Mesure de la mortalité des médecins au Québec à partir de données administratives

Ce mémoire de recherche a pour objectif d’obtenir une mesure approximative de la mortalité des hommes médecins au Québec retenus dans l’étude. En plus d’analyser l’évolution de la mortalité de ces médecins pendant les périodes 1993-1998, 1999-2004 et 2005-2010, leur mortalité est comparée à celle de l’ensemble de la population masculine québécoise. Nous comparons également la mortalité des médecins omnipraticiens à celle des médecins spécialistes. Les données utilisées dans le cadre de ce mémoire proviennent d’un fichier administratif du Collège des médecins du Québec, qui contient des informations concernant un certain nombre de médecins qui ont obtenu un permis pour pratiquer la médecine au Québec, sans égard à leur statut au sein du Collège à la date de l’émission du fichier. Ces données n’ont pas été collectées à des fins statistiques et ainsi le fichier présente certaines limitations qui ont restreint nos analyses de mortalité, notamment le fait qu’elles ne nous fournissent pas la population à risque de décéder durant chacune des périodes étudiées. Cependant, même étant consciente que des biais se produiraient, nous avons calculé deux estimations de l’exposition au risque de mourir chez les médecins, en essayant de pallier le plus possible les limites du fichier. À partir de la première méthode de calcul, nous avons estimé les taux de mortalité par groupes quinquennaux d’âge entre 40 et 75 ans pour les médecins inscrits au tableau des membres. En contrepartie, à partir de la deuxième méthode de calcul, nous avons obtenu des taux de mortalité pour les mêmes groupes d’âge pour les médecins de tous statuts confondus et enregistrés dans le fichier de données. Nous croyons à des mesures acceptables de la mortalité des hommes médecins en autant qu’elle soit analysée en tenant compte de toutes les limites des données. Les résultats obtenus démontrent une diminution de la mortalité des hommes médecins d’une période à l’autre, mais les différences ne sont significatives que pour les groupes d’âge à partir d’environ 60 ans, surtout lorsque les taux des périodes 1993-1998 et 2005-2010 sont comparés. De plus, pour toutes les périodes analysées, la mortalité de l’ensemble de la population masculine québécoise s’avère plus élevée que celle des hommes médecins enregistrés dans le fichier de données et cela pour les deux méthodes de calcul de l’exposition au risque de décéder considérées. Finalement, cette étude ne montre pas de différence significative entre la mortalité des hommes médecins omnipraticiens et celle des hommes médecins spécialistes.

La recherche sur le transfert des connaissances en santé publique dans les pays à faible revenu : une synthèse exploratoire

Essai doctoral présenté à la Faculté des études supérieures en vue de l’obtention du doctorat clinique en psychologie (D.Psy)

Rol del residente de Medicina Interna de la Universidad del Rosario como docente

Antecedentes: Cada vez es mayor la relevancia que se da al papel del residente como docente, no solo por su importancia en la formación de estudiantes, internos y otros miembros del equipo de salud, sino por su deber en la instrucción del paciente y su familia. A pesar de ello, el rol del residente como docente no se encuentra plenamente definido en nuestro medio. Objetivo: Caracterizar el rol de los residentes de Medicina Interna de la Universidad el Rosario en la Fundación Cardioinfantil como docentes. Métodos: Estudio cualitativo a partir de observaciones en escenarios de enseñanza y entrevistas semiestructuradas a 44 participantes distribuidos en grupos focales Resultados: Los residentes asumen un rol docente en diversos escenarios educativos con estudiantes, internos, residentes y docentes. Reconocen que no tienen la preparación necesaria para asumir esta responsabilidad ni funciones establecidas para tal fin. A pesar de esto, utilizan diferentes estrategias para enseñar y se sienten motivados para hacerlo. Conclusiones: El rol del residente como docente en el servicio de Medicina Interna en la Fundación Cardioinfantil es fundamental para la formación de los futuros médicos y especialistas según la percepción que tienen los grupos focales. Los encuentros pedagógicos están enmarcados por la disponibilidad de tiempo y dependen de características personales del residente, conocimiento disciplinar y formación para enseñar. Se considera que se debe apoyar más el entrenamiento en docencia de los residentes, avanzar en la formalización de las funciones docentes de los mismos y generar sistemas de evaluación de este proceso de enseñanza y aprendizaje.

