The KAI Cognitive Style Inventory: Was it personality all along?

Kirton's Adaption-Innovation Inventory (KAI) is a widely-used measure of "cognitive style." Surprisingly, there is very little research investigating the discriminant and incremental validity of the KAI. In two studies (n = 213), we examined whether (a) we could predict KAI scores with the "big five" personality dimensions and (b) the KAI scores predicted leadership behavior when controlling for personality and ability. Correcting for measurement error, we found that KAI scores were predicted mostly by personality and gender (multiple R = 0.82). KAI scores did not predict variance in leadership while controlling for established predictors. Our findings add to recent literature that questions the uniqueness and utility of cognitive style or similar "style" constructs; researchers using such measures must control for the big five factors and correct for measurement error to avoid confounded interpretations.

Impact of personality on termination of short-term group psychotherapy in depressed elderly outpatients

Objective Termination in group psychotherapy is an essential phase of the psychotherapeutic process, yet its clinical determinants remain largely unknown, especially in elderly patients. The aim of this study was to assess how patients' personality traits influence their way of leaving a short-term psychotherapy group as well as a larger therapeutic community program. <p>Method Personality traits were assessed with the NEO Five-Factor Inventory in 24 elderly depressed outpatients. Patients' terminations from the group as well as from the community were ranked into four classes according to their appropriateness (completeness of experience and ability to deal with feelings of separation). Results Neuroticism was not related to the quality of termination. In contrast, agreeableness and openness to experience were strongly associated with successful termination. Conscientiousness and extraversion may have a differential impact depending on the type of group (group psychotherapy versus therapeutic community). Conclusion Personality traits may be important clinical determinants of the quality of termination process in both group psychotherapy and therapeutic community settings for elderly depressed patients.

Autoreactive T cells that bypass negative selection are not tolerant and respond to self-antigen stimulation during infection

