Submitted by KAREN SANTOS BRAGHIROLI null (ka_braghiroli@hotmail.com) on 2016-03-14T00:21:49Z No. of bitstreams: 1 NOVO CORRETO-CORREÇÃO PÓS DEFESA- WORD-DISSERTAÇÃO DE MESTRADO-KAREN S BRAGHIROLI-DEFESA 24-2-2016.pdf: 812463 bytes, checksum: 5d0fe477b5ee642d2fd42d5a02dd5a18 (MD5) / Approved for entry into archive by Ana Paula Grisoto (grisotoana@reitoria.unesp.br) on 2016-03-15T12:13:23Z (GMT) No. of bitstreams: 1 braghiroli_ks_me_bot.pdf: 812463 bytes, checksum: 5d0fe477b5ee642d2fd42d5a02dd5a18 (MD5) / Made available in DSpace on 2016-03-15T12:13:23Z (GMT). No. of bitstreams: 1 braghiroli_ks_me_bot.pdf: 812463 bytes, checksum: 5d0fe477b5ee642d2fd42d5a02dd5a18 (MD5) Previous issue date: 2016-02-24 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) / Pró-Reitoria de Pesquisa (PROPe UNESP) / A população mundial está envelhecendo e o número de procedimentos anestésico-cirúrgicos está aumentando na faixa etária de 60 anos, comparando-se com outros grupos etários. Considerando essa realidade e a existência de diferenças na segurança do paciente entre países desenvolvidos e em desenvolvimento, a presente revisão comparou a incidência de Parada Cardíaca (PC) perioperatória e por fator anestésico em pacientes geriátricos em países desenvolvidos e em desenvolvimento de acordo com o IDH (Índice de Desenvolvimento Humano) e em dois períodos de tempo. Comparou-se também a literatura mundial da incidência de PC perioperatória e por fator anestésico ao longo do tempo (pré-1990s e 1990-2014) e em relação ao IDH. Métodos: Realizou-se uma revisão sistemática de estudos transversais da literatura mundial sobre a incidência de PC perioperatória e por fator anestésico em pacientes geriátricos. Foi realizada meta-análise da incidência de PC perioperatória e por fator anestésico em 10.000 anestesias, de acordo com o IDH dos países e o período de tempo (pré-1990s e 1990-2014). Utilizou-se a análise de metarregressão para analisar a incidência de PC perioperatória e por fator anestésico ao longo do tempo e do IDH dos países. A meta-análise e a metarregressão foram realizadas considerando um intervalo de confiança (IC) de 95%. Resultados: Foram incluídos 16 estudos de nove países diferentes, com um total de 1.758.153 pacientes geriátricos submetidos à anestesia. A meta-análise mostrou que a incidência de PC perioperatória e por fator anestésico diminuiu significativamente nos países com alto-IDH (38,6 [IC 95%, 37,8-39,6] no período pré-1990s para 7,7 [IC 95%, 7,6-7,8] em 1990-2014, p<0,001; e 9,2 [ IC 95%, 8,9-9,5], no período pré-1990s para 1,3 [ IC 95%, 0,2-6,5] em 1990-2014, p<0,001, respectivamente). Em países com baixo-IDH, não há estudos disponíveis na literatura com a incidência de PC perioperatória e por fator anestésico no período pré-1990, não permitindo a comparação entre os períodos de tempo. A incidência de PC perioperatória em 1990-2014 foi quatro vezes maior nos países com baixo-IDH, em comparação com países de alto IDH (p<0,001). A metarregressão mostrou uma relação significativa com redução da incidência de PC por fator anestésico e o tempo independentemente do IDH do país (slope= -0,0699; 95% IC= -0,1394 a -0,0003; p=0,049) assim como em países com alto-IDH (slope= -0,1049; 95% IC= -0,1762 a -0,0336; p=0,015). Por outro lado, a metarregressão não mostrou relação significativa entre a incidência da PC por fator anestésico e o IDH dos países. Também não houve relação significativa da PC perioperatória em relação ao tempo e ao IDH dos países. Conclusão: A incidência de PC por fator anestésico em pacientes geriátricos diminuiu significativamente nos últimos 60 anos, especialmente em países com alto-IDH. Existe uma redução clara e significativa na incidência de PC por fator anestésico e perioperatória somente em países com alto-IDH, comparando-se os dois períodos de tempo (cinco vezes e sete vezes, respectivamente). / The world population is ageing and the number of anesthesia and surgical procedures are increasing in the sixty-years-old compared to other age groups. Considering this and the differences in patient safety in low- and high-income countries, the