A tuberculose multirresistente (TBMR) - resistência simultânea a rifampicina e isoniazida, principais fármacos do esquema de tratamento da tuberculose (TB), gera mais ônus aos doentes e aos Serviços de Saúde, pois acarreta maiores custos, aumenta o tempo de tratamento e relaciona-se a prognósticos desfavoráveis. A TBMR ocorre devido à falha em algum princípio do tratamento, seja por parte dos profissionais e serviços de saúde, seja por questões ligadas ao doente. Frente a isso, o presente estudo objetivou identificar e analisar as condições de produção da TBMR relacionadas ao doente e seu entorno. Esta investigação foi realizada junto aos sujeitos em seguimento em um hospital de referência do interior paulista, entre janeiro de 2010 a janeiro de 2012. Foi utilizada a abordagem qualitativa. Por meio da análise dos prontuários médicos do serviço terciário, caracterizamos o universo do estudo - composto por todos os doentes já seguidos pela instituição, descrevendo e analisando dados sociodemográficos e clínicos correspondentes. Caracterizamos, também, a amostra estudada, formada por oito doentes de TBMR em seguimento, detalhando seu contexto de vida e trajetória com a doença, assim como a estruturação municipal para seu acompanhamento. A segunda etapa do trabalho constituiu na análise das percepções dos sujeitos a cerca do adoecimento por TB e pela forma MR. Os dados foram coletados por meio de entrevistas semi-estruturadas, gravadas e transcritas na íntegra. Os textos resultantes constituíram o corpus do estudo, organizado com recurso do software Atlas. Ti versão 7.0 e analisado sob o referencial teórico da Análise de Discurso, de matriz francesa. Os resultados da investigação baseiam-se na análise de três aspectos: percurso diagnóstico - em que é apontadas a percepção da doença e dos sintomas, as histórias pessoais e familiares do adoecimento por TB, o desenvolver até a obtenção do diagnóstico e as histórias de fracasso dos tratamentos convencionais; tratamento e acompanhamento dos casos MR - momento em que são discutidas questões ligadas a percepção do tratamento pelos doentes, as modalidades de supervisão empreendidas, os instrumentos e insumos fornecidos, além do apoio da rede familiar; coordenação da assistência - em que são analisadas as nuances da relação entre os diferentes serviços envolvidos na atenção ao doente, tanto dentro do mesmo nível assistencial quanto em sua intersecção com a atenção terciária, a fim de compreender suas fragilidades e promover as potencialidades para o tratamento dos sujeitos. Essas condições de produção mostraram-se complexas, ao passo que sofrem influência das peculiaridades da forma como os serviços locais de atenção organizando-se para atender esses doentes, além de questões relacionadas à trajetória de vida e doença desses sujeitos, apontando para a necessidade de ampliação do espaço de negociação dentro do sistema de saúde. / Multidrug-resistant tuberculosis - simultaneous resistance to rifampicin and isoniazid, the main drugs in the treatment for tuberculosis (TB), generates more onuses to patients and Health Services because it involves higher costs, increases the treatment time and relates to the unfavorable outcomes. MDR-TB occurs due to failure in some treatment principles, either by professionals and health services, or by patient issues. Concerning this, the present study aimed to identify and analyze the conditions of MDR-TB production related to the patients and their surroundings. This investigation was conducted with the subjects followed up in a referral hospital in São Paulo State, between January 2010 and January 2012. It was used a qualitative approach. By analyzing the medical records of the tertiary service, we characterized the universe of the study - consisting of all patients who were already followed by the institution, describing and analyzing the demographic and clinical data matching. We also characterized the sample, formed by eight MDR-TB patients in follow-up, detailing the context of their lives and the disease trajectory, as well as the municipal structure to monitor them. The second stage of the work consisted of analyzing the subjects\' perceptions about TB development and MR strain. Data was collected through semi-structured interviews which were recorded and fully transcribed. The resulting texts constituted the corpus of the study, organized using the Atlas.Ti software version 7.0 and analyzed from the theoretical framework of Discourse Analysis of French matrix. The results are based on analysis of three aspects: The first is diagnosis route - which shows the disease and symptoms perception of the patient, personal and family histories of TB development, the disease development until the diagnosis, and the failed conventional treatment stories. The second aspect was treatment and monitoring of MDR cases - when cases are discussed we focused on the following aspects: perceptions of treatment by patients, undertaken methods of supervision, instruments and inputs provided, and the familiar support network. The third is assistance coordination - where the nuances of the relationship between several departments involved in the patient care are analyzed, within the same care level as well as its intersection with tertiary care in order to understand their weaknesses and promote the potential treatments for the subjects. These production conditions proved to be complex whereas the local care services peculiarities influence the way they are organized to assist these patients, as well as aspects related to life and illness trajectory of these subjects, indicating the need of expanding the negotiation space within the health system

