The discrepancy between patients and informants on clinician-rated measures in major depressive disorder: implications for clinical trials and clinical practice.

Science.gov (United States)

Peselow, Eric D; Karamians, Reneh; Lord, Marie; Tobia, Gabriel; IsHak, Waguih William

2014-03-01

Clinician-rated measures are used in clinical trials and measurement-based clinical care settings to assess baseline symptoms and treatment outcomes of major depressive disorder (MDD), with a widely held dictum that they are sufficient in assessing the patient's clinical status. In this study, we examined clinician-rated measures of depressive and global symptom severity, obtained by interviewing patients as well as informants in an attempt to examine the potential difference or similarity between these two sources of information. The sample consisted of 89 treatment seeking, DSM-IV diagnosed MDD outpatients treated between 1995 and 2004. The clinician-rated measures used included the Montgomery Åsberg Depression Rating Scale (MADRS), and the Clinical Global Impression Scale (CGI) for Severity. The scores of the clinician-rated measures collected from patients' interviews were compared with those collected from informants' interviews. Clinician-rated scores, collected by interviewing patients, were significantly higher and indicative of greater symptom severity when compared with those collected by interviewing informants. This was true for both the MADRS before (Ppractical in MDD clinical trials or everyday clinical care. The discrepancies observed between the clinician-rated scores obtained from patients and informants emphasize the importance of incorporating collateral information during the assessment and rating of depressive symptom severity in both clinical trials as well as in clinical practice.

Mutations des métiers de l'information-documentation : vers l'émergence d'une culture de l'information numérique

OpenAIRE

Thiault , Florence

2012-01-01

National audience; Les sciences de l'information s'intéressent plus particulièrement à la construction des systèmes d'information, leurs usages et à la diffusion des savoirs par les moyens technologiques. L'inscription dans cette discipline des professions documentaires enrichit le cadre explicatif d'activités de nature technique. Les documents se sont diversifiés, la documentation est devenue un ensemble complexe de processus, reposant sur les anciennes méthodes bibliothéconomiques, mais int...

A comparison of clinicians' access to online knowledge resources using two types of information retrieval applications in an academic hospital setting.

Science.gov (United States)

Hunt, Sevgin; Cimino, James J; Koziol, Deloris E

2013-01-01

The research studied whether a clinician's preference for online health knowledge resources varied with the use of two applications that were designed for information retrieval in an academic hospital setting. The researchers analyzed a year's worth of computer log files to study differences in the ways that four clinician groups (attending physicians, housestaff physicians, nurse practitioners, and nurses) sought information using two types of information retrieval applications (health resource links or Infobutton icons) across nine resources while they reviewed patients' laboratory results. From a set of 14,979 observations, the authors found statistically significant differences among the 4 clinician groups for accessing resources using the health resources application (Pinformation-seeking behavior of clinicians may vary in relation to their role and the way in which the information is presented. Studying these behaviors can provide valuable insights to those tasked with maintaining information retrieval systems' links to appropriate online knowledge resources.

Inexperienced clinicians can extract pathoanatomic information from MRI narrative reports with high reproducability for use in research/quality assurance

DEFF Research Database (Denmark)

Kent, Peter; Briggs, Andrew M; Albert, Hanne Birgit

2011-01-01

Background Although reproducibility in reading MRI images amongst radiologists and clinicians has been studied previously, no studies have examined the reproducibility of inexperienced clinicians in extracting pathoanatomic information from magnetic resonance imaging (MRI) narrative reports and t...

Structured cues or modafinil for fatigue amelioration in clinicians? A double-blind, randomized controlled trial of critical clinical information recall in fatigued clinicians.

Science.gov (United States)

Flindall, Ian; Leff, Daniel Richard; Goodship, Jonathan; Sugden, Colin; Darzi, Ara

2016-04-01

To evaluate the impact of modafinil on "free" and "cued" recall of clinical information in fatigued but nonsleep-deprived clinicians. Despite attempts to minimize sleep deprivation through redesign of the roster of residents and staff surgeons, evidence suggests that fatigue remains prevalent. The wake-promoting agent modafinil improves cognition in the sleep-deprived fatigued state and may improve information recall in fatigued nonsleep-deprived clinicians. Twenty-four medical undergraduates participated in a double-blind, parallel, randomized controlled trial (modafinil-200 mg:placebo). Medication was allocated 2 hours before a 90-minute fatigue-inducing, continuous performance task (dual 2-back task). A case history memorization task was then performed. Clinical information recall was assessed as "free"(no cognitive aids) and "cued"(using aid memoirs). Open and closed cues represent information of increasing specificity to aid the recall of clinical information. Fatigue was measured objectively using the psychomotor vigilance task at induction, before and after the dual 2-back task. Modafinil decreased false starts and lapses (modafinil = 0.50, placebo = 9.83, P recall (modafinil = 137.8, placebo = 106.0, P recalled with open (modafinil = 62.3, placebo = 52.8, P = .1) and closed cues (modafinil = 80.1, placebo = 75.9, P = .3). Modafinil attenuated fatigue and improved free recall of clinical information without improving cue-based recall under the design of our experimental conditions. Memory cues to aid retrieval of clinical information are convenient interventions that could decrease fatigue-related error without adverse effects of the neuropharmacology. Copyright © 2016 Elsevier Inc. All rights reserved.

Disseminating effective clinician communication techniques: Engaging clinicians to want to learn how to engage patients.

Science.gov (United States)

Pollak, Kathryn I; Back, Anthony L; Tulsky, James A

2017-10-01

Patient-clinician communication that promotes patient engagement enhances health care quality. Yet, disseminating effective communication interventions to practicing clinicians remains challenging. Current methods do not have large and sustainable effects. In this paper, we argue that both top-down approaches (mandated by institutions) should be coupled with bottom-up approaches that address clinician motivation, confidence, and barriers. We need to engage clinicians in the same way we ask them to engage patients - strategically and with empathy. We discuss potentially innovative strategies to integrate top-down and bottom-up approaches in ways that fit clinicians' busy schedules and can inform policy. Copyright © 2017. Published by Elsevier B.V.

Le systeme d’information des reseaux de sante: la reorganisation de la medecine en e-sante

Directory of Open Access Journals (Sweden)

Maryline Margueritte

2013-01-01

Full Text Available Les réseaux de santé ont développé depuis plusieurs années des dispositifs permettant une prise en charge coordonnée des patients en France, tant sur les plans médical que médico-psycho-social et humain. Certains ont développé des dossiers de santé partagés informatisés permettant la mise en commun d’informations utiles à la coordination et à la continuité des soins. Depuis 2009 avec la réforme de l’hôpital on veut installer des modes de fonctionnement coopératifs entre les professionnels et avec les usagers du système de santé. La mise en œuvre d’un système d’information de santé pour assurer d’une part, la transversalité du processus métier avec le patient et d’autre part pouvoir mesurer les résultats médicaux et économiques de cette évolution d’un système complexe d’information. Dans ce contexte, les possibilités offertes par les technologies de l’information et de la communication (TIC permettent la mise en place d’applications favorisant une augmentation de la participation « on line » des citoyens. Le « virage ambulatoire » exporte la santé hors des murs. C’est une médecine innovante qui permet au patient de rester dans son « chez soi ». En France, ce re-engeneering repose sur quatre domaines : un dossier médical informatisé, une prise en charge collective par les professions médicales et paramédicales, une autonomisation et une mise en réseau du secteur de santé.

Foraging for Information in the EHR: The Search for Adherence Related Information by Mental Health Clinicians.

Science.gov (United States)

Gibson, Bryan; Butler, Jorie; Zirkle, Maryan; Hammond, Kenric; Weir, Charlene

2016-01-01

In this project we sought to qualitatively describe clinician's search for information related to the complex construct of adherence. Nineteen think aloud observations and semi-structured interviews were conducted with mental health providers as they prepared for a patient visit. The transcripts were coded according to constructs from information foraging theory (information goal, patch, scent, enrichment, and opportunity cost). The search strategies uncovered were complicated: provider's searches were sometimes multi-staged (e.g. a search of the EHR led to further enquiry when interviewing the patient), and involved multiple 'patches' (i.e. data from the EHR, the patient and other providers were all sought out). In addition, some information that providers considered relevant to understand adherence related questions was non-obvious (e.g. the absence of specific information was considered a useful cue). Providers' information search strategies for complex constructs are at times non-intuitive; implications for the design of EHR summarization tools are discussed.

Malaria Cases in the U.S. Reach 40-Year High: Information and Guidance for Clinicians

Centers for Disease Control (CDC) Podcasts

This podcast is an overview of the Clinician Outreach and Communication Activity (COCA) Call: Malaria Cases in the U.S. Reach 40-Year High: Information and Guidance for Clinicians. The number of malaria cases reported in the United States in 2011 was the largest since 1971, representing a 14 percent increase from 2010 and a 48 percent increase from 2008. A CDC subject matter expert describes malaria prevention strategies aimed at reducing the risk of malaria in travelers, discusses the diagnosis of malaria in patients with suspect malaria, and explains the treatment options for confirmed malaria cases.

How do practising clinicians and students apply newly learned causal information about mental disorders?

Science.gov (United States)

de Kwaadsteniet, Leontien; Kim, Nancy S; Yopchick, Jennelle E

2013-02-01

New causal theories explaining the aetiology of psychiatric disorders continuously appear in the literature. How might such new information directly impact clinical practice, to the degree that clinicians are aware of it and accept it? We investigated whether expert clinical psychologists and students use new causal information about psychiatric disorders according to rationalist norms in their diagnostic reasoning. Specifically, philosophical and Bayesian analyses suggest that it is rational to draw stronger inferences about the presence of a disorder when a client's presenting symptoms are from disparate locations in a causal theory of the disorder than when they are from proximal locations. In a controlled experiment, we presented experienced clinical psychologists and students with recently published causal theories for different disorders; specifically, these theories proposed how the symptoms of each disorder stem from a root cause. Participants viewed hypothetical clients with presenting proximal or diverse symptoms, and indicated either the likelihood that the client has the disorder, or what additional information they would seek out to help inform a diagnostic decision. Clinicians and students alike showed a strong preference for diverse evidence, over proximal evidence, in making diagnostic judgments and in seeking additional information. They did not show this preference in the control condition, in which they gave their own opinions prior to learning the causal information. These findings suggest that experienced clinical psychologists and students are likely to use newly learned causal knowledge in a normative, rational way in diagnostic reasoning. © 2011 Blackwell Publishing Ltd.

Perancangan Enkripsi Pada Citra Bitmap Dengan Algoritma Des, Triple Des, dan Idea

Directory of Open Access Journals (Sweden)

Agustinna Yosanny

2010-12-01

Full Text Available Rapid development of Information Technology causes information can access easier without space boundaries. Image is a form of information, which contains many information. Some image contains confidential information that cannot distribute to unauthorized persons. Therefore, image encryption application is create to encrypt part of image that has confidential information. The image encryption application is encrypt image by applying DES, Triple DES, and IDEA algorithms. The research was applying analysis and design methodology. The analysis methodology was undertaken through literature study and algorithm research and testing. The design methodology was undertaken through database, features, system, and screen layout design. Results of the research are image encryption application that can encrypt part of image and or all of image by applying three algorithms such as DES, Triple DES, and IDEA. This application is show comparation of these algorithms. In conclusion, method of encryption can apply to image, so that confidential information of the image can protect from unauthorized person. 

A snapshot of health information exchange across five nations: an investigation of frontline clinician experiences in emergency care.

Science.gov (United States)

Klapman, Seth; Sher, Emily; Adler-Milstein, Julia

2018-06-01

Ensuring the ability to exchange patient information among disparate electronic health records systems is a top priority and a domain of substantial public investment across countries. However, we know little about the extent to which current capabilities meet the needs of frontline clinicians. We conducted in-person, semistructured interviews with emergency care physicians and nurses in select hospitals in Canada, Denmark, Finland, Germany, and the USA. We characterized the state of health information exchange (HIE) by country and used thematic analysis to identify the perceived benefits of access to complete past medical history (PMH), the conditions under which PMH is sought, and the challenges to accessing and using HIE capabilities. HIE approaches, and the information electronically accessible to clinicians, differed by country. Benefits of access to PMH included safer care, reduced patient length of stay, and fewer lab and imaging orders. Conditions under which PMH was sought included moderate-acuity patients, patients with chronic conditions, and instances where accessing PMH was convenient. Challenges to HIE access and use included difficulty knowing where information is located, delay in receiving information, and difficulty finding information within documents. Even with different HIE approaches across countries, all clinicians reported shortcomings in their country's approach. Notably, challenges were similar and shaped the conditions under which PMH was sought. As countries continue to pursue broad-based HIE, they appear to be facing similar challenges in realizing HIE value and therefore have an opportunity to learn from one another.

Watson will see you now: a supercomputer to help clinicians make informed treatment decisions.

Science.gov (United States)

Doyle-Lindrud, Susan

2015-02-01

IBM has collaborated with several cancer care providers to develop and train the IBM supercomputer Watson to help clinicians make informed treatment decisions. When a patient is seen in clinic, the oncologist can input all of the clinical information into the computer system. Watson will then review all of the data and recommend treatment options based on the latest evidence and guidelines. Once the oncologist makes the treatment decision, this information can be sent directly to the insurance company for approval. Watson has the ability to standardize care and accelerate the approval process, a benefit to the healthcare provider and the patient.

Usages des TIC et socialisation professionnelle des enseignants-chercheurs

OpenAIRE

Lavielle-Gutnik, Nathalie; Massou, Luc

2013-01-01

En prenant appui sur une nouvelle analyse des données recueillies dans l’enquête Tec-Meus (2008-2011, MSH Lorraine) sur la place accordée par des enseignants-chercheurs en sciences humaines et sociales aux technologies de l’information et de la communication (TIC) dans leur activité d’enseignement, nous souhaitons nous focaliser dans cet article sur la compréhension des processus de socialisation professionnelle en jeu dans leur usage déclaré des TIC. Par socialisation professionnelle, nous e...

The role of technology in clinician-to-clinician communication.

Science.gov (United States)

McElroy, Lisa M; Ladner, Daniela P; Holl, Jane L

2013-12-01

Incomplete, fragmented and poorly organised communications contribute to more than half the errors that lead to adverse and sentinel events. Meanwhile, communication software and devices with expanding capabilities are rapidly proliferating and being introduced into the healthcare setting. Clinicians face a large communication burden, which has been exacerbated by the additional challenge of selecting a mode of communication. In addition to specific communication devices, some hospitals have implemented advanced technological systems to assist with communication. However, few studies have provided empirical evidence of the specific advantages and disadvantages of the different devices used for communication. Given the increasing quantities of information transmitted to and by clinicians, evaluations of how communication methods and devices can improve the quality, safety and outcomes of healthcare are needed.

Renforcement de l'autonomie des collectivités au moyen des ...

International Development Research Centre (IDRC) Digital Library (Canada)

Cette subvention permettra au ministère des Communications et des Technologies de l'information de l'Égypte ainsi qu'au fonds spécial réservé aux TI de consolider le modèle actuel des clubs de TI en Égypte, par l'entremise de services d'assistance sur demande, d'activités de formation à l'intention du personnel des ...

Engaging clinicians in health informatics projects.

Science.gov (United States)

Caballero Muñoz, Erika; Hullin Lucay Cossio, Carola M

2010-01-01

This chapter gives an educational overview of: * The importance of the engagement of clinicians within a health informatics project * Strategies required for an effective involvement of clinicians throughout a change management process within a clinical context for the implementation of a health informatics project * The critical aspects for a successful implementation of a health informatics project that involves clinicians as end users * Key factors during the administration of changes during the implementation of an informatics project for an information system in clinical practice.

[Italian physician's needs for medical information. Retrospective analysis of the medical information service provided by Novartis Pharma to clinicians].

Science.gov (United States)

Speroni, Elisabetta; Poggi, Susanna; Vinaccia, Vincenza

2013-10-01

The physician's need for medical information updates has been studied extensively in recent years but the point of view of the pharmaceutical industry on this need has rarely been considered. This paper reports the results of a retrospective analysis of the medical information service provided to Italian physicians by an important pharmaceutical company, Novartis Pharma, from 2004 to 2012. The results confirm clinicians' appreciation of a service that gives them access to tailored scientific documentation and the number of requests made to the network of medical representatives has been rising steadily, peaking whenever new drugs become available to physicians. The analysis confirms what -other international studies have ascertained, that most queries are about how to use the drugs and what their properties are. The results highlight some differences between different medical specialties: for example, proportionally, neurologists seem to be the most curious. This, as well as other interesting snippets, is worth further exploration. Despite its limits in terms of representativeness, what comes out of the study is the existence of an real unmet need for information by healthcare institutions and that the support offered by the pharmaceutical industry could be invaluable; its role could go well beyond that of a mere supplier to National Healthcare Systems, to that of being recognised as an active partner the process of ensuring balanced and evidence-based information. At the same time, closer appraisal of clinicians' needs could help the pharma industries to improve their communication and educational strategies in presenting their latest clinical research and their own products.

Malaria Cases in the U.S. Reach 40-Year High: Information and Guidance for Clinicians

Centers for Disease Control (CDC) Podcasts

2014-02-26

This podcast is an overview of the Clinician Outreach and Communication Activity (COCA) Call: Malaria Cases in the U.S. Reach 40-Year High: Information and Guidance for Clinicians. The number of malaria cases reported in the United States in 2011 was the largest since 1971, representing a 14 percent increase from 2010 and a 48 percent increase from 2008. A CDC subject matter expert describes malaria prevention strategies aimed at reducing the risk of malaria in travelers, discusses the diagnosis of malaria in patients with suspect malaria, and explains the treatment options for confirmed malaria cases.  Created: 2/26/2014 by Center for Global Health (CGH); Malaria Branch; Emergency Risk Communication Branch (ERCB); Office of Public Health Preparedness and Response (OPHPR).   Date Released: 2/26/2014.

Tentative d'évaluation du systéme d'information marketing au niveau des banques publiques Algériennes

OpenAIRE

Hassaine-kazi-tani, Amel

2014-01-01

Le premier chapitre présente les fondements théoriques relatifs au marketing, marketing des services et notamment le marketing bancaire.dans le deuxiéme chapitre seront développées les notions de base du concept d'information et celui de systéme d'information et puis le systéme d'information marketing.le troisiéme chapitre pratique présente une étude de cas auprés des banques publiques Algériennes.

DES-ncRNA: A knowledgebase for exploring information about human micro and long noncoding RNAs based on literature-mining

KAUST Repository

Salhi, Adil

2017-04-07

Noncoding RNAs (ncRNAs), particularly microRNAs (miRNAs) and long ncRNAs (lncRNAs), are important players in diseases and emerge as novel drug targets. Thus, unraveling the relationships between ncRNAs and other biomedical entities in cells are critical for better understanding ncRNA roles that may eventually help develop their use in medicine. To support ncRNA research and facilitate retrieval of relevant information regarding miRNAs and lncRNAs from the plethora of published ncRNA-related research, we developed DES-ncRNA ( www.cbrc.kaust.edu.sa/des_ncrna ). DES-ncRNA is a knowledgebase containing text- and data-mined information from public scientific literature and other public resources. Exploration of mined information is enabled through terms and pairs of terms from 19 topic-specific dictionaries including, for example, antibiotics, toxins, drugs, enzymes, mutations, pathways, human genes and proteins, drug indications and side effects, mutations, diseases, etc. DES-ncRNA contains approximately 878,000 associations of terms from these dictionaries of which 36,222 (5,373) are with regards to miRNAs (lncRNAs). We provide several ways to explore information regarding ncRNAs to users including controlled generation of association networks as well as hypotheses generation. We show an example how DES-ncRNA can aid research on Alzheimer\\'s disease and suggest potential therapeutic role for Fasudil. DES-ncRNA is a powerful tool that can be used on its own or as a complement to the existing resources, to support research in human ncRNA. To our knowledge, this is the only knowledgebase dedicated to human miRNAs and lncRNAs derived primarily through literature-mining enabling exploration of a broad spectrum of associated biomedical entities, not paralleled by any other resource.

DES-ncRNA: A knowledgebase for exploring information about human micro and long noncoding RNAs based on literature-mining.

Science.gov (United States)

Salhi, Adil; Essack, Magbubah; Alam, Tanvir; Bajic, Vladan P; Ma, Lina; Radovanovic, Aleksandar; Marchand, Benoit; Schmeier, Sebastian; Zhang, Zhang; Bajic, Vladimir B

2017-07-03

Noncoding RNAs (ncRNAs), particularly microRNAs (miRNAs) and long ncRNAs (lncRNAs), are important players in diseases and emerge as novel drug targets. Thus, unraveling the relationships between ncRNAs and other biomedical entities in cells are critical for better understanding ncRNA roles that may eventually help develop their use in medicine. To support ncRNA research and facilitate retrieval of relevant information regarding miRNAs and lncRNAs from the plethora of published ncRNA-related research, we developed DES-ncRNA ( www.cbrc.kaust.edu.sa/des_ncrna ). DES-ncRNA is a knowledgebase containing text- and data-mined information from public scientific literature and other public resources. Exploration of mined information is enabled through terms and pairs of terms from 19 topic-specific dictionaries including, for example, antibiotics, toxins, drugs, enzymes, mutations, pathways, human genes and proteins, drug indications and side effects, mutations, diseases, etc. DES-ncRNA contains approximately 878,000 associations of terms from these dictionaries of which 36,222 (5,373) are with regards to miRNAs (lncRNAs). We provide several ways to explore information regarding ncRNAs to users including controlled generation of association networks as well as hypotheses generation. We show an example how DES-ncRNA can aid research on Alzheimer disease and suggest potential therapeutic role for Fasudil. DES-ncRNA is a powerful tool that can be used on its own or as a complement to the existing resources, to support research in human ncRNA. To our knowledge, this is the only knowledgebase dedicated to human miRNAs and lncRNAs derived primarily through literature-mining enabling exploration of a broad spectrum of associated biomedical entities, not paralleled by any other resource.

DES-ncRNA: A knowledgebase for exploring information about human micro and long noncoding RNAs based on literature-mining

KAUST Repository

Salhi, Adil; Essack, Magbubah; Alam, Tanvir; Bajic, Vladan P.; Ma, Lina; Radovanovic, Aleksandar; Marchand, Benoit; Schmeier, Sebastian; Zhang, Zhang; Bajic, Vladimir B.

2017-01-01

Noncoding RNAs (ncRNAs), particularly microRNAs (miRNAs) and long ncRNAs (lncRNAs), are important players in diseases and emerge as novel drug targets. Thus, unraveling the relationships between ncRNAs and other biomedical entities in cells are critical for better understanding ncRNA roles that may eventually help develop their use in medicine. To support ncRNA research and facilitate retrieval of relevant information regarding miRNAs and lncRNAs from the plethora of published ncRNA-related research, we developed DES-ncRNA ( www.cbrc.kaust.edu.sa/des_ncrna ). DES-ncRNA is a knowledgebase containing text- and data-mined information from public scientific literature and other public resources. Exploration of mined information is enabled through terms and pairs of terms from 19 topic-specific dictionaries including, for example, antibiotics, toxins, drugs, enzymes, mutations, pathways, human genes and proteins, drug indications and side effects, mutations, diseases, etc. DES-ncRNA contains approximately 878,000 associations of terms from these dictionaries of which 36,222 (5,373) are with regards to miRNAs (lncRNAs). We provide several ways to explore information regarding ncRNAs to users including controlled generation of association networks as well as hypotheses generation. We show an example how DES-ncRNA can aid research on Alzheimer's disease and suggest potential therapeutic role for Fasudil. DES-ncRNA is a powerful tool that can be used on its own or as a complement to the existing resources, to support research in human ncRNA. To our knowledge, this is the only knowledgebase dedicated to human miRNAs and lncRNAs derived primarily through literature-mining enabling exploration of a broad spectrum of associated biomedical entities, not paralleled by any other resource.

Des Connaissances Aux Politiques

International Development Research Centre (IDRC) Digital Library (Canada)

Les synergies ont été mises en commun au fur et à mesure des progrès de la recherche. .... Recherche normative (sur le rôle et la performance des institutions .... Système national d'information sur la gestion environnementale connecté à 19 ...... Un fort contrôle centralisé sur l'élaboration des politiques nationales peut ...

La Rivière Seudre: intégration des données relatives à la qualité des eaux dans un système d'information géographique

OpenAIRE

Giraud, Sophie

1999-01-01

Dans le cadre d'un stage de D.E.S.S. effectué à l'IFREMER La Tremblade, j'ai mis en forme un cenains nombre de données environnementales dans un S.I.G. Ces informations concernaient: l'agriculture, l'ostréiculture, la qualité de l'eau, les réseaux de suivi IFREMER, les stations d'épuration etc ... Pour recueillir ces informations, j'ai contacté les administrations décentralisées de l'Etat, et d'autres organismes. L'état des lieux du bassin versant de la Seudre et la structuration des informat...

Turning attention to clinician engagement in Victoria.

Science.gov (United States)

Jorm, Christine; Hudson, Robyn; Wallace, Euan

2017-11-16

The engagement of clinicians with employing organisations and with the broader health system results in better safer care for patients. Concerns about the adequacy of clinician engagement in the state of Victoria led the Victorian Department of Health and Human Services to commission a scoping study. During this investigation more than 100 clinicians were spoken with and 1800 responded to surveys. The result was creation of a clear picture of what engagement and disengagement looked like at all levels - from the clinical microsystem to state health policy making. Multiple interventions are possible to enhance clinician engagement and thus the care of future patients. A framework was developed to guide future Victorian work with four elements: setting the agenda, informing, involving and empowering clinicians. Concepts of work or employee engagement that are used in other industries don't directly translate to healthcare and thus the definition of engagement chosen for use centred on involvement. This was designed to encourage system managers to ensure clinicians are full participants in design, planning and evaluation and in all decisions that affect them and their patients.

Interactions between non-physician clinicians and industry: a systematic review.

Directory of Open Access Journals (Sweden)

Quinn Grundy

2013-11-01

Full Text Available BACKGROUND: With increasing restrictions placed on physician-industry interactions, industry marketing may target other health professionals. Recent health policy developments confer even greater importance on the decision making of non-physician clinicians. The purpose of this systematic review is to examine the types and implications of non-physician clinician-industry interactions in clinical practice. METHODS AND FINDINGS: We searched MEDLINE and Web of Science from January 1, 1946, through June 24, 2013, according to PRISMA guidelines. Non-physician clinicians eligible for inclusion were: Registered Nurses, nurse prescribers, Physician Assistants, pharmacists, dieticians, and physical or occupational therapists; trainee samples were excluded. Fifteen studies met inclusion criteria. Data were synthesized qualitatively into eight outcome domains: nature and frequency of industry interactions; attitudes toward industry; perceived ethical acceptability of interactions; perceived marketing influence; perceived reliability of industry information; preparation for industry interactions; reactions to industry relations policy; and management of industry interactions. Non-physician clinicians reported interacting with the pharmaceutical and infant formula industries. Clinicians across disciplines met with pharmaceutical representatives regularly and relied on them for practice information. Clinicians frequently received industry "information," attended sponsored "education," and acted as distributors for similar materials targeted at patients. Clinicians generally regarded this as an ethical use of industry resources, and felt they could detect "promotion" while benefiting from industry "information." Free samples were among the most approved and common ways that clinicians interacted with industry. Included studies were observational and of varying methodological rigor; thus, these findings may not be generalizable. This review is, however, the

Interactions between non-physician clinicians and industry: a systematic review.

Science.gov (United States)

Grundy, Quinn; Bero, Lisa; Malone, Ruth

2013-11-01

With increasing restrictions placed on physician-industry interactions, industry marketing may target other health professionals. Recent health policy developments confer even greater importance on the decision making of non-physician clinicians. The purpose of this systematic review is to examine the types and implications of non-physician clinician-industry interactions in clinical practice. We searched MEDLINE and Web of Science from January 1, 1946, through June 24, 2013, according to PRISMA guidelines. Non-physician clinicians eligible for inclusion were: Registered Nurses, nurse prescribers, Physician Assistants, pharmacists, dieticians, and physical or occupational therapists; trainee samples were excluded. Fifteen studies met inclusion criteria. Data were synthesized qualitatively into eight outcome domains: nature and frequency of industry interactions; attitudes toward industry; perceived ethical acceptability of interactions; perceived marketing influence; perceived reliability of industry information; preparation for industry interactions; reactions to industry relations policy; and management of industry interactions. Non-physician clinicians reported interacting with the pharmaceutical and infant formula industries. Clinicians across disciplines met with pharmaceutical representatives regularly and relied on them for practice information. Clinicians frequently received industry "information," attended sponsored "education," and acted as distributors for similar materials targeted at patients. Clinicians generally regarded this as an ethical use of industry resources, and felt they could detect "promotion" while benefiting from industry "information." Free samples were among the most approved and common ways that clinicians interacted with industry. Included studies were observational and of varying methodological rigor; thus, these findings may not be generalizable. This review is, however, the first to our knowledge to provide a descriptive analysis

Data Science Meets the Clinician: Challenges and Future Directions.

Science.gov (United States)

Charitos, Efstratios I; Wilbring, Manuel; Treede, Hendrik

2018-01-01

In the last three decades a profound transformation of the medical profession has taken place. The modern clinician is required to consume vast amounts of information from clinical studies, critically reviewing evidence that may or may not lead to changes in clinical practice. The present article presents some challenges that this era of information poses to clinicians and patients. Georg Thieme Verlag KG Stuttgart · New York.

Clinicians' Knowledge and Perception of Telemedicine Technology.

Science.gov (United States)

Ayatollahi, Haleh; Sarabi, Fatemeh Zahra Pourfard; Langarizadeh, Mostafa

2015-01-01

Telemedicine is an application of information and communication technology in the healthcare environment. This study aimed to compare knowledge and perceptions of telemedicine technology among different groups of clinicians. This survey study was conducted in 2013. The potential participants included 532 clinicians who worked in two hospitals and three clinics in a northern province of Iran. Data were collected using a five-point Likert-scale questionnaire. The content validity of the questionnaire was checked, and the reliability was calculated using Cronbach's alpha coefficient (α = 0.73). The results showed that most of the clinicians (96.1 percent) had little knowledge about telemedicine. They perceived the advantages of telemedicine at a moderate level and its disadvantages at a low level. The knowledge of dentists about this technology was less than that of other groups, and as a result they were less positive about the advantages of telemedicine compared to nurses, general physicians, and specialists. The limited knowledge of clinicians about telemedicine seems to have influenced their perceptions of the technology. Therefore, providing healthcare professionals with more information about new technologies in healthcare, such as telemedicine, can help to gain a more realistic picture of their perceptions.

Ensembles de donnees nationales : sources d'information sur la garde des enfants au Canada

OpenAIRE

Forer, Barry; Hertzman, Clyde; Kohen, Dafna

2006-01-01

La presente etude fournit une description des differents ensembles de donnees canadiennes qui pourraient etre utilises pour examiner des questions relatives au recours aux services de garde. Les ensembles de donnees nationales qui traitent des tendances de l'emploi, de l'emploi du temps, des revenus familiaux, du soutien social ainsi que des mesures de la sante des enfants, des adolescents et des adultes ont ete inclus. On a conclu que de nombreuses questions demeurent sans reponse en ce qui ...

Etude des mécanismes d'interopérabilité des systèmes d'information ...

African Journals Online (AJOL)

MECHERI KARIMA

le problème d'hétérogénéité est pallié à l'aide d'une infrastructure de ... des langages orientés objets construits à partir d‟une analyse des .... sont : le service de médiation de données, le service de médiation fonctionnelle et le service de.

Clinicians and journalists responding to disasters.

Science.gov (United States)

Newman, Elana; Shapiro, Bruce

2014-02-01

Mass casualty events pose dilemmas for community clinicians, often challenging their existing clinical toolkits. However, few clinicians were trained to be experts in explaining the unfolding events to the community, creating resources, and interacting with journalists. The objective of this article is to explain knowledge, skills, and attitudes that mental health professionals need to consider when working with journalists, especially those covering children affected by disaster. In service of these objectives, this article reviews controversies, evidence, and best practices to facilitate effective collaborations and consultations with journalists. Advice includes information on how to be a good source to journalists. Clinicians can ethically and effectively help journalists tell accurate and compelling stories about the psychological effects of disasters when they understand and respect the aims, culture, and ethics of journalism.

Electronic medical records and communication with patients and other clinicians: are we talking less?

Science.gov (United States)

O'Malley, Ann S; Cohen, Genna R; Grossman, Joy M

2010-04-01

Commercial electronic medical records (EMRs) both help and hinder physician interpersonal communication--real-time, face-to-face or phone conversations--with patients and other clinicians, according to a new Center for Studying Health System Change (HSC) study based on in-depth interviews with clinicians in 26 physician practices. EMRs assist real-time communication with patients during office visits, primarily through immediate access to patient information, allowing clinicians to talk with patients rather than search for information from paper records. For some clinicians, however, aspects of EMRs pose a distraction during visits. Moreover, some indicated that clinicians may rely on EMRs for information gathering and transfer at the expense of real-time communication with patients and other clinicians. Given time pressures already present in many physician practices, EMR and office-work flow modifications could help ensure that EMRs advance care without compromising interpersonal communication. In particular, policies promoting EMR adoption should consider incorporating communication-skills training for medical trainees and clinicians using EMRs.

Clinician search behaviors may be influenced by search engine design.

Science.gov (United States)

Lau, Annie Y S; Coiera, Enrico; Zrimec, Tatjana; Compton, Paul

2010-06-30

Searching the Web for documents using information retrieval systems plays an important part in clinicians' practice of evidence-based medicine. While much research focuses on the design of methods to retrieve documents, there has been little examination of the way different search engine capabilities influence clinician search behaviors. Previous studies have shown that use of task-based search engines allows for faster searches with no loss of decision accuracy compared with resource-based engines. We hypothesized that changes in search behaviors may explain these differences. In all, 75 clinicians (44 doctors and 31 clinical nurse consultants) were randomized to use either a resource-based or a task-based version of a clinical information retrieval system to answer questions about 8 clinical scenarios in a controlled setting in a university computer laboratory. Clinicians using the resource-based system could select 1 of 6 resources, such as PubMed; clinicians using the task-based system could select 1 of 6 clinical tasks, such as diagnosis. Clinicians in both systems could reformulate search queries. System logs unobtrusively capturing clinicians' interactions with the systems were coded and analyzed for clinicians' search actions and query reformulation strategies. The most frequent search action of clinicians using the resource-based system was to explore a new resource with the same query, that is, these clinicians exhibited a "breadth-first" search behaviour. Of 1398 search actions, clinicians using the resource-based system conducted 401 (28.7%, 95% confidence interval [CI] 26.37-31.11) in this way. In contrast, the majority of clinicians using the task-based system exhibited a "depth-first" search behavior in which they reformulated query keywords while keeping to the same task profiles. Of 585 search actions conducted by clinicians using the task-based system, 379 (64.8%, 95% CI 60.83-68.55) were conducted in this way. This study provides evidence that

A Comparison of Participation Patterns in Selected Formal, Non-formal, and Informal Online Learning Environments / Comparaison des modes de participation dans des environnements formels, non formels et informels d'apprentissage en ligne

Directory of Open Access Journals (Sweden)

Richard Schwier

2012-11-01

Full Text Available Does learner participation vary depending on the learning context? Are there characteristic features of participation evident in formal, non-formal, and informal online learning environments? Six online learning environments were chosen as epitomes of formal, non-formal, and informal learning contexts and compared. Transcripts of online discussions were analyzed and compared employing Transcript Analysis Tools for measures of density, intensity, and reciprocity of participation (Fahy, Crawford, & Ally, 2001, and mean reply depth (Wiley, n.d.. This paper provides an initial description and comparison of participation patterns in a formal, non-formal, and informal learning environment, and discusses the significance of differences observed. La participation des apprenants varie-t-elle en fonction du contexte d'apprentissage? Existe-t-il des caractéristiques de participation spécifiques aux environnements formels, non formels et informels d'apprentissage en ligne? Six environnements d'apprentissage en ligne ont été sélectionnés pour illustrer les contextes formels, non formels et informels d'apprentissage et ont été comparés. Les transcriptions des discussions en ligne ont été analysées et comparées à l’aide des Transcript Analysis Tools pour mesurer la densité, l'intensité et la réciprocité de la participation (Fahy, Crawford, et Ally, 2001, ainsi que la profondeur moyenne de réponse (John Wiley & Sons, nd. Cet article décrit et compare les modes de participation dans un environnement formel, non formel et informel d'apprentissage, et discute la portée des différences observées.

Photonique des Morphos

CERN Document Server

Berthier, Serge

2010-01-01

La photonique est déjà présente dans notre vie quotidienne, et on attend maintenant que la manipulation des photons permette aussi le traitement logique des informations. Cependant, l’élément de base qui permet cette manipulation de la lumière, le cristal photonique, est d’une réalisation complexe et mal contrôlée. Dans la course à la maîtrise de la lumière, les structures photoniques naturelles ont beaucoup à nous apprendre. C’est ce que nous montre Serge Berthier qui étudie dans ce livre la structure des écailles des Morphos. Tenant compte de l’essor récent des approches biomimétiques, il présente de manière détaillée plus de dix-huit techniques expérimentales utilisées pour ses analyses, ainsi que les diverses approches théoriques développées pour la modélisation de structures multi-échelles complexes. Première étude quasi-exhaustive des structures fines d’un genre et des propriétés optiques ainsi que colorimétriques générées, ce livre fournit aux entomologiste...

Comment comprendre la nouvelle structure d’entreprise l’impact des technologies de l’information sur les principes organisationnels (How to reveal the new enterprises structure the impact of information technologies on organisational principles)

OpenAIRE

Chrystelle Gaujard

2006-01-01

Quelles sont les conséquences de l’application des technologies de l’information et de la communication sur l’organisation et les individus ? Comment peut-on caractériser, voire vulgariser les nouveaux agencements des entreprises, suite à cette rupture technologique ? Quelles sont les clefs de la motivation des individus ? Quel type de management doit être adopté ? Dans le passé, certains gestionnaires et sociologues se sont penchés sur les difficultés et les limites de la modélisation des en...

Patients' Contexts and Their Effects on Clinicians' Impressions of Conduct Disorder Symptoms

Science.gov (United States)

De Los Reyes, Andres; Marsh, Jessecae K.

2011-01-01

The purpose of this study was to examine whether contextual information about patients' clinical presentations affected clinicians' judgments of conduct disorder symptoms. Forty-five clinicians read vignettes describing hypothetical patients who displayed one conduct disorder symptom alongside information about the patients' home, school, and peer…

Analyste de la gestion des documents (h/f) | CRDI - Centre de ...

International Development Research Centre (IDRC) Digital Library (Canada)

Résumé des fonctions L'analyste de la gestion des documents est la ressource technique au sein de l'équipe de la Gestion de l'information et des documents. ... Se tenir également informé de toutes les pratiques exemplaires liées à la gestion de l'information et des documents électroniques et matériels que le CRDI doit ...

Innovation, apprentissage et cadres institutionnels dans des ...

International Development Research Centre (IDRC) Digital Library (Canada)

Trois secteurs de transformation des ressources naturelles - ceux des pâtes et ... devrait déboucher sur des recommandations concrètes pour l'élaboration de ... bibliothèque de ressources aideront à améliorer les systèmes d'information et ...

Critical Appraisal of Information on the Web in Practice: Undergraduate Students’ Knowledge, Reported Use, and Behaviour / Évaluation critique de l’information sur la toile : une vision pratique : les connaissances des étudiants de premier cycle, leur uti

Directory of Open Access Journals (Sweden)

Neil R. Hogan

2012-02-01

Full Text Available Undergraduates use a wide range of information resources for academic and nonacademic purposes, including web sites that range from credible, peer reviewed, online journal sites, to biased and inaccurate promotional web sites. Students are taught basic critical appraisal skills, but do they apply these skills to make decisions about information in different web sites? In an experimental setting, undergraduate students examined pairs of web sites containing conflicting information based on different aspects of critical appraisal, namely credibility of the author of the information, purpose of the web site, and last update of the site, and answered multiple choice questions about the conflicting information. Results indicated that students failed to use critical appraisal criteria, and that while knowledge of and self-reported use of these criteria were related to each other, they were not related to behaviour. This research demonstrates the need for alternative strategies for critical appraisal instruction and assessment. Les étudiants de premier cycle consultent une vaste gamme de sources d’information à des fins universitaires et non universitaires, y compris des sites Web allant de revues en ligne crédibles et évaluées par des pairs à des sites Web promotionnels partials et inexacts. On enseigne aux étudiants des méthodes de base d’évaluation critique, mais mettent-ils ces méthodes en pratique pour prendre des décisions relativement à l’information tirée de différents sites Web? Dans un cadre expérimental, les étudiants de premier cycle ont étudié des paires de sites Web contenant des informations contradictoires en se fondant sur différents aspects de l’évaluation critique, notamment la crédibilité de l’auteur de l’information, l’intention du site Web et la dernière mise à jour du site, et ont répondu à des questions à choix multiples concernant les informations contradictoires. Les r

Approches par points de vue pour l’ingénierie des Systèmes d’information

Directory of Open Access Journals (Sweden)

Brahim Lahna

2009-07-01

Full Text Available Les concepts de point de vue, de rôle, de perspective et de vue ont été largement étudiés et utilisés dans de nombreux travaux, dans divers domaines de l’informatique. On retrouve ces notions dans les Systèmes de Représentation de Connaissances par Objets, les Bases de Données Orientées Objets, les Méthodes de Conception, la Programmation Orientée Objets, etc. Chaque domaine lui donne sa propre définition et l’utilise dans son propre contexte. La notion de vue se développe indépendamment dans ces différentes disciplines. Bien que les propositions différent, elles sont confrontées aux mêmes problèmes : établir des relations entre vues et garantir la cohérence des vues entre elles ou vis-à-vis d'un modèle de référence. Nous présentons dans cet article des travaux relatifs aux notions de vues et points de vue dans différentes disciplines informatiques en insistant sur une proposition originale pour une nouvelle ingénierie des systèmes d’information orientée perspectives et composants multivues réutilisables.

GENOMIQUE ET LIPIDES Génomique et métabolisme des lipides des plantes

Directory of Open Access Journals (Sweden)

Delseny Michel

2002-03-01

Full Text Available Il existe dans les bases de données publiques une énorme quantité de séquences d’ADN dérivées de plantes, et notamment la séquence complète du génome d’Arabidopsis thaliana, une plante modèle pour les oléagineux, proche parente du colza. Ces données constituent une ressource importante non seulement pour la compréhension de métabolisme lipidique et de sa régulation, mais aussi pour la sélection et le développement de variétés nouvelles d’oléagineux produisant davantage d’huiles ou des huiles de composition nouvelle. Cette abondance de séquences peut être exploitée, en utilisant les recherches d’homologies, pour identifier les gènes, pour obtenir des informations sur leur fonction, comme pour repérer des gènes candidats codant des fonctions nouvelles. L’analyse de ces bases de données a révélé que la majeure partie des gènes codant des enzymes impliquées dans le métabolisme lipidique appartient à des petites familles multigéniques, reflétant la diversification des fonctions des isoformes. Une analyse du catalogue des ADNc séquencés en aveugle reflète les niveaux d’expression des différents gènes et fournit un aperçu des régulations des flux au travers des voies métaboliques conduisant à la biosynthèse des lipides de réserve. La disponibilité de mutants et de lignées transgéniques d’Arabidopsis et le développement de puces à ADN qui permettent l’analyse simultanée de plusieurs milliers de gènes conduiront à une meilleure compréhension des facteurs qui régulent le métabolisme des huiles dans les graines. Une telle connaissance facilitera la manipulation de la composition des huiles et des quantités produites dans les graines.

Adoption obligatoire des IFRS et asymétrie d’information dans le contexte français : effet modérateur de l’endettement

Directory of Open Access Journals (Sweden)

Hela Turki

2017-03-01

Full Text Available Cette étude examine les bienfaits de la décision d’imposition des IFRS sur la qualité informationnelle des chiffres comptables publiés. En appréhendant cette qualité par l’asymétrie d’information et en s’intéressant au contexte français, les résultats montrent que l’adoption obligatoire des IFRS a réduit significativement le coût de capital ainsi que l’erreur et la dispersion des prévisions des analystes financiers, ceci permet de déduire que la pertinence informationnelle des chiffres comptables s’est améliorée après l’application des ces normes. En examinant aussi l’effet modérateur de l’endettement, cette étude montre que l’adoption obligatoire des IFRS est plus bénéfique dans les entreprises les plus endettées.

Clinicians completion rate of radiology request card in a Nigerian ...

African Journals Online (AJOL)

The importance of adequately completing the radiology request card by the clinicians, in management of patient cannot be overemphasized. Omission of information on the request card may lead to reporting error. This study investigated the compliance rate of filling the radiology request card by clinicians received in a ...

Les frameworks au coeur des applications web

OpenAIRE

Moro, Arielle; Daehne, Peter

2010-01-01

Depuis quelques années, Internet est vraiment entré dans les mœurs : tant dans les entreprises qu’au sein de chaque foyer. En effet, Internet permet de communiquer à travers le monde en quelques secondes, de vendre toute sorte de produits en déployant des solutions e-commerce facilement et bien d’autres choses. Internet est donc un véritable vecteur de communication, de commerce et à présent, avec le Web 2.0, un vrai berceau d’informations (tant des informations personnelles que des informati...

Sommaires des demandes d'accès à l'information complétées ...

International Development Research Centre (IDRC) Digital Library (Canada)

... à ces demandes, veuillez envoyer un courriel à ATIP-AIPRP@crdi.ca ou écrire à l'adresse suivante: Coordonnatrice de l'accès à l'information et de la protection des renseignements personnels. Bureau du secrétaire et conseiller juridique. Centre de recherches pour le développement international 150, rue Kent CP 8500

Gatekeepers or intermediaries? The role of clinicians in commercial genomic testing.

Directory of Open Access Journals (Sweden)

Michelle L McGowan

Full Text Available Many commentators on "direct-to-consumer" genetic risk information have raised concerns that giving results to individuals with insufficient knowledge and training in genomics may harm consumers, the health care system, and society. In response, several commercial laboratories offering genomic risk profiling have shifted to more traditional "direct-to-provider" (DTP marketing strategies, repositioning clinicians as the intended recipients of advertising of laboratory services and as gatekeepers to personal genomic information. Increasing popularity of next generation sequencing puts a premium on ensuring that those who are charged with interpreting, translating, communicating and managing commercial genomic risk information are appropriately equipped for the job. To shed light on their gatekeeping role, we conducted a study to assess how and why early clinical users of genomic risk assessment incorporate these tools in their clinical practices and how they interpret genomic information for their patients.We conducted qualitative in-depth interviews with 18 clinicians providing genomic risk assessment services to their patients in partnership with DNA Direct and Navigenics. Our findings suggest that clinicians learned most of what they knew about genomics directly from the commercial laboratories. Clinicians rely on the expertise of the commercial laboratories without the ability to critically evaluate the knowledge or assess risks.DTP service delivery model cannot guarantee that providers will have adequate expertise or sound clinical judgment. Even if clinicians want greater genomic knowledge, the current market structure is unlikely to build the independent substantive expertise of clinicians, but rather promote its continued outsourcing. Because commercial laboratories have the most "skin in the game" financially, genetics professionals and policymakers should scrutinize the scientific validity and clinical soundness of the process by which

Gatekeepers or intermediaries? The role of clinicians in commercial genomic testing.

