Borderline Personality Disorder (BPD) is a major health problem and is associated with considerable psychosocial distress and impairment, resulting in a high degree of morbidity and a significant impact on the mental health system. Patients with BPD are difficult to treat clinically, the main issue being engaging the patient and then maintaining the relationship. Patients with BPD constitute 10-20% of psychiatric inpatients, utilise a large amount of mental health resources and have a 10% successful suicide rate. Therefore, it is essential that attention is given to improving effectiveness of treatment approaches for patients with BPD, including engagement. The purpose of the study was to explore and describe the lived world of patients with BPD in order to develop supporting guidelines to improve non-compliance of patients with BPD. The objective of the study was to develop guidelines to improve compliance, which is expected to minimise self-harm risks and improve the quality of the patients’ lives. A qualitative, phenomenological methodology was chosen because it is particularly well suited to study human experiences of health (LoBiondo-Wood & Haber, 2011:141). It is a design that emphasizes discovery through interpreting meaning as opposed to quantification and prediction. Understanding and interpretation of data was thus the hallmark of the research design. This phenomenological study examined human experiences through the descriptions provided by the people involved, i.e. lived experiences. Data collection was done using recorded interviews guided by a semi-structured interview schedule. Memos collected during interviews supplemented the data. Data analysis was hallmarked by constant comparison, contextualisation and description of emerging themes. The main findings, described in three main themes, were the importance of the relationship with the clinician, the overwhelming feelings experienced by the patients and the sense of futility in treatment. These were all linked to the lack of hope the patient felt regarding their clinician, ever being able to manage their continuously oscillating emotions and the purpose of treatment. The findings led to the construction of guidelines to foster initial and continued engagement in treatment with patients with BPD. The guidelines covered issues of clinical practice and management input. / Health Studies / D. Litt. et Phil. (Health Studies)

The study was aimed at assessing perceptions of local communities on the use of coastal natural resources in Coffee Bay and the “Hole in-the Wall” area. The environmental impact caused by non–compliance with environmental legislation was also assessed. Data was obtained through interviews conducted with members of 50 households chosen randomly and questionnaires that were distributed to government departments in charge of the resources. The study found that due to high illiteracy and unemployment in the area, people were compelled to use the available coastal natural resources to satisfy their basic needs. About 70% of them were aware of the legislation but felt they could not comply with it since they had not been consulted. The study’s recommendations are that the community should be consulted on legislation, more environmental awareness campaigns should be conducted and government plans should be aligned in terms of service delivery / Environmental Sciences / M.Sc. (Environmental Management)

