L'adoption d'une innovation technopédagogique par une communauté enseignante universitaire

Résumé: L'adoption d'une innovation technopédagogique par une communauté enseignante universitaire La thèse traite de l'adoption d'une innovation technopédagogique par une communauté enseignante universitaire. Cette étude longitudinale, réalisée dans le cadre d'une recherche-action, vise à comprendre la dynamique globale du processus d'adoption d'une innovation. Le cadre de réflexion théorique de l'étude provient de la recherche en management, en systèmes d'information et en éducation. Il tient à la fois compte des motivations et des besoins des individus (dimension individuelle), de la compatibilité des technologies de l'information selon les théories usuelles de l'apprentissage (dimension pédagogique) et du type de soutien à offrir aux utilisatrices-utilisateurs (dimension organisationnelle). Le modèle d'accompagnement émergeant de cette recherche se compose de cycles itératifs au cours desquels un groupe définit et résout un problème, puis réfléchit successivement aux enjeux émergents d'un cycle à l'autre. Le modèle tient explicitement compte des trois éléments clés suivants: l'individu, la pédagogie et l'organisation qui forment une dynamique systémique indissociable et en interaction les unes les autres pendant toute la durée du processus d'adoption de l'innovation. Il met aussi en lumière la nécessité de stimuler une réflexion critique grâce au concours de ressources externes crédibles pour déterminer la compatibilité des technologies à partir d'expériences concrètes. Une telle démarche participative systématique permet d'accroître la cohésion des idées du groupe par le dialogue et les débats d'opinions_ Par ailleurs, la proximité avec notre milieu de recherche sur une période de deux ans offre la possibilité de saisir plusieurs facettes de la dynamique organisationnelle. Lorsque l'on réalise une étude longitudinale qui met en évidence l'incidence d'événements concomitants, on constate la fragilité du processus et la réversibilité de la décision d'adoption. L'intention d'adoption évolue constamment au gré des expériences des individus et du contexte qui évolue lui-même. L'établissement de relations partenariales avec les groupes intéressés représente une activité essentielle pour pallier ou neutraliser les effets indésirables d'événements concomitants.||Abstract: This thesis deals with a university teaching community adopting a technological/pedagogical innovation. This longitudinal study--part of an action-research study--aims at gaining understanding of the overall dynamics involved in adopting an innovation. The study's conceptual framework derives from management, information-systems, and teaching research. It takes into account the motivations and needs of individuals (individual dimension), the compatibility of information technologies according to current learning theories (pedagogical dimension), and the type of support to be offered to users (organizational dimension). The companion model issuing from this research work comprises iterative cycles during which a group defines and solves a problem and then successively reflects on the issues emerging from one cycle to the next. The model takes explicit account of three key elements: the individual, pedagogical approach, and organization form an indissociable system dynamic in which all dimensions interact during the entire process of adopting innovation. It also sheds light on the need to stimulate critical reflection about the combination of credible external resources so that tangible experiences can be used to determine technology compatibility. This kind of systematic participative process yields greater cohesiveness of group ideas through dialogue and discussion. Moreover, the proximity to our research setting over two years provides the opportunity to seize the many facets of organizational dynamics. During the course of a longitudinal study that highlights the incidence of concomitant events, the fragility of the process and reversibility of the adoption decision become apparent. The adoption intention constantly fluctuates through the experiences of individuals and the context, which also changes. Establishing partnership relations with interested groups stands out as an essential activity in attenuating or counteracting the undesirable effects produced by concomitant events.

Algorithmen zur automatischen 4dimensionalen Flugbahnführung unter Berücksichtigung der momentanen Windsituation

Für das digitale Flugführungssystem des Versuchsflugzeugs HFB 320 wurde am Institut für Flugführung der DFVLR in Braunschweig eine Betriebsart zum automatischen zeitgenauen Fliegen im Flughafen-Nahbereich entwickelt und im Flugversuch erprobt. Der Bericht enthält die Beschreibung der eingesetzten Algorithmen zur Berechnung 4-dimensionaler Flugbahnen unter Berücksichtigung der momentanen Windsituation. Es werden verschiedene Verfahren zur Messung, Filterung und Vorhersage des Windvektors entwickelt und an Hand von Flugversuchsergebnissen diskutiert.

