Les caractéristiques, le contexte et les processus d’implantation et de pérennisation d’une activité de développement professionnel par une équipe d’infirmières

La mise à jour des connaissances par les infirmières et leur engagement dans un processus continu d’apprentissage est garant de soins de qualité à la population (Nesbitt, 2013; OIIQ, 2011b; Raelin, 2008; Wilson et al., 2015). Au Québec depuis 2012, les infirmières doivent être inscrites à un minimum de 20 heures de formation annuellement (OIIQ, 2011a). Les milieux de soins offrent de la formation souvent ponctuelle. Garcia, Meek, et Wilson (2011) soulignent que l’implantation d’activités pérennes de développement professionnel en milieu de travail demeure un défi. La présente étude avait pour but de documenter les caractéristiques, le contexte et les processus d’implantation et de pérennisation d’une activité de développement professionnel par une équipe d’infirmières. Il s’agissait d’un club de lecture dans un centre hospitalier universitaire (CHU) d’une grande métropole québécoise. Fondée sur le modèle de Pettigrew et Whipp (1991) Content, Context, and Process model of strategic change adapté par Stetler, Ritchie, Rycroft-Malone, Schultz, et Charns (2007), la méthode d’étude de cas a été choisie. Des entrevues individuelles (n=7), des focus groups (n=2) et des périodes d’observation (n=2) ont été réalisés afin de décrire les éléments de succès de l’implantation et de la pérennisation de cette activité. Il résulte comme caractéristique qu’une activité où les infirmières sont engagées et actives est une stratégie gagnante. Le contexte, une équipe de gestionnaires qui valorise la pratique clinique et la pratique fondée sur les résultats probants, soutient la pérennité. Une trajectoire avec des retombées concrètes pour la pratique, les soins aux patients et l’identité professionnelle des participantes est l’élément principal du processus qui contribue à ce que l’activité soit pérenne.

Sexual and relationship intimacy among women with provoked vestibulodynia and their partners : associations with sexual satisfaction, sexual function, and pain self-efficacy

Introduction Provoked vestibulodynia (PVD) is the most frequent subtype of vulvodynia. Women report negative consequences of PVD on their sexual and romantic relationships. Researchers have recently highlighted the importance of examining interpersonal factors such as intimacy, and of including both women and their partners in study designs. Aim The aim of this study was to investigate sexual and relationship intimacy as defined by the Interpersonal Process Model of Intimacy and their associations with sexual satisfaction, sexual function, pain self-efficacy, and pain intensity among women with PVD and their partners. Methods Ninety-one heterosexual women (M age = 27.38, SD = 6.04) diagnosed with PVD and their partners (M age = 29.37, SD = 7.79) completed measures of sexual and relationship intimacy, sexual satisfaction, sexual function, pain self-efficacy, and pain intensity. Main Outcome Measures Dependent measures were the (i) Global Measure of Sexual Satisfaction Scale; (ii) Female Sexual Function Index; (iii) Painful Intercourse Self-Efficacy Scale; and (iv) visual analog scale of pain intensity during intercourse. Results After controlling for women's age, women's greater sexual intimacy (β = 0.49, P < 0.001) was associated with women's greater sexual satisfaction and higher pain self-efficacy (β = 0.39, P = 0.001), beyond the effects of partners’ sexual intimacy. Also, women's greater sexual intimacy (β = 0.24, P = 0.05) and women's greater relationship intimacy (β = 0.54, P = 0.003) were associated with greater women's sexual function, beyond the effects of partners’ sexual and relationship intimacy. Conclusions Women's self-reported sexual and relationship intimacy in the couple relationship may promote higher sexual satisfaction, sexual function, and pain self-efficacy, as well as possibly foster greater sexual well-being among women with PVD. The authors discuss implications for the inclusion of emotional and interpersonal aspects of the couple's dynamic in clinical interventions and future research in PVD.

Development and Evaluation of Blind Identification Techniques for Nonlinear Systems

