Patients' understanding of blood tests and attitudes to HIV screening in the emergency department of a Swiss teaching hospital: a cross-sectional observational study.

BACKGROUND: In Switzerland, patients may undergo "blood tests" without being informed what these are screening for. Inadequate doctor-patient communication may result in patient misunderstanding. We examined what patients in the emergency department (ED) believed they had been screened for and explored their attitudes to routine (non-targeted) human immunodeficiency virus (HIV) screening. METHODS: Between 1st October 2012 and 28th February 2013, a questionnaire-based survey was conducted among patients aged 16-70 years old presenting to the ED of Lausanne University Hospital. Patients were asked: (1) if they believed they had been screened for HIV; (2) if they agreed in principle to routine HIV screening and (3) if they agreed to be HIV tested during their current ED visit. RESULTS: Of 466 eligible patients, 411 (88%) agreed to participate. Mean age was 46 ± 16 years; 192 patients (47%) were women; 366 (89%) were Swiss or European; 113 (27%) believed they had been screened for HIV, the proportion increasing with age (p ≤0.01), 297 (72%) agreed in principle with routine HIV testing in the ED, and 138 patients (34%) agreed to be HIV tested during their current ED visit. CONCLUSION: In this ED population, 27% believed incorrectly they had been screened for HIV. Over 70% agreed in principle with routine HIV testing and 34% agreed to be tested during their current visit. These results demonstrate willingness among patients concerning routine HIV testing in the ED and highlight a need for improved doctor-patient communication about what a blood test specifically screens for.

Enhancing teaching and learning speech acts: action research of Japanese as a foreign language /

This action research observes a second year Japanese class at a university where foreign language courses are elective for undergraduate students. In this study, using the six strategies to teach Japanese speech acts that Ishihara and Cohen (2006) suggested, I conducted three classes and analyzed my teaching practice with a critical friend. These strategies assist learners toward the development of their understanding of the following Japanese speech acts and also keep the learners to use them in a manner appropriate to the context: (I) invitation and refusal; (2) compliments; and (3) asking for a permission. The aim of this research is not only to improve my instruction in relation to second language (L2) pragmatic development, but also to raise further questions and to develop future research. The findings are analyzed and the data derived from my journals, artifacts, students' work, observation sheets, interviews with my critical friend, and pretests and posttests are coded and presented. The analysis shows that (I) after my critical friend encouraged my study and my students gave me some positive comments after each lesson, I gained confidence in teaching the suggested speech acts; (2) teaching involved explaining concepts and strategies, creating the visual material (a video) showing the strategies, and explaining the relationship between the strategy and grammatical forms and samples of misusing the forms; (3) students' background and learning styles influenced lessons; and (4) pretest and posttests showed that the students' Icvel of their L2 appropriate pragmatics dramatically improved after each instruction. However, after careful observation, it was noted that some factors prevented students from producing the correct output even though they understood the speech act differences.

The role of learning and growth hormone-releasing factor in the control of protein intake in rats /

