Relations intergroupes : attribution à la discrimination et perception d'hostilité chez autrui

Résumé: La thèse que nous présentons s'intéresse aux phénomènes d'attribution d'intentions hostiles. Dodge (1980) observe que les individus agressifs ont tendance, en situation ambiguë, à sur-attribuer des intentions hostiles à leurs pairs, ce qui induit des réponses agressives. Pour l'auteur, l'attribution d'intentions hostiles est un médiateur entre certaines caractéristiques personnelles (l'agressivité) des individus, et le type de réponses qu'ils apportent aux situations. Cependant, les informations concernant l'appartenance groupale des "pairs" ne sont jamais prises en compte dans leurs études. Si ce processus est perméable à l'influence des normes et croyances (Bègue et Muller, 2006), aucune étude ne met en évidence quel serait l'impact d'informations groupales sur l'élaboration des réponses aux situations, dans le cadre de ce modèle. L'objectif de cette thèse est de montrer que l'attribution d'intentions hostiles peut être envisagée comme un processus agissant également à un niveau intergroupes et donc prenant en compte des informations groupales sur les individus. En s'inspirant du modèle de Dodge, nous avons émis l'hypothèse que les logiques intergroupes intervenaient dans l'interprétation des intentions des acteurs impliqués dans les interactions, afin de produire une réponse adaptée aux logiques intergroupes. Afin de tester cette hypothèse, nous avons suivi trois axes de recherches: Dans le premier de ces axes, nous avons introduit, dans le paradigme de Dodge, des informations .sur l'appartenance groupale des protagonistes de l'interaction (endogroupe vs exogroupe). Nous avons montré que le type de situation (ambiguë vs hostile) est moins important que l'information groupale dans la production d'une réponse à la situation (Étude 1). En outre, nous avons mis en évidence des processus différents selon la position des individus dans leur groupe (Étude 2). Dans le second axe, nous avons montré que si les différences de statut entre groupes n'influençaient pas directement le modèle de Dodge, elles interagissaient avec l'appartenance groupale et la clarté de la situation au niveau de l'attribution d'intentions hostiles (étude 3) et des intentions comportementales (Ettide 4). Dans le troisième et deriúer axe, nous avons introduit l'attribution d'intentions hostiles dans un processus de dévalorisation d'une cible expliquant un échec par la discrimination (Kaiser et Miller, 2001; 2003). Nous avons alors montré que l'attribution d'intentions hostiles médiatisait le lien entre l'attribution mobilisée pour expliquer l'événement et l'évaluation de la cible (Étude 5), et que ce type d'attribution était spécifique, aux intentions comportementales agressives (Études 6). Nous avons alors conclu sur la dimension sociale de l'attribution d'intentions hostiles et sur le fait qu'il s'agissait d'un élément permettant la construction d'une représentation des interactions sociales. Abstract The present thesis focuses on the phenomena of hostile intents attribution. Dodge (1980) observes that in ambiguous situations, aggressive people tend to over attribute hostile intents to others. This attribution leads them to respond aggressively. According to the author, hostile intents attribution mediates the link between some personal characteristics (aggressiveness for example) of individuals and their responses to the situation. However information related to participants group membership is always neglected in these studies. Begue and Muller (2006) showed that some beliefs could moderate the interaction between aggressiveness and hostile intents attribution on behaviors, but no study exhibited evidence of a similar effect with social information. The aim of this thesis is to show that hostile intents attribution needs to be considered at an intergroup level by taking into account people's group ineinbership. Based on the Dodge model, we formulated the hypothesis that intergroup strategies had an impact on actors' intents interpretations which in return should lead to different but adapted reactions to the situation. To test this hypothesis, three lines of research were developed. In the first line, we introduced, in the Dodge's paradigm, some information about the participants group membership (ingroup vs outgroup). We showed that when elaborating a response to a specific situation its nature (ambiguous vs hostile) had less impact than group membership information (Study 1). In addition, we highlighted some different processes according to the position of individuals in their group (Study 2). In the second line, we showed that if the differences between groups status didn't influence the Dodge model, they interacted with group membership and situation nature to influence hostile intents attribution (Study 3) and behaviors intents (Study 4). In the last line of research, we introduced hostile intents attribution within the process of derogation of a target explaining its failure by discrimination (Kaiser and Miller, 2001; 2003). We showed that hostile intents attribution mediated the link between the attibution mobilized to explain the failure and the derogation of the target (Study 5), and that this attribution type was specifically linked to aggressive behavior intents (Study 6). We finally concluded that hostile intents attribution imply an important social dimension which needs to be taken into account because involved in the construction of a representation of social interactions.