Le répertoire cellulaire Τ a pour but d'être tolérant aux antigènes du soi afin d'éviter l'induction de maladies autoimmunes. C'est pourquoi les lymphocytes Τ autoréactifs sont éliminés dans le thymus lors de leur développement par le processus de sélection négative. La plupart des recherches étudient les lymphocytes Τ de haute avidité. Ces lymphocytes Τ de haute avidité sont très sensibles et réagissent fortement à un antigène du soi. En conséquence, ces cellules induisent le développement de maladies autoimmunes lorsqu'elles ciblent des organes exprimant l'antigène du soi. Plusieurs études ont montré que les lymphocytes Τ qui réagissent faiblement aux antigènes spécifiques à un tissu, nommé lymphocytes Τ de faible avidité, peuvent contourner les mécanismes de tolérance centrale et périphérique. J'ai utilisé des souris Rip-mOva qui expriment l'Ovalbumine comme antigène du soi spécifique à un tissu. Dans ces souris transgéniques Rip-mOva, les lymphocytes Τ de faible avidité survivent à la sélection négative. Une fois stimulés à la périphérie, ces lymphocytes Τ CD8+ de faible avidité ont la capacité d'infiltrer les organes qui expriment l'antigène du soi chez les souris Rip-mOva et peuvent induire une destruction tissulaire. L'objectif principal de mon projet de thèse était de comprendre les caractéristiques phénotypiques et fonctionnelles de ces lymphocytes Τ dans un état d'équilibre et dans un contexte infectieux. Pour étudier ces cellules dans un modèle murin bien défini, nous avons généré des souris exprimant un récepteur de cellule Τ transgénique appelé OT-3. Ces souris transgéniques OT-3 ont des lymphocytes Τ CD8+ de faible avidité spécifiques à l'épitope SIINFEKL de l'antigène Ovalbumine. Nous avons démontré qu'un grand nombre de lymphocytes Τ CD8+ OT-3 ne sont pas éliminés lors de la sélection négative dans le thymus après avoir rencontré l'antigène du soi. Par conséquent, les lymphocytes Τ OT-3 de faible avidité sont présents dans une fenêtre de sélection comprise entre la sélection positive et négative. Cette limite se définie comme le seuil d'affinité et est impliquée dans l'échappement de certains lymphocytes Τ OT- 3 autoréactifs. A la périphérie, ces cellules sont capables d'induire une autoimmunité après stimulation au cours d'une infection, ce qui nous permet de les définir comme étant non tolérante et non dans un état anergique à la périphérie. Nous avons également étudié le seuil d'activation des lymphocytes Τ OT-3 à faible avidité à la périphérie et avons constaté que des ligands peptidiques plus faibles que l'épitope natif SIINFEKL sont capables de les activer au cours d'une infection ainsi que de les différencier en lymphocytes Τ effecteurs et mémoires. Les données illustrent une déficience lors de la sélection négative dans le thymus de lymphocytes Τ CD8+ autoréactifs de faible avidité contre un antigène du soi spécifique à tissu et montrent que ces cellules sont entièrement compétentes lors d'une infection. - The diverse Τ cell repertoire needs to be tolerant to self-antigen to avoid the induction of autoimmunity. This is why autoreactive developing Τ cells are deleted in the thymus. The deletion of self-reactive Τ cells occurs through the process of negative selection. Most studies investigated high avidity Τ cells. These high avidity Τ cells are very sensitive and strongly react to a self-antigen. As a consequence, these cells induce the development of autoimmunity when they target organs which express the self-antigen. High avidity autoreactive CD8+ Τ cells are deleted in the thymus. However, several studies have shown Τ cells that weakly respond to tissue-restricted antigen, referred to as low avidity Τ cells, can bypass central and peripheral tolerance mechanisms. I used Rip-mOva mice that expressed Ovalbumin as a neo self-antigen in a tissue-restricted fashion. In these transgenic Rip-mOva mice low avidity CD8+ Τ cells survive negative selection. Upon stimulation in the periphery, these low avidity CD8+ Τ cells have the ability to infiltrate organs that express the self-antigen in the Rip-mOva mice and can also induce the destruction of the tissue. The major aim of my PhD project was to understand the phenotypic and functionality characteristics of these Τ cells in a steady-state condition and in a context of an infection. To study these cells in a well-defined mouse model, we generated OT-3 Τ cell receptor transgenic mice that express low avidity CD8+ Τ cells that are specific for the SIINFEKL epitope of the Ovalbumin antigen. We have been able to demonstrate that a large number of OT-3 CD8+ Τ cells survive negative selection in the thymus after encountering the self-antigen. Thus, low avidity OT-3 Τ cells are present in a window of selection comprised between positive and negative selection. This boundary defined as the affinity threshold is involved in the escape of some autoreactive low avidity OT-3 Τ cells. Once they circulate in the periphery, they are able to induce autoimmunity after stimulation during an infection, allowing us to allocate these cells as being non-tolerant and not in an anergic state in the periphery. We have also looked at the threshold of activation of low avidity OT-3 CD8+ Τ cells in the periphery and found that peptide ligands that are weaker than the native SIINFEKL epitope are able to activate OT-3 Τ cells during an infection and to differentiate them into effector and memory Τ cells. The data illustrate the impairment of negatively selecting low avidity autoreactive CD8+ Τ cells against a tissue-restricted antigen in the thymus and shows that these cells are fully competent upon an infection.

Are invasive marsh frogs (Pelophylax ridibundus) replacing the native P. lessonae /P. esculentus hybridogenetic complex in Western Europe? Genetic evidence from a field study.

The water-frog L-E system, widespread in Western Europe, comprises the pool frog Pelophylax lessonae and the hybridogenetic edible frog P. esculentus, which originated from hybridization between pool frogs and marsh frogs (P. ridibundus). In P. esculentus, the lessonae (L) genome is eliminated during meiosis and has to be gained anew each generation from a P. lessonae partner, while the ridibundus (R') genome is transmitted clonally. It therefore accumulates deleterious mutations, so that R'R' offspring from P. esculentus x P. esculentus crosses are normally unviable. This system is now threatened by invasive P. ridibundus (RR) imported from Eastern Europe and the Balkans. We investigated the genetic interactions between invasive marsh frogs and native water frogs in a Swiss wetland area, and used genetic data collected in the field to validate several components of a recently postulated mechanism of species replacement. We identified neo-ridibundus individuals derived from crosses between invasive ridibundus and native esculentus, as well as newly arisen hybridogenetic esculentus lineages stemming from crosses between invasive ridibundus (RR) and native lessonae (LL). As their ridibundus genomes are likely to carry less deleterious mutations, such lineages are expected to produce viable ridibundus offspring, contributing to species replacement. However, such crosses with invasive ridibundus only occurred at a limited scale; moreover, RR x LL crosses did not induce any introgression from the ridibundus to the lessonae genome. We did not find any ridibundus stemming from crosses between ancient esculentus lineages. Despite several decades of presence on the site, introduced ridibundus individuals only represent 15% of sampled frogs, and their spatial distribution seems shaped by specific ecological requirements rather than history of colonization. We therefore expect the three taxa to coexist stably in this area.

