Centralization and Decentralization: The Relationship of Bureaucracy, Autonomy and the Principalship in Elementary Schools.

Throughout the last decade, parents and communities have continued to press for more control over their schools in an attempt to improve performance. Members of the educational community have begun calling for school restructuring to return decision making power to the school site professionals. These calls for the decentralization of our highly centralized school systems have prompted educators, researchers and political scientists to examine the organizational settings in which schools operate. This study investigated the influence of organizational structure, namely centralized bureaucracy and decentralized autonomy on school leadership and the relationship of that leadership to the school\u27s culture. The study has been conducted in two phases. Phase I was quantitative in nature and examined the managerial practices of the principal. Phase II focused on the culture of the school as it is influenced by the principal and is a qualitative case study of four schools operating in both types of organizational structure as they exist in the public and non-public sector. Phase I employed a survey with responses subjected to chi-square analyses. Ten administrative tasks were selected to determine if a relationship existed between the type of governance (public/non-public) and the perception of organizational structure (centralized/decentralized). Six of the tasks showed a significant relationship. Phase II sought to discover the principal\u27s role in shaping the culture of a school which operated in each organizational structure. Qualitative case studies were employed to focus on a school in each group. Sashkin\u27s framework was employed in a cross-case analyses. In both the public and non-public sector, decentralization seemed to enhance the principal\u27s role in the culture building process

Proyecto de intervención psicosocial para pacientes con trastorno esquizofrénico crónico

El presente trabajo trata de una intervención psicosocial, dirigida a pacientes diagnosticados de esquizofrenia, derivados de cualquier unidad del Sistema Público de Sanidad y usuarios de un centro de día. El objetivo general es la mejora de la vida en comunidad de éstos a través de la rehabilitación cognitiva, el entrenamiento en habilidades sociales, la intervención familiar, el entrenamiento en actividades de la vida diaria y la psicoeducación. Con esta intervención se persigue una disminución en las recaídas de los pacientes con el consecuente descenso de su institucionalización

Rapeseed napin and cruciferin are readily digested by poultry

Rapeseed proteins have been considered as being poorly digestible in the gut of non-ruminants. The aim of the study was to assess the digestibility of napin and cruciferin in ileal digesta of broiler chickens, testing sixteen samples of rapeseed co-products with protein levels ranging from 293 g/kg to 560 g/kg dry matter. Each sample was included into a semi-synthetic diet at a rate of 500 g/kg and evaluated with broiler chickens in a randomised design. Dietary and ileal digesta proteins were extracted and identified by gel-based liquid chromatography–tandem mass spectrometry (LC-MS/MS). Three isomers of napin (a 2S albumin) and nine cruciferins (an 11S globulin) were identified in the rapeseed co-products, whereas six endogenous enzymes such as trypsin (I-P1, II-P29), chymotrypsin (elastase and precursor), carboxypeptidase B and α-amylase were found in the ileal digesta. It is concluded that as none of the rapeseed proteins were detected in the ileal digesta, rapeseed proteins can be readily digested by broiler chickens, irrespective of the protein content in the diet

Le développement des nouvelles technologies en médecine générale : utilisation, attentes et appréhensions des médecins généralistes du Cotentin dans leur pratique : étude qualitative par entretiens semi-dirigés auprès de médecins généralistes du Cotentin

