Déterminants qui favorisent ou non l’autogestion du diabète de type 2 chez les personnes souffrant de cette maladie en Haïti

Cette étude exploratoire menée à Mirebalais (Haïti) vise à mieux comprendre les stratégies d’autogestion utilisées par les personnes diabétiques vivant dans cette commune. Nous nous sommes basés sur le modèle de la triade desease / illness / sickness décrit par Kleinman et al. (1978) et Young (1982) pour appréhender l’adaptation des personnes diabétiques dans leur environnement social et familial. Treize entrevues individuelles semi-structurées de diabétiques ont été réalisées. Les personnes qui arrivent à mieux vivre avec le diabète sont celles qui ont combiné les recommandations médicales, le savoir populaire et leur contexte de vie. Les résultats de cette étude peuvent être utilisés comme piste d’intervention dans des programmes entourant la prévention des complications de la maladie et l’amélioration des conditions de vie des diabétiques.

Compétences en littératie visuelle chez les étudiantEs en biologie au niveau collégial: bilan des apprentissages selon des activités digitales ou des activités de dessins à la main

This study examines the role of visual literacy in learning biology. Biology teachers promote the use of digital images as a learning tool for two reasons: because biology is the most visual of the sciences, and the use of imagery is becoming increasingly important with the advent of bioinformatics; and because studies indicate that this current generation of teenagers have a cognitive structure that is formed through exposure to digital media. On the other hand, there is concern that students are not being exposed enough to the traditional methods of processing biological information - thought to encourage left-brain sequential thinking patterns. Theories of Embodied Cognition point to the importance of hand-drawing for proper assimilation of knowledge, and theories of Multiple Intelligences suggest that some students may learn more easily using traditional pedagogical tools. To test the claim that digital learning tools enhance the acquisition of visual literacy in this generation of biology students, a learning intervention was carried out with 33 students enrolled in an introductory college biology course. The study compared learning outcomes following two types of learning tools. One learning tool was a traditional drawing activity, and the other was an interactive digital activity carried out on a computer. The sample was divided into two random groups, and a crossover design was implemented with two separate interventions. In the first intervention students learned how to draw and label a cell. Group 1 learned the material by computer and Group 2 learned the material by hand-drawing. In the second intervention, students learned how to draw the phases of mitosis, and the two groups were inverted. After each learning activity, students were given a quiz on the material they had learned. Students were also asked to self-evaluate their performance on each quiz, in an attempt to measure their level of metacognition. At the end of the study, they were asked to fill out a questionnaire that was used to measure the level of task engagement the students felt towards the two types of learning activities. In this study, following the first testing phase, the students who learned the material by drawing had a significantly higher average grade on the associated quiz compared to that of those who learned the material by computer. The difference was lost with the second “cross-over” trial. There was no correlation for either group between the grade the students thought they had earned through self-evaluation, and the grade that they received. In terms of different measures of task engagement, there were no significant differences between the two groups. One finding from the study showed a positive correlation between grade and self-reported time spent playing video games, and a negative correlation between grade and self-reported interest in drawing. This study provides little evidence to support claims that the use of digital tools enhances learning, but does provide evidence to support claims that drawing by hand is beneficial for learning biological images. However, the small sample size, limited number and type of learning tasks, and the indirect means of measuring levels of metacognition and task engagement restrict generalisation of these conclusions. Nevertheless, this study indicates that teachers should not use digital learning tools to the exclusion of traditional drawing activities: further studies on the effectiveness of these tools are warranted. Students in this study commented that the computer tool seemed more accurate and detailed - even though the two learning tools carried identical information. Thus there was a mismatch between the perception of the usefulness of computers as a learning tool and the reality, which again points to the need for an objective assessment of their usefulness. Students should be given the opportunity to try out a variety of traditional and digital learning tools in order to address their different learning preferences.