Science.gov (United States)

McGowan, Michelle L; Fishman, Jennifer R; Settersten, Richard A; Lambrix, Marcie A; Juengst, Eric T

2014-01-01

Many commentators on "direct-to-consumer" genetic risk information have raised concerns that giving results to individuals with insufficient knowledge and training in genomics may harm consumers, the health care system, and society. In response, several commercial laboratories offering genomic risk profiling have shifted to more traditional "direct-to-provider" (DTP) marketing strategies, repositioning clinicians as the intended recipients of advertising of laboratory services and as gatekeepers to personal genomic information. Increasing popularity of next generation sequencing puts a premium on ensuring that those who are charged with interpreting, translating, communicating and managing commercial genomic risk information are appropriately equipped for the job. To shed light on their gatekeeping role, we conducted a study to assess how and why early clinical users of genomic risk assessment incorporate these tools in their clinical practices and how they interpret genomic information for their patients. We conducted qualitative in-depth interviews with 18 clinicians providing genomic risk assessment services to their patients in partnership with DNA Direct and Navigenics. Our findings suggest that clinicians learned most of what they knew about genomics directly from the commercial laboratories. Clinicians rely on the expertise of the commercial laboratories without the ability to critically evaluate the knowledge or assess risks. DTP service delivery model cannot guarantee that providers will have adequate expertise or sound clinical judgment. Even if clinicians want greater genomic knowledge, the current market structure is unlikely to build the independent substantive expertise of clinicians, but rather promote its continued outsourcing. Because commercial laboratories have the most "skin in the game" financially, genetics professionals and policymakers should scrutinize the scientific validity and clinical soundness of the process by which these laboratories

Comparisons of client and clinician views of the importance of factors in client-clinician interaction in hearing aid purchase decisions.

Science.gov (United States)

Poost-Foroosh, Laya; Jennings, Mary Beth; Cheesman, Margaret F

2015-03-01

the concepts understanding and meeting client needs, conveying device information by clinician, supporting choices and shared decision making, and factors in client readiness. Three concepts-understanding and meeting client needs, conveying device information by clinician, and supporting choices and shared decision making-were rated as more important by clients than by clinicians. One concept (ie, factors in client readiness) was rated as more important by clinicians than by clients. The concepts rated as most important by clients and clinicians are consistent with components of several existing models of client-centered and patient-centered care. These concepts reflect the clients' perception of the importance of their involvement in the decision-making process. A preliminary model of client-centered care within the hearing aid uptake process and implications for clinical audiology are described. American Academy of Audiology.

Renforcement des capacités d'évaluation dans le domaine des ...

International Development Research Centre (IDRC) Digital Library (Canada)

Les subtilités des interactions entre les technologies de l'information et de la communication (TIC) et les sociétés en développement exigent une évaluation réfléchie et systématique, axée sur l'utilité, les résultats et l'appropriation. Cette subvention permettra au projet de renforcement des capacités d'évaluation dans le ...

Les non-usages des TIC

OpenAIRE

Abid-Zarrouk, Sandoss Ben; Alava, Séraphin; Andrieu, Bernard; Audran, Jacques; Avanzini, Guy; Azzimani, Toufik; Béziat, Jacques; Bouamri, Abderrahmane; Boujelbène, Younes; Bréant, Françoise; Chauvel, Séverine; Daguet, Hervé; Daniel, Marie-France; Dessus, Philippe; Dupré, Damien

2012-01-01

Les ENT (Environnements Numériques de Travail), les plates formes d'EAD (Enseignement A Distance) et les logiciels éducatifs sont généralement étudiés dans la perspective de rendre compte des transformations des situations d'enseignement-apprentissage dans lequelles ils sont utilisés. Les recherches occultent ainsi, de façon non intentionnelle, tout ce qui reste dans l'ombre de l'introduction désormais massive des TIC (Technologies de l'Information et de la Communication), et qui explique pro...

Un système d'aide au traitement des informations de veille stratégique : concepts, méthode et résultats

NARCIS (Netherlands)

Rouibah, K.

2001-01-01

RÉSUMÉ Cette recherche s¿inscrit dans le cadre du traitement des informations fragmentaires et incertaines (IFI) de veille stratégique. Le traitement des IFI est un problème peu structuré, pour lequel il existe peu de recherches utiles aux dirigeants d¿entreprises. Devenu un axe de recherche assez

Rôle des universités dans le renforcement des technologies de l ...

International Development Research Centre (IDRC) Digital Library (Canada)

Rôle des universités dans le renforcement des technologies de l'information et de la communication au service du développement (TIC-D) en Asie. Jusqu'à maintenant, les efforts déployés dans le secteur de l'enseignement supérieur ont surtout été axés sur le téléapprentissage, l'apprentissage électronique et différentes ...

The role of the national general medical journal: surveys of which journals UK clinicians read to inform their clinical practice.

Science.gov (United States)

Jones, Teresa H; Hanney, Stephen; Buxton, Martin J

2008-12-01

For biomedical research findings to contribute toward health gains they must reach clinicians. Academic journals have historically been considered important information sources. Birken and Parkin found seven journals to most consistently contain the best pediatric evidence and, of these seven, four were general medical journals. We surveyed clinicians in three UK medical specialties (psychiatry, surgery and pediatrics), asking which journals they read and which they considered important to inform their clinical practice. The readership of general medical journals, in comparison to specialty and sub-specialty journals, is widespread across the three UK medical specialties, although the importance of general medical journals varies widely. The BMJ is the most prominent general medical journal in terms of readership and importance but a dominant specialty or sub-specialty journal was usually more important for most groups. The Lancet is less widely read and less important, although more academics than non-academics consider it important. Overall, key general medical journals play an important role. Journal availability and cost, particularly in relation to membership for UK clinicians, and the position of academics and non-academics have to be considered in any analysis. Three of the four general medical journals containing the best pediatric evidence were found to be widely read by UK pediatricians and two UK-based general medical journals, the BMJ and The Lancet, were also considered important in our survey. Further investigation of the reasons for the importance of a journal and studies that would allow international comparisons would provide greater input to the discussion.

Rapport d’étape – Le Système canadien hospitalier d’information et de recherche en prévention des traumatismes : un système de surveillance des blessures dynamique et novateur

Directory of Open Access Journals (Sweden)

J. Crain

2016-01-01

Full Text Available Ce rapport d’étape sur le Système canadien hospitalier d’information et de recherche en prévention des traumatismes (SCHIRPT, un système de surveillance des blessures et des empoisonnements utilisé par les services d’urgence, décrit le résultat de la migration d’un processus d’entrée et de codage des données centralisé vers le processus décentralisé de l’eSCHIRPT, réalisée en 2011. Ce système sécurisé accroît la souplesse et la rapidité globales du SCHIRPT, attributs clés d’un système de surveillance efficace. La plate-forme intégrée de l’eSCHIRPT permet une entrée de données et un accès aux données en temps quasi réel, comprend des outils conviviaux de gestion et d’analyse des données et facilite la communication et la connectivité au sein du réseau du SCHIRPT grâce à un centre de collaboration en ligne. L’essai pilote mené actuellement sur les outils automatisés de contrôle de données et d’analyse des tendances – destinés à surveiller et à mettre en évidence les données d’entrée à partir de critères prédéfinis (par exemple un nouveau produit de consommation – révèle le potentiel de détection rapide des nouveaux dangers, enjeux et tendances que possède l’eSCHIRPT.

Complexities of emergency communication: clinicians' perceptions of communication challenges in a trilingual emergency department.

Science.gov (United States)

Pun, Jack Kh; Chan, Engle Angela; Murray, Kristen A; Slade, Diana; Matthiessen, Christian Mim

2017-11-01

To understand the challenges that clinicians face in communicating with patients and other clinicians within a Hong Kong trilingual emergency department. Effective communication has long been recognised as fundamental to the delivery of quality health care, especially in high-risk and time-constrained environments such as emergency departments. The issue of effective communication is particularly relevant in Hong Kong emergency departments, due to the high volume of patients and the linguistic complexity of this healthcare context. In Hong Kong, emergency department clinicians are native speakers of Chinese, but have received their medical training in English. The clinicians read and record virtually all of their medical documentation in English, yet they communicate verbally with patients in Cantonese and Mandarin. In addition, communication between clinicians occurs in spoken Cantonese, mixed with medical English. Thus, medical information is translated numerous times within one patient journey. This complex linguistic environment creates the potential for miscommunication. A mixed-methods design consisting of a quantitative survey with a sequential qualitative interview. Data were collected in a survey from a purposive sample of 58 clinicians and analysed through descriptive statistics. Eighteen of the clinicians were then invited to take part in semi-structured interviews, the data from which were then subjected to a manifest content analysis. Nearly half of the clinicians surveyed believed that medical information may be omitted or altered through repeated translation in a trilingual emergency department. Eighty-three per cent of clinicians stated that there are communication problems at triage. Over 40% said that they have difficulties in documenting medical information. Around 50% believed that long work hours reduced their ability to communicate effectively with patients. In addition, 34% admitted that they rarely or never listen to patients during a

REPRISE DES COURS - Yoga

CERN Multimedia

Club de Yoga

2015-01-01

REPRISE DES COURS – Venez nombreux ! Yoga, Sophrologie, Tai Chi La liste des cours pour le semestre allant du 1er septembre 2015 au 31 janvier 2016 est disponible sur notre site web : http://club-yoga.web.cern.ch Lieu Les cours ont lieu dans la salle des clubs, à l’entresol du restaurant No 2, Bât. 504 (dans la salle no 3 pour la Sophrologie). Prix des cours Le prix pour le semestre (environ 18 leçons) est fixé à 220 CHF plus 10 CHF d’adhésion annuelle au Club. Couple : 200 CHF par personne. 2 cours par semaine : 400 CHF. Inscriptions Les inscriptions aux cours seront prises directement auprès du professeur, lors de la 1ère séance. Avant de s’inscrire pour le semestre, il est possible d’essayer une séance gratuitement. Informations : http://club-yoga.web.cern.ch ----------------------------------------- cern.ch/club-yoga/

Use of SERVQUAL to assess clinicians' satisfaction with the blood transfusion service.

Science.gov (United States)

Raspollini, E; Pappalettera, M; Riccardi, D; Parravicini, A; Sestili, S; Rebulla, P; Sirchia, G

1997-01-01

Limited information is available on the level of satisfaction of clinicians with services delivered by blood banks. The purpose of this study was to evaluate the satisfaction of clinicians with our blood transfusion service. We prepared a questionnaire based on SERVQUAL, a method used to measure customers' appreciation of quality of service, by assessing the gap between perceived and expected quality. The questionnaire consisted of 14 items grouped according to five dimensions of quality of service: assurance, empathy, responsiveness, reliability, tangibles. Clinicians were asked to give two scores on a scale from 1 to 7 for each item, score (e) representing what they expected from an 'excellent' service, score (r) how they graded the service received. We considered wide differences in scores of service expectation and receipt for a question to be indicative of either service above expected levels (r > e) or service below expectation (r SERVQUAL was useful to gather information on the level of clinicians' satisfaction with our transfusion service.

Approaches to ascertaining comorbidity information: validation of routine hospital episode data with clinician-based case note review.

Science.gov (United States)

Soo, Martin; Robertson, Lynn M; Ali, Tariq; Clark, Laura E; Fluck, Nicholas; Johnston, Marjorie; Marks, Angharad; Prescott, Gordon J; Smith, William Cairns S; Black, Corri

2014-04-21

In clinical practice, research, and increasingly health surveillance, planning and costing, there is a need for high quality information to determine comorbidity information about patients. Electronic, routinely collected healthcare data is capturing increasing amounts of clinical information as part of routine care. The aim of this study was to assess the validity of routine hospital administrative data to determine comorbidity, as compared with clinician-based case note review, in a large cohort of patients with chronic kidney disease. A validation study using record linkage. Routine hospital administrative data were compared with clinician-based case note review comorbidity data in a cohort of 3219 patients with chronic kidney disease. To assess agreement, we calculated prevalence, kappa statistic, sensitivity, specificity, positive predictive value and negative predictive value. Subgroup analyses were also performed. Median age at index date was 76.3 years, 44% were male, 67% had stage 3 chronic kidney disease and 31% had at least three comorbidities. For most comorbidities, we found a higher prevalence recorded from case notes compared with administrative data. The best agreement was found for cerebrovascular disease (κ = 0.80) ischaemic heart disease (κ = 0.63) and diabetes (κ = 0.65). Hypertension, peripheral vascular disease and dementia showed only fair agreement (κ = 0.28, 0.39, 0.38 respectively) and smoking status was found to be poorly recorded in administrative data. The patterns of prevalence across subgroups were as expected and for most comorbidities, agreement between case note and administrative data was similar. Agreement was less, however, in older ages and for those with three or more comorbidities for some conditions. This study demonstrates that hospital administrative comorbidity data compared moderately well with case note review data for cerebrovascular disease, ischaemic heart disease and diabetes, however there was

Des solutions communautaires au problème des déchets en Indonésie

International Development Research Centre (IDRC) Digital Library (Canada)

19 oct. 2010 ... Tant les collectivités que les divers ordres de gouvernement ont à leur disposition un outil appelé Informed Choice Catalogue (ICC), qui leur permet de faire ... Son personnel fournit donc des conseils sur les recherches nécessaires et sur l'exécution du projet HP3 et met à profit les enseignements tirés des ...

Efficacité des néonicotinoïdes et des pyréthrinoïdes utilisés contre le ...

African Journals Online (AJOL)

Efficacité des néonicotinoïdes et des pyréthrinoïdes utilisés contre le foreur des tiges du cacaoyer ( Eulophonotus myrmeleon Felder : Lepidoptera, Cossidae). Implications dans la stratégie de protection de la cacaoculture en Côte d'Ivoire.

Understanding clinicians' attitudes toward a mobile health strategy to childhood asthma management: A qualitative study.

Science.gov (United States)

Hollenbach, Jessica P; Cushing, Anna; Melvin, Emilie; McGowan, Bryanna; Cloutier, Michelle M; Manice, Melissa

2017-09-01

Mobile technology for childhood asthma can provide real-time data to enhance care. What real-time adherence information clinicians want, how they may use it, and if the data meet their clinical needs have not been fully explored. Our goal was to determine whether pediatric primary care and pulmonary clinicians believe if a sensor-based mobile intervention is useful in caring for patients with asthma. We recruited participants from 3 urban, primary care and 1 pulmonary practice from July to September 2015 in Hartford, CT. Forty-one participated in four focus groups, which included a demonstration of the technology. Participants were probed with open-ended questions on the type, frequency, and format of inter-visit patient information they found useful. 41 participants (mean age 49 (±13.7) years) were board-certified clinicians (41% MDs and 20% mid-level practitioners), practiced medicine on an average of 19 (±14) years, were primarily white (59%) and women (78%). Clinicians wanted 1) adherence to prescribed inhaler therapy and 2) data on inhaler technique. Clinicians wanted it at the time of a scheduled clinic visit but also wanted inter-visit alerts for excessive use of rescue therapy. Pulmonologists liked the mobile spirometer's provision of inter-visit lung function data; pediatricians did not share this view. Concerns with data accuracy were raised due to families who shared inhalers, access to smartphones, and protection of health information. Overall, clinicians view an asthma mobile health technology as enhancing the patient-centered medical home. Pediatric primary care clinicians and pulmonologists want different information from a mobile app.

Parent and Adolescent Interest in Receiving Adolescent Health Communication Information From Primary Care Clinicians.

Science.gov (United States)

Ford, Carol A; Cheek, Courtney; Culhane, Jennifer; Fishman, Jessica; Mathew, Leny; Salek, Elyse C; Webb, David; Jaccard, James

2016-08-01

Patient-centered health care recognizes that adolescents and parents are stakeholders in adolescent health. We investigate adolescent and parent interest in receiving information about health topics and parent-teen communication from clinicians. Ninety-one parent-adolescent dyads in one practice completed individual interviews. Items assessed levels of interest in receiving health and health communication information from the adolescent's doctor about 18 topics, including routine, mental health, sexual health, substance use, and injury prevention issues. Analyses tested differences between parents and adolescents, within-dyad correlations, and associations with adolescent gender and age. Most parents were female (84%). Adolescents were evenly divided by gender; 36 were aged 12-13 years, 35 were aged 14-15 years, and 20 were aged 16-17 years. Adolescent race reflected the practice population (60% black; 35% white). The vast majority of parents and adolescents reported moderate or high levels of interest in receiving information about all 18 health issues and information to increase parent-teen communication about these topics. Parents' interest in receiving information varied by adolescent age when the expected salience of topics varied by age (e.g., acne, driving safety), whereas adolescents reported similar interest regardless of age. Adolescent gender influenced parent and adolescent interest. Level of interest in receiving information from doctors within adolescent-parent pairs was not significantly correlated for one-half of topics. Parents and adolescents want health care professionals to help them learn and talk about a wide range of adolescent health topics. Feasible primary care interventions that effectively improve parent-teen health communication, and specific adolescent health outcomes are needed. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

DES-TOMATO: A Knowledge Exploration System Focused On Tomato Species

KAUST Repository

Salhi, Adil

2017-07-14

Tomato is the most economically important horticultural crop used as a model to study plant biology and particularly fruit development. Knowledge obtained from tomato research initiated improvements in tomato and, being transferrable to other such economically important crops, has led to a surge of tomato-related research and published literature. We developed DES-TOMATO knowledgebase (KB) for exploration of information related to tomato. Information exploration is enabled through terms from 26 dictionaries and combination of these terms. To illustrate the utility of DES-TOMATO, we provide several examples how one can efficiently use this KB to retrieve known or potentially novel information. DES-TOMATO is free for academic and nonprofit users and can be accessed at http://cbrc.kaust.edu.sa/des_tomato/, using any of the mainstream web browsers, including Firefox, Safari and Chrome.

DES-TOMATO: A Knowledge Exploration System Focused On Tomato Species

KAUST Repository

Salhi, Adil; Negrã o, Só nia; Essack, Magbubah; Morton, Mitchell J. L.; Bougouffa, Salim; Mohamad Razali, Rozaimi; Radovanovic, Aleksandar; Marchand, Benoit; Kulmanov, Maxat; Hoehndorf, Robert; Tester, Mark A.; Bajic, Vladimir B.

2017-01-01

Tomato is the most economically important horticultural crop used as a model to study plant biology and particularly fruit development. Knowledge obtained from tomato research initiated improvements in tomato and, being transferrable to other such economically important crops, has led to a surge of tomato-related research and published literature. We developed DES-TOMATO knowledgebase (KB) for exploration of information related to tomato. Information exploration is enabled through terms from 26 dictionaries and combination of these terms. To illustrate the utility of DES-TOMATO, we provide several examples how one can efficiently use this KB to retrieve known or potentially novel information. DES-TOMATO is free for academic and nonprofit users and can be accessed at http://cbrc.kaust.edu.sa/des_tomato/, using any of the mainstream web browsers, including Firefox, Safari and Chrome.

Dental Encounter System (DES)

Data.gov (United States)

Department of Veterans Affairs — Dental Encounter System (DES) is an automated health care application designed to capture critical data about the operations of VA Dental Services. Information on...

Santé des adolescents et des jeunes au Burkina Faso : état des ...

African Journals Online (AJOL)

Il s'est agi d'une étude évaluative ayant utilisé une revue documentaire associée à une interview des acteurs clés et un atelier de validation et d'identification des interventions pertinentes pour un plan stratégique national. La situation de la santé des adolescents et des jeunes est caractérisée par des grossesses précoces ...

La fabrique des sciences des institutions aux pratiques

CERN Document Server

Benninghoff, Martin; Crettaz von Roten, Fabienne; Merz, Martina

2006-01-01

Aujourd'hui, les façons de produire, d'organiser, d'évaluer et d'utiliser les savoirs sont en profond débat. De plus en plus, l'Etat, la société civile et l'économie tentent d'influencer les activités des universités et des laboratoires de recherche. Ces développements mettent à l'épreuve tout à la fois les fondements des systèmes d'enseignement supérieur et de recherche, l'autonomie des institutions scientifiques, la définition des frontières des savoirs et l'acceptation des sciences. Dans des contextes suisses et européens, cet ouvrage s'intéresse aux manières dont les sciences et les technologies sont fabriquées, en analysant leurs institutions et les pratiques. A partir d'une approche relationnelle, les sciences et les technologies sont conçues comme des phénomènes profondément sociaux, culturels et politiques. Une telle démarche déstabilise les visions parfois idéalisées et stéréotypées de la construction des savoirs. Des études de cas détaillées décrivent des phénomè...

Oral Cancer Knowledge Assessment: Newly Graduated versus Senior Dental Clinicians

Science.gov (United States)

Salgado de Souza, Ricardo; Gallego Arias Pecorari, Vanessa; Lauria Dib, Luciano

2018-01-01

The present study assessed the level of dentists' knowledge regarding oral cancer in the city of São Paulo, Brazil. A questionnaire was used to compare the level of knowledge among newly graduated and senior clinicians. A total of 20,154 e-mails were correctly delivered to the dentists registered in the database of the Regional Dentistry Council of São Paulo, and 477 (2.36%) responses were received. This sample consisted of 84 newly graduated clinicians and 105 senior clinicians. For the statistical analysis, the chi-square test and the logistic regression analysis were performed with α = 0.05, and the results were described herein. According to their knowledge level, the results were statistically different between the groups, since 19% of the newly graduated clinicians were evaluated with knowledge grade A (excellent) in comparison to 6.7% of the senior clinicians. In spite of the results indicated that newly graduated clinicians' knowledge regarding oral cancer was 2.1 times higher, 34.5% of the professionals in this group had regular or poor knowledge on the subject, and several questions relating to clinical characteristics and risk factors indicated that there still exist some knowledge gaps, demonstrating that there is a need for further studies and information activities addressing oral cancer. PMID:29666649

Examining Informal Learning using Mobile Devices in the Healthcare Workplace / Examen de l’apprentissage informel par l’utilisation d’appareils mobiles dans le milieu des soins de santé

Directory of Open Access Journals (Sweden)

Dorothy (Willy Fahlman

2013-12-01

Full Text Available The study of workplace learning and informal learning are not new to adult education and pedagogy. However, the use of mobile devices as learning tools for informal learning in the workplace is an understudied area. Using theories on informal learning and constructivism as a framework, this paper explores informal learning of registered nurses using mobile devices to meet their learning needs for continuing professional education, professional development, and continuing competence within the challenging healthcare workplace. In this mixed methods study, participants used their devices for self-directed informal learning with non-collaborative strategies/processes for evidence-based support, new procedures/treatments, professional development, patient/client teaching, and maintaining competency. Positive perceptions were articulated. Minimal differences were associated to the nurses’ age. However, workplace-related influences were relevant to the informal learning experiences with the mobile devices. L'étude de l'apprentissage en milieu de travail et de l’apprentissage informel n’est pas nouvelle dans le domaine de l'éducation des adultes et de la pédagogie. Cependant, l'utilisation d'appareils mobiles comme outils pour l'apprentissage informel en milieu de travail est un domaine peu étudié. En utilisant comme cadre d’analyse des théories de l'apprentissage informel et le constructivisme, cet article examine l'apprentissage informel des infirmières utilisant des appareils mobiles pour répondre à leurs besoins d'apprentissage en contexte de formation professionnelle continue, de perfectionnement professionnel et de maintien de leurs compétences dans le milieu difficile de la santé. Dans cette étude à méthodologies mixtes, les participants ont utilisé leurs appareils pour un apprentissage autodirigé informel à l’aide de stratégies et de processus non collaboratifs permettant un appui sur des données factuelles, pour

A qualitative analysis of oncology clinicians' perceptions and barriers for physical activity counseling in breast cancer survivors.

Science.gov (United States)

Fong, Angela J; Faulkner, Guy; Jones, Jennifer M; Sabiston, Catherine M

2018-03-24

Few breast cancer survivors (BCS) engage in sufficient physical activity (PA) to gain physical and mental health benefits. This may be due to a lack of appropriate PA information and support. While key messengers of PA information could be oncology clinicians, many do not consistently counsel their patients on PA. To examine factors affecting PA counseling in clinicians and inform future strategies. Focus groups were conducted with clinicians (N = 27) at four cancer hospitals to better understand factors that affect PA counseling. Focus group discussions were transcribed verbatim and analyzed using inductive thematic analysis. Clinicians perceived a lack of training and knowledge related to PA and BCS. Clinicians also discussed being unsure of when to integrate PA counseling into different phases of survivorship. Similarly, clinicians experienced barriers from hospital administration to maintain patient flow in-clinic, which decreased opportunities for PA counseling. Additionally, lack of awareness of community-based programs within large areas served by hospitals also decreased clinicians' self-efficacy for counseling. In order to facilitate PA counseling, clinicians wanted resources that promote patient-managed PA, available on multiple platforms (e.g., printed and online). Continued education, highlighting recent research and effective implementation of PA, was noted as an important facilitator. Researchers are encouraged to develop research agendas and test educational strategies that are integrated into current practice, empirically test barriers that developed from this study with a larger, representative sample to determine salient barriers and develop PA counseling strategies that are clinician-initiated but not dependent on clinicians.

L’utilisation des strat��gies d’apprentissage d’une langue dans un environnement des TICE L’utilisation des stratégies d’apprentissage d’une langue dans un environnement des TICE

Directory of Open Access Journals (Sweden)

Janet Atlan

2000-06-01

Full Text Available L'étude des différences individuelles qui caractérisent les apprenants s'intègre de plus en plus dans les travaux en didactique des langues. L'utilisation des stratégies d'apprentissage est un type de différences individuelles qui semble être assez sensible à l'environnement pédagogique. Cet article rend compte d'une étude expérimentale entreprise avec des étudiants français en IUT qui avait pour objectif de déterminer si l'utilisation des stratégies d'apprentissage par un apprenant de langues est influencée par la technologie de l'information et de la communication (TIC utilisée pour la présentation d'une tâche d'apprentissage. Le "Strategy Inventory for Language Learning" d'Oxford a été utilisé comme instrument lors de cette étude. L'étude a montré qu'il y a effectivement interaction entre la TIC utilisée et le choix de stratégies effectué par l'apprenant et les résultats permettent de tirer quelques conclusions quant à l'utilité d'un entraînement spécifique à l'utilisation des stratégies d'apprentissage en présence des technologies de l’information et de la communication pour l’enseignement (TICE.The study of the individual differences which characterize learners is becoming more and more common in language learning research, and the use of learning strategies is an instance of individual differences which seems to be rather sensitive to the pedagogical environment. This article reports on an experimental study undertaken with students in a French technical college to determine if the use of learning strategies by a foreign language student is influenced by the technology used to present a language learning task. Oxford's Strategy Inventory for Language Learning was the principal instrument used for this study. The study showed that there was indeed some interaction between the technology used and the choice of learning strategies and the results lead to some interesting considerations on the usefulness

Enhancing shared decision making through assessment of patient-clinician concordance on decision quality

DEFF Research Database (Denmark)

Kaltoft, Mette Kjer; Selby, Warwick; Salkeld, Glenn

to quantify, document, and suggest how future dyadic decisions can be enhanced by criterion prioritisation. Associations between patient’s MDQ-W before, and MDQ-R after consultation with their clinician were analysed along with patient scores from the Satisfaction With Decision (SWD) instrument. Results...... and clinician using the dually-personalised decomposable MyDecisionQuality (MDQ) instrument. This has the potential to guide future work on optimising dyad-specific patient-clinician communication for shared decision making and informed consent....

The interplay between teamwork, clinicians' emotional exhaustion, and clinician-rated patient safety: a longitudinal study.

Science.gov (United States)

Welp, Annalena; Meier, Laurenz L; Manser, Tanja

2016-04-19

Effectively managing patient safety and clinicians' emotional exhaustion are important goals of healthcare organizations. Previous cross-sectional studies showed that teamwork is associated with both. However, causal relationships between all three constructs have not yet been investigated. Moreover, the role of different dimensions of teamwork in relation to emotional exhaustion and patient safety is unclear. The current study focused on the long-term development of teamwork, emotional exhaustion, and patient safety in interprofessional intensive care teams by exploring causal relationships between these constructs. A secondary objective was to disentangle the effects of interpersonal and cognitive-behavioral teamwork. We employed a longitudinal study design. Participants were 2100 nurses and physicians working in 55 intensive care units. They answered an online questionnaire on interpersonal and cognitive-behavioral aspects of teamwork, emotional exhaustion, and patient safety at three time points with a 3-month lag. Data were analyzed with cross-lagged structural equation modeling. We controlled for professional role. Analyses showed that emotional exhaustion had a lagged effect on interpersonal teamwork. Furthermore, interpersonal and cognitive-behavioral teamwork mutually influenced each other. Finally, cognitive-behavioral teamwork predicted clinician-rated patient safety. The current study shows that the interrelations between teamwork, clinician burnout, and clinician-rated patient safety unfold over time. Interpersonal and cognitive-behavioral teamwork play specific roles in a process leading from clinician emotional exhaustion to decreased clinician-rated patient safety. Emotionally exhausted clinicians are less able to engage in positive interpersonal teamwork, which might set in motion a vicious cycle: negative interpersonal team interactions negatively affect cognitive-behavioral teamwork and vice versa. Ultimately, ineffective cognitive

Bed occupancy monitoring: data processing and clinician user interface design.

Science.gov (United States)

Pouliot, Melanie; Joshi, Vilas; Goubran, Rafik; Knoefel, Frank

2012-01-01

Unobtrusive and continuous monitoring of patients, especially at their place of residence, is becoming a significant part of the healthcare model. A variety of sensors are being used to monitor different patient conditions. Bed occupancy monitoring provides clinicians a quantitative measure of bed entry/exit patterns and may provide information relating to sleep quality. This paper presents a bed occupancy monitoring system using a bed pressure mat sensor. A clinical trial was performed involving 8 patients to collect bed occupancy data. The trial period for each patient ranged from 5-10 weeks. This data was analyzed using a participatory design methodology incorporating clinician feedback to obtain bed occupancy parameters. The parameters extracted include the number of bed exits per night, the bed exit weekly average (including minimum and maximum), the time of day of a particular exit, and the amount of uninterrupted bed occupancy per night. The design of a clinical user interface plays a significant role in the acceptance of such patient monitoring systems by clinicians. The clinician user interface proposed in this paper was designed to be intuitive, easy to navigate and not cause information overload. An iterative design methodology was used for the interface design. The interface design is extendible to incorporate data from multiple sensors. This allows the interface to be part of a comprehensive remote patient monitoring system.

How can clinician-educator training programs be optimized to match clinician motivations and concerns?

Science.gov (United States)

McCullough, Brendan; Marton, Gregory E; Ramnanan, Christopher J

2015-01-01

Several medical schools have implemented programs aimed at supporting clinician-educators with formal mentoring, training, and experience in undergraduate medical teaching. However, consensus program design has yet to be established, and the effectiveness of these programs in terms of producing quality clinician-educator teaching remains unclear. The goal of this study was to review the literature to identify motivations and perceived barriers to clinician-educators, which in turn will improve clinician-educator training programs to better align with clinician-educator needs and concerns. Review of medical education literature using the terms "attitudes", "motivations", "physicians", "teaching", and "undergraduate medical education" resulted in identification of key themes revealing the primary motivations and barriers involved in physicians teaching undergraduate medical students. A synthesis of articles revealed that physicians are primarily motivated to teach undergraduate students for intrinsic reasons. To a lesser extent, physicians are motivated to teach for extrinsic reasons, such as rewards or recognition. The key barriers deterring physicians from teaching medical students included: decreased productivity, lack of compensation, increased length of the working day, patient concerns/ethical issues, and lack of confidence in their own ability. Our findings suggest that optimization of clinician-educator training programs should address, amongst other factors, time management concerns, appropriate academic recognition for teaching service, and confidence in teaching ability. Addressing these issues may increase the retention of clinicians who are active and proficient in medical education.

Tombes et cimetières éthiopiens : des rois, des saints, des anonymes1

OpenAIRE

Derat, Marie-Laure

2009-01-01

L’histoire des tombes et cimetières éthiopiens, dans la longue durée, en est encore à ses balbutiements. Si les tombes des saints et des rois nous sont un peu mieux connus grâce à des textes témoignant à la fois des enjeux entourant les sépultures de ces personnages hors du commun et des soins apportés à leur inhumation, en revanche, les cimetières ordinaires échappent encore largement à l’enquête, en grande partie parce que le commun des mortels est inhumé dans l’anonymat et dans un grand dé...

Évaluation des pratiques agricoles des légumes feuilles : le cas des ...

African Journals Online (AJOL)

Face à ce constat, le défi de la recherche serait la détermination du niveau actuel de contamination des légumes feuilles et des eaux du barrage et celui de l'État serait l'initiation de programmes de sensibilisation des producteurs par rapport à une gestion plus rigoureuse des pesticides. Mots-clés : pratiques paysannes, ...

La convergence des rôles respectifs des relationnistes et des journalistes influence-t-elle la perception qu'ils ont les uns des autres?

DEFF Research Database (Denmark)

Valentini, Chiara

2017-01-01

la convergence des rôles respectifs des praticiens des relations publiques et des journalistes a un effet favorable sur la perception qu’ils ont les uns des autres. L’effet est plus marqué chez les praticiens des relations publiques, car leur vision de la profession en journalisme correspond à celle...

Mécanique des sols et des roches

CERN Document Server

Vullier, Laurent; Zhao, Jian

2016-01-01

La mécanique des sols et la mécanique des roches sont des disciplines généralement traitées séparément dans la littérature. Pour la première fois, un traité réunit ces deux spécialités, en intégrant également les connaissances en lien avec les écoulements souterrains et les transferts thermiques. A la fois théorique et pratique, cet ouvrage propose tout d'abord une description détaillée de la nature et de la composition des sols et des roches, puis s'attache à la modélisation de problèmes aux conditions limites et présente les essais permettant de caractériser les sols et les roches, tant d'un point de vue mécanique qu'hydraulique et thermique. La problématique des sols non saturés et des écoulements multiphasiques est également abordée. Une attention particulière est portée aux lois de comportement mécanique et à la détermination de leurs paramètres par des essais in situ et en laboratoire, et l'ouvrage offre également une présentation détaillée des systèmes de classi...

Communicating prognosis with parents of critically ill infants: direct observation of clinician behaviors.

Science.gov (United States)

Boss, R D; Lemmon, M E; Arnold, R M; Donohue, P K

2017-11-01

Delivering prognostic information to families requires clinicians to forecast an infant's illness course and future. We lack robust empirical data about how prognosis is shared and how that affects clinician-family concordance regarding infant outcomes. Prospective audiorecording of neonatal intensive care unit family conferences, immediately followed by parent/clinician surveys. Existing qualitative analysis frameworks were applied. We analyzed 19 conferences. Most prognostic discussion targeted predicted infant functional needs, for example, medications or feeding. There was little discussion of how infant prognosis would affect infant/family quality of life. Prognostic framing was typically optimistic. Most parents left the conference believing their infant's prognosis to be more optimistic than did clinicians. Clinician approach to prognostic disclosure in these audiotaped family conferences tended to be broad and optimistic, without detail regarding implications of infant health for infant/family quality of life. Families and clinicians left these conversations with little consensus about infant prognosis.

How can clinician-educator training programs be optimized to match clinician motivations and concerns?

Directory of Open Access Journals (Sweden)

McCullough B

2015-01-01

Full Text Available Brendan McCullough, Gregory E Marton, Christopher J Ramnanan Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada Background: Several medical schools have implemented programs aimed at supporting clinician-educators with formal mentoring, training, and experience in undergraduate medical teaching. However, consensus program design has yet to be established, and the effectiveness of these programs in terms of producing quality clinician-educator teaching remains unclear. The goal of this study was to review the literature to identify motivations and perceived barriers to clinician-educators, which in turn will improve clinician-educator training programs to better align with clinician-educator needs and concerns. Methods: Review of medical education literature using the terms “attitudes”, “motivations”, “physicians”, “teaching”, and “undergraduate medical education” resulted in identification of key themes revealing the primary motivations and barriers involved in physicians teaching undergraduate medical students. Results: A synthesis of articles revealed that physicians are primarily motivated to teach undergraduate students for intrinsic reasons. To a lesser extent, physicians are motivated to teach for extrinsic reasons, such as rewards or recognition. The key barriers deterring physicians from teaching medical students included: decreased productivity, lack of compensation, increased length of the working day, patient concerns/ethical issues, and lack of confidence in their own ability. Conclusion: Our findings suggest that optimization of clinician-educator training programs should address, amongst other factors, time management concerns, appropriate academic recognition for teaching service, and confidence in teaching ability. Addressing these issues may increase the retention of clinicians who are active and proficient in medical education. Keywords: clinician-educators, teaching, undergraduate medical

« Société de l'information », deuxième époque ? Transformation du statut de l'usage des TIC au travers des nouvelles propriétés des objets communicants

OpenAIRE

Weygand, Félix

2007-01-01

Notre contribution présente brièvement ce qu'on décrit actuellement comme de nouvelles ruptures techniques en cours dans les TIC. Il s'agira d'une part de repérer les « effets de mode » contenus dans ces descriptions, qui reprennent des appréhensions ou des enthousiasmes récurrents dès que l'on est confronté à des ruptures techniques, d'autre part de s'interroger sur la pertinence de nos outils d'analyse des innovations face à ces éventuelles ruptures. En effet, indépendamment de l'opinion op...

Knowledge management strategies: Enhancing knowledge transfer to clinicians and patients.

Science.gov (United States)

Roemer, Lorrie K; Rocha, Roberto A; Del Fiol, Guilherme; Bradshaw, Richard L; Hanna, Timothy P; Hulse, Nathan C

2006-01-01

At Intermountain Healthcare (Intermountain), executive clinical content experts are responsible for disseminating consistent evidence-based clinical content throughout the enterprise at the point-of-care. With a paper-based system it was difficult to ensure that current information was received and was being used in practice. With electronic information systems multiple applications were supplying similar, but different, vendor-licensed and locally-developed content. These issues influenced the consistency of clinical practice within the enterprise, jeopardized patient and clinician safety, and exposed the enterprise and its employees to potential financial penalties. In response to these issues Intermountain is developing a knowledge management infrastructure providing tools and services to support clinical content development, deployment, maintenance, and communication. The Intermountain knowledge management philosophy includes strategies guiding clinicians and consumers of health information to relevant best practice information with the intention of changing behaviors. This paper presents three case studies describing different information management problems identified within Intermountain, methods used to solve the problems, implementation challenges, and the current status of each project.

The Texts of the Agency's Agreements with the United Nations; Texte Des Accords Conclus Entre L'Agence Et L'Organisation Des Nations Unies

Energy Technology Data Exchange (ETDEWEB)

NONE

1959-10-30

The texts of the following agreements and supplementary agreements between the Agency and the United Nations are reproduced in this document for the information of all Members of the Agency: I. A. Agreement Governing the Relationship Between the United Nations and the International Atomic Energy Agency; B. Protocol Concerning the Entry into Force of the Agreement between the United Nations and the International Atomic Energy Agency; II. Administrative Arrangement Concerning the Use of the United Nations Laissez-Passer by Officials of the International Atomic Energy Agency; and III. Agreement for the Admission of the International Atomic Energy Agency into the United Nations Joint Staff Pension Fund [French] Le texte des accords et des accords additionnels ci-apres, conclus entre l'Agence et l'Organisation des Nations Unies, est reproduit dans le present document pour l'information de tous les Membres de l'Agence. A.Accord regissant les relations entre l'Organisation des Nations Unies et l'Agence internationale de l'energie atomique; B.Protocole relatif a l'entree en vigueur de l'accord conclu entre l'Organisation des Nations Unies et l'Agence internationale de l'energie atomique; II.Dispositions administratives concernant l'utilisation du laissez-passer de l'Organisation des Nations Unies par les fonctionnaires de l'Agence internationale de l'energie atomique; III.Accord en vue de l'admission de l'Agence internationale de l'energie atomique a la Caisse commune des pensions du personnel des Nations Unies.

Google maps - Google entre dans le monde des systèmes d'information géographique

OpenAIRE

Ingensand, Jens

2005-01-01

Avec Google Maps, le mammouth de la recherche sur l'internet riposte aux services de cartes existants, comme Yahoo Maps, Mapquest, Map24, etc. Ces services permettent notamment de consulter des cartes présentant de multiples fonctionnalités de recherche et de visualisation d'informations. Google vient par ailleurs de lancer sur le marché Google Earth - un programme qui reproduit les données de Google Maps en trois dimensions.

Use of laboratory test results in patient management by clinicians in Malawi.

Science.gov (United States)

Moyo, Kundai; Porter, Carol; Chilima, Ben; Mwenda, Reuben; Kabue, Mark; Zungu, Lutho; Sarr, Abdoulaye

2015-11-18

Malawi has a high burden of infectious disease. The expansion of programmes targeting these diseases requires a strong laboratory infrastructure to support both diagnosis and treatment. To assess the use of laboratory test results in patient management and to determine the requirements for improving laboratory services. A cross-sectional study was conducted in 2012 to survey practising clinicians. Two hospitals were purposively selected for observations of clinicians ordering laboratory tests. Twelve management-level key informants were interviewed. Descriptive statistics were conducted. A total of 242 clinicians were identified and 216 (89%) were interviewed. Of these, 189 (87%) reported doubting laboratory test results at some point. Clinicians most often doubted the quality of haematology (67%), followed by malaria (53%) and CD4 (22%) test results. A total of 151 (70%) clinicians reported using laboratory tests results in patient management. Use of laboratory test results at all times in patient management varied by the type of health facility ( P management. Key informants reported that the quality of laboratory services was good and useful, but that services were often unavailable. Gaps in the public laboratory system were evident. Key recommendations to enhance the use of laboratory test results in patient management were to strengthen the supply chain, reduce turn-around times, improve the test menu and improve the laboratory infrastructure.

Évaluation des pratiques agricoles des légumes feuilles : le cas des ...

African Journals Online (AJOL)

SARAH

30 sept. 2017 ... ... de Biochimie et Immunologie Appliquée, Centre de Recherche en Sciences Biologiques, Alimentaires et .... l'intoxication des agriculteurs et des consommateurs, ... source d'alimentation en eau et au pouvoir d'achat des.

Effects of clinical communication interventions in hospitals: a systematic review of information and communication technology adoptions for improved communication between clinicians.

Science.gov (United States)

Wu, Robert C; Tran, Kim; Lo, Vivian; O'Leary, Kevin J; Morra, Dante; Quan, Sherman D; Perrier, Laure

2012-11-01

To conduct a systematic review of the literature to identify, describe and assess interventions of information and communication technology on the processes of communication and associated patient outcomes within hospital settings. Studies published from the years 1996 to 2010 were considered and were selected if they described an evaluation of information and communication technology interventions to improve clinical communication within hospitals. Two authors abstracted data from full text articles, and the quality of individual articles were appraised. Results of interventions were summarized by their effect. There were 18 identified studies that evaluated the use of interventions that included alphanumeric paging, hands-free communication devices, mobile phones, smartphones, task management systems and a display based paging system. Most quantitative studies used a before and after study design and were of lower quality. Of all the studies, there was only one prospective randomized study, but this study used only simulated communication events. Quantitative studies identified improved perceptions of communication and some improvement in communication metrics. Qualitative studies described improvements in efficiency of communication but also issues of loss of control and reliability. Despite the rapid advancement in information and communications technology over the last decade, there is limited evidence suggesting improvements in the ability of health professionals to communicate effectively. Given the critical nature of communication, we advocate further evaluation of information and communication technology designed to improve communication between clinicians. Outcome measures should include measures of patient-oriented outcomes and efficiency for clinicians. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Modelisation des effets physico-techniques pour la conception des ...

African Journals Online (AJOL)

automatisation dans les installations industrielles a besoin d'une régulation automatique des commandes des processus technologiques pour lesquelles certaines contraintes sont à relever compte tenu des exigences des innovations scientifiques de ...

Agent des systèmes d'information financière (h/f) | CRDI - Centre de ...

International Development Research Centre (IDRC) Digital Library (Canada)

Répondre directement aux demandes des utilisateurs formulées par courriel ou par téléphone ou par l'entremise du système de gestion des appels de dépannage. Communiquer au besoin avec les fournisseurs de logiciels et le personnel responsable des TI pour régler les problèmes rencontrés par les utilisateurs finaux ...

L’OCDE évalue les compétences des adultes

OpenAIRE

Bardi, Anne-Marie

2014-01-01

Une dizaine d’années après les premiers résultats du Programme international de suivi des acquis des élèves (PISA), l’Organisation de coopération et de développement économiques (OCDE) livre une étude sur les compétences des adultes de 16 à 65 ans. Ce nouveau Programme pour l’évaluation internationale des compétences des adultes (PIIAC) est conçu en cycles, dont le premier s’achève en 2013. Il vise à informer sur la maîtrise des compétences jugées indispensables pour évoluer dans un monde hyp...

Vecteurs Singuliers des Theories des Champs Conformes Minimales

Science.gov (United States)

Benoit, Louis

En 1984 Belavin, Polyakov et Zamolodchikov revolutionnent la theorie des champs en explicitant une nouvelle gamme de theories, les theories quantiques des champs bidimensionnelles invariantes sous les transformations conformes. L'algebre des transformations conformes de l'espace-temps presente une caracteristique remarquable: en deux dimensions elle possede un nombre infini de generateurs. Cette propriete impose de telles conditions aux fonctions de correlations qu'il est possible de les evaluer sans aucune approximation. Les champs des theories conformes appartiennent a des representations de plus haut poids de l'algebre de Virasoro, une extension centrale de l'algebre conforme du plan. Ces representations sont etiquetees par h, le poids conforme de leur vecteur de plus haut poids, et par la charge centrale c, le facteur de l'extension centrale, commune a toutes les representations d'une meme theorie. Les theories conformes minimales sont constituees d'un nombre fini de representations. Parmi celles-ci se trouvent des theories unitaires dont les representation forment la serie discrete de l'algebre de Virasoro; leur poids h a la forme h_{p,q}(m)=[ (p(m+1) -qm)^2-1] (4m(m+1)), ou p,q et m sont des entiers positifs et p+q= 2. Ces representations possedent un sous-espace invariant engendre par deux sous-representations avec h_1=h_{p,q} + pq et h_2=h_{p,q} + (m-p)(m+1-q) dont chacun des vecteurs de plus haut poids portent le nom de vecteur singulier et sont notes respectivement |Psi _{p,q}> et |Psi_{m-p,m+1-q}>. . Les theories super-conformes sont une version super-symetrique des theories conformes. Leurs champs appartiennent a des representation de plus haut poids de l'algebre de Neveu-Schwarz, une des deux extensions super -symetriques de l'algebre de Virasoro. Les theories super -conformes minimales possedent la meme structure que les theories conformes minimales. Les representations sont elements de la serie h_{p,q}= [ (p(m+2)-qm)^2-4] /(8m(m+2)) ou p,q et m sont

A qualitative study examining methods of accessing and identifying research relevant to clinical practice among rehabilitation clinicians

Directory of Open Access Journals (Sweden)

Patel D

2017-12-01

Full Text Available Drasti Patel,1 Christine Koehmstedt,1 Rebecca Jones,1 Nathan T Coffey,1 Xinsheng Cai,2 Steven Garfinkel,2 Dahlia M Shaewitz,2 Ali A Weinstein1 1Center for Study of Chronic Illness and Disability, College of Health and Human Services, George Mason University, Fairfax, VA, 2American Institutes for Research, Washington, DC, USA Purpose: Research examining the utilization of evidence-based practice (EBP specifically among rehabilitation clinicians is limited. The objective of this study was to examine how various rehabilitative clinicians including physical therapists, occupational therapists, rehabilitation counselors, and physiatrists are gaining access to literature and whether they are able to implement the available research into practice.Methods: A total of 21 total clinicians were interviewed via telephone. Using NVivo, a qualitative analysis of the responses was performed.Results: There were similarities found with respect to the information-seeking behaviors and translation of research across the different clinician types. Lack of time was reported to be a barrier for both access to literature and implementation of research across all clinician types. The majority of clinicians who reported having difficulty with utilizing the published literature indicated that the literature was not applicable to their practice, the research was not specific enough to be put into practice, or the research found was too outdated to be relevant. In addition, having a supportive work environment aided in the search and utilization of research through providing resources central to assisting clinicians in gaining access to health information.Conclusion: Our study identified several barriers that affect EBP for rehabilitation clinicians. The findings suggest the need for researchers to ensure that their work is applicable and specific to clinical practice for implementation to occur. Keywords: health information, information behavior, knowledge utilization

Utilisation sans risque des eaux usées, des excréta et des eaux ...

International Development Research Centre (IDRC) Digital Library (Canada)

Les responsables de ce projet piloteront l'application et l'adaptation des principes directeurs relatifs à l'utilisation sans risque des eaux usées, des excreta et des eaux grises en agriculture et en aquaculture (Guidelines for the Safe Use of Wastewater, Excreta and Greywater in Agriculture and Aquaculture), que ...

