Influence d'un incitatif financier destiné aux médecins de famille sur la gestion du diabète des Néo-Brunswickois

Résumé: Problématique : En réponse à la prévalence accrue de la maladie du diabète et au fardeau économique important que représente cette maladie sur le système de santé international, des programmes incitatifs pour les maladies chroniques furent instaurés à travers le monde. Ces programmes visent à inciter les médecins à appliquer les lignes directrices chez leurs patients avec besoin complexe en vue d’améliorer la santé des patients et par la suite de réduire les coûts incombés par le système de santé. Les programmes incitatifs étant nombreux et différents d’un pays à l’autre, les études actuelles ne semblent pas s’entendre sur les répercussions de tels programmes sur la santé des patients atteints de diabète. L’objectif de cette étude est d’évaluer les retombées d’un incitatif financier sur le contrôle glycémique de la population atteinte de diabète du Nouveau-Brunswick, au Canada. Méthodes : Cette étude transversale répétée et de cohorte a été menée grâce à des bases de données administratives du Nouveau-Brunswick contenant des données sur dix ans pour 83 580 patients adultes atteints de diabète et 583 médecins de famille éligibles. La santé des patients a été évaluée au niveau du contrôle glycémique, en mesurant les valeurs moyennes d’A1C annuelles à l’aide de régressions linéaires multivariées. Afin d’évaluer si les médecins changeaient leur pratique avec l’implantation du programme incitatif, nous regardions au niveau de la probabilité de recours annuel à au moins deux tests d’A1C en utilisant des régressions logistiques multivariées. Résultats : La probabilité de recours annuel à au moins deux tests d’A1C était plus élevée dans quatre sous-groupes étudiés : les patients nouvellement diagnostiqués après l’implantation du programme avaient des cotes plus élevées comparées aux nouveaux patients avant l’implantation du programme (OR=1.23 [1.18-1.28]); les patients pour lesquels un médecin avait réclamé l’incitatif comparés aux patients pour lesquels aucun médecin n’avait réclamé l’incitatif (OR=2.73 [2.64-2.81]); les patients pour lesquels un médecin avait réclamé l’incitatif avaient des cotes plus élevées après l’implantation du programme comparé à avant (OR=1.89 [1.80-1.98]); et finalement, les patients suivis par un médecin de famille qui a déjà réclamé l’incitatif avaient des cotes 24% plus élevées (OR=1.24 [1.15-1.34]). Il n’y avait pas de différence dans les valeurs d’A1C annuelles entre les 4 sous-groupes étudiés. Conclusion : L’implantation du programme incitatif a démontré que les médecins ont une meilleure probabilité de prescrire au moins deux tests d’A1C, ce qui suggère une meilleure prise en charge des patients. Cependant, le manque de changement au niveau du contrôle glycémique du patient suggère que l’étude des répercussions de l’incitatif devra être poursuivie afin de voir si elle mène à une amélioration d’issues cliniques chez les patients.

Narratività, ritmo e forma audiovisivi in Regen di Joris Ivens con musica di Hanns Eisler.

Joris Ivens’ experimental film Regen and the music Hanns Eisler composed for it represent individually two major achievements in the artistic career of both the Dutch director and the German composer. Their union yielded a peculiar audiovisual product for at least two main reasons: on the one hand the music was composed more than ten years later, on the other hand, a result of a research project, Eisler’s composition responded to specific theoretical intentions that ‘commercial’ film music does not generally have. It is mostly because of the latter aspect that we can look at ‘Eisler’s Regen’ with a unique analytic perspective aimed to highlight traces of continuity in both the video and the music under three complementary viewpoints: narrative, rhythmic and formal. The outcome of such an analysis is meant to give proof of a highly integrated audiovisual creation that is rarely found in the history of experimental cinema.

„Reformpädagogik". Erneuter Versuch, ein erstaunliches Phänomen zu verstehen

„Reformpädagogik", so die zentrale These der Abhandlung, ist nach ihrem Ursprung nicht zu verstehen, ohne den Akt der Kreation und Konstruktion zu berücksichtigen, in dem vor allem die NoHL-Schule aus einer Vielzahl von Erziehungsexperimenten die Einheit einer Bewegung stiftet und die Bewegung zugleich formiert und diszipliniert. Systematisch, d. h. nach ihrer Möglichkeit, Funktion und Leistung sowie in der Kontinuität der Rezeption läßt sich Reformpädagogik allerdings erst erklären, wenn man sie - gegen den Vorwurf des Antimodernismus - nicht nur historisch interpretiert, sondern als Form der reflexiven Modernisierung der Erziehung auch konzeptionell, als Leistung versteht. (DIPF/Orig.)

