NCube/papyrus huggingface dataset:
Les enjeux identitaires de l’humain dans le débat philosophique sur la robotique humanoïde et l’amélioration humaine

Do human identity representations (human identity, natural/artificial distinction) still make sense in the context of the development of humanoid robotics (humanizing the robot) and human enhancement (automation of the human)? The problem is that critical philosophers, like Lin and Allhoff who founded the journal NanoEthics, challenge these representations of human identity, as if the discussion of the ethical evaluation of these representations was exhausted with regards to the two issues that they raise in 2009 in Ethics of Human Enhancement: 25 Questions and Answers, i.e.: “Does the notion of human dignity suffer with human enhancements?” and “Is the natural-artificial distinction morally significant in this debate?” The purpose of this article is to show – in light of various texts that constitute our framework for analyzing moral arguments – the limits of the scope and insufficiency of the critical arguments that Lin and Allhoff use to answer these two questions. But in applying our framework to these authors, we will also show how the question of human identity or the natural/artificial distinction still makes sense in the ethical evaluation.

Keyphrases: robot humanization, human enhancement, ethical evaluation, human identity, natural/artificial distinction
Perspectives des libérés conditionnels présentant une double problématique de délinquance et de consommation d'alcool et/ou de drogues

In order to produce the present report, the author completed an internship at Ville Marie Area Parole Office as a Parole Officer. She desired to better understand and analyze the relationship that may exist between drugs and delinquency but from the point of view of the parolees. To do this, six offenders were interviewed in order for them to share their life stories.  It seemed natural to begin this report by first exploring the world of drug use, including contextual and motivational factors that influence and individual to begin using drugs. As well, different associated behaviours were studied such as the frequency and intensity of use, as well as administration routes. Subsequently, the participants were asked to explain, in their eyes, the relationship that exists between their substance abuse and delinquency. Do the different explicative models in the scientific literature correlate with their reality? Lastly, the six participants explained their process of change and their current situation on parole. What are the challenges of returning to society? In parallel, the author wanted to analyze the impact of correctional programs on the process of change of the substance abusing offenders.  All in all, the group studied permitted first and foremost to confirm the complexity of the link between drugs and delinquency.

Keyphrases: Drug, Delinquency, Relationship between drug and delinquency, Motivation for change, Change process, Social reintegration, Parole
Healthy as a trout – as delicate as a dragon-fly

Rehabilitation hospitals provide a striking contrast between young, fit and largely able-bodied staff and patients who have experienced significant, often sudden, life-changing events. Bridging the gap between these worlds is not easy, but it can also be difficult to reconcile the values that the patients held before injury or illness with those that have begun to emerge on the road to recovery. Those working in rehabilitation medicine often endorse a process model of consent because they understand that patients with fresh injuries may need time for their values to adapt to their new lives. Despite this understanding, it can be a challenge to understand how best to respect patient autonomy whilst helping those same patients to appreciate some of the limits on their abilities. Drafting the following personal narrative, drawn from my own experience as a healthcare ethicist and reluctant patient, gave me greater insight into these perplexities. This reflection explores my changing approach to my professional practice – and especially my view of patient autonomy – in light of my own experience with post-partum depression.

Keyphrases: rehabilitation, autonomy, process-model of consent, post- partum depression, ethicist
Intervention familiale visant à faciliter le processus entourant la décision de non-réanimation de leur enfant atteint d'une condition médicale complexe

Abstract: The nurse plays a key role in helping parents with the process surrounding the decision to not resuscitate their child who has a complex medical condition. Despite the fact that the physician remains traditionally responsible for taking the do-not-resuscitate decision, the nurse is in a privileged position to establish a therapeutic family-centered relationship and thus facilitate discussions leading to this difficult decision. In order to further shed light on this parenting experience, a review of the theoretical and empirical literature was conducted on this topic. A critical analysis of the literature has identified support strategies that have inspired the development of a nursing family intervention to aid in the parents’ decision-making. Using a holistic and systemic approach, the nurse is called upon to promote a trusting relationship and recognize the parental role, while respecting the family’s values to facilitate the decision process. Interventions are developed that promote communication mutually perceived as honest and clear between parents and caregivers.

Keyphrases: Parent, DNR, Child, Decision making, Resuscitation, Pediatric, Nurse
L’auto-référencement en physiothérapie : la mise de l’avant d’une culture éthique pour encadrer la pratique organisationnelle

Self-referral in physiotherapy, that is, a healthcare professional referring a patient to a private physiotherapy clinic in which the same professional has a financial interest, presents significant organizational ethical implications. This article offers potential solutions to this ethically reprehensible practice. In addition to focusing on legislative and ethical strategies, private clinics should adopt guidelines and formal activities to improve the ethical culture of their company, by involving owners, shareholders and employees.

