Awareness of Stroke Risk after TIA in Swiss General Practitioners and Hospital Physicians.

BACKGROUND Transient ischemic attacks (TIA) are stroke warning signs and emergency situations, and, if immediately investigated, doctors can intervene to prevent strokes. Nevertheless, many patients delay going to the doctor, and doctors might delay urgently needed investigations and preventative treatments. We set out to determine how much general practitioners (GPs) and hospital physicians (HPs) knew about stroke risk after TIA, and to measure their referral rates. METHODS We used a structured questionnaire to ask GPs and HPs in the catchment area of the University Hospital of Bern to estimate a patient's risk of stroke after TIA. We also assessed their referral behavior. We then statistically analysed their reasons for deciding not to immediately refer patients. RESULTS Of the 1545 physicians, 40% (614) returned the survey. Of these, 75% (457) overestimated stroke risk within 24 hours, and 40% (245) overestimated risk within 3 months after TIA. Only 9% (53) underestimated stroke risk within 24 hours and 26% (158) underestimated risk within 3 months; 78% (473) of physicians overestimated the amount that carotid endarterectomy reduces stroke risk; 93% (543) would rigorously investigate the cause of a TIA, but only 38% (229) would refer TIA patients for urgent investigations "very often". Physicians most commonly gave these reasons for not making emergency referrals: patient's advanced age; patient's preference; patient was multimorbid; and, patient needed long-term care. CONCLUSIONS Although physicians overestimate stroke risk after TIA, their rate of emergency referral is modest, mainly because they tend not to refer multimorbid and elderly patients at the appropriate rate. Since old and frail patients benefit from urgent investigations and treatment after TIA as much as younger patients, future educational campaigns should focus on the importance of emergency evaluations for all TIA patients.

Food quality awareness : cases from shrimp producers in Thailand and vegetable producers in Vietnam

The high number of import rejections of food commodities suggests that producers in exporting countries are not complying with established standards. To understand why this is the case, we explore the behavior of producers and consumers in developing countries. First, we examine the successful transformation of production practices adopted by shrimp producers in Thailand. In support of the dramatic change in practices, we observe an important role played by the public sector in providing a means to visualize chemical residues and to control processes upstream of the supply chain via a registration system and a traceability system called Movement Document. Furthermore, very active information sharing by the private sector contributes to the dissemination of useful technical and market information among producers. We also examine the knowledge and perceptions of consumers with respect to food safety in Vietnam. We find that consumers in Hanoi and Ho Chi Minh City behave differently toward the third-party certification VietGAP, probably owing to differences in the history of market mechanisms between the two cities.

