Statin prescription initiation and lifestyle behaviour: a primary care cohort study

BACKGROUND: Statin prescribing and healthy lifestyles contribute to declining cardiovascular disease mortality. Recent guidelines emphasise the importance of giving lifestyle advice in association with prescribing statins but adherence to healthy lifestyle recommendations is sub-optimal. However, little is known about any change in patients' lifestyle behaviours when starting statins or of their recall of receiving advice. This study aimed to examine patients' diet and physical activity (PA) behaviours and their recall of lifestyle advice following initiation of statin prescribing in primary care.

METHOD: In 12 general practices, patients with a recent initial prescription of statin therapy, were invited to participate. Those who agreed received a food diary by post, to record food consumed over 4 consecutive days and return to the researcher. We also telephoned participants to administer brief validated questionnaires to assess typical daily diet (DINE) and PA level (Godin). Using the same methods, food diaries and questionnaires were repeated 3 months later. At both times participants were asked if they had changed their behaviour or received advice about their diet or PA.

RESULTS: Of 384 invited, 122 (32 %) participated; 109 (89.3 %) completed paired datasets; 50 (45.9 %) were male; their mean age was 64 years. 53.2 % (58/109) recalled receiving lifestyle advice. Of those who did, 69.0 % (40/58) reported having changed their diet or PA, compared to 31.4 % (16/51) of those who did not recall receiving advice. Initial mean daily saturated fat intake (12.9 % (SD3.5) of total energy) was higher than recommended; mean fibre intake (13.8 g/day (SD5.5)), fruit/vegetable consumption (2.7 portions/day (SD1.3)) and PA levels (Godin score 7.1 (SD13.9)) were low. Overall, although some individuals showed evidence of behaviour change, there were no significant changes in the proportions who reported high or medium fat intake (42.2 % v 49.5 %), low fibre (51.4 % v 55.0 %), or insufficient PA (80.7 % v 83.5 %) at 3-month follow-up.

CONCLUSION: Whilst approximately half of our cohort recalled receiving lifestyle advice associated with statin prescribing this did not translate into significant changes in diet or PA. Further research is needed to explore gaps between people's knowledge and behaviours and determine how best to provide advice that supports behaviour change.

Kvinnors upplevelser av att leva med bröstcanceren litteraturöversikt

Bakgrund: Bröstcancer är den vanligaste cancerformen hos kvinnor och antalet bröstcancerfall ökar. En cancerdiagnos leder till många emotionella förändringar. Som vårdpersonal är det viktigt att ha vetskap och förståelse om patientens subjektiva upplevelser kring sin sjukdom för att kunna ge en god vård. Syfte: Syftet med litteraturstudien är att beskriva kvinnors upplevelser av att leva med bröstcancer. Metod: Databaserna PubMed och Cinahl användes i sökningen av artiklar. Resultaten i artiklarna har analyserats genom en analysmetod för kvalitativa studier och resultatet i litteraturstudien baseras på 14 vetenskapliga artiklar av kvalitativ ansats. Resultat: Kvinnorna upplevde negativa förändringar i deras vardagliga liv relaterat till sjukdomen både fysiskt, psykiskt och socialt. De upplevde en förändrad roll i familjen och som kvinna. Vilken och hur mycket information kvinnorna önskade få om sitt tillstånd varierade. Kvinnorna fick en ny syn på livet och de uppskattade livet mer än de gjorde innan sjukdomen. Slutsats: Kvinnorna upplevde många svårigheter i och med bröstcancersjukdomen och dessa upplevelser är viktiga att ha i beaktande i vårdandet av patienter med bröstcancer.

