The Career Development of Black Female Chief Nurse Executives

This qualitative study was designed to explore the career development of Black female chief nurse executives. Although a small proportion of Black female nurses have achieved positions at the nurse executive level, there remains a paucity of Black female nurse executives in this crucial position which raised the question of what factors contributed to this lack of advancement, but, more important, what factors have contributed to the success of the few who have achieved such level of success in healthcare organizations. The purpose of the study was to explore the career paths of Black female chief nurse executives with a view of understanding the factors which both facilitate and hinder the career development of these leaders in healthcare organizations. The guiding research question was, How do Black female nurse executives in this sample describe their career development? The participants in this study were Black female chief nurse executives located throughout the United States who, for the most part, were raised in segregation with a strong family foundation. To collect data, semistructured telephone interviews were conducted with 10 Black female chief nurse executives throughout the United States. The transcripts from the interviews were transcribed, coded, and analyzed. Using Super’s (1990, 1996), and Gottfredson’s (1981, 1996, 2002, 2005) career development theories and critical race theory (Crenshaw, 1995; Delgado, 2000) as the theoretical framework, the researcher found that the participants’ career development was influenced by (a) strong support system, (b) guidance, (c) influence of diversity, and (d) servant leadership. The findings help us understand the factors that have contributed to their successes as Black chief nurse executives. With the increasingly diverse population and concurrent increasing diversity in nursing and concerns about healthcare disparities, it is imperative that organizations attract, hire, develop, retain, and advance qualified Black nurses. Future studies addressing not only the career development of Black nurses but nurses in general might be informed by the present study’s findings. Recommendations are offered for nursing practice, education, and organizational policy.

Las potencias subregionales en el sistema internacional de posguerra fría: ¿nuevos actores en la política internacional?

En trabajos anteriores, hemos avanzado en la identificación y diferenciación de tres categorías de potencias: potencias mundiales, potencias medias y potencias regionales. Pero, más allá de las potencias mundiales y las potencias medias que se encuentran en el centro del sistema-mundial, y las potencias regionales que se ubican en la semiperiferia, ¿es posible hablar de potencias que se encuentren en la periferia? Como se trata de Estados periféricos, ¿pueden ser calificados como “potencias”? ¿En qué radicaría su relevancia y envergadura? Dichas “potencias” ¿pueden ser agrupadas en una nueva categoría? De ser así ¿qué características compartirían? El objetivo de este documento es proponer una nueva  categoría de potencias en el sistema internacional: las potencias subregionales.

Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: 5-year outcomes of the randomised, non-inferiority, phase 3 CHHiP trial

BACKGROUND: Prostate cancer might have high radiation-fraction sensitivity that would give a therapeutic advantage to hypofractionated treatment. We present a pre-planned analysis of the efficacy and side-effects of a randomised trial comparing conventional and hypofractionated radiotherapy after 5 years follow-up.

METHODS: CHHiP is a randomised, phase 3, non-inferiority trial that recruited men with localised prostate cancer (pT1b-T3aN0M0). Patients were randomly assigned (1:1:1) to conventional (74 Gy delivered in 37 fractions over 7·4 weeks) or one of two hypofractionated schedules (60 Gy in 20 fractions over 4 weeks or 57 Gy in 19 fractions over 3·8 weeks) all delivered with intensity-modulated techniques. Most patients were given radiotherapy with 3-6 months of neoadjuvant and concurrent androgen suppression. Randomisation was by computer-generated random permuted blocks, stratified by National Comprehensive Cancer Network (NCCN) risk group and radiotherapy treatment centre, and treatment allocation was not masked. The primary endpoint was time to biochemical or clinical failure; the critical hazard ratio (HR) for non-inferiority was 1·208. Analysis was by intention to treat. Long-term follow-up continues. The CHHiP trial is registered as an International Standard Randomised Controlled Trial, number ISRCTN97182923.

FINDINGS: Between Oct 18, 2002, and June 17, 2011, 3216 men were enrolled from 71 centres and randomly assigned (74 Gy group, 1065 patients; 60 Gy group, 1074 patients; 57 Gy group, 1077 patients). Median follow-up was 62·4 months (IQR 53·9-77·0). The proportion of patients who were biochemical or clinical failure free at 5 years was 88·3% (95% CI 86·0-90·2) in the 74 Gy group, 90·6% (88·5-92·3) in the 60 Gy group, and 85·9% (83·4-88·0) in the 57 Gy group. 60 Gy was non-inferior to 74 Gy (HR 0·84 [90% CI 0·68-1·03], pNI=0·0018) but non-inferiority could not be claimed for 57 Gy compared with 74 Gy (HR 1·20 [0·99-1·46], pNI=0·48). Long-term side-effects were similar in the hypofractionated groups compared with the conventional group. There were no significant differences in either the proportion or cumulative incidence of side-effects 5 years after treatment using three clinician-reported as well as patient-reported outcome measures. The estimated cumulative 5 year incidence of Radiation Therapy Oncology Group (RTOG) grade 2 or worse bowel and bladder adverse events was 13·7% (111 events) and 9·1% (66 events) in the 74 Gy group, 11·9% (105 events) and 11·7% (88 events) in the 60 Gy group, 11·3% (95 events) and 6·6% (57 events) in the 57 Gy group, respectively. No treatment-related deaths were reported.