Den här studien syftar till att undersöka och skapa en större förståelse för bakgrunden till val av integrationsplattform inom regionerna i Sverige. Integrationsplattformar inom hälso- och sjukvården är ett komplext område, delvis på grund av den politiska styrningen men även för att IT-hanteringen idag är decentraliserad. Författaren har tittat på valet som de olika regionerna har gjort utifrån strategiska, ekonomiska, tekniska, verksamhetsmässiga och kulturella egenskaper. Studien tittar även på skillnader beroende på om det är ett större respektive mindre landsting.   En integrationsplattform kan underlätta och agera en mellanhand samt låter systemen kommunicera med varandra utan att behöva en point-to-point koppling. Många av regionerna har en budget att förhålla sig till och vill bedriva sin verksamhet till så låg kostnad som möjlig utan att behöva påverka organisationen och deras processer. I dagsläget finns det ingen integrationsplattform som ligger i framkant till att stödja alla de olika behoven som de olika regionerna har och därav kommer varje region finna den lösning som är bäst för regionen.   I jämförelse med tidigare studier där de strategiska egenskaperna visas det att i den här studien att det främst de ekonomiska egenskaperna inom den offentliga verksamheten som är av störst betydelse. / This study aims to investigate and create a better understanding of why the different regions of Sweden have chosen their integration platform within the healthcare sector. Due to the decentralisation and political governance there is a complexity within the healthcare sector various integration platforms. The author has looked at the choices that the different regions have made based on strategic, economical, technical, operational and cultural characteristics. The various regions size is also investigated as a factor, making a distinction between higher and lower populated regions.   An integration platform acts as an intermediary, allowing the various systems to communicate with each other without having a point-to-point connection. At present there is no integration platform at the forefront of supporting all the different needs of the different regions, each region finds the solution that is best for itself.

The demand for systems i·ntegration has become more and more significant in higher education as institutions want systems that provide coherent information with data that is up to date and not redundant and can seamlessly support the end user experience. Institutions have become more reliant on information systems to support both administrative functions and those involved in teaching, learning and research, but because each department supports a diverse array of computing platforms and applications, it becomes very difficult to integrate these systems. SOA is classified as an innovative approach to integrating existing systems involving the use of independent services that can be accessed without knowledge of the underlying platform implementation. Unfortunately, the SOA initiative will not be success if it is not understood and used correctly by various applications and systems throughout the organisation. SOA introduces complexity and challenges in systems integration, acceptance, governance, data, development planning, security and external opportunities. If an organisation does not embrace or enable change in each of these areas, it is not ready for the adoption of SOA. This research investigates the systems integration challenge in selected South African universities and explores factors for SOA adoption. The framework for the adoption of SOA comprises seven factors, of which Systems Integration is the most significant and represents an efficient starting point for institutions considering SOA adoption. Acceptance, Governance, Data, Development Planning, Security and External Opportunities are other factors of SOA adoption that require careful and thorough consideration before an institution can successfully adopt SOA. The results of this research emphasise the importance of being able to embrace change and innovation and modify strategies in order to reflect the constant changes required for the adoption of SOA. / KMBT_363 / Adobe Acrobat 9.54 Paper Capture Plug-in

