Organization and Provider Factors That Influence the Utilization of Arthritis Best Practices in Primary Care

Background: Most treatment for people with arthritis occurs at the primary care level yet many studies have documented the need for improved arthritis management in this environment. The dissemination of clinical practice guidelines (CPGs) has been suggested as one method for improving care delivery. Getting a Grip on Arthritis, a theory and evidence-based educational program was developed to disseminate arthritis best practices based on published CPGs for the management of osteoarthritis (OA) and rheumatoid arthritis (RA). Primary care organizations were invited to enroll providers in an inter-professional workshop. Six months of reinforcement activities were offered following the workshop to support the delivery of arthritis care in their communities. Purpose: This study was designed to determine which organizational and individual level characteristics contributed to improved provider use of arthritis best practices six months following the workshops. Methods: The ACREU Primary Care Survey was completed by workshop participants at baseline and six months following the workshops in order to evaluate their use of arthritis best practices. This survey measured providers’ responses to open-ended questions that asked how they would manage the individual patients described in three hypothetical case scenarios. One point was given for each recorded best practice and totaled for each case scenario, with the highest possible score being eight for the late RA case and moderate knee OA case, and seven for the early RA case. Requests for reinforcement activities were tracked by study staff during the six months following the workshops. A practice profile was also completed by each organization. Analysis: Two models of knowledge utilization (KU) were constructed for testing. For Model 1, two-level hierarchical linear modeling (HLM) was used to determine the direct effects of provider and organizational level variables on intended use of arthritis best practices six months post-workshops, while controlling for clustering within organizations. In model 2, logistic regression was used to determine the influence of organization level factors on one specific best practice, that is, dissemination of patient educational materials during the six months following the workshop. Results: 275 providers from 131 organizations completed both baseline and six month follow-up surveys. For Model 1, total best practice scores for all three case scenarios were predicted by the discipline of the provider, the model of care in which they worked and baseline best practice scores (P82% for community health centres, primary care networks and regionally funded models of care compared to 30% for the federally funded model of care (P<0.01), and was 88% for organizations that sent multidisciplinary team members to the workshops, compared to 70% for those that did not send such a team (P=0.07). Conclusions: Use of arthritis best practices may be influenced by provider characteristics (discipline, satisfaction and confidence in managing arthritis), the model of care in which they work and the team learning experience. These results have implications for the training and education of health professionals and the design of models of care to enhance arthritis care delivery

O SOCIALISMO EM MOVIMENTO (PARA FRENTE OU PARA TRÁS) DA REVISTA MOVIMENTO SOCIALISTA

As folhas do calendário começavam a se preparar para as boas vindas da década de 1960 quando surge em julho de 1959 a revista marxista Movimento Socialista, que responsável pela abertura de novas veredas à compreensão teórica da vida nacional e a perspectiva revolucionária do marxismo brasileiro, gestou em seu seio as linhas mestras de uma nova experiência organizativa extremamente frutífera ao movimento comunista do Brasil. Cabendo a este artigo, apresentar essa experiência histórica ainda desconhecida, por meio de uma ampla, e ainda não realizada, análise do conteúdo vinculado por esta curta publicação de duas edições (jul/59 e dez/59)

