606 resultados para Aspiration
Resumo:
Language socialization is a life-long process in which individuals are continuously socialized into new roles, statuses, and practices. This process becomes more complex in multilingual contexts. However, we know little of the language socialization of older adults and we know even less of minority-speaking elders' experiences of linguistic marginalization in contemporary communicative milieus. In this ethnographic and discourse-analytic study, I examine the language socialization of non-Mandarin-speaking elderly Taiwanese women in senior adult education programs in a rural township in Taiwan. Through examining autobiographical narratives, master narratives about elders, and classroom discourses, this study explores the historical construction of their sociolinguistic marginalization and their negotiation and resistance of such marginalization. The majority of the elderly women were denied education when they were young. Some received Japanese education during the Japanese colonization period. While the uneducated and illiterate elders have a strong aspiration for learning, they are dismissed as "unable to learn" by their teachers, peer students, and community leaders. By contrast, the Japanese literate exhibit a strong learning identity associated with colonial modernity. These two groups, however, have to contend with the social stereotype associated with their non-Mandarin speaking status. Under a Mandarin-only ideology that links Mandarin with modernity, discourses that have actively mobilized the category of “illiterate” to reference the older population are part and parcel of Taiwan’s modern identity. By demonstrating how these women are treated, in official discourses and in classroom interactions, as children for their lack of Mandarin abilities, I argue that the literacy education that set out to “compensate” these women for their earlier lack of educational opportunity has paradoxically reinforced their marginalization. Further, in recent years, they have become even more marginalized as the government has prioritized the education of recent young female marriage immigrants from Southeast Asia, who are considered in charge of educating the “future sons and daughters of Taiwan.” This research demonstrates how language socialization is a contested and life-long process and calls attention to the effects of language ideologies on literacy and language education. The findings have policy implications for improving literacy and language education both within Taiwan and elsewhere in the world.
Resumo:
Introdução: As neoplasias do espaço parafaríngeo são raras, representando apenas 0,5% dos tumores da cabeça e pescoço. A maioria são benignas, mas uma ampla variedade de patologias benignas e malignas podem ser encontradas neste espaço, o que cria desafios complexos de diagnóstico e tratamento. Objetivo: Descrever e analisar uma série de casos de neoplasias primárias do espaço parafaríngeo tratadas no Instituto Português de Oncologia de Lisboa Francisco Gentil (IPOLFG). Material e métodos: Estudo retrospetivo, com recolha e análise dos dados dos processos clínicos de tumores primários do espaço parafaríngeo, que foram diagnosticados ou referenciados ao IPOLFG entre 1 de Janeiro de 2003 e 31 de Dezembro de 2013. Resultados: Foram incluídos 38 doentes. A idade mediana foi de 52 anos (Âmbito Interquartil: 40-63 anos). Dez (26,3%) doentes eram assintomáticos. O sintoma mais comum à apresentação foi a sensação de corpo estranho orofaríngeo (23,7%) e o achado mais frequente foi um abaulamento orofaríngeo (78,4%). Todos os doentes fizeram exames de imagem pré-operatórios: 94,7% tomografia computorizada e 68,4% ressonância magnética. A citologia aspirativa foi realizada em 39,5%. 31 tumores eram benignos (81,6%), sendo os mais frequentes os adenomas pleomórficos (58,1%). 7 eram malignos (18,4%), com os carcinomas exadenomas pleomórficos (28,6%) e os linfomas (28,6%) sendo os mais comuns. 36 doentes (94,7%) foram submetidos a tratamento cirúrgico primário; os outros 2 doentes (5,3%) receberam tratamento não cirúrgico, com quimioterapia e quimioradioterapia, respectivamente. A abordagem cervical foi a mais utilizada (80%). A mandibulotomia foi necessária em apenas 5,7%. A complicação mais frequente foi a neuropatia de pares cranianos de novo, identificada em 22,2%. Destes, 75% foram sequela da resseção de tumores neurogénicos. Todas as neuropatias que resultaram da resseção de tumores não neurogénicos foram transitórias. O follow-up mediano foi de 6,5 anos. A taxa de recorrência foi de 13,5%. Conclusões: Os tumores do espaço parafaríngeo requerem um elevado índice de suspeição para serem diagnosticados num estadio precoce. A resseção cirúrgica completa é o principal tratamento. A abordagem cirúrgica deve ser selecionada caso a caso, mas a cervical fornece um excelente acesso à maioria dos tumores deste espaço
