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Aguir, Mohamed Salah. "Modèles stochastiques pour l'aide à la décision dans les centres d'appels". Phd thesis, Ecole Centrale Paris, 2004. http://tel.archives-ouvertes.fr/tel-00376312.
Pełny tekst źródłaDans la première partie de ce travail, nous étudions le phénomène de rappels. Nous commençons, d'abord, par montrer son importance dans le système. Par la suite, nous montrons que le fait d'ignorer ce phénomène engendre beaucoup d'erreurs lors du dimensionnement du centre d'appels et se traduit par des objectifs non satisfaits ou par un système surdimensionné sujet à des coûts supplémentaires. Cette analyse concerne le régime stationnaire. L'étude du système multi-période aboutit, elle, à la détermination de l'évolution de la demande réelle en fonction du temps et ce, à partir des arrivées observées.
Dans la deuxième partie, nous commençons par proposer des estimateurs du temps d'attente que les clients doivent passer dans la file avant d'être servis et ce, pour des clients répartis en plusieurs classes de priorité non-préemptive. En fonction de ces estimateurs, nous étudions plusieurs règles de routage. Nous comparons le système composé de plusieurs files d'attente, et nécessitant donc un routage, avec le système où les files d'attente sont fusionnées. Nous terminons cette partie par une analyse de deux disciplines de priorités probabilistes et nous les comparons avec la discipline de la priorité stricte. Comme dans le cas du routage, la comparaison s'effectue en fonction du nombre de conseillers nécessaires à la satisfaction de qualités de service objectif pour chaque classe de clients
Jouini, Oualid. "Modèles Stochastiques pour l'Aide à la Décision dans les Centres d'appels". Phd thesis, Ecole Centrale Paris, 2006. http://tel.archives-ouvertes.fr/tel-00133341.
Pełny tekst źródłaDans la première partie, nous considérons un centre d'appels où tous les agents sont groupés dans un même pool et les clients sont traités indifféremment par un des agents. Nous étudions les bénéfices de la migration depuis cette configuration vers un centre d'appels où les clients sont divisés en classes (appelées portefeuilles de clients). Chaque portefeuille de clients est servi par un pool de conseillers qui lui est exclusivement dédié. Ensuite, nous considérons un centre d'appels avec deux classes de clients impatients. Nous développons des politiques dynamiques pour l'affectation des clients (selon leurs types) aux différentes files d'attente. L'objectif étant lié aux qualités de service différentiées exprimées en terme du pourcentage des clients perdus, ainsi qu'en terme de la variance du temps d'attente. Enfin, nous étudions un centre d'appels qui annonce le délai d'attente à chaque nouveau client. Nous montrons les avantages de l'annonce sur les performances du centre d'appels.
Dans la deuxième partie, nous considérons un processus de naissance et de mort de forme générale. Nous calculons ensuite les moments de plusieurs variables aléatoires liées aux temps de premiers passages (ordinaires et conditionnels). Ensuite, nous montrons un résultat de concavité dans une file d'attente avec capacité limitée et avec une seule classe de clients impatients. Nous démontrons que la probabilité d'entrer en service est strictement croissante et concave en fonction de la taille de la file d'attente.
Gottfried, Fabrice. "Vers un outil d'aide à la décision en ingénierie territoriale appliqué à la géolocalisation de centres de santé". Thesis, Strasbourg, 2019. http://www.theses.fr/2019STRAH012.
Pełny tekst źródłaEveryone knows that our western societies are getting older. Our elderly use also a lot of health care where costs go up and up year after year. Thus, health managers have to face conflicting challenges : how to offer top health protection for all at a reasonable cost for each of us and at an acceptable cost for our local health authorities. A health management that is too rigorous limited to the sole expenditure may undermine intergenerational solidarity by sacrificing the most vulnerable populations. In this way of mind, our aid decision tool could help health managers and politics find alternative solutions to restore some equity, in our case health care accessibility, to ensure sustainable social justice, the cement of all advanced societies. We have tested our tool with 2 territories having very different geographical and demographic characteristics : the densely populated Bas-Rhin region located in the Eastern part of France and the less densely populated region of Estrie located in the South-eastern Province of Quebec (Canada). Our tool may only be part of the solution to these health care costs mentioned above but, its utility and originality are also easily transferable to other possible organizational environments
Videla-Haïdik, Marie-Hélène. "Modélisation du processus de décision dans les organisations à production économique et sociale : les centres d'aide par le travail". Bordeaux 1, 1992. http://www.theses.fr/1992BOR1D006.
Pełny tekst źródłaPezzoli, François. "Les pratiques du stationnement résidentiel en centre urbain : Evaluer l'acceptabilité des conditions de stationnement dans une perspective d'aide à la décision". Besançon, 2001. http://www.theses.fr/2001BESA1008.
Pełny tekst źródłaElatafy, Sherif. "La responsabilité des centres d'arbitrage". Thesis, Lyon, 2016. http://www.theses.fr/2016LYSE3013/document.
Pełny tekst źródłaParties to arbitration seek arbitral institutions to administrate their arbitration in order to have an extra guarantee that ensures the validity of the arbitral award. Given the role that arbitral institutions play during the arbitral procedure, parties unsatisfied either by the arbitral award or the annulment of the award tend to claim the liability of arbitral institution for the awards it had supervised, administered and participated in.The more the allegations of liability raise against the arbitral institutions before courts, the more the issue of arbitral institutions’ functions, powers and liability becomes controversial in different jurisdictions. Therefore, the present study tends to clarify the origin of the relationship existing between arbitral institutions and other parties involved in the arbitration at issue, the duties and powers assigned to the arbitral institutions and the functions performed by the arbitral intuitions, which helps eventually in establishing a kind of liability that complies with the functions performed by the arbitral institutions and can be applied in many jurisdictions
Agrebi, Maroi. "Méthodes d'aide à la décision multi-attribut et multi-acteur pour résoudre le problème de sélection dans un environnement certain/incertain : cas de la localisation des centres de distribution". Thesis, Valenciennes, 2018. http://www.theses.fr/2018VALE0013/document.
Pełny tekst źródłaThe research work presented in this thesis is part of the works’ continuity on multi-criteria group (decision-makers) decision-making, particularly in the field of the distribution centers’ location selection. Under certain environment, although the decision to select the location of the distribution centers has given rise in several research works, it has never been the object, to our knowledge, of a decision taken by several decision makers. In this regard, the first objective of this thesis is to develop a multi-attribute and multi-actor decision-making method (MAADM) to resolve the posed problem. For this purpose, we have adapted and extended the ELECTRE I method. Under uncertain environment, In view of the inherent uncertainty and inaccuracy of human decision-making, the future behavior of the market and companies, the second objective of this thesis is to propose a fuzzy multi-attribute and multi-actor decision-making method (FMAADM) to treat the problem in question. To this end, we have coupled the MAADM method with the fuzzy set theory. To validate the two contributions, we designed a decision support system (S-DSS) to implement the MAADM method and the FMAADM method. Based on the S-DSS, two experimental studies were conducted. We also applied a sensitivity analysis to verify the sensitivity of the solution retained vis-a-vis to weights’ variations of evaluation criteria. The obtained results prove that the MAADM method and the FMAADM method meet the desired objective and thus retained for the selection of the best location under certain/uncertain context of multi-attribute and multi-actor
Mhamdi, Samir. "La concurrence entre les places financières, vers une nouvelle géographie des activités financières et de nouveaux centres émergents : applications des Modèles multicritères d'Aide à la décision : ACP, logique floue et MCO". Nice, 2008. http://www.theses.fr/2008NICE0032.