Both learning and basic biological mechanisms have been shown to play a role in the control of protein int^e. It has previously been shown that rats can adapt their dietary selection patterns successfully in the face of changing macronutrient requirements and availability. In particular, it has been demonstrated that when access to dietary protein is restricted for a period of time, rats selectively increase their consumption of a proteincontaining diet when it becomes available. Furthermore, it has been shown that animals are able to associate various orosensory cues with a food's nutrient content. In addition to the role that learning plays in food intake, there are also various biological mechanisms that have been shown to be involved in the control of feeding behaviour. Numerous studies have documented that various hormones and neurotransmitter substances mediate food intake. One such hormone is growth hormone-releasing factor (GRF), a peptide that induces the release of growth hormone (GH) from the anterior pituitary gland. Recent research by Vaccarino and Dickson ( 1 994) suggests that GRF may stimulate food intake by acting as a neurotransmitter in the suprachiasmatic nucleus (SCN) and the adjacent medial preoptic area (MPOA). In particular, when GRF is injected directly into the SCN/MPOA, it has been shown to selectively enhance the intake of protein in both fooddeprived and sated rats. Thus, GRF may play a role in activating protein consumption generally, and when animals have a need for protein, GRF may serve to trigger proteinseeking behaviour. Although researchers have separately examined the role of learning and the central mechanisms involved in the control of protein selection, no one has yet attempted to bring together these two lines of study. Thus, the purpose of this study is to join these two parallel lines of research in order to further our understanding of mechanisms controlling protein selection. In order to ascertain the combined effects that GRF and learning have on protein intake several hypothesis were examined. One major hypothesis was that rats would successfully alter their dietary selection patterns in response to protein restriction. It was speculated that rats kept on a nutritionally complete maintenance diet (NCMD) would consume equal amount of the intermittently presented high protein conditioning diet (HPCD) and protein-free conditioning diet (PFCD). However, it was hypothesized that rats kept on a protein-free maintenance diet (PFMD) would selectively increase their intake of the HPCD. Another hypothesis was that rats would learn to associate a distinct marker flavour with the nutritional content of the diets. If an animal is able to make the association between a marker flavour and the nutrient content of the food, then it is hypothesized that they will consume more of a mixed diet (equal portion HPCD and PFCD) with the marker flavour that was previously paired with the HPCD (Mixednp-f) when kept on the PFMD. In addition, it was hypothesized that intracranial injection of GRF into the SCN/MPOA would result in a selective increase in HPCD as well as Mixednp-t consumption. Results demonstrated that rats did in fact selectively increase their consumption of the flavoured HPCD and Mixednp-f when kept on the NCMD. These findings indicate that the rats successfully learned about the nutrient content of the conditioning diets and were able to associate a distinct marker flavour with the nutrient content of the diets. However, the results failed to support previous findings that GRF increases protein intake. In contrast, the administration of GRF significantly reduced consumption of HPCD during the first hour of testing as compared to the no injection condition. In addition, no differences in the intake of the HPCD were found between the GRF and vehicle condition. Because GRF did not selectively increase HPCD consumption, it was not surprising that GRF also did not increase MixedHP-rintake. What was interesting was that administration of GRF and vehicle did not reduc^Mixednp-f consumption as it had decreased HPCD consumption.

Postsecondary Teaching and Learning Development Needs: Motivators and Barriers Associated With Participation in Educational Development

This study investigated instructor perceptions of motivators and barriers that exist with respect to participation in educational development in the postsecondary context. Eight instructors from a mid-size, research intensive university in south-western Ontario participated in semistructured interviews to explore this particular issue. Data were analyzed using a qualitative approach. Motivation theory was used as a conceptual framework in this study, referring primarily to the work of Ryan and Deci (2000), Deci and Ryan (1985), and Pink (2009). The identified motivators and barriers spanned all 3 levels of postsecondary institutions: the micro (i.e., the individual), the meso (i.e., the department or Faculty), and the macro (i.e., the institution). Significant motivators to participation in educational development included desire to improve one’s teaching (micro), feedback from students (meso), and tenure and promotion (macro). Significant barriers to participation included lack of time (micro), the perception that an investment towards one’s research was more important than an investment to enhancing teaching (meso), and the impression that quality teaching was not valued by the institution (macro). The study identifies connections between the micro, meso, macro framework and motivation theory, and offers recommendations for practice.

Ecotoxic Metal Records and its Degree of Geochemical Symphony in the Niche of Cochin Estuarine System- A Theraptic Perspective

