772 resultados para Urinary and bowel issues


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A comprehensive guide to planning and consultation issues around mixed income communities. This guide explores how to create attractive and well-managed places that meet the needs of all sections of the community. Drawing on the latest research, and featuring nine case study areas, it includes detailed guidance on: developing a strategy and negotiating the planning process; good practice in masterplanning, design, layout and long-term financial viability; how stakeholders can collaborate effectively and ensure that local residents are fully involved at all stages; how barriers to the development of sustainable communities might be overcome. The guide explores all types of mixed income communities, from the diversification of single-tenure inner-city estates to greenfield development on the urban fringe.

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Given the timing of the Scottish independence referendum in September 2014, the hosting of both the London 2012 Olympic Games and the Glasgow 2014 Commonwealth Games coincided with a period of considerable political turmoil and reflection within the United Kingdom. The extensive levels of public, political and media scrutiny of both of these major sporting events can therefore be framed within a wider consideration of the contemporary dynamics of the political union between the constituent nations of the UK, as well as the multifarious forms of national identities expressed within the various regions of the ‘nation-state’. Despite the growing influence of social media forms within contemporary society, politics and sport within the UK, the ‘traditional’ print media retain a central (although arguably diminishing) role in the dissemination of information relating to major societal, political and sporting issues to the British public. This paper will therefore critically reflect upon the nature of print media representations of ‘Britishness’, ‘Englishness’ and ‘Scottishness’ at London 2012 and Glasgow 2014 from both London-based and Scotland-based publications, drawing upon empirical data from completed and ongoing doctoral theses from the respective authors. In particular, the implications of the contrasting competitive structures of each event will be considered, given the symbolic differences between the unitary ‘Team GB’ at the London 2012 Olympics and the separated representative teams for Scotland and England at the Glasgow 2014 Commonwealth Games.

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Contractual agreements have become an accepted part of participation processes for athletes in a variety of sport contexts. Closer readings of these contracts,however, pose several questions regarding organizational intentions and motivations,the conceptualization of athletes as “workers,” and representation parity. In this article, we draw on four types of athlete contractual documents from both select international “amateur” and “professional” sport settings. Our key considerations include athletes’ ownership over their image and identities; medical and health disclosures; lifestyle, behavioral and body choices, and restrictions beyond sport; adherence to organizational philosophy and commitments; and social media and publicity constraints. Our exegesis here encourages sport researchers to deliberate whose “wellbeing” matters most when signing that seductive dotted line.

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As academic disciplines, Physical Education and Sport History share interests in performance, participation, physique and the politics of corporeal praxis. Engendering unity between the two disciplines, however, has not been without concern. Scholars working within (and across) both fields have highlighted how the potential for shared knowledge production and meaning making has been, to a degree, stymied by epistemological and methodological criticism and trepidation. Issues over contextualization, rigour, narrative schemas, conceptualizations of the body, and notions of agency and power still, in particular, constrain our current educational and historical readings and renderings of physical culture(s). Scholarly schisms and methodological differences can be overcome, however, and need not prohibit disciplinary collaborations that might better address prevailing ethical questions and affect political cause; vis-à-vis the body, the physical and sport. This brief piece is, consequently, recourse to the scholarly symbiosis between Physical Education and Sport History and echoes the encouragement of our earlier colleagues to play, inquire, create and produce together.

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This article provides an historical case study of an abortive attempt to revise policy and legislation relating to Religious Education (RE) in English schools in the late 1960s and early 1970s. Drawing upon published sources, including parliamentary debates, as well as previously unutilised national archival sources from the Department of Education and Science, it comments upon events which have hitherto been omitted from the historiography of RE, but which help to contextualise significant changes in RE theory and practice at that time. Moreover, it demonstrates that the current parlous state of RE in schools is in part the result of latent and longstanding issues and problems, rather than a consequence of present-day government policy alone. Therefore, in reviewing and developing RE policies and practices, all stakeholders are urged to look more closely at both changes and continuities in the subject’s past and the contexts in which they occurred.

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This article provides an overview of the Portuguese legislative election held on 4 October 2015 by exploring the economic and political context in which the election took place, the opinion polls, party positions and campaign issues, the results and, finally, the process that led to the formation of the first Socialist minority government supported by far-left parties. Due to this outcome, despite the relative majority of the votes obtained by the incumbent centre-right coalition, we argue that this election result cannot be interpreted as a victory of austerity, but rather as the first step towards contract parliamentarism in Portugal.

