Fibronectin/phosphorylcholine coatings on fluorocarboned surfaces: a study upon adsorption and grafting processes

Depuis ces dernières décennies, le domaine des biomatériaux a connu un essor considérable, évoluant de simples prothèses aux dispositifs les plus complexes pouvant détenir une bioactivité spécifique. Outre, le progrès en science des matériaux et une meilleure compréhension des systèmes biologiques a offert la possibilité de créer des matériaux synthétiques pouvant moduler et stimuler une réponse biologique déterminée, tout en améliorant considérablement la performance clinique des biomatériaux. En ce qui concerne les dispositifs cardiovasculaires, divers recouvrements ont été développés et étudiés dans le but de modifier les propriétés de surface et d’améliorer l’efficacité clinique des tuteurs. En effet, lorsqu’un dispositif médical est implanté dans le corps humain, son succès clinique est fortement influencé par les premières interactions que sa surface établit avec les tissus et les fluides biologiques environnants. Le recouvrement à la surface de biomatériaux par diverses molécules ayant des propriétés complémentaires constitue une approche intéressante pour atteindre différentes cibles biologiques et orienter la réponse de l’hôte. De ce fait, l’élucidation de l’interaction entre les différentes molécules composant les recouvrements est pertinente pour prédire la conservation de leurs propriétés biologiques spécifiques. Dans ce travail, des recouvrements pour des applications cardiovasculaires ont été créés, composés de deux molécules ayant des propriétés biologiques complémentaires : la fibronectine (FN) afin de promouvoir l’endothélialisation et la phosphorylcholine (PRC) pour favoriser l’hémocompatibilité. Des techniques d’adsorption et de greffage ont été appliquées pour créer différents recouvrements de ces deux biomolécules sur un polymère fluorocarboné déposé par traitement plasma sur un substrat en acier inoxydable. Dans un premier temps, des films de polytétrafluoroéthylène (PTFE) ont été utilisés en tant que surface modèle afin d’explorer l’interaction de la PRC et de la FN avec les surfaces fluorocarbonées ainsi qu’avec des cellules endothéliales et du sang. La stabilité des recouvrements de FN sur l’acier inoxydable a été étudiée par déformation, mais également par des essais statiques et dynamiques sous-flux. Les recouvrements ont été caractérisés par Spectroscopie Photoéléctronique par Rayons X, immunomarquage, angle de contact, Microscopie Électronique de Balayage, Microscopie de Force Atomique et Spectrométrie de Masse à Ionisation Secondaire à Temps de Vol (imagerie et profilage en profondeur). Des tests d’hémocompatibilité ont été effectués et l’interaction des cellules endothéliales avec les recouvrements a également été évaluée. La FN greffée a présenté des recouvrements plus denses et homogènes alors que la PRC quant à elle, a montré une meilleure homogénéité lorsqu’elle était adsorbée. La caractérisation de la surface des échantillons contenant FN/PRC a été corrélée aux propriétés biologiques et les recouvrements pour lesquels la FN a été greffée suivie de l’adsorption de la PRC ont présenté les meilleurs résultats pour des applications cardiovasculaires : la promotion de l’endothélialisation et des propriétés d’hémocompatibilité. Concernant les tests de stabilité, les recouvrements de FN greffée ont présenté une plus grande stabilité et densité que dans le cas de l’adsorption. En effet, la pertinence de présenter des investigations des essais sous-flux versus des essais statiques ainsi que la comparaison des différentes stratégies pour créer des recouvrements a été mis en évidence. D’autres expériences sont nécessaires pour étudier la stabilité des recouvrements de PRC et de mieux prédire son interaction avec des tissus in vivo.

