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Le développement professionnel infirmier (DPI) constitue une condition sine qua non d’une prestation de soins de qualité dans un contexte de vieillissement de la population qui présente des problèmes de santé complexes et d’intensification des soins à domicile (SAD). Des infirmières décrient cependant une inquiétude grandissante quant aux barrières susceptibles de freiner leur DPI ainsi que l’intégration de leurs apprentissages à la pratique. Parmi ces barrières se trouvent notamment une difficulté d’accès à des activités de DPI pertinentes, des contraintes de ressources pour participer aux activités de DPI, un équilibre difficile entre la vie personnelle et professionnelle ainsi qu’un climat organisationnel rigide. Pour relever ces barrières et répondre aux défis de la complexité des soins et des environnements évoluant rapidement, la nécessité d’utiliser des stratégies intégrant l’apprentissage au travail afin de soutenir le développement professionnel des infirmières s’impose. À cet égard, des stratégies d’enseignement-apprentissage actives comme la simulation clinique, des clubs de lecture et des groupes de codéveloppement ont fait l’objet d’études dans un contexte de DPI et d’autres, comme l’apprentissage collaboratif (AC), beaucoup moins. Pourtant, l’AC permettrait de réduire certaines barrières au DPI en tenant compte des caractéristiques contextuelles et individuelles des apprenants. Cette recherche collaborative vise à explorer comment l’AC contribue au DPI d’infirmières de SAD auprès d’aînés présentant des problèmes de santé complexes en répondant à deux questions de recherche qui visent à identifier : (1) les éléments contextuels qui influencent la participation d’infirmières de SAD à des groupes d'AC ainsi que (2) les caractéristiques de l’AC qui contribuent à la réalisation d’apprentissages chez ces mêmes infirmières de SAD. Les résultats témoignent que (1) le rapport au temps, (2) le soutien du gestionnaire ainsi que (3) l’accompagnement des groupes d’AC sont des éléments contextuels qui influencent la participation d’infirmières de SAD à un groupe d’AC ainsi que le processus d’AC qui se veut évolutif, itératif et réflexif. Cette étude a aussi permis d’identifier cinq caractéristiques de l’AC qui contribuent à la réalisation d’apprentissages. L’AC : (1) exige une motivation à apprendre pour améliorer la qualité des soins; (2) conduit à une réflexion sur sa pratique professionnelle pour mieux la comprendre; (3) crée un espace de partage valorisant le développement de relations égalitaires empreintes de respect et d’écoute; (4) oriente vers une recherche collective de solutions pragmatiques aux problèmes rencontrés dans la pratique et (5) suscite un sentiment de réalisation et d’accomplissement de soi. Bien que cette recherche collaborative soit parmi les premières du genre à être réalisée en SAD au Québec, le futur du DPI devrait consister à créer des environnements d’AC en milieu clinique. Pour ce faire, un changement de culture doit s’opérer profondément pour embrasser une perspective plus holistique et scientifique du DPI qui valorise sa pertinence et sa signifiance, notamment par l’AC. / Nursing professional development (NPD) is a sine qua non condition for quality care in a context of aging population with complex health problems and increasing home care (HC). However, nurses describe a growing concern about the barriers that may impede their NPD and the integration of their learning into practice. These barriers include difficulty accessing relevant NPD activities, resource constraints to participate in NPD activities, difficult work-life balance, and inflexible organizational climate. To address these barriers and meet the challenges of complex care and rapidly changing environments, there is a need to use strategies that integrate learning at work to support nurses' professional development. In this regard, active teaching-learning strategies such as clinical simulation, journal clubs and co-development groups have been studied in a NPD context and others, such as collaborative learning (CL), much less so. However, CL could reduce some of the barriers to NPD by considering the contextual and individual characteristics of learners. This collaborative research aims to explore how CL contributes to the NPD of HC nurses working with seniors with complex health problems by answering two research questions that aim to identify: (1) the contextual elements that influence the participation of HC nurses in CL groups as well as (2) the characteristics of CL that contribute to the achievement of learning in these same HC nurses. The results show that (1) the relationship to time, (2) the manager's support and (3) the support provided for CL groups are contextual elements that influence the participation of HC nurses in a CL group as well as the evolutionary, iterative and reflective CL process. This study also identified five characteristics of CL that contribute to learning. CL: (1) requires motivation to learn in order to improve the quality of care; (2) leads to reflection on one's professional practice in order to better understand it; (3) creates a space for sharing that values the development of egalitarian relationships marked by respect and listening; (4) leads to a collective search for pragmatic solutions to the problems encountered in practice; and (5) creates a sense of accomplishment and self-fulfillment. While this collaborative research is among the first of its kind to be conducted in HC in Quebec, the future of NPD should be in creating CL environments in clinical settings. To do so, a profound cultural shift must occur to embrace a more holistic and scientific perspective of NPD that values its relevance and meaning, particularly through CL.