Identification and Control of Non‐linear dynamical systems are challenging problems to the control engineers.The topic is equally relevant in communication,weather prediction ,bio medical systems and even in social systems,where nonlinearity is an integral part of the system behavior.Most of the real world systems are nonlinear in nature and wide applications are there for nonlinear system identification/modeling.The basic approach in analyzing the nonlinear systems is to build a model from known behavior manifest in the form of system output.The problem of modeling boils down to computing a suitably parameterized model,representing the process.The parameters of the model are adjusted to optimize a performanace function,based on error between the given process output and identified process/model output.While the linear system identification is well established with many classical approaches,most of those methods cannot be directly applied for nonlinear system identification.The problem becomes more complex if the system is completely unknown but only the output time series is available.Blind recognition problem is the direct consequence of such a situation.The thesis concentrates on such problems.Capability of Artificial Neural Networks to approximate many nonlinear input-output maps makes it predominantly suitable for building a function for the identification of nonlinear systems,where only the time series is available.The literature is rich with a variety of algorithms to train the Neural Network model.A comprehensive study of the computation of the model parameters,using the different algorithms and the comparison among them to choose the best technique is still a demanding requirement from practical system designers,which is not available in a concise form in the literature.The thesis is thus an attempt to develop and evaluate some of the well known algorithms and propose some new techniques,in the context of Blind recognition of nonlinear systems.It also attempts to establish the relative merits and demerits of the different approaches.comprehensiveness is achieved in utilizing the benefits of well known evaluation techniques from statistics. The study concludes by providing the results of implementation of the currently available and modified versions and newly introduced techniques for nonlinear blind system modeling followed by a comparison of their performance.It is expected that,such comprehensive study and the comparison process can be of great relevance in many fields including chemical,electrical,biological,financial and weather data analysis.Further the results reported would be of immense help for practical system designers and analysts in selecting the most appropriate method based on the goodness of the model for the particular context.

Research through DESIGN through research - a problem statement and a conceptual sketch

This paper re-addresses the issue of a lacking genuine design research paradigm. It tries to sketch an operational model of such a paradigm, based upon a generic design process model, which is derived from basic notions of evolution and learning in different domains of knowing (and turns out to be not very different from existing ones). It does not abandon the scientific paradigm but concludes that the latter has to be embedded into / subordinated under a design paradigm.

Fault diagnosis by refining the parameter uncertainty space of nonlinear dynamic systems

This paper deals with fault detection and isolation problems for nonlinear dynamic systems. Both problems are stated as constraint satisfaction problems (CSP) and solved using consistency techniques. The main contribution is the isolation method based on consistency techniques and uncertainty space refining of interval parameters. The major advantage of this method is that the isolation speed is fast even taking into account uncertainty in parameters, measurements, and model errors. Interval calculations bring independence from the assumption of monotony considered by several approaches for fault isolation which are based on observers. An application to a well known alcoholic fermentation process model is presented

Integrating predictive control and economic optimisation

In most commercially available predictive control packages, there is a separation between economic optimisation and predictive control, although both algorithms may be part of the same software system. This method is compared in this article with two alternative approaches where the economic objectives are directly included in the predictive control algorithm. Simulations are carried out using the Tennessee Eastman process model.

An Earth Observation Land Data Assimilation System (EO-LDAS)

Current methods for estimating vegetation parameters are generally sub-optimal in the way they exploit information and do not generally consider uncertainties. We look forward to a future where operational dataassimilation schemes improve estimates by tracking land surface processes and exploiting multiple types of observations. Dataassimilation schemes seek to combine observations and models in a statistically optimal way taking into account uncertainty in both, but have not yet been much exploited in this area. The EO-LDAS scheme and prototype, developed under ESA funding, is designed to exploit the anticipated wealth of data that will be available under GMES missions, such as the Sentinel family of satellites, to provide improved mapping of land surface biophysical parameters. This paper describes the EO-LDAS implementation, and explores some of its core functionality. EO-LDAS is a weak constraint variational dataassimilationsystem. The prototype provides a mechanism for constraint based on a prior estimate of the state vector, a linear dynamic model, and EarthObservationdata (top-of-canopy reflectance here). The observation operator is a non-linear optical radiative transfer model for a vegetation canopy with a soil lower boundary, operating over the range 400 to 2500 nm. Adjoint codes for all model and operator components are provided in the prototype by automatic differentiation of the computer codes. In this paper, EO-LDAS is applied to the problem of daily estimation of six of the parameters controlling the radiative transfer operator over the course of a year (> 2000 state vector elements). Zero and first order process model constraints are implemented and explored as the dynamic model. The assimilation estimates all state vector elements simultaneously. This is performed in the context of a typical Sentinel-2 MSI operating scenario, using synthetic MSI observations simulated with the observation operator, with uncertainties typical of those achieved by optical sensors supposed for the data. The experiments consider a baseline state vector estimation case where dynamic constraints are applied, and assess the impact of dynamic constraints on the a posteriori uncertainties. The results demonstrate that reductions in uncertainty by a factor of up to two might be obtained by applying the sorts of dynamic constraints used here. The hyperparameter (dynamic model uncertainty) required to control the assimilation are estimated by a cross-validation exercise. The result of the assimilation is seen to be robust to missing observations with quite large data gaps.

