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In catalan, free adjuncts with a gerund after the main clause are mostly considered acceptable if they describe simultaneous actions or events. But there are usually exceptions to this generalization (for example, the gerund referring to events ocurring immediately after the action in the main clause). Another criterion, which has been noted but never investigated properly, is the semantics of the adjunct. The aim of this article is to further our knowledge of three different discourse relations (Temporal Consequence, Elaboration, Continuation) on the basis of previous work that deals with these relationships from the perspective of the event structure of the relevant verbs. Certain types of verb show a propensity to combine with other verbs, like causatives expressing intrinsic causation, criterion predicates and predicates that describe general events, the reason being that they express complex events, and combination with another predicate makes it possible to find referents for the implied subordinate events.En català, els adjunts lliures de gerundi que apareixen en posició posterior a la clàusula principal es consideren acceptables en bona part si mantenen amb aquesta una relació de simultaneïtat. Aquesta generalització sol presentar contraexemples (per exemple, el gerundi de posterioritat immediata). Un criteri complementari, observat però mai tractat en profunditat, són els valors semàntics expressables per l'adjunt. L'objectiu d'aquest article és aprofundir en el coneixement de tres relacions discursives diferents (conseqüència, elaboració i continuació) a partir de treballs previs que tracten aquestes relacions des de la perspectiva de l'estructura de l'esdeveniment dels verbs implicats. Els verbs que pertanyen a certes classes semblen propensos a buscar la combinació amb altres verbs, com ara els causatius de causa implícita, els predicats de criteri i els predicats que expressen esdeveniments generals. El motiu és que expressen esdeveniments complexos, i la combinació amb un altre predicat permet trobar referents per als subesdeveniments pressuposats

Nuuska ja sen suuvaikutukset

Tämän kirjallisuuskatsauksen aiheena on nuuska ja sen vaikutukset suussa. Hieman tarkastellaan myös nuuskan vaikutuksia muualla kehossa. Tarkoituksena on koota yhteen viimeisin tutkimustieto siitä, minkälaisia vaikutuksia nuuskan käytöllä on. Nuuskan käytön aiheuttamista muutoksista ei ole tehty vielä kovin paljon pitkittäistutkimuksia muun muassa siksi, että usein nuuskaajat käyttävät myös muita nikotiinituotteita, jolloin ei voida varmuudella sanoa, mitkä ovat juuri nuuskan aiheuttamat muutokset kehossa. Nuuskan käyttö on kuitenkin lisääntynyt, joten olisi tärkeä tuoda esiin sen haitat. Aineistoa on kerätty PubMed- ja Google Scholar-hakutietokannoista. Osa artikkeleista on suomeksi, osa englanniksi ja niiden julkaisuajankohta on vuosien 1989 ja 2020 välissä. Suomessa käytetään pääasiassa ruotsalaista pussinuuskaa ja mukaan otetut artikkelit käsittelevätkin tätä nuuskatyyppiä. Lisäksi mukana on muutama potilastapaus Turun Opetushammashoitolasta. Potilailta on saatu luvat kuvien ja tietojen käyttöön. Aineistosta kävi ilmi, että nuuskalla on lukuisia vaikutuksia niin suussa kuin muuallakin kehossa. Suussa ehkä merkittävin muutos on nuuskaleesio, joka kehittyy yleensä siihen kohtaan, missä nuuskaa on pidetty. Nuuskaleesion muuttumisesta pahanlaatuiseksi on vielä hieman ristiriitaista tietoa, mutta on tehty tapausselostuksia, joissa vuosikymmenien nuuskan käytön jälkeen on kehittynyt levyepiteelikarsinooma suuhun. Muita vaikutuksia ovat muun muassa suurentunut riski tyypin II diabetekselle ja raskaana olevan kohonnut riski ennenaikaiselle synnytykselle. Ihmisten tietous nuuskan haitoista ei ole vielä niin hyvällä tasolla kuin tietous esimerkiksi tupakoinnin haitoista, joten muun muassa tämän vuoksi nuuska koetaan jollain tavalla vaarattomaksi tuotteeksi. Aihealue kaipaisi vielä paljon lisää tutkimusta

