Cyberadministration : un tremplin pour les pays émergents : illustration à travers un exemple, constats et perspectives

Nous assistons actuellement à une diffusion, à l'échelle planétaire, des Technologies de l'Information et de la Communication (TIC) même si elle se fait à des rythmes différents selon les nations (voire entre les régions d'un même pays) créant ainsi un fossé dit « numérique », en sus des multiples inégalités déjà présentes. Cette révolution informatique et technologique engendre de nombreux changements dans les rapports sociaux et permet de nombreuses applications destinées à simplifier la vie quotidienne de tout un chacun. Amine Bekkouche se penche sur la problématique de la cyberadministration comme conséquence importante des TIC, à l'instar du commerce électronique. Il présente, d'abord, une synthèse des principaux concepts de la cyberadministration ainsi qu'un panorama de la situation mondiale en ce domaine. Par la suite, il appréhende la cyberadministration dans la perspective des pays émergents, notamment, à travers l'illustration d'un pays en développement représentatif. Il propose alors des solutions concrètes qui prennent comme point de départ le secteur éducatif pour permettre une « alphabétisation informatique » de la société afin de contribuer justement à réduire le fossé numérique. Il élargit, ensuite, ces propositions à d'autres domaines et formule des recommandations facilitant leur mise en oeuvre. Il conclut, enfin, sur des perspectives qui pourraient constituer autant de pistes de recherches futures et permettre l'élaboration de projets de développement, à travers l'appropriation de ces TIC, pour améliorer la condition de l'administré, et plus globalement, du citoyen. - We are currently witnessing a distribution of Information and Communication Technologies (ICT) on a global scale. Yet, this distribution is carried out in different rhythms within each nation (and even among regions in a given country), which creates a "digital" gap, in addition to multiple inequalities already present. This computing and technological revolution engenders many changes in social relationships and permits numerous applications that are destined to simplify our lives. Amine Bekkouche takes a closer look at the issue of e-government as an important consequence of ICTs, following the example of electronic commerce. First, he presents a synthesis of the main concepts in e- government as well as a panoramic view of the global situation in this domain. Subsequently, he studies e-government in view of emerging countries, in particular through the illustration of a country in representative development. Then, he offers concrete solutions, which take the education sector as their starting point, to allow for a "computed digitalisation" of society that contribute to reduce the digital gap. Thereafter, he broadens these proposals to other domains and formulates recommendations that help their implementation. Finally, he concludes with perspectives that may constitute further research tracks and enable the elaboration of development projects, through the appropriation of ICTs, in order to improve the condition of the administered, and more generally, that of the citizen.

Examination of Curing Criteria for Cold In-Place Recycling, TR-553, 2008

Cold In-Place Recycling (CIR) has been used widely in rehabilitating the rural highways because it improves a long-term pavement performance. A CIR layer is normally covered by a hot mix asphalt (HMA) overlay in order to protect it from water ingress and traffic abrasion and obtain the required pavement structure and texture. Curing is the term currently used for the period of time that a CIR layer should remain exposed to drying conditions before an HMA overlay is placed. The industry standard for curing time is 10 days to 14 days or a maximum moisture content of 1.5 percent, which appear to be very conservative. When the exposed CIR layer is required to carry traffic for many weeks before the wearing surface is placed, it increases the risk of a premature failure in both CIR layer and overlay. This study was performed to explore technically sound ways to identify minimum in-place CIR properties necessary to permit placement of the HMA overlay. To represent the curing process of CIR pavement in the field construction, three different laboratory curing procedures were examined: 1) uncovered, 2) semi-covered and 3) covered specimens. The indirect tensile strength of specimens in all three curing conditions did not increase during an early stage of curing but increased during a later stage of curing usually when the moisture content falls below 1.5%. Dynamic modulus and flow number increased as curing time increased and moisture contents decreased. For the same curing time, CIR-foam specimens exhibited the higher tensile strength and less moisture content than CIR-emulsion. The laboratory test results concluded that the method of curing temperature and length of the curing period significantly affect the properties of the CIR mixtures. The moisture loss index was developed to predict the moisture condition in the field and, in the future, this index be calibrated with the measurements of temperature and moisture of a CIR layer in the field.

