Cancer diagnosis disclosure from Portuguese physicians

OBJECTIVE: Doctor-patient communication in oncology, particularly concerning diagnostic disclosure, is a crucial factor related to the quality of the doctor-patient relationship and the psychological state of the patient. The aims of our study were to investigate physicians' opinions and practice with respect to disclosure of a cancer diagnosis and to explore potential related factors. METHOD: A self-report questionnaire developed for our study was responded to by 120 physicians from Coimbra University Hospital Centre and its primary healthcare units. RESULTS: Some 91.7% of physician respondents generally disclosed a diagnosis, and 94.2% were of the opinion that the patient knowing the truth about a diagnosis had a positive effect on the doctor-patient relationship. A need for training about communicating with oncology patients was reported by 85.8% of participants. The main factors determining what information to provide to patients were: (1) patient intellectual and cultural level, (2) patient desire to know the truth, and (3) the existence of family. SIGNIFICANCE OF RESULTS: Our results point to a paradigm shift in communication with cancer patients where disclosure of the diagnosis should be made part of general clinical practice. Nevertheless, physicians still experience difficulties in revealing cancer diagnoses to patients and often lack the skills to deal with a patient's emotional responses, which suggests that more attention needs to be focused on communication skills training programs.

Tourist Destination Image in the New Technological Environments: Dialogism under the Public Relations Gaze

The dependence and influence of new media on social and organizational life have led to a new orientation of the communicational practices of organizations and to a research paradigm shift to a cocriational model within public relations theory. This model is based on dialogic rhetoric and dialogue that requires a joint production of content and meanings by organizations and publics, which have a central role in shaping image. The new social and communicational paradigms have also an impact on tourism research, implying the need to understand the role of new technologies, particularly websites, in image formation. The purpose of this study is to investigate the role of website in the formation of a tourist destination image (Portugal) through the understanding of the degree of adoption of dialogical principles on websites by official and unofficial tourist organizations and the identifying of denotative and connotative elements that are represented on published and shared photographs in these websites. The research corpus consisted of websites of entities and photographs published and shared on these websites. The methodology used is quantitative and qualitative, based on content analysis of data of websites and photographs. Results indicate that official tourist entities adopted the dialogic principles in a higher degree than unofficials. There is also a higher adoption of the principles related to technical dimension than dialogical dimension. Results confirm a relation between the adoption of dialogical link and an increased openness by entities to the possibility of photo sharing. The analysis of denotative and connotative elements of photography reflects a similarity in representations of entities and tourists. This study contributes to both theoretical perspectives, because it provides a conceptual scheme of destination image formation online and to a practical perspective, because it also suggests guidelines of dialogical practices to incorporate in websites of tourism entities.

Odwrót od rozwoju: kontrowersyjna czy obiecująca zmiana paradygmatu wczesnej edukacji

The article presents three approaches to the conceptualisation of development as a category which describes the dynamics of the biography of man, which the author defines as: universalisation, contextualisation / relativism, and problematisation / negation. Emphasis is laid on a shift in thinking about the child and childhood, to be observed in the post-structural analyses contingent on the thought of Michel Foucault and a critique of developmental psychology which is developing in the world, but has been absent from Poland so far. The strongest critique of both these perspectives is directed against the standardisation measures for which individuality, specificity and diversity become a deviation from the norm. The article shows how strong arguments showing the controversy of development perceived in this way have been collected and how debatable the category of development as such is.

Uma abordagem dinâmica e atual para o ensino das cônicas na educação básica

Dissertação (mestrado)—Universidade de Brasília, Instituto de Ciências Exatas, Departamento de Matemática, 2015.

Electracy in Praxis: Pedagogical Relays for an Undergraduate Writing Curriculum

The paradigm shift from traditional print literacy to the postmodern fragmentation, nonlinearity, and multimodality of writing for the Internet is realized in Gregory L. Ulmer’s electracy theory. Ulmer’s open invitation to continually invent the theory has resulted in the proliferation of relays, or weak models, by electracy advocates for understanding and applying the theory. Most relays, however, remain theoretical rather than practical for the writing classroom, and electracy instruction remains rare, potentially hindering the theory’s development. In this dissertation, I address the gap in electracy praxis by adapting, developing, and remixing relays for a functional electracy curriculum with first-year writing students in the Virginia Community College System as the target audience. I review existing electracy relays, pedagogical applications, and assessment practices – Ulmer’s and those of electracy advocates – before introducing my own relays, which take the form of modules. My proposed relay modules are designed for adaptability with the goals of introducing digital natives to the logic of new media and guiding instructors to possible implementations of electracy. Each module contains a justification, core competencies and learning outcomes, optional readings, an assignment with supplemental exercises, and assessment criteria. My Playlist, Transduction, and (Sim)ulation relays follow sound backward curricular design principles and emphasize core hallmarks of electracy as juxtaposed alongside literacy. This dissertation encourages the instruction of new media in Ulmer’s postmodern apparatus in which student invention via the articulation of fragments from various semiotic modes stems from and results in new methodologies for and understandings of digital communication.