Pełny tekst źródłaWhat is meant by ‘financial centres’? What part do these play nationally and internationally? How may one analyse competition between financial centres? In this context, what strategies are followed? Our research has aimed to provide answers to these questions by undertaking an in-depth theoretical study followed by an empirical study shedding light on theoretical concepts. Several themes are discussed here: the competition between financial centres and the various strategies adopted by financial markets; the impact of technological innovations, of internationalisation and of competitive strategies on the characteristics of future financial centres; and, the geography of international financial operations
Bégin, Jean-Pierre. "La théorie des sphères d'influence comme outil de gestion stratégique : les cas des centres hospitaliers québécois". Clermont-Ferrand 1, 1991. http://www.theses.fr/1991CLF10111.
Pełny tekst źródłaRichet, Cédric. "Partenariats public-privé et équipements sportifs : d’une vision normative à une réalité perçue : approche comparée « gestion déléguée/régie » des centres aquatiques publics". Caen, 2010. http://www.theses.fr/2010CAEN2062.
Pełny tekst źródłaThere is a long history of public-private partnerships (PPPs) in France. Their applications have diversified since decentralization laws. Most usually governed, the aquatic centers can thus tend to be delegated. The challenges, stakes and difficulties of such management echo a classic debate: make or buy. The thesis provides an organizational approach which combines contractualization phenomena described in the literature. Three aspects are first discussed: administrative doctrines applied to the PPPs, normative economic approach and public management modeling. A synthetic model, based on a conceptual transfer from contract to system, is then presented, mainly rooted in the sociology of organizations. Empirical data originate in a questionnaire, the in-depth study of the Court of Auditors reports, of judicial decisions, and 34 depth interviews conducted in two urban communities. Results for delegated and governed aquatic centers are distinguished. They reveal different origins for the PPPs whether the focus is put on investment or actual operation. Logics of public work are opposed to the establishment of a long lasting and perennial collaboration; logics of public utility reflect organizational learning processes. The economic and legal uncertainty, as well as constitute a breeding ground for conflict. The opportunity is grasped for launching and eventual questioning as to the “good” governance of public utilities
Michalot, Thierry. "L’évaluation par les travailleurs sociaux de la nécessité d’accueil en CHRS (Centre d’hébergement et de réinsertion sociale)". Thesis, Lyon 2, 2010. http://www.theses.fr/2010LYO20075/document.
Pełny tekst źródłaThe purpose of this research is to provide a detailed description of how social workers reach a decision with regard to the need to provide help. The work is of particular interest for admissions in Centres for Emergency Housing and Social Reintegration. In fact, faced with an increasing demand for housing, social workers in this field are forced to choose from among several candidates. However, the criteria defined by law are far from being sufficient to determine an order of priority. The first three parts discuss the theoretical framework and enable the main hypotheses to be set out. The other three parts are devoted to the presentation of the results of three empirical inquiries conducted with social workers in Centres for Emergency Housing and Social Reintegration, and with students in social work. The research explains the admission criteria used by social workers to determine the need to provide housing for a person in a reintegration centre. It prioritises these criteria and shows that some of them, defined by law, are less important than intra-subjective information. The research determines whether professional training plays a role in or acts as a curb on this phenomenon. This thesis provides an understanding of how social workers unconsciously participate in the development of systems which give priority to helping those persons in the target population who are least in need of help
Desmoulins, Lucile. "Le rôle des think tanks dans les processus de décision de politique extérieure analyse comparée, Etats-Unis, Royaume-Uni, France : les limites de "l'import-export institutionnel", le modèle d'expertise anglo-saxon incarné par les think tanks français internationalistes et spécialistes des questions de défense". Paris 4, 2005. http://www.theses.fr/2005PA040170.
Pełny tekst źródłaThrough a circular legitimization process, representations on government are at stake when such hybrid organizations as think tanks are concerned. In France, contractual procedures of expertise and research institutes specialized in public policy were based on an idealized vision of what Anglo-Saxon think tanks were thought to be. French think tanks specializing in defence seek permanence and political influence, whiche means their goal is heteromic by nature. They aim to moderate social debates but show the limits of "institutional import-export". The two expert devices examined in this doctoral dissertation (Foreign and Defence ministries) prove the experts'analysis to be a mere simulacre, as described by Jean Baudrillard. They also show experts'speech as tools aimed at reassuring, far from the rational ideal of enriching governmental information. Such procedures undermine the rationality of expertise. Researchers and experts therefore develop media discursive strategies. They can easily do so when they belong to think tanks considered as "truth guarantees". Expertise becomes both a mishap and an alibi for foreign policy evaluation. It is a mix of contractual, instrumental and dialogical situations. Relationships between political decision-makers and researchers were built around the dual themes of confrontation/denegation and instrumentalization/valorization. As a "missing link" between political decision-making, democratic space and research, French think tanks seem to contain both a "hidden potential" and the wasted opportunity for a discussion
Hamad, Mustapha. "Sharing resources for enhanced distributed hypothesis testing". Electronic Thesis or Diss., Institut polytechnique de Paris, 2022. http://www.theses.fr/2022IPPAT029.
Pełny tekst źródłaDistributed hypothesis testing has many applications in security, health monitoring, automotive car control, or anomaly detection. With the help of distributed sensors, the decision centers (DCs) in such systems aim to distinguish between a normal situation (null hypothesis) and an alert situation (alternative hypothesis). Our focus will be on maximizing the exponential decay of the type-II error probabilities (corresponding to missed detections), with increasing numbers of observations, while keeping the type-I error probabilities (corresponding to false alarms) below given thresholds. In this thesis, we assume that different systems or applications share the limited network resources and impose expected-rate constraints on the system's communication links. We characterize the first information-theoretic fundamental limits under expected-rate constraints for multi-sensor multi-DC systems. Our characterization reveals a new tradeoff between the maximum type-II error exponents at the different DCs that stems from different margins to exploit under expected-rate constraints corresponding to the DCs' different type-I error thresholds. We propose a new multiplexing and rate-sharing strategy to achieve the error-exponents. Our strategy also generalizes to any setup with expected-rate constraints with promising gains compared to the results on the same setup under maximum-rate constraints. The converse proof method that we use to characterize the information-theoretic limits can also be used to derive new strong converse results under maximum-rate constraints. It is even applicable to other problems such as distributed compression or computation
Bianconi, Renata. "L'œuvre de Celso Furtado à Paris : le parcours d'un intellectuel et homme d'Etat". Thesis, Paris 4, 2014. http://www.theses.fr/2014PA040082/document.
