813 resultados para Prescription writing.
Resumo:
This paper aims at analysing the writing of the Portuguese author António Lobo Antunes, considered one of the major writers in European Literature with 26 books published, by focusing on the strategies deployed in his texts of creating micro-narratives within the main frame, and conveying the elements of individual and collective memory, past and present, the self and the others, using various voices and silences. Lobo Antunes incorporates in his writing his background as a psychiatrist at a Mental Hospital in Lisbon, until 1985 (when he decided to commit exclusively to writing), his experience as a doctor in the Portuguese Colonial War battlefield, but also the daily routines of the pre and post 25th of April 1974 (Portuguese Revolution) with subtle and ironic details of the life of the middle and upper class of Lisbon‘s society: from the traumas of the war to the simple story of the janitor, or the couple who struggles to keep their marriage functional, everything serves as material to develop and interweave a complex plot, that a lot of readers find too enwrapped and difficult to follow through. Some excerpts taken from his first three novels and books of Chronicles and his later novel – Ontem não te Vi em Babilónia (2006) – will be put forward to exemplify the complexity of the writing and the main difficulties of the reader, lost in a multitude of narrators‘ voices. Recently, Lobo Antunes has commented on his work stating: What I write can be read in the darkness. This paper aims at throwing some light by unfolding some of the strategies employed to defy new borders in the process of reading.
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This article studies the intercultural trajectory of a Portuguese female aristocrat of the eighteenth to nineteenth centuries. Her trajectory of intercultural transition from a Portuguese provincial lady into an independent owner of a sugar mill in tropical Bahia is documented through family letters, which provide a polyphonic representation of a movement of personal, family, and social transculturation over almost two decades. Maria Bárbara began her journey between cultures as a simple spectator-reader, progressively becoming a commentator-actor-protagonist-author in society, in politics, and in history. These letters function as a translation that is sometimes consecutive, other times simultaneous, of the events lived and witnessed. This concept of intercultural translation is based on the theories of Boaventura de Sousa Santos (2006, 2008), who argues that cultural differences imply that any comparison has to be made using procedures of proportion and correspondence which, taken as a whole, constitute the work of translation itself. These procedures construct approximations of the known to the unknown, of the strange to the familiar, of the ‘other’ to the ‘self’, categories which are always unstable. Likewise, this essay explores the unstable contexts of its object of study, with the purpose of understanding different rationalities and worldviews.
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OBJECTIVE: While there is a dose-response relationship between physical activity (PA) and health benefit, little is known about the effectiveness of different PA prescriptions on total daily PA. AIM: To test, under real-life conditions and using an objective, non-invasive measurement technique (accelerometry), the effect of prescribing additional physical activity (walking only) of different durations (30, 60 and 90 min/day) on compliance (to the activity prescribed) and compensation (to total daily PA). Participants in each group were prescribed 5 sessions of walking per week over 4 weeks. METHODS: 55 normal-weight and overweight women (mean BMI 25 ± 5 kg/m(2), height 165 ± 1 cm, weight 68 ± 2 kg and mean age 27 ± 1 years) were randomly assigned to 3 prescription groups: 30, 60 or 90 min/day PA. RESULTS: Walking duration resulted in an almost linear increase in the number of steps per day during the prescription period from an average of about 10,000 steps per day for the 30-min prescription to about 14,000 for the 90-min prescription. Compliance was excellent for the 30-min prescription but decreased significantly with 60-min and 90-min prescriptions. In parallel, degree of compensation subsequent to exercise increased progressively as length of prescription increased. CONCLUSION: A 30-min prescription of extra walking 5 times per week was well tolerated. However, in order to increase total PA further, much more than 60 min of walking may need to be prescribed in the majority of individuals. While total exercise 'volume' increased with prescriptions longer than 30 min, compliance to the prescription decreased and greater compensation was evident. © 2014 S. Karger GmbH, Freiburg.
