438 resultados para ATROPHY INVOLVE


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Despite considerable research activity and application in treatment, the construct of craving remains poorly understood. We propose that cravings and urges are cognitive–emotional events in time, characterised by frequency, duration, intensity and salience. Commonly used measures of alcohol craving are reviewed, and their strengths and weaknesses identified. Most measures confound craving with behaviours, or with separable cognitive phenomena such as expectancies, intentions, or perceived behavioural control. These confounds have limited our advances in understanding the determinants and consequences of craving. Based on the criteria applied in this review, among the better performing multi-item measures are the Penn Alcohol Craving Scale and Obsessive subscale of the Obsessive–Compulsive Drinking Scale. Optimal assessment strategies are likely to involve daily assessments of peak intensity of cravings, desires or urges and of the frequency and duration of craving episodes. Of particular interest are measures of intensity at times when individuals are at risk of drinking or of other functional impacts from craving.

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The state of the practice in safety has advanced rapidly in recent years with the emergence of new tools and processes for improving selection of the most cost-effective safety countermeasures. However, many challenges prevent fair and objective comparisons of countermeasures applied across safety disciplines (e.g. engineering, emergency services, and behavioral measures). These countermeasures operate at different spatial scales, are funded often by different financial sources and agencies, and have associated costs and benefits that are difficult to estimate. This research proposes a methodology by which both behavioral and engineering safety investments are considered and compared in a specific local context. The methodology involves a multi-stage process that enables the analyst to select countermeasures that yield high benefits to costs, are targeted for a particular project, and that may involve costs and benefits that accrue over varying spatial and temporal scales. The methodology is illustrated using a case study from the Geary Boulevard Corridor in San Francisco, California. The case study illustrates that: 1) The methodology enables the identification and assessment of a wide range of safety investment types at the project level; 2) The nature of crash histories lend themselves to the selection of both behavioral and engineering investments, requiring cooperation across agencies; and 3) The results of the cost-benefit analysis are highly sensitive to cost and benefit assumptions, and thus listing and justification of all assumptions is required. It is recommended that a sensitivity analyses be conducted when there is large uncertainty surrounding cost and benefit assumptions.

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Objective: The nature of contemporary cancer therapy means that patients are faced with difficult treatment decisions about surgery, chemotherapy and radiotherapy. For some, this process may also involve consideration of therapies that sit outside the biomedical approach to cancer treatment, in our research, traditional Chinese medicine (TCM). Thus, it is important to explore how cancer patients in Taiwan incorporate TCM into their cancer treatment journey. This paper aims to explore of the patterns of combining the use of TCM and Western medicine into cancer treatment journey in Taiwanese people with cancer. Methods: The sampling was purposive and the data collected through in-depth interviews. Data collection occurred over an eleven month. The research was grounded in the premises of symbolic interactionism and adopted the methods of grounded theory. Twenty four participants who were patients receiving cancer treatment were recruited from two health care settings in Taiwan. Results: The study findings suggest that perceptions of health and illness are mediated through ongoing interactions with different forms of therapy. The participants in this study had a clear focus on “process and patterns of using TCM and Western medicine”. Further, ‘different importance in Western medicine and TCM’, ‘taken for granted to use TCM’, ‘each has specialized skills in Western medicine and TCM’ and ‘different symptoms use different approaches (Western medicine or TCM)’ may explicit how the participants in this study see CAM and Western medicine. Conclusions/Implications for practice: The descriptive frame of the study suggests that TCM and Western medicine occupy quite distinct domains in terms of decision making over their use. People used TCM based on interpretations of the present and against a background of an enduring cultural legacy grounded in Chinese philosophical beliefs about health and healthcare. The increasingly popular term of 'integrative medicine' obscures the complex contexts of the patterns of use of both therapeutic modalities. It is this latter point that is worthy of further exploration.

