Search

AimsTo test whether usual outpatient cardiac rehabilitation (CR) supplemented by a cognitive-behavioural therapy (CBT) intervention may reduce anxiety and depression compared with usual CR.Methods and resultsIn this multicentre randomized controlled trial, 147 cardiac patients (67% men, mean age 54 years, 92% with coronary artery disease) with psychological distress defined as a hospital anxiety and depression scale (HADS) anxiety or depression score ≥8 were randomized to five sessions of group CBT plus usual CR (intervention, n = 74) or CR alone (control, n = 73). Patients with severe distress or a psychiatric diagnosis were excluded. The intervention was delivered by cardiac nurses with CBT training and supervised by a psychologist. A reference, non-randomized group (background, n = 41) of consecutive patients without psychological distress receiving usual CR was included to explore the effect of time on HADS score. The primary outcome, total HADS score after 3 months, improved more in the intervention than in the control group [the mean total HADS score improved by 8.0 (standard deviation 5.6) vs. 4.1 (standard deviation 7.8), P < 0.001]. Significant between-group differences were maintained after 6 months. Compared with the control group, the intervention group also had greater adherence to CR (P = 0.003), more improvement in the heart-related quality of life (HeartQoL) at 6 months (P < 0.01), and a significant reduction in cardiac readmissions at 12 months (P < 0.01). The background group had no significant change in HADS score over time.ConclusionBrief CBT provided by cardiac nurses in relation to CR reduced anxiety and depression scores, improved HeartQoL and adherence to CR, and reduced cardiovascular readmissions. The programme is simple and may be implemented by CR nurses.

International audience; How can we understand multivocality in the changing world of education? In this keynote, I will present different visions of the term ‘multivocality’ as it is understood by diverse academic disciplines, and how it can be understood to have impact on society. Each of these visions produces different challenges. I will offer suggestions about what we can do now as educators, researchers, and policy makers in education to meet those challenges and pinpoint where we need more research.

International audience; Language and multimodal human interaction in context are central in modeling knowledge co-elaboration. Cognitive, linguistic, social, and emotional aspects are closely imbricated within such interaction, and analyses can target individual, small group, organizational, or cultural level phenomena. Given that many research questions in this area lead to crossing boundaries, I argue for both an interdisciplinary and a complex systems approach in constructing a new descriptive model entitled the MULTi-theoretical and Interdisciplinary model of the GRoup And Individual (MULTi-GRAIN). This model allows for the study of different types of unidirectional and bi-directional causality and is meant as a guide for setting up empirical work where emergence is studied in systems of different orders.

Background: Adolescence is a critical period within the life course, for developing adult occupational competencies and health behaviours. Few studies have considered how 16–17 year olds choose activities and behaviours from an occupational perspective. Aim and objectives: To explore how adolescents aged 16–17 years old make choices about their daily occupations to inform a theoretical model of occupational choice. Materials and methods: About 27 secondary school students aged 16–17 years attended one of six focus groups. Transcripts were analyzed using constructivist grounded theory, informing the iterative development of a theoretical model of occupational choice. Results: Adolescent occupational choice occurred in response to experiencing needs, and was characterized by ‘weighing up’ and ‘juggling’ the following four key domains: ‘Appraising values and priorities’, ‘Interacting with the situational context’, ‘Exploring skills and occupational repertoire’ and ‘Considering time factors’. A developing sense of responsibility and autonomy for occupational choices was described, leading to the development of the future occupational self. Conclusions and significance: A theory illuminating how adolescents make choices was developed. The theory aligns with existing developmental literature and provides unique insights, from an occupational science perspective, on the conscious process by which adolescents make, develop and adapt choices about the occupations they do considering contextual and individual opportunities and constraints.

International audience

Known as the "king of fishes," the Atlantic salmon (Salmo salar, Salmonidae) is an iconic freshwater species whose contribution to human well-being has long been recognized, as have widespread declines in its abundance, partly due to river regulation. To understand how salmon conservation has been addressed within the ecosystem services (ES) framework, we synthesized the peer-reviewed literature on ES provided by salmon in regulated rivers. We developed a search string to capture allusions to provisioning, regulating, supporting and cultural ES and assessed the results to identify knowledge gaps. The effects of hydropower on fisheries catches and on modelled populations were shown in several publications. Overall, few studies focused explicitly on ES from salmon and hydropower; this is surprising given the considerable body of literature on salmon in regulated rivers. Wild salmon as a food source and other provisioning services are less important today than historically. Because predators such as salmon are important for facilitating biodiversity by cycling nutrients and controlling food webs, there is a scope of work for future assessments of these regulating and supporting services. Few papers explicitly addressed cultural ES, despite the salmon's longstanding iconic status; this is a knowledge gap for future ES assessments in relation to hydropower. The influence of ES assessments for policy makers is growing through the Intergovernmental Panel for Biodiversity and Ecosystem Services (IPBES) and the post-2020 biodiversity strategy. Explicitly addressing ES poses an opportunity for river managers to raise awareness of aquatic conservation efforts and well-informed decision-making for sustaining ES.

