Global ETD Search

141	Archetype development and governance methodologies for the electronic health record Moner Cano, David 22 March 2021 (has links) [ES] La interoperabilidad semántica de la información sanitaria es un requisito imprescindible para la sostenibilidad de la atención sanitaria, y es fundamental para afrontar los nuevos retos sanitarios de un mundo globalizado. Esta tesis aporta nuevas metodologías para abordar algunos de los aspectos fundamentales de la interoperabilidad semántica, específicamente aquellos relacionados con la definición y gobernanza de modelos de información clínica expresados en forma de arquetipo. Las aportaciones de la tesis son: - Estudio de las metodologías de modelado existentes de componentes de interoperabilidad semántica que influirán en la definición de una metodología de modelado de arquetipos. - Análisis comparativo de los sistemas e iniciativas existentes para la gobernanza de modelos de información clínica. - Una propuesta de Metodología de Modelado de Arquetipos unificada que formalice las fases de desarrollo del arquetipo, los participantes requeridos y las buenas prácticas a seguir. - Identificación y definición de principios y características de gobernanza de arquetipos. - Diseño y desarrollo de herramientas que brinden soporte al modelado y la gobernanza de arquetipos. Las aportaciones de esta tesis se han puesto en práctica en múltiples proyectos y experiencias de desarrollo. Estas experiencias varían desde un proyecto local dentro de una sola organización que requirió la reutilización de datos clínicos basados en principios de interoperabilidad semántica, hasta el desarrollo de proyectos de historia clínica electrónica de alcance nacional. / [CA] La interoperabilitat semàntica de la informació sanitària és un requisit imprescindible per a la sostenibilitat de l'atenció sanitària, i és fonamental per a afrontar els nous reptes sanitaris d'un món globalitzat. Aquesta tesi aporta noves metodologies per a abordar alguns dels aspectes fonamentals de la interoperabilitat semàntica, específicament aquells relacionats amb la definició i govern de models d'informació clínica expressats en forma d'arquetip. Les aportacions de la tesi són: - Estudi de les metodologies de modelatge existents de components d'interoperabilitat semàntica que influiran en la definició d'una metodologia de modelatge d'arquetips. - Anàlisi comparativa dels sistemes i iniciatives existents per al govern de models d'informació clínica. - Una proposta de Metodologia de Modelatge d'Arquetips unificada que formalitza les fases de desenvolupament de l'arquetip, els participants requerits i les bones pràctiques a seguir. - Identificació i definició de principis i característiques de govern d'arquetips. - Disseny i desenvolupament d'eines que brinden suport al modelatge i al govern d'arquetips. Les aportacions d'aquesta tesi s'han posat en pràctica en múltiples projectes i experiències de desenvolupament. Aquestes experiències varien des d'un projecte local dins d'una sola organització que va requerir la reutilització de dades clíniques basades en principis d'interoperabilitat semàntica, fins al desenvolupament de projectes d'història clínica electrònica d'abast nacional. / [EN] Semantic interoperability of health information is an essential requirement for the sustainability of healthcare, and it is essential to face the new health challenges of a globalized world. This thesis provides new methodologies to tackle some of the fundamental aspects of semantic interoperability, specifically those aspects related to the definition and governance of clinical information models expressed in the form of archetypes. The contributions of the thesis are: - Study of existing modeling methodologies of semantic interoperability components that will influence in the definition of an archetype modeling methodology. - Comparative analysis of existing clinical information model governance systems and initiatives. - A proposal of a unified Archetype Modeling Methodology that formalizes the phases of archetype development, the required participants, and the good practices to be followed. - Identification and definition of archetype governance principles and characteristics. - Design and development of tools that provide support to archetype modeling and governance. The contributions of this thesis have been put into practice in multiple projects and development experiences. These experiences vary from a local project inside a single organization that required a reuse on clinical data based on semantic interoperability principles, to the development of national electronic health record projects. / This thesis was partially funded by the Ministerio de Economía y Competitividad, ayudas para contratos para la formación de doctores en empresas “Doctorados Industriales”, grant DI-14-06564 and by the Agencia Valenciana de la Innovación, ayudas del Programa de Promoción del Talento – Doctorados empresariales (INNODOCTO), grant INNTA3/2020/12. / Moner Cano, D. (2021). Archetype development and governance methodologies for the electronic health record [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/164916 / TESIS Archetype Definition Language (ADL) Historia clínica electrónica (HCE) Modelos de representación de arquetipos Gobierno de arquetipos Modelado de arquetipos Metodología del modelo dual Archetype modeling metodology Archetype modeling Archetype governance Dual model methodology ISO 13606 OpenEHR Electronic health record (EHR) FISICA APLICADA
