Ethical-moral courses of action and active citizenship in health students

Abstract Introduction: The practice of active citizenship, ethical-moral courses of action and civic, moral and ethics education are essentials for ethical decision making in health. Objetive: To determine if gender influences students’ ethical- moral course of action. Methods: Descriptive study with a non-probabilistic sample of 85 students enrolled in the 1st cycle of the health degree. Results: Of the participants surveyed 61.2% were found to say that action should take into account their moral principles, with ethical/ moral subjectivism prevailing; 44.7% consider that one should “Do what will have the best consequences for the greatest number of people”, with the principle of utilitarianism being significant; 55.3% think that “An action is ethically good” if “It is in accordance with morality”, thereby highlighting subjectivism/relativism; 45.9% believe that “ethical-moral values” “are relative and vary from society to society” agreeing with relativism as an explanatory principle for action. Males showed a greater tendency to support their decision-making with the principle of objectivism, (Fischer=.010). Conclusion: The results suggest that students’ ethical-moral education is required to promote an ethical-moral course of action in their professional practice. Thus, universities with their health courses should be at the forefront of this education, making their graduates ambassadors/interveners of a way of knowing and of being as well as promoters of the dignity of the citizen of the modern world.

Conceptualisation de l’activité pédagogique en contexte d’apprentissage hybride et développement professionnel des enseignant(e)s universitaires

L’intégration des nouvelles technologies en enseignement supérieur ne devrait pas être vue comme un simple effet de mode, mais plutôt comme un cadre de réflexion sur les orientations nouvelles à donner à l’Université du 21ème siècle, en termes de culture institutionnelle, de ressources organisationnelles et d’opérationnalisation d’objectifs de recherche et d’enseignement (Duderstadt et al, 2002 ; Guri-Rosenblit, 2005). En effet, l’émergence d’une nouvelle tendance de formation post-secondaire, qu’est l’intégration des solutions virtuelles au présentiel, n’est pas sans incidences sur les pratiques enseignantes. Or, la littérature n’offre pas de modèles descriptifs satisfaisants permettant de mieux saisir la pertinence des liens entre l’enseignement en contexte d’apprentissage hybride et le développement professionnel des enseignants universitaires. Aussi avons-nous procédé par des observations participantes de deux cours en sciences de la gestion à HEC Montréal, dans les programmes de certificat de premier cycle ainsi que par des entretiens d’explicitation et d’autoconfrontation, pendant toute la session d’automne 2014, pour respectivement recueillir des données sur les pratiques réelles d’un maître d’enseignement, en sociologie du travail, et d’une chargée de cours, en gestion de projets. Notre analyse du corpus, par catégorisations conceptualisantes, a permis la production d’énoncés nomologiques rendant compte de la dynamique de relations entre ces deux phénomènes. Sur le plan scientifique, elle a apporté un éclairage nouveau sur les processus de construction identitaire professionnelle en pédagogie universitaire, en regard des mutations technologiques, socioculturelles et économiques que subissent l’Université, en général, et les pratiques enseignantes et étudiantes, en particulier. L’approche inductive utilisée a donc permis de définir la structure des interactions des deux phénomènes, selon la perspective des deux enseignants, et d’élaborer des modèles d’intervention enracinés dans leurs pratiques quotidiennes. Aussi sur le plan social, ces modèles sont-ils l’expression d’une grammaire de la pensée et de l’action, ancrée dans les valeurs des enseignants eux-mêmes. Nous avons pris en compte le paradigme de la tâche réelle, versus celui de la tâche prescrite, en termes de mise en œuvre concrète des processus pédagogiques, pour rendre les résultats de cette recherche signifiants pour la pratique. Les modèles, qui ont émergé de notre configuration de la pensée dialogique des participants, peuvent être intégrés à la formation des enseignants universitaires en contexte de bimodalisation de l’Université.

Conceptualisation de l’activité pédagogique en contexte d’apprentissage hybride et développement professionnel des enseignant(e)s universitaires

