In recent years there has been a resurgence of interest in the use of arts, humanities and media-based approaches to teaching students in medicine, health, and social care-related disciplines. Here, it is widely assumed that 'the arts' are an undifferentiated force for good which will humanise curricula dominated by medical and scientific perspectives. Such approaches tend, however, to be implemented in something of a theoretical vacuum with little consideration of critical perspectives derived from cultural studies. 'Cinemeducation' is a term recently coined for the use of mainstream films which touch on particular medical conditions or 'disorders' in the education of medical students (Alexander et al, eds 2005). What is overlooked by advocates of this approach is that such films often perpetuate stereotypical views of the nature and causes of physical and emotional ill-being, and collude in their medicalisation. Scriptwriters and directors may also give in to the temptation to sensationalise or misrepresent conditions because this makes for box office success. Finally, there are subtleties related to denotation and connotation in film which mean that little can straightforwardly be assumed about educational outcomes. This presentation will draw on a study of both independent and mainstream films related to memory loss and cognitive impairment in the context of my own teaching in dementia studies, and will include clips from source material. Drawing on Ricoeur's concept of the hermeneutics of suspicion I seek to introduce a note of caution to the current 'arts and health' agenda.

The spatial pattern of plants reflects biotic and abiotic factors, including interactions with surrounding environmental conditions and other plants. Appalachian heath systems are presently understudied regarding spatial point pattern research, despite representing a unique and biologically valuable ecosystem. In this study, we characterized the spatial pattern of three tree species distributions in the upland heath barrens on Cabin Mountain in Canaan Valley, West Virginia through fieldwork, statistical modeling, and the use of geographical information systems (GIS). The research objectives were to: 1) quantify the global and local spatial patterns of trees to infer biotic process, and 2) identify how tree spatial pattern varies with selected biophysical variables, including ground curvature and topographic wetness index, to understand potential relationships between ambient conditions and spatial pattern. The spatial statistics, Ripley's K-function and nearest neighbor analysis, presented a series of different interaction types reflected across size-growth classes and species where the null hypothesis was rejected for some pairs and supported in others. The selected biophysical variables had no significant relationship to spatial pattern at the site. These findings suggest a range of both intraspecific and interspecific interactions are taking place in the heath barrens of Cabin Mountain, where significant levels of facilitation are occurring among encroaching red maple and striped maple, while red spruce is in competition with both species of maple, and that relationships are formed outside the influence of topographic characteristics of the site. / Master of Science / The spatial pattern of plants reflects biotic and abiotic factors, including interactions with surrounding environmental conditions and other plants. Appalachian heath barrens are presently understudied in regard to spatial point pattern research, despite representing a unique and biologically valuable ecosystem. In this study, we characterized the spatial pattern of three tree species in the red spruce heath barrens on Cabin Mountain in Canaan Valley, West Virginia through fieldwork, statistical modeling, and the use of geographical information systems (GIS). The research objectives were to: 1) quantify demographics and the spatial pattern of trees to assess for ongoing plant interaction, and 2) understand whether tree spatial pattern is affected by selected biophysical variables, including ground curvature and topographic wetness index, to understand potential relationships between environmental conditions and spatial pattern. The results suggested a range of interactions were occurring across the plot, intraspecies, different species-pairs, and size-growth classes. Most notably, encroaching striped and red maple species, had a positive relationship, while red spruce and both maple species had largely competitive relationships. Both topographic wetness index and ground curvature had no significant relationship to spatial pattern at the site. These findings suggest a range of both intraspecific and interspecific interactions are taking place in the heath barrens of Cabin Mountain, indicating the possibility of conversion from red spruce heath barrens to deciduous forest, that this pattern is formed outside the influence of topographic characteristics of the site.

