Introdução: A Medicina Baseada em Evidências, apesar da grande profusão de publicações da área, enfrenta desafios no intuito de melhorar a qualidade da assistência à saúde. O conhecimento gerado por suas publicações demora a ser posta em prática. Os softwares CDSS de apoio à decisão clínica, podem ser a solução de incorporação das evidências na prática clínica. Esses sistemas já foram associados a melhorias na qualidade de diversos aspectos da assistência à saúde, como a organização, minimização de erros, redução de custos, aumento da eficiência dos cuidados, mas pesquisas com desfechos centrados no paciente ainda são raras. Como outra qualquer intervenção em saúde, as afirmações de que os CDSS são benéficos para o paciente necessitam de confirmação por ensaios clínicos. Objetivos: Verificar se o uso dos CDSS com base em evidências, está associado com melhores resultados clínicos orientados para o paciente. Métodos: Revisão sistemática da literatura dos ensaios clínicos controlados e randomizados que compararam diretamente o uso de CDSS com práticas clínicas convencionais considerando os desfechos clínicos classificados como orientados para o paciente. Resultados: Nossa estratégia de pesquisa identificou 51283 artigos na base MEDLINE-PubMed, sendo 311 selecionados para leitura de título e resumo após a aplicação do filtro para ensaio clínico randomizado, 45 selecionados para leitura do texto completo, dos quais 19 preencheram o critério de elegibilidade. Outros 9 ensaios foram incluídos através da realização de um overview das revisões sistemáticas anteriores. Os ensaios foram publicados entre os anos de 1995 e 2015 e realizados em cinco contextos assistenciais, com duração máxima de 12 meses. A maioria das fontes de evidências que alimentaram os sistemas foram diretrizes de órgão governamental ou sociedades de especialidades. Doze ensaios avaliaram mortalidade, 14 avaliaram hospitalizações ou atendimento de emergência e 6 avaliaram desfechos relacionados a presença de sintomas. Foram realizadas meta-análises de acordo com o contexto assistencial e o tipo de desfecho. Somente uma meta-análise envolvendo a mortalidade de pacientes tratados em ambulatório por diferentes condições clínicas se mostrou estatisticamente significante, favorável ao grupo CDSS, em 3 ensaios randomizados por aglomerado, com risco de viés considerado moderado, que compromete a qualidade da evidência. Conclusões Apesar do potencial dos CDSS no apoio de intervenções de saúde, não há evidência de boa qualidade de que sejam efetivos para aumentar a sobrevida ou a qualidade de vida dos pacientes. O número de ensaios que avaliam esses desfechos, os períodos de tempo pelos quais os pacientes foram seguidos, o número insuficiente de participantes, bem como a heterogeneidade entre os estudos analisados quanto aos cenários clínicos e as fontes de informação que alimentam os softwares não permitiram resultados mais conclusivos / Background: In spite of the wealth of publications in the field, Evidence-Based Medicine faces challenges in order to improve quality of health care. It takes too long for knowledge produced by its publications to be put into practice. Clinical Decision Support Systems (CDSS) may be a solution for incorporation of evidence into clinical practice. These systems have been associated with improvements in quality of various aspects of health care, including its organization, error minimizations, cost reductions and increases in its efficiency, but patient-oriented outcomes are still rare in research literature. Like any other healthcare intervention, claims that CDSS are beneficial for patients need to be confirmed by clinical trials. Objective: To verify whether the use of evidence-based Clinical Decision Support Systems is associated with improved patient-oriented clinical outcomes. Methods: Systematic literature review of randomized controlled trials that directly compared the use of CDSS with usual practice considering clinical outcomes classified as patient-oriented. Results: Our search strategy has identified 51,283 entries in MEDLINE-PubMed and, after filtering for randomized controlled trials 311 papers were selected for title and abstract reading. Forty-five were selected for full-text reading of which 19 have met eligibility criteria. Another nine trials were included after an overview of previous systematic reviews. Trials were published between 1995 and 2015 and performed in five care settings with a maximum follow-up of 12 months. Most evidence sources feeding systems´ knowledge bases were government agency guidelines or specialty societies. Twelve trials have assessed mortality, 14 have assessed hospital admissions and/or emergency visits and nine have assessed symptom-related outcomes. Meta-analyses were performed according to trials´ care setting and outcome types. Only a meta-analysis of three cluster-randomized trials involving mortality among outpatients with different clinical conditions was statistically significant, favouring CDSS group, but risk of bias was moderate, compromising the quality of evidence. Conclusions: Despite the potential of CDSS to improve healthcare quality there is no reliable evidence that they improve patients´ life extension or quality. The insufficient numbers of trials assessing these outcomes, studies´ subjects and follow-up periods, the heterogeneities of clinical settings across studies and knowledge bases feeding the systems impede achieving results that are more conclusive

