Vers un changement de pratique dans une filière céréalière : apport de la modélisation de l’environnement

National audienceProject management, especially in the field of sustainable development, requires to take into account not only the working environment stricto sensu, but also supra components of environmental, social, economic, legislative, etc. Ergonomists and psychologists are then led to be interested in, and to develop modeling frameworks to better understand and to make more intelligible this complex environment. The study presented here, which requires taking into account this environment, aims at setting up a novel practice for improving the food safety of a cereal chain in a global context of sustainable development: protection of the environment (flora and fauna) and the health of farmers and consumers. As part of this study, a quick fungal contamination diagnostic tool and a corresponding decontamination process have been developed for an application in the barley-malt-beer food chain. However, the use of these processes may change the agricultural practices in antifungal treatments with the regular and high dose treatments replaced by fine targeted applications only where and when necessary. In relation with this technological development, the challenge is to identify the components of the environment that may become brakes and levers to the implementation of this new practice. In this scope, this investigation mobilizes the modeling of the environment of Thatcher and Yeow (2016). This paper is consequently aimed at presenting the underlying process to this construction, and this in relation with the characteristics of the study. At last, a discussion is initiated concerning the further use of such modelling practices for purposes other than the decision-making processes on ergonomic intervention purposes.L’intervention ergonomique dans le champ du développement durable requiert la prise en compte d’un environnement dépassant largement l’environnement de travail afin d’y intégrer des composants relevant de dimensions environnementales, économique, législative, etc. Les ergonomes et psychologues ergonomes sont alors conduits à développer des cadres de modélisation permettant d’appréhender et de rendre davantage intelligible cet environnement complexe. L’étude sur laquelle nous nous basons ici s’inscrit dans ce cadre et vise l’identification des freins et leviers à la mise en place d’une nouvelle pratique en matière de traitement antifongique pour la filière orge-malt-bière. Pour cette investigation, nous nous référons notamment à la modélisation de Thatcher et Yeow (2016). L’enjeu est de présenter le processus de recueil et d’analyse sous-jacente à la modélisation et de poursuivre par une réflexion quant à l’emploi de ces formes de modélisation au cours d’un processus d’intervention

A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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Diagnosis of mild bleeding disorders

The precise diagnosis of a severe haemorrhagic disorder is usually not too problematic. However, physicians are most often faced with individuals consulting for mild haemorrhagic symptoms, particularly occurring after a surgical intervention. The problem here is to evaluate whether this person really has a bleeding disorder requiring special investigations and treatments, particularly if another invasive procedure is planned. The key point is to ask the appropriate questions to discriminate bleeding occurring in normal subjects from that occurring in patients with haemostatic disorders. Recently, bleeding questionnaires allowing the calculation of bleeding scores have been proposed. Although they have some limitations, they are of help to better define and quantify the bleeding symptoms and to guide in the choice of selecting laboratory testing. This review focuses on inherited and not on acquired bleeding disorders

Very Long Term Stability of Mixed Chimerism after Allogeneic Hematopoietic Stem Cell Transplantation in Patients with Hematologic Malignancies

The objective of this study is to analyze the evolution of chimerism of all patients transplanted for hematologic malignancies in our unit during a 20-year period, alive without relapse at 1 year after allogeneic hematopoietic stem cell transplantation (HSCT). Chimerism was tested using short tandem repeat polymorphisms after separation into mononuclear cells and granulocytes by Ficoll density gradient centrifugation. Of 155 patients studied, 89 had full chimerism (FC), 36 mononuclear cells mixed chimerism (MNC-MC), and 30 granulocytic MC with or without mononuclear cells MC (Gran-MC). Survival was significantly better in MNC-MC than in Gran-MC patients, with FC patients being intermediate. There was more disease relapse in the Gran-MC group but not in the MNC-MC group as compared to FC. MC was stable up to 21 years in the MNC-MC group and up to 19 years in the Gran-MC group. Of MC patients alive at 10 years, MC persisted in 83% in the MNC-MC and 57% in the Gran-MC groups. In conclusion, mixed chimerism may remain stable over a very long time period. In survivors without relapse at 1 year after HSCT, determining lineage specific chimerism may be useful as outcome differs, MNC-MC being associated with better outcome than Gran-MC

Promoting Self-Management in Adults with Type 2 Diabetes: Development of the Impact of Glucose Monitoring on Self-Management Scale

