Variation in treatment strategies of Swiss general practitioners for subclinical hypothyroidism in older adults.

QUESTIONS UNDER STUDY: As the best management of subclinical hypothyroidism is controversial, we aimed to assess variations in treatment strategies depending on different Swiss regions, physician and patient characteristics. METHODS: We performed a case-based survey among general practitioners (GPs) in different Swiss regions, which consisted of eight hypothetical cases presenting a female patient with subclinical hypothyroidism and nonspecific complaints differing by age, vitality status and thyroid-stimulating hormone (TSH) concentration. RESULTS: A total of 262 GPs participated in the survey. There was considerable variation in the levothyroxine starting dose chosen by GPs, ranging from 25 µg to 100 µg. Across the Swiss regions, GPs in the Bern region were significantly more inclined to treat, with a higher probability of initiating treatment (60%, p = 0.01) and higher mean starting doses (45 µg, p <0.01) compared with the French-speaking region (44%, 36 µg); the Zurich region had intermediate values (52%, 39 µg). We found no association between treatment rate and other physician characteristics. GPs were more reluctant to initiate treatment in 85-year-old than in 70-year-old women (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.63-0.94), and more likely to treat women with a TSH of 15 mU/l than those with a TSH of 6mU/l (OR 8.71, 95% CI 6.21-12.20). CONCLUSIONS: There are strong variations in treatment strategies for elderly patients with subclinical hypothyroidism across different Swiss regions, including use of higher starting doses than the recommended 25 µg in the Swiss guidelines, which recommend a starting dose of 25 µg. These variations likely reflect the current uncertainty about the benefits of treatment, which arise from the current lack of evidence from adequately powered clinical trials.

The challenges and successful strategies of secondary school administrators /

This study presents information gathered during personal interviews in the area of challenges that administrators have faced in their careers, and the strategies they have found to be successful in meeting those challenges. This research is a qualitative study, using an inductive approach. Five participants were chosen, based on convenience sampling, with semi-structured interviews that were audio recorded. The theoretical research found that school violence and stafS'school morale were key challenges facing administrators, with a variety of approaches suggested to foster success in meeting those challenges. Some of these approaches included knowledge, team work, an ethic of care, and having a school vision. From the interviews it became clear that the challenges administrators faced included those posed by students, including disciplinary issues, those posed by adults and those posed by government changes in education. In regards to strategies for success, the interviews revealed three key concepts that were emphasized as vital. These were the assets of craft knowledge (experience), collegiality, and the use of other professional resources and educators.

The performance and strategies of adolescents in learning to read artificial words /

The present study explored processing strategies used by individuals when they begin to read c;l script. Stimuli were artificial words created from symbols and based on an alphabetic system. The words were.presented to Grade Nine and Ten students, with variations included in the difficulty of orthography and word familiarity, and then scores were recorded on the mean number of trials for defined learning variables. Qualitative findings revealed that subjects 1 earned parts of the visual a'nd auditory features of words prior to hooking up the visual stimulus to the word's name. Performance measures-which appear to affect the rate of learning were as follows: auditory short-term memory, auditory delayed short-term memory, visual delayed short- term memory, and word attack or decod~ng skills. Qualitative data emerging in verbal reports by the subjects revealed that strategies they pefceived to use were, graphic, phonetic decoding and word .reading.

Investigation into the Motivation Strategies of the Elite ITU Triathlon Coaches

The purpose of this study was to identify elite triathlon coaches’ beliefs and practices as they pertain to motivating world-class triathletes. Semi-structured interviews were conducted with four elite triathlon coaches operating out of three different training groups. Furthermore, the athletes within these groups completed questionnaires assessing their motivational profiles, basic psychological needs, and perceived autonomy support. The interviews were analyzed deductively according to the Motivational Model of the Coach-Athlete Relationship (Mageau & Vallerland, 2003). The data revealed that coaches predominantly used an autonomy-supportive coaching style while also providing structure and involvement. The coaches emphasized an individualized approach for each athlete to best meet their needs. Athletes’ responses to the questionnaires provide support for the coaches’ philosophies and perceived behaviours. The findings of this study provide valuable direction for elite and developing coaches looking to enhance their communication skills in order to optimize athlete needs and motivation.

Family Record of the Clement Family

Family Record of the Clement Family (1 printed page) listing Clement family members born from 1750 – 1808, n.d.

Family Record of the Clement Family (on fabric)

Family Record of the Clement Family (1 printed page) exactly as above, but printed on fabric, n.d.

Drawing and Explanation of the Cleveland Family Coat of Arms

Drawing and explanation of the Cleveland Family coat of arms. Pro Deo et Patria means For God and Country. The name is Saxon in origin and in 1403 the “de” was dropped from the name. The drawing and text are said to be from Cleveland Genealogy by J.B. Cleveland, 1881. It can also be found in An Account of the Lineage of General Moses Cleaveland (founder of the city of Cleveland, Ohio) of Canterbury, compiled by H.G. Cleveland, n.d.