[pt] A interação social é fator fundamental para o desenvolvimento do ser humano, a partir do uso de instrumentos e de signos, sendo o processo de comunicação essencial para esse desenvolvimento. Compreendemos que a comunicação se desenvolve ao longo da vida do sujeito e é estruturada como um complexo processo de aquisição da linguagem, tendo esta uma dupla função comunicativa, a primeira como um meio de comunicação e a segunda como um processo de compreensão e representação do pensamento. Nos casos de comprometimentos severos ou déficits na comunicação, ao menos um dos envolvidos acaba sendo prejudicado. Nestes casos a utilização de comunicação alternativa vem contribuindo com subsídios para complementar, suplementar ou construir esse processo de comunicação. Sendo assim, o objetivo geral desta tese foi desenvolver um sistema de comunicação alternativa de forma colaborativa, junto às famílias de crianças com deficiência múltipla em decorrência da Síndrome Congênita do Zika Vírus (SCZV) não oralizadas com foco em atividades que estimulem o desenvolvimento da capacidade de comunicação. Esse trabalho está vinculado aos estudos realizados no Grupo de Pesquisa Educação e Mídia, Grupem, no Programa de Pós-Graduação em Educação da Pontifícia Universidade Católica do Rio de Janeiro (PUC-Rio), com o Projeto “Estudo longitudinal de intervenção e acompanhamento do desenvolvimento da habilidade de comunicação de crianças com Síndrome Congênita do Zika Vírus”, que é um subprojeto do Projeto Pesquisas e ações intersetoriais entre educação e saúde na promoção da escolarização e do desenvolvimento de crianças com Síndrome Congênita do Zika Vírus na Baixada Fluminense. A pesquisa foi realizada na região da Baixada Fluminense, RJ, com seis famílias de crianças que nasceram com a Síndrome Congênita do Zika Vírus (SCZV). Realizamos uma pesquisa qualitativa, baseada nos pressupostos metodológicos da pesquisa colaborativa. Através desta metodologia, construímos, em conjunto com as famílias das crianças participantes, alternativas para as dificuldades de comunicação apresentadas por elas, assim como para o desenvolvimento do App Comunika, um protocolo digital voltado ao desenvolvimento da capacidade de comunicação e de interação social de crianças com SCZV. O trabalho de campo foi desenvolvido em dois momentos. No primeiro realizamos visitas às casas das famílias participantes da pesquisa para realização de entrevista e aplicação de questionário socioeconômico e do Participation and Environment-Children and Youth (PEM-CY), instrumento de avaliação da capacidade de participação das crianças na família, na escola e na comunidade. No segundo momento as famílias participaram de reuniões no Instituto Multidisciplinar (IM), campus da Universidade Federal Rural do Rio de Janeiro (UFRRJ), onde iniciamos o desenvolvimento do App Comunika. Realizamos a produção de dados utilizando a observação (com registro em diário de campo), entrevistas semiestruturadas, questionário socioeconômico e o documento PEM-CY. Como referencial teórico, empregamos a teoria histórico-cultural de Vigotski, tomando seus conceitos como aportes para a compreensão das especificidades do desenvolvimento das crianças participantes e para a criação das atividades que integraram o App. A partir os dados produzidos, elaboramos as atividades que o constituem. Foram criadas 100 atividades para trabalhar a comunicação e ampliar a participação dessas crianças com base nas expectativas e necessidades apresentadas pelas famílias. De toda essa investigação emergiram como principais resultados: compreender as possibilidades advindas dos recursos de tecnologias assistivas (TA) e comunicação alternativa (CA) e abordá-las como instrumentos para a compensação de limitações em benefício dos processos de participação e comunicação das crianças com deficiência múltipla não oralizadas em decorrência da SCZV; a importância do trabalho em colaboração com as famílias para a elaboração do App, assim como da mediação na relação com o contexto, mediatizados por instrumentos, signos e símbolos desenvolvidos culturalmente; o (re) conhecimento das famílias das capacidades e diversidades de comunicação das crianças para possíveis aprendizagens futuras, assim como o quanto consideram o recurso de comunicação alternativa como uma possibilidade para trabalhar o desenvolvimento e ampliação da comunicação com seus filhos em suas casas e, posteriormente fomentando sua participação em outros contextos e com outros interlocutores; o desenvolvimento e a disponibilização do App Comunika como um recurso