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Bumgarner, D., K. Owens, J. Correll, W. T. Dalton, and Jodi Polaha. "Primary Behavioral Health Care in Pediatric Primary Care." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/6597.
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Faulk, Janet, and Pamela Evanshen. "Primary Grades: Linking the Primary Classroom Environment to Learning." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/4462.
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Meade, Susie J. "Primary Metabolic Chemistry." Thesis, University of Canterbury. Chemistry, 1999. http://hdl.handle.net/10092/5794.
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Thioesters and acyl phosphates are important metabolites throughout the biosphere. This may imply that they were involved in prebiotic chemistry. The study of the reactivity of thioesters and acyl phosphates may therefore provide some insights into the possible roles for these molecules in prebiotic chemistry.
The work described in this thesis demonstrates that acetyl phosphate and inorganic phosphate react to form pyrophosphate in the presence of salts of some divalent metals. Divalent metal ions and nitrogen containing compounds act in synergy to promote pyrophosphate formation in some cases. Ferrous salts were much more efficient at promoting the formation of pyrophosphate than similar reactions containing magnesium ions, Addition of pyridine, or a variety of other nitrogen containing compounds, did not enhance the pyrophosphate yield. The promotion of pyrophosphate formation at near neutral pH by ubiquitous metal salts is considered to be a feasible route for prebiotic production of pyrophosphate.
One chemoautotrophic origin of life theory concentrates on the oxidative formation of pyrite (FeS2) from ferrous sulfide and hydrogen as a possible source of prebiotic reductive power.
N-Phenyl acetamide can be prepared from mercaptoacetic acid and aniline in water using FeS/H2S as a reagent system. We have established that one possible intermediate, N-phenyl mercaptoacetamide does react to give the product, and that this reaction is fast.
Ferrous ions were observed to promote the formation of N-acetyl alanine from alanine and thioacetic acid. Zinc and cadmium ions on the other hand, promote the hydrolysis of thioacetic acid to acetic acid in preference to the N-acylation reaction. Both ferrous ions and ferro cyanide ions were observed to promote the peptide bond formation between protected amino acid derivatives.
The results described in this thesis are consistent with the proposal that iron chemistry may have been important in prebiotic chemistry.
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Dodd, Will. "Primary Care Cases." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/8930.
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Lemmer, Eric Richard. "Primary sclerosing cholangitis." Master's thesis, University of Cape Town, 1993. http://hdl.handle.net/11427/25576.
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Thirty six consecutive patients with primary sclerosing cholangitis (PSC), 20 males median age 42 years, were studied in order to define prognostic variables and determine the influence of surgery on outcome. Presentation was usually with insidious cholestasis or recurrent cholangitis. Twenty six patients (72 per cent) had associated inflammatory bowel disease (ulcerative colitis 20, Crohn's disease 2, unclassified 4). Thirty two patients were followed prospectively for up to nine years. Twenty three remained either stable or had slowly progressive disease. Of the remaining nine patients, seven died (five from end-stage liver failure and two from cholangiocarcinoma) and two patients underwent liver transplantation. Actuarial survival at five years was 52 per cent. A raised serum bilirubin concentration was the only variable at presentation that independently predicted a poor outcome. Cholangiograms were available for detailed assessment in thirty PSC patients. Neither the extent of biliary involvement nor the presence of surgical correctable ("dominant") strictures in the extrahepatic ductal system were of prognostic importance. Six patients who developed obstructive jaundice associated with advanced liver disease underwent surgical drainage operations for dominant biliary strictures, but this did not seem to prevent progression of the disease. Two patients who progressed to end-stage liver disease went on to liver transplantation and were alive with functioning grafts at seven and fourteen months respectively. Nine patients with asymptomatic PSC were followed prospectively for up to twelve years. None of these patients developed overt liver disease but serum bilirubin levels became mildly elevated in two patients. It is concluded that symptomatic PSC is a progressive disease with a poor prognosis. Patients with advanced liver disease due to PSC should be considered directly for liver transplantation. In contrast, asymptomatic PSC patients may remain symptom-free for many years.
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Fellows, Matthew R. "Spatiotemporal tuning for position and velocity in primate primary motor cortex neurons /." View online version; access limited to Brown University users, 2005. http://wwwlib.umi.com/dissertations/fullcit/3174598.
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Button, Dianne. "Men and primary teaching." Thesis, University of Bristol, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.299729.
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Polaha, Jodi. "Primary Care Behavioral Health." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/6676.
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Polaha, Jodi. "ADHD in Primary Care." Digital Commons @ East Tennessee State University, 2011. https://dc.etsu.edu/etsu-works/6690.
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Dodd, Julia. "Trauma-Informed Primary Care." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/7348.
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Bharaj, Harnovdeep Singh. "Studies in primary hypercholesterolaemia." Thesis, University of Leicester, 1996. http://hdl.handle.net/2381/34134.
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Cholesterol is an integral part of the cell membrane and influences both its fluidity and activity. Furthermore membrane lipids are influenced by plasma lipid levels. In familial hypercholesterolaemia (FH) red cell rheology and platelet aggregation is abnormal. These effects could be due to changes in plasma lipids since they are improved by cholesterol reduction. Section A Fasting lipid profile, membrane cholesterol, red cell ghost and platelet fluidity [using diphenyl hexatriene (DPH) and trimethylamino-diphenyl hexatriene (TMA-DPH) fluorescence anisotropy] and Ca2+ -Mg2+ -ATPase activity (using [32P] ATP hydrolysis) in 30 patients with heterozygous FH and 19 controls were compared before and after treatment with colestipol (10g) , simvastatin (10mg) and maxepa (10g). The two groups were generally comparable with respect to age, sex, BMI and blood pressure. In FH plasma cholesterol, membrane cholesterol, TMA-DPH anisotropy and red cell Ca2+ -Mg2+ -ATPase were increased whilst platelet Ca2+ -Mg2+ -ATPase was reduced (p<0.05). Colestipol and simvastatin reversed these changes toward controls. Maxepa increased DPH anisotropy and reduced Ca2+-Mg2+ -ATPase. In FH membrane fluidity and activity is altered and normalised by cholesterol lowering. This may account for the abnormal cell function in this condition. Section B A double blind, randomized, placebo controlled trial in hypercholesterolaemia (cholesterol 6.5-10 mmol/l, triglycerides <3 mmol/l). After 8 weeks of an AHA step I diet, patients were randomized to A: placebo; B: 5g colestipol + 10mg simvastatin; or C: 10g colestipol + 10mg simvastatin for 8 weeks. Patients were assessed 4 weekly. 44 patients were screened, 32 completed the study. Groups were generally comparable (group C patients were older p<0.02). Active treatment resulted in a 38% reduction in LDL cholesterol (p0.8). Mild gastro-intestinal upset was the commonest adverse event. Low dose combinations are effective and well tolerated. There is no apparent advantage of 10g over 5g colestipol when combined with l0mg simvastatin. HDL cholesterol and triglycerides were unchanged.
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Mahoney, Erin Kathleen. "Erosion Of Primary Teeth." Thesis, Faculty of Dentistry, 2009. http://hdl.handle.net/2123/4612.
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Van, Tyanne Tuyen, and Tyanne Tuyen Van. "Medication Management in Primary Care: A Structured Review Checklist for Primary Care Providers." Diss., The University of Arizona, 2017. http://hdl.handle.net/10150/626647.
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Background: Medication management is an important aspect of health care to ensure patient safety and outcomes. Incomplete overview of medications is main cause of medication errors and discrepancies. The consequences of not completing medication management and reconciliation are associated with the wellness of the patients and result in increased health care cost. It is essential to improve medication management process to decrease medication discrepancies, minimize the prevalence of medication-related problems, increase patient health outcomes, and reduce health care cost in primary care settings. A Structured Review Checklist was recommended during routine comprehensive medication review as a process for evaluation of therapy, assessment of patients’ medication adherence, and resolution of medical record discrepancies.
