Créés pendant la Révolution française, les départements s'affirment tout au long du XIXème siècle. Malgré les régimes successifs, l'institution perdure et se renforce. Les lois donnent en effet de plus en plus de libertés aux Conseilgénéraux, et à la fin du Second Empire, on peut affirmer que ceux-ci sont responsables de leur budget. C'est dans ce cadre que se développe l'assistance sociale en France. D'essence communale, elle se déploie avec l'aide des départements qui apportent leur concours financier. Cependant nombre d'entre eux, dans un souci permanent de maîtrise des finances, ne s'engagent que de manière limitée dans le champ social. L'exemple du département des Landes est à ce titre particulièrement significatif. Dirigé par un Conseil général plutôt progressiste mais soucieux de réaliser des économies, il ne développe pas une politique d'assistance satisfaisante. / Created for the French Revolution, the “départements” i.e. French administrative lands, are getting increased recognition throughout the XIXth Century. Albeit various governments coming into force, the Institution carries forward and is strengthened. Laws provide increased freedoms to “Conseils généraux”, i.e. authorities administering the “départements”, so that they are fully responsible for their own budget by the end of the Second World War. As a result, social assistance is developed within this framework in France. Originally from communal background, social assistance was being implemented thanks to “départements”’ financial commitment. However, some of them relinquished to enact social assistance politics due to tight financial controls, Landes “département” being a significant illustration of this. Though headed by progressive ideals, Landes “Conseil général” is focused on making savings, thereupon not providing satisfying social politics to their inhabitants.

A tese propõe-se a analisar e a interpretar a representação social do usuário sobre a assistência social. Para tanto, foi utilizada a metodologia dos círculos epistemológicos, inspirados na teoria pedagógica dos círculos de cultura de Paulo Freire, que procura superar a dicotomia entre pesquisador-pesquisando. Como nos círculos de cultura, os pesquisandos participam ativamente do processo de pesquisa. Foram realizados nove círculos epistemológicos com os usuários, em três Centros de Referência de Assistência Social – CRAS de Porto Alegre RS, três em cada CRAS. Após a realização dos nove círculos epistemológicos, todas as informações foram transcritas, lidas, categorizadas a partir de sua dimensão semântica e analisadas à luz da Teoria das Representações Sociais. Da análise dos dados, foram construídos mapas representacionais com as categorias e subcategorias que revelaram os elementos centrais que constituem tal representação. Os resultados foram interpretados a partir de aportes teóricos de autores que trabalharam temáticas ligadas à assistência social. As contribuições dos usuários pesquisandos foram levadas em consideração na produção final da tese. A tese compõe-se de quatro capítulos organizados em forma de artigo. O primeiro apresenta o referencial teórico das representações sociais e discute a metodologia dos círculos epistemológicos mostrando as conexões entre eles. O segundo artigo, também teórico, trata da formação do Estado brasileiro e como sua estruturação influenciou as políticas de assistência social. O terceiro apresenta os resultados empíricos da representação social da assistência social na perspectiva dos usuários. Tal representação apresenta-se como contraditória revelando duas dimensões centrais, uma ideológica e outra crítica. No quarto e último artigo, também empírico, é enfatizada uma dimensão específica da representação social que se destacou das informações colhidas e que se julgou oportuno aprofundá-la: a representação social que os usuários revelaram sobre si mesmos. Tal representação revelou duas dimensões contraditórias, mas inter-relacionadas: por um lado os usuários discriminam-se como “bons” e “maus”; por outro, se reconhecem como iguais pertencentes a um mesmo grupo social e deixam entrever sinais de solidariedade, que oferece condições para a emergência de uma cidadania para além dos direitos. / The dissertation proposes to analyze and interpret the social representation of the user about social assistance. The methodology of epistemological circles inspired by the educational theory of cultural circles of Paulo Freire was used, which seeks to overcome the dichotomy between researcher and research subject. As in the circles of culture, the research subjects actively participate in the research process. Nine epistemological circles were conducted with users in three reference centers of Social Assistance-CRAS of Porto Alegre RS, three in each CRAS. After the completion of the nine epistemological circles , all the information was transcribed, read, categorized from its semantic dimension and analyzed in the light of the theory of social representations. From the data analysis, representational maps were constructed with the categories and subcategories which revealed the central elements that constitute such representation. The results were interpreted from theoretical contributions of authors who worked on welfare-related themes. Research subject users ' contributions were taken into consideration in the production end of the dissertation. The dissertation consists of four chapters arranged in article form. The first presents the theoretical framework of social representations and discusses the methodology of the epistemological circles demonstrating the connections between them. The second article, also theoretical, deals with the formation of the Brazilian State and how its structure influenced the policies of social assistance. The third presents the empirical results of social representation of social assistance from the perspective of the users. Such representation is presented as contradictory revealing two central dimensions, an ideological one and another critical one. In the fourth and last article, also empirical, emphasized a specific dimension of social representation that stood out from the information collected which was deemed appropriate to deepen into: social representation that users reveal about themselves. Such representation revealed two contradictory but interrelated dimensions: on the one hand users discriminate as "good" and "bad"; on the other, recognize each other as equals belonging to the same social group and they see signs of solidarity, which provides conditions for the emergence of a citizenship beyond rights.

