Impact of social vulnerability on the outcomes of predialysis chronic kidney disease patients in an interdisciplinary center

Introduction: Numerous studies examined the associations between socio-demographic, economic and individual factors and chronic kidney disease (CKD) outcomes and observed that the associations were complex and multifactorial. Socioeconomic factors can be evaluated by a model of social vulnerability (SV). Objective: To analyze the impact of SV on the outcomes of predialysis patients. Methods: Demographic, clinical and laboratory data were collected from a cohort of patients with predialysis stage 3 to 5 who were treated by an interdisciplinary team (January 2002 and December 2009) in Minas Gerais, Brazil. Factor, cluster and discriminant analysis were performed in sequence to identify the most important variables and develop a model of SV that allowed for classification of the patients as vulnerable or non-vulnerable. Cox regression was performed to examine the impact of SV on the outcomes of mortality and need for renal replacement therapy (RRT). Results: Of the 209 patients examined, 29.4% were classified as vulnerable. No significance difference was found between the vulnerable and non-vulnerable groups regarding either mortality (log rank: 0.23) or need for RRT (log rank: 0.17). In the Cox regression model, the hazard ratios (HRs) for the unadjusted and adjusted impact of SV on mortality were found to be 1.87 (confidence interval [CI]: 0.64-5.41) and 1.47 (CI: 0.35-6.0), respectively, and the unadjusted and adjusted impact of need for RRT to be 1.85 (CI: 0.71-4.8) and 2.19 (CI: 0.50-9.6), respectively. Conclusion: These findings indicate that SV did not influence the outcomes of patients with predialysis CKD treated in an interdisciplinary center.

Power Electronic Converters in Low-Voltage Direct Current Distribution – Analysis and Implementation

Over the recent years, smart grids have received great public attention. Many proposed functionalities rely on power electronics, which play a key role in the smart grid, together with the communication network. However, “smartness” is not the driver that alone motivates the research towards distribution networks based on power electronics; the network vulnerability to natural hazards has resulted in tightening requirements for the supply security, set both by electricity end-users and authorities. Because of the favorable price development and advancements in the field, direct current (DC) distribution has become an attractive alternative for distribution networks. In this doctoral dissertation, power electronic converters for a low-voltage DC (LVDC) distribution system are investigated. These include the rectifier located at the beginning of the LVDC network and the customer-end inverter (CEI) on the customer premises. Rectifier topologies are introduced, and according to the LVDC system requirements, topologies are chosen for the analysis. Similarly, suitable CEI topologies are addressed and selected for study. Application of power electronics into electricity distribution poses some new challenges. Because the electricity end-user is supplied with the CEI, it is responsible for the end-user voltage quality, but it also has to be able to supply adequate current in all operating conditions, including a short-circuit, to ensure the electrical safety. Supplying short-circuit current with power electronics requires additional measures, and therefore, the short-circuit behavior is described and methods to overcome the high-current supply to the fault are proposed. Power electronic converters also produce common-mode (CM) and radio-frequency (RF) electromagnetic interferences (EMI), which are not present in AC distribution. Hence, their magnitudes are investigated. To enable comprehensive research on the LVDC distribution field, a research site was built into a public low-voltage distribution network. The implementation was a joint task by the LVDC research team of Lappeenranta University of Technology and a power company Suur-Savon S¨ahk¨o Oy. Now, the measurements could be conducted in an actual environment. This is important especially for the EMI studies. The main results of the work concern the short-circuit operation of the CEI and the EMI issues. The applicability of the power electronic converters to electricity distribution is demonstrated, and suggestions for future research are proposed.

Innovation, competition and financial vulnerability in economic development

The financial sector has been viewed traditionally as either providing the "oil" for the "wheels of commerce" or as a parasite on the real sector of the economy where real productivity gains provide for increasing real wages and per capita incomes. The present paper takes a different route and attempts to an analysis of financial institutions on a par with the production sector of the economy. It also develops a link which amalgamates "the knowledge-based" perspective on firms' operations with Schumpeterian financial leverage to exploit productivity enhancing innovations, and Minsky's tendency towards financial fragility. The analysis also leads to some policy recommendations concerning financial regulation, risk management and financial institution's building.

