The association between the activity profile and cardiovascular risk.

OBJECTIVES: This study sought to better understand the interrelationships between physical activity and sedentary behaviour and the relationship to risk of cardiovascular disease (CVDR) in adults aged 30-75 years. DESIGN: Cross-sectional. METHODS: Data from two-year waves (2003-2004 and 2005-2006) of the National Health and Nutritional Examination survey were analysed in 2014. Accelerometer-derived time and proportion of time spent sedentary and on moderate-to-vigorous physical activity (MVPA) were calculated to generate four activity profiles based on cut-points to define low and high levels for the respective behaviours. Using health outcome data, CVDR was calculated for each person. Weighted multiple linear regression models were used to evaluate the predicted effects of sedentary and physical activity behaviours on the CVDR score, adjusting for participants' sex, age group, race, annual household income, and accelerometer wear time. RESULTS: The lowest CVDR was observed among Busy Exercisers (high MVPA and low sedentary; 8.5%), whereas Couch Potatoes (low MVPA and high sedentary) had the highest (18.6%). Compared with the reference group (Busy Exercisers), the activity profile associated with the highest CVDR was Couch Potatoes (adjusted mean difference 3.6, SE 0.38, p<0.0001). A smoothed three-dimensional response surface "risk landscape" was developed to better visualise the conjoint associations of MVPA and sedentary behaviour on CVDR for each activity profile. The association between MVPA was greater than that of sedentary behaviour; however, for people with low MVPA, shifts in sedentary behaviour may have the greatest impact on CVDR. CONCLUSIONS: Activity profiles that consider the interrelationships between physical activity and sedentary behaviour differ in terms of CVDR. Future interventions may need to be tailored to specific profiles and be dynamic enough to reflect change in the profile over time.

Relationships between civil engineering students’ learning approaches and their perception of curriculum and teaching quality

BACKGROUND: Deakin University graduated its first cohort from four-year undergraduate civil engineering course/program in 2012. The internal annual Course Experience Survey, which has been running annually since 2012, targets to identify the graduating students’ learning approaches and students’ perceptions of the curriculum and teaching quality. Literature suggests that students’ learning outcomes can be achieved more efficiently when the students’ perceptions of curriculum and teaching quality are closely aligned with their learning approaches. Where the students’ approaches to learning and their perception of curriculum and teaching quality are mismatched, a series of frustrations can result for the students that may not only negatively impact their learning achievement but also their learning experience.
PURPOSE OR GOAL: This study explores the relationships between students’ learning approaches and their perception of curriculum and teaching quality in an undergraduate civil engineering program/course. This will help understand whether the curriculum and teaching quality provided by the university have actually accommodated ‘all’ enrolled students in the similar way.
APPROACH: To uncover these relationships, this study adopts questionnaire survey approach to collect response data over a two year period by asking students about their perception through a series of statements. 5-point Likert-scale questionnaire survey (strongly disagree, disagree, neutral, agree, strongly agree) is developed and responses are collected. The responses are then statistically analysed in order to uncover the relationships between students’ learning approaches and their perception of curriculum and teaching quality provided by the university.
DISCUSSION: Deep learners and surface learners had a statistically different perception of curriculum and teaching quality. These results contradict the assumption that learners will have uniform preferences on the curriculum, teaching quality and the way they deal with the demands of specific learning situations. Anecdotal belief that ‘good course/program curriculum and good teaching approaches are good for all students and vice-versa’ may not be strictly true for contemporary heterogeneous student cohorts.
RECOMMENDATIONS/IMPLICATIONS/CONCLUSION: This finding highlights the challenge for curriculum designer to design appropriate course curriculum and teaching staff to implement efficient teaching strategies that benefit both surface and deep learners, who are usually enrolled together. It may be beneficial to provide diversity and flexibility in the curriculum and teaching approaches (rather than a uniform approach). However, this may demand additional resources and may also be questioned for equity and consistency of education. It is also important to note that due to relatively a small dataset, these results may not be generalised.