Perencanaan dan Realisasi Carrier Recovery Pada QPSK

ABSTRAKSI: Untuk mendapatkan sinyal informasi yang dikirimkan, pada penerima Quadrature Phase Shift Keying (QPSK) digunakan sistem deteksi koheren. Deteksi koheren merupakan proses untuk mengalikan sinyal masukan dengan sebuah gelombang pembawa referensi yang mempunyai fasa dan frekuensi yang sinkron terhadap sinyal masukan tersebut. Mekanisme deteksi koheren dicapai dengan penggunaan rangkaian carrier recovery. Fungsi carrier recovery adalah memulihkan sinyal pembawa yang mempunyai frekuensi dan fasa yang sama dengan sinyal pembawa aslinya dibagian modulator.Pada tugas akhir ini direalisasikan sebuah perangkat carrier recovery pada penerima QPSK. Ada beberapa metode carrier recovery, salah satunya adalah adalah metode ‘Squaring Loop’. Cara kerja squaring loop adalah sinyal QPSK dipangkatkan empat, sehingga didapat komponen frekuensi dengan frekuensi sama dengan empat kali frekuensi carrier, disertai dengan hilangnya pengaruh sinyal informasi. Kemudian sinyal tersebut dilewatkan ke Band Pass Filter (BPF) untuk menekan frekuensi-frekuensi harmonisa. Untuk mengunci fasa sinyal keluaran BPF, maka sinyal keluaran BPF dilewatkan ke rangkaian Phase Locked Loop (PLL). Selanjutnya sinyal keluaran PLL dengan frekuensi empat kali frekuensi carrier yang stabil frekuensi dan fasanya, dilewatkan pada rangkaian pembagi empat dan DAC untuk mendapatkan sinyal carrier yang diinginkan.Pengujian sistem carrier recovery tidak bisa dilakukan tanpa adanya bagian pengirim yang berupa modulator QPSK, dengan demikian pada tugas akhir ini juga direalisasikan modulator QPSK dengan laju data sebesar 64 kbps dan frekuensi carrier sebesar 640 kHz.Dari hasil realisasi dan pengukuran dalam domain frekuensi, telah didapatkan sinyal keluaran modulator QPSK sesuai dengan teori yaitu memiliki efisiensi bandwidth sebesar 1 bps/Hz, walaupun keluaran dalam domain waktu belum sempurna karena belum adanya filter. Sistem carrier recovery bekerja kurang sempurna dibagian pemangkat empat dan BPF. Bagian carrier recovery yang lain, yaitu PLL, pembagi empat, dan DAC bekerja dengan baik saat diuji dengan masukan dari function generator.Kata Kunci : -ABSTRACT: Quadrature Phase Shift Keying (QPSK) receiver is used coherent detection system to get information signal which was sent in transmitter. Coherent detection is processing input signal with one carrier signal reference. Those reference signal have synchronous frequency and phase. Carrier recovery is implemented in coherent detection mechanism. Carrier recovery function is restoring carrier signal in receiver. So, those signal have same frequency and phase from its origin in modulator block.This final project was realized carrier recovery tool in QPSK receiver. There was some carrier recovery methods, one of them was \u27Squaring Loop\u27 method. The way of Squaring Loop works is raising QPSK signal to double squarer, so it produces signal with four times carrier signal\u27s frequency component. And information signal’s influence will be removed. Then Squaring Loop output signal will be passed in BPF to press its harmonizing frequency. To lock output signal phase, BPF output signal is passed to Phase Lock Loop block. So, PLL output signal has four times frequency component from carrier signal\u27s frequency and stable frequency and phase. Then, PLL output will be passed into divider of four block to get desired carrier signal. Carrier recovery\u27s system testing cannot be implemented without QPSK modulator as transmitter block. So, this final project is also realizing QPSK modulator with 64 kbps bit rate and 640 kHz carrier frequency.Realization and measurement process in frequency domain result that QPSK modulator output signal is appropriate with basic theory. QPSK modulator output signal has 1bps/Hz bandwidth efficient, although it is not perfect in time domain. It is caused by the absence of filter block. Carrier recovery system work less in double squarer and BPF. Another carrier recovery section, like PLL, divider of four, and DAC blocks work well if it\u27s tested with function generator\u27s signal output.Keyword:

O SOM DO DISSENSO: Apontamentos para uma história/concepção dos partidos e organizações políticas em um caso concreto de pesquisa

Taking political parties as an object of study involves methodological risks to be properly analyzed. Some scholars tend to understand them as a monolithic group, free from internal differences, others tend to consider them as a restricted intellectual group, a type of political elite, apparently disconnected from the social conflicts that permeate and overcome it. Almost always, however, the uncompromising reality imposes itself. And if in many moments, from the interior of these objects, and from the archives available for research, the disharmony noises of dissenting voices sound, in others, what remains is to hear the sound of silence. Both can and should be interpreted by the attentive historian. Inspired by Gramsci's considerations, this article presents a theoretical methodological orientation on how to write about the history of political parties and organizations, using concrete research results on Polop.Tomar a los partidos políticos como objeto de estudio implica riesgos metodológicos para ser adecuadamente analizados. Algunos estudiosos tienden a entenderlos como un grupo monolítico, libre de diferencias internas, otros tienden a considerarlos como un grupo intelectual restringido, una especie de élite política, aparentemente desconectada de los conflictos sociales que la permean y superan. Casi siempre, sin embargo, la realidad intransigente se impone. Y si en muchos momentos, desde el interior de estos objetos, y desde los archivos disponibles para la investigación, suenan los ruidos de desarmonía de voces disidentes, en otros, lo que queda es escuchar el sonido del silencio. Ambos pueden y deben ser interpretados por el historiador atento. Inspirándose en las consideraciones de Gramsci, este artículo presenta una orientación teórico-metodológica sobre cómo escribir sobre la historia de los partidos y organizaciones políticas, utilizando resultados concretos de investigación sobre Polop.Tomar partidos políticos como objeto de estudo envolve riscos metodológicos a serem devidamente analisados. Alguns estudiosos tendem a compreendê-los como um grupo monolítico, isento de divergências internas, outros tantos tendem a considerá-los como um grupo intelectual restrito, um tipo de elite política, aparentemente desvinculada dos conflitos sociais que lhe perpassam e superam. Quase sempre, no entanto, a realidade, intransigente, se impõe. E se em muitos momentos, do interior destes objetos, e dos arquivos disponíveis a pesquisa, soam os ruídos de desarmonia das vozes em dissenso, em outros, o que resta é ouvir o som do silêncio. Ambos podem e devem ser interpretados pelo historiador atento. Inspirado nas ponderações de Gramsci, este artigo apresenta uma orientação teórico-metodológica de como se deve escrever sobre a história de partidos e organizações políticas, se valendo de resultados concretos de pesquisa sobre a Polop

