Les modifications de la relation médecin/patient au contact de la télématique médicale: quelques réflexions à battons rompus

La relation entre un médecin et son patient a grandement évolué. Aujourd’hui le médecin, loin de jouer le rôle paternaliste d’autrefois, se voit obligé d’établir un dialogue avec son patient. Des informations sont transmises de l’un à l’autre et de l’autre à l’un, le tout dans une optique de cogestion de la santé du patient. D’un côté le patient doit fournir au médecin les informations suffisantes pour que celui-ci établisse un diagnostic. D’un autre côté le médecin doit informer le patient de son état de santé et des mesures qu’il compte prendre. Dans la foulée du développement des nouvelles technologies, les modes de transmission de telles informations présentent de nouvelles problématiques. L’auteur propose ici une étude de la relation patient/médecin lorsqu’il s’agit de la transmission de données relatives à l’état de santé par Internet ou un réseau privé et du rôle de chacune des parties dans ce réseau en regard de la Directive 95/46/CE. Il ressort de cette étude que le médecin se voit imposer certaines responsabilités à titre de responsable du traitement, notamment en ce qui concerne le traitement des données personnelles de son patient. Ce dernier, en tant que personne concernée au sens de la Directive, se voit donc octroyer des droits fondamentaux en matière de confidentialité. De plus il détermine, en collaboration avec le médecin, les finalités du traitement de ces données personnelles.

Intervention éducative visant le transfert des résultats probants par les infirmières dans la pratique du contact peau à peau en post-partum immédiat

Rapport de stage présenté à la Faculté des sciences infirmières en vue de l’obtention du grade de Maître ès sciences (M. Sc.) en sciences infirmières option formation en sciences infirmières

Le contact des policiers avec les citoyens : les perceptions de jeunes hommes noirs de la ville de Montréal

Les relations entre les policiers et les citoyens issus des communautés culturelles représentent un enjeu de taille pour le Service de Police de la Ville de Montréal (SPVM). En effet, les relations entre les policiers et les minorités ethniques sont au centre de débats et de consultations depuis plusieurs décennies. Force est de constater qu’encore aujourd’hui des tensions demeurent. Plusieurs recherches se sont penchées sur les perceptions des citoyens de leur service de police, mais peu se sont intéressées aux perceptions détaillées des jeunes hommes noirs. Il est pourtant démontré que ce groupe entretient les perceptions les moins favorables envers les policiers et que, par ailleurs, ils sont plus susceptibles d’avoir des contacts avec les policiers. Les perceptions pouvant avoir une réelle influence sur la réponse au contact policier, il appert qu'il est primordial de comprendre l’origine de ces perceptions. Ainsi, ce mémoire vise à identifier les éléments formateurs des perceptions de jeunes hommes noirs de la ville de Montréal âgés de 18 à 25 ans. Pour ce faire, l’approche qualitative a été retenue et des entretiens de type semi-directifs ont été effectués. L’analyse du discours des participants révèle principalement que les interactions personnelles avec les policiers forment les perceptions et/ou renforcent des perceptions déjà existantes. De plus, l’approche de l’agent de police lors de ce contact est mainte fois soulignée par les jeunes lors des entretiens réalisés démontrant que les premiers instants d’une interaction suffisent à l’instauration d’une perception positive ou négative. Il ressort aussi de l’étude que les expériences indirectes ont un impact certain dans la formation des perceptions surtout lorsque ces expériences ont été vécues par un proche. Ces expériences indirectes s’inscrivent d’ailleurs dans un contexte où l’appartenance culturelle du jeune et une certaine culture de quartier tendent à dicter ce que les jeunes se doivent de penser de l’organisation policière. De plus, une méconnaissance des enjeux sous-jacents aux perceptions de ces jeunes hommes par les corps policiers paraît être un obstacle à la mise en place d’interventions efficaces et significatives auprès de cette population.

The Use of Carboxy Terminated Liquid Natural Rubber (CTNR) as an Adhesive in Bonding Rubber to Rigid and Non-rigid Substrates

Carboxy Terminated Liquid Natural Rubber (CTNR) was prepared by photochemical reaction using maleic anhydride and masticated natural rubber (NR). The use of CTNR as an adhesive in bonding rubber to rubber and rubber to metal was studied. The peel strengths and lap shear strengths of the adherends which were bonded using CTNR were determined. The effect of using a tri isocyanate with CTNR in rubber to metal bonding was also studied. It is found that CTNR can effectively be used in bonding rubber to rubber and rubber to mild steel.

