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Comment le Programme des Nations unies pour l’environnement (PNUE) se fait-il reconnaître une autorité propre au-delà de la dotation symbolique de son mandat onusien et en dépit de la circulation des experts environnementaux sur lesquels il s’appuie ?Depuis 1972, les savoirs experts du PNUE assurent à la fois sa crédibilité et sa pertinence auprès des acteurs rivalisant avec lui pour définir et observer l’environnement global. Cependant, la reconnaissance de l’autorité propre du PNUE fait face à deux défis. D'abord celui d’une bureaucratie limitée par ses moyens ad hoc et le contrôle par les États. Ensuite, celui d’une compétition entre experts pour imposer leur autorité comme étant celle du PNUE, par rapport à celle d’autres organisations. Or, en dépit du tumulte entourant le PNUE, les experts adhèrent au mandat du PNUE et l’intériorisent. Cette croyance dans la valeur du PNUE crée son illusio, c’est-à-dire un intérêt des individus dans le PNUE, lui distinguant ainsi une autorité propre.Cette thèse argumente que le PNUE assoit son autorité en cooptant celle des experts par des pratiques qui stabilisent un savoir propre dont émerge un domaine pertinent pour son mandat. Les pratiques d’ancrage du savoir du PNUE renforcent son illusio auprès des experts afin de les maintenir investis dans un mandat qu’ils perçoivent être dans l’intérêt de leur carrière. Pour saisir ces pratiques d’ancrage du savoir, cette thèse se concentre sur le domaine de compétences des conflits armés et catastrophes du PNUE, ce dernier étant initialement exclu de son mandat. Retraçant le parcours de cette expertise des « crises » du PNUE depuis les années 1990, cette thèse examine deux types de pratiques d’ancrage de ce savoir. D’abord, les pratiques bureaucratiques du PNUE, telles que la division du travail, la gestion des projets et la mise en écriture d’un savoir expert commun, ancrent les frontières symboliques de ce domaine. Ensuite, les pratiques professionnelles de cette branche du PNUE, d, Doctorat en Sciences politiques et sociales, info:eu-repo/semantics/nonPublished

Depuis une quinzaine d’années, les drones MALE (Moyenne Altitude, Longue Endurance), sont employés en opérations extérieures par le Royaume-Uni et la France, en Afghanistan, dans le Sahel, en Irak et en Syrie. Ces drones sont caractérisés par leur endurance en l’air de plus de 24 heures et leur capacité à être pilotés à distance par une liaison satellite depuis une station de contrôle à des milliers de kilomètres des théâtres d’opérations. Ils peuvent en outre être armés de bombes et de missiles. Si les travaux des Critical War Studies sont nombreux sur l’emploi des drones MALE par l’United States Air Force et plus encore par la Central Intelligence Agency, ils sont en revanche beaucoup plus rares en ce qui concerne l’utilisation de ces mêmes drones dans les forces armées européennes. L’objectif du présent travail est d’étudier comment les discours officiels au Royaume-Uni et en France ont participé à la normalisation de l’emploi des drones MALE dans les opérations militaires et défini un cadre à cet emploi. Empruntant aux travaux de Michel Foucault, nous y démontrons que deux communautés de discours au Royaume-Uni et en France ont porté un régime de vérité favorable à l’acquisition et l’emploi de ces drones, en usant parfois des mêmes arguments et en se basant sur les mêmes conceptions stratégiques. Au cours de cinq chapitres thématiques, le présent travail étudie successivement différents éléments du régime de vérité sur les drones construit au Royaume-Uni et en France par ces communautés de discours. Dans un premier chapitre, il montre comment les communautés de discours ont abordé le programme américain d’éliminations ciblées pour mettre de la distance entre les pratiques américaines et l’usage des drones qui pourrait être fait par les forces armées britanniques ou françaises. Un second chapitre est consacré aux discours présentant les drones avant tout comme des outils de renseignement et la présentation élogieuse qui est faite de leur capacité à comprendre les, Doctorat en Sciences politiques et sociales, info:eu-repo/semantics/nonPublished

