890 resultados para Referred morbidity inquiry
Resumo:
This study sought to apply the concepts of inquiry-based learning by increasing the number of laboratory experiments conducted in two science classes, and to identify the challenges of this instruction for students with special needs. Results showed that the grades achieved through lab write-ups greatly improved grades overall.
Resumo:
Urban ethnographic studies in social science usually proceed from within a pre-figured research framework that guides field activity and filters what is considered see-worthy and study-worthy to those phenomena which are in some way necessary for the fulfillment of specific research agendas. Reliance on formalized ethnographic research methods to explore the city, and the reflex to intellectualize that which is observed by using them, frequently leads to the neglect of much of what comprises the ethnographic richness of city-life through an overly-contemplative intellectuocentrism. ^ Flânerie, an avocational, proto-sociological ethnographic mode of urban exploration and observation originating in early-nineteenth-century Paris, is representative of an alternate approach to exploration and study of the city—one less subject to a compressed horizon of ethnographic experience. It affords insight into a broad range of phenomena taking place in interstitial urban space and time which often escape the instrumentally overly-determined gaze of professionalist research inquiry. ^ The present work addressed the fact that the concept of flânerie , though occasionally invoked in discussions of methodology in urban sociology and cultural studies, had not been subjected to a systematic attempt to relate it to the research methods of these disciplines. Though as a typological figure the flâneur is thought to have disappeared long ago, practices represented by the concept continue to be engaged in by persons inside and outside of academia who approach city life and social science with a perspective somewhat transcending the reified dichotomies of private-professional and art-and-science. This study transferred aspects of the experience of the city embodied in the flâneur to the realm of ethnographic urban studies and the building of grounded social theory, finding flânerie to be crucial to the development of a refined knowledge of urban life, and an important means by which previously overlooked social phenomena and silenced avenues of research inquiry might be exposed. ^ The conclusions reached found a “flâneuristic” approach to the city as being beneficial to research practice and the vitalization of urban ethnographic inquiry, by affording opportunities for exposure to, and immersion within, an expanded range of quotidian social phenomena that have frequently escaped the academicist gaze. ^
Resumo:
The purpose of the present study was to examine the origins of anxiety sensitivity (AS) by assessing youths' learning experiences in relation to their AS symptoms and anxiety symptoms. Participants were 33 youths between 7 to 13 years old (M = 9.39 years, SD = 2.01). Youths were assessed using a structured interview and self-report measures. Chi-square analyses revealed no statistically significant differences in the proportions of boys vs. girls, Hispanic vs. non-Hispanic, and married vs. non-married. Pearson correlation analyses revealed that youths' AS learning experiences were significantly related to youths' AS and to youths' anxiety symptoms scores. Partial correlations between youths' learning experiences associated with AS symptoms in relation to AS scores controlling for anxiety symptoms effects were statistically significant. Findings were consistent with theory and suggest that learning mechanisms may be involved in AS acquisition and maintenance. The findings' implications are discussed regarding possible learning experiences' role in the development of AS.
Resumo:
The old caretaker's work seeks to minimize suffering and morbidity resulting from physical, cognitive and emotional limitations of these individuals, being a practice permeated by the uniqueness of the subjects involved, therefore, a process in constant construction. In this notion, the caregiver's role is crucial to assist the elderly in everyday life, aiming at improving their quality of life. This study has descriptive and analytical character with quantitative and qualitative approach aimed to investigate the professional training of active caregivers in long-term stay institutions for the Elderly (ILPIs) in Natal/RN in the year 2014. For this, semi-structured interviews were conducted with 63 caregivers employed in nine ILPIs, representing 75% of the professionals performing activities in these institutions. The interviews captured data on the socioeconomic profile, the perception about the profession and training of caregivers. Data were analyzed by observation of absolute and relative measures of central tendency of the numeric variables frequencies. It was found that most caregivers had poor socioeconomic status and had no specific training course to practice caregiver role. However, among those who carried out courses, most reported that the content covered during the training gave security to perform the practice, although they have shown a contradiction when referred to the need to build capacity. The perception of care is mainly related to love and care for the other while the choice of profession is associated with care practice itself. The results also indicate the presence of a low level of formal training for the exercise of the occupation, also revealing the weaknesses ranging from the absence of a core curriculum that can guide the formation, compounded by the low educational professionals in focus.
