Gouvernance de l'information: définition, enjeux et perspectives en Ville de Genève

La gouvernance de l’information est de plus en plus implantée dans les entreprises du monde anglo-saxon, et progressivement dans certaines administrations publiques pour faire face aux défis croissants de la gestion de l’information. Les Archives de la Ville de Genève ont souhaité mener une réflexion sur la gouvernance de l’information au sein d’une organisation telle que la Ville de Genève, alors que le records management y est déjà en vigueur. A travers un état de l’art, nous définissons les concepts de gouvernance, d’information et de gouvernance de l’information, puis le positionnons face au records management. Notre démarche est exploratoire. Nous avons choisi de nous inspirer du modèle de maturité de gouvernance de l’information Generally Accepted Records Keeping de ARMA dont nous avons sélectionné quatre des huit principes préconisés : la responsabilité, la conformité, la conservation, la disposition. Nous avons élaboré des indicateurs, inspirés du modèle et tenté de les adapter à la réalité du terrain. Nous avons estimé que l’approche ne pouvait être que systémique, dans la mesure où nous n’envisagions pas d’effectuer d’étude comparative, ni de contrôler si les correspondante-s archives et records management accomplissaient la tâche qui leur incombe. Le souhait a été de comprendre à travers les mécanismes de gouvernance, si l’alignement entre les directives édictées et la réalité était possible et de mettre en lumière les écueils éventuels. Pour ce faire, nous commençons par étudier la structure organisationnelle et informationnelle de l’Administration municipale à travers la description des structures que nous considérons comme parties prenantes d’un programme de gouvernance de l’information. Nous avons choisi de nous concentrer sur un service avancé dans le programme de records management mis en place par les Archives de la Ville de Genève. Les entretiens menés d’une part avec la correspondante archives et records management du service Voirie-Ville Propre, et d’autre part avec la Directrice du Département de l’Environnement urbain et de la sécurité, ont permis de mettre en évidence certains risques. Enfin, nous proposons trois recommandations d’ordre stratégique (mise en place d’une politique de gouvernance, réflexion sur l’implantation d’une instance centrale de l’information, et dans l’intervalle, nomination d’un responsable de l’information au sein de la Direction du département), et une recommandation d’ordre opérationnel (outils de management), que nous résumons à travers une matrice RACI

Preregistration research training of speech and language therapists in the United Kingdom: a nationwide audit of quantity, content and delivery

AIM: To carry out an audit of the quantity and content of research teaching on UK preregistration speech and language therapy (SLT) degree programmes. METHOD: Lecturers delivering research teaching from each higher education institution providing preregistration training were invited to complete an online survey. QUESTIONS INCLUDED: Amount of research teaching, content of research teaching (including final-year projects), perceived confidence by staff of graduates in research awareness, research activity and leading research. Responses were received for 14 programmes (10 undergraduate and four postgraduate), representing 73% of all undergraduate courses and 44% of all postgraduate courses in the United Kingdom. RESULTS: Fifty percent of courses included over 30 h of research teaching, with wide variability across both undergraduate and postgraduate courses in number of hours, modules and credits devoted to research. There was no association between quantity of research teaching and perception of adequacy of quantity of teaching. Critical appraisal, statistical software and finding literature were the most common topics taught. Conversely, service evaluation and audit was the least common topic covered. All institutions provided a final-year project, with 11/14 requiring empirical research. Perceived confidence of graduates was higher for research awareness than active research and leading research, but this varied across institutions. There was a strong correlation between lecturers' perceived confidence of graduates in research awareness and number of hours of research teaching. CONCLUSION: Despite the requirements for healthcare professionals to engage in evidence-based practice, the amount and nature of research training in preregistration courses for SLTs in the United Kingdom is highly variable. Levels of perceived confidence of graduates were also variable, not only for active participation in research, and for leading research, but also for research awareness. This has implications for the ability of SLTs to use and embed research in their routine clinical practice

Factors influencing parent satisfaction in a children's emergency department: Prospective questionnaire-based study