Simulations in evolution. II. Relative fitness and the propagation of mutants.

In Neo-Darwinism, variation and natural selection are the two evolutionary mechanisms which propel biological evolution. Our previous article presented a histogram model [1] consisting in populations of individuals whose number changed under the influence of variation and/or fitness, the total population remaining constant. Individuals are classified into bins, and the content of each bin is calculated generation after generation by an Excel spreadsheet. Here, we apply the histogram model to a stable population with fitness F(1)=1.00 in which one or two fitter mutants emerge. In a first scenario, a single mutant emerged in the population whose fitness was greater than 1.00. The simulations ended when the original population was reduced to a single individual. The histogram model was validated by excellent agreement between its predictions and those of a classical continuous function (Eqn. 1) which predicts the number of generations needed for a favorable mutation to spread throughout a population. But in contrast to Eqn. 1, our histogram model is adaptable to more complex scenarios, as demonstrated here. In the second and third scenarios, the original population was present at time zero together with two mutants which differed from the original population by two higher and distinct fitness values. In the fourth scenario, the large original population was present at time zero together with one fitter mutant. After a number of generations, when the mutant offspring had multiplied, a second mutant was introduced whose fitness was even greater. The histogram model also allows Shannon entropy (SE) to be monitored continuously as the information content of the total population decreases or increases. The results of these simulations illustrate, in a graphically didactic manner, the influence of natural selection, operating through relative fitness, in the emergence and dominance of a fitter mutant.

Personality traits influence clinical outcome in day hospital-treated elderly depressed patients

OBJECTIVES: Although personality traits are considered significant predictors of both physical and mental health, their specific impact on treatment outcome in elderly patients with depression remains largely unexplored. Impact of personality traits on the evolution of depressive symptoms, quality of life, and perception of clinical progress was assessed in a psychotherapeutic community. DESIGN: A prospective longitudinal study was conducted in 62 elderly outpatients. SETTING: Day hospital treatment as usual combined group and individual therapies, pharmacological treatment, as well as family and network meetings. PARTICIPANTS: Patients presented with major depression or a depressive episode of bipolar disease. MEASUREMENTS: The Geriatric Depression Scale, the Short Form Survey, and the Therapeutic Community Assessment scale were administrated at admission, 3, 6, 12 months, and at discharge. Personality was evaluated with the NEO Five-Factor Personality Inventory. RESULTS: Outcome revealed reduced depression and improved mental quality of life and clinical progress. Higher Geriatric Depression Scale scores were found in individuals with higher levels of Neuroticism (and its Vulnerability facet). Better self-perception of clinical progress was observed in individuals with lower levels of the Depressiveness and Modesty facets and higher openness to action. Improvement in quality of life was predicted by high Positive emotions facet. All these associations remained significant after controlling for age, gender, and treatment length. CONCLUSION: Personality traits may predict clinical outcome in psychotherapeutic hospital day care for elderly patients with depression.