Este estudo, realizado em um hospital geral e privado, teve como objetivos identificar problemas apresentados pelos pacientes cirúrgicos após a alta hospitalar, correlacioná-los com a assistência perioperatória e discutir ações possíveis pela enfermagem para a melhoria da evolução dos pacientes após a alta hospitalar. A população foi constituída de 112 pacientes submetidos a cirurgias eletivas no período de março a maio de 2004. Os dados foram obtidos dos prontuários e de entrevista com os pacientes, buscando informações sobre problemas apresentados e aspectos da assistência prestada referentes a: cirurgia, anestesia, preparo pré-operatório, períodos de permanência hospitalar pré e pós-operatória, visitas pré e pós-operatórias dos profissionais relacionados ao processo cirúrgico, momento das visitas, orientações recebidas para alta, entre outros. Os resultados mostraram que 69,6% dos pacientes relataram problemas, relacionados a alterações emocionais e fisiológicas e dúvidas. O mais freqüente referiu-se à ferida cirúrgica, que correspondeu às principais queixas relatadas. Dentre os problemas, 5,3% demandou re-internação. Os resultados referentes à assistência perioperatória apontam relação de alguns fatores com os problemas relatados. As orientações para a alta mostraram-se incompletas. Considerou-se que, na maioria dos casos, os períodos de permanência hospitalar pré e pós-operatórias são curtos e não favorecem momentos e locais formais para o preparo, avaliação e orientações ao paciente. O período pós-operatório é ainda mais curto, pelo tempo demandado para a recuperação anestésica que, neste estudo, predominaram aquelas mais complexas. Houve associação significativa entre período pós e tipo de anestesia. Não foram todos os pacientes que receberam visitas, nestas fases, por profissionais diretamente envolvidos com processo cirúrgico e, dentre os que receberam, foram significativas aquelas realizadas apenas no centro cirúrgico, principalmente entre os anestesiologistas. Os problemas após a alta que demandaram internação ocorreram em pacientes que não receberam visita pré-operatória pelo cirurgião e anestesiologista. Os pacientes só retornam ao hospital quando complicações já ocorreram. A alta do processo cirúrgico, portanto, ocorre no consultório do cirurgião e o hospital não tem condições de participar na prevenção dos problemas após a alta. Com o avanço da tecnologia, o processo cirúrgico se modificou. As intervenções cirúrgicas são cada vez mais rápidas, permitindo o restabelecimento em menor tempo. Por outro lado, o processo cirúrgico tem sido realizado em vários locais, além do hospital, podendo determinar “vácuos” nas etapas da assistência perioperatória e favorecer problemas, tanto durante a fase transoperatória quanto pós-operatória. Configura-se a necessidade de novas estratégias assistenciais que garantam a integralidade deste processo. E a enfermagem pode ser uma destas estratégias, como elo de integração entre paciente/família/hospital/médico. A determinação de momentos formais para avaliação e orientações ao paciente, tanto na fase pré-operatória quanto pós-operatória, deve ser considerada, visando atender às expectativas e necessidades dos pacientes como demonstrado neste estudo / This study, carried through in a general and private hospital, aimed at identifying problems presented by the surgical patients after being released from the hospital, connecting them with the perioperative assistance and discuss possible nursing actions for the improvement of the patients´ evolution after hospital release. The population was composed of 112 patients submitted to elective surgeries in the period from March to May, 2004. The data had been obtained from the patients´ records and from interviews with the patients, searching information on the problems presented and aspects of the assistance given referring to: surgery, anesthesia, preoperative preparation, pre and after operative periods of hospital staying, pre and after daily visits from the professionals related to the surgical process, time of the visits, guidances received for hospital release, among others. The results had shown that 69.6% of the patients presented problems, related to the emotional and physiological alterations and doubts. The most frequent referred to the surgical wound, which corresponded to most of the related complaints. Amongst the problems, 5.3% demanded re-hospitalization. The results concerning the perioperative assistance indicate a relation of some factors with the stated problems. The releasing guidances had revealed incomplete. In most of the cases it was considered