Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal.

L’assurance médicaments est un des facteurs qui peuvent influencer l’adhésion aux médicaments. Les objectifs de ce mémoire étaient d’évaluer l’impact du type d’assurance médicaments (publique versus privée) sur l’adhésion et le coût des antihypertenseurs et d’évaluer l’impact des procédures de remboursement et de la contribution du patient sur l’adhésion aux médicaments prescrits pour traiter une maladie chronique. Afin de répondre à ces objectifs, deux cohortes rétrospectives ont été construites à partir des bases de données de la RAMQ et reMed : une cohorte appariée d’utilisateurs d’antihypertenseurs couverts par une assurance médicaments privée ou publique et une cohorte de patients couverts par une assurance médicaments privée ayant rempli au moins une ordonnance pour un médicament traitant une maladie chronique. Les résultats montrent que le niveau d’adhésion aux antihypertenseurs était similaire entre les deux types d’assurance médicaments et que le coût des antihypertenseurs était 28,9 % plus élevé au privé. De plus, il a été observé que les procédures de remboursement n’affectaient pas l’adhésion, alors que le niveau de contribution des patients l’affectait. Les patients qui déboursaient un plus grand montant à l’achat de leurs médicaments étaient moins adhérents (différence : -19,0 %, Intervalle de confiance [IC] à 95 % : -24,0 à -13,0), alors que les patients qui n’avaient rien à débourser étaient moins adhérents (différence : -9,0 %, IC à 95 % : -15,0 à -2,0), que ceux qui devaient débourser une petite somme. Les résultats présentés dans ce mémoire montrent que l’assurance médicaments influence l’adhésion par l’entremise des caractéristiques des plans d’assurance. / Drug insurance is one of many factors that can influence medication adherence. The objectives of this thesis were to evaluate the impact of the type of drug insurance (private versus public) on adherence to antihypertensive medications and the cost of medications, and to evaluate the impact of drug reimbursement procedures and out-of pocket expenses on adherence to medications prescribed for chronic diseases. To meet these objectives, two retrospective cohorts were constructed from the RAMQ and reMed databases: a matched cohort of antihypertensive users covered by private or public drug insurance and a cohort of patients covered by private drug insurance who filled at least one prescription for a medication prescribed for a chronic disease. The results have shown that the level of adherence to antihypertensive medications was similar between the two types of drug insurance and that the cost of antihypertensive medications was 28,9% higher for those privately insured. It was also observed that drug reimbursement procedures didn’t affect medication adherence, while the level of out-of-pocket expenses affected it. Patients with the highest out-of-pocket expenses were less adherent (difference: –19.0%; 95% confidence interval [CI]: –24.0 to –13.0), while patients with no out-of-pocket expenses were less adherent (difference: -9.0%; 95% CI: –15.0 to –2.0) than those with low out-of-pocket expenses. The results presented in this thesis have shown that drug insurance affects medication adherence through the characteristics of drug insurance plans.

