Made available in DSpace on 2014-06-11T19:22:20Z (GMT). No. of bitstreams: 0 Previous issue date: 2003-12-04Bitstream added on 2014-06-13T20:48:44Z : No. of bitstreams: 1 scadelai_ef_me_sjrp.pdf: 1349775 bytes, checksum: 74d3942519e4b14b380a919832db41ad (MD5) / Este trabalho estuda o verbo dizer como explicitador de atos de fala em notícias de jornal. No meio jornalístico, defende-se comumente que o verbo dizer utilizado na classificação de falas de entrevistados na notícia é, em grande medida, neutro, ou seja, não sinaliza - ou sinaliza muito pouco - uma interpretação dessas falas ao classificá-las. A discussão empreendida por este trabalho parte da consideração do verbo dizer como constituinte do procedimento de integração do discurso citado no discurso citante. Questionase, pois, a neutralidade do verbo dizer, mais pela abordagem lingüística da relação entre discurso citado/discurso citante do que pela discussão, já bastante conhecida, da neutralidade da prática jornalística. Para este estudo, foi utilizada a teoria dos atos de fala, de Austin, que defende que o sentido não está apenas nas palavras (no verbo, no caso), mas também nas circunstâncias que envolvem o seu uso. No que se refere às circunstâncias propriamente lingüísticas de integração desse verbo no processo de citação, foram utilizadas as noções de dialogia, de discurso de outrem e de gêneros do discurso (Bakhtin); de heterogeneidade(s) enunciativa(s) (Authier-Revuz) e de comentário (Foucault), por meio das quais procurou-se entender a complexidade enunciativa das formas de citação, que inclui as relações entre: discurso citado/discurso citante; fala do jornalista/fala da fonte (um entrevistado ou uma fonte de natureza institucional) citadas em discurso direto ou indireto, resultando num compósito de vozes; formas de citação/gênero notícia; formas clássicas de citação/comentário (este último aparecendo também como forma de citação, já que é um modo de redizer o discurso de outrem, que, além de o reformular, busca legitimar uma interpretação para ele)... / This work studies the verb to say as a specifier of speaking acts in the news of a newspaper. In the journalistic means, it is commonly defended that the verb to say used to classifify the lines of interviewed people in the news is, in a great measure, neutral, or in other words, it doesnþt signal - or it signals very little - an interpretation of these lines when classifying them. The discussion undertaken by this work starts from the consideration of the verb to say as constituent of the integragion procedure of the speech cited in the citing speech. Therefore, it is questioned the neutrality of the verb to say, more from the linguistic approach of the relation between cited/citing speech than from the discussion of the neutrality of the journalistic practice, already sufficiently known. For this study, the theory of the acts of speeches, of Austin, has been used and it defends that the meaning is not only in the words (in the verbal form, in this case), but also in the circumstances that involve its use. As for the properly linguistic circumstances of integration of this verb in the citation process, the cognition of dialogia, of other people speech and of sorts of the speech (Bakhtin); of enunciative heterogeneity(ies) (Authier-Revuz) and of commentary (Foucault) had been used, through which they tried to understand the enunciative complexity of the citation forms, that includes the relations between: cited/citing speech; the jornalist line/the source line (one interviewed or one source of institucional nature) cited in direct or indirect speech, resulting in a compósitorio of voices; citation/sort of news forms; classic forms of citation/comentary (this last one also appearing as citation form, since it is a way of retelling the speech of someone else, that searches to legitimize an interpretation for it beyond reformulating it)... (Complete abstract, click electronic address below)

The purpose of this study was to evaluate the course Eng 311, Advanced Communication Skills, offered by the Department of Modern Languages at Middle East Technical University. To fulfill this aim two questionnaires were designed to be administered to 198 out of 923 students taking this course, one at the beginning of the term and the other at the end of the term. What is more, another questionnaire was designed to be e-mailed to 114 graduate students who took this course before they graduated. In addition, a different version of the questionnaires was designed to be administered to 22 instructors teaching this course. Later, five of these instructors were also interviewed by the researcher. In this way, all these participants&rsquo / opinions about the objectives, materials and the assessment in Eng 311 were identified. The quantitative data gathered from the questionnaires were analysed by conducting t-tests, ANOVA tests and chi-square tests. The qualitative data gathered fro the open-ended questions in the questionnaires and the interviews were analysed by content analysis by the researcher. The results of the study revealed that the participants were satisfied with the course. Most of the objectives of the course were considered as important by most for the participants. As regard the materials, although there were some complaints about some parts of the textbook, it was considered as effective as a whole. The type of materials that were rated the lowest were CDs and videos. As for the assessment, it was revealed by the results that there were some problems regarding standardization in the department, and the breakdown of points. In addition to these, some instructors also complained that the time allotted to the components of this lesson was not sufficient.