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The construction industry has been under pressure for many years to produce economical buildings which offer value for money, not only during the construction phase, but more importantly, during the full life of the building. Whole Life Cycle Costing (WLCC) is a relatively new concept for the construction industry especially on residential development and particularly for Malaysia. Discussing the speculation in using WLCC for the Malaysian residential constructions is the aim for this paper and it is one of the research questions on my research. This paper also wants to gather more speculation that may involve through others experienced. Basically, this paper is written to facilitate the current or future individual which will involve in residential property development sector with a new sensible approach to what at times seems impressively confusing especially in simplifying the operations and maintenance services and rehabilitation as well.

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This paper invites consideration of how Australia should regulate voluntary euthanasia and assisted suicide. We have attempted to pose this question as neutrally as possible, acknowledging that both prohibition and legalisation of such conduct involve decisions about regulation. We begin by charting the wider field of law at the end of life, before considering the repeated, but ultimately unsuccessful, attempts at law reform in Australia. The situation in Australia is contrasted with permissive jurisdictions overseas where voluntary euthanasia and/or assisted suicide are lawful. We consider the arguments for and against legalisation of such conduct along with the available empirical evidence as to what happens in practice both in Australia and overseas. The paper concludes by outlining a framework for deliberating on how Australia should regulate voluntary euthanasia and assisted suicide. We ask a threshold question of whether such conduct should be criminal acts (as they presently are), the answer to which then leads to a range of possible regulatory options.

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Internationally there has been a move towards standards-referenced assessment with countries such as Australia developing a National Curriculum and Achievement Standards, New Zealand adopting National Standards for literacy and numeracy that involve schools making and reporting judgements about the reading, writing and mathematics achievement of children up to Year 8 (the end of primary school) and in Canada, classroom assessment standards aimed at the improvement of assessment practice of K-12 education are being formulated. Standards-driven reform has major implications for teachers’ work. The consequences of adopting a standards-driven approach to educational change by systems are often under-estimated with the unintended effects not fully understood by either the policy writers, and the public, including parents. It is for these reasons that the contention developed in this article relates to the teacher’s role, which it is argued remains central to policy focused on the improvement of the quality of education and educational standards.

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This article focuses on problem solving activities in a first grade classroom in a typical small community and school in Indiana. But, the teacher and the activities in this class were not at all typical of what goes on in most comparable classrooms; and, the issues that will be addressed are relevant and important for students from kindergarten through college. Can children really solve problems that involve concepts (or skills) that they have not yet been taught? Can children really create important mathematical concepts on their own – without a lot of guidance from teachers? What is the relationship between problem solving abilities and the mastery of skills that are widely regarded as being “prerequisites” to such tasks?Can primary school children (whose toolkits of skills are limited) engage productively in authentic simulations of “real life” problem solving situations? Can three-person teams of primary school children really work together collaboratively, and remain intensely engaged, on problem solving activities that require more than an hour to complete? Are the kinds of learning and problem solving experiences that are recommended (for example) in the USA’s Common Core State Curriculum Standards really representative of the kind that even young children encounter beyond school in the 21st century? … This article offers an existence proof showing why our answers to these questions are: Yes. Yes. Yes. Yes. Yes. Yes. And: No. … Even though the evidence we present is only intended to demonstrate what’s possible, not what’s likely to occur under any circumstances, there is no reason to expect that the things that our children accomplished could not be accomplished by average ability children in other schools and classrooms.