142	Understanding Dementia Caregiver Experiences of Burden and Positive Aspects of Caregiving: A Cluster Analytic Approach Cousins-Whitus, Elizabeth Andrea 04 April 2023 (has links) No description available. Clinical Psychology dementia caregiver burden dementia caregiver burden positive aspects of caregiving ZBI PAC cluster analysis caregiver profiles CMAI IADL ADL neuropsychiatric symptoms activities of daily living dementia severity caregiver experiences high burden high positive aspects of caregiving
143	An exploratory study of the methods and strategies implemented to integrate unaccompanied minors in five residential home in Sweden Dao, Catherine. H January 2014 (has links) The aim of the study was to explore what methods the personnel in five residential care homes in Götaland, Sweden, implement to integrate unaccompanied minors. The study investigated how and what methods are constructed as well as how the social interaction between the unaccompanied minors and the personnel at the homes bring about the learning of the methods. Five face-to-face semi-structured interviews were conducted and analysed through the perspective of social construction and social learning theory. The result revealed that the methods are not clearly identified by the personnel. The personals are still learning how to work with unaccompanied minors from their experiences. This indicates that the practice is at its infant stage. The study found a wide variety of methods, which were based on the child and where some methods intend to build good relationship, to integrate the children into society and to facilitate the development of strategies and methods. The study also addresses the issue of how the methods and strategies can be affected by the dynamic migratory flow and the question of evidence based practice within this field. Unaccompanied minors residential care homes integration methods construction BBIC action learning distraction support medication leisure activities relationship building drawing using sign language using translate car-method "having a coffee" tutoring ADL-training practical demonstrate explaining networking grocery shopping ART Marte Meo role-model role play 'Hitta Rätt' MI dialogue follow-up meeting house meeting supervision three-part parenthood
144	Effects of white-tailed deer herbivory on a tallgrass prairie remnant Gooch, Scott 11 January 2010 (has links) A study was conducted to determine what impact high white-tailed deer (Odocoileus virginianus) densities were having on the native grasslands of a tallgrass: aspen forest tract embedded within an agro-urban setting. Due to excessive spring moisture, row-crops were unavailable the first year. Using microhistological fecal analysis to determine dietary composition, deer were assessed to be placing the site’s favoured native plant species at risk of extirpation. Measuring woody stem abundance and height along and near the prairie: forest ecotone, deer were found to restructure woody growth but not directly influence encroachment rates. Indirectly, however, deer facilitated forest encroachment and prairie degradation through seed dispersal, nitrogen deposition, gap-dynamics, and trampling. Comparing dietary composition to nutritional data, deer grazed to maximize fitness, selecting foods high in IVDMD, minimizing energy expenditure, and optimizing CP. High crop CP was offset by intensively grazing particular native plants. ADF was an effective nutritional marker, not AIA. white-tailed deer herbivory fecal analysis nutrient cycling forest encroachment foraging strategy disturbance index ADL nutritional markers row-crops grazing preferences gap dynamics seed propagation ecological fitness native plants forbs restoration ADF CP AIA NDF deer management ecological management IVDMD overabundance tallgrass energetics forbs
145	Effects of white-tailed deer herbivory on a tallgrass prairie remnant Gooch, Scott 11 January 2010 (has links) A study was conducted to determine what impact high white-tailed deer (Odocoileus virginianus) densities were having on the native grasslands of a tallgrass: aspen forest tract embedded within an agro-urban setting. Due to excessive spring moisture, row-crops were unavailable the first year. Using microhistological fecal analysis to determine dietary composition, deer were assessed to be placing the site’s favoured native plant species at risk of extirpation. Measuring woody stem abundance and height along and near the prairie: forest ecotone, deer were found to restructure woody growth but not directly influence encroachment rates. Indirectly, however, deer facilitated forest encroachment and prairie degradation through seed dispersal, nitrogen deposition, gap-dynamics, and trampling. Comparing dietary composition to nutritional data, deer grazed to maximize fitness, selecting foods high in IVDMD, minimizing energy expenditure, and optimizing CP. High crop CP was offset by intensively grazing particular native plants. ADF was an effective nutritional marker, not AIA. white-tailed deer herbivory fecal analysis nutrient cycling forest encroachment foraging strategy disturbance index ADL nutritional markers row-crops grazing preferences gap dynamics seed propagation ecological fitness native plants forbs restoration ADF CP AIA NDF deer management ecological management IVDMD overabundance tallgrass energetics forbs