Jejunojejunal intussusception after Roux-en-Y gastric bypass: a review.

Small bowel intussusception is a rare long-term complication after Roux-en-Y gastric bypass, the etiology of which remains unclear. Except for one series reporting on 23 patients, case reports represent the vast majority of all cases reported so far. With this complete review of the world literature, based on a total of 63 patients including 2 of our own cases, we provide an extensive overview of the subject. The origin of intussusception after gastric bypass is different from that of intussusception of other causes, in that there is usually no lead point. It is likely related to motility disorders in the divided small bowel, especially in the Roux limb. This rare condition may cause obstruction and lead to bowel necrosis if not recognized and treated promptly. Clinical presentation is not specific. Computerized tomography scan represents the diagnostic test of choice, but surgery is sometimes the only way to establish the diagnosis. Treatment may be limited to reduction if the small bowel is viable, but resection of the affected segment is recommended on the basis of this review, since it seems to result in fewer recurrences. Knowledge of this entity and a high index of suspicion are required to make the correct diagnosis and offer appropriate treatment in a timely fashion.

Clival chordoma with an atypical presentation: a case report.

INTRODUCTION: Clival chordomas present with headache, commonly VI cranial nerve palsy or sometimes with lower cranial nerve involvement. Very rarely, they present with cerebrospinal fluid rhinorrhoea due to an underlying chordoma-induced skull base erosion. CASE PRESENTATION: A 60-year old Caucasian woman presented with meningitis secondary to cerebrospinal fluid rhinorrhoea. At first, radiological imaging did not reveal a tumoral condition, though intraoperative exploration and tissue histology revealed a chordoma which eroded her clivus and had a transdural extension. CONCLUSION: Patients who present with meningitis and cerebrospinal fluid rhinorrhoea could have an underlying erosive lesion which can sometimes be missed on initial radiological examination. Surgical exploration allows collecting suspicious tissue for histological diagnosis which is important for the actual treatment. A revision endoscopic excision of a clival chordoma is challenging and has been highlighted in this report.

Involuntary treatment of alcohol-dependent patients: a study of 17 consecutive cases of civil commitment.

AIM: To investigate the baseline and follow-up characteristics of a group of alcohol-dependent patients being treated under civil commitment. METHODS: This study involved a cross-sectional comparative analysis of baseline characteristics and a follow-up survey of a group of committed alcoholic patients. The study was undertaken in the Alcohol Unit of a 1,000-bed general and university hospital. The study included 17 consecutive cases of civil commitment (representing 15 patients, of whom 2 were committed twice) and a comparative group of 34 randomly selected age- and sex-matched patients. Baseline characteristics of the cases (at the time of commitment) and of patients from the comparative group were collected from medical records, including sociodemographic data, medical condition, patterns of drinking and number and dates of previous treatments for alcohol-related problems. A structured follow-up interview of the cases provided information on their medical condition, social status, patterns of alcohol use, type and duration of residential treatment as well as their perceptions of commitment. RESULTS: During a 4-year period, our Unit referred 23 cases of alcohol-dependent patients (out of 367) to the Guardianship Authority, requesting civil commitment. On 17 occasions, patients were committed to residential treatment, including 2 patients who underwent commitment on two separate occasions, thus representing a total of 15 different patients. In comparison with age- and sex-matched patients seen at the Unit, the cases were characterized by multiple medical, social and psychological alcohol-related impairments. At the time of follow-up, 14 out of 15 patients were alive, among whom 10 agreed to be interviewed. Eight of these reported complete abstinence, whereas 9 considered their alcohol problem as less severe than before. The average duration of commitment was 29 weeks. The majority of patients retrospectively considered the measure as having been justified and useful. The patients' satisfaction with the decision to commit was higher among women than among men. Health-related quality of life at the time of follow-up, as assessed by the MOS 36-Item Short Form Health Survey questionnaire, was good on average and better than that usually reported by other cohorts of alcoholics undergoing treatment. CONCLUSIONS: The usefulness of residential civil commitment of certain severely impaired alcohol-dependent patients is underscored. This study suggests that civil commitment not only may save the lives of endangered patients but could also be a health-promoting measure that may sometimes allow for recovery from dependence. Unexpectedly, this measure was retrospectively well accepted by many patients, who considered the commitment decision as having been justified and useful.

