Il est question d’analyser une tendance marquée des séries de science-fiction contemporaines, qui proposent un récit complexe et feuilletonnant, impliquant une intense participation de la part des spectateur.ice.s ; ces dernie.re.s se voient promettre, via l’énigme, la quête et/ou le voyage dans le temps, un dénouement qui serait la conséquence logique des évènements mis en scène. Au travers des énigmes de Lost (2004-2010, ABC), de la quête des humains dans Battlestar Galactica (2004-2009, Sci-Fi) ou de l’utilisation du voyage dans le temps dans Doctor Who (2005- ?, BBC1), il est possible de déceler des mécanismes narratifs visant à entretenir l’illusion d’une progression réfléchie vers un dénouement tantôt mis en avant, tantôt repoussé, dans un contexte de production où les scénaristes ne sont pas maîtres de leur récit. Babylon 5 (1993-1999, TNT), série dont le récit a été effectivement prévu à l’avance, sert de maître-étalon, tandis que Fringe (Fox, 2008-2013) permet d’envisager les limites de cette tendance. La capacité de ces programmes à construire une « intrigue macroscopique » à l’échelle de la série toute entière, éclaire plus largement les processus narratifs à l’œuvre dans la majorité des séries narrativement complexes contemporaines (au sens de Mittell). Au fil des liens avec l’intrigue des cycles littéraires, et d’une méthodologie centrée sur la visualisation de l’intrigue macroscopique, on peut, en s’appuyant sur une narratologie des séries télévisées encore expérimentale, entrevoir une poétique de l’écriture prospective télévisuelle. Dans une perspective contextualiste, il est vital de garder en vue les conditions d’écriture, de production et de réception de ces objets atypiques ; en retour, ces récits prospectifs apportent un nouvel éclairage au projet d’une narratologie transmédiatique porté par les études contemporaines du récit. / The aim of this work is to analyse a specific trend in contemporary science-fiction TV series : narratively complex programs (Mittell) that require an increased investment from the viewer and seem to make the promise of a logical and fulfilling ending where truth is revealed, quests are achieved and time-travel paradoxes are resolved. Looking at the mysteries from Lost (2004-2010, ABC), the quest of the Thirteenth Tribe in Battlestar Galactica (2004-2009, Sci-Fi) or the never-ending use of time-travel in Doctor Who (2005- ?, BBC1), it is possible to isolate narrative mechanisms that alternately foreshadow and defer the ending, in a world where writers can’t have full control over the plot. Babylon 5 (1993-1999, TNT), a show written in advance by its creator, will be our Rosetta Stone, while Fringe (Fox, 2008-2013) will take us to the edge of that growing trend. These programs’ ability to construct a “macroscopic plot” on the scale of the entire series, shines a light on narrative process operating in the majority of narratively complex TV series. Taking a closer look at research on literary cycles, and creating narrative diagrams to visualize this macroscopic plot, it is possible to outline a poetic of prospective writing, drawing on television series narratology. Following a contextualist view, it is important to consider the writing, production, reception of these programs; in return, studying macroscopic plots in TV series can give new clues for transmedial narratology (Herman).

Magister Commercii - MCom / The purpose of this research study is to explore the variables that contribute to improving the process of recruiting and retaining rural doctors within the South African context. The aim is to explore rural doctors’ perceptions of the role which the rural community can and ought to play in respect of the latter process. A basic recognition is that the emphasis on the Mainstream Approach (which elevates health workforce planning and management as well as market-related interventions and solutions) cannot exclusively achieve the desired result of effective and efficient recruitment and retention of rural doctors. The ‘active’ role which communities can and ought to play in the recruitment/ retention process, is an overlooked and neglected aspect within the South African research and healthcare service-delivery context. Even though the notion of collaborative management and governance of human resources within the health sector is generally mandated from a policy and legislative perspective, the practical manifestation and implementation thereof remain limited or at best piece-meal. An alternative governance model with reference to the humanresources- in-health system outlines the Partnership Approach advocating the need for the establishment of practical working relationships, amongst an identified range of multiple-stakeholders. This study examines the notions of ‘passive’ vis-à-vis ‘active’ community participation equated to the Utilitarian and Community Empowerment/ Development Perspectives continuum. The study introduces the ‘Principle of Balancing Model’ as well as the notion of a ‘hybrid perspective’ as key underpinnings of an efficacious rural-doctor recruitment and retention process.

