994 resultados para self-prescribing
Self-love and self-liking in the moral and political philosophy of Bernard Mandeville and David Hume
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This work offers a novel interpretation of David Hume’s (1711–1776) conception of the conjectural development of civil society and artificial moral institutions. It focuses on the social elements of Hume’s Treatise of human nature (1739–40) and the necessary connection between science of man and politeness, civilised monarchies, social distance and hierarchical structure of civil society. The study incorporates aspects of intellectual history, history of philosophy and book history. In order to understand David Hume’s thinking, the intellectual development of Bernard Mandeville (1670–1733) needs to be accounted for. When put into a historical perspective, the moral, political and social components of Treatise of human nature can be read in the context of a philosophical tradition, in which Mandeville plays a pivotal role. A distinctive character of Mandeville and Hume’s account of human nature and moral institutions was the introduction of a simple distinction between self-love and self-liking. The symmetric passions of self-interest and pride can only be controlled by the corresponding moral institutions. This is also the way in which we can say that moral institutions are drawn from human nature. In the case of self-love or self-interest, the corresponding moral institution is justice. Respectively, concerning self-liking or pride the moral institution is politeness. There is an explicit analogy between these moral institutions. If we do not understand this analogy, we do not understand the nature of either justice or politeness. The present work is divided into two parts. In the first part, ‘Intellectual development of Bernard Mandeville’, it is argued that the relevance of the paradigmatic change in Mandeville’s thinking has been missed. It draws a picture of Mandeville turning from the Hobbism of The Fable of the Bees to an original theory of civil society put forward in his later works. In order to make this change more apparent, Mandeville’s career and the publishing history of The Fable of the Bees are examined comprehensively. This interpretation, based partly on previously unknown sources, challenges F. B. Kaye’s influential decision to publish the two parts of The Fable of the Bees as a uniform work of two volumes. The main relevance, however, of the ‘Intellectual development of Mandeville’ is to function as the context for the young Hume. The second part of the work, ‘David Hume and Greatness of mind’, explores in philosophical detail the social theory of the Treatise and politics and the science of man in his Essays. This part will also reveal the relevance of Greatness of mind as a general concept for David Hume’s moral and political philosophy.
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BACKGROUND The Queensland University of Technology in collaboration with Queensland Health pioneered development of the Allied Health Prescribing Training Program to assist allied health professionals (AHPs) to competently prescribe medicines within their scope of practice. The study program consisted of two modules: Introduction to Clinical Therapeutics for Prescribers and Prescribing and Quality Use of Medicines. METHODS Pre- and post- surveys were developed for both modules. Key themes explored were understanding and confidence in selecting therapeutic choices for patients. For module 2 the learning objectives for safe and effective prescribing were investigated. Data were collected from participants in weeks one and thirteen of the modules via online surveys. RESULTS In the pre-module survey for the first module, participants had a limited degree of understanding and confidence regarding safe and effective use of medicines and appropriate therapeutic choices for managing patients, particularly for complex patients. This improved significantly in the post-module survey. In the pre-module survey for module 2, participants had a moderate degree of understanding and confidence regarding various prescribing learning objectives (including safe and effective prescribing, professional, legal and ethical aspects, communicating medication orders, prescribing safely in their select areas of practice, prescribing safely for complex patients in their area of practice). This increased significantly in the post-module survey. DISCUSSION This training program was implemented to develop a framework of knowledge and skills for AHPs to undertake a prescribing role. The program delivered an increase in participants’ knowledge in the key prescribing areas; and increased participants’ confidence in prescribing safely for patients and for complex patients in their select practice areas. An important aspect of this program was inclusion of prescribing–related activities under supervision of a designated medical practitioner. In conclusion, this educational program for Queensland Health AHP prescribers was successfully developed and is in the final stages of delivery.
