Évaluation des effets de la collaboration interprofessionnelle chez les professionnels et chez les patients dans les unités d'hospitalisation en oncologie et en hématologie

Thèse numérisée par la Direction des bibliothèques de l'Université de Montréal

Analytical Model of Socio-Technical Sustainability of Dynamic Hypermedia Devices

Este artículo presenta un modelo analítico de sostenibilidad de redes socio-técnicas para la construcción colaborativa de conocimiento en contextos institucionales y organizacionales. El objetivo se centra en fundamentar una perspectiva teórica-metodológica a partir de la noción de “dispositivo hipermedial dinámico” (DHD). En lo metodológico, desde un posicionamiento sociotécnico, se realiza una revisión de los principales debates y perspectivas teóricas sobre la expansión de TIC en relación a la problemática a tratar. Luego se desarrollan propositivamente las componentes del modelo de sostenibilidad-DHD siguiendo sus cuatro dimensiones: social, institucional, tecnológica y textual. El diseño del modelo, no jerárquico y relacional, se estima a su vez beneficioso para orientar el proceso constructivo de este tipo de dispositivos. Además, puede colaborar de manera flexible para analizar transformaciones socio-tecnológicas en diversos contextos situados. Finalmente, la consistencia de los resultados analíticos a alcanzar podría ser efectiva, ya que es posible vincular: el carácter dinámico, relacional e interactivo de las características de una tecnología; las tensiones sociales y políticas existentes en el marco socio-institucional donde se desarrolla; las posibles formas de diseño participativo, en función de los requerimientos de una institución u organización; y la producción colaborativa en red, promoviendo responsabilidades de gestión organizacional.Este artigo apresenta um modelo analítico de sustentabilidade de redes sociotécnicas para a construção colaborativa de conhecimento em contextos institucionais/organizacionais. O objetivo é focado na fundamentação de uma perspectiva teórico-metodológica a partir da noção de “dispositivo hipermedial dinâmico” (DHD). No metodológico, a partir de um posicionamento sociotécnico, é feita uma revisão dos principais debates e perspectivas teóricas sobre a expansão de TIC em relação à problemática a ser tratada. Depois, são desenvolvidos propositivamente os componentes do modelo de sustentabilidade-DHD seguindo suas quatro dimensões: social, institucional, tecnológica e textual. O design do modelo, não hierárquico e relacional, é também considerado propício para orientar o processo construtivo deste tipo de dispositivos. Além disso, pode colaborar de forma flexível para analisar transformações sociais tecnológicas em diversos contextos. Finalmente, a consistência dos resultados analíticos a serem alcançados poderia ser efetiva, pois é possível vincular: o caráter dinâmico, relacional e interativo das características de uma tecnologia; as tensões sociais e políticas existentes no plano social institucional onde é desenvolvido; as possíveis formas de design participativo, em função dos requerimentos de uma instituição ou organização; e a produção colaborativa em rede, promovendo responsabilidades de gestão organizacional.This paper presents an analytical model of sustainable socio-technical networks for the collaborative knowledge building in organizational/institutional contexts. Its objective focuses on supporting a theoretic-methodological perspective based on the idea of a “dynamic hypermedia device” (DHD). With regard to the methodological aspect, from a socio-technical position, the main debates and theoretical perspectives about the expansion of information and communication technologies pertinent to the issue to be discussed are reviewed. Then the components of the sustainability-DHD model are developed proactively, following its four dimensions: social, institutional, technological and textual. The design of the model, nonhierarchical and relational, is considered beneficial to guide the building process of these kinds of devices. In addition, it can collaborate in a flexible way in order to analyze the sociotechnological transformations in diverse situational contexts. Finally, the consistency of the analytical results to be reached could be effective, since it is possible to connect: the dynamic, relational and interactive aspects of the technology’s characteristics; the social and political tensions within the socio-institutional framework in which it develops; the possible ways of participative design, as a function of the institution or organization’s requirements; and the networked collaborative production, promoting organizational management responsibilities.Fil: Andres, Gonzalo Dario. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto Rosario de Investigaciones en Ciencias de la Educación. Universidad Nacional de Rosario. Instituto Rosario de Investigaciones en Ciencias de la Educación; ArgentinaFil: San Martin, Patricia Silvana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto Rosario de Investigaciones en Ciencias de la Educación. Universidad Nacional de Rosario. Instituto Rosario de Investigaciones en Ciencias de la Educación; ArgentinaFil: Rodriguez, Guillermo L.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto Rosario de Investigaciones en Ciencias de la Educación. Universidad Nacional de Rosario. Instituto Rosario de Investigaciones en Ciencias de la Educación; Argentin

