Server to Mobile Device Communication: A Case Study

Develop a client-server application for a mobile environment can bring many challenges because of the mobile devices limitations. So, in this paper is discussed what can be the more reliable way to exchange information between a server and an Android mobile application, since it is important for users to have an application that really works in a responsive way and preferably without any errors. In this discussion two data transfer protocols (Socket and HTTP) and three serialization data formats (XML, JSON and Protocol Buffers) were tested using some metrics to evaluate which is the most practical and fast to use.

Performance of an ICU ventilator and two turbin-based ventilators dedicated to non invasive ventilation (NIV) in simulated high inspiratory effort and rate: a NIV-bench-study.

INTRODUCTION. The role of turbine-based NIV ventilators (TBV) versus ICU ventilators with NIV mode activated (ICUV) to deliver NIV in case of severe respiratory failure remains debated. OBJECTIVES. To compare the response time and pressurization capacity of TBV and ICUV during simulated NIV with normal and increased respiratory demand, in condition of normal and obstructive respiratory mechanics. METHODS. In a two-chamber lung model, a ventilator simulated normal (P0.1 = 2 mbar, respiratory rate RR = 15/min) or increased (P0.1 = 6 mbar, RR = 25/min) respiratory demand. NIV was simulated by connecting the lung model (compliance 100 ml/mbar; resistance 5 or 20 l/mbar) to a dummy head equipped with a naso-buccal mask. Connections allowed intentional leaks (29 ± 5 % of insufflated volume). Ventilators to test: Servo-i (Maquet), V60 and Vision (Philips Respironics) were connected via a standard circuit to the mask. Applied pressure support levels (PSL) were 7 mbar for normal and 14 mbar for increased demand. Airway pressure and flow were measured in the ventilator circuit and in the simulated airway. Ventilator performance was assessed by determining trigger delay (Td, ms), pressure time product at 300 ms (PTP300, mbar s) and inspiratory tidal volume (VT, ml) and compared by three-way ANOVA for the effect of inspiratory effort, resistance and the ventilator. Differences between ventilators for each condition were tested by oneway ANOVA and contrast (JMP 8.0.1, p\0.05). RESULTS. Inspiratory demand and resistance had a significant effect throughout all comparisons. Ventilator data figure in Table 1 (normal demand) and 2 (increased demand): (a) different from Servo-i, (b) different from V60.CONCLUSION. In this NIV bench study, with leaks, trigger delay was shorter for TBV with normal respiratory demand. By contrast, it was shorter for ICUV when respiratory demand was high. ICUV afforded better pressurization (PTP 300) with increased demand and PSL, particularly with increased resistance. TBV provided a higher inspiratory VT (i.e., downstream from the leaks) with normal demand, and a significantly (although minimally) lower VT with increased demand and PSL.

Long-term efficacy and tolerability of flutamide combined with oral contraception in moderate to severe hirsutism: A 12-month, double-blind, parallel clinical trial

OBJECTIVE Our objective was to test the efficacy and tolerability of three doses of flutamide (125, 250, and 375 mg) combined with a triphasic oral contraceptive (ethynylestradiol/levonorgestrel) during 12 months to treat moderate to severe hirsutism in patients with polycystic ovary syndrome or idiopathic hirsutism. DESIGN We conducted a randomized, double-blind, placebo-controlled, parallel clinical trial. PATIENTS A total of 131 premenopausal women, suffering from moderate to severe hirsutism, were randomized to placebo or 125, 250, or 375 mg flutamide daily associated with a triphasic oral contraceptive pill. Hirsutism (Ferriman-Gallwey), acne and seborrhea (Cremoncini), and hormone serum levels were monitored at baseline and at 3 (except hormone serum levels), 6, and 12 months. Side effects and biochemical, hematological, and hepatic parameters were assessed. METHODS We used three-way ANOVA (subject, dose, and visit) with Scheffé adjustment for multiple comparisons or nonparametrical Friedman test and least-squares mean (paired data) and Kruskall-Wallis test for unpaired data analyses. We used chi(2) or Fisher's test for categorical data. RESULTS A total of 119 patients were included in the intention-to-treat analysis. All flutamide doses induced a significant decrease in hirsutism, acne, and seborrhea scores after 12 months compared with placebo without differences among dose levels. Similar related side effects were observed with placebo and 125 mg flutamide (12.5%), and slightly higher with 250 mg (17.3%) and 375 mg (21.2%). No statistically significant differences were observed either among doses or compared with placebo. CONCLUSIONS Flutamide at 125 mg daily during 12 months was the minimum effective dose to diminish hirsutism in patients with polycystic ovary syndrome or with idiopathic hirsutism.

