Impact de l’évolution du statut nutritionnel durant l’attente d’une transplantation pulmonaire sur la mortalité postopératoire

Cette étude vise à évaluer l’impact de l’état nutritionnel et de son évolution durant l’attente d’une transplantation pulmonaire sur la mortalité et la morbidité postopératoire. Nous avons examiné les 209 dossiers de patients greffés pulmonaires au Programme de Transplantation Pulmonaire du CHUM entre 2000 et 2007 et regardé la mortalité et les complications post-transplantation en fonction de l’IMC, des apports protéino-énergétiques, de certains paramètres biochimiques et selon l’évolution pondérale durant la période d’attente. Les résultats montrent que la mortalité augmente en fonction de l’augmentation des strates d’IMC avec un risque relatif de décès au cours du séjour hospitalier de 3,31 (IC95% 1,19-9,26) pour un IMC 25-29,9 et de 8,83 (IC95% 2,98-26,18) pour un IMC ≥ 30 avec une issue postopératoire plus sombre en terme de complications chirurgicales (p=0,003), de durée de séjour aux soins intensifs (p=0,031) et de durée de séjour à l’hôpital (p<0,001) chez les patients avec IMC ≥ 30 comparativement aux patients de poids normal. Les patients ayant présenté une évolution inadéquate de l’IMC durant la période d’attente ont connu une durée de séjour hospitalier prolongée (p=0,015). Ceux dont les apports nutritionnels étaient sous-optimaux en pré-greffe ont aussi connu une durée de séjour hospitalier prolongée (p=0,002) et davantage de complications infectieuses (p=0,038), digestives (p=0,003) et chirurgicales (p=0,029) mais sans impact détectable sur la mortalité. Nos résultats suggèrent que l’obésité et l’embonpoint ainsi qu’une évolution inadéquate de l’IMC durant la période d’attente de même que des apports protéino-énergétiques sous-optimaux affectent négativement l’issue d’une transplantation pulmonaire.

Évaluation de la valeur pronostique de la lactatémie lors de dilatation à droite de la caillette ou de volvulus abomasal chez la vache laitière

Dans les élevages laitiers d’aujourd’hui, les déplacements de la caillette sont parmi les conditions chirurgicales les plus souvent rencontrées. Le pronostic pour ces pathologies est cependant très différent que l’on soit en présence d’une dilatation de la caillette à droite (DCD) ou d’un volvulus de la caillette (VC). En pratique, la distinction en période préopératoire entre ces deux conditions est difficile. Afin de limiter les pertes économiques associées aux DCD/VC, l’identification et la réforme précoce des animaux ayant le plus grand risque d’avoir une mauvaise évolution postopératoire deviennent des enjeux de premier plan. Les objectifs de cette étude étaient de déterminer la valeur pronostique de la L-lactatémie (LAC) mesurée à la ferme en préopératoire à l’aide d’un appareil portatif chez des vaches souffrant de DCD ou VC et de suggérer des seuils de LAC cliniquement significatifs. Nos résultats indiquent que la LAC est un bon indicateur pronostique lors de DCD/VC. Une LAC ≤ 2 mmol/L est un bon indicateur de succès chirurgical et s’avère très utile pour appuyer la décision d’opérer l’animal (sensibilité, spécificité, valeurs prédictives positive et négative de respectivement 76.2, 82.7, 53.3 et 93.1%). Par ailleurs, il n’y a aucun avantage économique à effectuer une chirurgie chez des vaches commerciales souffrant de DCD/VC qui ont une LAC ≥ 6 mmol/L (sensibilité, spécificité, valeurs prédictives positive et négative de respectivement 28.6, 97.5, 75 et 84%). Par conséquent, ces animaux devraient, dans la plupart des cas, être réformés en raison de la probabilité élevée qu’ils aient une mauvaise évolution postopératoire.

Building information modelling : an issue of adoption and change management

Building Information Modelling (BIM) is an IT enabled technology that allows storage, management, sharing, access, update and use of all the data relevant to a project through out the project life-cycle in the form of a data repository. BIM enables improved inter-disciplinary collaboration across distributed teams, intelligent documentation and information retrieval, greater consistency in building data, better conflict detection and enhanced facilities management. While the technology itself may not be new, and similar approaches have been in use in some other sectors like Aircraft and Automobile industry for well over a decade now, the AEC/FM (Architecture, Engineering and Construction/ Facilities Management) industry is still to catch up with them in its ability to exploit the benefits of the IT revolution. Though the potential benefits of the technology in terms of knowledge sharing, project management, project co-ordination and collaboration are near to obvious, the adoption rate has been rather lethargic, inspite of some well directed efforts and availability of supporting commercial tools. Since the technology itself has been well tested over the years in some other domains the plausible causes must be rooted well beyond the explanation of the ‘Bell Curve of innovation adoption’. This paper discusses the preliminary findings of an ongoing research project funded by the Cooperative Research Centre for Construction Innovation (CRC-CI) which aims to identify these gaps and come up with specifications and guidelines to enable greater adoption of the BIM approach in practice. A detailed literature review is conducted that looks at some of the similar research reported in the recent years. A desktop audit of some of the existing commercial tools that support BIM application has been conducted to identify the technological issues and concerns, and a workshop was organized with industry partners and various players in the AEC industry for needs analysis, expectations and feedback on the possible deterrents and inhibitions surrounding the BIM adoption.