Pełny tekst źródłaThis thesis is devoted to the work of the Brazilian economist and historian Celso Furtado. It traces his career and presents the evolution of his thought and work during the time he taught at Paris (1965-1985). This study first presents Celso Furtado’s doctoral studies in France, when he received decisive influences for the subsequent evolution of his thinking on economic development. Next, it shows the author’s contribution at the formative years of the Economic Commission for Latin America (ECLAC-UN), school of thought that proposed an innovative approach to the problems of underdeveloped economies. His commitment to the Brazilian government (creator and director of the Superintendency for the Development of the Northeast, and first Minister of Planning), in an international context marked by the polarization of the Cold War, is also analyzed. In exile since the establishment of the Brazilian military dictatorship, he moved to Paris, where he develops a long academic career. Finally, this thesis highlights the contribution of Celso Furtado to the study of economic development and Latin American economies in France, as well as the new ways of thinking about the problems of underdevelopment undertaken by the author during his exile in Paris
Bianconi, Renata. "L'œuvre de Celso Furtado à Paris : le parcours d'un intellectuel et homme d'Etat". Electronic Thesis or Diss., Paris 4, 2014. http://www.theses.fr/2014PA040082.
Pełny tekst źródłaThis thesis is devoted to the work of the Brazilian economist and historian Celso Furtado. It traces his career and presents the evolution of his thought and work during the time he taught at Paris (1965-1985). This study first presents Celso Furtado’s doctoral studies in France, when he received decisive influences for the subsequent evolution of his thinking on economic development. Next, it shows the author’s contribution at the formative years of the Economic Commission for Latin America (ECLAC-UN), school of thought that proposed an innovative approach to the problems of underdeveloped economies. His commitment to the Brazilian government (creator and director of the Superintendency for the Development of the Northeast, and first Minister of Planning), in an international context marked by the polarization of the Cold War, is also analyzed. In exile since the establishment of the Brazilian military dictatorship, he moved to Paris, where he develops a long academic career. Finally, this thesis highlights the contribution of Celso Furtado to the study of economic development and Latin American economies in France, as well as the new ways of thinking about the problems of underdevelopment undertaken by the author during his exile in Paris
Dargirolle, Rébecca. "Les exclus de la mobilité : de l'observation à la décision". Thesis, Dijon, 2014. http://www.theses.fr/2014DIJOL040/document.
Pełny tekst źródłaIn contemporary societies, mobility is considered as a social norm necessary for integration. Conversely, immobility is often seen as the opposite. Therefore, it is associated with a significant risk of exclusion. An approach in terms of exclusion involves a sociological orientation. Nevertheless, this thesis follows a geographical approach. Thus, a first question emerges from this disciplinary position: immobility is it a geographical object? Furthermore, it is possible to consider the mobility and immobility as equivalent and not opposed. This means that their impact may not be reversed. This position engages a second question: the relationship between immobility and exclusion is it legitimate? To answer these two questions, a set of standardized tools can be used: the National Transport Surveys (ENT), Household Travel Surveys (EMD), continuous panels or surveys over several weeks. All these devices are focused on mobility. That’s why immobility is apprehended by default. However, they are essentials but should be completed. For this, an ad-hoc questionnaire focusing on immobility and local resources was set up in urban areas of Dijon and Besancon. The data processing of this tool identifies the socio-spatial determinants of immobility
Stanek, Piotr. "Efficiency of decision making in central banks : lessons for the European Central Bank". Lille 1, 2007. https://pepite-depot.univ-lille.fr/LIBRE/Th_Num/2007/50374-2007-13.pdf.
Pełny tekst źródłaHilt, Pauline. "Décision motrice et contrôle modulaire d'un système hyper-redondant". Thesis, Dijon, 2015. http://www.theses.fr/2015DIJOS061/document.
Pełny tekst źródłaThis thesis is aimed at better understanding how the Central Nervous System (CNS) plans and controls voluntary movements. When moving, humans must overcome intrinsic (e.g. choosing which muscles to activate) and extrinsic (e.g. choosing where to reach an object) redundancy, requiring selecting one motor solution among several potential ones. To better understand this process, we studied in parallel two important motor control theories: muscular synergies and motor decision. In a first part, we focused on intrinsic redundancy by testing the muscular synergies hypothesis. According to it, the CNS simplifies the control of muscles, in using a limited set of building blocks whose linear combinations allow the performance of virtually any motor task. In this study, we challenge the modular motor control hypothesis by combining a) the design of a highly comprehensive experiment with b) the use of a unifying modularity model to describe single-trial EMG activity in space and time and c) a module evaluation process that assesses the modular decomposition not only in input space (EMG data reconstruction) but also in task space (task discrimination). Our rationale is that an effective modular control implementation would allow not only the formation of a wide variety of muscle patterns but also the achievement of a large set of tasks. The main theoretical result is the existence of few spatial and temporal modules that not onlygive a concise representation of muscle patterns but also carry nearly all task-relevant information of EMG signals. In a second part, we studied the decisional process that underlies all voluntary movement. In daily life, human movement is guided by objective external constraints (e.g. an object to reach), potential external cost/benefits (e.g. monetary reward) and internal cost/benefits associated with each movement (e.g. energy expenditure). Here,we aimed at investigating internal variables orienting action selection when facing the complexity of human-environment interactions. To this aim, we designed an experimental protocol reducing external constraints: no predetermined endpoint (e.g. salient target) and no explicit reward (e.g. money). Subjects had to perform whole body reaching movements towards a uniform surface (no pre-determined endpoint). Our results illustrate the presence of idiosyncratic values guiding posture and movement coordination that can be combined in a flexible manner as a function of context and subject. A first value takes into account the energy expenditure and articular jerk, while the other favored stable dynamic equilibrium but requires larger energy expenditure and articular jerk. In conclusion of this work, we suggest that motor control can be viewed as a decision process evaluating internal values to elaborate the most efficient control in function of context. In addition, this control can be simplified by the use of functional modules allowing CNS to generate rapidly a large set of whole body movements
Diouf, Ibrahima. "Analyse positive de décisions de politique monétaire dans le cas des systèmes africains". Paris 1, 1994. http://www.theses.fr/1994PA010002.
Pełny tekst źródłaPublic choice analysis shows that monetary policy is a result of bargain between the central bank and the government. Normative theory of monetary policy must be complete by a positive theory in order to take in consideration effective goals of central bankers. This approach take these references to political monetary cycle theories which underline influences of political on the monetary policy choices. Central bank has been established as responsible of monetary policy in industrialised countries with democratic insitutions. It seems that monetary decisions are influenced by either political and economical factors. We examine how this analysis can be applied to african countries. In this former case the central bank is more receptive to political influence, so its autonomy becomes limited. These characteristics result from the financial system constraints and a few level of democracy; but also from a ligh rate of political instability in these countries. As consequence the central bank can sometimes be a puppet or a robot to the treasury of fiscal authority which is synonymous with the government. Our study is going to formalise the behaviour of monetary authorities, regarding the specificities of political market and bureaucratic habits in African countries. We show that inflation choices are connected to bureaucratic goals. Empirical test generally confirm the relative primacy of political or and bureaucratic goals on economics objectives
Aulia, A. Farid. "Intelligence économique (l'information stratégique au coeur de la décision de la Banque d'Indonésie)/ A. Farid Aulia". Aix-Marseille 3, 2000. http://www.theses.fr/2000AIX30030.
Pełny tekst źródłaTorres, Delgado José Fidel. "Un système interactif d'aide à la décision pour la régulation de charges de travail dans les ateliers". Phd thesis, Université Paul Sabatier - Toulouse III, 1995. http://tel.archives-ouvertes.fr/tel-00144253.
