L’infirmière en GMF : vers une meilleure connaissance des activités réalisées auprès des personnes atteintes de maladies chroniques

Résumé : Contexte : Depuis la création des Groupes de médecine de famille (GMF), les infirmières peuvent assurer le suivi des personnes atteintes de maladies chroniques (MC). Il existe des écarts entre la littérature et la pratique. Un constat provincial permettra une compréhension des enjeux d’optimisation de la pratique infirmière auprès de cette clientèle grandissante. Objectifs : 1) décrire les activités de l’infirmière en GMF auprès des personnes atteintes de MC; 2) décrire les éléments contextuels déterminants de ces activités; 3) dresser un portrait provincial des activités des infirmières de GMF auprès des personnes atteintes de MC. Méthode : Un devis mixte séquentiel exploratoire en trois volets a été effectué. Volet 1 : Une étude de cas multiple a été réalisée auprès de dix infirmières de GMF. Cinq sources de données ont été utilisées : 1) observation des rencontres infirmière-patient (n=10); 2) entrevues individuelles avec chaque infirmière (n=10); 3) entrevues individuelles avec chaque patient (n=10); 4) audit des notes infirmières au dossier des patients participant (n=10) et; 5) documents administratifs décrivant la pratique des infirmières à l’intérieur des GMF. L’analyse qualitative a permis de générer une liste d’activités et de décrire les éléments contextuels qui déterminent les activités. Volet 2 : Un questionnaire électronique a été créé à l’aide de la liste d’activités produite lors du Volet 1 et de la recension des écrits. Il a été validé et prétesté. Volet 3 : Une enquête provinciale a été réalisée auprès de 322 infirmières de GMF. Des analyses descriptives telles que des fréquences, moyennes, étendues et écarts types ont été effectuées. Résultats : Volet 1 : les activités des infirmières de GMF auprès des personnes atteintes de MC sont regroupées en cinq domaines. Des éléments liés à l’organisation, aux infirmières et aux personnes atteintes de MC peuvent influencer les activités. Volet 3 : 266 infirmières ont complété le questionnaire. Les résultats démontrent que leurs activités se situent principalement dans les domaines de la Promotion de la santé et de l’Évaluation globale de la condition de la personne. Les activités en lien avec la Collaboration infirmière-médecin et l’Organisation de l’offre de services sont réalisées de façon occasionnelle. Conclusion : Cette étude a permis une description en profondeur des activités des infirmières de GMF auprès des personnes atteintes de MC. Il s’agissait d’un jalon important en vue d’optimiser les interventions liées à la prise en charge des MC en soins de première ligne.

Tracing outsideness: young women's institutional journeys and the geographies of closed space

Understanding confinement and its complex workings between individuals and society has been the stated aim of carceral geography and wider studies on detention. This project contributes ethnographic insights from multiple sites of incarceration, working with an under-researched group within confined populations. Focussing on young female detainees in Scotland, this project seeks to understand their experiences of different types of ‘closed’ space. Secure care, prison and closed psychiatric facilities all impact on the complex geographies of these young women’s lives. The fluid but always situated relations of control and care provide the backdrop for their journeys in/out and beyond institutional spaces. Understanding institutional journeys with reference to age and gender allows an insight into the highly mobile, often precarious, and unfamiliar lives of these young women who live on the margins. This thesis employs a mixed-method qualitative approach and explores what Goffman calls the ‘tissue and fabric’ of detention as a complex multi-institutional practice. In order to be able to understand the young women’s gendered, emotional and often repetitive experiences of confinement, analysis of the constitution of ‘closed space’ represents a first step for inquiry. The underlying nature of inner regimes, rules and discipline in closed spaces, provide the background on which confinement is lived, perceived and processed. The second part of the analysis is the exploration of individual experiences ‘on the inside’, ranging from young women’s views on entering a closed institution, the ways in which they adapt or resist the regime, and how they cope with embodied aspects of detention. The third and final step considers the wider context of incarceration by recovering the young women’s journeys through different types of institutional spaces and beyond. The exploration of these journeys challenges and re-develops understandings of mobility and inertia by engaging the relative power of carceral archipelagos and the figure of femina sacra. This project sits comfortably within the field of carceral geography while also pushing at its boundaries. On a conceptual level, a re-engagement with Goffman’s micro-analysis challenges current carceral-geographic theory development. Perhaps more importantly, this project pushes for an engagement with different institutions under the umbrella of carceral geography, thus creating new dialogues on issues like ‘care’ and ‘control’. Finally, an engagement with young women addresses an under-represented population within carceral geography in ways that raise distinctly problematic concerns for academic research and penal policy. Overall, this project aims to show the value of fine grained micro-level research in institutional geographies for extending thinking and understanding about society’s responses to a group of people who live on the margins of social and legal norms.