Resumo:
Introduction : Le syndrome d’aspiration méconiale (SAM) est une pathologie respiratoire du nouveau-né qui, dans les cas les plus sévères, peut rester réfractaire aux traitements couramment utilisés et nécessiter in fine le recours à une oxygénation membranaire extracorporelle. Le développement d’un ventilateur liquidien par l’équipe Inolivent a ouvert une nouvelle voie thérapeutique en rendant possible l’utilisation de la ventilation liquidienne totale (VLT) qui utilise un perfluorocarbone liquide afin d’assurer les échanges gazeux tout en effectuant un lavage pulmonaire thérapeutique. En 2011, l’équipe Inolivent a montré la supériorité de la VLT pour retirer le méconium et assurer les échanges gazeux de façon plus efficace que le traitement contrôle, le lavage thérapeutique avec une solution diluée de surfactant exogène (S-LBA). À ce jour, il n’a jamais été montré la possibilité de ramener des agneaux en respiration spontanée au décours d’une VLT pour le traitement d’un SAM sévère. Les objectifs de cette étude sont i) montrer la possibilité de ramener des agneaux nouveau-nés en respiration spontanée sans aide respiratoire après le traitement d’un SAM sévère par VLT, ii) comparer l’efficacité avec le lavage par S-LBA. Méthodes : 12 agneaux nouveau-nés anesthésiés et curarisés ont été instrumentés chirurgicalement. Après l’induction d’un SAM sévère, les agneaux ont subi un lavage pulmonaire thérapeutique soit par VLT (n = 6) ou par S-LBA (n = 6). Les agneaux ont été sevrés de toute ventilation mécanique et suivit en respiration spontanée durant 36 h. Résultats : Il est possible de ramener en respiration spontanée des agneaux nouveau-nés traités par VLT pour le traitement d’un SAM sévère. Le temps nécessaire au sevrage de la ventilation mécanique conventionelle a été plus court chez le groupe S-LBA. Conclusion : Notre étude met en lumière pour la première fois connue à ce jour, la possibilité de ramener en respiration spontanée des agneaux nouveau-nés suivant une VLT dans le traitement d’un SAM sévère. Ces résultats très importants ouvrent la voie à des études sur l’utilisation de la VLT dans le traitement de détresses respiratoires aigües.
Resumo:
This thesis is an examination of the ASEAN’s prospects in establishing regional competition policy in the Southeast Asia region, a topic of contemporary relevance in light of the ASEAN’s recent foray into the economic integration field on 31 December 2015. It questions whether the current approach undertaken by the ASEAN could contribute to an effective regional competition policy under the regional market integration. In answering this question, the thesis first critically surveys the current terrain of regional competition laws and policies in order to determine the possible existence of an optimal template. It argues that although the EU model is oft used as a source of inspiration, each regional organisation conceives different configurations of the model in order to best adjust to the local regional contexts. The thesis makes an inquiry into the narratives of the ASEAN’s competition policy, as well as the ASEAN’s specific considerations in the development of competition policy, before comparing the findings to the actual approaches taken by the ASEAN in its pursuit of regional competition policy. This thesis reveals that the actual approach taken by the ASEAN demonstrates an important discrepancy from the economic integration goal. The ASEAN applies a soft harmonisation approach regarding substantive competition law while refraining from establishing a centralised institution or a representative institution. The sole organ with regards to competition policy at the regional level is an expert organ. The thesis also conducts an investigation into the reception of the ASEAN’s regional policy by the member states in order to ascertain the possibility of the achievement of the ASEAN’s aspiration of regional competition policy. The study reveals that despite some shared similarities in the broad principles of competition law amongst the member states, the various competition law regimes are not harmonised thus creating challenging obstacle to the ASEAN’s ambition. The thesis then concludes that the ASEAN’s approach to regional competition law is unlikely to be effective.