Pełny tekst źródłaKaisergruber, Isabelle. "Contributions à l'élaboration d'un modèle de prise de décision pour la validation de mesures analogiques". Paris 11, 1985. http://www.theses.fr/1985PA112028.
Pełny tekst źródłaCastor-Gauthier, Gaelle. "Organisation, communication et prise de décision dans les très petites entreprises françaises. Sociologie-anthropologie économique d’une PME du centre de la France". Thesis, Lyon 2, 2014. http://www.theses.fr/2014LYO20005.
Pełny tekst źródłaThe contexte of this research takes place within the framework of a contract Cifre.This contract was signed between a laboratory (the GLYSI, become MODYS), a company (small and medium-sized entreprise (SME) of 70 employees proposing phone solutions in very small entreprises) and the ANRT. Such a cooperation presented several advantages, both for the sociological research and for the SME.The research was so able to obtain to work on a segment of company still little studied, the very smalls companies from 0 to 9 employees, both from the point of view of the organization and of the communication, and to practise a sociology applied thanks to a total dumping in the SME, as for it, waited to understand the future waits of it final clientele thanks to a qualitative methodology and to bring answers to the internal communications problems and to the geographical subdivisions. The research concerns essentially the question of the link that maintain between them the communication and the organization of company and put the hypothesis that it is the decision-making which connect these two elements. The results of the analysis also highlight the relative importance of the new tools of information and communication in the functioning of the very small entreprises. As for the research led for the company, it is quickly confronted with a context of particular market. The market of telecommunications crosses a restless period, because France Télécom loses the monopole. In so doing, the group FT modifies its calls for tender what, later, is going to entrainer the closure of the SME
Gervais, Philippe. "L'importance de la satisfaction dans le processus de décision du choix d'un restaurant de type fast-food en contexte concurrentiel de centre commercial". Thèse, Université du Québec à Trois-Rivières, 2007. http://depot-e.uqtr.ca/1775/1/030008485.pdf.
Pełny tekst źródłaDumas, Stéphane. "Développement d'un système de veille stratégique dans un centre technique". Aix-Marseille 3, 1994. http://www.theses.fr/1994AIX30063.
Pełny tekst źródłaRuel, Annie. "Le rôle du réseau relationnel dans la décision d'entreprendre une thérapie : perspectives des usagers du Centre de réadaptation Ubald-Villeneuve orientés vers le programme intensif". Thesis, Université Laval, 2009. http://www.theses.ulaval.ca/2009/26192/26192.pdf.
Pełny tekst źródłaVazquez, Llana Jordan Diego. "Environnement big data et prise de décision intuitive : le cas du Centre d'Information et de Commandement (CIC) de la Police nationale des Bouches du Rhône (DDSP 13)". Thesis, Lyon, 2018. http://www.theses.fr/2018LYSE3063.
Pełny tekst źródłaGodé and Vazquez have previously demonstrated that French Police team operate in extreme contexts (Godé & Vazquez, 2017), simultaneously marked by high levels of change, uncertainty and mainly vital, material and legal risks (Godé, 2016), but also technological. In this context, the notion of big data environment, can affect the police decision-making process. The problematic of this thesis is : "What is the status of intuition in decision-making process in a big data environment?". We explain how the growth of available information volumes, the great diversity of their sources (social networks, websites, connected objects), their speed of diffusion (in real time or near real time) and their unstructured nature (Davenport & Soulard, 2014) introduces new decision-making challenges for National Police forces
Brana, Colette. "Evolution des decisions obstétricales dans les utérus unicicatriciels au cours des cinq dernières années (1986-1990) : étude rétrospective à la maternité du centre hospitalier de Bayonne". Bordeaux 2, 1991. http://www.theses.fr/1991BOR2M081.
Pełny tekst źródłaBennani, Hamza. "Essays on central banks communication and decisions". Thesis, Lille 1, 2014. http://www.theses.fr/2014LIL12012/document.
Pełny tekst źródłaThis thesis focuses on the link between central banks’ communication and their decision-making processes. Due to the fact that the recent empirical literature has not used central banks’ communication policy to understand their inner working, and notably their interest rate setting behavior, because of the boundaries of economic tools; the different chapters of this thesis propose to fill the gap of this literature. In a first step, we unveil the issues that some central banks face (like, e.g., the European Central Bank or the Federal Reserve), such as the heterogeneity in terms of monetary policy preferences between committee members, or the disagreements in terms of economic policy preferences in the context of the euro debt crisis. In a second step, we explain the determinants and the consequences of these disagreements and heterogeneity, using non standard analytical tools, along with theoretical and econometric models. Therefore, we consider the methodologies used in other social sciences, like sociology, psychology, or political science, to analyze the prolific communication policy of central banks, with the aim to unveil their decision-making processes
Dabbebi, Ines. "Conception et génération dynamique de tableaux de bord d’apprentissage contextuels". Thesis, Le Mans, 2019. http://www.theses.fr/2019LEMA1040/document.
Pełny tekst źródłaThis work is part of a broader issue of Learning Analytics (LA). It is particularly carried out within the context of the HUBBLE project, a national observatory for the design and sharing of data analysis processes. We are interested in communicating data analysis results to users by providing LA dashboards (LAD). Our main issue is the identification of generic LAD structures in order to generate dynamically tailored LAD. These structures must be generic to ensure their reuse, and adaptable to users’ needs. Existing works proposed LAD which remains too general or developed in an adhoc way. According to the HUBBLE project, we want to use identified decisions of end-users to generate dynamically our LAD. We were interested in the business intelligence area because of the place of dashboards in the decision-making process. Decision-making requires an explicit understanding of user needs. That's why we have adopted a user-centered design (UCD) approach to generate adapted LAD. We propose a new process for capturing end-users’ needs, in order to elaborate some models (Indicator, visualization means, user, pattern, …). These models are used by a generation process implemented in a LAD dynamic generator prototype. We conducted an iterative evaluation phase. The objective is to refine our models and validate the efficiency of our generation process. The second iteration demonstrates the impact of the decision on the LAD generation. Thus, we can confirm that the decision is considered as a central element for the generation of LADs
Buf, Audrey. "La prise de décision au sein de la Banque centrale européenne : l'enjeu de la transparence face à l'hétérogénéité de l'Eurozone". Thesis, Aix-Marseille, 2013. http://www.theses.fr/2013AIXM1114.
Pełny tekst źródłaThe lack of transparency of the European Central Bank (ECB), as well as the heterogeneity among European member states have generates many debates about the effectiveness of the decision-making process within the ECB’s governing council. Such a context creates uncertainties about the distribution of power inside the governing council. The purpose of this thesis is to analyse to what extent the decision-making process within the council responds to such lack of transparency. In the first part, we focus on the effect of the regional bias on monetary policy decisions. Our analysis shows that persistent heterogeneities among members generate uncertainties with regard to the effectiveness of the ECB’s monetary governance. In the second part, we analyse the ability of the governing council to generate strategic interactions among its members, and we focus in particular on coalitions formation. Our analysis based on voting power demonstrates that board members have only a weak impact on the decision-making process. Our thesis focuses on the inadequacies of the current ECB’s decision-making framework and on its necessary reform
Dubreuil, François. "Recruter sur un marché interne : les justifications des décisions d'attribution d'emploi de cadre, au sein d'une entreprise française de distribution d'énergie". Thesis, Université Laval, 2006. http://www.theses.ulaval.ca/2006/23947/23947_1.pdf.
