Accès aux soins et communication : vers une passerelle entre la communauté sourde et les soignants de Suisse romande

Cette étude pionnière dans le domaine de la psychologie communautaire de la santé, en donnant la parole à des membres de la communauté sourde suisse romande, jette un éclairage qualitatif sur les rapports soignants-patients. Trois focus groupes en langue des signes avec des personnes sourdes ainsi que 15 entretiens de recherche semi directifs avec des soignants ont été menés. Une analyse thématique de contenu assistée par le logiciel Iramuteq a été effectuée sur les données qualitatives récoltées. Les résultats mettent en lumière différents obstacles à la mise en place d'une communication satisfaisante entre ces acteurs du terrain. Les participants expriment des avis différents et nuancés au sujet de la surdité, des relations patients-soignants, de la communication et de ses obstacles, de l'autonomie des patients, du contexte médical actuel et de ses améliorations. Une comparaison de leurs discours a été effectuée afin de souligner les similitudes et les divergences qu'ils présentent. En élaborant des pistes concrètes d'amélioration ainsi que des perspectives technologiques, pédagogiques et politiques, basées sur les propos tenus par ses participants, cette étude entend sensibiliser le monde médical aux besoins spécifiques de cette communauté et participer activement à cette évolution. -- This pioneering community health psychology study, focusing on the deaf community of the French speaking part of Switzerland, throws a qualitative lighting on caregivers - patient relationships. Three focus groups in sign language with deaf people and 15 semi-structured interviews with caregivers were conducted. A thematic content analysis assisted by Iramuteq software was performed on collected qualitative data. The results of this community health psychology research highlight different barriers to the development of a good communication between those actors. Participants express different and nuanced opinions about deafness, patient-caregiver relationship, communication - and its barriers-, the current medical context and its improvement. A comparison of their speeches was carried out to highlight their similarities and differences. By developing concretes improvements and technological, educational and political perspectives - based on the words of the participants -, this study intends to educate the medical community to the specific needs of the deaf community and actively participate in this development

Fractional Moment Estimates for Random Unitary Operators

We consider unitary analogs of $d-$dimensional Anderson models on $l^2(\Z^d)$ defined by the product $U_\omega=D_\omega S$ where $S$ is a deterministic unitary and $D_\omega$ is a diagonal matrix of i.i.d. random phases. The operator $S$ is an absolutely continuous band matrix which depends on parameters controlling the size of its off-diagonal elements. We adapt the method of Aizenman-Molchanov to get exponential estimates on fractional moments of the matrix elements of $U_\omega(U_\omega -z)^{-1}$, provided the distribution of phases is absolutely continuous and the parameters correspond to small off-diagonal elements of $S$. Such estimates imply almost sure localization for $U_\omega$

Recurrence for discrete time unitary evolutions

We consider quantum dynamical systems specified by a unitary operator U and an initial state vector \phi. In each step the unitary is followed by a projective measurement checking whether the system has returned to the initial state. We call the system recurrent if this eventually happens with probability one. We show that recurrence is equivalent to the absence of an absolutely continuous part from the spectral measure of U with respect to \phi. We also show that in the recurrent case the expected first return time is an integer or infinite, for which we give a topological interpretation. A key role in our theory is played by the first arrival amplitudes, which turn out to be the (complex conjugated) Taylor coefficients of the Schur function of the spectral measure. On the one hand, this provides a direct dynamical interpretation of these coefficients; on the other hand it links our definition of first return times to a large body of mathematical literature.Comment: 27 pages, 5 figures, typos correcte

Localization for Random Unitary Operators

We consider unitary analogs of $1-$dimensional Anderson models on $l^2(\Z)$ defined by the product $U_\omega=D_\omega S$ where $S$ is a deterministic unitary and $D_\omega$ is a diagonal matrix of i.i.d. random phases. The operator $S$ is an absolutely continuous band matrix which depends on a parameter controlling the size of its off-diagonal elements. We prove that the spectrum of $U_\omega$ is pure point almost surely for all values of the parameter of $S$. We provide similar results for unitary operators defined on $l^2(\N)$ together with an application to orthogonal polynomials on the unit circle. We get almost sure localization for polynomials characterized by Verblunski coefficients of constant modulus and correlated random phases

