Convergences and divergences of diabetic patients' and healthcare professionals' opinions of care : a qualitative study

OBJECTIVES: To investigate opinions' convergences and divergences of diabetic patients and health-care professionals on diabetes care and the development of a regional diabetes programme. BACKGROUND: Development and implementation of a regional diabetes programme. RESEARCH DESIGN: Qualitative study using focus groups to elicit diabetic patients' and health-care professionals' opinions, followed by content analysis. SETTING AND PARTICIPANTS: Eight focus groups: four focus groups with diabetic patients (n = 39) and four focus groups with various health-care professionals (n = 34) residing or practicing in the canton of Vaud, Switzerland, respectively. RESULTS: Perceived quality of diabetes care varied between individuals and types of participants. To improve quality, patients favoured a comprehensive follow-up while professionals suggested considering existing structures and trained professionals. All participants mentioned communication difficulties between professionals and were favouring teamwork. In addition, they described the role that patients should have in care and self-management. Financial difficulties were also mentioned by both groups of participants. Finally, they were in favour of the development of a regional diabetes programme adapted to actors' needs. For patients indeed, such a programme would represent an opportunity to improve information and to have access to comprehensive care. For professionals, it would help the development of local networks and the reinforcement of existing tools and structures. DISCUSSION AND CONCLUSIONS: Acknowledging convergences and divergences of opinions of both diabetic patients and health-care professionals should help the further development of a programme adapted to users' needs, taking all stakeholders interests and priorities into consideration.

Prevalence of victims of violence admitted to an emergency department.

OBJECTIVE: To collect data on the consultation frequency and demographic profile of victims of violence attending an emergency department (ED) in Switzerland. METHODS: We undertook screening of all admitted adult patients (>16 years) in the ED of the CHUV, Lausanne, Switzerland, over a 1 month period, using a modified version of the Partner Violence Screen questionnaire. Exclusionary criteria were: life threatening injury (National Advisory Committee on Aeronautics score > or =4), or inability to understand or speak French, to give oral informed consent, or to be questioned without a family member or accompanying person being present. Data were collected on history of physical and/or psychological violence during the previous 12 months, the type of violence experienced by the patient, and if violence was the reason for the current consultation. Sociodemographic data were obtained from the registration documents. RESULTS: The final sample consisted of 1602 patients (participation rate of 77.2%), with a refusal rate of 1.1%. Violence during the past 12 months was reported by 11.4% of patients. Of the total sample, 25% stated that violence was the reason for the current consultation; of these, 95% of patients were confirmed as victims of violence by the ED physicians. Patients reporting violence were more likely to be young and separated from their partner. Men were more likely to be victims of public violence and women more commonly victims of domestic violence. CONCLUSIONS: Based on this monthly prevalence rate, we estimate that over 3000 adults affected by violence consult our ED per annum. This underlines the importance of the problem and the need to address it. Health services organisations should establish measures to improve quality of care for victims. Guidelines and educational programmes for nurses and physicians should be developed in order to enhance providers' skills and basic knowledge of all types of violence, how to recognise and interact appropriately with victims, and where to refer these patients for follow up care in their local networks.

A service perspective to digital innovation: exploring the emergence of autonomous shipping

