instruction; student orientation for online programs; motivation; and the need for some human interaction. (LRW)

Teleworking and Gender.

ERIC Educational Resources Information Center

Huws, Ursula; And Others

This report details a survey of 188 teleworkers throughout Europe that was supplemented by face-to-face interviews with 9 teleworkers in the United Kingdom, Sweden, and the Netherlands. The group of male and female home-based translators was chosen for two reasons: most surveys and case studies of teleworking have been company based and unable to…

Safety Early Warning Research for Highway Construction Based on Case-Based Reasoning and Variable Fuzzy Sets

PubMed Central

Liu, Yan; Xu, Zhen-Jun

2013-01-01

As a high-risk subindustry involved in construction projects, highway construction safety has experienced major developments in the past 20 years, mainly due to the lack of safe early warnings in Chinese construction projects. By combining the current state of early warning technology with the requirements of the State Administration of Work Safety and using case-based reasoning (CBR), this paper expounds on the concept and flow of highway construction safety early warnings based on CBR. The present study provides solutions to three key issues, index selection, accident cause association analysis, and warning degree forecasting implementation, through the use of association rule mining, support vector machine classifiers, and variable fuzzy qualitative and quantitative change criterion modes, which fully cover the needs of safe early warning systems. Using a detailed description of the principles and advantages of each method and by proving the methods' effectiveness and ability to act together in safe early warning applications, effective means and intelligent technology for a safe highway construction early warning system are established. PMID:24191134

Hybrid neural intelligent system to predict business failure in small-to-medium-size enterprises.

PubMed

Borrajo, M Lourdes; Baruque, Bruno; Corchado, Emilio; Bajo, Javier; Corchado, Juan M

2011-08-01

During the last years there has been a growing need of developing innovative tools that can help small to medium sized enterprises to predict business failure as well as financial crisis. In this study we present a novel hybrid intelligent system aimed at monitoring the modus operandi of the companies and predicting possible failures. This system is implemented by means of a neural-based multi-agent system that models the different actors of the companies as agents. The core of the multi-agent system is a type of agent that incorporates a case-based reasoning system and automates the business control process and failure prediction. The stages of the case-based reasoning system are implemented by means of web services: the retrieval stage uses an innovative weighted voting summarization of self-organizing maps ensembles-based method and the reuse stage is implemented by means of a radial basis function neural network. An initial prototype was developed and the results obtained related to small and medium enterprises in a real scenario are presented.

Safety early warning research for highway construction based on case-based reasoning and variable fuzzy sets.

PubMed

Liu, Yan; Yi, Ting-Hua; Xu, Zhen-Jun

2013-01-01

As a high-risk subindustry involved in construction projects, highway construction safety has experienced major developments in the past 20 years, mainly due to the lack of safe early warnings in Chinese construction projects. By combining the current state of early warning technology with the requirements of the State Administration of Work Safety and using case-based reasoning (CBR), this paper expounds on the concept and flow of highway construction safety early warnings based on CBR. The present study provides solutions to three key issues, index selection, accident cause association analysis, and warning degree forecasting implementation, through the use of association rule mining, support vector machine classifiers, and variable fuzzy qualitative and quantitative change criterion modes, which fully cover the needs of safe early warning systems. Using a detailed description of the principles and advantages of each method and by proving the methods' effectiveness and ability to act together in safe early warning applications, effective means and intelligent technology for a safe highway construction early warning system are established.

Learning to Explain Astronomy across Moving Frames of Reference: Exploring the Role of Classroom and Planetarium-Based Instructional Contexts

ERIC Educational Resources Information Center

Plummer, Julia Diane; Kocareli, Alicia; Slagle, Cynthia

2014-01-01

Learning astronomy involves significant spatial reasoning, such as learning to describe Earth-based phenomena and understanding space-based explanations for those phenomena as well as using the relevant size and scale information to interpret these frames of reference. This study examines daily celestial motion (DCM) as one case of how children…

Case-Based Web Learning Versus Face-to-Face Learning: A Mixed-Method Study on University Nursing Students.

PubMed

Chan, Aileen Wai-Kiu; Chair, Sek-Ying; Sit, Janet Wing-Hung; Wong, Eliza Mi-Ling; Lee, Diana Tze-Fun; Fung, Olivia Wai-Man

2016-03-01

Case-based learning (CBL) is an effective educational method for improving the learning and clinical reasoning skills of students. Advances in e-learning technology have supported the development of the Web-based CBL approach to teaching as an alternative or supplement to the traditional classroom approach. This study aims to examine the CBL experience of Hong Kong students using both traditional classroom and Web-based approaches in undergraduate nursing education. This experience is examined in terms of the perceived self-learning ability, clinical reasoning ability, and satisfaction in learning of these students. A mixture of quantitative and qualitative approaches was adopted. All Year-3 undergraduate nursing students were recruited. CBL was conducted using the traditional classroom approach in Semester 1, and the Web-based approach was conducted in Semester 2. Student evaluations were collected at the end of each semester using a self-report questionnaire. In-depth, focus-group interviews were conducted at the end of Semester 2. One hundred twenty-two students returned their questionnaires. No difference between the face-to-face and Web-based approaches was found in terms of self-learning ability (p = .947), clinical reasoning ability (p = .721), and satisfaction (p = .083). Focus group interview findings complemented survey findings and revealed five themes that reflected the CBL learning experience of Hong Kong students. These themes were (a) the structure of CBL, (b) the learning environment of Web-based CBL, (c) critical thinking and problem solving, (d) cultural influence on CBL learning experience, and (e) student-centered and teacher-centered learning. The Web-based CBL approach was comparable but not superior to the traditional classroom CBL approach. The Web-based CBL experience of these students sheds light on the impact of Chinese culture on student learning behavior and preferences.

Cost-sensitive case-based reasoning using a genetic algorithm: application to medical diagnosis.

PubMed

Park, Yoon-Joo; Chun, Se-Hak; Kim, Byung-Chun

2011-02-01

The paper studies the new learning technique called cost-sensitive case-based reasoning (CSCBR) incorporating unequal misclassification cost into CBR model. Conventional CBR is now considered as a suitable technique for diagnosis, prognosis and prescription in medicine. However it lacks the ability to reflect asymmetric misclassification and often assumes that the cost of a positive diagnosis (an illness) as a negative one (no illness) is the same with that of the opposite situation. Thus, the objective of this research is to overcome the limitation of conventional CBR and encourage applying CBR to many real world medical cases associated with costs of asymmetric misclassification errors. The main idea involves adjusting the optimal cut-off classification point for classifying the absence or presence of diseases and the cut-off distance point for selecting optimal neighbors within search spaces based on similarity distribution. These steps are dynamically adapted to new target cases using a genetic algorithm. We apply this proposed method to five real medical datasets and compare the results with two other cost-sensitive learning methods-C5.0 and CART. Our finding shows that the total misclassification cost of CSCBR is lower than other cost-sensitive methods in many cases. Even though the genetic algorithm has limitations in terms of unstable results and over-fitting training data, CSCBR results with GA are better overall than those of other methods. Also the paired t-test results indicate that the total misclassification cost of CSCBR is significantly less than C5.0 and CART for several datasets. We have proposed a new CBR method called cost-sensitive case-based reasoning (CSCBR) that can incorporate unequal misclassification costs into CBR and optimize the number of neighbors dynamically using a genetic algorithm. It is meaningful not only for introducing the concept of cost-sensitive learning to CBR, but also for encouraging the use of CBR in the medical area. The result shows that the total misclassification costs of CSCBR do not increase in arithmetic progression as the cost of false absence increases arithmetically, thus it is cost-sensitive. We also show that total misclassification costs of CSCBR are the lowest among all methods in four datasets out of five and the result is statistically significant in many cases. The limitation of our proposed CSCBR is confined to classify binary cases for minimizing misclassification cost because our proposed CSCBR is originally designed to classify binary case. Our future work extends this method for multi-classification which can classify more than two groups. Copyright © 2010 Elsevier B.V. All rights reserved.

Explanation-aware computing of the prognosis for breast cancer supported by IK-DCBRC: Technical innovation.

PubMed

Khelassi, Abdeldjalil

2014-01-01

Active research is being conducted to determine the prognosis for breast cancer. However, the uncertainty is a major obstacle in this domain of medical research. In that context, explanation-aware computing has the potential for providing meaningful interactions between complex medical applications and users, which would ensure a significant reduction of uncertainty and risks. This paper presents an explanation-aware agent, supported by Intensive Knowledge-Distributed Case-Based Reasoning Classifier (IK-DCBRC), to reduce the uncertainty and risks associated with the diagnosis of breast cancer. A meaningful explanation is generated by inferring from a rule-based system according to the level of abstraction and the reasoning traces. The computer-aided detection is conducted by IK-DCBRC, which is a multi-agent system that applies the case-based reasoning paradigm and a fuzzy similarity function for the automatic prognosis by the class of breast tumors, i.e. malignant or benign, from a pattern of cytological images. A meaningful interaction between the physician and the computer-aided diagnosis system, IK-DCBRC, is achieved via an intelligent agent. The physician can observe the trace of reasoning, terms, justifications, and the strategy to be used to decrease the risks and doubts associated with the automatic diagnosis. The capability of the system we have developed was proven by an example in which conflicts were clarified and transparency was ensured. The explanation agent ensures the transparency of the automatic diagnosis of breast cancer supported by IK-DCBRC, which decreases uncertainty and risks and detects some conflicts.

Elective Self-Care Course Emphasizing Critical Reasoning Principles

PubMed Central

2011-01-01

Objectives. To create, implement, and assess a self-directed online course based on 3 critical reasoning principles to develop pharmacy students’ skills in literature appraisal, content, metacognition, and assessment. Design. Students completed 3 assignments for the course: compile a literature appraisal on a healthcare topic; plan learning objectives and meta-cognitive skills for a learning module; and create a case-based online lesson with multi-structured feedback. Assessment. An online exit survey evaluated students’ perceptions regarding development of ACE (agency, collaboration, expertise) principles and preparation for competency. Students reported acquisition of ACE principles and noted improvements in their learning approaches, sense of responsibility for individual and community learning, skills, and confidence. Conclusions. An online elective course in self-care addressed practice standards for patient safety, maintenance of competency, and interprofessional education by emphasizing critical reasoning skills. PMID:22171110

Low Speed and High Speed Correlation of SMART Active Flap Rotor Loads

NASA Technical Reports Server (NTRS)

Kottapalli, Sesi B. R.

2010-01-01

Measured, open loop and closed loop data from the SMART rotor test in the NASA Ames 40- by 80- Foot Wind Tunnel are compared with CAMRAD II calculations. One open loop high-speed case and four closed loop cases are considered. The closed loop cases include three high-speed cases and one low-speed case. Two of these high-speed cases include a 2 deg flap deflection at 5P case and a test maximum-airspeed case. This study follows a recent, open loop correlation effort that used a simple correction factor for the airfoil pitching moment Mach number. Compared to the earlier effort, the current open loop study considers more fundamental corrections based on advancing blade aerodynamic conditions. The airfoil tables themselves have been studied. Selected modifications to the HH-06 section flap airfoil pitching moment table are implemented. For the closed loop condition, the effect of the flap actuator is modeled by increased flap hinge stiffness. Overall, the open loop correlation is reasonable, thus confirming the basic correctness of the current semi-empirical modifications; the closed loop correlation is also reasonable considering that the current flap model is a first generation model. Detailed correlation results are given in the paper.

Clinical reasoning in nursing, a think-aloud study using virtual patients - a base for an innovative assessment.

PubMed

Forsberg, Elenita; Ziegert, Kristina; Hult, Håkan; Fors, Uno

2014-04-01

In health-care education, it is important to assess the competencies that are essential for the professional role. To develop clinical reasoning skills is crucial for nursing practice and therefore an important learning outcome in nursing education programmes. Virtual patients (VPs) are interactive computer simulations of real-life clinical scenarios and have been suggested for use not only for learning, but also for assessment of clinical reasoning. The aim of this study was to investigate how experienced paediatric nurses reason regarding complex VP cases and how they make clinical decisions. The study was also aimed to give information about possible issues that should be assessed in clinical reasoning exams for post-graduate students in diploma specialist paediatric nursing education. The information from this study is believed to be of high value when developing scoring and grading models for a VP-based examination for the specialist diploma in paediatric nursing education. Using the think-aloud method, data were collected from 30 RNs working in Swedish paediatric departments, and child or school health-care centres. Content analysis was used to analyse the data. The results indicate that experienced nurses try to consolidate their hypotheses by seeing a pattern and judging the value of signs, symptoms, physical examinations, laboratory tests and radiology. They show high specific competence but earlier experience of similar cases was also of importance for the decision making. The nurses thought it was an innovative assessment focusing on clinical reasoning and clinical decision making. They thought it was an enjoyable way to be assessed and that all three main issues could be assessed using VPs. In conclusion, VPs seem to be a possible model for assessing the clinical reasoning process and clinical decision making, but how to score and grade such exams needs further research. © 2013.

Faultfinder: A diagnostic expert system with graceful degradation for onboard aircraft applications

NASA Technical Reports Server (NTRS)

Abbott, Kathy H.; Schutte, Paul C.; Palmer, Michael T.; Ricks, Wendell R.

1988-01-01

A research effort was conducted to explore the application of artificial intelligence technology to automation of fault monitoring and diagnosis as an aid to the flight crew. Human diagnostic reasoning was analyzed and actual accident and incident cases were reconstructed. Based on this analysis and reconstruction, diagnostic concepts were conceived and implemented for an aircraft's engine and hydraulic subsystems. These concepts are embedded within a multistage approach to diagnosis that reasons about time-based, causal, and qualitative information, and enables a certain amount of graceful degradation. The diagnostic concepts are implemented in a computer program called Faultfinder that serves as a research prototype.

Massively parallel support for a case-based planning system

NASA Technical Reports Server (NTRS)

Kettler, Brian P.; Hendler, James A.; Anderson, William A.

1993-01-01

Case-based planning (CBP), a kind of case-based reasoning, is a technique in which previously generated plans (cases) are stored in memory and can be reused to solve similar planning problems in the future. CBP can save considerable time over generative planning, in which a new plan is produced from scratch. CBP thus offers a potential (heuristic) mechanism for handling intractable problems. One drawback of CBP systems has been the need for a highly structured memory to reduce retrieval times. This approach requires significant domain engineering and complex memory indexing schemes to make these planners efficient. In contrast, our CBP system, CaPER, uses a massively parallel frame-based AI language (PARKA) and can do extremely fast retrieval of complex cases from a large, unindexed memory. The ability to do fast, frequent retrievals has many advantages: indexing is unnecessary; very large case bases can be used; memory can be probed in numerous alternate ways; and queries can be made at several levels, allowing more specific retrieval of stored plans that better fit the target problem with less adaptation. In this paper we describe CaPER's case retrieval techniques and some experimental results showing its good performance, even on large case bases.

Designing and Implementation of Fuzzy Case-based Reasoning System on Android Platform Using Electronic Discharge Summary of Patients with Chronic Kidney Diseases

PubMed Central

Tahmasebian, Shahram; Langarizadeh, Mostafa; Ghazisaeidi, Marjan; Mahdavi-Mazdeh, Mitra

2016-01-01

Introduction: Case-based reasoning (CBR) systems are one of the effective methods to find the nearest solution to the current problems. These systems are used in various spheres as well as industry, business, and economy. The medical field is not an exception in this regard, and these systems are nowadays used in the various aspects of diagnosis and treatment. Methodology: In this study, the effective parameters were first extracted from the structured discharge summary prepared for patients with chronic kidney diseases based on data mining method. Then, through holding a meeting with experts in nephrology and using data mining methods, the weights of the parameters were extracted. Finally, fuzzy system has been employed in order to compare the similarities of current case and previous cases, and the system was implemented on the Android platform. Discussion: The data on electronic discharge records of patients with chronic kidney diseases were entered into the system. The measure of similarity was assessed using the algorithm provided in the system, and then compared with other known methods in CBR systems. Conclusion: Developing Clinical fuzzy CBR system used in Knowledge management framework for registering specific therapeutic methods, Knowledge sharing environment for experts in a specific domain and Powerful tools at the point of care. PMID:27708490

Model of critical diagnostic reasoning: achieving expert clinician performance.

PubMed

Harjai, Prashant Kumar; Tiwari, Ruby

2009-01-01

Diagnostic reasoning refers to the analytical processes used to determine patient health problems. While the education curriculum and health care system focus on training nurse clinicians to accurately recognize and rescue clinical situations, assessments of non-expert nurses have yielded less than satisfactory data on diagnostic competency. The contrast between the expert and non-expert nurse clinician raises the important question of how differences in thinking may contribute to a large divergence in accurate diagnostic reasoning. This article recognizes superior organization of one's knowledge base, using prototypes, and quick retrieval of pertinent information, using similarity recognition as two reasons for the expert's superior diagnostic performance. A model of critical diagnostic reasoning, using prototypes and similarity recognition, is proposed and elucidated using case studies. This model serves as a starting point toward bridging the gap between clinical data and accurate problem identification, verification, and management while providing a structure for a knowledge exchange between expert and non-expert clinicians.

Orchestrating Semiotic Leaps from Tacit to Cultural Quantitative Reasoning--The Case of Anticipating Experimental Outcomes of a Quasi-Binomial Random Generator

ERIC Educational Resources Information Center

Abrahamson, Dor

2009-01-01

This article reports on a case study from a design-based research project that investigated how students make sense of the disciplinary tools they are taught to use, and specifically, what personal, interpersonal, and material resources support this process. The probability topic of binomial distribution was selected due to robust documentation of…

Inductive reasoning.

PubMed

Hayes, Brett K; Heit, Evan; Swendsen, Haruka

2010-03-01

Inductive reasoning entails using existing knowledge or observations to make predictions about novel cases. We review recent findings in research on category-based induction as well as theoretical models of these results, including similarity-based models, connectionist networks, an account based on relevance theory, Bayesian models, and other mathematical models. A number of touchstone empirical phenomena that involve taxonomic similarity are described. We also examine phenomena involving more complex background knowledge about premises and conclusions of inductive arguments and the properties referenced. Earlier models are shown to give a good account of similarity-based phenomena but not knowledge-based phenomena. Recent models that aim to account for both similarity-based and knowledge-based phenomena are reviewed and evaluated. Among the most important new directions in induction research are a focus on induction with uncertain premise categories, the modeling of the relationship between inductive and deductive reasoning, and examination of the neural substrates of induction. A common theme in both the well-established and emerging lines of induction research is the need to develop well-articulated and empirically testable formal models of induction. Copyright © 2010 John Wiley & Sons, Ltd. For further resources related to this article, please visit the WIREs website. Copyright © 2010 John Wiley & Sons, Ltd.

Case-Based Reasoning in Transfer Learning

DTIC Science & Technology

2009-01-01

study of transfer in psychology and education (e.g., Thorndike & Woodworth, 1901; Perkins & Salomon, 1994; Bransford et al., 2000), among other...Sutton, R., & Barto, A. (1998). Reinforcement learning: An introduction. Cambridge, MA: MIT Press. Thorndike , E.L., & Woodworth, R.S. (1901). The

Development of decision support systems for real-time freeway traffic routing : volume II.

DOT National Transportation Integrated Search

1998-01-01

Real-time traffic flow routing is a promising approach to alleviating congestion. Existing approaches to developing real-time routing strategies, however, have limitations. This study explored the potential for using case-based reasoning (CBR), an em...

Dynamic Uncertain Causality Graph for Knowledge Representation and Reasoning: Utilization of Statistical Data and Domain Knowledge in Complex Cases.

PubMed

Zhang, Qin; Yao, Quanying

2018-05-01

The dynamic uncertain causality graph (DUCG) is a newly presented framework for uncertain causality representation and probabilistic reasoning. It has been successfully applied to online fault diagnoses of large, complex industrial systems, and decease diagnoses. This paper extends the DUCG to model more complex cases than what could be previously modeled, e.g., the case in which statistical data are in different groups with or without overlap, and some domain knowledge and actions (new variables with uncertain causalities) are introduced. In other words, this paper proposes to use -mode, -mode, and -mode of the DUCG to model such complex cases and then transform them into either the standard -mode or the standard -mode. In the former situation, if no directed cyclic graph is involved, the transformed result is simply a Bayesian network (BN), and existing inference methods for BNs can be applied. In the latter situation, an inference method based on the DUCG is proposed. Examples are provided to illustrate the methodology.

[Child psychiatric assessment and the debate regarding the abuse of abuse].

PubMed

Fegert, J M

1995-03-01

The current discussion on false allegations in sexual abuse cases has led to a polarization in the views expressed about the credibility of children. Some authors even speak of a "child sexual accuse syndrome" or of a "sexual abuse allegation in divorce" (SAID) syndrome. A phenomenological analysis of the multiple reasons for misinterpretations is presented. Instead of stressing the importance only of false positives in child sexual abuse questions, an attempt is made to describe reasons for false negatives. Based on a retrospective analysis of 50 consecutive child psychiatric experts in connection with court cases, there does not appear to be an increase in false accusations. Rather, only about one third of the cases even involved suspected sexual abuse. Sexual abuse allegations were much more frequent in girls than in boys. Of 20 abuse allegations we judge four to be false allegations. In only one of these cases, that of an adolescent girl who had been abused in childhood, was the false allegation intended.

Towards a computational- and algorithmic-level account of concept blending using analogies and amalgams

NASA Astrophysics Data System (ADS)

Besold, Tarek R.; Kühnberger, Kai-Uwe; Plaza, Enric

2017-10-01

Concept blending - a cognitive process which allows for the combination of certain elements (and their relations) from originally distinct conceptual spaces into a new unified space combining these previously separate elements, and enables reasoning and inference over the combination - is taken as a key element of creative thought and combinatorial creativity. In this article, we summarise our work towards the development of a computational-level and algorithmic-level account of concept blending, combining approaches from computational analogy-making and case-based reasoning (CBR). We present the theoretical background, as well as an algorithmic proposal integrating higher-order anti-unification matching and generalisation from analogy with amalgams from CBR. The feasibility of the approach is then exemplified in two case studies.

Integrating Mission-Based Values into Accounting Curriculum: Catholic Social Teaching and Introductory Accounting

ERIC Educational Resources Information Center

Hise, Joan Vane; Koeplin, John P.

2010-01-01

This paper presents several reasons why mission-based values, in this case Catholic Social Teaching (CST), should be incorporated into a university business curriculum. The CST tenets include the sanctity of human life; call to family, community, and participation; rights and responsibilities; option for the poor and vulnerable; the dignity of…

Exploring Leadership in Schools-Based iPad Initiatives: A Case Study

ERIC Educational Resources Information Center

Harrold, Richard

2017-01-01

The world's first school-based one-to-one iPad initiative was implemented in a British school in 2010. Every year since, more iPad initiatives have been implemented in British schools, with school leaders citing various reasons for introducing them. However, results of iPad initiatives have not always matched expectations. British schools are also…

A Qualitative Study about Performance Based Assesment Methods Used in Information Technologies Lesson

ERIC Educational Resources Information Center

Daghan, Gökhan; Akkoyunlu, Buket

2014-01-01

In this study, Information Technologies teachers' views and usage cases on performance based assesment methods (PBAMs) are examined. It is aimed to find out which of the PBAMs are used frequently or not used, preference reasons of these methods and opinions about the applicability of them. Study is designed with the phenomenological design which…

Reflexive Principlism as an Effective Approach for Developing Ethical Reasoning in Engineering.

PubMed

Beever, Jonathan; Brightman, Andrew O

2016-02-01

An important goal of teaching ethics to engineering students is to enhance their ability to make well-reasoned ethical decisions in their engineering practice: a goal in line with the stated ethical codes of professional engineering organizations. While engineering educators have explored a wide range of methodologies for teaching ethics, a satisfying model for developing ethical reasoning skills has not been adopted broadly. In this paper we argue that a principlist-based approach to ethical reasoning is uniquely suited to engineering ethics education. Reflexive Principlism is an approach to ethical decision-making that focuses on internalizing a reflective and iterative process of specification, balancing, and justification of four core ethical principles in the context of specific cases. In engineering, that approach provides structure to ethical reasoning while allowing the flexibility for adaptation to varying contexts through specification. Reflexive Principlism integrates well with the prevalent and familiar methodologies of reasoning within the engineering disciplines as well as with the goals of engineering ethics education.

Casuistry as bioethical method: an empirical perspective.

PubMed

Braunack-Mayer, A

2001-07-01

This paper examines the role that casuistry, a model of bioethical reasoning revived by Jonsen and Toulmin, plays in ordinary moral reasoning. I address the question: 'What is the evidence for contemporary casuistry's claim that everyday moral reasoning is casuistic in nature?' The paper begins with a description of the casuistic method, and then reviews the empirical arguments Jonsen and Toulmin offer to show that every-day moral decision-making is casuistic. Finally, I present the results of qualitative research conducted with 15 general practitioners (GPs) in South Australia, focusing on the ways in which these GP participants used stories and anecdotes in their own moral reasoning. This research found that the GPs interviewed did use a form of casuistry when talking about ethical dilemmas. However, the GPs' homespun casuistry often lacked one central element of casuistic reasoning--clear paradigm cases on which to base comparisons. I conclude that casuistic reasoning does appear to play a role in every-day moral decision-making, but that it is a more subdued role than perhaps casuists would like.

The probability heuristics model of syllogistic reasoning.

PubMed

Chater, N; Oaksford, M

1999-03-01

A probability heuristic model (PHM) for syllogistic reasoning is proposed. An informational ordering over quantified statements suggests simple probability based heuristics for syllogistic reasoning. The most important is the "min-heuristic": choose the type of the least informative premise as the type of the conclusion. The rationality of this heuristic is confirmed by an analysis of the probabilistic validity of syllogistic reasoning which treats logical inference as a limiting case of probabilistic inference. A meta-analysis of past experiments reveals close fits with PHM. PHM also compares favorably with alternative accounts, including mental logics, mental models, and deduction as verbal reasoning. Crucially, PHM extends naturally to generalized quantifiers, such as Most and Few, which have not been characterized logically and are, consequently, beyond the scope of current mental logic and mental model theories. Two experiments confirm the novel predictions of PHM when generalized quantifiers are used in syllogistic arguments. PHM suggests that syllogistic reasoning performance may be determined by simple but rational informational strategies justified by probability theory rather than by logic. Copyright 1999 Academic Press.

Billing code algorithms to identify cases of peripheral artery disease from administrative data

PubMed Central

Fan, Jin; Arruda-Olson, Adelaide M; Leibson, Cynthia L; Smith, Carin; Liu, Guanghui; Bailey, Kent R; Kullo, Iftikhar J

2013-01-01

Objective To construct and validate billing code algorithms for identifying patients with peripheral arterial disease (PAD). Methods We extracted all encounters and line item details including PAD-related billing codes at Mayo Clinic Rochester, Minnesota, between July 1, 1997 and June 30, 2008; 22 712 patients evaluated in the vascular laboratory were divided into training and validation sets. Multiple logistic regression analysis was used to create an integer code score from the training dataset, and this was tested in the validation set. We applied a model-based code algorithm to patients evaluated in the vascular laboratory and compared this with a simpler algorithm (presence of at least one of the ICD-9 PAD codes 440.20–440.29). We also applied both algorithms to a community-based sample (n=4420), followed by a manual review. Results The logistic regression model performed well in both training and validation datasets (c statistic=0.91). In patients evaluated in the vascular laboratory, the model-based code algorithm provided better negative predictive value. The simpler algorithm was reasonably accurate for identification of PAD status, with lesser sensitivity and greater specificity. In the community-based sample, the sensitivity (38.7% vs 68.0%) of the simpler algorithm was much lower, whereas the specificity (92.0% vs 87.6%) was higher than the model-based algorithm. Conclusions A model-based billing code algorithm had reasonable accuracy in identifying PAD cases from the community, and in patients referred to the non-invasive vascular laboratory. The simpler algorithm had reasonable accuracy for identification of PAD in patients referred to the vascular laboratory but was significantly less sensitive in a community-based sample. PMID:24166724

Factors Influencing Students' Propensity for Semantic and Syntactic Reasoning in Proof Writing: A Case Study

ERIC Educational Resources Information Center

Mejía-Ramos, Juan Pablo; Weber, Keith; Fuller, Evan

2015-01-01

In this paper we present a case study of an individual student who consistently used semantic reasoning to construct proofs in calculus but infrequently used semantic reasoning to produce proofs in linear algebra. We hypothesize that the differences in these reasoning styles can be partially attributed to this student's familiarity with the…

Registered nurses' clinical reasoning skills and reasoning process: A think-aloud study.

PubMed

Lee, JuHee; Lee, Young Joo; Bae, JuYeon; Seo, Minjeong

2016-11-01

As complex chronic diseases are increasing, nurses' prompt and accurate clinical reasoning skills are essential. However, little is known about the reasoning skills of registered nurses. This study aimed to determine how registered nurses use their clinical reasoning skills and to identify how the reasoning process proceeds in the complex clinical situation of hospital setting. A qualitative exploratory design was used with a think-aloud method. A total of 13 registered nurses (mean years of experience=11.4) participated in the study, solving an ill-structured clinical problem based on complex chronic patients cases in a hospital setting. Data were analyzed using deductive content analysis. Findings showed that the registered nurses used a variety of clinical reasoning skills. The most commonly used skill was 'checking accuracy and reliability.' The reasoning process of registered nurses covered assessment, analysis, diagnosis, planning/implementation, and evaluation phase. It is critical that registered nurses apply appropriate clinical reasoning skills in complex clinical practice. The main focus of registered nurses' reasoning in this study was assessing a patient's health problem, and their reasoning process was cyclic, rather than linear. There is a need for educational strategy development to enhance registered nurses' competency in determining appropriate interventions in a timely and accurate fashion. Copyright © 2016 Elsevier Ltd. All rights reserved.

Simulation-Based Dysphagia Training: Teaching Interprofessional Clinical Reasoning in a Hospital Environment.

PubMed

Miles, Anna; Friary, Philippa; Jackson, Bianca; Sekula, Julia; Braakhuis, Andrea

2016-06-01

This study evaluated hospital readiness and interprofessional clinical reasoning in speech-language pathology and dietetics students following a simulation-based teaching package. Thirty-one students participated in two half-day simulation workshops. The training included orientation to the hospital setting, part-task skill learning and immersive simulated cases. Students completed workshop evaluation forms. They filled in a 10-question survey regarding confidence, knowledge and preparedness for working in a hospital environment before and immediately after the workshops. Students completed written 15-min clinical vignettes at 1 month prior to training, immediately prior to training and immediately after training. A marking rubric was devised to evaluate the responses to the clinical vignettes within a framework of interprofessional education. The simulation workshops were well received by all students. There was a significant increase in students' self-ratings of confidence, preparedness and knowledge following the study day (p < .001). There was a significant increase in student overall scores in clinical vignettes after training with the greatest increase in clinical reasoning (p < .001). Interprofessional simulation-based training has benefits in developing hospital readiness and clinical reasoning in allied health students.

Introduction of a computer-based surgical platform in the surgical care of patients with newly diagnosed uterine cancer: outcomes and impact on approach.

PubMed

Leitao, Mario M; Briscoe, Gabriel; Santos, Kevin; Winder, Abigail; Jewell, Elizabeth L; Hoskins, William J; Chi, Dennis S; Abu-Rustum, Nadeem R; Sonoda, Yukio; Brown, Carol L; Levine, Douglas A; Barakat, Richard R; Gardner, Ginger J

2012-05-01

To assess the introduction of computer-based surgery (ie, robotic surgery [RBT]) in the treatment of patients with newly diagnosed uterine cancer. We identified all patients who presented to our institution for initial surgical care of newly diagnosed uterine cancer from 5/1/07-12/31/10. Perioperative outcomes of laparotomy cases were compared to those of laparoscopic (LSC) or RBT cases. Complications within 30 days of surgery were graded. Of 752 patients, the planned approach was laparotomy in 103 (14%), LSC in 302 (40%), and RBT in 347 (46%). The rate of laparotomy for any reason (planned or converted) was 39% in 2007 compared to 18% in 2010 (P<0.001). Preoperative characteristics for LSC and RBT cases were similar, except 10% versus 15%, respectively, were morbidly obese (P=0.049). The extent of procedure, total nodal counts, and overall complications were similar between the LSC and RBT cases. The median length of stay was shorter for RBT cases (P<0.001). The median total room and operative times were longer for RBT cases (P<0.001), mainly due to cases in which the surgeon had less than ~40 RBT cases of experience. Robotics can be efficiently introduced into the surgical care of patients with newly diagnosed uterine cancers. RBT cases require the same operative times as LSC cases after accounting for the 40-case learning curve. Both approaches result in similar excellent patient outcomes and remain reasonable approaches for this disease. The introduction of robotics may lead to further reduction in the rate of laparotomy. Copyright © 2012 Elsevier Inc. All rights reserved.

Multi-scale modeling of CO2 dispersion leaked from seafloor off the Japanese coast.

PubMed

Kano, Yuki; Sato, Toru; Kita, Jun; Hirabayashi, Shinichiro; Tabeta, Shigeru

2010-02-01

A numerical simulation was conducted to predict the change of pCO(2) in the ocean caused by CO(2) leaked from an underground aquifer, in which CO(2) is purposefully stored. The target space of the present model was the ocean above the seafloor. The behavior of CO(2) bubbles, their dissolution, and the advection-diffusion of dissolved CO(2) were numerically simulated. Here, two cases for the leakage rate were studied: an extreme case, 94,600 t/y, which assumed that a large fault accidentally connects the CO(2) reservoir and the seafloor; and a reasonable case, 3800 t/y, based on the seepage rate of an existing EOR site. In the extreme case, the calculated increase in DeltapCO(2) experienced by floating organisms was less than 300 ppm, while that for immobile organisms directly over the fault surface periodically exceeded 1000 ppm, if momentarily. In the reasonable case, the calculated DeltapCO(2) and pH were within the range of natural fluctuation. Copyright 2009 Elsevier Ltd. All rights reserved.

Categorization and reasoning among tree experts: do all roads lead to Rome?

PubMed

Medin, D L; Lynch, E B; Coley, J D; Atran, S

1997-02-01

To what degree do conceptual systems reflect universal patterns of featural covariation in the world (similarity) or universal organizing principles of mind, and to what degree do they reflect specific goals, theories, and beliefs of the categorizer? This question was addressed in experiments concerned with categorization and reasoning among different types of tree experts (e.g., taxonomists, landscape workers, parks maintenance personnel). The results show an intriguing pattern of similarities and differences. Differences in sorting between taxonomists and maintenance workers reflect differences in weighting of morphological features. Landscape workers, in contrast, sort trees into goal-derived categories based on utilitarian concerns. These sorting patterns carry over into category-based reasoning for the taxonomists and maintenance personnel but not the landscape workers. These generalizations interact with taxonomic rank and suggest that the genus (or folk generic) level is relatively and in some cases absolutely privileged. Implications of these findings for theories of categorization are discussed.

Logic as Marr's Computational Level: Four Case Studies.

PubMed

Baggio, Giosuè; van Lambalgen, Michiel; Hagoort, Peter

2015-04-01

We sketch four applications of Marr's levels-of-analysis methodology to the relations between logic and experimental data in the cognitive neuroscience of language and reasoning. The first part of the paper illustrates the explanatory power of computational level theories based on logic. We show that a Bayesian treatment of the suppression task in reasoning with conditionals is ruled out by EEG data, supporting instead an analysis based on defeasible logic. Further, we describe how results from an EEG study on temporal prepositions can be reanalyzed using formal semantics, addressing a potential confound. The second part of the article demonstrates the predictive power of logical theories drawing on EEG data on processing progressive constructions and on behavioral data on conditional reasoning in people with autism. Logical theories can constrain processing hypotheses all the way down to neurophysiology, and conversely neuroscience data can guide the selection of alternative computational level models of cognition. Copyright © 2014 Cognitive Science Society, Inc.

Case Study: Lackland Air Force Base Commissary

EPA Pesticide Factsheets

DeCA chose to adopt a NH3/CO2 cascade system for two main reasons: (1) to control future capital and operating costs, and (2) to meet the energy and sustainability goals the U.S. Government has established for all public buildings.

Hybrid approach for robust diagnostics of cutting tools

NASA Astrophysics Data System (ADS)

Ramamurthi, K.; Hough, C. L., Jr.

1994-03-01

A new multisensor based hybrid technique has been developed for robust diagnosis of cutting tools. The technique combines the concepts of pattern classification and real-time knowledge based systems (RTKBS) and draws upon their strengths; learning facility in the case of pattern classification and a higher level of reasoning in the case of RTKBS. It eliminates some of their major drawbacks: false alarms or delayed/lack of diagnosis in case of pattern classification and tedious knowledge base generation in case of RTKBS. It utilizes a dynamic distance classifier, developed upon a new separability criterion and a new definition of robust diagnosis for achieving these benefits. The promise of this technique has been proven concretely through an on-line diagnosis of drill wear. Its suitability for practical implementation is substantiated by the use of practical, inexpensive, machine-mounted sensors and low-cost delivery systems.

Reasoning and Knowledge Acquisition Framework for 5G Network Analytics

PubMed Central

2017-01-01

Autonomic self-management is a key challenge for next-generation networks. This paper proposes an automated analysis framework to infer knowledge in 5G networks with the aim to understand the network status and to predict potential situations that might disrupt the network operability. The framework is based on the Endsley situational awareness model, and integrates automated capabilities for metrics discovery, pattern recognition, prediction techniques and rule-based reasoning to infer anomalous situations in the current operational context. Those situations should then be mitigated, either proactive or reactively, by a more complex decision-making process. The framework is driven by a use case methodology, where the network administrator is able to customize the knowledge inference rules and operational parameters. The proposal has also been instantiated to prove its adaptability to a real use case. To this end, a reference network traffic dataset was used to identify suspicious patterns and to predict the behavior of the monitored data volume. The preliminary results suggest a good level of accuracy on the inference of anomalous traffic volumes based on a simple configuration. PMID:29065473

Application of Psychological Theories in Agent-Based Modeling: The Case of the Theory of Planned Behavior.

PubMed

Scalco, Andrea; Ceschi, Andrea; Sartori, Riccardo

2018-01-01

It is likely that computer simulations will assume a greater role in the next future to investigate and understand reality (Rand & Rust, 2011). Particularly, agent-based models (ABMs) represent a method of investigation of social phenomena that blend the knowledge of social sciences with the advantages of virtual simulations. Within this context, the development of algorithms able to recreate the reasoning engine of autonomous virtual agents represents one of the most fragile aspects and it is indeed crucial to establish such models on well-supported psychological theoretical frameworks. For this reason, the present work discusses the application case of the theory of planned behavior (TPB; Ajzen, 1991) in the context of agent-based modeling: It is argued that this framework might be helpful more than others to develop a valid representation of human behavior in computer simulations. Accordingly, the current contribution considers issues related with the application of the model proposed by the TPB inside computer simulations and suggests potential solutions with the hope to contribute to shorten the distance between the fields of psychology and computer science.

