938 resultados para Business Study Case
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La formación investigadora en las distintas áreas del conocimiento es una desafío, una responsabilidad y una proyección para aquellas sociedades que busquen el desarrollo equilibrado y sostenible para el conjunto de sus ciudadanos. La investigación y la construcción del conociminento en los distintos campos del saber es el motor de cualquier región, o país. La memoria que aquí se expone refleja por un lado el proceso de formación de una investigadora novel en el área educativa, en el marco del programa de doctorado "“Diversidad y Cambio en Educació: Políticas y Prácticas" del Departamento de Didáctica y Organización Educativa, de la Universidad de Barcelona. Específicamente el área de investigación es la docencia universitaria y la consturcción de su conocimiento. A través de ella se revelan los distintos engranajes que van conformando el proceso formación. Además, por otro lado se presentan los puntos más relevantes del proyecto y del proceso de investigación, denominado "La Docencia Universitaria: su saber pedagógico desde distintas áreas del conocimiento. Un estudio de casos con docentes de la Universidad de Barcelona.
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This article aims to present the conceptual and methodological framework in which models techniques for species and ecosystems distribution are developed. An historical review of concepts behind these techniques is made as well as the presentation of the major methodological steps involved in these tests. A discussion on how these approaches are useful for the development of new questions in the field of biogeography and biological conservation is generated. Finally, an application of distribution modeling techniques, using the specie Beilschmiedia miersii (belloto Del Norte) as a study case, is presented. This conceptual and methodological review as well as the example applied, seeks to clarify the usefulness and potential of distribution models techniques, with the objective to go forward in biogeography research and thus, farther progress in understanding spatial and temporal patterns of organism's distribution
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Aquest projecte presenta un cas d'estudi a partir del qual es vol fer un procés de desenvolupament de programari. Concretament, l'objectiu és crear un sistema de venda de productes i serveis per mitjà de la xarxa d'Internet.
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A água é vital para a sobrevivência, saúde e dignidade do ser humano e uma fonte fundamental para o seu desenvolvimento. As reservas de água potável no mundo estão sob pressão constante embora muitos ainda não tenham acesso a esse precioso líquido para atender ás necessidades básicas. A água é um recurso natural com valor económico, estratégico e social. A percepção da escassez tem levado governos, a reorganizar o ambiente institucional e definir novos direitos de propriedade por meio de um sistema de gestão participativo e descentralizado que estimule a utilização do recurso de forma racional. A investigação está direccionada à gestão e à implementação da Lei n.º 41/II/84 de 18 de Junho, que Aprova o Código de Águas que estabelece as bases gerais do regime jurídico de propriedade, protecção, conservação, desenvolvimento, administração e uso dos recursos. O enfoque da pesquisa é as Instituições Governamentais que lidam com a água e as Associações de Bacias hidrográficas que, com os seus olhares e saberes, contribuem com informações para que se construa uma Proposta de Modelo de Gestão numa perspectiva de sustentabilidade. A proposta de modelo pretende contribuir para uma gestão sustentada. A pesquisa é do tipo qualitativa e usa como metodologia o Estudo de Caso. Foi constatada a complexidade da gestão das águas em Cabo Verde, na qual existem ainda muitos entraves e desafios. A Bacia Hidrográfica é a unidade básica de gestão, onde as Associações, as Câmaras Municipais, os Serviços Autónomos de Água e Saneamento, o Instituto Nacional de Gestão dos recursos Hidricos desempenham o papel de gerí-la e preservá-la. Foram identificados como dificuldades: a posse da água não está bem clara, o que dificulta a gestão da Bacia; os conflitos sociais são frequentes quanto ao uso da água no que tange à poluição; a população rural não está devidamente contemplada na gestão dos recursos hídricos. Por fim, constatou-se que Cabo Verde possui as ferramentas para a evolução da Gestão dos Recursos Hídricos, que é o Código de Água. Water is vital for the survival, health and dignity of the human being and a basic source for development. The drinking waters reserves in the world are under constant pressure. The water can be considered a natural resource with economic, strategically and social values. The perception of the scarcity has taken governments, to reorganize the institutional environment and to define new rights of property by means of participation and decentralized system of management that stimulates the use of the resource in rational form. This investigation addressed the Administration of Water Resources in Cabo Verde and the implementation of Law n.º 41/II/84 of 18 of June, which established the National Policy of Water Resources and the National System of Management. The approach of the research is the Governmental Institutions that deal with the water and the Associations that, at a glance, contribute with information that builds the proposal of water resources management in a sustainability perspective. The proposal has as objective to provide subsidies to advance more and more the research regarding sustainability in the administration of waters. The research was qualitative and it used as methodology the Study Case. We identified as difficulties: the ownership of the water is not well clear; the social conflicts are frequent concerning how to use the water. Finally, it was evidenced that Cape Verde has the tools for the evolution of water resources management, which is the Water Code.