Criação de um Microtesauro na área da Dança

Este trabalho de Investigação teve como objetivo a construção de um microtesauro na área da Dança. Face à inexistência de um Tesauro especializado na área da Dança, quer a nível nacional, quer internacional, e para dar resposta às necessidades de uma recuperação mais eficaz de informação nas Unidades Documentaisi Especializadas em Dança. Neste caso, em particular, no Centro de Informação e Documentação (CDI) da Escola Superior de Dança (ESD). Percebeu-se que a construção deste microtesauro, tendo em conta as normas nacionais e internacionais para o efeito. No âmbito das funções desempenhadas no CDI foi identificada a necessidade de existir um instrumento de Linguagem Documental adequado, que permitisse nas Pesquisas bibliográficas, recuperar por Assunto os documentos existentes na Base de Dados. A Pesquisa Bibliográfica, apenas disponível por Título e por Autor, veio a revelar-se insuficiente, e a impossibilidade de pesquiasr os documentos por Assunto traduzia-se numa carência crescente dos utilizadores e do próprio Serviço. A Metodologia seguida para a construção deste Microtesauro, teve como base uma lista de Termos de Indexação construída a partir da análise de uma amostra de 125 monografias e a consulta de várias fontes de informção (monografias e obras de referência, linguagens documentais, e entrevistas informais a docentes da ESD). A análise, quantificação e qualificação dos termos que constituem este microtesauro teve o acompanhamento, avaliação e adequação contínua por parte de alguns docentes da ESD, investigadores e especialistas em Dança. A Dança, enquanto objeto de exploração teórica, revela-se uma disciplina transversal a várias áreas do conhecimento que, agrupadas em classes, correspondem a 8 áreas do saber, relacionadas com a Dança, tendo em consideração as temáticas do espólio documental do CDI e as matérias lecionadas nas Unidades Curriculares dos cursos de Licenciatura e Mestrados da ESD. O microtesauro na área da Dança, que resulta do nosso trabalho de investigação, é constituído por Descritores, Não-Descritores, e suas relações de equivalência hierárquicas e associativas, apresentando-se no final deste trabalho, em apêndice, devido à sua dimensão. O mesmo resulta de um processos de construção individual, inicialmente elaborado de forma manual e posteriormente transposto para um Software Documental CDS/ISIS para Windows, que veio agilizar a estruturação do microtesauro. Este microtesauro na área da Dança, em Língua Portuguesa, constitui um importante contributo para as Bibliotecas e Centros de Documentação que detêm documentação nesta área específica, dado colmatar uma lacuna existente neste domínio do conhecimento.

On the time-dependent analysis of Gamow decay

Gamow's explanation of the exponential decay law uses complex 'eigenvalues' and exponentially growing 'eigenfunctions'. This raises the question, how Gamow's description fits into the quantum mechanical description of nature, which is based on real eigenvalues and square integrable wavefunctions. Observing that the time evolution of any wavefunction is given by its expansion in generalized eigenfunctions, we shall answer this question in the most straightforward manner, which at the same time is accessible to graduate students and specialists. Moreover, the presentation can well be used in physics lectures to students.

Can agroforest woodlots work as stepping stones for birds in the Atlantic forest region?

In fragmented landscapes, agroforest woodlots can potentially act as stepping stones facilitating movement between forest fragments. We assessed the influence of agroforest woodlots on bird distribution and diversity in the Atlantic forest region (SE Brazil), and also tested which categories of species can use different types of connection elements, and whether this use is influenced by the distance to large forest patches. We studied two fragmented landscapes, with and without stepping stones linking large fragments, and one forested landscape. Using a point count, a bird survey was undertaken in the fragmented landscapes in five different elements: large remnants (> 400 ha), agroforest woodlots (0.4-1.1 ha), small patches (0.5-7 ha), riparian corridor, and pasture areas (the main matrix). Generalist and open-area species were commonly observed in the agroforest system or other connection elements, whereas only a few forest species were present in these connections. For the latter species, the distance of woodlots to large patches was essential to determine their richness and abundance. Based on our results and data from literature, we suggest that there is an optimal relationship between the permeability of the matrix and the efficiency of stepping stones, which occurs at intermediate degrees of matrix resistance, and is species-dependent. Because the presence of agroforest system favors a higher richness of generalist species, they appeared to be more advantageous for conservation than the monoculture system; for this reason, they should be considered as a management alternative, particularly when the matrix permeability requirement is met.