Orientador: Eda Maria Góes / Banca: Maria Encarnação Beltrão Sposito / Banca: Everaldo Santos Melazzo / Banca: Marcia Metran de Mello / Banca: José Borzachiello da Silva / Resumo: A partir do estudo da cidade de Palmas, capital do Estado de Tocatins, o desafio fundamental da tese proposta é analisar o imaginário da cidade projetada e implantada, constituída num tempo compactado e, ainda, como esse espaço organizado no tempo ausente apresenta traços e encaixes na realidade do pós-modernismo. Brasília e Palmas são cidades do tempo ausente que, diferente das demais cidades não planejadas ou projetadas, tem o seu espaço-tempo surgido simultaneamente. Compreendemos teoricamente essa compactação ou simultaneidade, como ausência de tempo. A cidade de Palmas foi projetada e surgiu nessa condição de compactação temporal, sua paisagem urbana detem imagens cheias de simbolismos que jogam com a subjetividade do tempo... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: From a study on the city of Palmas, the capital of the state of Tocantins-Brazil, the fundamental problem on the thesis proposal is to analyze the Idea of an implanted pre designed city, settled in a compact period of time and still as IF this organized period of absent time presents treats and fits into post modernism reality. Brasília and Palmas are cities that belong to the so called "absent time" that different from other cities Just haven't been put into blueprint or pre-planned. They both have time and space emerged simultaneously. We theoretically understand that this compaction or simultaneity as "absence of time". The city of Palmas has been put into blueprint and came to being into a time compaction condition. It's urban design and landscaping is filled up with symbolism that simply plays with time subjectivity. The monuments are random temporal maps that represent different periods of time though they are all rather recently made creating an illusion to others perception with the goal of bringing some historic sense to the city. The path to understanding the city and its present/absent temporality on which it has been designed is based on a multiplicity logic that sketches and overlays urban image polysemy... (Complete abstract click electronic acces below) / Doutor

by Suen Lai Kuen, Denise. / Publication date from spine. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1995. / Includes bibliographical references (leaves 103-114). / Abstract --- p.i / Chapter Chapter 1 --- The issue and its background --- p.1 / Chapter 1.1 --- Languages in Hong Kong society --- p.1 / Chapter 1.2 --- Hong Kong Certificate of Education Examination --- p.2 / Chapter 1.3 --- The validation of the HKCE Eng. (B) Examination Paper III --- p.3 / Chapter Chapter 2 --- Review of relevant literature / Chapter 2.1 --- Reliability and validity --- p.6 / Chapter 2.1.1 --- Reliability --- p.6 / Chapter 2.1.2 --- Validity --- p.8 / Chapter 2.1.2.1 --- Test validation --- p.7 / Chapter 2.1.2.2 --- Construct validity --- p.10 / Chapter 2.1.2.3 --- Content validity . --- p.11 / Chapter 2.1.2.3.1 --- Qualitative and quantitative approaches to content validation --- p.12 / Chapter 2.1.2.3.2 --- Item difficulty and item discriminability --- p.13 / Chapter 2.1.2.3 --- Criterion-related validity --- p.14 / Chapter 2.1.3 --- Validity and reliability --- p.16 / Chapter 2.1.4 --- Summary --- p.16 / Chapter 2.2 --- Communicative paradigm and the study of language --- p.18 / Chapter 2.2.1 --- Communicative competence --- p.20 / Chapter 2.2.2 --- Framework of communicative competence --- p.21 / Chapter 2.2.3 --- Problems in communicative language testing --- p.23 / Chapter 2.2.4 --- Characteristics of communicative language tests --- p.24 / Chapter 2.2.5 --- HKCE Eng. (B) Examination Paper III in the communicative paradigm --- p.25 / Chapter 2.2.6 --- Features of spoken language --- p.26 / Chapter 2.2.6.1 --- Speaking against time --- p.26 / Chapter 2.2.6.2 --- Spoken against written language --- p.27 / Chapter 2.2.6.3 --- Variety of vocabulary --- p.28 / Chapter 2.2.6.4 --- Level of vocabulary --- p.29 / Chapter 2.2.6.5 --- Intonation unit --- p.30 / Chapter 2.2.6.6 --- Clausal construction --- p.32 / Chapter 2.2.6.7 --- Sentence construction --- p.33 / Chapter 2.2.6.8 --- "Involvement with audience, with self, and with concrete reality" --- p.33 / Chapter 2.2.6.9 --- Features of conversations and lectures --- p.34 / Chapter 2.2.7 --- Summary --- p.35 / Chapter 2.3 --- Second language listening comprehension --- p.37 / Chapter 2.3.1 --- Factors in L2 listening comprehension --- p.37 / Chapter 2.3.1.1 --- Speech rate and syntactic structure --- p.37 / Chapter 2.3.1.2 --- Sandhi and proficiency level --- p.38 / Chapter 2.3.1.3 --- "Syntactic simplication, repetition, and proficiency level" --- p.39 / Chapter 2.3.1.4 --- Discourse markers and proficiency level --- p.40 / Chapter 2.3.1.5 --- Background knowledge --- p.41 / Chapter 2.3.1.6 --- Text type and question type --- p.42 / Chapter 2.3.1.7 --- "Note taking, memory, and proficiency level" --- p.43 / Chapter 2.3.1.8 --- Syntactic simplicity and redundancy --- p.44 / Chapter 2.3.2 --- Different types of listening