Characterization of traditional raw materials used in housing construction in Huambo Region - Angola

The sustainability of buildings associated to the use of raw earth has motivated the studies and the development of techniques and methods in the context of this type of construction. In the region of Huambo, Angola, these construction techniques are widely used, especially for low-income families who represent the majority of the population. Much of the buildings in Huambo province are built with adobe. Due to the climate in this region, subtropical, hot and humid, with altitudes above 1000 meters and extensive river system, these buildings are particularly vulnerable to the action of water and develop, in many situations, early degradation. The Huambo Province is located in central Angola, has 36 km2 area and approximately 2 million inhabitants. This work aims to evaluate, by conducting in-situ tests, physical and mechanical properties of adobe blocks typically used in the construction of those buildings. The methodology is based on field campaigns where in-situ expeditious tests were performed in soils (smell test, color, touch, brightness, sedimentation, ball, hardness, etc.) and tests on adobes blocks made with traditional procedures, particularly in terms of durability and erodibility (erosion test at Geelong method; evaluation test of wet / dry cycle, applying the New Zealand standards 4297: 1998; 4297: 1998 and 4297: 1999). The results will contribute to the characterization of the geomaterials and methods used in construction with earth in Huambo Province, contributing to the improvement of these sustainable solutions, with a strong presence in this region. The results of this study will also contribute to the proposal of constructive solutions with improved performance characteristics, comfort, safety and durability.

Los diseños de método mixto en la investigación en educación: Una experiencia concreta

Recibido 14 de octubre de 2010 • Aceptado 09 de marzo de 2011 • Corregido 02 de junio de 2011  La utilización de los diseños de método mixto se constituyen, día a día, en una excelente alternativa para abordar temáticas de investigación en el campo educativo. Este ensayo plantea una revisión acerca de dichos diseños y los ejemplifica con una experiencia concreta de investigación realizada por la propia autora, en la que fue aplicado un diseño de método mixto para una temática en el campo educativo.

Equità di genere e pratiche trasformative in educazione fisica

A partire da un paradigma ecologico ad indirizzo critico, seguendo il filone degli studi femministi, le finalità della ricerca sono state: smascherare le forme di oppressione di genere nei contesti educativi (finalità trasformativa) e produrre un sapere utile alla pratica (finalità emancipativa). Data la complessità del contesto educativo scolastico e dell’argomento stesso che interseca vari domini di sapere, è stato adottato un approccio metodologico di metodo misto (mixed method) per poter dapprima costruire una configurazione del fenomeno oggetto d’interesse attraverso strumenti quantitativi e poi approfondirlo attraverso l’impiego di tecniche qualitative. Gli strumenti utilizzati sono stati: il questionario, l’intervista strutturata, le osservazioni, le biografie professionali, i focus-group. In sintesi, le evidenze emerse in letteratura ed empiriche mettono in luce la presenza di stereotipi di genere nelle lezioni di EF, sotto forma di pratiche inconsapevoli che gli insegnanti riproducono a seguito di un habitus socializzato in forma binaria secondo i due sessi e gerarchizzato. La dipendenza dell’EF dal mondo sportivo, dove gli stereotipi di genere sono presenti per ragioni storico-culturali e dal quale gli insegnanti attingono spesso parte del loro sapere professionale, li rende partecipi inconsapevoli del sistema di rinforzo degli stereotipi stessi, attraverso le pratiche che vanno sotto il nome di curricolo nascosto. Il termine nascosto sottolinea l’inconsapevolezza di tali pratiche, appunto nascoste alla coscienza e si deduce che la possibilità di svelarle necessita di una formazione specifica per gli insegnanti, una formazione che attinga ai processi riflessivi.

