Les besoins en soins de support chez les patients en phase d'un traitement ambulatoire, suivant l'annonce d'un diagnostic de cancer : étude descriptive transversale

Problématique L'incidence du cancer ne cesse d'augmenter dans les pays occidentaux et en Suisse, en constituant la deuxième cause de mortalité après les maladies cardiovasculaires. Si d'une part, les différents traitements oncologiques ont le potentiel de guérir certains cancers et d'augmenter l'espérance de vie des personnes concernées, ils sont associés à de multiples problèmes physiques et psychosociaux. De même, l'annonce de la maladie provoque une fragilité émotionnelle et sociale et la phase de traitement qui suit le diagnostic de cancer est souvent associé à des besoins psychologiques et d'information élevés. But Cette étude vise à décrire les besoins en soins de support insatisfaits chez les patients nouvellement diagnostiqués d'un cancer, au cours d'un traitement ambulatoire dans un Hôpital Cantonal de la Suisse. Elle vise également à identifier les associations entre les besoins en soins de support insatisfaits et les caractéristiques sociodémographiques et médicales. Méthode Cette étude corrélationnelle descriptive a été conduite auprès de 67 patients nouvellement atteints d'un cancer primaire ou d'une récidive, recrutés selon un échantillonnage non probabiliste par convenance consécutive. Le questionnaire auto-administré comprenait le Supportive Care Needs Survey Short Form 34 et un questionnaire sur des données sociodémographiques. Les données médicales ont été collectées par les chercheurs à travers les dossiers médicaux. Résultats Les trois besoins exprimés comme les plus insatisfaits étaient « la peur que le cancer se propage » (48,5%), « l'incertitude face à l'avenir » (45,4%) et « vos préoccupations face à l'incertitude de vos proches » (43,9%). Nous constatons une insatisfaction plus élevée des besoins psychologiques (M: 32,6 ; ET: 20,4) et des besoins d'information (M: 29,3 ; ET: 17,5) par rapport aux autres dimensions de besoins. À propos des caractéristiques associées a un plus haut niveau de besoins insatisfaits, nous trouvons qu'être plus jeune (29-56 ans) ou âgés de > 72 ans est positivement associé aux besoins insatisfaits du domaine psychologique (F = 3,50 ; p = 0,02) et de l'information/système de santé (F = 3,48 ; p = 0,02). Le jeune âge est aussi associé à plus de besoins dans le domaine sexuel (F = 2,85 ; p = 0,04). Il semble exister une association négative entre le niveau d'instruction et le degré d'insatisfaction des besoins psychologiques (F = 2,92, p = 0,06). Être retraité coïncide avec un plus grand degré d'insatisfaction dans les besoins physiques et des activités de la vie quotidienne (F = 4,64 ; p = 0,013). Finalement, avoir un moins bon état général est relié à plus de besoins physiques et de besoins issus du domaine des activités de la vie quotidienne (t = -2,85 ; p = 0,005). Conclusions Les présents résultats concordent avec les études antérieures. Cette étude a la particularité d'avoir identifié les besoins insatisfaits durant la phase de traitement qui suit l'annonce du diagnostic, sans se restreindre à une maladie cancéreuse spécifique, ce qui a été peu effectué auparavant. Les chercheurs infirmiers devraient poursuivre, en collaboration avec d'autres professionnels de la santé, les recherches visant le développement d'approches efficaces pour réduire les besoins insatisfaits chez des personnes atteintes de maladies cancéreuses.