Three-dimensional sequence stratigraphy and subtle stratigraphic traps associated with systems tracts: West Cameron region, offshore Louisiana, Gulf of Mexico

Three-dimensional sequence stratigraphy is a potent exploration and development tool for the discovery of subtle stratigraphic traps. Reservoir morphology, heterogeneity and subtle stratigraphic trapping mechanisms can be better understood through systematic horizontal identification of sedimentary facies of systems tracts provided by three-dimensional attribute maps used as an important complement to the sequential analysis on the two-dimensional seismic lines and the well log data. On new prospects as well as on already-producing fields, the additional input of sequential analysis on three-dimensional data enables the identification, location and precise delimitation of new potentially productive zones. The first part of this paper presents four typical horizontal seismic facies assigned to the successive systems tracts of a third- or fourth-order sequence deposited in inner to outer neritic conditions on a elastic shelf. The construction of this synthetic representative sequence is based on the observed reproducibility of the horizontal seismic facies response to cyclic eustatic events on more than 35 sequences registered in the Gulf coast Plio-Pleistocene and Late Miocene, offshore Louisiana in the West Cameron region of the Gulf of Mexico. The second part shows how three-dimensional sequence stratigraphy can contribute in localizing and understanding sedimentary facies associated with productive zones. A case study in the early Middle Miocene Cibicides opima sands shows multiple stacked gas accumulations in the top slope fan, prograding wedge and basal transgressive systems tract of the third-order sequence between SB15.5 and SB 13.8 Ma.

An analysis of the accounting principles applied by the European Farm Accountancy Data Network

In spite of its relative importance in the economy of many countriesand its growing interrelationships with other sectors, agriculture has traditionally been excluded from accounting standards. Nevertheless, to support its Common Agricultural Policy, for years the European Commission has been making an effort to obtain standardized information on the financial performance and condition of farms. Through the Farm Accountancy Data Network (FADN), every year data are gathered from a rotating sample of 60.000 professional farms across all member states. FADN data collection is not structured as an accounting cycle but as an extensive questionnaire. This questionnaire refers to assets, liabilities, revenues and expenses, and seems to try to obtain a "true and fair view" of the financial performance and condition of the farms it surveys. However, the definitions used in the questionnaire and the way data is aggregated often appear flawed from an accounting perspective. The objective of this paper is to contrast the accounting principles implicit in the FADN questionnaire with generally accepted accounting principles, particularly those found in the IVth Directive of the European Union, on the one hand, and those recently proposed by the International Accounting Standards Committee’s Steering Committeeon Agriculture in its Draft Statement of Principles, on the other hand. There are two reasons why this is useful. First, it allows to make suggestions how the information provided by FADN could be more in accordance with the accepted accounting framework, and become a more valuable tool for policy makers, farmers, and other stakeholders. Second, it helps assessing the suitability of FADN to become the starting point for a European accounting standard on agriculture.

MIAR: hacia un entorno colaborativo de editores, autores y evaluadores de revistas

Se describe la evolución del proyecto MIAR (Matriu d'Informació per l'Avaluació de Revistes), un sistema originalmente diseñado para cuantificar la indización en bases de datos de revistas de humanidades y ciencias sociales. Sin embargo, a la vista del panorama de recursos de evaluación actualmente disponibles en España, los autores plantean la transformación de MIAR hacia un portal colaborativo en el que todos los interesados puedan difundir las principales características de las revistas en las que participan directa o indirectamente. Se estudia una transformación del proyecto contemplando el uso de redes sociales, sistemas de votación y de sugerencia, y la aplicación de tecnologías como open linked data que permiten una mayor difusión y socialización de los datos recogidos para cada publicación. De esta manera los datos podrían ser mejor aprovechados por los tres colectivos más directamente interesados: evaluadores, editores y autores/lectores.