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- Objective We sought to assess the effect of long-term exposure to ambient air pollution on the prevalence of self-reported health outcomes in Australian women. - Design Cross-sectional study - Setting and participants The geocoded residential addresses of 26 991 women across 3 age cohorts in the Australian Longitudinal Study on Women's Health between 2006 and 2011 were linked to nitrogen dioxide (NO2) exposure estimates from a land-use regression model. Annual average NO2 concentrations and residential proximity to roads were used as proxies of exposure to ambient air pollution. - Outcome measures Self-reported disease presence for diabetes mellitus, heart disease, hypertension, stroke, asthma, chronic obstructive pulmonary disease and self-reported symptoms of allergies, breathing difficulties, chest pain and palpitations. - Methods Disease prevalence was modelled by population-averaged Poisson regression models estimated by generalised estimating equations. Associations between symptoms and ambient air pollution were modelled by multilevel mixed logistic regression. Spatial clustering was accounted for at the postcode level. - Results No associations were observed between any of the outcome and exposure variables considered at the 1% significance level after adjusting for known risk factors and confounders. - Conclusions Long-term exposure to ambient air pollution was not associated with self-reported disease prevalence in Australian women. The observed results may have been due to exposure and outcome misclassification, lack of power to detect weak associations or an actual absence of associations with self-reported outcomes at the relatively low annual average air pollution exposure levels across Australia.
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Background Prescribing is a complex task, requiring specific knowledge and skills, and the execution of effective, context-specific clinical reasoning. Systematic reviews indicate medical prescribing errors have a median rate of 7% [IQR 2%-14%] of medication orders [1-3]. For podiatrists pursuing prescribing rights, a clear need exists to ensure practitioners develop a well-defined set of prescribing skills, which will contribute to competent, safe and appropriate practice. Aim To investigate the methods employed to teach and assess the principles of effective prescribing in the undergraduate podiatry program and compare and contrast these findings with four other non-medical professions who undertake prescribing after training at Queensland University of Technology. Method The NPS National Prescribing Competency Standards were employed as the prescribing standard. A curriculum mapping exercise was undertaken to determine whether the prescribing principles articulated in the competency standards were addressed by each profession. Results A range of methods are currently utilised to teach prescribing across disciplines. Application of prescribing competencies to the context of each profession appears to influence the teaching methods used. Most competencies were taught using a multimodal format, including interactive lectures, self-directed learning, tutorial sessions and clinical placement. In particular clinical training was identified as the most consistent form of educating safe prescribers across all five disciplines. Assessment of prescribing competency utilised multiple techniques including written and oral examinations and research tasks, case studies, objective structured clinical examination exercises and the assessment of clinical practice. Effective and reliable assessment of prescribing undertaken by students in diverse settings remains challenging e.g. that occurring in the clinical practice environment. Conclusion Recommendations were made to refine curricula and to promote efficient cross-discipline teaching by staff from the disciplines of podiatry, pharmacy, nurse practitioner, optometry and paramedic science. Students now experience a sophisticated level of multidisciplinary learning in the clinical setting which integrates the expertise and skills of experience prescribers combined with innovative information technology platforms (CCTV and live patient assessments). Further work is required to establish a practical, effective approach to the assessment of prescribing competence especially between the university and clinical settings.
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Obesity has long been linked with prostate cancer progression, although the underlying mechanism is still largely unknown. Here, we report that adipocytes promote the enrichment of prostate cancer stem cells (CSCs) through a vicious cycle of autocrine amplification. In the presence of adipocytes, prostate cancer cells actively secrete the peptide hormone cholecystokinin (CCK), which not only stimulates prostate CSC self-renewal, but also induces cathepsin B (CTSB) production of the adipocytes. In return, CTSB facilitates further CCK secretion by the cancer cells. More importantly, inactivation of CCK receptor not only suppresses CTSB secretion by the adipocytes, but also synergizes the inhibitory effect of CTSB inhibitor on adipocyte-promoted prostate CSC self-renewal. In summary, we have uncovered a novel mechanism underlying the mutual interplay between adipocytes and prostate CSCs, which may help explaining the role of adipocytes in prostate cancer progression and provide opportunities for effective intervention.