Students who self-harm: coping style, rumination and alexithymia

Counsellors working with students or other young adults may encounter individuals who have self-harmed, either with suicidal or non-suicidal intent. Recent US studies reported rates of self-injury of up to 37% of the student population, but studies in the UK have focussed primarily on younger adolescents. This study examined reported self-harm incidents (scratching, cutting, poisoning, overdose etc) from a sample of 617 university students. A total of 27% reported at least one incident of self-harm, with almost 10% having harmed themselves while at university. Gender differences were not significant but psychology students reported significantly more self-harm than other students. Participants reporting self-harm scored significantly higher on maladaptive coping styles, rumination, and alexithymia (specifically difficulty in identifying emotions) and these differences were most marked for students reporting repetitive and recent self-harm. Rumination and Alexithymia factor 1 (difficulty identifying feelings) emerged as the most robust factors predicting self-harm status. Comments from students who self-harmed at university highlighted the importance of accessible services and academic staff support. The implications of these findings for counselling interventions are discussed, including challenging negative rumination tendencies and developing mindfulness skills.

Influência de diferentes estratégias de estabilização lombopélvica e de programas de exercícios de controlo motor no Active Straight Leg Raise

Introdução: O Active Straight Leg Raise (ASLR) tem sido sugerido como um indicador clínico da estabilidade lombopélvica. Estratégias passivas e ativas podem contribuir para aumentar esta estabilidade, assim como programas de exercício baseados nas mesmas estratégias ativas. Objetivos: Comparar os efeitos imediatos da compressão pélvica manual (CP), do drawing-in (DI) e do bracing abdominal (BA) durante o ASLR em indivíduos com e sem dor lombopélvica crónica e inespecífica, e avaliar o efeito prolongado das manobras de estabilização ativas através dos programas de exercícios de controlo motor, Pilates e McGill. Métodos: Estudo transversal, com uma amostra de 111 voluntários, 52 sem dor lombopélvica (NLPPG) e 59 com dor lombopélvica (LPPG), e estudo experimental, formado pelo LPPG dividido em 19 no grupo controlo (GC), 20 no grupo pilates (GP) e 20 no grupo mcgill (GMg). Foi avaliado o ASLR padrão, o ASLR com CP, o ASLR com DI e ASLR com BA. Os participantes foram avaliados antes e após as 8 semanas de implementação dos programas exercícios de McGill e Richardson, apenas aos respetivos grupos. Resultados: O LPPG apresentou significativamente maior score no ASLR comparativamente ao NLPPG (z=-9,361; p<0,001). Apesar do BA ter apresentado scores inferiores às restantes estratégias (p<0,001), todas elas foram capazes de diminuir o score do ASLR (p<0,001). Após a aplicação dos programas de exercícios, verificou-se que o GP (p<0,001) e o GMg (p<0,001) apresentaram scores significativamente menores no ASLR, relativamente ao GC. No GP e no GMg verificou-se uma diminuição do score do ASLR (Z=-4,028; p<0,001; Z=-4,179; p<0,001, respetivamente). Além disso, GMg apresentou uma tendência para apresentar menores scores do ASLR comparativamente ao GP. Conclusão: Qualquer uma destas manobras de estabilização quando adicionada ao ASLR pode aumentar a estabilidade lombopélvica, especialmente o BA. Os exercícios de Pilates e de McGill permitiram melhorar os scores do ASLR.

Angioplastia Primária na Mulher: Realidade Nacional

Objetivos: A mortalidade na mulher após angioplastia primária (ICP-P) é superior à do homem. Contudo, permanece contraditório o papel do sexo poder ser fator de risco independente para mortalidade no contexto de enfarte agudo do miocárdio com supradesnivelamento de ST (EAMST). Com base no Registo Nacional de Cardiologia de Intervenção (RNCI),pretendemos avaliar como é que o género feminino influencia o prognóstico a curto prazo nos doentes com EAMST submetidos a ICP-P a nível nacional. Métodos: De 60 158 doentes incluídos prospetivamente no RNCI de 2002-2012, incluímos na análise 7544 doentes com EAMST tratados por ICP-P, dos quais 25% foram mulheres. Utilizámos modelos de regressão logística e ajustamento por propensity score para avaliar o impacto do sexo na mortalidade hospitalar. Resultados: As mulheres foram mais idosas (68 ± 14 versus 61 ± 13, p < 0,001), mais diabéticas(30 versus 21%, p < 0,001) e hipertensas (69 versus 55%, p < 0,001). Os homens foram revascularizados mais cedo (71 versus 63% nas primeiras 6 horas, p < 0,001). Choque cardiogénico foi mais frequente nas mulheres (7,1 versus 5,7%, p = 0,032). Estas apresentaram um pior prognóstico a curto prazo, com 1,7 x maior risco de morte intra-hospitalar (4,3 versus 2,5%; IC 95% 1,30-2,27; p < 0,001). Utilizando um modelo de regressão ajustado através de um propensity score, o sexo deixa de ser preditor de mortalidade hospitalar (OR 1,00; IC 95% 0,68-1,48; p = 1,00). Conclusões: No RNCI as mulheres com EAMST tratadas com ICP-P apresentaram maior risco cardiovascular, um acesso menos atempado a ICP-P e um pior prognóstico. Contudo, após ajustamento do risco, o género feminino deixa de ser preditor independente de mortalidade hospitalar.

