Cognitive linguists posit that language as a system of meaning is closely related to cognition and to the associated perceptual and physiological structures of the body. From the cognitive semantic viewpoint, cognitive processes underpin and motivate linguistic phenomena such as categorisation, polysemy, metaphor, metonymy and image schemas. The pedagogical implication of the cognitive semantic perspective is that understanding these cognitive motivations facilitates language learning. This dissertation uses an applied cognitive semantic approach to `make sense' of a traditional knowledge system, Traditional Chinese Medicine (TCM). TCM views human physiology as a holistic and dynamic system that exemplifies the same principles as the cosmos-environment. TCM models result in a categorisation of physiological phenomena based on a complex system of experiential and cosmological correspondences. I suggest that the holistic epistemology of cognitive linguistics is well suited to an understanding of these holistic models. From a pedagogical viewpoint, I argue that an analysis of the cognitive motivations which underpin TCM categorisations and the polysemy of some key TCM terms can help the student make sense of TCM as a meaningful system of thought and practice. Both the theoretical and applied approaches explored in this dissertation should have relevance to other traditional knowledge systems, particularly traditional medical systems. / Linguistics and Modern Languages / M.A. (Linguistics)

Traditional Chinese medicine is one of the oldest curative methods in the world. It is focused particularly on the support of a body to recover balance and harmony that have become impaired. Owing to the growing number of the Chinese and the Vietnamese minorities in the Czech Republic, the medical staff providing healthcare may meet members of these minorities for whom this medicine may be of a large importance both when being ill and when being healthy. The new conception of the Czech nursing is outlined to provide every individual, regardless of the race, with the care which is able to satisfy their bio-psycho-social-religious needs. The nursing staff must possess a basic knowledge of the traditional Chinese medicine so that they are able to satisfy the needs of these patients/clients better. The objective of this diploma work is to ascertain what health problems are treated by members of the Chinese and the Vietnamese minorities through the traditional Chinese medicine, and what curative methods are used most frequently by them. The empirical part was processed in the form of a qualitative research. The data collection technique was a semi-structured interview of selected informants of the Chinese and the Vietnamese nationalities living in the Czech Republic. Based on the interviews of individual minorities, case studies were established and used as the research base for elaboration of categorization tables and charts presenting the most important results of the research. The main results of the research include the ascertained heath problems which are treated by means of the Chinese medicine by members of both minorities, and the ascertainment what curative methods are used most frequently, and whether the members of both minorities wish to make use of the medicine also during hospitalization. Based on the results of the research, the information material was elaborated that may be of use for the nursing staff in healthcare facilities and for other specialized public as a brief summary of methods of the Chinese medicine and of their application by the members of the Chinese and the Vietnamese minorities.

Introdução: A equipe de Enfermagem em hospitais tem sido exposta a ambientes de trabalho estressantes, submetidos, muitas vezes, à condições de trabalho precárias, com baixa qualidade de vida. A auriculoterapia chinesa apresentou eficácia em estudo preliminar para redução de estresse com um protocolo escolhido com base na Medicina Tradicional Chinesa(MTC) e este Ensaio Clínico se propôs a avaliar a eficácia e o alcance da técnica quando é aplicada com e sem protocolo fechado. Objetivos: Descrever e investigar os níveis de estresse da equipe de Enfermagem do Hospital Samaritano; Comparar a eficácia da auriculoterapia chinesa realizada com e sem protocolo, descrever os principais diagnósticos de MTC para estresse e a eficácia dos pontos escolhidos. Material e Método: Na primeira fase, 484 profissionais responderam a um questionário de dados sócio-demográficos e à Lista de Sintomas de Stress de Vasconcellos(LSS). Foram incluídos aqueles com pontuação entre 37 a 119 pontos (médio e alto estresse). Randomizaram-se 213 pessoas em 3 grupos (controle, grupo protocolo e grupo sem protocolo); 175 finalizaram o tratamento de 12 sessões de auriculoterapia com agulha semipermanente, duas vezes por semana, por seis semanas. O protocolo de pontos utilizado foi: ponto Rim, Tronco Cerebral, Shenmen e Yang do Fígado 1 e 2. Os instrumentos de Coleta de dados no Ensaio Clínico foram a LSS, o Inventário de Sintomas de Stress da Lipp (ISSL), o Instrumento de Qualidade de Vida (SF36v2), uma Ficha de diagnósticos de MTC. O período de coleta foi de novembro de 2011 a julho de 2012 e sete acupunturistas participaram do estudo. