Expérience utilisateur et services publics numériques : Améliorer l'interaction citoyen-administration dans l'ère de la transformation digitale

Cet article explore le rôle central de l'expérience utilisateur dans l'interaction entre les citoyens et l'administration publique à l'ère de la transformation digitale. Il met en avant l'importance de l'expérience utilisateur pour établir la confiance et la satisfaction des citoyens en proposant des services numériques adaptés à leurs besoins et préférences. L'étude analyse également l'impact positif de l'expérience utilisateur sur l'efficacité des processus administratifs en simplifiant les procédures et en réduisant les obstacles bureaucratiques. Des exemples concrets de bonnes pratiques d'interaction citoyen-administration, basées sur l'expérience utilisateur, sont présentés pour illustrer comment une approche centrée sur les utilisateurs peut améliorer la qualité des services publics et renforcer l'engagement des citoyens. Malgré les défis et les contraintes liés à la mise en œuvre de ces principes, tels que les contraintes budgétaires et les réglementations, l'article souligne l'importance cruciale de mettre en place une approche centrée sur les utilisateurs, en s'appuyant sur l'innovation technologique, l'évaluation continue et une réflexion éthique, afin de créer des services publics numériques efficaces, accessibles et axés sur les besoins des citoyens. &nbsp

Organizational change management of digital administration

The recent interest of management researchers in the issue of organizational change is mainly based on its indispensable role in the efficient and effective accompaniment of the administration in its reform and modernization. Organizational change is therefore an imperative for appreciating the benefits of digitalization, a field that is currently expanding and evolving, and is prompting professionals and researchers to analyze and study the digitalization of public services. Although organizational change is considered a central element of any modernization process, it has not been studied beforehand to understand how to implement adequate change management for the technological developments that public organizations are undergoing. This article aims to clarify the concept of organizational change in the context of the digital transformation of public administration through different dimensions and forms, and to present an overview of the elements that play an important role in its success. In the public sector, the resistance of administrators to structural changes is considerable. It is in this perspective that it is essential to prepare the change management of any company or organization before embarking on modernization, digitalization, and redesign of procedures, in order to better support the administration in the success of its organizational and digital transformation. This digital transformation cannot succeed without a real change management approach, which is seen as an essential element of the support of administrations to adapt to change, we will deepen our debate on the subject through the stages of change management and the keys to the success of the latter. The discussion and analysis of the different relationships between organizational change and digital administration have allowed us to propose a comprehensive theoretical framework in order to fundamentally identify multiple areas of future research and contribute to the knowledge of the subject.     JEL Classification: O32 ; O38 Paper type: Theoretical ResearchThe recent interest of management researchers in the issue of organizational change is mainly based on its indispensable role in the efficient and effective accompaniment of the administration in its reform and modernization. Organizational change is therefore an imperative for appreciating the benefits of digitalization, a field that is currently expanding and evolving, and is prompting professionals and researchers to analyze and study the digitalization of public services. Although organizational change is considered a central element of any modernization process, it has not been studied beforehand to understand how to implement adequate change management for the technological developments that public organizations are undergoing. This article aims to clarify the concept of organizational change in the context of the digital transformation of public administration through different dimensions and forms, and to present an overview of the elements that play an important role in its success. In the public sector, the resistance of administrators to structural changes is considerable. It is in this perspective that it is essential to prepare the change management of any company or organization before embarking on modernization, digitalization, and redesign of procedures, in order to better support the administration in the success of its organizational and digital transformation. This digital transformation cannot succeed without a real change management approach, which is seen as an essential element of the support of administrations to adapt to change, we will deepen our debate on the subject through the stages of change management and the keys to the success of the latter. The discussion and analysis of the different relationships between organizational change and digital administration have allowed us to propose a comprehensive theoretical framework in order to fundamentally identify multiple areas of future research and contribute to the knowledge of the subject.     JEL Classification: O32 ; O38 Paper type: Theoretical Researc

Transformer l'administration publique : le leadership agile et l'adaptation au changement technologique