Purpose: The purpose of this DNP project is to evaluate primary health care providers’ perceived usefulness, perceived ease of use, and behavioral intention of use regarding the Structured Review Checklist to further develop key recommendations and tools for use by primary care providers to reduce medication discrepancies and medication errors as well as increase health outcomes and patient satisfaction.
Method: The design is descriptive cross-sectional. The online survey developed with Qualtrics software was sent to Practice Managers at Banner Health Clinics to be distributed to targeted primary care providers. Their perceived usefulness, perceived ease of use, and behavioral intention of use regarding the Structured Review Checklist was assessed using 6-point Likert-type scales.
Outcomes: Only one health care provider completed the survey. The data cannot be used to analyze the perceived usefulness, perceived ease of use, and behavioral intention of use regarding the Structured Review Checklist. However, even with participant recruitment challenges, the project provided a significant amount of lessons to learn for future research study.
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MARQUES, BIANCA DE SOUZA ROSSINI. "DEVELOPMENT AND CERTIFICATION BY THE PRIMARY METHOD OF REFERENCE MATERIAL OF CONDUCTIVITY PRIMARY." PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2010. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=16710@1.
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PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIROA condutividade eletrolítica é a capacidade de medir o transporte de íons de uma solução. A rastreabilidade é o pré-requisito para a comparabilidade e a uniformidade das medições. No caso das medições de condutividade eletrolítica em soluções, a rastreabilidade é obtida por um sistema primário de condutividade que dará origem aos materiais de referência certificados (MRC) primários. Os MRC são usados para o controle e garantia da qualidade de resultados analíticos, além disso, são essenciais para calibração de instrumentos assegurando a rastreabilidade e confiabilidade dos resultados. A principal motivação para o desenvolvimento deste trabalho é a carência de MRC de baixa condutividade eletrolítica primário devido a sua relevância no controle da pureza da água, matéria-prima para a produção de medicamentos e vacina, além da qualidade do álcool combustível. O objetivo desta dissertação foi desenvolver e certificar um material de referência primário de condutividade eletrolítica de valor nominal de 5 uS.cm(-1) a 25 °C, produzida a partir do sal KCl em 30% (m/m) de 1-propanol. Os estudos de homogeneidade, caracterização e estabilidade, foram realizados de acordo com as Normas ISO série 30. Os resultados obtidos nos estudos de certificação da solução de condutividade eletrolítica, com sua respectiva incerteza expandida foram (5,00 +- 0,16) uS.cm(-1) a 25 °C, com k = 2, para um nível de confiança de aproximadamente 95%. A certificação deste material de referência primário contribuirá para a qualidade das medições de condutividade eletrolítica realizadas nos laboratórios do Brasil, o qual irá garantir a rastreabilidade metrológica dos resultados das medições, principalmente no monitoramento da pureza da água e da qualidade do álcool combustível.
Certified Reference Material (CRM) is a reference material, accompanied by documentation issued by an authoritative body and providing one or more specified property values with associated uncertainties and traceabilities, using valid procedures. The CRM are used for control and quality assurances of analytical results also are essential to calibrate instruments ensuring the traceability and reliability of results. Electrolytic conductivity is known as the ability of a solution to conduct electrical current. Traceability is a prerequisite for comparability and uniformity of measurements. In the case of electrolytic conductivity measurements on solutions, traceability is obtained through a primary system of conductivity that would lead to the CRM primary electrolytic conductivity. The CRM developed is low conductivity due to its importance in controlling the purity of water, raw material for production of medicines and vaccine, along with analysis of fuel ethanol. The studies of homogeneity, characterization and stability were carried out for CRM 5 uS.cm(-1) nominal value according to ISO 30 series. The result of studies of certification of the solution of electrolyte conductivity with its corresponding expanded uncertainty, with k = 2 for a confidence level (CL) of approximately 95% was (5.00 +- 0.16) uS.cm(-1) to 25 °C. The development and certification of primary reference material will contribute to the quality of the results of electrolytic conductivity measurements performed in various laboratories in Brazil and South America, which will guarantee the traceability and reliability of measurement results, especially when is related to monitoring purity of water and analysis of fuel ethanol.
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Lott, Leslie. "Primary Systems and Voter Turnout: Measuring the Institutional Effect of Primary Type on Voter Turnout." ScholarWorks@UNO, 2009. http://scholarworks.uno.edu/td/956.
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Using the 1990, 1994 and 1998 Congressional mid-term elections, this study looks at whether the type of primary system in a person's state has an effect on whether or not that person will vote in the general election. The five types of primary systems (closed, semi-closed, semiopen, open and blanket) are explained as well as traditional factors for likelihood of voting. It is hypothesized that the more closed the primary system, the less likely a person is to vote. Data analysis shows that when significant, living in an open primary state does significantly increase the likelihood that a person will vote. However, primary type was significant in only six of the nine models studied here.
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Pasarín, Rua María Isabel. "Evaluación de la atención primaria: Aproximación mediante el primary care assessment Tools (PCAT)." Doctoral thesis, Universitat Autònoma de Barcelona, 2016. http://hdl.handle.net/10803/369575.
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La Atención Primaria (AP) es un nivel clave en un sistema sanitario y la evaluación es una de las principales herramientas básicas para mejorar los servicios. Según el modelo de AP definido por B Starfield y de amplio consenso internacional, ésta debe: a) ser accesible y ser utilizada como el primer contacto con el sistema de salud; b) ofrecer una atención continuada y global, y c) estar coordinada con los otros niveles del sistema sanitario, además de tener un enfoque familiar y comunitario, y competencia cultural. Así, B Starfield definió las cuatro dimensiones esenciales de la atención primaria como: primer contacto, longitudinalidad, integralidad y coordinación; y las dimensiones relacionadas: enfoque familiar, orientación comunitaria y competencia cultural. En Estados Unidos, Starfield y Shy diseñaron un conjunto de instrumentos para valorar las dimensiones de la AP, Primary Care Assessment Tools (PCAT).
El objetivo general de esta tesis fue obtener instrumentos de evaluación del modelo teórico de la Atención Primaria (AP) que permitan su utilización en Catalunya y en el contexto español, y a partir de ellos hacer una primera evaluación en Catalunya bajo la perspectiva de desigualdades sociales.
Para ello se realizaron dos procesos independientes de adaptación del cuestionario Primary Care Assessment Tools (PCAT), uno para poder utilizarlo en una encuesta de salud y otro para obtener medidas de los Equipos de Atención Primaria (EAP). La metodología ha sido en gran parte la misma, en base a las recomendaciones de adaptación transcultural, siguiendo los siguientes pasos: traducción, retrotraducción, comité de expertos, prueba pretest y medición de propiedades psicométricas del cuestionario obtenido. Para la valoración de la AP en Catalunya se incluyó en el cuestionario de la encuesta de Salud de Catalunya del año 2006 el conjunto de ítems seleccionados en uno de los trabajos que se presentan en esta tesis doctoral. Se aplicó a una muestra representativa de la población mayor de 15 años (N=13.292). Se ajustaron modelos multivariados de regresión negativa para la obtención de las razones de prevalencia y sus intervalos de confianza del 95%.
Como resultados de esta tesis doctoral, se han obtenido dos instrumentos independientes, ambos en catalán y en castellano: a) un conjunto de ítems para poder incluir en la encuesta de salud, un PCAT abreviado de 10 ítems para adultos, y 2) el PCAT-Equipo de Atención Primaria versión extensa que permitirá el análisis de todas las dimensiones de la AP definidas por B Starfield (primer contacto, longitudinalidad, integralidad, coordinación, enfoque familiar, orientación comunitaria y competencia cultural).
El PCAT-10 incluido en la Encuesta de Salud de Catalunya del año 2006 permitió conocer que la valoración de la AP obtenía una puntación de 7 sobre 10, y sin presentar un patrón de desigualdad, ya que no se mostraron diferencias en las puntuaciones según clase social.
