Évaluation comparative de stratégies visant à augmenter les interventions de courte durée en cessation tabagique auprès du personnel infirmier de milieux hospitaliers

Introduction : Les résultats de recherches ont démontré que la cessation tabagique augmente là où des interventions professionnelles préventives sont appliquées avec constance. On rapporte qu’au Québec, 62 % des infirmières (toutes pratiques confondues) évaluent le statut tabagique de leurs clients et 38 % suggèrent la cessation tabagique. En milieu hospitalier, l’évaluation du statut tabagique diminue à 30 %. Or, le personnel infirmier hospitalier est présent dans les unités de soins 24 heures sur 24, ce qui laisse prévoir une influence potentielle non négligeable dans la décision des patients de cesser de fumer. Objectif : La présente recherche a pour objectif de comparer, avec un groupe contrôle, l’efficacité de stratégies (formation interactive, rappel, multiple) pour augmenter les interventions réalisées en cessation tabagique dans des unités de médecine et de chirurgie. Le choix de ces stratégies repose sur leur efficacité et leur potentiel d’implantation dans d’autres centres. Méthodologie : Un devis expérimental avec randomisation par groupe a été choisi. Le modèle factoriel permet d’évaluer l’effet de chacun des groupes expérimentaux en regard du groupe contrôle. Des mesures préstratégies et poststratégies (à 1 mois et à 3 mois) sont privilégiées. Plusieurs outils permettent de mesurer les effets des stratégies et ce, avec des sources diversifiées (personnel infirmier, patients, dossiers des patients, gestionnaires et responsables des centres d’abandon du tabac). Résultats : Au total, 156 infirmières et infirmières-auxiliaires ont répondu à des questionnaires au temps 1, 78 au temps 2 et 69 au temps 3. Parallèlement au personnel infirmier, 156 patients ont été rejoints au temps 1, 89 au temps 2 et 98 au temps 3. Les résultats démontrent que le personnel infirmier évalue le statut tabagique chez 35,7 % de la clientèle seulement et la motivation à cesser de fumer chez 17,6 % des patients. Au cours de notre recherche, peu d’interventions en cessation tabagique ont été réalisées dans les unités de médecine et de chirurgie; la présence de plusieurs obstacles de même qu’une perception d’inefficacité des interventions de la part du personnel infirmier semblent en être les causes. Les résultats de notre recherche ne nous a pas permis d’appuyer nos hypothèses. Cependant, des analyses complémentaires ont démontré que la stratégie de formation interactive a permis d’augmenter certaines pratiques cliniques à court terme et de diminuer la perception d’obstacles à l’intervention. Le rappel n’a pas fonctionné correctement et n’a pu être évalué. Conclusion : En considérant les résultats modestes des stratégies implantées, la formation interactive a eu un impact à très court terme sur les interventions courtes en cessation tabagique réalisées par le personnel infirmier d’unités de soins en médecine et en chirurgie. Les difficultés rencontrées lors de l’implantation des stratégies ont été expliquées, ce qui permettra une planification plus éclairée de futures recherches dans le domaine.

L’approche psycholinguistique de la mémoire à court terme verbale : études neuropsychologiques

