Ces dernières décennies, de nouvelles techniques d’anesthésie-analgésie locorégionales ont permis d’améliorer la prise en charge post-opératoire. Cependant, les anesthésiques locaux (AL) exposent les patients à un risque de toxicité systémique potentiellement fatale. La première étude est une étude rétrospective ayant inclus des cas potentiels de toxicité systémique aux AL. Cette étude a montré que, face à l’importante variabilité pharmacocinétique des AL observée, l’interprétation des concentrations est difficile. Sa contribution au diagnostic clinique est limitée aux prélèvements précoces après les signes de toxicité.La deuxième étude porte sur la pharmacocinétique de la lidocaine administrée en anesthésie locale tumescente. Il s’agit de la première description de sa pharmacocinétique dans cette indication. Les concentrations restent faibles pendant la durée de suivi. La modélisation par approche de population a permis de décrire le processus d’absorption systémique de la lidocaine après l’injection d’une solution tumescente. La troisième étude porte sur 10 patientes ayant reçu une infusion cicatricielle de ropivacaine de 40 heures. Il s’agit de la première description pharmacocinétique de l’infusion cicatricielle de ropivacaine dans cette indication. La modélisation a montré que l’absorption systémique de la ropivacaine est retardée et la concentration maximale est atteinte 2 heures après la fin de la perfusion. Les études rapportées dans cette thèse ont exploré les propriétés pharmacocinétiques des AL. L’objectif de ces travaux est de contribuer à une meilleure connaissance des thérapeutiques et de contribuer à une meilleure prise en charge des patients. / New locoregional anaesthetic techniques have permitted an improvement of care. However, local anaesthetics (LA) expose patients to systemic toxicity risks. It is essential to set guidelines for the use of these techniques. A retrospective study includes cases of suspected LA systemic toxicity. Systemic toxicity of LA occur when a large amount of LA reaches the systemic circulation. This thesis shows that the interpretation of plasmatic concentrations remains difficult because of the significant pharmacokinetics variability in the different nervous blocks. The second study deals with the population PK of lidocaine administrated in tumescent local anaesthetic. It is the first description of lidocaine PK is performed in this indication. The lidocaine concentrations remain low during the whole time of the operation. The modelling approach has allowed to highlight the slow systemic absorption process of lidocaine after injection of a tumescent solution. The third study focuses on the PK of ropivacaine administrated via continuous wound infusion in 10 women. It is the first time that the PK of ropivacaine administered using wound infusion is described. The modelling approach shows that systemic absorption of ropivacaine delayed and the maximal serum concentration is reached 2 hours after the end of ropivacaine infusion. These studies explored the PK properties of LA used as an anaesthetic or analgesic drug. The objective of this work is to contribute to a better knowledge of therapeutics and a better handling of patients.

Made available in DSpace on 2016-10-13T14:10:05Z (GMT). No. of bitstreams: 1 Neusa Santos de Souza.pdf: 1114004 bytes, checksum: 32e7e286b1c10a3081475ba2b89d2b65 (MD5) Previous issue date: 2012-03-22 / This work deals with the internationalization of firms belonging to the basic sanitation industry, a typically monopolist activity in which the State, held responsible for the services, may delegate the rights to exploration through public service concessions or other forms of public-private partnership. The general objective of the research is to compare the characteristics of the internationalization of sanitation firms with those foreseen by the selected International Business approaches and models. The research problem is related to the adequacy of established International Business theories to the explanation of idiosyncrasies of the path of internationalization of the firms in the water and sewerage industry. There were selected the Uppsala and the Transaction Costs Theory, the theoretical references having used elements of institutional theory and Industrial Economics, taking the specific market failures of this industry into account. This is a qualitative research, based in documental analysis. Firms selected were: : Veolia, Suez, Agbar, FCC, United Utilities, ACEA, RWE, Saur, Cascal and Biwater, which correspond to the ten largest in the world and they are responsible for roughly one fifth of the world water supply. Propositions verified are related to the pattern of internationalization, which in the sanitation industry is defined more upon specific windows of opportunity and not following the Uppsala pattern; and that the need for knowledge of local markets in host countries makes relevant the conjunction between political-institutional competences