Facilitators and barriers to hypertension self-management in urban African Americans: perspectives of patients and family members.

INTRODUCTION: We aimed to inform the design of behavioral interventions by identifying patients' and their family members' perceived facilitators and barriers to hypertension self-management. MATERIALS AND METHODS: We conducted focus groups of African American patients with hypertension and their family members to elicit their views about factors influencing patients' hypertension self-management. We recruited African American patients with hypertension (n = 18) and their family members (n = 12) from an urban, community-based clinical practice in Baltimore, Maryland. We conducted four separate 90-minute focus groups among patients with controlled (one group) and uncontrolled (one group) hypertension, as well as their family members (two groups). Trained moderators used open-ended questions to assess participants' perceptions regarding patient, family, clinic, and community-level factors influencing patients' effective hypertension self-management. RESULTS: Patient participants identified several facilitators (including family members' support and positive relationships with doctors) and barriers (including competing health priorities, lack of knowledge about hypertension, and poor access to community resources) that influence their hypertension self-management. Family members also identified several facilitators (including their participation in patients' doctor's visits and discussions with patients' doctors outside of visits) and barriers (including their own limited health knowledge and patients' lack of motivation to sustain hypertension self-management behaviors) that affect their efforts to support patients' hypertension self-management. CONCLUSION: African American patients with hypertension and their family members reported numerous patient, family, clinic, and community-level facilitators and barriers to patients' hypertension self-management. Patients' and their family members' views may help guide efforts to tailor behavioral interventions designed to improve hypertension self-management behaviors and hypertension control in minority populations.

The trade unions membership dynamics and union members’ trajectories

This text presents an analysis of aggregated membership’s dynamics for Spanish trade unions, using ECVT data, as well as union memberships’ trajectories, or members’ decisions about joining the organization, permanency and responsibilities, and subsequent attrition. For the analysis of trajectories we make use of information of the records of actual memberships and the record of quitting of CCOO, and of a survey-questionnaire to a sample of leavers of the same union. This study allows us to confirm a linkage between the decision and motivations to become union member, to participate in union activities, the time of permanency, and the motives to quit the organization. We also identify five types of union members’ trajectories, indicating that, far from views that assert a monolithic structure, unions are complex organizations.

Co-evaluation as a strategy to improve working group dynamics: an experience in Sport Sciences

The aim of this study was to analyze if the perceptions of students before and after carrying out the work, that is, their perception of different aspects of the functioning of the group, the working skills acquired as well as those they think that need to be improved, varied depending on whether the contribution of the different members of the group was being co-evaluated or not. 144 students of Physical Activity and Sport Sciences participated in this study. In order to analyze the students' perception of group work the adapted questionnaire by Bourne et al. (2001) was used. Results showed that groups which implemented co-evaluation assessed more negatively the experience in general than those which did not. However, co-evaluation groups perceived their competence to work as a team had improved to a greater extent than the groups without co-evaluation, evaluating more positively both the performance and the result of work and increasing their knowledge of the other team members. Using a co-evaluation system seems to generate both a better assessment of the running of the team and the result of its work.

Speciation in Red Algae: Members of the Ceramiales as Model Organisms

Red algae (Rhodophyta) are an ancient group with unusual morphological, biochemical, and life-history features including a complete absence of flagella. Although the red algae present many opportunities for studying speciation, this has rarely been explicitly addressed. Here, we examine an aspect of paternal gene flow by determining fertilization success of female Neosiphonia harveyi (Ceramiales), which retains a morphological record of all successful and unsuccessful female gametes. High fertilization rates were observed except when there were no males at all within the tidepool, or in a submerged marina environment. Small numbers of reproductive males were able to saturate fertilization rates, suggesting that limited availability of sperm may be less significant in red algae than previously thought. In another member of the Ceramiales, Antithamnion, relatively large chromosomes permit karyological identification of polyploids. The Western Pacific species Antithamnion sparsum is closely related to the diploid species Antithamnion defectum, known only from the Eastern Pacific, and appears to have evolved from it. Molecular evidence suggests that A. sparsum is an autopolyploid, and that the European species known as Antithamnion densum is divergent from the A. sparsum/defectum complex.