L’approche psycholinguistique suggère que la rétention à court terme verbale et le langage dépendent de mécanismes communs. Elle prédit que les caractéristiques linguistiques des items verbaux (e.g. phonologiques, lexicales, sémantiques) influencent le rappel immédiat (1) et que la contribution des niveaux de représentations linguistiques dépend du contexte de rappel, certaines conditions expérimentales (e.g. format des stimuli) favorisant l’utilisation de codes spécifiques (2). Ces prédictions sont évaluées par le biais de deux études empiriques réalisées auprès d’une patiente cérébrolésée qui présente une atteinte du traitement phonologique (I.R.) et de participants contrôles. Une première étude (Article 1) teste l’impact des modes de présentation et de rappel sur les effets de similarité phonologique et de catégorie sémantique de listes de mots. Une seconde étude (Article 2) évalue la contribution du code orthographique en mémoire à court terme (MCT) verbale en testant l’effet de la densité du voisinage orthographique des mots sur le rappel sériel immédiat de mots présentés visuellement. Compte tenu du rôle déterminant du code phonologique en MCT et du type d’atteinte de I.R., des effets linguistiques distincts étaient attendus chez elle et chez les contrôles. Selon le contexte de rappel, des effets sémantiques (Article 1) et orthographiques (Article 2) plus importants étaient prédits chez I.R. et des effets phonologiques plus marqués étaient attendus chez les participants contrôles. Chez I.R., le rappel est influencé par les caractéristiques sémantiques et orthographiques des mots, mais peu par leurs caractéristiques phonologiques et le contexte de rappel module l’utilisation de différents niveaux de représentations linguistiques. Chez les contrôles, une contribution relativement plus stable des représentations phonologiques est observée. Les données appuient une approche psycholinguistique qui postule que des mécanismes communs régissent la rétention à court terme verbale et le langage. Les implications théoriques et cliniques des résultats sont discutées en regard de modèles psycholinguistiques actuels.

Approche psycholinguistique des relations entre le traitement sémantique des mots et la rétention à court terme chez l’individu sain et dans la démence de type Alzheimer

Depuis ces deux dernières décennies, des efforts considérables en psychologie cognitive et neuropsychologie ont été déployés pour mieux comprendre les dynamiques entre les différents systèmes cognitifs (fonctions exécutives, mémoire, langage, etc.). L’observation d’une co-existence entre des atteintes en rétention à court terme verbale (RCTv) et en langage dans plusieurs pathologies a conduit certains chercheurs à concevoir une alternative à la conceptualisation classique de la RCTv, telle que proposée par le modèle initial de la mémoire de travail de Baddeley (1986). Particulièrement, les travaux sur l’aphasie ont conduit à l’émergence d’une approche psycholinguistique de la RCTv, postulant que le traitement et le maintien des mots font appel à des processus communs. Cette approche, et particulièrement le modèle d’activation interactive (N. Martin & Gupta, 2004; N. Martin & Saffran, 1997), prédit que les capacités en RCTv sont notamment modulées par les caractéristiques linguistiques engagées durant l’épreuve, variant selon la nature des items verbaux et la modalité de rappel, ainsi que par les compétences linguistiques des individus. L’objectif de la présente thèse était de tester ces prédictions à partir d’une exploration des relations entre le traitement sémantique des mots et la RCTv chez l’adulte sain (article 1) et dans la démence de type Alzheimer (DTA) (article 2). Dans le premier article, deux expériences mettent en évidence l’influence des liens associatifs entre les mots sur les capacités à maintenir temporairement des informations verbales. Les participants ont tendance à faussement reconnaître des mots associés aux mots de la liste, reflet d’une activation du réseau sémantique durant la rétention temporaire. Cette contribution sémantique est accentuée en situation de suppression articulatoire, une condition qui empêche le participant de répéter les listes durant la tâche. Les résultats du second article indiquent que la modalité de réponse module différemment la performance en RCTv chez les participants âgés sans atteinte neurologique et ceux atteints de la DTA. Ces données en RCTv sont compatibles avec les atteintes spécifiques du traitement du mot, également trouvées chez le groupe avec DTA. Les implications théoriques et cliniques de ces résultats sont discutées. Les limites et perspectives futures sont également abordées.