Traumatic Brain Injury in Iowa Inpatient Hospital Data, 2003-2005

According to the Centers for Disease Control and Prevention, unintentional injury is the fifth leading cause of death for all age groups and the first leading cause of death for people from 1 to 44 years of age in the United States, while homicide remains the 2nd leading cause of death for 15 to 24 years old (CDC, 2006). In 2004, there were approximately 144,000 deaths due to unintentional injuries in the US; 53% of which represent people over 45 years of age (CDC, 2004). With 20,322 suicidal deaths and 13,170 homicidal deaths, intentional injury deaths affect mostly people under 45 years old. On average, there are 1,150 unintentional deaths per year in Iowa. In 2004, 37% of unintentional deaths were due to motor vehicle accidents (MTVCC) occurring across all age ranges and 30% were due to falls involving persons over 65 years of age 82% of the time (IDPH Health Stat Div., 2004). The most debilitating outcome of injury is traumatic brain injury, which is characterized by the irreversibility of its damages, long-term effects on quality of life, and healthcare costs. The latest data available from the CDC estimated that, nationally, 50,000 traumatic brain injured (TBI) people die each year; three times as many are hospitalized and more than twenty times as many are released from emergency room (ER) departments (CDC, 2006). Besides the TBI registry, brain injury data is also captured through three other data sources: 1) death certificates; 2) hospital inpatient data; and, 3) hospital outpatient data. The inpatient and outpatient hospital data are managed by the Iowa Hospital Association, which provides to Iowa Department of Public Health the hospital data without personal identifiers. (The hospitals send reports to the Agency of Health Care Research and Quality, which developed the Health Care Utilization Project and its product, the National Inpatient Sample).

Blood pressure modifies the association between serum adiponectin and uric acid, in a sex-dependent manner

Purpose: Plasma adiponectin and serum uric acid (SUA) levels are negatively correlated. To better understand the possible mechanisms linking adiponectin and uric acid, we analyzed whether the association between adiponectin and SUA differed by hypertension status (or blood pressure level) and by sex. Methods and materials: We analyzed data from the populationbased CoLaus study (Switzerland). Fasting plasma adiponectin levels were assessed by ELISA and SUA by uricase-PAP. Blood pressure (BP) was measured using a validated automated device and hypertension was defined as having office BP 140/90 mm Hg or being on current antihypertensive treatment. Results: In the 2897 men and 3181 women, aged 35-74, BMI (mean ± SD) was 26.6 ± 4.0 and 25.1 ± 4.8 Kg/m2, systolic blood pressure (SBP) was 132.2 ± 16.6 and 124.8 ± 18.3 mm Hg, median (interquartile range) plasma adiponectin was 6.2 (4.1-9.2) and 10.6 (6.9-15.4) mg/dL, and hypertension prevalence was 42.0% and 30.2%, respectively. The age- and BMI- adjusted partial correlation coefficients between log-adiponectin and SUA were 0.09 and 0.06 in normotensive men and women (P <0.01), and 0.004 (P = 0.88) and 0.15 (P <0.001) in hypertensive men and women, respectively. In median regression adjusted for BMI, insulin, smoking, alcohol consumption, menopausal status and HDL-cholesterol, there was a significant three-way interaction between SUA, SBP and sex for their effect on adiponectin (dependent variable, P = 0.005), as well as interactions between SBP and sex (P = 0.014) and between SUA and sex (P = 0.033). Conclusion: Plasma adiponectin and SUA are negatively associated, independently of BMI and insulin, in a population-based study in Caucasians. However, BP modifies this inverse relationship, as it was significant mainly in women with elevated BP. This observation suggests that the link between adiponectin and SUA may be mediated by sex hormones and the hypertension status.