Resumo:
QUESTION UNDER STUDY: The aim of this study was to assess the prevalence of chronic kidney disease (CKD) among type 2 diabetic patients in primary care settings in Switzerland, and to analyse the prescription of antidiabetic drugs in CKD according to the prevailing recommendations. METHODS: In this cross-sectional study, each participating physician was asked to introduce anonymously in a web database the data from up to 15 consecutive diabetic patients attending her/his office between December 2013 and June 2014. Demographic, clinical and biochemical data were analysed. CKD was classified with the KDIGO nomenclature based on estimated glomerular filtration rate (eGFR) and urinary albumin/creatinine ratio. RESULTS: A total of 1 359 patients (mean age 66.5 ± 12.4 years) were included by 109 primary care physicians. CKD stages 3a, 3b and 4 were present in 13.9%, 6.1%, and 2.4% of patients, respectively. Only 30.6% of patients had an entry for urinary albumin/creatinine ratio. Among them, 35.6% were in CKD stage A2, and 4.1% in stage A3. Despite prevailing limitations, metformin and sulfonylureas were prescribed in 53.9% and 16.5%, respectively, of patients with advanced CKD (eGFR <30 ml/min). More than a third of patients were on a dipeptidyl-peptidase-4 inhibitor across all CKD stages. Insulin use increased progressively from 26.8% in CKD stage 1-2 to 50% in stage 4. CONCLUSIONS: CKD is frequent in patients with type 2 diabetes attending Swiss primary care practices, with CKD stage 3 and 4 affecting 22.4% of cases. This emphasizes the importance of routine screening of diabetic nephropathy based on both eGFR and urinary albumin/creatinine ratio, the latter being largely underused by primary care physicians. A careful individual drug risk/benefit balance assessment is mandatory to avoid the frequently observed inappropriate prescription of antidiabetic drugs in CKD patients.
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Abstract: In Imperial Eyes Mary Louise Pratt (1992: 7, emphasis original) defines autoethnography as "instances in which colonized subjects undertake to represent themselves in ways that engage with the colonizer's own terms ... in response to or in dialogue with . . . metropolitan representations." Although Pratt's conceptualization of autoethnography has much to offer post-colonial studies, it has received little attention in the field. In this thesis, I interrogate Pratt's notion of autoethnography as a theoretical tool for understanding the self-representations of subordinate peoples within transcultural terrains of signification. I argue that autoethnography is a concept that allows us to move beyond some theoretical dualisms, and to recognize the (necessary) coexistence of subordinate peoples' simultaneous accommodation of and resistance to dominant representations of themselves. I suggest that even when autoethnographic expressions seem to rely on or to reproduce dominant knowledges, their very existence as speech acts implicitly resists dominant discourses which objectify members of oppressed populations and re-create them as Native Informants. I use Pratt's concept to analyze two books by Islamic feminist sociologist Fatima Memissi. Memissi's Dreams ofTrespass and Scheherazade Goes West illustrate the simultaneity of accommodation and disruption evident in autoethnographic communication. Across the two books, Memissi shows herself renegotiating the discourses which discipline her (and her speech). She switches back and forth between the positions of reader and author, demonstrates the reciprocity of the disciplinary gaze (she looks back at her dominants, reading their own reading of her representation of her social group), and provides a model of autoethnographic dialogue.
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This study was a comparative investigation of face-toface (i.e., proximate) and computer-mediated written (i.e., graphic) pre-writing conferences. The participants in this study were advanced English as a second language students. The 2 types of conferences were compared in terms of textual features, participation, and the . degree to which they were on topic. Moreover, drafts written after the 2 types of conferences were compared in terms of textual features, and the degree to which they were related to the conferences. Students produced an equivalent amount of discourse in an equivalent amount of time in the 2 types of conferences. The discourse in graphic conferences displayed greater lexical range, and some evidence suggests that it was less on-topic. Both these results likely occurred because the graphic conferences contained more discourse demonstrating interactive competence. Participation in graphic conferences was found to be as balanced or more balanced among students, and among students and the group leader combined. Overall, the drafts produced after the 2 types of conferences were of equivalent length and topical range, but some evidence suggests that drafts written after proximate conferences were more related to the conferences.
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A cognitively based instructional program for narrative writing was developed. The effects of using cognitively based schematic planning organizers at the pre-writing stage were evaluated using subjects from the Primary, Junior and Intermediate divisions. Results indicate that the use of organizers based on problem solving significantly improved the organization and the overall quality of narrative writing for students in grades 3, 6 and 7. The magnitude of the improvement of the treatment group over the control group performance in Organization ranged from 10.7% to 22.9%. Statistical and observational data indicate many implications for further research into the cognitive basis for writing and reading; for the improvement and evaluation of school writing programs; for the design of school curricula; and for the inservice education for teachers of writing.
