Risks to patient confidentiality when communicating health information to blind and partially sighted patients.

The research reports on a survey of 228 blind and partially sighted persons in 15 health authorities across Scotland. The survey reports data on patient experience of receiving health information in accessible reading formats. Data indicated that about 90% of blind and partially sighted persons did not receive communications from various NHS health departments in a format that they could read by themselves. The implications for patient privacy, confidentiality and wider impact on life and health care are highlighted. The implications for professional ethical medical practice and for public policy are also discussed. Recommendations for improved practice are made.

A Systematic Review of End-of-Life Visual Impairment in Open-Angle Glaucoma: An Epidemiological Autopsy

PURPOSE: Glaucoma patients are still at risk of becoming blind. It is of clinical significance to determine the risk of blindness and its causes to prevent its occurrence. This systematic review estimates the number of treated glaucoma patients with end-of-life visual impairment (VI) and blindness and the factors that are associated with this.

METHODS: A systematic literature search in relevant databases was conducted in August 2014 on end-of-life VI. A total of 2574 articles were identified, of which 5 on end-of-life VI. Several data items were extracted from the reports and presented in tables.

RESULTS: All studies had a retrospective design. A considerable number of glaucoma patients were found to be blind at the end of their life; with up to 24% unilateral and 10% bilateral blindness. The following factors were associated with blindness: (1) baseline severity of visual field loss: advanced stage of glaucoma or substantial visual field loss at the initial visit; (2) factors influencing progression: fluctuation of intraocular pressure (IOP) during treatment, presence of pseudoexfoliation, poor patient compliance, higher IOP; (3) longer time period: longer duration of disease and older age at death because of a longer life expectancy; and (4) coexistence of other ocular pathology.

CONCLUSIONS: Further prevention of blindness in glaucoma patients is needed. To reach this goal, it is important to address the risk factors for blindness identified in this review, especially those that can be modified, such as advanced disease at diagnosis, high and fluctuating IOP, and poor compliance.

Processo RVCC para o público invisual

Relatório de estágio de mestrado, Ciências da Educação (Formação de Adultos), Universidade de Lisboa, Instituto de Educação, 2011

Sensory imagery in individuals who are blind and sighted: examining unimodal and multimodal forms

Introduction: Previous research has suggested that visual images are more easily generated, more vivid and more memorable than other sensory modalities. This research examined whether or not imagery is experienced in similar ways by people with and without sight. Specifically, the imabeability of visual, auditory and tactile cue words was compared. The degree to which images were multimodal or unimodal was also examined. Method: Twelve participants totally blind from early infancy and 12 sighted participants generated images in response to 53 sensory and non sensory words, rating imageability and the sensory modality, and describing images. From these 53 items, 4 subgroups of words, which stimulated images that were predominantly visual, tactile, auditory and low-imagery, respectively, were created. Results: T-tests comparing imageability ratings from blind and sighted participants found no differences for auditory and tactile words (both p>.1). Nevertheless, whilst participants without sight found auditory and tactile images equally imageable, sighted participants found images in response to tactile cue words harder to generate than visual cue words (mean difference: -0.51, p=.025). Participants with sight were also more likely to develop multisensory images than were participants without sight (both U≥15.0, N1=12, N2=12, p≤.008). Discussion: For both the blind and sighted, auditory and tactile images were rich and varied and similar language was used. Sighted participants were more likely to generate multimodal images. This was particularly the case for tactile words. Nevertheless, cue words that resulted in multisensory images were not necessarily rated as more imageable. The discussion considers whether or not multimodal imagery represent a method of compensating for impoverished unimodal imagery. Implications for Practitioners: Imagery is important not only as a mnemonic in memory rehabilitation, but also everyday uses for things such as autobiographical memory. This research emphasises both the importance of not only auditory and tactile sensory imagery, but also spatial imagery for people without sight.