The antecedents of post-initial adoption behavior in a S-D logic context

Repercussions of innovation adoption and diffusion studies have long been imperative to the success of novel introductions. However, perceptions and deductions of current innovation understandings have been changing over time. The paradigm shift from the goods-dominant (G-D) logic to the service-dominant (S-D) logic potentially makes the distinction between product (goods) innovation and service innovation redundant as the S-D logic lens views all innovations as service innovations (Vargo and Lusch, 2004; 2008; Lusch and Nambisan, 2015). From this perspective, product innovations are in essence service innovations, as goods serve as mere distribution mechanisms to deliver service. Nonetheless, the transition to such a broadened and transcending view of service innovation necessitates concurrently a change in the underlying models used to investigate innovation and its subsequent adoption. The present research addresses this gap by engendering a novel model for the most crucial period of service diffusion within the S-D logic context – the post-initial adoption phase, which demarcates an individual’s behavior after the initial adoption decision of a service. As a wellfounded understanding of service diffusion and the complementary innovation adoption still lingers in its infancy, the current study develops a model based on interdisciplinary domains mapping. Here fore, knowledge of the relatively established viral source domain is mapped to the comparatively undetermined target domain of service innovation adoption. To assess the model and test the importance of the explanatory variables, survey data from 750 respondents of a bank in Northern Germany is scrutinized by means of Structural Equation Modeling (SEM). The findings reveal that the continuance intention of a customer, actual usage of the service and the customer influencer value all constitute important postinitial adoption behavior that have meaningful implications for a successful service adoption. Second, the four constructs customer influencer value, organizational commitment, perceived usefulness and service customization are evidenced to have a differential impact on a iv customer’s post-initial adoption behavior. Third, this study indicates that post-initial adoption behavior further underlies the influence of a user’s age and besides that is also provoked by the internal and external environments of service adoption. Finally, this research amalgamates the broad view of service innovation by Nambisan and Lusch (2015) with the findings ensuing this enquiry’s model to arrive at a framework that it both, generalizable and practically applicable. Implications for academia and practitioners are captured along with avenues for future research.

Competencias a validar a través del trabajo de fin de grado en Derecho

A estas alturas estamos más que familiarizados con el cambio de paradigma que ha supuesto el Espacio Europeo de Educación Superior por el que se sitúa al alumno en el centro del proceso de aprendizaje, junto a la adquisición de competencias más allá de conocimientos. Ahora bien, estamos ante las primeras promociones que han de realizar el trabajo de fin de grado como parte de sus planes de estudio, trabajo que ha de constituir la gran oportunidad de validación de las competencias adquiridas por el alumno. La doble novedad del trabajo de fin de grado, tanto su incorporación obligatoria a los planes de estudio jurídicos que carecían de elementos semejantes, así como su orientación hacia la evaluación de las competencias, nos sitúa en un escenario en el que hemos de identificar cuáles son las competencias que se han de validar a través del trabajo de fin de grado. Ni todas las competencias tienen cabida en el trabajo de fin de grado, ni todas pueden ser trabajadas con la misma intensidad. La modalidad del trabajo, el tema a analizar e incluso el perfil e intereses del alumno serán los criterios que nos pueden ayudar a determinar la identificación de competencias.

Autenticidade na rede : estudo da identidade digital

Vivemos um tempo de mudança de paradigmas na educação. O advento da sociedade em rede nesta Era Digital está a transformar profundamente a sociedade e a educação. De um ensino industrial e de cariz comportamentalista, assistimos hoje à emergência de um ensino pós-industrial e de índole construtivista. A distinção entre o ensino presencial e o ensino online é cada vez menor, requerendo o desenvolvimento de competências digitais por parte de professores e alunos. Torna-se necessária a construção de uma identidade digital que não é apenas uma identificação do estudante, mas é a sua marca digital enquanto cidadão.

