Do Dietary Factors Contribute to Medical Cost for Cuban Americans with and without Type 2 Diabetes?

BACKGROUND: Cuban Americans have a high prevalence of type 2 diabetes, placing them at risk for cardiovascular disease (CVD) and increased medical costs. Little is known regarding the lifestyle risk factors of CVD among Cuban Americans. This study investigated modifiable CVD risk factors of Cuban Americans with and without type 2 diabetes. METHODS: Sociodemographics, anthropometrics, blood pressure, physical activity, dietary intake, and biochemical parameters were collected and assessed for n=79 and n=80 Cuban Americans with and without type 2 diabetes. RESULTS: Fourteen percent with diabetes and 24 percent without diabetes engaged in the recommended level of physical activity. Over 90 percent had over the recommended intake of saturated fats. Thirty-five percent were former or current smokers. DISCUSSION: Cuban Americans had several lifestyle factors that are likely to increase the risk of CVD. Their dietary factors were associated with blood cholesterol and body weight, which has been shown to impact on medical expenses. These findings may be used for designing programs for the prevention of CVD as well as type 2 diabetes for Cuban Americans.

The Use of a Computer Graphic Organizer for Persuasive Composition Writing by Hispanic Students with Specific Learning Disabilities

Many culturally and linguistically diverse (CLD) students with specific learning disabilities (SLD) struggle with the writing process. Particularly, they have difficulties developing and expanding ideas, organizing and elaborating sentences, and revising and editing their compositions (Graham, Harris, & Larsen, 2001; Myles, 2002). Computer graphic organizers offer a possible solution to assist them in their writing. This study investigated the effects of a computer graphic organizer on the persuasive writing compositions of Hispanic middle school students with SLD. A multiple baseline design across subjects was used to examine its effects on six dependent variables: number of arguments and supporting details, number and percentage of transferred arguments and supporting details, planning time, writing fluency, syntactical maturity (measured by T-units, the shortest grammatical sentence without fragments), and overall organization. Data were collected and analyzed throughout baseline and intervention. Participants were taught persuasive writing and the writing process prior to baseline. During baseline, participants were given a prompt and asked to use paper and pencil to plan their compositions. A computer was used for typing and editing. Intervention required participants to use a computer graphic organizer for planning and then a computer for typing and editing. The planning sheets and written composition were printed and analyzed daily along with the time each participant spent on planning. The use of computer graphic organizers had a positive effect on the planning and persuasive writing compositions. Increases were noted in the number of supporting details planned, percentage of supporting details transferred, planning time, writing fluency, syntactical maturity in number of T-units, and overall organization of the composition. Minimal to negligible increases were noted in the mean number of arguments planned and written. Varying effects were noted in the percent of transferred arguments and there was a decrease in the T-unit mean length. This study extends the limited literature on the effects of computer graphic organizers as a prewriting strategy for Hispanic students with SLD. In order to fully gauge the potential of this intervention, future research should investigate the use of different features of computer graphic organizer programs, its effects with other writing genres, and different populations.

Enhancing physical therapy students' attitudes toward telecommunication technology by using a demonstration model

The purpose of this study was to assess and enhance the attitudes and knowledge of physical therapy students toward telecommunication technology. A questionnaire was given to appraise the attitudes and knowledge of 156 physical therapy students toward telecommunication technology. The intervention was a one hour presentation on applications relevant to physical therapy practice. The majority of students expressed interest in telecommunication before the presentation, and felt that expanded use of telecommunication was important to the profession. However, only a minority of students demonstrated knowledge about specific medical telecommunication applications. The post-intervention questionnaire showed the presentation to be effective in changing students' attitudes toward telecommunication, and increasing their knowledge relevant to the practice of physical therapy. If physical therapy curricula were to include exposure to telecommunication, perhaps physical therapists will be more inclined to use the technology in the future.

