803 resultados para Expressed need
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Setting: Psychological stress is increasingly recognised within emergency medicine, given the environmental and clinical stressors associated with the specialism. The current study assessed whether psychological distress is experienced by emergency medical staff and if so, what is the expressed need within this population? Participants: Participants included ambulance personnel, nursing staff, doctors and ancillary support staff within two Accident and Emergency (A&E) departments and twelve ambulance bases within one Trust locality in NI (N = 107). Primary and secondary outcome measures: The General Health Questionnaire (GHQ-12, Goldberg, 1972, 1978), Secondary Traumatic Stress Scale (STSS, Bride, 2004) and an assessment of need questionnaire were completed and explored using mixed method analysis. Results: Results showed elevated levels of psychological distress within each profession except ambulance service clinical support officers (CSOs). Elevated levels of secondary trauma symptomatology were also found; the highest were within some nursing grades and junior doctors. Decreased enjoyment in job over time was significantly associated with higher scores. Analysis of qualitative data identified sources of stress to include low morale. A total of 65% of participants thought that work related stressors had negatively affected their mental health. Participants explored what they felt could decrease psychological distress including improved resources and psychoeducation. Conclusion: There were elevated levels of distress and secondary traumatic stress within this population as well as an expressed level of need, on both systemic and support levels.
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Recent advancements in the capabilities of information and communication technologies (ICT) offer unique avenues to support the delivery of nutrition care. Despite ICTs being widely available, evidence on the practices and attitudes with regard to ICT use among dietitians is limited. A cross-sectional survey of Dietitians Association of Australia members was administered online in August 2011. All dietitians who responded (n=87) had access to a computer at work. Half reported providing non face-to-face consultations, with the telephone and email the most common modes of delivery. The use of smart phones was prevalent for 49% of practitioners, with 30% recommending nutrition-related applications and/or programs to clients. Benefits to technology use in practice most commonly reported included improvements in access to information/resources, time management, and workflow efficiency. Barriers identified related to cost and access to technology, and lack of suitable programs/applications. Technology was viewed as an important tool in practice among 93% of dietitians surveyed, however only 38% were satisfied with their current level of use. The majority (81%) believed more technology should be integrated within dietetics, while 85% indicated that the development of suitable and practical applications andprograms is necessary for future practice. Technology is regarded as an important tool by Australian dietitians, with an expressed need for theirinclusion to further facilitate nutrition care. Regular and ongoing evaluation of technology use among dietitians is vital to ensure thatapplications and use are evidence based and relevant to consumers in the digital world.
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Domaine en plein développement, le transfert des connaissances (TC) se définit, comme l’ensemble des activités, des mécanismes et des processus favorisant l’utilisation de connaissances pertinentes (tacites et empiriques) par un public cible tel que les intervenants psychosociaux. Cette recherche vise à améliorer l’efficacité des méthodes linéaires écrites de TC en identifiant mieux les besoins d’information des intervenants en protection de la jeunesse. Notons que les méthodes linéaires écrites de TC désignent des outils d’information écrits unidirectionnels tels que les revues, les publications, les sites Internet, etc. Le premier objectif est de déterminer les catégories de besoins exprimés par les intervenants, c’est-à-dire déterminer si les besoins rapportés par des intervenants se regroupent en types ou sortes de besoins. Le deuxième objectif est d’établir l’importance relative de chacune de ces catégories. Enfin, cette étude vise à déterminer si ces besoins diffèrent selon les caractéristiques des intervenants ou de l’environnement. Deux facteurs sont étudiés, l’expérience de l’intervenant et la direction pour laquelle celui-ci travaille (Direction des services milieu à l’enfance ou Direction des services milieu à l’adolescence et ressources). Un devis mixte séquentiel exploratoire a été développé. Lors de la première étape, une analyse thématique a été effectuée à partir des réponses à une question ouverte posée aux membres de trois équipes et à partir d’un document résumant les requêtes effectuées auprès de l’équipe de la bibliothèque du Centre jeunesse de Montréal. Les résultats permettent de répondre au premier objectif de ce mémoire. En effet, les analyses ont permis de créer un arbre thématique comprenant 42 éléments classés hiérarchiquement. Les besoins se regroupent en deux thèmes généraux, soit les besoins qui concernent les « opérations » (c’est-à-dire l’action de l’intervenant) et les besoins concernant les « systèmes » (c’est-à-dire les éléments sur lesquels peuvent porter l’intervention). Cette dernière catégorie se subdivise entre l’usager, ses environnements