Objective: To identify the factors considered by parents to be most important in determining overall satisfaction with care in a children's emergency department, and to assess whether these factors are influenced by the child's age and triage category. Design: A prospective questionnaire-based study of parents attending a paediatric emergency department with their child. Setting: Bristol Royal Hospital for Children, Bristol, UK. Participants: The parent or next of kin adult accompanying a child to the emergency department during the study period. Outcome measures: The primary outcome measure was the response to the questionnaire. The secondary outcome analysed responses according to the child's age and triage category. Results: During the sampling period questionnaires were distributed to the parent or accompanying adult of 247 children, of which 225 (91%) were completed. The most important factors were: a clear explanation of the child's diagnosis and treatment plan; the ability of a parent to stay with their child at all times; rapid and adequate pain relief; and staff attitude. These factors significantly outranked waiting times and other process issues. The age and triage category of the child did not influence these preferences. Conclusion: Despite recent emphasis on waiting times and emergency department throughput in the UK, parents still value the clinical interaction above process issues when their child visits an emergency department. Current efforts to reduce the time spent by children in an emergency department must not undermine the core service values that are most appreciated by parents, and which will lead to the greatest satisfaction

Dressings and topical agents for arterial leg ulcers

Background: It is estimated that up to 1% of people in high-income countries suffer from a leg ulcer at some time in their life. The majority of leg ulcers are associated with circulation problems; poor blood return in the veins causes venous ulcers (around 70% of ulcers) and poor blood supply to the legs causes arterial ulcers (around 22% of ulcers). Treatment of arterial leg ulcers is directed towards correcting poor arterial blood supply, for example by correcting arterial blockages (either surgically or pharmaceutically). If the blood supply has been restored, these arterial ulcers can heal following principles of good wound-care. Dressings and topical agents make up a part of good wound-care for arterial ulcers, but there are many products available, and it is unclear what impact these have on ulcer healing. This is the third update of a review first published in 2003. Objectives: To determine whether topical agents and wound dressings affect healing in arterial ulcers. To compare healing rates and patient-centred outcomes between wound dressings and topical agents. Search methods: The Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register, Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature and Allied and Complementary Medicine databases, the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov trials register to 28 January 2019. Selection criteria: Randomised controlled trials (RCTs), or controlled clinical trials (CCTs) evaluating dressings and topical agents in the treatment of arterial leg ulcers were eligible for inclusion. We included participants with arterial leg ulcers irrespective of method of diagnosis. Trials that included participants with mixed arterio-venous disease and diabetes were eligible for inclusion if they presented results separately for the different groups. All wound dressings and topical agents were eligible for inclusion in this review. We excluded trials which did not report on at least one of the primary outcomes (time to healing, proportion completely healed, or change in ulcer area). Data collection and analysis: Two review authors independently extracted information on the participants' characteristics, the interventions, and outcomes using a standardised data extraction form. Review authors resolved any disagreements through discussion. We presented the data narratively due to differences in the included trials. We used GRADE to assess the certainty of the evidence. Main results: Two trials met the inclusion criteria. One compared 2% ketanserin ointment in polyethylene glycol (PEG) with PEG alone, used twice a day by 40 participants with arterial leg ulcers, for eight weeks or until healing, whichever was sooner. One compared topical application of blood-derived concentrated growth factor (CGF) with standard dressing (polyurethane film or foam); both applied weekly for six weeks by 61 participants with non-healing ulcers (venous, diabetic arterial, neuropathic, traumatic, or vasculitic). Both trials were small, reported results inadequately, and were of low methodological quality. Short follow-up times (six and eight weeks) meant it would be difficult to capture sufficient healing events to allow us to make comparisons between treatments. One trial demonstrated accelerated wound healing in the ketanserin group compared with the control group. In the trial that compared CGF with standard dressings, the number of participants with diabetic arterial ulcers were only reported in the CGF group (9/31), and the number of participants with diabetic arterial ulcers and their data were not reported separately for the standard dressing group. In the CGF group, 66.6% (6/9) of diabetic arterial ulcers showed more than a 50% decrease in ulcer size compared to 6.7% (2/30) of non-healing ulcers treated with standard dressing. We assessed this as very-low certainty evidence due to the small number of studies and arterial ulcer participants, inadequate reporting of methodology and data, and short follow-up period. Only one trial reported side effects (complications), stating that no participant experienced these during follow-up (six weeks, low-certainty evidence). It should also be noted that ketanserin is not licensed in all countries for use in humans. Neither study reported time to ulcer healing, patient satisfaction or quality of life. Authors' conclusions: There is insufficient evidence to determine whether the choice of topical agent or dressing affects the healing of arterial leg ulcers