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The project examined the responsiveness of the telenursing service provided by the Child Health Line (hereinafter referred to as CHL). It aimed to provide an account of population usage of the service, the call request types and the response of the service to the calls. In so doing, the project extends the current body of knowledge pertaining to the provision of parenting support through telenursing. Approximately 900 calls to the CHL were audio-recorded over the December 2005-2006 Christmas-New Year period. A protocol was developed to code characteristics of the call, the interactional features between the caller and nurse call-taker, and the extent to which there was (a) agreement on problem definition and the plan of action and (b) interactional alignment between nurse and caller. A quantitative analysis examined the frequencies of the main topics covered in calls to the CHL and any statistical associations between types of calls, length of calls and nurse-caller alignment. In addition, a detailed qualitative analysis was conducted on a subset of calls dealing with the nurse management of calls seeking medical advice and information. Key findings include: • Overall, 74% of the calls discussed parenting and child development issues, 48% discussed health/medical issues, and 16% were information-seeking calls. • More specifically: o 21% discussed health/medical and parenting and child development issues. o 3% discussed parenting and information-seeking issues. o 5% discussed health/medical, parenting/development and information issues. o 18% exclusively focussed on health and medical issues and therefore were outside the remit of the intended scope of the CHL. These calls caused interactional dilemmas for the nurse call-takers as they simultaneously dealt with parental expectations for help and the CHL guidelines indicating that offering medical advice was outside the remit of the service. • Most frequent reasons for calling were to discuss sleep, feeding, normative infant physical functions and parenting advice. • The average length of calls to the CHL was 7 minutes. • Longer calls were more likely to involve nurse call-takers giving advice on more than one topic, the caller displaying strong emotions, the caller not specifically providing the reason for the call, and the caller discussing parenting and developmental issues. • Shorter calls were characterised by the nurse suggesting that the child receive immediate medical attention, the nurse emphasising the importance or urgency of the plan of action, the caller referring to or requesting confirmation of a diagnosis, and caller and nurse call-taker discussion of health and medical issues. • The majority of calls, 92%, achieved parent-nurse alignment by the conclusion of the call. However, 8% did not. • The 8% of calls that were not aligned require further quantitative and qualitative investigation of the interactional features. The findings are pertinent in the current context where Child Health Line now resides within 13HEALTH. These findings indicate: 1. A high demand for parenting advice. 2. Nurse call-takers have a high level of competency in dealing with calls about parenting and normal child development, which is the remit of the CHL. 3. Nurse call-takers and callers achieve a high degree of alignment when both parties agree on a course of action. 4. There is scope for developing professional practice in calls that present difficulties in terms of call content, interactional behaviour and call closure. Recommendations of the project: 1. There are numerous opportunities for further research on interactional aspects of calls to the CHL, such as further investigations of the interactional features and the association of the features to alignment and nonalignment. The rich and detailed insights into the patterns of nurse-parent interactions were afforded by the audio-recording and analysis of calls to the CHL. 2. The regular recording of calls would serve as a way of increasing understanding of the type and nature of calls received, and provide a valuable training resource. Recording and analysing calls to CHL provides insight into the operation of the service, including evidence about the effectiveness of triaging calls. 3. Training in both recognising and dealing with problem calls may be beneficial. For example, calls where the caller showed strong emotion, appeared stressed, frustrated or troubled were less likely to be rated as aligned calls. In calls where the callers described being ‘at their wits end’, or responded to each proposed suggestion with ‘I’ve tried that’, the callers were fairly resistant to advice-giving. 4. Training could focus on strategies for managing calls relating to parenting support and advice, and parental well-being. The project found that these calls were more likely to be rated as being nonaligned. 5. With the implementation of 13HEALTH, future research could compare nurse-parent interaction following the implementation of triaging. Of the calls, 21% had both medical and parenting topics discussed and 5.3% discussed medical, parenting and information topics. Added to this, in 12% of calls, there was ambiguity between the caller and nurse call-taker as to whether the problem was medical or behavioural.

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‘Forced marriages’ involve a woman or girl being abducted and declared the ‘wife’ of her captor without her consent or her family’s consent. The practice generally occurs during wartime and the ‘wife’ is normally subjected to rape, forced impregnation and sexual slavery. Moreover, she is coerced into an intimate relationship with a man who is often the perpetrator of crimes against her and her community. While forced marriages have recently been recognised as a crime against humanity, this Article contends that this does not constitute full recognition of the destructive nature of forced marriages. Instead, this Article mirrors and extends the Akayesu decision that rape can be used as a tool of genocide and maintains that forced marriages can also be a form of genocide.

