A realistic evaluation of track and trigger systems and acute care training for early recognition and treatment of deteriorating ward-based patients: research protocol.

Aim The aim of the study is to evaluate factors that enable or constrain the implementation and service delivery of early warnings systems or acute care training in practice. Background To date there is limited evidence to support the effectiveness of acute care initiatives (early warning systems, acute care training, outreach) in reducing the number of adverse events (cardiac arrest, death, unanticipated Intensive Care admission) through increased recognition and management of deteriorating ward based patients in hospital [1-3]. The reasons posited are that previous research primarily focused on measuring patient outcomes following the implementation of an intervention or programme without considering the social factors (the organisation, the people, external influences) which may have affected the process of implementation and hence measured end-points. Further research which considers the social processes is required in order to understand why a programme works, or does not work, in particular circumstances [4]. Method The design is a multiple case study approach of four general wards in two acute hospitals where Early Warning Systems (EWS) and Acute Life-threatening Events Recognition and Treatment (ALERT) course have been implemented. Various methods are being used to collect data about individual capacities, interpersonal relationships and institutional balance and infrastructures in order to understand the intended and unintended process outcomes of implementing EWS and ALERT in practice. This information will be gathered from individual and focus group interviews with key participants (ALERT facilitators, nursing and medical ALERT instructors, ward managers, doctors, ward nurses and health care assistants from each hospital); non-participant observation of ward organisation and structure; audit of patients' EWS charts and audit of the medical notes of patients who deteriorated during the study period to ascertain whether ALERT principles were followed. Discussion & progress to date This study commenced in January 2007. Ethical approval has been granted and data collection is ongoing with interviews being conducted with key stakeholders. The findings from this study will provide evidence for policy-makers to make informed decisions regarding the direction for strategic and service planning of acute care services to improve the level of care provided to acutely ill patients in hospital. References 1. Esmonde L, McDonnell A, Ball C, Waskett C, Morgan R, Rashidain A et al. Investigating the effectiveness of Critical Care Outreach Services: A systematic review. Intensive Care Medicine 2006; 32: 1713-1721 2. McGaughey J, Alderdice F, Fowler R, Kapila A, Mayhew A, Moutray M. Outreach and Early Warning Systems for the prevention of Intensive Care admission and death of critically ill patients on general hospital wards. Cochrane Database of Systematic Reviews 2007, Issue 3. www.thecochranelibrary.com 3. Winters BD, Pham JC, Hunt EA, Guallar E, Berenholtz S, Pronovost PJ (2007) Rapid Response Systems: A systematic review. Critical Care Medicine 2007; 35 (5): 1238-43 4. Pawson R and Tilley N. Realistic Evaluation. London; Sage: 1997

Enquiring about traumatic experiences in psychosis: A comparison of case notes and self-report questionnaires

Purpose: Studies have found an association between a history of trauma and the presence of psychotic symptoms. Despite the research evidence it appears to be the case that many clinicians are not routinely asking about traumatic experiences. This study aims to ascertain the level of agreement between rates of self-reported trauma and that which is recorded in case notes.

Methods: The study population was drawn from all individuals with a confirmed diagnosis of psychosis, residing within a defined catchment area. Rates of childhood trauma, lifetime trauma and trauma related to the Troubles in Northern Ireland recorded in participants’ case notes were compared to their responses on self-report questionnaires: THQ, CTQ and TREQ.

Results: Relatively high levels of trauma were reported by participants on the self-report measures that were administered. The rates of trauma recorded in case note records were similar to that found in other studies. Also in line with other research were poor levels of agreement between self-report and case note data.

Conclusion: High levels of lifetime, childhood and trauma related to the Troubles in Northern Ireland were found when the individuals in the sample were directly assessed for the purposes of this study. In contrast much lower rates were recorded in patient notes on routine clinical assessment. The results suggest that clinicians do not routinely enquire about trauma histories with this population and as a result, case notes underestimate trauma prevalence.

