Evaluating fear of falling among community-dwelling older people: A qualitative pattern model based on the experience of falls

This research was conducted in the context of the project IRIS 8A Health and Society (2002-2008) and financially supported by the University of Lausanne. It was aomed at developping a model based on the elder people's experience and allowed us to develop a "Portrait evaluation" of fear of falling using their examples and words. It is a very simple evaluation, which can be used by professionals, but by the elder people themselves. The "Portrait evaluation" and the user's guide are on free access, but we would very much approciate to know whether other people or scientists have used it and collect their comments. (contact: Chantal.Piot-Ziegler@unil.ch)The purpose of this study is to create a model grounded in the elderly people's experience allowing the development of an original instrument to evaluate FOF.In a previous study, 58 semi-structured interviews were conducted with community-dwelling elderly people. The qualitative thematic analysis showed that fear of falling was defined through the functional, social and psychological long-term consequences of falls (Piot-Ziegler et al., 2007).In order to reveal patterns in the expression of fear of falling, an original qualitative thematic pattern analysis (QUAlitative Pattern Analysis - QUAPA) is developed and applied on these interviews.The results of this analysis show an internal coherence across the three dimensions (functional, social and psychological). Four different patterns are found, corresponding to four degrees of fear of falling. They are formalized in a fear of falling intensity model.This model leads to a portrait-evaluation for fallers and non-fallers. The evaluation must be confronted to large samples of elderly people, living in different environments. It presents an original alternative to the concept of self-efficacy to evaluate fear of falling in older people.The model of FOF presented in this article is grounded on elderly people's experience. It gives an experiential description of the three dimensions constitutive of FOF and of their evolution as fear increases, and defines an evaluation tool using situations and wordings based on the elderly people's discourse.

Use of the Cognitive Performance Scale (CPS) to detect cognitive impairment in the acute care setting: concurrent and predictive validity.

The Cognitive Performance Scale (CPS) was initially designed to assess cognition in long term care residents. Subsequently, the CPS has also been used among in-home, post-acute, and acute care populations even though CPS' clinimetric performance has not been studied in these settings. This study aimed to determine CPS agreement with the Mini Mental Status Exam (MMSE) and its predictive validity for institutionalization and death in a cohort (N=401) of elderly medical inpatients aged 75 years and over. Medical, physical and mental status were assessed upon admission. The same day, the patient's nurse completed the CPS by interview. Follow-up data were gathered from the central billing system (nursing home stay) and proxies (death). Cognitive impairment was present in 92 (23%) patients according to CPS (score >or= 2). Agreement with MMSE was moderate (kappa 0.52, P<.001). Analysis of discordant results suggested that cognitive impairment was overestimated by the CPS in dependent patients with comorbidities and depressive symptoms, and underestimated in older ones. During follow-up, subjects with abnormal CPS had increased risks of death (adjusted hazard ratio (adjHR) 1.7, 95% CI 1.0-2.8, P=.035) and institutionalization (adjHR 2.7, 95% CI 1.3-5.3, P=.006), independent of demographic, health and functional status. Interestingly, subjects with abnormal CPS were at increased risk of death only if they also had abnormal MMSE. The CPS predicted death and institutionalization during follow-up, but correlated moderately well with the MMSE. Combining CPS and MMSE provided additional predictive information, suggesting that domains other than cognition are assessed by professionals when using the CPS in elderly medical inpatients.

In the eye of the listener: pupil dilation elucidates discourse processing.

The current study investigated cognitive resource allocation in discourse processing by means of pupil dilation and behavioral measures. Short question-answer dialogs were presented to listeners. Either the context question queried a new information focus in the successive answer, or else the context query was corrected in the answer sentence (correction information). The information foci contained in the answer sentences were either adequately highlighted by prosodic means or not. Participants had to judge the adequacy of the focus prosody with respect to the preceding context question. Prosodic judgment accuracy was higher in the conditions bearing adequate focus prosody than in the conditions with inadequate focus prosody. Latency to peak pupil dilation was longer when new information foci were perceived compared to correction foci. Moreover, for the peak dilation, an interaction of focus type and prosody was found. Post hoc statistical tests revealed that prosodically adequate correction focus positions were processed with smaller peak dilation in comparison to all other dialog conditions. Thus, pupil dilation and results of a principal component analysis suggest an interaction of focus type and focus prosody in discourse processing.

Delirium and cognitive decline: more than a coincidence.

