927 resultados para Vischer, Peter, the younger, -1528.


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Global climate changes during the Quaternary reveal much about broader evolutionary effects of environmental change. Detailed regional studies reveal how evolutionary lineages and novel communities and ecosystems, emerge through glacial bottlenecks or from refugia. There have been significant advances in benthic imaging and dating, particularly with respect to the movements of the British (Scottish) and Irish ice sheets and associated changes in sea level during and after the Last Glacial Maximum (LGM). Ireland has been isolated as an island for approximately twice as long as Britain with no evidence of any substantial, enduring land bridge between these islands after ca 15 kya. Recent biogeographical studies show that Britain's mammal community is akin to those of southern parts of Scandinavia, The Netherlands and Belgium, but the much lower mammal species richness of Ireland is unique and needs explanation. Here, we consider physiographic, archaeological, phylogeographical i.e. molecular genetic, and biological evidence comprising ecological, behavioural and morphological data, to review how mammal species recolonized western Europe after the LGM with emphasis on Britain and, in particular, Ireland. We focus on why these close neighbours had such different mammal fauna in the early Holocene, the stability of ecosystems after LGM subject to climate change and later species introductions.

There is general concordance of archaeological and molecular genetic evidence where data allow some insight into history after the LGM. Phylogeography reveals the process of recolonization, e.g. with respect to source of colonizers and anthropogenic influence, whilst archaeological data reveal timing more precisely through carbon dating and stratigraphy. More representative samples and improved calibration of the ‘molecular clock’ will lead to further insights with regards to the influence of successive glaciations. Species showing greatest morphological, behavioural and ecological divergence in Ireland in comparison to Britain and continental Europe, were also those which arrived in Ireland very early in the Holocene either with or without the assistance of people. Cold tolerant mammal species recolonized quickly after LGM but disappeared, potentially as a result of a short period of rapid warming. Other early arrivals were less cold tolerant and succumbed to the colder conditions during the Younger Dryas or shortly after the start of the Holocene (11.5 kya), or the area of suitable habitat was insufficient to sustain a viable population especially in larger species. Late Pleistocene mammals in Ireland were restricted to those able to colonize up to ca 15 kya, probably originating from adjacent areas of unglaciated Britain and land now below sea level, to the south and west (of Ireland). These few, early colonizers retain genetic diversity which dates from before the LGM. Late Pleistocene Ireland, therefore, had a much depleted complement of mammal species in comparison to Britain.

Mammal species, colonising predominantly from southeast and east Europe occupied west Europe only as far as Britain between ca 15 and 8 kya, were excluded from Ireland by the Irish and Celtic Seas. Smaller species in particular failed to colonise Ireland. Britain being isolated as an island from ca. 8 kya has similar species richness and composition to adjacent lowland areas of northwest continental Europe and its mammals almost all show strongest genetic affinity to populations in neighbouring continental Europe with a few retaining genotypes associated with earlier, western lineages.

The role of people in the deliberate introduction of mammal species and distinct genotypes is much more significant with regards to Ireland than Britain reflecting the larger species richness of the latter and its more enduring land link with continental Europe. The prime motivation of early people in moving mammals was likely to be resource driven but also potentially cultural; as elsewhere, people exploring uninhabited places introduced species for food and the materials they required to survive. It is possible that the process of introduction of mammals to Ireland commenced during the Mesolithic and accelerated with Neolithic people. Irish populations of these long established, introduced species show some unique genetic variation whilst retaining traces of their origins principally from Britain but in some cases, Scandinavia and Iberia. It is of particular interest that they may retain genetic forms now absent from their source populations. Further species introductions, during the Bronze and late Iron Ages, and Viking and Norman invasions, follow the same pattern but lack the time for genetic divergence from their source populations. Accidental introductions of commensal species show considerable genetic diversity based on numerous translocations along the eastern Atlantic coastline. More recent accidental and deliberate introductions are characterised by a lack of genetic diversity other than that explicable by more than one introduction.

The substantial advances in understanding the postglacial origins and genetic diversity of British and Irish mammals, the role of early people in species translocations, and determination of species that are more recently introduced, should inform policy decisions with regards to species and genetic conservation. Conservation should prioritise early, naturally recolonizing species and those brought in by early people reflecting their long association with these islands. These early arrivals in Britain and Ireland and associated islands show genetic diversity that may be of value in mitigating anthropogenic climate change across Europe. In contrast, more recent introductions are likely to disturb ecosystems greatly, lead to loss of diversity and should be controlled. This challenge is more severe in Ireland where the number and proportion of invasive species from the 19th century to the present has been greater than in Britain.