Between Dugin’s Eurasianism and Mahan’s Sea Power Concept: Russia’s Geopolitical Discourse within Foucault’s ‘Discursive Tree’ before and After the Incorporation of the Crimea

The fall of 2013 could be characterized as a crossroad in the geopolitics of Eastern Europe, namely Ukraine. Two rivalry geopolitical projects have been developing throughout the post-Cold War years, and it seems that they reached a collision point in Ukraine; a country whose authorities have been for long switching sides between the European Union and the Russian Federation in their foreign policy commitments. The refusal/postponing to sign the Association Agreement with Brussels, an expected event by a large category of the Ukrainian society, by Yanukovich’s government led to the outset of the latter; and brought a pro-Western, anti-Russian government in Kyiv. It seems that Ukraine, after those events, has embarked definitively on the path of integration into the West (European Union and possibly NATO). The Russian Federation, who has been throughout Putin’s years engaged into the re-integration of post-Soviet space, reacted to these developments in an assertive manner by violating borders, agreements and the territorial integrity of Ukraine. Thus, the incorporation of the Crimea into the Russian Federation is the first in its kind in the post-Soviet space, despite the existence of various other conflicts that broke out in the region after the Soviet Union broke up. I will investigate in this thesis the nature of what will be labelled, in this work, the Crimean issue. I argue that the incorporation of the Crimean peninsula into the Russian Federation marks a new era in Russian geopolitical thinking that shapes, to a far extent, Russian foreign policy. Discourse analysis will be the methodological basis for this study, with a special focus on Michel Foucault’s Archaeology of Knowledge. The innovation that this research brings is the fact that it discusses Russian geopolitical discourse within the scope of Foucault’s ‘discursive tree’, with a reference to the Crimean issue. A wide range of primary sources will be consulted in this study such as presidential addresses to the Federal Assembly (2000-2014), Foreign Policy Concepts of the Russian Federation (2000, 2008), Russian maritime doctrines, as wells as Dugin’s Osnovy Geopolitiki (Foundations of Geopolitics), Mahan’s (The Influence of Sea Power Upon History, 1660–1783) and other Eurasianism related literature.

Grassroots Charity in China: Case Analysis of a Charity Project Organised by Jane Zhang Fan Club

As unregistered grassroots charities do not appear in official statistics in China, they tend to remain unnoticed by scholars. Also as they operate unofficially and avoid publicity, their work is usually not reported by the media. In this research I explore the grassroots charity activity of one pop music fan club from the viewpoint of trust as a sociological concept. I will also establish the general situation on charity in China. By using textual analysis on internet blogs and discussion forums I map the charity project from the discussion of the original idea to the execution and follow up phase. I study the roles the fan club members assume during the project as anonymous participants of internet conversations, as well as concrete active charity volunteers outside of the virtual world. I establish parties, other than the fan club, which are involved in the charity project. Interviews with one of the participant of the project in 2010, 2014 and 2015 bring valuable additional information and help in distributing the questionnaire survey. A quantitative questionnaire survey was distributed among the fan club members to get more detailed information on the motives and attitudes towards official and unofficial charity in China. Because of the inequality in China, the rural minority areas do not have similar educational opportunities as the mostly majority inhabited urban areas, even though the country officially has a nine year compulsory education. Grassroots charities can operate in relative freedom taking some of the government’s burden of social responsibilities if they are not criticizing the authorities. The problem with grassroots charity seems to be lack of sustainability. The lack of trust for authorities and official charities was the reason why the Jane Zhang fan club decided to conduct a charity case unofficially. As a group of people previously unknown to each other, they managed to build mutual trust to carry out the project transparently and successfully, though not sustainably. The internet has provided a new and effective platform for unofficial grassroots charities, who choose not to co-operate with official organisations. On grassroots level charities can have the transparency and trust that lack from official charities. I suggest, that interviewing the real persons behind the internet aliases and finding out what happened outside the discussion forums, would bring a more detailed and outspoken description of the project concerning of the contacts with the local authorities. Also travelling to the site and communicating with the local people in the village would establish how they have experienced the project.

Datenherrschaft – an Ethically Justified Solution to the Problem of Ownership of Patient Information

