On the transcriptional role of NLRC5 and the function of NLRC5-driven MHC class I expression in the immune system

Major histocompatibility complex (MHC) molecules are of crucial importance for the immune system to recognize and defend the body against external attacks. Foreign antigens are presented by specialized cells, called antigen presenting cells, to T lymphocytes in the context of MHC molecules, thereby inducing T cell activation. In addition, MHC molecules are essential for Natural Killer (NK) cell biology, playing a role in NK cell education and activation. Recently, the NOD-like receptor (NLR) family member NLRC5 (NLR caspase recruitment domain containing protein 5) was found to act as transcriptional regulator of MHC class I, in particular in T and NK cells. Its role in MHC class I expression is however minor in dendritic cells (DCs). This raised the question of whether inflammatory conditions, which augment the levels of NLRC5 in DCs, could increase its contribution to MHC class I expression. Our work shows that MHC class I transcript and intracellular levels depend on NLRC5, while its role in MHC class I surface expression is instead negligible. We describe however a general salvage mechanism that enables cells with low intracellular MHC class I levels to nevertheless maintain relatively high MHC class I on the cell surface. In addition, we lack a thorough understanding of NLRC5 target gene specificity and mechanism of action. Our work delineates the unique consensus sequence in MHC class I promoters required for NLRC5 recruitment and pinpoints conserved features conferring its specificity. Furthermore, through genome-wide analyses, we confirm that NLRC5 regulates classical MHC class I genes and identify novel target genes all encoding non-classical MHC class I molecules exerting an array of functions in immunity and tolerance. We finally asked why a dedicated factor co-regulates MHC class I expression specifically in T and NK lymphocytes. We show that deregulated NLRC5 expression affects the education of NK cells and alters the crosstalk between T and NK cells, leading to NK cell-mediated killing of T lymphocytes. Altogether this thesis work brings insights into molecular and physiological aspects of NLRC5 function, which might help understand certain aspects of immune responses and disorders. -- Les molécules du complexe majeur d'histocompatibilité (CMH) sont essentielles au système immunitaire pour l'initiation de la réponse immunitaire. En effet, l'activation des lymphocytes T nécessite la reconnaissance d'un antigène étranger présenté par les cellules présentatrices d'antigènes sur une molécule du CMH. Les molécules du CMH ont également un rôle fondamental pour la fonction des cellules Natural Killer (NK) puisqu'elles sont nécessaires à leur processus d'éducation et d'activation. Récemment, NLRC5 (NLR caspase recruitment domain containing protein 5), un membre de la famille des récepteurs de type NOD (NLRs), a été décrit comme un facteur de transactivation de l'expression des gènes du CMH de classe I. A l'état basai, cette fonction transcriptionnelle est essentielle dans les lymphocytes T et NK, alors que ce rôle reste mineur pour l'expression des molécules du CMH de classe I dans les cellules dendritiques (DCs). Dans des conditions inflammatoires, l'expression de NLRC5 augmente dans les DCs. Notre travail démontre que, dans ces conditions, les transcrits et les niveaux intracellulaires des molécules du CMH de classe I augmentent aussi d'une façon dépendante de NLRC5. A contrario, le rôle de NLRC5 sur les niveaux de molécules de surface reste minoritaire. Cette observation nous a conduits à l'identification d'un mécanisme général de compensation qui permet aux cellules de maintenir des niveaux relativement élevés de molécules de CMH de class I à leur surface malgré de faibles niveaux intracellulaires. De plus, il semblait nécessaire de s'orienter vers une approche plus globale afin de déterminer l'étendue de la fonction transcriptionnelle de NLRC5. Par une approche du génome entier, nous avons pu décrire une séquence consensus conservée présente dans les promoteurs des gènes du CMH de classe I, sur laquelle NLRC5 est spécifiquement recruté. Nous avons pu également identifier de nouveaux gènes cibles codant pour des molécules de CMH de classe I non classiques impliqués dans l'immunité et la tolérance. Finalement, nous nous sommes demandé quel est l'intérêt d'avoir un facteur transcriptionnel, en l'occurrence NLRC5, qui orchestre l'expression du CMH de classe I dans les lymphocytes T et NK. Nous montrons que la dérégulation de l'expression de NLRC5 affecte l'éducation des cellules NK et conduit à la mort cellulaire des lymphocytes T médiée par les cellules NK. Dans l'ensemble ce travail de thèse contribue à la caractérisation du rôle de NLRC5, tant au niveau moléculaire que physiologique, ce qui présente un intérêt dans le cadre de la compréhension de certains aspects physiopathologique de la réponse immunitaire.