Computer in Unterricht und Ausbildung. Neue Anforderungen an Lehrer, Ausbilder und Trainer?

Die Nützlichkeit des Einsatzes von Computern in Schule und Ausbildung ist schon seit einigen Jahren unbestritten. Uneinigkeit herrscht gegenwärtig allerdings darüber, welche Aufgaben von Computern eigenständig wahrgenommen werden können. Bewertet man die Übernahme von Lehrfunktionen durch computerbasierte Lehrsysteme, müssen häufig Mängel festgestellt werden. Das Ziel der vorliegenden Arbeit ist es, ausgehend von aktuellen Praxisrealisierungen computerbasierter Lehrsysteme unterschiedliche Klassen von zentralen Lehrkompetenzen (Schülermodellierung, Fachwissen und instruktionale Aktivitäten im engeren Sinne) zu bestimmen. Innerhalb jeder Klasse werden globale Leistungen der Lehrsysteme und notwendige, in komplementärer Relation stehende Tätigkeiten menschlicher Tutoren bestimmt. Das dabei entstandene Klassifikationsschema erlaubt sowohl die Einordnung typischer Lehrsysteme als auch die Feststellung von spezifischen Kompetenzen, die in der Lehrer- bzw. Trainerausbildung zukünftig vermehrt berücksichtigt werden sollten. (DIPF/Orig.)

Out with the old, in with the new: A reliable workflow in writing a report on diversity and inclusion

The Diversity Advisory Committee (DAC) will discuss the dynamics of the process of assessing the diversity health at the University of Maryland Libraries. From designing the survey instrument through analyzing the results to the final writing of the report of diversity and inclusion, the committee members will unveil their challenges and achievements in presenting unbiased conclusions from this assessment project. In completing this project, the committee consulted the university’s wisdom, including (1) the College of Information Studies for creating the survey; (2) the Office of Institutional Research, Planning and Assessment (IRPA), and Division of Information Technology (DIT) for analyzing the results; and (3) the Campus Assessment Working Group (CAWG) model for organizing the content of the final report.

Plan de estrategias para mejorar la participación de Geomedicos y posicionamiento de la categoría

Geomedicos S.A.S identifica mayor cantidad de servicios a sus clientes generando mayor valor agregado, logrando fidelización y canaliza las necesidades de su cliente potencial, basado en buenos estándares de calidad; representado en un buen servicio. Adoptando el siguiente paradigma “la calidad de un producto o servicio conduce a la satisfacción del cliente que lleva a la fidelización del cliente, que conduce a la rentabilidad. La participación de todo un grupo de trabajo orientados a dar las mejor resultados, es lo que más motiva para hacer que la empresa de logros positivos y óptimos de acuerdo a un plan estratégico que se hace interno y productivo para que la gerencia tome decisiones acordes al crecimiento y ponderación; determinando incentivos que favorezcan la calidad de vida de cada uno de sus empleados y de sus familias, haciendo partícipe a cada uno de ellos.

Análisis de las Olimpiadas Nacionales de Química en Costa Rica: alcances y retos para la población joven

La Escuela de Química ha promovido programas y proyectos académicos como las Olimpiadas de Química que estimulen y mejoren el aprendizaje de esta ciencia. Como competencia se identifican estudiantes de alto desempeño escolar y se promueven espacios de autosuperación sana y estimula el pensamiento científico. Después de más de una década de existencia, los datos se han compilado y organizado para analizar estadísticamente los primeros 10 años mediante el programa SPSS 11.5. Este artículo incluye análisis estadísticos para cada una de las ediciones, que incluye variabilidad y  significancia. La información se presenta en forma esquemática, y considera variables como género, ubicación geográfica de las instituciones educativas y modalidad. Se obtuvo una diferencia significativa entre hombres y mujeres, (T= 2,961, P < 0,03 participación eliminatoria, categoría A) y (T= 3,640, P < 0,00 notas eliminatoria, categoría A). Un patrón similar se obtiene en la modalidad educativa y ubicación geográfica.  Cuantitativamente, se demuestra el interés y entusiasmo creciente por la participación. Ya han pasado más de 10 años, y la Olimpiada de Química en Costa Rica es un programa consolidado, de alta credibilidad a nivel nacional e internacional que delinea futuros científicos en campos vinculados con las ciencias exactas y naturales.

