907 resultados para Borderline contradictions
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This study focuses on work commitment creation on rhetorical level, that is to say, the rhetorical and linguistic means that are used to construct or elicit worker commitment. The commitment of the worker is one of the most important objectives of all business communication. There is a strong demand for commitment, identification, or adherence to work in various walks of life, although the actual circumstances are often somewhat insecure and shortsighted. The analysis demonstrates that the actual object of commitment may vary from work itself or work organization to one’s career or professional development. The ideal pattern for commitment appears as comprehensive: it contains affective and rational as well as ideological dimensions. This thesis is a rhetorical discourse analysis, or rhetorical analysis with discourse-analytic influences. Primarily it is a rhetorical analysis in which discourses are observed mainly as tools of a rhetorician. The study also draws on various findings of sociology of work and organizational studies. Research material consists of magazines from three and web pages from six different companies. This study explores repeated discourses in commitment rhetoric, mainly through pointing core concepts and recurrent patterns of argumentation. In this analysis section, a semantic and concept-analytic approach is also employed. Companies talk about ideas, values, feelings and attitudes thus constructing a united and unanimous group and an ideal model of commitment. Probably the most important domain of commitment rhetoric is the construction of group and community. Collective identity is constructed through shared meanings, values and goals, and these rhetorical group constructs that can be used and modified in various ways. Every now and then business communication also focuses on the individual, employing different speakers, positions and discourses associated to them. Constructing and using these positions also paints the picture of an ideal worker and ideal work orientation. For example, the so called entrepreneurship model is frequently used here. Commitment talk and the rhetorical situation it constructs are full of tensions and contradictions; the presence of seemingly contradictory values, goals or identities is constant. This study demonstrates tensions like self-fulfilment and individuality versus conformity, and constant change and development versus dependable establishment, and analyses how they are used, processed and dealt with. An important dimension in commitment rhetoric is the way companies define themselves in respect of current social issues, and how they define themselves as responsible social actors, and how they, in this sense, seek to appear as attractive workplaces. This point of view gives rise to problematic questions as companies process the tensions between, for example, rhetoric and action, ethical ideals and business conditions and so on. For its part, the commitment talk also defines the meaning of waged work in human life. Changing society, changing working life, and changing business environments set new claims and standards for workers and contents of work. In this point of view this research contributes to the study of working life and takes part in current public discussion concerning the meaning, role and future of waged work.
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One of the most crucial tasks for a company offering a software product is to decide what new features should be implemented in the product’s forthcoming versions. Yet, existing studies show that this is also a task with which many companies are struggling. This problem has been claimed to be ambiguous and changing. There are better or worse solutions to the problem, but no optimal one. Furthermore, the criteria determining the success of the solution keeps changing due to continuously changing competition, technologies and market needs. This thesis seeks to gain a deeper understanding of the challenges that companies have reportedly faced in determining the requirements for their forthcoming product versions. To this end, product management related activities are explored in seven companies. Following grounded theory approach, the thesis conducts four iterations of data analysis, where each of the iterations goes beyond the previous one. The thesis results in a theory proposal intended to 1) describe the essential characteristics of organizations’ product management challenges, 2) explain the origins of the perceived challenges and 3) suggest strategies to alleviate the perceived challenges. The thesis concludes that current product management approaches are becoming inadequate to deal with challenges that have multiple and conflicting interpretations, different value orientations, unclear goals, contradictions and paradoxes. This inadequacy continues to increase until current beliefs and assumptions about the product management challenges are questioned and a new paradigm for dealing with the challenges is adopted.