New Framework and Metrics for Economic Evaluation of Medical Technology in the Presence of Heterogeneity and Its Application to the Evaluation of Bariatric Surgery

Thesis (Ph.D.)--University of Washington, 2016-07

Une approche algorithmique des difficultés de raisonnement clinique : étude d’utilité, d’acceptabilité et de faisabilité

Résumé: INTRODUCTION Si les cliniciens enseignants détectent aisément les difficultés des apprenants, ils sont souvent peu outillés pour les étapes subséquentes, du diagnostic à la remédiation. Quoique des outils aient été développés pour les guider face aux difficultés de raisonnement clinique de leurs apprenants, ces outils peuvent être moins familiers des cliniciens et moins adaptés à des contextes de supervision ponctuelle et de soins aigus comme l’urgence. Nous avons donc développé une application algorithmique, à partir de la taxonomie d’Audétat et al. (2010), pour guider les cliniciens enseignants juste-à-temps face aux difficultés de raisonnement clinique. MÉTHODOLOGIE Une étude descriptive interprétative a été réalisée afin d’évaluer l’utilité, l’acceptabilité et la faisabilité d’utiliser cette application à l’urgence. Des entrevues semi-dirigées ont été menées auprès d’un échantillon de convenance de douze urgentistes, avant et après une période d’essai de l’outil de trois mois. RÉSULTATS L’application a été perçue comme particulièrement utile pour préciser les difficultés de raisonnement clinique des apprenants. Utiliser l’outil a été considérée acceptable et faisable en contexte d’urgence, en particulier grâce au format mobile. DISCUSSION Ces résultats suggèrent que l’outil peut être considéré utile pour faciliter l’identification des difficultés des apprenants, mais aussi pour offrir un soutien professoral accessible. Le format mobile et algorithmique semble avoir été un facteur facilitant, ce format étant déjà utilisé par les cliniciens pour consulter ponctuellement de l’information lors de la résolution de problèmes cliniques. CONCLUSION L’étude a démontré globalement une bonne utilité, acceptabilité et faisabilité de l’outil dans un contexte de supervision ponctuelle en soins aigus, ce qui soutient son utilisation par les cliniciens enseignants dans ce contexte. L’étude corrobore également l’intérêt d’un format mobile et algorithmique pour favoriser le transfert de connaissances en pédagogie médicale.

The sexual health knowledge of people with intellectual disabilities: A review.

There is a growing recognition that people with disabilities have the same sexual needs and rights as people without disabilities. However, less attention is paid to the sexuality of people diagnosed with intellectual disabilities. This narrative review summarises what is currently known about the level of sexual health knowledge of people with intellectual disabilities. A literature review was conducted of the published literature using Google Scholar, PubMed, PsychInfo, EBSCOhost, and Science Direct. Forty eight articles were identified that addressed the question about the level of sexual health knowledge of people with intellectual disabilities. Overall, studies demonstrate that people with intellectual disabilities are highly variable in levels of sexual knowledge, but on average have a range of deficits in knowledge compared to non-disabled individuals. More tailored education and support in accessing formal and informal sources of information are needed.

Finnish Preclinical and Clinical Medical Students as Strategic L2 English Learners: Language Learning Strategies and Communicating with Patients

This thesis focused on medical students’ language learning strategies for patient encounters. The research questions concerned the types of learning strategies that medical students use and the differences between the preclinical students and the clinical students, two groups who have had varying amounts of experience with patients. Additionally, strategy use was examined through activity systems to gain information on the context of language learning strategy use in order to learn language for patient encounters. In total, 130 first-year medical students (preclinical) and 39 fifth-year medical students (clinical) participated in the study by filling in a questionnaire on language learning strategies. In addition, two students were interviewed in order to create activity systems for the medical students at different stages of their studies. The study utilised both quantitative and qualitative research methods; the analysis of the results relies on Oxford’s Strategic Self-Regulation Model in the quantitative part and on activity theory in the qualitative part. The theoretical sections of the study introduced earlier research and theories regarding English for specific purposes, language learning strategies and activity theory. The results indicated that the medical students use affective, sociocultural-interactive and metasociocultural-interactive strategies often and avoid using negative strategies, which hinder language learning or cease communication altogether. Slight differences between the preclinical and clinical students were found, as clinical students appear to use affective and metasociocultural-interactive strategies more frequently compared to the preclinical students. The activity systems of the two students interviewed were rather similar. The students were at different stages of their studies, but their opinions were very similar. Both reported the object of learning to be mutual understanding between the patient and the doctor, which in part explains the preference for strategies that support communication and interaction. The results indicate that the nature of patient encounters affects the strategy use of the medical students at least to some extent.