Made available in DSpace on 2015-04-14T14:27:08Z (GMT). No. of bitstreams: 1 418189.pdf: 1586821 bytes, checksum: 7ecc3da182a1c889a20983cc06121e1a (MD5) Previous issue date: 2014-03-21 / This dissertation has as main objective to test empirically what are the main determinants of foreign direct investment flows (FDI) for developing economies and in transition and whether for the region of Latin America and Caribbean, those same determinants remains or not. To support the empirical part of the job, chapter two, which is divided into two sections, started showing the evolution theory of the main approaches about the FDI including the Theory of Industrial Organization of Hymer (1976), the Theory of Internalization of Buckley and Casson (1976), the Product Cycle Theory of Vernon (1966), the Eclectic Theory of Dunning (1988, 1993 and 2000) and the New Trade Theory. And in the second section of the chapter, we reviewed a total of twenty articles with emphasis on empirical determinants of FDI flows to developing countries and in transition and for the countries of Latin America and Caribbean. In the third chapter will appear the evolution of the global FDI flows with two separate analyses: one for developing countries and in transition and one for the countries of Latin America and Caribbean. In the fourth chapter, using a methodology of panel data, regressions were estimated for a wide sample of 118 countries being 27 of Latin America and Caribbean for the period 1996-2011. The results show that there are differences in factors that determine inflows of FDI. Giving evidence that while in developing countries and in transition the main determinants are the search for markets (Market-seeking), and search for efficiency (Efficiency-seeking). The economies of Latin America and Caribbean prevails just search for markets (Market-seeking). / Esta disserta??o tem como objetivo principal testar empiricamente quais os principais fatores determinantes dos fluxos de Investimento Direto Externo (IDE) para as economias em desenvolvimento e em transi??o e saber se para a regi?o da Am?rica Latina e Caribe, esses mesmos determinantes se mant?m ou n?o. Para dar apoio ? parte emp?rica do trabalho, o cap?tulo dois, que est? dividido em duas se??es, iniciou apresentando a evolu??o te?rica das principais abordagens sobre o IDE compreendendo a Teoria da Organiza??o Industrial de Hymer (1976), a Teoria da Internaliza??o de Buckley e Casson (1976), a Teoria do Ciclo do Produto de Vernon (1966), a Teoria Ecl?tica de Dunning (1988, 1993 e 2000) e a Nova Teoria do Com?rcio. E na segunda se??o do cap?tulo, foram revisados um total de vinte artigos emp?ricos com ?nfase nos determinantes dos fluxos de IDE para os pa?ses em desenvolvimento e em transi??o e para os pa?ses da Am?rica Latina e Caribe. No terceiro cap?tulo ser? apresentada a evolu??o dos fluxos mundiais de IDE com duas analises separadas: uma para os pa?ses em desenvolvimento e em transi??o e outra para os pa?ses da Am?rica Latina e Caribe. No quarto cap?tulo, utilizando uma metodologia de dados em painel, foram estimadas regress?es para uma ampla amostra composta por 118 pa?ses sendo 27 da Am?rica Latina e Caribe para o per?odo 1996-2011. Os resultados mostram que existem diferen?as nos fatores que determinam os fluxos de entrada de IDE. Dando evid?ncias de que enquanto nos pa?ses em desenvolvimento e em transi??o os principais determinantes s?o a busca por mercados (Market-seeking), e busca por efici?ncia (Efficiency-seeking). Nas economias da Am?rica Latina e Caribe prevalece apenas a busca por mercados (Market-seeking).

African American women, in particular those who are economically marginalized, are disproportionately subject to surveillance by social service and criminal justice agencies (James et al., 2003) and are vulnerable to race- and gender-biased policy implementation (Chibnall et al., 2003; Zerai, 2002). They also experience population-specific personal (Ehrmin, 2001, 2002), social (Riehman, Iguchi, Zeller, & Morral, 2003; MacMaster, 2005), and economic barriers (Tighe & Saxe, 2006) to accessing and entering substance abuse treatment services. These factors contribute to lower rates of treatment entry follow-through (Siqueland et al., 2002) and higher drop-out rates (Scott-Lennox, Rose, Bohlig, & Lennox, 2000) than women from other racial and ethnic groups. This qualitative study explored African American women’s perceptions of mandated referral to substance abuse treatment and the impact of those perceptions on their treatment entry. The sample included 17 women age 18 years and over who were currently enrolled at three gender-specific treatment programs (one intensive outpatient and two residential) in a major southeastern urban area. This naturalistic inquiry (Lincoln and Guba, 1987) was informed by Black feminist epistemology (Collins, 2000) in accordance with recommendations for culturally sensitive research with women of color (Landrine, Klonoff, & Brown-Collins, 1995). Participants completed one-time, in-depth (one to two hour) interviews in which they were invited to explore their experiences with mandated substance abuse treatment referrals from state agencies (child protective services and the criminal justice system). Results indicate that participants generally perceived the treatment mandate as helpful. However, they also indicated that their willingness and ability to follow-through with treatment entry were influenced by multidimensional (Marlowe, Merikle, Kirby, Festinger, & McLellan, 2001) and interacting factors. Participants identified influence factors that included intra- and interpersonal concerns, the quality of interactions with state agencies, and treatment-specific issues. Results are presented along with suggestions for counselors and future research.

