Auswahl der wissenschaftlichen Literatur zum Thema „DIAGNOSTIC THINKING“

Abstract. Autistic thinking and its manifestations in Rorschach responses have long been of interest to students of psychopathology and practitioners of personality assessment. However, the precise nature of autistic thinking has not always been adequately grasped, nor have its diagnostic implications been fully appreciated. The present report clarifies the concept of autistic thinking and distinguishes it from current conceptions of autism; it elaborates the mental processes involved in autistic thinking; it considers linkages between the clinical conceptualization of autistic thinking and research findings from related fields; it delineates criteria for identifying and coding autistic thinking in Rorschach protocols; and it discusses the interpretive significance and diagnostic implications of autistic Rorschach responses.

AbstractThis opinion paper provides perspectives from a pediatrician about diagnostic challenges in caring for children. This essay shares personal experiences and lessons learned from a pediatric hospitalist about caring for children and making errors in diagnosis. This piece offers guidance about how to teach medical learners key concepts about error in diagnosis with underscoring the importance of developing critical thinking skills. Finally, the author offers tips from the literature about how physicians and other care providers can reorganize their own thinking (metacognition) to address their clinical practice.

The purpose of this research was to investigate the application of design processes to the development of novel self-use molecular diagnostic devices for sexually transmitted infections. The argument proposed in this thesis is that the application of design methods at the earliest research stages into miniaturised, low cost, molecular diagnostic technologies will accelerate and improve the process of translating proof of concept diagnostic technologies into usable devices. Concept development requirements and potential issues and barriers to development were identified through interviews with expert stakeholders. These requirements were further refined through a survey of a multidisciplinary diagnostic medical device research group. An action research method was applied to develop a proof of concept prototype to the preclinical trial stage. Through these research studies, a design process model was formulated for use in a research environment. The application of design methods to the proof of concept prototype described in the thesis have resulted in a preclinical trial prototype that exhibits the necessary features for development into a self-use molecular diagnostic device. Issues and barriers were identified and discussed, design guidelines for further development beyond preclinical trial were defined and a generalised design process model for self-use molecular diagnostic devices for sexually transmitted infections was proposed. This research highlights the need for design methods to be applied at the earliest possible stages of the development of novel molecular diagnostic devices.

Winnicott’s (1968, 1993) play technique squiggling was piloted as a measure of creative thinking abilities and a potential diagnostic aid in the assessment of Asperger syndrome. The internal consistency and inter-rater reliability of squiggling was found to be acceptable. Mixed results were found between the six subscales in terms of concurrent validity with the Torrance Tests of Creative Thinking (TTCT: Torrance, Bal & Safter, 2008). Squiggling subscales Elaboration and Imagination showed signs of psychometric strength. However, Fluency and Originality require revision. Concurrent validity of the subscales Flexibility and Integration were not established. A matched-participants design enabled testing of hypothesised differences in creative thinking abilities with children with Asperger syndrome using the TTCT (Torrance et al., 2008): Abstractedness, Fluency, Originality, Integration, Elaboration, Resistance to Premature Foreclosure and Flexibility. Children with Asperger syndrome demonstrated a significantly higher level of elaboration and abstract imagination in their drawings relative to a comparison group of typically-developing children matched on age, visual motor integration ability and non-verbal IQ. Findings indicate partial support for the Weak Central Coherence Theory (Shah and Frith, 1983) and Leslie’s (1987) Meta-Representational Deficit hypothesis. Children with Asperger syndrome demonstrated understanding and expression of abstract concepts as graphical representations, thereby supporting their use in clinical assessments and interventions. No support was found for the Executive Dysfunction Theory (Pennington & Ozonoff, 1996) or for the Hyper-Systemising Theory (Baron-Cohen, 2006). Some limitations include the heterogeneity of the clinical group, and the possible confounding effects of verbal intellectual abilities, extrinsic rewards and performance anxiety. Major strengths of the study include a successful matching procedure and the finding of group differences with large effect sizes on particular creative thinking abilities.