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La découverte d'archives photographiques militaires de la première guerre du Golfe constitue le point de départ de cette recherche. A partir de l'analyse de ces documents, il s'est agi d'étudier les différents régimes de visibilité mis à l'oeuvre dans les représentations actuelles des conflits, et de comprendre jusqu'à quel point la guerre donne à voir d'elle-même, à travers les images qu'elle produit. Considérée comme un ensemble de dispositifs de visualisation et de représentation, la guerre produit un visuel. Dès lors, qu'est-ce que la guerre dévoile dans ce qu'elle donne à voir et ce qu'elle ne montre pas ?La guerre doit être pensée en lien avec notre regard. Depuis la guerre du Golfe, conflit qui a marqué une rupture dans la façon de penser et de représenter la guerre, le monde est devenu un écran géant sur lequel se succèdent, et de façon de plus en plus rapide, un flux et un flot d'images ininterrompus. L'image de guerre, telle qu'elle était pensée, montrée, imaginée jusque-là, n'allait plus jamais être la même. Le conflit de 1990 dans le Golfe n'a rien montré. "On n'a rien vu", sont les mots les plus souvent utilisés pour décrire ce conflit, dont la représentation était totalement absente :elle était hors-champ ou plus précisément, une représentation nous était donnée, mais la réalité de la guerre était maintenue hors champ. Le concept de dé-subjectivation évoqué soulève bien évidemment des questions morales décisives en particulier, mais pas seulement, la question de la responsabilité, responsabilité des militaires, des politiques, des journalistes, mais également des artistes lorsqu'ils travaillent avec ce matériau de documentation., Doctorat en Art et Sciences de l'Art, info:eu-repo/semantics/nonPublished

Objectives: To evaluate the distribution and impact of ABO blood groups on postoperative outcomes in patients undergoing surgery for acute type A aortic dissection (ATAAD). Design: A total of 1144 surgical ATAAD patients from eight Nordic centres constituting the Nordic consortium for acute type A aortic dissection (NORCAAD) were analysed. Blood group O patients were compared to non-O subjects. The relative frequency of blood groups was assessed with t-distribution, modified for weighted proportions. Multivariable logistic regression was performed to identify independent predictors of 30-day mortality. Cox regression analyses were performed for assessing independent predictors of late mortality. Results: There was no significant difference in the proportions of blood group O between the study populations in the NORCAAD registry and the background population (40.6 (95% CI 37.7-43.4)% vs 39.0 (95% CI 39.0-39.0)%). ABO blood group was not associated with any significant change in risk of 30-day or late mortality, with the exception of blood group A being an independent predictor of late mortality. Prevalence of postoperative complications was similar between the ABO blood groups. Conclusions: In this large cohort of Nordic ATAAD patients, there were no associations between ABO blood group and surgical incidence or outcomes, including postoperative complications and survival., Funding Agencies:University of Iceland Landspitali Research Fund in Reykjavik, Iceland Mats Kleberg Foundation, Stockholm, Sweden

OBJECTIVES: Stroke is a serious complication in patients with acute type A aortic dissection (ATAAD). Previous studies investigating stroke in ATAAD patients have been limited by small cohorts and have shown diverging results. We sought to identify risk factors for stroke and to evaluate the effect of stroke on outcomes in surgical ATAAD patients. METHODS: The Nordic Consortium for Acute Type A Aortic Dissection database included patients operated for ATAAD at 8 Scandinavian Hospitals between 2005 and 2014. RESULTS: Stroke occurred in 177 (15.7%) out of 1128 patients. Patients with stroke presented more frequently with cerebral malperfusion (20.6% vs 6.3%, P < 0.001), syncope (30.6% vs 17.6%, P < 0.001), cardiogenic shock (33.1% vs 20.7%, P < 0.001) and pericardial tamponade (25.9% vs 14.7%, P < 0.001) and more often underwent total aortic arch replacement (10.7% vs 4.7%, P = 0.016), compared to patients without stroke. In the 86 patients presenting with cerebral malperfusion, 38.4% developed stroke. Thirty-day and 5-year mortality in patients with and without stroke were 27.1% vs 13.6% and 42.9% vs 25.6%, respectively. Stroke was an independent predictor of early- [odds ratio 2.02, 95% confidence interval (CI) 1.34-3.05; P < 0.001] and midterm mortality (hazard ratio 1.68, 95% CI 1.27-2.23; P < 0.001). CONCLUSIONS: Stroke in ATAAD patients is associated with increased early- and midterm mortality. Preoperative cerebral malperfusion and impaired haemodynamics, as well as total aortic arch replacement, were more frequent among patients who developed stroke. Importantly, a large proportion of patients presenting with cerebral malperfusion did not develop a permanent stroke, indicating that signs of cerebral malperfusion should not be considered a contraindication for surgery.

