Le rôle de l’Oxygénation Extracorporelle par Membrane (ECMO) dans la réanimation cardio-pulmonaire

Rapport de stage présenté à la Faculté de médecine en vue de l'obtention du grade de Maître ès sciences appliquées (M.Sc.A.) en génie biomédical, option génie clinique.

Continuité et discontinuité dans les trajectoires de soins de personnes ayant une problématique complexe de santé : Perceptions d’ergothérapeutes – une étude exploratoire

Article

Targeted Public Distribution System in Food Grains:Extent of Utlization by the Tribal Population in Kerala

In India, Food Security meant supply of food grains and the medium was Public Distribution System. Public Distribution System (PDS) is a rationing mechanism that entitles households to specified quantities of selected commodities at subsidized prices. The Objectives of PDS are maintaining Price Stability, rationing during times of scarcity, welfare of the poor, and keeping a check on private trade. Kerala has registered remarkable improvement in poverty reduction in general over the years among all social sections, including scheduled caste and scheduled tribe population. As part of the structural adjustment intended to reduce public expenditure, PDS has been modified as Revamped PDS (RPDS) during 1992 and later on as Targeted PDS (TPDS) in 1997, intended to target households on the basis of income criterion, classifying people as Below Poverty Line (BPL) and Above Poverty Line (APL). TPDS provides 25Kg. of food gra.ins through the Fair Price Shops per month @ Rs.3/- per Kg. of rice/ wheat to the BPL category and @Rs.8.90 and Rs.6.7O for rice and wheat respectively to the APL category of people. Since TPDS is intended to target the poor people, the subsidy spent by the government for the scheme should be beneficial to the poor people and naturally they should utilize the benefits by purchasing the food grains allotted under the scheme. Several studies have shown that there is underutilization of the allotments under TPDS. Therefore, the extent of utilization of TPDS in food grains, how and why remains as a major hurdle, in improving the structure and system of PDS. Livelihood of the tribal population being under threat due to increasing degradation of the resources, the targeting system ought to be effective among the tribal population. Therefore, performance of the TPDS in food grains, in terms of the utilization by the tribal population in Kerala, impact thereof and the factors, if any, affecting proper utilization were considered as the research problem in this study. The study concentrated on the pattern of consumption of food grains by the tribal people, whether their hunger needs are met by distribution of food grains through the TPDS, extent to which TPDS in food grains reduce their share of expenditure on food in the total household expenditure, and the factors affecting the utilization of the TPDS in food grains by the tribal population. Going through the literature, it has been noted that only few studies concentrated on the utilization of TPDS in food grains among the tribal population in Kerala.The Research Design used in this study is descriptive in nature, but exploratory in some aspects. Idukki, Palakkad and Wayanad have more than 60% of the population of the tribals in the state. Within the three districts mentioned above, 14 villages with scheduled tribe concentration were selected for the study. 95 tribal colonies were selected from among the various tribal settlements. Collection of primary data was made from 1231 households with in the above tribal colonies. Analysis of data on the socio-economic factors of the tribal people, pattern of food consumption, extent of reduction in the share of expenditure on food among the household expenditure of the tribal people and the impact of TPDS on the tribal families etc. and testing of hypotheses to find out the relation/association of each of the six variables, using the data on BPL and APL categories of households separately have resulted in findings such as six percent of the tribal families do not have Ration Cards, average per capita consumption of food grains by the tribal people utilizing TPDS meets 62% of their minimum requirement, whereas the per capita consumption of food grains by the tribal people is higher than the national average per capita consumption, 63% deficiency in food grains may be felt by tribal people in general, if TPDS is withdrawn, and the deficit for BPL tribal people may be 82%, TPDS facilitates a reduction of 9.71% in the food expenditure among the total household expenditure of the tribal people in general, share of food to non-food among BPL category of tribals is 55:45 and 40:60 among the APL, Variables, viz. household income, number of members in the family and distance of FPS from tribal settlements etc. have influence on the quantity of rice being purchased by the tribal people from the Fair Price Shops, and there is influence of household income and distance of FPS from tribal settlements on the quantity of rice being purchased by the tribal people from the open market. Rationing with differential pricing on phased allotments, rectification of errors in targeting, anomalies in norms and procedures for classifying tribal people as BPL/APL, exclusive Income Generation for tribal population, paddy cultivation in the landholdings possessed by the tribal people, special drive for allotment of Ration Cards to the tribal people, especially those belonging to the BPL category, Mobile Fair Price Shops in tribal settlements, ensure quality of the food grains distributed through the TPDS, distribution of wheat flour in packed condition instead of wheat through the Fair Price Shops are recommended to address the shortcomings and weaknesses of the TPDS vis-avis the tribal population in Kerala.