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Atherosclerotic vascular disease is the leading cause of death in the Western world. Its main three manifestations are coronary heart disease, cerebrovascular disease, and peripheral arterial disease. Asymptomatic peripheral arterial disease is usually diagnosed using the ankle brachial index, and values ≤ 0.90 are used to determine the diagnosis. The classical risk factors of peripheral arterial disease, such as smoking and diabetes, are well known and early interventions are mandatory to improve the prognosis. What is not well known is the role of inflammation as a risk factor. Yet, a novel approach to cardiovascular diseases is the measurement of endothelial function. In this thesis, we studied the ankle-brachial index, C-reactive protein and endothelial function in a cardiovascular risk population. A total of 2856 subjects were invited to the study and 2085 (73%) responded. From these subjects, a cohort of 1756 risk persons was screened. We excluded the subjects with previously known cardiovascular disease or diabetes, because they were already under systematic follow-up. Out of the study subjects, 983 (56%) were women and 773 (44%) men. The ankle brachial index and high-sensitivity C-reactive protein were measured from 1047 subjects. Endothelial function was assessed by measuring reactive hyperemia pulse amplitude tonometry from 66 subjects with borderline peripheral arterial disease. In this study, smoking was a crucial risk factor for peripheral arterial disease. Subclinical peripheral arterial disease seems to be more common in hypertensive patients even without comorbidities. The measurement of the ankle brachial index is an efficient method to identify patients at an increased cardiovascular risk. High-sensitivity C-reactive protein did not correlate with the ankle brachial index or peripheral arterial disease. Instead, it correlated with measures of obesity. In a cardiovascular risk population with borderline peripheral arterial disease, nearly every fourth subject had endothelial dysfunction. This might point out a subgroup of individuals in need of more intensive treatment for their risk factors.
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The decrease in morbidity and mortality of pancreaticoduodenectomy in reference centers has increased the incidence of benign histopathologic diagnosis in cases where a pre-operative diagnosis of pancreatic ductal carcinoma was expected (9,2%). Recent reports have shown that autoimune pancreatitis, an entity that can lead to a pathologic diagnosis of sclerosing lymphoplasmatic pancreatitis has been the cause of about 2,5% of wrong preoperative diagnosis. Clinical and image definitive diagnosis is still uncertain on those borderline cases. An increase in IgG4 has been reported as frequent in patients with autoimune pancreatitis which can respond to steroid treatment. In doubtful cases, four diagnosis can be expected: 1. Pancreatic ductal carcinoma; 2. Chronic alcoholic pancreatitis; 3. "Chronic pancreatitis secondary to choledocal lithiasis"; 4. Sclerosing lymphoplasmatic pancreatitis. Modern medical literature sugests that evaluation of IgG4 in doubtful cases of pancreatic tumor (pseudotumor of the pancreas) could avoid unnecessary pancreaticoduodenectomies in the future.
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PURPOSE:To verify the existence of associations between different maternal ages and the perinatal outcomes of preterm birth and intrauterine growth restriction in the city of São Luís, Maranhão, Northeastern Brazil.METHODS:A cross-sectional study using a sample of 5,063 hospital births was conducted in São Luís, from January to December 2010. The participants comprise the birth cohort for the study "Etiological factors of preterm birth and consequences of perinatal factors for infant health: birth cohorts from two Brazilian cities" (BRISA). Frequencies and 95% confidence intervals were used to describe the results. Multiple logistic regression models were applied to assess the adjusted odds ratio (OR) of maternal age associated with the following outcomes: preterm birth and intrauterine growth restriction.RESULTS:The percentage of early teenage pregnancy (12–15 years old) was 2.2%, and of late (16–19 years old) was 16.4%, while pregnancy at an advanced maternal age (>35 years) was 5.9%. Multivariate analyses showed a statistically significant increase in preterm births among females aged 12–15 years old (OR=1.6; p=0.04) compared with those aged 20–35 years. There was also a higher rate in preterm births among females aged 16–19 years old (OR=1.3; p=0.01). Among those with advanced maternal age (>35 years old), the increase in the prevalence of preterm birth had only borderline statistical significance (OR=1.4; p=0.05). There was no statistically significant association between maternal age and increased prevalence of intrauterine growth restriction.