INTERPRETATION: Hypofractionated radiotherapy using 60 Gy in 20 fractions is non-inferior to conventional fractionation using 74 Gy in 37 fractions and is recommended as a new standard of care for external-beam radiotherapy of localised prostate cancer.

FUNDING: Cancer Research UK, Department of Health, and the National Institute for Health Research Cancer Research Network.

Slow Oscillations in the Mouse Hippocampus Entrained by Nasal Respiration

Different types of network oscillations occur in different behavioral, cognitive, or vigilance states. The rodent hippocampus expresses prominentoscillations atfrequencies between 4 and 12Hz,which are superimposed by phase-coupledoscillations (30 –100Hz).These patterns entrain multineuronal activity over large distances and have been implicated in sensory information processing and memory formation. Here we report a new type of oscillation at near- frequencies (2– 4 Hz) in the hippocampus of urethane-anesthetized mice. The rhythm is highly coherent with nasal respiration and with rhythmic field potentials in the olfactory bulb: hence, we called it hippocampal respiration-induced oscillations. Despite the similarity in frequency range, several features distinguish this pattern from locally generatedoscillations: hippocampal respiration-induced oscillations have a unique laminar amplitude profile, are resistant to atropine, couple differentlytooscillations, and are abolished when nasal airflow is bypassed bytracheotomy. Hippocampal neurons are entrained by both the respiration-induced rhythm and concurrent oscillations, suggesting a direct interaction between endogenous activity in the hippocampus and nasal respiratory inputs. Our results demonstrate that nasal respiration strongly modulates hippocampal network activity in mice, providing a long-range synchronizing signal between olfactory and hippocampal networks.

O fenômeno da corrupção na esfera pública brasileira

This work aims to understand the phenomenon of corruption in the Brazilian public sphere and its implications for society. It has brought concepts of corruption, and has referred to its highest incidence in the public sphere in the three levels of government (despite its infiltration also in the privative sector) and has called attention to two subjects which intertwine public administration (as a means of ordering social life) and corruption (as a form of denial to the collective welfare). Through literature search whose analysis shows that the phenomenon contains the entire country history, from discovery to present day it was found to be common several dictatorial and democratic political regimes. Finally, it has emphasized the importance and necessity of citizen participation in process, as well as the organization of civil society and media, in addition to highlighting the relevance of autonomy and independence of Powers set for its effective confrontation and fighting

Avaliação da eficiência do sistema de abastecimento de água da APA

A água é um recurso essencial e escasso, como tal, é necessário encontrar medidas que permitam o seu uso de modo sustentável e garantam a proteção do meio ambiente. Devido a esta crescente preocupação assiste-se a um movimento legislativo, nacional e internacional, no sentido de garantir o desenvolvimento sustentável. Surge assim, a Diretiva Quadro da Água e a Lei da Água, que é complementada com legislação diversa. Como elemento constituinte do ciclo urbano da água, os Sistemas de Abastecimento têm sofrido evoluções nem sempre adequadas. É neste contexto que, em Portugal, nascem as diversas ferramentas para a melhoria da gestão dos recursos hídricos. As Entidades Gestoras têm como finalidade a gestão eficiente do bem água, e dispõe de dois importantes instrumentos, o Programa Nacional para o Uso Eficiente da Água e o Guia para o “controlo de perdas de água em sistemas públicos de adução e distribuição”(ERSAR). Esta Gestão passa, não só pela abordagem da problemática das perdas de água, reais e aparentes, como também pela análise do comportamento que origina o desperdício. A APA, enquanto entidade gestora, procura maximizar a eficiência do seu sistema de abastecimento, para tal, foram aplicadas as ferramentas propostas pelo ERSAR. Concluindo-se que este sistema tem um total de perdas de água de 34%, devendo-se estas perdas essencialmente ao envelhecido parque de contadores e perdas nos ramais de distribuição (teórico). As perdas comerciais representam cerca de 69%, o que revela que os volumes de água não faturados (medidos ou não) são muito elevados. Por outro lado, a realização do cálculo do Balanço Hídrico e dos índices de desempenho permitem classificar a performance do sistema de abastecimento e compará-la com os seus objetivos de gestão. Atendendo ao volume de água perdido nos ramais, foram efetuadas medições noturnas, verificando-se que no Porto de Pesca Costeira existe um volume de água escoado não justificado. Neste sentido, elaborou-se um plano de ação para aumentar a eficiência do sistema, ou seja, reduzir as perdas totais de 34% para 15%.

