794 resultados para assumptions, judgements, communication, failure to thrive, casual nurses, paediatrics
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Although very little is known about the transport, fate and toxic effects of medical compounds in aquatic environments, the presence of these compounds in potable water sources can no longer be overlooked. We can argue that trace concentrations of drugs in the water is relatively a minor problem, however, the current and future demands on global potable freshwater supplies will probably lead to greater incidents of indirect and direct water-reuse situations at the local, regional, and cross-border levels. It is important to remark that the solution of this emerging ecological issue does not rely on new and better wastewater treatment technologies, but a new paradigm of responsibility and the understanding of the relations between anthropogenic actions and their ecological effects as well. The objective of this brief communication is to present the state of the art of research conducted in the last decade in Europe and United States concerning the presence of pharmaceuticals products in aquatic environments.
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ABSTRACT Title of Dissertation: A BETTER PLACE TO BE: REPUBLICANISM AS AN ALTENATIVE TO THE AUTHORITARIANISM-DEMOCRACY DICHOTOMY Christopher Ronald Binetti, Doctor of Philosophy, and 2016 Dissertation directed by: Dr. Charled Frederick Alford, Department of Government and Politics In this dissertation, I argue that in modern or ancient regimes, the simple dichotomy between democracies and autocracies/dictatorships is both factually wrong and problematic for policy purposes. It is factually wrong because regimes between the two opposite regime types exist and it is problematic because the either/or dichotomy leads to extreme thinking in terms of nation-building in places like Afghanistan. In planning for Afghanistan, the argument is that either we can quickly nation-build it into a liberal democracy or else we must leave it in the hands of a despotic dictator. This is a false choice created by both a faulty categorization of regime types and most importantly, a failure to understand history. History shows us that the republic is a regime type that defies the authoritarian-democracy dichotomy. A republic by my definition is a non-dominating regime, characterized by a (relative) lack of domination by any one interest group or actor, mostly non-violent competition for power among various interest groups/factions, the ability of factions/interest groups/individual actors to continue to legitimately play the political game even after electoral or issue-area defeat and some measure of effectiveness. Thus, a republic is a system of government that has institutions, laws, norms, attitudes, and beliefs that minimize the violation of the rule of law and monopolization of power by one individual or group as much as possible. These norms, laws, attitudes, and beliefs ae essential to the republican system in that they make those institutions that check and balance power work. My four cases are Assyria, Persia, Venice and Florence. Assyria and Persia are ancient regimes, the first was a republic and then became the frightening opposite of a republic, while the latter was a good republic for a long time, but had effectiveness issues towards the end. Venice is a classical example of a medieval or early modern republic, which was very inspirational to Madison and others in building republican America. Florence is the example of a medieval republic that fell to despotism, as immortalized by Machiavelli’s writings. In all of these examples, I test certain alternative hypotheses as well as my own.
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O apoio prestado às famílias que vivenciam a parentalidade deve basear-se numa relação de confiança entre enfermeiros e pais. A satisfação dos clientes e dos enfermeiros durante a prestação de cuidados assume grande relevância e pode ser considerada um ganho em saúde. Objetivo: Compreender a experiência e o significado atribuído pelos pais de crianças entre os 11 e os 24 meses e dos enfermeiros que participaram na implementação da metodologia Touchpoints (TP), uma intervenção de enfermagem inovadora. Desenho do Estudo e Métodos: Estudo qualitativo de cariz fenomenológico. A recolha de dados foi efetuada através de (i) diários de itinerância dos enfermeiros que participaram na implementação da metodologia TP e da (ii) técnica de grupos focais realizada junto de 10 pais de crianças do grupo de intervenção. Resultados: os pais consideraram que as sessões TP, implementadas pelos enfermeiros, contribuíram para: Aquisição de conhecimentos e competências; Validação de práticas parentais; Melhoria do comportamento da criança; Confiança parental; Relacionamento interpessoal; Competências profissionais; Competências específicas; Satisfação. Os enfermeiros que participaram no estudo consideraram que a metodologia TP contribuiu para: Mobilização e aplicação dos princípios TP; Processo de aprendizagem; Interesse dos pais; Sentimentos/emoções; Satisfação. Implicações Clínicas: Os enfermeiros que cuidam de famílias devem implementar metodologias inovadoras que facilitem a adaptação à parentalidade, como os Touchpoints. A implementação da metodologia TP contribuiu para a satisfação dos pais e enfermeiros.
