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This article reviews Grammaire comparee des francais d’Acadie et de Louisiane avec un apercu sur Terre-Neuve

This paper discusses the pronominal system of Louisiana French, a variety of French spoken mainly in the south-western part of Louisiana State. The analysis of data (Girard Lomheim, 2016) shows that although Louisiana French clitics share certain features with clitics from other informal varieties of French and dialects of French, they cannot be analysed along quite the same lines. They have reached a more advanced stage of grammaticalization. They are moving away from the status of syntactic argument towards the status of agreement marker. The fact that they are subject to strong phonetic erosion and have been gradually replaced by weak pronouns shows that they are coming closer to the ultimate stadium of their grammaticalization cycle (van Gelderen, 2011), the null stadium. The progressive reduction of the clitic paradigm is accompanied by the emergence of a new class of weak pronouns, which leads us to claim that the pronominal system of this vernacular is organized in three classes of pronouns: strong pronouns and two classes of deficient pronouns: weak pronouns and clitics in the terms of Cardinaletti et Starke (1994 and 1999). We claim that the difference between strong and weak pronouns should be addressed in terms of syntax and morphology whereas the difference between weak pronouns and clitics should be accounted for in terms of morphosyntax and phonology.

Comme a bien des endroits dans le monde, le Quebec n’echappe pas aux reformes de son systeme de la sante, lesquelles peuvent malheureusement entrainer des obstacles a la qualite des soins, de meme qu’une certaine deshumanisation, et ce, tant au regard des soins a la clientele, qu’au niveau organisationnel, pour les professionnels de la sante. C’est ainsi que le « Modele humaniste des soins infirmiers - UdeM » (MHSI-UdeM) souhaite offrir une perspective novatrice visant l’amelioration de la qualite et de la securite des soins, de la satisfaction et du bien-etre de la clientele ainsi que celui des infirmieres. Tout en respectant leurs influences theoriques, les auteurs presentent leur vision des concepts centraux de la discipline de meme que des concepts cles du Modele, cherchant ainsi a les rendre plus comprehensibles, accessibles et applicables dans la pratique quotidienne des infirmieres. Cet article vise a faire connaitre le Modele a la communaute infirmiere, a promouvoir son implantation dans toutes les spheres d’activites de la profession infirmiere en plus d’en montrer son applicabilite et ses retombees en recherche infirmiere. Il apparait que ce modele s’avere prometteur dans l’actualisation et le developpement d’interventions de soins humanistes aupres de la clientele.

As in many other countries, Québec is not immune to healthcare reforms, which can unfortunately hinder quality of care as well as induce some dehumanization, both for the patients and the healthcare professionals. Thus, the « Humanistic Model of Nursing Care - UdeM » (HMNC-UdeM) aspires to offer an innovative perspective that aims at improving the quality and the safety of care, in addition to satisfaction and well-being for both patients and nurses. While respecting their theoretical influences, the authors present their vision of the central concepts of the discipline and the Model’s key concepts, seeking to make them more understandable, accessible, and applicable in nurses’ daily practice. Therefore, the aim of this article is to raise awareness of the Model into the nursing community, to promote its implantation in nursing’s spheres of activities, in addition to demonstrate its applicability and impact in nursing research. It appears that this model is promising for the renewal and the development of humanistic interventions for patients’ care.

La formation continue des infirmieres nouvellement diplomees (IND) depend de plusieurs facteurs relies aux caracteristiques des competences a developper, de la population cible et du contexte organisationnel. Peu d’etudes decrivent a la fois comment les infirmieres developpent leurs competences et comment les etablissements favorisent ce developpement. Les objectifs de cet article sont de decrire les comportements que les IND utilisent pour developper leurs competences de raisonnement et de leadership ; et de documenter les elements organisationnels qui facilitent ce developpement. Methode. Des entrevues individuelles ont ete effectuees aupres d’infirmieres (n=34) a l’aide d’une grille d’entrevue semi-structuree et deux entrevues de groupes ont ete realisees aupres d’infirmieres (n=7) et de gestionnaires (n=19) dans deux hopitaux universitaires de l’Est du Canada. Les resultats montrent que les infirmieres se developpent essentiellement en reflechissant sur leur pratique professionnelle dans leur milieu de travail. Or, l’absence de temps de reflexion dans l’espace de travail est un obstacle considerable alors que le leadership des gestionnaires est un atout important.

