Paths of the vocational training graduates: Estimation of a multi-state model using a stationary Markov chain.

Located at the hinge of education and employment, vocational training is supposed to provide profiles adapted to the labour market requirements. However, Moroccan graduates of vocational training often find it difficult to fit into the labour market. Indeed, according to the Ministry of Employment and Vocational Training, only 63% of the graduates in 2006 succeeded in integrating the working environment. Yet, this rate hides several realities and is likely to overestimate integration since it does not take into account some crucial variables in the analysis of professional integration, namely the duration of employment, the precariousness of employment, etc. Studies about the paths of vocational training graduates realized periodically (every two years) since 1987 by the Ministry of Employment and Vocational Training aim, by virtue of their longitudinal aspect, to analyze the stability and the evolution of these graduates employment as well as their behaviour. In other words, these studies seek to answer some questions about the dynamics of youth employment in the labour market. This work aims to model the transitions of vocational training graduates using a retrospective calendar recalling their professional situation starting from the date of obtaining the diploma (2002) until the date of the survey (2006). Our model uses a transition process generated by a homogeneous, stationary and ergodic Markov chain for the graduates state space. We propose to explain the transitions from one state to another, via a multivariate logistic link, through variables which can influence between-state transitions. This leads that the processual variables explain these transitions. To estimate the parameters of our model, we use an iterative method of unconstrained nonlinear optimization: Conjugate Gradient "CG”. The stationarity of the Markov chain and the estimation of the transition matrix allow us to compute labour market indicators used to describe the behaviour of young graduates as well as their professional mobility.llabour market, transitions, vocational training, Markov chain, "CG” Method, Morocco

Profile and course of early rheumatoid arthritis in Morocco: a two-year follow-up study

<p>Abstract</p> <p>Background</p> <p>This study aimed to establish the profile and the evolution of an early Rheumatoid arthritis <b>(RA) </b>cohort in the Moroccan population and also to search possible predictor factors of structural progression.</p> <p>Methods</p> <p>Patients with early RA (< 12 months) were enrolled in a 2-year follow-up study. Clinical, biological, immunogenetic, and radiographical data were analyzed at study entry and at 24 months. Presence of radiographic progression was retained when the total score was superior to the smallest detectable difference (SDD) calculated to be 5.4 according the Sharp/van der Heijde (SVDH) method.</p> <p>Results</p> <p>Fifty one patients (88.8% women, mean age of 46.9 [ 24-72 ] ± 10.8 years, mean disease duration of 24 [ 6-48 ] ± 13.9 weeks) were enrolled in this study. 68.6% were illiterate and 19.6% reported at least one comorbid condition. The mean delay in referral for specialist care was 140 [ 7-420 ] ± 43 days.</p> <p>Thirteen patients (62.5%) were IgM or IgA RF positive. HLA-DRB1*01 and DRB1*04 alleles were present respectively in 11.8% and 45.1% of patients.</p> <p>At baseline, 35.3% patients were taking corticosteroids and 7.8% were under conventional DMARDs.</p> <p>At 24 months, 77.2% received a median dose of 5 mg/day of prednisone. Methotrexate (MTX) was the most frequently prescribed DMARD, being taken by 65.2% of patients. 13.6% of patients had stopped their DMARD because of socioeconomic difficulties.</p> <p>Comparison of clinical and biologic parameters between baseline and 24 months thereafter revealed a significant global improvement of the disease status including morning stiffness, pain score, swollen joint count, DAS 28 and HAQ scores, ESR and CRP.</p> <p>Sixteen patients (34.8%) were in remission at 2 years versus no patients at baseline; <it>P </it>< 0.001.</p> <p>Forteen patients (27.5%) had at least one erosion at baseline. Radiographic progression occurred in 33.3% of patients and was associated in univariate analysis to swollen joint count (p = 0.03), total SVDH score (<it>P </it>= 0.04) and joint space narrowing score (<it>P </it>= 0.03). No independent factors of radiographic progression were shown by logistic regression.</p> <p>Conclusions</p> <p>These study reports, provided for the first time in Morocco, a developing African country, a large amount of information concerning the profile and the course of early RA.</p> <p>Patients who were receiving, for most of them, Methotrexate in monotherapy and low doses of corticosteroids, showed an improvement of all clinic and biologic disease parameters. Moreover, DAS remission was obtained in one third of patients and two thirds of the cohort had no radiographic progression at 2 years. No predictor factors of radiographic progression were found out.</p> <p>These results should be confirmed or not by a large unbiased RA cohort which will give more relevant information about early RA characteristics and its course and will constitute a major keystone of its management.</p

Effects of direct and intermodal transport on supplier selection: a multiobjective approach