Etude du support publicitaire, des critères de choix et de la satisfaction des patients de deux centres dentaires

Le propos général de ce mémoire est de déterminer pourquoi un nouveau patient choisit de prendre rendez-vous dans un centre dentaire et d'évaluer son niveau de satisfaction. L'étude est basée sur un questionnaire distribué lors du premier rendez-vous des nouveaux patients. Il est constitué de trois sections (socio-démographie, critères de choix, satisfaction) et est complété par le patient en deux phases, les parties socio-démographiques et critères de choix avant le traitement par le dentiste et la partie satisfaction après le traitement. L'échantillon de patients provient de deux centres dentaires ayant les mêmes exigences en termes d'accueil et de qualité des soins, l'un étant situé dans le canton de Zurich et l'autre dans le canton de Fribourg. [...] [Extrait p. 4]

La formulation de cas dans la formation à la psychothérapie. Enjeux pédagogiques du recours à un support filmique.

Un cas exemplaire, un cas d'école, un beau cas, un cas de figure, un cas extrême, un cas particulier, un cas épineux, un cas limite ... Les modalités de l'étude de cas sont multiples et expriment le fait que tout raisonnement suivi, toute explication, toute théorie bute une fois ou l'autre sur la nécessité d'explorer et d'approfondir les propriétés d'une singularité accessible à l'observation. Publier un ouvrage sur la question du cas unique, c'est participer à ce moment de réflexion sur les méthodes scientifiques en psychologie. C'est aussi oeuvrer à un repositionnement constructif de cette modalité de faire science, en donnant la parole aux auteurs spécialistes de ces questions ou directement concernés par celles-ci à travers leurs recherches ou leurs pratiques.

Extracorporeal support for pulmonary resection: current indications and results.

Extracorporeal assistances are exponentially used for patients, with acute severe but reversible heart or lung failure, to provide more prolonged support to bridge patients to heart and/or lung transplantation. However, experience of use of extracorporeal assistance for pulmonary resection is limited outside lung transplantation. Airways management with standard mechanical ventilation system may be challenging particularly in case of anatomical reasons (single lung), presence of respiratory failure (ARDS), or complex tracheo-bronchial resection and reconstruction. Based on the growing experience during lung transplantation, more and more surgeons are now using such devices to achieve good oxygenation and hemodynamic support during such challenging cases. We review the different extracorporeal device and attempt to clarify the current practice and indications of extracorporeal support during pulmonary resection.

Bidding support for computational resources

Peer-reviewed

Warranty Practices and Costs in the Industry of Welding Machines Manufacturing

The objective of the master’s thesis is to define the warranty practices and costs in the welding machines manufacturing company and do a proposal for a warranty policy based on the practices and costs. The study include a disquisition of the warranty practices in the subsidiaries and distributor sales. The disquisition of the warranty practices introduces the information relates to warranty period, warranty costs, including repair, spare part and other costs, the practices with the replaced parts, the utilization rate of the eWarranty system and information relates to special arrangements in the warranties. The warranty costs are defined besides the group level also separately per regions and product families. From some product families the disquisition is done per products. In this study is also done a proposal for a warranty policy for the company. The proposal speaks out the length of warranty period, the compensation of the warranty costs, the practices with replaced parts and usage of eWarranty system.

Present and future methodology for the implementation of decision support systems for traffic management

Real-time predictions are an indispensable requirement for traffic management in order to be able to evaluate the effects of different available strategies or policies. The combination of predicting the state of the network and the evaluation of different traffic management strategies in the short term future allows system managers to anticipate the effects of traffic control strategies ahead of time in order to mitigate the effect of congestion. This paper presents the current framework of decision support systems for traffic management based on short and medium-term predictions and includes some reflections on their likely evolution, based on current scientific research and the evolution of the availability of new types of data and their associated methodologies.