Influencia del líder en el clima organizacional

En este trabajo se evidenciará cómo el liderazgo y el clima organizacional, que son dos componentes importantes dentro de una organización, están estrechamente ligados de tal forma que uno se ve afectado por el otro bien sea de manera positiva o negativa. Así de esta manera quisimos evidenciar este lazo entre liderazgo y clima organizacional con base en el liderazgo auténtico, el cual surge como una nueva teoría alrededor de varios componentes esenciales en el líder: conciencia de sí mismo, transparencia en las relaciones, procesamiento equilibrado y moral internalizada (Walumbwa, Avolio, Gardner, Wernsing, Peterson, 2008). En la misión empresarial realizada en la ciudad de Nueva York desarrollamos nuestro trabajo de campo. Visitamos empresas de reconocimiento a nivel mundial tales como: Google, Bloomberg, N&C Company y Procolombia. En estas empresas investigamos por medio de encuestas qué estilo de liderazgo existía y lo contrastamos con el clima organizacional. Para nosotros la experiencia fue muy enriquecedora pues todas las organizaciones nos brindaron información muy importante para el desarrollo de la investigación. Encontramos que las empresas siguen un patrón de comportamiento similar: el trabajo en equipo, la innovación, la autonomía, la comunicación, la autoevaluación y la transparencia, fueron elementos que evidenciamos durante la misión empresarial realizada.

Creencias y prácticas de autoevaluación del aprendizaje vigentes en los procesos de formación profesional desarrollados en el CIDE durante el 2007

This article identifies beliefs and practices of self-learning existing processes developed in the CIDE during 2007. It is based on a research project with two groups of informants both academics from CIDE, that during the decade of the 90 participated in the experience of self-learning, some of themas teachers and other as students. Current practices being carried out by academics in the field of self-reporting of apprenticeships in the CIDE, show that they attach great importance to this process in the lesson and agree on the necessity to implement this process in concrete terms, that because, experiences become isolated initiatives that do not fall within any policy, guideline or orientation openly raised by the community CIDE. The beliefs of the participants with regard to the possibility of implementing self-evaluation processes of learning in the training that develops the CIDE, highlight the need for scholars to train group of academics and students in this field and also create more spaces for student involvement. Moreover, scholars believe that the self-assessment of learning is a strategy for developing metacognitive processes and reflective, which is considered a core importance in the training provided by the Centre.

Development, implementation and evaluation of a cancer survivor self-management care plan

Aim There is a growing population of people with cancer who experience physiological and psychological effects that persist long after treatment is complete. Interventions that enhance survivors’ self-management abilities might help offset these effects. The aim of this pilot study was to develop, implement and evaluate interventions tailored to assist patients to manage post-treatment health issues effectively. Method In this pre-post intervention cohort study, participants were recruited on completion of cancer treatment. Participants recruited preimplementation, who received usual care, comprised the control group. Participants recruited later formed the intervention group. In the intervention group, the Cancer Care Coordinator developed an individualised, structured Cancer Survivor Self-management Care Plan. Participants were interviewed on completion of treatment (baseline) and at three months. Assessments concerned health needs (CaSUN), self-efficacy in adjusting and coping with cancer and health-related quality of life (FACIT-B or FACT-C). The impact of the intervention was determined by independent t-tests of change scores. Results The intervention (n = 32) and control groups (n = 35) were comparable on demographic and clinical characteristics. Sample mean age was 54 + 10 years. Cancer diagnoses were breast (82%) and colorectal (18%). Statistically significant differences (p < 0.05) indicated improvement in the intervention group for: (a) functional well-being, from the FACIT, (Control: M = −0.69, SE = 0.91; Intervention: M = 3.04, SE = 1.13); and (b) self-efficacy in maintaining social relationships, (Control: M = −0.333, SE = 0.33; Intervention: M = 0.621, SE = 0.27). No significant differences were found in health needs, other subscales of quality of life, the extent and number of strategies used in coping and adjusting to cancer and in other domains of self-efficacy. Conclusions While the results should be interpreted with caution, due to the non-randomised nature of the study and the small sample size, they indicate the potential benefits of tailored self-management interventions warrant further investigation in this context.

