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Search Results: 1 - 10 of 2494 matches for " Karina Gibert "
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Knowledge discovery from data as a framework to decision support in medical domains
Karina Gibert
International Journal of Integrated Care , 2009,
Abstract:
The role of ontologies in supporting distributed medical systems
Karina Gibert,A?da Valls
International Journal of Integrated Care , 2009,
Abstract:
Integrating clinicians, knowledge and data: expert-based cooperative analysis in healthcare decision support
Karina Gibert, Carlos García-Alonso, Luis Salvador-Carulla
Health Research Policy and Systems , 2010, DOI: 10.1186/1478-4505-8-28
Abstract: This paper introduces a new hybrid methodology Expert-based Cooperative Analysis (EbCA), which incorporates explicit prior expert knowledge in data analysis methods, and elicits implicit or tacit expert knowledge (IK) to improve decision support in healthcare systems. EbCA has been applied to two different case studies, showing its usability and versatility: 1) Bench-marking of small mental health areas based on technical efficiency estimated by EbCA-Data Envelopment Analysis (EbCA-DEA), and 2) Case-mix of schizophrenia based on functional dependency using Clustering Based on Rules (ClBR). In both cases comparisons towards classical procedures using qualitative explicit prior knowledge were made. Bayesian predictive validity measures were used for comparison with expert panels results. Overall agreement was tested by Intraclass Correlation Coefficient in case "1" and kappa in both cases.EbCA is a new methodology composed by 6 steps:. 1) Data collection and data preparation; 2) acquisition of "Prior Expert Knowledge" (PEK) and design of the "Prior Knowledge Base" (PKB); 3) PKB-guided analysis; 4) support-interpretation tools to evaluate results and detect inconsistencies (here Implicit Knowledg -IK- might be elicited); 5) incorporation of elicited IK in PKB and repeat till a satisfactory solution; 6) post-processing results for decision support. EbCA has been useful for incorporating PEK in two different analysis methods (DEA and Clustering), applied respectively to assess technical efficiency of small mental health areas and for case-mix of schizophrenia based on functional dependency. Differences in results obtained with classical approaches were mainly related to the IK which could be elicited by using EbCA and had major implications for the decision making in both cases.This paper presents EbCA and shows the convenience of completing classical data analysis with PEK as a mean to extract relevant knowledge in complex health domains. One of the major benefits of Eb
Use of functioning-disability and dependency for case-mix and subtyping of schizophrenia
Ochoa,Susana; Salvador-Carulla,Luis; Villalta-Gil,Victoria; Gibert,Karina; Haro,Josep Maria; ,;
The European Journal of Psychiatry , 2012, DOI: 10.4321/S0213-61632012000100001
Abstract: background and objectives: to evaluate the utility of the constructs functioning and disability (f & d) and dependency for case-mix and subtyping of patients with schizophrenia by psychosocial, clinical, use of services and attention received from informal carers. methods: a randomly selected total of 205 people with schizophrenia, and their careers were evaluated through panss, das-sv, objective and subjective burden scale (ecfos-ii) and use of services. results: two groups and four profiles were identified according to levels of dependency: the non-dependent group was made of two profiles: independent (i), and persons with disability in the community (dic). the dependent group included persons with dependency in the community (dec) and persons with dependency in hospital care (deh). there are clinical and psychosocial differences between these profiles being the dependent the most severe. regarding use of services, dec use the most resources, with the exception deh (more hospitalization resources). the dec profile generate greater family burden in the following areas; taking medication, being accompanied to appointments, and management than the dic, despite both groups showing a high need for support. conclusions: dependency is a relevant construct for case-mix and subtyping in schizophrenia, and it is related to severity both at the social and clinical level. dec generate more family burden than the other profiles, followed by dic (patients with schizophrenia with disability but non-dependent).