Italian higher education students’ perspectives on internationalization at home and their identity as English as lingua franca users

This study aims to explore the Italian students’ perspectives on using English in English-medium instruction (EMI) programs in light of the practices of internationalization at home (IaH) at the University of Bologna (UNIBO) in Italy and further investigates whether these attitudes affect their language identity as English as lingua franca (ELF) users. To serve this aim, a mixed-method approach was adopted to collect quantitative and in-depth qualitative data in two phases through an online survey and a semi-structured interview. A total number of 78 Italian students participated in the survey, out of which 14 participants were interviewed. The findings of the online survey indicated that most participants (92%) held a positive perspective toward the use of English in EMI programs and the findings from the interviews were in line with the results of the survey. However, the purpose of the interviews was to explore the participants’ views on their language identity as ELF users. Thematic analysis of the interviews revealed that students experience emotional, cognitive, and social transitions in EMI programs in response to their shift from a non-EMI to an EMI academic setting. Overall, all the above-mentioned transitions were positive and could lead to personal development. However, it can be concluded that the EMI context provides few opportunities for the emergence of significant new subject positions mediated by English in this study. The focus on students’ perspectives on the use of English in EMI programs can contribute to the improvement in language policy planning and internationalized curriculum design by policymakers and alleviate tensions over the controversial issue of the Englishization of higher education by considering how EMI students perceive their use of English as ELF users not superior standard English users.

I festival culturali come strumento di creazione di cittadinanza attiva: il caso di Arona Citta Teatro

DOMANDA DI RICERCA La cultura comprende il patrimonio collettivo materiale e immateriale, sia come frutto di pensiero e speculazione, sia come insieme di pratiche, compresi i festival. Con la loro ritualità e creazione di identità collettiva, i festival culturali hanno un impatto sociale, culturale ed economico sul territorio e sui cittadini coinvolti. Ma in che modo festival culturali, seppur con la loro temporaneità, contribuiscono alla creazione di cittadinanza attiva? TEORIE DI RIFERIMENTO La ricerca si inserisce nella crescente attenzione ai festival culturali nell'ambito degli Event Studies che approfondiscono le questioni relative a eventi e manifestazioni, compresi i festival. Allo scopo di comprendere se i festival siano dispositivi della crescita del benessere del territorio, si calerà il dibattito all’interno delle riflessioni sui temi dell’audience development e del welfare culturale. METODOLOGIA Il festival caso studio per la ricerca, seguendo alcuni criteri selettivi, è stato individuato come Teatro sull'Acqua, festival nato ad Arona nel 2011 diretto da Dacia Maraini. Il caso studio è stato analizzato in oltre un anno di osservazione (aprile 2021 - settembre 2022), con un approccio mixed method, combinano ricerca qualitativa e quantitativa, ovvero si sono effettuate l’osservazione partecipante; interviste semi-strutturata; quattro questionari. RISULTATI Tra i risultati raggiunti c'è l'individuazione delle tipologie di audience del festival analizzato. Il campione di riferimento restituisce l'immagine di un pubblico prevalentemente femminile, maturo, con un alto livello di istruzione, locale e appartenente a un ceto medio. Un pubblico fidelizzato e fortemente partecipe alle pratiche culturali, per i quali il festival diventa un momento relazione, di condivisione esperienziale e sociale. Il festival ha un forte impatto sulla comunità e ha avvicinato a materie culturali prima sconosciuti, incentivando la fruizione a nuove attività culturali.