Neoadjuvant therapy with denosumab in a giant cell tumour. A case report

Introduction: Giant cell tumour (GCT) is a benign but locally aggressive primary osteolytic bone tumour, prone to local recurrence after surgery. Denosumab is a human antibody against RANKL, an over-expressed ligand present on normal multinucleated cells, responsible for bone destruction in GCT. We report the case of a patient with an advanced GCT of the distal radius. The lesion was treated with adjuvant denosumab , followed by curettage. Clinical case: A 28 years old patient presented with a classical honeycomb osteolytic lesion in the left distal radius. Core-needle biopsy confirmed the diagnosis of GCT. Due to the proximity to the radio-carpal joint and advanced scalloping of the metaphyseal cortical bone, joint-salvage surgery was not possible. We initiated a neo-adjuvant treatment with denosumab (XGEVA), 120mg/ week for 1 month, followed by monthly injections for 6 months. During this time, a substantial bone recorticalization, without progression of the size of the tumour was noted. No local or systemic side effects were observed. We performed intra-lesional (curettage) excision and bone grafting after 6 months. Histological analysis revealed islets (10%) of viable tumour cells within fibrous tissue. Post-op evolution was eventless. Discussion: While surgery remains the treatment of choice for GCT, joint-salvage may not always be possible in case of extensive epiphyseal involvement. The presence of osteoclast-like giant cells seems to make those lesions prone to the specific anti-RANKL treatment with denosumab. Denosumab appears to slow down tumour growth and promote recorticalization of eroded bone. It might allow less aggressive surgery in selected cases.

Quoi de neuf en chirurgie [Novelties in surgery in 2013?].

Multidisciplinary management of colorectal liver metastases allows an increase of about 20% in the resection rate of liver metastases. It includes chemotherapy, interventional radiology and surgery. In 2013, the preliminary results of the in-situ split of the liver associated with portal vein ligation (ALLPS) are promising with unprecedented mean hypertrophy up to 70% at day 9. However, the related morbidity of this procedure is about 40% and hence should be performed in the setting of study protocol only. For pancreatic cancer, the future belongs to the use of adjuvant and neo adjuvant therapies in order to increase the resection rate. Laparoscopic and robot-assisted surgery is still in evolution with significant benefits in the reduction of cost, hospital stay, and postoperative morbidity. Finally, enhanced recovery pathways (ERAS) have been validated for colorectal surgery and are currently assessed in other fields of surgery like HPB and upper GI surgery.

ANÁLISE DE IMAGENS NA DETERMINAÇÃO DA FORMA E TEXTURA DE AREIAS

A forma dos grãos tem importante papel na avaliação da distribuição granulométrica das partículas de um solo. Entretanto, a maioria das técnicas de peneiramento evidencia que os grãos são esféricos e descritos por um único parâmetro, o diâmetro. Este trabalho teve por objetivo estudar a aplicação da análise de imagens, aliada ao grau de esfericidade e à teoria dos fractais, como ferramenta para mensurar parâmetros de forma e textura superficial de duas areias de características supostamente distintas da região da Grande Vitória, Espírito Santo, Brasil. Os resultados dos parâmetros de forma e textura superficial das amostras são apresentados e discutidos. As análises dos resultados para a variável esfericidade mostram diferenças estatísticas significativas entre as duas areias de origens diferentes. A areia de jazida de cordão litorâneo (AJ) apresentou grau de esfericidade ligeiramente superior e textura superficial mais lisa do que a de rio (AR), indicando que as areias AJ sofreram maior intemperismo em razão do transporte.

VARIABILIDADE DE ATRIBUTOS FÍSICOS E QUÍMICOS DO SOLO E PRODUÇÃO DE FEIJOEIRO CULTIVADO EM SISTEMA DE CULTIVO MINIMO COM IRRIGAÇÃO

