Methodological challenges for collaborative learning research

Research on collaborative learning, both face-to-face and computer-supported, has thrived in the past 10 years. The studies range from outcome-oriented (individual and group learning) to process-oriented (impact of interaction on learning processes, motivation and organisation of collaboration) to mixed studies. Collaborative learning research is multi-disciplinary. This introduces a multitude of theoretical accounts for collaborative learning, accompanied by a broad spectrum of methods to study processes and outcomes of collaboration. This special issue will provide an overview of methods that are at the core of current research effort, but also identifies opportunities and problems to sensibly combine methods into mixed method approaches

Method and apparatus for determining and utilizing a time-expanded decision network

A method, apparatus and computer program for determining and utilizing a time-expanded decision network is presented. A set of potential system configurations is defined. Next, switching costs are quantified to create a "static network" that captures the difficulty of switching among these configurations. A time-expanded decision network is provided by expanding the static network in time, including chance and decision nodes. Minimum cost paths through the network are evaluated under plausible operating scenarios. The set of initial design configurations are iteratively modified to exploit high-leverage switches and the process is repeated to convergence. Time-expanded decision networks are applicable, but not limited to, the design of systems, products, services and contracts

Reliability of reported underlying causes of neonatal death : implications for the study of preventable mortality

Analisam-se as principais causas de morte neonatal, a confiabilidade da causa básica constante nas declarações de óbito e o impacto dos problemas de confiabilidade na análise de morte prevenível. A informação constante nas declarações de óbito de urna amostra de 15% dos óbitos neonatais, ocorridos entre maio de 1986 e abril de 1987, na Região Metropolitana do Rio de Janeiro, Brasil, é comparada com a dos prontuários hospitalares de 452 crianças falecidas. Identificou-se no prontuário o diagnóstico, denominado "causa básica modificada", considerada mais correta segundo as regras de classificação de doenças. A grande maioria dos óbitos foram devidos às causas perinatais (87%). A concordância simples entre a causa básica original e a modificada foi baixa - 38% para 3 dígitos da Classificação Internacional de Doenças e 33% para 4 dígitos. As causas básicas modificadas mostram maior peso das afecções e complicações maternas, com aumento de 12,8 vezes, e das complicações relacionadas com a placenta, cordão, trabalho de parto ou parto, que aumentaram 6,2 vezes em relação as causas originalmente declaradas. A utilização da causa básica modificada elevou consideravelmente (58%) o percentual de óbitos considerados "reduzíveis" pela classificação de mortalidade neonatal proposta pela Fundação Sistema Estadual de Análise de Dados. Do total dos óbitos, 75% foram considerados reduzíveis ou parcialmente reduzíveis. Foram identificados 107 (24%) óbitos em crianças com adequado peso ao nascer, 60% dos quais foram considerados como reduzível ou parcialmente reduzível, bem como 4 óbitos por sífilis congênita, 3 por doença hemolítica perinatal, e 21 crianças que vieram a morrer no domicílio. Em conclusão, foram constatados importantes problemas na confiabilidade da declaração da causa básica de óbitos neonatais, cuja correção tende a elevar a proporção considerada reduzível ou prevenível. Fica evidente o potencial de utilização do atestado de óbito para o monitoramento de qualidade, entretanto sendo necessário um aprimoramento da qualidade do seu preenchimento. _________________________________________________________________________________ ABSTRACTThe main causes of neonatal mortality, the reliability of the underlying cause of death registered in the death certificate, and the impact of problems of reliability on the analysis of preventable death were studied. The information on death certificates from a 15% sample of neonatal deaths between May 1986 and April 1987 in the Greater Metropolitan Region of Rio de Janeiro was compared to the information in the hospital records of the 452 deceased infants. A "modified underlying cause" considered most correct according to disease classification rules was identified from the records. The great majority of deaths (87%) were due to perinatal causes. Agreement between the originally declared and modified underlying causes of death was poor: 38% for 3 digits of the International Classification of Diseases Codes (CID-9) and 33% for 4 digits. The modified underlying causes are more weighted towards maternal conditions and complications, which increased by a factor of 12.8, and towards complications of the placenta, umbilical cord, labour and delivery, which rose by a factor of 6.2 in relation to the original causes. The utilization of the "modified" underlying cause elevated considerably (58%) the proportion of deaths considered reducible by the classification of neonatal death proposed by the SEADE Foundation. Seventy-five percent (75%) of deaths were considered reducible or partially reducible. One hundred and seven (24%) of the deaths of them being in infants of normal birthweight, of which 60% considered preventable. Four (4) deaths from congenital syphilis, 3 from perinatal hemolytic diseases, and 21 unattended home deaths of infants were also identified. In summary, important problems were identified in the reliability of the declaration of the underlying causes of neonatal death, whose correction tends to elevate the proportion considered reducible or preventable. The potential for the use of death certificate data for the monitoring of quality is evident, nonetheless improvements are needed in the quality of these data