Crack propagation in non-homogenous materials: Evaluation of mixed-mode SIFs, T-stress and kinking angle using a variant EFG method

A new variant of the Element-Free Galerkin (EFG) method, that combines the diffraction method, to characterize the crack tip solution, and the Heaviside enrichment function for representing discontinuity due to a crack, has been used to model crack propagation through non-homogenous materials. In the case of interface crack propagation, the kink angle is predicted by applying the maximum tangential principal stress (MTPS) criterion in conjunction with consideration of the energy release rate (ERR). The MTPS criterion is applied to the crack tip stress field described by both the stress intensity factor (SIF) and the T-stress, which are extracted using the interaction integral method. The proposed EFG method has been developed and applied for 2D case studies involving a crack in an orthotropic material, crack along an interface and a crack terminating at a bi-material interface, under mechanical or thermal loading; this is done to demonstrate the advantages and efficiency of the proposed methodology. The computed SIFs, T-stress and the predicted interface crack kink angles are compared with existing results in the literature and are found to be in good agreement. An example of crack growth through a particle-reinforced composite materials, which may involve crack meandering around the particle, is reported.

In-house ELISA method to analyze anti-Trypanosoma cruzi IgG reactivity for differential diagnosis and evaluation of Chagas disease morbidity

INTRODUCTION: The goal was to develop an in-house serological method with high specificity and sensitivity for diagnosis and monitoring of Chagas disease morbidity. METHODS: With this purpose, the reactivities of anti-T. cruzi IgG and subclasses were tested in successive serum dilutions of patients from Berilo municipality, Jequitinhonha Valley, Minas Gerais, Brazil. The performance of the in-house ELISA was also evaluated in samples from other relevant infectious diseases, including HIV, hepatitis C (HCV), syphilis (SYP), visceral leishmaniasis (VL), and American tegumentary leishmaniasis (ATL), and noninfected controls (NI). Further analysis was performed to evaluate the applicability of this in-house methodology for monitoring Chagas disease morbidity into three groups of patients: indeterminate (IND), cardiac (CARD), and digestive/mixed (DIG/Mix), based on their clinical status. RESULTS: The analysis of total IgG reactivity at serum dilution 1:40 was an excellent approach to Chagas disease diagnosis (100% sensitivity and specificity). The analysis of IgG subclasses showed cross-reactivity, mainly with NI, VL, and ATL, at all selected serum dilutions. Based on the data analysis, the IND group displayed higher IgG3 levels and the DIG/Mix group presented higher levels of total IgG as compared with the IND and CARD groups. CONCLUSIONS: These findings demonstrated that methodology presents promising applicability in the analysis of anti-T. cruzi IgG reactivity for the differential diagnosis and evaluation of Chagas disease morbidity.

Evaluation of email alerts in practice: Part 2. Validation of the information assessment method.

RATIONALE AND OBJECTIVE:. The information assessment method (IAM) permits health professionals to systematically document the relevance, cognitive impact, use and health outcomes of information objects delivered by or retrieved from electronic knowledge resources. The companion review paper (Part 1) critically examined the literature, and proposed a 'Push-Pull-Acquisition-Cognition-Application' evaluation framework, which is operationalized by IAM. The purpose of the present paper (Part 2) is to examine the content validity of the IAM cognitive checklist when linked to email alerts. METHODS: A qualitative component of a mixed methods study was conducted with 46 doctors reading and rating research-based synopses sent on email. The unit of analysis was a doctor's explanation of a rating of one item regarding one synopsis. Interviews with participants provided 253 units that were analysed to assess concordance with item definitions. RESULTS AND CONCLUSION: The content relevance of seven items was supported. For three items, revisions were needed. Interviews suggested one new item. This study has yielded a 2008 version of IAM.

