The meaning of multiple medication use in adults: A qualitative study

Over half of prescribed medications are not taken as prescribed, resulting in health and economic consequences. Using constructivist grounded theory, 15 interviews were conducted to develop a theory on understanding the medication adherence choices of individuals, who were between the ages of 40 to 55, were diagnosed with a chronic condition, and taking three or more medications. The results indicate that participants are engaging in self-management strategies, with massive variance in adherence behaviours. Medications are sacrificed for personal and financial reasons, resonating with feelings of fear for the person’s current situation and future. Individuals are struggling with who they have become to who they once were, which becomes related to their medications. Finally, individuals are citing the impact of their physician; citing barriers to communication and Canada’s health care system. Participants’ experiences provided an understanding of the meanings individuals associate with their medications and how this impacts their decision-making.

Diagnóstico del impacto generado con el desarrollo de una plataforma logística multimodal en Puerto Asís, Putumayo, en la región amazónica

Durante este trabajo se analizarán los impactos económicos, sociales y ambientales que generaría el desarrollo de una Plataforma Logística Multimodal en Puerto Asís, Putumayo, en la región amazónica comprendida por Colombia, Brasil y Ecuador, como opción de salida y entrada de mercancías. Esto con el fin de establecer cuál es la ruta más óptima para el transporte de mercancías hacia el continente asiático. Este proyecto surge como una iniciativa en la constitución de un eje de transporte para la interconexión de los puertos de la región amazónica. Consiste en el establecimiento de infraestructura para vías terrestres y marítimas que agilicen el transporte y reduzcan los altos costos a los que se enfrentan el comercio de la región. Para justificar la viabilidad de la realización este proyecto, es necesario evaluar diferentes impactos que producirían en diferentes ámbitos como los económicos, ambientales y sociales. Para la búsqueda de los impactos se establecen los perfiles actuales de los países vinculados al proyecto de la Plataforma Logística Multimodal en Puerto Asís, Putumayo. Esto con el fin de conocer sus respectivas condiciones actuales y hallar en qué medida se verán alteradas. Posteriormente, se expondrá las circunstancias de infraestructura de esta zona, demostrando los desafíos que exige el desarrollo de este tipo de proyectos en la región amazónica con la intención final de mejorar la infraestructura no solo de este sector sino del país, volviéndolo más competitivo a nivel global. Finalmente se evaluaran los efectos que la construcción de la plataforma generaría justificando su desarrollo.

Study habits inventory of physical therapy students in a decisions making class

Objective. To present the results of Study Habits Inventory, administered to students of the signature Decision Making IV, of Physiotherapy Program of the Rosario University. Methodology. It was investigated in the second half of 2006, study habits and conditions that influence how students of the subject assumes its university activity. The instrument used was the Inventory of Study Habits - described by Pozar, which let to know how the student engages in his studio, materials, environment and planning in its efforts to exercise their academic role. It was administered to a sample of 46 students enrolled in the 54 subjects at 85% of the total population. Results. 33% of students found that the environmental study is not satisfactory to the learning process, similar to the 41% who said that the planning study is insufficient, the use of materials was evaluated by 61% of students as a positive factor as well as 93% in the category of assimilation of content. This calls to validate the need to confront the meaning and significance for students and professors “content assimilation” as the study shows that it is reverse to academic performance. Discussion It is necessary to implement strategies that strengthen habits in students to achieve academic success and personal training considering the particular conditions of each group of students.

‘The Making of the Book’: Roy Fisher, the Circle Press and the poetics of book art