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Diante da crescente competitividade, característica do mercado global, e da necessidade de melhorar a eficiência e a produtividade nas organizações, torne-se imperativo o aperfeiçoamento, incessante, na forma de actuação dos gestores. Consciente que, até então, as empresas suportam, essencialmente, no sistema contabilístico, este que, muitas vezes, fornece informações insuficientes e restringidos à tomada de decisões de curto prazo, mostra-se necessário investir em sistemas de medição, ligado à estratégia organizacional, que permitam melhor planeamento e controlo e, ainda, gerar e medir indicadores de longo prazo. No intuito de contribuir para a melhoria do paradigma da gestão, mais concretamente da gestão das empresas Cabo-Verdianas, e, em particular a da empresa em estudo, propomos, como objectivo desta dissertação, o estudo da utilização das ferramentas de gestão tradicional, face às novas ferramentas emergentes. Nisto, apresentamos, como estudo de caso, a avaliação do sistema de controlo de gestão da Empresa Bento - Comércio, Construtores, Imobiliária e Investimentos, Sociedade Anónima, (Bento S.A.), analisando, à luz da literatura consultada, o sistema de gestão estratégica, seguido pela empresa de modo a poder propor eventuais melhorias. Durante a revisão bibliográfica, foram estudadas várias ferramentas da gestão estratégica, das quais escolhemos o Balanced Scorecard (BSC) como um instrumento capaz de responder às lacunas detectadas na estratégia de gestão da Empresa, em que após uma breve descrição dos aspectos teóricos do conceito, suportado nos estudos empíricos publicados, apresentámos uma proposta para sua adopção, concepção e implementação. É de realçar que, durante o estudo constatou-se, por parte da administração da empresa, uma maior consciência da importância da comunicação e divulgação da sua estratégia entre os diferentes níveis hierárquicos, o que evidencia que ela está, mesmo, disposta a apostar na sua inovação estratégica. With the raising competitiveness, characteristic of the global market, and of the need of improving the efficiency and productivity in organizations, the constant improvement in the way of acting of managers it becomes peremptory. Aware that, so far, enterprises support, essentially, on the accounting system, which, many times, gives restrict and insufficient information for the taking of decisions in a short term, it is shown to be necessary to invest in measuring systems, connected to the organizational strategy, which contains signs that allow a better planning and control and, furthermore, give birth to and measure signs on a long term. With the aim of contributing for the improvement of the managing pattern, specifically, the management of Cape Verdean enterprises, and, in particular, the one of the enterprise in study, we propose, as an aim of this dissertation, the study of the use of the traditional managing tools, in view of the emerging new tools. Thus, we present, as study case, the evaluation of the system of management control of the Enterprise Bento - Comércio, Construtores, Imobiliária e Investimentos, Sociedade Anónima, (Bento, S.A.), analyzing the system of strategic management, used by the enterprise to be able to propose eventual improvements. During the bibliographic revision, we studied many strategic management tools, among which we chose the Balanced Scorecard (BSC) as an instrument capable to respond to the gaps detected in the management strategy of the enterprise, in which, after a brief description of the theoretical aspects of the concept, supported on the empiric studies published, we present a proposal for its adoption, conception and implementation. We would like to accentuate that, during the study we noticed that there exists, on the behalf of the management of the enterprise, a major awareness of the importance of communication and diffusion of its strategy among the different hierarchical levels, what makes clear that the enterprise is really open to bet on its strategic innovation.
