Should I stay or should I go – Factors associated with hospitalization risk among older persons in Sweden

An increasingly older population will most likely lead to greater demands on the health care system, as older age is associated with an increased risk of having acute and chronic conditions. The number of diseases or disabilities is not the only marker of the amount of health care utilized, as persons may seek hospitalization without a disease and/or illness that requires hospital healthcare. Hospitalization may pose a severe risk to older persons, as exposure to the hospital environment may lead to increased risks of iatrogenic disorders, confusion, falls and nosocomial infections, i.e., disorders that may involve unnecessary suffering and lead to serious consequences. Aims: The overall aim of this thesis was to describe and explore individual trajectories of cognitive development in relation to hospitalization and risk factors for hospitalization among older persons living in different accommodations in Sweden and to explore older persons' reasons for being transferred to a hospital. Methods: The study designs were longitudinal, prospective and descriptive, and both quantitative and qualitative methods were used. Specifically, latent growth curve modelling was used to assess the association of cognitive development with hospitalization. The Cox proportional hazards regression model was used to analyse factors associated with hospitalization risk overtime. In addition, an explorative descriptive design was used to explore how home health care patients experienced and perceived their decision to seek hospital care. Results: The most common reasons for hospitalization were cardiovascular diseases, which caused more than one-quarter of first hospitalizations among the persons living in ordinary housing and nursing home residents (NHRs). The persons who had been hospitalized had a lower mean level of cognitive performance in general cognition, verbal, spatial/fluid, memory and processing speed abilities compared to those who had not been hospitalized. Significantly steeper declines in general cognition, spatial/fluid and processing speed abilities were observed among the persons who had been hospitalized. Cox proportional hazards regression analysis showed that the number of diseases, number of drugs used, having experienced a fall and being assessed as malnourished according to the Mini Nutritional Assessment scale were related to an increased hospitalization risk among the NHRs. Among the older persons living in ordinary housing, the risk factors for hospitalization were related to marital status, i.e., unmarried persons and widows/widowers had a decreased hospitalization risk. In addition, among social factors, receipt of support from relatives was related to an increased hospitalization risk, while receipt of support from friends was related to a decreased risk. The number of illnesses was not associated with the hospitalization risk for older persons in any age group or for those of either sex, when controlling for other variables. The older persons who received home health care described different reasons for their decisions to seek hospital care. The underlying theme of the home health care patients’ perceptions of their transfer to a hospital involved trust in hospitals. This trust was shared by the home health care patients, their relatives and the home health care staff, according to the patients. Conclusions: This thesis revealed that middle-aged and older persons who had been hospitalized exhibited a steeper decline in cognition. Specifically, spatial/fluid, processing speed, and general cognitive abilities were affected. The steeper decline in cognition among those who had been hospitalized remained even after controlling for comorbidities. The most common causes of hospitalization among the older persons living in ordinary housing and in nursing homes were cardiovascular diseases, tumours and falls. Not only health-related factors, such as the number of diseases, number of drugs used, and being assessed as malnourished, but also social factors and marital status were related to the hospitalization risk among the older persons living in ordinary housing and in nursing homes. Some risk factors associated with hospitalization differed not only between the men and women but also among the different age groups. The information provided in this thesis could be applied in care settings by professionals who interact with older persons before they decide to seek hospital care. To meet the needs of an older population, health care systems need to offer the proper health care at the most appropriate level, and they need to increase integration and coordination among health care delivered by different care services.

Jovens terena na cidade de Campo Grande (MS): política e geração

Research with indigenous in urban context are gaining steam in recent years, particularly with the intensification of migration resulting from problems such as lack of land for subsistence. However, in relation to Terena, subjects in this study, the contemporary anthropological research aimed at residents in cities still are not privileged, especially to youth. Thus, the dissertation has as main objective the discussion around some axes, among them indigenous youth Terena ethnicity politics, - indigenous movement - and racism. These themes appeared during fieldwork where privileged six trajectories of young Terena who migrated to Campo Grande (MS) and have different ways to mean the city and experiencing everyday life

