INTRODUÇÃO: Pacientes com diagnóstico de parafilias e de transtornos relacionados às parafilias ocupam a atenção pública e clínica por se tratarem de indivíduos potencialmente inconvenientes, causadores de problemas à sociedade e a si próprios. Caracteristicamente, apresentam padrões invulgares de comportamento sexual e distinguem-se pela escolha de parcerias ou de contextos sexuais incomuns. JUSTIFICATIVA: O tratamento atual leva em consideração comportamentos, fantasias e necessidades sexuais parafílicas e procura modificá-los por meio de psicoterapia cognitivocomportamental, medicação antidepressiva e antiandrogênica. Apenas a supressão destes comportamentos tem se mostrado insatisfatória e ainda apresenta altas taxas de reincidência. Não há resultados publicados sobre a efetividade de um novo tratamento psicoterapêutico, cujo foco esteja voltado para a identificação e a reestruturação da identidade sexual e cujo principal objetivo seja o de promover maior contato destes pacientes com parcerias sexuais convencionais. MÉTODO: A intervenção foi testada por meio de ensaio clínico de tratamento, randomizado, placebo controlado e unicego, realizado com dois grupos paralelos: experimental (N=6) e controle (N=8). Todos os pacientes apresentavam diagnóstico de parafilias e foram medicados com inibidores seletivos da recaptação de serotonina. As intervenções psicoterapêuticas duraram dezesseis semanas com frequência de uma sessão por semana. As mudanças comportamentais foram monitoradas por meio de um diário e as comorbidades psiquiátricas, a qualidade de vida e a adequação social foram avaliadas por meio de escalas psicométricas, nos três períodos do estudo: início, término e seguimento pósintervenção. RESULTADOS: Não houve melhora estatisticamente significante dos escores de depressão, qualidade de vida e adequação social para ambos os grupos. O grupo experimental apresentou tendência de melhor resposta para depressão ao se tomar esta variável de forma categorial. Ambos os grupos apresentaram: maior incapacidade de adequação social (comparados a populações não clínicas); tendência de aumento do estado de ansiedade; melhora clínica global e redução dos índices de gravidade das parafilias. Houve diferenças estatisticamente significantes entre os grupos. Para o grupo experimental: aumento de fantasias e masturbações normofílicas; maior procura por contatos eróticos normofílicos e diminuição de fantasias parafílicas. Porém, houve diminuição de contatos íntimos normofílicos (beijos, abraços e carícias) para este grupo. Houve diferenças estatisticamente significantes intragrupos. Para o grupo experimental: redução de contatos íntimos parafílicos e totais (parafílicos e normofílicos). Para o grupo placebo: aumento de relações sexuais parafílicas e da totalidade das fantasias sexuais (parafílicas e normofílicas). CONCLUSÕES: Os defechos favoráveis observados no grupo de intervenção evidenciaram a importância em se identificar e trabalhar psicoterapeuticamente o impedimento que os parafílicos apresentam de se relacionar com parcerias sexuais normofílicas, uma vez que para o grupo experimental as mudanças positivas observadas no comportamento, fantasias e necessidades sexuais caminharam em direção a padrões convencionais / INTRODUCTION: Patients diagnosed with paraphilia and paraphilia-related disorders have public and medical attention drawn to them because they are potentially disturbing individuals who cause problems to society and to themselves. Typically, they show unusual patterns of sexual behavior and make unusual choices related to sexual partners or sexual contexts. RATIONALE: Current treatment considers paraphilic behaviors, fantasies, and urges, trying to change these symptoms using cognitive-behavioral psychotherapy, antidepressants, and anti-androgen medication. The elimination of these behaviors has proved unsatisfactory and still has high recurrence rates. We could not find in the literature any studies on the effectiveness of a new psychotherapeutic treatment focused on identifying and restructuring the patients\' sexual identity to allow for the promotion of contact between these patients and conventional sexual partners. METHOD: We conducted a randomized, placebo-controlled, single-blind clinical trial with two groups: experimental (N = 6) and control (N = 8). All patients were diagnosed with paraphilia and were treated with selective serotonin reuptake inhibitors. The psychotherapeutic interventions lasted sixteen weeks, and its frequency was one session a week. Behavioral changes were monitored using a diary, whereas psychiatric comorbidities, quality of life, and social adequacy were assessed using psychometric scales in the three study