Spelling suggestions: "subject:"disproportionate"" "subject:"disproportionately""
1 |
Fiction et connaissance, du théâtre à la physique : l'esthétique et les sciences du point de vue de l'acteur : vers une philosophie féconde de l'absurde / Fiction and knowledge, from the theatre to physics : esthetics and the sciences from the actor's perspective : towards a fruitful philosophy of the absurdCloarec, Julie 14 December 2013 (has links)
La fiction, bien plutôt que de relever d'une illusion, stérile et dangereuse, engendrée par une imagination trop souvent réduite à n'être que la « folle du logis» par la tradition rationaliste de la philosophie, ne montre-t-elle pas toute sa pertinence et sa fécondité dans le double domaine de l'esthétique et de l'épistémologie, que ce soit, par exemple, dans le jeu paradoxal du comédien ou dans la métaphorisation du réel par le chercheur scientifique, qui s'alimentent, tous deux, à la source d'une mimésis où s'originent toute connaissance comme toute action humaines ? Mais la fiction ne trouve et ne prouve toute son ampleur théorique et pratique que d'être inscrite dans une « philosophie du comme si », dont la véritable filiation est à rechercher dans un kantisme élargi plutôt que dans l'orthodoxie pragmatiste. Ce fictionalisme, qui permet à l'esprit humain de se déprendre de ses habitudes conceptuelles en faisant primer l'intuition poïétique sur l'intelligence technique, ne peut lui-même faire son œuvre que d'être ancré en une philosophie de l'absurde qui, bien loin de réduire « l'homme absurde» au désespoir, en appelle à une décision existentielle de (c l'âme active» qui ré-éveille le génie qui sommeille en chaque homme à l'exigence d'une existence soucieuse de lucidité et de responsabilité, pour soi-même et les autres comme pour le monde. / Does not fiction, rather than arising from a sterile and dangerous illusion, engendered by a creative faculty that is too often reduced by the rationalist tradition in philosophy to nothing more than "an overactive imagination", reveal ail of its relevance and fecundity in the dual domain of esthetics and epistemology - for example in the paradoxical performance of an actor or the metaphorisation of the real by a scientific researcher, both of which draw from the source of a mimesis in which ail knowledge and ail human actions originate ? But the full theoretical and practical scope of fiction can only be found and proven when it is situated within a "philosophy of the as if, whose true filiation is to be found in a broadened Kantianism rather than in the pragmatist orthodoxy. Such a fictionalism, which allows the human mind to free itself from its conceptual habits by stressing intuition over technical intelligence, can itself do its work only by being rooted in a philosophy of the absurd which, far from reducing "the absurd man" to despair, calls for an existential decision of the "active soul" which re-awakens the spirit that lies dormant in each human individual to the demands of an existence mindful of lucidity an responsibility, for oneself and for others as for the world.
|
2 |
Fetal-pelvic Disproportion And Pelvic Asymmetry As A Potential Cause For High Maternal Mortality In Archaeological PopulationsStansfield, Sarah 01 January 2013 (has links)
Females of childbearing age are overrepresented in the population of the Kellis 2 cemetery (100-450 AD) in the Dakhleh Oasis, Egypt (Wheeler 2009). The demographic overrepresentation found here may be the result of complications related to childbirth. Clinical literature demonstrates that fetal size is rarely an explanation for failed labor (Cunningham et al. 2001) and the fetuses buried in the Kellis 2 Cemetery at the Dakhleh Oasis were not larger than average (Tocheri et al. 2005), directing the focus to dimensions of the maternal pelvis for evidence of obstetrical issues, such as abnormally compressed pelvises. To formulate a test for this hypothesis, a total of 50 adults, 24 of which are female, were examined for this study. The sample consisted of individuals from an archaeological population from the Dakhleh Oasis, Egypt as well as from six populations housed in the American Museum of Natural History (NYC). These include archaeological populations from the sites of El Hesa and Sai Island in the Sudan, also South Africa, Nubia, and India, as well as a medical collection from North America. Pelvic dimension and asymmetry was determined through nine measurements of the pelvis and sacrum. Kruskal-Wallis tests were used to analyze variance and assess whether the younger females in this group may have been at a higher risk of death during childbirth due to fetal-pelvic disproportion. Mann-Whitney-Wilcoxan nonparametric tests were used to assess differences in asymmetry in young and old groups. A MANOVA test assessed overall variation in the population. Results indicate significant differences between young and old females in pelvic outlet anteroposterior diameter, a measure of midpelvic contraction, as young females had smaller pelvic outlet anteroposterior diameters. There were also significant differences between iv young and old females in alar-pubis length asymmetry; the young females were more asymmetric. These differences were not found in the male groups. It is suggested that these differences could impact childbirth as a contracted midpelvis, such as that found in the young female group, can cause transverse arrest of the fetal head (Cunningham et al. 2010) and pelvic asymmetry can contribute to obstetrical complications (Campbell et al. 2011).
