799 resultados para TO-BRAIN COMMUNICATION
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Este estudo assenta nas relações entre liderança e cultura organizacional num serviço de imagiologia, entendendo-se, assim, que o papel do líder é fundamental para a orientação e o desenvolvimento do trabalho, através de condutas e estratégias que se adaptem às diversas situações. Deste modo, achou-se pertinente perceber o conceito de liderança, as suas abordagens teóricas e o modo como este conceito poderá ser posto em prática ao nível das instituições, contribuindo para fortalecer a comunicação e a cultura organizacional. No que respeita à cultura organizacional, esta resume-se a um conjunto de normas e comportamentos, os quais são utilizados pelas pessoas de forma a interagirem numa organização. Outra questão fundamental passa pela comunicação no seio da cultura organizacional, sendo um factor de extrema relevância, no que respeita à estrutura na sociedade e no funcionamento das organizações. Distinguem-se dois tipos de comunicação: a formal, uma comunicação sistemática; e a informal, uma comunicação assistemática. Em resumo, conclui-se que a liderança, movida pela comunicação, se trata de um processo em que as atitudes e os comportamentos dos líderes, bem como dos seus seguidores, incidem sobre a sua eficácia, a qual está, igualmente, dependente do contexto da cultura organizacional. ABSTRACT: This study builds on the relationship between leadership and organizational culture in a department of imaging, it being understood that, the role of leader is crucial to the direction and development of work, through pipelines and strategies that adapt to different situations. Thus, it is thought appropriate understand the concept of leadership, their theoretical approaches and how this concept could be implemented within the institutions, helping to strengthen communication and organizational culture. Regarding the organizational culture, this boils down to a number of norms and behaviours, which are used by people in order to interact in an organization. lt is assumed as a system of values, expressed through rituals, myths, beliefs and habits common to members of a particular institution, which produces widely accepted norms of behaviour by the group. Another key issue is through communication within the organizational culture, being a factor of extreme importance, with regard to the structure in society and the functioning of organizations. There are two types of communication: the formal, a systematic communication, and informally, a communications patchy. lt is through communication that are solved most problems, and is used to exploit many opportunities, managing organizational balanced life. ln summary, it appears that leadership, driven by communication, this is a process in which the attitudes and behaviours of leaders and their followers, focusing on its effectiveness, which is also dependent on context the organizational culture.
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A efetiva articulação entre os Cuidados de Saúde Primários e Hospitalares apresenta-se como uma estratégia para aumentar os ganhos em saúde, racionalizando os recursos financeiros, a eficiência dos serviços e a satisfação dos utentes. Com o presente projeto, pretendeu-se promover a comunicação entre as equipas de Saúde Escolar do Agrupamento de Centros de Saúde da Arrábida e a Consulta de Diabetes Juvenil do Centro Hospitalar de Setúbal, através da implementação de um protocolo de articulação, com o objetivo de assegurar o continuum dos cuidados de saúde às crianças e jovens acompanhadas na consulta de Diabetes Juvenil. Partindo das necessidades identificadas pelos e com os diversos profissionais de saúde envolvidos pretendeu-se garantir um plano assistencial integrado e desenvolver uma prática de complementaridade com a de outros profissionais de saúde e parceiros comunitários. Adotou-se a metodologia do planeamento em saúde e delinearam-se intervenções que envolveram os diferentes profissionais de saúde, conduzindo à reflexão e discussão sobre o tema, apontando para a mudança nas práticas, consubstanciado por etapas de conhecimento, motivação, apreciação, experimentação e finalmente de adoção; ABSTRACT: Effective coordination between Primary Health Care and Hospital presents itself as a strategy to increase health gains, streamlining financial resources, the efficiency of services and user satisfaction. With this project, the aim was to promote communication between the School Health Team of the Grouping Arrabida Health Centers and Juvenil e Diabetes Consultation of Setúbal Hospital Centre, through the implementation of a joint protocol with the objective of ensure the continuum of health care to children and young people accompanied the Juvenile Diabetes consultation. Starting from the needs identified by and with the various health professionals involved was intended to ensure an integrated care plan and develop a practice of complementarity with other health professionals and community partners. Adopted the planning methodology in health and outlined by interventions involving different health professionals, leading to reflection and discussion on the topic, pointing to the change in practice, embodied by stages of knowledge, motivation, appreciation, experimentation and finally adoption.
