How institutions shaped the last major evolutionary transition to large-scale human societies.

What drove the transition from small-scale human societies centred on kinship and personal exchange, to large-scale societies comprising cooperation and division of labour among untold numbers of unrelated individuals? We propose that the unique human capacity to negotiate institutional rules that coordinate social actions was a key driver of this transition. By creating institutions, humans have been able to move from the default 'Hobbesian' rules of the 'game of life', determined by physical/environmental constraints, into self-created rules of social organization where cooperation can be individually advantageous even in large groups of unrelated individuals. Examples include rules of food sharing in hunter-gatherers, rules for the usage of irrigation systems in agriculturalists, property rights and systems for sharing reputation between mediaeval traders. Successful institutions create rules of interaction that are self-enforcing, providing direct benefits both to individuals that follow them, and to individuals that sanction rule breakers. Forming institutions requires shared intentionality, language and other cognitive abilities largely absent in other primates. We explain how cooperative breeding likely selected for these abilities early in the Homo lineage. This allowed anatomically modern humans to create institutions that transformed the self-reliance of our primate ancestors into the division of labour of large-scale human social organization.

Hospitalisation du proche : fatigue et coping du proche aidant à l'occasion de cette transition

Le processus de vieillissement entraîne une augmentation et une complexification des besoins de soins. Or, la proportion de personnes vieillissantes dans le monde et en Suisse s'accroit. Les professionnels de la santé ne disposent pas des moyens économiques et humains pour couvrir l'ensemble des besoins de soins. Les proches aidants contribuent de manière importante à la couverture des besoins. Cette contribution devient un élément central de la politique du maintien à domicile. Cependant, l'engagement à long terme des proches aidants auprès de leur parent peut influencer négativement leur état de santé. Pour une même classe d'âge, la population des proches aidants déclare un niveau de fatigue plus élevée que le reste de la population. Dans ce contexte, la fatigue est définie comme le résultat de l'ambivalence entre la demande en soins et les ressources dont dispose le proche aidant. L'hospitalisation du parent, qu'elle soit ou non liée à la fatigue, constitue un moment de crise pour le proche aidant. Face à cette crise, l'aidant mettra en oeuvre des stratégies de coping telles que conceptualisées dans la théorie transactionnelle du stress. Dans le cadre de la théorique intermédiaire de la transition de Meleis, le coping est un indicateur de processus de la transition qui doit permettre d'appréhender la transition vécue par l'aidant à l'occasion de l'hospitalisation du parent. Avec un devis corrélationnel descriptif, cette étude décrit les caractéristiques de l'échantillon de proches aidants, et du rôle qu'ils assument. Elle décrit le degré de fatigue et les styles de coping utilisés, et explore la relation entre la fatigue et le coping du proche aidant à l'occasion de l'hospitalisation du parent. Deux questionnaires auto-administrés ont été complétés par 33 participants. Cette étude a permis de dégager les résultats suivants : le score moyen de fatigue dans cet échantillon indique une fatigue légère selon la classification établie par Piper. Les participants mettent en avant l'influence du rôle d'aidant sur leur fatigue, ainsi que l'influence de leur propre santé et des contraintes économicoprofessionnelles. Le score moyen de fatigue varie en fonction de la nature de l'aide fournie. Il est significativement plus élevé lorsque le proche aidant soutient son parent dans les activités de la vie quotidienne (AVQ). Le style de coping mobilisé préférentiellement dans cet échantillon est le coping centré sur le problème, suivi du coping centré sur la recherche du soutien social, et enfin le coping centré sur l'émotion. Les aidants soutenant leur proche dans les AVQ mobilisent plus le coping centré sur l'émotion que ceux qui n'offrent pas ce type d'aide. Les principales sources de stress nommées par les participants sont l'état de santé du parent, son hospitalisation, et la rencontre avec le système de santé. Dans cet échantillon, nous n'avons pas observé de corrélation entre le degré de fatigue et les trois styles de coping. Des limites liées à la petite taille de l'échantillon amènent à la prudence quant à la généralisation des résultats de cette étude.

Transition of young people with chronic conditions: a cross-sectional study of patient perceptions before and after transfer from pediatric to adult health care.