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This programme of research used a developmental psychopathology approach to investigate females across the adolescent period. A two-sided story is presented; first, a study of neuroendocrine and psychosocial parameters in a group of healthy female adolescents (N = 63), followed by a parallel study of female adolescents with anorexia nervosa (AN) (N = 8). A biopsychosocial, multi-method measurement approach was taken, which utilised self-report, interview and hypothalamic-pituitary-adrenocortical (HPA) axis measures. Saliva samples for the measurement of cortisol and DHEA were collected using the best-recommended methodology: multiple samples over the day, strict reference to time of awakening, and two consecutive sampling weekdays. The research was adolescent-orientated: specifically, by using creative and ageappropriate strategies to ensure participant adherence to protocol, as well as more generally by adopting various procedures to facilitate engagement with the research process. In the healthy females mean (± SD) age 13.9 (± 2.7) years, cortisol and DHEA secretion exhibited typical adult-like diurnal patterns. Developmental markers of chronological age, menarche status and body mass index (BMI) had differential associations with cortisol and DHEA secretory activity. The pattern of the cortisol awakening response (CAR) was sensitive to whether participants had experienced first menses, but not to chronological age or BMI. Those who were post-menarche generally reached their peak point of cortisol secretion at 45 minutes post-awakening, in contrast to the pre-menarche group who were more evenly spread. Subsequent daytime cortisol levels were also higher in post-menarche females, and this effect was also noted for increasing age and BMI. Both morning and evening DHEA were positively associated with developmental markers. None of the situational or self-report psychosocial variables that were measured modulated any of the key findings regarding cortisol and DHEA secretion. The healthy group of girls were within age-appropriate norms for all the self-report measures used, however just under half of this group were insecurely attached (as assessed by interview). Only attachment style was associated with neuroendocrine parameters. In particular, those with an anxious insecure style exhibited a higher awakening sample (levels were 7.16 nmol/l, 10.40 nmol/l and 7.93 nmol/l for secure, anxious and avoidant groups, respectively) and a flatter CAR (mean increases over the awakening period were 6.38 nmol/l, 2.32 nmol/l and 8.61 nmol/l for secure, anxious and avoidant groups, respectively). The afore-mentioned pattern is similar to that consistently associated with psychological disorder in adults, and so this may be a pre-clinical vulnerability factor for subsequent mental health problems. A group of females with AN, mean (± SD) age 15.1 (± 1.6) years, were recruited from a specialist residential clinic and compared to the above group of healthy control (HC) female adolescents. A general picture of cortisol and DHEA hypersecretion was revealed in those with AN. The mean (± SD) change exhibited in cortisol levels over the 30 minute post-awakening period was 7.05 nmol/l (± 5.99) and 8.33 nmol/l (± 6.41) for HC and AN groups, respectively. The mean (± SD) evening cortisol level for the HC girls was 1.95 nmol/l (± 2.11), in comparison to 6.42 nmol/l (± 11.10) for the AN group. Mean (± SD) morning DHEA concentrations were 1.47 nmol/l (± 0.85) and 2.25 nmol/l (± 0.88) for HC and AN groups, respectively. The HC group’s mean (± SD) concentration of 12 hour DHEA was 0.55 nmol/l (± 0.46) and the AN group’s mean level was 0.89 nmol/l (± 0.90). This adrenal steroid hypersecretion evidenced by the AN group was not associated with BMI or eating disorder symptomatology. Insecure attachment characterised by fearfulness and anger was most apparent; a style which was unparalleled in the healthy group of female adolescents. The causal directions of the AN group findings remain unclear. Examining some of the participants with AN as case studies one year post-discharge from the clinic illustrated that for one participant who was recovered, in terms of returning to ordinary school life and no longer exhibiting clinical levels of eating disorder symptomatology, her CARs were no longer inconsistent over sampling days and her DHEA levels were also now generally comparable to the healthy control group. For another participant who had not recovered from her AN one year later, the profile of her CAR continued to be inconsistent over sampling days and her DHEA concentrations over the diurnal period were significantly higher in comparison to the healthy control group. In its entirety, this work’s unique contribution lies in its consideration of methodological and developmental issues specifically pertaining to adolescents. Findings also contribute to knowledge of AN and understanding of vulnerability factors, and how these may be used to develop interventions dedicated to improving adolescent health.