current study compared the perioperative and anesthesia-related CA rates in geriatric patients in low- and high-income countries in two time periods. Additionally, we compared global data on anesthesia-related and perioperative cardiac arrest (CA) rates according to Human Development Index (HDI) status and by time. Methods: A systematic review was performed to identify worldwide observational studies in which geriatric patients were submitted to anesthesia with perioperative and/or anesthesia-related CA rates. Meta-analysis per 10,000 anesthetics and meta-regression were performed with 95% confidence intervals (CIs) to compare the perioperative and anesthesia-related CA rates by country’s HDI status (low-HDI versus high-HDI) and by time period (pre-1990s versus 1990-2014), and to evaluate data on perioperative and anesthesia-related CA rates according to country’s HDI status and by time. Results: Sixteen studies from 9 countries assessing 1,758,153 anesthetic administrations in geriatric patients were included. The meta-analysis showed that the perioperative and anesthesia-related CA rates declined in high-HDI (38.6 [95% CI, 37.8-39.6] before the 1990s to 7.7 [95% CI, 7.6-7.8] in the 1990-2014, P<0.001; and 9.2 [95% CI, 8.9-9.5] before the 1990s to 1.3 [95% CI, 0.2-6.5] in the 1990-2014, P<0.001, respectively). In low-HDI countries, there were no studies in perioperative and anesthesia-related CA before 1990 disabling the comparison between the periods. The perioperative CA rate in the 1990-2014 was 4-fold higher in low-HDI compared with high-HDI countries (P<0.001). Meta-regression showed the significant relationship between anesthesia-related CA rate and time independently of HDI status (slope= -0.0699; 95% CI= -0.1394 to -0.0003; P=0.049) as well as in high-HDI countries (slope= -0.1049; 95% CI= -0.1762 to -0.0336; P=0.015), but not according HDI status. The relationship between perioperative CA by time and by HDI status was not significant. Conclusions: Anesthesia-related CA rate in geriatric patients has declined significantly in the past 60 years, especially in high-HDI countries. There is a clear and consistently reduction in perioperative and anesthesia-related CA rates only in high-HDI countries comparing the two time periods (5-fold and 7-fold, respectively). / FAPESP: 2013/11007-6 / PROPe/CDC UNESP: #0143/004/13

Submitted by Marilene Donadel (marilene.donadel@unioeste.br) on 2018-04-25T00:28:56Z No. of bitstreams: 1 Joelmir_Santos_2016.pdf: 3759768 bytes, checksum: 953ccb765b5bea358bd87b6b493ab5cb (MD5) / Made available in DSpace on 2018-04-25T00:28:56Z (GMT). No. of bitstreams: 1 Joelmir_Santos_2016.pdf: 3759768 bytes, checksum: 953ccb765b5bea358bd87b6b493ab5cb (MD5) Previous issue date: 2016-02-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This study aimed the evaluation and application of methodology for multielement analyses by total reflection X-ray fluorescence spectrometry (TXRF) in order to provide analyte concentration measurements with accuracy and precision. Using the energy and intensity of the spectral lines of characteristic X-ray, a series of chemicals were identified and quantified, respectively, with a concentration below part per million to a few parts per billion, especially for transition metals. To ensure statistical reliability and reproducibility, a methodology based on the deposition of fine particles, less than 50 m, representative sample and uniformly spread on a quartz flat reflector, which was extremely clean and positioned at the angular condition of maximum reflectivity of monochromatic X-rays was applied. To ensure uniformity on the support surface and the sample representativeness, a number of replicas of specific quantities of samples, in the form of a fine powder was added in a diluted viscous organic solution containing a well-known concentration of an element choosing as internal standard. An aliquot of the viscous solution containing both the suspended particulate sample and an internal standard was deposited at the center of the quartz reflector and dried, yielding a very thin layer of