skills --- p.46 / Chapter 2.3.3 --- Summary --- p.49 / Chapter Chapter 3 --- Content validation of the HKCE Eng. (B) Examination Paper III / Chapter 3 1 --- Test objectives and test specifications --- p.51 / Chapter 3.2 --- Question types in the HKCE Eng. (B) Examination Paper III --- p.53 / Chapter 3.3 --- Validity of test specifications --- p.58 / Chapter 3.3.1 --- Domains of use --- p.58 / Chapter 3.3.2 --- Listening comprehension component skills as test specifcations --- p.59 / Chapter 3.4 --- Validity of test content --- p.61 / Chapter 3.4.1 --- Domains of use in test content --- p.62 / Chapter 3.4.1.1 --- Domains of use in section A items --- p.62 / Chapter 3.4.1.2 --- Domains of use in section B items --- p.66 / Chapter 3.4.2 --- Content validity in terms of skills --- p.66 / Chapter 3.4.3 --- Content validity in terms of text authenticity --- p.68 / Chapter 3.5 --- Quantitative approach to content validation --- p.71 / Chapter 3.6 --- Summary --- p.77 / Chapter Chapter 4 --- Criterion-related (concurrent) validation of the HKCE Eng. (B) Examination Paper III / Chapter 4.1 --- The choice of the criterion --- p.78 / Chapter 4.1.1 --- Test of English as a Foreign Language --- p.78 / Chapter 4.1.2 --- Section 1 (Listening comprehension) of the TOEFL --- p.79 / Chapter 4.1.3 --- The TOEFL program under the policy council --- p.80 / Chapter 4 1.4 --- Development of TOEFL questions --- p.80 / Chapter 4.1.5 --- Reliability and validity of the TOEFL --- p.81 / Chapter 4.1.6 --- TOEFL as the criterion --- p.86 / Chapter 4.2 --- The subjects and the procedure --- p.89 / Chapter 4.3 --- Basic assumptions of correlation analysis --- p.90 / Chapter 4.4 --- Statistical procedure and findings --- p.94 / Chapter Chapter 5 --- Discussion and conclusion / Chapter 5.1 --- Content validity of the HKCE Eng. (B) Examination Paper III --- p.98 / Chapter 5.1.1 --- Validity of test objectives and test specificiations --- p.99 / Chapter 5.1.2 --- Validity of test content in terms of testing specifications --- p.99 / Chapter 5.1.3 --- Content validity in terms of skills --- p.99 / Chapter 5.1.4 --- Content validity in terms of text authenticity --- p.100 / Chapter 5.1.5 --- Content validity based on internal analysis --- p.100 / Chapter 5.2 --- Criterion-related validity of the HKCE Eng. (B) Examination Paper III --- p.102 / Chapter 5.3 --- Further research as corroboration --- p.103 / Bibliography --- p.103 / Appendix Materials of the 1991 (session 2) HKCE Eng. (B) Examination Paper III --- p.115 / Appendix 2 Teacher A's evaluation form --- p.136 / Appendix 3 Teacher B's evaluation form --- p.142 / Appendix 4 Materials of the TOEFL Secion 1 (Listening Comprehension) used as the criterion --- p.147 / Appendix 5 HKCE scores and TOEFL scores in the criterion-related validation study --- p.158

Nachdem Unternehmen sich bisher eher mit der Reorganisation interner Prozesse beschäftigt haben, richtet sich der Blick nunmehr auf unternehmensübergreifende Geschäftsprozesse. Für das Logistikmanagement stellt insbesondere die kooperative Zusammenarbeit entlang der Wertschöpfungskette (vertikale Kooperationen) ein immer wichtiger werdendes Aufgabenfeld dar. Hierbei geht es darum, die logistischen Prozesse, die entlang der Versorgungskette (Supply Chain) auftreten, zur Kundenzufriedenheit zu gestalten. Eine Alternative, um die Produktionsund Logistikprozesse bei Beteiligung mehrerer rechtlich selbstständiger Unternehmen zu koordinieren, ist das Konzept des Vendor Managed Inventory (VMI), bei dem der Zulieferer die Disposition der Lagerbestände beim Abnehmer durchführt. Dieser Beitrag stellt das Konzept sowie verschiedene Ausgestaltungsvarianten vor. / Following reorganisation of their internal business processes, many firms are now concentrating on inter-company processes. Cooperation along the value chain (vertical cooperation) is becoming an ever more important task in logistics management. The objective is to manage logistics processes along the supply chain in a manner which promotes customer satisfaction. Vendor-managed inventory (VMI) is one concept able to coordinate the production and logistics processes between several legally independent companies, placing responsibility for management of the customer’s inventory in the hands of the supplier. In this paper, the VMI concept is presented and different arrangements are discussed.

碩士 / 中原大學 / 建築(工程)學系 / 83 / "地理"即是我們一般通稱的風水, 因為風水在臺灣民眾的認知中指的是墳 墓的風水, 因此本論文使用地理一詞來代表本文所探討之聚落與建築物的 風水。在臺灣有關聚落的研究中, 風水常被視為迷信而忽略不談, 直到近 年來才逐漸受到重視, 許多研究者發現聚落中的宅屋、廟宇及村落配置均 受到風水說法的影響. 但至目前為止並沒有專章探討風水之運用與影響 者,本論文即是以此為目的, 並以澎湖傳統聚落為對象, 透過田野調查、 現地觀察、地圖判讀等方式, 以全島、村落、建築三個層次來探討風水在 澎湖社會的應用及其對聚落空間的影響.透過上述三個層次的探討, 本論 文發現風水在澎湖社會的應用是廣泛的, 但其運用並非是全面而獨立的, 會因其所處的環境與目的之異同而有不同的考量並運用不同的風水觀念; 在全島的層次中, 風水特別為官方與學者所重視, 尤其是巒頭派風水中的 龍脈說法; 在村落層次所運用的風水觀念仍以巒頭派風水為主, 但特別重 視的是村落後方的靠山與前方的案山 , 此外, 村落內由神明指示的風水 設施與外圍的厭勝物均具有風水作用,此部份的風水則與民間信仰結合, 具有神秘的色彩; 在建築物層次所用的風水觀念中除了巒頭派風水外, 還 有向法風水與陽宅禁忌, 其中包含民間常用的流年、八字等擇向法則以及 各類的沖射禁忌, 對建物之內外部空間有重大影響.本論文之結論認為風 水觀念對澎湖聚落空間有以下八點影響: 1.風水成為聚落與建築物擇址的 準則之一, 2.風水決定村落與建築物的朝向, 3.風水影響了建築物平面格 局、匠師施作方式與門向, 4.風水間接影響了建築物興建的時間與尺度, 5.風水觀念影響了建築物興建過程中的儀式行為 , 6.風水影響了村落的 配置與成長, 7.風水影響了全島與村落的景觀, 8.風水間接影響了居民對 空間的認知.

