Perceptions et réactions des soignants et membres de famille à l’égard d’une intervention de réminiscence auprès de personnes atteintes de démence légère à modérée en soins de longue durée

La majorité des personnes atteintes de démence en soins de longue durée (SLD) souffre d’une détérioration de la cognition, des interactions sociales, de la santé mentale et de la qualité de vie (QdV). Par conséquent, les proches aidants et les soignants de cette population peuvent éprouver des difficultés, tel que le stress, en raison de la complexité du syndrome. Il s’avère essentiel de valider des interventions psychosociales adaptées à la population atteinte de démence et à ses aidants. La réminiscence, une intervention psychosociale misant sur les capacités résiduelles des personnes atteintes de démence, se fonde sur la remémoration des souvenirs anciens agréables. L’objectif général du mémoire était de valider la mise en œuvre d’une intervention de réminiscence menée par le personnel soignant auprès des personnes atteintes de démence et leurs familles dans un centre de SLD, en faisant appel aux avis experts des soignants et des familles des personnes atteintes de démence dans le contexte d’entrevues. Une évaluation pré-post intervention a permis de mesurer la santé mentale et la QdV des personnes atteintes de démence avant l’intervention, une semaine après et trois mois après l’intervention. Les résultats indiquent que la réminiscence a été bien appréciée par les soignants, les personnes atteintes de démence et leurs familles, et valident sa mise en œuvre en SLD. Des améliorations significatives (Wilcoxon p < 0,025) à court et à long terme ont été observées au niveau de la santé mentale et la QdV des personnes atteintes de démence.

Entre désincarnation et réincarnation : la poétique du corps dans le récit d'un soi anorexique suivi de Carnet d'une désincarnée

Mémoire de recherche et création, incluant une partie essai et un texte de création.

Vues imprenables ; suivi de Paradoxes du voir et de l'aveuglement dans Ceux d'à côté de Laurent Mauvignier

Vues imprenables est un récit où se succèdent les monologues de six personnages se trouvant dans un hôtel de luxe le temps d’une fin de semaine. À travers les détours discursifs que chaque personnage emprunte, les mécanismes textuels qu’il ou elle utilise pour éviter de dire et de se confronter aux réminiscences de ses fautes passées, la question du voir et de l’aveuglement se lie étroitement à celle du passage à l’acte. Quels forfaits ces hommes et ces femmes ont-ils commis ? Sont-ils capables de « se voir » réellement ? Quelle est la portée du regard sur le geste qu’ils ont antérieurement posé ? S’inspirant, entre autres, du jeu de société Clue, des Dix Commandements et de l’esthétique du film The Shining, Vues imprenables interroge la notion de repentir, cherchant à savoir jusqu’où le « voile » de la parole peut dissimuler certains actes, jusqu’à quel point le voir peut se révéler insaisissable. L’essai intitulé « Paradoxes du voir et de l’aveuglement dans Ceux d’à côté de Laurent Mauvignier » tisse également des liens avec Vues imprenables : en questionnant les limites et les possibilités du voir dans le roman de Mauvignier, il s’agit en effet d’analyser comment l’avènement de la vue, dans ce récit, laisse en tout temps présager sa possible perte, mais aussi de quelles façons le geste criminel devient « aveugle » au moment même où il est perpétré. En revisitant certains des plus grands mythes grecs, tels ceux d’Œdipe, de Tirésias et de Gorgô, cet essai étudie plus particulièrement la figure de l’alter ego, ce « moi à côté », tantôt coupable tantôt témoin, qui hante le récit de Mauvignier et il propose une réflexion sur les paradoxes du rapport au vu à partir des travaux d’Hélène Cixous, de Georges Didi-Huberman, de J.-B. Pontalis et de Maurice Merleau-Ponty.