Thermodynamic heuristics with case-based reasoning: combined insights for RNA pseudoknot secondary structure.

PubMed

Al-Khatib, Ra'ed M; Rashid, Nur'Aini Abdul; Abdullah, Rosni

2011-08-01

The secondary structure of RNA pseudoknots has been extensively inferred and scrutinized by computational approaches. Experimental methods for determining RNA structure are time consuming and tedious; therefore, predictive computational approaches are required. Predicting the most accurate and energy-stable pseudoknot RNA secondary structure has been proven to be an NP-hard problem. In this paper, a new RNA folding approach, termed MSeeker, is presented; it includes KnotSeeker (a heuristic method) and Mfold (a thermodynamic algorithm). The global optimization of this thermodynamic heuristic approach was further enhanced by using a case-based reasoning technique as a local optimization method. MSeeker is a proposed algorithm for predicting RNA pseudoknot structure from individual sequences, especially long ones. This research demonstrates that MSeeker improves the sensitivity and specificity of existing RNA pseudoknot structure predictions. The performance and structural results from this proposed method were evaluated against seven other state-of-the-art pseudoknot prediction methods. The MSeeker method had better sensitivity than the DotKnot, FlexStem, HotKnots, pknotsRG, ILM, NUPACK and pknotsRE methods, with 79% of the predicted pseudoknot base-pairs being correct.

Reasoning and Knowledge Acquisition Framework for 5G Network Analytics.

PubMed

Sotelo Monge, Marco Antonio; Maestre Vidal, Jorge; García Villalba, Luis Javier

2017-10-21

Autonomic self-management is a key challenge for next-generation networks. This paper proposes an automated analysis framework to infer knowledge in 5G networks with the aim to understand the network status and to predict potential situations that might disrupt the network operability. The framework is based on the Endsley situational awareness model, and integrates automated capabilities for metrics discovery, pattern recognition, prediction techniques and rule-based reasoning to infer anomalous situations in the current operational context. Those situations should then be mitigated, either proactive or reactively, by a more complex decision-making process. The framework is driven by a use case methodology, where the network administrator is able to customize the knowledge inference rules and operational parameters. The proposal has also been instantiated to prove its adaptability to a real use case. To this end, a reference network traffic dataset was used to identify suspicious patterns and to predict the behavior of the monitored data volume. The preliminary results suggest a good level of accuracy on the inference of anomalous traffic volumes based on a simple configuration.

[Behavioral phenotypes: cognitive and emotional explanation].

PubMed

Pérez-Alvarez, F; Timoneda-Gallart, C

We present a series of Behavioural phenotypes treated with neurocognitive and neuroemotional procedure. A sample of 26 cases were selected according to qualitative methodology from neuropediatric patients. The method was based on using the PASS theory of intelligence to approach the cognitive problem and the theory of masquerade behaviour as self-defence to solve the emotional problem. Both theories have neurological bases. DN:CAS battery was utilized for assessment of cognitive processes. On the other hand, analysis of cases was carried out doing data analysis with video recorder device. All cases were considered responder cases although in different degree. The responder was defined as the patient which reached better intellectual achievement with respect to cognitive function and which gave up, at least partially, masquerade Behaviour with respect to emotional function. The Behaviour of the Behavioural phenotypes has neurological rationale. The PASS theory and the planning, in particular, supported by prefrontal cortex justifies consistently some behaviours. The masquerade Behaviour theory is explained by the fear emotional response mechanism which means emotion is a cerebral processing with neurological rationale. The Behavioural phenotypes are Behaviours and every Behaviour can be explained by neurological reasons both cognitive and emotional reasons. So, they can be treated by a cognitive and emotional procedure understood in the light of the neurology.

Justify Your Answer: The Role of Written Think Aloud in Script Concordance Testing.

PubMed

Power, Alyssa; Lemay, Jean-Francois; Cooke, Suzette

2017-01-01

Construct: Clinical reasoning assessment is a growing area of interest in the medical education literature. Script concordance testing (SCT) evaluates clinical reasoning in conditions of uncertainty and has emerged as an innovative tool in the domain of clinical reasoning assessment. SCT quantifies the degree of concordance between a learner and an experienced clinician and attempts to capture the breadth of responses of expert clinicians, acknowledging the significant yet acceptable variation in practice under situations of uncertainty. SCT has been shown to be a valid and reliable clinical reasoning assessment tool. However, as SCT provides only quantitative information, it may not provide a complete assessment of clinical reasoning. Think aloud (TA) is a qualitative research tool used in clinical reasoning assessment in which learners verbalize their thought process around an assigned task. This study explores the use of TA, in the form of written reflection, in SCT to assess resident clinical reasoning, hypothesizing that the information obtained from the written TA would enrich the quantitative data obtained through SCT. Ninety-one pediatric postgraduate trainees and 21 pediatricians from 4 Canadian training centers completed an online test consisting of 24 SCT cases immediately followed by retrospective written TA. Six of 24 cases were selected to gather TA data. These cases were chosen to allow all phases of clinical decision making (diagnosis, investigation, and treatment) to be represented in the TA data. Inductive thematic analysis was employed when systematically reviewing TA responses. Three main benefits of adding written TA to SCT were identified: (a) uncovering instances of incorrect clinical reasoning despite a correct SCT response, (b) revealing sound clinical reasoning in the context of a suboptimal SCT response, and (c) detecting question misinterpretation. Written TA can optimize SCT by demonstrating when correct examinee responses are based on guessing or uncertainty rather than robust clinical rationale. TA can also enhance SCT by allowing examinees to provide justification for responses that otherwise would have been considered incorrect and by identifying questions that are frequently misinterpreted to avoid including them in future examinations. TA also has significant value in differentiating between acceptable variations in expert clinician responses and deviance associated with faulty rationale or question misinterpretation; this could improve SCT reliability. A written TA protocol appears to be a valuable tool to assess trainees' clinical reasoning and can strengthen the quantitative assessment provided by SCT.

The Pacor 2 expert system: A case-based reasoning approach to troubleshooting

NASA Technical Reports Server (NTRS)

Sary, Charisse

1994-01-01

The Packet Processor 2 (Pacor 2) Data Capture Facility (DCF) acquires, captures, and performs level-zero processing of packet telemetry for spaceflight missions that adhere to communication services recommendations established by the Consultative Committee for Space Data Systems (CCSDS). A major goal of this project is to reduce life-cycle costs. One way to achieve this goal is to increase automation. Through automation, using expert systems, and other technologies, staffing requirements will remain static, which will enable the same number of analysts to support more missions. Analysts provide packet telemetry data evaluation and analysis services for all data received. Data that passes this evaluation is forwarded to the Data Distribution Facility (DDF) and released to scientists. Through troubleshooting, data that fails this evaluation is dumped and analyzed to determine if its quality can be improved before it is released. This paper describes a proof-of-concept prototype that troubleshoots data quality problems. The Pacor 2 expert system prototype uses the case-based reasoning (CBR) approach to development, an alternative to a rule-based approach. Because Pacor 2 is not operational, the prototype has been developed using cases that describe existing troubleshooting experience from currently operating missions. Through CBR, this experience will be available to analysts when Pacor 2 becomes operational. As Pacor 2 unique experience is gained, analysts will update the case base. In essence, analysts are training the system as they learn. Once the system has learned the cases most likely to recur, it can serve as an aide to inexperienced analysts, a refresher to experienced analysts for infrequently occurring problems, or a training tool for new analysts. The Expert System Development Methodology (ESDM) is being used to guide development.

Using Psychometric Technology in Educational Assessment: The Case of a Schema-Based Isomorphic Approach to the Automatic Generation of Quantitative Reasoning Items

ERIC Educational Resources Information Center

Arendasy, Martin; Sommer, Markus

2007-01-01

This article deals with the investigation of the psychometric quality and constructs validity of algebra word problems generated by means of a schema-based version of the automatic min-max approach. Based on review of the research literature in algebra word problem solving and automatic item generation this new approach is introduced as a…

A hybrid intelligence approach to artifact recognition in digital publishing

NASA Astrophysics Data System (ADS)

Vega-Riveros, J. Fernando; Santos Villalobos, Hector J.

2006-02-01

The system presented integrates rule-based and case-based reasoning for artifact recognition in Digital Publishing. In Variable Data Printing (VDP) human proofing could result prohibitive since a job could contain millions of different instances that may contain two types of artifacts: 1) evident defects, like a text overflow or overlapping 2) style-dependent artifacts, subtle defects that show as inconsistencies with regard to the original job design. We designed a Knowledge-Based Artifact Recognition tool for document segmentation, layout understanding, artifact detection, and document design quality assessment. Document evaluation is constrained by reference to one instance of the VDP job proofed by a human expert against the remaining instances. Fundamental rules of document design are used in the rule-based component for document segmentation and layout understanding. Ambiguities in the design principles not covered by the rule-based system are analyzed by case-based reasoning, using the Nearest Neighbor Algorithm, where features from previous jobs are used to detect artifacts and inconsistencies within the document layout. We used a subset of XSL-FO and assembled a set of 44 document samples. The system detected all the job layout changes, while obtaining an overall average accuracy of 84.56%, with the highest accuracy of 92.82%, for overlapping and the lowest, 66.7%, for the lack-of-white-space.

["As Good as it Gets at Home" - Reasons for Institutionalisation in Dementia].

PubMed

Grau, H; Berth, H; Lauterberg, J; Holle, R; Gräßel, E

2016-09-01

What are the reasons for institutionalising community-dwelling persons with dementia? A written survey of family caregivers and general practitioners was undertaken. Within 2 years 47 of 351 people with dementia (13%) were institutionalised. The person with dementia was involved in the decision in only 1/3 of the cases. The 3 most common reasons were: ensuring the best possible care, high expenditure of care-giving time at home, deterioration of the health of the care-receiver. From the ethical point of view the exclusion of the persons with dementia from the decision-making with regard to institutionalisation has to be examined critically. The often given reason of ensuring the best possible care through institutionalisation could be counteracted by the improvement of community-based care. © Georg Thieme Verlag KG Stuttgart · New York.

Identifying the drivers of liking by investigating the reasons for (dis)liking using CATA in cross-cultural context: a case study on barbecue sauce.

PubMed

Choi, Ji-Hye; Gwak, Mi-Jin; Chung, Seo-Jin; Kim, Kwang-Ok; O'Mahony, Michael; Ishii, Rie; Bae, Ye-Won

2015-06-01

The present study cross-culturally investigated the drivers of liking for traditional and ethnic chicken marinades using descriptive analysis and consumer taste tests incorporating the check-all-that-apply (CATA) method. Seventy-three Koreans and 86 US consumers participated. The tested sauces comprised three tomato-based sauces, a teriyaki-based sauce and a Korean spicy seasoning-based sauce. Chicken breasts were marinated with each of the five barbecue sauces, grilled and served for evaluation. Descriptive analysis and consumer taste tests were conducted. Consumers rated the acceptance on a hedonic scale and checked the reasons for (dis)liking by the CATA method for each sauce. A general linear model, multiple factor analysis and chi-square analysis were conducted using the data. The results showed that the preference orders of the samples between Koreans and US consumers were strikingly similar to each other. However, the reasons for (dis)liking the samples differed cross-culturally. The drivers of liking of two sauces sharing relatively similar sensory profiles but differing significantly in hedonic ratings were effectively delineated by reasons of (dis)liking CATA results. Reasons for (dis)liking CATA proved to be a powerful supporting method to understand the internal drivers of liking which can be overlooked by generic descriptive analysis. © 2014 Society of Chemical Industry.

Location-Based Critical Infrastructure Interdependency (LBCII)

DTIC Science & Technology

2010-04-01

Effective disaster management reduces devastation and cost . This section describes the processes of disaster management, including the elements of CEM...it has reasonable probability, based on the tectonic geology and the history of the region. The case highlights the usability of network- centric...of earthquake risk assessment in Cartago, Costa Rica . International Institute for Geo-Information Science and Earth Observation (ITC): Enschede

Data-Based Decision Making in Teams: Enablers and Barriers

ERIC Educational Resources Information Center

Bolhuis, Erik; Schildkamp, Kim; Voogt, Joke

2016-01-01

Data use is becoming more important in higher education. In this case study, a team of teachers from a teacher education college was supported in data-based decision making by means of the data team procedure. This data team studied the reasons why students drop out. A team's success depends in part on whether the team is able to develop and apply…

THE USE OF ELECTRONIC DATA PROCESSING IN CORRECTIONS AND LAW ENFORCEMENT,

DTIC Science & Technology

Reviews the reasons, methods, accomplishments and goals of the use of electronic data processing in the fields of correction and law enforcement . Suggest...statistical and case history data in building a sounder theoretical base in the field of law enforcement . (Author)

A case-based reasoning view of thrombophilia risk.

PubMed

Vilhena, João; Vicente, Henrique; Martins, M Rosário; Grañeda, José M; Caldeira, Filomena; Gusmão, Rodrigo; Neves, João; Neves, José

2016-08-01

Thrombophilia stands for a genetic or an acquired tendency to hypercoagulable states that increase the risk of venous and arterial thromboses. Indeed, venous thromboembolism is often a chronic illness, mainly in deep venous thrombosis and pulmonary embolism, requiring lifelong prevention strategies. Therefore, it is crucial to identify the cause of the disease, the most appropriate treatment, the length of treatment or prevent a thrombotic recurrence. Thus, this work will focus on the development of a diagnosis decision support system in terms of a formal agenda built on a logic programming approach to knowledge representation and reasoning, complemented with a case-based approach to computing. The proposed model has been quite accurate in the assessment of thrombophilia predisposition risk, since the overall accuracy is higher than 90% and sensitivity ranging in the interval [86.5%, 88.1%]. The main strength of the proposed solution is the ability to deal explicitly with incomplete, unknown, or even self-contradictory information. Copyright © 2016 Elsevier Inc. All rights reserved.

Case-Based Capture and Reuse of Aerospace Design Rationale

NASA Technical Reports Server (NTRS)

Leake, David B.

2001-01-01

The goal of this project was to apply artificial intelligence techniques to facilitate capture and reuse of aerospace design rationale. The project combined case-based reasoning (CBR) and concept maps (CMaps) to develop methods for capturing, organizing, and interactively accessing records of experiences encapsulating the methods and rationale underlying expert aerospace design, in order to bring the captured knowledge to bear to support future reasoning. The project's results contribute both principles and methods for effective design-aiding systems that aid capture and access of useful design knowledge. The project has been guided by the tenets that design-aiding systems must: (1) Leverage a designer's knowledge, rather than attempting to replace it; (2) Be able to reflect different designers' differing conceptualizations of the design task, and to clarify those conceptualizations to others; (3) Include capabilities to capture information both by interactive knowledge modeling and during normal use; and (4) Integrate into normal designer tasks as naturally and unobtrusive as possible.

The reasonable woman standard: effects on sexual harassment court decisions.

PubMed

Perry, Elissa L; Kulik, Carol T; Bourhis, Anne C

2004-02-01

Some federal courts have used a reasonable woman standard rather than the traditional reasonable man or reasonable person standard to determine whether hostile environment sexual harassment has occurred. The current research examined the impact of the reasonable woman standard on federal district court decisions, controlling for other factors found to affect sexual harassment court decisions. Results indicated that there was a weak relationship between whether a case followed a reasonable woman precedent-setting case and the likelihood that the court decision favored the plaintiff. The implications of our findings for individuals and organizations involved in sexual harassment claims are discussed.

Choosing the Standard of Care in Private Individual Defamation Cases.

ERIC Educational Resources Information Center

Caudill, Susan

1989-01-01

Examines private individual defamation cases that include discussion of whether the reasonably prudent publisher/editor or the reasonably prudent person should set the standard of care when negligence is at issue. Considers the implication of judicial reasoning in adopting one standard of care rather than the other. (RS)

Hurrah for the Reasonable Woman.

ERIC Educational Resources Information Center

Leland, Dorothy

1994-01-01

Recent court cases on sexual harassment, and the outcomes, were reviewed in terms of how the court viewed a "reasonable" woman. Rulings in such cases can vary because of different interpretations of the "reasonable" concept. Also discusses how recent rulings will affect sexual harassment policymakers in the workplace and educational institutions.…

Patterns of Clinical Reasoning in Physical Therapist Students.

PubMed

Gilliland, Sarah; Wainwright, Susan Flannery

2017-05-01

Clinical reasoning is a complex, nonlinear problem-solving process that is influenced by models of practice. The development of physical therapists' clinical reasoning abilities is a crucial yet underresearched aspect of entry-level (professional) physical therapist education. The purpose of this qualitative study was to examine the types of clinical reasoning strategies physical therapist students engage in during a patient encounter. A qualitative descriptive case study design involving within and across case analysis was used. Eight second-year, professional physical therapist students from 2 different programs completed an evaluation and initial intervention for a standardized patient followed by a retrospective think-aloud interview to explicate their reasoning processes. Participants' clinical reasoning strategies were examined using a 2-stage qualitative method of thematic analysis. Participants demonstrated consistent signs of development of physical therapy-specific reasoning processes, yet varied in their approach to the case and use of reflection. Participants who gave greater attention to patient education and empowerment also demonstrated greater use of reflection-in-action during the patient encounter. One negative case illustrates the variability in the rate at which students may develop these abilities. Participants demonstrated development toward physical therapist--specific clinical reasoning, yet demonstrated qualitatively different approaches to the patient encounter. Multiple factors, including the use of reflection-in-action, may enable students to develop greater flexibility in their reasoning processes. © 2017 American Physical Therapy Association

Reasons For Not Performing Keratorefractive Surgery in Patients Seeking Refractive Surgery in a Hospital-Based Cohort in “Yemen”

PubMed Central

Bamashmus, Mahfouth A.; Saleh, Mahmoud F.; Awadalla, Mohamed A.

2010-01-01

Background: To determine and analyze the reasons why keratorefractive surgery, laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) were not performed in patients who presented for refractive surgery consultation. Materials and Methods: A retrospective observational study was performed between January 2006 and December 2007 in the Yemen Magrabi Hospital. The case records of 2,091 consecutive new patients who presented for refractive surgery were reviewed. Information from the pre-operative ophthalmic examination, such as refractive error, corneal topography and visual acuity, were analyzed. The reasons for not performing LASIK and PRK in the cases that were rejected were recorded and analyzed. Results: In this cohort, 1,660 (79.4%) patients were advised to have LASIK or PRK from the 2,091 patients examined. LASIK and PRK were not advised in 431 (21%) patients. The most common reasons for not performing the surgery were high myopia >-11.00 Diopters (19%), keratoconus (18%), suboptimal central corneal thickness (15%), cataract (12%) and keratoconus suspect (forme fruste keratoconus) (10%). Conclusion: Patients who requested keratorefractive surgery have a variety of problems and warrant comprehensive attention to selection criteria on the part of the surgeon. Corneal topographies and pachymetry of refractive surgery candidates need to be read cautiously. High-refractive error, keratoconus and insufficient corneal thickness were found to be the leading reasons for not performing keratorefractive surgery in this study. PMID:21180437

Application of nonlinear models to estimate the gain of one-dimensional free-electron lasers

NASA Astrophysics Data System (ADS)

Peter, E.; Rizzato, F. B.; Endler, A.

2017-06-01

In the present work, we make use of simplified nonlinear models based on the compressibility factor (Peter et al., Phys. Plasmas, vol. 20 (12), 2013, 123104) to predict the gain of one-dimensional (1-D) free-electron lasers (FELs), considering space-charge and thermal effects. These models proved to be reasonable to estimate some aspects of 1-D FEL theory, such as the position of the onset of mixing, in the case of a initially cold electron beam, and the position of the breakdown of the laminar regime, in the case of an initially warm beam (Peter et al., Phys. Plasmas, vol. 21 (11), 2014, 113104). The results given by the models are compared to wave-particle simulations showing a reasonable agreement.

Digital Tools to Enhance Clinical Reasoning.

PubMed

Manesh, Reza; Dhaliwal, Gurpreet

2018-05-01

Physicians can improve their diagnostic acumen by adopting a simulation-based approach to analyzing published cases. The tight coupling of clinical problems and their solutions affords physicians the opportunity to efficiently upgrade their illness scripts (structured knowledge of a specific disease) and schemas (structured frameworks for common problems). The more times clinicians practice accessing and applying those knowledge structures through published cases, the greater the odds that they will have an enhanced approach to similar patient-cases in the future. This article highlights digital resources that increase the number of cases a clinician experiences and learns from. Copyright © 2017 Elsevier Inc. All rights reserved.

Ethical case deliberation and decision making.

PubMed

Gracia, Diego

2003-01-01

During the last thirty years different methods have been proposed in order to manage and resolve ethical quandaries, specially in the clinical setting. Some of these methodologies are based on the principles of Decision-making theory. Others looked to other philosophical traditions, like Principlism, Hermeneutics, Narrativism, Casuistry, Pragmatism, etc. This paper defends the view that deliberation is the cornerstone of any adequate methodology. This is due to the fact that moral decisions must take into account not only principles and ideas, but also emotions, values and beliefs. Deliberation is the process in which everyone concerned by the decision is considered a valid moral agent, obliged to give reasons for their own points of view, and to listen to the reasons of others. The goal of this process is not the reaching of a consensus but the enrichment of one's own point of view with that of the others, increasing in this way the maturity of one's own decision, in order to make it more wise or prudent. In many cases the members of a group of deliberation will differ in the final solution of the case, but the confrontation of their reasons will modify the perception of the problem of everyone. This is the profit of the process. Our moral decisions cannot be completely rational, due to the fact that they are influenced by feelings, values, beliefs, etc., but they must be reasonable, that is, wise and prudent. Deliberation is the main procedure to reach this goal. It obliges us to take others into account, respecting their different beliefs and values and prompting them to give reasons for their own points of view. This method has been traditional in Western clinical medicine all over its history, and it should be also the main procedure for clinical ethics.

Canine parvovirus in Australia: A comparative study of reported rural and urban cases.

PubMed

Zourkas, Elaine; Ward, Michael P; Kelman, Mark

2015-12-31

Canine parvovirus (CPV) is a highly contagious and often fatal disease reported worldwide. Outbreaks occur throughout Australia, and it has been suggested that disproportionally more CPV cases occur in rural locations. However, evidence to support this suggestion-and possible reasons for such a predisposition-has not existed until now. In this study a total of 4870 CPV cases reported from an Australian disease surveillance system between September 2009 and July 2014 were analysed. Australian postcodes were classified as rural or urban (based on human population density) and reported CPV cases were then categorised as rural or urban based on their reported home postcode. Parvovirus cases were predominately young (<12 months), entire, unvaccinated, mixed-breed dogs. More than twice as many of the reported cases were from a rural area (3321 cases) compared to an urban area (1549 cases). The overall case fatality rate was 47.2%; it was higher for those CPV cases reported from urban areas (50.6%) than rural areas (45.5%). A greater proportion of rural cases were younger, entire dogs compared to urban cases. The final multivariable model of CPV cases being reported from a rural area included age (<12 months) and vaccination status (never vaccinated) as significant predictors. Poor socioeconomic status might be a reason for the decision of rural owners not to vaccinate their dogs as readily as urban owners. The excess reporting of rural CPV cases compared to urban cases and the predictive risk factors identified in this study can be used by veterinarians to reduce the incidence of CPV by educating owners about the disease and promoting better vaccination programs in rural areas. This study also supports that the increased risk of CPV in rural areas may necessitate a need for increased vigilance around preventing CPV disease spread, additional care with puppies which are the most susceptible to this disease and tighter vaccination protocols, compared to urban areas. Copyright © 2015 Elsevier B.V. All rights reserved.

Data Clustering and Evolving Fuzzy Decision Tree for Data Base Classification Problems

NASA Astrophysics Data System (ADS)

Chang, Pei-Chann; Fan, Chin-Yuan; Wang, Yen-Wen

Data base classification suffers from two well known difficulties, i.e., the high dimensionality and non-stationary variations within the large historic data. This paper presents a hybrid classification model by integrating a case based reasoning technique, a Fuzzy Decision Tree (FDT), and Genetic Algorithms (GA) to construct a decision-making system for data classification in various data base applications. The model is major based on the idea that the historic data base can be transformed into a smaller case-base together with a group of fuzzy decision rules. As a result, the model can be more accurately respond to the current data under classifying from the inductions by these smaller cases based fuzzy decision trees. Hit rate is applied as a performance measure and the effectiveness of our proposed model is demonstrated by experimentally compared with other approaches on different data base classification applications. The average hit rate of our proposed model is the highest among others.

Index cost estimate based BIM method - Computational example for sports fields

NASA Astrophysics Data System (ADS)

Zima, Krzysztof

2017-07-01

The paper presents an example ofcost estimation in the early phase of the project. The fragment of relative database containing solution, descriptions, geometry of construction object and unit cost of sports facilities was shown. The Index Cost Estimate Based BIM method calculationswith use of Case Based Reasoning were presented, too. The article presentslocal and global similarity measurement and example of BIM based quantity takeoff process. The outcome of cost calculations based on CBR method was presented as a final result of calculations.

Toward a Theory of Assurance Case Confidence

DTIC Science & Technology

2012-09-01

assurance case claim. The framework is based on the notion of eliminative induction—the princi- ple (first put forward by Francis Bacon ) that confidence in...eliminative induction. As first proposed by Francis Bacon [Schum 2001] and extended by L. Jonathan Cohen [Cohen 1970, 1977, 1989], eliminative induction is...eliminative in- duction—the principle (first put forward by Francis Bacon ) that confidence in the truth of a hypothesis (or claim) increases as reasons for

School-University Partnerships in Action: Concepts, Cases,

ERIC Educational Resources Information Center

Sirotnik, Kenneth A., Ed.; Goodlad, John I., Ed.

A general paradigm for ideal collaboration between schools and universities is proposed. It is based on a mutually collaborative arrangement between equal partners working together to meet self-interests while solving common problems. It is suggested that reasonable approximations to this ideal have great potential to effect significant…

Virtual TeleRehab: a case study.

PubMed

Pareto, Lena; Johansson, Britt; Zeller, Sally; Sunnerhagen, Katharina S; Rydmark, Martin; Broeren, Jurgen

2011-01-01

We examined the efficacy of a remotely based occupational therapy intervention. A 40-year-old woman who suffered a stroke participated in a telerehabilitation program. The intervention method is based on virtual reality gaming to enhance the training experience and to facilitate the relearning processes. The results indicate that Virtual TeleRehab is an effective method for motivational, economical, and practical reasons by combining game-based rehabilitation in the home with weekly distance meetings.

Priority setting at the micro-, meso- and macro-levels in Canada, Norway and Uganda.

PubMed

Kapiriri, Lydia; Norheim, Ole Frithjof; Martin, Douglas K

2007-06-01

The objectives of this study were (1) to describe the process of healthcare priority setting in Ontario-Canada, Norway and Uganda at the three levels of decision-making; (2) to evaluate the description using the framework for fair priority setting, accountability for reasonableness; so as to identify lessons of good practices. We carried out case studies involving key informant interviews, with 184 health practitioners and health planners from the macro-level, meso-level and micro-level from Canada-Ontario, Norway and Uganda (selected by virtue of their varying experiences in priority setting). Interviews were audio-recorded, transcribed and analyzed using a modified thematic approach. The descriptions were evaluated against the four conditions of "accountability for reasonableness", relevance, publicity, revisions and enforcement. Areas of adherence to these conditions were identified as lessons of good practices; areas of non-adherence were identified as opportunities for improvement. (i) at the macro-level, in all three countries, cabinet makes most of the macro-level resource allocation decisions and they are influenced by politics, public pressure, and advocacy. Decisions within the ministries of health are based on objective formulae and evidence. International priorities influenced decisions in Uganda. Some priority-setting reasons are publicized through circulars, printed documents and the Internet in Canada and Norway. At the meso-level, hospital priority-setting decisions were made by the hospital managers and were based on national priorities, guidelines, and evidence. Hospital departments that handle emergencies, such as surgery, were prioritized. Some of the reasons are available on the hospital intranet or presented at meetings. Micro-level practitioners considered medical and social worth criteria. These reasons are not publicized. Many practitioners lacked knowledge of the macro- and meso-level priority-setting processes. (ii) Evaluation-relevance: medical evidence and economic criteria were thought to be relevant, but lobbying was thought to be irrelevant. Publicity: all cases lacked clear and effective mechanisms for publicity. REVISIONS: formal mechanisms, following the planning hierarchy, were considered less effective, informal political mechanisms were considered more effective. Canada and Norway had patients' relations officers to deal with patients' dissensions; however, revisions were more difficult in Uganda. Enforcement: leadership for ensuring decision-making fairness was not apparent. The different levels of priority setting in the three countries fulfilled varying conditions of accountability for reasonableness, none satisfied all the four conditions. To improve, decision makers at the three levels in all three cases should engage frontline practitioners, develop more effectively publicized reasons, and develop formal mechanisms for challenging and revising decisions.

[Methodology of psychiatric case histories].

PubMed

Scherbaum, N; Mirzaian, E

1999-05-01

This paper deals with the methodology of psychiatric case histories. Three types of case histories are differentiated. The didactic case history teaches about the typical aspects of a psychiatric disorder or treatment by using an individual patient as an example. In the heuristic case history the individual case gives rise to challenging established concepts or to generate new hypotheses. Such hypotheses drawn from inductive reasoning have then to be tested using representative samples. The focus of hermeneutic case histories is the significance of pathological behaviour and experience in the context of the biography of an individual patient. So-called psychopathographies of important historical figures can also be differentiated according to these types. Based on these methodological considerations, quality standards for the named types of case histories are stated.

Influence of perceived difficulty of cases on student osteopaths' diagnostic reasoning: a cross sectional study.

PubMed

Noyer, Aurelien L; Esteves, Jorge E; Thomson, Oliver P

2017-01-01

Diagnostic reasoning refers to the cognitive processes by which clinicians formulate diagnoses. Despite the implications for patient safety and professional identity, research on diagnostic reasoning in osteopathy remains largely theoretical. The aim of this study was to investigate the influence of perceived task difficulty on the diagnostic reasoning of students osteopaths. Using a single-blinded, cross sectional study design, sixteen final year pre-registration osteopathy students diagnosed two standardized cases under two context conditions (complex versus control). Context difficulty was manipulated via verbal manipulation and case order was randomized and counterbalanced across subjects to ensure that each case was diagnosed evenly under both conditions (i.e. half of the subjects performed either case A or B first). After diagnosis, participants were presented with items (literal, inferred and filler) designed to represent analytical and non-analytical reasoning. Response time and error rate for each item were measured. A repeated measures analysis of variance (concept type x context) was performed to identify differences across conditions and make inferences on diagnostic reasoning. Participants made significantly more errors when judging literal concepts and took significantly less time to recognize filler concepts in the complex context. No significant difference in ability to judge inferred concepts across contexts was found. Although speculative and preliminary, our findings suggest the perception of complexity led to an increased reliance on analytical reasoning at the detriment of non-analytical reasoning. To reduce the associated cognitive load, osteopathic educational institutions could consider developing the intuitive diagnostic capabilities of pre-registration students. Postgraduate mentorship opportunities could be considered to enhance the diagnostic reasoning of professional osteopaths, particularly recent graduates. Further research exploring the influence of expertise is required to enhance the validity of this study.

Decision Support System for Medical Care Quality Assessment Based on Health Records Analysis in Russia.

PubMed

Taranik, Maksim; Kopanitsa, Georgy

2017-01-01

The paper presents developed decision system, oriented for healthcare providers. The system allows healthcare providers to detect and decrease nonconformities in health records and forecast the sum of insurance payments taking into account nonconformities. The components are ISO13606, fuzzy logic and case-based reasoning concept. The result of system implementation allowed to 10% increase insurance payments for healthcare provider.

Active devices based on organic semiconductors for wearable applications.

PubMed

Barbaro, Massimo; Caboni, Alessandra; Cosseddu, Piero; Mattana, Giorgio; Bonfiglio, Annalisa

2010-05-01

Plastic electronics is an enabling technology for obtaining active (transistor based) electronic circuits on flexible and/or nonplanar surfaces. For these reasons, it appears as a perfect candidate to promote future developments of wearable electronics toward the concept of fabrics and garments made by functional (in this case, active electronic) yarns. In this paper, a panoramic view of recent achievements and future perspectives is given.

Assessing progression of clinical reasoning through virtual patients: An exploratory study.

PubMed

Forsberg, Elenita; Ziegert, Kristina; Hult, Håkan; Fors, Uno

2016-01-01

To avoid test-driven learning, there have been discussions regarding the use of more formative assessments in health care education to promote students' deep learning. Feedback is important in formative assessment, but many students ignore it; therefore, interventions should be introduced which stimulate them to reflect on the new knowledge. The aim for this study was to explore if Virtual Patient (VP)-based formative assessments, in connection with self-evaluations, had an impact on postgraduate pediatric nursing students' development of clinical reasoning abilities. Students' self-evaluations served as the basis for measuring progress. Data was analysed using deductive content analysis. The findings showed a clear progression of the clinical reasoning ability of the students. After the first assessment, the students described feelings of uncertainty and that their knowledge gaps were exposed. At the mid-course assessment the awareness of improved clinical reasoning was obvious and the students were more certain of knowing how to solve the VP cases. In the final assessment, self-efficacy was expressed. VP-based assessments, in connection with self-evaluations, early in the education resulted in a gain of students' own identification of the concept of clinical reasoning, awareness of what to focus on during clinical practice and visualised expected clinical competence. Copyright © 2015 Elsevier Ltd. All rights reserved.

Radiotherapy supporting system based on the image database using IS&C magneto-optical disk

NASA Astrophysics Data System (ADS)

Ando, Yutaka; Tsukamoto, Nobuhiro; Kunieda, Etsuo; Kubo, Atsushi

1994-05-01

Since radiation oncologists make the treatment plan by prior experience, information about previous cases is helpful in planning the radiation treatment. We have developed an supporting system for the radiation therapy. The case-based reasoning method was implemented in order to search old treatments and images of past cases. This system evaluates similarities between the current case and all stored cases (case base). The portal images of the similar cases can be retrieved for reference images, as well as treatment records which show examples of the radiation treatment. By this system radiotherapists can easily make suitable plans of the radiation therapy. This system is useful to prevent inaccurate plannings due to preconceptions and/or lack of knowledge. Images were stored into magneto-optical disks and the demographic data is recorded to the hard disk which is equipped in the personal computer. Images can be displayed quickly on the radiotherapist's demands. The radiation oncologist can refer past cases which are recorded in the case base and decide the radiation treatment of the current case. The file and data format of magneto-optical disk is the IS&C format. This format provides the interchangeability and reproducibility of the medical information which includes images and other demographic data.

Interpreting Data: The Hybrid Mind

ERIC Educational Resources Information Center

Heisterkamp, Kimberly; Talanquer, Vicente

2015-01-01

The central goal of this study was to characterize major patterns of reasoning exhibited by college chemistry students when analyzing and interpreting chemical data. Using a case study approach, we investigated how a representative student used chemical models to explain patterns in the data based on structure-property relationships. Our results…

20 CFR 404.904 - Notice of the initial determination.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Section 404.904 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL OLD-AGE, SURVIVORS AND... written notice will explain in simple and clear language what we have determined and the reasons for and... language a statement of the case setting forth the evidence on which our determination is based. The notice...

32 CFR 724.806 - Decisional issues.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the exercise of discretion on the issue of equity in the applicant's case. (ii) If a reason is based... should exercise its equitable powers to change the discharge on the basis of the alleged error. If it..., specific circumstances surrounding the offense, number of offenses, lack of mitigating circumstances, or...

Quantitative Courses in a Liberal Education Program: A Case Study

ERIC Educational Resources Information Center

Wismath, Shelly L.; Mackay, D. Bruce

2012-01-01

This essay argues for the importance of quantitative reasoning skills as part of a liberal education and describes the successful introduction of a mathematics-based quantitative skills course at a small Canadian university. Today's students need quantitative problem-solving skills, to function as adults, professionals, consumers, and citizens in…

On Problematic Aspects in Learning Trigonometry

ERIC Educational Resources Information Center

Kamber, Dina; Takaci, Djurdjica

2018-01-01

In this paper, research on some problematic aspects high school students have in learning trigonometry is presented. It is based on making sense of mathematics through perception, operation and reason in the case of trigonometry. We analyzed students' understanding of trigonometric concepts in the frame of triangle and circle trigonometry…

Probabilistic self-localisation on a qualitative map based on occlusions

NASA Astrophysics Data System (ADS)

Santos, Paulo E.; Martins, Murilo F.; Fenelon, Valquiria; Cozman, Fabio G.; Dee, Hannah M.

2016-09-01

Spatial knowledge plays an essential role in human reasoning, permitting tasks such as locating objects in the world (including oneself), reasoning about everyday actions and describing perceptual information. This is also the case in the field of mobile robotics, where one of the most basic (and essential) tasks is the autonomous determination of the pose of a robot with respect to a map, given its perception of the environment. This is the problem of robot self-localisation (or simply the localisation problem). This paper presents a probabilistic algorithm for robot self-localisation that is based on a topological map constructed from the observation of spatial occlusion. Distinct locations on the map are defined by means of a classical formalism for qualitative spatial reasoning, whose base definitions are closer to the human categorisation of space than traditional, numerical, localisation procedures. The approach herein proposed was systematically evaluated through experiments using a mobile robot equipped with a RGB-D sensor. The results obtained show that the localisation algorithm is successful in locating the robot in qualitatively distinct regions.

Application of the critical pathway and integrated case teaching method to nursing orientation.

PubMed

Goodman, D

1997-01-01

Nursing staff development programs must be responsive to current changes in healthcare. New nursing staff must be prepared to manage continuous change and to function competently in clinical practice. The orientation pathway, based on a case management model, is used as a structure for the orientation phase of staff development. The integrated case is incorporated as a teaching strategy in orientation. The integrated case method is based on discussion and analysis of patient situations with emphasis on role modeling and integration of theory and skill. The orientation pathway and integrated case teaching method provide a useful framework for orientation of new staff. Educators, preceptors and orientees find the structure provided by the orientation pathway very useful. Orientation that is developed, implemented and evaluated based on a case management model with the use of an orientation pathway and incorporation of an integrated case teaching method provides a standardized structure for orientation of new staff. This approach is designed for the adult learner, promotes conceptual reasoning, and encourages the social and contextual basis for continued learning.

Economic costs of recorded reasons for cow mortality and culling in a pasture-based dairy industry.