Current research describes digital innovation largely similar to product innovation. Digital innovation is seen as an object of coherent activities, however in reality digital innovation results from convergence of variant technologies and those related actors with versatile business goals. To account for the dynamic nature of digital innovation, this study applies a service perspective to digital innovation. The purpose of the study is to understand how digital innovation emerges within a service ecosystem for autonomous shipping. The sub-objectives of this study are to 1) identify what factors motivate and demotivate actors to integrate resources for autonomous shipping, 2) explore the key technology areas to be integrated to realise the autonomous shipping concept, and 3) suggest how the technology areas are combined for mutual value creation within a service eco-system for autonomous shipping. Insights from autonomous driving were also included. This study draws on literatures on service innovation and service-dominant logic. The research was conducted as a qualitative exploratory case study. The data comprise interviews of 18 marine and automotive industry experts, 4 workshops, 4 seminars, and observations as well as various secondary data sources. The findings revealed that the key actors have versatile motivations regarding autonomous shipping. These varied from opportunities for single applications to occupying a central role in an autonomous technology platform. Thus, autonomous shipping can be seen as an umbrella concept comprising multiple levels. In technical terms, the development of the concept of autonomous shipping is largely based on combining existing technology solutions, which are gradually integrated towards more systemic entities comprising areas of the autonomous shipping concept. This study argues that a service perspective embraces the inherently complex and dynamic nature of digital innovation. This is captured in the developed research framework that describes digital innovation emerging on different levels of interaction: 1. strategic relationships for new solutions, 2. new local networks for technology platforms, and 3. global networks for new markets. The framework shows how the business models and motivations of digital innovation actors feed the emergence of digital innovation in overlapping service ecosystems that together comprise an innovation ecosystem for autonomous technologies. Digital innovation managers will benefit from seeing their businesses as part of a larger ecosystem of value co-creating actors. In orchestrating digital innovation within a service ecosystem, it is suggested that managers consider the resources, roles and institutions within the ecosystem. Finally, as autonomous shipping is at its infancy, the topic provides a number of interesting avenues for future research.

Étude du traitement visuel simple et complexe chez les enfants autistes

Les personnes ayant un trouble du spectre autistique (TSA) manifestent des particularités perceptives. En vision, des travaux influents chez les adultes ont mené à l’élaboration d’un modèle explicatif du fonctionnement perceptif autistique qui suggère que l’efficacité du traitement visuel varie en fonction de la complexité des réseaux neuronaux impliqués (Hypothèse spécifique à la complexité). Ainsi, lorsque plusieurs aires corticales sont recrutées pour traiter un stimulus complexe (e.g., modulations de texture; attributs de deuxième ordre), les adultes autistes démontrent une sensibilité diminuée. À l’inverse, lorsque le traitement repose principalement sur le cortex visuel primaire V1 (e.g., modulations locales de luminance; attributs de premier ordre), leur sensibilité est augmentée (matériel statique) ou intacte (matériel dynamique). Cette dissociation de performance est spécifique aux TSA et peut s’expliquer, entre autre, par une connectivité atypique au sein de leur cortex visuel. Les mécanismes neuronaux précis demeurent néanmoins méconnus. De plus, on ignore si cette signature perceptuelle est présente à l’enfance, information cruciale pour les théories perceptives de l’autisme. Le premier volet de cette thèse cherche à vérifier, à l’aide de la psychophysique et l’électrophysiologie, si la double dissociation de performance entre les attributs statiques de premier et deuxième ordre se retrouve également chez les enfants autistes d’âge scolaire. Le second volet vise à évaluer chez les enfants autistes l’intégrité des connexions visuelles descendantes impliquées dans le traitement des textures. À cet effet, une composante électrophysiologique reflétant principalement des processus de rétroaction corticale a été obtenue lors d’une tâche de ségrégation des textures. Les résultats comportementaux obtenus à l’étude 1 révèlent des seuils sensoriels similaires entre les enfants typiques et autistes à l’égard des stimuli définis par des variations de luminance et de texture. Quant aux données électrophysiologiques, il n’y a pas de différence de groupe en ce qui concerne le traitement cérébral associé aux stimuli définis par des variations de luminance. Cependant, contrairement aux enfants typiques, les enfants autistes ne démontrent pas une augmentation systématique d’activité cérébrale en réponse aux stimuli définis par des variations de texture pendant les fenêtres temporelles préférentiellement associées au traitement de deuxième ordre. Ces différences d’activation émergent après 200 ms et engagent les aires visuelles extrastriées des régions occipito-temporales et pariétales. Concernant la connectivité cérébrale, l’étude 2 indique que les connexions visuelles descendantes sont fortement asymétriques chez les enfants autistes, en défaveur de la région occipito-temporale droite. Ceci diffère des enfants typiques pour qui le signal électrophysiologique reflétant l’intégration visuo-corticale est similaire entre l’hémisphère gauche et droit du cerveau. En somme, en accord avec l’hypothèse spécifique à la complexité, la représentation corticale du traitement de deuxième ordre (texture) est atypiquement diminuée chez les enfants autistes, et un des mécanismes cérébraux impliqués est une altération des processus de rétroaction visuelle entre les aires visuelles de haut et bas niveau. En revanche, contrairement aux résultats obtenus chez les adultes, il n’y a aucun indice qui laisse suggérer la présence de mécanismes supérieurs pour le traitement de premier ordre (luminance) chez les enfants autistes.

