953 resultados para Four main Tobacco Manufacturers


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This Special Issue of The Holocene contains 16 research papers based on a symposium at the 11th International Meeting of the European Union of Geosciences held in Strasbourg in April 2001. The aim of the symposium was a state-of-the-art assessment of empirical studies of postglacial marine and terrestrial climatic archives and their integration with numerical climate models. This editorial places the individual papers in the broader context of natural climate variability and anthropogenic impacts on the global climate system, regional differences in climate between maritime and continental areas, and the need for an improved theoretical basis for understanding the underlying causes of environmental change. The focus of the Special Issue is the dynamic and relatively well-understood climate of the North Atlantic and the European realm, where, in relation to the steepest offshore temperature gradient on Earth, observational data are abundant and many recent advances have been made in climate reconstruction from proxy archives. The editorial also contains a summary and overview of the papers included in the four main sections of the Special Issue, which emphasize: (1) numerical modelling experiments; (2) models of glacier buildup and equilibrium-line altitude; (3) marine and terrestrial proxy records of climatic change; and (4) multiproxy palaeoenvironmental reconstruction of a Portuguese lagoonal system.

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Mineralogical, geochemical, magnetic, and siliciclastic grain-size signatures of 34 surface sediment samples from the Mackenzie-Beaufort Sea Slope and Amundsen Gulf were studied in order to better constrain the redox status, detrital particle provenance, and sediment dynamics in the western Canadian Arctic. Redox-sensitive elements (Mn, Fe, V, Cr, Zn) indicate that modern sedimentary deposition within the Mackenzie-Beaufort Sea Slope and Amundsen Gulf took place under oxic bottom-water conditions, with more turbulent mixing conditions and thus a well-oxygenated water column prevailing within the Amundsen Gulf. The analytical data obtained, combined with multivariate statistical (notably, principal component and fuzzy c-means clustering analyses) and spatial analyses, allowed the division of the study area into four provinces with distinct sedimentary compositions: (1) the Mackenzie Trough-Canadian Beaufort Shelf with high phyllosilicate-Fe oxide-magnetite and Al-K-Ti-Fe-Cr-V-Zn-P contents; (2) Southwestern Banks Island, characterized by high dolomite-K-feldspar and Ca-Mg-LOI contents; (3) the Central Amundsen Gulf, a transitional zone typified by intermediate phyllosilicate-magnetite-K-feldspar-dolomite and Al-K-Ti-Fe-Mn-V-Zn-Sr-Ca-Mg-LOI contents; and (4) mud volcanoes on the Canadian Beaufort Shelf distinguished by poorly sorted coarse-silt with high quartz-plagioclase-authigenic carbonate and Si-Zr contents, as well as high magnetic susceptibility. Our results also confirm that the present-day sedimentary dynamics on the Canadian Beaufort Shelf is mainly controlled by sediment supply from the Mackenzie River. Overall, these insights provide a basis for future studies using mineralogical, geochemical, and magnetic signatures of Canadian Arctic sediments in order to reconstruct past variations in sediment inputs and transport pathways related to late Quaternary climate and oceanographic changes.

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Background There is increasing interest in how culture may affect the quality of healthcare services, and previous research has shown that ‘treatment culture’—of which there are three categories (resident centred, ambiguous and traditional)—in a nursing home may influence prescribing of psychoactive medications. Objective The objective of this study was to explore and understand treatment culture in prescribing of psychoactive medications for older people with dementia in nursing homes. Method Six nursing homes—two from each treatment culture category—participated in this study. Qualitative data were collected through semi-structured interviews with nursing home staff and general practitioners (GPs), which sought to determine participants’ views on prescribing and administration of psychoactive medication, and their understanding of treatment culture and its potential influence on prescribing of psychoactive drugs. Following verbatim transcription, the data were analysed and themes were identified, facilitated by NVivo and discussion within the research team. Results Interviews took place with five managers, seven nurses, 13 care assistants and two GPs. Four themes emerged: the characteristics of the setting, the characteristics of the individual, relationships and decision making. The characteristics of the setting were exemplified by views of the setting, daily routines and staff training. The characteristics of the individual were demonstrated by views on the personhood of residents and staff attitudes. Relationships varied between staff within and outside the home. These relationships appeared to influence decision making about prescribing of medications. The data analysis found that each home exhibited traits that were indicative of its respective assigned treatment culture. Conclusion Nursing home treatment culture appeared to be influenced by four main themes. Modification of these factors may lead to a shift in culture towards a more flexible, resident-centred culture and a reduction in prescribing and use of psychoactive medication. 