Teaching Intercultural Communication in Foreign Language Education through Video Conferencing

Since 1980s, Western linguists and specialists on second language acquisition have emphasized the importance of enhancing students’ intercultural communication competence in foreign language education. At the same time, the demand for intercultural communicative competence increased along with the advances of communication technology with its increasingly global reach and the process of globalization itself.In the field of distance language education, these changes have resulted in a shift of focus from the production and distribution of learning materials towards communication and learning as a social process, facilitated by various internet-based platforms. The current focus on learners interacting and communicating synchronously trough videoconferencing is known as the fourth generation of distance language education. Despite the fact that teaching of Chinese as a foreign language (CFL) faces the same or even greater challenges as teaching other languages, the intercultural communication perspective is still quite a new trend in CFL and its implementation and evaluation are still under development. Moreover, the advocates of the new trends in CFL have so far focused almost exclusively on classroom-based courses, neglecting the distance mode of CFL and leaving it as an open field for others to explore. In this under-researched context, Dalarna University (Sweden), where I currently work, started to provide web-based courses of the Chinese language in 2007. Since 2010, the Chinese language courses have been available only in the distance form, using the same teaching materials as the previous campus-based courses. The textbooks used in both settings basically followed the functional nationalism approach. However, in order to catch up with the main trend of foreign-language education, we felt a need to implement the cross-cultural dimension into the distance courses as well. Therefore in 2010, a pilot study has been carried out to explore opportunities and challenges for implementing a cross-cultural perspective into existing courses and evaluating the effectiveness of this implementation based on the feedback of the students and on the experience of the teacher/researcher.

Atitude socialmente responsável ou estratégia comercial: o caso do pacto global

The discussion about corporate obligations toward the various stakeholders began in the postindustrial era and developed to culminate in the creation of rules, regulations, programs and projects focusing on the dissemination and promotion of what we know today as corporate social responsibility (CSR). In this context, satisfying this new demand and adopting social policies emerge as a determining factor in defining organizational strategies. Nevertheless, some questions are raised when we examine the subject, such as: To what extent should organizations intervene in society? Is the decision for the organizations to adopt a socially responsible attitude really linked to promoting social well being, or is it only a commercial strategy? How does social marketing relate to CSR projects? The study herein, based on the concept and understanding of CSR theories, stakeholders and social marketing, has sought to find evidence of this relationship, in the light of the Global Compact (GC). It was decided to use the multi-case study methodology, considering the possibility of explaining the reasons why the decisions were taken, how they were implemented and what was the outcome. Interviews, supported by previously prepared scripts, were held with CSR managers, employees from other areas of the organizations, and specialists on the subject. Complementary research studies were made in various sources, such as the website of companies under analysis, their sustainability reports, and the GC websites in Brazil and the United Nations (UN). The results obtained show that the organizations have worked increasingly with CSR projects, but the efforts have not been focused. Special mention is given to the programs that create major impact on the company¿s image and reputation, such as projects competing for prizes and participating in the formation of rankings or socially responsible organizations. From the view of Carroll¿s Pyramid (1991) for CSR, it is found that the projects are predominantly focusing on ethical and philanthropic issues. The driving power of the GC, action based on learning, dialogue and partnership, is not to be found. This factor contributes to the statement that social marketing tools are used to build an ethical and socially responsible image, in detriment to effective action by the organizations to meet the social requirements of their stakeholders. The social marketing has as an objective to transform the way a specific public sees a social question and promotes behavior changes, but what has been seen is the use of marketing tools exclusively to promote the company's image.

