Academic literature on the topic 'Lishin family'

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Journal articles on the topic "Lishin family"

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Kamarad, Ewa. "Wpływ traktatu lizbońskiego na unijne prawo prywatne międzynarodowe." Politeja 15, no. 54 (February 10, 2019): 216–27. http://dx.doi.org/10.12797/politeja.15.2018.54.14.

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The Impact of the Treaty of Lisbon on the EU Private International LawThe paper deals with private international law after the adoption of the Treaty of Lisbon. In particular, it discusses the legal basis for adopting secondary legislation in this field and the EU competence to conclude international agreements. Next, the EU legislative activity is presented, with particular emphasis on family law, in which enhanced cooperation has already been initiated twice.
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Milios, Georgios. "A Re-examination of the Family Reunification Directive in the post-Lisbon Fundamental Rights Scene." ICL Journal 12, no. 1 (April 25, 2018): 85–114. http://dx.doi.org/10.1515/icl-2017-0083.

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Abstract The article examines the issue of compatibility of the Family Reunification Directive with the important changes that the adoption of the Lisbon Treaty brought to the field of fundamental rights in the EU especially considering the fact that the Charter of Fundamental Rights of the EU gained the same legal value as the treaties. The article examines all possible scenarios that may derive from Art 52 (3) of the Charter and the problems or issues that each of them may entail for the immigrants’ right to family life in the EU. This examination reveals that certain aspects of the provisions of the Family Reunification Directive are not compatible with Art 8 of the European Convention on Human Rights, and proposes that the EU should, in any event, provide more extensive protection than the one provided for by the Convention. The article proposes a reunification model which may be more compatible with the post-Lisbon fundamental rights scene.
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F. Simões Vieira, Elisabete. "The effect on the performance of listed family and non-family firms." Managerial Finance 40, no. 3 (March 4, 2014): 234–53. http://dx.doi.org/10.1108/mf-06-2013-0134.

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Purpose – The purpose of this paper is to examine whether the ownership of public firms is related to accounting and market performance, comparing family and non-family listed firms. Design/methodology/approach – The paper uses regression analysis, considering a sample of Portuguese family and non-family firms (NFF) for the period between 1999 and 2010. Findings – Overall, the results show that family firms (FF) are older, are more indebted and have higher debt costs than NFF. However, they present lower levels of risk. The evidence suggests that FF outperform NFF when the author considers a market performance measure. The market performance of family-controlled firms is more sensitive to the crisis periods and age, compared to their counterparts. The empirical findings suggest that under economic adversity, the performance is especially compromised by the firms' age. Research limitations/implications – A limitation of this study is the small size of the sample, which derives from the small size of the Portuguese stock market, the Euronext Lisbon. Originality/value – This paper offers some insights on the ownership of public firms and firm performance by investigating a small European economy. The study also contributes to the stream of firm performance, considering new independent variables as determinants of firm performance, such as operational risk. Finally, the study examines the interaction between ownership and performance under both steady and adverse economic conditions, giving the opportunity to analyze whether firm performance differs according to market conditions.
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Victorino, Rui M. M., D. Guerreiro, M. Helena Lourenço, M. O. Santos Ferreira, and L. Cunha Teles. "Prevalence of HIV-2 Infection in a Family Planning Clinic in Lisbon." International Journal of STD & AIDS 3, no. 4 (July 1992): 281–84. http://dx.doi.org/10.1177/095646249200300410.

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A significant proportion (10%) of notified AIDS cases in Portugal are due to HIV-2 infection as a result of the close connections of Portugal with Western African Countries (ex-Portuguese colonies) where there is a high HIV-2 seroprevalence. We conducted a seroepidemiological study of HIV-1 and HIV-2 infection in 1400 women attending family planning and antenatal clinics in a health centre in Lisbon with the objective of analysing whether there was evidence of HIV-2 spread in this population. The seroprevalence for HIV, as determined by ELISA and confirmed by Western Blot, was 0.42% (6 cases) and 50% of these were of HIV-2 infection. Analysis of the epidemiological inquiries reveals that out of the 6 seropositive cases, only one was a drug addict (HIV-1) and another a western African black woman (HIV-2). The other 4 cases (2 HIV-2 and 2 HIV-1) were white Portuguese women with no history of travelling to Africa or previous blood transfusions, and the only risk factor was a history of multiple sexual partners (in 3 out of 4).
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Maltez, Fernando, Teresa Martins, Diana Póvoas, João Cabo, Helena Peres, Francisco Antunes, João Perdigão, and Isabel Portugal. "Tuberculose Multirresistente por Estirpes da Família Beijing, em Doentes de Lisboa, Portugal: Estudo Preliminar." Acta Médica Portuguesa 30, no. 3 (March 31, 2017): 175. http://dx.doi.org/10.20344/amp.7882.

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Introduction: Beijing family strains of Mycobacterium tuberculosis are associated with multidrug-resistance. Although strains of the Lisboa family are the most common among multidrug-resistant and extensively drug-resistant patients in the region, several studies have reported the presence of the Beijing family. However, the features of patients from whom they were isolated, are not yet known.Material and Methods: Retrospective study involving 104 multidrug-resistant and extensively drug-resistant strains of Mycobacterium tuberculosis, from the same number of patients, isolated and genotyped between 1993 and 2015 in Lisbon. We assessed the prevalence of strains of both families and the epidemiologic and clinical features of those infected with Beijing family strains.Results: Seventy-four strains (71.2%) belonged to the Lisboa family, 25 (24.0%) showed a unique genotypic pattern and five (4.8%) belonged to the Beijing family, the latter identified after 2009. Those infected with Beijing family strains were angolan (n = 1), ukrainian (n = 2) and portuguese (n = 2), mainly young-aged and, four of five immunocompetent and with no past history of tuberculosis. All had multidrug-resistant tuberculosis. We did not find any distinctive clinical or radiological features, neither a predominant resistance pattern. Cure rate was high (four patients).Discussion: Although the number of infected patients with Beijing strains was small, it suggests an important proportion of primary tuberculosis, a potential for transmission in the community but also a better clinical outcome when compared to other reported strains, such as W-Beijing and Lisboa.Conclusion: Although Lisboa family strains account for most of the multidrug and extensively drug-resistant tuberculosis cases in Lisbon area, Beijing strains are transmitted in the city and might change the local characteristics of the epidemics.
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Drumond Braga, Paulo. "Comer e sociabilizar à mesa em Lisboa em camisa (1882), de Gervásio Lobato." e-Letras com Vida: Revista de Estudos Globais — Humanidades, Ciências e Artes 05 (2020): 71–80. http://dx.doi.org/10.53943/elcv.0220_07.

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This article aims to study several aspects of food and sociability around the table in the Portuguese humorous book Lisboa em camisa (1882), by Gervásio Lobato, which portrays, with great humor, some episodes from the life of a petty bourgeois family from Lisbon in the 1880s.
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Stalford, Helen. "The impact of the Treaty of Lisbon on social welfare and family law." Journal of Social Welfare and Family Law 32, no. 1 (March 2010): 1–3. http://dx.doi.org/10.1080/09649061003675816.

