Vécu et adaptation des couples âgés séparés par l'entrée en institution de l'un des conjoints.

Cette thèse de doctorat porte sur le vécu et l'adaptation des couples âgés séparés par l'entrée de l'un des conjoints en institution. Notre démarche se fonde sur le paradigme compréhensif en sciences humaines. Nous avons rencontré sept couples dont l'un des conjoints vivait dans un Etablissement Médico-Social (EMS) de Suisse Romande, alors que l'autre continuait de vivre dans la communauté. Pour chaque situation, nous avons mené une interview individuelle de chacun des conjoints ainsi qu'une interview de couple. Nous avons effectué une analyse thématique du discours des interviewés. En outre, adoptant une perspective à la fois scientifique et clinique, nous avons étudié la dynamique conjugale des couples. Enfin, nous avons élaboré une typologie des différentes trajectoires de ces couples, en mettant en évidence les liens entre la dynamique de couple antérieure à l'hébergement, le vécu du moment de l'hébergement et le vécu lors des interviews. Nous avons montré le rôle central de l'ambivalence, vis-à-vis de la relation conjugale ou vis-à-vis de l'hébergement, dans les difficultés d'adaptation des couples à leur nouvelle situation de vie. -- This thesis is about the experience and adaptation of older couples separated by the accommodation of one spouse in a specialised institution. Our approach is based on the comprehensive paradigm in human sciences. We have met seven couples, of which one spouse was living in an institution (EMS) in the French speaking part of Switzerland, as the other spouse was still living in the community. In every situations, we have interviewed each spouse individually and both spouses together. We have carried out a thematic analysis of the discourses. Moreover, taking a scientific as well as a clinical perspective, we have studied the spousal dynamics of the couples. Finally, we have elaborated a typology of couples' trajectories, from earlier spousal dynamics to their experience of the transition and their experience in the time of the interviews. We have showed the crucial role of ambivalence, towards the couple relation or towards the accommodation, in couples' difficulties to adapt to their new living situation.

Postmortem measurement of human chorionic gonadotropin in vitreous humor and bile.

Postmortem human chorionic gonadotrophin (HCG) blood assay can confirm postmortem diagnosis of pregnancy or document situations in which HCG levels are elevated. In some cases, however, blood sampling is not possible at autopsy. In this study, HCG was quantified by enzyme-linked fluorescent assay (ELFA) in the bile (n = 5), vitreous humor (n = 4), and postmortem blood (n = 4) of five pregnant women. There were no false negatives in the pregnant subjects (n = 5) or false positives in controls (n = 34), enabling this test to be recommended for routine use in forensic contexts in which the detection of elevated HCG levels could be of interest.

How to identify and recruit nurses to a survey 14 and 24 years after graduation in a context of scarce data : lessons learnt from the 2012 nurses at work pilot study on nurses' career paths

Nursing workforce data are scarce in Switzerland, with no active national registry of nurses. The worldwide nursing shortage is also affecting Switzerland, so that evidence-based results of the nurses at work project on career paths and retention are needed as part of the health care system stewardship; nurses at work is a retrospective cohort study of nurses who graduated in Swiss nursing schools in the last 30 years. Results of the pilot study are presented here (process and feasibility). The objectives are (1) to determine the size and structure of the potential target population by approaching two test-cohorts of nursing graduates (1988 and 1998); (2) to test methods of identifying and reaching them 14 and 24 years after graduation; (3) to compute participation rates, and identify recruitment and participation biases.

Spanish adaptation of the Expectancy Questionnaire (EQ) about alcohol effects in adolescents

Background: Alcohol-related expectancies are especially relevant in relation to alcohol consumption during adolescence. The main aim of this study was to adapt and translate into Spanish (Castilian) the Expectancy Questionnaire (EQ), and to study its psychometric properties in adolescents. Method: The sample was composed of 514 adolescents (57.20% female, mean age = 15.21; SD = .63) who completed the EQ and the alcohol consumption questionnaire AIS-UJI. Results: Confi rmatory factor analysis indicated that an eight-factor model, grouped into two general factors of positive and negative expectancies, had acceptable fi t indices. Cronbach’s alphas ranged from .75 to .96. Finally, the structural equation model showed that positive expectancies were positively related to alcohol use, whereas negative expectancies were negatively related to drinking. Conclusions: Results showed that the Spanish version of the EQ for adolescents is a valid and reliable questionnaire to measure expectancies about alcohol effects.