Made available in DSpace on 2016-06-02T19:44:14Z (GMT). No. of bitstreams: 1 5134.pdf: 3904591 bytes, checksum: 196f7357f34d96d134a0ae6d9483aa8f (MD5) Previous issue date: 2013-03-05 / The literature has pointed to an increase in the incidence of children with visual impairments associated with neurological disorders and other disabilities, but the educational implications of the association of such impediments is considered a minor theme in the training of special education teachers. The present study aimed to develop and evaluate a collaborative consultation program in the field of visual impairment with a team of professionals of a special school for students with intellectual disabilities. The participants were the research/consultant, five teachers, two class assistants, a speech therapist, a physical therapist, a psychologist and an occupational therapist, plus 46 students with ages between 7 and 37 years. The study was carried out in three stages: preliminary step of conducting ethical procedures; Study-1, the diagnosis of institutional conditions; and Study-2, the intervention. The latter involved: a) theoretical training of 35 hours of lessons; b) practice based on case studies based on the development of a visual evaluation process of students, with the purpose of raising subsidies for educational planning and to apply the theoretical knowledge in practice; and c) final evaluation of the consultation/training program. The results of student s characterization showed that 30.4% were diagnosed with cerebral palsy; 30.4% with intellectual disabilities; 19.6% with Down syndrome, and 19.6% with other diagnoses. 83% of the students have already been through ophthalmological inspection with an average age of 4.2 years in first query. Two students were diagnosed with optic nerve atrophy and congenital cataracts, which was not reported by the parents to the school. As for the observation of visual difficulties, the parents have made 11 references, whereas the professionals made only 3. The results of the evaluation process of visual changes, duly complemented by medical information, were: 16 students (34.8%) showed no detected changes; 20 (43.5%) with minor changes (strabismus, refraction errors); 3 (6.5%) with visual impairment of ocular origin; 3 (6.5%) with cortical visual impairment; 1 (2.1%) with ocular and cortical visual impairment; and 3 (6.5%) with suspicion of visual impairment. The visual impairment was predominant among the cases of cerebral palsy. The case studies resulted in referrals to ophthalmological consultations, guidance to parents, propositions of pedagogical strategies, in addition the adjustment of materials and environment. The results concerning the evaluation of the collaborative consultation program showed that it was satisfactory regarding the professional development of the consultant and the consultees and regarding the possibilities of solving the addressed problem. The study highlights the need of ophthalmic and visual development assessment among students with intellectual and multiple disabilities and emphasizes the importance of collaborative practice between specialists, family and school professionals to an understanding of the problem of a student with visual impairment associated with intellectual or multiple disabilities. In addition, it suggests the need of a support network for teachers of special education, of generalist formation, what also includes teachers specialized in the visual impairment area, as well as other professionals with technical knowledge. / A literatura tem apontado um aumento na incidência de crianças com deficiência visual associada a distúrbios neurológicos e a outras deficiências, sendo as implicações educacionais da associação desses impedimentos um tema pouco considerado na formação dos professores de educação especial. O presente estudo teve como objetivo desenvolver e avaliar um programa de consultoria colaborativa na área da deficiência visual junto a uma equipe de profissionais de uma escola especial para alunos com deficiência intelectual. Foram participantes o pesquisador/consultor, cinco professoras, duas auxiliares de classe, uma fonoaudióloga, uma fisioterapeuta, uma psicóloga e uma terapeuta ocupacional, além de 46 alunos, de 7 a 37 anos. O estudo foi desenvolvido em três etapas, a saber: Etapa Preliminar de condução dos procedimentos éticos; Estudo 1, do diagnóstico das condições institucionais; e Estudo 2 da intervenção. Esta última envolveu: a) formação teórica de 35 horas/aula; b) parte prática baseada em estudos de casos através do desenvolvimento de um processo de avaliação visual dos alunos com a finalidade de levantar subsídios para o planejamento pedagógico e de aplicar na prática os conhecimentos teóricos; e c) avaliação final do programa através de análise de conhecimentos pré e pós-programa, entrevista e avaliação quantitativa pelos profissionais. Os resultados de caracterização dos alunos mostraram 30,4% com diagnóstico de paralisia cerebral; 30,4% com deficiência intelectual; 19,6% com síndrome de Down, e, 19,6% com outros diagnósticos. Haviam realizado consulta oftalmológica, 83,0% dos alunos, com uma média de idade da primeira consulta de 4,2 anos. Dois alunos tiveram diagnóstico de atrofia de nervo óptico e um de catarata congênita, que não foi comunicada pelos pais à escola. Quanto à observação de dificuldades visuais os pais fizeram 11 referências, enquanto os profissionais apenas três. Os resultados da avaliação das alterações visuais dos alunos complementada por informações médicas identificaram: 16 alunos (34,8%) sem alterações detectadas; 20 (43,5%) com alterações leves (estrabismo, erros de refração); três (6,5%) de deficiência visual de origem ocular; três (6,5%) de deficiência visual cortical; um (2,1%) com deficiência visual ocular e cortical; e três (6,5%) com suspeita de deficiência visual. A deficiência visual foi predominante entre os casos de paralisia cerebral. Os estudos de casos resultaram em encaminhamentos para consultas oftalmológicas, orientação aos pais, proposição de estratégias pedagógicas além de adaptação de materiais e ambiente. Os resultados quanto à avaliação do programa de consultoria colaborativa mostraram que foram satisfatórios do ponto de vista do desenvolvimento profissional, de ambas as partes, consultor e consultantes, e quanto às possibilidades de resolução da problemática abordada. O estudo destaca a necessidade da avaliação oftalmológica e do desenvolvimento visual entre alunos com deficiência intelectual e múltipla, e enfatiza a relevância da prática colaborativa entre especialistas, profissionais da escola e família para a compreensão da problemática do aluno com deficiência visual associada à deficiência intelectual ou múltipla. Além disso, sugere a necessidade de uma rede de apoio para os professores de educação especial, de formação, generalista, que inclui também professores especializados na área da deficiência visual, assim como outros profissionais com conhecimentos técnicos.