Introduction: the new technologies are being implemented in our health system and are going to transform progressively the face of our medicine. At this moment in time is the development of share medical record, telemedicine and connected tools. The objective is to work out the importance of these new technologies in the everyday practice of the Cotentin doctors. Methods: semi-directed interviews took place with a panel of general practitioners from Cotentin, according to a qualitative method with thematic study. Results: these doctors have integrated the informatic tool in their practice, improving the care of their patients, except in case of home visiting, a complex situation. They dream of a tool that could further simplify their daily practice.The DMP, welcomed rather favorably, should improve communication, espacially between city and hospital. But its implementation remains a source of questions. Despite some reluctance, doctors adhere to the telemedicine, which seems to be a concrete response to medical desertification. Discussion: doctors are aware that the development of new technologies, carried by the government, will transform their practice. Tools of the "future" are already developed by the government and private companies that have burst onto the telemedicine market, with a risk of consumerization of medicine. However, the delay of deployment of the very broadband internet slows down its growth. This digital revolution should not make us forget that the foundations of the medicine of tomorrow will always rest on the base of the doctor-patient relationship.Introduction : les nouvelles technologies sont en train d’intégrer notre système de santé et vont progressivement transformer le visage de la médecine. L’heure est au développement du Dossier Médical Partagé, de la télémédecine et des outils connectés. L’objectif était de faire un état des lieux de la place de ces nouvelles technologies dans la pratique des médecins généralistes du Cotentin. Méthode : des entretiens semi-dirigés ont été effectués auprès d'un panel de médecins généralistes du Cotentin selon la méthode qualitative avec étude thématique. Résultats : ces médecins ont bien intégré l’outil informatique dans leur pratique, qui améliore la prise en charge de leurs patients, sauf dans le cas de la visite à domicile, situation complexe. Ils rêvent d’un outil qui simplifierait encore leur quotidien. Le DMP, accueilli plutôt favorablement, devrait permettre d’améliorer surtout la communication entre ville et hôpital. Mais sa mise en pratique reste source d’interrogations. Malgré quelques réticences, les médecins adhèrent à la télémédecine, qui semble être une réponse concrète à la désertification médicale. Discussion : les médecins ont conscience que le développement des nouvelles technologies, porté par le gouvernement, va transformer leur pratique. Des outils du futur sont déjà développés par l’État et des sociétés privées qui se sont engouffrées sur le marché de la télémédecine, avec un risque de consumérisation de la médecine. Mais le retard de déploiement de l’internet très haut débit freine son essor. Cette révolution numérique ne devra pas faire oublier que les fondements de la médecine de demain reposeront toujours sur le socle de la relation médecin-patient

Modélisation simplifiée d'assemblages par éléments équivalents

Nowadays, numerical simulation has become a mandatory tool to design and optimise industrial parts. Even though the progress made in terms of computational resources have been tremendous, simulations are getting increasingly complex and thus ever more "memory and CPU greedy". All these issues have to be considered in the field of assembly. Indeed, modelling each assembly point with a non negligible number of nodes and elements would make the CPU cost explode because running a simulation of assemblies containing a high number of assembly points (e.g. plane, car, bridge, etc.) fully modelled would lead to solve many local non-linear problems such as contact problems, large deformations, plastic and damage behaviour, etc. A new way to carry out such simulations - while keeping at the same time reasonable CPU and memory needs - is then required. The idea is to create an equivalent element which would therefore be used in replacement of each assembly point and thus provide simplification in the treatment of each simulation. Although this element simplifies the model, it has to model as closely as possible all the non-linear mechanical behaviour and the geometrical properties of the initial assembly point. Several representation are presented including a virtual representation built with the default finite elements when two plates are simply put in contact. The aim of this equivalent element is to model one part of a structure containing an assembly point by a simplified part (e.g. beam element, spring, etc.) integrating a maximum of information about the nature of this part (mechanical properties, geometry, etc.) with respect to the local and global elastic plastic behaviour of the structure. An equivalent damage evolution law to model the rupture of the assembly point is also developped within the virtual representation. First of all, a complete model to help define properly the equivalent element must be introduced. This model depends on the materials (with a specific elastic plastic behaviour) and the geometry considered. The thermo-mechanical past due to the assembly point insertion is considered. The equivalent element's behaviour is then identified using F/d or C/d curves from the complete model through an optimisation step whose goal is to minimise a cost function representing the least square error between the complete and equivalent F/d an C/a curves. Eventually, an additional simplification of the assembly point - faster but less precise - has been elaborated using the connectors concept. A condensation of the virtual element to construct this connector is done through the use of all the results coming from former virtual representation's simulations. All these representations are validated on multipoint assemblies cases by comparing numerical and experimental results.Les départements de conception de pièces industrielles ont de plus en plus à modéliser de grandes structures contenant un nombre important de points d'assemblage (ex : avion, pont, rails, etc.). Cependant, exécuter des simulations avec une représentation explicite de chaque point d'assemblage reste à ce jour inenvisageable : problèmes numériques liés aux nombreux problèmes non-linéaires locaux à résoudre (contact, plasticité, endommagement), temps calculs et besoins mémoires trop importants, etc.). Afin de garder des temps de calcul raisonnables, une méthodologie visant à représenter en 3D le point d'assemblage de manière simple, tout en restant physiquement représentatif de la réalité, est nécessaire. Les travaux de cette thèse portent sur la mise au point d'une méthodologie basée sur une méthode innovante en éléments finis pour représenter de manière précise un point d'assemblage par déformation plastique (rivet, point clinché, vis, etc.) en prenant en compte le passé thermomécanique issu de la pose de ce point. Ces travaux sont réalisés sous FORGE et seront à terme développé dans la Cimlib. Plusieurs représentations du point d'assemblage sont proposées, notamment une représentation virtuelle, élaborée à partir des éléments finis définis par défaut lorsque deux plaques sont mises en contact. Le but d'un tel élément équivalent est de modéliser le comportement mécanique du point d'assemblage aussi précisément que possible selon six sollicitations mécaniques de base. Pour ce faire, le comportement équivalent optimal est identifiée à l'aide des courbes F/d et C/a des différentes sollicitations obtenus à l'aide d'un modèle complet numérique intégrant un comportement élasto-plastique. Une loi d'évolution de l'endommagement équivalent est aussi développée dans l'élément équivalent virtuel pour modéliser la rupture du point d'assemblage. Cette approche peut être assimilée à un problème d'optimisation où une fonction coût, définissant l'écart au sens des moindres carrés entre les deux courbes F/d ou C/a des modèles complet et équivalent, doit être minimisée. Une approche par Stratégie d'Evolution avec Métamodèle a été testée et s'est avérée fructueuse. Enfin, une synthèse du modèle équivalent virtuel vers un modèle simplifié utilisant un élément connecteur– plus rapide encore mais moins précis – est présentée. Toutes ces représentations sont validées sur des assemblages multipoints en comparant les résultats obtenus à la fois au modèle complet numérique et à des essais expérimentaux