Periodontitis and systemic diseases:A record of discussions of working group 4 of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases

Background There has been an explosion in research into possible associations between periodontitis and various systemic diseases and conditions. Aim To review the evidence for associations between periodontitis and various systemic diseases and conditions, including chronic obstructive pulmonary disease (COPD), pneumonia, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome and cancer, and to document headline discussions of the state of each field. Periodontal associations with diabetes, cardiovascular disease and adverse pregnancy outcomes were not discussed by working group 4. Results Working group 4 recognized that the studies performed to date were largely cross-sectional or case-control with few prospective cohort studies and no randomized clinical trials. The best current evidence suggests that periodontitis is characterized by both infection and pro-inflammatory events, which variously manifest within the systemic diseases and disorders discussed. Diseases with at least minimal evidence of an association with periodontitis include COPD, pneumonia, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome and cancer. The working group agreed that there is insufficient evidence to date to infer causal relationships with the exception that organisms originating in the oral microbiome can cause lung infections. Conclusions The group was unanimous in their opinion that the reported associations do not imply causality, and establishment of causality will require new studies that fulfil the Bradford Hill or equivalent criteria. Precise and community-agreed case definitions of periodontal disease states must be implemented systematically to enable consistent and clearer interpretations of studies of the relationship to systemic diseases. The members of the working group were unanimous in their opinion that to develop data that best inform clinicians, investigators and the public, studies should focus on robust disease outcomes and avoid surrogate endpoints. It was concluded that because of the relative immaturity of the body of evidence for each of the purported relationships, the field is wide open and the gaps in knowledge are large. © 2013 European Federation of Periodontology and American Academy of Periodontology.

Clinical end points for drug treatment trials in BCR-ABL1-negative classic myeloproliferative neoplasms: consensus statements from European LeukemiaNET (ELN) and Internation Working Group-Myeloproliferative Neoplasms Research and Treatment (IWG-MRT)

The discovery of somatic mutations, primarily JAK2V617F and CALR, in classic BCR-ABL1-negative myeloproliferative neoplasms (MPNs) has generated interest in the development of molecularly targeted therapies, whose accurate assessment requires a standardized framework. A working group, comprised of members from European LeukemiaNet (ELN) and International Working Group for MPN Research and Treatment (IWG-MRT), prepared consensus-based recommendations regarding trial design, patient selection and definition of relevant end points. Accordingly, a response able to capture the long-term effect of the drug should be selected as the end point of phase II trials aimed at developing new drugs for MPNs. A time-to-event, such as overall survival, or progression-free survival or both, as co-primary end points, should measure efficacy in phase III studies. New drugs should be tested for preventing disease progression in myelofibrosis patients with early disease in randomized studies, and a time to event, such as progression-free or event-free survival should be the primary end point. Phase III trials aimed at preventing vascular events in polycythemia vera and essential thrombocythemia should be based on a selection of the target population based on new prognostic factors, including JAK2 mutation. In conclusion, we recommended a format for clinical trials in MPNs that facilitates communication between academic investigators, regulatory agencies and drug companies.

Confidence in Contact: A New Perspective on Promoting Cross-Group Friendship Among Children and Adolescents

Intergroup contact theory proposes that positive interactions between members of different social groups can improve intergroup relations. Contact should be especially effective in schools, where opportunities may exist to engage cooperatively with peers from different backgrounds and develop cross-group friendships. In turn, these friendships have numerous benefits for intergroup relations. However, there is evidence that children do not always engage in cross-group friendships, often choosing to spend time with same-group peers, even in diverse settings. We argue that in order to capitalize on the potential impact of contact in schools for promoting harmonious intergroup relations, a new model is needed that places confidence in contact at its heart. We present an empirically driven theoretical model of intergroup contact that outlines the conditions that help to make young people contact ready, preparing them for successful, sustained intergroup relationships by giving them the confidence that they can engage in contact successfully. After evaluating the traditional approach to intergroup contact in schools, we present our theoretical model which outlines predictors of cross-group friendships that enhance confidence in and readiness for contact. We then discuss theory-driven, empirically tested interventions that could potentially promote confidence in contact. Finally, we make specific recommendations for practitioners and policy makers striving to promote harmonious intergroup relations in the classroom.