En conclusión, a partir del trabajo realizado se encuentran ya disponibles unos instrumentos en catalán y castellano que amplían el marco de evaluación de la AP en el contexto del sistema sanitario en España y Catalunya. Además permiten utilizar el enfoque de evaluación desde la población potencialmente usuaria así como de los equipos encargados de realizar la atención, los Equipos de Atención Primaria. Desde la perspectiva de la población, el PCAT-10 ha presentado buenas propiedades métricas, proporciona un índice para la evaluación de la AP y permitirá la monitorizado en el tiempo y el análisis en subgrupos y en el total de la población. A partir de la valoración de los directores/as de EAP se podrá evaluar el modelo teórico completo de la AP definido por B. Starfield.Primary Care is a key level in the health system, and evaluation is one of the main instruments to improve services. According to the model defined by B Starfield, one with broad international consensus, PC has to be: a) accessible and used as the first contact with the health system; b) it must offer longitudinal and comprehensiveness attention, and c) it must be coordinated with the other levels of the health care system, be focused on family, with community orientation, and demonstrate cultural competence. B. Starfield defines the four essential dimensions of PC: first contact, longitudinality, comprehensiveness and coordination; and as related dimensions: family focus, community orientation and cultural competence. In the United States, Starfield and Shy designed a group of instruments to evaluate the PC dimensions, the Primary care Assessment Tools (PCAT). The main objective of this thesis is to obtain instruments for the evaluation of the theoretical model of Primary Care (PC) for use in Catalonia, and in the Spanish context in general, and from them to make a first evaluation in Catalonia from the perspective of social inequalities. To this end, two independent processes of adapting the Primary Care Assessment Tool (PCAT) questionnaire have been made, one to use in a health survey and the other to obtain measurements of the PC facilities. To a great extent, the methodology has been the same for both, based of the recommendations for transcultural adaptation: translation, retro translation, committee of experts, pretest and measurement of psychometric properties of the obtained questionnaire. For the assessment of PC in Catalonia, the set of items selected in one of the works presented in this doctoral thesis was included in the questionnaire of 2006 – the Catalan Health Survey. It was conducted on a representative sample of the population over 15 years (N=13.292). It has been adjusted with multivariate negative binomial regression models to obtain prevalence ratios and their 95% confidence intervals. Two independent instruments have been obtained, in Catalan and Spanish: a) a set of items to be included in the health survey, a brief PCAT of 10 items for adults and b) PCAT- PC team, extended version, which will allow the analysis of all the dimensions of the PC defined by B Starfield (first contact, longitudinality, comprehensiveness, coordination, family centeredness, community orientation and cultural competence). The PCAT-10 included in the Health Survey of Catalonia in 2006 revealed that the evaluation of the AP resulted in a mark of 7 over 10, showing no pattern of inequality, since differences in the scores were not according to social class. In conclusion, there are already available instruments in Catalan and Spanish that extend the frame of evaluation of the PC in the context of the health system in Spain and Catalonia. From the perspective of the population, the abbreviated PCAT-10 has presented good metric properties and provides an index for the evaluation of the PC that will allow monitoring over time and analysis in sub-groups, as well as in the total population. Through the evaluation of directors of PC teams, the complete theoretical model of the AP defined by B Starfield will be able to be evaluated.
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Buth, Gerrit J. "Decomposition and primary production in salt marshes = Decompositie en primaire produktie in schorren /." [S.l. : s.n.], 1993. http://www.gbv.de/dms/bs/toc/131131834.pdf.
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Waugh, David George. "Primary schools at the crossroads : a study of primary schools' abilities to implement educational change, with a particular focus on small primary schools." Thesis, University of Hull, 2000. http://hydra.hull.ac.uk/resources/hull:11286.
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This thesis addresses the issue of primary schools' abilities to implement educational change and focuses, in particular, on small primary schools. A comparison is made between small and large primary schools, in order to determine whether there are differences between the ways in which each have adapted to and implemented changes. Whilst a series of educational changes since the Second World War have affected primary schools the thesis takes 1988 as a watershed date, since the Education Reform Act of that year made considerable statutory demands upon primary schools. The thesis examines, in particular, the ability of small schools to implement changes effectively, since this was questioned following the Act, and it seemed that this might precipitate closures and amalgamations at a faster rate than had previously been the case. The thesis is based upon research over an eight-year period, involving three postal surveys, a series of structured interviews, and a review of relevant literature. The focal point for much of the research is the headteacher, with all of the empirical work being focused on heads, since they have been central to the management of change in schools. Attention is also given, mainly through reviews of literature, to the role of the class eacher and the way in which this has changed in relation to that of the head. The thesis may be divided into two sections. In the first, the scene is set through an examination of the position of primary schools in general, and small primary schools in articular, before the Education Reform Act. This is followed by a review of published research and the author's empirical studies, in order to gain an understanding of the way n which schools have coped with the implementation of the Education Reform Act. The thesis ends with conclusions and recommendations which are based upon the research findings.
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Dunkley-Hickin, Catherine. "Effects of primary care reform in Quebec on access to primary health care services." Thesis, McGill University, 2014. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=123121.
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Primary health care reform has become an area of priority in health policy with a strong importance placed on interdisciplinary teams of health care professionals. Quebec's model, the groupes de médicine de famille (GMFs), were introduced late in 2002 emphasizing team-centered approaches to service delivery and aiming to improve access to primary health care, especially to improve after-hours access and to increase the number of Quebecers with a family doctor.A decade after their implementation, I investigated the impact of GMFs on various measures of access to primary health care and perceived remaining barriers. I emphasize potential access – i.e. measures that capture whether an individual has the ability to access needed health care including having a regular medical doctor.I used data from seven waves of the Canadian Community Health Survey to capture reported access to primary care and barriers to access. GMFs emerged at different rates in different health regions across Quebec allowing the construction of a GMF 'participation' measure using the share of primary care physicians practicing in GMFs in each health region and year. I employed a modified difference-in-difference analysis design that uses multivariate regression analysis to control for time trends in the outcomes, time-invariant differences between regions and individual-level covariates in an attempt to estimate the causal impact of GMF implementation on access to primary health care.I verified that pre-policy differences in terms of population and socioeconomic characteristics between regions with ultimately high vs. low rates of GMF participation are reasonable and remain fixed over time, making comparisons of these regions appropriate. Results suggest that rates of reported access have increased over time in most Quebec health regions. However, these measures of access vary across regions and some always report lower rates of access. Controlling for time trends, fixed differences between regions, and individual characteristics, reported access does not change significantly as GMF participation increases. Improved access to primary health care was one of the principal objectives of Quebec's primary care reform a decade ago. My findings suggest that increased GMF participation has not improved several important measures of access, and that additional policy measures may be necessary to increase potential access to primary health care.La réforme des soins de santé de première ligne occupe une place prioritaire parmi les réformes de santé, notamment avec une grande importance accordée à des équipes interdisciplinaires de professionnels de santé. Le modèle choisi par Québec, les groupes de médecine de famille (GMFs), a été mis en place à la fin de 2002. Ce modèle met l'emphase sur des équipes interprofessionnelles et vise à augmenter le nombre de Québécois avec un médecin de famille, ainsi qu'à offrir une plus grande accessibilité des services de la première ligne, notamment hors les heures normales de travail. Une décennie après leur implantation, j'ai étudié l'impact des GMFs sur diverses mesures d'accès aux soins de santé de première ligne. Je mets l'emphase sur l'accès potentiel – c'est-à-dire les mesures permettant de déterminer si un individu a la possibilité d'accéder aux soins de santé nécessaires, y compris d'avoir un médecin régulier.J'ai utilisé des données de sept cycles de l'Étude sur la santé dans les collectivités canadiennes pour capturer l'accès déclaré aux soins de première ligne et obstacles à cet accès. Il existe une variation régionale dans l'implantation des GMFs à travers les différentes régions sociosanitaires du Québec, ce qui me permet de construire une mesure de participation aux GMFs constituée de la proportion des médecins de première ligne pratiquant en GMF par région sociosanitaire et par année. J'ai employé une analyse qui consiste de modèles de différence-dans-les-différences modifiées qui utilise une analyse de régression multivariée pour contrôler les tendances temporelles, les différences constantes entre les régions, et les covariables au niveau individuel, le but étant d'estimer l'effet causal de la mise en œuvre des GMFs sur l'accès aux soins de santé de première ligne.J'ai vérifié que les différences de caractéristiques populationnelles et socio-économiques dans la période pré-politique entre les régions ayant un taux élevé par rapport à celles ayant un faible taux de participation aux GMFs sont raisonnables et fixes au cours des années de mon étude, rendant ainsi toute comparaison de ces régions appropriées. Les résultats suggèrent que les taux d'accès déclarés ont augmenté au fil du temps dans la plupart des régions sociosanitaires du Québec. Toutefois, ces mesures d'accès varient selon les régions et certains signalent toujours des taux inférieurs d'accès. Contrôlant pour les tendances temporelles, les différences fixes entre les régions, et les caractéristiques individuelles, l'accès déclaré ne change pas de manière significative avec l'augmentation de la participation aux GMFs.Un meilleur accès aux soins de santé de première ligne constituait l'un des principaux objectifs explicites de la réforme des soins de santé de première ligne de 2002. Mes résultats suggèrent que l'augmentation de la participation aux GMFs n'a pas amélioré plusieurs mesures importantes d'accès. En conséquence, des politiques supplémentaires pourraient être nécessaires pour accroître l'accès potentiel aux soins de santé de première ligne.
