981 resultados para Patrick Chamoiseau
Resumo:
We construct a weighted Euclidean distance that approximates any distance or dissimilarity measure between individuals that is based on a rectangular cases-by-variables data matrix. In contrast to regular multidimensional scaling methods for dissimilarity data, the method leads to biplots of individuals and variables while preserving all the good properties of dimension-reduction methods that are based on the singular-value decomposition. The main benefits are the decomposition of variance into components along principal axes, which provide the numerical diagnostics known as contributions, and the estimation of nonnegative weights for each variable. The idea is inspired by the distance functions used in correspondence analysis and in principal component analysis of standardized data, where the normalizations inherent in the distances can be considered as differential weighting of the variables. In weighted Euclidean biplots we allow these weights to be unknown parameters, which are estimated from the data to maximize the fit to the chosen distances or dissimilarities. These weights are estimated using a majorization algorithm. Once this extra weight-estimation step is accomplished, the procedure follows the classical path in decomposing the matrix and displaying its rows and columns in biplots.
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We study how relationship lending and transaction lending varyover the business cycle. We develop a model in which relationshipbanks gather information on their borrowers, which allows them toprovide loans for profitable firms during a crisis. Due to the servicesthey provide, operating costs of relationship-banks are higher thanthose of transaction-banks. In our model, where relationship-bankscompete with transaction-banks, a key result is that relationship-banks charge a higher intermediation spread in normal times, butoffer continuation-lending at more favorable terms than transactionbanks to profitable firms in a crisis. Using detailed credit registerinformation for Italian banks before and after the Lehman Brothers'default, we are able to study how relationship and transaction-banksresponded to the crisis and we test existing theories of relationshipbanking. Our empirical analysis confirms the basic prediction of themodel that relationship banks charged a higher spread before the crisis, offered more favorable continuation-lending terms in response tothe crisis, and suffered fewer defaults, thus confirming the informational advantage of relationship banking.
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Cet article propose une approche globale de la santé des personnes lesbiennes, gays, bisexuelles, et transgenres (LGBT), où respect des singularités et non-jugement occupent une position centrale. Il invite à dépasser une vision centrée sur les risques liés au VIH. Pour qui n'a pas connu de questionnement en lien avec son orientation sexuelle ou son identité de genre, il est difficile de concevoir comment la découverte d'une caractéristique identitaire pendant l'enfance peut se transformer sous le regard des autres en un fardeau souvent invisible mais fréquemment associé avec une morbidité émotionnelle et médicale considérable. Cet article pose la question suivante : combien de personnes LGBT ressortent chaque semaine d'une consultation médicale sans avoir eu l'opportunité de bénéficier d'une écoute, d'un soutien et de soins adaptés ? [Abstract] This article offers a comprehensive approach to the health of lesbian, gay, bisexual and transgender (LGBT) people, where respect for diversity and non judgemental care play a central role. It calls for a health and medical vision that goes beyond HIV risk. For those who never had to question their own sexual orientation or gender identity, it is certainly difficult to understand how the discovery of one's identity trait in childhood or early adolescence can be transformed under social pressure into a burden which often remains invisible but is associated with considerable emotional and medical morbidity. This article raises the following question : How many LGBT patients go unnoticed every week, leaving the physician's office without an opportunity to receive appropriate listening, support and care ?
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Ex vivo analysis of virus-specific CD8 T cell populations by anchored PCR has shown that the CD8 TCR repertoire was less oligoclonal (seven to nine clonotypes per individual epitope) than previously thought. In the current study, TCR diversity was investigated by assessing both the overall TCR β-chain variable regions usage as well as the CDR3 regions in ex vivo-isolated CMV- and EBV-specific CD8 T cells from 27 healthy donors. The average number of clonotypes specific to most single viral epitopes comprised between 14 and 77. Changes in the CD8 TCR repertoire were also longitudinally assessed under conditions of HIV-1 chronic infection (i.e., in patients with suppressed virus replication and after treatment interruption and Ag re-exposure). The results showed that a large renewal (≤80%) of the TRB repertoire occurred after Ag re-exposure and was eventually associated with an increased T cell recognition functional avidity. These results demonstrate that the global CD8 TCR repertoire is much more diverse (≤9-fold) than previously estimated and provide the mechanistic basis for supporting massive repertoire renewal during chronic virus infection and Ag re-exposure.
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Background: The type of anesthesia to be used for total hip arthroplasty (THA) is still a matter of debate. We compared the occurrence of per- and post-anesthesia incidents in patients receiving either general (GA) or regional anesthesia (RA). Methods: We used data from 29 hospitals, routinely collected in the Anaesthesia Databank Switzerland register between January 2001 and December 2003. We used multi-level logistic regression models. Results: There were more per- and post-anesthesia incidents under GA compared to RA (35.1% vs 32.7 %, n = 3191, and 23.1% vs 19.4%, n = 3258, respectively). In multi-level logistic regression analysis, RA was significantly associated with a lower incidence of per-anesthetic problems, especially hypertension, compared with GA. During the post-anesthetic period, RA was also less associated with pain. Conversely, RA was more associated with post-anesthetic hypotension, especially for epidural technique. In addition, age and ASA were more associated with incidents under GA compared to RA. Men were more associated with per-anesthetic problems under RA compared to GA. Whereas increased age (>67), gender (male), and ASA were linked with the choice of RA, we noticed that this choice depended also on hospital practices after we adjusted for the other variables. Conclusions: Compared to RA, GA was associated with an increased proportion of per- and post-anesthesia incidents. Although this study is only observational, it is rooted in daily practice. Whereas RA might be routinely proposed, GA might be indicated because of contraindications to RA, patients' preferences or other surgical or anaesthesiology related reasons. Finally, the choice of a type of anesthesia seems to depend on local practices that may differ between hospitals.
