Design thinking and the precautionary principle : development of a theoretical model complementing preventive judgment for design for sustainability enriched through a study of architectural competitions adopting LEED

Cette thèse contribue à une théorie générale de la conception du projet. S’inscrivant dans une demande marquée par les enjeux du développement durable, l’objectif principal de cette recherche est la contribution d’un modèle théorique de la conception permettant de mieux situer l’utilisation des outils et des normes d’évaluation de la durabilité d’un projet. Les principes fondamentaux de ces instruments normatifs sont analysés selon quatre dimensions : ontologique, méthodologique, épistémologique et téléologique. Les indicateurs de certains effets contre-productifs reliés, en particulier, à la mise en compte de ces normes confirment la nécessité d’une théorie du jugement qualitatif. Notre hypothèse principale prend appui sur le cadre conceptuel offert par la notion de « principe de précaution » dont les premières formulations remontent du début des années 1970, et qui avaient précisément pour objectif de remédier aux défaillances des outils et méthodes d’évaluation scientifique traditionnelles. La thèse est divisée en cinq parties. Commençant par une revue historique des modèles classiques des théories de la conception (design thinking) elle se concentre sur l’évolution des modalités de prise en compte de la durabilité. Dans cette perspective, on constate que les théories de la « conception verte » (green design) datant du début des années 1960 ou encore, les théories de la « conception écologique » (ecological design) datant des années 1970 et 1980, ont finalement convergé avec les récentes théories de la «conception durable» (sustainable design) à partir du début des années 1990. Les différentes approches du « principe de précaution » sont ensuite examinées sous l’angle de la question de la durabilité du projet. Les standards d’évaluation des risques sont comparés aux approches utilisant le principe de précaution, révélant certaines limites lors de la conception d’un projet. Un premier modèle théorique de la conception intégrant les principales dimensions du principe de précaution est ainsi esquissé. Ce modèle propose une vision globale permettant de juger un projet intégrant des principes de développement durable et se présente comme une alternative aux approches traditionnelles d’évaluation des risques, à la fois déterministes et instrumentales. L’hypothèse du principe de précaution est dès lors proposée et examinée dans le contexte spécifique du projet architectural. Cette exploration débute par une présentation de la notion classique de «prudence» telle qu’elle fut historiquement utilisée pour guider le jugement architectural. Qu’en est-il par conséquent des défis présentés par le jugement des projets d’architecture dans la montée en puissance des méthodes d’évaluation standardisées (ex. Leadership Energy and Environmental Design; LEED) ? La thèse propose une réinterprétation de la théorie de la conception telle que proposée par Donald A. Schön comme une façon de prendre en compte les outils d’évaluation tels que LEED. Cet exercice révèle cependant un obstacle épistémologique qui devra être pris en compte dans une reformulation du modèle. En accord avec l’épistémologie constructiviste, un nouveau modèle théorique est alors confronté à l’étude et l’illustration de trois concours d'architecture canadienne contemporains ayant adopté la méthode d'évaluation de la durabilité normalisée par LEED. Une série préliminaire de «tensions» est identifiée dans le processus de la conception et du jugement des projets. Ces tensions sont ensuite catégorisées dans leurs homologues conceptuels, construits à l’intersection du principe de précaution et des théories de la conception. Ces tensions se divisent en quatre catégories : (1) conceptualisation - analogique/logique; (2) incertitude - épistémologique/méthodologique; (3) comparabilité - interprétation/analytique, et (4) proposition - universalité/ pertinence contextuelle. Ces tensions conceptuelles sont considérées comme autant de vecteurs entrant en corrélation avec le modèle théorique qu’elles contribuent à enrichir sans pour autant constituer des validations au sens positiviste du terme. Ces confrontations au réel permettent de mieux définir l’obstacle épistémologique identifié précédemment. Cette thèse met donc en évidence les impacts généralement sous-estimés, des normalisations environnementales sur le processus de conception et de jugement des projets. Elle prend pour exemple, de façon non restrictive, l’examen de concours d'architecture canadiens pour bâtiments publics. La conclusion souligne la nécessité d'une nouvelle forme de « prudence réflexive » ainsi qu’une utilisation plus critique des outils actuels d’évaluation de la durabilité. Elle appelle une instrumentalisation fondée sur l'intégration globale, plutôt que sur l'opposition des approches environnementales.