Resumo:
Introdução: A aspiração de corpo estranho (ACE) é uma emergência pediátrica e uma causa importante de morte acidental na criança. A maioria dos casos ocorre com objetos orgânicos e inorgânicos de pequenas dimensões, sobretudo em idade pré-escolar. A ACE cursa com amplo espectro de manifestações e o seu diagnóstico representa muitas vezes um desafio. Caso clínico: Descrevemos o caso clínico de uma criança de dois anos que recorreu ao Serviço de Urgência por tosse, disfonia e disfagia. Ao exame objetivo apresentava acessos de tosse estridulosa, tiragem supra-esternal ligeira e auscultação pulmonar com sibilos inspiratórios/expiratórios e roncos dispersos bilateralmente. A telerradiografia do tórax evidenciava um reforço hilar bilateral, mais notável à direita. A avaliação por Otorrinolaringologia, incluindo a nasolaringofibroscopia, não de- mostrou alterações. A broncoscopia revelou a presença de corpo estranho vegetal condicionando obstrução superior a 50% do lúmen do brônquio principal direito. Conclusão: Pretendemos com este caso salientar a necessidade de manter alto índice de suspeição perante a possibilidade de ACE, pois o atraso no seu reconhecimento condiciona o seu tratamento e o eventual aparecimento de sequelas irreversíveis.
Resumo:
Strong evidence suggests that the climate is changing and that these changes are largely caused by human activities. A consensus exists among researchers that human activity is causing global warming and that actions to mitigate global warming need to be taken swiftly. The transportation sector, which relies heavily on fossil fuel burning and primarily oil, is one of the big contributors to air pollution problems at local, regional and global levels. It is the fastest growing source of greenhouse gas emissions and is estimated to be responsible for nearly a quarter of global energyrelated carbon dioxide emissions. Car sharing is a mobility solution encouraging its users to decrease private car usage in favour of communal transit and environmental goals. The idea of car sharing originates from the aspiration to decrease personal car ownership and to reduce vehicle distance travelled. This thesis seeks to complement the understanding of Finnish car sharing users and their usage through better categorization. Through better categorization and segmentation of Finnish car sharing users the thesis seeks to provide information for improved marketing insight. Research is done on the demographic and behavioural characteristics of Finnish car sharing users and they are compared with international findings about the characteristics of International car sharing users. The main research problem is Are Finnish car sharing users similar to international ones? A theoretical research framework on the determinants of individual car sharing usage is built based on international research about demographic and behaviouristic characteristics. After this a quantitative survey is performed to the customers of a Finnish car sharing organization. The data analysed in the thesis consist out of 532 answers received from the car sharing organizations customers. The data is analysed with descriptive and other exploratory methods, which create an understanding of Finnish car sharing users. At the end of the analysis the demographic and behavioural characteristics of Finnish car sharing users are compared with international ones. The research findings of the thesis indicate that the demographic and behavioural characteristics of Finnish car sharing usage largely follow those of their international counterparts. Thanks to the thesis results the car sharing organization is able to better target their customers through improved marketing insight.
