811 resultados para Intention to stay
Resumo:
The memoirs were written in 2000 in California and contains some of the author's diary entries during the years of the family's emigration and reminiscences of the author's father. Detailed description of family history going back to the early 19th century. The author's grandfather Moses Stern had a rawproduct business in Gelsenkirchen, Westphalia. His father Max Stern took his graduate exam (Abitur) at the Jacobsohn boarding school in 1904 and was sent to a business school in Brussles, Belgium. Work in the family business M. Stern AG. World War One and rise of the family business with branches throughout Germany and offices in New York, London, Milan and Stockholm. Due to political unrest at the end of the war the business administration moved to Essen. Description of the family background of Beate Herzberg, the author's mother. Courtship of his parents and marriage in 1922. Birth of his sister Annelore in 1923. Martin Stern was born in 1924. Description of the family household and domestic life in a well-to-do family the 1920s. Friday visits to the synagogue and celebration of Jewish holidays. Vacations at the North sea and skiinig in the Alps. Martin attended a Jewish elementary school. Rising National Socialism. After Hitler came to power in 1933 the author's father immediately started preparations for the family's emigration, but was persuaded to stay by his family. Life under National Socialism. Martin attended Gymnasium and was one of only two Jewish students in his class. Antisemitic incidents. Private lessons in piano and Hebrew. Bar Mitzvah in 1937. Recollections of performances of the Kulturbund.
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The book contains an introduction by Paul Weisz and a collection of family letters written during World War II. The letters were written between February 1938 and September 1945. Some were translated into English and complemented by commentary by the editor, Paul Weisz. Paul Weisz' introduction is 10 pages long and serves as a short memoir by itself. He provides a family chronicle, the living circumstances of his family, and his childhood in Vienna. He ends in 1938 when the family was eager to leave Austria. The following years are covered by the various letters he brought together in this book. The authors are cousin Willie, then already in Palestine, his father Samuel, his mother Stephanie, and his sister Ruth. His father and mother fled to Belgium, but were arrested after the beginning of World War II. They were deported to internment camps in France (St. Cyprien). His sister Ruth tried to escape from Austria to Palestine via the Danube. She got stuck in Yugoslavia, and was interned in Sabac internment camp. Paul's mother died in France in 1942, his father was sent to a concentration camp in Poland and murdered. His sister Ruth was murdered in Yugoslavia. Paul was released in Canada, and was enabled to go to college. He later named his children after his family members who did not survive the Nazi terror: Stephanie, Ruth, and Samuel.
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This paper provides a first look at the acceptance of Accountable-eHealth (AeH) systems–a new genre of eHealth systems designed to manage information privacy concerns that hinder the proliferation of eHealth. The underlying concept of AeH systems is appropriate use of information through after-the-fact accountability for intentional misuse of information by healthcare professionals. An online questionnaire survey was utilised for data collection from three educational institutions in Queensland, Australia. A total of 23 hypotheses relating to 9 constructs were tested using a structural equation modelling technique. The moderation effects on the hypotheses were also tested based on six moderation factors to understand their role on the designed research model. A total of 334 valid responses were received. The cohort consisted of medical, nursing and other health related students studying at various levels in both undergraduate and postgraduate courses. Hypothesis testing provided sufficient data to accept 7 hypotheses. The empirical research model developed was capable of predicting 47.3% of healthcare professionals’ perceived intention to use AeH systems. All six moderation factors showed significant influence on the research model. A validation of this model with a wider survey cohort is recommended as a future study.
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The increasing rate of pregnancies in teenagers and the high incident of the infections of sexual transmission (HIV/ AIDS, for example), these are health related issues (and especially the sexual and reproductive health), which have received great attention on the part of investigators and of the public opinion in general. Recently, there has been evidenced that teenagers carry out very easily risk sexual behaviors, and those who have not presented the above mentioned behaviors also show high levels of intention to carry out them. There is the hypothesis that besides cognitive variables such as attitudes, subjective norms, perceived behavioral control and intention, the personality of the young persons is an aspect that plays an important paper in their sexual and reproductive health. Significant correlations were found between the variales of the TPB and the personality traits; the results suggest that the direction of these correlations is associated with the specific type of behavior or situation that is assessed. Keywords: personality, theory of planned behavior, adolescents, reproductive sexuality.