"YHTEISTYÖLLÄ MENESTYKSEEN" : ITE-menetelmän hyödyntäminen oppivan organisaation kehittämisessä ja laadunhallinnassa

Satakunnan ammattikorkeakoulun kuntoutuksen koulutusohjelman (YAMK) opinnäytetyönä toteutetussa työelämän kehittämishankkeessa hyödynnettiin ITE- itsearviointimenetelmää ja toimintatutkimuksellista lähestymistapaa. Kehittämishanke toteutettiin Satakunnan Sairaanhoitopiirin Sosiaalipalveluiden toimialueella yhteistyössä Lastensuojeluyksikkö Kaislan henkilökunnan kanssa. Kehittämishankkeessa keskityttiin oman lähityöyhteisön Lastensuojeluyksikkö Kaislan kehittämiseen, työtä tehtiin yhteistyössä henkilöstön ja johdon kanssa. Hanke tavoitteli hyötyä niin organisaatio-, henkilökunta- kuin asiakastaholla. Tavoitteena oli myös oppivaan organisaatioon kuuluvan periaatteen mukaan tiedottaa ja jakaa osaamista ja kehittämistyön tuloksia yli yksikkörajojen. Toiveena oli, että kehittämistyöstä hyötyisi koko organisaatio, Satakunnan sairaanhoitopiirin Sosiaalipalvelut, oman lähityöyhteisön lisäksi. Kehittämishankkeen alussa Lastensuojeluyksikkö Kaislan henkilökunta arvioi toimintaansa ITE- itsearviointilomaketta käyttäen. Kehittämistyö suunniteltiin saatuja tuloksia hyödyntäen. Hankkeen lopussa Lastensuojeluyksikkö Kaislan henkilökunta arvioi toimintaansa uudelleen ITE – itsearviointilomakkeella. Lisäksi henkilökunta arvioi kehittämishankeen vaikutuksia erillisellä palautekyselyllä. Saatujen tulosten valossa ITE – menetelmä soveltuu hyvin työyksikköjen systemaattiseen kehittämisen sekä laadunhallinnan välineeksi. Kehittämishankkeelle nimetty ohjausryhmä arvioi hankkeen aikana ITE – menetelmän soveltuvuutta organisaatiotasolla (Satakunnan sairaanhoitopiirin Sosiaalipalvelut). ITE -menetelmän katsottiin soveltuvan hyvin käytettäväksi organisaation laadunhallinnan sekä kehittämistyön tukena. ITE – menetelmä otettiin jatkuvaan käyttöön organisaatiossa ja se linkitettiin osaksi organisaation laatutyöskentelyä. Kehittämishankkeen tavoitteiden voidaan katsoa toteutuneen hyvin. Hanke on toiminut oppimisprosessina, jonka aikana organisaatiossa on löydetty uusia mahdollisuuksia parantaa suomalaista työelämää ja sen laatua.The ITE- method combined with research into activity were used as means of approach in the development project on working life, conducted as a student work assignment of the Satakunta University Degree Programme in Rehabilitation. The project was conducted within the district of Satakunta Health Care District Social Services in cooperation with The Child Welfare Unit Kaisla. The development project was focused on the enhancement of immediate working unit, The Child Welfare Unit Kaisla, the work being done in cooperation with the staff and management. The aim of the project was to benefit the organization, the staff and the customers. According to the principals of an learning organization one of the aims was to share information and knowledge as well as the results of the work on development beyond the realms of a single unit. It was hoped that the whole organization, Satakunta Health Care District Social Services, would benefit from the work on development, as well as our immediate working unit. At the start of the project the staff of The Child Welfare Unit Kaisla made an assessment of their own activities making use of the ITE- self-assessment form. The developmental work was designed using the obtained results. At the end of the project the staff of Kaisla reassessed their activities using the ITE- self-assessment form. In addition the staff appraised the effects of the project with a separate feed-back questionnaire. According to the obtained results, the ITE- method is well suited to the systematic development of working units as well as quality control. During the project a team of instructors assigned to the development project assessed the suitability of the ITE-method on organizational level (Satakunta Health Care District Social Services). It was concluded that the ITE-method is well suited as a support mechanism within an organization’s quality control and development work. The ITE-method was adopted into continuous use and linked to the organization’s efforts on quality. The development project can be concluded to have been successful. The project has been a learning curve, during which new possibilities for the improvement of Finnish working life and its quality have been discovere

