947 resultados para chois modal


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The tension between technical experts and the populations they seek to serve is well established in the literature examining professional social problem solving. In this piece, I examine this tension as one between the distinct discursive worlds of technical expertise and community voice. I develop an analytic process, IMAP, for exploring this tension by looking at a wide variety of professional orientations around a relatively fixed concept of community voice. IMAP involves I&barbelow;dentifying social problem solvers, M&barbelow;apping social problem solvers' claims, A&barbelow;nalyzing professional orientations that arise from this mapping, and P&barbelow;redicting, diagnosing, and remediating conflicts. IMAP can be used by analysts external to social problem solving settings or by social problem solvers themselves. The use of IMAP by external experts poses questions of expert alignment with either of the discursive worlds. I examine two cases in public health practice settings: a mobile immunization service and the efforts of a foundation to improve health in an inner-city neighborhood. I develop four modal types that can be anticipated in social problem solving settings or, more specifically, in public health practice. Understanding of these “world views” can enhance mutual understanding between public health professionals and between public health professionals and the communities they seek to serve. IMAP might also address ongoing conflicts to clarify differences in unspoken normative commitments and the impact of these on social problem solving. I discuss implications of the research for public health practice and further research in the area. ^

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Negotiation of complex collaboration and effective teamwork among health care providers is essential to patient safety and to quality of care. This study examined characteristics of nursing students and faculty influencing communication between them. Psychological type (Myers-Briggs Type Inventory (MBTI) (Myers, McCaulley, Quenk, & Hammer, 1998) and explanatory style (Attributional Style Questionnaire) (ASQ) (Peterson et al., 1982) were compared for participating first year baccalaureate nursing students (N=286), and clinical nursing faculty (N=59) from both two- and four-year nursing programs. Modal student psychological type was ESFJ; modal faculty psychological type was ISTJ. The two groups demonstrated significant differences in processing information, and making decisions and judgments. Students were slightly more optimistic than faculty. Psychological type and level of optimism did not appear to correlate. Data from this pilot study provide an initial framework on which to base further research that could enhance the quality of teamwork among healthcare providers.

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This descriptive systematic review describes intervention trials for children and youth that targeted screen time (ST) as a way to prevent or control obesity and measured ST, and at least one of the following: physical activity, dietary intake, and adiposity. Both “hands-on” (e.g., video games) and “hands free” (e.g., television viewing) ST were included. Published, completed intervention trials (k=12), not-yet-published, completed trials (k=6), and in-progress trials (k=11) were identified through searches of electronic databases, including trial registries and bibliographies of eligible study reports. Study characteristics of the 29 identified trials were coded and presented in evidence tables. Considerable attention was paid to the type of ST addressed, measures used, and the type of interventions. Based on the number of in-progress and not-yet-published trials, the number of completed, published reports will double in the next three years. Most of the studies were funded by federal sources. General populations, not restricted by race, gender, or weight status, were targets of most interventions with children ages 9-12 yeas as the modal age group. Most trials used randomized control trials in which the majority of control or comparison group received an intervention. The mean number of participants was 242.8 (SD=314.7) and interventions were delivered over an average of 10.5 months and consisted of approximately 16 sessions, with a total time of about eight hours. The majority of completed trials evaluate each of the four constructs, however, most studies have more than one measure to assess each construct (e.g., BMI and tricep skinfold thickness to evaluate adiposity) and rarely did studies use the same measures. This is likely why the majority of studies produced at least one significant intervention effect on each outcome that was assessed. The four major outcomes should be evaluated in all interventions attempting to reduce screen time in order to determine the mechanisms involved that may contribute to obesity. More importantly researchers should work together to determine the best measures to evaluate the four main constructs to allow studies to be compared. Another area for consensus is the definition of ST. ^

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Introduction. Injury mortality was classically described with a tri-modal distribution, with immediate deaths at the scene, early deaths due to hemorrhage, and late deaths from organ failure. We hypothesized that trauma systems development have improved pre-hospital care, early resuscitation, and critical care, and altered this pattern. ^ Methods. This is a population-based study of all trauma deaths in an urban county with a mature trauma system (n=678, median age 33 years, 81% male, 43% gunshot, 20% motor vehicle crashes). Deaths were classified as immediate (scene), early (in hospital, ≤ 4 hours from injury), or late (>4 hours post injury). Multinomial regression was used to identify independent predictors of immediate and early vs. late deaths, adjusted for age, gender, race, intention, mechanism, toxicology and cause of death. ^ Results. There were 416 (61%) immediate, 199 (29%) early, and 63 (10%) late deaths. Immediate deaths remained unchanged and early deaths occurred much earlier (median 52 minutes vs. 120). However, unlike the classic trimodal distribution, there was no late peak. Intentional injuries, alcohol intoxication, asphyxia, and injuries to the head and chest were independent predictors of immediate deaths. Alcohol intoxication and injuries to the chest were predictors of early deaths, while pelvic fractures and blunt assaults were associated with late deaths. ^ Conclusion. Trauma deaths now have a bimodal distribution. Elimination of the late peak likely represents advancements in resuscitation and critical care that have reduced organ failure. Further reductions in mortality will likely come from prevention of intentional injuries, and injuries associated with alcohol intoxication. ^