Frequent users of the emergency department in a universal health coverage system : a randomized controlled trial of a case-management intervention

BACKGROUND: Frequent emergency department users represent a small number of patients but account for a large number of emergency department visits. They should be a focus because they are often vulnerable patients with many risk factors affecting their quality of life (QoL). Case management interventions have resulted in a significant decrease in emergency department visits, but association with QoL has not been assessed. One aim of our study was to examine to what extent an interdisciplinary case management intervention, compared to standard emergency care, improved frequent emergency department users' QoL. METHODS: Data are part of a randomized, controlled trial designed to improve frequent emergency department users' QoL and use of health-care resources at the Lausanne University Hospital, Switzerland. In total, 250 frequent emergency department users (≥5 attendances during the previous 12 months; ≥ 18 years of age) were interviewed between May 2012 and July 2013. Following an assessment focused on social characteristics; social, mental, and somatic determinants of health; risk behaviors; health care use; and QoL, participants were randomly assigned to the control or the intervention group (n=125 in each group). The final sample included 194 participants (20 deaths, 36 dropouts, n=96 in the intervention group, n=99 in the control group). Participants in the intervention group received a case management intervention by an interdisciplinary, mobile team in addition to standard emergency care. The case management intervention involved four nurses and a physician who provided counseling and assistance concerning social determinants of health, substance-use disorders, and access to the health-care system. The participants' QoL was evaluated by a study nurse using the WHOQOL-BREF five times during the study (at baseline, and at 2, 5.5, 9, and 12 months). Four of the six WHOQOL dimensions of QoL were retained here: physical health, psychological health, social relationship, and environment, with scores ranging from 0 (low QoL) to 100 (high QoL). A linear, mixed-effects model with participants as a random effect was run to analyze the change in QoL over time. The effects of time, participants' group, and the interaction between time and group were tested. These effects were controlled for sociodemographic characteristics and health-related variables (i.e., age, gender, education, citizenship, marital status, type of financial resources, proficiency in French, somatic and mental health problems, and behaviors at risk).

Debating as a classroom tool for adapting learning outcomes to the European higher education area

The creation of the European Higher Education Area has meant a number of significant changes to the educational structures of the university community. In particular, the new system of European credits has generated the need for innovation in the design of curricula and teaching methods. In this paper, we propose debating as a classroom tool that can help fulfill these objectives by promoting an active student role in learning. To demonstrate the potential of this tool, a classroom experiment was conducted in a bachelor’s degree course in Industrial Economics -Regulation and Competition-, involving a case study in competition policy and incorporating the techniques of a conventional debate -presentation of standpoints, turns, right to reply and summing up-. The experiment yielded gains in student attainment and positive assessments of the subject. In conclusion, the incorporation of debating activities helps students to acquire the skills, be they general or specific, required to graduate successfully in Economics.

CRM and higher education : developing a monitoring system to improve relationships in e-learning environments

Peer-reviewed

School funding and education policy-making models in Ontario /

The purpose of this thesis is to examine various policy implementation models, and to determine what use they are to a government. In order to insure that governmental proposals are created and exercised in an effective manner, there roust be some guidelines in place which will assist in resolving difficult situations. All governments face the challenge of responding to public demand, by delivering the type of policy responses that will attempt to answer those demands. The problem for those people in positions of policy-making responsibility is to balance the competitive forces that would influence policy. This thesis examines provincial government policy in two unique cases. The first is the revolutionary recommendations brought forth in the Hall -Dennis Report. The second is the question of extending full -funding to the end of high school in the separate school system. These two cases illustrate how divergent and problematic the policy-making duties of any government may be. In order to respond to these political challenges decision-makers must have a clear understanding of what they are attempting to do. They must also have an assortment of policy-making models that will insure a policy response effectively deals with the issue under examination. A government must make every effort to insure that all policymaking methods are considered, and that the data gathered is inserted into the most appropriate model. Currently, there is considerable debate over the benefits of the progressive individualistic education approach as proposed by the Hall -Dennis Committee. This debate is usually intensified during periods of economic uncertainty. Periodically, the province will also experience brief yet equally intense debate on the question of separate school funding. At one level, this debate centres around the efficiency of maintaining two parallel education systems, but the debate frequently has undertones of the religious animosity common in Ontario's history. As a result of the two policy cases under study we may ask ourselves these questions: a) did the policies in question improve the general quality of life in the province? and b) did the policies unite the province? In the cases of educational instruction and finance the debate is ongoing and unsettling. Currently, there is a widespread belief that provincial students at the elementary and secondary levels of education are not being educated adequately to meet the challenges of the twenty-first century. The perceived culprit is individual education which sees students progressing through the system at their own pace and not meeting adequate education standards. The question of the finance of Catholic education occasionally rears its head in a painful fashion within the province. Some public school supporters tend to take extension as a personal religious defeat, rather than an opportunity to demonstrate that educational diversity can be accommodated within Canada's most populated province. This thesis is an attempt to analyze how successful provincial policy-implementation models were in answering public demand. A majority of the public did not demand additional separate school funding, yet it was put into place. The same majority did insist on an examination of educational methods, and the government did put changes in place. It will also demonstrate how policy if wisely created may spread additional benefits to the public at large. Catholic students currently enjoy a much improved financial contribution from the province, yet these additional funds were taken from somewhere. The public system had it funds reduced with what would appear to be minimal impact. This impact indicates that government policy is still sensitive to the strongly held convictions of those people in opposition to a given policy.

