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Satisfaction des soins ambulatoires et qualité de vie des personnes dépendantes aux substances psychoactives / Satisfaction with care and quality of life in subjects with substance use disordersBourion, Stéphanie 14 December 2015 (has links)
Contexte : Les troubles liés à l’usage des substances psychoactives constituent une priorité de santé publique dans le champ des pathologies chroniques. Les indicateurs de type Patient-Reported Outcomes (PRO) offrent des perspectives complémentaires aux indicateurs classiques pour la mesure de l’état de santé des patients et l’appréciation de la qualité des soins. Objectifs : Étudier les propriétés psychométriques de questionnaires de qualité de vie (QV) et les déterminants de la satisfaction précoce vis-à-vis des soins ambulatoires de patients dépendants aux substances de type alcool ou opiacés. Méthode : Les caractéristiques des patients et des médecins ont été recueillies à l’inclusion dans la cohorte SUBUSQOL. La satisfaction précoce a été mesurée quinze jours après la première consultation et ses déterminants ont été testés dans des modèles de régression linéaires multivariés. Les propriétés psychométriques du questionnaire spécifique Q-LES-Q-SF ont été étudiées au préalable sur un échantillon de patients. Résultats : La version française du Q-LES-Q-SF constitue un outil unidimensionnel robuste et fiable, les items du SF-12 et Q-LES-Q-SF présentent peu ou pas de fonctionnement différentiel selon l’âge, le sexe, le niveau d’éducation et le type d’addiction. Peu de variables recueillies sont associées à la satisfaction. Les patients dépendants à l’alcool se révèlent être plus satisfaits des modalités de contact et du délai de rendez-vous et ceux sans aucun antécédent de prise en charge pour leur dépendance plus satisfaits de leur consultation avec le médecin. Conclusion : Les questionnaires SF-12 et Q-LES-Q-SF peuvent être utilisés dans des populations de patients suivis en ambulatoire pour une dépendance aux substances psychoactives / Context: Of chronic diseases, substance use disorders are a public health priority. Patient-reported outcome indicators (PRO) offer additional insights into the classical indicators used to measure the patient’s health status and appreciation of their quality of care. Objectives: to study the psychometric properties of quality of life instruments and to study the determinants of early outpatient satisfaction with ambulatory care in alcohol- or opiate-dependent patients. Method: Patient and physician characteristics were collected in the SUBUSQOL cohort. Early satisfaction with care was measured fifteen days after the first consultation. The determinants of satisfaction were tested using multivariate linear models of regression. Prior data on the self-reported health status of a sample of alcohol- or opiate-dependent outpatients were used to investigate the psychometric properties of a specific questionnaire, the Q-LES-Q-SF. Results: Our results establish that the French version of the Q-LES-Q-SF is a unidimensional, valid and reliable instrument of self-reported health status assessment for use in care or medical research and that few items of the SF-12 and the Q-LES-Q-SF displayed differential functioning according to age, sex, educational level and type of substance use disorder. Our results show that few variables are associated with the level of patient satisfaction. Alcohol dependence was strongly associated with higher satisfaction with appointment making, and patients with no history of previous care for substance use disorders had a higher level of satisfaction with the doctor consultation. Conclusion: The use of the SF-12 and the Q-LES-Q-SF is recommended for outpatients suffering from substance use disorders
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Subdesenvolvimento e dependência: a construção e revisão da teoria do subdesenvolvimento de Celso Furtado à luz do debate com a teoria da dependênciaPereira, Fernando de Castro Abdalla 16 June 2009 (has links)
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Previous issue date: 2009-06-16 / This research has the objective to show the elements that constitute the Underdevelopment Theory of Celso Furtado, and also to indicate how it was revised after the debate realized with the Theory of Dependence and the political and economical facts of midlle 1960´s on. In order to achieve this objective, the research starts with the analysis of the first main writings of Celso Furtado, with the objective to highlight his structural evaluation on the Brazilian economy, the critics made to some authors of the economic theory when regarding the study of development. Besides that, the study indicates the main critics realized by the Theory of Dependece to Furtado. Among them, there are the sociological critic from Fernando Henrique Cardoso and Enzo Faletto; the idea from Ruy Mauro Marini, which indicates that the dependence must be studied on the context of international relations between economies and how the Latin American economies inserted themselves on this scenario after