<p>Understanding the mechanisms whereby the sequence of the human genome is interpreted into diverse cellular phenotypes is a critical endeavor in modern biology. A major determinant of cellular phenotype is the spatial and temporal pattern gene expression, which is regulated in part by epigenomic properties such as histone post-translational modifications, DNA methylation, chromatin accessibility and the 3-dimensional architecture of the genome within the nucleus. These properties regulate the dynamic assembly of transcription factors and their co-regulatory proteins upon chromatin. To properly understand the interplay between the epigenomic framework of a cell and transcription factors, integrated analysis of transcription factor-DNA binding, chromatin status, and transcription is required. This work integrates information about chromatin accessibility, as measured by DNaseI hypersensitivity, transcription factor binding, as measured by chromatin immunoprecipitation, and transcription, as measured by microarray or transcriptome sequencing, to further understand the functional role of two important transcription factors, the androgen receptor (AR) and CTCF, in cancer cell line models. Data gathered from a prostate cancer cell line model demonstrate that the AR does not exclusively bind accessible chromatin upon ligand-activation, and induces significant changes in chromatin accessibility upon binding. Regions of quantitative change in chromatin accessibility contain motifs corresponding to potential collaborators for AR function, and are also significantly associated with AR-regulated transcriptional changes. Furthermore, base pair resolution of the DNaseI cleavage profile revealed three distinct patterns of AR-DNA interaction, suggesting multiple modes of AR interacting with the genome. A novel role for the nuclear receptor REV-ERB&#945; in AR-mediated transcription was explored within the same model system. Though preliminary, results thus far indicate that REV-ERB&#945; is required for AR-induced increases in target gene transcription in a manner that is likely dependent on HDAC3. Genetic knockdown of REV-ERB&#945; resulted in notable changes in chromatin accessibility around AR-target genes both before and after AR activation. The function of CTCF was interrogated using stable knockdown in a breast cancer cell line model. CTCF knockdown led to widespread changes in chromatin accessibility that were dependent on DNA sequence. Further analysis suggested that AP-1 and FOXA1 are involved in CTCF function. Together, the work presented in this dissertation offers novel insight into the behavior of two critical transcription factors in cancer cell lines, and describe a framework of analysis that can be extended and applied to any transcription factor within any desired cellular context.</p> / Dissertation

Darbo tikslas. Įvertinti asmens sveikatos priežiūros įstaigų (toliau ASPĮ), teikiančių ortopedijos traumatologijos ir/arba chirurgijos paslaugas, galimybes teikti kvalifikuotą pagalbą ir jų infrastruktūros atnaujinimo poreikius. Tyrimo metodika. Tyrimo objektas – ASPĮ, teikiančios pagalbą traumas patyrusiems pacientams bei GMP įstaigos. Tyrimo metodai: Mokslinės literatūros analizė, respondentų apklausa, statistinė duomenų analizė naudojant SPSS 13 versiją bei MS Excel, geografinės informacinės sistemos „Arc View 9.11” programinę įranga. Rezultatai. Esant vienam traumos centrui apskrityje (i��� viso 10 centrų), visiems Lietuvos gyventojams pagalba būtų prieinama per 1 val. Šiuo metu GMP per 15 minučių prieinama pusei LR teritorijos. Iš viso į 0 lygio traumos centrus kreipiasi beveik trečdalis visų traumą patyrusių pacientų, tačiau vienas šio lygio centras vidutiniškai aptarnauja 13,5 kartų mažiau pacientų, nei trečiojo lygio (p<0,005). Nulinio lygio centre vidutiniškai teikiama 9 kartų mažiau stacionarių paslaugų, lyginant su III lygio traumos centru (p<0,005). Nulinio lygio įstaigose traumos pacientų srautas yra nepakankamas lyginant su kitų lygių ASPĮ srautais. Dalis 0 lygio traumos centrų neturi pakankamo specialistų (ortopedų traumatologų, anesteziologų ir reanimatologų) skaičiaus, kurie užtikrintų nenutrūkstamą 24 valandų pagalbos teikimo ciklą. Didžiausias investicijų poreikis yra III lygio traumos centrų, tačiau investicijų poreikis 1 ligoniui šio lygio centre - 6,5... [toliau žr. visą tekstą] / The aim - to evaluate possibilities of the health care institutions which provides orthopaedic traumatology and/or surgery services, to provide qualified medical care and their infrastructure renewal needs. Methods. The object of the study is health care institutions which provide services for patients after trauma and also emergency service providers. Methods of the study: the analysis of the academic literature, respondents surveys, analysis of the statistical data using „SPPS“ 13th version, MS Excell program and geographical information system as well as Arc View 9.11 software program. Results. If there is one trauma centre in the area (there are 10 centres overall), all residents of Lithuania would have the access to the health care institutions in one hour. At this time emergency service is available in 15 minutes in the half of the Lithuanian territory. Overall, third part of the patients are maintained by zero level hospitals. Unfortunately, one of these centres (hospital) service 13.5 times less patients than third level canters (p < 0.005). On average, zero level centres provide service for the stationary care 9 times less compared to the third level hospitals (p<0.005). The demand for the zero level centres is insufficient compared to demand for university level care (hospitals). Part of the zero level trauma centres don‘t have sufficient number of specialists of anaesthesiology, reanimatology and traumatology disciplines that could provide continues 24 hour... [to full text]