Résumé Cette thèse est le rassemblement, par blocs homogènes, de notes d’orientation, de présentations orales, de textes variés, rédigés pour des revues scientifiques, comme chapitres de livres, pour des colloques ou des congrès, pour divers décideurs politiques, des années 80 à ce jour. Son but est de montrer leur cohérence avec un fil conducteur commun : le développement d’outils conceptuels et méthodologiques utiles pour la pratique de la médecine générale en particulier, pour le système de dispensation des soins plus globalement. L’impact espéré est une amélioration de la qualité des soins dispensés, à l’échelle individuelle (relation soignant/soigné) ou à l’échelle collective (système de santé). Les différents blocs se succèdent dans l’ordre suivant : q Chapitre 1 : Introduction. Bloc 1 : Concepts philosophiques q Chapitre 2 : La transdisciplinarité. Concept transcendant la multidisciplinarité (simple juxtaposition indépendante de différentes approches disciplinaires), l’interdisciplinarité (pénétration de différentes disciplines pour éclairer plus complètement un même phénomène) pour arriver à une compréhension globale et homogène où chaque discipline utilise des éléments des autres pour pallier ses manques et ses limites. q Chapitre 3 : La plainte, du normal au pathologique. Développements philosophiques et scientifiques, en complémentarité et en prise directe sur la réalité clinique, sur le normal et le pathologique, le moyen et le divergent, etc. q Chapitre 4 : Les quatre formes de la prévention. Prolongation du texte précédent, en définissant les trois formes classiques de la prévention (primaire au stade « normal », secondaire au stade pathologique mais pré-clinique, et tertiaire au stade clinique), et en introduisant le concept nouveau de prévention quaternaire, ou protection de la population et du système de soins de l’angoisse des soignés et des soignants. q Chapitre 5 : Critique et autocritique du principe de classification. Développement sur les nécessités contradictoires de l’homogénéité et de la complétude (donc du respect de toutes les nuances et de toutes les spécificités), et de la réduction et du traitement de l’information (donc de la prise en compte du classement et des catégorisations). Bloc 2 : Concepts politiques q Chapitre 6 : Les problèmes d’environnement en relation avec la santé. Rapport d’une recherche destinée à élaborer un outil opérationnel à l’usage des médecins généralistes, pour les aider à être sensibilisés aux problèmes d’environnement en relation avec la santé, à diagnostiquer les plus fréquents et les plus importants d’entre eux, et à les prendre en charge de manière non spécialisée. q Chapitre 7 : Faim de travail, fin de la santé. A partir de chiffres concrets, démonstration du lien entre morbidité/mortalité et statut socio-économique. Selon les temps et les lieux, les profils épidémiologiques sont différents, mais ce sont toujours les mêmes populations (position socio-économique basse dans la société, stress professionnel lié à la hiérarchie) qu’on retrouve dans le bas des échelles. q Chapitre 8 : L’éducation à la santé à la Maison Médicale de Forest. Rapport de 15 ans d’éducation et de promotion de la santé dans une maison médicale, sous différents angles (clinique, opérationnel, conceptuel, culturel etc). q Chapitres 9, 10, 11 et 12 : Les soins de santé de 1ère ligne ; Synthèse et communication, ou les fonctions de base de la médecine de famille ; Proposition « martyr » pour une restructuration de la 1ère ligne à Bruxelles ; Mise sur pied d’un centre pilote « urgences » ambulatoire. Plusieurs notes d’orientation proposant quelques modèles théoriques de systèmes de dispensation des soins, basés sur certains principes tels division en niveau de soins, filières de soins, intégration de l’ambulatoire et de l’hospitalier, prise en compte des spécificités des grandes métropoles, des problèmes liés à l’accessibilité et aux urgences. q Chapitre 13 : Les systèmes locaux de santé (SyLoS) : un élément de réponse à la crise du secteur de santé en Belgique ? Proposition, mise sur pied et évaluation de petites unités fonctionnelles de proximité, constituées de soignants intra- et extra-hospitaliers, dans un objectif commun d’amélioration de la qualité des soins, en partant de situations réellement vécues et ayant posé problème. q Chapitre 14 : Le financement forfaitaire à la capitation : une alternative au traditionnel payement à l’acte ? Revue de la littérature internationale sur les systèmes de financement des soins dans une vingtaine de pays différents. Démonstration des limites et des perversions du payement à l’acte intégral. Proposition d’un système de financement global mélangeant payement à l’acte, payement par forfait à la capitation, payement à l’objectif, payement structurel, payement par le patient. q Chapitre 15 : Les pratiques solo dispensent-elles des soins de moins bonne qualité ? Critiques et commentaires d’un article du BMJ sur le sujet. Tentative de réponses au départ d’éléments organisationnels, statistiques et épidémiologiques. Bloc 3 : Concepts relatifs à la pratique clinique q Chapitres 16 et 17 : L’assurance de qualité et le médecin de famille ; Les critères de qualité : tout le monde en parle. Synthèse théorique sur l’assurance de qualité en soins primaires. Définition des concepts de base : critères de qualité, standards et objectifs, méthodes, évaluation et indicateurs, limites et problèmes. q Chapitre 18 : Système de santé, système d’information et méthodes d’évaluation. Structuration du dossier médical global du médecin généraliste, positionnement dans les filières cliniques et de dispensation des soins, utilité pour l’auto-évaluation, la formation, la connaissance scientifique, l’assurance de qualité et la décision politique. q Chapitre 19 : La CISP, concepts généraux et développements. Construction de la Classification Internationale des Soins Primaires, version