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de Lima, Antónia Pedroso. "Businessmen and Female Family Managers. Gender Complementarity and Asymmetry in a Lisbon Elite." Lusotopie 12, no. 1 (September 1, 2005): 191–202. http://dx.doi.org/10.1163/176830805774719782.

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de Almeida, Ana Nunes. "Industry, Family, and Class: The Working-Class Community in Barreiro." Journal of Family History 19, no. 3 (September 1994): 197–212. http://dx.doi.org/10.1177/036319909401900301.

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Frequently placed on the edges of scientific debate and analyzed in relation to problems or theoretical constructs specific to other social groups, the portrait of the “working-class family” is too often the product of logical deductions and a sort of no-man's land. The research project described by the present article concerns factories, working-class groups, and family strategies in Barreiro, a Portuguese industrial town near Lisbon, the Portuguese capital. Special attention is given to reconstructing the industrial experience at a regional level and to the study of workers in the cork and heavy metallurgical industries of Barreiro. The results suggest the internal diversity of the working-class world and two different kinds of linkeage between family and workplace life—the survival strategy of cork workers in the 1920s, and the promotion strategy of the metal workers in the 1950s.
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Vieira, Elisabete Simões. "Board of directors characteristics and performance in family firms and under the crisis." Corporate Governance: The International Journal of Business in Society 18, no. 1 (February 5, 2018): 119–42. http://dx.doi.org/10.1108/cg-01-2017-0010.

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Purpose This paper aims to examine the relationship between board of directors’ characteristics and performance in family businesses. It offers evidence to the question of whether a family firm (FF) differs from a non-family firm and looks at the possibility of asymmetrical effects between periods of stability and economic adversity. Design/methodology/approach A panel data approach was applied to a sample of Portuguese firms listed the on Euronext Lisbon exchange between 2002 and 2013. Findings The results show that FFs are likely to have a lower proportion of independent members and higher gender diversity on their boards than non-family firms. FF performance is positively related to ownership concentration and gender diversity. There are performance premiums for family businesses, which have more gender diversity than their counterparts. These effects also depend on whether the economy is in recession. The evidence suggests that the presence of women on the board and the leverage and size of the FFs have a more significant impact on the performance in periods of economic adversity. Research limitations/implications One limitation of this study is the small size of the sample as it was drawn from the Euronext Lisbon exchange, a small stock exchange market. Originality/value This study provides input into the academic discussion on corporate governance and FF, an area which is in need of research. In addition, the authors examine this issue in conjunction with generalised economic adversity, focusing on the possible asymmetrical effects that the nature of the board of directors may have on performance in periods of stability and those of economic adversity. The role of board of directors is crucial to the understanding of corporate behaviour and the setting of the policy that regulates corporate activities.
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Dissertations / Theses on the topic "Lishin family"

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Hunt, Michelle. "“I’ve got something to say and I need you to listen” : a photovoice study with women who have experienced family violence." Thesis, Federation University Australia, 2021. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/180543.

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Family violence is recognised as a significant social issue in Australia that is predominantly perpetrated by men against women in intimate partner relationships. Once only of concern to women and feminist activists, family violence is now part of mainstream public policy and community service provision. This research was conducted within an industry, community and university partnership to improve services for women and children who have experienced family violence in the Central Highlands region of Victoria. This research study used photovoice, a feminist participatory research method, to gather the insights and knowledge of some of these women from this region. The participants produced, selected and contextualised photographs to share their vision of “strong families, safe children” as well as providing their insights on what services needed to do to support this vision. Ten women participated in the study and collectively contributed 42 photographs and attended 15 individual interviews and four group workshops over a six-month period. Through their photographs and narratives, the participants detailed their experiences of services, including the systemic abuse of power and coercion that undermined their relationships with their children. The participants described feeling blamed and further victimised when their interactions with services replicated the coercive control that they had experienced in their intimate partner relationships. Systemic racial discrimination and violence further compounded service encounters described by the Aboriginal women who participated in the study. The participants advocated for the transformation of family violence policy and practice from one reliant on patriarchal and colonial knowledge to one grounded in feminist epistemologies and women’s experiential knowledge. Consistent with feminist epistemologies, this research study highlights the importance of relational understandings of family violence, a position that acknowledges the significance of women’s social context and family networks, as well as the interconnectedness of women’s and children’s safety and wellbeing. This research study has implications for the family violence service system grappling with the inclusion of lived experience as being more than voice but encompassing the positioning of women’s experiential knowledge (with all its emotion, complexity and subjectivity) at the heart of policy and practice.
Doctor of Philosophy
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Almeida, Ricardo Gouveia de. "Habitação colectiva para um habitar imprevisível." Master's thesis, Universidade de Lisboa, Faculdade de Arquitetura, 2017. http://hdl.handle.net/10400.5/13922.

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Ireson, Deborah. "Antenatal clinic: Using ethnographic methods to listen to the voices of pregnant adolescents." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2015. https://ro.ecu.edu.au/theses/1752.

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Aim: This research aims to explore the motivating reasons and external influences that affect pregnant adolescents’ reasons for attending an antenatal clinic. Background: Pregnancy during adolescence has been researched from perceived ‘poor’ decision making during pregnancy and postnatal perspectives involving high-risk outcomes for mother and baby. Antenatal clinic attendance by pregnant adolescents is often characterised by late and infrequent attendance, limiting midwifery contact with this inexperienced group. Gaps in the literature exist where the real-time voices of pregnant adolescents offer their current experiences of antenatal clinic as a relevant means to inform midwifery practice. Research design: Using ethnographic methods, this research positioned a midwife to observe pregnant adolescents for a period of nine months while they attended a public antenatal clinic in Western Australia. Data collection and analysis: Data from participant observation was supplemented by in-depth key informant interviews. Analysis of the data was concurrent with data collection and guided by Spradley’s Developmental Research Sequence (1980). Findings: Findings revealed four themes influencing attendance for antenatal care during pregnancy: a) connecting with midwives b) the importance of the maternal mother c) supportive relationships and d) engaging with pregnancy. Themes highlighted maternal mothers are pivotal to antenatal clinic attendance; they provide guidance and antenatal advice that pregnant adolescents accept in preference to that of midwives. Adolescents are influenced to attend antenatal clinic by different milestones than those represented in midwifery care; this may provide opportunity for midwives to align themselves alongside adolescents to provide pregnancy education at moments most relevant to them. Conclusion: Information discovered will increase midwifery knowledge of what factors bring pregnant adolescents to antenatal clinic, aiding midwives to influence regular attendance in this group. To increase pregnant adolescents’ comfort and perceptions of value, midwives may need to reconsider the traditional environment of the antenatal clinic to make better use of waiting times and become more inclusive of adolescents’ supportive relationships. Embracing web-based technology is a pathway, which may effectively assist in the successful provision of antenatal education to this age group. Non-judgemental midwives offering a caring approach to antenatal care, verifying pregnant adolescents’ individual understanding, is identified as essential to engagement with this group.
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Caeiro, Sara Raquel Pacheco. "Voltei à escola: Perceção dos alunos de 3º ciclo face ao envolvimento parental: Um estudo realizado em Cuba do Alentejo." Master's thesis, ISPA - Instituto Universitário, 2013. http://hdl.handle.net/10400.12/2828.