Accuracy and efficiency evaluation of point-centered quarter method variations for vegetation sampling in an araucaria forest

In order to verify Point-Centered Quarter Method (PCQM) accuracy and efficiency, using different numbers of individuals by per sampled area, in 28 quarter points in an Araucaria forest, southern Paraná, Brazil. Three variations of the PCQM were used for comparison associated to the number of sampled individual trees: standard PCQM (SD-PCQM), with four sampled individuals by point (one in each quarter), second measured (VAR1-PCQM), with eight sampled individuals by point (two in each quarter), and third measuring (VAR2-PCQM), with 16 sampled individuals by points (four in each quarter). Thirty-one species of trees were recorded by the SD-PCQM method, 48 by VAR1-PCQM and 60 by VAR2-PCQM. The level of exhaustiveness of the vegetation census and diversity index showed an increasing number of individuals considered by quadrant, indicating that VAR2-PCQM was the most accurate and efficient method when compared with VAR1-PCQM and SD-PCQM.

Statistical evaluation of texture analysis from the biocrystallization method

The consumers are becoming more concerned about food quality, especially regarding how, when and where the foods are produced (Haglund et al., 1999; Kahl et al., 2004; Alföldi, et al., 2006). Therefore, during recent years there has been a growing interest in the methods for food quality assessment, especially in the picture-development methods as a complement to traditional chemical analysis of single compounds (Kahl et al., 2006). The biocrystallization as one of the picture-developing method is based on the crystallographic phenomenon that when crystallizing aqueous solutions of dihydrate CuCl2 with adding of organic solutions, originating, e.g., from crop samples, biocrystallograms are generated with reproducible crystal patterns (Kleber & Steinike-Hartung, 1959). Its output is a crystal pattern on glass plates from which different variables (numbers) can be calculated by using image analysis. However, there is a lack of a standardized evaluation method to quantify the morphological features of the biocrystallogram image. Therefore, the main sakes of this research are (1) to optimize an existing statistical model in order to describe all the effects that contribute to the experiment, (2) to investigate the effect of image parameters on the texture analysis of the biocrystallogram images, i.e., region of interest (ROI), color transformation and histogram matching on samples from the project 020E170/F financed by the Federal Ministry of Food, Agriculture and Consumer Protection(BMELV).The samples are wheat and carrots from controlled field and farm trials, (3) to consider the strongest effect of texture parameter with the visual evaluation criteria that have been developed by a group of researcher (University of Kassel, Germany; Louis Bolk Institute (LBI), Netherlands and Biodynamic Research Association Denmark (BRAD), Denmark) in order to clarify how the relation of the texture parameter and visual characteristics on an image is. The refined statistical model was accomplished by using a lme model with repeated measurements via crossed effects, programmed in R (version 2.1.0). The validity of the F and P values is checked against the SAS program. While getting from the ANOVA the same F values, the P values are bigger in R because of the more conservative approach. The refined model is calculating more significant P values. The optimization of the image analysis is dealing with the following parameters: ROI(Region of Interest which is the area around the geometrical center), color transformation (calculation of the 1 dimensional gray level value out of the three dimensional color information of the scanned picture, which is necessary for the texture analysis), histogram matching (normalization of the histogram of the picture to enhance the contrast and to minimize the errors from lighting conditions). The samples were wheat from DOC trial with 4 field replicates for the years 2003 and 2005, “market samples”(organic and conventional neighbors with the same variety) for 2004 and 2005, carrot where the samples were obtained from the University of Kassel (2 varieties, 2 nitrogen treatments) for the years 2004, 2005, 2006 and “market samples” of carrot for the years 2004 and 2005. The criterion for the optimization was repeatability of the differentiation of the samples over the different harvest(years). For different samples different ROIs were found, which reflect the different pictures. The best color transformation that shows efficiently differentiation is relied on gray scale, i.e., equal color transformation. The second dimension of the color transformation only appeared in some years for the effect of color wavelength(hue) for carrot treated with different nitrate fertilizer levels. The best histogram matching is the Gaussian distribution. The approach was to find a connection between the variables from textural image analysis with the different visual criteria. The relation between the texture parameters and visual evaluation criteria was limited to the carrot samples, especially, as it could be well differentiated by the texture analysis. It was possible to connect groups of variables of the texture analysis with groups of criteria from the visual evaluation. These selected variables were able to differentiate the samples but not able to classify the samples according to the treatment. Contrarily, in case of visual criteria which describe the picture as a whole there is a classification in 80% of the sample cases possible. Herewith, it clearly can find the limits of the single variable approach of the image analysis (texture analysis).