A study on the performance of flexible pavements on mature soil subgrades

The country has witnessed tremendous increase in the vehicle population and increased axle loading pattern during the last decade, leaving its road network overstressed and leading to premature failure. The type of deterioration present in the pavement should be considered for determining whether it has a functional or structural deficiency, so that appropriate overlay type and design can be developed. Structural failure arises from the conditions that adversely affect the load carrying capability of the pavement structure. Inadequate thickness, cracking, distortion and disintegration cause structural deficiency. Functional deficiency arises when the pavement does not provide a smooth riding surface and comfort to the user. This can be due to poor surface friction and texture, hydro planning and splash from wheel path, rutting and excess surface distortion such as potholes, corrugation, faulting, blow up, settlement, heaves etc. Functional condition determines the level of service provided by the facility to its users at a particular time and also the Vehicle Operating Costs (VOC), thus influencing the national economy. Prediction of the pavement deterioration is helpful to assess the remaining effective service life (RSL) of the pavement structure on the basis of reduction in performance levels, and apply various alternative designs and rehabilitation strategies with a long range funding requirement for pavement preservation. In addition, they can predict the impact of treatment on the condition of the sections. The infrastructure prediction models can thus be classified into four groups, namely primary response models, structural performance models, functional performance models and damage models. The factors affecting the deterioration of the roads are very complex in nature and vary from place to place. Hence there is need to have a thorough study of the deterioration mechanism under varied climatic zones and soil conditions before arriving at a definite strategy of road improvement. Realizing the need for a detailed study involving all types of roads in the state with varying traffic and soil conditions, the present study has been attempted. This study attempts to identify the parameters that affect the performance of roads and to develop performance models suitable to Kerala conditions. A critical review of the various factors that contribute to the pavement performance has been presented based on the data collected from selected road stretches and also from five corporations of Kerala. These roads represent the urban conditions as well as National Highways, State Highways and Major District Roads in the sub urban and rural conditions. This research work is a pursuit towards a study of the road condition of Kerala with respect to varying soil, traffic and climatic conditions, periodic performance evaluation of selected roads of representative types and development of distress prediction models for roads of Kerala. In order to achieve this aim, the study is focused into 2 parts. The first part deals with the study of the pavement condition and subgrade soil properties of urban roads distributed in 5 Corporations of Kerala; namely Thiruvananthapuram, Kollam, Kochi, Thrissur and Kozhikode. From selected 44 roads, 68 homogeneous sections were studied. The data collected on the functional and structural condition of the surface include pavement distress in terms of cracks, potholes, rutting, raveling and pothole patching. The structural strength of the pavement was measured as rebound deflection using Benkelman Beam deflection studies. In order to collect the details of the pavement layers and find out the subgrade soil properties, trial pits were dug and the in-situ field density was found using the Sand Replacement Method. Laboratory investigations were carried out to find out the subgrade soil properties, soil classification, Atterberg limits, Optimum Moisture Content, Field Moisture Content and 4 days soaked CBR. The relative compaction in the field was also determined. The traffic details were also collected by conducting traffic volume count survey and axle load survey. From the data thus collected, the strength of the pavement was calculated which is a function of the layer coefficient and thickness and is represented as Structural Number (SN). This was further related to the CBR value of the soil and the Modified Structural Number (MSN) was found out. The condition of the pavement was represented in terms of the Pavement Condition Index (PCI) which is a function of the distress of the surface at the time of the investigation and calculated in the present study using deduct value method developed by U S Army Corps of Engineers. The influence of subgrade soil type and pavement condition on the relationship between MSN and rebound deflection was studied using appropriate plots for predominant types of soil and for classified value of Pavement Condition Index. The relationship will be helpful for practicing engineers to design the overlay thickness required for the pavement, without conducting the BBD test. Regression analysis using SPSS was done with various trials to find out the best fit relationship between the rebound deflection and CBR, and other soil properties for Gravel, Sand, Silt & Clay fractions. The second part of the study deals with periodic performance evaluation of selected road stretches representing National Highway (NH), State Highway (SH) and Major District Road (MDR), located in different geographical conditions and with varying traffic. 8 road sections divided into 15 homogeneous sections were selected for the study and 6 sets of continuous periodic data were collected. The periodic data collected include the functional and structural condition in terms of distress (pothole, pothole patch, cracks, rutting and raveling), skid resistance using a portable skid resistance pendulum, surface unevenness using Bump Integrator, texture depth using sand patch method and rebound deflection using Benkelman Beam. Baseline data of the study stretches were collected as one time data. Pavement history was obtained as secondary data. Pavement drainage characteristics were collected in terms of camber or cross slope using camber board (slope meter) for the carriage way and shoulders, availability of longitudinal side drain, presence of valley, terrain condition, soil moisture content, water table data, High Flood Level, rainfall data, land use and cross slope of the adjoining land. These data were used for finding out the drainage condition of the study stretches. Traffic studies were conducted, including classified volume count and axle load studies. From the field data thus collected, the progression of each parameter was plotted for all the study roads; and validated for their accuracy. Structural Number (SN) and Modified Structural Number (MSN) were calculated for the study stretches. Progression of the deflection, distress, unevenness, skid resistance and macro texture of the study roads were evaluated. Since the deterioration of the pavement is a complex phenomena contributed by all the above factors, pavement deterioration models were developed as non linear regression models, using SPSS with the periodic data collected for all the above road stretches. General models were developed for cracking progression, raveling progression, pothole progression and roughness progression using SPSS. A model for construction quality was also developed. Calibration of HDM–4 pavement deterioration models for local conditions was done using the data for Cracking, Raveling, Pothole and Roughness. Validation was done using the data collected in 2013. The application of HDM-4 to compare different maintenance and rehabilitation options were studied considering the deterioration parameters like cracking, pothole and raveling. The alternatives considered for analysis were base alternative with crack sealing and patching, overlay with 40 mm BC using ordinary bitumen, overlay with 40 mm BC using Natural Rubber Modified Bitumen and an overlay of Ultra Thin White Topping. Economic analysis of these options was done considering the Life Cycle Cost (LCC). The average speed that can be obtained by applying these options were also compared. The results were in favour of Ultra Thin White Topping over flexible pavements. Hence, Design Charts were also plotted for estimation of maximum wheel load stresses for different slab thickness under different soil conditions. The design charts showed the maximum stress for a particular slab thickness and different soil conditions incorporating different k values. These charts can be handy for a design engineer. Fuzzy rule based models developed for site specific conditions were compared with regression models developed using SPSS. The Riding Comfort Index (RCI) was calculated and correlated with unevenness to develop a relationship. Relationships were developed between Skid Number and Macro Texture of the pavement. The effort made through this research work will be helpful to highway engineers in understanding the behaviour of flexible pavements in Kerala conditions and for arriving at suitable maintenance and rehabilitation strategies. Key Words: Flexible Pavements – Performance Evaluation – Urban Roads – NH – SH and other roads – Performance Models – Deflection – Riding Comfort Index – Skid Resistance – Texture Depth – Unevenness – Ultra Thin White Topping