International audienceObjectives: Type 2 diabetes (T2D) management requires behavioural engagement to achieve optimal outcomes and continuous glucose monitoring (CGM) technologies may facilitate self-management. In this study we describe the development and validation of a self-report instrument, the Impact of Glucose Monitoring on Self-Management Scale (IGMSS), assessing the impact of device use (primarily CGM but also self-monitored blood glucose [SMBG]) on the capability, motivation, and opportunity to engage in self-management. Methods: Potential items were generated from 3 sources: themes and quotes from 13 adults with T2D motivated by CGM use who participated in a qualitative study; behaviour change theory identifying capability, opportunity, and motivation to self-manage; and expert committee review of items. An initial pool of 42 items were generated describing CGM as promoting personalized knowledge, improved health (Capability), improved relationships, having positive device characteristics (Opportunity), and improved engagement in self-management (Motivation). Based on expert committee consensus, items were written so as to be completed by those using any glucose-sensing device (SMBG and CGM). Psychometric evaluation was conducted with 514 English-speaking Canadians. Scale reduction (22 final items) was completed using item-response distribution, internal consistency, factor analysis, and expert opinion. Construct and convergent validity were evaluated using the Impact of Glucose Monitoring Satisfaction Scale, the Diabetes Self-Management Questionnaire, the Diabetes Distress Scale, the 5-item World Health Organization Well-Being Index, and the Centre for Epidemiology Depression Scale. Test–retest reliability was determined for 130 participants. Results: Internal consistency was high for all scales, ranging from 0.73 to 0.91. Test–retest reliability ranged from 0.58 to 0.79, except for Device Characteristics. Construct and convergent validity indices were acceptable. There was substantial overlap between the IGMSS and established measures of CGM satisfaction. IGMSS findings were also predictive of self-management behaviour and emotional functioning. Conclusions: The IGMSS has positive psychometric characteristics and has the potential to screen people with T2D for engagement in diabetes self-management using CGM or any sensing device. Scores can be determined for various aspects of Capability (Personalized Knowledge, Improved Health), Opportunity (Relationships and Device Characteristics), and Motivation

Impact de l’interdisciplinarité : le cas d’un projet dans le champ du développement durable.

National audienceImpact de l'interdisciplinarité : le cas d'un projet dans le champ du développement durable. Résumé. Les universités promeuvent les recherches pluridisciplinaires par exemple à travers les appels PEPS (Projet Exploratoire Premier Soutien). Dans le cadre de cette communication il sera question de l'incidence d'une recherche interdisciplinaire sur la production des chercheurs et le processus d'intervention. Le projet s'inscrit dans le champ du développement durable, il s'agit de promouvoir l'emploi de procédés écologiques en matière de traitements antifongiques pour la filière orge-malt-bière. Mots-clés : Introduction et stratégies pour la conduite du changement Impact of interdisciplinarity: the case of a project in the field of sustainable development. Abstract. Universities promote multidisciplinary research for example through Project Exploratory first support calls. The purpose of this communication is to study the impact of interdisciplinary research on the production of the researchers and the intervention process. The study is in the field of sustainable development, it is to promote the use of ecological processes in antifungal treatment for the barley-malt-beer industry

Impact de l’interdisciplinarité : le cas d’un projet dans le champ du développement durable.

National audienceImpact de l'interdisciplinarité : le cas d'un projet dans le champ du développement durable. Résumé. Les universités promeuvent les recherches pluridisciplinaires par exemple à travers les appels PEPS (Projet Exploratoire Premier Soutien). Dans le cadre de cette communication il sera question de l'incidence d'une recherche interdisciplinaire sur la production des chercheurs et le processus d'intervention. Le projet s'inscrit dans le champ du développement durable, il s'agit de promouvoir l'emploi de procédés écologiques en matière de traitements antifongiques pour la filière orge-malt-bière. Mots-clés : Introduction et stratégies pour la conduite du changement Impact of interdisciplinarity: the case of a project in the field of sustainable development. Abstract. Universities promote multidisciplinary research for example through Project Exploratory first support calls. The purpose of this communication is to study the impact of interdisciplinary research on the production of the researchers and the intervention process. The study is in the field of sustainable development, it is to promote the use of ecological processes in antifungal treatment for the barley-malt-beer industry

A novel frameshift mutation in FGA (c.1846 del A) leading to congenital afibrinogenemia in a consanguineous Syrian family

Congenital afibrinogenemia is a rare autosomal recessive coagulation disorder characterized essentially by bleeding symptoms, but miscarriages and, paradoxically, thromboembolic events can also occur. Most reported mutations leading to congenital afibrinogenemia are located in FGA encoding the fibrinogen A α-chain. In this study, we analysed 12 individuals from a consanguineous Syrian family with reduced or absent fibrinogen levels: those with fibrinogen levels around 1 g/l (n = 7) were found to be heterozygous for a novel frameshift mutation in FGA exon 5 (c.1846 del A) and those with undetectable fibrinogen levels (n = 5) were homozygous for the same mutation. This novel frameshift mutation is the most C-terminal causative FGA mutation identified to date in afibrinogenemic patients. The resulting aberrant Aα-chain (p.Thr616HisfsX32) is most likely synthesized, but is less efficiently assembled and/or secreted into the circulation given the phenotype of asymptomatic hypofibrinogenemia in heterozygous individuals and bleeding diathesis in homozygous individuals