873 resultados para John E. Fogarty International Center for Advanced Study in the Health Sciences.


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The Convention on Biodiversity (CBD) was created in 1992 to coordinate global governments to protect biological resources. The CBD has three goals: protection of biodiversity, achievement of sustainable use of biodiversity and facilitation of equitable sharing of the benefits of biological resources. The goal of protecting biological resources has remained both controversial and difficult to implement. This study focused more on the goal of biodiversity protection. The research was designed to examine how globally constructed environmental policies get adapted by national governments and then passed down to local levels where actual implementation takes place. Effectiveness of such policies depends on the extent of actual implementation at local levels. Therefore, compliance was divided and examined at three levels: global, national and local. The study then developed various criteria to measure compliance at these levels. Both qualitative and quantitative methods were used to analyze compliance and implementation. The study was guided by three questions broadly examining critical factors that most influence the implementation of biodiversity protection policies at the global, national and local levels. Findings show that despite an overall biodiversity deficit of 0.9 hectares per person, global compliance with the CBD goals is currently at 35%. Compliance is lowest at local levels at 14%, it is slightly better at national level at 50%, and much better at the international level 64%. Compliance appears higher at both national and international levels because compliance here is paper work based and policy formulation. If implementation at local levels continues to produce this low compliance, overall conservation outcomes can only get worse than what it is at present. There are numerous weaknesses and capacity challenges countries are yet to address in their plans. In order to increase local level compliance, the study recommends a set of robust policies that build local capacity, incentivize local resource owners, and implement biodiversity protection programs that are akin to local needs and aspirations.

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This paper presents a proposal for analyzing discourses on gender equality in organizations. The research is carried out as a case study, focusing on the chemical industry in Tarragona. To the question: why there are still so many differences between women and men in labour market, despite having multiple tools to avoid inequalities? we propose to focus on discourses of equality to find an answer. The viewpoint that companies have on gender is crucial in enabling policies for equality. To ensure that policies are truly aimed at promoting equality, it is needed a gender approach that nowadays is not widespread in organizations. From these considerations, we present a fourfold typology of discourses on equality in organizations.

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Care has come to dominate much feminist research on globalized migrations and the transfer of labor from the South to the North, while the older concept of reproduction had been pushed into the background but is now becoming the subject of debates on the commodification of care in the household and changes in welfare state policies. This article argues that we could achieve a better understanding of the different modalities and trajectories of care in the reproduction of individuals, families, and communities, both of migrant and nonmigrant populations by articulating the diverse circuits of migration, in particular that of labor and the family. In doing this, I go back to the earlier North American writing on racialized minorities and migrants and stratified social reproduction. I also explore insights from current Asian studies of gendered circuits of migration connecting labor and marriage migrations as well as the notion of global householding that highlights the gender politics of social reproduction operating within and beyond households in institutional and welfare architectures. In contrast to Asia, there has relatively been little exploration in European studies of the articulation of labor and family migrations through the lens of social reproduction. However, connecting the different types of migration enables us to achieve a more complex understanding of care trajectories and their contribution to social reproduction.

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Oncological patients are submitted to invasive exams in order to obtain an accurate diagnosis; these procedures may cause maladaptative reactions (fear, anxiety and pain). Particularly in breast cancer, the most common diagnose technique is the incisional biopsy. Most of the patients are unaware about the procedure and for that reason they may focus their thoughts on possible events such as pain, bleeding, the anesthesia, or the later surgical wound care. Anxiety and pain may provoke physiological, behavioral and emotional complications, and because of this reason, the Behavioral Medicine trained psychologist takes an active role before and after the biopsy. The aim of this study was to evaluate the effect of a cognitive-behavioral program to reduce anxiety in women submitted to incisional biopsy for the first time. There were 10 participants from the Hospital Juárez de México, Oncology service; all of them were treated as external patients. The intervention program focused in psycho-education and passive relaxation training using videos, tape-recorded instructions and pamphlets. Anxiety measures were performed using the IDARE-State inventory, and a visual-analogue scale of anxiety (EEF-A), and the measurement of blood pressure and heart rate). Data were analyzed both intrasubject and intersubject using the Wilcoxon test (p≤0.05). The results show a reduction in anxiety (as in punctuation as in ranges) besides, a reduction in the EEF-A.