Sähköverkkoyhtiön keskijänniteverkon kehittämissuunnitelma

Tämän työn tavoitteena oli laatia KSS Energia Oy:n keskijänniteverkon kehittämissuunnitelma. Tätä varten selvitettiin verkon nykytila ja sen toimivuus korvaustilanteissa. Suunnitelmaa varten laadittiin verkoston vuoteen 2020 asti ulottuva kuormitusennuste. Kehittämissuunnitelmassa paikannettiin alueet, joilla kuormitettavuus, korvattavuus tai oikosulkukestoisuus olisivat toimivansähkönjakelun esteinä tulevaisuudessa. Työn painopistealueiksi muodostuivat Vuolenkosken, Paimenpolun ja Valkealan alueet. Näiden alueiden kasvavan tehontarpeen tyydyttämiseksi selvitettiin uusien sähköasemien rakentamisvaihtoehtoja. Suunnitelmassa tarkasteltiin ja vertailtiin kolmen uuden sähköaseman rakentamista keskijänniteverkon saneerausvaihtoehtoon. Työssä selvitettiin myös miten alueen kuormituksen kasvun aiheuttama lisätehontarpeen jakelu voidaan hoitaa. Näiden alueiden kuormituksen kasvu edellyttää uusien sähköasemien rakentamista seuraavien 10vuoden kuluessa.

Laryngospasme: présentation inhabituelle d'une maladie coeliaque [Laryngospasm: unusual manifestation of celiac disease]

Gluten-induced enteropathy or coeliac disease is a condition characterized by malabsorption and a variety of clinical manifestations. In adults, coeliac disease may be discovered while investigating iron-deficient anemia, bone pain or unexplained weight loss. We have recently diagnosed a case of gluten-induced enteropathy in an elderly woman whose symptoms were unusual. The patient had episodes of laryngospasm secondary to severe hypocalcemia and hypomagnesemia. The malabsorption syndrome was responsible for low levels of vitamin D, causing the electrolytic imbalance. Laryngospasm is a rare symptom of hypocalcemia and has not, to our knowledge, been described in the context of coeliac disease.

Kuopion Energian keskijänniteverkon kehittämissuunnitelma

Tämän työn tavoitteena oli laatia Kuopion Energian keskijänniteverkon kehittämissuunnitelma. Kehittämissuunnitelmaa varten selvitettiin ensin verkon nykytila ja toimivuus korvaustilanteissa. Tämän jälkeen laadittiin vuoteen 2020 asti ulottuvat kuormitusennusteet. Nykytilan ja kuormitusennusteiden pohjalta selvitettiin toimenpiteet, joilla Kuopion Energian keskijänniteverkko selviää tulevaisuuden vaatimuksista. Kehittämissuunnitelmassa selvitettiin alueet, joilla kuormitettavuus, korvattavuus tai oikosulkukestoisuus muodostuisi tulevaisuudessa toimivan sähkönjakelun esteeksi. Työn painopistealueiksi muodostuivat Savilahden ja Petosen alueet. Työssä selvitettiin, kuinka Petosen alueen nopean kuormituksen kasvun aiheuttama lisätehontarve saadaan hoidettua. Vaihtoehtoisina ratkaisutapoina selvitettiin lisäkapasiteetin rakentamista Petosen aluetta nykyisin syöttävälle Leväsen sähköasemalle tai uuden sähköaseman rakentamista. Savilahden alueen kasvavan tehontarpeen tyydyttämiseksi selvitettiin lisätehon saneeraamista Savilahden sähköasemalle tai vastaavasti uuden sähköaseman rakentamista Iloharjun kytkinasemalle.