Experiential learning styles in the age of a virtual surrogate

There is a long-held sense in general that the increasing use of computers and digital technology changes how a user experiences and learns about the world, not always for the better. This paper reports on a longitudinal study of 245 architecture and construction students over a two year period which examines the impact that virtual reality technologies have on the learning style preferences of students. A series of controlled experiments tests for the impact that increasing exposure to a proprietary virtual reality system has on the mode of learning and learning style preferences of individuals and particular cohorts. The results confirm that when virtual reality applications are used in teaching and learning, the learning behaviours will favour a more concrete experiential mode of learning and a preference for the Accommodator learning style. However, the results also demonstrate, consistently and for the first time, individual students do not privilege any particular mode of learning or learning style preference to any significant extent but rather engage in all modes and represent all learning styles. Novel visualisation techniques are introduced to examine and discuss this contrast.

A framework for mixed-type multi-outcome prediction with applications in healthcare

Health analysis often involves prediction of multiple outcomes of mixed-type. Existing work is restrictive to either a limited number or specific outcome types. We propose a framework for mixed-type multi-outcome prediction. Our proposed framework proposes a cumulative loss function composed of a specific loss function for each outcome type - as an example, least square (continuous outcome), hinge (binary outcome), poisson (count outcome) and exponential (non-negative outcome). Tomodel these outcomes jointly, we impose a commonality across the prediction parameters through a common matrix-Normal prior. The framework is formulated as iterative optimization problems and solved using an efficient Block coordinate descent method (BCD). We empirically demonstrate both scalability and convergence. We apply the proposed model to a synthetic dataset and then on two real-world cohorts: a Cancer cohort and an Acute Myocardial Infarction cohort collected over a two year period. We predict multiple emergency related outcomes - as example, future emergency presentations (binary), emergency admissions (count), emergency length-of-stay-days (non-negative) and emergency time-to-next-admission-day (non-negative). Weshow that the predictive performance of the proposed model is better than several state-of-the-art baselines.

Effets des variations dans l’implantation d’un programme sur le risque cardiométabolique dans six CSSS de Montréal sur les résultats chez les patients

En 2011, l’Agence de la santé et des services sociaux de Montréal (ASSSM), en partenariat avec les Centres de santé et services sociaux (CSSS) de la région, a coordonné la mise en œuvre d’un programme de prévention et de prise en charge intégré sur le risque cardiométabolique. Ce programme, s’inspirant du Chronic Care Model et s’adressant aux patients atteints de diabète et d’hypertension artérielle, est d’une durée de deux ans et comporte une séquence de suivis individuels avec l’infirmière et la nutritionniste, de cours de groupe et de séances d’activité physique. L’objectif de ce mémoire est d’évaluer, à l’aide d’un devis quasi-expérimental, l’impact de la variation dans l’implantation de certains aspects du programme dans les six CSSS participant à l’étude sur les résultats de santé des patients. Cinq aspects du programme ont été retenus : les ressources, la conformité au processus clinique prévu dans le programme régional, la maturité du programme, la coordination interne au sein de l’équipe de soins et la coordination externe avec les médecins de 1re ligne. Des analyses de différence de différences, incluant des scores de propension afin de rendre les groupes comparables, ont été effectuées dans le but d’évaluer l’influence de ces aspects sur quatre indicateurs de santé : l’hémoglobine glyquée, l’atteinte de la cible de tension artérielle et l’atteinte de deux cibles d’habitudes de vie concernant la répartition des glucides alimentaires et la pratique d’activité physique. Les résultats indiquent que les indicateurs de santé sélectionnés se sont améliorés chez les patients participant au programme et ce, indépendamment des variations dans son implantation entre les CSSS participant à l’étude. Très peu d’analyses de différence de différences ont en effet relevé un impact significatif des variables d’implantation étudiées sur ces indicateurs. Les résultats suggèrent que les effets bénéfiques d’un tel programme sont davantage tributaires de la prestation des interventions auprès des patients que d’aspects organisationnels liés à son implantation.