particulates. First, the instrumental TXRF was previously evaluated for its operation, spectral response and recovery of transition metal concentrations in a test sample supplied by the manufacturer. The reproducibility of the elemental concentration measurements was tested with a combination of the number of experimental replicates (five) and analytical (three) for each type of environmental matrix samples, namely certified reference materials or CRMs. Six types of CRMs were tested: river sediment, tomato leaves, rice, fish muscle, bone and bovine liver. The data were statistically processed data, resulting in a series of average and uncertainty values of the analyte concentrations was compared to certified reference values, reported in the technical reports of CRM. Regarding the multielement character of the TXRF technique, there was a good recovery, about 100%, for most of the certified concentrations of the referenced analytes in the six CRMs within the margin of variability of results found by both the TXRF technique and reports. It was also found that the detection limit depends on the density matrix of the material under study. However, the transition elements were those with the lowest values of detection limits. Having a good recovery of majority analyte concentrations in Buffalo River sediment reference material, the same methodology was applied to sediment material analysis of Bezerra stream that was collected in three locations and for a period of three years. A number of chemicals has been identified through their spectral lines K and L and quantified following the internal standard method. The set of concentration data was statistically processed from the point of view of the normality of the data and an analysis of principal components, revealing a systematic presence of high concentrations of heavy metals such as lead and chromium, comparatively higher those recommended by current environmental legislation (CONAMA 420/2009) as the maximum permissible limits. / Este trabalho teve como objetivo a avaliação e aplicação de metodologia para análise multielementar por meio da espectrometria de fluorescência de raios X por reflexão total (TXRF), a fim de fornecer medidas de concentração de analitos com acurácia e precisão. Usando a energia e a intensidade das linhas espectrais de raios X característicos, uma série de elementos químicos foram identificados e quantificados, respectivamente, com concentração abaixo de parte por milhão até poucas partes por bilhão, principalmente para metais de transição. A fim de garantir a confiabilidade e reprodutibilidade estatística, foi aplicada uma metodologia que se baseia na deposição de particulados finos, menores que 50 m, representativos da amostra e uniformemente distribuídos sobre um refletor plano de quartzo, previamente limpo, na condição angular de máxima refletividade de raios X monocromáticos. Para garantir a uniformidade no suporte e a representatividade da amostra, uma série de réplicas de quantidades específicas de amostras, na forma de um pó fino, foi adicionada em solução orgânica viscosa diluída contendo uma concentração conhecida de um elemento na qualidade de padrão interno. Uma alíquota da solução viscosa contendo ambos o particulado de amostra em suspensão e o padrão interno foi depositada no centro do refletor de quartzo e seca, obtendo-se uma camada fina de particulado. Primeiramente, o instrumental TXRF foi previamente avaliado quanto a operação, resposta espectral e recuperação de concentrações de metais de transição de uma amostra de teste fornecido pelo fabricante. A reprodutibilidade das medidas de concentração elementar foi testada com uma combinação da série de réplicas experimentais (cinco) e analíticas (três) para cada tipo de matriz de amostras ambientais, chamadas de Materiais de Referência Certificados ou MRC. Foram testados seis tipos de MCRs: sedimento de rio, folhas de tomate, arroz, músculo de peixe, osso e fígado bovino. Foram processados estatisticamente a série de dados de concentrações elementares de cada MCR, obtendo-se o valor médio e incerteza da concentração de cada