Patient information systems are crucial components for the modern healthcare and medicine. It is obvious that without them the healthcare cannot function properly – one can try to imagine how brain surgery could be done without using information systems to gather and show information needed for an operation. Thus, it can be stated that digital information is irremovable part of modern healthcare. However, the legal ownership of patient information lacks a coherent and justified basis. The whole issue itself is actually bypassed by controlling pa- tient information with different laws and regulations how patient information can be used and by whom. Nonetheless, the issue itself – who owns the patient in- formation – is commonly missed or bypassed. This dissertation show the problems if the legislation of patient information ownership is not clear. Without clear legislation, the outcome can be unexpected like it seems to be in Finland, Sweden and United Kingdom: the lack of clear regulation has come up with unwanted consequences because of problematic Eu- ropean Union database directive implementation in those countries. The legal ownership is actually granted to the creators of databases which contains the pa- tient information, and this is not a desirable situation. In healthcare and medicine, we are dealing with issues such as life, health and information which are very sensitive and in many cases very personal. Thus, this dissertation leans on four philosophical theories form Locke, Kant, Heidegger and Rawls to have an ethically justified basis for regulating the patient infor- mation in a proper way. Because of the problems of property and ownership in the context of information, a new concept is needed and presented to replace the concept of owning, that concept being Datenherrschaft (eng. mastery over in- formation). Datenherrschaft seems to be suitable for regulating patient infor- mation because its core is the protection of one’s right over information and this aligns with the work of the philosophers whose theories are used in the work. The philosophical argumentation of this study shows that Datenherrschaft granted to the patients is ethically acceptable. It supports the view that patient should be controlling the patient information about themselves unless there are such specific circumstance that justifies the authorities to use patient information to protect other people’s basic rights. Thus, if the patients would be legally grant- ed Datenherrschaft over patient information we would endorse patients as indi- viduals who have their own and personal experience of their own life and have a strong stance against any unjustified paternalism in healthcare. Keywords: patient information, ownership, Datenherrschaft, ethics, Locke, Kant, Heidegger, Rawls

In distrust we trust : analysis of academic apocalypse

The paper concentrates on trust as a research topic that receives increasing attention from the side of different social disciplines. The author of this thesis attempts to identify the reasons of this phenomenon, as well as the decline in usage of the concepts conveying a congenial idea, such as, solidarity, cooperation, social cohesion, social capital or connectedness. The key hypotheses, such as paradigmatic change within the social sciences, emergence of risk society, proliferation of the postmodem condition, new infonnation and communication technologies and the crisis of democracy are considered through the works of the authors who now mainly responsible for the shaping of the discourse of trust. The concepts of Luhmann, Putnam, Sztompka, Fukuyama and Hardin are analyzed from an epistemological viewpoint in its ontological and political implications. The primary goal of the paper is to overview trust from the methodological viewpoint, illustrating the limitations of the concept as a research strategy as weII as it advantages in the epoch when the social sciences acquire a status of moral disciplines.

Adolescent sexuality : an investigation into the relation between sexuality and self-concept /

The present study explored the connections among adolescents' sense of self, sexuality, and perceptions of risk. Such an exploration may help educators to further understand why adolescents engage in risk-taking behaviours such as unprotected sex. The study involved secondary analysis on the data collected from the Youth Lifestyle Choices - Community University Research Alliance 2000 (YLC - CURA) Youth Resilience Questionnaire (YRQ). Participants were 300 male and female students in Grades 9, 1 1 and OAC. Data analyses involved both descriptive and inferential statistics (correlational and multivariate analysis). Chi-square analyses were performed on the open-ended self-description question. Separate analyses were conducted on gender and age (grade levels). Correlational analyses revealed that adolescents with a more positive sense of self were more likely to perceive sexual involvement as a relatively high-risk behaviour. Specifically, results found that male adolescents were less likely than females to perceive sex to be risky. Results are discussed in relation to previous research in the area of selfcognitions and risk-taking sexual behaviour. Results are also discussed in terms of educational implications in that the current results may provide the beginnings of a framework for more holistic sexual education programs.

Marginal/minority popular music : the concept of the "third space" and the case for "hybridities" of cultures/identities /