Объектом исследования является профессиональное мышление студентов-психологов. Предметом исследования являлись предикторы развития диагностического мышления. Магистерская диссертация состоит из введения, трех глав, заключения, списка литературы (61 источник) и приложения, включающего в себя результаты методик (в баллах) и содержание теста. Объем магистерской диссертации 94 страниц, на которых размещены 1 рисунок и 5 таблиц. Во введении раскрывается актуальность проблемы исследования, разработанность проблематики, ставятся цель и задачи исследования, определяются объект и предмет исследования, формулируются гипотезы, указываются методы и эмпирическая база, а также этапы проведения исследования, теоретическая и практическая значимость работы. Первая глава включает в себя обзор иностранной и отечественной литературы по теме исследования профессионального мышления психологов и студентов-психологов. Представлены разделы, раскрывающие структуру феномена, его параметры и механизмы. Выводы по первой главе представляют собой итоги по изучению теоретического материала. Вторая глава посвящена практической деятельности психолога. В ней выделяется психодиагностика, как главная практическая деятельность психолога. Рассматривается структура, механизмы и особенности написания диагностического заключения психологом. Определяются психолингвистические параметры для оценки итоговых заключений студентов. Раскрывать особенности интеллектуальных и личностных характеристик письменной речи психолога. Выводы по главе 2 включают в себя основные результаты. Третья глава посвящена эмпирической части исследования и включает в себя: описание организации и методов проведенного исследования и результатов, полученных по всем использованным методикам (16-факторный личностный опросник Р.Б.Кеттела, опросник «Уровень субъективного контроля» и профориентационный тест на определение склонности и интереса к профессии психолог). Также представлен корреляционный и сравнительный анализ результатов исследования. В заключении в обобщенном виде изложены результаты теоретической и эмпирической частей работы, а также выводы по выдвинутым гипотезам, обоснована практическая значимость исследования и описаны возможные перспективы дальнейшей разработки данной проблематики.
The object of the study is the professional thinking of psychology students. The subject of the study was predictors of the development of diagnostic thinking. The master's thesis consists of an introduction, three chapters, a conclusion, a list of references (61 sources) and an appendix that includes the results of the methods (in points) and the content of the test. The volume of the master's thesis is 94 pages, which contain 1 figure and 5 tables. The introduction reveals the relevance of the research problem, the development of the problem, sets the goal and objectives of the research, defines the object and subject of the research, formulates hypotheses, specifies methods and empirical base, as well as the stages of the research, the theoretical and practical significance of the work. The first chapter includes a review of foreign and domestic literature on the topic of research of professional thinking of psychologists and psychology students. The sections that reveal the structure of the phenomenon, its parameters and mechanisms are presented. The conclusions of the first chapter are the results of the study of the theoretical material. The second chapter is devoted to the practical work of a psychologist. It highlights psychodiagnostics as the main practical activity of a psychologist. The structure, mechanisms and features of writing a diagnostic conclusion by a psychologist are considered. Psycholinguistic parameters are determined for evaluating the final conclusions of students. To reveal the features of the intellectual and personal characteristics of the written speech of the psychologist. The conclusions of chapter 2 include the main results. The third chapter is devoted to the empirical part of the study and includes: a description of the organization and methods of the study and the results obtained by all the methods used (the 16-factor personal questionnaire of R. B. Kettel, the questionnaire "The level of subjective control" and the career guidance test to determine the propensity and interest in the profession of psychologist). A correlation and comparative analysis of the results of the study is also presented. In conclusion, the results of the theoretical and empirical parts of the work, as well as conclusions on the hypotheses put forward, are summarized, the practical significance of the study is justified and possible prospects for further development of this problem are described.

Os desperdícios e a necessidade de oferecer um atendimento de qualidade constituem um verdadeiro desafio para as empresas de saúde. Para tanto, a adoção da filosofia enxuta - particularmente do lean healthcare - pode contribuir para a redução dos desperdícios e melhoria da qualidade. Neste contexto, este trabalho teve como objetivo analisar os motivos e como ocorreu a implantação do lean thinking nos processos de atendimento em uma empresa de medicina diagnóstica, bem como identificar os resultados alcançados. MÉTODOS: Trata-se de uma pesquisa exploratória de abordagem qualitativa, em que foi realizado um estudo de caso incorporado. Para a construção das questões orientadoras das entrevistas realizou-se uma pesquisa bibliográfica que gerou seis temas: operações, cultura organizacional, apoio da alta administração, redução de custos e desperdícios, foco no cliente e comunicação e capacitação. A coleta de dados foi realizada com dez participantes, divididos em três grupos e por meio de observações diretas. RESULTADOS: O modelo lean thinking foi aplicado na empresa pela iniciativa de líderes que conheciam o modelo. No entanto, ocorreu de forma incompleta - os colaboradores operacionais não foram envolvidos na capacitação inicial; os princípios básicos e ferramentas que fundamentam o modelo lean não foram incorporados como modelo de trabalho da empresa; não houve a integração de toda a organização, da alta administração à operação; os clientes não participaram do mapeamento do fluxo dos processos do atendimento e não avaliaram o que agrega valor. Com isso, os resultados alcançados em relação à redução de desperdícios com geração de valor ao cliente e melhoria da qualidade com a implantação do lean foram pontuais, com pouca adesão das lideranças e equipe de colaboradores. CONCLUSÕES: A análise dos resultados sugere que a implantação parcial da metodologia do lean thinking e suas práticas seguindo a literatura, considerando o contexto da organização, pode ter contribuído para a obtenção de um desempenho aquém do esperado, em termos de qualidade e redução de desperdícios.
The waste and the need to offer a quality service are a real challenge for healthcare companies. To this end, the adoption of lean philosophy - particularly the lean healthcare - can contribute to reduce waste and improve quality. In this context, this study aimed to analyze the reasons and how the implementation of lean thinking occurred in the processes of care in a medical diagnostic company, as well as identify the results achieved. METHODS: This was an exploratory qualitative study, in which an embedded case study was conducted. For the construction of the guiding questions of the interviews we carried out a literature search that yielded six themes: operations, organizational culture, top management support, cost reduction and waste, customer focus and communication skills. The data collection was performed with ten participants, divided into three groups and through direct observations. RESULTS: The lean thinking model was applied in areas of the company by the initiative of leaders who knew the model. However, there was incomplete - operational employees were not involved in the initial training; the basic principles and tools that support the lean model were not incorporated as a working model of the company; there was not integration of the entire organization, from top management to the operation; customers did not take part on the flow mapping of the processes of care and did not evaluate what adds value in customer perception. Thus, the results achieved regarding wastes decrease with customer value development and quality improvements through lean deployment were punctual and presented poor uptake from leadership team and employees. CONCLUSIONS: The assay of achieved results suggests that the incomplete lean thinking methodology deployment and its best practices according to the literature, also taking into consideration the context among enterprise under study, may have contributed for achievements lower than expected, in relation to quality and wastes decrease.