Resumo:
Introduction: Pelvic rami fractures in the elderly are associated with significant morbidity and mortality. Despite our rapidly aging population there is a paucity of literature dealing with fractures of the pelvic rami in this age group. The purpose of this study is report mortality rates following these injuries in the Eastern region of Newfoundland. Additionally, we aim to describe and quantify the important resultant morbidity in this vulnerable elderly population . Methods: A retrospective chart review was performed of all the pelvic fractures in individuals over the age of 60 between 2000 and 2005 in the Eastern Health region of Newfoundland and Labrador. From these patients, only those with the radiographic parameters consistent with low energy pattern pelvic ring injuries were included. Excluded from the study were those with concurrent fractures of the femur. Survival data, comorbidities, injury characteristics, hospital stay, ambulatory status, and place of residence were recorded from the chart. A surrogate control group was formulated from Statistics Canada survival data for use as a survival comparison group. Results: There were 80 fractures of the pelvis identified in patients over 60 years old from 2000-2005. Of these, 43 met our inclusion/exclusion criteria and were used in our analysis. The one and five year mortalities of these patients were 16.3% (95% CI; 7.80% to 30.3%) and 58.1% (95% CI; 43.3% to 71.6%), respectively. These were both significantly different from the point estimates from our constructed age and gender matched control group from the Statistics Canada data of 6.58% (one year mortality) and 31.3% (five year mortality). Morbidity was quantified by change in ambulatory status (independent, walker/cane assisted, wheelchair) and change in residential independence (independent, assisted living, nursing home). Post fracture, 36% of patients permanently required increased ambulatory aids and 21% of patients required a permanent increase in everyday level of care. Conclusion: This study suggests that there may be significantly increased mortality and morbidity following low energy pattern pelvic rami fractures in an elderly population compared to age and gender matched controls. In contrast to previous studies describing these injuries, there is greater homogeneity in this population with respect to age and mechanism of injury. This study generates several important hypotheses for future research and in particular highlights the need for larger prospective studies to identify factors predicting the highest risk for poor outcomes in this population.
Resumo:
We are grateful for the co-operation and assistance that we received from NHS staff in the co-ordinating centres and clinical sites. We thank the women who participated in TOMBOLA. The TOMBOLA trial was supported by the Medical Research Council (G9700808) and the NHS in England and Scotland. The TOMBOLA Group comprises the following: Grant-holders: University of Aberdeen and NHS Grampian, Aberdeen, Scotland: Maggie Cruickshank, Graeme Murray, David Parkin, Louise Smart, Eric Walker, Norman Waugh (Principal Investigator 2004–2008) University of Nottingham and Nottingham NHS, Nottingham, England: Mark Avis, Claire Chilvers, Katherine Fielding, Rob Hammond, David Jenkins, Jane Johnson, Keith Neal, Ian Russell, Rashmi Seth, Dave Whynes University of Dundee and NHS Tayside, Dundee, Tayside: Ian Duncan, Alistair Robertson (deceased) University of Ottawa, Ottawa, Canada: Julian Little (Principal Investigator 1999–2004) National Cancer Registry, Cork, Ireland: Linda Sharp Bangor University, Bangor, Wales: Ian Russell University of Hull, Hull, England: Leslie G Walker Staff in clinical sites and co-ordinating centres Grampian Breda Anthony, Sarah Bell, Adrienne Bowie, Katrina Brown (deceased), Joe Brown, Kheng Chew, Claire Cochran, Seonaidh Cotton, Jeannie Dean, Kate Dunn, Jane Edwards, David Evans, Julie Fenty, Al Finlayson, Marie Gallagher, Nicola Gray, Maureen Heddle, Alison Innes, Debbie Jobson, Mandy Keillor, Jayne MacGregor, Sheona Mackenzie, Amanda Mackie, Gladys McPherson, Ike Okorocha, Morag Reilly, Joan Rodgers, Alison Thornton, Rachel Yeats Tayside Lindyanne Alexander, Lindsey Buchanan, Susan Henderson, Tine Iterbeke, Susanneke Lucas, Gillian Manderson, Sheila Nicol, Gael Reid, Carol Robinson, Trish Sandilands Nottingham Marg Adrian, Ahmed Al-Sahab, Elaine Bentley, Hazel Brook, Claire Bushby, Rita Cannon, Brenda Cooper, Ruth Dowell, Mark Dunderdale, Dr Gabrawi, Li Guo, Lisa Heideman, Steve Jones, Salli Lawson, Zoë Philips, Christopher Platt, Shakuntala Prabhakaran, John Rippin, Rose Thompson, Elizabeth Williams, Claire Woolley Statistical analysis Seonaidh Cotton, Kirsten Harrild, John Norrie, Linda Sharp External Trial Steering Committee Nicholas Day (chair, 1999–2004), Theresa Marteau (chair 2004-), Mahesh Parmar, Julietta Patnick and Ciaran Woodman.