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In this paper I outline possibilities for, and issues arising from, opposition towards the dominant ideologies and practices of marketing knowledge (Hirschman 1993) through an engagement with feminist epistemology (Longino 1991, Harding 1987). Feminist epistemology is a political branch of naturalised epistemology (Quine 1969) primarily concerned with critique of constructions of gender, gender norms and gendered interests within the production of knowledge (Anderson 1995) and with theorising, grounding and legitimating feminist knowledge making practices (Harding 1987). It is most often associated with the feminist critique of science, and with feminist science and technology studies (Haraway 1987, Wajman 1997). Feminist epistemology asks the question, ‘what is the nature of the feminist critical project as a way of knowing?’ (McLennan 1995:392). This paper outlines the basis of the feminist critique of knowledge generally, and as applied to marketing knowledge, offers description of the three main epistemological approaches to this question and suggestions for their application in practice. The paper progresses important work by consumer behaviour theorists (Bristor and Fischer 1993, Hirschman 1993) on the potentials of feminist ways of knowing for marketing and consumer behaviour by moving beyond the tripartite of feminist approaches outlined, and extending the discussion to take into account the development of situated knowledges theory (Haraway 1989, 1997), which has become so important in the decade since these papers were written. It joins ongoing conversations in consumer behaviour and marketing that share similar feminist concerns (Catterall et al 1997, 2000, 2005, Bettany and Woodruffe Burton 1999, 2005, and Hogg et al 1999, 2000) but in this contribution it takes a slightly tangential approach, seeing marketing knowledge in terms of its epistemic culture by using a model of masculinity in academic cultures from feminist theory (Wagner 1994) to help conceptualise it as such. The dominant masculine ideology of marketing knowledge both in execution (Penaloza 1994, Bristor and Fischer 1994, Fischer and Bristor 1993, Woodruffe 1996), and values (Hirschman 1993, Brown 2000, Desmond 1997) has been well documented over the past fifteen years. However, although the basis of this, how is it manifested and how a feminist informed marketing knowledge could be achieved, have been addressed somewhat in the literature (Bristor and Fischer 1993, Hogg, Bettany and Long 2000) an updated rendering is necessary which focuses specifically on epistemology and situates this discussion within a cultural framework. To do this I use the notions of cultural masculinity in academic disciplines developed by Wagner (1994) of ‘organisational egocentrism’, ‘fake collectivity’ and ‘de realisation’. With these, I raise important and specific issues around the notion of the masculinity of marketing knowledge, and then present an outline of feminist epistemologies to illustrate how different feminist approaches to knowledge would address these concerns.

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This chapter reports on a study of teachers in transition, developing their practice and their cognitions regarding the integration of learning technologies with traditional approaches to the teaching of English for Academic Purposes (EAP). Taking a case study approach, it examines developments in the practice of three teachers during and after a teacher education programme on the use of technology in the EAP classroom. This is a study of cognition, teaching philosophy, and the relationship between pedagogy, technology, and content, and how teachers situate these within their own practice. The setting is the rapidly changing UK higher education environment, where the speed of change is such that today's latest fashions and gadgets may well be yesterday's news tomorrow. Thus, this is not a tale of individual technologies or tools to make teachers' lives better. This is a story of people, of pedagogy's traditional values intersecting with technology, and the issues arising from this, alongside the evolution of strategies for dealing with these issues.

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BACKGROUND: The second Swiss Multicenter Adolescent Survey on Health (SMASH02) was conducted among a representative sample (n = 7428) of students and apprentices aged 16 to 20 from the three language areas of Switzerland during the year 2002. This paper reports on health needs expressed by adolescents and their use of health care services over the 12 months preceding the survey. METHODS: Nineteen cantons representing 80% of the resident population agreed to participate. A complex iterative random cluster sample of 600 classes was drawn with classes as primary sampling unit. The participation rate was 97.7% for the classes and 99.8% for the youths in attendance. The self-administered questionnaire included 565 items. The median rate of item non-response was 1.8%. Ethical and legal requirements applying to surveys of adolescent populations were respected. RESULTS: Overall more than 90% of adolescents felt in good to excellent health. Suffering often or very often from different physical complaints or pain was also reported such as headache (boys: 15.9%, girls: 37.4%), stomach-ache (boys: 9.7%, girls: 30.0%), joint pain (boys: 24.7%, girls: 29.5%) or back pain (boys: 24.3%, girls: 34.7%). Many adolescents reported a need for help on psychosocial and lifestyle issues, such as stress (boys: 28.5%, girls: 47.7%) or depression (boys: 18.9%, girls: 34.4%). Although about 75% of adolescents reported having consulted a general practitioner and about one-third having seen another specialist, reported reasons for visits do not correspond to the expressed needs. Less than 10% of adolescents had visited a psychiatrist, a family planning centre or a social worker. CONCLUSIONS: The reported rates of health services utilisation by adolescents does not match the substantial reported needs for help in various areas. This may indicate that the corresponding problems are not adequately detected and/or addressed by professionals from the health and social sectors.

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No study to date has focused specifically on the reasons for and against disclosure of HIV-positive status among sub-Saharan migrant women. Thirty HIV-positive women from 11 sub-Saharan countries living in French-speaking Switzerland participated in semi-structured individual interviews. The reasons women reported for disclosure or nondisclosure of their HIV serostatus were classified into three categories: social, medical, and ethical. The women identified the stigma associated with HIV as a major social reason for nondisclosure. However, this study identifies new trends related to disclosure for medical and ethical reasons. Being undetectable played an important role in the life of sub-Saharan migrant women, and analysis revealed their medical reasons for both disclosure and nondisclosure. Disclosure to new sexual partners occurred when women had a more positive perception about HIV and when they believed themselves to be in a long-term relationship. Women reported nondisclosure to family members when they did not need help outside the support provided by the medical and social fields. The results on ethical reasons suggested that challenging stigma was a reason for disclosure. Since the women' perceptions on HIV changed when they came to see it as a chronic disease, disclosure occurred in an attempt to normalize life with HIV in their communities in migration and to challenge racism and discrimination. Our findings can help health providers better understand the communication needs of sub-Saharan migrant women with respect to HIV/AIDS and sexuality and offer them adequate disclosure advice that takes into account migration and gender issues.