Industrial Revolution. And the contribution of Theotônio dos Santos, that differentiates dependence and underdevelopment, with the argument that the Theory of Dependence aims to comprehend the restrictions of a development based on the hegemony of the groups and imperialist forces. This research also indicates how Celso Furtado revised his Theory after the debate of the Theory of Dependence and according to the change of regime in the country and to the idea that industrialization was being conducted by a State that acted on a political regime always criticized by this author. Facts that have made Furtado revise his speech, and even identifying the development as a Myth / Esta pesquisa visa evidenciar os elementos constitutivos da Teoria do Subdesenvolvimento e mostrar como ela foi revista frente ao debate com a Teoria da Dependência e aos acontecimentos políticos e econômicos de meados de 1960 em diante. Para isso, parte-se da análise das primeiras obras de Celso Furtado com o intuito de ressaltar sua avaliação estrutural da economia brasileira e sua crítica à teoria econômica quanto ao estudo do desenvolvimento. Além disso, procura-se indicar as principais críticas da Teoria da Dependência contra Furtado, à luz dos acontecimentos ocorridos no período. Dentre elas, destacam-se a crítica sociológica de Fernando Henrique Cardoso e Enzo Faletto; a idéia de Ruy Mauro Marini de que a dependência deve ser estudada no âmbito das relações internacionais entre economias e a forma através da qual se inseriram as economias da América Latina no contexto Pós Revolução Industrial; e a contribuição de Theotônio Dos Santos, que diferencia dependência e subdesenvolvimento, alegando que a Teoria da Dependência busca compreender as restrições de um desenvolvimento baseado na hegemonia dos grupos e das forças imperialistas. Indica-se também como Furtado reviu sua teoria a partir do debate com esta corrente, mediante a mudança de regime de governo país e da idéia de que a industrialização estava sendo conduzida por um Estado que atuava em regime político sempre criticado pelo autor. Esses últimos fatos fizeram com que Furtado mudasse o tom de seu discurso, identificando, inclusive, o desenvolvimento como mito
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Contribuições à geração de tráfego fractal por meio da transformada wavelet. / Constributions for fractal traffic generation by wavelest transform.Isabelle Reis Lund 26 June 2008 (has links)
Estudos mostraram que o tráfego nas redes de dados tanto locais quanto de grande área, possui propriedades fractais como dependência de longa duração - Long-Range Dependence (LRD) e auto-similaridade. Devido à heterogeneidade de aplicações nessas redes, os traces de tráfego podem apresentar dependência de longa duração - Long Range Dependence (LRD), dependência de curta duração - Short Range Dependence (SRD) ou uma mistura de LRD com SRD. Sendo assim, este trabalho tem como objetivo sintetizar séries temporais gaussianas com flexibilidade de processamento no plano tempo-frequência a serem inseridas num gerador de tráfego com as características estatísticas específicas do tráfego encontrado em redes por comutação de pacotes reais, como autossimilaridade, LRD e SRD. Para isto foram desenvolvidos dois métodos para síntese de séries temporais gaussianas com LRD e simultânea introdução de SRD em diferentes faixas de frequência: Discrete Wavelet Tansform (DWT) com mapa de variâncias e Discrete Wavelet Packet Tansform (DWPT). Estes métodos utilizaram o mapa de variâncias cujo conceito foi desenvolvido neste trabalho. A validação dos métodos foi feita através de análise estatística e comparação com resultados de séries geradas pelo método Discrete Wavelet Transfom (DWT) de Backar utilizado em [1]. Além disso, também foi validada a ideia de que a DWPT é mais interessante que a DWT por ser mais flexível e prover uma maior flexibilidade de processamento no plano tempo-frequência. / Studies demonstrated that the data network traffic of Local Area Network (LAN) and Wide Area Network has fractal properties as long range dependence (LRD) and self-similarity. The traffic traces can show long range dependence, short range dependence or the both behaviors because of applications heterogeneity in these networks. This work objective is to synthetisize gaussian time series with processor flexibility in the time-frequency plan to be inserted in a traffic generator with the specific statistical traffic characteristics of real packet networks such as selfsimilarity, long range dependence (LRD) and short range dependence (SRD). Two methods were developed for the gaussian time series with LRD and SRD synthesis: Discrete Wavelet Tansform (DWT) with variance map and Discrete Wavelet Packet Tansform (DWPT). These methods used the variance map which concept was developed in this work. The methods validation was done by statistic analysis and comparison with the time series generated by the B¨ackar Discrete Wavelet Transfom (DWT) used by [1]. Besides of this, the idea that the DWPT is more because of its processing flexibility in the time-frequency plan was validated.
