960 resultados para LOCAL PERCEPTIONS
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Résumé du document de thèse Quito, capitale andine de près de deux millions d'habitants, a vu se développer des quartiers ghettos réunissant une population en constante évolution. Mouvements migratoires mal connus, hétérogénéité ethnique et socioculturelle, accès limité aux services publics et conditions de vie difficiles jouent un rôle essentiel mais complexe dans la planification des services de santé. L'étude ciblée de cette problématique est un sérieux défi à relever car les mégalopoles latino-américaines connaissent une importante urbanisation avec pour corollaire une augmentation de la pauvreté urbaine. Les indicateurs de santé tels que mortalité infantile, espérance de vie ou incidence des maladies infectieuses montrent une amélioration globale qui ne reflète toutefois pas les importantes disparités caractéristiques du continent. La démarche exposée dans ce document est une réponse à la demande d'un appui médical par une communauté urbaine défavorisée, pour laquelle peu de données étaient disponibles. Une évaluation des conditions de vie et des besoins en soins a donc été effectuée par trois étudiants en médecine de Lausanne au moyen d'une enquête et d'ateliers qui ont permis de réunir les opinions des différents acteurs sociaux et sanitaires. Cette étude a pu identifier et mesurer les déterminants de santé, comprendre certaines dynamiques locales pour enfin cibler les principales lignes d'actions d'un centre de santé communautaire. Ce document décrit l'ensemble du processus conduit durant cinq ans et expose les données brutes ainsi que leur analyse ; il propose des recommandations concrètes pour une promotion de la santé adaptée aux besoins d'une communauté urbaine défavorisée d'Amérique du Sud. Son objectif est de fournir des données utilisables par les acteurs de santé locaux et de participer ainsi à la réflexion en cours sur la réforme du système de santé équatorien. Il comporte également une bibliographie, point de départ pour d'autres études sur le sujet. Le dossier, construit de manière chronologique, présente l'information de façon accessible et cohérente. Il se veut un témoignage utile, avec ses forces et ses faiblesses, à l'action locale sous forme d'une publication en espagnol qui sera distribuée aux différents acteurs sociaux et sanitaires concernés.
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Adaptació de l'habitatge a Lyon (França). Ponència presentada en el "2º Espacio de Encuentro Rehabilitación y Adaptación Funcional de la Vivienda" (Sant Sebastià, 9 Juny 2010)
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Adaptació de l'habitatge a Europea i experiències a l'àmbit local. Presentació a "2º Espacio de Encuentro Rehabilitación y Adaptación Funcional de la Vivienda".
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In ongoing studies on experimental transmission of Plasmodium falciparum in the city of Yaounde gametocyte carriers are daily being identified among dispensary patients with malaria-like complaints. This species comprises 93 of all parasitemias and because of the selection criteria most patients have it as a recent infection. 17 of all P. falciparum-positives carry detectable gametocytes with little difference between youngsters and adults. Blood of adult carriers is taken and infection of Anopheles gambiae mosquitoes is attempted by membrane feeding; the establishment of infection is judged by the presence of oocysts.
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The species x location interaction was of great importance in explaining the behaviour of genetic material. The study presented here shows, for the first time, the performance, under field conditions of the new tritordeum species, compared to wheat and triticale in a wide range of Mediterranean countries (Spain, Lebanon and Tunisia). The results obtained revealed that despite the diversity of environmental conditions, the main differences in yield were due to genotypes, especially to differences between species. The multi-local study with different growth conditions revealed important information about the water availability effect on yield. In the lowest yielding environments (Tunisia rainfed), Tritordeum and triticale yields were equivalent. However under better growth conditions (Spain), tritordeum yield was shown to be lower than wheat and triticale. Interestingly, when water limitation was extended during the pre-anthesis period, differences in tritordeum versus wheat-triticale yield rate were larger than when water stress occurred during anthesis. These variations were explained by the fact that kernel weight has been found as the limiting factor for yield determination in tritordeum, and a delay in the anthesis date may have been the cause for the low kernel weight and low yield under Mediterranean drought conditions. Such differences in yield between tritordeum and wheat or triticale could be explained by the fact that tritordeum is a relatively new species and far fewer resources have been devoted to its improvement when compared to wheat and triticale. Our results suggest that breeding efforts should be directed to an earlier anthesis date and a longer grain filling period. tritordeum proved to have possibilities to be grown under drought environments as a new crop, since its performance was quite close to wheat and triticale. Besides, it has qualitative added values that may improve farmers' income per unit land.
