826 resultados para Post-partum period


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This paper first summarizes the results of an empirical investigation of borrowing and repayment patterns of post-secondary graduates, then addresses a number of related policy issues, including i) the need for further research to generate the information needed to fully evaluate the student loan system, ii) the advantages of extending the assistance available for those facing problems with their debt burdens in the post-schooling period, iii) the need to increase borrowing limits, iii) the efficiency and equity advantages of providing assistance to post-secondary students through loans rather than the grants which many have been calling for, and iii) a proposal for revitalising the cash-strapped post-secondary system with infusions from both federal and provincial governments and students themselves of equal parts, the latter facilitated by the appropriate changes in the loan system (higher limits and more support for those who run into trouble with repayment).

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This dissertation examines a process of indigenous accumulation among Tonga farmers in Zambia’s Southern Province. In the 1970s multiple authors concluded that capitalist farmers had emerged among Tonga agro-pastoralists, predominantly within private titled holdings. Relying on archival research, newspapers, secondary sources and extensive oral testimony this thesis fills a 35-year gap on the topic, providing insights into the social and environmental impacts of neoliberal policy among African peasants and capitalist farmers. In contrast to dominant narratives of the post-independence period, this study argues that Zambia did experience a developmental process post-independence, which saw significant achievements made in the agricultural sector, including the doubling of national cattle stocks. The data reveals a painful process of disarticulation beginning in the late 1980s. Following neoliberal adjustment, we observe significant heterogeneity in production systems, some regional specialization, and processes of migration. Most importantly, the thesis uncovers processes of overwhelming ecosystemic change that contributed to livestock epidemics of severe scale and scope. Amazingly, this went largely undocumented because of the simultaneous crisis of the state, which left the national statistics office and other state bodies incapable of functioning from the late 1980s into the 2000s. In response, the Zambian state has introduced a number of neodevelopmental initiatives in the sector, yet the lack of animal traction remained up to 2008 and agricultural production declined, while more capitalized farmers (largely white, and/or with foreign direct investment) have become more significant players in the country. This thesis provides compelling evidence to challenge dominant economic thinking of the Washington institutions as well as many of the common Marxian formulations.

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This study looks at the impact of the recent financial crisis on the short-term performance of European acquisitions. We use institutional theory and transaction cost economic theory to study whether bidders derive lower or higher returns from acquisitions announced after 2008. We investigate shareholders’ stock price reaction to 2245 deals which occurred during 2004–12 across 22 European Union countries. Our results from both univariate and multivariate analysis show that the deals announced in the post-crisis period, corresponding to the period of economic recession, generate higher returns to shareholders as compared to acquisitions announced in the pre-crisis period. We also test the relevance of the Economic and Monetary Union (EMU), that is, the Eurozone, to this value accrual during the recessionary period. We observe that non-EMU transactions obtain significantly higher gains vis-à-vis EMU transactions in the post-crisis years. Overall, announcement returns of European acquisitions have been affected by the financial crisis and the global recession; and companies that target countries with different currency regimes are likely to generate better returns from their acquisitions.

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The cortisol awakening response (CAR) is typically measured in the domestic setting. Moderate sample timing inaccuracy has been shown to result in erroneous CAR estimates and such inaccuracy has been shown partially to explain inconsistency in the CAR literature. The need for more reliable measurement of the CAR has recently been highlighted in expert consensus guidelines where it was pointed out that less than 6% of published studies provided electronic-monitoring of saliva sampling time in the post-awakening period. Analyses of a merged data-set of published studies from our laboratory are presented. To qualify for selection, both time of awakening and collection of the first sample must have been verified by electronic-monitoring and sampling commenced within 15 min of awakening. Participants (n = 128) were young (median age of 20 years) and healthy. Cortisol values were determined in the 45 min post-awakening period on 215 sampling days. On 127 days, delay between verified awakening and collection of the first sample was less than 3 min (‘no delay’ group); on 45 days there was a delay of 4–6 min (‘short delay’ group); on 43 days the delay was 7–15 min (‘moderate delay’ group). Cortisol values for verified sampling times accurately mapped on to the typical post-awakening cortisol growth curve, regardless of whether sampling deviated from desired protocol timings. This provides support for incorporating rather than excluding delayed data (up to 15 min) in CAR analyses. For this population the fitted cortisol growth curve equation predicted a mean cortisol awakening level of 6 nmols/l (±1 for 95% CI) and a mean CAR rise of 6 nmols/l (±2 for 95% CI). We also modelled the relationship between real delay and CAR magnitude, when the CAR is calculated erroneously by incorrectly assuming adherence to protocol time. Findings supported a curvilinear hypothesis in relation to effects of sample delay on the CAR. Short delays of 4–6 min between awakening and commencement of saliva sampling resulted an overestimated CAR. Moderate delays of 7–15 min were associated with an underestimated CAR. Findings emphasize the need to employ electronic-monitoring of sampling accuracy when measuring the CAR in the domestic setting.