Vertical structure and physical processes of the Madden-Julian oscillation: Biases and uncertainties at short range

An analysis of diabatic heating and moistening processes from 12-36 hour lead time forecasts from 12 Global Circulation Models are presented as part of the "Vertical structure and physical processes of the Madden-Julian Oscillation (MJO)" project. A lead time of 12-36 hours is chosen to constrain the large scale dynamics and thermodynamics to be close to observations while avoiding being too close to the initial spin-up for the models as they adjust to being driven from the YOTC analysis. A comparison of the vertical velocity and rainfall with the observations and YOTC analysis suggests that the phases of convection associated with the MJO are constrained in most models at this lead time although the rainfall in the suppressed phase is typically overestimated. Although the large scale dynamics is reasonably constrained, moistening and heating profiles have large inter-model spread. In particular, there are large spreads in convective heating and moistening at mid-levels during the transition to active convection. Radiative heating and cloud parameters have the largest relative spread across models at upper levels during the active phase. A detailed analysis of time step behaviour shows that some models show strong intermittency in rainfall and differences in the precipitation and dynamics relationship between models. The wealth of model outputs archived during this project is a very valuable resource for model developers beyond the study of the MJO. In addition, the findings of this study can inform the design of process model experiments, and inform the priorities for field experiments and future observing systems.

Detecting regular sound changes in linguistics as events of concerted evolution

Background: Concerted evolution is normally used to describe parallel changes at different sites in a genome, but it is also observed in languages where a specific phoneme changes to the same other phoneme in many words in the lexicon—a phenomenon known as regular sound change. We develop a general statistical model that can detect concerted changes in aligned sequence data and apply it to study regular sound changes in the Turkic language family. Results: Linguistic evolution, unlike the genetic substitutional process, is dominated by events of concerted evolutionary change. Our model identified more than 70 historical events of regular sound change that occurred throughout the evolution of the Turkic language family, while simultaneously inferring a dated phylogenetic tree. Including regular sound changes yielded an approximately 4-fold improvement in the characterization of linguistic change over a simpler model of sporadic change, improved phylogenetic inference, and returned more reliable and plausible dates for events on the phylogenies. The historical timings of the concerted changes closely follow a Poisson process model, and the sound transition networks derived from our model mirror linguistic expectations. Conclusions: We demonstrate that a model with no prior knowledge of complex concerted or regular changes can nevertheless infer the historical timings and genealogical placements of events of concerted change from the signals left in contemporary data. Our model can be applied wherever discrete elements—such as genes, words, cultural trends, technologies, or morphological traits—can change in parallel within an organism or other evolving group.

Exploring invention capability

Research on invention has focused on business invention and little work has been conducted on the process and capability required for the individual inventor or the capabilities required for an advice to be considered an invention. This paper synthesises the results of an empirical survey of ten inventor case studies with current research on invention and recent capability affordance research to develop an integrated capability process model of human capabilities for invention and specific capabilities of an invented device. We identify eight necessary human effectivities required for individual invention capability and six functional key activities using these effectivities, to deliver the functional capability of invention. We also identified key differences between invention and general problem solving processes. Results suggest that inventive step capability relies on a unique application of principles that relate to a new combination of affordance chain with a new mechanism and or space time (affordance) path representing the novel way the device works, in conjunction with defined critical affordance operating factors that are the subject of the patent claims.

Joint data assimilation of satellite reflectance and net ecosystem exchange data constrains ecosystem carbon fluxes at a high-elevation subalpine forest

We utilized an ecosystem process model (SIPNET, simplified photosynthesis and evapotranspiration model) to estimate carbon fluxes of gross primary productivity and total ecosystem respiration of a high-elevation coniferous forest. The data assimilation routine incorporated aggregated twice-daily measurements of the net ecosystem exchange of CO2 (NEE) and satellite-based reflectance measurements of the fraction of absorbed photosynthetically active radiation (fAPAR) on an eight-day timescale. From these data we conducted a data assimilation experiment with fifteen different combinations of available data using twice-daily NEE, aggregated annual NEE, eight-day f AP AR, and average annual fAPAR. Model parameters were conditioned on three years of NEE and fAPAR data and results were evaluated to determine the information content from the different combinations of data streams. Across the data assimilation experiments conducted, model selection metrics such as the Bayesian Information Criterion and Deviance Information Criterion obtained minimum values when assimilating average annual fAPAR and twice-daily NEE data. Application of wavelet coherence analyses showed higher correlations between measured and modeled fAPAR on longer timescales ranging from 9 to 12 months. There were strong correlations between measured and modeled NEE (R2, coefficient of determination, 0.86), but correlations between measured and modeled eight-day fAPAR were quite poor (R2 = −0.94). We conclude that this inability to determine fAPAR on eight-day timescale would improve with the considerations of the radiative transfer through the plant canopy. Modeled fluxes when assimilating average annual fAPAR and annual NEE were comparable to corresponding results when assimilating twice-daily NEE, albeit at a greater uncertainty. Our results support the conclusion that for this coniferous forest twice-daily NEE data are a critical measurement stream for the data assimilation. The results from this modeling exercise indicate that for this coniferous forest, average annuals for satellite-based fAPAR measurements paired with annual NEE estimates may provide spatial detail to components of ecosystem carbon fluxes in proximity of eddy covariance towers. Inclusion of other independent data streams in the assimilation will also reduce uncertainty on modeled values.