The topic of this thesis is marginaVminority popular music and the question of identity; the term "marginaVminority" specifically refers to members of racial and cultural minorities who are socially and politically marginalized. The thesis argument is that popular music produced by members of cultural and racial minorities establishes cultural identity and resists racist discourse. Three marginaVminority popular music artists and their songs have been chosen for analysis in support of the argument: Gil Scott-Heron's "Gun," Tracy Chapman's "Fast Car" and Robbie Robertson's "Sacrifice." The thesis will draw from two fields of study; popular music and postcolonialism. Within the area of popular music, Theodor Adorno's "Standardization" theory is the focus. Within the area of postcolonialism, this thesis concentrates on two specific topics; 1) Stuart Hall's and Homi Bhabha's overlapping perspectives that identity is a process of cultural signification, and 2) Homi Bhabha's concept of the "Third Space." For Bhabha (1995a), the Third Space defines cultures in the moment of their use, at the moment of their exchange. The idea of identities arising out of cultural struggle suggests that identity is a process as opposed to a fixed center, an enclosed totality. Cultures arise from historical memory and memory has no center. Historical memory is de-centered and thus cultures are also de-centered, they are not enclosed totalities. This is what Bhabha means by "hybridity" of culture - that cultures are not unitary totalities, they are ways of knowing and speaking about a reality that is in constant flux. In this regard, the language of "Otherness" depends on suppressing or marginalizing the productive capacity of culture in the act of enunciation. The Third Space represents a strategy of enunciation that disrupts, interrupts and dislocates the dominant discursive construction of US and THEM, (a construction explained by Hall's concept of binary oppositions, detailed in Chapter 2). Bhabha uses the term "enunciation" as a linguistic metaphor for how cultural differences are articulated through discourse and thus how differences are discursively produced. Like Hall, Bhabha views culture as a process of understanding and of signification because Bhabha sees traditional cultures' struggle against colonizing cultures as transforming them. Adorno's theory of Standardization will be understood as a theoretical position of Western authority. The thesis will argue that Adorno's theory rests on the assumption that there is an "essence" to music, an essence that Adorno rationalizes as structure/form. The thesis will demonstrate that constructing music as possessing an essence is connected to ideology and power and in this regard, Adorno's Standardization theory is a discourse of White Western power. It will be argued that "essentialism" is at the root of Western "rationalization" of music, and that the definition of what constitutes music is an extension of Western racist "discourses" of the Other. The methodological framework of the thesis entails a) applying semiotics to each of the three songs examined and b) also applying Bhabha's model of the Third Space to each of the songs. In this thesis, semiotics specifically refers to Stuart Hall's retheorized semiotics, which recognizes the dual function of semiotics in the analysis of marginal racial/cultural identities, i.e., simultaneously represent embedded racial/cultural stereotypes, and the marginal raciaVcultural first person voice that disavows and thus reinscribes stereotyped identities. (Here, and throughout this thesis, "first person voice" is used not to denote the voice of the songwriter, but rather the collective voice of a marginal racial/cultural group). This dual function fits with Hall's and Bhabha's idea that cultural identity emerges out of cultural antagonism, cultural struggle. Bhabha's Third Space is also applied to each of the songs to show that cultural "struggle" between colonizers and colonized produces cultural hybridities, musically expressed as fusions of styles/sounds. The purpose of combining semiotics and postcolonialism in the three songs to be analyzed is to show that marginal popular music, produced by members of cultural and racial minorities, establishes cultural identity and resists racist discourse by overwriting identities of racial/cultural stereotypes with identities shaped by the first person voice enunciated in the Third Space, to produce identities of cultural hybridities. Semiotic codes of embedded "Black" and "Indian" stereotypes in each song's musical and lyrical text will be read and shown to be overwritten by the semiotic codes of the first person voice, which are decoded with the aid of postcolonial concepts such as "ambivalence," "hybridity" and "enunciation."

An analysis of Ibn al-'Arabi's al-Insan al-Kamil, the Perfect Individual, with a brief comparison to the thought of Sir Muhammad Iqbal

This thesis analyzes four philosophical questions surrounding Ibn al-'Arabi's concept of the al-iman al-kamil, the Perfect Individual. The Introduction provides a definition of Sufism, and it situates Ibn al-'Arabi's thought within the broader context of the philosophy of perfection. Chapter One discusses the transformative knowledge of the Perfect Individual. It analyzes the relationship between reason, revelation, and intuition, and the different roles they play within Islam, Islamic philosophy, and Sufism. Chapter Two discusses the ontological and metaphysical importance of the Perfect Individual, exploring the importance of perfection within existence by looking at the relationship the Perfect Individual has with God and the world, the eternal and non-eternal. In Chapter Three the physical manifestations of the Perfect Individual and their relationship to the Prophet Muhammad are analyzed. It explores the Perfect Individual's roles as Prophet, Saint, and Seal. The final chapter compares Ibn al-'Arabi's Perfect Individual to Sir Muhammad Iqbal's in order to analyze the different ways perfect action can be conceptualized. It analyzes the relationship between freedom and action.