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Kyritsi, Krystallia. "Creativity in primary schools : exploring perspectives on creativity within a Scottish primary school classroom." Thesis, University of Edinburgh, 2018. http://hdl.handle.net/1842/31518.
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This thesis explores children's and teachers' perspectives on creativity, and its implementation, within one primary school classroom in Scotland. The data collection phase of the research employed an ethnographic approach, involving four and a half months of fieldwork in the primary school classroom. Data were generated from participant observation/informal conversations with children and teachers and one round of semi-structured interviews with twenty-five children (aged eleven to twelve) and two teachers. Creativity within primary education has been mainly studied through psychological research, which is mainly based on theories of developmental psychology. Such theories view creativity solely as an individual trait. Despite recognition of the importance of sociocultural issues to the flourishing of children's creativity, the study of their collaborative creativity has been neglected - particularly in relation to socio-cultural power dynamics. This thesis specifically analyses the balance between individual and collective creativity in the primary classroom, examines how collaborative creativity can acknowledge childhood diversity, and poses questions about how we include children with differing and complex identities in creative processes. Furthermore, this research has been carried out in Scotland, within the context of a fairly new curriculum, the Curriculum for Excellence. This curriculum has been viewed by some as a progressive, modern and motivating curriculum that enables children's autonomy, and by others as one that has been highly influenced by accountability and performativity regimes, which leave limited space for children's and teachers' autonomy. This thesis examines how the Curriculum for Excellence is interpreted in everyday practice and the extent to which it enables the cultivation of children's creativity. The thesis does so by shedding light on the practical interconnections between children's and teachers' agency, structural enablers/barriers, and cultural processes. The findings of this study show that children perceive, perform and embody creativity not only as an individual trait, but also as a collaborative process. However, the findings also show that collaborative creativity entails many complexities and that cultural barriers to creativity may emerge when power among people (children and teachers) operates in ways that create cultures of exclusion. The thesis concludes that the multiple identities of the Curriculum for Excellence, its multiple interpretations, and lack of coherence regarding what is expected of teachers, leads to a blurred landscape of implementation. The thesis argues that lack of a clear plan, strategy and framework for enabling creativity inhibits the founding principles of the Curriculum for Excellence from being achieved. The thesis also argues that environmental and structural barriers within the research setting inhibit the flourishing of children's creativity, but that the structural barriers can sometimes be overcome through the construction of enabling cultures. The thesis is able to define enabling cultures as cultures that value diversity, promote inclusion, and view space not as static, but as a dynamic process. In so doing, the findings of this study emphasise the interconnected importance of: viewing creativity as an individual trait; perceiving creativity as a collaborative process; and thinking in spatial terms, for example, in ways that create the space for children to perceive, perform and embody creativity in their diverse, but equally valuable ways. This finding enables this study to argue that there is a need for future policies and curricula which promote and encourage greater flexibility in teaching and learning practices, in order to enhance children's and teachers' agency and thus allow them to collaboratively create the types of enabling environments, originally envisaged by the Curriculum for Excellence, that will allow children's creativity to flourish.
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Donadelli, Giovanni. "Geomedia in the primary school. An explorative study of European primary geography teachers' experience." Doctoral thesis, Università degli studi di Padova, 2017. http://hdl.handle.net/11577/3424913.
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This study aims to provide further understanding on European primary geography teachers' conceptual and factual standpoint on the use of digital technologies in primary geography lessons by researching their technological, pedagogical and content knowledge (TPACK), together with their teaching praxis and their teaching context.
The study includes both qualitative and quantitative methodology and consists of two research modules. The first is a large-scale survey administered online to a voluntary sample of primary geography teachers (N=200) teaching to 8-10 years old pupils in a selection of seven different European countries (United Kingdom, Italy, Germany, Spain, Finland, Romania and Turkey). The second is a national case-study (N=21) based on the experience of a continuing professional development workshop attended by a group of Italian primary geography teachers.
The results report that primary geography teachers share a critical perception of knowledge on geography and indicate the teachers own geographical education as the main problem of teaching geography with technology at primary level today. This lack of confidence, however, co-exist with other factors already studied in literature, as for example the presence of ICT at school and teachers' system of beliefs concerning the efficacy of implementing ICT in their lessons.
Ultimately, this study confirms that the simple implementation of ICT does not represent a valid solution to ameliorate geographical learning at primary level, and supports continuing professional development as a valid, appreciated, and efficient way to support teachers that want to improve their teaching of geography by introducing and using ICT in their lessons.Questa ricerca si pone l'obiettivo di approfondire, attraverso lo studio delle loro percezioni di conoscenza in ambito tecnologico, pedagogico e di contenuto (TPACK), delle loro prassi didattiche e dei loro contesti d'insegnamento, le percezioni di conoscenza ed utilizzo dei geomedia degli insegnanti Europei che insegnano geografia nella scuola primaria. Lo studio ha utilizzato metodologie sia di tipo quantitativo che qualitativo e si sviluppa in due diversi moduli di ricerca. Il primo consiste in un'indagine condotta su larga scala attraverso la somministrazione di un questionario in modalità online ad un campione volontario di insegnanti di geografia della scuola primaria (N=200) provenienti dai seguenti paesi europei: Regno Unito, Italia, Germania, Spagna, Finlandia, Romania e Turchia. Il secondo modulo consiste in uno studio di caso che riporta gli esiti di un'esperienza laboratoriale di formazione professionale, rivolta ad insegnanti della scuola primaria italiana (N=21), finalizzata a stimolare l'efficace integrazione delle TIC nell'insegnamento della geografia. I risultati mostrano che gli insegnanti di geografia della scuola primaria ritengono le proprie conoscenze geografiche non particolarmente solide. I dati, infatti, suggeriscono che il problema principale legato all'insegnamento della geografia nella scuola primaria attraverso l'uso delle tecnologie risieda principalmente nella scarsa conoscenza geografica degli stessi insegnanti. Questa mancanza di confidenza, ad ogni modo, risulta accompagnata da altri fattori già noti in letteratura, come la disponibilità delle TIC a scuola e la rigidità dei sistemi di credenze di alcuni insegnanti rispetto alle'fficacia stessa dell'uso delle TIC a supporto dell'azione didattica. Lo studio conferma che il semplice inserimento delle TIC a scuola non sia sufficiente per avviare il miglioramento dell'insegnamento della geografia e sostiene, allo stesso tempo, che la formazione professionale continua rappresenti una modalità valida ed efficace per sostenere gli insegnanti intenzionati ad utilizzare con maggiore efficacia le tecnologie a supporto dell'insegnamento e dell'apprendimento della geografia nella scuola primaria.