GPS to LRM: Integration of Spatial Point Features with Linear Referencing Methods, 2001

Global positioning systems (GPS) offer a cost-effective and efficient method to input and update transportation data. The spatial location of objects provided by GPS is easily integrated into geographic information systems (GIS). The storage, manipulation, and analysis of spatial data are also relatively simple in a GIS. However, many data storage and reporting methods at transportation agencies rely on linear referencing methods (LRMs); consequently, GPS data must be able to link with linear referencing. Unfortunately, the two systems are fundamentally incompatible in the way data are collected, integrated, and manipulated. In order for the spatial data collected using GPS to be integrated into a linear referencing system or shared among LRMs, a number of issues need to be addressed. This report documents and evaluates several of those issues and offers recommendations. In order to evaluate the issues associated with integrating GPS data with a LRM, a pilot study was created. To perform the pilot study, point features, a linear datum, and a spatial representation of a LRM were created for six test roadway segments that were located within the boundaries of the pilot study conducted by the Iowa Department of Transportation linear referencing system project team. Various issues in integrating point features with a LRM or between LRMs are discussed and recommendations provided. The accuracy of the GPS is discussed, including issues such as point features mapping to the wrong segment. Another topic is the loss of spatial information that occurs when a three-dimensional or two-dimensional spatial point feature is converted to a one-dimensional representation on a LRM. Recommendations such as storing point features as spatial objects if necessary or preserving information such as coordinates and elevation are suggested. The lack of spatial accuracy characteristic of most cartography, on which LRM are often based, is another topic discussed. The associated issues include linear and horizontal offset error. The final topic discussed is some of the issues in transferring point feature data between LRMs.

Lattices for 3-Dimensional Fuzzy Data generated by Fuzzy Galois Connections

Vagueness and high dimensional space data are usual features of current data. The paper is an approach to identify conceptual structures among fuzzy three dimensional data sets in order to get conceptual hierarchy. We propose a fuzzy extension of the Galois connections that allows to demonstrate an isomorphism theorem between fuzzy sets closures which is the basis for generating lattices ordered-sets

Sistema automático para determinação seqüencial de cianeto livre e total empregando eletrodo tubular íon-seletivo de membrana homogênea

This study presents an automated system for potentiometric determination of free and total cyanide which employs a homogeneous membrane tubular ion-selective electrode. After the electrode is assembled, it is connected to a system composed of 3 three-way solenoid valves, sample line, carrier line, acid stream, and gas diffusion chamber. A Turbo Pascal® computer program, developed specifically for this task, automatically performs all the steps involved in data acquisition and processing. The proposed analytical procedure offers operational simplicity, since detection is performed by a tubular electrode, whose assembly is fast and easy. The system has shown reproducibility (r.s.d. < 0.5%, n=6) and high speed (30 readings/hour); it is efficient for determination of free and total cyanide in waste waters of starch processing plants. The detection limit was 1.2x10-5 and 1.5x10-5 mol L-1, for determination of free and total cyanide, respectively. The linear response range was between 1.2x10-5 and 1.0x10-2 mol L-1 for free cyanide and between 1.5x10-5 and 1.0x10-2 for total cyanide.

Marketing of Lappeenranta University of Technology energy auditing services

The objective of this study was to find out how LUT Energy should start marketing its energy audit services, what would be the optimal pricing policy for its services and how LUT Energy could manage customer expectations towards quality of its auditing services. In order to answer these questions, a quantitative survey questionnaire was sent by e-mail to 56 companies from the regions of South Karelia and Kymenlaakso. The empirical data of the study was the answers and opinions of the companies, previous researches about energy efficiency and articles and presentations about the current situation in the energy efficiency market. The results of the study were that there is a great potential for energy audit services and also the legislation requires companies to improve their energy efficiency. To start marketing its services, LUT Energy should first clarify its service concept and divide its service offering into two offers. It should also clarify the marketing message it wants to send its customers and then do the marketing with the help of three-way-model. The best pricing policy for the service would be that the price is proportioned to the future savings. In order to ensure the quality of its services, LUT Energy has to make sure that both dimensions of the quality are managed properly and to fade out customer expectations towards the quality the auditing work has to be monitored.