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da EEUSP e do Hospital. Resultados: Na primeira fase, a pontuação média de estresse de 484 profissionais foi de 45,92 (nível médio). Os que apresentaram níveis mais elevados de estresse foram: as enfermeiras (p=0,012), profissionais do turno da manhã (p=0,022) e sujeitos com doenças auto referidas (p=0,001). Na segunda fase, os dois grupos de intervenção obtiveram diferenças estatísticas significativas quando comparadas ao grupo controle (p<0,05), com efeito superior para o grupo sem protocolo segundo a LSS no pós-tratamento e follow-up. Quanto ao ISSL, houve melhores resultados para o grupo sem protocolo para a fase de resistência/quase exaustão e domínio psicológico da fase de alerta. Quanto ao SF36v2, houve diferença estatística (p<0,05) somente para o grupo sem protocolo quanto ao domínio físico no follow-up. No domínio mental, ambos os grupos de intervenção obtiveram resultados positivos(p<0,05), com ligeira superioridade para o grupo sem protocolo quanto ao índice d de Cohen. Os principais diagnósticos de MTC foram: Estagnação de Qi e Xue nos meridianos tendino-musculares, Calor de Estômago e Subida de Yang do Fígado, Estagnação de Qi do Fígado, Distúrbio de Shen, Deficiência de Yin do Rim, Deficiência de Qi e Xue do Baço-Pâncreas. Os pontos mais utilizados foram os cinco pontos do protocolo somados a Estômago, Baço e pontos de dor. Conclusão: o grupo sem protocolo obteve melhores resultados para redução de estresse e melhoria de qualidade de vida, demonstrando que a auriculoterapia chinesa quando feita de forma individualizada / Introduction: Hospitals Nursing Team have been exposed to highly stressful work environment and submitted many times to precarious work conditions and thus low quality of life. Chinese auricular therapy has presented efficiency in a preliminary study to reduce stress by a selected protocol based on Chinese Traditional Medicine (MTC). This Clinical Trial is proposed to evaluate the effectiveness and reach of the technique whenever this is applied with or without a closed protocol. Objectives: Describe and investigate the stress levels of Samaritano Hospitals Nursing Team; Compare the effectiveness of Chinese Auricular Therapy performed with or without protocol; Describe the main diagnosis of MTC for stress and efficiency of the selected points. Material and Method: On the first phase, 484 professionals answered to a questionnaire containing demographic social data and to the Vasconcelos List of Stress Symptoms (LSS). Those ones with score between 37 and 119 points (average and high stress) were included. 213 people were randomized in 3 groups (control, protocol group and group without protocol); 175 ended a 12-session auricular therapy treatment with semi-permanent ear needles twice a week for six weeks. The scoring protocol used was: Kidney point, Brain stern point, Shenmen and Yang of the Liver 1 and 2. The instruments for the data collection in the Clinical Trial were LSS, Lipp Stress Symptoms Inventory (ISSL), Instrument of Life Quality (SF36v2), MTC diagnosis chart. The period of data collection was between November 2011 and July 2012 and seven acupuncturists participated in the trial. This study was approved by the School and Hospital Ethical Committee on Clinical Trial. Results: On the first phase, the average scoring of stress was of 45,92 (average level of stress). The professionals that presented higher stress levels were: nurses (p=0,012), morning shift professionals (p=0,022) and subjects with self-referred diseases (p=0,001). On the second phase, the two intervention groups presented differences once compared with the control group (p<0,05), with higher effect in the group without protocol according to LSS in the after treatment and follow-up. Regarding ISSL, there were better results to without protocol group for resistance/quasi-exhaustion phase and physical domain of alert phase. In relation to SF36v2, there was statistics difference (p<0,05) only for the group without protocol in connection with physical dominance during follow-up. In mental dominance, both of intervention groups presented positive results (p<0,05), with an slight superior effect for the group without protocol as per Cohens index. The main MTC diagnosis was: Qi stagnation and Xue in the tendino-muscular meridians, Stomach Heat and Rising of Yang of the Liver, Qi stagnation of the Liver, Shen Disturbs, Kidney Yin Deficiency, Qi deficiency and Xue of Spleen-Pancreas. The mostly used points were the five ones of the protocol plus Stomach, Spleen and pain points. Conclusion: the group without protocol presented the best results for stress reduction and improvement of life quality, demonstrating that Chinese auricular therapy made in a personalized way broaden the reach of the technique.

