2 resultados para Stratum

em Dalarna University College Electronic Archive


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This study investigates variable noun phrase number agreement (VNA) in two second language varieties of Portuguese, spoken in Maputo, Mozambique and in Mindelo, Cape Verde. Quantitative VARBRUL analysis is carried out based on recordings made in Maputo and Mindelo 2007 and 2008. Previous quantitative studies on VNA in varieties of Brazilian Portuguese (Guy, 1981; Lopes, 2001; Andrade, 2003) as well as on VNA in first and second language varieties of Portuguese from São Tomé (Baxter, 2004; Figueiredo, 2008, 2010) indicate contact between Portuguese and African languages as the main origin of this phenomenon. VNA in Brazilian Portuguese is, however, interpreted by Scherre (1988) and Naro & Scherre (1993, 2007) as the result of language internal drift. Varieties of Portuguese from Mozambique and Cape Verde are particularly interesting to contrast in order to investigate influences from African languages on VNA, as in Mozambique Bantu languages are first languages of the vast majority of Portuguese speakers, whereas in Cape Verde, practically all Portuguese speakers are first language speakers of Cape Verdean Creole, whose substrates are West African, and not Bantu, languages. Comparison is also made with previous studies from Brazil and São Tomé. The results of this study comment previously postulated explanations for VNA in Portuguese in various ways. The analysis of the variables onset age and age stratum indicates that VNA in the analyzed varieties is a phenomenon linked to the acquisition of Portuguese as a second language and/or language contact rather than the result of internal drift. The fact that all the compared varieties tend to mark plural on pre-head components contradicts Bantu transfer as an explanation for this pattern, and raises the need to also consider more general explanations based on language contact. The basic structural similarity between the compared varieties suggests the existence of a grammatical restructuring continuum.

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BACKGROUND: Reminder systems in electronic patient records (EPR) have proven to affect both health care professionals' behaviour and patient outcomes. The aim of this cluster randomised trial was to investigate the effects of implementing a clinical practice guideline (CPG) for peripheral venous catheters (PVCs) in paediatric care in the format of reminders integrated in the EPRs, on PVC-related complications, and on registered nurses' (RNs') self-reported adherence to the guideline. An additional aim was to study the relationship between contextual factors and the outcomes of the intervention. METHODS: The study involved 12 inpatient units at a paediatric university hospital. The reminders included choice of PVC, hygiene, maintenance, and daily inspection of PVC site. Primary outcome was documented signs and symptoms of PVC-related complications at removal, retrieved from the EPR. Secondary outcome was RNs' adherence to a PVC guideline, collected through a questionnaire that also included RNs' perceived work context, as measured by the Alberta Context Tool. Units were allocated into two strata, based on occurrence of PVCs. A blinded simple draw of lots from each stratum randomised six units to the control and intervention groups, respectively. Units were not blinded. The intervention group included 626 PVCs at baseline and 618 post-intervention and the control group 724 PVCs at baseline and 674 post-intervention. RNs included at baseline were 212 (65.4 %) and 208 (71.5 %) post-intervention. RESULTS: No significant effect was found for the computer reminders on PVC-related complications nor on RNs' adherence to the guideline recommendations. The complication rate at baseline and post-intervention was 40.6 % (95 % confidence interval (CI) 36.7-44.5) and 41.9 % (95 % CI 38.0-45.8), for the intervention group and 40.3 % (95 % CI 36.8-44.0) and 46.9 % (95 % CI 43.1-50.7) for the control. In general, RNs' self-rated work context varied from moderately low to moderately high, indicating that conditions for a successful implementation to occur were less optimal. CONCLUSIONS: The reminders might have benefitted from being accompanied by a tailored intervention that targeted specific barriers, such as the low frequency of recorded reasons for removal, the low adherence to daily inspection of PVC sites, and the lack of regular feedback to the RNs. TRIAL REGISTRATION: Current Controlled Trials ISRCTN44819426.