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Reports from individual centres suggest a preponderance of females with chronic cough. Females also have heightened cough reflex sensitivity. Here we have reviewed the age and sex of unselected referrals to 11 cough clinics. To investigate the cause of any observed sex dimorphism, functional magnetic resonance imaging of putative cough centres was analysed in normal volunteers. The demographic profile of consecutive patients presenting with chronic cough was evaluated. Cough challenge with capsaicin was undertaken in normal volunteers to construct a concentration-response curve. Subsequent functional magnetic resonance imaging during repeated inhalation of sub-tussive concentrations of capsaicin observed areas of activation within the brain and differences in the sexes identified. Of the 10 032 patients presenting with chronic cough, two-thirds (6591) were female (mean age 55 years). The patient profile was largely uniform across centres. The most common age for presentation was 60-69 years. The maximum tolerable dose of inhaled capsaicin was lower in females; however, a significantly greater activation of the somatosensory cortex was observed. Patients presenting with chronic cough from diverse racial and geographic backgrounds have a strikingly homogeneous demographic profile, suggesting a distinct clinical entity. The preponderance of females may be explained by sex-related differences in the central processing of cough sensation.

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BACKGROUND: Family-based cardiac screening programmes for persons at risk for genetic cardiac diseases are now recommended. However, the psychological wellbeing and health related quality of life (QoL) of such screened patients is poorly understood, especially in younger patients. We sought to examine wellbeing and QoL in a representative group of adults aged 16 and over in a dedicated family cardiac screening clinic.

METHODS: Prospective survey of consecutive consenting patients attending a cardiac screening clinic, over a 12 month period. Data were collected using two health measurement tools: the Short Form 12 (version 2) and the Hospital Anxiety and Depression Scale (HADS), along with baseline demographic and screening visit-related data. The HADS and SF-12v.2 outcomes were compared by age group. Associations with a higher HADS score were examined using logistic regression, with multi-level modelling used to account for the family-based structure of the data.

RESULTS: There was a study response rate of 86.6%, with n=334 patients providing valid HADS data (valid response rate 79.5%), and data on n=316 retained for analysis. One-fifth of patients were aged under 25 (n=61). Younger patients were less likely than older to describe significant depression on their HADS scale (p<0.0001), although there were overall no difference between the prevalence of a significant HADS score between the younger and older age groups (18.0% vs 20.0%, p=0.73). Significant positive associates of a higher HADS score were having lower educational attainment, being single or separated, and being closely related to the family proband. Between-family variance in anxiety and depression scores was greater than within-family variance.

CONCLUSIONS: High levels of anxiety were seen amongst patients attending a family-based cardiac screening clinic.Younger patients also had high rates of clinically significant anxiety. Higher levels of anxiety and depression tends to run in families, and this has implications for family screening and intervention programmes.