Use of functioning-disability and dependency for case-mix and subtyping of schizophrenia
Susana Ochoa,Luis Salvador-Carulla,Victoria Villalta-Gil,Karina Gibert
The European Journal of Psychiatry , 2012,
Abstract: Background and Objectives: To evaluate the utility of the constructs functioning and disability (F & D) and dependency for case-mix and subtyping of patients with schizophrenia by psychosocial, clinical, use of services and attention received from informal carers. Methods: A randomly selected total of 205 people with schizophrenia, and their careers were evaluated through PANSS, DAS-sv, Objective and Subjective Burden Scale (ECFOS-II) and use of services. Results: Two groups and Four profiles were identified according to levels of Dependency: The non-dependent group was made of two profiles: independent (I), and persons with disability in the community (DiC). The dependent group included persons with dependency in the community (DeC) and persons with dependency in hospital care (DeH). There are clinical and psychosocial differences between these profiles being the dependent the most severe. Regarding use of services, DeC use the most resources, with the exception DeH (more hospitalization resources). The DeC profile generate greater family burden in the following areas; taking medication, being accompanied to appointments, and management than the DiC, despite both groups showing a high need for support. Conclusions: Dependency is a relevant construct for case-mix and subtyping in schizophrenia, and it is related to severity both at the social and clinical level. DeC generate more family burden than the other profiles, followed by DiC (patients with schizophrenia with disability but non-dependent).
Moderniser la ville, réaménager la rue à Ho Chi Minh Ville
Marie Gibert
EchoGéo , 2010,
Abstract: Cet article se propose de faire de la rue un objet géographique permettant de lire les recompositions socio-spatiales de Ho Chi Minh Ville, à l’heure de la politique volontariste de renouvellement urbain des autorités. C’est à partir d’un double héritage étranger que la trame urbaine de Ho Chi Minh Ville s’est ensuite auto-développée pendant trois décennies donnant naissance à des rues étroites, support d’un bati dense et bas, lieu de pratiques urbaines multiformes. La redéfinition contemporaine de l’échelle de ces rues, devant permettre la verticalisation du bati riverain, invite alors à interroger les différentes modalités de renouvellement de la rue ainsi que la réappropriation de cette dernière par les citadins. This article considers the streets of Ho Chi Minh City as an original geographicalobject of researchthatallows to read the socio-spatial restructuration of the city in the currentcontext of urbanrenewal official policies. The urbanfabric network of Ho Chi Minh City is first and foremost a double foreigninheritagefromboth the Chinese and the French periods. It thendevelopped by itselfduringthreedecades. This urbanhistoryled to the development of a very dense network of narrowalleys, withmultiformurbanfunctions. The current official redefinition of the streetsscaleaims to allow for the verticalisation of the buildings environment. Then, theseprojects of streetrenewalenables us to examine the variousmodalities of streetrenewal and its new appropriation by the urbancitizens.
The Strategy of Combining Antidepressants in the Treatment of Major Depression: Clinical Experience in Spanish Outpatients
Luis M. Martín-López,Jose E. Rojo,Karina Gibert,Juan Carlos Martín,Lyli Sperry,Lurdes Du?ó,Antonio Bulbena,Julio Vallejo
Depression Research and Treatment , 2011, DOI: 10.1155/2011/140194
Abstract: Introduction. The combination of antidepressants is a useful tool in the treatment of major depression, especially in cases where there is a partial response to antidepressant monotherapy. However, the use of this strategy is a matter of controversy, and its frequency of use in clinical practice is not clear. The aim of our study is to assess the use of antidepressants combination in Spain by reviewing three databases used between 1997 and 2001. Methods. Databases pertain to patients who are study subjects of major depression treatment. These databases are a result of studies performed in Spain and in which 550 psychiatrists participated. The total studied sample was comprised of patients, aged over 18, fitting DSM-IV criteria for Major Depressive Episode. The percentage of patients who received more than one antidepressant and the types of combinations used was described. Subsequently, a comparative study between the group which received a combination of antidepressants ( ) and the group which received antidepressant monotherapy ( ) was performed. Results. 27.1% of patients were on antidepressive monotherapy treatment, and 2.2% were on combination therapy. In the comparison of patients on combination therapy and monotherapy, there were significant differences only in episode duration ( ). The most frequent combinations are SSRIs and tricyclic antidepressants. The active principle most widely combined is fluoxetine. Conclusions. The prevalence of use of antidepressant combination therapy is 2.2% of the global sample and 8.3% of treated patients. Other than duration of the depressive episode, no clinical characteristics exclusive to patients who received combination rather than monotherapy were found. Our study found that the most frequent combination is SSRIs + TCAs, also being the most studied. 1. Introduction According to numerous authors [1–5], the combination of antidepressants is a useful tool in the treatment of major depression. It is a therapeutic strategy indicated especially in cases where response to antidepressant monotherapy is partial [3]. These situations arise regardless of the type of therapy used. In a review of 102 studies of patients treated with tricyclic antidepressants (TCAs), results indicated that on average, 51% of subjects responded favorably [6]. Similarly, in a review of 39 studies of major depression treated with SSRIs 47% of patients had a sufficient response to treatment. Given that 15% of the general population is prone to suffer a major depression episode at some point in their life [7], a substantial number of patients