Lancefield group C and G streptococci in human infection : molecular typing, virulence and antimicrobial susceptibility

Tese de doutoramento, Ciências e Tecnologias da Saúde (Microbiologia), Universidade de Lisboa, Faculdade de Medicina, 2014

Perceptions of leadership in adolescent girls, members of the Girl Guides of Canada

Twenty-eight young women who were members of the Girl Guides of Canada as Rangers and Cadets from a convenience sample chose to participate in this case study. They were from four separate locations in Southern Ontario. The interviews and observations at unit meetings allowed an indepth look into the perceptions of leadership of these young women. The amount of time observing and interacting with each participant provided a snapshot of what they thought and how they responded to the questions asked at that particular time. Each girl responded to the question, "Are you a leader?" They then gave examples of their own leadership and described leaders they knew. Their responses are reported in relation to their definitions. Their identifications of effective and ineffective leaders were examined, as well as their views of the best and worst things a leader can do. This information is reported by unit, as some patterns in their responses emerged which were unique to each group. The responses of all of the girls to the leadership of Guiders, Rangers and Cadets and the hypothetical effect of male leaders and male Rangers in Guiding are reported. For these, the participants' views were sorted based on the common themes/ and regardless of their group affiliation, since many of the same themes emerged when examining these questions. The information collected was extensive and allowed for trends and parallels to become evident 0 All of the participants identified themselves as leaders. A diversity of views exists in their perceptions of leadership. For many, age makes a difference in leadership. The majority identified the single-sex aspect of the organization as comfortable and stated that it should remain so. Gender profoundly affects who is listened to and what opportunities are available.

Occupational therapist and client experiences of a mental health group

The purpose of this qualitative study was to understand the client and occupational therapist experiences of a mental health group. A secondary aim was to explore the extent to which this group seemed to have reflected a client-centred approach. The topic emerged from personal and professional issues related to the therapist as teacher and to inconsistencies in practice with the profession's client-centred philosophy. This philosophy, the study's frame of reference, was established in terms of themes related to the client-therapist relationship and to client values. Typical practice was illustrated through an extensive literature review. Structured didacticexperiential methods aiming toward skill development were predominant. The interpretive sciences and, to a lesser extent, the critical sciences directed the methodology. An ongoing support group at a community mental health clinic was selected as the focus of the study; the occupational therapist leader and three members became the key participants. A series of conversational interviews, the . core method of data collection, was supplemented by observation, document review, further interviews, and fieldnotes. Transcriptions of conversations were returned to participants for verification and for further reflection. Analysis primarily consisted of coding and organizing data according to emerging themes. The participants' experiences of group, presented as narrative stories within a group session vignette, were also returned to participants. There was a common understanding of the group's structure and the importance of having "air time" within the group; however, differences in perceptions of such things as the importance of the group in members' lives were noted. All members valued the therapeutic aspects of group, the role of group as weekly activity and, to a lesser extent, the learning that came from group. The researcher's perspective provided a critique of the group experience from a client-centred perspective. Some areas of consistency with client-centred practice were noted (e.g., therapist attitudes); however the group seemed to function far from a client-centred ideal. Members held little authority in a relationship dominated by the leaders, and leader agendas rather than member values controlled the session. Possible reasons for this discrepancy ranging from past health care encounters through to co-leader discord emerged. The actual and potential significance of this study was discussed according to many areas of implications: to OT practice, especially client-centred group practice, to theory development, to further areas of research and methodology considerations, to people involved in the group and to my personal growth and development.