disponível gratuitamente na web para celular, smartphone e tablete com sistema operacional Android. / [en] Social interaction is a key factor for human development, from the use of instruments and signs, with the communication process being fundamental to this development. We understand that communication develops throughout the life of the subject, and is structured as a complex process of language acquisition, which has a dual communicative function, the first as being a means of communication and the second, as a process of understanding and representing thought. In cases of severe impairment or communication deficits, at least one of those functions end up being harmed. In these cases, the use of alternative communication has contributed with subsidies to complement, supplement or build this communication process. Therefore, the general objective of this thesis was to develop an alternative communication system in a collaborative way, together with the families of non-oralized children with multiple disabilities due to Congenital Zika Virus Syndrome (SCVZ), with focus on activities that encourage the development of communication skills. This research is linked to studies carried out in the Education and Media Research Group (Grupem), in the Graduate Program in Education at the Pontifical Catholic University of Rio de Janeiro (PUC - Rio), with the project Longitudinal study of intervention and monitoring of the development of communication skills in children with Congenital Zika Virus Syndrome, which is a subject of the project Research and intersectoral action between education and health in promoting schooling schooling and development of children with congenital zika virus syndrome at Baixada Fluminense. The research was carried out in Baixada Fluminense, RJ, with six families of children who were born with Congenital Zika Virus Syndrome (SCVZ). We carried out qualitative research, based on the methodological assumptions of collaborative research. Through this methodology, we built, with the help of the families of the participating children, alternatives for the communication difficulties presented by them, as well as the development of the app Comunika, a digital protocol aimed at developing communication skills and social interaction in children with SCVZ. The field work was carried out in two moments. On the first one, we carried out visits to the homes of the families participating in the research to carry out an interview and apply a socioeconomic questionnaire and the Participation and Environment- Children and Youth (PEM-CY), an instrument for evaluating the children s ability to participate in the family and in the community. On a second moment, the families participated in a meeting at the Multidisciplinary Institute (IM), campus of the Federal Rural University of Rio de Janeiro (UFRRJ), where we started the development of the Comunika app. We produced data using observation (with a field diary) semi-structured interviews, a socioeconomic questionnaire and the PEM-CY document. As a theoretical framework, we used Vigotski s cultural-historical theory, taking his concepts as contributions to understanding the specificities of the participating children s development, and creating the activities that integrated the app. Based on the produced data, we developed activities that made constitute it. 100 activities were created to work on communication and expand the participation of these children based on expectations and needs presented by the families. The main results emerged from all this research: understanding the possibilities arising from TA and CA resources and approaching them as instruments for compensating limitations in favor of the participation and communication processes of children with multiple non-oralised due to SCVZ; the importance of working in collaboration with families for the development of the app, as well as the meditation in the relationship with the context, mediated by culturally developed instruments, signs and symbols; the knowledge of families of children s communication skills and diversity for possible future learning, as well as how much they consider the alternative communication resource as a possibility to work on the development and expansion of communication with their children at home and, subsequently, encouraging their participation in other contexts and with other interlocutors; the development and availability of the Comunika app as a resource available free of charge on the web for cell phones, smartphones and tablets with operating Android system.