Keyphrases: physiotherapy, rehabilitation, self-referral, ethical culture, private sector, conflicts of interest
La description de la pratique interprofessionnelle centrée sur le patient au cours de la trajectoire de soins en oncologie

The ministerial orientations drawn up by the Quebec government promote the concept of interprofessional patient-centred practice (IPPC) throughout the care trajectory to support patients who have been diagnosed with cancer. That form of practice improves communication between professionals and patients’ sense of security, as well as improving care and access to services (Health Canada, 2010). However, studies generally report professionals’ perceptions of care and services and provide information on organizational, procedural and relationship factors connected to that practice. It is necessary to document this important practice based on the perceptions of patients, family members and professionals in a real context of care. This study was designed to describe IPPC practice throughout the trajectory of oncology care. The Person Centred Nursing Framework (PCNF) of McCormack and McCance (2010) was adapted by integrating interprofessionality, as defined by Couturier (2009), and used to support that description.  A qualitative study of multiple cases was conducted with two interprofessional teams at a teaching hospital in the Montreal region. The sampling (N=31) consisted of 8 patients, 3 family members, 18 professionals and 2 managers. Twenty-eight interviews were conducted, as well as 57.6 hours of observation of clinical activities in which patients were participating (e.g. appointments, treatments). The results suggest that the teams’ IPPC practice reflected a duality of cultures (treatment-centred culture versus patient-centred culture). In addition, the IPPC practice of teams in the study fluctuated due to the influence of many factors, such as “how the team works,” “the physical environment” and the “stance” of patients and professionals. The results further suggested that the deployment of healthcare teams varied in intensity over the trajectory. The point was raised that patients experienced a variable IPPC practice, breakdowns in continuity of care, and difficult transitions between different periods in the trajectory. In addition, the description of the IPPC practice that patients, their family members and professionals would like to see suggests a form of accompaniment that would follow the patient’s own pace, without imposing professionals’ values, with assiduous collaboration from members of the team.  This study suggests that nursing could advance current interprofessional knowledge by taking a patient-centred perspective, a perspective consistent with values in this discipline. In addition, many avenues for further reflection are put forward in terms of practice, research, management and training.

Keyphrases: interprofessional practice, patient-centred care, interprofessional team, oncology, care trajectory, patient's perspective, case study, qualitative study
Évaluation économique du programme Housing First auprès de personnes itinérantes ayant des troubles de santé mentale : analyse après deux ans de suivi à Montréal dans le cadre du projet At Home / Chez Soi

We report on the efficacy of Housing First (HF) intervention to improve housing outcomes for homeless people with mental illness and evaluate its cost-effectiveness from a societal perspective. A RCT (n=469) comparing HF with treatment as usual (TAU) was done in Montreal, Canada. Questionnaires were administered at 6- and 3- month intervals during a 24 month period. HF increased time stably housed from 6.64% to 23.34% for HF high need participants vs. 6.64% to 23.34% for their TAU counterpart. Corresponding percentages for moderate need participants were 12.13% to 79.96% for HF vs. 6.45% to 34.01% for TAU. Total cost for high need participants were 73,301$ per year for HF vs. 64,715$ per year for TAU (ICER=49.85$/day). Total cost for moderate need participants were 47,746 $ for HF vs. 46,437$ for TAU (ICER=3.64$/day). Decreases in service cost associated with Housing First offset an important part of the intervention cost. Implementation of Housing First programs could significantly improve housing stability for homeless people with mental illness at little cost to society, particularly for people with moderate needs.

Keyphrases: housing first, mental health, homelessness, cost-effectiveness, costs, economic evaluation, housing first, housing
Effet de la pratique mixte sur les processus de consolidation lors de l'apprentissage concomitant de deux tâches interférentes

If the benefits of physical practice for motor learning are well established, many studies agree that it is also possible to learn a new skill by observing a model performing the task to learn. In addition, several researchers have shown that the mechanisms underlying the acquisition of a new motor skill by observation and physical practice are similar. However, learning continues beyond the practice sessions by "consolidation processes" that are essentials to long-term retention of the skill. To this end, Trempe, Sabourin, Rohbanfard and Proteau (2011) demonstrated that consolidation processes are not the same depending on whether the practice was done physically or by observation. Therefore, we sought to determine whether practicing a task by physical practice and another task by observation optimizes the concomitant learning of both tasks although they are normally interfering. Our results showed that task A caused anterograde interference on task B regardless of the type of practice, suggesting that the consolidation processes taking place following observation are rather similar to those that take place after physical practice. Thus, it appears that mixed practice does not allow to reduce interference when two interfering tasks are to be learned.