initiale. Nouveaux principes classificatoires développés au départ des limites de la CIM (Classification Internationale des Maladies) de l’OMS, utilisée dans les dossiers hospitaliers. Apports de la nouvelle (2e) version, CISP-2. Extension des classifications vers les thesaurus (LOCAS et TB3), au travers du transcodage CISP/CIM. q Chapitre 20 : L’approche par problèmes et les éléments du SOAP. Description de l’approche par épisodes (en lieu et place de la notion classique de diagnostics) et de l’analyse de la relation soignant/soigné dans ses quatre dimensions (subjectif, objectif, appréciation et planification). q Chapitre 21 : Structuration du dossier médical électronique : concepts et histoire. A partir des notions cliniques de problèmes et de SOAP, élaboration et explicitation d’un nouveau modèle de dossier médical informatisé, constitué de la relation entre 7 éléments structurants (élément de soins, démarche, contact, sous-contact, service, dispensateur, temps). Ce nouveau modèle est la base du label des logiciels médicaux électronique belges. q Chapitre 22 : Casuistique appliquée. Application à vocation pédagogique du précédent modèle, à partir de deux cas cliniques exemplatifs. q Chapitre 23 : Le DUSOI/Wonca, un indice de gravité pour la médecine générale. Outil développé par la Wonca pour évaluer la gravité de l’état de santé d’un patient à un moment donné au cours de son évolution clinique, évaluation à la fois ponctuelle et diachronique. Application pratique à plusieurs situations réelles. q Chapitre 24 : Evaluation de l’état fonctionnel : les cartes COOP/Wonca. Outil également développé par la Wonca pour l’auto-évaluation fonctionnelle des patients. Il s’agit d’un jeu de 6 cartes représentant graphiquement dans un langage universel l’état de santé somatique, mentale et sociale, de manière à la fois ponctuelle et longitudinale, évalué par le patient lui-même. q Chapitre 25 : Valeurs, paradigmes et recherche en médecine générale. Comparaison des concepts fondamentaux de la recherche traditionnelle, de la recherche opérationnelle et de la recherche action. Intérêt relatif de chacun de ces types de recherche pour des questions et des situations spécifiques, de même que pour l’utilisation des méthodes quantitatives ou qualitatives. q Chapitres 26 et 27 : La CISP et le système SOAP, des outils pour bien décider dans l’incertitude (application à la clinique de la céphalée en médecine de famille) ; « Docteur, j’ai mal au genou », le point de vue du généraliste. Applications à la connaissance scientifique et à la pratique clinique des différents concepts développés dans les chapitres précédents à partir de deux situations fréquentes : les céphalées et les douleurs du genou. q Chapitre 28 et 29 : Vous vouliez des statistiques ? Statistiques Maison Médicale Santé Plurielle 2003. Méthode d’analyse des différentes données disponibles dans une maisons médicale, recueillies systématiquement en temps réel pendant l’activité clinique. Démonstration de son intérêt pour l’auto-évaluation de l’institution, son pilotage cohérent, et les rapports avec le politique. Les chiffres sont des chiffres et seulement des chiffres. Ils doivent être compris, contextualisés, critiqués, commentés et rendus utiles dans leur situation locale spécifique, mais aussi comme partie d’un paquet plus global de données épidémiologiques. q Chapitre 30 : Le bilan biologique de base, un examen inutile ? Définition critique « evidence-based medicine » des examens biologiques de routine de dépistage. q Chapitre 31 : Un projet d’assurance de qualité « diabète » à la Maison Médicale Santé Plurielle. Compte-rendu de l’expérience d’un programme d’assurance de qualité multidisciplinaire dans une maison médicale. Définition opérationnelle d’une série d’indicateurs, évaluation de ceux-ci avant et après le programme. Apports et limites de l’expérience. et q Chapitre 32 : Conclusion. Trente et un chapitres, c’est beaucoup. Et en même temps, c’est très peu : la médecine générale se pratique dans un contexte radicalement différent de ce qu’il était il y a moins de 50 ans. Si elle ne redéfinit pas clairement son rôle et ses outils, elle risque donc de se replier dans des positions défensives et passéistes qui, si elles sont nécessaires face à la médicalisation et à la spécialisation croissantes, ne suffisent cependant pas pour expliciter et faire reconnaître sa spécificité. Rappelons que celle-ci réside essentiellement dans la complexité, puisqu’il s’agit d’aborder l’humain à la fois sur le plan individuel, dans une approche bio-médicale et psychodynamique, et sur le plan collectif, en terme de santé publique, et en faisant appel à diverses disciplines telles que la sociologie, l’anthropologie, l’ethnomédecine. Au fil de ma pratique, j’ai ressenti la nécessité de construire, en dehors du champ bio-médical qui reste la référence essentielle au niveau du savoir académique, des outils spécifiques permettant d’augmenter la qualité des soins primaires. Les outils présentés au fil de cette thèse ont été élaborés dans un constant aller-retour entre la théorie et la pratique, et selon un cheminement traversant plusieurs disciplines. Certains de ces outils sont de type conceptuel, comme la transdisciplinarité, la prévention quaternaire, d’autres sont d’ordre méthodologique, la structure du dossier médical, le SyLoS, les classifications et le thésaurus, le carnet de bord. Tous ces outils visent à baliser la démarche du médecin généraliste, à lui donner des repères théoriques et pratiques à même de le guider dans la complexité des situations qu’il rencontre, le but ultime étant de soutenir une pratique de qualité respectant la singularité des histoires, des sujets rencontrés. Ces outils spécifiques ont été testés sur le terrain ; ils sont actuellement utilisés et intégrés par des médecins généralistes et d’autres professionnels des soins de santé primaires. Leur faisabilité