A method for estimating the turbulent kinetic energy dissipation rate from a vertically pointing Doppler lidar, and independent evaluation from balloon-borne in situ measurements

A method of estimating dissipation rates from a vertically pointing Doppler lidar with high temporal and spatial resolution has been evaluated by comparison with independent measurements derived from a balloon-borne sonic anemometer. This method utilizes the variance of the mean Doppler velocity from a number of sequential samples and requires an estimate of the horizontal wind speed. The noise contribution to the variance can be estimated from the observed signal-to-noise ratio and removed where appropriate. The relative size of the noise variance to the observed variance provides a measure of the confidence in the retrieval. Comparison with in situ dissipation rates derived from the balloon-borne sonic anemometer reveal that this particular Doppler lidar is capable of retrieving dissipation rates over a range of at least three orders of magnitude. This method is most suitable for retrieval of dissipation rates within the convective well-mixed boundary layer where the scales of motion that the Doppler lidar probes remain well within the inertial subrange. Caution must be applied when estimating dissipation rates in more quiescent conditions. For the particular Doppler lidar described here, the selection of suitably short integration times will permit this method to be applicable in such situations but at the expense of accuracy in the Doppler velocity estimates. The two case studies presented here suggest that, with profiles every 4 s, reliable estimates of ϵ can be derived to within at least an order of magnitude throughout almost all of the lowest 2 km and, in the convective boundary layer, to within 50%. Increasing the integration time for individual profiles to 30 s can improve the accuracy substantially but potentially confines retrievals to within the convective boundary layer. Therefore, optimization of certain instrument parameters may be required for specific implementations.

A design of evaluation method for SaaS in cloud computing

Purpose: This paper aims to design an evaluation method that enables an organization to assess its current IT landscape and provide readiness assessment prior to Software as a Service (SaaS) adoption. Design/methodology/approach: The research employs a mixed of quantitative and qualitative approaches for conducting an IT application assessment. Quantitative data such as end user’s feedback on the IT applications contribute to the technical impact on efficiency and productivity. Qualitative data such as business domain, business services and IT application cost drivers are used to determine the business value of the IT applications in an organization. Findings: The assessment of IT applications leads to decisions on suitability of each IT application that can be migrated to cloud environment. Research limitations/implications: The evaluation of how a particular IT application impacts on a business service is done based on the logical interpretation. Data mining method is suggested in order to derive the patterns of the IT application capabilities. Practical implications: This method has been applied in a local council in UK. This helps the council to decide the future status of the IT applications for cost saving purpose.

Alveolar Bone Morphology in Patients With Bilateral Complete Cleft Lip and Palate in the Mixed Dentition: Cone Beam Computed Tomography Evaluation

Objectives: To verify the thickness and level of alveolar bone around the teeth adjacent to the cleft by means of cone beam computed tomography (CBCT) in patients with complete bilateral cleft lip and palate prior to bone graft surgery and orthodontic intervention. Method: The sample comprised 10 patients with complete bilateral cleft lip and palate (five boys and five girls) in the mixed dentition. The mean age was 9.5 years, and all subjects showed a G3 interarch relationship according to the Bauru index. The thickness of alveolar bone surrounding the maxillary incisors and the maxillary canines was measured in CBCT axial section using the software iCAT Xoran System. The distance between the alveolar bone crest and the cement-enamel junction (CEJ) was measured in cross sections. Results: The tomography images showed a thin alveolar bone plate around teeth adjacent to clefts. No bone dehiscence was observed in teeth adjacent to clefts during the mixed dentition. A slight increase in the distance between the alveolar bone crest and the CEJ was observed in the mesial and lingual aspects of canines adjacent to cleft. Conclusion: In patients with BCLP in the mixed dentition, teeth adjacent to the alveolar cleft are covered by a thin alveolar bone plate. However, the level of alveolar bone crest around these teeth seems to be normal, and no bone dehiscence was identified at this age.