Early-onset and late-onset Alzheimer’s disease are associated with distinct patterns of memory impairment

The goal of this study was to investigate the specific patterns of memory breakdown in patients suffering from early-onset Alzheimer’s disease (EOAD) and late-onset Alzheimer’s disease (LOAD). Twenty EOAD patients, twenty LOAD patients, twenty matched younger controls, and twenty matched older controls participated in this study. All participants underwent a detailed neuropsychological assessment, an MRI scan, an FDG-PET scan, and AD patients had biomarkers as supporting evidence of both amyloïdopathy and neuronal injury. Results of the neuropsychological assessment showed that both EOAD and LOAD groups were impaired in the domains of memory, executive functions, language, praxis, and visuoconstructional abilities, when compared to their respective control groups. EOAD and LOAD groups, however, showed distinct patterns of memory impairment. Even though both groups were similarly affected on measures of episodic, short term and working memory, in contrast semantic memory was significantly more impaired in LOAD than in EOAD patients. The EOAD group was not more affected than the LOAD group in any memory domain. EOAD patients, however, showed significantly poorer performance in other cognitive domains including executive functions and visuoconstructional abilities. A more detailed analysis of the pattern of semantic memory performance among patient groups revealed that the LOAD was more profoundly impaired, in tasks of both spontaneous recall and semantic recognition. Voxel-Based Morphometry (VBM) analyses showed that impaired semantic performance in patients was associated with reduced gray matter volume in the anterior temporal lobe region, while PET-FDG analyses revealed that poorer semantic performance was associated with greater hypometabolism in the left temporoparietal region, both areas reflecting key regions of the semantic network. Results of this study indicate that EOAD and LOAD patients present with distinct patterns of memory impairment, and that a genuine semantic impairment may represent one of the clinical hallmarks of LOAD.

Effect of human disturbance on long-term habitat use and breeding success of the European Nightjar, Caprimulgus europaeus

Land managers often respond to declining numbers of target species by creating additional areas of habitat. If these habitats are also subject to human disturbance, then their efforts may be wasted. The European Nightjar (Caprimulgus europaeus) is a ground-nesting bird that is listed as a species of European Conservation Concern. It appears to be susceptible to human disturbance during the breeding season. We examined habitat use and reproductive success over 10 years in a breeding population on 1335 ha of managed land in Nottinghamshire, England. The study site was divided into a heavily disturbed section and a less disturbed section of equal habitat availability, forming a natural long-term experiment. The site is open to the public, and visitor numbers approximately doubled during the study. We found that overall Nightjar density was significantly lower and there were significantly fewer breeding pairs in the heavily disturbed habitat compared with the less disturbed habitat. However, average breeding success per pair, in terms of eggs and fledglings produced, was not significantly different between the two sections across years. Our findings suggest that human recreational disturbance may drastically alter settlement patterns and nest site selection of arriving females in some migratory ground-nesting species and may reduce the utility of apparently suitable patches of remnant and created habitat. Land managers should bear this in mind when creating new areas of habitat that will also be accessible to the public. Our study also highlights the value of long-term population monitoring, which can detect trends that short-term studies may miss.

Long-term perspective of agile methods

Even if we have recognized many short-term benefits of agile methods, we still know very little about their long-term effects. In this panel, we discuss the long-term perspective of the agile methods. The panelists are either industrial or academic representatives. They will discuss problems and benefits related to the long-term lifecycle system management in agile projects. Ideally, the panel’s outcome will provide ideas for future research.

Redintegration and lexicality effects in children: do they depend upon the demands of the memory task?

The effect of long-term knowledge upon performance in short-term memory tasks was examined for children from 5 to 10 years of age. The emergence of a lexicality effect, in which familiar words were recalled more accurately than unfamiliar words, was found to depend upon the nature of the memory task. Lexicality effects were interpreted as reflecting the use of redintegration, or reconstruction processes, in short-term memory. Redintegration increased with age for tasks requiring spoken item recall and decreased with age when position information but not naming was required. In a second experiment, redintegration was found in a recognition task when some of the foils rhymed with the target. Older children were able to profit from a rhyming foil, whereas younger children were confused by it, suggesting that the older children make use of sublexical phonological information in reconstructing the target. It was proposed that redintegrative processes in their mature form support the reconstruction of detailed phonological knowledge of words.