UNLABELLED: The aim of this study was to compare perceived barriers to and the most preferred age for successful transition to adult health care between young people with chronic disorders who had not yet transferred from pediatric to adult health care (pre-transfer) and those who had already transferred (post-transfer). In a cross-sectional study, we compared 283 pre-transfer with 89 post-transfer young people, using a 28-item questionnaire that focused on perceived barriers to transition and beliefs about the most preferred age to transfer. Feeling at ease with the pediatrician was the most important barrier to successful transition in both groups, but was rated significantly higher in the pre-transfer compared to the post-transfer group (OR = 2.03, 95 %CI 1.12-3.71). Anxiety and lack of information were the next most important barriers, rated equally highly by the two groups (OR = 0.67, 95 %CI 0.35-1.28 and OR = 0.71, 95 %CI 0.36-1.38, respectively). More than 80 % of the respondents in both groups reported that 16-19 years was the most preferred age to transfer; more than half of all the respondents reported 18-19 years and older as the most preferred age. CONCLUSION: Better transition planning through the provision of regular and more detailed information about adult health-care providers and the transition process could reduce anxiety and contribute to a more positive attitude to overcome perceived barriers to transition from young people's perspective. Young people's preferences about transferring to adult health care provide a challenge to those children's hospitals that transfer to adult health care at a younger age.

The health of adolescents around a world in transition.

Since several years, the health of adolescents is on the agenda of ministers, decision makers and health professionals. Around the world, while there has been a steady decrease of the death rates among young children, this is not the case for young people. This is mainly linked with the fact that mortality and morbidity during this period of life is largely linked with non communicable diseases and conditions, including deaths from injuries, suicide, homicides and drug abuse. Unplanned pregnancies, illegal abortions, newly acquired HIV infections are also situations that have short and long term consequences. This paper reviews the epidemiological data pertaining to adolescent health and disease. It proposes evidence-informed avenues as how to address these issues in the field of health care (e.g. adolescent friendly services) and of prevention and health promotion. It also stresses the importance of creating safe environments for the development and well-being of young people and thus, of an interdisciplinary and inter sectorial approach to their complex health problems and challenges.

Tackling Societal Challenges Related to Ageing and Transport Transition: An Introduction to Philosophical Principles of Causation Adapted to the Biopsychosocial Model

In geriatrics, driving cessation is addressed within the biopsychosocial model. This has broadened the scope of practitioners, not only in terms of assessing fitness to drive, but also by helping to maintain social engagements and provide support for transport transition. Causes can be addressed at different levels by adapting medication, improving physical health, modifying behaviour, adapting lifestyle, or bringing changes to the environment. This transdisciplinary approach requires an understanding of how different disciplines are linked to each other. This article reviews the philosophical principles of causality between fields and provides a framework for understanding causality within the biopsychosocial model. Understanding interlevel constraints should help practitioners overcome their differences, and favor transversal approaches to driving cessation.

Is the sword moss (Bryoxiphium) a preglacial Tertiary relict?

The disjunction of floras between East Asia, Southeast North America, West North America, and Southwest Eurasia has been interpreted in terms of the fragmentation of a once continuous mixed mesophytic forest that occurred throughout the Northern Hemisphere due to the climatic and geological changes during the late Tertiary. The sword moss, Bryoxiphium, exhibits a distribution that strikingly resembles that of the mesophytic forest elements such as Liriodendron and is considered as the only living member of an early Tertiary flora in Iceland. These hypotheses are tested here using molecular dating analyses and ancestral area estimations. The results suggest that the extant range of Bryoxiphium results from the fragmentation of a formerly wider range encompassing North America and Southeast Asia about 10 million years ago. The split of continental ancestral populations is too recent to match with a continental drift scenario but is spatially and temporally remarkably congruent with that observed in Tertiary angiosperm relict species. The timing of the colonization of Iceland from Macaronesian ancestors, about two million years ago, is, however, incompatible with the hypothesis that Bryoxiphium is the only living member of an early Tertiary flora of the island. Alaska was recurrently colonized from East Asia. The ability of Bryoxiphium to overcome large oceanic barriers is further evidenced by its occurrence on remote oceanic archipelagos. In particular, Madeira was colonized twice independently from American and East Asian ancestors, respectively. The striking range disjunction of Bryoxiphium is interpreted in terms of its mating system, as the taxon exhibits a very singular pattern of spatial segregation of the sexes.