956 resultados para Type-a behavior pattern


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Fast spreading unknown viruses have caused major damage on computer systems upon their initial release. Current detection methods have lacked capabilities to detect unknown virus quickly enough to avoid mass spreading and damage. This dissertation has presented a behavior based approach to detecting known and unknown viruses based on their attempt to replicate. Replication is the qualifying fundamental characteristic of a virus and is consistently present in all viruses making this approach applicable to viruses belonging to many classes and executing under several conditions. A form of replication called self-reference replication, (SR-replication), has been formalized as one main type of replication which specifically replicates by modifying or creating other files on a system to include the virus itself. This replication type was used to detect viruses attempting replication by referencing themselves which is a necessary step to successfully replicate files. The approach does not require a priori knowledge about known viruses. Detection was accomplished at runtime by monitoring currently executing processes attempting to replicate. Two implementation prototypes of the detection approach called SRRAT were created and tested on the Microsoft Windows operating systems focusing on the tracking of user mode Win32 API system calls and Kernel mode system services. The research results showed SR-replication capable of distinguishing between file infecting viruses and benign processes with little or no false positives and false negatives.

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This study focuses on empirical investigations and seeks implications by utilizing three different methodologies to test various aspects of trader behavior. The first methodology utilizes Prospect Theory to determine trader behavior during periods of extreme wealth contracting periods. Secondly, a threshold model to examine the sentiment variable is formulated and thirdly a study is made of the contagion effect and trader behavior. The connection between consumers' sense of financial well-being or sentiment and stock market performance has been studied at length. However, without data on actual versus experimental performance, implications based on this relationship are meaningless. The empirical agenda included examining a proprietary file of daily trader activities over a five-year period. Overall, during periods of extreme wealth altering conditions, traders "satisfice" rather than choose the "best" alternative. A trader's degree of loss aversion depends on his/her prior investment performance. A model that explains the behavior of traders during periods of turmoil is developed. Prospect Theory and the data file influenced the design of the model. Additional research included testing a model that permitted the data to signal the crisis through a threshold model. The third empirical study sought to investigate the existence of contagion caused by declining global wealth effects using evidence from the mining industry in Canada. Contagion, where a financial crisis begins locally and subsequently spreads elsewhere, has been studied in terms of correlations among similar regions. The results provide support for Prospect Theory in two out of the three empirical studies. The dissertation emphasizes the need for specifying precise, testable models of investors' expectations by providing tools to identify paradoxical behavior patterns. True enhancements in this field must include empirical research utilizing reliable data sources to mitigate data mining problems and allow researchers to distinguish between expectations-based and risk-based explanations of behavior. Through this type of research, it may be possible to systematically exploit "irrational" market behavior.

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El Niño and the Southern Oscillation (ENSO) is a cycle that is initiated in the equatorial Pacific Ocean and is recognized on interannual timescales by oscillating patterns in tropical Pacific sea surface temperatures (SST) and atmospheric circulations. Using correlation and regression analysis of datasets that include SST’s and other interdependent variables including precipitation, surface winds, sea level pressure, this research seeks to quantify recent changes in ENSO behavior. Specifically, the amplitude, frequency of occurrence, and spatial characteristics (i.e. events with maximum amplitude in the Central Pacific versus the Eastern Pacific) are investigated. The research is based on the question; “Are the statistics of ENSO changing due to increasing greenhouse gas concentrations?” Our hypothesis is that the present-day changes in amplitude, frequency, and spatial characteristics of ENSO are determined by the natural variability of the ocean-atmosphere climate system, not the observed changes in the radiative forcing due to change in the concentrations of greenhouse gases. Statistical analysis, including correlation and regression analysis, is performed on observational ocean and atmospheric datasets available from the National Oceanographic and Atmospheric Administration (NOAA), National Center for Atmospheric Research (NCAR) and coupled model simulations from the Coupled Model Inter-comparison Project (phase 5, CMIP5). Datasets are analyzed with a particular focus on ENSO over the last thirty years. Understanding the observed changes in the ENSO phenomenon over recent decades has a worldwide significance. ENSO is the largest climate signal on timescales of 2 - 7 years and affects billions of people via atmospheric teleconnections that originate in the tropical Pacific. These teleconnections explain why changes in ENSO can lead to climate variations in areas including North and South America, Asia, and Australia. For the United States, El Niño events are linked to decreased number of hurricanes in the Atlantic basin, reduction in precipitation in the Pacific Northwest, and increased precipitation throughout the southern United Stated during winter months. Understanding variability in the amplitude, frequency, and spatial characteristics of ENSO is crucial for decision makers who must adapt where regional ecology and agriculture are affected by ENSO.