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This paper reports the findings from a study of the learning of English intonation by Spanish speakers within the discourse mode of L2 oral presentation. The purpose of this experiment is, firstly, to compare four prosodic parameters before and after an L2 discourse intonation training programme and, secondly, to confirm whether subjects, after the aforementioned L2 discourse intonation training, are able to match the form of these four prosodic parameters to the discourse-pragmatic function of dominance and control. The study designed the instructions and tasks to create the oral and written corpora and Brazil’s Pronunciation for Advanced Learners of English was adapted for the pedagogical aims of the present study. The learners’ pre- and post-tasks were acoustically analysed and a pre / post- questionnaire design was applied to interpret the acoustic analysis. Results indicate most of the subjects acquired a wider choice of the four prosodic parameters partly due to the prosodically-annotated transcripts that were developed throughout the L2 discourse intonation course. Conversely, qualitative and quantitative data reveal most subjects failed to match the forms to their appropriate pragmatic functions to express dominance and control in an L2 oral presentation.

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Purpose: We performed a multi-centre phase I study to assess the safety, pharmacokinetics (PK) and pharmacodynamics (PD) of the orally available small molecule mitogen-activated protein kinase kinase (MEK) 1/2 inhibitor, WX-554, and to determine the optimal biological dose for subsequent trials.
Experimental design: Patients with treatment-refractory, advanced solid tumours, with adequate performance status and organ function were recruited to a dose-escalation study in a standard 3 + 3 design. The starting dose was 25 mg orally once weekly with toxicity, PK and PD guided dose-escalation with potential to explore alternative schedules.
Results: Forty-one patients with advanced solid tumours refractory to standard therapies and with adequate organ function were recruited in eight cohorts up to doses of 150 mg once weekly and 75 mg twice weekly. No dose-limiting toxicities were observed during the study, and a maximum tolerated dose (MTD) was not established. The highest dose cohorts demonstrated sustained inhibition of extracellular signal-regulated kinase (ERK) phosphorylation in peripheral blood mononuclear cells following ex-vivo phorbol 12-myristate 13-acetate stimulation. There was a decrease of 70 ± 26% in mean phosphorylated (p)ERK in C1 day 8 tumour biopsies when compared with pre-treatment tumour levels in the 75 mg twice a week cohort. Prolonged stable disease (>6 months) was seen in two patients, one with cervical cancer and one with ampullary carcinoma.
Conclusions: WX-554 was well tolerated, and an optimal biological dose was established for further investigation in either a once or twice weekly regimens. The recommended phase 2 dose is 75 mg twice weekly.

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This thesis examines the effect of combating of human trafficking as a crime. Special emphasis has been placed on forced labour and the rights of trafficked victims and their protection. The study explores various legislations undertaken at regional, national and international levels and considers rights of trafficked victims under international human rights and Islamic rights. The aim of the thesis is to provide a critical and comparative analysis of the legal systems of the Kingdom of Saudi Arabia (KSA) and the United Kingdom (UK) in terms of human trafficking. The thesis consists of eight chapter; each covering a different aspect of the study. It begins by providing background information regarding the issue of human trafficking and proceeds to examine developments of legal frameworks across the two jurisdictions to combat this crime and penalize the criminals. It seeks to examine the legal system pertaining to human trafficking for forced labour and analyse the three distinct platforms, that is, prevention, protection, and punishment, by comparing the legal systems of the KSA and the UK. The examination of both countries aims to identify the strength and weaknesses of the KSA system as compared to the UK system. Thus, it concludes that the KSA can improve its ranking from Tier 2 watch list to Tier 1 if reforms are introduced in the legislation and enforcement domains. The study also demonstrates how the UK and the KSA portray ‘human trafficking’ in their regional laws. A problem often faced during the information-gathering and investigation stages is the lack of available evidence against traffickers, a particular issue in the KSA. The thesis concludes that the transnational aspect of this phenomenon makes it necessary to establish a thorough and comprehensive legal framework to cover all matters pertaining to this crime, including the protection of victims and punishment of criminals in the KSA and the UK, including immigration and ‘kafala’ strategies that may be of value in future researches.