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Before commencement of the academic year 2012/2013 the social sciences, public health and the biomedical sciences were taught to separate modules. This reinforced the idea off separate disciplines certainly for some of the younger students and a failure to appreciate the interconnectedness (whole person) perspective on health; separately modules taught and assessed in separate silos. There was limited understanding by the lecturers of the other areas that they were not teaching to -reflecting perhaps a dis-coordinated approach to health sciences (Mason and Whitehead 2003). As a result of significant discussion and interdisciplinary negotiation the life, social sciences public health/ health education were drawn together in the one module for the academic year 2012/13. The module provides the undergraduate students with an introduction to an understanding of Life Sciences, psychology, sociology and public health and their contribution within the context of nursing and midwifery. Each week’s teaching seeks to reflect against the other module delivered in first year - addressing clinical skills. The teaching is developing innovative e-learning approaches, including the use of a virtual community. The intention is to provide the student with a more integrated understanding and teaching to the individual’s health and to health within a social context (Lin 2001; Iles- Shih 2011). The focus is on health promotion rather than disease management. The module runs in three phases across the student’s first-year and teachers to the field of adult mental health, learning disability, children’s nursing and the midwifery students -progressively building on the student’s clinical experience. The predominant focus of the module remains on health and reflecting aspects of life and social life within N. Ireland. One of the particular areas of interest and an area of particular sensitivity is engaging the students to the context of the Northern Ireland civil unrest (the Troubles); this involves a co-educational initiative with service users, only previously attempted with social work students (Duffy 2012). The service users are represented by WAVE an organisation offering care and support to bereaved, traumatised or injured as a result of the violent civil conflict `the Troubles’. The `Troubles’ had ranged over an extended period and apart from the more evident and visual impact of death and injury, the community is marked by a disproportionate level of civil unrest, the extremes of bereavement, imprisonment, displacement antisocial behaviour and family dysfunction (Coulter et al. 2012). As co-educators with the School of Nursing and Midwifery, WAVE deliver a core lecture (augmented by online material), then followed by tutorials. The tutorials are substantially led by those who had been involved with and experienced loss and trauma as a result of the conflict (Health Service users) as `citizen trainers’ and provide an opportunity for them to share their experience and their recollection of personal interaction with nursing and midwifery students; in improving their understanding of the impact of `The Troubles’ on patients and clients affected by the events (Coulter et al. 2012) and to help better provide a quality of care cognisant of the particular needs of those affected by `the Troubles’ in N.Ireland. This approach is relatively unique to nursing in N. Ireland in that it involves many of those directly involved with and injured by the `Troubles’ as `citizen trainers’ and clearly reflects the School’s policy of progressively engaging with users and carers of nursing and midwifery services as co-educators to students (Repper & Breeze 2006). Only now could perhaps such a sensitive level of training to student nurses and midwives be delivered across communities with potential educative lessons for other communities experiencing significant civil unrest and sectarian conflict.

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Climate change during the last deglaciation was strongly influenced by the „bipolar seesaw‟, producing antiphase climate responses between the North and South Atlantic. However, mounting evidence demands refinements of this model, with the occurrence of abrupt events in southern low to mid latitudes occurring in-phase with North Atlantic climate. Improved constraints on the north-south phasing and spatial extent of these events are therefore critical to
understanding the mechanisms that propagate abrupt events within the climate system. We present a 19,400 year multi-proxy record of climate change obtained from a rock hyrax midden in southernmost Africa. Arid anomalies in phase with the Younger Dryas and 8.2 ka events are apparent, indicating a clear shift in the influence of the bipolar seesaw, which diminished as the Earth warmed, and was succeeded after ~14.6 ka by the emergence of a dominant interhemispheric atmospheric teleconnection.

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Tephrochronological age models and 48 14C age determinations on molluscs and foraminifera (planktonic and benthic) are applied for the calculation of marine 14C reservoir age variability during a time period covering the Heinrich event H1 to early Holocene (16–9 cal kyr BP). Our data source consists of four high-resolution marine sediment cores (HM107-04, HM107-05, MD99-2271, MD99-2275) from the North Icelandic shelf. The marine reservoir age (ΔR) is found to be extremely variable, ranging from 385 to 1065 14C years. Extreme ΔR values occur at the end of H1, with values around 1000 14C years (~15 cal kyr BP), probably due to reduced northward flow of well-ventilated subtropical surface waters and a southward expansion of polar waters, as well as an expansion of sea ice limiting air-sea gas exchange. With the onset of the Bølling-Allerød interstadial, the ΔR values decrease towards 0 14C years suggesting a more vigorous North Atlantic Current and an active meridional overturning circulation system. During the Younger Dryas stadial, ΔR values are consistently around 700 14C years suggesting e renewed expansion of polar waters and a weakened meridional overtuning circulation. Interestingly, ΔR values remain high (~200 14C years) at the onset of the Holocene suggesting continued high influence of polar waters. Subsequently, ΔR values rapidly decrease to ~¬ 250 14C years around 11 cal kyr BP, indicating increased air-sea CO2 exchange with the coeval atmosphere. The ΔR values average around 0 14C years from around 10.5 to 9.0 cal kyr BP.