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Background
Medical students transitioning into professional practice feel underprepared to deal with the emotional complexities of real-life ethical situations. Simulation-based learning (SBL) may provide a safe environment for students to probe the boundaries of ethical encounters. Published studies of ethics simulation have not generated sufficiently deep accounts of student experience to inform pedagogy. The aim of this study was to understand students’ lived experiences as they engaged with the emotional challenges of managing clinical ethical dilemmas within a SBL environment.

Methods
This qualitative study was underpinned by an interpretivist epistemology. Eight senior medical students participated in an interprofessional ward-based SBL activity incorporating a series of ethically challenging encounters. Each student wore digital video glasses to capture point-of-view (PoV) film footage. Students were interviewed immediately after the simulation and the PoV footage played back to them. Interviews were transcribed verbatim. An interpretative phenomenological approach, using an established template analysis approach, was used to iteratively analyse the data.

Results
Four main themes emerged from the analysis: (1) ‘Authentic on all levels?’, (2)‘Letting the emotions flow’, (3) ‘Ethical alarm bells’ and (4) ‘Voices of children and ghosts’. Students recognised many explicit ethical dilemmas during the SBL activity but had difficulty navigating more subtle ethical and professional boundaries. In emotionally complex situations, instances of moral compromise were observed (such as telling an untruth). Some participants felt unable to raise concerns or challenge unethical behaviour within the scenarios due to prior negative undergraduate experiences.

Conclusions
This study provided deep insights into medical students’ immersive and embodied experiences of ethical reasoning during an authentic SBL activity. By layering on the human dimensions of ethical decision-making, students can understand their personal responses to emotion, complexity and interprofessional working. This could assist them in framing and observing appropriate ethical and professional boundaries and help smooth the transition into clinical practice.

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L’idée selon laquelle les enfants sont des sujets à part entière de considérations de justice n’est pas très contestée. Les enfants ont des intérêts qui leur sont propres et ont un statut moral indépendant de leurs parents : ils ne sont ni la propriété de ces derniers ni une simple extension de leur personne. Pourtant, les travaux des plus grands théoriciens de la justice en philosophie politique contemporaine ne contiennent pas de discussion systématique du statut moral et politique des enfants et du contenu de nos obligations à leur égard. Cette thèse contribue à remédier à cette omission à travers l’examen de quatre grandes questions principales. (1) Quelles sont les obligations de justice de l’état libéral envers les enfants ? (2) Quels types de politiques publiques en matière d’éducation des enfants sont moralement légitimes ? (3) Jusqu’à quel point est-il moralement acceptable pour les parents de délibérément forger la vision du monde de leurs enfants ? (4) Quels critères moraux devraient guider l’élaboration de politiques en matière d’éducation morale dans les écoles ? Cette thèse est constituée de quatre articles. Le premier, « Political Liberalism and Children’s Education », aborde les questions du fondement normatif et des implications du principe de ‘neutralité éducative’ ou ‘anti-perfectionnisme éducatif’. Selon ce principe, il n’est pas légitime pour l’État libéral de délibérément promouvoir, à travers ses politiques publiques en éducation, une conception particulière de la vie bonne. L’article défend les idées suivantes. D’abord, ledit principe est exclusivement fondé sur des raisons de justice envers les parents. Ensuite, l’anti-perfectionnisme libéral n’est pas, pour autant, ‘mauvais pour les enfants’, puisqu’une vaste gamme d’interventions politiques dans la vie familiale et l’éducation des enfants sont, de manière surprenante, justifiables dans ce cadre théorique. Le deuxième article, « On the Permissibility of Shaping Children’s Values », examine la question de savoir si les parents ont un droit moral de forger délibérément l’identité, la conception du monde et les valeurs de leurs enfants. L’article développe une critique de la conception anti-perfectionniste des devoirs parentaux et propose un nouvel argument libéral à l’appui d’un droit parental conditionnel de forger l’identité de leurs enfants. L’article introduit également une distinction importante entre les notions d’éducation compréhensive et d’« enrôlement » compréhensif. Le troisième article, « Common Education and the Practice of Liberal Neutrality: The Loyola High School Case », défend trois thèses principales à travers une analyse normative de l’affaire juridique de l’école Loyola. Premièrement, il est légitime pour l’État libéral d’adopter un modèle d’éducation commune fort. Deuxièmement, la thèse selon laquelle la neutralité comme approche éducative serait impossible est injustifiée. Troisièmement, il existe néanmoins de bonnes raisons pour l’État libéral d’accommoder plusieurs écoles religieuses qui rejettent le modèle de la neutralité. Le quatrième article, « Which Moral Issues Should be Taught as Controversial? », critique à la fois le critère ‘épistémique’ dominant pour déterminer quels enjeux moraux devraient être enseignés aux jeunes comme ‘controversés’, et à la fois la manière dont le débat sur l’enseignement des enjeux controversés fut construit au cours des dernières années, d’un point de vue substantiel et méthodologique. L’article propose une manière alternative d’aborder le débat, laquelle prend adéquatement en compte la pluralité des objectifs de l’éducation et un ensemble d’autres considérations morales pertinentes.