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Shipping noise is a threat to marine wildlife. Grey seals are benthic foragers, and thus experience acoustic noise throughout the water column, which makes them a good model species for a case study of the potential impacts of shipping noise. We used ship track data from the Celtic Sea, seal track data and a coupled ocean-acoustic modelling system to assess the noise exposure of grey seals along their tracks. It was found that the animals experience step changes in sound levels up to ~20dB at a frequency of 125Hz, and ~10dB on average over 10-1000Hz when they dive through the thermocline, particularly during summer. Our results showed large seasonal differences in the noise level experienced by the seals. These results reveal the actual noise exposure by the animals and could help in marine spatial planning.

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The concept of patient activation has gained traction as the term referring to patients who understand their role in the care process and have the knowledge, skills and confidence necessary to manage their illness over time (Hibbard & Mahoney, 2010). Improving health outcomes for vulnerable and underserved populations who bear a disproportionate burden of health disparities presents unique challenges for nurse practitioners who provide primary care in nurse-managed health centers. Evidence that activation improves patient self-management is prompting the search for theory-based self-management support interventions to activate patients for self-management, improve health outcomes, and sustain long-term gains. Yet, no previous studies investigated the relationship between Self-determination Theory (SDT; Deci & Ryan, 2000) and activation. The major purpose of this study, guided by the Triple Aim (Berwick, Nolan, & Whittington, 2008) and nested in the Chronic Care Model (Wagner et al., 2001), was to examine the degree to which two constructs– Autonomy Support and Autonomous Motivation– independently predicted Patient Activation, controlling for covariates. For this study, 130 nurse-managed health center patients completed an on-line 38-item survey onsite. The two independent measures were the 6-item Modified Health Care Climate Questionnaire (mHCCQ; Williams, McGregor, King, Nelson, & Glasgow, 2005; Cronbach’s alpha =0.89) and the 8-item adapted Treatment Self-Regulation Questionnaire (TSRQ; Williams, Freedman, & Deci, 1998; Cronbach’s alpha = 0.80). The Patient Activation Measure (PAM-13; Hibbard, Mahoney, Stock, & Tusler, 2005; Cronbach’s alpha = 0.89) was the dependent measure. Autonomy Support was the only significant predictor, explaining 19.1% of the variance in patient activation. Five of six autonomy support survey items regressed on activation were significant, illustrating autonomy supportive communication styles contributing to activation. These results suggest theory-based patient, provider, and system level interventions to enhance self-management in primary care and educational and professional development curricula. Future investigations should examine additional sources of autonomy support and different measurements of autonomous motivation to improve the predictive power of the model. Longitudinal analyses should be conducted to further understand the relationship between autonomy support and autonomous motivation with patient activation, based on the premise that patient activation will sustain behavior change.

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OBJECTIVE: The literature contains many reports of balance function in children, but these are often on atypical samples taken from hospital-based clinics and may not be generalisable to the population as a whole. The purpose of the present study is to describe balance test results from a large UK-based birth cohort study. METHODS: Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) were analysed. A total of 5402 children completed the heel-to-toe walking test at age 7 years. At age 10 years, 6915 children underwent clinical tests of balance including beam-walking, standing heel-to-toe on a beam and standing on one leg. A proportion of the children returned to the clinic for retesting within 3 months allowing test-retest agreement to be measured. RESULTS: Frequency distributions for each of the balance tests are given. Correlations between measures of dynamic balance at ages 7 and 10 years were weak. The static balance of 10 year old children was found to be poorer with eyes closed than with eyes open, and poorer in boys than in girls for all measures. Balance on one leg was poorer than heel-to-toe balance on a beam. A significant learning effect was found when first and second attempts of the tests were compared. Measures of static and dynamic balance appeared independent. Consistent with previous reports in the literature, test-retest reliability was found to be low. CONCLUSIONS: This study provides information about the balance ability of children aged 7 and 10 years and provides clinicians with reference data for balance tests commonly used in the paediatric clinic.

