Role of patient factors, preferences, and distrust in health care and access to liver transplantation and organ donation.

Despite major improvements in access to liver transplantation (LT), disparities remain. Little is known about how distrust in medical care, patient preferences, and the origins shaping those preferences contribute to differences surrounding access. We performed a single-center, cross-sectional survey of adults with end-stage liver disease and compared responses between LT listed and nonlisted patients as well as by race. Questionnaires were administered to 109 patients (72 nonlisted; 37 listed) to assess demographics, health care system distrust (HCSD), religiosity, and factors influencing LT and organ donation (OD). We found that neither HCSD nor religiosity explained differences in access to LT in our population. Listed patients attained higher education levels and were more likely to be insured privately. This was also the case for white versus black patients. All patients reported wanting LT if recommended. However, nonlisted patients were significantly less likely to have discussed LT with their physician or to be referred to a transplant center. They were also much less likely to understand the process of LT. Fewer blacks were referred (44.4% versus 69.7%; P = 0.03) or went to the transplant center if referred (44.4% versus 71.1%; P = 0.02). Fewer black patients felt that minorities had as equal access to LT as whites (29.6% versus 57.3%; P < 0.001). For OD, there were more significant differences in preferences by race than listing status. More whites indicated OD status on their driver's license, and more blacks were likely to become an organ donor if approached by someone of the same cultural or ethnic background (P < 0.01). In conclusion, our analysis demonstrates persistent barriers to LT and OD. With improved patient and provider education and communication, many of these disparities could be successfully overcome. Liver Transplantation 22 895-905 2016 AASLD.

From Kandinsky to Java (The Use of 20th Century Abstract Art in Learning Programming)

At the University of Worcester we are continually striving to find new approaches to the learning and teaching of programming, to improve the quality of learning and the student experience. Over the past three years we have used the contexts of robotics, computer games, and most recently a study of Abstract Art to this end. This paper discusses our motivation for using Abstract Art as a context, details our principles and methodology, and reports on an evaluation of the student experience. Our basic tenet is that one can view the works of artists such as Kandinsky, Klee and Malevich as Object-Oriented (OO) constructions. Discussion of these works can therefore be used to introduce OO principles, to explore the meaning of classes, methods and attributes and finally to synthesize new works of art through Java code. This research has been conducted during delivery of an “Advanced OOP (Java)” programming module at final-year Undergraduate level, and during a Masters’ OO-Programming (Java) module. This allows a comparative evaluation of novice and experienced programmers’ learning. In this paper, we identify several instructional factors which emerge from our approach, and reflect upon the associated pedagogy. A Catalogue of ArtApplets is provided at the associated web-site.

QUALIDADE DE VIDA DAS PESSOAS COM 60 E MAIS ANOS

O aumento da longevidade e o consequente aumento do número de idosos coloca esta temática no plano central das sociedades modernas, nomeadamente na forma como se envelhece. Esta nova tendência demográfica, acarreta consigo novos desafios à responsabilidade individual e coletiva, com impacto significativo no desenvolvimento económico dos países, sendo um deles assegurar que os idosos vivam mais anos, com O presente estudo decorreu no Centro de Saúde de São Martinho do Bispo e teve como objetivos: caracterizar a QV qualidade de vida das pessoas com 60 e mais anos; analisar as variáveis sociodemográficas (idade, sexo, estado civil, coabitação, escolaridade e fonte de rendimento) com a QV qualidade de vida; analisar as variáveis estilos de vida (tabaco, álcool e hábitos alimentares) e o suporte social com a QV. Trata-se de um estudo quantitativo, descritivo-correlacional. A amostra foi constituída por 74 participantes, selecionados e por amostragem acidental . Foi aplicado Oo instrumento de recolha de dados foi composto pela caracterização sociodemográfica da amostra e pelas escalas: WHOQOL-OLD (World Health Organisation Quality of Life) e MSPSS (Multidimensional Scale Perceived Social Support). OS idosos representados na amostra apresentam uma QV moderada (65,85%). Em termos de características sociodemográficas, os homens possuem melhor QV que as mulheres , (p=0,007) e, idosos com maior escolaridade também possuem melhor QV (p=0,008). No que concerne aos estilos de vida, os dados sugerem que as pessoas que consumem álcool de forma moderada , possuem melhor QV (p=0,006). O suporte social apresenta uma correlação significativa, positiva e de força fraca com a QV (r_s=0,377; p=0,001). Conclui-se assim ,que a QV é um fenómeno multidimensional, que vai para além das variáveis sociodemográficas, de estilos de vida e de suporte social, pelo que o seu estudo impele para a análise de outros fatores.