Resumo:
Le fichiers qui accompagnent mon document ont été réalisés avec le logiciel Mathematica
Resumo:
Objective: Our study aimed at assessing the role of flexible bronchoscopy (FB) in improving diagnosis and management of children’s respiratory conditions in the pediatric unit of FB, newly created and unique in Tunisia. Methods: Retrospective study including all the FB achieved in our pediatric unit from 2009 to 2014. Results: We performed 365 FB in 333 patients aged 46 months on average (1 month - 15 years), often under conscious anesthesia (81.6%). FB was performed for diagnostic purposes in 341 cases and for therapeutic purposes in 24 cases. Eight anatomical abnormalities were revealed in 22 patients. An intraluminal bronchial obstruction was found in 71 FB, mainly due to a foreign body (n=36). A vascular anomaly was responsible for nine cases out of 17 extraluminal obstructions. Airways malacia was observed in 60 FB. Bronchoalveolar lavage was performed in 196 cases. It was determinant in 43.9% of the cases. FB was of great diagnostic value in 74.8% of the cases. It influenced the management of the patients in 58% of the cases. The FB for therapeutic purposes was beneficial in all cases. Few complications occurred (5.5%). Conclusion: FB is a safe tool providing precious diagnostic and/or therapeutic help for the clinician. Keywords:
Resumo:
This dissertation addresses the broader antecedents of the Communist Party of Albania (CPA) as one of a number of associations whose experience was central to Albanian political history. This long experience dates back to the informal national associations formed in the Ottoman Empire of the late nineteenth century. The dissertation examines the role of these associations which, pursuing language rights and political representation through imperial state reforms, set a pattern that struggled to connect nation and state, rather than asserting the territorial demands for a nation-state familiar across the region. Starting out in the Ottoman Empire, but then maturing in the Albanian diaspora in Romania, Bulgaria, Egypt and the United States, this dissertation shows politically significant processes of longer-term adaptation that created informal associations as institutional structures able to channel collective action. It then traces the reframing of these patterns through their destruction in the Balkan Wars and the First World War to the emergence of communist associations in the interwar period and beyond. This dissertation is a sustained study that traces long-term Ottoman imperial political legacies in the Albanian successor state. The story of the associations, based on hitherto unexamined archival documents, shows that the Albanians possessed a far greater capacity for political mobilization that previously acknowledged by historians. Moreover, the dissertation successfully challenges the conventional wisdom that portrays the Albanians as irreparably divided along sectarian and regional faultlines. It finds that Albanian national activism was civic in character rather than ethnic as elsewhere in the Balkans. The Albanians fought to remain within a multinational framework because this afforded them political security, social advancement and potential economic growth. In the late Ottoman period, this political objective was manifested in the acceptance of the supranational imperial order whereas during the Second World War, in the aspiration to become members of the Comintern internationalist movement. Another important find, is the newly-discovered evidence concerning the founding of the CPA and its wartime conduct as an organization created and led by the Albanians themselves, albeit with Yugoslav ideological assistance under the transnational umbrella of the Comintern.
Resumo:
Background: Stroke is one of the major causes of morbidity and mortality worldwide and apart from being exceedingly harmful in diabetics, stroke is a disabling disorder. The study was undertaken to describe the clinical characteristics, outcome pattern and predictors of mortality in a cohort of diabetic patients presenting with stroke in two tertiary health facilities in North Western Nigeria. Method: Out of all stroke patients seen from June 2007 to February 2011, persons with diabetes mellitus presenting with stroke in the emergency unit of the two tertiary hospitals in Kano were consecutively recruited for the study. Classification of stroke into hemorrhagic and infarctive subtypes was based on brain computerized tomography (CT), brain magnetic resonance imaging (MRI) and World Health Organization (WHO) criteria. Follow-up period was for thirty days. Result: Out of the five hundred and thirty six stroke patients seen during the study period, 85 (15.9%) patients, comprising 48 (56.5%) males, had diabetes. Thirty eight (44.7%) of the identified diabetics were previously undiagnosed. Sixty four (75.3%) had infarctive stroke. One-month case fatality rate was 30.6%. Factors associated with death included male sex, past history of TIA, abnormal respiratory pattern, hemorrhagic stroke, aspiration pneumonitis, and worsening GCS. Aspiration pneumonitis and worsening GCS were independent predictors of one month mortality of stroke in the patients. Conclusion: In DM patients studied, infarctive stroke was more common, case fatality was 30.6%. Male gender, past history of TIA, abnormal respiratory pattern, hemorrhagic stroke, aspiration pneumonitis, and worsening Glasgow Coma Score (GCS) were associated with mortality. Aspiration pneumonitis and worsening GCS were independent predictors of one month mortality of stroke in diabetic patients.
