712 resultados para DISADVANTAGE


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Social inequalities in health are a major public concern. Some of theseinequalities are currently not well documented, and are thus largely absentfrom debate. One important health issue is renal disease and access tothe corresponding therapies (dialysis and renal transplant). These twotherapeutic options have very different consequences in terms of labourmarket participation and physical well-being. Renal transplants offerpatients an enhanced quality of daily life and a longer life expectancy, butthis option is limited by organ availability. Here, drawing on two recentsurveys, Christian Baudelot, Yvanie Caillé, Olivier Godechot and SylvieMercier examine socially differentiated access to these two therapiesand explore the underlying mechanisms. At each stage in the diseaseand its treatment, a cumulative process puts the least educated patientsat a disadvantage in terms of access to a kidney transplant.

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El propósito de este artículo es práctico: enseñar al usuario de Winisis a reformatear las bases de datos diseñadas e implementadas en cualquier formato, normalizado o no, convirtiéndolas al formato de interés de la unidad de información.Winisis es un paquete que permite utilizar cualquier nomenclatura en la definición de las etiquetas que identifican los campos. Este aspecto es una ventaja y una desventaja porque permite libertad en la selección del formato a utilizar, pero, se generan una gran diversidad de formatos en las unidades de información, dificultando la compatibilidad en los sistemas automatizados de catalogación, la normalización y la transferencia efectiva de la información entre unidades de información.Algunos problemas que enfrentan los bibliotecólogos en su trabajo cotidiano al normalizar la información son por ejemplo:a) la diversidad de bases de datos sin normalización, b) la variación entre formatos, c) los diferentes números, etiquetas y nombres de los campos que integran las bases de datos, e incluso bases de datos creadas con diferentes versiones de Microisis; d) un catálogo automatizado en un formato sin normalización; e) para la participación en una red y exige la reconversión del catálogo al formato común de la red. En algunos casos se ha optado por digitar de nuevo la información en el nuevo formato, sin embargo, ante esta situación, Microisis y Winisis dispone de un recurso denominado "Tabla de Selección de Campos para reformateo".

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In den vergangenen Jahren hat die Diskussion um kulturelle Teilhabe im Rahmen der Ergebnisse großer Bildungsstudien zugenommen. Diese hatten eine hochgradige Abhängigkeit des Bildungserfolgs und des Kompetenzerwerbs vom sozialen Hintergrund der Kinder und ihrer Familien konstatiert (u.a. Ehmke & Jude 2010, S. 250). Auch für den Teilaspekt der kulturellen Teilhabe ließen sich in Studien soziale Disparitäten feststellen: Die rezeptive Nutzung kultureller Angebote durch Kinder und Jugendliche unterliegt einer deutlichen sozialen Selektivität (Autorengruppe Bildungsberichterstattung 2012, S. 165). Gleichzeitig ist mit dem Programm Jedem Kind ein Instrument eine große Initiative zur Förderung frühen Instrumentallernens in der Grundschulzeit angelaufen. Die Initiatoren verfolgen dabei explizit das Ziel, die Kluft „zwischen kulturaffinen Elternhäusern und bildungsfernen Schichten" (Kulturstiftung des Bundes, 2012) in Bezug auf kulturelle Bildung zu verringern, eine „Grundversorgung" (ebd.) sicherzustellen und im demokratischen Sinne niemanden von der Alphabetisierung in Sachen Kunst auszuschließen (Völckers, 2007). Die Teilnahme von Kindern an Instrumentalunterricht während der Grundschulzeit wird hier also als ein Aspekt aktiver kultureller Teilhabe gedeutet und wird im Folgenden einer Analyse unterzogen. (DIPF/Orig.)