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As Corporate Reputation (CR) evolves into an important asset for organizations, crises and disasters stand as threats to the preservation of the reputation capital since they usually result to negative projections to their audiences and to problematic evaluations by their stakeholders. Viewing CR as the accumulated trust and positive evaluations of the stakeholders, this paper proposes a conceptual and normative framework for Reputation Continuity, which enhances the ability of organizations to preserve their reputation, instead of working for its recovery in the post-crisis period. In our approach, we propose a process of maintaining trusted links, instead of restoring them and establishing a reputation resilient organization, instead of one struggling to recover from reputation losses, after the crisis has emerged. Working closely with stakeholders during the crisis, injecting a sense of normality continuity through effective leadership and mitigating image problems are seen as critical concerns, alongside a set of managerial practices to be followed. Ultimately, it is argued that, the value-based and strategically integrated view of Business Continuity must be enhanced and supported by Reputation Continuity activities.

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Este artículo pretende demostrar en qué medida Paseo por una guerra antigua (1948-1949), la práctica de segundo curso del Instituto de Investigaciones y Experiencias Cinematográficas (IIEC) en la que Juan Antonio Bardem rueda a un joven mutilado caminando por las ruinas de la Ciudad Universitaria de Madrid, constituye un intento pionero de desmontar los relatos oficiales de la Guerra Civil Española y rescatar la memoria de los vencidos. Filmar las ruinas del campus madrileño en aquellos años era un acto sub­versivo, puesto que el Régimen había emprendido su reconstrucción para borrar las huellas del Madrid republicano y de la Guerra Civil, resignificando por completo el recinto universitario. Por tanto, en Paseo por una guerra antigua, Bardem intenta reapropiarse de un espacio que en la época iba imponiéndose como uno de los “lugares de memoria” del franquismo. Esta película se vale de la función documental del cine para inmortalizar unas ruinas que simbolizan la República y la guerra, para preservarlas de la muerte simbólica que representa su reconstrucción. Mostrar esas ruinas en 1948-1949 equivale a “materializar” el pasado, a traerlo al presente de la posguerra, en un proceso que recuerda a los planteamientos sobre la Historia de Walter Benjamin, para proponer una visión alternativa de la contienda. Se trata de una visión teñida de una memoria íntima, ya que la película es un paseo no solo por las ruinas sino también por los recuerdos de este joven mutilado. En suma, Bardem propone una contramemoria de la Guerra Civil.

