542 research outputs found
Heroines and Murderers The World of Sophoclean Women
This thesis will examine the female characters of the extant and fragmentary plays of the 5th-century BC Athenian poet Sophocles. These playsâ composition date ranges from the second half of the 5th century BC. Not every play will be considered for this study, as some do not contain female characters or female characters cannot be ascribed to a fragmentary play. Only plays that feature female characters or plays in which female characters and their actions can be reasonably estimated will be used in this study. For the fragments and their information, I shall default to Hugh Lloyd-Jonesâ 1996 Sophocles: Fragments. To ascertain which fragmentary plays and quotes are relevant, I read Lloyd-Jonesâ description for each play which he believes existed and can provide evidence written by Sophocles. In my study I use the kurios as a reference point for each female character, which is how I divided each character as âgoodâ or âbadâ in theirrespective role. Some characters can take multiple roles, such as being both a mother and wife, and will be judged by each role, as some characters will appear twice in this paper. Although I am labeling the characters good or bad, I am not condemning nor endorsing their actions but am labeling based on their actions related to their kurios. I have divided each chapter based on the progression of a typical Athenian womanâs life, starting with girlhood, then marriage, and finallymotherhood. The most important theme in Sophoclesâ work is passion, which brings out the worst and the best in different characters. Overall, I believe my thesis works the same way, showing Sophoclesâ female characters at their best and worst. Passion is a neutral force in Sophoclean drama; it is the characters themselves that decide to wield it for good or bad, and no characters exemplify this more than the Sophoclean women
Une médiathÚque pour un nouveau départ
Dans la redĂ©finition dâun quartier, lâouverture dâune mĂ©diathĂšque est un geste fort qui rĂ©sume les choix faits et signe la direction prise. Transformer une ancienne Ă©cole maternelle en mĂ©diathĂšque de quartier, tel est lâobjectif que sâest fixĂ© la Ville dâĂpernay dans le cadre de lâOpĂ©ration de renouvellement urbain (ORU) de Bernon
Triumph of hope over experience: learning from interventions to reduce avoidable hospital admissions identified through an Academic Health and Social Care Network.
BACKGROUND: Internationally health services are facing increasing demands due to new and more expensive health technologies and treatments, coupled with the needs of an ageing population. Reducing avoidable use of expensive secondary care services, especially high cost admissions where no procedure is carried out, has become a focus for the commissioners of healthcare.
METHOD: We set out to identify, evaluate and share learning about interventions to reduce avoidable hospital admission across a regional Academic Health and Social Care Network (AHSN). We conducted a service evaluation identifying initiatives that had taken place across the AHSN. This comprised a literature review, case studies, and two workshops.
RESULTS: We identified three types of intervention: pre-hospital; within the emergency department (ED); and post-admission evaluation of appropriateness. Pre-hospital interventions included the use of predictive modelling tools (PARR - Patients at risk of readmission and ACG - Adjusted Clinical Groups) sometimes supported by community matrons or virtual wards. GP-advisers and outreach nurses were employed within the ED. The principal post-hoc interventions were the audit of records in primary care or the application of the Appropriateness Evaluation Protocol (AEP) within the admission ward. Overall there was a shortage of independent evaluation and limited evidence that each intervention had an impact on rates of admission.
CONCLUSIONS: Despite the frequency and cost of emergency admission there has been little independent evaluation of interventions to reduce avoidable admission. Commissioners of healthcare should consider interventions at all stages of the admission pathway, including regular audit, to ensure admission thresholds don't change
Combining Technical and Financial Impacts for Countermeasure Selection
Research in information security has generally focused on providing a
comprehensive interpretation of threats, vulnerabilities, and attacks, in
particular to evaluate their danger and prioritize responses accordingly. Most
of the current approaches propose advanced techniques to detect intrusions and
complex attacks but few of these approaches propose well defined methodologies
to react against a given attack. In this paper, we propose a novel and
systematic method to select security countermeasures from a pool of candidates,
by ranking them based on the technical and financial impact associated to each
alternative. The method includes industrial evaluation and simulations of the
impact associated to a given security measure which allows to compute the
return on response investment for different candidates. A simple case study is
proposed at the end of the paper to show the applicability of the model.Comment: In Proceedings AIDP 2014, arXiv:1410.322
A service dependency modeling framework for policy-based response enforcement
International audienceThe use of dynamic access control policies for threat response adapts local response decisions to high level system constraints. However, security policies are often carefully tightened during system design-time, and the large number of service dependencies in a system architecture makes their dynamic adaptation di±cult. The enforcement of a single re- sponse rule requires performing multiple con¯guration changes on multi- ple services. This paper formally describes a Service Dependency Frame- work (SDF) in order to assist the response process in selecting the pol- icy enforcement points (PEPs) capable of applying a dynamic response rule. It automatically derives elementary access rules from the generic access control, either allowed or denied by the dynamic response pol- icy, so they can be locally managed by local PEPs. SDF introduces a requires/provides model of service dependencies. It models the service architecture in a modular way, and thus provides both extensibility and reusability of model components. SDF is de¯ned using the Architecture Analysis and Design Language, which provides formal concepts for mod- eling system architectures. This paper presents a systematic treatment of the dependency model which aims to apply policy rules while minimizing con¯guration changes and reducing resource consumption