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La maladie de Parkinson (MP) est une maladie neurodégénérative qui se caractérise principalement par la présence de symptômes moteurs. Cependant, d’autres symptômes, dits non moteurs, sont fréquents dans la MP et assombrissent le pronostic; ceux ci incluent notamment les désordres du sommeil et les troubles cognitifs. De fait, sur une période de plus de 10 ans, jusqu’à 90 % des patients avec la MP développeraient une démence. L’identification de marqueurs de la démence dans la MP est donc primordiale pour permettre le diagnostic précoce et favoriser le développement d’approches thérapeutiques préventives. Plusieurs études ont mis en évidence la contribution du sommeil dans les processus de plasticité cérébrale, d’apprentissage et de consolidation mnésique, notamment l’importance des ondes lentes (OL) et des fuseaux de sommeil (FS). Très peu de travaux se sont intéressés aux liens entre les modifications de la microarchitecture du sommeil et le déclin cognitif dans la MP. L’objectif de cette thèse est de déterminer, sur le plan longitudinal, si certains marqueurs électroencéphalographiques (EEG) en sommeil peuvent prédire la progression vers la démence chez des patients atteints de la MP. La première étude a évalué les caractéristiques des OL et des FS durant le sommeil lent chez les patients avec la MP selon qu’ils ont développé ou non une démence (MP démence vs MP sans démence) lors du suivi longitudinal, ainsi que chez des sujets contrôles en santé. Comparativement aux patients MP sans démence et aux sujets contrôles, les patients MP démence présentaient au temps de base une diminution de la densité, de l’amplitude et de la fréquence des FS. La diminution de l’amplitude des FS dans les régions postérieures était associée à de moins bonnes performances aux tâches visuospatiales chez les patients MP démence. Bien que l’amplitude des OL soit diminuée chez les deux groupes de patients avec la MP, celle ci n’était pas associée au statut cognitif lors du suivi. La deuxième étude a évalué les marqueurs spectraux du développement de la démence dans la MP à l’aide de l’analyse quantifiée de l’EEG en sommeil lent, en sommeil paradoxal et à l’éveil. Les patients MP démence présentaient une diminution de la puissance spectrale sigma durant le sommeil lent dans les régions pariétales comparativement aux patients MP sans démence et aux contrôles. Durant le sommeil paradoxal, l’augmentation de la puissance spectrale en delta et en thêta, de même qu’un plus grand ratio de ralentissement de l’EEG, caractérisé par un rapport plus élevé des basses fréquences sur les hautes fréquences, était associée au développement de la démence chez les patients avec la MP. D’ailleurs, dans la cohorte de patients, un plus grand ralentissement de l’EEG en sommeil paradoxal dans les régions temporo occipitales était associé à des performances cognitives moindres aux épreuves visuospatiales. Enfin, durant l’éveil, les patients MP démence présentaient au temps de base une augmentation de la puissance spectrale delta, un plus grand ratio de ralentissement de l’EEG ainsi qu’une diminution de la fréquence dominante occipitale alpha comparativement aux patients MP sans démence et aux contrôles. Cette thèse suggère que des anomalies EEG spécifiques durant le sommeil et l’éveil peuvent identifier les patients avec la MP qui vont développer une démence quelques années plus tard. L’activité des FS, ainsi que le ralentissement de l’EEG en sommeil paradoxal et à l’éveil, pourraient donc servir de marqueurs potentiels du développement de la démence dans la MP.
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Les enfants d’âge préscolaire (≤ 5 ans) sont plus à risque de subir un traumatisme crânio-cérébral (TCC) que les enfants plus agés, et 90% de ces TCC sont de sévérité légère (TCCL). De nombreuses études publiées dans les deux dernières décennies démontrent que le TCCL pédiatrique peut engendrer des difficultés cognitives, comportementales et psychiatriques en phase aigüe qui, chez certains enfants, peuvent perdurer à long terme. Il existe une littérature florissante concernant l'impact du TCCL sur le fonctionnement social et sur la cognition sociale (les processus cognitifs qui sous-tendent la socialisation) chez les enfants d'âge scolaire et les adolescents. Or, seulement deux études ont examiné l'impact d'un TCCL à l'âge préscolaire sur le développement social et aucune étude ne s'est penchée sur les répercussions socio-cognitives d'un TCCL précoce (à l’âge préscolaire). L'objectif de la présente thèse était donc d'étudier les conséquences du TCCL en bas âge sur la cognition sociale. Pour ce faire, nous avons examiné un aspect de la cognition sociale qui est en plein essor à cet âge, soit la théorie de l'esprit (TE), qui réfère à la capacité de se mettre à la place d'autrui et de comprendre sa perspective. Le premier article avait pour but d'étudier deux sous-composantes de la TE, soit la compréhension des fausses croyances et le raisonnement des désirs et des émotions d'autrui, six mois post-TCCL. Les résultats indiquent que les enfants d'âge préscolaire (18 à 60 mois) qui subissent un TCCL ont une TE significativement moins bonne 6 mois post-TCCL comparativement à un groupe contrôle d'enfants n'ayant subi aucune blessure. Le deuxième article visait à éclaircir l'origine de la diminution de la TE suite à un TCCL précoce. Cet objectif découle du débat qui existe actuellement dans la littérature. En effet, plusieurs scientifiques sont d'avis que l'on peut conclure à un effet découlant de la blessure au cerveau seulement lorsque les enfants ayant subi un TCCL sont comparés à des enfants ayant subi une blessure n'impliquant pas la tête (p.ex., une blessure orthopédique). Cet argument est fondé sur des études qui démontrent qu'en général, les enfants qui sont plus susceptibles de subir une blessure, peu importe la nature de celle-ci, ont des caractéristiques cognitives pré-existantes (p.ex. impulsivité, difficultés attentionnelles). Il s'avère donc possible que les difficultés que nous croyons attribuables à la blessure cérébrale étaient présentes avant même que l'enfant ne subisse un TCCL. Dans cette deuxième