INTRODUÇÃO: Indicadores de qualidade em terapia nutricional (IQTN) são importantes ferramentas de avaliação e monitoramento de qualidade da terapia nutricional (TN). No Brasil, além da escassez de recursos humanos e materiais, a aplicação dos IQTNs,disponíveis para prática clínica, tem sido limitada devido ao seu elevado número. O presente estudo procurou identificar os dezIQTNs mais pontuados, dentre aqueles disponíveis no Brasil, através da avaliação da opinião de especialistas em TN. MÉTODOS: Todos os IQTNs disponíveis para aplicação clínica no Brasil (n=36) foram avaliados em duas fases distintas. Na fase 1 (seleção), especialistas em TN (n=26) pontuaramos IQTNs de acordo com quatro atributos (utilidade, simplicidade, objetividade, e baixo custo), utilizando a escala de Likert com 5 pontos. Os IQTNs foram classificadosem ordem da maior para menor pontuação e a confiabilidade da opinião de especialistas para cada indicador foi avaliada poralfa de Cronbach. Na fase 2, os dez IQTNs selecionados com maior pontuaçãoforam submetidos ànova análise dos especialistas, por meio de duas perguntas fechadas. RESULTADOS: Os dez IQTNs selecionadoscom maior pontuação, em ordem do mais para o menos pontuado, foram 1.) Frequência de realização de triagem nutricional em pacientes hospitalizados, 2.) Frequência de diarreia em pacientes em Terapia Nutricional Enteral, 3.) Frequência de saída inadvertida de sonda de nutrição em pacientes em Terapia Nutricional Enteral, 4.) Frequência de obstrução de sonda de nutrição em pacientes em Terapia Nutricional Enteral, 5.) Frequência de jejum digestório por mais de 24 horas em pacientes em Terapia Nutricional Enteral ou Oral, 6.) Frequência de pacientes com disfunção da glicemia em Terapia Nutricional Enteral e Parenteral, 7.) Frequência de medida ou estimativa do gasto energético e necessidades proteicas em pacientes em Terapia Nutricional, 8.) Frequência de infecção por Cateter Venoso Central em pacientes em Terapia Nutricional Parenteral, 9.) Frequência de conformidade de indicação da Terapia Nutricional Enteral, 10.) Frequência de aplicação de Avaliação Subjetiva Global (ASG) em pacientes em Terapia Nutricional. As opiniões dos especialistas entrevistados foram significantemente consistentes. Durante a fase 2, 96% dos especialistas informaram estar satisfeitos com os 10 IQTNs selecionados, e 100% manifestaram que esta seleção refletiu a mesma opinião anteriormente emitida,na primeira fase do estudo. CONCLUSÃO: A avaliação da opinião de especialistas em TN, com o uso de técnicas psicométricas e ferramentas estatísticas, possibilitou a identificação dedezIQTNsmais pontuados,com consistência e representatividade de opiniões entre eles.A redução do número de trinta e seis IQTNs para os dez presentemente identificados pode contribuir para sua aplicação clínica / BACKGROUND: Quality indicators in nutritional therapy (QINT) are central tools to evaluate and monitor the quality of nutritional therapy. In addition to the scarcity of human and material resources, the application of the QINT available for clinical practice in Brazil has been limited also due to its elevated number. This study attempted to identify the ten more scored QINT that suit in the clinical practice, among those available in Brazil, through evaluating experts in Nutritional Therapy (NT). METHODS: All the 36 available QINTs to the clinical application in Brazil were evaluated in two distinct phases. In the phase 1 (selection), 26 experts in NT rated the QINTs following four attributes (utility, simplicity, objectivity and low cost), on a 5- point Likert scale. The top 10 QINTs were identified from the top 10 scores; and the reliability of the experts opinion to each indicator were evaluated by Cronbachs alpha. In phase 2, the top 10 selected QINTs were subjected in a new experts analysis following two closed questions. RESULTS: The top 10 selected QINTs, from the biggest to the least scored order, were: 1) Frequency of carrying out nutrition screening of hospitalized patients, 2) Frequency of diarrhea in patients on Enteral Nutrition (EN), 3) Frequency of involuntary withdrawal of enteral feeding tubes, 4) Frequency of tube feeding occlusion in patients on EN, 5) Frequency of digestive fasting for more than 24 hours in patients on oral nutrition or EN, 