periods: baseline, end, and post-intervention follow-up. RESULTS: There was no significant improvement of depression, quality of life, and social adequacy scores for both groups. The experimental group showed a trend toward better response to depression when we considered this as categorical variable. Both groups showed higher inability of social adequacy (when compared with non-clinical populations); tendency of increased state of anxiety; improvement of overall clinical status, and reduced levels of paraphilia severity. There were statistically significant differences between the groups. The experimental group showed increased frequency of normophilic fantasies and masturbation; increased demand for normophilic erotic contact, and decreased paraphilic fantasies. However, there was a decrease in normophilic intimate contact (kisses, hugs, and caresses) in this group. There were statistically significant intragroup differences. The experimental group had reduced paraphilic and total (paraphilic and normophilic) intimate contact. The placebo group had increased paraphilic sexual intercourse and higher frequency of sexual fantasies (paraphilic and normophilic). CONCLUSIONS: The positive outcomes found in the intervention group showed the importance of psychotherapy in identifying and treating the paraphilic patients\' impediments that prevent them from having relationships with normophilic sexual partners. This was reinforced by the finding that the experimental group showed positive changes in terms of sexual behaviors, fantasies, and urges, which were closer to conventional standards

Au cours des 25 dernières années, le nombre de joint-ventures internationales (JVI), qui se forment lorsque deux ou plusieurs entreprises partenaires mettent une partie de leurs ressources au sein d’une organisation légale possédée conjointement, s’est multiplié. Parallèlement à cette prolifération, les déterminants de la performance des JVI ont retenu particulièrement l’attention des chercheurs. Dans le cadre de cette recherche, nous nous focalisons sur l’aspect de l’apprentissage organisationnel en le liant à l’efficacité organisationnelle des JVI.Nous avons développé notre cadre conceptuel en nous basant sur la théorie de l’apprentissage organisationnel, la théorie fondée sur les connaissances et des revues de la littérature. Ainsi, nous avons proposé un modèle et dix-neuf hypothèses de la recherche liés aux retours positifs de l’apprentissage organisationnel sur l’efficacité organisationnelle des JVI. Ceux-ci sont ensuite examinés empiriquement en utilisant la méthode PLS sur une base de données de 176 JVI du Vietnam. Les résultats empiriques ont montré le rôle indéniable de l’apprentissage organisationnel dans l’amélioration de l’efficacité organisationnelle des JVI.Principaux résultats de la recherche : (1) plus les connaissances sont acquises dans les JVI plus leur efficacité organisationnelle s’améliore ; (2) la qualité des relations entre les partenaires de la JVI explique bien et influence fortement la performance d’acquisition de connaissances ; (3) concernant la culture d’apprentissage organisationnel, les pratiques de l’apprentissage d’équipe ont été identifiées comme un élément central influençant directement la performance d’acquisition de connaissances. / Over the past 25 years, the number of International Joint Ventures (IJV), which are formed when two or more partner companies put their resources together in a jointly owned legal organization, has multiplied. Along with this proliferation, the determinants of the IJV performance have attracted particular attention from researchers. In this study, we focus on the aspect of organizational learning by linking it to the IJV organizational effectiveness.We have developed our conceptual framework based on the theory of organizational learning, knowledge-based theory and literature reviews. Thus, we have proposed a model with nineteen research hypotheses related to the positive impact of organizational learning on the IJV organizational effectiveness. Both the model and these hypotheses are then examined empirically using the PLS method on a database of 176 IJV in Vietnam. The results showed the undeniable role of organizational learning in improving the IJV organizational effectiveness.Key research findings : (1) the more knowledge acquired in the IJV, the more its organizational effectiveness improved; (2) the quality of relationships between the IJV partners explains well and strongly influences the performance of knowledge acquisition; and (3) on organizational learning culture, the practices of team learning have been identified as a key element influencing the performance of knowledge acquisition directly.