A importância do processo ensino: aprendizagem do trompete entre a música erudita e o jazz, tendo como objetivo a versatilidade na performance: relatório de estágio

Resumo I (Prática Pedagógica) - O Relatório de estágio foi concebido no âmbito da Unidade Curricular de Estágio do Ensino Especializado, Mestrado em Ensino da Música pela Escola Superior de Música de Lisboa. Assim, este documento assenta sobre a prática pedagógica desenvolvida no Conservatório de Música David de Sousa – Polo Pombal no ano letivo 2014-2015, abrangendo três alunos de diferentes graus de ensino. Neste Relatório será caracterizado o estabelecimento de ensino onde decorreu o estágio, assim como o desempenho que cada aluno teve durante o ano letivo, salientando os aspetos de competência motora, auditiva e expressiva. Este trabalho consistiu na avaliação do meu desempenho enquanto docente de trompete, permitindo-me refletir sobre os pontos bons e menos bons do meu trabalho, para que no futuro me seja possível atingir um nível mais elevado na minha atividade docente.

Recommendations for Nova School of Business and Economics to target yhe Colombian market

The growing connotation Internationalization has worldwide, alongside the economic, political and socio-environmental changes, is empowering a progressively global education economy. Therefore, this Work Project aims to help Nova SBE to understand the decision making process of the Colombian tertiary education students, as this market constitutes an enriching opportunity to meet both business and educative objectives. In order to do so, a qualitative research was conducted to comprehend the rationale behind Colombian students to study abroad. The study points out that the reputation of a HE institution and the Portuguese culture are the key attributes to pursue a degree in Portugal.

Flagellin promotes myeloid differentiation factor 88-dependent development of Th2-type response.

Activation of dendritic cells (DC) by microbial products via Toll-like receptors (TLR) is instrumental in the induction of immunity. In particular, TLR signaling plays a major role in the instruction of Th1 responses. The development of Th2 responses has been proposed to be independent of the adapter molecule myeloid differentiation factor 88 (MyD88) involved in signal transduction by TLRs. In this study we show that flagellin, the bacterial stimulus for TLR5, drives MyD88-dependent Th2-type immunity in mice. Flagellin promotes the secretion of IL-4 and IL-13 by Ag-specific CD4(+) T cells as well as IgG1 responses. The Th2-biased responses are associated with the maturation of DCs, which are shown to express TLR5. Flagellin-mediated DC activation requires MyD88 and induces NF-kappaB-dependent transcription and the production of low levels of proinflammatory cytokines. In addition, the flagellin-specific response is characterized by the lack of secretion of the Th1-promoting cytokine IL-12 p70. In conclusion, this study suggests that flagellin and, more generally, TLR ligands can control Th2 responses in a MyD88-dependent manner.

Adolescent Drug Abuse Diagnosis (ADAD) vs. Health of Nation Outcome Scale for Children and Adolescents (HoNOSCA) in clinical outcome measurement.

BACKGROUND: The Adolescent Drug Abuse Diagnosis (ADAD) and Health of Nation Outcome Scales for Children and Adolescents (HoNOSCA) are both measures of outcome for adolescent mental health services. AIMS: To compare the ADAD with HoNOSCA; to examine their clinical usefulness. METHODS: Comparison of the ADAD and HoNOSCA outcome measures of 20 adolescents attending a psychiatric day care unit. RESULTS: ADAD change was positively correlated with HoNOSCA change. HoNOSCA assesses the clinic's day-care programme more positively than the ADAD. The ADAD detects a group for which the mean score remains unchanged whereas HoNOSCA does not. CONCLUSIONS: A good convergent validity emerges between the two assessment tools. The ADAD allows an evidence-based assessment and generally enables a better subject discrimination than HoNOSCA. HoNOSCA gives a less refined evaluation but is more economic in time and possibly more sensitive to change. Both assessment tools give useful information and enabled the Day-care Unit for Adolescents to rethink the process of care and of outcome, which benefited both the institution and the patients.

ESL students' perceptions of web-based prewriting activities /

Although much research has explored computer mediated communication for its application in second language instruction, there still exists a need for empirical results from research to guide practitioners who wish to introduce web-based activities into their instruction. This study was undertaken to explore collaborative online task-based activities for the instruction of ESL academic writing. Nine ESL students in their midtwenties, enrolled at a community college in Ontario, engaged in two separate online prewriting activities in both a synchronous and an asynchronous environment. The students were interviewed in order to explore their perceptions of how the activities affected the generation and organization of ideas for academic essays. These interviews were triangulated with examples of the students' online writing, nonparticipatory observations of the students' interactions, and a discussion with the course instructor. The results of the study reveal that a small majority of students felt that brainstorming in writing with their peers in an asynchronous online discussion created a grammatical and lexical framework that supported idea generation and organization. The students did not feel that the synchronous chat activity was as successful. Although they felt that this activity also contributed to the generation of ideas, synchronous chat introduced a level of difficulty in communication that hindered the students' engagement in the task and failed to assist them with the organization of their ideas. The students also noted positive aspects of the web-based activities that were not related to prewriting tasks, for example, improved typing and word processing skills. Directions for future research could explore whether online prewriting activities can assist students in the creation of essays that are syntactically or lexically complex.