Effets des variations dans l’implantation d’un programme sur le risque cardiométabolique dans six CSSS de Montréal sur les résultats chez les patients

En 2011, l’Agence de la santé et des services sociaux de Montréal (ASSSM), en partenariat avec les Centres de santé et services sociaux (CSSS) de la région, a coordonné la mise en œuvre d’un programme de prévention et de prise en charge intégré sur le risque cardiométabolique. Ce programme, s’inspirant du Chronic Care Model et s’adressant aux patients atteints de diabète et d’hypertension artérielle, est d’une durée de deux ans et comporte une séquence de suivis individuels avec l’infirmière et la nutritionniste, de cours de groupe et de séances d’activité physique. L’objectif de ce mémoire est d’évaluer, à l’aide d’un devis quasi-expérimental, l’impact de la variation dans l’implantation de certains aspects du programme dans les six CSSS participant à l’étude sur les résultats de santé des patients. Cinq aspects du programme ont été retenus : les ressources, la conformité au processus clinique prévu dans le programme régional, la maturité du programme, la coordination interne au sein de l’équipe de soins et la coordination externe avec les médecins de 1re ligne. Des analyses de différence de différences, incluant des scores de propension afin de rendre les groupes comparables, ont été effectuées dans le but d’évaluer l’influence de ces aspects sur quatre indicateurs de santé : l’hémoglobine glyquée, l’atteinte de la cible de tension artérielle et l’atteinte de deux cibles d’habitudes de vie concernant la répartition des glucides alimentaires et la pratique d’activité physique. Les résultats indiquent que les indicateurs de santé sélectionnés se sont améliorés chez les patients participant au programme et ce, indépendamment des variations dans son implantation entre les CSSS participant à l’étude. Très peu d’analyses de différence de différences ont en effet relevé un impact significatif des variables d’implantation étudiées sur ces indicateurs. Les résultats suggèrent que les effets bénéfiques d’un tel programme sont davantage tributaires de la prestation des interventions auprès des patients que d’aspects organisationnels liés à son implantation.

Programas de escrita inventada: Será que a estrutura silábica das palavras influencia a evolução da escrita e da leitura?

Dissertação de Mestrado apresentada no ISPA – Instituto Universitário para obtenção de grau de Mestre na especialidade de Psicologia Educacional

The complexity in the implementation process of empowerment-based chronic kidney care: a case study

Background: This study is part of an interactive improvement intervention aimed to facilitate empowerment-based chronic kidney care using data from persons with CKD and their family members. There are many challenges to implementing empowerment-based care, and it is therefore necessary to study the implementation process. The aim of this study was to generate knowledge regarding the implementation process of an improvement intervention of empowerment for those who require chronic kidney care. Methods: A prospective single qualitative case study was chosen to follow the process of the implementation over a two year period. Twelve health care professionals were selected based on their various role(s) in the implementation of the improvement intervention. Data collection comprised of digitally recorded project group meetings, field notes of the meetings, and individual interviews before and after the improvement project. These multiple data were analyzed using qualitative latent content analysis. Results: Two facilitator themes emerged: Moving spirit and Encouragement. The healthcare professionals described a willingness to individualize care and to increase their professional development in the field of chronic kidney care. The implementation process was strongly reinforced by both the researchers working interactively with the staff, and the project group. One theme emerged as a barrier: the Limitations of the organization. Changes in the organization hindered the implementation of the intervention throughout the study period, and the lack of interplay in the organization most impeded the process. Conclusions: The findings indicated the complexity of maintaining a sustainable and lasting implementation over a period of two years. Implementing empowerment-based care was found to be facilitated by the cooperation between all involved healthcare professionals. Furthermore, long-term improvement interventions need strong encouragement from all levels of the organization to maintain engagement, even when it is initiated by the health care professionals themselves.

Lessons from Alison: a narrative study of differentiation in classroom teaching

Teaching is challenging in part because, although school structures are to some extent modelled on industrial approaches in which the ‘raw materials’ are assumed to be very similar, human beings are endlessly diverse. Understanding the many differences amongst students, and treating these differences as teaching resources rather than deficits, is a powerful approach. This paper draws on teacher interviews and classroom observations collected during a two-year study of two regional Queensland schools to explore issues of ‘recognition’, ‘distribution’ and social justice. It uses narrative vignettes from a single classroom to provide an occasion for reflection on the part of the reader on how schooling can better meet the needs of students, and outlines six pedagogical practices for effective classroom teaching.