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Novel self-supported natural and synthetic polymer membranes of chitosan-hydroxy ethyl Cellulose-montmorillonite (CS-HEC-MMT) and polyvinyl alcohol (PVA)-polystyrene sulfonic acid (PSSA) are prepared by solution casting method followed by crosslinking. These membranes are employed for air humidification at varying temperatures between 30 degrees C and 70 degrees C and their performances are compared with commercial Nafion membranes. High hater fluxes with desired humidified-air output have been achieved for CS-HEC-MMT and PVA-PSSA hybrid membranes at air-flow rates of 1-10 slpm. Variation in the air/water mixing ratio, dew point, and relative humidity that ultimately results in desired water flux With respect to air-flow rates are also quantified for all the membranes. Water flux values for CS-HEC-MMT are less than those for Nafion (R) and PVA-PSSA membranes, but the operational Stability of CS-HEC-MMT membrane is higher than PVA-PSSA and comparable with Nafion (R) both of which can operate up to 70 degrees C at repetitive cycles of humidification.
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Aggressive driving has been shown to be related to increased crash risk for car driving. However, less is known about aggressive behaviour and motorcycle riding and whether there are differences in on-road aggression as a function of vehicle type. If such differences exist, these could relate to differences in perceptions of relative vulnerability associated with characteristics of the type of vehicle such as level of protection and performance. Specifically, the relative lack of protection offered by motorcycles may cause riders to feel more vulnerable and therefore to be less aggressive when they are riding compared to when they are driving. This study examined differences in self-reported aggression as a function of two vehicle types: passenger cars and motorcycles. Respondents (n = 247) were all motorcyclists who also drove a car. Results were that scores for the composite driving aggression scale were significantly higher than on the composite riding aggression scale. Regression analyses identified different patterns of predictors for driving aggression from those for riding aggression. Safety attitudes followed by thrill seeking tendencies were the strongest predictors for driving aggression, with more positive safety attitudes being protective while greater thrill seeking was associated with greater self-reported aggressive driving behaviour. For riding aggression, thrill seeking was the strongest predictor (positive relationship), followed by self-rated skill, such that higher self rated skill was protective against riding aggression. Participants who scored at the 85th percentile or above for the aggressive driving and aggressive riding indices had significantly higher scores on thrill seeking, greater intentions to engage in future risk taking, and lower safety attitude scores than other participants. In addition participants with the highest aggressive driving scores also had higher levels of self-reported past traffic offences than other participants. Collectively, these findings suggest that people are less likely to act aggressively when riding a motorcycle than when driving a car, and that those who are the most aggressive drivers are different from those who are the most aggressive riders. However, aggressive riders and drivers appear to present a risk to themselves and others on road. Importantly, the underlying influences for aggressive riding or driving that were identified in this study may be amenable to education and training interventions.
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As the Internet becomes deeply embedded in consumers' life and continuously accessed through mobile devices, the boundary between the digital and the physical becomes less defined. This thesis investigates how this blurring boundary impacts on consumers' construction of their self-narrative and found that consumers' narrative is paradoxically coherent and fragmented and depicts a heroic story of the self. Prior studies show consumers achieve their desired life story through meaningful consumption, however, the notion of fragmented lives are challenged. Further, extensive digital leisure consumption is often viewed in a less positive light. Nevertheless, consumers, who significantly consume digital leisure, do not disregard their physical world or favour one space over the other. Rather, they negotiate key aspects from their digital and physical lives and fluidly move between these two worlds, creating a hybrid narrative that saves their self and others.