A revolução brasileira será socialista ou não será revolução: as origens da Polop e o nascimento da nova esquerda marxista

A fundação da Organização Revolucionária Marxista – Política Operária (ORM-Polop) é um marco inicial na renovação do movimento marxista brasileiro dos anos 1960. Identificando originalidades em sua posição teórico-política, produções memorialísticas e historiográficas a consideraram “matriz” do que se convencionou chamar de “nova esquerda”. Mas o que exatamente é isto que parte da literatura especializada identificou como a “nova esquerda”? Sua resposta pode ser encontrada ao fim do encaminhamento de uma outra pergunta: Quais condicionantes históricos permitiram a formação de uma organização como a Polop? Este artigo tem o objetivo de responder a ambas

'It felt like I was giving a present to myself': an exploration of service-users' experience of developing self-compassion

This thesis explored service-users' experience of developing self-compassion using Compassionate Mind Training (CMT). A systematic review of the existing literature on compassion and compassion-based interventions identified the primarily focused of research has been on symptom outcome measures utilizing quantitative approaches. No study that explored the experiences and processes of developing self-compassion was identified. The aims and epistemological stance of the researcher led to a qualitative methodology being used. Once ethical approval was gained, six participants were recruited from two CMT programmes, being run by the same facilitators. All service-users who completed the programme reported a development of self-compassion. Participants were interviewed face-to-face using a semi-structured interview schedule. Interpretative Phenomenological Analysis was selected to analyse the transcribed data. The analysis of the data identified four super-ordinate themes: essential components of self-compassion; process of self-compassion development over time; group experiences; and negotiating change. The first two themes focused on the development and experience of self-compassion. The second two themes included the experience of developing self-compassion in a group and the general change process. Each theme is discussed and presented with supporting quotes. The study found that service-users are able to develop components of self-compassion using CMT. However, continued practice of compassionate behaviours needs to follow the end of the programme for self-compassion to become habitual. The study also identified a number of group factors and processes that prevented or promoted therapeutic change. The results are discussed with reference to the current literature on self-compassion, compassion-based interventions, group processes, mechanisms of change, and further investigation. A model of self-compassion development is proposed. Finally, the researcher's critical reflections of the research process are presented

Afroempreendedores : desafios e oportunidades para empreendedores negros no Distrito Federal

Trabalho de Conclusão de Curso (graduação)—Universidade de Brasília, Faculdade de Administração, Contabilidade, Economia e Gestão de Políticas Públicas, Departamento de Administração, 2017.Apesar de negros já serem a maioria entre os empreendedores brasileiros, ainda há um longo caminho até alcançarem resultados similares a empreendedores brancos. Este estudo tem por objetivo analisar as contribuições de empreendedores negros para o fortalecimento da identidade negra. Para isso, foram realizadas 12 entrevistas em profundidade com empreendedores negros, de ambos os sexos em diferentes campos de atuação no Distrito Federal. Em um roteiro com 11 perguntas relacionadas a vivências, identidade, discriminação e opiniões a respeito da Feira Coisa de Preto e a Lei 5.447/2015, que instituiu o Programa Afroempreendedor do Distrito Federal. Para o tratamento dos dados coletados em campos foi utilizada a técnica de análise de conteúdo. Por fim conclui-se que o afroempreendedorismo tem colaborado para a mudança do imaginário da sociedade que historicamente vem atribuindo aos negros papeis inferiores. Esses empreendedores usam do espaço que alcançaram para afirmar sua identidade racial, com uma representação positiva do negro em seu empreendimento e na geração de empregos e/ou prestação de serviços para outros afrodescendentes