with specific technical competences. Propositions were confirmed and, against that background, the analysis suggests inadequacy of some assumptions of dominant theoretical models and the need of further theoretical elaboration so as to provide support to the internationalization process of this kind of firm / Esta dissertação trata da internacionalização de firmas pertencentes à indústria de saneamento básico, atividade tipicamente monopolista em que o Estado, responsável pelos serviços, pode delegar o direito de sua exploração por meio de concessões públicas ou outras formas de parceria público-privada. O objetivo geral desta pesquisa é confrontar as características de internacionalização das empresas de saneamento básico com aquelas previstas nas abordagens e modelos selecionados de Negócios Internacionais. O problema de pesquisa é relativo à adequação das abordagens estabelecidas de Negócios Internacionais na explicação das idiossincrasias do percurso de internacionalização das firmas da indústria de água e saneamento básico. Foram selecionadas a abordagen de Upsalla e a Teoria dos Custos de Transação, sendo que o referencial teórico utiliza elementos da teoria institucional e da Economia Industrial, considerando as falhas de mercado específicas presentes nessa indústria. A pesquisa é de caráter qualitativo, ancorada na técnica de análise documental. As empresas selecionadas são: Veolia, Suez, Agbar, FCC, United Utilities, ACEA, RWE, Saur, Cascal e Biwater, que correspondem às dez maiores do mundo e respondem por cerca de um quinto do fornecimento mundial de água. As proposições verificadas dizem respeito ao padrão de internacionalização, que na indústria do saneamento, é definido mais em função de janelas de oportunidade específicas e não conforme o padrão de Uppsala; e que a necessidade de conhecimento dos mercados locais dos países hospedeiros torna relevante à conjugação de competências de natureza político-institucional com competências técnicas específicas. As proposições foram confirmadas e, com isto, a análise aponta para a inadequação de alguns pressupostos dos modelos teóricos dominantes e para a necessidade de elaboração teórica para suportar a análise dos processos de internacionalização destas empresas.

Myalgic encephalomyelitis (ME), also referred to as chronic fatigue syndrome (CFS), is a symptomatically defined and debilitating condition that presents as a range of physiological and psychological effects. Post-exertional fatigue and ongoing low energy levels are cardinal features. Whilst ME-like conditions have been recognised for at least two hundred years, they have been characterised over recent decades by a fiercely contested debate as to whether aetiology is primarily psychological or physiological. ME sufferers experience profound changes to their self-perception, ability to maintain daily routines and activities and how they are perceived in terms of their capacity to carry out social roles, including illness-status. The contested aetiology results in-part from a climate of dualistic thought and the biomedical model upon which ME is treated and theorised. Whilst the effects of ME on self experience have been investigated from various qualitative and quantitative perspectives, the primary purpose of this thesis is to develop a psychosocial framework from which to explore previously neglected dimensions of the effect of ME on self experience. Developing a psychosocial understanding of ME is in keeping with a turn towards post-Cartesian and non-dualistic thinking. The second interconnected purpose of this thesis is to address the role played by the material environment and objects and to conceptualise their importance and relation to self and how it is affected by ME. This is currently absent in the literature on ME. Developing a psychosocial framework suitable for this purpose rested on a synthesis of Actor Network Theory (ANT) and a psychoanalytically influenced use of metaphor and metonymy. At the heart of this synthesis are the notions of relational ontology (Latour, 1997; DeLanda, 2002) and assemblage (Deleuze and Guattari, 1987; DeLanda, 2002; Hodder, 2012). A relational ontology focuses on the relations between disparate objects such as material artefacts, humans, other organisms and concepts and avoids prioritising any one ‘thing’ as more important than another. The notion of assemblage has emerged alongside ideas concerning complexity, chaos and indeterminacy and informs a vocabulary addressing the problem of causality, determination and the stability of social and psychological phenomena (Venn, 2006). As part of a psychoanalytically informed psychosocial framework these concepts enable an exploration of ME by bringing together disparate aspects such as everyday objects, experiences, symptoms and environments in a non-causal, non-dualistic and processual manner. The psychoanalytic element also enables an exploration of the unconscious and irrational aspects of experience, which is most