807 resultados para Hold
Resumo:
Lung cancer leads cancer-related mortality worldwide. Non-small-cell lung cancer (NSCLC), the most prevalent subtype of this recalcitrant cancer, is usually diagnosed at advanced stages, and available systemic therapies are mostly palliative. The probing of the NSCLC kinome has identified numerous nonoverlapping driver genomic events, including epidermal growth factor receptor (EGFR) gene mutations. This review provides a synopsis of preclinical and clinical data on EGFR mutated NSCLC and EGFR tyrosine kinase inhibitors (TKIs). Classic somatic EGFR kinase domain mutations (such as L858R and exon 19 deletions) make tumors addicted to their signaling cascades and generate a therapeutic window for the use of ATP-mimetic EGFR TKIs. The latter inhibit these kinases and their downstream effectors, and induce apoptosis in preclinical models. The aforementioned EGFR mutations are stout predictors of response and augmentation of progression-free survival when gefitinib, erlotinib, and afatinib are used for patients with advanced NSCLC. The benefits associated with these EGFR TKIs are limited by the mechanisms of tumor resistance, such as the gatekeeper EGFR-T790M mutation, and bypass activation of signaling cascades. Ongoing preclinical efforts for treating resistance have started to translate into patient care (including clinical trials of the covalent EGFR-T790M TKIs AZD9291 and CO-1686) and hold promise to further boost the median survival of patients with EGFR mutated NSCLC.
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In the globalising business environment ever fewer market areas remain unknown. Mongolia is yet only considered as an isolated strip between two power states. The purpose of this study is to put Mongolia on the map of academic business research. This is done by describing the transforming network of a foreign company operating in Mongolia. The objective of the study is approached through a case study, which presents the transformation of a Finnish company operating in Mongolia. This study aims at providing understanding on how the foreign case company observes the transformations of its network. The transformation within the case company is reflected to the transformations that occur in the Mongolian business environment. This study was conducted through a qualitative, intrinsic case study approach. The empirical data was gathered by using the method of network pictures. The network pictures were completed with the assistance of themed interviews. In order to be able to analyse the transformation within a network, three different time periods were observed: the past period around 2000, the present around 2014, and the estimated future around 2020. The data was collected from four executives positioned either in Finland, Russia or Mongolia. The respondents have a long experience within the case company, they hold managerial position, and therefore were able to offer valuable data for this study. The analytical framework used to analyse the collected data was built on the industrial network model, the ARA (actors-resources-activities)-model. The study shows that the changing business environment of Mongolia was utilised by the case company. In order to better meet the transforming customer wishes, the case company transformed from being a retailer to being a manufacturer. The case company was able to become a pioneer in the market. Thus, the case company has undergone similar kind of rapid transformation as the economy of Mongolia in entirety. This study shows that the general nature of the ARA-model makes it usable for new research contexts. The initial ARA-model offers a way to identify the dimensions of a network and a mean to understand these dimensions. The ARA-model can be applied to different contexts and to all time dimensions, past, present and future. The managerial recommendations offered in this study are directed towards the managers that plan to start operations in Mongolia. While this study is the first of its kind, it offers a good starting point for the future research on the change of Mongolian business networks. Valuable information could, for example, be obtained from a comparative study between the case company of this study and a multinational mining company operating in Mongolia.