O impacto da convergência tecnológica sobre o modelo organizacional das empresas

Estamos vivenciando uma era na qual a convergência entre a tecnologia da informação e a comunicação vem sendo identificada, por diversos estudiosos e acadêmicos, como a responsável pelas mudanças identificadas na sociedade, na economia e na revisão do papel do Estado ocorridas na segunda metade do século XX. Segundo estes pesquisadores, com sua apregoada capacidade de transformação dos conceitos de tempo e espaço, a convergência tecnológica vem introduzindo profundas transformações no modelo de gestão das empresas a partir do momento em que velocidade, flexibilidade, capacidade de integração e capacidade de inovação tornam-se fatores críticos de sucesso para qualquer organização que queira ser bem sucedida na economia atual. Cada vez mais eficácia, eficiência, disponibilidade e produtividade são exigidas dos profissionais, independentemente do nível hierárquico, da especialização ou da localização física de seus escritórios. Essa dissertação tem como objetivo verificar se a utilização de ferramentas oriundas da convergência da tecnologia da informação e comunicação pode ser considerada como um fator determinante para a implementação de uma organização com barreiras fluidas.

Análise do licenciamento ambiental como instrumento de política do meio ambiente no Rio Grande do Norte Período 1992-2003

This analysis on the ambient licensing is based on a research that identifies the fragilities and advances of the application of this instrument of politics of the environment in the ambient politics of the Rio Grande do Norte, in the period of 1992 the 2003. The isolated urban area of Búzios, situated in the City of Nísia Floresta/RN, situated in the eastern coast of the State, where concentrates the boarding of the ambient question as a matter in the Brazilian process of urbanization, over all the institutionalization and implementation of the ambient licensing. They are distinguished in the used methodology in consultation to the diverse involved social segments with the ambient subject in study, the example of the managers, technician and specialists, as well as the application of the legislation and norms techniques, the forms of appropriation of the common wealth and the procedures of ambient licensing of the competent agencies. The results of the research designate that the ambient licensing while instrument of the ambient politics is one of the alternatives more efficient as techniques in the process of sustainable development, since it is beyond the prerogatives to conciliate the activities and enterprises with the conservation of the environmental resources and natural benefits to the societies. In the RN one evidenced progress in the ambient legislation and the instructions techniques, and that the imperfections and limitations in the system of ambient licensing are not directly on to the instruments, but in the implementation of mechanisms of the ambient agencies. This because they do not make use of operational structure to apply in practical and established abilities, as an ambient management, institutional joint and deliberations of the State Counselor for Environment

Apoio pedagógico, ação coletiva e diálogo: tramas da formação continuada em educação inclusiva

This work detaches the importance of the continued formation of the educators in terms of the inclusive educational process, pointing as basic elements the continued formation of the educational professionals. In this direction, it points and it defends the dialogue in the perspective of David Bohm, with interfaces of the freireanas ideas, as a methodological resource of action that allows the organization of strategies of collective and effective pedagogical support in inclusive schools, in the same time articulates the continued formation of the professionals in education. Characterized as research in a dialogical action with collective participation and collaboration, it counted with the participation of 87 educators, between professors, pedagogical, managing coordinators and specialists of special education in two schools of the state and municipal public system of Natal/RN. The results had pointed with respect to the viability of the dialogue as articulated methodological tool of the continued formation in service, when providing the establishment of personal and professional relationship between the educators, favoring the discursive enjoyment of the lived experiences, allows the organization of strategies of collective and effective pedagogical support in the scholar environment. On the basis of these results, this work also points to some items to reflections as the reorganization of the Secretariats and the schools, in the direction to brighten up the fragmentation and the discontinuity of the pedagogical actions evidenced and to instigate a process of changes that has glimpsed the professional development of the educators through its continued formation in service and the improvement of the school in the way of the concretization of an education directed toward the acceptance, respect and attendance the diversity of its pupils, as detaches the official documents and the studies on the inclusive education