Le retour volontaire est une pratique d’éloignement qui a la particularité de s’appuyer sur la« volonté » des migrants, ou tout du moins, sur leur participation au processus de retour. Cetteambiguïté ne se révèle analytiquement féconde, qu’à condition de dépasser les schèmesdichotomiques d’appréhension des relations de pouvoir que renferme le retour volontaire. C’està cet effort de conceptualisation que nous invitent les migrants ouest et centre africains quis’engagent, depuis le Maroc, dans une procédure d’ « Aide au Retour Volontaire et à laRéintégration » (AVRR) diligentée par l’Organisation Internationale pour les Migrations(OIM). Selon la formule consacrée par les candidats au retour sur le terrain marocain, s’inscrireà l’OIM revient à « signer la déportation ». À travers cette expression émique, ils et ellesrévèlent dans quelle mesure épreuve de la violence et manifestation de l’agencéité tendent à seconfondre dans l’expérience du retour volontaire.La dialectique du contrôle et de l’agencéité cependant, ne constitue qu’une étape de la réflexionpermettant d’appréhender avec rigueur la participation des migrants à l’éloignement. En effet,l’ethnographie des retours volontaires démontre qu’entre la violence des frontières et la capacitéd’action des migrants, se trouvent des acteurs hétérogènes – humanitaires, caritatifs etassociatifs – qui jouent un rôle intermédiaire dans la mise en retour des migrants. C’est danscet espace médian que se joue la part d’indétermination, non seulement de l’issue, maiségalement des modalités du processus de retour volontaire. L’intermédiation constitue dans cesens un espace relationnel où convergent, se contestent et se déforment l’un l’autre, lesmécanismes d’éloignement et les expressions de l’agencéité migrante.En somme, ni tout à fait réductible à une forme d’expulsion, ni exclusivement synonyme d’uneliberté d’action des migrants, la participation des migrants au retour volontaire se façonne àpartir de trois pôles en tension :la, Doctorat en Sciences politiques et sociales, info:eu-repo/semantics/nonPublished

La thèse tente de conceptualiser l'asymétrie de la guerre asymétrique telle une prédation à la structure de la guerre, de la paix et de l'ordre politique., Doctorat en Philosophie, THPHILO, info:eu-repo/semantics/nonPublished

Att arbeta i olika typer av arbetsgrupper är idag vanligt förekommande i organisationer, och många företag tillämpar någon form av incitamentsprogram med rörlig lön för att motivera arbetsgrupperna till högre prestationer. Den forskning som finns är framförallt genomförd i laboratoriemiljö och undersöker hur individer påverkas av olika faktorer såsom andel rörlig lön och storlek på arbetsgrupper. Dock finns en brist på forskning som undersöker hur dessa program påverkar till exempel motivation och samarbete i verkliga miljöer. Syftet med denna studie är att studera hur incitamentsprogram för grupper kan utformas. Med studien vill vi ge företag ökad kunskap om hur de kan utforma incitamentsprogram för att öka prestationen i sina arbetsgrupper. Studien har en kvalitativ ansats. Semistrukturerade intervjuer har genomförts med totalt 15 personer ur två säljorganisationer i ett tjänsteföretag med verksamhet spridd över hela Sverige. Genom intervjuerna har vi sökt få svar på hur olika aspekter av incitamentsprogram för grupper motiverar de individuella medarbetarna samt påverkar samarbetet. Respondenternas svar antyder att faktorer som gruppstorlek, andel rörlig lön och frekvens på utbetalningar alla påverkar hur medarbetare beskriver att de motiveras av incitamentsprogrammen. Därutöver har att ett tydligt syfte och klara spelregler framträtt som avgörande för hur incitamentsprogrammen tas emot av de anställda, vilket har föranlett oss att ge ett förslag på hur befintliga modeller kan kompletteras., Today it is very common to work in different types of teams in organizations, and companies are applying incentive programs with variable salary to motivate their teams to increase performance. Existing research is primarily done in laboratory environments and only analyzes how individuals are affected by various factors, such as share of variable salary and team size. However, previous studies are missing to investigate how these programs affect for instance, motivation and collaboration in real environments. The aim of this study is therefore to study how incentive programs for groups in can be designed. With this study we want to give companies a deeper understanding for how they can design incentive programs to increase the performance in their teams. The study has a qualitative approach. Semi-structured interviews have been performed with a total of 15 persons from two sales organizations in a service company with its business spread over the whole of Sweden. Through the interviews we searched for answers to how different aspects of team-based incentive programs motivate the individual employees and how they affect collaboration. The respondent’s answers suggest that factors such as size of the team, share of variable salary and frequency of payments, all affect how employees describe how they are motivated by the incentive program. In addition, a clear purpose and a set of rules emerged as vital parts for how the incentive program will be received by the employees. This led us to propose how existing models may be complemented. The language of this thesis is Swedish.