analito de referência o qual foi comparado ao reportado nos laudos técnicos dos MCR. Considerando o caráter multielementar da técnica TXRF, verificou-se uma boa recuperação, em torno de 100%, da maioria das concentrações referenciadas e certificadas dos analitos nos seis MCRs, dentro da margem de variabilidade dos resultados encontrados pela técnica TXRF e reportados pelos laudos. Verificou-se também que o limite de detecção depende da densidade da matriz do material sob estudo. Contudo, os elementos de transição foram os que apresentaram os menores valores de limites de detecção. Tendo a boa recuperação das concentrações de analitos maioritários no material de referência sedimento Buffalo River, foi aplicada a mesma metodologia para análise de material de sedimento do córrego Bezerra-Cascavel que foi coletado em três locais ao longo dele e por um período de três anos. Uma série de elementos químicos foram identificados através de suas linhas espectrais K e L, e quantificados seguindo o método do padrão interno. O conjunto de dados de concentração foi processado estatisticamente do ponto de vista da normalidade dos dados e feita uma análise de componentes principais, revelando uma sistemática presença de altas concentrações de metais pesados, tais como chumbo e cromo, comparativamente maiores daqueles preconizados pela atual legislação ambiental (CONAMA 420/2009) quanto aos limites máximos permissíveis.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Globalization provoked in financial markets by means stock exchanges an interchange among the markets over the world. The aim of this study was to examine the relationship of the ten major main economic index of the world represented in New York (DJIA, S&P500 e Nasdaq), Tokyo (NIKKEI 225), London (FSTE 100), São Paulo (IBOV), Shanghai (SSE180), Paris (CAC-40), Frankfurt (DAX-30) and Buenos Aires (Merval) and looking for its co-integration, to demonstrate the behavior of these indexes and the long run equilibrium, from January of 2010 to March of 2011. To investigate the equilibrium and the long rum behavior the error correction model was used jointly with co-integration test and impulse response based on Cholesky decomposition. The results of this study show that the index of stock markets has long term equilibrium, and American markets, Argentina and English showed a strong influence over other markets. With this research we can infer that a relationship exists between the stock markets under study, confirming that the economy in a country can influence the others. In this sense, the contribution of this study, given this range of discussions involving the interconnection of economies with respect to trades made on the stock exchanges, was to show the relationships and influences in the world. / A internacionalização somada à abertura dos mercados financeiros transformou as economias antes fechadas em economias abertas, provocou um intercâmbio entre as economias mundiais por meio das bolsas de valores. O objetivo deste estudo é examinar a relação entre os dez principais índices econômicos do mundo, sendo eles: Nova York (DJIA, S&P500 e Nasdaq), Tóquio (Nikkei 225), Londres (FSTE 100), São Paulo (IBOV), Shangai (SSE180), Paris (CAC), Frankfurt (DAX-30) e Bueno Aires (Merval), por meio da análise de co-integrações para demonstrar o comportamento desses índices e seus equilíbrios no período de janeiro de 2010 a março de 2011. Para investigar e verificar o comportamento em longo prazo, foi utilizado o modelo de correção de erros e teste de impulso-resposta baseado na decomposição de Cholesky. Os resultados deste estudo mostram que existe equilíbrio em longo prazo entre os índices do mercado de ações. Os mercados americano, argentino e inglês mostraram forte influência sobre os demais mercados. Com esta pesquisa, verifica-se que existe uma relação entre os mercados de ações estudados, confirmando que a economia de um país influencia as demais. A contribuição deste estudo é verificar a assertiva das discussões atuais sobre a dependência das economias mundiais com as negociações por meio da bolsa de valores.