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Approximately 12,000 new cases of spinal cord injury (SCI) are added each year to the estimated 259,000 Americans living with SCI. The majority of these patients return to society, their lives forever changed by permanent loss of sensory and motor function. While there are no FDA approved drugs for the treatment of SCI or a universally accepted standard therapy, the current though controversial treatment includes the delivery of high dosages of the corticosteroid methyliprednisolone sodium succinate, surgical interventions to stabilize the spinal column, and physical rehabilitation. It is therefore critically important to fully understand the pathology of injury and determine novel courses and rationally-based therapies for SCI. ^ Vascular endothelial growth factor (VEGF) is an attractive target for treating central nervous system (CNS) injury and disease because it has been shown to influence angiogenesis and neuroprotection. Preliminary studies have indicated that increased vasculature may be associated with functional recovery; therefore exogenous delivery of a pro-angiogenic growth factor such as VEGF may improve neurobehavioral outcome. In addition, VEGF may provide protection from secondary injury and result in increased survival and axonal sprouting. ^ In these studies, SCI rats received acute intraspinal injections of VEGF, the antibody to VEGF, or vehicle control. The effect of these various agents was investigated using longitudinalmulti-modal magnetic resonance imaging (MRI), neuro- and sensory behavioral assays, and end point immunohistochemistry. We found that rats that received VEGF after SCI had increased tissue sparing and improved white matter integrity at the earlier time points as shown by advanced magnetic resonance imaging (MRI) techniques. However, these favorable effects of VEGF were not maintained, suggesting that additional treatments with VEGF at multiple time points may be more beneficial, Histological examinations revealed that VEGF treatment may result in increased oligodendrogenesis and therefore may eventually lead to remyelination and improved functional outcome. ^ On the neurobehavioral studies, treatments with VEGF and Anti-VEGF did not significantly affect performance on tests of open-field locomotion, grid walk, inclined plane, or rearing. However, VEGF treatment resulted in significantly increased incidence of chronic neuropathic pain. This phenomenon could possibly be attributed to the fact that VEGF treatment may promote axonal sprouting and also results in tissue sparing, thereby providing a substrate for the growth of new axons. New connections made by these sprouting axons may involve components of pathways involved in the transmission of pain and therefore result in increased pain in those animals. ^

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This study presents the results of high-resolution sedimentological and clay mineralogical investigations on sediments from ODP Sites 908A and 909AlC located in the central Fram Strait. The objective was to reconstruct the paleoclimate and paleoceanography of the high northern latitudes since the middle Miocene. The sediments are characterised in particular by a distinctive input of ice-rafted material, which most probably occurs since 6 Ma and very likely since 15 Ma. A change in the source area at 1 1.2 Ma is clearly marked by variations within clay mineral composition and increasing accumulation rates. This is interpreted as a result of an increase in water mass exchange through the Fram Strait. A further period of increasing exchange between 4-3 Ma is identified by granulometric investigations and points to a synchronous intensification of deep water production in the North Atlantic during this time interval. A comparison of the components of coarse and clay fraction clearly shows that both are not delivered by the Same transport process. The input of the clay fraction can be related to transport mechanisms through sea ice and glaciers and very likely also through oceanic currents. A reconstruction of source areas for clay minerals is possible only with some restrictions. High smectite contents in middle and late Miocene sediments indicate a background signal produced by soil formation together with sediment input, possibly originating from the Greenland- Scotland Ridge. The applicability of clay mineral distribution as a climate proxy for the high northern latitudes can be confirmed. Based on a comparison of sediments from Site 909C, characterised by the smectite/illite and chlorite ratio, with regional and global climatic records (oxygen isotopes), a middle Miocene cooling phase between 14.8-14.6 Ma can be proposed. A further cooling phase between 10-9 Ma clearly shows similarities in its Progress toward drastic decrease in carbonate sedimentation and preservation in the eastern equatorial Pacific. The modification in sea water and atmosphere chemistry may represent a possible link due to the built-up of equatorial carbonate platforms. Between 4.8-4.6 Ma clay mineral distribution indicates a distinct cooling trend in the Fram Strait region. This is not accompanied by relevant glaciation, which would otherwise be indicated by the coarse fraction. The intensification of glaciation in the northern hemisphere is distinctly documented by a rapid increase of illite and chlorite starting from 3.3 Ma, which corresponds to oxygen isotope data trends from North Atlantic.