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The paper focuses on the argumentative process through which new international norms prohibiting the use of weapons causing severe civilian harm emerge. It examines the debate surrounding the use and usefulness of landmines and cluster munitions and traces the process through which NGOs change conceptions of military utility and effectiveness of certain weapons by highlighting their humanitarian problems and questioning their military value. By challenging military thinking on these issues, NGOs redefine the terms of the debate – from a commonplace practice, the use of such weapons becomes controversial and military decisions need to be justified. The argument-counterargument dynamic shifts the burden of proof of the necessity and safety of the weapons to the users. The process witnesses the ability of NGOs to influence debates on military issues despite their disadvantaged position in hard security issue areas. It also challenges realist assumptions that only weapons that are obsolete or low-cost force equalizers for weak actors can be banned. To the contrary, the paper shows that in the case of landmines and cluster munitions, defining the military (in)effectiveness of the weapons is part and parcel of the struggle for their prohibition.
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We discuss necessary as well as sufficient conditions for the second iterated local multiplier algebra of a separable C*-algebra to agree with the first.
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Tumescent anesthesia is a local anesthesia produced by the infiltration of a large volume of very dilute anesthetic solution into the subcutaneous tissue. Many surgical procedures (liposuction, facelift, varicose vein surgery, etc.), which were previously performed under general or locoregional anesthesia, can now be achieved with local tumescent anesthesia. This type of anesthesia has many advantages: reduction of both anesthetic risks and surgical complications (bleeding, hematoma), prolonged anesthesia reducing the need for postoperative analgesia, and costs reduction because all these surgical procedures can be performed on an outpatient basis.
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RESUME Les changements locaux de la température à la surface de la peau humaine ont une influence importante sur sa perfusion. La chaleur augmente localement le flux sanguin cutané, mais les mécanismes et les médiateurs de cette réponse (réponse thermique d'hyperémie) sont incomplètement élucidés. Dans la présente étude, nous avons examiné la relation possible entre la réponse thermique d'hyperémie, les récepteurs cholinergiques muscariniques et la production des prostaglandines vasodilatatrices. Chez 13 sujets de sexe masculin en bonne santé âgés entre 20 et 30 ans, une chambre métallique (contenant de l'eau) dont la température peut être contrôlée, a été placée sur la face palmaire de leur avant-bras et utilisée pour augmenter la température de surface de 34 à 41°C. L'hyperémie cutanée consécutive a été enregistrée par l'intermédiaire d'un scanner laser-Doppler. Dans une expérience, chacun des 8 sujets a reçu un bolus i.v. de glycopyrolate (agent antimuscarinique) (4 µg/kg) lors d'une visite et de NaCl 0,9% lors de l'autre visite. La réponse thermique d'hyperémie a été déterminée dans l'heure suivant les injections. Les glycopyrolate a efficacement empêché la vasodilation des micro-vaisseaux cutanés induite par iontophorèse d'acétylcholine mais n'a pas influencé la réponse thermique d'hyperémie. Dans une deuxième expérience entreprise avec 5 autres sujets 1 g d'aspirine (inhibiteur de la cyclooxygénase) administrée oralement a totalement supprimé la vasodilatation induite dans la peau par le courant anodique, sans modifier la réponse thermique d'hyperémie. La présente étude confirme l'absence de stimulation des récepteurs muscariniques et la production de prostaglandines vaso-dilatatrices dans la vasodilatation induite chez l'homme par réchauffement local de la peau de l'avant-bras. ABSTRACT Local changes in surface temperature have a powerful influence on the perfusion of human skin. Heating increases local skin blood flow (SkBF), but the mechanisms and mediators of this response (thermal hyperemia response) are incompletely elucidated. In the present study, we examined the possible dependence of the thermal hyperemia response on stimulation of muscarinic cholinergic receptors