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Purpose of review: Health-related quality of life (HRQoL) is an important patient-reported outcome measure following critical illness. ‘Validated’ and professionally endorsed generic measures are widely used to evaluate critical care intervention and guide practice, policy and research. Although recognizing that they are ‘here to stay’, leading QoL researchers are beginning to question their ‘fitness for purpose’. It is therefore timely to review critiques of their limitations in the wider healthcare and social science literatures and to examine the implications for critical care research including, in particular, emerging interventional studies in which HRQoL is the primary outcome of interest. Recent findings: Generic HRQoL measures have provided important yet limited insights into HRQoL among survivors of critical illness. They are rarely developed or validated in collaboration with patients and cannot therefore be assumed to reflect their experiences and perspectives. Summary: Collaboration with patients is advocated in order to improve the interpretation and utility of such data. Failure to do so may result in important study effects being overlooked and the dismissal of potentially useful interventions.
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Climate change challenges the capacity of fishes to thrive in their habitat. However, through phenotypic diversity, they demonstrate remarkable resilience to deteriorating conditions. In fish populations, inter-individual variation in a number of fitness-determining physiological traits, including cardiac performance, is classically observed. Information about the cellular bases of inter-individual variability in cardiac performance is scarce including the possible contribution of excitation-contraction (EC) coupling. This study aimed at providing insight into EC coupling-related Ca2+ response and thermal plasticity in the European sea bass (Dicentrarchus labrax). A cell population approach was used to lay the methodological basis for identifying the cellular determinants of cardiac performance. Fish were acclimated at 12 and 22 A degrees C and changes in intracellular calcium concentration ([Ca2+](i)) following KCl stimulation were measured using Fura-2, at 12 or 22 A degrees C-test. The increase in [Ca2+](i) resulted primarily from extracellular Ca2+ entry but sarcoplasmic reticulum stores were also shown to be involved. As previously reported in sea bass, a modest effect of adrenaline was observed. Moreover, although the response appeared relatively insensitive to an acute temperature change, a difference in Ca2+ response was observed between 12- and 22 A degrees C-acclimated fish. In particular, a greater increase in [Ca2+](i) at a high level of adrenaline was observed in 22 A degrees C-acclimated fish that may be related to an improved efficiency of adrenaline under these conditions. In conclusion, this method allows a rapid screening of cellular characteristics. It represents a promising tool to identify the cellular determinants of inter-individual variability in fishes' capacity for environmental adaptation.
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Background: Pressure ulcers (PrUs) have a significant impact on health system expenditure and patient’s quality of life. It is a global problem. Many studies were undertaken in regard to PrU prevention and management. In Oman, no studies have been conducted to investigate nurses’ knowledge on prevention and management of PrUs. The purpose of this descriptive sequential explanatory mixed-method study was to explore the nurses’ level of knowledge in relation to prevention and management of PrUs in Oman. Methods: A mixed method design was used and the study was conducted over two Phases. In Phase I, a questionnaire was developed to explore nurses’ knowledge on PrU, policy, and resources. The main section of the questionnaire was the Pieper-Zulkowski Pressure Ulcer knowledge test (PZ-PUKT) which tests the knowledge on PrU. Another two sections were developed including questions about wound policy and resources available for PrU prevention and management in Oman. The questionnaire was distributed to nurses who were working in surgical, medical, orthopaedic, CCU, and ICU wards/units in seven hospitals. In Phase II study, semi-structured qualitative interviews were conducted with 16 of the questionnaire respondents. Interviews took approximately 30 minutes, were recorded and transcribed verbatim. Qualitative data were analysed using the Knowledge, Attitudes and Practice (KAP) model as the a priori framework. Results: In Phase I, 478 questionnaires were analysed. The knowledge test results showed the overall mean percent score for correctly answered questions was 51% suggesting a low level of knowledge. There was a significant relationship between nurses’ knowledge and age (P=0.001) and between knowledge and years of experience (P=0.001) with knowledge increasing with age and years of experience. In Phase II, four themes were identified from the interviews: knowledge, attitude, and practice (framework themes) and perception of role. Findings indicated positive and negative attitudes towards the care of PrUs. Some nurses stated feeling rewarded when they see wounds improving while others said they could not work with patients independently because they lacked the knowledge and the skills needed. There was variation in the management of PrU between hospitals. Both studies indicated that the wound management policy did not include enough information to guide nurses. Conclusion: Overall the nurses’ level of knowledge on PrU was relatively low. Most nurses were not familiar with wound management policy or different PrU prevention and management strategies. Nurses are aware of the risk of PrUs and try their best to manage them with the available resources however more training is required.