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Dissedrtação de Mestrado em Psicologia Educacional apresentada ao ISPA - Instituto Universitário
A presente investigação visa estudar as perceções dos alunos no que diz respeito: ao nível de apoio dos pais em relação às tarefas escolares, em relação á comunicação sobre a escolaridade, á mediação cultural praticada pelos pais, e por fim, em relação á participação escolar e extraescolar exercida pelos pais. Vários autores referem a importância aquando da participação dos alunos no momento de avaliar o envolvimento praticado pelos pais, no que diz respeito às práticas educativas. Ouvir os alunos é assim essencial, uma vez que, estes podem causar mudanças quer a nível escolar, quer a nível familiar. Participaram neste estudo, 88 estudantes do 7º. 8º, e 9º ano de uma escola básica do distrito de Beja com idades compreendidas entre os 12 e os 17 anos, sendo que 48% são do sexo masculino, e 52 % do sexo feminino. Todas as dimensões de envolvimento parental foram realizadas em função do género e ano de escolaridade dos alunos, e habilitações académicas dos encarregados de educação. No geral os resultados revelaram que tanto os rapazes como as raparigas percecionam de maneira idêntica as práticas de envolvimento parental. Em relação às habilitações académicas dos encarregados de educação, os alunos percecionaram que, quer os pais tenham escolaridade baixa ou escolaridade elevada, as práticas familiares são idênticas. Por fim, foram verificadas diferenças em relação ao ano de escolaridade, uma vez que, segundo a literatura, á medida que o ano escolar aumenta, os jovens começam a ter uma certa autonomia face aos encarregados de educação.
ABSTRACT: This research to study the perceptions of students in relation to: the level of support from parents regarding homework in relation to communication about education, cultural mediation will be practiced by parents, and finally, in their school participation and extra-school exercised by parents . Several authors refer to the importance of student participation when the time to evaluate the involvement practiced by parents regarding educational practices. Listening to students is so essential, since these can cause changes either at school or at the household level. Participated in this study, 88 students from the 7th, 8th and 9th grade of an elementary school in the district of Beja aged between 12 and 17 years, and 48 % are male and 52 % female . All dimensions of parental involvement were conducted by gender and grade students, and educational qualifications of parents. Overall the results showed that both boys and girls perceive identically practices of parental involvement. Regarding the educational qualifications of parents, students perceive that whether parents have low education or high school, family practices are identical. Finally, differences were observed with respect to grade, since, according to the literature, as it will increase the school year, young people begin to have a certain autonomy from parents.
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feng, Hsu shui, and 許水鳳. "The discussion of social work participation In the single-parent family children,s after school care service In Lishin The discussion of social work participation In the single-parent family children,s after school care service In Lishin." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/83591391282236607794.

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碩士
中國文化大學
青少年兒童福利研究所
95
Due to women rejoin the job market in the process of social structural change. After school care of their children becomes essential. The influence of social work regarding after school care is yet to be researched. After experience in related fields for many years, I try to establish a model depends mostly on social work rather than on living care and tutoring which are prevailing in Taiwan. Based on qualitative research method after questioning of administrators in private and official institutes and staff to Lishin including social workers, supervisors and physicians. On analysis elaborates the advantages of the involvement of social work in single-parent family was made and it will practically provide useful information to after school care. The discoveries in this research are as followings: 1.The involvement of social work in after school care can practically serve the need of after school care of single-parent family. 2.The involvement of social work in after school care can further prevent problems resulting from single-parent family. 3.The aggregate effects of the long term social service are essential for single-parent family care. 4.To ensure the social work playing a specific role in after school care makes after school care in single-parent family more efficient. 5.By emphasizing the advantages of children in single family would inspire the care for single-parent family. The research further discuss the questions like: the incomplete of laws, the shortcomings of the complimentary policy, supervising system is not feasible and whether or not the after school care of child is social welfare. Finally, the suggestions of after school care improvement for government policy, non-profit institutes and Lishin are also available in the context. We hope the government as well as private institutes can pay more attentions to single-parent family after school care and to serve its needs.
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Parry, Rita Adoma. "Resilience among Ghanaian migrants in Lisbon in accessing family reunification and learning of Portuguese language." Master's thesis, 2020. http://hdl.handle.net/10071/21012.

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This study explores the resilience of Ghanaian migrants in their migration trajectories, their transnational parenting experiences, language learning practices and plans of reunification in Lisbon, Portugal. The resilience theory informed the theoretical and analytical base for the study. A non-probability (snowball technique) sampling was used for selecting migrants who had had intentions of reuniting with their families in Portugal. A qualitative orientation research approach was employed to investigate the phenomenon among seven respondents using in-depth interviews. Textual analysis of policy documents, participant observations (both on sites and online) were used as sources of data as well. The study identified the delay in their regularization processes and lack of financial resources to fulfill requirements as the main challenges Ghanaian migrants in Lisbon faced in the process of accessing family reunification in Portugal. Despite the challenges, Portugal’s migration policies were perceived by migrants as friendly and benevolent to advance their future aspirations. Furthermore, transnational parenting practices including constant communication and sending of remittances played important roles in migrants’ efforts in maintaining family ties across borders. Importantly, individual skills and support from migrant networks served as the participants' main resilience strategies during their migration trajectories and while they anticipated family reunification. Lastly, resilience in learning Portuguese language was demonstrated through migrant’s self-determination to overcome language and communication barriers by adopting people-to-people strategies, technology-based language learning applications and accessing state provided language programs. In conclusion, due to the perceived permissive measures in Portugal’s migration policies, Ghanaian migrants in Portugal are likely to opt for long term settling in the country. In this way, the gradually increasing numbers of Ghanaian migrants will contribute to the overall linguistic and cultural diversity in Portugal as they bring along their cultural baggage such as ways of engaging in transnational parenting, family models and practices and their language learning strategies.
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Little, Gina. "They didn’t listen, they just didn’t listen: a study linking coercive control to alienation and systems abuse in post-separation co-parenting relationships." Thesis, 2020. http://hdl.handle.net/1959.13/1417117.

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Bachelor Honours - Bachelor of Social Science (Honours)
Abstract: Through qualitative interviews this thesis draws on the lived experiences of 6 parents; 3 men and 3 women post-separation between 40-65, to understand their co-parenting experiences in relationship to alienation, interpersonal manipulation and systems manipulation. All participants who took part either have been, or are currently, co-parenting with the partner of their child/children. Of the participants that were interviewed, three of the six had experienced complicated dynamics prior to separation. This research enquires about how they negotiated their relationships with their ex-partner and child/children post-separation. Two contemporary issues addressed are the use of coercive control in personal relationships between ex-partners and their children and coercive control in systems and institutions. Coercive control in personal relationships uncovered the subtle control of one parent over the other by cleverly using whatever tools or tactics were available, including manipulating systems, disabling the other parent’s ability to parent effectively and withholding information causing alienation. The use of coercive control in systems and institutions was also evident, ranging from phenomena such as gender bias, manipulation, emotional and financial pressures, to a lack of system connectivity putting parents and children at risk through systems abuse. The Australian Law Reform Commission has taken steps towards improving family law systems, however, have only addressed system oversites in part. From the stories shared in this thesis it would appear that greater information connectivity between government and private agencies could possibly create a safer systems approach for future victims (The Australian Law Reform commission, 2019). From a theoretical standpoint this research has been viewed through the lens of two theories. Firstly, Attachment Theory, then secondly, Bowen’s Family Systems Theory (Systems Theory). These theories have been chosen to enhance understanding of possible implications that arise through the presence of coercive control which can affect co-parenting outcomes (Lowenstein, 2010).
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Jamers, sun chie, and 簡上智. "The study of the effect about the changing of the ownership structure to operating performance after family business listing." Thesis, 1996. http://ndltd.ncl.edu.tw/handle/67422013800971644707.