The (Im)possibility of the Intellectual Worker Inside the Neoliberal University

The provocation and point of this paper is that universities of the North during the era of neoliberalism of have been sucked of their human life-giving capacities. What remains are closed doors and bare walls. Lest we give the impression of a hopelessly romantic view of the university (and embark upon a lament for some paradise lost), let us be clear from the outset: there is no such place – and there never has been. As will be outlined below, a consideration of the history of the university reveals it was born and has persistently drawn its life breath from oxygen formed in the tension ridden mix of an impulse to human freedom and accommodation to powers of church, state and capital. But, we contend, history is now the witness to the almost complete dissolution of that tension: to the exhaustion of emancipatory impulses in the service of indoctrination, regulation and accumulation. In the church-state-capital triad, it is the latter that has emerged hegemonic. Importantly, we argue, its dominance has emerged with the rise of what Paul Baran and Paul Sweezy describe as monopoly capital: the move from competitive (small entrepreneurial business) forms to monopolistic (large corporate business) regimes of accumulation (Baran & Sweezy 1966). A central feature of monopoly capitalism is its need for significant financial support of national states and the harnessing of public resources such as universities to feed accumulation. It is no surprise that neoliberalism, despite its neoclassical economic pronouncements, is a ‘big state’ advocate (Harvey 2005). Our argument is that neoliberalism, as the political workhorse of monopoly capitalism, has overseen a makeover of universities so they might behave like a monopoly capitalist corporation. Our time is the time of the near global domination of capital. The university has succumbed. In its colonisation – its capitalisation – the university has not only reinvented itself as a willing ally of capital but has also set about remaking itself in its image.

Higher Education - Border or Boundary? Can Theatre in Education Help Promote a University Education?

With the expansion and increased availability of Higher Education the progression to study for an undergraduate degree has been viewed as a simple stepping stone with examination success a straight - forward border pass. Changes in the funding of degree courses has established a series of more challenging boundaries to entry which demand a rigorous assessment of the benefits of Higher Education. The Widening Participation Unit at The University of Worcester has sought to ease this border crossing for pupils whose parents have not been to university. Their experience from previous projects was that school pupils more easily relate to undergraduate students whose experience of Higher Education is recent and relevant. With this in mind they commissioned the Drama and Performance Department to create a Theatre in Education programme that introduced an awareness of post sixteen options and future choices to challenge Higher Education stereotypes. As a result of this collaboration Why Bother? was created, directed by myself and devised and researched with four students who were studying drama. Their own experiences were used to inform the character development and dealt with worrying as a mature student about integration into full – time education, loss of income after working, the pressures of emotional commitments to partners and being away from home. The programme toured to two thousand year 9 – 11 pupils in Worcestershire and Herefordshire schools in January and May 2011. Devising and touring Why Bother provided students with an opportunity to work as a professional paid TIE team that it is not possible for them to do as part of their undergraduate degree course. My initial research looks at the effectiveness and limitations of this project based on pupil questionnaires and the experiences of the team which are explored within the broader context of TIE and its potential for affecting attitudinal change. This has given rise to a number of questions that need consideration in the development of a new TIE programme aimed at raising the awareness of sixth form students who are about to make the decision whether to apply to university or not. Collaboration with university students in exploring the value of an education that they have subscribed to raises issues of bias and whether their powers of persuasion actually prevent pupils from making their own individual decision. The ethics of promoting a “free” university education seem much less complex than the decision required now which involves balancing the real value against the high financial cost suggested in the working title of Is it Worth it? This paper will present my first attempts to develop research methods and methodologies that will enable me to evaluate the success of this and future TIE.

Vain lakiko lasta suojelee?