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Breakthrough technologies which now enable the sequencing of individual genomes will irreversibly modify the way diseases are diagnosed, predicted, prevented and treated. For these technologies to reach their full potential requires, upstream, access to high-quality biomedical data and samples from large number of properly informed and consenting individuals and, downstream, the possibility to transform the emerging knowledge into a clinical utility. The Lausanne Institutional Biobank was designed as an integrated, highly versatile infrastructure to harness the power of these emerging technologies and catalyse the discovery and development of innovative therapeutics and biomarkers, and advance the field of personalised medicine. Described here are its rationale, design and governance, as well as parallel initiatives which have been launched locally to address the societal, ethical and technological issues associated with this new bio-resource. Since January 2013, inpatients admitted at Lausanne CHUV University Hospital have been systematically invited to provide a general consent for the use of their biomedical data and samples for research, to complete a standardised questionnaire, to donate a 10-ml sample of blood for future DNA extraction and to be re-contacted for future clinical trials. Over the first 18 months of operation, 14,459 patients were contacted, and 11,051 accepted to participate in the study. This initial 18-month experience illustrates that a systematic hospital-based biobank is feasible; it shows a strong engagement in research from the patient population in this University Hospital setting, and the need for a broad, integrated approach for the future of medicine to reach its full potential.

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The application of contrast media in post-mortem radiology differs from clinical approaches in living patients. Post-mortem changes in the vascular system and the absence of blood flow lead to specific problems that have to be considered for the performance of post-mortem angiography. In addition, interpreting the images is challenging due to technique-related and post-mortem artefacts that have to be known and that are specific for each applied technique. Although the idea of injecting contrast media is old, classic methods are not simply transferable to modern radiological techniques in forensic medicine, as they are mostly dedicated to single-organ studies or applicable only shortly after death. With the introduction of modern imaging techniques, such as post-mortem computed tomography (PMCT) and post-mortem magnetic resonance (PMMR), to forensic death investigations, intensive research started to explore their advantages and limitations compared to conventional autopsy. PMCT has already become a routine investigation in several centres, and different techniques have been developed to better visualise the vascular system and organ parenchyma in PMCT. In contrast, the use of PMMR is still limited due to practical issues, and research is now starting in the field of PMMR angiography. This article gives an overview of the problems in post-mortem contrast media application, the various classic and modern techniques, and the issues to consider by using different media.

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Objective: Frequent Emergency Department (ED) users are vulnerable individuals and discrimination is usually associated with increased vulnerability. The aim of this study was to investigate frequent ED users' perceptions of discrimination and to test whether they were associated with increased vulnerability. Methods: In total, 250 adult frequent ED users were interviewed in Lausanne University Hospital. From a previously published questionnaire, we assessed 15 dichotomous sources of perceived discrimination. Vulnerability was assessed using health status: objective health status (evaluation by a healthcare practitioner including somatic, mental health, behavioral, and social issues - dichotomous variables) and subjective health status [self-evaluation including health-related quality of life (WHOQOL) and quality of life (EUROQOL) - mean-scores]. We computed the prevalence rates of perceived discrimination and tested associations between perceived discrimination and health status (Fischer's exact tests, Mann-Whitney U-tests)

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This research thesis analyses the motivation behind the cross-border mergers and acquisitions deals. How mergers and acquisitions of new knowledge and assets, enhance business with expansion into new streams and international markets. Also, how mega deals help them to gain a power in the international markets. The research focuses on understanding the interrelation between motivations which are contributing to M&A activities and how issues like cultural differences and different management styles are overcome by these firms in cross-border settings. Chapter 1, gives a background knowledge on cross-border M&A as popular internationalization strategy choice, continuing with describing the process in Finnish and Japanese cultural context, and how these deals are proceeding in particular cases. Chapter 2, reviews the important findings and touches the common gaps or aspects those are not studied extensively, does play a key role in the success and failure of M&A deals. A methodology is presented in chapter 3, presenting the hurdles faced by many in this research field. Chapter 4, present the case study is presented to show how M&A can play an important role in structuring the entire economy of Japan. At last chapter 5, presents the evidence, if cultural, HRM and geographical aspects really contribute to the success of M&A, based on which managerial implications are suggested and propositions are built for future research references.