PubMed

Kerslake, J I; Amer, P R; O'Neill, P L; Wong, S L; Roche, J R; Phyn, C V C

2018-02-01

The objective of this study was to determine the economic costs associated with different reasons for cow culling or on-farm mortality in a pasture-based seasonal system. A bioeconomic model was developed to quantify costs associated with the different farmer-recorded reasons and timing of cow wastage. The model accounted for the parity and stage of lactation at which the cows were removed as well as the consequent effect on the replacement rate and average age structure of the herd. The costs and benefits associated with the change were quantified, including animal replacement cost, cull salvage value, milk production loss, and the profitability of altered genetic merit based on industry genetic trends for each parity. The total cost of cow wastage was estimated to be NZ$23,628/100 cows per year (NZ$1 = US$0.69) in a pasture-based system. Of this total cost, NZ$14,300/100 cows worth of removals were for nonpregnancy and unknown reasons, and another NZ$3,631/100 cows was attributed to low milk production, mastitis, and udder problems. The total cost for cow removals due to farmer-recorded biological reasons (excluding unknown, production, and management-related causes) was estimated to be NZ$13,632/100 cows per year. Of this cost, an estimated NZ$10,286/100 cows was attributed to nonpregnancy, mastitis, udder problems, calving trouble, and injury or accident. There is a strong economic case for the pasture-based dairy industries to invest in genetic, herd health, and production management research focused on reducing animal wastage due to reproductive failure, mastitis, udder problems, injuries or accidents, and calving difficulties. Copyright © 2018 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Statistical inference and Aristotle's Rhetoric.

PubMed

Macdonald, Ranald R

2004-11-01

Formal logic operates in a closed system where all the information relevant to any conclusion is present, whereas this is not the case when one reasons about events and states of the world. Pollard and Richardson drew attention to the fact that the reasoning behind statistical tests does not lead to logically justifiable conclusions. In this paper statistical inferences are defended not by logic but by the standards of everyday reasoning. Aristotle invented formal logic, but argued that people mostly get at the truth with the aid of enthymemes--incomplete syllogisms which include arguing from examples, analogies and signs. It is proposed that statistical tests work in the same way--in that they are based on examples, invoke the analogy of a model and use the size of the effect under test as a sign that the chance hypothesis is unlikely. Of existing theories of statistical inference only a weak version of Fisher's takes this into account. Aristotle anticipated Fisher by producing an argument of the form that there were too many cases in which an outcome went in a particular direction for that direction to be plausibly attributed to chance. We can therefore conclude that Aristotle would have approved of statistical inference and there is a good reason for calling this form of statistical inference classical.

Euthanasia requests in a Canadian psychiatric emergency room: A case series: Part 1 of the McGill University euthanasia in psychiatry case series.

PubMed

Benrimoh, David; Perreault, Antoine; Van Den Eynde, Frederique

Euthanasia was decriminalized in Quebec in December 2015, and Canada-wide in June 2016. Both the Provincial and Federal legislation have limited the right to medical assistance in dying (MAID) to end-of-life cases; which makes MAID inaccessible to most patients solely suffering from psychiatric illness. While some end-stage anorexia nervosa or elderly patients may meet the end-of-life criterion because of their medical comorbidities or their age (Kelly et al., 2003), repeated suicide attempts or psychotic disorganization would not qualify since they would not be seen as elements of an illness leading to a foreseeable "natural death" (Canada, 2016). This is in contradiction to other jurisdictions, such as Belgium and the Netherlands as well as the eligibility criteria stated in the Supreme Court of Canada's decision in Carter v. Canada (Supreme Court of Canada, 2015). Here we analyze three cases of patients who presented to a psychiatric emergency department and requested MAID for psychiatric reasons. While none of the patients were eligible for MAID under Canadian law, we find that their demographics match closely that of patients granted MAID for psychiatric reasons in jurisdictions where that practice is allowed. Based on these cases, we comment on potentially negative consequences that may come from decriminalizing MAID for psychiatric reasons (such as an increased assessment burden on ED staff) and potentially positive consequences (such as encouraging suffering patients who had not consulted to seek care). While it is by no means our intention to take a political or moral stand on this important issue, or to conclusively weigh the negatives and positives of allowing MAID for psychiatric reasons, we do stress the importance of an active voice for psychiatry in this ongoing public debate. Copyright © 2017 Elsevier Ltd. All rights reserved.

Bayesian processing of context-dependent text: reasons for appointments can improve detection of influenza.

PubMed

Alemi, Farrokh; Torii, Manabu; Atherton, Martin J; Pattie, David C; Cox, Kenneth L

2012-01-01

This article aims to examine whether words listed in reasons for appointments could effectively predict laboratory-verified influenza cases in syndromic surveillance systems. Data were collected from the Armed Forces Health Longitudinal Technological Application medical record system. We used 2 algorithms to combine the impact of words within reasons for appointments: Dependent (DBSt) and Independent (IBSt) Bayesian System. We used receiver operating characteristic curves to compare the accuracy of these 2 methods of processing reasons for appointments against current and previous lists of diagnoses used in the Department of Defense's syndromic surveillance system. We examined 13,096 cases, where the results of influenza tests were available. Each reason for an appointment had an average of 3.5 words (standard deviation = 2.2 words). There was no difference in performance of the 2 algorithms. The area under the curve for IBSt was 0.58 and for DBSt was 0.56. The difference was not statistically significant (McNemar statistic = 0.0054; P = 0.07). These data suggest that reasons for appointments can improve the accuracy of lists of diagnoses in predicting laboratory-verified influenza cases. This study recommends further exploration of the DBSt algorithm and reasons for appointments in predicting likely influenza cases.

Knowledge and intelligent computing system in medicine.

PubMed

Pandey, Babita; Mishra, R B

2009-03-01

Knowledge-based systems (KBS) and intelligent computing systems have been used in the medical planning, diagnosis and treatment. The KBS consists of rule-based reasoning (RBR), case-based reasoning (CBR) and model-based reasoning (MBR) whereas intelligent computing method (ICM) encompasses genetic algorithm (GA), artificial neural network (ANN), fuzzy logic (FL) and others. The combination of methods in KBS such as CBR-RBR, CBR-MBR and RBR-CBR-MBR and the combination of methods in ICM is ANN-GA, fuzzy-ANN, fuzzy-GA and fuzzy-ANN-GA. The combination of methods from KBS to ICM is RBR-ANN, CBR-ANN, RBR-CBR-ANN, fuzzy-RBR, fuzzy-CBR and fuzzy-CBR-ANN. In this paper, we have made a study of different singular and combined methods (185 in number) applicable to medical domain from mid 1970s to 2008. The study is presented in tabular form, showing the methods and its salient features, processes and application areas in medical domain (diagnosis, treatment and planning). It is observed that most of the methods are used in medical diagnosis very few are used for planning and moderate number in treatment. The study and its presentation in this context would be helpful for novice researchers in the area of medical expert system.

Test Guide for ADS-33E-PRF

DTIC Science & Technology

2008-07-01

8501A (Reference 2), and from the V/STOL specification MIL-F-83300 (Reference 3). ADS-33E-PRF contains intermeshed requirements on not only shoi -t- and...While final verification will in most cases require flight testing, initial checks can be performed through analysis and on ground-based simulators...they are difficult to test, or for some reason are deficient in one or more areas. In such cases one or more alternate criteria are presented where

The role of strategy and redundancy in diagnostic reasoning.

PubMed

Bloch, Ralph F; Hofer, Daniel; Feller, Sabine; Hodel, Maria

2003-01-24

Diagnostic reasoning is a key competence of physicians. We explored the effects of knowledge, practice and additional clinical information on strategy, redundancy and accuracy of diagnosing a peripheral neurological defect in the hand based on sensory examination. Using an interactive computer simulation that includes 21 unique cases with seven sensory loss patterns and either concordant, neutral or discordant textual information, 21 3rd year medical students, 21 6th year and 21 senior neurology residents each examined 15 cases over the course of one session. An additional 23 psychology students examined 24 cases over two sessions, 12 cases per session. Subjects also took a seven-item MCQ exam of seven classical patterns presented visually. Knowledge of sensory patterns and diagnostic accuracy are highly correlated within groups (R2 = 0.64). The total amount of information gathered for incorrect diagnoses is no lower than that for correct diagnoses. Residents require significantly fewer tests than either psychology or 6th year students, who in turn require fewer than the 3rd year students (p < 0.001). The diagnostic accuracy of subjects is affected both by level of training (p < 0.001) and concordance of clinical information (p < 0.001). For discordant cases, refutation testing occurs significantly in 6th year students (p < 0.001) and residents (p < 0.01), but not in psychology or 3rd year students. Conversely, there is a stable 55% excess of confirmatory testing, independent of training or concordance. Knowledge and practice are both important for diagnostic success. For complex diagnostic situations reasoning components employing redundancy seem more essential than those using strategy.

On-Line Modal State Monitoring of Slowly Time-Varying Structures

NASA Technical Reports Server (NTRS)

Johnson, Erik A.; Bergman, Lawrence A.; Voulgaris, Petros G.

1997-01-01

Monitoring the dynamic response of structures is often performed for a variety of reasons. These reasons include condition-based maintenance, health monitoring, performance improvements, and control. In many cases the data analysis that is performed is part of a repetitive decision-making process, and in these cases the development of effective on-line monitoring schemes help to speed the decision-making process and reduce the risk of erroneous decisions. This report investigates the use of spatial modal filters for tracking the dynamics of slowly time-varying linear structures. The report includes an overview of modal filter theory followed by an overview of several structural system identification methods. Included in this discussion and comparison are H-infinity, eigensystem realization, and several time-domain least squares approaches. Finally, a two-stage adaptive on-line monitoring scheme is developed and evaluated.

Working smarter on cold cases: identifying factors associated with successful cold case investigations.

PubMed

Davis, Robert C; Jensen, Carl J; Burgette, Lane; Burnett, Kathryn

2014-03-01

Cold case squads have garnered much attention; however, they have yet to undergo significant empirical scrutiny. In the present study, the authors interviewed investigators and reviewed 189 solved and unsolved cold cases in Washington, D.C., to determine whether there are factors that can predict cold case solvability. In the interviews, new information from witnesses or information from new witnesses was cited as the most prevalent reason for case clearance. The case reviews determined that there were factors in each of the following domains that predicted whether cases would be solved during cold case investigations: Crime Context, Initial Investigation Results, Basis for Opening Cold Case, and Cold Case Investigator Actions. The results suggest that it is possible to prioritize cold case work based on the likelihood of investigations leading to clearances. © 2014 American Academy of Forensic Sciences.

Sound scattering by several zooplankton groups. II. Scattering models.

PubMed

Stanton, T K; Chu, D; Wiebe, P H

1998-01-01

Mathematical scattering models are derived and compared with data from zooplankton from several gross anatomical groups--fluidlike, elastic shelled, and gas bearing. The models are based upon the acoustically inferred boundary conditions determined from laboratory backscattering data presented in part I of this series [Stanton et al., J. Acoust. Soc. Am. 103, 225-235 (1998)]. The models use a combination of ray theory, modal-series solution, and distorted wave Born approximation (DWBA). The formulations, which are inherently approximate, are designed to include only the dominant scattering mechanisms as determined from the experiments. The models for the fluidlike animals (euphausiids in this case) ranged from the simplest case involving two rays, which could qualitatively describe the structure of target strength versus frequency for single pings, to the most complex case involving a rough inhomogeneous asymmetrically tapered bent cylinder using the DWBA-based formulation which could predict echo levels over all angles of incidence (including the difficult region of end-on incidence). The model for the elastic shelled body (gastropods in this case) involved development of an analytical model which takes into account irregularities and discontinuities of the shell. The model for gas-bearing animals (siphonophores) is a hybrid model which is composed of the summation of the exact solution to the gas sphere and the approximate DWBA-based formulation for arbitrarily shaped fluidlike bodies. There is also a simplified ray-based model for the siphonophore. The models are applied to data involving single pings, ping-to-ping variability, and echoes averaged over many pings. There is reasonable qualitative agreement between the predictions and single ping data, and reasonable quantitative agreement between the predictions and variability and averages of echo data.

Neighborhood graph and learning discriminative distance functions for clinical decision support.

PubMed

Tsymbal, Alexey; Zhou, Shaohua Kevin; Huber, Martin

2009-01-01

There are two essential reasons for the slow progress in the acceptance of clinical case retrieval and similarity search-based decision support systems; the especial complexity of clinical data making it difficult to define a meaningful and effective distance function on them and the lack of transparency and explanation ability in many existing clinical case retrieval decision support systems. In this paper, we try to address these two problems by introducing a novel technique for visualizing inter-patient similarity based on a node-link representation with neighborhood graphs and by considering two techniques for learning discriminative distance function that help to combine the power of strong "black box" learners with the transparency of case retrieval and nearest neighbor classification.

Errors in dentistry: a call for apology.

PubMed

Schwartz, Barry

2005-01-01

Bad outcomes occur in dentistry and sometimes these are the results of dental errors. In both cases, this essay will argue that apologies are very important in maintaining a relationship with the patient that is based on trust and mutual respect. Nevertheless, apologies are often not forthcoming in dentistry for a number of reasons that deserve careful examination. In particular, the dentist's fear that an apology will increase the risk of legal harm will be critiqued. Ethical and psychological reasons for making an apology will be discussed, and strategies to assist clinicians in making an apology will be offered.

Business Case Analysis: Identifying Concerns for the Continuum of Care for United States Air Force Cadets with the Implementation of Base Realignment and Close Initiatives at the Air force Academy Hospital

DTIC Science & Technology

2006-12-31

et al, 2003). Another reason that downsizing is a popular way in which a healthcare organization can become more efficient based on institutional ... theory . This theory states that since other hospitals have used downsizing as a means to become more efficient, so will we. This theory states that

A General Safety Assessment for Purified Food Ingredients Derived From Biotechnology Crops: Case Study of Brazilian Sugar and Beverages Produced From Insect-Protected Sugarcane.

PubMed

Kennedy, Reese D; Cheavegatti-Gianotto, Adriana; de Oliveira, Wladecir S; Lirette, Ronald P; Hjelle, Jerry J

2018-01-01

Insect-protected sugarcane that expresses Cry1Ab has been developed in Brazil. Analysis of trade information has shown that effectively all the sugarcane-derived Brazilian exports are raw or refined sugar and ethanol. The fact that raw and refined sugar are highly purified food ingredients, with no detectable transgenic protein, provides an interesting case study of a generalized safety assessment approach. In this study, both the theoretical protein intakes and safety assessments of Cry1Ab, Cry1Ac, NPTII, and Bar proteins used in insect-protected biotechnology crops were examined. The potential consumption of these proteins was examined using local market research data of average added sugar intakes in eight diverse and representative Brazilian raw and refined sugar export markets (Brazil, Canada, China, Indonesia, India, Japan, Russia, and the USA). The average sugar intakes, which ranged from 5.1 g of added sugar/person/day (India) to 126 g sugar/p/day (USA) were used to calculated possible human exposure. The theoretical protein intake estimates were carried out in the "Worst-case" scenario, assumed that 1 μg of newly-expressed protein is detected/g of raw or refined sugar; and the "Reasonable-case" scenario assumed 1 ng protein/g sugar. The "Worst-case" scenario was based on results of detailed studies of sugarcane processing in Brazil that showed that refined sugar contains less than 1 μg of total plant protein /g refined sugar. The "Reasonable-case" scenario was based on assumption that the expression levels in stalk of newly-expressed proteins were less than 0.1% of total stalk protein. Using these calculated protein intake values from the consumption of sugar, along with the accepted NOAEL levels of the four representative proteins we concluded that safety margins for the "Worst-case" scenario ranged from 6.9 × 10 5 to 5.9 × 10 7 and for the "Reasonable-case" scenario ranged from 6.9 × 10 8 to 5.9 × 10 10 . These safety margins are very high due to the extremely low possible exposures and the high NOAELs for these non-toxic proteins. This generalized approach to the safety assessment of highly purified food ingredients like sugar illustrates that sugar processed from Brazilian GM varieties are safe for consumption in representative markets globally.

A case-study of a socio-scientific issues curricular and pedagogical intervention in an undergraduate microbiology course: A focus on informal reasoning

NASA Astrophysics Data System (ADS)

Schalk, Kelly A.

The purpose of this investigation was to measure specific ways a student interest SSI-based curricular and pedagogical affects undergraduates' ability informally reason. The delimited components of informal reasoning measured were undergraduates' Nature of Science conceptualizations and ability to evaluate scientific information. The socio-scientific issues (SSI) theoretical framework used in this case-study has been advocated as a means for improving students' functional scientific literacy. This investigation focused on the laboratory component of an undergraduate microbiology course in spring 2008. There were 26 participants. The instruments used in this study included: (1) Individual and Group research projects, (2) journals, (3) laboratory write-ups, (4) a laboratory quiz, (5) anonymous evaluations, and (6) a pre/post article exercise. All instruments yielded qualitative data, which were coded using the qualitative software NVivo7. Data analyses were subjected to instrumental triangulation, inter-rater reliability, and member-checking. It was determined that undergraduates' epistemological knowledge of scientific discovery, processes, and justification matured in response to the intervention. Specifically, students realized: (1) differences between facts, theories, and opinions; (2) testable questions are not definitively proven; (3) there is no stepwise scientific process; and (4) lack of data weakens a claim. It was determined that this knowledge influenced participants' beliefs and ability to informally reason. For instance, students exhibited more critical evaluations of scientific information. It was also found that undergraduates' prior opinions had changed over the semester. Further, the student interest aspect of this framework engaged learners by offering participants several opportunities to influentially examine microbiology issues that affected their life. The investigation provided empirically based insights into the ways undergraduates' interest and functional scientific literacy can be promoted. The investigation advanced what was known about using SSI-based frameworks to the post-secondary learner context. Outstanding questions remain for investigation. For example, is this type of student interest SSI-based intervention broadly applicable (i.e., in other science disciplines and grade levels)? And, what challenges would teachers in diverse contexts encounter when implementing a SSI-based theoretical framework?

Pre-service middle school mathematics teachers' evaluations of discussions: the case of proof by contradiction

NASA Astrophysics Data System (ADS)

Demiray, Esra; Işıksal Bostan, Mine

2017-03-01

The purposes of this study are to investigate whether pre-service middle school mathematics teachers evaluate discussions in the cases regarding proof by contradiction correctly, to what extent they explain their correct evaluations by referring to proof by contradiction, and the reasons of their misinterpretations of discussions in the cases regarding proof by contradiction. Data were collected from pre-service middle school mathematics teachers enrolled in a state university in Ankara, Turkey, by asking them to evaluate discussions in two cases related to proof by contradiction. In data analysis, descriptive statistics and item-based analysis were employed. The results of the study indicated that pre-service middle school mathematics teachers are successful in evaluating discussions in the cases regarding proof by contradiction. In terms of year level, it was found that the percentage of the second year students' correct answers was the lowest in both cases. Moreover, the first year students were the most successful group in the first case, and the third year students were the most successful group in the second case. Nearly half of the students explained their correct answers by referring to proof by contradiction in the first case while the percentage of students who explained their correct answers by mentioning proof by contradiction in the second case was considerably low. When incorrect answers of pre-service middle school mathematics teachers were analyzed, two reasons of their misinterpretations of discussions were emerged as "misunderstanding of the assumption" and "perceiving proof as unnecessary".

A Computational Model of Reasoning from the Clinical Literature

PubMed Central

Rennels, Glenn D.

1986-01-01

This paper explores the premise that a formalized representation of empirical studies can play a central role in computer-based decision support. The specific motivations underlying this research include the following propositions: 1. Reasoning from experimental evidence contained in the clinical literature is central to the decisions physicians make in patient care. 2. A computational model, based upon a declarative representation for published reports of clinical studies, can drive a computer program that selectively tailors knowledge of the clinical literature as it is applied to a particular case. 3. The development of such a computational model is an important first step toward filling a void in computer-based decision support systems. Furthermore, the model may help us better understand the general principles of reasoning from experimental evidence both in medicine and other domains. Roundsman is a developmental computer system which draws upon structured representations of the clinical literature in order to critique plans for the management of primary breast cancer. Roundsman is able to produce patient-specific analyses of breast cancer management options based on the 24 clinical studies currently encoded in its knowledge base. The Roundsman system is a first step in exploring how the computer can help to bring a critical analysis of the relevant literature to the physician, structured around a particular patient and treatment decision.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bird, Lori; Cochran, Jaquelin; Wang, Xi

This report examines U.S. curtailment practices, with a particular emphasis on utilities in the Western states. The information presented here is based on a series of interviews conducted with utilities, system operators, wind energy developers, and non-governmental organizations. The report provides case studies of curtailment experience and examines the reasons for curtailment, curtailment procedures, compensation, and practices that can minimize curtailment.

On Cognitive Constraints and Learning Progressions: The Case of "Structure of Matter"

ERIC Educational Resources Information Center

Talanquer, Vicente

2009-01-01

Based on the analysis of available research on students' alternative conceptions about the particulate nature of matter, we identified basic implicit assumptions that seem to constrain students' ideas and reasoning on this topic at various learning stages. Although many of these assumptions are interrelated, some of them seem to change or…

Foundation Degrees: A Case for Greater Institutional Autonomy?

ERIC Educational Resources Information Center

Greenbank, Paul

2010-01-01

Foundation Degrees (FDs) were launched in 2000 by the Department for Education and Skills (DfES). One of the key reasons for their introduction was a belief that this new work-based higher education (HE) qualification could help meet employer demand for people with higher technician/associate professional-level skills. According to the Higher…

76 FR 31332 - Information Collection Being Reviewed by the Federal Communications Commission

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-31

... INFORMATION: OMB Control No.: 3060-0139. Title: Application for Antenna Structure Registration. Form No.: FCC... complete FCC Form 854; 1 hour to place registration number at base of antenna structure. Frequency of... in cases where there is a reasonable possibility that an antenna structure may cause a hazard to air...

Using Case-Based Reasoning to Improve the Quality of Feedback Provided by Automated Grading Systems

ERIC Educational Resources Information Center

Kyrilov, Angelo; Noelle, David C.

2014-01-01

Information technology is now ubiquitous in higher education institutions worldwide. More than 85% of American universities use e-learning systems to supplement traditional classroom activities while some have started offering Massive Online Open Courses (MOOCs), which are completely online. An obvious benefit of these online tools is their…

The Case for Women Mentoring Women

ERIC Educational Resources Information Center

Block, Betty Ann; Tietjen-Smith, Tara

2016-01-01

The authors argue that there will be a critical mass of women in leadership positions in kinesiology and across higher education for substantial gender-based mentoring to take place in the 21st century. First, the current state of women in higher education leadership, trends in mentoring, and the reasons it is important for women who have…

77 FR 38185 - Approval and Promulgation of Implementation Plans; State of North Carolina; Regional Haze State...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-27

... Transport Rule than BART; and EPA's proposed ``Better than BART'' determination relies on a 2014 base case... cannot be evaluated in isolation from one another. The Commenter supports its position by repeating... isolation from the reasonable progress requirements. We have on several occasions undertaken evaluations of...

24 CFR 884.106 - Housing assistance payments to owners.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., based on the owner's statement and other evidence, there is not a reasonable prospect that the project...-ASIDE FOR SECTION 515 RURAL RENTAL HOUSING PROJECTS Applicability, Scope and Basic Policies § 884.106... learning of the vacancy, has notified HUD or the PHA, as the case may be, of the vacancy or prospective...

Inquiry Style Interactive Virtual Experiments: A Case on Circular Motion

ERIC Educational Resources Information Center

Zhou, Shaona; Han, Jing; Pelz, Nathaniel; Wang, Xiaojun; Peng, Liangyu; Xiao, Hua; Bao, Lei

2011-01-01

Interest in computer-based learning, especially in the use of virtual reality simulations is increasing rapidly. While there are good reasons to believe that technologies have the potential to improve teaching and learning, how to utilize the technology effectively in teaching specific content difficulties is challenging. To help students develop…

Examining Teacher Framing, Student Reasoning, and Student Agency in School-Based Citizen Science

ERIC Educational Resources Information Center

Harris, Emily Mae

2017-01-01

This dissertation presents three interrelated studies examining opportunities for student learning through contributory citizen science (CS), where students collect and contribute data to help generate new scientific knowledge. I draw on sociocultural perspectives of learning to analyze three cases where teachers integrated CS into school science,…

Visual and Analytical Strategies in Spatial Visualisation: Perspectives from Bilateral Symmetry and Reflection

ERIC Educational Resources Information Center

Ramful, Ajay; Ho, Siew Yin; Lowrie, Tom

2015-01-01

This inquiry presents two fine-grained case studies of students demonstrating different levels of cognitive functioning in relation to bilateral symmetry and reflection. The two students were asked to solve four sets of tasks and articulate their reasoning in task-based interviews. The first participant, Brittany, focused essentially on three…

How clinical reasoning is taught and learned: Cultural perspectives from the University of Melbourne and Universitas Indonesia.

PubMed

Findyartini, Ardi; Hawthorne, Lesleyanne; McColl, Geoff; Chiavaroli, Neville

2016-07-21

The majority of schools in the Asia-Pacific region have adopted medical curricula based on western pedagogy. However to date there has been minimal exploration of the influence of the culture of learning on the teaching and learning process. This paper explores this issue in relation to clinical reasoning. A comparative case study was conducted in 2 medical schools in Australia (University of Melbourne) and Asia (Universitas Indonesia). It involved assessment of medical students' attitudes to clinical reasoning through administration of the Diagnostic Thinking Inventory (DTI), followed by qualitative interviews which explored related cultural issues. A total of 11 student focus group discussions (45 students) and 24 individual medical teacher interviews were conducted, followed by thematic analysis. Students from Universitas Indonesia were found to score lower on the Flexibility in Thinking subscale of the DTI. Qualitative data analysis based on Hofstede's theoretical constructs concerning the culture of learning also highlighted clear differences in relation to attitudes to authority and uncertainty avoidance, with potential impacts on attitudes to teaching and learning of clinical reasoning in undergraduate medical education. Different attitudes to teaching and learning clinical reasoning reflecting western and Asian cultures of learning were identified in this study. The potential impact of cultural differences should be understood when planning how clinical reasoning can be best taught and learned in the changing global contexts of medical education, especially when the western medical education approach is implemented in Asian contexts.

Estimation of the monthly average daily solar radiation using geographic information system and advanced case-based reasoning.

PubMed

Koo, Choongwan; Hong, Taehoon; Lee, Minhyun; Park, Hyo Seon

2013-05-07

The photovoltaic (PV) system is considered an unlimited source of clean energy, whose amount of electricity generation changes according to the monthly average daily solar radiation (MADSR). It is revealed that the MADSR distribution in South Korea has very diverse patterns due to the country's climatic and geographical characteristics. This study aimed to develop a MADSR estimation model for the location without the measured MADSR data, using an advanced case based reasoning (CBR) model, which is a hybrid methodology combining CBR with artificial neural network, multiregression analysis, and genetic algorithm. The average prediction accuracy of the advanced CBR model was very high at 95.69%, and the standard deviation of the prediction accuracy was 3.67%, showing a significant improvement in prediction accuracy and consistency. A case study was conducted to verify the proposed model. The proposed model could be useful for owner or construction manager in charge of determining whether or not to introduce the PV system and where to install it. Also, it would benefit contractors in a competitive bidding process to accurately estimate the electricity generation of the PV system in advance and to conduct an economic and environmental feasibility study from the life cycle perspective.

Evolution. A case of system dynamics.

PubMed

Apáthy, Z

1990-01-01

It is contended that the Darwinian theory of evolution is merely a special case of the obsolete Newtonian paradigm. A modern vision of reality, consistent with structuralism in biology, is presented. Some well-known neo-Darwinist explanations of the evolutionary process are quoted accompanied by structuralist interpretations of the same cases. These lead to a different 'mechanism' of evolution, based on internal factors, consistent with contemporary science. It is argued that a great number of specialists who dismiss the Darwinian theory of evolution share a common reason for rejecting it, but differ widely in guessing the motivating factor or factors of evolution.

Ferris Wheels and Filling Bottles: A Case of a Student's Transfer of Covariational Reasoning across Tasks with Different Backgrounds and Features

ERIC Educational Resources Information Center

Johnson, Heather Lynn; McClintock, Evan; Hornbein, Peter

2017-01-01

Using an actor-oriented perspective on transfer, we report a case of a student's transfer of covariational reasoning across tasks involving different backgrounds and features. In this study, we investigated the research question: How might a student's covariational reasoning on Ferris wheel tasks, involving attributes of distance, width, and…

Online Build-Order Optimization for Real-Time Strategy Agents using Multi-Objective Evolutionary Algorithms

DTIC Science & Technology

2014-03-27

Their chromosome representation is a binary string of 13 actions or 39 bits. Plans consist of a limited number of build actions for the creation of...injected via case-injection which resembles case-base reasoning. Expert actions are recorded and then transformed into chromosomes for injection into GAPs...sites supply a finite amount of a resource. For example, a gold mine in AOE will disappear after a player’s workers have extracted the finite amount of

[Skin eruption and itching after travel to Asia--a case report].

PubMed

Ólafsson, Guðmundur Dagur; Sigurðsson, Emil L; Sigurðardóttir, Bryndís

2015-09-01

One of the more common reasons patients seek medical advice after traveling in tropical countries are skin eruptions. Here we describe two cases of individuals who, after traveling to south east Asia, developed a skin eruption later diagnosed as cutaneous larva migrans. This particular skin condition is common among travelers to countries where the hookworm responsible is endemic. The diagnosis is based on travel history and clinical examination. The patients were treated with albendazole with good results and complete resolution of the symptoms.

Elective surgical case cancellation in the Veterans Health Administration system: identifying areas for improvement.

PubMed

Argo, Joshua L; Vick, Catherine C; Graham, Laura A; Itani, Kamal M F; Bishop, Michael J; Hawn, Mary T

2009-11-01

This study evaluated elective surgical case cancellation (CC) rates, reasons for these cancellations, and identified areas for improvement within the Veterans Health Administration (VA) system. CC data for 2006 were collected from the scheduling software for 123 VA facilities. Surveys were distributed to 40 facilities (10 highest and 10 lowest CC rates for high- and low-volume facilities). CC reasons were standardized and piloted at 5 facilities. Of 329,784 cases scheduled by 9 surgical specialties, 40,988 (12.4%) were cancelled. CC reasons (9,528) were placed into 6 broad categories: patient (35%), work-up/medical condition change (28%), facility (20%), surgeon (8%), anesthesia (1%), and miscellaneous (8%). Survey results show areas for improvement at the facility level and a standardized list of 28 CC reasons was comprehensive. Interventions that decrease cancellations caused by patient factors, inadequate work-up, and facility factors are needed to reduce overall elective surgical case cancellations.

EFFECTIVENESS OF PROBLEM BASED LEARNING AS A STRATEGY TO FOSTER PROBLEM SOLVING AND CRITICAL REASONING SKILLS AMONG MEDICAL STUDENTS.

PubMed

Asad, Munazza; Iqbal, Khadija; Sabir, Mohammad

2015-01-01

Problem based learning (PBL) is an instructional approach that utilizes problems or cases as a context for students to acquire problem solving skills. It promotes communication skills, active learning, and critical thinking skills. It encourages peer teaching and active participation in a group. It was a cross-sectional study conducted at Al Nafees Medical College, Isra University, Islamabad, in one month duration. This study was conducted on 193 students of both 1st and 2nd year MBBS. Each PBL consists of three sessions, spaced by 2-3 days. In the first session students were provided a PBL case developed by both basic and clinical science faculty. In Session 2 (group discussion), they share, integrate their knowledge with the group and Wrap up (third session), was concluded at the end. A questionnaire based survey was conducted to find out overall effectiveness of PBL sessions. Teaching through PBLs greatly improved the problem solving and critical reasoning skills with 60% students of first year and 71% of 2nd year agreeing that the acquisition of knowledge and its application in solving multiple choice questions (MCQs) was greatly improved by these sessions. They observed that their self-directed learning, intrinsic motivation and skills to relate basic concepts with clinical reasoning which involves higher order thinking have greatly enhanced. Students found PBLs as an effective strategy to promote teamwork and critical thinking skills. PBL is an effective method to improve critical thinking and problem solving skills among medical students.

Defining and describing birth centres in the Netherlands - a component study of the Dutch Birth Centre Study.

PubMed

Hermus, M A A; Boesveld, I C; Hitzert, M; Franx, A; de Graaf, J P; Steegers, E A P; Wiegers, T A; van der Pal-de Bruin, K M

2017-07-03

During the last decade, a rapid increase of birth locations for low-risk births, other than conventional obstetric units, has been seen in the Netherlands. Internationally some of such locations are called birth centres. The varying international definitions for birth centres are not directly applicable for use within the Dutch obstetric system. A standard definition for a birth centre in the Netherlands is lacking. This study aimed to develop a definition of birth centres for use in the Netherlands, to identify these centres and to describe their characteristics. International definitions of birth centres were analysed to find common descriptions. In July 2013 the Dutch Birth Centre Questionnaire was sent to 46 selected Dutch birth locations that might qualify as birth centre. Questions included: location, reason for establishment, women served, philosophies, facilities that support physiological birth, hotel-facilities, management, environment and transfer procedures in case of referral. Birth centres were visited to confirm the findings from the Dutch Birth Centre Questionnaire and to measure distance and time in case of referral to obstetric care. From all 46 birth locations the questionnaires were received. Based on this information a Dutch definition of a birth centre was constructed. This definition reads: "Birth centres are midwifery-managed locations that offer care to low risk women during labour and birth. They have a homelike environment and provide facilities to support physiological birth. Community midwives take primary professional responsibility for care. In case of referral the obstetric caregiver takes over the professional responsibility of care." Of the 46 selected birth locations 23 fulfilled this definition. Three types of birth centres were distinguished based on their location in relation to the nearest obstetric unit: freestanding (n = 3), alongside (n = 14) and on-site (n = 6). Transfer in case of referral was necessary for all freestanding and alongside birth centres. Birth centres varied in their reason for establishment and their characteristics. Twenty-three Dutch birth centres were identified and divided into three different types based on location according to the situation in September 2013. Birth centres differed in their reason for establishment, facilities, philosophies, staffing and service delivery.

Sketching the Invisible to Predict the Visible: From Drawing to Modeling in Chemistry.

PubMed

Cooper, Melanie M; Stieff, Mike; DeSutter, Dane

2017-10-01

Sketching as a scientific practice goes beyond the simple act of inscribing diagrams onto paper. Scientists produce a wide range of representations through sketching, as it is tightly coupled to model-based reasoning. Chemists in particular make extensive use of sketches to reason about chemical phenomena and to communicate their ideas. However, the chemical sciences have a unique problem in that chemists deal with the unseen world of the atomic-molecular level. Using sketches, chemists strive to develop causal mechanisms that emerge from the structure and behavior of molecular-level entities, to explain observations of the macroscopic visible world. Interpreting these representations and constructing sketches of molecular-level processes is a crucial component of student learning in the modern chemistry classroom. Sketches also serve as an important component of assessment in the chemistry classroom as student sketches give insight into developing mental models, which allows instructors to observe how students are thinking about a process. In this paper we discuss how sketching can be used to promote such model-based reasoning in chemistry and discuss two case studies of curricular projects, CLUE and The Connected Chemistry Curriculum, that have demonstrated a benefit of this approach. We show how sketching activities can be centrally integrated into classroom norms to promote model-based reasoning both with and without component visualizations. Importantly, each of these projects deploys sketching in support of other types of inquiry activities, such as making predictions or depicting models to support a claim; sketching is not an isolated activity but is used as a tool to support model-based reasoning in the discipline. Copyright © 2017 Cognitive Science Society, Inc.

Optimized model tuning in medical systems.

PubMed

Kléma, Jirí; Kubalík, Jirí; Lhotská, Lenka

2005-12-01

In medical systems it is often advantageous to utilize specific problem situations (cases) in addition to or instead of a general model. Decisions are then based on relevant past cases retrieved from a case memory. The reliability of such decisions depends directly on the ability to identify cases of practical relevance to the current situation. This paper discusses issues of automated tuning in order to obtain a proper definition of mutual case similarity in a specific medical domain. The main focus is on a reasonably time-consuming optimization of the parameters that determine case retrieval and further utilization in decision making/ prediction. The two case studies - mortality prediction after cardiological intervention, and resource allocation at a spa - document that the optimization process is influenced by various characteristics of the problem domain.

A structured framework for assessing sensitivity to missing data assumptions in longitudinal clinical trials.

PubMed

Mallinckrodt, C H; Lin, Q; Molenberghs, M

2013-01-01

The objective of this research was to demonstrate a framework for drawing inference from sensitivity analyses of incomplete longitudinal clinical trial data via a re-analysis of data from a confirmatory clinical trial in depression. A likelihood-based approach that assumed missing at random (MAR) was the primary analysis. Robustness to departure from MAR was assessed by comparing the primary result to those from a series of analyses that employed varying missing not at random (MNAR) assumptions (selection models, pattern mixture models and shared parameter models) and to MAR methods that used inclusive models. The key sensitivity analysis used multiple imputation assuming that after dropout the trajectory of drug-treated patients was that of placebo treated patients with a similar outcome history (placebo multiple imputation). This result was used as the worst reasonable case to define the lower limit of plausible values for the treatment contrast. The endpoint contrast from the primary analysis was - 2.79 (p = .013). In placebo multiple imputation, the result was - 2.17. Results from the other sensitivity analyses ranged from - 2.21 to - 3.87 and were symmetrically distributed around the primary result. Hence, no clear evidence of bias from missing not at random data was found. In the worst reasonable case scenario, the treatment effect was 80% of the magnitude of the primary result. Therefore, it was concluded that a treatment effect existed. The structured sensitivity framework of using a worst reasonable case result based on a controlled imputation approach with transparent and debatable assumptions supplemented a series of plausible alternative models under varying assumptions was useful in this specific situation and holds promise as a generally useful framework. Copyright © 2012 John Wiley & Sons, Ltd.

A Logic-Based Psychotherapy Approach to Treating Patients Which Focuses on Faultless Logical Functioning: A Case Study Method

PubMed Central

Almeida, Fernando; Moreira, Diana

2017-01-01

Many clinical patients present to mental health clinics with depressive symptoms, anxiety, psychosomatic complaints, and sleeping problems. These symptoms which originated may originate from marital problems, conflictual interpersonal relationships, problems in securing work, and housing issues, among many others. These issues might interfere which underlie the difficulties that with the ability of the patients face in maintaining faultless logical reasoning (FLR) and faultless logical functioning (FLF). FLR implies to assess correctly premises, rules, and conclusions. And FLF implies assessing not only FLR, but also the circumstances, life experience, personality, events that validate a conclusion. Almost always, the symptomatology is accompanied by intense emotional changes. Clinical experience shows that a logic-based psychotherapy (LBP) approach is not practiced, and that therapists’ resort to psychopharmacotherapy or other types of psychotherapeutic approaches that are not focused on logical reasoning and, especially, logical functioning. Because of this, patients do not learn to overcome their reasoning and functioning errors. The aim of this work was to investigate how LBP works to improve the patients’ ability to think and function in a faultless logical way. This work describes the case studies of three patients. For this purpose we described the treatment of three patients. With this psychotherapeutic approach, patients gain knowledge that can then be applied not only to the issues that led them to the consultation, but also to other problems they have experienced, thus creating a learning experience and helping to prevent such patients from becoming involved in similar problematic situations. This highlights that LBP is a way of treating symptoms that interfere on some level with daily functioning. This psychotherapeutic approach is relevant for improving patients’ quality of life, and it fills a gap in the literature by describing original case analyses. PMID:29312088

Describing content in middle school science curricula

NASA Astrophysics Data System (ADS)

Schwarz-Ballard, Jennifer A.

