Surpoids et obésité, prévention à l'école :: entre théories et pratiques au cycle 3

Le surpoids et l’obésité tendent à s’accroitre au niveau mondial. Cette problématique fait réfléchir tous les acteurs et les professionnels de la santé. Cette catastrophe sanitaire à un coût faramineux en termes d’argent et de vies humaines. Si les causes et les conséquences sont bien établies à l’heure actuelle, les moyens pour lutter contre ce fléau sont encore aléatoires. Il n’y a pas de remède, ni de programme garantissant l’éradication de ce phénomène sociétal moderne. La prévention joue donc un rôle primordial pour éduquer les jeunes aujourd’hui afin d’en faire des personnes responsables demain. En tant qu’acteur auprès de ces jeunes au niveau de l’enseignement dans des classes terminales, je propose un module projet pluridisciplinaire permettant d’aborder ce thème sous plusieurs angles. Ce travail de recherche-actions se base sur le PER (plan d’étude romand) afin de le rendre compatible avec le mandat professionnel qu’il m’est demandé d’assumer. Comme la plupart des programmes préventifs existants sont basés sur le volontariat individuel ou familial et qu’ils ne sont que rarement gratuits, je propose ici une action ciblée pour tous les élèves d’une classe. Sur une période de huit semaines, l’éducation physique, l’éducation nutritionnelle, les sciences de la nature, les mathématiques et certaines compétences transverses sont au centre de ce projet préventif. Le point final étant la participation commune à une course pédestre

Fiabilité intra- et inter-examinateurs du dynamomètre MicroFET2 pour la flexion et l'abduction de l'épaule: une étude transversale avec répétition des mesures

En physiothérapie, l’évaluation de la force musculaire est un élément essentiel du bilan et du suivi du patient. Le testing manuel se révèle subjectif et peu précis pour évaluer une force supérieure à 3. Les dynamomètres manuels sont une alternative pratique et peu coûteuse. Notre objectif est d’évaluer la fiabilité du dynamomètre MicroFET2 pour la mesure de la force isométrique maximale de la flexion et de l’abduction de l’épaule.In der Physiotherapie, ist die Auswertung der Muskelkraft ein wesentliches Element des Befundes und der Überwachung des Patienten. Der manuelle Muskeltest erweist sich subjektiv und ungenau, um eine Kraft über 3 zu messen. Der Dynamometer ist eine bequeme und preiswerte Alternative um die isometrische Kraft zu messen. Unser Ziel ist es eine Studie durchzuführen, um die Reliabilität des Dynamometers MicroFET2, der die maximale isometrische Kraft der Schulterabduktion und Schulterflexion misst, zu bewerten

Reliable and Total Order Broadcast in the Crash-Recovery Model

This paper addresses the problem of broadcasting messages in a reliable and totally ordered manner when processes and channels may crash and recover, or crash and never recover. We present a suite of specifications of reliable and total order broadcast primitives and we describe algorithms that implement those specifications. Our approach is modular and incremental. It is modular in the sense that the properties of broadcast primitives are first given separately and then composed: this provides a comprehensive design space for broadcast semantics. It is incremental in the sense that a broadcast algorithm implementing a given specification is obtained by transforming an algorithm that implements a weaker specification: this gives an automatic way to improve the resilience of broadcast primitives. We derive specific reliable and total order broadcast algorithms and we discuss their performance and optimality. Keywords:reliable broadcast, total order broadcast, modularity,transformation, optimisation, crash-recovery model

Making Consensus Practical

This paper presents the abstraction of lazy consensus and argues for its use as an effective component for building distributed agreement protocols in practical asynchronous systems where processes and links can crash and recover. Lazy consensus looks like consensus, is equivalent to consensus, but is not consensus. The specification of lazy consensus has an on-demand and a re-entrant flavors that makes its use very efficient, especially in terms of forced logs, which are known to be major sources of overhead in distributed systems. We illustrate the use of lazy consensus as a building block to develop efficient atomic broadcast and atomic commitment protocols: two central abstractions in our DACE middleware environment

The tripartite structure of pain-related affect: A confirmatory factor analysis

Numerous emotion-based constructs seem related to pain and pain-related disability. These include general affect constructs such as anxiety and depression, as well as specific anxiety-related constructs such as anxiety sensitivity and fear of pain. Few studies examine the relationships between these constructs. Those that have suggest they can be reduced to three or four underlying components. We used a confirmatory approach to test the models of pain-related anxiety found in previous exploratory studies. Adult participants (N = 294) completed commonly used measures of affect-related constructs relevant to pain. Confirmatory Factor Analyses tested three models to determine the best fit. The tripartite model, with small modifications, was found to provide the best fit. The model consisted of: 1) General distress, 2) Fear of pain from injury/insult, and 3) Cognitive intrusion of pain