Simultaneous MAP estimation of inhomogeneity and segmentation of brain tissues from MR images

Intrascan and interscan intensity inhomogeneities have been identified as a common source of making many advanced segmentation techniques fail to produce satisfactory results in separating brains tissues from multi-spectral magnetic resonance (MR) images. A common solution is to correct the inhomogeneity before applying the segmentation techniques. This paper presents a method that is able to achieve simultaneous semi-supervised MAP (maximum a-posterior probability) estimation of the inhomogeneity field and segmentation of brain tissues, where the inhomogeneity is parameterized. Our method can incorporate any available incomplete training data and their contribution can be controlled in a flexible manner and therefore the segmentation of the brain tissues can be optimised. Experiments on both simulated and real MR images have demonstrated that the proposed method estimated the inhomogeneity field accurately and improved the segmentation

Avaliação da assistência farmacêutica na atenção primária no Distrito Federal

OBJETIVO: O acesso a medicamentos e seus serviços é indispensável às ações de saúde e um direito do cidadão segundo a política de medicamentos e a legislação brasileira. O objetivo do estudo foi avaliar aspectos da assistência farmacêutica na atenção primária, em centros de saúde. MÉTODOS: Estudo transversal utilizando indicadores da assistência farmacêutica propostos pela Organização Mundial de Saúde, em amostra aleatória de 15 centros de saúde dos 62 do Distrito Federal, em 2001. Em cada centro foram entrevistados 30 usuários. RESULTADOS: Apenas 18,7% dos pacientes compreendiam integralmente a prescrição, sendo que 56,3% conseguiam ler a receita. Foram efetivamente dispensados 61,2% dos medicamentos prescritos, o tempo médio de dispensação foi de 53,2 segundos e o de consulta 9,4 minutos. Dos medicamentos prescritos, 85,3% pertenciam à Relação de Medicamentos Essenciais, bem como 60,6% dos não atendidos. Da lista de 40 medicamentos-chave, 83,2% estavam disponíveis. Apenas duas unidades tinham farmacêutico responsável pela farmácia. O número médio de medicamentos por prescrição foi de 2,3. Foram prescritos pelo nome genérico 73,2% dos medicamentos onde 26,4% eram antibióticos e 7,5% injetáveis. Os grupos farmacológicos mais prescritos foram: cardiovasculares (26,8%), antimicrobianos (13,1%), analgésicos (8,9%), antiasmáticos (5,8%), antidiabéticos (5,3%), psicoativos (3,7%) e associações (2,7%). CONCLUSÕES: Após 30 anos da elaboração da primeira relação de medicamentos essenciais no Brasil, esses ainda estão apenas parcialmente disponíveis na rede pública, inclusive os destinados a doenças crônicas. Os prescritores utilizam a relação atualizada e nomes genéricos, mas a eficiência das ações de assistência farmacêutica está seriamente comprometida pelos baixos níveis de compreensão dos pacientes e pela dificuldade de acesso.OBJECTIVE: Pharmaceutical assistance is essential in health care and a right of citizens according to Brazilian law and drug policies. The study purpose was to evaluate aspects of pharmaceutical assistance in public primary health care. METHODS: A cross-sectional study using WHO drug indicators was carried out in Brasília in 2001. From a random sample of 15 out of 62 centers thirty exiting patients per center were interviewed. RESULTS: Only 18.7% of the patients fully understood the prescription, 56.3% could read it, 61.2% of the prescribed drugs were actually dispensed, and mean duration of pharmaceutical dispensing was 53.2 seconds. Each visit lasted on average 9.4 minutes. Of prescribed and non-dispensed drugs, 85.3% and 60.6% were on the local essential drug list (EDL) respectively. On average 83.2% of 40 essential drugs were in stock, and only two centers had a pharmacist in charge of the pharmacy. The mean number of drugs per prescription was 2.3, 85.3% of prescribed drugs were on the EDL, 73.2% were prescribed using the generic denomination, 26.4% included antibiotics and 7.5% were injectables. The most prescribed groups were: cardiovascular drugs (26.8%), anti-infective drugs (13.1%), analgesics (8.9%), anti-asthmatic drugs (5.8%), anti-diabetic drugs (5.3%), psychoactive drugs (3.7%), and combination drugs (2.7%). CONCLUSIONS: Essential drugs were only moderately available almost 30 years after the first Brazilian EDL was formulated. While physician use of essential drugs and generic names was fairly high, efficiency was impaired by the poor quality of pharmaceutical care, resulting in very low patient understanding and insufficient guarantee of supply, particularly for chronic diseases

