Dialyse à domicile : évaluation du modèle de dialyse à domicile intégrée

Les modalités de dialyse à domicile, soit la dialyse péritonéale (DP) et l’hémodialyse à domicile (HDD), offrent plusieurs avantages aux patients avec insuffisance rénale terminale (IRT), que ce soit par rapport à la qualité de vie ou à une diminution des complications liées à l’IRT. Peu de données sont toutefois disponibles quant aux répercussions cliniques de l’initiation de la thérapie de suppléance rénale via la DP ou l’HDD et de l’optimisation subséquente du traitement à domicile. Le présent mémoire visait donc à répondre aux trois questions suivantes soit (1) la comparaison entre la survie des patients débutant la thérapie de suppléance rénale par une ou l’autre des modalités à domicile, (2) l’évaluation du modèle de dialyse à domicile intégrée (c’est la dire l’initiation de la suppléance rénale en DP avec un transfert subséquent en HDD) et (3) l’évaluation des prédicteurs dudit modèle de dialyse à domicile intégrée. L’évaluation de 11 416 patients ayant débuté la suppléance rénale en Australie et Nouvelle-Zélande entre 2000 et 2012 a montré une association entre une mortalité globale inférieure chez les patients traités par HDD comparativement à ceux traités par DP (rapport des risques [hazard ratio - HR] 0.47, intervalle de confiance [IC] de 95%, 0.38-0.59). Par contre, les patients ayant débuté la suppléance rénale en DP et ayant ensuite été transférés en HDD (modèle de dialyse à domicile intégrée) avaintt une survie en dialyse à domicile similaire à ceux directement traités par l’HDD (HR 0.92, IC de 95%, 0.52-1.62). Finalement, les caractéristiques démographiques de base (jeune âge, sexe masculin, ethnie), les comorbidités, la cause de l’insuffisance rénale terminale, la durée du traitement et la raison de l’arrêt de la DP étaient des prédicteurs du modèle de dialyse à domicile intégrée.

HVDC Power Transmission Simulation for Offshore Wind System with Three-Level Converter

An integrated mathematical model for the simulation of an offshore wind system performance is presented in this paper. The mathematical model considers an offshore variable-speed turbine in deep water equipped with a permanent magnet synchronous generator using multiple point full-power clamped three-level converter, converting the energy of a variable frequency source in injected energy into the electric network with constant frequency, through a HVDC transmission submarine cable. The mathematical model for the drive train is a concentrate two mass model which incorporates the dynamic for the blades of the wind turbine, tower and generator due to the need to emulate the effects of the wind and the floating motion. Controller strategy considered is a proportional integral one. Also, pulse width modulation using space vector modulation supplemented with sliding mode is used for trigger the transistors of the converter. Finally, a case study is presented to access the system performance.

Effectiveness of the cognitive differentiation program of the integrated psychological therapy: group versus individual treatment

The aim of the current pilot study was to compare two strategies in the application of the cognitive differentiation program of Integrated Psychological Therapy for people with schizophrenia. Twenty-six outpatients were randomly assigned to the application of the program in group sessions (CDg), or to its application in individualized sessions (CDi). The program provides cognitive exercises to promote better performance in cognition, and both groups of participants completed the same number of exercises following the same number of sessions per week. Outcomes were assessed on neuropsychological measures of attention, executive functioning and everyday memory, and everyday functioning. Effect sizes showed the absence of effects in everyday memory and social functioning, higher improvements in the CDi group in attention, and a higher improvement in the CDg condition in executive functioning. The results suggest that the program application model could be individualized, depending on patient-specific cognitive deficits.

How Minds Work: A Cognitive Theory of Everything - a Tutorial on the IDA Model of Cognition

The IDA model of cognition is a fully integrated artificial cognitive system reaching across the full spectrum of cognition, from low-level perception/action to high-level reasoning. Extensively based on empirical data, it accurately reflects the full range of cognitive processes found in natural cognitive systems. As a source of plausible explanations for very many cognitive processes, the IDA model provides an ideal tool to think with about how minds work. This online tutorial offers a reasonably full account of the IDA conceptual model, including background material. It also provides a high-level account of the underlying computational “mechanisms of mind” that constitute the IDA computational model.