Novos Rumos para o comunismo brasileiro : O PCB e as eleições de 1960

Starting from the perspective that the country's main contradiction resided in the conflict of national emancipation against imperialism, and not in the class conflict between capital and labor, for the PCB, the 1960 electoral campaign was summarized as the opposition between democratic nationalist forces and authoritarian deliverers. This polarization, which at the time, materialized in the antagonistic candidacies of Lott and Jânio, justified the engagement of the main communist party in the country in the presidential campaign in defense of the marshal. Put under critical review, however, this support has many weaknesses. Demonstrating that Lott did not adhere to the measures corresponding to the three main proposals of the national-democratic platform supported by the PCB, this article argues that the characterization of national-democratic that the party made of his candidacy was quite questionable. In practice, the 1960 election was the first concrete political test of the new tactics adopted by the PCB after the turn promoted by the “Declaration of March 1958”. In the course of this process, its deficiencies were radically exposed, making evident the limits of the new line taken by the party.Partindo da perspectiva de que a contradição principal do país residia no conflito da emancipação nacional contra o imperialismo, e não no conflito de classe entre capital e trabalho, para o PCB, a campanha eleitoral de 1960 se resumiu a oposição entre as forças nacionalistas democráticas e entreguistas autoritárias. Essa polarização, que na ocasião, se materializava nas candidaturas antagônicas de Lott e Jânio, justificou o engajamento do principal partido comunista do país na campanha presidencial em defesa do marechal. Posto em revisão crítica, no entanto, esse apoio apresenta muitas fragilidades. Demonstrando que Lott não aderiu as medidas correspondentes as três principais propostas da plataforma nacional-democrática apoiada pelo PCB, este artigo defende que a caracterização de nacional-democrática que o partido fez sobre a sua candidatura era bastante questionável. Na prática, a eleição de 1960 foi o primeiro teste político concreto da nova tática adotada pelo PCB após o giro promovido pela “Declaração de Março de 1958”. No desenrolar deste processo, suas deficiências foram radicalmente expostas, tornando evidente os limites da nova linha assumida pelo partido

Campuran kebimbangan dan kemurungan dalam kalangan ibu bapa kanak-kanak kurang upaya fizikal di luar bandar Sabah

Penyelidik terdahulu telah menunjukkan bahawa ibu bapa kanak-kanak kurang upaya fizikal mempunyai risiko tinggi untuk mempunyai masalah kesihatan mental yang disebabkan oleh cabaran besar dalam membesarkan anak kurang upaya. Cabaran ini ditambah lagi oleh kesukaran hidup di kawasan luar bandar. Kajian ini bertujuan untuk mengenalpasti sama ada ibu bapa kanak-kanak OKU fizikal mempunyai Mixed Anxiety and Depression (MAD) dan membina pemahaman yang mendalam "mengapa" ibu bapa mengalami MAD. Bahan untuk kajian kes ini diperoleh mengguna Kessler psychological ditress scale (K-10) dan temubual secara mendalam. Enam orang ibu bapa yang mempunyai MAD telah ditemubual. Analisis kandungan induktif dengan bantuan program komputer ATLAS.ti 7 telah menghasilkan enam simptom MAD ibu bapa (gangguan tidur, cepat marah, bimbang, mudah menangis, menjangkakan sesuatu yang buruk akan berlaku dan putus asa (hopeless) mengenai masa depan) dan lima sumber MAD (kekurangan sokongan, masalah penerimaan, kekurangan maklumat dan pengalaman, faktor luar bandar dan masalah kesihatan anak. Dapat disimpulkan, dapatan kajian ini berkaitan dengan cabaran yang dihadapi oleh ibu bapa dalam membesarkan anak-anak dari segi fizikal di luar bandar Sabah

'It felt like I was giving a present to myself': an exploration of service-users' experience of developing self-compassion

This thesis explored service-users' experience of developing self-compassion using Compassionate Mind Training (CMT). A systematic review of the existing literature on compassion and compassion-based interventions identified the primarily focused of research has been on symptom outcome measures utilizing quantitative approaches. No study that explored the experiences and processes of developing self-compassion was identified. The aims and epistemological stance of the researcher led to a qualitative methodology being used. Once ethical approval was gained, six participants were recruited from two CMT programmes, being run by the same facilitators. All service-users who completed the programme reported a development of self-compassion. Participants were interviewed face-to-face using a semi-structured interview schedule. Interpretative Phenomenological Analysis was selected to analyse the transcribed data. The analysis of the data identified four super-ordinate themes: essential components of self-compassion; process of self-compassion development over time; group experiences; and negotiating change. The first two themes focused on the development and experience of self-compassion. The second two themes included the experience of developing self-compassion in a group and the general change process. Each theme is discussed and presented with supporting quotes. The study found that service-users are able to develop components of self-compassion using CMT. However, continued practice of compassionate behaviours needs to follow the end of the programme for self-compassion to become habitual. The study also identified a number of group factors and processes that prevented or promoted therapeutic change. The results are discussed with reference to the current literature on self-compassion, compassion-based interventions, group processes, mechanisms of change, and further investigation. A model of self-compassion development is proposed. Finally, the researcher's critical reflections of the research process are presented