Outil d'évaluation de l'application des lois sur l'accès à l'information ...

International Development Research Centre (IDRC) Digital Library (Canada)

Des essais pilotes de l'IAT ont été réalisés en Afrique du Sud, au Bangladesh et au Mexique, avec l'appui de la Fondation William et Flora Hewlett. Ce financement permettra de réaliser d'autres essais dans jusqu'à sept pays, y compris les trois pays pilotes. Dans les sept pays, on fera appel au commissaire à l'information ...

ANALYSE DES PERCEPTIONS LOCALES ET DES FACTEURS ...

African Journals Online (AJOL)

AISA

1Faculté des Sciences Agronomiques (FSA), Université d'Abomey-Calavi (UAC), 01 BP 526 Cotonou Bénin. Email : cgbemavo@yahoo.fr. 2Institut National des Recherches Agricoles du Bénin, Centre de Recherches Agricoles d'Agonkanmey (CRA-A),. Laboratoire des Sciences du Sol, Eau et Environnement (LSSEE).

Review of Fusion Systems and Contributing Technologies for SIHS-TD (Examen des Systemes de Fusion et des Technologies d’Appui pour la DT SIHS)

Science.gov (United States)

2007-03-31

objective evaluation were identified: methods based on statistical characteristics, methods based on definition, methods based on information theory ...des auteurs et des documents connus, puis à suivre les références qu’ils fournissaient à d’autres ouvrages. À la fin de la recherche, environ 150...Information Theory .....................................54 4.3.3.2.4 Objective Evaluation Based on Important Features

variabilite des productions et des revenus des exploitations

African Journals Online (AJOL)

3Centre de coopération internationale en recherche agronomique pour le développement (CIRAD), UMR Innovation,. Montpellier, France. Doubangolo COULIBALY, Email kone_b@yahoo.fr. RESUME. La durabilité des systèmes de production à base de coton dans un contexte de variabilité des prix aux producteurs et de ...

Le statut vitaminique des individus et des populations…

Directory of Open Access Journals (Sweden)

Icart Jean-Claude

2000-05-01

Full Text Available Comme le souligne un récent rapport du Haut comité de santé publique, le statut vitaminique des individus et des populations demeure une question d’actualité. Si les études ne révèlent plus de signes évocateurs de carence, au plus des problèmes de déficiences pour certains groupes à risque, des interrogations, demeurent malgré le contexte d’abondance, concernant la couverture des besoins, laquelle pourrait s’avérer inférieure aux valeurs considérées comme satisfaisantes.

Application des TIC à l'atténuation des effets des catastrophes dans ...

International Development Research Centre (IDRC) Digital Library (Canada)

L'Amérique centrale est souvent aux prises avec des inondations et des ... (SIG) et de traitement des images, afin de cartographier les dangers et de modéliser les ... de l'Institut d'étude du développement international de l'Université McGill.

Model of critical diagnostic reasoning: achieving expert clinician performance.

Science.gov (United States)

Harjai, Prashant Kumar; Tiwari, Ruby

2009-01-01

Diagnostic reasoning refers to the analytical processes used to determine patient health problems. While the education curriculum and health care system focus on training nurse clinicians to accurately recognize and rescue clinical situations, assessments of non-expert nurses have yielded less than satisfactory data on diagnostic competency. The contrast between the expert and non-expert nurse clinician raises the important question of how differences in thinking may contribute to a large divergence in accurate diagnostic reasoning. This article recognizes superior organization of one's knowledge base, using prototypes, and quick retrieval of pertinent information, using similarity recognition as two reasons for the expert's superior diagnostic performance. A model of critical diagnostic reasoning, using prototypes and similarity recognition, is proposed and elucidated using case studies. This model serves as a starting point toward bridging the gap between clinical data and accurate problem identification, verification, and management while providing a structure for a knowledge exchange between expert and non-expert clinicians.

Controle optique de qubits lies a des centres isoelectroniques d'azote dans le GaAs

Science.gov (United States)

Ethier-Majcher, Gabriel

Le traitement de l'information quantique est un domaine de recherche actuellement en pleine effervescence car il laisse entrevoir une revolution dans notre facon de traiter et d'echanger de l'information. D'une part, l'ordinateur quantique promet de resoudre des problemes comme la factorisation d'un polynome de facon beaucoup plus efficace qu'un ordinateur classique. D'autre part, les communications quantiques promettent l'echange d'information de facon fondamentalement inviolable. Afin de tirer pleinement profit de ces nouvelles technologies, il sera avantageux de construire des reseaux quantiques. Dans un tel reseau, des processeurs quantiques, les noeuds, seront connectes par des photons voyageant dans des fibres optiques. Les reseaux quantiques permettront de deployer les communications quantiques a grande echelle et de creer des super-ordinateurs quantiques. La realisation de reseaux quantiques necessitera des interfaces optiques pouvant echanger l'information de facon coherente entre un qubit (bit d'information quantique) et un photon. L'implementation de telles interfaces dans un systeme physique s'avere un important defi scientifique et technologique. Or, les systemes actuellement envisages a cette fin souffrent d'un faible couplage avec la lumiere ou encore de grandes inhomogeneites, constituant des obstacles a la realisation de reseaux a grande echelle. Dans cette these, le potentiel des centres isoelectroniques pour realiser des interfaces optiques est evalue. Deux types de qubits lies a des paires d'azote dans le GaAs sont consideres : les qubits excitoniques et les qubits de spin electronique, controlables par l'intermediaire d'excitons charges. Le controle optique complet des qubits excitoniques est demontre, ce qui constitue la premiere realisation du genre dans les centres isoelectroniques. L'observation d'excitons charges dans ce systeme, liant a la fois des trous lourds et des trous legers, laisse entrevoir de nouvelles possibilites afin de

Designing User-Centric Patient Portals: Clinician and Patients' Uses and Gratifications.

Science.gov (United States)

Alpert, Jordan M; Krist, Alex H; Aycock, Rebecca A; Kreps, Gary L

2017-03-01

Legislation mandates that clinicians make patients' medical information available digitally. This has resulted in hurriedly installing patient portals that do not fully meet the needs of patients or clinicians. This study examined a specific portal, MyPreventiveCare (MPC), a patient-centered portal designed to promote preventive care to consumers, to elicit recommendations from patients and clinicians about how it could be more beneficial by uncovering their uses and gratifications (U&G). In-depth interviews with 31 patients and two clinician focus groups were conducted. Multiple methods were utilized, such as grounded theory coding to develop themes and content analysis to classify responses according to the U&G framework. Four main categories emerged that users desire to be included in health portals: integration with technology (27%), coordination of care (27%), incorporation of lifestyle (26%), and increased control (20%). Additional analysis revealed that health portals are mainly utilized to fulfill cognitive and affective needs, with over 80% of recommendations related to the U&G categories of cognitive and affective needs. Cognitive (60%), affective (21%), social integrative (10%), personal integrative (9%), and tension release (0%). Portals will continue to evolve and become important health communication tools if they address the user's perspective and are inclusive of new technological advances. Specifically, portals must become more user centric and incorporate aspects of the patients' lifestyle and integrate health information technology.

On a learning curve for shared decision making: Interviews with clinicians using the knee osteoarthritis Option Grid.

Science.gov (United States)

Elwyn, Glyn; Rasmussen, Julie; Kinsey, Katharine; Firth, Jill; Marrin, Katy; Edwards, Adrian; Wood, Fiona

2018-02-01

Tools used in clinical encounters to illustrate to patients the risks and benefits of treatment options have been shown to increase shared decision making. However, we do not have good information about how these tools are viewed by clinicians and how clinicians think patients would react to their use. Our aim was to examine clinicians' views about the possible and actual use of tools designed to support patients and clinicians to collaborate and deliberate about treatment options, namely, Option Grid decision aids. We conducted a thematic analysis of qualitative interviews embedded in the intervention phase of a trial of an Option Grid decision aid for osteoarthritis of the knee. Interviews were conducted with 6 participating clinicians before they used the tool and again after clinicians had used the tool with 6 patients. In the first interview, clinicians voiced concerns that the tool would lead to an increase in encounter duration, patient resistance regarding involvement in decision making, and potential information overload. At the second interview, after minimal training, the clinicians reported that the tool had changed their usual way of communicating, and it was generally acceptable and helpful to integrate it into practice. After experiencing the use of Option Grids, clinicians became more willing to use the tools in their clinical encounters with patients. How best to introduce Option Grids to clinicians and adopt their use into practice will need careful consideration of context, workflow, and clinical pathways. © 2016 John Wiley & Sons, Ltd.

Sommaires des demandes d'accès à l'information complétées en 2016

International Development Research Centre (IDRC) Digital Library (Canada)

Liste de tous les contrats émis par le Centre de recherches pour le développement international durant la période du 1er avril 2015 au 31 mars 2016, y compris a) les noms des fournisseurs; b) les numéros de référence des contrats; c) les dates des contrats; d) la description des services fournis; e) les dates de livraison; ...

The clinician's dilemma: two dimensions of ethical care.

Science.gov (United States)

Gillett, Grant; Chamberlain, Joshua

2013-01-01

There is a continuing intense medico-ethico-legal debate around legalized euthanasia and physician assisted suicide such that ethically informed clinicians often agree with the arguments but feel hesitant about the conclusion, especially when it may bring about a change in law. We argue that this confusion results from the convergence of two continua that underpin the conduct of a clinician and are especially prominent in psychiatry. The two continua concern the duty of care and the importance of patient autonomy and they do not quite map into traditional divides in debates about sanctity of life, paternalism, and autonomy. As ethical dimensions, they come into sharp focus in the psychological complexities of end-of-life care and they form two key factors in most ethical and legal or disciplinary deliberations about a clinician's actions. Whereas both dimensions are important when a clinician reflects on what s/he has done or should do, they need careful balancing in a request for euthanasia or physician assisted suicide where the patient wants to take a decisive role in his or her own end-of-life care. However, end-of-life is also a situation where clinicians often encounter 'cries for help' so that both continua are importantly in play. Balancing these two continua without using blunt legal instruments is often required in psychiatric care in such a way as to problematize the idea that patient decisions should dominate the care options available. A simplistic approach to that issue arguably plays into what has been called an 'impoverished construction of life and death' and, some would say, devalues the basic commitments fundamental to medical care. Copyright © 2013 Elsevier Ltd. All rights reserved.

Stigma in the mental health workplace: perceptions of peer employees and clinicians.

Science.gov (United States)

Stromwall, Layne K; Holley, Lynn C; Bashor, Kathy E

2011-08-01

Informed by a structural theory of workplace discrimination, mental health system employees' perceptions of mental health workplace stigma and discrimination against service recipients and peer employees were investigated. Fifty-one peer employees and 52 licensed behavioral health clinicians participated in an online survey. Independent variables were employee status (peer or clinician), gender, ethnicity, years of mental health employment, age, and workplace social inclusion of peer employees. Analysis of covariance on workplace discrimination against service recipients revealed that peer employees perceived more discrimination than clinicians and whites perceived more discrimination than employees of color (corrected model F = 9.743 [16, 87], P = .000, partial ŋ (2) = .644). Analysis of covariance on workplace discrimination against peer employees revealed that peer employees perceived more discrimination than clinicians (F = 4.593, [6, 97], P = .000, partial ŋ (2) = .223).

La gestion des résultats des entreprises innovantes

OpenAIRE

Dumas, Guillaume

2014-01-01

Cette thèse s’intéresse à la gestion des résultats dans le cadre des entreprises innovantes. Elle est constituée de trois articles. Dans le premier, il s’agit d’examiner si les résultats des entreprises innovantes sont gérés et si le stade de développement des innovations influence cette gestion des résultats. Il apparaît que les résultats des entreprises innovantes sont gérés à la hausse. Cette gestion ne semble intervenir qu’au cours de l’activité d’innovation (c’est-à-dire lorsque les entr...

Etude des erreurs d'estimation des populations par la méthode des captures successives (DeLURY, 2 captures et des captures-recaptures (PETERSEN

Directory of Open Access Journals (Sweden)

LAURENT M.

1978-01-01

Full Text Available L'estimation des populations naturelles par capture-recapture et par captures successives est souvent entachée d'erreur car, dans de nombreux cas, l'hypothèse fondamentale d'égalité des probabilités de captures pour tous les individus dans le temps et dans l'espace n'est pas respectée. Dans le cas des populations de poissons envisagés ici, les captures ont lieu par la pêche électrique. On a pu chiffrer l'ordre de grandeur des erreurs systématiques faites sur l'estimation des peuplements, en fonction des conditions particulières, biotiques et abiotiques, des différents milieux inventoriés.

An overview of meta-analysis for clinicians

Science.gov (United States)

Lee, Young Ho

2018-01-01

The number of medical studies being published is increasing exponentially, and clinicians must routinely process large amounts of new information. Moreover, the results of individual studies are often insufficient to provide confident answers, as their results are not consistently reproducible. A meta-analysis is a statistical method for combining the results of different studies on the same topic and it may resolve conflicts among studies. Meta-analysis is being used increasingly and plays an important role in medical research. This review introduces the basic concepts, steps, advantages, and caveats of meta-analysis, to help clinicians understand it in clinical practice and research. A major advantage of a meta-analysis is that it produces a precise estimate of the effect size, with considerably increased statistical power, which is important when the power of the primary study is limited because of a small sample size. A meta-analysis may yield conclusive results when individual studies are inconclusive. Furthermore, meta-analyses investigate the source of variation and different effects among subgroups. In summary, a meta-analysis is an objective, quantitative method that provides less biased estimates on a specific topic. Understanding how to conduct a meta-analysis aids clinicians in the process of making clinical decisions. PMID:29277096

An overview of meta-analysis for clinicians.

Science.gov (United States)

Lee, Young Ho

2018-03-01

The number of medical studies being published is increasing exponentially, and clinicians must routinely process large amounts of new information. Moreover, the results of individual studies are often insufficient to provide confident answers, as their results are not consistently reproducible. A meta-analysis is a statistical method for combining the results of different studies on the same topic and it may resolve conflicts among studies. Meta-analysis is being used increasingly and plays an important role in medical research. This review introduces the basic concepts, steps, advantages, and caveats of meta-analysis, to help clinicians understand it in clinical practice and research. A major advantage of a meta-analysis is that it produces a precise estimate of the effect size, with considerably increased statistical power, which is important when the power of the primary study is limited because of a small sample size. A meta-analysis may yield conclusive results when individual studies are inconclusive. Furthermore, meta-analyses investigate the source of variation and different effects among subgroups. In summary, a meta-analysis is an objective, quantitative method that provides less biased estimates on a specific topic. Understanding how to conduct a meta-analysis aids clinicians in the process of making clinical decisions.

'Learning Organizations': a clinician's primer.

Science.gov (United States)

O'Connor, Nick; Kotze, Beth

2008-06-01

Most clinicians are poorly informed in relation to the key concepts of organizational learning. Yet the paradigm may offer clinicians a powerful method for using their knowledge and skills to respond to the demands of a changing environment through experimentation and learning. The concept is critically examined. Organizational learning principles are presented, including a conceptual framework for assessing health services as Learning Organizations. Barriers to organizational learning and strategies to overcome these are discussed. The seminal works of Argyris and Senge are reviewed and a framework for assessing organizational learning in health services is proposed. Current area health service actions are evaluated against the 'diagnostic' framework for a Learning Organization. Although critical examination reveals a poor empirical basis for the concept, the metaphor of the Learning Organization provides a useful conceptual framework and tools for individuals and organizations to apply in developing knowledge and effecting change. The Clinical Practice Improvement and Root Cause Analysis programs being conducted across NSW area health services meet the criteria for effective organizational learning. Key concepts from organizational learning theory provide a diagnostic framework for evaluating area health services as Learning Organizations and support two current strategies for overcoming barriers to organizational learning.

Classification des apports d’Internet à l’apprentissage des langues Classification of the Internet Contribution to Language Learning

Directory of Open Access Journals (Sweden)

François Mangenot

1998-12-01

Full Text Available Cet article tente de classer les apports d’Internet à l’enseignement/apprentissage des langues en partant de l’approche centrée sur la tâche. Les exemples sont empruntés au FLE. L’unité classificatoire, appelée "ressource", n’est pas constituée simplement de ce que l’on trouve sur Internet (contenus des "pages" et sites, canaux de communication mais cherche aussi à prendre en compte, en les distinguant, l’activité de l’enseignant et celle de l’apprenant. Selon que l’on considère l’une ou l’autre des deux facettes d’Internet, l’information ou la communication, ressortent alors deux notions : concernant la recherche d’informations, on considère qu’il est fondamental que celle-ci soit guidée par des tâches ; concernant la communication, c’est la notion de projet qui est évoquée.This paper attempts to classify the contribution of the Internet to language teaching and learning. The approach is task-oriented and the examples use French as a Foreign Language. It is shown that the definition of a classifying unit, or "resource", should take account not only of the contents of the Internet (Web Pages, Web sites and communication tools, but should also consider what the teacher or learner are to do with these resources. From both aspects of the Internet, information and communication, arise two important concepts, those of task and project. The best way for the teacher to guide the search of information consists in giving students a task ; designing projects will avoid ’empty’ communication.

TIC et microentreprises en milieu urbain : optimisation des ...

International Development Research Centre (IDRC) Digital Library (Canada)

La population des villes croît à un rythme plus rapide que l'ensemble de la population mondiale, surtout dans les pays en développement. Les technologies de l'information et de la communication (TIC), notamment la téléphonie mobile, semblent s'implanter partout très rapidement. On parle souvent des ...

Data processing in gamma spectrometry. Application to the decay schemes study; Traitement des informations en spectrometrie gamma application a l'etude de schemas de desintegration

Energy Technology Data Exchange (ETDEWEB)

Boulanger, J P [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires, departement d' electronique generale, service d' instrumentation nucleaire

1968-06-01

The purpose of this thesis is the processing of the data issued from a gamma spectrometer, and its applications to the decay schemes study. The mathematical analysis of the full energy peaks, in connection with the very good resolution of semi-conductor detectors, leads to a very accurate determination of the energies. The resolution of complex spectra by the least squares method, completed by a spectra generating process, allows the calculation of branching ratios. Then, the handling of the two dimensional experiments permits the coincidence exam. For each of these methods, the calculation principle, then the systematics tests realized in order to prove their validity and to determine their application ranges as well as some experimental results appropriate to illustrate their possibilities, are presented. The energies of some nuclides, frequently used as standards have been thus measured and the decay schemes of {sup 134}Cs and {sup 110m}Ag determined precisely. (author) [French] Cette these est consacree aux methodes de traitement des informations issues d'un spectrometre {gamma}, et a leur application a l'etude des schemas de desintegration: l'analyse mathematique des pics d'absorption totale, conjuguee avec l'excellent pouvoir de resolution des detecteurs semi-conducteurs, conduit a une determination tres precise des energies. La decomposition des spectres complexes par la methode des moindres carres, completee par un procede de generation de spectres, autorise le calcul des rapports de branchement. Enfin le depouillement des experiences biparametriques permet l'examen des coincidences. Pour chacune de ces methodes, on expose le principe des calculs et les essais systematiques effectues afin d'eprouver leur validite et de definir leurs domaines d'application, ainsi que quelques resultats experimentaux propres a illustrer leurs possibilites. Les energies de quelques isotopes utilises couramment comme etalons ont ainsi ete mesurees, et les schemas de

un_focus - Les femmes et la terre : Des droits fonciers pour une ...

International Development Research Centre (IDRC) Digital Library (Canada)

1 janv. 2011 ... Étonnamment, il existe peu d'informations détaillées sur le rapport des femmes à la terre, et encore moins de données provenant des femmes elles-mêmes. Le présent livre, qui s'inspire des travaux de recherche financés par le CRDI au fil des ans, vise à combler ce vide. Multimédia : Une playlist YouTube.

Les reseaux de politique publique comme facteur d'influence du choix des instruments de politique energetique canadienne a des fins environnementales de 1993 a nos jours

Science.gov (United States)

Fathy El Dessouky, Naglaa

Au cours de la derniere decennie, les modes de la gouvernance ont pris place dans un contexte totalement different de celui qu'ils avaient auparavant. Les gouvernements modernes se rendent compte qu'ils perdent de plus en plus leur capacite a elaborer et a gerer les changements d'une maniere autonome. Ainsi, les fonctions et les activites traditionnellement accomplies exclusivement par le gouvernement engagent de nos jours une gamme d'acteurs etatiques et non etatiques. A l'encontre du concept traditionnel de l'Etat controleur, la gouvernance contemporaine est ainsi devenue moins une question d'offre de service et davantage une gestion indirecte des reseaux de politique publique. Dans cette entreprise, les gouvernements contemporains, cherchant plus d'information, de soutien et de legitimite en matiere de formulation des decisions, ont besoin d'etablir des relations avec les divers groupes d'interet qui, a leur tour, voulaient plus de promotion et de protection en faveur de leurs interets a travers leur implication au processus de l'elaboration et de la mise en oeuvre des politiques publiques. Ainsi, l'approche des reseaux de politique publique represente aujourd'hui un courant considerable au sein du champ d'analyse des politiques publiques. Toutefois, les preoccupations des chercheurs pour cette approche, dans le domaine des politiques energetiques a des fins environnementales, semblent recentes, et les etudes realisees sont encore trop peu nombreuses. Au Canada, au debut des annees 1990, le gouvernement ainsi que plusieurs groupes d'interets, des differents secteurs energetique, industriel et environnemental, ont commence a intensifier leurs efforts pour s'attaquer au probleme du changement climatique d'origine energetique, genere surtout par le secteur de l'industrie. Au cours de la derniere decennie, la question touchant plutot le sujet du developpement energetique durable represente le plus important domaine des politiques publiques ayant surgi recemment dans

Injectabilite des coulis de ciment dans des milieux fissures

Science.gov (United States)

Mnif, Thameur

Le travail presente ici est un bilan du travaux de recherche effectues sur l'injectabilite des coulis de ciment dans lu milieux fissures. Un certain nombre de coulis a base de ciment Portland et microfin ont ete selectionnes afin de caracteriser leur capacite a penetrer des milieux fissures. Une partie des essais a ete menee en laboratoire. L'etude rheologique des differents melanges a permis de tester l'influence de l'ajout de superplastifiant et/ou de fumee de silice sur la distribution granulometrique des coulis et par consequent sur leur capacite a injecter des colonnes de sable simulant un milieu fissure donne. La classe granulometrique d'un coulis, sa stabilite et sa fluidite sont apparus comme les trois facteurs principaux pour la reussite d'une injection. Un facteur de finesse a ete defini au cours de cette etude: base sur la classe granulometrique du ciment et sa stabilite, il peut entrer dans la formulation theorique du debit d'injection avant application sur chantier. La deuxieme et derniere partie de l'etude presente les resultats de deux projets de recherche sur l'injection realises sur chantier. L'injection de dalles de beton fissurees a permis le suivi de l'evolution des pressions avec la distance au point d'injection. L'injection de murs de maconnerie a caractere historique a montre l'importance de la definition de criteres de performance des coulis a utiliser pour traiter un milieu donne et pour un objectif donne. Plusieurs melanges peuvent ainsi etre predefinis et mis a disposition sur le chantier. La complementarite des ciments traditionnels et des ciments microfins devient alors un atout important. Le choix d'utilisation de ces melanges est fonction du terrain rencontre. En conclusion, cette recherche etablit une methodologie pour la selection des coulis a base de ciment et des pressions d'injection en fonction de l'ouverture des fissures ou joints de construction.

La gouvernance des risques naturels et la problematique des ...

African Journals Online (AJOL)

Depuis quelques années, la gouvernance des risques naturels dus aux inondations remet en cause les processus de mise en oeuvre des politiques urbaines et la qualité de la structure des aménagements dans les grandes villes du Golfe de Guinée. La perception de la gouvernance et l'application des politiques de ...

Competing priorities in treatment decision-making: a US national survey of individuals with depression and clinicians who treat depression.

Science.gov (United States)

Barr, Paul J; Forcino, Rachel C; Mishra, Manish; Blitzer, Rachel; Elwyn, Glyn

2016-01-08

To identify information priorities for consumers and clinicians making depression treatment decisions and assess shared decision-making (SDM) in routine depression care. 20 questions related to common features of depression treatments were provided. Participants were initially asked to select which features were important, and in a second stage they were asked to rank their top 5 'important features' in order of importance. Clinicians were asked to provide rankings according to both consumer and clinician perspectives. Consumers completed CollaboRATE, a measure of SDM. Multiple logistic regression analysis identified consumer characteristics associated with CollaboRATE scores. Online cross-sectional surveys fielded in September to December 2014. We administered surveys to convenience samples of US adults with depression and clinicians who treat depression. Consumer sampling was targeted to reflect age, gender and educational attainment of adults with depression in the USA. Information priority rankings; CollaboRATE, a 3-item consumer-reported measure of SDM. 972 consumers and 244 clinicians completed the surveys. The highest ranked question for both consumers and clinicians was 'Will the treatment work?' Clinicians were aware of consumers' priorities, yet did not always prioritise that information themselves, particularly insurance coverage and cost of treatment. Only 18% of consumers reported high levels of SDM. Working with a psychiatrist (OR 1.87; 95% CI 1.07 to 3.26) and female gender (OR 2.04; 95% CI 1.25 to 3.34) were associated with top CollaboRATE scores. While clinicians know what information is important to consumers making depression treatment decisions, they do not always address these concerns. This mismatch, coupled with low SDM, adversely affects the quality of depression care. Development of a decision support intervention based on our findings can improve levels of SDM and provide clinicians and consumers with a tool to address the existing

Once a clinician, always a clinician: a systematic review to develop a typology of clinician-researcher dual-role experiences in health research with patient-participants

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E. Jean C. Hay-Smith

2016-08-01

Full Text Available Abstract Background Many health researchers are clinicians. Dual-role experiences are common for clinician-researchers in research involving patient-participants, even if not their own patients. To extend the existing body of literature on why dual-role is experienced, we aimed to develop a typology of common catalysts for dual-role experiences to help clinician-researchers plan and implement methodologically and ethically sound research. Methods Systematic searching of Medline, CINAHL, PsycINFO, Embase and Scopus (inception to 28.07.2014 for primary studies or first-person reflexive reports of clinician-researchers’ dual-role experiences, supplemented by reference list checking and Google Scholar scoping searches. Included articles were loaded in NVivo for analysis. The coding was focused on how dual-role was evidenced for the clinician-researchers in research involving patients. Procedures were completed by one researcher (MB and independently cross-checked by another (JHS. All authors contributed to extensive discussions to resolve all disagreements about initial coding and verify the final themes. Results Database searching located 7135 records, resulting in 29 included studies, with the addition of 7 studies through reference checks and scoping searches. Two overarching themes described the most common catalysts for dual-role experiences – ways a research role can involve patterns of behaviour typical of a clinical role, and the developing connection that starts to resemble a clinician-patient relationship. Five subthemes encapsulated the clinical patterns commonly repeated in research settings (clinical queries, perceived agenda, helping hands, uninvited clinical expert, and research or therapy and five subthemes described concerns about the researcher-participant relationship (clinical assumptions, suspicion and holding back, revelations, over-identification, and manipulation. Clinician-researchers use their clinical skills in health

Patient and Clinician Perspectives on Shared Decision-making in Early Adopting Lung Cancer Screening Programs: a Qualitative Study.

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Wiener, Renda Soylemez; Koppelman, Elisa; Bolton, Rendelle; Lasser, Karen E; Borrelli, Belinda; Au, David H; Slatore, Christopher G; Clark, Jack A; Kathuria, Hasmeena

2018-02-21

Guidelines recommend, and Medicare requires, shared decision-making between patients and clinicians before referring individuals at high risk of lung cancer for chest CT screening. However, little is known about the extent to which shared decision-making about lung cancer screening is achieved in real-world settings. To characterize patient and clinician impressions of early experiences with communication and decision-making about lung cancer screening and perceived barriers to achieving shared decision-making. Qualitative study entailing semi-structured interviews and focus groups. We enrolled 36 clinicians who refer patients for lung cancer screening and 49 patients who had undergone lung cancer screening in the prior year. Participants were recruited from lung cancer screening programs at four hospitals (three Veterans Health Administration, one urban safety net). Using content analysis, we analyzed transcripts to characterize communication and decision-making about lung cancer screening. Our analysis focused on the recommended components of shared decision-making (information sharing, deliberation, and decision aid use) and barriers to achieving shared decision-making. Clinicians varied in the information shared with patients, and did not consistently incorporate decision aids. Clinicians believed they explained the rationale and gave some (often purposely limited) information about the trade-offs of lung cancer screening. By contrast, some patients reported receiving little information about screening or its trade-offs and did not realize the CT was intended as a screening test for lung cancer. Clinicians and patients alike did not perceive that significant deliberation typically occurred. Clinicians perceived insufficient time, competing priorities, difficulty accessing decision aids, limited patient comprehension, and anticipated patient emotions as barriers to realizing shared decision-making. Due to multiple perceived barriers, patient-clinician

Importance des indices dans la récupération de l’information en mémoire: cas des élèves de 4ème année primaire, suivant le sexe et la classe d’âge

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Florence Gheloube Épouse Ndong Obiang

2017-06-01

Full Text Available La présente étude montre l’importance des indices dans la récupération de l’information en mémoire à court terme (MCT, car la mémoire des apprenants est constamment sollicitée lors des apprentissages. La tâche de rappel indicé a été administrée à 111 élèves de 4ème année des écoles primaires de Libreville. Le traitement de données a été effectué à l’aide du logiciel Statistica. L’analyse de variance indique que, quels que soient le sexe et l’âge il n’y a pas de différence. Mais, Alloway (2006 souligne que la MCT verbale évolue avec l’âge. L’analyse de corrélation révèle qu’il y a une corrélation fortement négative lorsqu’on compare les scores obtenus au rappel indicé correct (RICO, à ceux du rappel indicé incorrect (RINONCO et au nombre d’essais (RIESSAIS. Il est donc essentiel que les enseignants et les élèves aient connaissance et appliquent ces données pour permettre d’améliorer les pratiques des enseignants et les performances des élèves.

When to use discrete event simulation (DES) for the economic evaluation of health technologies? A review and critique of the costs and benefits of DES.

Science.gov (United States)

Karnon, Jonathan; Haji Ali Afzali, Hossein

2014-06-01

Modelling in economic evaluation is an unavoidable fact of life. Cohort-based state transition models are most common, though discrete event simulation (DES) is increasingly being used to implement more complex model structures. The benefits of DES relate to the greater flexibility around the implementation and population of complex models, which may provide more accurate or valid estimates of the incremental costs and benefits of alternative health technologies. The costs of DES relate to the time and expertise required to implement and review complex models, when perhaps a simpler model would suffice. The costs are not borne solely by the analyst, but also by reviewers. In particular, modelled economic evaluations are often submitted to support reimbursement decisions for new technologies, for which detailed model reviews are generally undertaken on behalf of the funding body. This paper reports the results from a review of published DES-based economic evaluations. Factors underlying the use of DES were defined, and the characteristics of applied models were considered, to inform options for assessing the potential benefits of DES in relation to each factor. Four broad factors underlying the use of DES were identified: baseline heterogeneity, continuous disease markers, time varying event rates, and the influence of prior events on subsequent event rates. If relevant, individual-level data are available, representation of the four factors is likely to improve model validity, and it is possible to assess the importance of their representation in individual cases. A thorough model performance evaluation is required to overcome the costs of DES from the users' perspective, but few of the reviewed DES models reported such a process. More generally, further direct, empirical comparisons of complex models with simpler models would better inform the benefits of DES to implement more complex models, and the circumstances in which such benefits are most likely.

A clinician-driven home care delivery system.

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August, D A; Faubion, W C; Ryan, M L; Haggerty, R H; Wesley, J R

1993-12-01

The financial, entrepreneurial, administrative, and legal forces acting within the home care arena make it difficult for clinicians to develop and operate home care initiatives within an academic setting. HomeMed is a clinician-initiated and -directed home care delivery system wholly owned by the University of Michigan. The advantages of a clinician-directed system include: Assurance that clinical and patient-based factors are the primary determinants of strategic and procedural decisions; Responsiveness of the system to clinician needs; Maintenance of an important role for the referring physician in home care; Economical clinical research by facilitation of protocol therapy in ambulatory and home settings; Reduction of lengths of hospital stays through clinician initiatives; Incorporation of outcome analysis and other research programs into the mission of the system; Clinician commitment to success of the system; and Clinician input on revenue use. Potential disadvantages of a clinician-based system include: Entrepreneurial, financial, and legal naivete; Disconnection from institutional administrative and data management resources; and Inadequate clinician interest and commitment. The University of Michigan HomeMed experience demonstrates a model of clinician-initiated and -directed home care delivery that has been innovative, profitable, and clinically excellent, has engendered broad physician, nurse, pharmacist, and social worker enthusiasm, and has supported individual investigator clinical protocols as well as broad outcomes research initiatives. It is concluded that a clinician-initiated and -directed home care program is feasible and effective, and in some settings may be optimal.

Systematic Heuristic Evaluation of Computerized Consultation Order Templates: Clinicians' and Human Factors Engineers' Perspectives.

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Savoy, April; Patel, Himalaya; Flanagan, Mindy E; Weiner, Michael; Russ, Alissa L

2017-08-01

We assessed the usability of consultation order templates and identified problems to prioritize in design efforts for improving referral communication. With a sample of 26 consultation order templates, three evaluators performed a usability heuristic evaluation. The evaluation used 14 domain-independent heuristics and the following three supplemental references: 1 new domain-specific heuristic, 6 usability goals, and coded clinicians' statements regarding ease of use for 10 sampled templates. Evaluators found 201 violations, a mean of 7.7 violations per template. Minor violations outnumbered major violations almost twofold, 115 (57%) to 62 (31%). Approximately 68% of violations were linked to 5 heuristics: aesthetic and minimalist design (17%), error prevention (16%), consistency and standards (14%), recognition rather than recall (11%), and meet referrers' information needs (10%). Severe violations were attributed mostly to meet referrers' information needs and recognition rather than recall. Recorded violations yielded potential negative consequences for efficiency, effectiveness, safety, learnability, and utility. Evaluators and clinicians demonstrated 80% agreement in usability assessment. Based on frequency and severity of usability heuristic violations, the consultation order templates reviewed may impede clinical efficiency and risk patient safety. Results support the following design considerations: communicate consultants' requirements, facilitate information seeking, and support communication. While the most frequent heuristic violations involved interaction design and presentation, the most severe violations lacked information desired by referring clinicians. Violations related to templates' inability to support referring clinicians' information needs had the greatest potential negative impact on efficiency and safety usability goals. Heuristics should be prioritized in future design efforts.

Structurations formelle et conceptuelle des articles de dictionnaires : le deuxième modèle de codification des articles dans l’histoire des dictionnaires Larousse

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Corbin Pierre

2016-01-01

Full Text Available La contribution soumise s’inscrit dans un ensemble d’études sur les codifications utilisées durant les cent-soixante ans d’histoire des dictionnaires Larousse pour distinguer, hiérarchiser et ordonner les informations figurant dans leurs articles, qui ont déjà donné lieu à deux publications. En prenant en compte différentes modalités de codification, que nous rappelons liminairement, nous repérons trois jalons majeurs dans ce riche catalogue. Le premier, qui trouve son origine dans le “Nouveau dictionnaire de la langue française” de 1856, ayant déjà été décrit, nous présentons ici le deuxième, ancré dans le “Grand dictionnaire universel du XIXe siècle” de 1866-1876, après l’avoir situé entre les deux autres. Par rapport au premier modèle de structuration des articles, qui reposait sur des moyens textuels (réductions des formes ou des occurrences des items traités et des éléments métalinguistiques introduisant les subdivisions, typographiques (affectant seulement les caractères : gras, italique, capitales et graphématiques (contrastes de majuscules et de minuscules, ponctuations, sans recours significatif à la mise en page, ni aux symboles, le second modèle, qui s’est diffusé, pendant plus d’un siècle, dans des dictionnaires très divers, a donné une place croissante aux symboles diacritiques (mais pas alphanumériques – ce sera la spécificité du troisième modèle, à partir du “Dictionnaire du français contemporain” de 1966 et, dans les ouvrages les plus volumineux, il a tiré parti des moyens offerts par la mise en page. Notre contribution présente en détail, en parcourant les divers groupes de dictionnaires concernés, l’ensemble de la mise en œuvre de ce deuxième modèle, qui avait vocation à permettre à leurs utilisateurs de repérer plus aisément certaines subdivisions des articles, sans cependant toujours refléter leur structuration conceptuelle profonde, sans doute

Perancangan dan Penerapan Algoritme 4DES (Studi Kasus Pada Keamanan Berkas Rekam Medis

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Yeni Yanti

2017-01-01

Full Text Available Information is necessary for life because everything can not be done properly in the absence of information. The security problem is one of the most crucial aspects of a file containing sensitive information, for example, medical record files. Often, the file owner, designer, and manager of the information systems pay less attention to the security issues. One way to anticipate this is by using a cryptographic method, which is the science and art to keep the message security. This study aimed to evaluate the performance analysis and building a security system prototype of medical record files using the 4DES algorithm. The 4DES algorithm is a variant of the 3DES algorithm that is more robust and capable of protecting information properly. The 4DES security system has four keys; each key has a key length of 64 bits so that the total length of four keys is 256 bits and K1≠K2≠K3≠K4. The encrypted / decrypted files (Word, Excel, and Image  using an external key of minimum eight characters (64 bits. During encryption, there was an addition of padding bytes in each of data block size to minimalized attack from the attacker using a CBC operation mode process. Results showed that the processing speed of the encrypted files using the 4DES was 1 second faster than that of using the 3DES algorithm. Also, the 4DES algorithm has superiority regarding of file safety, which has time enduring 3.45 x1056years longer to brute force attack technique which able to discover text file and the secret key.

A qualitative study examining methods of accessing and identifying research relevant to clinical practice among rehabilitation clinicians.

Science.gov (United States)

Patel, Drasti; Koehmstedt, Christine; Jones, Rebecca; Coffey, Nathan T; Cai, Xinsheng; Garfinkel, Steven; Shaewitz, Dahlia M; Weinstein, Ali A

2017-01-01

Research examining the utilization of evidence-based practice (EBP) specifically among rehabilitation clinicians is limited. The objective of this study was to examine how various rehabilitative clinicians including physical therapists, occupational therapists, rehabilitation counselors, and physiatrists are gaining access to literature and whether they are able to implement the available research into practice. A total of 21 total clinicians were interviewed via telephone. Using NVivo, a qualitative analysis of the responses was performed. There were similarities found with respect to the information-seeking behaviors and translation of research across the different clinician types. Lack of time was reported to be a barrier for both access to literature and implementation of research across all clinician types. The majority of clinicians who reported having difficulty with utilizing the published literature indicated that the literature was not applicable to their practice, the research was not specific enough to be put into practice, or the research found was too outdated to be relevant. In addition, having a supportive work environment aided in the search and utilization of research through providing resources central to assisting clinicians in gaining access to health information. Our study identified several barriers that affect EBP for rehabilitation clinicians. The findings suggest the need for researchers to ensure that their work is applicable and specific to clinical practice for implementation to occur.

Clinicians' management strategies for patients with dyspepsia: a qualitative approach

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Ohlsson Bodil

2005-05-01

Full Text Available Abstract Background Symptoms from the upper gastrointestinal tract are frequently encountered in clinical practice and may be of either organic or functional origin. For some of these conditions, according to the literature, certain management strategies can be recommended. For other conditions, the evidence is more ambiguous. The hypothesis that guided our study design was twofold: Management strategies and treatments suggested by different clinicians vary considerably, even when optimal treatment is clear-cut, as documented by evidence in the literature. Clinicians believe that the management strategies of their colleagues are similar to their own. Methods Simulated case histories of four patients with symptoms from the upper gastrointestinal tract were presented to 27 Swedish clinicians who were specialists in medical gastroenterology, surgery, and general practice and worked at three hospitals in the southern part of Sweden. The patients' histories contained information on the patient's sex and age and the localisation of the symptoms, but descriptions of subjective symptoms and findings from examinations differed from history to history. Interviews containing open-ended questions were conducted. Results For the same patient, the management strategies and treatments suggested by the clinicians varied widely, as did the strategies suggested by clinicians in the same speciality. Variation was more pronounced if the case history noted symptoms but no organic findings than if the case history noted unambiguous findings and symptoms. However, even in cases with a consensus in the scientific literature on treatment, the variations in clinicians' opinion on management were pronounced. Conclusion Despite these variations, the clinicians believed that the decisions made by their colleagues would be similar to their own. The overall results of this study indicate that we as researchers must make scientific evidence comprehensible and communicate

Le système d’information sur la biodiversité de l’administration des parcs nationaux argentins

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Leonidas Lizarraga

2014-06-01

Full Text Available Introduction Le système d’information sur la biodiversité (SIB, Sistema de Información de Biodiversidad de l’administration des parcs nationaux argentins (APN, Administración de Parques Nacionales a été lancé en 2002, avec le soutien du Global Environment Fund (GEF dans le cadre du Projet de préservation de la biodiversité mené par l’État argentin. Le dispositif, abrégé en SIB-APN, est composé d’un ensemble de bases de données thématiques et d’un système d’information géographique : son ob...

Designing User-Centric Patient Portals: Clinician and Patients' Uses and Gratifications

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Krist, Alex H.; Aycock, Rebecca A.; Kreps, Gary L.

2017-01-01

Abstract Background: Legislation mandates that clinicians make patients' medical information available digitally. This has resulted in hurriedly installing patient portals that do not fully meet the needs of patients or clinicians. This study examined a specific portal, MyPreventiveCare (MPC), a patient-centered portal designed to promote preventive care to consumers, to elicit recommendations from patients and clinicians about how it could be more beneficial by uncovering their uses and gratifications (U&G). Materials and Methods: In-depth interviews with 31 patients and two clinician focus groups were conducted. Multiple methods were utilized, such as grounded theory coding to develop themes and content analysis to classify responses according to the U&G framework. Results: Four main categories emerged that users desire to be included in health portals: integration with technology (27%), coordination of care (27%), incorporation of lifestyle (26%), and increased control (20%). Additional analysis revealed that health portals are mainly utilized to fulfill cognitive and affective needs, with over 80% of recommendations related to the U&G categories of cognitive and affective needs. Cognitive (60%), affective (21%), social integrative (10%), personal integrative (9%), and tension release (0%). Conclusions: Portals will continue to evolve and become important health communication tools if they address the user's perspective and are inclusive of new technological advances. Specifically, portals must become more user centric and incorporate aspects of the patients' lifestyle and integrate health information technology. PMID:27333468

Online Mental Health Resources in Rural Australia: Clinician Perceptions of Acceptability

Science.gov (United States)

Holloway, Kristi; Riley, Geoffrey; Auret, Kirsten

2013-01-01

Background Online mental health resources have been proposed as an innovative means of overcoming barriers to accessing rural mental health services. However, clinicians tend to express lower satisfaction with online mental health resources than do clients. Objective To understand rural clinicians’ attitudes towards the acceptability of online mental health resources as a treatment option in the rural context. Methods In-depth interviews were conducted with 21 rural clinicians (general practitioners, psychologists, psychiatrists, and clinical social workers). Interviews were supplemented with rural-specific vignettes, which described clinical scenarios in which referral to online mental health resources might be considered. Symbolic interactionism was used as the theoretical framework for the study, and interview transcripts were thematically analyzed using a constant comparative method. Results Clinicians were optimistic about the use of online mental health resources into the future, showing a preference for integration alongside existing services, and use as an adjunct rather than an alternative to traditional approaches. Key themes identified included perceptions of resources, clinician factors, client factors, and the rural and remote context. Clinicians favored resources that were user-friendly and could be integrated into their clinical practice. Barriers to use included a lack of time to explore resources, difficulty accessing training in the rural environment, and concerns about the lack of feedback from clients. Social pressure exerted within professional clinical networks contributed to a cautious approach to referring clients to online resources. Conclusions Successful implementation of online mental health resources in the rural context requires attention to clinician perceptions of acceptability. Promotion of online mental health resources to rural clinicians should include information about resource effectiveness, enable integration with existing

EFFET DES TRAITEMENTS THERMIQUES SUR LA REACTION ENTRE DES COUCHES MINCES DE TITANE ET DES SUBSTRATS EN ACIER

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D Slimani

2015-06-01

Full Text Available Des couches minces du titane pur ont été déposées avec la méthode de pulvérisation cathodique sur des substrats en acier, type FF80 K-1 contenants ~1% mass. en carbone. La réaction entre les deux parties du système substrat-couche mince est activée avec des traitements thermiques sous vide dans l’intervalle de températures de 400 à900°Cpendant 30 minutes. Les Spectres de diffraction de rayons x confirment l’inter- diffusion des éléments  chimiques du système résultants la formation et la croissance des nouvelles phases en particulier le carbure binaire TiC ayant des caractéristiques thermomécaniques importantes. L’analyse morphologique des échantillons traités  avec le microscope électronique à balayage (MEB montre l’augmentation du flux de diffusion atomique avec la température de recuit, notamment la diffusion du manganèse et du fer vers la surface libre des échantillons aux températures élevées provoquant la dégradation des propriétés mécaniques des revêtements contrairement au premiers stades d’interaction où on a obtenu des bonnes valeurs de la microdureté.

Clinician researcher career pathway for registered nurses and midwives: A proposal.

Science.gov (United States)

Smith, Sheree; Gullick, Janice; Ballard, Jacqueline; Perry, Lin

2018-06-01

To consider clinician researcher career frameworks and propose a new pathway, integrating university and health service components to support research career progression within nursing and midwifery practice. Hospitals with research-active clinicians report fewer adverse events and better patient outcomes. Nursing clinician researcher career development is therefore an international priority, yet positions and expectations associated with this are not always well articulated, with nurses and midwives challenged to accommodate research and clinical careers. This discussion paper describes nurse/midwife clinician researcher career frameworks and a new pathway that aligns academic and nursing role descriptions. The new framework was informed by a brief literature search for international framework documents, three Australian state-based Nurses and Midwives Awards: the Australian Qualifications Framework, publically available University Academic (Research) Award schedules and academic staff descriptions, and state health department and health services publications. The implementation of research-based practice is a key element of nursing and midwifery roles and "advanced practice" position descriptions have well-defined research expectations. This paper considers structures to support their achievement. This paper provides a blueprint for clinician researcher career development. It elevates the research domain as an equal alongside clinical, managerial and educational clinical career development. © 2018 John Wiley & Sons Australia, Ltd.

Promouvoir l'entrepreneuriat inclusif des jeunes et des femmes ...

International Development Research Centre (IDRC) Digital Library (Canada)

Le projet vise à analyser la contribution réelle et potentielle de l'entrepreneuriat inclusif au bien-être des jeunes et des femmes en Côte d'Ivoire, au Burkina Faso et au Kenya. Après un état des lieux de la pratique de l'entrepreneuriat inclusif dans chacun des pays ciblés, l'équipe de recherche étudiera son incidence sur ...

Data processing in gamma spectrometry. Application to the decay schemes study; Traitement des informations en spectrometrie gamma application a l'etude de schemas de desintegration

Energy Technology Data Exchange (ETDEWEB)

Boulanger, J.P. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires, departement d' electronique generale, service d' instrumentation nucleaire

1968-06-01

The purpose of this thesis is the processing of the data issued from a gamma spectrometer, and its applications to the decay schemes study. The mathematical analysis of the full energy peaks, in connection with the very good resolution of semi-conductor detectors, leads to a very accurate determination of the energies. The resolution of complex spectra by the least squares method, completed by a spectra generating process, allows the calculation of branching ratios. Then, the handling of the two dimensional experiments permits the coincidence exam. For each of these methods, the calculation principle, then the systematics tests realized in order to prove their validity and to determine their application ranges as well as some experimental results appropriate to illustrate their possibilities, are presented. The energies of some nuclides, frequently used as standards have been thus measured and the decay schemes of {sup 134}Cs and {sup 110m}Ag determined precisely. (author) [French] Cette these est consacree aux methodes de traitement des informations issues d'un spectrometre {gamma}, et a leur application a l'etude des schemas de desintegration: l'analyse mathematique des pics d'absorption totale, conjuguee avec l'excellent pouvoir de resolution des detecteurs semi-conducteurs, conduit a une determination tres precise des energies. La decomposition des spectres complexes par la methode des moindres carres, completee par un procede de generation de spectres, autorise le calcul des rapports de branchement. Enfin le depouillement des experiences biparametriques permet l'examen des coincidences. Pour chacune de ces methodes, on expose le principe des calculs et les essais systematiques effectues afin d'eprouver leur validite et de definir leurs domaines d'application, ainsi que quelques resultats experimentaux propres a illustrer leurs possibilites. Les energies de quelques isotopes utilises couramment comme etalons ont ainsi ete

Regroupement des statistiques sur le secteur des TIC et analyse ...