|
3 |
Head descent, moulding and other intrapartum clinical findings in the prediction of cephalopelvic disproportionBuchmann, Eckhart Johannes 15 July 2008 (has links)
ABSTRACT
Cephalopelvic disproportion (CPD) is a common and serious obstetric condition,
especially in sub-Saharan Africa. Recognition relies on clinical observations, such as
cervical dilatation, head descent, moulding, and size of fetus, all made in a trial of labour.
No prospective studies have investigated intrapartum clinical observations and their
predictive value for CPD. The objectives of this research were 1) to determine the
association of intrapartum clinical findings, especially level of head and moulding, with
the outcome of CPD, 2) to determine inter-observer agreement of these findings between
clinicians, and 3) to compare intrapartum clinical palpation with symphysis-fundal height
(SFH) measurement in the prediction of birth weight.
A prospective cross-sectional comparative study was done in the Chris Hani
Baragwanath labour ward, a large referral centre. The subjects were women at term, in
the active phase of labour, with vertex presentations. The author, blinded to previous
clinical or ultrasound findings, performed clinical assessments at the same time as the
women’s attending clinicians. His observations were not divulged to the clinicians and he
did not participate in obstetric management of the women. The primary outcome
measures were CPD, defined as caesarean section for poor progress, and birth weight.
Five hundred and eight women were examined, of whom 113 (22.2%) had CPD.
Multivariate analysis identified short maternal stature, increased SFH, lesser cervical
dilatation, long duration of labour, high degree of parieto-parietal moulding, and high
degree of caput succedaneum as independent predictors for CPD. Fetal position and occipito-parietal moulding were not predictive, and level of head, by fifths and by station,
was poorly predictive. Inter-observer agreement between the author and attending
clinicians was moderate for cervical dilatation, engagement of the head in fifths, and
caput succedaneum, and poor for engagement of the head by station. SFH measurement
was a slightly better predictor of birth weight than clinical fetal weight estimation.
The clinical observations that were shown to be predictive for CPD may be useful
adjuncts in the management of a trial of labour. Inter-observer agreement of these
findings is at best moderate. Measurement of SFH deserves more attention as an
intrapartum predictor of birth weight.