Formal and philological inquiries into the nature of interrogatives, indefinites, disjunction, and focus in Sinhala and other languages

In this thesis I examine a variety of linguistic elements which involve ``alternative'' semantic values---a class arguably including focus, interrogatives, indefinites, and disjunctions---and the connections between these elements. This study focusses on the analysis of such elements in Sinhala, with comparison to Malayalam, Tlingit, and Japanese. The central part of the study concerns the proper syntactic and semantic analysis of Q[uestion]-particles (including Sinhala "da", Malayalam "-oo", Japanese "ka"), which, in many languages, appear not only in interrogatives, but also in the formation of indefinites, disjunctions, and relative clauses. This set of contexts is syntactically-heterogeneous, and so syntax does not offer an explanation for the appearance of Q-particles in this particular set of environments. I propose that these contexts can be united in terms of semantics, as all involving some element which denotes a set of ``alternatives''. Both wh-words and disjunctions can be analysed as creating Hamblin-type sets of ``alternatives''. Q-particles can be treated as uniformly denoting variables over choice functions which apply to the aforementioned Hamblin-type sets, thus ``restoring'' the derivation to normal Montagovian semantics. The treatment of Q-particles as uniformly denoting variables over choice functions provides an explanation for why these particles appear in just this set of contexts: they all include an element with Hamblin-type semantics. However, we also find variation in the use of Q-particles; including, in some languages, the appearance of multiple morphologically-distinct Q-particles in different syntactic contexts. Such variation can be handled largely by positing that Q-particles may vary in their formal syntactic feature specifications, determining which syntactic contexts they are licensed in. The unified analysis of Q-particles as denoting variables over choice functions also raises various questions about the proper analysis of interrogatives, indefinites, and disjunctions, including issues concerning the nature of the semantics of wh-words and the syntactic structure of disjunction. As well, I observe that indefinites involving Q-particles have a crosslinguistic tendency to be epistemic indefinites, i.e. indefinites which explicitly signal ignorance of details regarding who or what satisfies the existential claim. I provide an account of such indefinites which draws on the analysis of Q-particles as variables over choice functions. These pragmatic ``signals of ignorance'' (which I argue to be presuppositions) also have a further role to play in determining the distribution of Q-particles in disjunctions. The final section of this study investigates the historical development of focus constructions and Q-particles in Sinhala. This diachronic study allows us not only to observe the origin and development of such elements, but also serves to delimit the range of possible synchronic analyses, thus providing us with further insights into the formal syntactic and semantic properties of Q-particles. This study highlights both the importance of considering various components of the grammar (e.g. syntax, semantics, pragmatics, morphology) and the use of philology in developing plausible formal analyses of complex linguistic phenomena such as the crosslinguistic distribution of Q-particles.

Tomate industrial no submedio Sao Francisco e as pragas que limitam sua producao.

Neste trabalho sao relatados: a importancia economica do tomateiro, a melhor epoca de seu plantio, e as principais pragas que limitam a producao do tomate industrial na regiao do submedio Sao Francisco. As pragas sao: a traca-do-tomateiro, Scrobipalpula absoluta; o microacaro ou acaro-do-bronzeamento, Aculops lycopersici; o acaro-vermelho, Tetranychus evansi; a broca-dos-frutos, Heliothis zea e Pseudoplusia oo; a larva-minadora, Liromyza sativae e a lagarta-rosca Agrotis ipsilon.

La incidencia de los cupos indicativos en las relaciones ejecutivo-legislativo en la Ley anual de presupuesto

El propósito de este trabajo es analizar la incidencia que tienen los llamados cupos indicativos sobre las relaciones entre el ejecutivo y el legislativo, ubicados en el contexto de discusión y aprobación de la ley anual de presupuesto. El mecanismo conocido anteriormente como auxilios parlamentarios, hoy ha evolucionado y recibe el nombre de cupos indicativos. La investigación se divide en tres momentos: Marco legal de la ley anual de presupuesto y el derecho presupuestario en Colombia, el origen y evolución de los cupos indicativos durante los momentos históricos del derecho presupuestario. Finalmente, la incidencia de los cupos indicativos en las relaciones ejecutivo – legislativo.