Impact of an 8-month trial using height-adjustable desks on children's classroom sitting patterns and markers of cardio-metabolic and musculoskeletal health

During school hours, children can sit for prolonged and unbroken periods of time. This study investigated the impact of an 8-month classroom-based intervention focusing on reducing and breaking-up sitting time on children's cardio-metabolic risk factors (i.e., body mass index, waist circumference, blood pressure) and perceptions of musculoskeletal discomfort. Two Year-6 classes (24 students per class) in one primary school were assigned to either an intervention or control classroom. The intervention classroom was equipped with height-adjustable desks and the teacher was instructed in the delivery of pedagogical strategies to reduce and break-up sitting in class. The control classroom followed standard practice using traditional furniture. At baseline, and after 8-months, time spent sitting, standing, stepping, and sitting-bouts (occasions of continuous sitting) as well as the frequency of sit-to-stand transitions were obtained from activPAL inclinometers and the time spent in light-intensity physical activity was obtained from ActiGraph accelerometers. Demographics and musculoskeletal characteristics were obtained from a self-report survey. Hierarchical linear mixed models found that during class-time, children's overall time spent sitting in long bouts (>10 min) were lower and the number of sit-to-stand transitions were higher in the intervention group compared to the control group, while no changes were observed for musculoskeletal pain/discomfort. No significant intervention effects were found for the anthropometrics measures and blood pressure. Height-adjustable desks and pedagogical strategies to reduce/break-up sitting can positively modify classroom sitting patterns in children. Longer interventions, larger and varied sample size may be needed to show health impacts; however, these desks did not increase musculoskeletal pain/discomfort.

Evaluation and Process Improvement of Federal Excess Property for Fire Departments

Currently, there are two federal programs related to excess federal property in which the South Carolina Forestry Commission participates. There is a need to streamline the process for applying for federal excess property as well as tracking its location once it has been received and assigned.

Hallazgos tomográficos como predictores del resultado funcional en edema macular secundario a oclusiones venosas retinianas

INTRODUCCIÓN: El Edema Macular (EM) es la principal causa de perdida de agudeza visual en pacientes con Oclusión Venosa Retiniana (OVR); luego del tratamiento, algunos pacientes persisten con mala agudeza visual. OBJETIVO: Realizar una Revisión Sistemática de la Literatura (RSL), para identificar la evidencia existente sobre factores tomográficos que predicen el resultado visual en pacientes con EM secundario a OVR. FUENTE DE LA INFORMACIÓN: PUBMED, MEDLINE, EMBASE, LILACS, COCHRANE, literatura gris. SELECCIÓN DE LOS ESTUDIOS: Ensayos Clínicos Controlados (ECC) y estudios observacionales analíticos. EXTRACCIÓN Y SÍNTESIS DE LOS DATOS: Dos investigadores seleccionaron los artículos de forma independiente. Se realizó una síntesis cualitativa de la información siguiendo las recomendaciones de la declaración PRISMA 2009. MEDIDAS Y DESENLACE PRINCIPAL: Grosor Retiniano Central (GRC), integridad de Banda Elipsoide e Integridad de Membrana Limitante Externa (MLE), determinados por SD OCT. El desenlace principal es la Agudeza Visual Mejor Corregida (AVMC) a los 6, 12,18 y/o 24 meses. RESULTADOS: Se identificaron 872 abstract y se incluyeron 8 artículos en el análisis cualitativo. Seis estudios evaluaron el GRC sin encontrar asociación con resultado visual final. Solo 2 estudios evaluaron y encontraron asociación estadísticamente significativa de la integridad de la MLE con el desenlace visual, Kang, H 2012 (r2 0,51 p 0,000), Rodriguez, F 2014 (p< 0,001). La integridad de la BE fue asociada a pronostico visual en 4 de 5 estudios que evaluaron esta variable, con resultados estadísticamente significativos. La AVMC de base también se asocio con desenlace visual en 4 de 5 estudios que la evaluaron. El mejor modelo que predice el resultado funcional según el estudio de Kang, H 2012 fue: Integridad de MLE, integridad de BE y AVMC de base (R2 0,671 p 0,000), a los 12 meses de seguimiento. CONCLUSION: La evidencia actual sugiere que la integridad de la BE y la MLE son predictores del resultados funcional en pacientes con EM secundario a OVR después de 6 o mas meses de seguimiento. Es necesario la realización de estudios controlados para llegar a resultados mas concluyentes.