A Conceptual Model to Combine Creativity Techniques with Fuzzy Cognitive Maps for Enhanced Knowledge Management

This chapter introduces a conceptual model to combine creativity techniques with fuzzy cognitive maps (FCMs) and aims to support knowledge management methods by improving expert knowledge acquisition and aggregation. The aim of the conceptual model is to represent acquired knowledge in a manner that is as computer-understandable as possible with the intention of developing automated reasoning in the future as part of intelligent information systems. The formal represented knowledge thus may provide businesses with intelligent information integration. To this end, we introduce and evaluate various creativity techniques with a list of attributes to define the most suitable to combine with FCMs. This proposed combination enables enhanced knowledge management through the acquisition and representation of expert knowledge with FCMs. Our evaluation indicates that the creativity technique known as mind mapping is the most suitable technique in our set. Finally, a scenario from stakeholder management demonstrates the combination of mind mapping with FCMs as an integrated system.

Vocabulary learning through use of the picture-word inductive model for young English learners in China: A mixed methods examination using Cognitive Load Theory

English has been taught as a core and compulsory subject in China for decades. Recently, the demand for English in China has increased dramatically. China now has the world's largest English-learning population. The traditional English-teaching method cannot continue to be the only approach because it merely focuses on reading, grammar and translation, which cannot meet English learners and users' needs (i.e., communicative competence and skills in speaking and writing). ^ This study was conducted to investigate if the Picture-Word Inductive Model (PWIM), a new pedagogical method using pictures and inductive thinking, would benefit English learners in China in terms of potential higher output in speaking and writing. With the gauge of Cognitive Load Theory (CLT), specifically, its redundancy effect, I investigated whether processing words and a picture concurrently would present a cognitive overload for English learners in China. ^ I conducted a mixed methods research study. A quasi-experiment (pretest, intervention for seven weeks, and posttest) was conducted using 234 students in four groups in Lianyungang, China (58 fourth graders and 57 seventh graders as an experimental group with PWIM and 59 fourth graders and 60 seventh graders as a control group with the traditional method). No significant difference in the effects of PWIM was found on vocabulary acquisition based on grade levels. Observations, questionnaires with open-ended questions, and interviews were deployed to answer the three remaining research questions. A few students felt cognitively overloaded when they encountered too many writing samples, too many new words at one time, repeated words, mismatches between words and pictures, and so on. Many students listed and exemplified numerous strengths of PWIM, but a few mentioned weaknesses of PWIM. The students expressed the idea that PWIM had a positive effect on their English teaching. ^ As integrated inferences, qualitative findings were used to explain the quantitative results that there were no significant differences of the effects of the PWIM between the experimental and control groups in both grade levels, from four contextual aspects: time constraints on PWIM implementation, teachers' resistance, how to use PWIM and PWIM implemented in a classroom over 55 students.^

Vocabulary Learning through Use of the Picture-Word Inductive Model for Young English Learners in China: A Mixed Methods Examination Using Cognitive Load Theory

English has been taught as a core and compulsory subject in China for decades. Recently, the demand for English in China has increased dramatically. China now has the world’s largest English-learning population. The traditional English-teaching method cannot continue to be the only approach because it merely focuses on reading, grammar and translation, which cannot meet English learners and users’ needs (i.e., communicative competence and skills in speaking and writing). This study was conducted to investigate if the Picture-Word Inductive Model (PWIM), a new pedagogical method using pictures and inductive thinking, would benefit English learners in China in terms of potential higher output in speaking and writing. With the gauge of Cognitive Load Theory (CLT), specifically, its redundancy effect, I investigated whether processing words and a picture concurrently would present a cognitive overload for English learners in China. I conducted a mixed methods research study. A quasi-experiment (pretest, intervention for seven weeks, and posttest) was conducted using 234 students in four groups in Lianyungang, China (58 fourth graders and 57 seventh graders as an experimental group with PWIM and 59 fourth graders and 60 seventh graders as a control group with the traditional method). No significant difference in the effects of PWIM was found on vocabulary acquisition based on grade levels. Observations, questionnaires with open-ended questions, and interviews were deployed to answer the three remaining research questions. A few students felt cognitively overloaded when they encountered too many writing samples, too many new words at one time, repeated words, mismatches between words and pictures, and so on. Many students listed and exemplified numerous strengths of PWIM, but a few mentioned weaknesses of PWIM. The students expressed the idea that PWIM had a positive effect on their English teaching. As integrated inferences, qualitative findings were used to explain the quantitative results that there were no significant differences of the effects of the PWIM between the experimental and control groups in both grade levels, from four contextual aspects: time constraints on PWIM implementation, teachers’ resistance, how to use PWIM and PWIM implemented in a classroom over 55 students.