We conducted the study to explore and define the role of the social worker in Primary Health Care. The medical care model on its own is viewed as inappropriate for developing countries. We see Primary Health Care as holding the key to improving the health status of the many disadvantaged communities in South Africa. The Primary Health Care approach demands those health care providers, including social workers work collaboratively to provide the best possible services to the communities. Social Work is a profession concerned with the disadvantaged. However, social workers are assigned a very limited role in Primary Health Care. Since participants are concerned about subjective and experiential realities, participatory research was the appropriate research method. The major findings and conclusions were that, social workers have a role in Primary Health Care. They have to be assertive and tell others what is it that they do to find a place in Primary Health Care / Social Work / M.A. (Social Science (Mental Health))

The research project upon which this dissertation is based focused on enhancing understandings of the nature of current First Nations/non-Aboriginal relations in environmental management. The project was undertaken as a collaborative initiative by the author, a non-Aboriginal doctoral researcher, in partnership with Walpole Island First Nation. The research served as an opportunity for co-producing knowledge on this subject across cultures and worldviews, and as an effort to build towards our shared aspiration of learning how distinct, yet inextricably linked, First Nations/non-Aboriginal understandings, approaches and worldviews can come together within a context of mutual respect and mutual benefit. The purpose of the research was to investigate the existence and types of issues leading to First Nations/non-Aboriginal tensions in environmental management, to analyze and unpack underlying causes of challenges identified via the research, and to construct avenues for relationship improvement. The research project was grounded in a specific investigation into relations in species at risk conservation and recovery in southern Ontario, Canada. The resulting dissertation is structured around three primary focal areas: 1) investigating and exposing colonial influences at play in Canada’s Species at Risk Act, and offering a new model for co-governance in this arena and beyond; 2) investigating relations surrounding efforts towards traditional ecological knowledge (TEK) transfer in species at risk work, with a focus on exploring issues identified in relation to intellectual imperialism; and 3) introducing and characterizing an original, reconceptualized approach to First Nations/non-Aboriginal relationships in academic research; this approach focused on ways in which investigatory practice can become a means of working towards broader reconciliation goals. Research findings from this dissertation indicate that colonial factors, often unevenly visible to actors involved in environmental management and research, continue to strongly affect the potential for positive, productive First Nations/non-Aboriginal relations in these spheres - including within the species at risk conservation and recovery arena examined here. Project results provide insight into the nature of the factors influencing relationships, as well as potential avenues for addressing the vitality of colonialism in contemporary relations and overcoming the influences on First Nations and on First Nations/non-Aboriginal relationships.

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La vie de famille avec un adolescent comporte son lot de défis. Les émotions de l’adolescent qui se présentent parfois comme des montagnes russes peuvent rendre les relations tendues et difficiles au sein de la cellule familiale, voire même au-delà de celle-ci. Par son caractère inattendu, l’avènement d’un traumatisme craniocérébral (TCC) chez l’adolescent vient fragiliser encore davantage la dynamique familiale. En outre, la myriade d’impacts engendrés par le TCC contraint la famille à modifier son projet de vie en s’investissant ensemble pour le reconstruire. La résilience devant une situation de traumatisme ne se manifeste pas de la même façon pour toutes les familles qui y sont confrontées. Certaines d’entre elles réussissent à se transformer positivement, tandis que d’autres n’y parviennent pas ou manifestent plus de difficultés. Il convient alors d’actualiser des approches de soins interdisciplinaires centrées sur la famille qui favoriseraient la reconnaissance des éléments pouvant soutenir son processus de résilience à travers cette épreuve et, enfin, aider à transformer son projet de vie. Avec comme perspective disciplinaire le modèle humaniste des soins infirmiers (Cara, 2012; Cara & Girard, 2013; Girard & Cara, 2011), cette étude qualitative et inductive (LoBiondo-Wood, Haber, Cameron, & Singh, 2009), soutenue par une approche collaborative de recherche (Desgagné, 1997), a permis la coconstruction des composantes d’un programme d’intervention en soutien à la résilience familiale, avec des familles dont un adolescent est atteint d’un TCC modéré ou sévère et des professionnels de la réadaptation. Le modèle de développement et de validation d’interventions complexes (Van Meijel, Gamel, Van Swieten-Duijfjes, & Grypdonck, 2004) a structuré la collecte des données en trois volets. Le premier volet consistait à identifier les composantes du programme d’intervention selon les familles (n=6) et les professionnels de la réadaptation (n=5). La priorisation et la validation des composantes du programme d’intervention, soit respectivement le deuxième et troisième