977 resultados para Verbal protocol
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Introduction The majority of stage III patients with non-small cell lung cancer (NSCLC) are unsuitable for concurrent chemoradiotherapy, the non-surgical gold standard of care. As the alternative treatment options of sequential chemoradiotherapy and radiotherapy alone are associated with high local failure rates, various intensification strategies have been employed. There is evidence to suggest that altered fractionation using hyperfractionation, acceleration, dose escalation, and individualisation may be of benefit. The MAASTRO group have pioneered the concept of ‘isotoxic’ radiotherapy allowing for individualised dose escalation using hyperfractionated accelerated radiotherapy based on predefined normal tissue constraints. This study aims to evaluate whether delivering isotoxic radiotherapy using intensity modulated radiotherapy (IMRT) is achievable.
Methods and analysis Isotoxic IMRT is a multicentre feasibility study. From June 2014, a total of 35 patients from 7 UK centres, with a proven histological or cytological diagnosis of inoperable NSCLC, unsuitable for concurrent chemoradiotherapy will be recruited. A minimum of 2 cycles of induction chemotherapy is mandated before starting isotoxic radiotherapy. The dose of radiation will be increased until one or more of the organs at risk tolerance or the maximum dose of 79.2 Gy is reached. The primary end point is feasibility, with accrual rates, local control and overall survival our secondary end points. Patients will be followed up for 5 years.
Ethics and dissemination The study has received ethical approval (REC reference: 13/NW/0480) from the National Research Ethics Service (NRES) Committee North West—Greater Manchester South. The trial is conducted in accordance with the Declaration of Helsinki and Good Clinical Practice (GCP). The trial results will be published in a peer-reviewed journal and presented internationally.
Trial registration number NCT01836692; Pre-results.
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BACKGROUND: Cerebral palsy is a permanent disorder of posture and movement caused by disturbances in the developing brain. It affects approximately 1 in every 500 children in developed countries and is the most common form of childhood physical disability. People with cerebral palsy may also have problems with speech, vision and hearing, intellectual difficulties and epilepsy. Health and therapy services are frequently required throughout life, and this care should be effective and evidence informed; however, accessing and adopting new research findings into day-to-day clinical practice is often delayed.
METHODS/DESIGN: This 3-year study employs a before and after design to evaluate if a multi-strategy intervention can improve research implementation among allied health professionals (AHPs) who work with children and young people with cerebral palsy and to establish if children's health outcomes can be improved by routine clinical assessment. The intervention comprises (1) knowledge brokering with AHPs, (2) access to an online research evidence library, (3) provision of negotiated evidence-based training and education, and (4) routine use of evidence-based measures with children and young people aged 3-18 years with cerebral palsy. The study is being implemented in four organisations, with a fifth organisation acting as a comparison site, across four Australian states. Effectiveness will be assessed using questionnaires completed by AHPs at baseline, 6, 12 and 24 months, and by monitoring the extent of use of evidence-based measures. Children's health outcomes will be evaluated by longitudinal analyses.
DISCUSSION: Government, policy makers and service providers all seek evidence-based information to support decision-making about how to distribute scarce resources, and families are seeking information to support intervention choices. This study will provide knowledge about what constitutes an efficient, evidence-informed service and which allied health interventions are implemented for children with cerebral palsy.
TRIAL REGISTRATION: Trial is not a controlled healthcare intervention and is not registered.
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Background: The global transfer of nursing and midwifery education to higher education institutes has led to student nurses and midwives experiencing challenges previously faced by traditional third-level students, including isolation, loneliness, financial difficulties and academic pressure. These challenges can contribute to increased stress and anxiety levels which may be detrimental to the successful transition to higher education, thus leading to an increase in attrition rates. Peer mentoring as an intervention has been suggested to be effective in supporting students in the transition to third-level education through enhancing a sense of belongingness and improving student satisfaction, engagement and retention rates. This proposed systematic review aims to determine the effectiveness of peer mentoring in enhancing levels of student engagement, sense of belonging and overall satisfaction of first-year undergraduate students following transition into higher education.