|
4 |
L'infini en poids, nombre et mesure : la comparaison des incomparables dans l'œuvre de Blaise Pascal / Infinity in weight, number and measure : the comparison of incomparables in the works of Blaise PascalFigueiredo Nobre Cortese, João 30 October 2017 (has links)
Ce travail montre l'unité de l'œuvre de Pascal dans ce qui concerne la « comparabilité des incomparables » : la comparaison, langagière ou mathématique, qui se fait entre des choses qui ne pourraient pas en principe être rapprochées. Il s'agit de faire une approche historique et linguistique pour poser des questions philosophiques par rapport à la comparaison, notamment sur le rôle de principe que l'infini y joue selon Pascal. Nous identifions la comparaison des incomparables sous trois formes.La première partie de ce travail est consacrée à formuler une forme rhétorique d'analogie que nous nommons l'« analogie de disproportion » (nous inspirant de Secretan 1998). Si l'analogie est généralement dite faire une comparaison entre deux rapports, chacun desquels existe entre des choses homogènes, l'analogie de disproportion permet en revanche de montrer une ressemblance entre des rapports d'hétérogénéité, entre des disproportions ou entre des distances infinies: deux choses sont aussi différentes entre elles que deux autres. Pascal étant un auteur qui souligne surtout les disproportions, nous montrons qu'il compare ces disproportions, notamment pour délimiter à l'homme ce qu'il ne peut pas connaître parfaitement.La deuxième partie analyse la pratique mathématique de Pascal « en poids, nombre et mesure » : il s'agit de montrer que dans la méthode des indivisibles des Lettres de A. Dettonville, dans le Traité du triangle arithmétique et dans la comparaison du courbe et du droit, toujours l'infini (ou plutôt l'indéfini) intervient comme un facteur qui permet la comparabilité de ce qui semblait être incomparable. La troisième partie fait une discussion proprement philosophique sur l'infiniment petit et l'infiniment grand, prenant en compte la pratique mathématique de Pascal analysée dans la deuxième partie. Il est question de discuter sur la nature des « indivisibles », des « différences » et des « distances infinies ». Nous proposons que l'« infini » dans la pratique mathématique de Pascal relève plutôt de l'« indéfini », reliant cela à une distinction entre le sens absolu et le sens relatif des mots. Une exception dans la pratique mathématique de Pascal est la géométrie projective, où il faut accepter des éléments à distance infinie. La « rencontre » des deux infinis, finalement, permet de montrer la réciprocité de l'infini de grandeur et de l'infini de petitesse. Une discussion est faite à ce propos, reliant la proportion inverse entre les deux infinis à la grandeur et la petitesse de l'homme et au caractère paradoxal de certaines vérités selon Pascal, lesquelles sont résolues dans la personne du Christ. On conclut que Pascal propose non pas une connaissance directe de l'infini, mais plutôt une approche à la relation que l'homme, être fini, possède avec l'infini / This thesis shows the unity of Pascal's work in what concerns the "comparability of incomparables'': the comparison, either in mathematics our natural language, between things which could not in principle be brought together. The approach is both a historical and a linguistic one, and it aims to recovery some important questions regarding the philosophical nature of comparisons, more specifically, the role of the infinite in Pascal's thought. The comparison of incomparables may be identified in three different formsIn the first part, we formulate a rhetorical form of analogy that we call an "analogy of disproportion'' (inspired by Secretan 1998). If the analogy is generally said to make a comparison between two relations, each of which exists between homogeneous things, the analogy of disproportion, on the other hand, shows a resemblance between relations of heterogeneity, between disproportions or between infinite distances: two things may be as different from each other as any two other things. Even if disproportions are a central theme to Pascal, he did not shy away of comparing such disproportions -- in particular to delimit what man cannot know perfectly.The second part analyzes the mathematical practice of Pascal "in weight, number and measure'': it is necessary to show that in the method of indivisibles of the Lettres de A. Dettonville, in the Traité du Triangle Arithmétique and in the comparison of the curved and the straight lines, always the infinite (or rather the indefinite) intervenes as a factor that allows the