The development of an objective methodology to measure medication adherence to oral thiopurines in paediatric patients with acute lymphoblastic leukaemia - an exploratory study

Aims - To develop a method that prospectively assesses adherence rates in paediatric patients with acute lymphoblastic leukaemia (ALL) who are receiving the oral thiopurine treatment 6-mercaptopurine (6-MP). Methods - A total of 19 paediatric patients with ALL who were receiving 6-MP therapy were enrolled in this study. A new objective tool (hierarchical cluster analysis of drug metabolite concentrations) was explored as a novel approach to assess non-adherence to oral thiopurines, in combination with other objective measures (the pattern of variability in 6-thioguanine nucleotide erythrocyte concentrations and 6-thiouric acid plasma levels) and the subjective measure of self-reported adherence questionnaire. Results - Parents of five ALL patients (26.3%) reported at least one aspect of non-adherence, with the majority (80%) citing “carelessness at times about taking medication” as the primary reason for non-adherence followed by “forgetting to take the medication” (60%). Of these patients, three (15.8%) were considered non-adherent to medication according to the self-reported adherence questionnaire (scored ≥ 2). Four ALL patients (21.1%) had metabolite profiles indicative of non-adherence (persistently low levels of metabolites and/or metabolite levels clustered variably with time). Out of these four patients, two (50%) admitted non-adherence to therapy. Overall, when both methods were combined, five patients (26.3%) were considered non-adherent to medication, with higher age representing a risk factor for non-adherence (P < 0.05). Conclusions - The present study explored various ways to assess adherence rates to thiopurine medication in ALL patients and highlighted the importance of combining both objective and subjective measures as a better way to assess adherence to oral thiopurines.

Creative self-efficacy and individual creativity in teams:cross-level interactions with team informational resources

We propose a cross-level perspective on the relation between creative self-efficacy and individual creativity in which team informational resources, comprising both shared “knowledge of who knows what” (KWKW) and functional background diversity, benefit the creativity of individuals more with higher creative self-efficacy. To test our hypotheses, we conducted a multi-level study with 176 employees working in 34 research and development teams of a multinational company in 4 countries. In support of our hypotheses, the link between creative self-efficacy and individual creativity was more positive with greater shared KWKW, and this interactive effect was pronounced for teams of high rather than low functional background diversity. We discuss implications for the study of creative self-efficacy in team contexts. (PsycINFO Database Record (c) 2012 APA, all rights reserved).

A survey of self-awareness and its application in computing systems

Novel computing systems are increasingly being composed of large numbers of heterogeneous components, each with potentially different goals or local perspectives, and connected in networks which change over time. Management of such systems quickly becomes infeasible for humans. As such, future computing systems should be able to achieve advanced levels of autonomous behaviour. In this context, the system's ability to be self-aware and be able to self-express becomes important. This paper surveys definitions and current understanding of self-awareness and self-expression in biology and cognitive science. Subsequently, previous efforts to apply these concepts to computing systems are described. This has enabled the development of novel working definitions for self-awareness and self-expression within the context of computing systems.

Development, Annotation and Protection of Digital Archive “Bulgarian Folklore Heritage”

The key to prosperity in today's world is access to digital content and skills to create new content. Investigations of folklore artifacts is the topic of this article, presenting research related to the national program „Knowledge Technologies for Creation of Digital Presentation and Significant Repositories of Folklore Heritage” (FolkKnow). FolkKnow aims to build a digital multimedia archive "Bulgarian Folklore Heritage” (BFH) and virtual information portal with folk media library of digitized multimedia objects from a selected collection of the fund of Institute of Ethnology and Folklore Studies with Ethnographic Museum (IEFSEM) of the Bulgarian Academy of Science (BAS). The realization of the project FolkKnow gives opportunity for wide social applications of the multimedia collections, for the purposes of Interactive distance learning/self-learning, research activities in the field of Bulgarian traditional culture and for the cultural and ethno-tourism. We study, analyze and implement techniques and methods for digitization of multimedia objects and their annotation. In the paper are discussed specifics approaches used to building and protect a digital archive with multimedia content. Tasks can be systematized in the following guidelines: * Digitization of the selected samples * Analysis of the objects in order to determine the metadata of selected artifacts from selected collections and problem areas * Digital multimedia archive * Socially-oriented applications and virtual exhibitions artery * Frequency dictionary tool for texts with folklore themes * A method of modern technologies of protecting intellectual property and copyrights on digital content developed for use in digital exposures.

