Perceptions of Alzheimer's Disease in the French Population : Evolutions between 2008 and 2013 and Associated Factors in 2013

Abstract: Background. The negative image surrounding AD has a substantial impact on caregiving and on those affected by the disease. Opinion surveys was created as part of the 2008-2012 Alzheimer Plan in France, which included two surveys in general population, at the beginning and at the end. Objective. To evaluate changes of the French population in perceptions, knowledge and beliefs since 5 years and to analyze dimensions with sociodemographics criteria and proximity with AD. Methods. After selection by quota sampling, 2013 French people aged 18 years and over were interviewed by phone in 2008 and 2509 in 2013. Chi-squared tests were carried out to measure the changes between two periods and multivariate logistics regressions were used to assess perceptions. Results. People who cited AD as one of the three most serious diseases increased in 2013 (33.6% versus 26.7% in 2008; p < 0.001). There was no significant change as regards the fear, the sense of being informed and the feeling of embarrassment. Opinions "there are treatments available to improve the wellbeing of patients" and "it is normal to suffer memory loss as you get older" decreased in 2013. Close family carers had a greater sense of the seriousness, a higher risk perception, a better sense of being informed and a greater ease in the presence of a person with AD. Conclusions. The results serve as indicators of the effects of the Alzheimer Plan on French society and testify to the rather weak impact of the Plan on public opinion.

Families in the Shadow of Cancer

The aims of this study were 1) to clarify the factors associated with family functioning in cancer patient’s families with dependant children, 2) to examine children’ mental health when they are exposed to parental cancer, 3) to explore the subjective experience of having cancer during pregnancy, and finally, 4) to describe the implementation of a childcentred family intervention for cancer patients’ families with dependant children in an adult oncology setting. The study groups were collected between May 1st 2002 and April 30th 2004. They consisted of one European group collected from six different countries (N = 381) and two Finnish clinical groups (N = 85 and N = 2). The first Finnish clinical group of 85 cancer patient families with dependant children included a sub-sample of 54 families with children aged 11-17 years. The second Finnish clinical group consisted of two pregnant cancer patients. Additionally, a control group (N = 59) consisting of a sub-sample of 49 families with children aged 11-17 years was used. Quantitative methods (FAD, BDI, YSR, SOC, SF-8) and qualitative methods (observation, interviews, diaries, videotapes) were used exclusively and/or in combination. The results can be summarised as follows: 1) cancer “per se “ did not impair family functioning, children’s mental health, early interaction between ill mothers and their infant, 2) maternal depression or the ill parent’s depression were significantly associated with impairment in family functioning, 3) the individual’s good sense of coherence was associated with improvement in family functioning, and 4) a child-centred family intervention, which aims to give space for elaborating on cancer in the family, validates the sense of coherence and children’s feelings, and promotes open communication was welcomed. It is important to note that in the European study group, the prevalence of depression was 35 % (BDI > 16) among ill mothers, and 28% among healthy mothers, 28% among ill fathers, and 13% among healthy fathers. Early screening and effective treatment of depression in cancer patients and their partners is of paramount importance for the mental health of children and the well-being of the family. Pregnant cancer patients are in need of psychosocial support.

Institutional legacies, employment and professional integration of non EU/EEA doctors in France

Internationally, policies for attracting highly-skilled migrants have become the guidelines mainly used by the Organisation for Economic Co-operation and Development (OECD) countries. Governments are implementing specific procedures to capture and facilitate their mobility. However, all professions are not equal when it comes to welcoming highly-skilled migrants. The medical profession, as a protective market, is one of these. Taking the case of non-EU/EEA doctors in France, this paper shows that the medical profession defined as the closed labour market, remains the most controversial in terms of professional integration of migrants, protectionist barriers to migrant competition and challenge of medical shortage. Based on the path-dependency approach, this paper argues that non-EU/EEA doctors' issues in France derive from a complex historical process of interaction between standards settled in the past, particularly the historical power of medical corporatism, the unexpected long-term effects of French hospital reforms of 1958, and budgetary pressures. Theoretically, this paper shows two significant findings. Firstly, the French medical system has undergone a series of transformations unthinkable in the strict sense of a path-dependence approach: an opening of the medical profession to foreign physicians in the context of the Europeanisation of public policy, acceptance of non-EU/EEA doctors in a context of medical shortage and budgetary pressures. Secondly, there is no change of the overall paradigm: significantly, the recruitment policies of non-EU/EEA doctors continue to highlight the imprint of the past and reveal a significant persistence of prejudices. Non-EU/EEA doctors are not considered legitimate doctors even if they have the qualifications of physicians which are legitimate in their country and which can be recognised in other receiving countries.

