894 resultados para AHP Competence Baseline
Resumo:
Improving lifestyle behaviours has considerable potential for reducing the global burden of non-communicable diseases, promoting better health across the life-course and increasing well-being. However, realising this potential will require the development, testing and implementation of much more effective behaviour change interventions than are used conventionally. Therefore, the aim of this study was to conduct a multi-centre, web-based, proof-of-principle study of personalised nutrition (PN) to determine whether providing more personalised dietary advice leads to greater improvements in eating patterns and health outcomes compared to conventional population-based advice. A total of 5,562 volunteers were screened across seven European countries; the first 1,607 participants who fulfilled the inclusion criteria were recruited into the trial. Participants were randomly assigned to one of the following intervention groups for a 6-month period: Level 0-control group-receiving conventional, non-PN advice; Level 1-receiving PN advice based on dietary intake data alone; Level 2-receiving PN advice based on dietary intake and phenotypic data; and Level 3-receiving PN advice based on dietary intake, phenotypic and genotypic data. A total of 1,607 participants had a mean age of 39.8 years (ranging from 18 to 79 years). Of these participants, 60.9 % were women and 96.7 % were from white-European background. The mean BMI for all randomised participants was 25.5 kg m(-2), and 44.8 % of the participants had a BMI ≥ 25.0 kg m(-2). Food4Me is the first large multi-centre RCT of web-based PN. The main outcomes from the Food4Me study will be submitted for publication during 2015.
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Little is understood about the relationship between therapist competence and the outcome of patients treated for common mental health disorders. Understanding the relationship between competence and patient outcome is of fundamental importance to the dissemination and implementation of Cognitive Behavioural Therapy (CBT). The current study extends existing literature by exploring the relationship between CBT competence and patient outcome in routine clinical practice within the framework of the British Government’s Improving Access to Psychological Therapies (IAPT) programme. Participants comprised 43 therapists treating 1247 patients over a training period of one year. Results found little support of a general association between CBT competence and patient outcome; however significantly more patients of the most competent therapists demonstrated a reliable improvement in their symptoms of anxiety than would be expected by chance alone, and fewer experienced no reliable change. Conversely, significantly more patients treated by the least competent therapists experienced a reliable deterioration in their symptoms than would be expected. The implications of these results for the dissemination and implementation of CBT are discussed.
Resumo:
The functional relationships and properties of different subtypes of dendritic cells (DC) remain largely undefined. To better characterize these cells, we used global gene analysis to determine gene expression patterns among murine CD11c(high) DC subsets. CD4(+), CD8alpha(+), and CD8alpha(-) CD4(-) (double negative (DN)) DC were purified from spleens of normal C57/BL6 mice and analyzed using Affymetrix microarrays. The CD4(+) and CD8alpha(+) DC subsets showed distinct basal expression profiles differing by >200 individual genes. These included known DC subset markers as well as previously unrecognized, differentially expressed CD Ags such as CD1d, CD5, CD22, and CD72. Flow cytometric analysis confirmed differential expression in nine of nine cases, thereby validating the microarray analysis. Interestingly, the microarray expression profiles for DN cells strongly resembled those of CD4(+) DC, differing from them by <25 genes. This suggests that CD4(+) and DN DC are closely related phylogenetically, whereas CD8alpha(+) DC represent a more distant lineage, supporting the historical distinction between CD8alpha(+) and CD8alpha(-) DC. However, staining patterns revealed that in contrast to CD4(+) DC, the DN subset is heterogeneous and comprises at least two subpopulations. Gene Ontology and literature mining analyses of genes expressed differentially among DC subsets indicated strong associations with immune response parameters as well as cell differentiation and signaling. Such associations offer clues to possible unique functions of the CD11c(high) DC subsets that to date have been difficult to define as rigid distinctions.
Resumo:
Several studies of different bilingual groups including L2 learners, child bilinguals, heritage speakers and L1 attriters reveal similar performance on syntax-discourse interface properties such as anaphora resolution (Sorace, 2011 and references therein). Specifically, bilinguals seem to allow more optionality in the interpretation of overt subject pronouns in null subject languages, such as Greek, Italian and Spanish while the interpretation of null subject pronouns is indistinguishable from monolingual natives. Nevertheless, there is some evidence pointing to bilingualism effects on the interpretation of null subject pronouns too in heritage speakers’ grammars (Montrul, 2004) due to some form of ‘arrested’ development in this group of bilinguals. The present study seeks to investigate similarities and differences between two Greek–Swedish bilingual groups, heritage speakers and L1 attriters, in anaphora resolution of null and overt subject pronouns in Greek using a self-paced listening with a sentence-picture matching decision task at the end of each sentence. The two groups differ in crucial ways: heritage speakers were simultaneous or early bilinguals while the L1 attriters were adult learners of the second language, Swedish. Our findings reveal differences from monolingual preferences in the interpretation of the overt pronoun for both heritage and attrited speakers while the differences attested between the two groups in the interpretation of null subject pronouns affect only response times with heritage being faster than attrited speakers. We argue that our results do not support an age of onset or differential input effects on bilingual performance in pronoun resolution.
