Management à distance et santé au travail : Quels sont les impacts de l’éloignement et de la méconnaissance du travail réel ?

Cette recherche explore deux cas d’entreprises développant un management à distance. On montrera que ce management focalisé essentiellement sur un contrôle formel de l’activité créé des distorsions entre les représentations du management et celles des salariés. Or, les salariés étant confrontés à une forte incertitude lors de périodes de mutations exigeantes en termes de management des ressources humaines, ces distorsions génèrent chez eux perte de confiance, désengagement, stress et désespoir, qui peuvent avoir un impact important sur leur santé

What Information Technology Asks of Business Higher Education Institutions: The Case of Rhode Island

Using data from Rhode Island, this research examines the relationships among certifications, skills, educational levels and the level of compensation across the IT field and attempts to discriminate between ten major job functions. It assesses the significance of skills and certifications to specific IT worker categories. The level of education was found to predict success. Certification and skills vary across job functions, and did not necessarily differentiate across IT job functions. Suggestions on the development of curricula are proposed

Relationship Between Body Mass Index and Diagnosis of Obesity in the Military Health System Active Duty Population

OBJECTIVE: The overall rate of obesity is rising in the USA; this is also reflected in the military population. It is important that providers appropriately diagnose obesity and discuss treatment options with their patients.The purpose of this study was to investigate diagnosis of obesity compared to documented body mass index (BMI) in the military health system. METHODS: Institutional review board approval was obtained by the 59th Medical Wing (Lackland Air Force Base, Texas) as an exempt study. This study included active duty military service members aged 18-65 years who sought outpatient care at a military treatment facility from September 2013 to August 2018 with a weight within the range of 31.8-226.8 kg and height between 121.9 and 215.9 cm. Data were collected from the Clinical Data Repository vitals and M2 encounter data to determine the percentage of each sub-population with a diagnosis of obesity according to BMI (≥30 kg/m2) and International Classification of Diseases diagnosis codes. RESULTS: Using BMI, 19.2% of female and 26.8% of male service members can be diagnosed with obesity; however, only 42.2% and 35.1%, respectively, with a BMI ≥30 was diagnosed as such. This discrepancy was consistent among all service branches and BMI ranges. CONCLUSION: This study demonstrates that obesity is underdiagnosed compared to BMI. This may result in insufficient resources being provided to patients to reduce weight. Further investigation is warranted to identify causes of underdiagnosis and potential barriers to diagnosis

Systèmes d’information, contrôle des tâches et management des activités de service. Une analyse à partir de l’exemple des centres de relation client

Cette recherche explore le rôle et les attitudes du manager de proximité dans sa fonction d’encadrement de personnel dont les tâches sont hautement codifiées et contrôlées par les systèmes d’information. Elle s’intéresse à la manière dont le manager de proximité trouve sa place et sa légitimité lorsque sa mission est intrinsèquement liée à l’usage des TI. Elle s’appuie sur la théorie de la régulation sociale de J.D. Reynaud qu’elle propose d’enrichir en analysant les conditions de son application au secteur des services. A partir de trois études de cas réalisées en centre d’appels, elle montre que le manager de proximité est en charge de la régulation conjointe de l’activité, mais que l’efficacité organisationnelle de son rôle est étroitement liée à sa capacité à dépasser les TI. D’un point de vue pratique, elle permet, à la lumière d’une théorie de la régulation sociale enrichie, de mieux comprendre les conditions nécessaires à la bonne tenue du poste de manager intermédiaire en centre d’appels

Transcriptional profiling of differentially vulnerable motor neurons at pre-symptomatic stage in the Smn (2b/-) mouse model of spinal muscular atrophy

INTRODUCTION: The term motor neuron disease encompasses a spectrum of disorders in which motor neurons are the lost. Importantly, while some motor neurons are lost early in disease and others remain intact at disease end-stage. This creates a valuable experimental paradigm to investigate the factors that regulate motor neuron vulnerability. Spinal muscular atrophy is a childhood motor neuron disease caused by mutations or deletions in the SMN1 gene. Here, we have performed transcriptional analysis on differentially vulnerable motor neurons from an intermediate mouse model of Spinal muscular atrophy at a presymptomatic time point. RESULTS: We have characterised two differentially vulnerable populations, differing in the level neuromuscular junction loss. Transcriptional analysis on motor neuron cell bodies revealed that reduced Smn levels correlate with a reduction of transcripts associated with the ribosome, rRNA binding, ubiquitination and oxidative phosphorylation. Furthermore, P53 pathway activation precedes neuromuscular junction loss, suggesting that denervation may be a consequence, rather than a cause of motor neuron death in Spinal muscular atrophy. Finally, increased vulnerability correlates with a decrease in the positive regulation of DNA repair. CONCLUSIONS: This study identifies pathways related to the function of Smn and associated with differential motor unit vulnerability, thus presenting a number of exciting targets for future therapeutic development. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40478-015-0231-1) contains supplementary material, which is available to authorized users