This article thoroughly explores the crucial role of agile leadership and adaptation to technological change in the transformation of public administration. Drawing on recent research, a literature review examines and synthesizes existing research on this topic, highlighting the specific challenges faced by public administrators in the digital age. Additionally, a state-of-the-art analysis provides in-depth exploration of the latest advancements in the digital transformation of public administration, examining current trends, innovative practices, and emerging strategies related to agile leadership and technological adaptation. The study underscores the essential importance of dynamic leadership and organizational change in successfully carrying out digital transformations. To modernize and enhance public sector organizations, decision-makers and managers must adopt an agile approach, anticipate technological advancements, promote innovation, and foster collaboration. Practical recommendations stemming from the literature review and state-of-the-art analysis include creating an environment conducive to change, cultivating an innovation culture, enhancing employees' digital skills, and collaborating with external partners. By investing in effective change management systems and staying at the forefront of technological developments through continuous learning, public sector organizations can fully seize the opportunities presented by digital transformation. In doing so, they can improve operational efficiency, strengthen transparency, and deliver higher-quality public services to citizens. Consequently, this article provides practical recommendations and clear guidance for decision-makers and managers seeking to succeed in their digital transformation processes in the public sector, relying on a solid foundation of knowledge derived from rigorous literature review and state-of-the-art analysis.   Keywords: Digital transformation, agile leadership, technological change, organizational change. JEL Classification: O32; O38 Paper type: Théorical research.  Cet article explore de manière approfondie le rôle crucial du leadership agile et de l'adaptation au changement technologique dans la transformation de l'administration publique. En s'appuyant sur des recherches récentes, une revue de la littérature examine et synthétise les travaux de recherche existants sur ce sujet, mettant en évidence les défis spécifiques auxquels sont confrontés les administrateurs publics à l'ère numérique. D'autre part, un état de l'art explore de manière approfondie les dernières avancées dans le domaine de la transformation digitale de l'administration publique, en examinant les tendances actuelles, les pratiques innovantes et les stratégies émergentes liées au leadership agile et à l'adaptation au changement technologique. L'étude souligne l'importance essentielle du leadership dynamique et du changement organisationnel pour mener à bien les transformations digitales avec succès. Pour moderniser et améliorer les organisations du secteur public, les décideurs et les gestionnaires doivent adopter une approche agile, anticiper les évolutions technologiques, promouvoir l'innovation et encourager la collaboration. Les recommandations pratiques issues de la revue de la littérature et de l'état de l'art comprennent la création d'un environnement propice au changement, la promotion d'une culture d'innovation, le renforcement des compétences numériques des employés et la collaboration avec des partenaires externes. En investissant dans des systèmes de gestion du changement efficaces et en restant à la pointe des évolutions technologiques grâce à un apprentissage continu, les organisations du secteur public peuvent saisir pleinement les opportunités offertes par la transformation digitale pour améliorer leur efficacité opérationnelle, renforcer leur transparence et offrir des services publics de meilleure qualité aux citoyens. Par conséquent, cet article fournit des recommandations pratiques et des orientations claires pour les décideurs et les gestionnaires qui souhaitent réussir leur processus de transformation digitale dans le secteur public, en s'appuyant sur une base solide de connaissances issues d'une revue de la littérature et d'un état de l'art rigoureux   Mots clés : Transformation digitale, leadership agile, changement technologique, changement organisationnel Classification JEL :  O32 ; O38 Type de l’article : Article théoriqu

La transformation digitale de l’administration publique : Revue de littérature systématique

In recent years, many governments have turned to digital as a phenomenon that allows them to provide digital services to users, facilitating access to information and simplifying administrative procedures in order to bring the citizen closer to the public administration In order to appreciate the benefits of digital transformation, it is necessary to implement a strategy to support administrations in their digitalization process. This is why governments have adopted action plans and created monitoring bodies for the digital transformation strategy in order to better manage this revolutionary change in the public sector. This paper aims to synthesize the systematic literature review of the phenomenon of digital transformation and e-government, to analyze the factors influencing this transformation and to identify the obstacles that may arise during the process of digitalization, thus preventing organizations from appreciating the effectiveness and efficiency of this transformation. The research carried out shows that there are several prerequisites and determinants for the success of the digital transformation of the administration (trust, awareness, adoption, agility...). The digital transformation of public administrations would indeed allow the state to integrate the citizen as an actor influencing the reorientation of the vocation of governments, the focus on the satisfaction of the user of public services helps the administrations to customize the digital services provided according to the needs identified among users. Finally, the digitalization strategy adopted must take into account the country's context (legal, infrastructure, organizational, etc.) in order to adopt the appropriate organizational strategy for the success of the digitalization project and the creation of public value.   JEL Classification : O32 ; O38 Paper type: Theoretical Research Durant les dernières années, plusieurs gouvernements se sont orientés vers le digital comme phénomène leur permettant de fournir des services numériques aux usagers facilitant l’accès à l’information et simplifiant les procédures administratives dans le but de rapprocher le citoyen de l’administration publique Dans une optique d’apprécier les avantages de la transformation digitale, la mise en place d’une stratégie accompagnant les administrations dans leurs processus de digitalisation est nécessaire. C’est ainsi que les gouvernements ont adopté des plans d’action et créé des instances de suivi de la stratégie de transformation digitale afin de piloter au mieux ce changement révolutionnaire du secteur public. Ce papier vise à établir une synthèse de la revue de la littérature systématique sur le phénomène de la transformation digitale et de l’e-gouvernement, d’analyser les facteurs influençant cette transformation et d’identifier les obstacles qui peuvent survenir au cours du processus de digitalisation empêchant ainsi les organisations d’apprécier l’efficacité et l’efficience de cette transformation. Les recherches réalisées démontrent qu’il existe plusieurs prérequis et déterminants à la réussite de la transformation digitale de l’administration (confiance, sensibilisation, adoption, agilité...etc). La transformation digitale des administrations publiques permettrait en effet à l’état d’intégrer le citoyen comme acteur influençant la réorientation de la vocation des gouvernements, le centrage sur la satisfaction de l’usager des services publics aide les administrations à personnaliser les services numériques fournis en fonction des besoins identifiés chez les usagers. Enfin la stratégie de digitalisation adoptée doit tenir compte du contexte du pays (juridique, infrastructure, Organisationnelle...etc) afin d’adopter la stratégie organisationnelle adéquate pour la réussite du chantier de digitalisation et la création d’une valeur publique.   Classification JEL: O32 ; O38 Type de l’article : Article théoriqu