Tiivistelmä TURUN YLIOPISTO Oikeustieteellinen tiedekunta Perhe-oikeus VALJAKKA EEVA: Vain lakiko lasta suojelee? Väitöskirja, 219 s. Kesäkuu 2016 Tutkimuksessa tarkastellaan suomalaisen lastensuojelulainsäädännön pitkän ai- kavälin kehitystä 1800-luvun lopulta 2010-luvulle. Tavoitteena on selvittää, mil- lä tavoin lasten suojelun tarvetta on lastensuojelulakeja säädettäessä määritelty ja millaisin keinoin julkinen valta on suojellut lapsia. Tutkimuksessa luodaan myös yleisemmin kuvaa siitä, millaista keskustelua lastensuojelun yhteiskunnallisesta tehtävästä, yksityisen ja julkisen hyvinvointivastuun jakautumisesta sekä julkisen vallan perheen yksityisyyteen puuttuvien toimien tarpeellisuudesta ja oikeutukses- ta on eri aikoina käyty. Tutkimuksessa lastensuojelun käsitettä käytetään sekä laa- jemmassa (Child Welfare) että suppeammassa (Child Protection) merkityksessä. Tutkimus on lapsi- ja oikeuspoliittinen puheenvuoro, jossa lastensuojelun institutionaalisia kehityskulkuja tarkastellaan yhteiskunnassa sosioekonomisesti heikoimmassa asemassa olevan lapsiväestön ja lastensuojelun asiakkaiksi valikoi- tuvien lasten näkökulmasta. Tutkimusote on ongelmalähtöinen ja yhteyshakuinen siten, että tutkimuskysymyksiä tarkastellaan monitieteisesti hallinto- ja sosiaalioi- keudellisessa viitekehyksessä. Tutkimus osoittaa, että tarkasteltaessa lastensuojelua käsitteen suppeam- massa merkityksessä lastensuojeluinstituution rakenteet kuten lasten suojelutar- peen määrittely, suojelun keinot ja lastensuojelulain julkilausutut tavoitteet ovat pysyneet lähes samankaltaisina aina ensimmäisen lastensuojelulain (1936) säätä- misestä lukien. Tarkasteltaessa lastensuojelua käsitteen laajemmassa merkityksessä voidaan lastensuojelussa nähdä tapahtuneen muutoksia. Vähitellen hyvinvointivaltion laajentuessa lastensuojelua koskeva ymmärrys muuttui yhä moniulotteisemmak- si. Lastensuojelu merkitsi 1960-luvulle tultaessa laajaa lapsiväestön hyvinvointia turvaavaa yhteiskuntapoliittista ohjelmaa. Myös sosiaalipolitiikan suunnanmuutos 1990-luvulla ja sen myötä julkisen vallan vastuun kaventaminen merkitsivät muu- tosta lastensuojelussa. Monille yhteiskunnan eri osa-aluille ulottuvien perheiden ja lasten hyvinvointia tavoittelevien politiikkaohjelmien ja niiden toteuttamispyrki- mysten sijaan lastensuojelu kaventui niin käsitteenä kuin käytännön toimintanakin tarkoittamaan lähes yksinomaan sosiaalihuollon erityispalvelua eli lapsi- ja perhe- kohtaista lastensuojelua. Asiasanat: Lastensuojelu, lastensuojelulainsäädäntö, historiallinen kehitys, oikeu- dellinen sääntely, hyvinvointivaltio.

Promoção do envolvimento e da cooperação entre as famílias de alunos que frequentam uma unidade de apoio à multideficiência e a escola

Projeto de Intervenção apresentado à Escola Superior de Educação de Lisboa para obtenção de grau de mestre em Ciências de Educação - Especialidade em Educação Especial

Aconselhamento de produtos de apoio para alunos com NEE: levantamento das estratégias e modelos utilizados pelos CRTIC