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Neste trabalho foram cumpridos dois estudos intencionalmente diferenciados para avaliar factores afectivos e desempenho cognitivo no contexto de comportamento verbal em Língua segunda. No primeiro estudo foram descritos, analisados e discutidos os resultados que confirmam a influência da motivação, ansiedade e estilos de aprendizagem, em condição de aquisição de nova língua e de adaptação à cultura dominante. Essa influência é discutida na relação com variados factores e atendendo à diferenciação do valor de predição de cada um dos factores mencionados. A associação do factor idade ao factor cultural revelou-se a principal fonte diferenciadora das autoavaliações observadas. No segundo estudo, com a aplicação da bateria de testes em formato electrónico, foi possível averiguar os resultados e discutir as suas implicações ao nível do desempenho dos sujeitos, corroborando e refutando pressupostos teóricos de modelos que versam nesta área de estudo. O desempenho observado tem sérias implicações na reflexão pedagógica e práctica escolar, uma vez que, de forma geral, os sujeitos mais novos exibiram um desempenho medíocre quando comparado com a performance muito positiva dos participantes mais velhos, gerando conflito em relação aos pressupostos práticos implicados na teoria do período sensível para desenvolvimento de linguagem. Por outro lado, as duas amostras (nativos e imigrantes) revelam desempenhos muito próximos o que não destaca, como seria de esperar, o grupo nativo que deveria evidenciar vantagem devido ao conhecimento mais elevado relativamente ao léxico e gramática do Português, como Língua Materna. A relação entre motivação favorável, fraco índice de ansiedade linguística, e bom desempenho cognitivo não se revela linear e taxativa e devem ser revistos os princípios de modelos teóricos que advogam a consonância clássica entre determinados factores afectivos (motivação e estilos de aprendizagem) e cognitivos, no contexto da competência e performance verbais. Considerando os materiais desenvolvidos e observando os resultados obtidos, este estudo viabiliza o acesso a uma nova oportunidade de avaliação, em estilo de diagnose, dirigida aos alunos aprendentes de Português Língua Segunda, com experiência migratória.

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Relatório de estágio de mestrado, Estudos Regionais e Autárquicos, Universidade de Lisboa, Faculdade de Letras, 2012

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Concert Program for Jazz Innovations I, March 10, 2010

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Relatório da Prática Profissional Supervisionada Mestrado em Educação Pré-Escolar

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I (Prática Pedagógica) - O estágio foi realizado na Academia de Música de Almada (AMA) com três alunos de níveis diferentes: Aluno x, Iniciação Musical; Aluna y, 2º grau; e Aluna z, 5º grau. A planificação do trabalho foi feita com a colaboração do professor Vasco Broco e sob a supervisão do professor Pedro Saglimbeni Muñoz, tendo por base o programa da AMA e procurando corresponder às necessidades individuais de cada aluno, bem como respeitar os diferentes ritmos de aprendizagem. Dadas as diferenças de idade e de nível, os objectivos que procurei atingir com cada aluno durante o ano lectivo são naturalmente díspares, bem como a perspectiva de cada um em relação ao próprio instrumento e ao ensino da música. Enquanto que os mais novos encaram a aprendizagem musical como uma actividade meramente recreativa, pelo menos por enquanto, a Aluna z ambiciona fazer uma carreira como instrumentista. Mesmo entre os mais novos há diferenças, pois apesar de o Aluno x ainda estar a frequentar a Iniciação Musical, já iniciou a sua aprendizagem há mais tempo do que a Aluna y, encarando o ensino com mais seriedade. A AMA tem a vantagem de ter um pianista acompanhador disponível para cada dia da semana, o que tornou possível desenvolver um trabalho consistente com os alunos em termos de ensaios e audições. As audições e momentos de avaliação foram marcados em reuniões de Departamento Curricular, à excepção da calendarização das Provas Globais que foi feita em reunião de Conselho Pedagógico. O aproveitamento foi positivo para os três alunos no final do estágio, tendo todos transitado para o nível de ensino seguinte.