étude, nous avons donc comparé les performances aux tâches de TE d'enfants ayant subi un TCCL à ceux d'enfants appartenant à deux groupes contrôles, soit des enfants n'ayant subi aucune blessure et à des pairs ayant subi une blessure orthopédique. De façon générale, les enfants ayant subi un TCCL ont obtenu des performances significativement plus faibles à la tâche évaluant le raisonnement des désirs et des émotions d'autrui, 6 mois post-blessure, comparativement aux deux groupes contrôles. Cette étude visait également à examiner l'évolution de la TE suite à un TCCL, soit de 6 mois à 18 mois post-blessure. Les résultats démontrent que les moindres performances sont maintenues 18 mois post-TCCL. Enfin, le troisième but de cette étude était d’investiguer s’il existe un lien en la performance aux tâches de TE et les habiletés sociales, telles qu’évaluées à l’aide d’un questionnaire rempli par le parent. De façon intéressante, la TE est associée aux habiletés sociales seulement chez les enfants ayant subi un TCCL. Dans l'ensemble, ces deux études mettent en évidence des répercussions spécifiques du TCCL précoce sur la TE qui persistent à long terme, et une TE amoindrie seraient associée à de moins bonnes habiletés sociales. Cette thèse démontre qu'un TCCL en bas âge peut faire obstacle au développement sociocognitif, par le biais de répercussions sur la TE. Ces résultats appuient la théorie selon laquelle le jeune cerveau immature présente une vulnérabilité accrue aux blessures cérébrales. Enfin, ces études mettent en lumière la nécessité d'étudier ce groupe d'âge, plutôt que d'extrapoler à partir de résultats obtenus avec des enfants plus âgés, puisque les enjeux développementaux s'avèrent différents, et que ceux-ci ont potentiellement une influence majeure sur les répercussions d'une blessure cérébrale sur le fonctionnement sociocognitif.
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This study had three purposes. First, it aimed to re-conceptualize organization-public relationships (OPRs) in public relations and crisis communication. This OPR re-conceptualization helps find out when the OPR buffering effect or the OPR love-becomes-hate effect happens. Second, it aimed to examine how consumer emotions are influenced by OPRs and influence consumer behavioral intentions. Third, it aimed to address the current problematic operationalization of the concept of consumer. Three pilot studies and one main study were conducted. Apple and Whole Foods were the two brands examined. One crisis that undermined the self-defining attributes shared between the brand and its consumers and another crisis that did not were examined for each brand. Almost 500 Apple consumers and 400 Whole Foods consumers provided usable questionnaires. This study had several major findings. First, non-identifying relationship and identifying relationship were different constructs. Moreover, trust, satisfaction, and commitment were not conceptually separate dimensions of OPRs. Second, the non-identifying relationships offered buffering effects by increasing positive attitudes and tempering anger and disappointment. The identifying relationships primarily offered the love-becomes-hate effects by increasing anger and disappointment. Third, if the crisis was relevant to consumers’ daily lives, brand response strategies were less effective at mitigating consumer negative reactions. Moreover, apology-compensation-reminder strategy was more effective compared to no-comment strategy. However, the apology-compensation-reminder strategy was no more effective than other strategies as long as brands compensate to the victims. Identifying relationships increased the effectiveness of response strategies. If the crisis did not undermine the self-defining attributes shared between consumers and brands, the response strategies worked even better. This study contributes to crisis communication research in multiple ways. First, it advances the OPR conceptualization by demonstrating that non-identifying relationship and identifying relationship are different concepts. More importantly, it advances the theory building of OPRs’ influences on crises by finding out when the buffering effect and the love-becomes-hate effect happen. Second, it adds to emotion research by demonstrating that strong OPRs can lead to negative emotions and positive emotions can have negative behavioral consequences on organizations. Third, the precise operationalization of the concept of consumer gives more insights about consumer reactions to crises.
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Dissertação (mestrado)—Universidade de Brasília, Instituto de Letras, Departamento de Línguas Estrangeiras e Tradução, Programa de Pós-Graduação em Linguística Aplicada, 2015.
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Dissertação de Mestrado apresentada ao Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Social e das Organizações.
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Objetivo: Identificar la percepción de los médicos graduados en la Facultad de Ciencias Médicas, respecto a su formación en el tema de Relación y Comunicación Médico Paciente Diseño: es un estudio descriptivo transversal. Metodología: A través de encuesta a los médicos graduados en la Facultad de Ciencias Médicas de la Universidad de Cuenca. Se utilizó una base de datos del programa de Monitoreo de los graduados de la carrera de Medicina de la Universidad de Cuenca, 2003- 2012. Azuay. Resultados: Se realizaron 208 encuestas, 116 varones (56%) y 92 mujeres (44%), cuyas edades oscilan entre los 23 y 42 años, todos graduados de la Escuela de Medicina de la Universidad de Cuenca entre los años 2003 a 2012. El 98% de ellos residentes en el Ecuador. Respecto a la percepción sobre su formación en relación médico paciente y comunicación: para comunicación escrita, comunicación oral, entrega de noticias negativas, relación afectiva con los pacientes y participación comunitaria: la percepción es que su formación fue adecuada, en tanto aprecian como poco adecuado en manejo de situaciones de conflicto, al igual que en la aplicación del consentimiento informado
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76 p.