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In Scotland, life expectancy and health outcomes are strongly tied to socioeconomic status. Specifically, socioeconomically deprived areas suffer disproportionately from high levels of premature multimorbidity and mortality. To tackle these inequalities in health, challenges in the most deprived areas must be addressed. One avenue that merits attention is the potential role of general medical practitioners (GPs) in helping to address health inequalities, particularly due to their long-term presence in deprived communities, their role in improving patient and population health, and their potential advocacy role on behalf of their patients. GPs can be seen as what Lipsky calls ‘street-level bureaucrats’ due to their considerable autonomy in the decisions they make surrounding individual patient needs, yet practising under the bureaucratic structure of the NHS. While previous research has examined the applicability of Lipsky’s framework to the role of GPs, there has been very little research exploring how GPs negotiate between the multiple identities in their work, how GPs ‘socially construct’ their patients, how GPs view their potential role as ‘advocate’, and what this means in terms of the contribution of GPs to addressing existing inequalities in health. Using semi-structured interviews, this study explored the experience and views of 24 GPs working in some of Scotland’s most deprived practices to understand how they might combat this growing health divide via the mitigation (and potential prevention) of existing health inequalities. Participants were selected based on several criteria including practice deprivation level and their individual involvement in the Deep End project, which is an informal network comprising the 100 most deprived general practices in Scotland. The research focused on understanding GPs’ perceptions of their work including its broader implications, within their practice, the communities within which they practise, and the health system as a whole. The concept of street-level bureaucracy proved to be useful in understanding GPs’ frontline work and how they negotiate dilemmas. However, this research demonstrated the need to look beyond Lipsky’s framework in order to understand how GPs reconcile their multiple identities, including advocate and manager. As a result, the term ‘street-level professional’ is offered to capture more fully the multiple identities which GPs inhabit and to explain how GPs’ elite status positions them to engage in political and policy advocacy. This study also provides evidence that GPs’ social constructions of patients are linked not only to how GPs conceptualise the causes of health inequalities, but also to how they view their role in tackling them. In line with this, the interviews established that many GPs felt they could make a difference through advocacy efforts at individual, community and policy/political levels. Furthermore, the study draws attention to the importance of practitioner-led groups—such as the Deep End project—in supporting GPs’ efforts and providing a platform for their advocacy. Within this study, a range of GPs’ views have been explored based on the sample. While it is unclear how common these views are amongst GPs in general, the study revealed that there is considerable scope for ‘political GPs’ who choose to exercise discretion in their communities and beyond. Consequently, GPs working in deprived areas should be encouraged to use their professional status and political clout not only to strengthen local communities, but also to advocate for policy change that might potentially affect the degree of disadvantage of their patients, and levels of social and health inequalities more generally.

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Cementing operations are conducted at different times of the well s life and they have high importance, because the functions are fundamental to keep good properties during a long life of the well, such as, maintain the mechanical stability of the well, to promote the isolation hydraulic and support the tubing. In some situations, the rocky zones have low fractures pressures and require the use of lightweight slurries to prevent the hydrostatic pressure in the formation is greater than the pressure of fracture. There are three ways to reduce the density of cement slurries: exterders water additives, microspheres and foamed slurries. The most used extender water additive is sodium bentonite, which is a clay with a good capacity of water absorption and expansion of its volume, the main disadvantage of this additive is the reduction of the strength. Currently, the use of nanoscale particles has received special attention, mainly because they get new functionalities. Following this trend, this paper aims to use a colloidal solution of nano-silica as an exterders water additives for use in oil wells. Slurries were designed with fixed 13lb/gal density and concentration of nano silica 0.1 gpc; 0.4 gpc; 0.7 and 1gpc, the influence of nano-silica was studied at these levels in isolation and combined varying concentrations of CaCl2,. Tests including rheology, stability, strength, thickening time, porosity and permeability. Besides the API tests, microstructural characterizations were performed after 28 days of the slurries, X-ray diffraction (XRD) and scanning electron microscopy (SEM)