Introduktion: I den moderna prehospitala akutsjukvården kan ambulansens och ambulanshelikopterns samverkan ha stor betydelse för den svårt skadade eller sjuka patienten. Syfte: Syftet med studien var att undersöka vad sjuksköterskor inom ambulansen och sjuksköterska/läkare från helikoptern/akutbilen upplevde kunde påverka teamarbetet i den prehospitala miljön. Metod: En kvalitativ deskriptiv innehållsanalys med semistrukturerade intervjuer användes. 10 informanter från ett län i mellansverige inkluderades, fem kvinnor och fem män. Urvalet bestod i att informanterna skulle ha varit verksamma inom ambulansverksamheten i minst ett år samt ha erfarenhet av det prehospital samarbetet mellan ambulans och ambulanshelikopter. Intervjuerna spelades in, transkriberades till text och analyserades. Resultat: Studiens resultat presenterades i två teman med sju underkategorier. De två temana var: Ett dynamiskt teamarbete påverkas av tydliga roller och ett kontinuerligt förbättringsarbete och Teamarbete och kommunikation mellan kompetenserna i teamet. Konklusion: De olika rollerna vid teamarbetet har blivit tydligare med tiden och teamarbetet upplevdes ha blivit bättre med tiden. Hospitering och tid till övning beskrevs kunna optimera teamarbetet. Informanterna upplevde sig delaktiga i vården. Den prehospitala erfarenheten och bristen på den var av betydelse vid samverkan mellan enheterna. / Introduction: In the modern prehospital emergency care, ambulance and ambulance-helicopter's interactions play an important role for the severely injured or sick patients. Aim: The aim of the study is to examine what nurses in ambulance and nurse/doctor from the helicopter/emergency car experienced could affect the team work in the prehospital environment. Method: A qualitative descriptive content analysis of semi-structured interviews were used. 10 pieces of informants from a province in central Sweden were included five women and five men. The sample consisted of informants would have been active in the ambulance business for at least 1 year and have experience in the full spectrum of cooperation between ambulance and ambulance helicopter. The interviews were recorded, transcribed to text and analyzed. Results: The results of the study were presented in two themes with seven subcategories. The two themes were: A dynamic teamwork are influenced by clear roles and a continuous improvement and Team work and communication between the competencies of the team. Conclusion: The different roles in the cooperation has become clearer with time and team work was perceived to have become better with time. Site visits and time to exercise described to optimize teamwork. The informants perceived themselves involved in care. The prehospital experience and the lack of it was of importance to cooperation between units.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal.

Science teachers have a unique place in education due to their academic discipline and the fact that the public ties teacher accountability to student performance. One major measure of teacher accountability in the State of Florida is the end of course examinations (EOC). The purpose of this study was to examine selected high school Biology teachers’ perceptions about how their instructional practices have been affected by the administering of an EOC in comparison to other high school science teachers who are not required to administer an EOC. The overriding research question for this study was: What are the perceptions of selected high school science teachers whose students are subject to an EOC, as well as those whose students are not subject to an EOC? This qualitative study used a grounded theory, phenomenological approach to first elicit the perceptions of selected science teachers regarding how their instructional practices have been affected by the implementation of an EOC. These perceptions were examined within the context of other science teachers in the same school who were not subject to EOCs. Emergent understandings of these teachers’ perceptions were then used to build a theoretical understanding of the phenomena surrounding their construction. The sites for this research are science departments from high schools in a mid-sized central Florida school district. This research was accomplished by gathering data from preliminary surveys with open-ended responses, then followed up with more in-depth interviews constructed from the initial survey responses. Key findings from this study were the teachers’ need to cope with the pressure of time constraints on their instruction and working within the curriculum map as mandated by the county offices. Additionally, results of this study also indicated that teacher accountability and the pressures it engenders to increase student achievement are more pronounced for those teachers administering EOCs, who subsequently believe student learning is diminished. Importantly, teachers of subjects that include EOCs in this study themselves expressed understandings that these accountability pressures distorted their teaching practices to focus more on less cognitively complex classroom learning activities such as fact-based questions than their non-EOC teacher counterparts, although they knew these approaches to be less effective. Although this phenomenon of the unintended consequences of EOCs has been explored before, this study highlighted it from the vantage of teachers who were aware of its occurrence, but felt powerless to stop it.