The aim of this paper is to represent various distribution principles that occur when a municipality divide costs for expansion of public space between developers who act in the same detailed development plan. We will look at different principles to divide costs, compare projects, investigate geographical differences, compare the cost that is debited and discuss transparency in the land development agreements. To answer the aim, a collection and review of land development agreements have been made. Eleven of these are represented in the report. Three principles to divide costs are represented in the collected material, these are: gross area, gross area in combination with a factor related to permit use and future land proportion. The location of the projects has not been crucial, rather the nature of the project and the preferences of the municipality. Based on the agreements that has been reviewed, it’s common that the municipality charge the actual cost of expanding public space. One reason is that the municipality wants to avoid risk. The difficulty of finding out which distribution principle that is used varies a lot between the land development agreements that have been examined. There is no doubt that lack of transparency is a problem for a third part., Efter kontakt med exploateringsavdelningen på WSP i Stockholm fick vi förslaget att,i samarbete med dem, titta närmare på hur kostnader för utbyggnad av allmän platsfördelas när fler än en exploatör verkar inom samma detaljplan. En fråga som WSP, iform av rådgivande konsulter, anser är intressant att undersöka. 6 kap. 40 § plan- och bygglagen (2010:900) ligger till grund för kommunens rätt att taut kostnader för utbyggnad av allmän plats. Där anges att byggherrens eller fastighetsägarens åtagande ska stå i rimligt förhållande till dennes ”nytta” av planen. Hur nytta ska bedömas framgår däremot inte av paragrafen. Syftet med detta arbete är att belysa olika fördelningsprinciper som förekommer vid utbyggnad av allmän plats när fler än en exploatör verkar inom samma detaljplan. Fem frågeställningar ligger till grund för rapporten där vi undersöker olika fördelningsprinciper, jämför projekt, studerar geografiska skillnader, framställer vilken kostnad som debiteras, resonerar kring vem som står som riskbärare samt tar upp transparens i exploateringsavtalen. För att besvara rapportens frågeställningar har en insamling och granskning av exploateringsavtal gjorts. Denna resulterade i en slutgiltig sammanställning och analys av elva avtal. Studien är av kvalitativ art och några statistiska slutsatser kan därför inte dras utifrån rapporten. De fördelningsprinciper som finns representerade är BTA, BTA i kombination med värdefaktor för olika ändamål samt markandel för blivande kvartersmark. I projekten som använt BTA i kombination med värdefaktorer har nyttan för samma typ av bebyggelse bedömts något olika. Markandel har använts för ett logistikcentrum på Hisingen i Göteborg. Trots att varje projekt är unikt kan vi konstatera att nyttan främst bedömts utifrån kvadratmeter BTA. Projektens lokalisering har inte varit avgörande för val av fördelningsprincip, snarare projektens karaktär och kommunens preferenser. I de flesta avtal som studerats har kommunen valt att debitera den fa, Kostnader för utbyggnad av allmän plats fördelas utan tydliga riktlinjer Hur kostnader för utbyggnad av allmän plats ska fördelas när fler än en exploatör verkar inom samma detaljplan är absolut ingen självklarhet. Enligt lagstiftningen ska kostnaderna fördelas efter den ”nytta” exploatören har av detaljplanen. Nytta är i sammanhanget ett luddigt begrepp som varken kommunanställda eller konsulter verksamma som rådgivare inom exploateringsfrågor kan definiera. I vårt examensarbete ”Fördelningsprinciper gällande utbyggnadskostnader för allmän platsmark”, som avslutar våra studier till civilingenjörer i Lantmäteri vid Lunds Tekniska Högskola, har vi undersökt hur kostnader för utbyggnad av allmän plats fördelas i praktiken när fler än en exploatör verkar inom samma detaljplan. Vi har även studerat om kommunen debiterar en faktisk eller uppskattad kostnad för utbyggnaden, vilket är avgörande för vem av parterna som bär den största ekonomiska risken. För att ta reda på svaret har en insamling och granskning av exploateringsavtal gjorts. Vår förhoppning är att examensarbetet ska kunna utgöra underlag till personer som är verksamma inom exploatering för att underlätta arbetet vid val av fördelningsmetod i framtiden. Förekommande principer I de exploateringsavtal som granskats har vi stött på tre olika fördelningsprinciper. Den vanligast förekommande är baserad på kvadratmeter bruttoarea (BTA), med andra ord summan av en byggnads alla våningsplans area som begränsas av de omslutande byggnadsdelarnas utsida. En annan variant är BTA i kombination med en värdefaktor. Värdefaktorn varierar beroende på vilken typ av bebyggelse det rör sig om. Intressant är att de kommuner som använt sig av värdefaktorer bedömt nyttan för samma typ av bebyggelse något olika, vilket innebär att exploatörer som bygger bostäder får betala en större andel av kostnaderna. Den tredje fördelningsprincipen vi träffade på är baserad på markandel. Projektet utmärker sig genom att det utgör ett logistikcent