comparability of what would seem to be incomparable. The third part makes a philosophical discussion on the infinitely small and the infinitely large, taking into account Pascal's mathematical practice, which was analyzed in the second part. We discuss the nature of "indivisibles'', "differences'' and "infinite distances''. We suggest that the "infinite'' in Pascal's mathematical practice is rather an "indefinite'', linking it to a distinction between the absolute and the relative meaning of words. An exception in Pascal's mathematical practice is his projective geometry, where it is necessary to accept elements at an infinite distance. The "encounter'' of the two infinites makes it possible to show the reciprocity of the infinity of greatness and the infinity of smallness. Finally, we analyze the inverse proportionality between the two infinites with regard to the greatness and the wretchedness of man and to the paradoxical nature of certain truths according to Pascal, which are concealed in the person of the Christ. The conclusion is that Pascal arrives not at a direct knowledge of the infinite, but to an approach to the relation that man, a finite being, has with the infinite
|
5 |
Poétique de la situation dans quatre recueils d’Henri Michaux : La nuit remue, Plume précédé de Lointain intérieur, Épreuves, exorcismes et La vie dans les plis. Approche grammaticale et stylistique / Poetics of situation in four works by Henri Michaux : La nuit remue, Plume précédé de Lointain intérieur, Épreuves, exorcismes, and La vie dans les plis. A grammatical and stylistic approachDurain, Marc 12 December 2013 (has links)
La présente étude explore les diverses résonances de la notion de situation, dans quatre recueils poétiques d’Henri Michaux : La nuit remue, Plume précédé de Lointain intérieur, Épreuves, exorcismes et La vie dans les plis. Il s’agit de montrer, en se fondant sur un examen linguistique et grammatical précis de la construction de l’espace et de la temporalité dans ces textes, comment la notion de situation structure l’écriture michaldienne, suivant trois grandes entrées : la première, c’est le principe de disproportion. Michaux situe en effet souvent des objets trop grands dans des espaces trop petits, ou des objets petits dans des espaces immenses ; nous y voyons la marque d’une intervention particulière, diverse dans ses enjeux, sur l’espace textuel. La seconde entrée, c’est le principe de mobilité : en prenant appui sur les textes cadres des recueils et des sections, on met en évidence la densité du maillage assuré par les verbes de mouvement, illustrés dans toute la gamme de leurs significations, de leur emploi spatial concret (renvoyant à une modification de la situation au sens premier) à leur utilisation la plus abstraite ou désémantisée ; il apparaît ainsi que la mobilité revêt une dimension proprement linguistique. La troisième entrée enfin, c’est celle de l’énonciation : après avoir étudié les structurations situationnelles à l’œuvre dans le monde du texte, on s’intéresse à l’inscription, dans celui-ci, des coordonnées de la deixis, c’est-à-dire de l’ancrage personnel et spatio-temporel de l’énonciation ; ce qui permettra d’éclairer la singularité de la parole michaldienne, à la fois fortement située et souvent insituable. / This study explores various aspects of the concept of situation in four poetry collections by Henri Michaux: La nuit remue, Plume précédé de Lointain intérieur, Épreuves, exorcismes et La vie dans les plis. Based on detailed linguistic and grammatical analysis of how space and temporality are constructed in these texts, it aims at showing how this idea of situation structures Michaux’s writing through three main points of entry. First, disproportion. Indeed, Michaux often places items that are too big in spaces that are too small, or small objects into huge spaces. This testifies to a specific intervention—with various goals—on the textual space. Second, mobility. A wide network of verbs of movement can be found in the framing texts of the collections and of each section; these are used in all their meanings¬—from their literal spatial use (referring to a modification of the situation proper) to their more abstract or desemanticized sense. Mobility thereby takes on a properly linguistic dimension. Finally, enunciation. After having studied situational structuring in the realm of the texts, I focus on the coordinates of the deixis, i.e. the personal and spatio-temporal markers of enunciation, that appear in the poet’s writing; this will help bring out the singularity of Michaux’s voice—a located and unlocatable one.