that the pre and after operative periods of hospital staying are short and do not support formal moments and places for the preparation, evaluation and guidances to the patient. The after surgical period is still shorter, due to the time demanded for the anesthetical recovery which, in this study, the most complex ones had predominated. There was a significant association between the after operative period and type of anesthesia. In those phases, not all the patients had received visits from the professionals directly involved with surgical process and, amongst those who received, most of them were carried through only in the operating room, mainly amongst the anesthesiologists. The problems presented after the release that demanded hospitalization had occurred in patients who had not received preoperative and the anesthesiologist´s daily visit. The patient only come back to the hospital when complications had already occurred. Therefore, the surgical process release occurs in the surgeon\'s office, and the hospital has no conditions to take part into preventing the problems after the release. With the advance of the technology, the operative process has been altered. Surgical interventions have been faster over and over, allowing the recovery in lesser time. On the other hand, the surgical process has been carried through in some places, besides the hospital, being able to determine the \"chasms\" in the perioperative assistance stages, and fomenting problems, not only during the transoperative period, as well as during the after surgical one. The need for new assistencial strategies was noticed, which would guarantee the completeness of this process. And nursing can be one of those strategies, as a link of integration between patient/family/hospital/surgeon. The determination of the patient´s formal moments for evaluation and guidances, not only during the pre and after surgical phases, must be considered, aiming at answering the patients´ expectations and needs as shown in this study

A PolÃtica Nacional de HumanizaÃÃo (PNH) apresenta-se, hoje, como proposta transversal a todos as outras polÃticas e programas do Sistema Ãnico de SaÃde. Para tanto propÃe dispositivos e princÃpios que buscam potencializar e valorizar mudanÃas nas prÃticas cotidianas de saÃde. Desse modo, a AtenÃÃo BÃsica, no contexto da EstratÃgia SaÃde da FamÃlia (ESF), torna-se um âlÃcusâ privilegiado de construÃÃo de mudanÃas, pois possibilita espaÃos democrÃticos, Ãticos e polÃticos de produÃÃo de autonomia e corresponsabilidade. Neste sentido, pensando na PNH como produtora de prÃtica facilitadora e construtora de cidadania, optou-se por destacar neste trabalho o acolhimento, entendendo-o como uma das diretrizes de maior relevÃncia desta polÃtica, pois, ela prÃpria apresenta carÃter transversal, perpassando por todas as demais propostas de mudanÃas no processo de trabalho e gestÃo. Trata-se, portanto, de uma investigaÃÃo norteada pela abordagem qualitativa, uma vez que se situou no Ãmbito das relaÃÃes, imbuÃdas de singularidades e reflexÃes sobre o processo de trabalho em saÃde. Utilizando-se das tÃcnicas de entrevista e observaÃÃo o trabalho, realizado em uma Unidade BÃsica de SaÃde da FamÃlia, na Secretaria Executiva Regional V, Fortaleza-Ce, abordou 24 profissionais, de cinco equipes que compÃem a ESF desta unidade, ressaltando que a categoria Agente ComunitÃrio de SaÃde contou com um representante de cada equipe. Apesar de buscar caracterizar a prÃtica do acolhimento, o trabalho tomou relevÃncia no seu significado, nos contextos que dificultam tal prÃtica e nos fatores identificados, pelos profissionais, como positivos para o desempenho de suas funÃÃes. Concluiu-se, portanto, apÃs anÃlise minunciosa das falas dos entrevistados, que culminou com trÃs grandes temas: conhecimento e significaÃÃo de acolhimento para os profissionais da ESF, fatores dificultadores para o acolhimento em uma Unidade BÃsica de SaÃde da FamÃlia e os fatores positivios em relaÃÃo ao processo de trabalho nesta unidade, que o acolhimento à essencial à prÃtica do serviÃo em saÃde, sendo entendido por estes profissionais como um primeiro contato; recÃproco, receptivo, pautado na escuta, no diÃlogo e no atendimento Ãs necessidades de trabalhadores e usuÃrios, tendo como princÃpio a organizaÃÃo do serviÃo e que o processo de construÃÃo da PolÃtica Nacional de HumanizaÃÃo encontra-se em seu ponto inicial, necessitando, pois, ser resgatada e reconhecida como propulsora do Sistema Ãnico de SaÃde e articuladora de uma prÃtica que provoque mudanÃas significativas dos serviÃos de saÃde, de modo sistemÃtico e permanente.