Rigorous software design for nano and micro satellites using BIP framework

The CubETH satellite mission, a cooperative Swiss CubeSat mission involving ETH Zurich, EPF Lausanne, several universities of applied sciences, and Swiss companies, will allow technology demonstrations and proof-of-concepts concerning GNSS-based navigation information by carrying five patch antennas, each connected to two independent u-blox NEO-7N receivers. These very small, commercially available low-cost receivers are able to track single-frequency code and phase data of all the major GNSS, i.e. GPS, GLONASS, QZSS, Galileo and Beidou. The main science objective for the CubETH mission is to investigate precise orbit determination strategies using COTS hardware. The mission shall also demonstrate new technologies, applicable in the field of small satellites. In this work, we focus mostly on development of robust flight software for small and nano satellites. During the Swisscube project there were numerous problems with validation and verification of the flight software code. The software has to be adapted to the hardware architecture selected for every new satellite mission. While commercial tools exist to help with the issue, subject of robust software development was not addressed by the cubesat community, mostly due to lack of resources. Some projects simply structure their code in C/C++ and then extensively test it, maybe using some analysis tools such as "Lint" [5]. This is an helpful tool to find some design errors, but it does not guarantee that the software behavior is the desired one. Others use SysML/UML tools to describe the system as a whole and then check some properties such as energy consumption. SysML can be a valid tool for system engineering as a whole, but it is not rigorous enough to allow automatic software behavior verification and validation. In this project the “Behavior Interaction Priority” BIP framework will be used to design the software running in the control and data management subsystem (CDMS) of CubETH. The BIP framework has been developed by the Verimag laboratory in Grenoble university and is currently used in the EPFL by the "Rigorous System Design Laboratory" (RISD). We have designed and modeled a full software architecture using this framework to formally verify our software. We will present lessons learned and problems that were encountered during the development

Identification of nuclear genes responsible for respiratory chain disorders in childhood.

The primary aim of this work was to identify novel mutations in genes that cause mitochondrial disorders. Due to the clinical and genetic heterogeneity among these patients, a variety of analytical approaches were used. In patients from pedigrees which exhibited maternal inheritance or in whom cybrid cell studies indicated a mitochondrial mutation, mitochondrial DNA (mtDNA) was sequenced. A novel mutation in a subunit of complex I (ND3) was identified in a patient with cardiomyopathy. The functional relationship between mutant load and complex I activity, lactate/pyruvate ratios and oxygen consumption was investigated. However, the pathogenic status of this mutation remains uncertain. Where a mtDNA mutation had been excluded or other factors such as consanguinity suggested involvement of a nuclear gene, results from respiratory chain (RC) enzyme assays were used to prioritise candidate genes for sequence analysis. A homozygous G555E mutation was discovered in the flavoprotein subunit of succinate dehydrogenase in a patient with late-onset Leigh syndrome and complex II deficiency. Another patient has previously been described with the same mutation but presented with a substantially more severe lethal infantile form of the disease. Fibroblast cultures derived from both patients were used to compare the activities and stability of RC enzymes in order to explain this phenotypic variability. In consanguineous pedigrees where analysis of candidate genes had proved unsuccessful, homozygosity mapping was used to search for novel nuclear genes involved with mitochondrial disorders. A novel gene for complex I deficiency was mapped to 5 genetic regions in an Israeli family using the new 10K SNP chip from Affymetrix. Analysis of eight candidate genes (including NDUFV2 and AFG3L2) was negative. In another highly consanguineous Israeli pedigree with mtDNA depletion, microsatellite analysis was used to narrow a candidate region on chromosome 13 down to 20Mb. A complex rearrangement was found in this region in a gene called SUCLA2. This gene codes for a citric acid cycle protein, which is thought to affect mitochondrial nucleotide pools via an interaction with nucleoside diphosphate kinase. Mutations in the gene for mitochondrial DNA polymerase gamma were found in 13/17 paediatric patients in the majority of whom Southern blots had indicated depletion of mtDNA, and also in a three-generation pedigree with premature external ophthalmoplegia associated with early menopause