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The self-similar solution of the unsteady laminar compressible boundary-layer flow with variable properties at a three-dimensional stagnation point with mass transfer has been obtained when the free-stream velocity varies inversely as a linear function of time. The resulting ordinary differential equations have been solved numerically using an implicit finite-difference scheme. The results are found to be strongly dependent on the parameter characterizing the unsteadiness in the free-stream velocity. The velocity profiles show some features not encountered in steady flows.
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Structural and rheological features of a series of molecular hydrogels formed by synthetic bile salt analogues have been scrutinized. Among seven gelators, two are neutral compounds, while the others are cationic systems among which one is a tripodal steroid derivative. Despite the fact that the chemical structures are closely related, the variety of physical characteristics is extremely large in the structures of the connected fibers (either plain cylinders or ribbons), in the dynamical modes for stress relaxation of the associated SAFINs, in the scaling laws of the shear elasticity (typical of either cellular solids or fractal floc-like assemblies), in the micron-scale texture and the distribution of ordered domains (spherulites, crystallites) embedded in a random mesh, in the type of nodal zones (either crystalline-like, fiber entanglements, or bundles), in the evolution of the distribution and morphology of fibers and nodes, and in the sensitivity to added salt. SANS appears to be a suitable technique to infer all geometrical parameters defining the fibers, their interaction modes, and the volume fraction of nodes in a SAFIN. The tripodal system is particularly singular in the series and exhibits viscosity overshoots at the startup of shear flows, an “umbrella-like” molecular packing mode involving three molecules per cross section of fiber, and scattering correlation peaks revealing the ordering and overlap of 1d self-assembled polyelectrolyte species.
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Objective: Attention deficit hyperactivity disorder (ADHD) is a life-long condition, but because of its historical status as a self-remitting disorder of childhood, empirically validated and reliable methods for the assessment of adults are scarce. In this study, the validity and reliability of the Wender Utah Rating Scale (WURS) and the Adult Problem Questionnaire (APQ), which survey childhood and current symptoms of ADHD, respectively, were studied in a Finnish sample. Methods: The self-rating scales were administered to adults with an ADHD diagnosis (n = 38), healthy control participants (n = 41), and adults diagnosed with dyslexia (n = 37). Items of the self-rating scales were subjected to factor analyses, after which the reliability and discriminatory power of the subscales, derived from the factors, were examined. The effects of group and gender on the subscales of both rating scales were studied. Additionally, the effect of age on the subscales of the WURS was investigated. Finally, the diagnostic accuracy of the total scores was studied. Results: On the basis of the factor analyses, a four-factor structure for the WURS and five-factor structure for the APQ had the best fit to the data. All of the subscales of the APQ and three of the WURS achieved sufficient reliability. The ADHD group had the highest scores on all of the subscales of the APQ, whereas two of the subscales of the WURS did not statistically differ between the ADHD and the Dyslexia group. None of the subscales of the WURS or the APQ was associated with the participant's gender. However, one subscale of the WURS describing dysthymia was positively correlated with the participant's age. With the WURS, the probability of a correct positive classification was .59 in the current sample and .21 when the relatively low prevalence of adult ADHD was taken into account. The probabilities of correct positive classifications with the APQ were .71 and .23, respectively. Conclusions: The WURS and the APQ can provide accurate and reliable information of childhood and adult ADHD symptoms, given some important constraints. Classifications made on the basis of the total scores are reliable predictors of ADHD diagnosis only in populations with a high proportion of ADHD and a low proportion of other similar disorders. The subscale scores can provide detailed information of an individual's symptoms if the characteristics and limitations of each domain are taken into account. Improvements are suggested for two subscales of the WURS.
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Observational studies have shown that medical and dental students have poor psychological health worldwide; however, few interventional studies have been used to test approaches to help students. This thesis used a randomised control trial study design to evaluate the effect of a self-development coaching program on psychological health and the academic performance among medical and dental students in Saudi Arabia. The outcomes indicated that these medical and dental students in Saudi Arabia experienced high levels of depression, anxiety and stress, and that the self-development coaching program was a promising intervention to improve students' psychological health.
