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1.
Efforts to represent knowledge effectively have been central to progress in various aspects of medical informatics. These efforts range from relatively simple "electronic textbooks" to fairly sophisticated knowledge-based systems, which function as well as, or even better than, human experts faced with similar problems. Knowledge bases have been developed in many fields, but the relatively limited domains and structured language of medicine, as well as the importance of information in the provision of good medical care, have made research in medical knowledge representation an area of intense activity. This paper reviews representative knowledge bases and knowledge-based systems in medicine: electronic textbooks such as PDQ and the Hepatitis Knowledge Base (HKB), rule-based systems such as MYCIN, causal models (e.g., CASNET), and hypothesis- or frame-based systems, exemplified by PIP and INTERNIST-1. The paper describes the relationships among divergent approaches and provides a sense of current and future trends. It examines problems in knowledge-based systems, particularly in knowledge representation and acquisition, and the responses to these challenges. The latter include the use of domain-independent software shells for constructing knowledge bases, the adaptation and use of previously existing knowledge bases, and multiple uses of the same knowledge base for different purposes.  相似文献   
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‘Pathological demand avoidance’ (PDA) describes a pattern of difficulties increasingly recognised as forming part of the autistic spectrum. Although clinical reports suggest that children with PDA are likely to experience considerable difficulties in education, their educational experiences have not yet been explored in any systematic way. In the current study, 42 parents of children with PDA completed a questionnaire about their child's educational experiences. Parents' responses indicated that this group of children displays high levels of problem behaviours in school, and receives corresponding high levels of special educational need support and professional involvement. Despite this support, the group had experienced high rates of exclusion and placement breakdown, with only 48% now in mainstream education. Parents reported relatively high satisfaction in their children's educational placements, with success defined by parents in terms of child outcomes, school characteristics and PDA‐specific factors. Findings are discussed with reference to what is known about the educational experiences of children with more typical autism spectrum conditions and in terms of the implications for the inclusion of this group of children with complex needs.  相似文献   
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This article presents data from a series of life-history interviews with female student teachers of physical education. The intention is to forge links between the experiences of female student teachers, and their 'gender positioning' within the micro-politics of teacher education and the wider discourse that informs these interactions. On first entering teaching these women tended to adopt or enter 'survival mode', which endorsed particular professional identities that were consolidated by a form of instrumental rationality. These professional identities were closely tied to conventional conceptions of masculinity, and legitimated and contributed to, the reinforcement of particular gender inequalities in teacher education. The analysis suggests that a liberal discourse of equal opportunities masks the institutionalisation of social 'otherness' and inequality and supports the 'essentialisation' of male and female identities.  相似文献   
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An implicit assumption that fostering inclusion means having shared systems encompassing the needs of all children is evident in many aspects of policy development over the past decade. Reflecting this, the implementation of ‘baseline assessment’ schemes (i.e. testing at around age 5 years) is a statutory requirement on all state-maintained special and mainstream schools in England since 1998. Our argument is that the enthusiasm for commonality has obscured the need to question the value and validity of baseline assessment schemes for children with special educational needs (and possibly some others such as children having English as an additional language). We illustrate this position with reference to data from our recent study on baseline assessment in England. The study encompassed survey data from a national sample of 982 schools, of which 107 were special schools. Between them, these special schools used 42 different baseline assessment schemes. Comparisons between our mainstream and special school respondents indicated that there were similarities in the nature and perceived value of the schemes used. However, special schools were less satisfied with their schemes. We suggest that a reappraisal of the nature and purpose of baseline assessment for pupils with special educational needs warrants greater critical debate. Without this, there is a danger that a stress on commonality, veiling an inclusion orthodoxy, will ultimately be counterproductive.  相似文献   
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