L'objectif de ce travail doctoral est de caractériser ce que recouvre la notion de GRH territoriale, puis de comprendre comment celle-ci se construit. La recherche s'appuie sur les concepts issus des travaux sur l'instrumentation de gestion (Hatchuel et Weil, 1992 ; Oiry, 2003) ainsi que sur la théorie de l'acteur-réseau (Akrich et al. 1988, 2006 ; Callon, 1986). Une étude de cas multi-sites et longitudinale a été réalisée entre 2008 et 2010 auprès de deux projets de GRH territoriale en France. Les résultats de la recherche montrent que ces dispositifs ont été transformés au fil des négociations réalisées dans le temps entre les acteurs. Les résultats illustrent en outre des modalités de problématisation, d'intéressement, d'enrôlement et de mobilisation des alliés dissemblables, mettant en exergue une traduction partielle dans le cas 1, et une traduction aboutie, au moins temporairement dans le cas 2. / This PhD-work aims at characterizing the regional HRM notion, then at understanding how it can be successfully built. This research relies on a theoretical framework built from the management tool and device literature (Hatchuel and Weil, 1992; Oiry, 2003) and from the “actor-network theory” (Akrich et al., 1988, 2006; Callon, 1986; Latour, 1992 This research relies on a multisite and longitudinal case-study realized between 2008 and 2010 and based on two distinct regional projects in France. Our analyses show that these regional HRM devices have been transformed over time. Our results further show that these devices were built differently in terms of “problematisation”, “interessement”, “enrollment” and “mobilization of allies”. In the first case, the translation process remains partial, while the second project produced a more complete translation process.

The gestures of interpretation, for this research, depart from the Discourse Analysis of the French School (AD) as a theoretical device to generate the data. By the aim of examining how the relationship between educational policy and management device produce a discursive formation of educational system, it is suggested to interpret linguistic-discursive marks of public policy and thus not limit the policy as text, but as discourse and the effect of senses. It is understood that the management device from notions of democratization and des/centralization, which dismember the context of analytical possibilities and theoretical approaches. As analytical corpus, it is considered a range of public policies, which are potencies to the interpretive gesture and therefore thesis production to be defended. It is understood that the educational policy "speaks" from a "place" based on training rules, allowing it to "read" in historical moments, which keeps us from trying to saturate everything and take a system of discourse as absolute.The thesis indicates a discursive formation system, which has been produced in the game articulating democratic/neoliberal negotiations that, being subject to the blurring of the senses in a political arena,operates effects and directions lined to the democracy, managerialism, des/centralization and performativity "sayings . Despite democratic and neoliberal models differ in certain respects and display specific characteristics from one point of view, in the context of discursive conflict and alliance. This in no way means a calming or a certain harmonious tone, but a game, often uneven, in an attempt to ensure legitimacy. Again, the research is designed by means of the senses on the run, understanding that interpreting is moving on what is being said, not-said already-said in the discursive roller coaster. / Os gestos de interpretação, presentes nesta pesquisa, partem da Análise de Discurso da Escola Francesa (AD) como artefato teórico para a produção dos dados. Mediante o objetivo de analisar como a relação entre as políticas educacionais e o dispositivo gestão produz uma formação discursiva de sistema educacional, sugere-se interpretar marcas linguístico-discursivas de políticas públicas e, assim, não limitar a política como texto, mas como discurso e como efeito de sentidos. Compreende-se o dispositivo gestão a partir de noções de democratização e des/centralização, sob as quais desmembram-se o contexto de possibilidades analíticas e o aprofundamento teórico. Como corpus analítico, considera-se um elenco de políticas públicas, as quais são potência para o gesto interpretativo e, por conseguinte, produção da tese a ser defendida. Compreende-se que a política educacional fala de um lugar baseada em regras de formação, autorizando-a a dizeres em momentos históricos, o que nos afasta da tentativa de saturar tudo e de assumir um discurso de sistema como absoluto. A tese indica uma formação discursiva de sistema, o qual tem-se produzido na articulação do jogo de negociações democrático/neoliberais que, estando sujeitos à um borramento de sentidos numa arena de políticas, opera efeitos de sentidos alinhados aos dizeres de democracia, de gerencialismo, de des/centralização e de performatividade. Apesar de modelos democráticos e neoliberais divergirem e possuírem características próprias sob um ponto de vista, no contexto da trama discursiva estão em conflito e aliança. Isso de maneira alguma significa um apaziguamento ou um certo tom harmonioso, mas um jogo, muitas vezes desigual, na tentativa de garantir legitimidade. Outrossim, a pesquisa desenha-se mediante sentidos em fuga, entendendo que interpretar é movimentar-se naquilo que está sendo dito, não-dito e já-dito na montanha-russa discursiva.