Submitted by JOACIRA MOTA MATOS SANTOS (joaciramms@gmail.com) on 2018-06-25T17:48:30Z No. of bitstreams: 1 JOACIRA_TA_FINAL_22_06_2018_3.pdf: 969948 bytes, checksum: b466871c53b44e27219e6cfeab1bbb46 (MD5) / Approved for entry into archive by Simone de Andrade Lopes Pires (simone.lopes@fgv.br) on 2018-06-25T20:11:40Z (GMT) No. of bitstreams: 1 JOACIRA_TA_FINAL_22_06_2018_3.pdf: 969948 bytes, checksum: b466871c53b44e27219e6cfeab1bbb46 (MD5) / Approved for entry into archive by Suzane Guimarães (suzane.guimaraes@fgv.br) on 2018-06-26T12:33:20Z (GMT) No. of bitstreams: 1 JOACIRA_TA_FINAL_22_06_2018_3.pdf: 969948 bytes, checksum: b466871c53b44e27219e6cfeab1bbb46 (MD5) / Made available in DSpace on 2018-06-26T12:33:20Z (GMT). No. of bitstreams: 1 JOACIRA_TA_FINAL_22_06_2018_3.pdf: 969948 bytes, checksum: b466871c53b44e27219e6cfeab1bbb46 (MD5) Previous issue date: 2018-05-25 / Estudo quanti-qualitativo que objetivou avaliar a articulação entre serviços de atenção primária à Saúde e da atenção especializada no cuidado de pacientes hipertensos, na rede de atenção à saúde, no Distrito de Saúde do Campo Limpo do município de São Paulo. Participaram do estudo cento e trinta médicos que atuam em vinte e cinco Unidades Básicas de Saúde, sob a lógica da Estratégia de Saúde da Família. A coleta de dados foi feita por meio de questionário autoaplicado e os dados submetidos à análise quantitativa e de conteúdo temática. Ao analisar os dados, concluiu-se que há uma acentuada fragilidade na integração entre as equipes de saúde da família e os serviços de atenção secundária que atendem os pacientes hipertensos. Os achados permitiram analisar que há ausência de contrarreferência frente às demandas encaminhadas, pressão do paciente para ser encaminhado ao especialista; insegurança do médico generalista, envolvendo problemas na formação ou estratégias de educação continuada; falta de comprometimento, responsabilização das equipes de saúde da família, que ser relacionam a vinculação comprometida; total ausência de pactuação entre os serviços no território que corroboram para escassez de integração entre os serviços e ainda questões culturais relacionadas à desvalorização do médico generalista ou da atenção básica. Foi possível observar um grande interesse dos profissionais da atenção básica em melhorarem a relação com os profissionais da atenção especializada. Foram apresentadas propostas voltadas para criação de espaços coletivos de discussão, revisão de protocolos, alinhamento de fluxos e até mesmo, a incorporação entre os serviços e profissionais de mecanismos tecnológicos para favorecer essa integração no cotidiano dos serviços. A partir da análise dos aspectos limitantes e favorecedores para a articulação entre a atenção primária e a atenção especializada, no cuidado do paciente hipertenso, no território estudado foi possível elencar alguns problemas que devem ser superados, na perspectiva de fortalecer o desempenho da Rede de Atenção à Saúde, como também propor o desenvolvimento de um projeto local para fortalecimento do cuidado do paciente hipertenso em rede. / Quantitative-qualitative study aimed at evaluating the articulation between primary health care services and specialized care in the care of hypertensive patients in the health care network in the Campo Limpo Health District of the city of São Paulo. One hundred and thirty physicians working in twenty-five Basic Health Units participated in the study, under the logic of the Family Health Strategy. The data were collected through a self-administered questionnaire and the data submitted to the quantitative analysis and thematic content. When analyzing the data, it was concluded that there is a marked fragility in the integration between the family health teams and the secondary care services that serve hypertensive patients. The findings allowed us to analyze that there is no counter-referral to the demands submitted, the patient's pressure to be referred to the specialist; general practitioner insecurity, involving training problems or continuing education strategies; lack of commitment, accountability of family health teams, to be related to committed commitment; total lack of agreement between the services in the territory that corroborate to the lack of integration between services and also cultural issues related to the devaluation of the general practitioner or primary care. It was possible to observe a great interest of the professionals of the basic attention in improving the relation with the professionals of the specialized attention. Proposals aimed at creating collective spaces for discussion, protocol revision, alignment of flows and even the incorporation among services and professionals of technological mechanisms were proposed to favor this integration in the daily services. From the analysis of the limiting and favorable aspects for the articulation between the primary care and the specialized attention, in the care of the hypertensive patient, in the territory studied it was possible to list some problems that must be overcome, with a view to strengthening the performance of the Attention Network to Health, as well as to propose the development of a local project to strengthen the care of hypertensive patients in a network.