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Syria has been a major producer and exporter of fresh fruit and vegetables (FFV) in the Arabic region. Prior to 2011, Syrian FFV were mainly exported to the neighbouring countries, the Gulf States and Northern Africa as well as to Eastern European countries. Although the EU is potentially one of the most profitable markets of high quality FFV (such as organic ones) in the world, Syrian exports of FFV to Western European countries like Germany have been small. It could be a lucrative opportunity for Syrian growers and exporters of FFV to export organic products to markets such as Germany, where national production is limited to a few months due to climatic conditions. Yet, the organic sector in Syria is comparatively young and only a very small area of FFV is certified according to EU organic regulations. Up to the author’s knowledge, little was known about Syrian farmers’ attitudes towards organic FFV production. There was also no study so far that explored and analysed the determining factors for organic FFV adoption among Syrian farmers as well as the exports of these products to the EU markets. The overarching aim of the present dissertation focused on exploring and identifying the market potential of Syrian exports of organic FFV to Germany. The dissertation was therefore concerned with three main objectives: (i) to explore if German importers and wholesalers of organic FFV see market opportunities for Syrian organic products and what requirements in terms of quality and quantity they have, (ii) to determine the obstacles Syrian producers and exporters face when exporting agricultural products to Germany, and (iii) to investigate whether Syrian farmers of FFV can imagine converting their farms to organic production as well as the underlying reasons why they do so or not. A twofold methodological approach with expert interviews and a farmer survey were used in this dissertation to address the abovementioned objectives. While expert interviews were conducted with German and Syrian wholesalers of (organic) FFV in 2011 (9 interviews each), the farmer survey was administrated with 266 Syrian farmers of FFV in the main region for the production of FFV (i.e. the coastal region) from November 2012 till May 2013. For modelling farmers’ decisions to adopt organic farming, the Theory of Planned Behaviour as theoretical framework and Partial Least Squares Structural Equation Modelling as the main method for data analysis were used in this study. The findings of this dissertation yield implications for the different stakeholders (governmental institutions and NGOs, farmers, exporters, wholesalers, etc.) who are interested in prompting the Syrian export of organic products. Based on the empirical results and a literature review, an action plan to promote Syrian production and export of organic products was developed which can help in the post-war period in Syria at improving the organic sector.

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L’obésité est un facteur de risque lié à des problèmes physiques, émotionnels et comportementaux. Aujourd’hui, l’alimentation est composée d’un régime typiquement occidental «Western diet» qui est riche en acides gras saturés (AGS) et pauvre en acides gras polyinsaturés (AGPI) tel que les oméga-3 (N-3) et occasionnant un déséquilibre du ratio alimentaire N-6/N-3. Ce déséquilibre est une des causes de la prévalence des maladies mentales y compris celles des troubles de l'humeur et de l’anxiété. L’acide docosahexaénoïque (ADH, 22: 6 n-3) est l’acide gras (AG) le plus abondant dans le cerveau et son accumulation est particulièrement élevée pendant la période périnatale. Il joue un rôle important dans le développement neuronal et d'autres fonctions du cerveau tel l'apprentissage et la mémoire. Des perturbations de l’environnement périnatal peuvent influencer à très long terme l’avenir de la descendance en la rendant plus susceptible de développer des problèmes d’obésité dans un contexte nutritionnel riche. On ignore cependant si le déficit alimentaire chez la mère et particulièrement en ADH aura un impact sur la motivation alimentaire de la progéniture. L’objectif principal de cette thèse est d’étudier le rôle potentiel des N-3 sur la balance énergétique, la motivation alimentaire, la dépression et le niveau d’anxiété des descendants de souris mâles adultes assujetties à une alimentation riche en gras. Nos données ont démontré qu‘un régime maternel déficitaire en ADH durant la période périnatale incitait la descendance à fournir plus d’effort afin d’obtenir un aliment palatable. Ceci entraînerait un dérèglement de l’homéostasie énergétique en augmentant le gain de poids et en diminuant l’activité locomotrice tout en exacerbant le comportement de type anxieux dès que les souris sont exposées à un milieu obésogène. Les acides gras libres (AGL) sont des nutriments essentiels fonctionnant comme des molécules de signalisation dans le cerveau en ayant des récepteurs qui jouent un rôle important dans le contrôle du métabolisme énergétique. Parmi eux, on distingue un récepteur couplé à la protéine G (GPCR), le GPR120. Ce récepteur activé par les AGPI ω-3 intervient dans les mécanismes anti-inflammatoires et insulino-résistants via les N-3. Une mutation dans le gène GPR120 occasionnée par une réduction de l’activité de signalisation du gène est liée à l’obésité humaine. L'objectif premier de cette deuxième étude était d’évaluer l'impact de la stimulation pharmacologique de GPR120 dans le système nerveux central (SNC) sur l'alimentation, les dépenses d'énergie, le comportement de type anxieux et la récompense alimentaire. Nos résultats démontrent qu’une injection centrale aiguë d'agoniste GPR120 III réduit la prise alimentaire ad libitum et la motivation alimentaire pour un aliment riche en gras et en sucre; ainsi que les comportements de type anxieux. L’injection centrale chronique (21 jours) de ce même agoniste GPR120 III transmis par une pompe osmotique a démontré que les souris placées sous diète hypercalorique (HFD n’ont présenté aucune modification lors de la prise alimentaire ni de gain de poids mais qu’il y avait comparativement au groupe de véhicule, une réduction du comportement de type anxieux, que ce soit dans le labyrinthe en croix surélevé (LCS) ou dans le test à champ ouvert (OFT). L’ADH est reconnu pour ses propriétés anorexigènes au niveau central. De plus, la stimulation des récepteurs de GPR120 au niveau du cerveau avec un agoniste synthétique peut produire un effet intense intervenir sur le comportement lié à l'alimentation des rongeurs. Trouver une approche visant à contrôler à la fois la neuroinflammation, la récompense alimentaire et les troubles émotionnels aiderait assurément au traitement de l'obésité et du diabète de type 2.