et leur utilité pour améliorer la qualité des soins semblent donc démontrées, mais aussi certaines difficultés d’implantation puisqu’ils engagent les soignants dans une démarche réflexive, les amenant à se questionner sur le sens et l’efficacité de leurs pratiques, pour mieux les évaluer. Summary This thesis is the gathering, through homogenous blocks, of orientation’s notes, oral presentations and various texts, written for scientific journals, as book chapters, for colloquiums or conferences, for different political decision-makers, from the 1980s up until today. The goal is to demonstrate their coherence with a common direction: the development of conceptual and methodological tools for the practice of general medicine in particular, for the system of care-giving more globally. The hoped impact is an improvement of care quality, provided at the individual level (relationship care-receiver/care-giver) or at the collective level (health system). The different blocks are organized according to the following order: q Chapter 1 : Introduction. Block 1 : Philosophical concept q Chapter 2: Trandisciplinarity. Concept transcending the multidisciplinarity (simple juxtaposition independent from different disciplinary approaches) and the interdisciplinarity (penetration of different disciplines to more fully enlighten the same phenomenon) to reach a more global and homogenous understanding where disciplines use each others’ elements to overcome their own lacks and limitations. q Chapter 3: The complaint, from normal to pathological. Philosophical and scientific developments, complementing and directly connecting with the clinical reality, the normal and pathological, the average and the diverging, etc. q Chapter 4: The 4 forms of the prevention. Prolongation of the above-mentioned text, by defining the three classical forms of the prevention (primary at the “normal” stage, secondary at the pathological but pre-clinical stage and tertiary at the clinical stage), and by introducing the new concept of quaternary prevention, or protection of the population and the health system from the anguish of the care-receivers and givers. q Chapter 5: Criticism and auto-criticism of the principle of classification: Elaboration on the contradictory necessities of the homogeneity and completeness (thus of the respect of all the differences and specificities), and of the decrease and the treatment of the information (thus of the taking into account of the ranking and the categorizations). Block 2 : Political concepts q Chapter 6: The environmental problems relating to health. Report of a research aiming at elaborating an operational tool for the use of general practitioners, to help them become sensitive to environmental problems relating to health, to diagnose the most frequent and most important among those, and to take them over in a non-specialized manner. q Chapter 7: Hunger of work, end of health. From concrete numbers, demonstration of the link between morbidity/mortality and the socio-economical status. According to the times and locations, the epidemiological profiles are different but the same populations (low socio-economical position in the society, professional stress due to the hierarchy) are always found at the bottom of the ladders. q Chapter 8: Health education at the “Maison Médicale” of Forest. Report of 15 years of health education and promotion in a primary care health centre, from different angles (clinical, operational, conceptual, cultural etc.). q Chapters 9, 10, 11 and 12: First line health care; Synthesis and communication, or the basic functions of family medicine; “Martyr” proposition for the restructuring of the first line in Brussels; Establishment of a pilot ambulatory “emergency” center. Several orientation’s notes offering different theoretical models of care-providing systems, based on certain principles such as division into care levels, care networks, integration of the ambulatory and hospital, taking into account the specificities of large metropolises, of the problems related to the accessibility and to the emergencies. q Chapter 13: Local systems of health: a partial answer to the crisis of the health department in Belgium? Proposal, establishment and evaluation of small functional proximity units, consisting of intra- and extra-hospital care-givers, with the common goal of enhancing the quality of care, originating from real-life situations that have been problematic. q Chapter 14: Fixed financing by capitation: an alternative to the traditional fee for service payment? Review of the international literature about care financing systems in about twenty different countries. Demonstration of the limits and perversions of the integral fee for service payment. Proposal of a global financing system combining fee for service payment, fixed payment by capitation, target payment, structural payment, payment by the patient. q Chapter 15: Do solo practices provide less quality care? Criticisms and commentaries of a BMJ article on the topic. Attempt of an answer based on organizational, statistical and epidemiological elements. Block 3: Concepts related to clinical practice q Chapters 16 and 17: Quality insurance and the family doctor; Quality criteria: everybody speaks about it. Theoretical synthesis on quality insurance in primary care. Definition of the basic concepts: quality criteria, standards and objectives, methods, evaluation and indicators, limits and problems. q Chapter 18: Health system, information system and evaluation methods. Structuring the global medical record of general practitioners, positioning in the clinical and care-providing networks, use for the auto-evaluation, the formation, the scientific knowledge, the quality insurance and the political decision. q Chapter 19: ICPC, general concepts and developments. Construction of the International Classification of Primary Care, initial version. New