6) Frequency of patients with glycemic dysfunction on NT, 7) Frequency of measurement or estimation of energy expenditure and protein needs in patients on NT, 8) Frequency of Central Venous Catheter infection in patients on Parenteral Nutrition, 9) Frequency of indication compliance of NT 10) Frequency of application of Subjective Global Assessment in patients on NT. The opinions of the experts interviewed were significantly consistent. During the phase 2, 96% of the experts were found to be satisfied with the top 10 selected QINTs, and 100% expressed that the selection of the top 10 QINTs interfered the same opinion in the first phase of the study. CONCLUSION: The evaluation of the experts opinion in NT using psychometrics techniques and statistical tools, allowed the identification of the 10 most scored QINTs, with good applicability in NT and representativeness of opinions among them. The reduction of QINT number from 36 to ten, may contribute to their clinical application

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2017-04-13T14:14:10Z No. of bitstreams: 2 Dissertação - Lucas Gustavo do Nascimento Rigonato - 2017.pdf: 1847894 bytes, checksum: c9cdedf02a07e88f549b7eef0a874772 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2017-04-13T14:14:30Z (GMT) No. of bitstreams: 2 Dissertação - Lucas Gustavo do Nascimento Rigonato - 2017.pdf: 1847894 bytes, checksum: c9cdedf02a07e88f549b7eef0a874772 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2017-04-13T14:14:30Z (GMT). No. of bitstreams: 2 Dissertação - Lucas Gustavo do Nascimento Rigonato - 2017.pdf: 1847894 bytes, checksum: c9cdedf02a07e88f549b7eef0a874772 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2017-03-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / The teaching of Portuguese as a Foreign Language (PLE) has gained prominence in recent years (ALMEIDA FILHO, 2011; FARIA, 2015; FURTOSO, 2015). However, Almeida Filho (2011) calls our attention to the need for research in the area of PLE that re-elaborates the teaching of the language. In this study, I sought to investigate the possible benefits of using an orientation guide during peer review activities in a group of Portuguese as a Foreign Language. Peer review is an activity in which students correct the written text of each other and is premised on the argument that interaction favors learning (FIGUEIREDO, 2006; VYGOTSKY, 1998). For that, the first and second versions of texts written by non-Brazilian exchange students at the Federal University of Goiás (UFG) were contrasted during the first half of 2016. The first language of these students is Spanish. The data were analyzed qualitatively, although some numerical data were used to facilitate the comprehension of the results (NUNAN, 1992). The results demonstrate that peer review activities can be beneficial for language learning as it provides improvement in texts, and students feel benefited by discussing their texts with peers with the aid of an orientation guide. / O ensino de Português como Língua Estrangeira (PLE) tem ganhado destaque nos últimos anos (ALMEIDA FILHO, 2011; FARIA, 2015; FURTOSO, 2015). No entanto, Almeida Filho (2011) nos chama atenção para a necessidade de pesquisas na área de PLE que reelaborem o ensino do idioma. Neste estudo, procurei investigar os possíveis benefícios da utilização de um guia de orientação durante atividades de correção com os pares em uma turma de Português como Língua Estrangeira. A correção com os pares é uma atividade em que os alunos corrigem o texto escrito um do outro e parte da premissa de que a interação favorece a aprendizagem (FIGUEIREDO, 2006; VYGOTSKY, 1998). Para tanto, foram contrastadas as primeiras e segundas versões de textos escritos por estudantes intercambistas na Universidade Federal de Goiás (UFG) no primeiro semestre de 2016, cuja primeira língua é o espanhol. Os dados foram analisados prioritariamente de forma qualitativa, embora alguns dados numéricos tenham sido utilizados para facilitar a compreensão dos resultados (NUNAN, 1992). Os resultados demonstram que a correção com os pares pode ser benéfica para a aprendizagem de línguas, pois proporciona melhoria nos textos, e os alunos sentem-se beneficiados ao discutirem seus textos com os colegas com o auxílio de um guia de orientação.