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Okesli, Tayyibe Fulya. "Relationship Between Primary School Students." Master's thesis, METU, 2008. http://etd.lib.metu.edu.tr/upload/2/12609970/index.pdf.
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The purpose of this thesis was to investigate environmental literacy of 6th, 7th and 8th grades primary school students in public schools of Bodrum, Turkey. The study was carried out during the spring semester of the 2006-2007 academic years. A total of 848 students enrolled in four public primary schools completed the 49-item Environmental Literacy Questionnaire (Kaplowitz &Levine, 2005). The components of environmental literacy which are defined as knowledge, attitude, use and concern of students about environmental issues were examined by means of frequency distributions. Results displayed that although students had low levels of knowledge about the environent, they displayed positive attitudes and high levels of concern toward the environment. They were also aware of the importance of interaction between humans and the environment. Relationships among the components of the ELQ (knowledge, attitudes, uses, and concerns) have been analyzed by means of zero order correlations. The strongest correlation found between &lsquo
attitude and use&rsquo
and &lsquo
use and concern&rsquo
variables among the components of the ELQ indicating that the students with positive attitude towards environmental issues have positive views on environmental uses and service and students concerning about environmental problems have more positive views on environmental use and service. Canonical correlation analysis was used to examine the relationship, if any, between the background characteristics of students and the set of environmental literacy variables in the questionnaire. The results showed that students who were interested in environmental issues, who gave importance to environmental problems, who thought they had good knowledge about environmental issues, whose parents&rsquo
were interested in environmental issues and involved in environmental activities had better knowledge about environmental issues, more positive attitude towards environmental issues, more positive view on environmental uses and service and concern environmental problems. In addition, the results of analysis by means of Multivariate Analysis of Variance (MANOVA) demonstrated that female students had more positive attitudes towards environmental issues, more positive views on environmental use and more concern about environmental problems than male students&rsquo
had but same level of knowledge on environmental issues.
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Morley, Gavin W. "Gene hunting in primary osteoarthritis." Thesis, University of Oxford, 2004. https://ora.ox.ac.uk/objects/uuid:1529aa12-2d57-48fd-8cb9-a5bab0291116.
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Osteoarthritis (OA) is a common, disabling disease of the elderly. It is uncommon in individuals under 45 years of age, and prevalence is higher in females than males. OA is characterised by focal cartilage loss accompanied by osteophytes, sclerosis and often some inflammatory response. A significant genetic component to OA has been demonstrated by twin-pair, sibling risk and segregation studies. Our group previously carried out a two-stage genome-wide linkage scan and identified six chromosomal regions as potentially harbouring OA susceptibility genes. The aim of this project was to examine three of these linkage regions, one on chromosome 4 and two on chromosome 16, in more detail in order to further localise and determine the identity of the OA susceptibility gene(s) within these regions. Initially the three regions were linkage mapped using a staged approach. Linkage mapping of the region on chromosome 4q identified a region showing evidence of linkage to female hip OA with a multipoint LOD (MLS) score of 3.1. For chromosome 16 linkage mapping identified two regions with MLS of 1.7 and 1.9 respectively. The first region was restricted to families with female siblings concordant for hip OA while the second is accounted for by families with affected female siblings. The ADAMTS3 gene was identified as a strong candidate gene within the linkage region on chromosome 4 as a result of its role in procollagen processing. SNPs within the gene were identified and typed in cohorts of cases and controls. There was no evidence for an association with any of these SNPs and OA disease. Within the first linkage region on chromosome 16 the IL4R gene was identified as a strong candidate gene as a result of its proposed role in the normal response of chondrocytes to mechanotransduction. Again SNPs within the gene were identified and typed. Four SNPs show evidence of association with OA and for three of these there is evidence for a relationship between genetic variation and evidence for linkage. It appears that there is a dosage effect with at least two copies of different variant alleles being necessary to increase OA disease susceptibility.
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Brewer, Rhett, of Western Sydney Nepean University, of Performance Fine Arts and Design Faculty, and School of Design. "Paint, painters and primary perception." THESIS_FPFAD_SD_Brewer_R.xml, 1996. http://handle.uws.edu.au:8081/1959.7/300.
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This paper examine's painters attempts to find, in their chosen medium, a meaningful representation of nature. It proposes the idea that despite the best efforts of some of western art's most gifted artists, this has remained an elusive goal so far and this is likely to remain the case in the future. The paper concludes with an examination of Postmodern theoretical discourse and the effects it has had on painters who may want to attempt to make a meaningful statement about nature with their art. It goes on to make a case that despite the difficulty of the task, there are some very sound reasons why any painter wishing to attempt it, should do so. Some associated issues are raised in the course of the investigation: 1/. An investigation of perception of nature. 2/. The role of language in shaping our perceptions of nature. 3/. The inability of language itself to capture a satisfactory recreation of the experience of nature. 4/. An examination of Paul Cezanne's attempts to record nature using his empirical optical method. 5/. An examination of Barnett Newmans's attempts to recreate the experience of nature through the use of symbols. 6/. The work of the phenomenologists with regard to nature and painting. 7/. The problem of aesthetics. 8/. The apparent reluctance of many critics and theoreticians to take the importance of nature as a vital and indispensable starting point for some artistsMaster of Arts (Hons)
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Bergquist, Annika. "Cholangiocarcinoma in primary sclerosing cholangitis /." Stockholm : Karolinska Univ. Press, 2001. http://diss.kib.ki.se/2001/91-7349-037-7/.
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Hardie, Lorraine. "Successful primary school principal leadership /." Title page, contents and abstract only, 1991. http://web4.library.adelaide.edu.au/theses/09EDM/09edmh262.pdf.
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Vincent, Carol. "Parental participation in primary education." Thesis, University of Warwick, 1993. http://wrap.warwick.ac.uk/36101/.
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This thesis is a qualitative study of the power relations structuring interactions between parents and teachers in one inner London borough. The first three chapters consider the theories and practice of participation and the extent of its realisation in education. Individual parental involvement is seen as the accepted way for parents to intervene in their child's education; this tendency is heightened by the current New Right emphasis on the 'parent-asconsumer'. Such individual parental incursions can only have a limited effect upon the imbalance of power that defines relationships between teachers and working class parents. However opportunities for collective parental participation are found to be restricted. Chapters five to nine contain case studies of two primary schools, a home-school co-ordinators' project and a parents' centre. The ethnographic chapters use fieldwork data, gathered mainly through semi-structured interviews to illustrate the effects of social class, ethnicity and gender; firstly, on individual teacher-parent-officer relations, and secondly, on allowing access to school and LEA decisionmaking fora. These chapters illustrate the arguments of the earlier theoretical chapters, by showing how teachers as individuals and schools as institutions allow particular types of individual parental involvement whilst limiting opportunities for collective parental participation. The concluding chapter applies these findings to the theoretical arguments outlined in chapters one to three. It argues that allowing parents a role as participant would profoundly alter their relationship with the education system. Such a role - resulting in increased lay participation in a welfare state institution - is seen as an integral part of citizenship in a fully participative democracy.
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Soo, Wai-man, and 蘇慧雯. "Primary students' perception of bullying." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2000. http://hub.hku.hk/bib/B31961903.
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Pauline, Gina. "Primary motives of golf volunteers." Virtual Press, 2006. http://liblink.bsu.edu/uhtbin/catkey/1344202.