Background: The human secondary sex ratio has been the subject of long-standing medical, environmental and social scientific curiosity and research. A decline in male birth proportion in some industrialised countries is linked to endocrine disruption and is validated by some empirical studies. Increasing parental age and population stress and associated decreases in sex ratio have also been demonstrated. A thorough literature review of 123 relevant and diverse studies provides context for these assessments. Methods: A spatial-temporal investigation of birth sex ratio in Scotland and potential determinants of endocrine disruptor pollution, socio-economic factors including neighbourhood stress, deprivation, smoking, and maternal age, was conducted. This involved review of national and regional sex ratio time trends, and stratified/spatial analysis of such factors, including the use of GIS tools. Secondary data were sourced from Scottish Government web portals including Scottish Neighbourhood Statistics and the Scottish Environmental Protection Agency. Results: Regional differences in sex ratio between 1973 and 2010 are observed which likely lever the national male birth proportion downwards, with the region of poorest air quality from industrial emissions, the Forth Valley, displaying the greatest sex ratio reduction. Further analysis shows significant upwards skewing in sex ratio for the population cohort experiencing the least and 2nd most deprivation. Localised reductions in sex ratio for areas of high modelled endocrine disruptor pollution within the Central Region in Scotland are also displayed. Discussion: Limitations of the analyses include the danger of ecological fallacy in interpreting from area-based measurement and the simplified pollution modelling adopted. Despite this, and given elevated incidence of testicular cancer in Scottish regions mirrors the study’s results, tentative confirmation of the endocrine disruptor hypothesis can be substantiated. Further, elucidation on advanced parental age as a contributory factor to secondary sex ratio change is also given. Recommendations are made with respect to environmental monitoring and health protection, and preventative health strategies in Scotland.

The subject of this thesis are selected interest rate models and valuation of interest rate derivatives, especially interest rate options. Time-homogeneous one-factor short rate models, Vasicek and Cox-Ingersoll-Ross, and time-inhomogeneous short rate model, Hull{White, are treated. Heath-Jarrow-Morton framework is introduced as an alternative to short rate models, evolving the entire term structure of interest rates. The short rate models are shown to be special cases of models within the framework. The models are derived using the risk-neutral pricing methodology.

En dépit des objectifs énoncés de respect du principe d'équité horizontale, on observe des inégalités sociales dans la consommation de soins des pays dotés de systèmes de santé socialisés.Cette thèse se propose, au travers de quatre études, de contribuer à l’analyse des politiques publiques dans le système de santé, du point de vue de l’équité de recours aux services de santé. L’introduction propose des éléments descriptifs des inégalités sociales de recours aux soins en France ainsi que des principaux mécanismes qui, à l’intérieur du système de santé français, peuvent en être à l’origine.Le premier chapitre étudie les liens entre barrières financières à l’accès aux soins et état de santé. Il montre que le fait de renoncer à des soins pour des raisons financières est associé à un état de santé futur plus détérioré.Le deuxième chapitre propose une analyse de l’interaction médecin-patient et de son rôle dans la formation des inégalités de recours aux soins. Nous étudions les catégorisations opérées par les médecins au sujet de leurs patients en fonction de leurs situations sociales. Nous montrons ensuite les relations entre ces catégorisations et les pratiques observées.Un troisième chapitre collige deux études portant sur la réforme du médecin traitant. La première propose une analyse de la réforme et de son contexte, en particulier le rôle des différents acteurs. La seconde propose une étude des conséquences de la réforme sur l’accès financier aux soins de spécialistes / Although horizontal equity is considered a universal guiding principle in socialized health systems, most of the countries where such systems are implemented show social inequalities in health care services consumption.This thesis brings together four studies. It aims at contributing to the analyses of health system reforms regarding equity in access to health care services.The introduction provides a description of social inequalities in health care services consumption in France as well as of the main mechanisms which, inside the French health system, can give rise to these inequalities.In the first chapter we study the links between financial barriers in accessing healthcare and health status. We show that unmet needs for financial reasons are associated with worse future health status.The second chapter proposes an analysis of the doctor-patient interaction and how it can affects inequalities in health care consumption. We first study the categorizations operated by the doctors about their patients according to the patients’ socioeconomic status. We then study how these categorizations interact with observed practices patterns.The third chapter brings together two analyses of the “preferred doctor reform”. A first study analyses the reform and its context, with a focus on the role of the stakeholders. A second study investigates the consequences of the reform on financial access to specialist care.