Gestão de Recursos Humanos no Terceiro Setor: O Caso das Instituições Particulares de Solidariedade Social

O presente trabalho tem como objetivo geral estudar a gestão de recursos humanos (GRH) no terceiro setor, focando-se especificamente nas Instituições Particulares de Solidariedade Social (IPSS). Estas organizações têm vindo a demonstrar um papel cada vez mais relevante nas comunidades em que se inserem, pela sua missão em prestar serviços de cariz social e pela atual relevância como entidades empregadoras. A diversidade presente nas IPSS ao nível da estrutura, funcionamento, dimensão, organização e dinâmicas internas, proporciona o estudo e reflexão das especificidades na GRH. Para isso, abordam-se um conjunto de aspetos: i) diferenças entre meio empresarial e terceiro setor na GRH; ii) implicações da diversidade de respostas sociais e suas especificidades na gestão de pessoas; iii) o papel do Instituto de Segurança Social e as implicações legais na gestão de pessoas; iv) a localização geográfica e acesso a recursos humanos qualificados; v) a perspetiva das IPSS sobre os recursos humanos; vi) o perfil profissional dos colaboradores das IPSS; vii) práticas quotidianas na gestão de recursos humanos nas IPSS; viii) características da GRH nas IPSS (administrativa ou estratégica); ix) responsáveis pela GRH nas IPSS; x) o papel dos órgãos sociais na GRH; xi) profissionalização versus voluntariado; xii) a GRH, certificação e qualidade; xiii) as tendências do terceiro setor na gestão de pessoas. Foi utilizada uma metodologia qualitativa e aplicada a técnica de entrevista para recolher o conhecimento, experiências e perspetivas de diferentes interlocutores do terceiro setor, dirigentes, técnicos superiores, diretores de serviço, investigadores e representantes nacionais e distritais das IPSS. Da sistematização e análise dos dados recolhidos retiraram-se várias conclusões. As pessoas são consideradas o recurso mais importante para estas organizações, pela natureza social e humana das atividades desenvolvidas, prestadas por pessoas e destinadas a pessoas. Neste sentido, é demonstrada a importância do potencial humano aquando do recrutamento e seleção, pela primazia de requisitos como o relacionamento interpessoal em detrimento das qualificações. O perfil profissional característico das IPSS reconhece a importância da polivalência, disponibilidade, comprometimento, confiança, proximidade afetiva, voluntarismo e sentido de missão dos colaboradores, os quais tendem a ser são vistos como investimento tanto quanto reúnam estes aspetos; caso contrário podem ser encarados como custo. Quanto à acessibilidade a recursos humanos, surgem diferentes modalidades, consoante fatores de localização, dimensão, formação e estrutura organizacional, bem como o fenómeno da fuga de mão de obra, indício da dificuldade em captar e reter recursos humanos. O modelo de GRH nas IPSS é de cariz tradicional, caracterizado por uma gestão porimproviso com diferentes níveis de sensibilidade e capacidade das IPSS, no que concerne à implementação de processos de GRH, tais como sistemas de progressão na carreira, recrutamento interno e sistemas de avaliação de desempenho. Quanto aos aspetos da motivação e satisfação profissional, é assumida a importância da proximidade e apoio aos colaboradores, indicativos de um sistema de recompensas informal. É percetível a resistência na aplicação de técnicas de desenvolvimento organizacional, comprovada pela limitação na formação dos quadros de colaboradores. No entanto as IPSS são confrontadas com a rigidez dos instrumentos legais. A responsabilidade pela GRH é mais ou menos partilhada entre a direção técnica e os órgãos sociais, condicionada pelo estilo de liderança e relação de confiança entre si, em norma, pouco clara quanto aos papéis e funções desempenhadas. Por fim, é percebida a necessidade de coexistência de uma gestão profissionalizada e de direções voluntárias mais capacitadas e sensibilizadas para o desenvolvimento de metodologias e estratégias de gestão de pessoas, adaptadas às especificidades das IPSS. Este trabalho pretende contribuir com um espaço de reflexão para a elaboração de respostas mais eficazes e inovadoras que proporcionem o desenvolvimento organizacional, face às necessidades e transformações do terceiro setor. / This work main objective is the study of human resource management (HRM) in the third sector. It is focused specifically on Instituições Particulares de Solidariedade Social [Private Institutions for Social Solidarity] (IPSS). These kind of organizations have demonstrated an increased value in the communities they are inserted in, by providing social care services and by generating new jobs in the local communities. The study and reflection of HRM specificities is based on the variety in the structure, the purpose, the size, the internal organization and the dynamics of the different IPSS. For this purpose we explored the following aspects : i) the differences between business community and the third sector in HRM; ii) the implications of social responses diversity in people management; iii) the role of the National Insurance Institute and the legal impact on people management; iv) the geographic location and the IPSS access to skilled human resources; v) the understanding of IPSS on human resources; vi) the professional profile of IPSS employees; vii) the daily practices in human resource management on the IPSS; viii) the characteristics of HRM in IPSS (managerial or strategic); ix) who is responsible for HRM in IPSS; x) the role of executive board in HRM; xi) professionalization versus voluntary work; xii) HRM, quality and certification; xiii) the third sector trends in people management. The qualitative method and the interview technique were applied in order to gather knowledge, experiences and perspectives from several sources such as, different partners of the third sector, managers, service directors, technicians, researchers and national and local IPSS representatives. The results indicate several conclusions. Firstly the human resources are the most important resource of IPSS organizations due to the social nature of the services provided by them but also the importance of, the individual and social, skills required for these activities that are provided by people and are directed to people. This demonstrates the importance of interpersonal skills over professional qualifications during recruitment and selection. The IPSS recognize in their professionals the importance of versatility, availability, commitment, confidence, emotional proximity, voluntarism and sense of mission. If an employee fulfills these requirements, is considered an investment; otherwise might be seen as a cost. Regarding the accessibility of IPSS to qualified human resources, we consider different models, depending on location, size and training and organizational structure as well as the phenomenon run of hand labor, defined as the index of difficulty in capturing and retaining human resources. The model of HRM in IPSS is traditional in its nature and is characterized by management based on improvisation at different levels, regarding the implementation ofHRM processes such as career advancement systems, internal recruitment and performance evaluation. In regards to motivation and job satisfaction, it is valued the proximity and the support to the employees, showing therefore an informal system of rewards. There is a noticeable resistance to the application of organizational techniques which is demonstrated by controlling the formation of employees. However the IPSS are required to face the rigidity of legal instruments. The responsibility for HRM is shared between the technical direction and the management bodies, which depends on leadership style and mutual trust, and is generally unclear about the roles and duties performed. Finally, it becomes evident the need for coexistence between a professional management and a voluntary management, more capable and more sensible to the development of methods and strategies for people management, specifically adapted to each IPSS. This paper aims to contribute with space for reflection in the development of more effective and innovative responses for the organizational development, given the needs and transformations of the third sector.