Att leva med kroniska sår En litteraturöversikt

Bakgrund: Kroniska sår innefattas av bensår, fotsår, trycksår, diabetessår, sårskada, tumörer, reumatiska sår och vårdskador vid komplikationer efter kirurgiska ingrepp, som inte har läkt inom 6 veckor. Forskning visar att trots att förebyggande strategier används, utvecklas det sår som kräver behandling. I mötet med vården är en god omvårdnad och en god vårdrelation viktig. Bristen på dessa leder ofta till ett lidande som individen måste kämpa emot med copingstrategier. Syfte: Syftet med denna litteraturstudie var att belysa personers erfarenhet av att leva med kroniska sår. Metod: En litteraturöversikt gjordes i denna studie med 15 vetenskapliga artiklar, som bestod av både kvantitativ och kvalitativ metod. Resultat: 3 huvudkategorier identifierades: begränsningar, lidande samt coping. Deltagarna ansåg att en brist på information samt begränsningar i vardagen påverkade individens sociala umgänge och fysiska aktivitet. Smärta, skam och rädsla ledde till depression. För att hantera detta använde individerna sig av familjen och stöd av vårdpersonalen Slutsats: Det framkom att individernas dagliga liv påverkades av det kroniska såret. Den konstanta smärtan orsakade sömnsvårigheter hos individen, vilket ytterligare försvårade hanteringen av smärtan och vardagen. Kontinuitet hos vårdpersonal och i behandlingen gav personerna en trygghet och en ökad förståelse för sitt tillstånd. Det belystes att det var viktigt att vårdpersonalen ser individen bakom såret, och inte bara lägger sitt fokus på sårläkningen och behandlingen.

Lebensrealitäten im Zentrum der Wissensvermittlung. Afrikaspezifische Veranstaltungen der entwicklungspolitischen Bildungsarbeit

Der vorliegende Beitrag beschäftigt sich mit afrikaspezifischen Veranstaltungen der entwicklungspolitischen Bildungsarbeit und den durch Referent/inn/en vermittelten Inhalten über den Lebensalltag in afrikanischen Ländern. Es wird aufgezeigt, dass der Prozess der Herausbildung des vermittelten Wissens in den Veranstaltungen durch das Zusammenspiel verschiedener Aspekte charakterisiert ist. Dazu gehören die institutionelle und diskursive Einordnung entwicklungspolitischer Bildungsarbeit in die Gesellschaft, die biographischen Hintergründe der Referent/inn/en und ihre Wahrnehmung gesellschaftlicher Wirklichkeit. (DIPF/Orig.)

Colmeias: uma estratégia didático-pedagógica para potencializar a aprendizagem significativa através da colaboração nas redes sociais em contextos móveis

O presente trabalho procura atender as necessidades dos processos educativos da atualidade, reconhecendo que esses ocorrem numa sociedade denominada como a Sociedade da Informação (SI), num ambiente em que os aprendizes são nativos digitais. Na SI presencia-se um momento marcado por um modelo computacional móvel, no qual também é possível constatar-se a emergência de um novo paradigma educacional - a aprendizagem com mobilidade - que possibilita a integração das tecnologias móveis com os processos de ensino e de aprendizagem. Além disso, observa-se a ascensão do emprego das redes sociais na Internet (RSI) no dia a dia dos indivíduos impactando as práticas estabelecidas na SI. Nesse cenário, visando integrar a aprendizagem móvel com os recursos das RSI para promover-se uma educação mais sintonizada com o perfil atual dos estudantes, expõe-se nessa tese uma nova proposta metodológica - a Colmeias almejando dessa maneira facilitar uma aprendizagem significativa a partir de um processo colaborativo, em rede e em contextos de mobilidade. Com embasamento teórico em diversos autores, entre os quais se destacam Vygostky, Bruner e Ausubel, apoiados por Júlio Cesar Santos e Pierry Dillenbourg, salienta-se que a estratégia Colmeias representa um caminho alternativo para aqueles professores que desejam promover uma educação mais coerente com a atualidade. Nessa pesquisa ainda se apresenta a sua aplicação por meio de um estudo de caso na Matemática procurando, assim, aproximar a teoria com a prática.

A supervisão e orientação pedagógica de educadores e professores em São Tomé e Princípe : proposta de um programa de desenvolvimento profissional

Dissertação apresentada à Escola Superior de Educação de Santarém para obtenção do grau de mestre em Ciências de Educação na especialização de Supervisão e Orientação Pedagógica

Cultural citizenship and its implications for citizenship education: Chinese university students’ civic experience in relation to mass media and the university citizenship curriculum

