Formation et résolution de problèmes en groupe dans un milieu organisationnel : un schéma d’observation et d’analyse

L'auteur étudie le processus de formation et de résolution de problèmes en groupe dans un milieu organisationnel en mettant en évidence le rôle de la phase « identification » de ce processus.The process of identifying and solving problems in groups in an organization is a very complex phenomenon because of the numerous variables involved.The most important attempts to link the organization, the decision making process, and the decision maker can be found in the literature pertaining to organization theory and management. Paradoxically, most of the models developed show little interest for group decision making despite the fact that this type of decision making is rapidly increasing in popularity in organizations. Moreover, it is quite astonishing to notice that hardly any of the models have formally emphasized the key part played by the means used to identify problems in an attempt to explain the group decision making process. In this article, we shall stress the identification phase of the process of identifying and solving problems in groups in an organizational setting. Our study does not constitute an overview of the literature; rather, it is the expression of a viewpoint which emanates from the relevant literature.Each individual perceives the decision making process through his own set of coloured lenses. Like Piaget, we perceive it as a constant state of adaptation in which a person assimilates new knowledge and facts, and adjusts his behavior accordingly. In this context, the person interprets the present and anticipates the future according to his perception of the world around him: in other words, the person is not passively reacting to this environment ; rather, he interacts with it according to his way of seeing it. Furthermore, no two persons perceive the world around them in the same fashion because their backgrounds and antecedents differ. Consequently, we must admit that individual differ in their interpretation of the real world, as well as in the perception of the problems it brings forth.Organizations exist because people believe they produce synergy: one way of achieving this synergy is through the division of work, the attribution of roles to individuals, and the organization of the lot into a coherent whole. This whole is made up of jobs which contain both a socio-technical aspect as well as a social one. The social element reflects the informal relationships which take place within the organizations. As can be seen, formal contacts create informal groups which exist on account of similarities in jobs, interest and values, or on account of individual and social affinities, or again on account of the meshing of personalities. Thus it is inevitable that these emotional, motivational and political elements influence not only the perceptions of the world, but also the interpretations made by the various individuals or groups.Problems in an organization do not originate exclusively from the informal social relationships which occur within it ; the socio-technical element mentioned previously also causes difficulties. For instance, when jobs involving several people and requiring that a decision be made have to be carried out, it is easy to understand that certain difficulties will arise, and that the latter will be all the more burdensome that the jobs are poorly defined and unstructured. The individuals have to contend with two major obstacles. The first one is cognitive, and results from the fact that, given the same data, people do not necessarily reach the same conclusions. The second obstacle is emotional and motivational in character, and often leads to divergent preferences with respect to at leastone aspect of the final decision; the problem solving process in groups is therefore complicated further. In fact, a problem arises when something abnormal occurs; the solution to the problem can thus be seen as the use of various means in order to return to a state of normality. Since each person perceives and identifies problems by referring to the world around him as he sees it, a state of normality or abnormality is defined by him according to his own frame of reference.Bearing in mind the above considerations pertaining to the organization and to the human being, the problem solving process in groups can be described by the following propositions :• The various ways of perceiving the problem can be more or less blurry, and coincide to a greater or lesser extent ;• For every perception of normality or abnormality, there are several admissible solutions:• The greater the degree of coincidence among the various perceptions of the problem, the larger the number of admissible solutions which also coincide, and the easier it is to find a solution acceptable by all ;• The admissible solutions are not necessarily all known; furthermore, some of the admissible solutions are unacceptable ;• A perception of abnormality constrains a person within a set of admissible solutions. To avoid solutions which are admissible but unacceptable, one must discern between the personal perception and the stated perception of a problem ;• There are always at least two levels of problem solving; for each level, the ways and means of moving from an abnormal state to a normal state do not require the same rationality.The above propositions constitute the basic starting point in the establishment of a contingency table which clearly illustrates problem situations and anticipated resulting from efforts put forth by the group at the « identification » and«  solution » phases of the problem solving process (table 1).At the end of this paper, we mention other pertinent considerations suggested by our model ; these considerations involve various tactics commonly used in problem solving situations. Here is a partial list of tactics used by a specific negotiator:• To compel the largest number possible of members of the problem solving group to state as soon as possible their perceptions of the problem in order to confine them to a small number of admissible solutions. These who get caught in such a fashion lose a certain amount of leeway vis-à-vis the other members of the group because they have committed themselves before the others have expressed their point of view.• To avoid stating his perception of the problem early in order to preserve his amount of leeway for later on; in other words, commit yourself as late as possible if you wish to benefit from the largest amount of information possible.• To identify those group members whose perception of the problem seems most fuzzy, and attempt to influence their perception in such a way that it becomes similar to y ours; by doing so, you will eventually obtain their support.• To state a perception of the problem which is directly linked to the solution which you prefer; here you are merely putting to good advantage the sequence in the causal chain.• To attempt to show that the solution which you prefer is compatible with the way the other members perceive the problem. In short, indicate clearly that your solution is admissible when you take into account the normality expressed by the others.• To devise a solution not y et considered by the group, but which would stimulate its interest and be compatible with the stated perception of the problem expressed by the others.• To try to bring together the others' perception of the problem and your own by showing that the other members of the group :(a) took into account irrelevant data,(b) ignored or minimized the importance of key elements.• To weaken the credibility of the stated perception of the problems expressed by the others.• To attempt to demonstrate that an admissible solution suggested by a member of the group which does not appeal to you leads to a weak or faulty means-end relationship.• To say that you wish to clarify your stated perception of the problem in order to modify it in such a way that it becomes compatible with some of the solutions suggested by the others and which you are willing to accept.• To break down the problem into sub-problems which are almost independent, in hopes that the latter will be easier to solve

