La demande d’aide chez les parents vivant des difficultés avec leur adolescent - exploration de trajectoires à travers les réseaux d’aide formelle et informelle

Cette recherche, de nature exploratoire et descriptive, s’intéresse à la trajectoire de recherche d’aide chez les parents vivant des difficultés avec leur adolescent. Cette recherche utilise une méthodologie qualitative et vise à améliorer la compréhension actuelle des processus de recherche d’aide des parents et à identifier l’influence des dynamiques relationnelles et de la réponse sociale obtenue. Notre échantillon est composé de dix parents ayant eu recours à une aide professionnelle concernant des difficultés avec leur adolescent. Notre cueillette de données s’est faite à l’aide d’une entrevue semi-structurée à questions ouvertes et nous avons procédé à une analyse thématique de celles-ci. Les résultats révèlent la complexité derrière les comportements de recherches d’aide et les différentes difficultés rencontrées. Dans leurs trajectoires, trois principaux moments-clés sont distinguables : la reconnaissance du problème, la recherche de solutions et la réponse à la demande d’aide. Les différentes influences et interactions des membres du réseau d’aide informelle, du milieu scolaire et du système de services sont également détaillées. Les résultats mettent en lumière l’importance des dynamiques de négociation au sein du couple parental et l’impact des listes d’attente et des interruptions dans les services d’aide. Les résultats exposent que cette expérience est assez éprouvante pour les parents. Bien qu’elle ne permette pas de résoudre tous les problèmes rencontrés, elle se révèle avec le recul être salutaire, pour la plupart des parents.

Interrupting the courtroom organism: screaming bodies, material affects and the theatre of cruelty

This article offers a method of reading the courtroom which produces an alternative mapping of the space. My method combines a reading of Antonin Artaud’s Theatre of Cruelty with a Deleuzian theoretical analysis. I suggest that this is a useful method since it allows examination of the spatial praxes of the courtroom which pulsate with a power to organize, terrorize and to judge. This method is also able to conceptualize the presence of ‘‘screaming’’ bodies and living matter which are appropriated to build, as well as feed the presence and functioning of the courtroom space, or organism. By using a method that articulates the cry of these bodies in the shadow of the organism, it becomes clear that this cry is both unwelcome and suppressed by the courtroom. The howl of anxious bodies enduring the process and space of the law can be materialized through interruptions to the courtroom, such as when bodies stand when they should not and when they speak when they should be silent. These vociferous actualizations of the scream serve only to feed the organism they seek to disturb, yet if the scream is listened to before it disrupts, the interruption becomes-imperceptible to the courtroom. Through my Artaudian/Deleuzian reading, I give a voice to the corporeal gasp that lingers before the cry, which is embedded within the embodied multiplicity from which it is possible to draw a creative line of flight. The creative momentum of this line of flight produces a sustainable interruption to the courtroom process, which instead of being consumed by the system, has the potential to produce new courtroom alignments. My text therefore offers an alternative reading of the courtroom, and in doing so also offers a refined understanding of how to productively ‘‘interrupt’’ the courtroom process.

Caracterização dos incidentes na administração de medicamentos num serviço de Medicina Interna