pertinent with regards to the effects of ME. Thus, the premise of this research was to establish a psychosocial methodology and theoretical basis from which to explore the effects of ME on self experience. Moreover, this methodology was designed to engage with the complex, coincident and entangled nature of the symptoms, discourses, objects, material artefacts, environments and non-human organisms that ME appears to be comprised of. Methods were developed which enabled the researcher to be with and explore the day-to-day life and routines of eight ME sufferers in their everyday environments over a six month period. This involved working with the ME sufferers taking part primarily in their own homes and spaces around their home which they frequented, such as shopping malls and even a cemetery; in itself novel in terms of qualitative research into ME. Of these eight sufferers, three were male [age range 49 – 65; earliest formal diagnosis of ME occurring in 2005] and five females [age range 25 – 63; earliest diagnosis 2002]. Two sufferers were in paid employment, one was retired and five were unable to work due to their ME. Due to the extensive nature of the data, only 3 case studies, two male and three female, were selected for in-depth analysis. Cases selected were those that most clearly illustrated central analytic themes. Data comprised talk, audio-visual material and the affective responses of the researcher. Analytic methods were devised which initially adopted a thematic approach before metaphoric and metonymic equivalences were drawn between what ME sufferers discussed and aspects of the routines, objects and environments they were engaged with. This informed descriptions of how these things became networked, in an ANT sense, and how self experience was implicated. A key finding which emerged is the notion of debilitating spaces. This term captures the manner in which, for certain sufferers, the experience and hence the maintenance of ME was intrinsically enmeshed with their immediate physical environment. Further findings discussed include the way in which seemingly everyday objects such as food blenders can be co-opted by sufferers as a means of enhancing their self-experience in light of ME. Overall, the findings of this PhD are discussed in terms of the success and applicability of that premise and its contribution to the field of psychosocial approaches. The key assertion is that the methodology enhances an understanding of ME and its effects, highlighting the variable yet particular nature of ME and its effect on self experience and in incorporating the hitherto unconsidered range of objects outlined above.

Introdução: No curso de Fisioterapia, na disciplina de Recursos Terapêuticos Manuais, o aluno estará na situação de aprendizagem onde atuará como fisioterapeuta, aprenderá os recursos terapêuticos manuais e exercitará a aplicação de anamnese e de testes de avaliação funcional direcionados para aplicação de massagem. O conteúdo referente ao treinamento técnico do aluno deve focar os recursos terapêuticos e suas bases, mas não deve excluir a promoção de habilidades profissionalizantes envolvidas na relação fisioterapeuta - paciente. Objetivos: verificar a eficácia de um programa de treinamento de habilidades profissionalizantes envolvidas na relação fisioterapeuta-paciente durante sessão de massoterapia e identificar a opinião dos alunos sobre a experiência realizada. Sujeitos: Vinte e cinco graduandos em Fisioterapia. Método: I. Identificar as habilidades envolvidas na relação fisioterapeuta-paciente a partir da literatura e observação de 120 sessões de massoterapia. II. Validar a definição operacional das habilidades junto a dez peritos; III. Organizar a forma de ensino e aplicar o programa de treinamento das 21 habilidades selecionadas. IV. Analisar o desempenho dos alunos nas habilidades treinadas, classificadas em adequada, parcialmente adequada, inadequada ou não realizada durante prova prática. V. Analisar o relato escrito dos alunos sobre o programa proposto. Resultados: Todos os alunos realizaram 12 das 21 habilidades treinadas de forma adequada. As habilidades: acomodar o paciente sentado, mensurar a freqüência cardíaca pré intervenção, questionar sobre intercorrência física ou emocional, fornecer feedback verbal foram realizadas de forma parcialmente adequada por 5 alunos, sendo que os demais as realizaram de forma adequada. Não ocorreu situação de execução inadequada de habilidade. Os relatos escritos, analisados e categorizados, mostraram que 19 dos 25 alunos afirmaram ser a atividade treinada importante e necessária. Destes, 15 citaram que o treinamento facilitou a relação com o paciente e a compreensão da realidade clínica. O treinamento do autocuidado físico foi destacado como importante para o desenvolvimento profissional e apropriado para o contexto de ensino por dez alunos. Conclusão: o programa mostrou-se eficiente em capacitar os alunos para as habilidades propostas tendo sido bem aceito