Élaboration des énoncés visant à intégrer optimalement le modèle Trèfle chanceux au logiciel Copilote insertion.

On parle de plus en plus d'insertion professionnelle difficile. Les taux de chômage augmentent et cela implique une grande demande d'aide de la part des chercheurs d'emploi. Les ressources humaines pour répondre à leurs besoins sont débordées et doivent donner des services efficaces dans un court laps de temps. Le problème qui se pose alors, c'est de savoir comment faire une évaluation, un diagnostic ajusté de la situation du chercheur d'emploi, qui répond à la fois à ses besoins et à ses difficultés d'insertion, qui respecte son environnement, ses choix et qui s'adapte au contexte de notre société? Ce qui nous préoccupe donc ici, c'est de savoir comment mesurer l'employabilité d'un individu. Dans le premier chapitre nous définirons ce qu'est l'employabilité. Et nous ferons le point sur les réalités du marché du travail. Nous ferons aussi une analyse de certains instruments de mesure d'employabilité déjà existants et nous présenterons un modèle théorique d'intervention en employabilité nouveau et à jour pouvant répondre au besoin d'un instrument de mesure, le Trèfle chanceux de Limoges. Dans le deuxième chapitre, nous verrons l'instrument de mesure de l'employabilité que nous jugeons le plus avancé; "Copilote insertion" de Clavier. Dans un souci de répondre au besoin de posséder un instrument de mesure d'employabilité, nous allons utiliser Copilote insertion afin de vérifier la taxonomie du Trèfle chanceux. Dans le troisième chapitre, nous vous proposons un jeu bâti sur le modèle du Trèfle Chanceux; L'emploi à la Carte, que nous comparerons, par la suite, à Copilote insertion pour en faire ressortir les différences et similarités. C'est dans le quatrième et dernier chapitre que vous pourrez retrouver des recommandations afin d'amorcer la construction d'un instrument intégrant Copilote insertion et le Trèfle chanceux, tout en respectant les priorités des deux auteurs.

Utilisation du logiciel Copilote Insertion pour l'évaluation des gains en employabilité de sujets ayant participé à un Service d'Intégration Socioprofessionnelle.

La situation du marché de l'emploi a subi ces dernières années, des changements de structure en profondeur. Le résultat est qu'au Québec, le taux réel d'inactivité révèle que près d'un adulte sur quatre est sans emploi. Parmi les personnes les plus touchées par ces changements on retrouve celles qui sont sans formation spécifique, sans diplôme ou bien sans expérience de travail. Pour rendre apte au travail cette mam d'oeuvre inactive, le Ministère de l'éducation a mis sur pied au milieu des années 90, une mesure d'aide à l'insertion appelée Services d'Intégration Socioprofessionnelle ou S.I.S. Dans le présent essai, nous avons cherché à évaluer le développement de l'employabilité de participants aux S.I.S. Selon les objectifs visés par le Service, on suppose que chaque personne aura acquis certaines attitudes et aptitudes au travail, susceptible de l'aider à retrouver du travail et de le conserver. Nous avons utilisé la structure de recherche test-retest sur le même échantillon. En effet, chaque participant s'est vu administrer le même questionnaire, au début et à la fin des S.I.S. Nous avons ainsi pu suivre l'évolution des facteurs en causes dans une insertion professionnelle. À cela s'ajoutent des données recueillies dans un journal de bord par l'évaluateur/animateur. Celles-ci sont reprises pour donner un sens dans l'analyse des résultats. La mesure utilisée est le questionnaire informatisé Copilote Insertion version 2.20. Celui-ci fut administré une première fois, à seize personnes présentes en amorce des S.LS. Pour la mesure post, nous avions plus que 8 personnes toujours disponibles et respectant le devis de recherche. Pour ces sujets, nous avons comparé chacun des vingt facteurs de Copilote, ainsi que l'évolution des stratégies d'insertion. Pour chacun d'eux, nous avons pu déterminer lesquels des facteurs d'employabilité évalué par le logiciel, démontraient une progression. Il a été démontré que l'ensemble des participants s'accordait beaucoup de difficulté à surmonter l'image de dépendance et d'incapacité, intériorisé avec l'expérience du chômage. Comme quoi, cette clientèle a à faire face à un certain nombre de deuil non résolu. À ce niveau, la structure des S.I.S semble permettre ce nécessaire recadrage de l'expérience chômage. Nous avons aussi observé que la composition du groupe n'a pas été réalisée en respectant le développement de l'employabilité de chacun des participants. Par conséquent, les plus enthousiasmes ont eu à subir l'inconfort de devoir faire face aux discours démotivant des personnes non-prêtes à s'insérer en emploi. La difficulté de sélectionner des personnes dont les besoins en matière de développement de l'employabilité ne seraient pas homogènes pourrait être surmontée si des activités individuelles personnalisées, sont présentées en alternance avec le travail de groupe. Autre constat réalisé est que malgré le temps passé à l'intérieur des SIS, des participants s'accordent plus de difficultés à la fin qu'au début, pour des facteurs d'employabilités. C'est le cas des facteurs du thème Communication de Copilote. La difficulté de mettre en branle une campagne visant la mise en marché de son potentiel de travail, cela vient confirmer que le participant, bien qu'il ait réalisé un bout du trajet le séparant du monde du travail, qu'il n'est pas parvenu à destination.