International Development Research Centre (IDRC) Digital Library (Canada)

La présence et l'influence des technologies de l'information et de la communication (TIC) continuent de s'élargir et de s'accroître, tout comme leurs répercussions sur le développement économique. Toutefois, il reste encore beaucoup de travail à faire avant de pouvoir comprendre d'une manière systématique et ...

The power of clinicians' affective communication: how reassurance about non-abandonment can reduce patients' physiological arousal and increase information recall in bad news consultations. An experimental study using analogue patients.

Science.gov (United States)

Sep, Milou S C; van Osch, Mara; van Vliet, Liesbeth M; Smets, Ellen M A; Bensing, Jozien M

2014-04-01

The diagnosis of incurable cancer may evoke physiological arousal in patients. Physiological arousal can negatively impact patients' recall of information provided in the medical consultation. We aim to investigate whether clinicians' affective communication during a bad news consultation will decrease patients' physiological arousal and will improve recall. Healthy women (N=50), acting as analogue patients, were randomly assigned to watch one out of the two versions of a scripted video-vignette of a bad news consultation in which clinician's communication differed: standard vs. affective communication. Participants' skin conductance levels were obtained during video-watching, and afterwards their recall was assessed. While the diagnosis increased skin conductance levels in all analogue patients, skin conductance levels during the remainder of the consultation decreased more in the affective communication condition than in the standard condition. Analogue patients' recall was significantly higher in the affective condition. Breaking bad news evokes physiological arousal. Affective communication can decrease this evoked physiological arousal and might be partly responsible for analogue patients' enhanced information recall. Although our findings need to be translated to clinical patients, they suggest that clinicians need to deal with patients' emotions before providing additional medical information. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Patient-Clinician Communication About Pain: A Conceptual Model and Narrative Review.

Science.gov (United States)

Henry, Stephen G; Matthias, Marianne S

2018-02-01

Productive patient-clinician communication is an important component of effective pain management, but we know little about how patients and clinicians actually talk about pain in clinical settings and how it might be improved to produce better patient outcomes. The objective of this review was to create a conceptual model of patient-clinician communication about noncancer pain, review and synthesize empirical research in this area, and identify priorities for future research. A conceptual model was developed that drew on existing pain and health communication research. CINAHL, EMBASE, and PubMed were searched to find studies reporting empirical data on patient-clinician communication about noncancer pain; results were supplemented with manual searches. Studies were categorized and analyzed to identify crosscutting themes and inform model development. The conceptual model comprised the following components: contextual factors, clinical interaction, attitudes and beliefs, and outcomes. Thirty-nine studies met inclusion criteria and were analyzed based on model components. Studies varied widely in quality, methodology, and sample size. Two provisional conclusions were identified: contrary to what is often reported in the literature, discussions about analgesics are most frequently characterized by patient-clinician agreement, and self-presentation during patient-clinician interactions plays an important role in communication about pain and opioids. Published studies on patient-clinician communication about noncancer pain are few and diverse. The conceptual model presented here can help to identify knowledge gaps and guide future research on communication about pain. Investigating the links between communication and pain-related outcomes is an important priority for future research. © 2018 American Academy of Pain Medicine. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Droit administratif international - amélioration des rapports ...

International Development Research Centre (IDRC) Digital Library (Canada)

Le nouveau site Web facilitera l'enregistrement des événements démographiques afin d'améliorer l'accès aux services pour tous. Le nouveau site Web et la nouvelle bibliothèque de ressources aideront à améliorer les systèmes d'information et d'enregistrement des faits d'état civil dans les pays en développement.

Identification et prise en charge des femmes ayant des antécédents familiaux de cancer du sein

Science.gov (United States)

Heisey, Ruth; Carroll, June C.

2016-01-01

Résumé Objectif Résumer les meilleures données portant sur les stratégies d’identification et de prise en charge des femmes qui présentent des antécédents familiaux de cancer du sein. Sources d’information Une recherche a été effectuée sur PubMed à l’aide des mots-clés anglais suivants : breast cancer, guidelines, risk, family history, management et magnetic resonance imaging screening, entre 2000 et 2016. La plupart des données sont de niveau II. Message principal Une bonne anamnèse familiale est essentielle lors de l’évaluation du risque de cancer du sein afin d’identifier les femmes qui sont candidates à une recommandation en counseling génétique pour un éventuel test génétique. On peut sauver des vies en offrant aux femmes porteuses d’une mutation au gène BRCA des interventions chirurgicales de réduction des risques (mastectomie bilatérale prophylactique, salpingo-ovariectomie bilatérale). Il faut encourager toutes les femmes qui présentent des antécédents familiaux de cancer du sein à demeurer actives et à limiter leur consommation d’alcool à moins de 1 verre par jour; certaines femmes sont admissibles à la chimioprévention. Il faut offrir aux femmes dont le risque à vie de cancer du sein est de 20 à 25 % ou plus un dépistage poussé par imagerie par résonance magnétique en plus d’une mammographie. Conclusion Une vie saine et la chimioprévention (chez les candidates) pourraient réduire l’incidence du cancer du sein; le dépistage poussé pourrait entraîner une détection plus précoce. Le fait d’aiguiller des femmes porteuses d’une mutation au BRCA vers la chirurgie de réduction des risques sauve des vies. PMID:27737991

Prise en charge des urgences au service d'accueil des urgences ...

African Journals Online (AJOL)

Introduction: La prise en charge des patients dans les services d'accueil des urgences est une des meilleures vitrines d'un système de santé. En Afrique subsaharienne, la gestion des urgences se heurte à des difficultés humaines et matérielles. Le but de ce travail était d'évaluer les difficultés de prise en charge au Service ...

Professionnalisation de l'agriculture : Une alternative aux effets des ...

African Journals Online (AJOL)

La démarche méthodologique utilisée s'articule autour de la recherche documentaire et de la collecte des informations socio-économiques détaillées obtenues auprès des ménages sur les organisations professionnelles agricoles et sur le processus de professionnalisation de l'agriculture. Un diagnostic agroclimatique a ...

Clinicians' perceptions of organizational readiness for change in the context of clinical information system projects: insights from two cross-sectional surveys.

Science.gov (United States)

Paré, Guy; Sicotte, Claude; Poba-Nzaou, Placide; Balouzakis, George

2011-02-28

The adoption and diffusion of clinical information systems has become one of the critical benchmarks for achieving several healthcare organizational reform priorities, including home care, primary care, and integrated care networks. However, these systems are often strongly resisted by the same community that is expected to benefit from their use. Prior research has found that early perceptions and beliefs play a central role in shaping future attitudes and behaviors such as negative rumors, lack of involvement, and resistance to change. In this line of research, this paper builds on the change management and information systems literature and identifies variables associated with clinicians' early perceptions of organizational readiness for change in the specific context of clinical information system projects. Two cross-sectional surveys were conducted to test our research model. First, a questionnaire was pretested and then distributed to the future users of a mobile computing technology in 11 home care organizations. The second study took place in a large teaching hospital that had approved a budget for the acquisition of an electronic medical records system. Data analysis was performed using partial least squares. Scale items used in this study showed adequate psychometric properties. In Study 1, four of the hypothesized links in the research model were supported, with change appropriateness, organizational flexibility, vision clarity, and change efficacy explaining 75% of the variance in organizational readiness. In Study 2, four hypotheses were also supported, two of which differed from those supported in Study 1: the presence of an effective project champion and collective self-efficacy. In addition to these variables, vision clarity and change appropriateness also helped explain 75% of the variance in the dependent variable. Explanations for the similarities and differences observed in the two surveys are provided. Organizational readiness is arguably a key

The Texts of the Agency's Relationship Agreements with Specialized Agencies; Textes des Accords Conclus Entre l'Agence et des Institutions Specialisees

Energy Technology Data Exchange (ETDEWEB)

NONE

1960-09-27

The texts of the relationship agreements which the Agency has concluded with the specialized agencies listed below, together with the respective protocols authenticating them, are reproduced in this document in the order which the agreements entered into force, for the information of all Members of the Agency [French] Le present document reproduit les textes des accords que l'Agence a conclus avec les institutions specialisees enumerees ci-apres, ainsi que ceux des protocoles validant lesdits accords. Ces textes sont presentes, pour information, a tous les Membres de l'Agence dans l'ordre chronologique d'entree en vigueur desdits accords.

L'inégalité des sexes et la révolution de l'information en Afrique

International Development Research Centre (IDRC) Digital Library (Canada)

La prise en compte des femmes dans la politique des pays africains sur les ..... les stratégies visant à intégrer l'égalité des sexes dans les politiques africaines sur les TIC, .... À son avis, les entreprises de télécommunications devraient créer une ...... de vulgarisation agricole doivent former et recruter davantage de femmes.

Connaissances, attitudes et pratiques des prestataires de santé des ...

African Journals Online (AJOL)

... des prestataires interrogés avaient respectivement une bonne connaissance des facteurs de risque et des moyens de dépistage. Les signes évocateurs et les examens complémentaires nécessaires au diagnostic du cancer du sein étaient connus par 15,3 % des prestataires. La définition du cancer du sein et les moyens ...

Understanding Clinician Information Demands and Synthesis of Clinical Documents in Electronic Health Record Systems

Science.gov (United States)

Farri, Oladimeji Feyisetan

2012-01-01

Large quantities of redundant clinical data are usually transferred from one clinical document to another, making the review of such documents cognitively burdensome and potentially error-prone. Inadequate designs of electronic health record (EHR) clinical document user interfaces probably contribute to the difficulties clinicians experience while…

The nature of excellent clinicians at an academic health science center: a qualitative study.

Science.gov (United States)

Mahant, Sanjay; Jovcevska, Vesna; Wadhwa, Anupma

2012-12-01

To understand the nature of excellent clinicians at an academic health science center by exploring how and why excellent clinicians achieve high performance. From 2008 to 2010, the authors conducted a qualitative study using a grounded theory approach. Members of the Clinical Advisory Committee in the Department of Pediatrics at the University of Toronto nominated peers whom they saw as excellent clinicians. The authors then conducted in-depth interviews with the most frequently nominated clinicians. They audio-recorded and transcribed the interviews and coded the transcripts to identify emergent themes. From interviews with 13 peer-nominated, excellent clinicians, a model emerged. Dominant themes fell into three categories: (1) core philosophy, (2) deliberate activities, and (3) everyday practice. Excellent clinicians are driven by a core philosophy defined by high intrinsic motivation and passion for patient care and humility. They refine their clinical skills through two deliberate activities-reflective clinical practice and scholarship. Their high performance in everyday practice is characterized by clinical skills and cognitive ability, people skills, engagement, and adaptability. A rich theory emerged explaining how excellent clinicians, driven by a core philosophy and engaged in deliberate activities, achieve high performance in everyday practice. This theory of the nature of excellent clinicians provides a holistic perspective of individual performance, informs medical education, supports faculty career development, and promotes clinical excellence in the culture of academic medicine.

TEDx Place Des Nations | 11 December

CERN Multimedia

2014-01-01

On 11 December, Geneva will host the TEDxPlaceDesNations event.   TEDxPlaceDesNations, in the spirit of TED’s “Ideas Worth Spreading” principle, will involve innovators, humanitarians, entrepreneurs, scientists and peacemakers. The eleven speakers will share how their work can help find solutions to today’s challenges. Among the speakers will be Javier Serrano, a CERN physicist and electronics engineer. He is the co-author of the CERN Open Hardware License and the creator of the Open Hardware Repository, a web platform where companies, institutes and individuals can share their hardware designs for free. Additional information is available at the TEDxPlaceDesNations site. The detailed programme will be posted on 28 November. Seats are limited, so registration is essential. The event can be followed by live webcast here.

L'Empowerment au coeur des bouleversements induits par les TIC dans la gestion des ressources humaines

OpenAIRE

Blavier, André

2012-01-01

Observer l’influence des TIC (Technologies de l’Information et de la Communication” sur les ressources humaines à la lumière du seul débat “pour ou contre les réseaux sociaux dans l’entreprise ou l’organisation ?” est une approche bien trop restrictive. Les défis relatifs à l’évolution des ressources humaines s’inscrivent dans une perspective plus large, celle d’un environnement numérique global. Comme l’a souligné le rapport “Digital Economy Rankings 2010” d’IBM en collaboration avec l’Econ...

Evaluer des études de gestion des entreprises : combiner des éléments principales avec des éléments pratiques

NARCIS (Netherlands)

Pennink, B.J.W.

2002-01-01

Evaluer la recherche de gestion demande une combinaison des critères classiques et des critères pratiques. Par cette combinaison il est possible de trouver une réponse cerrecte concernant la validité et l'effet de la recherche. Dans cet article nous allons décrire comment une combinaison des

Les bases de données : outils de stockage et d'exploitation des échantillonnages piscicoles

Directory of Open Access Journals (Sweden)

SANLAVILLE-BOISSON C.

1995-04-01

Full Text Available L'étude des relations espèces-environnement à différentes échelles d'espace et de temps impose la manipulation de grands volumes de données et la confrontation de différents types d'informations (biologiques et environnementales. Afin d'optimiser la gestion informatique des données écologiques, plusieurs bases de données (correspondant à des données de structures différentes ont été élaborées sur micro-ordinateur en utilisant des systèmes de gestion de bases de données différents autour desquels ont été développées des applications spécifiques destinées à faciliter et compléter la gestion de l'information, depuis la saisie des données jusqu'à l'obtention des tableaux à analyser.

Aspects des Onychomycoses chez des patients camerounais de ...

African Journals Online (AJOL)

... biologiques et évolutifs des onychomycoses chez des patients camerounais. Méthode : Il s'agit d'une étude rétrospective et descriptive menée de mars 2011 à mars 2014 dans l'unité de dermatologie de l'hôpital général de Douala (HGD), incluant des patients chez lesquels le diagnostic d'onychomycose avait été posé.

Sigand : une application SIG sous androïd (tablette de la gestion des chantiers

Directory of Open Access Journals (Sweden)

CHAKIB SAFAR BATI

2016-12-01

Full Text Available L’introduction de données terrain pour les études environnementales ou de gestion de l’espace, régionales ou locales est une nécessité incontournable pour la validation des traitements et des interprétations mais aussi pour fournir des compléments d’informations aux divers travaux. Mais ce retour terrain est également de plus en plus demandé pour les gestionnaires de chantiers et de projets qui ont une exigence de contrôle ou de suivi et donc d’une information temps réel sur l’avancement des travaux, autrement pour introduire de nouvelles informations sur la base de données géoréférencées. Les avancées technologiques en matière de manipulation de l’information géographique (GPS, tablette graphique, téléphone portable, réalité augmentée permettent d’espérer la mise à dispositiondes professionnels, voire d’un plus large public, des outils adéquats pour de tels travaux. Actuellement, les outils d’élaboration, de gestion et d’exploitation des bases de données géographiques (solutions SIG ne sont pas encore complètement opérationnels en version « tablette » ; des applications telles que Qgis ou ArcGis sous Androïd attendent encore des développements. Nous présentons ici la première version d’une application SIG sous Androïd (disponible sur tablette pour la gestion en temps réel des chantiers qui permet de charger des couches vectorielles et de les mettre à jour sur le terrain en fonction de l’observation directe ; les couches (préalablement géoréférencées sont projetées sur des fonds cartographiques fournis par un serveur cartographique Google Maps (Route, Satellite, terrain; dans le cas d’absence de connexion internet, le fond cartographique est ramené d’un cache. Nous utilisons SpatialiteAndroïd pour le stockage et la manipulation des données géographiques. Le contrôleur de cartes Google Maps est employé pour afficher en mode cartographique les données stockées dans

Clinician and cancer patient views on patient participation in treatment decision-making: a quantitative and qualitative exploration

Science.gov (United States)

Pieterse, A H; Baas-Thijssen, M C M; Marijnen, C A M; Stiggelbout, A M

2008-01-01

Patient participation in treatment decision-making is being increasingly advocated, although cancer treatments are often guideline-driven. Trade-offs between benefits and side effects underlying guidelines are made by clinicians. Evidence suggests that clinicians are inaccurate at predicting patient values. The aim was to assess what role oncologists and cancer patients prefer in deciding about treatment, and how they view patient participation in treatment decision-making. Seventy disease-free cancer patients and 60 oncologists (surgical, radiation, and medical) were interviewed about their role preferences using the Control Preferences Scale (CPS) and about their views on patient participation using closed- and open-ended questions. Almost all participants preferred treatment decisions to be the outcome of a shared process. Clinicians viewed participation more often as reaching an agreement, whereas 23% of patients defined participation exclusively as being informed. Of the participants, ⩾81% thought not all patients are able to participate and ⩾74% thought clinicians are not always able to weigh the pros and cons of treatment for patients, especially not quality as compared with length of life. Clinicians seemed reluctant to share probability information on the likely impact of adjuvant treatment. Clinicians should acknowledge the legitimacy of patients' values in treatment decisions. Guidelines should recommend elicitation of patient values at specific decision points. PMID:18781148

Libéralisation du commerce des biens et services TIC : enjeux et ...

International Development Research Centre (IDRC) Digital Library (Canada)

Libéralisation du commerce des biens et services TIC : enjeux et implications pour la mise en oeuvre de politiques publiques en Afrique de l'Ouest. En Afrique de l'Ouest, les entreprises du secteur privé des technologies d'information et de la communication (TIC) ont démontré leur capacité à créer des emplois et à stimuler ...

The effect of core clinician interpersonal behaviours on depression.

Science.gov (United States)

Barnicot, K; Wampold, B; Priebe, S

2014-01-01

It is well-established that core clinician interpersonal behaviours are important when treating depression, but few studies have evaluated whether outcome is determined by clinicians׳ general behaviour rather than by the perception of the individual being treated. In the NIMH TDCRP, 157 patients rated their clinician׳s genuineness, positive regard, empathy and unconditional regard during cognitive behavioural therapy, interpersonal therapy or clinical management with placebo. The association between averaged ratings for each of 27 clinicians and their patients׳ self- and observer-rated depression outcomes was evaluated, adjusting for the deviation of individual patient ratings from the average for their clinician and other potential confounders. Clinicians in the clinical management condition were rated on average as less genuine and less empathic than those in the psychotherapy conditions. Clinicians׳ average genuineness, positive regard and empathy were significantly associated with lower depression severity during treatment, but not with recovery from depression, after adjusting for the deviation of the individual patient׳s rating of their clinician from the average for that clinician, treatment condition and baseline depression severity. Clinician unconditional regard was not significantly associated with outcome. Using averaged ratings of clinician behaviour likely reduced statistical power. Clinicians׳ ability to demonstrate genuineness, positive regard and empathy may represent a stable personal characteristic that influences the treatment of depression beyond the individual clinician-patient relationship or an individual patient׳s perception of their clinician. However, clinicians׳ ability to demonstrate these behaviours may be poorer when delivering an intervention without a specific rationale or treatment techniques. Copyright © 2014 Elsevier B.V. All rights reserved.

Contribution de la télédétection et des systèmes d'information géographique à la prise en compte du risque de prolifération des Aedes dans les zones humides de Bizerte (Nord de la Tunisie

Directory of Open Access Journals (Sweden)

Noura Brahmi

2010-10-01

Full Text Available Cette recherche a pour objectif d'aider les services d'hygiène en matière de cartographie numérique des biotopes potentiels à gîtes larvaires d'Aedes tout autour des zones humides de la région de Bizerte (Nord de la Tunisie. Ces zones humides subissent souvent des invasions inopinées de ces moustiques qui peuvent transmettre à l'homme des affections virales, microbiennes ou parasitaires (malaria, fièvre jaune, dengue…. Ces invasions posent des problèmes importants de nuisance qu'il importe d'analyser précisément si l'on veut se donner des chances de les enrayer. Pour lutter efficacement contre ces Aedes, il est nécessaire d'avoir une bonne connaissance de leur milieu et de leur écologie. C'est pourquoi, dans un premier temps, nous avons créé une base de données intégrée dans un système d'information géographique (SIG afin de définir, de localiser et d'analyser, par la superposition de plusieurs couches d'informations relatives au milieu naturel, les biotopes potentiels de prolifération des gîtes larvaires d'Aedes sur la carte d'aléa. Celle-ci constitue une source d'information nécessaire pour préciser le lien existant entre l'environnement et la nuisance, l'élément jugé vulnérable étant la population humaine. La carte du risque de nuisance est alors obtenue par croisement des cartes d'aléa et de vulnérabilité. La classe où le risque est fort concerne Menzel Bourguiba, Menzel Jmil, Menzel Abderrahmen, Tinja and Ghar el Melh. La classe correspondant à un risque moyen englobe toutes les villes et villages aux alentours du lac Ichkeul. La classe ne présentant pratiquement pas de risque couvre le bassin de l'oued Sejnene et la Garaât el Mabtouha.The major objective of this research is to provide concrete solutions numerical cartography of the potential biotopes to larval lodgings of Aedes all around the wetlands of the area of Bizerte (Northern of Tunisia. These zones are presented in the form of favourable

'So you want to be a clinician-educator...': designing a clinician-educator curriculum for internal medicine residents.

Science.gov (United States)

Heflin, Mitchell T; Pinheiro, Sandro; Kaminetzky, Catherine P; McNeill, Diana

2009-06-01

Despite a growing demand for skilled teachers and administrators in graduate medical education, clinician-educator tracks for residents are rare and though some institutions offer 'resident-as-teacher' programs to assist residents in developing teaching skills, the need exists to expand training opportunities in this area. The authors conducted a workshop at a national meeting to develop a description of essential components of a training pathway for internal medicine residents. Through open discussion and small group work, participants defined the various roles of clinician-educators and described goals, training opportunities, assessment and resource needs for such a program. Workshop participants posited that the clinician-educator has several roles to fulfill beyond that of clinician, including those of teacher, curriculum developer, administrator and scholar. A pathway for residents aspiring to become clinician educators must offer structured training in each of these four areas to empower residents to effectively practice clinical education. In addition, the creation of such a track requires securing time and resources to support resident learning experiences and formal faculty development programs to support institutional mentors and leaders. This article provides a framework by which leaders in medical education can begin to prepare current trainees interested in careers as clinician-educators.

L'exode des cerveaux et le renforcement des capacités en Afrique ...

International Development Research Centre (IDRC) Digital Library (Canada)

1 févr. 2011 ... Ce phénomène ébranle les assises économiques et politiques de bien des pays africains. ... le défi consiste à recruter ces cerveaux. ... des missions africaines, des organisations non gouvernementales et des groupes de la diaspora réunis pour parler de l'exode des cerveaux en Afrique et des stratégies à ...

US Health Care Clinicians' Knowledge, Attitudes, and Practices Regarding Human Papillomavirus Vaccination: A Qualitative Systematic Review.

Science.gov (United States)

Rosen, Brittany L; Shepard, Allie; Kahn, Jessica A

2018-03-01

Clinicians' recommendation for the human papillomavirus (HPV) vaccine appears to be an important driver of parental decisions about vaccination. Our aim was to synthesize the best available evidence exploring the perceptions and experiences regarding HPV vaccination, from the perspective of the US clinician. We conducted a comprehensive literature search of Academic Search Complete, CINAHL Plus, Communication & Mass Media Complete, Consumer Health Complete (EBSCOhost), ERIC, Health and Psychosocial Instruments, MEDLINE with full text, and PsycINFO databases. We identified 60 eligible articles: 48 quantitative and 12 qualitative. We extracted the following information: study purpose, use of theory, location, inclusion criteria, and health care provider classification. Results were organized into 5 categories: 1) clinicians' knowledge and beliefs about HPV and the HPV vaccine, 2) clinicians' attitudes and beliefs about recommending HPV vaccines, 3) clinicians' intention to recommend HPV vaccines, 4) clinicians' professional practices regarding HPV vaccination, and 5) patient HPV vaccination rates. Although clinicians were generally supportive of HPV vaccination, there was a discrepancy between clinicians' intentions, recommendation practices, and patient vaccination rates. Studies reported that clinicians tended not to provide strong, consistent recommendations, and were more likely to recommend HPV vaccines to girls versus boys and to older versus younger adolescents. Analyses revealed a number of facilitating factors and barriers to HPV vaccination at the clinician, parent/patient, and systems levels, including clinician knowledge, clinician beliefs, and office procedures that promote vaccination. This review provides an evidence base for multilevel interventions to improve clinician HPV vaccine recommendations and vaccination rates. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Influence de l'occupation des terres sur la dynamique des ...

African Journals Online (AJOL)

L'objectif de la présente étude est d'évaluer l'impact de mise en culture, des pâturages, des jachères et l'influence des villages sur la dynamique des communautés végétales de la commune de ..... mais il n'y a que peu de recrutement. Au-delà de cinq ans, taille et phytovolume diminuent, témoignant du vieillissement de la ...

Grappes des technologies de l'information et de la communication ...

International Development Research Centre (IDRC) Digital Library (Canada)

La Fundación Comisión Asesora de Alta Tecnología (CAATEC) du Costa Rica dirigera le projet et collaborera avec une équipe de chercheurs locaux en Argentine et en Uruguay. La section des affaires communautaires de Microsoft cofinance le projet par l'entremise de sa contribution à telecentre.org, un projet antérieur.

Des dispositions responsables à prendre pour la protection des ...

African Journals Online (AJOL)

En considérant l'effet néfaste des maladies, des parasites, du changement climatique et d'autres facteurs environnementaux (les OGM par exemple) sur la survie des abeilles, la baisse de leurs populations dans certaines parties du monde ne saurait être attribuée aux seules pesticides. En plus, l'impact de ces derniers sur ...

Applications des techniques de diffusion de la lumière, des rayons X et des neutrons a l'étude des systèmes colloïdaux. Troisième partie : caractérisation des microémulsions et des composés solides. Étude de différents systèmes d'intérêt industriel Application of Light, X-Ray and Neutron Diffusion Techniques to the Study of Colloidal Systems. Part Three: Microemulsions, Solid Materials, Liquids and Miscellaneous Systems with Industrial Uses

Directory of Open Access Journals (Sweden)

Espinat D.

2006-11-01

Full Text Available Cette troisième partie clôt une revue bibliographique concernant la caractérisation des systèmes colloïdaux par les techniques de diffusion (lumière, rayons X, neutrons (Rev. Inst. Franç. du Pétrole, Vol. 45, No 6, novembre-décembre 1990. Nous poursuivrons cette présentation en nous intéressant aux microémulsions. Après la présentation des informations que l'on peut obtenir sur les systèmes polymériques, les solutions micellaires ou les systèmes fractals, qui ont fait l'objet de multiples travaux, nous reviendrons sur les applications plus restreintes à des systèmes colloïdaux parfois moins bien définis et d'origine industrielle, telles les fractions lourdes des pétroles, les asphaltènes ou encore les additifs de lubrification. Les possibilités de la diffusion des rayons X et des neutrons à l'étude de matériaux solides seront présentées à travers la caractérisation des solides poreux et en particulier des catalyseurs. Nous terminerons cette présentation par les liquides purs ou les mélanges; les techniques de diffusion ont contribué fortement à la description des structures des phases liquides. This article is the second one (the first one was published in Revue de l'Institut Français du Pétrole No. 6, November-December 1990 concerning the application of techniques of light scattering, X rays and neutrons to the analysis of colloidal systems and more specifically to the theoretical description of the three methods. The aim of this second part is to make a nonexhaustive description of several fields of applications. A special effort is made to describe the potential of these methods for characterizing colloidal or divided systems encountered in a great many activities involving the petroleum industry. The first part of this article takes up polymer and colloidal solutions. Particular attention is paid to the importance of scattering techniques for characterizing polymers in solution and micellar solutions. A

Determination of the separation factor of uranium isotopes by gaseous diffusion; Determination des facteurs de separation des isotopes de l'uranium par diffusion gazeuse

Energy Technology Data Exchange (ETDEWEB)

Bilous, O; Counas, G [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1958-07-01

A 12-stage pilot separation cascade with a low output has been constructed to measure the separation factor of uranium isotopes by gaseous diffusion. The report describes some of the separation results obtained, and also provides information on the time necessary for equilibrium to be established and on the influence of various perturbations on the pressure profile in the cascade. (author) [French] Une cascade pilote de 12 etages de separation a faible debit a ete construite pour mesurer le facteur de separation des isotopes de l'uranium par diffusion gazeuse. Le rapport decrit certains des resultats de separation obtenus et fournit egalement des donnees sur les temps de mise en equilibre et l'influence de diverses perturbations sur le profil des pressions dans la cascade. (auteur)

Gestion des risques

CERN Document Server

Louisot, Jean-Paul

2009-01-01

Depuis le début du lie siècle, la gestion des risques connaît une véritable révolution culturelle. Jusqu'alors fonction technique, centrée autour de l'achat de couverture d'assurances, elle est devenue une discipline managériale et transversale : une valise d'instruments que chaque manager doit connaître et appliquer quels que soient son domaine de compétence et ses missions au sein de l'organisation. En effet, la gestion des risques est une culture qui doit être assimilée par chacun des acteurs. C'est précisément l'ambition des 101 questions rassemblées dans cet ouvrage : apporter à chaque manager d'entreprise, de collectivité, d'établissement de santé..., des réponses claires au " pourquoi " et au " comment " : Comment identifier les risques ? Comment analyser les risques ? Quels sont les objectifs de la gestion des risques ? Une carte des risques pour quoi faire ? Pourquoi faut-il financer les risques ? Les entreprises ont-elles des responsabilités pénales ? En quoi consiste la gestion...

Comportement des polluants des eaux pluviales urbaines en ...

African Journals Online (AJOL)

développement et la croissance des organismes vivant dans l'eau et particulièrement les micro- organismes. Le suivi des températures enregistrées oscille entre 9 et 16°C dans les trois sites d'observation durant la période ... de la lumière du soleil. Le site C est bien aéré et .... Effets de différents modes de gestion des eaux ...

Information processing in the deregulated market. Consequences of competition for gas utilities; Informationsverarbeitung im liberalisierten Markt. Konsequenzen des Wettbewerbs fuer Gasversorgungsunternehmen

Energy Technology Data Exchange (ETDEWEB)

Roeckerath, M. [Rhenag Rheinische Energie AG, Koeln (Germany)

2001-11-01

The liberation of the gas market gives rise to a fundamental rearrangement of the utilities companies information processing, accompanied by important changes in the organisational structures and processes of the enterprises. The application of new technologies, new contract management and changes in the enterprises product spectrum, as well as far-reaching changes in controlling, necessitate immediate action, while at the same time exploiting the opportunities presented by the Internet. (orig.) [German] Die Liberalisierung des Gasmarktes fuehrt zu einem grundlegenden Revirement in der Informationsverarbeitung der Versorgungsunternehmen, die begleitet wird von erheblichen Aenderungen in der Aufbau- und Ablauforganisation der Unternehmen. Der Einsatz neuer Techniken, ein neues Vertragsmanagement und eine geaenderte Produktpalette der Unternehmen sowie weitgehende Aenderungen im Controlling machen ein umgehendes Handeln dringend erforderlich, wobei gleichzeitig die Chancen des Internets zu wahren sind. (orig.)

Caractérisation des plantes médicinales à flavonoïdes des marchés ...

African Journals Online (AJOL)

Les espèces guinéo-congolaises sont les plus abondantes et le mode de dissémination majoritaire des diaspores est la zoochorie. Les plantes à flavonoïdes les plus utilisées sont : Combretum micranthum, Aloe vera, Ageratum conyzoïdes et Cylicodiscus gabonensis. Elles rentrent dans le traitement de 73 maladies parmi ...

Impact de la preparation des anodes crues et des conditions de cuisson sur la fissuration dans des anodes denses

Science.gov (United States)

Amrani, Salah

La fabrication de l'aluminium est realisee dans une cellule d'electrolyse, et cette operation utilise des anodes en carbone. L'evaluation de la qualite de ces anodes reste indispensable avant leur utilisation. La presence des fissures dans les anodes provoque une perturbation du procede l'electrolyse et une diminution de sa performance. Ce projet a ete entrepris pour determiner l'impact des differents parametres de procedes de fabrication des anodes sur la fissuration des anodes denses. Ces parametres incluent ceux de la fabrication des anodes crues, des proprietes des matieres premieres et de la cuisson. Une recherche bibliographique a ete effectuee sur tous les aspects de la fissuration des anodes en carbone pour compiler les travaux anterieurs. Une methodologie detaillee a ete mise au point pour faciliter le deroulement des travaux et atteindre les objectifs vises. La majorite de ce document est reservee pour la discussion des resultats obtenus au laboratoire de l'UQAC et au niveau industriel. Concernant les etudes realisees a l'UQAC, une partie des travaux experimentaux est reservee a la recherche des differents mecanismes de fissuration dans les anodes denses utilisees dans l'industrie d'aluminium. L'approche etait d'abord basee sur la caracterisation qualitative du mecanisme de la fissuration en surface et en profondeur. Puis, une caracterisation quantitative a ete realisee pour la determination de la distribution de la largeur de la fissure sur toute sa longueur, ainsi que le pourcentage de sa surface par rapport a la surface totale de l'echantillon. Cette etude a ete realisee par le biais de la technique d'analyse d'image utilisee pour caracteriser la fissuration d'un echantillon d'anode cuite. L'analyse surfacique et en profondeur de cet echantillon a permis de voir clairement la formation des fissures sur une grande partie de la surface analysee. L'autre partie des travaux est basee sur la caracterisation des defauts dans des echantillons d'anodes crues

Allied health clinicians using translational research in action to develop a reliable stroke audit tool.

Science.gov (United States)

Abery, Philip; Kuys, Suzanne; Lynch, Mary; Low Choy, Nancy

2018-05-23

To design and establish reliability of a local stroke audit tool by engaging allied health clinicians within a privately funded hospital. Design: Two-stage study involving a modified Delphi process to inform stroke audit tool development and inter-tester reliability. Allied health clinicians. A modified Delphi process to select stroke guideline recommendations for inclusion in the audit tool. Reliability study: 1 allied health representative from each discipline audited 10 clinical records with sequential admissions to acute and rehabilitation services. Recommendations were admitted to the audit tool when 70% agreement was reached, with 50% set as the reserve agreement. Inter-tester reliability was determined using intra-class correlation coefficients (ICCs) across 10 clinical records. Twenty-two participants (92% female, 50% physiotherapists, 17% occupational therapists) completed the modified Delphi process. Across 6 voting rounds, 8 recommendations reached 70% agreement and 2 reached 50% agreement. Two recommendations (nutrition/hydration; goal setting) were added to ensure representation for all disciplines. Substantial consistency across raters was established for the audit tool applied in acute stroke (ICC .71; range .48 to .90) and rehabilitation (ICC.78; range .60 to .93) services. Allied health clinicians within a privately funded hospital generally agreed in an audit process to develop a reliable stroke audit tool. Allied health clinicians agreed on stroke guideline recommendations to inform a stroke audit tool. The stroke audit tool demonstrated substantial consistency supporting future use for service development. This process, which engages local clinicians, could be adopted by other facilities to design reliable audit tools to identify local service gaps to inform changes to clinical practice. © 2018 John Wiley & Sons, Ltd.

RÉGIME FISCAL DES MEMBRES DU PERSONNEL EN FRANCE: DÉCLARATION DES REVENUS 2002 - French version only

CERN Multimedia

2003-01-01

http://cern.ch/hr-div/internal/generalinfo/impots/impots_fr.asp IMPORTANT 1) Les autorités fiscales françaises ont informé l'Organisation de certaines modifications concernant le régime fiscal applicable à certains membres du personnel du CERN domiciliés en France. La Direction générale du CERN tente actuellement de clarifier certaines modalités d'application de ces mesures. Pour le moment, les membres du personnel résidant en France sont priés de se conformer aux instructions ci-après, ainsi qu'à celles qui seront éventuellement publiées en la matière au cours de l'année 2003. 2) Pour faire face à l'augmentation des demandes de consultation, la Division des Ressources humaines a mis en place un service de "première orientation" ("help desk") au 72838 qui vous adressera vers les services internes ou extérieurs compétents. Cependant, la Division des Ressources humaines ne pouvant se substituer aux autorités fiscales et ne disposant pas des ressources nécessaires pour traiter l'ensemble ...

La cire cuticulaire des grains de raisin et des feuilles de la vigne

Directory of Open Access Journals (Sweden)

F. RADLER

1968-06-01

Full Text Available Je voudrais parler ici des recherches que j'ai effectuées dans le cadre d'un programme de recherches de l'Organisation australienne de recherches (C.S.I.R.O.. Ce sont des recherches sur la structure, la composition chimique et le rôle de la cire cuticulaire des grains de raisins et des feuilles. Ces recherches ont été effectuées principalement lors de l'étude des problèmes relatifs au séchage des raisins pour la production des raisins. Cependant, l'importance de la cire cuticulaire ne se limite pas seulement au séchage des raisins, car elle concerne aussi l'œnologie et les problèmes de la conservation des raisins de table. Je pense donc que mon exposé peut présenter pour vous un certain intérêt.

Gouvernance des systèmes alimentaires urbains pour la prévention ...

International Development Research Centre (IDRC) Digital Library (Canada)

... contre ces systèmes alimentaires en évolution et l'augmentation connexe des maladies ... les systèmes d'information et d'enregistrement des faits d'état civil dans les pays en ... GrowInclusive : la plateforme tant attendue est en construction.

Possibility of using radioactivity control measurements for determining contamination paths in nutritional vectors; Etude des possibilites d'utilisation des resultats de la surveillance de la radioactivite pour la recherche des trajectoires d'evolution de la contamination des vecteurs alimentaires

Energy Technology Data Exchange (ETDEWEB)

Garnier, A [Commissariat a l' Energie Atomique, Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires

1966-07-01

The object of the report is to study the possibility of using results of radioactivity controls for determining the paths followed by contamination in nutritional vectors; these are necessary for calculating protection norms. Radioactive contamination of a nutritional vector is expressed in terms of parameters which suggest that a certain number of criteria may be used for choosing the results which are to be exploited. An actual example of a 'vertical' study based on results of measurements made purely for control purposes shows the difficulties which may be encountered. A list of the results obtained by the control networks set up in the Community Countries, either for the atmosphere, for milk, or for other foodstuffs, shows that these networks are not at the present organised in such a way as to make such a study possible. It appears desirable that a large part of the work carried out by the control Services be oriented in such a way as to yield the complementary information required for experimental studies of radioactive contamination transfers. (author) [French] L'objet du rapport est l'examen des possibilites d'utilisation des resultats de la surveillance de la radioactivite pour la recherche des trajectoires d'evolution de la contamination des vecteurs alimentaires, necessaires au calcul des niveaux de protection. La contamination radioactive d'un vecteur alimentaire s'exprime en fonction de parametres, qui suggerent de retenir un certain nombre de criteres pour la selection des resultats a exploiter. Un exemple concret d'etude 'verticale' basee sur des resultats de mesures faites uniquement dans un but de controle met en evidence les difficultes rencontrees. L'inventaire des resultats obtenus par les reseaux de controle des differents Pays de la Communaute, soit pour l'atmosphere, soit pour le lait, soit pour d'autres aliments, montre que ces reseaux ne sont pas actuellement organises de facon a permettre de telles etudes, Il parait souhaitable qu

statut de la matiere organique des cambisols et des lixisols sous

African Journals Online (AJOL)

Administrateur

L'étude vise à évaluer la matière organique des Cambisols et des Lixisols sous formations naturelles de longue durée en zone climatique nord-soudanienne et à établir, les relations entre ... sont supérieures à celles des sols des zones sahélienne et sud-soudanienne. ... globale a eu une corrélation positive avec le pH.

Improving clinicians' access to cost data.

Science.gov (United States)

Kenagy, John; Shah, Ben

2014-08-01

Bringing clinical and financial data together is critical to effectively running and operating service lines. Helping clinicians use cost data to make decisions requires a shared vision and a partnership between finance leaders and physicians. Hosting a "jam session" of technical, financial, and clinical experts can accelerate an organization's business intelligence strategy. Labor and supply costs represent the most actionable cost data for clinicians. Clinician buy-in hinges on education and support. It is important to focus on easy wins at the beginning of the project.

Fiabilité des structures mécaniques adaptatives: effet de la panne des actionneurs ou des capteurs sur la stabilité

Science.gov (United States)

Fall, H.; Charon, W.; Kouta, R.

2002-12-01

Ces dernières décennies, des activités significatives dans le monde étaient dirigées autour du contrôle actif. Le but de ces recherches était essentiellement d'améliorer les performances, la fiabilité et la sécurité des systèmes. Notamment dans le cas des structures soumises à des vibrations aléatoires. D'importants travaux ont été consacré à l'utilisation des “matériaux intelligents” comme capteurs et actionneurs. Cette article propose l'analyse de la fiabilité des systèmes mécaniques en étudiant les pannes des actionneurs ou des capteurs. L'effet de ces pannes sur la stabilité et la performance du système y est démontré. Les méthodologies de conception y sont rappelées. Des exemples numériques sont fournis à travers le contrôle d'un panneau sous chargement dynamique pour illustrer la méthode proposée.

Évaluation des émissions de gaz à effet de serre des filières de traitement et de valorisation des boues issues du traitement des eaux usées

OpenAIRE

Reverdy, A.L.; Pradel, M.

2011-01-01

/ Ce rapport présente l'inventaire des différentes consommations énergétiques, en consommables et des GES pour chaque poste de traitement et de valorisation des boues issues du traitement des eaux usées.

A DES ASIC Suitable for Network Encryption at 10 Gbps and Beyond

International Nuclear Information System (INIS)

Gass, Karl; Pierson, Lyndon G.; Robertson, Perry J.; Wilcox, D. Craig; Witzke, Edward L.

1999-01-01

The Sandia National Laboratories (SNL) Data Encryption Standard (DES) Application Specific Integrated Circuit (ASIC) is the fastest known implementation of the DES algorithm as defined in the Federal Information Processing Standards (FIPS) Publication 46-2. DES is used for protecting data by cryptographic means. The SNL DES ASIC, over 10 times faster than other currently available DES chips, is a high-speed, filly pipelined implementation offering encryption, decryption, unique key input, or algorithm bypassing on each clock cycle. Operating beyond 105 MHz on 64 bit words, this device is capable of data throughputs greater than 6.7 Billion bits per second (tester limited). Simulations predict proper operation up to 9.28 Billion bits per second. In low frequency, low data rate applications, the ASIC consumes less that one milliwatt of power. The device has features for passing control signals synchronized to throughput data. Three SNL DES ASICS may be easily cascaded to provide the much greater security of triple-key, triple-DES

L' approche des options stratégiques des acteurs dans i' etude des relations tu travail

OpenAIRE

López Pino, Carmen Marina

2011-01-01

Faire une analyse de la proposition analytique développée par le MIT (Masachussetts Institute of Tecnology) inspirée du concept des options stratégiques pour I' objet de cet article. En premier lieu, les sujets traités seront la problematique des relations du travail et les découvertes fondamentales des différentes recherches de I' equipe du MIT. Après, I' étude fait une courte présentatión sur I' approche des systémes de Dunlop dont I' èquipe cherche améliorer. Ensuite, sont présentés...

La rivière Seudre : intégration des données relatives au bassin versant de la Seudre dans un système d'information géographique

OpenAIRE

Giraud, Sophie

1999-01-01

La préparation du S.A.G.E. Seudre se poursuit. Il doit permettre dans un premier temps d'informer, de communiquer, de faire un état des lieux de l'existant concernant les aspects environnementaux et socio-économique, la gestion de l'eau, de sa qualité ou d'autres points. L'IFREMER, qui a récemment acquis un logiciel de système d'information géographique l'a exploité pour réaliser un «début d'atlas» sur la Seudre. Cet atlas est donc mis à disposition des utilisateurs potentiels par l'IFREMER, ...

Caracterisation pratique des systemes quantiques et memoires quantiques auto-correctrices 2D

Science.gov (United States)

Landon-Cardinal, Olivier

Cette these s'attaque a deux problemes majeurs de l'information quantique: - Comment caracteriser efficacement un systeme quantique? - Comment stocker de l'information quantique? Elle se divise done en deux parties distinctes reliees par des elements techniques communs. Chacune est toutefois d'un interet propre et se suffit a elle-meme. Caracterisation pratique des systemes quantiques. Le calcul quantique exige un tres grand controle des systemes quantiques composes de plusieurs particules, par exemple des atomes confines dans un piege electromagnetique ou des electrons dans un dispositif semi-conducteur. Caracteriser un tel systeme quantique consiste a obtenir de l'information sur l'etat grace a des mesures experimentales. Or, chaque mesure sur le systeme quantique le perturbe et doit done etre effectuee apres avoir reprepare le systeme de facon identique. L'information recherchee est ensuite reconstruite numeriquement a partir de l'ensemble des donnees experimentales. Les experiences effectuees jusqu'a present visaient a reconstruire l'etat quantique complet du systeme, en particulier pour demontrer la capacite de preparer des etats intriques, dans lesquels les particules presentent des correlations non-locales. Or, la procedure de tomographie utilisee actuellement n'est envisageable que pour des systemes composes d'un petit nombre de particules. Il est donc urgent de trouver des methodes de caracterisation pour les systemes de grande taille. Dans cette these, nous proposons deux approches theoriques plus ciblees afin de caracteriser un systeme quantique en n'utilisant qu'un effort experimental et numerique raisonnable. - La premiere consiste a estimer la distance entre l'etat realise en laboratoire et l'etat cible que l'experimentateur voulait preparer. Nous presentons un protocole, dit de certification, demandant moins de ressources que la tomographie et tres efficace pour plusieurs classes d'etats importantes pour l'informatique quantique. - La seconde

Comprendre la construction des usages des TIC en formation : Vers un modèle d'analyse systémique

OpenAIRE

POYET , FRANCOISE

2014-01-01

Mémoire de HDR présenté et soutenu publiquement le 24 avril 2014 par Françoise POYETDepuis quelque trente ans, les Technologies de l’Information et de la Communication ont pris un essor considérable dans le monde professionnel et dans la plupart des activités de la vie quotidienne. Cet essor ne semble pas aussi rapide en ce qui concerne les domaines de l’éducation et de la formation dans lesquels les TIC prennent davantage de temps à s’intégrer durablement aux pratiques professionnelles des e...

Percussion use and training: a survey of music therapy clinicians.

Science.gov (United States)

Scheffel, Stephanie; Matney, Bill

2014-01-01

Percussion instruments are commonly used in music therapy practice; however, the body of published literature regarding music therapy-related percussion training and practice is limited. The purpose of our survey study was to describe: (a) clinician perspectives of their academic percussion training; (b) use of percussion testing during academic training; (c) clinician perspectives on relevance, adequacy, and importance of academic percussion training; (d) clinician perspectives of their nonacademic percussion training; and (e) current use of percussion in clinical practice. Through comparisons of these parameters, we sought to provide information that may inform future percussion use and training. Participants were selected using an email list from the Certification Board for Music Therapists. Board-certified music therapists (MT-BC) were provided with a researcher-created survey about academic percussion training, nonacademic percussion training, and use of percussion in clinical practice. Survey response rate was 14.4% (611/4234). We used demographic data to address potential nonresponse error and ensure population representation for region of residence and region of academic training. Results revealed concerns about perceived adequacy of percussion training received during music therapy education (14.6% reported receiving no academic percussion training; 40.6% reported training was not adequate), and absence of percussion-specific proficiency exams. Of the training received, 62.8% indicated that training was relevant; however, a majority (76.5%) recommended current music therapy students receive more percussion training on instruments and skills most relevant to clinical practice. Comparisons between academic training, perceived needs in academic training, and clinical usage may inform future training and clinical competency. We provide suggestions for developing future training, as well as for furthering clinical implementation and research. © the American

Evidence summaries (decision boxes) to prepare clinicians for shared decision-making with patients: a mixed methods implementation study.