Epiphyte plants use by birds in Brazil

This study firstly reviewed the interspecific interaction records between birds and epiphyte plants in Brazil. Forty two documents, including articles, scientific notes, books and thesis, and 35 personal records and from collaborators were argued, totaling 112 species of birds that interacted with 97 species of epiphyte plants. Two articles treated the theme specifically and another 40 treated related subjects, such as: pollination of epiphytes, ecology and feeding behavior of birds. Studies were concentrated mainly in Atlantic Forest, in the southeastern Brazilian region. The epiphyte species more visited by birds was Aechmea nudicaulis (Bromeliaceae). The main visitor of epiphytes was Ramphodon naevius (Trochilidae). According to the number of authors' citations an index of generality in bird-epiphyte interactions was created. As result the index inferred that the ovenbird Cichlocolaptes leucophrus and the bromeliad Nidularium procerum are less generalist and more specialist species in bird-epiphyte interactions. The totality of the papers showed a considerable number of bird species that use the epiphytes plants and its resources, including nectar, fruits, invertebrates, nest material, nesting place, water and bath. Considering the importance of epiphytes to supply a variety of resources for birds, these results highlighted the necessity of additional and specific studies about the theme in various Brazilian regions and biomes.

Atlas escolares municipais: a moda e os professores

Neste artigo abordamos o crescimento das pesquisas e da produção de atlas escolares municipais e a relação entre pesquisadores e professores, considerando o atual contexto curricular e a concepção do trabalho docente segundo a racionalidade técnica que caracteriza as reformas educacionais na sociedade neoliberal. em uma análise dos trabalhos apresentados sobre o tema atlas escolares, nos cinco eventos científicos realizados no Brasil sobre cartografia para crianças, notamos que predomina a produção desses materiais por pesquisadores e especialistas, externa ao âmbito do trabalho dos professores.

Referral letters in oral medicine: standard versus non-standard letters

Usually referral letters are the only means of communication between general practitioners and specialists in the health area. However, they are inadequate if important basic data are omitted. The aim of this study was to compare the content of standard and non-standard letters. A total of 1956 files from the Oral Medicine Service were consecutively evaluated (March 1996 to September 2000). Key items were considered for analysis and the results were stored in a database using the Epinfo 6.04 program. The X-2 test (a=0.05) was applied to the results. of the 1956 files examined, 34% (662) had a referral letter, 31% of them being standard letters and 69% non-standard letters. Most standard letters (87%) were from professionals of public health institutions. Most percent discrepancies between standard and non-standard letters were observed for patient address (14.90 vs 1.32%), patient age (54.81 vs 9.47%), chief complaint (32.21 vs 8.37%), fundamental lesion (29.33 vs 13.66%), and symptoms (27.81 vs 15.42%,,). Statistically significant differences were observed for patient age, professional referring the patient, chief complaint, and site of the lesion. The quality and quantity of the information differed significantly between the two types of letters. The standard letters were more complete and contained information commonly absent in the non-standard letters. We suggest the use of standard letters for improving the quality of communication among professionals.

Behavior of Atta sexdens rubropilosa (Hymenoptera: Formicidae) workers during the preparation of the leaf substrate for symbiont fungus culture

The behavioral repertory of Atta sexdens rubropilosa Forel (Hymenoptera: Formicidae) workers marked by size category was studied during the preparation of the leaf substrate in the laboratory. The workers were marked according to three physical castes, i.e., minima, generalist and forager. Seven types of behavioral acts were recorded for each caste, with the following frequencies: licking leaf fragments (64.6%), holding fragments on the surface of the fungus garden (16.4%), shredding the fragments (6.0%), chewing and crimping the edges of the fragments (9.0%), incorporating the fragments (2.7%), touching the surface of the fungus with their mandibles and other mouthparts after incorporation (0.3%), and depositing fecal fluid (0.1%). The minima workers were found to be more specialized in the activities related to the preparation of the leaf substrate, which represented 52% of the total number of tasks performed. The generalists performed 40.3% of these tasks, and the foragers 7.9%. Licking the substrate was the behavior most frequently recorded and performed for a longer period of time. In this way, the workers may feed and at the same time eliminate microorganisms that are harmful to the symbiont fungus. The smaller castes, minima and generalists, are those most responsible for the preparation of the leaf substrate and predominate within a colony. From a practical viewpoint, with the introduction of toxic bait containing insecticides, for example, these size categories will be those most intensely intoxicated, especially through the behavior of licking bait pellets. On the basis of the data obtained about these behaviors, we may raise the hypothesis that trophallaxis in not the major factor triggering contamination with an insecticide among the workers of a colony.