Analysis on the connotation of probability in the artificial intelligence algorithm for economic decision making.

This paper analyzes the inner relations between classical sub-scheme probability and statistic probability, subjective probability and objective probability, prior probability and posterior probability, transition probability and probability of utility, and further analysis the goal, method, and its practical economic purpose which represent by these various probability from the perspective of mathematics, so as to deeply understand there connotation and its relation with economic decision making, thus will pave the route for scientific predication and decision making.

Magnetic Theory and Applications in the Naples Bay (Southern Tyrrhenian Sea, Italy): Magnetic Anomaly Fields and Relationships with Morpho-Structural Lineaments

Magnetic theory and application to a complex volcanic area located in Southern Italy are here discussed showing the example of the Gulf of Naples, located at Southern Italy Tyrrhenian margin. A magnetic anomaly map of the Gulf of Naples has been constructed aimed at highlighting new knowledge on geophysics and volcanology of this area of the Eastern Tyrrhenian margin, characterized by a complex geophysical setting, strongly depending on sea bottom topography. The theoretical aspects of marine magnetometry and multibeam bathymetry have been discussed. Magnetic data processing included the correction of the data for the diurnal variation, the correction of the data for the offset and the leveling of the data as a function of the correction at the cross-points of the navigation lines. Multibeam and single-beam bathymetric data processing has been considered. Magnetic anomaly fields in the Naples Bay have been discussed through a detailed geological interpretation and correlated with main morpho-structural features recognized through morphobathymetric interpretation. Details of magnetic anomalies have been selected, represented and correlated with significant seismic profiles, recorded on the same navigation lines of magnetometry. They include the continental shelf offshore the Somma-Vesuvius volcanic complex, the outer shelf of the Gulf of Pozzuoli offshore the Phlegrean Fields volcanic complex, the relict volcanic banks of Pentapalummo, Nisida and Miseno, the Gaia volcanic bank on the Naples slope, the western slope of the Dohrn canyon, the Magnaghi canyon’s head and the magnetic anomalies among the Ischia and Procida islands.

Obtenção e caracterização de queratinase de bacillus sp. P45 a partir de coprodutos e aplicação na produção de queijos cremosos enriquecidos com chia e quinoa