Production of polyhydroxyalkanoates from oil-containing substrates

Different oil-containing substrates, namely, used cooking oil (UCO), fatty acids-byproduct from biodiesel production (FAB) and olive oil deodorizer distillate (OODD) were tested as inexpensive carbon sources for the production of polyhydroxyalkanoates (PHA) using twelve bacterial strains, in batch experiments. The OODD and FAB were exploited for the first time as alternative substrates for PHA production. Among the tested bacterial strains, Cupriavidus necator and Pseudomonas resinovorans exhibited the most promising results, producing poly-3-hydroxybutyrate, P(3HB), form UCO and OODD and mcl-PHA mainly composed of 3-hydroxyoctanoate (3HO) and 3-hydroxydecanoate (3HD) monomers from OODD, respectively. Afterwards, these bacterial strains were cultivated in bioreactor. C. necator were cultivated in bioreactor using UCO as carbon source. Different feeding strategies were tested for the bioreactor cultivation of C. necator, namely, batch, exponential feeding and DO-stat mode. The highest overall PHA productivity (12.6±0.78 g L-1 day-1) was obtained using DO-stat mode. Apparently, the different feeding regimes had no impact on polymer thermal properties. However, differences in polymer‟s molecular mass distribution were observed. C. necator was also tested in batch and fed-batch modes using a different type of oil-containing substrate, extracted from spent coffee grounds (SCG) by super critical carbon dioxide (sc-CO2). Under fed-batch mode (DO-stat), the overall PHA productivity were 4.7 g L-1 day-1 with a storage yield of 0.77 g g-1. Results showed that SCG can be a bioresource for production of PHA with interesting properties. Furthermore, P. resinovorans was cultivated using OODD as substrate in bioreactor under fed-batch mode (pulse feeding regime). The polymer was highly amorphous, as shown by its low crystallinity of 6±0.2%, with low melting and glass transition temperatures of 36±1.2 and -16±0.8 ºC, respectively. Due to its sticky behavior at room temperature, adhesiveness and mechanical properties were also studied. Its shear bond strength for wood (67±9.4 kPa) and glass (65±7.3 kPa) suggests it may be used for the development of biobased glues. Bioreactor operation and monitoring with oil-containing substrates is very challenging, since this substrate is water immiscible. Thus, near-infrared spectroscopy (NIR) was implemented for online monitoring of the C. necator cultivation with UCO, using a transflectance probe. Partial least squares (PLS) regression was applied to relate NIR spectra with biomass, UCO and PHA concentrations in the broth. The NIR predictions were compared with values obtained by offline reference methods. Prediction errors to these parameters were 1.18 g L-1, 2.37 g L-1 and 1.58 g L-1 for biomass, UCO and PHA, respectively, which indicates the suitability of the NIR spectroscopy method for online monitoring and as a method to assist bioreactor control. UCO and OODD are low cost substrates with potential to be used in PHA batch and fed-batch production. The use of NIR in this bioprocess also opened an opportunity for optimization and control of PHA production process.