This diploma thesis is covering topics of customer's loyalty, loyalty programs in banking and mainly topic is loyalty programs of payment cards in banking industry. First theoretical parts is guiding us though concept of customer's loyalty in banking industry and is describing specifics of this loyalty compared to loyalty to sales businesses. Further, this thesis is trying to show opportunities to be used to support customer's loyalty in bank with participation of credit and debit cards. In this sense, these payment cards are those that enable client's entry into the loyalty program and into the advantages that is loyalty program offering. Further, this thesis is describing interesting concept of loyalty program that is closely coupled with business partners that give opportunities to make the program very variable and interesting for customers. Practical part of this thesis is describing basis for technologies to be used while deploying the loyalty program and is discussing two main technical concepts regarding loyalty system integration with current bank information systems. One of those is further discussed and described from the point of view technical realization in common data warehouse systems. Main contribution of this work is preview of approaches to payment card loyalty programs and also preview of possibilities in way the loyalty program can be integrated with data warehouse currently deployed in the bank.

En transférant aux pouvoirs publics la capacité de décider l'emploi de la Participation des employeurs à l'effort de construction (PEEC), la loi de mobilisation pour le logement et la lutte contre l'exclusion du 25 mars 2009 a transformé en profondeur l'organisation du 1 % logement. L'objet de la recherche est de mettre en lumière les facteurs à l'origine d'une telle inflexion. Pour cela, l'analyse s'efforce d'explorer le passé de l'institution afin d'en extraire les éléments à même d'éclairer cet épisode récent. Elle montre que les mécanismes à l'origine de la transformation du 1 % logement – processus ancien et graduel dont la réforme de 2009 constitue la dernière manifestation en date – alimentent deux dynamiques qui influent historiquement sur la forme du gouvernement et la production des règles relatives à l'emploi des fonds du 1 % logement. La dégradation de la légitimité de l'institution, conséquence de l'impuissance des syndicats à développer une capacité de représentation dans le secteur du logement, entraîne une remise en cause de la présence des acteurs paritaires à la tête de l'institution. L'émergence au sein de l'Etat d'une volonté de reprendre en main le dispositif, effet indirect du tournant opéré pendant les années 1980 dans la conduite de l'action publique, se traduit par le transfert sur le 1 % logement d'une part croissante du coût de la politique du logement en substitution au budget de l'Etat. Dans un contexte marqué par la crise du syndicalisme et le renforcement de la contrainte budgétaire, la permanence de ces deux processus interroge aujourd'hui sur la capacité du 1 % logement à conserver un espace d'intervention dans la politique du logement / By transferring to public authorities the capacity to decide on the employment(use) of the Participation of the employers in the effort of construction ( PEEC), the law of mobilization for the accommodation(housing) and the fight against social exclusion of March 25th, 2009 transformed in depth the organization of the housing 1 %. The object of the search(research) is to bring to light factors(mailmen) at the origin of such an inflection

INTRODUÇÃO: No Brasil, os doadores de sangue são submetidos à triagem clinica antes da doação através de um questionário padronizado que segue recomendações do Ministério da Saúde. Apesar de não ser obrigatório, os serviços de hemoterapia brasileiros costumam perguntar aos candidatos sobre o número de parceiros sexuais nos doze meses que precederam aquela doação de sangue. Os candidatos que referem um número de parceiros acima do limite permitido em cada hemocentro são recusados na triagem clínica pré-doação. Este estudo analisa as características demográficas, o número de parceiros heterossexuais e marcadores sorológicos em 689.868 doações de três hemocentros brasileiros, participantes do REDS-II, entre 1 de julho de 2007 a 31 de dezembro de 2009. MÉTODOS: Os doadores foram classificados de acordo com o número máximo declarado de parceiros sexuais nos últimos doze meses permitidos em cada hemocentro. Os valores de corte para Belo Horizonte, Recife e São Paulo são dois, três e seis parceiros, respectivamente. Foram realizados os testes de qui-quadrado e regressão logística a fim de examinar associações entre características demográficas, número de parceiros sexuais em doze meses e taxas de marcadores sorológicos individuais e globais positivas para o vírus da imunodeficiência adquirida (HIV), vírus linfotrópico humano (HTLV) tipo 1 e 