As proteases constituem 60-65% do mercado global das enzimas industriais e são utilizadas na indústria de alimentos no processo de amaciamento de carne, na síntese de peptídeos, preparo de fórmulas infantis, panificação, cervejarias, produtos farmacêuticos, diagnósticos médicos, como aditivos na indústria de detergentes e na indústria têxtil no processo de depilação e transformação do couro. Proteases específicas produzidas por micro-organismos queratinolíticos são chamadas de queratinases e distinguem-se de outras proteases pela maior capacidade de degradação de substratos compactos e insolúveis como a queratina. Atualmente, processos que apontem o uso total das matérias-primas e que não resultem em impactos negativos ao meio ambiente tem ganhado destaque. Dentro desta temática, destacam-se a reutilização da farinha de penas residual durante o cultivo do Bacillus sp. P45 para produção de proteases e a biomassa residual de levedura, ambas com elevados teores de proteínas, podendo ser utilizadas no cultivo do Bacillus sp. P45 para obtenção de proteases. O objetivo deste trabalho foi obter a enzima queratinase purificada em grandes quantidades, sua caracterização, bem como a sua aplicação em processos de coagulação enzimática do leite para o desenvolvimento de um queijo cremoso enriquecido com farinha de chia e quinoa. Além disso, aplicar diferentes coprodutos para produção de enzimas proteolíticas e queratinolíticas. A presente tese foi dividida em quatro artigos: no primeiro foi realizado a obtenção da queratinase purificada em maiores quantidades e a determinação dos parâmetros de estabilidade térmica e a influência de componentes químicos na atividade enzimática. A obtenção da enzima em maiores quantidades alcançou fatores de purificação de 2,6, 6,7 e 4,0 vezes, paras 1º SAB, 2º SAB e diafiltração, respectivamente. A recuperação enzimática alcançou valores de 75,3% para o 1º SAB, 75,1% no 2º sistema e 84,3% na diafiltração. A temperatura de 55ºC e o pH 7,5 foram determinados como ótimos para atividade da enzima queratinase. O valor da energia de desativação (Ed) médio foi de 118,0 kJ/mol e os valores de z e D variaram de 13,6 a 18,8ºC, e 6,9 a 237,3 min, respectivamente. Além disso a adição de sais (CaCl2, CaO, C8H5KO4 e MgSO4) elevou a atividade da enzima na presença destes compostos. O segundo artigo apresenta a aplicação da queratinase como coagulante de leite bovino e sua aplicação na obtenção de queijo cremoso enriquecido com chia e quinoa. A enzima mostrou atividade de coagulação semelhante ao coagulante comercial, na concentração de 30mg/mL. A enzima purificada foi empregada de forma eficiente na fabricação do queijo cremoso, que apresentou valores de pH de 5,3 e acidez de 0,06 a 0,1 mol/L, com elevação durante os 25 dias de armazenamento. O terceiro artigo apresenta o perfil do queijo cremoso enriquecido com farinha de chia e quinoa, o qual apresentou alto índice de retenção de água (>99,0%) e baixos valores de sinérese (<0,72%). Elevados teores de fibras foi verificado (3,0 a 5,0%), sugerindo seu consumo como fonte de fibras. As análises microbiológicas foram de acordo com a legislação vigente. Na análise sensorial foi verificado altos valores de suavidade ao paladar e verificado maiores valores de consistência e untabilidade nas amostras com maiores concentrações de nata e quinoa. O quarto artigo traz a extração de β-galactosidase por ultrassom e o uso da biomassa residual da levedura, bem como o uso de farinha de penas residuais como substrato para obtenção de proteases. O ultrassom foi eficiente para ruptura celular e extração de β-galactosidase, apresentando alta atividade (35,0 U/mL) e rendimento (876,0 U/g de biomassa). A maior atividade proteolítica (1300 U/mL em 32 h) e queratinolítica (89,2 U/mL) verificadas ocorreram utilizando-se a biomassa e a farinha de penas residuais, respectivamente. Maior produtividade proteolítica (40,8 U/mL/h) foi verificado no meio utilizando biomassa residual como substrato. Já a maior produtividade queratinolítica (2,8 U/mL/h) foi alcançada utilizando farinha de penas reutilizada.

Types of embedded ties in buyer-supplier relationships and their combined effects on innovation performance

[EN] Purpose of the paper - This research analyzes the impact of three types of embedded ties, namely, specialized complementary resources, idiosyncratic investments, and knowledge sharing, on the innovation capacity of the firms. We also study the particularities of the Machine-Tool industry. Theoretical background – Our evaluation of the embedded buyer-supplier ties is based on the potential sources of relational rents proposed by Dyer and Sing (1998). We also draw on Uzzi and Lancaster (2003), Noordhoff et al. (2011), among others, to discuss the positive and negative aspects of embedded ties. Design/Methodology/Approach ‐ Using data from a survey of 202 European machine-tool firms acting as buyers and sellers, we propose and evaluate a Structural Equation model. Findings ‐ Only knowledge-sharing routines exert a significant positive effect on product innovation performance. Neither an increase in the idiosyncratic investments nor in complementary resources and capabilities enhance innovation performance. Also, knowledge-sharing routines mediate in the effect from idiosyncratic investments on innovation performance. Research Limitations. ‐ The machine tool industry has unique characteristics that make this generalization difficult. Also, there is considerable difficulty associated with testing more deeply the interrelations among these embedded ties in the long run. It is plausible to understand that these interrelations operate within a gradual process. Originality/Value/Contribution of Paper ‐ This research contributes to a better understanding of the role of embedded ties on innovativeness. To the best of our knowledge, there is no previous international empirical research analyzing the mediation effects among specialized complementary resources, idiosyncratic investments and knowledge sharing, and their effects on the innovation capacity of firms.