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Sangha, Jasjit. "Meri Kahanee Sono (Listen to My Story): A (Step) Mother's Journey Of Healing and Renewal." Thesis, 2010. http://hdl.handle.net/1807/29945.

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Loyalty conflicts. Resistance. Anger. This thesis will take you along on my journey as a South Asian woman and the mother and stepmother of a cross-cultural stepfamily. Through the form of an arts-informed auto-ethnography I will illustrate how I underwent personal and spiritual transformation while (step) mothering four children. It is a story that “both cuts and heals” (Luciani, 2000, p. 39). In this work I show how mothering and stepmothering can “deteriorate into martyrdom if a mother gives her children and spouse the love and care she doesn’t feel that she herself is worthy of receiving” (Northrup, 2005, p. 13). I explore how the pressure to be a “good mother” and “good stepmother” left me feeling inadequate, resentful, doubtful of my abilities and neglectful of my own needs. Hope. Solace. Spirituality. Love. This story is also about healing and renewal and my process of recapturing a sense of self by returning to spirituality. By sinking into my life as a mother and stepmother and viewing my life circumstance as a “vehicle for waking up” (Chodron, 1991, p. 71), I cultivated a conscious state in which anger and resentment was replaced by awe and wonder. I strengthened my agency by directing nurturing and caregiving to myself, pursuing my creativity, and sharing childrearing more equitably with my partner. Mothering and stepmothering became sites of empowerment as I found joy in my relationship with myself, my children, and the community around me. This research provides an example of how meaningful knowledge production can occur in alternative forms to mainstream academic discourse. Arts-informed, auto-ethnographic research offers insights on human relationships and interactions in the world by fostering an epistemological shift for the researcher as well as the reader. As Sameshina and Knowles note (2008) this methodology is “transformational in process and possibilities” (108).
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Li, Lan. "Social integration of international Chinese second generation of immigrants : research on the youth from 15 to 24 of Chinese immigrants in Lisbon, Portugal." Master's thesis, 2012. http://hdl.handle.net/10071/5184.

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Since the first group of immigrants from China arrival to Portugal, from 1950s on, more Chinese people came to work and live in this south European country. Under an in general flexible migration policy, Portugal becomes one of the springboards for immigrants entering EU. Migration is always a reflection of policy and economics, while concurrently affects the local society. Portugal has a long history of both emigration and immigration. Since immigrants are taking an important role in the hosting society, it is vital to pay attention to their living conditions. Second generation of immigrants is a group that grows up with the local’s. They are both contributors of supporting and creating future. In fact, this group in general is more vulnerable, with high risks and less care while growing up. My research chose the Chinese second generation of immigrants from 15 to 24 years old. Through Socialization and Social Integration theories, I am trying to find out their integration situations from three perspectives of family, school and community. The conclusions prove second generations of Chinese immigrants are mostly family-oriented, have a high drop-out rate and a high cognition of Chinese culture. Culture Identity highly manipulates the second generations’ practice in the three fields. Educational level limits their social development. The important findings are: Positive correlation between the social integration level of second generations’ and their parents’. The integration ability strongly represents their Family Social Capital competence. Besides, the local Chinese organizations play as the platform for second generations’ social participation and personal realization.
Desde o aparecimento do primeiro grupo de imigrantes provenientes da China, durante os anos cinquenta do século passado, mais chineses vieram viver e trabalhar neste país do Sul da Europa. Num processo correspondente a uma política de migração relativamente mais flexível, o país de chegada tornou-se uma das portas de ingresso na Europa para estas pessoas. A migração é sempre um reflexo da política do país, afectando simultaneamente a sociedade local. Portugal tem uma longa história de emigração e imigração. Posto que os imigrantes estão a desempenhar um papel mais importante na sociedade de acolhimento, é vital prestar atenção às suas condições de vida. A segunda geração de imigrantes é o grupo que cresce juntamente com o grupo local. Os seus membros são uma parte das futuras forças criativas e de suporte da sociedade. De facto, este grupo é mais vulnerável, correndo riscos maiores e dispondo de menos cuidados durante o seu crescimento. Esta pesquisa escolheu a segunda geração de imigrantes Chineses entre os 15 e os 24 anos de idade. Recorrendo às teorias da socialização e da integração social, procvrei descobrir os seus níveis de integração sob perspectivas familiares, escolares, laborais, de organização social e de identidade cultural. Os resultados permitem concluir que os imigrantes chineses da segunda geração são predominantemente guiados pelos valores familiares, apresentam uma elevada taxa de desistência escolar e um conhecimento mais elevado da cultura chinesa. O seu nível educacional limita o seu desenvolvimento social. Duas importantes constatações são a correlação positiva entre o nível de integração social dos imigrantes chineses de segunda geração e aquele dos seus pais. A sua capacidade de integração representa a importancia do respectivo capital social familiar. Adiciónalmente, as organizaçãoes locais chinesas agem como plataformas de participação social e realização pessoal para as segundas gerações.
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Books on the topic "Lishin family"

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author, Veber Vladimir, ed. Dli︠a︡ nikh monarkhi - krestnye ott︠s︡y: 400 let dvori︠a︡nskomu rodu Lishinykh : khronikalʹno-istoricheskoe povestvovanie. Ri︠a︡zanʹ: Litera M, 2020.

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Busche, Sharon. The family history and photo album of Jens and Olga Jensen, 1875-2005: Prepared for the Jensen family reunion, June 19, 2005, The Jensen family farm, rural Lisbon, North Dakota. [Fargo, North Dakota]: Sharon Busche, 2005.

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Queirós, Eça de. The Maias. London: Dent, 1986.

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Queirós, Eça de. Os Maias: Episódios da vida romântica. Lisboa: Edição "Livros do Brasil", 2003.

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Queirós, Eça de. The maias: Episodes from romantic life. New York: New Directions, 2007.

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Queirós, Eça de. The maias: Episodes from romantic life. New York: New Directions, 2007.

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Queirós, Eça de. The Maias. London: Penguin Books, 1998.

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Queirós, Eça de. The Maias. London: Dent, 1986.

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Queirós, Eça de. The Maias: Episodes from romantic life. New York: New Directions, 2007.

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Goldman, Leslie. On the job. New York: Disney Press, 2004.