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The purpose of this study was to examine the primary motives of golf volunteers at the Professional Golf Association (PGA) Championship and Ladies Professional Golf Association (LPGA) Solheim Cup event. The current study consisted of eight hundred and seventy seven participants (N=877) which included 470 volunteers from the PGA Championship and 407 volunteers from the Solheim Cup. Participants completed a demographic questionnaire and the Sport Volunteer Motivation Scale prior to serving as a volunteer for the respective golf event. Descriptive statistics revealed purposive motives was the most highly endorsed motive for PGA Championship and Solheim Cup volunteers. External motives proved to be endorsed the least among the participants. The demographic makeup of the volunteer population consisted of 56.3% males and 43.7% females. Respondents ages ranged from 18 to 84 years old, with a mean age of 55.5 years old. In regards to ethnicity, the volunteers were predominantly Caucasian (96.2%) and the majority (75.1%) reported a household income over $75,000. A series of 2 X 2 MANOVA's revealed significant differences by gender, women scored significantly higher than men on purposive, egoistic, external, and leisure motives. Significant differences were found for household income as those with an income of less than $75,000 had higher motives for material, external, leisure, and egoistic factors. Significant differences were also found for age as those younger than 56 years old had higher motives for material, leisure, and egoistic factors. A 2 X 5 MANOVA revealed a significant effect for highest degree earned, for the egoistic motive, volunteers who received a Bachelor's, Associate's, or High School/GED degrees were significantly greater than those volunteers who received a Doctoral degree. Solheim Cup volunteers had significantly higher motives than PGA Championship volunteers for all five factors. The results of the present study indicated the demographic makeup of the volunteer population needs to be examined in relationship to volunteer motivation as volunteers have different motives which must be considered for giving their time, effort, and energy to a respective sport event. Recommendations for future research examining sport event volunteer motives are also discussed.Department of Educational Studies
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Wikeley, Felicity Jane. "Parental choice of primary school." Thesis, University of Exeter, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.244957.
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Crowhurst, S. J. "Explaining in the primary classroom." Thesis, University of Exeter, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.380782.
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Placzek, M. R. "Genetic mechanisms in primary dystonia." Thesis, University College London (University of London), 2010. http://discovery.ucl.ac.uk/516144/.
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The molecular and genetic mechanisms involved in the pathogenesis of primary dystonia were investigated. This was carried out with two core studies. The pathogenesis of DYT1 dystonia was examined by the creation of a cell model. A single amino acid deletion in the DYT1 gene, which codes for a protein called torsinA, is responsible for most cases of primary, early-onset, generalized torsion dystonia. The gene in its wildtype and mutant forms were transfected into HEK 293 cells and the proteins locations and associations were studied. Wildtype torsinA was found to reside in the endoplasmic reticulum (ER). Mutant torsinA, however, was found in the nuclear envelope (NE) and in perinuclear inclusions that were not associated with the endoplasmic reticulum. In SH-SY5Y cells these inclusions were found to be associated with vesicular monoamine transporter type 2 (VMAT2), a transmembrane protein responsible for packaging catecholamine into vesicles. This association was studied in greater detail by immunoprecipitation and the functional implications were investigated by dopamine release experiments. The ultrastructure of the inclusions was also investigated by electron microscopy. Cervical dystonia and blepharospasm are the most common forms of focal primary dystonia. Most cases are apparently sporadic, although familial cases have been described. An allelic association study of genes involved in dopamine neurotransmission was carried out in order to determine whether genetic factors might contribute to an individual’s susceptibility to developing dystonia. An allele near the dopamine receptor 5 (DRD5) gene was found to be associated with cervical dystonia and blepharospasm. The presence of a causative mutation in the DRD5 gene was investigated by restriction fragment length polymorphism (RFLP) analysis and by sequencing.
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Johnson, Janet. "Therapeutic relationship in primary care." Thesis, Cardiff University, 2005. http://orca.cf.ac.uk/55546/.
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This inquiry stems from my work as a psychological counsellor working in primary care. The late 20th century has seen an increasing focus on self and emotions (e.g. McCarthy 1989) with technologies such as psychotherapy and counselling (Rose 1999) as key means through which transformation of self takes place. The demand for therapeutic services continues to rise, and NICE guidelines (2004) recommend counselling as a treatment of choice in primary care, that is, in the surgeries of General Practitioners. Referral for counselling is for those with mild to moderate mental health problems (Cocksedge 1997), and counselling is offered typically for six to eight sessions. There is much research in the NHS concerned with evidence-based practice, whereas I sought to examine the client's voice with regard to their counselling, and how counselling fits within their life-world (Schutz & Luckman 1973). My aim was to gather accounts from people who had attended for counselling at their GP surgery. Using qualitative methodology, this was achieved via individual interviews with former clients. Following ethical approval, interviewees were recruited from 16 practices in South Wales. The focus is of client perceptions of counselling, examined through the ways in which the clients present themselves, their problems, and their counselling. The research questions are concerned with how former clients describe their counselling, and how client accounts can inform debates about how to enhance the delivery and practice of counselling in primary care settings. From the analysis of client accounts it can be seen that unique client factors, the diversity in interventions appreciated by clients, and contextual factors relating to the primary care setting, suggest that counsellors working in primary care be adaptive to their environment and sufficiently responsive to offer techniques and interventions from a range of therapeutic approaches, to best meet the needs of their clients.
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Sebag, J., W. Gressler, M. Liang, D. Neill, C. Araujo-Hauck, J. Andrew, G. Angeli, et al. "LSST primary/tertiary monolithic mirror." SPIE-INT SOC OPTICAL ENGINEERING, 2016. http://hdl.handle.net/10150/622513.
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At the core of the Large Synoptic Survey Telescope (LSST) three-mirror optical design is the primary/tertiary (M1M3) mirror that combines these two large mirrors onto one monolithic substrate. The M1M3 mirror was spin cast and polished at the Steward Observatory Mirror Lab at The University of Arizona (formerly SOML, now the Richard F. Caris Mirror Lab at the University of Arizona (RFCML)). Final acceptance of the mirror occurred during the year 2015 and the mirror is now in storage while the mirror cell assembly is being fabricated. The M1M3 mirror will be tested at RFCML after integration with its mirror cell before being shipped to Chile.
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Russell, Anthony. "Primary science education in Botswana." Thesis, University College London (University of London), 1989. http://discovery.ucl.ac.uk/10019698/.
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Forsskåhl, Ellen. "Solvallas pre- and primary school." Thesis, KTH, Arkitektur, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-208544.
