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L'A.D.N. détermine toute fonction nécessaire à la VIe humaine. Les tests d'A.D.N. peuvent identifier presque tous les êtres humains. Exacts et fiables, ces tests ne nécessitent qu'un échantillon minime d'A.D.N. Ils ont chamboulé, non seulement la science, mais aussi le droit. Lorsque ces tests sont utilisés dans un but d'identification génétique (contrairement à un but médical), ceux-ci peuvent établir définitivement des liens filiaux. Comment le droit civil québécois détermine le meilleur intérêt de l'enfant lorsque des tests de paternité sont utilisés comme moyens de preuve de la filiation d'un enfant? Le meilleur intérêt de l'enfant est un concept-clé dans le droit civil québécois. Les règles régissant la filiation légale et la hiérarchie des moyens de preuve pour cette filiation sont aussi affectées. Une étude du droit civil québécois révèle différentes approches afin de déterminer le meilleur intérêt de l'enfant dans les cas de paternité: 1) l'approche de la primauté de la stabilité socio-affective de l'enfant, 2) celle de la primauté de la vérité biologique de l'enfant, et 3) celle dite «personnalisée». L'approche personnalisée pourrait être la plus adaptée puisqu'elle traite chaque enfant comme une personne à part, considère tous les facteurs dans sa vie et pèse les différentes relations entre les parties. L'approche semble répondre aux besoins et à la situation de chaque enfant comme personne unique. / DNA determines all functions necessary to human life. DNA tests can identify almost every human being. Accurate and reliable, these tests need only a minimal quantity of DNA. They have changed radically not only science, but also the law. When used for genetic identification purposes (as opposed to medical), they can establish definitely filial links. How does Québec's civil law determine the best interests of the child when DNA paternity tests are offered as proof of the filiation of a child? The best interests of the child are a key concept in the civil law of Québec. The rules establishing legal filiation and the hierarchy of proof within are also affected. A study of Québec case law reveals different approaches in determining the best interests of the child in paternity cases: 1) the approach preferring the primacy of socio-affective stability of the child, 2) the approach preferring the primacy of biological truth, and, 3) the personalized approach. The personalized approach may be the most appropriate since it treats each child as unique, considers every factor in his or her life and weighs aIl the different relationships between parties. This approach seems to provide for the needs and situation of every child as an individual. / "Mémoire présenté à la Faculté des études supérieures en vue de l'obtention du grade de maîtrise en Droit option Droit, Biotechnologies et Société"

中國有句諺語:「民以食為天」，食物乃人類生活所不可缺的要素之一，而人們對於食物則有各自的偏好，而要從琳瑯滿目的食物中依照個人喜好來推薦則成為一門重要的課題。 隨著科技的進步，智慧型手機的出現為人類帶來了許多便利，也逐漸改變了人們的生活方式，群眾可以透過智慧型手機來記錄生活的點滴，記錄的方式正走向數位化，而如何利用這些累積下來的數位資料來做分析與推薦也成為熱門的研究目標。 本論文從味覺方面著手，將LifeLog的飲食記錄與味覺做結合，並透過大眾分類與群眾外包的方式，將味覺資料由智慧型手機使用者處獲得，並建構成包含餐廳、餐點名稱以及其對應味覺之資料庫。 本論文實作了一個程式Foodtaste，包含了記錄餐點味覺資料，查詢個人記錄，以及實作數種推薦的功能。本論文並提出了數個計算方法，透過LifeLog累積下來的味覺資料進行計算，來獲得每位使用者的個人口味偏好和味覺比例，並將這些資料與餐點的味覺比例計算來對餐廳進行個人化的餐點推薦。 / Foods and eating are the basic element of human's life, and people have their own favorite in choosing foods. Thus it is an important issue to make some recommendation for people in front of a dazzling array of foods. With the advances in technology, smartphones bring convenience to people and change their life style. One can use smartphones to record various things in his life. The ways of memories become digitalized, and how to use these digital data to analyze and give opinions becomes popular. Base on one’s taste, present study combined dietary records and food taste in Lifelog, using Folksonomy and Crowdsourcing to acquire data of specific food taste from smartphone users, and linked these data to restaurant’s name and the name of the meal in our database. We designed a smartphone application which called "Foodtaste". It provided users to record what they ate and how did it taste, looking up personal records, and several recommending methods. Our study also provides several methods in calculating cumulative data in Lifelog and acquiring the preference of one’s taste and ratio in variable foods from every user. Then we calculated these data to carry out personalized food recommendation.