Nursing staffs' perceptions of a generic service manager position

The recent reengineering within the health care industry has challenged many assumptions regarding traditional structures and roles. Within a product-line management structure, the traditional viewpoint that those who manage patient care areas must have a nursing background, is an example of one such assumption being challenged. The nursing profession is often seen as the greatest obstacle to the implementation of a product-line management structure and generic manager positions (does not require a nursing background), due to the perceived loss of professional identity. This qualitative study focused on how nursing staff within a chronic care and rehabilitation facility perceived a generic service manager position. Focus groups were conducted in three phases, over a 14 month period of time. The data collected from the focus groups were then coded according to common themes. Each phase was analyzed independently, with the study concluding with an analysis and interpretation of the collective results. The results of this study revealed a significant shift in how the nursing staff perceived their professional identity and accountability in light of the implementation of the generic Service Manager position. Initial reactions of personal and professional vulnerability and resentment were seen to transform into an increased ability to explicitly articulate the role of nursing. Changes in behavior that were described included: increased consultation and collaboration with other

A Foucaultian analysis of power relations in child protection case work with youth and families

This thesis takes some steps in examining the child protection system from a position that is rarely discussed. Specifically, I explore how Foucault's concept of disciplinary power can be used to demonstrate how power operates within the client/worker relationship. This relationship is shown to be quite complex with power flowing bidirectionally, rather than hierarchically. Instead of viewing power imbalances as a function of state control, I show how the client/worker relationship is constituted by the worker, the client, the organization and the social body. A postmodern auto ethnography is used to document my journey as I expose the disciplinary practices and instruments that I was subject to and used with my clients. 2 Given that the child protection system is constantly shifting and changing in order to improve its ability to safeguard children a greater emphasis is required to examine how workers operate within this complex, overwhelming and multi-dimensional world. This thesis has shown that by engaging in a reflexive examination of my position of power different approaches to making intervention beneficial to all involved become available. This is important if child protection work aims to work with clients rather than on clients.

"The whole earth as village" : a chronotopic analysis of Marshall McLuhan's "Global Village" and Patrick McGoohan's The Prisoner

Marshall McLuhan's "global village", and his theories on communications and technology, in conjunction with Patrick McGoohan's television series The Prisoner (ATV, 1967-1968) are explored in this thesis. The Prisoner, brainchild of McGoohan, is about the abduction and confinement of a British government agent imprisoned within the impenetrable boundaries of a benign but totalitarian city -state called "The Village". The purpose of his abduction and imprisonment is for the extraction of information regarding his resignation as a government spy. Marshall McLuhan originally popularized the phrase "the global village" in The Gutenberg Galaxy: The Making o/the Topographic Man (1962), asserting that, "The new electronic interdependence recreates the world in the image of a global village" (p. 31). This thesis argues that valid parallels exist between McGoohan's conception of "village", as manifested in The Prisoner, and McLuhan's global village. The comprehensive methodological stratagem for this thesis includes Marshall McLuhan's "mosaic" approach, Mikhail Bakhtin's concept ofthe "chronotope", as well as a Foucauldian genealogicallhistorical discourse analysis. In the process of deconstructing McLuhan's texts and The Prisoner as products of the 1960s, an historical "constellation" (to use Walter Benjamin's concept) of the same present has been executed. By employing this synthesized methodology, conjunctions have been made between McLuhan's theories and the series' main themes of bureaucracy as dictatorship, the perversion of science and technology, freedom as illusion, and the individual in opposition to the collective. A thorough investigation of the global village and The Prisoner will determine whether or not Marshall McLuhan and/or Patrick McGoohan visualize the village as an enslaving technological reality.

Self concept, acculturation, and fashion orientation

The research begins with a discussion of the worldwide and the Canadian market. The research profiles the examination of the relationship between a person's self concept (as defined by Malhotra) and fashion orientation (as defined by Gutman and Mills), and to understand how these factors are influenced by acculturation, focusing in-depth on their managerial implications. To study these relationships; a random sample of 196 ChineseCanadian female university students living in Canada was given a survey based on Malhotra's self-concept scale, and the SLASIA acculturation scale. Based on multiple regression analysis, findings suggest that the adoption of language and social interaction dimensions of acculturation constructs have significant effects on the relationship between self concept and fashion orientation. This research contributes significantly to both marketing theory and practice. Theoretically, this research develops new insights on the dimensionality of fashion orientation, identifies various moderating effects of acculturation on the relationship of self concept and fashion orientation dimensions, and provides a framework to examine these effects, where results can be generalized across different culture. Practically, marketers can use available findings to improve their understanding of the fashion needs of Chinese-Canadian consumers, and target them based on these findings. The findings provide valuable implications for companies to formulate their fashion marketing strategies for enhance fashion orientation in terms of different dimensions, based on different levels of acculturation.

The vocation of responsibility : a conceptual analysis of a modern idea

Please consult the paper edition of this thesis to read. It is available on the 5th Floor of the Library at Call Number: Z 9999 P55 N48 2004