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Preproenkephalin Gene and mRNA : Studies of Structure, Function, Cocaine Responses in an Animal Model, and Genetic Association with Human Opiate AddictionLaForge, Karl Steven January 2004 (has links)
<p>The endogenous opioid enkephalin neuropeptides are mediators of pain perception and have been implicated in human addictions. The preproenkephalin gene and its mRNA have also provided many examples of tissue- and species-specific variations in mRNA structure produced through a variety of transcriptional and post-transcriptional mechanisms. Resultant differences in mRNA structure, in several cases, have impact on translation of enkephalin prepropeptide. The reports and discussion presented herein describe studies of the preproenkephalin gene and mRNA structure in the guinea pig, an animal that may have specific advantages for modeling the human endogenous opioid system. A guinea pig brain cDNA library was constructed and screened for clones of preproenkephalin and preprodynorphin, which were then sequenced. These studies confirmed the predicted mRNA structure that had been previously proposed based on homology with gene sequences and other methods. Multiple transcription initiation sites for each of these prepropeptide genes were also identified. Studies were conducted in the guinea pig to evaluate the effects of the administration of cocaine in a “binge” paradigm for two and seven days on preproenkephalin mRNA levels in several brain regions. “Binge” cocaine administration for seven (but not two) days resulted in differential changes in mRNA levels in different brain regions. Decreases were observed in the nucleus accumbens and hypothalamus, and increases in the frontal cortex, amygdala and hippocampus. These findings differ from those of previous rodent studies and suggest that this species may provide a useful alternative model for the study of the effects of cocaine on preproenkephalin gene expression in the human brain. Human genetic studies were also conducted in opioid-dependent (formerly heroin-addicted) and control subjects to test the hypothesis that the preproenkephalin gene is associated with heroin addiction. In two separate studies, we obtained evidence that this gene may be associated with the development of human heroin addiction.</p>
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Extensions to Gaussian copula modelsFang, Yan 01 May 2012 (has links)
A copula is the representation of a multivariate distribution. Copulas are used to model multivariate data in many fields. Recent developments include copula models for spatial data and for discrete marginals. We will present a new methodological approach for modeling discrete spatial processes and for predicting the process at unobserved locations. We employ Bayesian methodology for both estimation and prediction. Comparisons between the new method and Generalized Additive Model (GAM) are done to test the performance of the prediction.
Although there exists a large variety of copula functions, only a few are practically manageable and in certain problems one would like to choose the Gaussian copula to model the dependence. Furthermore, most copulas are exchangeable, thus implying symmetric dependence. However, none of them is flexible enough to catch the tailed (upper tailed or lower tailed) distribution as well as elliptical distributions. An elliptical copula is the copula corresponding to an elliptical distribution by Sklar's theorem, so it can be used appropriately and effectively only to fit elliptical distributions. While in reality, data may be better described by a "fat-tailed" or "tailed" copula than by an elliptical copula. This dissertation proposes a novel pseudo-copula (the modified Gaussian pseudo-copula) based on the Gaussian copula to model dependencies in multivariate data. Our modified Gaussian pseudo-copula differs from the standard Gaussian copula in that it can model the tail dependence. The modified Gaussian pseudo-copula captures properties from both elliptical copulas and Archimedean copulas. The modified Gaussian pseudo-copula and its properties are described. We focus on issues related to the dependence of extreme values. We give our pseudo-copula characteristics in the bivariate case, which can be extended to multivariate cases easily. The proposed pseudo-copula is assessed by estimating the measure of association from two real data sets, one from finance and one from insurance. A simulation study is done to test the goodness-of-fit of this new model. / Graduation date: 2012
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Preproenkephalin Gene and mRNA : Studies of Structure, Function, Cocaine Responses in an Animal Model, and Genetic Association with Human Opiate AddictionLaForge, Karl Steven January 2004 (has links)
