Public perceptions of personalised nutrition through the lens of Social Cognitive Theory

Social Cognitive Theory has been used to explain findings derived from focus group discussions (N = 4) held in the United Kingdom with the aim of informing best practice in personalised nutrition. Positive expectancies included weight loss and negative expectancies surrounded on-line security. Monitoring and feedback were crucial to goal setting and progress. Coaching by the service provider, family and friends was deemed important for self-efficacy. Paying for personalised nutrition symbolised commitment to behaviour change. The social context of eating, however, was perceived a problem and should be considered when designing personalised diets. Social Cognitive Theory could provide an effective framework through which to deliver personalised nutrition.

Measuring healthcare integration: Operationalization of a framework for a systems evaluation of palliative care structures, processes, and outcomes

BACKGROUND: Healthcare integration is a priority in many countries, yet there remains little direction on how to systematically evaluate this construct to inform further development. The examination of community-based palliative care networks provides an ideal opportunity for the advancement of integration measures, in consideration of how fundamental provider cohesion is to effective care at end of life.

AIM: This article presents a variable-oriented analysis from a theory-based case study of a palliative care network to help bridge the knowledge gap in integration measurement.

DESIGN: Data from a mixed-methods case study were mapped to a conceptual framework for evaluating integrated palliative care and a visual array depicting the extent of key factors in the represented palliative care network was formulated.

SETTING/PARTICIPANTS: The study included data from 21 palliative care network administrators, 86 healthcare professionals, and 111 family caregivers, all from an established palliative care network in Ontario, Canada.

RESULTS: The framework used to guide this research proved useful in assessing qualities of integration and functioning in the palliative care network. The resulting visual array of elements illustrates that while this network performed relatively well at the multiple levels considered, room for improvement exists, particularly in terms of interventions that could facilitate the sharing of information.

CONCLUSION: This study, along with the other evaluative examples mentioned, represents important initial attempts at empirically and comprehensively examining network-integrated palliative care and healthcare integration in general.

Initiating advance care planning on end-of-life issues in dementia: Ambiguity among UK and Dutch physicians

Background
In dementia, advance care planning (ACP) of end-of-life issues may start as early as possible in view of the patient’s decreasing ability to participate in decision making. We aimed to assess whether practicing physicians in the Netherlands and the United Kingdom who provide most of the end-of-life care, differ in finding that ACP in dementia should start at diagnosis.

Methods
In a cross-sectional study, we surveyed 188 Dutch elderly care physicians who are on the staff of nursing homes and 133 general practitioners from Northern Ireland. We compared difference by country in the outcome (perception of ACP timing), rated on a 1–5 agreement scale. Regression analyses examined whether a country difference can be explained by contrasts in demographics, presence, exposure and role perceptions.

Results
There was wide variability in agreement with the initiation of ACP at dementia diagnosis, in particular in the UK but also in the Netherlands (60.8% agreed, 25.3% disagreed and 14.0% neither agreed, nor disagreed). Large differences in physician characteristics (Dutch physicians being more present, exposed and adopting a stronger role perception) hardly explained the modest country difference. The perception that the physician should take the initiative was independently associated with agreeing with ACP at diagnosis.

Conclusions
There is considerable ambiguity about initiating ACP in dementia at diagnosis among physicians practicing in two different European health care systems and caring for different patient populations. ACP strategies should accommodate not only variations in readiness to engage in ACP early among patient and families, but also among physicians.

Satellite DNA as a target for TaqMan real-time PCR detection of the pinewood nematode, Bursaphelenchus xylophilus

The pinewood nematode (PWN), Bursaphelenchus xylophilus , is a major pathogen of conifers, which impacts on forest health, natural ecosystem stability and international trade. As a consequence, it has been listed as a quarantine organism in Europe. A real-time PCR approach based on TaqMan chemistry was developed to detect this organism. Specific probe and primers were designed based on the sequence of the Msp I satellite DNA family previously characterized in the genome of the nematode. The method proved to be specific in tests with target DNA from PWN isolates from worldwide origin. From a practical point of view, detection limit was 1 pg of target DNA or one individual nematode. In addition, PWN genomic DNA or single individuals were positively detected in mixed samples in which B. xylophilius was associated with the closely related non-pathogenic species B. mucronatus , up to the limit of 0.01% or 1% of the mixture, respectively. The real-time PCR assay was also used in conjunction with a simple DNA extraction method to detect PWN directly in artificially infested wood samples. These results demonstrate the potential of this assay to provide rapid, accurate and sensitive molecular identification of the PWN in relation to pest risk assessment in the field and quarantine regulation.