RESUMO - O problema do erro de medicação tem vindo a adquirir uma importância e um interesse crescentes nos últimos anos. As consequências directas no doente que condicionam frequentemente o prolongamento do internamento, a necessidade de utilização adicional de recursos e a diminuição de satisfação por parte dos doentes, são alguns dos aspectos que importa analisar no sentido de se aumentar a segurança do doente. No circuito do medicamento em meio hospitalar estão envolvidos diversos profissionais, estando o enfermeiro no final da cadeia quando administra a medicação ao doente. Na bibliografia internacional, são referidas incidências elevadas de eventos adversos relacionados com o medicamento. Em Portugal, não existem estudos disponíveis que nos permitam conhecer, nem o tipo de incidentes, nem a dimensão do problema do erro de medicação. Efectuamos um estudo descritivo, prospectivo, exploratório, utilizando a técnica de observação não participante, da administração de medicamentos. Os objectivos são, por um lado, determinar a frequência de incidentes na administração de medicação num Serviço de Medicina Interna e, por outro, caracterizar o tipo de incidentes na administração da medicação e identificar as suas possíveis causas. A população em estudo foi constituída pelos enfermeiros que administraram medicamentos aos doentes internados no Serviço de Medicina Interna seleccionado, durante os meses de junho a agosto de 2012, sendo observadas 1521 administrações. Foi utilizada uma grelha de observação, que incluiu os seguintes elementos: doente certo; medicamento certo; dose certa; hora certa; via certa; técnica de administração correcta (assépsia); tempo de infusão; monitorização correcta. Constatou-se que em 43% das doses administradas apresentavam pelo menos um erro, num total de 764 erros. Não foi observado nenhum erro de doente, de medicamento, de dose extra, de via, de forma farmacêutica, nem a administração de medicamento não prescrito. Detectaram-se 0,19% de erros na preparação, 0,72% de erros de dose, 1,7% erros de omissão, 1,97% de erros de administração, 13,52% de erros de monitorização, 28,73% de erros de v horário. O tempo de infusão da terapêutica parentérica não foi cumprida em 27,69% das oportunidades, tendo sido sempre administrado em tempo inferior ao preconizado. Não encontramos relação entre as interrupções durante a administração de terapêutica e os erros. Pelo contrário constatou-se haver relação entre o número de doses com erro e o turno em que ocorreram, sendo mais frequentes no turno da noite. Constatamos também que aos fins de semana os erros eram mais frequentes e o risco da ocorrência de um erro na administração de medicação aumenta 1,5 vezes quando o número de enfermeiros é insuficiente.

Caracterização da adesão terapêutica dos doentes seguidos no Centro Hospitalar Lisboa Norte, EPE, no decurso do tratamento da, Esclerose Múltipla, Esclerose Lateral Amiotrófica, Artrite Reumatóide, Espondilite Anquilosante, Artrite Psoriática, Artrite Idiopática Juvenil Poliarticular, Psoríase em Placas, Polineuropatia Amiloidótica Familiar (Paramiloidose) e HIV/Sida : análise retrospetiva

RESUMO - Objetivos: Caracterizar a adesão à terapêutica nos doentes do CHLN, na área do VIH/SIDA, Esclerose, Artrite Reumatóide, Psoríase e Paramiloidose e avaliar a hipótese de ser possível prever o risco de um doente se tornar, num doente sem adesão. Metodologia: Estudo retrospetivo, observacional e longitudinal, realizado entre Janeiro de 2010 a 31 de Dezembro de 2013, a 4.761 doentes, em que a adesão à terapêutica foi calculada com base nos registos informáticos das dispensas de medicação, efectuados pelos Serviços Farmacêuticos, com recurso à Compliance Rate (CR) e utilizada como variável dependente. A estatística descritiva foi utilizada para caracterizar os doentes e os seus levantamentos e a regressão logística para avaliar o efeito das variáveis (idade, sexo, distrito de residência, período de observação, número de interrupções superiores a trinta dias e tempo até à primeira interrupção) sobre a adesão à terapêutica. Resultados e Conclusões: A percentagem de doentes com adesão foi de 64%, no entanto no HIV/Sida e na Artrite Reumatóide e Psoríase esta percentagem foi significativamente mais baixa, 42% dos doentes interromperam a terapêutica por períodos superiores a 30 dias, ocorrendo essa interrupção maioritariamente entre o primeiro e segundo ano de terapêutica. O modelo de regressão logística permitiu verificar que só com as variáveis sociodemográficas não é possível prever o risco de um doente se tornar num doente sem adesão, sendo para tal necessário adicionar ao modelo a variável número de interrupções superiores a 30 dias que foi identificada como importante factor preditivo da não adesão (OR=15,9, p=0,000).

Horário por turnos : análise do seu efeito numa empresa do sector industrial

O presente estudo teve por objetivo analisar os possíveis efeitos do trabalho por turnos, incluindo o turno noturno, a nível da saúde, vida familiar e social, numa empresa do sector da indústria. Foi construído um questionário que abordava questões relativas aos dados sociodemográficos, organização temporal do trabalho, qualidade do sono, exigências da tarefa e envolvimento, saúde, vida familiar e social, e posteriormente foi aplicado a uma amostra de 24 trabalhadores com idades entre os 29 e os 52 anos (41,58±5,79 anos). Os resultados mostram uma tendência para doenças como a obesidade, colesterol elevado e manifestação de sintomas relacionados com problemas digestivos nos trabalhadores que trabalham por turnos à [sic] mais anos. Antes do primeiro turno noturno o tempo de sono é bastante reduzido e fica aquém do tempo que os trabalhadores sentem que necessitam dormir para se sentirem bem. O turno da tarde é o que permite os trabalhadores ficarem com um tempo de sono mais próximo desse “ideal”. Em relação à idade, todos os trabalhadores do grupo etário mais velho manifestam interrupções do sono diurno. Também se verifica um maior descontentamento destes trabalhadores com o tempo livre para realizar atividades que tragam bem-estar. Este estudo contribui para o conhecimento da realidade do trabalho por turnos na indústria e espera-se que desperte a procura de soluções que otimizem a vida destes trabalhadores.

Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008.

OBJECTIVE: To provide an update to the original Surviving Sepsis Campaign clinical management guidelines, "Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock," published in 2004. DESIGN: Modified Delphi method with a consensus conference of 55 international experts, several subsequent meetings of subgroups and key individuals, teleconferences, and electronic-based discussion among subgroups and among the entire committee. This process was conducted independently of any industry funding. METHODS: We used the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system to guide assessment of quality of evidence from high (A) to very low (D) and to determine the strength of recommendations. A strong recommendation (1) indicates that an intervention's desirable effects clearly outweigh its undesirable effects (risk, burden, cost) or clearly do not. Weak recommendations (2) indicate that the tradeoff between desirable and undesirable effects is less clear. The grade of strong or weak is considered of greater clinical importance than a difference in letter level of quality of evidence. In areas without complete agreement, a formal process of resolution was developed and applied. Recommendations are grouped into those directly targeting severe sepsis, recommendations targeting general care of the critically ill patient that are considered high priority in severe sepsis, and pediatric considerations. RESULTS: Key recommendations, listed by category, include early goal-directed resuscitation of the septic patient during the first 6 hrs after recognition (1C); blood cultures before antibiotic therapy (1C); imaging studies performed promptly to confirm potential source of infection (1C); administration of broad-spectrum antibiotic therapy within 1 hr of diagnosis of septic shock (1B) and severe sepsis without septic shock (1D); reassessment of antibiotic therapy with microbiology and clinical data to narrow coverage, when appropriate (1C); a usual 7-10 days of antibiotic therapy guided by clinical response (1D); source control with attention to the balance of risks and benefits of the chosen method (1C); administration of either crystalloid or colloid fluid resuscitation (1B); fluid challenge to restore mean circulating filling pressure (1C); reduction in rate of fluid administration with rising filing pressures and no improvement in tissue perfusion (1D); vasopressor preference for norepinephrine or dopamine to maintain an initial target of mean arterial pressure > or = 65 mm Hg (1C); dobutamine inotropic therapy when cardiac output remains low despite fluid resuscitation and combined inotropic/vasopressor therapy (1C); stress-dose steroid therapy given only in septic shock after blood pressure is identified to be poorly responsive to fluid and vasopressor therapy (2C); recombinant activated protein C in patients with severe sepsis and clinical assessment of high risk for death (2B except 2C for postoperative patients). In the absence of tissue hypoperfusion, coronary artery disease, or acute hemorrhage, target a hemoglobin of 7-9 g/dL (1B); a low tidal volume (1B) and limitation of inspiratory plateau pressure strategy (1C) for acute lung injury (ALI)/acute respiratory distress syndrome (ARDS); application of at least a minimal amount of positive end-expiratory pressure in acute lung injury (1C); head of bed elevation in mechanically ventilated patients unless contraindicated (1B); avoiding routine use of pulmonary artery catheters in ALI/ARDS (1A); to decrease days of mechanical ventilation and ICU length of stay, a conservative fluid strategy for patients with established ALI/ARDS who are not in shock (1C); protocols for weaning and sedation/analgesia (1B); using either intermittent bolus sedation or continuous infusion sedation with daily interruptions or lightening (1B); avoidance of neuromuscular blockers, if at all possible (1B); institution of glycemic control (1B), targeting a blood glucose < 150 mg/dL after initial stabilization (2C); equivalency of continuous veno-veno hemofiltration or intermittent hemodialysis (2B); prophylaxis for deep vein thrombosis (1A); use of stress ulcer prophylaxis to prevent upper gastrointestinal bleeding using H2 blockers (1A) or proton pump inhibitors (1B); and consideration of limitation of support where appropriate (1D). Recommendations specific to pediatric severe sepsis include greater use of physical examination therapeutic end points (2C); dopamine as the first drug of choice for hypotension (2C); steroids only in children with suspected or proven adrenal insufficiency (2C); and a recommendation against the use of recombinant activated protein C in children (1B). CONCLUSIONS: There was strong agreement among a large cohort of international experts regarding many level 1 recommendations for the best current care of patients with severe sepsis. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improved outcomes for this important group of critically ill patients.