Understanding changes in mobility & subsistence from terminal Pleistocene to Late Holocene in the highlands of New Guinea through intensity of lithic reduction, changing site types, and paleoclimate

Thesis (Ph.D.)--University of Washington, 2016-08

O Litoral e a metrópole dinâmica imobiliária, turismo e expansão urbana na região metropolitana de Natal-RN

The metropolitan regions of Northeast Brazil are being gradually included in a scenario of international investments, which are motivated by the restructuring of both touristic and real-estate sectors. The new capital, real-estate developers and space configurations that result from this process indicate the need for the creation and implementation of public tools which should, at least, allow the mitigation of the urban impacts and environmental losses resulting from this situation. The effects on landscape and on the socio-spatial configuration result from the intensification caused by the dynamism of the "real estate-tourism" sector. There is a regional integration as an expression of the urban expansion of the metropolitan area of Natal. This study investigates the uniqueness of the restructuring and territorial integration of coastal areas and the strategies of the circuit of capital accumulation formed by linking the real estate to tourism. It is intended to increase the understanding about the strategies of tourism, real estate and public policy agents involved in this territorial reconfiguration and in the fund-raising needed for the investments, to understand the existing social and environmental effects and their future trends and also to understand the forms of spatial production as results from the practices of approaching the land transformation and the tourism valorization of the landscape, in a synchronous manner, first in the Northeast region and, as a focal study, in the Metropolitan Area of Natal. Likewise, it is intended to apprehend the current processes of metropolization of the eastern coast of Rio Grande do Norte, in addition to indicate its physical-territorial transformation and the types of projects/developments promoted by the market in the recent period. Based upon analysis undertaken for the Metropolitan Region of Natal RN, this piece of work presents some considerations on possible legal instruments that can be adjusted to the municipalities which are experiencing the impact of this peculiar and recent phenomenon in the region, caused by the arrival of the real estate-touristic capital. It is also intended to point out basic proposals to the forms of public intervention, in a speculative way, starting from a Metropolitan Planning project within a medium and long term