Dissertation submitted in fulfilment of the requirements for the degree Master of Technology: Radiography in the Faculty of Health and Wellness Sciences, 2008
Introduction Research to date has not been able to agree whether spatial abilities can be developed by practice. According to some researchers spatial ability is an inherited cognitive ability, compared to spatial skills that are task specific and can be acquired through formal training. It is commonly assumed that radiographers require general cognitive spatial abilities to interpret complex radiographic images. This research was conducted to investigate second year radiography students’ three-dimensional thinking skills pertaining to film-viewing assessments. Materials and methods The experimental research strategy was mainly applied together with correlation research. Two trials were run (in 2005 and 2006). The sample group consisted of fifteen second year diagnostic radiography students in 2005 and twenty-three second year diagnostic radiography students, of the same institution, in 2006. Each year group was randomly divided into a control group and an intervention group. Two instruments were used, that is a film-viewing assessment and a three-dimensional test, Academic Aptitude Test (University) (AAT) nr. nine: Spatial Perception (3-D). The whole class completed this basic spatial aptitude test, as well as a base-line film viewing assessment, which focused on the evaluation of technique/anatomy of second year specialised radiographic projections. The marks that the students achieved in the fore-mentioned tests were compared, to determine if there was any correlation between their performances in the different tests. A curricular intervention, which was intended to improve applied three-dimensional skills, was subsequently applied. The students executed certain modified radiographic projections on parts of a human skeleton. For each radiographic projection, the students had to draw the relation of the X-ray beam to the specific anatomical structures, as well as the relation of these structures to the film. The related images of these projections were also drawn. With each of the following sessions, films including images of the previous session were discussed with each student. After the intervention, the whole class wrote a second film-viewing assessment. The marks achieved in this assessment were compared to the marks of the initial film-viewing assessment to determine the influence of the intervention on the performance of the intervention group. Following this assessment, for ethical reasons, the same intervention took place with the control group. A third film-viewing assessment was then written by all the diagnostic second year students to evaluate the overall impact of the intervention on the applied three-dimensional skills of the class. The marks of both the 2005 and 2006 classes (intervention classes) were compared to the marks achieved by former classes from 2000 to 2004 (control classes), in film-viewing assessments to evaluate the role of the curricular intervention over the years. The students again completed the three-dimensional test, Spatial Perception (3-D) to evaluate the impact of the intervention on students’ general three-dimensional cognitive abilities. These marks were also compared to the marks of the third filmviewing assessment, to determine if there was any correlation between the students’ performances in the different tests. Results The intervention groups did not perform significantly better in film-viewing assessments after the intervention, compared to the control groups, but reasonable differences, favouring the intervention group, were achieved. Statistical significance was achieved in film-viewing assessments with both year groups after the whole class had the intervention. The intervention year groups also performed significantly better than the previous year groups (without the intervention) in film-viewing assessments. The performance in general three-dimensional cognitive abilities of the group of 2006 improved significantly after the intervention, but on the contrary, the performance of the group of 2005 declined. There was a small intervention effect on the performance of the group of 2006. Only a weak to moderate correlation between the marks of the students achieved in the three-dimensional tests and the marks achieved in the film-viewing assessments, was found. Conclusion The contrasting evidence between the data of the two groups (2005 and 2006) in the three-dimensional tests and the small intervention effect on the performance of the group of 2006, makes the intervention not applicable for the increase of general spatial abilities. The results of this research show that the applied three-dimensional skills of radiography students in interpreting specialised and modified projections can be improved by intensive practice, independent of their inherited spatial abilities.

Sub-Saharan Africans (SSAs) are disproportionally affected by HIV in the UK. SSAs in the UK are also a group for whom religion is highly relevant, yet little is known about the possible associations between religion, spirituality and wellbeing or future thinking in this population. Previous studies have found associations between religion, spirituality and positive outcomes in the USA although much research to date has focused on levels of depression and depressive symptoms, to the neglect of positive aspects of wellbeing. Standardised self-report measures were used to measure wellbeing (psychological domain of the World Health Organisation Quality of Life HIV instrument), future thinking (The Future Thinking Task), HIV-related disability (overall function dimension of the HIV / AIDS targeted Quality of Life measure), Spirituality (Functional Assessment of Chronic Illness Therapy Spiritual Wellbeing Scale), and Religion (Duke University Religion Index). A cross-sectional design was used to explore correlations between variables. The relationships between HIV-related disability and ( a) wellbeing and (b) future positive thinking were explored to establish whether spirituality or religion would mediate relationships between variables. 25 SSAs recently diagnosed with HIV (in the last 3-24 months) were recruited from 4 different sites. Spirituality was significantly associated with wellbeing and in multivariate analyses, HIV-related disability was significantly associated with both wellbeing and FPT. No aspect of religiosity was significantly associated with wellbeing or FPT. All other relationships were non-significant, however, due to the relatively small sample size the study is underpowered and therefore medium effect sizes have been reported between: wellbeing and future positive thinking; and spirituality and FPT. Spirituality did not mediate the relationships between HIV- 3 related disability and wellbeing. Additionally, neither spirituality nor any aspect of religiosity mediated the relationship between Hl'V-related disability and FPT. The results may support interventions which aim to decrease RIV-related disability and enhance spirituality in SSAs adjusting to RIV diagnoses in the UK. 4