Disclosing and Reporting Practice Errors by Nurses in Residential Long-Term Care Settings: A Systematic Review

Patient safety is crucial for the sustainability of the healthcare system. However, this may be jeopardized by the high prevalence of practice errors, particularly in residential long-term care. Development of improvement initiatives depends on full reporting and disclosure of practice errors. This systematic review aimed to understand factors that influence disclosing and reporting practice errors by nurses in residential long-term care settings. A systematic review using an integrative design was conducted. Electronic databases including PubMed (including Medline), Scopus, CINAHL, Embase, and Nordic and Spanish databases were searched using keywords relating to reporting and disclosing practice errors by nurses in residential long-term care facilities to retrieve articles published between 2010 and 2019. The search identified five articles, including a survey, a prospective cohort, one mixed-methods and two qualitative studies. The review findings were presented under the categories of the theoretical domains of Vincent’s framework for analyzing risk and safety in clinical practice: ‘patient’, ‘healthcare provider’, ‘task’, ‘work environment’, and ‘organisation & management’. The review findings highlighted the roles of older people and their families, nurses’ individual responsibilities, knowledge and collaboration, workplace atmosphere, and support by nurse leaders for reporting and disclosing practice errors, which had implications for improving the quality of healthcare services in residential long-term care settings

Oral and Vaginal Hormonal Contraceptives Induce Similar Unfavorable Metabolic Effects in Women with PCOS: A Randomized Controlled Trial

This clinical trial aims to compare hormonal and metabolic changes after a 9-week continuous use of oral or vaginal combined hormonal contraceptives (CHCs) in women with polycystic ovary syndrome (PCOS). We recruited 24 women with PCOS and randomized them to use either combined oral (COC, n = 13) or vaginal (CVC, n = 11) contraception. At baseline and 9 weeks, blood samples were collected and a 2 h glucose tolerance test (OGTT) was performed to evaluate hormonal and metabolic outcomes. After treatment, serum sex hormone binding globulin (SHBG) levels increased (p < 0.001 for both groups) and the free androgen index (FAI) decreased in both study groups (COC p < 0.001; CVC p = 0.007). OGTT glucose levels at 60 min (p = 0.011) and AUCglucose (p = 0.018) increased in the CVC group. Fasting insulin levels (p = 0.037) increased in the COC group, and insulin levels at 120 min increased in both groups (COC p = 0.004; CVC p = 0.042). There was a significant increase in triglyceride (p < 0.001) and hs-CRP (p = 0.032) levels in the CVC group. Both oral and vaginal CHCs decreased androgenicity and tended to promote insulin resistance in PCOS women. Larger and longer studies are needed to compare the metabolic effects of different administration routes of CHCs on women with PCOS

The impact of gender-role-orientations on subjective career success: a multilevel study of 36 societies

International audienceWe investigate the relationships between gender-role-orientation (i.e., androgynous, masculine, feminine and undifferentiated) and subjective career success among business professionals from 36 societies. Drawing on the resource management perspective, we predict that androgynous individuals will report the highest subjective career success, followed by masculine, feminine, and undifferentiated individuals. We also postulate that meso-organizational culture and macro-societal values will have moderating effects on gender role's impact on subjective career success. The results of our hierarchical linear models support the hypothesized hierarchy of the relationships between gender-role-orientations and subjective career success. However, we found that ethical achievement values at the societal culture level was the only variable that had a positive moderating impact on the relationship between feminine orientation and subjective career success. Thus, our findings of minimal moderation effect suggest that meso- and macro-level environments may not play a significant role in determining an individual's perception of career success