Depuis les travaux de Perlmutter (1971), Kayne (1975) et Zwicky (1977), les pronoms clitiques des langues romanes en général et du français en particulier ont fait l’objet d’une recherche intense. Ces travaux, en ce qui concerne le français, se sont d’abord concentrés sur le français standard ou de référence (FR) avant de se tourner dans les années 1990 vers des variétés de français parlés informels (FPI) tels que celui de l’Hexagone (Zribi-Hertz, 1994), du Québec (Roberge,1990 et Auger,1995) ou encore du français pied-noir (Roberge, 1990), l’accent étant mis le plus souvent sur les pronoms sujets. Deux approches principales se dégagent de ces recherches sur le français, l’une traitant les pronoms clitiques comme des arguments et l’autre, commes des affixes flexionnels du verbe. Nous présenterons ici les pronoms clitiques sujets et objets du français cadien, une variété de français parlée dans le sud-ouest de la Louisiane, sur un territoire dénommé Acadiana, un triangle ayant pour base la côte du Golfe du Mexique et pour sommet, la paroisse d’Avoyelles. Les pronoms clitiques de cette variété de français essentiellement orale, dérivée de dialectes du Grand- Ouest, Poitou principalement (Bodin, 1987), arborent un certain nombre de particularismes qui en font un terrain d’étude intéressant de la variation dans ce domaine en français. Nous verrons que l’examen des données cadiennes révèle que les deux approches principales mentionnées ci-dessus pour le français s’avèrent inadéquates pour rendre compte des pronoms clitiques de cette variété dont le comportement se distingue à la fois de ceux du FR et des FPI même s’il partage plus de traits communs avec ces derniers. Nous montrerons pour conclure que, si les pronoms clitiques cadiens semblent bien impliqués dans un processus de grammaticalisation en direction du statut d’affixes marqueurs d’accord, ils présentent plusieurs traits dont une telle analyse ne saurait rendre compte. Références bibliographiques Auger, J. (1995). ‘Les clitiques pronominaux en français parlé informel : une approche morphologique’, Revue québécoise de linguistique, vol. 24,1 : 21-60. Bodin, C. (1987). The Dialectal Origins of Louisiana Acadian French, UMI (University Microfilms) Dissertation Services. Kayne, R. (1975). French Syntax : the Transformational Cycle, Cambridge (Mass) : MIT Press. Perlmutter, D. (1971). Deep and Surface Structure Constraints in Syntax, New York : Holt, Rinehart and Winston. Zriby-Hertz, A. (1994). ‘La syntaxe des clitiques nominatifs en français standard et avancé’, Travaux de linguistique et de philologie 32 :131-147. Zwicky, A. (1977). On Clitics, Bloomington : Indiana University Linguistics Club.

Introduction The overall aim of this project is to help develop knowledge about primary care delivery models likely to improve the accessibility, quality and efficiency of care. Operationally, this objective will be achieved through supporting and evaluating 8 primary care team pilot sites that rely on an expanded nursing role within a more intensive team-based, interdisciplinary setting. Methods and analysis The first research component is aimed at supporting the development and implementation of the pilot projects, and is divided into 2 parts. The first part is a logical analysis based on interpreting available scientific data to understand the causal processes by which the objectives of the intervention being studied may be achieved. The second part is a developmental evaluation to support teams in the field in a participatory manner and thereby learn from experience. Operationally, the developmental evaluation phase mainly involves semistructured interviews. The second component of the project design focuses on evaluating pilot project results and assessing their costs. This component is in turn made up of 2 parts. Part 1 is a pre-and-post survey of patients receiving the intervention care to analyse their care experience. In part 2, each patient enrolled in part 1 (around 4000 patients) will be matched with 2 patients followed within a traditional primary care model, so that a comparative analysis of the accessibility, quality and efficiency of the intervention can be performed. The cohorts formed in this way will be followed longitudinally for 4 years. Ethics and dissemination The project, as well as all consent forms and research tools, have been accepted by 2 health sciences research ethics committees. The procedures used will conform to best practices regarding the anonymity of patients.

Cognitive modeling of competencies is important to facilitate learning and evaluation. Clinical nursing leadership is considered a competency, as it is a "complex know-act" that students and nurses develop for the quality of care of patients and their families. Previous research on clinical leadership describes the attributes and characteristics of leaders and leadership, but, to our knowledge, a cognitive learning model (CLM) has yet to be developed. The purpose of our research was to develop a CLM of the clinical nursing leadership competency, from the beginning of a nursing program to expertise. An interpretative phenomenological study design was used 1) to document the experience of learning and practicing clinical leadership, and 2) to identify critical-learning turning points. Data was gathered from interviews with 32 baccalaureate students and 21 nurses from two clinical settings. An inductive analysis of data was conducted to determine the learning stages experienced: awareness of clinical leadership in nursing; integration of clinical leadership in actions; active leadership with patient/family; active leadership with the team; and, embedded clinical leadership extended to organizational level and beyond. The resulting CLM could have significant impact on both basic and continuing nursing education.