Les Persones de la tercera edat: són productives?

Destaca la importància del paper dels avis en la societat actual a l'hora de tenir cura dels néts

Productivity, demand and the home market effect

The causality between international trade and industrialization is still ambiguous. We consider a model of international trade with the Home Market Effect - with differences in income and productivity between sectors and between countries - in order to identify additional channels for determining the effects of international trade on industrialization. Introducing non-homothetic preferences and differences in productivity aids in the interpretation of any apparent paradoxes within international trade, such as the commercial relations between more populated countries like China and India and large economies such as the U.S. Population size, demand composition and productivity levels constitute the three main channels for determining the effects of international trade. Interactions among these channels define the results obtained in terms of industrialization, while welfare levels are always higher in relation to autarky.

Premios Joaqu??n Sama 1998 a la innovaci??n educativa

Se recogen los trabajos premiados en la IV edici??n de los Premios Joaqu??n Sama a la innovaci??n educativa: 'Acercamiento al mundo de la discapacidad' de Matilde Cuevas D??az; 'Recorros y visitas did??cticas al entorno' del profesorado del Colegio P??blico San Juan Bautista; 'Unidad did??ctica: el agua' de Antonio S??nchez Gil, Antonia Jim??nez Mart??n, Manuela Avis Gutierro, Mar??a del Pino Rodr??guez Mart??nez, Rosa Gal??n Nieto, Carmen Saavedra y Romero; 'Museo Nacional de Arte Romano de M??rida: gu??a did??ctica' de Santiago Garc??a Jim??nez; 'Calendario escolar de celebraciones y conmemoraciones significativas en el aula de Educaci??n Primaria y ESO' de Miguel Caballero Pe??as; 'Programa para la mejora de la autoestima y de las habilidades sociales' de Andr??s Garc??a G??mez y Mar??a Jes??s Cabezas Moreno; 'Una ventana hacia Europa' del profesorado del Colegio P??blico de Santo Domingo de Orellana la Vieja (Badajoz); 'De la motricidad al taller de teatro' de Jos?? Indalecio Cort??s Flores; 'Un d??a en los Barruecos... y m??s' de Remedios Corral Rodr??guez y Leonardo Criado Camb??n y 'Animaci??n a la lectura en las clases de Geograf??a e Historia' de Antonio Guti??rrez Egea.

Les Affiches engagées à l'école primaire: out un décodage!

La publicité est depuis bien longtemps un sujet de débat social sur lequel différents auteurs se sont penchés, l’ont étudiée et ont donné leur avis, ainsi que des pistes d’analyse pour mieux comprendre ce phénomène qui est partout et qui touche toutes les couches de la population. Parmi toutes les formes que la publicité peut revêtir, il y en a une que l’on retrouve partout où l’on va et qui s’impose à notre regard. Il s’agit des affiches publicitaires. Ces dernières peuvent parfois être confondues avec une autre sorte d’affiches: il s’agit des affiches dites engagées. En effet, les élèves retrouvent ce type d’affiches partout ; sur le chemin de l’école, lorsqu’ils marchent dans la rue, que cela soit à la ville comme à la campagne, dans les journaux ou encore sur Internet. Dans ce projet de mémoire, je me suis intéressée à la création d’une séquence d’enseignement aux messages visuels, qu’ils soient scripturaux et/ou iconiques, véhiculés par les affiches engagées pour une classe de 6P de l’école primaire genevoise. Cette séquence se compose de six leçons et a comme finalité la production, par les élèves eux-mêmes, d’une affiche engagée

La Tutoría virtual para la autogestión del aprendizaje en las enseñanzas técnicas

Este artículo propone el uso de herramientas de Aprendizaje VIrtual Síncrono (AVIS) para flexibilizar las tutorías. Estas herramientas permiten mantener audio/video conferencias y compartir aplicaciones y documentos. En este trabajo se resumen las experiencias de implantación de la herramienta Poli[ReunióN] (basada en Adobe Connect) para dar soporte a las tutorías virtuales en diferentes enseñanzas técnicas de la Universitat Politècnica de València durante el curso 2010/2011. Se detallan las principales ventajas y oportunidades, se discute el impacto en el profesorado y, finalmente, se analizan los resultados de las encuestas de opinión al alumnado sobre la incorporación de esta herramienta

Present state of global wetland extent and wetland methane modelling: conclusions from a model inter-comparison project (WETCHIMP)