volets, se sont réalisées auprès de ces mêmes familles (n=6 au volet 2 et n=4 au volet 3) et professionnels de la réadaptation (n=5 aux volets 2 et 3). Le processus d’analyse des données (Miles & Huberman, 2003) a repéré cinq thèmes intégrateurs, considérés comme les composantes du programme d’intervention en soutien à la résilience familiale à la suite du TCC modéré ou sévère d’un adolescent. Ce sont : 1) les caractéristiques de la famille et ses influences; 2) les stratégies familiales positives; 3) le soutien familial et social; 4) la prise en charge de l’aspect occupationnel et; 5) l’apport de la communauté et des professionnels de la santé. Les résultats issus de ce processus de coconstruction ont produit une matrice solide, suffisamment flexible pour pouvoir s’adapter aux différents contextes dans lesquels évoluent les familles et les professionnels de la réadaptation. Cette étude offre en outre des avenues intéressantes tant pour les praticiens que pour les gestionnaires et les chercheurs en sciences infirmières et dans d’autres disciplines quant à la mise en place de stratégies concrètes visant à soutenir le processus de résilience des familles dans des situations particulièrement difficiles de leur vie. / Family life with an adolescent has its share of challenges. The adolescent’s emotional rollercoasters can make relationships tense and difficult within the family unit, and even outside of it. By virtue of its unexpected character, the occurrence of traumatic brain injury (TBI) in an adolescent can undermine the family dynamics even further. Additionally, the myriad of impacts caused by a TBI forces the family to alter its plans for the future by committing themselves together to rebuild them. Resilience to trauma does not manifest itself in the same way for all families. Some manage to effect positive changes, while others are unable to do so, or experience more difficulties. In light of this, it appears relevant to develop family-centred care approaches fostering the recognition of elements that can support the family’s resilience process through hardships and, ultimately, help reconstruct its plans for the future. Using the humanist model of nursing care (Cara, 2012; Cara & Girard, 2013; Girard & Cara, 2011) as a disciplinary perspective, this qualitative and inductive study (LoBiondo-Wood, Haber, Cameron, & Singh, 2009), supported by a collaborative research approach (Desgagné, 1997), led to the co-construction of the building blocks for an intervention program to support family resilience in conjunction with families with an adolescent suffering from moderate or severe TBI and rehabilitation professionals. The complex intervention design and validation model (Van Meijel, Gamel, Van Swieten-Duijfjes, & Grypdonck, 2004) inspired a three-stage data collection process. The first stage consisted in identifying the building blocks of the intervention program in the eyes of families (n=6) and rehabilitation professionals (n=5). The prioritization and validation of these building blocks, respectively the second and third stages, were conducted with the same families (n=6 for stage 2 and n=4 for stage 3) and rehabilitation professionals (n=5 for stages 2 and 3). The data analysis process (Miles & Huberman, 2003) identified five encompassing themes, considered to be the building blocks of an intervention program to support family resilience following moderate to severe TBI in adolescents. They are: 1) family characteristics and its influences; 2) positive family strategies; 3) family and social support; 4) management of occupational aspects; 5) contribution of the community and health professionals. The results of this co-construction process established a strong matrix that is flexible enough to adapt to the various contexts in which families and rehabilitation professionals live and work. This study also offers promising avenues for practitioners, administrators and researchers in nursing and other fields with respect to the implementation of concrete strategies to support the resilience process of families facing particularly difficult times in their lives.

Der Beitrag "Voraussetzungen und Grenzen einer eigenschaftsmodellbasierten Korrektur St. Bäumler, C. Brecher, M. Wennemer; RWTH Aachen, Lehrstuhl für Werkzeugmaschinen" ist in dieser Version nicht enthalten, bitte nutzen Sie die Version unter oben angegebenen Link (Nachfolger). / Im Mittelpunkt der 2. Tagung des Sonderforschungsbereichs Transregio 96 „Thermo-energetische Gestaltung von Werkzeugmaschinen standen erste Ergebnisse zur Modellierung und Simulation von Komponenten und Baugruppen von Werkzeugmaschinen im Mittelpunkt. An den drei Standorten Aachen, Chemnitz und Dresden werden unterschiedliche Lösungsansätze für die steuerungsintegrierte Korrektur thermischer bedingter Strukturverformungen in spanenden Werkzeugmaschinen verfolgt. Von diesen wird eine unterschiedliche Wirksamkeit bzw. Eignung für verschiedene Einsatzfälle erwartet. Bevor diese in der Praxis umgesetzt werden können, müssen Fragen zur Beschreibung der Wärmequellen und zur Wärmeübertragung beantwortet werden. Außerdem bedarf die Umsetzung der Konzepte in den CNC-Steuerungen effizienter Verfahren zur Modellierung und Simulation der thermisch bedingten Strukturverformung. Für die Entwicklung und Bewertung der Korrekturverfahren sowie zur Berechnung der notwendigen Achs-Korrekturen ist die Systemsimulation u. a. an einem prozessaktuelle Werkzeugmaschinenabbild erforderlich. Für die Bewertung ihrer Praxisrelevanz werden die Einzellösungen nach und nach in ein betriebswirtschaftlich orientiertes Gesamtmodell integriert.

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