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The use of chemical control measures to reduce the impact of parasite and pest species has frequently resulted in the development of resistance. Thus, resistance management has become a key concern in human and veterinary medicine, and in agricultural production. Although it is known that factors such as gene flow between susceptible and resistant populations, drug type, application methods, and costs of resistance can affect the rate of resistance evolution, less is known about the impacts of density-dependent eco-evolutionary processes that could be altered by drug-induced mortality. The overall aim of this thesis was to take an experimental evolution approach to assess how life history traits respond to drug selection, using a free-living dioecious worm (Caenorhabditis remanei) as a model. In Chapter 2, I defined the relationship between C. remanei survival and Ivermectin dose over a range of concentrations, in order to control the intensity of selection used in the selection experiment described in Chapter 4. The dose-response data were also used to appraise curve-fitting methods, using Akaike Information Criterion (AIC) model selection to compare a series of nonlinear models. The type of model fitted to the dose response data had a significant effect on the estimates of LD50 and LD99, suggesting that failure to fit an appropriate model could give misleading estimates of resistance status. In addition, simulated data were used to establish that a potential cost of resistance could be predicted by comparing survival at the upper asymptote of dose-response curves for resistant and susceptible populations, even when differences were as low as 4%. This approach to dose-response modeling ensures that the maximum amount of useful information relating to resistance is gathered in one study. In Chapter 3, I asked how simulations could be used to inform important design choices used in selection experiments. Specifically, I focused on the effects of both within- and between-line variation on estimated power, when detecting small, medium and large effect sizes. Using mixed-effect models on simulated data, I demonstrated that commonly used designs with realistic levels of variation could be underpowered for substantial effect sizes. Thus, use of simulation-based power analysis provides an effective way to avoid under or overpowering a study designs incorporating variation due to random effects. In Chapter 4, I 3 investigated how Ivermectin dosage and changes in population density affect the rate of resistance evolution. I exposed replicate lines of C. remanei to two doses of Ivermectin (high and low) to assess relative survival of lines selected in drug-treated environments compared to untreated controls over 10 generations. Additionally, I maintained lines where mortality was imposed randomly to control for differences in density between drug treatments and to distinguish between the evolutionary consequences of drug treatment versus ecological processes affected by changes in density-dependent feedback. Intriguingly, both drug-selected and random-mortality lines showed an increase in survivorship when challenged with Ivermectin; the magnitude of this increase varied with the intensity of selection and life-history stage. The results suggest that interactions between density-dependent processes and life history may mediate evolved changes in susceptibility to control measures, which could result in misleading conclusions about the evolution of heritable resistance following drug treatment. In Chapter 5, I investigated whether the apparent changes in drug susceptibility found in Chapter 4 were related to evolved changes in life-history of C. remanei populations after selection in drug-treated and random-mortality environments. Rapid passage of lines in the drug-free environment had no effect on the measured life-history traits. In the drug-free environment, adult size and fecundity of drug-selected lines increased compared to the controls but drug selection did not affect lifespan. In the treated environment, drug-selected lines showed increased lifespan and fecundity relative to controls. Adult size of randomly culled lines responded in a similar way to drug-selected lines in the drug-free environment, but no change in fecundity or lifespan was observed in either environment. The results suggest that life histories of nematodes can respond to selection as a result of the application of control measures. Failure to take these responses into account when applying control measures could result in adverse outcomes, such as larger and more fecund parasites, as well as over-estimation of the development of genetically controlled resistance. In conclusion, my thesis shows that there may be a complex relationship between drug selection, density-dependent regulatory processes and life history of populations challenged with control measures. This relationship could have implications for how resistance is monitored and managed if life histories of parasitic species show such eco-evolutionary responses to drug application.