Phase modulation of microwave signals using point contact Germanium signal diodes

A forward - biased point contact germanium signal diode placed inside a waveguide section along the E -vector is found to introduce significant phase shift of microwave signals . The usefulness of the arrangement as a phase modulator for microwave carriers is demonstrated. While there is a less significant amplitude modulation accompanying phase modulation , the insertion losses are found to be negligible. The observations can be explained on the basis of the capacitance variation of the barrier layer with forward current in the diode

Photothermal Investigations on Certain Plasma Polymerized Thin Films and Near IR Overtone Studies of Some Organic Molecules

Photothermal effect refers to heating of a sample due to the absorption of electromagnetic radiation. Photothermal (PT) heat generation which is an example of energy conversion has in general three kinds of applications. 1. PT material probing 2. PT material processing and 3. PT material destruction. The temperatures involved increases from 1-. 3. Of the above three, PT material probing is the most important in making significant contribution to the field of science and technology. Photothermal material characterization relies on high sensitivity detection techniques to monitor the effects caused by PT material heating of a sample. Photothermal method is a powerful high sensitivity non-contact tool used for non-destructive thermal characterization of materials. The high sensitivity of the photothermal methods has led to its application for analysis of low absorbance samples. Laser calorimetry, photothermal radiometry, pyroelectric technique, photoacoustic technique, photothermal beam deflection technique, etc. come under the broad class ofphotothermal techniques. However the choice of a suitable technique depends upon the nature of the sample, purpose of measurement, nature of light source used, etc. The present investigations are done on polymer thin films employing photothermal beam deflection technique, for the successful determination of their thermal diffusivity. Here the sample is excited by a He-Ne laser (A = 6328...\ ) which acts as the pump beam. Due to the refractive index gradient established in the sample surface and in the adjacent coupling medium, another optical beam called probe beam (diode laser, A= 6500A ) when passed through this region experiences a deflection and is detected using a position sensitive detector and its output is fed to a lock-in amplifier from which the amplitude and phase of the deflection can be directly obtained. The amplitude and phase of the signal is suitably analysed for determining the thermal diffusivity.The production of polymer thin film samples has gained considerable attention for the past few years. Plasma polymerization is an inexpensive tool for fabricating organic thin films. It refers to formation of polymeric materials under the influence of plasma, which is generated by some kind of electric discharge. Here plasma of the monomer vapour is generated by employing radio frequency (MHz) techniques. Plasma polymerization technique results in homogeneous, highly adhesive, thermally stable, pinhole free, dielectric, highly branched and cross-linked polymer films. The possible linkage in the formation of the polymers is suggested by comparing the FTIR spectra of the monomer and the polymer.Near IR overtone investigations on some organic molecules using local mode model are also done. Higher vibrational overtones often provide spectral simplification and greater resolution of peaks corresponding to nonequivalent X-H bonds where X is typically C, N or O. Vibrational overtone spectroscopy of molecules containing X-H oscillators is now a well established tool for molecular investigations. Conformational and steric differences between bonds and structural inequivalence ofCH bonds (methyl, aryl, acetylenic, etc.) are resolvable in the higher overtone spectra. The local mode model in which the X-H oscillators are considered to be loosely coupled anharmonic oscillators has been widely used for the interpretation of overtone spectra. If we are exciting a single local oscillator from the vibrational ground state to the vibrational state v, then the transition energy of the local mode overtone is given by .:lE a......v = A v + B v2 • A plot of .:lE / v versus v will yield A, the local mode frequency as the intercept and B, the local mode diagonal anharmonicity as the slope. Here A - B gives the mechanical frequency XI of the oscillator and B = X2 is the anharmonicity of the bond. The local mode parameters XI and X2 vary for non-equivalent X-H bonds and are sensitive to the inter and intra molecular environment of the X-H oscillator.