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Solvallastaden är en ny stadsdel som planeras i Stockholms västra förorter, i närheten av Bromma flygplats. Idag ligger Sveriges största arena för travsport i området. Framöver kommer området prioritera grönska, möjligheter till idrott, framkomlighet till fots och bostäder. I den nya stadsdelen planerar vi en kombinerad lågstadie- och förskola, planerad för 240 barn i åldrarna 1 - 10 år. Tomten ligger i direkt anslutning till en lummig skog och ett planerat parkstråk. Den omgivande bebyggelsen består av bostadskvarter i olika höjd. Bebyggelsen närmast skogen är 5 våningar för att sedan etappvis bli högre mot vägen. Jag ville frigöra så mycket gårdsyta som möjligt, och har arbetat med en byggnad som omgärdar skolgården. Tillgången till skogen och möjligheten att utnyttja den som en förlängning av skolgården gjorde att jag har valt att öppna upp Den smala byggnaden sluter sig runt en gemensam, skyddad gårdsmiljö. Två portiker leder in besökaren utifrån, och kan också öppnas och bli helt genomgående in till gården. Från gatan skymtar innergården genom den dubbelglasade dörren. Byggnaden stiger i höjd i en spiralliknande sekvens. Den lägre delen är för förskolan, den högre för de äldre barnen. De varierande takhöjderna skapar olika rumsliga upplevelser interiört. Fasaden består av olika nyanser av rosa klinkerplattor i fiskbensformationer. Fönsersättningen är anpassad efter barnen i olika åldrar; på vissa ställen går fönstren från golvnivå till 100 cm, så att bara de små barnen ser ut. Taket är väldigt synligt och en central del av gestaltningen. Vattnet blir ett pedagogiskt element, som samlas in i en grund damm i ett hörn på gården. Jag har delat upp förskolan och F-3-klasserna i olika längor. Som sammankopplande länk ligger gemensamma funktioner som mat- och gympasal, förråd, lärarrum, kök och så vidare. Den lägre delen där förskolan huserar, mot sydost, möjliggör en ljus gårdsmiljö. Alla bas-, grupp- och lekrum är placerade i ett band mot den omhuldande ytterväggen. Kommunikations och vistelseytor ligger som ett skikt mellan innergården och rummen, där gården hela tiden är närvarande. Lärandemiljöerna har ett genomgående ljusflöde, med glaspartier som öppnar upp mot korridorerna och gården. Korridorerna som binder samman gården och undervisningsrummen skapar utrymme för umgänge. I skolan finns en böljande bänk med förvaring längs hela korridoren. På utvalda ställen vidgas korridoren, så att små fickor med väggyta för utställningar skapas.A new urban district, Solvalla city, is planned in the western suburbs of Stockholm. The task given was to plan a pre- and elementary school, for children aged one to ten years old. The school is planned to teach around 240 children. The plot, where the school building is to be situated, is linked to both to a forest and a park. I wanted my schoolyard to integrate with the forest, letting the forest flow into the playground and simultaneously maximize the use of the garden. I decided to separate the younger children, aged 1 to 5, and the older ones, due to different pedagogical needs. The younger ones will be using the lower, southeast wing, and the older children the opposite. I wanted there to be a connecting link, therefore I placed the common function, such as kitchen, the teacher’s room, school cantine, the sports hall and a grand main entrance in a wing in between the two. My aim was to create a building that in an embracing gesture envelops the garden, creating a safe space inside. I decided to let the outer wall be solid and closed, and the walls facing the courtyard transparent and light. The fluorescent glass walls lets the light and nature into the building. The corridors, surrounding the garden, become a layer between in and out. Placed along the solid wall are all teaching rooms; the classrooms, group rooms, play rooms and so forth. The corridor is more than a corridor, a space that effetively moves you from place A to B - it evolves into playful spaces and can be used for exhibitions, hanging around or playing. This is also the link between the garden and the rooms. The metallic roof gradually rises, in an almost circling motion, from low to high. This creates a playfulness and allows the water to be a pedagogical element, as well as symbolizing the growth of the children, from small to bigger. The facade is made of shiny, differently shaded, pink tiles in a herringbone formation. With the facade I strived for a bold appearance, creating identity and making the building stand out in the neighborhood.
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Blackwelder, Reid B. "Primary Care Approach to Cough." Digital Commons @ East Tennessee State University, 2003. https://dc.etsu.edu/etsu-works/6994.
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Leong, Colin D. "Whole-Lake Primary Production Calculator." Wright State University / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=wright1452795206.
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Foskett-Tharby, Rachel Christine. "Coordination of primary health care." Thesis, University of Manchester, 2014. https://www.research.manchester.ac.uk/portal/en/theses/coordination-of-primary-health-care(987d5002-cf2f-4ece-8f53-f89ea2127e1e).html.
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Background: Improving coordination of care is a major challenge for health systems internationally. Tools are required to evaluate alternative approaches to improve coordination from the patient perspective. This study aimed to develop and validate a new measure of coordination for use in a primary care setting. Methods: Four methods were used. Firstly, a concept analysis was undertaken to identify the essential attributes of coordination drawing upon literature from health and organisational studies and to establish its boundaries with related concepts such as continuity of care, integration and patient centred care. Secondly, existing measures of coordination were reviewed to assess the extent to which item content reflected the definition arising from the concept analysis and to appraise psychometric properties. Thirdly, a new instrument, the Care Coordination Questionnaire (CCQ), was developed utilising items from existing questionnaires and others developed following focus groups with 30 patients. Ten cognitive interviews were used to evaluate the items generated. Finally, the CCQ was administered in a cross sectional survey to 980 patients. Item and model analyses were performed. Test-retest reliability was evaluated through a second administration of the CCQ after two weeks. Concurrent validity was evaluated through correlation with the Client Perceptions of Coordination Questionnaire (CPCQ). Construct validity was evaluated through correlation with responses to a global coordination item and a satisfaction scale and the testing of two a prior hypotheses: i) coordination scores would decrease with increasing numbers of providers and ii) coordination scores would decrease with increasing numbers of long-term conditions. Results: The concept analysis suggested that coordination should be considered as a process for the organisation of patient care characterised by: purposeful activity, information exchange, knowledge of roles and responsibilities, and responsiveness to change. The systematic review identified 5 existing measures of coordination and a further 10 measures which incorporated a coordination subscale. Only one demonstrated conceptual coverage but had poor psychometric properties. A new instrument was therefore developed and tested as described above. 299 completed surveys were returned. Respondents were predominantly elderly and of white ethnicity; approximately half were female. Five items were deleted following item analyses. Model analysis suggested a four factor two-level model of coordination comprising of 18 items. This correlated well with the CPCQ, the global coordination item and satisfaction scale. The a priori hypotheses were upheld. Retest reliability was acceptable at the patient group level. Conclusions: The CCQ has demonstrated good psychometric characteristics in terms of item responses, reliability and construct validity. Further exploration of these properties is required in a larger, more diverse sample before it can be recommended for widespread use, but it shows potential utility in the evaluation of different approaches to coordinating care.
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Soo, Wai-man. "Primary students' perception of bullying." Hong Kong : University of Hong Kong, 2000. http://sunzi.lib.hku.hk/hkuto/record.jsp?B22278928.
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Brewer, Rhett. "Paint, painters and primary perception." Thesis, View thesis, 1996. http://handle.uws.edu.au:8081/1959.7/300.
Full textAbstract:
This paper examine's painters attempts to find, in their chosen medium, a meaningful representation of nature. It proposes the idea that despite the best efforts of some of western art's most gifted artists, this has remained an elusive goal so far and this is likely to remain the case in the future. The paper concludes with an examination of Postmodern theoretical discourse and the effects it has had on painters who may want to attempt to make a meaningful statement about nature with their art. It goes on to make a case that despite the difficulty of the task, there are some very sound reasons why any painter wishing to attempt it, should do so. Some associated issues are raised in the course of the investigation: 1/. An investigation of perception of nature. 2/. The role of language in shaping our perceptions of nature. 3/. The inability of language itself to capture a satisfactory recreation of the experience of nature. 4/. An examination of Paul Cezanne's attempts to record nature using his empirical optical method. 5/. An examination of Barnett Newmans's attempts to recreate the experience of nature through the use of symbols. 6/. The work of the phenomenologists with regard to nature and painting. 7/. The problem of aesthetics. 8/. The apparent reluctance of many critics and theoreticians to take the importance of nature as a vital and indispensable starting point for some artists
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Brewer, Rhett. "Paint, painters and primary perception." View thesis, 1996. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030903.175546/index.html.
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Evanshen, Pamela, and L. Phillips. "Primary Learning Environments That Teach!" Digital Commons @ East Tennessee State University, 2006. https://dc.etsu.edu/etsu-works/4365.
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Prince, Nanette Marie. "Balanced literacy in primary education." CSUSB ScholarWorks, 1998. https://scholarworks.lib.csusb.edu/etd-project/1655.
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de, Zambotti Massimiliano. "Cardiovascular Hyperarousal and Primary Insomnia." Doctoral thesis, Università degli studi di Padova, 2011. http://hdl.handle.net/11577/3421594.
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Previous researches has shown autonomic, neuroendocrine, neuroimmunological, elecrophysiological and neuroimaging evidence of increased levels of arousal during wakefulness and sleep in primary insomnia. However, few studies have focused on cardiovascular activity across sleep stages and there are even fewer that have studied cardiovascular activity during the process of falling asleep.
