L’influence de l’environnement de travail sur la satisfaction et l’intention entrepreneuriale des ingénieurs

In this article, we present a model of entrepreneurial intention of engineers based on their satisfaction at work and the nature of their work environment. The research was carried out using a sample of 517 Moroccan engineers through moderated mediation analysis. Results show that an unfavorable environment has a negative effect on satisfaction at work and that this effect is felt more by the engineers who are driven by a strong sense of self-determination. Results also reveal that the effect of the work environment on entrepreneurial intention, through job satisfaction, also depends on perceived feasibility. Theoretical and managerial implications of this research are discussed

Unknown Inputs Nonlinear Observer for an Activated Sludge Process

This paper deals with the jointly estimation problem of unknown inputs and nonmeasured states of one altering aerated activated sludge process (ASP). In order to provide accurate and economic concentration measures during aerobic and anoxic phases, a cascade high gain observer (HGO) approach is developed. Only two concentrations are available; the other process’s states are assumed unavailable. The observer converges asymptotically and it leads to a good estimation of the unavailable states which are the ammonia and substrate concentration, as well as a quite reconstruction of the unknown inputs, which are the influent ammonia and the influent substrate concentrations. To highlight the efficiency of the proposed HGO with this MIMO system’s dynamics, simulation results are validated with experimental data

Analysis of Risk Factors for Patient Safety Events Occurring in the Emergency Department

Objective : The aim of the study was to describe and analyze the risk factors associated with patient safety events (PSEs), defined as adverse events (AEs), preventable AEs (PAEs), and near-miss events (NMEs), in the emergency department (ED). Methods : It was a retrospective cohort study using ED patients’ data retrieved from January 2010 to December 2016. Quality assurance issues (QAIs) used as triggers included the following: issues during procedural sedation, death within 24 hours of admission, patients’ and physicians’ complaints, returns to the ED within 72 hours, and transfers to an intensive care unit within 24 hours. Results : Of 383,586 ED visits, 6519 (1.7%) QAIs were reported with a PSEs incidence of 6.1%. Among the 397 PSEs, 258 were AEs including 82 PAEs, and 139 NMEs. During the 7-year period, we observed a fourfold increase in NMEs, and despite a decrease in the rate of AEs with the highest (3.1%) and lowest (0.8%) incidence in 2011 and 2016, respectively, the incidence of PAEs events remained relatively constant. Unadjusted analysis showed that ED waiting time, boarding time, ED length of stay (LOS), ED disposition, as well as diagnostic and QAIs were significantly related to PSEs (P < 0.05). Multivariable analysis showed that the type of QAIs and diagnostic were associated with PSEs (P < 0.001). Type of QAIs was a risk factor for AEs and PAEs occurrence and factors involved in NMEs were type of QAIs (P = 0.02) and ED LOS (P < 0.001). “The odds of a PSE occurring increased by 0.2% for each additional minute increase in the ED waiting time, by 5.2% for each additional boarding hour, and by 4.5% for each ED LOS hour.” Conclusions : This study showed several potential risk factors for PSEs, especially ED LOS, type of QAIs, and diagnostic. Systematic interventions might have more impact on risk of PSE

The association between emergency department length of stay and in-hospital mortality in older patients using machine learning : an observational cohort study

The association between emergency department (ED) length of stay (EDLOS) with inhospital mortality (IHM) in older patients remains unclear. This retrospective study aims to delineate the relationship between EDLOS and IHM in elderly patients. From the ED patients (n = 383,586) who visited an urban academic tertiary care medical center from January 2010 to December 2016, 78,478 older patients (age >= 60 years) were identified and stratified into three age subgroups: 60-74 (early elderly), 75-89 (late elderly), and >= 90 years (longevous elderly). We applied multiple machine learning approaches to identify the risk correlation trends between EDLOS and IHM, as well as boarding time (BT) and IHM. The incidence of IHM increased with age: 60-74 (2.7%), 75-89 (4.5%), and >= 90 years (6.3%). The best area under the receiver operating characteristic curve was obtained by Light Gradient Boosting Machine model for age groups 60-74, 75-89, and >= 90 years, which were 0.892 (95% CI, 0.870-0.916), 0.886 (95% CI, 0.861-0.911), and 0.838 (95% CI, 0.782-0.887), respectively. Our study showed that EDLOS and BT were statistically correlated with IHM (p < 0.001), and a significantly higher risk of IHM was found in low EDLOS and high BT. The flagged rate of quality assurance issues was higher in lower EDLOS <= 1 h (9.96%) vs. higher EDLOS 7 h < t <= 8 h (1.84%). Special attention should be given to patients admitted after a short stay in the ED and a long BT, and new concepts of ED care processes including specific areas and teams dedicated to older patients care could be proposed to policymakers