Les pratiques du contrôle de gestion face au changement

Face à une économie mondiale caractérisée par l'ouverture des marchés, la libéralisation des échanges et l'avènement des technologies de l'information ; les entreprises sont contraintes de remettre en cause leurs pratiques de contrôle de gestion, ainsi que leur modèle d'organisation afin d'améliorer leur performance et d'être compétitives, condition nécessaire à leur pérennité. L'objet de cette communication consiste à étudier l'évolution des pratiques du contrôle de gestion face aux nouveaux besoins des entreprises qui sont confrontées à une turbulence de leur environnement. L'illustration sera faite à partir d'une validation empirique dans le contexte tunisien.contrôle de gestion; changement organisationnel; performance

Acinetobacter baumannii ventilator-associated pneumonia: epidemiology, clinical characteristics, and prognosis factors

SummaryObjectiveThe aim of this study was to describe the epidemiological characteristics of Acinetobacter baumannii ventilator-associated pneumonia (VAP) and to identify factors predictive of a poor outcome.MethodsA retrospective study was conducted over 16 months in a Tunisian intensive care unit (ICU). All adult patients with A. baumannii VAP were included.ResultsNinety-two patients were included in they study; 41 (44.6%) were admitted because of multiple trauma. The mean age of the patients was 44.5±19.5 years. All patients needed mechanical ventilation on admission. The mean SAPS II score was 39±15. The mean delay before VAP onset was 8.1±4.7 days. On VAP onset, 57 patients (62%) developed septic shock. Only 14.2% of isolated strains were susceptible to imipenem; none were resistant to colistin. The mean duration of mechanical ventilation was 20±11 days. The mean duration of ICU stay was 24.3±18.7 days. ICU mortality was 60.9%. In the multivariate analysis, factors predictive of a poor outcome were previously known hypertension (odds ratio 5.8, 95% confidence interval 1.4–24.9; p=0.018) and VAP-related septic shock (odds ratio 8.5, 95% confidence interval 3–23.7; p<0.001).ConclusionA. baumannii VAP is associated with a high mortality. Hemodynamic impairment is predictive of a poor outcome

Clinical characteristics and outcomes of critically ill COVID-19 patients in Sfax, Tunisia

Background Africa, like the rest of the world, has been impacted by the coronavirus disease 2019 (COVID-19) pandemic. However, only a few studies covering this subject in Africa have been published. Methods We conducted a retrospective study of critically ill adult COVID-19 patients—all of whom had a confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection—admitted to the intensive care unit (ICU) of Habib Bourguiba University Hospital (Sfax, Tunisia). Results A total of 96 patients were admitted into our ICU for respiratory distress due to COVID-19 infection. Mean age was 62.4±12.8 years and median age was 64 years. Mean arterial oxygen tension (PaO2)/fractional inspired oxygen (FiO2) ratio was 105±60 and ≤300 in all cases but one. Oxygen support was required for all patients (100%) and invasive mechanical ventilation for 38 (40%). Prone positioning was applied in 67 patients (70%). Within the study period, 47 of the 96 patients died (49%). Multivariate analysis showed that the factors associated with poor outcome were the development of acute renal failure (odds ratio [OR], 6.7; 95% confidence interval [CI], 1.75–25.9), the use of mechanical ventilation (OR, 5.8; 95% CI, 1.54–22.0), and serum cholinesterase (SChE) activity lower than 5,000 UI/L (OR, 5.0; 95% CI, 1.34–19). Conclusions In this retrospective cohort study of critically ill patients admitted to the ICU in Sfax, Tunisia, for acute respiratory failure following COVID-19 infection, the mortality rate was high. The development of acute renal failure, the use of mechanical ventilation, and SChE activity lower than 5,000 UI/L were associated with a poor outcome

Incidence, mechanisms and impact outcome of hyperglycaemia in severe scorpion-envenomed patients