Despite intense research efforts, the repair of large bone defects is still not satisfactory and remains a major challenge in Orthopaedic Surgery. In this context bone tissue engineering has emerged as a promising strategy. However, one of the fundamental principles underlying tissue engineering approaches is that newly formed tissue must maintain sufficient vascularization to support its growth. Thus an active blood vessel network is an essential pre-requisite for scaffold constructs to integrate within existing host tissue. Currently, great efforts are made to address this problem employing transplantation of vascular cells and loading of appropriate biological factors. Endothelial progenitor cells (EPCs) are a heterogeneous subpopulation of bone marrow mononuclear progenitor cells with potential for differentiation to the endothelial lineage and thus vasculogenic capacity. However, clinical studies reported that with the increase of age, increased susceptibility to apoptosis and accelerated senescence may contribute to the numerical and functional impairments observed in EPCs, which may lead to a reduced angiogenic capacity and an increased risk of vascular disease. Hence attention has increasingly been paid to enhance mobilization and differentiation of EPCs for therapeutic purposes. A large body of evidence indicates that in Traditional Chinese Medicine (TCM) a plethora of herbs and herbal extracts are effective in the treatment of vascular diseases such as chronic wounds, diabetic retinopathy and rheumatoid arthritis. Thus, it seems rational to explore these medicinal plants as potential sources of novel angiomodulatory factors. In this thesis we demonstrated that treatment with TCM herbal extracts promote cell growth, cell migration, cell-matrix and capillary-like tube formation of BM-EPCs. Among these TCM extracts, Salidroside (SAL) and Icariin (ICAR) incubation increased VEGF and nitric oxide secretion, which in turn mediated the enhancement of angiogenic differentiation of BM-EPCs. A mechanic evaluation provided evidence that SAL stimulates the phosphorylation of Akt, mammalian target of rapamycin (mTOR) and ribosomal protein S6 kinase (p70S6K), as well as phosphorylated ERK1/2, which is associated with the cell migration and tube formation. Furthermore, a pilot in vivo study showed that SAL has the potential to enhance bone formation in a murine femoral critical-size bone defects model. Another new finding of the present study is that hydrogen peroxide (H2O2)-induced cytotoxicity is counteracted by TCM extracts. We found that SAL, Salvianolic acid B (SalB) and ICAR significantly abrogated H2O2-induced cell apoptosis, reduced the intracellular level of reactive oxygen species (ROS) and nicotinamide adenine dinucleotide phosphate-oxidase (NADPH) expression, and restored the mitochondrial membrane potential of BM-EPCs. Our data suggest that this protective effect of SalB is mediated by the activation of mTOR, p70S6K, 4EBP1, and by the suppression of MKK3/6-p38 MAPK-ATF2 and ERK1/2 signaling pathways after H2O2 stress. In addition, the investigation also demonstrates that ICAR owns the ability to inhibit apoptotic and autophagic programmed cell death via restoring the loss of mTOR and attenuation of ATF2 activity upon oxidative stress. Based on the outcomes of the present work, we propose SAL, SalB and ICAR as novel proanigiogenic and cytoprotective therapeutic agents with potential applications in the fields of systemic and site-specific tissue regeneration including ischaemic disease and extended musculoskeletal tissue defects.