With nursing shortages reaching crisis proportions, staff nurses need to believe that nurse managers are supportive. However, evidence exists that staff nurses view nurse managers as moving away from basic nursing values. Using an exploratory philosophical approach, the authors examine this issue as a function of differing ethical frameworks used by nurses and nurse managers. The main question is whether nurse managers are expected to subscribe to a corporate ethic versus a nursing ethic in making decisions, and whether these approaches are fundamentally different. The authors' supposition was that exposing differences might account for some dissatisfaction that nurses express with regard to nursing leadership. They conclude that there are differences of emphasis in ethical principles that may cause tension. Incongruencies between corporate and individual values emerge under fiscal constraints and with differing perceptions, expectations and decision-making criteria. This paper offers suggestions to help staff nurses and nurse managers reduce tensions experienced when difficult choices, particularly those of resource allocation, are required.

Continuing education of newly graduated nurses (NGN) depends on several factors related to the characteristics of skills to be developed, the target population and the organizational context. Few studies describe both how nurses develop their skills and how institutions promote this development. The objectives of this manuscript are to (1) describe the behaviors that the NGN use to develop their reasoning skills and leadership and (2) document the organizational elements that facilitate this development. Method. Individual interviews were conducted with nurses (n = 34) using a grid of semistructured interviews and two group interviews were conducted with nurses (n = 7) and managers (n = 19) in two teaching hospitals in eastern Canada. The results show that nurses develop mainly by reflecting on their professional practice in their workplace. However, the lack of time for reflection in the workspace is a considerable obstacle while managerial leadership is an important asset.

Resume Nous abordons dans ce travail la place du mot dans la phonologie du francais. Nous montrons qu'un ensemble de phenomenes phonologiques conspirent a donner au mot une importance toute particuliere et nous etudions un nouveau type d'accentuation de plus en plus repandu chez les locuteurs francais qui prennent regulierement la parole en public. Apres avoir donne les caracteristiques de cet accent, que nous appelons accent initial, nous envisageons comment il influe sur certains domaines de la phonologie du francais, comme par exemple la liaison et la chute de schwa, modifiant aussi les regles de syllabation et la structure prosodique. Nous montrons enfin que la fonction principale de l'accent initial est de donner au mot une autonomie encore plus marquee.