Strategies towards evaluation beyond scientific impact

Various research fields, like organic agricultural research, are dedicated to solving real-world problems and contributing to sustainable development. Therefore, systems research and the application of interdisciplinary and transdisciplinary approaches are increasingly endorsed. However, research performance depends not only on self-conception, but also on framework conditions of the scientific system, which are not always of benefit to such research fields. Recently, science and its framework conditions have been under increasing scrutiny as regards their ability to serve societal benefit. This provides opportunities for (organic) agricultural research to engage in the development of a research system that will serve its needs. This article focuses on possible strategies for facilitating a balanced research evaluation that recognises scientific quality as well as societal relevance and applicability. These strategies are (a) to strengthen the general support for evaluation beyond scientific impact, and (b) to provide accessible data for such evaluations. Synergies of interest are found between open access movements and research communities focusing on global challenges and sustainability. As both are committed to increasing the societal benefit of science, they may support evaluation criteria such as knowledge production and dissemination tailored to societal needs, and the use of open access. Additional synergies exist between all those who scrutinise current research evaluation systems for their ability to serve scientific quality, which is also a precondition for societal benefit. Here, digital communication technologies provide opportunities to increase effectiveness, transparency, fairness and plurality in the dissemination of scientific results, quality assurance and reputation. Furthermore, funders may support transdisciplinary approaches and open access and improve data availability for evaluation beyond scientific impact. If they begin to use current research information systems that include societal impact data while reducing the requirements for narrative reports, documentation burdens on researchers may be relieved, with the funders themselves acting as data providers for researchers, institutions and tailored dissemination beyond academia.

The Impact of Gender and Pedagogy on the Development of Self-Regulated Learning Strategies in Undergraduate Engineering Classrooms

The purpose of this paper is to examine ways in which pedagogy and gender of instructor impact the development of self-regulated learning strategies as assessed by the Motivated Strategies for Learning Questionnaire (MSLQ) in male and female undergraduate engineering students. Pedagogy was operationalized as two general formats: lecture plus active learning techniques or problem-base/project-based learning. One hundred seventy-six students from four universities participated in the study. Within-group analyses found significant differences with regard to pedagogy, instructors’ gender, and student gender on the learning strategies and motivation subscales as operationalized by the MSLQ. Male and females students reported significant post-test differences with regard to the gender of instructor and the style of pedagogy. The results of this study showed a pattern where more positive responses for students of both genders were found with the same-gendered instructor. The results also suggested that male students responded more positively to project and problem-based courses with changes evidenced in motivation strategies and resource management. Female students showed decreases in resource management in these two types of courses. Further, female students reported increases in the lecture with active learning courses.

Real time optimization in chemical process: evaluation of strategies, improvements and industrial application.

The increasing economic competition drives the industry to implement tools that improve their processes efficiencies. The process automation is one of these tools, and the Real Time Optimization (RTO) is an automation methodology that considers economic aspects to update the process control in accordance with market prices and disturbances. Basically, RTO uses a steady-state phenomenological model to predict the process behavior, and then, optimizes an economic objective function subject to this model. Although largely implemented in industry, there is not a general agreement about the benefits of implementing RTO due to some limitations discussed in the present work: structural plant/model mismatch, identifiability issues and low frequency of set points update. Some alternative RTO approaches have been proposed in literature to handle the problem of structural plant/model mismatch. However, there is not a sensible comparison evaluating the scope and limitations of these RTO approaches under different aspects. For this reason, the classical two-step method is compared to more recently derivative-based methods (Modifier Adaptation, Integrated System Optimization and Parameter estimation, and Sufficient Conditions of Feasibility and Optimality) using a Monte Carlo methodology. The results of this comparison show that the classical RTO method is consistent, providing a model flexible enough to represent the process topology, a parameter estimation method appropriate to handle measurement noise characteristics and a method to improve the sample information quality. At each iteration, the RTO methodology updates some key parameter of the model, where it is possible to observe identifiability issues caused by lack of measurements and measurement noise, resulting in bad prediction ability. Therefore, four different parameter estimation approaches (Rotational Discrimination, Automatic Selection and Parameter estimation, Reparametrization via Differential Geometry and classical nonlinear Least Square) are evaluated with respect to their prediction accuracy, robustness and speed. The results show that the Rotational Discrimination method is the most suitable to be implemented in a RTO framework, since it requires less a priori information, it is simple to be implemented and avoid the overfitting caused by the Least Square method. The third RTO drawback discussed in the present thesis is the low frequency of set points update, this problem increases the period in which the process operates at suboptimum conditions. An alternative to handle this problem is proposed in this thesis, by integrating the classic RTO and Self-Optimizing control (SOC) using a new Model Predictive Control strategy. The new approach demonstrates that it is possible to reduce the problem of low frequency of set points updates, improving the economic performance. Finally, the practical aspects of the RTO implementation are carried out in an industrial case study, a Vapor Recompression Distillation (VRD) process located in Paulínea refinery from Petrobras. The conclusions of this study suggest that the model parameters are successfully estimated by the Rotational Discrimination method; the RTO is able to improve the process profit in about 3%, equivalent to 2 million dollars per year; and the integration of SOC and RTO may be an interesting control alternative for the VRD process.