Conventional hearing aid circuitry is often unable to provide children with hearing loss with sufficient high frequency information in order to develop adequate oral language skills due to the risk of acoustic feedback and the narrower frequency spectrum of conventional amplification. The purpose of this study was to investigate word recognition abilities of children with moderate-to-severe hearing loss using hearing aids with linear frequency transposition. Seven children with moderate-to-severe sensorineural hearing loss between the ages of 5 years 0 months and 7 years 11 months were selected for the participant group. Word recognition assessments were first performed with the participants using their own previous generation digital signal processing hearing aids. Twenty-five-word lists from the Word Intelligibility by Picture Identification (WIPI) test were presented to the participants in three test conditions, namely: at 55 dB HL in quiet, 55 dB HL with a +5 dB signal-to-noise ratio (SNR) and at 35 dB HL. The participants were then fitted with an ISP-based hearing aid without linear frequency transposition, and the word recognition assessments were repeated with different WIPI word lists under the same conditions as the first assessment. Linear frequency transposition was then activated in the ISP-based hearing aid and different WIPI word lists were presented once more under identical conditions as the previous assessments. A 12-day acclimatization period was allowed between assessments, and all fittings were verified according to the DSL v5 fitting algorithm. Results indicated a significant increase of more than 12% in word recognition score for some of the participants when they used the ISP-based hearing aid with linear frequency transposition. A significant decrease was also seen for some of the participants when they used the ISP-based hearing aid with linear frequency transposition, but all participants presented with better word recognition scores when they used the ISP-based hearing aids without linear frequency transposition compared to their previous generation digital signal processing hearing aids. This study has shown that linear frequency transposition may improve the word recognition skills of some children with moderate-to-severe sensorineural hearing loss, and more research is needed to explore the criteria that can be used to determine candidacy for linear frequency transposition. / Dissertation (MCommunication Pathology)--University of Pretoria, 2010. / Speech-Language Pathology and Audiology / Unrestricted

Apart from isolated programs in private and public health care sectors, South Africa has no existing systematic public infant hearing screening program at community level. As a result, early identification of hearing loss is certainly not being attained for the majority of infants in South Africa with far-reaching effects for individuals, families and society at large. Screening programs at primary health care immunization clinics have been proposed as an alternative to hospital-based programs in South Africa. The objective of this study was to evaluate the first systematic community-based infant hearing screening program in a developing South African community in the Western Cape. A combined descriptive and exploratory research methodology was followed incorporating aspects of a program evaluation design. The study was of a quantitative nature and the required data were collected by means of a questionnaire and OAE testing conducted by clinic nurses on subjects. A community-based universal infant hearing screening program initiated at eight primary health care clinics in the Cape Metropolitan area was evaluated over a 19-month research period. During this time 6227 infants who were candidates for screening attended their 6, 10 or 14-week immunization visit at the relevant clinic. Clinic nurses were trained as screening personnel. A two-stage distortion product otoacoustic emissions screening protocol was utilized. The target disorder for this study was bilateral permanent congenital and early onset hearing loss and infants referring the first screen were scheduled for a 4-week follow-up visit at the clinic. Diagnostic audiological and medical evaluations were scheduled at referral hospitals when indicated. The study evaluated the efficacy of the program based on coverage, referral and follow-up rates and diagnostic outcomes according to guidelines specified by the Health Professions Council of South Africa 2007 Position Statement. Overall coverage rate across the eight clinics was 32.4% with 2018 infants (aged 0- 14 weeks) screened. The mean age of the sample at first stage screen was 3.9 weeks of age and 13.5 weeks of age for first hospital visit. Overall first stage screen referral rate was 9.5% with 62 subjects (3%) referred for diagnostic services at hospital level after a follow-up screen. The average follow-up rate for rescreens at clinic level was 85.1% and for initial diagnostic assessments at hospital level it was 91.8%. Although minimal hearing loss was not the primary focus of the screening program the outcomes did include those subjects with fluctuating conductive hearing loss and permanent unilateral hearing loss. Prevalence rates were 4.5/1000 with significant hearing loss, including sensorineural (1.5/1000) and conductive (3/1000) losses, and 12.9/1000 for subjects with middle ear effusion.<p-> The community-based infant hearing screening program was valuable in attaining high follow-up return rates but reaching sufficient coverage may require dedicated screening personnel as opposed to existing nursing personnel. Furthermore, consideration of an alternative community-based platform such as midwife obstetric units may improve coverage and referral rates and prevalence of permanent congenital and early onset hearing loss. / Dissertation (MCommunication Pathology)--University of Pretoria, 2013. / Speech-Language Pathology and Audiology / Unrestricted

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This dissertation examines the effects of trade liberalization policies (represented by membership in the General Agreement on Tariffs and Trade/World Trade Organization on selected Least Developed Countries' (LDCs) human development (represented by the Human Development Index). In this dissertation, General Agreement on Tariffs and Trade (GATT) and World Trade Organization (WTO) policies are theorized to have two distinct types of effects: their direct effect and their indirect effect. Two questions are focused on: first, what is the effect (total, direct and indirect) of WTO policies on human development for selected LDCs? Second, what is the effect (total, direct and indirect) of WTO policies on human development for selected developing/developed countries (i.e. non-LDCs) holding economic development constant? Using the dependency theory of development as a theoretical basis, this dissertation examines the assumptions of modernization-theory-based policies as expressed in trade liberalization policies (i.e. the implementation of comparative advantage and now market fundamentalism) with world-system analysis techniques. To examine these questions, four panel regression models are constructed to measure the total, direct and indirect effects of WTO policies during the near-term (1998-2003) and during a longer historical term (1975-2000). The data for the analyses are taken from seven different sources of international data. The analyses seemingly demonstrate that there are quantifiable negative effects of GATT/WTO membership (trade liberalization policies) on human development in selected LDCs. The current implementation of trade liberalization policies does not benefit the well-being of all concerned as promoted by the WTO.