Hyperglycaemia is often observed in severe scorpion-envenomed patients. It is due to a severe autonomic storm with a massive release of catecholamines, increased glucagon levels, cortisol levels, and either decreased insulin levels or insulin resistance. The presence of hyperglycaemia is an indicator of severity in this specific condition. Indeed, hyperglycaemia was associated with the severity of clinical manifestations of severe scorpion envenomation requiring intensive care unit (ICU) admission. In fact, the presence of hyperglycaemia was associated with the presence of respiratory failure, pulmonary oedema, haemodynamic instability, neurological failure, multisystem organ failure, and an increased mortality and ICU length of stay. As a consequence, we think the presence of hyperglycaemia in scorpion-envenomed patients at the emergency department prompts searching for presence of systemic manifestations or cardiorespiratory manifestations. As a consequence, the presence of hyperglycaemia can help screen severe patients at the emergency department. The current management of severe scorpion envenomation involves the admission and close surveillance in the ICU, where vital signs and continuous monitoring enable early initiation of therapy for life-threatening complications. The use of antivenom for scorpion stings remains controversial. All patients with pulmonary oedema should receive prazosin and possibly dobutamine, according the scorpion’s species. Mechanical ventilation is usually used in severe cases. Insulin should be reserved for severe cases with confirmed excessive hyperglycaemia (>10 mmol/l)

Structural and relaxor behavior in lead-free (Ba0.8Sr0.2)Ti1-x(Zn1/3Nb2/3)(x)O-3 ceramics

International audienceThe Solid solutions of (1-x)Ba0.8Sr0.2TiO3-xBa(Zn1/3Nb2/3)O-3 (BST-BZN) with 0.025 = 0.1 were of relaxor type. It was found that degree of diffuseness and the relaxor effect increased, whereas the transition temperature (T-C or T-m) decreased when both zinc and niobium were introduced in the Ba0.8Sr0.2TiO3 lattice. For the composition with x >= 0.1, the frequency depend on Tm, satisfying the Vogel-Fulcher formula, which indicates a relaxor bahavior. (C) 2016 Published by Elsevier Ltd and Techna Group S.r.l

Synthesis and Characterization of Highly Photocatalytic Active Ce and Cu Co-Doped Novel Spray Pyrolysis Developed MoO3 Films for Photocatalytic Degradation of Eosin-Y Dye

The current work deals with the fabrication of novel MoO3 nanostructured films with Ce and Cu co-doping through the spray pyrolysis route on a glass substrate maintained at 460 &deg;C for the first time. The phase of developed films was approved by an X-ray diffraction study, and the crystallite size was determined between 82 and 92 nm. The optical transmission of the developed films was noticed to be reduced with doping and found between 45 and 90% for all films, and the absorption edge shifted to a higher wavelength with doping. The optical energy gap of the fabricated films was found to be reduced from 3.85 to 3.28 eV with doping. The developed films were used to degrade the harmful Eosin-Y dye under UV light. The system with 2% Ce and 1% Cu-doped MoO3 turned out to be the most effective catalyst for photodegradation of the dye in a period of 3H and almost degrade it. Hence, the MoO3 films prepared with 2% Ce and 1% Cu will be highly applicable as photocatalysts for the removal of hazardous dye from wastewater

Enhancement of dielectric, piezoelectric, ferroelectric, and electrocaloric properties in slightly doped (Na 0.5 Bi 0.5 ) 0.94 Ba 0.06 TiO 3 ceramic by samarium