Neutral Effect of Exenatide on Serum Testosterone in Men with Type 2 Diabetes Mellitus: A Prospective Cohort

BACKGROUND: Endogenous testosterone increases with weight loss from diet, exercise, and bariatric surgery. However, little is known about testosterone levels after weight loss from medication. OBJECTIVES: Uncover the effects of Glucagon-Like Peptide-1 receptor agonist (GLP-1 RA) therapy on serum testosterone. MATERIAL AND METHODS: Prospective cohort study of men starting GLP-1 RA therapy for type 2 diabetes mellitus. RESULTS: 51 men lost 2.27 kg (p = 0.00162) and their HbA1c values improved by 0.7% (p = 0.000503) after 6 months of GLP-1 RA therapy. There was no significant change in testosterone for the group as a whole. However, in subgroup analyses, there was a significant difference in total testosterone change between men starting with baseline total testosterone/dL (238.5 ± 56.5 ng/dL to 272.2 ± 82.3 ng/dL) compared to higher values (438 ± 98.2 ng/dL to 412 ± 141.2 ng/dL) (p = 0.0172);free testosterone increased if the baseline total testosterone was/dL (55.2 ± 12.8 pg/mL to 57.2 ± 17.6 pg/mL) and decreased if \u3e320 ng/dL (74.7 ± 16.3 pg/mL to 64.2 ± 17.7 pg/mL) (p = 0.00807). Additionally, there were significant differences in testosterone change between men with HbA1c improvements ≥1% (351.6 ± 123.9 ng/dL to 394.4 ± 136.5 ng/dL) compared to men with HbA1c changes CONCLUSION: GLP-1 RA therapy improves weight and HbA1c without adverse effects on testosterone. Those starting with lower testosterone values or attaining greater improvement in HbA1c may see additional benefits

Analysis of Current Thyroid Function Test Ordering Practices

RATIONALE: Current guidelines recommend thyroid stimulating hormone (TSH) alone as the best test to detect and monitor thyroid dysfunction, yet free thyroxine (FT4) and free triiodothyronine (FT3) are commonly ordered when not clinically indicated. Excessive testing can lead to added economic burden in an era of rising healthcare costs, while rarely contributing to the evaluation or management of thyroid disease. OBJECTIVE: To evaluate our institution\u27s practice in ordering thyroid function tests (TFTs) and to identify strategies to reduce inappropriate FT4 and FT3 testing. METHODS: A record of all TFTs obtained in the San Antonio Military Health System during a 3-month period was extracted from the electronic medical record. The TFTs of interest were TSH, FT4, thyroid panel (TSH + FT4), FT3, total thyroxine (T4), and total triiodothyronine (T3). These were categorized based on the presence or absence of hypothyroidism. RESULTS: Between August 1 and October 31, 2016, there were 38 214 individual TFTs ordered via 28 597 total laboratory requests; 11 486 of these requests were in patients with a history of hypothyroidism. The number (percent) of laboratory requests fell into these patterns: TSH alone 14 919 (52.14%), TSH + FT4 7641 (26.72%), FT3 alone 3039 (10.63%), FT4 alone 1219 (4.26%), TSH + FT4 + FT3 783 (2.74%), and others 996 (3.48%); 36.0% of TFTs ordered were free thyroid hormones. Projected out to a year, using Department of Defense laboratory costs, $317 429 worth of TFTs would be ordered, with free thyroid hormone testing accounting for$107 720. CONCLUSION: Inappropriate ordering of free thyroid hormone tests is common. In an era of rising healthcare costs, inappropriate thyroid function testing is an ideal target for efforts to reduce laboratory overutilization, which in our system, could save up to $120 000 per year. Further evaluation is needed to determine strategies that can reduce excessive thyroid hormone testing