Préparation de la version expérimentale d'un outil de mesure de l'employabilité "Copilote insertion

Depuis les dernières années, on assiste à une croissance du taux de chômage. Le nombre de chercheurs d'emploi ne cesse d'augmenter et beaucoup d'entre eux sont confrontés à de longues périodes sans emploi. D'après un récent rapport publié par le Développement des ressources humaines Canada, le taux de chômage a affiché une moyenne de 12.2% au Québec en 1994. Le nombre de chercheurs d'emploi augmente considérablement et ceux-ci proviennent de différents domaines d'activités d'emploi. Plusieurs de ces personnes ont besoin de support pour réintégrer le marché du travail. Des organismes d'aide à l'employabilité permettent à cette clientèle d'identifier des objectifs pour faciliter leur insertion. Afin de bien répondre aux besoins des chercheurs d'emploi par des moyens rapides et utiles, un logiciel a été conçu par Dominique Clavier, chercheur et clinicien Français. Ce logiciel s'appelle le Copilote insertion. Il permet aux usagers d'avoir un diagnostic complet des difficultés à trouver un emploi. Ce diagnostic donne aussi des recommandations conformes à la situation de la personne. Étant donné que cet outil a été d'abord conçu pour les Européens, on peut s'attendre que les énoncés formulés dans le Copilote présentent des difficultés pour les québécois. L'objet de cet essai est de ressortir les problèmes de compréhension pour ensuite faire l'adaptation culturelle du Copilote insertion. Dans le premier chapitre de cet ouvrage, nous nous attarderons à définir les enjeux du travail et la notion de l'employabilité. Nous aborderons par la suite deux modèles qui traitent des stratégies d'insertion : celui de Dominique Clavier auteur du logiciel Copilote insertion et celui de Jacques Limoges auteur du Trèfle chanceux. Il sera question par la suite de l'intégration de ces deux approches et de l'adaptation culturelle de ce logiciel. Le deuxième chapitre présentera la méthodologie qui indiquera la conduite de l'expérimentation auprès d'un échantillon de chercheurs d'emploi québécois. Un dernier chapitre permettra, suite à l'analyse des données, de présenter les résultats et de proposer des correctifs pour la refonte des énoncés du Copilote insertion.

Percutaneous insertion of Dual Growth Rods using a new mobile bearing implant

Growth rods are commonly used for the treatment of scoliosis in the immature spine. Many variations have been proposed but breakage of implants is a common problem. Growth rod insertion commonly involves large exposures at initial insertion followed by multiple smaller procedures for lengthening. We present our early experiences using a percutaneous technique of insertion of a new titanium mobile bearing implant (Medtronic Inc). The implant allows some rotatory motion in the middle of the construct thus reducing construct stresses and thus possibly reducing rod breakage risk. Based on this small initial series with 12 months follow-up, percutaneous insertion of growth rods using the new implant is a safe and reliable technique although the infection rate in our sample was of note. This may be related to the titanium wear and inflammation seen in the soft tissues at time of operation and visualised on histology. No implants have required removal due to infection, and all infections were treated with debridement at next lengthening and suppressive antibiotics. Propionibacterium is one of the commonest infections seen with spinal implants and sometimes does not respond to simple antibiotic suppression. The technique allows preservation of the soft tissues until definitive fusion is needed and may lead to a decrease in hospital stay. The implant is low profile and seems to offer advantages over other systems on the market. Further follow up is needed to look at longer term outcomes with this new implant type.