Pełny tekst źródłaStoessel, Charles. "Décisions risquées et organisations à risques : autonomie au travail et reconnaissance sociale dans la conduite d’une industrie de process". Thesis, Paris, CNAM, 2010. http://www.theses.fr/2010CNAM0723/document.
Pełny tekst źródłaThis doctoral dissertation describes the running of a high-risk process industry,nuclear power plants, and the operators’ autonomy to apply technical procedures.The chosen procedures must fit the "real-life" situations, which are always new, andultimately unique. Nuclear power technology is so complex that ambiguous situations often arise. The operators have to make technical decisions that encompassall the demanding issues of high-risk industries : nuclear safety, plant availabilityand generation output, workers’ safety, environmental protection, etc.Operating a nuclear power plant thus involves trade-offs between theoretically compatible concerns that in practice are incompatible or difficult to reconcile.Each option in the actual decision will have advantages for certain criteria anddisadvantages for others. Deciding thus always means forgoing something, andtechnical decision-making in high-risk organizations forces the field workers totake professional and personal risks. The dissertation thus examines the factors explaining why operators are still interested in getting involved in the action.Self-interest and cultural theories cannot explain all the cases encountered in thefield (workers with high commitment but paradoxically little interest in career advancement, strong differences between individuals in a supposedly homogenoussocio-professional groups, etc.). The research focuses on social recognition andgift/countergift theories as the primary explanation for motivation and cooperation at work
Vilkas, Catherine. "L'art de gouverner la science dans le système public français, le cas du CNRS : représentation, évaluation, direction de quatre disciplines". Paris, Institut d'études politiques, 2001. http://www.theses.fr/2001IEPP0006.
Pełny tekst źródłaLaloix, Thomas. "Méthodologie d’élaboration d’un bilan de santé de machines de production pour aider à la prise de décision en exploitation : application à un centre d’usinage à partir de la surveillance des composants de sa cinématique". Thesis, Université de Lorraine, 2018. http://www.theses.fr/2018LORR0291/document.
Pełny tekst źródłaThis PhD work has been initiated by Renault, in collaboration with Nancy Research Centre in Automatic Control (CRAN), with the aim to propose the foundation of a generic PHM-based methodology leading to machine health check regarding machine-product joint consideration and facing industrial requirements. The proposed PHM-based methodology is structured in five steps. The two first steps are developed in this PhD work and constitute the major contributions. The first originality represents the formalization of machine-product relationship knowledge based on the extension of well-known functioning/dysfunctioning analysis methods. The formalization is materialized by means of meta-modelling based on UML (Unified Modelling Language). This contribution leads to the identification of relevant parameters to be monitored, from component up to machine level. These parameters serve as a basis of the machine health check elaboration. The second major originality of the thesis aims at the definition of health check elaboration principles from the previously identified monitoring parameters and formalized system knowledge. Elaboration of such health indicators is based on Choquet integral as aggregation method, raising the issue of capacity identification. In this way, it is proposed a global optimization model of capacity identification according to system multi-level, by the use of Genetic Algorithms. Both contributions are developed with the objective to be generic (not only oriented on a specific class of equipment), according to industrial needs. The feasibility and the interests of such approach are shown on the case of machine tool located in RENAULT Cléon Factory
Lerouge, Mathieu. "Designing and generating user-centered explanations about solutions of a Workforce Scheduling and Routing Problem". Electronic Thesis or Diss., université Paris-Saclay, 2023. http://www.theses.fr/2023UPAST174.
Pełny tekst źródłaDecision support systems based on combinatorial optimization find application in various professional domains. However, decision-makers who use these systems often lack understanding of their underlying mathematical concepts and algorithmic principles. This knowledge gap can lead to skepticism and reluctance in accepting system-generated solutions, thereby eroding trust in the system. This thesis addresses this issue in the case of the Workforce Scheduling and Routing Problems (WSRP), a combinatorial optimization problem involving human resource allocation and routing decisions.First, we propose a framework that models the process for explaining solutions to the end-users of a WSRP-solving system while allowing to address a wide range of topics. End-users initiate the process by making observations about a solution and formulating questions related to these observations using predefined template texts. These questions may be of contrastive, scenario or counterfactual type. From a mathematical point of view, they basically amount to asking whether there exists a feasible and better solution in a given neighborhood of the current solution. Depending on the question types, this leads to the formulation of one or several decision problems and mathematical programs.Then, we develop a method for generating explanation texts of different types, with a high-level vocabulary adapted to the end-users. Our method relies on efficient algorithms for computing and extracting the relevant explanatory information and populates explanation template texts. Numerical experiments show that these algorithms have execution times that are mostly compatible with near-real-time use of explanations by end-users. Finally, we introduce a system design for structuring the interactions between our explanation-generation techniques and the end-users who receive the explanation texts. This system serves as a basis for a graphical-user-interface prototype which aims at demonstrating the practical applicability and potential benefits of our approach
Benmimoune, Lamine. "Une approche pour la conception de systèmes d'aide à la décision médicale basés sur un raisonnement mixte à base de connaissance". Thesis, Belfort-Montbéliard, 2016. http://www.theses.fr/2016BELF0307/document.
Pełny tekst źródłaTo support health professionals in their clinical processes, several monitoring and medical care systems have beenbuilt and deployed in the hospital setting. These systems are mainly used to collect medical data on patients,analyze and present the outcomes in different ways. They represent support and assistance to health professionalsin their decision making regarding the evolution in the health status of the patients followed. The use of suchsystems always requires an adaptation to both the medical field and the mode of intervention. It is necessary, in ahospital setting, to adapt and evolve these systems in a simple manner, limiting any corrective or evolutionarymaintenance. Moreover, these systems should be able to consider dynamically the domain knowledge from medicalexperts.To meet these requirements, we proposed an approach for the construction of a medical decision support system(MDSS). This MDSS can adapt to the medical field and to the appropriate mode of intervention to assist healthprofessionals in their clinical processes. This approach allows especially the organization of the medical datacollection by taking into account the patient¿s context, the ontology-based knowledge representation of the domainand permits the exploitation of the medical guidelines and the clinical experience.In continuity of our research team¿s previous work, we chose to expand with our approach, the E-care platformwhich is dedicated to monitoring and early detection of any abnormality of the health status of patients with chronicdiseases. We were able to adapt easily the E-care platform for the various experiments that have been conducted,including EPHAD of the Mutualité Française in Anjou-Mayenne, Hautepierre hospital and Lausanne hospital(CHUV).The outcomes of these experiments have shown the effectiveness of the proposed approach. Where, the adaptationof the platform regarding to the domain and mode of intervention of each of these experiments is limited to thesimple configuration. Furthermore, the proposed approach has attracted the interest of the medical staff regardingthe organization of the medical data collection, and the exploitation of the medical knowledge which bringsassistance to the health professionals for better decision making
Tsopra, Tahiraly Rosy. "Conception et évaluation d'un système décisionnel informatisé basé sur le raisonnement des experts élaborant les guides de bonnes pratiques en antibiothérapie empirique". Thesis, Paris 13, 2014. http://www.theses.fr/2014PA132034/document.