Päämääriä, ajelehtimista, tietämättömyyttä, etsintää: Koulutusvalinnat, opinnot ja koulutuksen vaihtaminen yliopisto-opiskelijoiden kokemana 2000 -luvun taitteessa

Tutkimuksessa tarkastellaan yliopisto-opiskelua, opintojen kokemista ja niiden kulkua alkaen koulutusvalinnoista. Lisäksi tutkimuksessa pyritään ymmärtämään ja kuvaamaan yliopisto-opintojen aikaista koulutuksen vaihtamista prosessina. Kyseessä on seurantatutkimus Turun yliopistossa vuonna 1998 aloittaneesta opiskelijakohortista. Tutkittavat opiskelijat valittiin sillä perusteella, että he vastasivat kolmeen opintoja koskevaan kyselyyn ja olivat vähintään kolmen vuoden ajan läsnä olevina opiskelijoina. Opiskelijat (n=440) jaettiin neljään vertailuryhmään: 1) opintoihinsa tyytyväiset, 2) ensimmäisen vuoden jälkeen koulutusta vaihtaneet, 3) toisen vuoden jälkeen koulutusta vaihtaneet ja 4) koulutusta vaihtaa halunneet. Tutkimusaineisto koostuu kolmesta kyselystä, opintorekisteriaineistosta ja koulutusta opintojen aikana vaihtaneiden opiskelijoiden haastatteluista (n=22). Kyselyt tehtiin ensimmäisen, toisen ja kolmannen opintovuoden kevätlukukausilla ja haastattelut vuonna 2002, jolloin opiskelijat opiskelivat Turun yliopistossa neljättä tai viidettä vuotta. Kyselyiden avulla tutkittiin eroavatko koulutusta vaihtaneet opiskelijat muista opiskelijoista rakenteellisilta tekijöiltään tai opintokokemuksissaan. Opintorekisteriaineiston perusteella tutkittiin eroavatko koulutusta vaihtaneet opiskelijat koulutuksessa pysyneistä opiskelijoista opintojen kulussa. Kyselyiden ja haastatteluiden avulla tutkittiin minkälaisia tietoja ja odotuksia opiskelijoilla oli yliopisto-opiskelusta ollut ennen opintojen aloittamista. Haastatteluiden perusteella tutkittiin mitä syitä koulutuksen vaihtamisen taustalla oli ja minkälaisina kertomuksina koulutuksen vaihtamisprosessi näyttäytyi. Koulutusta vaihtaneet opiskelijat erosivat koulutuksessa pysyneistä opiskelijoista aiemman koulutuksen määrän, iän ja perheellisyyden suhteen. Verrattaessa ensimmäisen ja toisen vuoden jälkeen koulutusta vaihtaneita opiskelijoita keskenään havaittiin näillä ryhmillä olevan erilainen perhetausta. Koulutusta valittaessa tärkein tekijä oli kiinnostus alaa kohtaan. Toiseksi voimakkain hakutekijä oli muilla paitsi ensimmäisen vuoden jälkeen koulutusta vaihtaneilla valmiudet haluttuun ammattiin. Vuorostaan ensimmäisen vuoden jälkeen koulutusta vaihtaneilla toiseksi tärkein tekijä hakeutumisessa oli helppo sisäänpääsy opintoihin. Suurin osa opiskelijoista oli päässyt ensisijaisesti haluamaansa koulutukseen. Koulutusta myöhemmin vaihtaneissa ryhmissä ja koulutuksen vaihtoa halunneiden ryhmässä ensisijaisesti haluttuun koulutukseen päässeitä oli alle puolet. Odotukset opiskelusta eivät täysin täyttyneet ensimmäisen puolen vuoden opiskelun aikana. Tutkittujen ryhmien välillä havaittiin eroja kokemuksissa koulutuksen sopivuudesta itselle. Koulutuksen vaihtaminen oli myönteinen kokemus, ja uusi koulutus koettiin aiempaa koulutusta sopivammaksi itselle. Kolmannen vuoden kevätlukukaudella omaa koulutusta kohtaan koettu kiinnostus oli voimakasta muissa ryhmissä paitsi koulutuksen vaihtoa halunneissa. Harvimmin positiivisia tunteita opiskelua kohtaan kokivat vaihtoa halunneet opiskelijat. Koulutuksen vaihtaminen vähensi opintoihin kiinnittymättömyyttä. Koulutuksen vaihtoa halunneiden kokemukset nykyisen koulutuksensa ilmapiiristä olivat negatiivisimpia. Koulutuksen vaihtaminen vaikutti myönteisesti myös opetuksen kokemiseen. Opinnot etenivät kaikissa tutkituissa ryhmissä tasaisesti. Koulutuksen vaihtamisen jälkeisenä vuonna opinnot etenivät vaihtaneissa ryhmissä keskimääräistä enemmän. Haastatteluiden mukaan pääasiallisia syitä koulutuksen vaihtamiselle olivat päätyminen toissijaiseen koulutukseen ja pettyminen aloittamaansa koulutukseen. Narratiivien analyysin avulla tutkimuksessa löydettiin neljä erilaista tarinaa vaihtamisprosessista: 1) toissijaisesta koulutuksesta ensisijaiseen koulutukseen vaihtaminen, 2) ensisijaiseen koulutukseen pettyminen, 3) kiinnostavampaan koulutukseen ajautuminen ja 4) oman alan löytyminen etsinnän kautta. Vaikka koulutuspolitiikassa koulutuksen vaihtaminen nähdään ongelmana, oli se tämän tutkimuksen mukaan opiskelijalle myönteinen kokemus. Tämän tutkimuksen perusteella tulisikin kiinnittää huomiota opiskelijoihin, jotka haluaisivat vaihtaa koulutuksesta toiseen. Heillä opintojen eteneminen osoittautui hitaimmaksi ja opintokokemukset negatiivisimmiksi. Koulutusta vaihtaneiden opiskelijoiden opintojen eteneminen näytti hitaalta verrattuna opintoihinsa tyytyväisiin opiskelijoihin. Koulutuksen vaihtamisen jälkeen opintojen eteneminen kuitenkin nopeutui ja opintotyytyväisyys lisääntyi.