Manipulador robótico con visión artificial

En los tiempos que corren la robótica forma uno de los pilares más importantes en la industria y una gran noticia para los ingenieros es la referente a las ventas de estos, ya que en 2013, unos 179.000 robots industriales se vendieron en todo el mundo, de nuevo un máximo histórico y un 12% más que en 2012 según datos de la IFR (International Federation of Robotics). Junto a esta noticia, la robótica colaborativa entra en juego en el momento que los robots y los seres humanos deben compartir el lugar de trabajo sin que nos veamos excluidos por las maquinas, por lo tanto lo que se intenta es que los robots mejoren la calidad del trabajo al hacerse cargo de los trabajos peligrosos, tediosos y sucios que no son posibles o seguros para los seres humanos. Otro concepto muy importante y directamente relacionado con lo anterior que está muy en boga y se escucha desde hace relativamente poco tiempo es el de la fabrica del futuro o “Factory Of The Future” la cual intenta que los operarios y los robots encuentren la sintonía en el entorno laboral y que los robots se consideren como maquinaria colaborativa y no como sustitutiva, considerándose como uno de los grandes nichos productivos en plena expansión. Dejando a un lado estos conceptos técnicos que nunca debemos olvidar si nuestra carrera profesional va enfocada en este ámbito industrial, el tema central de este proyecto está basado, como no podía ser de otro modo, en la robótica, que junto con la visión artificial, el resultado de esta fusión, ha dado un manipulador robótico al que se le ha dotado de cierta “inteligencia”. Se ha planteado un sencillo pero posible proceso de producción el cual es capaz de almacenar piezas de diferente forma y color de una forma autónoma solamente guiado por la imagen capturada con una webcam integrada en el equipo. El sistema consiste en una estructura soporte delimitada por una zona de trabajo en la cual se superponen unas piezas diseñadas al efecto las cuales deben ser almacenadas en su lugar correspondiente por el manipulador robótico. Dicho manipulador de cinemática paralela está basado en la tecnología de cables, comandado por cuatro motores que le dan tres grados de libertad (±X, ±Y, ±Z) donde el efector se encuentra suspendido sobre la zona de trabajo moviéndose de forma que es capaz de identificar las características de las piezas en situación, color y forma para ser almacenadas de una forma ordenada según unas premisas iníciales.

Technology roadmap for new sales support and management system for crane manufacturing company

Sales configurators are essential tools for companies that offer complicated case specifically crafted products for customers. Most sophisticated of them are able to design an entire end product on the fly according to given constraints, calculate price for the offer and move the order into production. This thesis covers a sales configurator acquisition project in a large industrial company that offers cranes for its customers. The study spans the preliminary stages of a large-scale software purchase project starting from the specification of problem domain and ending up presenting the most viable software solution that fulfils the requirements for the new system. The project consists of mapping usage environment, use cases, and collecting requirements that are expected from the new system. The collected requirements involve fitting the new sales system into enterprise application infrastructure, mitigating the risks involved in the project and specifying new features to the application whilst preserving all of the admired features of the old sales system currently used in the company. The collected requirements were presented to a number of different sales software vendors who were asked to provide solution suggestions that would fulfil all the demands. All of the received solution proposals were exposed to an evaluation to determine the most feasible solutions, and the construction of evaluation criteria itself was a part of the study. The final outcome of this study is a short-list of the most feasible sales configurator solutions together with a description of how software purchase process in large enterprises work, and which aspects should be paid attention in large projects of similar kind.

LSB Matching Steganalysis Based on Patterns of Pixel Differences and Random Embedding

Peer-reviewed

Gathering support from rivals: the two rivals case

Two voters must choose between two alternatives. Voters vote in a fixed linear order. If there is not unanimity for any alternative, the procedure is repeated. At every stage, each voter prefers the same alternative to the other, has utilities decreasing with stages, and has an impatience degree representing when it is worth voting for the non-preferred alternative now rather than waiting for the next stage and voting for the preferred alternative. Intuition suggests that the more patient voter will get his preferred alternative. I found that in the unique solution of the sequential voting procedure obtained by backward induction, the first voter get his preferred alternative at the first stage independently from his impatience rate. Keywords: sequential voting, impatience rate, multi-stage voting, unanimity

Explosion-proof requirements for Electrical Machines in Chemical, Oil and Gas Industry in Russia and CIS Countries