PURPOSE OF REVIEW: To review the recent findings on the relationships between delirium and cognitive decline in the elderly. RECENT FINDINGS: Current advances in the field include substantial new evidence that delirium increases the risk of dementia in patients without previous cognitive impairment and accelerates cognitive decline in patients with Alzheimer's disease. Findings on cognitive trajectories and domains affected contribute to better understanding of the clinical nature of cognitive impairment after delirium. Volume loss and disruption of white matter integrity may represent early MRI markers for long-term cognitive impairment. Neurodegenerative and low-level chronic inflammatory processes predispose to exaggerated response to incident stimuli that may precipitate both acute brain dysfunction and persisting cerebral damage. SUMMARY: Still little is known about the relationship between delirium and cognitive trajectories in the elderly, and the underlying pathophysiological mechanisms. The association of neurodegenerative and inflammatory processes appears to play an important role in the pathogenesis and the clinical course of cognitive impairment after delirium. The hypothetical role of several other factors remains to be clarified. Further clinical studies are needed to evaluate whether prevention and treatment approaches that proved to be useful to reduce delirium incidence and severity may also improve long-term outcomes, and prevent cognitive decline.

Are the World AIDS Conferences guilty of gender bias? Evidence from trends in the monitoring of WAC scientific discourse from 1989 to 2012

Background : The issue of gender is acknowledged as a key issue for the AIDS epidemic. World AIDS Conferences (WAC) have constituted a major discursive space for the epidemic. We sought to establish the balance regarding gender in the AIDS scientific discourse by following its development in the published proceedings of WAC. Fifteen successive WAC 1989-2012 served to establish a "barometer" of scientific interest in heterosexual and homo/bisexual men and women throughout the epidemic. It was hypothesised that, as in other domains of Sexual and Reproductive Health, heterosexual men would be "forgotten" partners. Method : Abstracts from each conference were entered in electronic form into an Access database. Queries were created to generate five categories of interest and to monitor their annual frequency. All abstract titles including the term "men" or "women" were identified. Collections of synonyms were systematically and iteratively developed in order to classify further abstracts according to whether they included terms referring to "homo/bisexual" or "heterosexual". Reference to "Mother to Child Transmission" (MTCT) was also flagged. Results : The category including "men", but without additional reference to "homo-bisexuel" (i.e. referring to men in general and/or to heterosexual men) consistently appears four times less often than the equivalent category for women. Excluding abstracts on women and MTCT has little impact on this difference. Abstracts including reference to both "men" and "homo-bisexual" emerge as the secondmost frequent category; presence of the equivalent category for women is minimal. Conclusion : The hypothesised absence of heterosexual men in the AIDS discourse was confirmed. Although the relative presence of homo-bisexual men and women as a focal subject may be explained by epidemiological data, this is not so in the case of heterosexual men and women. This imbalance has consequences for HIV prevention.

Iowa Development of Rubblized Concrete Pavement Base Mills County, Construction Report, HR-315, 1990

The concept of rubblizing existing concrete pavement prior to the placement of an asphaltic cement concrete overlay has been around for several years and, in fact, has been tried successfully in the states of New York, Michigan, and Ohio. With available construction and maintenance dollars usually not meeting the demands of the needed work, much of the necessary rehabilitation of existing Portland cement concrete pavements is not being completed when it would be most beneficial. Research project HR-315, "Iowa Development of Rubblized Concrete", has been undertaken to determine the effects of rubblized concrete pavement base as it affects the cracking pattern and longevity of the ACC overlay.

Suomi tiellä sivistyskieleksi. Suomenkielisen maantieteen sanaston kehittyminen ja kehittäminen 1800-luvulla

Tutkimukseni käsittelee suomen kielen sanaston kehitystä 1800-luvulla eli aikana, jolloin suomen kielestä kehittyi monialainen sivistyskieli. Esimerkkiaineistona on yhden erikoisalan, maantieteen sanasto. Suomen kirjakieli syntyi 1500-luvulla, mutta aluksi kirjoitettua kieltä tarvittiin pääasiassa uskonnollisissa yhteyksissä. 1800-luvun aikana kielen käyttöalat monipuolistuivat ja uutta sanastoa tarvittiin monien erikoisalojen tarpeisiin. Ryhdyttiin tietoisesti kääntämään tietokirjallisuutta ja kirjoittamaan eri aiheista. Tutkimukseni selvittää maantieteen sanaston kehittymistä sadassa vuodessa erityisesti maantieteen oppikirjoissa. Tutkimus kuvaa sanaston kehitystä teoreettisesti uudenlaisista lähtökohdista tarkastelemalla leksikaalista variaatiota. Variaatiota on kuvattu tarkasti sekä yksittäisten käsitteiden nimitysten kehityksenä että ilmiönä yleisesti. Tutkimus hyödyntää myös kognitiivista lähestymistapaa, etenkin sosiokognitiivisen terminologian teoriaa. Aineiston analyysin pohjalta syntyy kuva sanaston kehityksestä ja vakiintumisesta. Tutkimus kuvaa myös tapoja, joilla uusia käsitteitä nimettiin. Se pohtii eri nimeämistapojen suhdetta sekä kirjoittajien ja aikalaisten roolia sanaston vakiintumisessa. 1800-luvun maantieteen sanastossa on runsaasti variaatiota; vain harvojen käsitteiden nimitykset ovat vakiintuneita tai vakiintuvat nopeasti. Tämän variaation kuvaaminen leksikaalisena variaationa osoittautui tutkimuksessa hyväksi metodiksi. Koska kirjakieli oli vakiintumatonta, nimityksissä esiintyy paljon kontekstuaalista variaatiota esimerkiksi sanojen kirjoitusasuissa. Kirjoittajat myös pohtivat havainnollista tapaa nimetä käsitteitä, ja tästä aiheutuu onomasiologista variaatiota. Semasiologinen variaatio taas kertoo käsitejärjestelmän vakiintumattomuudesta. Aineiston sanaston lähtökohdat ovat vanhan kirjasuomessa, mutta tältä pohjalta luodaan valtava määrä uutta sanastoa tai otetaan aiemmin kirjakielessä käytettyjä nimityksiä uuteen merkitykseen. Tärkeä rooli on sekä nimitysten muodostamisella kotoisista aineksista että kääntämisellä, jossa malli saadaan toisesta kielestä mutta nimitysten ainekset ovat omaperäisiä.