Voices of the Undereducated in Adult Education and Training in Ontario: A Phenomenographic Approach

This doctoral study was an exploration of the qualitatively different ways in which undereducated adults (at or below a high school level of formal education) reported their experiences of participation in adult education and training (AET) programmes offered by publicly funded school boards or their arms-length affiliate in the province of Ontario. In light of a low participation rate in the Canadian AET system by undereducated adults, the rationale was to examine whether or not AET programmes are meeting the needs of undereducated adults beyond a narrow focus on an instrumental approach associated with human capital development. This study was located in a theoretical framework consisting of (a) learning theory, (b) motivations for participation, (c) general barriers to participation, (d) structural barriers to participation, and (e) transformative learning. The purposive sample consisted of 11 participants between the ages of 18-58 who were drawn from service providers in 4 geographic regions of Ontario. Data collection consisted of (a) demographics, (b) voice recordings from face-to-face participant interviews, (c) participant weekly critical incident reports, and (d) researcher reflexive journal notes. Data were analyzed in accordance with a phenomenographic approach within a constructivist/interpretivist research paradigm. Findings revealed 4 qualitatively different ways in which undereducated adult learners reported their experiences of participation in AET and were reported as the voice of (a) security, (b) engagement, (c) relationship, and (d) competency. Implications to theory and practice and to further inquiry were outlined.

A Study of a Comprehensive Career Services System in Chinese Universities

Since 1999, with the adoption of expansion policy in higher education by the Chinese government, enrollment and graduate numbers have been increasing at an unprecedented speed. Accustomed to a system in which university graduates were placed, many students are not trained in “selling themselves”, which exacerbates the situation leading to a skyrocketing unemployment rate among new graduates. The idea of emphasizing career services comes with increasing employment pressure among university graduates in recent years. The 1998 “Higher Education Act” made it a legislative requirement. Thereafter, the Ministry of Education issued a series of documents in order to promote the development of career services. All higher education institutions are required to set up special career service centers and to set a ratio of 1:500 between career staff and the total number of students. Related career management courses, especially career planning classes, are required to be clearly included as specific modules into the teaching plan with a requirement of no less than 38 sessions in one semester at all universities. Developing career services in higher education has thus become a hot issue. One of the more notable trends in higher education in recent years has been the transformation of university career service centers from merely being the coordinators of on-campus placement into full service centers for international career development. The traditional core of career services in higher education had been built around guidance, information and placements (Watts, 1997). This core was still in place, but the role of higher education career services has changed considerably in recent years and the nature of each part is being transformed (Watts, 1997). Most services are undertaking a range of additional activities, and the career guidance issue is emphasized much more than before. Career management courses, especially career planning classes, are given special focus in developing career services in the Chinese case. This links career services clearly and directly with the course provision function. In China, most career service centers are engaging in the transformation period from a “management-oriented” organization to a “service-oriented” organization. Besides guidance services, information services and placement activities, there is a need to blend them together with the new additional teaching function, which follows the general trend as regulated by the government. The role of career services has been expanding and this has brought more challenges to its development in Chinese higher education. Chinese universities still remain in the period of exploration and establishment in developing their own career services. In the face of the new situation, it is very important and meaningful to explore and establish a comprehensive career services system to address student needs in the universities. A key part in developing this system is the introduction of career courses and delivering related career management skills to the students. So there is the need to restructure the career service sectors within the Chinese universities in general. The career service centers will operate as a hub and function as a spoke in the wheel of this model system, providing support and information to staff located in individual teaching departments who are responsible for the delivery of career education, information, advice and guidance. The career service centers will also provide training and career planning classes. The purpose of establishing a comprehensive career services system is to provide a strong base for student career development. The students can prepare themselves well in psychology, ideology and ability before employment with the assistance of effective career services. To conclude, according to the different characteristics and needs of students, there will be appropriate services and guidance in different stages and different ways. In other words, related career services and career guidance activities would be started for newly enrolled freshmen and continue throughout their whole university process. For the operation of a comprehensive services system, there is a need for strong support by the government in the form of macro-control and policy guarantee, but support by the government in the form of macro-control and policy guarantee, but also a need for close cooperation with the academic administration and faculties to be actively involved in career planning and employment programs. As an integral function within the universities, career services must develop and maintain productive relationships with relevant campus offices and key stakeholders both within the universities and externally.