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El Niño and the Southern Oscillation (ENSO) is a cycle that is initiated in the equatorial Pacific Ocean and is recognized on interannual timescales by oscillating patterns in tropical Pacific sea surface temperatures (SST) and atmospheric circulations. Using correlation and regression analysis of datasets that include SST’s and other interdependent variables including precipitation, surface winds, sea level pressure, this research seeks to quantify recent changes in ENSO behavior. Specifically, the amplitude, frequency of occurrence, and spatial characteristics (i.e. events with maximum amplitude in the Central Pacific versus the Eastern Pacific) are investigated. The research is based on the question; “Are the statistics of ENSO changing due to increasing greenhouse gas concentrations?” Our hypothesis is that the present-day changes in amplitude, frequency, and spatial characteristics of ENSO are determined by the natural variability of the ocean-atmosphere climate system, not the observed changes in the radiative forcing due to change in the concentrations of greenhouse gases. Statistical analysis, including correlation and regression analysis, is performed on observational ocean and atmospheric datasets available from the National Oceanographic and Atmospheric Administration (NOAA), National Center for Atmospheric Research (NCAR) and coupled model simulations from the Coupled Model Inter-comparison Project (phase 5, CMIP5). Datasets are analyzed with a particular focus on ENSO over the last thirty years. Understanding the observed changes in the ENSO phenomenon over recent decades has a worldwide significance. ENSO is the largest climate signal on timescales of 2 - 7 years and affects billions of people via atmospheric teleconnections that originate in the tropical Pacific. These teleconnections explain why changes in ENSO can lead to climate variations in areas including North and South America, Asia, and Australia. For the United States, El Niño events are linked to decreased number of hurricanes in the Atlantic basin, reduction in precipitation in the Pacific Northwest, and increased precipitation throughout the southern United Stated during winter months. Understanding variability in the amplitude, frequency, and spatial characteristics of ENSO is crucial for decision makers who must adapt where regional ecology and agriculture are affected by ENSO.

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Macrobrachium rosenbergii is a freshwater prawn which presents agonistic behavior and heterogeneous growth. It is known that captive conditions can intensify agonism causing injuries and decreased survival, generating a condition of poor welfare. Based on this, we aim to investigate the behavior of M. rosenbergii in the juvenile phase according to different types of shelter and frequencies of feed offer, emphasizing their agonistic behavior. For this, juveniles were observed in the laboratory in three steps. At step I we characterized the behavioral profile; prawns were kept in eight aquariums (27 prawns/m2 ), identified and observed four times along both phases of 24 h light cycle. At step II (2 experiments), we evaluated the use of shelters (brick or polyethylene rolls) and their influence on agonism by the animals. For classification of animals in dominance rank, the method used was David's Score. At step III (3 experiments), we evaluated different frequencies of feed offer on the behavior of individuals, in particular agonism. Results showed that juveniles do not present a pattern activity/inactivity between the phases of the light cycle. We identified a dominance hierarchy among individuals taking advantage of access to food by the dominant, which showed greater weight gain although the frequency of intake did not differ between individuals. The type of shelter influenced the behavior of animals. Brick shelter generated a higher frequency of permanence and a reduction in the frequency of agonistic interactions. The distribution of food more frequently throughout the day, decreased the motivation of animals for food, as well as to fight. Prawns fed four times showed lower frequency of feed intake and agonistic interactions. Thus, we conclude the shelters which reduce animal’s detection by coespecifics and offer the food four times along the day reduce agonistic behavior. This result causes na improvement in life quality of the prawns and also in its quality as final product.