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Children may benefit from minimally invasive surgery (MIS) in the correction of Morgagni hernia (MH). The present study aims to evaluate the outcome of MIS through a multicenter study. National institutions that use MIS in the treatment of MH were included. Demographic, clinical and operative data were analyzed. Thirteen patients with MH (6 males) were operated using similar MIS technique (percutaneous stitches) at a mean age of 22.2±18.3 months. Six patients had chromosomopathies (46%), five with Down syndrome (39%). Respiratory complaints were the most common presentation (54%). Surgery lasted 95±23min. In none of the patients was the hernia sac removed; prosthesis was never used. In the immediate post-operative period, 4 patients (36%) were admitted to intensive care unit (all with Down syndrome); all patients started enteral feeds within the first 24h. With a mean follow-up of 56±16.6 months, there were two recurrences (18%) at the same institution, one of which was repaired with an absorbable suture; both with Down syndrome. The application of MIS in the MH repair is effective even in the presence of comorbidities such as Down syndrome; the latter influences the immediate postoperative recovery and possibly the recurrence rate. Removal of hernia sac does not seem necessary. Non-absorbable sutures may be more appropriate.

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Thesis (Ph.D.)--University of Washington, 2016-06

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This article examines European Union (EU) approaches to the question of human rights violations in Kosovo before and after its proclamation of independence, in February 2008. While the 1999 NATO-led humanitarian intervention in the region was often justified as necessary due to the continuous abuses of human rights, perpetrated by the Serbian forces against the ethic Kosovo Albanians, the post-interventionist period has witnessed a dramatic reversal of roles, with the rights of the remaining Serbian minority being regularly abused by the dominant Albanian population. However, in contrast to the former scenario, the Brussels administration has remained quite salient about the post-independence context – a grey zone of unviable political and social components, capable of generating new confrontations and human rights abuses within the borders of Kosovo. Aware of this dynamic and the existing EU official rhetoric, it is possible to conclude that the embedded human rights concerns in Kosovo are not likely to disappear, but even more importantly, their relevance has been significantly eroded.

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Brazilian Housing policy has always promoted homeownership. In 1999, a new form of housing promotion was set up in the country with the PAR (Programa de Arrendamento Residencial, or residential rental programme). This is a sort of leasing, in which a right to buy is granted at the end of contract. Again, with this, the final objective is homeownership. This dissertation aims at further understanding the role of PAR in the wake of the country s housing policies of the post-BNH period, analysing the case of João Pessoa, capital city of Paraíba state. By focusing in the city, it has been possible to analyse also the impact of the programme in the dynamics of the city s urban development. Accordingly, the analysis of PAR seeks to understand the programme s operational aspects as well as its location, urban and architectural aspects. The operational aspects refer to how the programme is operated, considering the differences to the other housing programmes in the country. The urban and architectural aspects refer to location, typology and construction characteristics of housing estates produced under the scheme. This study gives a general view of the country s recent housing policy and programmes and the specific characteristics of PAR, observing also its impacts in the city development

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Die Frage des Neubeginns pädagogischer Wissenschaft in Deutschland wird hier im Blick auf die gesellschaftliche Funktion von Wissenschaft gestellt und am Beispiel einer Teildisziplin, der Berufs- und Wirtschaftspädagogik (BWP), vorläufig beantwortet. Basis dafür sind die Berufsbiographien sowie die Theorie- und Wissensproduktion samt der Diskursform von 23 Hochschullehrern der BWP, dem vermutlich vollständigen Personenkorpus dieser Disziplin und der ersten Generation ihrer Vertreter in Westdeutschland nach 1945. Danach zeichnet sich die BWP durch personale Kontinuität, theoretische Homogenität und diskursive Selbstreferentialität aus und zeigt sich dieser Konstanz nach als ein geschlossener Wissenschaftsprozeß seit 1930 bis 1960. Der war freilich politisch offen; gesellschaftlich gesehen war und verhielt sich die Disziplin funktional. (DIPF/Orig.)