No description available.

Arabic text / الحمدُ لله الذي أكْرَمَنَا بِنُورالعلمِ المُبَدِّدِ للظُلمات, وعصَمَنا به من الأهواءِ المُرْدِية والآراءِ المُضلة رافع الإصْرَ عنَّا, جاء بالدين الوَسَطِ وحَذَّرَ من الوَكْسِ والشَطَطِ وبعدُ : فإنَّ أحقَ العلومِ بالتَّسْطِيرِ وأنفَسهَا عند الجَمْعِ والتَّحْبِيرِ , تِبْيَان وجهِ الحقِّ فيما تتعَاورهُ الأفهام بالجهلِ تار ة , وتار ة بما عرض لها من الأَوْهَامِ , ومن المهم تَجْديد وتَرْسِيخِ المفاهيم السياسية في ضوء نظام الشريعة الإسلامية, مِفْتَاح الهداية ونَهْجِ السعادة, بل وتصحيحها مما اعْتَراهَا من التشويه والزَّيفِ إذ ذاك من أفضل النوافل وأعظمها نفعا وعائدة, وأوفرها خيرا وفائدة. واعلم أن الناس أصنافٌ مختلفون وأطوارٌ مُتباينون يتقاطعون بالإيثار تابعا ومتبوعا ويتساعدون على أعمالهم آمِرا ومَأْمُور ا , فكان لزاما أن أحرر بحثا للرسالة, وانْصَبَّ الإختيار على السياسة ليوافق المقال الحال, فالإنتفاضات والثورات الشعبية تَتْرَا في دولنا الإسلامية, والمرحلةُ تستلزم المشاركة وتوضيح المفاهيم الشرعية, وجلاء الحقائق وإسْقَاطها على الواقع وتصحيح المسارات, فالرأي العام بين مُوجِبٍ ومُبيحٍ للثورات, وسَاكتٍ ومُطيعٍ لهذه الحكومات. لذلكَ ارتأيتُ أن أُبْحِرَ في خِضمِّ هذه الأمواج الفكرية المُتلاطمةِ , وأُشَمِرَعن ساعدي راجيا أن أبلغ الحقيقة الصائبة, وأُرْشِد القارىء الكريم إلى فَهْمِ السياسةِ الراشدة / Recent political turmoil and developments in the Muslim World have motivated me to present this dissertation aimed at renewing, correcting and deepening an understanding of political concepts in light of the Islamic code. It is thus my endeavour to relate them to current reality as I perceive it. A primary concern that I address herein are debates revolving around political rebellion; namely, their permissibility or the need to remain sycophantic towards prevailing political authorities. / Religious Studies and Arabic / M.A. (Islamic Studies)

No description available.