146	Analyse discriminante et perceptron multicouche-liens formels et applications Diagne, Elhadji Diaraff Diegane January 2019 (has links) (PDF) No description available. AD ADF ADL ADM ADP ADQ Algorithme Analyse Application Bruto Classification Discriminant Donnée Fisher Flexible Formel Gaussien HTRU2 Iris Lien Linéaire Mars MclustDA MDA Mélange Multicouche Pénalisé Perceptron PMC Pulsar Quadratique Rétropropagation RFMT Roc Taux TBC TMC
147	Enrichment of Archetypes with Domain Knowledge to Enhance the Consistency of Electronic Health Records Giménez Solano, Vicente Miguel 21 January 2022 (has links) [ES] La consistencia de los datos de la HCE, como dimensión de la calidad, se considera un requisito esencial para la mejora de la prestación de la asistencia sanitaria, los procesos de toma de decisiones clínicas y la promoción de la investigación clínica. En este contexto, la cooperación entre la información y los modelos de dominio se considera esencial en la literatura, pero la comunidad científica no la ha abordado adecuadamente hasta la fecha. La contribución principal de esta tesis es el desarrollo de métodos y herramientas para la inclusión de expresiones de enlaces terminológicos en reglas de consistencia. Las contribuciones específicas son: - Definición de un método para ejecutar ECs sobre una base de datos de SNOMED CT orientada a grafos. - Definición de métodos para simplificar ECs antes y después de su ejecución, y su validación semántica conforme al Machine Readable Concept Model de SNOMED CT (MRCM). - Definición de un método para visualizar, explorar dinámicamente, comprender y validar subconjuntos de SNOMED CT. - Desarrollo de SNQuery, una plataforma que ejecuta, simplifica y valida ECs y visualiza los subconjuntos resultantes. - Definición de EHRules, un lenguaje de expresiones basado en el openEHR Expression Language para la especificación de reglas de consistencia en arquetipos, incluido el enlace terminológico de contenido, con el fin de enriquecer los arquetipos con conocimiento del dominio. - Definición de un método para ejecutar las expresiones de EHRules con el fin de validar la consistencia de los datos de la HCE mediante la ejecución de dichas expresiones sobre instancias de datos de pacientes. Nuestro objetivo es que estas contribuciones ayuden a mejorar la calidad de la HCE, ya que proporcionan métodos y herramientas para la validación y mejora de la consistencia de los datos de la HCE. Pretendemos, además, mediante la definición de enlaces de contenido entre modelos de información y terminologías clínicas, elevar el nivel de interoperabilidad semántica, para lo cual la definición de enlaces terminológicos es crucial. / [CA] La consistència de les dades de la HCE, com a dimensió de la qualitat, es considera un requisit essencial per a la millora de la prestació de l'assistència sanitària, els processos de presa de decisions clíniques i la promoció de la investigació clínica. En aquest context, la cooperació entre la informació i els models de domini es considera essencial en la literatura, però la comunitat científica no l'ha abordada adequadament fins hui. La contribució principal d'aquesta tesi és el desenvolupament de mètodes i ferramentes per a la inclusió d'expressions d'enllaços terminològics en regles de consistència. Les contribucions específiques són: - Definició d'un mètode per a executar ECs sobre una base de dades de SNOMED CT orientada a grafs. - Definició de mètodes per a simplificar ECs abans i després de la seua execució, i la seua validació semàntica conforme al Machine Readable Concept Model de SNOMED CT (MRCM). - Definició d'un mètode per a visualitzar, explorar dinàmicament, comprendre i validar subconjunts de SNOMED CT. - Desenvolupament de SNQuery, una plataforma que executa, simplifica i valida ECs i visualitza els subconjunts resultants. - Definició de EHRules, un llenguatge d'expressions basat en l'openEHR Expression Language per a l'especificació de regles de consistència en arquetips, inclòs l'enllaç terminològic de contingut, amb la finalitat d'enriquir els arquetips amb coneixement del domini. - Definició d'un mètode per a executar les expressions de EHRules amb la finalitat de validar la consistència de les dades de la HCE mitjançant l'execució d'aquestes expressions sobre instàncies de dades de pacients. El nostre objectiu és que aquestes contribucions ajuden a millorar la qualitat de la HCE, ja que proporcionen mètodes i ferramentes per a la validació i millora de la consistència de les dades de la HCE. Pretenem, a més, mitjançant la definició d'enllaços de contingut entre models d'informació i terminologies clíniques, elevar el nivell d'interoperabilitat semàntica, per a la qual cosa la definició d'enllaços terminològics és crucial. / [EN] Consistency of EHR data, as a dimension of quality, is considered an essential requirement to the improvement of healthcare delivery, clinical decision-making processes, and the promotion of clinical research. In this context, cooperation between information and domain models has been considered essential in the literature, but it has not been adequately addressed by the scientific community to date. The main contribution of this thesis