Du principe de continuité de l'exploitation en comptabilité : contribution à la formalisation de la démarche cognitive du réviseur aux comptes dans la validation de ce principe à l'aide d'un système abductif de modélisation de croyance basé sur un processus stochastique

Résumé : J'ai souvent vu des experts être d'avis contraires. Je n'en ai jamais vu aucun avoir tort. Auguste Detoeuf Propos d'O.L. Brenton, confiseur, Editions du Tambourinaire, 1948. En choisissant volontairement une problématique comptable typiquement empirique, ce travail s'est attelé à tenter de démontrer la possibilité de produire des enseignements purement comptables (ie à l'intérieur du schème de représentation de la Comptabilité) en s'interdisant l'emprunt systématique de theories clé-en-main à l'Économie -sauf quant cela s'avère réellement nécessaire et légitime, comme dans l'utilisation du CAPM au chapitre précédent. Encore une fois, rappelons que cette thèse n'est pas un réquisitoire contre l'approche économique en tant que telle, mais un plaidoyer visant à mitiger une telle approche en Comptabilité. En relation avec le positionnement épistémologique effectué au premier chapitre, il a été cherché à mettre en valeur l'apport et la place de la Comptabilité dans l'Économie par le positionnement de la Comptabilité en tant que discipline pourvoyeuse de mesures de représentation de l'activité économique. Il nous paraît clair que si l'activité économique, en tant que sémiosphère comptable directe, dicte les observations comptables, la mesure de ces dernières doit, tant que faire se peut, tenter de s'affranchir de toute dépendance à la discipline économique et aux théories-méthodes qui lui sont liées, en adoptant un mode opératoire orthogonal, rationnel et systématique dans le cadre d'axiomes lui appartenant en propre. Cette prise de position entraîne la définition d'un nouveau cadre épistémologique par rapport à l'approche positive de la Comptabilité. Cette dernière peut se décrire comme l'expression philosophique de l'investissement de la recherche comptable par une réflexion méthodique propre à la recherche économique. Afin d'être au moins partiellement validé, ce nouveau cadre -que nous voyons dérivé du constructivisme -devrait faire montre de sa capacité à traiter de manière satisfaisante une problématique classique de comptabilité empirico-positive. Cette problématique spécifique a été choisie sous la forme de traitement-validation du principe de continuité de l'exploitation. Le principe de continuité de l'exploitation postule (énonciation d'une hypothèse) et établit (vérification de l'hypothèse) que l'entreprise produit ses états financiers dans la perspective d'une poursuite normale de ses activités. Il y a rupture du principe de continuité de l'exploitation (qui devra alors être écartée au profit du principe de liquidation ou de cession) dans le cas de cessation d'activité, totale ou partielle, volontaire ou involontaire, ou la constatation de faits de nature à compromettre la continuité de l'exploitation. Ces faits concernent la situation financière, économique et sociale de l'entreprise et représentent l'ensemble des événements objectifs 33, survenus ou pouvant survenir, susceptibles d'affecter la poursuite de l'activité dans un avenir prévisible. A l'instar de tous les principes comptables, le principe de continuité de l'exploitation procède d'une considération purement théorique. Sa vérification requiert toutefois une analyse concrète, portant réellement et de manière mesurable à conséquence, raison pour laquelle il représente un thème de recherche fort apprécié en comptabilité positive, tant il peut (faussement) se confondre avec les études relatives à la banqueroute et la faillite des entreprises. Dans la pratique, certaines de ces études, basées sur des analyses multivariées discriminantes (VIDA), sont devenues pour l'auditeur de véritables outils de travail de par leur simplicité d'utilisation et d'interprétation. À travers la problématique de ce travail de thèse, il a été tenté de s'acquitter de nombreux objectifs pouvant être regroupés en deux ensembles : celui des objectifs liés à la démarche méthodologique et celui relevant de la mesure-calibration. Ces deux groupes-objectifs ont permis dans une dernière étape la construction d'un modèle se voulant une conséquence logique des choix et hypothèses retenus.