An equivalent element approach for modelling assembly points in joined structures

International audienceThis paper presents an innovative computational methodology to create an equivalent element which best simplifies assembly points while keeping its physical behaviour realistic

Supplementary data Cutaneous tuberculosis

Supplementary data concerning manuscript "Cutaneous tuberculosis: a 24-year retrospective multicenter study in Paris, France"THIS DATASET IS ARCHIVED AT DANS/EASY, BUT NOT ACCESSIBLE HERE. TO VIEW A LIST OF FILES AND ACCESS THE FILES IN THIS DATASET CLICK ON THE DOI-LINK ABOV

Pragmatic Function and Frequency of the Discourse Markers Yeʕni, Êsta, Xoi, and Îtr in Spoken Contexts in Central Kurdish

This is a sociolinguistic study which explores how the discourse markers (DMs) yeʕni, êsta, xoi and îtr (usually translated as English I mean) are used in conversation by three groups of Kurdish-speaking participants (12 first year undergraduate students, 12 fourth year undergraduate students, and 12 lecturers) who study and work in the English departments in universities in Kurdistan. The motivation behind this study is to discover the functions of the DMs in Kurdish, and to understand and explain the similarities and differences in the uses of the DMs by the different groups. The research first qualitatively and quantitatively investigates the pragmatic functions of yeʕni and then compares the results to functions identified in previous Arabic, Turkish, and Persian studies. The data analysis demonstrates that the use of yeʕni in Kurdish is similar to its use in other languages. Next, I analyse the pragmatic functions signalled by the three possible equivalent DMs in Kurdish: êsta, xoi, and îtr. The findings reveal that êsta, xoi, and îtr were used to signal several of pragmatic functions associated with yeʕni. In addition, the results indicate that interchangeability between yeʕni and êsta, xoi and îtr is possible in some cases. The results suggest that principles of grammaticalisation, such as phonetic reduction and layering, could explain the development of interchangeability of the DMs. Furthermore, I have investigated and explained the behaviour of the groups using a quantitative analysis of frequencies and sociolinguistic concepts such as Community of Practice. This study contributes to our understanding of language variation and grammaticalisation, the functions of discourse markers, and the Kurdish language. It should be of interest to linguists, researchers, lecturers, and students who study Kurdish, Arabic, and English