Tthe right to effective judicial protection and disability: the convention on the rights of persons with disabilities

On 13 December 2006, the General Assembly of the United Nations adopted the Convention on the Rights of Persons with Disabilities (CRPD). It is the first comprehensive human rights treaty of the 21st century. The Convention is intended as a human rights instrument with an explicit, social development dimension. It adopts a broad categorization of persons with disabilities and reaffirms that all persons with all types of disabilities must enjoy all human rights and fundamental freedoms. Precisely, the Convention marks a 'paradigm shift' in attitudes and approaches to persons with disabilities The Convention contains two articles directly connected with judicial effective protection, one more than the other, but on the other hand, one cannot be understood without the other. Both articles are Article 12 –Equal recognition before the law- and Article 13 –access to justice- As a scholar in Procedural Law, my contribution to the International Scientific Congress on Private Law of the Philippines and Spain aims to enshrine the relevant importance of the both provisions that guarantee effective judicial protection for persons with disabilities in order to analyze, subsequently, the implementation of them in Spanish legislation

Intervenção precoce em contextos naturais : uma revisão sistemática da literatura

A Intervenção Precoce é uma área científica que evidencia uma evolução muito significativa em poucos anos. A mudança de paradigma – do modelo centrado na criança para o modelo centrado na família – implica novos contextos e formas de prestação de serviços, sendo prática recomendada na atualidade – a intervenção em contextos naturais. Este trabalho surge assim com o objetivo de realizar uma revisão da literatura sobre esta temática: Intervenção Precoce em contextos naturais. Pretendeu-se discutir o conceito e a sua importância no panorama atual, diversos instrumentos, modelos e propostas de intervenção, bem como resultados de investigações conduzidas a nível internacional e nacional. No seio dos contextos naturais surge um conceito ainda mais específico designado como rotinas, merecendo papel de destaque pela sua relevância, num trabalho de base ecológica. Aprofundamos mais especificamente, o tema das rotinas em contexto familiar e das rotinas em contexto educativo pois o contexto educativo e domiciliário são dos contextos naturais mais referidos na literatura em crianças entre os 0 e os 6 anos de idade. A literatura científica demonstrou, de forma clara, que as rotinas que acontecem nos contextos naturais da criança são mais eficazes para apoiar e sustentar o trabalho em intervenção precoce. Concluímos ainda que é uma área que carece de investigação, tanto em termos internacionais como nacionais, estando, o nosso país mais focado no desenvolvimento e investigação de intervenções baseadas nas rotinas em contexto domiciliário do que em contexto educativo.

Igual consideração e respeito, independência ética e liberdade de expressão em Dworkin : uma reconciliação entre igualdade e liberdade e a possibilidade do discurso do ódio em um ordenamento coerente de princípios

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Direito, Pós-Graduação Stricto Sensu em Direito, 2016.

A Organização e os Dispositivos Móveis

O uso de dispositivos móveis está a ganhar cada vez mais espaço dentro das organizações. O aumento do consumo de material informático por parte dos consumidores está a levar a que os mesmos comecem a tentar utilizar os seus dispositivos móveis1 Notebooks, Tablets e Smartphones no interior das organizações. Este tipo de comportamento, levou ao aparecimento de uma nova tendência – o Bring Your Own Device (BYOD), a utilização de dispositivos móveis para fins laborais, levanta várias e sérias questões de segurança aos departamentos de TI das organizações, fazendo com que as organizações necessitem de definir novas políticas de segurança para que a sua informação e os seus dados se mantenham seguros. O trabalho adiante desenvolvido pretende mostrar de que forma as organizações veem esta mudança de paradigma, em que os próprios colaboradores utilizam os seus dispositivos móveis como ferramenta de trabalho na organização. Por outro lado analisar os modelos de segurança que se podem associar ao BYOD e aos dispositivos móveis para permitir uma maior segurança dos dados e informação que circula entre a organização e o dispositivo móvel.

Towards a 21st-century roadmap for biomedical research and drug discovery: consensus report and recommendations

Decades of costly failures in translating drug candidates from preclinical disease models to human therapeutic use warrant reconsideration of the priority placed on animal models in biomedical research. Following an international workshop attended by experts from academia, government institutions, research funding bodies, and the corporate and nongovernmental organisation (NGO) sectors, in this consensus report, we analyse, as case studies, five disease areas with major unmet needs for new treatments. In view of the scientifically driven transition towards a human pathway-based paradigm in toxicology, a similar paradigm shift appears to be justified in biomedical research. There is a pressing need for an approach that strategically implements advanced, human biology-based models and tools to understand disease pathways at multiple biological scales. We present recommendations to help achieve this.