Integrated Proteomics Identified Up-regulated Focal Adhesion-mediated Proteins In Human Squamous Cell Carcinoma In An Orthotopic Murine Model.

Understanding the molecular mechanisms of oral carcinogenesis will yield important advances in diagnostics, prognostics, effective treatment, and outcome of oral cancer. Hence, in this study we have investigated the proteomic and peptidomic profiles by combining an orthotopic murine model of oral squamous cell carcinoma (OSCC), mass spectrometry-based proteomics and biological network analysis. Our results indicated the up-regulation of proteins involved in actin cytoskeleton organization and cell-cell junction assembly events and their expression was validated in human OSCC tissues. In addition, the functional relevance of talin-1 in OSCC adhesion, migration and invasion was demonstrated. Taken together, this study identified specific processes deregulated in oral cancer and provided novel refined OSCC-targeting molecules.

Deciphering the weathering processes using environmental mineralogy and geochemistry: Towards an integrated model of laterite and podzol genesis in the Upper Amazon Basin

This article reports major results from collaborative research between France and Brazil on soil and water systems, carried out in the Upper Amazon Basin. It reveals the weathering processes acting in the partly inundated, low elevation plateaus of the Basin, mostly covered by evergreen forest. Our findings are based on geochemical data and mineral spectroscopy that probe the crystal chemistry of Fe and Al in mineral phases (mainly kaolinite, Al- and Fe-(hydr)oxides) of tropical soils (laterites). These techniques reveal crystal alterations in mineral populations of different ages and changes of metal speciation associated with mineral or organic phases. These results provide an integrated model of soil formation and changes (from laterites to podzols) in distinct hydrological compartments of the Amazon landscapes and under altered water regimes. (C) 2010 Academie des sciences. Published by Elsevier Masson SAS. All rights reserved.

Incorporating cognitive-behavioral therapy with occupational therapy: A comparative study with patients with low back pain

This paper reports on the implementation of a psychoeducational program utilizing cognitive-behavioral principles. The efficacy of this psychoeducational treatment program in modifying dysfunctional attitudes in patients with chronic low back pain was examined using a two-group pretest posttest design with a follow-lip at 3 months Thirty patients (average age = 44.37 SD = 13.71) participated in the study, with 15 in the psychoeducational treatment group and 15 in the placebo control group. These two conditions were added on to an existing eclectic inpatient pain management program. After assessment on the IPAM (The Integrated Psychosocial Assessment Model), scores were reduced to multivariate composite scores on the factors of illness behavior depressed and negative cognitions, and acute pain strategies. Results of a group x time repeated measures analysis of variance for the three pain factors revealed a significant main effect for group (F(23,1) = 5.00 p < .04), tempered by a significant interaction between group and rime on the 'depressed and negative' pain factor (F(23,1) = 4.77 p < .04). Patients in the treatment group improved significantly over time and significantly more than the placebo control group patients at posttreatment. Results provide support for the program in increasing patients' feelings of control over their pain and the use of positive coping strategies, while reducing perceived helplessness, depression, disability, and pain intensity.

Conception of a flexible integrator and lean model for integrated management systems

