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L’expérience infirmière en psychiatrie et santé mentale : enquête sur les dynamiques de professionnalisation et de construction du rapport au métier
No full textThis research confronts the concerns surrounding the professionalisation of psychiatric and mental health nurses. It takes place in a financed context through its implementation as a CIFRE programme (research and training agreement). As its sponsor, the mental health care facility of the Lille Metropolitan area has set up a plan called “professionalisation and tutoring” in order to complete nurses’ initial training, judged insufficient since the psychiatric nurses’ degree and its associated training were shut down in 1992. The plan’s significance is analysed through three levels and from a comprehensive approach. The first level regards its situation in the historical and cultural evolution of the professional group. The second, that which concerns the plan’s actors getting involved to make it work. The final level refers to the neo-nurses appropriation of the educative work instituted by the plan. It is shown that the plan expresses an intention of (re)professionalising the social group by establishing a relation between work and training. This third level is used as an analytical line allowing the study of how, in neo-nurses’ experience, the relationship with the craft is built. The theme of violence in psychiatry is also examined through the relation between work and training to study how it is taken into account in the nurses’ practices. Finally, the typicality of this research, financed by a sponsor’s funds, implies that it has to deal with a system of expectations composed of different levels. Here, the researcher is made to consider its involvement and give an interventionist dimension by training some actors of the field.Cette recherche traite des préoccupations de professionnalisation des infirmiers en psychiatrie et santé mentale. Elle s’inscrit dans un contexte commandité via sa mise en œuvre en convention industrielle de formation par la recherche (CIFRE). Commanditaire de ce travail, l’établissement public de santé mentale Lille-Métropole a développé un dispositif dit de « professionnalisation et tutorat » pour compléter une formation initiale jugée insuffisante après que le diplôme d’infirmier de secteur psychiatrique, et la formation y conduisant, aient été supprimés en 1992. La portée de ce dispositif est analysée à trois échelles, à partir d’une démarche compréhensive. D’abord, celle de son inscription dans l’évolution historico-culturelle du groupe professionnel. Ensuite, celle des acteurs mobilisés pour son fonctionnement. Enfin, celui de son appropriation par les néo-infirmiers destinataires de ce travail éducatif institué par le dispositif. Il est montré que le dispositif exprime une intention de (re)professionnalisation du groupe social par l’institution d’une relation entre travail et formation. Celle-ci est mobilisée comme axe analytique permettant d’examiner comment, dans l’expérience des néo-infirmiers, se construit le rapport au métier. La question de la violence en psychiatrie est aussi examinée à l’aune de cette relation pour étudier la manière dont elle est prise en compte dans les pratiques infirmières. Enfin, le caractère commandité de cette recherche la positionne dans un système d’attentes à plusieurs niveaux. Le chercheur est alors conduit à penser son implication et lui donner une dimension interventionniste, ceci par la formation de certains acteurs du terrain
Sequential variable neighborhood descent variants: an empirical study on the traveling salesman problem
No full textInternational audienceIn a single local search algorithm, several neighborhood structuresare usually explored. The simplest way is todefine a single neighborhood as the union of all predefined neighborhood structures; the other possibility is tomake an order (or sequence) of the predefined neighborhoods,and to use them in the first improvement or thebest improvement fashion, following that order. In this work, first we classify possible variants of sequentialuse of neighborhoods and then, empirically analyze them in solving the classical traveling salesman problem(TSP). We explore the most commonly used TSP neighborhood structures, such as 2-opt and insertionneighborhoods. In our empirical study, we tested 76 differentsuch heuristics on 15,200 random test instances.Several interesting observations are derived. In addition, the two best of 76 heuristics (used as local searcheswithin a variable neighborhood search) are tested on 23 test instances taken from the TSP library (TSPLIB).It appears that the union of neighborhoods does not perform well
High-throughput sequencing in acute lymphoblastic leukemia: Follow-up of minimal residual disease and emergence of new clones
No full textInternational audienceMinimal residual disease (MRD) is known to be an independent prognostic factor in patients with acute lymphoblastic leukemia (ALL). High-throughput sequencing (HTS) is currently used in routine practice for the diagnosis and follow-up of patients with hematological neoplasms. In this retrospective study, we examined the role of immunoglobulin/T-cell receptor-based MRD in patients with ALL by HTS analysis of immunoglobulin H and/or T-cell receptor gamma chain loci in bone marrow samples from 11 patients with ALL, at diagnosis and during follow-up. We assessed the clinical feasibility of using combined HTS and bioinformatics analysis with interactive visualization using Vidjil software. We discuss the advantages and drawbacks of HTS for monitoring MRD. HTS gives a more complete insight of the leukemic population than conventional real-time quantitative PCR (qPCR), and allows identification of new emerging clones at each time point of the monitoring. Thus, HTS monitoring of Ig/TCR based MRD is expected to improve the management of patients with ALL
Differential Privacy for Bayesian Inference through Posterior Sampling
No full textInternational audienceDifferential privacy formalises privacy-preserving mechanisms that provide access to a database. Can Bayesian inference be used directly to provide private access to data? The answer is yes: under certain conditions on the prior, sampling from the posterior distribution can lead to a desired level of privacy and utility. For a uniform treatment, we define differential privacy over arbitrary data set metrics, outcome spaces and distribution families. This allows us to also deal with non-i.i.d or non-tabular data sets. We then prove bounds on the sensitivity of the posterior to the data, which delivers a measure of robustness. We also show how to use posterior sampling to provide differentially private responses to queries, within a decision-theoretic framework. Finally, we provide bounds on the utility of answers to queries and on the ability of an adversary to distinguish between data sets. The latter are complemented by a novel use of Le Cam's method to obtain lower bounds on distinguishability. Our results hold for arbitrary metrics, including those for the common definition of differential privacy. For specific choices of the metric, we give a number of examples satisfying our assumptions. *. A preliminary version of this paper appeared in Algorithmic Learning Theory 2014 (Dimitrakakis et al., 2014). This version corrects proofs, constant factors in the upper bounds and introduces new material on utility analysis, lower bounds and examples
Distribution des emplois et identification des centres d'affaires : une approche non paramétrique
No full textNous étudions la distribution des emplois sur la métropole lilloise afin d'identifier les principaux centres d'affaires et caractériser la forme urbaine de cette aggloméra-tion. Il ne s'agit pas seulement de repérer les communes avec des niveaux d'emplois élevés, mais celles qui exercent aussi une influence significative sur la distribution des emplois. Nos résultats confirment la structure polycentrique de l'agglomération lilloise et nous trouvons que la commune de Roubaix (parfois accompagnée par Tourcoing) se distingue par une centralité importante. En moyenne, l'éloignement d'un sous-centre d'affaires d'un kilomètre diminue la densité d'emploi de près de 20%. L'identification des sous-centres d'affaires est importante car ces zones d'emploi influencent les déci-sions de localisation des acteurs économiques, et sont donc à prendre en compte dans l'élaboration des politiques urbaines. La difficulté technique consiste à séparer l'effet du centre ville (le principal centre d'affaires) de l'effet des multiples sous-centres. Comme le révèle notre application empirique, les approches non paramétriques sont plus efficaces que les approches paramétriques