Science.gov (United States)

Giguere, Anik M C; Labrecque, Michel; Haynes, R Brian; Grad, Roland; Pluye, Pierre; Légaré, France; Cauchon, Michel; Greenway, Matthew; Carmichael, Pierre-Hugues

2014-10-05

Decision boxes (Dboxes) provide clinicians with research evidence about management options for medical questions that have no single best answer. Dboxes fulfil a need for rapid clinical training tools to prepare clinicians for clinician-patient communication and shared decision-making. We studied the barriers and facilitators to using the Dbox information in clinical practice. We used a mixed methods study with sequential explanatory design. We recruited family physicians, residents, and nurses from six primary health-care clinics. Participants received eight Dboxes covering various questions by email (one per week). For each Dbox, they completed a web questionnaire to rate clinical relevance and cognitive impact and to assess the determinants of their intention to use what they learned from the Dbox to explain to their patients the advantages and disadvantages of the options, based on the theory of planned behaviour (TPB). Following the 8-week delivery period, we conducted focus groups with clinicians and interviews with clinic administrators to explore contextual factors influencing the use of the Dbox information. One hundred clinicians completed the web surveys. In 54% of the 496 questionnaires completed, they reported that their practice would be improved after having read the Dboxes, and in 40%, they stated that they would use this information for their patients. Of those who would use the information for their patients, 89% expected it would benefit their patients, especially in that it would allow the patient to make a decision more in keeping with his/her personal circumstances, values, and preferences. They intended to use the Dboxes in practice (mean 5.6±1.2, scale 1-7, with 7 being "high"), and their intention was significantly related to social norm, perceived behavioural control, and attitude according to the TPB (Pdecision aids and training in shared decision-making would facilitate the use of the Dbox information. Some participants would have liked

Postoperative Pain Management: Clinicians' Knowledge and ...

African Journals Online (AJOL)

Postoperative Pain Management: Clinicians' Knowledge and Practices on Assessment and Measurement at Moi Teaching and Referral Hospital. ... A standardized questionnaire was administered to 236 hospital – based clinicians including medical doctors, nurses and clinical officers. The questionnaire consisted of ...

A Qualitative Case Study of Smartphone-Connected Hearing Aids: Influences on Patients, Clinicians, and Patient-Clinician Interactions.

Science.gov (United States)

Ng, Stella L; Phelan, Shanon; Leonard, MaryAnn; Galster, Jason

2017-06-01

Innovations in hearing aid technology influence clinicians and individuals who use hearing aids. Little research, to date, explains the innovation adoption experiences and perspectives of clinicians and patients, which matter to a field like audiology, wherein technology innovation is constant. By understanding clinician and patient experiences with such innovations, the field of audiology may develop technologies and ways of practicing in a manner more responsive to patients' needs, and attentive to society's influence. The authors aimed to understand how new innovations influence clinician and patient experiences, through a study focusing on connected hearing aids. "Connected" refers to the wireless functional connection of hearing aids with everyday technologies like mobile phones and tablets. The authors used a qualitative collective case study methodology, borrowing from constructivist grounded theory for data collection and analysis methods. Specifically, the authors designed a collective case study of a connected hearing aid and smartphone application, composed of two cases of experience with the innovation: the case of clinician experiences, and the case of patient experiences. The qualitative sampling methods employed were case sampling, purposive within-case sampling, and theoretical sampling, and culminated in a total collective case n = 19 (clinician case n = 8; patient case n = 11). These data were triangulated with a supplementary sample of ten documents: relevant news and popular media collected during the study time frame. The authors conducted interviews with the patients and clinicians, and analyzed the interview and document data using the constant comparative method. The authors compared their two cases by looking at trends within, between, and across cases. The clinician case highlighted clinicians' heuristic-based candidacy judgments in response to the adoption of the connected hearing aids into their practice. The patient case revealed

Developpement des betons semi autoplacants a rheologie adaptee pour des infrastructures

Science.gov (United States)

Sotomayor Cruz, Cristian Daniel

Au cours des dernières décennies, les infrastructures canadiennes et québécoises comportent plusieurs structures en béton armé présentant des problèmes de durabilité dus aux conditions climatiques sévères, à la mauvaise conception des structures, à la qualité des matériaux, aux types des bétons choisis, aux systèmes de construction ou à l'existence d'événements incontrôlables. En ce qui concerne le choix du béton pour la construction des infrastructures, une vaste gamme de béton divisée en deux principaux types peut être utilisée: le béton conventionnel vibré (BCV) et le béton autoplaçant (BAP). Dans le cas d'un BCV, la consolidation inadéquate par vibration a été un problème récurrent, occasionnant des dommages structuraux. Ceci a conduit à une réduction de la durabilité et à une augmentation du coût d'entretien et de réparation des infrastructures. Rien que l'utilisation d'un BAP a des avantages tels que l'élimination de la vibration, la réduction des coûts de main d'oeuvre et l'amélioration de la qualité des structures, néanmoins, le coût initial d'un BAP par rapport à un BCV ne permet pas encore de généraliser son utilisation dans l'industrie de la construction. Ce mémoire présente la conception d'une nouvelle gamme de béton semi-autoplaçant pour la construction des infrastructures (BSAP-I) exigeant une vibration minimale. Il s'agit de trouver un équilibre optimal entre la rhéologie et le coût initial du nouveau béton pour conférer une bonne performance structurale et économique aux structures. Le programme expérimental établi a premièrement permis d'évaluer la faisabilité d'utilisation des BSAP-I pour la mise en place des piliers d'une infrastructure de pont à Sherbrooke. En plus, l'utilisation d'un plan d'expériences a permis l'évaluation de trois paramètres de formulation sur les propriétés des mélanges de BSAP-I à l'état frais et durci. Finalement, l'évaluation de la performance des

Libération des acides gras par autolyse enzymatique des triglycérides des graines oléoprotéagineuses

Directory of Open Access Journals (Sweden)

Alibert Gilbert

2001-01-01

Full Text Available Les acides gras produits par hydrolyse chimique des lipides des plantes sont des matériaux de base pour l’industrie des biocarburants, des lubrifiants, des plastiques, des détergents et également des adjuvants de préparations commerciales d’herbicides. Cependant les procédés actuels de production des acides gras sont hautement polluants et coûteux en énergie. Dans ce travail nous développons un nouveau procédé de production des acides gras mettant en œuvre des plantes génétiquement modifiées. Nous avons introduit dans le tabac, retenu comme plante modèle, une construction génétique comprenant un gène de lipase (de la levure Geotrichum candidum sous le contrôle d’un promoteur graine spécifique (promoteur AtEm1 d’Arabidopsis thaliana. Ce promoteur devrait permettre l’expression du gène de lipase au niveau de l’axe embryonnaire tandis que les lipides s’accumulent dans les corps lipidiques des cotylédons. Dans ces conditions, les lipides de la graine devraient être séparés de la lipase par une compartimentation tissulaire et ne pas interférer. Après broyage des graines on peut penser que la mise en contact des lipides et de la lipase conduira à la libération d’acides gras. Plusieurs transformants ont été produits par transfert de gène à l’aide d’Agrobacterium tumefaciens, quelques-uns d’entre eux exprimant, comme attendu, la lipase dans leurs graines. Trois clones (2, 19 et 43 présentent une activité lipase significative et ont été retenus pour des études complémentaires. Cependant l’activité enzymatique observée est faible et certains clones présentent un défaut de compartimentation entre l’enzyme et les lipides se traduisant par la production d’acides gras dans la graine intacte. Lorsque les graines du clone 43 sont broyées dans un tampon, des acides gras sont produits dans le milieu réactionnel, validant le procédé imaginé. De nouvelles constructions réalisées, soit

Paternité des articles et intérêts concurrents : une analyse des recommandations aux auteurs des journaux traitant de pratique pharmaceutique

Science.gov (United States)

Courbon, Ève; Tanguay, Cynthia; Lebel, Denis; Bussières, Jean-François

2014-01-01

RÉSUMÉ Contexte : La présence d’auteurs honorifiques et fantômes ainsi que les intérêts concurrents représentent des difficultés bien documentées, liées à la publication d’articles scientifiques. Il existe des lignes directrices encadrant la rédaction et la publication de manuscrits scientifiques, notamment celles de l’International Committee of Medical Journal Editors (ICMJE). Objectifs : L’objectif principal de cette étude descriptive et transversale visait à recenser les instructions portant sur la paternité des articles et les intérêts concurrents provenant des recommandations aux auteurs des journaux traitant de pratique pharmaceutique. L’objectif secondaire visait à déterminer des mesures correctrices pour une paternité des articles plus transparente. Méthode : La recherche a débuté par l’identification des journaux traitant de pratique pharmaceutique. La consultation des instructions aux auteurs des journaux a permis ensuite de recenser les recommandations destinées à éviter les problèmes de paternité des articles et d’intérêts concurrents. Finalement, les membres de l’équipe de recherche se sont consultés afin de définir des mesures correctrices possibles à l’intention des chercheurs. Résultats : Des 232 journaux traitant de pharmacie, 33 ont été définis comme traitant de pratique pharmaceutique. Un total de 24 (73 %) journaux mentionnaient suivre la politique de l’ICMJE, 14 (42 %) demandaient aux auteurs de remplir un formulaire de déclaration d’intérêts concurrents au moment de la soumission de l’article, 17 (52 %) présentaient une définition de la qualité d’auteur et 5 (15 %) demandaient de détailler les contributions de chaque auteur. Une grille de 40 critères a été élaborée pour définir l’attribution du statut d’auteur. Conclusion : Moins de la moitié des journaux demandait aux auteurs de transmettre un formulaire de déclaration des intérêts concurrents au moment de la

The structure of para-toluidine by X-ray and neutron diffraction; Etude de la structure de la para-toluidine par la diffraction des rayons X et des neutrons

Energy Technology Data Exchange (ETDEWEB)

Bertinotti, A.L. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1965-12-01

The crystal and molecular structure of para-toluidine has been solved by X-ray and neutron diffraction counter techniques. The molecules are arranged in the form of infinite chains in the crystal, each molecule being linked to two neighbours by hydrogen bonds. The presence of the H bonds makes clear the difference in the melting points between para-toluidine and benzene hydrocarbons of related symmetry and molecular weight. Their direction accounts for the (001) cleavage and the growth anisotropy of crystals from supersaturated vapour phase. A structure-seeking method by computer has been elaborated, using lattice energy calculations applied to molecules treated as rigid bodies and making use of a simplex method for function minimization without calculation of derivatives. The way the available information is handled allows to increase the range of convergence, as shown in the case of para-toluidine. (author) [French] La structure cristalline et moleculaire de la para-toluidine a ete resolue a l'aide de la diffraction des rayons X et des neutrons. L'analyse a revele que la structure presentait un encha ement particulier des molecules, liees entre elles par des ponts hydrogene. La presence des liaisons rend compte de l'elevation du point de fusion de la para-toluidine par rapport a celui des carbures benzeniques de symetrie et de poids moleculaires voisins. La direction des liaisons explique le clivage facile (001) des cristaux obtenus par fusion et l'anisotropie de croissance des cristaux en phase vapeur. Une methode de recherche de structures par ordinateur a ete elaboree, faisant usage du concept d'energie reticulaire applique aux molecules considerees comme rigides et faisant appel a une methode de simplexe pour la minimisation des fonctions sans calcul de derivees. La maniere dont est exploitee l'information disponible permet d'accro re, comme cela est montre dans le cas de la para-toluidine, l'etendue du domaine de

The structure of para-toluidine by X-ray and neutron diffraction; Etude de la structure de la para-toluidine par la diffraction des rayons X et des neutrons

Energy Technology Data Exchange (ETDEWEB)

Bertinotti, A L [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1965-12-01

The crystal and molecular structure of para-toluidine has been solved by X-ray and neutron diffraction counter techniques. The molecules are arranged in the form of infinite chains in the crystal, each molecule being linked to two neighbours by hydrogen bonds. The presence of the H bonds makes clear the difference in the melting points between para-toluidine and benzene hydrocarbons of related symmetry and molecular weight. Their direction accounts for the (001) cleavage and the growth anisotropy of crystals from supersaturated vapour phase. A structure-seeking method by computer has been elaborated, using lattice energy calculations applied to molecules treated as rigid bodies and making use of a simplex method for function minimization without calculation of derivatives. The way the available information is handled allows to increase the range of convergence, as shown in the case of para-toluidine. (author) [French] La structure cristalline et moleculaire de la para-toluidine a ete resolue a l'aide de la diffraction des rayons X et des neutrons. L'analyse a revele que la structure presentait un encha ement particulier des molecules, liees entre elles par des ponts hydrogene. La presence des liaisons rend compte de l'elevation du point de fusion de la para-toluidine par rapport a celui des carbures benzeniques de symetrie et de poids moleculaires voisins. La direction des liaisons explique le clivage facile (001) des cristaux obtenus par fusion et l'anisotropie de croissance des cristaux en phase vapeur. Une methode de recherche de structures par ordinateur a ete elaboree, faisant usage du concept d'energie reticulaire applique aux molecules considerees comme rigides et faisant appel a une methode de simplexe pour la minimisation des fonctions sans calcul de derivees. La maniere dont est exploitee l'information disponible permet d'accro re, comme cela est montre dans le cas de la para-toluidine, l'etendue du domaine de convergence. (auteur)

Contribution des radios communautaires a l'education des ...

African Journals Online (AJOL)

Contribution des radios communautaires a l'education des populations rurales pour un developpement durable au Benin: etude de cas. ... Journal de la Recherche Scientifique de l'Université de Lomé. Journal Home · ABOUT THIS JOURNAL ...

Rôle des germes parasites des bactéries pathogènes dans l'autoépuration des eaux

Directory of Open Access Journals (Sweden)

GUELIN A.

1969-04-01

Full Text Available Existence dans les eaux polluées de germes parasites qui s'attaquent aux bactéries pathogènes. Le pouvoir bactéricide des eaux polluées dû, en grande partie à la présence dans ces eaux de différents représentants des germes parasites. Possibilité d'application pratique des germes parasites pour l'assainissement des eaux polluées.

Assurer l'apport des pays du Sud à l'action mondiale | CRDI - Centre ...

International Development Research Centre (IDRC) Digital Library (Canada)

10 juin 2016 ... ... des chaînes d'approvisionnement et des systèmes d'information –, la Commission recommande 10 mesures précises en lien avec d'autres initiatives de renforcement des systèmes de santé global. Il est essentiel d'établir de tels liens, car les produits ne représentent qu'une infime partie d'un système de ...

Effets des extraits vegetaux sur la dynamique de populations des ...

African Journals Online (AJOL)

La présente étude se propose de trouver une alternative de l'utilisation des pesticides chimiques en testant l'effet insecticide des extraits aqueux des feuilles de Hyptis suaveolens, graines de Ricinus communis et de Azadirachta indica contre les ravageurs du niébé en conditions de champ en utilisant le cyperméthrine ...

The power of clinicians' affective communication: how reassurance about non-abandonment can reduce patients' physiological arousal and increase information recall in bad news consultations. An experimental study using analogue patients

NARCIS (Netherlands)

Sep, Milou S. C.; van Osch, Mara; van Vliet, Liesbeth M.; Smets, Ellen M. A.; Bensing, Jozien M.

2014-01-01

The diagnosis of incurable cancer may evoke physiological arousal in patients. Physiological arousal can negatively impact patients' recall of information provided in the medical consultation. We aim to investigate whether clinicians' affective communication during a bad news consultation will

USER FRUSTRATION IN HIT INTERFACES: EXPLORING PAST HCI RESEARCH FOR A BETTER UNDERSTANDING OF CLINICIANS' EXPERIENCES.

Science.gov (United States)

Opoku-Boateng, Gloria A

2015-01-01

User frustration research has been one way of looking into clinicians' experience with health information technology use and interaction. In order to understand how clinician frustration with Health Information Technology (HIT) use occurs, there is the need to explore Human-Computer Interaction (HCI) literature that addresses both frustration and HIT use. In the past three decades, HCI frustration research has increased and expanded. Researchers have done a lot of work to understand emotions, end-user frustration and affect. This paper uses a historical literature review approach to review the origins of emotion and frustration research and explore the research question; Does HCI research on frustration provide insights on clinicians' frustration with HIT interfaces? From the literature review HCI research on emotion and frustration provides additional insights that can indeed help explain user frustration in HIT. Different approaches and HCI perspectives also help frame HIT user frustration research as well as inform HIT system design. The paper concludes with a suggested directions on how future design and research may take.

La participation des femmes à la vie politique se traduit par des ...

International Development Research Centre (IDRC) Digital Library (Canada)

La participation des femmes à la vie politique se traduit par des économies locales plus vigoureuses. 08 juin 2016. Image. Des femmes assistent à une réunion d'un groupe d'entraide près d'. Edgard Rodriguez - IDRC. Des femmes assistent à une réunion d'un groupe d'entraide près d'Hyderabad, en Inde. Keenara ...

Incidence des prix et des taxes sur la consommation de produits du ...

International Development Research Centre (IDRC) Digital Library (Canada)

Incidence des prix et des taxes sur la consommation de produits du tabac en Argentine, en Bolivie et au Chili. Partout en Amérique du Sud, les adultes et les enfants font une grande consommation de tabac. Un nouveau projet de recherche se penchera sur les avantages et les limites des stratégies de fixation des prix et de ...

Multimedia reviews: multimedia convergence for clinicians.

Science.gov (United States)

Taintor, Zebulon

2003-12-01

Introduction by the column editor: In this final column of the year, Dr. Taintor provides an overview of exciting technological developments via his report on the 2003 annual meeting of the American Association for Technology in Psychiatry (AATP). Advances-and convergences-in technology are providing clinicians with increasingly useful tools to enhance the effectiveness of their treatments, increase access to care, reduce errors, and save time. As Dr. Taintor notes, AATP's meeting is traditionally held in conjunction with the annual meeting of the American Psychiatric Association (APA). I hope that his report will encourage APA's members to attend some of next year's informative sessions.

DES Science Portal: Computing Photometric Redshifts

Energy Technology Data Exchange (ETDEWEB)

Gschwend, Julia [LIneA, Rio de Janeiro

2016-01-01

An important challenge facing photometric surveys for cosmological purposes, such as the Dark Energy Survey (DES), is the need to produce reliable photometric redshifts (photo-z). The choice of adequate algorithms and configurations and the maintenance of an up-to-date spectroscopic database to build training sets, for example, are challenging tasks when dealing with large amounts of data that are regularly updated and constantly growing. In this paper, we present the first of a series of tools developed by DES, provided as part of the DES Science Portal, an integrated web-based data portal developed to facilitate the scientific analysis of the data, while ensuring the reproducibility of the analysis. We present the DES Science Portal photometric redshift tools, starting from the creation of a spectroscopic sample to training the neural network photo-z codes, to the final estimation of photo-zs for a large photometric catalog. We illustrate this operation by calculating well calibrated photo-zs for a galaxy sample extracted from the DES first year (Y1A1) data. The series of processes mentioned above is run entirely within the Portal environment, which automatically produces validation metrics, and maintains the provenance between the different steps. This system allows us to fine tune the many steps involved in the process of calculating photo-zs, making sure that we do not lose the information on the configurations and inputs of the previous processes. By matching the DES Y1A1 photometry to a spectroscopic sample, we define different training sets that we use to feed the photo-z algorithms already installed at the Portal. Finally, we validate the results under several conditions, including the case of a sample limited to i<22.5 with the color properties close to the full DES Y1A1 photometric data. This way we compare the performance of multiple methods and training configurations. The infrastructure presented here is an effcient way to test several methods of

Roles et taches des accompagnateurs des patients hospitalises ...

African Journals Online (AJOL)

Roles et taches des accompagnateurs des patients hospitalises dans le service de pneumo-phtysiologie au Centre Hospitalier Universitaire Yalgado Ouedraogo de ... Logistical support represented by material support, drug supply, cleaning of premises, and littering occupied respectively 100%, 91%, 42% and 73%.

Examination of the relationship between management and clinician perception of patient safety climate and patient satisfaction.

Science.gov (United States)

Mazurenko, Olena; Richter, Jason; Kazley, Abby Swanson; Ford, Eric

2017-04-25

The aim of this study was to explore the relationship between managers and clinicians' agreement on deeming the patient safety climate as high or low and the patients' satisfaction with those organizations. We used two secondary data sets: the Hospital Survey on Patient Safety Culture (2012) and the Hospital Consumer Assessment of Healthcare Providers and Systems (2012). We used ordinary least squares regressions to analyze the relationship between the extent of agreement between managers and clinicians' perceptions of safety climate in relationship to patient satisfaction. The dependent variables were four Hospital Consumer Assessment of Healthcare Providers and Systems patient satisfaction scores: communication with nurses, communication with doctors, communication about medicines, and discharge information. The main independent variables were four groups that were formed based on the extent of managers and clinicians' agreement on four patient safety climate domains: communication openness, feedback and communication about errors, teamwork within units, and teamwork across units. After controlling for hospital and market-level characteristics, we found that patient satisfaction was significantly higher if managers and clinicians reported that patient safety climate is high or if only clinicians perceived the climate as high. Specifically, manager and clinician agreement on high levels of communication openness (β = 2.25, p = .01; β = 2.46, p = .05), feedback and communication about errors (β = 3.0, p = .001; β = 2.89, p = .01), and teamwork across units (β = 2.91, p = .001; β = 3.34, p = .01) was positively and significantly associated with patient satisfaction with discharge information and communication about medication. In addition, more favorable perceptions about patient safety climate by clinicians only yielded similar findings. Organizations should measure and examine patient safety climate from multiple perspectives and be aware that individuals

effet des ados en courbes de niveau sur la distribution et la diversite ...

African Journals Online (AJOL)

Administrateur

d'arachide a permis d'évaluer les performances des ados en courbes de niveau. ... However, in a context of global environmental degradation, only some information on their effects on ..... gestion de l'eau du sol et le rendement des cultures ...

Des Ogle's old stump

International Nuclear Information System (INIS)

Jones, M.; Sutton, D.; Wallace, R.

1998-01-01

On 17 October 1997 Sylvia Bryan of RD4 Kaitaia wrote to 'Dear Somebody-Everybody' at the Anthropology Department, University of Auckland, urging further examination of an adzed stump found by Des Ogle during planting out of the Te Aupouri forest. The authors have since sought out relevant information and present it here for the interests of our readers. (author). 7 refs., 1 fig

Utilisation des mousses et des pâtes syntactiques pour combler les lacunes des poteries archéologiques

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Viviane Bechoux

2008-10-01

Full Text Available Filling potteries missing parts with plaster raises now complex problems during the de-restoration treatments. Ceramics restorers have recurrently questions on the use of plaster in the field of archaeological ceramics restoration. Some researches point to the choice of other filling materials. At the present time other methods can be devised by proposing plaster replacement by a lightened composite material: syntactic foams and pastes.Le comblement des lacunes des poteries à partir du plâtre pose actuellement des problèmes complexes lors des traitements de dérestauration. Les restaurateurs de céramiques s'interrogent de manière récurrente sur l'utilisation du plâtre dans le domaine de la restauration des céramiques archéologiques. Des recherches s'orientent vers le choix d'autres matériaux d'obturation. Actuellement, d'autres méthodes peuvent être mises en place en proposant le remplacement du plâtre par un matériau composite allégé, les mousses et les pâtes syntactiques.

Développer le leadership dans des villes de l'Amérique latine et des ...

International Development Research Centre (IDRC) Digital Library (Canada)

Développer le leadership dans des villes de l'Amérique latine et des Caraïbes dans le contexte des changements climatiques. En raison des changements climatiques, de la croissance démographique et de l'urbanisation rapide non planifiée, les villes des pays en développement sont à la fois le principal déclencheur des ...

La Question de L'impunité des Auteurs de Violations des Droits de L'homme

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Maria dos Remédios Fontes Silva

2010-10-01

Full Text Available Ce travail pretend faire reflechir à propos de la question de l'impunite des autorites de L'Etat face aux violations des droits de l'homme. On abordera cet egard: a le role de I'amnistie ble complicite des autoritesadministratives c la lenteur des procedures judicieuse.     L'analyse de cette question montre qui L'impunite des responsables des violations des droits de l'homme fait peser une menace sur I'ensemble du systeme de protection universelle des droits de l'homme.          On peut on conduire qu 'aucune societe que aspire à la democratie et ala justice ne peut se construire sur I'amoralite des crimes impunis et I'amnesie officielle.

Clinicians' experiences of becoming a clinical manager: a qualitative study.

Science.gov (United States)

Spehar, Ivan; Frich, Jan C; Kjekshus, Lars Erik

2012-11-22

There has been an increased interest in recruiting health professionals with a clinical background to management positions in health care. We know little about the factors that influence individuals' decisions to engage in management. The aim of this study is to explore clinicians' journeys towards management positions in hospitals, in order to identify potential drivers and barriers to management recruitment and development. We did a qualitative study which included in-depth interviews with 30 clinicians in middle and first-line management positions in Norwegian hospitals. In addition, participant observation was conducted with 20 of the participants. The informants were recruited from medical and surgical departments, and most had professional backgrounds as medical doctors or nurses. Interviews were analyzed by systemic text condensation. We found that there were three phases in clinicians' journey into management; the development of leadership awareness, taking on the manager role and the experience of entering management. Participants' experiences suggest that there are different journeys into management, in which both external and internal pressure emerged as a recurrent theme. They had not anticipated a career in clinical management, and experienced that they had been persuaded to take the position. Being thrown into the position, without being sufficiently prepared for the task, was a common experience among participants. Being left to themselves, they had to learn management "on the fly". Some were frustrated in their role due to increasing administrative workloads, without being able to delegate work effectively. Path dependency and social pressure seems to influence clinicians' decisions to enter into management positions. Hospital organizations should formalize pathways into management, in order to identify, attract, and retain the most qualified talents. Top managers should make sure that necessary support functions are available locally, especially

A Genome-Wide Association Study Primer for Clinicians

Directory of Open Access Journals (Sweden)

Tzu-Hao Wang

2009-06-01

Full Text Available Genome-wide association studies (GWAS use high-throughput genotyping technology to relate hundreds of thousands of genetic markers (genotypes to clinical conditions and measurable traits (phenotypes. This review is intended to serve as an introduction to GWAS for clinicians, to allow them to better appreciate the value and limitations of GWAS for genotype-disease association studies. The input of clinicians is vital for GWAS, since disease heterogeneity is frequently a confounding factor that can only really be solved by clinicians. For diseases that are difficult to diagnose, clinicians should ensure that the cases do indeed have the disease; for common diseases, clinicians should ensure that the controls are truly disease-free.

Big-Data Based Decision-Support Systems to Improve Clinicians' Cognition.

Science.gov (United States)

Roosan, Don; Samore, Matthew; Jones, Makoto; Livnat, Yarden; Clutter, Justin

2016-01-01

Complex clinical decision-making could be facilitated by using population health data to inform clinicians. In two previous studies, we interviewed 16 infectious disease experts to understand complex clinical reasoning. For this study, we focused on answers from the experts on how clinical reasoning can be supported by population-based Big-Data. We found cognitive strategies such as trajectory tracking, perspective taking, and metacognition has the potential to improve clinicians' cognition to deal with complex problems. These cognitive strategies could be supported by population health data, and all have important implications for the design of Big-Data based decision-support tools that could be embedded in electronic health records. Our findings provide directions for task allocation and design of decision-support applications for health care industry development of Big data based decision-support systems.

Membrane fluidization by alcohols inhibits DesK-DesR signalling in Bacillus subtilis.

Science.gov (United States)

Vaňousová, Kateřina; Beranová, Jana; Fišer, Radovan; Jemioła-Rzemińska, Malgorzata; Matyska Lišková, Petra; Cybulski, Larisa; Strzałka, Kazimierz; Konopásek, Ivo

2018-03-01

After cold shock, the Bacillus subtilis desaturase Des introduces double bonds into the fatty acids of existing membrane phospholipids. The synthesis of Des is regulated exclusively by the two-component system DesK/DesR; DesK serves as a sensor of the state of the membrane and triggers Des synthesis after a decrease in membrane fluidity. The aim of our work is to investigate the biophysical changes in the membrane that are able to affect the DesK signalling state. Using linear alcohols (ethanol, propanol, butanol, hexanol, octanol) and benzyl alcohol, we were able to suppress Des synthesis after a temperature downshift. The changes in the biophysical properties of the membrane caused by alcohol addition were followed using membrane fluorescent probes and differential scanning calorimetry. We found that the membrane fluidization induced by alcohols was reflected in an increased hydration at the lipid-water interface. This is associated with a decrease in DesK activity. The addition of alcohol mimics a temperature increase, which can be measured isothermically by fluorescence anisotropy. The effect of alcohols on the membrane periphery is in line with the concept of the mechanism by which two hydrophilic motifs located at opposite ends of the transmembrane region of DesK, which work as a molecular caliper, sense temperature-dependent variations in membrane properties. Copyright © 2017 Elsevier B.V. All rights reserved.

Screening phytochimique et identification spectroscopique des ...

African Journals Online (AJOL)

Origin

plante, effectuée pour la première fois, a révélé la présence des alcaloïdes, des flavonoïdes, des tanins catéchiques, des terpènes, des coumarines et des composés cyanogénétiques. Quant aux saponines et les quinones libres, ils sont présents chez les fleurs et absents chez les feuilles. La caractérisation des molécules.

Etude du processus de changement vecu par des familles ayant decide d'adopter volontairement des comportements d'attenuation des changements climatiques

Science.gov (United States)

Leger, Michel T.

Les activites humaines energivores telles l'utilisation intensive de l'automobile, la surconsommation de biens et l'usage excessif d'electricite contribuent aux changements climatiques et autres problemes environnementaux. Bien que plusieurs recherches rapportent que l'etre humain est de plus en plus conscient de ses impacts sur le climat de la planete, ces memes recherches indiquent qu'en general, les gens continuent a se comporter de facon non ecologique. Que ce soit a l'ecole ou dans la communaute, plusieurs chercheurs en education relative a l'environnement estiment qu'une personne bien intentionnee est capable d'adopter des comportements plus respectueux de l'environnement. Le but de cette these etait de comprendre le processus d'integration de comportements d'attenuation des changements climatiques dans des familles. A cette fin, nous nous sommes fixe deux objectifs : 1) decrire les competences et les procedes qui favorisent l'adoption de comportements d'attenuation des changements climatiques dans des familles et 2) decrire les facteurs et les dynamiques familiales qui facilitent et limitent l'adoption de comportements d'attenuation des changements climatiques dans des familles. Des familles ont ete invitees a essayer des comportements personnels et collectifs d'attenuation des changements climatiques de sorte a integrer des modes de vie plus ecologiques. Sur une periode de huit mois, nous avons suivi leur experience de changement afin de mieux comprendre comment se produit le processus de changement dans des familles qui decident volontairement d'adopter des comportements d'attenuation des changements climatiques. Apres leur avoir fourni quelques connaissances de base sur les changements climatiques, nous avons observe le vecu de changement des familles durant huit mois d'essais a l'aide de journaux reflexifs, d'entretiens d'explicitation et du journal du chercheur. La these comporte trois articles scientifiques. Dans le premier article, nous presentons une

L'accumulation des métaux lourds au niveau des cultures : Cas des ...

African Journals Online (AJOL)

Le Bassin de Sebou présente une importance socio-économique pour le Maroc. En effet, il est sujet de diverses utilisations ; eau potable, eau d'irrigation et eau industrielle. Toutefois, ce bassin subit des pressions multiples, notamment par la pollution métallique. Considérant le risque de bioaccumulation des métaux par ...

How do intake clinicians use patient characteristics to select treatment for patients with personality disorders?

Science.gov (United States)

van Manen, Janine; Kamphuis, Jan Henk; Visbach, Geny; Ziegler, Uli; Gerritsen, Ad; Van Rossum, Bert; Rijnierse, Piet; Timman, Reinier; Verheul, Roel

2008-11-01

Treatment selection in clinical practice is a poorly understood, often largely implicit decision process, perhaps especially for patients with personality disorders. This study, therefore, investigated how intake clinicians use information about patient characteristics to select psychotherapeutic treatment for patients with personality disorder. A structured interview with a forced-choice format was administered to 27 experienced intake clinicians working in five specialist mental health care institutes in the Netherlands. Substantial consensus was evident among intake clinicians. The results revealed that none of the presented patient characteristics were deemed relevant for the selection of the suitable treatment setting. The appropriate duration and intensity are selected using severity or personal strength variables. The theoretical orientation is selected using personal strength variables.

Crytosystem Program Planning for Securing Data/Information of the Results of Research and Development using Triple DES Algorithm

International Nuclear Information System (INIS)

Tumpal P; Naga, Dali S.; David

2004-01-01

This software is a cryptosystem that uses triple DES algorithm and uses ECB (Electronic Code Book) mode. This cryptosystem can send a file with any extension whether it is encrypted or not, encrypt the data that representing the picture of bitmap file or text, as well as view the calculation that can be written. Triple DES is an efficient and effective developments of DES because same algorithm but the three times repeated operation causing the key become 168 bit from 56 bit. (author)

Contrôle des Circuits Auxiliaires des PFW (arrêt machines 2002/2003)

CERN Document Server

Ottaviani, J

2003-01-01

Les PFW sont des nappes polaires installées sur les pôles des aimants du PS. Elles sont au nombre de 4 par unité d aimant et constituées d un circuit principal (dans lequel circule le courant désiré selon le cycle magnétique utilisé) et de circuits auxiliaires. Les circuits auxiliaires sont des enroulements de correction (boucles de tour et pick-up brasés sur les enroulements). Pendant la variation du champ magnétique de l aimant PS, on utilise des tensions induites dans ces circuits auxiliaires pour corriger les erreurs de champ dues aux courants de Foucault dans la chambre à vide. Chaque année, pendant l arrêt machine, on vérifie si les caractéristiques des circuits auxiliaires correspondent aux normes (mesures des résistances des boucles de tours, résistances entre pick-up et isolation des circuits) afin de faire un suivi. Les 404 PFW sont ainsi vérifiées. Dans cette note, on ne relèvera que les PFW ayant des défauts (valeurs hors tolérances, boucles ouvertes ou en court-circuit, déf...

Take the money and run? Redemption of a gift card incentive in a clinician survey.

Science.gov (United States)

Chen, Jane S; Sprague, Brian L; Klabunde, Carrie N; Tosteson, Anna N A; Bitton, Asaf; Onega, Tracy; MacLean, Charles D; Harris, Kimberly; Schapira, Marilyn M; Haas, Jennifer S

2016-02-24

Clinician surveys provide critical information about many facets of health care, but are often challenging to implement. Our objective was to assess use by participants and non-participants of a prepaid gift card incentive that could be later reclaimed by the researchers if unused. Clinicians were recruited to participate in a mailed or online survey as part of a study to characterize women's primary health care provider attitudes towards breast and cervical cancer screening guidelines and practices (n = 177). An up-front incentive of a $50 gift card to a popular online retailer was included with the study invitation. Clinicians were informed that the gift card would expire if it went unused after 4 months. Outcome measures included use of gift cards by participants and non-participants and comparison of hypothetical costs of different incentive strategies. 63.5% of clinicians who responded to the survey used the gift card, and only one provider who didn't participate used the gift card (1.6%). Many of those who participated did not redeem their gift cards (36.5% of respondents). The price of the incentives actually claimed totaled $3700, which was less than half of the initial outlay. Since some of the respondents did not redeem their gift cards, the cost of incentives was less than it might have been if we had provided a conditional incentive of $50 to responders after they had completed the survey. Redeemable online gift card codes may provide an effective way to motivate clinicians to participate in surveys.

Étude floristique et ethnobotanique des plantes médicinales ...

African Journals Online (AJOL)

Objectif : Cette étude ethnobotanique a été menée dans la préfecture d'Agadir Ida-Outanane afin de recueillir des informations sur les usages thérapeutiques des plantes médicinales pratiquées dans cette région. Méthodologie et résultats : A l'aide de 270 fiches questionnaires, une série d'enquêtes ethnobotaniques a été ...

Smart use of data, information and communication: the INFORM-ed Best Local Practice Project--Grafton Base Hospital.

Science.gov (United States)

Lloyd, Sheree; Collie, Jean; McInnes, Alastair; King, Kevin; Lollback, Alison; Garland, Angie

This paper describes current progress for an information management project in a medium-sized rural hospital after the first four months of the one-year project. In particular, the article examines some of the project outcomes to date as these relate to the National Hospitals and Health Reform recommendations for the smart use of data, information and communication. The paper identifies a number of important challenges and issues that have been addressed by the project and proposes that the project findings may be used to inform similar projects in other settings. These findings relate to clinician requirements for reports, investment in human resources, development, and time for information management activities. An understanding of data collected, information systems, and presentation of clinician data are also important. The benefits of information sharing in assisting quality improvement activities are particularly relevant but, more importantly, they can engage and involve clinicians in the use of information. The importance of local data, information, and knowledge is described. Finally, issues for the health information management profession, such as working collegially and sharing knowledge and expertise, are outlined.

Diffusion et réception des chroniques : Chronica Naiarensis, Liber regum, Chronica regum Castellae

OpenAIRE

Arizaleta , Amaia

2006-01-01

International audience; Il est question dans ces pages des chroniques composées dans l'espace castillan au tournant du XIIe et du XIIIe siècles, afin d'avancer des informations sur le cadre pragmatique de réception des histoires royales qui devaient circuler au palais, ainsi que sur le plaisir de raconter que devaient ressentir les écrivains du roi et les auditeurs de la cour.

Contribution des TICs à l'abandon des mutilations génitales ...

International Development Research Centre (IDRC) Digital Library (Canada)

Contribution des TIC à l'abandon des MGF en Afrique de l'Ouest francophone : rôle des jeunes citoyennes; rapport technique no. 5 (rapport technique final), 18 octobre 2008 - 31 mars 2009. Download PDF. Related content. New website will help record vital life events to improve access to services for all. A new website ...

utilisation des donnees pour l'evaluation de l'heterogeneite des sols

African Journals Online (AJOL)

AISA

étude a permis de caractériser l'hétérogénéité des sols ferrallitiques, à travers sa couleur. Mots-clés : Couleur ... ainsi qu'à l'application des recommandations des doses de fertilisant. ..... de « système sol » en zone de contact forêt- savane du ...

Statistical treatment of data. Application to nuclear electronics; Traitement des informations en regime statistique. Applications a l'electronique nucleaire

Energy Technology Data Exchange (ETDEWEB)

Sicard, F [Commissariat a l' Energie Atomique, Saclay (France).Centre d' Etudes Nucleaires

1960-07-01

In this report the data of probability calculations are applied to the analyses of counting losses in experiments on chance events encountered in nuclear physics. The distribution of time intervals according to Poisson's law is studied and various applications of this are given: calculation of counting losses on a scale preceded by a fast de-multiplying circuit, decrease of the counting rate on the multichannel selectors, recording of statistical distribution phenomena on magnetic bands. (author) [French] Ce rapport applique les donnees du calcul des probabilites a l'analyse des pertes de comptage dans les experiences sur des evenements aleatoires rencontres en physique nucleaire. La distribution des intervalles de temps suivant une loi de Poisson est etudiee et differentes applications en sont donnees: calcul des pertes de comptage sur une echelle precedee d'un circuit de demultiplication rapide, diminution du taux de comptage sur les selecteurs multicanaux, enregistrement de phenomenes a distribution statistique sur bandes magnetiques. (auteur)

Les lexiques des jeunes dans les discours écrits des blogs : pour une approche descriptive

Directory of Open Access Journals (Sweden)

Lorenz Paulina

2014-07-01

Full Text Available S’il ne faut pas confondre ce qui est appelé communément « langage SMS » et « langage des jeunes », nous avancerons toutefois que les pratiques langagières écrites des jeunes sur les supports modernes de communication, et notamment dans les blogs, présentent des particularités encore peu étudiées. Les traits observables les plus saillants sont ceux de la morphologie graphique, mais il n’en reste pas moins que certains jeunes utilisent des lexiques particuliers dans les blogs qui méritent une attention particulière. Nous nous proposons donc d’étudier les différents lexiques utilisés par des jeunes de 12 à 22 ans dans les blogs de la plateforme skyrock.com aux niveaux de sa diversité, de ses usages sémantiques variable d’un scripteur à l’autre pour un même mot, et de ses particularités morphosyntaxiques. En effet, nous observerons des lexiques divers allant des lexiques perçus comme relevant des cités à des lexiques perçus comme étant « branchés-jeunes », ou encore à des lexiques propres aux supports modernes de communication. Ainsi, nous analyserons des lexiques variés dans leurs usages écrits tels que bolos, bédave, gérer, ouf, tigen, ou encore des lexiques empruntés tels que mouv, full, etc., ainsi que des emplois particuliers de séquences autonomes comme lol. Quelques questions périphériques complèteront notre analyse telle que celles qui concerne l’influence des usages lexicaux entre pairs et le savoir partagé, la distinction de différentes communautés en fonction des lexiques utilisés, ou encore la variabilité des représentations graphiques d’un même mot.

Contrôle des circuits auxiliaires des P.F.W. (arret machine 2004/2006)

CERN Document Server

Ottaviani, J

2005-01-01

Les PFW sont des nappes polaires installées sur les pôles des aimants du PS. Elles sont au nombre de 4 par unité d’aimant et constituées d’un circuit principal (dans lequel circule le courant désiré selon le cycle magnétique utilisé) et de circuits auxiliaires. Les circuits auxiliaires sont des enroulements de correction (boucles de tour et “pick-up” brasés sur les enroulements principaux). Pendant la variation du champ magnétique de l’aimant PS, on utilise des tensions induites dans ces circuits auxiliaires pour corriger les erreurs de champ dues aux pertes par courants de Foucault dans la chambre à vide. Chaque année, pendant l’arrêt machine, on vérifie si les caractéristiques des circuits auxiliaires correspondent aux normes (mesures des résistances des boucles de tours, résistances entre “pick-up” et isolation des circuits) afin de faire un suivi. Les 404 PFW sont ainsi vérifiées. Dans cette note, on ne relèvera que les PFW ayant des défauts (valeurs hors tolérances, ...

The clinician factor: Personality characteristics of clinicians and their impact upon clinical outcomes in the management of children and adolescents with type 1 diabetes.

Science.gov (United States)

Cameron, Fergus J; Russell, Ellyn; McCombe, Julia; O'Connell, Michele A; Skinner, Timothy

2018-06-01

The purpose of this study was to estimate clinician qualities that influence metabolic outcomes in youth with type 1 diabetes. Data were gathered over two 3 month periods in a large tertiary diabetes center (1500 patients, 8 clinicians) from patients with type 1 diabetes who received continuous care from each clinician. Data included sex, age, diabetes duration, insulin regimen, body mass index (BMI), insulin dose and episodes of severe hypoglycemia. Clinician data included target blood glucose levels, target glycated hemoglobin (HbA1c), Diabetes Attitude Scale and Big 5 Personality Inventory Scale. Mean HbA1c per clinician was the primary outcome variable. The 8 clinicians saw a total of 464 patients during the first time period, and 603 in the second time period. Lowest to highest mean HbA1c per clinician varied by 0.7%. There were small but statistically significant differences between clinicians with their patients' age at diagnosis, duration of diabetes, age, gender, treatment type and BMI SD score. After controlling for these differences, the clinician characteristics that were associated with lower mean HbA1c were having no lower limit in target HbA1c and being self-reportedly "less agreeable." The impact of these clinician attitudinal traits was equivalent to the combined effects of patient characteristics and treatment type. There was a significant variation in metabolic outcomes between treating clinicians. After controlling for patient clinical differences, clinician mean HbA1c was associated with lower limit in target HbA1c and being "less agreeable." Clinicians who were more demanding and dogmatic appeared to have better outcomes. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Etat des lieux des soins de premier recours des malades mentaux à Antananarivo : étude rétrospective

Science.gov (United States)

Bakohariliva, Hasina Andrianarivony; Rafehivola, Imisanavalona Hanitrinihaja; Raobelle, Evah Norotiana; Raharivelo, Adeline; Rajaonarison, Bertille Hortense

2018-01-01

Résumé Religion et guérisseurs traditionnels occupent encore une place prépondérante dans la prise en charge des maladies mentales à Madagascar. Ainsi, nous nous sommes fixés comme objectif d'établir un état des lieux sur les soins de premier recours des malades mentaux. Nous avons mené une étude rétrospective descriptive s'étalant sur une période de 16 mois allant de janvier 2014 en avril 2015 au sein du service de psychiatrie du CHU de Befelatanana à Antananarivo. La prévalence des psychoses était de 25%. Le genre féminin (53%), l'ethnie merina (77%), les étudiants (45%), le niveau d'étude secondaire (40%), les célibataires (72%), la religion protestante (45%), ainsi que le niveau socio-économique moyen (57,5%) étaient prédominants. Dans les paramètres cliniques, le mode de début brutal (52%), le premier recours à la religion (40%), la présence d'antécédents des cas similaire (90%), étaient majoritaires. La schizophrénie était la pathologie la plus rencontrée dans la moitié des cas. Le délai d'amélioration en cas de traitement religieux et traditionnels était dans la moitié des cas de plus de 10 jours d'hospitalisation. Les patients ayant reçu une prise en charge psychiatrique en premier recours, étaient améliorés dans 75 % cas en moins de 10jours. Le retard du recours aux soins psychiatriques est une réalité à Madagascar qui aggrave le pronostic des psychoses. PMID:29632623

L'intégration des accélérateurs du CERN

CERN Document Server

Chemli, S; CERN. Geneva. TS Department

2008-01-01

L?intégration du LHC a ouvert des perspectives pour une gestion plus complète des accélérateurs du CERN. La base de données LAYOUT a permis d'assurer la continuité des phases de définition optique du projet, d'intégration 3D et de contrôles de conformité des installations. Les scans et modélisations 3D en couches des installations réalisées constituent un outil déterminant pour la préparation des interventions dans le cadre des procédures de sécurité ALARA. Il est proposé de reproduire cette méthodologie pour les nouveaux projets comme pour les accélérateurs existants. La mise à jour de l'anneau SPS dans LAYOUT semble être la priorité. La base de données SURVEY contient déjà une vue d'ensemble des accélérateurs, chaque composant étant référencé dans le Système de Coordonnées du CERN, selon les définitions théoriques "sources" au 1/100 mm. Base pour l'alignement, elle stocke également les positions réelles des machines. Elle complète ainsi l'information linéaire de LAY...

Literature study of the radiobiological parameters of Caesium-137 required for evaluating internal irradiation doses as a function of age; Etude bibliographique des parametres radiobiologiques du cesium-137 necessaires a l'evaluation des doses d'irradiation interne en fonction de l'age

Energy Technology Data Exchange (ETDEWEB)

Garnier, A [Commissariat a l' Energie Atomique, 92 - Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires

1968-07-01

This document reassembles information published in scientific literature on radiobiological parameters of Cs-137, necessary for the estimate of the internal irradiation dose of man according to his age (during growth). The data are completed by a commented review of the mathematical models, proposed in order to value the irradiation doses from ingested cesium and the biological parameters. (author) [French] Ce document rassemble les informations publiees dans la litterature scientifique, concernant les parametres radiobiologiqueo du cesium-137, necessaires a l'evaluation des doses d'irradiation interne de l'homme en fonction de l'age. Ces donnees sont completees par une revue commentee des modeles mathematiques proposes en vue de l'evaluation des doses d'irradiation a partir des quantites de cesium ingerees et des parametres biologiques. (auteur)

La politique qualité de la certification des comptes publics. Le cas de la Cour des comptes

OpenAIRE

Portal , Marine

2009-01-01

This research concerns the quality of the public accounts financial audit and more specifically the quality policy of this financial audit carries out by the Cour des comptes. The context is characterized by an increase of demands concerning the quality of financial and accounting information. The accounting and budgetary reform in France, generated by the LOLF 2001, is changing deeply performance of public management and accountancy by emphasizing transparence and quality for information, tw...