Este estudo objetiva investigar enfermeiros assistenciais, acerca da concepção deles sobre os temas Educação para a Saúde, cuidado e humanização, procurando instrumentalizar esses enfermeiros sobre como esses eixos temáticos podem estar implicados na postura e na prática profissional em saúde, concernente aos ideais e princípios do SUS. A pesquisa caracterizou-se como natureza qualitativa, apropriando-se de um estudo descritivo-exploratório, mediatizado pela metodologia da pesquisa-ação. Em relação às técnicas deste estudo, trabalhamos a observação participante, tendo como instrumento para registro e anotação dos dados, o diário de campo; e utilizamos, ainda, a entrevista individual, para identificação dos participantes e com questões norteadoras sobre as temáticas centrais, sendo disponibilizado o questionário que serviu como instrumento para a coleta das respostas. A análise e interpretação dos dados foi feita por categorização, baseada em fundamentação teórico-metodológica de Paulo Freire e adaptada por Bueno (2001), buscando, após, o desenvolvimento de ação conscientizadora e avaliação do processo educativo. Percebemos que os temas Educação para a Saúde, cuidado e humanização, norteados pelo universo conceitual freireano, não deixam de permear, sobremaneira, o respeito, a solidariedade, a ética e a cidadania, concernentes ao que o SUS pretende operacionalizar. Assim, as temáticas investigadas convergem para a necessidade de se revisar a postura educativa/profissional do enfermeiro e de seus valores para o cuidado e a humanização, visando a melhoria dos serviços, bem como a melhoria da saúde e da qualidade de vida, individual e coletivamente. / This study investigates nurses, about their view on the themes Education Health, care and humanization, trying to instrumentalize these nurses on how these themes may be involved in posture and practice in health, concerning the ideals and principles of SUS. The survey characterized as qualitative, appropriating a descriptive exploratory study, mediated by the research-action methodology. Regarding the techniques in this study, we employed participant observation, taking as a tool for recording and annotation of data, field journal, and, we also used individual interviews to identify the participants and questions directed to the central themes, and provided in the questionnaire that served as a tool to collect the responses. The analysis and interpretation of data was performed according to categories, based on theoretical and methodological Paulo Freire and adapted by Bueno (2001), looking after the development of critical consciousness and action evaluation of the educational process. We realize that the themes Education Health, care and humanization, guided by the conceptual universe Freire, nevertheless permeate, above all, respect, solidarity, citizenship and ethics, related to the SUS intends to operate. Thus, the issue investigated converge to the need to revise the stance educational/vocational nurses and their values for the care and humanization, aimed at improving services and improving health and quality of life, individually and collectively.

Trata-se de um estudo misto metodológico e analítico com delineamento quase-experimental, com objetivos de elaborar e validar um instrumento para avaliar conhecimento de agentes comunitários de saúde sobre um conjunto de doenças sexualmente transmissíveis quanto à aparência, ao conteúdo e à semântica, elaborar e validar quanto a conteúdo e estratégia de sistematização e aplicação do processo de capacitação destes profissionais e avaliar o impacto de um processo de capacitação, em São Sebastião do Paraíso- MG, no ano de 2015. Os dados foram obtidos por meio do instrumento elaborado e validado para avaliar o conhecimento desses profissionais em relação a um conjunto de doenças sexualmente transmissíveis, por meio de livro de registros para avaliar o número de orientações em sala de espera dessas doenças pelos agentes, por meio de livro de registros para avaliar o número de encaminhamentos de portadores desses agravos para tratamento e por meio de fichas de notificações realizadas pelas equipes das unidades saúde da família dessas doenças. A população do estudo foi constituída de 134 Agentes Comunitários de Saúde pertencentes às 20 unidades saúde da família que receberam capacitação no tema, com emprego de metodologia ativa, sendo o processo educativo realizado pela própria pesquisadora. Os resultados da validação aparente e de conteúdo do instrumento mostraram que foi necessário mudar duas palavras em dois itens, sendo os demais itens avaliados positivamente por 100% dos participantes. Na validação semântica, foram empregados formulários adaptados do DISABKIDS® para 24 agentes do ensino fundamental e médio que participaram da mesma, e 91,3% de ambos os grupo acharam os itens do instrumento relevantes, relataram dificuldades em relação a três itens. Os participantes da capacitação referiram adquirir novos