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The aim of this study was to identify key aspects in the exchange of information and to determine how nurses communicate news to hospitalised children. For this study, we applied the critical incident technique with 30 children aged between 8 and 14 years. Data were collected in paediatric units in a hospital in Alicante (Spain) using participant observation and semi-structured interviews. The analysis yielded three main categories: the children’s reaction to the information, nursing staff behaviour as a key aspect in the exchange of information and communication of news as well as children’s experience. This article emphasises the need to promote children’s consent and participation in nursing interventions. An analysis of these aspects will verify whether children’s rights are being respected and taken into account in order to promote children’s well-being and adaptation to hospitalisation.
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A presente investigação empírica, desenvolvida na área da formação contínua, procura compreender como se processa a formação continua em contexto de trabalho dos enfermeiros de uma organização hospitalar, centrando-se na percepção e representações dos enfermeiros de cuidados gerais sobre a qualidade, autopercepção do impacte e importância da formação no desenvolvimento de competências e motivação para a participação na formação contínua, como forma de promover o desenvolvimento de competências. Considerando-se que a problemática do paradigma da formação, subsiste na falta de articulação entre os processos comunicacionais, motivadores, procedimentais e dos recursos à disposição dos usuários e gestores da formação, a nível micro dos serviços da organização e macro da tutela o que contribui para a inexistência de resultados quantificáveis, em termos de eficácia e eficiência da formação no desenvolvimento de competências dos colaboradores e crescimento da organização. Apesar da formação contínua, nas organizações, objectivar o desenvolvimento de competências, implicar a construção de um quadro de referência a partir de uma abordagem multidisciplinar, de forma a incluir a complexidade dos fenómenos, a investigação dos factores determinantes que concorrem para a performance dos enfermeiros, parece ser uma abordagem imprescindível para compreender e analisar a problemática na sua dimensão. O estudo empírico consistiu numa investigação exploratória/descritiva, partindo de uma amostragem não probabilística, optando-se por uma metodologia quantitativa, através da aplicação de questionários a 208 enfermeiros da prestação de cuidados, de uma organização hospitalar pública EPE, da Administração Regional de Saúde de Lisboa e Vale do Tejo. Esta investigação permitiu verificar que no geral, os enfermeiros têm uma percepção positiva sobre a qualidade da formação contínua desenvolvida no serviço onde desempenham funções. Maioritariamente consideram importante a formação contínua como factor de desenvolvimento de competências, sentem-se motivados e participam activamente na formação. No entanto, não se conseguiu efectuar qualquer tipo de inferências ou correlações entre as variáveis de estudo constatando-se que os enfermeiros responderam frequentemente e Sempre, na grande maioria das questões, havendo heterogenia nas respostas a questões semelhantes. O estudo demonstrou que apesar da percepção positiva dos enfermeiros sobre a formação contínua desenvolvida no serviço, não se consegue ter a verdadeira percepção de como é conduzida a formação em serviço qual o seu impacte na melhoria do desempenho dos enfermeiros e se a organização evidencia uma cultura de formação voltada para uma estratégia de melhoria continua das qualificações dos enfermeiros. À luz dos resultados, foi desenvolvido um projecto de intervenção sócio-organizacional na área da gestão da formação, numa perspectiva de estratégia de desenvolvimento organizacional, melhoria das competências individuais e proposto um portfólio de descrição de funções do enfermeiro responsável pela formação. ABSTRACT: This study, based on the issues of continuous professional training in the hospital setting, as a factor to develop nurses competencies, intends to understand how the training program in the hospital milieu is conducted, focusing on perceptions and concepts of quality, impact, importance and motivation to participate in ongoing professional training, according to general care registered nurses point of