International audienceWe investigated the structural, dielectric, piezoelectric, ferroelectric, and electrocaloric properties of the samarium doped (Na0.5Bi0.5)(0.94)Ba0.06TiO3 (NBT-6BT) ceramic. X-ray diffraction and Raman spectra confirm the coexistence of the rhombohedral and tetragonal structures for a low amount of Sm (<= 8 mol. %), while the compositions with a higher amount of Sm2O3 (11 mol. %) have a pseudocubic structure. The thermal dependency of the dielectric permittivity revealed two phase transitions from ferroelectric to antiferroelectric at low temperatures, then to paraelectric phase at higher temperatures. The substitution of NBT-6BT with 2 mol. % of Sm2O3 remarkably enhances the ferroelectric and the piezoelectric properties of the (Na0.5Bi0.5)(0.94)Ba0.06TiO3 ceramic. Furthermore, a large electrocaloric effect (Delta T = 1.4K) was directly measured on the ceramic doped with 2 mol. % of Sm2O3 under an applied electric field of 50 kV/cm. Published under license by AIP Publishing

The effect of combined isometric and plyometric training versus contrast strength training on physical performance in male junior handball players

Exploring resistance training methods is crucial for optimizing performance programs. Isometric muscle actions have gained popularity in athletic training, but their impact on dynamic performance is uncertain. Isolated isometric actions also lack ecological validity. We compared the effects of 8-week combined isometric and plyometric (COMB) training and contrast strength training (CST) programs on junior male handball players. Thirty-six male first national division players (17.6 ± 1.0 years) were enrolled and randomly assigned to COMB, CST, or control (CONT) groups (all n = 12). Sprinting, change of direction, ball throwing velocity, jumping, and strength were assessed pre- and post-intervention. A significant group × time interaction was observed between the COMB and CONT groups for 20 and 30 m sprints (p ≤ 0.002) and between the COMB and CST groups (p ≤ 0.042). The COMB group had the largest improvements in change of direction and the modified T-test, with significant group × time interactions between the COMB and CONT groups (p ≤ 0.021). Significant group × time interactions were observed between the COMB and CST groups and between the COMB and CONT groups for 3 step running throw (p = 0.003; p < 0.001), running throw (p = 0.02; p = 0.031), and jumping throw (p = 0.001; p < 0.001). Countermovement jump showed a significant group × time interaction (p = 0.014), with the COMB group outperforming the other groups. Generally, COMB yielded larger improvements than CST. Coaches should consider incorporating a combination of isometric and plyometric exercises for in-season strength training

Effect of post-activation potentiation induced by one, two or three half-squats on repeated sprint acceleration performance

Introduction: The aim of this study was to analyze the effect of different post-activation potentiation (PAP) protocols on initial-acceleration (0-10 m) and late-acceleration phases (10 to 30 m) within a repeated sprint ability (RSA) test. Methods: Twenty athletes (age: 20.8±1.2 years, height: 180.2±5.3 cm, body mass: 76.8±6.4 kg, % body fat: 10.9±2.8, and 3 repetition maximum [3-RM] of half-squats 152.9±14.8 kg) completed 4 testing sessions of RSA testing (7x30-m sprints, starting every 25s, with an active recovery inbetween). Five minutes before the RSA-testing, conditioning protocols were performed: I) one halfsquats at 90% of 1 repetition maximum (1RM) [PAP1]; II) two half-squats at 90% of 1RM [PAP2]; III) three half-squats at 90% of 1RM [PAP3], and (IV) the control protocol [CON]: no effort. Each conditioning condition was applied in a counterbalanced, randomized order on separate days separated by a minimum of 72 hours’ rest. Results: ANOVA showed that PAP1 and PAP2 sessions were similar, and brought significantly improved results for: 0-30m and 0-10m sprints of the RSA-time (p[removed]0.05, ES=small). Furthermore, magnitude-based inference revealed that both PAP1 and PAP2 protocols elicited changes >75% likelihood of exceeding the smallest worthwhile change (>99% likely) for mean sprint-time (RSAmean) and the percentage of sprint-decrement (RSAdec) in overall 0-30 m and 0-10 m of the RSA test. Conclusion: PAP1 and PAP2 exert a positive effect on the initial-acceleration phase of the RSA and could be considered in the preparation routine of repeated sprinting activities. © 2018, CIC Edizioni Internazionali s.r.l. All rights reserved.Scopu