A growing body of research has argued that university citizenship curricula are inefficient in promoting civic participation, while there is a tendency towards a broader citizenship understanding and new forms of civic engagements and citizenship learning in everyday life. The notion of cultural citizenship in this thesis concentrates on media practices’ relation to civic expression and civic engagement. This research thus argues that not enough attention has been paid to the effects of citizenship education policy on students and students’ active citizenship learning in China. This thesis examines the civic experience of university students in China in the parallel contexts of widespread adoption of mass media and of university citizenship education courses, which have been explicitly mandatory for promoting civic morality education in Chinese universities since 2007. This research project raises significant questions about the meditating influences of these two contexts on students’ perceptions of civic knowledge and civic participation, with particular interest to examine whether and how the notion of cultural citizenship could be applied in the Chinese context and whether it could provide certain implications for citizenship education in China. University students in one university in Beijing contributed to this research by providing both quantitative and qualitative data collected from mixed-methods research. 212 participants contributed to the questionnaire data collection and 12 students took part in interviews. Guided by the theoretical framework of cultural citizenship, a central focus of this study is to explore whether new forms of civic engagement and civic learning and a new direction of citizenship understanding can be identified among university students’ mass media use. The study examines the patterns of students’ mass media use and its relationship to civic participation, and also explores the ways in which mass media shape students and how they interact and perform through the media use. In addition, this study discusses questions about how national context, citizenship tradition and civic education curricula relate to students’ civic perceptions, civic participation and civic motivation in their enactment of cultural citizenship. It thus tries to provide insights and identify problems associated with citizenship courses in Chinese universities. The research finds that Chinese university students can also identify civic issues and engage in civic participation through the influence of mass media, thus indicating the application of cultural citizenship in the wider higher education arena in China. In particular, the findings demonstrate that students’ citizenship knowledge has been influenced by their entertainment experiences with TV programs, social networks and movies. However, the study argues that the full enactment of cultural citizenship in China is conditional with regards to characteristics related to two prerequisites: the quality of participation and the influence of the public sphere in the Chinese context. Most students in the study are found to be inactive civic participants in their everyday lives, especially in political participation. Students express their willingness to take part in civic activities, but they feel constrained by both the current citizenship education curriculum in universities and the strict national policy framework. They mainly choose to accept ideological and political education for the sake of personal development rather than to actively resist it, however, they employ creative ways online to express civic opinions and conduct civic discussion. This can be conceptualised as the cultural dimension of citizenship observed from students who are not passively prescribed by traditional citizenship but who have opportunities to build their own civic understanding in everyday life. These findings lead to the conclusion that the notion of cultural citizenship not only provides a new mode of civic learning for Chinese students but also offers a new direction for configuring citizenship in China. This study enriches the existing global literature on cultural citizenship by providing contemporary evidence from China which is a developing democratic country, as well as offering useful information for Chinese university practitioners, policy makers and citizenship researchers on possible directions for citizenship understanding and citizenship education. In particular, it indicates that it is important for efforts to be made to generate a culture of authentic civic participation for students in the university as well as to promote the development of the public sphere in the community and the country generally.

Utilising presence in places to support mobile interaction

Physical places are given contextual meaning by the objects and people that make up the space. Presence in physical places can be utilised to support mobile interaction by making access to media and notifications on a smartphone easier and more visible to other people. Smartphone interfaces can be extended into the physical world in a meaningful way by anchoring digital content to artefacts, and interactions situated around physical artefacts can provide contextual meaning to private manipulations with a mobile device. Additionally, places themselves are designed to support a set of tasks, and the logical structure of places can be used to organise content on the smartphone. Menus that adapt the functionality of a smartphone can support the user by presenting the tools most likely to be needed just-in-time, so that information needs can be satisfied quickly and with little cognitive effort. Furthermore, places are often shared with people whom the user knows, and the smartphone can facilitate social situations by providing access to content that stimulates conversation. However, the smartphone can disrupt a collaborative environment, by alerting the user with unimportant notifications, or sucking the user in to the digital world with attractive content that is only shown on a private screen. Sharing smartphone content on a situated display creates an inclusive and unobtrusive user experience, and can increase focus on a primary task by allowing content to be read at a glance. Mobile interaction situated around artefacts of personal places is investigated as a way to support users to access content from their smartphone while managing their physical presence. A menu that adapts to personal places is evaluated to reduce the time and effort of app navigation, and coordinating smartphone content on a situated display is found to support social engagement and the negotiation of notifications. Improving the sensing of smartphone users in places is a challenge that is out-with the scope of this thesis. Instead, interaction designers and developers should be provided with low-cost positioning tools that utilise presence in places, and enable quantitative and qualitative data to be collected in user evaluations. Two lightweight positioning tools are developed with the low-cost sensors that are currently available: The Microsoft Kinect depth sensor allows movements of a smartphone user to be tracked in a limited area of a place, and Bluetooth beacons enable the larger context of a place to be detected. Positioning experiments with each sensor are performed to highlight the capabilities and limitations of current sensing techniques for designing interactions with a smartphone. Both tools enable prototypes to be built with a rapid prototyping approach, and mobile interactions can be tested with more advanced sensing techniques as they become available. Sensing technologies are becoming pervasive, and it will soon be possible to perform reliable place detection in-the-wild. Novel interactions that utilise presence in places can support smartphone users by making access to useful functionality easy and more visible to the people who matter most in everyday life.