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OBJECTIVES: To determine the prevalence of problems with treatment adherence among type-2 diabetic patients with regards to medication, dietary advice, and physical activity; to identify the associated clinical and psychosocial factors; and to investigate the degree of agreement between patient-perceived and GP-perceived adherence. METHODS: Consecutive patients were solicited during visits to 39 GPs. In total, 521 patients self-reported on treatment adherence, anxiety and depression, and disease perception. The GPs reported clinical and laboratory data and patients' adherence. A multivariate analysis identified the factors associated with adherence problems. RESULTS: Problems of adherence to medication, dietary advice, and physical activity recommendations were reported by 17%, 62%, and 47% of the patients, respectively. Six independent factors were found associated with adherence problems: young age, body-mass index (BMI) > 30 kg/m(2), glycosylated haemoglobin (HbA(1c)) > 8%, single life, depression, and perception of medication as a constraint. Agreement between patients' and GPs' assessments of treatment problems reached 70%. CONCLUSION: In type 2 diabetes, problems with dietary advice or physical activity are far more frequent than problems with medication, and not all physicians are fully aware of patients' problems. More active listening and shared decision-making should enhance adherence and improve outcomes.
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[Table des matières] 1 Contexte de la saisine. - 2 Définitions et terminologie. - 3 Minéralogie et géologie du talc. - 4 Production et utilisation du talc. - 5 Echantillonnage et analyse des fibres. - 6 Exposition professionnelle à la poussière de talc. - 7 Réglementation. - 8 Effets sur la santé - données cliniques - autres effets que le cancer. - 9 Etudes épidémiologiques. - 10 Données toxicologiques. - 11 Conclusions. - 12 Recommandations. - 13 Bibliographie. - Annexe 1: Liste des organismes sollicités dans le cadre de l'expertise. - Annexe 2: Compte rendu des auditions. - Annexe 3 : Analyse critique des études épidémiologiques menées en industrie extractive. - Annexe 4 : Importations françaises du talc de 2007 à 2009
Resumo:
The present study provides a comprehensive view of (a) the time dynamics of the psychophysiological responding in performing music students (n = 66) before, during, and after a private and a public performance and (b) the moderating effect of music performance anxiety (MPA). Heart rate (HR), minute ventilation (VE), and all affective and somatic self-report variables increased in the public session compared to the private session. Furthermore, the activation of all variables was stronger during the performances than before or after. Differences between phases were larger in the public than in the private session for HR, VE, total breath duration, anxiety, and trembling. Furthermore, while higher MPA scores were associated with higher scores and with larger changes between sessions and phases for self-reports, this association was less coherent for physiological variables. Finally, self-reported intra-individual performance improvements or deteriorations were not associated with MPA. This study makes a novel contribution by showing how the presence of an audience influences low- and high-anxious musicians' psychophysiological responding before, during and after performing. Overall, the findings are more consistent with models of anxiety that emphasize the importance of cognitive rather than physiological factors in MPA.
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Les deux notions, migrations d'une part et développement d'autre part, sont en elles-mêmes complexes, les mettre en relation amplifie cette complexité. Il n'est pas dans notre intention d'introduire un débat sur leur histoire, l'évolution de leur approche et les multiples définitionss possibles, mais simplement de préciser un cadrage scientifique privilégiant une nouvelle catégorie d'acteurs. La formulation du titre du livre, émigrés/immigrés, n'avait pas pour seul objectif de rappeler le double regard porté sur les migrations internationales, celui du pays de départ ou celui du pays d'arrivée, mais d'énoncer une construction signifiant les évolutions récentes dans le champ des pratiques migratoires. Pays d'origine, d'arrivée ou d'installation, de transits et de rebond, font partie d'un même espace migratoire qu'il s'avère nécessaire d'appréhender dans sa globalité si l'on souhaite comprendre les mutations en cours. Ce livre s'est donc intéressé à l'ensemble de la réalité migratoire, le migrant étant à la fois émigré et immigré, ce qui signifie la prise en compte des effets de cette présence pour les pays d'acceuil et d'installation et les pays d'origine. Quant au développement, nous sommes dans le registre des "concepts valise" chacun le définissant à sa manière. Notion polysémique par excellence, une multitude de qualificatifs lui ont été accolés : il peut être rural ou urbain, endogène ou exogène, local ou global, durable ou soutenable. Il s'agirait d'un "concept magique", permettant pour des personnes et des espaces, de passer de moins de production à plus de production, de moins de souffrance à plus de confort, du "moins être"à un bien-être social, économique et politique...
Resumo:
Sponge morphological plasticity has been a long-standing source of taxonomic difficulty. In the Caribbean, several morphotypes of the sponge Callyspongia vaginalis have been observed. To determine the taxonomic status of three of these morphotypes and their relationship with the congeneric species C. plicifera and C. fallax, we compared the spicule composition, spongin fiber skeleton and sequenced fragments of the mitochondrial genes 16S and COI and nuclear genes 28S and 18S ribosomal RNA. Phylogenetic analyses with ribosomal markers 18S and 28S rRNA confirmed the position of our sequences within the Callyspongiidae. None of the genetic markers provided evidence for consistent differentiation among the three morphotypes of C. vaginalis and C. fallax, and only C. plicifera stood as a distinct species. The 16S mtDNA gene was the most variable molecular marker for this group, presenting a nucleotide variability (π = 0.024) higher than that reported for COI. Unlike recent studies for other sponge genera, our results indicate that species in the genus Callyspongia maintain a high degree of phenotypic plasticity, and that morphological characteristics may not reflect reproductive boundaries in C. vaginalis.