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This thesis discusses the basic problem of the modern portfolio theory about how to optimise the perfect allocation for an investment portfolio. The theory provides a solution for an efficient portfolio, which minimises the risk of the portfolio with respect to the expected return. A central feature for all the portfolios on the efficient frontier is that the investor needs to provide the expected return for each asset. Market anomalies are persistent patterns seen in the financial markets, which cannot be explained with the current asset pricing theory. The goal of this thesis is to study whether these anomalies can be observed among different asset classes. Finally, if persistent patterns are found, it is investigated whether the anomalies hold valuable information for determining the expected returns used in the portfolio optimization Market anomalies and investment strategies based on them are studied with a rolling estimation window, where the return for the following period is always based on historical information. This is also crucial when rebalancing the portfolio. The anomalies investigated within this thesis are value, momentum, reversal, and idiosyncratic volatility. The research data includes price series of country level stock indices, government bonds, currencies, and commodities. The modern portfolio theory and the views given by the anomalies are combined by utilising the Black-Litterman model. This makes it possible to optimise the portfolio so that investor’s views are taken into account. When constructing the portfolios, the goal is to maximise the Sharpe ratio. Significance of the results is studied by assessing if the strategy yields excess returns in a relation to those explained by the threefactormodel. The most outstanding finding is that anomaly based factors include valuable information to enhance efficient portfolio diversification. When the highest Sharpe ratios for each asset class are picked from the test factors and applied to the Black−Litterman model, the final portfolio results in superior riskreturn combination. The highest Sharpe ratios are provided by momentum strategy for stocks and long-term reversal for the rest of the asset classes. Additionally, a strategy based on the value effect was highly appealing, and it basically performs as well as the previously mentioned Sharpe strategy. When studying the anomalies, it is found, that 12-month momentum is the strongest effect, especially for stock indices. In addition, a high idiosyncratic volatility seems to be positively correlated with country indices on stocks.
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The addition of okara flour to an emulsified meat product (Frankfurter type sausage) was evaluated based on the physical, chemical, technological, and sensory characteristics of the final product. Okara, residue from soymilk production, was provided by two soymilk producing companies whose production systems were based on the hot disintegration of the decorticated (company B) or undecorticated (company A) soybeans. The okara was dehydrated using a flash dryer and then ground into flour (>420 µm). However, The okara flours A and B showed approximately the same amount of protein (35 and 40 g.100 g-1 dwb). However, the okara flour A presented higher values (p < 0.05) for all technological functional properties studied (emulsification capacity, emulsion stability, protein solubility, and water hold capacity) than those of okara flour B. The A and B okara flours were used in a frankfurter sausage formulation as substitution of 1.5% and 4% of meat. The results showed that the sausages containing okara flours A and B, as well as the control sausage, were accepted by the sensory panel. Moreover, there were no significant differences (p < 0.05) in the physical (color, objective texture, and emulsion stability) and chemical (pH and proximate composition) measurements of the sausages with and without the okara flour.
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Starches and gums are hydrocolloids frequently used in food systems to provide proper texture, moisture, and water mobility. Starch-gum interaction in food systems can change the starch granule swelling and its gelatinization and rheological properties. In this study, the effect of the addition of xanthan gum (XG), sodium carboxymethyl cellulose (SCMC), and carrageenan (CAR) at the concentrations of the 0.15, 0.25, 0.35 and 0.45% (w/v) on the pasting, thermal, and rheological properties of cassava starch was studied. The swelling power (SP) and the scanning electron microscopy (SEM) of the starch gels were also evaluated. The results obtained showed that xanthan gum (XG) had a strong interaction with the cassava starch penetrating between starch granules causing increase in pasting viscosities, SP, storage and loss (G', and G", respectively) modulus and reduction in the setback of the starch; sodium carboxymethyl cellulose (SCMC) greatly increased the pasting viscosities, the SP, and the storage and loss (G', and G", respectively) modulus of the starch-mixtures, mainly due to its greater capacity to hold water and not due to the interaction with cassava starch. Carrageenan (CAR) did not change any of the starch properties since there was no interaction between this gum and cassava starch at the concentrations used.