Practices of place-making through locative media artworks

Peer-reviewed

Under what conditions? Therapist and client characteristics moderate the role of change talk in brief motivational intervention.

OBJECTIVE: Client change talk has been proposed as a mechanism of change in motivational interviewing (MI) by mediating the link between therapist MI-consistent behaviors (MICO) and client behavioral outcomes. We tested under what circumstances this mechanism was supported in the context of a clinical trial of brief MI for heavy drinking among nontreatment seeking young men. METHOD: We conducted psycholinguistic coding of 174 sessions using the MI Skill Code 2.1 and derived the frequency of MICO and the strength of change talk (CTS) averaged over the session. CTS was examined as a mediator of the relationship between MICO and a drinking composite score measured at 3-month follow-up, controlling for the composite measure at baseline. Finally, we tested therapist gender and MI experience as well as client readiness to change and alcohol problem severity as moderators of this mediation model. RESULTS: CTS significantly predicted outcome (higher strength related to less drinking), but MICO did not predict CTS. However, CTS mediated the relationship between MICO and drinking outcomes when therapists had more experience in MI and when clients had more severe alcohol problems (i.e., significant conditional indirect effects). CONCLUSIONS: The mechanism hypothesized by MI theory was operative in our brief MI with heavy drinking young men, but only under particular conditions. Our results suggest that attention should be paid to therapist selection, training, and/or supervision until they reach a certain level of competence, and that MI might not be appropriate for nontreatment seeking clients drinking at a lower level of risk. (PsycINFO Database Record

Assessment of research competences using e-portfolio

The challenges posed by the assessment of distance learning is a topic that requires, on the one hand, evolution with new trends and, on the other improving evaluative processes, to promote good practices. This demand becomes more imperative when we are dealing with a formativescenario based on distance assessment of competence-based learning.The Open University of Catalonia has begun to work with these formative tools, promoting new practices for online education. A very clear example of these educational practices is the assessment of research competences using the e-portfolio system. To meet this aim a profound and solid process has been developed over recent years, with the intention of making this tool an assessment alternative, and providing the opportunity to use it in a formative context. The objective is to study its strengths and limitations keeping in mind the final goal of offering the higher education community a validated assessment system.

The experience of identity transformation process for people living with tetraplegia and paraplegia = El proceso de reconstrucción de la identidad de las personas afectadas de una paraplejia o tetraplejia

A spinal cord injury (SCI) is perceived as a source of biographical disruption, not only at a physical level but also in terms of people’s life stories, their motivation and their self-esteem. The aim of this study is to explore the factors that people with spinal cord injuries perceive as contributing to rebuilding their sense of self. Two focus groups were established from the SCIcommunity, one of which was made up of 14 people with paraplegia and the other of 9 people with tetraplegia. In addition, four individual interviews were conducted with the participants. The results of content analysis show that the two most prominent factors in the process of identity renegotiation are the partial transformation of the subject’s identity followed by a coming to terms with that new identity. To rebuild self-worth, the importance of finding a balance between change and continuity was identified. Renegotiation of identity after a spinal cord injury is a complex phenomenon that greatly influences the SCI individual’s quality of life perceptions. Reaching a balance between the changes experienced due to the injury and finding a sense of continuity can be either facilitated or obstructed by the economic, political, legal, architectural, and social context