Conceptions of Quality and Approaches to Quality Assurance in Ontario’s Universities

Many international, political, and economic influences led to increased demands for development of new quality assurance systems for universities. Like many policies and processes that aim to assure quality, Ontario’s Quality Assurance Framework (QAF) did not define quality. This study sought to explore conceptions of quality and approaches to quality assurance used within Ontario’s universities. A document analysis of the QAF’s rationale and structure suggested that quality was conceived primarily as fitness for purpose, while suggested indicators represented an exceptional conception of quality. Ontario universities perpetuated such confusion by adopting the framework without customizing it to their institutional conceptions of quality. Drawing upon phenomenographic traditions, a qualitative investigation was conducted to better understand various conceptions of quality held by university administrators and to appreciate ways in which they implemented the QAF. Three main approaches to quality assurance were identified: (a) Defending Quality, characterized by conceptions of quality as exceptional, which focuses on administrative accountability and uses a hands-off strategy to defend traditional notions of quality inputs and resources; (b) Demonstrating Quality, characterized by conceptions of quality as fitness for purpose and value for money, which focuses on accountability to students and uses centralized engaged strategies to demonstrate how programs meet current priorities and intended outcomes; and (c) Enhancing Quality, characterized by conceptions of quality as transformation, which focuses on reflection and learning experience and uses engaged strategies to find new ways of improving learning and teaching. The development of a campus culture that values the institution’s function in student learning and quality teaching would benefit from Enhancing Quality approaches to quality assurance. This would require holistic consideration of the beliefs held by members of the institution, a clear articulation of the institution’s conceptions of quality, and a critical analysis of how these conceptions align with institutional practices and policies.

Le code d'éthique dans les organisations du réseau de la santé: outil de régulation des conduites?

Au Québec, la Loi sur les services de santé et les services sociaux, Chapitre S-4.2, à son article 233, demande à ce que chacun des établissements de santé, dispose d’un code d’éthique qui essentiellement demande de préciser les droits des usagers et de fixer les conduites attendues du personnel. Le législateur souhaitait améliorer les conduites du personnel dès le début des années 1990 et envisageait désigner un organisme de surveillance pour s’en assurer. Cette contrainte ne fut pas retenue et 20 ans plus tard, la volonté d’assurer des conduites attendues n’est toujours pas assujettie de contraintes ou de contrôles même si elle est toujours souhaitée. En 2003 toutefois, le Ministre a mis en place un processus de visites ministérielles dans les milieux d’hébergement et à ce jour quelques 150 établissements ont été visités. Ces équipes se sont préoccupées entre autre de la fonction du code d’éthique pour soutenir les directions de ces établissements. Elles ne réussissent pas à pouvoir s’appuyer sur le code d’éthique pour qu’il soit l’assise pour baser les décisions cliniques, organisationnelles et de gestion de chacune des organisations du réseau de la santé et des services sociaux du Québec. Il faut à ce moment-ci faire le constat que le code d’éthique, obligatoire, figure au nombre des nombreuses contraintes rencontrées par les organisations. Les établissements doivent passer un processus d’agrément aux trois ans et le code d’éthique n’est pas davantage un élément dynamique retenu à ce processus de validation de normes de qualité. De plus, une revue québécoise spécialisée en gestion de la santé a consacré un numéro complet de 15 articles sur « éthique et comportements » et le code d’éthique y est absent sauf pour deux articles qui s’y attardent spécifiquement. Est-ce une question d’éthique dont il est question par ce code, ou si ce n’est pas davantage de la déontologie, d’autant que le législateur veut avant tout s’assurer de comportements adéquats de la part des employés et des autres personnes qui exercent leur profession. Est-ce qu’un code de conduite ne serait pas plus approprié pour atteindre les fins visées? Cette question est répondue dans ce mémoire qui regarde les concepts d’éthique, de déontologie, de codes, de régulation des comportements. De plus, des analyses détaillées de 35 codes d’éthique actuels de divers établissements et de diverses régions du Québec iv sont présentées. La littérature nous donne les conditions de réussite pour un code et outre l’importance à accorder aux valeurs énoncées dans l’organisation, il est également question des sanctions à prévoir au non-respect de ces valeurs. Elles se doivent d’être claires et appliquées. Enfin, beaucoup d’organisations parlent maintenant de code de conduite et ce terme serait tout à fait approprié pour rejoindre le souhait du législateur qui veut assurer des conduites irréprochables des employés et autres personnes qui y travaillent. C’est la conclusion de ce travail, énoncée sous forme de recommandation.