The effect of insertion time on the axial pullout strength of anterior vertebral body screws

Top screw pullout occurs when the screw is under too much axial force to remain secure in the vertebral body. In vitro biomechanical pullout tests are commonly done to find the maximum fixation strength of anterior vertebral body screws. Typically, pullout tests are done instantaneously where the screw is inserted and then pulled out immediately after insertion. However, bone is a viscoelastic material so it shows a time dependent stress and strain response. Because of this property, it was hypothesised that creep occurs in the vertebral trabecular bone due to the stress caused by the screw. The objective of this study was therefore to determine whether the axial pullout strength of anterior vertebral body screws used for scoliosis correction surgery changes with time after insertion. This study found that there is a possible relationship between pullout strength and time; however more testing is required as the sample numbers were quite small. The design of the screw is made with the knowledge of the strength it must obtain. This is important to prevent such occurrences as top screw pullout. If the pullout strength is indeed decreased due to creep, the design of the screw may need to be changed to withstand greater forces.

Rapid quantification of free cholesterol in tears using direct insertion/electron ionization-Mass spectrometry

Purpose. To establish a simple and rapid analytical method, based on direct insertion/electron ionization-mass spectrometry (DI/EI-MS), for measuring free cholesterol in tears from humans and rabbits. Methods. A stable-isotope dilution protocol employing DI/EI-MS in selected ion monitoring mode was developed and validated. It was used to quantify the free cholesterol content in human and rabbit tear extracts. Tears were collected from adult humans (n = 15) and rabbits (n = 10) and lipids extracted. Results. Screening, full-scan (m/z 40-600) DI/EI-MS analysis of crude tear extracts showed that diagnostic ions located in the mass range m/z 350 to 400 were those derived from free cholesterol, with no contribution from cholesterol esters. DI/EI-MS data acquired using selected ion monitoring (SIM) were analyzed for the abundance ratios of diagnostic ions with their stable isotope-labeled analogues arising from the D6-cholesterol internal standard. Standard curves of good linearity were produced and an on-probe limit of detection of 3 ng (at 3:1 signal to noise) and limit of quantification of 8 ng (at 10:1 signal to noise). The concentration of free cholesterol in human tears was 15 ± 6 μg/g, which was higher than in rabbit tears (10 ± 5 μg/g). Conclusions. A stable-isotope dilution DI/EI-SIM method for free cholesterol quantification without prior chromatographic separation was established. Using this method demonstrated that humans have higher free cholesterol levels in their tears than rabbits. This is in agreement with previous reports. This paper provides a rapid and reliable method to measure free cholesterol in small-volume clinical samples. © 2013 The Association for Research in Vision and Ophthalmology, Inc.

The effect of intervertebral staple insertion on bovine spine segment stiffness

Introduction There is growing interest in the biomechanics of ‘fusionless’ implant constructs used for deformity correction in the thoracic spine. Intervertebral stapling is a leading method of fusionless corrective surgery. Although used for a number of years, there is limited evidence as to the effect these staples have on the stiffness of the functional spinal unit. Materials and Methods Thoracic spines from 6-8 week old calves were dissected and divided into motion segments including levels T4-T11 (n=14). Each segment was potted in polymethylemethacrylate. An Instron Biaxial materials testing machine with a custom made jig was used for testing. The segments were tested in flexion/extension, lateral bending and axial rotation at 37⁰C and 100% humidity, using moment control to a maximum 1.75 Nm with a loading rate of 0.3 Nm per second. This torque was found sufficient to achieve physiologically representative ranges of movement. The segments were initially tested uninstrumented with data collected from the tenth load cycle. Next a left anterolateral Shape Memory Alloy (SMA) staple was inserted (Medtronic Sofamor Danek, USA). Biomechanical testing was repeated as before with data collected from the tenth load cycle. Results In flexion/extension there was an insignificant drop in stiffness of 3% (p=0.478). In lateral bending there was a significant drop in stiffness of 21% (p<0.001). This was mainly in lateral bending away from the staple, where the stiffness reduced by 30% (p<0.001). This was in contrast to lateral bending towards the staple where it dropped by 12% which was still statistically significant (p=0.036). In axial rotation there was an overall near significant drop in stiffness of 11% (p=0.076). However, this was more towards the side of the staple measuring a decrease of 14% as opposed to 8% away from the staple. In both cases it was a statistically insignificant drop (p=0.134 and p=0.352 respectively). Conclusion Insertion of intervertebral SMA staples results in a significant reduction in motion segment stiffness in lateral bending especially in the direction away from the staple. The staple had less effect on axial rotation stiffness and minimal effect on flexion/extension stiffness.