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This collection is mainly composed of correspondence between Ms. Stern and Mrs. Roosevelt, spanning the years from their first acquaintance in 1941 to Mrs. Roosevelt's decease in 1962. Letters that hold particular interest concern Ms. Stern's experience at the Summer Student Leadership Institute, and the White House. Additional material in the collection encompasses articles, newsclippings, programs, press releases, and photographs. The articles and newsclippings folder contains information pertaining to Ms. Stern's college career, the first Summer Student Leadership Institute, Mrs. Roosevelt's talk at Community Day, National Youth Association, and a donation of an ambulance to the war effort by Hunter college students. Naomi Block Manners Stern personal folder contains an article Naomi Block wrote in her college magazine, "Echo," describing her perceptions of President Roosevelt and Prime Minister Winston Churchill during her first visit at the White House. Also included is her graduation program, listing Mrs. Roosevelt as the main speaker, a commemoration of President Roosevelt in 1972 in which Ms. Stern took part, an article and press release describing Ms. Stern's career at Revlon, and a 2003 written summary of Ms. Stern's relationship with Mrs. Roosevelt. Photographs were taken by Naomi Block and others at the Summer Leadership Institute in 1941 portray identified fellow students, Mrs. Roosevelt, James Roosevelt, the Roosevelt home in Campobello, and Felix Frankfurter.
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Background: The development of a horse vaccine against Hendra virus has been hailed as a good example of a One Health approach to the control of human disease. Although there is little doubt that this is true, it is clear from the underwhelming uptake of the vaccine by horse owners to date (approximately 10%) that realisation of a One Health approach requires more than just a scientific solution. As emerging infectious diseases may often be linked to the development and implementation of novel vaccines this presentation will discuss factors influencing their uptake; using Hendra virus in Australia as a case study. Methods: This presentation will draw on data collected from the Horse owners and Hendra virus: A Longitudinal cohort study To Evaluate Risk (HHALTER) study. The HHALTER study is a mixed methods research study comprising a two-year survey-based longitudinal cohort study and qualitative interview study with horse owners in Australia. The HHALTER study has investigated and tracked changes in a broad range of issues around early uptake of vaccination, horse owner uptake of other recommended disease risk mitigation strategies, and attitudes to government policy and disease response. Interviews provide further insights into attitudes towards risk and decision-making in relation to vaccine uptake. A combination of quantitative and qualitative data analysis will be reported. Results: Data collected from more than 1100 horse owners shortly after vaccine introduction indicated that vaccine uptake and intention to vaccinate was associated with a number of risk perception factors and financial cost factors. In addition, concerns about side effects and veterinarians refusing to treat unvaccinated horses were linked to uptake. Across the study period vaccine uptake in the study cohort increased to more than 50%, however, concerns around side effects, equine performance and breeding impacts, delays to full vaccine approvals, and attempts to mandate vaccination by horse associations and event organisers have all impacted acceptance. Conclusion: Despite being provided with a safe and effective vaccine for Hendra virus that can protect horses and break the transmission cycle of the virus to humans, Australian horse owners have been reluctant to commit to it. General issues pertinent to novel vaccines, combined with challenges in the implementation of the vaccine have led to issues of mistrust and misconception with some horse owners. Moreover, factors such as cost, booster dose schedules, complexities around perceived risk, and ulterior motives attributed to veterinarians have only served to polarise attitudes to vaccine acceptance.