Adultos com experiências precoces de vitimação e resiliência

A literatura tem vindo a comprovar que determinados indivíduos conseguem integrar-se ou ajustar-se de forma positiva e normativa nas sociedades em que vivem, apesar das vivências altamente adversas ocorridas, ainda numa idade precoce, poderem potenciar um percurso significativamente diferente. O presente estudo, de índole qualitativo, tem como objetivo geral analisar e caracterizar o percurso de vida de adultos, que precocemente vivenciaram formas de vitimação em contexto familiar, procurando identificar os fatores que contribuíram para o seu ajustamento psicossocial. Para tal, recorreu-se a uma entrevista semiestruturada, elaborada para o efeito, e a qual foi administrada a 10 participantes com idades entre 19 e 41 anos (M=26.1; DP=8), selecionados a partir de informantes privilegiados e que os identificaram como sendo resilientes. O conteúdo das entrevistas foi analisado através da grounded analysis. Os resultados revelam que os participantes no decorrer do processo de vitimação desenvolveram características comportamentais semelhantes (e.g., isolamento, baixa autoestima, revolta, agressividade), identificando a retirada do meio familiar como elemento promotor da mudança ocorrida no seu percurso e autoconceito. De igual modo, identificaram a existência de sonhos, de objetivos de vida e a presença de pessoas significativas (e.g., irmãos, parceiros, amigos) como sendo determinantes na construção do seu percurso resiliente. A retirada do contexto familiar foi identificada pelos participantes como uma medida de intervenção relevante na proteção da criança e subsequente ajustamento psicossocial. Os resultados do presente estudo permitem evidenciar a importância dos fatores protetivos no ajustamento psicossocial, algo que deve ser considerado na intervenção psicoterapêutica com crianças em risco.

Drosophila Adaptation to Viral Infection through Defensive Symbiont Evolution

Microbial symbionts can modulate host interactions with biotic and abiotic factors. Such interactions may affect the evolutionary trajectories of both host and symbiont. Wolbachia protects Drosophila melanogaster against several viral infections and the strength of the protection varies between variants of this endosymbiont. Since Wolbachia is maternally transmitted, its fitness depends on the fitness of its host. Therefore, Wolbachia populations may be under selection when Drosophila is subjected to viral infection. Here we show that in D. melanogaster populations selected for increased survival upon infection with Drosophila C virus there is a strong selection coefficient for specific Wolbachia variants, leading to their fixation. Flies carrying these selected Wolbachia variants have higher survival and fertility upon viral infection when compared to flies with the other variants. These findings demonstrate how the interaction of a host with pathogens shapes the genetic composition of symbiont populations. Furthermore, host adaptation can result from the evolution of its symbionts, with host and symbiont functioning as a single evolutionary unit.

Viel bringt viel? Effekte lernzeitverlängernder Maßnahmen auf die Lese- und Mathematikleistungen von Grundschülerinnen und Grundschülern mit ungünstiger Lernausgangslage

Der vorliegende Beitrag untersucht die Effekte von lernzeitverlängernden Maßnahmen für Grundschülerinnen und Grundschüler in Mecklenburg-Vorpommern mit einer ungünstigen Lernausgangslage zum Zeitpunkt der Einschulung. Dazu wurde über die gesamte Grundschulzeit hinweg die Leistungsentwicklung von 67 Kindern in den Bereichen Lesen und Rechnen erfasst. Bei 19 Kindern wurde eine Lernzeitverlängerung durch Diagnoseförderklassen (DFK) realisiert, bei 18 durch eine Klassenwiederholung (KW) und 30 Kinder lernten in regulären Grundschulklassen (GSK) ohne eine Lernzeitverlängerung. Die Auswertungen der Daten mittels Hierarchisch-linearer Modelle (HLM) weisen auf gleiche Entwicklungsverläufe der drei Untersuchungsgruppen in den Bereichen Lesen und Mathematik hin. Zum Ende der Klasse 4 erreichten die drei Gruppen ähnliche Leistungsniveaus. In allen drei Settings fiel auf, dass die Entwicklung mathematischer Kompetenzen über die Schulzeit hinweg verzögert erfolgte. Ungünstige Lernausgangslagen im Bereich Mathematik konnten den Analysen zufolge durch keine der untersuchten Beschulungsformen ausreichend kompensiert werden. (DIPF/Orig.)

Experiências formativas de jovens instrumentistas : um estudo a partir de entrevistas narrativas

Dissertação (mestrado)—Universidade de Brasília, Instituto de Artes, Departamento de Música, Programa de Pós-graduação em Música, 2015.