Population Movement and State Building: A Case Study of Migratory Policies in Italy

The current study examines Italian laws and policies around migratory movements since Italy first became a modern nation state in 1861 up until April 2019, when the research was concluded. This paper is a case study of Italian migratory policies. It first looks at the way Italy’s early efforts at nation building coincided with the mass emigration of its citizens, informing its policies on emigration and colonial expansion. The study then analyzes the way in which Italy developed a policy response to the growing immigrant and refugee population in the late 1980s following geo-political transformations in Europe. The evolution of Italy’s reactive immigration laws, which went from addressing the presence of foreigners as a temporary labor necessity to a more permanent political phenomenon, stemmed from its ambitions at situating itself as a founding member of the European Union. The thesis grapples with the fact that although Italy’s current response to the European migrant crisis has invited controversy for its seemingly restrictive and punitive measures, its response is part of a larger historical continuum, in which Italy’s socio-legal infrastructure reflects its attempt to define a national identity in opposition to demographic panic

Understanding dressing evaluation: A pragmatist perspective

This thesis shed light on the complexities of dressing evaluation. Dressings are categorised as medical devices and as such manufacturers are not required to provide evidence of effectiveness. Instead, they promote their products by offering clinicians samples to try during their clinical work. Researchers using trial methodologies have been unable to provide a clinically helpful body of evidence. Placed within the movement critiquing Evidence-Based Practice, this thesis brings the discussion to the world of dressing evaluation, where an alternative methodology is proposed. This study takes inspiration from John Dewey’s pragmatic philosophy; based on experimentalism, clinician’s experience is given a key place within a structured inquiry and offers a vision for the development of this important branch of wound care. This offers a unique contribution to knowledge. In order to understand the world of dressing evaluation, the study begins with the collection of qualitative data, with focus group and interviews with seven Tissue Viability Nurses and two Pharmacists. Having gained an insight into the way dressing evaluations are undertaken in clinical practice, the data inform a subsequent, mixed-methods study, with participant observation, interviews and review of documents take place with ten patients, thirty-one nurses, one orthopaedic surgeon and five trauma sisters. Using this newly designed methodology, a PHMB foam dressing is evaluated in the care of pin sites, enabling the development of a clinical protocol that has since been adopted regionally. This offers a unique contribution to practice

What works, how and in which contexts when supporting parents to implement intensive speech and language therapy at home for children with speech sound disorder? A protocol for a realist review

Introduction Speech and Language Therapists (SLTs) worldwide report challenges with providing recommended, evidence-based intervention intensity for children with speech sound disorder (SSD). Challenges such as service constraints and/or family contexts impact on access to optimal therapy intensity. Existing research indicates that empowering and training parents to deliver intervention at home, alongside SLT support, offers one possible solution to increasing the intensity of intervention children with SSD receive. Digital health could increase accessibility to intensive home-practise and help sustain engagement with therapy activities. Further exploration is needed around what makes parent-implemented interventions for children with speech sound disorder effective, for who, in which situations. This paper outlines the protocol for a realist review which aims to explore the active ingredients and contextual factors of effective digital parent-led interventions.Methods and analysis A realist review will explore the research question, following six stages. The scope of the review will be determined, and initial programme theories will be developed about what works in digital parent-implemented interventions for SSD, for whom, how, why, and in what circumstances. Relevant secondary data, identified through a formal search strategy, will be selected, appraised, analysed, and synthesised using realist principles to test and further refine the initial programme theories. This process will develop refined underpinning explanatory theories which capture the interaction between contexts, mechanisms, and outcomes of the intervention. An expert steering group will provide insight to inform explanatory theories, searches, and dissemination.Ethics and dissemination Ethical approval is not required for this review. The refined programme theories from the review will inform the next stages of a wider study. A subsequent realist evaluation will test and further refine theories with key stakeholders. Following this, the underpinning programme theory will be used to co-produce a digital tool, to support parents to deliver home-intervention alongside SLT support. <br/