Evaluation of breeding strategies for polledness in dairy cattle using a newly developed simulation framework for quantitative and Mendelian traits

Background: Intensified selection of polled individuals has recently gained importance in predominantly horned dairy cattle breeds as an alternative to routine dehorning. The status quo of the current polled breeding pool of genetically-closely related artificial insemination sires with lower breeding values for performance traits raises questions regarding the effects of intensified selection based on this founder pool. Methods: We developed a stochastic simulation framework that combines the stochastic simulation software QMSim and a self-designed R program named QUALsim that acts as an external extension. Two traits were simulated in a dairy cattle population for 25 generations: one quantitative (QMSim) and one qualitative trait with Mendelian inheritance (i.e. polledness, QUALsim). The assignment scheme for qualitative trait genotypes initiated realistic initial breeding situations regarding allele frequencies, true breeding values for the quantitative trait and genetic relatedness. Intensified selection for polled cattle was achieved using an approach that weights estimated breeding values in the animal best linear unbiased prediction model for the quantitative trait depending on genotypes or phenotypes for the polled trait with a user-defined weighting factor. Results: Selection response for the polled trait was highest in the selection scheme based on genotypes. Selection based on phenotypes led to significantly lower allele frequencies for polled. The male selection path played a significantly greater role for a fast dissemination of polled alleles compared to female selection strategies. Fixation of the polled allele implies selection based on polled genotypes among males. In comparison to a base breeding scenario that does not take polledness into account, intensive selection for polled substantially reduced genetic gain for this quantitative trait after 25 generations. Reducing selection intensity for polled males while maintaining strong selection intensity among females, simultaneously decreased losses in genetic gain and achieved a final allele frequency of 0.93 for polled. Conclusions: A fast transition to a completely polled population through intensified selection for polled was in contradiction to the preservation of high genetic gain for the quantitative trait. Selection on male polled genotypes with moderate weighting, and selection on female polled phenotypes with high weighting, could be a suitable compromise regarding all important breeding aspects.

The development and evaluation of an innovative nursing practice model to improve undergraduate nursing students' competence in paediatric physical assessment