Immunological mechanism of action and clinical profile of disease-modifying treatments in multiple sclerosis.

Multiple sclerosis (MS) is a life-long, potentially debilitating disease of the central nervous system (CNS). MS is considered to be an immune-mediated disease, and the presence of autoreactive peripheral lymphocytes in CNS compartments is believed to be critical in the process of demyelination and tissue damage in MS. Although MS is not currently a curable disease, several disease-modifying therapies (DMTs) are now available, or are in development. These DMTs are all thought to primarily suppress autoimmune activity within the CNS. Each therapy has its own mechanism of action (MoA) and, as a consequence, each has a different efficacy and safety profile. Neurologists can now select therapies on a more individual, patient-tailored basis, with the aim of maximizing potential for long-term efficacy without interruptions in treatment. The MoA and clinical profile of MS therapies are important considerations when making that choice or when switching therapies due to suboptimal disease response. This article therefore reviews the known and putative immunological MoAs alongside a summary of the clinical profile of therapies approved for relapsing forms of MS, and those in late-stage development, based on published data from pivotal randomized, controlled trials.

Influence of noninjecting and injecting drug use on mortality, retention in the cohort, and antiretroviral therapy, in participants in the Swiss HIV Cohort Study.

OBJECTIVES: We studied the influence of noninjecting and injecting drug use on mortality, dropout rate, and the course of antiretroviral therapy (ART), in the Swiss HIV Cohort Study (SHCS). METHODS: Cohort participants, registered prior to April 2007 and with at least one drug use questionnaire completed until May 2013, were categorized according to their self-reported drug use behaviour. The probabilities of death and dropout were separately analysed using multivariable competing risks proportional hazards regression models with mutual correction for the other endpoint. Furthermore, we describe the influence of drug use on the course of ART. RESULTS: A total of 6529 participants (including 31% women) were followed during 31 215 person-years; 5.1% participants died; 10.5% were lost to follow-up. Among persons with homosexual or heterosexual HIV transmission, noninjecting drug use was associated with higher all-cause mortality [subhazard rate (SHR) 1.73; 95% confidence interval (CI) 1.07-2.83], compared with no drug use. Also, mortality was increased among former injecting drug users (IDUs) who reported noninjecting drug use (SHR 2.34; 95% CI 1.49-3.69). Noninjecting drug use was associated with higher dropout rates. The mean proportion of time with suppressed viral replication was 82.2% in all participants, irrespective of ART status, and 91.2% in those on ART. Drug use lowered adherence, and increased rates of ART change and ART interruptions. Virological failure on ART was more frequent in participants who reported concomitant drug injections while on opiate substitution, and in current IDUs, but not among noninjecting drug users. CONCLUSIONS: Noninjecting drug use and injecting drug use are modifiable risks for death, and they lower retention in a cohort and complicate ART.

Estee Klar fonds, 2005-2014

Estee Klar is the founder and executive director of The Autism Acceptance Project, an organization that strives to support people with autism by promoting acceptance and inclusion of these individuals. She is the mother of a son, Adam, who has autism, and writes about her experiences with him on her blog, found at http://www.esteeklar.com. She also writes about issues concerning autism in the area of human rights, law, and social justice, and has contributed to several books, including The Thinking Person's Guide to Autism, Between Interruptions: Thirty Women Tell the Truth about Motherhood, and Concepts of Normality: The Autistic and Typical Spectrum. Currently, she is a Ph.D. candidate at York University, Critical Disability Studies, as well as a writer and freelance curator of art.