This study is an investigation of the perspectives and practices of U.K. expert practitioners regarding the accessibility of tests in higher education online learning environments. As a growing area of concern in the higher education field, the accessibility of online tests is a particularly complex and challenging topic. To explore this topic further, twelve U.K. higher education expert practitioners were consulted. Five major themes that were identified by the participants included: 1. Requirement for balance between academic integrity and accessibility; 2. Need for inclusive design to better support the creation and delivery of accessible online tests; 3. Issues related to the mainstreaming of accessible online tests and testing processes; 4. Resources required to support the design and delivery of accessible online tests; and 5. Technology issues and approaches. The participants shared their research findings, experiences, and reflections regarding their work related to different types of online tests and accessibility.

This study is an investigation of the perspectives and practices of U.K. expert practitioners regarding the accessibility of tests in higher education online learning environments. As a growing area of concern in the higher education field, the accessibility of online tests is a particularly complex and challenging topic. To explore this topic further, twelve U.K. higher education expert practitioners were consulted. Five major themes that were identified by the participants included: 1. Requirement for balance between academic integrity and accessibility; 2. Need for inclusive design to better support the creation and delivery of accessible online tests; 3. Issues related to the mainstreaming of accessible online tests and testing processes; 4. Resources required to support the design and delivery of accessible online tests; and 5. Technology issues and approaches. The participants shared their research findings, experiences, and reflections regarding their work related to different types of online tests and accessibility.

Education methodology of people with disabilities is not very well developed and it is the reason why disabled people are facing problems in using of unadapted educational materials. More and more disabled people are choosing distance learning due to its convenience and possibility to learn from home. In most cases materials are presented in hypertext format. There are no sufficient tools for adaptation of hypertext documents for disabled people usage and it makes work with those documents very hard or even impossible. Due to the fact, that preparation of teachers and professors for work with hypertext may be very time consuming and difficult, this thesis’s where trying to use different approach - find a solution for non HTML literate person to adapt HTML documents for disabled people. Set of rules was created and flexible tool lets effectively adapt hypertext materials for disabled.

HEALTH 21, a document of the World Health Organization, stresses the importance of tackling social inequalities in health (WHO Regional Office for Europe, 1999). This issue is especially important in countries that are undergoing rapid social, economic and political reforms. The present socio-economic situation in Lithuania calls for the start of research regarding unemployment and its impact on the health status of this society. The aim of this study is to evaluate the associations of unemployment with health and health care accessibility.This was a cross-sectional study. Questionnaires were distributed to randomly selected unemployed persons who attended the Kaunas Labour Market Office in 2005. The questionnaires were distributed to selected respondents during these meetings. The total number of returned questionnaires was 429 (a response rate of 53.6%). This study adds to the growing evidence of associations between unemployment and poor health. Results indicate that health problems are more prevalent among the long-term unemployed. The long-term compared to the short-term unemployed were more likely to perceive their health negatively, feel shame and loneliness, have poor relations with their family members, be more depressive and have a lower sense of coherence.