NEW PERSPECTIVES: TRANSCRIPTIONS FOR VIOLA

One must only glance upon Franz Zeyringer’s 400-page, exhaustive Literatur für Viola to understand the error of the familiar but casual criticism of the paucity of the viola catalogue. Examining Zeyringer’s resource, however, we find a trend: while the viola repertoire contains many pieces (over 14,000 works) and does lay claim to many masterworks (Bartok’s Viola Concerto, Hindemith’s Sonatas, Mozart’s Sinfonia Concertante, etc.), many of the pieces originally written for the instrument are not widely recognized compositions and not often considered outstanding achievements. The violist, much like the double-bassist, bassoonist, and hornist, faces a certain challenge when selecting repertoire for a recital: a lack of large, important works that both fit the instrument and challenge the recitalist. This project will aim to expand recital repertoire for the viola through the development of new transcriptions, using the previously transcribed Fantasy Pieces by Schumann (trans. Leonard Davis) and Sonata No. 2 in E-flat, Op. 120 by Brahms (trans. Brahms) as an inspiration and guide. As a result, the catalogue of viola repertoire will not only be increased but the difference in tone and depth of the instrument may unveil previously unnoticed perspectives on the works. With a primary aim to expand the literature of the viola through the development of new transcriptions, this project will also strive to offer new, previously unnoticed perspectives on preexisting works. Through the changing of the instrumentation, listeners and performers will have the opportunity to explore the character of the compositions in a fresh and possibly illuminating way. Perhaps this project will encourage previously unexplored transcriptions to be realized and performed. While the recital repertoire for the viola boasts many and great works, the original transcriptions of this project attempt to infuse the collection with new and interesting possibilities for both study and performance. This dissertation project is comprised of three recitals featuring works transcribed for viola and, in most cases, newly transcribed by myself. All events took place on the campus of University of Maryland, College Park: Recital #1 on November 9, 2014 in the Gildenhorn Recital Hall of the Clarice Smith Performing Arts Center; Recital #2 on May 9, 2015, in Ulrich Recital Hall; and Recital #3 on November 6, 2015, in the Gildenhorn Recital Hall. 

St Helens College: LinkedIn opens up the world of work

At St Helens College LinkedIn accounts are enabling foundation degree students to showcase their achievements and form relationships with potential employers to boost their employability.

Linking electronic journals - Lessons from the Open Journal project

The Open Journal project has completed its three year period of funding by the UK Electronic Libraries (eLib) programme (Rusbridge 1998). During that time, the number of journals that are available electronically leapt from a few tens to a few thousand. Some of these journals are now developing the sort of features the project has been advocating, in particular the use of links within journals, between different primary journals, with secondary journals data, and to non-journal sources. Assessing the achievements of the project and considering some of the difficulties it faced, we report on the different approaches to linking that the project developed, and summarise the important user responses that indicate what works and what does not. Looking ahead, there are signs of change, not just to simple linking within journals but to schemes in which links are the basis of "distributed" journals, where information may be shared and documents built from different sources. The significance has yet to be appreciated, but this would be a major change from printed journals. If projects such as this and others have provided the initial impetus, the motivation for distributed journals comes, perhaps surprisingly, from within certain parts of the industry, as the paper shows.

DNA Barcoding as a tool for Zoological Taxonomy: Identification of bony fish in the Mediterranean Sea

The description of all the species present in nature is a vast task to be fulfilled by using the classical approach of morphological description of the organisms. In recent years, the traditional taxonomy, based primarily on identification keys of species, has shown a number of limitations in the use of the distinctive features in many animal taxa and inconsistencies with the genetic data. Furthermore, the increasing need to get a true estimate of biodiversity has led Zoological Taxonomy to seek new approaches and methodologies to support the traditional methods. The classification procedure has added modern criteriasuch as the evolutionary relationships and the genetic, biochemical and morphological characteristics of the organisms.Until now the Linnean binomial was the only abbreviated code associated with the description of the morphology of a species. The new technologies aim to achieve a short nucleotide sequence of the DNA to be used as an unique and solely label for a particular species, a specific genetic barcode. For both morphological and genetic approaches, skills and experience are required. Taxonomy is one of zoological disciplines that has been benefited from the achievements reached by modern molecular biotechnology. Using a molecular approach it is possible to identify cryptic species, to establish a family relationship between species and their membership of taxonomic categories or to reconstruct the evolutionary history of a taxon.