As researchers and designers, we intuitively recognize differences between curricula and describe them in terms of design strategy: project-based, laboratory-based, modular, traditional, and textbook, among others. We assume that practitioners recognize the differences in how each requires that students use knowledge, however these intuitive differences have not been captured or systematically described by the existing languages for describing learning goals. In this dissertation I argue that we need new ways of capturing relationships among elements of content, and propose a theory that describes some of the important differences in how students reason in differently designed curricula and activities. Educational researchers and curriculum designers have taken a variety of approaches to laying out learning goals for science. Through an analysis of existing descriptions of learning goals I argue that to describe differences in the understanding students come away with, they need to (1) be specific about the form of knowledge, (2) incorporate both the processes through which knowledge is used and its form, and (3) capture content development across a curriculum. To show the value of inquiry curricula, learning goals need to incorporate distinctions among the variety of ways we ask students to use knowledge. Here I propose the Epistemic Structures Framework as one way to describe differences in students reasoning that are not captured by existing descriptions of learning goals. The usefulness of the Epistemic Structures framework is demonstrated in the four curriculum case study examples in Part II of this work. The curricula in the case studies represent a range of content coverage, curriculum structure, and design rationale. They serve both to illustrate the Epistemic Structures analysis process and make the case that it does in fact describe learning goals in a way that captures important differences in students reasoning in differently designed curricula. Describing learning goals in terms of Epistemic Structures provides one way to define what we mean when we talk about "project-based" curricula and demonstrate its "value added" to educators, administrators and policy makers.

Reasoning process characteristics in the diagnostic skills of beginner, competent, and expert dentists.

PubMed

Crespo, Kathleen E; Torres, José E; Recio, María E

2004-12-01

The purpose of this study was to evaluate qualitative differences in the diagnostic reasoning process at different developmental stages of expertise. A qualitative design was used to study cognitive processes that characterize the diagnosis of oral disease at the stages of beginner (five junior students who had passed the NBDE I), competent (five GPR first-year residents), and expert dentists (five general dentists with ten or more years of experience). Individually, each participant was asked to determine the diagnosis of an oral condition based on a written clinical case, using the think aloud technique and retrospective reports. A subsequent interview was conducted to obtain the participants' diagnostic process model and pathophysiology of the case. The analysis of the verbal protocols indicated that experts referred to the patient's sociomedical context more frequently, demonstrated better organization of ideas, could determine key clinical findings, and had an ability to plan for the search of pertinent information. Fewer diagnostic hypotheses were formulated by participants who used forward reasoning, independent of the stage of development. Beginners requested additional diagnostic aids (radiographs, laboratory tests) more frequently than the competent/expert dentists. Experts recalled typical experiences with patients, while competent/beginner dentists recalled information from didactic courses. Experts evidenced cognitive diagnostic schemas that integrate pathophysiology of disease, while competent and beginner participants had not achieved this integration. We conclude that expert performance is a combination of a knowledge base, reasoning skills, and an accumulation of experiences with patients that is qualitatively different from that of competent and beginner dentists. It is important for dental education to emphasize the teaching of cognitive processes and to incorporate a wide variety of clinical experiences in addition to the teaching of disciplinary content.

Development of essentialist thinking about religion categories in Northern Ireland (and the United States).

PubMed

Smyth, Kirsty; Feeney, Aidan; Eidson, R Cole; Coley, John D

2017-03-01

Social essentialism, the belief that members of certain social categories share unobservable properties, licenses expectations that those categories are natural and a good basis for inference. A challenge for cognitive developmental theory is to give an account of how children come to develop essentialist beliefs about socially important categories. Previous evidence from Israel suggests that kindergarteners selectively engage in essentialist reasoning about culturally salient (ethnicity) categories, and that this is attenuated among children in integrated schools. In 5 studies (N = 718) we used forced-choice (Study 1) and unconstrained (Studies 2-4) category-based inference tasks, and a questionnaire (Study 5) to study the development of essentialist reasoning about religion categories in Northern Ireland (Studies 1-3 & 5) and the U.S. (Study 4). Results show that, as in Israel, Northern Irish children selectively engage in essentialist reasoning about culturally salient (religion) categories, and that such reasoning is attenuated among children in integrated schools. However, the development trajectory of essentialist thinking and the patterns of attenuation among children attending integrated schools in Northern Ireland differ from the Israeli case. Meta-analysis confirmed this claim and ruled out an alternative explanation of the results based on community diversity. Although the Northern Irish and Israeli case studies illustrate that children develop selective essentialist beliefs about socially important categories, and that these beliefs are impacted by educational context, the differences between them emphasize the importance of historical, cultural, and political context in understanding conceptual development, and suggest that there may be more than one developmental route to social essentialism. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Uncertainty management by relaxation of conflicting constraints in production process scheduling

NASA Technical Reports Server (NTRS)

Dorn, Juergen; Slany, Wolfgang; Stary, Christian

1992-01-01

Mathematical-analytical methods as used in Operations Research approaches are often insufficient for scheduling problems. This is due to three reasons: the combinatorial complexity of the search space, conflicting objectives for production optimization, and the uncertainty in the production process. Knowledge-based techniques, especially approximate reasoning and constraint relaxation, are promising ways to overcome these problems. A case study from an industrial CIM environment, namely high-grade steel production, is presented to demonstrate how knowledge-based scheduling with the desired capabilities could work. By using fuzzy set theory, the applied knowledge representation technique covers the uncertainty inherent in the problem domain. Based on this knowledge representation, a classification of jobs according to their importance is defined which is then used for the straightforward generation of a schedule. A control strategy which comprises organizational, spatial, temporal, and chemical constraints is introduced. The strategy supports the dynamic relaxation of conflicting constraints in order to improve tentative schedules.

Withdrawing Versus Withholding Freedoms: Nudging and the Case of Tobacco Control.

PubMed

Schmidt, Andreas T

2016-07-01

Is it a stronger interference with people's freedom to withdraw options they currently have than to withhold similar options they do not have? Drawing on recent theorizing about sociopolitical freedom, this article identifies considerations that often make this the case for public policy. However, when applied to tobacco control, these considerations are shown to give us at best only very weak freedom-based reason to prioritize the status quo. This supports a popular argument for so-called "endgame" tobacco control measures: If we believe that cigarettes would and should be withheld from entering markets in hypothetical scenarios in which they do not yet exist, then we also have reason to seek their abolition in situations, such as ours, in which cigarettes do exist-if necessary by banning their sale. The same considerations are then used to disarm objections that have recently been raised to using nudges in public policy.

Slow reception and under-citedness in climate change research: A case study of Charles David Keeling, discoverer of the risk of global warming.

PubMed

Marx, Werner; Haunschild, Robin; French, Bernie; Bornmann, Lutz

2017-01-01

The Keeling curve has become a chemical landmark, whereas the papers by Charles David Keeling about the underlying carbon dioxide measurements are not cited as often as can be expected against the backdrop of his final approval. In this bibliometric study, we analyze Keeling's papers as a case study for under-citedness of climate change publications. Three possible reasons for the under-citedness of Keeling's papers are discussed: (1) The discourse on global cooling at the starting time of Keeling's measurement program, (2) the underestimation of what is often seen as "routine science", and (3) the amount of implicit/informal citations at the expense of explicit/formal (reference-based) citations. Those reasons may have contributed more or less to the slow reception and the under-citedness of Keeling's seminal works.

Socio-demographic and academic correlates of clinical reasoning in a dental school in South Africa.

PubMed

Postma, T C; White, J G

2017-02-01

There are no empirical studies that describe factors that may influence the development of integrated clinical reasoning skills in dental education. Hence, this study examines the association between outcomes of clinical reasoning in relation with differences in instructional design and student factors. Progress test scores, including diagnostic and treatment planning scores, of fourth and fifth year dental students (2009-2011) at the University of Pretoria, South Africa served as the outcome measures in stepwise linear regression analyses. These scores were correlated with the instructional design (lecture-based teaching and learning (LBTL = 0) or case-based teaching and learning (CBTL = 1), students' grades in Oral Biology, indicators of socio-economic status (SES) and gender. CBTL showed an independent association with progress test scores. Oral Biology scores correlated with diagnostic component scores. Diagnostic component scores correlated with treatment planning scores in the fourth year of study but not in the fifth year of study. 'SES' correlated with progress test scores in year five only, while gender showed no correlation. The empirical evidence gathered in this study provides support for scaffolded inductive teaching and learning methods to develop clinical reasoning skills. Knowledge in Oral Biology and reading skills may be important attributes to develop to ensure that students are able to reason accurately in a clinical setting. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Introspective Reasoning Models for Multistrategy Case-Based and Explanation

DTIC Science & Technology

1997-03-10

symptoms and diseases to causal 30 principles about diseases and first-principle analysis grounded in basic science. Based on research in process...the symptoms of the failure to conclusion that the process which posts learning goals a causal explanation of the failure. Secondl,,. the learner...the vernacular, a "jones" is a drug habit accompanied the faucet for water. Therefore, the story can end with by withdrawal symptoms . The verb "to jones

La mejora de la educacion infantil desde el analisis del pensamiento practico de sus educadores. [The Improvement of Early Childhood Education from an Analysis of the Practical Thinking of Early Childhood Educators.

ERIC Educational Resources Information Center

Argos, Javier

2000-01-01

Discusses proposals for the innovation and development of early childhood education practice, based on findings from case studies on the practical knowledge of four experienced female early childhood educators. Argues that improving early childhood education should be based on its reasons and purposes rather than content or method. (JPB)

Computer aided fixture design - A case based approach

NASA Astrophysics Data System (ADS)

Tanji, Shekhar; Raiker, Saiesh; Mathew, Arun Tom

2017-11-01

Automated fixture design plays important role in process planning and integration of CAD and CAM. An automated fixture setup design system is developed where when fixturing surfaces and points are described allowing modular fixture components to get automatically select for generating fixture units and placed into position with satisfying assembled conditions. In past, various knowledge based system have been developed to implement CAFD in practice. In this paper, to obtain an acceptable automated machining fixture design, a case-based reasoning method with developed retrieval system is proposed. Visual Basic (VB) programming language is used in integrating with SolidWorks API (Application programming interface) module for better retrieval procedure reducing computational time. These properties are incorporated in numerical simulation to determine the best fit for practical use.

Defense Small Business Innovation Research Program (SBIR). Volume 4. Defense Agency Projects, Abstracts of Phase 1 Awards from FY 1989 SBIR Solicitation

DTIC Science & Technology

1990-04-01

EXPLOSIVE ACTIVITY . FINDINGS AND MEASUREMENTS FROM EACH IMAGE WILL BE COMBINED IN A GEOGRAPHIC INFORMATION DATA BASE . VARIOUS IMAGE AND MAP PROJECTS WILL BE...PROPOSAL OF LAND MINES DETECTION BY A NUCLEAR ACTIVATION METHOD IS BASED ON A NEW EXTREMELY INTENSE, COMPACT PULSED SOURCE OF 14.1 MeV NEUTRONS (WITH A...CONVENTIONAL KNOWLEDGE- BASED SYSTEMS TOPIC# 38 OFFICE: PM/SBIR IDENT#: 33862 CASE- BASED REASONING (CBR) REPRESENTS A POWERFUL NEW PARADIGM FOR BUILDING EXPERT

A new scenario-based approach to damage detection using operational modal parameter estimates

NASA Astrophysics Data System (ADS)

Hansen, J. B.; Brincker, R.; López-Aenlle, M.; Overgaard, C. F.; Kloborg, K.

2017-09-01

In this paper a vibration-based damage localization and quantification method, based on natural frequencies and mode shapes, is presented. The proposed technique is inspired by a damage assessment methodology based solely on the sensitivity of mass-normalized experimental determined mode shapes. The present method differs by being based on modal data extracted by means of Operational Modal Analysis (OMA) combined with a reasonable Finite Element (FE) representation of the test structure and implemented in a scenario-based framework. Besides a review of the basic methodology this paper addresses fundamental theoretical as well as practical considerations which are crucial to the applicability of a given vibration-based damage assessment configuration. Lastly, the technique is demonstrated on an experimental test case using automated OMA. Both the numerical study as well as the experimental test case presented in this paper are restricted to perturbations concerning mass change.

It's not all about moral reasoning: Understanding the content of Moral Case Deliberation.

PubMed

Svantesson, Mia; Silén, Marit; James, Inger

2018-03-01

Moral Case Deliberation is one form of clinical ethics support described as a facilitator-led collective moral reasoning by healthcare professionals on a concrete moral question connected to their practice. Evaluation research is needed, but, as human interaction is difficult to standardise, there is a need to capture the content beyond moral reasoning. This allows for a better understanding of Moral Case Deliberation, which may contribute to further development of valid outcome criteria and stimulate the normative discussion of what Moral Case Deliberation should contain. To explore and compare the content beyond moral reasoning in the dialogue in Moral Case Deliberation at Swedish workplaces. A mixed-methods approach was applied for analysing audio-recordings of 70 periodic Moral Case Deliberation meetings at 10 Swedish workplaces. Moral Case Deliberation facilitators and various healthcare professions participated, with registered nurses comprising the majority. Ethical considerations: No objection to the study was made by an Ethical Review Board. After oral and written information was provided, consent to be recorded was assumed by virtue of participation. Other than 'moral reasoning' (median (md): 45% of the spoken time), the Moral Case Deliberations consisted of 'reflections on the psychosocial work environment' to a varying extent (md: 29%). Additional content comprised 'assumptions about the patient's psychosocial situation' (md: 6%), 'facts about the patient's situation' (md: 5%), 'concrete problem-solving' (md: 6%) and 'process' (md: 3%). The findings suggest that a restorative function of staff's wellbeing in Moral Case Deliberation is needed, as this might contribute to good patient care. This supports outcome criteria of improved emotional support, which may include relief of moral distress. However, facilitators need a strategy for how to proceed from the participants' own emotional needs and to develop the use of their emotional knowing to focus on the ethically difficult patient situation.

A Learner-Centered Technique and Clinical Reasoning, Reflection, and Case Presentation Attributes in Athletic Training Students

PubMed Central

Heinerichs, Scott; Vela, Luzita I.; Drouin, Joshua M.

2013-01-01

Context: Providing opportunities to develop clinical decision-making skills, including clinical reasoning, is an important aspect of clinical education. The learner-centered technique of summarizing the history and findings, narrowing the differential, analyzing the differential, probing the instructor about uncertainties, plan management, and selecting an issue for self-directed study (SNAPPS) is used in medicine to express clinical reasoning. Objective: To investigate the effects of SNAPPS on the clinical reasoning, reflection, and 4 case presentation attributes (length, conciseness, case summary, and expression of clinical reasoning) in athletic training students. Design: Randomized controlled clinical trial. Setting: Three undergraduate programs accredited by the Commission on Accreditation of Athletic Training Education. Patients or Other Participants: We randomly assigned 38 athletic training students (17 men, 21 women; age = 21.53 ± 1.18 years, grade point average = 3.25 ± 0.31) who had completed at least 1 year of clinical education and all orthopaedic evaluation coursework to the SNAPPS group or the usual and customary group using a stratification scheme. Intervention(s): The SNAPPS group completed four 45-minute clinical reasoning and case presentation learning modules led by an investigator to learn the SNAPPS technique, whereas the usual and customary group received no formal instruction. Both groups audio recorded all injury evaluations performed over a 2-week period. Main Outcome Measures: Participants completed the Diagnostic Thinking Inventory and Reflection in Learning Scale twice. Case presentations were analyzed for 4 attributes: length, conciseness, case summary, and expression of clinical reasoning. Results: Case presentations were longer (t18.806 = −5.862, P < .001) but were more concise (t32 = 11.297, P < .001) for the SNAPPS group than for the usual and customary group. The SNAPPS group performed better on both the case summary subscale (t32 = 2.857, P = .007) and the clinical reasoning subscale (t25.773 = −14.162, P < .001) than the other group. We found a time effect for Diagnostic Thinking Inventory scores (F1,34 = 6.230, P = .02) but observed no group effects (F1,34 = 0.698, P = .41) or time-by-group interaction (F1,34 = 1.050, P = .31). The Reflection in Learning Scale scores analysis revealed no group-by-time interaction (F1,34 = 1.470, P = .23) and no group (F1,34 = 3.751, P = .06) or time (F1,34 = 0.835, P = .37) effects. Conclusions: The SNAPPS is an effective and feasible clinical education technique for case presentations. This learner-centered technique provides the opportunity for the expression of clinical reasoning skills. PMID:23675796

Formalization and Analysis of Reasoning by Assumption

ERIC Educational Resources Information Center

Bosse, Tibor; Jonker, Catholijn M.; Treur, Jan

2006-01-01

This article introduces a novel approach for the analysis of the dynamics of reasoning processes and explores its applicability for the reasoning pattern called reasoning by assumption. More specifically, for a case study in the domain of a Master Mind game, it is shown how empirical human reasoning traces can be formalized and automatically…

Clinical decision-making by midwives: managing case complexity.

PubMed

Cioffi, J; Markham, R

1997-02-01

In making clinical judgements, it is argued that midwives use 'shortcuts' or heuristics based on estimated probabilities to simplify the decision-making task. Midwives (n = 30) were given simulated patient assessment situations of high and low complexity and were required to think aloud. Analysis of verbal protocols showed that subjective probability judgements (heuristics) were used more frequently in the high than low complexity case and predominated in the last quarter of the assessment period for the high complexity case. 'Representativeness' was identified more frequently in the high than in the low case, but was the dominant heuristic in both. Reports completed after each simulation suggest that heuristics based on memory for particular conditions affect decisions. It is concluded that midwives use heuristics, derived mainly from their clinical experiences, in an attempt to save cognitive effort and to facilitate reasonably accurate decisions in the decision-making process.

An evidence-based concept of implant dentistry. Utilization of short and narrow platform implants.

PubMed

Ruiz, Jose-Luis

2012-09-01

As a profession, we must remember that tooth replacement is not a luxury; it is often a necessity for health reasons. Although bone augmentation and CBCT and expensive surgical guides are often indicated for complex cases, they are being overused. Simple or straightforward implant cases, when there is sufficient natural bone for narrow or shorter implant, can be predictable performed by well-trained GPs and other trained specialists. Complex cases requiring bone augmentation and other complexities as described herein, should be referred to a surgical specialist. Implant courses and curricula have to be based on the level of complexity of implant surgery that each clinician wishes to provide to his or her patients. Using a "logical approach" to implant dentistry keeps cases simple or straightforward, and more accessible to patients by the correct use of narrow and shorter implants.

Development of the Computerized Model of Performance-Based Measurement System to Measure Nurses' Clinical Competence.

PubMed

Liou, Shwu-Ru; Liu, Hsiu-Chen; Tsai, Shu-Ling; Cheng, Ching-Yu; Yu, Wei-Chieh; Chu, Tsui-Ping

2016-04-01

Critical thinking skills and clinical competence are for providing quality patient care. The purpose of this study is to develop the Computerized Model of Performance-Based Measurement system based on the Clinical Reasoning Model. The system can evaluate and identify learning needs for clinical competency and be used as a learning tool to increase clinical competency by using computers. The system includes 10 high-risk, high-volume clinical case scenarios coupled with questions testing clinical reasoning, interpersonal, and technical skills. Questions were sequenced to reflect patients' changing condition and arranged by following the process of collecting and managing information, diagnosing and differentiating urgency of problems, and solving problems. The content validity and known-groups validity was established. The Kuder-Richardson Formula 20 was 0.90 and test-retest reliability was supported (r = 0.78). Nursing educators can use the system to understand students' needs for achieving clinical competence, and therefore, educational plans can be made to better prepare students and facilitate their smooth transition to a future clinical environment. Clinical nurses can use the system to evaluate their performance-based abilities and weakness in clinical reasoning. Appropriate training programs can be designed and implemented to practically promote nurses' clinical competence and quality of patient care.

Using Case-Based Reasoning to Improve the Quality of Feedback Provided by Automated Assessment Systems for Programming Exercises

ERIC Educational Resources Information Center

Kyrilov, Angelo

2017-01-01

Information technology is now ubiquitous in higher education institutions worldwide. More than 85% of American universities use e-learning systems to supplement traditional classroom activities. An obvious benefit of these online tools is their ability to automatically grade exercises submitted by students and provide immediate feedback. Most of…

Increasing Self-Regulation and Classroom Participation of a Child Who Is Deafblind

ERIC Educational Resources Information Center

Nelson, Catherine; Hyte, Holly A.; Greenfield, Robin

2015-01-01

Self regulation has been identified as essential to school success. However, for a variety of reasons, its development may be compromised in children and youth who are deafblind. A single-case multiple baseline study of a child who was deafblind examined the effects of three groups of evidence-based interventions on variables thought to be…

Exploring motivation for leisure-based physical activity: a case study of college students

Treesearch

Alvin Hung Chih Yu

2007-01-01

The benefits of physical activity have been well documented in recent years. Physical activity may decrease the risk of cardiovascular disease, assist in weight management, improve personal mood, and promote physiological health. In light of this increased activity, it is important to understand the reasons for it. This exploratory study attempted to identify college...

Blending Problem-Based Learning and Peer-Led Team Learning, in an Open Ended "Home-Grown" Pharmaceutical Chemistry Case Study

ERIC Educational Resources Information Center

Veale, Clinton G. L.; Krause, Rui W. M.; Sewry, Joyce D.

2018-01-01

Pharmaceutical chemistry, medicinal chemistry and the drug discovery process require experienced practitioners to employ reasoned speculation in generating creative ideas, which can be used to evolve promising molecules into drugs. The ever-evolving world of pharmaceutical chemistry requires university curricula that prepare graduates for their…

Hybrid Architectures and Their Impact on Intelligent Design

NASA Technical Reports Server (NTRS)

Kandel, Abe

1996-01-01

In this presentation we investigate a novel framework for the design of autonomous fuzzy intelligent systems. The system integrates the following modules into a single autonomous entity: (1) a fuzzy expert system; (2) artificial neural network; (3) genetic algorithm; and (4) case-base reasoning. We describe the integration of these units into one intelligent structure and discuss potential applications.

Is Drop-Out from University Dependent on National Culture and Policy? The Case of Denmark

ERIC Educational Resources Information Center

Troelsen, Rie; Laursen, Per F.

2014-01-01

National cultures are known to influence educational institutions and practices in many ways. It therefore seems reasonable to assume that drop-out from university is also influenced by differences in national cultures. In this article, we compare drop-out from Danish universities with drop-out from European universities. Based on Danish national…

5 CFR 300.103 - Basic requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... leading to a target position at a higher level; and (ii) New employees, within a reasonable period of time... performance in the position to be filled (or in the target position in the case of an entry position) and the... position the required relevance may be based upon the target position when— (i) The entry position is a...

5 CFR 300.103 - Basic requirements.

Code of Federal Regulations, 2011 CFR

2011-01-01

... leading to a target position at a higher level; and (ii) New employees, within a reasonable period of time... performance in the position to be filled (or in the target position in the case of an entry position) and the... position the required relevance may be based upon the target position when— (i) The entry position is a...

5 CFR 300.103 - Basic requirements.

Code of Federal Regulations, 2014 CFR

2014-01-01

... leading to a target position at a higher level; and (ii) New employees, within a reasonable period of time... performance in the position to be filled (or in the target position in the case of an entry position) and the... position the required relevance may be based upon the target position when— (i) The entry position is a...

5 CFR 300.103 - Basic requirements.

Code of Federal Regulations, 2012 CFR

2012-01-01

... leading to a target position at a higher level; and (ii) New employees, within a reasonable period of time... performance in the position to be filled (or in the target position in the case of an entry position) and the... position the required relevance may be based upon the target position when— (i) The entry position is a...

42 CFR 405.502 - Criteria for determining reasonable charges.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) of this section, in the case of services of assistants-at-surgery as defined in § 405.580 in teaching and non-teaching settings, charges that are not more than 16 percent of the prevailing charge in the... deficient payment amount. (v) The limit is either a specific dollar amount or is based on a special method...

Case Studies of a Robot-Based Game to Shape Interests and Hone Proportional Reasoning Skills

ERIC Educational Resources Information Center

Alfieri, Louis; Higashi, Ross; Shoop, Robin; Schunn, Christian D.

2015-01-01

Background: Robot-math is a term used to describe mathematics instruction centered on engineering, particularly robotics. This type of instruction seeks first to make the mathematics skills useful for robotics-centered challenges, and then to help students extend (transfer) those skills. A robot-math intervention was designed to target the…

Some Simple Solutions to the Problem of Predicting Boundary-Layer Self-Induced Pressures

NASA Technical Reports Server (NTRS)

Bertram, Mitchel H.; Blackstock, Thomas A.

1961-01-01

Simplified theoretical approaches are shown, based on hypersonic similarity boundary-layer theory, which allow reasonably accurate estimates to be made of the surface pressures on plates on which viscous effects are important. The consideration of viscous effects includes the cases where curved surfaces, stream pressure gradients, and leadingedge bluntness are important factors.

Design Decisions in Developing Learning Trajectories-Based Assessments in Mathematics: A Case Study

ERIC Educational Resources Information Center

Penuel, William R.; Confrey, Jere; Maloney, Alan; Rupp, André A.

2014-01-01

This article analyzes the design decisions of a team developing diagnostic assessments for a learning trajectory focused on rational number reasoning. The analysis focuses on the design rationale for key decisions about how to develop the cognitive assessments and related validity arguments within a fluid state and national policy context. The…

Export Controls and Nonproliferation Policy

DTIC Science & Technology

1994-05-01

Export Control Classification Numbers ( ECCNs ). The ECCNs do not correspond one-for-one to single commodity technology, or software items: in some...cases an ECCN covers only a single, narrowly defined item, but in many cases multiple related items fall under the same ECCN . The reason for control of...each ECCN category may be single or multiple (e.g., for both National Security and Nuclear Proliferation) but the reason(s) listed may in fact apply

The role of emotions in moral case deliberation: theory, practice, and methodology.

PubMed

Molewijk, Bert; Kleinlugtenbelt, Dick; Widdershoven, Guy

2011-09-01

In clinical moral decision making, emotions often play an important role. However, many clinical ethicists are ignorant, suspicious or even critical of the role of emotions in making moral decisions and in reflecting on them. This raises practical and theoretical questions about the understanding and use of emotions in clinical ethics support services. This paper presents an Aristotelian view on emotions and describes its application in the practice of moral case deliberation. According to Aristotle, emotions are an original and integral part of (virtue) ethics. Emotions are an inherent part of our moral reasoning and being, and therefore they should be an inherent part of any moral deliberation. Based on Aristotle's view, we examine five specific aspects of emotions: the description of emotions, the attitude towards emotions, the thoughts present in emotions, the reliability of emotions, and the reasonable principle that guides an emotion. We then discuss three ways of dealing with emotions in the process of moral case deliberation. Finally, we present an Aristotelian conversation method, and present practical experiences using this method. © 2011 Blackwell Publishing Ltd.

Knowledge-light adaptation approaches in case-based reasoning for radiotherapy treatment planning.

PubMed

Petrovic, Sanja; Khussainova, Gulmira; Jagannathan, Rupa

2016-03-01

Radiotherapy treatment planning aims at delivering a sufficient radiation dose to cancerous tumour cells while sparing healthy organs in the tumour-surrounding area. It is a time-consuming trial-and-error process that requires the expertise of a group of medical experts including oncologists and medical physicists and can take from 2 to 3h to a few days. Our objective is to improve the performance of our previously built case-based reasoning (CBR) system for brain tumour radiotherapy treatment planning. In this system, a treatment plan for a new patient is retrieved from a case base containing patient cases treated in the past and their treatment plans. However, this system does not perform any adaptation, which is needed to account for any difference between the new and retrieved cases. Generally, the adaptation phase is considered to be intrinsically knowledge-intensive and domain-dependent. Therefore, an adaptation often requires a large amount of domain-specific knowledge, which can be difficult to acquire and often is not readily available. In this study, we investigate approaches to adaptation that do not require much domain knowledge, referred to as knowledge-light adaptation. We developed two adaptation approaches: adaptation based on machine-learning tools and adaptation-guided retrieval. They were used to adapt the beam number and beam angles suggested in the retrieved case. Two machine-learning tools, neural networks and naive Bayes classifier, were used in the adaptation to learn how the difference in attribute values between the retrieved and new cases affects the output of these two cases. The adaptation-guided retrieval takes into consideration not only the similarity between the new and retrieved cases, but also how to adapt the retrieved case. The research was carried out in collaboration with medical physicists at the Nottingham University Hospitals NHS Trust, City Hospital Campus, UK. All experiments were performed using real-world brain cancer patient cases treated with three-dimensional (3D)-conformal radiotherapy. Neural networks-based adaptation improved the success rate of the CBR system with no adaptation by 12%. However, naive Bayes classifier did not improve the current retrieval results as it did not consider the interplay among attributes. The adaptation-guided retrieval of the case for beam number improved the success rate of the CBR system by 29%. However, it did not demonstrate good performance for the beam angle adaptation. Its success rate was 29% versus 39% when no adaptation was performed. The obtained empirical results demonstrate that the proposed adaptation methods improve the performance of the existing CBR system in recommending the number of beams to use. However, we also conclude that to be effective, the proposed adaptation of beam angles requires a large number of relevant cases in the case base. Copyright © 2016 Elsevier B.V. All rights reserved.

Achieving 95% cross-methodological concordance in HER2 testing: causes and implications of discordant cases.

PubMed

Grimm, Erin E; Schmidt, Rodney A; Swanson, Paul E; Dintzis, Suzanne M; Allison, Kimberly H

2010-08-01

We were interested in determining our concordance between fluorescence in situ hybridization (FISH) and a previously validated immunohistochemical HER2 assay to identify possible reasons for discordance and to determine if all reasons for discordance were addressed by the American Society of Clinical Oncology/College of American Pathologists guidelines. We reviewed 697 cases (2004-2007) in which HER2 immunohistochemical and FISH testing were concurrently done. Overall concordance between nonequivocal immunohistochemical and FISH results was 96%. Of the 19 discordant cases, 13 (68%) were interpreted as positive immunohistochemically but negative by FISH. The primary reason for this discordance was immunohistochemical interpretation. Weak stain intensity, granular staining, and interpretation in areas of crush artifact were identified as the most common issues. Of the 6 cases interpreted as immunohistochemically negative and FISH-positive, 2 were from patients known to be receiving trastuzumab at the time of biopsy, 1 was very close to the FISH equivocal category, and 4 cases had fewer than 1.5 CEP17 signals per cell (1 patient in this group was also receiving trastuzumab). Focusing on issues with HER2 immunohistochemical interpretation can improve concordance rates for immunohistochemically positive cases, but biologic reasons may explain some discordant immunohistochemically negative cases.

Novel examination for evaluating medical student clinical reasoning: reliability and association with patients seen.

PubMed

Hemmer, Paul A; Dong, Ting; Durning, Steven J; Pangaro, Louis N

2015-04-01

Medical students learn clinical reasoning, in part, through patient care. Although the numbers of patients seen is associated with knowledge examination scores, studies have not demonstrated an association between patient problems and an assessment of clinical reasoning. To examine the reliability of a clinical reasoning examination and investigate whether there was association between internal medicine core clerkship students' performance on this examination and the number of patients they saw with matching problems during their internal medicine clerkship. Students on the core internal medicine clerkship at the Uniformed Services University students log 11 core patient problems based on the Clerkship Directors in Internal Medicine curriculum. On a final clerkship examination (Multistep), students watch a scripted video encounter between physician and patient actors that assesses three sequential steps in clinical reasoning: Step One focuses on history and physical examination; Step Two, students write a problem list after viewing additional clinical findings; Step Three, students complete a prioritized differential diagnosis and treatment plan. Each Multistep examination has three different cases. For graduating classes 2010-2012 (n = 497), we matched the number of patients seen with the problem most represented by the Multistep cases (epigastric pain, generalized edema, monoarticular arthritis, angina, syncope, pleuritic chest pain). We report two-way Pearson correlations between the number of patients students reported with similar problems and the student's percent score on: Step One, Step Two, Step Three, and Overall Test. Multistep reliability: Step 1, 0.6 to 0.8; Step 2, 0.41 to 0.65; Step 3, 0.53 to 0.78; Overall examination (3 cases): 0.74 to 0.83. For three problems, the number of patients seen had small to modest correlations with the Multistep Examination of Analytic Ability total score (r = 0.27 for pleuritic pain, p < 0.05, n = 81 patients; r = 0.14 for epigastric pain, p < 0.05, n = 324 patients; r = 0.19 for generalized edema, p < 0.05, n = 118 patients). DISCUSSION or Although a reliable assessment, student performance on a clinical reasoning examination was weakly associated with the numbers of patients seen with similar problems. This may be as a result of transfer of knowledge between clinical and examination settings, the complexity of clinical reasoning, or the limits of reliability with patient logs and the Multistep. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Facilitating progress in health behaviour theory development and modification: the reasoned action approach as a case study.

PubMed

Head, Katharine J; Noar, Seth M

2014-01-01

This paper explores the question: what are barriers to health behaviour theory development and modification, and what potential solutions can be proposed? Using the reasoned action approach (RAA) as a case study, four areas of theory development were examined: (1) the theoretical domain of a theory; (2) tension between generalisability and utility, (3) criteria for adding/removing variables in a theory, and (4) organisational tracking of theoretical developments and formal changes to theory. Based on a discussion of these four issues, recommendations for theory development are presented, including: (1) the theoretical domain for theories such as RAA should be clarified; (2) when there is tension between generalisability and utility, utility should be given preference given the applied nature of the health behaviour field; (3) variables should be formally removed/amended/added to a theory based on their performance across multiple studies and (4) organisations and researchers with a stake in particular health areas may be best suited for tracking the literature on behaviour-specific theories and making refinements to theory, based on a consensus approach. Overall, enhancing research in this area can provide important insights for more accurately understanding health behaviours and thus producing work that leads to more effective health behaviour change interventions.

Integrated Case Learning: Teaching Clinical Reasoning

ERIC Educational Resources Information Center

Radomski, Natalie; Russell, John

2010-01-01

Learning how to "think like doctors" can be difficult for undergraduate medical students in their early clinical years. Our model of collaborative Integrated Case Learning (ICL) and simulated clinical reasoning aims to address these issues. Taking a socio-cultural perspective, this study investigates the reflective learning interactions…

Risk-based corrective action and brownfields restorations. Geotechnical special publication No. 82

DOE Office of Scientific and Technical Information (OSTI.GOV)

Benson, C.H.; Meegoda, J.N.; Gilbert, R.G.

Risk-based corrective action (RBCA) and brownfields restoration now play a significant role in contaminated site remediation. RBCA provides the necessary framework for balancing health and environmental risks with costs while targeting the ultimate objective of sensible remediation. Brownfields is a reasonable, economical approach for remediating contaminated land intended for industrial use. This book describes the tools and methods employed in RBCA, and provides illustrative examples through case histories with emphasis on brownfields restorations.

Patients who make terrible therapeutic choices.

PubMed

Curzer, Howard J

2014-01-01

The traditional approaches to dental ethics include appeals to principles, duties (deontology), and consequences (utilitarianism). These approaches are often inadequate when faced with the case of a patient who refuses reasonable treatment and does not share the same ethical framework the dentist is using. An approach based on virtue ethics may be helpful in this and other cases. Virtue ethics is a tradition going back to Plato and Aristotle. It depends on forming a holistic character supporting general appropriate behavior. By correctly diagnosing the real issues at stake in a patient's inappropriate oral health choices and working to build effective habits, dentists can sometimes respond to ethical challenges that remain intractable given rule-based methods.

Estimation of the contribution of private providers in tuberculosis case notification and treatment outcome in Pakistan.

PubMed

Chughtai, A A; Qadeer, E; Khan, W; Hadi, H; Memon, I A

2013-03-01

To improve involvement of the private sector in the national tuberculosis (TB) programme in Pakistan various public-private mix projects were set up between 2004 and 2009. A retrospective analysis of data was made to study 6 different public-private mix models for TB control in Pakistan and estimate the contribution of the various private providers to TB case notification and treatment outcome. The number of TB cases notified through the private sector increased significantly from 77 cases in 2004 to 37,656 in 2009. Among the models, the nongovernmental organization model made the greatest contribution to case notification (58.3%), followed by the hospital-based model (18.9%). Treatment success was highest for the district-led model (94.1%) and lowest for the hospital-based model (74.2%). The private sector made an important contribution to the national data through the various public-private mix projects. Issues of sustainability and the lack of treatment supporters are discussed as reasons for lack of success of some projects.

How do people evaluate social sexual conduct at work? A psycholegal model.

PubMed

Wiener, R L; Hurt, L E

2000-02-01

The authors tested a psycholegal model of how people evaluate social sexual conduct at work with videotaped reenactments of interviews with alleged complainants, perpetrators, and other workers. Participants (200 full-time male and female workers) were randomly assigned to evaluate the complaints with either the reasonable person or reasonable woman legal standard. Participants answered questions about sexual harassment law and completed the Ambivalent Sexism Inventory. Participants who took the reasonable woman perspective, as compared with those who took the reasonable person perspective, were more likely to find the conduct harassing; this was especially the case among participants high in hostile sexism. Medium-sized gender effects were found in the severe case but were absent in the weaker, more ambiguous case. The implications of these findings for hostile work environment law are discussed.

Principles of reasoning in historical epidemiology.

PubMed

Tulodziecki, Dana

2012-10-01

The case of John Snow has long been important to epidemiologists and public health officials. However, despite the fact that there have been many discussions about the various aspects of Snow's case, there has been virtually no discussion about what guided Snow's reasoning in his coming to believe his various conclusions about cholera. Here, I want to take up this question in some detail and show that there are a number of specific principles of reasoning that played a crucial role for Snow. Moreover, these principles were epistemologically important to Snow, a fact about which Snow is explicit in many places. An analysis of Snow's case suggests that, because of the epistemic role such principles of reasoning can play, health care practitioners ought to understand their practices to be theoretically informed in these ways, and not just data driven. © 2012 Blackwell Publishing Ltd.