La complémentarité des approches systémique et scientifique dans le domaine des sciences humaines.

La notion de « système » est largement utilisée dans le domaine des relations industrielles, et cela, depuis fort longtemps. Elle implique un mode de reconstitution de la réalité différent de l'approche causale linéaire sur laquelle se fonde la méthodologie de la recherche empirique. Au lieu d'accentuer les différences entre ces deux modes de réflexion, les auteurs de cet article tentent de démontrer qu'ils sont complémentaires pour l'acquisition des connaissances dans le domaine des sciences humaines.In the field on human sciences, the researcher is constantly faced with numerous and difficult methodological problems. Moreover, the methods and techniques, on which he can count, often come from other disciplines and their application to human sciences is not without creating some difficulties.Particularly in the case of human sciences one can notice in the passed years, the proliferation of a certain literature said to be « systemic ». Such a situation interested the researchers of those fields who, generally, must cope with very complex phenomena and, consequently, are in search of methods better adapted to their problems and capable of maintaining a high degree of scientific exactness.However, a survey of this literature is worrysome. Beside the writing of which only the title is systemic, it is remarkable to notice the atmosphere of near-religion surrounding this literature: the reader has the impression to be in presence of a second« Discours de la Méthode ». This type of pro-systemic literature has raised many categorical antagonists (D.C. Phillips, 1969, 1972; F. Thayer, 1972). This literature is criticized because of its unpreciseness, its prejudice toward the scientific method, the low predictive value of the models conceived from the approach explosed in this literature. Some will even pretend that the Systems approach has nothing to offer that has not been already offered by the scientific method.Is the traditional scientific method obsolete? Is it opposed to the Systems approach? If such is the case, where can we find such an opposition? On the other hand, if there is no real opposition between those two approaches, is it possible that they could be complementary and/or have specific fields of application? Such questions are at the origin of this paper.This paper does not pretend to give a complete and definitive answer to those questions. It merely tries to gather around two main topics (The concept of « connection » and of « reconstruction of reality ») some elements of an answer scattered throughout literature. Moreover, an analysis of the complementarity of the two approaches is made with the help of a model inspired from cognitive psychology.The scientific method is born from the preoccupation of certain men facing a mode of knowledge acquisition favoring almost exclusively exploration and cristalisation, using a mode of knowledge transmission based on intellectual authoritarianism. The mode of acquisition of this era (and this was the problem facing Descartes) abandoned the rigour of the realisation and specification phases. The scientific method has had so much success (the theories were so numerous), that, for a long time, we mingled scientific method with method of acquisition of knowledge.This fashion for Systems approach anses from the necessity to take up, in a rigourous manner, the study of the first two dimensions of the cognitive process. Without a well devined System and a verifiable structure, a verification method loses its meaning.We must notice the fact that many of the supporters of the Systems approach were recruited in some new scientific fields, where phenomena are highly complex and finalised. These scientists were forced to acknowledge the limits of the scientific method.According to us, the Systems approach completes the scientific method. On one hand, it enlarges the universe of the phenomena that could be studied; on the other hand, it furnishes the descriptive tools permitting the formulation of a frame of reference for the investigated problems. The Systems approach constitutes a serious effort, while still unperfect, to develop a method of exploration. The scientific method and the Systems approach, together, constitute a research methodology which, for the first time, matches the totality of the steps of the cognitive process