A Spanish version of the athens insomnia scale

Objectives To develop and validate a Spanish version of the Athens Insomnia Scale (AIS). Methods The AIS is designed to assess sleep difficulty and comprises eight items: the first five refer to the sleep disturbance and the last three to the daytime consequences. Either the full eight-item scale (AIS-8) or the brief form (AIS-5) can be administered. The adaptation used a backtranslation design. The validation process was based on a sample of 323 participants (undergraduates, community sample and psychiatric outpatients), which completed the AIS and other questionnaires: anxiety (BAI), depression (BDI) and psychological well-being (GHQ-12) scales. Results The internal consistency coefficients for both versions were above 0.80. The study of dimensionality revealed a single factor with high loadings and a percentage of explained variance above 50% in both versions. Test-retest reliability was above 0.70 (AIS-5) and over 0.80 (AIS-8) at a one-month interval. The correlation between the AIS and the previously mentioned scales was for both the AIS-5 and the AIS-8 above 0.40 and 0.50, respectively.

Does phylogeographic structure relate to climatic niche divergence? A test using maritime pine (Pinus pinaster Ait.)

Aim To disentangle the effects of environmental and geographical processes driving phylogenetic distances among clades of maritime pine (Pinus pinaster). To assess the implications for conservation management of combining molecular information with species distribution models (SDMs; which predict species distribution based on known occurrence records and on environmental variables). Location Western Mediterranean Basin and European Atlantic coast. Methods We undertook two cluster analyses for eight genetically defined pine clades based on climatic niche and genetic similarities. We assessed niche similarity by means of a principal component analysis and Schoener's D metric. To calculate genetic similarity, we used the unweighted pair group method with arithmetic mean based on Nei's distance using 266 single nucleotide polymorphisms. We then assessed the contribution of environmental and geographical distances to phylogenetic distance by means of Mantel regression with variance partitioning. Finally, we compared the projection obtained from SDMs fitted from the species level (SDMsp) and composed from the eight clade-level models (SDMcm). Results Genetically and environmentally defined clusters were identical. Environmental and geographical distances explained 12.6% of the phylogenetic distance variation and, overall, geographical and environmental overlap among clades was low. Large differences were detected between SDMsp and SDMcm (57.75% of disagreement in the areas predicted as suitable). Main conclusions The genetic structure within the maritime pine subspecies complex is primarily a consequence of its demographic history, as seen by the high proportion of unexplained variation in phylogenetic distances. Nevertheless, our results highlight the contribution of local environmental adaptation in shaping the lower-order, phylogeographical distribution patterns and spatial genetic structure of maritime pine: (1) genetically and environmentally defined clusters are consistent, and (2) environment, rather than geography, explained a higher proportion of variation in phylogenetic distance. SDMs, key tools in conservation management, better characterize the fundamental niche of the species when they include molecular information.

Physician behavioral adaptability: A model to outstrip a "one size fits all" approach

Objective: Based on a literature review, we propose a model of physician behavioral adaptability (PBA) with the goal of inspiring new research. PBA means that the physician adapts his or her behavior according to patients' different preferences. The PBA model shows how physicians infer patients' preferences and adapt their interaction behavior from one patient to the other. We claim that patients will benefit from better outcomes if their physicians show behavioral adaptability rather than a "one size fits all" approach. Method: This literature review is based on a literature search of the PsycINFO1 and MEDLINE1 databases. Results: The literature review and first results stemming from the authors' research support the validity and viability of parts of the PBA model. There is evidence suggesting that physicians are able to show behavioral flexibility when interacting with their different patients, that a match between patients' preferences and physician behavior is related to better consultation outcomes, and that physician behavioral adaptability is related to better consultation outcomes. Practice implications: Training of physicians' behavioral flexibility and their ability to infer patients' preferences can facilitate physician behavioral adaptability and positive patient outcomes.

Large Break Blowdown Test Facility Study

Työn tarkoituksena on kerätä yhteen tiedot kaikista maailmalta löytyvistä ison LOCA:n ulospuhallusvaiheen tutkimiseen käytetyistä koelaitteistoista. Työn tarkoituksena on myös antaa pohjaa päätökselle, onko tarpeellista rakentaa uusi koelaitteisto nesterakenne-vuorovaikutuskoodien laskennan validoimista varten. Ennen varsinaisen koelaitteiston rakentamista olisi tarkoituksenmukaista myös rakentaa pienempi pilottikoelaitteisto, jolla voitaisiin testata käytettäviä mittausmenetelmiä. Sopivaa mittausdataa tarvitaan uusien CFD-koodien ja rakenneanalyysikoodien kytketyn laskennan validoimisessa. Näitä koodeja voidaan käyttää esimerkiksi arvioitaessa reaktorin sisäosien rakenteellista kestävyyttä ison LOCA:n ulospuhallusvaiheen aikana. Raportti keskittyy maailmalta löytyviin koelaitteistoihin, uuden koelaitteiston suunnitteluperusteisiin sekä aiheeseen liittyviin yleisiin asioihin. Raportti ei korvaa olemassa olevia validointimatriiseja, mutta sitä voi käyttää apuna etsittäessä validointitarkoituksiin sopivaa ison LOCA:n ulospuhallusvaiheen koelaitteistoa.