et le contexte culturel et sociétal. Lors de la deuxième étape, une analyse de la variance (ANOVA) et une analyse de variance multivariée (MANOVA) ont été effectuées à partir des réponses de 82 intervenants à un questionnaire en ligne structuré selon les catégories de besoins d’informations déterminées à l’étape qualitative précédente. Les résultats permettent de répondre au deuxième objectif de ce mémoire et de mesurer le degré de force ou d’importance de chacune des catégories de besoins, identifiées lors de la première étape, selon les intervenants eux-mêmes. Les besoins ont ainsi pu être classés par ordre décroissant d’importance. Il a été possible de définir un groupe de neuf besoins prioritaires (portant sur l’animation, les caractéristiques personnelles des usagers, les caractéristiques des parents et leurs relations avec l’enfant, ainsi que l’intervention interculturelle et les problématiques sociales) et un autre groupe de sept besoins moins élevés (portant sur les autres « opérations » et les services professionnels dont a bénéficié l’usager). L’interprétation de ces résultats indique que les besoins en TC des intervenants se limitent aux informations qui concernent directement leur mandat, leur pratique ou les problématiques rencontrées. Les résultats de cette étape ont également permis de répondre au troisième objectif de ce mémoire. En effet, les résultats indiquent que l’importance ressentie des besoins (sur une échelle de 1 à 7) ne diffère pas significativement selon la direction pour laquelle travaille l’intervenant, mais elle diffère significativement selon l’expérience de ce dernier (moins de 10 ans ou plus de 10 ans). Cette différence est discutée et plusieurs hypothèses explicatives sont envisagées telles que l’accumulation de connaissances liée à l’expérience ou les changements cognitifs liés à l’expertise. Enfin, dans la discussion, les résultats sont mis en contexte parmi les autres types de besoins existants et les autres caractéristiques des connaissances qui doivent être prises en considération. Cela permet de formuler des recommandations pour améliorer la production de documents écrits ainsi que pour poursuivre la recherche dans le domaine de l’évaluation des besoins de TC. Bien que présentant certaines limites méthodologiques, cette recherche ouvre la voie au développement de meilleurs outils d’évaluation des besoins et à l’amélioration des techniques de transfert linéaires écrites.
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Basándose en la necesidad manifiesta de la empresa Thomas Greg & Sons de Colombia por controlar los costos en los que incurre por adoptar un Sistema de Gestión de Calidad, se realizó una investigación de los procesos que realiza la empresa a nivel productivo y el esquema de costos que utiliza a nivel organizacional, con el fin de proponer y concebir un modelo de administración de costos de la calidad y de la no calidad que sea conforme a lo esperado por la alta gerencia y que contribuya significativamente al control de costos.
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In Vietnam, as in other Asian countries, co-operation with foreign universities plays an important role for the development of higher education. This paper is based on personal experiences from teaching a Swedish Master Programme in Education Science at Vietnam National University in Hanoi. Using theories developed by Lev Vygotsky and Donald Schon, the programme is explored as an inter-cultural learning process. Three aspects are focused upon. Firstly, the fact that communication between students and teachers is conducted with the help of translators who support both teachers and students in their attempt to understand and make themselves understood. Secondly, the expressed need to connect the ideas and techniques which are studied in the programme to the students´ professional worlds. Thirdly, the need to construct a framework wherein the students can inquire into their own situations and to encourage them to try new and more productive ways to deal with problems they are confronted with.
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Pós-graduação em Televisão Digital: Informação e Conhecimento - FAAC
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Pós-graduação em História - FCHS
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This work had as objective the development of a prototype of educational content, as an experimental process, making use of resources from Interactive Digital TV. The characteristics of interactive digital terrestrial television are presented, in the form of a media mode capable of performing as a complementary source to education. The methodology used is composed of four phases: deduction, analysis, induction and synthesis. Its conception takes as issue the expressed need stated by UNESCO to use ICT (Information and Communications Technology) towards education, as well as the possibility of applying digital television in an educational process. The content is structured in the form of a quiz, a type of question-answer game as an informal way of education for high school students. The prototype developed in this work is presented as a structural script and map, taking into account the necessary activities and routines to put it into operation in the tested environments, eclipse, virtual set-top-box and Developer Box. The practice of prototyping was carried out in NCLua, based on middleware Ginga. As a result, we concluded that Ginga offers enough support to carry out the task, providing characteristics of interaction to publish the proposed content, at the moment of the actual practice.