Automated fit quantification of tibial nail designs during the insertion using computer three-dimensional modelling

Intramedullary nailing is the standard fixation method for displaced diaphyseal fractures of the tibia. An optimal nail design should both facilitate insertion and anatomically fit the bone geometry at its final position in order to reduce the risk of stress fractures and malalignments. Due to the nonexistence of suitable commercial software, we developed a software tool for the automated fit assessment of nail designs. Furthermore, we demonstrated that an optimised nail, which fits better at the final position, is also easier to insert. Three-dimensional models of two nail designs and 20 tibiae were used. The fitting was quantified in terms of surface area, maximum distance, sum of surface areas and sum of maximum distances by which the nail was protruding into the cortex. The software was programmed to insert the nail into the bone model and to quantify the fit at defined increment levels. On average, the misfit during the insertion in terms of the four fitting parameters was smaller for the Expert Tibial Nail Proximal bend (476.3 mm2, 1.5 mm, 2029.8 mm2, 6.5 mm) than the Expert Tibial Nail (736.7 mm2, 2.2 mm, 2491.4 mm2, 8.0 mm). The differences were statistically significant (p ≤ 0.05). The software could be used by nail implant manufacturers for the purpose of implant design validation.

Is there a bone-nail specific entry point? automated fit quantification of tibial nail designs during the insertion for six different nail entry points

Intramedullary nailing is the standard fixation method for displaced diaphyseal fractures of tibia. Selection of the correct nail insertion point is important for axial alignment of bone fragments and to avoid iatrogenic fractures. However, the standard entry point (SEP) may not always optimise the bone-nail fit due to geometric variations of bones. This study aimed to investigate the optimal entry for a given bone-nail pair using the fit quantification software tool previously developed by the authors. The misfit was quantified for 20 bones with two nail designs (ETN and ETN-Proximal Bend) related to the SEP and 5 entry points which were 5 mm and 10 mm away from the SEP. The SEP was the optimal entry point for 50% of the bones used. For the remaining bones, the optimal entry point was located 5 mm away from the SEP, which improved the overall fit by 40% on average. However, entry points 10 mm away from the SEP doubled the misfit. The optimised bone-nail fit can be achieved through the SEP and within the range of a 5 mm radius, except posteriorly. The study results suggest that the optimal entry point should be selected by considering the fit during insertion and not only at the final position.

Automated fit assessment of intramedullary nail designs during insertion

Modern intramedullary nails, which are utilised for the treatment of bone fractures, need to be designed to fit the anatomy of the patient population. Traditional and recent semi-automated approaches for quantifying the anatomical fit between bones and nail designs suffer from various drawbacks. This thesis proposed an automated comprehensive nail design validation method. The developed software tool was utilised to quantify the anatomical fit of four commercial nail designs. Furthermore, the thesis demonstrated the existence of a bone-nail specific nail entry point. The developed method is of great benefit for the implant manufacturing industry as a nail design validation tool.

Reversible Insertion of Methyl Isothiocyanate into Copper(I)Aryloxides

MeNCS undergoes insertion into the copper(I)-aryloxide bond to form [N-methylimino(aryloxy)methanethiolato]-copper(I) complexes. This insertion occurs in the absence of ancillary ligands unlike the analogous insertion of PhNCS. The reaction with 4-methylphenoxide results in the formation of hexakis[[N-methylimino(4-methylphenoxy) methanethiolato]copper(I)] (1), which has been characterized by X-ray crystallography. Crystal data for 1: hexagonal , a = 12.365(3) Angstrom, c = 36.734(16) Angstrom, gamma = 120 degrees, Z = 3, V = 4863(3) Angstrom(3), R = 0.0306. Reactions of 2,6-dimethyl- and 4-chlorophenoxides also result in analogous copper(I) complexes 2 and 3. Addition of stochiometric amounts of PPh(3) to the oligomeric complexes typically results in the extrusion of MeNCS. The ease of extrusion is dependent on the substituents on the aryloxide, and this deinsertion is accelerated by water. However, the extrusion reaction is slow enough in the case of the N-methylimino(2,6-dimethylphenoxy)-methanethiolate complex and the isolation of an intermediate monomeric product bis(triphenylphosphine)[N-methylimino(2, 6-dimethylphenoxy)methanethiolato] copper(I) (4) is possible. Crystal data for 4: triclinic , a = 10.088(2) Angstrom, b = 11.302(1) Angstrom, c = 17.990(2) Angstrom, alpha = 94.06(1)degrees, beta = 95.22(2)degrees, gamma = 103.94(1)degrees, Z = 2, V = 1974.4(7) Angstrom(3), R = 0.0361. In the presence of of PPh(3), the insertion reaction becomes reversible. This allows the exchange of the heterocumulene MeNCS or the aryloxy group in these molecules with another heterocumulene or a phenol, respectively, when catalytic amounts of PPh(3) are added. Oligomers with exchanged heterocumulmes and phenols could be characterized by independent synthesis.