The current study had two purposes. The first purpose was to examine the association between family rules and routines and first grade children's teacher-rated and peer-rated behavioral competencies (e.g., emotional symptoms, conduct problems, peer problems, hyperactivity, and prosocial behavior) after controlling for both family stressors (i.e., single parent home, mobility, socioeconomic status, property ownership) and child ethnicity (African American, Caucasian, Hispanic). The second purpose was to determine if child regulatory control abilities mediates the effects of family rules and routines and children's behavioral competencies. The parents of 215 ethnically diverse children (38%, Caucasian, 22% African American, 33% Hispanic, 7% Other) were interviewed in their homes with a modified and shortened version of Family Routines Inventory (FRI; Jensen, James, Boyce, & Hartnett, 1983). Teachers completed the Strengths and Difficulties Questionnaire (SDQ; Goodman, 1997), and peers completed a modified version of the Class Play (Masten, Morison & Pelligrini, 1985). Scores from the SDQ were standardized and combined with the standardized scores obtained from the peer nominations to create composites of the behavioral competencies. Additionally, teachers completed a modified version of the California Child Q-set (CCQ) (Block & Block, 1980) as a measure of these children's regulatory control abilities. African American parents' ratings of their family's rules and routines were higher than those of Hispanic and Caucasian parents' ratings. Additionally, family stressors were positively associated with higher teacher and peer ratings of conduct problems and lower ratings of prosocial behavior. Neither ethnicity nor family rules and routines predicted child competencies. A statistically significant curvilinear relationship was found between family rules and routines and conduct problems such that children of parents reporting the highest and lowest levels of family rules and routines have more conduct problems. No associations were found between family rules and routines and child competencies or children's regulatory control abilities. Limitations of the study are discussed in terms of inadequate measurement of family rules and routines, a defensive response set, self-selection on the part of the parents to participate in the interview, and a sample that is not representative of the community of parents and children in the participating schools.

Les molécules H2, HD et D2 occupent une place fondamentale en physique moléculaire, en astrophysique et en physique des plasmas. H2 est la molécule la plus abondante dans l'univers. Les récentes observations à haute résolution des transitions VUV de cette molécule et de son isotope HD ont été effectuées par le satellite FUSE dans le domaine 90.5 -118.7 nm. Ces observations permettent de déterminer le rapport d'intensités des raies HD/H2, considéré comme un outil nouveau pour évaluer le rapport d'abondances D/H, qui est connu pour être un traceur efficace de l'évolution chimique de l'Univers. Par ailleurs, les molécules H2, HD et D2 sont formées dans le plasma de bord des tokamaks et contribuent aux pertes radiatives du milieu. Par conséquent, il est indispensable de disposer de données spectroscopiques de haute qualité obtenues en laboratoire pour une exploitation fiable des résultats d'observations ou pour une modélisation réaliste des plasmas de fusion.<br /> <br />L'objectif de cette thèse est d'effectuer une étude expérimentale à haute résolution des spectres d'émission et d'absorption des isotopes D2 et HD de l'hydrogène moléculaire dans le VUV et de la compléter par une étude théorique des états électroniques excités en relation avec les transitions observées. Une telle étude avait été effectuée dans notre laboratoire et avait abouti à la réalisation d'un atlas VUV dans le domaine 78-170 nm.<br /> <br />Les spectres d'émission de HD et D2 sont produits par une source à décharge Penning opérant sous faible pression, et sont enregistrés dans la région spectrale 78 -170 nm à l'aide du spectrographe sous vide de 10 mètres à haute résolution (~ 150 000) de l'Observatoire de Meudon, soit sur plaques photographiques, soit sur des écrans phosphore photostimulables pour mesure d'intensités. Les spectres enregistrés contiennent plus de 20 000 raies. Les longueurs d'onde sont mesurées avec une précision de Δλ/λ= 10-6.Les raies des molécules D2 et H2 étant inévitablement présentes dans le spectre de HD, nous avons d'abord cherché à réaliser l'analyse du spectre de D2, qui consiste à identifier et à assigner les raies aux transitions électroniques entre des niveaux d'énergie de la molécule.<br /><br /> Nous avons par ailleurs réalisé une étude en absorption des molécules HD et D2 au Centre Laser LCVU d'Amsterdam. Nous avons mesuré par spectroscopie laser à deux photons 1XUV+1UV, de nouvelles longueurs d'onde avec une précision inégalée de Δλ/λ= 10-8 dans le domaine spectral 99.9-104 nm permis par l'accordabilité du laser XUV.<br /><br /> Ces nouvelles longueurs d'ondes constitueront une base de données de raies de référence pour la calibration des spectres moléculaires, mais leurs intérêts ne s'arrêtent pas au laboratoire. En effet, les nouvelles raies de HD mesurées par spectroscopie laser, ajoutées aux raies de H2 déjà mesurées avec une précision similaire, seront utilisées comme référence pour mettre en évidence une possible variation cosmologique du rapport de masse proton-électron μ= mp/me, par comparaison avec des longueurs d'onde de raies de H2 ou de HD observées dans les spectres d'absorption de quasars à grands déplacements vers le rouge. Cette étude nécessite la connaissance des coefficients de sensibilité des longueurs d'onde par rapport à la possible variation de μ, que nous avons calculés par la résolution d'un système d'équations couplées pour les états électroniques B, B', C et D de la molécule H2 et HD pour diverses valeurs de μ. <br /><br />Durant ce travail de thèse, nous nous sommes également intéressés à des transitions entre états libres-libres et états libres-liés de la molécule H2. Ces transitions se produisent lors d'une collision H-H formant une quasi-molécule et sont responsables de l'apparition de satellites dans l'aile des raies de l'atome d'hydrogène. Nous avons effectué une étude quantique du satellite quasi-moléculaire de la raie Lymanβ et calculé le profil d'absorption du satellite en fonction de la température. Cette variation est un outil important de diagnostic pour la détermination des caractéristiques des atmosphères des naines blanches.