Study of the Self-Assessment as а Component of the Model of Self-Regulated Learning for Engineering Students

Report published in the Proceedings of the National Conference on "Education and Research in the Information Society", Plovdiv, May, 2015

An examination of the UK community pharmacist's role in facilitating patient self-management of cardiovascular disease through lifestyle behaviours

The progression of cardiovascular disease (CVD) is largely modifiable through lifestyle behaviours. UK pharmacists are contractually obliged to facilitate patient self-management of chronic conditions such as CVD. Pharmacists are easily accessible health professionals who are well placed to identify “at risk” patients through medication regimes. Research has identified varying attitudes towards and levels of involvement in pharmacist-led health promotion activity. Given the diverse and exploratory nature of the work, a pragmatic, mixed methods approach was used to explore community pharmacists’ role in facilitating patient self-management of CVD. The thesis presents four studies: a qualitative study with pharmacists; a cross sectional questionnaire of community pharmacists; a systematic review and a qualitative study with patients with CVD. The qualitative study with pharmacists gave an insight into pharmacists’ experiences of giving patients with CVD lifestyle advice and the factors underpinning commonly cited barriers to providing public health services. This informed the development of the cross-sectional questionnaire which identified the predictors of pharmacists’ intentions to give two different types of advice to facilitate patient self-management. The systematic review identified a small number of interventions to prepare pharmacists to facilitate patient lifestyle behaviour change and evaluated the theories and behaviour change techniques used in successful interventions; however due to poor study quality and poor reporting of the interventions limited conclusions about the efficacy of the interventions could reliably be drawn. Finally, the qualitative study gave an insight into the experiences of patients with CVD using community pharmacy services and their expectations of the service they receive from community pharmacists. Recommendations about changes to pharmacy policy and practice in order to support pharmacists’ provision of CVD self-management advice are made.

Perceptions of self-testing for chlamydia:understanding and predicting self-test use

Background: Self-testing technology allows people to test themselves for chlamydia without professional support. This may result in reassurance and wider access to chlamydia testing, but anxiety could occur on receipt of positive results. This study aimed to identify factors important in understanding self-testing for chlamydia outside formal screening contexts, to explore the potential impacts of self-testing on individuals, and to identify theoretical constructs to form a Framework for future research and intervention development. Methods: Eighteen university students participated in semi-structured interviews; eleven had self-tested for chlamydia. Data were analysed thematically using a Framework approach. Results: Perceived benefits of self-testing included its being convenient, anonymous and not requiring physical examination. There was concern about test accuracy and some participants lacked confidence in using vulvo-vaginal swabs. While some participants expressed concern about the absence of professional support, all said they would seek help on receiving a positive result. Factors identified in Protection Motivation Theory and the Theory of Planned Behaviour, such as response efficacy and self-efficacy, were found to be highly salient to participants in thinking about self-testing. Conclusions: These exploratory findings suggest that self-testing independently of formal health care systems may no more negatively impact people than being tested by health care professionals. Participants’ perceptions about self-testing behaviour were consistent with psychological theories. Findings suggest that interventions which increase confidence in using self-tests and that provide reassurance of test accuracy may increase self-test intentions.

Developing a robust self evaluation framework for active learning:the first stage of an ERASMUS+ project (QAEMarketPlace4HEI)

In ensuring the quality of learning and teaching in Higher Education, self-evaluation is an important component of the process. An example would be the approach taken within the CDIO community whereby self-evaluation against the CDIO standards is part of the quality assurance process. Eight European universities (Reykjavik University, Iceland; Turku University of Applied Sciences, Finland; Aarhus University, Denmark; Helsinki Metropolia University of Applied Sciences, Finland; Ume? University, Sweden; Telecom Bretagne, France; Aston University, United Kingdom; Queens University Belfast, United Kingdom) are engaged in an EU funded Erasmus + project that is exploring the quality assurance process associated with active learning. The development of a new self-evaluation framework that feeds into a ?Marketplace? where participating institutions can be paired up and then engage in peer evaluations and sharing around each institutions approach to and implementation of active learning. All of the partner institutions are engaged in the application of CDIO within their engineering programmes and this has provided a common starting point for the partnership to form and the project to be developed. Although the initial focus will be CDIO, the longer term aim is that the approach could be of value beyond CDIO and within other disciplines. The focus of this paper is the process by which the self-evaluation framework is being developed and the form of the draft framework. In today?s Higher Education environment, the need to comply with Quality Assurance standards is an ever present feature of programme development and review. When engaging in a project that spans several countries, the wealth of applicable standards and guidelines is significant. In working towards the development of a robust Self Evaluation Framework for this project, the project team decided to take a wide view of the available resources to ensure a full consideration of different requirements and practices. The approach to developing the framework considered: a) institutional standards and processes b) national standards and processes e.g. QAA in the UK c) documents relating to regional / global accreditation schemes e.g. ABET d) requirements / guidelines relating to particular learning and teaching frameworks e.g. CDIO. The resulting draft self-evaluation framework is to be implemented within the project team to start with to support the initial ?Marketplace? pairing process. Following this initial work, changes will be considered before a final version is made available as part of the project outputs. Particular consideration has been paid to the extent of the framework, as a key objective of the project is to ensure that the approach to quality assurance has impact but is not overly demanding in terms of time or paperwork. In other words that it is focused on action and value added to staff, students and the programmes being considered.