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The aim of this thesis was to examine how aquatic organisms, such as fish, behave in an altered environmental condition. Many species of fish use vision as their primary tool to gain information about their surrounding environment. The visual conditions of aquatic habitats are often altered as a result of anthropogenic disturbance, such as eutrophication that initiates algal turbidity. In general, turbidity reduces the visibility and can be hypothesized to have an influence on the behaviour of fish. I used the three-spined stickleback (Gasterosteus aculeatus) as a model species and conducted four studies in the laboratory to test how algal turbidity affects its behaviour. In this thesis, two major behavioural aspects are discussed. The first is antipredator behaviour. In study I, the combined effects of turbidity and shoot density on habitat choice (shelter vs open) behaviour was tested on a group of sticklebacks (20 fish) in the presence and absence of piscivorous perch (Perca fluviatilis). In study II, I examined the behavioural responses of feeding sticklebacks when they were exposed to the sudden appearance of an avian predator (the silhouette of a common tern, Sterna hirundo). The study was done in turbid and clear water using three different groups sizes (1, 3 and 6 fish). The second aspect is foraging behaviour. Study III & IV focused on the effects of algal turbidity on the foraging performance of sticklebacks. In study III, I conducted two separate experiments to examine the effects of turbidity on prey consumption and prey choice of sticklebacks. In this experiment turbidity levels and the proportion of large and small prey (Daphnia spp.) were manipulated. In study IV, I studied whether a group of six sticklebacks can distribute themselves according to food input at two feeding stations in a way that provided each fish with the same amount of food in clear and turbid water. I also observed whether the fish can follow changes in resource distribution between the foraging patches. My results indicate an overall influence of algal turbidity on the antipredator and foraging behaviour of sticklebacks. In the presence of a potential predator, the use of the sheltered habitat was more pronounced at higher turbidity. Besides this, sticklebacks reduced their activity levels with predator presence at higher turbidity and shoot density levels, suggesting a possible antipredator adaptation to avoid a predator. When exposed to a sudden appearance of an avian predator, sticklebacks showed a weaker antipredator response in turbid water, which suggests that turbidity degrades the risk assessment capabilities of sticklebacks. I found an effect of group size but not turbidity in the proportion of sticklebacks that fled to the shelter area, which indicates that sticklebacks are able to communicate among group members at the experimental turbidity levels. I found an overall negative effect of turbidity on food intake. Both turbidity and changes in the proportion of prey sizes played a significant role in a stickleback’s prey selection. At lower turbidity levels (clear <1 and 5 NTU) sticklebacks showed preferences for large prey, whereas in more turbid conditions and when the proportion of large to small prey increased sticklebacks became increasingly random in their prey selection. Finally, my results showed that groups of sticklebacks disperse themselves between feeding stations according to the reward ratios following the predictions of the ideal free distribution theory. However, they took a significantly longer time to reach the equilibrium distribution in turbid water than in clear water. In addition, they showed a slower response to changes in resource distribution in a turbid environment. These findings suggest that turbidity interferes with the information transfer among group foragers. It is important to understand that aquatic animals are often exposed to a degraded environment. The findings of this thesis suggest that algal turbidity negatively affects their behavioural performance. The results also shed light on the underlying behavioural strategies of sticklebacks in turbid conditions that might help them adapt to an altered environmental situation and increase their survival. In conclusion, I hold that although algal turbidity has detrimental effects on the antipredator and foraging behaviour of sticklebacks, their behavioural adjustment might help them adapt to a changing environment.
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This dissertation examines parental disciplinary violence against children in authority records and in the criminal procedure in Finland. The main aim is to analyze disciplinary violence, how it is defined, and how it is constructed as a crime by social workers, the police, and parents. This dissertation consists of four sub-studies and a summary article. In the first sub-study, I examine how disciplinary violence appears in child welfare documents and analyze the decision-making processes and measures taken by the child welfare workers. The second sub-study, utilizing police interview data, examines police officers’ perceptions of disciplinary violence, its criminalization, and its investigation. In addition to this analysis of police officers’ own perceptions, in the third sub-study, I use reports of crime and pre-trial investigation documents to look at what a typical suspicion of disciplinary violence coming to the attention of the police is and examine the decision-making processes of the police. Utilizing authority data, the fourth sub-study analyzes how parents rationalize the use of disciplinary violence to the authorities investigating these suspicions. The research provides findings that are unprecedented in Finland. Firstly, it was shown that social workers’ decision-making processes in suspicions of disciplinary violence follow three pathways of reasoning, with many factors taken into consideration; and in less than one-third of the cases, a request for criminal investigation has been made to the police. Secondly, it was verified that police officers hold different perceptions of disciplinary violence, and these perceptions have multiple effects on the investigation of these cases and the construction of disciplinary violence as a crime. Thirdly, the analysis of the reports of crime and pre-trial investigation documents showed that almost two-thirds of the cases of disciplinary violence had been sent to a prosecutor by the police and, thus, defined as a crime. However, in many cases, acts of disciplinary violence were often seen as ‘educational, petty one-off incidents’ and a possible trial and punishment for the perpetrator were seen as unreasonable. Fourthly, it was found that parents often try to neutralize and rationalize the violence they have used against their children, for example, either by denying the victim, the criminal intent, or the entire act, or relying on the necessity of the forbidden act. The dissertation concludes that disciplinary violence is defined and constructed in authority policies and practices, first and foremost, by the severity of the act, the nature of the act as continuous or singular, the perceived harm caused by the act to a child, and the perceptions of authorities regarding physical punishment of children. The asymmetrical power setting present in disciplinary violence and parents’ legitimized right to raise and discipline their children partly seem to explain why criminal-law processing of these suspicions of violence and understanding these as crimes is difficult. Finally, this research calls for more coherent and consistent authority practices and policies, achieved by educating authorities and increasing awareness on disciplinary violence, questions the need for a concept like ‘disciplinary’ violence, and suggests more emphasis on unambiguous perceptions of a child’s best interest.