Les changements technologiques: Une stratégie d'étude exploratoire

Cet article présente une stratégie d'investigation reliée à l'implantation de changements technologiques dans les milieux syndiqués.Two distinct categories can be established in the field of exploratory studies. First, there are studies on subjects that are relevant but which, for various reasons, have been left more or less unexplored. The second category of exploratory studies comes above the first category since these studies revolve around issues which relevance has not been yet supported in a way that would justify thorough consideration and adéquate investment, even if a certain form of argumentation could be elaborated on their potential interest. To work with the second category of exploratory studies, it is necessary to create an approach that will confïrm or invalidate their potential interest and, in the case of a confirmation, determine the orientation of the subsequent studies.A problem may arise from the use of the last mentioned category of stratégies. When these strategies do confirm the potential interest of the studies, they have to be given up for other strategies that are best suited to carry out the research. Consequently, new resources as well as additional time are required. In both scientifically and professionally oriented fields, this problem could have a negative impact since the researches carried out in these fields often give rise to more immediate concerns and expectations. In our opinion, the problem arising from this discontinuity is not necessarily unavoidable.In this article, our objective is to set out and examine an investigation strategy that we already used to tackle a problem falling in the second category of exploratory studies and relating to the implementation of technological changes in unionized environments.This strategy uses concepts such as «concrete action System», «power», and «uncertainty zone» which form the basis of the theory of organizations elaborated by Crozier and Friedberg (1977). This approach avoids the discontinuity problem previously mentioned and indicates interesting investigation paths, when such paths exist. Moreover, it does not require a large investment at the beginning of the research. Finally, it seems to us that this strategy can easily be used and adapted for several research problems that arise in the field of relations in the workplace

Etude des connaissances, attitudes et pratiques en matière de réintégration sociale des femmes victimes de fistule obstétricale: région de l’Extrême-nord, Cameroun

Introduction: la fistule obstétricale est un orifice entre le vagin et la vessie ou le rectum, voire les deux. Ses impacts sont des conséquences anatomo-fonctionnelles et sociales. On estime à plus de 19 000 le nombre de femmes qui souffrent de fistule obstétricale au Cameroun. Méthodes: il s'agissait d'une étude transversale descriptive conduite dans trois districts de santé de la région de l'Extrême-nord. Vingt-huit femmes victimes de fistules obstétricales, quarante-deux membres de leur entourage et vingt-quatre agents de santé ont été interviewés entre Novembre et Décembre 2013. Trois types de questionnaires ont été utilisés. Les données ont été analysées dans Epi Info version 7.1.4.0. Les moyennes et les fréquences ont été calculées avec un intervalle de confiance à 95%. Résultats: 46,4% des femmes victimes de fistule obstétricales interviewées avaient subi une intervention chirurgicale réparatrice parmi lesquelles, 61,5% bénéficiaient de la réintégration. Le fonds de commerce (62,5%) était l'aide la plus reçue. Vingt-deux membres de l'entourage savaient pourquoi on fait la réintégration. Selon eux, les considérations socioculturelles (68,2%), sont la principale barrière de la réintégration. D'après les agents de santé, le suivi psychosocial (58,3%) est la principale activité de la réintégration dans les centres de prise en charge de la fistule. Conclusion: la prise en charge des fistules obstétricales au Cameroun souffre de manque de réintégration sociale. Ceci expliquerait en partie la persistance de cette pathologie. Un accent devrait être mis sur l'appui matériel, financier et sur le suivi psychosocial des femmes victimes de fistule obstétricale

The utilisation of health research in policy-making: Concepts, examples and methods of assessment

The importance of health research utilisation in policy-making, and of understanding the mechanisms involved, is increasingly recognised. Recent reports calling for more resources to improve health in developing countries, and global pressures for accountability, draw greater attention to research-informed policy-making. Key utilisation issues have been described for at least twenty years, but the growing focus on health research systems creates additional dimensions. The utilisation of health research in policy-making should contribute to policies that may eventually lead to desired outcomes, including health gains. In this article, exploration of these issues is combined with a review of various forms of policy-making. When this is linked to analysis of different types of health research, it assists in building a comprehensive account of the diverse meanings of research utilisation. Previous studies report methods and conceptual frameworks that have been applied, if with varying degrees of success, to record utilisation in policy-making. These studies reveal various examples of research impact within a general picture of underutilisation. Factors potentially enhancing utilisation can be identified by exploration of: priority setting; activities of the health research system at the interface between research and policy-making; and the role of the recipients, or 'receptors', of health research. An interfaces and receptors model provides a framework for analysis. Recommendations about possible methods for assessing health research utilisation follow identification of the purposes of such assessments. Our conclusion is that research utilisation can be better understood, and enhanced, by developing assessment methods informed by conceptual analysis and review of previous studies

Cause of Death and Predictors of All-Cause Mortality in Anticoagulated Patients With Nonvalvular Atrial Fibrillation : Data From ROCKET AF