Intracellular trafficking of protease : Activated Receptor 2 (PAR2) by members of sorting nexins family

Le dogme voulant que les récepteurs couplés aux protéines G (GPCRs) activent des voies de signalisation seulement lorsqu’ils sont localisés à la membrane plasmatique, a récemment été remis en question. Des données récentes indiquent que certains GPCRs peuvent également induire une réponse intracellulaire à partir des compartiments intracellulaires dont le noyau. Les récepteurs activés par la protéase (PAR) sont des membres de la famille GPCR. Les PARs sont activés par le clivage de la partie N–terminale du récepteur ce qui permet au ligand attaché sur le récepteur de se lier à sa poche réceptrice. Quatre PARs ont été décrits : PAR1, PAR2, PAR3 et PAR4. PAR2 peut susciter des effets mitogéniques et participer aux processus comme l’angiogenèse et l'inflammation. Alors que beaucoup d'effets intracellulaires de PAR2 peuvent être expliqués lorsqu’il est localisé à la membrane plasmatique, une fonction intracrine de PAR2 a aussi été proposée. Pourtant les mécanismes par lesquels PAR2 peut provoquer l’expression de gènes ciblés sont toujours inconnus. Le but de notre étude était de vérifier l’existence d’une population nucléaire de PAR2. Nous avons également émis l’hypothèse que les voies activées par l’activation de PAR2 dépendent de sa localization cellulaire. En utilisant des techniques de microscopie confocale et de "Western Blot" nous avons démontré la présence d’une population nucléaire de PAR2. À la suite de la stimulation de PAR2, nous avons observé une augmentation de la translocation du récepteur de la membrane plasmatique au noyau. En utilisant la technique de "RT – PCR", nous avons observé des rôles différents de PAR2 à la surface de la cellule et du noyau dans l’initiation de l’expression des gènes. Afin d’identifier les mécanismes responsables de la translocation nucléaire de PAR2, nous avons évalué l’implication des membres de la famille de "Sorting Nexins (SNX)" dans la translocation nucléaire de PAR2. "Sorting Nexins" est un groupe de protéines avec des fonctions de transport bien établies. SNX1 et SNX2 ont été identifiés comme responsables du transfert de PAR1 vers les lysosomes. SNX11 n'a pas encore été étudié et nous avons émis l’hypothèse qu'il pourrait être un autre membre de la famille des SNX impliqué dans la signalisation de PAR2. Pour ce faire, nous avons développé des "knockdowns" stables pour SNX1, SNX2 et SNX11 dans les cellules HEK293. En utilisant les essais d’immunofluorescence, "Western Blot" et de cytométrie en flux, nous avons déterminé que tous les trois membres du groupe SNX sont des partenaires d'interaction de PAR2. Toutefois, seul SNX11 se co-localise avec son partenaire au noyau et est responsable de sa translocation nucléaire. Les expériences de "RT - PCR" sur les lignées de cellule de SNXs "knockdowns" ont démontré que la fonction de PAR2 nucléaire dépend surtout de SNX11; néanmoins SNX1 et SNX2 peuvent aussi l’influencer, suggérant qu'ils font aussi partie du réseau signalétique de PAR2. En conclusion, PAR2 est déplacé de la membrane plasmatique à la membrane nucléaire après sa stimulation avec un agoniste. La translocation nucléaire de PAR2 par un mécanisme impliquant SNX11, initie des effets intracellulaires différents de sa signalisation membranaire. Mots clés : récepteurs couplés à la protéine G, “Sorting Nexins”, récepteurs activés par la protéase, translocation nucléaire, membrane nucléaire, signal nucléaire.