Evaluation de la douleur chez les personnes cérébrolésées non-communicantes aux soins intensifs

La douleur est fréquente en milieu de soins intensifs et sa gestion est l'une des missions des infirmières. Son évaluation est une prémisse indispensable à son soulagement. Cependant lorsque le patient est incapable de signaler sa douleur, les infirmières doivent se baser sur des signes externes pour l'évaluer. Les guides de bonne pratique recommandent chez les personnes non communicantes l'usage d'un instrument validé pour la population donnée et basé sur l'observation des comportements. A l'heure actuelle, les instruments d'évaluation de la douleur disponibles ne sont que partiellement adaptés aux personnes cérébrolésées dans la mesure où ces personnes présentent des comportements qui leur sont spécifiques. C'est pourquoi, cette étude vise à identifier, décrire et valider des indicateurs, et des descripteurs, de la douleur chez les personnes cérébrolésées. Un devis d'étude mixte multiphase avec une dominante quantitative a été choisi pour cette étude. Une première phase consistait à identifier des indicateurs et des descripteurs de la douleur chez les personnes cérébrolésées non communicantes aux soins intensifs en combinant trois sources de données : une revue intégrative des écrits, une démarche consultative utilisant la technique du groupe nominal auprès de 18 cliniciens expérimentés (6 médecins et 12 infirmières) et les résultats d'une étude pilote observationnelle réalisée auprès de 10 traumatisés crâniens. Les résultats ont permis d'identifier 6 indicateurs et 47 descripteurs comportementaux, vocaux et physiologiques susceptibles d'être inclus dans un instrument d'évaluation de la douleur destiné aux personnes cérébrolésées non- communicantes aux soins intensifs. Une deuxième phase séquentielle vérifiait les propriétés psychométriques des indicateurs et des descripteurs préalablement identifiés. La validation de contenu a été testée auprès de 10 experts cliniques et 4 experts scientifiques à l'aide d'un questionnaire structuré qui cherchait à évaluer la pertinence et la clarté/compréhensibilité de chaque descripteur. Cette démarche a permis de sélectionner 33 des 47 descripteurs et valider 6 indicateurs. Dans un deuxième temps, les propriétés psychométriques de ces indicateurs et descripteurs ont été étudiés au repos, lors de stimulation non nociceptive et lors d'une stimulation nociceptive (la latéralisation du patient) auprès de 116 personnes cérébrolésées aux soins intensifs hospitalisées dans deux centres hospitaliers universitaires. Les résultats montrent d'importantes variations dans les descripteurs observés lors de stimulation nociceptive probablement dues à l'hétérogénéité des patients au niveau de leur état de conscience. Dix descripteurs ont été éliminés, car leur fréquence lors de la stimulation nociceptive était inférieure à 5% ou leur fiabilité insuffisante. Les descripteurs physiologiques ont tous été supprimés en raison de leur faible variabilité et d'une fiabilité inter juge problématique. Les résultats montrent que la validité concomitante, c'est-à-dire la corrélation entre l'auto- évaluation du patient et les mesures réalisées avec les descripteurs, est satisfaisante lors de stimulation nociceptive {rs=0,527, p=0,003, n=30). Par contre la validité convergente, qui vérifiait l'association entre l'évaluation de la douleur par l'infirmière en charge du patient et les mesures réalisés avec les descripteurs, ainsi que la validité divergente, qui vérifiait si les indicateurs discriminent entre la stimulation nociceptive et le repos, mettent en évidence des résultats variables en fonction de l'état de conscience des patients. Ces résultats soulignent la nécessité d'étudier les descripteurs de la douleur chez des patients cérébrolésés en fonction du niveau de conscience et de considérer l'hétérogénéité de cette population dans la conception d'un instrument d'évaluation de la douleur pour les personnes cérébrolésées non communicantes aux soins intensifs. - Pain is frequent in the intensive care unit (ICU) and its management is a major issue for nurses. The assessment of pain is a prerequisite for appropriate pain management. However, pain assessment is difficult when patients are unable to communicate about their experience and nurses have to base their evaluation on external signs. Clinical practice guidelines highlight the need to use behavioral scales that have been validated for nonverbal patients. Current behavioral pain tools for ICU patients unable to communicate may not be appropriate for nonverbal brain-injured ICU patients, as they demonstrate specific responses to pain. This study aimed to identify, describe and validate pain indicators and descriptors in brain-injured ICU patients. A mixed multiphase method design with a quantitative dominant was chosen for this study. The first phase aimed to identify indicators and descriptors of pain for nonverbal brain- injured ICU patients using data from three sources: an integrative literature review, a consultation using the nominal group technique with 18 experienced clinicians (12 nurses and 6 physicians) and the results of an observational pilot study with 10 traumatic brain injured patients. The results of this first phase identified 6 indicators and 47 behavioral, vocal and physiological descriptors of pain that could be included in a pain assessment tool for this population. The sequential phase two tested the psychometric properties of the list of previously identified indicators and descriptors. Content validity was tested with 10 clinical and 4 scientific experts for pertinence and comprehensibility using a structured questionnaire. This process resulted in 33 descriptors to be selected out of 47 previously identified, and six validated indicators. Then, the psychometric properties of the descriptors and indicators were tested at rest, during non nociceptive stimulation and nociceptive stimulation (turning) in a sample of 116 brain-injured ICLI patients who were hospitalized in two university centers. Results showed important variations in the descriptors observed during the nociceptive stimulation, probably due to the heterogeneity of patients' level of consciousness. Ten descriptors were excluded, as they were observed less than 5% of the time or their reliability was insufficient. All physiologic descriptors were deleted as they showed little variability and inter observer reliability was lacking. Concomitant validity, testing the association between patients' self report of pain and measures performed using the descriptors, was acceptable during nociceptive stimulation (rs=0,527, p=0,003, n=30). However, convergent validity ( testing for an association between the nurses' pain assessment and measures done with descriptors) and divergent validity (testing for the ability of the indicators to discriminate between rest and a nociceptive stimulation) varied according to the level of consciousness These results highlight the need to study pain descriptors in brain-injured patients with different level of consciousness and to take into account the heterogeneity of this population forthe conception of a pain assessment tool for nonverbal brain-injured ICU patients.