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Produced water constitutes the largest volume of waste from offshore oil and gas operations and is composed of a wide range of organic and inorganic compounds. Although treatment processes have to meet strict oil in water regulations, the definition of “oil” is a function of the analysis process and may include aliphatic hydrocarbons which have limited environmental impact due to degradability whilst ignoring problematic dissolved petroleum species. This thesis presents the partitioning behavior of oil in produced water as a function of temperature and salinity to identify compounds of environmental concern. Phenol, p-cresol, and 4-tert-butylphenol were studied because of their xenoestrogenic power; other compounds studied are polycyclic aromatic hydrocarbon PAHs which include naphthalene, fluorene, phenanthrene, and pyrene. Partitioning experiments were carried out in an Innova incubator for 48 hours, temperature was varied from 4゚C to 70゚C, and two salinity levels of 46.8‰ and 66.8‰ were studied. Results obtained showed that the dispersed oil concentration in the water reduces with settling time and equilibrium was attained at 48 h settling time. Polycyclic aromatic hydrocarbons (PAHs) partitions based on dispersed oil concentration whereas phenols are not significantly affected by dispersed oil concentration. Higher temperature favors partitioning of PAHs into the water phase. Salinity has negligible effect on partitioning pattern of phenols and PAHs studied. Simulation results obtained from the Aspen HYSYS model shows that temperature and oil droplet distribution greatly influences the efficiency of produced water treatment system.

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Thèse réalisée en cotutelle entre l'Université de Montréal et l'Université Pierre et Marie Curie, Paris 06, Sorbonne Universités.

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In this Rapid Communication we demonstrate the applicability of an augmented Gibbs ensemble Monte Carlo approach for the phase behavior determination of model colloidal systems with short-ranged depletion attraction and long-ranged repulsion. This technique allows for a quantitative determination of the phase boundaries and ground states in such systems. We demonstrate that gelation may occur in systems of this type as the result of arrested microphase separation, even when the equilibrium state of the system is characterized by compact microphase structures.

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Forests change with changes in their environment based on the physiological responses of individual trees. These short-term reactions have cumulative impacts on long-term demographic performance. For a tree in a forest community, success depends on biomass growth to capture above- and belowground resources and reproductive output to establish future generations. Here we examine aspects of how forests respond to changes in moisture and light availability and how these responses are related to tree demography and physiology.

First we address the long-term pattern of tree decline before death and its connection with drought. Increasing drought stress and chronic morbidity could have pervasive impacts on forest composition in many regions. We use long-term, whole-stand inventory data from southeastern U.S. forests to show that trees exposed to drought experience multiyear declines in growth prior to mortality. Following a severe, multiyear drought, 72% of trees that did not recover their pre-drought growth rates died within 10 years. This pattern was mediated by local moisture availability. As an index of morbidity prior to death, we calculated the difference in cumulative growth after drought relative to surviving conspecifics. The strength of drought-induced morbidity varied among species and was correlated with species drought tolerance.

Next, we investigate differences among tree species in reproductive output relative to biomass growth with changes in light availability. Previous studies reach conflicting conclusions about the constraints on reproductive allocation relative to growth and how they vary through time, across species, and between environments. We test the hypothesis that canopy exposure to light, a critical resource, limits reproductive allocation by comparing long-term relationships between reproduction and growth for trees from 21 species in forests throughout the southeastern U.S. We found that species had divergent responses to light availability, with shade-intolerant species experiencing an alleviation of trade-offs between growth and reproduction at high light. Shade-tolerant species showed no changes in reproductive output across light environments.