|
6 |
O sistema eleitoral brasileiro: uma análise sobre as questão da desproporcionalidade.Carvalho, Eder Aparecido de 07 December 2005 (has links)
Made available in DSpace on 2016-06-02T19:25:31Z (GMT). No. of bitstreams: 1
DissEAC.pdf: 453086 bytes, checksum: adffd8356f5e2c14e6238c04faa71f7b (MD5)
Previous issue date: 2005-12-07 / Universidade Federal de Minas Gerais / Emphasizing the existing disproportions in the Brazilian electoral system, the present work analyses some of the elements which distort its proportionality such as, the formula for converting votes into seats - highest average (d'Hondt version) -, the clause of electoral exclusion, the electoral coalitions, and the unequal allocation of seats to each Brazilian state. Additionally, this work shows through simulations that an electoral system, which is free of clauses and coalitions and followed by redistribution of electoral district boundaries, leads to a considerable reduction in the country s existing electoral disproportion. / A presente pesquisa, dando ênfase às desproporcionalidades existentes no sistema eleitoral brasileiro, examina alguns dos elementos que distorcem a proporcionalidade do mesmo a
fórmula de conversão dos votos em assentos (d Hondt de maiores médias), cláusula de exclusão eleitoral, coligações eleitorais e alocação desigual das cadeiras entre as unidades
federativas. A mesma ilustra, por sua vez, através de simulações, que um sistema eleitoral isento de cláusulas e coligações e, ainda, seguido de uma redistritalização tende a reduzir consideravelmente a desproporcionalidade eleitoral do país.
|
7 |
De la faillibilité au serf-arbitre : le tournant herméneutique de Paul RicoeurYelle, Jean-François 08 1900 (has links)
Ce mémoire a pour but de montrer que le premier tournant herméneutique de Paul Ricœur en 1960 gravite essentiellement autour de la problématique de la volonté mauvaise. Nous soutenons autrement dit que Ricœur a initialement donné une tournure herméneutique à sa philosophie pour penser le serf-arbitre, c’est-à-dire pour penser la liberté captive d’elle-même. Afin de rendre compte adéquatement de ce tournant, notre attention sera principalement dirigée vers le deuxième tome de la Philosophie de la volonté de Ricœur, Finitude et culpabilité. Notre question se pose ainsi : comment et pourquoi, dans une problématique du mal, Ricœur entame-t-il son tournant herméneutique? Pour y répondre, nous expliciterons le parcours de Ricœur allant de L’homme faillible à La symbolique du mal. Nous verrons dans un premier temps que si le philosophe arrive à thématiser le concept de faillibilité à partir d’une ontologie de la disproportion, si la réflexion a accès à la possibilité du mal, il n’en ira pas de même pour le noème inintelligible que constitue le mal moral. Afin de penser la faute, nous verrons que Ricœur se tournera vers l’herméneutique en se mettant à l’écoute du langage de l’aveu. Ainsi, dans la deuxième partie de notre mémoire, nous expliciterons les trois moments de compréhension (phénoménologique, herméneutique et réflexif) propre à l’herméneutique philosophique de Ricœur de 1960. / The purpose of this dissertation is to show that the first hermeneutics turn of Paul Ricœur in 1960 essentially revolves around the problematic of bad will. We argue ie that Ricœur initially gave a hermeneutics twist to his philosophy to think the servile will, that is the freedom captive of itself. To properly account for this turn, our attention was mainly directed to the second volume of the Philosophy of the Will of Ricœur, Faillible man and The symbolism of evil. Our question is this : how and why, in a problematic of evil, Ricœur starts his hermeneutics turn? To answer this question, we will explain the course of Ricœur from Fallible man to The Symbolism of evil. We will see at first that if the philosopher comes to thematize the concept of fallibility from an ontology of disproportion, if the reflection has access to the possibility of evil, it does not go well for the unintelligible noema that is moral evil. To think of the fault, we will see that Ricœur will turn to hermeneutics is by listening to the language of confession. Thus, in the second part of our dissertation, we will explain the three stages of understanding (phenomenological, hermeneutics and reflexive) to own philosophical hermeneutics of Ricœur 1960.