Proyecto de viabilidad para el diseño e implementación de una empresa consultora en el área administrativa y económico - financiera en la ciudad de Quito.

El presente estudio permite conocer las diferentes etapas que debe seguir un proyecto de Consultoría para conocer su viabilidad, en el mercado del Distrito Metropolitano de Quito, internándose en un proyecto de prestación de servicios. Un servicio de consultoría favorece el desempeño de las compañías, debido a la asesoría que brinda y a la solución de diversos problemas que se presentan. Por lo que este servicio se ha tornado cada vez más indispensable en el país; es por ello que el número de empresas consultoras ha aumentado en los últimos años. Sin embargo como se analizará en el Estudio de Mercado, un elevado porcentaje de empresas no recurre a este tipo de servicios. En el Capítulo I, que amplía esta información, se realiza un diagnóstico de la situación actual, tanto de oferta como demanda de los servicios de consultoría en la Ciudad de Quito, analizando primero el mercado en general para luego poder conocer en qué tipo de mercado se sitúa el presente proyecto. Posteriormente se estudia al servicio desde un aspecto general, para proceder a analizar la Oferta y Demanda, determinando de esta manera la demanda insatisfecha de servicios de consultoría en el DMQ. Finalizando este capítulo con el estudio y determinación de precios para la prestación del servicio. Todo este análisis es el punto de partida para conocer la viabilidad del proyecto de consultoría.

Creación de la Microempresa Procesadora de Flores inmortalizadas en la Parroquia el Quinche y su comercialización en la zona norte de Quito

El Ecuador es un país privilegiado que ocupa uno de los primeros lugares en el mundo por la calidad y la gran variedad de sus flores, la utilización de mano de obra calificada y la habilidad de manejar costos de producción más bajos que los de la competencia. La producción florícola en el Ecuador es la actividad exportable que mayor dinamismo y repunte ha alcanzado en los últimos 10 años, en virtud de los factores favorables ya mencionados que han permitido su desarrollo en un medio competitivo. Los empresarios deben reforzar sus factores para de esta forma enfrentar con éxito el creciente comercio internacional de estos productos. La situación actual, estructura e importancia de este sector dentro de la economía nacional, los mercados de destino y los potenciales para la comercialización contribuyen al mantenimiento y consolidación de la ventaja competitiva en la producción de flores.

Velhice na cultura contemporânea: um estudo sobre a perda emocional profunda

A velhice é uma etapa da vida marcada por múltiplas perdas simbólicas e/ou concretas que, embora se apresentem inelutáveis e façam parte integrante do ciclo da vida, são, para o sujeito que as vivencia, experiências penosas que obrigam a novas formas de existir. As sociedades contemporâneas, sociedades hedonistas onde a morte é tabu e o tempo um bem precioso, condicionam amplamente a forma como as pessoas idosas, especialmente as institucionalizadas, lidam com a perda, uma vez que este processo implica a aceitação de uma nova vida e a (re)estruturação da identidade própria. Não alheias ao condicionamento social, a cultura e as mundividências culturais afetam, de forma decisiva, o modo como a adaptação à perda decorre na quotidianidade das instituições de acolhimento para pessoas idosas. A presente investigação, elaborada no âmbito dos Estudos Culturais, assume um carácter qualitativo, com contornos etnográficos, e analisa 15 “mini-histórias” de vida de indivíduos com mais de 75 anos de idade, residentes em estruturas residenciais, e que sofreram uma perda emocional profunda por morte do cônjuge, já na idade adulta avançada. Num momento em que a institucionalização permanente em estruturas de acolhimento é uma das respostas sociais mais utilizadas pelos indivíduos idosos e suas famílias, procuramos, com este estudo, conhecer as condições críticas presentes na interiorização de um perfil adaptativo ou não adaptativo à perda e que, consequentemente, condicionam a forma como se mobilizam as respostas adaptativas na (re)composição do quotidiano do sujeito idoso enlutado.