Introduction The purpose of this study was to develop, implement and evaluate the impact of an educational intervention, comprising an innovative model of clinical decisionmaking and educational delivery strategy for facilitating nursing students‘ learning and development of competence in paediatric physical assessment practices. Background of the study Nursing students have an undergraduate education that aims to produce graduates of a generalist nature who demonstrate entry level competence for providing nursing care in a variety of health settings. Consistent with population morbidity and health care roles, paediatric nursing concepts typically form a comparatively small part of undergraduate curricula and students‘ exposure to paediatric physical assessment concepts and principles are brief. However, the nursing shortage has changed traditional nursing employment patterns and new graduates form the majority of the recruitment pool for paediatric nursing speciality staff. Paediatric nursing is a popular career choice for graduates and anecdotal evidence suggests that nursing students who select a clinical placement in their final year intend to seek employment in paediatrics upon graduation. Although concepts of paediatric nursing are included within undergraduate curriculum, students‘ ability to develop the required habits of mind to practice in what is still regarded as a speciality area of practice is somewhat limited. One of the areas of practice where this particularly impacts is in paediatric nursing physical assessment. Physical assessment is a fundamental component of nursing practice and competence in this area of practice is central to nursing students‘ development of clinical capability for practice as a registered nurse. Timely recognition of physiologic deterioration of patients is a key outcome of nurses‘ competent use of physical assessment strategies, regardless of the practice context. In paediatric nursing contexts children‘s physical assessment practices must specifically accommodate the child‘s different physiological composition, function and pattern of clinical deterioration (Hockenberry & Barrera, 2007). Thus, to effectively manage physical assessment of patients within the paediatric practice setting nursing students need to integrate paediatric nursing theory into their practice. This requires significant information processing and it is in this process where students are frequently challenged. The provision of rules or models can guide practice and assist novice-level nurses to develop their capabilities (Benner, 1984; Benner, Hooper-Kyriakidis & Stannard, 1999). Nursing practice models are cognitive tools that represent simplified patterns of expert analysis employing concepts that suit the limited reasoning of the inexperienced, and can represent the =rules‘ referred to by Benner (1984). Without a practice model of physical assessment students are likely to be uncertain about how to proceed with data collection, the interpretation of paediatric clinical findings and the appraisal of findings. These circumstances can result in ad hoc and unreliable nursing physical assessment that forms a poor basis for nursing decisions. The educational intervention developed as part of this study sought to resolve this problem and support nursing students‘ development of competence in paediatric physical assessment. Methods This study utilised the Context Input Process Product (CIPP) Model by Stufflebeam (2004) as the theoretical framework that underpinned the research design and evaluation methodology. Each of the four elements in the CIPP model were utilised to guide discrete stages of this study. The Context element informed design of the clinical decision-making process, the Paediatric Nursing Physical Assessment model. The Input element was utilised in appraising relevant literature, identifying an appropriate instructional methodology to facilitate learning and educational intervention delivery to undergraduate nursing students, and development of program content (the CD-ROM kit). Study One employed the Process element and used expert panel approaches to review and refine instructional methods, identifying potential barriers to obtaining an effective evaluation outcome. The Product element guided design and implementation of Study Two, which was conducted in two phases. Phase One employed a quasiexperimental between-subjects methodology to evaluate the impact of the educational intervention on nursing students‘ clinical performance and selfappraisal of practices in paediatric physical assessment. Phase Two employed a thematic analysis and explored the experiences and perspectives of a sample subgroup of nursing students who used the PNPA CD-ROM kit as preparation for paediatric clinical placement. Results Results from the Process review in Study One indicated that the prototype CDROM kit containing the PNPA model met the predetermined benchmarks for face validity and the impact evaluation instrumentation had adequate content validity in comparison with predetermined benchmarks. In the first phase of Study Two the educational intervention did not result in statistically significant differences in measures of student performance or self-appraisal of practice. However, in Phase Two qualitative commentary from students, and from the expert panel who reviewed the prototype CD-ROM kit (Study One, Phase One), strongly endorsed the quality of the intervention and its potential for supporting learning. This raises questions regarding transfer of learning and it is likely that, within this study, several factors have influenced students‘ transfer of learning from the educational intervention to the clinical practice environment, where outcomes were measured. Conclusion In summary, the educational intervention employed in this study provides insights into the potential e-learning approaches offer for delivering authentic learning experiences to undergraduate nursing students. Findings in this study raise important questions regarding possible pedagogical influences on learning outcomes, issues within the transfer of theory to practice and factors that may have influenced findings within the context of this study. This study makes a unique contribution to nursing education, specifically with respect to progressing an understanding of the challenges faced in employing instructive methods to impact upon nursing students‘ development of competence. The important contribution transfer of learning processes make to students‘ transition into the professional practice context and to their development of competence within the context of speciality practice is also highlighted. This study contributes to a greater awareness of the complexity of translating theoretical learning at undergraduate level into clinical practice, particularly within speciality contexts.

Psychometric evaluation of the Chinese version of the diabetes coping measure scale

Purpose: To evaluate the psychometric properties of a Chinese version of the Diabetes Coping Measure (DCM-C) scale.----- Methods: A self-administered questionnaire was completed by 205 people with type 2 diabetes from the endocrine outpatient departments of three hospitals in Taiwan. Confirmatory factor analysis, criterion validity, and internal consistency reliability were conducted to evaluate the psychometric properties of the DCM-C.----- Findings: Confirmatory factor analysis confirmed a four-factor structure (χ2 /df ratio=1.351, GFI=.904, CFI=.902, RMSEA=.041). The DCM-C was significantly associated with HbA1c and diabetes self-care behaviors. Internal consistency reliability of the total DCM-C scale was .74. Cronbach’s alpha coefficients for each subscale of the DCM-C ranged from .37 (tackling spirit) to .66 (diabetes integration).----- Conclusions: The DCM-C demonstrated satisfactory reliability and validity to determine the use of diabetes coping strategies. The tackling spirit dimension needs further refinement when applies this scale to Chinese populations with diabetes.----- Clinical Relevance: Healthcare providers who deal with Chinese people with diabetes can use the DCM-C to implement an early determination of diabetes coping strategies.