Between 1972 and 2001, the English late-modernist poet Roy Fisher provided the text for nine separate artist's books produced by Ron King at the Circle Press. Taken together, as Andrew Lambirth has written, the Fisher-King collaborations represent a sustained investigation of the various ways in which text and image can be integrated, breaking the mould of the codex or folio edition, and turning the book into a sculptural object. From the three-dimensional pop-up designs of Bluebeard's Castle (1973), each representing a part of the edifice (the portcullis, the armoury and so on), to ‘alphabet books’ such as The Half-Year Letters (1983), held in an ingenious french-folded concertina which can be stretched to over a metre long or compacted to a pocketbook, the project of these art books is to complicate their own bibliographic codes, and rethink what a book can be. Their folds and reduplications give a material form to the processes by which meanings are produced: from the discovery, in Top Down, Bottom Up (1990), of how to draw on both sides of the page at the same time, to the developments of The Left-Handed Punch (1987) and Anansi Company (1992), where the book becomes first a four-dimensional theatre space, in which a new version of Punch and Judy is played out by twelve articulated puppets, and then a location for characters that are self-contained and removable, in the form of thirteen hand-made wire and card rod-puppets. Finally, in Tabernacle (2001), a seven-drawer black wooden cabinet that stands foursquare like a sculpture (and sells to galleries and collectors for over three thousand pounds), the conception of the book and the material history of print are fully undone and reconstituted. This paper analyses how the King-Fisher art books work out their radically material poetics of the book; how their emphasis on collaboration, between artist and poet, image and text, and also book and reader – the construction of meaning becoming a co-implicated process – continuously challenges hierarchies and fixities in our conception of authorship; and how they re-think the status of poetic text and the construction of the book as material object.

Multimodal Literacy as a form of Communication : What is the state of the students at Dalarna University multimodal literacy?

Literacy is an invaluable asset to have, and has allowed for communication, documentation and the spreading of ideas since the beginning of the written language. With technological advancements, and new possibilities to communicate, it is important to question the degree to which people’s abilities to utilise these new methods have developed in relation to these emerging technologies. The purpose of this bachelor’s thesis is to analyse the state of students’ at Dalarna University mulitimodal literacy, as well as their experience of multimodality in their education. This has led to the two main research questions: What is the state of the students at Dalarna University multimodal literacy? And: How have the students at Dalarna University experienced multimodality in education? The paper is based on a mixed-method study that incorporates both a quantitative and qualitative aspect to it. The main thrust of the research paper is, however, based on a quantitative study that was conducted online and emailed to students via their program coordinators. The scope of the research is in audio-visual modes, i.e. audio, video and images, while textual literacy is presumed and serves as an inspiration to the study. The purpose of the study is to analyse the state of the students’ multimodal literacy and their experience of multimodality in education. The study revealed that the students at Dalarna University have most skill in image editing, while not being very literate in audio or video editing. The students seem to have had mediocre experience creating meaning through multimodality both in private use and in their respective educational institutions. The study also reveals that students prefer learning by means of video (rather than text or audio), yet are not able to create meaning (communicate) through it.

Languaging in virtual learning sites : studies of online encounters in the language-focused classroom

This thesis focuses upon a series of empirical studies which examine communication and learning in online glocal communities within higher education in Sweden. A recurring theme in the theoretical framework deals with issues of languaging in virtual multimodal environments as well as the making of identity and negotiation of meaning in these settings; analyzing the activity, what people do, in contraposition to the study of how people talk about their activity. The studies arise from netnographic work during two online Italian for Beginners courses offered by a Swedish university. Microanalyses of the interactions occurring through multimodal video-conferencing software are amplified by the study of the courses’ organisation of space and time and have allowed for the identification of communicative strategies and interactional patterns in virtual learning sites when participants communicate in a language variety with which they have a limited experience. The findings from the four studies included in the thesis indicate that students who are part of institutional virtual higher educational settings make use of several resources in order to perform their identity positions inside the group as a way to enrich and nurture the process of communication and learning in this online glocal community. The sociocultural dialogical analyses also shed light on the ways in which participants gathering in discursive technological spaces benefit from the opportunity to go to class without commuting to the physical building of the institution providing the course. This identity position is, thus, both experienced by participants in interaction, and also afforded by the ‘spaceless’ nature of the online environment.