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The research goal was to clarify how ministers in the Evangelical Lutheran Church of Finland construct their identities when they confront family and sexual issues, particularly as seen in their narrations about their work and the factors that influence their ways of working. The approach was a narrative one placing the emphases was on the internal story. The research material consisted of interviews of 19 ministers and the written biographies of 3 ministers who had also been interviewed. The data was analysed narratively (analysis of the narrations and a narrative analysis). The life stories were classified on the basis of the logic in each, and five different internal story types were created: the persons on the road to recovery, those within safe boundaries, those who had learnt to be critical, those with an obligation to help, and those who had grown to be open. In all of the story types was evidented a conflict between the ministry of the Church and the way it was adapted to the lives of individuals experiencing family and sexual issues. On one hand, this was a source of stress at work, but on the other, it offered a chance to create new images of ministers struggling with family and sexual issues. Life experience was found to be important when the study subjects interpreted and dealt with family and sexual issues. Those on the road to recovery felt that becoming a Christian and the personal recovery that faith had made possible had a significant impact on their personal lives. This healing effect of faith was also a strengthening factor for them when they dealt with family and sexual issues. Typically, they approached work situations by taking into account their faith and the type of psychological knowledge that was acceptable within the boundaries set by it. Those within safe boundaries worked within the limits prescribed by the revivalist movement that they had grown up in, from their childhood onwards, and their experiences in adulthood had even strengthened their commitment to the movement. Typically, they were keen to proclaim the views of the movement in public, but they were also prone to stay silent if and when felt those views would cause an uproar. Those who had learnt to be critical had previously been holistically committed to the views expressed by the Church in family and sexual matters. It was their experiences in life that had led them into conflict with the teachings of the Church. Their approach to work was one of ambivalence resulting from a conflict between their current and previous views, which was further exacerbated by their irresolution concerning how a minister should act in these situations. Those with an obligation to help questioned the church teachings marriage as the only family ideal. When they met various kinds of families and sexual identities, and also when they adopted the identity of a helper, the foundation of their ministerial identity was the Two Commandments of Love. Their work was burdened, however, by a fear of how the Church and the parishioners would take their teaching. Those who had grown to be open were more sure of themselves than the other groups. Years in the ministry as well as life-long experience had made them into persons who were following paths of their own. Openly critical of the views on family and sexual issues proclaimed by the Church, they were keen to present their personal convictions and were able to defend these publicly when necessary. Search words: Narrative research, internal story, minister, church, family, sexuality.
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This study of the Finns at the International Lenin School (ILS) reflects history of the Soviet Union during Stalin's era, history of the Communist International (Comintern) as well as history of Finnish communism. The life span of the ILS (1926-1938) matches up with creating and establishing the power structures of Stalinism. Both the ILS and Finnish Communism in the USSR became casualties of the Great Terror (1937-1938). After the WW2, however, the Soviet education was appreciated inside the Communist Party of Finland (CPF). If Finland would have become People's Democracy, the former ILS students would have composed the inner circle of the new "democratic" government. The Finnish teachers of the ILS were leaders of the CPF that was headquartered in Moscow. At the ILS studied in total 141 Finnish communists. The purpose of the ILS was to educate the communist parties' leading stratum of functionaries. They were supposed to internalize current values, methods and discipline of the Bolsheviks. This study evaluates the effects of the total school experience on the Finns that often ended in another total institution in Finland: prison. The curricula of the ILS consisted of theory of Marxism-Leninism, party history, political economics and themes of campaigns of Stalinism. The ILS year included participation in Bolshevik party life and practical work. During summer excursions (praktikas) the students could acquaint themselves with building of socialism in the Soviet Republics. At the ILS, intention to ideological moulding was not hidden. The students were supposed to adopt the Stalinist identity of the professional revolutionaries of the era. The ILS was saturated with ideology and propaganda. This study analyzes especially uses of history as vehicle of ideological standardisation and as instrument of power. Stalin contributed personally to shortcomings of history writing of the communist party. Later he supervised writing of the inclusive handbook of communism, "History of the All-Union Communist Party. Short Course". Special attention will be paid to the effects of Stalin's intervention at the ILS and inside the CPF. The life of the Finns at the ILS and outside the school is described at grass roots. The dividing line between personal and political is analyzed by charting emotional, intimate and bodily experiences of the Finns of the ILS. The fates of the ILS Finns after the studying or teaching period in Moscow are explored in detail. The protagonist among the teachers is Yrjö Sirola that was called "father of the CPF cadres". The Finnish ILS teachers and the formed students that had remained in the USSR were most severely hit by the Great Terror. The Soviet education had most importance in Finland of post WW2 period. The training at the ILS, however, did not contribute to revolution in Finland. The main heading of the study, "A Short Course of Stalinism", crystallises interpretation of the ILS as seat of learning of ideological unity of Stalinism. On the other hand, the title includes a statement of incompleteness of the Stalinist education if the schooling at the ILS had remained in one year.