Reconstruction and analysis of surface variation using photometric stereo

In many industrial applications, accurate and fast surface reconstruction is essential for quality control. Variation in surface finishing parameters, such as surface roughness, can reflect defects in a manufacturing process, non-optimal product operational efficiency, and reduced life expectancy of the product. This thesis considers reconstruction and analysis of high-frequency variation, that is roughness, on planar surfaces. Standard roughness measures in industry are calculated from surface topography. A fast and non-contact method to obtain surface topography is to apply photometric stereo in the estimation of surface gradients and to reconstruct the surface by integrating the gradient fields. Alternatively, visual methods, such as statistical measures, fractal dimension and distance transforms, can be used to characterize surface roughness directly from gray-scale images. In this thesis, the accuracy of distance transforms, statistical measures, and fractal dimension are evaluated in the estimation of surface roughness from gray-scale images and topographies. The results are contrasted to standard industry roughness measures. In distance transforms, the key idea is that distance values calculated along a highly varying surface are greater than distances calculated along a smoother surface. Statistical measures and fractal dimension are common surface roughness measures. In the experiments, skewness and variance of brightness distribution, fractal dimension, and distance transforms exhibited strong linear correlations to standard industry roughness measures. One of the key strengths of photometric stereo method is the acquisition of higher frequency variation of surfaces. In this thesis, the reconstruction of planar high-frequency varying surfaces is studied in the presence of imaging noise and blur. Two Wiener filterbased methods are proposed of which one is optimal in the sense of surface power spectral density given the spectral properties of the imaging noise and blur. Experiments show that the proposed methods preserve the inherent high-frequency variation in the reconstructed surfaces, whereas traditional reconstruction methods typically handle incorrect measurements by smoothing, which dampens the high-frequency variation.

Lukion opettajien ääni - Aineenopettajien käsityksiä muutoksista ja visioista lukiossa