Understanding the Reaction Mechanism of Nanocomposite Thermites

Nanocomposite energetics are a relatively new class of materials that combine nanoscale fuels and oxidizers to allow for the rapid release of large amounts of energy. In thermite systems (metal fuel with metal oxide oxidizer), the use of nanomaterials has been illustrated to increase reactivity by multiple orders of magnitude as a result of the higher specific surface area and smaller diffusion length scales. However, the highly dynamic and nanoscale processes intrinsic to these materials, as well as heating rate dependencies, have limited our understanding of the underlying processes that control reaction and propagation. For my dissertation, I have employed a variety of experimental approaches that have allowed me to probe these processes at heating rates representative of free combustion with the goal of understanding the fundamental mechanisms. Dynamic transmission electron microscopy (DTEM) was used to study the in situ morphological change that occurs in nanocomposite thermite materials subjected to rapid (10^11 K/s) heating. Aluminum nanoparticle (Al-NP) aggregates were found to lose their nanostructure through coalescence in as little as 10 ns, which is much faster than any other timescale of combustion. Further study of nanoscale reaction with CuO determined that a condensed phase interfacial reaction could occur within 0.5-5 µs in a manner consistent with bulk reaction, which supports that this mechanism plays a dominant role in the overall reaction process. Ta nanocomposites were also studied to determine if a high melting point (3280 K) affects the loss of nanostructure and rate of reaction. The condensed phase reaction pathway was further explored using reactive multilayers sputter deposited onto thin Pt wires to allow for temperature jump (T-Jump) heating at rates of ~5x10^5 K/s. High speed video and a time of flight mass spectrometry (TOFMS) were used to observe ignition temperature and speciation as a function of bilayer thickness. The ignition process was modeled and a low activation energy for effective diffusivity was determined. T-Jump TOFMS along with constant volume combustion cell studies were also used to determine the effect of gas release in nanoparticle systems by comparing the reaction properties of CuO and Cu2O.

Strategic Management of Resources for International Business Operations in Small Consulting Firms - People, Processes and Tools in Managing International operations

Research on strategic management of resources for small consulting firms which are international or planning to operate internationally is scarce or not existing at all. It is however important to start generating the theories that will support managers in their decision making and planning. This thesis investigates how do small management consulting firms manage their internal and external resources while operating in international markets. Throughout the study, aspects related to internal and external resources management as well as management strategies in these firms have been examined in relations to firm’s internationalisation activities. A qualitative analysis was carried out whereby four small consulting firms in Export Management Consulting, Integration Services Consulting-, Software Development Consulting- and Business Solutions Consulting companies were interviewed. In order to generate the holistic understanding of the study, the thesis writer selected Value Enhanced Collaborative Working (VECW) model as an analysis framework. The model focuses on people, processes and tools as key elements that small consulting firms consider when thinking about managing their international operations. The findings of the thesis reveal that, internal and external resources in the interviewed consulting firms are viewed similarly, but managed differently depending on the nature and size of the firm. Firm’s management strategies concentrate on the adequate utilisation of the employees' motivation and experiences, effective stakeholders' management, various administrative evaluation processes and tools, the ability to realise useful networks, constant improvement through employee trainings, employees and customers’ feedbacks as well as enhanced freedom in order to support employees’ creativity. Further research to examine functional administrative tools and tools that small consulting firms could use to assess their resource capabilities when planning to become international would benefit the smaller businesses in terms of resources management and certainty in planning.