Orientador: Leandro Gobbo Braz / Resumo: A população mundial está envelhecendo e o número de procedimentos anestésico-cirúrgicos está aumentando na faixa etária de 60 anos, comparando-se com outros grupos etários. Considerando essa realidade e a existência de diferenças na segurança do paciente entre países desenvolvidos e em desenvolvimento, a presente revisão comparou a incidência de Parada Cardíaca (PC) perioperatória e por fator anestésico em pacientes geriátricos em países desenvolvidos e em desenvolvimento de acordo com o IDH (Índice de Desenvolvimento Humano) e em dois períodos de tempo. Comparou-se também a literatura mundial da incidência de PC perioperatória e por fator anestésico ao longo do tempo (pré-1990s e 1990-2014) e em relação ao IDH. Métodos: Realizou-se uma revisão sistemática de estudos transversais da literatura mundial sobre a incidência de PC perioperatória e por fator anestésico em pacientes geriátricos. Foi realizada meta-análise da incidência de PC perioperatória e por fator anestésico em 10.000 anestesias, de acordo com o IDH dos países e o período de tempo (pré-1990s e 1990-2014). Utilizou-se a análise de metarregressão para analisar a incidência de PC perioperatória e por fator anestésico ao longo do tempo e do IDH dos países. A meta-análise e a metarregressão foram realizadas considerando um intervalo de confiança (IC) de 95%. Resultados: Foram incluídos 16 estudos de nove países diferentes, com um total de 1.758.153 pacientes geriátricos submetidos à anestesia. A meta-análise most... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The world population is ageing and the number of anesthesia and surgical procedures are increasing in the sixty-years-old compared to other age groups. Considering this and the differences in patient safety in low- and high-income countries, the current study compared the perioperative and anesthesia-related CA rates in geriatric patients in low- and high-income countries in two time periods. Additionally, we compared global data on anesthesia-related and perioperative cardiac arrest (CA) rates according to Human Development Index (HDI) status and by time. Methods: A systematic review was performed to identify worldwide observational studies in which geriatric patients were submitted to anesthesia with perioperative and/or anesthesia-related CA rates. Meta-analysis per 10,000 anesthetics and meta-regression were performed with 95% confidence intervals (CIs) to compare the perioperative and anesthesia-related CA rates by country’s HDI status (low-HDI versus high-HDI) and by time period (pre-1990s versus 1990-2014), and to evaluate data on perioperative and anesthesia-related CA rates according to country’s HDI status and by time. Results: Sixteen studies from 9 countries assessing 1,758,153 anesthetic administrations in geriatric patients were included. The meta-analysis showed that the perioperative and anesthesia-related CA rates declined in high-HDI (38.6 [95% CI, 37.8-39.6] before the 1990s to 7.7 [95% CI, 7.6-7.8] in the 1990-2014, P<0.001; and 9.2 [95% CI, 8.9-9.5] befor... (Complete abstract click electronic access below) / Mestre

L'accord ADPIC a été accepté par la Tunisie comme un mal nécessaire afin d'obtenir des bénéfices commerciaux dans les secteurs de grand intérêt. Il était également considéré comme bien pensé car il accordait une période de transition aux PED afin qu'ils puissent adapter leurs systèmes à cet instrument exhaustif et établir un standard minimum qui pourrait s'appliquer à tous les pays et rattacher les DPI au commerce. La Tunisie constitue un cas d'analyse intéressant et ce, surtout comparativement aux autres pays qui ont maintenu une attitude de rejet par rapport aux traités classiques de PI. Notre pays était membre aux conventions de Paris et de Berne depuis plus d'un siècle. Il était certes le bon élève qui s'est harmonisé en développant une nouvelle culture de protection à la PI conformément au nouveau système international. La raison est que la PI est conçue afin d'être, dans la nouvelle économie cognitive, un outil important dans la compétitivité internationale. Elle constitue également un instrument pour attirer les IDE. En même temps, et comme le stipule l'ADPIC, la PI serait un composant essentiel