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BACKGROUND Negative donation experiences, including vasovagal reactions, deter donor retention. However, whether this deterrence effect varies as a function of whole blood (WB) donation history and requests to donate the same or a different product remains unclear. STUDY DESIGN AND METHODS The responses of 894 eligible WB donors who had been approached to convert to plasmapheresis and 954 eligible first-time plasmapheresis donors who had been surveyed on their last donation experience and their intention to donate plasma were considered. This information was matched with individual vasovagal reaction records, deferral category, WB donation history, and subsequent donation behavioral data obtained from the blood collection agency. RESULTS Path analysis indicated that the application of a deferral and an officially recorded vasovagal reaction decreased donors' intentions to continue plasmapheresis donation, but had no effect on WB donors' intentions to convert to plasmapheresis. Consistent with past findings, vasovagal reactions occurred more frequently with female and inexperienced donors. CONCLUSION Experiencing vasovagal reactions and deferrals may not universally deter donors from continuing to donate. Rather, the offer to convert to another form of donation—in this instance, plasmapheresis—after experiencing a negative donation event while donating WB may be sufficient to eliminate the deterrence effect on retention.
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High luminance contrast between windows and surrounding surfaces could cause discomfort glare, which could reduce office workers’ productivity. It might also increase energy usage of buildings due to occupants’ interventions in lighting conditions to improve indoor visual quality. It is presumed that increasing the luminance of the areas surrounding the windows using a supplementary system, such Light Emitting Diodes (LEDs), could reduce discomfort glare. This paper reports on the results of a pilot study in a conventional office in Brisbane, Australia. The outcomes of this study indicated that a supplementary LED system could reduce the luminance contrast on the window wall from values in the order of 24:1 to 12:1. The results suggest that this reduction could significantly reduce discomfort glare from windows, as well as diminishing the likelihood of users’ intention to turn on the ceiling lights and/ or to move the blind down.
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Frictional performance of molybdenum disulfide (MoS2) particles sprayed on a substrate is investigated in a ball-on-disc tribometer. The ability of large (similar to 2 mu m) and small (similar to 50 nm) particles to generate low-friction transfer film is investigated with a view to elucidate the requirement for film formation. Particle migration, particle stability in the contact region, oxidation potential, and particle adhesion to the substrate are explored within a span of operating parametersp; normal load, and sliding velocity. It is found that the larger particles are able to migrate to the contact to raise a homogeneous but nonuniform low-friction transfer film that flows plastically to yield large contact areas, which aid in wear protection. Within the present load and speed range, the inability of small particles to stay in the contact region and undergo basal slip militates against the formation of a low-friction transfer film.