Measurement Properties of the Smartphone-Based B-B Score in Current Shoulder Pathologies.

NlmCategory="UNASSIGNED">This study is aimed at the determination of the measurement properties of the shoulder function B-B Score measured with a smartphone. This score measures the symmetry between sides of a power-related metric for two selected movements, with 100% representing perfect symmetry. Twenty healthy participants, 20 patients with rotator cuff conditions, 23 with fractures, 22 with capsulitis, and 23 with shoulder instabilities were measured twice across a six-month interval using the B-B Score and shoulder function questionnaires. The discriminative power, responsiveness, diagnostic power, concurrent validity, minimal detectable change (MDC), minimal clinically important improvement (MCII), and patient acceptable symptom state (PASS) were evaluated. Significant differences with the control group and significant baseline-six-month differences were found for the rotator cuff condition, fracture, and capsulitis patient groups. The B-B Score was responsive and demonstrated excellent diagnostic power, except for shoulder instability. The correlations with clinical scores were generally moderate to high, but lower for instability. The MDC was 18.1%, the MCII was 25.2%, and the PASS was 77.6. No floor effect was observed. The B-B Score demonstrated excellent measurement properties in populations with rotator cuff conditions, proximal humerus fractures, and capsulitis, and can thus be used as a routine test to evaluate those patients.

Combining niche modelling and landscape genetics to study local adaptation: A novel approach illustrated using alpine plants

Understanding the factors that shape adaptive genetic variation across species niches has become of paramount importance in evolutionary ecology, especially to understand how adaptation to changing climate affects the geographic range of species. The distribution of adaptive alleles in the ecological niche is determined by the emergence of novel mutations, their fitness consequences and gene flow that connects populations across species niches. Striking demographical differences and source sink dynamics of populations between the centre and the margin of the niche can play a major role in the emergence and spread of adaptive alleles. Although some theoretical predictions have long been proposed, the origin and distribution of adaptive alleles within species niches remain untested. In this paper, we propose and discuss a novel empirical approach that combines landscape genetics with species niche modelling, to test whether alleles that confer local adaptation are more likely to occur in either marginal or central populations of species niches. We illustrate this new approach by using a published data set of 21 alpine plant species genotyped with a total of 2483 amplified fragment length polymorphisms (AFLP), distributed over more than 1733 sampling sites across the Alps. Based on the assumption that alleles that were statistically associated with environmental variables were adaptive, we found that adaptive alleles in the margin of a species niche were also present in the niche centre, which suggests that adaptation originates in the niche centre. These findings corroborate models of species range evolution, in which the centre of the niche contributes to the emergence of novel adaptive alleles, which diffuse towards niche margins and facilitate niche and range expansion through subsequent local adaptation. Although these results need to be confirmed via fitness measurements in natural populations and functionally characterised genetic sequences, this study provides a first step towards understanding how adaptive genetic variation emerges and shapes species niches and geographic ranges along environmental gradients.

Dose calibrator linearity test: 99mTc versus 18F radioisotopes

Objective: The present study was aimed at evaluating the viability of replacing 18F with 99mTc in dose calibrator linearity testing. Materials and Methods: The test was performed with sources of 99mTc (62 GBq) and 18F (12 GBq) whose activities were measured up to values lower than 1 MBq. Ratios and deviations between experimental and theoretical 99mTc and 18F sources activities were calculated and subsequently compared. Results: Mean deviations between experimental and theoretical 99mTc and 18F sources activities were 0.56 (± 1.79)% and 0.92 (± 1.19)%, respectively. The mean ratio between activities indicated by the device for the 99mTc source as measured with the equipment pre-calibrated to measure 99mTc and 18F was 3.42 (± 0.06), and for the 18F source this ratio was 3.39 (± 0.05), values considered constant over the measurement time. Conclusion: The results of the linearity test using 99mTc were compatible with those obtained with the 18F source, indicating the viability of utilizing both radioisotopes in dose calibrator linearity testing. Such information in association with the high potential of radiation exposure and costs involved in 18F acquisition suggest 99mTc as the element of choice to perform dose calibrator linearity tests in centers that use 18F, without any detriment to the procedure as well as to the quality of the nuclear medicine service.