The effect of short-term workshop on improving clinical reasoning skill of medical students

PubMed Central

Yousefichaijan, Parsa; Jafari, Farshad; Kahbazi, Manijeh; Rafiei, Mohammad; Pakniyat, AbdolGhader

2016-01-01

Background: Clinical reasoning process leads clinician to get purposeful steps from signs and symptoms toward diagnosis and treatment. This research intends to investigate the effect of teaching clinical reasoning on problem-solving skills of medical students. Methods: This research is a semi-experimental study. Nineteen Medical student of the pediatric ward as case group participated in a two-day workshop for training clinical reasoning. Before the workshop, they filled out Diagnostic Thinking Inventory (DTI) questionnaires. Fifteen days after the workshop the DTI questionnaire completed and "key feature" (KF) test and "clinical reasoning problem" (CRP) test was held. 23 Medical student as the control group, without passing the clinical reasoning workshop DTI questionnaire completed, and KF test and CRP test was held. Results: The average score of the DTI questionnaire in the control group was 162.04 and in the case group before the workshop was 153.26 and after the workshop was 181.68. Compare the average score of the DTI questionnaire before and after the workshop there is a significant difference. The difference between average KF test scores in the control and the case group was not significant but between average CRP test scores was significant. Conclusion: Clinical reasoning workshop is effectiveness in promoting problem-solving skills of students. PMID:27579286

The effect of short-term workshop on improving clinical reasoning skill of medical students.

PubMed

Yousefichaijan, Parsa; Jafari, Farshad; Kahbazi, Manijeh; Rafiei, Mohammad; Pakniyat, AbdolGhader

2016-01-01

Clinical reasoning process leads clinician to get purposeful steps from signs and symptoms toward diagnosis and treatment. This research intends to investigate the effect of teaching clinical reasoning on problem-solving skills of medical students. This research is a semi-experimental study. Nineteen Medical student of the pediatric ward as case group participated in a two-day workshop for training clinical reasoning. Before the workshop, they filled out Diagnostic Thinking Inventory (DTI) questionnaires. Fifteen days after the workshop the DTI questionnaire completed and "key feature" (KF) test and "clinical reasoning problem" (CRP) test was held. 23 Medical student as the control group, without passing the clinical reasoning workshop DTI questionnaire completed, and KF test and CRP test was held. The average score of the DTI questionnaire in the control group was 162.04 and in the case group before the workshop was 153.26 and after the workshop was 181.68. Compare the average score of the DTI questionnaire before and after the workshop there is a significant difference. The difference between average KF test scores in the control and the case group was not significant but between average CRP test scores was significant. Clinical reasoning workshop is effectiveness in promoting problem-solving skills of students.

Retrocausal Effects As A Consequence of Orthodox Quantum Mechanics Refined To Accommodate The Principle Of Sufficient Reason

NASA Astrophysics Data System (ADS)

Stapp, Henry P.

2011-11-01

The principle of sufficient reason asserts that anything that happens does so for a reason: no definite state of affairs can come into being unless there is a sufficient reason why that particular thing should happen. This principle is usually attributed to Leibniz, although the first recorded Western philosopher to use it was Anaximander of Miletus. The demand that nature be rational, in the sense that it be compatible with the principle of sufficient reason, conflicts with a basic feature of contemporary orthodox physical theory, namely the notion that nature's response to the probing action of an observer is determined by pure chance, and hence on the basis of absolutely no reason at all. This appeal to pure chance can be deemed to have no rational fundamental place in reason-based Western science. It is argued here, on the basis of the other basic principles of quantum physics, that in a world that conforms to the principle of sufficient reason, the usual quantum statistical rules will naturally emerge at the pragmatic level, in cases where the reason behind nature's choice of response is unknown, but that the usual statistics can become biased in an empirically manifest way when the reason for the choice is empirically identifiable. It is shown here that if the statistical laws of quantum mechanics were to be biased in this way then the basically forward-in-time unfolding of empirical reality described by orthodox quantum mechanics would generate the appearances of backward-time-effects of the kind that have been reported in the scientific literature.

Newly developed liquid-based cytology. TACAS™: cytological appearance and HPV testing using liquid-based sample.

PubMed

Kubushiro, Kaneyuki; Taoka, Hideki; Sakurai, Nobuyuki; Yamamoto, Yasuhiro; Kurasaki, Akiko; Asakawa, Yasuyuki; Iwahara, Minoru; Takahashi, Kei

2011-09-01

Cell profiles determined by the thin-layer advanced cytology assay system (TACAS™), a liquid-based cytology technique newly developed in Japan, were analyzed in this study. Hybrid capture 2 (HC-2) was also performed using the liquid-based samples prepared by TACAS to ascertain its ability to detect human papillomavirus (HPV). Cell collection samples from uterine cervix were obtained from 359 patients and examined cytologically. A HC-2 assay for HPV was carried out in the cell specimens. All specimens were found to show background factors such as leukocytes. After excluding the 5 unsatisfactory cases from the total 354 cases, 82 cases (23.2%) were positive and 272 cases (76.8%) were negative for HPV. Cell specimens from 30 HPV-positive cases and 166 HPV-negative cases were subjected to 4 weeks of preservation at room temperature. Then, when subsequently re-assayed, 28 cases (93.3%) in the former group were found to be HPV positive and 164 cases (98.8%) in the latter group were found to be HPV negative. These results supported the excellent reproducibility of TACAS for HPV testing. A reasonable inference from the foregoing analysis is that TACAS may be distinguished from other liquid-based cytological approaches, such as ThinPrep and SurePath, in that it can retain the cell backgrounds. Furthermore, this study raises the possibility that cell specimens prepared using TACAS could be preserved for at least 4 weeks prior to carrying out a HC-2 assay for HPV.

Relationships between Fractional Knowledge and Algebraic Reasoning: The Case of Willa

ERIC Educational Resources Information Center

Lee, Mi Yeon; Hackenberg, Amy J.

2014-01-01

To investigate relationships between students' quantitative reasoning with fractions and their algebraic reasoning, a clinical interview study was conducted with 18 middle and high school students. The students were interviewed twice, once to explore their quantitative reasoning with fractions and once to explore their solutions of problems…

The Reasonable Woman in a Hostile Work Environment.

ERIC Educational Resources Information Center

Shoop, Robert J.

1992-01-01

Briefly traces the sociological and legal development of the hostile-work-environment concept, and discusses the "reasonable woman" standard as applied in two cases. The use of the "reasonable woman" standard marks a shift in judicial reasoning that makes the legal system more responsive to women. (79 references) (MLF)

Cognitive Trait Modelling: The Case of Inductive Reasoning Ability

ERIC Educational Resources Information Center

Kinshuk, Taiyu Lin; McNab, Paul

2006-01-01

Researchers have regarded inductive reasoning as one of the seven primary mental abilities that account for human intelligent behaviours. Researchers have also shown that inductive reasoning ability is one of the best predictors for academic performance. Modelling of inductive reasoning is therefore an important issue for providing adaptivity in…

A Rule-Based Spatial Reasoning Approach for OpenStreetMap Data Quality Enrichment; Case Study of Routing and Navigation

PubMed Central

2017-01-01

Finding relevant geospatial information is increasingly critical because of the growing volume of geospatial data available within the emerging “Big Data” era. Users are expecting that the availability of massive datasets will create more opportunities to uncover hidden information and answer more complex queries. This is especially the case with routing and navigation services where the ability to retrieve points of interest and landmarks make the routing service personalized, precise, and relevant. In this paper, we propose a new geospatial information approach that enables the retrieval of implicit information, i.e., geospatial entities that do not exist explicitly in the available source. We present an information broker that uses a rule-based spatial reasoning algorithm to detect topological relations. The information broker is embedded into a framework where annotations and mappings between OpenStreetMap data attributes and external resources, such as taxonomies, support the enrichment of queries to improve the ability of the system to retrieve information. Our method is tested with two case studies that leads to enriching the completeness of OpenStreetMap data with footway crossing points-of-interests as well as building entrances for routing and navigation purposes. It is concluded that the proposed approach can uncover implicit entities and contribute to extract required information from the existing datasets. PMID:29088125

Rule-Based Reasoning Is Fast and Belief-Based Reasoning Can Be Slow: Challenging Current Explanations of Belief-Bias and Base-Rate Neglect

ERIC Educational Resources Information Center

Newman, Ian R.; Gibb, Maia; Thompson, Valerie A.

2017-01-01

It is commonly assumed that belief-based reasoning is fast and automatic, whereas rule-based reasoning is slower and more effortful. Dual-Process theories of reasoning rely on this speed-asymmetry explanation to account for a number of reasoning phenomena, such as base-rate neglect and belief-bias. The goal of the current study was to test this…

Moral reasoning and decisions in dilemmas of neonatal care.

PubMed

Candee, D; Sheehan, T J; Cook, C D; Husted, S D; Bargen, M

1982-10-01

The relationship between levels of moral reasoning and decisions in dilemmas of neonatal care was investigated in a sample of 452 pediatricians. Subjects included residents, faculty members, and practitioners recruited from a variety of university-affiliated and community hospitals. It was hypothesized that physicians whose moral reasoning was more fully developed would less actively treat particular cases. Such cases might include those where a patient's family requested such a limit (designated "negative family attitude") or the quality of life likely to be led after therapy was so low as to preclude even a minimal degree of human activity or social interaction (designated "unsalvageable prognosis"). The hypothesis was tested through the use of two questionnaires. The first questionnaire, devised by Crane, assessed the physician's reported degree of activism in treating six cases of infants born with severe defects. The structure of moral reasoning was measured by a second questionnaire, Rest's Defining Issue Test. Subjects were scored by the degree to which they use universal, ethical principles in resolving a series of moral dilemmas. Results of the absolute level of activism (Table 1) showed that among both residents and postresidents, the degree to which cases are actively treated depends, for salvageable patients, on the type of damage and on the possibility for research. Results involving moral reasoning showed a different pattern among residents and postresidents. Among residents, a significant correlation exists between principled reasoning and the absence of active treatment (r = - 0.41, Form A; r = - 0.23, Form B). As predicted, such correlations were strongest for cases of negative family attitude or of unsalvageable prognosis. The pattern of correlations among postresidents showed either no relationship to moral reasoning or the reverse of the residency pattern (r = -0.08, Form A; r = 0.30, Form B). The influence of the type of institution a resident operates within was assessed by analysis of variance. Inasmuch as moral reasoning and institutional type both had significant main effects (Form A), their magnitude differed. Institutional type accounted for 43% of the variation in mean activism scores whereas moral reasoning accounted for only 4%; however, because one could, a priori, expect institutional norms and customs to be powerful determinants of behavior, any additional, identifiable influence deserves attention. The structure of individuals' moral reasoning seems to be such an influence.

From Role Models to Nations in Need of Advice: Norway and Sweden under the OECD's Magnifying Glass

ERIC Educational Resources Information Center

Pettersson, Daniel; Prøitz, Tine Sophie; Forsberg, Eva

2017-01-01

By analysing five separate OECD reviews of evaluation and assessment practices with Norway and Sweden as cases, our study illustrates different ways in which a specific international educational reasoning is blended into more context-based national education policies and, as such, works in parallel with internal reforms and agendas. It is evident…

Towards a Differentiated and Domain-Specific View of Educational Technology: An Exploratory Study of History Teachers' Technology Use

ERIC Educational Resources Information Center

Voet, Michiel; De Wever, Bram

2017-01-01

Adopting a differentiated and domain-specific view of educational technology, the present study focuses on the case of school history. It argues that, in this particular context, one of technology's main assets is its ability to support inquiry-based learning activities, during which students interpret the past through historical reasoning. As…

Unintended knowledge learnt in primary science practical lessons

NASA Astrophysics Data System (ADS)

Park, Jisun; Abrahams, Ian; Song, Jinwoong

2016-11-01

This study explored the different kinds of unintended learning in primary school practical science lessons. In this study, unintended learning has been defined as student learning that was found to occur that was not included in the teachers learning objectives for that specific lesson. A total of 22 lessons, taught by five teachers in Korean primary schools with 10- to 12-year-old students, were audio-and video recorded. Pre-lesson interviews with the teachers were conducted to ascertain their intended learning objectives. Students were asked to write short memos after the lesson about what they learnt. Post-lesson interviews with students and teachers were undertaken. What emerged was that there were three types of knowledge that students learnt unintentionally: factual knowledge gained by phenomenon-based reasoning, conceptual knowledge gained by relation- or model-based reasoning, and procedural knowledge acquired by practice. Most unintended learning found in this study fell into the factual knowledge and only a few cases of conceptual knowledge were found. Cases of both explicit procedural knowledge and implicit procedural knowledge were found. This study is significant in that it suggests how unintended learning in practical work can be facilitated as an educative opportunity for meaningful learning by exploring what and how students learnt.

Public-Interest and Level-of-Evidence Considerations in Cold Fusion Public Policy

NASA Astrophysics Data System (ADS)

Grinshaw, Thomas

2008-03-01

Cold fusion (CF) protagonists and antagonists would no doubt agree that scientific processes have been challenged in the CF case. The public interest in CF turns on two questions: What are the potential benefits? What is the probability that CF is ``real''? Potential benefits have been agreed on since CF announcement in 1989. The probability of CF reality may be assessed based on level of evidence (LoE): preponderance of evidence (PoE); clear and convincing evidence (CCE); and beyond a reasonable doubt (BRD). PoE, from civil law, indicates a probability of 50% or higher. BRD, from criminal law, has a probability approaching 90%. CCE, in between, thus has a 70-75% probability. CF experimental evidence, based on: 1) initial affirmations, 2) the large number of corroborations since marginalization, and 3) particularly demonstrative experiments, reasonably indicates at least a PoE level of evidence for excess heat. A case can also be made for a CCE (but probably not for a BRD) LoE. In either the PoE or CCE scenario a clear need is demonstrated for change in policy toward CR, given its potential benefits to humanity.

Attorney Argumentation and Supreme Court Opinions.

ERIC Educational Resources Information Center

Benoit, William L.

1989-01-01

Investigates the relationship between argumentation advanced by attorneys in four Supreme Court cases and the reasoning proffered by the Court in its decisions in those cases. Finds attorney argumentation sometimes irrelevant to the Court's reasoning and sometimes adopted by the Court. Offers a perspective on argumentation and decision making to…

Case-based reasoning using electronic health records efficiently identifies eligible patients for clinical trials

PubMed Central

Miotto, Riccardo

2015-01-01

Objective To develop a cost-effective, case-based reasoning framework for clinical research eligibility screening by only reusing the electronic health records (EHRs) of minimal enrolled participants to represent the target patient for each trial under consideration. Materials and Methods The EHR data—specifically diagnosis, medications, laboratory results, and clinical notes—of known clinical trial participants were aggregated to profile the “target patient” for a trial, which was used to discover new eligible patients for that trial. The EHR data of unseen patients were matched to this “target patient” to determine their relevance to the trial; the higher the relevance, the more likely the patient was eligible. Relevance scores were a weighted linear combination of cosine similarities computed over individual EHR data types. For evaluation, we identified 262 participants of 13 diversified clinical trials conducted at Columbia University as our gold standard. We ran a 2-fold cross validation with half of the participants used for training and the other half used for testing along with other 30 000 patients selected at random from our clinical database. We performed binary classification and ranking experiments. Results The overall area under the ROC curve for classification was 0.95, enabling the highlight of eligible patients with good precision. Ranking showed satisfactory results especially at the top of the recommended list, with each trial having at least one eligible patient in the top five positions. Conclusions This relevance-based method can potentially be used to identify eligible patients for clinical trials by processing patient EHR data alone without parsing free-text eligibility criteria, and shows promise of efficient “case-based reasoning” modeled only on minimal trial participants. PMID:25769682

Development and initial evaluation of an instrument to assess physiotherapists' clinical reasoning focused on clients' behavior change.

PubMed

Elvén, Maria; Hochwälder, Jacek; Dean, Elizabeth; Söderlund, Anne

2018-05-01

A systematically developed and evaluated instrument is needed to support investigations of physiotherapists' clinical reasoning integrated with the process of clients' behavior change. This study's aim was to develop an instrument to assess physiotherapy students' and physiotherapists' clinical reasoning focused on clients' activity-related behavior and behavior change, and initiate its evaluation, including feasibility and content validity. The study was conducted in three phases: 1) determination of instrument structure and item generation, based on a model, guidelines for assessing clinical reasoning, and existing measures; 2) cognitive interviews with five physiotherapy students to evaluate item understanding and feasibility; and 3) a Delphi process with 18 experts to evaluate content relevance. Phase 1 resulted in an instrument with four domains: Physiotherapist; Input from client; Functional behavioral analysis; and Strategies for behavior change. The instrument consists of case scenarios followed by items in which key features are identified, prioritized, or interpreted. Phase 2 resulted in revisions of problems and approval of feasibility. Phase 3 demonstrated high level of consensus regarding the instrument's content relevance. This feasible and content-validated instrument shows potential for use in investigations of physiotherapy students' and physiotherapists' clinical reasoning, however continued development and testing are needed.

Estimating the capacity value of concentrating solar power plants: A case study of the southwestern United States

DOE PAGES

Madaeni, Seyed Hossein; Sioshansi, Ramteen; Denholm, Paul

2012-01-27

Here, we estimate the capacity value of concentrating solar power (CSP) plants without thermal energy storage in the southwestern U.S. Our results show that CSP plants have capacity values that are between 45% and 95% of maximum capacity, depending on their location and configuration. We also examine the sensitivity of the capacity value of CSP to a number of factors and show that capacity factor-based methods can provide reasonable approximations of reliability-based estimates.

[Communication management of collaborative networks of science, technology and innovation in health].

PubMed

Martins, Wagner de Jesus; Artmann, Elizabeth; Rivera, Francisco Javier Uribe

2012-12-01

The objective of the article was to propose a model of communication management of networks for the Health Innovation System in Brazil. The health production complex and its relationship with the nation's development are addressed and some suggestions for operationalization of the proposed model are also presented. The discussion is based on Habermas' theory and similar cases from other countries. Communication strategies and approaches to commitment dialogue for concerted actions and consensus-building based on critical reasoning may help strengthen democratic networks.

Exploring a New Simulation Approach to Improve Clinical Reasoning Teaching and Assessment: Randomized Trial Protocol

PubMed Central

Moussa, Ahmed; Loye, Nathalie; Charlin, Bernard; Audétat, Marie-Claude

2016-01-01

Background Helping trainees develop appropriate clinical reasoning abilities is a challenging goal in an environment where clinical situations are marked by high levels of complexity and unpredictability. The benefit of simulation-based education to assess clinical reasoning skills has rarely been reported. More specifically, it is unclear if clinical reasoning is better acquired if the instructor's input occurs entirely after or is integrated during the scenario. Based on educational principles of the dual-process theory of clinical reasoning, a new simulation approach called simulation with iterative discussions (SID) is introduced. The instructor interrupts the flow of the scenario at three key moments of the reasoning process (data gathering, integration, and confirmation). After each stop, the scenario is continued where it was interrupted. Finally, a brief general debriefing ends the session. System-1 process of clinical reasoning is assessed by verbalization during management of the case, and System-2 during the iterative discussions without providing feedback. Objective The aim of this study is to evaluate the effectiveness of Simulation with Iterative Discussions versus the classical approach of simulation in developing reasoning skills of General Pediatrics and Neonatal-Perinatal Medicine residents. Methods This will be a prospective exploratory, randomized study conducted at Sainte-Justine hospital in Montreal, Qc, between January and March 2016. All post-graduate year (PGY) 1 to 6 residents will be invited to complete one SID or classical simulation 30 minutes audio video-recorded complex high-fidelity simulations covering a similar neonatology topic. Pre- and post-simulation questionnaires will be completed and a semistructured interview will be conducted after each simulation. Data analyses will use SPSS and NVivo softwares. Results This study is in its preliminary stages and the results are expected to be made available by April, 2016. Conclusions This will be the first study to explore a new simulation approach designed to enhance clinical reasoning. By assessing more closely reasoning processes throughout a simulation session, we believe that Simulation with Iterative Discussions will be an interesting and more effective approach for students. The findings of the study will benefit medical educators, education programs, and medical students. PMID:26888076

Exploring a New Simulation Approach to Improve Clinical Reasoning Teaching and Assessment: Randomized Trial Protocol.

PubMed

Pennaforte, Thomas; Moussa, Ahmed; Loye, Nathalie; Charlin, Bernard; Audétat, Marie-Claude

2016-02-17

Helping trainees develop appropriate clinical reasoning abilities is a challenging goal in an environment where clinical situations are marked by high levels of complexity and unpredictability. The benefit of simulation-based education to assess clinical reasoning skills has rarely been reported. More specifically, it is unclear if clinical reasoning is better acquired if the instructor's input occurs entirely after or is integrated during the scenario. Based on educational principles of the dual-process theory of clinical reasoning, a new simulation approach called simulation with iterative discussions (SID) is introduced. The instructor interrupts the flow of the scenario at three key moments of the reasoning process (data gathering, integration, and confirmation). After each stop, the scenario is continued where it was interrupted. Finally, a brief general debriefing ends the session. System-1 process of clinical reasoning is assessed by verbalization during management of the case, and System-2 during the iterative discussions without providing feedback. The aim of this study is to evaluate the effectiveness of Simulation with Iterative Discussions versus the classical approach of simulation in developing reasoning skills of General Pediatrics and Neonatal-Perinatal Medicine residents. This will be a prospective exploratory, randomized study conducted at Sainte-Justine hospital in Montreal, Qc, between January and March 2016. All post-graduate year (PGY) 1 to 6 residents will be invited to complete one SID or classical simulation 30 minutes audio video-recorded complex high-fidelity simulations covering a similar neonatology topic. Pre- and post-simulation questionnaires will be completed and a semistructured interview will be conducted after each simulation. Data analyses will use SPSS and NVivo softwares. This study is in its preliminary stages and the results are expected to be made available by April, 2016. This will be the first study to explore a new simulation approach designed to enhance clinical reasoning. By assessing more closely reasoning processes throughout a simulation session, we believe that Simulation with Iterative Discussions will be an interesting and more effective approach for students. The findings of the study will benefit medical educators, education programs, and medical students.

Intrusion-based reasoning and depression: cross-sectional and prospective relationships.

PubMed

Berle, David; Moulds, Michelle L

2014-01-01

Intrusion-based reasoning refers to the tendency to form interpretations about oneself or a situation based on the occurrence of a negative intrusive autobiographical memory. Intrusion-based reasoning characterises post-traumatic stress disorder, but has not yet been investigated in depression. We report two studies that aimed to investigate this. In Study 1 both high (n = 42) and low (n = 28) dysphoric participants demonstrated intrusion-based reasoning. High-dysphoric individuals engaged in self-referent intrusion-based reasoning to a greater extent than did low-dysphoric participants. In Study 2 there were no significant differences in intrusion-based reasoning between currently depressed (n = 27) and non-depressed (n = 51) participants, and intrusion-based reasoning did not predict depressive symptoms at 6-month follow-up. Interestingly, previously (n = 26) but not currently (n = 27) depressed participants engaged in intrusion-based reasoning to a greater extent than never-depressed participants (n = 25), indicating the possibility that intrusion-based reasoning may serve as a "scar" from previous episodes. The implications of these findings are discussed.

26 CFR 1.412(c)(3)-1 - Reasonable funding methods.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 26 Internal Revenue 5 2010-04-01 2010-04-01 false Reasonable funding methods. 1.412(c)(3)-1... Reasonable funding methods. (a) Introduction—(1) In general. This section prescribes rules for determining whether or not, in the case of an ongoing plan, a funding method is reasonable for purposes of section 412...

26 CFR 1.412(c)(3)-1 - Reasonable funding methods.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 5 2012-04-01 2011-04-01 true Reasonable funding methods. 1.412(c)(3)-1 Section...(c)(3)-1 Reasonable funding methods. (a) Introduction—(1) In general. This section prescribes rules for determining whether or not, in the case of an ongoing plan, a funding method is reasonable for...

26 CFR 1.412(c)(3)-1 - Reasonable funding methods.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 5 2011-04-01 2011-04-01 false Reasonable funding methods. 1.412(c)(3)-1...(c)(3)-1 Reasonable funding methods. (a) Introduction—(1) In general. This section prescribes rules for determining whether or not, in the case of an ongoing plan, a funding method is reasonable for...

26 CFR 1.412(c)(3)-1 - Reasonable funding methods.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 5 2013-04-01 2013-04-01 false Reasonable funding methods. 1.412(c)(3)-1...(c)(3)-1 Reasonable funding methods. (a) Introduction—(1) In general. This section prescribes rules for determining whether or not, in the case of an ongoing plan, a funding method is reasonable for...

The Co-Emergence of Aggregate and Modelling Reasoning

ERIC Educational Resources Information Center

Aridor, Keren; Ben-Zvi, Dani

2017-01-01

This article examines how two processes--reasoning with statistical modelling of a real phenomenon and aggregate reasoning--can co-emerge. We focus in this case study on the emergent reasoning of two fifth graders (aged 10) involved in statistical data analysis, informal inference, and modelling activities using TinkerPlots™. We describe nine…

Mapping Variation in Children's Mathematical Reasoning: The Case of "What Else Belongs?"

ERIC Educational Resources Information Center

Vale, Colleen; Widjaja, Wanty; Herbert, Sandra; Bragg, Leicha A.; Loong, Esther Yoon-Kin

2017-01-01

Explaining appears to dominate primary teachers' understanding of mathematical reasoning when it is not confused with problem solving. Drawing on previous literature of mathematical reasoning, we generate a view of the critical aspects of reasoning that may assist primary teachers when designing and enacting tasks to elicit and develop…

Depictive Gestures as Evidence for Dynamic Mental Imagery in Four Types of Student Reasoning

NASA Astrophysics Data System (ADS)

Stephens, A. Lynn; Clement, John J.

2007-01-01

We discuss evidence for the use of runnable imagery (imagistic simulation) in four types of student reasoning. In an in-depth case study of a high school physics class, we identified multiple instances of students running mental models, using analogies, using extreme cases, and using Gedanken experiments. Previous case studies of expert scientists have indicated that these processes can be central during scientific model construction; here we discuss their spontaneous use by students. We also discuss their association with spontaneous, depictive gestures, which we interpret as an indicator of the use of dynamic and kinesthetic imagery. Of the numerous instances of these forms of reasoning observed in the class, most were associated with depictive gestures and over half with gestures that depicted motion or force. This evidence suggests that runnable, dynamic mental imagery can be very important in student reasoning.

Describing the clinical reasoning process: application of a model of enablement to a pediatric case.

PubMed

Furze, Jennifer; Nelson, Kelly; O'Hare, Megan; Ortner, Amanda; Threlkeld, A Joseph; Jensen, Gail M

2013-04-01

Clinical reasoning is a core tenet of physical therapy practice leading to optimal patient care. The purpose of this case was to describe the outcomes, subjective experience, and reflective clinical reasoning process for a child with cerebral palsy using the International Classification of Functioning, Disability, and Health (ICF) model. Application of the ICF framework to a 9-year-old boy with spastic triplegic cerebral palsy was utilized to capture the interwoven factors present in this case. Interventions in the pool occurred twice weekly for 1 h over a 10-week period. Immediately post and 4 months post-intervention, the child made functional and meaningful gains. The family unit also developed an enjoyment of exercising together. Each individual family member described psychological, emotional, or physical health improvements. Reflection using the ICF model as a framework to discuss clinical reasoning can highlight important factors contributing to effective patient management.

Purpose, processes, partnerships, and products: four Ps to advance participatory socio-environmental modeling

USGS Publications Warehouse

Gray, Steven; Voinov, Alexey; Paolisso, Michael; Jordan, Rebecca; BenDor, Todd; Bommel, Pierre; Glynn, Pierre D.; Hedelin, Beatrice; Hubacek, Klaus; Introne, Josh; Kolagani, Nagesh; Laursen, Bethany; Prell, Christina; Schmitt-Olabisi, Laura; Singer, Alison; Sterling, Eleanor J.; Zellner, Moira

2018-01-01

Including stakeholders in environmental model building and analysis is an increasingly popular approach to understanding ecological change. This is because stakeholders often hold valuable knowledge about socio-environmental dynamics and collaborative forms of modeling produce important boundary objects used to collectively reason about environmental problems. Although the number of participatory modeling (PM) case studies and the number of researchers adopting these approaches has grown in recent years, the lack of standardized reporting and limited reproducibility have prevented PM's establishment and advancement as a cohesive field of study. We suggest a four-dimensional framework (4P) that includes reporting on dimensions of (1) the Purpose for selecting a PM approach (the why); (2) the Process by which the public was involved in model building or evaluation (the how); (3) the Partnerships formed (the who); and (4) the Products that resulted from these efforts (the what). We highlight four case studies that use common PM software-based approaches (fuzzy cognitive mapping, agent-based modeling, system dynamics, and participatory geospatial modeling) to understand human–environment interactions and the consequences of ecological changes, including bushmeat hunting in Tanzania and Cameroon, agricultural production and deforestation in Zambia, and groundwater management in India. We demonstrate how standardizing communication about PM case studies can lead to innovation and new insights about model-based reasoning in support of ecological policy development. We suggest that our 4P framework and reporting approach provides a way for new hypotheses to be identified and tested in the growing field of PM.

Purpose, processes, partnerships, and products: four Ps to advance participatory socio-environmental modeling.

PubMed

Gray, Steven; Voinov, Alexey; Paolisso, Michael; Jordan, Rebecca; BenDor, Todd; Bommel, Pierre; Glynn, Pierre; Hedelin, Beatrice; Hubacek, Klaus; Introne, Josh; Kolagani, Nagesh; Laursen, Bethany; Prell, Christina; Schmitt Olabisi, Laura; Singer, Alison; Sterling, Eleanor; Zellner, Moira

2018-01-01

Including stakeholders in environmental model building and analysis is an increasingly popular approach to understanding ecological change. This is because stakeholders often hold valuable knowledge about socio-environmental dynamics and collaborative forms of modeling produce important boundary objects used to collectively reason about environmental problems. Although the number of participatory modeling (PM) case studies and the number of researchers adopting these approaches has grown in recent years, the lack of standardized reporting and limited reproducibility have prevented PM's establishment and advancement as a cohesive field of study. We suggest a four-dimensional framework (4P) that includes reporting on dimensions of (1) the Purpose for selecting a PM approach (the why); (2) the Process by which the public was involved in model building or evaluation (the how); (3) the Partnerships formed (the who); and (4) the Products that resulted from these efforts (the what). We highlight four case studies that use common PM software-based approaches (fuzzy cognitive mapping, agent-based modeling, system dynamics, and participatory geospatial modeling) to understand human-environment interactions and the consequences of ecological changes, including bushmeat hunting in Tanzania and Cameroon, agricultural production and deforestation in Zambia, and groundwater management in India. We demonstrate how standardizing communication about PM case studies can lead to innovation and new insights about model-based reasoning in support of ecological policy development. We suggest that our 4P framework and reporting approach provides a way for new hypotheses to be identified and tested in the growing field of PM. © 2017 by the Ecological Society of America.

A report on case reports

PubMed Central

Gopikrishna, Velayutham

2010-01-01

Case reports are defined as the scientific documentation of a single clinical observation and have a time-honored and rich tradition in medicine and scientific publication. This article discusses the role and relevance of case reports in the current evidence-based medical literature. It also seeks to help and guide authors to understand how to prepare a reasonable and well-written case report and how they may anticipate concerns that peer reviewers may express when scrutinizing their manuscript. An overview of the Journal of Conservative Dentistry’s review process of a manuscript submission is provided for the benefit of future authors. It is important to be able to read a case report critically and to use the information they contain appropriately. This article also discusses the factors to consider in evaluating individual case reports, and discusses a practical conceptual scheme for evaluating the potential value and educational content of a case report. PMID:21217956

Refusal of blood by Jehovah's Witnesses and the patient's right to self-determination.

PubMed

Ariga, Tomonori

2009-04-01

Jehovah's Witnesses love life and do whatever is reasonable in order to prolong it. Hence, they seek quality health care and accept the vast majority of medical treatments. However, for Bible-based religious reasons, Jehovah's Witnesses do not accept allogeneic blood transfusion. Instead, they request nonblood alternatives. We will discuss medical and legal aspects concerning this position of Jehovah's Witnesses and the patient's right to self-determination. Also, the treatment for minors often becomes an issue. When a patient is a mature minor, his wishes should be respected. In the case of a minor patient lacking decision-making capacity, the wishes of the parents should be respected as much as possible.

Case-Based Capture and Reuse of Aerospace Design Rationale

NASA Technical Reports Server (NTRS)

Leake, David B.

1998-01-01

The goal of this project is to apply artificial intelligence techniques to facilitate capture and reuse of aerospace design rationale. The project applies case-based reasoning (CBR) and concept mapping (CMAP) tools to the task of capturing, organizing, and interactively accessing experiences or "cases" encapsulating the methods and rationale underlying expert aerospace design. As stipulated in the award, Indiana University and Ames personnel are collaborating on performance of research and determining the direction of research, to assure that the project focuses on high-value tasks. In the first five months of the project, we have made two visits to Ames Research Center to consult with our NASA collaborators, to learn about the advanced aerospace design tools being developed there, and to identify specific needs for intelligent design support. These meetings identified a number of task areas for applying CBR and concept mapping technology. We jointly selected a first task area to focus on: Acquiring the convergence criteria that experts use to guide the selection of useful data from a set of numerical simulations of high-lift systems. During the first funding period, we developed two software systems. First, we have adapted a CBR system developed at Indiana University into a prototype case-based reasoning shell to capture and retrieve information about design experiences, with the sample task of capturing and reusing experts' intuitive criteria for determining convergence (work conducted at Indiana University). Second, we have also adapted and refined existing concept mapping tools that will be used to clarify and capture the rationale underlying those experiences, to facilitate understanding of the expert's reasoning and guide future reuse of captured information (work conducted at the University of West Florida). The tools we have developed are designed to be the basis for a general framework for facilitating tasks within systems developed by the Advanced Design Technologies Testbed (ADTT) project at ARC. The tenets of our framework are (1) that the systems developed should leverage a designer's knowledge, rather than attempting to replace it; (2) that learning and user feedback must play a central role, so that the system can adapt to how it is used, and (3) that the learning and feedback processes must be as natural and as unobtrusive as possible. In the second funding period we will extend our current work, applying the tools to capturing higher-level design rationale.

Conceptualizing Rolling Motion through an Extreme Case Reasoning Approach

ERIC Educational Resources Information Center

Hasovic, Elvedin; Mešic, Vanes; Erceg, Nataša

2017-01-01

In this paper we are going to show how learning about some counterintuitive aspects of rolling motion can be facilitated by combining the use of analogies with extreme case reasoning. Specifically, the intuitively comprehensible examples of "rolling" polygonal prisms are used as an analogical anchor that is supposed to help the students…

The Principle-Based Method of Practical Ethics.

PubMed

Spielthenner, Georg

2017-09-01

This paper is about the methodology of doing practical ethics. There is a variety of methods employed in ethics. One of them is the principle-based approach, which has an established place in ethical reasoning. In everyday life, we often judge the rightness and wrongness of actions by their conformity to principles, and the appeal to principles plays a significant role in practical ethics, too. In this paper, I try to provide a better understanding of the nature of principle-based reasoning. To accomplish this, I show in the first section that these principles can be applied to cases in a meaningful and sufficiently precise way. The second section discusses the question how relevant applying principles is to the resolution of ethical issues. This depends on their nature. I argue that the principles under consideration in this paper should be interpreted as presumptive principles and I conclude that although they cannot be expected to bear the weight of definitely resolving ethical problems, these principles can nevertheless play a considerable role in ethical research.

Continuity and change in the development of category-based induction: The test case of diversity-based reasoning.

PubMed

Rhodes, Marjorie; Liebenson, Peter

2015-11-01

The present research examined the extent to which the cognitive mechanisms available to support inductive inference stay constant across development or undergo fundamental change. Four studies tested how children (ages 5-10) incorporate information about sample composition into their category-based generalizations. Children's use of sample composition varied across age and type of category. For familiar natural kinds, children ages 5-8 generalized similarly from diverse and non-diverse samples of evidence, whereas older children generalized more broadly from more diverse sets. In contrast, for novel categories, children of each age made broader generalizations from diverse than non-diverse samples. These studies provide the first clear evidence that young children are able to incorporate sample diversity into their inductive reasoning. These findings suggest developmental continuity in the cognitive mechanisms available for inductive inference, but developmental changes in the role that prior knowledge plays in shaping these processes. Copyright © 2015 Elsevier Inc. All rights reserved.

Understanding differences between DELFT3D and empirical predictions of alongshore sediment transport gradients

USGS Publications Warehouse

List, Jeffrey; Benedet, Lindino; Hanes, Daniel M.; Ruggiero, Peter

2009-01-01

Predictions of alongshore transport gradients are critical for forecasting shoreline change. At the previous ICCE conference, it was demonstrated that alongshore transport gradients predicted by the empirical CERC equation can differ substantially from predictions made by the hydrodynamics-based model Delft3D in the case of a simulated borrow pit on the shoreface. Here we use the Delft3D momentum balance to examine the reason for this difference. Alongshore advective flow accelerations in our Delft3D simulation are mainly driven by pressure gradients resulting from alongshore variations in wave height and setup, and Delft3D transport gradients are controlled by these flow accelerations. The CERC equation does not take this process into account, and for this reason a second empirical transport term is sometimes added when alongshore gradients in wave height are thought to be significant. However, our test case indicates that this second term does not properly predict alongshore transport gradients.

Student-generated case reports.

PubMed

Good, Christopher J

2009-01-01

When students create teaching materials, learning can be enhanced. Therefore, a project was designed based on the traditional clinical case report and the chiropractic technique and principles curriculum at the University of Bridgeport College of Chiropractic. The objectives were to increase mastery in a clinical topic, increase awareness of different patient presentations and management options, and enhance information technology skills. Following lectures about the components of a case report and neurological reflexes related to visceral comorbidities and subluxation and joint dysfunction, students created a case report based on a template provided by the instructor. A survey gathered student perspectives on the exercise. More than 70% of the surveyed students felt the project was at least moderately helpful in improving understanding of a case report, the condition investigated, their clinical reasoning, and the ability to integrate information. Most felt that they improved their understanding of neurological reflexes, use of the literature, and the practice of evidence-based care. The majority believed that they identified weakness in knowledge, improved self-learning skills, and increased confidence in managing patients. Most enjoyed it at least somewhat and 70% agreed that the project should be continued. Many believed that they were better prepared for national boards and had improved their writing skills.

Creation and pilot testing of cases for case-based learning: A pedagogical approach for pathology cancer diagnosis.

PubMed

Sayed, Shahin; Lester, Susan C; Wilson, Michael; Berney, Daniel; Masia, Ricard; Moloo, Zahir; Stall, Jennifer; Eslan, Alexia; Ayers, Stephanie; Mutuku, Angela; Guarner, Jeannette

2017-01-01

Case-based learning (CBL) is an established pedagogical active learning method used in various disciplines and defined based on the field of study and type of case. The utility of CBL for teaching specific aspects of cancer diagnosis to practising pathologists has not been previously studied in sub-Saharan Africa. We aimed to pilot test standardised cancer cases on a group of practising pathologists in sub-Saharan Africa to evaluate case content, clarity of questions and delivery of content. Expert faculty created cases for the four most commonly diagnosed cancers. The format included mini-cases and bullet cases which were all open-ended. The questions dealt with interpretation of clinical information, gross specimen examination, morphologic characteristics of tumours, ancillary testing, reporting and appropriate communication to clinicians. Cases on breast, cervical, prostate and colorectal cancers were tested on seven practising pathologists. Each case took an average of 45-90 min to complete.Questions that were particularly challenging to testers were on: Specimens they should have been but for some reason were not exposed to in routine practice.Ancillary testing and appropriate tumour staging.New knowledge gained included tumour grading and assessment of radial margins. Revisions to cases were made based on testers' feedback, which included rewording of questions to reduce ambiguity and adding of tables to clarify concepts. Cases were created for CBL in Kenya, but these are applicable elsewhere in Africa and beyond to teach cancer diagnosis. The pilot testing of cases prepared faculty for the actual CBL course and feedback provided by the testers assisted in improving the questions and impact on day-to-day practice.