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The methodology outlined in this study for teaching exposit ory writing to advanced (five year phase) grade eleven students is based on the assumption that writing as a problem solving strategy is a high level cognitive skill . In adhering to this assumption, a cognitively based schematic organizer known as a cross-classification chart was tested for its effectiveness a t the planning stage of the writing process . Results were not significant in any of the three components that were evaluated; however , a post- hoc analysis undertaken because of recorded observed data indicated a significant difference in the mean score on the Organization component for the treatment subgroup using the cross- classification organizer . Furthermore, the treatment group's positive response from the attitude survey towards planning writing is encouraging enough that replication and extension of the application of schema theory to wri ting should be pursued in cross-section and longitud i nal studies.
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This study attempted to determine whether or not dialogue journal writing encouraged critical reflection in the adult ESL (English as a Second Language) learner. According to research in adult education and anecdotal evidence, the process ofdialogue journal writing can facilitate critical reflection in the adult learner. However, little research has been conducted to examine whether or not journal writing can facilitate critical reflection in the second language learner. As a result, ten low-intermediate level adult ESL students from Brock University's Intensive English Language Programme participated in a dialogue journal writing programme in their writing class. The participants wrote journal entries over a 10-week period, and were interviewed once throughout the process to determine their perceptions ofthe journal writing experience. They also were observed by the researcher throughout the journal writing sessions to establish whether any behaviours or intrusions might affect the participants' writing processes. After the content ofthe journals and the interviews, and the observations made by the researcher were analysed, it was confirmed that, for these participants, dialogue journal writing did not necessarily encourage critical reflection. Moreover, the participants' perceptions ofjournal writing were that it helped them to practise the syntax, vocabulary, and rhetorical patterns ofEnglish; nevertheless, it did not foster critical reflection or thinking.
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Based on the critical research paradigm and using a mix of methodologies, this study examined student perceptions of the process approach used to teach writing. A class of 19 ESL students in an academic writing class at a small university paliicipated in the study. As collaborators in the study, they assessed their personality types using the PET Type Check (Crantoll & Knoop, 1995) and tlleir learning styles using Kolb'sLearning Styles Inventory (1976). Interviews, classroom observations, and journals provided a data base for case studies llilQ teacher reflection. Results indicated that students perceived the prewriting step of brainstonning and peer review as most useful. Student perceptions of the tasks and course and implications for theory and practice are examined.
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It is estimated that five to ten percent of children experience sensory motor difficulties that result in various learnlng disabilitiies , among them. inabllity to output Information on paper in the appropriate manner (Ayres ,1985). The relationship between sensorimotorabillty and handwriting is well documented in the literature (Freeman,1917; Townsend , 1951; Nlkola-Ll sa, 1987). While much of the literature is inconclusive, there are findings to suggest that muitisensory handwriting programmes are an effective approach to improvlng writing abIlity in these chlldren. For a number of years, Occupational Therapists have been involved in the remediation of handwriting utllizing , amongst other approaches . multisensory programmes. While subjective assessments of effectiveness have been extremerly positive. scientIfic evaluation has been minimal . If further intervention in this area is to occur, it Is essential that the profession be able to justify the existence of such programmes . The purpose of this study was to examine what effects a multlsensory writing prog~am would have on the curslve writing ability of chlldren with sensorimotor dlfficulties. A single case with multiple baselines across be havlours design was used , with the behavlours being cursive writing abilIty of fIve distInct letter groups. The fIve groups were taught in random order, one group every two weeks , In a one-hour session. Repeated measurements of writing speed and qualIty for each letter group were made. This design was repeated over three other cases . Results of the study yielded statistical signifi cance in trend changes In specIfic letter groups for all of the chlldren following interventlon. One child achieved statistical significance In the overall change In quality , while none of the children achieved overall statistical significance In speed score changes . Teacher reports and an assessment of written language prior to and following the program suggest that Intervention may have had a positive effect on self-confidence in written output, and on the maturlty of written expression in some of the cases . Further research in this field is needed to validate the continual use of multisensory writing programmes by Occupational Theraplsts worklng with this specific population and to provide some directlon with regards to the Integration of multlsensory writing programmes within the regular academic remedial programme .