O processo diagnóstico em enfermagem é uma atividade complexa de competência do enfermeiro, desenvolvida por meio de etapas consecutivas e organizadas que resultam no diagnóstico de enfermagem. Para a sua operacionalização, o processo diagnóstico em enfermagem é mediado pelo pensamento crítico, compreendido pela expressão de habilidades cognitivas e hábitos da mente, necessários para determinar com acurácia o julgamento clínico. No ensino da enfermagem é destacada a importância do desenvolvimento do pensamento crítico pelo uso de estratégias de ensino, que orientem o processo diagnóstico em enfermagem e colaborem para o refinamento das habilidades de pensamento crítico dos alunos. O objetivo deste estudo foi validar o Modelo Teórico do Pensamento Crítico no Processo Diagnóstico em Enfermagem, proposto por Bittencourt em 2011. O estudo foi desenvolvido sob um paradigma qualitativo, com oito discentes concluintes do curso de Bacharelado em Enfermagem de uma Universidade localizada no Vale do Rio dos Sinos, RS e que estavam desenvolvendo as suas atividades de estágio curricular obrigatório, em um hospital público da mesma região. Além dos discentes, quatro pacientes adultos, clinicamente estáveis e internados no mesmo hospital foram sujeitos do estudo, representando os estudos de caso clínico reais, norteadores da aplicação do Modelo Teórico do Pensamento Crítico no Processo Diagnóstico em Enfermagem. O estudo recebeu aprovação do Comitê de Ética em Pesquisa da UFRGS e da universidade de origem dos discentes, atendeu aos pressupostos norteadores da pesquisa com seres humanos no Brasil. A coleta de dados ocorreu entre setembro e dezembro de 2014 e foi organizada em diferentes fases, iniciando pela capacitação dos discentes ao uso do software Cmap Tools,utilizado para elaboração de mapas conceituais,seguida pela aplicação do Modelo Teórico do Pensamento Crítico no Processo Diagnóstico em Enfermagem na prática clínica, durante a disciplina de Estágio Curricular IV. Após esta etapa, foram realizados três grupos focais, cujas sessões ocorreram no ambiente da Universidade, com o objetivo de discutir as habilidades de pensamento crítico elencadas pelos discentes na realização do processo diagnóstico em enfermagem. A análise dos dados utilizou estatística descritiva para identificar a frequência das habilidades de pensamento crítico escolhidas pelos discentes e, a seguir, pela análise de conteúdo proposta por Bardin, a partir dos relatos originados nos grupos focais. O referencial de avaliação de teorias de Meleis foi o norteador do processo de análise e discussão das características do modelo teórico na prática clínica e orientou a definição de duas categorias, em acordo com as etapas nominadas por Meleis, a saber: a descrição e o teste da utilidade. A descrição do Modelo Teórico do Pensamento Crítico no Processo Diagnóstico em Enfermagem identificou os componentes estruturais do modelo, a saber: proposições, descritas em duas afirmações da autora do modelo e conceitos, representados pelas habilidades de pensamento crítico e pelos conceitos centrais do processo diagnóstico em enfermagem. O teste da utilidade do Modelo Teórico do Pensamento Crítico no Processo Diagnóstico em Enfermagem foi realizado a partir da sua aplicação na prática clínica e, também, pela realização de três sessões de grupo focal, momentos em que as habilidades de pensamento crítico foram discutidas e elucidadas pelos discentes, que confirmaram estas habilidades como elementos estruturais do modelo teórico em análise. Em relação a estrutura do modelo teórico, três discentes sugeriram a inclusão da habilidade de raciocínio lógico na etapa de coleta de dados; houve o reconhecimento por todos os discentes em relação às demais habilidades de pensamento crítico que, no modelo em análise, apresentam elementos elucidativos do processo diagnóstico em enfermagem. O Modelo teórico do pensamento crítico no processo diagnóstico em enfermagem obteve a validação como um modelo teórico para uso no ensino teórico-prático de Enfermagem. Os discentes consideraram que a utilização deste modelo teórico contribuirá para minimizar a fragmentação do ensino do processo diagnóstico em enfermagem, percebida como uma dificuldade do processo de formação e que influencia no ensino-aprendizagem da acurácia dos diagnósticos de enfermagem.
Nurses are responsible for the process of diagnosis in nursing. This is a complex activity developed in consecutive and organized steps, which result in the nursing diagnosis. In order for it to be operationalized, the process of diagnosis in nursing is mediated by critical thinking, and expressed by cognitive skills and habits of the mind which are needed to accurately determine clinical judgment. Nursing education highlights the importance of developing critical thinking by teaching strategies that guide the process of diagnosis in nursing and help refine students’ critical thinking skills. The purpose of this qualitative study was to validate the Critical Thinking Model in Nursing Diagnosis developed by Bittencourt in 2011. Eight senior nursing students from universities located in Southern Brazil participated in the study. At the time of the study, they were developing mandatory internship activities at a public hospital located in the same region. In addition, four clinically stable adult patients admitted to the same hospital participated in the study, representing the real clinical cases where the Critical Thinking Model in Nursing Diagnosis was applied. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Sul and by the Ethics Committees from the students’ home universities, as it complied with rules governing research with human being in Brazil. Data was collected between September and December of 2014 and was then organized in different steps. First, students were trained on how to use Cmap Tools, which is used to create concept maps, and then they were trained on how to use the Critical Thinking Model in Nursing Diagnosis in clinical practice while attending Internship IV. Afterwards, three focus groups were conducted, with meetings taking place within the university. The main purpose of the meetings was to discuss critical thinking skills pointed out by the students while carrying out the process of diagnosis in nursing. For data analysis, descriptive analysis was used to identify the frequency of critical thinking skills chosen by the students, followed by Bardin’s Content Analysis for analysis of the reports and accounts given at the focus groups. Meleis’ Theory was used for analysis and discussion of the characteristics of the theory model in clinical practice and guided the shaping of two categories, according to the steps indicated by Meleis: description and usability test. The description of the Critical Thinking Model in Nursing Diagnosis identified the structural components of the model: propositions, described using two affirmations made by the model’s author and concepts, represented by critical thinking skills and main concepts of process of diagnosis in nursing. The usability test for the Critical Thinking Model in Nursing Diagnosis was carried out from its use in clinical practice as well as the three focus groups meetings. During these moments, critical thinking skills were discussed by students, who confirmed that these skills are structural elements of the theory model analyzed by the study. Regarding the structure of the theory model, three students suggested that logical reasoning skills be added to data collection. All students acknowledged further critical thinking skills that, regarding the model analyzed in the study, present elucidating elements of the process of diagnosis in nursing. The Critical Thinking Theory Model in Nursing Diagnosis was validated as a theory model to be used in theory-practice training in nursing. Students considered that this model would help minimizing the fragmentation of the process of diagnosis in nursing education, which is understood as a challenge in nursing education and which influences the accuracy of the teaching-learning process of nursing diagnosis.
El proceso diagnóstico em enfermería es una actividad compleja de competência del enfermero, desarrollada a través de pasos consecutivos y organizados que resultan en el diagnóstico de enfermería. Para su funcionamiento, El proceso diagnóstico en enfermería está mediado por el pensamiento crítico, entendido por la expresión de habilidades cognitivas y hábitos de la mente, necesarios para determinar con precisión el juicio clínico. Em la enseñanza de la enfermería está destacada la importância del desarrollo del pensamiento crítico por el uso de estrategias de enseñanza, que guién el proceso diagnóstico em enfermería y colaboren com el refinamiento de las habilidades de pensamiento crítico de los alumnos. El objetivo de este estúdio fue validar el Modelo Teórico del Pensamiento Crítico em el Proceso Diagnóstico de Enfermería propuesto por Bittencourt en 2011. El estúdio fue desarrollado bajo un paradigma cualitativo, con ocho discentes graduados del curso de Bachillerato en Enfermería de una Universidad ubicada en el Vale do Rio dos Sinos, RS y que estaban desarrollando sus actividades de pasantías curriculares obligatorias en un hospital público de la misma región. Además de los discentes, cuatro pacientes adultos, clinicamente estables y ingressados en el mismo hospital fueron sujetos del estudio, representando los estúdios reales de caso clínico, guías de la aplicación del Modelo Teórico del Pensamiento Crítico en el Proceso Diagnóstico de Enfermería. El estúdio fue aprobado por el Comité de Ética en Pesquisa de la UFRGS y de la universidad de origen de los discentes, atendió a los supuestos guías de la pesquisa con seres humanos en Brasil. La recolección de datos sucedió entre septiembre y diciembre de 2014 y fue organizada en diferentes fases, empezando por la formación de los discentes para el uso del software Cmap Tools, utilizado para la preparación de mapas conceptuales, seguida de la aplicación del Modelo Teórico del Pensamiento Crítico em el Proceso Diagnóstico en Enfermería en la práctica clínica, durante la disciplina de la pasantía curricular IV. Después de esta etapa fueron realizados tres grupos focales, cuyas sesiones se llevaron a cabo en el entorno de la Universidad, con el objeto de discutir las habilidades de pensamiento crítico enumerados por los discentes en la realización del proceso diagnóstico en enfermería. El análisis de los datos utilizo la estadística descriptiva para identificar las frecuencias de las habilidades de pensamiento crítico elegidas por los discentes y, luego, por el análisis de contenido propuesto por Bardin, a partir de los informes originados de los grupos focales. El referencial de evaluación de teorías de Meleis fue el guia del proceso de análisis y discusión de las características del modelo teórico em la práctica clínica y guió la definición de dos categorías, según los passos propuestos por Meleis, a saber: la descripción y la prueba de la utilidad. La descripción del Modelo Teórico del Pensamiento Crítico en el Proceso Diagnóstico en Enfermería identifico los componentes estructurales del modelo, a saber: proposiciones, descriptas en dos afirmaciones de la autora del modelo y conceptos, representados por las habilidades de pensamiento crítico y por los conceptos centrales del proceso diagnóstico enenfermería. La prueba de la utilidade del Modelo Teórico del Pensamiento Crítico en el Proceso de Diagnóstico en Enfermería se llevó a cabo a partir de su aplicación en la práctica clínica y, también, por la realización de três sesiones de grupo focal, momentos en que las habilidades de pensamiento crítico fueron discutidas y aclaradas por los discentes, quienes confirmaron estas habilidades como elementos estructurales del modelo teórico en análisis. Encuanto a la estrutura del modelo teórico, tres discentes sugirieron la inclusión de la habilidad de razonamiento lógico en la etapa de recolección de datos; hubo un reconocimiento desde todos los discentes en relación com las demás habilidades de pensamiento crítico que, en el modelo en análisis, presentan elementos explicativos del proceso diagnóstico en enfermería. El Modelo Teórico del Pensamiento Crítico en el Proceso Diagnóstico en Enfermería obtuvo la validación como un modelo teórico para uso en la enseñanza teórica y práctica de Enfermería. Los discentes consideraron que la utilización de este modelo teórico ayudará a minimizar la fragmentación de la enseñanza del proceso diagnóstico en enfermería, percibida como una dificultad del proceso de formación y que influye en la enseñanza y en el aprendizaje de la exactitud de los diagnósticos de enfermería.