The heavy metal contamination in the environment may lead to circumstances like bioaccumulation and inturn biomagnification. Hence cheaper and effective technologies are needed to protect the precious natural resources and biological lives. A suitable technique is the one which meets the technical and environmental criteria for dealing with a particular remediation problem and should be site-specific due to spatial and climatic variations and it may not economically feasible everywhere. The search for newer technologies for the environmental therapy, involving the removal of toxic metals from wastewaters has directed attention to adsorption, based on metal binding capacities of various adsorbent materials. Therefore, the present study aim to identify and evaluate the most current mathematical formulations describing sorption processes. Although vast amount of research has been carried out in the area of metal removal by adsorption process using activated carbon few specific research data are available in different scientific institutions. The present work highlights the seasonal and spatial variations in the distribution of some selected heavy metals among various geochemical phases of Cochin Estuarine system and also looked into an environmental theraptic/remedial approach by adsorption technique using activated charcoal and chitosan, to reduce and thereby controlling metallic pollution. The thesis has been addressed in seven chapters with further subdivisions. The first chapter is introductory, stating the necessity of reducing or preventing water pollution due to the hazardous impact on environment and health of living organisms and drawing it from a careful review of literature relevant to the present study. It provides a constricted description about the study area, geology, and general hydrology and also bears the major objectives and scope of the present study.

3D Simultaneous Inversion for Seismic Structure and Local Hypocenters in Germany under Consideration of Seismic Anisotropy in the Upper Mantel

The main task of this work has been to investigate the effects of anisotropy onto the propagation of seismic waves along the Upper Mantle below Germany and adjacent areas. Refraction- and reflexion seismic experiments proved the existence of Upper Mantle anisotropy and its influence onto the propagation of Pn-waves. By the 3D tomographic investigations that have been done here for the crust and the upper mantle, considering the influence of anisotropy, a gap for the investigations in Europe has been closed. These investigations have been done with the SSH-Inversionprogram of Prof. Dr. M. Koch, which is able to compute simultaneously the seismic structure and hypocenters. For the investigation, a dataset has been available with recordings between the years 1975 to 2003 with a total of 60249 P- and 54212 S-phase records of 10028 seismic events. At the beginning, a precise analysis of the residuals (RES, the difference between calculated and observed arrivaltime) has been done which confirmed the existence of anisotropy for Pn-phases. The recognized sinusoidal distribution has been compensated by an extension of the SSH-program by an ellipse with a slow and rectangular fast axis with azimuth to correct the Pn-velocities. The azimuth of the fast axis has been fixed by the application of the simultaneous inversion at 25° - 27° with a variation of the velocities at +- 2.5 about an average value at 8 km/s. This new value differs from the old one at 35°, recognized in the initial residual analysis. This depends on the new computed hypocenters together with the structure. The application of the elliptical correction has resulted in a better fit of the vertical layered 1D-Model, compared to the results of preceding seismological experiments and 1D and 2D investigations. The optimal result of the 1D-inversion has been used as initial starting model for the 3D-inversions to compute the three dimensional picture of the seismic structure of the Crust and Upper Mantle. The simultaneous inversion has showed an optimization of the relocalization of the hypocenters and the reconstruction of the seismic structure in comparison to the geology and tectonic, as described by other investigations. The investigations for the seismic structure and the relocalization have been confirmed by several different tests. First, synthetic traveltime data are computed with an anisotropic variation and inverted with and without anisotropic correction. Further, tests with randomly disturbed hypocenters and traveltime data have been proceeded to verify the influence of the initial values onto the relocalization accuracy and onto the seismic structure and to test for a further improvement by the application of the anisotropic correction. Finally, the results of the work have been applied onto the Waldkirch earthquake in 2004 to compare the isotropic and the anisotropic relocalization with the initial optimal one to verify whether there is some improvement.

Impact of sward type, cutting date and conditioning temperature on mass and energy flows in the integrated generation of solid fuel and biogas from semi-natural grassland