Higher Education Governance in Vietnam: University Action, the State and Changing Relationships

Diese Dissertation stellt eine Studie da, welche sich mit den Änderungen in der Governance der Hochschulbildung in Vietnam beschäftigt. Das zentrale Ziel dieser Forschungsarbeit ist die Untersuchung der Herkunft und Änderung in der Beziehung der Mächte zwischen dem vietnamesischen Staat und den Hochschulbildungsinstituten (HI), welche hauptsächlich aus der Interaktion dieser beiden Akteure resultiert. Die Macht dieser beiden Akteure wurde im sozialen Bereich konstruiert und ist hauptsächlich durch ihre Nützlichkeit und Beiträge für die Hochschulbildung bestimmt. Diese Arbeit beschäftigt sich dabei besonders mit dem Aspekt der Lehrqualität. Diese Studie nimmt dabei die Perspektive einer allgemeinen Governance ein, um die Beziehung zwischen Staat und HI zu erforschen. Zudem verwendet sie die „Resource Dependence Theory“ (RDT), um das Verhalten der HI in Bezug auf die sich verändernde Umgebung zu untersuchen, welche durch die Politik und eine abnehmende Finanzierung charakterisiert ist. Durch eine empirische Untersuchung der Regierungspolitik sowie der internen Steuerung und den Praktiken der vier führenden Universitäten kommt die Studie zu dem Schluss, dass unter Berücksichtigung des Drucks der Schaffung von Einkommen die vietnamesischen Universitäten sowohl Strategien als auch Taktiken entwickelt haben, um Ressourcenflüsse und Legitimität zu kontrollieren. Die Entscheidungs- und Zielfindung der Komitees, die aus einer Mehrheit von Akademikern bestehen, sind dabei mächtiger als die der Manager. Daher werden bei initiativen Handlungen der Universitäten größtenteils Akademiker mit einbezogen. Gestützt auf die sich entwickelnden Muster der Ressourcenbeiträge von Akademikern und Studierenden für die Hochschulbildung prognostiziert die Studie eine aufstrebende Governance Konfiguration, bei der die Dimensionen der akademischen Selbstverwaltung und des Wettbewerbsmarktes stärker werden und die Regulation des Staates rational zunimmt. Das derzeitige institutionelle Design und administrative System des Landes, die spezifische Gewichtung und die Koordinationsmechanismen, auch als sogenanntes effektives Aufsichtssystem zwischen den drei Schlüsselakteuren - der Staat, die HI/Akademiker und die Studierenden – bezeichnet, brauchen eine lange Zeit zur Detektion und Etablierung. In der aktuellen Phase der Suche nach einem solchen System sollte die Regierung Management-Tools stärken, wie zum Beispiel die Akkreditierung, belohnende und marktbasierte Instrumente und das Treffen informations-basierter Entscheidungen. Darüber hinaus ist es notwendig die Transparenz der Politik zu erhöhen und mehr Informationen offenzulegen.

Demonstrating the validity of three general scores of PET in predicting higher education achievement in Israel

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Poldering a teaching qualification system in Higher Education in the Netherlands : a typical dutch phenomenon

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Some indicators of satisfaction with the support system for students with disabilities in Secondary Education in Croatia

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Postsecondary education for the deaf and its supportive system: the United States in comparison to Japan

This paper examines available post-secondary education and supportive systems for the deaf in Japan as compared to the United States.