Farm Programmes of Electronic Media: A Comparative Study of Audience Perception in Kerala

Farm communication and extension programs are vital part of the farm development attempts. Electronic media plays a major role in farm extension activities. Kerala, the consumer state, which was a complete agricultural state in pre-independence period, is the sprouting land of agricultural extension and publication activities in print media. Later AIR (All India Radio) farm programs and farm broadcasting of Doordarshan enriched the role of electronic media in farm extension activities. The media saturated southern state of India received this new electronic media farm communication revolution whole heartedly. However, after 1990, Kerala witnessed a flood of private T V channels and currently there are 24 channels in this regional language, named Malayalam. All major news and entertainment channels are broadcasting farm programs. Farm programs of AIR and Doordarshan, broadcasted in Malayalam language, have been well accepted to the farmers‘ in Kerala. However, post-independence period, witnessed the formation of Kerala state in Indian Union and the first ballot-elected communist Government started its administration. After the land reform bills, the state witnessed a gradual decrease in agricultural production. Even if it is not reflected much in the attitude and practices of farm community and farm broadcast of traditional electronic broadcasting, a change is observable after the post-liberalization era of India. Private Television channels, which were focused on entertainment value of programs, started broadcasting farm programs and the parameters of program production went through certain changes. In this situation, there is ample relevance for a study about the farm programs of electronic media in terms of a comparative study of audience perception. The study is limited in the state of Kerala as it is the most media saturated state in India. The study analyzes the rate, nature and scope of adoption of farming methods transmitted through electronic media (T.V. and Radio) in Malayalam language.All kinds of Farm programs including comprehensive program serials, success stories, seasonal cropping methods, experts opinion, been analyzed on the basis of the following objectives.  To find whether propagating new farm methods through farm programs in electronic media or the availability of adequate infrastructure and economic factors make a farmer to adopt a new farming method.  To find which electronic media has more influence on farmers to adopt agricultural programs.  To find which form of electronic media gets better feedback from farmers  To find out whether the programs of T.V. or Radio is more acceptable to farmers than the print media.  To find whether farmers gets the message through their preferred medium for the message. The researcher recorded opinions from a panel of agricultural officers, farm Information officers, agro extension researchers and experts. According to their opinions and guidelines, a pilot study is designed and conducted in Kanjikuzhy Panchayath, in Alappuzha district, Kerala. The Panchayath is selected by considering its ideal nature of being the sample for a social Science research. Besides, the nature of farming in the Panchayath, which devoid of the cultivation of cash crops also supported its sample value. As per the observations from the pilot study, researcher confirmed the Triangulation method as the methodology of research. The questionnaire survey, being the primary part contained 42 Questions with 6 independent and 32 dependent variables. The survey is conducted among 400 respondents in Idukki, Alappuzha and Pathanamthitta districts considering geographical differences and distribution of different types of crops. The response from a total of 360 respondents, 120 from each district, finally selected for tabulation and data analysis.The data analysis, based on percentage analysis, along with the results from focus group discussion among a selected group of 20 farmers, together produced the results as follows. Farmers, who are the audience of farm programs, have a very serious approach towards the medium. They are maintaining a critical point of view towards the content of the programs. Farmers are reasonably aware about the financial side of the programs and the monitory aspirations of both private and Government owned Television channels. Even though, the farmers are not aware on the technical terminology and jargons, they have ideas about success stories, program serials and they are even informed about channels are not maintaining an audience research section like AIR. Though the farmers accept Doordarshan as the credential source of farm information and methods, they are inclined to the entertainment value of programs too. They prefer to have more entertainment value for the programs of Doordarshan. Surprisingly, they have very solid suggestions on even about the shots which add entertainment value to the farm broadcasting methods of Doordarshan. Farmers are very much aware about the fact that media is just an instrument for inspiration and persuasion. They strongly believe that the source of information and new methods is agricultural research and an effective change happens only when there are adequate infrastructure and marketing facilities, along with the proper support from Government agricultural guideline and support systems like Krishi Bhavans. They strongly believe that media alone cannot create any magic in increasing agricultural production. Farmers are pointing out the lack of response to the feedback and queries of farmers on farming methods, as an evidence for the difference in levels of commitment of Government and private owned Television channels.Farmers are still perceiving AIR farm programs are far more committed to farmers and farming than any other electronic medium. However, they are seriously lacking Radio receivers with medium wave reception facility. Farmers perceive that the farming methods on new crops are more adoptable than the farming methods of traditional crops in both private and Government owned Television channels. There are multiple factors behind this observation from farmers. Farmers changed in terms of viewing habits and they prefer success stories, which are totally irrelevant and they even think that such stories encourage people to go for farming and they opined that such stories are good sources of inspiration. However, they are all very much sure about the importance and particular about the presence of entertainment factor even in farm programs. Farmers expect direct interaction of any expert of the new farming method to implement the method in their agriculture practices. Though introduction of a new idea in the T.V. is acceptable, farmers need the direct instruction of expert on field to start implementing the new farming practices Farmers still have an affinity towards print media reports and agricultural pages and they have complaints to print media on the removal of agricultural information pages from news papers. They prefer the reports in print media as it facilitates them to collect and refer articles when they need it. Farmers are having an eye of doubt about the credibility of farm programs by private T.V. channels. Even if they prefer private Television channels for listening and adopting new farming methods and other farm information, they scrutinize programs to know whether they are sponsored programs by agrochemical or agro-fertilizer manufacturer.

