Contraintes vécues, idéal normatif et actions déployées en vue de transformer l’exercice de la profession infirmière en centre hospitalier : une étude exploratoire auprès d’infirmières québécoises politiquement engagées

Les changements socioéconomiques des dernières décennies ont profondément transformé le rapport qu’entretient le Québec avec ses professionnels de la santé. En ouvrant le champ à l’accumulation privée du capital dans les années 1990, se met en place au sein de la fonction publique une philosophie politique issue du monde des affaires. Dès lors, le paradigme de la gouvernance investit les hôpitaux, où exerce 65 % de l’effectif infirmier québécois. Des chercheurs ont investigué les contraintes et torts subis par les infirmières consécutivement à la restructuration du système de santé, cependant, peu d’entre eux ont tenu compte des rapports de force et des structures de pouvoir dans lesquels s’enracine le vécu des infirmières. La présente étude a pour but d’explorer les expériences vécues d’infirmières soignantes politiquement engagées qui exercent en centre hospitalier (CH), de rendre compte de l’ordre social existant au sein de cette institution, de décrire la façon dont elles aimeraient idéalement exercer et de répertorier les idées qu’elles ont et les actions qu’elles mettent en place individuellement ou collectivement de façon à favoriser la transformation de l’ordre social et de l’exercice infirmier en CH. Épistémologiquement, notre étude qualitative s’inscrit dans cette idée que la réalité est complexe, mouvante et dépendante de la perception des personnes, proposant une orientation compréhensive et contextualisée de l’action humaine et du politique; c’est ainsi que le point de vue politique des infirmières participantes est pris en compte. L’articulation des expériences vécues, de l’idéal normatif et de l’action politique des participantes est explorée suivant une perspective postmoderniste, praxéologique et dialectique issue de la théorie critique qui réfléchit non seulement sur ce qui est, mais également sur ce qui est souhaitable; une réflexion qui sous certaines conditions s’ouvre sur l’action transformatrice. Les notions de pouvoir, de rapport de force, de résistance et d’émancipation influencent notre analyse. Au terme de cette étude, les résultats indiquent la présence d’une déprofessionnalisation graduelle en faveur d’une technicisation du soin infirmier et d’une dérive autoritaire grandissante au sein des CH s’arrimant au registre sémantique de l’économie de marché à partir des notions d’efficacité, de performance et d’optimisation. Les infirmières soignantes perçues comme des « automates performants » se voient exclues des processus décisionnels, ce qui les prive de leurs libertés de s’exprimer et de se faire critiques devant ce qui a été convenu par ceux qui occupent les hautes hiérarchies du pouvoir hospitalier et qui déterminent à leur place la façon dont s’articule l’exercice infirmier. Le pouvoir disciplinaire hospitalier, par l’entremise de technologies politiques comme la surveillance continue, les représailles et la peur, la technicisation du soin et le temps supplémentaire obligatoire, concourt à la subjectivation des infirmières soignantes, en minimisant l’importance de leur jugement clinique, en affaiblissant la solidarité collective et en mettant au pas l’organisation syndicale, ce qui détournent ces infirmières de la revendication de leurs droits et idéaux d’émancipation les ramenant à une position subalterne. Nos résultats indiquent que les actions politiques que les participantes souhaitent déployer au sein des CH visent l’humanisation des soins et l’autodétermination professionnelle. Toutefois, nombre des actions répertoriées avaient pour finalité fonctionnelle la protection et la survie des infirmières au sein d’un dispositif hospitalier déshumanisant. Certaines infirmières soignantes s’objectent en conscience, déploient des actions de non-coopération individuelles et collectives, font preuve d’actes de désobéissance civile ou souhaitent agir en ce sens pour établir un rapport de force nécessaire à la prise en compte de leurs revendications par une gouvernance hospitalière qui autrement ferait la sourde oreille. Le pouvoir exercé de façon hostile par la gouvernance hospitalière doit à notre avis être contrecarré par une force infirmière collective égale ou supérieure, sans quoi les politiques qui lui sont associées continueront de leur être imposées. Le renouvellement radical de la démocratie hospitalière apparaît comme la finalité centrale vers laquelle doivent s’articuler les actions infirmières collectives qui permettront l’établissement d’un nouveau rapport de force puisque c’est à partir de celle-ci que les infirmières soignantes pourront débattre de l’orientation que doit prendre l’exercice infirmier.