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The SimCalc Vision and Contributions Advances in Mathematics Education 2013, pp 419-436 Modeling as a Means for Making Powerful Ideas Accessible to Children at an Early Age Richard Lesh, Lyn English, Serife Sevis, Chanda Riggs … show all 4 hide » Look Inside » Get Access Abstract In modern societies in the 21st century, significant changes have been occurring in the kinds of “mathematical thinking” that are needed outside of school. Even in the case of primary school children (grades K-2), children not only encounter situations where numbers refer to sets of discrete objects that can be counted. Numbers also are used to describe situations that involve continuous quantities (inches, feet, pounds, etc.), signed quantities, quantities that have both magnitude and direction, locations (coordinates, or ordinal quantities), transformations (actions), accumulating quantities, continually changing quantities, and other kinds of mathematical objects. Furthermore, if we ask, what kind of situations can children use numbers to describe? rather than restricting attention to situations where children should be able to calculate correctly, then this study shows that average ability children in grades K-2 are (and need to be) able to productively mathematize situations that involve far more than simple counts. Similarly, whereas nearly the entire K-16 mathematics curriculum is restricted to situations that can be mathematized using a single input-output rule going in one direction, even the lives of primary school children are filled with situations that involve several interacting actions—and which involve feedback loops, second-order effects, and issues such as maximization, minimization, or stabilizations (which, many years ago, needed to be postponed until students had been introduced to calculus). …This brief paper demonstrates that, if children’s stories are used to introduce simulations of “real life” problem solving situations, then average ability primary school children are quite capable of dealing productively with 60-minute problems that involve (a) many kinds of quantities in addition to “counts,” (b) integrated collections of concepts associated with a variety of textbook topic areas, (c) interactions among several different actors, and (d) issues such as maximization, minimization, and stabilization.

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Purpose: Within the context of high global competitiveness, knowledge management (KM) has proven to be one of the major factors contributing to enhanced business outcomes. Furthermore, knowledge sharing (KS) is one of the most critical of all KM activities. From a manufacturing industry perspective, supply chain management (SCM) and product development process (PDP) activities, require a high proportion of company resources such as budget and manpower. Therefore, manufacturing companies are striving to strengthen SCM, PDP and KS activities in order to accelerate rates of manufacturing process improvement, ultimately resulting in higher levels of business performance (BP). A theoretical framework along with a number of hypotheses are proposed and empirically tested through correlation, factor and path analyses. Design/methodology/approach: A questionnaire survey was administered to a sample of electronic manufacturing companies operating in Taiwan to facilitate testing the proposed relationships. More than 170 respondents from 83 organisations responded to the survey. The study identified top management commitment and employee empowerment, supplier evaluation and selection, and design simplification and modular design as the key business activities that are strongly associated with the business performance. Findings: The empirical study supports that key manufacturing business activities (i.e., SCM, PDP, and KS) are positively associated with BP. The findings also evealed that some specific business activities such as SCMF1,PDPF2, and KSF1 have the strongest influencing power on particular business outcomes (i.e., BPF1 and BPF2) within the context of electronic manufacturing companies operating in Taiwan. Practical implications: The finding regarding the relationship between SCM and BP identified the essential role of supplier evaluation and selection in improving business competitiveness and long term performance. The process of forming knowledge in companies, such as creation, storage/retrieval, and transfer do not necessarily lead to enhanced business performance; only through effectively applying knowledge to the right person at the right time does. Originality/value: Based on this finding it is recommended that companies should involve suppliers in partnerships to continuously improve operations and enhance product design efforts, which would ultimately enhance business performance. Business performance depends more on an employee’s ability to turn knowledge into effective action.

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Teacher assessment literacy is a phrase that is often used but rarely defined. Yet understanding teacher assessment literacy is important in an international curriculum and assessment reform context that continues to challenge teachers’ assessment practices. In this article situated examples of classroom assessment literacies are analysed using Bernstein’s (Pedagogy, symbolic control and identity: Theory, research and critique, Taylor and Francis, London, 1996; Br J Sociol Educ 20(2):157–173, 1999) theoretical tools of vertical and horizontal discourses, classification and framing. Drawing on a sociocultural view of learning, the authors define teacher assessment literacies as dynamic social practices which are context dependent and which involve teachers in articulating and negotiating classroom and cultural knowledges with one another and with learners, in the initiation, development and practice of assessment to achieve the learning goals of students. This conceptualisation of assessment literacy aims to make explicit some underpinning theoretical constructs of assessment literacy to inform dialogue and decision making for policy and practice to benefit student learning and achievement.