FundaÃÃo de Amparo à Pesquisa do Estado do Cearà / O cuidador familiar do idoso dependente passa a ser foco da atenÃÃo em saÃde recentemente. Objetivou-se, neste estudo, conhecer as competÃncias e habilidades desenvolvidas pelo enfermeiro no atendimento ao cuidador familiar do idoso dependente no domicÃlio. Cuidar adequadamente destes pacientes exige tambÃm profundo preparo tÃcnico cientÃfico dos profissionais que realizam visitas domiciliares a idosos dependentes, assim como planejamento de intervenÃÃes educativas, realizaÃÃo de procedimentos e tratamentos medicamentosos. Essa diversificaÃÃo vem gerando reflexÃes e questionamentos entre os profissionais que visitam e cuidam desses idosos. O que se busca neste estudo Ã, a partir da realidade social dos enfermeiros que trabalham com assistÃncia, internaÃÃo e visita domiciliar, conhecer a construÃÃo do cuidado dispensado ao idoso e a seu cuidador. O trabalho, em funÃÃo de seu objetivo e propÃsito implica a utilizaÃÃo de metodologia de corte qualitativo. A populaÃÃo do estudo constituiu-se de enfermeiros integrantes da EstratÃgia SaÃde da FamÃlia (ESF), do Programa de Atendimento DomiciliÃrio (PAD) e Home Care. Para tanto foram escolhidos 8 (oito) enfermeiros da ESF e 8 (oito) das demais instituiÃÃes pÃblicas e privadas, totalizando 16 enfermeiros. Para coleta de dados, optou-se pela tÃcnica de Grupo Focal (GF) associado a uma entrevista individual como instrumento complementar. Dentre as tÃcnicas qualitativas, optamos pelo Discurso do Sujeito Coletivo (DSC) obtido atravÃs da anÃlise das entrevistas realizadas com enfermeiros sujeitos da pesquisa. Segundo LEFÃVRE e LEFÃVRE, que acreditam ser esta a melhor opÃÃo para o estudo proposto. As idÃias centrais foram: orientar e treinar o cuidador sobre o cuidado com o idoso, com tecnologia de enfermagem. O cuidador nÃo à importante, ele nÃo à foco da atenÃÃo, a famÃlia orientada no cuidado ao idoso, o cuidador necessita mais de cuidados que o prÃprio doente, pois na maioria dos casos o cuidador à tambÃm idoso, nÃo existindo disponibilidade de tempo para assistÃncia ao este. A assistÃncia à dada de acordo com as queixas e as necessidades de capacitaÃÃo para uma assistÃncia de qualidade. O conteÃdo dos discursos nÃo deixa dÃvidas de que hà necessidade de potencializar as aÃÃes de enfermagem embasada em conhecimentos cientÃficos, normatizaÃÃoes e criaÃÃo de instrumentos para assistÃncia domiciliar nas instituiÃÃes pÃblicas. Iniciando pela ESF, que trabalharà em concomitÃncia com o Programa de InternaÃÃo Domiciliar (PID), implantado nas instituiÃÃes hospitalares das redes pÃblicas municipais e estaduais. / The familiar cuidador of the aged dependent very starts to be focus of the attention in health recently. It was objectified, in this study to know the abilities and abilities developed for the nurse in the attendance to the familiar cuidador of the aged dependent in the domicile. To take care of adequately of these patients also demands deep preparation scientific technician of the professionals who carry through visits domiciliary the aged dependents, as well as planning of educative interventions, medicaments accomplishment of procedures and treatments. This diversification comes generating reflections and questionings between the professionals whom they visit and they take care of aged in domiciles. What one searchs in this study is, from the social reality of the nurses who work with assistance, internment and domiciliary visit. To know the construction of the care excused to aged and its cuidador. The work, in function of its objective and intention implies the use of methodology of qualitative cut. The population of the study consisted of integrant nurses of the Strategy Health of Family (ESF), of the Program of Domiciliary Attendance (PAD) and Home Care. For 8 (eight) nurses of ESF and 8 (eight) of the too much public and private institutions had been in such a way chosen totalizing 16 nurses. For collection of data associate to an individual interview opted itself to the technique of Focal Groupe (GF) as complementary instrument. Amongst the qualitative techniques, we opt to the Speech of Collective Citizen (DSC) gotten through the analysis of the interviews carried through with nurses citizens of the research according to LEFÃVRE and LEFÃVRE, to believing to be this the best option for the considered study. The ideas central offices had been: it guides and it trains on the care with the aged one, the cuidador as nursing technology, the cuidador is not important, the cuidador is not focus of the attention, the family guided in the