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This paper uses the exploration of the grounds of a common criticism of luck egalitarianism to try to make an argument about both the proper subject of theorising about justice and how to approach that subject. It draws a distinction between what it calls basic structure views and a priori baseline views, where the former take the institutional aspects of political prescriptions seriously and the latter do not. It argues that objections to luck egalitarianism on the grounds of its harshness can in part be explained by this blindness to relevant features of institutions. Further, it may be that luck egalitarianism cannot regard its own enactment as just. A related objection to Dworkin’s equality of resources, which claims that it cannot pick a particular institutional background to set the costs of resources and so is radically indeterminate, is also presented. These results, I argue, give us good reason to reject all a priori baseline views.
Resumo:
This paper integrates research on child simultaneous bilingual (2L1) acquisition more directly into the heritage language (HL) acquisition literature. The 2L1 literature mostly focuses on development in childhood, whereas heritage speakers (HSs) are often tested at an endstate in adulthood. However, insights from child 2L1 acquisition must be considered in HL acquisition theorizing precisely because many HSs are the adult outcomes of child 2L1 acquisition. Data from 2L1 acquisition raises serious questions for the construct of incomplete acquisition, a term broadly used in HL acquisition studies to describe almost any difference HSs display from baseline controls (usually monolinguals). We offer an epistemological discussion related to incomplete acquisition, highlighting the descriptive and theoretical inaccuracy of the term. We focus our discussion on two of several possible causal factors that contribute to variable competence outcomes in adult HSs, input (e.g., Sorace, 2004; Rothman, 2007; Pascual y Cabo & Rothman, 2012) and formal instruction (e.g., Kupisch, 2013; Kupisch et al., 2014) in the HL. We conclude by offering alternative terminology for HS outcomes.
Resumo:
Oocyte developmental competence depends on maternal stores that support development throughout a transcriptionally silent period during early embryogenesis. Previous attempts to investigate transcripts associated with oocyte competence have relied on prospective models, which are mostly based on morphological. criteria. Using a retrospective model, we quantitatively compared mRNA among oocytes with different embryo development competence. A cytoplasm biopsy was removed from in vitro matured oocytes to perform comparative analysis of amounts of global polyadenylated (polyA) mRNA and housekeeping gene transcripts. After parthenogenetic activation of biopsied oocytes, presumptive zygotes were cultured individually in vitro and oocytes were classified according to embryo development: (i) blocked before the 8-cell stage; (ii) blocked between the 8-cell and morulae stages; or (iii) developed to the blastocyst stage. Sham-manipulated controls confirmed that biopsies did not alter development outcome. Total polyA mRNA amounts correlate with oocyte diameter but not with the ability to develop to the 8-cell and blastocyst stages. The last was also confirmed by relative quantification of GAPDH, H2A and Hprt1 transcripts. In conclusion, we describe a novel retrospective model to identify putative markers of development competence in single oocytes and demonstrate that global mRNA amounts at the metaphase II stage do not correlate with embryo development in vitro.
Resumo:
Oocyte maturation is a long process during which oocytes acquire their intrinsic ability to support the subsequent stages of development in a stepwise manner, ultimately reaching activation of the embryonic genome. This process involves complex and distinct, although linked, events of nuclear and cytoplasmic maturation. Nuclear maturation mainly involves chromosomal segregation, whereas cytoplasmic maturation involves organelle reorganization and storage of mRNAs, proteins and transcription factors that act in the overall maturation process, fertilization and early embryogenesis. Thus, for didactic purposes, we subdivided cytoplasmic maturation into: (1) organelle redistribution, (2) cytoskeleton dynamics, and (3) molecular maturation. Ultrastructural analysis has shown that mitochondria, ribosomes, endoplasmic reticulum, cortical granules and the Golgi complex assume different positions during the transition from the germinal vesicle stage to metaphase II. The cytoskeletal microfilaments and microtubules present in the cytoplasm promote these movements and act on chromosome segregation. Molecular maturation consists of transcription, storage and processing of maternal mRNA, which is stored in a stable, inactive form until translational recruitment. Polyadenylation is the main mechanism that initiates protein translation and consists of the addition of adenosine residues to the 3` terminal portion of mRNA. Cell cycle regulators, proteins, cytoplasmic maturation markers and components of the enzymatic antioxidant system are mainly transcribed during this stage. Thus, the objective of this review is to focus on the cytoplasmic maturation process by analyzing the modifications in this compartment during the acquisition of meiotic competence for development. (c) 2009 Elsevier Inc. All rights reserved.