L’objet de cette recherche est de proposer des méthodes et des outils de gestion qui permettent de prévenir la dégradation de la santé mentale et somatique des personnes qui travaillent. Les dirigeants et les managers semblent en effet assez démunis face à l’augmentation des troubles appelés « psychosociaux » et ils ne parviennent que rarement àdépasser le stade de l’évaluation des facteurs psychosociaux de risques. Notre thèse est articulée autour de deux recherches-interventions. L’une s’est déroulée dans une PME de conseils aux entreprises et la seconde au sein d’un groupe multinational et coopératif de l’agroalimentaire. En mobilisant notamment des connaissances et desméthodes de l’ergonomie de l’activité, nous avons pu co-construire avec les acteurs des réponses pratiques à leurs besoins initiaux de prévention. Le management n’est plus centré exclusivement sur la personne qui travaille dont on cherche l’adhésion aux projets managériaux. Les encadrants managent le travail et l’autorité devient synonyme d’autorisation de faire du « bon travail ». Pour ce faire, des espaces de discussion sur le travail ont été organisés et les résultats de ces discussions sont institutionnalisés au sein du dispositif de gestion. Finalement, c’est le développement conjoint de l’entreprise et des personnes qui travaillent que cherchent désormais à atteindre les managers. / This research aims at offering management methods and tools to prevent mental and somatic health diseases in the workforce. Chief executive officers and managers appear to be helpless in the face of rising psychosocial disorders and their response rarely goes beyond the assessment stage of psychosocial risks’ factors. This thesis is built upon two research-intervention projects. One took place in a b-to-b smallscale consultancy venture, whilst the second was set in a multinational and cooperative agrifood firm. Researchers and company staff jointly developed practical actions to address their initial need for prevention by transforming situations in using ergon omics-oriented information. Staff management is no longer centered on seeking the agreement of the workforce with managers’ projects. Instead the company executives organize everyone’s occupation by dealing with the gap between the “real done job” and the prescribed one. Authority istranslated into authorization of doing a “well done job”. To this end, allowance for discussions on the occupational organization and ways to do the job has been made, and results of those discussions are formally integrated in the management device. Overall, managers are now aiming for the joint personal development of staff in addition to the firmdevelopment.

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Author's name: Bc. Irena Malá School: Charles university, Prague 1st Faculty of Medicine Institut of Theory and Practice of Nursing Vídeňská 800, 140 59 Prague 4 - Krč Program: Health Care Administration Title: Early postoperative care of the patient with the left ventricular assist device HeartMate II Diploma thesis supervisor: PhDr. Hocková Jana, PhD. Number of pages: 170 Number of attachments: 41 Year: 2013 Key words: early postoperative care, hypotermia, blood transfusion, fluid resuscitation, perioperative cardiovascular dysfunction, pharmacologic support, ventricular assist device HeartMateII, monitoration, device, cardiac arrhythmias, ventilation management, postoperative anticoagulation, glycemic kontrol, renal insufficiency, nutrition, nursing, complications, physiotherapy, psychological aspects The occurrence of the heart failure is similar to an epidemic with high mortality. This fact, together with stagnate or even decreasing number of suitable donors, led to a need of replacing the heart pump activity with an artificial one. Mechanical cardiac support systems are sophisticated devices that are able to support a certain period of time or completely replace the function of the heart as a pump. The indications implantation of mechanical cardiac support is significant symptomatic heart...