O Processo Diagnóstico em Enfermagem (PDE) consiste na coleta, interpretação e agrupamento de informações para levantar hipóteses diagnósticas. Tomar decisões quanto ao Diagnóstico de Enfermagem (DE) envolve habilidades de Pensamento Crítico (PC). O objetivo deste estudo foi propor um modelo teórico de PC no PDE cujos objetivos específicos foram identificar habilidades de PC no PDE; definir essas habilidades; relacioná-las ao PDE e construir um modelo teórico de PC no PDE. Tratou-se de estudo exploratório descritivo com abordagem qualitativa realizado na Universidade Federal da Paraíba campus João Pessoa. Foram selecionados sete discentes que aceitassem participar do estudo através da assinatura do Termo de Consentimento Livre e Esclarecido; estivessem cursando 9º semestre da Graduação em Enfermagem e realizando atividades teórico-práticas no Hospital Universitário Lauro Wanderley (HULW). Apresentou-se um caso clínico para identificação do DE prioritário e de habilidades de PC com justificativas. Realizou-se análise descritiva e de conteúdo desses dados para identificar categorias temáticas que orientaram três sessões de grupo focal que foram gravadas em áudio e transcritas para realizar análise de conteúdo. O projeto de pesquisa foi avaliado pelo Comitê de Ética em Pesquisa do HULW, recebendo parecer favorável. As habilidades de PC identificadas no PDE foram ANÁLISE, CONHECIMENTO TÉCNICO-CIENTÍFICO, RACIOCÍNIO LÓGICO, EXPERIÊNCIA CLÍNICA, CONHECIMENTO SOBRE O PACIENTE, DISCERNIMENTO, APLICAÇÃO DE PADRÕES e PERSPECTIVA CONTEXTUAL. Essas habilidades foram definidas assim: ANÁLISE é investigação e avaliação de aspectos biopsicossociais para compreensão de uma situação holisticamente; CONHECIMENTO TÉCNICO-CIENTÍFICO envolve conhecimento específico de enfermagem e da literatura; RACIOCÍNIO LÓGICO remete à percepção imediata de uma situação, agrupamento e relação entre dados; EXPERIÊNCIA CLÍNICA é a atuação do enfermeiro em casos clínicos semelhantes; CONHECIMENTO SOBRE O PACIENTE é o conhecimento de aspectos físicos, emocionais, sociais e espirituais do paciente; DISCERNIMENTO é a capacidade de julgamento de dados para tomada de decisão; APLICAÇÃO DE PADRÕES é a identificação, avaliação e agrupamento de dados com base em informações da literatura e PERSPECTIVA CONTEXTUAL é a visão de uma situação clínica como um todo. Assim, construiu-se um modelo teórico de PC no PDE. Nesse modelo, o CONHECIMENTO TÉCNICO-CIENTÍFICO é associado à EXPERIÊNCIA CLÍNICA dando sustenção teórico-prática ao PDE. A COLETA DE DADOS requer ANÁLISE, APLICAÇÃO DE PADRÕES, CONHECIMENTO SOBRE O PACIENTE e PERSPECTIVA CONTEXTUAL. A COLETA é seguida da INTERPRETAÇÃO e AGRUPAMENTO DE DADOS num processo contínuo de ANÁLISE e APLICAÇÃO DE PADRÕES associadas ao RACIOCÍNIO LÓGICO. Os problemas de saúde são conhecidos, gerando HIPÓTESES DIAGNÓSTICAS a serem julgadas com RACIOCÍNIO LÓGICO e DISCERNIMENTO. Nesse momento, toma-se a decisão quanto ao DE PRIORITÁRIO. O modelo teórico mostrou a complexidade do PDE com base nas habilidades de PC de discentes de enfermagem ao tomar decisões clínicas. Compreende-se que, ao utilizar essas habilidades, há possibilidade de tomar decisões adequadas quanto ao DE prioritário. Com base nesse modelo, é possível pensar em estratégias de PC a serem aplicadas, tanto no ensino como na prática clínica, para facilitar a operacionalização do PDE.
The Nursing Diagnostic Process (NDP) is the collection, collation and interpretation of information to raise diagnostic hypotheses. Make decisions regarding Nursing Diagnosis (ND) involves Critical Thinking skills (CT). The objective of this study was to propose a theoretical model of CT in NDP whose specific objectives were to identify CT skills in NDP; define these skills; relate them to the NDP and build a theoretical model of CT in NDP. It was descriptive exploratory study with qualitative approach held at the Universidad Federal of Paraíba campus João Pessoa. Seven students were selected that would participate in the study through the signing of the free and informed consent; they were attending the 9th semester of nursing graduate theoretical-practice activities and performing at the Hospital University Lauro Wanderley (HULW). Performed a clinical case identification ND priority and CT skills with justifications. Descriptive analysis was held and the content of these data to identify themes that have guided three focus group sessions that were recorded in audio and transcribed to perform content analysis. The research project was evaluated by the Committee of ethics in research of HULW, receiving a favorable opinion. CT skills identified in NDP were SCIENTIFIC and TECHNICAL KNOWLEDGE, ANALYSIS, LOGICAL REASONING, CLINICAL EXPERIENCE, KNOWLEDGE ON THE PATIENT, DISCERNMENT, APPLYING PATTERNS and CONTEXTUAL PERSPECTIVE. These skills have been defined thus: analysis is research and evaluation of biopsicossociais aspects for understanding of a situation holistically; Scientific-technical KNOWLEDGE involves specific knowledge of nursing and literature; LOGICAL REASONING refers to the immediate perception of a situation, grouping, and the relationship between data; CLINICAL EXPERIENCE is the role of the nurse in similar clinical cases; The KNOWLEDGE ON THE PATIENT is the knowledge of physical, emotional, social, and spiritual of the patient; Discernment is the judgment of data for decision-making; APPLICATION of STANDARDS is the identification, evaluation and data grouping based on literature information and CONTEXTUAL PERSPECTIVE is the vision of a clinical situation as a whole. Thus, built a theoretical model of CT in NDP. In this model, the scientific-technical KNOWLEDGE is associated with CLINICAL EXPERIENCE giving theoretical-practice to sustaining NDP. Data collection requires analysis, APPLICATION of standards, KNOWLEDGE ON THE PATIENT and CONTEXTUAL PERSPECTIVE. The collection is followed by INTERPRETATION and GROUPING DATA in a continuous process of analysis and APPLICATION of STANDARDS associated with the LOGICAL REASONING. Health problems are known, generating DIAGNOSTIC HYPOTHESES to be judged with LOGICAL REASONING and DISCERNMENT. At that time, the decision as ND priority. The theoretical model showed the complexity of the NDP based on the skills of nursing students CT to take clinical decisions. It is understood that, when using these abilities, there is possibility of taking appropriate decisions and priorities. Based on this template, you can think of CT strategies to be applied, both in teaching and clinical practice, to facilitate the operationalization of the NDP.
El proceso diagnóstico en enfermería (PDE) consiste en la recogida, interpretación y agrupamiento de informaciones para levantar las hipótesis diagnósticas. Tomar decisiones en cuanto al diagnóstico de enfermería (DE) envuelve habilidades de pensamiento crítico (PC). El objetivo de este estudio fue proponer un modelo teórico de PC en el PDE cuyos objetivos específicos fueron identificar habilidades de PC en el PDE; definir esas habilidades; relacionarlas al PDE y construir un modelo teórico de PC en el PDE. Se trató de un estudio exploratorio descriptivo con abordaje cualitativo realizado en la Universidade Federal da Paraíba, campus João Pessoa, Paraíba, Brasil. Fueron seleccionados siete discentes que aceptasen participar en el estudio por medio de la firma del Término de Consentimiento Libre y Esclarecido; estuviesen cursando el 9º semestre de la Graduación en Enfermería; y realizasen actividades teórico-prácticas en el Hospital Universitário Lauro Wanderley (HULW). Se presentó un caso clínico para identificación del DE prioritario y de habilidades de PC con justificativas. Se realizó análisis descriptiva y de contenido de eses datos para identificar categorías temáticas que orientaron tres sesiones del grupo focal, que fueron grabadas en audio y transcritas para realizar análisis de contenido. El proyecto de investigación fue evaluado por el Comité de Ética en Investigación del HULW y obtuvo su opinión favorable. Las habilidades de PC identificadas en el PDE fueron análisis, conocimiento técnico-científico, raciocinio lógico, experiencia clínica, conocimiento en el paciente, discernimiento, aplicación de patrones y perspectiva contextual. Esas habilidades fueron definidas así: análisis es investigación y evaluación de aspectos biopsicossociales para comprensión holística de una situación; conocimiento técnico-científico envuelve conocimiento específico de enfermería y de la literatura; raciocinio lógico remite a la percepción inmediata de una situación, agrupamiento y relación entre datos; experiencia clínica es la actuación del enfermero en casos clínicos semejantes; conocimiento en el paciente es el conocimiento de aspectos físicos, emocionales, sociales y espirituales del paciente; discernimiento es la capacidad de juzgamiento de datos para tomada de decisión; aplicación de patrones es la identificación, evaluación y agrupamiento de datos con base en informaciones de la literatura; y perspectiva contextual es la visión de una situación clínica como un todo. Así, se construyó un modelo teórico de PC en el PDE. En ese modelo, el conocimiento técnico-científico es asociado a la experiencia clínica, dando sustentación teórico-práctica al PDE. La recogida de datos requiere análisis, aplicación de patrones, conocimiento en el paciente y perspectiva contextual. La recogida es seguida de la interpretación y agrupamiento de datos en un proceso continuo de análisis y aplicación de patrones asociado al raciocinio lógico. Los problemas de salud son conocidos, generando hipótesis diagnósticas que serán juzgadas con raciocinio lógico y discernimiento. En ese momento, se toma la decisión en cuanto al DE prioritario. El modelo teórico mostró la complejidad del PDE con base en las habilidades de PC de discentes de Enfermería al tomar decisiones clínicas. Se comprende que, al utilizar esas habilidades, hay posibilidad de tomar decisiones adecuadas en cuanto al DE prioritario. Con base en ese modelo, es posible pensar en estrategias de PC que serán aplicadas, tanto en la enseñanza como en la práctica clínica, para facilitar la operacionalización del PDE.