e recomendado pelos alunos. / Introduction: In the discipline of Manual Therapeutic Resources of the Physiotherapy course, the students will be in a learning setting in which they will act as a physical therapist, will learn the manual therapeutic resources and will exercise the application of anamnesis and functional evaluation tests targeted to massage application. The contents referring to the technical training of the student should focus on the therapeutic resources and their bases, but should not exclude the promotion of the professionalizing abilities involved in the physical therapist-patient relation. Objectives: To check the efficacy of a training program of professionalizing abilities involved in the physical therapist-patient relation during the massotherapy session and identify the students’opinions about the experiment carried out. Participants: Twenty-five physicaltherapy undergraduate students. Methods:I. Identify the abilities involved in the physical therapist-patient relation starting from the literature and observation of 120 massotherapy sessions. II. Validate the operating definition of the abilities with ten experts: III. Organize the teaching manner and employ the training program of the 21 abilities selected. IV. Analyse the students’ performance as to the trained abilities, ranked as adequate, partially adequate, inadequate or not undertaken during the practical test. V. Analyse the students’ written report on the proposed program. Results: All the students undertook 12 out of the 21 trained abilities in an adequate manner. The abilities — accommodate the patient in a sitting position, measure the preintervention heart rate, question about intercurrent physical or emotional conditions, supply an oral feedback — were undertaken in a partially adequate manner by 5 students, and the others undertook them in an adequate manner. There wasn’t any situation of inadequate ability execution. The written reports, analysed and categorized, showed that 19 out of the 25 students stated that the trained activity is relevant and necessary. Out of those, 15 mentioned that the training facilitated the relation with the patient and the understanding of the clinical reality. The training of the physical self-care was pointed out as relevant to the professional development and appropriate to the teaching context by 10 students. Conclusions: The program proved to be efficient at enabling the students to the proposed abilities; it was well accepted and recommended by the students.

O agrupamento de dados é uma técnica fundamental em aplicações de diversos campos do mercado e da ciência, como, por exemplo, no comércio, na biologia, na psiquiatria, na astronomia e na mineração da Web. Ocorre que em um subconjunto desses campos, como engenharia industrial, ciências sociais, engenharia sísmica e recuperação de documentos, as bases de dados são usualmente descritas apenas pelas proximidades entre os objetos (denominadas bases de dados relacionais). Mesmo em aplicações nas quais os dados não são naturalmente relacionais, o uso de bases relacionais permite que os dados em si sejam mantidos sob sigilo, o que pode ser de grande valia para bancos ou corretoras, por exemplo. Nesta dissertação é apresentada uma revisão de algoritmos de agrupamento de dados que lidam com bases de dados relacionais, com foco em algoritmos que produzem partições rígidas (hard ou crisp) dos dados. Particular ênfase é dada aos algoritmos evolutivos, que têm se mostrado capazes de resolver problemas de agrupamento de dados com relativa acurácia e de forma computacionalmente eficiente. Nesse contexto, propõe-se nesta dissertação um novo algoritmo evolutivo de agrupamento capaz de operar sobre dados relacionais e também capaz de estimar automaticamente o número de grupos nos dados (usualmente desconhecido em aplicações práticas). É demonstrado empiricamente que esse novo algoritmo pode superar métodos tradicionais da literatura em termos de eficiência computacional e acurácia / Data clustering is a fundamental technique for applications in several fields of science and marketing, as commerce, biology, psychiatry, astronomy, and Web mining. However, in a subset of these fields, such as industrial engineering, social sciences, earthquake engineering, and retrieval of documents, datasets are usually described only by proximities between their objects (called relational datasets). Even in applications where the data are not naturally relational, the use of relational datasets preserves the datas secrecy, which can be of great value to banks or brokers, for instance. This dissertation presents a review of data clustering algorithms which deals with relational datasets, with a focus on algorithms that produce hard or crisp partitions of data. Particular emphasis is given to evolutionary algorithms, which have proved of being able to solve problems of data clustering accurately and efficiently. In this context, we propose a new evolutionary algorithm for clustering able to operate on relational datasets and also able to automatically estimate the number of clusters (which is usually unknown in practical applications). It is empirically shown that this new algorithm can overcome traditional methods described in the literature in terms of computational efficiency and accuracy