[Support Institutions:] Department of Administration of Health, University of Montreal, Canada Public Health School of Fudan University, Shanghai, China / Afin de développer un instrument de la version chinoise d`OMS outil d'auto-évaluation de la promotion de la santé dans l'hôpital(OMSOAEPSH), un processus complexe de traduction socio-culturelle a été nécessaire. De plus, de tester la fiabilité et la validité, un enquête a été menée à la fois en Chine et au Canada (Montréal), cette recherche a été le premier fois d`adopter un contre-culture de l`approche complétée qui comprend : cet origine outil en anglais d`OMSOAEPSH proposé par l’OMS a été traduit et adapté en Chinois; la traduction de l’édition source de l’OMSAÉPSH en chinois, puis sa retraduction en anglais par une autre personne afin de tester la pertinence de la ` traduction culturelle`, ensuite trois professionnels de la santé qui connaissent bien l’anglais ont commenté la qualité de la traduction. Une méthode d’échantillonnage non aléatoire a été utilisée. Huit professionnels chinois qui travaillent au sein d’organisations de santé à Montréal ont d’abord été interviewés pour finaliser une épreuve pilote. Ensuite, une enquête formelle a été effectuée dans 3 capitales provinciales en Chine (Shanghai, Kunming et Hefei) au cours de l’été 2008. Au total, quarante gestionnaires issus de vingt-deux hôpitaux de ces trois villes ont participé à la recherche. Deuxièmement, pour fournir un première description de la situation actuelle de la chine de la promotion de la santé en utilisant cette outil chinoise, ces trois villes ont les différents niveaux de développement économique et de culture différente mais ils sont tous profondément influencé par la médecine traditionnelle chinoise. Le modèle de gestion des hôpitaux chinois, l’influence et le rôle de la Médecine Traditionnelle Chinoise (MTC) pour développer la promotion de la santé en Chine ont fait l’objet d’une discussion approfondie dans cette thèse. Tous les répondants ont été volontaires pour participer à la première enquête et la reprise de l`enquête après trois – sept jours. La fiabilité des analyses de cohérence interne par Alpha de Cronbach, inter-évaluateurs fiabilité par analyses de corrélation, Test-retest fiabilité par Paire Sample T-test, la validité des essais par le biais de l`analyse factorielle et Pearson Bivariate Correlations analyse. NPAR test a été utilisé d`analyser la promotion de la santé entre les différentes villes et de comparer leurs différents niveaux entre les différent hôpitaux de grade. Résultats : Seul un item sur quarante (le mot <contenter>) a été jugé unanimement comme ayant un sens différent par rapport à la version originale. Le coefficient alpha de Cronbach’s était 0.938 pour l'ensemble des items et de 0.896 pour l`ensemble des domaines. Cette total de Cronbach Appha de l` coefficient pourrait être affecté par le nombre d`indicateurs. L'alpha de Cronbach’s de la norme 1 à norme 5 était : 0.79, 0.82, 0.81, 0.79 et 0.76. L’analyse du modèle ‘Split-half’ de 0.1 à 1, indiquant qu'il n'y avait aucune différence significative entre les valeurs de l'essai initial et l'essai de répétition de chaque article (pré et post test). Ceci montre que l'outil (version chinoise) est fiable. L’analyse factorielle confirme la validité d`OMSOAEPSH chinoise en général, mais sa validité a besoin de nouvelles recherches théoriques et empiriques. Les données qualitatives montrent que tous les participants pensent que cet outil d'auto-évaluation est avantageux en théorie mais, en pratique, seulement 17 des 35 répondants [chefs d’hôpitaux] entendent utiliser cet instrument dans leur milieu de travail, 15 des 35 gestionnaires d'hôpital l'ont refusé, et 3 employés ne sont pas sûr de l'utiliser. Le score moyen de promotion de la santé, du plus élevé au moins élevé était: norme 5 : 28.95 (72.4% du score plein), norme 4 : 35.7 (71.4%) ; norme 3 : 21.34 (71.1%) ; norme 2 : 28.85 (68.1%) ; norme 1 : 28.17 (62.6%). Le score mayen d`évaluation pour les différents hôpitaux de Grade III à Grade I était154.19 + 7.34 (n=21), 158.67 + 10.7 (n=9), 144.82 + 14.54 (n=11). Le résultat d’analyse de variance a montré qu'il n'y avait aucune différence significative entre les valeurs de différents Grades hôpitaux. Cette thèse a souligné les valeurs caractéristiques du système de soins chinois, notamment que la prévention