Four-month-olds make triangular bids to father and mother during trilogue play with still-face

(from the journal abstract) A new observational procedure, Trilogue Play with Still-face, revealed 4-month-olds' capacities to address both their fathers and mothers, by rapidly shifting gaze and affect between them. Infants were observed in four interactive contexts: (1) '3-together' play with both parents; (2) '2 + 1' play with one parent engaging and the other as third party; (3) the same, with one parent posing a still-face; (4) '3-together' play. Infants were able to discriminate between the four contexts. They coordinated three social poles of attention in each one. Their affect configurations were context sensitive. These findings demonstrate the infant's social capacities for triangular, three-person interactions, in addition to dyadic, two-person, and triadic, two-person plus object, ones. They support a view of intersubjectivity as primary and point to a promising field of investigation for the study of family process. (PsycINFO Database Record (c) 2005 APA, all rights reserved)

Adjuvant early breast cancer systemic therapies according to daily used technologies.

Prognosis of early breast cancer patients is significantly improved with the use of adjuvant therapies. Various guidelines have been proposed to select patients who will derive the most benefit from such treatments. However, classifications have limited usefulness in subsets of patients such as those with node negative breast cancer. The 2007 St. Paul de Vence Clinical Practice Recommendations proposed to consider adjuvant therapy in accordance with the 10-year relapse-free survival reduction estimated by Adjuvant! Online. However, many limitations remain regarding the use of Adjuvant! Online. Among them, adverse prognostic and/or predictive factors such as vascular invasion, mitotic activity, progesterone receptor negativity, and HER-2 expression are not incorporated in the routine clinical decision process. Our group has therefore issued guidelines based on the consideration of both Adjuvant! Online calculations and the prognostic and/or predictive effects of these markers. In addition, web-accessible comprehensive tables summarizing these recommendations are provided.

Fructose toxicity: is the science ready for public health actions?

PURPOSE OF REVIEW: The assumption that fructose may be toxic and involved in the pathogenesis of noncommunicable diseases such as obesity, diabetes mellitus, dyslipidemia, and even cancer has resulted in the call for public health action, such as introducing taxes on sweetened beverages. This review evaluates the scientific basis for such action. RECENT FINDINGS: Although some studies hint towards some potential adverse effects of excessive fructose consumption especially when combined with excess energy intake, the results from clinical trials do not support a significant detrimental effect of fructose on metabolic health when consumed as part of a weight-maintaining diet in amounts consistent with the average-estimated fructose consumption in Western countries. However, definitive studies are missing. SUMMARY: Public health policies to eliminate or limit fructose in the diet should be considered premature. Instead, efforts should be made to promote a healthy lifestyle that includes physical activity and nutritious foods while avoiding intake of excess calories until solid evidence to support action against fructose is available. Public health is almost certainly to benefit more from policies that are aimed at promoting what is known to be good than from policies that are prohibiting what is not (yet) known to be bad.

L'Écho de Paris

1885/03/07 (Numéro 361).