Tulevaisuusorientaatio on tullut entistä tärkeämmäksi myös koulumaailmassa johtuen yhteiskunnassa nopeasti eteen tulevista muutoksista. On myös esitetty epäilyjä, että tulevaisuuteen reagoimisessa heikoin tilanne olisikin juuri kuntatason päätöksenteossa. Ymmärrys ja tieto opettajan työstä nimenomaan opettajan omasta perspektiivistä tarkasteltuna mahdollistavat lähtökohdan ja edellytykset todelliselle koulun uudistamiselle. Peruskysymys, johon tässä tutkimuksessa etsittiin vastausta oli: Millaisia ovat lukion aineenopettajien käsitykset lukion muutosprosesseista ja miten he visioivat oman lukionsa ja yleensä lukioiden tulevaisuutta? Aineiston keruu osui ajankohtaan, joka oli hyvin otollinen tulevaisuuden tarkasteluun, sillä uusi opetussuunnitelma otettiin käyttöön kaikissa Suomen lukioissa viimeistään lukuvuonna 2005-2006. Tutkimuksessa oli mukana kaksi hyvin erilaista lukiota Länsi-Suomen läänistä eli pieni maaseudun lukio ja hyvin suuri kaupunkilukio. Tutkimusaineiston keruu eteni kaksivaiheisesti: informoitu kysely ja teemahaastattelu. Tutkimusjoukon suuruus oli yhteensä 20, joista puolet oli miehiä ja puolet naisia. Aineenopettajien käsityksiä muutoksista ja visioista tutkittiin fenomenografisen tutkimusotteen avulla. Fenomenografiassa kiinnostuksen kohteena ovat ihmisten erilaiset käsitykset todellisuudesta ja näin saatava ymmärrys tavoista, joilla ihmiset kokevat tilanteita ja maailmaa. Organisaation muutosprosesseja voidaan kutsua myös oppimiseksi. Tutkimuksen oppivan organisaation näkökulmat perustuivat juuri yhteistyössä tapahtuvaan yhteisen toiminnan kehittämiseen. Aineenopettajien käsityksiä työyhteisöstään tarkasteltiin seuraavista oppivan organisaatiomallin näkökulmista: vuorovaikutus, päätöksenteko sekä rehtorin ja aineenopettajan rooli ja asema työyhteisössä. Aineenopettajien keskeisimmät käsitykset muutoksista lukiossa viime vuosina kohdistuivat aineenopettajan ammattirooliin ja lukio-opiskelijaan sekä opiskelijalta vaadittaviin lukio-opintoihin. Muutokset ammattiroolissa korostavat tutkimustulosten perusteella aineenopettajilta vaadittavia muitakin kuin opetettavien aineiden hallintataitoja. Suoranaista ammattitaidon puutetta opettajat kokivat varsinkin ryhmänohjaustehtävien yhteydessä, osittain myös uusien oppimisympäristöjen, esimerkiksi verkkopedagogisten taitojen, yhteydessä. Opettajien lisäkoulutuksen tarve koetaan konkreettisena, mutta sekä koulutusten sisältöihin, järjestelyihin ja ajankohtiin että koulun sijais- ym. järjestelyihin kaivattaisiin parannuksia. Verrattuna aikaisempiin tutkimuksiin näyttäisi siltä, että luokaton lukio on saanut opettajat enenevässä määrin huolestumaan opiskelijoiden syrjäytymisriskistä ja hyvinvoinnista. Opiskelijoiden syrjäytymisriskin kasvu lukio-opintojen aikana nouseekin yhdeksi lukion pessimistiseksi skenaarioksi. Muista pessimistisistä skenaarioista lukiolle, jotka saattoi johtaa tutkimustuloksista, voidaan mainita työyhteisön demokratiavajeen syveneminen sekä opetussuunnitelmasisältöjen ja ylioppilastutkintovaatimusten välisen kuilun syveneminen. Aineenopettajien käsitykset oman lukionsa visioista olivat sisällöiltään pääosin välineellisiä ja ne kohdentuivat kaikki opiskelijoihin. Esimerkiksi työyhteisöllisiä kehittämisajatuksia ei visioissa ilmennyt. Myöskään visioinnin dynaamisuus ei aineistossa korostunut. Aineenopettajien käsitykset visioiden arvopohjasta heijastivat perinteistä suomalaista arvomaailmaa eli itsekuria, velvollisuudentuntoa, kuuliaisuutta esivaltaa kohtaan ja perinteisten arvojen kunnioittamista. Sen sijaan antiikista perityviä Sokrateen edustamia keskustelua ja auktoriteettien kyseenalaistamista ei arvoissa ilmennyt, eikä myöskään uusliberalistista individualismia. Käsitykset visioiden synnystä näyttävät parhaiten selittävän opettajan muita käsityksiä liittyen visioon, visiointiin ja työyhteisöllisiin vaikutusmahdollisuuksiin sekä opettajan tulevaisuusorientoitumiseen.. Käsitykset vision syntytaustasta voidaan jakaa seuraaviin pää- ja alakategorioihin: 1. auktoriteettikeskeinen visiointi: johdon linjaus tai valtakunnallinen linjaus, 2. yhteisökeskeinen visiointi: yhteisöllinen linjaus tai toiminnallinen linjaus ja 3. yksilökeskeinen visiointi. Pessimistisimmiksi eli vähiten tulevaisuusorientoituneiksi opettajiksi työyhteisössä osoittautuivat ne opettajat, jotka pitivät oman lukionsa visiota koulun johdon sanelemana. Monet teoriat oppivasta organisaatiosta korostavat johtajuuden merkitystä työyhteisöä kehitettäessä. Johtajuuden merkitys nousi tämänkin tutkimuksen aineistosta keskeisesti esiin. Pyrkimystä kohti oppivaa organisaatiota opettajien puheista löytyy paljonkin, esimerkkeinä viittaukset johtajuuden ja vuorovaikutustapojen kehittämistarpeisiin. Sen sijaan opettajien puheet omista työyhteisöllisistä kehittymistarpeistaan, ns. alaistaidot, jäivät vähäisiksi. Tutkimustuloksista on luotu sovellusmalli kouluyhteisöjen visioinnin ja muun kehittämistyön tueksi.

Efficacy of virtual reality for triggering smoking craving: relation with level of presence and nicotine dependence

Virtual Reality environments that reproduce typical contexts associated with tobacco use may be useful for aiding smoking cessation. The main objective of this study was to assess the capacity of eight environments to produce the craving to smoke and determine the relation of craving to nicotine dependence and level of presence. The results show that all the environments were able to generate the desire to smoke; a direct relation was found between sense of presence and craving.

