O ensino de canto nos ramos genérico e vocacional no 1º ciclo do ensino básico: um estudo de caso múltiplo

Tese de Doutoramento em Estudos da Criança (área de especialização em Educação Musical).

Alfabetização de jovens e adultos no estado do Rio de Janeiro, Brasil: o significado de um desafio para a inclusão social

Tese de Doutoramento em Ciências da Educação

Music performance anxiety among full-time music students

Introduction Music performance anxiety (MPA, often referred to as "stage fright") is one of the leading severe medical problems among musicians. For about 15-25% of musicians MPA is a serious problem. Particularly high levels of MPA are observed among music students. Musical performance can induce negative emotions, including anxiety, which in some individuals can approach extreme levels of terror and take the form of panic attack, impair the quality of the performance, lead to avoidance of performance situations, and consequently have debilitating effects on the career. Coping efforts used by musicians in their attempts to manage MPA, such as sedatives, alcohol, and β-blockers can have deleterious health side-effects. Music ranks high in the cultural and economic life of Switzerland. In ten university music schools, students from all around the world are educated to become professional musicians. Despite the importance of musical education in Switzerland, data concerning the phenomenon of MPA are largely lacking. Goal and Methods The main goal of this research was to survey the occurrence, experience, and management of MPA among full-time music students in French Swiss conservatories. A questionnaire was developed based on the literature and interviews with music students and teachers and distributed to all the students of the conservatories of Fribourg, Geneva, Lausanne, and Neuchâtel in the spring 2007. 194 students (61% women) returned the questionnaire. Results The size of the problem: MPA is a major problem for 1/3 of the students (ranks 3 and 4). The consequences of MPA: 22% and 35% of the students think that they have failed exams and auditions, respectively, because of MPA. Further, 25% of the students have already avoided performing and 11% have interrupted public performances because of MPA. Coping with MPA: 90% of the students have never used alcohol prior to performing, whereas 97% and 81%, respectively, have never used recreation drugs and medication. The majority of students use relaxation exercises, respiratory exercises, and meditation techniques to prepare themselves. About ¾ of the students think that the use of alcohol and recreational drugs to manage MPA is never justified. 53% of the students think that the use of medication is justified on some occasions. Need for information and support: 66% of the students would like to receive more support and help to cope with music performance situations. This support should mainly come from their teachers and specialists. 53% of the students know nothing or little about possible means for the management of MPA. About 50% consider themselves not at all or little informed about the possible risks associated with the consumption of alcohol, recreational drugs, and medication for the management of performance situations. 89% would like to know more about MPA and 94% think that this topic should be discussed much more in their musical education at the conservatory. Conclusions The results of this survey indicate that MPA is a major problem for 1/3 of the students with serious consequences on their career. There is a huge need for more information and support on how to manage the stress due to performance situations. The use of alcohol, recreational drugs, and medication is modest but the students are poorly informed about possible side-effects of these coping strategies. It seems clear that more should be done in the French Swiss conservatories about music performance anxiety to inform, educate, and prepare the students for their future professional career.

Evaluation cardiologique préopératoire avant chirurgie non cardiaque: du choix cornélien a l'arbre décisionnel [Pre-operative cardiac assessment in non-cardiac surgery: a frequent dilemma simplified by a decision tree].

In patients undergoing non-cardiac surgery, cardiac events are the most common cause of perioperative morbidity and mortality. It is often difficult to choose adequate cardiologic examinations before surgery. This paper, inspired by the guidelines of the European and American societies of cardiology (ESC, AHA, ACC), discusses the place of standard ECG, echocardiography, treadmill or bicycle ergometer and pharmacological stress testing in preoperative evaluations. The role of coronary angiography and prophylactic revascularization will also be discussed. Finally, we provide a decision tree which will be helpful to both general practitioners and specialists.

Transcatheter renal denervation for the treatment of resistant arterial hypertension: the Swiss expert consensus.

Transcatheter (or percutaneous) renal denervation is a novel technique developed for the treatment of resistant hypertension. So far, only one randomised controlled trial has been published, which has shown a reduction of office blood pressure. The Swiss Society of Hypertension, the Swiss Society of Cardiology, The Swiss Society of Angiology and the Swiss Society of Interventional Radiology decided to establish recommendations to practicing physicians and specialists for good clinical practice. The eligibility of patients for transcatheter renal denervation needs (1.) confirmation of truly resistant hypertension, (2.) exclusion of secondary forms of hypertension, (3.) a multidisciplinary decision confirming the eligibility, (4.) facilities that guarantee procedural safety and (5.) a long-term follow-up of the patients, if possible in cooperation with a hypertension specialist. These steps are essential until long-term data on safety and efficacy are available.