Resumo:
Background: Human papillomavirus (HPV) causes cervical cancer and external genital warts. The purpose of this study is to document the genotype distribution of HPV in females aged between 18 and 34 who self-referred to an STI clinic with visible external genital warts (EGW). Scrapings were taken from visible external genital warts (EGW). These scrapings were analysed by PCR for the presence of HPV DNA. Positive samples were then genotyped by means of a commercially available assay (LiPA). A comparison of genotyping results determined by the LiPA assay and direct amplicon DNA sequencing was also performed. Results: Ninety-two patients out of 105 samples (88%) had detectable levels of HPV DNA. The majority of individuals with EGW (66%) showed the presence of two or more genotypes. The most common HPV genotypes present in the study population were HPV-6, HPV-11, HPV-16, HPV-18, HPV-33 and HPV-53. Potential effects of vaccination on HPV molecular epidemiology indicate that 40% of the patients could have been protected from the high risk genotypes HPV-16 and HPV-18.Conclusion: This is the first report of the molecular epidemiology of external genital warts in women aged between 18 and 34 from Ireland based on results from a LiPA assay. The study shows that most individuals are infected with multiple genotypes including those with high oncogenic potential and that the newly available HPV vaccines could have a significant impact on prevalence of the most common HPV genotypes in this study population.
Resumo:
Background: Post-cesarean section peritonitis is the leading cause of maternal morbidity and mortality at the main referral hospital in Rwanda. Published data on the management of post-cesarean section peritonitis is limited. This study examined predictors of maternal morbidity and mortality for post-cesarean peritonitis.
Methods: We performed a prospective observational cohort study at the University Teaching Hospital Kigali (CHUK) from January 1 until December 31 2015, followed by a retrospective chart review of all subjects with post-cesarean section peritonitis admitted to CHUK from January 1 until December 31, 2014. All patients admitted with the diagnosis of post-cesarean section peritonitis undergoing exploratory laparotomy at CHUK were enrolled. Patients were followed to either discharge or death. Study variables included baseline demographic/clinical characteristics, admission physical exam, intraoperative findings, and management. Data were analyzed using STATA version 14.
Results: Of the 167 patients enrolled, 81 survived without requiring hysterectomy (49%), 49 survived requiring hysterectomy (29%), and 36 died (22%). In the multivariate analysis, severe sepsis was the most significant predictor of mortality (RR=4.0 [2.2-7.7]) and uterine necrosis was the most significant predictor of hysterectomy (RR=6.3 [1.6-25.2]). There were high rates of antimicrobial resistance (AMR) among the bacterial isolates cultured from intra-abdominal pus, with 52% of bacteria resistant to third-generation cephalosporins.
Conclusions: Post-cesarean section peritonitis carries a high mortality rate in Rwanda. It is also associated with a high rate of hysterectomy. Understanding the disease process and identifying factors associated with outcomes can help guide management during admission.