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Generally, cellulose ethers improves mortar properties such as water retention, workability and setting time, along with adherence to the substrate. However, a major disadvantage of the addition of cellulose ethers in mortars is the delay in hydration of the cement. In this paper a cellulose phosphate (Cp) was synthesized water soluble and has been evaluated the effect of their incorporation into mortar based on Portland cement. Cellulose phosphate obtained was characterized by spectrophotometry Fourier transform infrared (FTIR), X-ray diffraction (XRD), elemental analysis and scanning electron microscopy (SEM). Mortar compositions were formulated with varying phosphorus content in cellulose and cellulose phosphate concentrations, when used in partial or total replacement of the commercial additive based hydroxyethyl methyl cellulose (HEMC). The mortars formulated with additives were prepared and characterized by: testing in the fresh state (consistency index, water retention, bulk density and air content incorporated) and in the hardened state (absorption by capillarity, density, flexural and compression strength). In mixtures the proportion of sand:cement of 1:5 (v / v) and factor a / c = 1.31 and water were held constant. Overall, the results showed that the celluloses phosphates employed in mortars added acted significantly when partially substituting the commercial additive. With regard to consistency index, water retention and bulk density in the fresh state and absorption by capillarity and bulk density apparent in the hardened state, showed no appreciable differences as compared to the commercial additive. The incorporated air content in the fresh state reduced markedly, but did not affect other properties. The mortars with cellulose phosphate, partially replacing the commercial additive showed an improvement of the properties of flexural strength and compressive strength

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O princípio do posicionamento por GNSS baseia-se, resumidamente, na resolução de um problema matemático que envolve a observação das distâncias do utilizador a um conjunto de satélites com coordenadas conhecidas. A posição resultante pode ser calculada em modo absoluto ou relativo. O posicionamento absoluto necessita apenas de um recetor para a determinação da posição. Por sua vez, o posicionamento relativo implica a utilização de estações de referência e envolve a utilização de mais recetores para além do pertencente ao próprio utilizador. Assim, os métodos mais utilizados na determinação da posição de uma plataforma móvel, com exatidão na ordem dos centímetros, baseiam-se neste último tipo de posicionamento. Contudo, têm a desvantagem de estarem dependentes de estações de referência, com um alcance limitado, e requerem observações simultâneas dos mesmos satélites por parte da estação e do recetor. Neste sentido foi desenvolvida uma nova metodologia de posicionamento GNSS em modo absoluto, através da modelação ou remoção dos erros associados a cada componente das equações de observação, da utilização de efemérides precisas e correções aos relógios dos satélites. Este método de posicionamento tem a designação Precise Point Positioning (PPP) e permite manter uma elevada exatidão, equivalente à dos sistemas de posicionamento relativo. Neste trabalho, após um estudo aprofundado do tema, foi desenvolvida uma aplicação PPP, de índole académica, com recurso à biblioteca de classes C++ do GPS Toolkit, que permite determinar a posição e velocidade do recetor em modo cinemático e em tempo real. Esta aplicação foi ensaiada utilizando dados de observação de uma estação estática (processados em modo cinemático) e de uma estação em movimento instalada no NRP Auriga. Os resultados obtidos permitiram uma exatidão para a posição na ordem decimétrica e para a velocidade na ordem do cm/s.

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Combination of signals from the two eyes is the gateway to stereo vision. To gain insight into binocular signal processing, we studied binocular summation for luminance-modulated gratings (L or LM) and contrast-modulated gratings (CM). We measured 2AFC detection thresholds for a signal grating (0.75 c/deg, 216msec) shown to one eye, both eyes, or both eyes out-of-phase. For LM and CM, the carrier noise was in both eyes, even when the signal was monocular. Mean binocular thresholds for luminance gratings (L) were 5.4dB better than monocular thresholds - close to perfect linear summation (6dB). For LM and CM the binocular advantage was again 5-6dB, even when the carrier noise was uncorrelated, anti-correlated, or at orthogonal orientations in the two eyes. Binocular combination for CM probably arises from summation of envelope responses, and not from summation of these conflicting carrier patterns. Antiphase signals produced no binocular advantage, but thresholds were about 1-3dB higher than monocular ones. This is not consistent with simple linear summation, which should give complete cancellation and unmeasurably high thresholds. We propose a three-channel model in which noisy monocular responses to the envelope are binocularly combined in a contrast-weighted sum, but also remain separately available to perception via a max operator. Vision selects the largest of the three responses. With in-phase gratings the binocular channel dominates, but antiphase gratings cancel in the binocular channel and the monocular channels mediate detection. The small antiphase disadvantage might be explained by a subtle influence of background responses on binocular and monocular detection.