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Book chapters on the topic "Lishin family"

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Webster, Sandra. "You Listen to Us, We'll Listen to You." In Creating Family–School Partnerships, 115–23. London: Routledge, 2023. http://dx.doi.org/10.4324/9781003352952-10.

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Byars, Natasha, and Aditi Subramaniam. "Reflections on the Talk, Touch, and Listen Facilitator Learning Community: Braiding the Personal, the Professional, and Liberation." In Therapeutic Cultural Routines to Build Family Relationships, 159–71. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-83726-6_12.

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Bowden, Caroline, Nicky Hallett, Elizabeth Perry, and Victoria Van Hyning. "Letters to and from Bruges, Lisbon and Paris: Correspondence of the Huddleston Family." In English Convents in Exile, 1600-1800, Part I, vol 3, 295–306. London: Routledge, 2024. http://dx.doi.org/10.4324/9781003553816-17.

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Magano, Olga, and Maria Manuela Mendes. "Key Factors to Educational Continuity and Success of Ciganos in Portugal." In Social and Economic Vulnerability of Roma People, 135–51. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-52588-0_9.

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AbstractThe goal of this article is to analyse the impact of specific public policies on the school trajectories of socially vulnerable Ciganos (Gypsies/Roma) who reside/live in the Metropolitan Areas of Lisbon and Porto. Through carrying out qualitative research, the analysis of key factors will allow us to understand the reasons behind school continuity and educational success of Ciganos, as well as the identity (re)configuration processes associated with the education paths of these individuals. We find that trajectories are not only intertwined with public policies and programmes, but also with other explanatory factors inherent to the individual, to the type of support he/she receives from his/her family, the presence of key figures in their lives, and the importance of peers and institutional factors inherent to the way public schools operate.
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Atar, Ozlem. "Kingston Blues." In IMISCOE Research Series, 77–84. Cham: Springer Nature Switzerland, 2023. http://dx.doi.org/10.1007/978-3-031-41348-3_4.

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AbstractI often explore my relationship to Kingston, Canada when I am on the go. My daily walks take me to other times and places, and the songs I listen to on these wanderings reverberate through my body and soul. My submission to the StOries Project is a personal reflection. I am sharing thoughts and feelings evoked while listening to some of my favourite songs according to Spotify. In my first year in Kingston, I didn’t know many people and was experiencing emotional disconnect with family. Music was where I escaped when I was not working or sleeping. For this specific piece, I mostly focus on my first year in Canada, with some parts travelling back and forth in time. My first Canadian winter was quite lonely, hence the title “Kingston Blues”!
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Crickmay, Ursula, and Caroline Welsh. "Sensing in Liminal Spaces: Words, Music and Dementia." In Creative Ruptions for Emergent Educational Futures, 155–80. Cham: Springer Nature Switzerland, 2024. http://dx.doi.org/10.1007/978-3-031-52973-3_7.

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AbstractThis chapter offers insight into a project which provokes alternative educational futures and imaginative ways of facing current challenging issues, in this case dementia, through adopting an approach which values emergence, creativity and care-ful responses. In our co-writing and making, we reflect on an improvisatory musical practice involving people with dementia, their family, carers and a team of professional musicians and facilitators, working together with voices, instruments, words and images. We consider this practice, melding the human, the sonic and the material, in dialogue with posthuman theory which we weave together with music, words and images creatively generated by the group and the authors in recent workshops both in person and online. Through a series of ‘diffractions’ of our data, we consider how those living with dementia may help us to focus on learning as a response-able encounter, a co-creative emergence in a liminal space that opens towards the unforeseeable future. There are a series of field recordings that accompany this text: you will find links to them next to headings and subheadings; we invite you to listen to them as you read.
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Preti, Sara, and Enrico di Bella. "Gender Equality as EU Strategy." In Social Indicators Research Series, 89–117. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-41486-2_4.