2, hepatite B, hepatite C e sífilis. RESULTADOS: Doadores de primeira vez, jovens e com maior nível educacional foram associados a maior número de parceiros sexuais recentes, assim como o gênero em São Paulo e Recife (p < 0, 001). Marcadores sorológicos globais, para HIV e sífilis foram associados com maior número de parceiros em São Paulo e Recife (p < 0, 001), mas não em Belo Horizonte. Na análise de regressão logística, o número de parceiros sexuais foi associado com marcadores sorológicos positivos [razão de chance ajustada (AOR) 1,2-1,5], especialmente no HIV (AOR 1,9-4,4). Em conclusão, o número de parceiros sexuais nos doze meses antes da doação de sangue, foi associado com positividade para HIV e taxas globais de marcadores sorológicos para doenças transmissíveis por transfusão. A associação não foi consistente entre os centros, tornando difícil definir um valor de corte uniforme para todos os hemocentros brasileiros. Estes achados corroboram que o uso da informação dos contatos heterossexuais recentes é um importante critério de inaptidão e de melhora na segurança transfusional no Brasil / INTRODUCTION: In Brazil, blood donors undergo medical screening before donation through a standardized questionnaire that follows recommendations from the Ministry of Health. Although not required, most of the Brazilian blood centers routinely ask candidates about the number of sexual partners in the twelve months preceding that blood donation. Candidates who refer a number of partners over the limit allowed in each blood center are refused at the predonation clinic screening. This study analyzes the demographic characteristics, the number of heterosexual partners and serological markers in 689,868 donations from three Brazilian blood center, participants in the REDS-II, from 1 July 2007 to December 31, 2009. METHODS: Donors were classified according to the stated maximum of the number of sexual partners in the last twelve months, allowed at each blood center. The cutoff values for Belo Horizonte, Recife and Sao Paulo are two, three and six partners, respectively. We conducted the chi-square and logistic regression to examine associations between demographic characteristics, number of sexual partners in twelve months and rates of individual and global serological markers positive for human immunodeficiency virus (HIV), human lymphotropic virus (HTLV) type 1 and 2, hepatitis B, hepatitis C and syphilis. RESULTS: First time donors, young and better educated were associated with increased number of recent sexual partners, as well as gender in São Paulo and Recife (p < 0.001). Global serological markers for HIV and syphilis were associated with greater number of partners in Sao Paulo and Recife (p < 0.001), but not in Belo Horizonte. In logistic regression analysis, the number of sexual partners was associated with positive serological markers [adjusted odds ratio (AOR) 1.2 to 1.5], especially HIV (AOR 1.9 to 4.4). In conclusion, the number of sexual partners in the twelve months before blood donation was associated with HIV positivity and overall rates of serologic markers for transfusion-transmissible diseases. The association was not consistent among the Brazilian blood centers, making it difficult to set a uniform cut off value for all blood banks in Brazil. These findings confirm that, the use of information from recent heterosexual contacts is an important criterion of disability and improvement in transfusion safety in Brazil

<p>This essay’s focus lies on the collaboration that takes place in hospitals and called a care-plan (vårdplanering) between the two organisations: Health-care (landsting) and social-care (kommun). According to the Swedish-law are these organizations responsible for the care of elderly individuals in Sweden. The aim of this essay has been to study closely this collaboration in order to see which partner has the most influencing power.</p><p>This essay is of a qualitative character, which means that the results that are presented are based on six individual interviews with employees from the two organizations. The employees chosen for this essay all have job experiences from the collaboration that takes place during care-plans in hospitals.</p><p>One of the main results of this essay has been that the two organizations are not equal collaboration-partners. All the interviewed individuals talked highly about the importance of collaboration while in reality they end up in an subliminal battle against each other. The main conclusion of this essay is that the focus of a care-plan meeting appears to be on gaining the most power, in order to influence the outcome of a care-plan, rather than giving priority to the elderly individual’s needs and concerns.</p>