Problem solving and computer-assisted instruction in science education : analysis of research findings and the research process /

The quantitative component of this study examined the effect of computerassisted instruction (CAI) on science problem-solving performance, as well as the significance of logical reasoning ability to this relationship. I had the dual role of researcher and teacher, as I conducted the study with 84 grade seven students to whom I simultaneously taught science on a rotary-basis. A two-treatment research design using this sample of convenience allowed for a comparison between the problem-solving performance of a CAI treatment group (n = 46) versus a laboratory-based control group (n = 38). Science problem-solving performance was measured by a pretest and posttest that I developed for this study. The validity of these tests was addressed through critical discussions with faculty members, colleagues, as well as through feedback gained in a pilot study. High reliability was revealed between the pretest and the posttest; in this way, students who tended to score high on the pretest also tended to score high on the posttest. Interrater reliability was found to be high for 30 randomly-selected test responses which were scored independently by two raters (i.e., myself and my faculty advisor). Results indicated that the form of computer-assisted instruction (CAI) used in this study did not significantly improve students' problem-solving performance. Logical reasoning ability was measured by an abbreviated version of the Group Assessment of Lx)gical Thinking (GALT). Logical reasoning ability was found to be correlated to problem-solving performance in that, students with high logical reasoning ability tended to do better on the problem-solving tests and vice versa. However, no significant difference was observed in problem-solving improvement, in the laboratory-based instruction group versus the CAI group, for students varying in level of logical reasoning ability.Insignificant trends were noted in results obtained from students of high logical reasoning ability, but require further study. It was acknowledged that conclusions drawn from the quantitative component of this study were limited, as further modifications of the tests were recommended, as well as the use of a larger sample size. The purpose of the qualitative component of the study was to provide a detailed description ofmy thesis research process as a Brock University Master of Education student. My research journal notes served as the data base for open coding analysis. This analysis revealed six main themes which best described my research experience: research interests, practical considerations, research design, research analysis, development of the problem-solving tests, and scoring scheme development. These important areas ofmy thesis research experience were recounted in the form of a personal narrative. It was noted that the research process was a form of problem solving in itself, as I made use of several problem-solving strategies to achieve desired thesis outcomes.

Influence d’un atelier de prise de notes sur la capacité d’étudiants du collégial à restituer les idées principales d’un texte de philosophie : une vision contrastive étudiants – professeurs de philosophie.

Cette recherche avait pour but de déterminer quelle était l’influence de l’administration d’un atelier de prise de notes dans le cadre du premier cours de philosophie du collégial qui se donnait au début de la deuxième session des apprenants. Elle se situait dans le cadre d’une recherche intervention et le point de vue des parties prenantes, à savoir les apprenants et les enseignants, était recueilli de façon qualitative. Les premiers, forts d’une expérience d’une session au niveau collégial, ont exprimé le besoin de suivre une formation formelle liée à la prise de notes, quand bien même celle-ci leur demanderait un effort supplémentaire. Les deuxièmes nous ont fait part de leurs préoccupations en ce qui a trait à la qualité des notes de leurs étudiants. Nous avons demandé aux répondants de restituer les thèmes principaux de deux textes équivalents distribués de façon simultanée en fonction des rangées (première rangée – premier texte, deuxième rangée – deuxième texte, etc.), puis nous avons interverti l’ordre de distribution des textes après l’atelier. Lors de l’analyse des résultats, nous avons constaté que les répondants avaient restitué les thèmes dans un ordre d’importance plus approprié après l’atelier qu’avant celui-ci, mais nous avons surtout remarqué une amélioration significative dans l’emploi des stratégies de prise de notes et dans la constance de leur utilisation tout au long du second texte étudié.

Primary music education: the misrepresentation of the ideals of curricula in research

The author starts from a historical viewpoint to suggest that, at primary level, we have tended to perpetuate a nineteenth-century notion of music education. This is evident in the selection and organisation of musical content in curriculum documents, the scope of the teacher-pupil transaction implicit in these and the assumptions about music education which underpin research on practice conducted at official policy level. In light of the introduction of the 1999 Revised Primary School Curriculum, with its change in emphasis, she notes that it is timely to reconsider the situation. Central to this is the need to challenge the notion of music as a set of delineated skills, to explore the relationship between the primary teacher and music, and to move towards a notion of research which acknowledges the richness of multiple interpretations teachers bring to the curriculum.

Introduction: some notes on the generative study of L3 acquisition.

This article serves as a state-of the-science review of the blossoming field of generative third language (L3) acquisition as well as an introduction to this special issue on the same topic. We present and argue for the relevance of adult L3/Ln acquisition for many perennial questions that have sat at the core of linguistic approaches to adult language acquisition since the Principles and Parameters framework was first adopted into second language acquisition (SLA; e.g. Flynn, 1985, 1987; Liceras, 1985; White, 1985a, 1985b; Schwartz, 1986). Furthermore, we highlight the unique, specific questions that have emerged from studying L3/Ln from a generative perspective thus far while suggesting refinements to these questions and additional ones that should emerge in future inquiry.