Presence-DHD as an Event in the Physical-Virtual Educational Context

El artículo propone un recorrido reflexivo que posibilite la co-construcción de prácticas educativas mediatizadas considerando procesos de socialización del patrimonio cultural. Su objetivo es proponer la noción “Presencialidad-DHD” (Presencialidad en el Dispositivo Hipermedial Dinámico) como clave de dichas prácticas. Desde un recorrido filosófico que vincula los términos Identidad, Memoria y Patrimonio, y la noción de redes socio-técnicas-culturales, se argumenta desde una propuesta realizada en el dispositivo digital Creativa Monumento por estudiantes de nivel secundario. Finalmente, frente a quienes entienden lo presencial sólo como asistencia física de los cuerpos en un lugar común, considerar la presencialidad como acontecimiento, invita al ejercicio del saber ha-ser.The article proposes a reflective journey that enables the co-construction of mediated educational practices considering processes of socialization of cultural heritage. Its objective is to propose the notion “Presence-DHD” (Presence in the Dynamic Hypermedia Device) as a key to these practices. From a philosophical journey that links the terms Identity, Memory and Heritage, and the notion of socio-technical-cultural networks, it is argued from a process carried out in the Creative Monument digital device by secondary school students. Finally, for those who understand face to face only as physical assistance of bodies in a common place, considering presence as an event invites the exercise of knowing how to be.Fil: San Martin, Patricia Silvana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto Rosario de Investigaciones en Ciencias de la Educación. Universidad Nacional de Rosario. Instituto Rosario de Investigaciones en Ciencias de la Educación; ArgentinaFil: Pettinari, Roque Jesús Antonio. Colegio Polivalente No 2009; ArgentinaFil: Rodriguez, Guillermo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto Rosario de Investigaciones en Ciencias de la Educación. Universidad Nacional de Rosario. Instituto Rosario de Investigaciones en Ciencias de la Educación; Argentin

Presence-DHD as an Event in the Physical-Virtual Educational Context

El artículo propone un recorrido reflexivo que posibilite la co-construcción de prácticas educativas mediatizadas considerando procesos de socialización del patrimonio cultural. Su objetivo es proponer la noción “Presencialidad-DHD” (Presencialidad en el Dispositivo Hipermedial Dinámico) como clave de dichas prácticas. Desde un recorrido filosófico que vincula los términos Identidad, Memoria y Patrimonio, y la noción de redes socio-técnicas-culturales, se argumenta desde una propuesta realizada en el dispositivo digital Creativa Monumento por estudiantes de nivel secundario. Finalmente, frente a quienes entienden lo presencial sólo como asistencia física de los cuerpos en un lugar común, considerar la presencialidad como acontecimiento, invita al ejercicio del saber ha-ser.The article proposes a reflective journey that enables the co-construction of mediated educational practices considering processes of socialization of cultural heritage. Its objective is to propose the notion “Presence-DHD” (Presence in the Dynamic Hypermedia Device) as a key to these practices. From a philosophical journey that links the terms Identity, Memory and Heritage, and the notion of socio-technical-cultural networks, it is argued from a process carried out in the Creative Monument digital device by secondary school students. Finally, for those who understand face to face only as physical assistance of bodies in a common place, considering presence as an event invites the exercise of knowing how to be.Fil: San Martin, Patricia Silvana. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto Rosario de Investigaciones en Ciencias de la Educación. Universidad Nacional de Rosario. Instituto Rosario de Investigaciones en Ciencias de la Educación; ArgentinaFil: Pettinari, Roque Jesús Antonio. Colegio Polivalente No 2009; ArgentinaFil: Rodriguez, Guillermo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Rosario. Instituto Rosario de Investigaciones en Ciencias de la Educación. Universidad Nacional de Rosario. Instituto Rosario de Investigaciones en Ciencias de la Educación; Argentin

DNA end resection requires constitutive sumoylation of CtIP by CBX4

DNA breaks are complex DNA lesions that can be repaired by two alternative mechanisms: non-homologous end-joining and homologous recombination. The decision between them depends on the activation of the DNA resection machinery, which blocks non-homologous end-joining and stimulates recombination. On the other hand, post-translational modifications play a critical role in DNA repair. We have found that the SUMO E3 ligase CBX4 controls resection through the key factor CtIP. Indeed, CBX4 depletion impairs CtIP constitutive sumoylation and DNA end processing. Importantly, mutating lysine 896 in CtIP recapitulates the CBX4-depletion phenotype, blocks homologous recombination and increases genomic instability. Artificial fusion of CtIP and SUMO suppresses the effects of both the non-sumoylatable CtIP mutant and CBX4 depletion. Mechanistically, CtIP sumoylation is essential for its recruitment to damaged DNA. In summary, sumoylation of CtIP at lysine 896 defines a subpopulation of the protein that is involved in DNA resection and recombination