Understanding stakeholder participation in post-disaster recovery (case study: Nagapattinam, India)

Stakeholder participation is widely acknowledged as a critical component of post-disaster recovery because it helps create a shared understanding of local hazard risk and vulnerability, improves recovery and mitigation decision efficacy, and builds social capital and local resilience to future disasters. But approaches commonly used to facilitate participation and empower local communities depend on lengthy consensus-building processes which is not conducive to time-constrained post-disaster recovery. Moreover, these approaches are often criticized for being overly technocratic and ignoring existing community power and trust structures. Therefore, there is a need for more nuanced, analytical and applied research on stakeholder participation in planning for post-disaster recovery. This research examines participatory behavior of three stakeholder groups (government agencies, non-local non-government organizations, local community-based organizations) in three coastal village communities of Nagapattinam (India) that were recovering from the 2004 Indian Ocean tsunami. The study found eight different forms of participation and non-participation in the case study communities, ranging from 'transformative' participation to 'marginalized' non-participation. These forms of participation and non-participatory behavior emanated from the negotiation of four factors, namely stakeholder power, legitimacy, trust, and urgency for action. The study also found that the time constraints and changing conditions of recovery pose particular challenges for how these factors operated on the ground and over the course of recovery. Finally, the study uses these insights to suggest four strategies for recovery managers to use in the short- and long-term to facilitate more effective stakeholder participation in post-disaster recovery.

An analysis of state crime: negotiating multiple insecurities around the U.S. Mexico Border

This research looks into forms of state crime taking place around the U.S.-Mexico border. On the Mexican side of the border violent corruption and criminal activities stemming from state actors complicity with drug trafficking organisations has produced widespread violence and human casualty while forcing many to cross the border legally or illegally in fear for their lives. Upon their arrival on the U.S. side of the border, these individuals are treated as criminal suspects. They are held in immigration detention facilities, interrogated and categorised as inadmissible ‘economic migrants’ or ‘drug offenders’ only to be denied asylum status and deported to dangerous and violent zones in Mexico. These individuals have been persecuted and victimised by the state during the 2007-2012 counter narcotic operations on one side of the border while criminalised and punished by a categorizing anti-immigration regime on the other side of the border. This thesis examines this border crisis as injurious actions against border residents have been executed by the states under legal and illegal formats in violation of criminal law and human rights conventions. The ethnographic research uses data to develop a nuanced understanding of individuals’ experiences of state victimisation on both sides of the border. In contributing to state crime scholarship it presents a multidimensional theoretical lens by using organised crime theoretical models and critical criminology concepts to explain the role of the state in producing multiple insecurities that exclude citizens and non-citizens through criminalisation processes.

A framework for better understanding drinking-water quality in Happy Valley-Goose Bay, Labrador: Implications for optimization and protection of municipally supplied water

This research project was driven by the recurring complaints and concerns voiced in the media by residents living in the Valley area of the community of Happy Valley-Goose Bay, Labrador. Drinking water in this town is supplied by two water treatment plants (a municipality treatment plant and a DND treatment plant), which use raw water from two different sources (groundwater from multiple wells versus surface water from Spring Gulch brook) and use two different processes of drinking-water treatment. In fact, the drinking water supplied in the Valley area has a unique distribution arrangement. To meet demand, the Valley area is served by a blend of treated waters from a storage reservoir (Sandhill reservoir), which is fed by both water treatment plants. Most of the time, treated water from the municipal treatment plant dominates in the mixture. As water travels through the distribution system and household plumbing, specific reactions can occur either in the water itself and/or at the solid–liquid interface at the pipe walls; this is strongly influenced by the physical and chemical characteristics of the water. These reactions can introduce undesirable chemical compounds and/or favor the growth of bacteria in the drinking water, causing the deterioration of the quality of water reaching the consumer taps. In the distribution system in general, these chemical constituents and bacteria may pose potential threats to health or the water’s aesthetic qualities (smell, taste or appearance). Drinking water should be not only safe, but also palatable.