Compétences en soins patiatifs : que faut-il savoir faire en tant que médecin [Competencies in palliative care : what should the physicians be able to do?]

Palliative patients (patients with progressive incurable illnesses) have a number of needs, early and late in their illness trajectories. This article highlights some of the most important competencies required by physicians to address these needs. They cover a broad spectrum of domains and include pain and symptom management, communication, disclosure, prognostication, and psychological, social and spiritual needs. All physicians, generalists and specialists alike, should possess the basic competencies but should also recognize that some patients, especially those not responding to initial strategies, require timely referrals to specialized palliative care teams.

Quelle organisation des soins pour le patient polymorbide? [How should we organize health care for multimorbidity patients?].

Polymorbidity affects an increasing number of patients of all ages as demonstrated by a recent epidemiological study and represents a real challenge for the organization of health care. Appropriate management of polymorbid patients requires an interdisciplinary approach associating generalist and specialist physicians, but also nurses, other health professionals and social workers. An improvement in transition care between the community and the hospital is necessary in both directions. Prioritizing the treatment objectives is essential to allow patient adherence and avoid cumulative drug interactions and adverse effects. Those objectives are difficult to attain in the context of our present health care organization. This paper attempts to identify the difficulties involved in caring for polymorbid patients and propose ways to improve it.

Tuloskortti, strategia ja tavoitteet, Case: TeliaSonera Finland Oyj, Verkot ja tuotanto -divisioona

Tuloskortti on mittaristo, jonka avulla yritystä johdetaan, tuloksia mitataan, luodaan yrityksen strategia ja asetetaan sekä pitkän että lyhyen aikavälin tavoitteet. Se toimii myös raportoinnin välineenä. Tutkielman teoreettinen tavoite on selvittää miten tuloskorttia voi hyödyntää yrityksen strategian implementoinnissa ja sitä kauttayrityksen sille asettamiin tavoitteisiin pääsemisessä. Tuloskortin avulla ohjataan liiketoimintaa sekä organisaation nykyistä ja tulevaisuuden suorituskykyä. Tuloskortin mittariston tavoitteet johdetaan strategiasta ja toisaalta strategia johdetaan tuloskortin tavoitteista. Hyvätuloskortti kertoo tarinan yrityksen strategiasta ja visiosta. Tutkielman empiirinen osa liittyy caseyrityksen TeliaSonera Finland Oyj:n Verkot ja tuotanto - divisioonassa suoritettuun kyselytutkimukseen. Empiirisenä tavoitteena on tutkia, miten työntekijän asema organisaatiossa vaikuttaa suhtautumisessa tuloskorttiin ja sen avulla suoritettavaan työn ohjaukseen. Miten vastaajat kokevat tuloskortin avulla asetetun yrityksen suunnan sekä tuloksellisuuden mittauksen? Onko näkemyseroja esimiesten ja asiantuntijoiden välillä? Kirjoittaja havaitsi, että kyseiset luokat suhtautuvat varsin yhteneväisesti kysymyksiin. Näkemyseroa ilmenee lähinnä siinä, miten tuloskortin avulla voidaan vaikuttaa ja miten tärkeää se on. Tuloskortti koetaan myös tärkeänä sitouttamisen sekä palkitsemisen välineenä.

Cancer incidence in Vaud (2003-2007)

CANCER CARE FACILITIES: In 2005, the registration area had about 3200 hospital beds available for cancer diagnosis and treatment (about 5 per 1000 residents). There were about 3600 hospital medical residents and private practitioners (1 per 180 residents). The canton has a major, multidisciplinary, public university oncology and radiotherapy centre and two private radiotherapy units (available to all residents), as well as several peripheral (mostly hospital-based) medical and surgical oncology facilities and specialists. REGISTRY STRUCTURE AND METHODS: The registry is part of the Cancer Epidemiology Unit of the Institute of Social and Preventive Medicine within the Faculty of Biology and Medicine of the University of Lausanne. Notiĺcation is voluntary. The registry's main sources of information are the University Institute of Pathology at the University of Lausanne and three major private pathology laboratories. Passive and active follow-up are conducted. Data on all deaths in the canton (including cancer deaths) are available. Other features of the registry are good registration of non-melanoma skin cancers, linkage of reports of selected preneoplastic conditions to the registry database (to study subsequent cancer risk), analysis.