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AbstractGender equality is an increasingly topical issue, but it has deep historical roots. The principle of gender equality found its legitimacy, even if limited to salary, in the 1957 Treaty of Rome, establishing the European Economic Community (EEC). This treaty, in Article 119, sanctioned the principle of equal pay between male and female workers. The EEC continued to protect women’s rights in the 1970s through equal opportunity policies. These policies referred, first, to the principle of equal treatment between men and women regarding education, access to work, professional promotion, and working conditions (Directive 75/117/EEC); second, to the principle of equal pay for male and female workers (Directive 76/207/EEC); and finally, enshrined the principle of equal treatment between men and women in matters of social security (Directive 79/7/EEC). Since the 1980s, several positive action programmes have been developed to support the role of women in European society. Between 1982 and 2000, four multiyear action programmes were implemented for equal opportunities. The first action programme (1982–1985) called on the Member States, through recommendations and resolutions by the Commission, to disseminate greater knowledge of the types of careers available to women, encourage the presence of women in decision-making areas, and take measures to reconcile family and working life. The second action programme (1986–1990) proposed interventions related to the employment of women in activities related to new technologies and interventions in favour of the equal distribution of professional, family, and social responsibilities (Sarcina, 2010). The third action programme (1991–1995) provided an improvement in the condition of women in society by raising public awareness of gender equality, the image of women in mass media, and the participation of women in the decision-making process at all levels in all areas of society. The fourth action programme (1996–2000) strengthened the existing regulatory framework and focused on the principle of gender mainstreaming, a strategy that involves bringing the gender dimension into all community policies, which requires all actors in the political process to adopt a gender perspective. The strategy of gender mainstreaming has several benefits: it places women and men at the heart of policies, involves both sexes in the policymaking process, leads to better governance, makes gender equality issues visible in mainstream society, and, finally, considers the diversity among women and men. Among the relevant interventions of the 1990s, it is necessary to recall the Treaty of Maastricht (1992) which guaranteed the protection of women in the Agreement on Social Policy signed by all Member States (except for Great Britain), and the Treaty of Amsterdam (1997), which formally recognised gender mainstreaming. The Treaty of Amsterdam includes gender equality among the objectives of the European Union (Article 2) and equal opportunity policies among the activities of the European Commission (Article 3). Article 13 introduces the principle of non-discrimination based on gender, race, ethnicity, religion, or handicaps. Finally, Article 141 amends Article 119 of the EEC on equal treatment between men and women in the workplace. The Charter of Fundamental Rights of the Nice Union of 2000 reaffirms the prohibition of ‘any discrimination based on any ground such as sex’ (Art. 21.1). The Charter of Fundamental Rights of the European Union also recognises, in Article 23, the principle of equality between women and men in all areas, including employment, work, and pay. Another important intervention of the 2000s is the Lisbon strategy, also known as the Lisbon Agenda or Lisbon Process. It is a reform programme approved in Lisbon by the heads of state and governments of the member countries of the EU. The goal of the Lisbon strategy was to make the EU the most competitive and dynamic knowledge-based economy by 2010. To achieve this goal, the strategy defines fields in which action is needed, including equal opportunities for female work. Another treaty that must be mentioned is that of Lisbon in 2009, thanks to which previous treaties, specifically the Treaty of Maastricht and the Treaty of Rome, were amended and brought together in a single document: the Treaty on European Union (TEU) and the Treaty on the Functioning of the European Union (TFEU). Thanks to the Lisbon Treaty, the Charter of Fundamental Rights has assumed a legally binding character (Article 6, paragraph 1 of the TEU) both for European institutions and for Member States when implementing EU law. The Treaty of Lisbon affirms the principle of equality between men and women several times in the text and places it among the values and objectives of the union (Articles 2 and 3 of the TEU). Furthermore, the Treaty, in Art. 8 of the TFEU, states that the Union’s actions are aimed at eliminating inequalities, as well as promoting equality between men and women, while Article 10 of the TFEU provides that the Union aims to ‘combat discrimination based on sex, racial or ethnic origin, religion or belief, disability, age, or sexual orientation’. Concerning the principle of gender equality in the workplace, the Treaty, in Article 153 of the TFEU, asserts that the Union pursues the objective of equality between men and women regarding labour market opportunities and treatment at work. On the other hand, Article 157 of the TFEU confirms the principle of equal pay for male and female workers ‘for equal work or work of equal value’. On these issues, through ordinary procedures, the European Parliament and the Council may adopt appropriate measures aimed at defending the principle of equal opportunities and equal treatment for men and women. The Lisbon Treaty also includes provisions relating to the fight against trafficking in human beings, particularly women and children (Article 79 of the TFEU), the problem of domestic violence against women (Article 8 of the TFEU), and the right to paid maternity leave (Article 33). Among the important documents concerning gender equality is the Roadmap (2006–2010). In 2006, the European Commission proposed the Roadmap for equality between women and men, in addition to the priorities on the agenda, the objectives, and tools necessary to achieve full gender equality. The Roadmap defines six priority areas, each of which is associated with a set of objectives and actions that makes it easier to achieve them. The priorities include equal economic independence for women and men, reconciliation of private and professional life, equal representation in the decision-making process, eradication of all forms of gender-based violence, elimination of stereotypes related to gender, and promotion of gender equality in external and development policies. The Commission took charge of the commitments included in the Roadmap, which were indirectly implemented by the Member States through the principle of subsidiarity and the competencies provided for in the Treaties (Gottardi, 2013). The 2006–2010 strategy of the European Commission is based on a dual approach: on the one hand, the integration of the gender dimension in all community policies and actions (gender mainstreaming), and on the other, the implementation of specific measures in favour of women aimed at eliminating inequalities. In 2006, the European Council approved the European Pact for Gender Equality which originated from the Roadmap. The European Pact for Gender Equality identified three macro areas of intervention: measures to close gender gaps and combat gender stereotypes in the labour market, measures to promote a better work–life balance for both women and men, and measures to strengthen governance through the integration of the gender perspective into all policies. In 2006, Directive 2006/54/EC of the European Parliament and Council regulated equal opportunities and equal treatment between male and female workers. Specifically, the Directive aims to implement the principle of equal treatment related to access to employment, professional training, and promotion; working conditions, including pay; and occupational social security approaches. On 21 September 2010, the European Commission adopted a new strategy to ensure equality between women and men (2010–2015). This new strategy is based on the experience of Roadmap (2006–2010) and resumes the priority areas identified by the Women’s Charter: equal economic independence, equal pay, equality in decision-making, the eradication of all forms of violence against women, and the promotion of gender equality and women’s empowerment beyond the union. The 2010–2015 Strategic Plan aims to improve the position of women in the labour market, but also in society, both within the EU and beyond its borders. The new strategy affirms the principle that gender equality is essential to supporting the economic growth and sustainable development of each country. In 2010, the validity of the Lisbon Strategy ended, the objectives of which were only partially achieved due to the economic crisis. To overcome this crisis, the Commission proposed a new strategy called Europe 2020, in March 2010. The main aim of this strategy is to ensure that the EU’s economic recovery is accompanied by a series of reforms that will increase growth and job creation by 2020. Specifically, Europe’s 2020 strategy must support smart, sustainable, and inclusive growth. To this end, the EU has established five goals to be achieved by 2020 and has articulated the different types of growth (smart, sustainable, and inclusive) in seven flagship initiatives. Among the latter, the initiative ‘an agenda for new skills and jobs’, in the context of inclusive growth, is the one most closely linked to gender policies and equal opportunities; in fact, it substantially aims to increase employment rates for women, young, and elderly people. The strategic plan for 2010–2015 was followed by a strategic commitment in favour of gender equality 2016–2019, which again emphasises the five priority areas defined by the previous plan. Strategic commitment, which contributes to the European Pact for Gender Equality (2011–2020), identifies the key actions necessary to achieve objectives for each priority area. In March 2020, the Commission presented a new strategic plan for equality between women and men for 2020–2025. This strategy defines a series of political objectives and key actions aimed at achieving a ‘union of equality’ by 2025. The main objectives are to put an end to gender-based violence and combat sexist stereotypes, ensure equal opportunities in the labour market and equal participation in all sectors of the economy and political life, solve the problem of the pay and pension gap, and achieve gender equality in decision-making and politics. From the summary of the regulatory framework presented, for the European Economic Community first, then for the European Community, and finally for the European Union, gender equality has always been a fundamental value. Interest in the issues of the condition of women and equal opportunities has grown over time and during the process of European integration, moving from a perspective aimed at improving the working conditions of women to a new dimension to improve the life of the woman as a person, trying to protect her not only professionally but also socially, and in general in all those areas in which gender inequality may occur. The approach is extensive and based on legislation, the integration of the gender dimension into all policies, and specific measures in favour of women. From the non-exhaustive list of the various legislative interventions, it is possible to note a continuous repetition of the same thematic priorities which highlights, on the one hand, the poor results achieved by the implementation of the policies, but, on the other hand, the Commission’s willingness to pursue the path initially taken. Among the achievements in the field of gender equality obtained by the EU, there is certainly an increase in the number of women in the labour market and the acquisition of better education and training. Despite progress, gender inequalities have persisted. Even though women surpass men in terms of educational attainment, gender gaps still exist in employment, entrepreneurship, and public life (OECD, 2017). For example, in the labour market, women continue to be overrepresented in the lowest-paid sectors and underrepresented in top positions (according to the data released in the main companies of the European Union, women represent only 8% of CEOs).
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"Plant Family Listing." In Plant Systematics, 741. Elsevier, 2010. http://dx.doi.org/10.1016/b978-0-12-374380-0.50031-2.

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Ghríofa, Doireann Ní. "Listen:." In Famine Pots, 205–6. Michigan State University Press, 2020. http://dx.doi.org/10.14321/j.ctv128fqfb.20.

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Forbes, Julia, and Marianna Adams. "Ch03. Stop, Look, Listen." In Family Spaces in Art Museums, 23–34. Rowman & Littlefield Publishers, 2022. http://dx.doi.org/10.5771/9781538148860-23.

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Conference papers on the topic "Lishin family"

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"A Male Spouse’s Second Language Emergence with Respect to His Workplace, Family and Spouse Identities." In Dec. 17-19, 2018 Lisbon (Portugal). Dignified Researchers Publication, 2018. http://dx.doi.org/10.17758/dirpub5.dir1218441.