The endogenous opioid enkephalin neuropeptides are mediators of pain perception and have been implicated in human addictions. The preproenkephalin gene and its mRNA have also provided many examples of tissue- and species-specific variations in mRNA structure produced through a variety of transcriptional and post-transcriptional mechanisms. Resultant differences in mRNA structure, in several cases, have impact on translation of enkephalin prepropeptide. The reports and discussion presented herein describe studies of the preproenkephalin gene and mRNA structure in the guinea pig, an animal that may have specific advantages for modeling the human endogenous opioid system. A guinea pig brain cDNA library was constructed and screened for clones of preproenkephalin and preprodynorphin, which were then sequenced. These studies confirmed the predicted mRNA structure that had been previously proposed based on homology with gene sequences and other methods. Multiple transcription initiation sites for each of these prepropeptide genes were also identified. Studies were conducted in the guinea pig to evaluate the effects of the administration of cocaine in a “binge” paradigm for two and seven days on preproenkephalin mRNA levels in several brain regions. “Binge” cocaine administration for seven (but not two) days resulted in differential changes in mRNA levels in different brain regions. Decreases were observed in the nucleus accumbens and hypothalamus, and increases in the frontal cortex, amygdala and hippocampus. These findings differ from those of previous rodent studies and suggest that this species may provide a useful alternative model for the study of the effects of cocaine on preproenkephalin gene expression in the human brain. Human genetic studies were also conducted in opioid-dependent (formerly heroin-addicted) and control subjects to test the hypothesis that the preproenkephalin gene is associated with heroin addiction. In two separate studies, we obtained evidence that this gene may be associated with the development of human heroin addiction.
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A Static Slicing Tool for Sequential Java ProgramsDevaraj, Arvind January 2007 (has links) (PDF)
A program slice consists of a subset of the statements of a program that can potentially affect values computed at some point of interest. Such a point of interest along with a set of variables is called a slicing criterion. Slicing tools are useful for several applications, such as program understanding, testing, program integration, and so forth. Slicing object oriented programs has some special problems that need to be addressed due to features like inheritance, polymorphism and dynamic binding. Alias analysis is important for precision of slices. In this thesis we implement a slicing tool for sequential Java programs in the Soot framework. Soot is a front-end for Java developed at McGill University and it provides several forms of intermediate code. We have integrated the slicer into the framework. We also propose an improved technique for intraprocedural points-to analysis. We have implemented this technique and compare the results of the analysis with those for a flow-insensitive scheme in Soot. Performance results of the slicer are reported for several benchmarks.
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As ambiguidades de escolha de calibre e de parametrização da métrica em gravitação quânticaGonçalves, Jeferson Dias 27 February 2018 (has links)
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Previous issue date: 2018-02-27 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Nesta tese expomos primeiramente um breve histórico-motivacional para a construção de uma teoria de gravitação quântica, bem como, rápidas revisões orientadas sobre elementos de teorias quânticas de campos e sobre a técnica de Schwinger-Dewitt. De posse destas ferramentas, discutimos a dependência de calibre e da parametrização
para uma teoria quântica de gravitação em um espaço-tempo de dimensão arbitrária D. Com este objetivo, calculamos explicitamente as correções quânticas a 1-loop, da ação efetiva da teoria, considerando a parametrização mais geral possível para a métrica quântica. Essa parametrização contém inicialmente sete parâmetros, sendo
que alguns deles serão fixados através da condição de fixação de calibre, o que torna o nosso cálculo um pouco mais simples. Por fim, para esta teoria, confirmamos a validade de um teorema geral, o qual garante a independência das divergências on-shell, a 1-loop, com respeito às ambiguidades nas escolhas de calibre e de parametrização da métrica quântica. / In this thesis we first present a brief historical-motivational for a construction of a theory of quantum gravitation, as well as quick reviews oriented on elements of quantum field theory and Schwinger- Dewitt technique. In possession of these tools, the gauge and parametrization dependence is discussed in quantum gravity in an arbitrary dimension D. Explicit one-loop calculations are performed within the most general parametrization of quantum metric with seven arbitrary parameters. On the other hand, some of the
gauge fixing parameters are fixed to make the calculations relatively simple. We confirm the general theorem stating that the on shell local terms in the one-loop effective action are independent of the gauge and parametrization ambiguity.