Ce mémoire vise à mieux comprendre les débats politiques concernant la participation des peuples autochtones à la prise de décision en matière de développement du territoire et des ressources dans le contexte de l’évaluation d’impact au Canada. Si l’évaluation d’impact est perçue comme un mécanisme au sein duquel se matérialisent les droits autochtones (dont l’obligation de consulter de la Couronne), les principaux acteurs de ces processus (gouvernement fédéral, promoteurs des projets et groupes autochtones) ne semblent pas s’entendre sur la signification et la portée des normes en matière de participation autochtone, en particulier sur le consentement préalable, libre et éclairé (CPLE). Par une analyse du discours de ces intervenants dans le cadre des travaux parlementaires menant à l’adoption de la Loi sur l’évaluation d’impact (2019), cette recherche révèle trois conceptions principales de la place des Autochtones dans les processus de prise de décision de l’évaluation d’impact : procédurale, partenariale et fondée sur l’autodétermination. Ce mémoire met aussi en évidence d’importantes différences en ce qui concerne les attentes face au modèle de participation et plus spécifiquement sur l’interprétation du CPLE. Ces différences reposent en grande partie sur la façon dont ceux-ci conçoivent l’autorité décisionnelle en matière de gouvernance territoriale au Canada. Pour les intervenants gouvernementaux et autochtones, les conceptions en matière de participation et d’autorité décisionnelle s’appuient sur des fondements juridiques. En revanche, pour l’industrie, la justification de la participation des Autochtones est davantage de nature économique et liée à son impact sur l’approbation des projets. / This thesis aims to better understand the political debates regarding Indigenous peoples’ participation in land and resource decision-making in the context of impact assessment in Canada. While impact assessment is viewed as a mechanism through which Indigenous rights (including the Crown's duty to consult) are realized, the actors in these processes (federal government authorities, project promoters and indigenous groups) do not seem to agree on the meaning and scope of Indigenous participation norms, notably regarding free, prior and informed consent (FPIC). Through discourse analysis of these actors within the framework of the parliamentary work leading to the adoption of the Impact Assessment Act (2019), this research reveals three main conceptions of the place of Indigenous peoples in impact assessment decision-making processes: procedural, partnership and based on self-determination. This thesis also highlights important differences in terms of expectations regarding the type of participation and more specifically on FPIC interpretations. These differences are largely based on how they conceive decision-making authority in matters of territorial governance in Canada. For the government and the Indigenous actors, notions of participation and decision-making authority are based on legal foundations. In contrast, for the industry, the rationale behind Indigenous participation is rather economic and linked to its impact on project approval.

This Inuvialuit ‘story’ revolves around the Inuvialuit uprising and resurgence against government and industrial encroachment, and the self determination efforts to regain sovereignty of traditional territories. This ‘story’ also discusses how meaningful consultation made the Inuvialuit Final Agreement a reality, through which Inuvialuit land rights and freedoms were formally acknowledged and entrenched in the Canadian Constitution. Through meaningful consultation, Inuvialuit have become ‘meaningful participants’ in sustainable and future-making decisions of Inuvialuit nunangat (Inuvialuit lands) and waters, with respect to the Inuvialuit People and natural beings that Inuvialuit depend upon and maintain relationship with. As ‘meaningful participants’, Inuvialuit have the sovereign rights to “make meaning” and carve out a future as a sovereign nation within the country of Canada. This Inuvialuit ‘story’ is told with an informal framework through which it decolonizes academia, while also highlighting Indigenous voice through an Indigenous lens and worldview. The government and industry are called upon to meaningfully consult with Indigenous Peoples who have not only inhabited Turtle Island for millennia, but who have inherent Indigenous rights and freedoms, as Indigenous embodiment and well-being, and temporality and future-making are entangled with homelands. / Graduate

Le Canada se classe parmi les plus grands émetteurs de gaz à effet de serre au monde. Le secteur industriel et celui du transport sont responsables de la majorité de ces émissions qui provoquent des problèmes environnementaux importants. Étant donné qu'une amélioration de l'intensité énergétique constitue une solution envisageable afin de réduire ces émissions, il serait donc important d'analyser sa variation. Le but de notre étude sera de déterminer les principaux facteurs qui peuvent influencer la variation de l'intensité énergétique dans le secteur manufacturier de quatre provinces canadiennes (i.e. le Québec, l'Ontario, l'Alberta et la Colombie-Britannique) entre les années 1976 et 2006. Afin d'y arriver, nous avons développé un modèle de régression linéaire qui a été estimé par la méthode du maximum de vraisemblance, et ce, pour les trois sous-périodes suivantes: 1976-1985, 1986-1999 et 2000-2006. Les résultats de notre étude démontrent que la valeur de la production et le ratio du prix d'énergie sur le prix de la main-d'oeuvre constituent les principales forces motrices de la variation de l'intensité énergétique en l'influençant significativement et négativement. Mots clés : intensité énergétique, efficacité énergétique, secteur manufacturier, émissions, Gaz à effet de serre, facteurs, influence.