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Recycling of oceanic crust into the deep mantle via subduction is a widely accepted mechanism for creating compositional heterogeneity in the upper mantle and for explaining the distinct geochemistry of mantle plumes. The oxygen isotope ratios (d18O) of some ocean island basalts (OIB) span values both above and below that of unmetasomatised upper mantle (5.5 ± 0.4 per mil) and provide support for this hypothesis, as it is widely assumed that most variations in d18O are produced by near-surface low-temperature processes. Here we show a significant linear relationship between d18O and stable iron isotope ratios (d57Fe) in a suite of pristine eclogite xenoliths. The d18O values of both bulk samples and garnets range from values within error of normal mantle to significantly lighter values. The observed range and correlation between d18O and d57Fe is unlikely to be inherited from oceanic crust, as d57Fe values determined for samples of hydrothermally altered oceanic crust do not differ significantly from the mantle value and show no correlation with d18O. It is proposed that the correlated d57Fe and d18O variations in this particular eclogite suite are predominantly related to isotopic fractionation by disequilibrium partial melting although modification by melt percolation processes cannot be ruled out. Fractionation of Fe and O isotopes by removal of partial melt enriched in isotopically heavy Fe and O is supported by negative correlations between bulk sample d57Fe and Cr content and bulk sample and garnet d18O and Sc contents, as Cr and Sc are elements that become enriched in garnet- and pyroxene-bearing melt residues. Melt extraction could take place either during subduction, where the eclogites represent the residues of melted oceanic lithosphere, or could take place during long-term residence within the lithospheric mantle, in which case the protoliths of the eclogites could be of either crustal or mantle origin. This modification of both d57Fe and d18O by melting processes and specifically the production of low-d18O signatures in mafic rocks implies that some of the isotopically light d18O values observed in OIB and eclogite xenoliths may not necessarily reflect near-surface processes or components.

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In-situ proton-microprobe analyses are presented for glasses, plagioclases, pyroxenes, olivines, and spinels in eleven samples from Sites 834-836, 839, and 841 (vitrophyric rhyolite), plus a Tongan dacite. Elements analyzed are Mn, Ni, Cu, Zn, Ga, Rb, Sr, Y, Zr, Pb, and Sn (in spinels only). The data are used to calculate two sets of partition coefficients, one set based on the ratio of element in mineral/element in coexisting glass. The second set of coefficients, thought to be more robust, is corrected by application of the Rayleigh fractionation equations, which requires additional use of modal data. Data are presented for phenocryst core-rim phases and microphenocryst-groundmass phases from a few samples. Comparison with published coefficients reveals an overall consistency with those presented here, but with some notable anomalies. Examples are relatively high Zr values for pyroxenes and abnormally low Mn values in olivines and clinopyroxenes from Site 839 lavas. Some anomalies may reflect kinetic effects, but interpretation of the coefficients is complicated, especially in olivines from Sites 836 and 839, by possible crystal-liquid disequilibrium resulting from mixing processes.

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Detrital modes for 524 deep-marine sand and sandstone samples recovered on circum-Pacific, Caribbean, and Mediterranean legs of the Deep Sea Drilling Project and the Ocean Drilling Program form the basis for an actualistic model for arc-related provenance. This model refines the Dickinson and Suczek (1979) and Dickinson and others (1983) models and can be used to interpret the provenance/tectonic history of ancient arc-related sedimentary sequences. Four provenance groups are defined using QFL, QmKP, LmLvLs, and LvfLvmiLvl ternary plots of site means: (1) intraoceanic arc and remnant arc, (2) continental arc, (3) triple junction, and (4) strike-slip-continental arc. Intraoceanic- and remnant-arc sands are poor in quartz (mean QFL%Q < 5) and rich in lithics (QFL%L > 75); they are predominantly composed of plagioclase feldspar and volcanic lithic fragments. Continental-arc sand can be more quartzofeldspathic than the intraoceanic- and remnant-arc sand (mean QFL%Q values as much as 10, mean QFL%F values as much as 65, and mean QmKP%Qm as much as 20) and has more variable lithic populations, with minor metamorphic and sedimentary components. The triple-junction and strike-slip-continental groups compositionally overlap; both are more quartzofeldspathic than the other groups and show highly variable lithic proportions, but the strike-slip-continental group is more quartzose. Modal compositions of the triple junction group roughly correlate with the QFL transitional-arc field of Dickinson and others (1983), whereas the strike-slip-continental group approximately correlates with their dissected-arc field.