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Compeyrot-Lacassagne, Sandrine, Christine Twoney, Harry Petrushkin, Dhanes Thomas, Emily Robinson, Lucia Kossarova, and Ameenat Lola Solebo. "THU0531 ”BOTHERING TO LISTEN”: ENABLING PATIENT AND FAMILY INVOLVEMENT IN CHILDHOOD UVEITIS HEALTHCARE." In Annual European Congress of Rheumatology, EULAR 2019, Madrid, 12–15 June 2019. BMJ Publishing Group Ltd and European League Against Rheumatism, 2019. http://dx.doi.org/10.1136/annrheumdis-2019-eular.7262.

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Radina, Ana. "GUARDIANSHIP AS A MEANS OF PROTECTION OF ADULT PERSONS WITH MENTAL DISORDERS IN THE CROATIAN FAMILY LAW - A NEED FOR A CHANGE." In 43rd International Academic Conference, Lisbon. International Institute of Social and Economic Sciences, 2018. http://dx.doi.org/10.20472/iac.2018.043.037.

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Penman, Joy, and Kerre A Willsher. "New Horizons for Immigrant Nurses Through a Mental Health Self-Management Program: A Pre- and Post-Test Mixed-Method Approach." In InSITE 2021: Informing Science + IT Education Conferences. Informing Science Institute, 2021. http://dx.doi.org/10.28945/4759.

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Aim/Purpose: This research paper reports on the evaluation of a mental health self-management program provided to immigrant nurses working at various rural South Australian aged care services. Background: The residential aged care staffing crisis is severe in rural areas. To improve immigrant nurses’ employment experiences, a mental health self-management program was developed and conducted in rural and regional health care services in South Australia. Methodology: A mixed approach of pre- and post-surveys and post workshop focus groups was utilized with the objectives of exploring the experiences of 25 immigrant nurses and the impact of the mental health program. Feminist standpoint theory was used to interpret the qualitative data. Contribution: A new learning environment was created for immigrant nurses to learn about the theory and practice of maintaining and promoting mental health. Findings: Statistical tests showed a marked difference in responses before and after the intervention, especially regarding knowledge of mental health. The results of this study indicated that a change in thinking was triggered, followed by a change in behaviour enabling participants to undertake self-management strategies. Recommendations for Practitioners: Include expanding the workshops to cover more health care practitioners. Recommendations for Researchers: Feminist researchers must actively listen and examine their own beliefs and those of others to create knowledge. Extending the program to metropolitan areas and examining differences in data. E technology such as zoom, skype or virtual classrooms could be used. Impact on Society: The new awareness and knowledge would be beneficial in the family and community because issues at work can impact on the ability to care for the family, and there are often problems around family separation. Future Research: Extending the research to include men and staff of metropolitan aged care facilities.
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Kuwahara a, Noriaki, Tsuji Airi a, Taro Asada b, Yasunari Yoshitomi b, Jin Narumoto c, and Kazunari Morimoto a. "The Development of a Mental Support System for the Elderly Living in Depopulated Areas of Japan." In Applied Human Factors and Ergonomics Conference. AHFE International, 2021. http://dx.doi.org/10.54941/ahfe100576.

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We have studied a method to improve the QOL for the elderly receiving facility care, or home care in depopulated areas of Japan by taking advantage of information and communication technology (ICT). As part of these efforts, old photos of the elderly were digitized and uploaded to cloud services. We created an environment to make these images accessible to staff caregivers so that they could utilize the data in various long-term care settings. Multimedia, such as interactive digital photo albums and slide show videos were produced by using uploaded photos. The elderly, along with their families and caregivers enjoyed watching personal images which resulted in stronger relationships with family and the care staff. We also created an environment to introduce and promote video chat software in order to increase the opportunity of communication between the elderly and their significant others. Video chat software makes it possible for the person you are talking with to share reminiscent media, as described above, and to be able to listen from a remote location. Finally, we have organized human resources and collaborated with a local welfare service and a local hospital in order to provide support to the elderly living alone. A method was proposed to build a rapport between the elderly and their support systems..
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Santos, Claudio F. G., and João Paulo Papa. "Avoiding Overfitting: new algorithms to improve generalization in Convolutional Neural Networks." In Anais Estendidos da Conference on Graphics, Patterns and Images. Sociedade Brasileira de Computação - SBC, 2022. http://dx.doi.org/10.5753/sibgrapi.est.2022.23255.

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Deep Learning has achieved state-of-the-art results in several domains, such as im- age processing, natural language processing, and audio processing. To accomplish such results, it uses neural networks with several processing layers along with a massive amount of labeled information. One particular family of Deep Learning is the Convolutional Neural Networks (CNNs), which work using convolutional layers de- rived from the digital signal processing area, being very helpful to detect relevant features in unstructured data, such as audio and pictures. One way to improve results on CNN is to use regularization algorithms, which aim to make the training process harder but generate models that generalize better for inference when used in applications. The present work contributes to the area of regularization methods for CNNs, proposing more methods for use in different image processing tasks. This thesis presents a collection of works developed by the author during the research period, which were published or submitted until the present time, presenting: (i) a survey, listing recent regularization works and highlighting the solutions and problems of the area; (ii) a neuron dropping method to use in the tensors generated during CNNs training; (iii) a variation of the mentioned method, changing the dropping rules, targeting different features of the tensor; and (iv) a label regularization algorithm used in different image processing problems.
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Forni, Massimo, Alessandro Poggianti, Nicola Ranieri, and Gerardo De Canio. "Shaking Table Tests on Innovative Anti-Seismic Systems Developed in the Framework of the LESSLOSS European Integrated Project." In ASME 2008 Pressure Vessels and Piping Conference. ASMEDC, 2008. http://dx.doi.org/10.1115/pvp2008-61229.

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The Integrated Project LESSLOSS (Risk Mitigation for Earthquakes and Landslides), partially funded by the European Commission within the 6th Framework Programme, started on September 2004 and was concluded in August 2007. Activities were carried out by 46 European partners, with a total budget of 9.4 ME. The Project was divided into 11 Sub-Projects. This paper describes the activities performed in the framework of Sub-Project 6 (Development and Manufacturing of Energy Dissipation Devices and Seismic Isolators), which was coordinated by ENEA and whose partnership included two manufacturers of antiseismic devices (ALGA, Milan, Italy and MAURER SHO¨NE, Munich, Germany) and two consulting and construction companies (STAP, Lisbon, Portugal and VINCI, Paris-Rueil, France). Aim of Sub-Project 6 was the development and validation of two innovative antiseismic devices (a low stiffness isolator and an electroinductive damper), the improvement of the performances of a slider with curved surface and the evaluation of benefits and limits of isolation systems based on steel hysteretic dissipaters coupled with flat sliders. The Low Stiffness Isolator (LSI) was developed by ALGA; it is a natural rubber seismic isolator particularly addressed to light structures like family houses. The Electroinductive Damper (DECS), developed by ALGA, is an energy dissipater based on the interaction of a diamagnetic material, like aluminium, with an electric field generated by permanent magnets. The Sliding Isolation Pendulum (SIP) developed by MAURER is an improved curved surface slider, capable of withstanding high weights for long periods without creep effects and high velocity deformations without damages due to friction. Finally, several types of Steel Hysteretic (SH) elements of different geometries and materials have been analyzed and tested in order of evaluating the benefits and the limits of such devices, with particular regard to the re-centering capabilities. All the abovementioned devices have been tested on the ENEA shaking table of the Casaccia labs (near Rome), with a suitable mock-up capable of providing a 300 kN force on the devices in the acceleration and frequency ranges of interest, using several natural and artificial acceleration time histories purposely developed by ENEA. The paper describes the main features of the devices, the numerical activity aimed at the optimization of their behavior and the results of the four shaking table campaigns carried out on each device.
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Reports on the topic "Lishin family"

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MacFarlane, Andrew. 2021 medical student essay prize winner - A case of grief. Society for Academic Primary Care, July 2021. http://dx.doi.org/10.37361/medstudessay.2021.1.1.