Gestion adaptative des ressources dans les réseaux maillés sans fil à multiples-radios multiples-canaux

Depuis quelques années, la recherche dans le domaine des réseaux maillés sans fil ("Wireless Mesh Network (WMN)" en anglais) suscite un grand intérêt auprès de la communauté des chercheurs en télécommunications. Ceci est dû aux nombreux avantages que la technologie WMN offre, telles que l'installation facile et peu coûteuse, la connectivité fiable et l'interopérabilité flexible avec d'autres réseaux existants (réseaux Wi-Fi, réseaux WiMax, réseaux cellulaires, réseaux de capteurs, etc.). Cependant, plusieurs problèmes restent encore à résoudre comme le passage à l'échelle, la sécurité, la qualité de service (QdS), la gestion des ressources, etc. Ces problèmes persistent pour les WMNs, d'autant plus que le nombre des utilisateurs va en se multipliant. Il faut donc penser à améliorer les protocoles existants ou à en concevoir de nouveaux. L'objectif de notre recherche est de résoudre certaines des limitations rencontrées à l'heure actuelle dans les WMNs et d'améliorer la QdS des applications multimédia temps-réel (par exemple, la voix). Le travail de recherche de cette thèse sera divisé essentiellement en trois principaux volets: le contrôle d‟admission du trafic, la différentiation du trafic et la réaffectation adaptative des canaux lors de la présence du trafic en relève ("handoff" en anglais). Dans le premier volet, nous proposons un mécanisme distribué de contrôle d'admission se basant sur le concept des cliques (une clique correspond à un sous-ensemble de liens logiques qui interfèrent les uns avec les autres) dans un réseau à multiples-sauts, multiples-radios et multiples-canaux, appelé RCAC. Nous proposons en particulier un modèle analytique qui calcule le ratio approprié d'admission du trafic et qui garantit une probabilité de perte de paquets dans le réseau n'excédant pas un seuil prédéfini. Le mécanisme RCAC permet d‟assurer la QdS requise pour les flux entrants, sans dégrader la QdS des flux existants. Il permet aussi d‟assurer la QdS en termes de longueur du délai de bout en bout pour les divers flux. Le deuxième volet traite de la différentiation de services dans le protocole IEEE 802.11s afin de permettre une meilleure QdS, notamment pour les applications avec des contraintes temporelles (par exemple, voix, visioconférence). À cet égard, nous proposons un mécanisme d'ajustement de tranches de temps ("time-slots"), selon la classe de service, ED-MDA (Enhanced Differentiated-Mesh Deterministic Access), combiné à un algorithme efficace de contrôle d'admission EAC (Efficient Admission Control), afin de permettre une utilisation élevée et efficace des ressources. Le mécanisme EAC prend en compte le trafic en relève et lui attribue une priorité supérieure par rapport au nouveau trafic pour minimiser les interruptions de communications en cours. Dans le troisième volet, nous nous intéressons à minimiser le surcoût et le délai de re-routage des utilisateurs mobiles et/ou des applications multimédia en réaffectant les canaux dans les WMNs à Multiples-Radios (MR-WMNs). En premier lieu, nous proposons un modèle d'optimisation qui maximise le débit, améliore l'équité entre utilisateurs et minimise le surcoût dû à la relève des appels. Ce modèle a été résolu par le logiciel CPLEX pour un nombre limité de noeuds. En second lieu, nous élaborons des heuristiques/méta-heuristiques centralisées pour permettre de résoudre ce modèle pour des réseaux de taille réelle. Finalement, nous proposons un algorithme pour réaffecter en temps-réel et de façon prudente les canaux aux interfaces. Cet algorithme a pour objectif de minimiser le surcoût et le délai du re-routage spécialement du trafic dynamique généré par les appels en relève. Ensuite, ce mécanisme est amélioré en prenant en compte l‟équilibrage de la charge entre cliques.

Queues with Customer Induced Interruption

In this thesis we have introduced and studied the notion of self interruption of service by customers. Service interruption in queueing systems have been extensively discussed in literature (see, Krishnamoorthy, Pramod and Chakravarthy [38]) for the most recent survey. So far all work reported deal with cases in which service interruptions are generated by sources other than customers. However, there are situations where interruptions are due to the customers rather than the system. Such situations are especially arise at doctors clinic, banks, reservation counter etc. Our attempt is to quantify a few of such problems. Systematically we have proceed from single server queue (in Chapter 2) to multi-server queues (Chapter 3). In Chapte 4, we have studied a very general multiserver queueing model with service interruption and protection of service phases. We also introduced customer interruption in a retrial setup (in Chapter 5). All models (from Chapter 2 to Chapter 4) that were analyzed involve 'non-preemptive priority' for interrupted customers where as in the model discussed in Chapter 5 interruption of service by customers is not encouraged. So the interrupted customers cannot access the server as long as there are primary customers in the system. In Chapter 5 we have obtained an explicit expression for the stability condition of the system. In all models analyzed in this thesis, we have assumed that no more than one interruption is allowed for a customer while in service. Since the models are not analytically tractable, a large number of numerical illustrations were given in each chapter it illustrate the working of the systems. We can extend the models discussed in this thesis to several directions. For example some of the models can be analyzed with both server induced and customer induced interruptions the results for which are not available till date. Another possible extension of work is to the case where there is no bound on the number of interruptions a customer is permitted to have before service completion. More complex is the case where a customer is permitted to have a nite number (K ≥ 2) of We can extend the models discussed in this thesis to several directions.