Resumo:
This research aimed to describe, understand, and discuss the curriculum development process of a Brazilian-Portuguese heritage language community-based school in South Florida. This study was guided by the following research questions: (a) What roles does this HL community-based school aim to play for its students? This investigation was also related to the subsidiary question: (b) How does this HL community-based school organize its curriculum development process? In order to explore these research questions, I observed and interviewed teachers and coordinators based on a qualitative research approach. I analyzed the interviews’ transcripts, and the program’s website with a central focus of describing and understanding their curriculum development process. Hopefully, the findings will help Brazilian and other HL community schools toward discussing and elaborating their own curriculum development, as well as to look for specific teacher training courses.
Resumo:
This dissertation investigates the question: has financial speculation contributed to global food price volatility since the mid 2000s? I problematize the mainstream academic literature on the 2008-2011 food price spikes as being dominated by neoclassical economic perspectives and offer new conceptual and empirical insights into the relationship between financial speculation and food. Presented in three journal style manuscripts, manuscript one uses circuits of capital to conceptualize the link between financial speculators in the global north and populations in the global south. Manuscript two argues that what makes commodity index speculation (aka ‘index funds’ or index swaps) novel is that it provides institutional investors with what Clapp (2014) calls “financial distance” from the biopolitical implications of food speculation. Finally, manuscript three combines Gramsci’s concepts of hegemony and ‘the intellectual’ with the concept of performativity to investigate the ideological role that public intellectuals and the rhetorical actor the market play in the proliferation and governance of commodity index speculation. The first two manuscripts take an empirically mixed method approach by combining regression analysis with discourse analysis, while the third relies on interview data and discourse analysis. The findings show that financial speculation by index swap dealers and hedge funds did indeed significantly contribute to the price volatility of food commodities between June 2006 and December 2014. The results from the interview data affirm these findings. The discourse analysis of the interview data shows that public intellectuals and rhetorical characters such as ‘the market’ play powerful roles in shaping how food speculation is promoted, regulated and normalized. The significance of the findings is three-fold. First, the empirical findings show that a link does exist between financial speculation and food price volatility. Second, the findings indicate that the post-2008 CFTC and the Dodd-Frank reforms are unlikely to reduce financial speculation or the price volatility that it causes. Third, the findings suggest that institutional investors (such as pension funds) should think critically about how they use commodity index speculation as a way of generating financial earnings.
Resumo:
The rate of non-full-time faculty members has increased rapidly over the last decade (Louis, 2009; MacKay, 2014; Meranze & Newfield, 2013), as the post-secondary landscape of fluctuating enrolment, fiscal and operational challenges, and the requirement to hire specialized skill sets have required institutions to rely heavily on this demographic. In the Ontario Colleges of Applied Arts and Technology (CAATs) system, institutions have tried to preserve and enhance educational quality with fewer resources through greater reliance on non-full-time faculty. The purpose of this study was to explore the perceptions and experiences of teaching and support of non-full-time faculty at one Eastern Ontario college. Employing a narrative inquiry methodology, data were collected from four participants through their writing three individual letters at the end of each month and participating in one interview at the end of the contract period. The data were analyzed and coded. This analysis revealed five themes: motivation, connection and engagement, compensation, teaching and development, and performance evaluation. Differences in the participants’ perceptions tended to reflect divergences across career stage: retired versus early career. The compensation package provided to non-full-time faculty was considered inadequate for those in the early career stage, especially comparing it to that of full-time faculty. In addition, the amount of previous teaching experience was an important indicator for the appropriate level of teaching resources and support provided by the institution. The newer faculty members required a higher level of support to combat feelings of role isolation. The temporary nature of the role made it difficult to establish a feeling of a strong connection to the institution and subsequently opportunities to engage further to deepen the relationship. Despite these differences across participants, autonomous motivators were consistent across all narratives, as participants expressed their desire to teach and share their knowledge to help students achieve their goals. Participants concluded their narratives by sharing future advice for faculty interested in pursuing the role. The narratives provided areas for improvement that would help increase the level of job satisfaction for non-full-time college faculty members: (a) establishing a more thorough performance evaluation process to align with institutional supports, (b) offering more diverse teaching resources to better prepare faculty and enhance teaching practices, (c) overhauling the compensation package to better recognize the amount of time and effort spent in the role and aligning with the compensation provided to full-time faculty, and (d) including rewards and incentives as part of the compensation package to enhance the level of commitment and availability for the role. These changes might well increase the job satisfaction and improve the retention of non-full-time faculty members.