conhecimentos por meio da metodologia empregada. O intervalo de tempo para a coleta de dados foi de 12 meses. Em relação aos resultados do conhecimento em doenças sexualmente transmissíveis, houve aumento estatisticamente significativo com mudanças de erros para acertos dos 24 itens do instrumento pelos agentes, no período pós-capacitação. Houve aumento da média de 4,2% para 23,4% (p < 0,0001) no número de orientações realizadas pelos agentes, em sala de espera, no período pós-capacitação. Houve aumento da média de 5,2 para 17,9% (p < 0,0001) do número de encaminhamentos de portadores de doenças sexualmente transmissíveis para tratamento e aumento da média de 2,5% para 18,7% (p < 0,0001) do número de notificações realizadas desses agravos, no período pós-capacitação. Frente aos resultados obtidos, conclui-se que a capacitação produziu mudanças positivas no conhecimento e nas práticas dos Agentes Comunitários de Saúde, em relação ao conjunto das doenças sexualmente transmissíveis estudadas, e espera-se que este estudo torne relevante o desenvolvimento de futuras capacitações nesse tema, possibilitando aos profissionais de saúde repensarem suas condutas, fortalecerem o trabalho em equipe e transformarem suas práticas profissionais / This is a mixed methodological and analytical joint study with quasi- experimental desing, whith aims to develop and validate an instrument to assess knowledge of community health agents on a range of sexually transmitted diseases according to the appearance, content and semantics, develop and validate as the content and strategy of systematizing and implementation of the training of these professionals process, and evaluate the impact of a training process in São Sebastião do Paraíso - MG. Data were obtained through the elaborated and validated tool to assess these professionals\' knowledge in relation to a set of sexually transmitted diseases. A book of records was also used to assess the number of waiting room orientations for these diseases by the health agents, and to assess the number of referrals of patients with these diseases for treatment. The notification forms filled out by members of the family health units\' teams were also considered. The study population consisted of 134 Community Health Workers belonging to 20 family health units who received training on the subject, with active methodology and the educational process was carried out by the researcher. The results of the apparent validation and of the instrument contents showed that it was necessary to change two words in two items. The remaining items were evaluated positively by 100% of participants. In semantic validation, forms adapted from DISABKIDS® were applied to 24 agents working in Brazilian basic education (primary school and high school), and 91.3% of both groups found the instrument questions relevant and, in the specific part of the form, the difficulty both groups presented in relation to three items. Participants of the training mentioned they acquired new knowledge through this study methodology. The time interval for the data collection was 12 months. Regarding the results of knowledge on sexually transmitted diseases, there was a statistically significant increase with changes from errors to correct answers of the 24 items of the instrument, by the health community agents, in the post-training period: there was an increase in the average of 4.2% to 23.4% (p <0.0001) in the number of orientations performed by agents in the waiting room; an increase average of 5.2 to 17.9% (p <0.0001) in the number of referrals of patients with sexually transmitted diseases for treatment; and, an increased average of 2.5% to 18.7% (p <0 , 0001) in the number of these diseases notifications. Given the results, it is concluded that the training produced positive changes in knowledge and practices of community health agents in respect of all the sexually transmitted diseases studied, and it is hoped that this study becomes important to develop future trainings in this theme, allowing health professionals to rethink their behavior, to strengthen teamwork and to change their professional practices

This thesis established the cubature method developed by Gyurkó &amp; Lyons (2010) and Lyons &amp; Victor (2004) for the Heath–Jarrow–Morton (HJM) model. The HJM model was first proposed by Heath, Jarrow, and Morton (1992) to model the evolution of interest rates through the dynamics of the forward rate curve. These dynamics are described by an infinite-dimensional stochastic equation with the whole forward rate curve as a state variable. To construct the cubature method, we first discretize the infinite dimensional HJM equation and thereafter apply stochastic Taylor expansion to obtain cubature formulae. We further used their results to construct cubature formulae to degree 3, 5, 7 and 9 in 1-dimensional space. We give, a considerable step by step calculation regarding construction of cubature formulae on Wiener space.