Not the outside but the inside matters : functional analysis of Capricious and Tartan during Drosophila tracheal morphogenesis

The tubular structures, which transport essential gases, liquids, or cells from one site to another, are shared among various divergent organisms. These highly organized tubular networks include lung, kidney, vasculature and mammary gland in mammals as well as trachea and salivary gland in Drosophila melanogaster. Many questions regarding the tubular morphogenesis cannot be addressed sufficiently by investigating the mammalian organs because their structures are extremely complex and therefore, systematic analyses of genetic and cellular programs guiding the development is not possible. In contrast, the Drosophila tracheal development provides an excellent model system since many molecular markers and powerful tools for genetic manipulations are available. Two mechanisms were shown to be important for the outgrowth of tracheal cells: the FGF signaling pathway and the interaction between the tracheal cells and the surrounding mesodermal cells. The Drosophila FGF ligand encoded by branchless (bnl) is localized in groups of cells near tracheal metameres. The tracheal cells expressing the FGF receptor breathless (btl) respond to these sources of FGF ligand and extend towards them. However, this FGF signaling pathway is not sufficient for the formation of continuous dorsal trunk, the only muticellular tube in tracheal system. Recently, it was found out that single mesodermal cells called bridge-cells are essential for the formation of continuous dorsal trunk as they direct the outgrowth of dorsal trunk cells towards the correct targets. The results in this PhD thesis demonstrate that a cell adhesion molecule Capricious (Caps), which is specifically localized on the surface of bridge-cells, plays an essential role in guiding the outgrowing dorsal trunk cells towards their correct targets. When caps is lacking, some bridge-cells cannot stretch properly towards the adjacent posterior tracheal metameres and thus fail to interconnect the juxtaposing dorsal trunk cells. Consequently, discontinuous dorsal trunks containing interruptions at several positions are formed. On the other hand, when caps is ectopically expressed in the mesodermal cells through a twi-GAL4 driver, these mesodermal cells acquire a guidance function through ectopic caps and misguide the outgrowing dorsal trunk cells in abnormal directions. As a result, disconnected dorsal trunks are formed. These loss- and gain-of-function studies suggest that Caps presumably establishes the cell-to-cell contact between the bridge-cells and the tracheal cells and thereby mediates directly the guidance function of bridge-cells. The most similar protein known to Caps is another cell adhesion molecule called Tartan (Trn). Interestingly, trn is expressed in the mesodermal cells but not in the bridge-cells. When trn is lacking, the outgrowth of not only the dorsal trunks but also the lateral trunks are disrupted. However, in contrast to the ectopic expression of caps, the misexpression of trn does not affect tracheal development. Whereas Trn requires only its extracellular domain to mediate the matrix function, Caps requires both its extracellular and intracellular domains to function as a guidance molecule in the bridge-cells. These observations suggest that Trn functions differently from Caps during tracheal morphogenesis. Presumably, Trn mediates a matrix function of mesodermal cells, which support the tracheal cells to extend efficiently through the surrounding mesodermal tissue. In order to determine which domains dictate the functional specificity of Caps, two hybrid proteins CapsEdTrnId, which contains the Caps extracellular domain and the Trn intracellular domain, and TrnEdCapsId, which consists of the Trn extracellular domain and the Caps intracellular domain, were constructed. Gain of function and rescue experiments with these hybrid proteins suggest on one hand that the extracellular domains of Caps and Trn are functionally redundant and on the other hand that the intracellular domain dictates the functional specificity of Caps. In order to identify putative interactors of Caps, yeast two-hybrid screening was performed. An in vivo interaction assay in yeast suggests that Ras64B interacts specifically with the Caps intracellular domain. In addition, an in vitro binding assay reveals a direct interaction between an inactive form of Ras64B and the Caps intracellular domain. ras64B, which encodes a small GTPase, is expressed in the mesodermal cells concurrently as caps. Finally, a gain-of-function study with the constitutively active Ras64B suggests that Ras64B presumably functions downstream of Caps. All these results suggest consistently that the small GTPase Ras64B binds specifically to the Caps intracellular domain and may thereby mediate the guidance function of Caps.