Global wetlands are believed to be climate sensitive, and are the largest natural emitters of methane (CH4). Increased wetland CH4 emissions could act as a positive feedback to future warming. The Wetland and Wetland CH4 Inter-comparison of Models Project (WETCHIMP) investigated our present ability to simulate large-scale wetland characteristics and corresponding CH4 emissions. To ensure inter-comparability, we used a common experimental protocol driving all models with the same climate and carbon dioxide (CO2) forcing datasets. The WETCHIMP experiments were conducted for model equilibrium states as well as transient simulations covering the last century. Sensitivity experiments investigated model response to changes in selected forcing inputs (precipitation, temperature, and atmospheric CO2 concentration). Ten models participated, covering the spectrum from simple to relatively complex, including models tailored either for regional or global simulations. The models also varied in methods to calculate wetland size and location, with some models simulating wetland area prognostically, while other models relied on remotely sensed inundation datasets, or an approach intermediate between the two. Four major conclusions emerged from the project. First, the suite of models demonstrate extensive disagreement in their simulations of wetland areal extent and CH4 emissions, in both space and time. Simple metrics of wetland area, such as the latitudinal gradient, show large variability, principally between models that use inundation dataset information and those that independently determine wetland area. Agreement between the models improves for zonally summed CH4 emissions, but large variation between the models remains. For annual global CH4 emissions, the models vary by ±40% of the all-model mean (190 Tg CH4 yr−1). Second, all models show a strong positive response to increased atmospheric CO2 concentrations (857 ppm) in both CH4 emissions and wetland area. In response to increasing global temperatures (+3.4 °C globally spatially uniform), on average, the models decreased wetland area and CH4 fluxes, primarily in the tropics, but the magnitude and sign of the response varied greatly. Models were least sensitive to increased global precipitation (+3.9 % globally spatially uniform) with a consistent small positive response in CH4 fluxes and wetland area. Results from the 20th century transient simulation show that interactions between climate forcings could have strong non-linear effects. Third, we presently do not have sufficient wetland methane observation datasets adequate to evaluate model fluxes at a spatial scale comparable to model grid cells (commonly 0.5°). This limitation severely restricts our ability to model global wetland CH4 emissions with confidence. Our simulated wetland extents are also difficult to evaluate due to extensive disagreements between wetland mapping and remotely sensed inundation datasets. Fourth, the large range in predicted CH4 emission rates leads to the conclusion that there is both substantial parameter and structural uncertainty in large-scale CH4 emission models, even after uncertainties in wetland areas are accounted for.

Present state of global wetland extent and wetland methane modelling: methodology of a model inter-comparison project (WETCHIMP)

The Wetland and Wetland CH4 Intercomparison of Models Project (WETCHIMP) was created to evaluate our present ability to simulate large-scale wetland characteristics and corresponding methane (CH4) emissions. A multi-model comparison is essential to evaluate the key uncertainties in the mechanisms and parameters leading to methane emissions. Ten modelling groups joined WETCHIMP to run eight global and two regional models with a common experimental protocol using the same climate and atmospheric carbon dioxide (CO2) forcing datasets. We reported the main conclusions from the intercomparison effort in a companion paper (Melton et al., 2013). Here we provide technical details for the six experiments, which included an equilibrium, a transient, and an optimized run plus three sensitivity experiments (temperature, precipitation, and atmospheric CO2 concentration). The diversity of approaches used by the models is summarized through a series of conceptual figures, and is used to evaluate the wide range of wetland extent and CH4 fluxes predicted by the models in the equilibrium run. We discuss relationships among the various approaches and patterns in consistencies of these model predictions. Within this group of models, there are three broad classes of methods used to estimate wetland extent: prescribed based on wetland distribution maps, prognostic relationships between hydrological states based on satellite observations, and explicit hydrological mass balances. A larger variety of approaches was used to estimate the net CH4 fluxes from wetland systems. Even though modelling of wetland extent and CH4 emissions has progressed significantly over recent decades, large uncertainties still exist when estimating CH4 emissions: there is little consensus on model structure or complexity due to knowledge gaps, different aims of the models, and the range of temporal and spatial resolutions of the models.

L’évolution du français par rapport à l’histoire et en comparaison avec celle du suédois

Une langue est comme un être vivant. Elle porte les traces des avis, des sentiments, de la joie et des déceptions de nos ancêtres. En même temps elle reflète les toutes tous derniers modes de vie et la manière de penser et d’agir dans la vie quotidienne. Ce sont sa grammaire, ses mots, ses proverbes et ses citations qui en témoignent. Ses sons soulignés par l’intonation et la prosodie nous laissent presque deviner l’esprit de vitalité, de mélancolie ou d’élégance de la langue et de ces locuteurs. Mais est-ce qu’il est possible de trouver aussi les traces des événements historiques et sociaux dans l’évolution d’une langue? Cette question est centrale dans ce mémoire qui suit l’évolution du français à partir du latin parlé dans l’Antiquité et en comparaison avec celle d’autres langues notamment celle du suédois.