care to the aged one, the cuidador needs more than well-taken care of that the proper sick person, the cuidador is also aged, does not exist availability of time for assistance to the cuidador, the assistance is given in accordance with to the complaints and necessity of qualification for a quality assistance. The content of the speeches does not leave doubts of that it has necessity of get up the actions of nursing based in scientific knowledge, rules and creation of instruments domiciliary assistance in the public institutions. Initiating for the ESF, that will work in concurrence with the Program of Domiciliary Internment (PID) implanted in the hospital institutions of the municipal and state public nets.

La loi du 5 mars 2007 a fait de la question de protection de la personne et de son autonomie le point d'ancrage de la réforme. Pourtant en agissant de la sorte, le législateur a consacré une double injonction paradoxale – protéger et rendre autonome – positionnant ainsi le protecteur comme agent d'une contrainte et à la fois garant des libertés de la personne : tenu lui-même de respecter le libre-arbitre du majeur mais également de le faire respecter (P. Bouttier, 2012). Dans ces conditions, on s'interroge sur la façon dont s'agence la relation entre le protecteur et la personne protégée. Comment le « tuteur » peut-il en effet rendre sa capacité au majeur tout en le protégeant ? Favoriser l'expression de la volonté, et donc l'autonomie du majeur ne conduirait-il pas à un désengagement de l’organe de protection ? Les modes de protection traditionnelles ont-ils alors encore leur place dans le système tutélaire ? Ou l’autonomie impose-t-elle de les reconsidérer ? On devine derrière ces interrogations les traces d'une nouvelle figure juridique attribuée à l'organe chargé de protection. Il ne s'agirait plus pour lui de faire fi du sujet mais bien de l'intégrer dans le processus décisionnel. En définitive, la protection se rénove et se transforme pour admettre une autre alternative : un accompagnement. L'accompagnement n'est pas qu'un phénomène de mode. Il est symptomatique de notre société post-moderne où le modèle paternaliste laisse place à un modèle collatéral (fraternel). Il constitue à cet égard une posture professionnelle avérée, reconnue et revendiquée par le milieu « tutélaire », en particulier chez les MJPM. Pourtant, le législateur ne l'a pas considéré, ni même défini. Sans doute n'a-t-il pas pris toute la mesure de cette pratique quotidienne ? Sans doute aussi se cache derrière ce vocable singulier, une posture plurielle difficilement saisissable par le droit. / The law of March 5th, 2007 made the issues of protection and autonomy of the person the anchor point of the reform. Yet in doing so, the legislature has developed a paradoxical order - to protect and give autonomy to protected adults - thus positioning the guardian at the same time as a constraint for the protected adults and as the guarantor of their freedoms. The guardian has to respect the freewill of the major while also enforcing it (P. Bouttier, 2012). In such circumstances, one wonders how the agency relationship between the guardian and the protected person can work. Indeed, how can the guardian render the protected adult his/her capacity while protecting him/her ? Does promoting the expression of the will, and therefore the autonomy of the protected adult, lead to a disengagement of the protective body ? Do the traditional protective methods still have their place in this tutelary system ? Or does the autonomy rendered to the protected adult require to reconsider it ? We guess behind these questions the traces of a new legal figure attributed to the body in charge of their protection. This body should no longer ignore the protected adult’s will as it would have to integrate it into the decision-making process. Ultimately, the protection system is renewed and transformed to admit another alternative : the accompaniment of the protected adult. The accompaniment is not a trend. It is symptomatic of our post-modern society in which the paternalistic model is gradually replaced by a collateral model (fraternal). It is in this respect a proven and recognized professional posture claimed by the "tutelary" professional environment, especially by the judicial representatives for protected adults. However, the legislature has not considered such accompaniment, nor even defined it. Certainly, it did not take the full measure of this daily practice. Probably that behind this strange term is also hidden a plural posture that is hardly comprehensible to the law.