Database Rights in Safe European Home: The Path to More Rigorous Protection of Information

1. Introduction "The one that has compiled ... a database, the collection, securing the validity or presentation of which has required an essential investment, has the sole right to control the content over the whole work or over either a qualitatively or quantitatively substantial part of the work both by means of reproduction and by making them available to the public", Finnish Copyright Act, section 49.1 These are the laconic words that implemented the much-awaited and hotly debated European Community Directive on the legal protection of databases,2 the EDD, into Finnish Copyright legislation in 1998. Now in the year 2005, after more than half a decade of the domestic implementation it is yet uncertain as to the proper meaning and construction of the convoluted qualitative criteria the current legislation employs as a prerequisite for the database protection both in Finland and within the European Union. Further, this opaque Pan-European instrument has the potential of bringing about a number of far-reaching economic and cultural ramifications, which have remained largely uncharted or unobserved. Thus the task of understanding this particular and currently peculiarly European new intellectual property regime is twofold: first, to understand the mechanics and functioning of the EDD and second, to realise the potential and risks inherent in the new legislation in economic, cultural and societal dimensions. 2. Subject-matter of the study: basic issues The first part of the task mentioned above is straightforward: questions such as what is meant by the key concepts triggering the functioning of the EDD such as presentation of independent information, what constitutes an essential investment in acquiring data and when the reproduction of a given database reaches either qualitatively or quantitatively the threshold of substantiality before the right-holder of a database can avail himself of the remedies provided by the statutory framework remain unclear and call for a careful analysis. As for second task, it is already obvious that the practical importance of the legal protection providedby the database right is in the rapid increase. The accelerating transformationof information into digital form is an existing fact, not merely a reflection of a shape of things to come in the future. To take a simple example, the digitisation of a map, traditionally in paper format and protected by copyright, can provide the consumer a markedly easier and faster access to the wanted material and the price can be, depending on the current state of the marketplace, cheaper than that of the traditional form or even free by means of public lending libraries providing access to the information online. This also renders it possible for authors and publishers to make available and sell their products to markedly larger, international markets while the production and distribution costs can be kept at minimum due to the new electronic production, marketing and distributionmechanisms to mention a few. The troublesome side is for authors and publishers the vastly enhanced potential for illegal copying by electronic means, producing numerous virtually identical copies at speed. The fear of illegal copying canlead to stark technical protection that in turn can dampen down the demand for information goods and services and furthermore, efficiently hamper the right of access to the materials available lawfully in electronic form and thus weaken the possibility of access to information, education and the cultural heritage of anation or nations, a condition precedent for a functioning democracy. 3. Particular issues in Digital Economy and Information Networks All what is said above applies a fortiori to the databases. As a result of the ubiquity of the Internet and the pending breakthrough of Mobile Internet, peer-to-peer Networks, Localand Wide Local Area Networks, a rapidly increasing amount of information not protected by traditional copyright, such as various lists, catalogues and tables,3previously protected partially by the old section 49 of the Finnish Copyright act are available free or for consideration in the Internet, and by the same token importantly, numerous databases are collected in order to enable the marketing, tendering and selling products and services in above mentioned networks. Databases and the information embedded therein constitutes a pivotal element in virtually any commercial operation including product and service development, scientific research and education. A poignant but not instantaneously an obvious example of this is a database consisting of physical coordinates of a certain selected group of customers for marketing purposes through cellular phones, laptops and several handheld or vehicle-based devices connected online. These practical needs call for answer to a plethora of questions already outlined above: Has thecollection and securing the validity of this information required an essential input? What qualifies as a quantitatively or qualitatively significant investment? According to the Directive, the database comprises works, information and other independent materials, which are arranged in systematic or methodical way andare individually accessible by electronic or other means. Under what circumstances then, are the materials regarded as arranged in systematic or methodical way? Only when the protected elements of a database are established, the question concerning the scope of protection becomes acute. In digital context, the traditional notions of reproduction and making available to the public of digital materials seem to fit ill or lead into interpretations that are at variance with analogous domain as regards the lawful and illegal uses of information. This may well interfere with or rework the way in which the commercial and other operators have to establish themselves and function in the existing value networks of information products and services. 4. International sphere After the expiry of the implementation period for the European Community Directive on legal protection of databases, the goals of the Directive must have been consolidated into the domestic legislations of the current twenty-five Member States within the European Union. On one hand, these fundamental questions readily imply that the problemsrelated to correct construction of the Directive underlying the domestic legislation transpire the national boundaries. On the other hand, the disputes arisingon account of the implementation and interpretation of the Directive on the European level attract significance domestically. Consequently, the guidelines on correct interpretation of the Directive importing the practical, business-oriented solutions may well have application on European level. This underlines the exigency for a thorough analysis on the implications of the meaning and potential scope of Database protection in Finland and the European Union. This position hasto be contrasted with the larger, international sphere, which in early 2005 does differ markedly from European Union stance, directly having a negative effect on international trade particularly in digital content. A particular case in point is the USA, a database producer primus inter pares, not at least yet having aSui Generis database regime or its kin, while both the political and academic discourse on the matter abounds. 5. The objectives of the study The above mentioned background with its several open issues calls for the detailed study of thefollowing questions: -What is a database-at-law and when is a database protected by intellectual property rights, particularly by the European database regime?What is the international situation? -How is a database protected and what is its relation with other intellectual property regimes, particularly in the Digital context? -The opportunities and threats provided by current protection to creators, users and the society as a whole, including the commercial and cultural implications? -The difficult question on relation of the Database protection and protection of factual information as such. 6. Dsiposition The Study, in purporting to analyse and cast light on the questions above, is divided into three mainparts. The first part has the purpose of introducing the political and rationalbackground and subsequent legislative evolution path of the European database protection, reflected against the international backdrop on the issue. An introduction to databases, originally a vehicle of modern computing and information andcommunication technology, is also incorporated. The second part sets out the chosen and existing two-tier model of the database protection, reviewing both itscopyright and Sui Generis right facets in detail together with the emergent application of the machinery in real-life societal and particularly commercial context. Furthermore, a general outline of copyright, relevant in context of copyright databases is provided. For purposes of further comparison, a chapter on the precursor of Sui Generi, database right, the Nordic catalogue rule also ensues. The third and final part analyses the positive and negative impact of the database protection system and attempts to scrutinize the implications further in the future with some caveats and tentative recommendations, in particular as regards the convoluted issue concerning the IPR protection of information per se, a new tenet in the domain of copyright and related rights.