OBJECTIVES: Acute aortic dissection type A is a life-threatening condition, warranting immediate surgery. Presentation with sudden chest pain confers a risk of misdiagnosis as acute coronary syndrome resulting in subsequent potent antiplatelet treatment. We investigated the impact of dual antiplatelet therapy (DAPT) on bleeding and mortality using the Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD) database.METHODS: The NORCAAD database is a retrospective multicentre database where 119 of 1141 patients (10.4%) had DAPT with ASA + clopidogrel (n = 108) or ASA + ticagrelor (n = 11) before surgery. The incidence of major bleeding and 30-day mortality was compared between DAPT and non-DAPT patients with logistic regression models before and after propensity score matching.RESULTS: Before matching, 51.3% of DAPT patients had major bleeding when compared to 37.7% of non-DAPT patients (P = 0.0049). DAPT patients received more transfusions of red blood cells [median 8 U (Q1-Q3 4-15) vs 5.5 U (2-11), P < 0.0001] and platelets [4 U (2-8) vs 2 U (1-4), P = 0.0001]. Crude 30-day mortality was 19.3% vs 17.0% (P = 0.60). After matching, major bleeding remained significantly more common in DAPT patients, 51.3% vs 39.3% [odds ratio (OR) 1.63, 95% confidence interval (CI) 1.05-2.51; P = 0.028], but mortality did not significantly differ (OR 0.88, 95% CI 0.51-1.50; P = 0.63). Major bleeding was associated with increased 30-day mortality (adjusted OR 2.44, 95% CI 1.72-3.46; P < 0.0001).CONCLUSIONS: DAPT prior to acute aortic dissection repair was associated with increased bleeding and transfusions but not with mortality. Major bleeding per se was associated with a significantly increased mortality. Correct diagnosis is important to avoid DAPT and thereby reduce bleeding risk, but ongoing DAPT should not delay surgery.

OBJECTIVES: To evaluate the effect of preoperative malperfusion on 30-day and late mortality and postoperative complications using data from the Nordic Consortium for Acute Type A Aortic Dissection (ATAAD) registry.METHODS: We studied 1159 patients who underwent ATAAD surgery between January 2005 and December 2014 at 8 Nordic centers. Multivariable logistic and Cox regression analyses were performed to identify independent predictors of 30-day and late mortality.RESULTS: Preoperative malperfusion was identified in 381 of 1159 patients (33%) who underwent ATAAD surgery. Thirty-day mortality was 28.9% in patients with preoperative malperfusion and 12.1% in those without. Independent predictors of 30-day mortality included any malperfusion (odds ratio, 2.76; 95% confidence interval [CI], 1.94-3.93), cardiac malperfusion (odds ratio, 2.37; 95% CI, 1.34-4.17), renal malperfusion (odds ratio, 2.38; 95% CI, 1.23-4.61) and peripheral malperfusion (odds ratio, 1.95; 95% CI, 1.26-3.01). Any malperfusion (hazard ratio, 1.72; 95% CI, 1.21-2.43), cardiac malperfusion (hazard ratio, 1.89; 95% CI, 1.24-2.87) and gastrointestinal malperfusion (hazard ratio, 2.25; 95% CI, 1.18-4.26) were predictors of late mortality. Malperfusion was associated with significantly poorer survival at 1, 3, and 5 years (95.0% ± 0.9% vs 88.7% ± 1.9%, 90.1% ± 1.3% vs 84.0% ± 2.4%, and 85.4% ± 1.7% vs 80.8% ± 2.7%; log rank P = .009).CONCLUSIONS: Malperfusion has a significant influence on early and late outcomes in ATAAD surgery. Management of preoperative malperfusion remains a major challenge in reducing mortality associated with surgical treatment of ATAAD.

BACKGROUND: Female sex is known to have increased perioperative mortality in cardiac surgery. Studies reporting effects of sex on outcome following surgical repair for acute Type A aortic dissection (ATAAD) have been limited by small cohorts of heterogeneous patient populations and have shown diverging results. This study aimed to compare perioperative characteristics, operative management, and postoperative outcome between sexes in a large and well-defined cohort of patients operated for ATAAD.METHODS: The Nordic Consortium for Acute Type A Aortic Dissection study included patients with surgical repair of ATAAD at eight Nordic centers between January 2005 and December 2014. Independent predictors of 30-day mortality were identified using multivariable logistic regression.RESULTS: Females represented 373 (32%) out of 1,154 patients and were significantly older (65 ± 11 vs. 60 ± 12 years, p < 0.001), had lower body mass index (25.8 ± 5.4 vs. 27.2 ± 4.3 kg/m2, p < 0.001), and had more often a history of hypertension (59% vs. 48%, p = 0.001) and chronic obstructive pulmonary disease (8% vs. 4%, p = 0.033) compared with males. More females presented with DeBakey class II as compared with males with dissection of the ascending aorta alone (33.4% vs. 23.1%, p = 0.003). Hypothermic cardiac arrest time (28 ± 16 vs. 31 ± 19 minutes, p = 0.026) and operation time (345 ± 133 vs. 374 ± 135 minutes, p < 0.001) were shorter among females. There was no difference between the sexes in unadjusted intraoperative death (9.1% vs. 6.7%, p = 0.17) or 30-day mortality (17.7% vs. 17.4%, p = 0.99). In a multivariable analysis including perioperative factors influencing mortality, no difference was found between females and males in 30-day mortality (odds ratio: 0.92, 95% confidence interval: 0.62-1.38, p = 0.69).CONCLUSIONS: This study found no association between sex and early mortality following surgery for ATAAD, despite females being older and having