Perioperative nutrition is still a surgical orphan

Objective: To assess if screening programs and treatment of preoperative malnutrition have been implemented into surgical practice to decrease morbidity. There is strong evidence that postoperative morbidity can be minimized by early identifying and treating patients at nutritional risk before major surgery.The validated nutritional risk score (NRS) is recommended by the European Society of Parenteral and Enteral Nutrition for nutritional screening. It remains unclear whether routine preoperative nutritional assessment and perioperative nutrition is widely implemented.Methods: A survey was conducted in 173 Swiss and Austrian surgical departments. Implementation of nutritional screening, perioperative nutrition, and estimated impact on clinical outcome were assessed. Non-responders were repeatedly contacted by the authors.Results: The overall response rate was 55%, whereby 69% (54/78) of Swiss and 44% (42/95) of Austrian centers responded. Despite 80% and 59% of the responding centers are aware of a reduced complication rate and shortened hospital stay, respectively, only 20% of them implemented routine nutritional screening. Financial (49%) and logistic restrictions (33%) are the predominant reasons against the routine clinical use. Screening is mainly performed either in the outpatient's clinic (52%) or during admission (54%). The NRS is only used by 14%. Instead, various clinical (78%), e.g. BMI and laboratory findings (56%), e.g. albumine, are used. Indication for perioperative nutrition is based on preoperative screening in 49%.While 23% use preoperative nutrition, 68% apply nutritional support pre- and postoperatively. Preoperative nutritional treatment ranged from three days (33%), to five days (31%) and even seven days (20%).Conclusion: Despite malnutrition is well recognized as major risk factor for increased postoperative morbidity, the majority of surgeons are reluctant to implement routine screening and nutritional support. If nutritional assessment is performed, local institutional screening parameters are still preferred. It remains difficult to overcome traditions, and to change surgeon's mind.

Argumentation and education. Theoretical foundations and practices

During the last decade, argumentation has attracted growing attention as a means to elicit processes (linguistic, logical, dialogical, psychological, etc.) that can sustain or provoke reasoning and learning. Constituting an important dimension of daily life and of professional activities, argumentation plays a special role in democracies and is at the heart of philosophical reasoning and scientific inquiry. Argumentation, as such, requires specific intellectual and social skills. Hence, argumentation will have an increasing importance in education, both because it is a critical competence that has to be learned, and because argumentation can be used to foster learning in philosophy, history, sciences and in many other domains. Argumentation and Education answers these and other questions by providing both theoretical backgrounds, in psychology, education and theory of argumentation, and concrete examples of experiments and results in school contexts in a range of domains. It reports on existing innovative practices in education settings at various levels.

Transcatheter renal denervation for the treatment of resistant arterial hypertension: the Swiss expert consensus.

Transcatheter (or percutaneous) renal denervation is a novel technique developed for the treatment of resistant hypertension. So far, only one randomised controlled trial has been published, which has shown a reduction of office blood pressure. The Swiss Society of Hypertension, the Swiss Society of Cardiology, The Swiss Society of Angiology and the Swiss Society of Interventional Radiology decided to establish recommendations to practicing physicians and specialists for good clinical practice. The eligibility of patients for transcatheter renal denervation needs (1.) confirmation of truly resistant hypertension, (2.) exclusion of secondary forms of hypertension, (3.) a multidisciplinary decision confirming the eligibility, (4.) facilities that guarantee procedural safety and (5.) a long-term follow-up of the patients, if possible in cooperation with a hypertension specialist. These steps are essential until long-term data on safety and efficacy are available.