de la maladie est primauté, le service centré sur le patient- sens. La MTC, combinée avec la médecine occidentale, ainsi que le rôle de l'hôpital, doivent permettre la promotion de la santé dans les communautés environnantes ; ce sont les stratégies pour développer la promotion de la santé, même si la Chine présente un certain nombre de conditions difficiles à ce développement. Cette recherche crée une base pour de futures recherches sur une promotion de la santé efficace dans les hôpitaux chinois. / The first purpose of this research is to develop a Chinese version (WHO self-assessment tool for Health Promotion in Hospital(WHOSATHPH), and test its reliability and validity through a pilot test in Canada (Montréal) and spot field investigation in China, this research was the first time to adopt completely cross-culture approach which includes:translated the source English edition tool into Chinese, then back translated it into English. 8 Chinese health professionals who have worked both in China and Montreal were investigated to complete the pilot test. Then 3 health professionals whose work language is English (1 Native American, 1 evaluation professor, the author of WHOSATHPH) commented the back-translation quality. The spot field investigation was performed in three Chinese capital cities, Shanghai, Hefei and Kunming from 5 June to 30 August 2008. Non-probability sample was used to survey 40 hospital leaders who are from 22 China hospitals, and 3 health management researchers (include 1 government officer). The second purpose of this research is to provide a primary description of China current HPH development by using this Chinese version WHOSATHPH, and to discuss China current hospital service evaluating principle and management model, and analysis the value and culture of TCM and its role and influence to China HPH development. Three capital cities(Shanghai, Kunming, and Hefei) which stand for different economic development level and different culture context feature but all deep influenced by TCM were investigated. 22 hospitals and 35 hospital leaders were given interview while they answered the questionnaire. All the respondents were vonluntary to take part in the first survey and the repeat survey after 3-7 days if they would like to. Reliability analysis include internal consistency(Cronbach Alpha),inter-rater relibility(Correlation analysis),Test-retest reliability( Paire-Sample T-test), Validity Test through factor analysis and Pearson Bivariate Correlations analysis. NPAR test was used to analyize the different cities and different grade hospitals comparison. Result: Only 1 word <satisfy>) was marked different meaning comparing with the back translation English version with original version by all of them. Reliability measures utilized Cronbach's Alpha, the general coefficient of the Chinese version WHOSATHPH was 0.938, Cronbach's alpha for the domains was 0.896. The Cronbach`s alpha for v five standards from one to five were: 0.793, 0.819, 0.807, 0.785, 0.755. 8 groups data were used for Inner-raters analysis, result shows that Shanghai respondents had comment consistency but Hefei and Kunming respondents didn't show inner raters assessed consistency. Pair T-Test for 40 items between pre and post test, the signification p was from 0.1-1 which indicates not statistic significant difference. Factor analysis shows this tool has the general theory construct validity, but the domain construct validity has not show the contruct validity. The results showed that Chinese version WHOSATHPH has high internal consistency but the high Cronbach`s Alpha might concern to the number of items. All the respondents thought WHOSATHPH was valuable in theory research, 15 respondents refused to use this instrument in their work, only 17 respondents accepted it, 3 respondents were not sure to use. The rejective reasons were: no government finance budget support, no demand from the government, difficult to follow. The acceptive reasons were: help to improve the work quality, help to guide HPH development. This research result shows that the Chinese version has reliability and general construct validity, but its validity needs the further conceptual and empirical research to prove. ① For five standards from the highest to lowest: standard5 (continuity and cooperation) 28.95(72.4% of full score), standard4 (healthy