L’intégration des nouvelles technologies en enseignement supérieur ne devrait pas être vue comme un simple effet de mode, mais plutôt comme un cadre de réflexion sur les orientations nouvelles à donner à l’Université du 21ème siècle, en termes de culture institutionnelle, de ressources organisationnelles et d’opérationnalisation d’objectifs de recherche et d’enseignement (Duderstadt et al, 2002 ; Guri-Rosenblit, 2005). En effet, l’émergence d’une nouvelle tendance de formation post-secondaire, qu’est l’intégration des solutions virtuelles au présentiel, n’est pas sans incidences sur les pratiques enseignantes. Or, la littérature n’offre pas de modèles descriptifs satisfaisants permettant de mieux saisir la pertinence des liens entre l’enseignement en contexte d’apprentissage hybride et le développement professionnel des enseignants universitaires. Aussi avons-nous procédé par des observations participantes de deux cours en sciences de la gestion à HEC Montréal, dans les programmes de certificat de premier cycle ainsi que par des entretiens d’explicitation et d’autoconfrontation, pendant toute la session d’automne 2014, pour respectivement recueillir des données sur les pratiques réelles d’un maître d’enseignement, en sociologie du travail, et d’une chargée de cours, en gestion de projets. Notre analyse du corpus, par catégorisations conceptualisantes, a permis la production d’énoncés nomologiques rendant compte de la dynamique de relations entre ces deux phénomènes. Sur le plan scientifique, elle a apporté un éclairage nouveau sur les processus de construction identitaire professionnelle en pédagogie universitaire, en regard des mutations technologiques, socioculturelles et économiques que subissent l’Université, en général, et les pratiques enseignantes et étudiantes, en particulier. L’approche inductive utilisée a donc permis de définir la structure des interactions des deux phénomènes, selon la perspective des deux enseignants, et d’élaborer des modèles d’intervention enracinés dans leurs pratiques quotidiennes. Aussi sur le plan social, ces modèles sont-ils l’expression d’une grammaire de la pensée et de l’action, ancrée dans les valeurs des enseignants eux-mêmes. Nous avons pris en compte le paradigme de la tâche réelle, versus celui de la tâche prescrite, en termes de mise en œuvre concrète des processus pédagogiques, pour rendre les résultats de cette recherche signifiants pour la pratique. Les modèles, qui ont émergé de notre configuration de la pensée dialogique des participants, peuvent être intégrés à la formation des enseignants universitaires en contexte de bimodalisation de l’Université.

Infants' Understanding of Object Weight: Relations with Action Experience and Strength

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

Risk-based decision support system for life cycle management of industrials plants

Dissertação para obtenção do Grau de Doutor em Engenharia Electrotécnica e de Computadores

Transplantation tolerance induced by regulatory T cells: in vivo mechanisms and sites of action.

The mechanisms by which CD4(+)CD25(+)Foxp3(+) T (Treg) cells regulate effector T cells in a transplantation setting and their in vivo homeostasis still remain to be clarified. Using a mouse adoptive transfer model, we analyzed the in vivo expansion, trafficking, and effector function of alloreactive T cells and donor-specific Treg cells, in response to a full-thickness skin allograft. Fluorescent-labeled CD4(+)CD25(-) and antigen-specific Treg cells were transferred alone or co-injected into syngeneic BALB/c-Nude recipients transplanted with skins from (C57BL/6 x BALB/c) F1 donors. Treg cells divided in vivo, migrated and accumulated in the allograft draining lymph nodes as well as within the graft. The co-transfer of Treg cells did not modify the early activation and homing of CD4(+)CD25(-) T cells in secondary lymphoid organs. However, in the presence of Treg cells, alloreactive CD4(+)CD25(-) T cells produced significantly less IFN-gamma and were present in reduced numbers in the secondary lymphoid organs. Furthermore, time-course studies showed that Treg cells were recruited into the allograft at a very early stage after transplantation and effectively prevented the infiltration of effector T cells. In conclusion, suppression of rejection requires the early recruitment to the site of antigenic challenge of donor-specific Treg cells, which then mainly regulate the effector arm of T cell alloresponses.

Importance of TNF-alpha in the course of acute infection with Trypanosoma cruzi: influence of its inhibition by pentoxifylline treatment

Infection of C3H/He mice with the Peruvian strain of Trypanosoma cruzi (Biodeme type I, Z2b), a macrophagotropic strain, determined severe parasitism of macrophages, necrosis of the spleen, and high host mortality. In the present study, pentoxifylline (PTX), an inhibitor of TNF-alpha was investigated on its action upon splenic necrosis, parasitemia and host survival. Immunohistochemical data suggested the importance of this cytokine in parasite destruction and decreasing of parasitemia, although paradoxically contributing to the high mortality of infected mice. Necrotic lesions involving several organs, specially the heart, in acute Chagas disease, are important aggravating factors, increasing cardiac morbidity. Advantage of inhibiting TNF-alpha action was herein investigated. Infected mice were divided into two groups: untreated (n = 24), and PTX treated mice (n = 25). PTX was administered in two daily doses of 30 mg/kg/bw, by intraperitoneal route. Normal controls either treated with PTX or saline were also included. Histopathology of the spleen and in situ immunolabeling of TNF-alpha, using anti-TNF-alpha monoclonal antibody, were performed. Necrotic areas were evaluated by morphometry. Mice treated with PTX showed a significant decrease of necrotic areas and diminution of TNF-alpha expression in spleen tissue, suggesting that PTX treatment could control TNF-alpha effects, and thus be used as an adjuvant in the treatment of acute Chagas' disease.