Ziel: Entwicklung eines gesundheitsökonomischen Evaluationskonzepts zum Nachweis einer Kostenreduktion unter gleichzeitiger Optimierung des medizinischen Nutzens durch pharmakogenetisches Screening bei Erstdiagnose einer Schizophrenie. Finale Zielsetzung ist die Aufnahme der pharmakogenetischen a priori-Diagnostik für die Indikation Schizophrenie in die GKV-Regelversorgung. Methodik: Basierend auf dem aktuellen Stand gendiagnostischer Forschung sowie der evidenzbasierten Schizophrenietherapie wurde eine prospektive, randomisierte und kontrollierte, dreiarmige, offene, multizentrische Pilotstudie im Paralleldesign über 3 Jahre konzeptioniert. Studienpopulation: 300 Patienten (1:1:1) im Alter von 18 bis 65 Jahren mit erstmaliger F20-Diagnose (ICD-10). Interventionen: pharmakogenetisches Screening und integrierte Versorgung; integrierte Versorgung; Standardversorgung. Die Erhebung des medizinischen Nutzens erfolgt durch Messung des klinischen Outcome bzgl. der patientenrelevanten Endpunkte Mortalität, Morbidität, Lebensqualität und Nebenwirkungen zu definierten Zeitpunkten. Perspektivisch relevante Kosten werden im "piggy back"-Verfahren ermittelt. Ergebnisse: Angesichts zurzeit bestehender Limitationen im deutschen Gesundheitssystem (z.B. unzureichendes intersektorales Schnittstellenmanagement bei der Arzneimittelversorgung und Informationsweitergabe) wird die Integrierte Versorgung als geeignete Versorgungsform für den Nutzennachweis eingestuft. Die Integrierte Versorgung stellt jedoch momentan nicht den allgemeinen Standard der psychiatrischen Patientenversorgung dar. Aus GKV-Perspektive wesentliche Kostentreiber der Schizophrenietherapie sind Rückfälle, Krankenhausaufenthalte, Arbeitslosigkeit und vorzeitige Verrentung. Eine Verringerung der Häufigkeit dieser Parameter könnte z.B. zu einer Reduktion der Erstjahres-Behandlungskosten (zurzeit ca. 30% der Gesamtkosten) führen. Die Kosten-Effektivitäts-Analyse erweist sich als Studienform mit der geringsten Anfälligkeit für Bias und Confounder. Trotz einer vergleichsweise hohen externen Validität ist das Studiensetting nicht uneingeschränkt übertragbar auf die Versorgungsrealität des deutschen Gesundheitssystems. Es existiert aktuell keine generelle Empfehlung für den Einsatz der Gendiagnostik zur Steuerung der Arzneimitteltherapie in Psychiatrie. Ebenso hat die integrierte Versorgung bisher keinen umfassenden Einzug in den psychiatrischen Behandlungsalltag gefunden, so dass die beschriebenen Limitationen einen positiven Nutzennachweis erschweren. Dennoch ist das Konzept als praktisch umsetzbar zu bewerten. Schlussfolgerung: Bei dieser Faktenlage ist das Interesse der GKV an der Veranlassung einer gesundheitsökonomischen Evaluation mit dem Ziel einer Erstattungsfähigkeit des a priori durchgeführten pharmakogenetischen Screenings bei Schizophrenie als eher gering einzustufen. Jedoch lassen das Update der S3-Praxisleitlinie mit dem Einbezug der strukturierten u. integrierten Versorgung sowie der Aktionsplan „Individualisierte Medizin“ des Bundesforschungsministeriums auf eine Fokussierung auf diese Fragestellung und veränderte Interessenlage bzgl. der Initiierung der Pilotstudie hoffen. Weitere Forschungstätigkeit sowie die praktische Erprobung neuer gendiagnostischen Verfahren sind, basierend auf versorgungsbezogenen Pilotstudien wie der hier konzeptionierten, fachübergreifend erforderlich, um die Relevanz der Methodik für den psychiatrischen Versorgungsalltag zu belegen. / Purpose: Development of a health-economic investigation method to study whether a cost reduction under concurrent optimisation of the medical use exists by using pharmacogenetic a- priori- screening with first diagnosis of a schizophrenia. Final objective is the reimbursement of pharmacogenetic diagnostics for the indication schizophrenia in the German health statutory insurance (GKV). Methods: A prospective, randomised and controlled, 3-armed, parallel, open, multicentre pilot study with a duration of 3 years was designed based on the actual status of genetic-diagnostic research as well as the evidence-based therapy of schizophrenia. Study population: 300 patients (1:1:1) aged 18 to 65 years with initial F20 diagnosis (ICD-10). Interventions: pharmacogenetic screening and integrated care; integrated care; standard care. For evaluation of the medical benefit the clinical outcome is measured at defined times with regard to the patients' relevant endpoints mortality, morbidity, quality of life and side effects. In perspective relevant costs are determined by "piggy back" procedure. Results: In view of actually existing limitations within the German health system (e.g., insufficient intersectional medication and information management) the integrated care is considered being a suitable setting to demonstrate the advantage of using pharmacogenetic screening. Nevertheless, the integrated care does not show the general standard of the psychiatric patient's care at the moment. From GKV perspective essential cost drivers of schizophrenia therapy are relapses, hospital stays, unemployment and untimely superannuation. Diminishing the rate of these parametres could lead, e.g., to a reduction of the first year medical costs (at the moment approx. 30% of the total expenses). The cost-effectiveness analysis seems to be the study form with the slightest susceptibility to bias and confounding. In spite of a relatively high external validity the study setting is not unconditionally transferable to the German health system. Currently no general recommendation exists for the application of the genetic diagnostics to manage medication therapy in psychiatry. Up to now also the integrated care has not found a comprehensive entry in psychiatric practice, so that the described limitations are complicating a positive use proof. Nevertheless, the investigational concept can be regarded as feasible. Conclusion: Based on the existing situation the GKV's interest in performing a health-economic evaluation, which is focussed on the reimbursement of pharmacogenetic a priori-diagnostics in schizophrenia, is considered to be low. However, the situation may change in view of the expected update of the S3-practise guideline with the focus on structured and integrated care as well as the action plan „individualised medicine“ of the German federal research ministry. Thus, there is hope for changing interests in a pilot study. Based on care-related pilot studies as presented here, further research activities and practical testing of recent gene diagnostic procedures are necessary to demonstrate the relevance of the methodology for psychiatric practice.

Learning the knowledge and procedures of the Assessment of Basic Learning Abilities (ABLA) is a major practical priority for direct-care service providers who work with individuals with intellectual disabilities (IDs) and autism spectrum disorders (ASDs). The present study compared the effects of two training conditions involving a self-instructional manual (SIM) alone and its combination with a Web-based computer-aided personalized system of instruction (WebCAPSI) program (SIM plus WebCAPSI) on teaching knowledge and implementation of the ABLA to university students. A multiple-baseline design across training conditions was used. The results indicate that the SIM combined with passing unit tests delivered via WebCAPSI was beneficial for knowledge acquisition while viewing demonstration videos was beneficial for conducting the ABLA. The findings suggest that a combination of a SIM combined with unit tests delivered via WebCAPSI and videos provides an effective approach to teach both knowledge and application of behavioural procedures to potential knowledge users.