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SUMMARY Organizational creativity – hegemonic and alternative discourses Over the course of recent developments in the societal and business environment, the concept of creativity has been brought into new arenas. The rise of ‘creative industries’ and the idea of creativity as a form of capital have attracted the interests of business and management professionals – as well as academics. As the notion of creativity has been adopted in the organization studies literature, the concept of organizational creativity has been introduced to refer to creativity that takes place in an organizational context. This doctoral thesis focuses on organizational creativity, and its purpose is to explore and problematize the hegemonic organizational creativity discourse and to provide alternative viewpoints for theorizing about creativity in organizations. Taking a discourse theory approach, this thesis, first, provides an outline of the currently predominant, i.e. hegemonic, discourse on organizational creativity, which is explored regarding themes, perspectives, methods and paradigms. Second, this thesis consists of five studies that act as illustrations of certain alternative viewpoints. Through these exemplary studies, this thesis sheds light on the limitations and taken-for-granted aspects of the hegemonic discourse and discusses what these alternative viewpoints could offer for the understanding of and theorizing for organizational creativity. This study leans on an assumption that the development of organizational creativity knowledge and the related discourse is not inevitable or progressive but rather contingent. The organizational creativity discourse has developed in a certain direction, meaning that some themes, perspectives, and methods, as well as assumptions, values, and objectives, have gained a hegemonic position over others, and are therefore often taken for granted and considered valid and relevant. The hegemonization of certain aspects, however, contributes to the marginalization of others. The thesis concludes that the hegemonic discourse on organizational creativity is based on an extensive coverage of certain themes and perspectives, such as those focusing on individual cognitive processes, motivation, or organizational climate and their relation to creativity, to name a few. The limited focus on some themes and the confinement to certain prevalent perspectives, however, results in the marginalization of other themes and perspectives. The negative, often unintended, consequences, implications, and side effects of creativity, the factors that might hinder or prevent creativity, and a deeper inquiry into the ontology and epistemology of creativity have attracted relatively marginal interest. The material embeddedness of organizational creativity, in other words, the physical organizational environment as well as the human body and its non-cognitive resources, has largely been overlooked in the hegemonic discourse, although thereare studies in this area that give reason to believe that they might prove relevant for the understanding of creativity. The hegemonic discourse is based on an individual-centered understanding of creativity which overattributes creativity to an individual and his/her cognitive capabilities, while simultaneously neglecting how, for instance, the physical environment, artifacts, social dynamics and interactions condition organizational creativity. Due to historical reasons, quantitative as well as qualitative yet functionally- oriented studies have predominated the organizational creativity discourse, although studies falling into the interpretationist paradigm have gradually become more popular. The two radical paradigms, as well as methodological and analytical approaches typical of radical research, can be considered to hold a marginal position in the field of organizational creativity. The hegemonic organizational creativity discourse has provided extensive findings related to many aspects of organizational creativity, although the con- ceptualizations and understandings of organizational creativity in the hegemonic discourse are also in many respects limited and one-sided. The hegemonic discourse is based on an assumption that creativity is desirable, good, necessary, or even obligatory, and should be encouraged and nourished. The conceptualiza- tions of creativity favor the kind of creativity which is useful, valuable and can be harnessed for productivity. The current conceptualization is limited to the type of creativity that is acceptable and fits the managerial ideology, and washes out any risky, seemingly useless, or negative aspects of creativity. It also limits the possible meanings and representations that ‘creativity’ has in the respective discourse, excluding many meanings of creativity encountered in other discourses. The excessive focus on creativity that is good, positive, productive and fits the managerial agenda while ignoring other forms and aspects of creativity, however, contributes to the dilution of the notion. Practices aimed at encouraging the kind of creativity may actually entail a risk of fostering moderate alterations rather than more radical novelty, as well as management and organizational practices which limit creative endeavors, rather than increase their likelihood. The thesis concludes that although not often given the space and attention they deserve, there are alternative conceptualizations and understandings of organizational creativity which embrace a broader notion of creativity. The inability to accommodate the ‘other’ understandings and viewpoints within the organizational creativity discourse runs a risk of misrepresenting the complex and many-sided phenomenon of creativity in organizational context. Keywords: Organizational creativity, creativity, organization studies, discourse theory, hegemony