Comparative costs and outcomes of traumatic brain injury from biking accidents with or without helmet use

Contexte: Évaluer les déterminants de maladies évitables et leurs coûts est nécessaire dans le contexte d’assurance maladie universelle. Le moment d’évaluer les impacts des traumatismes crâniocérébraux (TCC) survenus lors d’accidents de vélo est idéal vu la popularité récente du cyclisme au Québec. Objectifs: Comparer les caractéristiques démographiques et médicales, ainsi que les coûts sociétaux qu’engendrent les TCC de cyclistes portant ou non un casque. Méthodologie: Étude rétrospective de 128 cyclistes avec TCC admis à l’Hôpital Général de Montréal entre 2007 et 2011. Les variables indépendantes sont sociodémographiques, cliniques et le port du casque. Les variables dépendantes sont la durée de séjour, l’échelle GOS-E, l’échelle ISS, l’orientation au congé, les décès et les coûts à la société. Résultats: Le groupe portant un casque était plus vieux, plus éduqué, retraité et marié; au niveau médical, ils avaient des TCCs moins sévères à l’imagerie, des hospitalisations aux soins intensifs plus courtes et moins de neurochirurgies. Les coûts médians à la société pour les TCC isolés de cyclistes avec casque étaient significativement moindres. Conclusion: Dans cette étude, le port du casque semblait prévenir certaines complications des TCC et permettait de faire économiser de l’argent à l’état. Le port de casque est recommandé.

Organic consumers' attitudes and preferences regarding alternatives to piglet castration without anaesthesia and analgesia in organic farming - an explorative analysis

In Germany and other European countries piglets are routinely castrated in order to avoid the occurrence of boar taint, an off-flavour and off-odour of pork. Sensory perception of boar taint varies; however, it is regarded as very unpleasant by many people. Surgical castration which is an effective means against boar taint has commonly been performed without anaesthesia or analgesia within the piglets’ first seven days of life. Piglet castration without anaesthesia has been heavily criticised, as the assumption that young piglets perceive less pain than older animals cannot be supported by scientific evidence. Consequently, surgical castration is only allowed with anaesthesia and/or analgesia in organic farming throughout the European Union since January 2012. Abandoning piglet castration without pain relief requires the implementation of alternative methods which improve animal welfare while maintaining sensory meat quality. There are three relevant alternatives: castration with anaesthesia and/or analgesia to reduce pain, a vaccination against boar taint (immunocastration) and the fattening of uncastrated male pigs (fattening of boars) combined with measures to reduce and detect boar taint in meat. Consumers’ attitudes and opinions regarding the alternatives are an important factor with regard to the implementation of alternatives, as they are finally supposed to buy the meat. The objective of this dissertation was to explore organic consumers’ attitudes, preferences and willingness-to-pay regarding piglet castration without pain relief and the three alternatives. Important aspects for the evaluation of the alternatives and influencing factors (e.g. information, taste) on preferences and willingness-to-pay should also be identified. In autumn 2009 nine focus group discussions were conducted each followed by a Vickrey auction including a tasting of boar salami. Overall, 89 consumers of organic pork participated in the study. Information on piglet castration and alternatives (in three variants) was provided as a basis for discussion. The focus group data were analysed using qualitative content analysis. In order to compare the focus group results with those from the auctions, an innovative approach applying an adapted scoring model to further analyse the data set was used. The majority of participants were not aware that piglets are castrated without anaesthesia in organic farming. They reacted shocked and disappointed on learning about this practice which did not fit into their image of animal welfare standards in organic farming. Overall, the results show, that for consumers of organic pork castration with anaesthesia and analgesia as well as the fattening of boars may be acceptable alternatives in organic farming. Considering the strong food safety concerns regarding immunocastration, acceptance of this alternative may be questioned. Communication regarding alternatives to piglet castration without anaesthesia and analgesia should take into account that the relevance of the aspects animal welfare, food safety, taste and costs differs between alternatives. Furthermore, it seems advisable not to address an unappetizing topic like piglet castration directly at the point of sale so as not to deter consumers from buying organic pork. The issue of piglet castration demonstrates exemplarily that it is important for the organic sector to implement and maintain high animal welfare standards and communicate them in an appropriate way, thereby trying to prevent strong discrepancies between consumers’ expectations regarding animal husbandry in organic farming and actual conditions. So, disappointment of consumers and a loss of image due to negative reports about animal welfare issues can be avoided.

Second-order Møller-Plesset perturbation theory without basis set superposition error : II : open-shell systems

The basis set superposition error-free second-order MØller-Plesset perturbation theory of intermolecular interactions was studied. The difficulties of the counterpoise (CP) correction in open-shell systems were also discussed. The calculations were performed by a program which was used for testing the new variants of the theory. It was shown that the CP correction for the diabatic surfaces should be preferred to the adiabatic ones

Endogenous collateral: arbitrage and equilibrium without bounded short sales

We study the implications of the absence of arbitrage in an two period economy where default is allowed and assets are secured by collateral choosen by the borrowers. We show that non arbitrage sale prices of assets are submartingales, whereas non arbitrage purchase prices of the derivatives (secured by the pool of collaterals) are supermartingales. We use these non arbitrage conditions to establish existence of equilibrium, without imposing bounds on short sales. The nonconvexity of the budget set is overcome by considering a continuum of agents. Our results are particularly relevant for the collateralized mortgage obligations(CMO) markets.