|
8 |
De la faillibilité au serf-arbitre : le tournant herméneutique de Paul RicoeurYelle, Jean-François 08 1900 (has links)
Ce mémoire a pour but de montrer que le premier tournant herméneutique de Paul Ricœur en 1960 gravite essentiellement autour de la problématique de la volonté mauvaise. Nous soutenons autrement dit que Ricœur a initialement donné une tournure herméneutique à sa philosophie pour penser le serf-arbitre, c’est-à-dire pour penser la liberté captive d’elle-même. Afin de rendre compte adéquatement de ce tournant, notre attention sera principalement dirigée vers le deuxième tome de la Philosophie de la volonté de Ricœur, Finitude et culpabilité. Notre question se pose ainsi : comment et pourquoi, dans une problématique du mal, Ricœur entame-t-il son tournant herméneutique? Pour y répondre, nous expliciterons le parcours de Ricœur allant de L’homme faillible à La symbolique du mal. Nous verrons dans un premier temps que si le philosophe arrive à thématiser le concept de faillibilité à partir d’une ontologie de la disproportion, si la réflexion a accès à la possibilité du mal, il n’en ira pas de même pour le noème inintelligible que constitue le mal moral. Afin de penser la faute, nous verrons que Ricœur se tournera vers l’herméneutique en se mettant à l’écoute du langage de l’aveu. Ainsi, dans la deuxième partie de notre mémoire, nous expliciterons les trois moments de compréhension (phénoménologique, herméneutique et réflexif) propre à l’herméneutique philosophique de Ricœur de 1960. / The purpose of this dissertation is to show that the first hermeneutics turn of Paul Ricœur in 1960 essentially revolves around the problematic of bad will. We argue ie that Ricœur initially gave a hermeneutics twist to his philosophy to think the servile will, that is the freedom captive of itself. To properly account for this turn, our attention was mainly directed to the second volume of the Philosophy of the Will of Ricœur, Faillible man and The symbolism of evil. Our question is this : how and why, in a problematic of evil, Ricœur starts his hermeneutics turn? To answer this question, we will explain the course of Ricœur from Fallible man to The Symbolism of evil. We will see at first that if the philosopher comes to thematize the concept of fallibility from an ontology of disproportion, if the reflection has access to the possibility of evil, it does not go well for the unintelligible noema that is moral evil. To think of the fault, we will see that Ricœur will turn to hermeneutics is by listening to the language of confession. Thus, in the second part of our dissertation, we will explain the three stages of understanding (phenomenological, hermeneutics and reflexive) to own philosophical hermeneutics of Ricœur 1960.
|
9 |
Equal But Separate: The Disproportionate Representation of African American Students in Special EducationPonder, Rochelle 01 January 2016 (has links)
African American students are 4 times more likely to be placed in special education than are their European American peers. The purpose of the study was to determine whether the application of professional development (PD) would change teachers' attitudes toward African American students who were achieving below grade level. Teachers in one school district received PD; the teachers in a separate school district did not receive PD. Bandura's social learning theory and Kunjufu's Afrocentric curriculum served as the theoretical framework. A preexperimental design and a static group comparison were used. The sample comprised 83 teachers, with 52 (63%) from the school district that received PD and 31 (37%) from the other school district. An amended version of the 21-item Teacher Attitude Survey, which measures teachers' attitudes toward low-achieving students, PD, and special education, was given to both groups after the treatment was applied to the first school district. Survey results were used to test 4 hypotheses: (a) There were no differences in teachers' attitudes toward achievement by district, (b) the amount of training on cultural sensitivity did not relate to teachers' attitudes toward achievement, (c) there were no differences in the average number of students referred to special education for each teacher by district, and (d) the amount of training on cultural sensitivity did not relate to the number of students referred to special education. Spearman's rho, t tests, and Mann-Whitney U test were applied. All but Null Hypothesis 3 failed to be rejected. Implications for positive social change begin with educating teachers about the effect of attitudes on the academic futures of African American students. Engagement in PD will begin the work of ensuring equity for all students in public education in the United States.