Diabetes gestacional como factor de riesgo para incontinencia urinaria: revisión sistemática de la literatura

La diabetes mellitus es una de las patologías frecuentes durante el embarazo, existe literatura que la ha relacionado con un mayor riesgo de aparición de incontinencia urinaria en el postparto patología que de manera clara afecta la calidad de vida de las mujeres, pero a la fecha la literatura no es concluyente. Con la presente revisión sistemática se pretendió evaluar la evidencia relacionada con la diabetes gestacional como causa de incontinencia urinaria en el postparto.

Integració 3D de detectors de píxels híbrids

La miniaturització de la industria microelectrònica és un fet del tot inqüestionables i la tecnologia CMOS no n'és una excepció. En conseqüència la comunitat científica s'ha plantejat dos grans reptes: En primer lloc portar la tecnologia CMOS el més lluny possible ('Beyond CMOS') tot desenvolupant sistemes d'altes prestacions com microprocessadors, micro - nanosistemes o bé sistemes de píxels. I en segon lloc encetar una nova generació electrònica basada en tecnologies totalment diferents dins l'àmbit de les Nanotecnologies. Tots aquests avanços exigeixen una recerca i innovació constant en la resta d'àrees complementaries com són les d'encapsulat. L'encapsulat ha de satisfer bàsicament tres funcions: Interfície elèctrica del sistema amb l'exterior, Proporcionar un suport mecànic al sistema i Proporcionar un camí de dissipació de calor. Per tant, si tenim en compte que la majoria d'aquests dispositius d'altes prestacions demanden un alt nombre d'entrades i sortides, els mòduls multixip (MCMs) i la tecnologia flip chip es presenten com una solució molt interessant per aquests tipus de dispositiu. L'objectiu d'aquesta tesi és la de desenvolupar una tecnologia de mòduls multixip basada en interconnexions flip chip per a la integració de detectors de píxels híbrids, que inclou: 1) El desenvolupament d'una tecnologia de bumping basada en bumps de soldadura Sn/Ag eutèctics dipositats per electrodeposició amb un pitch de 50µm, i 2) El desenvolupament d'una tecnologia de vies d'or en silici que permet interconnectar i apilar xips verticalment (3D packaging) amb un pitch de 100µm. Finalment aquesta alta capacitat d'interconnexió dels encapsulats flip chip ha permès que sistemes de píxels tradicionalment monolítics puguin evolucionar cap a sistemes híbrids més compactes i complexes, i que en aquesta tesi s'ha vist reflectit transferint la tecnologia desenvolupada al camp de la física d'altes energies, en concret implantant el sistema de bump bonding d'un mamògraf digital. Addicionalment s'ha implantat també un dispositiu detector híbrid modular per a la reconstrucció d'imatges 3D en temps real, que ha donat lloc a una patent.