Patent pools and competition law : an examination of the enforcement strategies of competition authorities

"Mémoire présenté à la Faculté des études supérieures en vue de l'obtention du grade de maîtrise en droit, option recherche"

Inventing interventions : strategies of reappropriation in Native American and First Nations literatures

Ma thèse de doctorat, intitulée Inventing Interventions: Strategies of Reappropriation in Native and First Nations Literatures traite du sujet de la réappropriation de la langue anglaise et de la langue française dans les littératures autochtones du Canada et des États-Unis, en tant que stratégie d’intervention de re-narration et de récupération. De fait, mon projet fait abstraction, autant que possible, des frontières nationales et linguistiques, vu que celles-ci sont essentiellement des constructions culturelles et coloniales. Ainsi, l’acte de réappropriation de la langue coloniale implique non seulement la maîtrise de base de cette dernière à des fins de communication, cela devient un moyen envers une fin : au lieu d’être possédés par la langue, les auteurs sur lesquels je me penche ici possèdent à présent cette dernière, et n’y sont plus soumis. Les tensions qui résultent d’un tel processus sont le produit d’une transition violente imposée et expérimentale d’une réalité culturelle à une autre, qui, pour plusieurs, n’a pas réussie et s’est, au contraire, effritée sur elle-même. Je soutiens donc que les auteurs autochtones ont créé un moyen à travers l’expression artistique et politique de répondre (dans le sens de « write back ») à l’oppression et l’injustice. À travers l’analyse d’oeuvres contemporaines écrites en anglais ou en français, que ce soit de la fiction, de l’autobiographie, de la poésie, du théâtre, de l’histoire ou du politique, ma recherche se structure autour de quatre concepts spécifiques : la langue, la résistance, la mémoire, et le lieu. J’examine comment ces concepts sont mis en voix, et comment ils sont interdépendants et s’affectent à l’intérieur du discours particulier issu des littératures autochtones et des différentes stratégies d’intervention (telles la redéfinition ou l’invention) et du mélange de différentes formules littéraires.

Strategies of empirical justification in experimental science

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

STUDIES ON SOME ASPECTS OF REPRODUCTION OF FEMALE ANABAS TESTUDINEUS ( BLOCH )

Department of Marine Biology, Microbiology and Biochemistry

Assessment of the strategies of organic fruit production and fruit drying in Uganda

Organic agriculture in Uganda is developing at a fast pace and despite this trend Uganda is still unable to produce enough fresh and dry organic fruits mainly pineapple to meet the exporters demand. This current research investigated the strategies of farmers at production level by assessing the pros and cons of fruit growing, organic agriculture and fruit drying in order to understand the underlying causal factor for the low production of organic dry fruits in a major fruit producing district of Uganda. The study was carried out in two separate and distinctive areas; one which only produces and export fresh organic pineapple and the other which exports dried fruits (mainly pineapple and papaya). About 10% of the farmers in the two study areas were surveyed using questionnaires which were further followed by semi-structured interviews and participatory rural appraisals activities with various types of farmers in order to understand the different decisions and strategies of farmers. 82% and 74% of farmers in the two study areas grew fruits as it gave better economic returns and for 77% and 90% respectively in the two study areas, the reasons for growing fruit was the ease of selling compared to other crops. All the farmers were relying on coffee husk for growing organic pineapples. However, 50% of the farmers want to grow pineapples (either organic or conventional) but couldn't afford to buy coffee husk. Fruit drying was mainly a strategy to utilize cheap fruits during harvesting seasons for value addition. 71% and 42% of farmers in the two study areas wanted to dry fruits but it was beyond their economic capacity to buy the driers. Decision of the farmers whether to grow fruits or cereals, organic or conventional agriculture and selling the fruits as fresh or dry were dependent mainly on the economic, knowledge and resource availability of each type of practices. It is concluded that the main barrier for an increase in the production of organic dried fruits is at the processing level, and the limited capacity for investments in drying facilities.

A Comparative study of germination strategies of two species of genus Allium sect. Allium

Germination experiments were performed with seeds of two species of genus Allium section Allium, a rare and endangered species A. pyrenaicum and a common A. sphaerocephalon. Different pre-treatments and a photoperiod of 24 h darkness were applied in order to simulate different germination conditions. Both species showed a high percentage of viable seeds a part of which were dormant. An elevate percentage of dormant seeds could be caused by a later collection time. Low altitude populations had more mortality than the others, possibly caused by the hard summer conditions during flowering and fruiting time. Comparisons between dates of species coexistence localities only show inter-population variability and it could be caused by the detected dormancy. Darkness accelerates germination, possibly for elongation radicle stimulation. Heat-shock pre-treatments decreased germination time in seeds from localities where fire is a probable event. The rarity of A. Pyrenaicum not seems to be caused by restricted germination requirements but is attributable to distinct habitat preferences, related to his altitudinal range of distribution

Strategies of psychological terrorism perpetrated by ETA's network : Delimitation and classification

Resumen tomado de la publicaci??n

Family Characterization of Young Experimental Consumers of Psychoactive Substances Seen in the Toxicology Department at Colsubsidio

This investigation characterized families of adolescents experimenting with psychoactive substances (PAS) consumption. Materials and methods: For this purpose, a qualitative study with a hermeneutical emphasis was conducted among a population of adolescents between the ages of 12 and 17 who have experimented with PAS. Semi-structured interviews were conducted with patients and their families employing a flexible protocol of 14 categories. Results: The findings showed low levels of family cohesion and sense of family identity, inconsistency between educational patterns followed by the parents, as well as deficient parental support. Similarly, the findings indicate significant peer influence during the first stages of consumption of illegal substances. In this regard, the findings suggest that more than providing physical satisfaction, consumption represents a form of acquiring prestige and social position while granting a sensation of psychological, emotional and social well-being. Conclusions: Parental influence was also found considerable in regarding the consumption of legal PAS, like alcohol and tobacco. The study identified as a high-priority need to promote and incorporate communication and conflict resolution skills within the family dynamics by means of prevention and monitoring programs. Those skills and programs would be aimed at providing parents of adolescents experimenting with PAS consumption with new educational tools to orientate new raising guidelines so as to respond appropriately to the problems identified in this study.