This essay’s focus lies on the collaboration that takes place in hospitals and called a care-plan (vårdplanering) between the two organisations: Health-care (landsting) and social-care (kommun). According to the Swedish-law are these organizations responsible for the care of elderly individuals in Sweden. The aim of this essay has been to study closely this collaboration in order to see which partner has the most influencing power. This essay is of a qualitative character, which means that the results that are presented are based on six individual interviews with employees from the two organizations. The employees chosen for this essay all have job experiences from the collaboration that takes place during care-plans in hospitals. One of the main results of this essay has been that the two organizations are not equal collaboration-partners. All the interviewed individuals talked highly about the importance of collaboration while in reality they end up in an subliminal battle against each other. The main conclusion of this essay is that the focus of a care-plan meeting appears to be on gaining the most power, in order to influence the outcome of a care-plan, rather than giving priority to the elderly individual’s needs and concerns.

La transcription, la maturation d’ARN, et le remodelage de la chromatine sont tous des processus centraux dans l'interprétation de l'information contenue dans l’ADN. Bien que beaucoup de complexes de protéines formant la machinerie cellulaire de transcription aient été étudiés, plusieurs restent encore à identifier et caractériser. En utilisant une approche protéomique, notre laboratoire a purifié plusieurs composantes de la machinerie de transcription de l’ARNPII humaine par double chromatographie d’affinité "TAP". Cette procédure permet l'isolement de complexes protéiques comme ils existent vraisemblablement in vivo dans les cellules mammifères, et l'identification de partenaires d'interactions par spectrométrie de masse. Les interactions protéiques qui sont validées bioinformatiquement, sont choisies et utilisées pour cartographier un réseau connectant plusieurs composantes de la machinerie transcriptionnelle. En appliquant cette procédure, notre laboratoire a identifié, pour la première fois, un groupe de protéines, qui interagit physiquement et fonctionnellement avec l’ARNPII humaine. Les propriétés de ces protéines suggèrent un rôle dans l'assemblage de complexes à plusieurs sous-unités, comme les protéines d'échafaudage et chaperonnes. L'objectif de mon projet était de continuer la caractérisation du réseau de complexes protéiques impliquant les facteurs de transcription. Huit nouveaux partenaires de l’ARNPII (PIH1D1, GPN3, WDR92, PFDN2, KIAA0406, PDRG1, CCT4 et CCT5) ont été purifiés par la méthode TAP, et la spectrométrie de masse a permis d’identifier de nouvelles interactions. Au cours des années, l’analyse par notre laboratoire des mécanismes de la transcription a contribué à apporter de nouvelles connaissances et à mieux comprendre son fonctionnement. Cette connaissance est essentielle au développement de médicaments qui cibleront les mécanismes de la transcription. / Genomes encode most of the functions necessary for cell growth and differentiation. Gene transcription, RNA processing, and chromatin remodeling are central processes in the interpretation of the information contained in genomic DNA. Although many protein complexes forming the cellular machinery that interprets mammalian genomes have been studied, a number of additional complexes remain to be identified and characterized. Using proteomic approaches, Dr. Benoit Coulombe’s laboratory purified many components of the RNAPII transcription machinery using tandem affinity purification (TAP), a procedure that allows the isolation of protein complexes as they likely exist in live mammalian cells, and the identification of interaction partners using mass spectrometry. High confidence interactions were selected computationally and used to draw the map of a network connecting many components of the mRNA transcriptional machinery. By applying this procedure, our lab has identified, for the first time, a group of proteins, that interacts both physically and functionally with human RNAPII, and whose properties suggest a role in the assembly of multi-subunit complexes, acting as RNAPII-specific scaffolding proteins and chaperones. The aim of my project was to continue the characterization of the network of protein complexes involving transcription factors, and thus, further pursuing our survey of protein complexes in whole cell extracts. Eight novel RNAPII interaction partners (PIH1D1, GPN3, WDR92, PFDN2, KIAA0406, PDRG1, CCT4 and CCT5) were purified using the tandem affinity purification (TAP) method, and their interaction partners were identified by mass spectrometry. Over the years, our lab’s analysis of transcriptional regulation and mechanisms has contributed novel and important knowledge that provided better understanding of mRNA synthesis. This knowledge is paramount to the development of therapeutics that will target transcriptional mechanisms.