Clinician Perspectives on an Electronic Portal to Improve Communication with Patients and Families in the Intensive Care Unit.

Science.gov (United States)

Bell, Sigall K; Roche, Stephanie D; Johansson, Anna C; O'Reilly, Kristin P; Lee, Barbara S; Sands, Kenneth E; Talmor, Daniel S; Brown, Samuel M

2016-12-01

Communication in the intensive care unit (ICU) often falls short of patient and family needs, putting them at risk for significant physical and emotional harm. As electronic patient portals rapidly evolve, one designed specifically for the ICU might potentially enhance communication among patients, family members, and clinicians; however, the views of frontline ICU staff on such technology are unknown. To identify clinician perspectives on the current state of communication among patients, families, and clinicians in the ICU, and assess their views on whether and how an electronic portal may address existing communication deficits and improve care. Three focus groups comprised altogether of 26 clinicians from 6 ICUs, representing several disciplines in an academic medical center in Boston, Massachusetts. Transcripts were analyzed inductively for major themes using grounded theory. We identified seven themes reflecting clinician perspectives on communication challenges and desired portal functionality: (1) comprehension and literacy; (2) results and updates; (3) patient and family preferences; (4) interclinician communication; (5) family informational needs; (6) the ICU as an unfamiliar environment; and (7) enhancing humanism through technology. Each theme included current gaps in practice, potential benefits and concerns related to an ICU communication portal, and participant recommendations. Benefits included enhanced education, patient/family engagement, and clinician workflow. Challenges included the stress and uncertainty of ICU care, fear of technology replacing human connection, existing interclinician communication failures, and the tension between informing families without overwhelming them. Overall, clinicians were cautiously supportive of an electronic portal to enhance communication in the ICU and made several specific recommendations for design and implementation. As new technologies expand opportunities for greater transparency and participation in

Le réseau de politiques fondées sur des données probantes ...

International Development Research Centre (IDRC) Digital Library (Canada)

Les résultats de recherche n'ont aucune valeur s'ils ne sont pas mis à la disposition des praticiens et des responsables des politiques. Les articles scientifiques ne suffisent pas. Il est nécessaire d'organiser les résultats de recherche en fonction d'un plus vaste public et de faire en sorte que l'information circule dans les ...

Going Tobacco-Free: Predictors of Clinician Reactions and Outcomes of the NY State OASAS Tobacco-Free Regulation

Science.gov (United States)

de Tormes Eby, Lillian Turner; George, Kerrin; Brown, B. Lindsay

2012-01-01

In an effort to reduce patient tobacco dependence and create healthier work environments, New York State (NYS) mandated 100% tobacco-free addiction treatment programs for state funded or certified facilities in 2008. We present the results of a longitudinal study examining how local implementation features shape clinician reactions to the regulation and influence post-regulation clinician behavior and strain. A cohort of 147 clinicians associated with 13 treatment organizations throughout NYS completed a survey prior to the passage of the regulation and again approximately 1 year post-regulation. Findings reveal that local implementation features of clinician participation in the planning for change, the provision of change-related information, and perceived organizational support predicted perceptions of change management fairness, which in turn predicted clinical practice behaviors to support smoking cessation, as well as psychological and behavioral strain. In contrast, self-efficacy for change was neither related to local implementation or clinician outcomes. Practical implications are discussed. PMID:22959978

Harmonisation des méthodologies de planification et d'évaluation ...

International Development Research Centre (IDRC) Digital Library (Canada)

Le nouveau site Web facilitera l'enregistrement des événements démographiques afin d'améliorer l'accès aux services pour tous. Le nouveau site Web et la nouvelle bibliothèque de ressources aideront à améliorer les systèmes d'information et d'enregistrement des faits d'état civil dans les pays en développement.

Santé des mères et des enfants | CRDI - Centre de recherches pour ...

International Development Research Centre (IDRC) Digital Library (Canada)

Il faut aussi souligner que la plus importante cohorte de jeunes de l'histoire arrive à l'âge de procréer. Ces adolescents n'ont pas toujours l'information nécessaire ni la possibilité d'exercer leurs droits et d'accéder aux services dont ils ont besoin pour se protéger contre des situations dommageables et leurs conséquences.

Accès à l'eau : des solutions techniques et sociales aident des ...

International Development Research Centre (IDRC) Digital Library (Canada)

Grâce à la modélisation par ordinateur faisant appel à des techniques de pointe et à la consultation des collectivités, l'organisme bolivien Agua Sustentable a trouvé des solutions politiques à des conflits qui auraient pu s'avérer désastreux au sujet de l'accès à l'eau. Cet organisme de recherche subventionné par le CRDI a ...

JournalBase - Une étude comparative internationale des bases de données des revues scientifiques en sciences humaines et sociales (SHS

Directory of Open Access Journals (Sweden)

Christine Kosmopoulos

2009-06-01

Full Text Available Pour la première fois en 2009 ont été ici présentés dans un tableau comparatif les contenus des bases de données qui recensent les revues en sciences humaines et sociales (SHS, du Web of Science (publié par Thomson Reuters et de Scopus (publié par Elsevier ainsi que des listes de référence European Reference Index for Humanities (ERIH (publiée par la Fondation européenne pour la Science et de l'AERES. Avec quelque 20 000 entrées, c’est une vue quasi exhaustive de la richesse des publications en sciences humaines et sociales qui est enfin apportée par ce tableau. La nomenclature adoptée pour classer les revues par discipline est celle en 27 postes de la Fondation Européenne pour la Science. Les affectations multiples révèlent la multidisciplinarité des revues, assez fréquente en SHS, mais parfois aussi les incohérences des bases de données qui n’ont pas été rectifiées.La recherche a été réalisée en 2008 avec le soutien financier du TGE Adonis du CNRS.Une mise à jour prochaine sera proposée en ligne.L’objectif final de ce projet, qui concerne l'ensemble de la communauté internationale en SHS, était de mettre en ligne, en version bilingue anglais/français, la base de données de JournalBase en mode interactif sur une plate-forme collaborative ainsi que le rapport final de l’étude, afin que les décideurs, les scientifiques, les experts de l'information scientifique disposent d’informations à jour et qu’ils puissent contribuer à faire avancer la réflexion sur ces questions, par l’échange d’expériences et de bonnes pratiques d’utilisation.Un article présentant l'historique du projet, la méthodologie mise en place et les difficultés rencontrées dans la comparaison des données a été publié le 8 janvier 2010. Il analyse également les premiers résultats.Désormais vous pouvez accéder à l'information intégrale de JournalBase sur le site : http://journalbase.cnrs.fr

Le Débat des semences

International Development Research Centre (IDRC) Digital Library (Canada)

Solutions pour les lois nationales régissant le contrôle des ressources génétiques et des ...... des pouvoirs) qui reconnaissent, dans une certaine mesure, les droits de gestion collectifs des ...... documentés, les performances physiques, etc.

Caracterisation environnementale des emissions atmospheriques d'une source fixe et creation d'un outil de gestion dynamique =

Science.gov (United States)

Fournier, Marie-Claude

Une caracterisation des emissions atmospheriques provenant des sources fixes en operation, alimentees au gaz et a l'huile legere, a ete conduite aux installations visees des sites no.1 et no.2. La caracterisation et les calculs theoriques des emissions atmospheriques aux installations des sites no.1 et no.2 presentent des resultats qui sont en dessous des valeurs reglementaires pour des conditions d'operation normales en periode hivernale et par consequent, a de plus fortes demandes energetiques. Ainsi, pour une demande energetique plus basse, le taux de contaminants dans les emissions atmospheriques pourrait egalement etre en dessous des reglementations municipales et provinciales en vigueur. Dans la perspective d'une nouvelle reglementation provinciale, dont les termes sont discutes depuis 2005, il serait souhaitable que le proprietaire des infrastructures visees participe aux echanges avec le Ministere du Developpement Durable, de l'Environnement et des Parcs (MDDEP) du Quebec. En effet, meme si le principe de droit acquis permettrait d'eviter d'etre assujetti a la nouvelle reglementation, l'application de ce type de principe ne s'inscrit pas dans ceux d'un developpement durable. L'âge avance des installations etudiees implique la planification d'un entretien rigoureux afin d'assurer les conditions optimales de combustion en fonction du type de combustible. Des tests de combustion sur une base reguliere sont donc recommandes. Afin de supporter le processus de suivi et d'evaluation de la performance environnementale des sources fixes, un outil d'aide a la gestion de l'information environnementale a ete developpe. Dans ce contexte, la poursuite du developpement d'un outil d'aide a la gestion de l'information environnementale faciliterait non seulement le travail des personnes affectees aux inventaires annuels mais egalement le processus de communication entre les differents acteurs concernes tant intra- qu'inter-etablissement. Cet outil serait egalement un bon

Supporting the information domains of fall-risk management in home care via health information technology.

Science.gov (United States)

Alhuwail, Dari; Koru, Güneş; Mills, Mary Etta

2016-01-01

In the United States, home care clinicians often start the episode of care devoid of relevant fall-risk information. By collecting and analyzing qualitative data from 30 clinicians in one home health agency, this case study aimed to understand how the currently adopted information technology solutions supported the clinicians' fall-risk management (FRM) information domains, and explored opportunities to adopt other solutions to better support FRM. The currently adopted electronic health record system and fall-reporting application served only some information domains with a limited capacity. Substantial improvement in addressing the FRM information domains is possible by effectively modifying the existing solutions and purposefully adopting new solutions.

Intégration de l'évaluation évolutive à des initiatives de ...

International Development Research Centre (IDRC) Digital Library (Canada)

... développement se déroulent dans des environnements caractérisés par la complexité du contexte social et l'incertitude. ... Les subtilités des interactions entre les technologies de l'information et de la communication (TIC) et les sociétés en ...

Randomised clinical trials with clinician-preferred treatment.

Science.gov (United States)

Korn, E L; Baumrind, S

1991-01-19

The standard design for randomised clinical trials may be inappropriate when the clinician believes that one of the treatments being tested is superior for the patient, or when the clinician has a preference for one of the treatments. For such instances the suggestion is that the patient is randomly allocated to treatment only when there is clinical disagreement about treatment of choice for that patient, and then the patient is assigned to a clinician who had thought that the regimen allocated is the one most appropriate for that patient.

Performances de ponte et qualité des oeufs des poules pondeuses ...

African Journals Online (AJOL)

Les performances de ponte et la qualité des oeufs de 216 poules pondeuses ISA Brown âgées de 21 semaines ont été déterminées en les alimentant avec des rations contenant des feuilles séchées de manioc (Manihot esculenta, Crantz). Pendant douze semaines, trois groupes de 72 poules chacun (réparties en trois ...

Freins et leviers à la diversification des cultures : étude au niveau des exploitations agricoles et des filières

Directory of Open Access Journals (Sweden)

Meynard Jean-Marc

2013-07-01

Full Text Available La diversification des cultures est souvent présentée comme un levier d’action pour accroître la durabilité des systèmes de production agricoles. Bien raisonnée, elle favorise en effet une réduction de l’usage d’intrants extérieurs à l’exploitation – pesticides, engrais, eau – et des nuisances environnementales associées à leur utilisation excessive. À l’inverse, la simplification des systèmes de culture engagée depuis plus de 40 ans s’est accompagnée d’un recours croissant aux intrants. Cependant, malgré son intérêt pour les systèmes de production en termes de durabilité écologique mais aussi économique (répartition des risques, et son inscription dans divers plans et dispositifs incitatifs, la diversification des cultures progresse peu. Les ministères en charge de l’agriculture et de l’environnement ont donc commandé à l’INRA une étude visant à identifier les freins à la diversification des cultures en France et les leviers mobilisables, par les pouvoirs publics notamment, pour la favoriser. L’hypothèse de travail est que ces freins relèvent du fonctionnement global du système agro-industriel, et de la capacité de développement de filières valorisant les cultures de diversification. L’étude a examiné un certain nombre de cas représentatifs de la diversité des filières et notamment de leurs modes d’organisation, qui déterminent la coordination et l’engagement des acteurs économiques impliqués dans le développement d’une culture de diversification.

Impact écotoxicologique de mélanges de pesticides sur des fonctions microbiennes des sols : apport d’une prise en compte écologique dans l’évaluation des risques

OpenAIRE

Devers-Lamrani, Marion; Rouard, Nadine; Cheviron, Nathalie; Grondin, Virginie; Martin-Laurent, Fabrice

2015-01-01

L’utilisation de pesticides permet d’assurer la qualité de la production végétale mais elle contribue à la contamination des sols et des eaux et produit des effets sur des organismes noncibles. L’évaluation des risques requièrent actuellement une meilleure prise en compte des effets des pesticides sur le fonctionnement des écosystèmes. Or, les démarches et indicateurs classiques manquent de représentativité écologique. La fonction microbienne de biodégradation des pesticides est essentielle c...

Mesure de la masse volumique des particules des eaux résiduaires urbaines : protocole et évaluation des incertitudes

OpenAIRE

RUBAN, Gwenaël; LABORATOIRE CENTRAL DES PONTS ET CHAUSSEES - LCPC

2004-01-01

La connaissance de la masse volumique des particules des eaux résiduaires urbaines est intéressante notamment pour l'étude de leur traitement par décantation ainsi que des relations entre concentrations en matières en suspension et paramètres optiques (turbidimétrie).Une étude des différentes méthodes de mesure de la masse volumique appliquées aux eaux résiduaires a été effectuée par G. Chebbo (1992). Il en a conclu que le pycnomètre à gaz type Beckman est le seul appareil donnant satisfactio...

Problèmes entomologiques en replantation des palmeraies et des cocoteraies

Directory of Open Access Journals (Sweden)

Mariau Dominique

2000-03-01

Full Text Available C’est aux alentours de la vingt-cinquième année que l’on envisage de replanter une palmeraie. C’est en effet vers cet âge que commencent à se poser des problèmes de récolte en raison de la taille des palmiers. En un quart de siècle, l’amélioration génétique aura suffisamment fait de progrès pour escompter un gain de production de l’ordre de 20%. Enfin, dans certaines situations, plusieurs maladies ont pu affecter les vieilles palmeraies. Avec de 15 à 25% d’arbres manquants, principalement lorsque ceux-ci se présentent sous la forme de taches, une diminution de la production se fait nettement sentir. Cela peut, par exemple, être le cas avec les maladies de la fusariose en Afrique de l’Ouest, lorsque la palmeraie n’a pas été plantée avec du matériel végétal tolérant, ou du ganoderma en Malaisie. Le renouvellement des cocoteraies se fait avec un espace de temps beaucoup plus long. En effet, la récolte des noix peut se faire au sol et la hauteur des cocotiers n’est donc pas un facteur limitant. Par ailleurs, la majorité des cocoteraies étant sous la forme de petites plantations villageoises, les agriculteurs rechignent toujours à abattre leurs cocotiers, même si des semences potentiellement plus productives leurs sont proposées. Ce sont les raisons pour lesquelles les cocoteraies de 50 ans et plus représentent la règle. L’abattage d’une plantation de palmiers à huile ou de cocotiers constitue naturellement un changement brutal de l’environnement, ce qui a des conséquences importantes notamment sur l’entomofaune, parmi laquelle des ravageurs majeurs ainsi que leurs ennemis naturels.

2011 "Cour des Contes" storytelling festival

CERN Multimedia

2011-01-01

The "Cour des Contes" storytelling festival will take place in Plan-les-Ouates (Geneva) from 6 to 15 May 2011. This year, for the first time, stories will be told in English at 11 a.m. on Sunday, 15 May, at the "La Julienne" arts and culture centre.   More information  

Take the money and run? Redemption of a gift card incentive in a clinician survey

Directory of Open Access Journals (Sweden)

Jane S. Chen

2016-02-01

Full Text Available Abstract Background Clinician surveys provide critical information about many facets of health care, but are often challenging to implement. Our objective was to assess use by participants and non-participants of a prepaid gift card incentive that could be later reclaimed by the researchers if unused. Methods Clinicians were recruited to participate in a mailed or online survey as part of a study to characterize women’s primary health care provider attitudes towards breast and cervical cancer screening guidelines and practices (n = 177. An up-front incentive of a $50 gift card to a popular online retailer was included with the study invitation. Clinicians were informed that the gift card would expire if it went unused after 4 months. Outcome measures included use of gift cards by participants and non-participants and comparison of hypothetical costs of different incentive strategies. Results 63.5 % of clinicians who responded to the survey used the gift card, and only one provider who didn’t participate used the gift card (1.6 %. Many of those who participated did not redeem their gift cards (36.5 % of respondents. The price of the incentives actually claimed totaled $3700, which was less than half of the initial outlay. Since some of the respondents did not redeem their gift cards, the cost of incentives was less than it might have been if we had provided a conditional incentive of $50 to responders after they had completed the survey. Conclusions Redeemable online gift card codes may provide an effective way to motivate clinicians to participate in surveys.

Innovation pour la santé des mères et des enfants d'Afrique

International Development Research Centre (IDRC) Digital Library (Canada)

Corey Piccioni

... détermineront les interventions devant absolument faire partie de la formation des travailleurs de santé communautaire. Cela pourrait comprendre des régimes de vitamines prénatals et des billets de transport à des établissements de santé pour le dépistage de troubles d'hypertension ou d'infection au VIH, entre autres.

Clinician perspectives of an intensive comprehensive aphasia program.

Science.gov (United States)

Babbitt, Edna M; Worrall, Linda E; Cherney, Leora R

2013-01-01

Intensive comprehensive aphasia programs (ICAPs) have increased in number in recent years in the United States and abroad. To describe the experiences of clinicians working in an ICAP. A phenomenological approach was taken. Seven clinicians from 3 ICAPs were interviewed in person or on the phone. Their interviews were transcribed and coded for themes relating to their experiences. Clinicians described 3 major themes. The first theme related to the intensity component of the ICAP that allowed clinicians to provide in-depth treatment and gave them a different perspective with regard to providing treatment and the potential impact on the person with aphasia. The second theme of rewards for the clinicians included learning and support, seeing progress, and developing relationships with their clients and family members. Third, challenges were noted, including the time involved in learning new therapy techniques, patient characteristics such as chronicity of the aphasia, and the difficulty of returning to work in typical clinical settings after having experienced an ICAP. Although there is a potential for bias with the small sample size, this pilot study gives insight into the clinician perspective of what makes working in an ICAP both worthwhile and challenging.

Examination of Routine Practice Patterns in the Hospital Information Data Warehouse: Use of OLAP and Rough Set Analysis with Clinician Feedback

Science.gov (United States)

Grant, Andrew; Grant, Gwyneth; Gagné, Jean; Blanchette, Carl; Comeau, Émilie; Brodeur, Guillaume; Dionne, Jonathon; Ayite, Alphonse; Synak, Piotr; Wroblewski, Jakub; Apanowitz, Cas

2001-01-01

The patient centred electronic patient record enables retrospective analysis of practice patterns as one means to assist clinicians adjust and improve their practice. An interrogation of the data-warehouse linking test use to Diagnostic Related Group (DRG) of one years data of the Sherbrooke University Hospital showed that one-third of patients used two-thirds of these diagnostic tests. Using RoughSets analysis, zones of repeated tests were demonstrated where results remained within stable limits. It was concluded that 30% of fluid and electrolyte testing was probably unnecessary. These findings led to an endorsement of changing the test request formats in the hospital information system from profiles to individual tests requiring justification.

Isolement et identification des levures.

Directory of Open Access Journals (Sweden)

S. DOMERCQ

1967-06-01

Full Text Available La fermentation du moût de raisin est assurée par les levures qui se trouvent sur la pellicule du raisin, sur les rafles, et aussi, par celles qui envahissent le matériel de vendange et de vinification dès que la récolte est commencée. L'apparition deLa fermentation du moût de raisin est assurée par les levures qui se trouvent sur la pellicule du raisin, sur les rafles, et aussi, par celles qui envahissent le matériel de vendange et de vinification dès que la récolte est commencée. L'apparition des signes de la fermentation est spontanée. La fermentation est rapide dans la majorité des cas, si elle devient trop violente et que la température s'élève dangeureusement, il faut la « canaliser », la calmer. Des accidents peuvent se produire; des arrêts de fermentation laissant des sucres non fermentés pouvant être attaqués par d'autres microorganismes, des développements de levures formant des substances nuisibles à la qualité; par la suite, il s'agit d'obtenir la stabilité du vin, en particulier, éviter les refermentations des vins doux. L'étude de ces problèmes nécessite une étude préliminaire, celle des levures responsables de la fermentation alcoolique du jus de raisin, qui ne peut être faite que sur des cultures pures, isolées au préalable à l'aide de prélèvements soigneusement réalisés.s signes de la fermentation est spontanée. La fermentation est rapide dans la majorité des cas, si elle devient trop violente et que la température s'élève dangeureusement, il faut la « canaliser », la calmer. Des accidents peuvent se produire; des arrêts de fermentation laissant des sucres non fermentés pouvant être attaqués par d'autres microorganismes, des développements de levures formant des substances nuisibles à la qualité; par la suite, il s'agit d'obtenir la stabilité du vin, en particulier, éviter les refermentations des vins doux. L'étude de ces problèmes nécessite une étude pr

Nouvelles approches ergonomiques de la cartographie des risques industriels

Directory of Open Access Journals (Sweden)

Éliane Propeck-Zimmermann

2009-12-01

Full Text Available Les cartes actuelles présentent des insuffisances pour une gestion territoriale des risques industriels. En redéfinissant le concept de «situation à risques» et en l'implémentant dans un SIG, on peut disposer à la demande d'informations riches et variées: cartes analytiques, de synthèse, typologies, requêtes spatiales diverses. Les recherches en cours visent à développer une interface ergonomique pour faciliter la concertation entre différents acteurs.

Innovation pour la santé des mères et des enfants d'Afrique | CRDI ...

International Development Research Centre (IDRC) Digital Library (Canada)

L'initiative Innovation pour la santé des mères et des enfants d'Afrique (ISMEA) cherche à améliorer la santé des mères, des nouveau-nés et des enfants en ... Cette initiative de 36 millions de dollars sur sept ans – financée conjointement par les Instituts de recherche en santé du Canada, Affaires mondiales Canada et le ...

Clinician preferences and the estimation of causal treatment differences

OpenAIRE

Korn, Edward L.; Baumrind, Sheldon

1998-01-01

Clinician treatment preferences affect the ability to perform randomized clinical trials and the ability to analyze observational data for treatment effects. In clinical trials, clinician preferences that are based on a subjective analysis of the patient can make it difficult to define eligibility criteria for which clinicians would agree to randomize all patients who satisfy the criteria. In addition, since each clinician typically has some preference for the choice of treatment for a given ...

Les pensions dans les pays de l'OCDE 2009 panorama des systèmes de retraite

CERN Document Server

Organisation for Economic Cooperation and Development. Paris

2009-01-01

Les politiques menées en matière de pensions et de retraite ont connu des évolutions considérables au cours des dernières années, les pouvoirs publics s’efforçant de concilier deux objectifs : assurer des revenus suffisants aux retraités et garantir la viabilité financière à long terme des systèmes de retraite face au vieillissement de la population. Panorama des Pensions 2009 propose un cadre de référence cohérent permettant de comparer les politiques adoptées dans ce domaine par les différents pays de l’OCDE, ainsi qu’un ensemble de données fiables. Cette troisième édition renferme des informations actualisées sur les principales caractéristiques des pensions versées au sein des pays de l’OCDE et contient des projections relatives aux revenus que percevront demain les salariés d’aujourd’hui. Elle offre également une gamme élargie d’indicateurs, parmi lesquels figurent des données chiffrées concernant les actifs, les performances des investissements, l’ampleur des ...

Online Health Searches and their Perceived Effects on Patients and Patient-Clinician Relationships: A Systematic Review,,✯✯✯.

Science.gov (United States)

Wang, Jane; Ashvetiya, Tamara; Quaye, Emmanuel; Parakh, Kapil; Martin, Seth S

2018-05-03

Online health searches are common and may be impacting patients and their relationships with their clinicians in ways that are not fully understood. We searched PubMed, Embase, Cochrane Reviews, Cochrane Trials, Scopus, and CINAHL from 1 January 1990 to 29 January 2016 for studies in which patients searched online for any aspect of healthcare and then visited their clinician. We extracted data pertaining to either patients' or clinicians' perceptions of the effects of these online searches on patients and the patient-clinician relationship. Searches seemed to induce patient anxiety but more often led to patient reassurance, clinical understanding, and empowerment. Patients tended to perceive that online health searches had a positive effect on the patient-clinician relationship, though the nature of the effect could depend on the clinician's response to patient queries regarding the information. Clinicians generally perceived neutral effects on patients and the patient-clinician relationship, and commonly raised concerns about accuracy of online content. Significant methodological heterogeneity prevented quantitative synthesis. Accuracy of online health search content was not assessed, and randomized controlled trials were notably lacking. Copyright © 2018. Published by Elsevier Inc.

Barriers and facilitators to sexual and reproductive health communication between pediatric oncology clinicians and adolescent and young adult patients: The clinician perspective.

Science.gov (United States)

Frederick, Natasha N; Campbell, Kevin; Kenney, Lisa B; Moss, Kerry; Speckhart, Ashley; Bober, Sharon L

2018-04-26

Sexual and reproductive health (SRH) is identified by adolescent and young adult (AYA) patients with cancer as an important but often neglected aspect of their comprehensive cancer care. The purpose of this study was to investigate the attitudes and perceptions of pediatric oncology clinicians towards discussing SRH with AYAs, and to understand perceived barriers to effective communication in current practice. Pediatric oncology clinicians (physicians, certified nurse practitioners, and physician assistants) participated in semi-structured qualitative interviews investigating attitudes about SRH communication with AYAs and barriers to such conversations. Twenty-two clinicians participated from seven institutions in the Northeastern United States. Interviews were audio-recorded, transcribed, and coded using a thematic analysis approach. Interviews with pediatric oncology clinicians revealed the following five primary themes: the role for pediatric oncology clinicians to discuss SRH, the focus of current SRH conversations on fertility, the meaning of "sexual health" as safe sex and contraception only, clinician-reported barriers to SRH conversations, and the need for education and support. Communication barriers included lack of knowledge/experience, lack of resources/referrals, low priority, parents/family, patient discomfort, clinician discomfort, time, and lack of rapport. Clinicians identified resource and support needs, including formal education and SRH education materials for patients and families. Although the study participants identified a role for pediatric oncology clinicians in SRH care for AYA patients with cancer, multiple barriers interfere with such discussions taking place on a regular basis. Future efforts must focus on resource development and provider education and training in SRH to optimize the care provided to this unique patient population. © 2018 Wiley Periodicals, Inc.

Oncology clinicians' defenses and adherence to communication skills training with simulated patients: an exploratory study.

Science.gov (United States)

Bernard, Mathieu; de Roten, Yves; Despland, Jean-Nicolas; Stiefel, Friedrich

2012-06-01

The aim of this exploratory study was to assess the impact of clinicians' defense mechanisms-defined as self-protective psychological mechanisms triggered by the affective load of the encounter with the patient-on adherence to a communication skills training (CST). The population consisted of oncology clinicians (N=31) who participated in a CST. An interview with simulated cancer patients was recorded prior and 6 months after CST. Defenses were measured before and after CST and correlated with a prototype of an ideally conducted interview based on the criteria of CST-teachers. Clinicians who used more adaptive defense mechanisms showed better adherence to communication skills after CST than clinicians with less adaptive defenses (F(1, 29) =5.26, p=0.03, d=0.42). Improvement in communication skills after CST seems to depend on the initial levels of defenses of the clinician prior to CST. Implications for practice and training are discussed. Communication has been recognized as a central element of cancer care [1]. Ineffective communication may contribute to patients' confusion, uncertainty, and increased difficulty in asking questions, expressing feelings, and understanding information [2, 3], and may also contribute to clinicians' lack of job satisfaction and emotional burnout [4]. Therefore, communication skills trainings (CST) for oncology clinicians have been widely developed over the last decade. These trainings should increase the skills of clinicians to respond to the patient's needs, and enhance an adequate encounter with the patient with efficient exchange of information [5]. While CSTs show a great diversity with regard to their pedagogic approaches [6, 7], the main elements of CST consist of (1) role play between participants, (2) analysis of videotaped interviews with simulated patients, and (3) interactive case discussion provided by participants. As recently stated in a consensus paper [8], CSTs need to be taught in small groups (up to 10

Analyse des caractéristiques structurelles et des performances ...

African Journals Online (AJOL)

SARAH

28 févr. 2014 ... performances technico-économiques de la riziculture irriguée en Côte d' .... en nous basant sur les prix des intrants et des produits en vigueur au cours ..... la recherche et de la vulgarisation et le transfert de technologies ; (2) ...

Enquête de satisfaction des restaurants

CERN Multimedia

Staff Association

2016-01-01

Comité de surveillance des restaurants L’Association du personnel est représentée dans plusieurs comités dont le Comité de surveillance des restaurants (CSR) qui a pour mandat : de donner son avis sur toute question relative à la politique générale de l’Organisation en matière de restauration sur le site, y compris en ce qui concerne les termes et l’attribution des contrats d’exploitation des restaurants ; de définir dans le cadre des contrats d’exploitation des restaurants, les prestations correspondant aux besoins et, dans la mesure du possible, aux désirs du personnel ; de surveiller les prestations des restaurants, y compris en ce qui concerne la qualité et la préparation des produits ; de négocier avec les concessionnaires des restaurants au sujet des tarifs et de surveill...

Contraintes d'adoption des technologies de gestion de la fertilite des ...

African Journals Online (AJOL)

La baisse de fertilité des sols, l'une des principales contraintes du secteur agricole au Togo, sévit encore plus dans la riziculture irriguée où les terres sont exploitées chaque année sans jachère. Face à cette situation, diverses solutions comme les technologies de gestion de la fertilité des sols ont été proposées.

contraintes d'adoption des technologies de gestion de la fertilite des ...

African Journals Online (AJOL)

La baisse de fertilité des sols, l'une des principales contraintes du secteur agricole au Togo, sévit encore plus dans la riziculture irriguée où les terres sont exploitées chaque année sans jachère. Face à cette situation, diverses solutions comme les technologies de gestion de la fertilité des sols ont été proposées.

Droit des organisations internationales

CERN Document Server

Sorel, Jean-Marc; Ndior, Valère

2013-01-01

Cet ouvrage collectif offre aux enseignants et chercheurs en droit international, aux praticiens et aux étudiants, une analyse actualisée du droit des organisations internationales. Il dresse en cinq parties un tableau, illustré par des exemples variés, des problématiques que soulève le phénomène polymorphe d institutionnalisation de la société internationale. La première partie est consacrée au phénomène des « organisations internationales », sous l angle à la fois de l institutionnalisation progressive des relations internationales et de la difficulté à cerner une catégorie unifiée. La deuxième partie rend compte de la création, de la disparition et des mutations des organisations internationales, ici envisagées comme systèmes institutionnels et ordres juridiques dérivés. La troisième partie analyse l autonomie que l acquisition de la personnalité juridique et de privilèges et immunités, un organe administratif intégré, un personnel ou un budget propres confèrent aux organi...

The Texts of the Agency's Co-operation Agreements with Regional Intergovernmental Organizations; Texte des Accords de Cooperation Conclus entre L'Agence et des Organisations Intergouvernementales Regionales

Energy Technology Data Exchange (ETDEWEB)

NONE

1961-02-07

The texts of the Agency's agreements for co-operation with the regional inter-governmental organizations listed below, together with the respective protocols authenticating them, are reproduced in this document in the order in which the agreements entered into force, for the information of all Members of the Agency [French] Le present document reproduit le texte des accords de cooperation que l'Agence a conclus avec les organisations intergouvernementales regionales enumerees ci-apres, ainsi que celui des protocoles validant lesdits accords. Le texte de ces instruments, classes dans l'ordre chronologique de leur entree en vigueur, est communique, pour information, a tous les Membres de l'Agence.

De la problématique des articles synopsis dans la compilation des ...

African Journals Online (AJOL)

Autrement dit, au Gabon l'attention doit porter sur l'utilisation des articles synopsis dans la compilation des dictionnaires, en vue de refléter dans ses ouvrages la diversité linguistique et culturelle de ce pays. Ceci est d'autant plus vrai que l'utilisation des articles synopsis ne dépend aucunement de la typologie du ...

Feedback mechanisms of change: How problem alerts reported by youth clients and their caregivers impact clinician-reported session content

Science.gov (United States)

Douglas, Susan R.; Jonghyuk, Bae; de Andrade, Ana Regina Vides; Tomlinson, M. Michele; Hargraves, Ryan Pamela; Bickman, Leonard

2015-01-01

Objective This study explored how clinician-reported content addressed in treatment sessions was predicted by clinician feedback group and multi-informant cumulative problem alerts that appeared in computerized feedback reports for 299 clients aged 11 to 18 years receiving home-based community mental health treatment. Method Measures included a clinician-report of content addressed in sessions and additional measures of treatment progress and process (e.g., therapeutic alliance) completed by clinicians, clients, and their caregivers. Item responses in the top 25th percentile in severity from these measures appeared as ‘problem alerts’ on corresponding computerized feedback reports. Clinicians randomized to the feedback group received feedback weekly while the control group did not. Analyses were conducted using the Cox proportional hazards regression for recurrent events. Results For all content domains, the results of the survival analyses indicated a robust effect of the feedback group on addressing specific content in sessions, with feedback associated with shorter duration to first occurrence and increased likelihood of addressing or focusing on a topic compared to the non-feedback group. Conclusion There appears to be an important relationship between feedback and cumulative problem alerts reported by multiple informants as they influence session content. PMID:26337327

Evaluation des pratiques de gestion des adventices en riziculture

African Journals Online (AJOL)

Les résultats ont montré que les méthodes de gestion de l'enherbement ont .... Le contrôle des adventices en riziculture irriguée a principalement .... mesurer la hauteur des plantes et la longueur ..... Performance agronomique du Sys- tème de ...

Loyalty in the trenches: practical teleology for office clinicians responding to terrorism.

Science.gov (United States)

Trotter, Griffin

2004-08-01

Were terrorists ever to effectively deploy weapons of mass destruction, medical practice would be quickly transformed. Many ordinary clinicians would be asked or required to treat unfamiliar yet serious medical conditions in a setting of overwhelming urgency and impossible odds. Clinical focus would shift from doing good things for a succession of individual patients to considering many patients at once, a change that could beget loss of trust and rapport with patients. Clinicians might also experience restrictions in personal liberties and appropriation of their property. The purpose of this essay is to develop a teleological framework for undertaking this transformation. In ordinary clinical medicine, the elusiveness of the individual telos (i.e.,the good for the individual) is acknowledged in procedures (such as social history taking,informed consent and outpatient scheduling) designed to protect patients' (and clinicians')prerogatives to interpret the telos for themselves. In mass casualty scenarios, on the other hand, the telos is standardized and regarded as an Immediate Object (usually as a state of affairs in which survival is maximized and permanent disability is minimized). Clinicians who provide mass casualty care will face a number of ethical challenges that can be negotiated by appealing to the political and ethical rationale, and limits, pertaining to the pursuit of aggregate survival as an Immediate Object.

Experiencing mental health diagnosis: a systematic review of service user, clinician, and carer perspectives across clinical settings.

Science.gov (United States)

Perkins, Amorette; Ridler, Joseph; Browes, Daniel; Peryer, Guy; Notley, Caitlin; Hackmann, Corinna

2018-04-18

Receiving a mental health diagnosis can be pivotal for service users, and it has been described in both positive and negative terms. What influences service-user experience of the diagnostic process is unclear; consequently, clinicians report uncertainty regarding best practice. This Review aims to understand and inform diagnostic practice through a comprehensive synthesis of qualitative data on views and experiences from key stakeholders (service users, clinicians, carers, and family). We searched five databases and identified 78 papers for inclusion, originating from 13 countries and including 2228 participants. Eligible papers were assessed for quality, and data were coded and then developed into themes, which generated a model representing factors to consider for clinicians conveying, and individuals receiving, mental health diagnoses. Themes included disclosure, information provision, collaboration, timing, stigma, and functional value of diagnosis for recovery. Variations between different stakeholders and clinical contexts are explored. Findings support an individualised, collaborative, and holistic approach to mental health diagnosis. Copyright © 2018 Elsevier Ltd. All rights reserved.

Contrôle des Circuits Auxiliaires des P.F.W. (arrêt machine 2003/2004)

CERN Document Server

Ottaviani, J

2004-01-01

Les PFW sont des nappes polaires installées sur les pôles des aimants du PS. Elles sont au nombre de 4 par unité d'aimant et constituées d'un circuit principal (dans lequel circule le courant désiré selon le cycle magnétique utilisé) et des circuits auxiliaires. Les circuits auxiliaires sont des enroulements de correction (boucles de tour et "pick-up" brasés sur les enroulements principaux). Pendant la variation du champ magnétique del'aimant PS, on utilise des tensions induites dans ces circuits auxiliaires pour corriger les erreurs de champ dues aux pertes par courants de Foucault dans la chambre à vide. Chaque année, pendant l'arrêt machine, on vérifie si les caractéristiques des circuits auxiliaires correspondent aux normes (mesures de résistances des boucles de tours, résistances entre "pick-up" et isolation des circuits) afin de faire un suivi. Les 404 PFW sont ainsi vérifiées. Dans cette note, on ne relèvera que les PFW ayant des défauts (valeurs hors tolérances, boucles ouvertes ...

Application of the Moessbauer effect to the study of the structure of transition metal complexes; Applications de l'effet Mossbauer a l'etude de la structure des complexes des metaux de transition

Energy Technology Data Exchange (ETDEWEB)

Tsymbal, C [Commissariat a l' Energie Atomique, Grenoble (France). Centre d' Etudes Nucleaires

1968-07-01

In this survey, the structural investigations of transition metal complexes by the hyperfine interactions in the Moessbauer effect are described. The isomer shift provides a unique tool for estimating s electrons covalency in high spin complexes and one of the best pieces of evidence for the importance of bacle donation in low spin complexes. The electric field gradient deriving from quadrupole coupling measurements is correlated with the energy levels distribution of d orbitals in high spin complexes, whereas in low spin complexes it originates from the unbalanced d electrons. (authors) [French] Dans cette etude, nous decrivons les applications des interactions hyperfines dans l' effet Mossbauer a l'etude de la structure des complexes des metaux de transition. Le deplacement isomerique donne des informations tres utiles sur la covalence des electrons s dans les complexes a spin eleve et met en evidence d'une maniere nette l'importance du phenomene de 'bacle donation' dans les complexes a spin faible. Le gradient de champ electrique qui provient des mesures d'interaction quadripolaire est lie a la distribution des niveaux d'energie des orbitales d dans les complexes a spin eleve alors que dans les complexes a spin faible, il est provoque par des electrons d non apparies. (auteurs)

Performances des équipements utilisés en liaison froide en liaison froide en restauration hospitalière - Suivi des températures des entrées froides

OpenAIRE

Rosset , Philippe; Morelli , Elisabeth; Noël , Véronique; Poumeyrol , Gérard

2007-01-01

La restauration hospitalière présente un système de distribution des repas qui lui est spécifique : assemblage des denrées préparées et constitution des plateaux-repas dans un local dédié (dit d'allotissement) ; transport des plateaux-repas vers les unités de soins dans des enceintes mobiles permettant le maintien au froid des denrées consommées froides et la remise en température des aliments à consommer chauds. La présente étude concerne le suivi des températures de hors-d'œuvre dans trois ...

Application des techniques de diffusion de la lumière des rayons x et des neutrons à l'étude des systèmes colloïdaux. Deuxième partie : étude des différents systèmes : polymères en solution à l'état solide, solutions micellaires, systèmes fractals Application of Light, X-Ray and Neutron Diffusion Techniques to the Study of Colloidal Systems. Part Two: Research on Different Systems: Polymers in Solution in the Solid State, Micellar Solutions, Fractals Systems

Directory of Open Access Journals (Sweden)

Espinat D.

2006-11-01

Full Text Available Cet article fait suite à la première partie (Revue Inst. Franç. du Pétrole, vol. 45, n°6, novembre-décembre 1990 concernant l'application des techniques de diffusion de la lumière, des rayons X et des neutrons à l'étude des systèmes colloïdaux et plus précisément à la présentation théorique des trois méthodes. L'objet de cette deuxième partie est la présentation non exhaustive de quelques domaines d'applications. Nous nous attacherons tout particulièrement à présenter les potentialités des méthodes pour la caractérisation de systèmes colloïdaux ou divisés rencontrés dans de nombreuses branches d'activité de l'industrie pétrolière. Nous aborderons dans une première partie les solutions polymériques et colloïdales. En particulier nous nous attarderons sur l'importance des techniques de diffusion pour la caractérisation des polymères en solution et des solutions micellaires. Nous verrons également quelles informations la diffusion centrale peut apporter sur la macrostructure des polymères cristallisés ou amorphes à l'état solide. De nombreux systèmes présentent une structure de type fractal ; après présentation de quelques exemples, nous montrerons que les méthodes de diffusion peuvent apporter certaines informations sur ces matériaux, notamment la dimension fractale. This article is the second one (the first one was published in Revue de l'Institut Français du Pétrole No. 6, NovemberDecember 1990 concerning the application of techniques of light scattering, X rays and neutrons to the analysis of colloidal systems and more specifically to the theoretical description of the three methods. The aim of this second part is to make a nonexhaustive description of several fields of applications. A special effort is made to describe the potential of these methods for characterizing colloidal or divided systems encountered in a great many activities involving the petroleum industry. The first part of this

Postnatal gestational diabetes mellitus follow-up: Perspectives of Australian hospital clinicians and general practitioners.

Science.gov (United States)

Kilgour, Catherine; Bogossian, Fiona Elizabeth; Callaway, Leonie; Gallois, Cindy

2018-05-04

The reasons for low postnatal screening rates for women with gestational diabetes mellitus are not well understood. Multiple care providers, settings and changes to diagnostic criteria, may contribute to confusion over postnatal care. Quality of communication between clinicians may be an important influence for the completion of postnatal gestational diabetes mellitus follow-up. Describe and analyse communication processes between hospital clinicians (midwives, medical, allied staff) and general practitioners who provide postnatal gestational diabetes mellitus care. Purposive sampling and convergent interviews explored participants' communication experiences providing gestational diabetes mellitus postnatal follow-up. Data were analysed with Leximancer automated content analysis software; interpretation was undertaken using Communication Accommodation Theory. Clinicians who provided maternity care at a tertiary referral hospital (n=13) in Queensland, Australia, and general practitioners (n=16) who provided maternity shared care with that hospital between December 2012 and July 2013. Thematic analysis identified very different perspectives between the experiences of General Practitioners and hospital clinicians; six themes emerged. General practitioners were concerned about themes relating to discharge summaries and follow-up guidelines. In contrast, hospital clinicians were more concerned about themes relating to gestational diabetes mellitus antenatal care and specialist clinics. Two themes, gestational diabetes mellitus women and postnatal checks were shared. Gestational diabetes mellitus follow-up is characterised by communication where general practitioners appear to be information seekers whose communication needs are not met by hospital clinicians. Midwives are ideally placed to assist in improving communication and postnatal gestational diabetes mellitus follow-up. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights

Usability testing of two e-learning resources: methods to maximize potential for clinician use.

Science.gov (United States)

Menon, Anita; Korner-Bitensky, Nicol; Chignell, Mark; Straus, Sharon

2012-04-01

Rigorous usability testing of e-learn-ing resources is an important prerequisite to their wide-spread use among clinicians. This study demonstrates the application of an evidence-based approach to usability testing of two stroke-related e-learning resources (StrokEngine). 14 stroke rehabilitation clinicians (occupational therapists and physiotherapists) from Ontario, Canada participated in a 1.5 h in-person testing session. Clinicians navigated StrokEngine in search of information to answer questions on stroke assessment/intervention. Their search patterns were observed and clinicians provided verbal/written feedback about StrokEngine. Content analysis was used to generate themes and categorize them under two broad categories: facilitators and barriers to use. Five key facilitators and three key barriers to Strok-Engine use were identified and related to screen format, layout/organization, ease of navigation, quality of content, likelihood of using StrokEngine in the future, and system dysfunctions. All 14 clinicians were very or extremely satisfied with the layout/organization, quality and clinical relevance of the content, stating that they were likely to use StrokEngine in the future. All identified barriers from this study were addressed with website modifications in order to maximize the usability and navigability of StrokEngine. This rigorous methodology for usability testing can be applied during the design process of any e-learning resource.

Hyperspective, un outil d'aide à la définition des problématiques d'Intelligence Economique

OpenAIRE

Goria, Stéphane; Geffroy, Philippe

2004-01-01

International audience; Tout dialogue entre deux personnes peut donner suite à de malheureux quiproquos après une interprétation erronée d'un ou plusieurs des termes (et des concepts sous-jacents à ces derniers) employés par l'un ou l'autre des intervenants. Aussi, suite à certaines observations effectuées sur le terrain de l'Intelligence Territoriale, nous avons décidé de développer un outil d'aide à la définition des sujets des demandes de recherche d'information et de veilles, combinant le...

On-line ethics education for occupational therapy clinician-educators: a single-group pre-/post-test study.

Science.gov (United States)

VanderKaay, Sandra; Letts, Lori; Jung, Bonny; Moll, Sandra E

2018-05-20

Ethics education is a critical component of training rehabilitation practitioners. There is a need for capacity-building among ethics educators regarding facilitating ethical decision-making among students. The purpose of this study was to evaluate the utility of an on-line ethics education module for occupational therapy clinician-educators (problem-based learning tutors/clinical placement preceptors/evidence-based practice facilitators). The Knowledge-to-Action Process informed development and evaluation of the module. Clinician-educators (n = 33) viewed the module and reported on its impact on knowledge and facilitation practices via pre, post, and follow-up questionnaires. Pre- and post-test data indicated improvement in self-reported ethics knowledge (t = 8.275, p ethics education module for clinician-educators. Future recommendations include broader consideration of context, adding supplemental knowledge translation components, and further research exploring outcomes with larger samples, longer follow-up and randomized trial methodology. Implications for Rehabilitation The on-line ethics module has potential to improve rehabilitation practice by addressing the noted gap in knowledge among clinician-educators. Viewing an on-line module regarding approaches to ethics education may not be sufficient to change clinician-educators' teaching practices. More time and opportunities to discuss ethics with student occupational therapists may be required to effect practice change among clinician-educators. Developing ethics education tools for clinician-educators requires ongoing and iterative input from knowledge users to optimize translation of ideas to practice.

Vers une meilleure comprehension des savoirs disciplinaires et curriculaires des enseignants ou Ie paradigme retrouve

Directory of Open Access Journals (Sweden)

Stephane Martineau

1999-01-01

Full Text Available eet article se veut essentieUement un travail de synthese sous la forme d 'une breve revue de litterature au sujet des savoirs disciplinaires et curriculaires en enseignement. Plus specifiquement, il vise a determiner queUes sont les principales conclusions qui se degagent de la lecture des recherches empiriques sur les savoirs disciplinaires et curriculaires des enseignants des ordres d'enseignement primaire et secondaire. Il propose donc une classification des differentes dimensions constitutives du rapport entre les savoirs disciplinaires et curriculaires et la pratique enseignante. Les resultats mis au jour permettent d 'une part, d'identifier les facteurs qui entrainent des differences dans les connaissances disciplinaires et curriculaires des enseignants et d'autre part, de mieux saisir comment ces connaissances de l'enseignant peuvent influencer en retour sa pratique.

Formation des formateurs en ligne : obstacles, rôles et compétences

Directory of Open Access Journals (Sweden)

Louise Sauvé

2004-01-01

Full Text Available L’adoption d’une technologie de l’information et de la communication (TIC pour la formation ne peut se faire sans changement dans l’organisation. Ces changements touchent les formateurs, hommes et femmes, qui ont une histoire professionnelle, une mentalité, des pratiques qui se sont construites au cours des années et dans un contexte précis de travail. Or les changements technologiques peuvent déstabiliser la vie professionnelle des formateurs. Il est donc essentiel de gérer ce changement, car le succès des projets d’introduction des TIC dans la formation n’est plus fonction de la puissance des technologies, mais plutôt de la capacité des formateurs à exploiter leur potentiel afin de changer et d’améliorer l’efficience du processus d’apprentissage. C’est dans un contexte d’implantation d’une formation des formateurs en ligne que se situe cet article qui aborde les questions suivantes : quels sont les obstacles au changement par rapport à l’adoption des TIC dans le milieu de la formation? Quels sont les principaux rôles d’un formateur en ligne (ou e-formateur? Quelles sont les compétences générales que les formateurs doivent développer pour soutenir les apprenants dans un contexte de formation en ligne (synchrone et asynchrone?