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Presentation Research of the Practicum and externships has a long history and involves important aspects for analysis. For example, the recent changes taking place in university grades allot more credits to the Practicum course in all grades, and the Company-University collaboration has exposed the need to study in new learning environments. The rise of ICT practices like ePortfolios, which require technological solutions and methods supported by experimentation, study and research, require particular examination due to the dynamic momentum of technological innovation. Tutoring the Practicum and externships requires remote monitoring and communication using ePortfolios, and competence-based assessment and students’ requirement to provide evidence of learning require the best tutoring methods available with ePortfolios. Among the elements of ePortfolios, eRubrics emerge as a tool for design, communication and competence-assessment. This project aims to consolidate a research line on eRubrics, already undertaken by another project -I+D+i [EDU2010-15432]- in order to expand the network of researchers and Centres of Excellence in Spain and other countries: Harvard University in USA, University of Cologne in Germany, University of Colima in Mexico, Federal University of Parana, University of Santa Catarina in Brasil, and Stockholm University in Sweden(1). This new project [EDU2013-41974-P](2) examines the impact of eRubrics on tutoring and on assessing the Practicum course and externships. Through technology, distance tutoring grants an extra dimension to human communication. New forms of teaching with technological mediation are on the rise and are highly valuable, not only for formal education but especially in both public and private sectors of non-formal education, such as occupational training, unemployed education and public servant training. Objectives Obj. 1. To analyse models of technology used in assessing learning in the Practicum of all grades at Spanish Faculties of Education. Obj. 2. To study models of learning assessment measured by eRubrics in the Practicum. Obj. 3. To analyse communication through eRubrics between students and their tutors at university and practice centres, focusing on students’ understanding of competences and evidences to be assessed in the Practicum. Obj. 4. To design assessment services and products, in order to federate companies and practice centres with training institutions. Among many other features, it has the following functions CoRubric(3) 1. The possibility to assess people, products or services by using rubrics. 2. Ipsative assessment. 3. Designing fully flexible rubrics. 4. Drafting reports and exporting results from eRubrics in a project. 5. Students and teachers talk about the evaluation and application of the criteria Methodology, Methods, Research Instruments or Sources Used The project will use techniques to collect and analyse data from two methodological approaches: 1. In order to meet the first objective, we suggest an initial exploratory descriptive study (Buendía Eisman, Colás Bravo & Hernández Pina, 1998), which involves conducting interviews with Practicum coordinators from all educational grades across Spain, as well as analysing the contents of the teaching guides used in all educational grades across Spain. 55 academic managers were interviewed from about 10 faculties of education in public universities in Spain (20%), and course guides 376 universities from 36 public institutions in Spain (72%) are analyzed. 2. In order to satisfy the second objective, 7 universities have been selected to implement the project two instruments aimed at tutors practice centers and tutors of the faculty. All instruments for collecting data were validated by experts using the Delphi method. The selection of experts had three aspects: years of professional experience, number and quality of publications in the field (Practicum, Educational Technology and Teacher Training), and self-rating of their knowledge. The resulting data was calculated using the Coefficient of Competence (Kcomp) (Martínez, Zúñiga, Sala & Meléndez, 2012). Results in all cases showed an average experience of more than 0.09 points. The two instruments of the first objective were validated during the first half of 2014-15 year, data collected during the second half. And the second objective during the first half of 2015-16 year and data collection for the second half. The set of four instruments (two for each objective 1 and 2) have the same dimensions as each of the sources (Coordinators, course guides, tutors of practice centers and faculty) as they were: a. Institution-Organization, b. Nature of internships, c. Relationship between agents, d. Management Practicum, e. Assessment. F. Technological support, g. Training and h. Assessment Ethics. Conclusions, Expected Outcomes or Findings The first results respond to Objective 1, where we find different conclusions depending on each of the six dimensions. In the case of internal regulations governing the organization and structure of the practicum, we note that most traditional degrees (Elementary and Primary grades) share common internal rules, in particular development methodology and criteria against other grades (Pedagogy and Social Education ). It is also true that the centers of practices in last cases are very different from each other and can be a public institution, a school, a company, a museum, etc. The memory with a 56.34% and 43.67% daily activities are more demands on students in all degrees, Lesson plans 28.18% 19.72% Portfolio 26.7% Didactic units and Others 32,4%. The technical support has been mainly used the platform of the University 47.89% and 57.75% Email, followed by other services and tools 9.86% and rubric platforms 1.41%. The assessment criteria are divided between formal aspects of 12.38%, Written expresión 12.38%, treatment of the subject 14.45%, methodological rigor of work 10.32%, and Level of argument Clarity and relevance of conclusions 10.32%. In general terms, we could say that there is a trend and debate between formative assessment against a accreditation. It has not yet had sufficient time to further study and confront other dimensions and sources of information. We hope to provide more analysis and conclusions in the conference date.