Aplicação do software EdiLim na sala de atividades em educação pré-escolar

Relatório de Estágio apresentado à Escola Superior de Educação do Instituto Politécnico de Castelo Branco para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Educação Pré-Escolar e Ensino do 1º Ciclo Básico.

Protocolo de roteamento para redes oportunistas utilizando otimização por enxame de partículas

In this research work, a new routing protocol for Opportunistic Networks is presented. The proposed protocol is called PSONET (PSO for Opportunistic Networks) since the proposal uses a hybrid system composed of a Particle Swarm Optimization algorithm (PSO). The main motivation for using the PSO is to take advantage of its search based on individuals and their learning adaptation. The PSONET uses the Particle Swarm Optimization technique to drive the network traffic through of a good subset of forwarders messages. The PSONET analyzes network communication conditions, detecting whether each node has sparse or dense connections and thus make better decisions about routing messages. The PSONET protocol is compared with the Epidemic and PROPHET protocols in three different scenarios of mobility: a mobility model based in activities, which simulates the everyday life of people in their work activities, leisure and rest; a mobility model based on a community of people, which simulates a group of people in their communities, which eventually will contact other people who may or may not be part of your community, to exchange information; and a random mobility pattern, which simulates a scenario divided into communities where people choose a destination at random, and based on the restriction map, move to this destination using the shortest path. The simulation results, obtained through The ONE simulator, show that in scenarios where the mobility model based on a community of people and also where the mobility model is random, the PSONET protocol achieves a higher messages delivery rate and a lower replication messages compared with the Epidemic and PROPHET protocols.

Investigating assistive technology to support memory for people with cognitive impairments

Technologies such as automobiles or mobile phones allow us to perform beyond our physical capabilities and travel faster or communicate over long distances. Technologies such as computers and calculators can also help us perform beyond our mental capabilities by storing and manipulating information that we would be unable to process or remember. In recent years there has been a growing interest in assistive technology for cognition (ATC) which can help people compensate for cognitive impairments. The aim of this thesis was to investigate ATC for memory to help people with memory difficulties which impacts independent functioning during everyday life. Chapter one argues that using both neuropsychological and human computing interaction theory and approaches is crucial when developing and researching ATC. Chapter two describes a systematic review and meta-analysis of studies which tested technology to aid memory for groups with ABI, stroke or degenerative disease. Good evidence was found supporting the efficacy of prompting devices which remind the user about a future intention at a set time. Chapter three looks at the prevalence of technologies and memory aids in current use by people with ABI and dementia and the factors that predicted this use. Pre-morbid use of technology, current use of non-tech aids and strategies and age (ABI group only) were the best predictors of this use. Based on the results, chapter four focuses on mobile phone based reminders for people with ABI. Focus groups were held with people with memory impairments after ABI and ABI caregivers (N=12) which discussed the barriers to uptake of mobile phone based reminding. Thematic analysis revealed six key themes that impact uptake of reminder apps; Perceived Need, Social Acceptability, Experience/Expectation, Desired Content and Functions, Cognitive Accessibility and Sensory/Motor Accessibility. The Perceived need theme described the difficulties with insight, motivation and memory which can prevent people from initially setting reminders on a smartphone. Chapter five investigates the efficacy and acceptability of unsolicited prompts (UPs) from a smartphone app (ForgetMeNot) to encourage people with ABI to set reminders. A single-case experimental design study evaluated use of the app over four weeks by three people with severe ABI living in a post-acute rehabilitation hospital. When six UPs were presented through the day from ForgetMeNot, daily reminder-setting and daily memory task completion increased compared to when using the app without the UPs. Chapter six investigates another barrier from chapter 4 – cognitive and sensory accessibility. A study is reported which shows that an app with ‘decision tree’ interface design (ApplTree) leads to more accurate reminder setting performance with no compromise of speed or independence (amount of guidance required) for people with ABI (n=14) compared to a calendar based interface. Chapter seven investigates the efficacy of a wearable reminding device (smartwatch) as a tool for delivering reminders set on a smartphone. Four community dwelling participants with memory difficulties following ABI were included in an ABA single case experimental design study. Three of the participants successfully used the smartwatch throughout the intervention weeks and these participants gave positive usability ratings. Two participants showed improved memory performance when using the smartwatch and all participants had marked decline in memory performance when the technology was removed. Chapter eight is a discussion which highlights the implications of these results for clinicians, researchers and designers.