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En esta tesis se trabaja sobre la hipótesis de que el componente didáctico del discurso divulgativo queda delimitado por estrategias discursivas originadas en el tratamiento modal y actualizadas en los niveles funcional, situacional, semántico y formal-gramatical. El objetivo es caracterizar tales estrategias para identificar tendencias en la realización lingüísticodiscursiva del componente didáctico. El corpus se ha formado teniendo en cuenta soporte (web), formato (hipertexto) y dominio disciplinar (Análisis Sensorial de Vinos). La metodología es, fundamentalmente, cualitativo-ejemplar, basada en el modelo multinivel propuesto por Ciapuscio (2003) para el análisis de textos especializados. Los resultados sugieren que en el nivel funcional, el componente didáctico se distingue por el predominio de los términos positivos de las categorías modales epistémica (función informar) y ética (función dirigir); en el nivel situacional, por tres tipos de construcciones discursivas: la del enunciador experto, la del enunciatario lego y la de la pertenencia del lego a la comunidad especializada; en el nivel semántico, por la estandarización de partes textuales y por el predominio tanto de axiologización eufórica ética y cognoscitiva, como de secuencias expositivas y de procedimientos explicativos causales, descriptivos e ilustrativos; en el nivel formal, por recursos paratextuales e hipertextuales que refuerzan la actualización del componente didáctico.

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El objeto de estudio de este trabajo es la subjetivización, es decir el proceso por el cual los hablantes pasan con el paso del tiempo a atribuir significados a expresiones que codifican sus perspectivas y actitudes. Dicho proceso ha sido definido como “el mecanismo más penetrante en el cambio semántico" (Trauggot y Dasher 2001:30). Un caso muy conocido de variación dialectal en la gramática del español es el dequeísmo, el cual puede explicarse en términos de la subjetivización. El trabajo respalda dicha hipótesis a través de un análisis contrastivo de datos reunidos a través de un corpus computarizado. En primer lugar se bosqueja la evolución del dequeísmo desde el español medieval hasta el español contemporáneo, lo que prueba un creciente grado de subjetivización dado por un cambio concomitante que muestra una evolución desde un alto a un bajo grado de compromiso del hablante respecto al grado de veracidad de la proposición. En segundo lugar, se analiza la posibilidad de hacer un reanálisis categorial de la preposición “de", la que ha pasado de ser utilizada como marcador espacial a un marcador modal abstracto en subordinadas dequeístas. Los resultados nos permiten reflexionar no sólo sobre la evolución de las proposiciones dequeístas sino también sobre la relación entre cambio semántico y gramaticalización.

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La mayor parte de los estudios sobre la mutación vocal se ha focalizado sobre las variaciones de la frecuencia fundamental del habla en relación con la edad, el peso, la altura, el vello axilar y pubiano y el nivel de testosterona en sangre. Los maestros de canto y los vocólogos que trabajan con voces infantiles, ya sean cantadas o habladas, deberían conocer profundamente las características de la mutación vocal. Con esa finalidad, llevamos a cabo un estudio de seguimiento longitudinal de 18 niños (9 cantores y 9 no cantores) durante 18 meses. Efectuamos,además, un estudio transversal por rangos de edad a 98 niños y jóvenes. Todos los sujetos fueron examinados a través de un examen perceptual y de un examen acústico luego de un examen ORL normal. Los resultados muestran que las roturas de registro desde el falsete al modal, a través de la producción de un glissando descendente, son el signo más importante de mutación desde un punto de vista perceptual. Estas roturas son independientes del entrenamiento vocal y ocurren tanto en cantores como en no cantores de la misma manera. Las roturas de registro determinan otra serie de características como el estrechamiento del rango fonacional, las roturas de voz y el descenso excesivo de la frecuencia fundamental del habla. Las roturas de registro producidas a través de un glissando descendente son muy llamativas durante el período crítico de mutación. No aparecen en las voces infantiles ni en las voces adultas saludables, sean estas voces con o sin entrenamiento. La mutación vocal de los niños varones atraviesa los siguientes estadíos: período pre-mutacional, comienzos de mutación, período crítico y período fi nal; cada estadio evidencia sus características distintivas tanto desde el punto de vista perceptual como acústico.

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Se analiza aquí la crítica que Santo Tomás hizo a Aristóteles sobre el concepto de posibilidad en un pasaje de su Comentario al Peryermeneias. A partir de ese texto parece que Aristóteles no considera suficientemente la contingencia desde un punto de vista metafísico. Entre las interpretaciones modernas del pensamiento del Aquinate, no es frecuente encontrar advertida dicha crítica, y, como consecuencia de ello, se olvida aquello que articula el entendimiento de la filosofía tomista sobre las modalidades: la posibilidad necesaria.