view. The study main goal is to identify how is developed professional training in a medical institution from Sub-Região de Saúde de Lisboa and Vale do Tejo, and evaluate the impact of the training program. Considering that a problematic exists in the articulation between the communication processes, motivational drives, procedures and resources at the disposition of the participants and managers of the professional development program, at a micro level of services in the organization and at a macro level of the government policies and organizational strategies leaders; which contributed to the absence of quantifiable results and little evidence, in terms of efficiency of the professional development program to enhance the professional competencies of those participating in the study. The investigation of the factorial determinants related to nurse’s efficient performance enhanced by participating in continuous professional training, seems to be an imperative approach to understand and analyze the problematic in its own dimension. The empirical study consisted in an exploratory/descriptive investigation, departing from a random sample, by means of a quantitative methodology approach; through the use of questionnaires being administered to 208 nurses in general care, from a public medical organization. This study, allowed to verify that nurses have a positive perception of the professional development programs established in their workplace, and the competencies of those nurses in charge of delivering the program. The majority, considered the maintenance of a continuous professional development program, imperative to maintain good professional skills; they feel motivated and actively participate in professional development programs. However, it was not possible to make any correlations between the variables of the study, noticing that the nurses answered frequently and always, to the majority of the questions. The study demonstrated that even though nurses have a positive perception of professional development in terms of their workplace, it was inconclusive to ascertain the training quality programs delivered at medical facilities. ln conclusion, a plan of intervention centered on a socio-organizational model, was developed to create a uniform, procedural approach to developing high standards competencies for the registered nurses, by a professional training program, that include monitoring the process and assessing the results of the program. Management competencies according to a balanced scorecard it's another proposal of this study.
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The effects of individual teacher expectations have been the subject of intensive research. Results indicate that teachers use their expectations to adapt their interactions with their students to some degree (as summarized in a review by Jussim & Harber, 2005). This can in turn lead to expectancy-confirming student developments. While there are studies on the Pygmalion effect on individual students, there is only little research on teacher judgements of whole classes and schools. Our study aims to extend the perspective of teacher judgements at the collective level to stereotypes within the context of school tracking. The content and structure of teachers’ school track stereotypes are investigated as well as the question of whether these stereotypical judgements are related to teachers’ perception of obstacles to their teaching and their teaching self-efficacy beliefs. Cross-sectional data on 341 teachers at two different school types from the Panel Study at the Research School „Education and Capabilities“ in North Rhine-Westphalia (PARS) (see Bos et al., 2016) were used for two purposes: First, the structure of teachers’ stereotypes was identified via an exploratory factor analysis. Second, in follow-up regression analyses, the stereotype dimensions extracted were used to predict teachers’ perceptions of obstacles to their classroom work and their individual and collective teacher self-efficacy beliefs. Results showed that – after controlling for the average cognitive abilities and the average cultural capital of the students – teacher stereotypes were indeed related to perceived obstacles concerning their classroom work and their self-efficacy beliefs. After a discussion of the strengths and limitations of the present research, the article closes with a short proposal of a future research framework for collective Pygmalion effects. (DIPF/Orig.)