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AimTo identify the bioclimatic niche of the endangered Andean cat (Leopardus jacobita), one of the rarest and least known felids in the world, by developing a species distribution model.LocationSouth America, High Andes and Patagonian steppe. Peru, Bolivia, Chile, Argentina.MethodsWe used 108 Andean cat records to build the models, and 27 to test them, applying the Maxent algorithm to sets of uncorrelated bioclimatic variables from global databases, including elevation. We based our biogeographical interpretations on the examination of the predicted geographic range, the modelled response curves and latitudinal variations in climatic variables associated with the locality data.ResultsSimple bioclimatic models for Andean cats were highly predictive with only 3-4 explanatory variables. The climatic niche of the species was defined by extreme diurnal variations in temperature, cold minimum and moderate maximum temperatures, and aridity, characteristic not only of the Andean highlands but also of the Patagonian steppe. Argentina had the highest representation of suitable climates, and Chile the lowest. The most favourable conditions were centrally located and spanned across international boundaries. Discontinuities in suitable climatic conditions coincided with three biogeographical barriers associated with climatic or topographic transitions.Main conclusionsSimple bioclimatic models can produce useful predictions of suitable climatic conditions for rare species, including major biogeographical constraints. In our study case, these constraints are also known to affect the distribution of other Andean species and the genetic structure of Andean cat populations. We recommend surveys of areas with suitable climates and no Andean cat records, including the corridor connecting two core populations. The inclusion of landscape variables at finer scales, crucially the distribution of Andean cat prey, would contribute to refine our predictions for conservation applications.
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Ecological speciation and its hallmark, adaptive radiation is a process from which most of the current biodiversity derives. As ecological opportunity allows species to colonise unoccupied niches, natural selection drives adaptive phenotypical change. In this thesis, I begin by describing how this evolutionary process acted on the evolution of the clownfishes. During its infancy, this iconic group of coral reef fishes developed a mutualism with sea anemone species. I show how this event triggered the evolutionary radiation of the group, generating species that now inhabit diverse habitats of the coral reefs. Following the appearance of the mutualism, the diversification of the clownfish was catalysed by hybridisation events which shuffled genes, allowing hybrids to reach new fitness optima. While the clownfishes appeared in the region of the coral triangle, a lineage colonised the eastern shores of Africa. I reconstructed the geographic history of the group and showed that this event lead to the rapid appearance of new species, replicating the evolutionary patterns of the original radiation. To better grasp the mechanisms of ecological speciation, I conducted analyses at the population level and identified similar evolutionary patterns than found at the clade level. I discuss how such result suggests a continuity bridging micro- and macroevolution, which so far only been theorised. In parallel to this study case, I question whether biotic and abiotic interactions can promote or restrain ecological speciation. Indeed, I show how the ecological setting of species can drastically impact on their diversification dynamics. Moreover, tradeoffs can occur between specialisation made on different ecological axes allowing species cohabitation. Overall, I show in this work that regardless of the few simple rules that explain the mechanism of ecological speciation, the unavoidable interactions with the ever changing ecological context lead diversification events to give always a different outcome. It is thus primordial to account for the ecological settings of species when discussing their evolutionary dynamics. LA SPÉCIATION ÉCOLOGIQUE RACONTÉE AU TRAVERS DE L'ÉTUDE DE L'ÉVOLUTION DES POISSONS-CLOWNS ET DE QUELQUES AUTRES Le phénomène de spéciation écologique est à l'origine de la majeure partie de la biodiversité que l'on rencontre aujourd'hui. Au fil des opportunités qu'elles rencontrent, les espèces colonisent l'espace écologique laissant la sélection naturelle forger leur phénotype moyen. Malgré l'omniprésence de ce phénomène dans la nature, beaucoup de questions qui lui sont relatives restent à élucider. C'est afin de mieux comprendre ce mécanisme que j'étudie les poissons-clowns, célèbres habitants des récifs coralliens. Dans ce travail, je démontré que le développement du comportement mutualiste liant les poissons-clowns aux anémones de mer fut l'événement qui déclencha leur diversification. Suite à ce premier événement, j'illustre comment l'hybridation entre lignées primordiales a remodelé la diversité génétique du groupe et catalysé leur radiation évolutive. Je poursuis en reconstruisant l'expansion géographique des poissons-clowns au cours du temps depuis le triangle de corail, leur lieu d'origine, jusqu'aux côtes d'Afrique de l'Ouest. Afin d'affiner ces analyses générales sur le groupe, je continue en étudiant plus finement des populations d'une seule espèce de poisson-clown. Cette fine résolution me permet de comprendre plus précisément quels sont les facteurs écologiques qui permettent aux poissons-clowns de se différencier. Les résultats de ces analyses suggèrent qu'il est important de comprendre les liens entre le contexte écologique et la diversification des espèces. J'étudie cette question dans la seconde partie de ce travail en montrant que l'hétérogénéité du paysage ou les liens entretenus avec un partenaire mutualiste influencent fortement la dynamique évolutive des espèces. Finalement, j'illustre les compromis que chaque espèce réalise en se spécialisant ou non dans ses interactions avec l'environnent. Plus généralement, je souligne dans ce travail l'influence du contexte écologique sur le résultat de la spéciation écologique. Ce sont ces interactions entre les organismes et leur environnent qui sont à l'origine de l'incroyable diversité de la vie. Il est donc primordial de les prendre en compte lors de l'étude de l'évolution des espèces.