Chancen und Risiken der Arbeit im E-Business

E-Business, verstanden als ganzheitliche Strategie zur Reorganisation von Geschäftsprozessen, Strukturen und Beziehungen in Unternehmen, bietet für die Arbeitsgestaltung in einer digital vernetzten Welt Chancen und Risiken in Hinblick auf die Humankriterien. Empirische Untersuchungen in 14 Unternehmen zeigen „good practice“-Ansätze im B2B-Feld (Business-to-Business). Untersucht wurden die Tätigkeiten der elektronisch vernetzten Auftragsbearbeitung, des Web-, Content-Managements, der digitalen Druckvorlagenherstellung sowie der CAD- Bauplanzeichnung. Die beobachteten Arbeitsplätze zeigen, dass Arbeitsinhalte eher ganzheitlich und komplex gestaltet sind. Planende, ausführende, kontrollierende und organisierende Anteile weisen auf eine vielfältige Aufgabengestaltung hin, die hohe Anforderungen beinhaltet. Während alle beobachteten Tätigkeiten mit Aufnahme-, Erarbeitungs-, Verarbeitungs-, Übertragungs- und Weitergabeprozessen von Informationen zu tun haben, gibt es Differenzen in Bezug auf den Arbeitsumfang, den Zeitdruck, Fristsetzungen, erwartete Arbeitsleistungen sowie die Planbarkeit der Aufgaben. Die vorgefundenen Aufgabentypen (wenig bis sehr anforderungsreich im Sinne von Denk- und Planungsanforderungen) sind gekennzeichnet durch eine unterschiedlich ausgeprägte Aufgabenkomplexität. Interessant ist, dass, je anforderungsreicher die Aufgabengestaltung, je höher die Aufgabenkomplexität, je größer die Wissensintensität und je niedriger die Planbarkeit ist, desto größer sind die Freiräume in der Aufgabenausführung. Das heißt wiederum, dass bei zunehmenden E-Business-Anteilen mehr Gestaltungsspielräume zur Verfügung stehen. Die bestehenden Chancen auf eine humane Aufgabengestaltung sind umso größer, je höher die E-Business-Anteile in der Arbeit sind. Diese Wirkung findet sich auch bei einem Vergleich der Aufgabenbestandteile wieder. Die negativen Seiten des E-Business zeigen sich in den vorgefundenen Belastungen, die auf die Beschäftigten einwirken. Diskutiert wird die Verschiebung von körperlichen hin zu psychischen und vorrangig informatorischen Belastungen. Letztere stellen ein neues Belastungsfeld dar. Ressourcen, auf welche die Mitarbeiter zurückgreifen können, sind an allen Arbeitsplätzen vorhanden, allerdings unterschiedlich stark ausgeprägt. Personale, organisationale, soziale, aufgabenbezogene und informatorische Ressourcen, die den Beschäftigten zur Verfügung stehen, werden angesprochen. In Bezug auf die Organisationsgestaltung sind positive Ansätze in den untersuchten E-Business-Unternehmen zu beobachten. Der Großteil der untersuchten Betriebe hat neue Arbeitsorganisationskonzepte realisiert, wie die vorgefundenen kooperativen Organisationselemente zeigen. Die kooperativen Organisationsformen gehen allerdings nicht mit einer belastungsärmeren Gestaltung einher. Das vorgefundene breite Spektrum, von hierarchisch organisierten Strukturen bis hin zu prozess- und mitarbeiterorientierten Organisationsstrukturen, zeigt, dass Organisationsmodelle im E-Business gestaltbar sind. Neuen Anforderungen kann insofern gestaltend begegnet und somit die Gesundheit und das Wohlbefinden der Mitarbeiter positiv beeinflusst werden. Insgesamt betrachtet, zeigt E-Business ein ambivalentes Gesicht, das auf der Basis des MTO-Modells (Mensch-Technik-Organisation) von Uhlich (1994) diskutiert wird, indem vernetzte Arbeitsprozesse auf personeller, technischer sowie organisationaler Ebene betrachtet werden. E-business, seen as more than only the transformation of usual business processes into digital ones, furthermore as an instrument of reorganisation of processes and organisation structures within companies, offers chances for a human oriented work organisation. Empirical data of 14 case studies provide good practice approaches in the field of B2B (Business-to-Business). The observed work contents show, that tasks (e.g. order processing, web-, contentmanagement, first print manufacturing and architectural drawing) are well arranged. Executive, organising, controlling and coordinating parts constitute a diversified work content, which can be organised with high demands. Interesting is the result, that the more e-business-parts are within the work contents, on the one hand the higher are the demands of the type of work and on the other hand the larger is the influence on workmanship. The observed enterprises have realised new elements of work organisation, e.g. flexible working time, cooperative leadership or team work. The direct participation of the employees can be strengthened, in particular within the transformation process. Those companies in which the employees were early and well informed about the changes coming up with e-business work, the acceptance for new technique and new processes is higher than in companies which did not involve the person concerned. Structured in an ergonomic way, there were found bad patterns of behaviour concerning ergonomic aspects, because of missing knowledge regarding work-related ergonomic expertise by the employees. E-business indicates new aspects concerning requirements – new in the field of informational demands, as a result of poorly conceived technical balance in the researched SME. Broken systems cause interruptions, which increase the pressure of time all the more. Because of the inadequate usability of software-systems there appear in addition to the informational strains also elements of psychological stress. All in all, work contents and work conditions can be shaped and as a result the health and well-being of e-business-employees can be influenced: Tasks can be structured and organised in a healthfulness way, physiological strain and psychological stress are capable of being influenced, resources are existent and developable, a human work design within e-business structures is possible. The ambivalent face of e-business work is discussed on the basis of the MTO- (Mensch-Technik-Organisation) model (Ulich 1994). Thereby new and interesting results of researches are found out, concerning the personal/human side, the technical side and the organisational side of e-business work.