Southern Ocean isopycnal mixing and ventilation changes driven by winds

Observed and predicted changes in the strength of the westerly winds blowing over the Southern Ocean have motivated a number of studies of the response of the Antarctic Circumpolar Current and Southern Ocean Meridional Overturning Circulation (MOC) to wind perturbations and led to the discovery of the``eddy-compensation" regime, wherein the MOC becomes insensitive to wind changes. In addition to the MOC, tracer transport also depends on mixing processes. Here we show, in a high-resolution process model, that isopycnal mixing by mesoscale eddies is strongly dependent on the wind strength. This dependence can be explained by mixing-length theory and is driven by increases in eddy kinetic energy; the mixing length does not change strongly in our simulation. Simulation of a passive ventilation tracer (analogous to CFCs or anthropogenic CO$_2$) demonstrates that variations in tracer uptake across experiments are dominated by changes in isopycnal mixing, rather than changes in the MOC. We argue that, to properly understand tracer uptake under different wind-forcing scenarios, the sensitivity of isopycnal mixing to winds must be accounted for.

Matrix Representation of the Stationary Measure for the Multispecies TASEP

In this work we construct the stationary measure of the N species totally asymmetric simple exclusion process in a matrix product formulation. We make the connection between the matrix product formulation and the queueing theory picture of Ferrari and Martin. In particular, in the standard representation, the matrices act on the space of queue lengths. For N > 2 the matrices in fact become tensor products of elements of quadratic algebras. This enables us to give a purely algebraic proof of the stationary measure which we present for N=3.

Förstudie kring ledningssystem vid reklambyrån Confetti

The aim of the project is to develop a tool for a management system at the advertising agency ofConfetti. The company has during a longer period of time felt a need of introducing a quality and environmentalsystem but have a lack in resources of knowledge, time and money. Their goal is to have aconcrete documentation which describes their quality policy and the function of the activity.The work has been performed by mapping and analyzing the processes of the company according tothe process model with focus on one pilot process. New routines have been developed and documentedin a management system.Confetti would like their management system to fulfil the ISO-standard so that they eventually inthe future can be certified. Therefore a literature study has been done according to management systemsand standards. The project has been directed to fulfil the ISO-standards demands for a qualitymanagement system. It has resulted in the creation of a comprehensible and userfriendly managementsystem which includes a routine model and new routines for the pilot process of PDF-handling. A oneyear-plan has been created to facilitate for the continuos development of the quality management systemat Confetti. The new quality implementations demands investment, why a budget has been calculatedshowing profitability.Confetti has to continue the development of the management system very soon. They ought to createan analyzis of the companys current situation and choose the processes that they themeselves considermost important or easiest to improve. A management system will not operate by it self, it needsmaintenance and development.

Licenshantering av programvaror i enkommunal verksamhet : En fallstudie över licenshanteringen i Falu kommun

Forskningen visar att förändringar av informationsteknologin och en ökande anskaffning av nya programvaror har lett till underliggande problem som kan drabba heterogena programvarulicensmiljöer och stora organisationer. Underliggande problem i den stora kontexten är mjukvaruhantering. Licenshantering av programvaror är just en förgrening av det stora problemet. Stora organisationer som en kommunal verksamhet är drabbad av det här underliggande problemet på grund av komplexitet hos organisationens miljö. Att tillämpa förändringar i området programvarulicens är omöjligt utan att göra förändringar i hela den organisationsprocess som följer med det. Fallstudiens uppdrag är ett nytt omfattande område kring licenshantering av programvaror som kan vara väldigt lärorikt och en bra erfarenhet att ta del av. Uppsatsen beskriver hur en kommunal verksamhets licenshantering av programvaror ser ut och de problem som finns med den nuvarande licenshanteringsprocessen. Förarbetet med en litteraturstudie tillsammans med datagenereringsmetoderna intervjuer, dokumentstudier och observationer används för att studera fallet på djupet. Målet är att kunna ta fram de nuvarande problem som finns, analysera dem och ge rekommendation för åtgärder som det studerade fallobjektet, Falu Kommuns IT-kontor, kan använda. En rekommendation för en tydlig licenshanteringsprocessmodell anses vara ett bra akademiskt bidrag eftersom problemet med licenshanteringen av programvaror är ett generellt problem. Uppsatsens resultat är en processmodell om licenshantering av programvaror för organisationer med IT-tjänstkunder. Det är en generisk lösning som skulle kunna användas av andra kommunverksamheter och liknande organisationer.