From the human rights-based approach to an ecological approach on how to achieve successful inclusion in international disability education

The barriers that people with disabilities face around the world are not only inherent to the limitations resulting from the disability itself, but, more importantly, these barriers rest with the societal technologies of exclusion. Using a mixed methodology approach, I conduct a quest to revealing several societal factors that limit full participation of people with disabilities in their communities, which will contribute to understanding and developing a more comprehensive framework for full inclusion of people with disabilities into the society. First, I conduct a multiple regression analysis to seek whether there is a statistical relationship between the national level of development, the level of democratization, and the level of education within a country’s population on one hand, and expressed concern for and preparedness to improve the quality of life for people of disabilities on another hand. The results from the quantitative methodology reveal that people without disabilities are more prepared to take care of people with disabilities when the level of development of the country is higher, when the people have more freedom of expression and hold the government accountable for its actions, and when the level of corruption is under control. However, a greater concern for the well-being of people with disabilities is correlated with a high level of country development, a decreased value of political stability and absence of violence, a decreased level of government effectiveness, and a greater level of law enforcement. None of the dependent variables are significantly correlated with the level of education from a given country. Then, I delve into an interpretive analysis to understand multiple factors that contribute to the construction of attitudes and practices towards people with disabilities. In doing this, I build upon the four main principles outlined by the United Nations as strongly recommended to be embedded in all international programmes: (1) identification of claims of human rights and the corresponding obligations of governments, hence, I assess and analyze disability rights in education, looking at United Nation, United States, and European Union Perspectives Educational Rights Provisions for People with Disabilities (Ch. 3); (2) estimated capacity of individuals to claim their rights and of governments to fulfill their obligations, hence, I look at the people with disabilities as rights-holders and duty-bearers and discuss the importance of investing in special capital in the context of global development (Ch. 4); (3) programmes monitor and evaluate the outcomes and the processes under the auspices of human rights standards, hence, I look at the importance of evaluating the UN World Programme of Action Concerning People with Disabilities from multiple perspectives, as an example of why and how to monitor and evaluate educational human rights outcomes and processes (Ch. 5); and (4) programming should reflect the recommendations of international human rights bodies and mechanisms, hence, I focus on programming that fosters development of the capacity of people with disabilities, that is, planning for an ecology of disabilities and ecoducation for people with disabilities (Ch. 6). Results from both methodologies converge to a certain point, and they further complement each other. One common result for the two methodologies employed is that disability is an evolving concept when viewed in a broader context, which integrates the four spaces that the ecological framework incorporates. Another common result is that factors such as economic, social, legal, political, and natural resources and contexts contribute to the health, education and employment opportunities, and to the overall well-being of people with disabilities. The ecological framework sees all these factors from a meta-systemic perspective, where bi-directional interactions are expected and desired, and also from a human rights point of view, where the inherent value of people is upheld at its highest standard.

Predictive Models for Tomato Spotted Wilt Virus Spread Dynamics, Considering Frankliniella occidentalis Specific Life Processes as Influenced by the Virus

Several models have been studied on predictive epidemics of arthropod vectored plant viruses in an attempt to bring understanding to the complex but specific relationship between the three cornered pathosystem (virus, vector and host plant), as well as their interactions with the environment. A large body of studies mainly focuses on weather based models as management tool for monitoring pests and diseases, with very few incorporating the contribution of vector's life processes in the disease dynamics, which is an essential aspect when mitigating virus incidences in a crop stand. In this study, we hypothesized that the multiplication and spread of tomato spotted wilt virus (TSWV) in a crop stand is strongly related to its influences on Frankliniella occidentalis preferential behavior and life expectancy. Model dynamics of important aspects in disease development within TSWV-F. occidentalis-host plant interactions were developed, focusing on F. occidentalis' life processes as influenced by TSWV. The results show that the influence of TSWV on F. occidentalis preferential behaviour leads to an estimated increase in relative acquisition rate of the virus, and up to 33% increase in transmission rate to healthy plants. Also, increased life expectancy; which relates to improved fitness, is dependent on the virus induced preferential behaviour, consequently promoting multiplication and spread of the virus in a crop stand. The development of vector-based models could further help in elucidating the role of tri-trophic interactions in agricultural disease systems. Use of the model to examine the components of the disease process could also boost our understanding on how specific epidemiological characteristics interact to cause diseases in crops. With this level of understanding we can efficiently develop more precise control strategies for the virus and the vector.