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Dependência de trajetória no setor elétricoMüller, Matheus 05 March 2013 (has links)
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Previous issue date: 2013-03-05 / The proccess of reform of the electricity industry in Brazil followed the global trend over the years 1990 and materialized in line with market principles. The purpose of social, economic and political state went through a long process of restructuring where new regulatory framework was established for the electricity sector. The logic state back to make room for the competitive logic, a kind of return to the origins of the development of the electrical industry, albeit with a conformation organizational and productive much more dense and complex. It is on this background that focuses the study, with the main objective to analyze national policy of restructuring the electricity sector over the decade from 1990 to 2000, from the approach of path dependence. This analytical method is relevant to show that even the innovative initiatives in terms of public policies carry with them elements of structures, institutions and previous policies that act to reinforce actions already initiated. The results point to a policy of power sector reform marked by continue even after the exhaustion of their models. / O processo de reforma da indústria de eletricidade brasileira acompanhou a tendência mundial ao longo dos anos 1990 e se concretizou em consonância com os princípios de mercado. A finalidade social, econômica e política do Estado passou por longo processo de reestruturação, onde novo marco regulatório foi estabelecido para o setor elétrico. A lógica estatal volta a ceder espaço para a lógica competitiva,
numa espécie de retorno às origens do processo de desenvolvimento da indústria elétrica, embora com uma conformação organizacional e produtiva muito mais densa
e complexa. É sobre esse panorama que se debruça o estudo, com o objetivo principal de analisar a política nacional de reestruturação do setor elétrico ao longo da década de 1990 e 2000, a partir da abordagem da path dependence. Esse método analítico se torna relevante ao demonstrar que, mesmo as iniciativas inovadoras em termos de políticas públicas carregam consigo elementos de estruturas, instituições e políticas anteriores, que atuam de forma a reforçar ações já
iniciadas. Os resultados apontam para uma política de reforma do setor elétrico marcada por continuísmos, mesmo após a exaustão do modelo adotado.
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Normer och praxis : tre ideella föreningar och deras redovisning / The norms and practices : three non-profit organizations and their accountingGustafson, Agneta January 2006 (has links)
The focus of this study is the accounting of private non-profit organizations. Accounting is understood as a situated practice under specific conditions prevailing in different types of private non-profits. First, a pilot study of the financial reports of 39 Swedish non-profit organizations was undertaken. It identified similarities and differences between their reporting and the norms used in commercial accounting. Three case studies of private non-profits of different kinds and sizes were then undertaken. The purpose was both to describe how non-profits report their activities and their financial position to external interest groups and attempt to explain what lies behind their accounting practices. A combination of an institutional perspective and a resource dependence perspective has been used. The study contributes to our knowledge of practices in non-profit organization accounting and suggests some explanations of their accounting practices. The following research question was explored: When does institutional isoformism and when does resource dependence determine the accounting practices in these private non-profits? The main findings are the following: the purpose of the annual reports of these private non-profits is to show how they have used their resources. Their income statements are more like reports of financial flows. It has been difficult to measure the efficiency of their activities and for that reason they report more about doing the “right” things. A verbal story is needed to give a fair account of their performance. In trying to explain the accounting practices of these organizations four things were highlighted: · They imitated conventional accounting norms when the issues had no direct influence on future resources. · They diverged from conventional accounting norms and showed their distinctive character in that they created ways of presenting information according to what was needed by their interested parties, when the issues could influence future flow of resources. This is true even after the accounting regulations were established in 2001. However, when they were forced to follow conventional accounting norms, coercive isomorphic pressure meant that they had less freedom. · When the organizations used other channels than their annual reports to communicate with their supporters, the accounting practices did not influence future resources. Then they applied conventional accounting norms for business organizations. · When the organizations used their annual reports in planning for future obligations and in internal follow up, the accounting practices were also influenced by internal considerations. As they diverged from commercial accounting their differences form commercial organizations were highlighted and their need to communicate in a somewhat different way was seen. Key words: Private non-profit organizations, accounting, accounting theory, accounting norms, accounting practices, institutional theory, isomorfism, resources, resource dependence theory.
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