A framework for building distributed social network websites

Las redes son la esencia de comunidades y sociedades humanas; constituyen el entramado en el que nos relacionamos y determinan cómo lo hacemos, cómo se disemina la información o incluso cómo las cosas se llevan a cabo. Pero el protagonismo de las redes va más allá del que adquiere en las redes sociales. Se encuentran en el seno de múltiples estructuras que conocemos, desde las interaciones entre las proteínas dentro de una célula hasta la interconexión de los routers de internet. Las redes sociales están presentes en internet desde sus principios, en el correo electrónico por tomar un ejemplo. Dentro de cada cliente de correo se manejan listas contactos que agregadas constituyen una red social. Sin embargo, ha sido con la aparición de los sitios web de redes sociales cuando este tipo de aplicaciones web han llegado a la conciencia general. Las redes sociales se han situado entre los sitios más populares y con más tráfico de la web. Páginas como Facebook o Twitter manejan cifras asombrosas en cuanto a número de usuarios activos, de tráfico o de tiempo invertido en el sitio. Pero las funcionalidades de red social no están restringidas a las redes sociales orientadas a contactos, aquellas enfocadas a construir tu lista de contactos e interactuar con ellos. Existen otros ejemplos de sitios que aprovechan las redes sociales para aumentar la actividad de los usuarios y su involucración alrededor de algún tipo de contenido. Estos ejemplos van desde una de las redes sociales más antiguas, Flickr, orientada al intercambio de fotografías, hasta Github, la red social de código libre más popular hoy en día. No es una casualidad que la popularidad de estos sitios web venga de la mano de sus funcionalidades de red social. El escenario es más rico aún, ya que los sitios de redes sociales interaccionan entre ellos, compartiendo y exportando listas de contactos, servicios de autenticación y proporcionando un valioso canal para publicitar la actividad de los usuarios en otros sitios web. Esta funcionalidad es reciente y aún les queda un paso hasta que las redes sociales superen su condición de bunkers y lleguen a un estado de verdadera interoperabilidad entre ellas, tal como funcionan hoy en día el correo electrónico o la mensajería instantánea. Este trabajo muestra una tecnología que permite construir sitios web con características de red social distribuída. En primer lugar, se presenta una tecnología para la construcción de un componente intermedio que permite proporcionar cualquier característica de gestión de contenidos al popular marco de desarrollo web modelo-vista-controlador (MVC) Ruby on Rails. Esta técnica constituye una herramienta para desarrolladores que les permita abstraerse de las complejidades de la gestión de contenidos y enfocarse en las particularidades de los propios contenidos. Esta técnica se usará también para proporcionar las características de red social. Se describe una nueva métrica de reusabilidad de código para demostrar la validez del componente intermedio en marcos MVC. En segundo lugar, se analizan las características de los sitios web de redes sociales más populares, con el objetivo de encontrar los patrones comunes que aparecen en ellos. Este análisis servirá como base para definir los requisitos que debe cumplir un marco para construir redes sociales. A continuación se propone una arquitectura de referencia que proporcione este tipo de características. Dicha arquitectura ha sido implementada en un componente, Social Stream, y probada en varias redes sociales, tanto orientadas a contactos como a contenido, en el contexto de una asociación vecinal tanto como en proyectos de investigación financiados por la UE. Ha sido la base de varios proyectos fin de carrera. Además, ha sido publicado como código libre, obteniendo una comunidad creciente y está siendo usado más allá del ámbito de este trabajo. Dicha arquitectura ha permitido la definición de un nuevo modelo de control de acceso social que supera varias limitaciones presentes en los modelos de control de acceso para redes sociales. Más aún, se han analizado casos de estudio de sitios de red social distribuídos, reuniendo un conjunto de caraterísticas que debe cumplir un marco para construir redes sociales distribuídas. Por último, se ha extendido la arquitectura del marco para dar cabida a las características de redes sociales distribuídas. Su implementación ha sido validada en proyectos de investigación financiados por la UE. Abstract Networks are the substance of human communities and societies; they constitute the structural framework on which we relate to each other and determine the way we do it, the way information is diseminated or even the way people get things done. But network prominence goes beyond the importance it acquires in social networks. Networks are found within numerous known structures, from protein interactions inside a cell to router connections on the internet. Social networks are present on the internet since its beginnings, in emails for example. Inside every email client, there are contact lists that added together constitute a social network. However, it has been with the emergence of social network sites (SNS) when these kinds of web applications have reached general awareness. SNS are now among the most popular sites in the web and with the higher traffic. Sites such as Facebook and Twitter hold astonishing figures of active users, traffic and time invested into the sites. Nevertheless, SNS functionalities are not restricted to contact-oriented social networks, those that are focused on building your own list of contacts and interacting with them. There are other examples of sites that leverage social networking to foster user activity and engagement around other types of content. Examples go from early SNS such as Flickr, the photography related networking site, to Github, the most popular social network repository nowadays. It is not an accident that the popularity of these websites comes hand-in-hand with their social network capabilities The scenario is even richer, due to the fact that SNS interact with each other, sharing and exporting contact lists and authentication as well as providing a valuable channel to publize user activity in other sites. These interactions are very recent and they are still finding their way to the point where SNS overcome their condition of data silos to a stage of full interoperability between sites, in the same way email and instant messaging networks work today. This work introduces a technology that allows to rapidly build any kind of distributed social network website. It first introduces a new technique to create middleware that can provide any kind of content management feature to a popular model-view-controller (MVC) web development framework, Ruby on Rails. It provides developers with tools that allow them to abstract from the complexities related with content management and focus on the development of specific content. This same technique is also used to provide the framework with social network features. Additionally, it describes a new metric of code reuse to assert the validity of the kind of middleware that is emerging in MVC frameworks. Secondly, the characteristics of top popular SNS are analysed in order to find the common patterns shown in them. This analysis is the ground for defining the requirements of a framework for building social network websites. Next, a reference architecture for supporting the features found in the analysis is proposed. This architecture has been implemented in a software component, called Social Stream, and tested in several social networks, both contact- and content-oriented, in local neighbourhood associations and EU-founded research projects. It has also been the ground for several Master’s theses. It has been released as a free and open source software that has obtained a growing community and that is now being used beyond the scope of this work. The social architecture has enabled the definition of a new social-based access control model that overcomes some of the limitations currenly present in access control models for social networks. Furthermore, paradigms and case studies in distributed SNS have been analysed, gathering a set of features for distributed social networking. Finally the architecture of the framework has been extended to support distributed SNS capabilities. Its implementation has also been validated in EU-founded research projects.