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Maximum entropy modeling (Maxent) is a widely used algorithm for predicting species distributions across space and time. Properly assessing the uncertainty in such predictions is non-trivial and requires validation with independent datasets. Notably, model complexity (number of model parameters) remains a major concern in relation to overfitting and, hence, transferability of Maxent models. An emerging approach is to validate the cross-temporal transferability of model predictions using paleoecological data. In this study, we assess the effect of model complexity on the performance of Maxent projections across time using two European plant species (Alnus giutinosa (L.) Gaertn. and Corylus avellana L) with an extensive late Quaternary fossil record in Spain as a study case. We fit 110 models with different levels of complexity under present time and tested model performance using AUC (area under the receiver operating characteristic curve) and AlCc (corrected Akaike Information Criterion) through the standard procedure of randomly partitioning current occurrence data. We then compared these results to an independent validation by projecting the models to mid-Holocene (6000 years before present) climatic conditions in Spain to assess their ability to predict fossil pollen presence-absence and abundance. We find that calibrating Maxent models with default settings result in the generation of overly complex models. While model performance increased with model complexity when predicting current distributions, it was higher with intermediate complexity when predicting mid-Holocene distributions. Hence, models of intermediate complexity resulted in the best trade-off to predict species distributions across time. Reliable temporal model transferability is especially relevant for forecasting species distributions under future climate change. Consequently, species-specific model tuning should be used to find the best modeling settings to control for complexity, notably with paleoecological data to independently validate model projections. For cross-temporal projections of species distributions for which paleoecological data is not available, models of intermediate complexity should be selected.
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While collective identity markers are constantly evolving in today's city, the hyper-consumption society has allowed retail, even though greatly transformed, to remain a community hub for socialization. Society's commodification takes shape precisely within the public realm and the urban scene: sprawling analogous drivable retail-only suburbs and turning city centers into bland, soulless and undefined places displaying homogeneous frontages characterized by the same retail storefronts worldwide. More than ever, urban policies on retail oriented servicescapes seem crucial to urban and regional planning from a sustainable perspective. Thorough the study case of Lausanne, our research focuses on how the urban planning model and its policies could set into place spatial strategies to enhance urban quality and to reorganize retail centralities without succumbing to the prevailing commodification of the public realm. -- Les indicateurs d'identité collective se reformulent dans la ville actuelle, mais la société de l'hyperconsommation a permis au commerce, aussi transformé soit-il, de rester un lieu d'échange et de brassage social. La marchandisation de la société prend des formes précises dans l'espace et a un impact certain sur le paysage urbain : multipliant les espaces marchands périphériques monofonctionnels ou encore transformant nos centres-villes en paysages anodins, présentant des vitrines semblables quel que soit le pays où elles se situent. Plus que jamais, une régulation des espaces de consommation semble incontournable pour l'aménagement du territoire et l'urbanisme dans une perspective de durabilité. À travers le cas lausannois, cette thèse s'interroge sur la façon dont les modèles urbanistiques de régulation des jeux d'acteurs privés peuvent participer à la mise en place de stratégies de qualification urbaine et d'organisation des centralités commerciales sans céder à la tentation de la marchandisation des espaces publics.