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AIM OF THE STUDY: Patients presenting with acute type A aortic dissection (ATAAD) and cardiac arrest before surgery are considered to have very poor prognosis, but limited data is available. We used a large database to evaluate the outcome of ATAAD patients with a cardiac arrest before surgery. METHODS: We evaluated 1154 surgically treated ATAAD patients from the Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD) database between 2005 and 2014. Patients with (n = 44, 3.8%) and without preoperative cardiac arrest were compared and variables univariably associated with mortality in the cardiac arrest group were identified. Median follow-up time was 2.7 years (interquartile range 0.5-5.5). RESULTS: Thirty-day mortality in the arrest and non-arrest group was 43.2% and 16.6%, respectively (odds ratio [OR] 3.83, CI 2.06-7.09; P < 0.001). In the nine patients with ongoing cardiopulmonary resuscitation when cardiopulmonary bypass was initiated, five died intraoperatively and one died after 65 days. In patients surviving the operation, stroke was significantly more common in the arrest group (48.4% vs 18.2%; OR 4.21, CI 2.05-8.67; P < 0.001). In total, 50.0% (22/44) of the arrest patients survived to the end of follow-up. Non-survivors in the arrest group more often had DeBakey type I dissection, cardiac tamponade, cardiac malperfusion and higher preoperative serum lactate (all P < 0.05). CONCLUSIONS: Early mortality and complications after ATAAD surgery in patients with a preoperative cardiac arrest are high, but mid-term outcome after surviving the initial period is acceptable. Preoperative cardiac arrest should not be considered an absolute contraindication for a surgical ATAAD repair., Funding Agencies:Sahlgrenska University Hospital Finnish Medical Foundation Turku University Foundation

Background: Aortic dissection type A requires immediate surgery. In general surgery populations, patients operated on during weekends have higher mortality rates compared with patients whose operations occur on weekdays. The weekend effect in aortic dissection type A has not been studied in detail. Methods: The Nordic Consortium for Acute Type A Aortic Dissection (NORCAAD) registry includes data for 1,159 patients who underwent type A dissection surgery at 8 Nordic centers during 2005 to 2014. This study is based on data relating to surgery conducted during weekdays versus weekends and starting between 8:00 AM and 8:00 Pm ("daytime") versus from 8:00 Pm to 8:00 AM ("nighttime"), as well as time from symptoms, admittance, and diagnosis to surgery. The influence of timing of surgery on the 30-day mortality rate was assessed using logistic regression analysis. Results: The 30-day mortality was 18% (204 of 1,159), with no difference in mortality between surgery performed on weekdays (17% [150 of 889]) and on weekends (20% [54 of 270], p = 0.45), or during nighttime (19% [87 of 467]) versus daytime (17% [117 of 680], p = 0.54). Time from symptoms to surgery (median 7.0 hours vs 6.5 hours, p = 0.31) did not differ between patients who survived and those who died at 30 days. Multivariable regression analysis of risk factors for 30-day mortality showed no weekend effect (odds ratio, 1.04; 95% confidence interval, 60.67 to 1.60; p = 0.875), but nighttime surgery was a risk factor (odds ratio, 2.43; 95% confidence interval, 1.29 to 4.56; p = 0.006). Conclusions: The 30-day mortality in surgical repair of aortic dissection type A was not significantly affected by timing of surgery during weekends versus weekdays. Nighttime surgery seems to predict increased 30-day mortality, after correction for other risk factors., Funding Agencies:University of Iceland Research Fund, Reykjavik Landspitali Research Fund, Reykjavik Mats Kleberg Foundation, Stockholm

This thesis is motivated and informed by three observations of the literature on EU democracy promotion. First of all, such studies tend to be conceptually and methodologically Eurocentric in that they do not sufficiently consider the experiences, perceptions and attitudes of those who are at the receiving end of EU policy. Second, the EU and civil society as actors promoting democracy in transitioning countries are often framed as rather monolithic political entities and interaction between the two is often analysed under that premise. Third, and partly as a result of this, less attention is devoted to what individuals and groups engaged in democracy promotion actually do in practice as well as how their practices interact with each other. This motivates the overarching research question of this thesis: How do EU democracy promotion practices shape civil society in transitioning countries?Using Tunisian civil society and its practices as a case study, the thesis has two main objectives: First of all, it seeks to identify, map and examine the practices appearing at the nexus of EU and civil society engagement in the context of democracy promotion. On that basis, it then seeks to understand how these practices relate and react to each other. In order to avoid Eurocentrism, it does so by strongly drawing upon the accounts of Tunisian civil society activists interacting with the EU.Whilst scholars of democracy promotion tend to focus on either the formulation of policies or their impact, this thesis demonstrates the centrality of the practices employed in their context. It shows that to understand democracy promotion and its outcomes, we need to revisit the repertoires of practices of those enacting it within countries in transition. This includes both internal actors such as civil society as well as external actors such as the European Union, both of which can be conceived of as democracy promoters.The thesis shows that the practices, through which the EU and Tunisian, Doctorat en Sciences politiques et sociales, info:eu-repo/semantics/nonPublished

