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.

Re-engineering and Re-defining University Libraries in the context of modern Information and Communication Technologies: a study with special reference to the University Libraries in Kerala

Information and communication technologies are the tools that underpin the emerging “Knowledge Society”. Exchange of information or knowledge between people and through networks of people has always taken place. But the ICT has radically changed the magnitude of this exchange, and thus factors such as timeliness of information and information dissemination patterns have become more important than ever.Since information and knowledge are so vital for the all round human development, libraries and institutions that manage these resources are indeed invaluable. So, the Library and Information Centres have a key role in the acquisition, processing, preservation and dissemination of information and knowledge. ln the modern context, library is providing service based on different types of documents such as manuscripts, printed, digital, etc. At the same time, acquisition, access, process, service etc. of these resources have become complicated now than ever before. The lCT made instrumental to extend libraries beyond the physical walls of a building and providing assistance in navigating and analyzing tremendous amounts of knowledge with a variety of digital tools. Thus, modern libraries are increasingly being re-defined as places to get unrestricted access to information in many formats and from many sources.The research was conducted in the university libraries in Kerala State, India. lt was identified that even though the information resources are flooding world over and several technologies have emerged to manage the situation for providing effective services to its clientele, most of the university libraries in Kerala were unable to exploit these technologies at maximum level. Though the libraries have automated many of their functions, wide gap prevails between the possible services and provided services. There are many good examples world over in the application of lCTs in libraries for the maximization of services and many such libraries have adopted the principles of reengineering and re-defining as a management strategy. Hence this study was targeted to look into how effectively adopted the modern lCTs in our libraries for maximizing the efficiency of operations and services and whether the principles of re-engineering and- redefining can be applied towards this.Data‘ was collected from library users, viz; student as well as faculty users; library ,professionals and university librarians, using structured questionnaires. This has been .supplemented by-observation of working of the libraries, discussions and interviews with the different types of users and staff, review of literature, etc. Personal observation of the organization set up, management practices, functions, facilities, resources, utilization of information resources and facilities by the users, etc. of the university libraries in Kerala have been made. Statistical techniques like percentage, mean, weighted mean, standard deviation, correlation, trend analysis, etc. have been used to analyse data.All the libraries could exploit only a very few possibilities of modern lCTs and hence they could not achieve effective Universal Bibliographic Control and desired efficiency and effectiveness in services. Because of this, the users as well as professionals are dissatisfied. Functional effectiveness in acquisition, access and process of information resources in various formats, development and maintenance of OPAC and WebOPAC, digital document delivery to remote users, Web based clearing of library counter services and resources, development of full-text databases, digital libraries and institutional repositories, consortia based operations for e-journals and databases, user education and information literacy, professional development with stress on lCTs, network administration and website maintenance, marketing of information, etc. are major areas need special attention to improve the situation. Finance, knowledge level on ICTs among library staff, professional dynamism and leadership, vision and support of the administrators and policy makers, prevailing educational set up and social environment in the state, etc. are some of the major hurdles in reaping the maximum possibilities of lCTs by the university libraries in Kerala. The principles of Business Process Re-engineering are found suitable to effectively apply to re-structure and redefine the operations and service system of the libraries. Most of the conventional departments or divisions prevailing in the university libraries were functioning as watertight compartments and their existing management system was more rigid to adopt the principles of change management. Hence, a thorough re-structuring of the divisions was indicated. Consortia based activities and pooling and sharing of information resources was advocated to meet the varied needs of the users in the main campuses and off campuses of the universities, affiliated colleges and remote stations. A uniform staff policy similar to that prevailing in CSIR, DRDO, ISRO, etc. has been proposed by the study not only in the university libraries in kerala but for the entire country.Restructuring of Lis education,integrated and Planned development of school,college,research and public library systems,etc.were also justified for reaping maximum benefits of the modern ICTs.

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.

Abgrenzung bestehender Beschreibungsmittel für die Modellierung und Spezifikation von Manufacturing Execution Systems

Die Modellierung und Spezifikation von Manufacturing Execution Systems (MES) als prozessnah operierende Software-Systeme stellt eine Herausforderung interdisziplinärer Kommunikation dar. Bisher existiert kein grafisches Beschreibungsmittel, das diesen Prozess ausdrücklich unterstützt. In diesem Diskussionspapier werden bestehende Beschreibungsmittel aus angrenzenden Bereichen, wie die Business Process Modeling Notation, Petrinetze, die formalisierte Prozessbeschreibung oder die Unified Modelling Language anhand allgemeiner und MES-spezifischer Anforderungen auf ihre Eignung untersucht. Es wurden erhebliche Lücken bei der Erfüllung der Anforderungen durch bestehende Beschreibungsmittel identifiziert.