The aim of the present study is to analyze cardiovascular activity during sleep in primary insomniacs compared to good sleepers. We also aim to detect differences in cardiovascular activity and cognitive performance between insomniacs and good sleepers. This will be done by employing Impedance Cardiography and heart rate variability (HRV) analysis. The task employed, Stop Signal Task, assesses motor inhibition processes and was administered in two sessions, before and after a night of polysomnographic recording.
Performance results showed prolonged Stop Signal Delay (SSD) in the morning in both groups and slower Stop Signal Reaction Time (SSRT) in insomniacs compared with good sleepers, while no effects were observed for performance accuracy. The myocardial contractility, in insomniacs, was higher (elevated heart rate and reduced left ventricular ejection time) in the evening task session and during wake compared to sleep. Pre-ejection period, an index inversely related to sympathetic beta-adrenergic activity, was lower in insomniacs overall the night and task sessions in agreement with the hypothesized sympathetic hyperactivity underlied the disorder. In addition, HRV indexes showed an increased parasympathetic involvement (elevated high frequency) in wake, but only in insomniacs.
These findings suggest that, in insomniacs, a greater parasympathetic activation is required to fall asleep; possibly to contrast the sympathetic hyperactivation reflected in other variables. In addition, these findings suggest a deficit of motor inhibition control in insomnia, matched with high levels of cardiovascular arousal.
These results support the etiological hypothesis of physiological hyperarousal underlying primary insomnia. Furthermore, elevated contractility indexes suggest an association between insomnia and increased risk for cardiovascular diseases.Dalla letteratura emerge come l’insonnia sia associata ad una condizione di iperattivazione generalizzata. Ciononostante solamente pochi studi si sono focalizzati sull’attività cardiovascolare nel sonno degli insonni ed in particolar modo rimane poco studiato l’addormento, ritenuto fondamentale nella comprensione del disturbo. Lo scopo dello studio è di analizzare l’attività cardiovascolare durante il sonno nell’insonnia primaria utilizzando la Cardiografia ad Impedenza e misure derivate dall’analisi della variabilità della frequenza cardiaca. Inoltre ci si propone di analizzare la prestazione cognitiva e la reattività cardiovascolare ad un compito che coinvolge l’inibizione motoria, in un gruppo di insonni confrontati con buoni dormitori. I risultati dello studio mostrano, negli insonni, un rallentamento nei tempi di risposta ai segnali di stop (SSRT), mentre l’accuratezza non sembra differire tra insonni e controlli. A livello fisiologico, gli insonni, alla sera e nel confronto tra veglia e sonno, mostravano un elevata contrattilità miocardica (maggiore frequenza cardiaca e minore tempo di eiezione ventricolare sinistra). Il periodo pre-eiettivo, un indice inversamente relato all’attività simpatica beta-adrenergica, era inferiore negli insonni in tutte le condizioni sperimentali. In aggiunta, gli indici derivati dalla variabilità della frequenza cardiaca hanno evidenziato negli insonni un incremento del coinvolgimento parasimpatico in veglia. Questi risultati suggeriscono come negli insonni sia necessaria un importante influenza vagale per permettere l’addormentamento, possibilmente per contrastare l’iperattivazione simpatica. In aggiunta, questi risultati suggeriscono un deficit nel controllo dell’inibizione motoria negli insonni che contemporaneamente esibiscono degli elevate livelli di arousal cardiovascolare durante l’esecuzione del compito. I risultati supportano l’ipotesi eziologica di una iperattivazione psicofisiologica alla base del disturbo. Inoltre, gli elevati indici di contrattilità negli insonni, suggeriscono un associazione tra insonnia e rischio cardiovascolare.
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Al-Tuwaijiri, A. M. "Primary eye care in Saudi Arabia : an integral part of the primary health care system." Thesis, Swansea University, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.635734.
Full textAbstract:
Blindness is a serious socioeconomic handicap and most causes of blindness are preventable. The Primary Health Care System has been identified by the World Health Organisation as the 'first line of defence' in tackling the health care problems of developing countries. This is as true for eye care as it is for the whole range of other diseases and illnesses that affect a country's population. The Primary Eye Care system is, therefore, essential in the prevention of many ocular disorders that may cause blindness. The aim of the thesis is to define the current status of primary eye care systems in the Kingdom of Saudi Arabia. It will concern itself with identifying and assessing the current resources and facilities that are available for eye patients at the primary health care level. It will also determine the strengths and weaknesses of the existing primary eye care system in the country according to geographical location, covering both urban and rural areas. Specific recommendations for action are formulated, in the light of the data collected, aimed at the reduction, control or elimination of avoidable and curable blindness. The ultimate goal of this thesis is, therefore, to add to the existing knowledge of eye care problems in the Kingdom and to put forward a series of recommendations to help in the prevention of blindness in the Kingdom of Saudi Arabia.
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Florini, Marita A. "Primary care providers' perception of care coordination needs and strategies in adult primary care practice." Thesis, State University of New York at Binghamton, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=3630859.
Full textAbstract:
Problem: Medical and nursing literature poorly identify primary care providers' (PCP) relationship to care coordination (CC). Primary care providers' education, experience, and perspective, contribute to: (a) assessments of patient's care coordination needs, and (b) variability in behavior to address needs. Dissimilar approaches to CC by PCPs affect work relationships and office flow.
Purpose: To pre-pilot a new tool describing PCPs' knowledge, perception, and behavior regarding CC. Methods: Primary care physicians, nurse practitioners, and physician assistants were surveyed.
Analysis: Frequencies and percentages provided sample characteristics. Descriptive statistics analyzed provider responses within and between groups. Narratives were analyzed for themes. Tool refinement is suggested however, the tool does describe PCPs and CC activities.
Significance: A tool was developed to evaluate areas of CC activity performed by PCPs. Information from surveys of PCPs can illuminate behaviors that lead to improved work flow, efficiency, and patient outcomes. Doctors of Nursing Practice who are PCPs contribute to primary care CC through leadership, experience, and descriptive evidence.
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Bansi, Devinder Singh. "Immunologyical mechanisms in primary primary sclerosing cholangitis : the role of the anti-neutrophil cytoplasmic antibody." Thesis, University of Southampton, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.242304.
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Kazamia-Paschalidou, Androulla. "Development in primary and pre-primary education and curriculum in Cyprus since independence (1959-2003)." Thesis, University College London (University of London), 2004. http://discovery.ucl.ac.uk/10019814/.
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Lundberg, Maya. "Location choice of private primary healthcare providers in Sweden : After the Primary Care Choice Reform." Thesis, Umeå universitet, Nationalekonomi, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-174828.
Full textAbstract:
This study aims to analyse the location choices made by private primary healthcare providers as a result of the Primary Care Choice Reform. This will be done by analysing a unique dataset covering all new private primary healthcare providers during the time period of 2008 to 2018 in Sweden’s 290 municipalities. In order to examine the probability of a private primary healthcare provider locating in a given municipality, two logit regression models based on the year 2018 containing the number of private primary healthcare providers as the dependent variable, will be used for the empirical analysis. The results are presented as marginal effects and are calculated from the coefficients of the two logit regression models. In addition, there exist alternative measures to the dependent variable when analysing the location choice of private primary healthcare providers. For this reason, an alternative regression will be presented where the dependent variable is the share of healthcare providers in the municipality that is privately owned, to see if any new conclusions can be drawn. There is a broad range of possible determinants for where to locate. Those included in this study are the Care Need Index, political party, domestic net migration, distance, socio-economic variables and a variable measuring the population size. Furthermore, all private primary healthcare providers will be grouped according to which county council they belong to, since all county councils have different reimbursement systems. The findings imply that private primary healthcare providers are, on average, less likely to locate in municipalities defined as rural, compared to municipalities defined as urban. Socio-economic factors such as elderly people and income further influence the location decision, where people with less socio-economic status are at a disadvantage. For this reason, there are some questions about if the objectives of the Primary Care Choice Reform have been achieved and for whom.