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The objective of this research was to find how the critical factors enabling intraorganizational knowledge sharing could be implemented to be part of case organization’s actions. The theoretical framework of the research was constituted based on previous scientific discussions concerning knowledge and its dimensions, knowledge sharing and its linkage to organizational learning. The intraorganizational knowledge sharing critical factors form an essential part of the theoretical framework. The study was a qualitative case study. The data was collected using focus group interviews and analyzed using theme analysis. In the empirical part of the study case organizations characteristics to the intraorganizational knowledge sharing were researched, intraorganizational knowledge sharing goals were mapped and finally improvement actions were suggested. The most significant suggestions were creating an organization wide knowledge sharing strategy, facilitating the development of social networks and communicating the top management support for knowledge sharing activities.
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ABSTRACT Precision agriculture (PA) allows farmers to identify and address variations in an agriculture field. Management zones (MZs) make PA more feasible and economical. The most important method for defining MZs is a fuzzy C-means algorithm, but selecting the variable for use as the input layer in the fuzzy process is problematic. BAZZI et al. (2013) used Moran’s bivariate spatial autocorrelation statistic to identify variables that are spatially correlated with yield while employing spatial autocorrelation. BAZZI et al. (2013) proposed that all redundant variables be eliminated and that the remaining variables would be considered appropriate on the MZ generation process. Thus, the objective of this work, a study case, was to test the hypothesis that redundant variables can harm the MZ delineation process. BAZZI This work was conducted in a 19.6-ha commercial field, and 15 MZ designs were generated by a fuzzy C-means algorithm and divided into two to five classes. Each design used a different composition of variables, including copper, silt, clay, and altitude. Some combinations of these variables produced superior MZs. None of the variable combinations produced statistically better performance that the MZ generated with no redundant variables. Thus, the other redundant variables can be discredited. The design with all variables did not provide a greater separation and organization of data among MZ classes and was not recommended.
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ABSTRACTObjective:identify risk factors for mortality in patients who underwent laparotomy after blunt abdominal trauma.Methods:retrospective study, case-control, which were reviewed medical records of blunt trauma victims patients undergoing laparotomy, from March 2013 to January 2015, and compared the result of the deaths group with the group healed.Results:of 86 patients, 63% were healed, 36% died, and one patient was excluded from the study. Both groups had similar epidemiology and trauma mechanism, predominantly young adults males, automobilistic accident. Most cases that evolved to death had hemodynamic instability as laparotomy indication - 61% against 38% in the other group (p=0.02). The presence of solid organ injury was larger in the group of deaths - 80% versus 48% (p=0.001) and 61% of them had other associated abdominal injury compared to 25% in the other group (p=0.01). Of the patients who died 96% had other serious injuries associated (p=0.0003). Patients requiring damage control surgery had a higher mortality rate (p=0.0099). Only one of 18 patients with isolated hollow organ lesion evolved to death (p=0.0001). The mean injury score of TRISS of cured (91.70%) was significantly higher than that of deaths (46.3%) (p=0.002).Conclusion:the risk factors for mortality were hemodynamic instability as an indication for laparotomy, presence of solid organ injury, multiple intra-abdominal injuries, need for damage control surgery, serious injury association and low index of trauma score.