Hydrodynamic modelling of overtopping flow over granular dikes

[EN] This paper presents a comparative analysis of the last advances in depth-averaged modelling of overtopping flow over granular dikes. Among the most relevant models in this field, three families of models are described: (i) non-hydrostatic models with sediment transport, (ii) hydrostatic models with sediment transport and dynamic granular beds, and (iii) hydrostatic models with sediment transport as bed-load. To study their suitability, examples of the three families of models are compared using experimental data of dike overtopping. Whilst the hydrostatic model with bed-load sediment transport shows a fair agreement with the experimental data, the results by the non-hydrostatic model produces a more accurate free surface profile up to the dike crest domain. The results by the hydrostatic model assuming dynamic bed deformation enhances the predictions near the dike toe downstream. Finally, the limitations of the models are discussed.[ES] Este trabajo presenta un análisis comparativo entre los últimos avances en el modelado promediado de flujos sobre diques de materiales sueltos. Entre los modelos más relevantes se encuentran: (i) modelos no hidrostáticos con transporte de sedimentos, (ii) modelos hidrostáticos con transporte de sedimentos y movimiento dinámico granular y (iii) modelos hidrostáticos con transporte de sedimentos por carga de fondo. Los tres tipos de modelos son comparados con datos experimentales para discutir su aplicabilidad. Mientras que el modelo hidrostático con transporte de sedimentos por carga de fondo presenta una solución adecuada en términos generales, el modelo no hidrostático permite mejorar la predicción del flujo en la cresta del dique, mientras que el modelo con movimiento granular dinámico permite mejorar las predicciones cerca del pie del dique. Por último, se discuten las limitaciones de los modelos.Este trabajo ha sido financiado por el Ministerio de Ciencia, Innovación y Universidades a través del proyecto de investigación CTM2017-85171-C2-1-R, el Programa Juan de la Cierva 2016 (FJCI-2016-28009) y el Programa Juan de la Cierva 2017 (FJCI-2017-31781).Cantero-Chinchilla, F.; Bergillos, R.; Castro-Orgaz, O. (2019). Modelización hidrodinámica del flujo sobre diques de materiales sueltos. Ingeniería del Agua. 23(3):215-227. https://doi.org/10.4995/ia.2019.12085SWORD21522723

Efecto de diferentes formulaciones de carga de fondo en flujos transitorios con lecho móvil

El objetivo de este trabajo es realizar un estudio comparativo entre diferentes formulaciones de carga de fondo (García, 2008), y su efecto en transitorios con lecho móvil, tomando como caso de estudio la rotura de presa, a través de la modificación empírica propuesta por Wu y Wang (2007). Para ello se emplean las ecuaciones de Saint-Venant para lecho móvil desarrolladas por Wu y Wang (2007), las cuales se resuelven mediante el uso de un esquema de volúmenes finitos

Development of a Novel Prediction Model for Red Blood Cell Transfusion Risk in Cardiac Surgery

Background: Cardiac surgery is a complex and invasive procedure that often requires blood transfusions to replace the blood lost during surgery. Blood products are a scarce and expensive resource. Therefore, it is essential to develop a standardized approach to determine the need for blood transfusions in cardiac surgery. The main objective of our study is to develop a simple prediction model for determining the risk of red blood cell transfusion in cardiac surgery. Methods: Retrospective cohorts of adult patients who underwent cardiac surgery between 2017 and 2019 were studied to identify hypothetical predictors of blood transfusion. Finally, a multivariable logistic regression model was developed to predict the risk of transfusion in cardiac surgery using the AUC and the Hosmer–Lemeshow goodness-of-fit test. Results: We included 1234 patients who underwent cardiac surgery. Of the entire cohort, 875 patients underwent a cardiac procedure 69.4% [CI 95% (66.8%; 72.0%)]; 119 patients 9.6% [CI 95% (8.1%; 11.4%)] underwent a combined procedure, and 258 patients 20.9% [CI 95% (18.7; 23.2)] underwent other cardiac procedures. The median perioperative hemoglobin was 13.0 mg/dL IQR (11.7; 14.2). The factors associated with the risk of transfusion were age > 60 years OR 1.37 CI 95% (1.02; 1.83); sex female OR 1.67 CI 95% (1.24; 2.24); BMI > 30 OR 1.46 (1.10; 1.93); perioperative hemoglobin < 14 OR 2.11 to 51.41 and combined surgery OR 3.97 CI 95% (2.19; 7.17). The final model shows an AUC of 80.9% for the transfusion risk prediction [IC 95% (78.5–83.3%)]; p < 0.001]. Conclusions: We have developed a model with good discriminatory ability, which is more parsimonious and efficient than other models