A Twenty-First Century Assessment of Values Across the Global

This article provides current Schwartz Values Survey (SVS) data from samples of business managers and professionals across 50 societies that are culturally and socioeconomically diverse. We report the society scores for SVS values dimensions for both individual- and societallevel analyses. At the individual-level, we report on the ten circumplex values sub-dimensions and two sets of values dimensions (collectivism and individualism; openness to change, conservation, self-enhancement, and self- transcendence). At the societal-level, we report on the values dimensions of embeddedness, hierarchy, mastery, affective autonomy, intellectual autonomy, egalitarianism, and harmony. For each society, we report the Cronbach’s a statistics for each values dimension scale to assess their internal consistency (reliability) as well as report interrater agreement (IRA) analyses to assess the acceptability of using aggregated individual level values scores to represent country values. We also examined whether societal development level is related to systematic variation in the measurement and importance of values. Thus, the contributions of our evaluation of the SVS values dimensions are two-fold. First, we identify the SVS dimensions that have cross-culturally internally reliable structures and withinsociety agreement for business professionals. Second, we report the society cultural values scores developed from the twenty-first century data that can be used as macro-level predictors in multilevel and single-level international business research

Airport emission particles:Exposure characterization and toxicity following intratracheal instillation in mice

Background: Little is known about the exposure levels and adverse health effects of occupational exposure to airplane emissions. Diesel exhaust particles are classified as carcinogenic to humans and jet engines produce potentially similar soot particles. Here, we evaluated the potential occupational exposure risk by analyzing particles from a non-commercial airfield and from the apron of a commercial airport. Toxicity of the collected particles was evaluated alongside NIST standard reference diesel exhaust particles (NIST2975) in terms of acute phase response, pulmonary inflammation, and genotoxicity after single intratracheal instillation in mice. Results: Particle exposure levels were up to 1 mg/m3 at the non-commercial airfield. Particulate matter from the non-commercial airfield air consisted of primary and aggregated soot particles, whereas commercial airport sampling resulted in a more heterogeneous mixture of organic compounds including salt, pollen and soot, reflecting the complex occupational exposure at an apron. The particle contents of polycyclic aromatic hydrocarbons and metals were similar to the content in NIST2975. Mice were exposed to doses 6, 18 and 54 μg alongside carbon black (Printex 90) and NIST2975 and euthanized after 1, 28 or 90 days. Dose-dependent increases in total number of cells, neutrophils, and eosinophils in bronchoalveolar lavage fluid were observed on day 1 post-exposure for all particles. Lymphocytes were increased for all four particle types on 28 days post-exposure as well as for neutrophil influx for jet engine particles and carbon black nanoparticles. Increased Saa3 mRNA levels in lung tissue and increased SAA3 protein levels in plasma were observed on day 1 post-exposure. Increased levels of DNA strand breaks in bronchoalveolar lavage cells and liver tissue were observed for both particles, at single dose levels across doses and time points. Conclusions: Pulmonary exposure of mice to particles collected at two airports induced acute phase response, inflammation, and genotoxicity similar to standard diesel exhaust particles and carbon black nanoparticles, suggesting similar physicochemical properties and toxicity of jet engine particles and diesel exhaust particles. Given this resemblance as well as the dose-response relationship between diesel exhaust exposure and lung cancer, occupational exposure to jet engine emissions at the two airports should be minimized.publishedVersionPeer reviewe

Ethical preferences for influencing superiors: A 41-society study

With a 41-society sample of 9990 managers and professionals, we used hierarchical linear modeling to investigate the impact of both macro-level and micro-level predictors on subordinate influence ethics. While we found that both macro-level and micro-level predictors contributed to the model definition, we also found global agreement for a subordinate influence ethics hierarchy. Thus our findings provide evidence that developing a global model of subordinate ethics is possible, and should be based upon multiple criteria and multilevel variables