Clinical presentation and time-course of postoperative venous thromboembolism: Results from the RIETE Registry

There is little literature about the clinical presentation and time-course of postoperative venous thromboembolism (VTE) in different surgical procedures. RIETE is an ongoing, prospective registry of consecutive patients with objectively confirmed, symptomatic acute VTE. In this analysis, we analysed the baseline characteristics, thromboprophylaxis and therapeutic patterns, time-course, and three-month outcome of all patients with postoperative VTE. As of January 2006, there were 1,602 patients with postoperative VTE in RIETE: 393 (25%) after major orthopaedic surgery (145 elective hip arthroplasty, 126 knee arthroplasty, 122 hip fracture); 207 (13%) after cancer surgery; 1,002 (63%) after other procedures. The percentage of patients presenting with clinically overt pulmonary embolism (PE) (48%, 48%, and 50% respectively), the average time elapsed from surgery to VTE (22 +/- 16, 24 +/- 16, and 21 +/- 15 days, respectively), and the three-month incidence of fatal PE (1.3%, 1.4%, and 0.8%, respectively), fatal bleeding (0.8%, 1.0%, and 0.2%, respectively), or major bleeding (2.3%, 2.9%, and 2.8%, respectively) were similar in the three groups. However, the percentage of patients who had received thromboprophylaxis (96%, 76% and 52%, respectively), the duration of prophylaxis (17 +/- 9.6, 13 +/- 8.9, and 12 +/- 11 days, respectively) and the mean daily doses of low-molecular-weight heparin (4,252 +/- 1,016, 3,260 +/- 1,141, and 3,769 +/- 1,650 IU, respectively), were significantly lower in those undergoing cancer surgery or other procedures. In conclusion, the clinical presentation, time-course, and three-month outcome of VTE was similar among the different subgroups of patients, but the use of prophylaxis in patients undergoing cancer surgery or other procedures was suboptimal.

Change in defense mechanisms and coping over the course of short-term dynamic psychotherapy for adjustment disorder.

Short-term dynamic psychotherapy (STDP) has rarely been investigated with regard to its underlying mechanisms of change, even if psychoanalytic theory informs us about several potential putative mechanisms of change in patients. Change in overall defensive functioning is one. In this study, we explored the role of overall defensive functioning, by comparing it on the process level with the neighbouring concept of overall coping functioning. A total of N=32 patients, mainly presenting adjustment disorder, were included in the study. The patients underwent STDP up to 40 sessions; three sessions per psychotherapy were transcribed and analyzed by using two observer-rating scales: Defense Mechanism Rating Scales (Perry, 1990) and Coping Action Patterns (Perry, Drapeau, Dunkley, & Blake, 2005). Hierarchical linear modeling was applied to model the change over the course of therapy and relate it to outcome. Results suggest that STDP has an effect on the target variable of overall defensive functioning, which was absent for overall coping functioning. Links with outcome confirm the importance of the effect. These results are discussed from methodological and clinical viewpoints.

Prevalence and time course of acute mountain sickness in older children and adolescents after rapid ascent to 3450 meters

OBJECTIVE: Acute mountain sickness is a frequent and debilitating complication of high-altitude exposure, but there is little information on the prevalence and time course of acute mountain sickness in children and adolescents after rapid ascent by mechanical transportation to 3500 m, an altitude at which major tourist destinations are located throughout the world. METHODS: We performed serial assessments of acute mountain sickness (Lake Louise scores) in 48 healthy nonacclimatized children and adolescents (mean +/- SD age: 13.7 +/- 0.3 years; 20 girls and 28 boys), with no previous high-altitude experience, 6, 18, and 42 hours after arrival at the Jungfraujoch high-altitude research station (3450 m), which was reached through a 2.5-hour train ascent. RESULTS: We found that the overall prevalence of acute mountain sickness during the first 3 days at high altitude was 37.5%. Rates were similar for the 2 genders and decreased progressively during the stay (25% at 6 hours, 21% at 18 hours, and 8% at 42 hours). None of the subjects needed to be evacuated to lower altitude. Five subjects needed symptomatic treatment and responded well. CONCLUSION: After rapid ascent to high altitude, the prevalence of acute mountain sickness in children and adolescents was relatively low; the clinical manifestations were benign and resolved rapidly. These findings suggest that, for the majority of healthy nonacclimatized children and adolescents, travel to 3500 m is safe and pharmacologic prophylaxis for acute mountain sickness is not needed.