Creation and pilot testing of cases for case-based learning: A pedagogical approach for pathology cancer diagnosis

PubMed Central

Wilson, Michael; Masia, Ricard; Moloo, Zahir; Stall, Jennifer; Eslan, Alexia; Ayers, Stephanie; Mutuku, Angela

2017-01-01

Background Case-based learning (CBL) is an established pedagogical active learning method used in various disciplines and defined based on the field of study and type of case. The utility of CBL for teaching specific aspects of cancer diagnosis to practising pathologists has not been previously studied in sub-Saharan Africa. Objectives We aimed to pilot test standardised cancer cases on a group of practising pathologists in sub-Saharan Africa to evaluate case content, clarity of questions and delivery of content. Methods Expert faculty created cases for the four most commonly diagnosed cancers. The format included mini-cases and bullet cases which were all open-ended. The questions dealt with interpretation of clinical information, gross specimen examination, morphologic characteristics of tumours, ancillary testing, reporting and appropriate communication to clinicians. Results Cases on breast, cervical, prostate and colorectal cancers were tested on seven practising pathologists. Each case took an average of 45–90 min to complete. Questions that were particularly challenging to testers were on: Specimens they should have been but for some reason were not exposed to in routine practice.Ancillary testing and appropriate tumour staging. New knowledge gained included tumour grading and assessment of radial margins. Revisions to cases were made based on testers’ feedback, which included rewording of questions to reduce ambiguity and adding of tables to clarify concepts. Conclusion Cases were created for CBL in Kenya, but these are applicable elsewhere in Africa and beyond to teach cancer diagnosis. The pilot testing of cases prepared faculty for the actual CBL course and feedback provided by the testers assisted in improving the questions and impact on day-to-day practice. PMID:29147646

Multimodal hybrid reasoning methodology for personalized wellbeing services.

PubMed

Ali, Rahman; Afzal, Muhammad; Hussain, Maqbool; Ali, Maqbool; Siddiqi, Muhammad Hameed; Lee, Sungyoung; Ho Kang, Byeong

2016-02-01

A wellness system provides wellbeing recommendations to support experts in promoting a healthier lifestyle and inducing individuals to adopt healthy habits. Adopting physical activity effectively promotes a healthier lifestyle. A physical activity recommendation system assists users to adopt daily routines to form a best practice of life by involving themselves in healthy physical activities. Traditional physical activity recommendation systems focus on general recommendations applicable to a community of users rather than specific individuals. These recommendations are general in nature and are fit for the community at a certain level, but they are not relevant to every individual based on specific requirements and personal interests. To cover this aspect, we propose a multimodal hybrid reasoning methodology (HRM) that generates personalized physical activity recommendations according to the user׳s specific needs and personal interests. The methodology integrates the rule-based reasoning (RBR), case-based reasoning (CBR), and preference-based reasoning (PBR) approaches in a linear combination that enables personalization of recommendations. RBR uses explicit knowledge rules from physical activity guidelines, CBR uses implicit knowledge from experts׳ past experiences, and PBR uses users׳ personal interests and preferences. To validate the methodology, a weight management scenario is considered and experimented with. The RBR part of the methodology generates goal, weight status, and plan recommendations, the CBR part suggests the top three relevant physical activities for executing the recommended plan, and the PBR part filters out irrelevant recommendations from the suggested ones using the user׳s personal preferences and interests. To evaluate the methodology, a baseline-RBR system is developed, which is improved first using ranged rules and ultimately using a hybrid-CBR. A comparison of the results of these systems shows that hybrid-CBR outperforms the modified-RBR and baseline-RBR systems. Hybrid-CBR yields a 0.94% recall, a 0.97% precision, a 0.95% f-score, and low Type I and Type II errors. Copyright © 2015 Elsevier Ltd. All rights reserved.

Push and pull models to manage patient consent and licensing of multimedia resources in digital repositories for case-based reasoning.

PubMed

Kononowicz, Andrzej A; Zary, Nabil; Davies, David; Heid, Jörn; Woodham, Luke; Hege, Inga

2011-01-01

Patient consents for distribution of multimedia constitute a significant element of medical case-based repositories in medicine. A technical challenge is posed by the right of patients to withdraw permission to disseminate their images or videos. A technical mechanism for spreading information about changes in multimedia usage licenses is sought. The authors gained their experience by developing and managing a large (>340 cases) repository of virtual patients within the European project eViP. The solution for dissemination of license status should reuse and extend existing metadata standards in medical education. Two methods: PUSH and PULL are described differing in the moment of update and the division of responsibilities between parties in the learning object exchange process. The authors recommend usage of the PUSH scenario because it is better adapted to legal requirements in many countries. It needs to be stressed that the solution is based on mutual trust of the exchange partners and therefore is most appropriate for use in educational alliances and consortia. It is hoped that the proposed models for exchanging consents and licensing information will become a crucial part of the technical frameworks for building case-based repositories.

Retrocausal Effects as a Consequence of Quantum Mechanics Refined to Accommodate the Principle of Sufficient Reason

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stapp, Henry P.

2011-05-10

The principle of sufficient reason asserts that anything that happens does so for a reason: no definite state of affairs can come into being unless there is a sufficient reason why that particular thing should happen. This principle is usually attributed to Leibniz, although the first recorded Western philosopher to use it was Anaximander of Miletus. The demand that nature be rational, in the sense that it be compatible with the principle of sufficient reason, conflicts with a basic feature of contemporary orthodox physical theory, namely the notion that nature's response to the probing action of an observer is determinedmore » by pure chance, and hence on the basis of absolutely no reason at all. This appeal to pure chance can be deemed to have no rational fundamental place in reason-based Western science. It is argued here, on the basis of the other basic principles of quantum physics, that in a world that conforms to the principle of sufficient reason, the usual quantum statistical rules will naturally emerge at the pragmatic level, in cases where the reason behind nature's choice of response is unknown, but that the usual statistics can become biased in an empirically manifest way when the reason for the choice is empirically identifiable. It is shown here that if the statistical laws of quantum mechanics were to be biased in this way then the basically forward-in-time unfolding of empirical reality described by orthodox quantum mechanics would generate the appearances of backward-time-effects of the kind that have been reported in the scientific literature.« less

Provider biases and choices: the role of gender.

PubMed

Wertz, D C

1993-09-01

Genetic counseling provides a unique opportunity to test the influence of gender on moral reasoning. The theories of Carol Gilligan on women's "relationship based" framework for ethical decision making were contrasted with Kohlberg's research on men's resolution of conflicts based on abstract, universal principles in an impersonal and fair manner. Discussion also focussed on the theories of sociologists, such as Kanter's that a profession prestige and income as well as the proportion of women in profession determine the approach to ethical problems. This study reports on survey data in 1985 and 1986 collected from medical geneticists in 19 countries that had at least 10 medical geneticists, with at least one available to distribute questionnaires, and the appropriate geographic distribution. The survey did not include genetic counselors and allied professionals. The questionnaire asked for responses to 14 case studies, 4 questions on genetic screening and access to test results, and 12 questions on the goals and conduct of genetic counseling. 62% responded. Sociodemographic data were also collected and analyzed in stepwise logistic regressions. THe results showed that gender was the single most important determinant of ethical decision making and ethical reasoning. There were gender differences in responses to 6 of the 14 cases and, in the US, for a 7th case: sex selection. In the US, women were 4.4 times more likely to counsel indirectly about XYY fetuses and 3.6 more likely to bring up issues like false paternity or genetic carriers in other family members. Patient autonomy was an issued in a case involving a 25-year-old woman who demanded prenatal diagnosis with no genetic or medical indications and another case involving a couple desiring a son after having 4 daughters. Rights based responses were provided by 49% and relationship based responses by 44%. Gilligan's hypothesis was not supported. Similar results were found in a survey of genetic counselors, who were 94% women. A summary of other studies involving actual practices was given. Further research is needed to determine the processes of professionals' self definition, ethical views, and extent to which views and practices are gender or profession related; training programs may affect provider attitudes.

Junction-to-Case Thermal Resistance of a Silicon Carbide Bipolar Junction Transistor Measured

NASA Technical Reports Server (NTRS)

Niedra, Janis M.

2006-01-01

Junction temperature of a prototype SiC-based bipolar junction transistor (BJT) was estimated by using the base-emitter voltage (V(sub BE)) characteristic for thermometry. The V(sub BE) was measured as a function of the base current (I(sub B)) at selected temperatures (T), all at a fixed collector current (I(sub C)) and under very low duty cycle pulse conditions. Under such conditions, the average temperature of the chip was taken to be the same as that of the temperature-controlled case. At increased duty cycle such as to substantially heat the chip, but same I(sub C) pulse height, the chip temperature was identified by matching the V(sub BE) to the thermometry curves. From the measured average power, the chip-to-case thermal resistance could be estimated, giving a reasonable value. A tentative explanation for an observed bunching with increasing temperature of the calibration curves may relate to an increasing dopant atom ionization. A first-cut analysis, however, does not support this.

Coming to terms: a case study of hospice collaboration challenges.

PubMed

Pietroburgo, Julie; Bush, Richard

Recent research has focused on the growing phenomenon of mergers, collaborations, and alliances among nonprofit organizations and what makes such arrangements work. Examination of failed collaborative efforts is perhaps just as instructive. This case study examines recent attempts at collaboration between 2 nonprofit hospice organizations. The study finds that despite compelling reasons for and significant commonalities on which to base collaboration, the organizations were initially unable to forge any ongoing and substantive collaborative arrangement because of insurmountable cultural factors and past history. Furthermore, without imminent external pressures to collaborate, these organizations had insufficient motivation to attempt to move beyond their differences. The case also reviews the changed circumstances and factors that later facilitated partnering attempts.

Working Memory, Reasoning, and Expertise in Medicine--Insights into Their Relationship Using Functional Neuroimaging

ERIC Educational Resources Information Center

Hruska, Pam; Krigolson, Olav; Coderre, Sylvain; McLaughlin, Kevin; Cortese, Filomeno; Doig, Christopher; Beran, Tanya; Wright, Bruce; Hecker, Kent G.

2016-01-01

Clinical reasoning is dependent upon working memory (WM). More precisely, during the clinical reasoning process stored information within long-term memory is brought into WM to facilitate the internal deliberation that affords a clinician the ability to reason through a case. In the present study, we examined the relationship between clinical…

46,XX males: a case series based on clinical and genetics evaluation.

PubMed

Mohammadpour Lashkari, F; Totonchi, M; Zamanian, M R; Mansouri, Z; Sadighi Gilani, M A; Sabbaghian, M; Mohseni Meybodi, A

2017-09-01

46,XX male sex reversal syndrome is one of the rarest sex chromosomal aberrations. The presence of SRY gene on one of the X chromosomes is the most frequent cause of this syndrome. Based on Y chromosome profile, there are SRY-positive and SRY-negative forms. The purpose of our study was to report first case series of Iranian patients and describe the different clinical appearances based on their genetic component. From the 8,114 azoospermic and severe oligozoospermic patients referred to Royan institute, we diagnosed 57 cases as sex reversal patients. Based on the endocrinological history, we performed karyotyping, SRY and AZF microdeletion screening. Patients had a female karyotype. According to available hormonal reports of 37 patients, 16 cases had low levels of testosterone (43.2%). On the other hand, 15 males were SRY positive (90.2%), while they lacked the spermatogenic factors encoding genes on Yq. Commencing the testicular differentiation in males, the SRY gene is considered to be very important in this process. Due to homogeneous results of karyotyping and AZF deletion, there are both positive and negative SRY cases that show similar sex reversal phenotypes. Evidences show that there could be diverse phenotypic differences that could be raised from various reasons. © 2016 Blackwell Verlag GmbH.

What physicians reason about during admission case review.

PubMed

Juma, Salina; Goldszmidt, Mark

2017-08-01

Research suggests that physicians perform multiple reasoning tasks beyond diagnosis during patient review. However, these remain largely theoretical. The purpose of this study was to explore reasoning tasks in clinical practice during patient admission review. The authors used a constant comparative approach-an iterative and inductive process of coding and recoding-to analyze transcripts from 38 audio-recorded case reviews between junior trainees and their senior residents or attendings. Using a previous list of reasoning tasks, analysis focused on what tasks were performed, when they occurred, and how they related to the other tasks. All 24 tasks were observed in at least one review with a mean of 17.9 (Min = 15, Max = 22) distinct tasks per review. Two new tasks-assess illness severity and patient decision-making capacity-were identified, thus 26 tasks were examined. Three overarching tasks were identified-assess priorities, determine and refine the most likely diagnosis and establish and refine management plans-that occurred throughout all stages of the case review starting from patient identification and continuing through to assessment and plan. A fourth possible overarching task-reflection-was also identified but only observed in four instances across three cases. The other 22 tasks appeared to be context dependent serving to support, expand, and refine one or more overarching tasks. Tasks were non-sequential and the same supporting task could serve more than one overarching task. The authors conclude that these findings provide insight into the 'what' and 'when' of physician reasoning during case review that can be used to support professional development, clinical training and patient care. In particular, they draw attention to the iterative way in which each task is addressed during a case review and how this finding may challenge conventional ways of teaching and assessing clinical communication and reasoning. They also suggest that further research is needed to explore how physicians decide why a supporting task is required in a particular context.

In Search of a Pony: Sources, Methods, Outcomes, and Motivated Reasoning.

PubMed

Stone, Marc B

2018-05-01

It is highly desirable to be able to evaluate the effect of policy interventions. Such evaluations should have expected outcomes based upon sound theory and be carefully planned, objectively evaluated and prospectively executed. In many cases, however, assessments originate with investigators' poorly substantiated beliefs about the effects of a policy. Instead of designing studies that test falsifiable hypotheses, these investigators adopt methods and data sources that serve as little more than descriptions of these beliefs in the guise of analysis. Interrupted time series analysis is one of the most popular forms of analysis used to present these beliefs. It is intuitively appealing but, in most cases, it is based upon false analogies, fallacious assumptions and analytical errors.

MapReduce in the Cloud: A Use Case Study for Efficient Co-Occurrence Processing of MEDLINE Annotations with MeSH.

PubMed

Kreuzthaler, Markus; Miñarro-Giménez, Jose Antonio; Schulz, Stefan

2016-01-01

Big data resources are difficult to process without a scaled hardware environment that is specifically adapted to the problem. The emergence of flexible cloud-based virtualization techniques promises solutions to this problem. This paper demonstrates how a billion of lines can be processed in a reasonable amount of time in a cloud-based environment. Our use case addresses the accumulation of concept co-occurrence data in MEDLINE annotation as a series of MapReduce jobs, which can be scaled and executed in the cloud. Besides showing an efficient way solving this problem, we generated an additional resource for the scientific community to be used for advanced text mining approaches.

A cloud-based multimodality case file for mobile devices.

PubMed

Balkman, Jason D; Loehfelm, Thomas W

2014-01-01

Recent improvements in Web and mobile technology, along with the widespread use of handheld devices in radiology education, provide unique opportunities for creating scalable, universally accessible, portable image-rich radiology case files. A cloud database and a Web-based application for radiologic images were developed to create a mobile case file with reasonable usability, download performance, and image quality for teaching purposes. A total of 75 radiology cases related to breast, thoracic, gastrointestinal, musculoskeletal, and neuroimaging subspecialties were included in the database. Breast imaging cases are the focus of this article, as they best demonstrate handheld display capabilities across a wide variety of modalities. This case subset also illustrates methods for adapting radiologic content to cloud platforms and mobile devices. Readers will gain practical knowledge about storage and retrieval of cloud-based imaging data, an awareness of techniques used to adapt scrollable and high-resolution imaging content for the Web, and an appreciation for optimizing images for handheld devices. The evaluation of this software demonstrates the feasibility of adapting images from most imaging modalities to mobile devices, even in cases of full-field digital mammograms, where high resolution is required to represent subtle pathologic features. The cloud platform allows cases to be added and modified in real time by using only a standard Web browser with no application-specific software. Challenges remain in developing efficient ways to generate, modify, and upload radiologic and supplementary teaching content to this cloud-based platform. Online supplemental material is available for this article. ©RSNA, 2014.

Similarity networks as a knowledge representation for space applications

NASA Technical Reports Server (NTRS)

Bailey, David; Thompson, Donna; Feinstein, Jerald

1987-01-01

Similarity networks are a powerful form of knowledge representation that are useful for many artificial intelligence applications. Similarity networks are used in applications ranging from information analysis and case based reasoning to machine learning and linking symbolic to neural processing. Strengths of similarity networks include simple construction, intuitive object storage, and flexible retrieval techniques that facilitate inferencing. Therefore, similarity networks provide great potential for space applications.

Thermometric titration of acids in pyridine.

PubMed

Vidal, R; Mukherjee, L M

1974-04-01

Thermometric titration of HClO(4), HI, HNO(3), HBr, picric acid o-nitrobenzoic acid, 2,4- and 2,5-dinitrophenol, acetic acid and benzoic acid have been attempted in pyridine as solvent, using 1,3-diphenylguanidine as the base. Except in the case of 2,5-dinitrophenol, acetic acid and benzoic acid, the results are, in general, reasonably satisfactory. The approximate molar heats of neutralization have been calculated.

[A radiological case collection with interactive character as a new element in the education of medical students].

PubMed

Heye, T; Kurz, P; Eiers, M; Kauffmann, G W; Schipp, A

2008-04-01

Evaluation of an interactive, multimedia case-based learning platform for the radiological education of medical students. An interactive electronic learning platform for the education of medical students was built in HTML format independent of the operating system in the context of the Heidelberg Curriculum Medicinale (HeiCuMed). A case collection of 30 common and authentic clinical cases is used as the central theme and clinical background. The user has to work on each case by making decisions regarding a selection of diagnostic modalities and by analyzing the chosen studies. After a reasonable selection and sequence of diagnostic radiological modalities and their interpretation, a diagnosis has to be made. An extensive collection of normal findings for any modality is available for the user as a reference in correlation with the pathology at anytime within each case. The case collection consists of 2053 files with 1109 Internet pages (HTML) and 869 image files (.jpeg) with approximately 10 000 crosslinks (links). The case collection was evaluated by a questionnaire (scale 1 - 5) at the end of the radiological student course. The development of the results of the radiological course exam was analyzed to investigate any effect on the learning performance after the case collection was introduced. 97.6 % of the course participants would use the case collection beyond the radiological student course to learn radiology in their medical studies. The handling of the case collection was rated excellent in 36.9 %, good in 54.6 %, satisfactory in 8 % and unsatisfactory in 0.4 %. 41 % felt that the case collection was overall excellent, 49.2 % good, 7.8 % satisfactory, 1.6 % unsatisfactory and 0.4 % poor. A positive trend in the development of the results in the radiological course exam with less variance after the introduction of the case collection was found but failed statistical significance. A platform-independent, interactive, multimedia learning platform with authentic clinical cases and multiple choice elements for the user is the ideal method for supporting and expanding medical education in radiology. The usefulness and the reasonable exertion of diagnostic modalities are conveyed in a practical context as teaching goals. The high acceptance among students is based on the interactivity and use of multimedia.

Assessing the Effectiveness of Problem-Based Learning as a New Approach on Health Care Provider Ethical Reasoning Development in Shiraz University of Medical Sciences.

PubMed

Bazrafcan, Leila; Takmil, Farnaz; Shokrpour, Nasrin

2018-06-18

Problem-based learning (PBL) has become a distinct approach in learning. To assess the effectiveness of PBL in teaching ethics to medical students and the effect it has on their ethical reasoning, we decided to hold a PBL ethics workshop and then evaluate them based on pretest and posttest. This quasi-experimental comparative study in Shiraz University of Medical Sciences was designed based on pretest-posttest nonequivalent groups. After obtaining their consent, 120 health care providers were randomly selected and assigned in 4 groups and then asked to attend the ethics workshop. For measuring the participants' ethical reasoning through pretesting and posttesting, a case study consisting of 21 multiple-choice questions (cognitive domain-apply level) was performed. Data were then collected using a questionnaire, which was completed by the participants and analyzed using SPSS software (version 17). The comparison between the participants' attitude and knowledge toward ethics before and after the workshop revealed that all indices in the cognitive domain were changed (P < .001). The scores of pretest and posttest were significantly different. As to the results of our study, the PBL groups showed a more positive learning attitude and higher motivation in comparison with the control group who were subjected to traditional-based method of learning. The result of our study suggests that PBL can and should be used as an alternative method in teaching ethics in medical students because it is more effective and motivates the students.

Towards Measurement of Confidence in Safety Cases

NASA Technical Reports Server (NTRS)

Denney, Ewen; Paim Ganesh J.; Habli, Ibrahim

2011-01-01

Arguments in safety cases are predominantly qualitative. This is partly attributed to the lack of sufficient design and operational data necessary to measure the achievement of high-dependability targets, particularly for safety-critical functions implemented in software. The subjective nature of many forms of evidence, such as expert judgment and process maturity, also contributes to the overwhelming dependence on qualitative arguments. However, where data for quantitative measurements is systematically collected, quantitative arguments provide far more benefits over qualitative arguments, in assessing confidence in the safety case. In this paper, we propose a basis for developing and evaluating integrated qualitative and quantitative safety arguments based on the Goal Structuring Notation (GSN) and Bayesian Networks (BN). The approach we propose identifies structures within GSN-based arguments where uncertainties can be quantified. BN are then used to provide a means to reason about confidence in a probabilistic way. We illustrate our approach using a fragment of a safety case for an unmanned aerial system and conclude with some preliminary observations

Enabling the use of hereditary information from pedigree tools in medical knowledge-based systems.

PubMed

Gay, Pablo; López, Beatriz; Plà, Albert; Saperas, Jordi; Pous, Carles

2013-08-01

The use of family information is a key issue to deal with inheritance illnesses. This kind of information use to come in the form of pedigree files, which contain structured information as tree or graphs, which explains the family relationships. Knowledge-based systems should incorporate the information gathered by pedigree tools to assess medical decision making. In this paper, we propose a method to achieve such a goal, which consists on the definition of new indicators, and methods and rules to compute them from family trees. The method is illustrated with several case studies. We provide information about its implementation and integration on a case-based reasoning tool. The method has been experimentally tested with breast cancer diagnosis data. The results show the feasibility of our methodology. Copyright © 2013 Elsevier Inc. All rights reserved.

Setbacks in the process of assimilation of problematic experiences in two cases of emotion-focused therapy for depression.

PubMed

Mendes, Inês; Rosa, Catarina; Stiles, William B; Caro Gabalda, Isabel; Gomes, Pedro; Basto, Isabel; Salgado, João

2016-11-01

Research on the assimilation model has suggested that psychological change takes place in a sequence of stages punctuated by setbacks, that is, by transient reversals in the developmental course. This study analyzed such setbacks in one good outcome case and one poor outcome case of Emotion-focused therapy (EFT) for depression. Intensive analyses of five transcribed sessions from each case identified 26 setbacks in the good outcome case and 27 in the poor outcome case. The reason for each setback was classified into one of four categories: balance strategy, exceeding the therapeutic zone of proximal development either induced by the therapist (ZPD-T) or induced by the client (ZPD-C), or spontaneous switches. In the good outcome case the most frequent reasons for setbacks were balance strategy and spontaneous switches, whereas in the poor outcome case the most frequent reason for setbacks was ZPD-T. As in previously studied therapies, setbacks in EFT, usually represent productive work on relatively less advanced strands of the client's major problems. Results point to the importance of the therapist attending to the limits of the client's therapeutic ZPD.

Eosinophilic Gastroenteritis: Case Report and Review in Search for Diagnostic Key Points

PubMed Central

López-Medina, Guillermo; Gallo, Manuel; Prado, Alejandro; Vicuña-Honorato, Iliana; Castillo Díaz de León, Roxana

2015-01-01

Eosinophilic gastroenteritis is considered an uncommon disease with a low incidence rate that remains as a diagnostic challenge for the clinician, in spite of the fact that seventy years have passed since its original description. Hereby we present the case of a 29-year-old male without history of allergies who was evaluated for unspecific gastrointestinal symptoms, without relevant findings on physical examination and presenting an initial complete blood count (CBC) with severe eosinophilia. The patient was evaluated and the diagnosis of eosinophilic gastroenteritis was confirmed by histopathological findings. The relevance of the case resides in highlighting the lack of guidelines or consensus for histological diagnosis being virtually the only one available. To a similar extent, treatment evidence is based on case series with a reasonable number of patients and case reports. PMID:26075112

Increasing Reasoning Awareness: Video Analysis of Students' Two-Party Virtual Patient Interactions.

PubMed

Edelbring, Samuel; Parodis, Ioannis; Lundberg, Ingrid E

2018-02-27

Collaborative reasoning occurs in clinical practice but is rarely developed during education. The computerized virtual patient (VP) cases allow for a stepwise exploration of cases and thus stimulate active learning. Peer settings during VP sessions are believed to have benefits in terms of reasoning but have received scant attention in the literature. The objective of this study was to thoroughly investigate interactions during medical students' clinical reasoning in two-party VP settings. An in-depth exploration of students' interactions in dyad settings of VP sessions was performed. For this purpose, two prerecorded VP sessions lasting 1 hour each were observed, transcribed in full, and analyzed. The transcriptions were analyzed using thematic analysis, and short clips from the videos were selected for subsequent analysis in relation to clinical reasoning and clinical aspects. Four categories of interactions were identified: (1) task-related dialogue, in which students negotiated a shared understanding of the task and strategies for information gathering; (2) case-related insights and perspectives were gained, and the students consolidated and applied preexisting biomedical knowledge into a clinical setting; (3) clinical reasoning interactions were made explicit. In these, hypotheses were followed up and clinical examples were used. The researchers observed interactions not only between students and the VP but also (4) interactions with other resources, such as textbooks. The interactions are discussed in relation to theories of clinical reasoning and peer learning. The dyad VP setting is conducive to activities that promote analytic clinical reasoning. In this setting, components such as peer interaction, access to different resources, and reduced time constraints provided a productive situation in which the students pursued different lines of reasoning. ©Samuel Edelbring, Ioannis Parodis, Ingrid E Lundberg. Originally published in JMIR Medical Education (http://mededu.jmir.org), 27.02.2018.

Increasing Reasoning Awareness: Video Analysis of Students’ Two-Party Virtual Patient Interactions

PubMed Central

Parodis, Ioannis; Lundberg, Ingrid E

2018-01-01

Background Collaborative reasoning occurs in clinical practice but is rarely developed during education. The computerized virtual patient (VP) cases allow for a stepwise exploration of cases and thus stimulate active learning. Peer settings during VP sessions are believed to have benefits in terms of reasoning but have received scant attention in the literature. Objective The objective of this study was to thoroughly investigate interactions during medical students’ clinical reasoning in two-party VP settings. Methods An in-depth exploration of students’ interactions in dyad settings of VP sessions was performed. For this purpose, two prerecorded VP sessions lasting 1 hour each were observed, transcribed in full, and analyzed. The transcriptions were analyzed using thematic analysis, and short clips from the videos were selected for subsequent analysis in relation to clinical reasoning and clinical aspects. Results Four categories of interactions were identified: (1) task-related dialogue, in which students negotiated a shared understanding of the task and strategies for information gathering; (2) case-related insights and perspectives were gained, and the students consolidated and applied preexisting biomedical knowledge into a clinical setting; (3) clinical reasoning interactions were made explicit. In these, hypotheses were followed up and clinical examples were used. The researchers observed interactions not only between students and the VP but also (4) interactions with other resources, such as textbooks. The interactions are discussed in relation to theories of clinical reasoning and peer learning. Conclusions The dyad VP setting is conducive to activities that promote analytic clinical reasoning. In this setting, components such as peer interaction, access to different resources, and reduced time constraints provided a productive situation in which the students pursued different lines of reasoning. PMID:29487043

Preliminary Indications for the Use of Sugammadex After Its Addition to a Formulary at a Tertiary Care Children's Hospital.

PubMed

Barry, N'Diris; Uffman, Joshua C; Tumin, Dmitry; Tobias, Joseph D

2018-01-01

Neuromuscular blocking agents (NMBAs) are administered to facilitate endotracheal intubation and provide skeletal muscle relaxation in surgical procedures. Sugammadex (Bridion) recently received approval by the United States Food and Drug Administration for reversal of rocuronium and vecuronium-induced neuromuscular blockade thereby providing an alternative to acetylcholinesterase inhibitors such as neostigmine. This quality improvement analysis sought to investigate the clinical reasons and common clinical perceptions for choosing sugammadex over neostigmine to reverse NMBAs. One hundred cases were reviewed where sugammadex was used for neuromuscular blockade reversal in the operating room. Cases were identified from electronic medical record reports. Anesthesia providers responsible for administering sugammadex were interviewed to obtain rationales for sugammadex use in the perioperative setting. Responses were reviewed to identify distinct reasons for using sugammadex. Two independent raters ranked the reasons according to prevalence. The study was exempt from Institutional Review Board approval as a quality improvement (QI) project. Forty-two anesthesia providers (15 Certified Registered Nurse Anesthetists, 5 anesthesiology trainees, and 22 attending anesthesiologists) were interviewed to identify reasons why sugammadex was administered intraoperatively in 100 surgical cases (69/31 male/female patients, age 9.4 ± 6.5 years). The author identified the top 19 common reasons respondents chose to use sugammadex for each case, and independent raters reviewed the response summaries for those 19 primary reasons sugammadex was used. The most common reasons for choosing sugammadex were: 1) beneficial pharmacokinetics of the agent; 2) sugammadex's perceived superior efficacy over neostigmine; and 3) concerns regarding adverse effects of neostigmine and/or the anticholinergic agent. Sugammadex has recently been introduced for clinical use to reverse NMBAs at our institution. Primary reasons and perceptions for its use over neostigmine included a limited adverse effect profile, a greater sense of control and predictability of patients' response, and a limited incidence of residual neuromuscular blockade.

A ligand predication tool based on modeling and reasoning with imprecise probabilistic knowledge.

PubMed

Liu, Weiru; Yue, Anbu; Timson, David J

2010-04-01

Ligand prediction has been driven by a fundamental desire to understand more about how biomolecules recognize their ligands and by the commercial imperative to develop new drugs. Most of the current available software systems are very complex and time-consuming to use. Therefore, developing simple and efficient tools to perform initial screening of interesting compounds is an appealing idea. In this paper, we introduce our tool for very rapid screening for likely ligands (either substrates or inhibitors) based on reasoning with imprecise probabilistic knowledge elicited from past experiments. Probabilistic knowledge is input to the system via a user-friendly interface showing a base compound structure. A prediction of whether a particular compound is a substrate is queried against the acquired probabilistic knowledge base and a probability is returned as an indication of the prediction. This tool will be particularly useful in situations where a number of similar compounds have been screened experimentally, but information is not available for all possible members of that group of compounds. We use two case studies to demonstrate how to use the tool. 2009 Elsevier Ireland Ltd. All rights reserved.

The Special Place Project: Efficacy of a Place-Based Case Study Approach for Teaching Geoscience

NASA Astrophysics Data System (ADS)

Moosavi, Sadredin

2014-05-01

Achieving geoscience literacy of the general population has become increasingly important world wide as ever more connected and growing societies depend more and more on our planet's limited natural resource base. Building citizen understanding of their dependence on the local environment, and the geologic processes which created and continue to change it, has become a great challenge to educators at all levels of the education system. The Special Place Project described in this presentation explores use of a place-based case study approach combining instruction in geoscience content with development of observation, reasoning, writing and presentation skills. The approach allows students to select the locations for their individual case studies affording development of personal connections between the learner and his environment. The approach gives instructors at many grade levels the ability to develop core pedagogical content and skills while exploring the unique geologic environments relevant to the local population including such critical issues as land use, resource depletion, energy, climate change and the future of communities in a changing world. The geologic reasons for the location of communities and key events in their histories can be incorporated into the students' case studies as appropriate. The project is unique in placing all course instruction in the context of the quest to explore and gain understanding of the student's chosen location by using the inherently more generalized course content required by the curriculum. By modeling how scientists approach their research questions, this pedagogical technique not only integrates knowledge and skills from across the curriculum, it captures the excitement of scientific thinking on real world questions directly relevant to students' lives, increasing student engagement and depth of learning as demonstrated in the case study reports crafted by the students and exam results. Student learning of topics directly touched upon by the case study, such as geomorphologic features and processes observable at Earth's surface, is compared to learning on more abstract topics, such as subsurface Earth structure and tectonic processes, to provide a quantitative assessment of this pedagogical approach.

Preventing readmissions through comprehensive discharge planning.

PubMed

Hunter, Tabitha; Nelson, James Rex; Birmingham, Jackie

2013-01-01

Case managers, including nurses and social workers, provide essential services to hospitalized patients, including mandated discharge planning that has been shown to impact patient safety and patient outcomes. The heightened attention to readmission is evident in both reimbursement and accreditation initiatives. The Centers for Medicare & Medicaid Services, Office of Clinical Standards & Quality/Survey & Certification Group, is revising worksheets to be used by surveyors to review how hospitals are complying with the Medicare Conditions of Participation with a focus on discharge planning as it relates to patient safety. This is an opportunity for case managers to apply the principles of case management to the targeted problem of readmissions. Now case managers must identify the reasons for readmission on a patient-by-patient basis, collect data, analyze processes, and then change practice in the hospital and work more closely with community-based providers. The purpose of this article is to recommend improvement in a consistent case management practice that will positively influence patient readmissions. Hospital-based case managers who are responsible for discharge planning functions. Hospital administrators will also find this information valuable as a tool to assess strategies to control preventable readmissions and to comply with the Medicare Conditions of Participation for discharge planning. Hospital-based case managers, responsible for discharge planning, have a unique opportunity to interact face-to-face with patients who are readmitted to determine factors that lead to the readmission. Case managers need to change their practice to include assessing patients on the basis of their prior level of care. Pharmacists need to play a bigger role in discharge planning, especially for patients who have experienced a potentially avoidable readmission. Working closely with community-based providers is essential to target reasons for readmission. The Medicare Conditions of Participation for Discharge Planning can be used not only to show compliance but as tools to evaluate current practice and identify areas of improvement. Preventable readmissions or rehospitalizations directly affect patient safety, patient outcome, hospital reimbursement, and hospital accreditation. Preventable readmissions can be controlled by comprehensive discharge planning. Case managers are directly involved in discharge planning and thus have direct accountability regarding readmissions; therefore, they must refine the admission assessment screening to include specific information based on a patient's preadmission level of care. Collaboration with community-based providers is essential to managing readmissions or rehospitalizations. Hospitals will find it beneficial to track readmissions by using specific data points unique to readmissions such as source of admission and previous length of stay. Self-assessment of compliance will help identify opportunities for quality improvement in the case management department. PLEASE NOTE: Rules and regulations are constantly changing. It is critical to monitor changes in standards. Information contained in this article is current at the time of submission, and readers are encouraged to review the content of this article with administration before implementing changes.

Clinical Case Studies in Psychoanalytic and Psychodynamic Treatment

PubMed Central

Willemsen, Jochem; Della Rosa, Elena; Kegerreis, Sue

2017-01-01

This manuscript provides a review of the clinical case study within the field of psychoanalytic and psychodynamic treatment. The method has been contested for methodological reasons and because it would contribute to theoretical pluralism in the field. We summarize how the case study method is being applied in different schools of psychoanalysis, and we clarify the unique strengths of this method and areas for improvement. Finally, based on the literature and on our own experience with case study research, we come to formulate nine guidelines for future case study authors: (1) basic information to include, (2) clarification of the motivation to select a particular patient, (3) information about informed consent and disguise, (4) patient background and context of referral or self-referral, (5) patient's narrative, therapist's observations and interpretations, (6) interpretative heuristics, (7) reflexivity and counter-transference, (8) leaving room for interpretation, and (9) answering the research question, and comparison with other cases. PMID:28210235

Reasons for Silence: A Case Study of Two Korean Students at a U.S. Graduate School

ERIC Educational Resources Information Center

Choi, Jung Yun

2015-01-01

This article explores the perception and reasons for Korean students' silence and low levels of oral participation in U.S. graduate programs. It analyzes a case study conducted with two Korean students currently attending graduate school in urban settings. The researcher conducted semi-structured interviews with the participants, using a constant…

41 CFR 102-80.150 - What is meant by “reasonable worst case fire scenario”?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 41 Public Contracts and Property Management 3 2011-01-01 2011-01-01 false What is meant by âreasonable worst case fire scenarioâ? 102-80.150 Section 102-80.150 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 80...

41 CFR 102-80.150 - What is meant by “reasonable worst case fire scenario”?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false What is meant by âreasonable worst case fire scenarioâ? 102-80.150 Section 102-80.150 Public Contracts and Property Management Federal Property Management Regulations System (Continued) FEDERAL MANAGEMENT REGULATION REAL PROPERTY 80...

Visual Reasoning in Computational Environment: A Case of Graph Sketching

ERIC Educational Resources Information Center

Leung, Allen; Chan, King Wah

2004-01-01

This paper reports the case of a form six (grade 12) Hong Kong student's exploration of graph sketching in a computational environment. In particular, the student summarized his discovery in the form of two empirical laws. The student was interviewed and the interviewed data were used to map out a possible path of his visual reasoning. Critical…

Frequency, probability, and prediction: easy solutions to cognitive illusions?

PubMed

Griffin, D; Buehler, R

1999-02-01

Many errors in probabilistic judgment have been attributed to people's inability to think in statistical terms when faced with information about a single case. Prior theoretical analyses and empirical results imply that the errors associated with case-specific reasoning may be reduced when people make frequentistic predictions about a set of cases. In studies of three previously identified cognitive biases, we find that frequency-based predictions are different from-but no better than-case-specific judgments of probability. First, in studies of the "planning fallacy, " we compare the accuracy of aggregate frequency and case-specific probability judgments in predictions of students' real-life projects. When aggregate and single-case predictions are collected from different respondents, there is little difference between the two: Both are overly optimistic and show little predictive validity. However, in within-subject comparisons, the aggregate judgments are significantly more conservative than the single-case predictions, though still optimistically biased. Results from studies of overconfidence in general knowledge and base rate neglect in categorical prediction underline a general conclusion. Frequentistic predictions made for sets of events are no more statistically sophisticated, nor more accurate, than predictions made for individual events using subjective probability. Copyright 1999 Academic Press.