Os ratos Wistar são amplamente empregados como modelo animal na pesquisa biomédica e o controle sanitário dos biotérios é essencial para garantir a qualidade dos experimentos. O objetivo do estudo foi a caracterização do estado sanitário da colônia de ratos Wistar em sistema de criação convencional e para tanto determinar as bactérias, fungos, virus e parasitos, bem como caracterizar as lesões anatomopatológicas do sistema respiratório. Foram utilizados 273 ratos (N), machos (M) e fêmeas (F), das faixas etárias 4, 8, 12, 16 a 20 semanas e entre 12 a 18 meses, para as determinações de peso e condição corpórea (N=273, 140M, 133F); avaliação bacteriológica de orofaringe, mucosa intestinal e lavado traqueobrônquico (N=40, 20M, 20F); determinação de anticorpos para vírus e bactérias (N=20, 10M, 10F); exame parasitológico (N=60, 30M, 30F); identificação molecular de Mycoplasma pulmonis em amostras de pulmão (N=25, 15M, 10F), e caracterização anatomopatológica da cavidade nasal, orofaringe, laringe, traqueia e pulmão (N=106, 53M, 53F). Foram realizadas ainda avaliações microbiológicas das salas dos ratos em três períodos com isolamento de Micrococcus spp., Staphylococcus spp., Bacillus spp., Aspergillus spp. e Penicillium spp. O peso se mostrou homogêneo dentro da faixa etária e gênero, com apenas sete animais magros (2,56%) e nove em sobrepeso (3,30%). Não foram isoladas bactérias patogênicas na orofaringe, mucosa intestinal e lavado traqueobrônquico por cultivo. Mycoplasma pulmonis foi determinado em 72% das amostras pulmonares e em 100% dos soros testados. Em 35% foram detectados anticorpos para Reovirus tipo III e em 100% para bacilos associados ao epitélio respiratório ciliado. Syphacia muris foi diagnosticada em 91,67%, Eimeria spp. em 3,33% e Entamoeba muris em 1,67%. Lesões relacionadas a infecção por agentes exógenos foram observadas em cavidade nasal e na orofaringe, laringe e traqueia a partir da 4 semanas de idade e, em pulmão desde as 12 semanas, com aumento de frequência de ocorrência e do grau de progressão, com o avançar da idade, nos vários segmentos estudados. Concluímos que a caracterização do estado sanitário dos ratos permite conhecer as particularidades do modelo biológico utilizado e compor base de dados para auxiliar no desenho e na interpretação experimental dos pesquisadores, além de garantir uma base para o programa de monitorização sanitária de biotérios em condições similares / The Wistar rats are widely used as an animal model in biomedical research and the health monitoring of animal facilities is essential to ensure the experiments quality. The aim of this study was to characterize the Wistar rats colony&rsquo;s health status in a conventional breeding facility, to determine both bacteria, fungi, viruses and parasites, as well as characterize the anatomopathological lesions of the respiratory system. 273 rats (N) were used, males (M) and females (F), ages 4, 8, 12, 16 and 20 weeks, and between 12 to 18 months, for weight and body condition determination (N=273, 140M,133F); bacteriological evaluation of the oropharynx, intestinal mucosa and tracheobronchial lavage (N=40, 20M, 20F); antibodies to viruses and bacteria determination (10M, 10F); parasite examination (N=60, 30M, 30F); molecular identification of Mycoplasma pulmonis in lung samples (N=25, 15M, 10F) and histopathological characterization of the nasal cavity, oropharynx, larynx, trachea and lung (N=106, 53M, 53F). Microbiological evaluations of the rats rooms were made in three periods with isolation of Micrococcus spp., Staphylococcus spp., Bacillus spp., Aspergillus spp. and Penicillium spp. Weight proved to be homogeneous within age and gender, with only seven lean animals (2.56%) and nine overweight (3.30%). Pathogenic bacteria weren&rsquo;t isolated by cultivation in the oropharynx, intestinal mucosa and tracheobronchial lavage. Mycoplasma pulmonis was determined in 72% of lung samples and in 100% of tested serum. In 35% antibodies were detected to Reovirus type III and 100% for cilia-associated respiratory bacillus. Syphacia muris was diagnosed in 91.67%, Eimeria spp. in 3.33%, and Entamoeba muris in 1.67%. Lesions related to infection by exogenous agents were observed in the nasal cavity and oropharynx, larynx and trachea from the 4 weeks of age, and lungs from 12 weeks, with an increase of occurrence frequency and degree of progression, with advancing age, in the various studied segments. We conclude that the characterization of rats health status allows us to know the particularities of the animal model used, and compose a database to assist in the design and experimental interpretation of researchers, as well as ensure a basis for the health monitoring program of breeding and research facilities in similar conditions