A preliminary taxonomy and a standard knowledge base for mental-health system indicators in Spain
Luis Salvador-Carulla, José Salinas-Pérez, Manuel Martín, Mont-serrat Grané, Karina Gibert, Miquel Roca, Antonio Bulbena, the GClin-SEP group
International Journal of Mental Health Systems , 2010, DOI: 10.1186/1752-4458-4-29
Abstract: A qualitative method with two experts panels was used to develop a framing document, a preliminary taxonomy with a conceptual map of health indicators, and a knowledge base consisting of key documents, glossary and database of indicators with an evaluation of their relevance for Spain.A total of 661 indicators were identified and organised hierarchically in 4 domains (Context, Resources, Use and Results), 12 subdomains and 56 types. Among these the expert panels identified 200 indicators of relevance for the Spanish system.The classification and hierarchical ordering of the mental health indicators, the evaluation according to their level of relevance and their incorporation into a knowledge base are crucial for the development of a basic list of indicators for use in mental health planning.Health indicators are tools designed to measure the health status of people and the functioning of health services through the various factors that influence them (demographic, economic, social) [1,2]. These provide the basic information for system analysis and decision-making in policies, planning and health management. The area of mental health presents added difficulties for the development of a useful list of health indicators for a variety of reasons. Firstly, this is a complex area in which health, social, educational and criminal and justice services coexist, where the care teams are multidisciplinary, and in which an integral care focus should be adopted [3]. Secondly, there are no reliable biological indicators for either the disorders assessed or the results, which complicates epidemiological and outcome research. Thirdly, mental health has been included late into the general health system (in Spain from 1986), it presents problems of under-financing and the lack of national data bases which exists in other disciplines (e.g. Oncology or AIDS) [4].The instruments which compile indicators are rarely organised as a knowledge-base and they lack adequate semantic interoperab
Obliteration study of lambdatic and obelionic region sutures in ruminant, carnivores and hominids
Gibert, J.,Ribot, F.,Gibert, P.,Gibert, L.
Estudios Geologicos , 2006, DOI: 10.3989/egeol.0662112
Abstract: The morphology of Orce cranial fragment VM-0 is contrasted with the fronto-parietal region in artiodactyls, and the obelionic region in carnivores and primates including hominids. Sutural development at obelion is compared in those taxa throughout the growth period up to the onset of sutural obliteration, and ontogenetic differences between non-primates and primates lead us to conclude that the configuration in VM-0 more resembles that found in hominids than in artiodactyls or carnivores. Moreover, cranial capacity for VM-0 is estimated at >470cm3, comparable to Plio Pleistocene hominids, but greater than in young equids. La morfología del fragmento cranial de Orce (VM-0) se contrasta con la región fronto-parietal de los artiodáctilos y con la región obélica de los carnívoros y primates incluyendo los homínidos. Se compara en estos taxones, el desarrollo de las suturas en esta región a lo largo del periodo de crecimiento hasta que ocurre la obliteración de las mismas. Las diferencias ontogenéticas entre no primates y primates nos permiten concluir que la anatomía de VM-0 es más próxima a los hominidos que a la de los artiodáctilos y carnívoros. Se estima que la capacidad craneana de VM-0 tiene que ser > 470 cm3, comparable a la de los homínidos del Plio-Pleistoceno y mayor que la de los équidos juveniles.
Trabajando con alumnos no alfabetizados
Isabel Gibert Escofet
Foro de Profesores de E/LE , 2010,
Abstract: Cuándo aprendimos a leer y a escribir?, qué recuerdos guardamos de entonces? Desde luego, yo recuerdo alguno de mis primeros libros de lengua y guardo un borroso pero grato recuerdo de cómo mi maestra me ense ó las letras por sonidos, y recuerdo cuando a la be le llamaba bbbb y a la eme, mmm. También recuerdo el primer libro que leí; pero no os podría decir el momento exacto en que pasé de conocer el sonido y la grafía de las letras a juntarlas y a comprender lo que leía. El proceso de alfabetización es un proceso sumamente complicado por el nivel de abstracción que comporta; y me cuesta entender cómo ni os de tan corta edad pueden llegar a aprender a leer. Misterios del cerebro humano!
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