14 research outputs found

    Development of Immune-Specific Interaction Potentials and Their Application in the Multi-Agent-System VaccImm

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    Peptide vaccination in cancer therapy is a promising alternative to conventional methods. However, the parameters for this personalized treatment are difficult to access experimentally. In this respect, in silico models can help to narrow down the parameter space or to explain certain phenomena at a systems level. Herein, we develop two empirical interaction potentials specific to B-cell and T-cell receptor complexes and validate their applicability in comparison to a more general potential. The interaction potentials are applied to the model VaccImm which simulates the immune response against solid tumors under peptide vaccination therapy. This multi-agent system is derived from another immune system simulator (C-ImmSim) and now includes a module that enables the amino acid sequence of immune receptors and their ligands to be taken into account. The multi-agent approach is combined with approved methods for prediction of major histocompatibility complex (MHC)-binding peptides and the newly developed interaction potentials. In the analysis, we critically assess the impact of the different modules on the simulation with VaccImm and how they influence each other. In addition, we explore the reasons for failures in inducing an immune response by examining the activation states of the immune cell populations in detail

    Méthode d'opérationnalisation de mesures de la performance sensibles aux soins infirmiers basées sur des données de routine

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    Introduction : L’opérationnalisation de mesures de la performance sensibles aux soins infirmiers s’avère très variable. Elle aboutit à des mesures parfois sous-optimales et difficiles d’accès pour les gestionnaires et le personnel infirmier. L’objectif est de proposer une méthode rigoureuse d’opérationnalisation de mesures de la performance sensibles aux soins infirmiers basées sur des données de routine. Source d’information : La source d’information principale de cet article est une méthode d’opérationnalisation adaptée d’un guide de rapport et d’un instrument d’évaluation de mesures de performance. Elle comprend 7 processus et 33 attributs de qualité interreliés. L’application de cette méthode d’opérationnalisation a été expérimentée avec succès dans un hôpital universitaire. Discussion : L’opérationnalisation de mesures de la performance sensibles aux soins infirmiers est un processus complexe. Cette méthode est une proposition originale qui permet de justifier et d’argumenter les choix réalisés. Nous discutons la façon dont cette méthode constitue une réponse à 3 enjeux méthodologiques majeurs : des méthodes d’opérationnalisation hétérogènes et peu détaillées ; des attributs essentiels (p. ex. pertinence, validité scientifique, faisabilité) qui ne font pas consensus et des modèles d’architecture des données hétérogènes. Implication et conclusion : Cette méthode d’opérationnalisation offre une approche systématique et transparente pour produire des mesures de la performance sensibles aux soins infirmiers à partir de données de routine. Elle pourrait permettre de bonifier leur opérationnalisation, faciliter leur compréhension et leur évaluation

    Impact of a nurse led telephone intervention on satisfaction and health outcomes of children with inflammatory rheumatic diseases and their families ::a crossover randomized clinical trial

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    Background. Children suffering from rheumatic disease are faced with multidimensional challenges that affect their quality of life and family dynamics. Symptom management and monitoring of the course of the disease over time are important to minimize disability and pain. Poor disease control and anticipation of the need for treatment changes may be prompted by specialist medical follow-up and regular nurse-led consultations with the patient and families, in which information and support is provided. The purpose of this study was to evaluate the impact of a nurse-led telephone intervention or Telenursing (TN) compared to standard care (SC) on satisfaction and health outcomes of children with inflammatory rheumatic diseases and their parents. Methods. A multicentered, randomized, longitudinal, crossover trial was conducted with pediatrics outpatients newly diagnosed with inflammatory rheumatic diseases. Participants were randomly assigned to two groups TN and SC for 12 months and crossed-over for the following 12 months. TN consisted of providing individualized affective support, health information and aid to decision making. Satisfaction (primary outcome) and health outcomes were assessed with the Client Satisfaction Questionnaire-8 and the Juvenile Arthritis Multidimensional Assessment Report, respectively. A mixed effect model, including a group x time interaction, was performed for each outcome. Results. Satisfaction was significantly higher when receiving TN (OR = 7.7, 95% CI: 1.8–33.6). Morning stiffness (OR = 3.2, 95% CI: 0.97–7.15) and pain (OR = 2.64, 95% CI: 0.97–7.15) were lower in the TN group. For both outcomes a carry-over effect was observed with a higher impact of TN during the 12 first months of the study. The other outcomes did not show any significant improvements between groups. Conclusion. TN had a positive impact on satisfaction and on morning stiffness and pain of children with inflammatory rheumatic diseases and their families. This highlights the importance of support by specialist nurses in improving satisfaction and symptom management for children with inflammatory rheumatisms and their families. Trial registration. ClinicalTrial.gov identifier: NCT01511341 (December 1st, 2012)
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