The grand challenge of food security - general lessons from a comprehensive approach to protecting stored grain from insect pests in Australia and India

We outline a philosophical approach to Grand Challenge projects, with particular reference to our experience in our food security project involving the protection of stored grain from insect attack in two countries on different continents. A key consideration throughout has been the management of resistance in these pests to the valuable fumigant phosphine. Emphasis is given to the chain of research issues that required solution and the assembly of a well-integrated team, overlapping in skills for effective communication, in each country to solve the problems identified along that chain. A crucial aspect to maintaining direction is the inclusion of key end users in all deliberations, as well as the establishment and maintenance of effective outlets for the dissemination of practical recommendations. We finish with a summary of our achievements with respect to our approach to this food security Grand Challenge.

Escarcéu e escassez no teatro de Mossoró: percursos e percalços de uma dramaturgia na rua

This research is a result of the theatrical Street show named A Árvore dos Mamulengos, an appropriation of the drama text by Vital Santos, this presentation was done from 1989 to 2001, with the Companhia Escarcéu de Teatro, in the city of Mossoró/RN, Brazil. The intention here is to mapping the voices and memories of actors and actresses who have experienced the performance, the developments and achievements which resulted from twelve years of the season. In our study, we consider the importance of the choice for the open space such as streets and squares as the main local for representation considering it as a catalyst factor of aesthetic choice. However, we`ve consider the option for the collaborative process as the methodology staging by interpreters, as well as, the social and cultural determinants that were taking place deeming the realization of the spectacle

Prática pedagógica em educação de infância : consciência fonológica e desenvolvimento de competências orais e escritas

Relatório de estágio para a obtenção do grau de mestre em Educação pré-escolar e 1º Ciclo do ensino básico

Jung and Goddess: the significance of Jungian and post-Jungian theory to the development of the Western Goddess Movement

This study is concerned with the significance of Jungian and post-Jungian theory to the development of the contemporary Western Goddess Movement, which includes the various self-identified nature-based, Pagan, Goddess Feminism, Goddess Consciousness, Goddess Spirituality, Wicca, and Goddess-centred faith traditions that have seen a combined increase in Western adherents over the past five decades and share a common goal to claim Goddess as an active part of Western consciousness and faith traditions. The Western Goddess Movement has been strongly influenced by Jung’s thought, and by feminist revisions of Jungian Theory, sometimes interpreted idiosyncratically, but presented as a route to personal and spiritual transformation. The analysis examines ways in which women encounter Goddess through a process of Jungian Individuation and traces the development of Jungian and post-Jungian theories by identifying the key thinkers and central ideas that helped to shape the development of the Western Goddess Movement. It does so through a close reading and analysis of five biographical ‘rebirth’ memoirs published between 1981 and 1998: Christine Downing’s (1981) The Goddess: Mythological Images of the Feminine; Jean Shinoda Bolen’s (1994) Crossing to Avalon: A Woman’s Midlife Pilgrimage; Sue Monk Kidd’s (1996) The Dance of the Dissident Daughter: A Woman’s Journey from Christian Tradition to the Sacred Feminine; Margaret Starbird’s (1998) The Goddess in the Gospels: Reclaiming the Sacred Feminine; and Phyllis Curott’s (1998) Book of Shadows: A Modern Woman’s Journey into the Wisdom of Witchcraft and the Magic of the Goddess. These five memoirs reflect the diversity of the faith traditions in the Western Goddess Movement. The enquiry centres upon two parallel and complementary research threads: 1) critically examining the content of the memoirs in order to determine their contribution to the development of the Goddess Movement and 2) charting and sourcing the development of the major Jungian and post-Jungian theories championed in the memoirs in order to evaluate the significance of Jungian and post-Jungian thought in the Movement. The aim of this study was to gain a better understanding of the original research question: what is the significance of Jungian and post-Jungian theory for the development of the Western Goddess Movement? Each memoir is subjected to critical review of its intended audiences, its achievements, its functions and strengths, and its theoretical frameworks. Research results offered more than the experiences of five Western women, it also provided evidence to analyse the significance of Jungian and post-Jungian theory to the development of the Western Goddess Movement. The findings demonstrate the vital contributions of the analytical psychology of Carl Jung, and post-Jungians M Esther Harding, Erich Neumann, Christine Downing, E.C. Whitmont, and Jean Shinoda Bolen; the additional contributions of Sue Monk Kidd, Margaret Starbird, and Phyllis Curott, and exhibit Jungian and post-Jungian pathways to Goddess. Through a variety of approaches to Jungian categories, these memoirs constitute a literature of Individuation for the Western Goddess Movement.