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[Creating a local collection of professional reports. A stake in the engineering of diploma education and research in continuing education].

The question of the dissertation written during the training is tackled through the entry key offered by the professional dissertations written during the training courses leading to qualification in the framework of a university department of vocational training. 72 professional dissertations, defended between 1993 and 1996, were analysed on the basis of observation sheets filled out by the directors. In reference to the semiotic approach which provides relevant theoretical and methodological materials for the problem posed, we shall show the interest of considering that these documents are, above all, "object-speeches" and must therefore be studied as such. According to the demands to be determined, related to the types of speeches to deliver, the professional dissertations considered as written traces reconstituting the practices and praxis which found them, as well on the professional as on the scientific level, can provide indications for training, in the area of research as well as in the one of praxeology. The written document is thought of as an object of transition from practice to professional praxis, rallying the scientific praxis which is expressed particularly in the writing work.

Academic Dissertations as Topic↗

Discrimination of changes in osteoporosis outcomes.

The purpose of this paper was to identify existing work related to discrimination, responsiveness, and minimal clinically important differences (MCID) for 4 key clinical outcomes in osteoporosis, to serve as a background to discussions about how to define MCID for both individuals and groups. The outcomes assessed were bone density, fractures, quality of life, and function. We conducted a systematic literature search in MEDLINE, EMBASE, and Current Contents for articles that discussed responsiveness, detectable difference, improvement criteria, and clinical importance. We used the Beaton cube to classify the studies depending on whether they compared differences between or changes within individuals or groups. Although a number of studies were identified that presented data on detectable differences beyond error and observed differences, few studies presented data on how to define clinically important differences. A key priority for future research is to define minimally clinical important differences for clinically important osteoporosis outcomes using a consensus based approach that will be accepted by the osteoporosis community at large. Furthermore, these MCID will likely be different for individual patients seen in clinical practice than for individuals in a clinical trial.

Clinical Trials as Topic↗

Towards a definition of "difference" in osteoarthritis.

To assess existing information regarding detectable differences in osteoarthritis (OA), a systematic literature search was conducted up to December 1999. Thirty-three articles were considered methodologically relevant to the definition and categorization of detectable differences in OA. It was determined that the musculoskeletal literature contains a wealth of information that relates to observed changes, much of which is derived from the clinical trials literature, but there have been relatively few methodological studies that have systematically evaluated the nature, categorization, and relevance of the change. Furthermore, most of those that have been published take the perspective of an individual or groups of experts other than that of the patient. This summary of the current literature reveals that the diverse sources of information go part way towards developing an understanding of detectable differences and their importance in the area of OA research and clinical practice. Stakeholders' interests as well as factors that modulate perceptions of importance need to be taken under consideration. In particular, the patient's perspective of the importance of change at an individual level requires further evaluation. This area of clinical research is relatively underdeveloped, but there is considerable opportunity for progress.

Clinical Trials as Topic↗

[A qualified clinical trial system for cancer chemotherapy, an urgent motion].

Since cancer chemotherapy is generally carried out in the combination form, seldom in single regimen, a new treatment using new drug is not readily available for the clinical use, unless appropriate clinical trial will be performed. Although most clinical trials so far have been used to in the company-oriented-form in our country, new aspects and challenge to the cancer chemotherapy strongly demand to establish stable system to conduct a qualified clinical trial independently conducted from the company. The problems related to this item were analyzed based on the author's own experience of JFMC, and urgent motion was proposed thereupon.

Clinical Trials as Topic↗