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By providing vehicle-to-vehicle and vehicle-to-infrastructure wireless communications, vehicular ad hoc networks (VANETs), also known as the “networks on wheels”, can greatly enhance traffic safety, traffic efficiency and driving experience for intelligent transportation system (ITS). However, the unique features of VANETs, such as high mobility and uneven distribution of vehicular nodes, impose critical challenges of high efficiency and reliability for the implementation of VANETs. This dissertation is motivated by the great application potentials of VANETs in the design of efficient in-network data processing and dissemination. Considering the significance of message aggregation, data dissemination and data collection, this dissertation research targets at enhancing the traffic safety and traffic efficiency, as well as developing novel commercial applications, based on VANETs, following four aspects: 1) accurate and efficient message aggregation to detect on-road safety relevant events, 2) reliable data dissemination to reliably notify remote vehicles, 3) efficient and reliable spatial data collection from vehicular sensors, and 4) novel promising applications to exploit the commercial potentials of VANETs. Specifically, to enable cooperative detection of safety relevant events on the roads, the structure-less message aggregation (SLMA) scheme is proposed to improve communication efficiency and message accuracy. The scheme of relative position based message dissemination (RPB-MD) is proposed to reliably and efficiently disseminate messages to all intended vehicles in the zone-of-relevance in varying traffic density. Due to numerous vehicular sensor data available based on VANETs, the scheme of compressive sampling based data collection (CS-DC) is proposed to efficiently collect the spatial relevance data in a large scale, especially in the dense traffic. In addition, with novel and efficient solutions proposed for the application specific issues of data dissemination and data collection, several appealing value-added applications for VANETs are developed to exploit the commercial potentials of VANETs, namely general purpose automatic survey (GPAS), VANET-based ambient ad dissemination (VAAD) and VANET based vehicle performance monitoring and analysis (VehicleView). Thus, by improving the efficiency and reliability in in-network data processing and dissemination, including message aggregation, data dissemination and data collection, together with the development of novel promising applications, this dissertation will help push VANETs further to the stage of massive deployment.
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Near infrared spectroscopy (NIRS) is an emerging non-invasive optical neuro imaging technique that monitors the hemodynamic response to brain activation with ms-scale temporal resolution and sub-cm spatial resolution. The overall goal of my dissertation was to develop and apply NIRS towards investigation of neurological response to language, joint attention and planning and execution of motor skills in healthy adults. Language studies were performed to investigate the hemodynamic response, synchrony and dominance feature of the frontal and fronto-temporal cortex of healthy adults in response to language reception and expression. The mathematical model developed based on granger causality explicated the directional flow of information during the processing of language stimuli by the fronto-temporal cortex. Joint attention and planning/ execution of motor skill studies were performed to investigate the hemodynamic response, synchrony and dominance feature of the frontal cortex of healthy adults and in children (5-8 years old) with autism (for joint attention studies) and individuals with cerebral palsy (for planning/execution of motor skills studies). The joint attention studies on healthy adults showed differences in activation as well as intensity and phase dependent connectivity in the frontal cortex during joint attention in comparison to rest. The joint attention studies on typically developing children showed differences in frontal cortical activation in comparison to that in children with autism. The planning and execution of motor skills studies on healthy adults and individuals with cerebral palsy (CP) showed difference in the frontal cortical dominance, that is, bilateral and ipsilateral dominance, respectively. The planning and execution of motor skills studies also demonstrated the plastic and learning behavior of brain wherein correlation was found between the relative change in total hemoglobin in the frontal cortex and the kinematics of the activity performed by the participants. Thus, during my dissertation the NIRS neuroimaging technique was successfully implemented to investigate the neurological response of language, joint attention and planning and execution of motor skills in healthy adults as well as preliminarily on children with autism and individuals with cerebral palsy. These NIRS studies have long-term potential for the design of early stage interventions in children with autism and customized rehabilitation in individuals with cerebral palsy.