workplace) 35.71(71.4%), standard3 (patient information and prevention) 21.34 (71.1%), standard2 (patients assessment) 23.85 (68.1%), standard1 (management and policy) 28.17(only 62.6% of full score). These results show China hospitals has better HPH development level, their means are all over 60% of full score,②The mean of the total score for different grade hospital were: Grade III (n=21)154.19 + 7.34, Grade II(n=9) 158.67 + 10.7, Grade I (n=11) 144.82 + 14.54. Variance analysis result shows that there was no statistic significant difference between different grade hospitals. However, the last conclusion need further research with large ramdom sample size investigation. This thesis discussed the quality and weakness of China health care system and its successive strategies to develop HPH in very poor finance support, huge population, and difficult social condition and polluted environment. Disease prevention first, patient-center, combined the TCM with west medicine are regarded as the successive strategies for China HPH development. This research created a foundation for future HPH research.

Afin de développer un instrument de la version chinoise d`OMS outil d'auto-évaluation de la promotion de la santé dans l'hôpital(OMSOAEPSH), un processus complexe de traduction socio-culturelle a été nécessaire. De plus, de tester la fiabilité et la validité, un enquête a été menée à la fois en Chine et au Canada (Montréal), cette recherche a été le premier fois d`adopter un contre-culture de l`approche complétée qui comprend : cet origine outil en anglais d`OMSOAEPSH proposé par l’OMS a été traduit et adapté en Chinois; la traduction de l’édition source de l’OMSAÉPSH en chinois, puis sa retraduction en anglais par une autre personne afin de tester la pertinence de la ` traduction culturelle`, ensuite trois professionnels de la santé qui connaissent bien l’anglais ont commenté la qualité de la traduction. Une méthode d’échantillonnage non aléatoire a été utilisée. Huit professionnels chinois qui travaillent au sein d’organisations de santé à Montréal ont d’abord été interviewés pour finaliser une épreuve pilote. Ensuite, une enquête formelle a été effectuée dans 3 capitales provinciales en Chine (Shanghai, Kunming et Hefei) au cours de l’été 2008. Au total, quarante gestionnaires issus de vingt-deux hôpitaux de ces trois villes ont participé à la recherche. Deuxièmement, pour fournir un première description de la situation actuelle de la chine de la promotion de la santé en utilisant cette outil chinoise, ces trois villes ont les différents niveaux de développement économique et de culture différente mais ils sont tous profondément influencé par la médecine traditionnelle chinoise. Le modèle de gestion des hôpitaux chinois, l’influence et le rôle de la Médecine Traditionnelle Chinoise (MTC) pour développer la promotion de la santé en Chine ont fait l’objet d’une discussion approfondie dans cette thèse. Tous les répondants ont été volontaires pour participer à la première enquête et la reprise de l`enquête après trois – sept jours. La fiabilité des analyses de cohérence interne par Alpha de Cronbach, inter-évaluateurs fiabilité par analyses de corrélation, Test-retest fiabilité par Paire Sample T-test, la validité des essais par le biais de l`analyse factorielle et Pearson Bivariate Correlations analyse. NPAR test a été utilisé d`analyser la promotion de la santé entre les différentes villes et de comparer leurs différents niveaux entre les différent hôpitaux de grade. Résultats : Seul un item sur quarante (le mot <contenter>) a été jugé unanimement comme ayant un sens différent par rapport à la version originale. Le coefficient alpha de Cronbach’s était 0.938 pour l'ensemble des items et de 0.896 pour l`ensemble des domaines. Cette total de Cronbach Appha de l` coefficient pourrait être affecté par le nombre d`indicateurs. L'alpha de Cronbach’s de la norme 1 à norme 5 était : 0.79, 0.82, 0.81, 0.79 et 0.76. L’analyse du modèle ‘Split-half’ de 0.1 à 1, indiquant qu'il n'y avait aucune différence significative entre les valeurs de l'essai initial et l'essai de répétition de chaque article (pré et post test). Ceci montre que l'outil (version chinoise) est fiable. L’analyse factorielle confirme la validité d`OMSOAEPSH chinoise en général, mais sa validité a besoin de nouvelles recherches théoriques et empiriques. Les données