Reactivity of Cationic Terminal Borylene Complexes: Novel Mechanisms for Insertion and Metathesis Chemistry Involving Strongly Lewis Acidic Ligand Systems

The reactions of terminal borylene complexes of the type [CpFe(CO)(2)(BNR2)](+) (R = `Pr, Cy) with heteroallenes have been investigated by quantum-chemical methods, in an attempt to explain the experimentally observed product distributions. Reaction with dicyclohexylcarbodiimide (CyNCNCy) gives a bis-insertion product, in which 1 equiv of carbodiimide is assimilated into each of the Fe=B and B=N double bonds to form a spirocyclic boronium system. In contrast, isocyanates (R'NCO, R' = Ph, 2,6-wXy1, CY; XYl = C6H3Me2) react to give isonitrile complexes of the type [CpFe(CO)(2)(CNR')]+, via a net oxygen abstraction (or formal metathesis) process. Both carbodiimide and socyanate substrates are shown to prefer initial attack at the Fe=B bond rather than the B=N bond of the borylene complex. Further mechanistic studies reveal that the carbodiimide reaction ultimately leads to the bis-insertion compounds [CpFe(CO)(2)C(NCy)(2)B(NCY)(2)CNR2](+), rather than to the isonitrile system [CpFe(CO)(2)(CNCy)](+), on the basis of both thermodynamic (product stability) and kinetic considerations (barrier heights). The mechanism of the initial carbodiimide insertion process is unusual in that it involves coordination of the substrate at the (borylene) ligand followed by migration of the metal fragment, rather than a more conventional process: i.e., coordination of the unsaturated substrate at the metal followed by ligand migration. In the case of isocyanate substrates, metathesis products are competitive with those from the insertion pathway. Direct, single-step metathesis reactivity to give products containing a coordinated isonitrile ligand (i.e. [CpFe(CO)(2)(CNR')](+)) is facile if initial coordination of the isocyanate at boron occurs via the oxygen donor (which is kinetically favored); insertion chemistry is feasible when the isocyanate attacks initially via the nitrogen atom. However, even in the latter case, further reaction of the monoinsertion product so formed with excess isocyanate offers a number of facile (low energetic barrier) routes which also generate ['CpFe(CO)(2)(CNR')](+), rather than the bis-insertion product [CpFe(CO)(2)C(NR')(O)B(NR')(O)CNR2](+) (i.e., the direct analogue of the observed products in the carbodiimide reaction).

Membrane Insertion of C-tail Anchored Proteins

The correct localization of proteins is essential for cell viability. In order to achieve correct protein localization to cellular membranes, conserved membrane targeting and translocation mechanisms have evolved. The focus of this work was membrane targeting and translocation of a group of proteins that circumvent the known targeting and translocation mechanisms, the C-tail anchored protein family. Members of this protein family carry out a wide range of functions, from protein translocation and recognition events preceding membrane fusion, to the regulation of programmed cell death. In this work, the mechanisms of membrane insertion and targeting of two C-tail anchored proteins were studied utilizing in vivo and in vitro methods, in yeast and mammalian cell systems. The proteins studied were cytochrome b(5), a well characterized C-tail anchored model protein, and N-Bak, a novel member of the Bcl-2 family of regulators of programmed cell death. Membrane insertion of cytochrome b(5) into the endoplasmic reticulum membrane was found to occur independently of the known protein conducting channels, through which signal peptide-containing polypeptides are translocated. In fact, the membrane insertion process was independent of any protein components and did not require energy. Instead membrane insertion was observed to be dependent on the lipid composition of the membrane. The targeting of N-Bak was found to depend on the cellular context. Either the mitochondrial or endoplasmic reticulum membranes were targeted, which resulted in morphological changes of the target membranes. These findings indicate the existence of a novel membrane insertion mechanism for C-tail anchored proteins, in which membrane integration of the transmembrane domain, and the translocation of C-terminal fragments, appears to be spontaneous. This mode of membrane insertion is regulated by the target membrane fluidity, which depends on the lipid composition of the bilayer, and the hydrophobicity of the transmembrane domain of the C-tail anchored protein, as well as by the availability of the C-tail for membrane integration. Together these mechanisms enable the cell to achieve spatial and temporal regulation of sub-cellular localization of C-tail anchored proteins.