The analytic hierarchy process to support decision-making processes in infrastructure projects with social impact

There is an increasing awareness among all kinds of organisations (in business,government and civil society) about the benefits of jointly working with stakeholders to satisfy both their goals and the social demands placed upon them. This is particularly the case within corporate social responsibility (CSR) frameworks. In this regard, multi-criteria tools for decision-making like the analytic hierarchy process (AHP) described in the paper can be useful for the building relationships with stakeholders. Since these tools can reveal decision-maker’s preferences, the integration of opinions from various stakeholders in the decision-making process may result in better and more innovative solutions with significant shared value. This paper is based on ongoing research to assess the feasibility of an AHP-based model to support CSR decisions in large infrastructure projects carried out by Red Electrica de España, the sole transmission agent and operator of the Spanishelectricity system.

Psychological and Social Perspectives on Malingering and Symptom Exaggeration: Conceptualization and Interventions Using Acceptance and Commitment Therapy

Malingering and the production of false symptoms seen in such disorders as Factitious Disorder are an ongoing mystery to medical and mental health professionals. Historically, these presentations have been difficult to identify and treat. As might be expected, individuals with such symptomology rarely agree to participate in research, possibly because of a reluctance to admit to the feigning or exaggerating behaviors and a fear of reprisals. Many different etiologies have been proposed, including the assumption of roles in order to manage impressions, taking control of symptoms in order to gain attention or other rewards or avoid aversive events, and even the production of symptoms that is largely out of awareness such as is seen in conversion or somatoform presentations. By examining historical and present-day beliefs about etiology and treatment interventions, professionals can explore what new types of effective treatment might look like. The behaviorist philosophy that underlies Acceptance and Commitment Therapy proposes a perspective emphasizing effective working in context. This philosophy also suggests individuals sometimes engage in behavior in order to escape from or avoid aversive experiences. Utilizing case examples and fresh behavioral perspectives provides insight and ideas for conceptualization of these behaviors of interest. Using the above conceptualizations, an ACT based treatment of those who produce false symptoms is introduced.

Social Policy Reforms in the EU: A Cross-national Comparison. Social Inclusion Monitor Europe (SIM) – Reform Barometer. Pilot Study

European countries are losing momentum for social policy reforms: The results of the SIM Europe Index report on social justice, published in September 2014, suggested a growing social divide among the member states. Assessing six policy areas of social inclusion, the data revealed the deteriorating social situation since 2009 across the EU. The report stressed, in particular, the difficulties southern EU member states were having in coping with the effects of the financial and economic crisis. This second report, the SIM Europe Reform Barometer, takes up these results and delivers two tasks: to impartially assess the extent of problem awareness of governments, and to ask whether they have enacted concrete social policy initiatives to tackle these challenges and to counterbalance the growing divide. Southern European member states, especially, did not or have not been able to pursue reforms to limit their withering levels of a socially inclusive society. In almost all key dimensions of social inclusion, those member states most affected by the implications of the protracted economic and fiscal crisis in the EU have been least able to confine the ongoing ‘internal devaluation’ in terms of socially balanced governmental activity. By contrast, some northern member states have legislated acts which seem well-suited to at least stabilise or even increase their level of social inclusion.