Bakgrund: Trots allmänna råd och riktlinjer råder stor brist på nutritionskunskaperna inom hälso- och sjukvården i hela Europa. Många äldre riskerar att drabbas av undernäring och får ett minskat välbefinnande och en för tidig död. Genom att arbeta med att personanpassa kosten kan patienten få bli aktiv i egna beslut som påverkar dennes liv och hälsa. Syfte: Syftet med studien var att belysa omvårdnadspersonalens erfarenheter av kost som ges personanpassad på ett korttidsboende för äldre. Metod: I denna studie användes induktiv ansats där datamaterialet analyserades med kvalitativ innehållsanalys. Sex omvårdnadspersonal intervjuades på ett korttidsboende för äldre i södra Sverige. Resultat: Ur analysen av datamaterialet fyra kategorier; utgår från patientens syn på situationen, möjliggör val, möjligheter i måltidsmiljö, begränsningar i arbetsmiljön med åtta underkategorier. Slutsats: Omvårdnadspersonalen kan ge en personanpassad kost om det erbjudande matsortimentet blir bredare och genom förändringar på arbetsmiljön. / Background: Despite general recommendation and guidelines, there is lack of nutrition knowledge in healthcare throughout Europe. Many elderly people are at risks of malnutrition. They expericence a decline in well-being and an untimely death. By working with a personalized diet, may patient become more active in decisions affecting their lives and health. Purpose: The aim of this study was to elucidate nursing staffs experiences of diet given personalized on a short-term housing for the elderly. Method: In this study, an inductive approach in which the data were analyzed using qualitaitive content analysis. Six nursing staff were interviewed on a short-term housing for the elderly in southern of Sweden. Results: From the analysis of the data four categories; the patient´s view of the situation, allowing choices, oppotunities in the culinary environment, limitations of working with eight subkategories. Conclusion: Nursing staff can provide a personalized diet if the offer a wider of food range and through changes the work environment. / <p></p><p></p>

People generally want to engage in a healthy lifestyle, to live in harmony with the environment, to contribute to social causes, and to avoid behaviours that are harmful for themselves and others. However, people often find it difficult to motivate themselves to engage in these beneficial behaviours. Even adopting a healthy lifestyle, such as healthy eating, physical activity, or smoking cessation, is hard despite being aware of the benefits. The increasing adoption and integration of technologies into our daily lives present unique opportunities to assist individuals to adopt healthy behaviours using technology. As a result, research on how to use technology to motivate health behaviour change has attracted the attention of both researchers and health practitioners. Technology designed for the purpose of bringing about desirable behaviour and attitude changes is referred to as Persuasive Technology (PT). Over the past decade, several PTs have been developed to motivate healthy behaviour, including helping people with addictive behaviour such as substance abuse, assisting individuals to achieve personal wellness, helping people manage diseases, and engaging people in preventive behaviours. Most of these PTs take a one-size-fits-all design approach. However, people differ in their motivation and beliefs about health and what constitutes a healthy life. A technology that motivates one type of person to change her behaviour may actually deter behaviour change for another type of person. As a result, existing PTs that are based on the one-size-fits-all approach may not be effective for promoting healthy behaviour change for most people. Because of the motivational pull that games offer, many PTs deliver their intervention in the form of games. This type of game-based PTs are referred to as persuasive games. Considering the increasing interest in delivering PT as a game, this dissertation uses persuasive games as a case study to illustrate the danger of applying the one-size-fits-all approach, the value and importance of tailoring PT, and to propose an approach for tailoring PTs to increase their efficacy. To address the problem that most existing PTs employ the one-size-fits-all design approach, I developed the Model-driven Persuasive Technology (MPT) design approach for tailoring PTs to various user types. The MPT is based on studying and modelling user’s behaviour with respect to their motivations. I developed the MPT approach in two preliminary studies (N = 221, N = 554) that model the determinants of healthy eating for people from different cultures, of different ages, and of both genders. I then applied the MPT approach in two large-scale studies to develop models for tailoring persuasive games to various gamer types. In the first study (N = 642), I examine eating behaviours and associated determinants, using the Health Belief Model. Using data from the study, I modelled the determinants of healthy eating behaviour for various gamer types. In the second study (N = 1108), I examined the persuasiveness of PT design strategies and developed models for tailoring the strategies to various gamer types. Behavioural determinants and PT design strategies are the two fundamental building blocks that drive PT interventions. The models revealed that some strategies were more effective for particular gamer types, thus, providing guidelines for tailoring persuasive games to various gamer types. To show the feasibility of the MPT design approach, I applied the model to design and develop two versions of a Model-driven Persuasive Game (MPG) targeting two distinct gamer types. To demonstrate the importance of tailoring persuasive games using the MPG approach, I conducted a large-scale evaluation (N = 802) of the two versions of the game and compared the efficacy of the tailored, contra-tailored, and the one-size-fits-all persuasive games condition with respect to their ability to promote positive changes in attitude, self-efficacy, and intention. To also demonstrate that the tailored MPG games inspire better play experience than the one-size-fits-all and the contra-tailored persuasive games, I measure the gamers’ perceived enjoyment and competence under the different game conditions. The results of the evaluation showed that while PTs can be effective for promoting healthy behaviour in terms of attitude, self-efficacy, and intention, the effectiveness of persuasion depends on using the right choice of persuasive strategy for each gamer type. The results showed that one size does not fit all and answered my overarching research question of whether there is a value in tailoring PT to an individual or group. The answer is that persuasive health interventions are more effective if they are tailored to the user types under consideration and that not tailoring PTs could be detrimental to behaviour change.