Methods: MEDLINE, Web of Knowledge, ProQuest, Embase, CINAHL, ERIC, PsycINFO and CENTRAL databases will be searched for qualitative, quantitative and mixed methods studies on the implementation of peer assessment strategies in higher education institutes (HEIs) or universities for full-time, first-year adult students (>17 years). Included studies will be limited to the English language. The quality of included studies will be assessed using a validated Mixed Methods Appraisal Tool (MMAT). The findings will be presented as a narrative synthesis or meta-analysis as appropriate following sequential explanatory synthesis.
Discussion: The review will provide clear, non-biased evidence-based guidance to all third-level educators on the effectiveness of peer-mentoring programmes for first-year undergraduates. The review is necessary to help establish which type of peer mentoring is most effective. The evidence from qualitative and quantitative studies drawn from the international literature will be utilised to illustrate the best way to implement and evaluate peer mentoring as an effective intervention and will be useful in guiding future research and practice in this area. These findings may be applied internationally across all disciplines.
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This is the protocol for a review and there is no abstract. The objectives are as follows:
To evaluate the effectiveness of child-focused psychosocial interventions for anger and aggression in children under 12 years of age.
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Dissertação mest., Ciências da Educação, Universidade do Algarve, 2009
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Dissertação de mestrado, Aquacultura e Pescas, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2015
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Introduction: Coronary heart disease (CHD) is one of the leading causes of death in both men and women worldwide. Despite the common misconception that CHD is a ‘man's disease’, it is now well accepted that women endure worse clinical outcomes than men following CHD-related events. A number of studies have explored whether or not gender differences exist in patients presenting with CHD, and specifically whether women delay seeking help for cardiac conditions. UK and overseas studies on help-seeking for emergency cardiac events are contradictory, yet suggest that women often delay help-seeking. In addition, no studies have looked at presumed cardiac symptoms outside an emergency situation. Given the lack of understanding in this area, an explorative qualitative study on the gender differences in help-seeking for a non-emergency cardiac events is needed. Methods and analysis: A purposive sample of 20–30 participants of different ethnic backgrounds and ages attending a rapid access chest pain clinic will be recruited to achieve saturation. Semistructured interviews focusing on help-seeking decision-making for apparent cardiac symptoms will be undertaken. Interview data will be analysed thematically using qualitative software (NVivo) to understand any similarities and differences between the way men and women construct help-seeking. Findings will also be used to inform the preliminary development of a cardiac help-seeking intentions questionnaire. Ethics and dissemination: Ethical approvals were sought and granted. Namely, the University of Westminster (sponsor) and St Georges NHS Trust REC, and the Trust Research and Development Office granted approval to host the study on the Queen Mary's Roehampton site. The study is low risk, with interviews being conducted on hospital premises during working hours. Investigators will disseminate findings via presentations and publications. Participants will receive a written summary of the key findings.
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O uso da imagem, no livro ilustrado, está associado às idades em que a criança ainda não tem domínio da escrita sendo a descodificação e a exploração das imagens as primeiras competências a serem adquiridas. À medida que a criança se familiariza com a leitura verbal e com o desenvolvimento desta competência, a imagem é gradualmente retirada do livro. No âmbito do projeto prático integrado no Mestrado em Ilustração e Animação foi criado um livro para a infância com atividades onde o leitor intervenha tornando-se também autor, concluindo-o e produzindo um objeto único. Propusemo-nos, ainda, apresentar o livro ilustrado e as atividades/ experiências visuais como instrumentos que ajudam a criança a crescer sem frustrações, onde descobrem e desenvolvem capacidades estéticas, emocionais e intelectuais. Dentro do livro ilustrado pretendemos estudar os livros interativos que exploram as duas linguagens, criando uma narrativa plástica e que permitem explorar a tridimensionalidade e o brincar ao faz de conta. Estes são produtos de experiências visuais e tácteis, repletos de estímulos para que a criança seja capaz de explorar e comunicar verbalmente e visualmente, articulando muitas vezes entre o bidimensional com o tridimensional, a regra com o acaso e a forma com a “não forma”, permitindo uma apreciação máxima do objeto.