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Kuppikartongin yksi tärkeimmistä ominaisuuksista on reunaimeytymän vastustuskyky, joka tulee olla riittävällä tasolla laadun takaamiseksi. Koska yksinkertainen juomakuppi on bulkki¬tuote, ei sen raakareunaa kannata taloudellisuuden vuoksi suojata tätä varten kehitellyillä menetelmillä vaan itse kartongin tulee vastustaa nesteitä riittävässä määrin. Tämän diplomityön tarkoituksena oli selvittää hydrofobointiin käytettävän massaliiman (hartsi) sekä pintaliiman joukkoon annosteltavan lisäaineen välinen optimaalinen suhde parhaan vastustuskyvyn saavuttamiseksi. Lisäksi selvitettiin joidenkin liimapuristimen ajo-olosuhteiden vaikutusta pintaliiman pick-upiin sekä koneen pH-tason oikeellisuus. Jauhatuksen vaikutusta tutkittiin lähinnä historiatietojen avulla. Tutkimus koostui viidestä tehdasmittakaavaisesta koeajosta, joiden avulla selvitettiin muuttujien vaikutus sisäisellä reunaimeytymän määritysmenetelmällä sekä määrittä¬mällä koepisteistä kulloinkin mielenkiinnon kohteena olleet kemikaalipitoisuudet. Viimeisen koeajon koepisteet jalostettiin lisäksi valmiiksi kupeiksi. Käytetty reunaimeytymän määritysmenetelmä osoittautui virhealttiiksi eivätkä raakakartongista tehtyjen määritysten tulokset korreloineet kovinkaan voimakkaasti PE-päällystettyjen näytteiden kanssa. Menetelmän kehitystä on viety eteenpäin tämän työn rinnalla ja työ jatkuu edelleen. Lisäksi kartongin hartsipitoisuusmääritysten tuloksista paljastui ristiriitaisuuksia, joiden vuoksi menetelmää uusittiin voimakkaasti. Reunaimeytymän vastustuksen riittävyydeksi koneella käytettävien massaliima-annosten tulee olla vähintään valitulla nollatasolla kaikissa kerroksissa ja pintaliiman lisäaine tulee pitää käytössä. Mikäli lisäaine jätetään pois käytöstä, tulee massaliima-annokset olla hyvin korkeita, eikä tämäkään takaa täysin reunaimeytymätöntä lopputuotetta. Lisäaineen ollessa käytössä ei suuremmalla massaliima-annoksella ole puolestaan merkittävää vaikutusta. Konetta ajetaan nykyisin hyvin alhaisella pH-tasolla, mutta tason nostaminen aiheuttaa selvän liimauksen heikkenemisen. Liimapuristimelle tulevan radan kosteudella ja pintaliiman kuiva-aineella ei näyttäisi olevan vaikutusta kartongin reunaimeytymän vastustuskykyyn. Myöskään taustakerroksen koivun jauhatusasteella ei ole merkitystä alueella, jolla koneella operoidaan. CTMP-massan jauhatuksen tulee sen sijaan olla riittävä, jotta keskikerrokseen ei synny yksittäisiä, pitkiä imeytymiä.
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Tutkimuksen tavoitteena oli kuvata ja ymmärtää tunneälymallin osa-alueiden ja transformationaalisen johtamisosaamisen ilmenemistä kosmetiikkatoimialalla toimivan case-yrityksen päälliköiden käytännön esimiestyössä. Aihetta tarkasteltiin teoreettisen viitekehyksen kautta empiirisesti myymäläpäälliköille tehdyn kvalitatiivisen teemahaastattelun ja kvantitatiivisin menetelmin kerätyn johtamisen itsearvion vastausten sekä alaisten antamien arvioiden avulla. Tutkimuksesta nousi esille useita yhteneväisyyksiä ja ristiriitaisuuksia aikaisempiin tunneälyn ja transformationaalisen johtamisen tutkimuksiin. Lähes kaikkien muuttujien tilastollisesti erittäin merkitsevät ja korkeat korrelaatiot nousivat tutkimuksen tuloksista yllätykseksi. Tuloksina havaittiin, että päälliköillä oli hyvin kehittyneet tunneälytaidot interpersonaallisten tekijöiden ja yleisen hyvinvoinnin alueilla sekä karismaattisen ja transaktionaalisen passiivisen johtamisen alueilla. Päälliköiden heikoiten kehittyneet tunneälytaidot olivat paineensietokyvyn alueilla. Johtopäätöksenä voitiin havaita esimiesten luovan positiivista palveluilmastoa sosiaalisen vuorovaikutuksen ja merkitysten luomisen kautta ja siten johtaminen perustui vahvasti käytännönläheiseen realismiin ja korkeaan tunneälyyn.