Given that the above patterns depend on the maintenance of transpiration, we next developed an approach for predicting whole-tree water use from sap flux observations. Accurately scaling these observations to tree- or stand-levels requires accounting for variation in sap flux between wood types and with depth into the tree. We compared different models with sap flux data to test the hypotheses that radial sap flux profiles differ by wood type and tree size. We show that radial variation in sap flux is dependent on wood type but independent of tree size for a range of temperate trees. The best-fitting model predicted out-of-sample sap flux observations and independent estimates of sapwood area with small errors, suggesting robustness in new settings. We outline a method for predicting whole-tree water use with this model and include computer code for simple implementation in other studies.

Finally, we estimated tree water balances during drought with a statistical time-series analysis. Moisture limitation in forest stands comes predominantly from water use by the trees themselves, a drought-stand feedback. We show that drought impacts on tree fitness and forest composition can be predicted by tracking the moisture reservoir available to each tree in a mass balance. We apply this model to multiple seasonal droughts in a temperate forest with measurements of tree water use to demonstrate how species and size differences modulate moisture availability across landscapes. As trees deplete their soil moisture reservoir during droughts, a transpiration deficit develops, leading to reduced biomass growth and reproductive output.

This dissertation draws connections between the physiological condition of individual trees and their behavior in crowded, diverse, and continually-changing forest stands. The analyses take advantage of growing data sets on both the physiology and demography of trees as well as novel statistical techniques that allow us to link these observations to realistic quantitative models. The results can be used to scale up tree measurements to entire stands and address questions about the future composition of forests and the land’s balance of water and carbon.

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Neophobia, the fear of novelty, is a behavioral trait found across a number of animal species, including humans. Neophobic individuals perceive novel environments and stimuli to have aversive properties, and exhibit fearful behaviors when presented with non-familiar situations. The present study examined how early life exposure to aversive novel stimuli could reduce neophobia in bobwhite quail chicks. Experiment 1 exposed chicks to a novel auditory tone previously shown to be aversive to naïve chicks (Suarez, 2012) for 24 hours immediately after hatching, then subsequently tested them in the presence of the tone within a novel maze task. Postnatally exposed chicks demonstrated decreased fearfulness compared to naïve chicks, and behaved more similarly to chicks tested in the presence of a known attractive auditory stimulus (a bobwhite maternal assembly call vocalization). Experiment 2 exposed chicks to the novel auditory tone for 24 hours prenatally, then subsequently tested them within a novel maze task. Prenatally exposed chicks showed decreased fearfulness to a similar degree as those postnatally exposed, revealing that both prenatal and postnatal exposure methods are capable of decreasing fear of auditory stimuli. Experiment 3 exposed chicks to a novel visual stimulus for 24 hours postnatally, then subsequently tested them within a novel emergence box / T-maze apparatus. Chicks exposed to the visual stimulus showed decreased fearfulness compared to naïve chicks, thereby demonstrating the utility of this method across sense modalities. Experiment 4 assessed whether early postnatal exposure to one novel stimulus could generalize and serve to decrease fear of novelty when chicks were tested in the presence of markedly different stimuli. By combining the methods of Experiments 1 and 3, this experiment revealed that chicks exposed to one type of stimulus (auditory or visual) demonstrated decreased fear when subsequently tested in the presence of the opposite type of novel stimulus. These results suggest that experience with novel stimuli can moderate the extent to which neophobia will develop during early development.

