Endometriosis, a disease of reproductive age women, is a major cause of infertility, menstrual disorders and pelvic pain. Little is known about its etiopathology, but chronic pelvic inflammation is a common feature in affected women. Beside symptomatic treatment of endometriosis-associated pain, only two main suboptimal therapeutic approaches (hormonal and invasive surgery) are generally recommended to patients and no specific targeted treatment is available. Our studies led to the detection of a marked increase in the expression of macrophage migration inhibitory factor (MIF) in the eutopic endometrium, the peripheral blood and the peritoneal fluid of women with endometriosis, and in early, vascularized and active endometriotic lesions. Herein, we developed a treatment model of endometriosis, where human endometrial tissue was first allowed to implant into the peritoneal cavity of nude mice, to assess in vivo the effect of a specific antagonist of MIF (ISO-1) on the progression of endometriosis and evaluate its efficacy as a potential therapeutic tool. Administration of ISO-1 led to a significant decline of the number, size and in situ dissemination of endometriotic lesions. We further showed that ISO-1 may act by significantly inhibiting cell adhesion, tissue remodeling, angiogenesis and inflammation as well as by altering the balance of pro- and anti-apoptotic factors. Actually, mice treatment with ISO-1 significantly reduced the expression of cell adhesion receptors αv and ß3 integrins (P<0.05), matrix metalloproteinases (MMP) 2 and 9 (P<0.05), vascular endothelial cell growth factor (VEGF) (P<0.01), interleukin 8 (IL8) (P<0.05), cyclooxygenease (COX)2 (P<0.001) and the anti-apoptotic protein Bcl2 (P<0.01), but significantly induced the expression of Bax (P<0.05), a potent pro-apoptotic protein. These data provide evidence that specific inhibition of MIF alters endometriotic tissue growth and progression in vivo and may represent a promising potential therapeutic avenue.

Evidence suggests that citizens outside larger urban centers are less prone to use the various functionalities of e-government, while they are the most likely to benefit from these services. Few studies have been performed to understand rural citizens' attitudes. Our purpose was to identify factors that influence the use of e-government services in outlying regions in the Province of Quebec (Canada). Our study was based on a subset of attitude-related variables that were shown to be strong predictors in prior research. We performed a survey involving 1587 citizens living in four selected outlying regions of Quebec, and held two focus groups with users and non-users of e-government. Our results confirm that attitude is influenced by perceived usefulness; perceived ease of use, perceived risk and trust and that attitude is strongly related to the intention to use e-government services. These results may help to plan more effective strategies to increase use in non-urban areas.

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The promise of increased organizational performance has brought about a high level of interest for knowledge management (KM) from the part of actors involved in research and practice over the last 15 years. Governments are also actively launching KM projects to meet increasing needs of high quality and responsiveness. This interest has contributed to the development of various aspects of knowledge management, but has also underscored a lack of systemic vision, as evidenced by the sheer number of approaches, as well as lingering skepticism in both practice and the scientific literature. In this article, we will argue for the necessity for a more global and high level analysis for orienting KM strategic planning. We illustrate the use of a new approach in the context of Quebec's efforts in planning a global and integrated KM strategy for managing its water related knowledge. This case study shows that the auditing approach provided a useful guide to identify critical issues in KM planning, particularly in a complex and large scale environment.

E-government offers the potential to provide easy and flexible access to a vast array of government services, particularly in outlying regions where traditional service centers are scarce and costly. However, past research shows that online services use decreases in non-urban areas. The objective of this chapter is to identify factors that influence the use of e-government services in outlying regions. In the delivery of any government services, there are two parties: citizens and the government. Hence, in order to better identify these factors, we conducted our study from two points of view: the citizens’ and the government’s managers. These results show that attitude positively affects intention to use e-government services. From the citizens’ perspective, attitude is in turn influenced by perceived usefulness, perceived ease of use, perceived risk, and trust. From the managers’ perspective, several social, economic, demographic, and psychological factors should be considered for the development of online services.