Transformación de la Doctrina de Seguridad de la OTAN, en la Post- Guerra Fría, y sus efectos en la intervención en Macedonia (2001-2003)

El objetivo de esta monografía es examinar la transformación de la doctrina de seguridad de la OTAN en la Post-Guerra Fría y sus efectos en la intervención en la República de Macedonia. La desintegración del bloque soviético implicó la variación en la definición de las amenazas que atentan contra la supervivencia de los países miembro de la Alianza Atlántica. A partir de la década de los noventa, los conflictos de naturaleza interétnica pasaron a formar parte de los riesgos que transgreden la seguridad de los Aliados y la estabilidad del área Euro-Atlántica. Por lo anterior, la OTAN intervino en aquellos Estados en los que prevalecían las confrontaciones armadas interétnicas, como por ejemplo: en Macedonia. Allí, la Alianza Atlántica ejecutó operaciones de gestión de crisis para contrarrestar la amenaza. El fenómeno a estudiar en esta investigación será analizado a partir del Realismo Subalterno y de la Teoría de la Seguridad Colectiva.

Educação de meninos no espaço religioso : um estudo sobre a educação católica arquidiocesana (1961 - 1966)

O trabalho foca e analisa o Ginásio Arquidiocesano Sagrado Coração de Jesus, colégio criado na Arquidiocese de Aracaju/Se, escola confessional exclusiva na educação de homens no período de 1961 a 1966, criada pelo Padre José Carvalho de Souza, como um instrumento a serviço da Educação Católica na cidade de Aracaju. Os padres Diocesanos do Sagrado Coração de Jesus tinham como objeto a instrução de rapazes de todo o estado sergipano, a partir dos princípios da fé cristã. Como objeto principal, o trabalho discute a trajetória desta instituição de ensino a partir da cultura escolar católica masculina em seus primeiros anos de existência, mediante as memórias de ex-alunos, professores, membros da instituição, documentos institucionais, e do arquivo público do Estado de Sergipe, através dos periódicos consultados.

Reading fluency in children who are deaf or hard of hearing

This literature review explores the role of reading fluency in children who are deaf or hard of hearing and the essential role reading fluency plays in reading comprehension. The information gathered in this paper supports the importance of direct instruction of reading fluency with children who are deaf or hard of hearing.