Introduction: Balancing Everyday Life (BEL) is a new lifestyle intervention for mental health services users, developed to support meaningful engagement in daily activities and a balanced lifestyle. This study aimed at exploring the BEL participants’ process of making lifestyle changes. Methods: This constructivist grounded theory study took place in Sweden from 2013–2017 and explored the processes of 19 BEL participants when making lifestyle changes. Data were collected through 29 interviews. Results: A process of breaking a cycle of perceived failure and making changes toward a more balanced lifestyle was constructed, consisting of five categories: Going at it gently: change is an on-going process; Support for progress, permission to fail; Prioritising and setting boundaries; Adjusting for a sustainable balance; and Caring for a valued self. Each category included a strategy for change as well as a related inner change. Strategies involved learning and trying techniques for making changes toward a more balanced lifestyle, whereas the personal changes often involved a more self-compassionate approach and allowing oneself to utilise these techniques. Conclusion: The results contribute to knowledge in the process of making lifestyle changes, specifically, how strategies for change and inner changes interact and can support personal recovery toward mental health. This knowledge could help to support clients in making personally meaningful changes toward a more balanced lifestyle as well as inform future research in the process of making change. (Less)

Collaborations are essential in research, especially in answering increasingly complex questions that require integrating knowledge from different disciplines and that engage multiple stakeholders. Fostering such collaboration between newcomers and established researchers helps keep scientific communities alive while opening the way to innovation. But this is a challenge for scientific communities, especially as little is known about the onset of such collaborations. Prior social network research suggests that face-to-face interaction at scientific events as well as both network-driven selection patterns (reciprocity and transitivity) and patterns of active selection of specific others (homophily / heterophily) may be important. Learning science research implies, moreover, that selecting appropriate collaboration partners may require group awareness. In a field study at two scientific events on technology-enhanced learning (Alpine Rendez-Vous 2011 and 2013) including N = 5736 relations between 287 researchers, we investigated how researchers selected future collaboration partners, looking specifically at the role of career level, disciplinary background, and selection patterns. Face-to-face contact was measured using RFID devices. Additionally, a group awareness intervention was experimentally varied. Data was analyzed using RSiena and meta-analyses. The results showed that transitivity, reciprocity and contact duration are relevant for the identification of new potential collaboration partners. PhD students were less often chosen as new potential collaboration partners, and researchers with a background in Information Technology selected fewer new potential collaboration partners. However, group awareness support balanced this disciplinary difference. Theoretical, methodological, and practical implications of these findings are discussed.

International audience; When producing an explanation, the speakers are confronted with a task involving two main objectives: 1- the referential construction inherent in the object of the explanation and 2- the management of the interaction and interlocutors. The objective of this study is to see how a procedural explanation with an interactional issue is managed by the child and from when he begins to master both referential and pragmatic constraints of spoken language production. To do this, explanations of children aged 9 to 13 years were collected and analyzed. The results show that age has an impact on children’s informational and gestural choices, that children rely on the gestural modality of language and differently according to age, and that, as they age, they improve the way they manage interactional constraints; Lors de la production d’une explication, les locuteurs sont confrontés à une tâche impliquant deux principaux objectifs : 1- la construction référentielle inhérente à l’objet de l’explication et 2- la gestion de l’interaction et des interlocuteurs. L’objectif de cette étude est ainsi de voir comment une explication procédurale à enjeu interactionnel est gérée par l’enfant et à partir de quand il commence à maîtriser à la fois les contraintes référentielles et pragmatiques de la production langagière. Pour ce faire, des explications d’enfants âgés de 9 à 13 ans ont été collectées et analysées. Les résultats montrent que l’âge a un impact sur les choix informationnels et gestuels des enfants, que les enfants s’appuient sur la modalité gestuelle du langage et différemment selon l’âge et enfin qu’en grandissant ils améliorent la gestion des contraintes interactionnelles.