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Background: Helicobacter pylori infection is usually acquired in early childhood and is rarely resolved spontaneously. Eradication therapy is currently recommended virtually to all patients. While the first and second therapies are prescribed without knowing the antibiotic resistance of the bacteria, it is important to know the primary resistance in the population. Aim: This study evaluates the primary resistance of H. pylori among patients in primary health care throughout Finland, the efficacy of three eradication regimens, the symptomatic response to successful therapy, and the effect of smoking on gastric histology and humoral response in H. pylori-positive patients. Patients and methods: A total of 23 endoscopy referral centres located throughout Finland recruited 342 adult patients with positive rapid urease test results, who were referred to upper gastrointestinal endoscopy from primary health care. Gastric histology, H. pylori resistance and H. pylori serology were evaluated. The patients were randomized to receive a seven-day regimen, comprising 1) lansoprazole 30 mg b.d., amoxicillin 1 g b.d. and metronidazole 400 mg t.d. (LAM), 2) lansoprazole 30 mg b.d., amoxicillin 1 g b.d. and clarithromycin 500 mg b.d. (LAC) or 3) ranitidine bismuth citrate 400 mg b.d., metronidazole 400 mg t.d. and tetracycline 500 mg q.d. (RMT). The eradication results were assessed, using the 13C-urea breath test 4 weeks after therapy. The patients completed a symptom questionnaire before and a year after the therapy. Results: Primary resistance of H. pylori to metronidazole was 48% among women and 25% among men. In women, metronidazole resistance correlated with previous use of antibiotics for gynaecologic infections and alcohol consumption. Resistance rate to clarithromycin was only 2%. Intention-to-treat cure rates of LAM, LAC, and RMT were 78%, 91% and 81%. While in metronidazole-sensitive cases the cure rates with LAM, LAC and RMT were similar, in metronidazole resistance LAM and RMT were inferior to LAC (53%, 67% and 84%). Previous antibiotic therapies reduced the efficacy of LAC, to the level of RMT. Dyspeptic symptoms in the Gastrointestinal Symptoms Rating Scale (GSRS) were decreased by 30.5%. In logistic regression analysis, duodenal ulcer, gastric antral neutrophilic inflammation and age from 50 to 59 years independently predicted greater decrease in dyspeptic symptoms. In the gastric body, smokers had milder inflammation and less atrophy and in the antrum denser H. pylori load. Smokers also had lower IgG antibody titres against H. pylori and a smaller proportional decrease in antibodies after successful eradication. Smoking tripled the risk of duodenal ulcers. Conclusions: in Finland H. pylori resistance to clarithromycin is low, but metronidazole resistance among women is high making metronidazole-based therapies unfavourable. Thus, LAC is the best choice for first-line eradication therapy. The effect of eradication on dyspeptic symptoms was only modest. Smoking slows the progression of atrophy in the gastric body.
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Exercise that targets ankle joint mobility may lead to improvement in calf muscle pump function and subsequent healing. The objectives of this research were to assess the impact of an exercise intervention in addition to routine evidence-based care on the healing rates, functional ability and health-related quality of life for adults with venous leg ulcers (VLUs). This study included 63 patients with VLUs. Patients were randomised to receive either a 12-week exercise intervention with a telephone coaching component or usual care plus telephone calls at the same timepoints. The primary outcome evaluated the effectiveness of the intervention in relation to wound healing. The secondary outcomes evaluated physical activity, functional ability and health-related quality of life measures between groups at the end of the 12 weeks. A per protocol analysis complemented the effectiveness (intention-to-treat) analysis to highlight the importance of adherence to an exercise intervention. Intention-to-treat analyses for the primary outcome showed 77% of those in the intervention group healed by 12 weeks compared to 53% of those in the usual care group. Although this difference was not statistically significant due to a smaller than expected sample size, a 24% difference in healing rates could be considered clinically significant. The per protocol analysis for wound healing, however, showed that those in the intervention group who adhered to the exercise protocol 75% or more of the time were significantly more likely to heal and showed higher rates for wound healing than the control group (P = 0·01), that is, 95% of those who adhered in the intervention group healed in 12 weeks. The secondary outcomes of physical activity, functional ability and health-related quality of life were not significantly altered by the intervention. Among the secondary outcomes (physical activity, functional ability and health-related quality of life), intention-to-treat analyses did not support the effectiveness of the intervention. However, per protocol analyses revealed encouraging results with those participants who adhered more than 75% of the time (n = 19) showing significantly improved Range of Ankle Motion from the self-management exercise programme (P = 0·045). This study has shown that those participants who adhere to the exercise programme as an adjunctive treatment to standard care are more likely to heal and have better functional outcomes than those who do not adhere to the exercises in conjunction with usual care.