qualitatives montrent que tous les participants pensent que cet outil d'auto-évaluation est avantageux en théorie mais, en pratique, seulement 17 des 35 répondants [chefs d’hôpitaux] entendent utiliser cet instrument dans leur milieu de travail, 15 des 35 gestionnaires d'hôpital l'ont refusé, et 3 employés ne sont pas sûr de l'utiliser. Le score moyen de promotion de la santé, du plus élevé au moins élevé était: norme 5 : 28.95 (72.4% du score plein), norme 4 : 35.7 (71.4%) ; norme 3 : 21.34 (71.1%) ; norme 2 : 28.85 (68.1%) ; norme 1 : 28.17 (62.6%). Le score mayen d`évaluation pour les différents hôpitaux de Grade III à Grade I était154.19 + 7.34 (n=21), 158.67 + 10.7 (n=9), 144.82 + 14.54 (n=11). Le résultat d’analyse de variance a montré qu'il n'y avait aucune différence significative entre les valeurs de différents Grades hôpitaux. Cette thèse a souligné les valeurs caractéristiques du système de soins chinois, notamment que la prévention de la maladie est primauté, le service centré sur le patient- sens. La MTC, combinée avec la médecine occidentale, ainsi que le rôle de l'hôpital, doivent permettre la promotion de la santé dans les communautés environnantes ; ce sont les stratégies pour développer la promotion de la santé, même si la Chine présente un certain nombre de conditions difficiles à ce développement. Cette recherche crée une base pour de futures recherches sur une promotion de la santé efficace dans les hôpitaux chinois. / The first purpose of this research is to develop a Chinese version (WHO self-assessment tool for Health Promotion in Hospital(WHOSATHPH), and test its reliability and validity through a pilot test in Canada (Montréal) and spot field investigation in China, this research was the first time to adopt completely cross-culture approach which includes:translated the source English edition tool into Chinese, then back translated it into English. 8 Chinese health professionals who have worked both in China and Montreal were investigated to complete the pilot test. Then 3 health professionals whose work language is English (1 Native American, 1 evaluation professor, the author of WHOSATHPH) commented the back-translation quality. The spot field investigation was performed in three Chinese capital cities, Shanghai, Hefei and Kunming from 5 June to 30 August 2008. Non-probability sample was used to survey 40 hospital leaders who are from 22 China hospitals, and 3 health management researchers (include 1 government officer). The second purpose of this research is to provide a primary description of China current HPH development by using this Chinese version WHOSATHPH, and to discuss China current hospital service evaluating principle and management model, and analysis the value and culture of TCM and its role and influence to China HPH development. Three capital cities(Shanghai, Kunming, and Hefei) which stand for different economic development level and different culture context feature but all deep influenced by TCM were investigated. 22 hospitals and 35 hospital leaders were given interview while they answered the questionnaire. All the respondents were vonluntary to take part in the first survey and the repeat survey after 3-7 days if they would like to. Reliability analysis include internal consistency(Cronbach Alpha),inter-rater relibility(Correlation analysis),Test-retest reliability( Paire-Sample T-test), Validity Test through factor analysis and Pearson Bivariate Correlations analysis. NPAR test was used to analyize the different cities and different grade hospitals comparison. Result: Only 1 word <satisfy>) was marked different meaning comparing with the back translation English version with original version by all of them. Reliability measures utilized Cronbach's Alpha, the general coefficient of the Chinese version WHOSATHPH was 0.938, Cronbach's alpha for the domains was 0.896. The Cronbach`s alpha for v five standards from one to five were: 0.793, 0.819, 0.807, 0.785, 0.755. 