A compreensão do potencial agrícola de um solo muitas vezes é com base apenas na interpretação por meio de análises univariadas, podendo elevar a dimensão dos problemas no momento de escolher o manejo adequado ao solo. Dessa forma, a análise multivariada surge como alternativa, pois ela é um conjunto de procedimentos que visa agrupar e discriminar grupos de indivíduos. Também, serve como instrumento de seleção de variáveis, na medida em que aquelas com maior peso na construção dos primeiros componentes principais são as possíveis que melhor representam o conjunto de dados estudados. O objetivo deste trabalho foi identificar, por meio de análises multivariadas, os atributos do solo que melhor explicam a variabilidade espacial na produção da cultura do feijão. No ano agrícola de 2006/2007, no município de Selvíria, MS, foi analisada a produtividade do feijão em razão de alguns atributos físicos e químicos de um Latossolo Vermelho distroférrico, cultivado nas condições de elevado nível tecnológico de manejo pelo sistema de cultivo mínimo irrigado com pivô central. Foi demarcada a malha geoestatística para a coleta de dados do solo e da planta, com 117 pontos amostrais, numa área de 2.025 m2 e declive homogêneo de 0,055 m m-1. A classificação em grupos foi feita por três métodos: método de agrupamentos hierárquico, método não hierárquico k-means e análise de componentes principais. Essa última análise permitiu identificar três grupos que explicam 86,3 % da variabilidade total dos dados, os quais são constituídos pelos atributos físicos: densidade do solo, porosidade total, umidade gravimétrica e umidade volumétrica, que se evidenciaram com maior poder de explicação da variação da produtividade. Pode-se concluir que a análise multivariada aliada à geoestatística é importante ferramenta no auxílio ao manejo localizado.

Geology of the NW Indian Himalaya

This review paper deals with the geology of the NW Indian Himalaya situated in the states of Jammu and Kashmir, Himachal Pradesh and Garhwal. The models and mechanisms discussed, concerning the tectonic and metamorphic history of the Himalayan range, are based on a new compilation of a geological map and cross sections, as well as on paleomagnetic, stratigraphic, petrologic, structural, metamorphic, thermobarometric and radiometric data. The protolith of the Himalayan range, the North Indian flexural passive margin of the Neo-Tethys ocean, consists of a Lower Proterozoic basement, intruded by 1.8-1.9 Ga bimodal magmatites, overlain by a horizontally stratified sequence of Upper Proterozoic to Paleocene sediments, intruded by 470-500 Ma old Ordovician mainly peraluminous s-type granites, Carboniferous tholeiitic to alkaline basalts and intruded and overlain by Permian tholeiitic continental flood basalts. No elements of the Archaen crystalline basement of the South Indian shield have been identified in the Himalayan range. Deformation of the Himalayan accretionary wedge resulted from the continental collision of India and Asia beginning some 65-55 Ma ago, after the NE-directed underthrusting of the Neo-Tethys oceanic crust below Asia and the formation of the Andean-type 103-50 (-41) Ma old Ladakh batholith to the north of the Indus Suture. Cylindrical in geometry, the Himalayan range consists, from NE to SW, from older to younger tectonic elements, of the following zones: 1) The 25 km wide Ladakh batholith and the Asian mantle wedge form the backstop of the growing Himalayan accretionary wedge. 2) The Indus Suture zone is composed of obducted slices of the oceanic crust, island arcs, like the Dras arc, overlain by Late Cretaceous fore arc basin sediments and the mainly Paleocene to Early Eocene and Miocene epi-sutural intra-continental Indus molasse. 3) The Late Paleocene to Eocene North Himalayan nappe stack, up to 40 km thick prior to erosion, consists of Upper Proterozoic to Paleocene rocks, with the eclogitic and coesite bearing Tso Morari gneiss nappe at its base. It includes a branch of the Central Himalayan detachment, the 22-18 Ma old Zanskar Shear zone that is intruded and dated by the 22 Ma Gumburanjun leucogranite; it reactivates the frontal thrusts of the SW-verging North Himalayan nappes. 4) The late Eocene-Miocene SW-directed High Himalayan or ``Crystalline'' nappe comprises Upper Proterozoic to Mesozoic sediments and Ordovician granites, identical to those of the North Himalayan nappes. The Main Central thrust at its base was created in a zone of Eocene to Early Oligocene anatexis by ductile detachment of the subducted Indian crust, below the pre-existing 25-35 km thick NE-directed Shikar Beh and SW-directed North Himalayan nappe stacks. 5) The late Miocene Lesser Himalayan thrust with the Main Boundary Thrust at its base consists of early Proterozoic to Cambrian rocks intruded by 1.8-1.9 Ga bimodal magmatites. The Subhimalaya is a thrust wedge of Himalayan fore deep basin sediments, composed of the Early Eocene marine Subathu marls and sandstones as well as the up to 8'000 m-thick Miocene to recent Ganga molasse, a coarsening upwards sequence of shales, sandstones and conglomerates. The active frontal thrust is covered by the sediments of the Indus-Ganga plains.