Legal disclosure of childhood sexual abuse: what can professionals tell us?

ABSTRACT: Purpose: This study explores how the decision to disclose Childhood Sexual Abuse (CSA) to the legal setting for adult victims is perceived by key informants, specifically factors that are believed to facilitate or prevent legal disclosure from occurring. Background: Prevalence rates of CSA are high (Pereda, Guilera, Forns & Gomez-Benito, 2009) and the negative consequences caused by the abuse acknowledged (Filipas & Ullman, 2006). Disclosure of this crime is understood to be complex and delayed disclosure recognised (Arata, 1998) but little is known about disclosure to the legal system. Rates of legal disclosure of CSA remain low and the attrition rates high (London, Bruck, Ceci & Shuman, 2005), but investigation and understanding of the contributory factors is rare. Disclosure of CSA to the legal system enables prosecution of the abuser and protection of the victim and others. Method: 10 “key informants” consisting of specialised clinicians working with adult victims of CSA were interviewed. Each informant completed an indepth interview exploring their beliefs about factors that facilitated or prevented adult victims of CSA from disclosing their experience to the legal system. Interviews were transcribed and the qualitative data subjected to Thematic Analysis. Conclusions: Two super-ordinate themes (Legal Disclosures Are Rare: “Why would they do that?” and The Anomalies: Acknowledging that this is a crime) and four sub-ordinate themes emerged from the analysis and an analytical narrative constructed. Themes emphasised the rarity of legal disclosure and the significant number of barriers adult victims of CSA perceive. Implications for clinical practice and future research are outlined.

Formação e supervisão das práticas clínicas : uma abordagem ecológica

Nos últimos anos, um conjunto de mudanças de natureza tecnológica institucional, legal e cultural alteraram as funções, a responsabilidade social e a estrutura das organizações de saúde. Estas transformações estão na base do debate actual sobre supervisão clínica em enfermagem enquanto estratégia de promoção da satisfação profissional, segurança e qualidade dos cuidados. A emergência da supervisão clínica em enfermagem permitiu interrogar e dar visibilidade a novas modalidades de formação no contexto de trabalho. A supervisão clínica é um processo multidimensional que inclui encontros regulares entre supervisores e supervisados, com o objectivo de analisar experiências de trabalho e de formação. Dedica-se especial atenção às dimensões emocionais, qualidade de cuidados, relação terapêutica e desenvolvimento pessoal e profissional. A presente pesquisa assume a forma de um estudo de caso realizado num hospital psiquiátrico (Hospital Magalhães Lemos). O objectivo principal do estudo consistiu em compreender o processo amplo e complexo de aprendizagens desenvolvidas em contexto clínico e a forma como estas condicionam as estratégias supervisivas. Recorrendo ao modelo bioecológico de Bronfenbrenner, o estudo interroga de forma sistemática a origem e as relações entre formação e supervisão. Os participantes do estudo foram 18 enfermeiros do referido hospital. Contamos, igualmente, com a colaboração de três peritos com profundo conhecimento da cultura e realidade hospitalar. A informação foi colhida com base em questionários e entrevistas semiestruturadas. O questionário (Clinical Supervision Nursing Inventory – CSNI - V1) inclui três partes. A parte I e II foram relevantes para caracterizar os participantes e o contexto clínico. A parte III do instrumento inclui um inventário com 24 itens. O Alfa de Cronbach calculado pelo autor foi de 0,93 para os 24 itens da escala, indicando excelentes resultados psicométricos. A entrevista semi-estruturada foi usada para a recolha de dados junto dos três peritos. Os enfermeiros possuem uma atitude positiva perante a supervisão clínica. O desenvolvimento pessoal e profissional dos enfermeiros estava relacionado com as oportunidades de formação emergentes no contexto das práticas. Embora a expressão “supervisão clínica” seja por vezes utilizada de forma incorrecta nas organizações, concluímos que existiam no hospital boas práticas a nível da supervisão dos cuidados, relacionando desenvolvimento pessoal, qualidade de cuidados e competências profissionais. Tentámos problematizar as experiências supervisivas partindo de teorias sócio-culturais e bio-ecológicas. Os participantes do estudo referiram que há necessidade de formalizar o sistema de supervisão clínica em enfermagem, evitando relacionálo com o sistema de supervisão de gestão. São apresentados e discutidos diversos subsídios para o desenvolvimento do sistema de supervisão clínica em enfermagem, no hospital.