Personnalité et compétences en emploi : comparaison de la capacité prévisionnelle de deux configurations de la personnalité

Certaines études récentes confirment que les tests de personnalité sont largement utilisés à des fins de sélection dans les organisations nord-américaines et que leur fréquence d’utilisation continue de croître (Boudrias, Pettersen, Longpré, & Plunier, 2008; Rothstein & Goffin, 2006). Or, les résultats des recherches portant sur le lien prévisionnel entre la personnalité et le rendement global au travail sont peu convaincants (Morgeson et al., 2007b; Murphy & Dzieweczynski, 2005). La présente thèse vise à vérifier si une amélioration des liens prédictifs entre la personnalité et le rendement au travail pourrait être obtenue en modifiant la façon d’opérationnaliser les variables prévisionnelles issues des inventaires de personnalité et en précisant les critères à prédire de manière à les rendre plus spécifiques et mieux arrimés. Pour ce faire, la capacité prévisionnelle d’une approche centrée sur le critère, c’est-à-dire l’utilisation de composites de traits de personnalité, est comparée à l’approche traditionnelle centrée sur le prédicteur, dans ce cas-ci, les cinq grands facteurs de personnalité (Big Five). D’autre part, le rendement au travail est opérationnalisé sous l’angle des compétences en emploi, ce qui permet d’en différencier les dimensions et d’augmenter la spécificité des critères. Des hypothèses précisant les facteurs de personnalité qui devraient permettre de prédire chacune des compétences évaluées sont testées. De plus, des hypothèses précisant les traits de personnalité servant à créer les variables composites sont aussi testées. Finalement, une hypothèse portant sur la comparaison de la puissance prévisionnelle des deux approches est mise à l’épreuve. L’échantillon de la recherche est composé de 225 employés occupant divers emplois au sein d’une grande organisation québécoise. Ils ont complété un inventaire de personnalité au travail dans le cadre des processus de sélection de l’organisation. Leur supérieur immédiat a effectué une évaluation de leurs compétences et de leur rendement au moins six (6) mois après leur embauche. Les résultats démontrent que la maîtrise des compétences est mieux prédite par une approche centrée sur le prédicteur (c’est-à-dire les Big Five) que par une approche centrée sur le critère (c’est-à-dire les variables composites). En effet, seules trois hypothèses portant sur le lien entre certains facteurs de personnalité et les compétences se sont avérées partiellement soutenues. Les résultats d’analyses statistiques supplémentaires, réalisées a posteriori afin de mieux comprendre les résultats, laissent supposer la présence de variables modératrices, dont, notamment, les caractéristiques situationnelles. En somme, il nous semble plus probable d’arriver, dans le futur, à trouver une méthode structurée de création des variables composites qui permettrait d’obtenir des liens prévisionnels plus puissants que de découvrir des variables composites qui seraient elles-mêmes généralisables à tous les emplois et à toutes les organisations. Par ailleurs, nous encourageons les praticiens à porter attention à la façon d’utiliser les données de personnalité. Pour le moment, il semble que les facteurs de personnalité permettent de prédire, en partie, le rendement futur en emploi. Or, les preuves empiriques concernant l’efficacité d’autres approches demeurent relativement rares et, surtout, insuffisantes pour guider fidèlement les praticiens à travers les choix nécessaires à leur utilisation.