classifying principles developed out of the limits of the ICD (International Classification of Diseases) of the WHO, used in hospital records. Contributions of the new (2nd) version, ICPC-2. Extension of the classification towards the thesaurus (LOCAS and TB3), through transcoding ICPC/ICD. q Chapter 20: Approach by problems and elements of the SOAP. Description of the approach by episodes (instead of the classical notion of diagnostics) and the analysis of relationship care-receiver/care-giver in the four dimensions (subjective, objective, appreciation and planning). q Chapter 21: Structuring of the electronic medical record: concepts and history. From the clinical notions of problems and SOAP, elaboration and clarification of a new model of computerized medical record, consisting of the relationship between 7 structuring elements (element of care, approach, contact, sub-contact, service, provider, time). This new model is the base for the label of Belgian electronic medical softwares. q Chapter 22: Applied casuistic. Application with pedagogical vocation of the former model, based on two exemplary clinical cases. q Chapter 23: The DUSOI/Wonca, a gravity index for the general practice. Tool developed by the Wonca to evaluate the gravity of a patient’s health status at a given moment in the course of his/her clinical evolution, evaluation both punctual and diachronic. Practical application to several real-life situations. q Chapter 24: Evaluation of the functional state: The COOP/Wonca cards. Tool also developed by the Wonca for the functional auto-evaluation of patients. It consists of a game of 6 cards graphically representing in a universal language the somatic, mental and social health state, both punctually and longitudinally, evaluated by the patient him/herself. q Chapter 25: Values, paradigms and research in general practice. Comparison of the fundamental concepts of the traditional research, the operational research and the action research. Relative interest of each of these research types for specific questions and situations, as well as for the use of quantitative and qualitative methods. q Chapter 26 and 27: The ICPC and the SOAP system, tools to well decide in uncertainty (application to the headache in family medicine); “Doctor, my knee hurts”, the view point of the general practitioner. Applications to the scientific knowledge and to the general practice of the different concepts developed in the previous chapters based on two frequent situations: the cephalalgia and the knee pains. q Chapters 28 and 29: Did you want statistics? Statistics “Maison Médicale Santé Plurielle 2003”. Method of analysis of the various data available in a primary care health centre, systematically collected in real-time during the clinical activity. Demonstration of its interest for the institution’s auto-evaluation, its coherent piloting, and the relationship with the politics. Numbers are numbers and only numbers. They have to be understood, contextualized, criticized, commented and made useful in their specific local situation, but also as part of a more global package of epidemiological data. q Chapter 30: The basic biological assessment, a useful exam? Critical definition evidence-based medicine of the routine screening biological exams. q Chapter 31: A project of “diabetic” quality insurance at the “Maison Médicale Santé Plurielle”. Report of the experience of a multidisciplinary insurance quality program in a primary care health centre. Operational definition of a series of indicators, evaluation of the latter before and after the program. Contributions and limits of the experience. and q Chapter 32 : Conclusion. Thirty-one chapters, it is a lot. And at the same time it is very little: general practice is carried out in a radically different context than it was less than 50 years ago. If it does not clearly redefine its role and tools, there is a risk for it to fall back to defensive and passeist positions which, even though they are necessary facing the increasing medicalization and specialization, are nevertheless not enough to explain its specificity and make it acknowledged. Let us remember that the latter resides essentially in complexity, since it consists of dealing with the human being at the individual level, in a bio-medical and psychodynamic approach, and at the collective level, in terms of public health, and by bringing in various disciplines such as sociology, anthropology, ethno-medicine. In the course of my practice, I felt the need to construct, outside of the bio-medical field which remains the essential reference at the level of the academic knowledge, specific tools allowing to increase the quality of primary care. The tools presented throughout this thesis have been elaborated through a constant back and forth between theory and practice, and according to a path crossing several disciplines. Some of these tools are conceptual, such as the transdisciplinarity and the quaternary prevention, others are methodological, such as the structure of the medical record, the SyloS, the classifications and the thesaurus, the logbook. All these tools are meant to mark out the approach of the general practitioner, to give him some theoretical and practical points of reference able to guide him in the complexity of the situations he encounters, the ultimate goal being to maintain a practice of quality respectful of the singularity of encountered stories and subjects. These specific tools have been tested in the field; they are currently used and integrated by general practitioners and other professionals of primary health care. Their feasibility and use to enhance the quality of care seemed therefore demonstrated, as well as some implantation difficulties, since it engages the care-providers in a reflexive approach, leading them to question the meaning and efficacy of their practices, to better evaluate them.