The effectiveness of workplace coaching:A meta-analysis of learning and performance outcomes; scale development; theoretical model of individual differences and longitudinal study

The extant literature on workplace coaching is characterised by a lack of theoretical and empirical understanding regarding the effectiveness of coaching as a learning and development tool; the types of outcomes one can expect from coaching; the tools that can be used to measure coaching outcomes; the underlying processes that explain why and how coaching works and the factors that may impact on coaching effectiveness. This thesis sought to address these substantial gaps in the literature with three linked studies. Firstly, a meta-analysis of workplace coaching effectiveness (k = 17), synthesizing the existing research was presented. A framework of coaching outcomes was developed and utilised to code the studies. Analysis indicated that coaching had positive effects on all outcomes. Next, the framework of outcomes was utilised as the deductive start-point to the development of the scale measuring perceived coaching effectiveness. Utilising a multi-stage approach (n = 201), the analysis indicated that perceived coaching effectiveness may be organised into a six factor structure: career clarity; team performance; work well-being; performance; planning and organizing and personal effectiveness and adaptability. The final study was a longitudinal field experiment to test a theoretical model of individual differences and coaching effectiveness developed in this thesis. An organizational sample of 84 employees each participated in a coaching intervention, completed self-report surveys, and had their job performance rated by peers, direct reports and supervisors (a total of 352 employees provided data on participant performance). The results demonstrate that compared to a control group, the coaching intervention generated a number of positive outcomes. The analysis indicated that coachees’ enthusiasm, intellect and orderliness influenced the impact of coaching on outcomes. Mediation analysis suggested that mastery goal orientation, performance goal orientation and approach motivation in the form of behavioural activation system (BAS) drive, were significant mediators between personality and outcomes. Overall, the findings of this thesis make an original contribution to the understanding of the types of outcomes that can be expected from coaching, and the magnitude of impact coaching has on outcomes. The thesis also provides a tool for reliably measuring coaching effectiveness and a theoretical model to understand the influence of coachee individual differences on coaching outcomes.

LCME Planning and Self-Study Materials

Cope of the LCME's planning and self-study materials. Includes information on the LCME accreditation process and policies, as well as an overview of the LCME as an an organization.

Institutional Self study for the Liaison Committee on Medical Education

Draft of the College of Medicine's Institutional Self-Study for the LCME. Includes an overview of the College of Medicine's history, development, and vision, as well as details regarding the organization of the college, educational programs and resources, and future goals.

Shade promotes thorn development in a tropical liana, Artabotrys hexapatalus (Annonaceae)

The liana Artabotrys hexapetalus (L.f.) Bhand., which is widely planted in the Tropics and native to African rain forests, produced new reiterations (new leader shoots) normally and after damage induced by Hurricane Andrew (August 24, 1992). In each new orthotropic shoot, there is a gradient in lateral branch structures from basal thorns, to vegetative leafy branches, to distal leafy flowering branches. We noted that reiterations developing in shade had more thorns than similar reiterations developing in full sun. Tents with clear (66% photosynthetically active radiation [PAR]) and shaded plastic film (12%–14% PAR) were placed over nodes when the axillary buds began to expand to produce reiteration shoots. After 2 mo of growth inside the tents and in the open, the types of lateral outgrowths (thorn vs. branch) were recorded. Shoots in spectrally neutral shade (red to far red of full sun) and spectrally altered shade (red to far red of canopy shade) produced significantly more thorns at the lower nodes of the shoots as compared to those in full sun. Shoots in control clear plastic tents were the same as those in full sun. We conclude that the fate of lateral bud development is controlled by irradiance (light level) but not by light quality. Increased thorn production in shade could be advantageous to plants growing in the deep shade of rain forests. Thorns in the self-shaded regions of the plant, and well below the forest canopy, could aid in protection from herbivory and in climbing by acting as hooks.