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As a student undertaking a Longitudinal Integrated Clerkship (LIC)1 based in a GP practice in a rural community in the North of Scotland, I have been lucky to be given responsibility and my own clinic lists. Every day I conduct consultations that change my practice: the challenge of clinically applying the theory I have studied, controlling a consultation and efficiently exploring a patient's problems, empathising with and empowering them to play a part in their own care2 – and most difficult I feel – dealing with the vast amount of uncertainty that medicine, and particularly primary care, presents to both clinician and patient. I initially consulted with a lady in her 60s who attended with her husband, complaining of severe lower back pain who was very difficult to assess due to her pain level. Her husband was understandably concerned about the degree of pain she was in. After assessment and discussion with one of the GPs, we agreed some pain relief and a physio assessment in the next few days would be a practical plan. The patient had one red flag, some leg weakness and numbness, which was her ‘normal’ on account of her multiple sclerosis. At the physio assessment a few days later, the physio felt things were worse and some urgent bloods were ordered, unfortunately finding raised cancer and inflammatory markers. A CT scan of the lung found widespread cancer, a later CT of the head after some developing some acute confusion found brain metastases, and a week and a half after presenting to me, the patient sadly died in hospital. While that was all impactful enough on me, it was the follow-up appointment with the husband who attended on the last triage slot of the evening two weeks later that I found completely altered my understanding of grief and the mourning of a loved one. The husband had asked to speak to a Andrew MacFarlane Year 3 ScotGEM Medical Student 2 doctor just to talk about what had happened to his wife. The GP decided that it would be better if he came into the practice - strictly he probably should have been consulted with over the phone due to coronavirus restrictions - but he was asked what he would prefer and he opted to come in. I sat in on the consultation, I had been helping with any examinations the triage doctor needed and I recognised that this was the husband of the lady I had seen a few weeks earlier. He came in and sat down, head lowered, hands fiddling with the zip on his jacket, trying to find what to say. The GP sat, turned so that they were opposite each other with no desk between them - I was seated off to the side, an onlooker, but acknowledged by the patient with a kind nod when he entered the room. The GP asked gently, “How are you doing?” and roughly 30 seconds passed (a long time in a conversation) before the patient spoke. “I just really miss her…” he whispered with great effort, “I don’t understand how this all happened.” Over the next 45 minutes, he spoke about his wife, how much pain she had been in, the rapid deterioration he witnessed, the cancer being found, and cruelly how she had passed away after he had gone home to get some rest after being by her bedside all day in the hospital. He talked about how they had met, how much he missed her, how empty the house felt without her, and asking himself and us how he was meant to move forward with his life. He had a lot of questions for us, and for himself. Had we missed anything – had he missed anything? The GP really just listened for almost the whole consultation, speaking to him gently, reassuring him that this wasn’t his or anyone’s fault. She stated that this was an awful time for him and that what he was feeling was entirely normal and something we will all universally go through. She emphasised that while it wasn’t helpful at the moment, that things would get better over time.3 He was really glad I was there – having shared a consultation with his wife and I – he thanked me emphatically even though I felt like I hadn’t really helped at all. After some tears, frequent moments of silence and a lot of questions, he left having gotten a lot off his chest. “You just have to listen to people, be there for them as they go through things, and answer their questions as best you can” urged my GP as we discussed the case when the patient left. Almost all family caregivers contact their GP with regards to grief and this consultation really made me realise how important an aspect of my practice it will be in the future.4 It has also made me reflect on the emphasis on undergraduate teaching around ‘breaking bad news’ to patients, but nothing taught about when patients are in the process of grieving further down the line.5 The skill Andrew MacFarlane Year 3 ScotGEM Medical Student 3 required to manage a grieving patient is not one limited to general practice. Patients may grieve the loss of function from acute trauma through to chronic illness in all specialties of medicine - in addition to ‘traditional’ grief from loss of family or friends.6 There wasn’t anything ‘medical’ in the consultation, but I came away from it with a real sense of purpose as to why this career is such a privilege. We look after patients so they can spend as much quality time as they are given with their loved ones, and their loved ones are the ones we care for after they are gone. We as doctors are the constant, and we have to meet patients with compassion at their most difficult times – because it is as much a part of the job as the knowledge and the science – and it is the part of us that patients will remember long after they leave our clinic room. Word Count: 993 words References 1. ScotGEM MBChB - Subjects - University of St Andrews [Internet]. [cited 2021 Mar 27]. Available from: https://www.st-andrews.ac.uk/subjects/medicine/scotgem-mbchb/ 2. Shared decision making in realistic medicine: what works - gov.scot [Internet]. [cited 2021 Mar 27]. Available from: https://www.gov.scot/publications/works-support-promote-shared-decisionmaking-synthesis-recent-evidence/pages/1/ 3. Ghesquiere AR, Patel SR, Kaplan DB, Bruce ML. Primary care providers’ bereavement care practices: Recommendations for research directions. Int J Geriatr Psychiatry. 2014 Dec;29(12):1221–9. 4. Nielsen MK, Christensen K, Neergaard MA, Bidstrup PE, Guldin M-B. Grief symptoms and primary care use: a prospective study of family caregivers. BJGP Open [Internet]. 2020 Aug 1 [cited 2021 Mar 27];4(3). Available from: https://bjgpopen.org/content/4/3/bjgpopen20X101063 5. O’Connor M, Breen LJ. General Practitioners’ experiences of bereavement care and their educational support needs: a qualitative study. BMC Medical Education. 2014 Mar 27;14(1):59. 6. Sikstrom L, Saikaly R, Ferguson G, Mosher PJ, Bonato S, Soklaridis S. Being there: A scoping review of grief support training in medical education. PLOS ONE. 2019 Nov 27;14(11):e0224325.
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2

Listen Up! How can social and behavior change programming improve reproductive health and family planning behaviors of out-of-school youth in the Philippines? Population Council, 2021. http://dx.doi.org/10.31899/pgy18.1032.

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Abstract:
The Breakthrough RESEARCH project, in collaboration with De La Salle University’s Social Development Research Center in Manila, conducted a targeted study to better understand which social and behavior change programming approaches are most effective for encouraging out-of-school youth (OSY) ages 15 to 19 to adopt priority reproductive health (RH) and family planning (FP) behaviors. The study was conducted among OSY in four urban regions of the Philippines: Manila, Quezon City, Cebu City, and Davao City.
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