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OBJECTIVE: To investigate the association of prenatal alcohol exposure with balance in10-year-old children. DESIGN: Population-based prospective longitudinal study. SETTING: Former Avon region of UK (Southwest England). PARTICIPANTS: 6915 children from the Avon Longitudinal Study of Parents and Children who had a balance assessment at age 10 and had data on maternal alcohol consumption. OUTCOME MEASURES: 3 composite balance scores: dynamic balance (beam-walking), static balance eyes open, static balance eyes closed (heel-to-toe balance on a beam and standing on one leg, eyes open or closed). RESULTS: Most mothers (95.5%) consumed no-to-moderate amounts (3-7 glasses/week) of alcohol during pregnancy. Higher total-alcohol consumption was associated with maternal-social advantage, whereas binge drinking (≥4 units/day) and abstinence were associated with maternal social disadvantage. No evidence was found of an adverse effect of maternal-alcohol consumption on childhood balance. Higher maternal-alcohol use during pregnancy was generally associated with better offspring outcomes, with some specific effects appearing strong (static balance eyes open and moderate total alcohol exposure at 18 weeks, adjusted OR 1.23 (95% CI 1.01 to 1.49); static balance eyes closed and moderate total alcohol exposure at 18 weeks, adjusted OR 1.25 (95% CI 1.06 to 1.48). Similar results were found for both paternal and postnatal maternal alcohol exposure. A Mendelian-randomization approach was used to estimate the association between maternal genotype and offspring balance using the non-synonymous variant rs1229984*A (ADH1B) to proxy for lower maternal alcohol consumption; no strong associations were found between this genotype/proxy and offspring balance. CONCLUSIONS: No evidence was found to indicate that moderate maternal alcohol consumption in this population sample had an adverse effect on offspring balance at age 10. An apparent beneficial effect of higher total maternal alcohol consumption on offspring balance appeared likely to reflect residual confounding.

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Plasmids play a key role in the horizontal spread of antibiotic resistance determinants among bacterial pathogens. When an antibiotic resistance plasmid arrives in a new bacterial host, it produces a fitness cost, causing a competitive disadvantage for the plasmid-bearing bacterium in the absence of antibiotics. On the other hand, in the presence of antibiotics, the plasmid promotes the survival of the clone. The adaptations experienced by plasmid and bacterium in the presence of antibiotics during the first generations of coexistence will be crucial for the progress of the infection and the maintenance of plasmid-mediated resistance once the treatment is over. Here we developed a model system using the human pathogen Haemophilus influenzae carrying the small plasmid pB1000 conferring resistance to β-lactam antibiotics to investigate host and plasmid adaptations in the course of a simulated ampicillin therapy. Our results proved that plasmid-bearing clones compensated for the fitness disadvantage during the first 100 generations of plasmid-host adaptation. In addition, ampicillin treatment was associated with an increase in pB1000 copy number. The augmentation in both bacterial fitness and plasmid copy number gave rise to H. influenzae populations with higher ampicillin resistance levels. In conclusion, we show here that the modulations in bacterial fitness and plasmid copy number help a plasmid-bearing bacterium to adapt during antibiotic therapy, promoting both the survival of the host and the spread of the plasmid.