is the development of methods and tools for the inclusion of terminology binding expressions in consistency rules. Specific contributions are: - Definition of a method to execute ECs over a SNOMED CT graph-oriented database. - Definition of methods to simplify ECs before and after its execution and semantic validation according to the SNOMED CT Machine Readable Concept Model (MRCM). - Definition of a method to visualize, dynamically explore, understand and validate SNOMED CT subsets. - Development of SNQuery, an execution platform that executes, simplifies and validates ECs, and visualizes the resulting subsets. - Definition of EHRules, an expression language based on the openEHR Expression Language for the specification of consistency expressions in archetypes, including value set bindings, in order to enrich archetypes with domain knowledge. - Definition of a method to execute EHRules expressions in order to validate the consistency of EHR data by executing such rules over patient data instances. Our objective is that these contributions help to enhance the quality of EHR, as they provide methods and tools for the validation and enhancement of the EHR data consistency. We also intend, by defining value set bindings between information models and clinical terminologies, to raise the level of semantic interoperability, for which the definition of terminological bindings is crucial. / This thesis was partially funded by Ministerio de Economía y Competitividad, “Doctorados Industriales”, grant DIN2018-009951, and by Universitat Politècnica de València, “Formación de Personal Investigador” (FPI-UPV). / Giménez Solano, VM. (2021). Enrichment of Archetypes with Domain Knowledge to Enhance the Consistency of Electronic Health Records [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/180082 / TESIS Semantic interoperability Terminology binding Archetype Model (AM) Archetype Definition Language (ADL) Archetype Modelling Language (AML) Electronic Health Record (EHR) SNOMED CT Historia Clínica Electrónica Interoperabilidad semántica Consistencia Consistency Enlace terminológico Subconjuntos Subsets Modelo de arquetipos Lenguaje de definición de arquetipos Lenguaje de modelado de arquetipos FISICA APLICADA TECNOLOGIA ELECTRONICA
148	Health for community dwelling older people : trends, inequalities, needs and care in rural Vietnam Van Hoi, Le January 2011 (has links) Background InVietnam, the proportion of people aged 60 and above has increased rapidly in recent decades. The majority live in rural areas where socioeconomic status is more disadvantaged than in urban areas.Vietnam’s economic status is improving but disparities in income and living conditions are widening between groups and regions. A consistent and emerging danger of communicable diseases and an increase of non-communicable diseases exist concurrently. The emigration of young people and the impact of other socioeconomic changes leave more elderly on their own and with less family support. Introduction of user fees and development of a private sector improve the coverage and quality of health care but increase household health expenditures and inequalities in health care. Life expectancy at birth has increased, but not much is known about changes during old age. There is a lack of evidence, particularly in rural settings, about health-related quality of life (HRQoL) among older people within the context of socioeconomic changes and health-sector reform. Knowledge of long-term elderly care needs in the community and the relevant models are still limited. To provide evidence for developing new policies and models of care, this thesis aimed to assess general health status, health care needs, and perspectives on future health care options for community-dwelling older people. Methods An abridged life table was used to estimate cohort life expectancies at old age from longitudinal data collected by FilaBavi DSS during 1999-2006. This covered 7,668 people aged 60 and above with 43,272 person-years. A 2007 cross-sectional survey was conducted among people aged 60 and over living in 2,240 households that were randomly selected from the FilaBavi DSS. Interviews used a structured questionnaire to assess HRQoL, daily care needs, and willingness to use and to pay for models of care. Participant and household socioeconomic characteristics were extracted from the 2007 DSS re-census. Differences in life expectancy are examined by socioeconomic factors. The EQ-5D index is calculated based on the time trade-off tariff. Distributions of study subjects by study variables are described with 95% confidence intervals. Multivariate analyses are performed to identify socioeconomic determinants of HRQoL, need of support, ADL index, and willingness to use and pay for models of care. In addition, four focus group discussions with the elderly, their household members, and community association representatives were conducted to explore perspectives on the use of services by applying content analysis. Results Life expectancy at age 60 increased by approximately one year from 1999-2002 to 2003-2006, but tended to decrease in the most vulnerable groups. There is a wide gap in life expectancy by poverty status and living arrangement. The sex gap in life expectancy is consistent across all socioeconomic groups and is wider among the more disadvantaged populations. The