11C-Methionine-PET in multiple myeloma: a combined study from two different institutions

$^{11}$C-methionine (MET) has recently emerged as an accurate marker of tumor burden and disease activity in patients with multiple myeloma (MM). This dual-center study aimed at further corroboration of the superiority of MET as positron emission tomography (PET) tracer for staging and re-staging MM, as compared to $^{18}$F-2`-deoxy-2`-fluoro-D-glucose (FDG). 78 patients with a history of solitary plasmacytoma (n=4), smoldering MM (SMM, n=5), and symptomatic MM (n=69) underwent both MET- and FDG-PET/computed tomography (CT) at the University Centers of Würzburg, Germany and Navarra, Spain. Scans were compared on a patient and on a lesion basis. Inter-reader agreement was also evaluated. In 2 patients, tumor biopsies for verification of discordant imaging results were available. MET-PET detected focal lesions (FL) in 59/78 subjects (75.6%), whereas FDG-PET/CT showed lesions in only 47 patients (60.3%; p<0.01), accordingly disease activity would have been missed in 12 patients. Directed biopsies of discordant results confirmed MET-PET/CT results in both cases. MET depicted more FL in 44 patients (56.4%; p<0.01), whereas in two patients (2/78), FDG proved superior. In the remainder (41.0%, 32/78), both tracers yielded comparable results. Inter-reader agreement for MET was higher than for FDG (κ = 0.82 vs κ = 0.72). This study demonstrates higher sensitivity of MET in comparison to standard FDG to detect intra- and extramedullary MM including histologic evidence of FDG-negative, viable disease exclusively detectable by MET-PET/CT. MET holds the potential to replace FDG as functional imaging standard for staging and re-staging of MM

Neutrophil Function in Elderly Patients Hospitalized with Community- Acquired Pneumonia

Background: Advanced age is associated with immunosenescence as well as increased risk for poor outcomes during episodes of community-acquired pneumonia (CAP). Data on neutrophil function in hospitalized elderly patients with CAP is lacking. In this study we compared neutrophil function in elderly and non-elderly hospitalized patients with CAP. Methods: Prospective study of healthy controls (HC) and patients hospitalized with CAP nonelderly (NE-CAP) and elderly (E-CAP). Blood samples were obtained on the day of hospitalization. The following neutrophil functional assays were performed: degranulation of secretory vesicles (CD35), degranulation of specific granules (CD66b), phagocytosis, and hydrogen peroxide (H2O2) production. The Mann-Whitney U-test was used to compare differences in neutrophil function. Results: A total of 12 HC, 28 NE-CAP, and 12 E-CAP were evaluated. There were no significant differences between NE-CAP and E-CAP patients in regard to CD35 expression (p=0.465), CD66b expression (p=0.601), phagocytosis (p=0.654), or H2O2 production (p=0.541) Conclusions: We failed to demonstrate any significant difference in neutrophil function in nonelderly versus elderly patients hospitalized with CAP in relation to membrane expression of CD35 and CD66b, phagocytosis, and respiratory burst. Abnormal neutrophil function is unlikely to be an important component of the immunosenescence described in elderly patients with CAP

Neutrophil function in elderly patients hospitalized with community-acquired pneumonia.

Background: Advanced age is associated with immunosenescence as well as increased risk for poor outcomes during episodes of community-acquired pneumonia (CAP). Data on neutrophil function in hospitalized elderly patients with CAP is lacking. In this study we compared neutrophil function in elderly and non-elderly hospitalized patients with CAP. Methods: Prospective study of healthy controls (HC) and patients hospitalized with CAP nonelderly (NE-CAP) and elderly (E-CAP). Blood samples were obtained on the day of hospitalization. The following neutrophil functional assays were performed: degranulation of secretory vesicles (CD35), degranulation of specific granules (CD66b), phagocytosis, and hydrogen peroxide (H2O2) production. The Mann-Whitney U-test was used to compare differences in neutrophil function. Results: A total of 12 HC, 28 NE-CAP, and 12 E-CAP were evaluated. There were no significant differences between NE-CAP and E-CAP patients in regard to CD35 expression (p=0.465), CD66b expression (p=0.601), phagocytosis (p=0.654), or H2O2 production (p=0.541) Conclusions: We failed to demonstrate any significant difference in neutrophil function in nonelderly versus elderly patients hospitalized with CAP in relation to membrane expression of CD35 and CD66b, phagocytosis, and respiratory burst. Abnormal neutrophil function is unlikely to be an important component of the immunosenescence described in elderly patients with CAP