Vi har undersökt hur instruktionernas utformning inför deltagande i en kamratrespons påverkar högstadieelevers motivation att lära sig samt måluppfyllelse av kunskapskravet att utforma egen undersökning i ämnet biologi. Efter en kort genomgång av hur en egen undersökning ska utformas fick eleverna från tre åk 7 klasser och två åk 8 klasser i uppgift att utforma en egen undersökning i ämnet biologi. Uppgiften var utformad efter nationella provet del 3 från 2017. Vid nästa lektion blev elever indelade i par efter likvärdig måluppfyllelse. Slumpmässigt fick elevparen antingen förenklade, ospecificerade instruktioner som inbjöd till öppen, elevledd dialog eller detaljerade, punktformade instruktioner som uppmuntrade till en specifik innehåll och samtalsstruktur. Vi genomförde en enkät före och efter deltagandet i kamratresponsen som uppmätte elevens motivation att lära sig de olika kunskapskraven för biologi i högstadiet samt elevens upplevelse av deltagandet och sitt eget lärande. Uppgiften bedömdes efter Skolverkets bedömningsmall för rättning av nationella prov. Vi fann inga belägg för att elevers motivation att lära sig kunskapsmålen i ämnet biologi påverkades av varken kamratrespons som helhet eller instruktionernas utformning. Däremot fann vi en högre förbättringsgrad av måluppfyllelse bland de elever som fick de detaljerade, strukturerade instruktionerna jämfört med de förenklade, öppna instruktionerna. Vi drar slutsatserna att kamratrespons är ett användbart pedagogisk verktyg för att ge individuell formativ bedömning som leder till förbättrad måluppfyllelse under arbetes gång i kunskapskravet att forma egen undersökning och att utformningen av instruktionerna bör vara tydliga och detaljerade för att nå maximal resultat.

"The promotion and protection of human rights is important both at the national and international level. However, at the national level, several factors including government excesses tend to negatively affect the status of implementation of human rights. This has led to national human rights situations being measured against international standards. In this regard, different strategies have been developed to ensure compliance with international norms, the most basic of which is that of state reporting. ... This procedure is found in international and regional human rights instruments. Examples are treaties in the United Nations (UN), European, Inter-American and African human rights systems. In the African system, the African Charter on Human and Peoples' Rights is the core human rights instrument. The African Charter is seen as a 'unique' document that represents the 'African' concept of rights. ... Under article 1 of the Charter, state parties undertake to adopt legislative and other measures to give effect to the rights in the Charter. Article 62 obliges each state party to submit every two years, from the date the Charter comes into force, a report on the legislative or other measures taken with a view to giving effect to the rights and freedoms recognised and guaranteed by the Charter. The organ responsible for evaluation of reports is the African Commission on Human and Peoples' Rights (African Commission). ... It should be noted from the outset that the African Commission's competence to ensure effective implementation of the African Charter by member states has been affected due to various problems affecting the state reporting system. The most endemic of these include infrequent and inadequate reporting. ... Chapter one introduces the study, the framework of the problem that the study seeks to address and the methodology to be employed. Chapter two discusses the concept of state reporting, how the system works under the African Charter and the challenges therein. A comparative analysis of other international and regional reporting systems is also made with the chief objective of identifying how they deal with state reporting problems. Chapter three presents an overview of the APRM which includes an analysis of the human rights aspects of the mechanism. Chapter four critically analyses how the APRM can be utilised to help the African Commission address the problems of infrequent and inadequate reporting under the African Charter, and chapter five contains the conclusion and recommendations of the study." -- Introduction. / Thesis (LLM (Human Rights and Democratisation in Africa)) -- University of Pretoria, 2006. / Prepared under the supervision of Dr. Alejandro Lorite at the Department of Law, American University in Cairo, Cairo, Egypt / http://www.chr.up.ac.za/academic_pro/llm1/dissertations.html / Centre for Human Rights / LLM

