786 resultados para Serious suicide attempts
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Increased global uptake of entertainment gaming has the potential to lead to high expectations of engagement and interactivity from users of technology-enhanced learning environments. Blended approaches to implementing game-based learning as part of distance or technology-enhanced education have led to demonstrations of the benefits they might bring, allowing learners to interact with immersive technologies as part of a broader, structured learning experience. In this article, we explore how the integration of a serious game can be extended to a learning content management system (LCMS) to support a blended and holistic approach, described as an 'intuitive-guided' method. Through a case study within the EU-Funded Adaptive Learning via Intuitive/Interactive, Collaborative and Emotional Systems (ALICE) project, a technical integration of a gaming engine with a proprietary LCMS is demonstrated, building upon earlier work and demonstrating how this approach might be realized. In particular, how this method can support an intuitive-guided approach to learning is considered, whereby the learner is given the potential to explore a non-linear environment whilst scaffolding and blending provide guidance ensuring targeted learning objectives are met. Through an evaluation of the developed prototype with 32 students aged 14-16 across two Italian schools, a varied response from learners is observed, coupled with a positive reception from tutors. The study demonstrates that challenges remain in providing high-fidelity content in a classroom environment, particularly as an increasing gap in technology availability between leisure and school times emerges.
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The European Leonardo da Vinci Transfer of Innovation project “Teacher training to improve attractiveness and quality of management education through the simulation tool ‘Emerald Forest’” which emphases on using the computer simulation tool for increasing attractiveness of teaching and learning in economics is presented in this paper. The observation of using computer systems and especially serious games in education is provided as well. “Education is not the filling of a pail, but the lighting of a fire” - William Butler Yeats
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The emergence of innovative and revolutionary Integration Technologies (IntTech) has highly influenced the local government authorities (LGAs) in their decision-making process. LGAs that plan to adopt such IntTech may consider this as a serious investment. Advocates, however, claim that such IntTech have emerged to overcome the integration problems at all levels (e.g. data, object and process). With the emergence of electronic government (e-Government), LGAs have turned to IntTech to fully automate and offer their services on-line and integrate their IT infrastructures. While earlier research on the adoption of IntTech has considered several factors (e.g. pressure, technological, support, and financial), inadequate attention and resources have been applied in systematically investigating the individual, decision and organisational context factors, influencing top management's decisions for adopting IntTech in LGAs. It is a highly considered phenomenon that the success of an organisation's operations relies heavily on understanding an individual's attitudes and behaviours, the surrounding context and the type of decisions taken. Based on empirical evidence gathered through two intensive case studies, this paper attempts to investigate the factors that influence decision makers while adopting IntTech. The findings illustrate two different doctrines - one inclined and receptive towards taking risky decisions, the other disinclined. Several underlying rationales can be attributed to such mind-sets in LGAs. The authors aim to contribute to the body of knowledge by exploring the factors influencing top management's decision-making process while adopting IntTech vital for facilitating LGAs' operational reforms.
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Purpose: This paper presents the system architecture of a serious game, which is going to be run in parallel to Rolls Royce tra ining on product-service systems (PSS). Design/methodology/approach: The original game is outlined, requirements for an onl ine version are defined, and the architecture is proposed. Findings: The games approach has proven its value in design for service tra ining but an online version is needed to improve the opportunit ies to deliver the game. Originality/value: Such a system presents opportunities for the acquisition and development of specific professional knowledge, skills, and competencies
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Background: Adverse drug reactions (ADRs) cause significant morbidity and mortality and account for around 6.5% of hospital admissions. Patient experiences of serious ADRs and their long-term impact on patients' lives, including their influence on current attitudes towards medicines, have not been previously explored. Objective: The aim of the study was to explore the experiences, beliefs, and attitudes of survivors of serious ADRs, using drug-induced Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) as a paradigm. Methods: A retrospective, qualitative study was undertaken using detailed semi-structured interviews. Fourteen adult survivors of SJS and TEN, admitted to two teaching hospitals in the UK, one the location of a tertiary burns centre, were interviewed. Interview transcripts were independently analysed by three different researchers and themes emerging from the text identified. Results: All 14 patients were aware that their condition was drug induced, and all but one knew the specific drug(s) implicated. Several expressed surprise at the perceived lack of awareness of the ADR amongst healthcare professionals, and described how the ADR was mistaken for another condition. Survivors believed that causes of the ADR included (i) being given too high a dose of the drug; (ii) medical staff ignoring existing allergies; and (iii) failure to monitor blood tests. Only two believed that the reaction was unavoidable. Those who believed that the condition could have been avoided had less trust in healthcare professionals. The ADR had a persisting impact on their current lives physically and psychologically. Many now avoided medicines altogether and were fearful of becoming ill enough to need them. © 2011 Adis Data Information BV. All rights reserved. Conclusions: Life-threatening ADRs continued to affect patients’ lives long after the event. Patients’ beliefs regarding the cause of the ADR differed, and may have influenced their trust in healthcare professionals and medicines. We propose that clear communication during the acute phase of a serious ADR may therefore be important.