Nonparametric estimation of the leverage effect: a trade-off between robustness and efficiency

We consider two new approaches to nonparametric estimation of the leverage effect. The first approach uses stock prices alone. The second approach uses the data on stock prices as well as a certain volatility instrument, such as the CBOE volatility index (VIX) or the Black-Scholes implied volatility. The theoretical justification for the instrument-based estimator relies on a certain invariance property, which can be exploited when high frequency data is available. The price-only estimator is more robust since it is valid under weaker assumptions. However, in the presence of a valid volatility instrument, the price-only estimator is inefficient as the instrument-based estimator has a faster rate of convergence. We consider two empirical applications, in which we study the relationship between the leverage effect and the debt-to-equity ratio, credit risk, and illiquidity.

Copper Doped Methylene Blue Sensitized Poly(vinyl alcohol)–Acrylamide Films for Stable Diffraction Efficiency

Copper doped methylene blue sensitized poly(vinyl alcohol) (MBPVA)–acrylamide films were fabricated to improve the storage life of recorded gratings. The films were fabricated using gravity settling method and the copper chloride concentration was optimized as 3:18 10 3 mol/l for a dye concentration of 6:2 10 4 mol/l. The gratings recorded on the optimized film constitution could be stored for months with stable diffraction efficiency (24%) without any chemical or thermal fixing techniques. The resolution of the material is found to be unaffected with the addition of copper chloride.

Copper Doped Methylene Blue Sensitized Poly(vinyl alcohol)–Acrylamide Films for Stable Diffraction Efficiency

Copper doped methylene blue sensitized poly(vinyl alcohol) (MBPVA)–acrylamide films were fabricated to improve the storage life of recorded gratings. The films were fabricated using gravity settling method and the copper chloride concentration was optimized as 3:18 10 3 mol/l for a dye concentration of 6:2 10 4 mol/l. The gratings recorded on the optimized film constitution could be stored for months with stable diffraction efficiency (24%) without any chemical or thermal fixing techniques. The resolution of the material is found to be unaffected with the addition of copper chloride.

Enhancement of Diffraction Efficiency and Storage Life of Poly (Vinyl Chloride) Based Optical Recording Medium with the Incorporation of an Electron Donor

The differaction efficiency,sensitivity and storage life of Methylene Blue sencitized poly (vinyl chloride) film was improved by the addition of an electron donor in the matrix. The addition of pyridine enhanced the diffraction efficiency by two times and storage life of the gratings was increased to 2-3 days.

Effect of Chromium Doping on the Diffraction Efficiency of Methylene Blue Sensitized PVA/Acrylamide Films

The effect of chromium doping on methylene blue sensitized Poly (vinyl alcohol)/Acrylamide was carried out by varying the ratios of Ammonium dichromate and methylene blue. In the case of films without ammonium dichromate, the diffraction efficiency was found to decrease on storage. On chromium doping the storage life was improved. Interestingly, a self-enhancement in efficiency was observed for a particular ratio of methylene blue and ammonium dichromate.

Copper Doped Methylene Blue Sensitized Poly(vinyl alcohol)–Acrylamide Filmsfor Stable Diffraction Efficiency

Copper doped methylene blue sensitized poly(vinyl alcohol) (MBPVA)–acrylamide films were fabricated to improve the storage life of recorded gratings. The films were fabricated using gravity settling method and the copper chloride concentration was optimized as 3:18 10 3 mol/l for a dye concentration of 6:2 10 4 mol/l. The gratings recorded on the optimized film constitution could be stored for months with stable diffraction efficiency (24%) without any chemical or thermal fixing techniques. The resolution of the material is found to be unaffected with the addition of copper chloride.