The present thesis aims to describe teenagers as peer reviewers and explore possible benefits of giving feedback. My study was carried out in two EFL classrooms in year eight in a Swedish lower secondary school, where the pupils were engaged with the written task to write an informative reply letter in English. The teaching unit included negotiations of a joint criteria list, feedback training, peer review, and the production of first and final drafts of the reply letter. Data were collected from multiples sources: texts produced in class, audio- and video-recordings, questionnaires and interviews. My main findings suggest that pupils can learn about writing from giving feedback. By adopting a reader perspective, the pupils raised their genre and audience awareness. Moreover, the peer-reviewed reply letters served as inspiration both in terms of transfer of structure, such as rhetorical organisation, and of ideas and content. Self-reports indicated that the pupils in my study enhanced their ability to self-assess and edit their own writing, which suggests that transferable skills were developed as a result of peer review. As regards micro-level aspects of writing, reading and commenting on peers’ reply letters seemed to influence a smaller number of pupils to transfer patterns and spelling. In their role as peer reviewers, the pupils successfully identified strengths and weaknesses in their peers’ writing, but the feedback comments did not include much specific formative information. My findings contribute to research on L2 writing and peer feedback by showing that younger learners can benefit from giving feedback. This is significant since previous research has mainly been carried out at university and college level. In addition, by combining text analyses, classroom observation and pupils’ self-reports, my study offers a comprehensive understanding of peer review. / Syftet med min licentiatuppsats är att beskriva tonåringar som kamratbedömare och undersöka möjliga fördelar med att ge feedback. Min studie genomfördes i två engelskklassrum i årskurs åtta i en svensk högstadieskola där eleverna  arbetade med att skriva svarsbrev på engelska. Arbetsområdet inkluderade diskussioner om en gemensam kriterielista, träning i att ge feedback, kamratbedömning och skriftlig produktion av utkast och slutlig version av svarsbrevet. Material samlades in från flera olika källor: de texter som skrevs i klassrummet, ljud- och videoinspelningar, enkäter och intervjuer. Mina resultat visar att elevers eget skrivande kan gynnas genom att ge feedback. Genom att de fick ett läsarperspektiv på sitt skrivande ökade elevernas medvetenhet om genre och mottagare. Dessutom fungerade de brev som eleverna läste och gav feedback på som inspiration, vilket visades genom att de överförde disposition och strukturer, samt idéer och innehåll till sitt eget skrivande. Eleverna uttryckte själva att de förbättrade sin förmåga att självbedöma och rätta sina texter, vilket indikerar att det är möjligt att utveckla överförbara färdigheter genom att bedöma andras texter. Ett mindre antal elever överförde ord och grammatiska strukturer från sina kamraters texter, men överlag påverkades skrivandets mikronivå i mindre utsträckning än makronivån (organisation och innehåll). I sin roll som kamratbedömare kunde eleverna  identifiera styrkor och svagheter i sina klasskamraters texter, men deras feedbackkommentarer innehöll relativt lite formativ information. Tidigare forskning inom området har främst utförts på högskole- och universitetsnivå  och mina resultat bidrar till forskning om skrivande i främmande språk och kamratfeedback genom att visa att också högstadieelevers skrivande kan gynnas av att ge feedback.

This paper focuses on peer reviewing as part of the writing process and as a pedagogical strategy that can help students develop their writing and critical thinking skills. To do so, it examines the extent to which peer reviewing can develop English as a foreign language (EFL) students’ ability to evaluate and reflect on their writing in upper secondary school. Moreover, this study investigates whether digital tools can help to facilitate the peer review process. By reviewing and synthesizing ten empirical studies from the period 2013-2020, the study found that students who engage in peer reviewing in writing develop critical thinking skills, self-regulation and evaluation. It further shows that there is a consensus between researchers regarding the usefulness of peer review in developing critical thinking skills. However, the findings indicate the importance of including guided peer review training before peer review activities. Furthermore, there is a strong indication that digital tools can help facilitate the peer review process if used appropriately. Digital tools help engage students in the peer review process since they are able to interact with each other’s texts online. Lastly, the findings of the study are in line with the Swedish national curriculum and the English syllabus for upper secondary school. Therefore, teachers in Sweden should consider the use of familiar digital tools to engage students in peer review to develop their writing and critical thinking skills.