On the rationale of population screening for chronic kidney disease : a public health perspective

Chronic kidney disease (CKD) and its complications represent an enormous and increasing public health burden worldwide [1]. More than one in ten adults suffers from CKD in the general population [2], with a majority of people being in its early stages (i.e. 1 to 3) [2]. In the general population, the prevalence of CKD sharply increases with age [3]. CKD can be considered as a condition associated with premature ageing with accelerated vascular disease [4]. The large number of people with CKD, or at high risk of CKD (i.e. patients with hypertension, diabetes and/or CVD), implies that primary care providers and specialists other than nephrologists frequently encounter patients with CKD [5], a situation in which most CKD cases are diagnosed via opportunistic kidney function screening or automated eGFR reporting. The aim of this review is to discuss the rationale and currently available evidence for, or against, population-based screening for CKD. The focus will be on the situation of screening asymptomatic individuals at early stages of CKD regardless of the presence or absence of CKD risk factors.

The temporal dynamics of resource use by frugivorous birds: a network approach

Ecological network patterns are influenced by diverse processes that operate at different temporal rates. Here we analyzed whether the coupled effect of local abundance variation, seasonally phenotypic plastic responses, and species evolutionary adaptations might act in concert to shape network patterns. We studied the temporal variation in three interaction properties of bird species (number of interactions per species, interaction strength, and interaction asymmetry) in a temporal sequence of 28 plant frugivore interaction networks spanning two years in a Mediterranean shrubland community. Three main hypotheses dealing with the temporal variation of network properties were tested, examining the effects of abundance, switching behavior between alternative food resources, and morphological traits in determining consumer interaction patterns. Our results demonstrate that temporal variation in consumer interaction patterns is explained by short-term variation in resource and bird abundances and seasonal dietary switches between alternative resources (fleshy fruits and insects). Moreover, differences in beak morphology are associated with differences in switching behavior between resources, suggesting an important role of foraging adaptations in determining network patterns. We argue that beak shape adaptations might determine generalist and specialist feeding behaviors and thus the positions of consumer species within the network. Finally, we provide a preliminary framework to interpret phylogenetic signal in plant animal networks. Indeed, we show that the strength of the phylogenetic signal in networks depends on the relative importance of abundance, behavioral, and morphological variables. We show that these variables strongly differ in their phylogenetic signal. Consequently, we suggest that moderate and significant phylogenetic effects should be commonly observed in networks of species interactions. Read More: http://www.esajournals.org/doi/abs/10.1890/07-1939.1

Development of research networks : the case of social capital

The aim of this study is to explore how a new concept appears inscientific discussion and research, how it diffuses to other fields and out of the scientific communities, and how the networks are formed around the concept. Text and terminology take the interest of a reader in the digital environment. Texts create networks where the terminology used is dependent on the ideas, viewsand paradigms of the field. This study is based mainly on bibliographic data. Materials for bibliometric studies have been collected from different databases. The databases are also evaluated and their quality and coverage are discussed. The thesauri of those databases that have been selected for a more in depth study have also been evaluated. The material selected has been used to study how long and in which ways an innovative publication, which can be seen as a milestone in a specific field, influences the research. The concept that has been chosen as a topic for this research is Social Capital, because it has been a popular concept in different scientific fields as well as in everyday speech and the media. It seemed to be a `fashion concept´ that appeared in different situations at the Millennium. The growth and diffusion of social capital publications has been studied. The terms connected with social capital in different fields and different stages of the development have also been analyzed. The methods that have been used in this study are growth and diffusion analysis, content analysis, citation analysis, coword analysis and cocitation analysis. One method that can be used tounderstand and to interpret results of these bibliometric studies is to interview some key persons, who are known to have a gatekeeper position in the diffusion of the concept. Thematic interviews with some Finnish researchers and specialists that have influenced the diffusion of social capital into Finnish scientificand social discussions provide background information. iv The Milestone Publications on social capital have been chosen and studied. They give answers to the question "What is Social Capital?" By comparing citations to Milestone Publications with the growth of all social capital publications in a database, we can drawconclusions about the point at which social capital became generally approved `tacit knowledge´. The contribution of the present study lies foremost in understanding the development of network structures around a new concept that has diffused in scientific communities and also outside them. The network means both networks of researchers, networks of publications and networks of concepts that describe the research field. The emphasis has been on the digital environment and onthe socalled information society that we are now living in, but in this transitional stage, the printed publications are still important and widely used in social sciences and humanities. The network formation is affected by social relations and informal contacts that push new ideas. This study also gives new information about using different research methods, like bibliometric methods supported by interviews and content analyses. It is evident that interpretation of bibliometric maps presupposes qualitative information and understanding of the phenomena under study.