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Quantitative methods can help us understand how underlying attributes contribute to movement patterns. Applying principal components analysis (PCA) to whole-body motion data may provide an objective data-driven method to identify unique and statistically important movement patterns. Therefore, the primary purpose of this study was to determine if athletes’ movement patterns can be differentiated based on skill level or sport played using PCA. Motion capture data from 542 athletes performing three sport-screening movements (i.e. bird-dog, drop jump, T-balance) were analyzed. A PCA-based pattern recognition technique was used to analyze the data. Prior to analyzing the effects of skill level or sport on movement patterns, methodological considerations related to motion analysis reference coordinate system were assessed. All analyses were addressed as case-studies. For the first case study, referencing motion data to a global (lab-based) coordinate system compared to a local (segment-based) coordinate system affected the ability to interpret important movement features. Furthermore, for the second case study, where the interpretability of PCs was assessed when data were referenced to a stationary versus a moving segment-based coordinate system, PCs were more interpretable when data were referenced to a stationary coordinate system for both the bird-dog and T-balance task. As a result of the findings from case study 1 and 2, only stationary segment-based coordinate systems were used in cases 3 and 4. During the bird-dog task, elite athletes had significantly lower scores compared to recreational athletes for principal component (PC) 1. For the T-balance movement, elite athletes had significantly lower scores compared to recreational athletes for PC 2. In both analyses the lower scores in elite athletes represented a greater range of motion. Finally, case study 4 reported differences in athletes’ movement patterns who competed in different sports, and significant differences in technique were detected during the bird-dog task. Through these case studies, this thesis highlights the feasibility of applying PCA as a movement pattern recognition technique in athletes. Future research can build on this proof-of-principle work to develop robust quantitative methods to help us better understand how underlying attributes (e.g. height, sex, ability, injury history, training type) contribute to performance.

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BACKGROUND/OBJECTIVES: There is limited information to support definitive recommendations concerning the role of diet in the development of type 2 Diabetes mellitus (T2DM). The results of the latest meta-analyses suggest that an increased consumption of green leafy vegetables may reduce the incidence of diabetes, with either no association or weak associations demonstrated for total fruit and vegetable intake. Few studies have, however, focused on older subjects.

SUBJECTS/METHODS: The relationship between T2DM and fruit and vegetable intake was investigated using data from the NIH-AARP study and the EPIC Elderly study. All participants below the age of 50 and/or with a history of cancer, diabetes or coronary heart disease were excluded from the analysis. Multivariate logistic regression analysis was used to calculate the odds ratio of T2DM comparing the highest with the lowest estimated portions of fruit, vegetable, green leafy vegetables and cabbage intake.

RESULTS: Comparing people with the highest and lowest estimated portions of fruit, vegetable or green leafy vegetable intake indicated no association with the risk of T2DM. However, although the pooled OR across all studies showed no effect overall, there was significant heterogeneity across cohorts and independent results from the NIH-AARP study showed that fruit and green leafy vegetable intake was associated with a reduced risk of T2DM OR 0.95 (95% CI 0.91,0.99) and OR 0.87 (95% CI 0.87,0.90) respectively.

CONCLUSIONS: Fruit and vegetable intake was not shown to be related to incident T2DM in older subjects. Summary analysis also found no associations between green leafy vegetable and cabbage intake and the onset of T2DM. Future dietary pattern studies may shed light on the origin of the heterogeneity across populations.European Journal of Clinical Nutrition advance online publication, 17 August 2016; 