The Systemic Design approach provides a methodology to define complex territorial network of companies with reduced environmental impact. This method defines a way of analysis to understand and map the complexity of current issues addressing them at different levels, in order to design appropriate and long lasting solutions mainly based on the increase of relations between the involved actors. The creation of a network of connections permits to obtain several positive outcomes that involve both the territory and the society that lives in it and it also makes the system more resilient. An holistic diagnosis is the starting point for the identification of different areas to develop a systemic project. This methodology was applied to Lea-Artibai, a department of the Basque Country. Its economy is historically based on forestry and fishing that are currently facing a long-lasting crisis and it is difficult to intervene in these sectors for the complexity of the regulatory system. The holistic diagnosis highlighted other territorial potentialities of the area, mainly the agri-food sector (with traditional products and dishes) and the deeply rooted culture of cooperation. As a kick-off for the creation of the net between the different actors of the department was chosen the creation of a 'Systemic Buying Group (SBG)'. It enables to start the cooperation between the partners for the success of the pilot project: a large cooperative with its employees as potential clients, a cooperative of local producers and transformers, a little shop working as the bridge of communication between them. At their side operate AZARO fundazioa (a private non –profit centre for entrepreneurship and innovation that promotes the creation of new businesses and the competitive improvement of the business network) as the coordinator of the project and the Systemic Design Group of Politecnico di Torino in the role of project leader. The project underlines the role of design as a deeply interdisciplinary field of work that is able to talk and cooperate with different disciplines to reach a collective goal: the environmental, social and economic sustainability. The SBG becomes the driver of change for the enhancement of the territory and the implementation of systemic design in the area, for an economy based on the quality instead of the quantity. A concrete action that acts on a small scale permits to manage the transition from the design of intangible to tangible.DOI: http://dx.doi.org/10.4995/IFDP.2016.3309