and on production of vasodilator prostanoids. In 13 male healthy subjects aged 20 - 30 years, a temperature- controlled chamber was positioned on the volar face of one forearm and used to raise surface temperature from 34to41°C. The time-course of the resulting thermal hyperemia response was recorded with a laser-Doppler imager. In one experiment, each of 8 subjects received an i.v. bolus of the antimuscarinic agent glycopyrrolate (4µg/kg) on one visit and saline on the other. The thermal hyperemia response was determined within the hour following the injections. Glycopyrrolate effectively inhibited the skin vasodilation induced by iontophoresis of acetylcholine, but did not influence the thermal hyperemia response. In a second experiment conducted in 5 other subjects, 1 gram of the cyclooxygenase inhibitor aspirin administered orally totally abolished the vasodilation induced in the skin by anodal current, but also failed to modify the thermal hyperemia response. The present study excludes the stimulation of muscarinic receptors and the production of vasodilator prostaglandins as essential and nonredundant mechanisms for the vasodilation induced by local heating in human forearm skin.
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Dietary supplement (DS) use increased rapidly over the last years. However evidence of benefits of many DS for healthy users are scarce and may not equate known risks of overdose, drug interaction and recently discovered negative long-term effects. Therefore this study aimed to investigate perceptions and motivations of DS users in Lausanne, Switzerland. Method A convenience sample was recruited at the entrance of local sales points. Data were collected in on-site semi-structured interviews to assess dietary supplementation habits. Results The 119 participants provided information on 147 users. Among 273 declared products, the majority were mixed products, containing minerals and vitamins (78), mineral products (69), and herbal products (28). 55% of DS users took more than one product simultaneously. Seventy five percent of participants indicated that DS use presents no risk or nearly no risk and about half (49%) of participants did not inform their physician about their consumption. Male participants reported to share this information with their physicians significantly less frequently than female participants (p = 0.008). About half of participants looked for information on potential risks of DS, men significantly more often than women (p=0.001). Discussion According to other studies in the US, our study shows that, in Lausanne (Switzerland), DS are commonly used as mixed products. Risk perception seems generally low among DS users. Implications Physicians should be trained to evaluate patientsʼ health behaviour and needs in order to provide good evidence based information or propose alternatives to DS use.
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In the context of resource allocation on the basis of priorities, Ergin (2002) identifies a necessary and sufficient condition on the priority structure such that the student-optimal stable mechanism satisfies a consistency principle. Ergin (2002) formulates consistency as a local property based on a fixed population of agents and fixed resources -- we refer to this condition as local consistency and to his condition on the priority structure as local acyclicity. We identify a related but stronger necessary and sufficient condition (unit acyclicity) on the priority structure such that the student-optimal stable mechanism satisfies a more standard global consistency property. Next, we provide necessary and sufficient conditions for the student-optimal stable mechanism to satisfy converse consistency principles. We identify a necessary and sufficient condition (local shift-freeness) on the priority structure such that the student-optimal stable mechanism satisfies local converse consistency. Interestingly, local acyclicity implies local shift-freeness and hence the student-optimal stable mechanism more frequently satisfies local converse consistency than local consistency. Finally, in order for the student-optimal stable mechanism to be globally conversely consistent, one again has to impose unit acyclicity on the priority structure. Hence, unit acyclicity is a necessary and sufficient condition on the priority structure for the student-optimal stable mechanism to satisfy global consistency or global converse consistency.