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Abstract: Career programs in the Cegep system base their training on various learning activities, which are followed by a practicum. The objective is to achieve a certain number of competencies, deemed necessary by the Ministry of Education, for entry-level occupations in to the workforce. The Graphic Communications program offered at Champlain College Saint-Lambert is a three-year career program that leads to employment in the field of graphics. Many students have part-time jobs during their schooling period but most of those jobs do not relate to their field of study. Several graduates stated they were unable to persuade employers to hire them for an externship or stage at the end of their program. While jobs are important for their general skills, since they are not directly related to the field, these jobs may not have given the students a suitable model for the conduct of an employment interview. Practice interviews may be one of many successful training methods to lower communication apprehension (CA) levels. CA is defined as "an individual's level of fear or anxiety associated with either real or anticipated communication with another person or persons." This paper examines the literature on CA and employment interviews and evaluates whether pedagogical interventions, including monitored phone calls to employers and practice-videotaped interviews, allow students to feel more confident about interviewing for a future job. A qualitative tool was used to gather scientific measurements of the participants' levels of CA both at the beginning and at the end of the Career Planning course. Open-ended reflective journals gathered quantitative data on the impact specific instructional strategies had on the participants. The pedagogical interventions that were examined and tested were as follows: preparation of scripts, monitored phone calls, videotaped practice interviews, and in-class access to professional assistance. Results indicate that all interventions had a positive impact on lowering levels of CA. It is clear that positive conclusions were drawn by the students as to the usefulness of these activities. Overall, participants who responded to the reflective journal questions felt positive about the contribution of this preparatory career course to their CA levels. The results of the quantitative tool were consistent with previous research and the analysis of the reflective journals gave additional support to the usefulness of the interventions on students' confidence levels. Recommendations for improvements to the curriculum include the need for students to be taught formally about metacognition and how to monitor it. Students need to be exposed to videotaped interviews more often. They should be better prepared for unexpected interview questions, and they should experience formal rehearsals with one of their instructors before the actual practice interview. Some of these recommendations have already been successfully implemented in the program's curriculum.||Résumé: Le but de ce travail était de vérifier si certaines activités pédagogiques sont efficaces pour faire baisser le niveau d'anxiété lié à la communication orale lors de leurs entrevues d'embauche. L'objectif des programmes techniques au Québec est de fournir aux étudiants un certain nombre de compétences définies par le ministère de l'Éducation, des Loisirs et du Sport afin que ces derniers puissent fournir des services de techniciens spécialisés aux entreprises. Le programme nommé Office Systems Technology (412) du collège Champlain de Saint-Lambert, a choisi la voie de la spécialisation en microédition et hypermédia en 1999 et a changé son nom pour Graphic Communications en 2005. Les programmes techniques au Cégep incluent un stage en milieu de travail à la fin d'un programme de trois ans et par le fait même, une entrevue pour obtenir un stage en entreprise. La compétence visée par cette étude est l'intégration au marché du travail et le cheminement professionnel des étudiants. Lors d'enquêtes informelles, plusieurs étudiants du programme ont fait part de leurs difficultés à trouver un stage en fin d'études. Certains auteurs suggèrent que ces étudiants n'ont pas de modèles appropriés lors de la tenue d'une entrevue d'emploi. Ils proposent de diminuer le niveau d'anxiété lié à la communication orale lors d'entrevues d'embauche en offrant des pratiques d'entrevue aux étudiants. Cette recherche a examiné la littérature au sujet de l'anxiété de communication, plus précisément lors d'entrevues. Elle avait pour mandat d'évaluer si les activités pédagogiques d'un cours de préparation à la carrière ont été efficaces pour faire baisser les taux d'anxiété en communication orale lors d'entrevues. En plus, une conseillère à l'emploi fut invitée à plusieurs reprises afin de fournir un support professionnel en classe, étant donné que les étudiants ne prennent pas nécessairement le temps de consulter des professionnels en raison de leurs activités personnelles trop nombreuses. Le type d'enseignement évalué est considéré comme stratégique, étant donné qu'il agit au niveau cognitif et métacognitif de l'étudiant. Le cours de préparation à l'emploi débute par la vérification des acquis antérieurs des étudiants et il tient compte de leur motivation scolaire et professionnelle. De plus, il est axé sur la construction du savoir en proposant des activités de plus en plus complexes, débutant par la rédaction de textes à utiliser lors d'appels aux employeurs, en passant par la préparation et la pratique d'appels et se terminant par des entrevues d'emploi qui serviront de modèle à perfectionner par chaque étudiant. Ces entrevues se font avec des employeurs qui ont déjà embauché des étudiants du programme de Graphic Communications au collège Champlain de Saint-Lambert et sont enregistrées sur bande vidéo afin de permettre