The first chapter describes the situation of the use of industrial robots in the market of machine-building production. The sales volumes of modern robots are considered depending on the industries where they are applied. Comparative statistics on the implementation of robots for performing various operations are also given. The level of robotization in Russia and in the world is analyzed. The advantages and disadvantages associated with the introduction of robots into enterprises are revealed. In the second chapter, the topic of flexible production systems is discussed. The existing systems for designing flexible machining modules are evaluated. It also provides a definition of risk, its evaluation. The types of risks were identified during the implementation of the robotic machine module at the enterprise of the machine-building complex. Methods for determining the magnitude of risks are presented. The third chapter presents the most commonly used tools for risk analysis. The main features of the expert assessment method are considered in details. The sequence of actions of the expert survey is presented. On the basis of the chosen method, an order of actions for assessing the risks of the robotic modules presented in the second chapter of the CAD algorithms was developed. Visual images based on summary tables of each CAD algorithm are constructed. Measures to eliminate intolerable risks are suggested. The master's thesis consists of an explanatory note of 80 pages, 18 figures, 11 tables and includes an introduction, three chapters, conclusion, a list of sources used, consisting of 35 titles, and three appendixes. / В 1-й главе описывается ситуация применения промышленных роботов на рынке машиностроительного производства. Рассмотрены объемы продаж современных роботов в зависимости от отраслей, где они применяются. Также была приведена сравнительная статистика по реализации роботов для выполнения различных операций. Проанализирован уровень роботизации в России и в мире. Выявлены преимущества и недостатки, связанные с внедрением роботов на предприятия. Во 2-й главе затрагивается тема гибких производственных систем. Осуществляется оценка существующих систем проектирования гибких модулей механообработки. Также дается определение риска, его оценки. Были выявлены виды рисков при внедрении роботизированного станочного модуля на предприятии машиностроительного комплекса. Приводятся методы для определения величины рисков. В 3-й главе представлены наиболее часто используемые инструменты для анализа рисков. Рассмотрены более подробно основные особенности метода экспертных оценок. Представлена последовательность действий экспертного опроса. На основе выбранного метода был разработан порядок действий оценки рисков приведенных во второй главе алгоритмов САПР роботизированных модулей. Построены наглядные изображения на основе сводных таблиц каждого алгоритма САПР. Предложены мероприятия по устранению непереносимых рисков. Магистерская диссертация состоит из пояснительной записки объемом 80 страниц, 18 рисунков, 11 таблиц и включает в себя введение, три главы, заключение, список использованных источников, состоящий из 35 наименований, а также три приложения.

In recent years, there have been incidents which decreased people's trust in some organizations and authorities responsible for ratings and accreditation. For a few prominent examples, there was a security breach at Equifax (2017), misconduct was found in the Standard & Poor's Ratings Services (2015), and the Accrediting Council for Independent Colleges and Schools (2022) validated some of the low-performing schools as delivering higher standards than they actually were. A natural solution to these types of issues is to decentralize the relevant trust management processes using blockchain technologies. The research problems which are tackled in this thesis consider the issue of trust in reputation for assessment and review credibility at different angles, in the context of blockchain applications. We first explored the following questions. How can we trust courses in one college to provide students with the type and level of knowledge which is needed in a specific workplace? Micro-accreditation on a blockchain was our solution, including using a peer-review system to determine the rigor of a course (through a consensus). Rigor is the level of difficulty in regard to a student's expected level of knowledge. Currently, we make assumptions about the quality and rigor of what is learned, but this is prone to human bias and misunderstandings. We present a decentralized approach that tracks student records throughout the academic progress at a school and helps to match employers' requirements to students' knowledge. We do this by applying micro-accredited topics and Knowledge Units (KU) defined by NSA's Center of Academic Excellence to courses and assignments. We demonstrate that the system was successful in increasing accuracy of hires through simulated datasets, and that it is efficient, as well as scalable. Another problem is how can we trust that the peer reviews are honest and reflect an accurate rigor score? Assigning reputation to peers is a natural method to ensure correctness of these assessments. The reputation of the peers providing rigor scores needs to be taken into account for an overall rigor of a course, its topics, and its tasks. Specifically, those with a higher reputation should have more influence on the total score. Hence, we focused on how a peer's reputation is managed. We explored decentralized reputation management for the peers, choosing a decentralized marketplace as a sample application. We presented an approach to ensuring review credibility, which is a particular aspect of trust in reviews and reputation of the parties who provide them. We use a Proof-of-Stake based Algorand system as a base of our implementation, since this system is open-source, and it has a rich community support. Specifically, we directly map reputation to stake, which allows us to deploy Algorand at the blockchain layer. Reviews are analyzed by the proposed evaluation component using Natural Language Processing (NLP). In our system, NLP gauges the positivity of the written review, compares that value to a scaled numerical rating given, and determines adjustments to a peer's reputation from that result. We demonstrate that this architecture ensures credible and trustworthy assessments. It also efficiently manages the reputation of the peers, while keeping reasonable consensus times. We then turned our focus on ensuring that a peer's reputation is credible. This led us to introducing a new type of consensus called "Proof-of-Review". Our proposed implementation is again based on Algorand, since its modular architecture allows for easy modifications, such as adding extra components, but this time, we modified the engine. The proposed model then provides a trust in evaluations (review and assessment credibility) and in those who provide them (reputation credibility) using a blockchain. We introduce a blacklisting component, which prevents malicious nodes from participating in the protocol, and a minimum-reputation component, which limits the influence of under-performing users. Our results showed that the proposed blockchain system maintains liveliness and completeness. Specifically, blacklisting and the minimum-reputation requirement (when properly tuned) do not affect these properties. We note that the Proof-of-Review concept can be deployed in other types of applications with similar needs of trust in assessments and the players providing them, such as sensor arrays, autonomous car groups (caravans), marketplaces, and more.