Pełny tekst źródłaContext: CDSS (Clinical Decision Support System) for the empiric prescription of antibiotics present many limits: (i) recommendations are only given for clinical situations that are described in CPGs (Clinical Practice Guidelines); (ii) updating is infrequent; (iii) poor ergonomics is an impediment to clinical adoption. To overcome these limits, we propose an approach leading to a CDSS that is able to generate ecommendations as in CPGs, and to display recommendations in an interface supporting knowledge. Methods: Our approach consists in (i) extracting from CPGs the deep medical reasoning used by experts to establish recommendations, (ii) using the decision process in empiric antibiotherapy and the usability principles to design a pleasant interface. Results: The implementation of the medical reasoning of the experts as an algorithm using 12 properties of antibiotics, allows to retrieve automatically the recommended antibiotics for all clinical situations, without the intervention of the experts. These properties could be updated automatically thanks to others resources like drugs data bases. The design of an interface supporting knowledge according to the decision process in empiric antibiotherapy and the usability principles, improve significantly the perceived usability and the confidence in the system. Conclusion: The extrapolation of our approach to the chronic diseases should be assessed
Bollon, Florent. "Recognized Cyber Picture et Confiance interpersonnelle : optimiser les activités collaboratives cyber militaires". Thesis, Bordeaux, 2020. http://www.theses.fr/2020BORD0113.
Pełny tekst źródłaSince the early 2000s, civilian and military networks are faced with an increasing number of cyber-attacks. In order to facilitate decision making and to better coordinate actions in case of attacks coming from the cyberspace, it has become necessary for the French Air Force (armée de l’air, AA) to put in place a system or tool that would allow a shared representation of the cyber state of its infrastructures. Although this system (or tool), named Recognized Cyber Picture (RCP), is not yet entirely defined, it will probably be deployed in the command and control centres (C2) of the AA. The role of the RCP will be to identify and highlight potential problems in the information received by the C2 (modified, added or lost information). Therefore, operators of C2 equipped with RCP may be confronted with a dissonance in terms of information processing and transmission. To facilitate decision making, C2 operators would need to put in place mechanisms to “compensate” for this dissonance. Among these mechanisms, interpersonal trust has been identified in the literature as a decision making facilitator in highly uncertain environments. This thesis proposes to study the role of trust on the behaviors of operators present in C2 integrating this cyber dimension. In order to answer this (research) question, we developed and then tested an experimental protocol that allows to induce several levels of trust and to investigate their impact on behaviours. Based on this protocol, 4 experiments were carried out in the laboratory with potential operators of the RCP. The first experiment (conducted on 200 participants from the AA, including 160 operational and 40 students from the AA Academy) focused on the role of psychosocial characteristics of individuals, and their behaviours when working with unknown and more or less trustworthy collaborators. The second experiment (conducted with 40 participants from the AA Academy), investigated the differences in behaviour when activity relies on trust between two human operators or between a human operator and an automated system (an emulated artificial intelligence). The third experiment (conducted with 35 engineering students) explored the influence of self-confidence of an individual on his behaviour towards more or less trustworthy co-workers. These first three experiments highlight, in particular, behavioural changes induced by the level of trust within the relationship, which have been little studied to date. This includes supervision, quality of supervision, time management, but also the acceptance of the information transmitted by the co-worker. The last experiment (conducted with 40 engineering students) explored the influence of both the level of confidence in a relationship and the uncertainty in the data on operator decision making. This experiment shows that the level of coherence of available information and trust levels play an important role in the operator’s decisional processes. The results of these experiments have been confronted to models from the literature, and have allowed to bring into light new elements to adjust and adapt these models to the case of a C2 with a cyber component. This thesis makes a theoretical contribution to the understanding of trust mechanisms, and a practical contribution to support the implementation of the RCP in Command and Control centers
Bélisle, Annick. "Expérimentation d'une démarche d'apprentissage dans l'action visant l'adoption de comportements à mobiliser lors d'animations de réunions éclair, chez des gestionnaires d'un centre hospitalier". Thèse, Université de Sherbrooke, 2011. http://savoirs.usherbrooke.ca/handle/11143/2831.
Pełny tekst źródłaLequesne, Christian. "L'appareil politico-administratif central de la France et la Communauté européenne : mai 1981 - mai 1991". Paris, Institut d'études politiques, 1992. http://www.theses.fr/1992IEPP0015.
Pełny tekst źródłaThis empirical study deals with the behaviourand the working of the French central politico-administrative apparatus vis a vis the European Community. Limited to the period May 1981 - May 1991 , different approaches and logics ( both opposed and complementary) which guide the organs of the central executive and legislative powers along the various community decision-making processes
Roche, Amelie. "Proposition d'une méthode de conception systémique d'interface homme-système adaptée aux situations de multihandicap". Thesis, Bordeaux, 2015. http://www.theses.fr/2015BORD0272/document.
Pełny tekst źródłaIn the field of Human-System Interface (HSI) design, one key concept is the User-Centred Design (UCD), an approach that considers the user as the centre of the design process. Although this approach is a significant advance to provide solutions that meets the needs and expectations of end-users, it is not totally suitable for end-users with multiple disabilities. Moreover, despite the benefits of the UCD, only few designers apply this approach. The use of standard approaches remains dominant. There is a general lack of awareness among designers on how take account of end-users, even less when the end-users have multiples disabilities.In view of these observations, our work has been structured to two main axes, conducted in parallel. We have elaborated and formalized design method of HSI, named AMICAS (Innovative Methodological Approach of Adapted Systemic Design), in order to design tools or services adapted for users, whatever their disabilities are. This method has been tested to children with multiple disabilities in educational context and with elderly in care homes. Also, we have developed a decision support tool. The purpose of this tool is to help designers to take into account end-users and their disabilities into the design stage. Based on the results, we suggest in synthesizing an improved version of AMICAS and we have published the decision support tool online
Ciptomulyono, Udisubakti. "Un modèle d'aide à la sélection des projets : l'intégration de la procédure analyse hiérarchique (AHP) et la programmation mathématique à objectif multiple (application aux projets de développement de centrales électriques en Indonésie)". Aix-Marseille 3, 2000. http://www.theses.fr/2000AIX30019.
Pełny tekst źródłaBrun, Laurie. "Spécification d'Interfaces Homme Machine et de stratégies d’assistance à la conduite dans une démarche de conception centrée sur l'utilisateur : application à l’anti-renversement des poids-lourds". Caen, 2016. http://www.theses.fr/2016CAEN1003.
Pełny tekst źródłaThis thesis work deals with the user-centered design of Human Machine Interfaces (HMI). Its aim is to investigate the relationship between the HMI of a driver support system, in particular the display formats used to represent the situation, and the user linked mental representations. An HMI designed in an iterative confrontation with the user should allow updating the mental representation of the situation in a relevant way, in order to support him with his activity management. Applied to the driving of specific industrial vehicles, concrete mixers, the experimental part focuses on the design and assessment of a Human Machine Interface of a truck anti-rollover system on the road. Based on anticipation, this system supports drivers in curves approach and crossing. Three sequential studies were conducted. The first study was to collect mental representations of on road rollover situations from professional concrete mixer drivers. An HMI integrating salient elements of the representation was specified on this basis. The ergonomics of a system prototype was assessed using a dynamic driving simulator in the second study, and on the field in the third study. The overall ergonomics of the system was validated, in terms of usability, mental workload and acceptation. The anticipation characteristic of the COROLA system widens its potential applications, in particular for the risk perception and the Eco driving. This work improves the understanding of the relationship between the situation representation used by a system (through its HMI) and the users’ mental representation of this situation. Data suggest that the display format to prefer should be imaged
Mano, Marie-Charlotte. "La relation de soin à l'épreuve des représentations sociales : enjeux éthiques en orthopédie dento-faciale hospitalière". Thesis, Sorbonne Paris Cité, 2015. http://www.theses.fr/2015USPCB192.