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Plasmid pB1000 is a mobilizable replicon bearing the bla(ROB-1) beta-lactamase gene that we have recently described in Haemophilus parasuis and Pasteurella multocida animal isolates. Here we report the presence of pB1000 and a derivative plasmid, pB1000', in four Haemophilus influenzae clinical isolates of human origin. Pulsed-field gel electrophoresis showed unrelated patterns in all strains, indicating that the existence of pB1000 in H. influenzae isolates is not the consequence of clonal dissemination. The replicon can be transferred both by transformation and by conjugation into H. influenzae, giving rise to recipients resistant to ampicillin and cefaclor (MICs, > or =64 microg/ml). Stability experiments showed that pB1000 is stable in H. influenzae without antimicrobial pressure for at least 60 generations. Competition experiments between isogenic H. influenzae strains with and without pB1000 revealed a competitive disadvantage of 9% per 10 generations for the transformant versus the recipient. The complete nucleotide sequences of nine pB1000 plasmids from human and animal isolates, as well as the epidemiological data, suggest that animal isolates belonging to the Pasteurellaceae act as an antimicrobial resistance reservoir for H. influenzae. Further, since P. multocida is the only member of this family that can colonize both humans and animals, we propose that P. multocida is the vehicle for the transport of pB1000 between animal- and human-adapted members of the Pasteurellaceae.

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La réserve générale interdite de partage entre les membres est un avoir obligatoire, impartageable tout au long de l’existence de la coopérative et sujet à la «dévolution désintéressée en cas de liquidation ou de dissolution». Cette réserve fonctionne comme un levier de soutien au développement de la coopérative et du mouvement coopératif dans son ensemble. Le principe de l’impartageabilité de la réserve est l’interdiction faite à toutes les coopératives du Québec de partager la réserve générale entre tous les membres et l’interdiction de la diminuer, notamment par l’attribution d’une ristourne tout au long de l’existence de la coopérative. En effet, l’impartageabilité de la réserve se fonde sur l’idée que la coopérative n’a pas pour but l’accumulation des capitaux afin de les répartir entre les membres, mais il s’agit de la création d’un capital collectif qui bénéficie à tous les adhérents présents et futurs. Si le concept de l’impartageabilité de la réserve interdit donc le partage de la réserve tout au long de l’existence de la coopérative, cette même interdiction prend le nom de la dévolution désintéressée de l’actif net au moment de la disparition de la coopérative. Cette dévolution désintéressée signifie l’interdiction faite à toutes les coopératives non financières de partager le solde de l’actif lors de la disparition (dissolution ou liquidation) de la coopérative à l’exception des coopératives agricoles qui peuvent décider dans ce cas, de distribuer le solde de l’actif aux membres sans qu’on sache les raisons de cette exception. Par ailleurs, l’impartageabilité de la réserve est considérée comme un simple inconvénient juridique pour les membres et a connu quelques réécritures dans les législations sur les coopératives sans qu’on connaisse vraiment les raisons de ces modifications. L’objectif de notre thèse est d’engager une discussion critique autour du questionnement central suivant : au regard du cadre juridique actuel sur les coopératives, le principe de l’impartageabilité de la réserve doit être maintenu comme tel dans la Loi sur les coopératives, ou être tout simplement supprimé, comme dans la société par actions, où il est inexistant sans que cette suppression ne porte atteinte à la notion juridique de la coopérative? Plus précisément, quel est ce cadre juridique et quels sont les motifs qui peuvent plaider en faveur du maintien ou de la suppression du principe de l’impartageabilité de la réserve? Pour répondre à cette question, cette thèse se divise en deux parties. La première partie explore le cadre juridique des coopératives non financières au Québec en comparaison avec certains concepts juridiques issus d’autres législations. Elle étudie les fondements juridiques sous-jacents à l’impartageabilité de la réserve en droit québécois des coopératives non financières. La deuxième partie réalise une discussion critique autour de l’histoire du principe de l’impartageabilité de la réserve (ch. 3), des différents arguments juridiques disponibles (ch. 4) et d’hypothèses articulées autour des effets concrets disponibles (ch. 5). Elle explore ces dimensions au soutien du maintien ou non de l’impartageabilité de la réserve de la législation actuelle sur les coopératives non financières. Bien que la recherche effectuée conduise à une réponse nuancée, l'ensemble des résultats milite plutôt en faveur du maintien du principe de l'impartageabilité de la réserve. Au préalable, l’observation des fondements juridiques des concepts sous-jacents à l’impartageabilité de la réserve en droit québécois des coopératives non financières a permis de comprendre les concepts sous-jacents à ce principe avant de répondre à la question autour de son maintien ou de sa suppression de la législation actuelle sur les coopératives. La discussion réalisée a permis de souligner l’importance d’une réalité de base assez évidente : ce principe permet de préserver la réserve, utile au développement de la coopérative et du mouvement coopératif dans son ensemble. De plus, ce principe de l’impartageabilité de la réserve s’inscrit dans le cadre de la vocation sociale de la coopérative, qui n’a pas pour but la maximisation du profit pécuniaire. L’impartageabilité de la réserve s’inscrit également dans le cadre de la cohérence du droit québécois des coopératives avec la notion de coopérative telle que définie par le mouvement coopératif québécois et l’ACI tout en répondant aux finalités historiques d’équité entre les générations et de solidarité. Enfin, même si la discussion des arguments tirés des illustrations de données comptables et de quelques entretiens réalisés avec certains membres actifs du mouvement coopératif ne permet pas de mener à toute conclusion ferme, il ressort que l’impartageabilité de la réserve ne freinerait pas la tendance à la hausse des investissements et du chiffre d’affaires des coopératives non financières. Cette interdiction constituerait même un mécanisme d’autofinancement de la coopérative et un symbole de solidarité.