Autonomes Performance-Management in dienstorientierten Architekturen

Die Bedeutung des Dienstgüte-Managements (SLM) im Bereich von Unternehmensanwendungen steigt mit der zunehmenden Kritikalität von IT-gestützten Prozessen für den Erfolg einzelner Unternehmen. Traditionell werden zur Implementierung eines wirksamen SLMs Monitoringprozesse in hierarchischen Managementumgebungen etabliert, die einen Administrator bei der notwendigen Rekonfiguration von Systemen unterstützen. Auf aktuelle, hochdynamische Softwarearchitekturen sind diese hierarchischen Ansätze jedoch nur sehr eingeschränkt anwendbar. Ein Beispiel dafür sind dienstorientierte Architekturen (SOA), bei denen die Geschäftsfunktionalität durch das Zusammenspiel einzelner, voneinander unabhängiger Dienste auf Basis deskriptiver Workflow-Beschreibungen modelliert wird. Dadurch ergibt sich eine hohe Laufzeitdynamik der gesamten Architektur. Für das SLM ist insbesondere die dezentrale Struktur einer SOA mit unterschiedlichen administrativen Zuständigkeiten für einzelne Teilsysteme problematisch, da regelnde Eingriffe zum einen durch die Kapselung der Implementierung einzelner Dienste und zum anderen durch das Fehlen einer zentralen Kontrollinstanz nur sehr eingeschränkt möglich sind. Die vorliegende Arbeit definiert die Architektur eines SLM-Systems für SOA-Umgebungen, in dem autonome Management-Komponenten kooperieren, um übergeordnete Dienstgüteziele zu erfüllen: Mithilfe von Selbst-Management-Technologien wird zunächst eine Automatisierung des Dienstgüte-Managements auf Ebene einzelner Dienste erreicht. Die autonomen Management-Komponenten dieser Dienste können dann mithilfe von Selbstorganisationsmechanismen übergreifende Ziele zur Optimierung von Dienstgüteverhalten und Ressourcennutzung verfolgen. Für das SLM auf Ebene von SOA Workflows müssen temporär dienstübergreifende Kooperationen zur Erfüllung von Dienstgüteanforderungen etabliert werden, die sich damit auch über mehrere administrative Domänen erstrecken können. Eine solche zeitlich begrenzte Kooperation autonomer Teilsysteme kann sinnvoll nur dezentral erfolgen, da die jeweiligen Kooperationspartner im Vorfeld nicht bekannt sind und – je nach Lebensdauer einzelner Workflows – zur Laufzeit beteiligte Komponenten ausgetauscht werden können. In der Arbeit wird ein Verfahren zur Koordination autonomer Management-Komponenten mit dem Ziel der Optimierung von Antwortzeiten auf Workflow-Ebene entwickelt: Management-Komponenten können durch Übertragung von Antwortzeitanteilen untereinander ihre individuellen Ziele straffen oder lockern, ohne dass das Gesamtantwortzeitziel dadurch verändert wird. Die Übertragung von Antwortzeitanteilen wird mithilfe eines Auktionsverfahrens realisiert. Technische Grundlage der Kooperation bildet ein Gruppenkommunikationsmechanismus. Weiterhin werden in Bezug auf die Nutzung geteilter, virtualisierter Ressourcen konkurrierende Dienste entsprechend geschäftlicher Ziele priorisiert. Im Rahmen der praktischen Umsetzung wird die Realisierung zentraler Architekturelemente und der entwickelten Verfahren zur Selbstorganisation beispielhaft für das SLM konkreter Komponenten vorgestellt. Zur Untersuchung der Management-Kooperation in größeren Szenarien wird ein hybrider Simulationsansatz verwendet. Im Rahmen der Evaluation werden Untersuchungen zur Skalierbarkeit des Ansatzes durchgeführt. Schwerpunkt ist hierbei die Betrachtung eines Systems aus kooperierenden Management-Komponenten, insbesondere im Hinblick auf den Kommunikationsaufwand. Die Evaluation zeigt, dass ein dienstübergreifendes, autonomes Performance-Management in SOA-Umgebungen möglich ist. Die Ergebnisse legen nahe, dass der entwickelte Ansatz auch in großen Umgebungen erfolgreich angewendet werden kann.

Quality Governance based on Enterprise Engineering Method and Six Sigma Approach

Enterprise Modeling (EM) is currently in operation either as a technique to represent and understand the structure and behavior of the enterprise, or as a technique to analyze business processes, and in many cases as support technique for business process reengineering. However, EM architectures and methods for Enterprise Engineering can also used to support new management techniques like SIX SIGMA, because these new techniques need a clear, transparent and integrated definition and description of the business activities of the enterprise to be able to build up, optimize and operate an successful enterprise. The main goal of SIX SIGMA is to optimize the performance of processes. A still open question is: "What are the adequate Quality criteria and methods to ensure such performance? What must we do to get Quality governance?" This paper describes a method including an Enterprise Engineering method and SIX SIGMA strategy to reach Quality Governance

Enterprise Engineering Method supporting Six Sigma Approach

Enterprise Modeling (EM) is currently in operation either as a technique to represent and understand the structure and behavior of the enterprise, or as a technique to analyze business processes, and in many cases as support technique for business process reengineering. However, EM architectures and methodes for Enterprise Engineering can also used to support new management techniques like SIX SIGMA, because these new techniques need a clear, transparent and integrated definition and description of the business activities of the enterprise to be able to build up, to optimize and to operate an successful enterprise.