Choosing the Right Promotional Tool in the Hotel Industry: The Case of the Chinese Consumer.

The rapid growth of the Chinese tourism has stimulated competition within tourism-related industries, such as the hospitality industry. The purpose of this study is to examine the Chinese consumer reaction to different promotional tools used by hotels in China and, thus, to provide a deeper understanding for marketers of how to use sales promotion effectively to generate appropriate consumer responses. An experimental survey was administered yielding a total sample of 319 Chinese customers, who were probed using different types of sales promotion tools. Data analysis indicates that bonus packs (e.g. a 3-night stay at a hotel for the price of 2) induced the highest consumer perceived value, brand switching, and purchase acceleration intention, whereas price discounts resulted in the highest intention to spend more. Although this study has its limitations given its reliance on a convenience sample, it offers insightful practical implications for hotel business owners in Asia regarding targeting the right customers with the right promotional tools, where it is proposed that bonus packs successfully attract new Chinese customers and price discounts support in generating more sales.

A Doctoral Concert Featuring Compositions by Brad Sherman,June 9, 1999

A Doctoral Concert Featuring Compositions by Brad Sherman, June 9, 1999

Desenvolvimento de um modelo para a gestão de stocks no grupo Nors

Hoje em dia, um dos grandes objetivos das empresas é conseguirem uma gestão eficiente. Em particular, empresas que lidam com grandes volumes de stocks têm a necessidade de otimizar as quantidades dos seus produtos armazenados, com o objetivo, de entre outros, reduzir os seus custos associados. O trabalho documentado descreve um novo modelo, desenvolvido para a gestão de encomendas de uma empresa líder em soluções de transporte. A eficiência do modelo foi alcançada com a utilização de vários métodos matemáticos de previsão. Salientam-se os métodos de Croston, Teunter e de Syntetos e Boylan adequados para artigos com procuras intermitentes e a utilização de métodos mais tradicionais, tais como médias móveis ou alisamento exponencial. Os conceitos de lead time, stock de segurança, ponto de encomenda e quantidade económica a encomendar foram explorados e serviram de suporte ao modelo desenvolvido. O stock de segurança recebeu especial atenção. Foi estabelecida uma nova fórmula de cálculo em conformidade com as necessidades reais da empresa. A eficiência do modelo foi testada com o acompanhamento da evolução do stock real. Para além de uma redução significativa do valor dos stocks armazenados, a viabilidade do modelo é reflectida pelo nível de serviço alcançado.

Tracking the source of cerebellar epilepsy: hemifacial seizures associated with cerebellar cortical dysplasia.

Traditionally, subcortical structures such as the cerebellum are supposed to exert a modulatory effect on epileptic seizures, rather than being the primary seizure generator. We report a 14-month old girl presenting, since birth, with seizures symptomatic of a right cerebellar dysplasia, manifested as paroxystic contralateral hemifacial spasm and ipsilateral facial weakness. Multimodal imaging was used to investigate both anatomical landmarks related to the cerebellar lesion and mechanisms underlying seizure generation. Electric source imaging (ESI) supported the hypothesis of a right cerebellar epileptogenic generator in concordance with nuclear imaging findings; subsequently validated by intra-operative intralesional recordings. Diffusion spectrum imaging-related tractography (DSI) showed severe cerebellar structural abnormalities confirmed by histological examination. We suggest that hemispheric cerebellar lesions in cases like this are likely to cause epilepsy via an effect on the facial nuclei through ipsilateral and contralateral aberrant connections.

Discovery and fine mapping of serum protein loci through transethnic meta-analysis.