une visualisation ultérieure et cohérente avec les objectifs visés. La méthodologie de cette recherche inclut deux outils, un quantitatif et un qualitatif. L'outil quantitatif permet de mesurer scientifiquement les taux d'appréhension en communication des étudiants au début et à la fin du cours de préparation à l'emploi. Cet outil est la fusion de deux outils, le Personal Report of Communication Apprehension ou PRCA-24, qui fut développé par McCroskey (1984), en tandem avec celui de Wongprasert & Ayres (2000), qui lui met l'accent sur les entrevues d'emploi. Les réponses à cet outil combiné sont évaluées sur une échelle Likert de cinq points. L'outil qualitatif est une série de questions auxquelles les étudiants ont répondu quatre fois lors de la session. Les réponses à ces questions ont été analysées et les commentaires des étudiants évalués. Il découle de cette analyse que les niveaux d'anxiété des étudiants qui ont participé (14) étaient définitivement à la baisse en fin de cours. La pratique téléphonique structurée, dans un laboratoire avec les téléphones, a été très révélatrice pour les étudiants. Ils ont appris comment utiliser un script comme piste de départ pour un appel et qu'il était possible de contourner certains obstacles de façon professionnelle. Ensuite, lors d'une visite d'une compagnie de graphisme, ils ont pu observer divers modèles d'emploi. Ils ont eu la possibilité de poser des questions sur le fonctionnement et les besoins de l'entreprise. Ceci facilita la rédaction de leur curriculum vitae en leur permettant de mieux décrire leurs acquis en fonction d'emplois recherchés. Par la suite, ils se sont préparés pour une pratique d'entrevue, filmée. Les interviewers avaient déjà travaillé avec le collège et avaient déjà embauché certains étudiants de ce programme, donc ils connaissaient leur potentiel. Une liste de questions possibles fut suggérée mais il n'en restait pas moins que les interviewers pouvaient les modifier, ceci étant représentatif du marché de l'emploi. Même si le collège fournit un enseignement en anglais, un des intervieweurs donna ses entrevues en français. Trois étudiants se sont portés volontaires, mais deux ont constaté qu'ils auraient dû pratiquer leur script en français avant l'entrevue pour mieux diminuer leur niveau d'anxiété. Finalement, les étudiants durent visionner leur segment d'entrevue : ceci leur a permis de voir si leur attitude non-verbale concordait avec ce qu'ils ressentaient en entrevue et d'emmener les correctifs appropriés. Les taux d'anxiété furent vérifiés une deuxième fois en fin de session et les résultats ont démontré une baisse des taux d'appréhension. Les résultats de cette étude concordent donc avec ceux trouvés dans la littérature et donnent de bonnes pistes pour l'amélioration de ce cours de préparation à la carrière. L'auteur recommande d'enseigner la métacognition de façon formelle et ainsi de faciliter la prise de conscience des apprentissages que les étudiants effectuent. De plus, les étudiants devraient être filmés en studio au moins une fois par année pour diminuer le facteur de stress causé par les caméras et finalement ils pourraient certainement bénéficier de pratiques formelles d'entrevue avec un instructeur avant l'entrevue filmée. L'augmentation des pratiques a déjà été mise en oeuvre dans le programme et des résultats positifs se sont ensuivis.
Resumo:
Pulmonary arterial hypertension (PAH) is a progressive disease of the small pulmonary arteries, characterised by pulmonary vascular remodelling due to excessive proliferation and resistance to apoptosis of pulmonary artery endothelial cells (PAECs) and pulmonary artery smooth muscle cells (PASMCs). The increased pulmonary vascular resistance and elevated pulmonary artery pressures result in right heart failure and premature death. Germline mutations of the bone morphogenetic protein receptor-2 (bmpr2) gene, a receptor of the transforming growth factor beta (TGF-β) superfamily, account for approximately 75%-80% of the cases of heritable form of PAH (HPAH) and 20% of sporadic cases or idiopathic PAH (IPAH). IPAH patients without known bmpr2 mutations show reduced expression of BMPR2. However only ~ 20% of bmpr2-mutation carriers will develop the disease, due to an incomplete penetrance, thus the need for a ‘second hit’ including other genetic and/or environmental factors is accepted. Diagnosis of PAH occurs most frequently when patients have reached an advanced stage of disease. Although modern PAH therapies can markedly improve a patient’s symptoms and slow the rate of clinical deterioration, the mortality rate from PAH remains unacceptably high. Therefore, the development of novel therapeutic approaches is required for the treatment of this multifaceted disease. Noncoding RNAs (ncRNAs) include microRNAs (miRNAs) and long noncoding RNAs (lncRNAs). MiRNAs are ~ 22 nucleotide long and act as negative regulators of gene ex-pression via degradation or translational inhibition of their target mRNAs. Previous studies showed extensive evidence for the role of miRNAs in the development of PAH. LncRNAs are transcribed RNA molecules greater than 200 nucleotides in length. Similar to classical mRNA, lncRNAs are translated by RNA polymerase II and are generally alternatively spliced and polyadenylated. LncRNAs are highly versatile and function to regulate gene expression by diverse mechanisms. Unlike miRNAs, which exhibit well-defined actions in negatively regulating gene expression via the 3’-UTR of mRNAs, lncRNAs play more diverse and unpredictable regulatory roles. Although a number of lncRNAs have been intensively investigated in the cancer field, studies of the role of lncRNAs in vascular diseases such as PAH are still at a very early stage. The aim of this study was to investigate the involvement of specific ncRNAs in the development of PAH using experimental animal models and cell culture. The