This thesis focuses on issues of communication between doctor and patient. After a brief introduction of communication in general, the theoretical part focuses on the specifics of doctor-patient communication. It then deals with different factors that influence communication and selected topics connected to communication. The last chapter summarizes several studies focusing on communication training of doctors and its effect. In the empirical part, the semi-structured interviews were used to explore opinions, attitudes and experiences of doctors concerning their communication with patients. The results suggest, that doctors perceive communication with patients as an important part of their work (even though they differ in the amount of importance they attribute to communication). In accordance with this finding is the fact, that the description of a "good doctor" and "good communication" were quite similar. Almost all respondents considered the undergraduate training in communication as useless, suggesting that the main reason may be the perceived unimportance of this subject at medical school. Some of the communication barriers generally seen by the patients were also seen as important by the doctors (such as time pressure or lack of privacy while consulting with patients), important...

Inom mjukpappersindustrin är det viktigt att utvecklas och upprätthålla en så bra kvalité som möjligt på produkterna för att hålla sig kvar på marknaden. Det är därför betydelsefullt att ha kunskap kring tillverkningsprocessens alla steg och hur de påverkar det slutgiltiga resultatet. En viktig del av tillverkningen är kräppningsprocessen som till stor del ger papperet sina egenskaper och kvalité. Det är i detta steg av tillverkningen som strukturen på papperet bestäms. Detta gör att ett stort fokus ligger på att förstå och utveckla kräppningsprocessen.  Denna rapport görs i samarbete med en mjukpapperstillverkare som under den senaste tiden upptäckt en större efterfrågan hos kunder att vara med och styra inställningarna av kräppschabern. Då det råder en bristande kunskap om hur olika faktorer påverkar kräppningen har en osäkerhet uppstått. Syftet med denna rapport är att bidra med den kunskap som krävs kring kräppningsprocessen och klingegenskaperna för att företaget ska ha möjlighet att tillfredsställa kundernas efterfrågan och behov.  I kräppningsprocessen är kräppschabern den viktigaste komponenten att granska då det är denna klinga som utför själva kräppningen. De mest relevanta faktorerna för kräppschaberns inställning väljs ut för att undersökas i denna rapport. Analysen av parametrarna utförs genom att variera en parameter i taget för att sedan kontrollera hur böjningen av kräppschabern ser ut. Med hjälp av utböjningen av klingan kan sedan en kräppvinkel beräknas för att slutligen få fram förhållandet mellan de utvalda parametrarna och kräppvinklen. Detta kommer utföras med hjälp av tre olika metoder vars resultat sedan jämförs med varandra för att fastställa de beräknade förhållandena. De olika metoderna som används är en analytisk beräkning som baseras på den elastiska linjens ekvation samt två undersökningar i FEM-program där klinggeometrin modelleras.   Plottar utformas med värden från de olika undersökningarna som grund. Ett diagram för varje parameter skapas, diagrammen visar hur kräppvinkeln ändras då parametern varierar inom de utvalda intervallen. Alla parametrar som undersökts visade sig påverka kräppvinkeln på en nivå som gör de relevanta för inställningen av kräppschabern då en önskad kvalité är efterfrågad. Efter en jämförelse mellan resultaten från de olika metoderna kunde vissa avvikelser hittas. Dessa avvikelser är dock inte stora och kan därför försummas. Det finns många tänkbara anledningar till avvikelserna som t.ex. olika antaganden och beräkningsmässiga skillnader. Slutsatserna som kan göras av denna rapport är att alla de parametrar som undersöktes har en betydande roll för kräppvinklens minskning och att de olika beräkningssätten gav överensstämmande resultat. I framtida undersökningar kan därför den smidigaste av de undersökta metoderna rekommenderas. / In the tissue industry, it is important to develop and maintain as good a quality as possible on the products in order to stay on the market. It is therefore important to have knowledge of all the steps of the manufacturing process and how they affect the final result. An important part of the production is the creping process, which largely gives the paper its properties and quality. It is in this stage of manufacturing process that the structure of the paper is determined. This means that a great focus is to understand and develop the creping process.   This report is made in collaboration with a tissue manufacturer who recently discovered a greater demand from customers to participate in and control the settings in their projects. Since there is a lack of knowledge of how different factors affect the creping, uncertainty has arisen. The purpose of this report is to contribute with the knowledge required about the creping process in order to reduce uncertainty in the company and satisfy the customers' demand and needs. In the creping process, creping blade is the most important component to examine as it is this blade that performs the creping itself.   The most relevant factors for the creping blades settings are selected to be examined in this report. The analysis of the parameters is performed by varying one parameter at a time and then checking how the bending of the creping blade looks. With the deflection of the blade, a crepe angle can be calculated in order to highlight the relationship between the chosen parameters and the crepe angle. This will be accomplished by using three different methods, the results of which are then compared with each other to determine the calculated conditions. The different methods who are used is an analytical calculation based on the linear elasticity equation and two studies in FEM programs where the blade geometry is modeled.   Plots are designed, displaying values ​​from the different analysis’s as a basis. A chart for each parameter is created, the charts show how the crepe angle changes as the parameter varies within the selected intervals. All parameters examined were found to affect the crepe angle more or less, but all at a level that makes them relevant to the setting of the creping blade as a certain desired quality is required. After a comparison of the results from the different methods, some deviations could be found. However, these deviations are not significant and may therefore be ignored. There are many possible reasons for these deviations such as e.g. various presumptions and computational differences. The conclusions that can be made about this report are that all the parameters that were examined have a significant role in the reduction of the crepe angle and that the results from the various methods gave consistent results. In future investigations, therefore, the most convenient of the methods tested may be recommended.