RoMEO studies 7: creation of a controlled vocabulary to analyse copyright transfer agreements

This paper describes the process of creating a controlled vocabulary which can be used to systematically analyse the copyright transfer agreements (CTAs) of journal publishers with regard to self-archiving. The analysis formed the basis of the newly created Copyright Knowledge Bank of publishers’ self-archiving policies. Self-archiving terms appearing in publishers’ CTAs were identified and classified, with these then being simplified, merged, and discarded to form a definitive list. The controlled vocabulary consists of three categories that describe ‘what’ can be self-archived, the ‘conditions’ of self-archiving and the ‘restrictions’ of self-archiving. Condition terms include specifications such as ‘where’ an article can be self archived, restriction terms include specifications such as ‘when’ the article can be self archived. Additional information on any of these terms appears in ‘free-text’ fields. Although this controlled vocabulary provides an effective way of analysing CTAs, it will need to be continually reviewed and updated in light of any major new additions to the terms used in publishers’ copyright and self-archiving policies.

Representações sociais acerca da AIDS e percepção de risco da infecção entre estudantes universitários

Neste estudo exploratório procurouse identificar as representações sociais que jovens universitários elaboram sobre a aids e a percepção de risco em relação à infecção pelo HIV. Utilizou-se um instrumento de evocação que se baseia na associação livre de ideias, partindo-se do termo indutor aids. Participaram da pesquisa 201 estudantes, de ambos os sexos, matriculados em diferentes cursos de uma universidade pública. Os dados foram analisados pelo programa de computação EVOC. Os resultados indicaram que os universitários construíram um saber sobre a aids ancorado no conhecimento médico-científico sobre a síndrome da imunodeficiência adquirida. Sexo, morte e doença foram as palavras mais evocadas que, junto a medo, constituem o provável núcleo organizador das representações acerca da aids. Crenças e preconceito relacionados a grupos estigmatizados e a comportamentos considerados desviantes não apareceram nas associações dos universitários. Percebem-se como vulneráveis à infecção identificando comportamentos de risco em toda a população, inclusive no grupo interno. ____________________________________________________________________________________ ABSTRACT

O ensino e aprendizagem da programação de computadores no ensino a distância : uma proposta de instanciação do modelo pedagógico virtual da Universidade Aberta

Hoje em dia o ensino e aprendizagem a distância online de nível universitário é, em grande medida, baseado em estratégias de aprendizagem colaborativa, onde, além de aprender sozinho, os estudantes também participam de ações colaborativas dentro de uma classe virtual. O nível de interação do estudante online representa um fator fundamental para o sucesso do processo de ensino-aprendizagem pois é a base da partilha de informação e construção do conhecimento entre estudantes e professores, enquanto todas as ações e atividades integram um modelo pedagógico comum. Existem muitas diferenças e desafios nas áreas de ensino em termos de instanciação do modelo pedagógico e adoção das estratégias de ensino-aprendizagem, como por exemplo, entre as áreas das ciências sociais e das engenharias. Uma área que atrai especial atenção como um todo é a das ciências da computação (CS), e de forma específica, a da programação de computadores. A programação de computadores exige, em primeiro lugar, o desenvolvimento de um bom raciocínio lógico e uma estratégia de resolução segundo uma abordagem “dividir para conquistar”, onde os principais problemas são divididos em problemas menores que são resolvidos individualmente. A programação exige também uma combinação entre o trabalho individual e em grupo, com elevados níveis de revisão e depuração do código fonte em desenvolvimento. O ensino online de programação de computadores é constituído por estes aspectos, exigindo um elevado grau de interação entre estudantes e entre estudantes e professor. Neste capítulo, vamos discutir e apresentar a nossa experiência no ensino online da programação de computadores com base no modelo pedagógico virtual da Universidade Aberta, e propor a sua instanciação e extensão específica para incluir novas estratégias de aprendizagem colaborativa e uma abordagem construtivista para o processo global de aprendizagem.