Cette thèse s'intéresse à la production et au partage cohérent de connaissances distribuées dans le domaine des sciences de la vie. Malgré l'augmentation constante des capacités de stockage et de calcul des infrastructures informatiques, les approches centralisées pour la gestion de grandes masses de données scientifiques multi-sources deviennent inadaptées pour plusieurs raisons: (i) elles ne garantissent pas l'autonomie des fournisseurs de données qui doivent conserver un certain contrôle sur les données hébergées pour des raisons éthiques et/ou juridiques, (ii) elles ne permettent pas d'envisager le passage à l'échelle des plateformes en sciences computationnelles qui sont la source de productions massives de données scientifiques. Nous nous intéressons, dans le contexte des plateformes collaboratives en sciences de la vie NeuroLOG et VIP, d'une part, aux problématiques de distribution et d'hétérogénéité sous-jacentes au partage de ressources, potentiellement sensibles ; et d'autre part, à la production automatique de connaissances au cours de l'usage de ces plateformes, afin de faciliter l'exploitation de la masse de données produites. Nous nous appuyons sur une approche ontologique pour la modélisation des connaissances et proposons à partir des technologies du web sémantique (i) d'étendre ces plateformes avec des stratégies efficaces, statiques et dynamiques, d'interrogations sémantiques fédérées et (ii) d'étendre leur environnent de traitement de données pour automatiser l'annotation sémantique des résultats d'expérience ``in silico'', à partir de la capture d'informations de provenance à l'exécution et de règles d'inférence spécifiques au domaine. Les résultats de cette thèse, évalués sur l'infrastructure distribuée et contrôlée Grid'5000, apportent des éléments de réponse à trois enjeux majeurs des plateformes collaboratives en sciences computationnelles : (i) un modèle de collaborations sécurisées et une stratégie de contrôle d'accès distribué pour permettre la mise en place d'études multi-centriques dans un environnement compétitif, (ii) des résumés sémantiques d'expérience qui font sens pour l'utilisateur pour faciliter la navigation dans la masse de données produites lors de campagnes expérimentales, et (iii) des stratégies efficaces d'interrogation et de raisonnement fédérés, via les standards du Web Sémantique, pour partager les connaissances capitalisées dans ces plateformes et les ouvrir potentiellement sur le Web de données. Mots-clés: Flots de services et de données scientifiques, Services web sémantiques, Provenance, Web de données, Web sémantique, Fédération de bases de connaissances, Intégration de données distribuées, e-Sciences, e-Santé. / This thesis addresses the issues of coherent distributed knowledge production and sharing in the Life-science area. In spite of the continuously increasing computing and storage capabilities of computing infrastructures, the management of massive scientific data through centralized approaches became inappropriate, for several reasons: (i) they do not guarantee the autonomy property of data providers, constrained, for either ethical or legal concerns, to keep the control over the data they host, (ii) they do not scale and adapt to the massive scientific data produced through e-Science platforms. In the context of the NeuroLOG and VIP Life-science collaborative platforms, we address on one hand, distribution and heterogeneity issues underlying, possibly sensitive, resource sharing ; and on the other hand, automated knowledge production through the usage of these e-Science platforms, to ease the exploitation of the massively produced scientific data. We rely on an ontological approach for knowledge modeling and propose, based on Semantic Web technologies, to (i) extend these platforms with efficient, static and dynamic, transparent federated semantic querying strategies, and (ii) to extend their data processing environment, from both provenance information captured at run-time and domain-specific inference rules, to automate the semantic annotation of ``in silico'' experiment results. The results of this thesis have been evaluated on the Grid'5000 distributed and controlled infrastructure. They contribute to addressing three of the main challenging issues faced in the area of computational science platforms through (i) a model for secured collaborations and a distributed access control strategy allowing for the setup of multi-centric studies while still considering competitive activities, (ii) semantic experiment summaries, meaningful from the end-user perspective, aimed at easing the navigation into massive scientific data resulting from large-scale experimental campaigns, and (iii) efficient distributed querying and reasoning strategies, relying on Semantic Web standards, aimed at sharing capitalized knowledge and providing connectivity towards the Web of Linked Data.