Collaborative care is a philosophy which guides the work of interdisciplinary teams and patients and their families internationally. It has been demonstrated to improve quality of care, safety, and patient and staff satisfaction, yet applying this philosophy still requires much investigation. This thesis describes processes of change directed towards a vision to enhance collaborative care relationships with patients and families within one hospital site of a non-acute academic health science centre in Ontario, Canada. By building focused conversations around existing patient and family centred education and using an initial conceptual framework of customer service, healthcare providers, mid- and senior level leaders shared their perspectives, negotiated meanings and created innovations to enhance collaborative relationships within the organization. Based within the critical paradigm, a critical collaborative ethnography was constructed with the use of sequential and mixed research methodologies. The ethnography evolved over three phases in a step-wise and additive design during the three year period of study. Phase 1 examined the perspectives of healthcare providers in an exploratory case study which contributed to mid-level leaders’ discussions in Phase 2. Cumulative findings from Phases 1 and 2 were brought to discussions with senior leaders in Phase 3. Members of a participative action research team assisted with research design and study processes. Shared meanings and innovative change ideas were developed and captured through the use of semi-structured focus groups and interviews, survey, participant observation and inductive analysis. A conceptual framework of ‘partners-in-care’ emerged and was used to assist participants to make sense of the values and factors important in their work with respect to collaborative relationships. The research processes facilitated the development of many innovations to enhance collaborative practice within the hospital. The organization was described by the research as undergoing directed change to enhance collaborative care as evidenced through participant self-reports, observed initiatives and the ethnographic descriptions. / Thesis (Ph.D, Rehabilitation Science) -- Queen's University, 2012-06-25 15:06:24.687

Les couples mariés qui ont des convictions religieuses fortes doivent respecter deux ordres juridiques parallèles: l’ordre étatique et l’ordre religieux. Des conflits peuvent surgir entre ces deux ordres, notamment lors du divorce des parties. Une brève présentation du droit québécois du mariage et du divorce ainsi que des droits religieux catholique, musulman et juif permet d’effectuer des comparaisons entre ces droits et d’identifier un certain nombre de points de jonctions normatifs. Des voies permettant d’harmoniser les deux univers normatifs sont explorées, dans une perspective de droit préventif: l’adaptation du contrat de mariage civil et du processus de la médiation familiale et la rédaction des ententes entre conjoints. / Married couples with strong religious beliefs must respect two parallel legal orders : the state order and the religious order. Conflicts can arise between these two orders, in particular when the parties divorce. A brief presentation of Quebec’s marriage and divorce laws and catholic, muslim and jewish religious law allows comparison between these systems of law and reveal some normative jonction points. In a preventive law perspective, ways to harmonize these two normative universes are explored : arrangement of the civil marriage contract, of the family mediation’s processus and of the writing of the agreements between partners.