10 pagesInternational audienceThe impact of transportation on the supplier selection has received a very scant attention in the literature. It induces a great limitation because splitting orders across multiple suppliers will lead to smaller transportation quantities which will likely imply larger transportation cost. Moreover, transportation and inventory elements are highly interrelated and contribute most to the total logistics costs. In this paper, we present a nonlinear multiobjective programming approach of selecting suppliers and allocating the order quantity among them, taking transportation into account. . In our study, we consider the case where the product brought from selected suppliers can be shipped directly or via consolidation terminals to the buyer. Shipping via a terminal can incur an inventory holding cost. The model considers the total production cost and the lead-time as the criteria to minimize concurrently subject to suppliers and buyer constraints. The total cost is the sum of transportation, inventory and ordering costs. An evaluation of the model is presented under various scenarios

An approach to assessing the individual competence level in the scheduling problem

International audienceno abstrac

Construction d'une méthode de conduite du changement par l'analyse du projet d'établissement hospitalier (cas du Maroc)

Cette thèse se positionne dans un cadre multidisciplinaire entre les Sciences Appliquées et les Sciences de Gestion. Elle étudie le changement dans le milieu hospitalier au Maroc et apporte une contribution dans le domaine de la conduite du changement. Le fruit de notre recherche est une nouvelle méthode d accompagnement au changement qui permet de représenter le changement envisagé à l aide des perceptions des acteurs en l intégrant dans une planification stratégique. Il s agit de la méthode Actor Representations of Change (ARC) qui se base sur un travail d équipe et sur la modélisation des éléments internes et externes influençant le changement hospitalier.En effet, l organisation hospitalière présente certaines particularités étroitement liées à la problématique de conduite du changement. Sa structure organisationnelle met en valeur le centre opérationnel et l importance des acteurs. Ces particularités sont prises en considération dans notre problématique de recherche dans le but de réussir le changement. Une conduite qui tient compte des acteurs reste très attachée à son contexte car elle cherche à les impliquer et à les engager dans sa finalité. Pour contribuer au niveau d une conduite du changement dédié aux acteurs dans le milieu hospitalier, nous choisissons de les lier à leur contexte par le biais de leurs perceptions au changement. Notre objectif est de concevoir une représentation des perceptions des acteurs pour réussir les changements induits par le Projet d Etablissement Hospitalier (PEH). Pour atteindre cet objectif, nous adoptons une méthodologie de recherche ingénierique (Chanal et al., 1997) qui encourage notre positionnement multidisciplinaire et nous aide à travailler en étroite collaboration avec les acteurs hospitaliers.This thesis is positioned in a multidisciplinary framework between Applied Science and Management Science. It studies the change in the hospital environment in Morocco and contributes in the field of change management.The result of our research is a new method of change management support that represents the proposed change through the perceptions of those involved in this change, incorporating it into a strategic planning. This is the Actor' Representations of Change method (ARC) which is based on a teamwork and a modeling of internal and external factors influencing the hospital change. Indeed, the hospital organization has certain characteristics tightly linked with the question of change management. Its structure emphasizes the operational centre and the importance of the actors. These distinctive features are taken into account in our research question in order to success in the change management. A change management that takes into account the actors is very linked to its context as it aims to involve and engage the actors in its finality. In order to contribute to the change management dedicated to actors in a hospital environment, we choose to connect them to their context by their perceptions of the change. Our objective is to conceive a representation of the actors perceptions to success in the changes led by the PEH. To reach this objective, we adopt an Engineerical Methodology of Research (Chanal and al., 1997) which justifies our multidisciplinary position and helps us to work in close collaboration with the hospital actors.NICE-BU Droit Sci.Eco.Gestion (060882103) / SudocSudocFranceF

Proposition of a Quantified Method for the Individual Competence Assessment in Manufacturing Industry

International audienceAbstract

doi:10.1016/j.jbspin.2011.02.019

a b s t r a c t Objective: This study aimed to evaluate remission in patients with early RA treated by conventional DMARDs and to identify its possible predictor factors. Methods: Patients with early RA (&lt; 12 months) were enrolled in a 2-year follow-up study. Standard evaluation completed at baseline and at 24 months included clinical, laboratory, functional and structural assessment. Clinical remission after 2 years of follow-up was defined when DAS28 was less than 2.6. Possible predictor factors for remission were analyzed. Results: Fifty-one patients (88.2% women, mean age of 46.9 [24-72] years, mean disease duration of 24 [6-48] weeks) were enrolled in this study. The delay in referral for specialist care was 140 days. Rheumatoid factor, anti-CCP, HLA-DRB1*01 and DRB1*04 alleles were present respectively in 62.5, 56.6, 11.8, and 45.1% of patients. At 24 months, 77.2% received a median dose of 5 (0-8) mg/day of prednisone and 65.2% was taking methotrexate (MTX). 13.6% of patients had stopped their DMARD because of socioeconomic difficulties. At 24 months, we noted a significant improvement of morning stiffness, pain score, swollen joint count, ESR, CRP, DAS28 and HAQ scores. Remission at 2 years was noted in 34.8% of patients and was significantly associated in univariate but not in multivariate analysis to male sex (P = 0.02) and to short delay in referral for specialist (P = 0.03). Conclusion: In this cohort of early RA patients treated with conventional DMARDs, especially with methotrexate in monotherapy, remission at 2-year of follow-up was obtained in one third of patients. No predictor factors of remission were found out. These results should be verified by further studies