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Community development is centrally concerned with people in communities working together to achieve a common goal, that is, to collaborate, whether within local geographical communities, in communities of shared interests or among groups sharing a common identity. Its overarching goal is one of progressive transformational social change. As Belfast transitions from a conflict to a post-conflict society, there is a need for greater, more effective work at local community level in order to address a range of ongoing social and economic issues facing communities, including high levels of disadvantage and division. Given the significance of leadership in building effective collaboration and the centrality of collaboration for community development, it is important to understand how leadership is currently enacted and what kinds of leadership are required to support communities to collaborate effectively to bring about social change. This thesis thus centers on the kind of leadership practised and required to support collaboration for social change within the community sector in Belfast, a city that contains an estimated 28% of the total number of community and voluntary sector (CVS) organisations in Northern Ireland (Northern Ireland Council for Voluntary Action, 2012). Through a series of qualitative, in-depth interviews with people playing leadership roles in local communities, the study critically explores and analyses their experiences and perceptions in relation to leadership and collaboration. Community development in Belfast today is practised within a wider context of neoliberal policies, characterised by austerity and public spending cuts. Whilst not the only influencing factor, this context has had a particular and profound impact on the nature and role of community development practised, and on the kind of leadership enacted within it. The space for reflection and transformative action appears to be shrinking as the contraction of resources to support community development in local communities continues unabated. Those playing leadership roles increasingly find themselves compelled to spend time seeking resources and managing complex funding arrangements rather than focusing on the social change dimensions of their work. Collaboration as promoted by the state seems to have become an instrumental tactic used to implement its austerity measures and curtail the potential of the community sector. Despite this, local leaders are driving initiatives that attempt to push back, helping the sector refocus on its transformational goals of social change. To do this requires support. Those playing leadership roles require resources, including time, to encourage and enable communities to reconnect with the purpose and underpinning values of community development. Leaders also need support to develop and promote new, progressive narratives and visions and pursue these through building collaboration and solidarity.

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Trabalho Complementar apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de licenciada em Ciências da Nutrição