dans la promotion de l'innovation et la facilité du transfert de technologie. Mais ce schéma d'harmonisation sur la base de prétendus standards minimums n'a pas satisfait l'engouement des pays industrialisés qui se sont lancés dans la conclusion d'accords commerciaux bilatéraux au-delà de l'ADPIC. Notre objectif est donc d'analyser ces présupposés et d'essayer d'expliquer ce qui s'est passé depuis l'accord ADPIC. La question est de savoir si le pays, en procédant de cette manière, avait réussi à établir cette articulation entre les considérations commerciales qu'exige l'ADPIC et les préoccupations internes se rapportant à la santé, l'agriculture, la diversité culturelle et l'environnement. Vingt trois ans après, le pays a-t-il tiré profit de l'alignement de son régime de PI sur l'accord ADPIC ? L'un des objectifs avoués de l'ADPIC était la diffusion du savoir et par là, l'amélioration des capacités R & D. Cependant, très peu de progrès a été réalisé, il semble même que la situation ait empiré. / The TRIPS agreement has been accepted by Tunisia as a necessary evil in order to obtain commercial benefits in sectors of great interest. It was also considered well thought out because it provided a transition period for developing countries to adapt their systems to this comprehensive instrument and establish a minimum standard that could apply to all countries and link IPR to trade. Tunisia is an interesting case of analysis, especially in comparison with other countries maintaining an attitude of rejection towards the traditional treaties of IP. Our country has been a member of the Paris and Berne Conventions for more than a century. It was, of course, the right student who harmonized by developing a new culture of IP protection in accordance with the new international system. The reason is that IP is designed to be, in the new cognitive economy, an important tool in international competitiveness. It is also an instrument for attracting FDI. At the same time, and as stipulated in TRIPS, IP would be an essential component in promoting innovation and ease of technology transfer. But this pattern of harmonization on the basis of so-called minimum standards has not satisfied the enthusiasm of the industrialized countries that have embarked on the conclusion of bilateral trade agreements beyond TRIPS. Our objective is therefore to analyze these assumptions and try to explain what has happened since the TRIPS agreement. The question is whether, in doing so, the country has succeeded in establishing this link between the trade considerations required by TRIPS and the internal concerns related to health, agriculture, cultural diversity and environment. Twenty-three years later, has the country benefited from the alignment of its IP regime with the TRIPS Agreement? One of the stated objectives of TRIPS was the spread of knowledge and thereby the improvement of R & D capabilities. However, very little progress has been made, and it seems that the situation has worsened.

The study focused on the effects of Continuing Professional Teacher Development on teachers’ workload in the Gauteng province. Apart from the literature review, the objectives of this study were: to determine the understanding of new approaches to Continuing Professional Development on the workload of teachers. To establish the administrative barriers that frustrate teachers’ efforts in accepting responsibility for improving not only their practice, but also the shared practice of the profession. To draw recommendations for the successful implementation of Continuing Professional Teacher Development on teachers’ workload in the Gauteng province. The qualitative research methodology was adopted and engaged to investigate the effects of CPTD on teachers’ workload in Gauteng schools. The importance or significance of the study was to find out ways and means of dealing with the new roles that form part of teachers’ workload. The participants’ perceptions on the topic were generally in agreement that the schools value the Professional Development initiatives of teachers. Additionally, their learners’ scholastic achievements showed a great improvement as a result. / Educational Management and Leadership / D. Phil. (Educational Leadership and Management)