Enhancement of Diffraction Efficiency and Storage Life of Poly (Vinyl Chloride) Based Optical Recording Medium with the Incorporation of an Electron Donor

The differaction efficiency,sensitivity and storage life of Methylene blue sensitized poly(vinyl chloride) film was improved by the addition of an electron donor in the matrix. The addition of pyridine enhanced the diffraction efficiency by two times and storage life of the gratings was increased to 2-3 days.

Dielecting-resonator-loaded microstrip antenna for enhanced impedance bandwidth and efficiency

A new method for enhancing the 2.1 VSWR impedance bandwidth of microstrip antennas is presented. Bandwidth enhancement is achieved by loading the microstrip antenna by a ceramic microwave dielectric resonator (DR). The validity of this technique has been established using rectangular and circular radiating geometries. This method improves the bandwidth of a rectangular microstrip antenna to more than 10% (= 5 times that of a conventional rectangular microstrip antenna) with an enhanced gain of I dB

Efficiency in Central Public Sector Enterprises in Kerala

For the analysis of productivity, capacity utilisation and profitability the data relating to the manufacturing central public sector enterprises in Kerala have been collected from the published annual reports of the companies, public enterprises surveys of Bureau of Public Enterprises (BPE), Economic Review of State Planning Board (SPB) and statistical review of central government enterprises by Centre for Monitoring Indian Economy (CMIE). Primary data have been collected by conducting personal interview with the high and middle level executives.

Metabolic Efficiency of Penaeus Indicus H.Milne Edwards Under Different Salinity Stress Conditions

The investigation was aimed at establishing the effect of salinity on the culture performance of Peneus Indicus in pokkali fields and also to find out the growth performance of the shrimp at varying salinities. The experiments were laid out at Rice Research Station, Vyttila of Kerala Agriculture University in three fields of area 1000 m2 each. The results of the experiment clearly establish that shrimps when stocked at higher salinity (20-25 ppt) for 45 days has given higher growth, survival and production than those stocked at lower salinity (10-15 ppt) in all the above parameters even when the culture experiment was maintained for longer periods in lower salinity. In the prolonged culture experiments conducted for 120 days in 10-25 ppt salinity, the results were poorer than the short period culture in higher salinity and the production values similar to lower saline culture. This clearly establishes the importance of salinity as an ecological factor which will have profound influence in shrimp farming operations.

Solid acid-catalyzed dehydration/Beckmann rearrangement of aldoximes: towards high atom efficiency green processes

Rare earth metal ion exchanged (La3+, Ce3+, RE3+) KFAU-Y zeolites were prepared by simple ion-exchange methods and have been characterized using different physico-chemical techniques. In this paper a novel application of solid acid catalysts in the dehydration/ Beckmann rearrangement of aldoximes; benzaldoxime and 4-methoxybenzaldoxime is reported. Dehydration/Beckmann rearrangement reactions of benzaldoxime and 4-methoxybenzaldoxime is carried out in a continuous down flow reactor at 473K. 4-Methoxybenzaldoxime gave both Beckmann rearrangement product (4-methoxyphenylformamide) and dehydration product (4-methoxybenzonitrile) in high overall yields. The difference in behavior of the aldoximes is explained in terms of electronic effects. The production of benzonitrile was near quantitative under heterogeneous reaction conditions. The optimal protocol allows nitriles to be synthesized in good yields through the dehydration of aldoximes. Time on stream studies show a fast decline in the activity of the catalyst due to neutralization of acid sites by the basic reactant and product molecules.

Studies on Fluorescence Efficiency and Photodegradation of Rhodamine 6G Doped PMMA Using a Dual Beam Thermal Lens Technique

In this paper we report the use of the dual beam thermal lens technique as a quantitative method to determine absolute fluorescence quantum efficiency and concentration quenching of fluorescence emission from rhodamine 6G doped Poly(methyl methacrylate) (PMMA), prepared with different concentrations of the dye. A comparison of the present data with that reported in the literature indicates that the observed variation of fluorescence quantum yield with respect to the dye concentration follows a similar profile as in the earlier reported observations on rhodamine 6G in solution. The photodegradation of the dye molecules under cw laser excitation is also studied using the present method.