Hematological parameters in apparently Healthy Eritrean blood donors at the National Blood Transfusion Center, Asmara, Eritrea.

Introduction: This study was done to measure the Hemoglobin levels, Red Blood Cells count, and Red Blood cell parameters: MCV, MCH, MCHC, RDW, and Hematocrit of the apparently healthy blood donors attending the National Blood Bank of Eritrea. Methods: Blood samples were collected from the peripheral veins into the (EDTA)-tube and examined for Red Blood Cell count (RBC), hemoglobin (Hb), Hematocrit (%), mean cell volume (MCV), mean cell hemoglobin (MCH), mean cell hemoglobin concentration (MCHC), and red cell distribution width (RDW), analyzed and measured by automated blood analyzer. Results: The mean Hemoglobin level was 14.428±1.485 g/dl, RBCs count was 4.744±0.482×1012/L, HCT was 41.929 ±3.75%, Red cell distribution width (RDW) mean was 13.571±0.744%, MCV was 88.582± 4.0558 Fimtoliter, MCH was 30.470±2.188 picogram, and MCHC was a mean of 34.393±1.347g/dl. The difference between males and females in MCV and MCHC was significant in favor of female donors. And a weak positive correlation had been found between the weight and age of donors and the Hemoglobin level. All the measured values were found to be within the global referenced ranges. Conclusion: Hemoglobin, RBCs count and RBCs indices of apparently healthy Eritrean blood donors were measured for reference, and all values were found within normal reference ranges

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

31st Annual Meeting and Associated Programs of the Society for Immunotherapy of Cancer (SITC 2016) : part two

Background The immunological escape of tumors represents one of the main ob- stacles to the treatment of malignancies. The blockade of PD-1 or CTLA-4 receptors represented a milestone in the history of immunotherapy. However, immune checkpoint inhibitors seem to be effective in specific cohorts of patients. It has been proposed that their efficacy relies on the presence of an immunological response. Thus, we hypothesized that disruption of the PD-L1/PD-1 axis would synergize with our oncolytic vaccine platform PeptiCRAd. Methods We used murine B16OVA in vivo tumor models and flow cytometry analysis to investigate the immunological background. Results First, we found that high-burden B16OVA tumors were refractory to combination immunotherapy. However, with a more aggressive schedule, tumors with a lower burden were more susceptible to the combination of PeptiCRAd and PD-L1 blockade. The therapy signifi- cantly increased the median survival of mice (Fig. 7). Interestingly, the reduced growth of contralaterally injected B16F10 cells sug- gested the presence of a long lasting immunological memory also against non-targeted antigens. Concerning the functional state of tumor infiltrating lymphocytes (TILs), we found that all the immune therapies would enhance the percentage of activated (PD-1pos TIM- 3neg) T lymphocytes and reduce the amount of exhausted (PD-1pos TIM-3pos) cells compared to placebo. As expected, we found that PeptiCRAd monotherapy could increase the number of antigen spe- cific CD8+ T cells compared to other treatments. However, only the combination with PD-L1 blockade could significantly increase the ra- tio between activated and exhausted pentamer positive cells (p= 0.0058), suggesting that by disrupting the PD-1/PD-L1 axis we could decrease the amount of dysfunctional antigen specific T cells. We ob- served that the anatomical location deeply influenced the state of CD4+ and CD8+ T lymphocytes. In fact, TIM-3 expression was in- creased by 2 fold on TILs compared to splenic and lymphoid T cells. In the CD8+ compartment, the expression of PD-1 on the surface seemed to be restricted to the tumor micro-environment, while CD4 + T cells had a high expression of PD-1 also in lymphoid organs. Interestingly, we found that the levels of PD-1 were significantly higher on CD8+ T cells than on CD4+ T cells into the tumor micro- environment (p < 0.0001). Conclusions In conclusion, we demonstrated that the efficacy of immune check- point inhibitors might be strongly enhanced by their combination with cancer vaccines. PeptiCRAd was able to increase the number of antigen-specific T cells and PD-L1 blockade prevented their exhaus- tion, resulting in long-lasting immunological memory and increased median survival