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Les antimoniures sont des semi-conducteurs III-V prometteurs pour le développement de dispositifs optoélectroniques puisqu'ils ont une grande mobilité d'électrons, une large gamme spectrale d'émission ou de détection et offrent la possibilité de former des hétérostructures confinées dont la recombinaison est de type I, II ou III. Bien qu'il existe plusieurs publications sur la fabrication de dispositifs utilisant un alliage d'In(x)Ga(1-x)As(y)Sb(1-y) qui émet ou détecte à une certaine longueur d'onde, les détails, à savoir comment sont déterminés les compositions et surtout les alignements de bande, sont rarement explicites. Très peu d'études fondamentales sur l'incorporation d'indium et d'arsenic sous forme de tétramères lors de l'épitaxie par jets moléculaires existent, et les méthodes afin de déterminer l'alignement des bandes des binaires qui composent ces alliages donnent des résultats variables. Un modèle a été construit et a permis de prédire l'alignement des bandes énergétiques des alliages d'In(x)Ga(1-x)As(y)Sb(1-y) avec celles du GaSb pour l'ensemble des compositions possibles. Ce modèle tient compte des effets thermiques, des contraintes élastiques et peut aussi inclure le confinement pour des puits quantiques. De cette manière, il est possible de prédire la transition de type de recombinaison en fonction de la composition. Il est aussi montré que l'indium ségrègue en surface lors de la croissance par épitaxie par jets moléculaires d'In(x)Ga(1-x)Sb sur GaSb, ce qui avait déjà été observé pour ce type de matériau. Il est possible d'éliminer le gradient de composition à cette interface en mouillant la surface d'indium avant la croissance de l'alliage. L'épaisseur d'indium en surface dépend de la température et peut être évaluée par un modèle simple simulant la ségrégation. Dans le cas d'un puits quantique, il y aura une seconde interface GaSb sur In(x)Ga(1-x)Sb où l'indium de surface ira s'incorporer. La croissance de quelques monocouches de GaSb à basse température immédiatement après la croissance de l'alliage permet d'incorporer rapidement ces atomes d'indium et de garder la seconde interface abrupte. Lorsque la composition d'indium ne change plus dans la couche, cette composition correspond au rapport de flux d'atomes d'indium sur celui des éléments III. L'arsenic, dont la source fournit principalement des tétramères, ne s'incorpore pas de la même manière. Les tétramères occupent deux sites en surface et doivent interagir par paire afin de créer des dimères d'arsenic. Ces derniers pourront alors être incorporés dans l'alliage. Un modèle de cinétique de surface a été élaboré afin de rendre compte de la diminution d'incorporation d'arsenic en augmentant le rapport V/III pour une composition nominale d'arsenic fixe dans l'In(x)Ga(1-x)As(y)Sb(1-y). Ce résultat s'explique par le fait que les réactions de deuxième ordre dans la décomposition des tétramères d'arsenic ralentissent considérablement la réaction d'incorporation et permettent à l'antimoine d'occuper majoritairement la surface. Cette observation montre qu'il est préférable d'utiliser une source de dimères d'arsenic, plutôt que de tétramères, afin de mieux contrôler la composition d'arsenic dans la couche. Des puits quantiques d'In(x)Ga(1-x)As(y)Sb(1-y) sur GaSb ont été fabriqués et caractérisés optiquement afin d'observer le passage de recombinaison de type I à type II. Cependant, celui-ci n'a pas pu être observé puisque les spectres étaient dominés par un niveau énergétique dans le GaSb dont la source n'a pu être identifiée. Un problème dans la source de gallium pourrait être à l'origine de ce défaut et la résolution de ce problème est essentielle à la continuité de ces travaux.