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RESUMO - Portugal continental, como outros países europeus, foi afectado por uma onda de calor de grande intensidade no Verão de 2003, com efeitos na mortalidade da população. O excesso de óbitos associados à onda de calor foi estimado pela comparação do número de óbitos observados entre 30 de Julho e 15 de Agosto de 2003 e o número de óbitos esperados se a população tivesse estado exposta às taxas de mortalidade médias do biénio 2000-2001 no respectivo período homólogo. Os óbitos esperados foram calculados com ajustamento para a idade. O número de óbitos observados (O) foi superior ao número esperado (E) em todos os dias do período estudado e o seu excesso global foi estimado em 1953 óbitos (excesso relativo de 43%), dos quais 1317 (61%) ocorreram no sexo feminino e 1742 no grupo de 75 e + anos (89%). A nível distrital, Portalegre teve o maior aumento relativo do número de óbitos (+89%) e Aveiro o menor (+18%). Numa área geográfica contínua do interior do território (Guarda, Castelo Branco, Portalegre e Évora) houve aumentos relativos superiores a 80%. Em termos absolutos, o maior excesso de óbitos ocorreu no distrito de Lisboa (mais cerca de 396) e no do Porto (mais cerca de 183). As causas de morte «golpe de calor» e «desidratação e outros distúrbios metabólicos» tiveram os aumentos relativos mais elevados (razões O/E de, respectivamente, 70 e 8,65). Os maiores aumentos absolutos do número de óbitos ocorreram no grupo das «doenças do aparelho circulatório» (mais 758), nas «doenças do aparelho respiratório» (mais 255) e no conjunto de «todas as neoplasias malignas» (mais 131). No período da onda de calor e no período de comparação, a percentagem dos óbitos que ocorreu nos hospitais (52% e 56%), no domicílio (32 e 33%) e em «outros locais» foi semelhante. A discussão sobre os factores que condicionaram a obtenção dos valores apresentados, relativos ao excesso de óbitos por sexo, grupo etário, distrito, causa e local da morte, permite concluir que os mesmos se afiguram adequados para medir a ordem de grandeza e caracterizar o efeito da onda de calor na mortalidade. O erro aleatório, medido pelos intervalos de confiança, e alguns possíveis erros sistemáticos associados ao período de comparação escolhido não deverão afectar de modo relevante as estimativas.

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A national survey conducted in Switzerland aimed to evaluate the knowledge of physiotherapists regarding the legal requirements for record keeping and to collect their feedback about record keeping in general. Three physiotherapists from various professional practice groups and a lawyer specialised in health law developed a questionnaire that was sent to the 7,753 members of two existing national associations of physiotherapists. The questionnaire evaluated the participants' knowledge by calculating a score of legal knowledge, which had a maximum of 30 points. We included 825 questionnaires in the analysis. The large majority (83.4%) of participants confessed an ignorance of the legal requirements concerning record keeping prior to the survey. The average score of legal compatibility was 8 points. The younger age of the physiotherapists was a significant predictor of having knowledge of the legal requirements for record keeping (p <0.001). The participants had an appreciation of the value of records, but they did not have the relevant knowledge regarding the legal requirements for keeping records. The participants blamed a lack of time and remuneration for their failure to keep records according to known requirements. All practising allied health professionals should keep up-to-date and accurate records that conform to active legal requirements and existing international guidelines. In addition to the existing legal requirements, the emergence of e-health and the electronic era will trigger major changes in patient record management by physiotherapists.