The development and analysis of a field project model curriculum and its impact on achievement and attitude toward science and the environment with at-risk eleventh and twelfth grade students

This study was an evaluation of a Field Project Model Curriculum and its impact on achievement, attitude toward science, attitude toward the environment, self-concept, and academic self-concept with at-risk eleventh and twelfth grade students. One hundred eight students were pretested and posttested on the Piers-Harris Children's Self-Concept Scale, PHCSC (1985); the Self-Concept as a Learner Scale, SCAL (1978); the Marine Science Test, MST (1987); the Science Attitude Inventory, SAI (1970); and the Environmental Attitude Scale, EAS (1972). Using a stratified random design, three groups of students were randomly assigned according to sex and stanine level, to three treatment groups. Group one received the field project method, group two received the field study method, and group three received the field trip method. All three groups followed the marine biology course content as specified by Florida Student Performance Objectives and Frameworks. The intervention occurred for ten months with each group participating in outside-of-classroom activities on a trimonthly basis. Analysis of covariance procedures were used to determine treatment effects. F-ratios, p-levels and t-tests at p $<$.0062 (.05/8) indicated that a significant difference existed among the three treatment groups. Findings indicated that groups one and two were significantly different from group three with group one displaying significantly higher results than group two. There were no significant differences between males and females in performance on the five dependent variables. The tenets underlying environmental education are congruent with the recommendations toward the reform of science education. These include a value analysis approach, inquiry methods, and critical thinking strategies that are applied to environmental issues. ^

The impact of CEO compensation and CEO horizon on a firm's discretionary research and development expenditures

Agency costs are said to arise as a result of the separation of ownership from control inherent in the corporate form of ownership. One such agency problem concerns the potential variance between the time horizons of principal shareholders and agent managers. Agency theory suggests that these costs can be alleviated or controlled through performance-based Chief Executive Officer (CEO) contracting. However, components of a CEO's compensation contract can exacerbate or mitigate agency-related problems (Antle and Smith, 1985). According to the horizon hypothesis, a self-serving CEO reduces discretionary research and development (R&D) expenditures to increase earnings and earnings-based bonus compensation. Agency theorists contend that a CEO's market-based compensation component can mitigate horizon problems. This study seeks to determine whether there is a relationship between CEO earnings- and market-based compensation components and R&D expenditures in the largest United States industrial firms from 1987 to 1993.^ Consistent with the horizon hypothesis, results provide evidence of a negative and statistically significant relationship between CEO cash compensation (i.e., salary and bonus) and the firm's R&D expenditures. Consistent with the expectations of agency theory, results provide evidence of a positive and statistically significant relationship between market-based CEO compensation and R&D.^ Further results of this study provide evidence of a positive and statistically significant relationship between CEO tenure and the firm's R&D expenditures. Although there is a negative relationship between CEO age and the firm's R&D, it was not statistically significant at the 0.5 level. ^

Salient factors in child molestation: Moral development, social competence, and type of offender

The current study was designed to build on and extend the existing knowledge base of factors that cause, maintain, and influence child molestation. Theorized links among the type of offender and the offender's levels of moral development and social competence in the perpetration of child molestation were investigated. The conceptual framework for the study is based on the cognitive developmental stages of moral development as proposed by Kohlberg, the unified theory, or Four-Preconditions Model, of child molestation as proposed by Finkelhor, and the Information-Processing Model of Social Skills as proposed by McFall. The study sample consisted of 127 adult male child molesters participating in outpatient group therapy. All subjects completed a Self-Report Questionnaire which included questions designed to obtain relevant demographic data, questions similar to those used by the researchers for the Massachusetts Treatment Center: Child Molester Typology 3's social competency dimension, the Defining Issues Test (DIT) short form, the Social Avoidance and Distress Scale (SADS), the Rathus Assertiveness Schedule (RAS), and the Questionnaire Measure of Empathic Tendency (Empathy Scale). Data were analyzed utilizing confirmatory factor analysis, t-tests, and chi-square statistics. Partial support was found for the hypothesis that moral development is a separate but correlated construct from social competence. As predicted, although the actual mean score differences were small, a statistically significant difference was found in the current study between the mean DITP scores of the subject sample and that of the general male population, suggesting that child molesters, as a group, function at a lower level of moral development than does the general male population, and the situational offenders in the study sample demonstrated a statistically significantly higher level of moral development than the preferential offenders. The data did not support the hypothesis that situational offenders will demonstrate lower levels of social competence than preferential offenders. Relatively little significance is placed on this finding, however, because the measure for the social competency variable was likely subject to considerable measurement error in that the items used as indicators were not clearly defined. The last hypothesis, which involved the potential differences in social anxiety, assertion skills, and empathy between the situational and preferential offender types, was not supported by the data. ^