Based on socio-historic and ethnographic fieldwork, this thesis analysis the birth and evolutions of immigration detention in Belgium. In particular, the socio-historic approach sheds light on how the creation of the centres has to be replaced within the field of immigration policy-making in which different actors (both individual as well as institutional) vie for the symbolic power to define legitimate movement. From this perspective the creation of the centres is seen to have contributed to the autonomisation of this field. The immigration office (IO), which is the public administration in charge of the implementing migration policies in Belgium, benefited the most from the creation of the centres and as such became a hegemonic actor in the field of migration policy-making.The ethnographic approach then turns to the daily practices and organisation of the centres. In particular it looks at what the "humanisation" of detention changed in the daily organisation. I argue that the process of humanisation must be seen as the result of power struggles within the IO, which is considered as a field in which these actors struggles for the symbolic power to define legitimate detention policies. My data show how the process of humanisation has been one through which the security teams of the centres, who used to be hegemonic at their creation, have been dispossessed of their power to the benefit of management and social staff. The latter defined the visions of legitimate practices during my field work and as such occupied a dominating position in the organisational field.This shift however was only possible because social staff actually contributed to the elaboration and expansion of security in the centres. In particular I analyse how in their daily routines social staff actually functioned as risk managers because they had access to the biographical information of detainees, which they then put together and analysed to formulate guidelines on how to behave and interact wit, Doctorat en Sciences politiques et sociales, info:eu-repo/semantics/nonPublished

The ‘international’ can be conceived of as a highly sought after symbolic capital. People seek to internationalise their curriculum vitae or resumes, study international subjects, get international diplomas, travel internationally, obtain international jobs. As symbolic capital the ‘international’ can be converted into ‘profit’ complementing other forms of capital (economic, cultural and social capital), deployed in struggles for social domination. It is used as a strategy of social positioning and social domination quasi-globally, but it is not recognised everywhere in the same way. We are particularly interested in the unequal distribution of this symbolic capital, the way differential conversion rates and social boundaries operate in the generation of social inequalities. For this, we will work with and against Bourdieu, in analysing the ‘international’ as a source of a highly contextual form of symbolic power, deployed in a variety of social group formations, but with uneven, differential effects, a naturalised and disguised form of domination. Ultimately, this article problematises how claims to ‘internationality’ operate in social relations and power-struggles and provides an analytical framework hereof., SCOPUS: ar.j, info:eu-repo/semantics/published

OBJECTIVES: Our goal was to validate the Swedish Cardiac Surgery Registry by reviewing the reported cardiac operations to assess the completeness and quality of the registered data and the EuroSCORE II variables. METHODS: A total of 5837 cardiac operations were reported to the Swedish Cardiac Surgery Registry in Sweden during 2015. A randomly selected sample of 753 patient records (13%) was scrutinized by 3 surgeons at all 8 units in Sweden performing open cardiac surgery in adults. RESULTS: Coverage was excellent with 99% [95% confidence interval (CI) 98-99%] of the performed procedures found in the registry. Reported waiting times for surgery were correct in 78% (95% CI 76-79%) of the cases. The main procedural code was correctly reported in 96% (95% CI 95-97%) of the cases. The correlation between reported and monitored logistic EuroSCORE II had a coefficient of 0.79 (95% CI 0.76-0.82), and the median difference in EuroSCORE II was 0% (interquartile range -0.4% to 0.4%). The majority of EuroSCORE II variables had good agreement and coherence; however, New York Heart Association functional class, preoperative renal dysfunction, left ventricular ejection fraction, Canadian Cardiovascular Society Class IV angina and poor mobility were less robust Postoperative complications were rare and in general had a high degree of completeness and agreement. CONCLUSIONS: The reliability of the variables in the national Swedish Cardiac Surgery Registry was excellent. Thus, the registry is a valuable source of data for quality studies and research. Some EuroSCORE II variables require improved and stricter definitions to obtain uniform reporting and high validity.