M. Kaste on työryhmän ROCKET AF Steering Comm jäsen.Background-Atrial fibrillation is associated with higher mortality. Identification of causes of death and contemporary risk factors for all-cause mortality may guide interventions. Methods and Results-In the Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation (ROCKET AF) study, patients with nonvalvular atrial fibrillation were randomized to rivaroxaban or dose-adjusted warfarin. Cox proportional hazards regression with backward elimination identified factors at randomization that were independently associated with all-cause mortality in the 14 171 participants in the intention-to-treat population. The median age was 73 years, and the mean CHADS(2) score was 3.5. Over 1.9 years of median follow-up, 1214 (8.6%) patients died. Kaplan-Meier mortality rates were 4.2% at 1 year and 8.9% at 2 years. The majority of classified deaths (1081) were cardiovascular (72%), whereas only 6% were nonhemorrhagic stroke or systemic embolism. No significant difference in all-cause mortality was observed between the rivaroxaban and warfarin arms (P=0.15). Heart failure (hazard ratio 1.51, 95% CI 1.33-1.70, P= 75 years (hazard ratio 1.69, 95% CI 1.51-1.90, P Conclusions-In a large population of patients anticoagulated for nonvalvular atrial fibrillation, approximate to 7 in 10 deaths were cardiovascular, whereasPeer reviewe

A global experiment on motivating social distancing during the COVID-19 pandemic

Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges

Albiglutide and cardiovascular outcomes in patients with type 2 diabetes and cardiovascular disease (Harmony Outcomes): a double-blind, randomised placebo-controlled trial

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarction, or stroke. Methods: We did a double-blind, randomised, placebo-controlled trial in 610 sites across 28 countries. We randomly assigned patients aged 40 years and older with type 2 diabetes and cardiovascular disease (at a 1:1 ratio) to groups that either received a subcutaneous injection of albiglutide (30–50 mg, based on glycaemic response and tolerability) or of a matched volume of placebo once a week, in addition to their standard care. Investigators used an interactive voice or web response system to obtain treatment assignment, and patients and all study investigators were masked to their treatment allocation. We hypothesised that albiglutide would be non-inferior to placebo for the primary outcome of the first occurrence of cardiovascular death, myocardial infarction, or stroke, which was assessed in the intention-to-treat population. If non-inferiority was confirmed by an upper limit of the 95% CI for a hazard ratio of less than 1·30, closed testing for superiority was prespecified. This study is registered with ClinicalTrials.gov, number NCT02465515. Findings: Patients were screened between July 1, 2015, and Nov 24, 2016. 10 793 patients were screened and 9463 participants were enrolled and randomly assigned to groups: 4731 patients were assigned to receive albiglutide and 4732 patients to receive placebo. On Nov 8, 2017, it was determined that 611 primary endpoints and a median follow-up of at least 1·5 years had accrued, and participants returned for a final visit and discontinuation from study treatment; the last patient visit was on March 12, 2018. These 9463 patients, the intention-to-treat population, were evaluated for a median duration of 1·6 years and were assessed for the primary outcome. The primary composite outcome occurred in 338 (7%) of 4731 patients at an incidence rate of 4·6 events per 100 person-years in the albiglutide group and in 428 (9%) of 4732 patients at an incidence rate of 5·9 events per 100 person-years in the placebo group (hazard ratio 0·78, 95% CI 0·68–0·90), which indicated that albiglutide was superior to placebo (p<0·0001 for non-inferiority; p=0·0006 for superiority). The incidence of acute pancreatitis (ten patients in the albiglutide group and seven patients in the placebo group), pancreatic cancer (six patients in the albiglutide group and five patients in the placebo group), medullary thyroid carcinoma (zero patients in both groups), and other serious adverse events did not differ between the two groups. There were three (<1%) deaths in the placebo group that were assessed by investigators, who were masked to study drug assignment, to be treatment-related and two (<1%) deaths in the albiglutide group. Interpretation: In patients with type 2 diabetes and cardiovascular disease, albiglutide was superior to placebo with respect to major adverse cardiovascular events. Evidence-based glucagon-like peptide 1 receptor agonists should therefore be considered as part of a comprehensive strategy to reduce the risk of cardiovascular events in patients with type 2 diabetes. Funding: GlaxoSmithKline

Measurement of the cross-section for Z → e⁺e^- production in pp collisions at &#8730;<span style="text-decoration:overline">s</span>=7 TeV

A measurement of the cross-section for pp → Z → e+e− is presented using data at s√=7 TeV corresponding to an integrated luminosity of 0.94 fb−1. The process is measured within the kinematic acceptance p T &#62; 20 GeV/c and 2 &#60; η &#60; 4.5 for the daughter electrons and dielectron invariant mass in the range 60–120 GeV/c 2. The cross-section is determined to be σ(pp→Z→e+e−)=76.0±0.8±2.0±2.6pb where the first uncertainty is statistical, the second is systematic and the third is the uncertainty in the luminosity. The measurement is performed as a function of Z rapidity and as a function of an angular variable which is closely related to the Z transverse momentum. The results are compared with previous LHCb measurements and with theoretical predictions from QCD