Ao oferecer condições, tanto para que o indivíduo possa enfrentar situações novas que se delineiam frente aos avanços das tecnologias de informação e comunicação, como para que ele possa gerar descobertas e inovações, novas políticas de formação são requeridas. O cenário mais provável do processo de ensino e aprendizagem será o de sistemas \"integrados\", que oferecem oportunidades diversas de formação, organizáveis de modo flexível, com atividades presenciais e a distância, viabilizando a interação entre professores e estudantes. As DINÂMICAS COLABORATIVAS apresentam-se, então, como uma estratégia educativa para a formação do futuro profissional. A presente pesquisa investigou quais fatores interferem na dinâmica de colaboração on line em processos educacionais desencadeados em cursos via Internet. Para isso, o presente estudo apresentou a análise de uma proposta pedagógica de dinâmica colaborativa construída pela pesquisadora, desenvolvida em uma disciplina de pósgraduação na modalidade a distância, via Internet, em quatro edições consecutivas. Com encaminhamento de natureza qualitativa, adotou-se como estratégia de pesquisa o Método do Estudo de Caso. A partir do reagrupamento dos dados coletados, foram delimitadas cinco categorias, as quais orientaram a análise e ordenaram a construção do texto da pesquisa: infraestrutura tecnológica, posturas individuais, posturas coletivas, estratégias metodológicas colaborativas e gestão. O resultado dessa investigação comprovou a hipótese de que as dinâmicas colaborativas on line possibilitam a criação de uma comunidade de aprendizagem e revelam-se como formas diferenciadas de se atuar com qualidade em educação on line, uma vez que atividades em grupo constituem o cerne da formação atual, tanto presencial quanto a distância. A análise dos dados coletados demonstrou que tais dinâmicas colaborativas consistem num processo complexo de atividades sociolingüísticas. Esse processo envolve a inter-relação de aspectos cognitivo-afetivos individuais e construção social de conhecimento, onde ocorre identificação pessoal por meio da interação com outras pessoas. Assim, devem ser considerados os fatores pertinentes à mediação de atividades individuais e de grupo, tendo por meta o alcance de objetivos comuns de aprendizagem. O foco não deve ser a tecnologia, mas a atividade humana em realização. / Once conditions are offered, not only to the individual can face the new situations present in the advances of information and communication technologies, but also to he/she can generate new discoveries and innovations, new policies of formation are required. The most probable scenery of teaching and learning process will be that of \"integrated\" systems, that offer several opportunities of formation, organized by a flexible way, with in-class and at a distance activities, making possible the teachers-students interaction. Thus, the COLLABORATIVE DYNAMICS present themselves as an educational strategy to the formation of the future professional. The present research investigated which factors interfere in the collaborative dynamic on line in the educational processes aroused from courses via Internet. To this end, the present study presented the analysis of a collaborative dynamic pedagogical proposal designed by the researcher, developed in a post-graduation discipline in distance modality, via Internet, in four consecutive editions. With a qualitative nature orientation, the Study of Case Method was adopted as the research strategy. From the collected data regroup, five categories were delimited, which oriented the analysis and arranged the research text construction: technological infra-structure, individual postures, collective postures, collaborative methodological strategies and management. The result of this investigation confirmed the hypothesis that collaborative dynamics on line make possible the creation of a learning community and revel themselves as different ways of acting with quality in on line education, since group activities constitute the core of the current formation, both in-class and at a distance. The collected data analysis demonstrated that such collaborative dynamics consist in a complex process of socio-linguistic activities. This process involves the inter-relation of individual affective/cognitive aspects and social construction of knowledge, in which personal identification occurs by means of the interaction with other people. Thus, the factors related to the mediation of individual and group activities must be considerate, aiming at reaching the common objectives of learning. The focus should not be the technology, but the human activity in progress.