Las cuevas prehistóricas de Serinyà (Pla de l’Estany, Girona)

The Reclau Caves, which form part of the Serinyà Prehistoric Caves Park (Pla de l’Estany, Girona), are shelters formed by waterfall travertines which have been in turn affected by karstification phenomena. Though relatively small, these cavities were big enough to held human occupation. Its evolution has seen the falling of blocks and infilling of terrigenous materials. Thus, the caves were completely filled and had most of their original roofs fallen. The first excavations of these caves were made in the mid 1940s and they continued, albeit with some interruptions, until present times. The caves were occupied by humans since the late Middle Pleistocene until the Holocene. Hence, the main occupation periods can be attributed to the Middle Paleolithic and Upper Paleolithic cultures. Given the existence of these sites, the project of an archeological park was started and its first phase opened to the public in the summer of 1997. The creation of this park has led to the protection of the three main caves of the site (Arbreda, Mollet and Reclau Viver Caves). The caves have also been adapted and singposted to open them to the public. Other facilities of the park include a reception building and an activity area. The caves can be visited in guided tours which include the projection of a film, the visit to the permanent exhibition room, the three main caves and the participation in some prehistoric-related activities

On the structural differences between markers and genomic AC microsatellites

AC microsatellites have proved particularly useful as genetic markers. For some purposes, such as in population biology, the inferences drawn depend on the quantitative values of their mutation rates. This, together with intrinsic biological interest, has led to widespread study of microsatellite mutational mechanisms. Now, however, inconsistencies are appearing in the results of marker-based versus non-marker-based studies of mutational mechanisms. The reasons for this have not been investigated, but one possibility, pursued here, is that the differences result from structural differences between markers and genomic microsatellites. Here we report a comparison between the CEPH AC marker microsatellites and the global population of AC microsatellites in the human genome. AC marker microsatellites are longer than the global average. Controlling for length, marker microsatellites contain on average fewer interruptions, and have longer segments, than their genomic counterparts. Related to this, marker microsatellites show a greater tendency to concentrate the majority of their repeats into one segment. These differences plausibly result from scientists selecting markers for their high polymorphism. In addition to the structural differences, there are differences in the base composition of flanking sequences, marker flanking regions being richer in C and G and poorer in A and T. Our results indicate that there are profound differences between marker and genomic microsatellites that almost certainly affect their mutation rates. There is a need for a unified model of mutational mechanisms that accounts for both marker-derived and genomic observations. A suggestion is made as to how this might be done.