Women in Post –1961 Goa : Problems and Challenges

When the women of Goa begin to reminiscence about the last four and a half decades of Goan history it will be a journey of mixed responses, for the women’s movement has witnessed gains and losses, successes and failures, times of expression and times of being silenced, times of vibrant activity and times of lulls and importantly, times of prolonged protests against markets and developmental forces, and media projections. For decades the women of Goa have taken a vociferous stand against arbitrary Development practices that the Government has attempted to foist upon the people of the State and especially its women. For decades the women of Goa have demanded for a gendered perspective and an equal representation in the development processes in the State.

Inconstitucionalidad por omisión en la jurisprudencia de la Corte Constitucional ecuatoriana. Sentencia No. 001-1L-SIO-CC (caso No. 0005-10-IO) [Jurisprudencia]

El presente trabajo pretende mostrar de manera objetiva y técnica, las motivaciones, contenidos y demás elementos de sustento utilizados por la Corte Constitucional ecuatoriana en el control abstracto de inconstitucionalidad por omisión normativa. Previo el análisis de la sentencia se presentan conceptos relativos al control de constitucionalidad por omisión en el derecho comparado y en la doctrina, además se hace un breve recorrido histórico del aparecimiento de la mencionada institución jurídica. Finalmente, se revisa la sentencia en cada una de sus partes y se van describiendo los aspectos más relevantes y conflictivos.

An efficient shock capturing scheme for the pseudo-unsteady equations representing steady inviscid flow

An efficient algorithm is presented for the solution of the steady Euler equations of gas dynamics. The scheme is based on solving linearised Riemann problems approximately and in more than one dimension incorporates operator splitting. The scheme is applied to a standard test problem of flow down a channel containing a circular arc bump for three different mesh sizes.

Effekten av reminiscens- och musikterapi hos deprimerade äldre på äldreboende : en litteraturöversikt

Syftet Att undersöka vilken effekt reminiscens- och musikterapi har på äldre deprimerade personer på äldreboende. Metod: Litteratursökning utfördes i databaserna CHINAL, Medline, Psycinfo samt Scopus. Till grund för resultatet valdes n=13 artiklar med kvantitativ design. Urvalet av artiklarna till resultatet har utförts med hjälp av inklusionskriterier, relevant abstract och publicerade mellan 2000-2013. Artiklarna skulle motsvara syfte och frågeställningar samt uppfylla hög eller medelpoäng i kvalitetsgranskningen. Resultat: Reminiscensterapi kunde reducera och minska depressiva symtom hos äldre personer på äldreboende. Musikterapi kunde också vara en effektiv åtgärd för att minska depression hos äldre personer på äldreboende. Ett annat resultat som framkom var att sömnen kan förbättras av musikterapi. Slutsats: Reminiscens- och musikterapi kunde minska depression hos äldre personer som bor på äldreboende, genom att musik stimulerar limbiska systemet och reminiscensterapin låter de äldre att återberätta och leva på nytt genom sina minnen. Det kan vara värdefullt för de äldre att vårdgivare på äldreboende lär sig grunder för reminiscens och musikterapi för att kunna använda det i den dagliga vården av de äldre för att minska depression men även som en förebyggande åtgärd.  

Acesso à justiça enquanto direito fundamental: efetivação pela defensoria pública

The Federal Constitution of 1988 is recognized for its enlargement in the face of large amount of provisions that make it up, among which many are fundamental rights. The fundamental rules set up the foundation of a democratic state, however, are the necessary legal mechanisms to be effective, its exercise is not enough merely to state them, but to offer ways for them to stop being just written standard on paper, and come to be viewed and exercised day-to-day. In this sense, access to justice presents itself in our times, as a cornerstone for a just society dictates. In this light, access to justice can be seen as the most fundamental of rights, which translates as instruments able to safeguard the fundamental rights not only against the action/omission violating the state but also the very particular. Furthermore, access to justice within the legal country, is not right for everyone, despite the willingness of the Citizen Charter in its article 5, paragraph LXXIV, ensuring that the State shall provide full and free legal assistance to those in need. More than half of the population lives in poverty and can´t afford to pay legal fees or court costs as well as a bump in their own ignorance of their rights. The judiciary, in their primary function, is in charge of trying to correct the violation of the rights, intending to effect a true distributive justice, serving as a paradigm for the promotion of substantive equality of human beings, however, is difficult and tortuous access Justice for those without financial resources. In this vein, we present the Public Defender, as keeper of the masses in its institutional role, defending a disadvantage, in the words, as a mechanism for effective access to justice, ensuring therefore fundamental rights. Public Defenders arise at the time or much discussion highlights the priority of actual access to justice, custody, therefore, intimate bond with the pursuit of fundamental rights, in which, that advance the broad range of rights, without whom could defend them or guardianship them