Novel adhesive systems based on neoprene-phenolic blends

The aim of the investigation is to develop new high performance adhesive systems based on neoprene-phenolic blends. Initially the effect of addition of all possible ingredients like fillers, adhesion promoters, curing agents and their optimum compositions to neoprene solution is investigated. The phenolic resin used is a copolymer of phenol-cardanolformaldehyde prepared in the laboratory. The optimum ratio between phenol and cardanol that gives the maximum bond strength in metal-metal, rubber-rubber and rubber-metal specimens has been identified. Further the ratio between total phenols and formaldehyde is also optimised. The above adhesive system is further modified by the addition of epoxidized phenolic novolacs. For this purpose, phenolic novolac resins are prepared in different stoichiometric ratios and are subsequently epoxidized. The effectiveness of the adhesive for bonding different metal and rubber substrates is another part of the study. To study the ageing behaviour, different bonded specimens are exposed to high temperature, hot water and salt water and adhesive properties have been evaluated. The synthesized resins have been characterized by FTIR , HNMR spectroscopy. The molecular weights of the resins have been obtained by GPC. Thermogravimetric analysis and differential scanning calorimetry are used to study the thermal properties. The fractured surface analysis is studied by scanning electron microscopy. The study has brought to light the influence of phenol/ formaldehyde stoichiometric ratio, addition of cardanol (a renewable resource), adhesion promoters and suitability of the adhesive for different substrates and the age resistance of adhesive joints among other things.

Contact potential induced enhancement of magnetization in polyaniline coated nanomagnetic iron oxides by plasma polymerization

The present work derives motivation from the so called surface/interfacial magnetism in core shell structures and commercial samples of Fe3O4 and c Fe2O3 with sizes ranging from 20 to 30 nm were coated with polyaniline using plasma polymerization and studied. The High Resolution Transmission Electron Microscopy images indicate a core shell structure after polyaniline coating and exhibited an increase in saturation magnetization by 2 emu/g. For confirmation, plasma polymerization was performed on maghemite nanoparticles which also exhibited an increase in saturation magnetization. This enhanced magnetization is rather surprising and the reason is found to be an interfacial phenomenon resulting from a contact potential.

Contact Sensing: A Sequential Decision Approach to Sensing Manipulation Contact

This paper describes a new statistical, model-based approach to building a contact state observer. The observer uses measurements of the contact force and position, and prior information about the task encoded in a graph, to determine the current location of the robot in the task configuration space. Each node represents what the measurements will look like in a small region of configuration space by storing a predictive, statistical, measurement model. This approach assumes that the measurements are statistically block independent conditioned on knowledge of the model, which is a fairly good model of the actual process. Arcs in the graph represent possible transitions between models. Beam Viterbi search is used to match measurement history against possible paths through the model graph in order to estimate the most likely path for the robot. The resulting approach provides a new decision process that can be use as an observer for event driven manipulation programming. The decision procedure is significantly more robust than simple threshold decisions because the measurement history is used to make decisions. The approach can be used to enhance the capabilities of autonomous assembly machines and in quality control applications.

From First Contact to Close Encounters: A Developmentally Deep Perceptual System for a Humanoid Robot

This thesis presents a perceptual system for a humanoid robot that integrates abilities such as object localization and recognition with the deeper developmental machinery required to forge those competences out of raw physical experiences. It shows that a robotic platform can build up and maintain a system for object localization, segmentation, and recognition, starting from very little. What the robot starts with is a direct solution to achieving figure/ground separation: it simply 'pokes around' in a region of visual ambiguity and watches what happens. If the arm passes through an area, that area is recognized as free space. If the arm collides with an object, causing it to move, the robot can use that motion to segment the object from the background. Once the robot can acquire reliable segmented views of objects, it learns from them, and from then on recognizes and segments those objects without further contact. Both low-level and high-level visual features can also be learned in this way, and examples are presented for both: orientation detection and affordance recognition, respectively. The motivation for this work is simple. Training on large corpora of annotated real-world data has proven crucial for creating robust solutions to perceptual problems such as speech recognition and face detection. But the powerful tools used during training of such systems are typically stripped away at deployment. Ideally they should remain, particularly for unstable tasks such as object detection, where the set of objects needed in a task tomorrow might be different from the set of objects needed today. The key limiting factor is access to training data, but as this thesis shows, that need not be a problem on a robotic platform that can actively probe its environment, and carry out experiments to resolve ambiguity. This work is an instance of a general approach to learning a new perceptual judgment: find special situations in which the perceptual judgment is easy and study these situations to find correlated features that can be observed more generally.