Seres humanos são capazes de desenvolver complexas estruturas de conhecimento que podem ser utilizadas de modo flexível para lidar com o ambiente de maneira apropriada. Estas estruturas de conhecimento constituem um núcleo que suporta processos cognitivos, tais como a percepção, a categorização, o planejamento, etc. A Inteligência Artificial, enquanto área de investigação, ocupa-se de desenvolver meios que viabilizem a reprodução destas capacidades cognitivas em agentes artificiais. Por este motivo, a investigação de abordagens que permitam a representação de conhecimento de um modo flexível se revela altamente relevante. Com o objetivo de superar algumas das limitações típicas da teoria clássica, que é adotada por várias abordagens propostas na Inteligência Artificial, este trabalho propõe um arcabouço cognitivamente inspirado para representação de conhecimento e raciocínio que integra aspectos de três diferentes teorias cognitivas a respeito de como conceitos são representados na cognição humana: teoria clássica, teoria do protótipo e teoria do exemplar. O arcabouço resultante é capaz de suportar a composicionalidade, a tipicalidade, a representação de instâncias atípicas dos conceitos, e a representação da variabilidade de indivíduos classificados por cada conceito. Consequentemente, o arcabouço proposto também suporta raciocínio lógico e baseado em similaridade. As principais contribuições deste trabalho são a concepção teórica e a formalização de um arcabouço cognitivamente inspirado para representação de conhecimento e raciocínio. Uma outra contribuição deste trabalho é uma abordagem de raciocínio para classificação que utiliza a abordagem de representação de conhecimento proposta. Além disso, este trabalho também apresenta duas abordagens para seleção de exemplares representativos de cada conceito e uma abordagem para extração de protótipos de conceitos. Nesta tese também é apresentado um sistema para interpretação automática de processos deposicionais que adota o arcabouço proposto. Experimentos realizados em uma tarefa de classificação sugerem que o arcabouço proposto é capaz de oferecer classificações mais informativas que as oferecidas por uma abordagem puramente clássica. / Human beings can develop complex knowledge structures that can be used for dealing with the environment in suitable ways. These knowledge structures constitute a core that supports several cognitive processes, such as perception, categorization, planning, etc. The Artificial Intelligence, as a research field, aims at developing approaches for mimicking these cognitive capabilities in machines. Due to this, it is important to investigate approaches that allow representing the knowledge in flexible ways. In order to overcome some limitations of the classical theory of knowledge representation, which is adopted by several approaches proposed in the Artificial Intelligence field, this work proposes a cognitively-inspired framework for knowledge representation and reasoning which integrates aspects from three different cognitive theories about concept representation in the human cognition: classical theory, prototype theory and exemplar theory. The resulting framework can support compositionality, typicality, representation of atypical instances of concepts, and representation of the variability of the individuals classified by each concept. Consequently, the proposed framework also supports logical reasoning and similarity-based reasoning. The main contributions of this work are the formalization of a cognitively-inspired framework for knowledge representation and reasoning, two approaches for selecting representative exemplars of each concept and an approach of reasoning for classification that integrates logical reasoning and similarity-based reasoning and that is supported by definitions, prototypes and exemplars of concepts. This thesis also presents a system for automatic interpretation of depositional processes application that adopts the proposed framework. The experiments, which were performed on a classification task, suggest that the proposed framework provides classifications that are more informative than the ones provided by a classical approach.

The purpose of this study was to evaluate the effect of a three-day session using an integrated didactic and experiential approach for training in interpersonal skills for sheltered workshop supervisors.