Transition aux soins adultes : une vue d'ensemble [Transition to adult care: an overview]

De nos jours, près de 90% des enfants atteints d'une maladie chronique survivent au-delà de l'âge de vingt ans et doivent passer de la pédiatrie aux soins adultes et de l'enfance à l'adolescence et à l'âge adulte. Selon la Society for Adolescent Medicine and Health (SAHM), les objectifs d'une transition organisée et coordonnée aux soins adultes pour les jeunes malades chroniques devraient permettre d'optimiser leur santé et de faciliter la réalisation de leur potentiel maximal.1 En conséquence, bien que le but principal de la transition soit la continuité des soins, elle n'est pas limitée au transfert (le passage de l'information et du patient de la pédiatrie aux soins adultes) mais est beaucoup plus large et inclut la préparation à la vie adulte. Ainsi donc, la transition devrait commencer tôt pendant l'adolescence, finir quand le patient devient un jeune adulte et englober trois parties : une phase de préparation en pédiatrie, une de transfert de la pédiatrie aux soins adultes et une dernière d'engagement aux soins adultes. Nowadays nearly 90% of children with a chronic condition survive to adulthood and must make the transition from pediatric to adult care. This transition must include not only the continuity of care but also the preparation for adult life so that these young people can develop their full potential. Divided into three phases (preparation, transfer and engagement), the transition process should be adapted to adolescents and ensure access to quality care.

Bosque y turismo

This paper presents a number of considerations on the recreational/tourism function offorests and some regulations that should be present in the planning of the public use of forestspace. We are going to examine studies on frequency of use, the features that condition theuse of forests and the criteria that should be present on planning of recreational use of forests

Mechanical circulatory support for destination therapy.

Patients with chronic heart failure who are not eligible for heart transplant and whose life expectancy depends mainly on the heart disease may benefit from mechanical circulatory support. Mechanical circulatory support restores adequate cardiac output and organ perfusion and eventually improves patients' clinical condition, quality of life and life expectancy. This treatment is called destination therapy (DT) and we estimate that in Switzerland more than 120 patients per year could benefit from it. In the last 10 years, design of the devices, implantation techniques and prognoses have changed dramatically. The key to successful therapy with a left ventricular assist device is appropriate patient selection, although we are still working on the definition of reliable inclusion and exclusion criteria and optimal timing for surgical implantation. Devices providing best long-term results are continuous flow, rotary or axial blood pumps implanted using minimally invasive techniques on a beating heart. These new devices (Thoratec HeartMate II and HeartWare HVAD) have only a single moving part, and have improved durability with virtually 10 years freedom from mechanical failure. In selected patients, the overall actuarial survival of DT patients is 75% at 1 year and 62% at 2 years, with a clear improvement in quality of life compared with medical management only. Complications include bleeding and infections; their overall incidence is significantly lower than with previous devices and their management is well defined. DT is evolving into an effective and reasonably cost-effective treatment option for a growing population of patients not eligible for heart transplant, showing encouraging survival rates at 2 years and providing clear improvement in quality of life. The future is bright for people suffering from chronic heart failure.

Avaliação de ICP OES com configuração axial ou radial para determinação de iodo em sal de cozinha

The performance of inductively-coupled plasma optical emission spectrometers with axial and radial views for determination of iodine in table salt was evaluated. Interference and memory effects in nitric acid and water-soluble tertiary amines (CFA-C) media were studied. Based on a factorial experiment, one optimum instrument operational condition for axial configuration, and two optima conditions for radial configuration was established. The ICP OES with axial view was 5-fold more sensitive than the radial view. Both matrix matching and standard addition methods were used for iodine quantification and for most samples, both strategies of calibration led to similar results. Recoveries ranged from 104 to 114%.