Construção das capacidades organizacionais de tecnologia da informação no contexto dos sistemas institucionais integrados de gestão da UFRN

The IT capability is a organizational ability to perform activities of this role more effectively and an important mechanism in creating value. Its building process (stages of creation and development) occurs through management initiatives for improvement in the performance of their activities, using human resources and IT assets complementary responsible for the evolution of their organizational routines. This research deals with the IT capabilities related to SIG (integrated institutional management systems), built and deployed in UFRN (Universidade Federal do Rio Grande do Norte) to realization and control of administrative, academic and human resources activities. Since 2009, through cooperative agreements with federal and educational institutions of direct administration, UFRN has supported the implementation of these systems, currently involving more than 30 institutions. The present study aims to understand how IT capabilities, relevant in the design, implementation and dissemination of SIG, were built over time. This is a single case study of qualitative and longitudinal nature, performed by capturing, coding and analysis from secondary data and from semi-structured interviews conducted primarily with members of Superintenência de Informática, organizational unit responsible for SIG systems in UFRN. As a result, the technical, of internal relationship and external cooperation capabilities were identified as relevant in the successful trajectory of SIG systems, which have evolved in different ways. The technical capacity, initiated in 2004, toured the stages of creation and development until it reached the stage of stability in 2013, due to technological limits. Regarding the internal relationship capability, begun in 2006, it toured the stages of creation and development, having extended its scope of activities in 2009, being in development since then. Unlike the standard life cycle observed in the literature, the external cooperation capability was initiated by an intensity of initiatives and developments in the routines in 2009, which were decreasing to cease in 2013 in order to stabilize the technological infrastructure already created for cooperative institutions. It was still identified the start of cooperation in 2009 as an important event selection, responsible for changing or creating trajectories of evolution in all three capacities. The most frequent improvements initiatives were of organizational nature and the internal planning activity has been transformed over the routines of the three capabilities. Important resources and complementary assets have been identified as important for the realization of initiatives, such as human resources technical knowledge to the technical capabilities and external cooperation, and business knowledge, for all of them, as well as IT assets: the iproject application for control of development processes, and the document repository wiki. All these resources and complementary assets grew along the capacities, demonstrating its strategic value to SINFO/UFRN

Modelling human behaviour and event detection from videos

Automatic analysis of human behaviour in large collections of videos is gaining interest, even more so with the advent of file sharing sites such as YouTube. However, challenges still exist owing to several factors such as inter- and intra-class variations, cluttered backgrounds, occlusion, camera motion, scale, view and illumination changes. This research focuses on modelling human behaviour for action recognition in videos. The developed techniques are validated on large scale benchmark datasets and applied on real-world scenarios such as soccer videos. Three major contributions are made. The first contribution is in the area of proper choice of a feature representation for videos. This involved a study of state-of-the-art techniques for action recognition, feature extraction processing and dimensional reduction techniques so as to yield the best performance with optimal computational requirements. Secondly, temporal modelling of human behaviour is performed. This involved frequency analysis and temporal integration of local information in the video frames to yield a temporal feature vector. Current practices mostly average the frame information over an entire video and neglect the temporal order. Lastly, the proposed framework is applied and further adapted to real-world scenario such as soccer videos. A dataset consisting of video sequences depicting events of players falling is created from actual match data to this end and used to experimentally evaluate the proposed framework.

Universities and Welfare States Coping with Permanent Financial Austerity: Pressures on (Competing) Public Institutions

A chapter linking universities and welfare states to permanent financial austerity can take a shorter or a longer historical perspective. This chapter looks further back (to the postwar expansion of European welfare states) to better understand future transformations of both public institutions. Their long-term sustainability problems did not start with the financial crisis of 2008 but have been growing since the 1970s (Schäfer and Streeck 2013; Bonoli and Natali 2012; Hay and Wincott 2012). Financial austerity is not a post-crisis phenomenon. As a concept, it was used in welfare state research at least a decade earlier, although it does not seem to have been used in higher education studies until recently. Two quotations bring us to the heart of the matter: welfare states and universities are currently changing under adverse financial conditions caused by an array of interrelating and mutually reinforcing forces and their long-term financial sustainability is at stake across Europe. The welfare state is a “particular trademark of the European social model” (Svallfors 2012: 1), “the jewel in the crown” and a “fundamental part of what Europe stands for” (Giddens 2006: 14), as are tuition-free universities, the cornerstone of intergenerational social mobility in Continental Europe. The past trajectories of major types of welfare states and of universities in Europe tend to go hand in hand: first vastly expanding following the Second World War, and especially in the 1960s and 1970s, and then being in the state of permanent resource-driven and legitimacy-based “crisis” in the last two decades. Welfare states and universities, two critically important public institutions, seem to be under heavy attacks from the public, the media and politicians. Their long-term sustainability is being questioned, and solutions to their (real and perceived) problems are being sought at global, European, and national levels.