Circadian Variations of Ischemic Burden Among Patients with Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Introduction Le rythmes circadiens influencent différents paramètres de la physiologie et de la physiopathologie cardiovasculaire. Récemment, une relation entre la taille d'un infarctus et l'heure du jour à laquelle il se produit a été suggérée dans des modèles expérimentaux d'infarctus du myocarde. Le but de cette étude a été de déterminer si les rythmes circadiens pouvaient influencer la gravité d'un infarctus en terme de taille et de mortalité chez les patients hospitalisés pour un infarctus du myocarde avec sus-décalage du segment ST (STEMI) ayant bénéficié d'une intervention coronarienne percutanée primaire (ICPP). Méthode Chez 353 patients consécutifs admis avec un STEMI et traités par ICPP, l'heure à la survenue des symptômes, le pic de créatine kinase (reflet de la taille d'un infarctus) et le suivi à 30 jours ont été collectés. Les patients ont été répartis en 4 groupes en fonction de l'heure de survenue de leurs symptômes (00 :00 - 05h59, 06:00 - 11 59 12 00-17h59 et 18h00-23h59). Résultats Aucune différence statistiquement significative n'a été retrouvée entre les différents groupes en ce qui concerne les caractéristiques des patients ou de leur prise en charge. Après analyse multivariée, nous avons mis en évidence une différence statistiquement significative entre les pics de créatine kinase chez les patients avec survenue des symptômes entre 00 :00 et 05:59, qui étaient plus élevés que les pics de créatine kinase chez les patients avec survenue des symptômes à tout autre moment de la journée (augmentation moyenne de 38,4%, ρ <0.05). A 30 jours, la mortalité des patients avec survenue des symptômes entre 00 :00 et 05:59 était également significativement plus élevé que celle des patients avec survenue à tout autre moment de la journée (p <0.05). Conclusion Notre étude démontre une corrélation indépendante entre la taille d'un infarctus STEMI traité par ICPP et le moment de la journée où les symptômes apparaissent. Ces résultats suggèrent que ce moment devrait être un paramètre important à prendre en compte pour évaluer le pronostic des patients.

Influence of socioeconomic factors on delays, management and outcome amongst patients with acute myocardial infarction undergoing primary percutaneous coronary intervention.

The outcome after primary percutaneous coronary intervention (pPCI) for ST-elevation myocardial infarction (STEMI) is strongly affected by time delays. In this study, we sought to identify the impact of specific socioeconomic factors on time delays, subsequent STEMI management and outcomes in STEMI patients undergoing pPCI, who came from a well-defined region of the French part of Switzerland. A total of 402 consecutive patients undergoing pPCI for STEMI in a large tertiary hospital were retrospectively studied. Symptom-to-first-medical-contact time was analysed for the following socioeconomic factors: level of education, origin and marital status. Main exclusion criteria were: time delay beyond 12 hours, previous treatment with fibrinolytic agents or patients immediately referred for coronary artery bypass graft surgery. Therefore, 222 patients were finally included. At 1 year, there was no difference in mortality between the different socioeconomic groups. Furthermore, there was no difference in management characteristics between them. Symptom-to-first-medical-contact time was significantly longer for patients with a low level of education, Swiss citizens and unmarried patients, with median differences of 23 minutes, 18 minutes and 13 minutes, respectively (p <0.05). Nevertheless, no difference was found regarding in-hospital management and clinical outcome. This study demonstrates that symptom-to-first-medical-contact time is longer amongst people with a lower educational level, Swiss citizens and unmarried people. Because of the low mortality rate in general, these differences in delays did not affect clinical outcomes. Still, tertiary prevention measures should particularly focus on these vulnerable populations.

Low statin use in adults hospitalized with acute coronary syndrome.

OBJECTIVE: To assess recommended and actual use of statins in primary prevention of cardiovascular disease (CVD) based on clinical prediction scores in adults who develop their first acute coronary syndrome (ACS). METHOD: Cross-sectional study of 3172 adults without previous CVD hospitalized with ACS at 4 university centers in Switzerland. The number of participants eligible for statins before hospitalization was estimated based on the European Society of Cardiology (ESC) guidelines and compared to the observed number of participants on statins at hospital entry. RESULTS: Overall, 1171 (37%) participants were classified as high-risk (10-year risk of cardiovascular mortality ≥5% or diabetes); 1025 (32%) as intermediate risk (10-year risk <5% but ≥1%); and 976 (31%) as low risk (10-year risk <1%). Before hospitalization, 516 (16%) were on statins; among high-risk participants, only 236 of 1171 (20%) were on statins. If ESC primary prevention guidelines had been fully implemented, an additional 845 high-risk adults (27% of the whole sample) would have been eligible for statins before hospitalization. CONCLUSION: Although statins are recommended for primary prevention in high-risk adults, only one-fifth of them are on statins when hospitalized for a first ACS.