Coconstruction des composantes d'un programme d'intervention en soutien à la résilience de familles dont un adolescent est atteint d'un traumatisme craniocérébral

La vie de famille avec un adolescent comporte son lot de défis. Les émotions de l’adolescent qui se présentent parfois comme des montagnes russes peuvent rendre les relations tendues et difficiles au sein de la cellule familiale, voire même au-delà de celle-ci. Par son caractère inattendu, l’avènement d’un traumatisme craniocérébral (TCC) chez l’adolescent vient fragiliser encore davantage la dynamique familiale. En outre, la myriade d’impacts engendrés par le TCC contraint la famille à modifier son projet de vie en s’investissant ensemble pour le reconstruire. La résilience devant une situation de traumatisme ne se manifeste pas de la même façon pour toutes les familles qui y sont confrontées. Certaines d’entre elles réussissent à se transformer positivement, tandis que d’autres n’y parviennent pas ou manifestent plus de difficultés. Il convient alors d’actualiser des approches de soins interdisciplinaires centrées sur la famille qui favoriseraient la reconnaissance des éléments pouvant soutenir son processus de résilience à travers cette épreuve et, enfin, aider à transformer son projet de vie. Avec comme perspective disciplinaire le modèle humaniste des soins infirmiers (Cara, 2012; Cara & Girard, 2013; Girard & Cara, 2011), cette étude qualitative et inductive (LoBiondo-Wood, Haber, Cameron, & Singh, 2009), soutenue par une approche collaborative de recherche (Desgagné, 1997), a permis la coconstruction des composantes d’un programme d’intervention en soutien à la résilience familiale, avec des familles dont un adolescent est atteint d’un TCC modéré ou sévère et des professionnels de la réadaptation. Le modèle de développement et de validation d’interventions complexes (Van Meijel, Gamel, Van Swieten-Duijfjes, & Grypdonck, 2004) a structuré la collecte des données en trois volets. Le premier volet consistait à identifier les composantes du programme d’intervention selon les familles (n=6) et les professionnels de la réadaptation (n=5). La priorisation et la validation des composantes du programme d’intervention, soit respectivement le deuxième et troisième volets, se sont réalisées auprès de ces mêmes familles (n=6 au volet 2 et n=4 au volet 3) et professionnels de la réadaptation (n=5 aux volets 2 et 3). Le processus d’analyse des données (Miles & Huberman, 2003) a repéré cinq thèmes intégrateurs, considérés comme les composantes du programme d’intervention en soutien à la résilience familiale à la suite du TCC modéré ou sévère d’un adolescent. Ce sont : 1) les caractéristiques de la famille et ses influences; 2) les stratégies familiales positives; 3) le soutien familial et social; 4) la prise en charge de l’aspect occupationnel et; 5) l’apport de la communauté et des professionnels de la santé. Les résultats issus de ce processus de coconstruction ont produit une matrice solide, suffisamment flexible pour pouvoir s’adapter aux différents contextes dans lesquels évoluent les familles et les professionnels de la réadaptation. Cette étude offre en outre des avenues intéressantes tant pour les praticiens que pour les gestionnaires et les chercheurs en sciences infirmières et dans d’autres disciplines quant à la mise en place de stratégies concrètes visant à soutenir le processus de résilience des familles dans des situations particulièrement difficiles de leur vie.