This dissertation thesis introduces new methods of automated knowledge-base creation and tuning in information and expert systems. The thesis is divided in the two following parts. The first part is focused on the legacy expert system NPS32 developed at the Faculty of Electrical Engineering and Communication, Brno University of Technology. The mathematical base of the system is expression of the rule uncertainty using two values. Thus, it extends information capability of the knowledge-base by values of the absence of the information and conflict in the knowledge-base. The expert system has been supplemented by a learning algorithm. The learning algorithm sets weights of the rules in the knowledge base using differential evolution algorithm. It uses patterns acquired from an expert. The learning algorithm is only one-layer knowledge-bases limited. The thesis shows a formal proof that the mathematical base of the NPS32 expert system can not be used for gradient tuning of the weights in the multilayer knowledge-bases. The second part is focused on multilayer knowledge-base learning algorithm. The knowledge-base is based on a specific model of the rule with uncertainty factors. Uncertainty factors of the rule represents information impact ratio. Using a learning algorithm adjusting weights of every single rule in the knowledge base structure, the modified back propagation algorithm is used. The back propagation algorithm is modified for the given knowledge-base structure and rule model. For the purpose of testing and verifying the learning algorithm for knowledge-base tuning, the expert system RESLA has been developed in C#. With this expert system, the knowledge-base from medicine field, was created. The aim of this knowledge base is verify learning ability for complex knowledge-bases. The knowledge base represents heart malfunction diagnostic base on the acquired ECG (electrocardiogram) parameters. For the purpose of the comparison with already existing knowledge-basis, created by the expert and knowledge engineer, the expert system was compared with professionally designed knowledge-base from the field of agriculture. The knowledge-base represents system for suitable cultivar of winter wheat planting decision support. The presented algorithms speed up knowledge-base creation while keeping all advantages, which arise from using rules. Contrary to the existing solution based on neural network, the presented algorithms for knowledge-base weights tuning are faster and more simple, because it does not need rule extraction from another type of the knowledge representation.

<p>  </p> <p>School-based agricultural education programs use laboratories to develop cognitive, psychomotor, and procedural skills (Phipps et al., 2008). It is important to help preservice teachers develop the ability to design instruction to cultivate skills that are taught in laboratory settings. Shulman (1986) authored a term called Pedagogical Content Knowledge (PCK), which is a teacher’s knowledge of teaching. Animal science dissection was the topic chosen for this study, as PCK is topic-specific (Chan & Hume, 2018). There are many interpretations of PCK. The Refined Consensus Model (RCM) of PCK in Science Education (Carlson et al., 2019) was the conceptual model used in this study, as it is the most recent PCK model, and was developed by experts in science education from multiple countries. This model asserts that PCK is comprised of three realms: Collective PCK (cPCK), Personal PCK (pPCK), and Enacted PCK (ePCK). The first purpose of this study was to describe preservice agriculture teachers' Professional Knowledge Bases (which informs pPCK), before and after instruction, on the topic of animal science dissection in a Laboratory Practices in Agricultural Education (LPAE) course. The second purpose was to describe preservice agriculture teachers' cPCK, after instruction, on animal science dissection in an LPAE course. Content Representations (CoRes), a common tool used for PCK research, were used identify evidence of the Professional Knowledge Bases (PKBs) in preservice agriculture teachers’ instructional planning. Results from this study showed elevated descriptions of Professional Knowledge Bases, and participants collectively gained new ideas and collaboration skills. Overall LPAE dissection experience appeared to push the depth of student thinking and ability to make connections with future learning. Future research recommendations include using the RCM of PCK (Carlson et al., 2019) and CoRes in agricultural education; more PCK research, specifically exploring the development of Curricular Knowledge, on preservice teachers in agricultural education; and PCK research on other topics in agricultural education. It is recommended to not only include PCK development in teacher preparation programs but also have more than one exposure to PCK development.</p>

Ziel dieses Beitrags aus der Lehrpraxis ist es, die erforderlichen Herangehensweisen für die Erstellung von fachübergreifenden Wissensbasen und deren Nutzung im Rahmen studentischer Semesterprojekte exemplarisch am Lehrbeispiel einer anwendenden Ingenieurdisziplin darzustellen.