Predictions of the MCMI-III personality disorders from NEO-PI-R domains and facets: Comparison between American and Spanish samples

Este estudio ex post facto analiza las relaciones entre las dimensiones y facetas del NEO-PI-R y los 14 trastornos de personalidad del MCMI-III en una muestra no clínica española (N = 674). Se exploran las diferencias y similitudes con los resul- tados de Dyce y O’Connor en una muestra americana con los mismos instrumentos. Como se esperaba, los análisis factoriales de facetas reteniendo cinco factores mostraron un modelo de relaciones muy similar entre ambas muestras, con un coeficiente de la congruencia total de 0,92, y coeficientes de congruencia de factor aceptables, salvo para el factor Apertura (0,68). En consonancia con las predicciones de Widiger y Widiger et al. los porcentajes de correlaciones significativas estaban alrededor de 60% en ambas muestras, y la mayoría coincidían. El análisis de regresión múltiple con dimensiones también reveló un gran parecido entre los resultados americanos y españoles, Neuroticismo fue el predictor más relacionado con los trastornos de personalidad. Se encontraron diferencias en las regresiones por facetas, aunque la varianza explicada fue prácticamente la misma que en las dimensiones. Se discute la validez transcultural y el valor predictivo del NEO-PI-R sobre los trastornos de personalidad del MCMI-III, junto con las ventajas relativas de las facetas sobre las dimensiones.

Senyals i espills

L'objectiu d'aquest article és discutir una antiga matriu comunicativa parcialment assenyalada per A. Comte, Ch. S. Peirce i U. Eco. Aquests autors reconegueren la relació entre marques, fletxes, ensenyes i espills com a diferents metàfores bàsiques de diverses operacions cognitives, encara que no en van presentar una visió de conjunt. Tots tres van treballar la distinció entre metàfora i metonímia, que va resultar tan fructífera en diferents dominis de recerca, com Jakobson (entre altres) ens va ensenyar. La meua hipòtesi és que aquestes quatre metàfores bàsiques (marques, fletxes, ensenyes i espills) es poden deduir correctament d'una matriu que relacioni l'eix metàfora-metonímia amb menes de codi ficació. E. Verón llançà una interessant reflexió sobre els modes analògic i digital, tot partint d'un problema semblant. Marques, etxes, ensenyes i miralls poden recordar bé operacions com senyalar i assenyalar, representar i reflectir, respectivament: estipular de manera aproximada com aquests objectes i aquestes operacions estan connectats podria ser una petita contribució a l'antic programa de Peirce i els altres.