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Neste artigo procuramos reflectir sobre a dimensão dos elementos para- -linguísticos e extra-linguísticos na actividade conversacional e no papel que detêm na gestão deste espaço interlocutivo.
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Database query languages on relations (for example SQL) make it possible to join two relations. This operation is very common in desktop/server database systems but unfortunately query processing systems in networked embedded computer systems currently do not support this operation; specifically, the query processing systems TAG, TinyDB, Cougar do not support this. We show how a prioritized medium access control (MAC) protocol can be used to efficiently execute the database operation join for networked embedded computer systems where all computer nodes are in a single broadcast domain.
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The IEEE 802.15.4 is the most widespread used protocol for Wireless Sensor Networks (WSNs) and it is being used as a baseline for several higher layer protocols such as ZigBee, 6LoWPAN or WirelessHART. Its MAC (Medium Access Control) supports both contention-free (CFP, based on the reservation of guaranteed time-slots GTS) and contention based (CAP, ruled by CSMA/CA) access, when operating in beacon-enabled mode. Thus, it enables the differentiation between real-time and best-effort traffic. However, some WSN applications and higher layer protocols may strongly benefit from the possibility of supporting more traffic classes. This happens, for instance, for dense WSNs used in time-sensitive industrial applications. In this context, we propose to differentiate traffic classes within the CAP, enabling lower transmission delays and higher success probability to timecritical messages, such as for event detection, GTS reservation and network management. Building upon a previously proposed methodology (TRADIF), in this paper we outline its implementation and experimental validation over a real-time operating system. Importantly, TRADIF is fully backward compatible with the IEEE 802.15.4 standard, enabling to create different traffic classes just by tuning some MAC parameters.
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In this paper, we address the problem of sharing a wireless channel among a set of sporadic message streams where a message stream issues transmission requests with real-time deadlines. We propose a collision-free wireless medium access control (MAC) protocol which implements static-priority scheduling, supports a large number of priority levels and is fully distributed. It is an adaptation to a wireless channel of the dominance protocol used in the CAN bus. But, unlike that protocol, our protocol does not require a node having the ability to receive an incoming bit from the channel while transmitting to the channel. The evaluation of the protocol with real embedded computing platforms is presented to show that the proposed protocol is in fact collision-free and prioritized. We measure the response times of our implementation and show that the response-time analysis developed for the protocol offers an upper bound on the response times.
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The IEEE 802.15.4/ZigBee protocols are gaining increasing interests in both research and industrial communities as candidate technologies for Wireless Sensor Network (WSN) applications. In this paper, we present an open-source implementation of the IEEE 802.15.4/Zigbee protocol stack under the TinyOS operating system for the MICAz motes. This work has been driven by the need for an open-source implementation of the IEEE 802.15.4/ZigBee protocols, filling a gap between some newly released complex C implementations and black-box implementations from different manufacturers. In addition, we share our experience on the challenging problem that we have faced during the implementation of the protocol stack on the MICAz motes. We strongly believe that this open-source implementation will potentiate research works on the IEEE 802.15.4/Zigbee protocols allowing their demonstration and validation through experimentation.
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Consider a wireless sensor network (WSN) where a broadcast from a sensor node does not reach all sensor nodes in the network; such networks are often called multihop networks. Sensor nodes take sensor readings but individual sensor readings are not very important. It is important however to compute aggregated quantities of these sensor readings. The minimum and maximum of all sensor readings at an instant are often interesting because they indicate abnormal behavior, for example if the maximum temperature is very high then it may be that a fire has broken out. We propose an algorithm for computing the min or max of sensor reading in a multihop network. This algorithm has the particularly interesting property of having a time complexity that does not depend on the number of sensor nodes; only the network diameter and the range of the value domain of sensor readings matter.