자연주의적 탐구조사(Naturalistic Inquiry)

Experience and Educationis the best concise statement on education ever published by John Dewey, the man acknowledged to be the pre-eminent educational theorist of the twentieth century. Written more than two decades after Democracy and Education(Dewey's most comprehensive statement of his position in educational philosophy), this book demonstrates how Dewey reformulated his ideas as a result of his intervening experience with the progressive schools and in the light of the criticisms his theories had received. Analysing both "traditional" and "progressive" education, Dr. Dewey here insists that neither the old nor the new education is adequate and that each is miseducative because neither of them applies the principles of a carefully developed philosophy of experience. Many pages of this volume illustrate Dr. Dewey's ideas for a philosophy of experience and its relation to education. He particularly urges that all teachers and educators looking for a new movement in education should think in terms of the deeped and larger issues of education rather than in terms of some divisive "ism" about education, even such an "ism" as "progressivism." His philosophy, here expressed in its most essential, most readable form, predicates an American educational system that respects all sources of experience, on that offers a true learning situation that is both historical and social, both orderly and dynamic.

经验与教育 = Experience and education

Probability Distributions.- Linear Models for Regression.- Linear Models for Classification.- Neural Networks.- Kernel Methods.- Sparse Kernel Machines.- Graphical Models.- Mixture Models and EM.- Approximate Inference.- Sampling Methods.- Continuous Latent Variables.- Sequential Data.- Combining Models.

Pattern Recognition and Machine Learning

A general inductive approach for analysis of qualitative evaluation data is described. The purposes for using an inductive approach are to (a) condense raw textual data into a brief, summary format; (b) establish clear links between the evaluation or research objectives and the summary findings derived from the raw data; and (c) develop a framework of the underlying structure of expe- riences or processes that are evident in the raw data. The general inductive approach provides an easily used and systematic set of procedures for analyzing qualitative data that can produce reliable and valid findings. Although the general inductive approach is not as strong as some other analytic strategies for theory or model development, it does provide a simple, straightforward approach for deriving findings in the context of focused evaluation questions. Many evaluators are likely to find using a general inductive approach less complicated than using other approaches to qualitative data analysis.

/pdf/a-general-inductive-approach-for-analyzing-qualitative-1xoxxy6mp5.pdf

A General Inductive Approach for Analyzing Qualitative Evaluation Data

How has Japan become a major economic power, a world leader in the automotive and electronics industries? What is the secret of their success? The consensus has been that, though the Japanese are not particularly innovative, they are exceptionally skilful at imitation, at improving products that already exist. But now two leading Japanese business experts, Ikujiro Nonaka and Hiro Takeuchi, turn this conventional wisdom on its head: Japanese firms are successful, they contend, precisely because they are innovative, because they create new knowledge and use it to produce successful products and technologies. Examining case studies drawn from such firms as Honda, Canon, Matsushita, NEC, 3M, GE, and the U.S. Marines, this book reveals how Japanese companies translate tacit to explicit knowledge and use it to produce new processes, products, and services.

The knowledge-creating company : how Japanese companies create the dynamics of innovation

T he terms "frail" and "frailty" are now part of the language of geriatric medicine and gerontology.'` Characterizing the physiologic basis of frailty has been described as one of the most important research endeavours in medical gerontology.2'5 However, "frail" and "frailty" are often undefined.5 As the concept of frailty is increasingly invoked (a MEDLINE search revealed that citations with the MeSH term "frailty" increased from 13 in 1986 to 80 in the first 9 months of 1992), it is important to understand what is meant by the term and to discover if this understanding offers any useful insights. In this article we review existing definitions of frailty and examine an alternative working definition that en-

Frailty in elderly people: an evolving concept.

Frailty is associated with postoperative complications in older adults with medical problems.

Background: Atypical disease presentations, such as delirium, are associated with adverse health outcomes. They are also markers of frailty in elderly people, which is itself associated with adverse hospital outcomes. We investigated the relationship between frailty and atypical disease presentation in predicting adverse hospital outcomes and complications of the hospital course of elderly patients admitted to general medical services. Methods: We conducted a cohort study in a large (800 beds) tertiary care university hospital. The prevalence of atypical disease presentations and the incidence of adverse hospital outcomes (death, nursing home admission, prolonged hospital stay, and failure to regain premorbid functional status) were studied in previously well and previously frail elderly patients. Results: Patients were classified as being well or frail on the basis of the premorbid Barthel Index (well, score of ≥95 [n=76]; frail, score of Conclusions: Premorbid functional dependency, atypical disease presentation, and functional decline on admission have independent impacts on adverse hospital outcomes. Assessment of each should be incorporated into the routine care of elderly patients. (Arch Intern Med. 1995;155:1060-1064)

Illness Presentation in Elderly Patients

Objective To apply recently published consensus panel guidelines to a series of hospital inpatient charts to develop and validate a brief screening tool for potentially inappropriate prescriptions in the elderly. Setting A 400-bed acute care hospital in London, Ontario. Methods Three hundred and sixty-one consecutive inpatient charts, 185 from a clinical teaching unit (CTU) and 176 from a geriatric assessment unit (GAU) were examined for potentially inappropriate prescriptions as listed by McLeod et al. The potentially inappropriate prescribing practices detected were used to develop the Improving Prescribing in the Elderly Tool (IPET). Construct validity was examined by looking for a predicted difference in the rate of potentially inappropriate prescriptions between the CTU and the GAU. Interrater reliability was determined by applying the IPET to a new series of 100 charts. Results Forty-two of 361 individuals (12.5%) had 45 potentially inappropriate prescriptions representing 14 different potential drug/disease interactions; these were used to construct the IPET. A demonstrated difference in the rate of potentially inappropriate prescriptions between the CTU and GAU indicated construct validity. The interrater reliability of the IPET (kappa) when applied to a new series of 100 charts was 1.0. Interpretation The IPET is a brief, reliable and valid tool based on the published literature that may be used to screen for potentially inappropriate prescriptions in the elderly.

Development and validation of an improving prescribing in the elderly tool.

OBJECTIVES: To test a model of frailty by examining factors associated with institutionalization of older people in Canada; to assess whether diagnostic data provided information about risk beyond that provided by data on functional capacity and demographic variables.



METHODS: Cross-sectional study of 1258 institutional subjects and 9113 community-dwelling older adults from the Canadian Study of Health and Aging.



RESULTS: Multiple logistic regression analysis showed that female gender, being unmarried, absence of a caregiver, presence of cognitive impairment (including all types of dementia), functional impairment, diabetes mellitus, stroke, and Parkinson's disease were independently associated with being in a long-term care facility.



CONCLUSION: Frailty appears to be a multidimensional construct, and not simply a synonym for dependence in Activities of Daily Living. Studies of health outcomes in older people should include diagnostic data as well as demographic information and data on functional capacity.

Paul Stolee

Papers

Frailty in elderly people: an evolving concept.

Frailty is associated with postoperative complications in older adults with medical problems.

Illness Presentation in Elderly Patients

Development and validation of an improving prescribing in the elderly tool.

Factors Associated with Institutionalization of Older People in Canada: Testing a Multifactorial Definition of Frailty