The Internet is a tremendous resource where one can find documents to enrich a personal information space. The question is: how can one find relevant documents and how can these be organized into an information space? In this paper, we describe a prototype which aims to provide the user with assistance in these two tasks. Our approach assumes the existence of an initial concept structure set up by the user. This structure may contain only rudimentary descriptions for each concept. The system's task is to find relevant documents from the Internet and to insert them in the appropriate places in the concept structure.
To determine whether the need to use doses of infliximab greater than 3 mg/kg every 8 weeks to achieve or maintain clinical response in patients with rheumatoid arthritis (RA) is associated with differences in baseline clinical characteristics or anti-infliximab antibodies.Baseline clinical characteristics and anti-infliximab levels were evaluated retrospectively in a cohort of 51 consecutive patients with RA treated with infliximab at a single center. Patients were divided into 2 groups for comparison: Group 1 patients achieved and maintained clinical responses with infliximab 3 mg/kg every 8 weeks; Group 2 patients required higher doses.Thirty-two (63%) patients required infliximab dose escalation (Group 2). There were no statistically significant differences in baseline or clinical characteristics between Group 1 and Group 2 patients. Anti-infliximab antibodies occurred in 47% of Group 2 versus 27% of Group 1 patients, with higher anti-infliximab antibody concentrations in Group 2 patients (mean +/- SD: 18.3 +/- 8.9 g/ml vs 7.5 +/- 4.8 g/ml; p = 0.02). Patients who developed anti-infliximab antibodies were younger and receiving less prednisone at the time of infliximab initiation than patients who did not.Finding higher anti-infliximab antibody concentrations in patients who needed dose escalation of infliximab to achieve or maintain clinical responses with lower serum trough levels of infliximab suggests that development of anti-infliximab antibodies may reduce clinical efficacy of infliximab in some patients with RA.
La question de l'attachement fait partie de la realite du travail social depuis de tres nombreuses annees. Meme si on parlait alors de « carence affective », ce n'est qu'au cours des dernieres decennies que plusieurs auteurs ont examine sous plusieurs angles une definition plus contemporaine pour mieux comprendre la dynamique relationnelle de l'enfant. Parmi les facteurs explicatifs, l'explosion de l'adoption internationale au cours des annees 1990 a contribue a l'urgence de bonifier la recherche vue l'augmentation des demandes de consultations aupres des services publics. Ceci etant, la complexite des interventions associees aux problemes d'attachement et a la relation parent-enfant a cree certaines « lacunes » de savoir chez les professionnels. Dit autrement, si nous parlons plus des questions liees a l'attachement, le processus d'intervention avec des reperes precis est loin d'etre etoffe. En privilegiant des interventions visant une approche familiale et systemique, ce memoire propose une representation multifactorielle du phenomene de l'attachement. A travers des entrevues en profondeur aupres d'intervenants experts, cette demarche nous permet d'identifier des modeles d'intervention existants et des reperes d'intervention qui permettent l'amelioration des dynamiques familiales et jusqu'a un certain point, le renouvellement des pratiques. Dans une perspective de travail social et de changement, ce memoire suggere egalement quelques pistes d'intervention.
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MOTS-CLES DE L’AUTEUR : Attachement, post adoption, famille adoptante, famille d'accueil, relations parent-enfant, intervention familiale.
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