Indiana University-Purdue University Indianapolis (IUPUI) / The rapid infusion of artificial intelligence into everyday technologies means that consumers are likely to interact with intelligent systems that provide suggestions and recommendations on a daily basis in the very near future. While these technologies promise much, current issues in low transparency create high potential to confuse end-users, limiting the market viability of these technologies. While efforts are underway to make machine learning models more transparent, HCI currently lacks an understanding of how these model-generated explanations should best translate into the practicalities of system design. To address this gap, my research took a pragmatic approach to improving system transparency for end-users. Through a series of three studies, I investigated the need and value of transparency to end-users, and explored methods to improve system designs to accomplish greater transparency in intelligent systems offering recommendations. My research resulted in a summarized taxonomy that outlines a variety of motivations for why users ask questions of intelligent systems; useful for considering the type and category of information users might appreciate when interacting with AI-based recommendations. I also developed a categorization of explanation types, known as explanation vectors, that is organized into groups that correspond to user knowledge goals. Explanation vectors provide system designers options for delivering explanations of system processes beyond those of basic explainability. I developed a detailed user typology, which is a four-factor categorization of the predominant attitudes and opinion schemes of everyday users interacting with AI-based recommendations; useful to understand the range of user sentiment towards AI-based recommender features, and possibly useful for tailoring interface design by user type. Lastly, I developed and tested an evaluation method known as the System Transparency Evaluation Method (STEv), which allows for real-world systems and prototypes to be evaluated and improved through a low-cost query method. Results from this dissertation offer concrete direction to interaction designers as to how these results might manifest in the design of interfaces that are more transparent to end users. These studies provide a framework and methodology that is complementary to existing HCI evaluation methods, and lay the groundwork upon which other research into improving system transparency might build.

No description available.

No description available.

<p><strong>Introduction</strong></p> <p>Despite increasing global interest in regional palliative care networks (PCN) to integrate care, little explicit direction exists to guide their evaluation. The first step of this research was to develop a comprehensive conceptual framework using a systems approach for evaluating integrated palliative care. This framework was then used to guide a rigorous examination of a selected PCN.</p> <p><strong>Methods</strong></p> <p>The conceptual framework was derived from the empirical literature, incorporating principal features of network integration. A case study methodology was used to assess structure (administration) and process (provider) levels in the framework through document review, a PCN executive interview, and surveys with organizational administrators and health professionals who provide palliative care in the community catchment of the PCN.</p> <p><strong>Results</strong></p> <p>Key features to efficient palliative care delivery are currently lacking across this PCN area. Still, the 20 responding administrators (90% response rate) largely viewed Network accomplishments positively and the resulting partnerships as beneficial and collaborative. Additional efforts were seen as required in ensuring palliative care patient identification, reducing silos between organizations, and greater by-in from regional authorities. Relative to processes, the 86 health care providers (85% response rate) reported valuing collaboration and reflected positively on many of the framework elements measured. Insufficiencies were perceived in support for case conferencing and evaluative activities, as well as in informational access.</p> <p><strong> </strong></p> <p><strong>Conclusion</strong></p> <p>This study enabled us to test both the utility of the framework and the capacity of the selected PCN for providing quality, integrated palliative care. This study represents an important initial attempt at examining network-integrated palliative care.</p> / Doctor of Philosophy (PhD)

Thesis (M.S. in Systems Engineering)--Naval Postgraduate School, June 2010. / Thesis Advisor(s): Goshorn, Rachel ; Goshorn, Deborah. "June 2010." Description based on title screen as viewed on June 24, 2010. Author(s) subject terms: Anomaly Detection, Artificial Intelligence, Automation, Behavior Analysis, Distributed Artificial Intelligence, Intelligence-Surveillance-Reconnaissance, Maritime Domain Awareness, Maritime Force Protection, Multi-agent Systems, Network-centric Operations, Network-centric Systems Engineering, Network-centric Warfare, Smart Sensor Networks, Systems Engineering, Systems Integration, System of Systems. Includes bibliographical references (p. 209-212). Also available in print.