The time course of ethanol tolerance: associative learning

The effect of different contextual stimuli on different ethanol-induced internal states was investigated during the time course of both the hypothermic effect of the drug and of drug tolerance. Minimitters were surgically implanted in 16 Wistar rats to assess changes in their body temperature under the effect of ethanol. Rat groups were submitted to ethanol or saline trials every other day. The animals were divided into two groups, one receiving a constant dose (CD) of ethanol injected intraperitoneally, and the other receiving increasing doses (ID) during the 10 training sessions. During the ethanol training sessions, conditioned stimuli A (tone) and B (buzzer) were presented at "state +" (35 min after drug injection) and "state -" (170 min after drug injection), respectively. Conditioned stimuli C (bip) and D (white noise) were presented at moments equivalent to stimuli A and B, respectively, but during the saline training sessions. All stimuli lasted 15 min. The CD group, but not the ID group, developed tolerance to the hypothermic effect of ethanol. Stimulus A (associated with drug "state +") induced hyperthermia with saline injection in the ID group. Stimulus B (associated with drug "state -") reduced ethanol tolerance in the CD group and modulated the hypothermic effect of the drug in the ID group. These results indicate that contextual stimuli acquire modulatory conditioned properties that are associated with the time course of both the action of the drug and the development of drug tolerance.

An exploration of the experience of implementing the second step violence prevention curriculum in one primary general learning disabilities class /

Violence has always been a part of the human experience, and therefore, a popular topic for research. It is a controversial issue, mostly because the possible sources of violent behaviour are so varied, encompassing both biological and environmental factors. However, very little disagreement is found regarding the severity of this societal problem. Most researchers agree that the number and intensity of aggressive acts among adults and children is growing. Not surprisingly, many educational policies, programs, and curricula have been developed to address this concern. The research favours programs which address the root causes of violence and seek to prevent rather than provide consequences for the undesirable behaviour. But what makes a violence prevention program effective? How should educators choose among the many curricula on the market? After reviewing the literature surrounding violence prevention programs and their effectiveness, The Second Step Violence Prevention Curriculum surfaced as unique in many ways. It was designed to address the root causes of violence in an active, student-centred way. Empathy training, anger management, interpersonal cognitive problem solving, and behavioural social skills form the basis of this program. Published in 1992, the program has been the topic of limited research, almost entirely carried out using quantitative methodologies.The purpose of this study was to understand what happens when the Second Step Violence Prevention Curriculum is implemented with a group of students and teachers. I was not seeking a statistical correlation between the frequency of violence and program delivery, as in most prior research. Rather, I wished to gain a deeper understanding of the impact ofthe program through the eyes of the participants. The Second Step Program was taught to a small, primary level, general learning disabilities class by a teacher and student teacher. Data were gathered using interviews with the teachers, personal observations, staff reports, and my own journal. Common themes across the four types of data collection emerged during the study, and these themes were isolated and explored for meaning. Findings indicate that the program does not offer a "quick fix" to this serious problem. However, several important discoveries were made. The teachers feU that the program was effective despite a lack of concrete evidence to support this claim. They used the Second Step strategies outside their actual instructional time and felt it made them better educators and disciplinarians. The students did not display a marked change in their behaviour during or after the program implementation, but they were better able to speak about their actions, the source of their aggression, and the alternatives which were available. Although they were not yet transferring their knowledge into positive action,a heightened awareness was evident. Finally, staff reports and my own journal led me to a deeper understanding ofhow perception frames reality. The perception that the program was working led everyone to feel more empowered when a violent incident occurred, and efforts were made to address the cause rather than merely to offer consequences. A general feeling that we were addressing the problem in a productive way was prevalent among the staff and students involved. The findings from this investigation have many implications for research and practice. Further study into the realm of violence prevention is greatly needed, using a balance of quantitative and qualitative methodologies. Such a serious problem can only be effectively addressed with a greater understanding of its complexities. This study also demonstrates the overall positive impact of the Second Step Violence Prevention Curriculum and, therefore, supports its continued use in our schools.

Review of the implementation of the Programme of Action for the Sustainable Development of Small Island Developing States in the Caribbean subregion, 1994-2004

This document contains a review of the implementation, in the Caribbean subregion, of the Programme of Action for the Sustainable Development of Small Island Developing States (SIDS POA). It is divided into two Parts. Part 1 sets out an overall review of the implementation experience and identifies the activities pursued, the achievements recorded, as well as the constraints that were encountered in the process. This Part also addresses some of the more general issues arising from the implementation process as the subregion and the international community, in general, sought to come to terms with the SIDS POA, in search of a more comprehensive sustainable development ethos. Part 1 also documents the operational implications of these aspects over the decade that has elapsed since the adoption of the POA. The presentation of the review findings by reference to more or less precisely defined time periods represents an attempt to chronicle the subregional experience in a manner which permits an appreciation of the evolution of the implementation process.

Review of the implementation of the Programme of Action for the Sustainable Development of Small Island Developing States (SIDS) in the Caribbean subregion, 1994-2003

Includes bibliography

Time course of the meiotic arrest in sheep cumulus-oocyte complexes treated with roscovitine

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)