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O presente estudo teve como objetivo geral elaborar uma proposta de processo de enfermagem contemplando históricos de enfermagem, diagnósticos de enfermagem, prescrição de cuidados de enfermagem para gestantes e puérperas em Unidade de Internação Obstétrica à luz de Horta, fundamentada em NANDA e, como objetivos específicos: identificar os dados clínico-obstétricos mais frequentes das gestantes em Unidade de Internação Obstétrica; identificar os dados clínico-obstétricos mais frequentes das puérperas em Unidade de Internação Obstétrica; identificar os diagnósticos de enfermagem a partir dos dados clínico-obstétricos mais frequentes das gestantes em Unidade de Internação Obstétrica; identificar os diagnósticos de enfermagem a partir dos dados clínico-obstétricos mais frequentes das puérperas em Unidade de Internação Obstétrica; elaborar modelos de histórico de enfermagem e de prescrição de cuidados de enfermagem para os diagnósticos de enfermagem identificados; e obter o consenso dos enfermeiros assistenciais da Unidade de Internação Obstétrica sobre a proposta construída. Trata-se de pesquisa qualitativa, descritiva e exploratória, realizada em uma Unidade de Internação Obstétrica de um hospital universitário do Sul do Brasil. Realizou-se uma consulta documental em 148 prontuários, com vistas à identificação dos diagnósticos e cuidados de enfermagem, baseados, respectivamente, na taxonomia II da North American Diagnosis Association 2009-2011 e da Nursing Intervention Classification. Desenvolveu-se um modelo de histórico de enfermagem para gestante/puérpera e outro para o recém-nascido. No total, identificaram-se 26 diagnósticos de enfermagem, assim distribuídos: nove direcionados às gestantes; nove, às puérperas; dois, ao binômio mãe/filho; seis, ao recém-nascido. A análise foi realizada por meio da apresentação da proposta construída e discussão com base em autores da área. Com isso, almeja-se contribuir para direcionar o cuidado de enfermagem às necessidades das gestantes, puérperas, binômios mãe/filho e recém-nascidos nesse microcenário, favorecendo a educação em saúde, a identificação precoce e a prevenção de complicações. Permanecem lacunas quanto às necessidades psicoespirituais, visto que elas não foram abordadas nos resultados. Assim, essa proposta de Processo de Enfermagem em Unidade Obstétrica contemplando históricos, diagnósticos e cuidados de enfermagem mantém em aberto o aperfeiçoamento do modelo, visando à inclusão de outros diagnósticos de enfermagem, de forma a aproximar-se de um cuidado mais holístico.

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A Síndrome de Boca Ardente (SBA) é uma condição caracterizada por uma sensação descrita pelo paciente como ardência e que afeta a mucosa oral. Tem sido referida como dor orofacial crónica, sem lesões na mucosa oral ou outros sinais clínicos evidentes. Afeta predominantemente mulheres no período pós-menopáusico. A sua etiologia foi considerada multifatorial, contudo foram sugeridos como fatores etiológicos os seguintes fatores: locais, sistémico, psicológicos, neuropáticos e idiopático. O seu diagnóstico é complexo e essencialmente por exclusão. De forma a compreender quais são os fatores etiológicos implicados nesta síndrome, como é realizado o seu diagnóstico e quais são os tratamentos utilizados de forma eficaz, foi realizada uma revisão bibliográfica nas bases de dados “PubMed”e “B-On”. O tratamento geralmente tem como objetivo o alívio sintomático de forma a melhorar a qualidade de vida das pessoas afetadas por SBA, as modalidades de tratamento podem variar desde farmacológicos até aos não farmacológicos. Ainda não existe um consenso relativamente aos critérios de diagnósticos que devem ser utilizados e nem do mais eficaz. Há necessidade de realização de mais estudos de forma a criar algoritmos específicos para esta condição.