Predictors of smoking craving during virtual reality exposure

Cue exposure treatment (CET) consists of controlled and repeated exposure to drugrelated stimuli in order to reduce cue-reactivity. Virtual reality (VR) has proved to be a promising tool for exposition. However, identifying the variables that can modulate the efficacy of this technique is essential for selecting the most appropriate exposure modality. The aim of this study was to determine the relation between several individual variables and self-reported craving in smokers exposed to VR environments. Fortysix smokers were exposed to seven complex virtual environments that reproduce typical situations in which people smoke. Self-reported craving was selected as the criterion variable and three types of variables were selected as the predictor variables: related to nicotine dependence, related to anxiety and impulsivity, and related to the sense of presence in the virtual environments. Sense of presence was the only predictor of self-reported craving in all the experimental virtual environments. Nicotine dependence variables added predictive power to the model only in the virtual breakfast at home. No relation was found between anxiety or impulsivity and self-reported craving. Virtual reality technology can be very helpful for improving CET for substance use disorders. However, the use of virtual environments would make sense only insofar as the sense of presence was high. Otherwise, the effectiveness of exposure might be affected. © 2012 by the Massachusetts Institute of Technology.

Clinical validation of a virtual environment for normalizing eating patterns in eating disorders

The purpose of the present study was to examine the clinical validation of a Virtual Reality Environment (VRE) designed to normalize eating patterns in Eating Disorders (ED). The efficacy of VR in eliciting emotions, sense of presence and reality of the VRE were explored in 22 ED patients and 37 healthy eating individuals. The VRE (non-immersive) consisted of a kitchen room where participants had to eat a virtual pizza. In order to assess the sense of presence and reality produced by the VRE, participants answered seven questions with a Likert scale (0-10) during the experience, and then filled out the Reality Judgment and Presence Questionnaire (RJPQ) and ITC-Sense of Presence Inventory (ITC-SOPI). The results showed that the VRE induced a sense of presence and was felt as real for both groups, without differences in the experience of 'ease' with the VRE, sense of physical space, or the ecological validity assigned to the virtual kitchen and eating virtually. However, the ED patients reported paying more attention and experiencing greater emotional involvement and dysphoria after virtual eating. The results suggest that the VRE was clinically meaningful to the ED patients and might be a relevant therapy tool for normalizing their eating patterns.

On Doing Successful ICT Business with Russian Manufacturing Enterprises

This Master’s thesis addresses different approaches using which a foreign IT company could enter Russian manufacturing industry with its enterprise information systems and IT services. In order to define the most suitable market entry approach, several aspects related to Russian manufacturing enterprises are studied. These aspects include challenges of doing ICT business with the previously mentioned enterprises, their perception of ICT role and their ICT preferences, as well as their buying behavior related to acquisition of information systems (IS). The study results show that there are several challenges that can be faced by a foreign IT vendor when starting conducting ICT business with Russian manufacturing enterprises. The results also show that Russian manufacturing industry is still rather immature in sense of business process automation, and its IT buying behavior is rather specific and complicated. The results suggest that an efficient way to approach these enterprises is through a network of trusted partners that consists of reliable Russian IS integrators and business consultants having established connections to Russian manufacturing companies and possessing the needed competence.

On the institution of the moral subject: on the commander and the commanded in Nietzsche's discussion of law