Energy production from biomass and the conservation of ecologically valuable grassland habitats are two important issues of agriculture today. The combination of a bioenergy production, which minimises environmental impacts and competition with food production for land with a conversion of semi-natural grasslands through new utilization alternatives for the biomass, led to the development of the IFBB process. Its basic principle is the separation of biomass into a liquid fraction (press fluid, PF) for the production of electric and thermal energy after anaerobic digestion to biogas and a solid fraction (press cake, PC) for the production of thermal energy through combustion. This study was undertaken to explore mass and energy flows as well as quality aspects of energy carriers within the IFBB process and determine their dependency on biomass-related and technical parameters. Two experiments were conducted, in which biomass from semi-natural grassland was conserved as silage and subjected to a hydrothermal conditioning and a subsequent mechanical dehydration with a screw press. Methane yield of the PF and the untreated silage was determined in anaerobic digestion experiments in batch fermenters at 37°C with a fermentation time of 13-15 and 27-35 days for the PF and the silage, respectively. Concentrations of dry matter (DM), ash, crude protein (CP), crude fibre (CF), ether extract (EE), neutral detergent fibre (NDF), acid detergent fibre (ADF), acid detergent ligning (ADL) and elements (K, Mg, Ca, Cl, N, S, P, C, H, N) were determined in the untreated biomass and the PC. Higher heating value (HHV) and ash softening temperature (AST) were calculated based on elemental concentration. Chemical composition of the PF and mass flows of all plant compounds into the PF were calculated. In the first experiment, biomass from five different semi-natural grassland swards (Arrhenaterion I and II, Caricion fuscae, Filipendulion ulmariae, Polygono-Trisetion) was harvested at one late sampling (19 July or 31 August) and ensiled. Each silage was subjected to three different temperature treatments (5°C, 60°C, 80°C) during hydrothermal conditioning. Based on observed methane yields and HHV as energy output parameters as well as literature-based and observed energy input parameters, energy and green house gas (GHG) balances were calculated for IFBB and two reference conversion processes, whole-crop digestion of untreated silage (WCD) and combustion of hay (CH). In the second experiment, biomass from one single semi-natural grassland sward (Arrhenaterion) was harvested at eight consecutive dates (27/04, 02/05, 09/05, 16/05, 24/05, 31/05, 11/06, 21/06) and ensiled. Each silage was subjected to six different treatments (no hydrothermal conditioning and hydrothermal conditioning at 10°C, 30°C, 50°C, 70°C, 90°C). Energy balance was calculated for IFBB and WCD. Multiple regression models were developed to predict mass flows, concentrations of elements in the PC, concentration of organic compounds in the PF and energy conversion efficiency of the IFBB process from temperature of hydrothermal conditioning as well as NDF and DM concentration in the silage. Results showed a relative reduction of ash and all elements detrimental for combustion in the PC compared to the untreated biomass of 20-90%. Reduction was highest for K and Cl and lowest for N. HHV of PC and untreated biomass were in a comparable range (17.8-19.5 MJ kg-1 DM), but AST of PC was higher (1156-1254°C). Methane yields of PF were higher compared to those of WCD when the biomass was harvested late (end of May and later) and in a comparable range when the biomass was harvested early and ranged from 332 to 458 LN kg-1 VS. Regarding energy and GHG balances, IFBB, with a net energy yield of 11.9-14.1 MWh ha-1, a conversion efficiency of 0.43-0.51, and GHG mitigation of 3.6-4.4 t CO2eq ha-1, performed better than WCD, but worse than CH. WCD produces thermal and electric energy with low efficiency, CH produces only thermal energy with a low quality solid fuel with high efficiency, IFBB produces thermal and electric energy with a solid fuel of high quality with medium efficiency. Regression models were able to predict target parameters with high accuracy (R2=0.70-0.99). The influence of increasing temperature of hydrothermal conditioning was an increase of mass flows, a decrease of element concentrations in the PC and a differing effect on energy conversion efficiency. The influence of increasing NDF concentration of the silage was a differing effect on mass flows, a decrease of element concentrations in the PC and an increase of energy conversion efficiency. The influence of increasing DM concentration of the silage was a decrease of mass flows, an increase of element concentrations in the PC and an increase of energy conversion efficiency. Based on the models an optimised IFBB process would be obtained with a medium temperature of hydrothermal conditioning (50°C), high NDF concentrations in the silage and medium DM concentrations of the silage.