Physical separation of students and instructors creates the gap of anonymity. The ability of academic institutions to authenticate students and their academic work at various points during a course is necessary for preserving not only the perceived credibility but also for public safety. This study examines the question of what measures universities with large distance education programs employ to align identity of learners with the academic work they do, as well as examines effectiveness, challenges and barriers to their implementation. The research is undertaken using a multiple case approach and analyzes survey data collected from academic administrators at five officially accredited post secondary institutions in three countries. They are: Athabasca University, Open University UK, Penn State University World Campus, University of Maryland University College and eConcordia– Concordia University's distance learning facility. This study is not an exhaustive attempt to examine all aspect of academic integrity, but rather to create awareness about various learner authentication strategies and also outline challenges and advantages that these measure entail. This study confirms that secure learner authentication in distance education environment is possible. A combination of technology and administrative procedures may facilitate a secure testing environment. Furthermore, with greater pressure to enhance security of learner authentication, the openness of open learning is challenged and may change as we know it. / 2013-05

Pertvarkant pirminės sveikatos priežiūros įstaigų tinklą ir optimizuojant teikiamų paslaugų spektrą, siekiama gerinti socialinių paslaugų prieinamumą ir priimtinumą, todėl aktualu periodiškai tirti pacientų/klientų požiūrį į socialinių paslaugų, teikiamų sveikatos priežiūros įstaigose, prieinamumą bei priimtinumą įvairioms socialinėms grupėms. Darbo objektas: socialinės paslaugos asmens sveikatos priežiūros įstaigose. Darbo tikslas: išanalizuoti socialinių paslaugų prieinamumo ir priimtinumo sveikatos priežiūros įstaigose ypatumus pacientų/klientų požiūriu. Darbo uždaviniai: 1. Aptarti socialinių paslaugų priedermę ir teisės aktus, reglamentuojančius socialinių paslaugų teikimą. 2. Atskleisti socialinių paslaugų integravimo į sveikatos priežiūros sistemą priežastingumą ir svarbą klientų/pacientų sveikatai. 3. Empiriškai ištirti klientų/pacientų požiūrį į asmens sveikatos priežiūros įstaigos teikiamų socialinių paslaugų prieinamumo ir priimtinumo aspektus. Darbo metodai: - Mokslinės literatūros analizė. - Dokumentų analizė. - Kiekybinis tyrimo metodas. VšĮ Varėnos PSPC ir LR VRM Medicinos centro Vilniaus filiale buvo atlikta anketinė pacientų/klientų apklausa. Apklausoje dalyvavo 211 respondentų. Siekiant gerinti socialinių ir sveikatos paslaugų prieinamumą ir priimtinumą klientams/pacientams, nuolat vykdomas veiklos optimizavimas, kuriam įtaką daro Vyriausybės programos, ekonominė ir politinė šalies situacija. Visa tai galima... [toliau žr. visą tekstą] / Reformation of the primary healthcare network and optimization of the spectrum of the provided services are aimed at improving accessibility and acceptability of social services. For this reason, it is highly relevant to perform periodic evaluation of clients’/patients’ attitude towards accessibility and acceptability of social services provided at healthcare institutions to various social groups. The object of the study: social services at personal healthcare institutions. The aim of the study: to analyze the peculiarities of accessibility and acceptability of social services provided at healthcare institutions from the clients’/patients’ perspective. Objectives: 1. To discuss the purpose of social services and legal acts regulating provision of social services. 2. To reveal the reasons for the integration of social services into the healthcare system, and the importance of this integration for clients’/patients’ health. 3. To conduct empirical research on clients’/patients’ attitude towards various aspects of accessibility and acceptability of social services provided at healthcare institutions. Methods of the study: - Analysis of scientific literature. - Analysis of documents. - A quantitative study. A questionnaire-based inquiry of clients was performed at the public institution Varėna Primary Healthcare Center and Vilnius branch of Health Center of the Ministry of Interior of the Republic of Lithuania. In... [to full text]

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The study attempts to investigate the availability, accessibility and utilization of health care services in a rural area. The study has been conducted in one of the rural areas (Ndwedwe) in the Province of KwaZulu Natal (Durban) near the town called Verulam. The Ndwedwe area consists of a population of about 170 000 and the number of households is hard even to estimate because of the geographical setting of the area. The study has been conducted at the centre of the entire area called Ndwedwe central w!:lere the Ndwedwe municipality is located. Most of the people spend most of the time in this area because it has most of the services that are needed by the community. The questionnaires administered and the interviews conducted were systematic because in all the sixteen areas, interviews were conducted (at least two ihterview encounters in one area consisting of the entire Ndwedwe area) and questionnaires were administered the same way. The findings show that the majority of people in the Ndwedwe area do not have enough health care service institutions and the very services are not equally and evenly distributed amongst areas that constitute the entire Ndwedwe area. / Thesis (M.A.)-University of Durban-Westville, 2002