Reflections of Teaching Narratives

This narrative describes the experiences of a high school English teacher who uses innovative teaching methods to adapt to online teaching during the recent pandemic. Students relied on writing to reflect on their emotional health and found comfort in relating to works of literature. The creative projects and motivational strategies discussed can apply to anyone looking to cope with difficult times, find more motivation to achieve a goal, or practice self-compassion when confronted with unexpected events.

Using Principal–Steward Contracting and Scenario Planning to Manage Megaprojects

Performance on megaprojects is dismal. Megaprojects are complex, but people use constructs inappropriate in complex situations for their management, particularly contractual arrangements based on principal–agent governance and conventional project management, which is good at solving puzzles, but not at enlightening mysteries. I review current thinking. Principal–steward contracting is a liberal governance structure required in complex situations. Conventional project management emphasizes control at the expense of innovation. In cases of high uncertainty, innovation is required as unexpected events occur. Scenario planning is offered as a way of approaching the management of complex megaprojects, to construct narratives, and to identify alternative outcomes.

Self-extubation after major trauma: another trauma?

Self-extubation can lead to detrimental outcomes for the patient. Complications that result from self-extubation range from laryngeal injury, respiratory distress, arrhythmia, pneumonia, to even death. With respect to patient safety, not only is prevention of self-extubation one of the most important goals in all intensive care units around the world, but also it is one of the most common mishaps in the area of intensive care. Since self-extubation and consequent re-intubation are unexpected events, they can embarrass the medical staff and negatively affect the treatment choice, and consequently, require other invasive procedures that may not have been necessary. The most important thing for patients exposed to self-extubation is to keep in mind the presence of airway damage, which can be confirmed through our experience as described here, through repeated re-intubations and eventually tracheostomy.

Acting and Learning with Goal and Task Decomposition

<p><b>Two central problems of creating artificial intelligent agents that can operate in the human world are learning the necessary knowledge to achieve routine tasks, and using that knowledge effectively in a complex and unpredictable domain. The thesis argues that an important part of this domain knowledge should be represented in the form of decomposition rules that decompose tasks into subgoals. The thesis presents HOPPER, an implemented planning system that uses decomposition rules and a least-commitment decomposition strategy that strikes a balance between reactive and deliberative planning. Like reactive planners, HOPPER is able to robustly handle and recover from unexpected events with minimal disruption to its plan. Like deliberative planners, it is also able to plan ahead to take advantage of opportunities to interleave and shorten its sub-plans. The thesis also presents TADPOLE, an implemented learning system that learns both the structure and preconditions of new decomposition rules from a small number of lessons demonstrated by a teacher. It learns by parsing and interpreting the teacher’s behaviour in terms of decomposition rules it already knows. It extends its rule set by filling in the holes in its parses of the teacher’s lessons.</b></p> <p>Both HOPPER and TADPOLE have been evaluated together in two different domains: a kitchen domain that emphasizes complexity, and a logistics domain that emphasizes plan efficiency. Every rule used by HOPPER was learned by TADPOLE and every rule learned by TADPOLE was successfully used by HOPPER to achieve various tasks, showing that TADPOLE is able to learn effective decomposition rules from minimal lessons from a teacher, and that HOPPER is able to robustly make use of them even in the face of unexpected events.</p>

Acting and Learning with Goal and Task Decomposition

<p><b>Two central problems of creating artificial intelligent agents that can operate in the human world are learning the necessary knowledge to achieve routine tasks, and using that knowledge effectively in a complex and unpredictable domain. The thesis argues that an important part of this domain knowledge should be represented in the form of decomposition rules that decompose tasks into subgoals. The thesis presents HOPPER, an implemented planning system that uses decomposition rules and a least-commitment decomposition strategy that strikes a balance between reactive and deliberative planning. Like reactive planners, HOPPER is able to robustly handle and recover from unexpected events with minimal disruption to its plan. Like deliberative planners, it is also able to plan ahead to take advantage of opportunities to interleave and shorten its sub-plans. The thesis also presents TADPOLE, an implemented learning system that learns both the structure and preconditions of new decomposition rules from a small number of lessons demonstrated by a teacher. It learns by parsing and interpreting the teacher’s behaviour in terms of decomposition rules it already knows. It extends its rule set by filling in the holes in its parses of the teacher’s lessons.</b></p> <p>Both HOPPER and TADPOLE have been evaluated together in two different domains: a kitchen domain that emphasizes complexity, and a logistics domain that emphasizes plan efficiency. Every rule used by HOPPER was learned by TADPOLE and every rule learned by TADPOLE was successfully used by HOPPER to achieve various tasks, showing that TADPOLE is able to learn effective decomposition rules from minimal lessons from a teacher, and that HOPPER is able to robustly make use of them even in the face of unexpected events.</p>