Kirjanpitolainsäädännön muutosten vaikutus mikro- ja pienyritysten tilinpäätökseen

Tutkimuksen tarkoituksena oli tarkastella, miten kirjanpitolainsäädäntöön ehdotetut muutokset vaikuttavat mikro- ja pienyritysten tilinpäätökseen. Tutkimus oli jaettu kahteen eri osaan: miten muutokset vaikuttavat tilinpäätöksestä saatavaan informaatioon ja miten muutokset vaikuttavat tilinpäätöksen laadintaan. Tutkimus toteutettiin laadullisena tutkimuksena ja se perustui hallituksen esitykseen HE 89/2015 vp, joka koski kirjanpitolainsäädännön muuttamista. Hallituksen esityksessä ehdotettuja muutoksia verrattiin voimassaolevaan lainsäädäntöön ja muutosten tulkinnassa käytettiin alan asiantuntijoiden lausuntoja. Lainsäädännön muutoksella ei tutkimuksen mukaan ole merkittäviä vaikutuksia tilinpäätösinformaation käyttäjien kannalta. Muutokset eivät tuoneet helpotuksia voimassaolevan lainsäädännön ongelmiin. Lainsäädännön muutoksella ei myöskään ole merkittäviä vaikutuksia tilinpäätöksen laadintaan. Pienempiä helpotuksia on tehty, mutta niiden hyödyt vaikuttavat pieniltä. Lainsäädäntöön ehdotetut muutokset kuitenkin helpottavat kirjanpitolainsäädännön tulkintaa selkiyttämällä säädöksiä ja niiden rakennetta.

SME Growth Strategy - Exploring New Market Segments

Tämän tutkimuksen tarkoituksena oli tunnistaa uusia markkinoita ja markkinasegmenttejä yrityksen kasvustrategiaa varten. Yritys on kasvanut erittäin voimakkaasti viime vuosina nykyisillä markkinoillaan ja haluaa nyt jatkaa kasvuaan uusilla markkinoilla. Työ koostuu kirjallisuuskatsauksesta ja empiirisestä osuudesta. Kirjallisuuskatsauksessa on tunnistettu useita pk-yrityksen kasvuun vaikuttavia tekijöitä, uusien markkinoiden kartoittamiseen ja arvioimiseen vaikuttavia tekijöitä, ja lisäksi liiketoimintastrategiaan ja markkinasegmentin valintaan vaikuttavia tekijöitä. Empiirisen osuuden data kerättiin 60 asiantuntijahaastattelusta, joilla kartoitettiin kokonaismarkkinoita ja saatiin tarkkaa markkinainformaatiota kohdemarkkinoista. Tutkimuksessa tunnistettiin kymmenen potentiaalista toimialaa ja 54 potentiaalista markkinasegmenttiä. Kirjallisuudesta tunnistetuilla kriteereillä, teknologisin perustein ja yrityksen omien näkökulmien perusteella näistä valittiin kohdemarkkinoiksi kahdeksan. Tutkimuksessa kehitettiin markkinasegmenttien arviointiin malli. Mallin avulla valitut kahdeksan markkinasegmenttiä listattiin järjestykseen niiden houkuttelevuuden perusteella. Jatkotoimenpiteenä yrityksessä tullaan kehittämään kasvustrategia perustuen tutkimuksen tuloksille.

Facteurs influençant l'implantation des adjoints au médecin au Québec

Cette étude exploratoire a pour but d’identifier les facteurs pouvant influencer l’implantation des adjoints au médecin dans le système de santé québécois, selon les perceptions de médecins omnipraticiens et de médecins spécialistes. La collecte de données pour cette étude qualitative s’est effectuée à l’aide d’entrevues semi-structurées effectuées auprès de 13 omnipraticiens et spécialistes provenant d’hôpitaux de Montréal et de la clinique médicale des Forces canadiennes de St-Jean (Québec). L’étude a démontré que des obstacles perçus, tels que le corporatisme et le manque d’information sur la profession, pourraient interférer avec l’intégration des adjoints au médecin au Québec. Cependant, les participants s’entendent pour dire que ces obstacles ne seraient pas insurmontables et ont, par la même occasion, identifié de nombreux éléments pouvant faciliter cette intégration. Les adjoints au médecin ont des compétences uniques et travaillent déjà dans d’autres provinces canadiennes qui ont un réseau de santé similaire au nôtre. Cette étude permet donc d’approfondir les connaissances à l’égard de cette profession, en plein essor au pays, dans l’éventualité d’une intégration de ce groupe professionnel au Québec.