Search

The aim of this article was to compare gene expression programming (GEP) method with three types of neural networks in the prediction of adverse events of radical hysterectomy in cervical cancer patients. One-hundred and seven patients treated by radical hysterectomy were analyzed. Each record representing a single patient consisted of 10 parameters. The occurrence and lack of perioperative complications imposed a two-class classification problem. In the simulations, GEP algorithm was compared to a multilayer perceptron (MLP), a radial basis function network neural, and a probabilistic neural network. The generalization ability of the models was assessed on the basis of their accuracy, the sensitivity, the specificity, and the area under the receiver operating characteristic curve (AUROC). The GEP classifier provided best results in the prediction of the adverse events with the accuracy of 71.96 %. Comparable but slightly worse outcomes were obtained using MLP, i.e., 71.87 %. For each of measured indices: accuracy, sensitivity, specificity, and the AUROC, the standard deviation was the smallest for the models generated by GEP classifier.

In this paper, the method of the graphical interpretation of the single-layer network weights is introduced. It is shown that the network parameters can be converted to the image and their particular elements are the pixels. For this purpose, weight-to-pixel conversion formula is used. Moreover, new weights' modification method is proposed. The weight coefficients are computed on the basis of pixel values for which image filtration algorithms are implemented. The approach is applied to the weights of three types of the models: single-layer network, two-layer backpropagation network and the hybrid network. The performance of the models is then compared on two independent data sets. By means of the experiments, it is presented that the adjustment of the weights to new values decreases test error value compared to the error obtained for initial set of weights.

In response to the growing evidence that disruptive behaviors within health-care teams constitute a major threat to the quality of care, the Joint Commission on Accreditation of Healthcare Organization (JCAHO; Joint Commission Resources, 2008) has a new leadership standard that addresses disruptive and inappropriate behaviors effective January 1, 2009. For professionals who work in human resources and organization development, these standards represent a clarion call to design and implement evidence-based interventions to create health-care communities of respectful engagement that have zero tolerance for disruptive, uncivil, and intimidating behaviors by any professional. In this chapter, we will build an evidence-based argument that sustainable change must include organizational, team, and individual strategies across all professionals in the organization. We will then describe an intervention model--Toxic Organization Change System--that has emerged from our own research on toxic behaviors in the workplace (Kusy & Holloway, 2009) and provide examples of specific strategies that we have used to prevent and ameliorate toxic cultures.

Instructional systems design is a process for assessing learning needs, creating instructional programs, and evaluating effectiveness of learning. We discuss the benefits of including instructional systems design theory and practice in the curriculum, with an emphasis on making the process relevant for student nurse anesthetists.

The authors conducted a national study to determine the factors associated with the success of physician leaders. They utilized the Leadership Practices Inventory (LPI) and a demographic survey followed by individual interviews with respondents. Data analysis revealed several implications for the selection, training, management, and career development of physician leaders. The results suggest that: Physician leadership training should have a strong focus on the "human side" of management, including negotiation, organizational "politics," conflict resolution, team building, and motivation. Data management and finance should be a focus represented in the curriculum. Mentoring relationships should be developed as an aspiring physician leader pursues a career shift. Self assessment, including an analysis of style, strengths, best potential organizational fit, and specific areas of strength and weakness should be an integral part of the development of an aspiring physician leader. Screening mechanisms to ascertain a physician's motivation to move toward a full-time leadership role should be developed to ensure appropriate intent. To facilitate this implication, more effective assessment tools need to be developed.

Performance evaluation is often used as a tool to determine salary adjustment as well as an opportunity to improve job performance. When inappropriately applied, performance evaluations may be perceived as being unfair, wasteful, and demeaning. In some organizations, there has been a trend to break down job functions to their most detailed level, weight each activity, judge it, and then add up all the invalid numbers to achieve a more invalid judgment of a person's performance. This non-Gestalt evaluation is an inspection philosophy that has not served manufacturing or health care very effectively. Over the past four years, we have evolved a performance evaluation process at Minneapolis Children's Medical Center for physicians in both patient care and management roles. In this article, we will describe the evolution to the present system and discuss its dovetailing with customer service-driven continuous quality improvement efforts and our plans to improve the process.

A needs assessment identified leadership, management, and interpersonal skills as training and development areas for hospital's physician executives. Training sessions were developed and occurred quarterly over a two-year period. Development strategies were designed to enhance transfer of learning from the classroom setting and incorporated personalized coaching sessions, development of a peer mentoring program, group redesign of the performance appraisal process, strategic planning, and performance feedback sessions. The comprehensiveness of the approaches taken in this program is critical to successful training and development efforts of physician executives.