Open Consensus

This paper presents the abstraction of open consensus and argues for its use as an effective component for building reliable agreement protocols in practical asynchronous systems where processes and links can crash and recover. The specification of open consensus has a decoupled, on-demand and re-entrant flavour that make its use very efficient, especially in terms of forced logs, which are known to be major sources of overhead in distributed systems. We illustrate the use of open consensus as a basic building block to develop a modular, yet efficient, total order broadcast protocol. Finally, we describe our Java implementation of our open consensus abstraction and we convey our efficiency claims through some practical performance measures

Asynchronous Leasing

Leasing is a very effective way to improve the performance of distributed algorithms without hampering their fault-tolerance. The notion of lease has traditionally been defined using a global notion of time and was hence strongly tied to synchronous system models. This paper introduces a new notion of lease devised for an asynchronous system model. We give the precise properties of our lease abstraction, we show how it can be implemented in an asynchronous system model, and we then illustrate its use by significantly improving the performance of a consensus-based atomic broadcast algorithm

Concerns about medication and medication adherence in patients with chronic pain recruited from general practice

This study examines the concerns and beliefs about medication reported by patients with nonmalignant chronic pain encountered within general practice. Two hundred thirty-nine patients with chronic pain took part in this research. Patients completed the Pain Medication Attitudes Questionnaire, a measure of patient concerns and beliefs relating to addiction, withdrawal, side effects, mistrust in doctors, perceived need of medication, scrutiny from others, and tolerance. The data revealed that patient concerns and beliefs predicted general medication nonadherence. In addition, concerns were related to the direction of nonadherence: overuse of medication was related to increased perceived need for medication and greater concern over side effects; underuse was related to decreased concerns over withdrawal and increased mistrust in the prescribing doctor. Analyses also indicated that patient attitudes and concerns about medication were more predictive of nonadherence than both level of pain and the reported frequency of experienced side effects. This research contributes to the increasing evidence that patient attitudes and beliefs about pain medication are associated with adherence behavior. Training general practitioners to identify and address these concerns may reduce concerns, improve adherence, and facilitate the doctor-patient relationship

Work stress in NHS employees: a mixed-methods study

The United Kingdom’s National Health Service (NHS) has a higher-than-average level of stress-related sickness absence of all job sectors in the country. It is important that this is addressed as work stress is damaging to employees and the organisation, and subsequently impacts patient care. The aim of this study was to gain an in-depth understanding of working conditions and wellbeing in NHS employees from three employing NHS Trusts through a mixed-methods investigation. First, a cross-sectional organisational survey was completed by 1644 respondents. Questions examined working conditions, stress, psychological wellbeing, job satisfaction, and presenteeism. This was followed by 33 individual semistructured interviews with NHS staff from a variety of clinical and nonclinical roles. Quantitative findings revealed that working conditions were generally positive, although most staff groups had high levels of workload. Regression outcomes demonstrated that a number of working conditions influenced mental wellbeing and stress. Three themes were generated from thematic analysis of the interview data: wellbeing at work, relationships, and communication. These highlight areas which may be contributing to workplace stress. Suggestions are made for practical changes which could improve areas of difficulty. Such changes could improve staff wellbeing and job satisfaction and reduce sickness absence

Multi-Lead Wavelet-Based ECG Delineation on a Wearable Embedded Sensor Platform

This work is dedicated to the sensible optimization and porting of a multi-lead (ML) wavelet-transform (WT)-based electrocardiogram (ECG) wave delineator to a state-of-the-art commercial wearable embedded sensor platform with limited processing and storage resources. The original offline algorithm was recently proposed and validated in the literature, as an extension of an earlier well-established single-lead (SL) WT-based ECG delineator. Several ML ECG delineation approaches, including SL selection according to various criteria and lead combination into a single root-mean-squared (RMS) curve, are carefully optimized for real-time operation on a state-of-the-art commercial wearable embedded sensor platform. Furthermore, these ML ECG delineation approaches are contrasted in terms of their delineation accuracy, complexity and memory usage, as well as suitability for ambulatory real-time operation. Finally, the robustness and stability of the ML ECG delineation approaches are benchmarked with respect to a validated SL implementation