The meaning of evidence-based management to brazilian senior nurse leaders

Purpose: The study objective was to understand the meaning of evidence-based management for senior nurse leaders in accredited, public hospitals in the State of Sao Paulo, Brazil. Design and Method: A phenomenological approach was used to analyze interviews conducted with 10 senior nurse leaders between August 2011 and March 2012. The analytic method was developed by the Brazilian phenomenologist, Martins. Findings: Senior nurse leaders described how they critically appraise many sources of evidence when making managerial decisions. They emphasized the importance of working with their teams to locally adapt and evaluate best evidence associated with managerial decision making and organizational innovations. Their statements also demonstrated how they use evidence-based management to support the adoption of evidence-based practices. They did not, however, provide specific strategies for seeking out and obtaining evidence. Notable challenges were traditional cultures and rigid bureaucracies, while major facilitators included accreditation, teamwork, and shared decision making. Conclusions: Evidence-based management necessitates a continuous process of locating, implementing, and evaluating evidence. In this study leaders provided multiple, concrete examples of all these processes except seeking out and locating evidence. They also gave examples of other leadership skills associated with successful adoption of evidence-based practice and management, particularly interdisciplinary teamwork and shared decision making. Clinical Relevance: This study demonstrates senior nurse leaders' awareness and utilization of evidence-based management. The study also suggests what aspects of evidence-based management need further development, such as more active identification of potential, new organizational innovations. © 2013 Sigma Theta Tau International.

Emergetic ternary diagrams: five examples for application in environmental accounting for decision-making

In a recent paper, "A combined tool for environmental scientists and decision makers: ternary diagrams and emergy accounting." [Giannettti BF, Barrella FA, Almeida CMVB. A combined tool for environment scientists and decision makers: ternary diagrams and emergy accounting. J Clean Prod, in press http://dx.doi.org/10.1016/j.jclepro.2004.09.002] Ternary diagrams were proposed as a graphical tool to assist emergy analysis. The graphical representation of the emergy accounting data makes it possible to compare processes and systems with and without ecosystem services, to evaluate improvements and to follow the system performance over time. The graphic tool is versatile and adaptable to represent products, processes, systems, countries, and different periods of time.The use and the versatility of ternary diagrams for assisting in performing emergy analyses are illustrated by means of five examples taken from the literature, which are presented and discussed. It is shown that emergetic ternary diagram's properties assist the assessment of the system of the system efficiency, its dependance upon renewable and non-renewable inputs and the environmental support for dilution and abatement of process emissions. With the aid of ternary diagrams, details such as the interaction between systems and between systems and the environment are recognized and evaluated. Such a tool for graphical analysis allows a transparent presentation of the results and can serve as an interface between emergy scientists and decision makers, provided the meaning of each line in the diagram is carefully explained and understood. (c) 2005 Elsevier Ltd. All rights reserved.

Identificação de alunos com altas habilidades ou superdotação a partir de uma avaliação multimodal

Pós-graduação em Psicologia do Desenvolvimento e Aprendizagem - FC

"Two hundred ninety-four": Remediation and multimodal performance in tourist placemaking

We offer here a multimodal discourse analysis of a range of verbal (writing and speech), nonverbal (movement and gesture) and technological (photography and video) resources used by tourists at the Leaning Tower of Pisa. In doing so, we pin-point the recycling and layering of mediatized representations (e.g. guidebooks and official brochures), mediated actions (e.g. climbing the Tower or posing in front of it), and remediated practices (e.g. posting a YouTube video of oneself climbing the 294 steps to the top of the Tower). Through this kind of empirically-based examination of tourists’ discursive and embodied performances – their ways of talking about and behaving in spaces – we witness how people never simply visit places but are always actively shaping and making these places. The Leaning Tower of Pisa is, therefore, as much an emergent production of the tourist imagination as it is a pre-existing, lop-sided construction of stone.

Making the most of Energy Union. CEPS Commentary, 16 December 2014

By elevating “Energy Union” to the status of a Commission mission statement, Commission President Jean-Claude Juncker succeeded in forging a new EU consensus on energy and climate change at the October European Council meeting. In a move that was made possible by linking the internal energy market and climate change agendas to security of supply, solidarity and infrastructure, the initiative notably meets the interests of Central and Eastern Europe as well as the peripheral member states. This commentary by a team of energy specialists at CEPS applauds this new development, but cautions that the European Commission will soon need to give it real meaning and substance before Energy Union can become reality. With this objective in mind, the authors outline six priorities to which Commission Vice President Maroš Šefčovič should give immediate attention.