Is the legal protection for the foetus adequate in clinical trials?

In 2009 and 2010, the major drug regulatory bodies, the European Medicines Agency and the Food and Drug Administration in the USA, issued requests for the generation of information relating to the absorption, distribution, metabolism, excretion, efficacy and safety of investigational drugs in pregnant women prior to approval. In the wake of thalidomide, research involving pregnant women other than for obstetric or gynaecologic purposes became rare, and studies of investigational drugs practically unknown. Consequently, none of the legislation applicable in the UK and few of the guidelines introduced in the last 40 years properly addresses the conduct of clinical trials of investigational drugs in this population. This thesis questions whether the legal protection for the foetus is adequate in clinical trials. The answer appears to be a qualified “no”. Arguments persist regarding the moral standing of the foetus, particularly regarding abortion. That will not be the intent of such trials, and a moral case is made for the conduct of clinical trials in this population by analogy with the neonate, and the pregnant woman’s autonomy. Legally, we already recognise the foetus has ‘interests’ which crystallise upon live birth, and that compensation is recoverable for harm inflicted in utero manifesting as congenital injury. The essence of research is quite different from medical practice, and the extent to which this is understood by trial participants is unclear. The approvals processes contain a number of inadequacies which have the potential to expose the foetus to harm and affect the consent of the pregnant woman. The recovery of compensation in the event of children born injured following clinical trials during pregnancy in many ways may be more complex than other personal injury cases.. The conclusions of this thesis are that the existence of a foetus does merit recognition by the law in this setting and that morally such studies are justifiable. However, the present legislation and approval processes potentially expose the foetus to avoidable risk and may not be appropriate to enable the recovery of compensation, thereby creating potential to deter future trial participants. A proposal is made regarding an approach to simplify the process for recovery of compensation, and thereby strengthen the approval and consent processes.

Governance and community capitals : understanding how governance has worked in three faith-based schools in the Western Highlands of Papua New Guinea

This thesis, titled Governance and Community Capitals, explores the kinds of practical processes that have made governance work in three faith-based schools in the Western Highlands of Papua New Guinea (PNG). To date, the nation of PNG has been unable to meet its stated educational goals; however, some faith-based primary schools have overcome educational challenges by changing their local governance systems. What constitutes good governance in developing countries and how it can be achieved in a PNG schooling context has received very little scholarly attention. In this study, the subject of governance is approached at the nexus between the administrative sciences and asset-based community development. In this space, the researcher provides an understanding of the contribution that community capitals have made to understandings of local forms of governance in the development context. However, by and large, conceptions of governance have a history of being positioned within a Euro-centric frame and very little, if anything is known about the naming of capitals by indigenous peoples. In this thesis, six indigenous community capitals are made visible, expanding the repertoire of extant capitals published to date. The capitals identified and named in this thesis are: Story, Wisdom, Action, Blessing, Name and Unity. In-depth insights into these capitals are provided and through the theoretical idea of performativity, the researcher advances an understanding of how the habitual enactment of the practical components of the capitals made governance work in this unique setting. The study draws from a grounded and appreciative methodology and is based on a case study design incorporating a three-stage cycle of investigation. The first stage tested the application of an assets-based method to documentary sources of data including most significant change stories, community mapping and visual diaries. In the second stage, a group process method relevant to a PNG context was developed and employed. The third stage involved building theory from case study evidence using content analysis, language and metaphorical speech acts as guides for complex analysis. The thesis demonstrates the contribution that indigenous community capitals can make to understanding local forms of governance and how PNG faith-based schools meet their local governance challenges.