A Statewide survey regarding awareness and attitudes toward AIDS : for the Illinois Department of Public Health.

"September 15, 1988."

Early practical experience and the social responsiveness of clinical education: Systematic review

Objectives To find how early experience in clinical and community settings (early experience) affects medical education, and identify strengths and limitations of the available evidence. Design A systematic review rating, by consensus, the strength and importance of outcomes reported in the decade 1992-2001. Data sources Bibliographical databases and journals were searched for publications on the topic, reviewed under the auspices of the recently formed Best Evidence Medical Education (BEME) collaboration. Selection of studies All empirical studies (verifiable, observational data) were included, whatever their design, method, or language of publication. Results Early experience was most commonly provided in community settings, aiming to recruit primary care practitioners for underserved populations. It increased the popularity of primary care residencies, albeit among self selected students. It fostered self awareness and empathic attitudes towards ill people, boosted students' confidence, motivated them, gave them satisfaction, and helped them develop a professional identity. By helping develop interpersonal skills, it made entering clerkships a less stressful experience. Early experience helped students learn about professional roles and responsibilities, healthcare systems, and health needs of a population. It made biomedical, behavioural, and social sciences more relevant and easier to learn. It motivated and rewarded teachers and patients and enriched curriculums. In some countries,junior students provided preventive health care directly to underserved populations. Conclusion Early experience helps medical students learn, helps them develop appropriate attitudes towards their studies and future practice, and orientates medical curriculums towards society's needs. Experimental evidence of its benefit is unlikely to be forthcoming and yet more medical schools are likely to provide it. Effort could usefully be concentrated on evaluating the methods and outcomes of early experience provided within non-experimental research designs, and using that evaluation to improve the quality of curriculums.

Copying actions and copying outcomes: Social learning through the second year

The present work documents how the logic of a model's demonstration and the communicative cues that the model provides interact with age to influence how children engage in social learning. Children at ages 12, 18, and 24 months (n = 204) watched a model open a series of boxes. Twelve-month-old subjects only copied the specific actions of the model when they were given a logical reason to do so- otherwise, they focused on reproducing the outcome of the demonstrated actions. Eighteen-month-old subjects focused on copying the outcome when the model was aloof. When the model acted socially, the subjects were as likely to focus on copying actions as outcomes, irrespective of the apparent logic of the model's behavior. Finally, 24-month-old subjects predominantly focused on copying the model's specific actions. However, they were less likely to produce the modeled outcome when the model acted nonsocially.

The role of social capital in the promotion of conservation farming: The case of 'landcare' in the southern Philippines

'Social capital' refers to the relationships of trust, communication, and cooperation that facilitate collective action in a community. It is particularly relevant to soil conservation in developing countries, which requires collective efforts to raise awareness of soil degradation, provide effective training in soil conservation practices, and implement soil conservation measures on individual farms. The Landcare Program in the Southern Philippines promotes simple conservation practices in upland environments through establishing and supporting community landcare groups and municipal landcare associations, thus augmenting the social capital of farmers in these locations. An evaluation of the Landcare Program in Barangay Ned, South Cotabato, based on a survey of 313 farm households and case studies of nine landcare groups, shows that, despite extreme isolation and difficult working conditions, farmers responded by rapidly forming landcare groups and a landcare association, and adopting contour barriers on their maize farms. They utilized the bonding social capital inhering in their local communities to build stocks of bridging social capital, linking them to information, training and resources from outside their immediate locality. A logistic regression model of the factors affecting adoption of contour barriers shows that farmers who had undergone the practical, farmer-based training provided by the Landcare Program, and who were members of a landcare group, were significantly more likely to adopt conservation measures. These results confirm the value of investing in social capital to promote soil conservation. Copyright (c) 2005 John Wiley & Sons, Ltd.