Pełny tekst źródłaA discourse focused on the Other is firmly anchored in medical discourse. But what Other is being spoken about? What identity are we talking about when considering the otherness, recognition and vulnerability of the recipient of care? Whom are we recognising? Here, we will be exploring the relational balance within the patient-carer relationship in the field of dentofacial orthopedics. A structural approach to social representations, using concept maps, will be adopted in order to examine the relationship of the therapeutic partners to the concept of care provision - a symbolic component of the treatment process which is difficult to define explicitly. Introducing the notion of care provision means placing an emphasis on the ethical, technical and political content of the care relationship. The notion of the favourable reception of the patient, a central element of the relationship which is revealed by an analysis of representations based on questionnaires, highlights the role of identity in the contemporary reconfiguration of the care relationship - a hybrid model which combines a modulated form of medical paternalism and comparative emancipation. This original perspective enables us to examine these various value registers, which illustrate and testify to the notion of the individual. This dialectic of sameness and the Other, of the identity and the recognition of the participants, thus gives rise to a debate, simultaneously theoretical, ethical and political, focused on the relational space associated with care
Sidibe, Cheick Abou Kounta. "Epidémiologie de la Péripneumonie Contagieuse bovine(PPCB) dans les régions du Delta Central du Mali : évaluation des performances de deux tests de diagnostic pour analyser la dynamique de transmission et développement d'outils d'aide à la décision pour la surveillance et le contrôle". Thesis, Montpellier 2, 2012. http://www.theses.fr/2012MON20019/document.
Pełny tekst źródłaTwo serological tests (complement fixation test (CFT) and competitive ELISA (cELISA)) are recommended by the OIE and commonly used in Central Veterinary Laboratory of Bamako sometimes in parallel, in the diagnosis and screening for contagious (CBPP). The performance of these tests has been estimated differently by several authors in different epidemiological settings using standard statistical methods with a real status of animals partially or completely known. In an environment where CBPP is endemic and where different stages of disease are available, given that serological tests are not perfect (not gold standard), the use of Bayesian approach seemed appropriate for an accurate assessment of the performance parameters of tests which are the sensitivity, specificity and predictive values to better assess the prevalence of the disease in cattle in the central Niger delta in Mali. The results of laboratory analysis of field samples were used as large database for epidemiological analysis of the geographical distribution of seroprevalence and the influence of major risk factors for the spread of CBPP. This, in order to aid reflection on tools research and new strategies in the process of prevention and eradication of CBPP by developing for implementation of an innovative, practical and effective methodology as sanitary qualification of cattle. This thesis has helped define the correlations between the two tests, observing a better sensitivity of cELISA compared to CFT to justify its use only in a program of widespread testing of CBPP in an endemic environment. In this study, the proof of the existence of aggregation of seropositive animals across herds and geographical level shows that a sanitary qualification system of cattle can play in collaboration with the national network of veterinary epidemiological surveillance a leadership role in targeted control and mastery of the spread of CBPP in Mali.Keys words: CBPP- cELISA - CFT- Bayesian approach -Aggregation- Sanitary qualification –Bovine
Hak, Jean-Luc. "Engineering annotations for supporting the design process of interactive systems : a model based approach and a tool suite". Thesis, Toulouse 3, 2019. http://www.theses.fr/2019TOU30062.
Pełny tekst źródłaDuring the development process of an interactive system, different actors collaborate in the activities of this process and several design choices are made to converge to a solution that meets both user needs and requirements. To achieve this solution, many artifacts are produced, used and reviewed by the various stakeholders of the process. In order to communicate on particular points of an artifact, to collaborate in its elaboration or simply to add additional information, annotations can be created on these artifacts. Depending on the annotations and their contents, some artefacts may subsequently evolve, thus reflecting the influence of annotations on these artifacts and therefore reflecting their influence on the project. Thus, it is possible to consider annotations as a versatile tool playing a significant role in the design process. Nevertheless, several issues can be identified regarding the integration of annotations within the activities of the design process of interactive systems. First, the role of annotations is not clearly defined in the different design processes. While there is a widespread and a ubiquitous use of annotations in the design of interactive systems, current design processes do not address how to relate them to the tasks to be performed and the artifacts to be produced. Secondly, an annotation can be related to several artifacts as each models are giving a complementary representation of the interactive system. However, the multiplicity of artifact types and tools for creating these artifacts is a problem since each tool that provide features for annotations implements their own annotation model. These models are usually restricted to one type of artifact: the one handled by the tool. This implies that the annotations produced within a project are scattered by sets and that each these annotation set is closed to a single type of artifact. This PhD thesis is based on an analysis of annotations and their uses as well as on the W3C "Web Annotation Data Model" recommendation to propose an annotation model and an architecture to centralize the annotations of a project. This architecture also allows to include the annotations support on various tools and type of artifacts. This contribution has been applied on three different case studies to explore the possible integrations of annotations within a design process. The first case study demonstrates the integration and customization of annotations within a prototyping tool. The second case study focuses on the presentation of a tool allowing to consult in a single view all the annotations created on different artefacts and on different models of a project. The third case study illustrates an integration of annotations into an industrial environment that includes existing tools and an existing design process. Thus, these contributions around annotations are used as a basis for the realization of complementary works such as the use of annotations to structure and connect the different models of an interactive system, the use of annotations as a resource for the decisions making processes, and the use of annotations to study the traceability of the evolution of an interactive system. Indeed, by linking the artifacts to each other using annotations and justifying the choice of designs with annotations, it would be possible to ensure the traceability of the different design choices made during a project as well as the traceability of the impact of these different choices on the artifacts
Fiteni, Frédéric. "Les critères de jugement centrés sur le patient dans les essais cliniques en oncologie thoracique". Thesis, Besançon, 2016. http://www.theses.fr/2016BESA3012/document.
Pełny tekst źródłaOverall survival (OS) is the gold standard endpoint in oncology clinical trials. Nevertheless, intermediate tumor-centered endpoints which are assessed earlier are more and more used as surrogate of OS. Health-related quality of life is an endpoint which assesses a direct benefit for the patient. We demonstrated that 32% of endpoints in advanced non-small-cell lung phase III clinical trials were not defined at all, 43% were not clearly defined and none ofthem has demonstrated its surrogacy on OS. We demonstrated the weakness and the heterogeneity of the measurement, analysis, and reporting of HRQoL in phase III advanced NSCLC trials. Precise and uniform recommendations are needed. We longitudinally compared HRQoL using tüne until definitive deterioration (TUDD) method in 451 patients aged 70-89 years with advanced NSCLC randomly assigned to receive a doublet of chemotherapy or a monochemotherapy. We demonstrated the benefit of the doublet chemotherapy in terms ofHRQoL. On a methodological point ofview TUDD method is feasible and provide clinically meaningful results. We proposed another approach which would be to combine intermediate endpoint• with HRQoL as co-primary endpoints. Finally, we demonstrated the additional prognostic value of HRQoL data at baseline to identify vulnerable subpopulations in elderly NSCLC patients
Fortin, Gabrielle. "Élaboration et évaluation d’une stratégie d’application des connaissances pour les professionnels de la santé sur la détermination des objectifs de soins avec les personnes malades". Doctoral thesis, Université Laval, 2020. http://hdl.handle.net/20.500.11794/67446.