A green profession? A global survey of RICS members and their engagement with the sustainability agenda

Purpose – This study seeks to provide a review of the background and context to the engagement of RICS members with the sustainability agenda, and to examine the extent to which the surveying profession uses relevant information, tools and techniques to achieve the key objectives of sustainable development (or sustainability). Design/methodology/approach – The paper analyses results from a major international online survey of 4,600 RICS respondent members, supported by 31 structured telephone interviews. Findings – The results suggest that, although sustainability is highly relevant to RICS members’ work, a lack of knowledge and expertise is making it more difficult for sustainability tools and other information to be used effectively. Research limitations/implications – The survey is based on a substantial number of responses which are broadly representative of the global RICS population. A key implication is that “laggard” faculties include the disciplines of commercial property and valuation. Practical implications – The research suggests that key stakeholders must work together to provide better information, guidance and education and training to “hardwire” the sustainability agenda across RICS faculties. Originality/value – This is the first truly global survey of its kind and focuses particularly on those faculties that play a major role in property investment and finance (i.e. valuation and commercial property), comparing their position with that of other faculties in an international context.

Emotional geographies of enthusiasm: belonging to the Telecommunications Heritage Group

Enthusiasm has long been associated with notions of impassioned mood, intensity of feeling and passionate dedication. Despite this burgeoning field of ‘enthusiastic geographies’, the conceptualisation of enthusiasm has until now remained largely untouched by geographers. This article develops recent work on emotional geographies in order to shed light on the emergence, experience and spatial implications of enthusiasm in group settings. It draws upon interview material with members of the UK’s Telecommunications Heritage Group in order to examine enthusiasm as an emotional affiliation. It is argued in this article that enthusiasm influences passions, performances and actions in space, revealing the mutual ‘closeness’, exclusivity of knowledgeability and sociability among participants.

Best practice in the training, appointment and remuneration of members of dispute boards for large infrastructure projects

This paper reports part of a qualitative study into evolving practice in the implementation of the Dispute Adjudication Board (DAB) construction dispute resolution technique, a variant of the Dispute Review Board (DRB) concept used in the US and Canada. Data was collected through a focus group interview of 20 highly experienced dispute resolution practitioners from engineering and the law. The group was assembled from members of FIDIC-NET with direct experience of project DABs. The part reported here concerns practice and procedure for establishing DABs. The main findings are that: constitution of the DABs is often delayed because of either project owners' ignorance of the DAB process or deterrence by the cost of the DABs; such owners also tend to insist on appointing DAB members from local engineers and lawyers without sufficient understanding of the DAB process; rates of remuneration of DAB members vary widely; the training provision for DAB membership and advocacy skills is inadequate; the process of selecting candidates for DAB membership and negotiating the tripartite agreement between each member and the contractual parties needs to be navigated with great care to avoid raising ethical problems. The research contribution is threefold. First, it highlights the importance of realistic fees for DAB members within a standard framework in achieving timely establishment of a board that works well as a team. Second, it illustrates the use of qualitative focus group interview to study the impact of new contract terms from multiple stakeholder perspectives. Finally, it identifies areas where further research is needed.

Cue properties change timing strategies in group movement synchronisation

To maintain synchrony in group activities, each individual within the group must continuously correct their movements to remain in time with the temporal cues available. Cues might originate from one or more members of the group. Current research suggests that when synchronising movements, individuals optimise their performance in terms of minimising variability of timing errors (asynchronies) between external cues and their own movements. However, the cost of this is an increase in the timing variability of their own movements. Here we investigate whether an individual’s timing strategy changes according to the task, in a group scenario. To investigate this, we employed a novel paradigm that positioned six individuals to form two chains with common origin and termination on the circumference of a circle. We found that participants with access to timing cues from only one other member used a strategy to minimise their asynchrony variance. In contrast, the participant at the common termination of the two chains, who was required to integrate timing cues from two members, used a strategy that minimised movement variability. We conclude that humans are able to flexibly switch timekeeping strategies to maintain task demands and thus optimise the temporal performance of their movements.