Ensuring that nurses can practise according to the philosophical underpinnings of their profession is recognized as an important factor in job satisfaction and is therefore a key element of retention and recruitment of the nursing workforce. Creating a culture of excellence requires making explicit a set of values and performance expectations to which all nurses can subscribe and that influences practice behaviours. The vice president and chief nursing officer of a large health region in Western Canada therefore sought to establish a foundation for building such a culture of excellence, through the creation of a mission, vision and Professional Practice Framework for the region’s nurses. The author describes the development of the nursing Professional Practice Framework for this health region, presents the results of a participatory approach to promoting nurses’ ownership of the model and discusses plans for assessing the impact of the framework on nurses’ practice and patient care. Professional Practice in Nursing: A Framework Francine Girard, RN, BN, MN, PhD Senior Vice President, Professional Practice and Research Chief Nursing Officer Calgary Health Region Calgary, AB Noreen Linton, RN, BN, MN Director, Chief Nursing Portfolio Calgary Health Region Calgary, AB Jeanne Besner, RN, PhD Director, Research Initiatives in Nursing and Health Calgary Health Region Calgary, AB Nursing Leadership On-line Exclusive • June 2005 2 The past decade in healthcare has been characterized by hospital restructuring, with mergers of previously independent organizations and their associated cultures into larger, regionalized entities. Concurrently, cutbacks due to fiscal constraints during the 1990s contributed to heavy workloads, long hours and reported difficulty by nurses in carrying out their professional roles (Baumann et al. 2001). Recognizing the importance of practice environments that conform to the philosophy of care held by the nursing profession (Baumann et al. 2001), many organizations have developed professional practice models to guide nursing care delivery, with the goal of empowering the nursing workforce and improving the quality of patient care (London Health Sciences Centre 2004; Ottawa Hospital 2004; University Health Network 2004). The newly appointed vice president and chief nursing officer (CNO) of the Calgary Health Region (“the Region”) requested that the Regional Nursing Council begin work on developing a Professional Practice Framework for nursing. A task force was struck, with a mandate to complete a first draft of the framework by Nursing Week (May 2003). This paper describes the process used to solicit input into the development of the framework and presents results of the participatory approach to obtaining ownership of the model by nurses. It concludes with a brief commentary on plans for assessing the impact of the framework on nurses’ practice and on patient care. Literature Support Ensuring that nurses can practise according to the philosophical underpinnings of their profession is recognized as an important factor in job satisfaction and hence is critical to retention and recruitment of the nursing workforce (Baumann et al. 2001). Employers share responsibility with nurses, professional associations and others for promoting environments that support quality professional practice (Canadian Nurses Association 2001). Achieving high-quality healthcare requires that we make explicit the expectations related to professional nursing practice (Ferguson-Pare et al. 2002). Nurses’ effectiveness in achieving the outcomes for which they are accountable is inextricably tied to the extent to which they can exercise control over the delivery of care for which they are responsible (Hoffart and Woods 1996). Professional practice models generally address nurses’ need for autonomy and accountability and are considered important to organizational empowerment of nurses and to the creation of effective work teams (Spence Laschinger and Havens 1996). A set of values and performance expectations to which all nurses can subscribe and that influences practice behaviours is essential to creating a culture of excellence (Kramer 1990). Achieving excellence in nursing practice was the aim in development of the Calgary Health Region Professional Practice Framework. Development of the Framework One of the first priorities of the vice president and CNO of the Calgary Health Region was to develop a vision for nursing in the Region. Through the development of this vision, it became apparent that a mission for nursing was also essential. As this work progressed, an evident need emerged to establish a definition of professional practice and a guideline or framework that nurses could utilize on a daily basis to achieve the vision and mission of nursing in the Region. This foundational work is described in Figure 1. The mission and vision formed the foundation on which development of the Professional Practice Framework was based. An important first step was to articulate clearly, in concise terms, the meaning of “professional nursing practice.” Consultation with nurses in the Region provided the substance from which the following definition was crafted: Professional nursing practice is a commitment to compassion, caring and strong ethical values; continuous development of self and others; accountability and responsibility for insightful practice; demonstrating a spirit of collaboration and flexibility. One of the main concerns of the task force mandated with the development of the Professional Practice Framework was that all nurses be given the opportunity for involvement in its development. Hence, a participatory approach was used to solicit nurses’ input. A number of focus groups were held, which were offered at different times of the day on various days of the week and at various sites across the Region. Subsequent to analysis of the focus group data, questionnaires to validate the focus group findings were distributed in hard copy at all regional sites and simultaneously placed on the internal website to increase access for nurses in the Region and to invite them to complete the survey. Purpose and Objectives The purpose of the focus groups was to obtain nurses’ views about the defining elements of professional nursing practice within the Region. Three questions were asked of participants in the focus groups, only the first of which is addressed in this paper: Professional Practice in Nursing: A Framework 3 Figure 1. Vision and mission for nursing, Calgary Health Region Our vision for nursing: Excellent healthcare through professional nursing practice. Nursing mission: We are committed to professional nursing practice that promotes quality, family-centred care and efficient and effective delivery of integrated services provided in collaboration with community partners and members of the multidisciplinary healthcare team.

Background: Despite the critical role of nursing care in determining high-performing healthcare delivery, performance science in this area is still at an early stage of development and nursing’s contribution most often remains invisible to policy-makers and managers. The objectives of this study were: 1) to develop a theoretically based framework to conceptualize nursing care performance; 2) to analyze how the different components of the framework have been operationalized in the literature; and 3) to develop a pool of indicators sensitive to various aspects of nursing care that can be used as a basis for designing a performance measurement system. Methods: We carried out a systematic review of published literature across three databases (MEDLINE, EMBASE and CINAHL), focusing on literature between 1990 and 2008. Screening of 2,103 papers resulted in final selection of 101 papers. A detailed template was used to extract the data. For the analysis, we used the method of interpretive synthesis, focusing first on 31 papers with theoretical or conceptual frameworks; the remaining 70 articles were used to strengthen and consolidate the findings. Results: Current conceptualizations of nursing care performance mostly reflect a system perspective that builds on system theory, Donabedian’s earlier works on healthcare organization, and Parsons’ theory of social action. Drawing on these foundational works and the evidence collated, the Nursing Care Performance Framework (NCPF) we developed conceptualizes nursing care performance as resulting from three nursing subsystems that operate together to achieve three key functions: (1) acquiring, deploying and maintaining nursing resources, (2) transforming nursing resources into nursing services, and (3) producing changes in patients’ conditions. Based on the literature review, these three functions are operationalized through 14 dimensions that cover 51 variables. The NCPF not only specifies core aspects of nursing performance, it also provides decision-makers with a conceptual tool to serve as a common ground from which to define performance, devise a common and balanced set of performance indicators for a given sector of nursing care, and derive benchmarks for this sector. Conclusions: The NCPF provides a comprehensive, integrated and theoretically based model that allows performance evaluation of both the overall nursing system and its subsystems. Such an approach widens the view of nursing performance to embrace a multidimensional perspective that encompasses the diverse aspects of nursing care.