Organizational excellence through quality governance

This paper provides an overview of an Enterprise Engineering method called IEM (Integrated Enterprise Modeling) and it describes the usage of SIX SIGMA approach for performance measurement of an enterprise. Based on these two instruments a methodology including procedure and tools is developed, which allows enterprises to define their adequate quality criteria for performance, to measure performance and quality and to derive reasonable actions to take for optimization. Determination of adequate quality and performance criteria and reasonable measures for the enterprise organization means “Quality Governance”.

Managing Quality Properties of Web Service Compositions

Web services from different partners can be combined to applications that realize a more complex business goal. Such applications built as Web service compositions define how interactions between Web services take place in order to implement the business logic. Web service compositions not only have to provide the desired functionality but also have to comply with certain Quality of Service (QoS) levels. Maximizing the users' satisfaction, also reflected as Quality of Experience (QoE), is a primary goal to be achieved in a Service-Oriented Architecture (SOA). Unfortunately, in a dynamic environment like SOA unforeseen situations might appear like services not being available or not responding in the desired time frame. In such situations, appropriate actions need to be triggered in order to avoid the violation of QoS and QoE constraints. In this thesis, proper solutions are developed to manage Web services and Web service compositions with regard to QoS and QoE requirements. The Business Process Rules Language (BPRules) was developed to manage Web service compositions when undesired QoS or QoE values are detected. BPRules provides a rich set of management actions that may be triggered for controlling the service composition and for improving its quality behavior. Regarding the quality properties, BPRules allows to distinguish between the QoS values as they are promised by the service providers, QoE values that were assigned by end-users, the monitored QoS as measured by our BPR framework, and the predicted QoS and QoE values. BPRules facilitates the specification of certain user groups characterized by different context properties and allows triggering a personalized, context-aware service selection tailored for the specified user groups. In a service market where a multitude of services with the same functionality and different quality values are available, the right services need to be selected for realizing the service composition. We developed new and efficient heuristic algorithms that are applied to choose high quality services for the composition. BPRules offers the possibility to integrate multiple service selection algorithms. The selection algorithms are applicable also for non-linear objective functions and constraints. The BPR framework includes new approaches for context-aware service selection and quality property predictions. We consider the location information of users and services as context dimension for the prediction of response time and throughput. The BPR framework combines all new features and contributions to a comprehensive management solution. Furthermore, it facilitates flexible monitoring of QoS properties without having to modify the description of the service composition. We show how the different modules of the BPR framework work together in order to execute the management rules. We evaluate how our selection algorithms outperform a genetic algorithm from related research. The evaluation reveals how context data can be used for a personalized prediction of response time and throughput.

Value Stream Analysis and Mapping for Product Development

This paper explores the concept of Value Stream Analysis and Mapping (VSA/M) as applied to Product Development (PD) efforts. Value Stream Analysis and Mapping is a method of business process improvement. The application of VSA/M began in the manufacturing community. PD efforts provide a different setting for the use of VSA/M. Site visits were made to nine major U.S. aerospace organizations. Interviews, discussions, and participatory events were used to gather data on (1) the sophistication of the tools used in PD process improvement efforts, (2) the lean context of the use of the tools, and (3) success of the efforts. It was found that all three factors were strongly correlated, suggesting success depends on both good tools and lean context. Finally, a general VSA/M method for PD activities is proposed. The method uses modified process mapping tools to analyze and improve process.

Value Stream Analysis and Mapping for Product Development

This paper explores the concept of Value Stream Analysis and Mapping (VSA/M) as applied to Product Development (PD) efforts. Value Stream Analysis and Mapping is a method of business process improvement. The application of VSA/M began in the manufacturing community. PD efforts provide a different setting for the use of VSA/M. Site visits were made to nine major U.S. aerospace organizations. Interviews, discussions, and participatory events were used to gather data on (1) the sophistication of the tools used in PD process improvement efforts, (2) the lean context of the use of the tools, and (3) success of the efforts. It was found that all three factors were strongly correlated, suggesting success depends on both good tools and lean context. Finally, a general VSA/M method for PD activities is proposed. The method uses modified process mapping tools to analyze and improve process.

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

Análisis del ciclo económico en una economía con rigideces nominales y un amplio sector informal

En este trabajo se construye un modelo de Equilibrio General Dinámico Estocástico (DSGE) con sector informal y rigideces en precios, usando como marco de análisis la teoría de búsqueda y emparejamiento del mercado de trabajo. El objetivo principal es analizar el efecto de los diferentes tipos de choques económicos sobre las principales variables del mercado laboral, en una economía con presencia importante del sector informal. Igualmente se estudia el efecto de la política monetaria, ya que la presencia de este sector afecta la dinámica del ciclo económico, y por ende los mecanismos de transmisión de la política monetaria. En particular, se analiza la dinámica del modelo bajo diferentes reglas de política monetaria y se compara el bienestar agente representativo generado por cada una de estas reglas.