Architectural image and idiom: Making local

Using photographic images from South East Queensland mid-twentieth-century architecture, this essay investigates the translation and regeneration of modern themes into a local idiom that resonates with poetic qualities of pre-existent forms of inhabitation. It contributes to the discussion of the photograph's role in communicating meaning in architecture through its potential to "reveal" the idiomatic.

The making of an ideology of the third way:the evolution of christian democracy in Germany (with special reference to 1945-49)

This study investigates the search for the third way in the history of German Christian Democracy. Today, in the United Kingdom, the 'third way' is seen as a new phenomenon, a synthesis of post-war belief in the welfare state and neo-liberal conservatism. Yet it insufficiently acknowledges that the origins of third way thinking, the marriage of social justice with free market economics, of individualism with collective responsibility, are found in the early philosophies of Catholic Social Theory and Protestant Social Ethical Teaching in Germany. This study shows that in the hundred years from the 1840s to the end of the 1940s, there were Catholic and Protestant socio-ethical thinkers and political reformists in Germany who attempted to bridge the philosophical differences between liberalism and socialism, to develop a socio-economic order based on Christian moral values. It will focus on the period 1945-1949, when the CDU was founded as the first interdenominational, Christian party. The study provides the first comprehensive account of the political debates in Christian democratic groups in the Soviet, British, French and American allied occupied zones, also giving equal attention to the contribution from the Protestant wing, alongside the more widely acknowledged role of Catholics in the birth of the CDU. It examines how Christian Democrats envisaged correcting the aberrations of German history, by uniting all social classes and Christian religions in one all-embracing Volkspartei, and transforming party politics from its earlier obsession with sectarian and ideological interests towards a more pragmatic 'third way' programme. The study argues that through the making of its ideology, the CDU modified the nation's understanding of its history, re-interpreted its traditions, and redefined the meaning and perception of established political philosophies. This reveals how the ambiguity of political terminology, and the flexible practice of 'third way' politics, were an invaluable political resource in the CDU's campaign for unity, ideological legitimisation and political power.

Multimodal field data entry:performance and usability issues

Mobile technologies have yet to be widely adopted by the Architectural, Engineering, and Construction (AEC) industry despite being one of the major growth areas in computing in recent years. This lack of uptake in the AEC industry is likely due, in large part, to the combination of small screen size and inappropriate interaction demands of current mobile technologies. This paper discusses the scope for multimodal interaction design with a specific focus on speech-based interaction to enhance the suitability of mobile technology use within the AEC industry by broadening the field data input capabilities of such technologies. To investigate the appropriateness of using multimodal technology for field data collection in the AEC industry, we have developed a prototype Multimodal Field Data Entry (MFDE) application. This application, which allows concrete testing technicians to record quality control data in the field, has been designed to support two different modalities of data input speech-based data entry and stylus-based data entry. To compare the effectiveness or usability of, and user preference for, the different input options, we have designed a comprehensive lab-based evaluation of the application. To appropriately reflect the anticipated context of use within the study design, careful consideration had to be given to the key elements of a construction site that would potentially influence a test technician's ability to use the input techniques. These considerations and the resultant evaluation design are discussed in detail in this paper.

Multimodal 'Eyes-Free' interaction techniques for mobile devices

Mobile and wearable computers present input/output prob-lems due to limited screen space and interaction techniques. When mobile, users typically focus their visual attention on navigating their environment - making visually demanding interface designs hard to operate. This paper presents two multimodal interaction techniques designed to overcome these problems and allow truly mobile, 'eyes-free' device use. The first is a 3D audio radial pie menu that uses head gestures for selecting items. An evaluation of a range of different audio designs showed that egocentric sounds re-duced task completion time, perceived annoyance, and al-lowed users to walk closer to their preferred walking speed. The second is a sonically enhanced 2D gesture recognition system for use on a belt-mounted PDA. An evaluation of the system with and without audio feedback showed users' ges-tures were more accurate when dynamically guided by au-dio-feedback. These novel interaction techniques demon-strate effective alternatives to visual-centric interface de-signs on mobile devices.