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This paper consolidates evidence and material from a range of specialist and disciplinary fields to provide an evidence-based review and synthesis on the design and use of serious games in higher education. Search terms identified 165 papers reporting conceptual and empirical evidence on how learning attributes and game mechanics may be planned, designed and implemented by university teachers interested in using games, which are integrated into lesson plans and orchestrated as part of a learning sequence at any scale. The findings outline the potential of classifying the links between learning attributes and game mechanics as a means to scaffold teachers’ understanding of how to perpetuate learning in optimal ways while enhancing the in-game learning experience. The findings of this paper provide a foundation for describing methods, frames and discourse around experiences of design and use of serious games, linked to methodological limitations and recommendations for further research in this area.
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Background People diagnosed with serious mental illnesses (SMIs) such as schizophrenia and bipolar affective disorder are frequently treated with antipsychotics. National guidance advises the use of shared decision-making (SDM) in antipsychotic prescribing. There is currently little data on the opinions of health professionals on the role of SDM. Objective To explore the views and experiences of UK mental health pharmacists regarding the use of SDM in antipsychotic prescribing in people diagnosed with SMI. Setting The study was conducted by interviewing secondary care mental health pharmacists in the UK to obtain qualitative data. Methods Semi-structured interviews were recorded. An inductive thematic analysis was conducted using the method of constant comparison. Main outcome measure Themes evolving from mental health pharmacists on SDM in relation to antipsychotic prescribing in people with SMI. Results Thirteen mental health pharmacists were interviewed. SDM was perceived to be linked to positive clinical outcomes including adherence, service user satisfaction and improved therapeutic relations. Despite more prescribers and service users supporting SDM, it was not seen as being practised as widely as it could be; this was attributed to a number of barriers, most predominantly issues surrounding service user’s lacking capacity to engage in SDM and time pressures on clinical staff. The need for greater effort to work around the issues, engage service users and adopt a more inter-professional approach was conveyed. Conclusion The mental health pharmacists support SDM for antipsychotic prescribing, believing that it improves outcomes. However, barriers are seen to limit implementation. More research is needed into overcoming the barriers and measuring the benefits of SDM, along with exploring a more inter-professional approach to SDM.
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Purpose – The purpose of this paper is to present a conceptual framework in order to analyse and understand the twin developments of successful microeconomic reform on the one hand and failed macroeconomic stabilisation attempts on the other hand in Hungary. The case study also attempts to explore the reasons why Hungarian policymakers were willing to initiate reforms in the micro sphere, but were reluctant to initiate major changes in public finances both before and after the regime change of 1989/1990. Design/methodology/approach – The paper applies a path-dependent approach by carefully analysing Hungary's Communist and post-Communist economic development. The study restricts itself to a positive analysis but normative statements can also be drawn accordingly. Findings – The study demonstrates that the recent deteriorating economic performance of Hungary is not a recent phenomenon. By providing a path-dependent explanation, it argues that both Communist and post-Communist governments used the general budget as a buffer to compensate the losers of economic reforms, especially microeconomic restructuring. The gradualist success of the country – which dates back to at least 1968 – in the field of liberalisation, marketisation and privatisation was accompanied by a constant overspending in the general government. Practical implications – Hungary has been one of the worst-hit countries of the 2008/2009 financial crisis, not just in Central and Eastern Europe but in the whole world. The capacity and opportunity for strengthening international investors' confidence is, however, not without doubts. The current deterioration is deeply rooted in failed past macroeconomic management. The dissolution of fiscal laxity and state paternalism in a broader context requires, therefore, an all-encompassing reform of the general government, which may trigger serious challenges to the political regime as well. Originality/value – The study aims to show that a relatively high ratio of redistribution, a high and persistent public deficit and an accelerated indebtedness are not recent phenomena in Hungary. In fact, these trends characterised the country well before the transformation of 1989/1990, and have continued in the post-socialist years, too. To explain such a phenomenon, the study argues that in the last couple of decades the hardening of the budget constraint of firms have come at the cost of maintaining the soft budget constraint of the state.