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A presente dissertação discute a cada vez maior exigência de qualidade nas organizações de saúde, que deve ser encarada como uma ferramenta de gestão e de mudança, e a necessidade intrínseca de uma melhor e mais abrangente rede de comunicação, que se impõe para a transmissão de informação e conhecimento, numa sociedade que a uma velocidade atroz se encontra em constante mutação e desenvolvimento. Neste sentido, a temática em estudo assume particular importância no contexto actual, pois apenas a qualidade representa o garante da subsistência da organização abrindo caminho à eficiência e à eficácia organizacional e de interesse para a instituição, pois parte do conhecimento da percepção dos enfermeiros, que na organização de saúde estão directa e proporcionalmente relacionados com a satisfação do cliente. Os enfermeiros asseguram a manutenção dos padrões de qualidade, que a organização pretende alcançar e comunicar, sendo fundamentais na imagem global transmitida e, consequentemente, na criação de valor da própria organização. Este estudo apresenta como objectivo principal averiguar o conhecimento, o envolvimento e quais as necessidades sentidas, na perspectiva dos enfermeiros, no âmbito da comunicação organizacional, de modo a melhorar a comunicação na organização de saúde, de forma a promover uma gestão de qualidade, garantindo uma subsequente imagem global de excelência. A investigação empírica analisou de forma sistemática informação relevante na área da qualidade, da comunicação organizacional e da inovação. Assim, aplicou-se um inquérito por questionário, fundamentado nos princípios de autores como Deming (1986); Chiavenato (2004); Druker (2000); Biscaia (2000) e Jeffries, (1992), junto dos enfermeiros do Hospital CUF Infante Santo. Com a realização de uma investigação exploratório-descritiva coloca-se a tónica na definição de conceitos e na descrição de factores, através de uma abordagem híbrida qualitativa e quantitativa, foi possível empreender-se o estudo e edificar-se os resultados, que permitem fazer uma caracterização de um conjunto de necessidades a colmatar no âmbito da comunicação interna e verificar a receptividade a inovações de forma a conseguir um maior envolvimento, formação e adesão dos enfermeiros nas políticas de qualidade. As conclusões apuradas levaram à apresentação da indispensabilidade de um envolvimento dos enfermeiros na gestão organizacional ao nível das políticas de qualidade e dos processos de melhoria contínua, observando a emergência de necessidades comunicacionais, nomeadamente a intranet, numa atitude afirmativa de imposição deste canal como um importante facilitador, desde que adaptado à realidade da organização. ABSTRACT: This dissertation discusses the increasing demand for quality in health organizations, which should be seen as a management and change tool, and the intrinsic need of a better and wider communication network, which is required for the transmission of information and knowledge, in a society that is at an atrocious speed constantly changing and developing. ln this sense, the theme in study assumes particular importance in the current context, thus only the quality represents the guarantee of the continuation and existence of the organization opening the way to organizational efficiency and effectiveness and of interest to the institution, as by part of the perception knowledge of the nurses, which in the health organization are directly and proportionately related to the client’s satisfaction. The nurses ensure the maintenance of the quality standards, that the organization aims to reach and communicate, being fundamental in the global image transmitted, and consequently, in the creation of value for the organization itself. The study presents as main objective the investigation of knowledge, the involvement and which necessities needed and felt, in the nurses' perspective, within the organizational communication, as to better the communication within the health organization, in such a way to promote the quality management, guaranteeing a subsequent global image of excellence. The empirical research analyzed in systematic way information relevant in the area of quality, of the organizational communication and innovation. Thus, a survey questionnaire was applied, based on the principles of authors such as Deming (1986); Chiavenato (2004); Druker (2000); Biscaia (2000) e Jeffries, (1992), among nurses of the Infante Santo CUF Hospital. With the completion of an exploratory-descriptive research, the emphasis was put on the concepts definition and the factors description, through a quality and quantity hybrid approach, it was possible to carry out the study and edify the results, which permit in the making of a characterization of a group or set of necessities to cover in the internal communication ambit and verify the acceptability to innovations so that a greater involvement be achieved, training and adherence of the nurses in the quality policies. The conclusions reached led to the presentation of the indispensability of an involvement of the nurses in the organizational management at the level of the quality policies and the processes for continuous improvement, observing the emergency of communication needs, namely the intranet, in an affirmative attitude of imposition of this channel such as an important facilitator, as long as ifs adapted to the reality of the organization.