Methods to test gas tightness of packages

One of the primary goals for food packages is to protect food against harmful environment, especially oxygen and moisture. The gas transmission rate is the total gas transport through the package, both by permeation through the package material and by leakage through pinholes and cracks. The shelf life of a product can be extended, if the food is stored in a gas tight package. Thus there is a need to test gas tightness of packages. There are several tightness testing methods, and they can be broadly divided into destructive and nondestructive methods. One of the most sensitive methods to detect leaks is by using a non destructive tracer gas technique. Carbon dioxide, helium and hydrogen are the most commonly used tracer gases. Hydrogen is the lightest and the smallest of all gases, which allows it to escape rapidly from the leak areas. The low background concentration of H2 in air (0.5 ppm) enables sensitive leak detection. With a hydrogen leak detector it is also possible to locate leaks. That is not possible with many other tightness testing methods. The experimental work has been focused on investigating the factors which affect the measurement results with the H2leak detector. Also reasons for false results were searched to avoid them in upcoming measurements. From the results of these experiments, the appropriate measurement practice was created in order to have correct and repeatable results. The most important thing for good measurement results is to keep the probe of the detector tightly against the leak. Because of its high diffusion rate, the HZ concentration decreases quickly if holding the probe further away from the leak area and thus the measured H2 leaks would be incorrect and small leaks could be undetected. In the experimental part hydrogen, oxygen and water vapour transmissions through laser beam reference holes (diameters 1 100 μm) were also measured and compared. With the H2 leak detector it was possible to detect even a leakage through 1 μm (diameter) within a few seconds. Water vapour did not penetrate even the largest reference hole (100 μm), even at tropical conditions (38 °C, 90 % RH), whereas some O2 transmission occurred through the reference holes larger than 5 μm. Thus water vapour transmission does not have a significant effect on food deterioration, if the diameter of the leak is less than 100 μm, but small leaks (5 100 μm) are more harmful for the food products, which are sensitive to oxidation.

Radio Frequency Measurement Method for Detecting Bearing Currents in Induction Motors

Induction motors are widely used in industry, and they are generally considered very reliable. They often have a critical role in industrial processes, and their failure can lead to significant losses as a result of shutdown times. Typical failures of induction motors can be classified into stator, rotor, and bearing failures. One of the reasons for a bearing damage and eventually a bearing failure is bearing currents. Bearing currents in induction motors can be divided into two main categories; classical bearing currents and inverter-induced bearing currents. A bearing damage caused by bearing currents results, for instance, from electrical discharges that take place through the lubricant film between the raceways of the inner and the outer ring and the rolling elements of a bearing. This phenomenon can be considered similar to the one of electrical discharge machining, where material is removed by a series of rapidly recurring electrical arcing discharges between an electrode and a workpiece. This thesis concentrates on bearing currents with a special reference to bearing current detection in induction motors. A bearing current detection method based on radio frequency impulse reception and detection is studied. The thesis describes how a motor can work as a “spark gap” transmitter and discusses a discharge in a bearing as a source of radio frequency impulse. It is shown that a discharge, occurring due to bearing currents, can be detected at a distance of several meters from the motor. The issues of interference, detection, and location techniques are discussed. The applicability of the method is shown with a series of measurements with a specially constructed test motor and an unmodified frequency-converter-driven motor. The radio frequency method studied provides a nonintrusive method to detect harmful bearing currents in the drive system. If bearing current mitigation techniques are applied, their effectiveness can be immediately verified with the proposed method. The method also gives a tool to estimate the harmfulness of the bearing currents by making it possible to detect and locate individual discharges inside the bearings of electric motors.

Adaptation of "Niagara Rosada" grape must to winemaking by partial cluster dehydration

This study aimed to verify the influence of partial dehydration of "Niagara Rosada" grape clusters in physicochemical quality of the pre- fermentation must. In Brazil, during the winemaking process it is common to need to adjust the grape must when the physicochemical characteristics of the raw material are insufficient to produce wines in accordance with the Brazilian legislation for classification of beverages, which establishes the minimum alcohol content of 8.6 % for the beverage to be considered wine. Therefore, given that the reduction in the water content of grape berries allows the concentration of chemical compounds present in its composition, especially the concentration of total soluble solids, we proceeded with the treatments that were formed by the combination of two temperatures (T1-37.1ºC and T2-22.9 ºC) two air speeds (S1: 1.79 m s-1 and S2: 3.21 m s-1) and a control (T0) that has not gone through the dehydration treatment. Analysis of pH, Total Titratable Acidity (TTA) were performed in mEq L-1, Total Soluble Solids (TSS) in ºBrix, water content on a dry basis and Concentration of Phenolic Compounds (CPC) in mg of gallic acid per 100g of must. The average comparison test identified statistically significant modifications for the adaptation of must for winemaking purposes, having the treatment with 22.9 ºC and air speed of 1.79 m s-1 shown the largest increase in the concentration of total soluble solids, followed by the second best result for concentration of phenolic compounds.