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A wide variety of experiments that involve the physics of small particles (μm to cm in size) of planetary significance can be conducted on the Space Station. Processes of interest include nucleation and condensation of particles from a gas, aggregation of small particles into larger ones, and low velocity collisions of particles. Only experiments relevant to planetary processes will be discussed in detail here.

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Music and dance are art forms that involve a full mind-body experience, integrating the cognitive, affective and kinesthetic domains. To engage in creating music and dance is to use information to express oneself and communicate. In this chapter I explore the information experience of two distinct groups: those who compose music for an audience, and those who dance socially with a partner. For the composer, information sources can be a stimulus for creation. Sounds, feelings, moods, images, ideas and life experiences can trigger a creative idea. These ideas are shaped by existing musical styles and structures, and by the composer’s personal aesthetic. The intention of the composer is to communicate their expressive ideas to an audience. For the social dancer, information sources are those used to communicate with a partner. There is no intention to perform for an audience. A social dancer aims to express the music and style of the dance while creating a strong connection with their partner. Information sources include the music, the partner’s body, the emotions generated by the dance, the position of other couples on the floor and the feeling of the floor. Use of information in the arts is an under-researched experience. Most information studies are based on the assumption that information is documentary and codified. Subjective and affective information is rarely recognised and legitimised. Information-as-it-is-experienced through creative practice such as music and dance is holistic in acknowledging mind, body and spirit as well as traditional documentary forms of information. This chapter draws on empirical research to illustrate experiencing information as creating and expressing.

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In this thesis, I contribute to the study of how arrangements are made in social interaction. Using conversation analysis, I examine a corpus of 375 telephone calls between employees and clients of three Community Home Care (CHC) service agencies in metropolitan Adelaide, South Australia. My analysis of the CHC data corpus draws upon existing empirical findings within conversation analysis in order to generate novel findings about how people make arrangements with one another, and some of the attendant considerations that parties to such an activity can engage in: Prospective informings as remote proposals for a future arrangement – Focusing on how employees make arrangements with clients, I show how the employees in the CHC data corpus use ‘prospective informings’ to detail a future course of action that will involve the recipient of that informing. These informings routinely occasion a double-paired sequence, where informers pursue a response to their informing. This pursuit often occurs even after recipients have provided an initial response. This practice for making arrangements has been previously described by Houtkoop (1987) as ‘remote proposing.’ I develop Houtkoop’s analysis to show how an informing of a future arrangement can be recompleted, with response solicitation, as a proposal that is contingent upon a recipient’s acceptance. Participants’ understanding of references to non-present third parties – In the process of making arrangements, references are routinely made to non-present third parties. In the CHC data corpus, these third parties are usually care workers. Prior research (e.g., Sacks & Schegloff, 1979; Schegloff, 1996b) explains how the use of ‘recognitional references’ (such as the bare name ‘Kerry’), conveys to recipients that they should be able to locate the referent from amongst their acquaintances. Conversely, the use of ‘non-recognitional references’ (such as the description ‘a lady called Kerry’), conveys that recipients are unacquainted with the referent. I examine instances where the selection of a recognitional or non-recognitional reference form is followed by a recipient initiating repair on that reference. My analysis provides further evidence thatthe existing analytic account of these references corresponds to the way in which participants themselves make sense of them. My analysis also advances an understanding of how repair can be used, by recipients, to indicate the inappositeness of a prior turn. Post-possible-completion accounts – In a case study of a problematic interaction, I examine a misunderstanding that is not resolved within the repair space, the usual defence of intersubjectivity in interaction (cf. Schegloff, 1992b). Rather, I explore how the source of trouble is addressed, outside of the sequence of its production, with a ‘post-possible-completion account.’ This account specifies the basis of a misunderstanding and yet, unlike repair, does so without occasioning a revised response to a trouble-source turn. By considering various aspects of making arrangements in social interaction, I highlight some of the rich order that underpins the maintenance of human relationships across time. In the concluding section of this thesis I review this order, while also discussing practical implications of this analysis for CHC practice.