Harnessing bacterial signals for suppression of biofilm formation in the nosocomial fungal pathogen Aspergillus fumigatus

Faced with the continued emergence of antibiotic resistance to all known classes of antibiotics, a paradigm shift in approaches toward antifungal therapeutics is required. Well characterized in a broad spectrum of bacterial and fungal pathogens, biofilms are a key factor in limiting the effectiveness of conventional antibiotics. Therefore, therapeutics such as small molecules that prevent or disrupt biofilm formation would render pathogens susceptible to clearance by existing drugs. This is the first report describing the effect of the Pseudomonas aeruginosa alkylhydroxyquinolone interkingdom signal molecules 2-heptyl-3-hydroxy-4-quinolone and 2-heptyl-4-quinolone on biofilm formation in the important fungal pathogen Aspergillus fumigatus. Decoration of the anthranilate ring on the quinolone framework resulted in significant changes in the capacity of these chemical messages to suppress biofilm formation. Addition of methoxy or methyl groups at the C5–C7 positions led to retention of anti-biofilm activity, in some cases dependent on the alkyl chain length at position C2. In contrast, halogenation at either the C3 or C6 positions led to loss of activity, with one notable exception. Microscopic staining provided key insights into the structural impact of the parent and modified molecules, identifying lead compounds for further development.

Apprendre avec la technologie : l'impact sur l'enseignement et l'apprentissage de l’utilisation de la technologie numérique (SMARTBOARD) dans les classes

This research was devoted to gaining information on teachers? use of technology, specifically SMARTBOARD technology, for teaching and promoting learning in the classroom. Research has suggested that use of technology can enhance learning and classroom practices. This has resulted in administrators encouraging the use of SMARTBOARDS, installing them in classrooms and providing training and support for teachers to use this technology. Adoption of new technology, however, is not simple. It is even more challenging because making the best use of new technologies requires more than training; it requires a paradigm shift in teachers? pedagogical approach. Thus, while it may be reasonable to believe that all we need to do is show teachers the benefits of using the SMARTBOARD; research tells us that changing paradigms is difficult for a variety of reasons. This research had two main objectives. First, to discover what factors might positively or negatively affect teachers? decisions to take up this technology. Second, to investigate how the SMARTBOARD is used by teachers who have embraced it and how this impacts participation in classrooms. The project was divided into two parts; the first was a survey research (Part 1), and the second was an ethnographic study (Part 2). A thirty-nine item questionnaire was designed to obtain information on teachers? use of technology and the SMARTBOARD. The questionnaire was distributed to fifty teachers at two EMSB schools: James Lyng Adult Centre (JLAC) and the High School of Montreal (HSM). Part 2 was an ethnographic qualitative study of two classes (Class A, Class B) at JLAC. Class A was taught by a male teacher, an early-adopter of technology and a high-level user of the SMARTBOARD; Class B was taught by a female teacher who was more traditional and a low-level user. These teachers were selected because they had similar years of experience and general competence in their subject matter but differed in their use of the technology. The enrollment in Class A and Class B were twenty-three and twenty-four adult students, respectively. Each class was observed for 90 minutes on three consecutive days in April 2010. Data collection consisted of videotapes of the entire period, and observational field notes with a graphical recording of participatory actions. Information from the graphical recording was converted to sociograms, a graphic representation of social links among individuals involved in joint action. The sociogram data was tabulated as quantified data. The survey results suggest that although most teachers are interested in and use some form of technology in their teaching, there is a tendency for factors of gender and years of experience to influence the use of and opinions on using technology. A Chi Square analysis of the data revealed (a) a significant difference (2 = 6.031, p < .049) for gender in that male teachers are more likely to be interested in the latest pedagogic innovation compared to female teachers; and, (b) a significant difference for years of experience (2 = 10.945, p < .004), showing that teachers with ?6 years experience were more likely to use the SMARTBOARD, compared to those with more experience (>6 years). All other items from the survey data produced no statistical difference. General trends show that (a) male teachers are more willing to say yes to using the SMARTBOARD compared to female teachers, and (b) teachers with less teaching experience were more likely to have positive opinions about using the SMARTBOARD compared to teachers with more experience. The ethnographic study results showed differences in students? response patterns in the two classrooms. Even though both teachers are experienced and competent, Teacher A elicited more participation from his students than Teacher B. This was so partly because he used the SMARTBOARD to present visual materials that the students could easily respond to. By comparison, Teacher B used traditional media or methods to present most of her course material. While these methods also used visual materials, students were not able to easily relate to these smaller, static images and did not readily engage with the material. This research demonstrates a generally positive attitude by teachers towards use of the SMARTBOARD and a generally positive role of this technology in enhancing students? learning and engagement in the classroom. However, there are many issues related to the SMARTBOARD use that still need to be examined. A particular point is whether teachers feel adequately trained to integrate SMARTBOARD technology into their curricula. And, whether the gender difference revealed is related to other factors like a need for more support, other responsibilities, or a general sense of anxiety when it comes to technology. Greater opportunity for training and ongoing support may be one way to increase teacher use of the SMARTBOARD; particularly for teachers with more experience (>6 years) and possibly also for female teachers.