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Search Results: 1 - 10 of 3807 matches for " Ruth Epstein "
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Event-based knowledge elicitation of operating room management decision-making using scenarios adapted from information systems data
Franklin Dexter, Ruth E Wachtel, Richard H Epstein
BMC Medical Informatics and Decision Making , 2011, DOI: 10.1186/1472-6947-11-2
Abstract: A process of event-based knowledge elicitation was developed to assess OR management decision-making that may reduce the efficiency of use of OR time. Hypothetical scenarios addressing every OR management decision influencing OR efficiency were created from published examples. Scenarios are adapted, so that cues about conditions are accurate and appropriate for each facility (e.g., if OR 1 is used as an example in a scenario, the listed procedure is a type of procedure performed at the facility in OR 1). Adaptation is performed automatically using the facility's OR information system or anesthesia information management system (AIMS) data for most scenarios (43 of 45). Performing the needs assessment takes approximately 1 hour of local managers' time while they decide if their decisions are consistent with the described scenarios. A table of contents of the indexed scenarios is created automatically, providing a simple version of problem solving using case-based reasoning. For example, a new OR manager wanting to know the best way to decide whether to move a case can look in the chapter on "Moving Cases on the Day of Surgery" to find a scenario that describes the situation being encountered.Scenarios have been adapted and used at 22 hospitals. Few changes in decisions were needed to increase the efficiency of use of OR time. The few changes were heterogeneous among hospitals, showing the usefulness of individualized assessments.Our technical advance is the development and use of automated event-based knowledge elicitation to identify suboptimal OR management decisions that decrease the efficiency of use of OR time. The adapted scenarios can be used in future decision-making.Operating room (OR) information system data or anesthesia information management system (AIMS) data can be analyzed to identify and quantify potential improvements in performance. For example, McIntosh and colleagues reviewed how to calculate changes in OR allocations to achieve maximal efficienc
Learning from the problems of problem-based learning
Richard Epstein
BMC Medical Education , 2004, DOI: 10.1186/1472-6920-4-1
Abstract: Analysis of the literature indicates that the recent rapid rise of PBL has closely paralleled the timing of the information explosion. The growing dominance of PBL could thus worsen the problems of information management in medical education via several mechanisms: first, by creating the impression that a defined spectrum of core factual knowledge suffices for clinical competence despite ongoing knowledge expansion (quality cost); second, by dissuading teachers from refining the educational utility of didactic modalities (improvement cost); and third, by reducing faculty time for developing reusable resources to impart factual knowledge more efficiently (opportunity cost).These costs of PBL imply a need for strengthening the knowledge base of 21st-century medical graduates. New initiatives towards this end could include the development of more integrated cognitive techniques for facilitating the comprehension of complex data; the design of differentiated medical curricula for producing graduates with defined high-priority skill sets; and the encouragement of more cost-effective faculty teaching activities focused on the prototyping and testing of innovative commercializable educational tools.Many doctors have commented that their medical education began in earnest on the first day that they entered the hospital wards as a hands-on practitioner. Claims of this kind support the view that the apprenticeship model of professional learning – which has been the backbone of training in the healing arts for thousands of years [1] – remains as central to medical career development today as ever [2]. A perennial complaint of the medical apprentice-in-training is that there are too few structured teaching activities within the busy world of postgraduate work [3], a concern which many institutions have addressed by developing formalised continuing education initiatives reminiscent of medical school courses [4-6]. Predictably, different complaints prevail at the pre-licensure ph
O dilema do prisioneiro e a ética
Epstein, Isaac;
Estudos Avan?ados , 1995, DOI: 10.1590/S0103-40141995000100010
Abstract: historically the words altruism and ethics ocurre rather in religious or philosophical discourses than in texts about behavioral sciences. recently, however, a theoretical approach of one kind of human interaction called prisioner's dilemma generated softwares designed by researchers in the field that simulate this situation. the results of computer tournamentes among different designs of softwares reveals that those strategies based in cooperation gave to their performers a better chance of survival then the softwares based on predatory or competitive strategies.
Chronic idiopathic constipation
D Epstein
Continuing Medical Education , 2009,
Abstract: The function of the colon is to conserve water, split dietary fibre by the action of colonic bacteria and allow the expulsion of residue at a convenient time.