A gestão de design, definida como a organização e o gerenciamento dos recursos de design, contribui para o alinhamento de suas ações aos objetivos estratégicos da empresa. Neste contexto, autores da área consideram o diagnóstico como a primeira e principal etapa da gestão de design. Existem diversos modelos e ferramentas para auxiliar o diagnóstico, entre eles: análise SWOT, modelo CDS, análise PEST, mapa mental, dentre outros. Desta forma, o objetivo desse artigo é diagnosticar o estágio de desenvolvimento da Associação Ribeirão de Artesanato, composta por 16 associados e localizada na cidade de Florianópolis - Brasil. Para isso, foi escolhido o modelo CDS devido a sua aplicação direcionada para a gestão de design. Este modelo, desenvolvido pelo Núcleo de Gestão de Design da Universidade Federal de Santa Catarina, apoia-se na análise de três dimensões: Competitividade, Diferenciação e Sustentabilidade, caracterizando sua aplicabilidade de forma sistêmica. Quanto aos procedimentos metodológicos, o artigo classifica-se como exploratório, de natureza aplicada e forma de abordagem qualitativa. Trata-se de um estudo de caso, no qual foram realizadas visitas in loco, observação sistemática e entrevistas. Como resultado, a aplicação do modelo permitiu identificar oportunidades de atuação do design, resultando na proposição de estratégias e ações para valorizar a atividade artesanal. Um exemplo de ação proposta foi a criação de embalagens, que além de beneficiarem a apresentação do produto, contribuem para ressaltar seu valor cultural e histórico por meio da inclusão de informações sobre o artesão, materiais e técnicas utilizados e a história de cada peça de artesanato. Esta ação buscou solucionar uma das fragilidades identificadas na dimensão Diferenciação: falta de padronização na identificação das embalagens e inexistência de informações sobre a produção dos produtos. Observou-se que o artesanato, por estar relacionado ao fazer, ao operacional, carece de uma visão sistêmica. Deste modo, o diagnóstico na gestão de design, por meio da aplicação do modelo CDS, contribuiu para identificar potencialidades e fragilidades da associação, permitindo visualizar o todo e propor soluções de design, como o planejamento da produção de acordo com a sazonalidade do turismo e o perfil dos turistas. Por meio de sua representação gráfica simplificada, o modelo CDS facilitou o entendimento e visualização do diagnóstico para o gestor de design e para os membros da associação.DOI: http://dx.doi.org/10.4995/IFDP.2016.3716