Reasons for operation cancellations at a teaching hospital: prioritizing areas of improvement.

PubMed

Abeeleh, Mahmoud Abu; Tareef, Tareq M; Hani, Amjad Bani; Albsoul, Nader; Samarah, Omar Q; ElMohtaseb, M S; Alshehabat, Musa; Ismail, Zuhair Bani; Alnoubani, Omar; Obeidat, Salameh S; Halawa, Sami Abu

2017-08-01

To report rates of and reasons for operation cancellation, and to prioritize areas of improvement. Retrospective data were extracted from the monthly reports of cancelled listed operations. Data on 14 theatres were collected by the office of quality assurance at Jordan University Hospital from August 2012 to April 2016. Rates and reasons for operation cancellation were investigated. A Pareto chart was constructed to identify the reasons of highest priority. During the period of study, 6,431 cases (9.31%) were cancelled out of 69,066 listed cases. Patient no-shows accounted for 62.52% of cancellations. A Pareto analysis showed that around 80% of the known reasons for cancellation after admission were due to a lack of surgical theatre time (30%), incomplete preoperative assessment (21%), upper respiratory tract infection (19%), and high blood pressure (13%). This study identified the most common reasons for operation cancellation at a teaching hospital. Potential avoidable root causes and recommended interventions were suggested accordingly. Future research, available resources, hospital policies, and strategic measures directed to tackle these reasons should take priority.

Analysis of public responses to preparedness policies: the cases of H1N1 influenza vaccination and gas mask distribution

PubMed Central

2013-01-01

Background During several months in 2009–2010, the Israeli population was asked to take part in two preparedness programs: Acquisition of gas masks against a potential chemical-warfare attack, and vaccination against the A/H1N1 influenza pandemics. Compliance with the first request was moderate and did not attract much attention, whereas compliance with the second request was very low and was accompanied by significant controversy. The aims of this study are to compare the public’s attitudes towards these two preparedness campaigns, and to explore the roles of trust, reasoned assessment, and reflexive reactions in the public’s response to governmental preparedness policies. Methods The comparative analysis was based on a telephone survey of 2,018 respondents representing a cross-section of the adult Israeli population. Univariate analysis to describe associations of public response and attitude was performed by Chi-square tests. Findings A set of queries related to actual compliance, trust in credibility of authorities, personal opinions, reasons for non-compliance, and attitudes towards uncertainties was used to characterize the response to mask-acquisition and vaccination. In the case of mask-acquisition, the dominant response profile was of trusting compliance based on non-conditional belief in the need to adhere to the recommendation (35.6% of respondents). In the case of vaccination, the dominant response profile was of trusting non-compliance based on a reflective belief in the need for adherence (34.8% of respondents). Among the variables examined in the study, passivity was found to be the major reason for non-compliance with mask-acquisition, whereas reasoned assessment of risk played a major role in non-compliance with vaccination. Realization of the complexity in dealing with uncertainty related to developing epidemics and to newly-developed vaccines was identified in the public’s response to the H1N1 vaccination campaign. Conclusions The newly identified profile of “trusting-reflective-non-complier” individuals should be of concern to policy makers. The public is not accepting governmental recommendations in an unconditional manner. This is not driven by lack of trust in authorities, but rather by the perception of the responsibility of individuals in confronting forthcoming risks. Nevertheless, under certain conditions the public may respond in a non-reflective way and delegate this responsibly to authorities in an uncontested manner. This leaves the policy makers with the complex challenge of interacting with a passive non-involved public or alternatively with an opinionated, reflexive public. PMID:23537171

Using an Ishikawa diagram as a tool to assist memory and retrieval of relevant medical cases from the medical literature.

PubMed

Wong, Kam Cheong

2011-03-29

Studying medical cases is an effective way to enhance clinical reasoning skills and reinforce clinical knowledge. An Ishikawa diagram, also known as a cause-and-effect diagram or fishbone diagram, is often used in quality management in manufacturing industries.In this report, an Ishikawa diagram is used to demonstrate how to relate potential causes of a major presenting problem in a clinical setting. This tool can be used by teams in problem-based learning or in self-directed learning settings.An Ishikawa diagram annotated with references to relevant medical cases and literature can be continually updated and can assist memory and retrieval of relevant medical cases and literature. It could also be used to cultivate a lifelong learning habit in medical professionals.

Prefrontal and medial temporal contributions to episodic memory-based reasoning.

PubMed

Suzuki, Chisato; Tsukiura, Takashi; Mochizuki-Kawai, Hiroko; Shigemune, Yayoi; Iijima, Toshio

2009-03-01

Episodic memory retrieval and reasoning are fundamental psychological components of our daily lives. Although previous studies have investigated the brain regions associated with these processes separately, the neural mechanisms of reasoning based on episodic memory retrieval are largely unknown. Here, we investigated the neural correlates underlying episodic memory-based reasoning using functional magnetic resonance imaging (fMRI). During fMRI scanning, subjects performed three tasks: reasoning, episodic memory retrieval, and episodic memory-based reasoning. We identified dissociable activations related to reasoning, episodic memory retrieval, and linking processes between the two. Regions related to reasoning were identified in the left ventral prefrontal cortices (PFC), and those related to episodic memory retrieval were found in the right medial temporal lobe (MTL) regions. In addition, activations predominant in the linking process between the two were found in the left dorsal and right ventral PFC. These findings suggest that episodic memory-based reasoning is composed of at least three processes, i.e., reasoning, episodic memory retrieval, and linking processes between the two, and that activation of both the PFC and MTL is crucial in episodic memory-based reasoning. These findings are the first to demonstrate that PFC and MTL regions contribute differentially to each process in episodic memory-based reasoning.

Influenza vaccine refusal in Israeli young adults.

PubMed

Balicer, Ran D; Grotto, Itamar; Huerta, Michael; Levian, Yardena; Davidovitch, Nadav

2007-10-01

The purpose of this study was to identify correlates of noncompliance with influenza immunization among young adults and to determine the reasons leading to immunization refusal. Self-administered questionnaires were distributed in 10 military bases during two consecutive annual Israel Defense Force influenza vaccination campaigns. Multivariate logistic regression was performed to identify independent correlates. Of 2,000 questionnaires distributed over two seasons, 942 were completed and returned. Of those, 401 respondents were not vaccinated either because of medical contraindication or for administrative reasons. The remaining 541 respondents who reported either receiving the vaccine or refusing to receive it were analyzed. Risk groups for vaccine refusal included older age (17.9% vs. 3.5% refusal rate) and officer rank (25.9% vs. 13.8% refusal rate). The main reasons for vaccine refusal differed significantly between officers and nonofficers (chi2 = 7.587, p = 0.023). Officers refused mainly (60%) because of fear of possible vaccine adverse effects, whereas nonofficers refused mainly (44.2%) because of disbelief in the vaccine's efficacy in preventing illness. Officers serve as a negative role model in this case, and efforts directed toward dissemination of evidence-based information regarding vaccine-related adverse effects should be introduced to increase vaccination rates in this group.

Quality assessment and improvement of "Unsatisfactory" liquid-based cervicovaginal papanicolaou smears.

PubMed

Mirzamani, Neda; Chau, Karen; Rafael, Oana; Shergill, Uday; Sajjan, Sujata; Sumskaya, Irina; Gimenez, Cecilia; Klein, Melissa; Das, Kasturi

2017-10-01

The quality of cervicovaginal smears determines the success of cytology in screening programs for cervical cancer. Bethesda 2014 revisited the adequacy criteria for atrophic smears and redefined the squamous cell count in the "unsatisfactory" category. In this study, we evaluated the smear quality of Thinprep liquid-based cervicovaginal Papanicolaou cytology slides (TPS) that were previously deemed unsatisfactory, to determine reasons for such categorization. In addition, we attempted to establish the impact of the new adequacy criteria on the rate and management of unsatisfactory diagnosis. About 234 unsatisfactory TPS were examined. The reasons for unsatisfactory were noted. The number of squamous cells was recounted, as per the new Bethesda criteria, in borderline adequacy cases that showed an atrophic pattern. The leading cause for unsatisfactory TPS was lubricating gel, followed by blood, as observed in older and younger age groups, respectively (Figure 1). Eleven borderline cases were reclassified as "satisfactory" using the new Bethesda cell count, with 27% above 60 years of age. About 82% of these borderline cases were negative for intraepithelial lesion or malignancy on repeat testing. There was no difference of management or change in rate of unsatisfactory when patients above 60 were reclassified into the satisfactory category using the new Bethesda count. However, a larger study is needed to evaluate whether the new recommendation for minimum cellularity can be implemented in patients above a certain age cut-off. The study highlights the need for improvement in collection practices and education of practitioners. © 2017 Wiley Periodicals, Inc.

A seasonal forecast scheme for the Inner Mongolia spring drought part-II: a logical reasoning evidence-based method for spring predictions

NASA Astrophysics Data System (ADS)

Gao, Tao; Wulan, Wulan; Yu, Xiao; Yang, Zelong; Gao, Jing; Hua, Weiqi; Yang, Peng; Si, Yaobing

2018-05-01

Spring precipitation is the predominant factor that controls meteorological drought in Inner Mongolia (IM), China. This study used the anomaly percentage of spring precipitation (PAP) as a drought index to measure spring drought. A scheme for forecasting seasonal drought was designed based on evidence of spring drought occurrence and speculative reasoning methods introduced in computer artificial intelligence theory. Forecast signals with sufficient lead-time for predictions of spring drought were extracted from eight crucial areas of oceans and 500-hPa geopotential height. Using standardized values, these signals were synthesized into three examples of spring drought evidence (SDE) depending on their primary effects on three major atmospheric circulation components of spring precipitation in IM: the western Pacific subtropical high, North Polar vortex, and East Asian trough. Thresholds for the SDE were determined following numerical analyses of the influential factors. Furthermore, five logical reasoning rules for distinguishing the occurrence of SDE were designed after examining all possible combined cases. The degree of confidence in the rules was determined based on estimations of their prior probabilities. Then, an optimized logical reasoning scheme was identified for judging the possibility of spring drought. The scheme was successful in hindcast predictions of 11 of the 16 (accuracy: 68.8%) spring droughts that have occurred during 1960-2009. Moreover, the accuracy ratio for the same period was 82.0% for drought (PAP ≤ -20%) or not (PAP > -20%). Predictions for the recent 6-year period (2010-2015) demonstrated successful outcomes.

An Automated Approach to Reasoning Under Multiple Perspectives

NASA Technical Reports Server (NTRS)

deBessonet, Cary

2004-01-01

This is the final report with emphasis on research during the last term. The context for the research has been the development of an automated reasoning technology for use in SMS (symbolic Manipulation System), a system used to build and query knowledge bases (KBs) using a special knowledge representation language SL (Symbolic Language). SMS interpreters assertive SL input and enters the results as components of its universe. The system operates in two basic models: 1) constructive mode (for building KBs); and 2) query/search mode (for querying KBs). Query satisfaction consists of matching query components with KB components. The system allows "penumbral matches," that is, matches that do not exactly meet the specifications of the query, but which are deemed relevant for the conversational context. If the user wants to know whether SMS has information that holds, say, for "any chow," the scope of relevancy might be set so that the system would respond based on a finding that it has information that holds for "most dogs," although this is not exactly what was called for by the query. The response would be qualified accordingly, as would normally be the case in ordinary human conversation. The general goal of the research was to develop an approach by which assertive content could be interpreted from multiple perspectives so that reasoning operations could be successfully conducted over the results. The interpretation of an SL statement such as, "{person believes [captain (asserted (perhaps)) (astronaut saw (comet (bright)))]}," which in English would amount to asserting something to the effect that, "Some person believes that a captain perhaps asserted that an astronaut saw a bright comet," would require the recognition of multiple perspectives, including some that are: a) epistemically-based (focusing on "believes"); b) assertion-based (focusing on "asserted"); c) perception-based (focusing on "saw"); d) adjectivally-based (focusing on "bight"); and e) modally-based (focusing on "perhaps"). Any conclusion reached under a line of reasoning that employs such an assertion or its associated implications should somehow reflect the employed perspectives. The investigators made significant progress in developing an approach that would enable a system to conduct reasoning operations over assertions of this kind while maintaining consistency in its knowledge bases. Significant accomplishments were made in the areas of: 1) integration and inferencing; 2) generation of perspectives, including wholistic ad composite views; and 3) consistency maintenance.

The Kaiser Permanente shoulder arthroplasty registry: results from 6,336 primary shoulder arthroplasties.

PubMed

Dillon, Mark T; Ake, Christopher F; Burke, Mary F; Singh, Anshuman; Yian, Edward H; Paxton, Elizabeth W; Navarro, Ronald A

2015-06-01

Shoulder arthroplasty is being performed in the United States with increasing frequency. We describe the medium-term findings from a large integrated healthcare system shoulder arthroplasty registry. Shoulder arthroplasty cases registered between January 2005 and June 2013 were included for analysis. The registry included patient characteristics, surgical information, implant data, attrition, and patient outcomes such as surgical site infections, venous thromboembolism, and revision procedures. During the study period, 6,336 primary cases were registered. Median follow-up time for all primaries was 3.3 years; 461 cases were lost to follow-up by ending of health plan membership. Primary cases were predominantly female (56%) and white (81%), with an average age of 70 years. The most common reason for surgery was osteoarthritis in 60% of cases, followed by acute fracture (17%) and rotator cuff tear arthropathy (15%). In elective shoulder arthroplasty procedures, 200 all-cause revisions (4%) were reported, with glenoid wear being the most common reason. Most arthroplasties were elective procedures: over half performed for osteoarthritis. Glenoid wear was the most common reason for revision of primary shoulder arthroplasty in elective cases.

Learning to Explain Astronomy Across Moving Frames of Reference: Exploring the role of classroom and planetarium-based instructional contexts

NASA Astrophysics Data System (ADS)

Plummer, Julia Diane; Kocareli, Alicia; Slagle, Cynthia

2014-05-01

Learning astronomy involves significant spatial reasoning, such as learning to describe Earth-based phenomena and understanding space-based explanations for those phenomena as well as using the relevant size and scale information to interpret these frames of reference. This study examines daily celestial motion (DCM) as one case of how children learn to move between frames of reference in astronomy wherein one explains Earth-based descriptions of the Sun's, Moon's, and stars' apparent motion using the Earth's daily rotation. We analysed interviews with 8-9-year-old students (N = 99) who participated in one of four instructional conditions emphasizing: the space-based perspective; the Earth-based perspective in the planetarium; constructing explanations for the Earth-based observations; and a combination of the planetarium plus constructing explanations in the classroom. We used an embodied cognition framework to analyse outcomes while also considering challenges learners face due to the high cognitive demands of spatial reasoning. Results support the hypothesis that instruction should engage students in learning both the Earth-based observations and space-based explanations, as focusing on a single frame of reference resulted in less sophisticated explanations; however, few students were able to construct a fully scientific explanation after instruction.

Weather-based prediction of Plasmodium falciparum malaria in epidemic-prone regions of Ethiopia II. Weather-based prediction systems perform comparably to early detection systems in identifying times for interventions.

PubMed

Teklehaimanot, Hailay D; Schwartz, Joel; Teklehaimanot, Awash; Lipsitch, Marc

2004-11-19

Timely and accurate information about the onset of malaria epidemics is essential for effective control activities in epidemic-prone regions. Early warning methods that provide earlier alerts (usually by the use of weather variables) may permit control measures to interrupt transmission earlier in the epidemic, perhaps at the expense of some level of accuracy. Expected case numbers were modeled using a Poisson regression with lagged weather factors in a 4th-degree polynomial distributed lag model. For each week, the numbers of malaria cases were predicted using coefficients obtained using all years except that for which the prediction was being made. The effectiveness of alerts generated by the prediction system was compared against that of alerts based on observed cases. The usefulness of the prediction system was evaluated in cold and hot districts. The system predicts the overall pattern of cases well, yet underestimates the height of the largest peaks. Relative to alerts triggered by observed cases, the alerts triggered by the predicted number of cases performed slightly worse, within 5% of the detection system. The prediction-based alerts were able to prevent 10-25% more cases at a given sensitivity in cold districts than in hot ones. The prediction of malaria cases using lagged weather performed well in identifying periods of increased malaria cases. Weather-derived predictions identified epidemics with reasonable accuracy and better timeliness than early detection systems; therefore, the prediction of malarial epidemics using weather is a plausible alternative to early detection systems.

Experimenting with Case-Based Reasoning to Present Educative Health Information on the Internet: The Example of SeniorGezond.

PubMed

Ezendam, Nicole P M; Alpay, Laurence L; Rövekamp, Ton A J M; Toussaint, Pieter J

2005-01-01

Information about health prevention can contribute to the awareness and the knowledge of consumers and patients about their own health. Messages originating from other users (cases) can be perceived as more credible and hence more persuasive. With this in mind, we have developed an informative website called SeniorGezond, which includes a case-based tailoring component, in the domain area of fall incidences. To investigate whether the use of cases is suitable for presenting and tailoring educative health information; and to gain insights in the user's opinion about the use of cases to provide tailored preventive information. We conducted a qualitative study using questionnaires, focus group discussions, interviews, and observations. Participants were elderly, family caregivers and healthcare professionals. Users were able to find relevant cases for their problems, but had a mixed reaction on the usefulness and appreciation of the cases. There is a need for a delicate balance between a recognizable story with all the important health information and good readable and concise information. A good text structure is required to support this. While cases do have potential in health education, further research is needed in order to identify the necessary requirements which will make the cases successful.

Identifying Kinds of Reasoning in Collective Argumentation

ERIC Educational Resources Information Center

Conner, AnnaMarie; Singletary, Laura M.; Smith, Ryan C.; Wagner, Patty Anne; Francisco, Richard T.

2014-01-01

We combine Peirce's rule, case, and result with Toulmin's data, claim, and warrant to differentiate between deductive, inductive, abductive, and analogical reasoning within collective argumentation. In this theoretical article, we illustrate these kinds of reasoning in episodes of collective argumentation using examples from one…

The Probability Heuristics Model of Syllogistic Reasoning.

ERIC Educational Resources Information Center

Chater, Nick; Oaksford, Mike

1999-01-01

Proposes a probability heuristic model for syllogistic reasoning and confirms the rationality of this heuristic by an analysis of the probabilistic validity of syllogistic reasoning that treats logical inference as a limiting case of probabilistic inference. Meta-analysis and two experiments involving 40 adult participants and using generalized…

Students' self-explanations while solving unfamiliar cases: the role of biomedical knowledge.

PubMed

Chamberland, Martine; Mamede, Sílvia; St-Onge, Christina; Rivard, Marc-Antoine; Setrakian, Jean; Lévesque, Annie; Lanthier, Luc; Schmidt, Henk G; Rikers, Remy M J P

2013-11-01

General guidelines for teaching clinical reasoning have received much attention, despite a paucity of instructional approaches with demonstrated effectiveness. As suggested in a recent experimental study, self-explanation while solving clinical cases may be an effective strategy to foster reasoning in clinical clerks dealing with less familiar cases. However, the mechanisms that mediate this benefit have not been specifically investigated. The aim of this study was to explore the types of knowledge used by students when solving familiar and less familiar clinical cases with self-explanation. In a previous study, 36 third-year medical students diagnosed familiar and less familiar clinical cases either by engaging in self-explanation or not. Based on an analysis of previously collected data, the present study compared the content of self-explanation protocols generated by seven randomly selected students while solving four familiar and four less familiar cases. In total, 56 verbal protocols (28 familiar and 28 less familiar) were segmented and coded using the following categories: paraphrases, biomedical inferences, clinical inferences, monitoring statements and errors. Students provided more self-explanation segments from less familiar cases (M = 275.29) than from familiar cases (M = 248.71, p = 0.046). They provided significantly more paraphrases (p = 0.001) and made more errors (p = 0.008). A significant interaction was found between familiarity and the type of inferences (biomedical versus clinical, p = 0.016). When self-explaining less familiar cases, students provided significantly more biomedical inferences than familiar cases. Lack of familiarity with a case seems to stimulate medical students to engage in more extensive thinking during self-explanation. Less familiar cases seem to activate students' biomedical knowledge, which in turn helps them to create new links between biomedical and clinical knowledge, and eventually construct a more coherent mental representation of diseases. This may clarify the previously found positive effect that self-explanation has on the diagnosis of unfamiliar cases. © 2013 John Wiley & Sons Ltd.

Prevalence and Characteristics of Infant's Unexplained Breast Preference for Nursing One Breast: A Self-Administered Survey.

PubMed

Al-Abdi, Sameer Yaseen; Al Omran, Sadek Abdullah; Al-Aamri, Maryam Ali; Al Nasser, Mohammad Hasan; Al Omran, Abbas Moosa

2015-12-01

Breastfeeding is recommended by international bodies as the only source of infant nutrition during the first 6 months of life. Sometimes infants prefer to nurse on one breast for no obvious reason (hereafter called infant's unexplained breast preference [IUBP]). IUBP might reduce the rate of exclusive breastfeeding. The prevalence of IUBP is unknown because most of the literature on IUBP so far has been anecdotal. This study's objective was to investigate the prevalence and characteristics of IUBP among healthy infants in Al-Ahsa, Saudi Arabia. We conducted a population-based, cross-sectional study between March and August 2013 in the Al-Ahsa area, Eastern Province, Saudi Arabia. Healthy infants who had been born at full term (≥37 weeks of gestation) and were 2-24 months of age were included. We distributed 600 self-administered surveys to mothers who attended vaccination clinics in nine primary healthcare centers. Of 478 mothers who responded to the survey, 121 (25.3%) reported unilateral breastfeeding. IUBP was the most common reason for unilateral breastfeeding, with a prevalence of 13.6% (65/478). IUBP developed at a median age of 1 month (range, 1 day-9 months) and was familial in 42.9% of cases. It was the only reason for formula feeding during the first 6 months of life in 18.5% of cases. IUBP is common, develops very early in life, and can be familial and a reason for formula feeding. However, these findings need to be confirmed in other studies of other populations.

How to tell a patient's story? Influence of the case narrative design on the clinical reasoning process in virtual patients.

PubMed

Hege, Inga; Dietl, Anita; Kiesewetter, Jan; Schelling, Jörg; Kiesewetter, Isabel

2018-02-28

Virtual patients (VPs) are narrative-based educational activities to train clinical reasoning in a safe environment. Our aim was to explore the influence of the design of the narrative and level of difficulty on the clinical reasoning process, diagnostic accuracy and time-on-task. In a randomized controlled trial, we analyzed the clinical reasoning process of 46 medical students with six VPs in three different variations: (1) patients showing a friendly behavior, (2) patients showing a disruptive behavior and (3) a version without a patient story. For easy VPs, we did not see a significant difference in diagnostic accuracy. For difficult VPs, the diagnostic accuracy was significantly higher for participants who worked on the friendly VPs compared to the other two groups. Independent from VP difficulty, participants identified significantly more problems and tests for disruptive than for friendly VPs; time on task was comparable for these two groups. The extrinsic motivation of participants working on the VPs without a patient story was significantly lower than for the students working on the friendly VPs. Our results indicate that the measured VP difficulty has a higher influence on the clinical reasoning process and diagnostic accuracy than the variations in the narratives.

Undermining Reasonableness: Expert Testimony in a Case Involving a Battered Woman Who Kills

ERIC Educational Resources Information Center

Terrance, Cheryl; Matheson, Kimberly

2003-01-01

Student participants (N = 316) viewed a videotaped simulated case involving a woman who had entered a self-defense plea in the shooting death of her abusive husband. As successful claims of self-defense rest on the portrayal of a defendant who has responded reasonably to his/her situation, the implications of various forms of expert testimony in…

8 CFR 1216.6 - Petition by entrepreneur to remove conditional basis of lawful permanent resident status.

Code of Federal Regulations, 2011 CFR

2011-01-01

... reasonable time ten full-time jobs for qualifying employees. In the case of a “troubled business” as defined... demonstrates to the director's satisfaction that failure to file a timely petition was for good cause and due... to create within a reasonable period of time ten full-time jobs to qualifying employees. In the case...

Case-based retrieval framework for gene expression data.

PubMed

Anaissi, Ali; Goyal, Madhu; Catchpoole, Daniel R; Braytee, Ali; Kennedy, Paul J

2015-01-01

The process of retrieving similar cases in a case-based reasoning system is considered a big challenge for gene expression data sets. The huge number of gene expression values generated by microarray technology leads to complex data sets and similarity measures for high-dimensional data are problematic. Hence, gene expression similarity measurements require numerous machine-learning and data-mining techniques, such as feature selection and dimensionality reduction, to be incorporated into the retrieval process. This article proposes a case-based retrieval framework that uses a k-nearest-neighbor classifier with a weighted-feature-based similarity to retrieve previously treated patients based on their gene expression profiles. The herein-proposed methodology is validated on several data sets: a childhood leukemia data set collected from The Children's Hospital at Westmead, as well as the Colon cancer, the National Cancer Institute (NCI), and the Prostate cancer data sets. Results obtained by the proposed framework in retrieving patients of the data sets who are similar to new patients are as follows: 96% accuracy on the childhood leukemia data set, 95% on the NCI data set, 93% on the Colon cancer data set, and 98% on the Prostate cancer data set. The designed case-based retrieval framework is an appropriate choice for retrieving previous patients who are similar to a new patient, on the basis of their gene expression data, for better diagnosis and treatment of childhood leukemia. Moreover, this framework can be applied to other gene expression data sets using some or all of its steps.

Secondary Breast Augmentation: Managing Each Case

PubMed Central

Sanchez, Kyrenia

2010-01-01

Breast augmentation is one of the most regularly performed interventions requiring reoperation in aesthetic surgery. For this reason, it involves a greater chance for complications. In this report, the authors aim to provide young plastic surgeons with guidelines based on their experience for responding to each of these complications, to explain the causes and ways of avoiding them, and to show how they can be treated when they occur. PMID:20838791

Assessment of increased wet wood bonding for epoxy-bonded samples using a melamine-urea-formaldehyde priming agent

Treesearch

Jermal G. Chandler; Charles R. Frihart

2005-01-01

Is the hydroxymethylated resorcinol (HMR) primer unique or can a melamine- based primer also increase the wet wood strength of epoxy bonds? Although the exact reason for poor durability with some wood adhesives is not known, the HMR priming agent was found to facilitate durable bonds in most cases tested. A model of cell wall stabilization that is believed to be the...

Shrouds of Silence: A Case Study of Sexual Abuse in Schools in the Limpopo Province in South Africa

ERIC Educational Resources Information Center

Masehela, Boledi; Pillay, Venitha

2014-01-01

This study seeks to understand the reasons that allow a parent, a principal and a teacher to maintain silence when young girls under their care are sexually abused. Put another way, it attempts to explain what it is about sexual abuse that makes these parties relinquish their role as protectors of innocent children. This paper, based on a larger…

Reasoning with Incomplete and Uncertain Information

DTIC Science & Technology

1991-08-01

are rationally compatible (just as is the case in the fundamental computational mechanisms of truth maintenance systems ). The logics we construct will...complete, pre- cise, and unvarying. This fundamental assumption is a principal source of the limitation of many diagnostic systems to single fault diagnoses...Air Force Systems Command Griffiss Air Force Base, NY 13441-5700 This report has been reviewed by the Rome Laboratory Public Affairs Dffice (PA) and

Memory Reconsolidation and Computational Learning

DTIC Science & Technology

2010-03-01

Cooper and H.T. Siegelmann, "Memory Reconsolidation for Natural Language Processing," Cognitive Neurodynamics , 3, 2009: 365-372. M.M. Olsen, N...computerized memories and other state of the art cognitive architectures, our memory system has the ability to process on-line and in real-time as...on both continuous and binary inputs, unlike state of the art methods in case based reasoning and in cognitive architectures, which are bound to

On problematic aspects in learning trigonometry

NASA Astrophysics Data System (ADS)

Kamber, Dina; Takaci, Djurdjica

2018-02-01

In this paper, research on some problematic aspects high school students have in learning trigonometry is presented. It is based on making sense of mathematics through perception, operation and reason in the case of trigonometry. We analyzed students' understanding of trigonometric concepts in the frame of triangle and circle trigonometry contexts, as well as the transition between these two contexts. In the conclusion, we present some new problematic aspects we noticed.

Connecting United States Air Force Core Values to Mission Accomplishment

DTIC Science & Technology

2014-06-04

making ( Kohlberg , 2008), to published works with a specific focus on ethics in the Air Force. The case studies referenced throughout the paper are used...useful backdrop for solving this problem. Lawrence Kohlberg , an American psychologist, experimentally derived a model for moral development based...on the cognitive reasoning one employs in making moral decisions and solving ethical quandaries ( Kohlberg , 2008). How one thinks through moral and

Extending Case-Based Reasoning (CBR) Approaches to Semi-automated Network Alert Reporting

DTIC Science & Technology

2013-04-01

connecting to the domain is likely infected with malware, or may have been exposed to malicious code. -- Detailed Information: The Sourcefire VRT ...to be generated by malware. After applying an extensive whitelist, the VRT pulls out the most commonly visited domains and adds them to its...malicious software. The VRT recommends ClamAV for Windows 3.0. 39 -- Contributors: Sourcefire Vulnerability Research Team -- Additional

Framework for the mapping of the monthly average daily solar radiation using an advanced case-based reasoning and a geostatistical technique.

PubMed

Lee, Minhyun; Koo, Choongwan; Hong, Taehoon; Park, Hyo Seon

2014-04-15

For the effective photovoltaic (PV) system, it is necessary to accurately determine the monthly average daily solar radiation (MADSR) and to develop an accurate MADSR map, which can simplify the decision-making process for selecting the suitable location of the PV system installation. Therefore, this study aimed to develop a framework for the mapping of the MADSR using an advanced case-based reasoning (CBR) and a geostatistical technique. The proposed framework consists of the following procedures: (i) the geographic scope for the mapping of the MADSR is set, and the measured MADSR and meteorological data in the geographic scope are collected; (ii) using the collected data, the advanced CBR model is developed; (iii) using the advanced CBR model, the MADSR at unmeasured locations is estimated; and (iv) by applying the measured and estimated MADSR data to the geographic information system, the MADSR map is developed. A practical validation was conducted by applying the proposed framework to South Korea. It was determined that the MADSR map developed through the proposed framework has been improved in terms of accuracy. The developed MADSR map can be used for estimating the MADSR at unmeasured locations and for determining the optimal location for the PV system installation.

A way forward for teaching and learning of Physiology: Students’ perception of the effectiveness of teaching methodologies

PubMed Central

Rehan, Rabiya; Ahmed, Khalid; Khan, Hira; Rehman, Rehana

2016-01-01

Objective: To compare the perception of medical students on the usefulness of the interactive lectures, case-based lectures, and structured interactive sessions (SIS) in teaching and learning of Physiology. Methods: A cross-sectional study was carried out from January to December 2012 at Bahria University Medical & Dental College, Karachi, which had qualitative and quantitative aspects, assessed by self- reported questionnaire and focused group discussion (FGD). The questionnaire was distributed to 100 medical students after completion of first year of teaching of MBBS Physiology. The data was analyzed using SPSS version 15. Differences were considered significant at p-values <0.05 after application of Friedman test. Responses of FGD were analyzed. Results: All the teaching methodologies helped in understanding of precise learning objectives. The comprehension of structure and functions with understanding of difficult concepts was made best possible by SIS (p=0.04, p<0.01). SIS enabled adult learning, self-directed learning, peer learning and critical reasoning more than the other teaching strategies (p< 0.01). Conclusion: SIS involved students who used reasoning skills and power of discussion in a group to comprehend difficult concepts for better understanding of Physiology as compared to interactive and case-based lectures. PMID:28083047

Analysis of caries status development in relation to socio-economic variables using a case-based system.

PubMed

Swedberg, Y; Norén, J G

2001-01-01

The aim of this study was to detect, using case-based reasoning (CBR) induction methods in time series analysis, how measurable socio-economical adjustments were related to the caries status development. The study concerned the year classes leaving the organised dental care for the time period 1987-95, and had received dental care at the Public Dental Service of Göteborg. The results, as presented by a caries incidence index, indicated that at least one socioeconomical factor, individuals seeking employment, was of importance for the caries status development, a factor with an increase of considerable proportions since 1990. The findings indicated that the other socio-economic variables used did not have the same importance for the caries status development. One feasible explanation is that these factors reflect more upon the social family situation than the economical. If the caries status reflects the social situation of the individual more than the economical, this argument will elucidate the reasoning. Using CBR for the analysis of relationships between oral disease and parameters possibly influencing health development has proven to be a valuable tool and complement to more traditional statistical methods. The analysis can make relationships explicit through the hierarchic knowledge trees and also show redundant information, attributes not appearing in the trees.

From spoken narratives to domain knowledge: mining linguistic data for medical image understanding.

PubMed

Guo, Xuan; Yu, Qi; Alm, Cecilia Ovesdotter; Calvelli, Cara; Pelz, Jeff B; Shi, Pengcheng; Haake, Anne R

2014-10-01

Extracting useful visual clues from medical images allowing accurate diagnoses requires physicians' domain knowledge acquired through years of systematic study and clinical training. This is especially true in the dermatology domain, a medical specialty that requires physicians to have image inspection experience. Automating or at least aiding such efforts requires understanding physicians' reasoning processes and their use of domain knowledge. Mining physicians' references to medical concepts in narratives during image-based diagnosis of a disease is an interesting research topic that can help reveal experts' reasoning processes. It can also be a useful resource to assist with design of information technologies for image use and for image case-based medical education systems. We collected data for analyzing physicians' diagnostic reasoning processes by conducting an experiment that recorded their spoken descriptions during inspection of dermatology images. In this paper we focus on the benefit of physicians' spoken descriptions and provide a general workflow for mining medical domain knowledge based on linguistic data from these narratives. The challenge of a medical image case can influence the accuracy of the diagnosis as well as how physicians pursue the diagnostic process. Accordingly, we define two lexical metrics for physicians' narratives--lexical consensus score and top N relatedness score--and evaluate their usefulness by assessing the diagnostic challenge levels of corresponding medical images. We also report on clustering medical images based on anchor concepts obtained from physicians' medical term usage. These analyses are based on physicians' spoken narratives that have been preprocessed by incorporating the Unified Medical Language System for detecting medical concepts. The image rankings based on lexical consensus score and on top 1 relatedness score are well correlated with those based on challenge levels (Spearman correlation>0.5 and Kendall correlation>0.4). Clustering results are largely improved based on our anchor concept method (accuracy>70% and mutual information>80%). Physicians' spoken narratives are valuable for the purpose of mining the domain knowledge that physicians use in medical image inspections. We also show that the semantic metrics introduced in the paper can be successfully applied to medical image understanding and allow discussion of additional uses of these metrics. Copyright © 2014 Elsevier B.V. All rights reserved.

15 CFR 970.210 - Reasonable time for full compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Reasonable time for full compliance... THE ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR EXPLORATION LICENSES Applications Procedures § 970.210 Reasonable time for full compliance. Priority of right will not be lost in case of any...

A Priori Knowledge and Heuristic Reasoning in Architectural Design.

ERIC Educational Resources Information Center

Rowe, Peter G.

1982-01-01

It is proposed that the various classes of a priori knowledge incorporated in heuristic reasoning processes exert a strong influence over architectural design activity. Some design problems require exercise of some provisional set of rules, inference, or plausible strategy which requires heuristic reasoning. A case study illustrates this concept.…

What Physicians Reason about during Admission Case Review

ERIC Educational Resources Information Center

Juma, Salina; Goldszmidt, Mark

2017-01-01

Research suggests that physicians perform multiple reasoning tasks beyond diagnosis during patient review. However, these remain largely theoretical. The purpose of this study was to explore reasoning tasks in clinical practice during patient admission review. The authors used a constant comparative approach--an iterative and inductive process of…

Professional Learning in Mathematical Reasoning: Reflections of a Primary Teacher

ERIC Educational Resources Information Center

Herbert, Sandra; Widjaja, Wanty; Bragg, Leicha A.; Loong, Esther; Vale, Colleen

2016-01-01

Reasoning is an important aspect in the understanding and learning of mathematics. This paper reports on a case study presenting one Australian primary teacher's reflections regarding the role played by a professional learning program in her developing understanding of mathematical reasoning. Examination of the transcripts of two interviews…

Math Activities that Encourage Inductive Thinking

ERIC Educational Resources Information Center

Freeman, Christopher

2005-01-01

There are two kinds of logical reasoning: "inductive" and "deductive". Inductive reasoning proceeds from effect back to cause, from special case to general principle. Detectives use it, examining the clues and conjecturing the actions that caused them. On the other hand, deductive reasoning proceeds from cause to effect, from principle to…

Cognitive and attentional functioning in adolescents and young adults with Tetralogy of Fallot and d-transposition of the great arteries.

PubMed

Murphy, Lexa K; Compas, Bruce E; Reeslund, Kristen L; Gindville, Melissa C; Mah, May Ling; Markham, Larry W; Jordan, Lori C

2017-01-01

The objective of this study is to investigate cognitive and attentional function in adolescents and young adults with operated congenital heart disease. Previous research has indicated that children with congenital heart disease have deficits in broad areas of cognitive function. However, less attention has been given to survivors as they grow into adolescence and early adulthood. The participants were 18 non-syndromic adolescents and young adults with tetralogy of Fallot and d-transposition of the great arteries that required cardiac surgery before the age of 5 years, and 18 healthy, unaffected siblings (11-22 years of age for both groups). Cases with congenital heart disease and their siblings were administered Wechsler Intelligence scales and reported attention problems using the Achenbach System of Empirically Based Assessments. Cases were compared to both healthy siblings and established norms. Cases performed significantly lower than siblings on full scale IQ and processing speed, and significantly lower than norms on perceptual reasoning. Cases also reported more attention problems compared to both siblings and norms. Effect sizes varied with medium-to-large effects for processing speed, perceptual reasoning, working memory, and attention problems. Findings suggest that neurocognitive function may continue to be affected for congenital heart disease survivors in adolescence and young adulthood, and that comparisons to established norms may underestimate neurocognitive vulnerabilities.

Severe forms of concealed penis without hypospadias: Surgical strategies

PubMed Central

de Jesus, Lisieux Eyer; Dekermacher, Samuel; Anderson, Kleber M.

2015-01-01

Introduction: Concealed penis (CP) may vary in severity and includes megaprepuce (MP) as a variant. Many different surgical strategies have been described in order to maximize penile exposure and to deal with skin deficiency. We describe the strategies that we use to overcome technical problems in severe cases of CP. Materials and Methods: Six consecutive cases of severe CP (including 3 with MP) were treated in a 2-year period between January 2011 and April 2013. These patients were treated using extensive degloving, removal of dysplastic dartos, Alexander's preputial flap, scrotal flaps and skin grafts. Three patients had been previously circumcised. Cases associated with hypospadias, obesity, disorders of sexual differentiation and micropenises were excluded. Results: All six patients attained good results, with good exposure of the penis, ability to void standing with a well-directed flow and reasonable esthetic results. A technical algorithm for the treatment of primary or recurring cases of CP is proposed. Conclusion: Alexander’ s distally based ventral preputial flap is a useful technical resource to treat MP cases. Free skin grafts and/or laterally based scrotal flaps may be used to cover the penis after release in severe cases of CP. PMID:26604447

Microwave Passive Ground-Based Retrievals of Cloud and Rain Liquid Water Path in Drizzling Clouds: Challenges and Possibilities

DOE PAGES

Cadeddu, Maria P.; Marchand, Roger; Orlandi, Emiliano; ...