Objectives: To describe the relationship between the extent of primary aortic repair and the incidence of reoperations after surgery for type A aortic dissection. Methods: A retrospective cohort of 1159 patients treated for type A aortic dissection at eight Nordic low-to medium-sized cardiothoracic centers from 2005 to 2014. Data were gathered from patient records and national registries. Patients were separately divided into 3 groups according to the distal anastomoses technique (ascending aorta [n = 791], hemiarch [n = 247], and total arch [n = 66]), and into 2 groups for proximal repair (aortic root replacement [n = 285] and supracoronary repair [n = 832]). Freedom from reoperation was estimated with cumulative incidence survival and Fine-Gray competing risk regression model was used to identify independent risk factors for reoperation. Results: The median follow-up was 2.7 years (range, 0-10 years). Altogether 51 out of 911 patients underwent reoperation. Freedom from distal reoperation at 5 years was 96.9%, with no significant difference between the groups (P = .22). Freedom from proximal reoperation at 5 years was 97.8%, with no difference between the groups (P = .84). Neither DeBakey classification nor the extent of proximal or distal repair predicted freedom from a later reoperation. The only independent risk factor associated with a later proximal reoperation was a history of connective tissue disease. Conclusions: Type A aortic dissection repair in low-to medium-volume centers was associated with a low reoperation rate and satisfactory midterm survival. The extent of the primary repair had no significant influence on reoperation rate or midterm survival., Funding Agency:Finnish governmental research funding

Cette thèse analyse l’institutionnalisation du Haut représentant de l’UE dans les négociations sur le programme nucléaire iranien entre 2003 et 2015. Si au départ le rôle qu’occupe le Haut représentant dans le dossier iranien est codifié dans les traités européens, à partir de 2006, ce sont notamment les résolutions du Conseil de sécurité de l’ONU qui le définissent. Ainsi mandaté par deux groupes d’acteurs distincts – les acteurs institutionnels de l’UE et les six puissances impliquées dans les négociations avec l’Iran – le diplomate en chef de l’UE est amené à endosser deux rôles contradictoires, celui du Haut représentant de l’UE et celui du Haut représentant des E3+3.En combinant la sociologie de l’UE avec la sociologie des RI, cette thèse interroge les dynamiques qui ont amené le Haut représentant à être reconnu comme légitime par l’ensemble des acteurs de la configuration du dossier nucléaire iranien. À partir de ce questionnement, ce travail propose un cadre d’analyse pour étudier l’institutionnalisation de l’Europe de la politique étrangère.La littérature sur l’institutionnalisation de l’action extérieure commune est divisée entre des travaux qui s’intéressent aux interactions entre des acteurs européens, d’un côté, et des travaux qui étudient l’institutionnalisation de l’UE sur la scène internationale, de l’autre. Ainsi, ils omettent que la construction de l’action extérieure commune est le produit de l’enchevêtrement des dynamiques globales et européennes. Cette thèse surmonte ce clivage en ce qu’elle met l’enjeu des dimensions interne et externe de l’institutionnalisation de l’UE au cœur de l’analyse. En m’appuyant sur l’hypothèse de la différenciation des espaces sociaux, je prendrai en compte les logiques distinctes structurant l’arène globale de la négociation nucléaire et l’arène de la PESC, tout en les appréhendant comme des arènes enchevêtrées. L’enquête empirique qui s’appuie sur des entretiens et des archives, met en exergue que le Haut représenta, This thesis analyses the institutionalisation of the EU High Representative in the negotiations on Iran's nuclear programme between 2003 and 2015. Although initially the role of the High Representative in the Iranian dossier was codified in the European treaties, from 2006 onwards, it was notably the UN Security Council resolutions that defined it. Thus mandated by two distinct groups of actors - the EU's institutional actors and the six powers involved in the negotiations with Iran - the EU's chief diplomat is led to assume two contradictory roles, that of the EU High Representative and that of the E3+3 High Representative.By combining sociology of the EU with sociology of IR, this thesis examines the dynamics that led the High Representative to be recognised as legitimate by all those involved in the configuration of the Iranian nuclear dossier. Based on this guiding question, this work proposes an analytical framework for studying the institutionalisation of Europe's foreign policy.The literature on the institutionalisation of common external action is divided between work that looks at the interactions between European actors, on the one hand, and work that studies the institutionalisation of the EU on the international scene, on the other. Thus this bifurcation in the scholarly literature precludes a vision of European integration as the product of the tangle of global and European dynamics. This thesis overcomes this divide in that it puts the internal and external dimensions of the institutionalisation of the EU at the heart of the analysis. Based on the hypothesis of the differentiation of social spaces, I will take into account the distinct logics structuring the global arena of nuclear negotiation and the arena of the CFSP, while apprehending them as entangled arenas. The empirical survey, which is based on interviews and archives, highlights that the High Representative is becoming more autonomous from his obligations as EU High Representative to assume t, Doctorat en Sciences politiques et sociales, info:eu-repo/semantics/nonPublished