Resumo:
Knight M, Acosta C, Brocklehurst P, Cheshire A, Fitzpatrick K, Hinton L, Jokinen M, Kemp B, Kurinczuk JJ, Lewis G, Lindquist A, Locock L, Nair M, Patel N, Quigley M, Ridge D, Rivero-Arias O, Sellers S, Shah A on behalf of the UKNeS coapplicant group. Background Studies of maternal mortality have been shown to result in important improvements to women’s health. It is now recognised that in countries such as the UK, where maternal deaths are rare, the study of near-miss severe maternal morbidity provides additional information to aid disease prevention, treatment and service provision. Objectives To (1) estimate the incidence of specific near-miss morbidities; (2) assess the contribution of existing risk factors to incidence; (3) describe different interventions and their impact on outcomes and costs; (4) identify any groups in which outcomes differ; (5) investigate factors associated with maternal death; (6) compare an external confidential enquiry or a local review approach for investigating quality of care for affected women; and (7) assess the longer-term impacts. Methods Mixed quantitative and qualitative methods including primary national observational studies, database analyses, surveys and case studies overseen by a user advisory group. Setting Maternity units in all four countries of the UK. Participants Women with near-miss maternal morbidities, their partners and comparison women without severe morbidity. Main outcome measures The incidence, risk factors, management and outcomes of uterine rupture, placenta accreta, haemolysis, elevated liver enzymes and low platelets (HELLP) syndrome, severe sepsis, amniotic fluid embolism and pregnancy at advanced maternal age (≥ 48 years at completion of pregnancy); factors associated with progression from severe morbidity to death; associations between severe maternal morbidity and ethnicity and socioeconomic status; lessons for care identified by local and external review; economic evaluation of interventions for management of postpartum haemorrhage (PPH); women’s experiences of near-miss maternal morbidity; long-term outcomes; and models of maternity care commissioned through experience-led and standard approaches. Results Women and their partners reported long-term impacts of near-miss maternal morbidities on their physical and mental health. Older maternal age and caesarean delivery are associated with severe maternal morbidity in both current and future pregnancies. Antibiotic prescription for pregnant or postpartum women with suspected infection does not necessarily prevent progression to severe sepsis, which may be rapidly progressive. Delay in delivery, of up to 48 hours, may be safely undertaken in women with HELLP syndrome in whom there is no fetal compromise. Uterine compression sutures are a cost-effective second-line therapy for PPH. Medical comorbidities are associated with a fivefold increase in the odds of maternal death from direct pregnancy complications. External reviews identified more specific clinical messages for care than local reviews. Experience-led commissioning may be used as a way to commission maternity services. Limitations This programme used observational studies, some with limited sample size, and the possibility of uncontrolled confounding cannot be excluded. Conclusions Implementation of the findings of this research could prevent both future severe pregnancy complications as well as improving the outcome of pregnancy for women. One of the clearest findings relates to the population of women with other medical and mental health problems in pregnancy and their risk of severe morbidity. Further research into models of pre-pregnancy, pregnancy and postnatal care is clearly needed.
Resumo:
This paper deals with the conceptions of the different school actors about the meaning and the implications of mediation in their schools, drawing on data from a qualitative approach carried out as part of a wider project to map mediation perspectives and practices in Catalonia. The authors analyze the scope of the situations regarded as suitable or unsuitable for the introduction of restorative practices, as well as the resistance to change in the practice of conflict resolutions and in the democratization of school culture.
Resumo:
Full paper presented at EC-TEL 2016
Resumo:
Demo paper presented at EC-TEL 2016