Acoso laboral y sus efectos en la salud del trabajador : revisión de la literatura

Introducción: Desde los años 80 se viene haciendo énfasis en el acoso laboral, conocido en otros países como Mobbing, describiéndose como una forma de abuso y violencia psicológica en el lugar de trabajo, realizado ya sea por una sola persona o por un grupo de personas y que por sus implicaciones se estima de alto impacto para los trabajadores, y las organizaciones. Considerando la importancia y prevalencia del mobbing en la sociedad actual, se convierte en un tema relevante para el área de salud ocupacional. Objetivo: El objetivo de este estudio fue identificar los efectos del acoso laboral generados en la salud del trabajador. Metodología: Se realizó una revisión sistemática utilizando el método PRISMA, de las publicaciones vigentes entre los años 2006 a 2016 sobre los efectos del acoso laboral en la salud del trabajador. En la búsqueda se obtuvieron 778 artículos de los cuales 27 cumplían con los criterios de inclusión. Resultados: se encontró que la prevalencia del acoso laboral puede ser diferente de acuerdo a la definición utilizada, instrumento de medida y población estudiada, la cual fluctúa entre el 7% al 88% según el estudio analizado. Además se evidenció que la prevalencia también difiere dependiendo de quién sea el perpetrador del acoso, si el líder o jefe es el acosador es mayor (60,3%) que cuando es causado por colegas o por clientes (41,5%). El impacto del acoso laboral, según la mayoría de los estudios, es que provoca efectos negativos en la salud emocional del trabajador siendo la depresión una de las principales consecuencias con una relación estadísticamente significativa (p<0,001). Las enfermedades del aparato respiratorio y del sistema musculo esquelético y del tejido conectivo fueron las que se presentaron con mayor frecuencia en los trabajadores que sufren de acoso con un 43,5% y un 37.8% respectivamente. Conclusiones: éstos resultados demuestran que el acoso laboral no solamente es un problema desde el punto de vista organizacional, sino que conlleva consecuencias en la salud mental y física de los trabajadores que lo sufren. Palabras clave: Mobbing, workplace, acoso laboral, acoso psicológico, bullying, harassment, salud ocupacional, occupational health.

Transición 6 grado a 7año, ¿problema o desafío?

The present article displays the results of a two-year research experience carried out by an interdisciplinary research team from the five academic departments (units) at CIDE. The study is part of a larger research project named Profiles, Dynamics and Challenges of Costa Rican education at CIDE, which is directed by the Deanery. The study was conducted during 2006 and part of 2007 in secondary schools which were identified as successful institutions regarding academic achievements. The research focused on exploring the factors which influence students’ academic performance positively as they move from primary to secondary school and as they remain within successful academic indicators during those transition years. This research, besides involving an important literature review, required field work which took place in ten secondary schools from diverse settings all over the country. Observations were made and the seventh and eighth graders’ beliefs, as well as, their parents’ and teachers’ assumptions were explored. In addition, paralleled to the aspects mentioned, an important population of sixth grade students, their parents, and teachers were studied, since those primary institutions were related to the secondary schools involved in the study.

La integración curricular: Una experiencia en el primer nivel de diplomado de la carrera de Licenciatura en Pedagogía con énfasis en Educación Preescolar

Recibido 28 de setiembre de 2011 • Aceptado 24 de octubre de 2011 • Corregido 06 de noviembre de 2011     Se plantea una reflexión acerca de la experiencia de integración curricular realizada por académicos y académicas universitarias, del primer nivel de diplomado de la carrera de Licenciatura en Pedagogía con énfasis en Educación Preescolar, de la División de Educación Básica de la Universidad Nacional, durante el primer semestre del año 2011. La integración ha sido concebida por el equipo del nivel como un proceso de crecimiento personal y profesional, para generar oportunidades que permitan el fortalecimiento de equipos docentes y de los cursos del nivel, en procura de brindar mayores oportunidades para el desarrollo estudiantil.