Thèse numérisée par la Division de la gestion de documents et des archives de l'Université de Montréal

AIM: To evaluate the prevalence of orthodontic problems and quality of life in relation to orthodontic problems among adolescent children in the city of Chennai, India. OBJECTIVES: To analyze the differences in the need for orthodontic treatment among children in the public and private schools; to analyze the need for orthodontic treatment among the various socioeconomic groups; to evaluate the Quality of Life (QoL) among the children; to analyze the relationship between Quality of Life (QoL) and the need for orthodontic treatment. METHODS: 200 children participated in the study, out of which 100 were from the private school and 100 from the public school from the city of Chennai, India. Two sets of questionnaires were used for the study, one was filled by the children and the other was filled by the researchers and trained dental assistants after doing a thorough dental examination and asking questions from the participants. This was carried out according to the recommendations of WHO oral health assessment. Statistical data was collected, recorded and analyzed using the software SPSS 17.0 for Windows. RESULTS: The private school children had more orthodontic problems than the public school children (49% and 44% respectively). The need for Orthodontic Treatment was the highest in children under the rich category (56.4%), followed by the children under the poor category (45.3%) and is least among the children under the average category (44.4%). The Quality of Life was... [to full text] / TIKSLAS: Įvertinti ortodontinio problemas ir perspektyvas atsižvelgiant į ortodontinio problemas tarp paauglių vaikų mieste Chennai, Indija. TIKSLAI: Analizuoti skirtumus reikalingas Ortodontinis gydymas tarp vaikų, viešąsias ir privačias mokyklas; analizuoti kad ortodontinio gydymo tarp įvairių socialinių ir ekonominių grupių; vertinti gyvenimo kokybę (QoL) tarp vaikų; išanalizuoti ryšį tarp gyvenimo kokybę (QoL) ir ortodontinio gydymo poreikį. METODAI: 200 vaikai dalyvavo tyrime, iš kurių 100 buvo privati mokykla ir 100 iš viešųjų mokyklų iš miesto Chennai, Indija. Vienų, ir klausimynų buvo naudojami tyrimo, vienas buvo užpildyti vaikų ir kitų buvo užpildyti mokslininkų ir apmokyti dantų padėjėjai po daro dantų nuodugniai ir užduoti klausimus iš dalyvių. Tai buvo daroma pagal PSO burnos sveikatos vertinimo rekomendacijas. Statistiniai duomenys buvo renkami, įrašytos ir analizuoti naudojant SPSS 17,0 programinė įranga Windows. REZULTATAI: Privačios mokyklos vaikai turėjo daugiau ortodontinio problemų nei valstybinių mokyklų vaikai (atitinkamai 49 % ir 44 %). Ortodontinio gydymo poreikis buvo didžiausias vaikams pagal turtingas kategorija (56.4 %), po to vaikai iki prastos kategorija (45.3 %) ir kas tarp vaikų iki vidutinės kategorijos (44.4 %). Gyvenimo kokybė buvo nustatyta, kad geriau tarp vaikų, privačios mokyklos nei valstybinėse mokyklose (90,6 % ir 89.0 % atitinkamai). Vaikams, kurie neturėjo nei gera gyvenimo kokybė turėjo mažai arba visai nėra ortodontinio kai... [toliau žr. visą tekstą]