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Introduction : Le diabète de type 2 est une maladie évolutive débilitante et souvent mortelle qui atteint de plus en plus de personnes dans le monde. Le traitement antidiabétique non-insulinique (TADNI) notamment le traitement antidiabétique oral (TADO) est le plus fréquemment utilisé chez les adultes atteints de cette maladie. Toutefois, plusieurs de ces personnes ne prennent pas leur TADO tel que prescrit posant ainsi la problématique d’une adhésion sous-optimale. Ceci entraîne des conséquences néfastes aussi bien pour les patients que pour la société dans laquelle ils vivent. Il serait donc pertinent d’identifier des pistes de solution à cette problématique. Objectifs : Trois objectifs de recherche ont été étudiés : 1) Explorer la capacité de la théorie du comportement planifié (TCP) à prédire l’adhésion future au TADNI chez les adultes atteints de diabète de type 2, 2) Évaluer l’efficacité globale des interventions visant à améliorer l’adhésion au TADO chez les adultes atteints de diabète de type 2 et étudier l’influence des techniques de changement de comportement sur cette efficacité globale, et 3) Évaluer l’efficacité globale de l’entretien motivationnel sur l’adhésion au traitement médicamenteux chez les adultes atteints de maladie chronique et étudier l’influence des caractéristiques de cette intervention sur son efficacité globale. Méthodes : Pour l’objectif 1 : Il s’agissait d’une enquête web, suivie d’une évaluation de l’adhésion au TADNI sur une période de 30 jours, chez des adultes atteints de diabète de type 2, membres de Diabète Québec. L’enquête consistait à la complétion d’un questionnaire auto-administré incluant les variables de la TCP (intention, contrôle comportemental perçu et attitude) ainsi que d’autres variables dites «externes». Les informations relatives au calcul de l’adhésion provenaient des dossiers de pharmacie des participants transmis via la plateforme ReMed. Une régression linéaire multivariée a été utilisée pour estimer la mesure d’association entre l’intention et l’adhésion future au TADNI ainsi que l’interaction entre l’adhésion passée et l’intention. Pour répondre aux objectifs 2 et 3, deux revues systématiques et méta-analyses ont été effectuées et rapportées selon les lignes directrices de PRISMA. Un modèle à effets aléatoires a été utilisé pour estimer l’efficacité globale (g d’Hedges) des interventions et son intervalle de confiance à 95 % (IC95%) dans chacune des revues. Nous avons également quantifié l’hétérogénéité (I2 d’Higgins) entre les études, et avons fait des analyses de sous-groupe et des analyses de sensibilité. Résultats : Objectif 1 : Il y avait une interaction statistiquement significative entre l’adhésion passée et l’intention (valeur-p= 0,03). L’intention n’était pas statistiquement associée à l’adhésion future au TADNI, mais son effet était plus fort chez les non-adhérents que chez les adhérents avant l’enquête web. En revanche, l’intention était principalement prédite par le contrôle comportemental perçu à la fois chez les adhérents [β= 0,90, IC95%= (0,80; 1,00)] et chez les non-adhérents passés [β= 0,76, IC95%= (0,56; 0,97)]. Objectif 2 : L’efficacité globale des interventions sur l’adhésion au TADO était de 0,21 [IC95%= (-0,05; 0,47); I2= 82 %]. L’efficacité globale des interventions dans lesquelles les intervenants aidaient les patients et/ou les cliniciens à être proactifs dans la gestion des effets indésirables était de 0,64 [IC95%= (0,31; 0,96); I2= 56 %]. Objectif 3 : L’efficacité globale des interventions (basées sur l’entretien motivationnel) sur l’adhésion au traitement médicamenteux était de 0,12 [IC95%= (0,05; 0,20); I2= 1 %. Les interventions basées uniquement sur l’entretien motivationnel [β= 0,18, IC95%= (0,00; 0,36)] et celles dans lesquelles les intervenants ont été coachés [β= 0,47, IC95%= (0,03; 0,90)] étaient les plus efficaces. Aussi, les interventions administrées en face-à-face étaient plus efficaces que celles administrées par téléphone [β= 0,27, IC95%=(0,04; 0,50)]. Conclusion : Il existe un écart entre l’intention et l’adhésion future au TADNI, qui est partiellement expliqué par le niveau d’adhésion passée. Toutefois, il n’y avait pas assez de puissance statistique pour démontrer une association statistiquement significative entre l’intention et l’adhésion future chez les non-adhérents passés. D’un autre côté, quelques solutions au problème de l’adhésion sous-optimale au TADO ont été identifiées. En effet, le fait d’aider les patients et/ou les cliniciens à être proactifs dans la gestion des effets indésirables contribue efficacement à l’amélioration de l’adhésion au TADO chez les adultes atteints de diabète de type 2. Aussi, les interventions basées sur l’entretien motivationnel améliorent efficacement l’adhésion au traitement médicamenteux chez les adultes atteints de maladie chronique. L’entretien motivationnel pourrait donc être utilisé comme un outil clinique pour soutenir les patients dans l’autogestion de leur TADO.

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Thesis (Ph.D.)--University of Washington, 2016-08