Simulations in Evolution. III. Randomness as a Generator of Opportunities.

In Neo-Darwinism, variation and natural selection are the two evolutionary mechanisms which propel biological evolution. Our previous reports presented a histogram model to simulate the evolution of populations of individuals classified into bins according to an unspecified, quantifiable phenotypic character, and whose number in each bin changed generation after generation under the influence of fitness, while the total population was maintained constant. The histogram model also allowed Shannon entropy (SE) to be monitored continuously as the information content of the total population decreased or increased. Here, a simple Perl (Practical Extraction and Reporting Language) application was developed to carry out these computations, with the critical feature of an added random factor in the percent of individuals whose offspring moved to a vicinal bin. The results of the simulations demonstrate that the random factor mimicking variation increased considerably the range of values covered by Shannon entropy, especially when the percentage of changed offspring was high. This increase in information content is interpreted as facilitated adaptability of the population.

Analysis of gene expression patterns in animals

During my PhD, my aim was to provide new tools to increase our capacity to analyse gene expression patterns, and to study on a large-scale basis the evolution of gene expression in animals. Gene expression patterns (when and where a gene is expressed) are a key feature in understanding gene function, notably in development. It appears clear now that the evolution of developmental processes and of phenotypes is shaped both by evolution at the coding sequence level, and at the gene expression level.Studying gene expression evolution in animals, with complex expression patterns over tissues and developmental time, is still challenging. No tools are available to routinely compare expression patterns between different species, with precision, and on a large-scale basis. Studies on gene expression evolution are therefore performed only on small genes datasets, or using imprecise descriptions of expression patterns.The aim of my PhD was thus to develop and use novel bioinformatics resources, to study the evolution of gene expression. To this end, I developed the database Bgee (Base for Gene Expression Evolution). The approach of Bgee is to transform heterogeneous expression data (ESTs, microarrays, and in-situ hybridizations) into present/absent calls, and to annotate them to standard representations of anatomy and development of different species (anatomical ontologies). An extensive mapping between anatomies of species is then developed based on hypothesis of homology. These precise annotations to anatomies, and this extensive mapping between species, are the major assets of Bgee, and have required the involvement of many co-workers over the years. My main personal contribution is the development and the management of both the Bgee database and the web-application.Bgee is now on its ninth release, and includes an important gene expression dataset for 5 species (human, mouse, drosophila, zebrafish, Xenopus), with the most data from mouse, human and zebrafish. Using these three species, I have conducted an analysis of gene expression evolution after duplication in vertebrates.Gene duplication is thought to be a major source of novelty in evolution, and to participate to speciation. It has been suggested that the evolution of gene expression patterns might participate in the retention of duplicate genes. I performed a large-scale comparison of expression patterns of hundreds of duplicated genes to their singleton ortholog in an outgroup, including both small and large-scale duplicates, in three vertebrate species (human, mouse and zebrafish), and using highly accurate descriptions of expression patterns. My results showed unexpectedly high rates of de novo acquisition of expression domains after duplication (neofunctionalization), at least as high or higher than rates of partitioning of expression domains (subfunctionalization). I found differences in the evolution of expression of small- and large-scale duplicates, with small-scale duplicates more prone to neofunctionalization. Duplicates with neofunctionalization seemed to evolve under more relaxed selective pressure on the coding sequence. Finally, even with abundant and precise expression data, the majority fate I recovered was neither neo- nor subfunctionalization of expression domains, suggesting a major role for other mechanisms in duplicate gene retention.