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Tämä pro gradu- tutkimus tutkii lääkärijohtajuutta, ylilääkäreiden ammatti-identiteettiä ja sen suhdetta rooleihin ja työmotivaatioon. Tutkimus selvittää myös sitä, mistä ylilääkäreiden asiantuntijuus syntyy ja millainen on asiantuntijalääkäri. Tutkimus toteutettiin haastattelemalla viisi ylilääkäriä, joilla on sekä kliinistä että hallinnollista työtä. Analyysi toteutettiin sisällönanalyysin keinoin. Tutkimustulosten perusteella voidaan todeta, että lääkärijohtajuus perustuu kliiniseen osaamiseen ja ammattitaitoon. Ylilääkäreillä on lukuisia rooleja, joista asiantuntijarooli on yksi tärkeimmistä. Ylilääkärin ammatti-identiteetti perustuu koulutukseen ja työkokemukseen. Ammatillinen kasvu alkaa jo opiskeluaikana ja se osittain tietoista suunnan luomista. Toisaalta ammatti-identiteetti on niin vahva, että se voi muuttua huomaamattomaksi. Lääkärin ja johtajan roolien erilaisuus luo ristiriitaa ylilääkärin ammatti-identiteetille.
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L‘interculturel est un concept souvent partagé mais rarement défini dans la recherche alors que ses compréhensions, interprétations et applications sont variées, ce qui mène à des malentendus et des positionnements épistémologiques et méthodologiques ambigus. En parallèle, de nombreuses critiques et propositions de réorientations de la notion voient le jour. Nous entendons faire le point sur la notion et son intégration potentielle dans l‘enseignement de la communication interculturelle (ECI). Notre étude se base sur l‘analyse de six groupes focalisés d‘enseignants (-chercheurs) impliqués dans l‘enseignement de l‘interculturel du niveau supérieur en Finlande, pays du nord de l‘Europe. Nous avons recours aux paradigmes postmodernes et aux sciences du langage (analyse du discours inspirée d‘auteurs français, et plus particulièrement de l‘école française de la deuxième génération (les théories de l‘énonciation (Kerbrat-Orecchioni, 2002 ; Marnette, 2005) et une approche du dialogisme inspirée par Bakhtine (1977))). Ces méthodes permettent de mettre en avant la complexité identitaire en posant l‘hétérogénéité du discours comme principe, c‘est-à-dire qu‘elles considèrent que tout discours inclut la « voix » de l‘autre. Repérer la présence de ces voix dans les discours des enseignants/chercheurs nous a permis de démontrer comment celles-ci participaient à la construction de leur identité pendant l‘interaction. Nous avons pu observer comment les relations entre ces interactions verbales donnaient lieu à des instabilités (contradictions, omissions), dont l‘étude nous a aidée à déduire leur(s) façon(s) de concevoir l‘interculturel. Les discours analysés révèlent a) que la définition de l‘interculturel est partagée sans être perçue de la même manière et b) que les différentes représentations du concept peuvent varier dans le discours d‘un même enseignant, mettant en évidences des contradictions qui posent problème s‘il s‘agit de communiquer un savoir-être aux apprenants. Nous nous sommes efforcée de trouver la place d‘un interculturel renouvelé parmi ces discours et de dissocier l‘image de l‘éducation interculturelle qui est promue en Finlande de ce qui est proposé en réalité : les changements actuels semblent avoir un minimum d‘impact sur la façon dont les enseignants traitent l‘interculturel. Nous nous demandons alors comment l‘Etat finlandais peut promouvoir un enseignement interculturel cohérent sans proposer aux enseignants/chercheurs une formation qui leur permettrait de reconnaitre les diverses diversités impliquées par l‘interculturel. Mots clés : Communication interculturelle, diversité, culture, enseignement supérieur finlandais.