The relationship between absolute and proportion scores of serial order memory: simulation predictions and empirical data

The capability of a feature model of immediate memory (Nairne, 1990; Neath, 2000) to predict and account for a relationship between absolute and proportion scoring of immediate serial recall when memory load is varied (the list-length effect, LLE) is examined. The model correctly predicts the novel finding of an LLE in immediate serial order memory similar to that observed with free recall and previously assumed to be attributable to the long-term memory component of that procedure (Glanzer, 1972). The usefulness of formal models as predictive tools and the continuity between short-term serial order and longer term item memory are considered.

Auditory distraction from low-intensity noise: a review of the consequences for learning and workplace environments

The 'irrelevant sound effect' in short-term memory is commonly believed to entail a number of direct consequences for cognitive performance in the office and other workplaces (e.g. S. P. Banbury, S. Tremblay, W. J. Macken, & D. M. Jones, 2001). It may also help to identify what types of sound are most suitable as auditory warning signals. However, the conclusions drawn are based primarily upon evidence from a single task (serial recall) and a single population (young adults). This evidence is reconsidered from the standpoint of different worker populations confronted with common workplace tasks and auditory environments. Recommendations are put forward for factors to be considered when assessing the impact of auditory distraction in the workplace. Copyright (c) 2005 John Wiley & Sons, Ltd.

The long-term price-earnings ratio

price-earnings ratio;value premium;arbitrage trading rule;UK stock returns;contrarian investment Abstract:  The price-earnings effect has been thoroughly documented and is the subject of numerous academic studies. However, in existing research it has almost exclusively been calculated on the basis of the previous year's earnings. We show that the power of the effect has until now been seriously underestimated due to taking too short-term a view of earnings. Looking at all UK companies since 1975, using the traditional P/E ratio we find the difference in average annual returns between the value and glamour deciles to be 6%. This is similar to other authors' findings. We are able to almost double the value premium by calculating the P/E ratio using earnings averaged over the previous eight years.

Does short termism affect the quality of urban design in the UK?

This paper follows the report on the “Quality of Urban Design: Study of the Influence of Private Property Decision Maker in Urban Design” (RICS 1996). It focuses on one of the findings in the report, namely that decisions made in development, investment and occupation seemed overly influenced by short term considerations. In this paper, the authors review the Report and examine the concept of short termism as it affects urban design decisions. The paper concludes that although it is difficult to establish whether or not short termism exists in many decisions, there are grounds for believing that a priori short termism might particularly influence property orientated decisions. The paper ends with some implications for policy both at the economy and local level.

RACORO extended-term, aircraft observations of boundary-layer clouds

A first-of-a-kind, extended-term cloud aircraft campaign was conducted to obtain an in-situ statistical characterization of continental boundary-layer clouds needed to investigate cloud processes and refine retrieval algorithms. Coordinated by the Atmospheric Radiation Measurement (ARM) Aerial Facility (AAF), the Routine AAF Clouds with Low Optical Water Depths (CLOWD) Optical Radiative Observations (RACORO) field campaign operated over the ARM Southern Great Plains (SGP) site from 22 January to 30 June 2009, collecting 260 h of data during 59 research flights. A comprehensive payload aboard the Center for Interdisciplinary Remotely-Piloted Aircraft Studies (CIRPAS) Twin Otter aircraft measured cloud microphysics, solar and thermal radiation, physical aerosol properties, and atmospheric state parameters. Proximity to the SGP's extensive complement of surface measurements provides ancillary data that supports modeling studies and facilitates evaluation of a variety of surface retrieval algorithms. The five-month duration enabled sampling a range of conditions associated with the seasonal transition from winter to summer. Although about two-thirds of the cloud flights occurred in May and June, boundary-layer cloud fields were sampled under a variety of environmental and aerosol conditions, with about 77% of the flights occurring in cumulus and stratocumulus. Preliminary analyses illustrate use of these data to analyze cloud-aerosol relationships, characterize the horizontal variability of cloud radiative impacts, and evaluate surface-based retrievals. We discuss how an extended-term campaign requires a simplified operating paradigm that is different from that used for typical, short-term, intensive aircraft field programs.