first ncRNA we focused on was miR-143, which is up-regulated in the lung and right ventricle tissues of various animal models of PH, as well as in the lungs and PASMCs of PAH patients. We show that genetic ablation of miR-143 is protective against the development of chronic hypoxia induced PH in mice, assessed via measurement of right ventricular systolic pressure (RVSP), right ventricular hypertrophy (RVH) and pulmonary vascular remodelling. We further report that knockdown of miR-143-3p in WT mice via anti-miR-143-3p administration prior to exposure of mice to chronic hypoxia significantly decreases certain indices of PH (RVSP) although no significant changes in RVH and pulmo-nary vascular remodelling were observed. However, a reversal study using antimiR-143-3p treatment to modulate miR-143-3p demonstrated a protective effect on RVSP, RVH, and muscularisation of pulmonary arteries in the mouse chronic hypoxia induced PH model. In vitro experiments showed that miR-143-3p overexpression promotes PASMC migration and inhibits PASMC apoptosis, while knockdown miR-143-3p elicits the opposite effect, with no effects observed on cellular proliferation. Interestingly, miR-143-3p-enriched exosomes derived from PASMCs mediated cell-to-cell communication between PASMCs and PAECs, contributing to the pro-migratory and pro-angiogenic phenotype of PAECs that underlies the pathogenesis of PAH. Previous work has shown that miR-145-5p expression is upregulated in the chronic hypoxia induced mouse model of PH, as well as in PAH patients. Genetic ablation and pharmacological inhibition (subcutaneous injection) of miR-145-5p exert a protective against the de-velopment of PAH. In order to explore the potential for alternative, more lung targeted delivery strategies, miR-145-5p expression was inhibited in WT mice using intranasal-delivered antimiR-145-5p both prior to and post exposure to chronic hypoxia. The decreased expression of miR-145-5p in lung showed no beneficial effect on the development of PH compared with control antimiRNA treated mice exposed to chronic hypoxia. Thus, miR-143-3p modulated both cellular and exosome-mediated responses in pulmonary vascular cells, while the inhibition of miR-143-3p prevented the development of experimental pulmonary hypertension. We focused on two lncRNAs in this project: Myocardin-induced Smooth Muscle Long noncoding RNA, Inducer of Differentiation (MYOSLID) and non-annotated Myolnc16, which were identified from RNA sequencing studies in human coronary artery smooth muscle cells (HCASMCs) that overexpress myocardin. MYOSLID was significantly in-creased in PASMCs from patients with IPAH compared to healthy controls and increased in circulating endothelial progenitor cells (EPCs) from bmpr2 mutant PAH patients. Exposure of PASMCs to hypoxia in vitro led to a significant upregulation in MYOSLID expres-sion. MYOSLID expression was also induced by treatment of PASMC with BMP4, TGF-β and PDGF, which are known to be triggers of PAH in vitro. Small interfering RNA (siR-NA)-mediated knockdown MYOSLID inhibited migration and induced cell apoptosis without affecting cell proliferation and upregulated several genes in the BMP pathway in-cluding bmpr1α, bmpr2, id1, and id3. Modulation of MYOSLID also affected expression of BMPR2 at the protein level. In addition, MYOSLID knockdown affected the BMP-Smad and BMP-non-Smad signalling pathways in PASMCs assessed by phosphorylation of Smad1/5/9 and ERK1/2, respectively. In PAECs, MYOSLID expression was also induced by hypoxia exposure, VEGF and FGF2 treatment. In addition, MYOSLID knockdown sig-nificantly decreased the proliferation of PAECs. Thus, MYOSLID may be a novel modulator in pulmonary vascular cell functions, likely through the BMP-Smad and –non-Smad pathways. Treatment of PASMCs with inflammatory cytokines (IL-1 and TNF-α) significantly in-duced the expression of Myolnc16 at a very early time point. Knockdown of Myolnc16 in vitro decreased the expression of il-6, and upregulated the expression of il-1 and il-8 in PASMCs. Moreover, the expression levels of chemokines (cxcl1, cxcl6 and cxcl8) were sig-nificantly decreased with Myolnc16 knockdown. In addition, Myolnc16 knockdown decreased the MAP kinase signalling pathway assessed by phosphorylation of ERK1/2 and p38 MAPK and inhibited cell migration and proliferation in PASMCs. Thus, Myolnc16 may a novel modulator of PASMCs functions through anti-inflammatory signalling pathways. In summary, in this thesis we have demonstrated how miR-143-3p plays a protective role in the development of PH both in vivo animal models and patients, as well as in vitro cell cul-ture. Moreover, we have showed the role of two novel lncRNAs in pulmonary vascular cells. These ncRNAs represent potential novel therapeutic targets for the treatment of PAH with further work addressing to investigate the target genes, and the pathways modulated by these ncRNAs during the development of PAH.
Resumo:
Esta investigación midió la percepción del personal asistencial sobre la cultura de seguridad de los pacientes en un hospital de primer nivel de complejidad por medio de un estudio descriptivo de corte transversal. Se utilizó como herramienta de medición la encuesta ‘Hospital Survey on Patient Safety Cultura’ (HSOPSC) de la Agency of Healthcare Research and Quality (AHRQ) versión en español, la cual evalúa doce dimensiones. Los resultados mostraron fortalezas como el aprendizaje organizacional, las mejoras continuas y el apoyo de los administradores para la seguridad del paciente. Las dimensiones clasificadas como oportunidades de mejora fueron la cultura no punitiva, el personal, las transferencias y transiciones y el grado en que la comunicación es abierta. Se concluyó que aunque el personal percibía como positivo el proceso de mejoramiento y apoyo de la administración también sentía que era juzgado si reportaba algún evento adverso.