Resumo:
Contrasting with the 1929 great crisis, authorities intervened forcefully in 2008 to stop the disintegration of the financial system. Governments and central banks then sought to revise the prudential regulation in depth. It would be optimistic, however, to believe that prudential measures, alone, could deliver full economic recovery, at least in the countries that had been involved in the financial turmoil. Indeed, the collapse of the "state of confidence" and the negative effects of private debts on consumption and investment decisions have fed depressive forces and policy challenges which could hold for a while, even once the financial sector is made safe. On the one hand, the economic slowdown and the direct and indirect assistance provided by the governments to the private sectors are having a heavy impact on public finances, meanwhile, on the other hand, the massive amounts of money which artificially inflated the prices of housing and financial products could produce inflationary pressures in the post-crisis period, unless a new assets bubble is allowed for. Authorities could therefore be facing high unemployment in a damaged context of public deficits and inflationary pressures. The paper aims at discussing these new challenges. The inadequacy of inflation targets and fiscal orthodoxy in a depressed economy is emphasized, and the outlines of a Post Keynesian alternative policy are examined.
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In the background of the thematic The Eldest – life is acquiring one finds both previews and myths. Wisdom belongs to these myths. The hermeneutical philosophy refers to thinking as o movement from myth to logos in a dialogical oneness. The research uncovers dimensions in the element wisdom as empowered. The experiences of older are saved for further learning and transformation to younger with reference to vulnerable situations where common regulations are no more usefull. The interest goes to an Eldest. The Eldest in the study is pictorial in accordance to the main literature in the study.The Eldest is etymological, fictive and symbolic: – a man who understands higher matters of life, even Gods holy matters. She will set the fulfillment of others as the highest endowment out of an innermost ethos and an innermost wisdom. The innermost is wisdom. The aim is to discover a meaningful message in life is acquiring. In order to see and to learn from the experiences the study aim to uncover the innermost, an innermost wisdom out of a caritative approach. This innermost is anticipated as a longing for unity and health in dayly matters and in a caring ability for the other. The main overstatement is: What will this most meaningfull and innermost by the Eldest out of a living in factual life mirrored in a caring perspective be? Two questions expired; what will the meaningful message in the acquiring be? What will the innermost wisdom in serving the good be? This message and its innermost wisdom will get an expanded meaning out of a caring sentence: Man who dare – seeing back with gratitude, seeing forward in confidence, seeing aside with love and upward in fate wear that dignity, that holiness and that mercy and empathy which belong to life in its basics. The persons attending the research are situated in two contexts. One group has roots in the Lutheran church and the other in a caring profession. The datamaterial is formed out of the usages from these persons, from the spoken (conversation) and the written word (a guestbook). The usages as particular and common are continually integrated in the leading caring sentence from the beginning of the study to the end. The usages stand by the methodological for the final message and wisdom and at the same they form the operative dimension in the study, the evident and the validity. The overarching methodological approach is in the hermeneutic philosophy in accordance with the abductive logic. The usages out of two research groups are most significant in this deductive, inductive and abductive strategy. The usages from the research groups are confronted with the caring sentence in dialogical spaces, halts. The meaning and the innermost searched for will be pictured through the abductive and hermeneutic interpretation and will stand for an articulation of and a successively expansion of meaning. A twine of horizons out of the entire dissemination, the deductive and the inductive, creates the result, as the final message as the ground for an understanding of an even more embracing meaning in an innermost wisdom. The identified bearing movement in the groups in accordance with the caring sentence goes for something higher, something higher than me, to the wellbeing of the other. A conclusion is made and a thesis is identified. This thesis is out from the usages: What can I do in a creating of this caritative? An antithesis is also identified, is a man able to look outside one own and go to something higher, something greater? The synthesis is articulated as a dialogical movement from something … to something higher. The bridge could be maturation, transcendence, the divine or wisdom. The statement finds its root in the attending groups but a difference is also identified. This higher matter is different. The contexts and their meaningfulness decide. A final statement is: learn to see man and her matters hold in life.