An innovative strategy to create equivalent elements for modelling assembly points in joined structures

International audiencePurpose - Large structures (e.g. plane, bridge, etc.) often include several hundreds of assembly points. Structural computations often use over-simplistic approximations for these points; among others, they do not take into account the thermo-mechanical history due to the assembling process. Running computations with each assembly point modelled completely would require too much time to achieve a simulation. There is thus a need to create equivalent elements for assembly points in order to: take into account the mechanical state of the assembly point in the design stage - while reducing the computational time cost at the same time. This paper aims to discuss these issues. Design/methodology/approach - This paper introduces an innovative strategy based on a coupling procedure between a finite element tool for modelling the assembly process in order to access to the mechanical state of the assembly point and an optimisation algorithm, in order to identify the equivalent element parameters. Findings - The strategy has proven to be successful. A connector model easier to use and much faster than the complete model, has been obtained. Results obtained with this element are in good agreement with experimental tests in the case of multipoint assemblies and with the simulation results of the complete numerical model. Finally the connector model appears to be easier to use and much faster than the complete model, more difficult to model properly. Originality/value - The main innovative aspects of this strategy lie in the fact that the creation of this equivalent element is based on a complete numerical approach. The thermo-mechanical history due to the assembly process is considered - the element parameters are identified thanks to an evolution strategy based on the coupling between a finite element model and a zero-order minimisation algorithm

Farmacovigilancia intensiva del uso de antibióticos prescritos a pacientes ingresados en el servicio de cirugía del Hospital Escuela Oscar Danilo Rosales Argüello, del 26 de abril al 26 de julio del año 2017

Tesis (Dr. Médico y Cirujano)-Universidad Nacional Autónoma de Nicaragua, LeónIntroducción: Las R.A.M. son causas importantes de mortalidad y morbilidad, tanto en pacientes hospitalizados y ambulatorios. En muchos países las R.A.M. se encuentran entre las 10 principales causas de mortalidad, estas pueden ocurrir ante la exposición a cualquier medicamento. La categoría farmacológica que produjo con mayor frecuencia de R.A.M. fueron los antibióticos, registrándose las mismas en aproximadamente el 16% de los pacientes. Metodología: Se realizó un estudio de utilización de medicamentos de corte transversal, con énfasis en la identificación de reacciones adversas causadas por los antibióticos, en pacientes ingresados en el servicio de cirugía del HEODRA, del 26 de abril al 26 de julio del 2017. Resultados: Se incluyeron al estudio 204 pacientes, de los cuales el 65.7% fueron del sexo femenino y el 77% mayores de 20 años (rango 12 a 98). Según las categorías diagnósticas de la CIE10 la enfermedad biliar y enfermedad del apéndice fueron las principales causas de ingresos. Los antibióticos administrados en estos pacientes con mayor frecuencia fueron la ceftriaxona (48.5%) y cefazolina (46.5%). El 7.8 % (n = 16) de los pacientes, expuestos a los antibióticos presentaron al menos una R.A.M. imputable a éstos. El antibiótico que provocó más R.A.M fue ceftriaxona (31.2%), seguido de clindamicina (18.7%), gentamicina y metronidazol cada una con 12.5%; además de otros como ciprofloxacino, penicilina cristalina, levofloxacino y amikacina cada una respectivamente con 6.2%. Según la escala de evaluación de Naranjo que imputa la causalidad de las reacciones adversas de los medicamentos en dudosa, posible, probable y definitiva, en nuestro estudio el 90% (n=27) fueron posibles y el 10%(n=3) probables; según la clasificación Rawlings y Thompson el 96.6% fueron de Tipo A, siendo éstas dependientes de la dosis y predecible a las acciones farmacológicas del medicamento y, el 3.3% de tipo B, las cuales son impredecibles y su tratamiento requiere la suspensión de éste. De acuerdo a la escala de severidad de la reacción adversa propuesta por Hartwing y Siegel, el 70% fueron leves, seguido de las moderadas con 30%UNAN-LEO