This study aimed to demonstrate the effects of the contextual factors (socio-economic conditions and level of urbanization) on family processes and outcomes related to women. The family processes of interest were spousal relations relative power, feelings of mastery, and self evaluation of women in familial roles. Another aim was to investigate the effect of participation in the activities of family support and women education programs on women&#039 / s attitudes in relation to family roles. I studies with an accidental sample of 145 women in various districts of Kadik&ouml / y, istanbul. There were three groups of women (1) women living in poor districts of Kadik&ouml / y and in touch with &quot / Family Guiding/ Solidarity Center&quot / of Kadik&ouml / y Munucipality, (2) women living in the same districts but not in touch with (FG/SC), (3) women living in central-whealthy neighborhoods of Kadik&ouml / y. There were three main predictions / (1) education was predicted to determine economic status, which would influence mastery. Mastery in turn, would affect spousal relationsand decision making processes in family. Finally, spousal relations would predict self-evaluation (2) urbanization was predicted to influence modern attitudes toward spousal roles positively and traditional attitudes negatively, (3) women who were in touch with FG/SC were predicted to have more favorable attitudes toward modern spousal roles, but less favorable toward traditional spousal roles. The model of the first prediction revealed that / economic status determined mastery, which influences warmth and equality. Warmth and equality in turn influences individual&#039 / s self evaluation. As expected in the second prediction, urbanization was negatively related to traditional attitudes. Comparison of the three groups revealed that, women living in pheripheral districts showed more favorable attitudes towards traditional gender stereotypic duties of women, and maledominance than women living in central districts. Women living in pheripheral districts and intouch with FG/SC, showed more favorable attitudes toward women&#039 / s participation inlabor market than women living in the same area but not in touch with FG/SC, and women living in the central districts.

This study linked to the line of research "Development of network educational technology", from the Professional Master course on Network Educational Technology, aims to contribute to the provision of Specialized Educational Service (SES). To do so, it was sought to develop a Digital Educational Material (DEM) to enhance SES; specifically the objectives were: 1) expand the SES, implementing a DEM in order to be used presentially and at a distance; 2) adapt the pedagogical model DEM, making it accessible to the target audience of the Special Education Student (SPES) and 3) validate the possibilities of motivation, autonomy and learning of DEM with SPES, under the assessment of SES teachers. On the basis of theories, it can include four axes: first, contemplating the special education; the second, with studies of digital educational materials, Learning objects; the third on Teaching Design (TD) in the construction of DEM and the fourth axis referring to the accessibility of digital educational materials. By applying a qualitative research, the focus was on teachers who work in Multifunctional Resource Rooms, performing the SES of state public schools in the city of Santa Maria, RS state. Data collected went through content analysis (Bardin, 2011), using three categories: motivation for the use of DEM, the autonomy in the use of DEM and potential for learning. The results of the analyzed categories allow evidence that the motivation to use DEM is present due to the context of illustrations, content and accessibility; as the autonomy, the results indicate that the non-linear path and affordable navigation possibilities are important characteristics for the development of a DEM, and finally, the potential for learning is present from the developed educational activities in accordance with the practices the SES and the possibilities of using DEM presentially and at distance. Thus, the study achieved its goals, understanding that the virtual room of multifunction resources gives SES greater potential. / O presente estudo vinculado à linha de pesquisa Desenvolvimento de tecnologias educacionais em rede , do Mestrado Profissional em Tecnologias Educacionais em Rede, pretendeu contribuir com a oferta do Atendimento Educacional Especializado (AEE). Para tanto, buscou desenvolver um Material Educacional Digital (MED) para potencializar o AEE; especificamente os objetivos foram: 1) ampliar o AEE, implementando um MED de forma a ser utilizado presencial e a distância; 2) adaptar o Modelo Pedagógico MED, tornando-o acessível ao Estudante Público-alvo da Educação Especial (EPAEE) e 3) validar as possibilidades de motivação, autonomia e aprendizagem do MED com os EPAEE, sob a avaliação dos professores do AEE. Nas teorias de base, referenciam-se quatro eixos: o primeiro, contemplando a Educação Especial; o segundo, apresentando estudos sobre Materiais Educacionais Digitais, objetos de Aprendizagem; o terceiro, sobre Design Pedagógico (DP) na construção dos MED e o quarto eixo referindo-se à acessibilidade em Materiais Educacionais Digitais. Com uma pesquisa qualitativa, aplicada, o foco recaiu sobre professores que atuam nas Salas de Recursos Multifuncionais, realizando o AEE de Escolas Públicas Estaduais, na cidade de Santa Maria, RS. Os dados coletados passaram pela análise de conteúdo (Bardin, 2011), por meio de três categorias: motivação para o uso do MED, autonomia no uso do MED e potencial para a aprendizagem. Os resultados das categorias analisadas permitem evidenciar que a motivação para uso do MED está presente devido à contextualização das ilustrações, conteúdos e acessibilidade; quanto à autonomia, os resultados apontam que o percurso não linear e as possibilidades de navegação acessíveis são características importantes para o desenvolvimento de um MED e, por fim, o potencial para aprendizagem se faz presente a partir das atividades pedagógicas elaboradas de acordo com as práticas do AEE e das possibilidades de uso do MED presencial e a distância. Assim, o estudo realizado contemplou os objetivos, entendendo que a Sala virtual de Recursos Multifuncionais potencializa o AEE.