The population dynamics of disease on short and long time-scales

Observational evidence is scarce concerning the distribution of plant pathogen population sizes or densities as a function of time-scale or spatial scale. For wild pathosystems we can only get indirect evidence from evolutionary patterns and the consequences of biological invasions.We have little or no evidence bearing on extermination of hosts by pathogens, or successful escape of a host from a pathogen. Evidence over the last couple of centuries from crops suggest that the abundance of particular pathogens in the spectrum affecting a given host can vary hugely on decadal timescales. However, this may be an artefact of domestication and intensive cultivation. Host-pathogen dynamics can be formulated mathematically fairly easily–for example as SIR-type differential equation or difference equation models, and this has been the (successful) focus of recent work in crops. “Long-term” is then discussed in terms of the time taken to relax from a perturbation to the asymptotic state. However, both host and pathogen dynamics are driven by environmental factors as well as their mutual interactions, and both host and pathogen co-evolve, and evolve in response to external factors. We have virtually no information about the importance and natural role of higher trophic levels (hyperpathogens) and competitors, but they could also induce long-scale fluctuations in the abundance of pathogens on particular hosts. In wild pathosystems the host distribution cannot be modelled as either a uniform density or even a uniform distribution of fields (which could then be treated as individuals). Patterns of short term density-dependence and the detail of host distribution are therefore critical to long-term dynamics. Host density distributions are not usually scale-free, but are rarely uniform or clearly structured on a single scale. In a (multiply structured) metapopulation with coevolution and external disturbances it could well be the case that the time required to attain equilibrium (if it exists) based on conditions stable over a specified time-scale is longer than that time-scale. Alternatively, local equilibria may be reached fairly rapidly following perturbations but the meta-population equilibrium be attained very slowly. In either case, meta-stability on various time-scales is a more relevant than equilibrium concepts in explaining observed patterns.

Evaluation of boundary-layer type in a weather forecast model utilising long-term Doppler lidar observations

Many studies evaluating model boundary-layer schemes focus either on near-surface parameters or on short-term observational campaigns. This reflects the observational datasets that are widely available for use in model evaluation. In this paper we show how surface and long-term Doppler lidar observations, combined in a way to match model representation of the boundary layer as closely as possible, can be used to evaluate the skill of boundary-layer forecasts. We use a 2-year observational dataset from a rural site in the UK to evaluate a climatology of boundary layer type forecast by the UK Met Office Unified Model. In addition, we demonstrate the use of a binary skill score (Symmetric Extremal Dependence Index) to investigate the dependence of forecast skill on season, horizontal resolution and forecast leadtime. A clear diurnal and seasonal cycle can be seen in the climatology of both the model and observations, with the main discrepancies being the model overpredicting cumulus capped and decoupled stratocumulus capped boundary-layers and underpredicting well mixed boundary-layers. Using the SEDI skill score the model is most skillful at predicting the surface stability. The skill of the model in predicting cumulus capped and stratocumulus capped stable boundary layer forecasts is low but greater than a 24 hr persistence forecast. In contrast, the prediction of decoupled boundary-layers and boundary-layers with multiple cloud layers is lower than persistence. This process based evaluation approach has the potential to be applied to other boundary-layer parameterisation schemes with similar decision structures.

Long term changes in EUV and X-ray emissions from the solar corona and chromosphere as measured by the response of the Earth’s ionosphere during total solar eclipses from 1932 to 1999

Measurements of the ionospheric E region during total solar eclipses in the period 1932-1999 have been used to investigate the fraction of Extreme Ultra Violet and soft X-ray radiation, phi, that is emitted from the limb corona and chromosphere. The relative apparent sizes of the Moon and the Sun are different for each eclipse, and techniques are presented which correct the measurements and, therefore, allow direct comparisons between different eclipses. The results show that the fraction of ionising radiation emitted by the limb corona has a clear solar cycle variation and that the underlying trend shows this fraction has been increasing since 1932. Data from the SOHO spacecraft are used to study the effects of short-term variability and it is shown that the observed long-term rise in phi has a negligible probability of being a chance occurrence.