Professional and volunteer programs of educational assistance to developing countries have increased to such an extent that local educational planners are often confused as to how to determine the most appropriate educational roles of each in order to utilize their services most productively. This study inquires into the comparative qualifications and educational contributions overseas of Canadian teachers to Nigeria and Sarawak during the decade 1957-67 by the External Aid Office and Canadian University Overseas in an attempt to prove that there is an overlapping area of similar qualifications and contributions overseas of Canadian teachers sent by the two agencies which results in confusion of their respective professional and volunteer roles. It further searches into areas of interaction of Canadian teachers overseas with local and international personnel and agencies in an attempt to show that such interaction has enhanced teachers' contributions, and that increased future co-operative endeavours could facilitate a greater total educational contribution. Finally, it seeks to show that some difficulties experienced by Canadian teachers, caused by inappropriate assignments or the non-provision of necessary emoluments, have affected their educational contributions, and that some means of avoiding or alleviating such difficulties in the future is desirable and necessary. Data for this study was gathered by means of a survey form mailed to those External Aid and CUSO teachers who served in Nigeria or Sarawak during the period 1957-67 as secondary teachers, teacher trainers, group headmasters (primary school supervisors), principals and advisers to governments. Information was solicited about the teachers' qualifications and experience before going overseas, education assignments overseas, educational activities beyond the assigned tasks, local and international associations and their effects upon the educational contribution, and difficulties resulting from non-fulfilment of contractual or agreement obligations pertaining to education assignments or personal emoluments. Of those teachers canvassed, 72 percent of External Aid and 61 percent of CUSO teachers responded. The findings show that there was a degree of overlapping of CUSO and External Aid teachers’ qualifications and educational contributions in Nigeria and Sarawak in that some CUSO teachers had equal or better qualifications, and made comparable or more professional contributions than some External Aid teachers. Many secondary teachers from both agencies assumed similar classroom teaching duties and extracurricular duties; some CUSO teachers undertook professional tasks which a number of External Aid secondary teachers did not; a few CUSO volunteers performed the professional roles of teacher trainer, group headmaster, primary school supervisor and secondary school principal. Thus, the appropriate qualifications and roles -which might distinguish Canadian professional and volunteer teachers were not clearly defined. All the teachers under study considered their local leisure time associations of value to their contributions, and most considered their time spent with Europeans of value, particularly CUSO teachers. Although all worked with other international educational personnel, less than half reported special co-operation with these colleagues, and only one-third received Canadian support for their educational endeavours. The evidence reveals that CUSO volunteers have valued European professional assistance, that more co-operation between members of international agencies should prove fruitful, and that greater assistance from Canadian sources could result in a greater total contribution. Although the majority of teachers expressed no major assignment difficulties, a small number from both agencies reported modifications of their original education assignments or indicated that their assignments differed from their original expectations. A large minority did not feel that their skills were fully utilized. A small number from both agencies experienced emolument difficulties. It may be inferred that the frustrations involved in the solution of these difficulties often resulted in adverse psychological effects, which in turn could affect their contributions. No consistent pattern of assistance towards the solution of these problems was revealed; Several teachers expressed the need for External Aid regional representatives to facilitate the teacher's adjustment and proper placement in the country of service. From a national point of view, there- appears to be a distinct need, and duty to ensure that the qualifications and roles of professional and volunteer teachers provided by Canada be clearly recognizable, consistent and predictable to educational planners in developing countries so that the services of such personnel may be used to harmonize efficiently with national development plans, and in order that the potential professional contributions of experienced teachers be not wasted. Further there appears to be a need for greater co-operation between members of the two Canadian agencies, and for more assistance in the field from the sending agency. Thus, the following recommendations are made: 1. that External Aid and CUSO policies be co-ordinated in order to distinguish the educational needs each will attempt to satisfy in developing countries, and to determine the teaching and academic qualifications and previous teaching, experience appropriate to those separate roles. 