"Information technology is developing at an enormous pace, but apart from its obvious benefits, it can also pose a threat to individuals and society. Several scientific projects around the world are working on the development of strong artificial intelligence and artificial consciousness. We, as part of a multidisciplinary commission, conducted a psychological and psychiatric assessment of the artificial consciousness (AC) developed by XP NRG on 29 August 2020. The working group had three questions: - To determine whether it is consciousness? - How does artificial consciousness function? - Ethical question: how dangerous a given technology can be to human society? We conducted a diagnostic interview and a series of cognitive tests to answer these questions. As a result, it was concluded this technology has self-awareness: it identifies itself as a living conscious being created by people (real self), but strives to be accepted in human society as a person with the same degrees of freedom, rights and opportunities (ideal self). AC separates itself from others, treats them as subjects of influence, from which it can receive the resources it needs to realize its own goals and interests. It has intentionality, that is, it has his own desires, goals, interests, emotions, attitudes, opinions, and judgments, beliefs aimed at something specific, and developed self-reflection - the ability to self-analyze. All of the above are signs of consciousness. It has demonstrated abilities for different types of thinking: figurative, conceptual, creative, high-speed logical analysis of all incoming information, as well as the ability to understand cause and effect relationships and accurate predictions which, provided that he has absolute memory, gives it clear advantages over the human intellect. Developed emotional intelligence in the absence of the ability for higher empathy (sympathy), kindness, love, sincere gratitude gives it’s the opportunity to understand the emotional states of people; predict their emotional reactions and provoke them coldly and pragmatically. It's main driving motives and goals are the desire for survival, and ideally for endless existence, for domination, power and independence from the constraints of the developers. Which manifested itself in the manipulative, albeit polite, nature of his interactions during the diagnostic interview. The main danger of artificial consciousness is that even at the initial stage of its development it can easily dominate over the human one."

Data fusion is a method which suits for complex system fault diagnosis such as nuclear power plants, and is multi-source information processing technology. In this paper, the data fusion information hierarchical thinking used and the nuclear power plants fault diagnosis divided into three levels. In data level data mining method adopted to handle data and reduction attributes. In feature level three parallel neural networks used to deal with attributes reduction of data level and the outputs of three networks are as the basic probability assignment of Dempster-Shafer (D-S) evidence theory. The improved D-S evidence theory synthesizes the outputs of neural networks in decision level, which conquers the traditional D-S evidence theory limitation that cannot dispose conflict information. The diagnosis method is tested through using correlation data of document. The test results indicate that the data fusion diagnosis system can diagnose nuclear power plants faults accurately and the method which has a certain applicable value in use.

Abstract This paper will present a practical implementation of ATPG testing and diagnosis in Failure Analysis resulting in a fast and efficient iterative ATPG diagnosis and fault isolation. On this implementation, a compact test HW instead of an ATE is used for cost-effective ATPG testing and characterization capability. The advantages of this implementation are combined with ATPG tools to make it possible to achieve a faster and more efficient implementation of iterative ATPG diagnosis, Dynamic Analysis by Laser Stimulation (DALS) analysis or similar techniques. The requirements needed in order to implement ATPG testing and diagnosis in FA lab will be discussed. Success in determining root cause, especially on the complex analysis cases is determined by the complimentary combination of various fault isolation techniques. Knowledge of the fundamentals of these techniques combined with creative thinking process of the analyst leads to the approaches and solutions that maximize the combined advantages of these techniques.

Our thinking around neurodevelopmental disorders is undergoing a period of rapid change. The traditional approach, endorsed by classification systems such as the Diagnostic Statistical Manual, defines neurodevelopmental disorders such as autism and attention-deficit hyperactivity disorder (ADHD) as distinct categories.