Management systems standards (MSSs) have developed in an unprecedented manner in the last few years. These MSS cover a wide array of different disciplines, aims and activities of organisations. Also, organisations are populated with an enormous diversity of independent management systems (MSs). An integrated management system (IMS) tends to integrate some or all components of the business. Maximising their integration in one coherent and efficient MS is increasingly a strategic priority and constitutes an opportunity for businesses to be more competitive and consequently, promote its sustainable success. Those organisations that are quicker and more efficient in their integration and continuous improvement will have a competitive advantage in obtaining sustainable value in our global and competitive business world. Several scholars have proposed various theoretical approaches regarding the integration of management sub-systems, leading to the conclusion that there is no common practice for all organisations as they encompass different characteristics. One other author shows that several tangible and intangible gains for organisations, as well as to their internal and external stakeholders, are achieved with the integration of the individual standardised MSs. The purpose of this work was to conceive a model, Flexible, Integrator and Lean for IMSs, according to ISO 9001 for quality; ISO 14001 for environment and OHSAS 18001 for occupational health and safety (IMS–QES), that can be adapted and progressively assimilate other MSs, such as, SA 8000/ISO 26000 for social accountability, ISO 31000 for risk management and ISO/IEC 27001 for information security management, among others. The IMS–QES model was designed in the real environment of an industrial Portuguese small and medium enterprise, that over the years has been adopting, gradually, in whole or in part, individual MSSs. The developed model is based on a preliminary investigation conducted through a questionnaire. The strategy and research methods have taken into consideration the case study. Among the main findings of the survey we highlight: the creation of added value for the business through the elimination of several organisational wastes; the integrated management of the sustainability components; the elimination of conflicts between independent MS; dialogue with the main stakeholders and commitment to their ongoing satisfaction and increased contribution to the company’s competitiveness; and greater valorisation and motivation of employees as a result of the expansion of their skill base, actions and responsibilities, with their consequent empowerment. A set of key performance indicators (KPIs) constitute the support, in a perspective of business excellence, to the follow up of the organisation’s progress towards the vision and achievement of the defined objectives in the context of each component of the IMS model. The conceived model had many phases and the one presented in this work is the last required for the integration of quality, environment, safety and others individual standardised MSs. Globally, the investigation results, by themselves, justified and prioritised the conception of an IMS–QES model, to be implemented at the company where the investigation was conducted, but also a generic model of an IMS, which may be more flexible, integrator and lean as possible, potentiating the efficiency, added value both in the present and, fundamentally, for future.

Integrated didactics: an example of a curriculum model enhancing knowledge crossing

In this paper, we introduce an innovative course in the Portuguese Context, the Master's Course in “Integrated Didactics in Mother Tongue, Maths, Natural and Social Sciences”, taking place at the Lisbon School of Education and discussing in particular the results of the evaluation made by the students who attended the Curricular Unit - Integrated Didactics (CU-ID). This course was designed for in-service teachers of the first six years of schooling and intends to improve connections between different curriculum areas. In this paper, we start to present a few general ideas about curriculum development; to discuss the concept of integration; to present the principles and objectives of the course created as well as its structure; to describe the methodology used in the evaluation process of the above mentioned CU-ID. The results allow us to state that the students recognized, as positive features of the CU-ID, the presence in all sessions of two teachers simultaneously from different scientific areas, as well as invitations issued to specialists on the subject of integration and to other teachers that already promote forms of integration in schools. As negative features, students noted a lack of integrated purpose, applying simultaneously the four scientific areas of the course, and also indicated the need to be familiar with more models of integrated education. Consequently, the suggestions for improvement derived from these negative features. The students also considered that their evaluation process was correct, due to the fact that it was focused on the design of an integrated project for one of the school years already mentioned.

Exporting a model of integrated disease management: A cross-case study analysis and application to Associação Protectora dos Diabéticos de Portugal

Although literature is lacking in the topic of internationalization of services, we manage to apply both the Uppsala model and the Eclectic Theory to the healthcare service. A cross-case study analysis with three international hospitals is done in order to define an internationalization pattern and conditions for a successful process. This is then applied to Associação Protectora dos Diabéticos de Portugal with the purpose of defining an internationalization strategy to the Association.

An integrated system for human action recognition from video using hidden Markov model

In this paper, we present an integrated system for real-time automatic detection of human actions from video. The proposed approach uses the boundary of humans as the main feature for recognizing actions. Background subtraction is performed using Gaussian mixture model. Then, features are extracted from silhouettes and Vector Quantization is used to map features into symbols (bag of words approach). Finally, actions are detected using the Hidden Markov Model. The proposed system was validated using a newly collected real- world dataset. The obtained results show that the system is capable of achieving robust human detection, in both indoor and outdoor environments. Moreover, promising classification results were achieved when detecting two basic human actions: walking and sitting.