Être médecin diplômé à l’étranger au Québec : des parcours contrastés d’intégration professionnelle

En 2015, il y aurait au Québec plus de 5 000 médecins diplômés à l’étranger, dont près de 2 500 travaillent comme médecins et possiblement autant qui ont emprunté d’autres voies professionnelles, momentanément ou durablement. Les migrants très qualifiés sont réputés faire face à de multiples barrières sur le marché du travail, particulièrement ceux membres de professions réglementées. Le cas des médecins est exemplaire compte tenu de sa complexité et de la multiplicité des acteurs impliqués au cours du processus de reconnaissance professionnelle. Ayant comme principal objectif de documenter les trajectoires d’intégration professionnelle de diplômés internationaux en médecine (DIM) et leurs expériences sur le marché du travail québécois, cette thèse s’attache à comprendre ce qui pourrait distinguer les trajectoires d’intégration en emploi pour un même groupe professionnel. En observant notamment les stratégies d’intégration et les ressources mobilisées, nous cherchons à mieux saisir les parcours des DIM qui se requalifient et qui exercent au Québec et ceux qui se réorientent vers d’autres secteurs d’activités. La démarche méthodologique est qualitative (terrain 2009 à 2012), le cœur des analyses étant basé sur 31 récits de vie professionnelle de DIM ayant migré au Québec principalement dans les années 2000. Les données secondaires incluent 22 entretiens non dirigés auprès d’acteurs clés de milieux institutionnels, communautaires ou associatifs ainsi qu’auprès de DIM très récemment immigrés ou ayant le projet d’immigrer. S’y ajoute l’observation ethnographique ponctuelle, telle que des activités associatives. La forme retenue pour cette thèse en est une par articles. Le fil directeur est l’exploration de l’interface entre les politiques, les pratiques et les individus au cœur des trajectoires d’intégration professionnelle. Les trois articles (chapitres 4 à 6) visent des focales complémentaires avec le même objectif : l’exploration de la complexité des trajectoires d’intégration professionnelle et la dialectique entre les niveaux micro, méso et macrosociaux. Ces derniers renvoient respectivement à la puissance d’agir des individus et leurs contraintes d’action, les relations sociales, les institutions et les pratiques organisationnelles et plus largement les structures sociopolitiques. Les résultats de cette thèse mettent en lumière des aspects complémentaires de l’intégration professionnelle et en interaction dynamique : 1) dimension macrosociale et politique; 2) dimensions institutionnelles et relations sociales; 3) identité professionnelle. Suite à l’introduction, la problématique (chap. 1) et la méthodologie (chap.2), le chapitre 3 expose les types des trajectoires d’intégration des DIM, leur hétérogénéité, et met en relief leurs récits de vie professionnelle. Le chapitre 4 soulève le paradoxe entre les politiques d’attraction de l’immigration déployés par les gouvernements canadien et québécois et les mécanismes de régulation opérant sur le marché du travail. Le chapitre 5 explore les stratégies et ressources mobilisées par les DIM et met en lumière l’effet positif des ressources symboliques. Les ressources institutionnelles de soutien, quoique élémentaires dans le processus de reconnaissance professionnelle, ne sont subjectivement pas considérées comme un élément central. Ce sont plutôt les ressources informelles qui jouent ce rôle d’appui significatif, en particulier les pairs DIM. Le chapitre 6 adopte une perspective microsociale et explore le caractère dynamique et relationnel de l’identité professionnelle, mais surtout, la puissance des conditions d’appartenance qui obligent à une flexibilité professionnelle et parfois au retrait de la profession ou du pays. Le chapitre 7 discute au plan théorique de l’intérêt d’une combinaison d’échelles analytiques et d’une ouverture disciplinaire afin de souligner les tensions et angles morts en ce qui concerne les mobilités de professionnels de la santé et leur intégration professionnelle. Cette thèse explore l’interrelation complexe entre les ressources économiques, sociales et symboliques, dans un contexte de fragmentation des ressources institutionnelles et de corporatisme.