Congestion probability routing in virtual path ATM network

This dissertation focuses on the problem of providing mechanisms for routing point to point and multipoint connections in ATM networks. In general the notion of multipoint connection refers to connections that involve a group of users with more than two members. The main objective of this dissertation is to contribute to design efficient routing protocols with alterative routes in fully connected VP-based ATM Networks for call establishment of point to point and multipoint VC connections. An efficient route should be computed during this connection establishment phase.

Análise de desempenho experimental de redes IEEE 802.3.

The Ethernet technology dominates the market of computer local networks. However, it was not been established as technology for industrial automation set, where the requirements demand determinism and real-time performance. Many solutions have been proposed to solve the problem of non-determinism, which are based mainly on TDMA (Time Division Multiple Access), Token Passing and Master-Slave. This work of research carries through measured of performance that allows to compare the behavior of the Ethernet nets when submitted with the transmissions of data on protocols UDP and RAW Ethernet, as well as, on three different types of Ethernet technologies. The objective is to identify to the alternative amongst the protocols and analyzed Ethernet technologies that offer to a more satisfactory support the nets of the industrial automation and distributed real-time application

Sismicidade e correlação com feições geológicas: o caso do lineamento Pernambuco e seu entorno

This thesis presents and discusses the results of the various seismic areas in the State of Pernambuco, with the aim of having a vision of regional seismicity and its causes. To the papers published in journals were added two new original works submitted to international journals, dealing with seismic areas located in the counties of São Caetano, Cupira, and Agrestina. All seismic areas mentioned in this thesis are located on the Pernambuco Lineament and its surroundings (both in branches or single faults within 40 km of it). The Pernambuco Lineament is a Neoproterozoic shear zone of continental-scale that deformed the Borborema Province, and presents as branches, shear zones with NE-SW direction. The new submitted papers are from the analysis of data collected by three local networks of stations that operated in the following areas: network SO07 (seismicity in the district of Santa Luzia - São Caetano, 2007), network BM10 (data from seismic areas of Serra Verde ( Cupira) and Barra do Chata (Agrestina), in 2010), network SO10 (seismicity near the urban center of São Caetano in 2010). These data were used for determining the hypocenters and focal mechanisms in order to discuss the relationship between the seismicity and geological features of the area. The new mechanisms obtained, as well as the previously published allowed the determination of the direction of the average stress in the region. The direction of stress in the region involving the various seismic areas, now or previously studied, is quite stable and approximate EW direction (SHmax). The correlation between seismicity and geological features is observed on the lineament and north of it. In the south (Cupira and Agrestina), in seismic areas nearby shear zones NE-SW, there is no correlation and seismogenic EW normal faults are active and its motion is compatible with regional stresses. It is probable that these active faults are more recent than the Neoproterozoic, probably of the Cretaceous period, when the last great movement of the Pernambuco Lineament occurred

Web Services Aplicados à Visualização

With the rapid growth of the use of Web applications in various fields of knowledge, the term Web service enter into evidence in the current scenario, which refers to services from different origins and purpose, offered through local networks and also available in some cases, on the Internet. The architecture of this type of application offers data processing on server side thereby, running applications and complex and slow processes is very interesting, which is the case with most algorithms involving visualization. The VTK is a library intended for visualization, and features a large variety of methods and algorithms for this purpose, but with a graphics engine that requires processing capacity. The union of these two resources can bring interesting results and contribute for performance improvements in the VTK library. This study is discussed in this project, through testing and communication overhead analysis