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Recent perspectives on Pedagogy for Early Childhood Education emphasize children's participation in line with the Children's Rights Convention. The study aimed to analyse how children's rights are dealt with during recess in a school (Early Childhood and Primary Education) in Portugal. The aims were: to characterize the style of the adult (teaching assistants) and the interactions that are established with the children at the playground/recess, and analyse them in terms of children's rights. The qualitative approach was based on the observation during the recess for three weeks. The Adult Style Observation Schedule for Early Childhood Education (ASOS-ECE) was used to register and code the dynamics of six teaching assistants (3 ECE and 3 PE). Critical incidents were also registered. Statistical analysis of the ASOS-ECE levels were complemented with the content analysis of the notes. The playground space was quite limited and affected children's play and well-being. The outdoor playground was never used for the Early Childhood classes, only for Primary Education students but with little supervision. Children were often deprived of playground time by decision of the teaching assistants, as punishment. The results obtained through the Adult Style Observation Schedule for Early Childhood Education (ASOS-ECE) are not satisfactory and are below what would meet the minimum quality value (3,5). For Early Childhood Education, sensibility is the most valued dimension but with very low levels (<2,5). For Primary Education it was autonomy that scored highest (<2,5). The analysis of the notes/critical incidents highlighted articles 12 (expression of own views), 13 (freedom of expression), 19 (protection against violence), 29 (development of personality) and 31 (rest and leisure, play and recreational activities) as being put into question by actions of the adults responsible for the children. Children's rights and well-being need to be put forward in the knowledge base for all adults working with children so that Pedagogy can fulfil its purpose fully.

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Hypertension is a common condition causing cardio and cerebrovascular complications. Portugal has one of the highest mortality rates from stroke and a high prevalence of hypertension. Systolic Blood Pressure (SBP) is an important risk factor for cardiovascular events (myocardial infarction and stroke) and premature mortality, particularly in the elderly population. The present study aims to estimate the prevalence of hypertension in a Portuguese population living in a coastal city and to identify some of its determinants (namely gender, age, the body mass index and physical activity frequency). A total of 91 adults who attended three pharmacies of a coastal city in the center of Portugal, between May and August of 2013 were evaluated. Attendants who reported to have diabetes or taking antihypertensive drugs in the 2 previous weeks were excluded from the study. Sociodemographic factors, BMI, habits of exercise and BP were assessed. Hypertension was defined as blood pressure ≥140/90 mmHg. The majority of the studied population was constituted by women (75.8%), with a mean age of 54.2±1.6 years old, married or living in civil union and that had completed secondary school or had higher education (40%). They presented a mean BMI of 26.2±4.76 Kg/m2., and were sedentary. The mean BP was 127.0±17.77mmHg- 74.69 ± 9.53. In this population we found 4.3% of people with hypertension and 16.1% with normal high blood pressure. Men exhibit a tendency to present higher systolic blood pressure values than women. Of all the factors considered, SBP values also tended to be higher with age and higher BMI values. Despite the fact that the mean values of SBP did not present values higher than 140 mmHg we must be concerned because the studied population is undiagnosed for hypertension. Although this is a preliminary study, it might be a prelude to the upcoming research about the underlying factors responsible for the occurrence of SBP.

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El presente trabajo se realizó con el objetivo de tener una visión completa de las teorías del liderazgo, teniendo de este una concepción como proceso y poder examinar las diversas formas de aplicación en las organizaciones contemporáneas. El tema es enfocado desde la perspectiva organizacional, un mundo igualmente complejo, sin desconocer su importancia en otros ámbitos como la educación, la política o la dirección del estado. Su enfoque tiene que ver con el estudio académico del cual es la culminación y se enmarca dentro de la perspectiva constitucional de la Carta Política Colombiana que reconoce la importancia capital que tienen la actividad económica y la iniciativa privada en la constitución de empresas. Las diversas visiones del liderazgo han sido aplicadas de distintas maneras en las organizaciones contemporáneas y han generado diversos resultados. Hoy, no es posible pensar en una organización que no haya definido su forma de liderazgo y en consecuencia, confluyen en el campo empresarial multitud de teorías, sin que pueda afirmarse que una sola de ellas permita el manejo adecuado y el cumplimiento de los objetivos misionales. Por esta razón se ha llegado a concebir el liderazgo como una función compleja, en un mundo donde las organizaciones mismas se caracterizan no solo por la complejidad de sus acciones y de su conformación, sino también porque esta característica pertenece también al mundo de la globalización. Las organizaciones concebidas como máquinas que en sentido metafórico logran reconstituirse sus estructuras a medida que están en interacción con otras en el mundo globalizado. Adaptarse a las cambiantes circunstancias hace de las organizaciones conglomerados en permanente dinámica y evolución. En este ámbito puede decirse que el liderazgo es también complejo y que es el liderazgo transformacional el que más se acerca al sentido de la complejidad.