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It's akin to the old Spanish, English and Portuguese explorers. They would take their boats until they found some edge of land, then they would go up and plant the flag of their king or queen. They didn't know what they'd discovered; how big it is, where it goes to - but they would claim it anyway. David Korn of the Association of American Medical Colleges This article analyses recent litigation over patent law and expressed sequence tags (ESTs). In the case of In re Fisher, the United States Court of Appeals for the Federal Circuit engaged in judicial consideration of the revised utility guidelines of the United States Patent and Trademark Office (USPTO). In this matter, the agricultural biotechnology company Monsanto sought to patent ESTs in maize plants. A patent examiner and the Board of Patent Appeals and Interferences had doubted whether the patent application was useful. Monsanto appealed against the rulings of the USPTO. A number of amicus curiae intervened in the matter in support of the USPTO - including Genentech, Affymetrix, Dow AgroSciences, Eli Lilly, the National Academy of Sciences, and the Association of American Medical Colleges. The majority of the Court of Appeals for the Federal Circuit supported the position of the USPTO, and rejected the patent application on the grounds of utility. The split decision highlighted institutional tensions over the appropriate thresholds for patent criteria - such as novelty, non-obviousness, and utility. The litigation raised larger questions about the definition of research tools, the incremental nature of scientific progress, and the role of patent law in innovation policy. The decision of In re Fisher will have significant ramifications for gene patents, in the wake of the human genome project. Arguably, the USPTO utility guidelines need to be reinforced by a tougher application of the standards of novelty and non-obviousness in respect of gene patents.
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A large number of polymorphic simple sequence repeats (SSRs) or microsatellites are needed to develop a genetic map for shrimp. However, developing an SSR map is very time-consuming, expensive, and most SSRs are not specifically linked to gene loci of immediate interest. We report here on our strategy to develop polymorphic markers using expressed sequence tags (ESTs) by designing primers flanking single or multiple SSRs with three or more repeats. A subtracted cDNA library was prepared using RNA from specific pathogen-free (SPF) Litopenaeus vannamei juveniles (similar to 1 g) collected before (0) and after (48 h) inoculation with the China isolate of white spot syndrome virus (WSSV). A total of 224 clones were sequenced, 194 of which were useful for homology comparisons against annotated genes in NCBI nonredundant (nr) and protein databases, providing 179 sequences encoded by nuclear DNA, 4 mitochondrial DNA, and 11 were similar to portions of WSSV genome. The nuclear sequences clustered in 43 groups, 11 of which were homologous to various ESTs of unknown function, 4 had no homology to any sequence, and 28 showed similarities to known genes of invertebrates and vertebrates, representatives of cellular metabolic processes such as calcium ion balance, cytoskeleton mRNAs, and protein synthesis. A few sequences were homologous to immune system-related (allergens) genes and two were similar to motifs of the sex-lethal gene of Drosophila. A large number of EST sequences were similar to domains of the EF-hand superfamily (Ca2+ binding motif and FRQ protein domain of myosin light chains). Single or multiple SSRs with three or more repeats were found in approximately 61 % of the 179 nuclear sequences. Primer sets were designed from 28 sequences representing 19 known or putative genes and tested for polymorphism (EST-SSR marker) in a small test panel containing 16 individuals. Ten (53%) of the 19 putative or unknown function genes were polymorphic, 4 monomorphic, and 3 either failed to satisfactorily amplify genomic DNA or the allele amplification conditions need to be further optimized. Five polymorphic ESTs were genotyped with the entire reference mapping family, two of them (actin, accession #CX535973 and shrimp allergen arginine kinase, accession #CX535999) did not amplify with all offspring of the IRMF panel suggesting presence of null alleles, and three of them amplified in most of the IRM F offspring and were used for linkage analysis. EF-hand motif of myosin light chain (accession #CX535935) was placed in ShrimpMap's linkage group 7, whereas ribosomal protein S5 (accession #CX535957) and troponin I (accession #CX535976) remained unassigned. Results indicate that (a) a large number of ESTs isolated from this cDNA library are similar to cytoskeleton mRNAs and may reflect a normal pathway of the cellular response after im infection with WSSV, and (b) primers flanking single or multiple SSRs with three or more repeats from shrimp ESTs could be an efficient approach to develop polymorphic markers useful for linkage mapping. Work is underway to map additional SSR-containing ESTs from this and other cDNA libraries as a plausible strategy to increase marker density in ShrimpMap.