Cognitive anatomy of the temporal lobe: Effect of personality in population with mild cognitive impairment & Functional specialization for memory systems in healthy individuals.

Résumé: L'impact de la maladie d'Alzheimer (MA) est dévastateur pour la vie quotidienne de la personne affectée, avec perte progressive de la mémoire et d'autres facultés cognitives jusqu'à la démence. Il n'existe toujours pas de traitement contre cette maladie et il y a aussi une grande incertitude sur le diagnostic des premiers stades de la MA. La signature anatomique de la MA, en particulier l'atrophie du lobe temporal moyen (LTM) mesurée avec la neuroimagerie, peut être utilisée comme un biomarqueur précoce, in vivo, des premiers stades de la MA. Toutefois, malgré le rôle évident du LMT dans les processus de la mémoire, nous savons que les modèles anatomiques prédictifs de la MA basés seulement sur des mesures d'atrophie du LTM n'expliquent pas tous les cas cliniques. Au cours de ma thèse, j'ai conduit trois projets pour comprendre l'anatomie et le fonctionnement du LMT dans (1) les processus de la maladie et dans (2) les processus de mémoire ainsi que (3) ceux de l'apprentissage. Je me suis intéressée à une population avec déficit cognitif léger (« Mild Cognitive Impairment », MCI), à risque pour la MA. Le but du premier projet était de tester l'hypothèse que des facteurs, autres que ceux cognitifs, tels que les traits de personnalité peuvent expliquer les différences interindividuelles dans le LTM. De plus, la diversité phénotypique des manifestations précliniques de la MA provient aussi d'une connaissance limitée des processus de mémoire et d'apprentissage dans le cerveau sain. L'objectif du deuxième projet porte sur l'investigation des sous-régions du LTM, et plus particulièrement de leur contribution dans différentes composantes de la mémoire de reconnaissance chez le sujet sain. Pour étudier cela, j'ai utilisé une nouvelle méthode multivariée ainsi que l'IRM à haute résolution pour tester la contribution de ces sous-régions dans les processus de familiarité (« ou Know ») et de remémoration (ou « Recollection »). Finalement, l'objectif du troisième projet était de tester la contribution du LTM en tant que système de mémoire dans l'apprentissage et l'interaction dynamique entre différents systèmes de mémoire durant l'apprentissage. Les résultats du premier projet montrent que, en plus du déficit cognitif observé dans une population avec MCI, les traits de personnalité peuvent expliquer les différences interindividuelles du LTM ; notamment avec une plus grande contribution du neuroticisme liée à une vulnérabilité au stress et à la dépression. Mon étude a permis d'identifier un pattern d'anormalité anatomique dans le LTM associé à la personnalité avec des mesures de volume et de diffusion moyenne du tissu. Ce pattern est caractérisé par une asymétrie droite-gauche du LTM et un gradient antéro-postérieur dans le LTM. J'ai interprété ce résultat par des propriétés tissulaires et neurochimiques différemment sensibles au stress. Les résultats de mon deuxième projet ont contribué au débat actuel sur la contribution des sous-régions du LTM dans les processus de familiarité et de remémoration. Utilisant une nouvelle méthode multivariée, les résultats supportent premièrement une dissociation des sous-régions associées aux différentes composantes de la mémoire. L'hippocampe est le plus associé à la mémoire de type remémoration et le cortex parahippocampique, à la mémoire de type familiarité. Deuxièmement, l'activation correspondant à la trace mnésique pour chaque type de mémoire est caractérisée par une distribution spatiale distincte. La représentation neuronale spécifique, « sparse-distributed», associée à la mémoire de remémoration dans l'hippocampe serait la meilleure manière d'encoder rapidement des souvenirs détaillés sans interférer les souvenirs précédemment stockés. Dans mon troisième projet, j'ai mis en place une tâche d'apprentissage en IRM fonctionnelle pour étudier les processus d'apprentissage d'associations probabilistes basé sur le feedback/récompense. Cette étude m'a permis de mettre en évidence le rôle du LTM dans l'apprentissage et l'interaction entre différents systèmes de mémoire comme la mémoire procédurale, perceptuelle ou d'amorçage et la mémoire de travail. Nous avons trouvé des activations dans le LTM correspondant à un processus de mémoire épisodique; les ganglions de la base (GB), à la mémoire procédurale et la récompense; le cortex occipito-temporal (OT), à la mémoire de représentation perceptive ou l'amorçage et le cortex préfrontal, à la mémoire de travail. Nous avons également observé que ces régions peuvent interagir; le type de relation entre le LTM et les GB a été interprété comme une compétition, ce qui a déjà été reporté dans des études récentes. De plus, avec un modèle dynamique causal, j'ai démontré l'existence d'une connectivité effective entre des régions. Elle se caractérise par une influence causale de type « top-down » venant de régions corticales associées avec des processus de plus haut niveau venant du cortex préfrontal sur des régions corticales plus primaires comme le OT cortex. Cette influence diminue au cours du de l'apprentissage; cela pourrait correspondre à un mécanisme de diminution de l'erreur de prédiction. Mon interprétation est que cela est à l'origine de la connaissance sémantique. J'ai également montré que les choix du sujet et l'activation cérébrale associée sont influencés par les traits de personnalité et des états affectifs négatifs. Les résultats de cette thèse m'ont amenée à proposer (1) un modèle expliquant les mécanismes possibles liés à l'influence de la personnalité sur le LTM dans une population avec MCI, (2) une dissociation des sous-régions du LTM dans différents types de mémoire et une représentation neuronale spécifique à ces régions. Cela pourrait être une piste pour résoudre les débats actuels sur la mémoire de