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Strikes provide a current, fresh but also a seldom-addressed issue to study from economic sciences perspective. This study provides to filling this research gap by trying to identify attitudes towards strikes that can be found inside organizations. The research problem this study then sets out to answer is: “What kinds of attitudes exist inside organizations towards industrial actions and how attitudes vary between labour, management and human resources?” This study has been planned with a view to test how qualitative attitudinal research, as a method, is suited to studying a phenomenon such as strike. At the heart of this research approach lies an assumption linked to rhetoric social psychology, that attitude is a phenomenon that can be identified in argumentation. For this research 10 semi-structured interviews in 4 organizations were conducted utilizing statements and pictures as stimulants for discussion. The material was transcribed and analysed following the two levels, categorical and interpretive, demanded by the chosen method. Altogether five attitudes were discovered; three of them negative, one indifferent and one positive by nature. The negative attitudes of unfairness, failure and personification towards strikes represented the side of strikes that was perhaps the most anticipated, portraying the contradictions between employees and employer. The attitude of ordinariness, which portrayed indifference, and the positive attitude of change however, were more unanticipated findings. They reflect shared understanding and trust between conflict parties. The utilization of qualitative attitudinal approach to study strikes was deemed successful. The results of this study support prior literature on workplace conflicts for example in regards of the definition of conflict and typologies conflicts. In addition the multifaceted nature of strikes can be perceived as one statement supported by this study. It arises in the nature of the attitudes, the diversity of discussion themes during the interviews as well as in the extent of possible theories to apply.
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Forming (Arts and crafts) and children’s creative action with materials and tools are less in use in the kindergarten than before. Political focus on children’s early learning has led to shifts in kindergartens toward other specific disciplines, and requirements for individual testing also of the smallest children’s competencies within these. Kindergarten teachers, educators, researchers and participants in social debate have pointed out that there are epistemological contradictions in descriptions of kindergarten quality as well as between current kindergarten policy documents and requirements for the kindergartens’ staff. Meanwhile, the content and methods in many kindergartens are inspired by practice and philosophy in the municipal kindergartens in Reggio Emilia, Italy. Correlation between kindergartens’ formingprojects and experiences from Reggio Emilia is actualized in particular through the workshop and the studio’s role in children’s learning processes. One starting point for the thesis’ problem area is a documented need for more knowledge about kindergarten’s educational content. The overarching goal of the thesis is to develop new knowledge about how learning takes place in kindergarten through examining the field of forming in kindergartens inspired by Reggio Emilia’s atelier culture. The thesis is theoretically anchored within pragmatism, and ties kindergarten’s aesthetic operations with materials and tools to socio-cultural perspective, social constructivism and post humanistic theory. The empirical material is obtained through a qualitative study with ethnography as methodological approach. The fieldwork is conducted in kindergarten, with two leading research questions: 1) How is atelierism perceived and unfolded in Norwegian Reggio Emilia-inspired kindergartens, and 2) how is forming perceived and unfolded in Norwegian Reggio Emilia-inspired kindergartens. A comprehensive and multifaceted material is analyzed, and the results are presented in the form of three themes: The physical environment, Relations and actions in interplay, and Expression forms and forms of expression. Each of these topics are supported by examples from kindergartens’ adult voices and the constructed empirical material. Insights into how learning takes place in the kindergarten subject of forming with inspiration from the Reggio Emilia atelier culture is discussed in the tension between educational philosophy, Nordic kindergarten tradition and neoliberal trends that kindergarten teachers must adhere to. Learning potentials in children’s opportunities for action in forming in light of the atelier appears in the results of the empirical study. The educational context described is characterized by experimental and playful actions where children’s sensations, curiosity and resistance are interacting with the identity of materials and tools. The results imply aesthetic, ethical, democratic and ecological reflections, which are also valid on a practical action level. The thesis contributes to description and understanding of kindergarten’ content and young children’s learning, the importance of atelier culture as inspiration for the kindergarten, and the further development of methodology and documentation of knowledge expressions.