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Driver fatigue has received increased attention during recent years and is now considered to be a major contributor to approximately 15–30% of all crashes. However, little is known about fatigue in city bus drivers. It is hypothesized that city bus drivers suffer from sleepiness, which is due to a combination of working conditions, lack of health and reduced sleep quantity and quality. The overall aim with the current study is to investigate if severe driver sleepiness, as indicated by subjective reports of having to fight sleep while driving, is a problem for city based bus drivers in Sweden and if so, to identify the determinants related to working conditions, health and sleep which contribute towards this. The results indicate that driver sleepiness is a problem for city bus drivers, with 19% having to fight to stay awake while driving the bus 2–3 times each week or more and nearly half experiencing this at least 2–4 times per month. In conclusion, severe sleepiness, as indicated by having to fight sleep during driving, was common among the city bus drivers. Severe sleepiness correlated with fatigue related safety risks, such as near crashes.
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Background The irreversible ErbB family blocker afatinib and the reversible EGFR tyrosine kinase inhibitor gefitinib are approved for first-line treatment of EGFR mutation-positive non-small-cell lung cancer (NSCLC). We aimed to compare the efficacy and safety of afatinib and gefitinib in this setting. Methods This multicentre, international, open-label, exploratory, randomised controlled phase 2B trial (LUX-Lung 7) was done at 64 centres in 13 countries. Treatment-naive patients with stage IIIB or IV NSCLC and a common EGFR mutation (exon 19 deletion or Leu858Arg) were randomly assigned (1:1) to receive afatinib (40 mg per day) or gefitinib (250 mg per day) until disease progression, or beyond if deemed beneficial by the investigator. Randomisation, stratified by EGFR mutation type and status of brain metastases, was done centrally using a validated number generating system implemented via an interactive voice or web-based response system with a block size of four. Clinicians and patients were not masked to treatment allocation; independent review of tumour response was done in a blinded manner. Coprimary endpoints were progression-free survival by independent central review, time-to-treatment failure, and overall survival. Efficacy analyses were done in the intention-to-treat population and safety analyses were done in patients who received at least one dose of study drug. This ongoing study is registered with ClinicalTrials.gov, number NCT01466660. Findings Between Dec 13, 2011, and Aug 8, 2013, 319 patients were randomly assigned (160 to afatinib and 159 to gefitinib). Median follow-up was 27·3 months (IQR 15·3–33·9). Progression-free survival (median 11·0 months [95% CI 10·6–12·9] with afatinib vs 10·9 months [9·1–11·5] with gefitinib; hazard ratio [HR] 0·73 [95% CI 0·57–0·95], p=0·017) and time-to-treatment failure (median 13·7 months [95% CI 11·9–15·0] with afatinib vs 11·5 months [10·1–13·1] with gefitinib; HR 0·73 [95% CI 0·58–0·92], p=0·0073) were significantly longer with afatinib than with gefitinib. Overall survival data are not mature. The most common treatment-related grade 3 or 4 adverse events were diarrhoea (20 [13%] of 160 patients given afatinib vs two [1%] of 159 given gefitinib) and rash or acne (15 [9%] patients given afatinib vs five [3%] of those given gefitinib) and liver enzyme elevations (no patients given afatinib vs 14 [9%] of those given gefitinib). Serious treatment-related adverse events occurred in 17 (11%) patients in the afatinib group and seven (4%) in the gefitinib group. Ten (6%) patients in each group discontinued treatment due to drug-related adverse events. 15 (9%) fatal adverse events occurred in the afatinib group and ten (6%) in the gefitinib group. All but one of these deaths were considered unrelated to treatment; one patient in the gefitinib group died from drug-related hepatic and renal failure. Interpretation Afatinib significantly improved outcomes in treatment-naive patients with EGFR-mutated NSCLC compared with gefitinib, with a manageable tolerability profile. These data are potentially important for clinical decision making in this patient population.