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-06-01T20:55:55Z No. of bitstreams: 1 ArthurHenriquePereiraTeseParcial2015.pdf: 625611 bytes, checksum: 72c916368b06d32685c569816ae62499 (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2017-06-01T20:57:03Z (GMT) No. of bitstreams: 1 ArthurHenriquePereiraTeseParcial2015.pdf: 625611 bytes, checksum: 72c916368b06d32685c569816ae62499 (MD5) / Made available in DSpace on 2017-06-01T20:57:03Z (GMT). No. of bitstreams: 1 ArthurHenriquePereiraTeseParcial2015.pdf: 625611 bytes, checksum: 72c916368b06d32685c569816ae62499 (MD5) Previous issue date: 2015-11-06 / The present thesis used Heath Ledger???s acting career in the production and interpretation of the Joker character in the movie Batman ??? The dark knight, to investigate the phenomenon denominated by the US media as "Joker effect". It is suspected that immersion in character generated an imaginary experience in the actor, which caused a disturbing and fatal psychological reality effect. For this research, we studied the case through the theoretical and bibliographical research, seeking imaginary theory to show how this intersects with the construction of the actor's role; and subsequently referred to the Stanislavski theory, which was approximated to Jung???s psychoanalysis, and sometimes Deleuze, to show the relationship between the creation and the creator, as well as the psychological processes that are caused and affected. Based on this theoretical material, we were able to analyze the interviews on Heath regarding his professional and personal practice, connecting them with the imaginary development of the Joker and its effect on the actor. / En esta tesis se utiliz?? la carrera del actor Heath Ledger en la producci??n y interpretaci??n del Joker personaje de la pel??cula de Batman - The Dark Knight, para investigar el fen??meno llamado por los medios de comunicaci??n estadunidense del "efecto Joker". Se sospecha que la inmersi??n en car??cter genera una experiencia imaginaria en el actor hab??a causado un efecto de realidad psicol??gica inquietante y fatal. Para realizar esta investigaci??n, se estudi?? el caso a trav??s de la investigaci??n te??rica y bibliogr??fica, la b??squeda de la teor??a imaginario para mostrar c??mo este se cruza con la construcci??n del rol del actor y luego usando la teor??a de Stanislavski, que se aproxima al psicoan??lisis Jung, ayudando a veces Deleuze, para mostrar la relaci??n entre la creaci??n y el creador, y los procesos psicol??gicos que se producen y afectados. Sobre la base de este material te??rico, podr??amos analizar las entrevistas sobre Heath sobre su pr??ctica profesional y personal, conect??ndolos con el desarrollo imaginario del Joker y su efecto causado el actor. / A presente tese utilizou a trajet??ria do ator Heath Ledger na produ????o e interpreta????o da personagem Curinga no filme Batman ??? cavaleiro das trevas, para investigar o fen??meno denominado pela m??dia norte-americana de ???efeito Curinga???. Suspeita-se que a imers??o na personagem gerou uma experi??ncia imagin??ria no ator que provocou um efeito de realidade psicol??gica perturbadora e fatal. Para tal investiga????o, estudou-se o caso por meio da pesquisa te??rico-bibliogr??fica, buscando a teoria do imagin??rio para mostrar como este se intersecta com a constru????o do papel do ator e, em seguida, recorrendo ?? teoria de Stanislavski que foi aproximada ?? psican??lise de Jung, auxiliando-se, ??s vezes, de Deleuze, para mostrar a rela????o entre a cria????o e o criador, e os processos psicol??gicos que s??o provocados e afetados. Tendo como base esse material te??rico, foi poss??vel analisar as entrevistas sobre Heath a respeito de sua pr??tica profissional e pessoal, conectando-as com o desenvolvimento imagin??rio do Curinga e o seu efeito provocado no ator.