Identification of the Learning Styles in the Students of Exercise Physiology in the Rehabilitation and Human Development Faculty

The object of this study is to identify the learning styles (LS) used by the students of the subject of physiology of the exercise of the program of Physiotherapy, with the purpose of establishing a direct relationship later on between the learning styles and the possible pedagogic strategies that but they favor the compression of the physiology of the exercise 48 subject of second and third year of career they were interviewed through the instrument standardized compound number (CHAEA). This study carried out an analysis descriptive and of typical deviation of the data. They were differences statistically significant in the styles of active and reflexive learning, in front of the Theoretical and pragmatic styles what puts in evidence the necessity to generate pedagogic strategies inside the subject that this chord with the tendency of the active and reflexive learning of the students.

Una aproximación documental para la creación e integración de juegos digitales en entornos virtuales de enseñanza. A documental approach to the creation and integration of digital videogames in virtual learning environments

Desde el campo de la informática educativa, varios autores exponen el posible efecto positivo de incorporar videojuegos y simulaciones con elementos de juego en los procesos educativos. Esta postura continúa siendo objeto de debate y sus detractores identifican, dos problemas fundamentales, por un lado el excesivo coste de estas iniciativas y, por otro, su carácter limitado que obliga a que formen parte de variados procesos educativos.. En este trabajo se estudia cómo abordar estos dos problemas desde un punto de vista tecnológico. Se propone una plataforma menor que e-adventure, un entorno de desarrollo para juegos educativos. Esta plataforma aborda el primer problema planteando, un modelo de proceso de desarrollo inspirado en la aproximación documental al desarrollo de software. El modelo de proceso incluye la propuesta de un lenguaje de marcado extendido, XML, específico del dominio de las aventuras gráficas educativas. Este lenguaje es sencillo de utilizar y facilita la creación de este tipo de juegos e incluye construcciones específicamente educativas que dan soporte a la evaluación de la actividad del alumno y a patrones de aprendizaje adaptativo. El segundo problema se aborda proponiendo la integración de dichos juegos con plataformas de tele-enseñanza, LMS, que se emplean tanto en la enseñanza a través de internet como en aproximaciones del aprendizaje electrónico, e-learning, combinadas con la enseñanza tradicional.. Se incluye la implementación de un prototipo de la plataforma propuesta y varios juegos educativos desarrollados con ella, en colaboración con investigadores e instructores de otros campos..

All in all : a plural view of our teaching and learning. 'En total : una visión plural de nuestra enseñanza y aprendizaje'.

Textos en español y en inglés

Cross-curricular teaching and learning in the secondary school. 'Enseñanza y aprendizaje de temas transversales en educación secundaria'.

Resumen basado en el de la publicación

Toward a pedagogy of advanced studies in the University : the production of an inventive academic writing in the Social Sciences, Arts and Humanities

Resumen basado en el de la publicaci??n

Appeal to the Universities for the development of Teaching and Research in the areas of Urban Planning in the CPLP countries

Work document prepared at the Universidade Lusófona de Humanidades e Tecnologias in its role as Consulting Observer attributed by the Council of Ministers of the CPLP gathered in Bissau for the 11th General Meeting on 16. and 17. July, 2006.

Diagnostic analysis of atmospheric moisture and clear-sky radiative feedback in the Hadley Centre and Geophysical Fluid Dynamics Laboratory (GFDL) climate models

The interannual variability of the hydrological cycle is diagnosed from the Hadley Centre and Geophysical Fluid Dynamics Laboratory (GFDL) climate models, both of which are forced by observed sea surface temperatures. The models produce a similar sensitivity of clear-sky outgoing longwave radiation to surface temperature of ∼2 W m−2 K−1, indicating a consistent and positive clear-sky radiative feedback. However, differences between changes in the temperature lapse-rate and the height dependence of moisture fluctuations suggest that contrasting mechanisms bring about this result. The GFDL model appears to give a weaker water vapor feedback (i.e., changes in specific humidity). This is counteracted by a smaller upper tropospheric temperature response to surface warming, which implies a compensating positive lapse-rate feedback.