Keyphrases: Observation, Consolidation, Motor learning, Stabilization
La pratique de soins infirmiers en pédopsychiatrie dans un contexte clinique interculturel

The challenges in mental health care in an intercultural clinical context are numerous, notably, because of the differences in perceptions and cultural stigma of mental illness (Hwang, Myers, Abe-Kim, & Ting, 2008; Alegria, Atkins, Farmer, Slaton, & Stelk, 2010). Nursing practices in mental health don’t always seem suited to the specific needs of the adolescents and their families from culturally diverse backgrounds (Alegria, Vallas, & Pumariega, 2010; Dogra & Vostanis, 2007; McKenzie et al., 2009). The practice of nursing in this context is poorly documented to address this issue in depth. The purpose of this multiple case study (Stake, 2005), is to describe the practice of nursing in child and adolescent psychiatry in an intercultural clinical context. The six areas of expertise required for the mental health nurses and psychiatric nurses describe by the Quebec Order of nurses (2009) were used as framework. The results of this qualitative study were obtained from descriptive analysis of individual interviews (n=7) with child and adolescent psychiatric nurses who accompanied at least one teenager and his family in an intercultural clinical context. The data from these interviews were validated in two group interviews, where a prototype case, made from data from the individual interviews, was submitted to discussion. The results of this study indicate perceptions of nursing practice in an intercultural clinical context and preferred nursing practices. Recommendations for practice, education and nursing research were made.

Keyphrases: Nursing practices, Nursing interventions, Child and adolescent psychiatry, Clinical intercultural context
L’exploration des incitatifs et des obstacles à entreprendre des études universitaires dans le cadre d’un cursus intégré DEC-BAC en sciences infirmières

Quebec nurses do not require a bachelor’s degree in order to obtain their license to practice. Choosing the college diploma entitles nurses to obtain a bachelor’s degree in two years instead of three by doing a DEC-BAC in nursing. Although many studies have shown the positive impact of having a greater number of baccalaureate-level nurses in the health care system, (Aiken, Clarke, Cheung, Sloane & Silber, 2003 ; Kane, Shamliyan, Mueller, Duval & Wilt, 2007 ; Tourangeau, Cranley & Jeffs, 2006 ; Aiken et al., 2014) the majority of nursing students choose not to enroll in university studies. The goal of the present study was to explore the incentives and obstacles to engage in university studies in the context of an integrated DEC-BAC curriculum.  Fifty-six new CEGEP graduates completed a self-administered open-ended questions survey on the Internet. The theoretical framework used to guide this exploratory study was the transition middle-range theory of Meleis, Sawyer, Im, Hilfinger Messias and Schumacher (2010). Following this theory, data was collected and grouped into two themes, « incentives » and « obstacles », which were then analysed in order to see if they were determined by personal, community or societal conditions. The major incentives to engaging in university studies in the context of a DEC-BAC curriculum were related to the community conditions and were found to be better anticipated working conditions and the possibility of professional development. The major obstacles found were related to personal conditions and, particularly, to an unfavorable financial or family situation. We also found that Quebec’s context influences the decision to engage in university studies. Recommendations were provided for nursing practice and education, as well as for research.

Keyphrases: obstacles, nursing education, incentives, barriers, undergraduate studies, integrated DEC-BAC education, transition theory, Quebec
Les conceptions et préférences des infirmières quant aux modalités de l'organisation de leur travail

Title: The views and preferences of nurses’ with respect to job design Background: Given the tasks that they perform throughout the different levels of continuum of care, nurses play a pivotal role in healthcare services. The elevated quality of the services offered relies greatly on a motivated nursing staff, working in a highly organised environment that provides a satisfying work experience. However, various studies suggest that modes of job design currently in use are not always effective in creating conditions and environments conducive to enhancing performance, and the quality of life at work (Institute of Medicine, 2001; Hickam & al., 2003; Shojania, Duncan, McDonald, & Wachter, 2001). A better understanding of nurses’ views and preferences is useful to guide the required changes in healthcare environments in order to improve the management of nursing work. Objectives: This descriptive and qualitative research, which aims to explore nurses’ views and concerns with respect to job design, could improve their work experience in the context of a hospital and, more specifically, a medicine unit. Methodology: Semi-structured interviews have been performed with eight nurses. Content analysis techniques were used to analyze the results for the study. The conceptual framework of job design of Filion-Côté used centers around care procedures, staffing, and working environments. Findings: This study shows that the views on job design shared among nurses reflect upon two main concepts: the first relate to the definition of roles and division of tasks, the second refers to the mode of coordination of work and the interaction between team members. This study also shows that nurses’ main preferences are expressed through factors related to the availability of adequate personnel to perform various tasks, support from immediate superiors, support from management for professional development and practice development, and the planning of physical working conditions. It is also important to note that many concerns expressed by nurses echo their views on job design. Conclusion: This study allows a better understanding of nurses’ views and preferences with respect to job design. It also helps to better identify factors which administrators may act upon to develop job design projects, such as staffing in healthcare environments, team support, communication, and the planning of physical working conditions. Furthermore, nurses themselves have a role to play and can have an influence on many of these factors.