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Aim. To examine whether the people with diabetes who ask for psychological support are those who are experiencing clinically significant levels of psychological distress.
Method. In total 300 people with diabetes were asked to complete psychometrically validated questionnaires that assessed subjective need and objective psychological distress.
Results. High levels of psychological distress were reported: 25% of the sample reported depressive symptomatology, 41% reported clinically significant levels if anxiety and 51% reported a degree of binge eating behaviour. Participants also indicated a desire to talk to diabetes professionals about various problem areas in diabetes. Chi-square analysis demonstrated that those reporting psychological distress, especially depression, were most likely to indicate a desire to talk to somebody about living with diabetes.
Conclusions. Those who want to talk are those who need to talk. Future service development issues should acknowledge the needs and expressed wishes of service users.
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Motivation: Recently, many univariate and several multivariate approaches have been suggested for testing differential expression of gene sets between different phenotypes. However, despite a wealth of literature studying their performance on simulated and real biological data, still there is a need to quantify their relative performance when they are testing different null hypotheses.
Results: In this article, we compare the performance of univariate and multivariate tests on both simulated and biological data. In the simulation study we demonstrate that high correlations equally affect the power of both, univariate as well as multivariate tests. In addition, for most of them the power is similarly affected by the dimensionality of the gene set and by the percentage of genes in the set, for which expression is changing between two phenotypes. The application of different test statistics to biological data reveals that three statistics (sum of squared t-tests, Hotelling's T2, N-statistic), testing different null hypotheses, find some common but also some complementing differentially expressed gene sets under specific settings. This demonstrates that due to complementing null hypotheses each test projects on different aspects of the data and for the analysis of biological data it is beneficial to use all three tests simultaneously instead of focusing exclusively on just one.
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We conducted a qualitative case study as part of a needs assessment for a day hospice in a small Ontario city. Data were gathered from semi-structured interviews with 28 stakeholders: nine health care administrators, 11 health care providers, and eight lay people (terminally ill adults and informal caregivers). Respondents described support, counselling, social activities, and respite as key day hospice services. They also described several barriers to accessing services, including location, transportation, admission criteria, referrals, and fees. For most respondents, the ideal staff mix includes both volunteers and paid professionals in either a free-standing organization or institutionally linked hospice. Although the vast majority of participants were reluctant to impose admission criteria or other limitations on hospice clientele, they expressed the need to ensure equitable access to this scarce resource. Opinions varied greatly across stakeholder groups, highlighting the need to collect information from ail relevant stakeholder groups when planning hospices.
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Dissertação de mest., Ciências Biomédicas, Faculdade de Ciências e Tecnologia, Universidade do Algarve, 2009
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The aim of this study was to assess patterns and correlates of family variables in 31 adolescents treated for their first episode of a schizophrenia spectrum disorder (early-onset schizophrenia [EOS]). Expressed emotion, perceived criticism, and rearing style were assessed. Potential correlates were patient psychopathology, premorbid adjustment, illness duration, quality of life (QoL), sociodemographic variables, patient and caregiver "illness concept," and caregiver personality traits and support. Families were rated as critical more frequently by patients than raters (55% vs. 13%). Perceived criticism was associated with worse QoL in relationship with parents and peers. An adverse rearing style was associated with a negative illness concept in patients, particularly with less trust in their physician. Future research should examine perceived criticism as a predictor of relapse and indicator of adolescents with EOS who need extended support and treatment. Rearing style should be carefully observed because of its link with patients' illness concept and, potentially, to service engagement and medication adherence