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Hiljainen tieto muodostaa organisaatioiden keskeisen kilpailutekijän, sillä sitä on vaikea kopioida. Hiljaista tietoa pyritään siirtämään erilaisia osaamisen kehittämisen menetelmiä hyödyntäen. Tässä tutkielmassa tutkitaan, miten hiljaista tietoa siirretään mentoroinnissa. Mentorointiin liittyvissä tutkimuksissa ei ole tutkittu sitä vuorovaikutukseen perustuvaa prosessia, jonka aikana hiljaista tietoa siirretään mentorilta aktorille. Tämä tutkielma toi lisää tietoa tähän tutkimusaukkoon. Tutkielman teoreettisessa osiossa esiteltiin kolme näkökulmaa, jotka muo-dostivat tutkielman viitekehyksen: hiljainen tieto ja sen siirtäminen, mentorointi sekä kognitiivinen oppipoikamalli. Tutkimusmenetelmänä käytettiin fenomenografista tapaustutkimusta. Tutkimuksen kohderyhmän muodostivat neljä mentori-aktori –paria, joita haastateltiin teemahaastattelulla. Empiiriset tulokset osoittivat, että hiljaisen tiedon siirtäminen mentoroinnissa tapahtui kognitiivisen oppipoikamallin vaiheita hyödyntäen. Kaikki kognitiivisen oppipoikamallin vaiheet esiintyivät mentorointiprosessissa. Siirrettävässä hiljaisessa tiedossa näyttäytyivät tiedon toiminnallinen, situationaalinen ja sosiaalinen luonne. Keskeisimmiksi hiljaisen tiedon siirtämisen menetelmiksi osoittautuivat mentorin läsnäolo, kuuntelu, kysymysten tekeminen ja aktorin oivalluttaminen. Tutkielman keskeisenä tuloksena ja toimenpide-ehdotuksena esitettiin hiljaisen tiedon siirtämisen malli mentoroinnissa, joka kehitettiin tutkimuksen teoreettisen viitekehyksen ja tutkimuksesta saatujen tulosten pohjalta.
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Highly dynamic systems, often considered as resilient systems, are characterised by abiotic and biotic processes under continuous and strong changes in space and time. Because of this variability, the detection of overlapping anthropogenic stress is challenging. Coastal areas harbour dynamic ecosystems in the form of open sandy beaches, which cover the vast majority of the world’s ice-free coastline. These ecosystems are currently threatened by increasing human-induced pressure, among which mass-development of opportunistic macroalgae (mainly composed of Chlorophyta, so called green tides), resulting from the eutrophication of coastal waters. The ecological impact of opportunistic macroalgal blooms (green tides, and blooms formed by other opportunistic taxa), has long been evaluated within sheltered and non-tidal ecosystems. Little is known, however, on how more dynamic ecosystems, such as open macrotidal sandy beaches, respond to such stress. This thesis assesses the effects of anthropogenic stress on the structure and the functioning of highly dynamic ecosystems using sandy beaches impacted by green tides as a study case. The thesis is based on four field studies, which analyse natural sandy sediment benthic community dynamics over several temporal (from month to multi-year) and spatial (from local to regional) scales. In this thesis, I report long-lasting responses of sandy beach benthic invertebrate communities to green tides, across thousands of kilometres and over seven years; and highlight more pronounced responses of zoobenthos living in exposed sandy beaches compared to semi-exposed sands. Within exposed sandy sediments, and across a vertical scale (from inshore to nearshore sandy habitats), I also demonstrate that the effects of the presence of algal mats on intertidal benthic invertebrate communities is more pronounced than that on subtidal benthic invertebrate assemblages, but also than on flatfish communities. Focussing on small-scale variations in the most affected faunal group (i.e. benthic invertebrates living at low shore), this thesis reveals a decrease in overall beta-diversity along a eutrophication-gradient manifested in the form of green tides, as well as the increasing importance of biological variables in explaining ecological variability of sandy beach macrobenthic assemblages along the same gradient. To illustrate the processes associated with the structural shifts observed where green tides occurred, I investigated the effects of high biomasses of opportunistic macroalgae (Ulva spp.) on the trophic structure and functioning of sandy beaches. This work reveals a progressive simplification of sandy beach food web structure and a modification of energy pathways over time, through direct and indirect effects of Ulva mats on several trophic levels. Through this thesis I demonstrate that highly dynamic systems respond differently (e.g. shift in δ13C, not in δ15N) and more subtly (e.g. no mass-mortality in benthos was found) to anthropogenic stress compared to what has been previously shown within more sheltered and non-tidal systems. Obtaining these results would not have been possible without the approach used through this work; I thus present a framework coupling field investigations with analytical approaches to describe shifts in highly variable ecosystems under human-induced stress.