[pt] A oferta de serviços por meio de interfaces conversacionais, ou chatbots, tem se tornado cada vez mais popular, com aplicações que variam de aplicativos de bancos e reserva de bilheteria a consultas em um banco de dados. No entanto, dado a quantidade massiva de dados disponível em alguns domínios, o usuário pode ter dificuldade em formular as consultas e recuperar as informações desejadas. Esta dissertação tem como objetivo investigar e avaliar o uso de recomendações na busca de informações numa base de dados de filmes através de chatbots. Neste trabalho, implementamos um chatbot por meio do uso de frameworks e técnicas da área de processamento de linguagem natural (NLP - Natural Language Processing). Para o reconhecimento de entidades e intenções, utilizamos o framework RASA NLU. Para a identificação das relações entre essas entidades, utilizamos as redes Transformers. Além disso, propomos diferentes estratégias para recomendações feitas a partir da ontologia de domínio. Para avaliação deste trabalho, conduzimos um estudo com usuários para avaliar o impacto das recomendações no uso do chatbot e aceitação da tecnologia por meio de um questionário baseado no Technology Acceptance Model (TAM). Por fim, discutimos os resultados do estudo, suas limitações e oportunidades de futuras melhorias. / [en] The offer of services provided through conversational interfaces, or chatbots, has become increasingly popular, with applications that range from bank applications and ticket booking to database queries. However, given the massive amount of data available in some domains, the user may find it difficult to formulate queries and retrieve the desired information. This dissertation investigates and evaluates the use of the recommendations in the search for information on a movie database through a chatbot. In this work, we implement a chatbot with the use of frameworks and techniques from the area of natural language processing (NLP). For the recognition of entities and intents, we use the RASA NLU framework. For the identification of relations between those entities, we use the Transformers networks. In addition, we propose different strategies for the recommendation from the domain ontology. To evaluate this work, we have conducted an empirical study with volunteer users to assess the impact of the recommendations on chatbot use and the acceptance of the technology through a survey based on the Technology Acceptance Model (TAM). Lastly, we discuss the results of this study, its limitations, and avenues for future improvements.

No description available.