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This work aims to analyze risks related to information technology (IT) in procedures related to data migration. This is done considering ALEPH, Integrated Libray System (ILS) that migrated data to the Library Module present in the software called Sistema Integrado de Gestão de Atividades Acadêmicas (SIGAA) at the Zila Mamede Central Library at the Federal University of Rio Grande do Norte (UFRN) in Natal/Brazil. The methodological procedure used was of a qualitative exploratory research with the realization of case study at the referred library in order to better understand this phenomenon. Data collection was able once there was use of a semi-structured interview that was applied with (11) subjects that are employed at the library as well as in the Technology Superintendence at UFRN. In order to examine data Content analysis as well as thematic review process was performed. After data migration the results of the interview were then linked to both analysis units and their system register with category correspondence. The main risks detected were: data destruction; data loss; data bank communication failure; user response delay; data inconsistency and duplicity. These elements point out implication and generate disorders that affect external and internal system users and lead to stress, work duplicity and hassles. Thus, some measures were taken related to risk management such as adequate planning, central management support, and pilot test simulations. For the advantages it has reduced of: risk, occurrence of problems and possible unforeseen costs, and allows achieving organizational objectives, among other. It is inferred therefore that the risks present in data bank conversion in libraries exist and some are predictable, however, it is seen that librarians do not know or ignore and are not very worried in the identification risks in data bank conversion, their acknowledge would minimize or even extinguish them. Another important aspect to consider is the existence of few empirical research that deal specifically with this subject and thus presenting the new of new approaches in order to promote better understanding of the matter in the corporate environment of the information units
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This paper studies the development of the brand Monte da Ravasqueira, in the Brazilian market. A brief industry analysis, together with the evaluation of microfactors, was undertaken in order to define a positioning statement, which would suit this specific brand. In addition, three strategic options were suggested in order to enter this market, followed by a marketing and communication plan. To conclude, a financial forecast was undertaken in order to examine the potential of the project.
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An increasing focus in evolutionary biology is on the interplay between mesoscale ecological and evolutionary processes such as population demographics, habitat tolerance, and especially geographic distribution, as potential drivers responsible for patterns of diversification and extinction over geologic time. However, few studies to date connect organismal processes such as survival and reproduction through mesoscale patterns to long-term macroevolutionary trends. In my dissertation, I investigate how mechanism of seed dispersal, mediated through geographic range size, influences diversification rates in the Rosales (Plantae: Anthophyta). In my first chapter, I validate the phylogenetic comparative methods that I use in my second and third chapters. Available state speciation and extinction (SSE) models assumptions about evolution known to be false through fossil data. I show, however, that as long as net diversification rates remain positive – a condition likely true for the Rosales – these violations of SSE’s assumptions do not cause significantly biased results. With SSE methods validated, my second chapter reconstructs three associations that appear to increase diversification rate for Rosalean genera: (1) herbaceous habit; (2) a three-way interaction combining animal dispersal, high within-genus species richness, and geographic range on multiple continents; (3) a four-way interaction combining woody habit with the other three characteristics of (2). I suggest that the three- and four-way interactions represent colonization ability and resulting extinction resistance in the face of late Cenozoic climate change; however, there are other possibilities as well that I hope to investigate in future research. My third chapter reconstructs the phylogeographic history of the Rosales using both non-fossil-assisted SSE methods as well as fossil-informed traditional phylogeographic analysis. Ancestral state reconstructions indicate that the Rosaceae diversified in North America while the other Rosalean families diversified elsewhere, possibly in Eurasia. SSE is able to successfully identify groups of genera that were likely to have been ancestrally widespread, but has poorer taxonomic resolution than methods that use fossil data. In conclusion, these chapters together suggest several potential causal links between organismal, mesoscale, and geologic scale processes, but further work will be needed to test the hypotheses that I raise here.
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Introduction - Learning about ageing and the appropriate management of older patients is important for all doctors. This survey set out to evaluate what medical undergraduates in the UK are taught about ageing and geriatric medicine and how this teaching is delivered. Methods – An electronic questionnaire was developed and sent to the 28/31 UK medical schools which agreed to participate. Results – Full responses were received from 17 schools. 8/21 learning objectives were recorded as taught, and none were examined, across every school surveyed. Elder abuse and terminology and classification of health were taught in only 8/17 and 2/17 schools respectively. Pressure ulcers were taught about in 14/17 schools but taught formally in only 7 of these and examined in only 9. With regard to bio- and socio- gerontology, only 9/17 schools reported teaching in social ageing, 7/17 in cellular ageing and 9/17 in the physiology of ageing. Discussion – Even allowing for the suboptimal response rate, this study presents significant cause for concern with UK undergraduate education related to ageing. The failure to teach comprehensively on elder abuse and pressure sores, in particular, may be significantly to the detriment of older patients.