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La prééclampsie est responsable du quart des mortalités maternelles et est la deuxième cause de décès maternels associés à la grossesse au Canada et dans le monde. L’identification d’une stratégie efficace pour la prévention de la prééclampsie est une priorité et un défi primordial dans les milieux de recherche en obstétrique. Le rôle des éléments nutritifs dans le développement de la prééclampsie a récemment reçu davantage d’attention. Plusieurs études cliniques et épidémiologiques ont été menées pour déterminer les facteurs de risque alimentaires potentiels et examiner les effets d’une supplémentation nutritive dans le développement de troubles hypertensifs de la grossesse. Pour déterminer les effets de suppléments antioxydants pris pendant la grossesse sur le risque d’hypertension gestationnelle (HG) et de prééclampsie, un essai multicentrique contrôlé à double insu a été mené au Canada et au Mexique (An International Trial of Antioxidants in the Prevention of Preeclampsia – INTAPP). Les femmes, stratifiées par risque, étaient assignées au traitement expérimental quotidien (1 gramme de vitamine C et 400 UI de vitamine E) ou au placebo. En raison des effets secondaires potentiels, le recrutement pour l’essai a été arrêté avant que l’échantillon complet ait été constitué. Au total, 2640 femmes éligibles ont accepté d’être recrutées, dont 2363 (89.5%) furent incluses dans les analyses finales. Nous n’avons retrouvé aucune évidence qu’une supplémentation prénatale de vitamines C et E réduisait le risque d’HG et de ses effets secondaires (RR 0,99; IC 95% 0,78-1,26), HG (RR 1,04; IC 95% 0,89-1,22) et prééclampsie (RR 1,04; IC 95% 0,75-1,44). Toutefois, une analyse secondaire a révélé que les vitamines C et E augmentaient le risque de « perte fœtale ou de décès périnatal » (une mesure non spécifiée au préalable) ainsi qu’une rupture prématurée des membranes avant terme. Nous avons mené une étude de cohorte prospective chez les femmes enceintes recrutées dans l’INTAPP afin d’évaluer les relations entre le régime alimentaire maternel en début et fin de grossesse et le risque de prééclampsie et d’HG. Un questionnaire de fréquence alimentaire validé était administré deux fois pendant la grossesse (12-18 semaines, 32-34 semaines). Les analyses furent faites séparément pour les 1537 Canadiennes et les 799 Mexicaines en raison de l’hétérogénéité des régimes alimentaires des deux pays. Parmi les canadiennes, après ajustement pour l’indice de masse corporelle (IMC) précédant la grossesse, le groupe de traitement, le niveau de risque (élevé versus faible) et les autres facteurs de base, nous avons constaté une association significative entre un faible apport alimentaire (quartile inférieur) de potassium (OR 1,79; IC 95% 1,03-3,11) et de zinc (OR 1,90; IC 95% 1,07-3,39) et un risque augmenté de prééclampsie. Toujours chez les Canadiennes, le quartile inférieur de consommation d’acides gras polyinsaturés était associé à un risque augmenté d’HG (OR 1,49; IC 95% 1,09-2,02). Aucun des nutriments analysés n’affectait les risques d’HG ou de prééclampsie chez les Mexicaines. Nous avons entrepris une étude cas-témoins à l’intérieur de la cohorte de l’INTAPP pour établir le lien entre la concentration sérique de vitamines antioxydantes et le risque de prééclampsie. Un total de 115 cas de prééclampsie et 229 témoins ont été inclus. Les concentrations de vitamine E ont été mesurées de façon longitudinale à 12-18 semaines (avant la prise de suppléments), à 24-26 semaines et à 32-34 semaines de grossesse en utilisant la chromatographie liquide de haute performance. Lorsqu’examinée en tant que variable continue et après ajustement multivarié, une concentration de base élevée de gamma-tocophérol était associée à un risque augmenté de prééclampsie (quartile supérieur vs quartile inférieur à 24-26 semaines : OR 2,99, IC 95% 1,13-7,89; à 32-34 semaines : OR 4,37, IC 95% 1,35-14,15). Nous n’avons pas trouvé de lien entre les concentrations de alpha-tocophérol et le risque de prééclampsie. En résumé, nous n’avons pas trouvé d’effets de la supplémentation en vitamines C et E sur le risque de prééclampsie dans l’INTAPP. Nous avons toutefois trouvé, dans la cohorte canadienne, qu’une faible prise de potassium et de zinc, tel qu’estimée par les questionnaires de fréquence alimentaire, était associée à un risque augmenté de prééclampsie. Aussi, une plus grande concentration sérique de gamma-tocophérol pendant la grossesse était associée à un risque augmenté de prééclampsie.