Globalization and the Business of Law: Lessons for Legal Education

Cross-border law practice is growing to serve the increasingly global business of its clients, and U.S. and U.K. firms have been leaders in this global expansion of law practice. Expansion takes several forms, including the physical--with law firms opening offices in faraway locations to serve existing and new clients1--as well as the virtual--based on technology that supports the economics of cross-border activity by enabling practice apart from physical presence. Whether working for global or local organizations, lawyers today are increasingly faced with the prospect of working with colleagues and competitors who are diverse in terms of nationality, education and training, and with clients whose problems may be as locally-focused as a Chicago zoning matter or as distant as the acquisition of one non-U.S. company by another

Between Diffusion and Distinctiveness in Globalization: U.S. Law Firms Go Glocal

There is widespread agreement that law firms have embraced globalization, but what this means and why it matters are subjects still cloaked with uncertainty. Do law firms follow the models and processes of globalization characteristic of other businesses? Or are law firms forced to take a different approach because of the nature of law and its basis in a particular national system? In this article, we consider these questions as they apply to U.S. law firms, and offer a new lens to interpret the role of globalization in the activities of law firms and their lawyers. We use data relating to the overseas offices of 64 leading U.S.-based law firms - among the largest and most globally-oriented U.S. firms - to learn how the firms transform themselves into global organizations. Our investigation reveals that U.S. law firms take a glocal or hybrid approach to globalization

On the Process and Outcomes of Inquiry Learning: Changing Approaches to Assessment [Organizer]

Inquiry learning is an educational approach that involves a process of exploration, asking questions and making discoveries in the search for new understandings. Researchers however are divided about the value of the approach. In the symposium, it is argued that one of the reasons for this controversy is the way that inquiry learning is assessed. Consequently, we aim to present papers which reflect on the challenge of assessing inquiry learning by describing the prevailing approaches to assessment and how technological and theoretical advancement is changing these approaches. The aim is not just to describe these approaches but reflect upon the opportunities that are created and difficulties that must be overcome as we pursue the goal of assessing the processes and outcomes of inquiry learning

Globalization and the Business of Law: Lessons for Legal Education

Whether working for global or local organizations, lawyers today are increasingly faced with the prospect of working with colleagues and competitors who are diverse in terms of nationality, education and training, and with clients whose problems may be as locally-focused as a Chicago zoning matter or as distant as the acquisition of one non-U.S. company by another. The global forces shaping business and the practice of law are felt in legal education, too, and U.S. law schools occupy a leading role in educating domestic and non-U.S. students for practice in the transnational marketplace. In spite of this, however, the core educational experience at nearly all U.S. law schools remains distinctly domestic in terms of substantive focus. The first year curriculum generally emphasizes exclusively U.S. law, and even most core upper level courses are jurisdictionally limited to U.S. law. While this U.S.-centric approach may continue to be appropriate in terms of the substantive focus of the curriculum, it may not adequately prepare students to work across national boundaries, both as collaborators and competitors with lawyers and clients from diverse jurisdictions and disciplinary backgrounds. Certainly, a strong education in substantive U.S. law is a necessity, but it is insufficient. In addition, what we might term global sensitivity is crucial, as is the need to understand business and apply its lessons to legal practice. If law schools can educate students to be globally sensitive as well as provide training in basic business concepts, they will strengthen the competitiveness of U.S. law graduates in the global market for legal services as well as the enhance the value of U.S. legal education