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We present a new technique for obtaining model fittings to very long baseline interferometric images of astrophysical jets. The method minimizes a performance function proportional to the sum of the squared difference between the model and observed images. The model image is constructed by summing N(s) elliptical Gaussian sources characterized by six parameters: two-dimensional peak position, peak intensity, eccentricity, amplitude, and orientation angle of the major axis. We present results for the fitting of two main benchmark jets: the first constructed from three individual Gaussian sources, the second formed by five Gaussian sources. Both jets were analyzed by our cross-entropy technique in finite and infinite signal-to-noise regimes, the background noise chosen to mimic that found in interferometric radio maps. Those images were constructed to simulate most of the conditions encountered in interferometric images of active galactic nuclei. We show that the cross-entropy technique is capable of recovering the parameters of the sources with a similar accuracy to that obtained from the very traditional Astronomical Image Processing System Package task IMFIT when the image is relatively simple (e. g., few components). For more complex interferometric maps, our method displays superior performance in recovering the parameters of the jet components. Our methodology is also able to show quantitatively the number of individual components present in an image. An additional application of the cross-entropy technique to a real image of a BL Lac object is shown and discussed. Our results indicate that our cross-entropy model-fitting technique must be used in situations involving the analysis of complex emission regions having more than three sources, even though it is substantially slower than current model-fitting tasks (at least 10,000 times slower for a single processor, depending on the number of sources to be optimized). As in the case of any model fitting performed in the image plane, caution is required in analyzing images constructed from a poorly sampled (u, v) plane.
Resumo:
In the past few decades, the demands for coping with the rapid development of information communication technology, internationalization and globalization worldwide have shifted the focus of Chinese as a second language (CSL) towards intercultural communication competence in which the role of culture in the acquisition of CSL and in the pragmatic use of the language is emphasized and promoted. However, most of the present research in this academic area still remains only on a theoretical level. In order to explore the possibilities and limitations of integrating Chinese culture and implementing intercultural communication theory into CSL education, an action research has been conducted since the beginning of 2013 to review an actual course for beginners. This paper will present the findings of the research: 1) By applying the theoretical framework of intercultural communicative competence, the findings indicated that the existing CSL course provided limited information explaining the cultural elements that are reflected in the Chinese language. 2) The findings also suggested that the cultural skills acquired in the students’ first language do influence their acquisition of CSL. This is demonstrated in the students’ written tasks such as introducing themselves and presenting other people, etc. The findings can be examples and resources for further research in this academic field.
Resumo:
BACKGROUND: International organisations, e.g. WHO, stress the importance of competent registered nurses (RN) for the safety and quality of healthcare systems. Low competence among RNs has been shown to increase the morbidity and mortality of inpatients. OBJECTIVES: To investigate self-reported competence among nursing students on the point of graduation (NSPGs), using the Nurse Professional Competence (NPC) Scale, and to relate the findings to background factors. METHODS AND PARTICIPANTS: The NPC Scale consists of 88 items within eight competence areas (CAs) and two overarching themes. Questions about socio-economic background and perceived overall quality of the degree programme were added. In total, 1086 NSPGs (mean age, 28.1 [20-56]years, 87.3% women) from 11 universities/university colleges participated. RESULTS: NSPGs reported significantly higher scores for Theme I "Patient-Related Nursing" than for Theme II "Organisation and Development of Nursing Care". Younger NSPGs (20-27years) reported significantly higher scores for the CAs "Medical and Technical Care" and "Documentation and Information Technology". Female NSPGs scored significantly higher for "Value-Based Nursing". Those who had taken the nursing care programme at upper secondary school before the Bachelor of Science in Nursing (BSN) programme scored significantly higher on "Nursing Care", "Medical and Technical Care", "Teaching/Learning and Support", "Legislation in Nursing and Safety Planning" and on Theme I. Working extra paid hours in healthcare alongside the BSN programme contributed to significantly higher self-reported scores for four CAs and both themes. Clinical courses within the BSN programme contributed to perceived competence to a significantly higher degree than theoretical courses (93.2% vs 87.5% of NSPGs). SUMMARY AND CONCLUSION: Mean scores reported by NSPGs were highest for the four CAs connected with patient-related nursing and lowest for CAs relating to organisation and development of nursing care. We conclude that the NPC Scale can be used to identify and measure aspects of self-reported competence among NSPGs.
Resumo:
The aim of this thesis is to investigate the use of literature within the Swedish Upper Secondary EFL-classroom from the students’ perspective. How do the students in the study relate to literature and its use to enhance and enable their communicative competence and cultural understanding? Also, how do their answers compare with their teacher’s and the adult perspectives and findings from previous international research? The empirical data obtained from the study has been analysed from the perspectives of sociocultural and motivational theory, and the findings show that the participating students believe literature to be a good didactic tool to apply in the EFL-classroom, both in order to enhance their communicative competence and their cultural understanding. The students prefer to have a sociocultural approach to their literature-learning, with group-discussions of various sizes. The key for the students in this respect is interesting, relevant and engaging subject-matter, as well as a positive and motivational teacher. The responses given by the students correlate with those given by their teacher as well as previous international research. The students regard literature as a way of gaining new perspectives, as well as experiencing language in use. Where they diverge somewhat from the international research is in regard to literature’s use for enhancing their competence to speak in class, and that some students seem to think that communication and cultural understanding are separable. Future studies within this field might include the conducting of a larger and more in-depth survey regarding the students’ ideas about literature, culture and communication. Why do so many of the student respondents neither agree nor disagree with the statement concerning communication and cultural understanding being inseparable? This can be an important issue to investigate in today’s global climate of cross-cultural and intercultural experiences, especially in view of the political climate of diverse attitudes towards refugees, immigrants and emigration