Social capital society and peace: Reflections on conflict transformation in the Philippines

Civil society is recognised as comprising complex and multifaceted entities, resilient to and yet responsive to both the state apparatus and global market processes. Civil society in the Philippines, long regarded as one of the most vibrant, diverse and innovative in Asia, has emerged as a significant actor in the field of conflict resolution and peace-building. In thinking about the work of peace, this paper engages with the effectiveness of civil society in mobilising societal awareness for a ‘just and lasting peace’ in the southern Philippines. Shaped by development paradigms that privilege concepts such as social capital, the paper aims to interrogate how such concepts situated within the development–security nexus proposed by the Philippine government and funding agencies have influenced conflict-transformation initiatives in Mindanao, Philippines.

A INCLUSÃO SOCIAL E AS MEDIAÇÕES NA RECEPÇÃO DA COMUNICAÇÃO MERCADOLÓGICA TELEVISIVA POR PESSOAS COM DEFICIÊNCIA VISUAL

Este trabalho é estimulado pela reflexão sobre a recepção da comunicação mercadológica televisiva por pessoas com deficiência visual, assim como sobre a percepção quanto às iniciativas do governo e das empresas em prol da inclusão. O estudo busca, com base na Teoria das Mediações, que é estudada por teóricos dos Estudos de Recepção, entender de que forma as pessoas com deficiência visual interagem com as diferentes categorias de comerciais de televisão, a partir de seus valores, percepções de mundo e condições em que se encontram. Deste modo, observa-se ainda o nível de sentimento de pertencimento das pessoas com deficiência visual quanto à preocupação do governo e das empresas em causas sociais. Os procedimentos que dirigem a investigação caracterizam-se por uma reflexão a partir de dados decorrentes de pesquisa bibliográfica, articulada a uma pesquisa de campo de natureza qualitativa. O trabalho conclui que a percepção das pessoas com deficiência visual se distancia do que está sendo proposto, feito e aparentemente sendo bem divulgado em prol da inclusão; bem como, observa a necessidade de aprimoramento da conscientização da sociedade, e consequentemente dos comunicadores, sobre a importância da aproximação entre as pessoas com deficiência visual e a comunicação mercadológica televisiva. Nesta percepção, o trabalho apresenta sugestões no âmbito comunicacional que poderiam tornar as causas sociais realmente expressivas na vida das pessoas com deficiência visual.

Bringing hope to crisis: critical thinking, ethical action and social change

This paper departs from this point to consider whether and how crisis thinking contributes to practices of affirmative critique and transformative social action in late-capitalist societies. I argue that different deployments of crisis thinking have different ‘affect-effects’ and consequences for ethical and political practice. Some work to mobilize political action through articulating a politics of fear, assuming that people take most responsibility for the future when they fear the alternatives. Other forms of crisis thinking work to heighten critical awareness by disrupting existential certainty, asserting an ‘ethics of ambiguity’ which assumes that the continuous production of uncertain futures is a fundamental part of the human condition (de Beauvoir, 2000). In this paper, I hope to illustrate that the first deployment of crisis thinking can easily justify the closing down of political debate, discouraging radical experimentation and critique for the sake of resolving problems in a timely and decisive way. The second approach to crisis thinking, on the other hand, has greater potential to enable intellectual and political alterity in everyday life—but one that poses considerable challenges for our understandings of and responses to climate change...

Absence of corporate social reporting (CSR) in Bangladesh: a research note

This paper aims to broaden the present CSR literature by extending its focus to the absence of CSR within a developing country, an area which, to date, is relatively under researched in comparison to the more widely studied presence of CSR within developed Western countries. In particular this paper concentrates upon the lack of disclosure on three particular eco-justice issues: child labour, equal opportunities and poverty alleviation. We critically examine why this is the case and thereby illuminate underlying motives behind corporate unwillingness to address these issues. For this purpose, 23 semi-structured interviews were undertaken with senior corporate managers in Bangladesh. The findings suggest that the main reasons for non-disclosure include lack of legal requirements, lack of knowledge/awareness, poor performance and fear of bad publicity. Given these findings the paper raises some serious concerns as to why corporations would ever be expected to voluntarily report on eco-justice issues where performance is poor and negative publicity would be generated. These significant issues require careful consideration by policy makers at the national, regional and international levels.