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ABSTRACT Background: Previous studies have implied that weight-bearing, intense and prolonged physical activities optimize bone accretion during the grow^ing years. The majority of past inquiries have used dual-energy X-ray absorptiometry (DXA) to examine bone strength and hand-wrist radiography to determine skeletal maturity in children. Recently, quantitative ultrasound (QUS) technologies have been developed to examine bone properties and skeletal maturity in a safe, noninvasive and cost-effective manner. Objective: The purpose of this study was to compare bone properties and skeletal maturity in competitive male child and adolescent athletes with minimallyactive, age-matched controls, using QUS technology. >. Methods: In total, 224 males were included in the study. The 115 pre-pubertal boys aged 10-12 years consisted of control, minimally-active children (n=34), soccer players (n=26), gymnasts (n=25) and hockey players (n=30). In addition, the 109 late-pubertal boys aged 14-16 years consisted of control, minimally-active adolescents (n=31), soccer players (n=30), gymnasts (n=17) and hockey players (n=31). The athletic groups were elite level players that predominantly trained year-round. Physical activity, nutrition and sports participation were assessed with various questionnaires. Anthropometries, such as height, weight and relative body fat percentage (BF%) were assessed using standard measures. Skeletal strength and age were evaluated using bone QUS. Lastly, salivary testosterone (sT) concentration was measured using Radioimmunoassay (RIA). Results: Within each age group, there were no significant differences between the activity groups in age and pubertal stage. An age effect was apparent in all variables, as expected. A sport effect was noted in all physical characteristics: the child and adolescent gymnasts were shorter and lighter than other sports groups. Adiposity was greater in the controls and in the hockey players. All child subjects were pubertal stage (fanner) I or II, while adolescent subjects were pubertal stage IV or V. There were no differences in daily energy and mineral intakes between sports groups. In both age groups, gymnasts had a higher training volume than other athletic groups. Bone speed of sound (50s) was higher in adolescents compared with the children. Gymnasts had signifieantly higher radial 50S than controls, hockey and soccer players in both age cohorts. Hockey athletes also had higher radial 50S than controls and soccer players in the child and adolescent groups, respectiyely. Child gymnasts and soccer players had greater tibial 50S compared with the hockey players and control groups. Likewise, adolescent gymnasts and soccer players had higher tibial SoS compared with the control group. No interaction was apparent between age and type of activity in any of the bone measures. » Lastly, maturity as assessed by sT and secondary sex characteristics (Tanner stage) was not different between sports group within each age group. Despite the similarity in chronological age, androgen levels and sexual maturity, differences between activity groups were noted in skeletal maturity. In the younger group, hockey players had the highest bone age while the soccer players had the lowest bone age. In the adolescent group, gymnasts and hockey players were characterized by higher skeletal maturity compared with controls. An interaction between the age and sport type effects was apparent in skeletal maturity, reflecting the fact that among the children, the soccer players were significantly less mature than the rest of the groups, while in the adolescents, the controls were the least skeletally mature. Summary and Conclusions: In summary, radial and tibial SOS are enhanced by the unique loading pattern in each sport (i.e, upper and lower extremities in gymnastics, lower extremities in soccer), with no cumulative effect between childhood and adolescence. That is, the effect of sport participation on bone SOS was apparent already among the young athletes. Enhanced bone properties among athletes of specific sports suggest that participation in these sports can improve bone strength and potential bone health.

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years 8 months) and 24 older (M == 7 years 4 months) children. A Monitoring Process Model (MPM) was developed and tested in order to ascertain at which component process ofthe MPM age differences would emerge. The MPM had four components: (1) assessment; (2) evaluation; (3) planning; and (4) behavioural control. The MPM was assessed directly using a referential communication task in which the children were asked to make a series of five Lego buildings (a baseline condition and one building for each MPM component). Children listened to instructions from one experimenter while a second experimenter in the room (a confederate) intetjected varying levels ofverbal feedback in order to assist the children and control the component ofthe MPM. This design allowed us to determine at which "stage" ofprocessing children would most likely have difficulty monitoring themselves in this social-cognitive task. Developmental differences were obselVed for the evaluation, planning and behavioural control components suggesting that older children were able to be more successful with the more explicit metacomponents. Interestingly, however, there was no age difference in terms ofLego task success in the baseline condition suggesting that without the intelVention ofthe confederate younger children monitored the task about as well as older children. This pattern ofresults indicates that the younger children were disrupted by the feedback rather than helped. On the other hand, the older children were able to incorporate the feedback offered by the confederate into a plan ofaction. Another aim ofthis study was to assess similar processing components to those investigated by the MPM Lego task in a more naturalistic observation. Together the use ofthe Lego Task ( a social cognitive task) and the naturalistic social interaction allowed for the appraisal of cross-domain continuities and discontinuities in monitoring behaviours. In this vein, analyses were undertaken in order to ascertain whether or not successful performance in the MPM Lego Task would predict cross-domain competence in the more naturalistic social interchange. Indeed, success in the two latter components ofthe MPM (planning and behavioural control) was related to overall competence in the naturalistic task. However, this cross-domain prediction was not evident for all levels ofthe naturalistic interchange suggesting that the nature ofthe feedback a child receives is an important determinant ofresponse competency. Individual difference measures reflecting the children's general cognitive capacity (Working Memory and Digit Span) and verbal ability (vocabulary) were also taken in an effort to account for more variance in the prediction oftask success. However, these individual difference measures did not serve to enhance the prediction oftask performance in either the Lego Task or the naturalistic task. Similarly, parental responses to questionnaires pertaining to their child's temperament and social experience also failed to increase prediction oftask performance. On-line measures ofthe children's engagement, positive affect and anxiety also failed to predict competence ratings.