Resumo:
Background Chronic suppurative otitis media (CSOM) is still a significant health problem in developing countries. Therefore, it was pertinent to determine the local Malawian microbiology in order to guide adequate treatment, avoid complications, and provide records for future reference. Aim The study sought to determine the CSOM-causing microorganisms at Queen Elizabeth Central Hospital in Blantyre, Malawi, and establish their relationship signs and symptoms, and with the demographic pattern of the study. Methods This was a hospital-based cross-sectional descriptive study carried out at the ENT outpatient clinic and the Microbiology Department of Queen Elizabeth Central Hospital.The sample comprised 104 patients with unilateral or bilateral active CSOM, who met the inclusion criteria. All patients were evaluated through a detailed history and clinical examination. Pus samples from draining ears were collected by aspiration with a sterile pipette. The specimens were immediately sent for microbiological analysis. Data were analyzed using SPSS.version 20. Results The study found that Proteus mirabilis , Pseudomonas aeruginosa , and Staphylococcus aureus were the most prevalent aerobic bacteria, while Bacteroides spp. and Peptostreptococcus spp. were the commonest anaerobic bacteria causing CSOM. These CSOM-causing microorganisms were predominant among males aged 18 years and below. Some CSOMcausing microorganisms were—significantly more so than the others— characteristically associated with each of the following clinical features: quantity of pus drainage, mode of onset, otalgia, hearing loss, location of tympanic membrane perforation, and mucosal appearance.
Resumo:
Resettlement associated with development projects results in a variety of negative impacts. This dissertation uses the resettlement context to frame the dynamic relationships formed between peoples and places experiencing development. Two case studies contribute: (a) the border zone of Mozambique’s Limpopo National Park where residents contend with changes to land access and use; and (b) Bairro Chipanga in Moatize, Mozambique where a resettled population struggles to form place attachment and transform the post-resettlement site into a “good” place. Through analysis of data collected at these sites between 2009 and 2015, this dissertation investigates how changing environments impact person-place relationships before and after resettlement occurs. Changing environments create conditions leading to disemplacement—feeling like one no longer belongs—that reduces the environment’s ability to foster place attachment. Research findings indicate that responses taken by individuals living in the changing environment depend heavily upon whether resettlement has already occurred. In a pre-resettlement context, residents adjust their daily lives to diminish the effects of a changing environment and re-create the conditions to which they initially formed an attachment. They accept impoverishing conditions, including a narrowing of the spaces in which they live their daily lives, because it is preferred to the anxiety that accompanies being forced to resettle. In a post-resettlement context, resettlement disrupts the formation of place attachment and resettled peoples become a placeless population. When the resettlement has not resulted in anticipated outcomes, the aspiration for social justice—seeking conditions residents had reason to expect—negatively influences residents’ perspectives about the place. The post-resettlement site becomes a bad place with a future unchanged from the present. At best, this results in a population in which more members are willing to move away from the post-resettlement site, and, at worse, complete disengagement of other members from trying to improve the community. Resettlement thus has the potential to launch a cycle of movement- displacement-movement that prevents an entire generation from establishing place attachment and realizing its benefits. At the very least, resettlement impedes the formation of place attachment to new places. Thus, this dissertation draws attention to the unseen and uncompensated losses of resettlement.
Resumo:
The purpose of this study was to improve an instrument used to assess career aspirations (the Career Aspiration Scale) so the revised measure can be used with confidence by counseling psychologists in research and practice. Three studies were conducted with a total of 583 undergraduate and graduate women. Results of these studies provided support for the reliability and validity of the Career Aspiration Scale-Revised when used with undergraduate and graduate women. Results from confirmatory factor analyses indicated that the three-factor solution had good model fit, thus supporting a revised measure with three subscales assessing achievement, leadership, and educational aspirations. Suggestions for future research and practice using the Career Aspiration Scale- Revised are provided.
Resumo:
320 p.
Resumo:
Brain abscesses can cause an incapacitating neurological deicit in up to 50% of patients, thus the reduction of these sequelae becomes the main goal of its timely and speciic surgical and medical treatment. With technological advances in bacteriological identiication and diagnostic imaging, the clinical suspicion can be conirmed, and the speciic etiological agent can be identiied in a larger number of cases. New pathogens have emerged through this process, such as Streptococcus porcinus, in which the ability to affect the central nervous system has not been documented. A clinical case is presented of a brain abscess in an immunocompetent patient, and its favorable response to surgical drainage t hrough a skull burr h ole and nee dle aspiration with antibiotic therapy (ceftriaxone, metronidazole and vancomycin) is discussed.