Vécu des situations à risque d’erreur en réanimation : une étude qualitative auprès des médecins et infirmiers

Intensive care units are considered as services with a high risk of error. More and more studies have measured the incidence and impact of errors in intensive care units, but few of them are centered on the impact of the risk of error for professionals. This study focuses on the perception of the risk of error, how it is experienced, and the way in which professionals cope with it. Forty professionals (20 physicians, 20 nurses) participated in clinical interviews. We transcribed recordings and analysed the data using a phenomenological approach. The risk of error is omnipresent in intensive care units. For nurses with less than one years experience, the risk of error is associated with important manifestations of anxiety. On the contrary, for doctors and nurses who have worked for more than one year in ICU, their experience and the relationship of cooperation built with colleagues gives them a feeling of control over risky situations. Our results show that it is important to take into account the risk of error in order to better target the support and training for the ICU professionals.     

Closed-loop bird–computer interactions: a new method to study the role of bird calls

In the field of songbird research, many studies have shown the role of male songs in territorial defense and courtship. Calling, another important acoustic communication signal, has received much less attention, however, because calls are assumed to contain less information about the emitter than songs do. Birdcall repertoire is diverse, and the role of calls has been found to be significant in the area of social interaction, for example, in pair, family, and group cohesion. However, standard methods for studying calls do not allow precise and systematic study of their role in communication. We propose herein a new method to study bird vocal interaction. A closed-loop computer system interacts with canaries, Serinus canaria, by (1) automatically classifying two basic types of canary vocalization, single versus repeated calls, as they are produced by the subject, and (2) responding with a preprogrammed call type recorded from another bird. This computerized animal–machine interaction requires no human interference. We show first that the birds do engage in sustained interactions with the system, by studying the rate of single and repeated calls for various programmed protocols. We then show that female canaries differentially use single and repeated calls. First, they produce significantly more single than repeated calls, and second, the rate of single calls is associated with the context in which they interact, whereas repeated calls are context independent. This experiment is the first illustration of how closed-loop bird–computer interaction can be used productively to study social relationships.     

Frequency-shift detectors bind binaural as well as monaural frequency representations

Previous psychophysical work provided evidence for the existence of automatic frequency-shift detectors (FSDs) that establish perceptual links between successive sounds. In this study, we investigated the characteristics of the FSDs with respect to the binaural system. Listeners were presented with sound sequences consisting of a chord of pure tones followed by a single test tone. Two tasks were performed. In the "present/absent" task, the test tone was either identical to one of the chord components or positioned halfway in frequency between two components, and listeners had to discriminate between these two possibilities. In the "up/down" task, the test tone was slightly different in frequency from one of the chord components and listeners had to identify the direction (up or down) of the corresponding shift. When the test tone was a pure tone presented monaurally, either to the same ear as the chord or to the opposite ear, listeners performed the up/down task better than the present/absent task. This paradoxical advantage for directional frequency shifts, providing evidence for FSDs, persisted when the test tone was replaced by a dichotic stimulus consisting of noise but evoking a pitch sensation as a consequence of binaural processing. Performance in the up/down task was similar for the dichotic stimulus and for a monaural narrow-band noise matched in pitch salience to it. Our results indicate that the FSDs are insensitive to sound localization mechanisms and operate on central frequency representations, at or above the level of convergence of the monaural auditory pathways.     

Does group identification facilitate or prevent collective guilt about past misdeeds? Resolving the paradox

The influence of group identification on collective guilt and attitudes towards reparation was examined in the context of the Belgian colonization of Congo. People should experience collective emotions to the extent that being a member of the relevant group is part of their self-concept. Yet, the acknowledgement of ingroup responsibility for past misdeeds is particularly threatening for high identifiers and may lead to defensive reactions aimed at avoiding guilt. We therefore predicted, and found, a curvilinear effect of identification on collective guilt. Attitudes towards reparation of past wrongdoings were also assessed and yielded a linear trend: identification predicted less favourable attitudes towards reparation but this effect was marginally stronger as identification increased.     

Comparative interinstrument reliability of uniaxial and triaxial accelerometers in free-living conditions

The aim of this study was to measure the inter-instrument reliability of the ActiGraph and RT3 accelerometers in free-living conditions. 15 healthy adults wore eight ActiGraph accelerometers and five RT3 accelerometers fastened to their back with an elastic belt and adjustable buckle in free-living conditions. For both accelerometers, the inter-instrument coefficient of variation (CV) decreased with increasing physical activity intensity. The inter-instrument CV of the ActiGraph (3% to 10.5%) was significantly lower than that of the RT3 (12.6% to 35.5%; p < 0.05). This finding demonstrates that the ActiGraph has higher inter-instrument reliability than the RT3. For both accelerometers, the inter-instrument reliability was higher for moderate and vigorous physical activity, the two intensities recommended for public health purposes. Studies using these devices can be compared with a low risk of misclassification of participants who meet the recommendation to perform moderate to vigorous physical activity.     

Les modèles de changements de comportements dans le domaine de la santé

Chronic diseases require both a medical treatment that a patient adherence to health recommendations. These include changes in lifestyle to adopt healthy behaviors. However, these changes are hardly adopted by patients. This article provides a review of theoretical models to explain resistance to change or factors motivating new behaviors. After presenting the steps by which a person gets through when changing an aspect of her lifestyle, we will discuss the factors involved in motivational and volitional phases of change. Thus, in the motivational phase, we will refer to classic sociocognitive models, illness representations model and the self-determination model. In the volitional phase, we discuss concepts related to action monitoring and action planning, self-control, and the anticipation of barriers to help maintain the action in time.     

L’impact du stress professionnel sur les intervenants SMUR

The aim of this work is to identify the situations of stress experienced by SAMU staff and to study the extent to which they can have an impact on burnout and the level of psychological distress observed in this population. Our sample consists of a group of 69 SAMU staff and a control group of 50 professionals working in hospital services. All subjects provided sociodemographic data and completed three clinical scales – the Job Stress Survey (JSS), the Maslach Burnout Inventory (MBI) and the General Health Questionnaire (GHQ-12) – and the clinical interview. This study shows that SAMU staff have low levels of professional stress, burnout and psychological distress per report with the personnel of the services of hepato-gastroenterology, endocrinology and digestive surgery. We discuss these results by examining the ability of the SAMU staff to manage situations of stress.     

Too fatigued to care: Ego depletion,guilt, and prosocial behavior

Although guilt feels bad to the individual, it is good for society because guilty feelings can prompt people to perform good deeds. This study tests whether fatigue decreases guilty feelings and subsequent prosocial behavior. Participants were randomly assigned to a depletion condition in which they watched a movie about butchering animals for their meat or skin and were told to express no emotions, or to a no-depletion condition in which they watched the same movie, but could express their emotions. Having participants play a game in which another person was punished for their errors induced guilt. Finally, participants played a dictator game in which they could leave money for the next participant. After the experiment, participants could also anonymously donate money to an anti-AIDS charity. The results showed that depleted participants felt less guilty than did non-depleted participants, and the less guilty participants felt the less helpful they were.