Diss. (sammanfattning) Linköping : Linköpings universitet, 2009. / Härtill 5 uppsatser.

由於全球化時代的來臨，企業無不善用全球的人才與資源，以提升自我的競爭力，增加企業發展的契機。為了加速企業發展速度，越來越多企業透過購併模式，快速結合不同公司的人才與資源，提升自我的競爭力。但在購併的過程中，如何有效整合不同公司的人才與資源，就變成一個很重要發展課題。 在整合不同的公司過程中，除了外在的人才與資源整合外，內在各公司間核心知識的整合與應用更為重要。透過PLM（Product Lifecycle Management）系統平台，可以實踐整合外在的人才與資源，更可以進一步整合各公司間的核心知識，進而產生各項應用與回饋。 本研究由相關文獻探討，藉由企業購併、知識管理和資訊系統整合之概念，推展出以「組織」、 「流程」和「資料」三個構面的研究架構，透過跨公司 PLM 系統整併實際案例，整理出一PLM系統平台運作方式，探討企業產品生命週期管理系統整合發展之影響因子。 由個案分析與研究發現得出研究結論如下: 研究結論1： 企業間進行產品生命週期管理系統整合前，具有RD 開發和 IT 技術專業背景之A型人才擔任此整合專案規劃和執行者，是導入成功的關鍵考量因素。 研究結論2： 企業間進行產品生命週期管理系統整合時，高層主管在專案中的有力支持與表達、良好的溝通、良好完整的教育訓練與技術轉移計畫，是成功的關鍵做法。 研究結論3： 企業間進行產品生命週期管理系統整合時，做好完整的Legacy Data Migration和以流程再造／創新的態度，將不合理流程一併進行調整與改善，是成功的關鍵做法。 研究結論4：企業間進行產品生命週期管理系統整合後，使用該單一、公開、共用的資訊流程平台，有助於新產品之開發時程縮短和開發成本降低。 關鍵字: 知識管理，產品生命週期，系統整合，PLM / Since the advent of the era of globalization, companies take advantage of are all use of personnel and resources of the world, to enhance its competitiveness and to increase opportunities for enterprise growing up. In order to accelerate the pace of enterprise enlargement, more and more companies are through M&A mode, quickly combining different company's talents and resources to enhance its competitiveness. But in the process of acquisition, how to effectively integrate the talents and resources of different companies becomes a very important studying. In addition to the integration of external talents and resources, the inner core between each company in the integration and application of knowledge is more important, in the process of integrating different companies. It can integrate the external talent and resources via PLM (Product Lifecycle Management) system platform operation. And even to the core knowledge among the companies to reproduce various applications and feedback. Case study analysis & findings conclude as bellows: Conclusions 1: Planning phase, before inter-enterprise PLM systems integration, a high position, both RD engineering and IT professional skill background, A-type talent as this integrated project owner of planning and implementation, is the key to the success of the considerations. Conclusions 2: Execution phase, during inter-enterprise PLM systems integration, the strong support for the project from the executives, a well communication and a comprehensive training & technology transfer programs are the keys to success. Conclusions 3: Execution phase, during inter-enterprise PLM system integration, it is critical to have a full span Legacy data migration and to adjust/improve the unreasonable the process with process reengineering/process innovative attitude. Conclusions 4: Sustaining phase, after inter-enterprise PLM system integration, the use of the unique, opened platform for information sharing, contributes to the shortening of the develoemnt schedule and the reducing materials costs on new products development. Keywords: knowledge management, product life-cycle, systems integration, PLM