Vertailu kahden erityyppisen virtasyötetyn hakkurin soveltuvuudesta polttokennokäyttöihin

Concerns about condition of the environment and rising fossil fuel prices have accelerated the research of finding new cheap and environmental friendly energy source. Fuel cells are one of the most promising green technologies, especially in the field of distributed energy generation, backup power systems, transportation and mobile power generation. In this bachelor’s thesis use of fuel cells is studied, especially from the DC-DC converter point of view. This bachelor’s thesis concentrates on study of two different DC-DC converters. The aim of this thesis is to study design and steering methods for proposed converters. The ultimate aim of this thesis is to determine which one of proposed converters is most suitable for fuel cell applications.

Diskreettiaikainen liukuvan moodin säätö kiinteäoksidipolttokennon DC-tasonnostossa

Huoli ympäristön tilasta ja fossiilisten polttoaineiden hinnan nousu ovat vauhdittaneet tutkimusta uusien energialähteiden löytämiseksi. Polttokennot ovat yksi lupaavimmista tekniikoista etenkin hajautetun energiantuotannon, varavoimalaitosten sekä liikennevälineiden alueella. Polttokenno on tehonlähteenä kuitenkin hyvin epäideaalinen, ja se asettaa tehoelektroniikalle lukuisia erityisvaatimuksia. Polttokennon kytkeminen sähköverkkoon on tavallisesti toteutettu käyttämällä galvaanisesti erottavaa DC/DC hakkuria sekä vaihtosuuntaajaa sarjassa. Polttokennon kulumisen estämiseksi tehoelektroniikalta vaaditaan tarkkaa polttokennon lähtövirran hallintaa. Perinteisesti virran hallinta on toteutettu säätämällä hakkurin tulovirtaa PI (Proportional and Integral) tai PID (Proportional, Integral and Derivative) -säätimellä. Hakkurin epälineaarisuudesta johtuen tällainen ratkaisu ei välttämättä toimi kaukana linearisointipisteestä. Lisäksi perinteiset säätimet ovat herkkiä mallinnusvirheille. Tässä diplomityössä on esitetty polttokennon jännitettä nostavan hakkurin tilayhtälökeskiarvoistusmenetelmään perustuva malli, sekä malliin perustuva diskreettiaikainen integroiva liukuvan moodin säätö. Esitetty säätö on luonteeltaan epälineaarinen ja se soveltuu epälineaaristen ja heikosti tunnettujen järjestelmien säätämiseen.

Treatment of Acute Otitis Media

Background: Acute otitis media (AOM) is the most common bacterial infection in young children, but the optimal management of AOM remains controversial. The aim of this study was to assess the efficacy of antimicrobial treatment, either immediate or delayed, for AOM and to compare parental experiences regarding the management of AOM in two countries with very different treatment guidelines. Methods: Altogether, 322 children participated in a randomized, double-blind, placebocontrolled trial. Children 6–35 months of age with AOM received amoxicillin-clavulanate or placebo for 7 days. The primary outcome was the time to treatment failure. In the second study, the delayed antimicrobial treatment group consisted of recipients of placebo who had received rescue treatment. The immediate antimicrobial treatment group consisted of children allocated to amoxicillin-clavulanate group. Parental expectations and opinions were evaluated by questionnaires sent via public day care in Turku, Finland, and Utrecht, the Netherlands. Results: Treatment failure occurred significantly more often in children receiving placebo as compared to antimicrobial treatment (45% vs. 19%, P<0.001). Delayed initiation of antimicrobial treatment did not worsen the recovery from AOM, but it was associated with worsening of the child’s condition, prolongation of symptoms, and absenteeism from day care and parental absenteeism from work. According to the comparative questionnaire, antimicrobial use was more common in Finland than in the Netherlands. Finnish parents believed more often than Dutch parents that antimicrobials are necessary in the treatment of AOM. Conclusions: Children with AOM benefit from antimicrobial treatment. Delayed initiation of antimicrobial does not worsen the overall recovery from AOM, but it might increase the symptom burden and create economic losses. Treatment practices and parental expectations seem to interact with each other. This needs to be considered when AOM treatment guidelines are updated.