|
10 |
Matrices emplois-expositions et émergence des risques professionnels : application au sein du Réseau National de Vigilance des Pathologies Professionnelles / Job-exposure matrix and emergence of occupational hazards : application within the french national occupational disease surveillance and prevention networkFlorentin, Arnaud 29 November 2017 (has links)
La veille sanitaire dans le champ de la santé au travail est cruciale pour détecter l’apparition de nouveaux risques. Le réseau National de Vigilance et de Prévention des Pathologies Professionnelles (RNV3P), réseau national d’experts opérationnel depuis 2011, y participe activement. Pour cela, le RNV3P a déployé plusieurs méthodes pour détecter les nouveaux risques : émergence clinique et émergence statistique. La méthode des mesures de disproportion couramment utilisée dans le domaine de la pharmacovigilance a déjà été appliquée avec succès aux données du RNV3P. Néanmoins, une limite importante peut être soulevée. Les professionnels de santé déclarant les expositions qui leur semble liées à la pathologie déclarée, nous pouvons légitimement suspecter l'existence d'un biais de sélection de ces expositions : l'exposition la plus reconnue par le monde professionnel sera forcément déclarée. Pour tenter de maîtriser ce biais, nous avons proposé d’appliquer les matrices emploi / exposition (MEE) sur les données du RNV3P et d’examiner leur impact sur les mesures de disproportion. Dans un premier temps, nous avons testé la faisabilité de l’application des MEE au RNV3P et leur apport. Pour cela, 3 MEE issues du programme Matgéné ont été appliquées (benzène, poussières respirables de silice cristalline libre et solvants chlorés). Les données d’exposition rapportées respectivement par les experts et par la MEE ont été comparées en particulier pour des associations bien connues comme la silicose/silice ou les maladies hématopoïétiques/benzène, et pour des associations moins connues ou douteuses comme la sclérose systémique/silice et les maladies hématopoïétiques/solvants chlorés (trichloréthylène). Dans un second temps, nous avons appliqué les mesures de disproportion de type fréquentielle et bayésienne en comparant les résultats obtenus par les experts et les MEE pour trois nuisances : silice, trichloroéthylène et tétrachloroéthylène. Au final, les MEE permettent de rapporter plus d’expositions que les experts pour chaque nuisance testée et ce d’autant plus que l’association est peu connue. Cet apport d’information permet la génération de nouveaux signaux avec les mesures de disproportion qu’il est intéressant de discuter et d’explorer avec des experts / Health surveillance in the field of occupational health is crucial to detect the emergence of new risks The National Network of Vigilance and Prevention of Occupational Pathologies (RNV3P), a national network of experts operating since 2011, actively participates in. The RNV3P has deployed several methods to detect new risks: clinical emergence and statistical emergence. In the latter case, the disproportionate measures used in the field of pharmacovigilance have been successfully applied to RNV3P. Nevertheless, an important limitation can be raised. As health professionals report exposures associated with the declared pathology, we can legitimately suspect the existence of a selection bias: the most well known exposures of the professional community inevitably are most liable to be more frequently declared. To try to control this bias, we proposed to apply job / exposure matrices (JEM) on the data of the RNV3P and to examine their impact on the measures of disproportion. Initially, we tested the feasibility of applying MEE to the RNV3P data and their contribution. For this, 3 JEMs from the Matgéné program were applied (benzene, free crystalline silica breathing dusts and chlorinated solvents). The exposure data reported by the experts and the JEM were compared in particular for well-known associations such as silicosis / silica or hematopoietic / benzene diseases, and for less known or doubtful associations such as systemic sclerosis and hematopoietic diseases / chlorinated solvents (trichloroethylene). Secondly, we applied the frequency and Bayesian disproportion measures by comparing the results obtained for experts and JEM and for three nuisances: silica, trichloroethylene and tetrachloroethylene. In summary, MEE help to provide more exposure than the experts for each tested chemicals and especially if the association is little known. These new data allow the generation of new signals with the disproportion measures that it is interesting to discuss and explore with experts
|
Page generated in 0.1098 seconds