Objetivos: verificar se indivíduos que acessam a Internet a utilizam para consultar informações sobre saúde e doenças; se o paciente, acessando a Internet muda sua atitude de paciente e se verifica mais ativo e mais participante do processo de decisão sobre sua saúde; e se, do ponto de vista do paciente, houve mudança na atitude do profissional médico frente ao maior uso da Internet por parte desse paciente. Metodologia: pesquisa com abordagem qualiquantitativa. A técnica empregada foi a do Discurso do Sujeito Coletivo – DSC, que possibilita a identificação e a construção de sujeitos e discursos coletivos distintos, por meio da análise de material individual e da extração das idéias centrais, compondo-se, com o conteúdo das idéias centrais semelhantes, discursos-síntese que expressam as representações sociais de uma coletividade. Para a coleta de dados foi publicado na Internet um questionário on-line que ficou disponível por três meses. Resultados: A maioria dos entrevistados acessa a Internet com freqüência de pelo menos uma vez por semana, a utiliza para consultar informações sobre saúde e doenças, informações relacionadas a casos vivenciados por eles ou por aqueles que os afetam diretamente (familiares) e, após alguma consulta médica, para verificar, entender ou complementar as informações oferecidas por seus médicos. Parte significativa dos entrevistados considera que as informações acessadas na Internet sobre saúde e doenças são úteis, utiliza tais informações para conversar com seus médicos em consultas posteriores e demonstra mudança de atitude, para uma postura mais participativa no processo de decisão sobre sua saúde. Conclusão: identificou-se uma diversidade de discursos coletivos distintos que, analisados e organizados em tipos e escalas, auxiliam na compreensão de questões tais como o tipo de participação do paciente durante a consulta médica, o grau de autonomia do paciente, os tipos de interação entre médico e paciente e os tipos de reações produzidas pelos profissionais médicos durante tal processo. / This research aims to verify whether individuals who have access the Internet use it to consult information on health and diseases; whether accessing the Internet changes the attitude of the patient and whether he becomes more active and more participant in the decision process about his health; and whether from the standpoint of the patient there were changes in the attitude of the medical professional as a consequence of the more intense use of the Internet by this patient. Procedure: research with quali-quantitative approach. The employed technique was the Speech of Collective Citizen - DSC, which allows the identification and construction of distinctive citizens and collective speeches through the analysis of individual material and the extration of the main ideas, composing, with the content of similar central ideas, speech-synthesis which express the social representations of a collective. For the data collection an on-line inquiry was published in the Internet and it was available for three months. Results: most of the interviewed individuals had frequent access to the Internet at least once a week, use it to consult information about health, diseases and information regarding medical cases experienced by them or by other people who affect them directly (relatives), and after some medical consultation, to verify, to understand or to complement the information offered by their doctors. A significant part of the interviewed ones consider that the information accessed in the Internet about health and diseases is useful, use such information to talk to their doctors in subsequent consultations and manifest an attitude change towards a participating position in the decision process about their own health. Conclusion: there is a diversity of distinctive collective speeches that, analyzed and organized in types and scales, assist in the understanding of questions such as the type of participation of the patient during the medical consultation, the degree of autonomy of the patient, the types of interaction between doctor and patient and the types of reactions produced for the medical professionals during such process.