Contrôle hormonal des caractéristiques des fibres musculaires après la naissance

OpenAIRE

Cassar-Malek, Isabelle; Listrat, Anne; Picard, Brigitte

1998-01-01

Après la naissance, la croissance et les propriétés contractiles et métaboliques des fibres musculaires sont soumises à une régulation endocrinienne complexe. A l’exception des glucocorticoïdes, la plupart des hormones présente une action anabolique sur le tissu musculaire. Leur influence sur les caractéristiques des fibres est cependant très différente. Ainsi, les hormones somatotropes affectent peu la composition en fibres des muscles. La GH, comme l’IGF-1, régulerait cependant l’expression...

Reducing Negative Outcomes of Online Consumer Health Information: Qualitative Interpretive Study with Clinicians, Librarians, and Consumers

Science.gov (United States)

Pluye, Pierre; Thoër, Christine; Rodriguez, Charo

2018-01-01

Background There has been an exponential increase in the general population’s usage of the internet and of information accessibility; the current demand for online consumer health information (OCHI) is unprecedented. There are multiple studies on internet access and usage, quality of information, and information needs. However, few studies explored negative outcomes of OCHI in detail or from different perspectives, and none examined how these negative outcomes could be reduced. Objective The aim of this study was to describe negative outcomes associated with OCHI use in primary care and identify potential preventive strategies from consumers’, health practitioners’, and health librarians’ perspectives. Methods This included a two-stage interpretive qualitative study. In the first stage, we recruited through a social media survey, a purposeful sample of 19 OCHI users who had experienced negative outcomes associated with OCHI. We conducted semistructured interviews and performed a deductive-inductive thematic analysis. The results also informed the creation of vignettes that were used in the next stage. In the second stage, we interviewed a convenient sample of 10 key informants: 7 health practitioners (3 family physicians, 2 nurses, and 2 pharmacists) and 3 health librarians. With the support of the vignettes, we asked participants to elaborate on (1) their experience with patients who have used OCHI and experienced negative outcomes and (2) what strategies they suggest to reduce these outcomes. We performed a deductive-inductive thematic analysis. Results We found that negative outcomes of OCHI may occur at three levels: internal (such as increased worrying), interpersonal (such as a tension in the patient-clinician relationship), and service-related (such as postponing a clinical encounter). Participants also proposed three types of strategies to reduce the occurrence of these negative outcomes, namely, providing consumers with reliable OCHI, educating

Modélisation des propriétés diélectriques des nanocomposites ...

African Journals Online (AJOL)

Dans ce travail, nous nous intéressons aux propriétés diélectriques dans le domaine des micro-ondes (2.45, 9.50 et 35 GHz) des composites constitués des inclusions de noir de carbone dans une matrice résine époxyde. Nous avons utilisé deux types de carbone : le monarch 700 et le sterling, dont les diamètres des ...

Renforcement des capacités de recherche sur les TIC-D au Moyen ...

International Development Research Centre (IDRC) Digital Library (Canada)

La recherche sur les incidences et les impacts des technologies de l'information et de la communication (TIC) sur le développement social et humain est embryonnaire au Moyen-Orient et en Afrique du Nord (région MOAN). Ce projet vise à encourager les chercheurs de la région MOAN à entreprendre des recherches ...

Civili, langue des Baloango

DEFF Research Database (Denmark)

Mavoungou, Paul Achille; Ndinga-Koumba-Binza, Hugues Steve

, Congo, Angola, etc.) issus de la décolonisation. Il présente de façon succincte quelques phénomènes historiques, phonologiques, morphosyntaxiques, homonymiques et analogiques de la langue. Des faits sémantiques des emprunts linguistiques y sont également décrits dans le cadre des changements...

AphasiaBank: a resource for clinicians.

Science.gov (United States)

Forbes, Margaret M; Fromm, Davida; Macwhinney, Brian

2012-08-01

AphasiaBank is a shared, multimedia database containing videos and transcriptions of ~180 aphasic individuals and 140 nonaphasic controls performing a uniform set of discourse tasks. The language in the videos is transcribed in Codes for the Human Analysis of Transcripts (CHAT) format and coded for analysis with Computerized Language ANalysis (CLAN) programs, which can perform a wide variety of language analyses. The database and the CLAN programs are freely available to aphasia researchers and clinicians for educational, clinical, and scholarly uses. This article describes the database, suggests some ways in which clinicians and clinician researchers might find these materials useful, and introduces a new language analysis program, EVAL, designed to streamline the transcription and coding processes, while still producing an extensive and useful language profile. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Comment constituer et traiter des corpus issus des médias sociaux à l’aide des CAQDAS? NVivo : un instrument pour l’analyse des discours numériques

Directory of Open Access Journals (Sweden)

Ferrari Giovannipaolo

2015-01-01

Full Text Available Avec l’apparition des médias sociaux, le chercheur en Sciences Humaines et Sociales a vu s’ouvrir des possibilités de création de corpus à partir des données disponibles en ligne. Le risque dans ces modalités de création de corpus est de créer de grandes bases de données difficilement gérables avec les outils traditionnels et surtout dans le cadre d’une recherche qualitative. Pour cette raison, il semble important de mobiliser des outils numériques pour l’aide à la recherche. Ces logiciels sont appelés CAQDAS. Cette contribution montre comment les utiliser pour une enquête de terrain en ligne ou numérique afin d’organiser et d’analyser un corpus. Ce corpus est constitué en vue d’une analyse des discours produits dans le contexte professionnel de la radio utilisant les nouveaux médias.

Ethnobotanique des plantes médicinales anti hémorroïdaires des ...

African Journals Online (AJOL)

SARAH

2015-12-31

Dec 31, 2015 ... but est de valoriser la médecine à base des plantes dans le traitement des pathologies ... médicinales anti hémorroïdaires et le coût réduit des recettes serait pour les populations démunies, ...... l'Afrique, Unesco/Aetfat/Unso.

Capacité de recherche accrue pour améliorer la gestion des ...

International Development Research Centre (IDRC) Digital Library (Canada)

Le nouveau site Web facilitera l'enregistrement des événements démographiques afin d'améliorer l'accès aux services pour tous. Le nouveau site Web et la nouvelle bibliothèque de ressources aideront à améliorer les systèmes d'information et d'enregistrement des faits d'état civil dans les pays en développement.

Analyse du financement de la santé et des avantages en Ouganda ...

International Development Research Centre (IDRC) Digital Library (Canada)

Le nouveau site Web facilitera l'enregistrement des événements démographiques afin d'améliorer l'accès aux services pour tous. Le nouveau site Web et la nouvelle bibliothèque de ressources aideront à améliorer les systèmes d'information et d'enregistrement des faits d'état civil dans les pays en développement.

Table des illustrations

OpenAIRE

2016-01-01

Tableaux Dates d’inauguration des grands hôtels japonais entre 1860 et 1945… 19 Histoire, tourisme et hôtellerie en Corée depuis les années 1870… 59-60 Dates d’inauguration des grands hôtels chinois depuis 1863… 84 Les hôtels de luxe et leurs capacités d’hébergement en Corée en 2000… 103 Les flux de personnes suscités par les hôtels « super luxe » de Séoul en 2000… 105 L’activité des grands hôtels à Séoul en 1999 (en wons)… 106 Propriété et gestion des grands hôtels à Séoul en 1999…. 110 La c...

La recherche en action : des solutions locales, des effets durables ...

International Development Research Centre (IDRC) Digital Library (Canada)

15 déc. 2010 ... Le Centre de recherches pour le développement international (CRDI) appuie la production et l'application de connaissances qui améliorent de façon notable la situation des habitants des pays en développement.

Santé sexuelle et reproductive des adolescentes de Bobo Dioulasso, Burkina Faso: place de la communication parents-adolescentes pour la réduction des risques

Science.gov (United States)

Some, Donmozoun Télesphore; Some, Der Adolphe; Hien, Hervé; Diallo, Ramata; Zingue, Dézémon; Diallo, Ibrahim; Diagbouga, Serge; Dao, Blami

2012-01-01

Introduction Les adolescentes sont très vulnérables face aux Infections Sexuellement Transmissibles (IST) et au VIH/SIDA. Notre étude a pour objectifs d’explorer la qualité de la communication entre les adolescentes et leurs parents sur les IST/VIH/SIDA et de recueillir leurs suggestions pour l’amélioration de cette communication. Méthodes L’étude était transversale qualitative sur 2 mois. La population de l’étude était composée par des adolescentes de 13 à 17 ans et leurs parents habitant la ville de Bobo Dioulasso. Vingt (20) adolescentes scolarisées ont été tirés au sort dans trois établissements secondaires et 20 autres non scolarisées choisies de façon accidentelle dans la ville. Les informations ont été collectées à l’aide de 8 focus groups. Les discussions ont été enregistrées sur cassettes, retranscrites en verbatim, et analysées à l’aide du logiciel QSR NVIVO 2.0. Résultats Les adolescentes et leurs parents communiquent très peu ou pas sur les questions des IST/VIH/SIDA; l’auto-information par les paires ou les médias est la première source d’information. Pour les parents, l’information existe et est accessible aux adolescentes alors que pour ces dernières, leurs connaissances de ces maladies sont parfois erronées. L’abstinence, la fidélité et le dépistage volontaire comme moyen de prévention sont très peu évoqués par les adolescentes de même que par leurs parents. Conclusion La communication parents-adolescentes est insuffisante voire absente dans certains milieux. Il est urgent de conduire des actions auprès des adolescentes et leurs parents pour mieux les informer sur les IST/VIH/SIDA et améliorer la communication sur ces maladies. PMID:22655099

La revolution des savants

CERN Document Server

Chavanne, A

1989-01-01

Premiere cassette : - 1666 : impact de la creation de l'Academie des Sciences par Colbert, trente ans apres le proces de Galile, et au moment des disparitions de Pascal, Descartes et Fermat. Elle dirigee par le hollandais Huyggens jusqu'a sa fuite de France au moment de la revocation de l'Edit de Nantes. - 1750 : l'Encyclopedie (ou "Dictionnaire raisonne des Sciences, des Arts et des Metiers") de Diderot et d'Alembert, soutenus par Malherbes, Buffon, Condorcet et Rousseau. - 1789 : Revolution francaise. - 8 aout 1793 : l'Assemblee, par une declaration de Marat, dissout l'Academie des Sciences. Celle-ci continue cependant ses travaux pour les poids et mesures jusqu'en 1795. - la Terreur : la condamnation a mort, pas au nom d'une "Revolution qui n'a pas besoin de savants" mais pour d'autres raisons, de trois grands hommes de science : Lavoisier, Bailly et Condorcet. - 1793-1794 : Au printemps 93, le Comite de Salut Publique s'inquiete du demi-million de soldats etrangers de toutes les pays frontaliers qui essai...

Clinicians and their cameras: policy, ethics and practice in an Australian tertiary hospital.

Science.gov (United States)

Burns, Kara; Belton, Suzanne

2013-09-01

Medical photography illustrates what people would prefer to keep private, is practiced when people are vulnerable, and has the power to freeze a moment in time. Given it is a sensitive area of health, lawful and ethical practice is paramount. This paper recognises and seeks to clarify the possibility of widespread clinician-taken medical photography in a tertiary hospital in northern Australia, examining the legal and ethical implications of this practice. A framework of Northern Territory law, state Department of Health policy and human rights theory were used to argue the thesis. Clinicians from 13 purposively chosen wards were asked to participate in an anonymous survey and confidential in-depth interviews. Questions were generated from the literature and local knowledge on the topics of 'occurrence', 'image use', 'quality of consent', 'cameras and technology', 'confidentiality', 'data storage and security', 'hospital policy and law' and 'cultural issues'. One hundred and seventy surveys and eights interviews were analysed using descriptive statistics and theme and content analysis, then triangulated for similarity, difference and unique responses. Forty-eight percent of clinicians surveyed take medical photographs, with the majority using hospital-owned cameras. However, one-fifth of clinicians reported photographing with personal mobile phones. Non-compliance with written consent requirements articulated in policy was endemic, with most clinicians surveyed obtaining only verbal consent. Labeling, storage, copyright and cultural issues were generally misunderstood, with a significant number of clinicians risking the security of patient information by storing images on personal devices. If this tertiary hospital does not develop a clinical photography action plan to address staff lack of knowledge, and noncompliance with policy and mobile phone use, patients' data is at risk of being distributed into the public domain where unauthorised publication may cause

Literature study of the radiobiological parameters of Caesium-137 required for evaluating internal irradiation doses as a function of age; Etude bibliographique des parametres radiobiologiques du cesium-137 necessaires a l'evaluation des doses d'irradiation interne en fonction de l'age

Energy Technology Data Exchange (ETDEWEB)

Garnier, A. [Commissariat a l' Energie Atomique, 92 - Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires

1968-07-01

This document reassembles information published in scientific literature on radiobiological parameters of Cs-137, necessary for the estimate of the internal irradiation dose of man according to his age (during growth). The data are completed by a commented review of the mathematical models, proposed in order to value the irradiation doses from ingested cesium and the biological parameters. (author) [French] Ce document rassemble les informations publiees dans la litterature scientifique, concernant les parametres radiobiologiqueo du cesium-137, necessaires a l'evaluation des doses d'irradiation interne de l'homme en fonction de l'age. Ces donnees sont completees par une revue commentee des modeles mathematiques proposes en vue de l'evaluation des doses d'irradiation a partir des quantites de cesium ingerees et des parametres biologiques. (auteur)

Diversification des moyens de subsistance des petits producteurs de ...

International Development Research Centre (IDRC) Digital Library (Canada)

L'économie du Malawi repose essentiellement sur la culture du tabac, qui représente plus de 70 % des revenus d'exportation. Pour 60 % des 100 000 membres de la National Smallholder Farmers' Association of Malawi (NASFAM), le tabac est la seule et unique source de revenus. Les cultivateurs de tabac, au Malawi ...

À l’aube des dieux

Directory of Open Access Journals (Sweden)

Pascal Semonsut

2011-03-01

Full Text Available De l’avis même des préhistoriens, la Préhistoire assiste à la naissance du sentiment religieux. Cette religion des origines, quelle image en ont les Français ? Telle est la question que cet article aborde à partir de l’étude des manuels scolaires et des œuvres de fiction (littérature, cinéma et bande dessinée de la seconde moitié du XXe siècle. Si l’enseignement et la fiction n’accordent pas la même place à ce thème, en revanche tous deux font des préhistoriques des polythéistes adorant le soleil, construisant des mégalithes et prenant le plus grand soin de leurs morts. Ce mélange d’obscurantisme et de vraie spiritualité n’a qu’un but : montrer que notre espèce ne pouvait être que victorieuse dans ce combat qu’est l’humanisation.

Knowledge transfer to clinicians and consumers by the Cochrane Musculoskeletal Group.

Science.gov (United States)

Santesso, Nancy; Maxwell, Lara; Tugwell, Peter S; Wells, George A; O'connor, Annette M; Judd, Maria; Buchbinder, Rachelle

2006-11-01

The Cochrane Musculoskeletal Group (CMSG) is one of 50 groups of the Cochrane Collaboration that prepares, maintains, and disseminates systematic reviews of treatments for musculoskeletal diseases. Once systematic reviews are completed, the next challenge is presenting the results in useful formats to be integrated into the healthcare decisions of clinicians and consumers. The CMSG recommends 3 methods to aid knowledge translation and exchange between clinicians and patients: produce clinical relevance tables, create graphical displays using face figures, and write consumer summaries and patient decision aids. Accordingly, CMSG has developed specific guidelines to help researchers and authors convert the pooled estimates of metaanalyses in the systematic reviews to user-friendly numbers. First, clinical relevance tables are developed that include absolute and relative benefits or harms and the numbers needed to treat. Next, the numbers from the clinical relevance tables are presented graphically using faces. The faces represent a group of 100 people and are shaded according to how many people out of 100 benefited or were harmed by the interventions. The user-friendly numbers are also included in short summaries and decision aids written for patients. The different levels of detail in the summaries and decision aids provide patients with tools to prepare them to discuss treatment options with their clinicians. Methods to improve the effects and usability of systematic reviews by providing results in more clinically relevant formats are essential. Both clinicians and consumers can use these products to use evidence-based information in individual and shared decision-making.

Entre structure et action : la compétence communicative des TIC

Directory of Open Access Journals (Sweden)

Serge Agostinelli

2011-06-01

Full Text Available Cet article théorique explore comment les concepts de structure et d’action permettent une approche originale du concept de compétence dans le domaine des TIC. Cette approche relève d’une recherche de compatibilité entre des modèles issus des Technologies qui proposent les structures socio-techniques et ceux des Sciences Humaines qui organisent l’action des individus. Les modèles théoriques invoqués de domaines disciplinaires différents (sociologie, ethnométhodologie, psychologie sociale, linguistique, sciences de l’éducation et sciences de l’information-communication donnent au concept de compétence en TIC une nouvelle consistance, plus anthropocentrée et moins technico-pratique. Ils posent la question du rapport entre micro et macro, du rapport de l’individu au groupe, et posent aussi la question ontologique des structures. Les compétences ne se réduisent pas à la seule connaissance des aspects techniques, mais sont élargies à la maîtrise des conditions d’utilisation adéquate et des possibilités offertes par la technique. Utiliser les technologies, c’est construire de la relation grâce aux compétences communicatives des TIC.This theoretical article investigates how the concepts of structure and action allow an original approach of the concept of skill in the field of ICT. This approach concerns a search for compatibility between stemming models Technologies which propose the socio-technical structures and those of the Human Sciences who organize the action of the individuals. The theoretical models called by different disciplinary domains (sociology, ethnomethodology, social psychology, linguistic, education, communication and information science give to the concept of skill in ICT a new consistency, more anthropology centred and less technico-practical. They ask the question of the relationship between micro and macro, the relationship of the individual to the group, and also ask the ontological question

La maison des mathématiques

CERN Document Server

Villani, Cédric; Moncorgé, Vincent

2014-01-01

Comment travaillent les mathématiciens ? C'est peut-être en se promenant dans les couloirs de la première des " maisons des mathématiques " de France, l'institut Henri Poincaré, que l'on trouvera quelques réponses. Le mathématicien Cédric Villani et le physicien Jean-Philippe Uzan nous invitent à découvrir cette discipline et ses acteurs. Au fil des pages on suit, à travers de superbes images signées du photographe Vincent Moncorgé, la façon dont se fabrique cette science qui reste souvent mystérieuse. Toutes les dimensions, scientifique, esthétique et poétique, des mathématiques sont convoquées grâce à des regards croisés : la diversité des inspirations des chercheurs, la source de leur créativité, l'imaginaire littéraire et artistique des mathématiques, la drôle de tribu des mathématiciens. Un voyage au cœur de cette " auberge espagnole " des mathématiques, campus " à la française " accueillant des centaines de chercheurs du monde entier, devenu un lieu d'émulation et d'éc...

Modernisation des marchés agroalimentaires - inclusion des petits ...

International Development Research Centre (IDRC) Digital Library (Canada)

Les marchés agroalimentaires connaissent de rapides changements dans les pays en développement et les pays en transition. Sous l'influence de la libéralisation du commerce et des nouvelles technologies de transformation des aliments et de commerce de détail, les marchés agroalimentaires évoluent vers une plus ...

Culture du bambou : diversification des moyens de subsistance des ...

International Development Research Centre (IDRC) Digital Library (Canada)

Culture du bambou : diversification des moyens de subsistance des petits producteurs de tabac du sud de la province de Nyanza, au Kenya - phase II. Au cours de la première phase du projet (projet no 103765), les chercheurs ont effectué une analyse de marché pour le bambou et les produits du bambou, comparé les ...

Canary: An NLP Platform for Clinicians and Researchers.

Science.gov (United States)

Malmasi, Shervin; Sandor, Nicolae L; Hosomura, Naoshi; Goldberg, Matt; Skentzos, Stephen; Turchin, Alexander

2017-05-03

Information Extraction methods can help discover critical knowledge buried in the vast repositories of unstructured clinical data. However, these methods are underutilized in clinical research, potentially due to the absence of free software geared towards clinicians with little technical expertise. The skills required for developing/using such software constitute a major barrier for medical researchers wishing to employ these methods. To address this, we have developed Canary, a free and open-source solution designed for users without natural language processing (NLP) or software engineering experience. It was designed to be fast and work out of the box via a user-friendly graphical interface.

Structurations formelle et conceptuelle des articles de dictionnaires : le premier modèle de codification des articles dans l’histoire des dictionnaires Larousse

Directory of Open Access Journals (Sweden)

Corbin Pierre

2014-07-01

Nous nous proposons d’examiner, dans l’histoire des dictionnaires généraux monolingues Larousse des origines à nos jours, une sélection de jalons de l’articulation entre structure conceptuelle et structure formelle des articles. Au regard de l’ampleur des données à couvrir, il ne pourra bien entendu s’agir que d’un survol, mais celui-ci permettra (1 de présenter le premier des trois modèles majeurs de codification des articles dans l’histoire des dictionnaires Larousse, celui qui trouve son origine dans le Nouveau dictionnaire de la langue française de 1856 ou ses éditions révisées, (2 de prendre en compte les dictionnaires proposés par cet éditeur en un siècle et demi qui ont repris le modèle de 1856 ou sa forme révisée, et (3 de présenter contrastivement au premier les deux autres modèles majeurs, qui trouvent leur ancrage chronologique respectivement dans le Grand dictionnaire universel du XIXe siècle de 1866-1876 et le Dictionnaire du français contemporain de 1966.

Clinicians' views and experiences of offering two alternative consent pathways for participation in a preterm intrapartum trial: a qualitative study.

Science.gov (United States)

Chhoa, Celine Y; Sawyer, Alexandra; Ayers, Susan; Pushpa-Rajah, Angela; Duley, Lelia

2017-04-26

The Cord Pilot Trial compared alternative policies for timing of cord clamping at very preterm birth at eight UK hospitals. Preterm birth can be rapid and unexpected, allowing little time for the usual consent process. Therefore, in addition to the usual procedure for written consent, a two-stage pathway for consent for use when birth was imminent was developed. The aims of this study were to explore clinicians' views and experiences of offering two consent pathways for recruitment to a randomised trial of timing of cord clamping at very preterm birth. This was a qualitative study using semi-structured interviews. Clinicians from eight hospitals in the UK who had been involved in offering consent to the Cord Pilot Trial were invited to take part in an interview. Clinicians were interviewed in person or by telephone. Interviews were analysed using inductive systematic thematic analysis. Seventeen clinicians who had either offered usual written consent only (n = 6) or both the two-stage pathway (with oral assent before the birth and written consent after the birth) and usual written consent (n = 11) were interviewed. Six themes were identified: (1) team approach to offering participation; (2) consent form as a record; (3) consent and participation as a continual process; (4) different consent pathways for different trials; (5) balance between time, information, and understanding; and (6) validity of consent. Overall, clinicians were supportive of the two-stage consent pathway. Some clinicians felt that in time-critical situations oral assent presented an advantage over the usual written consent as they provided information on a "need to know" basis. However, there was some concern about how much information should be given for oral assent, and how this is understood by women when birth is imminent. The two-stage pathway for consent developed for use in the Cord Pilot Trial when birth was imminent was acceptable to clinicians for comparable low-risk studies

Do clinicians assess patients' religiousness? An audit of an aged psychiatry community team.

Science.gov (United States)

Payman, Vahid; Lim, Zheng Jie

2018-03-01

To determine the frequency and quality of religious history taking of patients by clinicians working in an old age psychiatry service. A retrospective audit of 80 randomised patient files from the Koropiko Mental Health Services for Older People (MHSOP) in Middlemore Hospital, Auckland, New Zealand. A total of 66 clinical records were available for analysis. A religious history was taken in 33/66 (50%) patients. However, when such histories were evaluated using the FICA assessment tool, only 10/33 (30.3%) histories contained detailed information regarding the patient's religiousness. The infrequency and low quality of religious histories discovered in this audit suggest that clinicians need more training in taking a religious history from patients.

Deriving Empirically-Based Design Guidelines for Advanced Learning Technologies that Foster Disciplinary Comprehension / Définir des lignes directrices fondées sur des données empiriques pour les technologies d’apprentissage avancé qui favorisent la compr

Directory of Open Access Journals (Sweden)

Eric Poitras

2012-02-01

Full Text Available Planning, conducting, and reporting leading-edge research requires professionals who are capable of highly skilled reading. This study reports the development of an empirically informed computer-based learning environment designed to foster the acquisition of reading comprehension strategies that mediate expertise in the social sciences. Empirical data were gathered in a mixed-methods explanatory sequential design that examined the reading comprehension strategies used by an expert social scientist while reading a professional-level text. Process data were collected through a concurrent think-aloud protocol and coded according to reading comprehension processes. We combined both quantitative and qualitative analyses to identify, describe, and explain patterns in the expert’s use of reading strategies. Our findings indicate that highly-skilled reading is characterized by critiquing text information, relating information to prior knowledge, and evaluating one’s own understanding of text information. Findings are used to inform the design of worked-examples and a pedagogical agent embedded within the Highly-Skilled Reading Tutor. Le type de planification, de réalisation et l’analyse qui caractérise une recherche d’avant-garde nécessite des professionnels en mesure d’effectuer des lectures hautement spécialisées. La présente étude dresse un rapport sur l’élaboration d’un milieu d’apprentissage informatisé conçu pour favoriser l’acquisition de stratégies de compréhension en lecture permettant d’assurer la transmission des connaissances spécialisées en sciences sociales. La collecte de données empiriques s’est effectuée suivant une conception séquentielle explicative fondée sur une méthode mixte, qui étudiait les stratégies de compréhension de lecture utilisées par un expert en sciences sociales lors de sa lecture d’un texte de calibre professionnel. La collecte des données sur le processus s�

Mentoring for clinician-educators.

Science.gov (United States)

Farrell, Susan E; Digioia, Natalie M; Broderick, Kerry B; Coates, Wendy C

2004-12-01

Mentorship has been shown to have a positive impact on academic faculty members in terms of career advancement. The guidance of a mentor has been shown to increase academic outcome measures such as peer-reviewed publications and grant support for junior academic faculty. In addition, career satisfaction of mentored faculty is greater than those with no mentorship. There is little research on the effects of mentorship on the careers of clinician-educators. This group has also been reported to have a lower scholarly productivity rate than the typical research-based faculty. This article addresses the current state of mentorship as it applies specifically to clinician-educators, offers advice on how a potential protégé might seek out a potential mentor, and finally, suggests a possible mentoring system for academic emergency physicians who are focusing on careers in medical education.

Corrélats des enquêtes conjointes des services de protection de l'enfance et des services de police sur les abus sexuels d'enfants : résultats de l'Étude canadienne sur l'incidence des signalements de cas de violence et de négligence envers les enfants 2008

Directory of Open Access Journals (Sweden)

L. Tonmyr

2015-01-01

Full Text Available Introduction : Dans cette étude, nous examinons la fréquence des enquêtes conjointes menées par les services de protection de l'enfance et les services de police dans les cas d'abus sexuels en comparaison des autres types de maltraitance. Nous examinons également les associations, dans les enquêtes conjointes, entre les caractéristiques relatives à l'enfant, celles relatives au pourvoyeur de soins de l'enfant, celles relatives aux mauvais traitements eux-mêmes et celles relatives à l'enquête, en nous intéressant plus particulièrement aux enquêtes sur les abus sexuels. Méthodologie : Nous avons analysé par régression logistique les données de l'Étude canadienne sur l'incidence des signalements de cas de violence et de négligence envers les enfants 2008. Résultats : D'après les données, les enquêtes conjointes portent en premier lieu sur les abus sexuels (55 %, puis sur la violence physique, la négligence et la violence psychologique. La corroboration des mauvais traitements, les mauvais traitements graves, le placement, l'intervention des tribunaux de la jeunesse et l'orientation d'un membre de la famille vers des services spécialisés sont plus fréquents quand les services de police participent à l'enquête. Conclusion : Cette étude vient bonifier l'information limitée dont on dispose sur les corrélats des enquêtes conjointes menées par les agences de protection de l'enfance et les services de police. D'autres recherches devront être effectuées pour déterminer l'efficacité de ces enquêtes conjointes.

Etat des lieux de la gestion des insecticides au Togo, Afrique de l ...

African Journals Online (AJOL)

Pour parvenir à une gestion optimale des maladies à transmission vectorielle ou tout au moins la nuisance culicidienne, une surveillance permanente des facteurs de risque devient nécessaire. Le principal facteur de risque est le vecteur qui transmet la maladie, et le contrôle du vecteur passe par des stratégies de lutte qui ...

Rôle et limites des tiers-lieux dans la fabrique des villes contemporaines

OpenAIRE

Besson, Raphaël

2017-01-01

La notion de tiers-lieux se développe de manière essentiellement empirique. Elle recouvre des réalités multiples, comme des projets de coworking spaces, de living labs et de fab labs. Certains tiers-lieux s’intéressent tout particulièrement à la ville et aux nouvelles conditions de la fabrique urbaine. En s’appuyant sur des méthodes d’innovation ouverte et le potentiel des outils numériques, ces tiers-lieux défendent l’idée d’un urbanisme qui ne soit plus le patrimoine exclusif d’experts, mai...

Clinical Decision-Making in Community Children's Mental Health: Using Innovative Methods to Compare Clinicians With and Without Training in Evidence-Based Treatment.

Science.gov (United States)

Baker-Ericzén, Mary J; Jenkins, Melissa M; Park, Soojin; Garland, Ann F

2015-02-01

Mental health professionals' decision-making practice is an area of increasing interest and importance, especially in the pediatric research and clinical communities. The present study explored the role of prior training in evidence-based treatments on clinicians' assessment and treatment formulations using case vignettes. Specifically, study aims included using the Naturalistic Decision Making (NDM) cognitive theory to 1) examine potential associations between EBT training and decision-making processes (novice versus expert type), and 2) explore how client and family contextual information affects clinical decision-making. Forty-eight clinicians across two groups (EBT trained=14, Not EBT trained=34) participated. Clinicians were comparable on professional experience, demographics, and discipline. The quasi-experimental design used an analog "think aloud" method where clinicians read case vignettes about a child with disruptive behavior problems and verbalized case conceptualization and treatment planning out-loud. Responses were coded according to NDM theory. MANOVA results were significant for EBT training status such that EBT trained clinicians' displayed cognitive processes more closely aligned with "expert" decision-makers and non-EBT trained clinicians' decision processes were more similar to "novice" decision-makers, following NDM theory. Non-EBT trained clinicians assigned significantly more diagnoses, provided less detailed treatment plans and discussed fewer EBTs. Parent/family contextual information also appeared to influence decision-making. This study offers a preliminary investigation of the possible broader impacts of EBT training and potential associations with development of expert decision-making skills. Targeting clinicians' decision-making may be an important avenue to pursue within dissemination-implementation efforts in mental health practice.

analyse de la variabilite des rendements du riz selon les varietes et ...

African Journals Online (AJOL)

ACSS

15 févr. 2018 ... objectif, l'étude s'est basée sur une phase d'enquête basée sur un questionnaire intégré dans un Smartphone, et une autre phase d'observation, basée sur la mise en place des placettes et sous-placettes dans les champs des producteurs afin de recueillir les informations sur les pratiques culturales du riz ...

L'incidence du prix et des stratégies d'emballage des produits du ...

International Development Research Centre (IDRC) Digital Library (Canada)

Des données internationales, en provenance surtout des pays à revenu élevé, ... pour s'attaquer aux stratégies de marketing ciblant des groupes vulnérables dans ... Les conclusions d'un programme financé par le CRDI au premier plan de la ...

Etat des lieux de la reproduction sexuée des ignames africaines ...

African Journals Online (AJOL)

Les ignames sont d'importantes plantes alimentaires à multiplication végétative dont l'amélioration et la création variétale dépendent, comme chez les végétaux, de la maîtrise de la biologie de la reproduction sexuée. L'état des lieux des cultivars florifères des ignames africaines Dioscorea cayenensis – D. rotundata a été ...

La réforme des politiques sociales : Évolution des perspectives du ...

International Development Research Centre (IDRC) Digital Library (Canada)

Le XXe siècle est une époque remarquable sur le plan des progrès matériels et des transformations d'ordre social et politique. Partout dans le monde, les conditions de vie de la population ont profondément changé à bien des égards: le taux de mortalité infantile et l'analphabétisme chez les adultes ont diminué de façon ...

Francis Jauréguiberry & Serge Proulx, Usages et enjeux des technologies de communication

Directory of Open Access Journals (Sweden)

Jean-Pierre Durand

2013-03-01

Full Text Available Ce petit ouvrage propose une très large revue de littérature sur les usages des technologies de l’information et de la communication. On peut dire que cet ouvrage est complet, en particulier parce qu’il couvre aussi la production intellectuelle du monde anglo-saxon. Il est très agréable à lire parce que les thèses y sont exposées clairement. C’est aussi un ouvrage qui reprend l’historique des usages des TIC et leurs analyses dans les sciences humaines. Le premier chapitre propose un cadrage t...

Increasing consumer demand for tobacco treatments: Ten design recommendations for clinicians and healthcare systems.

Science.gov (United States)

Woods, Susan Swartz; Jaén, Carlos Roberto

2010-03-01

Health professionals play an important role in addressing patient tobacco use in clinical settings. While there is clear evidence that identifying tobacco use and assisting smokers in quitting affects outcomes, challenges to improve routine, clinician-delivered tobacco intervention persist. The Consumer Demand Initiative has identified simple design principles to increase consumers' use of proven tobacco treatments. Applying these design strategies to activities across the healthcare system, we articulate ten recommendations that can be implemented in the context of most clinical systems where most clinicians work. The recommendations are: (1) reframe the definition of success, (2) portray proven treatments as the best care, (3) redesign the 5A's of tobacco intervention, (4) be ready to deliver the right treatment at the right time, (5) move tobacco from the social history to the problem list, (6) use words as therapy and language that makes sense, (7) fit tobacco treatment into clinical team workflows, (8) embed tobacco treatment into health information technology, (9) make every encounter an opportunity to intervene, and (10) end social disparities for tobacco users. Clinical systems need to change to improve tobacco treatment implementation. The consumer- and clinician-centered recommendations provide a roadmap that focuses on increasing clinician performance through greater understanding of the clinician's role in helping tobacco users, highlighting the value of evidence-based tobacco treatments, employing shared decision-making skills, and integrating routine tobacco treatment into clinical system routines. Published by Elsevier Inc.

Factors influencing rural and urban emergency clinicians' participation in an online knowledge exchange intervention.

Science.gov (United States)

Curran, Janet A; Murphy, Andrea L; Sinclair, Douglas; McGrath, Patrick

2013-01-01

Rural emergency departments (EDs) generally have limited access to continuing education and are typically staffed by clinicians without pediatric emergency specialty training. Emergency care of children is complex and the majority of children receive emergency care in non-pediatric tertiary care centers. In recent decades, there has been a call to action to improve quality and safety in the emergency care of children. Of the one million ED visits by children in Ontario in 2005-2006, one in three visited more than once in a year and one in 15 returned to the ED within 72 hours of the index visit. This study explored factors influencing rural and urban ED clinicians' participation in a Web-based knowledge exchange intervention that focused on best practice knowledge about pediatric emergency care. The following questions guided the study: (i) What are the individual, context of practice or knowledge factors which impact a clinician's decision to participate in a Web-based knowledge exchange intervention?; (ii) What are clinicians' perceptions of organizational expectations regarding knowledge and information sources to be used in practice?; and (iii) What are the preferred knowledge sources of rural and urban emergency clinicians? A Web-based knowledge exchange intervention, the Pediatric Emergency Care Web Based Knowledge Exchange Project, for rural and urban ED clinicians was developed. The website contained 12 pediatric emergency practice learning modules with linked asynchronous discussion forums. The topics for the modules were determined through a needs assessment and the module content was developed by known experts in the field. A follow-up survey was sent to a convenience sample of 187 clinicians from nine rural and two urban Canadian EDs participating in the pediatric emergency Web-based knowledge exchange intervention study. The survey response rate was 56% (105/187). Participation in the knowledge exchange intervention was related to individual

Cartographie interactive sur minitel: l'Atlas télématique des villes françaises

Directory of Open Access Journals (Sweden)

Philippe WANIEZ

1986-03-01

Full Text Available L'atlas télématique des villes françaises met à la disposition d'un large public des informations statistiques, sous la forme de cartes s'affichant sur l'écran des terminaux minitel. Deux exemples de session d'interrogation illustrent l'usage pouvant être fait de ce nouveau service vidéotex: les élections européennes de 1984, la criminalité en 1982.

Recueillir des données probantes à l'échelle des collectivités pour ...

International Development Research Centre (IDRC) Digital Library (Canada)

Ce projet contribue à la collecte, à l'échelle des collectivités, de données probantes sur les souvenirs des victimes de violations des droits de la personne. Il vise aussi à trouver des stratégies de reconstruction post-atrocités dans un cadre local sûr. Enfin, l'équipe a créé un site Web et produit plusieurs publications.

Innova on pour la santé des mères et des enfants d'Afrique

International Development Research Centre (IDRC) Digital Library (Canada)

19 janv. 2018 ... Les conclusions révèlent des similitudes parmi les cas de divers contextes na onaux, fournissant une riche base de preuves afin d'inspirer des ini a ves visant à améliorer l'équité en ma ère de santé. OUVRIR LE PDF | COMMANDER LE LIVRE. Innova on pour la santé des mères et des enfants d'Afrique.

Clinicians' perception of the preventability of inpatient mortality.

Science.gov (United States)

Nash, Robert; Srinivasan, Ramya; Kenway, Bruno; Quinn, James

2018-03-12

Purpose The purpose of this paper is to assess whether clinicians have an accurate perception of the preventability of their patients' mortality. Case note review estimates that approximately 5 percent of inpatient deaths are preventable. Design/methodology/approach The design involved in the study is a prospective audit of inpatient mortality in a single NHS hospital trust. The case study includes 979 inpatient mortalities. A number of outcome measures were recorded, including a Likert scale of the preventability of death- and NCEPOD-based grading of care quality. Findings Clinicians assessed only 1.4 percent of deaths as likely to be preventable. This is significantly lower than previously published values ( p<0.0001). Clinicians were also more likely to rate the quality of care as "good," and less likely to identify areas of substandard clinical or organizational management. Research limitations/implications The implications of objective assessment of the preventability of mortality are essential to drive quality improvement in this area. Practical implications There is a wide disparity between independent case note review and clinicians assessing the care of their own patients. This may be due to a "knowledge gap" between reviewers and treating clinicians, or an "objectivity gap" meaning clinicians may not recognize preventability of death of patients under their care. Social implications This study gives some insight into deficiencies in clinical governance processes. Originality/value No similar study has been performed. This has significant implications for the idea of the preventability of mortality.

Towards reinforcing telemedicine adoption amongst clinicians in Nigeria.

Science.gov (United States)

Adenuga, Kayode I; Iahad, Noorminshah A; Miskon, Suraya

2017-08-01

Telemedicine systems have been considered as a necessary measure to alleviate the shortfall in skilled medical specialists in developing countries. However, the obvious challenge is whether clinicians are willing to use this technological innovation, which has aided medical practice globally. One factor which has received little academic attention is the provision of suitable encouragement for clinicians to adopt telemedicine, in the form of rewards, motivation or incentives. A further consideration for telemedicine usage in developing countries, especially sub-Saharan Africa and Nigeria in particular, are to the severe shortage of available practising clinicians. The researchers therefore explore the need to positively reinforce the adoption of telemedicine amongst clinicians in Nigeria, and also offer a rationale for this using the UTAUT model. Data were collected using a structured paper-based questionnaire, with 252 physicians and nurses from six government hospitals in Ondo state, Nigeria. The study applied SmartPLS 2.0 for analysis to determine the relationship between six variables. Demographic moderating variables, age, gender and profession, were included. The results indicate that performance expectancy (ptelemedicine systems, as predicted using the extended UTAUT model. Our results showed that the use of telemedicine by clinicians in the Nigerian context is perceived as a dual responsibility which requires suitable reinforcement. In addition, performance expectancy, effort expectancy, facilitating condition and reinforcement determinants are influential factors in the use of telemedicine services for remote-patient clinical diagnosis and management by the Nigerian clinicians. Copyright © 2017. Published by Elsevier B.V.

Administration et gestion des contrats XL

CERN Document Server

Senouf, J

2000-01-01

Les grands contrats de travaux génèrent un grand nombre de commandes (OSVC) passées par un grand nombre de responsables techniques. Ils sont généralement basés sur des bordereaux de prix associés à un éventail de conditions économiques adaptées aux besoins complexes et variés des multiples utilisateurs du CERN nécessitant des calculs sophistiqués. L'administration des commandes, le suivi des travaux et de la facturation doivent répondre aux besoins de tous les acteurs. Les responsables techniques doivent jouir de la plus large indépendance administrative dans le respect des règlements CERN et des conditions contractuelles. Le contrôle des métrés et décomptes doit être rigoureux et d'une traçabilité complète. L'utilisation des bases de données Oracle a déjà permis l'intégration des données administratives et techniques. Le Web nous invite à une communication totale et transparente entre les utilisateurs, les services techniques et les contractants. De nouveaux types de contrat so...

Approche historique des classifications en psychiatrie

OpenAIRE

Garrabé , J.

2011-01-01

Resume Des le milieu du xixe siecle s?est posee la question des criteres de classification des maladies. Pour les maladies mentales, diverses classifications ont alors ete proposees par des auteurs francais (Morel) et allemands (Kahlbaum, Kraepelin). A partir de la fin du xixe siecle, le Bureau International de Statistique (Paris) a publie a une Classification Internationale des Maladies, a revision decennale (J. Bertillon). Cette tache a ete poursuivie dans l?entre-deux-guerres pa...

Étude sur la nutrition menée dans des écoles de la Grenade - des ...

International Development Research Centre (IDRC) Digital Library (Canada)

Étude sur la nutrition menée dans des écoles de la Grenade - des données probantes pour éclairer les politiques. Prévention des maladies non transmissibles. (PMNT). PROFIL DE PROJET. Le programme Prévention des maladies non transmissi- bles (PMNT) soutient la production de nouvelles connais- sances en vue ...

Les folksonomies comme support émergent de navigation sociale et de structuration des données du Web

OpenAIRE

Crépel , Maxime

2008-01-01

En nous basant sur les premiers travaux venant alimenter le débat soulevé par le modèle de classification des folksonomies, ainsi que de résultats d’enquêtes réalisées à partir d’entretiens auprès d’utilisateurs du site Flickr, il s’agit d’analyser les enjeux de ce nouveau mode d’indexation des informations comme modèle controversé de structuration des ressources du web et de comprendre les implications de son intégration pour la recherche d’information et la navigation sur internet....

Les effets des interfaces sur les proprietes magnetiques et de transport des multicouches nickel/iron et cobalt/silver

Science.gov (United States)

Veres, Teodor

Cette these est consacree a l'etude de l'evolution structurale des proprietes magnetiques et de transport des multicouches Ni/Fe et nanostructures a base de Co et de l'Ag. Dans une premiere partie, essentiellement bibliographique, nous introduisons quelques concepts de base relies aux proprietes magnetiques et de transport des multicouches metalliques. Ensuite, nous presentons une breve description des methodes d'analyse des resultats. La deuxieme partie est consacree a l'etude des proprietes magnetiques et de transport des multicouches ferromagnetiques/ferromagnetiques Ni/Fe. Nous montrerons qu'une interpretation coherente de ces proprietes necessite la prise en consideration des effets des interfaces. Nous nous attacherons a mettre en evidence, a evaluer et a etudier les effets de ces interfaces ainsi que leur evolution, et ce, suite a des traitements thermiques tel que le depot a temperature elevee et l'irradiation ionique. Les analyses correlees de la structure et de la magnetoresistance nous permettront d'emettre des conclusions sur l'influence des couches tampons entre l'interface et le substrat ainsi qu'entre les couches elles-memes sur le comportement magnetique des couches F/F. La troisieme partie est consacree aux systemes a Magneto-Resistance Geante (MRG) a base de Co et Ag. Nous allons etudier l'evolution de la microstructure suite a l'irradiation avec des ions Si+ ayant une energie de 1 MeV, ainsi que les effets de ces changements sur le comportement magnetique. Cette partie debutera par l'analyse des proprietes d'une multicouche hybride, intermediaire entre les multicouches et les materiaux granulaires. Nous analyserons a l'aide des mesures de diffraction, de relaxation superparamagnetique et de magnetoresistance, les evolutions structurales produites par l'irradiation ionique. Nous etablirons des modeles qui nous aideront a interpreter les resultats pour une serie des multicouches qui couvrent un large eventail de differents comportements magnetiques

Radioisotopes in sedimentology; Emploi des radioelements en sedimentologie

Energy Technology Data Exchange (ETDEWEB)

Courtois, G [CEA, Centre d' etudes Nucleaires de Saclay (France)

1967-05-15

, surface and mass labelling (with particular reference to the problem of silting), immersion and detection equipment, and problems of navigation and topographical reference points. In the section dealing with the application of the results, the problem of obtaining quantitative results is discussed and the proposed methods described. The author also refers to the current, highly commendable attempts to relate the numerous sediment transport theories to measurements carried out in situ with radioactive tracers. The author also goes into some aspects of the safety question. The methods described may also be applied to related problems of considerable importance (soil erosion, soil stabilization and the movement of sand dunes) and brief references are made to these problems. Finally, the author reviews the current possibilities of using radioisotopes in sedimentology, their limitations and the improvement which should be made in their application. Continuous turbidity measurements. Since the transport of suspended solids is generally much more significant than bed-load movement, continuous measurements are of great importance. A number of examples are given of the value of information obtained by such measurements. Measurements of this kind can be carried out by means of gauges described in the literature. The author describes the principles and operation of such gauges, giving bibliographical references. The author also shows what information concerning turbidity can be obtained by measuring the natural radioactivity of suspended sediment and compares the two methods. Other measurements. Other radioisotope techniques which may also be used in sedimentology are touched on: dating, analytical studies (either continuous analysis of core samples by means of X-ray fluorescence or the detection of trace elements by activation analysis), use of tracers, for example for the study of particle movements when affected by freezing of the soil or for the study of the formation and

Processing of data issued from a {gamma} spectrometer; Traitement des informations issues d'un spectrometre {gamma}

Energy Technology Data Exchange (ETDEWEB)

Boulanger, J P [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1966-03-01

The purpose of the following report is the study of computation method applied to analysis by gamma spectrometry. We first study quantitative analysis by the least-squares method, improved by a gain-shift correction. Then the single full-energy peaks and the resolution of complex peaks are dealt with. In both cases, the calculation principle, then the systematic tests achieved in order to-prove their validity and determine their application ranges are described and finally some experimental results appropriate to illustrate their possibilities are presented. (author) [French] Le present rapport a pour objet l'etude de methodes de calcul applicables a l'analyse par spectrometrie gamma. On etudie d'abord l'analyse quantitative par la methode des moindres carres, completee par une correction de derive du gain. Puis on examine les pics d'absorption totale simples et la resolution des pics complexes. Dans les deux cas, on expose le principe des calculs et les essais systematiques effectues pour eprouver leur validite et definir leurs domaines d'application, ainsi que quelques resultats experimentaux propres a illustrer leurs possibilites.

Les caractéristiques des stomates des feuilles de Ficus benjamina L ...

African Journals Online (AJOL)

SARAH

25 mars 2014 ... gaz d'échappement des véhicules et des cheminés des usines (Barima et al., 2014). En outre, ces .... inférieures de celle-ci ont été nettoyées à l'eau distillée. Une partie de chaque face inférieure de la feuille a ..... réaction de la plante à empêcher l'absorption de polluants tout en optimisant l'absorption de ...