Estado, administração publica e tecnoburocracia no Brasil: a experiencia realizada na Diretoria de Treinamento de Recursos Humanos da Fundação Escola de Serviço Publico do Rio de Janeiro (DTRH/FESP) - periodo 1983/86

O estudo que ora apresentamos nesta dissertação tem como objetivo principal a descrição e análise de projetos e atividades desenvolvidas no âmbito da Diretoria de Treinamento de Recursos Humanos da Fundaçio Escola de Serviço Público do Rio de Janeiro (DTRH/FESP), período 1983/86, referenciando-as vis-avis ao contexto econômico e político-social vigente à época.

A teoria da argumentação de Chaim Perelman

Nosso interesse pela Teoria da Argumentação de Chaim Perelman se relaciona à proposta de um modelo jurídico preconizado por ele para as ciências humanas, que têm ainda seu estatuto epistemológico questionado, disfarçando esta dificuldade na procura inaceitável do modelo aplicado nas ciências matemáticas. A Nova Retórica elaborada por Perelman é, a nosso ver, a resposta ao conceito restrito de razão desenvolvido pela lógica formal e imposto aos domínios que expressam nossas preferências e embasam nossas decisões.

O aluno surdo em classe regular: concepções e práticas dos professores

Le texte se rapporte à une recherche sur les conceptions d enseignants concernant l inclusion scolaire d élèves sourds , et leurs ralations avec les pratiques qu ils développent dans les classe régulières. Elle a été conduite dans une école publique régulière appartenant à la commune de Assu RN, et dont le choix méthodologique a été une approche qualitative, du genre ethnographyque. La construction des données devient d un processus d observation, de l application d entretiens demi-structurés et de l analyse de documents, ayant pour sujets quatre enseignants des années initiales de l enseignement fondamental. L apport théorique de base a été la théorie socio-culturelle proposée par Vygotsky (2003 ; 2005), censée traduire la compréhension de l homme dans sa dimension historique et culturelle, et mettre en évidence l interaction sociale en tant que condition pour le développement des individus. Les données font connaître que les enseignants sujets de la recherche sont favorables à l inclusion scolaire des élèves sourds dans les classes régulières, néanmoins soulignent le besoin d un changement à l école pour que l inclusion devienne une réalité. Les enseignants sont d avis que l apprentissage des élèves sourds se fait d une façon qui met trop de temps, moyennant l utilisation de recours spécifiques, tels que l usage du langage des signes (Libras). Ils signalent les difficultés qu ils doivent faire face quand il s agit de travailler pédagogiquement avec ces élèves dans le quotidien, telles que : manque d un travail collectif à l école ; besoin d une formation spécialisée ; démonstration de sentiments de peur, ou préjugés de la part de quelques uns du personnel de l école , tout celà interférant directement dans leurs attitudes et leurs actions faces aux élèves ; manque d appui des instances administratives de l école ; absence de politiques consistentes pour guider l éducation sous un regard inclusif. Quant aux pratiques pédagogiques développées à l école, la recherche laisse voir que, par rapport à la présence des élèves sourds, très peu d adaptations y ont été introduites, d où se dégage que la planification des actions éducatives à l école se tourne, prioritairement, vers les élèves qui écoutent, c est-à-dire, vers un groupe apparemment homogène. On a constaté, en plus, qu il n existe pas à l école aucun professionnel habilité pour l établissement d un processus de communication avec les élèves sourds. Malgré ces difficultés, les enseignants avouent, quand même, que travailler avec ces élèves rapporte toujours des bénéfices, tels que la collaboration et le respect mutuels chez les élèves, l acquisition de nouveaux savoirs et l amélioration de la pratique pédagogique des enseignants

Sartre: a conferência de Araraquara

Dans sa Conférence prononcée au Brésil, à Araraquara, Sartre, dans la même ligne de pensée de Question de Méthode, reprend le thème - que la Résistance avait mis à l'ordre du jour - des rapports entre la théorie et la pratique. Or, on pourrait se demander pourquoi l'auteur, au seuil des années 60, reprend, d'une manière si décisive, un sujet qu'il avait privilegié dans les années de l'après-guerre. La réponse à cette question, à notre avis, doit être cherchée dans les développements de la célèbre polémique des années 50 autour des essais de Sartre Les Communistes et la Paix et, par conséquent, dans le cadre politique et philosophique de l'époque.