Investigamos, a partir de uma intervenção pontual, implicações e encaminhamentos para o campo educacional, quando se busca contemplar abordagens CTS no ensino médio. A partir de uma ampla revisão sobre os sentidos que vêm sendo atribuídos a essas abordagens, identificamos a necessidade de um referencial educacional mais amplo para seu encaminhamento. Optamos por investigar, tanto em âmbito teórico quanto prático, os elementos de articulação entre a abordagem CTS e a perspectiva freireana de educação. Como metodologia, utilizamos a Pesquisa Participante, confrontando elementos de nossas reflexões com ações concretas. Essas últimas constituíram-se no desenvolvimento de uma intervenção, realizada em uma escola da rede pública de Salvador das Missões/RS, onde está em fase de construção uma usina hidrelétrica. Os instrumentos que foram utilizados para obtenção de \"dados\" são: registros escritos sob a forma de diários, questionários e trabalhos realizados pelos alunos. Os resultados foram analisados à luz de três categorias: (i) estratégia utilizada, (ii) a proposta e a escola e (iii) objetivos educacionais. A partir dessa investigação, foi possível reiterar a contribuição em articular propostas CTS com a perspectiva freireana. Essa articulação implicou em redesenhar alguns elementos, etapas e procedimentos para a intervenção, tomando como ponto de partida a investigação temática. Destacamos as dificuldades em envolver, de forma efetiva, a escola e seus professores; limitações no aprofundamento do conhecimento por parte dos alunos e dificuldades em promover uma postura crítica. Por outro lado, constatamos seu significativo, através de um novo nível de conhecimento da realidade, além de mudanças de percepção, por parte dos alunos, sobre o sentido da escola, do próprio conhecimento e da questão em estudo. / We investigated the concerns of STS (Science-Technology-Society) approaches on secondary school taking into account the results from a real school intervention. The meaning and objectives of STS perspectives were analyzed in an extensive bibliography review, which indicated a large variety and multiplicity of significations. It also resulted that it must be considered the advantages of STS association with a general education perspective. In this sense, we investigated possible consonance and connections between STS and Paulo Freire\'s ideas, in theoretical as well as practices propositions. With this intention we developed a school project in Salvador das Missões, RS-Brazil, where it is being built a hydroelectric power plant. From data and development analyses of this project, we tried to confront ideas and practices through research-participant methodology. Our research approaches took in account three different classes of considerations: (i) project strategy, (ii) school involvement and (iii) educational objectives. The results from these perspectives reinforced the contribution of Freire\'s idea to STS approaches, allowing to identify its potentialities as well as some restrictions and challenges.

Construire des terminologies de maladies est un enjeu majeur dans le développement des systèmes d’information épidémiologiques et d’aide à la décision de santé publique qui soient efficients et durables. A partir du contexte du registre français de l'Insuffisance Rénale Terminale, une analyse des besoins de représentation des termes de maladies a été réalisée mettant en évidence le problème aigu et occulté de continuité statistique dans les bases de données et de connaissances. La « continuité terminologique » est proposée comme une réponse au besoin de continuité statistique. Une méthode générative de construction de Ressources Termino-Ontologiques a été conçue et expérimentée. Plutôt que de s’intéresser à l’ensemble des termes qui sont nécessaires pour décrire un domaine, nous nous sommes concentré uniquement sur la modélisation d'un sous ensemble de connaissances élémentaires sur les maladies. Cette méthode générative produit simultanément des termes normalisés (Nomenclature artificielle) et leur représentation sémantique/conceptuelle formelle se basant sur le formalisme des Graphes Conceptuels (GC). Les opérations de généralisation/spécialisation des GC sont utilisées pour déduire l’organisation poly-hiérarchique La continuité terminologique doit être considéré comme étant un critère majeur dans la construction de terminologies de maladies au même titre que la couverture terminologique. Les approches génératives contribuent à améliorer la continuité terminologique, car elles imposent cette contrainte de créer chaque nouveau terme sur des bases formelles avec des propriétés définitoires nécessairement sémantiquement définis dans une ontologie existante. / Expressing terms referring to pathological conceptualization is an important issue toward the development of clinical research and public health decision support systems. From the context of the French Registry of End Stage Renal Disease, requirements for disease terms representation are anlysed highlighting the acute and hidden problem of statistical continuity in disease data and knowledge representation. The underpinned assumption relies on the idea of ensuring terminological continuity through agenerative method of building Ontology Based Terminological systems. Rather than looking at all the terms that are necessary to describe a domain, we focused solely on the modeling of basic and definitional knowledge about disease. A set ontological rules for diseases hierachies were defined. Eperiments have been designed and implemented taking advantage of GC formalism and a logic programming toll called prolog-GC. The results confimed that such method allow performing two major activities that are carried out in the conventional building process of medical terminologies : refinement of disease terms granularity and consistency improvement. Terminological continuity needs to be considered as major criteria in disease terminological building. Generative approaches helps to improve the terminological continuity as imposes to create news terms of the bases of existing ones formal definitions.