Redes sociais no processo de gestão coletiva : o caso dos projetos de assentamento do programa nacional de crédito fundiário no município de Unaí – MG

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Agronomia e Medicina Veterinária, Programa de Pós-Graduação em Agronegócios, 2015.

Cyber foraging for green computing, improving performance and prolonging battery life of mobile devices

The increasing dependency of everyday life on mobile devices also increases the number and complexity of computing tasks to be supported by these devices. However, the inherent requirement of mobility restricts them from being resources rich both in terms of energy (battery capacity) and other computing resources such as processing capacity, memory and other resources. This thesis looks into cyber foraging technique of offloading computing tasks. Various experiments on android mobile devices are carried out to evaluate offloading benefits in terms of sustainability advantage, prolonging battery life and augmenting the performance of mobile devices. This thesis considers two scenarios of cyber foraging namely opportunistic offloading and competitive offloading. These results show that the offloading scenarios are important for both green computing and resource augmentation of mobile devices. A significant advantage in battery life gain and performance enhancement is obtained. Moreover, cyber foraging is proved to be efficient in minimizing energy consumption per computing tasks. The work is based on scavenger cyber foraging system. In addition, the work can be used as a basis for studying cyber foraging and other similar approaches such as mobile cloud/edge computing for internet of things devices and improving the user experiences of applications by minimizing latencies through the use of potential nearby surrogates.

A VOICE OF THEIR OWN: MUSIC AND SOCIAL COHESION IN TURKISH ALEVI LIFE

This dissertation examines the role that music has played in the expression of identity and revitalization of culture of the Alevis in Turkey, since the start of their sociocultural revival movement in the late 1980s. Music is central to Alevi claims of ethnic and religious difference—singing and playing the bağlama (Turkish folk lute) constitutes an expressive practice in worship and everyday life. Based on research conducted from 2012 to 2014, I investigate and present Alevi music through the lens of discourses on the construction of identity as a social and musical process. Alevi musicians perform a revived repertoire of the ritual music and folk songs of Anatolian bards and dervish-lodge poets that developed over several centuries. Contemporary media and performance contexts have blurred former distinctions between sacred and secular, yet have provided new avenues to build community in an urban setting. I compare music performances in the worship services of urban and small-town areas, and other community events such as devotional meetings, concerts, clubs, and broadcast and social media to illustrate the ways that participation—both performing and listening—reinforces identity and solidarity. I also examine the influence of these different contexts on performers’ musical choices, and the power of music to evoke a range of responses and emotional feelings in the participants. Through my investigation I argue that the Alevi music repertoire is not only a cultural practice but also a symbol of power and collective action in their struggle for human rights and self-determination. As Alevis have faced a redefined Turkish nationalism that incorporates Sunni Muslim piety, this music has gained even greater potency in their resistance to misrecognition as a folkloric, rather than a living, tradition.

Los no privilegiados ante la muerte: el caso de Córdoba a finales del siglo XV

Este estudio versa sobre la muerte en Córdoba entre las capas sociales medias y bajas, basándose en el análisis de actas testamentarias de la segunda mitad del siglo XV conservadas en el Archivo Histórico Provincial de Córdoba. Los testamentos permiten conocer cómo sentían, actuaban y reaccionaban estos grupos sociales ante la proximidad de la muerte -tanto propia como ajena-, además de aportar interesantes datos sobre diversos aspectos de su vida cotidiana, tal y como presentamos en este artículo.