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A literatura contemporânea é caracterizada por uma variedade de representações da identidade pessoal. Desde os anos 1960, a presença do sujeito narrativo no discurso literário é ubíqua. Neste artigo, discuto três modelos subjacentes à representação dos personagens ficcionais na ficção do Quebec: pós-modernismo, literatura imigrante e cultura transnacional. O princípio norteador da análise é que o sujeito literário é fortemente condicionado por mudanças sociológicas e epistemológicas. Dizer Eu na literatura contemporânea é expressar a multiplicidade do sujeito pós-moderno, a angústia da voz imigrante e a emancipação do personagem ficcional transnacional

Background: Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario - Canada's most populous province - include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials., Methods: Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention., Results: Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%), severe weather (68%) and poor air-quality (57%). Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies., Conclusions: This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into policies and programs, while higher levels of government must improve efforts to support local adaptation and provide the capacity through which local adaptation can succeed.

Chronic conditions place a significant burden on the Australian health care system, and this burden continues to increase. This literature review examines the concepts of chronic illness and chronic condition self-management (CCSM), particularly in the context of asthma. It explores the implementation of, and barriers to, CCSM in the modern health care system with a focus on CCSM in children and adolescents, and the differences that need to be recognized when dealing with Indigenous Australian children.

Telemedicine allows experts to assess patients in remote locations, enabling quality convenient, cost-effective care. To help assess foot wounds remotely, we investigated the reliability of a novel optical imaging system employing a three-dimensional camera and disposable optical marker. We first examined inter- and intraoperator measurement variability (correlation coefficient) of five clinicians examining three different wounds. Then, to assess of the system's ability to identify key clinically relevant features, we had two clinicians evaluate 20 different wounds at two centers, recording observations on a standardized form. Three other clinicians recorded their observations using only the corresponding three-dimensional images. Using the in-person assessment as the criterion standard, we assessed concordance of the remote with in-person assessments. Measurement variation of area was 3.3% for intraoperator and 11.9% for interoperator; difference in clinician opinion about wound boundary location was significant. Overall agreement for remote vs. in-person assessments was good, but was lowest on the subjective clinical assessments, e.g., value of debridement to improve healing. Limitations of imaging included inability to show certain characteristics, e.g., moistness or exudation. Clinicians gave positive feedback on visual fidelity. This pilot study showed that a clinician viewing only the three-dimensional images could accurately measure and assess a diabetic foot wound remotely., (© 2010 by the Wound Healing Society.)