Fases e criticalidade no modelo ashkin - teller de três cores

The usual Ashkin-Teller (AT) model is obtained as a superposition of two Ising models coupled through a four-spin interaction term. In two dimension the AT model displays a line of fixed points along which the exponents vary continuously. On this line the model becomes soluble via a mapping onto the Baxter model. Such richness of multicritical behavior led Grest and Widom to introduce the N-color Ashkin-Teller model (N-AT). Those authors made an extensive analysis of the model thus introduced both in the isotropic as well as in the anisotropic cases by several analytical and computational methods. In the present work we define a more general version of the 3-color Ashkin-Teller model by introducing a 6-spin interaction term. We investigate the corresponding symmetry structure presented by our model in conjunction with an analysis of possible phase diagrams obtained by real space renormalization group techniques. The phase diagram are obtained at finite temperature in the region where the ferromagnetic behavior is predominant. Through the use of the transmissivities concepts we obtain the recursion relations in some periodical as well as aperiodic hierarchical lattices. In a first analysis we initially consider the two-color Ashkin-Teller model in order to obtain some results with could be used as a guide to our main purpose. In the anisotropic case the model was previously studied on the Wheatstone bridge by Claudionor Bezerra in his Master Degree dissertation. By using more appropriated computational resources we obtained isomorphic critical surfaces described in Bezerra's work but not properly identified. Besides, we also analyzed the isotropic version in an aperiodic hierarchical lattice, and we showed how the geometric fluctuations are affected by such aperiodicity and its consequences in the corresponding critical behavior. Those analysis were carried out by the use of appropriated definitions of transmissivities. Finally, we considered the modified 3-AT model with a 6-spin couplings. With the inclusion of such term the model becomes more attractive from the symmetry point of view. For some hierarchical lattices we derived general recursion relations in the anisotropic version of the model (3-AAT), from which case we can obtain the corresponding equations for the isotropic version (3-IAT). The 3-IAT was studied extensively in the whole region where the ferromagnetic couplings are dominant. The fixed points and the respective critical exponents were determined. By analyzing the attraction basins of such fixed points we were able to find the three-parameter phase diagram (temperature £ 4-spin coupling £ 6-spin coupling). We could identify fixed points corresponding to the universality class of Ising and 4- and 8-state Potts model. We also obtained a fixed point which seems to be a sort of reminiscence of a 6-state Potts fixed point as well as a possible indication of the existence of a Baxter line. Some unstable fixed points which do not belong to any aforementioned q-state Potts universality class was also found

Comparação entre dois tipos de suspensão passiva de barra em condições simuladas de pista de prova normalizada

In this paper we conducted several analysis of the simulated dynamic behavior of two passive suspension types of the trailed sprayer booms. The suspension analysis was conducted under conditions of a bump track test ISO 5008, with two levels of speed (5 km h(-1) and 15 km h(-1)) and two track profiles proposed in these standards (bumpy and smooth). It was used the simulations software MATLAB (R), SIMULINK (R) and Visual Nastran (R). The results obtained showed that suspensions of trapezoidal type have good performance at low frequencies input (omega < 0,2 Hz) while suspensions of simple pendulum type have good performance in others conditions.

The megalopa and early juvenile stages of Calappa tortugae Rathbun, 1933 (Crustacea, Brachyura) reared in the laboratory from South Carolina neuston samples

Neuston samples collected from the Charleston Bump region off the coast of South Carolina, U.S.A., during the summers of 2002 and 2003 consistently included a decapod species of undetermined identity with a large brachyuran megalopa. Despite their resemblance to some calappids, it was impossible to make a definitive identification based solely on general morphology. Therefore, additional neuston tows were taken on the continental shelf near Charleston, during the summer of 2004 to obtain these living megalopae. These were raised successfully through five juvenile stages at the Southeastern Regional Taxonomic Center (SERTC) laboratory. The morphology of the juveniles provided evidence that they are megalopae of Calappa tortugae Rathbun, 1933. Comparisons with megalopae of Hepatus epheliticus (Linnaeus, 1763), H. pudibundus (Herbst, 1785), Calappa flammea (Herbst, 1794) and Cryptosoma balguerii (Desbonne, 1867) are presented here. This is the first complete description of the megalopa morphology of a member of the genus Calappa Weber, 1795 from the Western Atlantic, and it is helpful for taxonomic, systematic and ecological purposes.