CMV matrices in random matrix theory and integrable systems: a survey

We present a survey of recent results concerning a remarkable class of unitary matrices, the CMV matrices. We are particularly interested in the role they play in the theory of random matrices and integrable systems. Throughout the paper we also emphasize the analogies and connections to Jacobi matrices.Comment: Based on a talk given at the Short Program on Random Matrices, Random Processes and Integrable Systems, CRM, Universite de Montreal, 200

Early Postoperative Monitoring of the Liver Graft

Liver transplantation (LT) is a common current technique for end-stage liver disease. Complications after the surgical procedure, though uncommon, can be of very different origin and can also be severe enough to lead to liver and multiorgan failure and finally graft loss and/or recipient’s death. Intensivists and the surgical team must be familiarized with these early complications to detect them as soon as possible in order to use the best diagnostic tools and take the best therapeutic measures to restore anatomical integrity and organ function to optimize the liver graft. In this chapter, we present an updated state of the art for efficiently tackling with all different, most usual complications that an LT patient can present during early postoperative period

Refinación de la aleación de magnesio AZ91 obtenida en el reciclado de virutas de mecanizado

Fil: Lucci, Roberto O. Universidad Tecnológica Nacional, Facultad Regional Córdoba. Departamento de Ingeniería Metalúrgica; Argentina.Fil: López Padilla, Roger M. Universidad Tecnológica Nacional, Facultad Regional Córdoba. Departamento de Ingeniería Metalúrgica; Argentina.Fil: Bariles, Raúl. Universidad Tecnológica Nacional, Facultad Regional Córdoba. Departamento de Ingeniería Metalúrgica; Argentina.Fil: Cantero, Santiago. Universidad Tecnológica Nacional, Facultad Regional Córdoba. Departamento de Ingeniería Metalúrgica; Argentina.Fil: Oldani, Carlos R. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Departamento de Materiales y Tecnología; Argentina.En los últimos años se incrementó el interés por el reciclado y reutilización de las aleaciones de magnesio. La aleación de magnesio AZ91 es la de mayor aplicación. Ésta se utiliza en la industria automotriz para la fabricación de cajas de velocidades, obteniéndose en su mecanizado una gran cantidad de virutas como residuo. Las aleaciones recicladas tienen diferentes inconvenientes para su reutilización, como ser la contaminación con inclusiones no metálicas, presencia de porosidades y desajustes en la composición química. En este trabajo se presentan resultados conseguidos en la refinación de la aleación AZ91 obtenida previamente en el reciclado de virutas. El rendimiento del proceso de refinación permite recuperar un 90% del metal fundido. Las sales utilizadas permiten una refinación parcial de las aleaciones, ya que la estructura metalográfica presenta una disminución notable de inclusiones y porosidades, pero la composición química de las aleaciones obtenidas no coincide con los valores normalizados.Fil: Lucci, Roberto O. Universidad Tecnológica Nacional, Facultad Regional Córdoba. Departamento de Ingeniería Metalúrgica; Argentina.Fil: López Padilla, Roger M. Universidad Tecnológica Nacional, Facultad Regional Córdoba. Departamento de Ingeniería Metalúrgica; Argentina.Fil: Bariles, Raúl. Universidad Tecnológica Nacional, Facultad Regional Córdoba. Departamento de Ingeniería Metalúrgica; Argentina.Fil: Cantero, Santiago. Universidad Tecnológica Nacional, Facultad Regional Córdoba. Departamento de Ingeniería Metalúrgica; Argentina.Fil: Oldani, Carlos R. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas, Físicas y Naturales. Departamento de Materiales y Tecnología; Argentina.Otras Ingeniería de los Materiale