This research thesis set out to better understand the professional knowledge bases of Western teachers working in offshore education in Indonesia. This research explored what two groups of Western teachers said about the students they taught, their own role, professional and social identity, the knowledge transmitted, and their pedagogical strategies whilst teaching offshore. Such an investigation is significant on a number of levels. Firstly, these teachers were working within a period of rapid economic, political, cultural and educational change described as 'New Times' (Hall, 1996a). Secondly, the experiences of teachers working in offshore education have rarely been reported in the literature (see Johnston, 1999). A review of the literature on teachers' professional knowledge bases (Shulman, 1986a, 1986b, 1987; Turner-Bisset, 1997, 1999) concluded that, in general terms, teachers draw on three main interrelated and changing knowledge bases: knowledge of content, knowledge of teaching processes and knowledge of their students. This review also explored the notion that teachers had an additional knowledge base that was in a continual state of negotiation and closely related to the aforementioned knowledge bases: teachers' knowledge of their own and students' pedagogic identities (Bernstein, 2000). A theoretical framework appropriate to exploring the overarching research problem was developed. This framework drew on models of teachers' knowledge bases (Elbaz, 1983; Shulman, 1986a, 1986b, 1987; Nias, 1989; Turner-Bisset, 1997, 1999), the sociology of knowledge (Bernstein, 1975, 1990, 1996, 1999, 2000), and notions of pedagogic identity (Bernstein, 2000). This framework theorised the types of knowledges taught, categories of teaching process knowledge, and the range of pedagogic identities made available to teachers and students in new times. More specifically, this research examined two case studies (see Stake, 1988, 2000; Yin, 1994) of Western teachers employed by Australian educational institutions who worked in Central Java, Indonesia, in the mid-to-late 1990s. The teacher participants from both case studies taught a range of subjects and used English as the medium of instruction. Data for both case studies were generated via semistructured interviews (see Kvale, 1996; Silverman, 1985, 1997). The interviews focused on the teachers' descriptions of the learner characteristics of Indonesian students, their professional roles whilst teaching offshore, and curriculum and pedagogic design. The analyses produced four major findings. The first major finding of the analyses confirmed that the teacher participants in this study drew on all proposed professional knowledge bases and that these knowledge bases were interrelated. This suggests that teachers must have all knowledge bases present for them to do their work successfully. The second major finding was that teachers' professional knowledge bases were constantly being negotiated in response to their beliefs about their work and the past, present and future demands of the local context. For example, the content and teaching processes of English lessons may have varied as their own and their students' pedagogic identities were re-negotiated in different contexts of teaching and learning. Another major finding was that it was only when the teachers entered into dialogue with the Indonesian students and community members and/or reflective dialogue amongst themselves, that they started to question the stereotypical views of Indonesian learners as passive, shy and quiet. The final major finding was that the teachers were positioned in multiple ways by contradictory and conflicting discourses. The analyses suggested that teachers' pedagogic identities were a site of struggle between dominant market orientations and the criteria that the teachers thought should determine who was a legitimate teacher of offshore Indonesian students. The accounts from one of the case studies suggested that dominant market orientations centred on experience and qualifications in unison with prescribed and proscribed cultural, gender and age relations. Competent teachers who were perceived to be white, Western, male and senior in terms of age relations seemed to be the most easily accepted as offshore teachers of foundation programs for Indonesian students. The analyses suggested that the teachers thought that their legitimacy to be an offshore teacher of Indonesian students should be based on their teaching expertise alone. However, managers of Australian offshore educational institutions conceded that it was very difficult to bring about change in terms of teacher legitimisation. These findings have three implications for the work of offshore teachers and program administrators. Firstly, offshore programs that favour the pre-packaging of curricula content with little emphasis on the professional development and support needs of teachers do not foster work conditions which encourage teachers to re-design or modify curricula in response to the specific needs of learners. Secondly, pre-packaged programs do not support teachers to enter into negotiations concerning students' or their own pedagogic identities or the past, present and future demands of local contexts. These are important implications because they affect the way that teachers work, and hence how responsive teachers can be to learners' needs and how active they can be in the negotiation process as it relates to pedagogic identities. Finally, the findings point to the importance of establishing a learning community or learning network to assist Western teachers engaged in offshore educational work in Asian countries such as Indonesia. Such a community or network would enable teachers to engage and modify the complexity of knowledge bases required for effective localised offshore teaching. Given the burgeoning increase in the availability and use of electronic technology in new times, such as internet, emails and web cameras, these learning networks could be set up to have maximum benefit with minimal on-going costs.

The main aim of this licentiate thesis is to examine how local actors in a medium-sized Swedish municipality, Värnamo, in their role as decision-makers at the local arena, describe and explain the preconditions and strategies for local economic and social development. The analysis uses semi-structured interviews to reveal the connections between the local actors representations of social and economic structures and their representations of central and future strategic choices. The local actors are represented by a) firm owners or central firm managers, b) local politicians in the municipal executive board, c) civil servants in central positions and d) key actors connected to local and regional organizations. The methodological approach is based on discourse analysis. The overall aim of the study is to understand how local discourses are constructed and communicated. The analysis is deepened by relating the local discourses to relevant theoretical models in contemporary economic geography. The economic-geographical theoretical models used in the analysis focus on industrial districts, clusters and innovation systems. Path-dependency, social embeddedness and creative class are other concepts of importance to understand the formation of the local discourse. The analysis shows how local discourses are affected by the perceived globalization process while being at the same time linked to a) specific historical and environmental factors leading to predominant behavioral norms and values stating that you should be hard working, economical, cooperative and trustworthy and b) the relative location, which is conceived to be central regarding communications and regional service functions. This is combined with an image of a creative and innovative local/regional production system, based on traditions in manufacturing and trade. The foundations in manufacturing and trade are however challenged by new sectors like logistics, design, and higher education in cooperation with universities in the region.

This master's thesis describes Semantic Enrichment Component (SEC), that searches entities (e.g., persons or places) in the input text document and returns information about them. The goals of this component are to create a single interface for named entity recognition tools, to enable parallel document processing, to save memory while using the knowledge base, and to speed up access to its content. To achieve these goals, the output of the named entity recognition tools in the text was specified, the tool for storing the preprocessed knowledge base into the shared memory was implemented, and the client-server scheme was used to create the component.