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This paper describes a sediment survey undertaken to unravel patterns of distribution and dispersion of trace metals in an Iberian Peninsula northwestern coastal lagoon (Ria de Aveiro). Cadmium, lead, chromium, copper and zinc were analyzed in bottom sediments. Geochemical normalization is performed and two different regression models for each metal versus aluminum are tested and compared using the respective enrichment factors (EF), an estimation of the relative importance of anthropogenic contributions to the studied sediments. Mean sediment quality guideline quotients (mSQGQ) are used to evaluate sediment quality and associated potential risk to biota with effects range low as empirical sediment quality guideline (SQG) in the basis for mSQGQ calculation. Additionally, the geoaccumulation index is calculated to compare studied sediment levels to global baseline levels. The application of SQGs revealed insufficient characterization capability, especially when contrasted to EF calculated from the regression methods. These pointed a mildly enriched system with localized “hot spot” areas. Therefore, it can be considered that bottom sediments in the Ria de Aveiro system are in their majority unpolluted, zinc being the only metal of concern, presenting enrichment in all four main channels. The major rivers outlets (Caster, Antuã, and Vouga) constitute point sources, thus presenting potential risk for biota. Yet, the strong tidal influence creates a damping effect by efficiently redistributing sediment bound metals.

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To gain insights on long-term social-ecological resilience, we examined adaptive responses of small-scale societies to dryland-related hazards in different regions and chronological periods, spanning from the mid-Holocene to the present. Based on evidence from Africa (Sahara and Sahel), Asia (south margin of the Thar desert), and Europe (South Spain), we discuss key traits and coping practices of small-scale societies that are potentially relevant for building resilience. The selected case studies illustrate four main coping mechanisms: mobility and migration, storage, commoning, and collective action driven by religious beliefs. Ultimately, the study of resilience in the context of drylands emphasizes the importance of adaptive traits and practices that are distinctive of small-scale societies: a strong social-ecological coupling, a solid body of traditional ecological knowledge, and a high degree of internal cohesion and self-organization.