Na senda do contexto legislativo de outros países, também Portugal criou uma conjuntura legislativa, no âmbito da Educação Especial, que consagrou a possibilidade de utilização de produtos de apoio, como um recurso ao serviço dos alunos com Necessidades Educativas Especiais (NEE). Entre outras iniciativas, o Ministério da Educação lançou, em 2007, uma rede constituída por 25 centros, designados por Centro de Recursos TIC para Educação Especial (CRTIC) que, entre outras missões, são responsáveis pela avaliação de alunos com NEE tendo em vista a implementação dos produtos de apoio na intervenção educativa junto deste tipo de discentes. É neste contexto que surge a proposta de, com o estudo aqui apresentado, investigar e compreender as práticas atualmente em curso nos CRTIC, nomeadamente no que respeita às estratégias e os modelos aplicados nas avaliações de alunos com NEE, para efeitos de atribuição de produtos de apoio. O referencial teórico que sustentou este estudo foi analisado considerando o contexto legislativo nacional e internacional, que enquadra a utilização deste tipo de recursos junto destes alunos. Considerámos ainda as classificações existentes que caracterizam a diversidade dos produtos de apoio disponíveis no mercado, tendo a presente investigação sido focada no âmbito do aconselhamento tipicamente realizado pelos CRTIC. Por último, fez-se uma reflexão acerca dos processos implicados na prestação de serviços, analisando alguns indicadores de qualidade de serviço aconselhados pela literatura da especialidade. Do ponto de vista metodológico, e atendendo à finalidade desta investigação, delineou-se uma estratégia que permitiu recolher dados provenientes de diferentes fontes, tendo-se desenvolvido um estudo do tipo survey, sustentado por um paradigma pluri-metodológico, cujo corpus de análise proveio da análise documental de relatórios oficiais e de inquéritos por entrevista e por questionário. Estes últimos foram aplicados a todo o universo dos CRTIC (25 centros), tendo-se obtido uma taxa de resposta de 100%. A análise dos dados obtidos revelou que o processo de avaliação desenvolvido por estes centros já tem em conta alguns dos aspetos destacados na literatura, tais como: equipas multidisciplinares; tomada de decisão colaborativa e observação dos fatores ambientais do aluno. Porém, verifica-se que são escassos os CRTIC que disponibilizam um apoio sistemático e continuo aos intervenientes educativos na fase de implementação/utilização dos produtos atribuídos. Sustentados na constatação deste facto, conceptualizámos e prototipámos uma proposta de uma plataforma de apoio à avaliação e monitorização dos produtos de apoio, designada por “Rede NEE”, que visa facilitar a comunicação entre os intervenientes. Esta proposta revela-se inovadora no modo como os pedidos podem ser realizados, contemplando ainda estratégias que poderão facilitar a monitorização dos produtos de apoio atribuídos.

A supervisão pedagógica promotorade práticas reflexivas na escola atual : um estudo de caso

Dissertação apresentada para a obtenção do grau de Mestre em Ciências da Educação na área de Supervisão e Orientação Pedagógica

Minería de oro en el marco de la inseguridad normativa, los grupos de interés y las zonas de exclusión

En este artículo se aborda el tema de la minería en zonas excluibles, por medio de una revisión bibliográfica de la legislación vigente, y se ejemplifican dos casos icono que se han presentado en Colombia en relación con la minería de oro en áreas de protección: el Parque Nacional Yaigojé-Apaporis y el Páramo de Santurbán. En ambos casos se evidencia la falta de coordinación entre las autoridades mineras y ambientales, y el vacío legislativo especialmente en la fase exploratoria, que, además de causar serios impactos ambientales y vulnerar los derechos de minorías étnicas y la población en general, crea inseguridad normativa y grandes costos a las empresas mineras. En un primer momento se describe el panorama jurídico que rige la explotación minera en Colombia, seguido de un contexto técnico del ciclo minero y de las implicaciones desde el punto de vista jurídico de este tipo de explotaciones en áreas protegidas. Luego, se presenta una cronología de los estudios de caso de la minería en un área protegida del sistema de Parques Nacionales y otra de carácter regional, concluyendo que la falta de coordinación entre instituciones deja al sector en un limbo jurídico.

A supervisão pedagógica promotorade práticas reflexivas na escola atual : um estudo de caso

Dissertação apresentada para a obtenção do grau de Mestre em Ciências da Educação na área de Supervisão e Orientação Pedagógica

Slow Oscillations in the Mouse Hippocampus Entrained by Nasal Respiration

Different types of network oscillations occur in different behavioral, cognitive, or vigilance states. The rodent hippocampus expresses prominentoscillations atfrequencies between 4 and 12Hz,which are superimposed by phase-coupledoscillations (30 –100Hz).These patterns entrain multineuronal activity over large distances and have been implicated in sensory information processing and memory formation. Here we report a new type of oscillation at near- frequencies (2– 4 Hz) in the hippocampus of urethane-anesthetized mice. The rhythm is highly coherent with nasal respiration and with rhythmic field potentials in the olfactory bulb: hence, we called it hippocampal respiration-induced oscillations. Despite the similarity in frequency range, several features distinguish this pattern from locally generatedoscillations: hippocampal respiration-induced oscillations have a unique laminar amplitude profile, are resistant to atropine, couple differentlytooscillations, and are abolished when nasal airflow is bypassed bytracheotomy. Hippocampal neurons are entrained by both the respiration-induced rhythm and concurrent oscillations, suggesting a direct interaction between endogenous activity in the hippocampus and nasal respiratory inputs. Our results demonstrate that nasal respiration strongly modulates hippocampal network activity in mice, providing a long-range synchronizing signal between olfactory and hippocampal networks.