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The purpose of this study was to explore the employer brand image and its formation of a Finnish (yet international) service company in B2B sector. In the research qualitative case study method was used to explore the most preferred attributes in employer attraction, the employer brand perceptions towards the case company, and the effectors behind these brand perceptions among the prospective group of employees. The research was conducted through in-depth semistructured interviews among 23-30 undergraduate or graduate business students in Finnish universities close to their graduation. After deriving the attributes of an attractive employer, and exploring their relation to the case company, the employer brand image of the case company was determined and its attractiveness level evaluated. Moreover, the formation of the employer brand image was investigated and its sources detected. The most important factors for the target group in employer attractiveness were found to be company reputation and company culture/work atmosphere. Also career opportunities and international opportunities were seen important. The case company was found to hold a positive, attractive image on company culture and international opportunities, but failing to hold a good reputation as a fair employer. The main and most impactful source of employer brand image was former and current employees - directly or indirectly. Company’s own actions played only small part in employer brand formation as credibility is a critical factor in brand image formation and corporate communication found not to be perceived genuine. Based on the findings, suggestions for further employer branding were made.
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Globalization and the developments of supply chain have made inexpensive labor and the low production costs of developing countries available to businesses worldwide. Unfortunately, these developments have also led to the exploitation of human and natural resources. The increasing supply of cheap and fashionable clothing has created a contradiction between consumers’ concerns for sustainability and their purchase behavior in the fashion industry. Since the uncovering of several sweatshop scandals in the 1980’s and 1990’s ethical fashion brands have started to emerge. Ethical fashion has sparked the interest of consumers and studies have shown promising positive attitudes towards it. However, these attitudes have failed to translate into action and purchase behavior of ethical fashion has not reached the expectations. In order to translate the positive attitudes into buying companies must understand consumer’s motivations and reasons behind the purchase decision. The objective of this study is to understand the antecedents behind young consumer’s purchase intention of ethical fashion. The study is based on the theory of planned behavior which has been widely used to study consumer behavior and purchase decisions. The theory has also been used in ethical decision-making and fashion context before. According to the theory, in order to understand purchase intentions consumer’s attitudes toward buying ethical fashion were studied. The theory also states that attitudes are formed from beliefs, thus, consumer’s beliefs about the fashion industry were studied. To contribute to existing research, the effect of sweatshop issues and environmental issues were compared. The data was collected from university students (n=617) with an online survey. The results were analyzed by statistical methods and they revealed that young Finnish consumers hold positive attitudes towards buying ethical fashion as well as positive purchase intentions of ethical fashion. A strong relationship was found between positive attitudes and positive purchase intentions. Also, the more negative consumers’ beliefs of the fashion industry were the more positive their attitudes toward buying ethical fashion were. In contradiction to previous research this study revealed that environmental issues had greater effect on attitudes than sweatshop issues. Interesting differences between consumers were found depending on their field of education. Students from humanities and social sciences held the most negative beliefs as well as most positive attitudes and purchase intentions of ethical fashion.