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Tämän kandidaatintutkielman tarkoituksena on tutkia johdon laskentatoimen kuukau-siraportointia ja sen kehittämistä case-yrityksen avulla. Tutkielman teoriaosuus muo-dostaa työlle sen teoreettisen viitekehyksen. Empiriaosuudessa käsiteltävä kuukausi-raportoinnin kehittäminen alkaa sen lähtötason määrittelemisellä. Tämän jälkeen tun-nistetaan prosessiin liittyviä kehitystä vaativia asioita sekä pyritään löytämään keinot näiden ongelmien ratkaisemiseksi. Tutkielmassa käytettävä empiirinen aineisto on kerätty laadullisen tutkimuksen mene-telmiä käyttäen. Tähän on kuulunut sekä työnteon havainnointia että haastatteluja. Ha-vainnointi koostui kahden kuukaudenvaihteen raportointiprosessin seuraamisesta. Siitä saatua aineistoa hyödynnettiin erityisesti raportoinnin lähtötason määrittämiseksi. Haastatteluja hyödynnettiin puolestaan prosessin ongelmakohtien tunnistamiseksi ja niiden ratkaisemiseksi. Tutkimuksesta selvisi, että case-yrityksen kuukausiraportointiprosessin lähtötilanne on yleisesti ottaen hyvä. Raportoinnille tunnistettiin kolme keskeistä päämäärää: hyvä ai-kataulutus, korkea automaation taso ja analyysin hyödynnettävyys. Koska kuukausira-portointi on jatkuvasti kehittyvä prosessi, on siinä aina jotain parannettavaa. Tutkimuk-sesta nousikin kolme keskeistä raportointiprosessin kehittämiskohdetta: aikataulutuk-sen ja talousosaston sisäisen kommunikaation haasteet, raportointityökalut sekä tie-don tiedon analyysin ja yksiköiden välisen kommunikaation haasteet. Näistä jokaiseen löydettiin konkreettisia parannusehdotuksia, joita case-yritys voi hyödyntää raportoin-tiprosessin päämäärien saavuttamiseksi.

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Le cordon ombilical humain suscite beaucoup d’intérêt comme source de cellules à des fins de recherche et de thérapie. Quatre types cellulaires majeurs - les cellules épithéliales, stromales, musculaires lisses et endothéliales - composent les tissus solides du cordon ombilical. Quelques-uns de ces types cellulaires ont été utilisés en recherche scientifique depuis longtemps, alors que d’autres commencent à peine à dévoiler leur potentiel. Nous avons développé un protocole unique pour l’extraction séquentielle de tous ces types cellulaires d’un seul cordon ombilical, permettant ainsi la reconstruction à partir d’une même source. La combinaison des techniques de perfusion, immersion et explants a mené à la mise en culture et à l’expansion de ces cellules, dont les cellules épithéliales et les cellules stromales de la gelée de Wharton qui ont été caractérisées plus en détail par l’immunomarquage de protéines spécifiques. Leur potentiel pour la médecine régénératrice a été démontré par la production de tissus par génie tissulaire. Un vaisseau sanguin composé de cellules stromales et de cellules musculaires lisses du cordon ombilical démontra une résistance substantielle à l’éclatement. Les capacités de différenciation des cellules épithéliales ont été étudiées dans le contexte d’une peau bilamellaire reconstruite en combinaison avec des kératinocytes, des fibroblastes dermiques, et des cellules stromales de la gelée de Wharton. Les cellules épithéliales ont montré une différenciation similaire à celle des kératinocytes lorsque cultivées sur des fibroblastes dermiques et exposées à l’air, tandis que sur des cellules stromales du cordon, elles ont subi une désorganisation. Finalement, la différenciation des cellules stromales a été induite en culture vers plusieurs types cellulaires afin de compléter cette étude. L’ensemble des résultats fait ressortir l’importance non seulement de l’influence du milieu physique sur la croissance et la différenciation des cellules, mais également de l’impact de la provenance des cellules sur la qualité des tissus reconstruits.

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Micropapillary serous borderline tumor of the ovary is characterized by a more frequent association with extraovarian, especially invasive, implants. The aim of this study was to report the clinicopathological findings of a rare case of micropapillary serous borderline tumor of the ovary since there are less than 100 similar cases in the published literature. Additionally, the successful management of evisceration that complicated the postoperative stay of the patient is analyzed. The incidence of this severe complication is estimated between 0.29-2.3%. There are four main causes: suture tearing through the fascia, knot failure, suture failure, and extrusion of abdominal contents between sutures placed too far apart. At least 50% of the cases are due to technical error with a potentially lethal result.