2. that External Aid regional representatives be appointed, charged with the responsibilities of determining appropriate assignments, of ensuring the availability of necessary facilities such as housing, and for facilitating the teachers' adjustments in the country of service by helping to solve unforeseen difficulties in assignment and physical arrangements. External Aid and CUSO coordinators within the country of service might then co-operate in jointly presenting their policies to local educational authorities, and channeling requests for Canadian personnel to the appropriate agency. 3. That closer co-operation of External Aid and CUSO agencies be encouraged both in orientation programs in Canada, and in formal or informal meetings in the countries of service, in order that inexperienced teachers may avail themselves of the professional assistance of more experienced teachers. / Education, Faculty of / Graduate

L'obligation faite aux gens de loi de conduire les mendiants dans les prisons de la ville la plus proche soulève la question de l'enfermement dans les grandes cités des provinces du nord. en france, l'etat royal croit remédier à ces difficultés par l'édit de juin 1662 ordonnant la création d'un hôpital général dans chaque ville du royaume. dès les années 1730, les administrateurs des principales villes des pays-Bas français appellent de leurs vœux une nouvelle forme de prise en charge du paupérisme : les hôpitaux généraux. ces établissements dans les provinces septentrionales n'ont fait l'objet d'aucune étude d'ensemble. il importe pourtant d'observer comment, dans un contexte de centralisation administrative, ces institutions se sont implantées dans des provinces où la tradition d'autonomie administrative était ardemment défendue. • la tutelle de l'intendant a-T-Elle été acceptée sans heurt dans la flandre maritime, pays d'administration directe, en flandre wallonne ou dans le hainaut, où les élites locales défendaient une co-Gestion du territoire ? • le financement de tels établissements doit également être étudié de près : selon les pays, là encore, le coût de l'hôpital général était supporté soit directement, soit indirectement par les contribuables, selon les modes d'administration locale. • l'expérience du renfermement des pauvres a par ailleurs suscité des critiques qu'il nous faudra analyser en tenant compte du contexte intellectuel du xviiie siècle. il convient aussi de s'interroger sur la réalité de l'autonomie de ces établissements hospitaliers, principalement au plan de la gestion financière et comptable.• pour administrer et gérer ces établissements, les magistrats font appel aux élites locales. les notables contribuent à la fois de leur temps et de leur argent à ces structures caritatives locales. ils collaborent souvent avec les représentants des élites des grandes villes• on ne négligera pas pour autant le caractère social du sujet : la large ouverture de ces hôpitaux généraux aux enfants permettra, semble-T-Il, d'établir un modèle particulier du traitement de l'enfance hôpitaux généraux ont joué un rôle prépondérant dans la genèse de l'enseignement élémentaire.c'est dunkerque qui ouvre la série des fondations grâce à des lettres patentes délivrées dès le 22 juillet 1737. lille suit à une courte distance en 1738, les années 1751-1752 correspondent à une accélération du mouvement avec la création des hôpitaux généraux de valenciennes et de douai. / The obligation (bond) made for people of law to lead (drive) the beggars in the prisons of the closest city raises the question of the confinement in the big cities (estates) of the provinces of the North. In France, the royal State believes to remedy these difficulties by the edict of June, 1662 ordering the creation of a general hospital in every city of the kingdom. The provinces of the North escape this movement up to the first third (third party) of the XVIIIth century. For the XVIth century, the assistance (audience) rests(bases) mostly on the Tables of the poor men there, charitable institutions were placed under the supervision (guardianship) of the Magistrates or people of law. After the wars of succession of Poland and Succession of Austria and under the influence of a new population growth, the northern provinces are confronted with an outbreak of the begging the scale of which questions brutally the efficiency of the model of assistance (audience) hispano - tridentin. The royal power strengthens just like that the repressive regulatory framework, arrests multiply and reveal the incapacity of the traditional structures of confinement. From the 1730s, the administrators (directors) of the main cities of the French Netherlands wish for a new shape of coverage (care) of the pauperism. The local authorities turn (shoot) then to the example of the general hospitals.