This research explores peer review in the academic writing of ESL university students. It investigates the problem from both qualitative and quantitative perspectives. Overall findings showed no significant differences between the holistic coherence ratings given to the original and final drafts of the group of students exposed to a process approach to writing with peer review. Similarly, there were no significant differences between the holistic coherence ratings of this experimental group and control group on their final drafts. However, the findings of finer-grained comparative analyses of each experimental group student's original and final drafts revealed both positive and negative results with respect to changes made. The study also explores the changes in terms of the peer review process, so attempting to analyse in more qualitative detail how coherence is constituted in student academic writing. / Linguistics and Modern Languages / M.A. (Linguistics)

This thesis argues that truth-telling in high level (nursing home) aged care is a undamentally important aspect of care that ought to reside equally alongside instrumental care. The health of the resident in a nursing home, as with individuals in other care contexts, is directly linked to care provision that allows the resident to be self determining about their care and thus allows them to make reasonable choices and decisions. This qualitative study explores the meaning of truth-telling in the care providerresident dyad in high level (nursing home) aged care. Grounded within the epistemology of social constructionism and the theoretical stance of symbolic interactionism, this study relied on oral and written text from care providers (personal care assistants and registered nurses) and residents. Thematic analysis of data relied on practices within grounded theory to determine their understanding and the conditions and consequences of their understanding about truth-telling in the nursing home. Through an understanding of the relationship-role-residency trinity, truth-telling in high level (nursing home) care comes to be understood. It has been determined that the link between truth-telling and the nature of the care provider-resident (and residents' families) relationship is that both personal carers and nurses in this study premise their understanding of truth disclosure on knowing a resident's (and resident's family's) capacity for coping with the truth and therefore catering for the resident's or family's best interests. The breadth and depth of this knowing and how the relationship is perceived and described determine what care providers will or will not tell. That is, the perceptions both personal carers and nurses have about the relationship - how they describe themselves as 'family like', 'friend' and 'stranger', has implications for the way disclosure operates and is described. Additionally, how care providers perceive and understand their role determines what care providers will or will not tell. That is, the perceptions both carers and nurses have about their own and each other's role - how they describe themselves for example as 'hands-on' carer and 'happy good nurse' has implications for the way disclosure operates and is described. Furthermore, care providers' meaning and understanding of truth-telling in aged care is not possible in the absence of an appreciation of how the care providers give meaning to and come to understand the care circumstance - residency, the aged care facility, the nursing home. That is, the perceptions both personal carers and nurses have about the aged care facility - how they describe residency as 'Home away from Home' (and what this means), as a place of little time and a plethora of situations have implications for the operation of truth-telling as a whole. Recommendations from the study include the implementation of a telling audit to better serve the truth-telling preferences of residents and the reorientation of care practices to emphasise affective care (talk rather than tasks). Furthermore, it is recommended that changes occur to the care provider roles, that care providers define themselves as facilitators rather than protectors, and education be ongoing to improve communication with and care of residents with dementia and those dying. Finally, the language of residency as 'home' needs to capture an alternate philosophy and attendant practices for improved open communication.