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Pro graduavhanlingens svenska sammanfattning
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Our objective was to estimate the efficacy of the measurement of serum YKL-40 alone or with CA125 as biomarkers for the diagnosis of epithelial ovarian cancer (EOC) using the YKL-40 ELISA kit. An experimental group of 49 ovarian cancer patients included 42 patients with EOC (53 ± 15 years, range: 19-81 years) and 7 patients (48 ± 13 years, range: 29-36 years) with borderline epithelial ovarian tumor. A control group of 88 non-malignant cases included 42 patients (43 ± 10 years, range: 26-77 years) with benign gynecological disease and 46 healthy women (45 ± 14 years, range: 30-68 years) at a teaching hospital. Both YKL-40 (220.1 ± 94.1 vs 61.6 ± 48.4 and 50.1 ± 41.2 ng/mL) and CA125 (524.9 ± 972.5 vs 13.4 ± 7.6 and 28.5 ± 29.6 U/mL) levels were significantly higher (P < 0.05) in patients with ovarian cancer compared to the healthy and non-malignant groups. YKL-40 had 92.9% sensitivity and 94.4% specificity for the diagnosis of EOC. When YKL-40 and CA125 were tested in parallel, the sensitivity was increased to 98.2%, but the specificity was decreased to 81.3%. The correlations between serum YKL-40 and tumor stage, grade histology, performance status, patient age, and extension of debulking surgery were tested. With increasing stage and grade of EOC, preoperative serum YKL-40 levels were significantly increased (P = 0.029, P = 0.05, respectively). Serum YKL-40 alone or with serum CA125 levels are useful, although with some limitations, to diagnose ovarian cancer. Our study showed that YKL-40 may not be an independent prognostic factor for ovarian cancer. This prospective study may be a new trend in looking for biomarkers that optimize diagnosis of ovarian cancer.
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Leprosy is an infectious disease caused by Mycobacterium leprae. The polymerase chain reaction (PCR) has been applied to detect M. leprae in different clinical samples and urine seems to be attractive for this purpose. PCR was used to improve the sensitivity for diagnosing leprosy by amplifying a 151-bp PCR fragment of the M. leprae pra gene (PCR-Pra) in urine samples. Seventy-three leprosy patients (39 males and 34 females, 14 to 78 years old) were selected for leprosy diagnosis at a reference laboratory in Maringá, PR, Brazil. Of these, 36 were under anti-leprosy multidrug therapy with dapsone and rifampicin for tuberculoid (TT) and dapsone, rifampicin and clofazimine for borderline (BB) and lepromatous (LL) forms. The control group contained 50 healthy individuals without any clinical history of leprosy. DNA isolated from leprosy patients’ urine samples was successfully amplified by PCR-Pra in 46.6% (34/73) of the cases. The positivity of PCR-Pra for patients with the TT form was 75% for both patients under treatment and non-treated patients (P = 0.1306). In patients with the LL form, PCR-Pra positivity was 52 and 30% for patients under treatment and non-treated patients, respectively (P = 0.2386). PCR-Pra showed a statistically significant difference in detecting M. leprae between the TT and LL forms of leprosy in patients under treatment (P = 0.0033). Although the current study showed that the proposed PCR-Pra has some limitations in the detection of M. leprae, this method has the potential to be a useful tool for leprosy diagnosis mainly in TT leprosy where the AFB slit-skin smear is always negative.
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Idiopathic dilated cardiomyopathy (IDC) has been hypothesized as a multifactorial disorder initiated by an environment trigger in individuals with predisposing human leukocyte antigen (HLA) alleles. Published data on the association between HLA-DR3 antigen and IDC risk are inconclusive. To derive a more precise estimation of the relationship, a meta-analysis was performed. Studies were identified by searching the PUBMED and Embase database (starting from June 2015). A total of 19 case-control studies including 1378 cases and 10383 controls provided data on the association between HLA-DR3 antigen and genetic susceptibility to IDC. Overall, significantly decreased frequency of HLA-DR3 allele (OR=0.72; 95%CI=0.58-0.90; P=0.004) was found in patients with IDC compared with controls. When stratified by myocardial biopsy or non-biopsy cases, statistically decreased risk was found for IDC in myocardial biopsy cases (OR=0.69; 95%CI=0.57-0.84; P=0.0003). In the subgroup analysis by ethnicity, borderline statistically significantly decreased risk was found among Europeans from 12 case-control studies (OR=0.76; 95%CI=0.58-1.00; P=0.05). In conclusion, our results suggest that individuals with HLA-DR3 antigen may have a protective effect against IDC.