2017-08-11

Satellite and ground-based microwave radiometers are routinely used for the retrieval of liquid water path (LWP) under all atmospheric conditions. The retrieval of water vapor and LWP from ground-based radiometers during rain has proved to be a difficult challenge for two principal reasons: the inadequacy of the nonscattering approximation in precipitating clouds and the deposition of rain drops on the instrument's radome. In this paper, we combine model computations and real ground-based, zenith-viewing passive microwave radiometer brightness temperature measurements to investigate how total, cloud, and rain LWP retrievals are affected by assumptions on the cloud drop size distribution (DSD) andmore » under which conditions a nonscattering approximation can be considered reasonably accurate. Results show that until the drop effective diameter is larger than similar to 200 mu m, a nonscattering approximation yields results that are still accurate at frequencies less than 90 GHz. For larger drop sizes, it is shown that higher microwave frequencies contain useful information that can be used to separate cloud and rain LWP provided that the vertical distribution of hydrometeors, as well as the DSD, is reasonably known. The choice of the DSD parameters becomes important to ensure retrievals that are consistent with the measurements. A physical retrieval is tested on a synthetic data set and is then used to retrieve total, cloud, and rain LWP from radiometric measurements during two drizzling cases at the atmospheric radiation measurement Eastern North Atlantic site.« less

Microwave Passive Ground-Based Retrievals of Cloud and Rain Liquid Water Path in Drizzling Clouds: Challenges and Possibilities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Cadeddu, Maria P.; Marchand, Roger; Orlandi, Emiliano

Satellite and ground-based microwave radiometers are routinely used for the retrieval of liquid water path (LWP) under all atmospheric conditions. The retrieval of water vapor and LWP from ground-based radiometers during rain has proved to be a difficult challenge for two principal reasons: the inadequacy of the nonscattering approximation in precipitating clouds and the deposition of rain drops on the instrument's radome. In this paper, we combine model computations and real ground-based, zenith-viewing passive microwave radiometer brightness temperature measurements to investigate how total, cloud, and rain LWP retrievals are affected by assumptions on the cloud drop size distribution (DSD) andmore » under which conditions a nonscattering approximation can be considered reasonably accurate. Results show that until the drop effective diameter is larger than similar to 200 mu m, a nonscattering approximation yields results that are still accurate at frequencies less than 90 GHz. For larger drop sizes, it is shown that higher microwave frequencies contain useful information that can be used to separate cloud and rain LWP provided that the vertical distribution of hydrometeors, as well as the DSD, is reasonably known. The choice of the DSD parameters becomes important to ensure retrievals that are consistent with the measurements. A physical retrieval is tested on a synthetic data set and is then used to retrieve total, cloud, and rain LWP from radiometric measurements during two drizzling cases at the atmospheric radiation measurement Eastern North Atlantic site.« less

Faculty Development for Fostering Clinical Reasoning Skills in Early Medical Students Using a Modified Bayesian Approach.

PubMed

Addy, Tracie Marcella; Hafler, Janet; Galerneau, France

2016-01-01

Clinical reasoning is a necessary skill for medical students to acquire in the course of their education, and there is evidence that they can start this process at the undergraduate level. However, physician educators who are experts in their given fields may have difficulty conveying their complex thought processes to students. Providing faculty development that equips educators with tools to teach clinical reasoning may support skill development in early medical students. We provided faculty development on a modified Bayesian method of teaching clinical reasoning to clinician educators who facilitated small-group, case-based workshops with 2nd-year medical students. We interviewed them before and after the module regarding their perceptions on teaching clinical reasoning. We solicited feedback from the students about the effectiveness of the method in developing their clinical reasoning skills. We carried out this project during an institutional curriculum rebuild where clinical reasoning was a defined goal. At the time of the intervention, there was also increased involvement of the Teaching and Learning Center in elevating the status of teaching and learning. There was high overall satisfaction with the faculty development program. Both the faculty and the students described the modified Bayesian approach as effective in fostering the development of clinical reasoning skills. Through this work, we learned how to form a beneficial partnership between a clinician educator and Teaching and Learning Center to promote faculty development on a clinical reasoning teaching method for early medical students. We uncovered challenges faced by both faculty and early learners in this study. We observed that our faculty chose to utilize the method of teaching clinical reasoning in a variety of manners in the classroom. Despite obstacles and differing approaches utilized, we believe that this model can be emulated at other institutions to foster the development of clinical reasoning skills in preclerkship students.

The need for the use of XACML access control policy in a distributed EHR and some performance considerations.

PubMed

Sucurovic, Snezana; Milutinovic, Veljko

2008-01-01

The Internet based distributed large scale information systems implements attribute based access control (ABAC) rather than Role Based Access Control (RBAC). The reason is that the Internet is identity less and that ABAC scales better. EXtensible Access Control Markup Language is standardized language for writing access control policies, access control requests and access control responses in ABAC. XACML can provide decentralized administration and credentials distribution. In year 2002 version of CEN ENV 13 606 attributes have been attached to EHCR components and in such a system ABAC and XACML have been easy to implement. This paper presents writing XACML policies in the case when attributes are in hierarchical structure. It is presented two possible solutions to write XACML policy in that case and that the solution when set functions are used is more compact and provides 10% better performances.

The effect of question format and task difficulty on reasoning strategies and diagnostic performance in Internal Medicine residents.

PubMed

Heemskerk, Laura; Norman, Geoff; Chou, Sophia; Mintz, Marcy; Mandin, Henry; McLaughlin, Kevin

2008-11-01

Previous studies have suggested an association between reasoning strategies and diagnostic success, but the influence on this relationship of variables such as question format and task difficulty, has not been studied. Our objective was to study the association between question format, task difficulty, reasoning strategies and diagnostic success. Study participants were 13 Internal Medicine residents at the University of Calgary. Each was given eight problem-solving questions in four clinical presentations and were randomized to groups that differed only in the question format, such that a question presented as short answer (SA) to the first group was presented as extended matching (EM) to the second group. There were equal numbers of SA/EM questions and straightforward/difficult tasks. Participants performed think-aloud during diagnostic reasoning. Data were analyzed using multiple logistic regression. Question format was associated with reasoning strategies; hypothetico-deductive reasoning being used more frequently on EM questions and scheme-inductive reasoning on SA questions. For SA question, non-analytic reasoning alone was used more frequently to answer straightforward cases than difficult cases, whereas for EM questions no such association was observed. EM format and straightforward task increased the odds of diagnostic success, whereas hypothetico-deductive reasoning was associated with reduced odds of success. Question format and task difficulty both influence diagnostic reasoning strategies and studies that examine the effect of reasoning strategies on diagnostic success should control for these effects. Further studies are needed to investigate the effect of reasoning strategies on performance of different groups of learners.

Application of a temporal reasoning framework tool in analysis of medical device adverse events.

PubMed

Clark, Kimberly K; Sharma, Deepak K; Chute, Christopher G; Tao, Cui

2011-01-01

The Clinical Narrative Temporal Relation Ontology (CNTRO)1 project offers a semantic-web based reasoning framework, which represents temporal events and relationships within clinical narrative texts, and infer new knowledge over them. In this paper, the CNTRO reasoning framework is applied to temporal analysis of medical device adverse event files. One specific adverse event was used as a test case: late stent thrombosis. Adverse event narratives were obtained from the Food and Drug Administration's (FDA) Manufacturing and User Facility Device Experience (MAUDE) database2. 15 adverse event files in which late stent thrombosis was confirmed were randomly selected across multiple drug eluting stent devices. From these files, 81 events and 72 temporal relations were annotated. 73 temporal questions were generated, of which 65 were correctly answered by the CNTRO system. This results in an overall accuracy of 89%. This system should be pursued further to continue assessing its potential benefits in temporal analysis of medical device adverse events.

SOMWeb: a semantic web-based system for supporting collaboration of distributed medical communities of practice.

PubMed

Falkman, Göran; Gustafsson, Marie; Jontell, Mats; Torgersson, Olof

2008-08-26

Information technology (IT) support for remote collaboration of geographically distributed communities of practice (CoP) in health care must deal with a number of sociotechnical aspects of communication within the community. In the mid-1990s, participants of the Swedish Oral Medicine Network (SOMNet) began discussing patient cases in telephone conferences. The cases were distributed prior to the conferences using PowerPoint and email. For the technical support of online CoP, Semantic Web technologies can potentially fulfill needs of knowledge reuse, data exchange, and reasoning based on ontologies. However, more research is needed on the use of Semantic Web technologies in practice. The objectives of this research were to (1) study the communication of distributed health care professionals in oral medicine; (2) apply Semantic Web technologies to describe community data and oral medicine knowledge; (3) develop an online CoP, Swedish Oral Medicine Web (SOMWeb), centered on user-contributed case descriptions and meetings; and (4) evaluate SOMWeb and study how work practices change with IT support. Based on Java, and using the Web Ontology Language and Resource Description Framework for handling community data and oral medicine knowledge, SOMWeb was developed using a user-centered and iterative approach. For studying the work practices and evaluating the system, a mixed-method approach of interviews, observations, and a questionnaire was used. By May 2008, there were 90 registered users of SOMWeb, 93 cases had been added, and 18 meetings had utilized the system. The introduction of SOMWeb has improved the structure of meetings and their discussions, and a tenfold increase in the number of participants has been observed. Users submit cases to seek advice on diagnosis or treatment, to show an unusual case, or to create discussion. Identified barriers to submitting cases are lack of time, concern about whether the case is interesting enough, and showing gaps in one's own knowledge. Three levels of member participation are discernable: a core group that contributes most cases and most meeting feedback; an active group that participates often but only sometimes contribute cases and feedback; and a large peripheral group that seldom or never contribute cases or feedback. SOMWeb is beneficial for individual clinicians as well as for the SOMNet community. The system provides an opportunity for its members to share both high quality clinical practice knowledge and external evidence related to complex oral medicine cases. The foundation in Semantic Web technologies enables formalization and structuring of case data that can be used for further reasoning and research. Main success factors are the long history of collaboration between different disciplines, the user-centered development approach, the existence of a "champion" within the field, and nontechnical community aspects already being in place.

SOMWeb: A Semantic Web-Based System for Supporting Collaboration of Distributed Medical Communities of Practice

PubMed Central

Gustafsson, Marie; Jontell, Mats; Torgersson, Olof

2008-01-01

Background Information technology (IT) support for remote collaboration of geographically distributed communities of practice (CoP) in health care must deal with a number of sociotechnical aspects of communication within the community. In the mid-1990s, participants of the Swedish Oral Medicine Network (SOMNet) began discussing patient cases in telephone conferences. The cases were distributed prior to the conferences using PowerPoint and email. For the technical support of online CoP, Semantic Web technologies can potentially fulfill needs of knowledge reuse, data exchange, and reasoning based on ontologies. However, more research is needed on the use of Semantic Web technologies in practice. Objectives The objectives of this research were to (1) study the communication of distributed health care professionals in oral medicine; (2) apply Semantic Web technologies to describe community data and oral medicine knowledge; (3) develop an online CoP, Swedish Oral Medicine Web (SOMWeb), centered on user-contributed case descriptions and meetings; and (4) evaluate SOMWeb and study how work practices change with IT support. Methods Based on Java, and using the Web Ontology Language and Resource Description Framework for handling community data and oral medicine knowledge, SOMWeb was developed using a user-centered and iterative approach. For studying the work practices and evaluating the system, a mixed-method approach of interviews, observations, and a questionnaire was used. Results By May 2008, there were 90 registered users of SOMWeb, 93 cases had been added, and 18 meetings had utilized the system. The introduction of SOMWeb has improved the structure of meetings and their discussions, and a tenfold increase in the number of participants has been observed. Users submit cases to seek advice on diagnosis or treatment, to show an unusual case, or to create discussion. Identified barriers to submitting cases are lack of time, concern about whether the case is interesting enough, and showing gaps in one’s own knowledge. Three levels of member participation are discernable: a core group that contributes most cases and most meeting feedback; an active group that participates often but only sometimes contribute cases and feedback; and a large peripheral group that seldom or never contribute cases or feedback. Conclusions SOMWeb is beneficial for individual clinicians as well as for the SOMNet community. The system provides an opportunity for its members to share both high quality clinical practice knowledge and external evidence related to complex oral medicine cases. The foundation in Semantic Web technologies enables formalization and structuring of case data that can be used for further reasoning and research. Main success factors are the long history of collaboration between different disciplines, the user-centered development approach, the existence of a “champion” within the field, and nontechnical community aspects already being in place. PMID:18725355

To Produce Conjectures and to Prove Them within a Dynamic Geometry Environment: A Case Study

ERIC Educational Resources Information Center

Furinghetti, Fulvia; Paola, Domingo

2003-01-01

This paper analyses a case study of a pair of students working together, who were asked to produce conjectures and to validate them within the dynamic geometry environment Cabri. Our aim is to scrutinize the students' reasoning, how the gap from perception to theory is filled, how Cabri influences the reasoning. We have singled out a sequence of…

Model Based Reasoning by Introductory Students When Analyzing Earth Systems and Societal Challenges

NASA Astrophysics Data System (ADS)

Holder, L. N.; Herbert, B. E.

2014-12-01

Understanding how students use their conceptual models to reason about societal challenges involving societal issues such as natural hazard risk assessment, environmental policy and management, and energy resources can improve instructional activity design that directly impacts student motivation and literacy. To address this question, we created four laboratory exercises for an introductory physical geology course at Texas A&M University that engages students in authentic scientific practices by using real world problems and issues that affect societies based on the theory of situated cognition. Our case-study design allows us to investigate the various ways that students utilize model based reasoning to identify and propose solutions to societally relevant issues. In each of the four interventions, approximately 60 students in three sections of introductory physical geology were expected to represent and evaluate scientific data, make evidence-based claims about the data trends, use those claims to express conceptual models, and use their models to analyze societal challenges. Throughout each step of the laboratory exercise students were asked to justify their claims, models, and data representations using evidence and through the use of argumentation with peers. Cognitive apprenticeship was the foundation for instruction used to scaffold students so that in the first exercise they are given a partially completed model and in the last exercise students are asked to generate a conceptual model on their own. Student artifacts, including representation of earth systems, representation of scientific data, verbal and written explanations of models and scientific arguments, and written solutions to specific societal issues or environmental problems surrounding earth systems, were analyzed through the use of a rubric that modeled authentic expertise and students were sorted into three categories. Written artifacts were examined to identify student argumentation and justifications of solutions through the use of evidence and reasoning. Higher scoring students justified their solutions through evidence-based claims, while lower scoring students typically justified their solutions using anecdotal evidence, emotional ideologies, and naive and incomplete conceptions of earth systems.

Taeniasis/cysticercosis in Bali, Indonesia.

PubMed

Wandra, Toni; Sudewi, A A Raka; Swastika, I Kadek; Sutisna, Putu; Dharmawan, Nyoman S; Yulfi, Hemma; Darlan, Dewi Masyithah; Kapti, I Nengah; Samaan, Gina; Sato, Marcello Otake; Okamoto, Munehiro; Sako, Yasuhito; Ito, Akira

2011-07-01

Taenia solium and Taenia saginata are found in humans in Bali, Indonesia. During a field survey of 660 people in Bali from 2002-2009 of taeniasis/cysticercosis cases using mitochondrial DNA confirmation of the species, we detected 80 cases of T. saginata taeniasis, 2 dual T. saginata/T. solium infections with T. solium metacestodes in the brain and 12 neurocysticercosis (NCC) cases at Sanglah Hospital, Denpasar. Although the prevalence of NCC in Bali is low, sporadic cases are still present. There is no Taenia asiatica in Bali. We summarize here the field survey findings of taeniasis, including 1 dual infection with taeniasis and cysticercosis in 2007, and the reason why there are no T. asiatica cases and we describe 3 NCC cases admitted to Sanglah Hospital, Denpasar, Bali in 2004. Diagnosis was based on anamnesis, clinical examination, including CT Scan, histopathological, serological and mitochondrial DNA examinations. In order to prevent unexpected symptomatic NCC after treatment with praziquantel, we recommend introducing a rapid test to confirm taeniasis carriers and cysticercosis cases as a tool for real time diagnosis.

Using Computer Simulations for Promoting Model-based Reasoning. Epistemological and Educational Dimensions

NASA Astrophysics Data System (ADS)

Develaki, Maria

2017-11-01

Scientific reasoning is particularly pertinent to science education since it is closely related to the content and methodologies of science and contributes to scientific literacy. Much of the research in science education investigates the appropriate framework and teaching methods and tools needed to promote students' ability to reason and evaluate in a scientific way. This paper aims (a) to contribute to an extended understanding of the nature and pedagogical importance of model-based reasoning and (b) to exemplify how using computer simulations can support students' model-based reasoning. We provide first a background for both scientific reasoning and computer simulations, based on the relevant philosophical views and the related educational discussion. This background suggests that the model-based framework provides an epistemologically valid and pedagogically appropriate basis for teaching scientific reasoning and for helping students develop sounder reasoning and decision-taking abilities and explains how using computer simulations can foster these abilities. We then provide some examples illustrating the use of computer simulations to support model-based reasoning and evaluation activities in the classroom. The examples reflect the procedure and criteria for evaluating models in science and demonstrate the educational advantages of their application in classroom reasoning activities.

Combination of DNA-based and conventional methods to detect human leukocyte antigen polymorphism and its use for paternity testing.

PubMed

Kereszturya, László; Rajczya, Katalin; Lászikb, András; Gyódia, Eva; Pénzes, Mária; Falus, András; Petrányia, Gyõzõ G

2002-03-01

In cases of disputed paternity, the scientific goal is to promote either the exclusion of a falsely accused man or the affiliation of the alleged father. Until now, in addition to anthropologic characteristics, the determination of genetic markers included human leukocyte antigen gene variants; erythrocyte antigens and serum proteins were used for that reason. Recombinant DNA techniques provided a new set of highly variable genetic markers based on DNA nucleotide sequence polymorphism. From the practical standpoint, the application of these techniques to paternity testing provides greater versatility than do conventional genetic marker systems. The use of methods to detect the polymorphism of human leukocyte antigen loci significantly increases the chance of validation of ambiguous results in paternity testing. The outcome of 2384 paternity cases investigated by serologic and/or DNA-based human leukocyte antigen typing was statistically analyzed. Different cases solved by DNA typing are presented involving cases with one or two accused men, exclusions and nonexclusions, and tests of the paternity of a deceased man. The results provide evidence for the advantage of the combined application of various techniques in forensic diagnostics and emphasizes the outstanding possibilities of DNA-based assays. Representative examples demonstrate the strength of combined techniques in paternity testing.

Current status of cardiovascular surgery in Japan, 2013 and 2014: A report based on the Japan Cardiovascular Surgery Database 3. Coronary artery bypass surgery.

PubMed

Saito, Aya; Hirahara, Norimichi; Motomura, Noboru; Miyata, Hiroaki; Takamoto, Shinichi

2018-01-01

Data on isolated coronary artery bypass grafting (CABG) performed in 2013 and 2014, and registered in the Japan Cardiovascular Surgery Database were reviewed for preoperative characteristics, postoperative outcomes, and choice of graft material for the left anterior descending artery (LAD). Isolated CABG was performed off-pump in 54.7% of cases, and graft material for the LAD was left internal thoracic artery in 74.3% and right internal thoracic artery in 15.6%. Operative mortality was 2.0% in elective cases, 8.2% in emergency cases, and 3.0% overall. In elective cases, operative mortality was 1.1% for off-pump CABG compared with 3.0% for on-pump CABG. Clinical results of our isolated CABG were reasonable and acceptable.

Reasoning over taxonomic change: exploring alignments for the Perelleschus use case.

PubMed

Franz, Nico M; Chen, Mingmin; Yu, Shizhuo; Kianmajd, Parisa; Bowers, Shawn; Ludäscher, Bertram

2015-01-01

Classifications and phylogenetic inferences of organismal groups change in light of new insights. Over time these changes can result in an imperfect tracking of taxonomic perspectives through the re-/use of Code-compliant or informal names. To mitigate these limitations, we introduce a novel approach for aligning taxonomies through the interaction of human experts and logic reasoners. We explore the performance of this approach with the Perelleschus use case of Franz & Cardona-Duque (2013). The use case includes six taxonomies published from 1936 to 2013, 54 taxonomic concepts (i.e., circumscriptions of names individuated according to their respective source publications), and 75 expert-asserted Region Connection Calculus articulations (e.g., congruence, proper inclusion, overlap, or exclusion). An Open Source reasoning toolkit is used to analyze 13 paired Perelleschus taxonomy alignments under heterogeneous constraints and interpretations. The reasoning workflow optimizes the logical consistency and expressiveness of the input and infers the set of maximally informative relations among the entailed taxonomic concepts. The latter are then used to produce merge visualizations that represent all congruent and non-congruent taxonomic elements among the aligned input trees. In this small use case with 6-53 input concepts per alignment, the information gained through the reasoning process is on average one order of magnitude greater than in the input. The approach offers scalable solutions for tracking provenance among succeeding taxonomic perspectives that may have differential biases in naming conventions, phylogenetic resolution, ingroup and outgroup sampling, or ostensive (member-referencing) versus intensional (property-referencing) concepts and articulations.

Assessment of horse owners' ability to recognise equine laminitis: A cross-sectional study of 93 veterinary diagnosed cases in Great Britain.

PubMed

Pollard, D; Wylie, C E; Verheyen, K L P; Newton, J R

2017-11-01

Use of owner-reported data could further epidemiological knowledge of equine laminitis. However, owner recognition of laminitis has not previously been assessed. The primary objective was to establish whether cases of owner-suspected laminitis would be confirmed as laminitis by the attending veterinary surgeon. Secondary objectives were to compare owner- and veterinary-reported information from veterinary-confirmed cases of equine laminitis. Cross-sectional study. Twenty-five British veterinary practices were invited to submit laminitis reporting forms (LRFs) for active laminitis cases attended between January 2014 and October 2015; detailing 27 clinical signs, 5 underlying conditions and 7 risk factors associated with laminitis. Owners were invited to independently complete a modified LRF if reason for the veterinary visit was suspicion of laminitis. Differences between paired veterinary and owner LRFs, and between cases where owners did and did not recognise laminitis, were assessed using McNemar's and Fisher's Exact tests, respectively. Veterinary LRFs were received for 93 veterinary-diagnosed laminitis cases. All 51 owner-suspected cases were confirmed by veterinary diagnosis, with the remaining 42 (45.2%) not recognised as laminitis by owners. Undefined lameness, foot abscesses, colic and stiffness were common reasons for owner-requested veterinary visits in owner-unrecognised cases. 'Divergent growth rings' (prevalence difference: +27.3%, P = 0.01) and 'breed type' (prevalence difference: +21.2%, P = 0.04) were more commonly reported by veterinary surgeons in owner-recognised compared to owner-unrecognised cases. 'Difficulty turning', 'shifting weight' and risk factor 'body condition' were more frequently reported by veterinary surgeons whilst 'increased hoof temperature' was reported more frequently by owners. The limited clinical data restricted statistical inferences regarding the secondary objectives. All owner-suspected laminitis cases were confirmed upon veterinary examination, showing validity for the inclusion of owner-reported cases in future epidemiological studies. However, failure of laminitis recognition by owners highlights further need for evidence-based education to ensure early disease detection. © 2017 EVJ Ltd.

Evaluating Secondary Students' Scientific Reasoning in Genetics Using a Two-Tier Diagnostic Instrument

NASA Astrophysics Data System (ADS)

Tsui, Chi-Yan; Treagust, David

2010-05-01

While genetics has remained as one key topic in school science, it continues to be conceptually and linguistically difficult for students with the concomitant debates as to what should be taught in the age of biotechnology. This article documents the development and implementation of a two-tier multiple-choice instrument for diagnosing grades 10 and 12 students' understanding of genetics in terms of reasoning. The pretest and posttest forms of the diagnostic instrument were used alongside other methods in evaluating students' understanding of genetics in a case-based qualitative study on teaching and learning with multiple representations in three Western Australian secondary schools. Previous studies have shown that a two-tier diagnostic instrument is useful in probing students' understanding or misunderstanding of scientific concepts and ideas. The diagnostic instrument in this study was designed and then progressively refined, improved, and implemented to evaluate student understanding of genetics in three case schools. The final version of the instrument had Cronbach's alpha reliability of 0.75 and 0.64, respectively, for its pretest and the posttest forms when it was administered to a group of grade 12 students (n = 17). This two-tier diagnostic instrument complemented other qualitative data collection methods in this research in generating a more holistic picture of student conceptual learning of genetics in terms of scientific reasoning. Implications of the findings of this study using the diagnostic instrument are discussed.

Problem-based learning: effects on student’s scientific reasoning skills in science

NASA Astrophysics Data System (ADS)

Wulandari, F. E.; Shofiyah, N.

2018-04-01

This research aimed to develop instructional package of problem-based learning to enhance student’s scientific reasoning from concrete to formal reasoning skills level. The instructional package was developed using the Dick and Carey Model. Subject of this study was instructional package of problem-based learning which was consisting of lesson plan, handout, student’s worksheet, and scientific reasoning test. The instructional package was tried out on 4th semester science education students of Universitas Muhammadiyah Sidoarjo by using the one-group pre-test post-test design. The data of scientific reasoning skills was collected by making use of the test. The findings showed that the developed instructional package reflecting problem-based learning was feasible to be implemented in classroom. Furthermore, through applying the problem-based learning, students could dominate formal scientific reasoning skills in terms of functionality and proportional reasoning, control variables, and theoretical reasoning.

Clinical Reasoning in the Assessment and Planning for Intervention for Oppositional Defiant Disorder

ERIC Educational Resources Information Center

Wilcox, Gabrielle; Heudes, Alethea

2017-01-01

Clinical reasoning requires thoughtful consideration of a variety of factors that contribute to the conceptualization of a case such as the reason for referral, school information, home environment, assessment outcomes, and behavioural observations made during assessments. The purpose of this article is to provide the reader with insight into the…

28 CFR 75.5 - Inspection of records.

Code of Federal Regulations, 2010 CFR

2010-07-01

... regular working hours and at other reasonable times, and within reasonable limits and in a reasonable..., which in no case may be less than 20 hours per week. (2) Upon commencing an inspection, the investigator... place during normal business hours and at such places as specified in § 75.4. For the purpose of this...

Stellate-cell lipidosis in liver biopsy specimens. Recognition and significance.

PubMed

Levine, Pascale Hummel; Delgado, Yara; Theise, Neil D; West, A Brian

2003-02-01

Hepatic stellate-cell lipidosis due to hypervitaminosis A can lead to cirrhosis, which can be averted by restricting vitamin A intake. Other causes, including the use of synthetic retinoids, have been postulated. We studied the frequency and etiology of stellate-cell lipidosis in patients undergoing liver biopsy for reasons other than vitamin A abuse. Fourteen cases (1.1%) were identified retrospectively among 1,235 nontransplant liver biopsy specimens examined from January 1995 through December 1999. Diagnostic criteria included the following: lipid-laden cells in the space of Disse; small, dark, crescent-shaped nuclei with inconspicuous nucleoli; and wispy cytoplasmic strands separating fat droplets. Patient details, reason for biopsy, and medication use were studied. Reasons for biopsy included hepatitis C (10 cases), abnormal liver enzyme levels (2 cases), methotrexate use (1 case), and alcohol abuse (1 case). Hypervitaminosis A was not suspected clinically in the 5 patients who used oral vitamin A or 3 who used topical tretinoin (Retin-A). In 6 patients, no cause of stellate-cell lipidosis was discerned. Stellate-cell lipidosis should be reported to alert clinicians to a potentially preventable form of liver injury.

In defense of compilation: A response to Davis' form and content in model-based reasoning

NASA Technical Reports Server (NTRS)

Keller, Richard

1990-01-01

In a recent paper entitled 'Form and Content in Model Based Reasoning', Randy Davis argues that model based reasoning research aimed at compiling task specific rules from underlying device models is mislabeled, misguided, and diversionary. Some of Davis' claims are examined and his basic conclusions are challenged about the value of compilation research to the model based reasoning community. In particular, Davis' claim is refuted that model based reasoning is exempt from the efficiency benefits provided by knowledge compilation techniques. In addition, several misconceptions are clarified about the role of representational form in compilation. It is concluded that techniques have the potential to make a substantial contribution to solving tractability problems in model based reasoning.

Improving critical thinking and clinical reasoning with a continuing education course.

PubMed

Cruz, Dina Monteiro; Pimenta, Cibele Mattos; Lunney, Margaret

2009-03-01

Continuing education courses related to critical thinking and clinical reasoning are needed to improve the accuracy of diagnosis. This study evaluated a 4-day, 16-hour continuing education course conducted in Brazil.Thirty-nine nurses completed a pretest and a posttest consisting of two written case studies designed to measure the accuracy of nurses' diagnoses. There were significant differences in accuracy from pretest to posttest for case 1 (p = .008) and case 2 (p = .042) and overall (p = .001). Continuing education courses should be implemented to improve the accuracy of nurses' diagnoses.

Labour market trajectories following sickness absence due to self-reported all cause morbidity--a longitudinal study.

PubMed

Pedersen, Pernille; Lund, Thomas; Lindholdt, Louise; Nohr, Ellen A; Jensen, Chris; Søgaard, Hans Jørgen; Labriola, Merete

2016-04-16

To investigate differences in return to work (RTW) and employment trajectories in individuals on sick leave for either mental health reasons or other health related reasons. This study was based on 2036 new sickness absence cases who completed a questionnaire on social characteristics, expectations for RTW and reasons for sickness absence. They were divided into two exposure groups according to their self-reported sickness absence reason: mental health reasons or other health reasons. The outcome was employment status during the following 51 weeks and was measured both as time-to-event analysis and with sequence analysis. Individuals with mental health reasons for sickness absence had a higher risk of not having returned to work (RR 0.87 (0.80;0.93)). Adjusting for gender, age, education and employment did not change the estimate, however, after adding RTW expectations to the model, the excess risk was no longer present (RR 1.01 (0.95;1.08)). In relation to the sequence analysis, individuals with mental health related absence had significantly higher odds of being in the sickness absence cluster and significantly lower odds for being in the fast RTW cluster, but when adjusting for RTW expectations, the odds were somewhat attenuated and no longer significant. Employees on sick leave due to self-reported mental health problems spent more weeks in sickness absence and temporary benefits and had a higher risk of not having returned to work within a year compared to employees on sick leave due to other health reasons. The difference could be explained by their lower RTW expectations at baseline. This emphasises the need to develop suitable and specific interventions to facilitate RTW for this group of sickness absentees.

Idiopathic masseter muscle hypertrophy.

PubMed

Kebede, Biruktawit; Megersa, Shimalis

2011-11-01

Benign Masseteric Hypertrophy is a relatively uncommon condition that can occur unilaterally or bilaterally. Pain may be a symptom, but most frequently a clinician is consulted for cosmetic reasons. In some cases prominent Exostoses at the angle of the mandible are noted. Although it is tempting to point to Malocclusion, Bruxism, clenching, or Temporomandibular joint disorders, the etiology in the majority of cases is unclear. Diagnosis is based on awareness of the condition, clinical and radiographic findings, and exclusion of more serious Pathology such as Benign and Malignant Parotid Disease, Rhabdomyoma, and Lymphangioma. Treatment usually involves resection of a portion of the Masseter muscle with or without the underlying bone.

ED-WAVE tool design approach: Case of a textile wastewater treatment plant in Blantyre, Malawi

NASA Astrophysics Data System (ADS)

Chipofya, V.; Kraslawski, A.; Avramenko, Y.

The ED-WAVE tool is a PC based package for imparting training on wastewater treatment technologies. The system consists of four modules viz. Reference Library, Process Builder, Case Study Manager, and Treatment Adviser. The principles of case-based design and case-based reasoning as applied in the ED-WAVE tool are utilised in this paper to evaluate the design approach of the wastewater treatment plant at Mapeto David Whitehead & Sons (MDW&S) textile and garments factory, Blantyre, Malawi. The case being compared with MDW&S in the ED-WAVE tool is Textile Case 4 in Sri Lanka (2003). Equalisation, coagulation and rotating biological contactors is the sequencing of treatment units at Textile Case 4 in Sri Lanka. Screening, oxidation ditches and sedimentation is the sequencing of treatment units at MDW&S textile and garments factory. The study suggests that aerobic biological treatment is necessary in the treatment of wastewater from a textile and garments factory. MDW&S incorporates a sedimentation process which is necessary for the removal of settleable matter before the effluent is discharged to the municipal wastewater treatment plant. The study confirmed the practical use of the ED-WAVE tool in the design of wastewater treatment systems, where after encountering a new situation; already collected decision scenarios (cases) are invoked and modified in order to arrive at a particular design alternative. What is necessary, however, is to appropriately modify the case arrived at through the Case Study Manager in order to come up with a design appropriate to the local situation taking into account technical, socio-economic and environmental aspects.

Electrical conductivity modeling and experimental study of densely packed SWCNT networks.

PubMed

Jack, D A; Yeh, C-S; Liang, Z; Li, S; Park, J G; Fielding, J C

2010-05-14

Single-walled carbon nanotube (SWCNT) networks have become a subject of interest due to their ability to support structural, thermal and electrical loadings, but to date their application has been hindered due, in large part, to the inability to model macroscopic responses in an industrial product with any reasonable confidence. This paper seeks to address the relationship between macroscale electrical conductivity and the nanostructure of a dense network composed of SWCNTs and presents a uniquely formulated physics-based computational model for electrical conductivity predictions. The proposed model incorporates physics-based stochastic parameters for the individual nanotubes to construct the nanostructure such as: an experimentally obtained orientation distribution function, experimentally derived length and diameter distributions, and assumed distributions of chirality and registry of individual CNTs. Case studies are presented to investigate the relationship between macroscale conductivity and nanostructured variations in the bulk stochastic length, diameter and orientation distributions. Simulation results correspond nicely with those available in the literature for case studies of conductivity versus length and conductivity versus diameter. In addition, predictions for the increasing anisotropy of the bulk conductivity as a function of the tube orientation distribution are in reasonable agreement with our experimental results. Examples are presented to demonstrate the importance of incorporating various stochastic characteristics in bulk conductivity predictions. Finally, a design consideration for industrial applications is discussed based on localized network power emission considerations and may lend insight to the design engineer to better predict network failure under high current loading applications.

Positive and negative effects of dielectric breakdown in transformer oil based magnetic fluids

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Jong-Chul, E-mail: jclee01@gwnu.ac.kr; Lee, Won-Ho; Lee, Se-Hee

The transformer oil based magnetic fluids can be considered as the next-generation insulation fluids because they offer exciting new possibilities to enhance dielectric breakdown voltage as well as heat transfer performance compared to pure transformer oils. In this study, we have investigated the dielectric breakdown strength of the fluids with the various volume concentrations of nanoparticles in accordance with IEC 156 standard and have tried to find the reason for changing the dielectric breakdown voltage of the fluids from the magnetic field analysis. It was found that the dielectric breakdown voltage of pure transformer oil is around 12 kV withmore » the gap distance of 1.5 mm. In the case of our transformer oil-based magnetic fluids with 0.08% < Φ < 0.6% (Φ means the volume concentration of magnetic nanoparticles), the dielectric breakdown voltage shows above 40 kV, which is 3.3 times higher positively than that of pure transformer oil. Negatively in the case when the volume concentration of magnetic nanoparticles is above 0.65%, the dielectric breakdown voltage decreases reversely. From the magnetic field analysis, the reason might be considered as two situations: the positive is for the conductive nanoparticles dispersed well near the electrodes, which play an important role in converting fast electrons to slow negatively charged particles, and the negative is for the agglomeration of the particles near the electrodes, which leads to the breakdown initiation.« less

On Using Satellite-Based Networks for Capacity Building and Education for All: A Case Study of Rajiv Gandhi Project for EduSat-Supported Elementary Education

ERIC Educational Resources Information Center

Chaudhary, Sohanvir; Garg, Suresh

2010-01-01

One of the serious problems associated with Indian school education has been high dropout rate. The reasons are many and varied but the major constraints are: non-availability of adequate number of competent and trained teachers in most of the schools and separate room for each class. To overcome such problems and increase equitable access to all,…

The cost of cancer registry operations: Impact of volume on cost per case for core and enhanced registry activities

PubMed Central

Subramanian, Sujha; Tangka, Florence K.L.; Beebe, Maggie Cole; Trebino, Diana; Weir, Hannah K.; Babcock, Frances

2016-01-01

Background Cancer registration data is vital for creating evidence-based policies and interventions. Quantifying the resources needed for cancer registration activities and identifying potential efficiencies are critically important to ensure sustainability of cancer registry operations. Methods Using a previously validated web-based cost assessment tool, we collected activity-based cost data and report findings using 3 years of data from 40 National Program of Cancer Registry grantees. We stratified registries by volume: low-volume included fewer than 10,000 cases, medium-volume included 10,000–50,000 cases, and high-volume included >50,000 cases. Results Low-volume cancer registries incurred an average of $93.11 to report a case (without in-kind contributions) compared with $27.70 incurred by high-volume registries. Across all registries, the highest cost per case was incurred for data collection and abstraction ($8.33), management ($6.86), and administration ($4.99). Low- and medium-volume registries have higher costs than high-volume registries for all key activities. Conclusions Some cost differences by volume can be explained by the large fixed costs required for administering and performing registration activities, but other reasons may include the quality of the data initially submitted to the registries from reporting sources such as hospitals and pathology laboratories. Automation or efficiency improvements in data collection can potentially reduce overall costs. PMID:26702880

Searching for a two-factor model of marriage duration: commentary on Gottman and Levenson.

PubMed

DeKay, Michael L; Greeno, Catherine G; Houck, Patricia R

2002-01-01

Gottman and Levenson (2002) report a number of post hoc ordinary least squares regressions to "predict" the length of marriage, given that divorce has occurred. We argue that the type of statistical model they use is inappropriate for answering clinically relevant questions about the causes and timing of divorce, and present several reasons why an alternative family of models called duration models would be more appropriate. The distribution of marriage length is not bimodal, as Gottman and Levenson suggest, and their search for a two-factor model for explaining marriage length is misguided. Their regression models omit many variables known to affect marriage length, and instead use variables that were pre-screened for their predictive ability. Their final model is based on data for only 15 cases, including one unusual case that has undue influence on the results. For these and other technical reasons presented in the text, we believe that Gottman and Levenson's results are not replicable, and that they should not be used to guide interventions for couples in clinical settings.