EQ-5D index at old age is 0.876. Younger age groups, position as household head, working, literacy, and belonging to better wealth quintiles are determinants of higher HRQoL. Ageing has a primary influence on HRQoL that is mainly due to reduction in physical (rather than mental) functions. Being a household head and working at old age are advantageous for attaining better HRQoL in physical rather than psychological terms. Economic conditions affect HRQoL through sensory rather than physical functions. Long-term living conditions are more likely to affect HRQoL than short-term economic conditions. Dependence in instrumental or intellectual activities of daily living (ADLs) is more common than in basic ADLs. People who need complete help are fewer than those who need some help in almost all ADLs. Over two-fifths of people who needed help received enough support in all ADL dimensions. Children and grand-children are confirmed to be the main caregivers. Presence of chronic illness, age groups, sex, educational level, marital status, household membership, working status, household size, living arrangement, residential area, household wealth, and poverty status are determinants of the need for care. Use of mobile teams is the most requested service; the fewest respondents intend to use a nursing centre. Households expect to use services for their elderly to a greater extent than did the elderly themselves. Willingness to use services decreases when potential fees increase. The proportion of respondents who require free services is 2 to 3 times higher than those willing to pay full cost. Households are willing to pay more for day care and nursing centres than are the elderly. The elderly are more willing to pay for mobile teams than are their households. ADL index, age group, sex, literacy, marital status, living arrangement, head of household status, living area, working status, poverty and household wealth are factors related to willingness to use services. Conclusions There is a trend of increasing life expectancy at older ages in ruralVietnam. Inequalities in life expectancy exist between socioeconomic groups. HRQoL at old age is at a high level, but varies substantially according to socioeconomic factors. An unmet need of daily care for older people remains. Family is the main source of support for care. Need for care is in more demand among disadvantaged groups. Development of a social network for community-based long-term elderly care is needed. The network should focus on instrumental and intellectual ADLs rather than basic ADLs. Home-based care is more essential than institutionalized care. Community-based elderly care will be used and partly paid for if it is provided by the government or associations. The determinants of elderly health and care needs should be addressed by appropriate social and health policies with greater targeting of the poorest and most disadvantaged groups. Building capacity for health professionals and informal caregivers, as well as support for the most vulnerable elderly groups, is essential for providing and assessing the services. / Aging and Living Conditions Program / Vietnam-Sweden Collaborative Program in Health, SIDA/Sarec older people elderly health health status life expectancy health-related quality of life EQ-5D mobility self-care usual activities pain discomfort anxiety depression activity of daily living basic ADL instrumental ADL intellectual ADL non-communicable diseases need of care health service model of care mobile team day care centre nursing centre inequalities cost of care socioeconomic education marital status living arrangement household head working status living area wealth quintile poverty line community cohort study household survey focus group discussion qualitative research rural Vietnam developing country Asia người cao tuổi y tế thực trạng sức khỏe hy vọng sống chất lượng cuộc sống EQ-5D đi lại tự chăm sóc hoạt động thường xuyên đau khó chịu lo lắng trầm cảm hoạt động hàng ngày bệnh không lây nhiễm nhu cầu chăm sóc dịch vụ y tế mô hình chăm sóc đội lưu động trung tâm chăm sóc ban ngày trung tâm dưỡng lão bất bình đẳng chi phí chăm sóc kinh tế xã hội giáo dục hôn nhân sắp xếp cuộc sống chủ hộ tình trạng làm việc khu vực sống ngũ phân thịnh vượng chuẩn nghèo cộng đồng nghiên cứu theo dõi dọc điều tra hộ gia đình thảo luận nhóm tập trung nghiên cứu định tính nông thôn Việt Nam nước đang phát triển châu Á
149	Implementace obecného assembleru / Implementation of General Assembler Husár, Adam January 2007 (has links) This thesis describes the design of the universal assembler that represents a part of the Lissom project. You will be provided with the description of the assembler architectures and their usual tasks. Special attention is paid to GNU assembler. Designed assembler consists of the fixed and the generated part. The generated part is created automatically from the description of instruction set, that is defined using architecture and instructions set description language ISAC. Using this approach, it is possible to change assembler target architecture automatically. The second part of thesis describes the Parserlib2 library implementation that is a part of the Lissom project and provides the information about the target instruction set for an assembler generator.

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