Calcolo della posizione di reti di stazioni permanenti

Con il trascorrere del tempo, le reti di stazioni permanenti GNSS (Global Navigation Satellite System) divengono sempre più un valido supporto alle tecniche di rilevamento satellitare. Esse sono al tempo stesso un’efficace materializzazione del sistema di riferimento e un utile ausilio ad applicazioni di rilevamento topografico e di monitoraggio per il controllo di deformazioni. Alle ormai classiche applicazioni statiche in post-processamento, si affiancano le misure in tempo reale sempre più utilizzate e richieste dall’utenza professionale. In tutti i casi risulta molto importante la determinazione di coordinate precise per le stazioni permanenti, al punto che si è deciso di effettuarla tramite differenti ambienti di calcolo. Sono stati confrontati il Bernese, il Gamit (che condividono l’approccio differenziato) e il Gipsy (che utilizza l’approccio indifferenziato). L’uso di tre software ha reso indispensabile l’individuazione di una strategia di calcolo comune in grado di garantire che, i dati ancillari e i parametri fisici adottati, non costituiscano fonte di diversificazione tra le soluzioni ottenute. L’analisi di reti di dimensioni nazionali oppure di reti locali per lunghi intervalli di tempo, comporta il processamento di migliaia se non decine di migliaia di file; a ciò si aggiunge che, talora a causa di banali errori, oppure al fine di elaborare test scientifici, spesso risulta necessario reiterare le elaborazioni. Molte risorse sono quindi state investite nella messa a punto di procedure automatiche finalizzate, da un lato alla preparazione degli archivi e dall’altro all’analisi dei risultati e al loro confronto qualora si sia in possesso di più soluzioni. Dette procedure sono state sviluppate elaborando i dataset più significativi messi a disposizione del DISTART (Dipartimento di Ingegneria delle Strutture, dei Trasporti, delle Acque, del Rilevamento del Territorio - Università di Bologna). E’ stato così possibile, al tempo stesso, calcolare la posizione delle stazioni permanenti di alcune importanti reti locali e nazionali e confrontare taluni fra i più importanti codici scientifici che assolvono a tale funzione. Per quanto attiene il confronto fra i diversi software si è verificato che: • le soluzioni ottenute dal Bernese e da Gamit (i due software differenziati) sono sempre in perfetto accordo; • le soluzioni Gipsy (che utilizza il metodo indifferenziato) risultano, quasi sempre, leggermente più disperse rispetto a quelle degli altri software e mostrano talvolta delle apprezzabili differenze numeriche rispetto alle altre soluzioni, soprattutto per quanto attiene la coordinata Est; le differenze sono però contenute in pochi millimetri e le rette che descrivono i trend sono comunque praticamente parallele a quelle degli altri due codici; • il citato bias in Est tra Gipsy e le soluzioni differenziate, è più evidente in presenza di determinate combinazioni Antenna/Radome e sembra essere legato all’uso delle calibrazioni assolute da parte dei diversi software. E’ necessario altresì considerare che Gipsy è sensibilmente più veloce dei codici differenziati e soprattutto che, con la procedura indifferenziata, il file di ciascuna stazione di ciascun giorno, viene elaborato indipendentemente dagli altri, con evidente maggior elasticità di gestione: se si individua un errore strumentale su di una singola stazione o se si decide di aggiungere o togliere una stazione dalla rete, non risulta necessario il ricalcolo dell’intera rete. Insieme alle altre reti è stato possibile analizzare la Rete Dinamica Nazionale (RDN), non solo i 28 giorni che hanno dato luogo alla sua prima definizione, bensì anche ulteriori quattro intervalli temporali di 28 giorni, intercalati di sei mesi e che coprono quindi un intervallo temporale complessivo pari a due anni. Si è così potuto verificare che la RDN può essere utilizzata per l’inserimento in ITRF05 (International Terrestrial Reference Frame) di una qualsiasi rete regionale italiana nonostante l’intervallo temporale ancora limitato. Da un lato sono state stimate le velocità ITRF (puramente indicative e non ufficiali) delle stazioni RDN e, dall’altro, è stata effettuata una prova di inquadramento di una rete regionale in ITRF, tramite RDN, e si è verificato che non si hanno differenze apprezzabili rispetto all’inquadramento in ITRF, tramite un congruo numero di stazioni IGS/EUREF (International GNSS Service / European REference Frame, SubCommission for Europe dello International Association of Geodesy).