Graffitis et inscriptions murales de Montevideo
Ariela Epstein
Amerika : Mémoires, Identités, Territoires , 2010, DOI: 10.4000/amerika.708
Abstract: Recouverts de graffitis, de pochoirs, de fresques politiques ou artistiques, les murs de Montevideo sont une entrée pour une ethnologie de la ville et des cultures urbaines. Ces discours textuels et iconographiques mobilisent des langages, des symboles et des imaginaires particuliers, en une polyphonie qui reflète nombre de débats et de conflits en jeu dans la société. Le graffiti et la peinture murale sont considérés comme faisant partie du champ des cultures populaires, des formes d’expressions de celles-ci. En effet, et contrairement à d’autres formes de productions culturelles, la question du populaire se pose ici essentiellement du point de vue des auteurs et donc de la pratique. à travers l’assemblage chaotique d’esthétiques particulières (locales ou réappropriées), la trame visuelle des murs montévidéens compose un ensemble hétérogène qui reflète les processus d’hybridation dont parle García Canclini. On voit alors comment différents groupes sociaux se donnent, à travers ces inscriptions, une place dans la société. Nous interrogeons, à travers des énoncés militants et d’autres apparemment neutres, les fa ons dont cultures et politique se mêlent et se mettent en scène dans l’Uruguay contemporain. The walls of Montevideo, covered in graffiti, and political or artistic frescos, are a possible key to an ethnological study of the city and of urban cultures. Such textual and iconographic discourse uses languages, symbols and specific imaginaries, forming a polyphonic gathering which mirrors many debates and conflicts within Uruguayan society. Graffiti and murals are seen as belonging to popular cultures and their own forms of expression. Indeed, and contrary to other types of cultural productions, the issue of the “popular” is mainly addressed here from the point of view of the artists and therefore of such a practice. Through the chaotic superimposition of specific aesthetics (whether local or transferred), the overall view of Montevideo walls gives a heterogeneous composition reflecting the hybridization process Garcia Canclini mentions. Through such inscriptions, different social groups are therefore given a role within society. Our study will analyze the different ways in which “cultures” and “politics” blend and are staged in modern Uruguay, through committed or apparently neutral inscriptions.
Obama’s Economic Policy: Achievements, Problems and Prospects
Gerald Epstein
Revue de la Régulation : Capitalisme, Institutions, Pouvoirs , 2009,
Abstract: 1. IntroductionIn late November, 2008, just after President Barak Obama won the American election, a group of progressive economists met in New York city at the New School for Social Research, to discuss the ongoing economic crisis and to try to reach a consensus on financial and macroeconomic policies that the group should advise the Obama Administration to implement. Organized under the sponsorship of the New School’s Schwartz Center for Economic Policy (SCEPA) and the University of Massach...
Learning from the problems of problem-based learning
Epstein Richard
BMC Medical Education , 2004,
Abstract: Background The last decade has witnessed a rapid expansion of biomedical knowledge. Despite this, fashions in medical education over the same period have shifted away from factual (didactic) teaching and towards contextual, or problem-based, learning (PBL). This paradigm shift has been justified by studies showing that PBL improves reasoning and communication while being associated with few if any detectable knowledge deficits. Discussion Analysis of the literature indicates that the recent rapid rise of PBL has closely paralleled the timing of the information explosion. The growing dominance of PBL could thus worsen the problems of information management in medical education via several mechanisms: first, by creating the impression that a defined spectrum of core factual knowledge suffices for clinical competence despite ongoing knowledge expansion (quality cost); second, by dissuading teachers from refining the educational utility of didactic modalities (improvement cost); and third, by reducing faculty time for developing reusable resources to impart factual knowledge more efficiently (opportunity cost). Summary These costs of PBL imply a need for strengthening the knowledge base of 21st-century medical graduates. New initiatives towards this end could include the development of more integrated cognitive techniques for facilitating the comprehension of complex data; the design of differentiated medical curricula for producing graduates with defined high-priority skill sets; and the encouragement of more cost-effective faculty teaching activities focused on the prototyping and testing of innovative commercializable educational tools.
Aktuelles: Osteoporose-Management im Rückblick
Epstein S
Journal für Mineralstoffwechsel , 2011,
Abstract:
Politiques publiques : un panorama des recompositions à l’ uvre.
Renaud Epstein
EspacesTemps.net , 2006,
Abstract: L’ école grenobloise constituée autour du cerat (Centre de Recherche sur l’Administration, la politique et le Territoire) se distingue dans le paysage de l’analyse des politiques publiques par ses travaux sur la dimension cognitive de ces dernières. Suivant l’approche proposée par Jobert et Muller autour du concept de référentiel, une politique publique n’est pas qu’un espace dans lequel s’affrontent des acteurs mus par leurs intérêts, mais aussi le lieu où une ...
Existence and properties of p-tupling fixed points
Henri Epstein
Physics , 2000, DOI: 10.1007/s002200000311
Abstract: We prove the existence of fixed points of p-tupling renormalization operators for interval and circle mappings having a critical point of arbitrary real degree r > 1. Some properties of the resulting maps are studied: analyticity, univalence, behavior as $r$ tends to infinity.
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