Isolated limb perfusion with tumor necrosis factor and melphalan for non-resectable soft tissue sarcomas: long-term results on efficacy and limb salvage in a selected group of patients

Background And Objectives: Isolated limb perfusion with TNF-alpha and melphalan (TM-ILP) is a limb salvage therapy for non-resectable soft tissue sarcomas (STS) of the extremities. It is indicated for patients for whom amputation or debilitating surgery is the only alternative. It can be used either as an exclusive therapy (in palliation) or as a neo-adjuvant treatment, followed by marginal resection of tumor remnants with minimal functional impairment. Methods: Between February 1992 and March 2006, 57 TM-ILPs were performed on 51 patients with 88% high grade and 84% advanced stage tumors. Results: Mean follow-up is 38.9 months (4-159, median 22 months). Twenty-one percent patients had significant early complications, with 3 major re-operations, and 23% suffered long-lasting complications. Complete response was observed in 25%, partial response in 42%, stable disease in 14% and progressive disease in 14%. Resection of the tumor remnants was possible in 65%. A complementary treatment was necessary in 31%, mostly radiation therapy. A local recurrence was observed in 35%, after a mean of 20.3 months (2-78), and distant relapse was seen in 45%, after a mean of 13.4 months (5-196). Mean Disease-free survival was 14.9 months, and overall 5-year-survival 43.5%. Amputation rate at 5 years was 24%. Conclusions: TM-ILP is a conservative treatment with a high complications rate, but it can be successful even for the most severe STS of extremities. As a consequence the limb can be spared from amputation or debilitating surgery on the long term in about 75% of patients

Une européanisation des politiques de conciliation de la vie familiale et professionnelle? : les cas de l'Italie et de la France

Les différents pays membres de l'UE connaissent des politiques dites de « conciliation de la vie professionnelle et familiale » qui correspondent à un ensemble de dispositifs hétéroclites, plus ou moins complexes, mais rarement cohérents. Alliant des objectifs tels que la hausse de la natalité, la protection des mères et des enfants, l'égalité entre femmes et hommes, la lutte contre la pauvreté des enfants et des familles monoparentales et l'activation des femmes, ces politiques sont fortement ancrées dans des traditions nationales de politiques familiales, d'emploi et fiscales. Ces politiques portent en elles l'héritage et les tensions de l'histoire d'un pays. Au moment où un nouvel acteur international, l'Union européenne, intervient de manière de plus en plus explicite dans le débat et dans la définition de ces politiques, la présente étude tend à analyser l'influence exercées par les référentiels européens en matière de politiques de conciliation sur les discours et politiques nationales de l'Italie et de la France. A partir d'une analyse cognitive du processus d'européanisation, nous montrons que les référentiels développés au sein de l'UE, par leur caractère abstrait et flou, n'ont eu jusqu'ici qu'une faible influence sur les discours et politiques en Italie et en France. Croisant une perspective néo-institutionnaliste historique et discursive, notre recherche a été construite autour de deux axes de réflexion. Premièrement, il a été question d'analyser, d'une part, l'évolution du discours tenu par les différentes instances européennes (notamment de la Commission européenne, le Conseil européen et le Fonds Social européen) et, d'autre part, questionner comment un consensus a pu émerger entre des pays et des acteurs qui ont des traditions extrêmement différentes en matière de politique sociale, de politique familiale et de convention de genre. Deuxièmement, il a été question d'analyser si et comment un cadre de référence conçu au niveau communautaire a pu influencer les discours et politiques au niveau national. - The reconciliation of work and family life policies forms, in the EU's member States, a plurality of politics, more or less complex, but rarely coherent. Combining different objectives such as fertility increase, mothers and children protection, equality between men and women, fight against children and lone-parent families poverty and women activation, these policies are part of the national traditions of family, employment and tax policy and bear the heritage and the tensions of the country history. At a moment when a new global player, the European Union, interferes increasingly explicitly in the debate and the definition of reconciling work and family life policies, the question at the heart of this thesis was to define what kind of influence the référentiels of European discourses have on reconciliation policies since the late 1990s, in the Italian and French discourses and policies. Starting from a cognitive analysis of the Europeanization process, we show that the référentiels developed within the EU, by their abstract and vague nature, have had little influence in Italy and France. Crossing an historical and a discursive neo-institutionalist perspective, our research was based on two axes of reasoning. First, we have analysed, on the one hand, the evolution of various European institutions' discoursed (including the European Commission, the European Council and the European Social Fund) and, on the other hand, we have questioned how a consensus has emerged between countries and actors who have very different traditions in social policy, family policy and gender conventions. Secondly, we have observed if and how a framework developed at Community level, as a kind of ideal to strive for, has influenced discourses and policies at the national level.