The article discusses how Nietzsche understands the institution of law and morals in distinction to Kant and the Christian tradition. It argues that Nietzsche to a large extent is inspired by the paradigm-shift toward a evolutionary biological thinking introduced by several of his peers in the late 19th century, among else F. A. Lange, who sees this shift as a sobering scientific-materialistic alternative to Kant. In Nietzsche, the Kantian moral imperative is replaced with a notion of a morality emerging thanks to historical, or pre-historical, civilizational processes, imposed on a feebleminded human without any inherent rational dispositions to obey Law. It is also a process, which rather than universalizing the human, splits it in a duality where one part obeys old immediate self-interests and another part obeys new 'commands,' having been shouted 'into the ear' by a so-called 'commander.' The compliance with law takes two radically different forms in Nietzsche: servile and mediocre individuals need to be exposed to discipline and punishment in order to adopt Law; while so-called 'sovereign' individuals are able to impose law upon themselves. The figure of the 'sovereign' has consequently been an issue for vigorous debate in especially the Anglo-Saxon tradition of Nietzsche research, since his apparent 'respect for law' and 'sense of duty' reiterate typical Kantian qualities. Relating to these discussions, I suggest that Nietzsche's 'sovereign' (in one context) is identical his 'commander' (in other contexts). When the 'sovereign' as such imposes law upon himself and others, his act is conventional and arbitrary (like language in Saussure), and is rather irrational than rational as in Kant. His will is not a good will, nor a rational will with a vision of human autonomy. His command of himself and others is a performative, thus without truth-value (like illocutionary speech-acts in Austin and Searle).

Molecular modeling of asymmetric induction in heterogeneously catalyzed hydrogenation of the C=O bond

Modifiering av metallytor med starkt adsorberade kirala organiska molekyler är eventuellt den mest relevanta teknik man vet i dag för att skapa kirala ytor. Den kan utnyttjas i katalytisk produktion av enantiomeriskt rena kirala föreningar som behövs t.ex. som läkemedel och aromkemikalier. Trots många fördelar av asymmetrisk heterogen katalys jämfört med andra sätt för att få kirala föreningar, har den ändå inte blivit ett allmänt verktyg för storskaliga tillämpningar. Detta beror t.ex. på brist på djupare kunskaper i katalytiska reaktionsmekanismer och ursprunget för asymmetrisk induktion. I denna studie användes molekylmodelleringstekniker för att studera asymmetriska, heterogena katalytiska system, speciellt hydrering av prokirala karbonylföreningar till motsvarande kirala alkoholer på cinchona-alkaloidmodifierade Pt-katalysatorer. 1-Fenyl-1,2-propandion (PPD) och några andra föreningar, som innehåller en prokiral C=O-grupp, användes som reaktanter. Konformationer av reaktanter och cinchona-alkaloider (som kallas modifierare) samt vätebundna 1:1-komplex mellan dem studerades i gas- och lösningsfas med metoder som baserar sig på vågfunktionsteori och täthetsfunktionalteori (DFT). För beräkningen av protonaffiniteter användes också högst noggranna kombinationsmetoder såsom G2(MP2). Den relativa populationen av modifierarnas konformationer varierade som funktion av modifieraren, dess protonering och lösningsmedlet. Flera reaktant–modifierareinteraktionsgeometrier beaktades. Slutsatserna på riktning av stereoselektivitet baserade sig på den relativa termodynamiska stabiliteten av de diastereomeriska reaktant–modifierare-komplexen samt energierna hos π- och π*-orbitalerna i den reaktiva karbonylgruppen. Adsorption och reaktioner på Pt(111)-ytan betraktades med DFT. Regioselektivitet i hydreringen av PPD och 2,3-hexandion kunde förklaras med molekyl–yta-interaktioner. Storleken och formen av klustret använt för att beskriva Pt-ytan inverkade inte bara på adsorptionsenergierna utan också på de relativa stabiliteterna av olika adsorptionsstrukturer av en molekyl. Populationerna av modifierarnas konformationer i gas- och lösningsfas korrelerade inte med populationerna på Pt-ytan eller med enantioselektiviteten i hydreringen av PPD på Pt–cinchona-katalysatorer. Vissa modifierares konformationer och reaktant–modifierare-interaktionsgeometrier var stabila bara på metallytan. Teoretiskt beräknade potentialenergiprofiler för hydrering av kirala α-hydroxiketoner på Pt implicerade preferens för parvis additionsmekanism för väte och selektiviteter i harmoni med experimenten. De uppnådda resultaten ökar uppfattningen om kirala heterogena katalytiska system och kunde därför utnyttjas i utvecklingen av nya, mera aktiva och selektiva kirala katalysatorer.