Análisis estructural de la visión estratégica futura internacional de la organización para alcanzar objetivos diferenciales enfocados en contact center: MAPFRE, ANDIASISTENCIA

Por medio del estudio realizado a los diferentes enfoques y estudios hechos hacia el área de recursos humanos y cultura (organizacional y nacional) se han logrado identificar ciertos procesos y características que pueden ser implementados en el modelo de integración de operaciones de Call Center de Mapfre. Partiendo de la cultura organizacional pasando por la cultura nacional y sabiendo como ingresar y ser aceptado en una cultura internacional. Características y procesos totalmente opuestos desde su implementación pasando por sus costos y su posterior gestión; debido al choque cultural y la forma de gestión planteada por la organización basado en su modelo estructural de jerarquización y centralización de toma de decisiones. Queriendo lograr con éste trabajo generar un proyecto de unificación de un sector operativo dirigido hacia servicio al cliente y de la misma manera servir como un ejemplo a demás organizaciones nacionales o multinacionales con el objetivo de aumentar la eficiencia de su administración y la eficiencia de su estructura de costos siempre enfocado a un bien último que es el servicio al cliente.

Plan de empresa : S. R. Contact Center

El presente trabajo de grado esgrime un plan de empresa. S.R. Contact Center es una compañía del sector servicios en Colombia, que como su nombre lo indica se dedica a tercerizar operaciones relacionadas con los centros de contacto. El contenido que encontrará en sus páginas abarca un análisis del sector en el que se encuentra, una revisión a la competencia y el espacio que hay en el mercado para la empresa. Se profundiza en la forma de trabajar, un esquema desvinculado del espacio físico, con alto componente tecnológico y de innovación, que dará nuevas oportunidades de empleo a una población menos favorecida; la empresa se enfocará al minucioso cuidado y aplicación de la información y de sus clientes y usuarios del sistema. También se analiza la viabilidad de la empresa desde el punto de vista jurídico, comercial, financiero y social.

Prevalencia de estrés laboral en trabajadores de un contact center de Bogotá

Introducción. Los Contact Center son una tendencia global que cada vez se impone más en nuestro país, y el estrés es un factor común ligado a sus trabajadores alrededor del mundo. Materiales y métodos. Este estudio de corte transversal, evalúo desde tres perspectivas el estrés buscando hallar la prevalencia de estresores laborales y síntomas de estrés en 440 trabajadores de un Contac Center en Bogotá en el 2015, a través de la realización de las encuestas JCQ (Job Content Questionnaire), ERI (Effort Reward Imbalance Questionaire), y Cuestionario para la Evaluación del Estrés (Ministerio de Protección Social) comparando los hallazgos entre el grupo de operadores que usan y los que no usan el audífono en diadema. Resultados. La prevalencia total de estrés bajo fue del 13%, muy bajo del 83,8% y 3,2% no reportaron síntomas de estrés. No se encontraron niveles de estrés medio o alto. En las prevalencias de estrés según el uso de la diadema, se encontró un nivel bajo de estrés en el 25% de los que usan diadema, muy bajo en el 68% y 6,5% no presentaron síntomas de estrés; por el contrario, el grupo que no usa la diadema presento sólo el 1% de estrés bajo y el 99% de estrés muy bajo, no hubo participantes que no reportaran estrés. Estresores laborales como la autoridad de decisión y la percepción de recompensa variaron en ambos grupos. El riesgo al usar la diadema de tener un nivel de estrés bajo fue del OR 2,32 IC95%(1,56-6,09), mostrando que al usar la diadema se tiene un doble de riesgo de bajo estrés en trabajadores operativos de Contact Center frente a presentar un estrés muy bajo. Conclusiones. La prevalencia de estrés general fue baja en ambos grupos evaluados. Las mujeres, los jóvenes y participantes estrato 2 y 3 fueron los grupos predominantes. Hay dos veces mayor riesgo al usar la diadema de tener estrés bajo en trabajadores operativos. Se recomienda mayor seguimiento por parte de los Contac center a los estresores y síntomas de estrés a los que están expuestos sus trabajadores por lo que se requiere promover más estudios que sirvan de soporte para evaluar la diadema como factor estresor laboral.