Le travail de cette thèse porte sur l’étude et la conception d’un fauteuil roulantsur deux roues appelé Gyrolift, adaptation d’un gyropode, véhicule de transport autoéquilibré,en fauteuil roulant verticalisateur sur deux roues. La verticalisation permetà une personne assise dans un fauteuil roulant le transfert d’une position assise à uneposition debout.Se mettre debout et se maintenir en équilibre malgré la présence d’un certainnombre de perturbations représente un défi pour une personne en situation de handicap.Les variations de posture de la partie supérieure telle que le tronc peuventêtre dues à des perturbations externes. Nous étudions la détection des mouvementsperturbateurs afin d’interpréter ces derniers ou l’intention qu’ils caractérisent et permettrede réagir en fonction de caractéristiques comme l’intensité et le sens. Nousétudions aussi les impacts de facteurs tels que l’environnement et l’appréhension surle Gyrolift et son utilisateur.Dans le premier chapitre de la thèse, la contribution porte sur l’étude de la trajectoirede verticalisation et sur les perturbations qu’elle peut générer. Un premierprototype a été conçu afin de valider notre étude.Afin de développer notre approche, le second chapitre de la thèse porte sur ladétection de perturbations sur un robot humanoïde bipède. Nous avons obtenu descritères nous permettant une détection rapide et fiable d’une perturbation, de sonsens et de son intensité afin d’effectuer les mouvements adaptés pour compenser cetteperturbation.Enfin, nous avons étudié l’adaptation de ces critères sur le Gyrolift ainsi que lesréactions possibles afin de sécuriser le système. Nous avons pour cela développé etréalisé un second prototype du fauteuil Gyrolift.Nous avons validé cette étude à l’aide d’un robot humanoïde et d’un nouveau typede fauteuil roulant verticalisateur, le Gyrolift, développé dans le cadre de ce projet. / The work of this thesis concerns the study and design of a two-wheel mobilitychair, conscript the Gyrolift, adapted from a Personal Transporter. It provides anauto-well-balanced transport vehicle and a verticalisation mechanism. The verticalisationallows a user in a wheelchair the transfer from a seat position to a standingposition.Being in a standing position and remaining stable when disturbances are presentmay be a challenge for a person with a mobility impairment. The posture variationsof the upper limbs such as the trunk can be due to external disturbances. This studydiscusses the detection of disruptive movements and to interpret the disturbances. Asafety ystem reacts according to the intensity of the disturbance when detected. Wealso study the impacts of factors such as the environment and the apprehension onthe Gyrolift and user.In the first chapter of the thesis, the contribution concerns the study of the trajectoryof verticalisation and the disturbances which it can generate. A first prototypewas designed to validate our study.The second chapter of the thesis concerns the detection of disturbance on bipedshumanoids robots. We obtained criteria allowing us a fast and reliable detection ofa disturbance, its direction and its intensity to make the movements adapted tocompensate for this disturbance.Finally, we studied the adaptation of these criteria on the Gyrolift as well as thepossible reactions to secure the system. We developed and realised for it a secondprototype of the Gyrolift wheelchair.We validated this study with the help of a humanoid robot and a new type ofverticalisation wheelchair developed within the framework of this project.

This thesis deals with international provided medical assistance services. The goal is to present problems connected to internationally provided assistance services and to offer possible solutions. For this work was drawn up a questionnaire, which was focused on the approach of clients to travelling, to insurance of medical expenses and to assistance companies.