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Az elmúlt évtizedek felgyorsult technológiai fejlődése komoly kihívásokat jelent mind a cégeknek, mind az egyéneknek. Intézményesített „jövőkezelésre” és ennek menedzselésére van szükség. A szerzők tanulmányukban át kívánják tekinteni a jövőkutatás, a technológiamenedzsment, az innovációmenedzsment és egyéb megközelítések releváns alapjait, viszonyait és lehetséges integrációjukat. Be kívánják mutatni a meghatározó területeket és trendeket. Keresik azokat a menedzsment-alapkérdéseket, tanulságokat és dilemmákat, amelyek minden olyan vállalatnak érdekesek és hasznosak lehetnek, amelyek a fejlődő technológia lehetőségeit szeretnék kiaknázni, vagy csak egyszerűen szeretnének a követhetetlenül gyors fejlődésben talpon maradni. _____________ The fast pace technology development creates a serious challenge both for individuals and for companies. There is a concept which attempts to handle this challenge by “institutional future management”. In their paper the authors survey the relevant concepts of future studies, technology management and other areas, and explore their connections and integration possibilities. They also would like to introduce some key technology trends, and at the same time some basic managerial questions, dilemmas, conclusions which might have importance to those corporations which have to survive in an environment determined by accelerated technology based innovation.
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This paper explains how Poisson regression can be used in studies in which the dependent variable describes the number of occurrences of some rare event such as suicide. After pointing out why ordinary linear regression is inappropriate for treating dependent variables of this sort, we go on to present the basic Poisson regression model and show how it fits in the broad class of generalized linear models. Then we turn to discussing a major problem of Poisson regression known as overdispersion and suggest possible solutions, including the correction of standard errors and negative binomial regression. The paper ends with a detailed empirical example, drawn from our own research on suicide.
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Early childhood research beginning in the 1960s has focused on the literacy experiences of preschool children in the home and the contribution of those experiences to later school success. Decades of research since then have investigated learning experiences of preschool children as they interacted with caregivers, siblings or peers prior to formal schooling (Durkin, 1966; Heath, 1983). ^ In this qualitative investigation into early literacy events that occur between disadvantaged Irish mothers and their children, four research questions were investigated. (1) How do disadvantaged Irish mothers engage their preschool children in literacy events such as storybook reading and jigsaw puzzle building? (2) How does the mother's previous school experience affect her role as the child's first teacher? (3) How does the culture of the neighborhood affect the child's developing literacy? (4) What risk factors inhibit literacy development in these Irish children? ^ This study examined the conversational exchanges between three disadvantaged Irish mothers and their preschool children living near Dublin, Ireland, as the mothers read a storybook to their children and assisted them in jigsaw puzzle building. Conversations were recorded, transcribed and analyzed into reading skill and teaching strategy categories for the purpose of determining the mothers' literacy intent during her turn. Journal notes, field notes and interviews with the mothers recorded other information and allowed for triangulation of data. ^ The results of this investigation indicated four findings. The first finding was that these disadvantaged mothers employed many of the same techniques that classroom teachers use during the reading lesson. They attempted high-level and low-level questions, teaching strategies, and other interactions that are so familiar in the classroom. The second finding was that jigsaw puzzle building produced a richer literacy interaction than storybook reading. The third finding was that the environment of the disadvantaged neighborhood posed many risks to children's literacy development. A final finding was that the mothers used thinking out loud behavior to vocalize their inner thoughts during literacy interactions. ^ Future research suggests studying mother/child dyads in other socio-economic environments and cultures to determine if other mothers practice the same skills and strategies as these mothers. ^
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The rate of fatal crashes in Florida has remained significantly higher than the national average for the last several years. The 2003 statistics from the National Highway Traffic Safety Administration (NHTSA), the latest available, show a fatality rate in Florida of 1.71 per 100 million vehicle-miles traveled compared to the national average of 1.48 per 100 million vehicle-miles traveled. The objective of this research is to better understand the driver, environmental, and roadway factors that affect the probability of injury severity in Florida. ^ In this research, the ordered logit model was used to develop six injury severity models; single-vehicle and two-vehicle crashes on urban freeways and urban principal arterials and two-vehicle crashes at urban signalized and unsignalized intersections. The data used in this research included all crashes that occurred on the state highway system for the period from 2001 to 2003 in the Southeast Florida region, which includes the Miami-Dade, Broward and Palm Beach Counties.^ The results of the analysis indicate that the age group and gender of the driver at fault were significant factors of injury severity risk across all models. The greatest risk of severe injury was observed for the age groups 55 to 65 and 66 and older. A positive association between injury severity and the race of the driver at fault was also found. Driver at fault of Hispanic origin was associated with a higher risk of severe injury for both freeway models and for the two-vehicle crash model on arterial roads. A higher risk of more severe injury crash involvement was also found when an African-American was the at fault driver on two-vehicle crashes on freeways. In addition, the arterial class was also found to be positively associated with a higher risk of severe crashes. Six-lane divided arterials exhibited the highest injury severity risk of all arterial classes. The lowest severe injury risk was found for one way roads. Alcohol involvement by the driver at fault was also found to be a significant risk of severe injury for the single-vehicle crash model on freeways. ^