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We demonstrate a chain length dependent crossover in the structural properties of linear hydrocarbon (n-alkane) chains using detailed atomistic simulations in explicit water. We identify a number of exotic structures of the polymer chain through energy minimization of representative snapshots collected from molecular dynamics trajectory. While the collapsed state is ring-like (circular) for small chains (CnH2n+2; n <= 20) and spherical for very long ones (n = 100), we find the emergence of ordered helical structures at intermediate lengths (n similar to 40). We find different types of disordered helices and toroid-like structures at n = 60. We also report a sharp transition in the stability of the collapsed state as a function of the chain length through relevant free energy calculations. While the collapsed state is only marginally metastable for C20H42, a clear bistable free energy surface emerges only when the chain is about 30 monomers long. For n = 30, the polymer exhibits an intermittent oscillation between the collapsed and the coil structures, characteristic of two stable states separated by a small barrier.
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A high level of heterozygosity in domesticated pineapple is one of the main obstacles hindering the efficient development of new varieties. Selfing has been proposed as a strategy to minimise this heterozygosity through the development of parentals with a greater level of homozygosity. Selfing and a range of lesser levels of inbreeding were evaluated for their effects on seed production and inbreeding depression in the early growth of seedlings. Selfing produced few seeds, and very few viable seedlings. The paternal backcross and several half-sib combinations exhibited minimal effects on seed development or early growth and in some cases were similar to the outcross. Sibcrosses were generally unsuccessful. The highest inbreeding coefficient that was not associated with severe inbreeding depression was approximately 0.25. The effect of inbreeding depression and the level of homozygosity on several quantitative traits including those related to fruit quality within the inbred populations, is now being assessed.
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This cross-sectional study analyzed psychological well-being at school using the Self-Determination theory as a theoretical frame-work. The study explored basic psychological needs fulfillment (BPNS), academic (SRQ-A), prosocial self-regulation (SRQ-P) and motivation, and their relationship with achievement in general, special and selective education (N=786, 444 boys, 345 girls, mean age 12 yrs 8 mths). Motivation starts behavior which becomes guided by self-regulation. The perceived locus of control (PLOC) affects how self-determined this behavior will be; in other words, to what extent it is autonomously regulated. In order learn and thus to be able to accept external goals, a student has to feel emotionally safe and have sufficient ego-flexibility—all of which builds on satisfied psychological needs. In this study those conditions were explored. In addition to traditional methods Self-organizing maps (SOM), was used in order to cluster the students according to their well-being, self-regulation, motivation and achievement scores. The main impacts of this research were: a presentation of the theory based alternative of studying psychological well-being at school and usage of both the variable and person-oriented approach. In this Finnish sample the results showed that the majority of students felt well, but the well-being varied by group. Overall about for 11–15% the basic needs were deprived depending on the educational group. Age and educational group were the most effective factors; gender was important in relation to prosocial identified behavior. Although the person-oriented SOM-approach, was in a large extent confirming what was no-ticed by using comparison of the variables: the SEN groups had lower levels of basic needs fulfillment and less autonomous self-regulation, interesting deviations of that rule appeared. Some of the SEL- and GEN-group members ended up in the more unfavorable SOM-clusters, and not all SEN-group members belonged to the poorest clusters (although not to the best either). This evidence refines the well-being and self-regulation picture, and may re-direct intervention plans, and turn our focus also on students who might otherwise remain unnoticed. On the other hand, these results imply simultaneously that in special education groups the average is not the whole truth. On the basis of theoretical and empirical considerations an intervention model was sug-gested. The aim of the model was to shift amotivation or external motivation in a more intrinsic direction. According to the theoretical and empirical evidence this can be achieved first by studying the self-concept a student has, and then trying to affect both inner and environmental factors—including a consideration of the basic psychological needs. Keywords: academic self-regulation, prosocial self-regulation, basic psychological needs, moti-vation, achievement