P.178 Neurosurgical Faculty Expectations of Entrustable Professional Activities Evaluations

Background: Competence by Design (CBD), a new outcomes-based approach to medical education, has been recently introduced into neurosurgical programs across Canada. A cornerstone of this educational paradigm shift requires evaluation of residents’ performances of entrustable professional activities (EPAs). This study aimed to define Faculty expectations and markers of competence for resident EPA performances. Methods: Canada-wide survey of neurosurgical Faculty (NSF) with a 55-item online questionnaire referencing 15/45 available core neurosurgery EPAs. Results: Of the 52 respondents, majority believed that being able to perform safely (98%), effectively (92%) and independently (90%) and being able to adapt to contextual complexities of the case (88%) and unexpected events (88%) represented necessary qualities for demonstrating competence achievement of an EPA. Performing efficiently, without supervision and responding to rare events were all considered less important. On average, NSF believed that at least five separate assessments involving two or more different assessors were necessary for documenting competence achievement of each EPA. Proportion believing EPAs were representative of general neurosurgery competences varied significantly across all EPAs (p<0.00001) with >25% believing 5/15 EPAs required fellowship training. Conclusions: This study defined expectations and indicators of competent surgical performance and revealed a significant debate regarding perceived appropriateness of current EPAs for general neurosurgical training.

Between the real and the imaginary: the construction of the symbolic in the attack on New York.

This article examines the political participation of mythology and the imaginary and the role of the history of unexpected events. It demonstrates how the attack on the Twin Towers in New York on September 11, 2001, determined contextualization of the event and 'resymbolization.' Working with the concept of the state of cinema, this article explores the possibilities of constructing modern culture which, based on the action of images and the movies. We analyze the North American imperial discourse, and the fabrication of a picture of the world based on a cinematographic, symbolic, and media process was - in the duel against the bad guy, and the American hero.

Management of Cash Flows during Covid-19

Any company, regardless of size or field of activity, can face several strategic and tactical challenges, especially when there are sudden economic changes, caused by emergencies and unexpected events, such as Covid-19. In order to adapt to ever-changing circumstances and opportunities, many companies are forced to make fundamental changes to their strategies and pay more attention to treasury management in order to achieve sustainable development.

EP.FRI.596 A Tale of Two Ultrasounds

Background Testicular torsion is a common cause of acute testicular pain, which requires immediate investigation and treatment. We describe a unique presentation of testicular torsion, which required the operating surgeon to assess the viability of a clinically dead testis through surgical manipulation, 16 hours after onset of pain. Case Report A 19 year old male presented with a 12 hour history of pain and swelling in the left scrotum. Examination revealed the left testes was hard, swollen and tender with a palpable spermatic cord. Clinical diagnosis of testicular mass or epididymo-orchitis was suggested and scrotal ultrasound was organised. This reported no blood flow in the left testis, and so torsion was suspected. Patient was taken immediately to theatre. Examination was performed under general anaesthetic, which revealed a hard, swollen testis, with no torsion clinically. Midline scrotal incision was made. On visual examination, left testis was black and hard, but there was no obvious torsion in the cord. However, during manipulation, the testis softened and started to change colour, eventually becoming dusky. A small incision into the testis showed bright red blood, and the decision was made to replace the testis and fix both testes. The patient made an excellent recovery post-operatively. Repeat ultrasound showed return of testicular vascularity. Conclusion This case showcases the importance of considering salvage in patients who have presented even after the generally accepted 6-8 hour time window. It also highlights the value of an experienced surgeon’s judgement in unusual presentations and with unexpected events intraoperatively.