Primary caregivers' satisfaction with clinicians' response to them as informal carers of young people with first-episode psychosis: a qualitative study.

Science.gov (United States)

McCann, Terence V; Lubman, Dan I; Clark, Eileen

2012-01-01

To explore first-time primary caregivers' experience of the way mental health nurses and other mental health clinicians respond to them as carers of young people with first-episode psychosis. Caregivers have a key role in supporting family members/relatives with mental illness, but their contribution is undervalued frequently by mental health nurses and other mental health clinicians. Design.  Qualitative interpretative phenomenological analysis. A qualitative interpretative design was undertaken, using semi-structured, audio-recorded interviews. Twenty primary caregivers were recruited through Orygen Youth Health, a first-episode psychosis centre in Melbourne. Interpretative phenomenological analysis was used to identify themes in the data. Two competing themes were identified in the data, highlighting caregivers' contrasting experience with mental health nurses and other mental health clinicians. First, most clinical staff were approachable and supportive. Second, several carers felt their contribution was undervalued by some clinical staff. This was as a consequence of being excluded from clinical deliberations because of clinical staffs' concerns and young people's requests about maintaining confidentiality regarding treatment, as well as carers feeling their role was not taken seriously by clinical staff. First-time primary carers have positive and negative experiences with first-episode psychosis mental health nurses and other clinicians, and these competing events are interrelated. Experiences are affected directly by the manner they are treated by clinical staff and this may, in turn, affect carers' commitment to caring, the way they engage with clinical staff on subsequent occasions and towards the first-episode psychosis service generally. Greater appreciation is needed of the contribution, experience and difficulties caregivers encounter in their role and in engaging with mental health nurses and other clinicians. Additional training is required for

Inventaire des cavités souterraines abandonnées et cartographie des dangers qui leur sont liés

Directory of Open Access Journals (Sweden)

Claire ARNAL

1994-12-01

Full Text Available Un inventaire national des cavités souterraines abandonnées, des accidents de sol qui leur sont imputables et de leurs conséquences dommageables a été réalisé à l’échelle de 1/1 000 000 en 1993 et 1994 par le BRGM pour le ministère de l’Environnement (Direction de la Prévention des Pollutions et des Risques. Il a conduit à élaborer des documents cartographiques de synthèse et à définir des niveaux de dangers dont la localisation permettra de lancer des études plus détaillées en vue d’assurer la sécurité des personnes et des biens

Les sciences de l'information et de la communication face à l'émergence d'internet: vers un renouveau de la construction du "public" :approche théorique et méta-analyse des "publics" d'internet

OpenAIRE

Patriarche, Geoffroy

2005-01-01

Cette dissertation doctorale entend contribuer au renouveau des sciences de l’information et de la communication (SIC) et plus particulièrement de la construction du « public » dans un contexte caractérisé par une remise en question des savoirs théoriques et méthodologiques associée à l’émergence d’internet. Cette problématique est développée en trois temps. Dans un premier temps, nous effectuons une synthèse des constructions du public dans la recherche sur les médias classiques. Les multipl...

Kontrolle des Verwaltungsrates : eine Untersuchung der internen und externen Kontrollinstitutionen, -instrumente und -mechanismen

OpenAIRE

Reust, Dominik

2014-01-01

Eine wichtige Erkenntnis dieser Arbeit ist, dass eine effiziente und effektive Kontrolle des Verwaltungsrates nur über das Zusammenspiel der internen körperschaftlichen Kontrollinstitutionen und -instrumente mit den externen Kontrollinstitutionen und Kontrollmechanismen des Marktes erreicht wird. Die Vorschriften der VegüV betreffend transparente Entschädigungspolitik und unabhängige Stimmrechtsvertreter sowie die in der Aktienrechtsrevision angestrebte Stärkung der Informations-, Mitwirk...

Un mur contre la malaria : Du nouveau dans la prévention des ...

International Development Research Centre (IDRC) Digital Library (Canada)

Le nouveau site Web facilitera l'enregistrement des événements démographiques afin d'améliorer l'accès aux services pour tous. Le nouveau site Web et la nouvelle bibliothèque de ressources aideront à améliorer les systèmes d'information et d'enregistrement des faits d'état civil dans les pays en développement.

Evaluation des pratiques de gestion des adventices en riziculture ...

African Journals Online (AJOL)

Le riz est l'aliment principal pour la quasi-totalité des populations vivant en Côte d'Ivoire. Cependant, les adventices sont considérées comme la contrainte biologique la plus importante faisant obstacle à la production rizicole. L'objectif de cette étude menée en 2015 était d'évaluer différentes techniques de gestion des ...

Cartographie des zones d'intervention des partenaires techniques et ...

African Journals Online (AJOL)

cartographier les zones d'intervention des partenaires techniques et financiers au Bénin. L'approche méthodologique utilisée a consisté à la recherche documentaire, à la collecte de données auprès des partenaires techniques et financiers et à l'analyse de ces données. Les résultats ont permis de constater que cent dix ...

Neutron Dosimetry and Irradiation of Solids; Dosimetrie des neutrons et irradiation des solides

Energy Technology Data Exchange (ETDEWEB)

Perriot, G; Schmitt, A P [Commissariat a l' Energie Atomique. Centre d' Etudes Nucleaires de Saclay, 91 - Gif-sur-Yvette (France)

1962-07-01

Results of work at C.E.A. from 1958 to 1960 are reviewed. The possibilities offered by classical dosimetry methods are discussed. The tests which led to the utilization, for fast neutron dosimetry, of resistivity variations induced in solid W by such neutrons are described. Experimental W irradiation results led to a definition of neutron efficiency which describes the relations between neutron energy and their effects on materials. Possibilities offered by detectors which make use of radiation damage and are sensitive to neutrons at keV energies were explored. In other work, the principal French reactors were classified according to their ability to produce damage in materials such as W. (authors) [French] Dans ce rapport on a presente les resultats essentiels de travaux qui ont ete effectues de 1958 a 1980 par des chercheurs du CEA issus de differents services. En meme temps qu'une revue des possibilites offertes a l'epoque par les methodes classiques de dosimetrie (utilisation des detecteurs par activation), on a decrit les essais qui devaient permettre d'utiliser, a la dosimetrie les neutrons rapides, les variations de resistivite qu'ils creent dans un corps solide (tungstene). L'irradiation du tungstene a montre l'importance qu'il y avait a definir 'l'efficacite' des neutrons, c'est-a-dire leur aptitude plus ou moins grande, selon leur energie, a creer des defauts dans les materiaux. L'efficacite d'un emplacement d'irradiation se trouvant liee au spectre neutronique, on a vu les difficultes qu'il y avait a utiliser les detecteurs par activation des qu'on n'avait plus affaire a un spectre en 1/E ou de fission et on a pu entrevoir les possibilites offertes par les detecteurs utilisant la creation des defauts qui repondent a tous les neutrons d'energies, superieures a quelques keV. Enfin, on a classe les principaux types de Piles Francaises selon leur aptitude a creer plus ou moins rapidement des dommages dans des materiaux comme le tungstene. (auteur)

Biometrische Untersuchungen des Stylopodiums, Zygopodiums und Metapodiums pleistozäner Ursiden im Hinblick auf die Evolution des Höhlenbären und die Klassifizierung des Fundmaterials Einhornhöhle / Harz

OpenAIRE

Athen, Kerstin Anja

2007-01-01

In der vorliegenden Dissertation "Biometrische Untersuchungen des Stylopodiums, Zygopodiums und Metapodiums pleistozäner Ursiden im Hinblick auf die Evolution des Höhlenbären und die Klassifizierung des Fundmaterials Einhornhöhle / Harz" wurden Daten des oberpliozänen Ursus etruscus, des pleistozänen Ursus deningeri sowie des Ursus spelaeus ausgewertet. Zur Datenerhebung wurden 249 Messgrößen an den Skelettelementen Humerus, Ulna, Radius, Metacarpalia I-V, Femur, Tibia, Fibula und Metatarsali...

The use of traditional Chinese medicine among breast cancer patients: implications for the clinician.

Science.gov (United States)

Wong, Kar Yong; Tan, Ern Yu; Chen, Juliana J C; Teo, Christine; Chan, Patrick M Y

2014-02-01

Traditional Chinese Medicine or Traditional Complementary Medicine (TCM) is commonly used in our culture. There are several concerns regarding its use in patients undergoing conventional treatments for breast cancer. In this study, we aimed to evaluate the prevalence and pattern of TCM use among our breast cancer patients, and to identify patients who were most likely to choose TCM. A total of 300 patients on active follow-up with Breast Service at Tan Tock Seng Hospital were interviewed using a structured questionnaire. A total of 35% (104 of 296) of patients reported using TCM. The majority of the patients were introduced to TCM by family and friends following the diagnosis of breast cancer. All except 3 patients continued with recommended conventional therapy although most did not inform their clinicians of TCM use. None of the patients reported any serious adverse events and 75% of them perceived a benefit from TCM use. Younger patients and those of Chinese ethnicity were more likely to use TCM (P 0.05). TCM use is common among our breast cancer patients, particularly the younger women. However, most patients do not inform their clinicians of TCM use while on recommended conventional therapies. It is therefore important for clinicians to initiate discussions regarding TCM use in order to be aware of potential unwanted drug interactions.

Clinician-Reported Barriers to Implementing Breast Cancer Chemoprevention in the UK: A Qualitative Investigation.

Science.gov (United States)

Smith, Samuel G; Side, Lucy; Meisel, Susanne F; Horne, Rob; Cuzick, Jack; Wardle, Jane

2016-01-01

The use of tamoxifen and raloxifene as preventive therapy for women at increased risk of breast cancer was approved by the National Institute for Health and Care Excellence (NICE) in 2013. We undertook a qualitative investigation to investigate the factors affecting the implementation of preventive therapy within the UK. We recruited general practitioners (GPs) (n = 10) and clinicians working in family history or clinical genetics settings (FHCG clinicians) (n = 15) to participate in semi-structured interviews. Data were coded thematically within the Consolidated Framework for Implementation Research. FHCG clinicians focussed on the perceived lack of benefit of preventive therapy and difficulties interpreting the NICE guidelines. FHCG clinicians felt poorly informed about preventive therapy, and this discouraged patient discussions on the topic. GPs were unfamiliar with the concept of preventive therapy, and were not aware that they may be asked to prescribe it for high-risk women. GPs were reluctant to initiate therapy because it is not licensed, but were willing to continue a prescription if it had been started in secondary or tertiary care. Barriers to implementing preventive therapy within routine clinical practice are common and could be addressed by engaging all stakeholders during the development of policy documents. © 2016 The Author(s) Published by S. Karger AG, Basel.

Can promoting patient decision making be exclusionary? Moral expectations and cultural difference in the narratives of UK maternity clinicians.

Science.gov (United States)

Davies, Myfanwy; Elwyn, Glyn; Papadopoulos, Irena; Fleming, Lon; Williams, Gareth

2009-01-01

Patient autonomy in health care decision making is increasingly advocated as a means of promoting patients' 'responsibilities' for treatments and costs. However, little is known with regard to clinicians' understanding of patients' potential responsibilities in decision making. We explore how clinicians may view decision making as a 'moral' obligation and examine how moral virtue is discursively constructed in this context and in the face of ethnic and social difference. Data reported are derived from an interview study that examined perceptions of maternity decision making among Arab Muslim women and clinicians. Results reported here are from the clinician sample which includes obstetricians, general practitioners (GPs) and midwives. Clinicians perceived that a key element of their role involved imparting relevant information to their clients and, increasingly, involving them in making autonomous decisions about their care. However, by analysing and assessing the attribution of specific cultural differences in clinicians' discussion of decision making processes with minority group women, we demonstrate how some clinicians justified their failure to promote autonomy through shared decision making with women from these groups. We will demonstrate these attributes to be those of passivity and non-rationality which entail some negative moral judgements and which have a complex relationship to gender and power

GESTION DES RISQUES ET DES INCERTITUDES L'EMERGENCE D'UN CONTRÔLE DE GESTION " PAR EXCEPTION "

OpenAIRE

Wegmann , Grégory

2003-01-01

International audience; Le thème de la gestion des risques a été peu abordé en contrôle de gestion et le fonctionnement des outils traditionnels comme les budgets postulent une maîtrise des risques et des incertitudes. L'émergence de nouvelles approches en contrôle de gestion montre une évolution sur ce point.

Analyse des systèmes de gestion des déchets par l’étude du mécanisme de répartition des déchets

OpenAIRE

Bergeron, Francis

2015-01-01

Le renforcement de l’usage concurrentiel des déchets nous amène à étudier les processus d’approvisionnement des filières de valorisation et d’élimination sous l’angle de la circulation des flux de déchets au sein d’un système de gestion des déchets. L’objectif du présent article de recherche est de concevoir un cadre théorique autour du concept de mécanisme de répartition des déchets qui désigne le processus de distribution des flux de déchets entre les filières d’élimination et de valorisati...

Littoral Infrared Ship Self Defence Technology Studies (Autodefense cotiere infrarouge des navires etudes technologiques)

Science.gov (United States)

2014-05-01

Panels, vous pouvez demander d’être inclus soit à titre personnel, soit au nom de votre organisation, sur la liste d’envoi. Les publications de la STO...doivent comporter la dénomination « STO », « RTO » ou « AGARD » selon le cas, suivi du numéro de série. Des informations analogues, telles que le titre ...ou « AGARD » selon le cas, suivie du numéro de série (par exemple AGARD-AG-315). Des informations analogues, telles que le titre et la date de

Questions de mathématiques élémentaires à l'usage des candidats aux écoles du Gouvernement, des aspirants au baccalauréat ès sciences et des élèves des établissements d'enseignement secondaire

CERN Document Server

Vuibert, Henry

1879-01-01

Questions de mathématiques élémentaires à l'usage des candidats aux écoles du Gouvernement, des aspirants au baccalauréat ès sciences et des élèves des établissements d'enseignement secondaire

Graphite reactor physics; Physique des piles a graphite

Energy Technology Data Exchange (ETDEWEB)

Bacher, P; Cogne, F [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires; Noc, B [Electricite de France (EDF), 75 - Paris (France)

1964-07-01

The study of graphite-natural uranium power reactor physics, undertaken ten years ago when the Marcoule piles were built, has continued to keep in step with the development of this type of pile. From 1960 onwards the critical facility Marius has been available for a systematic study of the properties of lattices as a function of their pitch, of fuel geometry and of the diameter of cooling channels. This study has covered a very wide field: lattice pitch varying from 19 to 38 cm. uranium rods and tubes of cross-sections from 6 to 35 cm{sup 2}, channels with diameters between 70 and 140 mm. The lattice calculation methods could thus be checked and where necessary adapted. The running of the Marcoule piles and the experiments carried out on them during the last few years have supplied valuable information on the overall evolution of the neutronic properties of the fuel as a function of irradiation. More detailed experiments have also been performed in Marius with plutonium-containing fuels (irradiated or synthetic fuels), and will be undertaken at the beginning of 1965 at high temperature in the critical facility Cesar, which is just being completed at Cadarache. Spent fuel analyses complement these results and help in their interpretation. The thermalization and spectra theories developed in France can thus be verified over the whole valid temperature range. The efficiency of control rods as a function of their dimensions, the materials of which they are made and the lattices surrounding them has been measured in Marius, and the results compared with calculation on the one hand and with the measurements carried out in EDF 1 on the other. Studies on the control proper of graphite piles were concerned essentially with the risks of spatial instability and the means of detecting and controlling them, and with flux distortions caused by the control rods. (authors) [French] Entreprise il y a dix ans a l'occasion de la construction des piles de Marcoule, l'etude de la

Contribution à l’identification des déterminants fondamentaux en évaluation des banques

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Badr Habba

2016-03-01

Full Text Available Ce papier étudie l’influence des facteurs fondamentaux sur l’évaluation des banques. Dans un premier temps, nous avons sélectionné, sur la base d’une revue de la littérature, les caractéristiques fondamentales susceptibles d’influencer l’évaluation des banques. Ensuite, nous avons estimé un modèle économétrique mettant en relation la valeur des banques et six variables explicatives à l’aide de l’économétrie des données de panel. L’échantillon est constitué d’un panel de 82 banques cotées entre 2005 et 2013. Les résultats obtenus montrent qu’il existe une influence très significative de la qualité du portefeuille bancaire de crédits, du niveau de capitalisation, du niveau de diversification du portefeuille d’activités, de l’efficience et de la taille de la banque sur l’évaluation des firmes bancaires.

Impacts des caractéristiques physico-chimiques des eaux sur la ...

African Journals Online (AJOL)

Impacts des caractéristiques physico-chimiques des eaux sur la distribution du ... chimiques qui sont à l'origine d'une dégradation croissante de la qualité d'eau. ... Les valeurs d'indice de diversité de Shannon Weaver traduisent une grande ...

ETUDE EXPLORATOIRE DES ACIDES GRAS POLYINSATURÉS DES AIGUILLES DE PIN

OpenAIRE

KADARI, Abdelhamid

2012-01-01

Depuis les temps les plus anciens, l’utilisation des plantes dans le domaine de la santé est toujours d’actualité (1), dans la mesure où elle représente une alternative sérieuse ou tout au moins un complément appréciable à la pharmacie classique issue de la chimie moderne. En effet, plus de 25 % des médicaments prescrits dans le monde entier dérivent directement ou indirectement des plantes (2). Cependant, en tant que sources de médicaments, les plantes restent encore sous plusieurs études, s...

Analyse des mécanismes de transmission des infections sexuellement transmissibles

OpenAIRE

Abraham, Shahnaz

2008-01-01

Ce travail comprend une étude de l'épidémiologie des infections sexuellement transmissibles (IST) et du VIH à Genève et en Suisse. Nous constatons une recrudescence des IST pendant la période analysée 1999-2004, supersosable à la situation observée dans les autres métropoles européennes, tandis que l'incidence du VIH est restée stable. Nous analysons les facteurs importants pour la transmission des IST-VIH et soulignons l'importance de poursuivre les campagnes de prévention, visant non seulem...

The decision to extract: part II. Analysis of clinicians' stated reasons for extraction.

Science.gov (United States)

Baumrind, S; Korn, E L; Boyd, R L; Maxwell, R

1996-04-01

In a recently reported study, the pretreatment records of each subject in a randomized clinical trial of 148 patients with Class I and Class II malocclusions presenting for orthodontic treatment were evaluated independently by five experienced clinicians (drawn from a panel of 14). The clinicians displayed a higher incidence of agreement with each other than had been expected with respect to the decision as to whether extraction was indicated in each specific case. To improve our understanding of how clinicians made their decisions on whether to extract or not, the records of a subset of 72 subjects randomly selected from the full sample of 148, have now been examined in greater detail. In 21 of these cases, all five clinicians decided to treat without extraction. Among the remaining 51 cases, there were 202 decisions to extract (31 unanimous decision cases and 20 split decision cases). The clinicians cited a total of 469 reasons to support these decisions. Crowding was cited as the first reason in 49% of decisions to extract, followed by incisor protrusion (14%), need for profile correction (8%), Class II severity (5%), and achievement of a stable result (5%). When all the reasons for extraction in each clinician's decision were considered as a group, crowding was cited in 73% of decisions, incisor protrusion in 35%, need for profile correction in 27%, Class II severity in 15% and posttreatment stability in 9%. Tooth size anomalies, midline deviations, reduced growth potential, severity of overjet, maintenance of existing profile, desire to close the bite, periodontal problems, and anticipation of poor cooperation accounted collectively for 12% of the first reasons and were mentioned in 54% of the decisions, implying that these considerations play a consequential, if secondary, role in the decision-making process. All other reasons taken together were mentioned in fewer than 20% of cases. In this sample at least, clinicians focused heavily on appearance

Épuration des eaux usées des villes pour soutenir l'agriculture ...

International Development Research Centre (IDRC) Digital Library (Canada)

2 févr. 2011 ... Les eaux usées : manne liquide ? ... Les racines de la plante emprisonnent les matières solides en ... le compostage des déchets ménagers ou l'arrosage des pépinières. ... à la gestion locale de la demande », dans Épuration des eaux usées et l'agriculture urbaine, Editions Enda, Dakar, août 2002. Mbodj ...

Améliorer les conditions de vie des jeunes et des femmes en ...

International Development Research Centre (IDRC) Digital Library (Canada)

Améliorer les conditions de vie des jeunes et des femmes en développant la petite entreprise : mesure de l'impact. Durant les années 2000, la croissance économique et l'augmentation des investissements sociaux ont réduit la pauvreté et offert aux populations de l'Amérique latine de multiples débouchés sur le marché du ...

Development of a wheelchair maintenance training programme and questionnaire for clinicians and wheelchair users.

Science.gov (United States)

Toro, Maria Luisa; Bird, Emily; Oyster, Michelle; Worobey, Lynn; Lain, Michael; Bucior, Samuel; Cooper, Rory A; Pearlman, Jonathan

2017-11-01

Purpose of state: The aims of this study were to develop a Wheelchair Maintenance Training Programme (WMTP) as a tool for clinicians to teach wheelchair users (and caregivers when applicable) in a group setting to perform basic maintenance at home in the USA and to develop a Wheelchair Maintenance Training Questionnaire (WMT-Q) to evaluate wheelchair maintenance knowledge in clinicians, manual and power wheelchair users. The WMTP and WMT-Q were developed through an iterative process. A convenience sample of clinicians (n = 17), manual wheelchair (n ∞ 5), power wheelchair users (n = 4) and caregivers (n = 4) provided feedback on the training programme. A convenience sample of clinicians (n = 38), manual wheelchair (n = 25), and power wheelchair users (n = 30) answered the WMT-Q throughout different phases of development. The subscores of the WMT-Q achieved a reliability that ranged between ICC(3,1) = 0.48 to ICC(3,1) = 0.89. The WMTP and WMT-Q were implemented with 15 clinicians who received in-person training in the USA using the materials developed and showed a significant increase in all except one of the WMT-Q subscores after the WMTP (p users. This training complements the World Health Organization basic wheelchair service curriculum, which only includes training of the clinicians, but does not include detailed information to train wheelchair users and caregivers. This training program offers a time efficient method for providing education to end users in a group setting that may mitigate adverse consequences resulting from wheelchair breakdown. This training program has significant potential for impact among wheelchair users in areas where access to repair services is limited.

Harmonische Reduktion des linken Ventrikels

OpenAIRE

Atila, M. (Mehmet)

2005-01-01

In der vorliegenden Arbeit wurde die harmonische Reduktion des linken Ventrikels am Modell des ausgewachsenen Hausschweins, unter Verwendung von Saugkappen variabler Größe untersucht. In 10 Schweinen mit Herzen normaler Größe und Funktion wurde eine Saugkappe, in Größe und Form an das abzufaltende Wandsegment angepasst, auf die epikardiale Oberfläche des schlagenden Herzens gesetzt. Wir führten Messungen der linksventrik. und der pulmonalart. Drücke, des ventrikulären Durchmessers und der Her...

Evaluer la qualité des archives ouvertes : le certificat DINI

Directory of Open Access Journals (Sweden)

Joachim Schöpfel

2014-04-01

Full Text Available L’article présente le certificat DINI, un référentiel pour la certification et l’audit des archives ouvertes, des archives institutionnelles et des plateformes de revues en libre accès, développé par l’Initiative Allemande pour l’Information en Réseau DINI. L’article décrit le contexte, l’objectif et l’historique de ce certificat avant d’exposer sa structure et son contenu. Parmi les huit sections du certificat figurent la visibilité du site, la sécurité de l’information et l’archivage pérenne. La discussion porte sur l’objet du référentiel, sur son influence et sur la nécessité d’une adaptation au contexte francophone. La traduction française du certificat a été publiée en 2012. The article presents the DINI certificate, standard recommendations for the certification of document and publishing services, i.e. open archives, institutional repositories and platforms for open access journals, developed by the German Initiative for Networked Information DINI. The article describes the context, purpose and history of this certificate before exposing its structure and content. The eight areas include criteria for the visibility of the site, information security and long-term preservation. The article discusses the object of certification, its impact and the need to adapt some recommendations to the French-speaking context. The French translation of the certificate has been published in 2012.

Étude des impacts écologiques du dynamisme spatio-temporel des ...

African Journals Online (AJOL)

transformer radicalement les occupations du sol. Toutefois, le recul des .... également de cette protection (Roberge et Angelstam 2004). L'objectif est de ... distribution des espèces cibles a ensuite été cartographiée sur la couche d'unités de ...

50 Modélisation des propriétés diélectriques des nanocomposites ...

African Journals Online (AJOL)

AKA BOKO

3 Laboratoire de Physique des Solides et des Couches Minces, Faculté des Sciences,. Sémlalia ... renfort (fibres de verre, carbone ou Kevlar,..) ont alors été utilisés ... diélectrique. Par ailleurs, pour modéliser le comportement diélectrique à la.

Développer le leadership dans des villes de l'Amérique latine et des ...

International Development Research Centre (IDRC) Digital Library (Canada)

urbanisation rapide non planifiée, les villes des pays en développement sont à la fois le principal déclencheur des changements climatiques et le lieu approprié pour mettre en oeuvre des solutions. À l'heure actuelle, les villes de taille ...

Charte du Conseil des Gouverneurs

International Development Research Centre (IDRC) Digital Library (Canada)

Office 2004 Test Drive User

7. favoriser des communications ouvertes et franches entre le personnel, la direction ..... de dresser le procès-verbal des réunions du Conseil et de ses comités et de veiller à ce ... et des résultats qu'il obtient, et non de sa gestion quotidienne.

Étude de la compétitivité de complexation des métaux issus des ...

African Journals Online (AJOL)

Les analyses chimiques effectuées sur le phosphate naturel révèlent la présence des métaux lourds. Pour étudier les risques de rétrogradation de ces engrais phosphatés, notre étude s'est portée sur la complexation des substances humiques naturelles extraites des sols sur des ions métalliques tels que le calcium, ...

Utilisation des sous-produits agroalimentaires dans l’alimentation des poissons d’élevage en Côte d’Ivoire

Directory of Open Access Journals (Sweden)

Kimou Nestor B.

2016-03-01

Full Text Available Cette étude évalue l’impact de l’utilisation des sous-produits agroalimentaires dans l’alimentation des poissons d’élevage en Côte d’Ivoire. Une enquête a été réalisée en 2013 dans quinze principales zones piscicoles sur les caractéristiques technico-économiques des fermes, le profil socio-économique des promoteurs et les pratiques aquacoles, particulièrement l’alimentation des poissons. Les résultats révèlent que 71 % des pisciculteurs enquêtés utilisent des sous-produits agricoles durant au moins un stade de production. Parmi eux, 53 % utilisent exclusivement des sous-produits. Le son de riz (52 % et le mélange de sons de riz et de maïs (28 % sont les plus utilisés. Les prix moyens de ces sous-produits varient entre 20 et 105 FCFA/kg. Oreochromis niloticus et Heterotis niloticus sont les principales espèces élevées en polyculture sur les fermes. Les sous-produits sont utilisés en système semi-intensif, extensif et en rizipisciculture, en majorité en zone rurale. Les pisciculteurs sont pour la plupart des agriculteurs, âgés de plus de 40 ans. Les taux d’utilisation des sous-produits sont plus élevés dans les régions de l’Ouest, du Centre-Ouest et du Sud-Ouest de la Côte d’Ivoire, par rapport à celles du Sud et de l’Est. Les rendements des fermes sont relativement faibles (544 à 2445 kg/ha/an, avec des gains moyens quotidiens de 0,87 et 9,97 g/j pour le tilapia et l’heterotis respectivement. L’analyse des stratégies des acteurs suggère la nécessité de définir des mécanismes d’accompagnement et de financement de la pisciculture, afin que ces acteurs puissent améliorer les formulations alimentaires à partir des matières premières locales et accessibles.

L’entretien des corps / Body care

Directory of Open Access Journals (Sweden)

Pascal Gaberel

2008-10-01

Full Text Available Nous analysons ici le rapport à l’alimentation d’une cohorte de 387 personnes en situation de pauvreté reconnue. Ces usagers genevois de l’aide sociale ont été interrogés par questionnaires et entretiens durant une étude à long terme. Après un examen des lois et règlements cadrant la nécessité alimentaire et d’autres sources d’information, nous explorerons la conception du bien manger des usagers. Nous la comparerons ensuite à leurs consommations hebdomadaires et aux activités alimentaires régulières : courses, préparation, consommation, invitations et sorties. Deux tiers disent, comme les mangeurs ordinaires, que bien manger c’est « manger sainement » et suivre les recommandations diététiques actuelles. Une moitié affirme suivre un régime pour raisons médicales. Un tiers des usagers de l’aide sociale définit le Bien manger comme un art de vivre ou une gastronomie qui nécessite des moyens financiers indisponibles et contrarient les régimes médicaux. Un cinquième dit respecter des prescriptions éthiques, dont l’interdit du porc ou de l’alcool, qui recoupent une tendance végétarienne et une orientation musulmane. Une personne sur vingt adopte une définition minimaliste et ascétique : bien manger c’est nourrir son corps. Comme les régimes médicaux et l’ascétisme, prescriptions et interdits vont de pair avec la loi d’Engels favorisant économie et privations, comme cela apparaît en comparant les consommations des usagers de l’aide sociale et de la population générale.This article looks at how people who live on welfare relate to nutrition, food and meals. A total of 387 French-speaking Genevan welfare recipients took part in a long term study based on questionnaires and personal interviews. After considering the place of nutrition in Welfare legislation and other sources of information available to welfare recipients, we compare their conception of "good eating" with their weekly

Spectrochemical analysis of impurities in plutonium and its compounds; L'analyse spectrochimique des impuretes dans le plutonium et ses composes

Energy Technology Data Exchange (ETDEWEB)

Buffereau, M; Crehange, G; Deniaud, S; Leclainche, C [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

1967-07-01

After a review of previous works, various powdered or wet analytical methods are studied. One tries to give an explanation for some phenomena. A detailed know-how of studied methods is given. Validity of results is discussed. Problem of impurities in alloys analysis and non spectroscopic elements determination is quickly reviewed. One concludes to the interest of the use of some particular methods and the necessity of basic studies in order to obtain best information. (author) [French] Apres une revue des travaux precedents on etudie les differentes methodes d'analyse soit sur poudre (oxyde), soit sur solution. On tente de donner une interpretation de certains phenomenes. On donne un mode d'emploi detaille des methodes etudiees, on envisage la validite des resultats. On passe en revue rapidement le probleme de l'analyse des impuretes dans les alliages et de la determination des elements non spectroscopiques. On conclut a l'interet de l'emploi de certaines methodes, et a la necessite d'etudes fondamentales en vue d'aboutir a une meilleure obtention des informations. (auteur)

Efficacité des politiques publiques brésiliennes visant à s'attaquer à ...

International Development Research Centre (IDRC) Digital Library (Canada)

Ces plats font l'objet d'une vive promotion au sein des groupes à faible revenu les plus touchés par le taux d'obésité élevé. L'emballage des aliments et le marketing alimentaire ne sont encadrés par aucune règle et sont souvent considérés comme trompeurs et inadéquats sur le plan de l'information nutritionnelle.

Gestion des déchets dangereux et responsabilité sociale des firmes

Directory of Open Access Journals (Sweden)

Faouzi Bensebaa

2010-10-01

Full Text Available Prenant les déchets électriques et électroniques comme terrain d’observation, cette recherche étudie les fondements du commerce illégal de déchets dangereux des pays développés vers les PED. En effet, malgré la multiplication des législations, le problème des déchets dans les pays développés, loin d’être traité en amont, l’est en grande partie en aval par leur délocalisation dans les PED. Les deux lectures proposées, économique et institutionnelle, permettent de montrer comment les contraintes de coût de gestion des déchets dans les pays développés conjuguées à l’imperfection et à la non-application des législations conduisent à des comportements socialement irresponsables. À partir de là, l’implication des parties prenantes est suggérée comme solution pour éliminer ce type de comportements.Based on the analysis of the waste electrical and electronic equipments (WEEE, the research investigates the motivations for the illegal cross-border trade in hazardous wastes from developed countries to developing countries. Although many developed countries have implemented waste shipment regulations, they are passing the risks and costs of E-waste to developing countries. Indeed, E-waste is often sent for recycling and refurbishing in developing countries. The two-side proposed approach (i.e. economical and institutional suggests that both the cost for firms to comply with increasing regulations and the imperfect implementation of regulatory restrictions lead to socially irresponsible behaviours. An increasing and better involvement of stakeholders may be put forward as a solution.

L’impact de la participation bancaire dans le capital des entreprises sur la politique de distribution des dividendes

Directory of Open Access Journals (Sweden)

Naoel Mezgani

2013-11-01

Full Text Available L’objectif de ce papier est de tester l’incidence de la participation bancaire dans le capital des entreprises non financières sur la politique de distribution des dividendes. En utilisant des données de panel des trente entreprises tunisiennes durant la période de 1999 à 2004, nous vérifions si en détenant le capital et la dette, la banque a la possibilité de contraindre la distribution des dividendes pour garantir le remboursement de ses fonds prêtés. Les résultats empiriques obtenus ne confirment pas l’impact significatif des banques actionnaires majoritaires et principaux créditeurs sur la distribution des dividendes dans les entreprises tunisiennes. Ces dernières soutiennent surtout la stabilité du niveau des dividendes payés d’une année à une autre.

Dégâts des bruches sur le pouvoir germinatif des graines de quatre ...

African Journals Online (AJOL)

SARAH

29 févr. 2016 ... cultures vivrières de base en Afrique Occidentale et centrale (MULEBA et al., 1997). En RD Congo il est ... correspondant à deux cycles de reproduction, avec des trous ou des œufs sur elles. Les trous ... tout simplement de déterminer le nombre des bruches et leurs espèces à charger dans chaque boite ...

autonomisation économique des femmes et économie du soin des ...

International Development Research Centre (IDRC) Digital Library (Canada)

Alanna Karpa

dépend en grande partie d'un financement versé par des bailleurs de fonds et qui est aux prises avec ... services dont leurs enfants ont besoin et à intégrer le marché du travail. ..... roulement, qui produit des services de soins de faible qualité.

What patient characteristics make clinicians recommend brief treatment?

NARCIS (Netherlands)

Schaefer, B. A.; Koeter, M. W. J.; Wouters, L.; Emmelkamp, P. M. G.; Schene, A. H.

2003-01-01

Objective: Assessing self-rated items that might have an impact on clinicians recommending brief treatment (BT) over unlimited or long-term treatment (ULT). Method: On the basis of patient self-report data we compared patients referred by clinicians to BT (n =71) with those referred to ULT (n =145).

Les paysages périurbains montagnards à la croisée des regards des sciences écologiques et des sciences socio-économiques

Directory of Open Access Journals (Sweden)

Nathalie Bertrand

2009-06-01

Full Text Available Les mutations des paysages régionaux dues aux pressions urbaines questionnent l’usage du sol. Elles interpellent à la fois des enjeux économiques, sociaux et environnementaux voire spatiaux sous-tendus par l’étalement urbain, l’accroissement des déplacements domicile-travail, le mitage de l’espace. Ces évolutions et dysfonctionnements renvoient à la question de la durabilité du développement des régions, et particulièrement des Alpes, espace contraint géographiquement et objet de nombreuses pressions anthropiques et riche en biotopes remarquables. Cet article est basé sur deux ans de travaux menés par des socio-économistes et des écologues sur les effets sur le paysage et l’environnement de la périurbanisation d’un massif alpin. Nous avons pris en compte l’espace dans les processus environnementaux, économiques ou sociaux. Intrinsèque dans les analyses écologiques, elle a longtemps posé problème à l’économie pour intégrer l’espace comme dimension à part entière des processus économiques. Trois thèmes sont ici développés : l’approche du point de vue du paysage, les problèmes d’échelles spatiales et temporelles, le choix d’indicateurs. Ils demandent de hiérarchiser les questions et de pratiquer le travail en commun. Aller au-delà nécessite de développer une interrogation plus écologique ou plus économique et/ou sociale en quittant de ce fait l’interface pour favoriser des interrogations disciplinaires particulières.Changes in regional landscapes due to urban pressures raise questions regarding land use. They also give rise to economic, social and environmental issues related to urban sprawl, increases in daily commuting, and land consumption. These changes and dysfunctions are ultimately underpinned by the question of sustainable regional development. Mountain regions such as the Alps, with their various outstanding biotopes in a restricted space, are particularly vulnerable.

ADAPTATION DES PRATIqUES D'ÉLEvAGE DES PRODUCTEURS ...

African Journals Online (AJOL)

1 Centre international de recherche développement sur l'élevage en zone subhumide (CIRDES). Unité de ... En saison des pluies, la taille élevée du cheptel des éleveurs ne leur permet pas l'accès aux bas-fonds (p <. 0,01). ..... animaux sont alors mis sur le marché pour faire .... modes de conduite alimentairedes animaux.

Clinician-scientists in Canada: barriers to career entry and progress.

Directory of Open Access Journals (Sweden)

Bryn Lander

Full Text Available BACKGROUND: Clinician-scientists play an important role in translating between research and clinical practice. Significant concerns about a decline in their numbers have been raised. Potential barriers for career entry and progress are explored in this study. METHODS: Case-study research methods were used to identify barriers perceived by clinician-scientists and their research teams in two Canadian laboratories. These perceptions were then compared against statistical analysis of data from Canadian Institutes of Health Research (CIHR databases on grant and award performance of clinician-scientists and non-clinical PhDs for fiscal years 2000 to 2008. RESULTS: Three main barriers were identified through qualitative analysis: research training, research salaries, and research grants. We then looked for evidence of these barriers in the Canada-wide statistical dataset for our study period. Clinician-scientists had a small but statistically significant higher mean number of degrees (3.3 than non-clinical scientists (3.2, potentially confirming the perception of longer training times. But evidence of the other two barriers was equivocal. For example, while overall growth in salary awards was minimal, awards to clinician-scientists increased by 45% compared to 6.3% for non-clinical PhDs. Similarly, in terms of research funding, awards to clinician-scientists increased by more than 25% compared with 5% for non-clinical PhDs. However, clinician-scientist-led grants funded under CIHR's Clinical thematic area decreased significantly from 61% to 51% (p-value<0.001 suggesting that clinician-scientists may be shifting their attention to other research domains. CONCLUSION: While clinician-scientists continue to perceive barriers to career entry and progress, quantitative results suggest improvements over the last decade. Clinician-scientists are awarded an increasing proportion of CIHR research grants and salary awards. Given the translational importance of

Évaluation de la valeur nutritive et recherche des substances ...

African Journals Online (AJOL)

SARAH

30 juin 2016 ... et des lipides. Puis, l'évaluation a été effectuée sur ces échantillons pour rechercher la présence des alcaloïdes, des saponines, des quinones, des stéroïdes, des terpenoïdes, des flavonoïdes, des leucoanthocyanes, des tannoïdes et des hétérosides cyanogénétiques. Les teneurs moyennes en humidité ...

Complications du traitement traditionnel des fractures : aspects ...

African Journals Online (AJOL)

Tous les patients reçus avec des complications du traitement traditionnel des fractures ont été inclus dans ce travail. Le diagnostic des lésions était clinique et radiologique. Nous avions reçu 51 patients porteurs de complications suite à des traitements de médecine traditionnelle, soit 13,7% du total des patients hospitalisés ...

Etude theorique et experimentale des evaporateurs de dioxyde de carbone operant dans des conditions de givrage

Science.gov (United States)

Bendaoud, Adlane Larbi

Les evaporateurs de refrigeration sont surtout du type tube a ailettes, appeles serpentins, et fonctionnent dans l'une des conditions suivantes: seche, humide ou avec formation de givre. Il a ete demontre que la formation du givre sur la paroi exterieure de l'echangeur engendre une surconsommation energetique a cause des operations de degivrage puisque 15 a 20% seulement de la chaleur produite sert au degivrage tandis que le reste est dissipee dans l'environnement [1]. Avec l'avenement des nouveaux refrigerants, moins nocifs envers l'environnement, l'industrie du froid se trouve penalisee du fait que peu ou pas de composantes mecaniques (compresseur, pompe, echangeur...etc.) adaptees sont disponibles [3]. Il s'agit pour la communaute des frigoristes de combler ce retard technologique en redeveloppant ces composantes mecaniques afin qu'elles soient adaptees aux nouveaux refrigerants. Dans cette optique, et afin de mieux comprendre le comportement thermique des evaporateurs au CO2 fonctionnant dans des conditions seches, qu'un groupe de chercheurs du CanmetENERGIE avaient lance, en 2000, un programme de R & D. Dans le cadre de programme un outil de simulation des evaporateurs au CO2 a ete developpe et un banc d'essai contenant une boucle secondaire de refrigeration utilisant le CO2 comme refrigerant a ete construit. Comme continuite de ce travail de recherche, en 2006 ce meme groupe de recherche a lance un nouveau projet qui consiste a faire une etude theorique et experimentale des evaporateurs au CO2 operants dans des conditions de givrage. Et, c'est exactement dans le cadre de ce projet que se positionne ce travail de these. Ce travail de recherche a ete entrepris pour mieux comprendre le comportement thermique et hydrodynamique des serpentins fonctionnant dans des conditions de givrage, l'effet des circuits de refrigerant ainsi que celui des parametres geometriques et d'operation. Pour cela, un travail theorique supporte par une etude experimentale a ete effectue

Aspects structurels et fonctionnels de la biodiversité des peuplements de poissons

Directory of Open Access Journals (Sweden)

WINEMILLER K. O.

1995-04-01

-spécifique, mais également souvent au niveau intra-spécifique, particulièrement durant l'ontogenèse. La structuration en guildes trophiques est plus complexe dans les peuplements comprenant beaucoup d'espèces. Le partage des ressources alimentaires est généralement perceptible quand les régimes sont examinés sur une période de temps suffisamment longue pour gommer les variations de disponibilité des ressources. La structure et le fonctionnement des réseaux trophiques est variable dans l'espace et dans le temps, et des maillons biotiques et abiotiques peuvent être fortement affectés par les poissons. La gestion des peuplements de poissons au sein d'une biosphère en modification nécessite des informations accrues sur les liens existant entre la diversité biologique et l'habitat, une meilleure connaissance des facteurs qui sont à l'origine des tendances observées, et le développement de modèles qui prédisent les relations entre structure et fonctionnement écologique.

The meaning of co- production for clinicians: an exploratory case study of Practitioner Trainers in one Recovery College.

Science.gov (United States)

Dalgarno, Mark; Oates, Jennifer

2018-05-15

Co-production between service users and clinicians is a desirable element of recovery-oriented practice in mental health but the effect of co-production on clinicians has not been explored thoroughly. to explore the meaning of co-production for clinicians based on their experience of co-production in a Recovery College Method: Thematic analysis of eight semi-structured interviews with clinicians who have co-produced and co-delivered workshops with a Recovery College Peer Trainer. The 'meaning of co-production' had four themes: definitions, power dynamics, negotiating roles and influence on practice. Clinicians' experience of co-production meant a reassessment of their expert role and power. They said that this altered their clinical practice, particularly the language they used and the personal information they shared. Role negotiation between Practitioner and Peer Trainers is an iterative process, whereby clinicians may revise their perspectives on personal disclosure, professional identity and collegiate support. The Peer and Practitioner Trainer relationship is characterised by reciprocity and mutuality, and there is some evidence that Practitioner involvement in a co-produced activity has the potential to transform service user and provider relationships beyond the Recovery College setting. Engaging in co-produced educational workshops can alter clinicians' perspectives on roles, power and clinical expertise. Findings from this case study must be tested against research on other Recovery Colleges. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Remote clinical decision-making: a clinician's definition.

Science.gov (United States)

Brady, Mike; Northstone, Kate

2017-05-12

Aims Remote clinical decision-making (RCDM), commonly known as 'telephone triage' or 'hear and treat', describes clinicians' non-face-to-face involvement with patient care, and is an established strategy in UK ambulance services for managing increasing demand. However, there is no suitable definition of RCDM that fully explains the roles undertaken by clinicians in 999 hubs, or for its use as an ambulance quality indicator (AQI). The aim of this study, which is part of a larger evaluation of a new RCDM module in higher education, is to determine how clinicians define RCDM. Methods Three participants were asked, during semi-structured interviews, to define RCDM. The interviews were recorded, transcribed and thematically analysed. Results Clinicians do not focus on outcomes when defining RCDM, but on the efficacy of the process and the appropriateness of the determined outcome. Conclusion There is no precise description of the role of healthcare professionals in 999 clinical hubs, but there is a need for role clarity, for employees and organisations. The study questions the suitability of the definition of hear and treat as an AQI, as it does not appear to represent fully the various duties undertaken by 999 clinical hub healthcare professionals. More research is needed to consider the definition of RCDM in all its forms.

L'enrichissement des sols et des semences permet d'améliorer la ...

International Development Research Centre (IDRC) Digital Library (Canada)

6 juin 2016 ... Grâce à des sols en meilleure santé et à l'utilisation de variétés améliorées, les agriculteurs du sud de l'Éthiopie ont multiplié par deux le rendement du pois chiche. L'amélioration des méthodes de transformation et de préparation de cet aliment, conjuguée à des programmes d'éducation, s'est traduite par ...

EVALUATION DES POLITIQUES PUBLIQUES DE GESTION DES INONDATIONS AU JAPON - RAPPORT DE L'OCDE

OpenAIRE

Kovacs , Yves; Forestier , Ségolène; Lahidji , Ulf; Stevens , Barrie; Radisch , Jack; Schieb , Pierre-Alain

2009-01-01

18 p.; International audience; Méthodologie En coopération avec le gouvernement Japonais, le programme de l'OCDE sur l'avenir a entrepris en 2006 une évaluation de la politique Japonaise en matière de gestion des inondations. L'équipe sélectionnée par l'OCDE en charge de cette évaluation était composée d'experts indépendants. Suite à une étude préliminaire, l'équipe d'experts s'est déplacée au Japon pour interviewer des membres du gouvernement, des collectivités locales, des associations non ...

Différences de sexe et rôle de l'internalisation des règles sur la propension des enfants à prendre des risques à vélo

OpenAIRE

GRANIE, Marie-Axelle

2011-01-01

L'objectif de cette étude est d'explorer les différences de sexe et l'effet de l'internalisation des règles routières sur la propension des enfants à prendre des risques à vélo. La perception du risque accidentel pour soi, l'internalisation des règles routières relatives aux comportements cyclistes et la propension à prendre des risques à vélo de 145 enfants (86 garçons et 59 filles) de 9 à 12 ans ont été mesurés par un autoquestionnaire. Les résultats montrent des différences de sexe sur l'i...

Clinician and Parent Perspectives on Educational Needs for Increasing Adolescent HPV Vaccination.

Science.gov (United States)

Widman, Christy A; Rodriguez, Elisa M; Saad-Harfouche, Frances; Twarozek, Annamaria Masucci; Erwin, Deborah O; Mahoney, Martin C

2018-04-01

Human papillomavirus (HPV)-related morbidity and mortality remain a significant public health burden despite the availability of HPV vaccines for cancer prevention. We engaged clinicians and parents to identify barriers and opportunities related to adolescent HPV vaccination within a focused geographic region. This mixed-method study design used an interviewer-administered semi-structured interview with clinicians (n = 52) and a written self-administered survey with similar items completed by parents (n = 54). Items focused on experiences, opinions, and ideas about HPV vaccine utilization in the clinical setting, family, and patient perceptions about HPV vaccination and potential future efforts to increase vaccine utilization. Quantitative items were analyzed using descriptive statistics, while qualitative content was analyzed thematically. Suggested solutions for achieving higher rates of HPV vaccination noted by clinicians included public health education, the removal of stigma associated with vaccines, media endorsements, and targeting parents as the primary focus of educational messages. Parents expressed the need for more information about HPV-related disease, HPV vaccines, vaccine safety, sexual concerns, and countering misinformation on social media. Results from this mixed-method study affirm that educational campaigns targeting both health care professionals and parents represent a key facilitator for promoting HPV vaccination; disease burden and cancer prevention emerged as key themes for this messaging.

L’espace social des étudiants marocains dans la mobilité internationale. Spatialisation des réseaux et recomposition territoriale

Directory of Open Access Journals (Sweden)

Sabrina Marchandise

2014-02-01