Many disorders are associated with altered serum protein concentrations, including malnutrition, cancer, and cardiovascular, kidney, and inflammatory diseases. Although these protein concentrations are highly heritable, relatively little is known about their underlying genetic determinants. Through transethnic meta-analysis of European-ancestry and Japanese genome-wide association studies, we identified six loci at genome-wide significance (p < 5 × 10(-8)) for serum albumin (HPN-SCN1B, GCKR-FNDC4, SERPINF2-WDR81, TNFRSF11A-ZCCHC2, FRMD5-WDR76, and RPS11-FCGRT, in up to 53,190 European-ancestry and 9,380 Japanese individuals) and three loci for total protein (TNFRS13B, 6q21.3, and ELL2, in up to 25,539 European-ancestry and 10,168 Japanese individuals). We observed little evidence of heterogeneity in allelic effects at these loci between groups of European and Japanese ancestry but obtained substantial improvements in the resolution of fine mapping of potential causal variants by leveraging transethnic differences in the distribution of linkage disequilibrium. We demonstrated a functional role for the most strongly associated serum albumin locus, HPN, for which Hpn knockout mice manifest low plasma albumin concentrations. Other loci associated with serum albumin harbor genes related to ribosome function, protein translation, and proteasomal degradation, whereas those associated with serum total protein include genes related to immune function. Our results highlight the advantages of transethnic meta-analysis for the discovery and fine mapping of complex trait loci and have provided initial insights into the underlying genetic architecture of serum protein concentrations and their association with human disease.

Var går gränsen? : vårdnadshavares uppfattning om lärares ansvarsområden.

Syftet med denna avhandling är att undersöka vårdnadshavares uppfattning om lärares ansvarsområden utöver undervisning. Ansvarsområdena som undersökts har namngetts tillgänglighet, fostran och lärares externa uppgifter. Med tillgänglighet avses kontakten mellan hem och skola, med fostran avses hemmets respektive skolans ansvar för fostran och med lärares externa uppgifter avses uppgifter som lärare har trots att uppgifterna enligt lag inte är en del av läraruppdraget. Skillnader i vårdnadshavares uppfattning har analyserats utgående från vårdnadshavares utbildningsgrad och familjesituation. Utgående från avhandlingens syfte har följande forskningsfrågor utformats: 1. Vad är vårdnadshavares uppfattning om ansvarområdena tillgänglighet, fostran och lärares externa uppgifter? 2. Hurdana skillnader finns det i vårdnadshavares uppfattning om lärares ansvarsområden utgående från vårdnadshavares utbildningsgrad? 3. Hurdana skillnader finns det i vårdnadshavares uppfattning om lärares ansvarsområden utgående från vårdnadshavares familjesituation? För att besvara ovanstående forskningsfrågor användes webbenkät som datainsamlingsmetod, vilket innebär att undersökningen är kvantitativ. Undersökningen har även kvalitativa inslag på grund av ett fåtal öppna frågor i webbenkäten. Forskningsansatsen är positivistisk. För att analysera materialet gjordes envägs variansanalys (one-way ANOVA) och engrupps t-test i statistikprogrammet SPSS. Respondenterna för undersökningen är vårdnadshavare till elever i årskurs tre och fyra i svenskspråkiga skolor från tre städer i Svenskfinland. Det totala antalet respondenter i undersökningen är 79. Resultatet visar att vårdnadshavarna uppfattar ansvarsområdet tillgänglighet vara mindre viktigt än det neutrala mittenvärdet samt att ansvaret för fostran och externa uppgifter inte enbart är lärarens. Vid analys av ansvarsområdena utgående från utbildningsgrad visar endast resultatet för analysen av ansvarsområdet tillgänglighet på signifikanta skillnader. Skillnaden kan ses mellan vårdnadshavarna med examen på andra stadiet respektive universitetsexamen. Resultatet visar dock att vårdnadshavarna med examen på andra stadiet anser att lärare har större ansvar för både fostran och externa uppgifter jämfört med vad vårdnadshavarna med yrkeshögskoleexamen respektive universitetsexamen gjorde. Vid analys av ansvarsområdena utgående från familjesituation visar resultatet inga signifikanta skillnader. Resultaten visar dock att vårdnadshavarna med äldre barn som går eller har gått i grundskolan anser att lärare har större ansvar för fostran jämfört med vad vårdnadshavarna vars barn är det första i grundskolan anser. Vid motsvarande analys av externa uppgifter anser vårdnadshavarna vars barn är det första i grundskolan att lärare har större ansvar.