Strategic short termism as an issue of top-teams’ temporal orientation

Short-termism among firms, the tendency to excessively discount long-term benefits and favour less valuable short-term benefits, has been a prominent issue in business and public policy debates but research to date has been inconclusive. We study how managers frame, interpret, and resolve problems of intertemporal choice in actual decisions by using computer aided text analysis to measure the frequency of top-team temporal references in 1653 listed Australian firms between 1992-2005. Contrary to short-termism arguments we find evidence of a significant general increase in Future orientation and a significant decrease in Current/Past orientation. We also show top-teams’ temporal orientation is related to their strategic orientation, specifically the extent to which they focus on Innovation-Expansion and Capacity Building.

Mining trading partners’ preferences for efficient multi-issue bargaining in E‑business

Classical negotiation models are weak in supporting real-world business negotiations because these models often assume that the preference information of each negotiator is made public. Although parametric learning methods have been proposed for acquiring the preference information of negotiation opponents, these methods suffer from the strong assumptions about the specific utility function and negotiation mechanism employed by the opponents. Consequently, it is difficult to apply these learning methods to the heterogeneous negotiation agents participating in e‑marketplaces. This paper illustrates the design, development, and evaluation of a nonparametric negotiation knowledge discovery method which is underpinned by the well-known Bayesian learning paradigm. According to our empirical testing, the novel knowledge discovery method can speed up the negotiation processes while maintaining negotiation effectiveness. To the best of our knowledge, this is the first nonparametric negotiation knowledge discovery method developed and evaluated in the context of multi-issue bargaining over e‑marketplaces.

Australasian horror special issue editorial : putting Australian and New Zealand horror movies on the map of cinema studies

This Australasian horror special issue is an important step forward in putting Australian and New Zealand horror movies on the map of film and cinema studies as a subject worthy of intellectual debate. The journal issue is the first devoted solely to the academic discussion of Australasian horror movies. While an Australian horror movie tradition has produced numerous titles since the 1970s achieving commercial success and cult popularity worldwide, the horror genre is largely missing from Australian film history. While there have been occasional essays on standout titles such as Wolf Creek (Mclean, 2005), an increasing number of articles on ‘Ozploitation’ movies, and irregular discussion about Australian Gothic, overall the nature of Australian horror as a genre remains poorly understood. In terms of New Zealand, debate has tended to revolve around ‘Kiwi Gothic’ and of course Peter Jackon’s early splatter films, rather than Kiwi horror as a specific filmmaking tradition.

Merging fact with fiction : a study of year 9 students' developing scientific literacy through the writing of hybridised scientific narratives on a socioscientific issue

International assessments of student science achievement, and growing evidence of students' waning interest in school science, have ensured that the development of scientific literacy continues to remain an important educational priority. Furthermore, researchers have called for teaching and learning strategies to engage students in the learning of science, particularly in the middle years of schooling. This study extends previous national and international research that has established a link between writing and learning science. Specifically, it investigates the learning experiences of eight intact Year 9 science classes as they engage in the writing of short stories that merge scientific and narrative genres (i.e., hybridised scientific narratives) about the socioscientific issue of biosecurity. This study employed a triangulation mixed methods research design, generating both quantitative and qualitative data, in order to investigate three research questions that examined the extent to which the students' participation in the study enhanced their scientific literacy; the extent to which the students demonstrated conceptual understanding of related scientific concepts through their written artefacts and in interviews about the artefacts; and the extent to which the students' participation in the project influenced their attitudes toward science and science learning. Three aspects of scientific literacy were investigated in this study: conceptual science understandings (a derived sense of scientific literacy), the students' transformation of scientific information in written stories about biosecurity (simple and expanded fundamental senses of scientific literacy), and attitudes toward science and science learning. The stories written by students in a selected case study class (N=26) were analysed quantitatively using a series of specifically-designed matrices that produce numerical scores that reflect students' developing fundamental and derived senses of scientific literacy. All students (N=152) also completed a Likert-style instrument (i.e., BioQuiz), pretest and posttest, that examined their interest in learning science, science self-efficacy, their perceived personal and general value of science, their familiarity with biosecurity issues, and their attitudes toward biosecurity. Socioscientific issues (SSI) education served as a theoretical framework for this study. It sought to investigate an alternative discourse with which students can engage in the context of SSI education, and the role of positive attitudes in engaging students in the negotiation of socioscientific issues. Results of the study have revealed that writing BioStories enhanced selected aspects of the participants' attitudes toward science and science learning, and their awareness and conceptual understanding of issues relating to biosecurity. Furthermore, the students' written artefacts alone did not provide an accurate representation of the level of their conceptual science understandings. An examination of these artefacts in combination with interviews about the students' written work provided a more comprehensive assessment of their developing scientific literacy. These findings support extensive calls for the utilisation of diversified writing-to-learn strategies in the science classroom, and therefore make a significant contribution to the writing-to-learn science literature, particularly in relation to the use of hybridised scientific genres. At the same time, this study presents the argument that the writing of hybridised scientific narratives such as BioStories can be used to complement the types of written discourse with which students engage in the negotiation of socioscientific issues, namely, argumentation, as the development of positive attitudes toward science and science learning can encourage students' participation in the discourse of science. The implications of this study for curricular design and implementation, and for further research, are also discussed.

Introduction and Epilogue to Special Issue: Re-conceiving the artful in management development and education

The editorial focus of this issue is on artful, aesthetic and artistic endeavours in management. Being artful is not about arts-based quick fixes. In the context of this Special Issue, to be artful is to transform self through profound learning experiences that expand human consciousness, often facilitated by artistic processes. In management education and development this suggests a shift from instrumental management towards a paradigm of artful creation. Why the arts and artfulness? And why now? In what ways can the arts inform, inspire and leverage management development and education?