reconnaissance. Finalement, (3) le LTM est aussi un système de mémoire impliqué dans l'apprentissage et qui peut interagir avec les GB par une compétition. Nous avons aussi mis en évidence une interaction dynamique de type « top -down » et « bottom-up » entre le cortex préfrontal et le cortex OT. En conclusion, les résultats peuvent donner des indices afin de mieux comprendre certains dysfonctionnements de la mémoire liés à l'âge et la maladie d'Alzheimer ainsi qu'à améliorer le développement de traitement. Abstract: The impact of Alzheimer's disease is devastating for the daily life of the affected patients, with progressive loss of memory and other cognitive skills until dementia. We still lack disease modifying treatment and there is also a great amount of uncertainty regarding the accuracy of diagnostic classification in the early stages of AD. The anatomical signature of AD, in particular the medial temporal lobe (MTL) atrophy measured with neuroimaging, can be used as an early in vivo biomarker in early stages of AD. However, despite the evident role of MTL in memory, we know that the derived predictive anatomical model based only on measures of brain atrophy in MTL does not explain all clinical cases. Throughout my thesis, I have conducted three projects to understand the anatomy and the functioning of MTL on (1) disease's progression, (2) memory process and (3) learning process. I was interested in a population with mild cognitive impairment (MCI), at risk for AD. The objective of the first project was to test the hypothesis that factors, other than the cognitive ones, such as the personality traits, can explain inter-individual differences in the MTL. Moreover, the phenotypic diversity in the manifestations of preclinical AD arises also from the limited knowledge of memory and learning processes in healthy brain. The objective of the second project concerns the investigation of sub-regions of the MTL, and more particularly their contributions in the different components of recognition memory in healthy subjects. To study that, I have used a new multivariate method as well as MRI at high resolution to test the contribution of those sub-regions in the processes of familiarity and recollection. Finally, the objective of the third project was to test the contribution of the MTL as a memory system in learning and the dynamic interaction between memory systems during learning. The results of the first project show that, beyond cognitive state of impairment observed in the population with MCI, the personality traits can explain the inter-individual differences in the MTL; notably with a higher contribution of neuroticism linked to proneness to stress and depression. My study has allowed identifying a pattern of anatomical abnormality in the MTL related to personality with measures of volume and mean diffusion of the tissue. That pattern is characterized by right-left asymmetry in MTL and an anterior to posterior gradient within MTL. I have interpreted that result by tissue and neurochemical properties differently sensitive to stress. Results of my second project have contributed to the actual debate on the contribution of MTL sub-regions in the processes of familiarity and recollection. Using a new multivariate method, the results support firstly a dissociation of the subregions associated with different memory components. The hippocampus was mostly associated with recollection and the surrounding parahippocampal cortex, with familiarity type of memory. Secondly, the activation corresponding to the mensic trace for each type of memory is characterized by a distinct spatial distribution. The specific neuronal representation, "sparse-distributed", associated with recollection in the hippocampus would be the best way to rapidly encode detailed memories without overwriting previously stored memories. In the third project, I have created a learning task with functional MRI to sudy the processes of learning of probabilistic associations based on feedback/reward. That study allowed me to highlight the role of the MTL in learning and the interaction between different memory systems such as the procedural memory, the perceptual memory or priming and the working memory. We have found activations in the MTL corresponding to a process of episodic memory; the basal ganglia (BG), to a procedural memory and reward; the occipito-temporal (OT) cortex, to a perceptive memory or priming and the prefrontal cortex, to working memory. We have also observed that those regions can interact; the relation type between the MTL and the BG has been interpreted as a competition. In addition, with a dynamic causal model, I have demonstrated a "top-down" influence from cortical regions associated with high level cortical area such as the prefrontal cortex on lower level cortical regions such as the OT cortex. That influence decreases during learning; that could correspond to a mechanism linked to a diminution of prediction error. My interpretation is that this is at the origin of the semantic knowledge. I have also shown that the subject's choice and the associated brain activation are influenced by personality traits and negative affects. Overall results of this thesis have brought me to propose (1) a model explaining the possible mechanism linked to the influence of personality on the MTL in a population with MCI, (2) a dissociation of MTL sub-regions in different memory types and a neuronal representation specific to each region. This could be a cue to resolve the actual debates on recognition memory. Finally, (3) the MTL is also a system involved in learning and that can interact with the BG by a competition. We have also shown a dynamic interaction of « top -down » and « bottom-up » types between the pre-frontal cortex and the OT cortex. In conclusion, the results could give cues to better understand some memory dysfunctions in aging and Alzheimer's disease and to improve development of treatment.