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This qualitative study examined the effects of hospital restructuring on a group of nurses at a community hospital. Eleven nurses were asked questions in order to gain insight into their experience in this situation. Ten of these participants were female, and one was male. The intent was to gather information about how restructuring has affected their lives, including, their motivational factors and barriers to participation in continuing education, and their descriptions of their workplace environment. Audiotaped interviews were conducted on two occasions to obtain this data. Emergent themes included the nurses' comments about continuing education, motivational factors, barriers that included geography and time, reactions of co-workers, restructuring, the College of Nurses' Quality Assurance Program including peer feedback, and performance appraisals. The literature review compares the barriers and motivational factors to the previous research findings. Thus, this study gave voice to the experience of this group of nurses, working in a healthcare setting that is involved in restructuring. This information is important to the healthcare system, since many areas are involved in restructuring. The whole process, if it is to be successful, depends on the frontline workers, namely the nurses. Thus, if there is anything to be learned from this group of people, that could be used to improve this progression, everyone would benefit from this information, were it to be implemented. Everyone is a stakeholder in the quality of healthcare in our province. The frontline workers are the ones that hold the vantage point to be able to provide suggestions for the changes needed to successful. These nurses are not just motivated by work issues however, and educating them and motivating them will also improve the care provided through increased knowledge and enhanced self-esteem.
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Autism is a developmental disorder that is characterized by abnonnal social interactions and communications as well as repetitive and restricted activities and interests. There is evidence of a genetic component, as 5% of younger siblings are diagnosed if their older sibling has been diagnosed. Autism is generally not diagnosed until age 3 at the earliest, yet it has been shown that early intervention for children with autism can greatly increase their functioning. Because of this, it is important that symptoms of autism are identified as early as possible so that diagnosis can occur as soon as possible to allow these children the earliest intervention. This thesis was divided into two parts. The first looked at the psychometrics of two proposed measures, the Parent Observation Checklist (POC), administered monthly, and the Infant Behavior Summary Evaluation (mSE), administered bimonthly, to see if they can be used with the infant population to identify autistic symptoms in infants who are at high risk for autism or related problems because they have an older sibling with autism. Study 1 reported acceptable psychometric properties of both the POC and IBSE in terms of test-retest reliability, internal consistency, construct validity and predictive validity. These results provide preliminary evidence that parent report measures can help to detect early symptoms of ASD in infants. The POC was shown to differentiate infants who were diagnosed from a matched group that was not diagnosed by 3 years of age. The second part of this thesis involved a telephone interview of parents who reported developmental and/or behavior problems in their high-risk infants that may be early signs of Autism Spectrum Disorder (ASD). During the interview, a service questionnaire was administered to see what interventions (including strategies recommended by the researchers) their at risk infants and affected older siblings were receiving, how satisfied the parents were with them and how effective they felt the interventions were. 3 Study 2 also yielded promising results. Parents utilized a variety of services for at risk infants and children with ASD. The interventions included empirically validated early intervention (e.g., ABA) to non-empirically validated treatments (e.g., diet therapy). The large number of nonempirically validated treatments parents used was surprising, yet parents reported being involved and satisfied, and thought that the services were effective. Parents' perceptions of their stress levels went down slightly and feelings of competence rose when they accessed services for their infants. Overall, the results of this thesis provide new evidence that parent-report methods hold promise as early detection instruments for ASD in at-risk infants. More research is needed to further validate these instruments as well as to understand the variables related to the parents' choice of early intervention for their at risk and affected children.
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"I began these pages for myself, in order to think out my own particular pattern of living, my own individual balance of life, work and human relationships." Lindbergh (1983) p.9. In this thesis, I use self-study research as I focus on the topic of living legacy. This is a personal story, using narrative methodology and method as a means of uncovering and naming life lessons learned. I write to gain insight into my interpretation of the concept of living legacy - what living legacy means to me and why this concept is significant to me - and how living legacy impacts the person that I am in the present. Using a narrative lens, I inquire into stories that connect me to my spirit, my gender, education and theology, through my living legacy lessons, and I seek the impact these stories hold for me in my life today. I utilize a variety of methods including personal journals, course work, and arts-based research experiences as I explore the connections to my emerging perceptions ofmy living legacy lessons. This thesis represents the beginning of a continuing journey of self-discovery. I take the journey in order to uncover hidden and ongoing lessons of living legacy and the impact they have on the student and educator that I am.