An ice machine adapted into an autonomous photovoltaic system without batteries using a variable-speed drive

The adaptation of a commercially available ice machine for autonomous photovoltaic operation without batteries is presented. In this adaptation a 1040 W(p) photovoltaic array directly feeds a variable-speed drive and a 24 V(dc) source. The drive runs an induction motor coupled by belt-and-pulley to an open reciprocating compressor, while the dc source supplies a solenoid valve and the control electronics. Motor speed and refrigerant evaporation pressure are set aiming at continuously matching system power demand to photovoltaic power availability. The resulting system is a simple integration of robust, standard, readily available parts. It produces 27 kg of ice in a clear-sky day and has ice production costs around US$0.30/kg. Although a few machine features might be specific to Brazil, its technical and economical guidelines are applicable elsewhere. Copyright (C); 2010 John Wiley & Sons, Ltd.

Double-blinded, randomized controlled trial comparing real versus placebo acupuncture to improve tolerance of diagnostic esophagogastroduodenoscopy without sedation: a study protocol

Background Sedation prior to performance of diagnostic esophagogastroduodenoscopy (EGDE) is widespread and increases patient comfort. But 98% of all serious adverse events during EGDEs are ascribed to sedation. The S3 guideline for sedation procedures in gastrointestinal endoscopy published in 2008 in Germany increases patient safety by standardization. These new regulations increase costs because of the need for more personnel and a prolonged discharge procedure after examinations with sedation. Many patients have difficulties to meet the discharge criteria regulated by the S3 guideline, e.g. the call for a second person to escort them home, to resign from driving and working for the rest of the day, resulting in a refusal of sedation. Therefore, we would like to examine if an acupuncture during elective, diagnostic EGDEs could increase the comfort of patients refusing systemic sedation. Methods/Design A single-center, double blinded, placebo controlled superiority trial to compare the success rates of elective, diagnostic EGDEs with real and placebo acupuncture. All patients aged 18 years or older scheduled for elective, diagnostic EGDE who refuse a systemic sedation are eligible. 354 patients will be randomized. The primary endpoint is the rate of successful EGDEs with the randomized technique. Intervention: Real or placebo acupuncture before and during EGDE. Duration of study: Approximately 24 months. Discussion Organisation/Responsibility The ACUPEND - Trial will be conducted in accordance with the protocol and in compliance with the moral, ethical, and scientific principles governing clinical research as set out in the Declaration of Helsinki (1989) and Good Clinical Practice (GCP). The Interdisciplinary Endoscopy Center (IEZ) of the University Hospital Heidelberg is responsible for design and conduct of the trial, including randomization and documentation of patients' data. Data management and statistical analysis will be performed by the independent Institute for Medical Biometry and Informatics (IMBI) and the Center of Clinical Trials (KSC) at the Department of General, Visceral and Transplantation Surgery, University of Heidelberg.

Comparison of medical care costs, utilization, and satisfaction of AIDS patients with and without home care

A sample of 157 AIDS patients 17 years of age or over were followed for six months from the date of hospital discharge to derive average total cost of medical care, utilization and satisfaction with care. Those referred for home care follow-up after discharge from the hospital were compared with those who did not receive home care.^ The average total cost of medical care for all patients was $34,984. Home care patient costs averaged \$29,614 while patients with no home care averaged $37,091. Private hospital patients had average costs of \$50,650 compared with $25,494 for public hospital patients. Hospital days for the six months period averaged 23.9 per patient for the no home care group and 18.5 days for home care group. Patient satisfaction with care was higher in the home care group than no home care group, with a mean score of 68.2 compared with 61.1.^ Other health services information indicated that 98% of the private hospital patients had insurance while only 2% of public hospital patients had coverage. The time between the initial date of diagnosis with AIDS and admission to the study was longer for private hospital patients, survival time over the study period was shorter, and the number of hospitalizations prior to entering the study was higher for private hospital patients. These results suggest that patients treated in the private hospital were sicker than public hospital patients, which may explain their higher average total cost. Statistical analyses showed that cost and utilization have no significant relationship with home care or no home care when controlling for indicators of the severity of illness and treatment in public or private hospital.^ In future studies, selecting a matched group of patients from the same hospital and following them for nine months to one year would be helpful in making a more realistic comparison of the cost effectiveness of home care. ^

Guaranteed student loans : legislative and regulatory changes needed to reduce default costs : report to Congressional requesters /

"B-204708"--P. [1].