The present study evaluated the use of a self-instructional manual supported by a computer-aided personalized system of instruction (CAPSI) for teaching Discrete-Trials Teaching (DTT) to university students. Prior to studying the manual, five participants taught three tasks, commonly taught to children with Autism Spectrum Disorders (ASD), to a confederate role-playing a child with an ASD. Using the Discrete-Trials Teaching Evaluation Form (DTTEF), the main researcher assessed the participants’ ability to perform DTT accurately. Subsequently, participants studied a self-instructional manual using CAPSI to demonstrate mastery of study questions about DTT. Finally, participants once again attempted to teach the three tasks to a confederate role-playing a child with an ASD. Overall mean baseline accuracy on the DTTEF was 54.86%, and improved to 84.73% in post-treatment, a 30% improvement. Participants’ self-recorded study time was an average of 12 hours and 48 minutes. The results suggest that CAPSI is an effective educational tool for the delivery of the self-instructional manual. Future research should investigate (1) how to make CAPSI even more effective, and (2) whether these results can be generalized to other populations such as ABA tutors, parents, and paraprofessionals working with children with ASD.

Learning the knowledge and procedures of the Assessment of Basic Learning Abilities (ABLA) is a major practical priority for direct-care service providers who work with individuals with intellectual disabilities (IDs) and autism spectrum disorders (ASDs). The present study compared the effects of two training conditions involving a self-instructional manual (SIM) alone and its combination with a Web-based computer-aided personalized system of instruction (WebCAPSI) program (SIM plus WebCAPSI) on teaching knowledge and implementation of the ABLA to university students. A multiple-baseline design across training conditions was used. The results indicate that the SIM combined with passing unit tests delivered via WebCAPSI was beneficial for knowledge acquisition while viewing demonstration videos was beneficial for conducting the ABLA. The findings suggest that a combination of a SIM combined with unit tests delivered via WebCAPSI and videos provides an effective approach to teach both knowledge and application of behavioural procedures to potential knowledge users.

Oração sem sujeito é toda e qualquer oração destituída de SN sujeito, exceto nos casos em que tal SN encontra-se em elipse. Sua manifestação na língua pode se dar tanto em termos pessoais quanto impessoais. Estas incluem ocorrências essenciais, aqui chamadas de fenomenológicas e acidentais, denominadas impessoalizadas. Já aquelas se apresentam nos casos de indeterminação de agente por omissão do SN sujeito, tradicionalmente alcunhados casos de sujeito indeterminado e por meio do processo de ergativização em sua versão secundária, aquele que atua sobre verbos não causativos e tem sido porta de entrada à concretização de orações destituídas de SN sujeito no português brasileiro. Objetivamos neste trabalho a descrição de todas as estruturas apontadas, em termos de seus comportamentos morfossintáticos na língua, pois compreendemos que descrever a oração sem sujeito portuguesa é identificar contextos morfossintáticos de dispensa, em distintos graus, do SN sujeito. Para tanto, valemo-nos de um enfoque prototípico da língua, através do qual dialogamos com a natureza escalar de nosso objeto de estudo / Subject-absent sentences are all and every sentence devoid of subject Nominal Phrase (NP), except in cases when NP is in ellipse. They occur in the language on personal or impersonal terms. On impersonal terms, they include essential occurrences, here called phenomenological occurrences and accidental occurrences, here called a-personalized occurrences. While on personal terms, they appear in cases of indetermination of the agent by ommission of subject NP, also known as indeterminate subject cases, and through the ergativization process in their secondary version. This kind of ergativization process acts on non-causative verbs, and has been the basis for the construction of most sentences devoid of subject NP in Brazilian Portuguese. In this thesis, we describe all structures indicated above, in terms of their morphosyntactic behavior in the language, as we argue that to describe subject-absence sentence means to identify morphosyntactic contexts for exemption of the subject NP, in different degrees. For this goal, we make use of a prototypical approach to the language, through which we engage with the gradual nature of our object of study