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This paper considers the recent focus on citizenship within education by taking curricular reform within Scottish secondary schooling as a case study. In Scotland the Curriculum for Excellence reform places citizenship as one of four main capacities that pupils must work towards as part of their education. A central theme in this reform is the need for students to take a global perspective and work across different disciplines. In this model of citizenship education learners are enabled to develop their sense of citizenship identity in response to a fast-paced world of innovation and change. Citizenship is therefore linked to a futurist agenda, where the learner-citizen is positioned as an ongoing project, as something to be worked at or perhaps worked on. However, this kind of notion of agency is an expression of an ideological construction of the citizen as a flexible resource for society. Such citizens are active in the sense of being adaptive to change through utilizing intellectual skills but without a sense of identity grounded in one's commitments or reflexive engagement with different forms of understanding. The paper offers a critical assessment of this learner-citizen discourse as focusing on ratiocination rather than relational identity.

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This paper considers the recent focus on citizenship within education by taking curricular reform within Scottish secondary schooling and its linkage with higher education as a case study. In Scotland the Curriculum for Excellence reform places citizenship as one of four main capacities that pupils must work towards as part of their education. Likewise, there has been a move in within the Scottish higher education Enhancement Themes framework to include citizenship as part of graduate attributes that students work towards as they progress through their courses. A unifying theme in these reforms is the need for students to take a global perspective and work across different disciplines by, for example, considering how knowledge relates to wider issues such as in relation to sustainable development, e-democracy or human rights. One feature that unites these disparate areas is that, above all, students must learn to be active through the acquisition of appropriate knowledge and skills. In this model of citizenship education, learners are enabled to develop their sense of citizenship identity in response to a fast-paced world of innovation and change. Citizenship is therefore linked to a futurist agenda, where the learner-citizen is positioned as an ongoing project, as something to be worked at or perhaps worked on. However, this kind of notion of agency is an expression of an ideological construction of the citizen as a flexible resource for society. Such citizens are active in the sense of being adaptive to change through utilizing intellectual skills but without a sense of identity grounded in one’s commitments or reflexive engagement with different forms of understanding. The paper offers a critical assessment of this learner-citizen discourse as focusing on ratiocination rather than relational identity.

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A sensing device for a touchless, hand gesture, user interface based on an inexpensive passive infrared pyroelectric detector array is presented. The 2 x 2 element sensor responds to changing infrared radiation generated by hand movement over the array. The sensing range is from a few millimetres to tens of centimetres. The low power consumption (< 50 μW) enables the sensor’s use in mobile devices and in low energy applications. Detection rates of 77% have been demonstrated using a prototype system that differentiates the four main hand motion trajectories – up, down, left and right. This device allows greater non-contact control capability without an increase in size, cost or power consumption over existing on/off devices.

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This paper considers the recent focus on citizenship within education by taking curricular reform within Scottish secondary schooling and its linkage with higher education as a case study. In Scotland the Curriculum for Excellence reform places citizenship as one of the four main capacities that pupils must work towards as part of their education. This is echoed to some extent within higher education through the Enhancement Theme reforms and the focus on graduate attributes. A unifying theme in these reforms is the need for students to work across different disciplines, to develop a cross-disciplinary perspective on the world by, for example, considering issues of sustainability in relation to scientific or technological developments. In this model of curriculum development teaching staff are considered as agents of change, enabling learners to develop their sense of citizenship in response to a fast-paced world of innovation and change. This kind of change is objectified as a need that must be responded to and met if tomorrow’s citizens are to be able to not only cope, but thrive in the world in which they inhabit. As such, the citizen is positioned as an ongoing project, as something to be worked at and worked on. However, this kind of notion of agency cloaks an neoliberal ideological construction of the citizen as a flexible resource for society, and usually in relation to economic output. The paper seeks to subject this construction of the citizen to critical scrutiny in relation to the idea that, in education, learners are developing their ability to be creative and enquiring in order to be adaptive to change.