Les transformations de l'Ătat territorial (2007-2010), saisies par l'analyse de l'activitĂ© des directeurs dĂ©partementaux en matiĂšre de gestion des personnels
Le processus de modernisation des services territoriaux de l'Ătat, et tout particuliĂšrement son volet managĂ©rial, s'inscrit dans une histoire dĂ©jĂ ancienne, mĂȘme si la dynamique et les modalitĂ©s du changement varient selon les dĂ©partements ministĂ©riels. Dans ces histoires, la pĂ©riode 2003-2007, avec l'introduction d'une approche budgĂ©taire diffĂ©rente (la LOLF), d'une recomposition des services dĂ©partementaux de l'Ătat (la RĂ©aTE), et d'une rĂ©novation des modalitĂ©s de gestion des emplois et des compĂ©tences, constitue un tournant qui peut ĂȘtre compris comme la diffusion des principes du new public management. La thĂšse repose sur une analyse du travail des directeurs dĂ©partementaux des ministĂšres Ă©voquĂ©s dans la rĂ©organisation dans ce contexte de modernisation tout particuliĂšrement autour du volet RH. Cette analyse est prĂ©parĂ©e par une prĂ©sentation des histoires diffĂ©renciĂ©es de la rĂ©forme dans les ministĂšres de l'Ă©quipement, de l'agriculture et de l'inspection du travail, et une prĂ©sentation de la perception de ces transformations par les agents. Ces deux aspects constituent en effet les contraintes essentielles de l'activitĂ© de conduite du changement. Ils permettent de montrer que la fonction ressources humaines joue un rĂŽle central dans les transformations propres Ă chaque ministĂšre. Ătudier le travail de ces cadres, restituer leurs secrets de fabrique, c'est Ă la fois Ă©clairer l'activitĂ© de cadres dirigeants dans une administration, qui se trouve mise Ă dĂ©couvert par le changement durant cette pĂ©riode, et mettre en Ă©vidence les enjeux de ce moment de la rĂ©forme. L'analyse des marges de manĆuvre qui leur permettent de conduire le changement, rĂ©vĂšle aussi combien se concentrent sur eux les tensions gĂ©nĂ©rĂ©es par les contradictions d'une rĂ©forme tous azimuts. La maniĂšre dont ils expriment leur inquiĂ©tude pose la question des risques d'un affaiblissement trop important de ces acteurs, seuls en mesure de mettre en cohĂ©rence des missions, des hommes et leurs compĂ©tences, et une organisation du travailThe process of modernization of the territorial services of the State, and quite particularly its manager part, is part of an already ancient story, even if the dynamics and the modalities of the change vary according to the ministerial departments. In this context, the period 2003-2007, with the introduction of a different budgetary approach (the LOLF), the reorganization of the departmental services of the State (RĂ©aTE), and the renovation of the modalities of jobs and skills management, constitutes a turning point which can be seen as the application of the principles of the new public management. The thesis bases on a job analysis of the departmental managers of ministries evoked in the reorganization in this context of modernization, quite particularly around the human resources part. This analysis is prepared by a presentation of the stories of the reform in the ministries of equipment, of agriculture, and the factory inspectorate, and a display of the perception of these transformations by the agents. These two aspects indeed constitute the essential constraints of the activity of managing the change. They show that the "human resources" post plays a central role in the transformations specific to every ministry. To study the work of these executives, to give an account of their processes, is at the same time to shed light on executives' activity in an administration, that is put openly by the change during this period, and on the stakes in this moment of the reform. The analysis of the rooms to maneuver, which enable them to lead the change, reveals also how much the tensions, generated by the contradictions of a reform everywhere, concentrate on them. The way they express their anxiety puts the question of the risks of a too important decline of these actors, the only ones able to put in coherence the missions, the men and their skills, and a work organizationPARIS-EST-UniversitĂ© (770839901) / SudocSudocFranceF
Acupuncture and Chiropractic Care: Utilization and Electronic Medical Record Capture
Objectives: To describe acupuncture and chiropractic use among patients with chronic musculoskeletal pain (CMP) at a health maintenance organization, and explore issues of benefit design and electronic medical record (EMR) capture. Study Design: Cross-sectional survey.
Methods: Kaiser Permanente members meeting EMR diagnostic criteria for CMP were invited to participate. The survey included questions about self-identified presence of CMP, use of acupuncture and chiropractic care, use of ancillary self-care modalities, and communication with conventional medicine practitioners. Analysis of survey data was supplemented with a retrospective review of EMR utilization data.
Results: Of 6068 survey respondents, 32% reported acupuncture use, 47% reported chiropractic use, 21% used both, and 42% used neither. For 25% of patients using acupuncture and 43% of those using chiropractic care, utilization was undetected by the EMR. Thirty-five percent of acupuncture users and 42% of chiropractic users did not discuss this care with their health maintenance organization (HMO) clinicians. Among chiropractic users, those accessing care out of plan were older (P \u3c.01), were more likely to use long-term opioids (P = .03), and had more pain diagnoses (P = .01) than those accessing care via clinician referral or self-referral. For acupuncture, those using the clinician referral mechanism exhibited these same characteristics.
Conclusions: A majority of participants had used acupuncture, chiropractic care, or both. While benefit structure may materially influence utilization patterns, many patients with CMP use acupuncture and chiropractic care without regard to their insurance coverage. A substantial percentage of acupuncture and chiropractic use thus occurs beyond detection of EMR systems, and many patients do not report such care to their HMO clinicians
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