A common cognitive, psychiatric, and dysmorphic phenotype in carriers of NRXN1 deletion

Deletions in the 2p16.3 region that includes the neurexin (NRXN1) gene are associated with intellectual disability and various psychiatric disorders, in particular, autism and schizophrenia. We present three unrelated patients, two adults and one child, in whom we identified an intragenic 2p16.3 deletion within the NRXN1 gene using an oligonucleotide comparative genomic hybridization array. The three patients presented dual diagnosis that consisted of mild intellectual disability and autism and bipolar disorder. Also, they all shared a dysmorphic phenotype characterized by a long face, deep set eyes, and prominent premaxilla. Genetic analysis of family members showed two inherited deletions. A comprehensive neuropsychological examination of the 2p16.3 deletion carriers revealed the same phenotype, characterized by anxiety disorder, borderline intelligence, and dysexecutive syndrome. The cognitive pattern of dysexecutive syndrome with poor working memory and reduced attention switching, mental flexibility, and verbal fluency was the same than those of the adult probands. We suggest that in addition to intellectual disability and psychiatric disease, NRXN1 deletion is a risk factor for a characteristic cognitive and dysmorphic profile. The new cognitive phenotype found in the 2p16.3 deletion carriers suggests that 2p16.3 deletions might have a wide variable expressivity instead of incomplete penetrance

Making Sense of Women Managers’ Identities through the Constructions of Managerial Career and Gender

This doctoral thesis is about gendered managerial identity construction of women managers. Finnish women managers have been researched from the viewpoints of equality and discrimination issues, careers, and women’s overall positions in work life. However, managerial identity has remained as an unexplored territory. The phenomenon is approached discourse analytically; an interview material that is gathered from 13 women managers in the South-Karelian region is in focus. By studying discourses it is possible to open up understandings how meanings are given to experiences. Women managers’ identity construction is examined from the perspectives of managerial career, managerial practices, and gender. Gender is a meta-concept in this research, as it so profoundly affects our sense of being and acting, although the meaning of it often remains undervalued, invisible, or even denied. This research shows that gender becomes highly visible in managerial contexts, when it is used for some specific purpose, that is, treated as a strategy. By studying women managers it is possible to demystify often so abstract managerial ideals, and open up their taken-for-granted masculine subtexts. It is argued that from the point of view of conducting managerial work, the meaning of self-knowledge appears as critical.

Innovative Culture – Searching for Innovativeness in a Construction Company

The purpose of the thesis is to study innovativeness in a context of the construction industry especially the front-end of the innovation process. The construction industry is often considered an old-fashioned manufacturing industry. Innovations and innovativeness are rarely linked to the industry. The construction industry, as well as other industries in Finland, is facing challenges such as productivity, the climate change and internationalization. The meaning of innovations is greater than ever in continuously changing markets, for standing out from competitors or increasing the competitiveness. Traditional production methods, tight building regulations, unique buildings, one-of-a-kind project organizations and highlighting the cheapest price in building contracts are particular challenges in the construction industry. The research questions of the thesis were: - What kind of factors shift the existing company culture towards innovativeness? - What are the phases of the front-end of the innovation process? - What kind of tools and methods enable managing the front-end of the innovation process? The theoretical part of the thesis bases on the literature review. The research methodology of the empirical part was the action research and qualitative approach. Empirical data was collected by the theme interviews from three companies. The results were practical methods and experiences from innovation activities of the companies. The results of the thesis can be clarified as follows: enhancement of the innovation activities requires support and commitment of the top management, innovative culture and innovation strategy. Innovativeness can be promoted by systematical methods for example collecting ideas from employees. Controlling and managing the front-end phase is essential to succeeding. Despite that managing the front-end is the most challenging part of the innovation process, development and management of that save companies’ money, resources and prevents useless investments. Further clarification and studies are needed to find out furthermore functional tools and methods to manage innovations and implementing them to the culture of the companies.