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Aquatic toxins are responsible for a number of acute and chronic diseases in humans. Okadaic acid (OA) and other dinoflagellate derived polyketide toxins pose serious health risks on a global scale. Ingestion of OA contaminated shellfish causes diarrheic shellfish poisoning (DSP). Some evidence also suggests tumor promotion in the liver by OA. Microcystin-LR (MC-LR) is produced by cyanobacteria and is believed to be the most common freshwater toxin in the US. Humans may be exposed to this acute hepatotoxin through drinking or recreational use of contaminated waters. ^ OA producing dinoflagellates have not been cultured axenically. The presence of associated bacteria raises questions about the ultimate source of OA. Identification of the toxin-producing organism(s) is the first step in identifying the biosynthetic pathways involved in toxin production. Polyketide synthase (PKS) genes of toxic and non-toxic species were surveyed by construction of clonal libraries from PCR amplicons of various toxic and non-toxic species of Prorocentrum in an effort to identify genes, which may be part of the biosynthetic pathway of OA. Analysis of the PKS sequences revealed that toxic species shared identical PKS genes not present in non-toxic species. Interestingly, the same PKS genes were identified in a library constructed from associated bacteria. ^ Subsequent bacterial small subunit RNA (16S) clonal libraries identified several common bacterial species. The most frequent 16S sequences found were identified as species of the genus Roseobacter which has previously been implicated in the production of OA. Attempts to culture commonly occurring bacteria resulted in the isolation of Oceanicaulis alexandrii , a novel marine bacterium previously isolated from the dinoflagellate Alexandrium tamarense, from both P. lima, and P. hoffmanianum. ^ Metabolic studies of microcystin-LR, were conducted to probe the activity of the major human liver cytochromes (CYP) towards the toxin. CYPs may provide alternate routes of detoxification of toxins when the usual routes have been inhibited. For example, some research indicates that cyanobacterial xenobiotics, in particular, lipopolysaccharides may inhibit glutathione S-transferases allowing the toxin to persist long enough to be acted upon by other enzymes. These studies found that at least one human liver CYP was capable of metabolizing the toxin. ^
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Suicide in correctional facilities is a major issue institutions have to face on a daily basis. Identifying potential risks and factors could help prevent suicide as well as aid in the foundation of more rehabilitative programs. This paper examines suicide and the main factors that influence this phenomenon.
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To promote regional or mutual improvement, numerous interjurisdictional efforts to share tax bases have been attempted. Most of these efforts fail to be consummated. Motivations to share revenues include: narrowing fiscal disparities, enhancing regional cooperation and economic development, rationalizing land-use, and minimizing revenue losses caused by competition to attract and keep businesses. Various researchers have developed theories to aid understanding of why interjurisdictional cooperation efforts succeed or fail. Walter Rosenbaum and Gladys Kammerer studied two contemporaneous Florida local-government consolidation attempts. Boyd Messinger subsequently tested their Theory of Successful Consolidation on nine consolidation attempts. Paul Peterson's dual theories on Modern Federalism posit that all governmental levels attempt to further economic development and that politicians act in ways that either further their futures or cement job security. Actions related to the latter theory often interfere with the former. Samuel Nunn and Mark Rosentraub sought to learn how interjurisdictional cooperation evolves. Through multiple case studies they developed a model framing interjurisdictional cooperation in four dimensions. ^ This dissertation investigates the ability of the above theories to help predict success or failure of regional tax-base revenue sharing attempts. A research plan was formed that used five sequenced steps to gather data, analyze it, and conclude if hypotheses concerning the application of these theories were valid. The primary analytical tools were: multiple case studies, cross-case analysis, and pattern matching. Data was gathered from historical records, questionnaires, and interviews. ^ The results of this research indicate that Rosenbaum-Kammerer theory can be a predictor of success or failure in implementing tax-base revenue sharing if it is amended as suggested by Messinger and further modified by a recommendation in this dissertation. Peterson's Functional and Legislative theories considered together were able to predict revenue sharing proposal outcomes. Many of the indicators of interjurisdictional cooperation forwarded in the Nunn-Rosentraub model appeared in the cases studied, but the model was not a reliable forecasting instrument. ^