Orientador: Sanae Kasahara / Banca: Guaracy Tadeu Rocha / Banca: Ives José Sbalqueiro. / Banca: Orlando Moreira Filho / Banca: Alejo Mesa Larrambebere. / A data da defesa é 20/02/2006, sendo a entrega do original em dezembro de 2000 / Resumo: Foram coletados exemplares roedores de pequenos porte em diversas localidades do estado do Tocantins, distribuídas em 3 tipos de região de acordo a vegetação predominante: Norte sob a influência da Floresta Amazônica, Centro-Sul e Leste sob influência do Cerrado e Médio Araguaia constituído pelo complexo da Ilha do Bananal. As preparações cromossômicas foram submetidas à coloração convencional, assim como às técnicas de bandas G, C e RON. Diferenciação cromossômica foi produzida nos cromossomos de alguns indivíduos, após tratamento das células com brometo de etídio. Foram cariotipados um total de 102 exemplares distribuídos em 9 gêneros e 12 espécies: Bolomys lasiurus (2n=34 e NA=34), Calomys tener (2n=66 e NA=66), Calomys sp.n. (2n=46 e NA=66), Nectomys rattus (2n=52, 53 e NA=52, 54), Oligoryzomys flavescens (2n=64 e NA=66), Oligoryzomys sp.n. (2n=70 e NA=76), Oryzomys megacephalus (Cariótipo A com 2n=54 e NA=62; Cariótipo B com 2n=52/53 e NA=58/60), Oryzomys gr. subflavus (2n=46 e NA=56), Rhipidomys macrurus (2n=44 e NA=48), pertencentes à família Cricetidae; Proechimys roberti (2n=30 e NA=54), Trichomys apereoides (2n=30 e NA=54), pertencentes à família Echimyidae; e Rattus rattus (2n=38 e NA=58), pertencente a família Muridae. Da espécie Oecomys gr. concolor, não obtivemos preparações cromossômicas. A grande maioria das espécies tem ocorrência relatada para as regiões Norte e Centro-Oeste do Brasil e a respectiva cariologia já é conhecida. Observa-se que os cariótipos encontrados são, de maneira geral, similares ou idênticos àqueles descritos na literatura, com raros casos de polimorfismos cromossômicos. Alguns exemplares da (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Small rodents were collected at different sites in the state of Tocantins, distributed into three types of region according to the predominant vegetation: North, under the influence of the Amazon Forest, Mid-South and East under the influence of the Cerrado, and Middle Araguaia consisting of the complex of Bananal Island. The chromosomal preparations were submitted to conventional staining, as well as to G, C and NOR banding techniques. Chromosome differentiation was produced in the chromosomes of some individuals, after cell treatment with ethidium bromide. A total of 102 specimens were karyotyped, and they were distributed into 9 genera and 12 species: Bolomys lasiurus (2n=34 and NA=34), Calomys tener (2n=66 and NA=66), Calomys sp.n. (2n=46 and NA=66), Nectomys rattus (2n=52, 53 and NA=52, 54), Oligoryzomys flavescens (2n=64 and NA=66), Oligoryzomys sp.n. (2n=70 and NA=76), Oryzomys megacephalus (Karyotype A with 2n=54 and NA=62; Karyotype B with 2n=52/53 and NA=58/60), Oryzomys gr subflavus (2n=46 and NA=56), and Rhipidomys macrurus (2n=44 and NA=48), belonging to the family Cricetidae; Proechimys roberti (2n=30 and NA=54) and Trichomys apereoides (2n=30 and NA=54), belonging to the family Echimyidae, and Rattus rattus (2n=38 and NA=58), belonging to the family Muridae. Chromosome preparation from Oecomys gr. concolor were not obtained. The majority of the species have been reported to occur in the Northern and Mid-Western regions of Brazil and their karyology is already known. The...(Complete abstract click electronic access below) / Doutor

Orientador: Antonio Vicente Marafioti Garnica / Banca: Heloíza da Silva / Banca: Luzia Aparecida de Souza / Banca: Maria Laura Gomes / Banca: Arlete Brito / Resumo: Neste trabalho pretendemos constituir uma história da formação de professores de matemática e dos primeiros cursos que preparavam estes profissionais no Estado do Tocantins. A pesquisa aborda a estrutura física dos estabelecimentos, o perfil de discentes e docentes, as disciplinas ministradas, as motivações políticoadministrativas e sociais que influenciaram a criação e desenvolvimento dos cursos, as principais práticas de formação, dentre outros aspectos. Valendo-se da História Oral como alternativa metodológica central e mobilizando fontes escritas disponíveis, constituímos uma análise narrativa em que se entrelaçam situações particulares do contexto educacional tocantinense, a criação do próprio estado, o processo de migração de professores, as influências políticas, o improviso na condução de cursos, as carências, urgências e transitoriedades que marcam a formação de professores de Matemática no Estado / Abstract: The goal of this work is to build a history of the undergraduate programs whose main objective is the formation of Math teachers in Tocantins State, Brazil. The research discusses the physical structure of these courses, the academic profile of their students and teachers, the curricular content and approaches, the administrative and political motivations that influenced the creation and development of the first courses, the formative practices, among other elements related to these institutions. The methodological approach was based on Oral History as well in the analysis of written documents available. The data collected allowed us to create a narrative in which some particular events are focused in order to bring to the light the creation of Tocantins, its educational context, the migration of teachers, all sorts of political influences, the improvisation in the process of creating and developing such courses, the urgencies, needs and transitoriness that characterizes the formation of mathematics teachers in that State / Doutor

The term equivalence comes from the Latin word "aequivalentia" and means equivalence. "Aequus" stands for equal and "valere" for worth. So two objects are equivalent if they have the same value. Equivalence plays an important role in translation science. "Translation science deals with the process of translation, i.e. the process that leads from a written source language text (ST text) to a written target language text (TL text), the translation Therefore, a TL (target language) text must be equivalent to the original ST (source language) text. However, a perfect equivalent transmission of the message in the target language is not always so easy to achieve, because languages differ at different levels. The languages reflect your own culture, way of seeing, expression, grammar and syntax. When you try to adapt these elements to a new language, it often happens that the equivalence is not achieved due to this heterogeneity and diversity. If you don't achieve them, it is not a translation but a text reproduction or text production that is not the same is worth to the original text. That is why the search for real equivalence has occupied various translators and scientists for years. They have defined various equivalence criteria that can be helpful for an accurate translation. For all these reasons, it is essential to achieve the correct equivalence when translating. This thesis researches the concept of equivalence in order to better understand it and then use it in practice, namely when translating.