8 groups data were used for Inner-raters analysis, result shows that Shanghai respondents had comment consistency but Hefei and Kunming respondents didn't show inner raters assessed consistency. Pair T-Test for 40 items between pre and post test, the signification p was from 0.1-1 which indicates not statistic significant difference. Factor analysis shows this tool has the general theory construct validity, but the domain construct validity has not show the contruct validity. The results showed that Chinese version WHOSATHPH has high internal consistency but the high Cronbach`s Alpha might concern to the number of items. All the respondents thought WHOSATHPH was valuable in theory research, 15 respondents refused to use this instrument in their work, only 17 respondents accepted it, 3 respondents were not sure to use. The rejective reasons were: no government finance budget support, no demand from the government, difficult to follow. The acceptive reasons were: help to improve the work quality, help to guide HPH development. This research result shows that the Chinese version has reliability and general construct validity, but its validity needs the further conceptual and empirical research to prove. ① For five standards from the highest to lowest: standard5 (continuity and cooperation) 28.95(72.4% of full score), standard4 (healthy workplace) 35.71(71.4%), standard3 (patient information and prevention) 21.34 (71.1%), standard2 (patients assessment) 23.85 (68.1%), standard1 (management and policy) 28.17(only 62.6% of full score). These results show China hospitals has better HPH development level, their means are all over 60% of full score,②The mean of the total score for different grade hospital were: Grade III (n=21)154.19 + 7.34, Grade II(n=9) 158.67 + 10.7, Grade I (n=11) 144.82 + 14.54. Variance analysis result shows that there was no statistic significant difference between different grade hospitals. However, the last conclusion need further research with large ramdom sample size investigation. This thesis discussed the quality and weakness of China health care system and its successive strategies to develop HPH in very poor finance support, huge population, and difficult social condition and polluted environment. Disease prevention first, patient-center, combined the TCM with west medicine are regarded as the successive strategies for China HPH development. This research created a foundation for future HPH research. / [Support Institutions:] Department of Administration of Health, University of Montreal, Canada Public Health School of Fudan University, Shanghai, China

The illegal trade in endangered animals in KwaZulu-Natal, with an emphasis on rhino poaching, is tactically addressed in this dissertation. The aim is to expose the nature and extent of these crimes; the victims, offenders and modus operandi involved; the adjudication of wildlife offences; the causes and consequences concerned; the relevant criminological theories to explain these crimes; and recommendations for prevention. This research intends to examine the contemporary pandemic of rhino poaching in KwaZulu-Natal, South Africa, and offer potential techniques for intervention. Furthermore, one of the main goals of the study is to reveal and enhance the extremely neglected field of conservation criminology. A general disregard by society for the environment, as well as the overall ineffectiveness and corruption of criminal justice and conservation authorities, comes to the fore. The purpose of the research is therefore to suggest possible prevention strategies in order to protect the rights of endangered species. / Criminology and Security Science / M.A. (Criminology)

The illegal trade in endangered animals in KwaZulu-Natal, with an emphasis on rhino poaching, is tactically addressed in this dissertation. The aim is to expose the nature and extent of these crimes; the victims, offenders and modus operandi involved; the adjudication of wildlife offences; the causes and consequences concerned; the relevant criminological theories to explain these crimes; and recommendations for prevention. This research intends to examine the contemporary pandemic of rhino poaching in KwaZulu-Natal, South Africa, and offer potential techniques for intervention. Furthermore, one of the main goals of the study is to reveal and enhance the extremely neglected field of conservation criminology. A general disregard by society for the environment, as well as the overall ineffectiveness and corruption of criminal justice and conservation authorities, comes to the fore. The purpose of the research is therefore to suggest possible prevention strategies in order to protect the rights of endangered species. / Criminology and Security Science / M.A. (Criminology)