Pełny tekst źródłaGoals of care conversation (GOCC), a process which consists in identifying with patients the appropriate care for their health condition in accordance with their life plan, is arguably one of the most difficult decisions patients with serious illnesses will face. GOCC implies discussion between the physician and the patient (or his Substitute Decision Maker). It is often complex, since the preferred care orientation for patients must consider their health situation while being consistent with their beliefs, preferences and values as well as those of their relatives. To address these complex situations, the contribution of an interprofessional team is required to support patients in their global perspective. There is, however, a gap that needs to be filled amidst interdisciplinary teamwork in order to integrate GOCC discussions in the routine of care teams so that GOCC no longer rely solely on discussions between the physicians and their patients. In order to reduce this gap, a knowledge transfer strategy aimed at optimizing interprofessional collaboration practices in GOCC situations with the participation of the patients and their relatives was proposed. Co-constructed and deployed in a clinical environment in collaboration with health and social services providers, the knowledge transfer strategy was evaluated in three successive phases, either at the time of its development, during its implementation and finally, after this in order to assess the impact on clinical practices. Twenty-six healthcare providers from different disciplines practicing at the CHU de Québec- Université Laval and at the CIUSSS de la Capitale-Nationale took part in the knowledge strategy, which main activity was the interprofessional training session held during Winter 2018. Analysis of collected data during development and implementation phases highlights : 1) relevance in mobilizing the various players targeted by the knowledge transfer strategy in order to develop relevant content that takes into account the needs and realities in practice context; 2) the need to obtain support from the management of establishments to facilitate the deployment of this type of initiative in health care and health services environments; 3) the importance of fostering a climate of openness and discussion spaces during interdisciplinary training session to promote the appropriation of interprofessional competencies, as well as a place conducive to the development of critical reflections on the participants' GOCC practice. The highlights of the short-term impact assessment phase of the strategy emphasized three main changes observed by the participants in their GOCC practice: 1) better appropriation of a harmonized level of care form for discussing end-of-life issues with patients; 2) improved IPC practices in complex GOCC situations through better affirmation of their expertise role along with recognition of other professionals’ role in this decision-making process, and 3) reaffirmed roles of advocacy, support and enabler with patients and families in GOCC context. In light of these results, recommendations are made to optimize the timely participation of sick people in informed decision-making processes about their end-of-life care, this in an interprofessional collaboration perspective. Recommendations related to the provision of earlier support services in the care trajectory of patients with serious illness, with a potentially fatal outcome in order to facilitate dialogue between patients and stakeholders in anticipation of end-of-life are also presented. This thesis concludes by proposing avenues to be explored in research.Goals of care conversation (GOCC), a process which consists in identifying with patients the appropriate care for their health condition in accordance with their life plan, is arguably one of the most difficult decisions patients with serious illnesses will face. GOCC implies discussion between the physician and the patient (or his Substitute Decision Maker). It is often complex, since the preferred care orientation for patients must consider their health situation while being consistent with their beliefs, preferences and values as well as those of their relatives. To address these complex situations, the contribution of an interprofessional team is required to support patients in their global perspective. There is, however, a gap that needs to be filled amidst interdisciplinary teamwork in order to integrate GOCC discussions in the routine of care teams so that GOCC no longer rely solely on discussions between the physicians and their patients. In order to reduce this gap, a knowledge transfer strategy aimed at optimizing interprofessional collaboration practices in GOCC situations with the participation of the patients and their relatives was proposed. Co-constructed and deployed in a clinical environment in collaboration with health and social services providers, the knowledge transfer strategy was evaluated in three successive phases, either at the time of its development, during its implementation and finally, after this in order to assess the impact on clinical practices. Twenty-six healthcare providers from different disciplines practicing at the CHU de Québec- Université Laval and at the CIUSSS de la Capitale-Nationale took part in the knowledge strategy, which main activity was the interprofessional training session held during Winter 2018. Analysis of collected data during development and implementation phases highlights : 1) relevance in mobilizing the various players targeted by the knowledge transfer strategy in order to develop relevant content that takes into account the needs and realities in practice context; 2) the need to obtain support from the management of establishments to facilitate the deployment of this type of initiative in health care and health services environments; 3) the importance of fostering a climate of openness and discussion spaces during interdisciplinary training session to promote the appropriation of interprofessional competencies, as well as a place conducive to the development of critical reflections on the participants' GOCC practice. The highlights of the short-term impact assessment phase of the strategy emphasized three main changes observed by the participants in their GOCC practice: 1) better appropriation of a harmonized level of care form for discussing end-of-life issues with patients; 2) improved IPC practices in complex GOCC situations through better affirmation of their expertise role along with recognition of other professionals’ role in this decision-making process, and 3) reaffirmed roles of advocacy, support and enabler with patients and families in GOCC context. In light of these results, recommendations are made to optimize the timely participation of sick people in informed decision-making processes about their end-of-life care, this in an interprofessional collaboration perspective. Recommendations related to the provision of earlier support services in the care trajectory of patients with serious illness, with a potentially fatal outcome in order to facilitate dialogue between patients and stakeholders in anticipation of end-of-life are also presented. This thesis concludes by proposing avenues to be explored in research.
Decerle, Jérémy. "Contribution à l'optimisation de la planification des tournées de soins pour l'hospitalisation à domicile". Thesis, Bourgogne Franche-Comté, 2018. http://www.theses.fr/2018UBFCA033/document.
Pełny tekst źródłaThis thesis deals with the planning of care routes for home health care. Under the impulse of the various public health policies put in place in France, the demand for patients to receive their treatment in a familiar and safe environment has steadily increased. Revealing new organizational problems in home health care structures, our work focuses on optimizing care routes planning by considering medical, logistical and economic constraints. As a first step, we study the planning of home health care routes with a particular focus on time window and synchronization constraints. By relaxing these constraints, we bring more flexibility to problem modeling by individually defining the wishes of patients to receive their treatment in order to improve the quality of patient planning and patient satisfaction. In a second step, we integrate in our modeling the workload balancing of the caregivers. This aspect must not be neglected in order to obtain fairness and ensure the applicability of our planning. Subsequently, we study the problem in its multi-objective form. The prioritization of objectives may be confusing for the decision makers, we propose a memetic algorithm for multi-objective optimization in order to obtain a set of solutions representing various trade-offs between the objectives. Finally, the last part of this thesis focuses on the assignment of visits and caregivers to home health care centers in a multi-center configuration. The geographical dispersion of patients on the territory may lead to the opening of new centers, the assignment of caregivers to home health care centers is becoming a new aspect to optimize. For each problem, experiments are carried out in order to evaluate the quality of our solving methods on instances of the literature