O presente trabalho tem por escopo o estudo do princípio do respeito à autonomia do paciente à luz das recentes alterações trazidas pelo novo CEM Resolução do Conselho Federal de Medicina nº 1.931, de 17 de setembro de 2009 , que prestigia a autonomia do paciente e propõe um novo formato para a relação médico-paciente, impondo novas posturas tanto ao médico como ao paciente, e privilegia sua autodeterminação, ao mesmo tempo em que o obriga à tomada de decisões e à assunção de responsabilidade compartilhada quanto ao processo terapêutico. O objeto do estudo é a nova relação médico-paciente sob o enfoque da autonomia do último, ressaltando-se a responsabilidade compartilhada com o médico em relação à tomada de decisões atinentes ao processo terapêutico, às escolhas terapêuticas, bem como os limites e o conteúdo do poder de decidir e sua autonomia diante da enfermidade e da terminalidade da vida. Nesta hipótese, a reflexão concentra-se nos cuidados paliativos e na adoção de diretivas prévias estatuídas pelo paciente a serem observadas pelo médico e por eventual terceiro responsável por aquele, caso ele não possa manifestar sua vontade durante cuidados paliativos ou situações que revelem iminente terminalidade. / This proposal aims to study the principle of respect for patient autonomy in light of recent changes introduced by the new CEM Resolution of the Federal Medical Council nº 1931 of September 17, 2009 which honors the patients autonomy and proposes a new format for the doctor-patient relationship, imposing new attitudes to both the patient and physician, emphasizes self-determination and, at the same time that forces decision making and the assumption of shared responsibility as to the therapeutic process. The object of the study is the new doctor-patient relationship from the perspective of this autonomy, emphasizing shared responsibility with the physician regarding decisions pertaining to the therapeutic process, the therapeutic choices, and the limits of power and content and their autonomy to decide on the terminally ill and life. In this case, reflection focuses on palliative care and the adoption of policies laid by the previous patient to be seen by the doctor and by any third party responsible for that, if he can not express his desire for palliative care or situations that reveal impending finality.

Tese aborda, inicialmente, a mobilidade de médicos pelo mundo a partir de levantamento bibliográfico em base de dados. Identifica a escassez de informações referentes aos médicos brasileiros, apesar de existirem algumas evidências a respeito da emigração destes profissionais para exercerem sua profissão em outros países. OBJETIVO: analisar aspectos que determinam a emigração de médicos brasileiros para os EUA. METODOLOGIA: a principio foi realizada uma etapa exploratória, seguida de levantamento de dados em conselhos de classe brasileiros e sites norte-americanos. Utilizou-se uma amostra por conveniência através da técnica \"bola de neve\"; identificou-se a existência de médicos que emigraram; foi enviado, via e-mail, questionário elaborado pela autora com questões fechadas e abertas a respeito dos motivos pelos quais escolheram os EUA para emigrar, por que foram, por que ficaram, por que voltariam e por que não voltariam a morar no Brasil. Realizadas algumas entrevistas por Skype. Foi realizada a tabulação dos dados quanti e qualitativos. RESULTADOS: inicialmente os médicos escolhem emigrar por motivos pessoais (família, oportunidades profissionais, oportunidades em geral, facilidade do idioma); ao se estabelecerem nos EUA vivenciam uma nova forma de vida, o que os faz escolher permanecer (melhores condições de trabalho, qualidade de vida, família e oportunidades gerais); as causas do não retorno ao Brasil passam a ter motivos externos (insegurança, cenários profissional, politico e econômico). CONCLUSÃO: existe um processo emigratório de médicos brasileiros para os EUA; a principio a vontade de emigrar não está bem definida; o salário não é citado como questão primordial para emigrar; a presença da família facilita a permanência no país; fluência na língua inglesa é fundamental e é necessário recomeçar a vida profissional como um recém-formado em medicina pois não existe processo de validação de diploma ou de especialidades / OBJECTIVE: to analyze aspects that determine the emigration of Brazilian doctors to the United States of America. METHODOLOGY: at first there was an exploratory stage, followed by a data collection in Brazilian professional associations and North American websites. A sample by convenience was used through the \"snowball\" technique; the existence of doctors that emigrated was identified; a questionnaire, elaborated by the author with closed and open questions, was sent by e-mail, regarding their motives to choose the USA to emigrate, why they have gone, why they stayed and why they would or wouldn\'t come back to live in Brazil. A few interviews were made by Skype. A tabulation of the quantitative and qualitative data was made. RESULTS: initially the doctors choose to emigrate for personal motives (family, professional opportunities, general opportunities, no language barriers); when established in the USA, they experience a new way of life that makes them stay (better work condition, quality of life, family and general opportunities); external motives become the cause not to come back to Brazil (the lack of security, professional, political and economic scenarios). CONCLUSION: there is an emigrational process of Brazilian doctors to the USA; at first the will to emigrate is not well defined; the salary is not mentioned as a primal reason to emigrate; the presence of the family eases the stay in the country; the proficiency in the English language is fundamental and it is necessary to restart the professional life as a recently graduated in med school since there isn\'t an university degree or medical specialty degree validation.