One of the main industries which form the basis of Russian Economical structure is oil and gas. This industry is also playing a significant role for CIS countries. Oil and gas industry is developing intensively attracting foreign investments. This situation is providing sustainable development of machinery production for hazardous areas. Operating in oil and gas areas is always related with occurrence of explosion gas atmospheres. Machines for hazardous areas must be furnished with additional protection of different types. Explosion protection is regulated with standards according to which equipment must be manufactured. In Russia and CIS countries explosion-proof equipment must be constructed in compliance with GOST standards. To confirm that equipment is manufactured according to standards’ requirements and is safe and reliable it must undergo the approval procedure. Certification in Russia is governed by Federal Laws and legislation. Each CIS country has its own approval certificates and permissions for operating in hazardous areas.

Real-Time Simulation of Mobile and Industrial Machines Using the Multibody Simulation Approach

This thesis introduces a real-time simulation environment based on the multibody simulation approach. The environment consists of components that are used in conventional product development, including computer aided drawing, visualization, dynamic simulation and finite element software architecture, data transfer and haptics. These components are combined to perform as a coupled system on one platform. The environment is used to simulate mobile and industrial machines at different stages of a product life time. Consequently, the demands of the simulated scenarios vary. In this thesis, a real-time simulation environment based on the multibody approach is used to study a reel mechanism of a paper machine and a gantry crane. These case systems are used to demonstrate the usability of the real-time simulation environment for fault detection purposes and in the context of a training simulator. In order to describe the dynamical performance of a mobile or industrial machine, the nonlinear equations of motion must be defined. In this thesis, the dynamical behaviour of machines is modelled using the multibody simulation approach. A multibody system may consist of rigid and flexible bodies which are joined using kinematic joint constraints while force components are used to describe the actuators. The strength of multibody dynamics relies upon its ability to describe nonlinearities arising from wearing of the components, friction, large rotations or contact forces in a systematic manner. For this reason, the interfaces between subsystems such as mechanics, hydraulics and control systems of the mechatronic machine can be defined and analyzed in a straightforward manner.

Developing an Improved System for Allocating Support Unit Costs to Business Units

The objective of this study is to develop an improved support unit cost allocation system for a medium-sized technology company, and to examine which options for overhead cost accounting exist. The study begins with presenting the terminology and methods associated with overhead cost accounting and responsibility accounting. Also the most common challenges and resulting benefits of overhead cost allocation system development are brought up. As one research method two case studies were conducted for benchmarking purposes. These external cases are compared with the principal company’s cost allocation system and reflected against the theoretical background. In the empirical section interviews were used as the primary source of information alongside self studying principal company’s old cost allocation method. Interviews revealed the main weaknesses of the old system and proposals for a new one, which were utilized in setting targets for developing the new system. As a result of the development process an improved support unit cost allocation system was realized for year 2009. The new system is able to handle support unit costs in more detail enhancing the transparency and fairness of resulting cost allocations. Parts of support unit costs are now seen as business units’ own costs rather than group-level overhead. Also recommendations for further development are made after analyzing how well the targets were reached.

Análisis de los apoyos que reciben los jóvenes con discapacidad intelectual en su transición a la vida adulta en España: una investigación a partir de experiencias de profesionales y personas con discapacidad = Analysis of support received by young people with intellectual disabilities in their transition to adulthood in Spain: an investigation based on the experiences of professionals and people with disabilities

The objective of this study is to gather information regarding the adaptation of the range of socio educational projects and services aimed at the transition to an adult life of young persons with intellectual disabilities in Spain. The research of the study has been done in three stages. During each stage, a specific tool has been used. One to one in-depth interviews have been undertaken with 45 professionals and 20 individuals with intellectual disabilities. The Delphi method has been applied to two panels consisting of 20 experts each. Firstly, results focus on the approach to different issues related to the devices. Secondly, the training opportunities that these individuals receive to ease the transition period is addressed. And finally, the study refers to the participation of the individuals themselves and their families in the process. The developed analysis allows us to propose strategies to improve the transition to adult life