An illustrated checklist of Bromeliaceae from Parque Estadual do Rio Preto, Minas Gerais, Brazil, with notes on phytogeography and one new species of Cryptanthus

A checklist of the 14 genera and 34 species of Bromeliaceae from the Parque Estadual do Rio Preto in Sao Goncalo do Rio Preto municipality, Minas Gerais state, southeastern Brazil, is presented. The Tillandsioideae was the most diverse subfamily and was found to be concentrated in rocky field areas. Bromelioideae is also a species rich subfamily, but its taxa have shown a preference to forested areas and savannas at lower altitudes. Pitcairnioideae is highlighted by its level of endemism, but has only four species. Cryptanthus micrus, a new species found in this area is described and illustrated. Our cluster analysis indicated that the Rio Preto State Park has a Bromeliaceae flora more similar to that from Pico do Itambe and Grao Mogol State Parks. Taxa like Dyckia glandulosa, Orthophytum itambense and Vriesea medusa, which were previously considered to be endemic to Pico do Itambe, now have their area of occurrence extended to Rio Preto. These new occurrences highlight the importance to create a corridor joining these neighboring reserves to connect populations of narrowly ranged or rare species. In this work we present pictures of 19 species in their habitats within the park, and we hope that these illustrations will help in the identification and conservation of these taxa.

Taxonomic redescription and biological notes on Diaugia angusta (Diptera,Tachinidae): parasitoid of the palm boring weevils Metamasius ensirostris and M. hemipterus (Coleoptera, Dryophthoridae)

Diaugia angusta Perty, 1833 is a Neotropical species of Tachinidae (Diptera) reported here as a parasitoid of Metamasius ensirostris (Germar, 1824) and M hemipterus (Linnaeus, 1758) (Coleoptera: Dryophthoridae) in Brazil. Several species of Dryophthoridae and Curculionidae cause damage to bromeliad and palm species, and most are regarded as pests. In the present study, the male and female of D. angusta are morphologically characterized and illustrated to provide a means for the identification of this parasitoid. Data obtained from preliminary field research show that natural parasitism of Metamasius pupae by D. angusta varies by year but can reach nearly 30%. A network of parasitoid-host interactions among tachinid parasitoids and coleopteran hosts reported as bromeliad and palm pests (Dryophthoridae and Curculionidae) in the Americas indicates that the species of the tribe Dexiini sensu lam (including D. angusta) might be promising as biological control agents of these pests.

Notes on beta-deformations of the pure spinor superstring in AdS(5) x S(5)

We study the properties of the vertex operator for the beta-deformation of the superstring in AdS(5) x S(5) in the pure spinor formalism. We discuss the action of supersymmetry on the infinitesimal beta-deformation, the application of the homological perturbation theory, and the relation between the worldsheet description and the spacetime supergravity description. (C) 2011 Elsevier B.V. All rights reserved.

Banking efficiency, governance and financial regulation in Brazil: some brief explorative notes

In this note I will analyze briefly some issues that I consider important in the discussion related to the banking efficiency, governance and financial regulation, with special focus on Brazil. The subject is complex as involve different dimensions and I will explore here only some of them, some related to past researches other that should be explored in further research.

Taxonomic redescription and biological notes on Diaugia angusta (Diptera,Tachinidae): parasitoid of the palm boring weevils Metamasius ensirostris and M. hemipterus (Coleoptera, Dryophthoridae)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Chartergellus golfitensis West-Eberhard: A new species of Neotropical swarm-founding wasp (Hymenoptera: Vespidae, Polistinae) with notes on the taxonomy of Chartergellus zonatus Spinola

Chartergellus golfitensis West-Eberhard new species, is described from Central America and compared with C. zonatus Spinola, a species heretofore inadequately described.

Notes on technical change induced under conditions of protection, distortions and rationing

Includes bibliography

ECLAC Notes Nº 35

Productive development in open economies OPINION by José Luis Machinea Regional integration will improve international participation Countries of Latin America and the Caribbean have "three speed" economies Public-private alliance proposed to improve regional infrastructure Latin America and the Caribbean are behind in research and development New social cohesion covenant for the region Industrial legacy key to Puerto Rico's economic development Statistical Appendix Recent Titles Calendar