Riesgos de victimización de adolescentes menores en los contextos tecnológicos de socialidad

[ES]En el presente trabajo, se abordan las formas cambiantes en las relaciones de socialidad de los adolescentes menores, la influencia de los avances tecnológicos en estas, así como los conflictos entre iguales que emergen en estos nuevos espacios, enfocando el trabajo en el fenómeno del cyberbullying desde un punto de vista criminológico. El objetivo ha consistido en analizar las nuevas formas de relación social que se expanden hoy en día, sobre todo por la irrupción de Internet como forma de interacción social y reconocer las conductas de riesgo que comienzan a aparecer en este ámbito, para identificar las formulas necesarias de prevención. La primera parte del trabajo está centrada en contextualizar la forma de socialidad, desde una conceptualización amplia hasta las características actuales derivadas del uso de la tecnología como herramienta de relación social, recogiendo los debates generados en torno al posible debilitamiento del capital social. En el siguiente apartado, se explora el ciberespacio, sus riesgos y oportunidades delictivas, buscando analizar posteriormente y en profundidad el cyberbullying, así como sus factores de victimización y sus similitudes y diferencias con respecto al bullying tradicional. A continuación, con el fin de subrayar y extraer las características que debe tener un programa de prevención, se expone una iniciativa pionera, a modo de estudio de caso. En esta se utiliza la formación en mediación de los propios menores para resolver o prevenir estas problemáticas, implantado en un instituto público de Zaragoza.

Jovens terena na cidade de Campo Grande (MS): política e geração

Research with indigenous in urban context are gaining steam in recent years, particularly with the intensification of migration resulting from problems such as lack of land for subsistence. However, in relation to Terena, subjects in this study, the contemporary anthropological research aimed at residents in cities still are not privileged, especially to youth. Thus, the dissertation has as main objective the discussion around some axes, among them indigenous youth Terena ethnicity politics, - indigenous movement - and racism. These themes appeared during fieldwork where privileged six trajectories of young Terena who migrated to Campo Grande (MS) and have different ways to mean the city and experiencing everyday life

Suupa uchinaanchu : a construção da rede transnacional okinawana

Tese (doutorado)—Universidade de Brasília, Instituto de Ciências Sociais, Departamento de Antropologia, Programa de Pós-graduação em Antropologia Social, 2016.

Políticas de geração distribuída e sustentabilidade do sistema elétrico

Tese (doutorado)—Universidade de Brasília, Centro de Desenvolvimento Sustentável, 2015.

Comportamentos agressivos entre pares e padrões de vinculação : Um estudo com jovens adolescentes

Embora de natureza radicalmente distinta, bullying e vinculação são fenómenos de natureza relacional. Se o bullying é descrito como um abuso sistemático de poder, que ocorre intencional e repetidamente entre pares, a vinculação refere-se ao estabelecimento de laços afectivos fortes com determinadas pessoas significativas, especialmente em momentos percepcionados como perigosos. A investigação, apesar do reduzido número de estudos, mostra uma relação entre estes conceitos. A agressão instrumental interpares parece estar relacionada com vinculações inseguras. O objectivo deste estudo é compreender a relação entre o bullying e os padrões de vinculação. Foi realizado em três escolas da zona de Évora, com os alunos do 7° ano (237 alunos). Utilizaram-se dois questionários de auto-relato: o QEVE - Questionário de Exclusão Social e Violência Escolar e o IVIA - Inventário sobre Vinculação para a Infância e a Adolescência. Os resultados deste estudo corroboram os estudos anteriores, relativamente aos comportamentos agressivos entre pares. Mostram que existem correlações estatisticamente significativas entre as dimensões da vitimação e da agressão e, ainda, verificou-se que a vinculação segura parece funcionar como um factor protector para a vitimação e a agressividade e a vinculação ansiosa parece relacionar-se com a vitimação. ABSTRACT: Although radically different, bullying and attachment are relational in nature phenomena. lf the bullying is described as a systematic abuse of power, which is intentionally and repeatedly between peers, attachment refers to the establishment of strong emotional ties with certain significant others, especially at times perceived as dangerous. The research, despite the small number of studies show a relationship between these concepts. Instrumental peer aggression seems to be associated with insecure attachments. The aim of this study is to understand the relationship between bullying and patterns of binding. lt was conducted in three schools in the district of Évora with the students of 7th Grade (237 students). We used two questionnaires self-report: the QEVE - Questionnaire of Social Exclusion and Violence in School and IVIA - lnventory on Attachment for Children and Adolescents. These results corroborate previous studies, for aggressive behavior among peers. Show that there are statistically significant correlations between the dimensions of victimization and aggression and also found that a secure attachment appears to be a protective factor for victimization and aggression and anxious attachment seems to relate to the victimization.