Keyphrases: Job design, Work design, Views and concerns, Care process, Staffing, Work environment, Work satisfaction, Professional identity
L’analyse d’indicateurs de la qualité des soins infirmiers aux personnes ayant subi un AVC en Catalogne

Abstract Stroke is a leading cause of death and disability worldwide. Recovery and reduced disability after stroke depend among others factors on early diagnosis and treatment and on highly specialized care services. Clinical practice guidelines (CPG) for stroke care management were published and distributed throughout Catalonia’s health care system in 2005 to promote evidence-based good clinical practice in stroke care. In addition, three audits exploring in-hospital acute stroke care were carried out in 2005, 2007 and 2010 to assess and improve implementation of guideline-based recommendations. Adherence to these recommendations --some of which refer to nursing care-- was measured using a limited number of quality indicators or performance measures. However, analysis of these indicators did not identify factors influencing adherence to nursing recommendations or the impact of adherence on patient health outcome. Thus, the purpose of this study is to analyse indicators of the quality of nursing care for stroke patients in Catalonia. More specifically, it aims to: 1) describe adherence to nursing care recommendations in people who suffered from stroke in 2010 in Catalonia using six specific nursing care quality indicators; 2) analyse the evolution of the adherence to nursing care recommendations in the audits carried out in Catalonia in 2005, 2007 and 2010; 3) identify factors that may have influenced adherence to selected recommendations in 2010; and 4) determine the relationship between adherence to pre-specified recommendations and clinical outcome.  We performed a secondary analysis using data from the 2010 audit on stroke. This audit was conducted in 46 of the 49 public hospitals in Catalonia and included a sample of 2,190 stroke cases representing a stroke population of 10,842. The analyses show high adherence to recommendations related to completion of baseline ECG, baseline determination of blood sugar and early mobilization. Compliance with dysphagia screening improved throughout audit editions but remained sub-optimal. Adherence to mood assessment and patient/carer education were very low. High admission rates in neurology wards and in large hospitals (over 300 stroke admissions/year) are factors influencing high adherence to dysphagia screening in the analyses adjusted by patient characteristics and stroke severity. Moreover, high compliance with dysphagia screening was observed in patients at high risk of pneumonia. In addition, length of hospital stay was longer in patients who received mood assessments and shorter in patients mobilized early and in those without dysphagia. Although, adherence to certain recommendations remains very low, these results indicate progressive improvement in nursing recommendations adherence and consequently in quality of stroke care, and serve to highlight the usefulness of audits to monitor and improve stroke care quality.

Keyphrases: stroke indicators, quality of nursing care, pneumonia, length of stay
Le statut de Rome de la cour pénale internationale et le droit interne d’un pays en situation de conflit armé : le cas de la Colombie

The incorporation of the Rome Statute of the International Criminal Court into the domestic legal system of a State Party constitutes an enormous commitment to justice and the protection and guarantee of fundamental human rights. This situation is especially interesting in Colombia, where the violation of human rights has been historically well-known during the internal armed conflict in which the country has gone through for several years now.   Since its ratification of the Rome Statute, Colombia has a duty to search for truth and justice, as well as providing for integral repair and guarantees of non-repetition for the victims of the armed conflict. The treaty does not allow the creation of rules that allow for impunity and prevent knowledge of the truth which can explain that the conflict has persisted for so many years.  The implementation of the Rome Statute by Colombia adjustment has produced different legal effects into its legal system. Some of these effects can be observed in certain laws adopted by the Congress of the Republic and in the Constitutional’s Court and the Supreme Court of Justice’s judgements. These laws and judgments have relied on the international obligations of the country contained in human rights treaties and the Statute of Rome. This master thesis exposes, among other things, how the provisions of laws relating to amnesties and the Law Justice and peace make the Rome Statute inefficient in Colombia.

Keyphrases: International law, Rome Statute of the International Criminal Court, Colombia, Domestic law, Armed conflict, Victims, Impunity, International crimes