Culture's Calling: Mobile Phones, Gender, and the Making of an African Migrant Village in Lisbon

In this article, I explore how immigrants from the West African nation of Guinea-Bissau living in Portugal use mobile phones in their daily lives in Lisbon. Whereas one might assume that mobile phones and other new information technologies facilitate transnational communication between Africa and Portugal, the ethnographic fieldwork that I conducted in Lisbon from 1999 to 2003 revealed a different scenario. Instead, mobile phones as imagined and used by the Guinean immigrants I met in Lisbon revealed less about transnationalism and globalization than they did about constructing community and identity in a new locale. As Guinean immigrants in Portugal reconfigured their relationship to their former colonizers and struggled to make their way in a new, multicultural Europe, they used their mobile phones to engage local networks, shape local identities, and transform Lisbon's sprawl into an African migrant village. Here, I highlight the gendered dimensions of this process and contend that Guinean men's and women's varied uses of mobile phones in Lisbon underscore contrasting experiences of migration, mobility, and belonging.

Culture's Calling: Mobile Phones, Gender, and the Making of an African Migrant Village in Lisbon

In this article, I explore how immigrants from the West African nation of Guinea-Bissau living in Portugal use mobile phones in their daily lives in Lisbon. Whereas one might assume that mobile phones and other new information technologies facilitate transnational communication between Africa and Portugal, the ethnographic fieldwork that I conducted in Lisbon from 1999 to 2003 revealed a different scenario. Instead, mobile phones as imagined and used by the Guinean immigrants I met in Lisbon revealed less about transnationalism and globalization than they did about constructing community and identity in a new locale. As Guinean immigrants in Portugal reconfigured their relationship to their former colonizers and struggled to make their way in a new, multicultural Europe, they used their mobile phones to engage local networks, shape local identities, and transform Lisbon's sprawl into an African migrant village. Here, I highlight the gendered dimensions of this process and contend that Guinean men's and women's varied uses of mobile phones in Lisbon underscore contrasting experiences of migration, mobility, and belonging.

Las mediaciones locales de la protesta. El caso del Trelewazo (octubre de 1972)

El trabajo se propone la reconstrucción y el análisis de la movilización popular conocida como el Trelewazo, prestando especial atención a las mediaciones y redes locales que le dieron forma y sentidos específicos. Consideramos que la dimensión local en el análisis de las movilizaciones populares de los años setenta, especialmente en el caso de aquellas conocidas como puebladas o azos, resulta de fundamental importancia no sólo para una mejor comprensión de estas protestas en sí mismas, sino también para avanzar en el análisis de los mecanismos que articularon y resignificaron procesos de carácter general, como la radicalización política y el creciente autoritarismo de la Revolución Argentina, con la vida cotidiana de los habitantes de las distintas regiones del país.

Las mediaciones locales de la protesta. El caso del Trelewazo (octubre de 1972)

El trabajo se propone la reconstrucción y el análisis de la movilización popular conocida como el Trelewazo, prestando especial atención a las mediaciones y redes locales que le dieron forma y sentidos específicos. Consideramos que la dimensión local en el análisis de las movilizaciones populares de los años setenta, especialmente en el caso de aquellas conocidas como puebladas o azos, resulta de fundamental importancia no sólo para una mejor comprensión de estas protestas en sí mismas, sino también para avanzar en el análisis de los mecanismos que articularon y resignificaron procesos de carácter general, como la radicalización política y el creciente autoritarismo de la Revolución Argentina, con la vida cotidiana de los habitantes de las distintas regiones del país.

Las mediaciones locales de la protesta. El caso del Trelewazo (octubre de 1972)

El trabajo se propone la reconstrucción y el análisis de la movilización popular conocida como el Trelewazo, prestando especial atención a las mediaciones y redes locales que le dieron forma y sentidos específicos. Consideramos que la dimensión local en el análisis de las movilizaciones populares de los años setenta, especialmente en el caso de aquellas conocidas como puebladas o azos, resulta de fundamental importancia no sólo para una mejor comprensión de estas protestas en sí mismas, sino también para avanzar en el análisis de los mecanismos que articularon y resignificaron procesos de carácter general, como la radicalización política y el creciente autoritarismo de la Revolución Argentina, con la vida cotidiana de los habitantes de las distintas regiones del país.